Jichi Medical School Cohort Study Research Articles

Association between physical activity and mortality in the Japanese general population with mild to moderate impaired renal function: the Jichi Medical School (JMS) cohort study.

The association between physical activity volume or intensity and mortality in general population with impaired renal function is unclear. We assessed these relationships among Japanese residents with impaired renal function. We analyzed 638 individuals with estimated creatinine clearance below 60ml/min in the Jichi Medical School cohort study. Exposures included the daily amount of physical activity converted to the physical activity index (PAI) used in the Framingham study and the activity time for each intensity. Physical activity intensity was classified into sedentary and nonsedentary. Nonsedentary activity was further divided into light-intensity and moderate-to-vigorous physical activity (MVPA). The outcome was all-cause mortality. Quartiles of the exposures were created, and hazard ratios (HRs) were calculated using the Cox proportional hazards model. The mean age of the subjects was 63.3years, and 72.4% were female. In total, 172 deaths were registered during 11,567 person-years. No significant association was found between PAI and mortality. A significant association was found between long sedentary time and increased mortality (p = 0.042). Regarding nonsedentary activity, the HRs [95% confidence intervals (CIs)] for Q2, Q3, and Q4 versus Q1 were 0.85 (0.55-1.31), 0.67 (0.41-1.08), and 0.90 (0.54-1.45), respectively. In the subdivided analysis for light-intensity activity, the HRs (95% CIs) of Q2, Q3, and Q4 versus Q1 were 0.53 (0.33-0.84), 0.51 (0.34-0.82), and 0.57 (0.34-0.96), respectively. No significant association was found between MVPA and mortality. Nonsedentary activity, especially light-intensity activity, significantly reduced mortality among residents with impaired renal function.

TG/HDL-C ratio as a predictor of stroke in the population with healthy BMI: The Jichi Medical School Cohort Study

Background and aimsThe triglycerides-to-high-density lipoprotein cholesterol ratio (TG/HDL-C) is a predictor of metabolic syndrome and cardiovascular disease onset. However, the relationship between TG/HDL-C and stroke has not been established. This study examined whether TG/HDL-C helps in predicting stroke onset; this was compared between the whole population and healthy body mass index (BMI) population. Methods and resultsThe Jichi Medical School Cohort Study is a prospective cohort study involving baseline data collected in 12 Japanese districts between April 1992 and July 1995. We used data from 11,699 participants; participants with a healthy BMI (20.0–24.9 kg/m2) were grouped into sex-specific TG/HDL-C quartiles. Using the first quartile groups as references, the hazard ratios (HRs) and 95% confidence intervals (CIs) of the Cox proportional hazards model were calculated. During the mean 10.8 years of follow-up, 419 new stroke events were recorded. The multivariable-adjusted HRs (95% CIs) in the fourth quartile of the whole population were 1.28 (0.94–1.75), 1.78 (0.91–3.48), 1.20 (0.82–1.77), and 1.13 (0.50–2.54), as compared to those in the fourth quartile of the healthy BMI population, which were 1.87 (1.24–2.83), 3.06 (1.21–7.74), 1.79 (1.05–3.05), and 1.29 (0.49–3.41) for all patients with all stroke, intracerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage, respectively. ConclusionIncreased TG/HDL-C correlated with a significant increase in stroke risk only in the healthy BMI population and not the whole population. Furthermore, it was primarily associated with increased intracerebral hemorrhage and cerebral infarction risk.

Hemoglobin Concentration and the Incidence of Stroke in the General Japanese Population: The Jichi Medical School Cohort Study.

