Publications by authors named "Sanmei Chen"

37 Publications

Development of a risk prediction model for incident hypertension in Japanese individuals: the Hisayama Study.

Hypertens Res 2021 May 31. Epub 2021 May 31.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

The identification of individuals at high risk of developing hypertension can be of great value to improve the efficiency of primary prevention strategies for hypertension. The objective of this study was to develop a risk prediction model for incident hypertension based on prospective longitudinal data from a general Japanese population. A total of 982 subjects aged 40-59 years without hypertension at baseline were followed up for 10 years (2002-12) for the incidence of hypertension. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or the use of antihypertensive agents. The risk prediction model was developed using a Cox proportional hazards model. A simple risk scoring system was also established based on the developed model. During the follow-up period (median 10 years, interquartile range 5-10 years), 302 subjects (120 men and 182 women) developed new-onset hypertension. The risk prediction model for hypertension consisted of age, sex, SBP, DBP, use of glucose-lowering agents, body mass index (BMI), parental history of hypertension, moderate-to-high alcohol intake, and the interaction between age and BMI. The developed model demonstrated good discrimination (Harrell's C statistic=0.812 [95% confidence interval, 0.791-0.834]; optimism-corrected C statistic based on 200 bootstrap samples=0.804) and calibration (Greenwood-Nam-D'Agostino χ statistic=12.2). This risk prediction model is a useful guide for estimating an individual's absolute risk for hypertension and could facilitate the management of Japanese individuals at high risk of developing hypertension in the future.
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http://dx.doi.org/10.1038/s41440-021-00673-7DOI Listing
May 2021

N-Terminal Pro-B-Type Natriuretic Peptide and Incident CKD.

Kidney Int Rep 2021 Apr 16;6(4):976-985. Epub 2021 Jan 16.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Introduction: Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been associated with the progression of kidney impairment among patients with chronic kidney disease (CKD), but only a few studies have investigated the association between serum NT-proBNP levels and incident CKD in general populations.

Methods: A total of 2486 Japanese community-dwelling residents ≥40 years of age without CKD at baseline were followed up by repeated annual health examinations for 10 years. Participants were divided into 4 groups according to serum NT-proBNP levels. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m or the presence of proteinuria. Cox proportional hazards models were used to estimate hazard ratios (HRs) for risk of CKD. Linear mixed models were used to compare changes in eGFR.

Results: During the follow-up period, 800 participants developed CKD. The multivariable-adjusted HRs (95% confidence intervals [CIs]) for developing CKD were 1.00 (reference), 1.32 (1.11-1.57), 1.40 (1.10-1.78), and 1.94 (1.38-2.73) for serum NT-proBNP levels of <55, 55-124, 125-299, and ≥300 pg/ml, respectively ( for trend <0.001). The decline of eGFR during the follow-up was significantly more rapid among participants with higher serum NT-proBNP levels ( for trend <0.001). Adding serum NT-proBNP to the model composed of known risk factors for CKD improved the predictive ability for developing CKD.

Conclusions: Higher serum NT-proBNP levels were associated with greater risks of developing CKD and greater decline in eGFR. Serum NT-proBNP could be a useful biomarker for assessing the future risk of CKD in a general Japanese population.
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http://dx.doi.org/10.1016/j.ekir.2021.01.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071624PMC
April 2021

Midlife and late-life diabetes and sarcopenia in a general older Japanese population: The Hisayama Study.

J Diabetes Investig 2021 Mar 20. Epub 2021 Mar 20.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Aims/introduction: To investigate the association between midlife or late-life diabetes and the development of sarcopenia in an older Japanese population.

Materials And Methods: A total of 824 Japanese residents aged 65 to 84 years without sarcopenia were followed up from 2012 to 2017. Sarcopenia was determined following the Asian Working Group for Sarcopenia definition. The time of diabetes diagnosis was classified as midlife or late-life diabetes by the age at first diagnosis of diabetes (< 65 or ≥ 65 years) based on annual health checkups data over the past 24 years. The duration of diabetes was categorized into three groups of < 10, 10-15, and > 15 years. The odds ratios of incident sarcopenia according to the diabetic status were estimated using a logistic regression analysis.

