Yuji Miyoshi

Alcohol consumption and the risk of diabetes by body mass index levels in a cohort of 5,636 Japanese

The association between alcohol consumption and the risk of diabetes in Japanese with a low-body mass index (BMI) (< or = 22.0 kg/m(2)), middle-BMI (22.1-24.9 kg/m(2)) and high-BMI (> or =25.0 kg/m(2)) was investigated among a cohort of 5,636 employees of a Japanese insurance company. Participants were free of diabetes at baseline and were followed up for a mean of 5.7 years with annual assessments of fasting plasma glucose (FPG). The outcome was a clinical diagnosis of diabetes on the basis of a questionnaire administered at each follow-up assessment or a follow-up FPG level of 7.8 mmol/l or more. Relative risks and 95% confidence intervals (95% CIs) were estimated by fitting pooled logistic regression models, which included age, gender, BMI, baseline FPG level, current tobacco use and current alcohol consumption. A total of 264 outcome events were recorded. The relative risk of diabetes associated with current alcohol consumption was 3.19 (95% CI 1.09-9.37) among low-BMI individuals, 0.41 (0.23-0.73) among middle-BMI individuals and 0.74 (0.44-1.25) among high-BMI individuals. In this study, current alcohol consumption was associated with an increased risk of diabetes among low-BMI individuals and a decreased risk of diabetes among middle-BMI individuals. A tendency for an association of alcohol consumption with a decreased risk of diabetes among high-BMI individuals was noted, although without statistical significance.

Degree of agreement between weight perception and body mass index of Japanese workers: MY Health Up Study.

Degree of Agreement between Weight Perception and Body Mass Index of Japanese Workers: MY Health Up Study: Mariko Inoue, et al. Department of Public Health, Graduate School of Medicine, University of Tokyo—The objective of this study was to assess the degree of agreement between body mass index (BMI) and weight perception of Japanese office workers between the ages of 20 and 65. We sent 43,064 self‐administered health‐related questionnaires to all employees of a financial firm in Japan in October 2004. The questionnaire asked the respondents for their height, weight, and their weight perception. The kappa coefficient was calculated to investigate the degree of agreement between the BMI calculated using the self‐reported data and weight perception for three categories. Of the questionnaires, 34,921 (81.1%) were returned and 33,514 responses (77.8%) were used for the analysis. Based on Japanese obesity criteria, 2,202 men (31.2%) and 5,145 women (19.5%) were obese; and 179 men (2.5%) and 2,769 women (10.5%) were underweight. The kappa coefficient was 0.374 for men and 0.297 for women. The kappa coefficients for different age groups—twenties, thirties, forties, fifties, and sixties (up to 65)—were respectively as follows: 0.315, 0.355, 0.374, 0.406, and 0.425 for men; and 0.194, 0.275, 0.285, 0.334, and 0.355 for women. In conclusion, the degree of agreement between BMI and weight perception differed by age and sex. The degree of agreement was smaller among women than among men and the degree of agreement among younger women was weaker than among older women.

Marital status and cardiovascular risk factors among middle-aged Japanese male workers: The High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study

Marital Status and Cardiovascular Risk Factors among Middle‐aged Japanese Male Workers: The High‐risk and Population Strategy for Occupational Health Promotion (HIPOP‐OHP) Study: Yuko Kamon, et al. Department of Health Science, Shiga University of Medical Science—Marital status is related to cardiovascular disease (CVD) risk factors in Western countries. However, few studies have addressed the relationship between marital status and CVD risk factors in other populations. We investigated lifestyle and CVD risk factors relative to marital status among middle‐aged Japanese men. We analyzed baseline data of 40–59‐yr‐old male workers who participated in the high‐risk and population strategy for occupational health promotion (HIPOPOHP) study. We compared lifestyle and CVD risk factors between men who were married (Group M; n=1,419, mean age 47.9 ± 5.1 yr) and those who had never married (Group N; n=163, mean age 46.7 ± 4.3 yr). Men in Group N were more likely to skip breakfast, work more shifts and exercise less. Current smoking rates, as well as average values of diastolic blood pressure (DBP), serum total cholesterol and fasting plasma glucose were also higher in Group N than in Group M. The proportion of participants with three or more CVD risk factors, namely smoking, hypertension, hypercholesterolemia and hyperglycemia was higher in Group N, than in Group M (12.9% vs. 5.0%, p<0.01). The difference between Groups M and N was more evident in the subgroup of living with others, than in the subgroup of living alone. Since men who have never married might be at higher risk for CVD, effort should be made to educate this population about decreasing lifestyle‐related risk factors.