BackgroundSeveral studies have described an association between hemoglobin concentration and stroke; however, the influence of hemoglobin on stroke incidence has not been fully revealed. Our objective was to elucidate the association between hemoglobin concentration and stroke incidence in Japanese community residents.MethodsIn the present study, we collected the data of 12,490 subjects who were enrolled between April 1992 and July 1995 in the Jichi Medical School (JMS) Cohort Study. We excluded the subjects with a history of stroke. Hemoglobin concentrations were grouped in quartiles, and quartile 2 (Q2) was used as the reference category. A Cox proportional-hazards model was used to examine hazard ratios (HRs) and the stroke incidence rates with 95% confidence intervals (CIs).ResultsDuring 10.8 years of follow-up, 409 participants (212 men and 197 women) experienced a new stroke, including 97 intracerebral hemorrhages, 259 cerebral infarctions, and 52 subarachnoid hemorrhages (SAH). In sex-specific hemoglobin quartiles, the multivariate-adjusted HR was statistically significantly higher in Q1 than in Q2, and a relationship similar to a J shape was observed between all strokes (HR in Q2 vs Q1, 1.36; 95% CI, 1.02–1.83; Q3, 1.20; 95% CI, 0.87–1.64; and Q4, 1.16; 95% CI, 0.84–1.60). Furthermore, the analysis of stroke subtypes showed a statistically significantly higher multivariate-adjusted HR in Q1 than in Q2 for SAH (HR 2.61; 95% CI, 1.08–6.27).ConclusionsA low hemoglobin concentration was associated with an increased risk of stroke, which was strongly influenced by the incidence of SAH.

Stroke Risk Due to Smoking Characterized by Sex Differences in Japan: The Jichi Medical School Cohort Study

ObjectivesSmoking is a risk factor for stroke. The relationship between smoking and the risk of different subtypes of stroke has not been fully elucidated. We investigated the relationship between smoking and the incidence of stroke in the Japanese population. Materials and methodsThis prospective, population-based cohort study included 11,324 participants (4447 men; 6877 women) from 12 districts in Japan, between April 1992 and July 1995. Participants were stratified according to smoking status (non-smoker [never smoked]/ex-smoker/current smoker). Male current smokers were further stratified according to the number of cigarettes smoked per day (1–14, 15–29, or ≥ 30). The non-smoking group was used as a reference. Cox proportional hazards analysis was used to determine the risk of stroke due to smoking. ResultsFour hundred and seventeen new stroke events (212 men; 205 women) were recorded during a mean follow-up of 10.7 years, including 95 intracerebral hemorrhages (48 men; 47 women), 267 cerebral infarctions (152 men; 115 women), and 54 subarachnoid hemorrhages (12 men; 42 women). In multivariable analysis, the hazard ratios (95% confidence intervals) for male current smokers (≥ 30 cigarettes/day) were 1.89 (1.08–3.31) and 3.41 (1.22–9.57) for all strokes and intracerebral hemorrhages, respectively; those for female current smokers were 2.78 (1.62–4.74), 3.14 (1.51–6.54), and 4.03 (1.64–9.93) for all strokes, cerebral infarctions, and subarachnoid hemorrhages, respectively. ConclusionsSmoking ≥ 30 cigarettes/day is a risk factor for stroke, especially intracerebral hemorrhage in men. Furthermore, smoking increases the risk of cerebral infarction and subarachnoid hemorrhage in women.

Coffee consumption and mortality in Japan with 18 years of follow-up: the Jichi Medical School Cohort Study

ObjectiveCoffee consumption can be expected to reduce mortality due to cardiovascular diseases and cancer. This study tested the hypothesis of an inverse association between coffee intake and all-cause mortality and mortality due to cancer, coronary heart disease, or stroke. Study designProspective cohort study. MethodsWe analyzed data from the Jichi Medical School Cohort Study, Japan, enrolling 9946 subjects (men/women: 3870/6,076, age: 19–93 years) from 12 communities. A food frequency questionnaire assessing the subjects’ daily coffee consumption was used. ResultsDuring an average follow-up of 18.4 years, the total number of deaths was 2024, including 677 for cancer, 238 for coronary heart disease, and 244 for stroke. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality and cause-specific mortality due to cancer, coronary heart disease, and stroke. Overall, no significant association was shown between coffee consumption and all-cause mortality. In the cause-specific mortality analyses, stroke mortality was significantly lower in those who consumed 1–2 cups of coffee daily (HR [95% CI]: 0.63 [0.42–0.95]) than in those who do not consume coffee, and this association occurred only in men. ConclusionThis study showed no significant association between coffee consumption and all-cause mortality. A U-shaped association between coffee consumption and stroke mortality with a 37% lower stroke mortality, only significant in men who consume 1–2 cups of coffee daily was observed. It is necessary to examine the possibility of intervention studies to reduce stroke mortality through coffee consumption

Association between P wave polarity in atrial premature complexes and cardiovascular events in a community-dwelling population

ObjectiveTo examine the association between polarity of atrial premature complexes (APCs) and stroke.DesignA prospective study.Setting and participantsA total of 11 092 participants in the Jichi Medical School cohort study were...