Results: During follow-up, 47 subjects developed sarcopenia. The multivariable-adjusted odds ratio for incident sarcopenia was significantly greater in subjects with diabetes at baseline than in those without it (odds ratio 2.51, 95% confidence interval 1.26-5.00). Subjects with midlife diabetes had a significantly greater risk of incident sarcopenia, whereas no significant association between late-life diabetes and incident sarcopenia was observed. With a longer duration of diabetes, the risk of incident sarcopenia increased significantly (P for trend = 0.002).

Conclusions: The present study suggests that midlife diabetes and a longer duration of diabetes are significant risk factors for incident sarcopenia in the older population. Preventing diabetes in midlife may reduce the risk of the development of sarcopenia in later life.
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http://dx.doi.org/10.1111/jdi.13550DOI Listing
March 2021

Development and Validation of a Risk Prediction Model for Atherosclerotic Cardiovascular Disease in Japanese Adults: The Hisayama Study.

J Atheroscler Thromb 2021 Jan 22. Epub 2021 Jan 22.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.

Aim: To develop and validate a new risk prediction model for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in Japanese adults.

Methods: A total of 2,454 participants aged 40-84 years without a history of cardiovascular disease (CVD) were prospectively followed up for 24 years. An incident ASCVD event was defined as the first occurrence of coronary heart disease or atherothrombotic brain infarction. A Cox proportional hazards regression model was used to construct the prediction model. In addition, a simplified scoring system was translated from the developed prediction model. The model performance was evaluated using Harrell's C statistics, a calibration plot with the Greenwood-Nam-D'Agostino test, and a bootstrap validation procedure.

Results: During a median of a 24-year follow-up, 270 participants experienced the first ASCVD event. The predictors of the ASCVD events in the multivariable Cox model included age, sex, systolic blood pressure, diabetes, serum high-density lipoprotein cholesterol, serum low-density lipoprotein cholesterol, proteinuria, smoking habits, and regular exercise. The developed models exhibited good discrimination with negligible evidence of overfitting (Harrell's C statistics: 0.786 for the multivariable model and 0.789 for the simplified score) and good calibrations (the Greenwood-Nam-D'Agostino test: P=0.29 for the multivariable model, 0.52 for the simplified score).

Conclusion: We constructed a risk prediction model for the development of ASCVD in Japanese adults. This prediction model exhibits great potential as a tool for predicting the risk of ASCVD in clinical practice by enabling the identification of specific risk factors for ASCVD in individual patients.
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http://dx.doi.org/10.5551/jat.61960DOI Listing
January 2021

High Serum Folate Concentrations Are Associated with Decreased Risk of Mortality among Japanese Adults.

J Nutr 2021 03;151(3):657-665

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background: Folate and vitamin B-12 are essential nutrients for normal cell growth and replication, but the association of serum folate and vitamin B-12 concentrations with mortality risk remains uncertain.

Objective: This study was performed to investigate the associations of serum folate and vitamin B-12 concentrations with mortality risk and test whether the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism modifies these associations.

Methods: A total of 3050 Japanese community residents aged ≥40 y were prospectively followed-up for mortality between 2002 and 2012. Cox proportional hazards models and restricted cubic splines were used to estimate HRs and 95% CIs of mortality.

