Received Health Check-ups Research Articles

The association between insulin resistance and the consumption of nut including peanut, pine nut and almonds in working-aged Korean population.

Studies have reported that nuts intake is potentially beneficial to cardiometabolic health. However, there have been heterogeneous results regarding the association between nut intake/consumption and the risk of diabetes mellitus (DM). Insulin resistance (IR) is a major pathophysiology of DM. Thus, this study was to assess the association between nuts consumption and IR. A retrospective cross-sectional study. Multivariable-adjusted OR and 95 % CI for increased IR (adjusted OR (95 % CI)) were calculated according to the frequency of consuming one serving dose (15 g) of nuts including peanut, pine nut and almond (< 1/month, 1/month-1/week, 1-3/week, 3-5/week, ≥ 5/week). Elevated IR was defined in homoeostasis model assessment-insulin resistance corresponding to the fourth quartile levels within each study group. Subgroup analysis was conducted for gender, glycaemic status (normal, prediabetes and DM) and age (≥ and < 40 years). 379 310 Koreans who received health check-up. Compared with nut consumption < 1/month (reference), nuts consumption ≥ 1/month had the lower OR and 95 % CI for elevated IR (1/month-1/week: 0·90 (95 % CI 0·89, 0·92), 1-3/week: 0·90 (95 % CI 0·87, 0·92), 3-5/week: 0·94 (95 % CI 0·89, 0·98) and ≥ 5/week: 0·90 (95 % CI 0·86, 0·94)). This association was more remarkable in women, normal glycaemic group and young age group (< 40 years). However, men, prediabetes, DM and old age group did not show the significant association. Nuts consumption ≥ 1/month was less associated with elevated IR. Increased nuts consumption may have a favourable effect on IR.

Age, male sex, smoking and metabolic syndrome as risk factors of advanced colorectal neoplasia for fecal immunochemical test negative patients

Fecal immunochemical test (FIT) is worldwide strategy for colorectal cancer screening. The subjects with negative FIT still have the risk of an advanced colorectal neoplasia (AN), including adenoma with villous histology, high grade dysplasia or larger than 1cm in size, or adenocarcinoma. The study determined the risk factors associated with AN in FIT-negative subjects. The study included asymptomatic subjects who received health checkup colonoscopy and have provided FIT study within 6 months prior to colonoscopy. The risk factors to have AN in cases with negative FIT were analyzed. The numbers of colonoscopies needed to detect one AN were calculated for the subjects with different risk factors. There were 1411 cases, 85 with positive FIT and 1326 with negative FIT within 6 months before colonoscopy. In FIT positive and FIT negative cases, 45.9% and 34.6% were found to have colorectal adenoma, while 20.2% and 4.6% had AN, respectively. The univariate and multivariate logistic regression analyses showed that age more than 50 years old, male sex, smoking history and metabolic syndrome were the significant risk factors to have AN in the FIT negative cases. For cases with negative FIT to have these risk factors, the number of colonoscopies needed to detect one AN was 3.7, lower than 4.5 of the cases with positive FIT. For the cases with negative FIT, colonoscopy screening should be considered for those male patients over 50 years old, with a history of smoking and metabolic syndrome to detect AN.

Association between metabolic syndrome and Behçet's disease: A nationwide population-based study.

Metabolic syndrome (MetS) is characterized by insulin resistance, high blood pressure/sugar, dyslipidemia, and obesity. Whether MetS and its components affect the development of Behçet's disease (BD) remains unclear. This study was performed to investigate the associations between metabolic syndrome and risk of BD using nationwide population data. We conducted a retrospective cohort study of 10505818 Korean subjects who received health checkups in 2009-2012. Patients were classified into a MetS and its components group and were followed-up until 2016 for new-onset BD. A Cox proportional hazards model was used to assess the independent or synergistic effects of MetS and its components on the risk of incident BD. Compared to subjects without MetS components, the hazard ratio (HR) for development of BD in patients with MetS was 0.874 (95% confidence interval [CI]: 0.819-0.933) and this association was more prominent when all components of MetS were present (HR=0.675, 95% CI=0.571-0.798). Subjects with low high density lipoprotein (HDL) has a significantly increased risk of the development of BD (HR=1.51, 95% CI=1.4-1.594) compared to controls. This study showed that the incidence of Behçet's disease was reduced in subjects with MetS. Moreover, the presence of MetS components, with the exception of HDL, was negatively related to the development of BD.