High-Density Lipoprotein Cholesterol and Risk of Stroke Subtypes: Jichi Medical School Cohort Study.

We aimed to investigate the relationship between high-density lipoprotein cholesterol (HDL-C) concentration and the incident stroke subtypes. We enrolled 11 027 participants between the ages of 18 and 90 years without a history of stroke in 12 Japanese communities. Cox's regression models were used for stroke subtypes, adjusted for traditional risk factors, according to the categories based on HDL-C concentrations: 1.04 to 1.55 mmol/L, ≥1.56 mmol/L, and <1.03 mmol/L (as the reference). During a mean follow-up of 10.7 years, 412 stroke events had occurred. However, HDL-C was not significantly associated with the incidence of cerebral infarction and subarachnoid hemorrhage. High HDL-C concentration was associated with a decreased incidence of intracerebral hemorrhage in women (hazard ratio = 0.23; 95% confidence interval = 0.06-0.89), but not in men (hazard ratio = 0.73; 95% confidence interval = 0.27-1.97). Therefore, high HDL-C concentration might have a protective effect on the incidence of intracerebral hemorrhage, particularly in women.

Isolated low levels of high‐density lipoprotein cholesterol and stroke incidence: JMS Cohort Study

BackgroundThe cardiovascular relevance of isolated low levels of high‐density lipoprotein cholesterol (HDL‐C) is yet to be determined. Stroke often leads to long‐term disability, and thus, not only stroke mortality but also stroke incidence is a topic of research. Although isolated low HDL‐C level has been found to be a predictor for stroke mortality previously, whether it can predict stroke incidence is unknown.MethodsIn the Jichi Medical School cohort study, 11 025 community‐living residents without a history of stroke were examined. Hazard ratios (HRs) for isolated and non‐isolated low HDL‐C levels were calculated relative to those for normal HDL‐C levels in stroke patients using Cox's regression models.ResultsDuring the mean follow‐up period of 10.7 years, 412 residents had their first‐ever stroke. The multivariable‐adjusted HRs for the levels of isolated and non‐isolated low HDL‐C were 1.11 (95% confidence interval, 0.85‐1.44) and 1.35 (1.01‐1.81), respectively, when compared to that for normal HDL‐C.ConclusionLow HDL‐C levels with other dyslipidemias may contribute to the incidence of stroke, not isolated low HDL‐C.

Metabolic syndrome is a risk factor for cancer mortality in the general Japanese population: the Jichi Medical School Cohort Study

BackgroundMetabolic syndrome (MetS) and cancer are major public health problems worldwide. The relationship between MetS and cancer death is of great interest. We examined the predictive value of MetS for cancer mortality in Japan.MethodsStudy participants included 4495 men and 7028 women aged 18–90 years who were registered between 1992 and 1995 as part of the Jichi Medical School Cohort Study. We used a definition of MetS modified for the Japanese population. The primary outcome was cancer mortality. Additionally, the relationship between MetS and cancer-type specific mortality was examined. Analyses were conducted with Cox’s regression models adjusted for age, smoking status, alcohol drinking status, marital status, educational attainment, physical activity, occupational category, and menopausal status (only in women).ResultsDuring a mean follow-up of 18.5 years, 473 men and 297 women died from cancer. MetS was positively associated with cancer mortality in women (hazard ratio [HR], 1.69; 95% confidence interval [CI] 1.21–2.36), but not in men (HR, 1.21; 95% CI 0.90–1.62). Additionally, MetS was associated with a high risk of colorectal (HR, 3.48; 95% CI 1.68–7.22) and breast (HR, 11.90; 95% CI 2.25–62.84) cancer deaths in women.ConclusionMetS was a significant predictor of cancer mortality in women.

The ratio of fasting plasma glucose to hemoglobin A1c as a predictor of all-cause mortality in individuals with normal glucose levels: The Jichi Medical School cohort study.

