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Hiroyasu Iso 2 Articles
The associations of cardiovascular and lifestyle factors with mortality from chronic kidney disease as the underlying cause: the JACC study
Shuai Guo, Tomoko Sankai, Kazumasa Yamagishi, Tomomi Kihara, Akiko Tamakoshi, Hiroyasu Iso
Epidemiol Health. 2024;e2024077.   Published online September 13, 2024
DOI: https://doi.org/10.4178/epih.e2024077    [Accepted]
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  • 27 Download
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Abstract
OBJECTIVES
This study investigated conventional cardiovascular and lifestyle risk factors affecting mortality from chronic kidney disease as the underlying cause in the general Japanese population.
METHODS
We conducted an 18.8-year follow-up study of 44,792 men and 61,522 women aged 40-79 from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk between 1986 and 1990. Cox proportional hazard models were used to analyze the association between risk factors and mortality from chronic kidney disease.
RESULTS
During the follow-up period, 373 participants (185 men and 188 women) died from chronic kidney disease. A body mass index of ≥27 kg/m2 (hazard ratio [95% confidence interval] = 2.00 [1.19-3.36] for men and 1.91 [1.19-3.07] for women, compared with 23.0-24.9 kg/m2), a history of hypertension (2.32 [1.67-3.22] for men and 2.01 [1.44-2.81] for women) and a history of diabetes mellitus (5.21 [3.68-7.37] for men and 7.10 [4.93-10.24] for women) were associated with an increased risk of mortality from chronic kidney disease in both sexes. In men, smoking was also associated with an increased risk (1.91 [1.25-2.90]), while current drinking (0.58 [0.34-0.98] for <23 g/day, 0.48 [0.29-0.80] for 23-45 g/day and 0.53 [0.32-0.86] for ≥46 g/day) and exercising ≥5 hours/week (0.42 [0.18-0.96]) were associated with a lower risk. Similar but non-significant associations for smoking and drinking were observed in women.
CONCLUSIONS
In addition to a history of hypertension and a history of diabetes mellitus, body mass index, smoking status, drinking status, and exercise habits were associated with the risk of mortality from chronic kidney disease.
Summary
The criteria for metabolic syndrome and the national health screening and education system in Japan
Kazumasa Yamagishi, Hiroyasu Iso
Epidemiol Health. 2017;39:e2017003.   Published online January 6, 2017
DOI: https://doi.org/10.4178/epih.e2017003
  • 22,061 View
  • 607 Download
  • 94 Web of Science
  • 89 Crossref
AbstractAbstract PDF
Abstract
Two major definitions of metabolic syndrome have been proposed. One focuses on the accumulation of risk factors, a measure used by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI); the other focuses on abdominal obesity, a measure used by the International Diabetes Federation (IDF) and the Japanese government. The latter definition takes waist circumference (WC) into consideration as an obligatory component, whereas the former does not. In 2009, the IDF, NHLBI, AHA, and other organizations attempted to unify these criteria; as a result, WC is no longer an obligatory component of those systems, while it remains obligatory in the Japanese criteria. In 2008, a new Japanese cardiovascular screening and education system focused on metabolic syndrome was launched. People undergoing screening are classified into three groups according to the presence of abdominal obesity and the number of metabolic risk factors, and receive health educational support from insurers. This system has yielded several beneficial outcomes: the visibility of metabolic syndrome at the population level has drastically improved; preventive measures have been directed toward metabolic syndrome, which is expected to become more prevalent in future generations; and a post-screening education system has been established. However, several problems with the current system have been identified and are under debate. In this review, we discuss topics related to metabolic syndrome, including (1) the Japanese criteria for metabolic syndrome; (2) metabolic syndrome and the universal health screening and education system; and (3) recent debates about Japanese criteria for metabolic syndrome.
Summary

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