Results: During a median follow-up period of 10.2 y, 336 participants died. Higher serum folate concentrations were associated with lower risks of all-cause mortality [multivariable-adjusted HR: 0.73; 95% CI: 0.56, 0.96 for the second tertile (8.8-12.2 nmol/L; median 10.4 nmol/L) and HR: 0.61; 95% CI: 0.46, 0.80 for the third tertile (≥12.5 nmol/L; median 15.6 nmol/L) serum folate concentrations compared with the first tertile (≤8.6 nmol/L; median 7.0 nmol/L)]. This association remained significant in all sensitivity analyses. Spline analyses showed a steady decline in all-cause mortality risk with increasing serum folate concentrations up to 20-25 nmol/L. This association persisted regardless of the MTHFR C677T genotypes. For serum vitamin B-12, the multivariable-adjusted HR of 1.32 (95% CI: 0.97, 1.79) of all-cause mortality was marginally significantly greater in the first tertile compared with the second tertile. This association was attenuated and nonsignificant after the exclusion of participants with a history of cardiovascular disease or cancer, or participants aged ≥85 y at baseline, or deaths in the first 3 y of follow-up.

Conclusions: Serum folate concentrations were inversely associated with the risk of all-cause mortality in Japanese adults. Serum vitamin B-12 concentrations were not consistently associated with all-cause mortality risk after accounting for reverse-causation bias.
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http://dx.doi.org/10.1093/jn/nxaa382DOI Listing
March 2021

Changes in Body Weight and Concurrent Changes in Cardiovascular Risk Profiles in Community Residents in Japan: the Hisayama Study.

J Atheroscler Thromb 2021 Jan 17. Epub 2021 Jan 17.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.

Aim: We investigated the influence of weight change on concurrent changes in predicted cardiovascular disease (CVD) risk and individual CVD risk factors over time.

Methods: A total of 2,140 community-dwellers aged 40-74 years participated in both 2002 and 2007 health examinations. Obesity was defined as body mass index ≥ 25 kg/m. Weight trajectories were classified as: "stable obese" (obese at both examinations), "obese to nonobese" (obese in 2002 but nonobese in 2007), "nonobese to obese" (nonobese in 2002 but obese in 2007), or "stable nonobese" (nonobese at both examinations). We compared changes in the model-predicted risk for CVD and individual CVD risk factors across weight-change categories.

Results: The predicted risk for CVD increased during 5 years in all groups; the increment in the predicted risk for CVD was smallest in the obese to nonobese participants and steepest in the nonobese to obese subjects. Compared with the stable obese participants, the obese to nonobese participants had greater favorable changes in waist circumferences, blood pressure, fasting plasma glucose, serum high-density lipoprotein cholesterol, serum triglycerides, and liver enzymes. For all these parameters, opposite trends were observed when comparing the nonobese to obese participants with the stable nonobese group.

Conclusions: We demonstrated the favorable association of losing weight in obese people and avoiding excessive weight gain in nonobese people with global risk of future CVD and individual CVD risk factors in a real-world setting. The findings could improve behavioral lifestyle interventions that provide information on the health consequences of weight change at health checkups.
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http://dx.doi.org/10.5551/jat.59394DOI Listing
January 2021

Validity of the prognostication tool PREDICT version 2.2 in Japanese breast cancer patients.

Cancer Med 2021 03 15;10(5):1605-1613. Epub 2021 Jan 15.

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Introduction: PREDICT is a prognostication tool that calculates the potential benefit of various postsurgical treatments on the overall survival (OS) of patients with nonmetastatic invasive breast cancer. Once patient, tumor, and treatment details have been entered, the tool will show the estimated 5-, 10-, and 15-year OS outcomes, both with and without adjuvant therapies. This study aimed to conduct an external validation of the prognostication tool PREDICT version 2.2 by evaluating its predictive accuracy of the 5- and 10-year OS outcomes among female patients with nonmetastatic invasive breast cancer in Japan.

Methods: All female patients diagnosed from 2001 to 2013 with unilateral, nonmetastatic, invasive breast cancer and had undergone surgical treatment at Kyushu University Hospital, Fukuoka, Japan, were selected. Observed and predicted 5- and 10-year OS rates were analyzed for the validation population and the subgroups. Calibration and discriminatory accuracy were assessed using Chi-squared goodness-of-fit test and area under the receiver operating characteristic curve (AUC).