Objectives:The fasting plasma glucose/hemoglobin A1c ratio is considered a marker associated with glucose metabolism disorders, including fasting hyperglycemia. However, it remains unclear whether this ratio can be used for the prevention of deaths in individuals with normal fasting plasma glucose levels. This study aimed to see the predictive value of the fasting plasma glucose/hemoglobin A1c ratio for all-cause mortality in a general population with normal fasting plasma glucose levels.Methods:The study investigated prospectively a cohort of 1087 multi-regional, community-dwelling Japanese participants (women, 69.2%) for a follow-up period of 11.3 years. We included individuals with fasting plasma glucose levels <6.11 mmol/L and excluded those meeting the diabetes criteria. All-cause mortality was the primary outcome and hazard ratios were calculated using the Cox proportional hazard model after dividing the fasting plasma glucose/hemoglobin A1c ratios into tertiles.Results:There were 54 deaths (25 women) during the follow-up period. The high tertile group had a significantly higher hazard ratio for all-cause mortality than the low tertile group in women (multivariate-adjusted hazard ratio = 4.45; 95% confidence interval = 1.26–15.72), but not clearly in men.Conclusion:The data of the population-based cohort study suggest that a high fasting plasma glucose/hemoglobin A1c ratio can predict all-cause mortality in women with normal fasting plasma glucose levels.

Body Mass Index and Incidence of Subarachnoid Hemorrhage in Japanese Community Residents: The Jichi Medical School Cohort Study

Whereas high body mass index (BMI) is reportedly a risk factor for cardiovascular events in Western countries, low BMI has been reported as a risk factor for cardiovascular death in Asia, including Japan. Although subarachnoid hemorrhage (SAH) is a highly fatal disease and common cause of disability, few cohort studies have examined the associations between BMI and SAH in Japan. This study investigated the associations between BMI and incidence of SAH using prospective data from Japanese community residents. Data were analyzed from 12,490 participants in the Jichi Medical School Cohort Study. Participants were categorized into 5 BMI groups: ≤18.5, 18.6-21.9, 22.0-24.9, 25.0-29.9, and ≥30.0 kg/m2. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard model with BMI of 22.0-24.9 kg/m2 as the reference category. During the mean follow-up period of 10.8 years, 55 participants (13 men, 42 women) experienced SAH. BMI ≥30.0 kg/m2 was associated with significantly higher risk for SAH (HR, 5.98; 95% CI, 2.25-15.87). BMI ≤18.5 kg/m2 showed a nonsignificant tendency toward high risk of SAH (HR, 2.51; 95% CI, .81-7.79). High BMI was a significant risk factor for SAH. Lower BMI showed a nonsignificant tendency toward higher risk of SAH. Our results suggest a J-shaped association between BMI and risk of SAH incidence.

Body mass index and stroke incidence in Japanese community residents: The Jichi Medical School (JMS) Cohort Study.

BackgroundHigh body mass index (BMI) has been reported as a risk factor for cardiovascular events in Western countries, while low BMI has been reported as a risk factor for cardiovascular death in Asian countries, including Japan. Although stroke is a major cause of death and disability in Japan, few cohort studies have examined the association between BMI and stroke incidence in Japan. This study aimed to examine the association between BMI and stroke incidence using prospective data from Japanese community residents.MethodsData were analyzed from 12,490 participants in the Jichi Medical School Cohort Study. Participants were categorized into five BMI groups: ≤18.5, 18.6–21.9, 22.0–24.9, 25.0–29.9, and ≥30.0 kg/m2. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard model. The group with a BMI of 22.0–24.9 kg/m2 was used as the reference category.ResultsDuring mean follow-up of 10.8 years, 395 participants (207 men and 188 women) experienced stroke, including 249 cerebral infarctions and 92 cerebral hemorrhages. Men with a BMI ≤18.5 kg/m2 (HR 2.11; 95% CI, 1.17–3.82) and women with a BMI ≥30.0 kg/m2 (HR 2.25; 95% CI, 1.28–5.08) were at significantly higher risk for all-stroke. Men with a BMI ≤18.5 kg/m2 were at significantly higher risk for cerebral infarction (HR 2.15; 95% CI, 1.07–4.33).ConclusionsThe association between BMI and stroke incidence observed in this population was different than those previously reported: low BMI was a risk factor for all-stroke and cerebral infarction in men, while high BMI was a risk factor for all-stroke in women.

