General Japanese Population Research Articles

Impact of resting heart rate on cardiovascular mortality according to serum albumin levels in a 24-year follow-up study on a general Japanese population: NIPPON DATA80.

BackgroundElevated resting heart rate (RHR) is associated with an increased risk for cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum ALB levels in a Japanese general population.MethodsIn total, 8363 individuals without a history of CVD were followed-up for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1-Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated.ResultsWe found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR: 1.27 [95% confidence interval, CI: 1.02-1.57]) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR: 0.61 [95% CI: 0.47-0.79]) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (p<0.001).ConclusionsThe impact of RHR on CVD mortality differed according to ALB levels in a general Japanese population.

Practical Cutoff Values of Brachial-Ankle Pulse Wave Velocity to Predict 10-Year CHD Risk in the Japanese General Population.

Practical Cutoff Values of Brachial-Ankle Pulse Wave Velocity to Predict 10-Year CHD Risk in the Japanese General Population.

Cutoff Values of Brachial-Ankle Pulse Wave Velocity for Atherosclerotic Risks by Age and Sex in the Japanese General Population.

In this study, we aim to analyze the correlation between brachial-ankle pulse wave velocity (baPWV) and Suita score or Framingham risk score and obtain the cutoff value of baPWV by sex and age for cardiovascular risk, as assessed by these scores in the large Japanese annual health checkup data. In total, 25,602 participants (14,539 men and 11,063 women), who had their annual health checkups, were included in this study. Cutoff values of baPWV for the moderate- and high-risk groups stratified by sex and age were obtained using a receiver operating characteristic (ROC) curve analysis. As per our findings, the Suita score demonstrated better correlations with baPWV than the Framingham risk score in both sexes (men, Suita score R2=0.41 and Framingham risk score R2=0.37; women, Suita score R2=0.54 and Framingham risk score R2=0.33). The ROC curve analysis demonstrated the cutoff values of baPWV for moderate- and high-risk groups estimated using the Suita score, and they are as follows: in men, the baPWV cutoff values were 1,350 cm/s in the 40s, 1,430 cm/s in the 50s, 1,520 cm/s in the 60s, and 1,880 cm/s in the 70s. In women, the baPWV cutoff values were 1,350 cm/s in the 40s, 1,430 cm/s in the 50s, 1,570 cm/s in the 60s, and 1,800 cm/s in the 70s. We demonstrated that baPWV significantly correlated with the Suita score or Framingham risk score in both men and women, with the former presenting a stronger correlation than the latter. We propose the cutoff values of baPWV for moderate- and high-risk groups estimated using the Suita score.

Prediction models for neutralization activity against emerging SARS-CoV-2 variants: A cross-sectional study.

Despite extensive vaccination campaigns to combat the coronavirus disease (COVID-19) pandemic, variants of concern, particularly the Omicron variant (B.1.1.529 or BA.1), may escape the antibodies elicited by vaccination against SARS-CoV-2. Therefore, this study aimed to evaluate 50% neutralizing activity (NT50) against SARS-CoV-2 D614G, Delta, Omicron BA.1, and Omicron BA.2 and to develop prediction models to predict the risk of infection in a general population in Japan. We used a random 10% of samples from 1,277 participants in a population-based cross-sectional survey conducted in January and February 2022 in Yokohama City, the most populous municipality in Japan. We measured NT50 against D614G as a reference and three variants (Delta, Omicron BA.1, and BA.2) and immunoglobulin G against SARS-CoV-2 spike protein (SP-IgG). Among 123 participants aged 20-74, 93% had received two doses of SARS-CoV-2 vaccine. The geometric means (95% confidence intervals) of NT50 were 65.5 (51.8-82.8) for D614G, 34.3 (27.1-43.4) for Delta, 14.9 (12.2-18.0) for Omicron BA.1, and 12.9 (11.3-14.7) for Omicron BA.2. The prediction model with SP-IgG titers for Omicron BA.1 performed better than the model for Omicron BA.2 (bias-corrected R 2 with bootstrapping: 0.721 vs. 0.588). The models also performed better for BA.1 than for BA.2 (R 2 = 0.850 vs. 0.150) in a validation study with 20 independent samples. In a general Japanese population with 93% of the population vaccinated with two doses of SARS-CoV-2 vaccine, neutralizing activity against Omicron BA.1 and BA.2 were substantially lower than those against D614G or the Delta variant. The prediction models for Omicron BA.1 and BA.2 showed moderate predictive ability and the model for BA.1 performed well in validation data.