COVID-19 SEROPREVALENCE AMONG ROYAL THAI ARMY PERSONNEL IN BANGKOK METROPOLITAN AREA FROM JULY-SEPTEMBER 2020

Background: COVID-19 is an ongoing pandemic that causes millions of deaths worldwide. Seroprevalence studies play a crucial role in identifying asymptomatic infection and providing the true prevalence of COVID-19 in the community. However, no COVID-19 seroprevalence in Thailand has been reported before.&#x0D; Objective: The study aimed to measure the prevalence of the SARS-CoV-2 antibody among army personnel residing in the Bangkok Metropolitan Area.&#x0D; Methods: All army personnel receiving health checkups from 1 July - 30 September 2020 were invited to participate in the study after providing informed consent. The seroprevalence was conducted using leftover serum without additional venipuncture. The screening conducted using the Rapid test by Wondfo®. When a screening test was positive, a confirmation test would be performed using ELISA by EuroImmun®. In case of a positive ELISA confirmation test result, the COVID-19 investigation team would be activated and deployed.&#x0D; Results: In all, 6,651 army personnel participated in this study. The age of participants ranged from 20-60 years with mean age of 40.5+12.02. Most participants were male (85.5%). The rapid screening test using Wondfo® was positive in 41 cases (0.61%). The confirmation test using ELISA yielded a positive result in 1 subject (0.015%). That person was a known case of COVID-19 infection, who received a full course of treatment and was confirmed to have negative RT-PCR before being discharged from the hospital a few weeks earlier.&#x0D; Conclusion: This was the first large scale seroprevalence surveillance of COVID-19 in Thailand. Our study revealed no new detectable case of asymptomatic COVID-19 infection in the Bangkok Metropolitan Area.

Associations of aging trajectories for an index of frailty score with mortality and medical and long-term care costs among older Japanese undergoing health checkups.

Using up to 13 years of repeated-measures data, we identified aging trajectories for an index in frailty score among older Japanese undergoing health checkups. In addition, we examined whether these trajectories were associated with all-cause and cause-specific mortality and healthcare costs. In total, 1698 adults aged ≥65 years completed annual assessments during 2002-2014. During follow-up, the average number of follow-up assessments was 3.9, and the total number of observations was 6373. Frailty was defined by using the following criteria from Fried's phenotype: slowness, weakness, exhaustion, low physical activity and weight loss. We identified four aging trajectories for frailty. Specifically, 6.5%, 47.3%, 30.3% and 16.0% of participants were in the high, second, third and low trajectory groups, respectively. As compared with the low trajectory group, the high trajectory group had greater risks of cardiovascular disease (adjusted hazard ratios of 3.42) and other-cause death (adjusted hazard ratios of 3.04). The high trajectory group had the highest medical costs until late in the eighth decade of life, costs decreased after age 70 years and were lowest at age 90 years (estimated at $116.7); however, medical and long-term care costs greatly increased after age 80 years in the second and third trajectory groups. Higher aging trajectories in frailty score were associated with elevated risks for cardiovascular, other-cause and all-cause death among older Japanese receiving health checkups. Medical and care needs greatly increased for the second and third trajectory groups when their frailty level was progressed in later life. Geriatr Gerontol Int 2020; 20: 1072-1078..

Diagnosis of Helicobacter pylori infection in the elderly using an immunochromatographic assay-based stool antigen test.