Results: A total of 636 eligible cases were selected from 1, 213 records. Predicted and observed OS differed by 0.9% (p = 0.322) for 5-year OS, and 2.4% (p = 0.086) for 10-year OS. Discriminatory accuracy results for 5-year (AUC = 0.707) and 10-year (AUC = 0.707) OS were fairly well.

Conclusion: PREDICT tool accurately estimated the 5- and 10-year OS in the overall Japanese study population. However, caution should be used for interpretation of the 5-year OS outcomes in patients that are ≥65 years old, and also for the 10-year OS outcomes in patients that are ≥65 years old, those with histologic grade 3 and Luminal A tumors, and in those considering ETx or no systemic treatment.
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http://dx.doi.org/10.1002/cam4.3713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940221PMC
March 2021

Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study.

Alzheimers Res Ther 2020 12 18;12(1):167. Epub 2020 Dec 18.

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer's disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts.

Methods: We combined individual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence.

Results: The sample comprised 39,387 cognitively unimpaired individuals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3-24.4%) and IRT (25.6%, 95%CI = 25.1-26.1%); however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1-7.0%, to 52.7%, 95%CI = 47.4-58.0%; IRT: 7.8%, 95%CI = 6.8-8.9%, to 52.7%, 95%CI = 47.4-58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades.

Conclusions: SCD is frequent in old age. Having a quarter of older individuals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help individuals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.
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http://dx.doi.org/10.1186/s13195-020-00734-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749505PMC
December 2020

Association between serum glycated albumin and risk of cardiovascular disease in a Japanese community: The Hisayama Study.

Atherosclerosis 2020 10 29;311:52-59. Epub 2020 Aug 29.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background And Aims: We aimed to investigate the association of serum glycated albumin (GA) levels with the risk of cardiovascular disease (CVD) and its subtypes, including coronary heart disease (CHD) and stroke, in a general Japanese population.

Methods: A total of 2965 Japanese community-dwellers aged ≥40 years were followed prospectively for a median of 10.2 years (2002-2012). Serum GA was measured by the enzymatic method and divided into quartiles. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of serum GA levels on CVD risk.

Results: During the follow-up, 213 subjects developed CVD; 95 had CHD, and 133 had stroke. The cumulative incidence of CVD, CHD, and stroke increased significantly with increasing serum GA levels (all p for trend <0.02). Compared with the lowest serum GA quartile (<13.6%), the multivariable-adjusted HRs (95% CI) of the highest quartile (≥15.7%) were 2.33 (1.46-3.68) for CVD, 2.23 (1.11-4.50) for CHD, and 2.47 (1.38-4.40) for stroke. In addition, a subgroup analysis showed that CVD risk increased significantly with increasing levels of serum GA in both subjects with and without diabetes mellitus. The increasing trend of CVD risk for higher serum GA levels was also observed in subjects with low hemoglobin A levels (hemoglobin A <5.46%).

Conclusions: Our findings suggest that higher serum GA levels are significantly associated with the development of CVD and its subtypes, even among subjects without diabetes or those with normal hemoglobin A levels, in a general Japanese population.
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http://dx.doi.org/10.1016/j.atherosclerosis.2020.08.016DOI Listing
October 2020

Physical frailty and its associated factors among elderly nursing home residents in China.

BMC Geriatr 2020 08 17;20(1):294. Epub 2020 Aug 17.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background: Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing home residents in China.

Methods: Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health.

Results: The overall prevalence of physical frailty and prefrailty was 55.6, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail.

Conclusion: We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.
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http://dx.doi.org/10.1186/s12877-020-01695-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433121PMC
August 2020

Education and the moderating roles of age, sex, ethnicity and apolipoprotein epsilon 4 on the risk of cognitive impairment.

Arch Gerontol Geriatr 2020 Nov/Dec;91:104112. Epub 2020 Jul 13.

Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.

Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).

Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.

Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.

Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.
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http://dx.doi.org/10.1016/j.archger.2020.104112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724926PMC
December 2020

The association of leisure-time physical activity and walking during commuting to work with depressive symptoms among Japanese workers: A cross-sectional study.

J Occup Health 2020 Jan;62(1):e12120

Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Japan.

Objective: To examine whether the cross-sectional association of leisure-time physical activity and walking during commuting to work with depressive symptoms depends on the level of work-related physical activity among Japanese workers.

Methods: Participants were 2024 workers aged 19-69 years in two manufacturing companies in Japan. Leisure-time physical activity and walking during commuting to work were ascertained via a self-administered questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. The odds ratio (OR) of depressive symptoms (CES-D score ≥16) was estimated by using multiple logistic regression with adjustment for covariates.

Results: Leisure-time physical activity was inversely associated with depressive symptoms; multivariable-adjusted ORs (95% confidence intervals) of having depressive symptoms for leisure-time physical activity were 1.00 (reference), 0.85 (0.64, 1.12), 0.69 (0.51, 0.94), and 0.59 (0.44, 0.80) for 0, >0 to <3.0, 3.0 to <10.0, and ≥10.0 MET-h/wk, respectively (P for trend <.001). This inverse trend for leisure-time physical activity was clearer among individuals who had low physical activity at workplace (less than 7.0 MET-h/d). For walking to work, such an inverse association was not observed.

Conclusion: Leisure-time physical activity was associated with fewer depressive symptoms, especially in workers with low work-related physical activity.
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http://dx.doi.org/10.1002/1348-9585.12120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199475PMC
January 2020

Influence of Neuroticism on Depressive Symptoms Among Chinese Adolescents: The Mediation Effects of Cognitive Emotion Regulation Strategies.

Front Psychiatry 2020 14;11:420. Epub 2020 May 14.

School of Education, Hunan University of Science and Technology, Xiangtan, China.

Objective: This study aims to explore the multilevel mediation effects of cognitive emotion regulation strategies (CERS) on the link between neuroticism and depressive symptoms among Chinese adolescents.

Method: A total of 1,265 Chinese adolescents were surveyed using the Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C), the neuroticism scale of the Chinese children's version of the Eysenck Personality Questionnaire (EPQ-Ck), and the Chinese Children's Depressive symptoms Inventory (CDI-C). Partial correlation analyses, multigroup confirmatory factor analyses, and structural equation modeling were used.

Results: (1) Neuroticism had significant, positive correlations with maladaptive CERS strategies (self-blame, acceptance, rumination, catastrophizing, and other-blame) and depressive symptoms ( < 0.001). Adaptive CERS strategies (positive refocusing, refocus on planning, positive reappraisal, and putting into perspective) had significant, negative correlations with neuroticism and depressive symptoms ( < 0.001). (2) Neuroticism and CERS strategies significantly predicted depressive symptoms. CERS strategies played partially mediating roles in the relationship between adolescents' neuroticism and depressive symptoms.

Conclusion: CERS strategies have partial multilevel mediation effects on the link between neuroticism and depressive symptoms.
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http://dx.doi.org/10.3389/fpsyt.2020.00420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240031PMC
May 2020

Serum homocysteine and risk of dementia in Japan.

J Neurol Neurosurg Psychiatry 2020 05 31;91(5):540-546. Epub 2020 Mar 31.

Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Objective: To examine the association between serum total homocysteine levels (tHcy) and dementia risk.

Methods: A total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia.

Results: During the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer's disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 µmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 µmol/L) were 2.28 (1.51-3.43) for all-cause dementia, 1.96 (1.19-3.24) for AD and 2.51 (1.14-5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8-15 µmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07).

Conclusion: High serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy.
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http://dx.doi.org/10.1136/jnnp-2019-322366DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231445PMC
May 2020

Dose-Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study.

J Gerontol A Biol Sci Med Sci 2020 09;75(9):1763-1770

Center for Health Science and Counseling, Kyushu University, Fukuoka, Japan.