Awareness and treatment of hypertension and hypercholesterolemia in Japanese workers: The High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study

The objective of this study was to clarify the awareness and treatment status of hypertension in Japanese workers, comparing with those of hypercholesterolemia. The subjects were 6,186 workers (age 19 to 69 years), who worked at 12 workplaces in Japan and who continuously participated in the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study at the baseline (1999 or 2000) and the subsequent year (2000 or 2001). No intervention was performed during the study period. Blood pressure and total cholesterol level were measured at baseline. Awareness and treatment status were examined by a self-administered questionnaire in the following year. Untreated subjects were defined as those were not aware of hypertension (or hypercholesterolemia) or those not taking medication and not undergoing lifestyle modification. The percentages of subjects with hypertension defined as aware were 65.7% in men and 72.7% in women, respectively. The percentages of subjects with hypercholesterolemia defined as aware were 55.7% in men and 58.6% in women, respectively. In subjects 40 years and older, the awareness rate for hypertension was significantly higher than the awareness rate for hypercholesterolemia (75.0% vs. 59.2%, p<0.001). The percentage of untreated subjects with hypertension was significantly lower than the percentage of untreated subjects with hypercholesterolemia (41.0% vs. 57.1%, p<0.001). Although Japanese workers ≥40 years old have a higher awareness of and are more often treated for hypertension than for hypercholesterolemia, there are still many unaware and untreated individuals with either disease in all age groups. It is important to increase the awareness of risk factors in individuals with positive findings for these conditions.

Self-Reported Periodontitis and Incident Type 2 Diabetes among Male Workers from a 5-Year Follow-Up to MY Health Up Study.

Aims The purpose of this study was to examine whether periodontitis is associated with incident type 2 diabetes in a Japanese male worker cohort. Methods The study participants were Japanese men, aged 36–55 years, without diabetes. Data were extracted from the MY Health Up study, consisting of self-administered questionnaire surveys at baseline and following annual health examinations for an insurance company in Japan. The oral health status of the participants was classified by two self-reported indicators: (1) gingival hemorrhage and (2) tooth loosening. Type 2 diabetes incidence was determined by self-reporting or blood test data. Modified Poisson regression approach was used to estimate the relative risks and the 95% confidence intervals of incident diabetes with periodontitis. Covariates included age, body mass index, family history of diabetes, hypertension, current smoking habits, alcohol use, dyslipidemia, and exercise habits. Results Of the 2895 candidates identified at baseline in 2004, 2469 men were eligible for follow-up analysis, 133 of whom were diagnosed with diabetes during the 5-year follow-up period. Tooth loosening was associated with incident diabetes [adjusted relative risk = 1.73, 95% confidence interval = 1.14–2.64] after adjusting for other confounding factors. Gingival hemorrhage displayed a similar trend but was not significantly associated with incident diabetes [adjusted relative risk = 1.32, 95% confidence interval = 0.95–1.85]. Conclusions Tooth loosening is an independent predictor of incident type 2 diabetes in Japanese men.