The diagnostic value of Helicobacter pylori stool antigen (HpSA) tests in elderly subjects remains unclear. The objective of this study was to assess the diagnostic accuracy of the immunochromatographic assay‐based HpSA test in a male elderly cohort and identify factors affecting the accuracy. Data for asymptomatic elderly male citizens (≥65 years old) who received health checkups at the Chinese PLA General Hospital between July 2007 and November 2018 were collected. The diagnostic accuracy of the HpSA test was determined using the 13C‐urea breath test as a reference standard. Associations between baseline comorbidities and the accuracy of the HpSA test were analyzed. In total, 316 participants were enrolled, including 193 in the pre‐treatment group (77.2 ± 7.8 years old) and 123 in the post‐treatment group (78.7 ± 8.3 years old). The accuracy (91.5%, 91.2%, and 91.9%) and specificity (97.6%, 98.7%, and 96.0%) were high in all participants, pre‐ and post‐treatment groups, respectively. However, sensitivities were only 68.7%, 65.1%, and 75.0%, respectively. In the pre‐treatment group, constipation was associated with decreased sensitivity (p = 0.039), while colorectal polyps were associated with increased sensitivity (p = 0.010). Multivariate analysis indicated that constipation and colorectal polyps are independent factors for the sensitivity of HpSA in the pre‐treatment group. The immunochromatographic assay‐based HpSA test achieved high accuracy with high specificity but suboptimal sensitivity in the elderly male cohort. Constipation and colorectal polyps were negatively and positively associated with HpSA sensitivity, respectively, in the pre‐treatment group.

Prolonged hyperlipidemia exposure increases the risk of arterial stiffness in young adults: a cross-sectional study in a cohort of Chinese

BackgroundHyperlipidemia is associated with arterial stiffness. Herein, We examined the effect of prolonged exposure to hyperlipidemia on the risk of arterial stiffness in young adults.MethodsA study cohort (35–55 years old) that received health check-ups in the Kailuan study (2014–2016) were assessed. Hyperlipidemia was defined as a low-density lipoprotein cholesterol ≥160 mg/dL according to the Chinese Guidelines for the Management of Dyslipidemia in Adults. Subjects were divided into three groups based on the number of years with hyperlipidemia: normal (0 years), low exposure (1–5 years), and high exposure (5–10 years) groups. Arterial stiffness was defined as brachial-ankle pulse wave velocity > 1400 cm/s. For all subjects and subjects that did not meet statin treatment criteria under guidelines, logistics regression was used to analyze the effect of prolonged hyperlipidemia exposure on arterial stiffness in different age groups.ResultsAmong 12,431 subjects, the mean age was 46.42 ± 5.34 years with 9000 men (72.4%). Brachial-ankle pulse wave velocity gradually increased with increased exposure duration. Logistic regression analysis showed that hyperlipidemia exposure was a risk factor for arterial stiffness in the low (1.22 times) and high (1.49 times) exposure groups compared with the normal group. In the different age groups, the risk of arterial stiffness increased with the duration of hyperlipidemia exposure, apart for the 35–40-year-old population. The effect of hyperlipidemia exposure duration on arterial stiffness in young adults that did not meet statin treatment criteria under guidelines was similar to the general population.ConclusionsProlonged exposure to hyperlipidemia in young adults increases the risk of arterial stiffness. Young adults with this condition may benefit from more aggressive primary prevention.Trial registrationName of the registry: Risk factors and intervention for cardiology, cerebrovascular and related disease (Kailuan Study)Trial registration number: CHiCTR-TNC1100 1489Date of registration: Aug 24, 2011URL of trial registry record: http://www.chictr.org.cn/showproj.aspx?proj=8050

Description of Maternal Smoking Status Before and After Pregnancy: A Longitudinal, Community-Based Cohort Study