Age and sex differences in the risk of cardiovascular diseases by chronic kidney disease in a general Japanese population.

The risk of cardiovascular diseases (CVD) by chronic kidney disease (CKD) stratified by age and sex has not been examined in detail in rural Japanese populations. Therefore, we herein investigated the long-term risk of CVD by CKD and performed an age- and sex-stratified risk analysis. We examined 5163 subjects who underwent health screening between 1992 and 1995 with calculated eGFR and follow-up information on CVD events. The mean follow-up period was 10years. We analyzed the incidences of CVD events, including stroke and myocardial infarction (MI). We compared the risk of CVD between subjects with and without CKD using a Cox proportional hazards model adjusted for well-known CVD confounding factors.The total number of CVD events was 175. The hazard ratios (HRs) for all events, stroke, MI, and sudden death by CKD relative to non-CKD were 1.18 (95% C.I.:0.83-1.68), 0.96 (0.63-1.46), 3.02 (1.2-7.62), and 1.29 (0.43-3.87), respectively. HRs for MI were 7.24 in subjects < 65years and 1.65 in those ≥ 65years. HRs for MI by sex were 3.55 in men and 2.09 in women. A younger age and men sex were identified as independent risk factors for the risk of MI in the presence of CKD. These results suggest that among CKD patients, the management of a younger age group and men will effectively prevent MI.

Birth cohort effects in incident renal replacement therapy in Japan, 1982-2021.

This study aimed to investigate the long-term trends of incident end-stage kidney disease (ESKD) requiring renal replacement therapy (RRT) in Japan using age-period-cohort analysis and evaluated birth cohort effects for incident ESKD requiring RRT. The number of incident RRT patients aged between 20 and 84years by sex from 1982 to 2021 was extracted from the Japanese Society of Dialysis Therapy registry data. Annual incidence rates of RRT were calculated using census population as denominators, and changes in the incidence rates were evaluated using an age-period-cohort model. The age and survey year period categories generated 20 birth cohorts with 5-year intervals (from 1902-1907 to 1997-2001). The incidence rates of RRT in both sexes initially rose in the birth cohorts born in the early 1900s, and then decelerated and peaked during 1940-1960s in men and 1930-1940s in women, following a steady decline in both sexes. Compared with the reference 1947-1951 birth cohort, the highest cohort rate ratio was 1.14 (95% CI, 1.04-1.25) in the 1967-1971 birth cohort in men and 1.04 (95% CI, 0.98-1.10) in the 1937-1941 birth cohort in women. Significant cohort effects were identified in both sexes, but the peak of RRT was different for each sex. Our findings suggest that men born between 1940 and 1960s and women born between 1930 and 40s may be important target populations to consider when decreasing incidence rates of RRT among the general Japanese population.

Impact of genomic literacy components on genetic testing decision-making in the general Japanese population in the 20s and 30s.

In promoting genomic medicine, genomic literacy, which is the public's ability to acquire and utilize the knowledge and skills related to genetics and genomes, requires urgent improvement. This study determined how the three components of genomic literacy (genetic/genomic knowledge, health numeracy, and interactive and critical health literacy) are associated with risk and benefit perception for genetic testing and decision-making related to genetic testing. Using an online questionnaire, we surveyed genetic/genomic knowledge, health numeracy, interactive and critical health literacy, risk and benefit perception of genetic testing, and intention toward genetic testing of 857 Japanese citizens (aged 20-39). A vignette was created to measure the intention toward genetic testing, and respondents were asked about their willingness to undergo genetic testing and to share the results with their partners and children. The path analysis, which was done by creating a path diagram revealing the relationship of the three components with risk and benefit perception, revealed that genetic and genomic knowledge and interactive and critical health literacy affected the respondents' intention to undergo genetic testing via recognition of the benefits of such testing. Further, it was suggested that health numeracy affects benefit perception through risk perception toward genetic testing. However, the goodness of fit of this model for the intention of conveying positive results to partners and children was relatively low, thus indicating that the hypothetical model needs to be reexamined.