Factor VII and incidence of myocardial infarction in a Japanese population: The Jichi Medical School Cohort Study.

The role of factor VII (FVII) as a risk factor in myocardial infarction (MI) has been the subject of numerous studies. However, it remains uncertain whether the FVII levels are associated with development of MI. The subjects were 4142 men and women whose activated FVII (FVIIa) and FVII coagulant (FVIIc) levels were measured in the Jichi Medical School Cohort Study. Subjects were divided into tertiles by FVIIa and FVIIc levels, and Cox's proportional hazard model was used to calculate hazard ratios (HRs) for MI. The multivariate-adjusted HRs (95% confidential interval [CI]) for FVIIa in men were 0.67 (0.67-1.78) in tertile 2 (T2), and 0.52 (0.17-1.60) in T3. In women, the multivariate-adjusted HRs (95% CI) were 0.18 (0.02-1.60) in T2, and 0.39 (0.07-2.20) in T3. The multivariate-adjusted HRs (95% CI) for FVIIc in men were 0.54 (0.21-1.36) in T2, and 0.20 (0.04-0.91) in T3. In women, the multivariate-adjusted HRs (95% CI) were 0.44 (0.07-2.85) in T2, and 0.35 (0.06-2.22) in T3. We used T1 as a reference for all measures. Our findings revealed a significant association between low FVIIc level and incidence of MI in men. The FVIIa and FVIIc levels were inversely related to increased MI risk, but did not reach statistical significance. Future studies are needed to confirm this association.

Coffee Consumption and Incidence of Subarachnoid Hemorrhage: The Jichi Medical School Cohort Study.

BackgroundPrevious studies on the association between coffee consumption and subarachnoid hemorrhage (SAH) have provided inconsistent results. We examine the risk of SAH from coffee consumption in a Japanese population.MethodsOur analyses were based on the Jichi Medical School Cohort Study, a large-scale population-based prospective cohort study. A total of 9941 participants (3868 men and 6073 women; mean age 55 years) with no history of cardiovascular disease or carcinoma were examined. Participants were asked to choose one of five options to indicate their daily coffee consumption: none, less than 1 cup a day, 1–2 cups a day, 3–4 cups a day, or 5 or more cups a day. The incidence of SAH was assessed independently by a diagnostic committee. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their 95% confidence intervals (CI) after adjustment for age and sex (HR1) and for additional potential confounders (HR2).ResultsDuring 10.7 years of follow-up, SAH occurred in 47 participants. When compared with the participants who consumed less than 1 cup of coffee a day, the HR of SAH was significantly higher in the group who consumed 5 or more cups a day in both models (HR1 4.49; 95% CI, 1.44–14.00; HR2 3.79; 95% CI, 1.19–12.05).ConclusionsThe present community-based cohort study showed that heavy coffee consumption was associated with an increased incidence of SAH after adjusting for age, sex, and multiple potential cardiovascular confounders.

Salt Preference and the Incidence of Cardiovascular Disease in a Japanese General Population: The Jichi Medical School Cohort Study

Dietary salt intake has been reported to be associated with cardiovascular disease (CVD). However, there were few studies that assessed the relationship of salt preference with CVD. We examined the association between salt preference and the incidence of CVD and its subtypes in a Japanese general population. Based on the prospective Jichi Medical School Cohort Study, data were analyzed from 11,394 eligible participants. A baseline survey of the preference for salt was obtained by questionnaire and health examinations from April 1992 through July 1995 in 12 communities in Japan. The participants were followed up until December 2005 (mean follow-up period, 10.7 ± 2.4 years). Subjects were divided into three categories according to their preference for salt: favor, so-so, and disfavor. A Cox proportional hazards model was used to calculate hazard ratios (HRs) of the incidence of CVD according to the preference categories. We observed 485 cardiovascular events (258 in men and 227 in women). Among the men, the multivariable adjusted HRs for incidence of myocardial infarction and subarachnoid hemorrhage for favor versus so-so salt preference were 0.34 (95% confidence interval, 0.17 - 0.71) and 7.10 (0.88 - 56.84), respectively. Among the women, age-adjusted HRs for the incidence of CVD, total stroke, cerebral hemorrhage, and cerebral infarction for the favor preference were 1.41 (1.02 - 1.95), 1.36 (0.97 - 1.91), 1.79 (0.87 - 3.71), and 1.40 (0.89 - 2.19), respectively. The data indicated that preference for salt may be associated with an increase in the incidence of CVD in women.