BackgroundMaternal smoking during pregnancy is a major risk for adverse perinatal outcomes, as well as children’s health status. Thus, it is important to describe maternal smoking status during pregnancy and child-rearing to devise better intervention strategies. However, there have been no longitudinal studies to describe the status. Thus, in this study, we aimed to describe maternal smoking status during pregnancy and child-rearing based on population-based maternal and child health information. Moreover, we explored the factors associated with maternal smoking relapse after delivery.MethodsWe performed a survey of 1,220 mothers in a Japanese rural area who responded to a questionnaire upon registration of their pregnancies. When their children received health checkups at 4, 18, and 36 months of age, maternal smoking status was also surveyed. We then performed multiple logistic regression analysis to explore factors associated with maternal smoking relapse after delivery.ResultsUltimately, the total number of mothers with data available for longitudinal analysis was 727 (59.6%). At the time of pregnancy registration, there were 74 current smokers (10.2%) and 176 former smokers (24.2%). Among them, 59 (33.5%) relapsed after delivery. Under 28 years of maternal age at pregnancy registration (OR 2.6; 95% CI, 1.2–5.4) was associated with maternal smoking relapse after delivery.ConclusionsLongitudinal analyses showed that about 60% of mothers who smoked before and after delivery failed smoking cessation. In addition, younger mothers were significantly likely to relapse smoking after delivery.

Dietary pattern and its association with right-colonic diverticulosis.

In East Asia, colonic diverticulosis develops most commonly in the right colon and is known to have different characteristics compared with left-sided one. This study was designed to investigate whether right-colonic diverticulosis is associated with posteriori dietary patterns. We retrospectively reviewed medical records of prospectively collected cohort that received health check-up in Korea between May 2011 and January 2012. Their anthropometric data, biochemical results, medication history, underlying diseases, colonoscopic findings, and dietary data obtained from semi-quantitative food-frequency questionnaire were analyzed. Three dietary patterns were identified using factor analysis: healthy dietary pattern (vegetables, fish, seaweed, fruits, and beans), meat dietary pattern (red meat, processed meat/fish, fried noodle, poultry, and cephalopods), and snack dietary pattern (bread, sweets, dairy products, nuts, and rice cake). Out of the total 1911 patients, 203 (10.6%) had right-colonic diverticulosis, 21 (1.1%) had pan-colonic diverticulosis, and 12 (0.6%) had left-colonic diverticulosis. Among the total, none of the three patterns were associated with right-colonic diverticulosis, under adjustment with age, gender, body mass index, metabolic syndrome, and total energy intake. However, among women, meat dietary pattern was positively associated with right-colonic diverticulosis (odds ratio 1.866, 95% confidence interval: 1.0983-3.173, P=0.021). This study demonstrated that meat dietary pattern is positively associated with right-colonic diverticulosis among women.

Benefits of knowing own health status: effects of health check-ups on health behaviours and labour participation

ABSTRACT Lifestyle-related diseases account for a large proportion of mortality rates and healthcare expenses. These diseases are largely preventable with behavioural changes, but people often do not have adequate information to change their risky health behaviours. This study, for the first time, examines the extent to which health check-ups, which provide relevant information, affect health behaviours and labour outcomes of people with lifestyle-related diseases. Using nationally representative data on health and socioeconomic status in Japan, this study employs propensity score matching to compare two samples with similar attributes who had or had not received health check-ups. The results show that people who had health check-ups exhibit healthier behaviours and longer working hours than people who had not. Considering their cost and the benefits derived from resultant increases in annual income, health check-ups can be regarded as cost-effective.

Sex differences between Helicobacter pylori infection and cholesterol levels in an adult health checkup program.