Questionnaire survey on the prevention and development of cervical cancer in patients with systemic lupus erythematosus in Japan.

The aim is to evaluate the prevention and development of cervical cancer in systemic lupus erythematosus (SLE) patients in Japan and its background based on a questionnaire survey. The questionnaire was handed to 460 adult female SLE patients at 12 medical institutions. The participants were grouped by age, and data related to their human papillomavirus vaccination status, age at first coitus, cervical cancer screening, and diagnosis of cervical cancer were analysed. A total of 320 responses were received. Patients aged 35-54 years included a higher proportion of patients whose age at first coitus was <20 years. This group also showed a higher rate of cervical cancer/dysplasia. Only nine patients had a human papillomavirus vaccination history. Adequate frequency of cervical cancer screening was slightly higher (52.1%) among SLE patients than in the Japanese general population. However, 23% of the patients had never undergone examination, primarily because of a feeling of troublesome. The incidence of cervical cancer was significantly higher among SLE patients. One reason for this may be associated with the use of immunosuppressants, although the difference was not significant. SLE patients are at a higher risk of cervical cancer and dysplasia. Rheumatologists should proactively recommend vaccination and screening examinations for SLE female patients.

Association of prediabetes with reduced brain volume in a general elderly Japanese population.

Diabetes frequently results in cognitive impairment, but it is less clear if brain health is adversely affected during the prediabetic stage. Our aim is to identify possible changes in brain volume as measured by magnetic resonance imaging (MRI) in a large elderly population stratified according to level of "dysglycemia." This is a cross-sectional study of 2144 participants (median age 69years, 60.9% female) who underwent 3-T brain MRI. Participants were divided into 4 dysglycemia groups based on HbA1c levels (%): normal glucose metabolism (NGM) (< 5.7%), prediabetes (5.7 to < 6.5%), undiagnosed diabetes (6.5% or higher), and known diabetes (defined by self-report). Of the 2144 participants, 982 had NGM, 845 prediabetes, 61 undiagnosed diabetes, and 256 known diabetes. After adjustment for age, sex, education, body weight, cognitive status, smoking, drinking, and disease history, total gray matter volume was significantly lower among participants with prediabetes (0.41% lower, standardized β = - 0.0021 [95% CI - 0.0039, - 0.00039], p = 0.016), undiagnosed diabetes (1.4% lower, standardized β = - 0.0069 [95% CI - 0.012, - 0.002], p = 0.005), and known diabetes (1.1% lower, standardized β = - 0.0055 [95% CI - 0.0081, - 0.0029], p < 0.001) compared to the NGM group. After adjustment, total white matter volume and hippocampal volume did not differ significantly between the NGM group and either the prediabetes group or the diabetes group. Sustained hyperglycemia may have deleterious effects on gray matter integrity even prior to the onset of clinical diabetes. • Sustained hyperglycemia has deleterious effects on gray matter integrity even prior to the onset of clinical diabetes.

Health literacy and COVID-19-related beliefs and behaviors: a longitudinal study of the Japanese general population.

Since the outbreak of novel coronavirus disease-2019 (COVID-19), health communication has played a critical role in the process of disease prevention. Based on the concepts of health literacy and protection motivation theory, this study longitudinally examined the relationship between general health literacy measured immediately before the COVID-19 outbreak, and COVID-19-related information utilization, health literacy, beliefs and protective behaviors during the subsequent year in the Japanese general population. The participants were 767 Japanese residents who completed self-administered questionnaire surveys in January 2020 and February 2021. Based on the hypotheses, we constructed and tested a path model to predict the adoption of protective behaviors. Higher health literacy in 2020 was significantly related to higher COVID-19-related health literacy in 2021, which, in turn, was related to the adoption of recommended protective behaviors both directly and indirectly through threat and coping appraisal. Coping appraisal, but not threat appraisal, significantly differed by health literacy level. Generic health literacy skills for accessing, understanding and applying health information may enable people to better adapt to specific health risks. Our findings provide guidance for future health literacy education and health risk communication in populations with different health literacy levels.