Early age at natural menopause and risk of cardiovascular and all-cause mortality: A meta-analysis of prospective observational studies

Menopause is defined as the permanent cessation of menstruation because of loss of ovarian follicular function. Menopause is a marker of the end of a woman's reproductive life. The age at menopause varies in different ethnic populations [ [1] Baber R.J. East is east and West is west: perspectives on the menopause in Asia and the West. Climacteric. 2014; 17: 23-28 Crossref PubMed Scopus (19) Google Scholar ]. Menopause between the ages of 40 and 45 years is usually described as early menopause [ [2] Miro F. Parker S.W. Aspinall L.J. Coley J. Perry P.W. Ellis J.E. Sequential classification of endocrine stages during reproductive aging in women: the FREEDOM study. Menopause. 2005; 12: 281-290 Crossref PubMed Scopus (34) Google Scholar ], while occurring before the age of 40 years is defined as premature menopause [ [3] Luborsky J.L. Meyer P. Sowers M.F. Gold E.B. Santoro N. Premature menopause in a multi-ethnic population study of the menopause transition. Hum. Reprod. 2003; 18: 199-206 Crossref PubMed Scopus (302) Google Scholar ]. Early or premature menopause can be naturally spontaneous or induced by medical interventions including chemotherapy or bilateral oophorectomy. Some epidemiologic studies [ 4 Snowdon D.A. Kane R.L. Beeson W.L. Burke G.L. Sprafka J.M. Potter J. et al. Is early natural menopause a biologic marker of health and aging?. Am. J. Public Health. 1989; 79: 709-714 Crossref PubMed Scopus (279) Google Scholar , 5 Cooper G.S. Sandler D.P. Age at natural menopause and mortality. Ann. Epidemiol. 1998; 8: 229-235 Abstract Full Text Full Text PDF PubMed Scopus (219) Google Scholar , 6 Jacobsen B.K. Knutsen S.F. Fraser G.E. Age at natural menopause and total mortality and mortality from ischemic heart disease: the Adventist Health Study. J. Clin. Epidemiol. 1999; 52: 303-307 Abstract Full Text Full Text PDF PubMed Scopus (195) Google Scholar , 7 Mondul A.M. Rodriguez C. Jacobs E.J. Calle E.E. Age at natural menopause and cause-specific mortality. Am. J. Epidemiol. 2005; 162: 1089-1097 Crossref PubMed Scopus (184) Google Scholar , 8 Cooper G.S. Baird D.D. Weinberg C.R. Ephross S.A. Sandler D.P. Age at menopause and childbearing patterns in relation to mortality. Am. J. Epidemiol. 2000; 151: 620-623 Crossref PubMed Scopus (49) Google Scholar , 9 Jacobsen B.K. Heuch I. Kvale G. Age at natural menopause and all-cause mortality: a 37-year follow-up of 19,731 Norwegian women. Am. J. Epidemiol. 2003; 157: 923-929 Crossref PubMed Scopus (208) Google Scholar , 10 Amagai Y. Ishikawa S. Gotoh T. Kayaba K. Nakamura Y. Kajii E. Age at menopause and mortality in Japan: the Jichi Medical School Cohort Study. J. Epidemiol. 2006; 16: 161-166 Crossref PubMed Scopus (44) Google Scholar , 11 Hong J.S. Yi S.W. Kang H.C. Jee S.H. Kang H.G. Bayasgalan G. et al. Age at menopause and cause-specific mortality in South Korean women: Kangwha Cohort Study. Maturitas. 2007; 56: 411-419 Abstract Full Text Full Text PDF PubMed Scopus (72) Google Scholar , 12 Tom S.E. Cooper R. Wallace R.B. Guralnik J.M. Type and timing of menopause and later life mortality among women in the Iowa Established Populations for the Epidemiological Study of the Elderly (EPESE) cohort. J. Womens Health (Larchmt). 2012; 21: 10-16 Crossref PubMed Scopus (21) Google Scholar , 13 Li S. Rosenberg L. Wise L.A. Boggs D.A. LaValley M. Palmer J.R. Age at natural menopause in relation to all-cause and cause-specific mortality in a follow-up study of US black women. Maturitas. 2013; 75: 246-252 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar , 14 Wu X. Cai H. Kallianpur A. Gao Y.T. Yang G. Chow W.H. et al. Age at menarche and natural menopause and number of reproductive years in association with mortality: results from a median follow-up of 11.2 years among 31,955 naturally menopausal Chinese women. PLoS One. 2014; 9: e103673 Crossref PubMed Scopus (57) Google Scholar , 15 Jacobsen B.K. Heuch I. Kvale G. Age at natural menopause and stroke mortality: cohort study with 3561 stroke deaths during 37-year follow-up. Stroke. 2004; 35: 1548-1551 Crossref PubMed Scopus (46) Google Scholar ] suggested that women who experienced early natural menopause or premature menopause were at increased risk of all-cause mortality. However, findings from these studies are conflicting. Therefore, we conducted this meta-analysis on all available prospective studies to quantitatively evaluate the early age at natural menopause and risk of cardiovascular or all-cause mortality.