Helicobacter pylori (Hpylori) infection is suggested to be a risk factor of metabolic syndrome (MS) and lipid abnormalities. The aim of this study was to investigate the influence of Hpylori infection on MS and lipid abnormalities according to sex differences. We analyzed a total of 4551 adults who received health checkups from January 2016 to May 2017. We enrolled participants who did not have a history of hypertension, diabetes, hyperlipidemia, or cancer among those who underwent endoscopy with a rapid urease test. We included a total of 1065 participants, and 663 patients (62.3%) were Hpylori-positive. The Hpylori infection rate was 59.3% (426/719) in males and 68.5% (237/346) in females. The mean level of total cholesterol (P=.003), low-density lipoprotein (LDL) cholesterol (P=.046), and triglycerides (P=.029) were statistically higher in Hpylori-infected males. The mean level of high-density lipoprotein (HDL) cholesterol was statistically lower in Hpylori-infected females (P=.032). Multivariate analysis showed that total cholesterol in males (odds ratio [OR], 1.007; 95% confidence interval [CI], 1.002-1.011) and HDL cholesterol in females (OR, 0.983; 95% CI, 0.968-0.998) were associated with active Hpylori infection. The prevalence of MS was higher in both male and female Hpylori-infected groups; however, there was no statistical significance. Hpylori infection is significantly related to increased total cholesterol in males and to decreased HDL cholesterol in females, which suggests that Hpylori could affect lipid profiles and may be different by sex.

Risks and perception of non-communicable diseases and health promotion behavior of middle-aged female immigrants in Japan: a qualitative exploratory study

BackgroundEnsuring good health of immigrants is a serious issue across countries, including Japan. This study focused on the health of middle-aged female immigrants in Japan who experienced changes to their health as well as an increased risk of non-communicable diseases. Specifically, the study aimed to clarify the risks and perceptions of non-communicable diseases and health promotion behavior of middle-aged female immigrants in Japan.MethodsThis investigation used an exploratory design. The participants were a purposive sample of 35 middle-aged female immigrants (age ≥ 40 years) living in urban and rural areas of Japan. Data were generated using mixed methods. A quantitative approach provided data of their risks of non-communicable diseases. Focus group discussions provided insights to identify their health promotion perceptions.ResultsBlood pressure measurement revealed that 29% of the immigrants had hypertension, 29% had a body mass index of > 30, and 71% had an abdominal girth of > 80 cm. About 31% had a history of chronic disease and 34% had regular medication. There were 80% who received regular health check-up, 49% who received breast cancer screening, and 34% who received cervical cancer screening. The focus group discussions indicated that the middle-aged female immigrants recognized the threat of non-communicable diseases. However, they lacked knowledge about the prevention of non-communicable diseases, and they felt that non-communicable diseases were unavoidable. They also failed to understand the benefits of health promotion behavior. The study revealed that the monolingual Japanese health service prevented immigrant women from understanding their health check-up and cancer screening results, and how to utilize the health service system.ConclusionsMiddle-aged female immigrants in Japan had potential risks of non-communicable diseases, and recognized their threat. These settled immigrant women received health check-ups and cancer screenings with the support of their family, and consequently attained the same level of adherence as that of Japanese women. However, lack of knowledge about health promotion and its benefits and the absence of a culturally sensitive health service system for immigrants in Japan constrained their health-promotion behavior. Sociocultural multilingual-tailored interventions including interpretation services by care providers with cultural sensitivities must be developed.

Screening tool for identifying adults with excessive salt intake among community-dwelling adults: a population-based cohort study

Excessive salt intake is widely known to be a cause of hypertension, cardiovascular events, and so on. However, simple tools for screening excessive salt intake are lacking. We aimed to develop a simple screening tool to identify community-dwelling adults with excessive salt intake. The present study involved participants who received health check-ups in Fukushima, Japan, in 2016 and 2017. We defined data from the 2016 check-up as the derivation set, and data from those who received check-ups in 2017 but not 2016 as the validation set. The outcome measure was excessive salt intake, defined as the estimated daily salt intake of 1 SD or more. Candidate predictors associated with the outcome were extracted using the Delphi method by an expert panel and narrowed down with clinical expertise and stepwise backward selection. The screening tool was developed using a coefficient-based multivariable scoring method and externally validated. A total of 1101 participants were included in the derivation set and 249 in the validation set. At the conclusion of the deviation process, 8 predictors were selected and scored. The areas under the receiver operating characteristic curve for derivation and external validation were 0.70 (95% CI: 0.67, 0.74) and 0.71 (95% CI: 0.62, 0.80), respectively. The calibration slope and intercept for external validation were 1.16 and -0.03, respectively. We developed a screening tool to identify adults with excessive salt intake. By extracting groups with excessive salt intake, target populations needing intervention for salt reduction can be highlighted efficiently.