J-shape relationship between normal fasting plasma glucose and risk of type 2 diabetes in the general population: results from two cohort studies

BackgroundPrevious studies have reported that high fasting plasma glucose (FPG), even that within the normal range, is associated with the risk of type 2 diabetes (T2D). Nevertheless, these findings are limited to specific populations. Thus, studies in the general population are imperative.MethodsThis study included two cohorts comprising 204 640 individuals who underwent physical examinations at the Rich Healthcare Group present at 32 locations in 11 cities of China from 2010 to 2016 and 15 464 individuals who underwent physical tests at the Murakami Memorial Hospital in Japan. Cox regression, restricted cubic spline (RCS), Kaplan–Meier (KM) curves, and subgroup analysis were used to determine the relationship between FPG and T2D. Receiver operating characteristic (ROC) curves were used to evaluate the predictive power of FPG for T2D.ResultsThe mean age of the 220 104 participants (204 640 Chinese and 15 464 Japanese participants) was 41.8 years (41.7 years for the Chinese and 43.7 years for the Japanese participants). During follow-up, 2611 individuals developed T2D (2238 Chinese and 373 Japanese participants). The RCS demonstrated a J-shaped relationship between FPG and T2D risk, with inflexion points of 4.5 and 5.2 for the Chinese and Japanese populations, respectively. Multivariate-adjusted hazard ratio (HR) was 7.75 for FPG and T2D risk after the inflexion point (7.3 for Chinese and 21.13 for Japanese participants).ConclusionsIn general Chinese and Japanese populations, the normal baseline FPG range showed a J-shaped relationship with the risk of T2D. Baseline FPG levels help identify individuals at high risk of T2D and may enable early primary prevention to improve their outcomes.

Serum High-Sensitivity Cardiac Troponin T as an Independent Predictor for Incident Coronary Heart Disease in the Japanese General Population: The Circulatory Risk in Communities Study (CIRCS).

Epidemiological evidence is extremely limited about high-sensitivity cardiac troponin T (hs-cTnT) and future coronary heart disease (CHD) events for the general population in countries with low mortality from CHD. Therefore, we investigated the association between hs-cTnT levels and the risk of incident CHD using a nested case-control study in a large Japanese cohort study. The participants were residents of four Japanese communities in the Circulatory Risk in Communities Study (CIRCS). We obtained 120 cases (81 men and 39 women, aged 38-86 years at baseline) of first incident CHD and 240 controls matched by age, sex, communities, and blood sampling term. Serum hs-cTnT levels were measured using an electrochemiluminescence immunoassay with stored sera collected between 2001 and 2011. The median period between sampling at survey and CHD incidence was 2.0 (interquartile range, 0.9-3.7) years. After adjusting for conventional risk factors, the multivariable odds ratios (ORs) of CHD were calculated using conditional logistic regression analyses. hs-cTnT ranged from ≤ 3 (assay detection limit) to 155 ng/L. Compared with the lowest quartile of hs-cTnT, multivariable ORs (95% confidence intervals) of CHD for the second, third, and highest quartiles were 1.30 (0.57-2.95), 2.48 (1.09-5.64), and 3.01 (1.27-7.12), respectively. Similar associations were observed after adjusting for estimated glomerular filtration, or after excluding matched groups, including people with chronic kidney disease. Serum hs-cTnT could predict CHD in the Japanese general population. These findings implicate a benefit from monitoring hs-cTnT to predict CHD even among populations in countries with low mortality from CHD.

Structural Variants of Midnolin, a Genetic Risk Factor for Parkinson's Disease, in a Yamagata Cohort.

Parkinson's disease (PD) is a common neurodegenerative disease. We previously identified Midnolin (MIDN) to be a genetic risk factor for PD in both Yamagata (Japan) and British populations. However, the scale of our previous study was not sufficient to identify MIDN structural variants in the ascertained control of Yamagata Prefecture. We, therefore, reanalyzed MIDN variants in 3021 individuals from Yamagata Prefecture to compare with that in our previous British cohort study. MIDN copy number loss was only found in two cases (0.0662%), which was a lower frequency than that (1.64%) of the previously studied British cohort. Between the Yamagata and British groups, there was significant difference for rs3746106, located in the 5'-UTR of MIDN mRNA (p = 0.0003344, odds ratio 1.143), and for rs3746107, which corresponds to Ala34 (p < 2.2 × 10-16, odds ratio 5.89401). This study indicates that MIDN loss is relatively rare in the general Japanese population. Considering our previous studies that the frequency of MIDN loss is high among patients with PD (10.5 and 6.55% in Yamagata and Britain, respectively), the MIDN variants are much higher genetic risk factors for PD in a Japanese population than in a British population.