Background: It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability.

Methods: A total of 1,678 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist.

Results: Functional disability was identified in 274 participants (16.3%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81-0.92) and 0.96 (0.93-0.99), respectively.

Conclusions: Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose-response manner in older adults.
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http://dx.doi.org/10.1093/gerona/glaa046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494030PMC
September 2020

Trajectories of body mass index and waist circumference before the onset of diabetes among people with prediabetes.

Clin Nutr 2020 09 25;39(9):2881-2888. Epub 2019 Dec 25.

Mitsui Chemicals, Inc., Tokyo, Japan.

Background & Aims: To investigate trajectories of body mass index (BMI) and waist circumference (WC) among prediabetic people who progressed to diabetes, people who remained with prediabetes, and those who returned to normoglycemia.

Methods: We used data from 22,945 prediabetic people who received an annual health checkup for up to eight years. The development of diabetes was defined using the American Diabetes Association criteria. People who did not progress to diabetes during the observation period were classified as 'remained with prediabetes' or 'returned to normoglycemia', based on their last health checkup data. Trajectories of BMI and WC were evaluated using linear mixed models for repeated measures, with adjustment for a wide range of covariates.

Results: During the study period, 2972 people progressed to diabetes, 4706 returned to normoglycemia, and 15,267 remained with prediabetes. People who progressed to diabetes had a larger increase in mean BMI from 7 years to 1 year prior to diagnosis, which was about three times that of people who remained with prediabetes (annual change rate, 0.20 [95% confidence interval; 0.15 to 0.24] vs 0.06 [0.04 to 0.08] kg/m per year, P < 0.001), regardless of their BMI levels at the initial health checkup. Among people who returned to normoglycemia, mean BMI remained almost the same over time (-0.04 [-0.09 to 0.002] kg/m per year), except for those with obesity (-0.16 [-0.28 to -0.05] kg/m per year). As for WC, the annual change rate among people who developed diabetes was about 7 times that of people who remained with prediabetes (0.38 [0.32 to 0.45] vs 0.05 [0.03 to 0.08] cm per year, P < 0.001). We also observed a constant mean WC over time among people who had no central obesity and later returned to normoglycemia (-0.02 [-0.06 to 0.03] cm per year), and an annual decrease in mean WC among those who had central obesity and later returned to normoglycemia (-0.40 [-0.47 to -0.32] cm per year).

Conclusions: Our study provides strong evidence that avoiding weight gain could help prediabetic people minimize the risk of developing diabetes, regardless of whether they are obese. Losing weight could help obese people restore normoglycemia from a prediabetic state, whereas maintaining current weight may help nonobese people return to normoglycemia.
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http://dx.doi.org/10.1016/j.clnu.2019.12.023DOI Listing
September 2020

Smoking Cessation, Weight Gain, and the Trajectory of Estimated Risk of Coronary Heart Disease: 8-Year Follow-up From a Prospective Cohort Study.

Nicotine Tob Res 2021 01;23(1):85-91

Mitsui Chemicals, Inc, Tokyo, Japan.

Introduction: The effect of weight gain following smoking cessation on cardiovascular risks is unclear. We aimed to prospectively investigate the association of weight gain following smoking cessation with the trajectory of estimated risks of coronary heart disease (CHD).

Methods: In a cohort of 18 562 Japanese male employees aged 30-64 years and initially free of cardiovascular diseases, participants were exclusively grouped into sustained smokers, quitters with weight gain (body weight increase ≥5%), quitters without weight gain (body weight increase <5% or weight loss), and never smokers. Global 10-year CHD risk was annually estimated by using a well-validated prediction model for the Japanese population. Linear mixed models and piecewise linear mixed models were used to compare changes in the estimated 10-year CHD risk by smoking status and weight change following smoking cessation.