SAT-353 COMPARISON OF METABOLIC RISK BETWEEN LIVING KIDNEY DONORS AND HEALTHY CONTROLS ACCORDING TO ERA IN SOUTH KOREA

Living donor kidney transplantation has been increasing in South Korea. Considering rapid changes in lifestyle and chronic diseases in South Korea over the years, time-trend exploration and comparison of metabolic risk in live donors and healthy controls may help to estimate the future risk of live donors. Living kidney donors in seven national university hospital of South Korea from 1982 to 2018 were enrolled. To compare living kidney donors with individuals having similar health status, individuals voluntarily receiving health check-up in two tertiary hospital from 1995 to 2016 were included. After excluding participants with estimated glomerular filtration rate (eGFR) <50mL/min/1.73m2, diabetes and cancer, living kidney donors and healthy populations were matched for age, sex, baseline eGFR and era using direct matching methods. Hyperuricemia was defined as uric acid greater than 7mg/dL for male, 6mg/dL for female. Underweight, overweight and obesity were defined as body mass index (BMI) <18.5, 25-29.9, and ≥30kg/m2, respectively. The era of the transplant was classified into 4 groups as follows; 1995-2000, 2001-2006, 2007-2011 and 2012-2016. To compare trends of metabolic risk factors between living kidney donor and matched healthy control according to the era, logistic regression analysis were performed using interaction terms on the era and kidney donation. The number of matched living kidney donors and healthy controls were 2,101, respectively. Their mean age was 42.3±11.5 years and 47.2% were male. Over the 21 years, the proportion of hyperuricemia increased across the era in both living kidney donors (4.3% at 1995-2002, 12.1% at 2012-2016) and healthy controls (7.0% at 1995-2002, 17.9% at 2012-2016), respectively. When compared to the slope of the trend for hyperuricemia between matched healthy control groups and living kidney donors, there were no difference. In the matched healthy control group, the percentage of SBP ≥140mmHg seemed to increased and the proportion of living kidney donors remained stable approximately 9%, but there was no significant difference in the trend according to the era between two groups. In the view of overweight/obesity, BMI ≥25kg/m2 was increased recently in the matched healthy control group from 25.0% at 1995-2000 to 30.7% at 2012-2016, while no definite changes were observed in living kidney donors (32.6% at 1995-2000 to 34.6%). However, the statistical difference between the trends between donors and matched controls did not observed. There were no differences in the trends of metabolic risk including hyperuricemia, overweight/obesity, systolic blood pressure ≥140mmHg of living kidney donors and matched healthy controls.

Distribution of hemoglobin levels and prevalence of anemia according to sex, age group, and region in 13 Korean cities

The distribution of hemoglobin (Hb) levels and the prevalence of anemia are significant public health indicators. The aims of this study were to determine the distribution of Hb levels and the prevalence of anemia according to sex, age group, and region throughout Korea. The study analyzed data on 1159298 subjects who received health checkups at 16 health-promotion centers in 13 Korean cities during 2018. Anemia and its severity were defined according to the World Health Organization classification for Hb levels as follows: mild anemia (11-12.9g/dL in males and 11-11.9g/dL in females), moderate anemia (10-10.9g/dL in both sexes), and severe anemia (<10.0g/dL in both sexes). The Hb level in the general sample was lower in females (13.25±1.13g/dL, mean±SD) than in males (15.29±1.22g/dL). The overall prevalence of anemia was 6.0% (2.98% in males and 8.56% in females), and the prevalence of severe anemia was 0.92% (0.23% in males and 1.51% in females). While the prevalence of anemia increased monotonically with age in males, it was bimodal in females with two peaks at 40-49years and ≥80years. The highest prevalence of anemia in females aged 40-49years was attributed to microcytic anemia, while increases in anemia prevalence in males aged ≥50years and females aged ≥70years were attributed to macrocytic anemia. The distribution of Hb levels and the prevalence of anemia overall and by severity differ according to sex, age group, and region throughout Korea.