Abstract P443: Cross-Sectional Association Between Sedentary Behavior and Cardiometabolic Risk Factors in Japanese Population: The NIPPON DATA2010

Introduction: Physical inactivity is one of the major worldwide health concerns. Associations of sedentary behavior with cardiovascular diseases have been reported; however, there are few reports from Japanese population where obesity is less prevalent compared with Western populations. We investigated the association of sedentary behavior with cardiometabolic risk factors in a Japanese representative population. Methods: This is a cross-sectional study of 2,402 general Japanese populations (1,050 men, 1,352 women, aged 20 years and older) (the National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged 2010; the NIPPON DATA2010), who participated in the National Health and Nutrition Survey of Japan conducted in 2010. The most usual ways to spend time of the day for each participant were collected from self-completion questionnaire and interview by trained interviewers in the baseline survey of NIPPON DATA2010. The physical activities were categorized into vigorous physical activity, moderate physical activity, slight physical activity, TV-viewing, sitting, and basal level of activity. Sedentary time was calculated as the sum of TV-viewing and sitting time. Odds ratios and 95% confidence intervals for each cardiometabolic risk factors according to the tertiles of sedentary or TV-viewing time were estimated by logistic regression models, adjusting for age, smoking status, drinking status, residential area, and equivalent household expenditure. Results: The medians (25th percentiles, 75th percentiles) of sedentary time (hours/day) and TV-viewing time (hours/day) were 5.0 (3.0, 7.5) and 3.0 (2.0, 4.0) in men, and 4.5 (3.0, 7.0) and 2.0 (1.0, 3.5) in women, respectively. In total, sedentary time was positively associated with high triglycerides (OR [95% confidence intervals]: 1.30 [1.01-1.66]) and low HDL cholesterol (1.50 [1.08-2.07]), and TV-viewing time was positively associated with high triglycerides (1.65 [1.27-2.15]), low HDL cholesterol (2.09 [1.46-3.00]) and high LDL cholesterol (1.32 [1.05-1.66]). In men, sedentary time and TV-viewing time were positively associated with low HDL cholesterol (1.98 [1.13-3.49], 1.99 [1.13-3.53], respectively). In women, sedentary time was positively associated with high triglycerides (1.61 [1.09-2.37]), and TV-viewing time was positively associated with obesity (1.64 [1.13-2.38]), high triglycerides (1.96, [1.29-2.98]), low HDL cholesterol (2.05 [1.27-3.30]) and high LDL cholesterol (1.41, [1.02-1.95]). There were no significant associations of sedentary or TV-viewing time with hypertension and diabetes after adjusting for age. Conclusions: In conclusion, sedentary behavior including TV-viewing was positively associated with cardiometabolic risk factors, especially dyslipidemia in general Japanese population.

Abstract P310: Dietary Pattern Associated With Future Better Gait Speed in a Japanese General Population: Tanushimaru Cohort Study