Elevated liver enzymes in women with a family history of diabetes

Both elevated liver enzymes and a family history of diabetes mellitus (FHDM) are independent risk factors for type 2 diabetes. This study evaluates the epidemiological association between elevated liver enzymes and FHDM. Subjects included 3512 women workers without diabetes, hepatitis, a smoking habit, or a history of alcohol intake. Blood samples and personal data were collected from all subjects. Subjects with FHDM had a higher mean body mass index (BMI: 23.9kg/m(2) vs. 23.4kg/m(2); p=0.003). Laboratory testing also revealed higher mean fasting plasma glucose (FPG: 5.67mmol/L vs. 5.22mmol/L; p<0.001), asparate aminotransferase (AST: 20.0IU/L vs. 19.2IU/L; p=0.049), alanine aminotransferase (ALT: 18.4IU/L vs. 16.7IU/L; p=0.004), gamma-glutamyltranspeptidase (GGT: 24.1IU/L vs. 20.5IU/L; p<0.001), and triglycerides (TG: 1.09mmol/L vs. 1.00mmol/L; p=0.011) for FHDM subjects, when adjusted for age and BMI. Multiple linear regression analysis revealed that FHDM, age, BMI, FPG, and TG were correlated with GGT (p=0.004 for FHDM; p<0.001 for age, BMI, FPG, and TG). Elevated liver enzymes were associated with FHDM. In particular, elevated GGT was related to FHDM, independent of the other variables. Elevated liver enzymes, probably due to fat deposition in the liver, may play a role in increasing the risk of diabetes in individuals with FHDM.

Association between Periodontal Disease and Peptic Ulcers among Japanese Workers: MY Health Up Study

Objective: This study aimed to investigate the association between periodontal disease and peptic ulcers in a working population. Methods: Self-administered questionnaires were distributed to all employees of a large insurance company in Japan. The questionnaire asked about their health status and lifestyle habits. Peptic ulcer was defined as either stomach ulcer, duodenal ulcer, or both. For the evaluation of periodontal disease, three indices were used: (a) loss of five or more teeth, (b) having been told of having periodontitis, and (c) periodontal risk score. Results: Of the eligible 28 765 subjects analyzed, peptic ulcer was present in 397 (1.4%). The results of bivariate analyses showed that a significantly higher proportion of subjects with peptic ulcer reported that they lost five or more teeth (35.3 vs. 17.4%, p<0.001) or that they were told they had periodontitis (33.5 vs. 20.7%, p<0.001). Moreover, the periodontal risk score was higher for those with peptic ulcer than those without (mean 0.83 vs. 0.59, p<0.001). In multivariate logistic regression analyses, statistical associations were found between the presence of peptic ulcer and loss of five or more teeth (odds ratio (OR): 1.41, 95% confidence interval (CI): 1.13–1.76, p<0.01), having been told of having periodontitis (OR: 1.28, 95% CI: 1.03–1.59, p<0.05), and a 1-point increase in the periodontal risk score (OR: 1.17, 95% CI: 1.04–1.30, p<0.01), respectively. Conclusion: Modest but statistically significant associations were found between the self-reported measures of periodontal disease and peptic ulcers.

Relationship between Hematological Parameters and Incidence of Ischemic Heart Diseases among Japanese White-Collar Male Workers

Relationship between Hematological Parameters and Incidence of Ischemic Heart Diseases among Japanese White‐Collar Male Workers: Toshio Kobayashi, et al. Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine—The determination whether high hematocrit (Hct) and hemoglobin (Hb) are risk factors for ischemic heart diseases (IHD) remains controversial in Japan. To examine whether hematological parameters are independent risk factors for IHD, we conducted a case control study among 3,924 Japanese male white‐collar workers aged 35‐60 yr. IHD cases were defined as men with a first episode of acute myocardial infarction or angina pectoris during the investigation period (from April 1995 to April 2000). Five controls without a history of IHD were assigned for each case, matching for age and smoking status. Twenty‐two IHD cases were developed during the study period and 110 controls were assigned. Hematological parameters, obtained from periodic health examinations undergone before the onset of the disease, were analyzed with the conditional logistic regression model. Multivariate adjusted odds ratios (OR) with 95% confidence interval (95%CI) were estimated, controlling for Body Mass Index, total cholesterol, alcohol use, hypertension and fasting blood sugar. Crude OR (95%CI) for Hct, Hb, red blood cell count (RBC) and Mean corpuscular volume (MCV) were 1.21 (1.03‐1.42), 2.04 (1.17‐3.56), 1.09 (0.96‐1.24) and 1.09 (0.98‐1.22), respectively. The multivariate adjusted OR (95%CI) for Hct, Hb, RBC and MCV were 1.28 (1.06‐1.54), 2.75 (1.39‐5.46), 1.08 (0.92‐1.28) and 1.09 (0.97‐1.24), respectively. These results suggest that Hct and Hb are independent risk factors for ischemic heart diseases among Japanese middle‐aged male white‐collar workers.