Longitudinal Study of Diabetic Differences between International Migrants and Natives among the Asian Population.

Migration presents a substantial social and public health issue. However, it is unclear whether diabetes is worse among Asian migrants than natives of South Korea over time. This longitudinal study investigated the nationwide population, including 2,680,495 adults aged 20 years and older (987,214 Asian migrants and 1,693,281 natives), who received health check-ups, using the Korean National Health Insurance Service data (2009–2015). Joinpoint regression was used to estimate the annual percentage change of diabetes, and multivariable logistic regression was used to examine differences in incident type 2 diabetes between Asian migrants and natives adjusting for age, sex, economic status, body mass index, smoking status, any alcohol use, and physical activity. The age-adjusted prevalence of diabetes increased among native men (from 8.8% in 2009 to 9.7% in 2015, APC=1.64, p<0.05) compared to Asian migrant men, and the age-adjusted prevalence of diabetes increased among native women (from 6.0% in 2009 to 6.7% in 2015, APC=1.88, p<0.05) compared to Asian migrant women. In the multivariate analyses, Asian migrants were less likely to get type 2 diabetes than natives (odds ratio, 0.82; 95% CI, 0.78 to 0.86) between the first and last health check-ups. However, the odds ratio for developing type 2 diabetes was 1.15 (95% CI, 1.10 to 1.20) among low-income levels compared to high-income levels, regardless of whether they were Asian migrants or natives. The results could help to establish a new strategy for prevention, treatment, and management of diabetes among the Asian population.

Non-participation in health checkup and Kihon Checklist predicts loss of certification-free survival in community-dwelling older adults.

Despite efforts toward health promotion and preventive care for older adults, including health checkups and postal Kihon Checklist survey, one fifth of community-dwelling older adults do not participate in them. The aim of the present study was to examine the relationship between this non-participation and the end of certification-free survival in older adults. In a cohort of 4120 older adults with no prior history of Long-Term Care Insurance certification, the associations of non-participation with risk of later death without certification and support/care-need certification for 72 months were evaluated using Cox proportional hazards analysis. Of them, 4022 (mean age 72.7 years, 54.7% women) were followed up (97.6%). At baseline, 1072 received health checkups, 2085 replied to the Kihon Checklist alone and 865 did not participate. During 72 months, 310 deaths without certification and 701 certifications occurred. After adjustment, non-participating individuals had significantly higher hazard ratios for death up to 72 months and for certification up to 36 months, compared with the other two groups. The Kruskal-Wallis test showed associations of increasing incidence of certification due to stroke in pre-old (aged 65-74 years) men for 72 months, and due to arthralgia/fracture and dementia in old (aged ≥75 years) women for 24 months, with non-participation in health promotions. Certified non-participating individuals incurred higher estimated Long-Term Care Insurance expenditure per person for 72 months, especially in pre-old men and old women. Health promotion by health checkup and even Kihon Checklist survey increases certification-free survival in older residents, and decreases Long-Term Care Insurance expenditure. Geriatr Gerontol Int 2019; 19: 1206-1214.

Report of health checkup system for chronic kidney disease in general population in Okayama city: effect of health guidance intervention on chronic kidney disease outcome.