Introduction: Sarcopenia is a core contributor to falls, fractures and disability. Previous cohort studies showed that healthy dietary pattern like plant-focused diets had beneficial effects on cognitive and physical health. However, few longitudinal studies have investigated the association between dietary patterns and future gait speed, which is strongly related to sarcopenia. Therefore, we aimed to evaluate the relationship between dietary patterns and gait speed in a 9-year follow-up. Methods: We recruited 1943 men and women aged 40 to 95 years in the prospective Tanushimaru cohort study in Japan in 2009. Their dietary intake was assessed using a brief self-administered diet history questionnaire (BDHQ). Principal component analysis (PCA) identified the main dietary patterns. In 976 participants re-examined in 2018, walk time for 5m was examined and &lt;1m/sec of gait speed was defined as slow gait speed. Multivariable logistic regression analyses were performed to examine the association of the main dietary patterns with slow gait speed. Covariates included traditional cardiovascular risk factor (hypertension, dyslipidemia and diabetes), history of cardiovascular diseases, physical activity and cognitive function at baseline. Results: The prevalence of slow gait speed in 2018 was 46.9%. The PCA revealed three major dietary patterns: vegetable pattern (vegetables, potatoes, mushrooms and seaweeds); rice pattern (rice, bread and miso soup); and alcohol pattern (alcoholic beverages, cakes and snacks). The higher vegetable pattern score was significantly associated with slower gait speed (p=0.002), while other patterns were not. Estimated risk for slow gait speed in the fully-adjusted model was 39.1% in the highest versus 55.8% in the lowest tertile of vegetable dietary pattern scores (p=0.001). Conclusions: The vegetable pattern was significantly associated with a lower risk for slow gait speed in a 9-year follow-up.

Abstract P220: Dietary Patterns and Lower Risk of Early Stage of Renal Dysfunction in 9-Year Follow-Up in a Japanese General Population: Tanushimaru Cohort Study

Introduction: Chronic kidney disease (CKD) is a growing public health problem with aging society and a progression to end-stage renal disease is associated with a higher risk of death. Previous studies have suggested that healthy dietary patterns like vegetable-based diet may reduce risk of incident CKD in general populations. However, there is less evidence on whether dietary patterns have impact on early stage of renal dysfunction (RD). Therefore, we investigated the longitudinal association between dietary patterns and early stage of RD in a general population. Methods: We recruited 1943 men and women aged 40 to 95 years in the prospective Tanushimaru cohort study in Japan in 2009. Their dietary intake was assessed using a brief self-administered diet history questionnaire (BDHQ). Principal component analysis (PCA) identified the main dietary patterns. In 984 participants re-examined in 2018, estimated glomerular filtration rate (eGFR) was calculated by CKD-EPI method in 2009 and 2018. RD and early RD were defined as eGFR &lt; 60 and &lt; 90 mL/min/1.73m 2 , respectively . Multivariable linear and logistic regression analyses were performed to examine the association of the main dietary patterns in 2009 with RD and early RD in 2018. Covariates included cardiovascular risk factors and eGFR at baseline. Results: Mean levels of eGFR in 2009 and 2018 were 94.0 and 84.3 mL/min/1.73m 2 . The prevalence of RD and early RD in 2018 were 8.8% (n=87) and 58.5% (n=576), respectively. The PCA revealed three major dietary patterns: vegetable pattern (vegetables, mushrooms and seaweeds); rice pattern (rice, bread and miso soup); and alcohol pattern (alcoholic beverages, cakes and snacks). The higher vegetable pattern score was significantly associated with higher eGFR in 2018 (p=0.006) and modestly associated with lower risk of early RD (p=0.06), but not RD (p=0.1) in the fully-adjusted models. Conclusions: The vegetable pattern was significantly associated with higher eGFR and may prevent an early stage of RD in a 9-year follow-up.

Newspaper Campaign to Promote Deceased Organ Donation: Who Can Appeal to the General Japanese Population?

Various interventions are reportedly effective in promoting organ donor registration. However, the identity of those who best serve as presenters to appeal to the general public is not known. A campaign for organ donor registration was conducted through a local newspaper advertisement in Japan. The advertisement appeared in 439,733 copies of the newspaper on January 9, 2021. In addition to the main message, 6 different presenters with photos of their faces and quick response codes were listed in the advertisement, namely a urologist, transplant physician, nephrologist, dialysis physician, ophthalmologist, and kidney transplant recipient who was a nephrologist himself (ie, a recipient and nephrologist). Newspaper readers watched each video about deceased organ donation via the quick response codes, and the number of video views acquired 30 days after the appearance was the main outcome, which was assessed using YouTube analytics. The proportions (95% CI) of people who watched each video among 439,733 newspaper readers were compared among the 6 presenters. The analyzed videos were viewed 262 times. The video produced by the recipient and nephrologist had the highest number of views among the 6 presenters (proportion: 0.019% [95% CI, 0.015-0.023]), followed by the one produced by the dialysis physician (0.011% [95% CI, 0.008-0.014]), the nephrologist (0.010% [95% CI, 0.007-0.014]), the urologist (0.008% [95% CI, 0.006-0.012]), the transplant physician (0.006% [95% CI, 0.004-0.009]), and the ophthalmologist (0.005% [95% CI, 0.004-0.008]). The appeal by the recipient and the nephrologist reached the highest proportion of people who watched the video about deceased organ donation in Japan.