Relationship between screening plasma glucose concentrations and cancer- and all-cause mortality: the Jichi Medical School (JMS) cohort study

Aim Whether plasma glucose concentrations at the screening level in the public health care setting can predict mortality remains to be determined in Japanese people. The aim of this study was to investigate the relationships between screening plasma glucose concentrations and cause- and all-cause mortality in a general Japanese cohort.

Mortality risks in relation to occupational category and position among the Japanese working population: the Jichi Medical School (JMS) cohort study

ObjectivesA well-known demographic finding in modern society is the inverse association between socioeconomic status and mortality. The purpose of the study was to examine socioeconomic indicators, such as occupational category...

Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)

BackgroundExperimental studies support the anti-neoplastic effect of apo(a), but several clinical studies have reported contradictory results. The purpose of this study was to determine whether a low lipoprotein(a) [Lp(a)] concentration is related to mortality from major causes of death, especially cancer.MethodsThe subjects were 10,413 participants (4,005 men and 6,408 women) from a multi-center population-based cohort study in Japan (The Jichi Medical School cohort study). The average age at registration was 55.0 years, and the median observation period was 4,559 days. As the estimated hazard ratio was high for both the low and very high Lp(a) levels, we defined two Lp(a) groups: a low Lp(a) group [Lp(a)<80 mg/L] and an intermediate-to-high Lp(a) group [Lp(a)≥80]. Participants who died from malignant neoplasms (n = 316), cardiovascular disease (202), or other causes (312) during the observation period were examined.ResultsCumulative incidence plots showed higher cumulative death rates for the low Lp(a) group than for the intermediate-to-high Lp(a) group for all-cause, cancer, and miscellaneous-cause deaths (p<0.001, p = 0.03, and p = 0.03, respectively). Cox proportional hazards analyses with the sex and age of the participants, body mass index, and smoking and drinking histories as covariates showed that a low Lp(a) level was a significant risk for all-cause, cancer, and miscellaneous-cause deaths (p<0.001, p = 0.003, and p = 0.01, respectively). The hazard ratio (95% CI) [1.48, 1.15–1.92] of a low Lp(a) level for cancer deaths was almost the same as that for a male sex (1.46, 1.00–2.13).ConclusionsThis is the first report to describe the association between a low Lp(a) level and all-cause or cancer death, supporting the anti-neoplastic effect of Lp(a). Further epidemiological studies are needed to confirm the present results.

P2-124 Lower Lipoprotein(a) levels cause cerebral haemorrhage: the Jichi Medical School Cohort Study

IntroductionLipoprotein(a) (Lp(a)) plays an important role in atherosclerosis. Some observational studies report Lp(a) as positively associated with myocardial infarction, but the relationship between Lp(a) and stroke is unclear. We examined...