BackgroundFrom 2011, Okayama municipal government started the health checkup follow-up project to find those who were unaware of suffering chronic kidney disease and to prevent from aggravation of CKD stage. In this study, we aimed to evaluate the effect of 2 years' CKD-follow-up project regarding renal function and CKD risks.Patients and methodsThose who received a health checkup by the national health insurance in Okayama city in 2011 were recruited. The patients with lifestyle-related diseases or metabolic syndrome were excluded. Subjects who had an estimated glomerular filtration rate<50 mL/min/1.73 m2 or urinary protein positive by dipstick test were defined as compromised renal function group. They were recommended to visit a medical institution. Non-compromised renal function participants with two or more risks for CKD (hyperglycemia, higher blood pressure, dyslipidemia, hyperuricemia) were recommended to receive a health guidance (risk group). The change of renal function and CKD risks between 2011 and 2013 in each group was examined.ResultsA total of 28,309 people received a health checkup in 2011. In compromised renal function group, 39.5% (96/243) of the subjects improved their CKD stages in 2013 regardless of the visit of medical institutions or the frequency of receiving health checkup. In risk group, 63.4% (260/410) of the subjects decreased their CKD risks in 2013 independent of the reception of health guidance.ConclusionIn both compromised renal function group and risk group, more than half of subjects kept their kidney function (217/243) and decreased the number of CKD risks (260/410) in 2 years' follow-up. Receiving a health checkup itself and notification of one’s own health condition could exert a protective effect on kidney function.

Low Bioelectrical Impedance Phase Angle Is a Significant Risk Factor for Frailty.

The phase angle, which is measured via bioelectrical impedance analysis (BIA), is a clinically important bioimpedance parameter used for nutritional assessment and evaluating the risk of various diseases, such as locomotive syndrome (LS). It remains unclear if the phase angle is associated with frailty (fragile state of physical and mental health). We therefore examined this association in a large prospective sample. Of 1081 individuals receiving health checkups, 550 (male; 235, female; 365) were enrolled in this study. We applied the Japanese version of the Cardiovascular Health Study criteria to evaluate frailty and administered the 25-Item Geriatric Locomotive Function Scale to diagnose LS. The phase angle was measured via BIA. Multiple logistic regression analysis was used to evaluate the relationship between the phase angle and frailty. For all participants and for each sex, the phase angle was significantly lower among individuals with frailty. After controlling for age, sex, and body mass index, we found that a low phase angle was a significant risk factor of frailty. As a result of multiple regression analysis including other confounding factors, among male participants, a low phase angle was significantly related with both frailty (P = 0.015) and LS (P < 0.001), whereas among female participants, the low phase angle had a stronger association with frailty (P = 0.001) than with LS (P = 0.52). Our findings suggest that a low angle is a risk factor of frailty. Furthermore, among female participants, frailty has a stronger relation with the phase angle than does LS. Therefore, the phase angle may be considered a useful indicator of frailty that does not require lengthy or costly assessment.

Effects of Sulfur Dioxide on Fractional Exhaled Nitric Oxide Concentration in the Child Residents of Miyakejima Island

The island of Miyakejima in Japan is subject to ongoing emissions of volcanic gases, including high concentrations of sulfur dioxide (SO2). Annual health checkups on the island, therefore, include the examination of respiratory system parameters. Here, we aimed to investigate the relationship between SO2 exposure and fractional exhaled nitric oxide (FeNO) concentration among children who received health checkups from 2008 to 2014. The subjects were 83 and 31 second-year junior high school students aged 13–14 years who resided on Miyakejima island and an SO2-free reference island, respectively. SO2 concentration in the air was measured at 6 fixed-point monitoring stations. FeNO was examined according to the American Thoracic Society guideline and European Respiratory Society recommendations for standardized procedures. Average concentrations of SO2 on Miyakejima over a period of 3 months prior to each health checkup from 2008 to 2014 were 22.2, 20.6, 8.9, 10.5, 10.7, 4.4 and 8.0 ppb, respectively. Among the Miyakejima students, geometric mean (GM) FeNO concentrations measured at each health checkup from 2008 to 2014 were 28.2, 18.2, 23.6, 35.5, 36.9, 28.1, and 32.1 ppb. The GM FeNO concentration measured from all Miyakejima students across the study period was 28.3ppb. No clear dose-response relationship was observed. The GM FeNO concentration among the students from the reference island was 27.7ppb in 2017. No significant difference was observed between the two populations, even when the data was stratified by sex and sensitivity. There was no clear significant difference in GM of FeNO concentration between Miyakejima and control students, when the average concentration of SO2 over a period of 3 months was 22ppb or less.