Nonrestorative sleep is a risk factor for metabolic syndrome in the general Japanese population

BackgroundThis longitudinal study aimed to investigate the effects of nonrestorative sleep on developing metabolic syndrome (MetS) and related diseases in a general Japanese middle-aged population.MethodsOverall, 83,224 adults without MetS (mean age: 51.5 ± 3.5 years) from the Health Insurance Association in Japan were followed up for a maximum of 8 years between 2011 and 2019. The Cox proportional hazard method was used to determine whether nonrestorative sleep, assessed using a single-item question, was significantly associated with the respective development of MetS, obesity, hypertension, diabetes, and dyslipidemia. The MetS criteria were adopted by the Examination Committee for Criteria of Metabolic Syndrome in Japan.ResultsThe mean follow-up duration was 6.0 years. The incidence rate of MetS was 50.1 person-years/1,000 during the study period. Data suggested that nonrestorative sleep was associated with MetS (hazard ratio [HR]: 1.12, 95% confidence interval [CI]: 1.08–1.16) and other disorders, such as obesity (HR: 1.07, 95% CI: 1.02–1.12), hypertension (HR: 1.07, 95% CI: 1.04–1.11), and diabetes (HR: 1.07, 95% CI: 1.01–1.12) but not with dyslipidemia (HR: 1.00, 95% CI: 0.97–1.03).ConclusionsNonrestorative sleep is associated with the development of MetS and many of its core components in the middle-aged Japanese population. Therefore, assessing nonrestorative sleep may help identify individuals at a risk of MetS development.

A J-shaped Relationship between Sleep Duration and the Risk of Insulin Resistance in a General Japanese Population.

Objective Data on the role of sleep in the risk of insulin resistance (IR) are lacking. We therefore examined the association between sleep duration and IR in a general Japanese population. Methods Data of 1,344 individuals 34 to 89 years old from the Tanushimaru Study were analysed. IR was calculated using the fasting plasma glucose level×fasting insulin level/405, i.e. the homeostasis model assessment of IR (HOMA-IR). IR was defined as a HOMA-IR ≥1.73 based on the diagnostic criteria used in Japan. Information regarding sleep duration was collected via questionnaire. Results The frequencies of IR and metabolic syndrome (MetS) were 36.7% and 26.9%, respectively. A J-shaped relationship between sleep duration and IR was observed, and the same relationship was also shown between sleep duration and MetS; however, the relationship with MetS disappeared after adjusting for age, sex, and other confounding factors. Conclusion A J-shaped relationship was observed between sleep duration and the risks of IR in a general Japanese population.

Unincreased mortality of patients with early rheumatoid arthritis compared to the general population in the past 17 years: Analyses from the IORRA cohort.

The aim of this article is to investigate the mortality rate of patients with early rheumatoid arthritis (RA) over the past 17 years. Japanese patients with early RA enrolled in the Institute of Rheumatology, Rheumatoid Arthritis cohort from 2001 to 2012 were classified into Groups A (2001-06) and B (2007-12). The standardized mortality ratio (SMR) and 5-year survival rate were calculated. Groups A and B had 1609 and 1608 patients, of which 167 and 178 patients were lost during follow-up and 47 and 45 deaths were confirmed, respectively. The SMR (95% confidence intervals) for Groups A and B were 0.81 (0.59-1.08) and 0.78 (0.57-1.04), respectively, with the condition that all untraceable patients were alive. Assuming that the mortality rate of untraceable patients was twice as high as that of the general population, the SMR was 0.90 (0.68-1.19) for Group A and 0.92 (0.68-1.23) for Group B. The 5-year survival rates were 96.9% and 97.0% for Groups A and B, respectively. The 5-year mortality of patients with early RA has been comparable to that of the general Japanese population. The 5-year survival rate has been stable over the past 17 years.