Results: During a maximum of 8-year follow-up, both quitters with and without weight gain had a substantially decreased level of estimated 10-year CHD risk after quitting smoking, compared with sustained smokers (all ps for mean differences < .001). The estimated 10-year CHD risk within the first year after cessation decreased more rapidly in quitters without weight gain than in quitters with weight gain (change rate [95% confidence interval, CI] -0.90 [-1.04 to -0.75] vs. -0.40 [-0.60 to -0.19] % per year, p < .0001). Thereafter, the estimated 10-year CHD risk in both groups increased at similar rates (change rate [95% CI] -0.07 [-0.21 to 0.07] vs. 0.11 [-0.09 to 0.30] % per year, p = .16, from year 1 to year 2; and 0.10 [0.05 to 0.15] vs. 0.11 [0.04 to 0.18] % per year, p = .80, from year 2 to year 8).

Conclusions: In this population of middle-aged, Japanese male workers, smoking cessation greatly reduces the estimated 10-year risk of CHD. However, weight gain weakens the beneficial effect of quitting smoking in a temporary and limited fashion.

Implications: To the best of our knowledge, this study is the first to examine the effect of weight gain following smoking cessation on the trajectory of the absolute risk of CHD. Our data imply that the benefits of cessation for reducing the absolute risk of CHD outweigh the potential risk increase due to weight gain, and suggest that in order to maximize the beneficial effects of quitting smoking, interventions to control post-cessation weight gain might be warranted.
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http://dx.doi.org/10.1093/ntr/ntz165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789946PMC
January 2021

Smoking Cessation, Weight Gain, and the Trajectory of Estimated Risk of Coronary Heart Disease: 8-Year Follow-up From a Prospective Cohort Study.

Nicotine Tob Res 2021 01;23(1):85-91

Mitsui Chemicals, Inc, Tokyo, Japan.

Introduction: The effect of weight gain following smoking cessation on cardiovascular risks is unclear. We aimed to prospectively investigate the association of weight gain following smoking cessation with the trajectory of estimated risks of coronary heart disease (CHD).

Methods: In a cohort of 18 562 Japanese male employees aged 30-64 years and initially free of cardiovascular diseases, participants were exclusively grouped into sustained smokers, quitters with weight gain (body weight increase ≥5%), quitters without weight gain (body weight increase <5% or weight loss), and never smokers. Global 10-year CHD risk was annually estimated by using a well-validated prediction model for the Japanese population. Linear mixed models and piecewise linear mixed models were used to compare changes in the estimated 10-year CHD risk by smoking status and weight change following smoking cessation.

Results: During a maximum of 8-year follow-up, both quitters with and without weight gain had a substantially decreased level of estimated 10-year CHD risk after quitting smoking, compared with sustained smokers (all ps for mean differences < .001). The estimated 10-year CHD risk within the first year after cessation decreased more rapidly in quitters without weight gain than in quitters with weight gain (change rate [95% confidence interval, CI] -0.90 [-1.04 to -0.75] vs. -0.40 [-0.60 to -0.19] % per year, p < .0001). Thereafter, the estimated 10-year CHD risk in both groups increased at similar rates (change rate [95% CI] -0.07 [-0.21 to 0.07] vs. 0.11 [-0.09 to 0.30] % per year, p = .16, from year 1 to year 2; and 0.10 [0.05 to 0.15] vs. 0.11 [0.04 to 0.18] % per year, p = .80, from year 2 to year 8).

Conclusions: In this population of middle-aged, Japanese male workers, smoking cessation greatly reduces the estimated 10-year risk of CHD. However, weight gain weakens the beneficial effect of quitting smoking in a temporary and limited fashion.

Implications: To the best of our knowledge, this study is the first to examine the effect of weight gain following smoking cessation on the trajectory of the absolute risk of CHD. Our data imply that the benefits of cessation for reducing the absolute risk of CHD outweigh the potential risk increase due to weight gain, and suggest that in order to maximize the beneficial effects of quitting smoking, interventions to control post-cessation weight gain might be warranted.
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http://dx.doi.org/10.1093/ntr/ntz165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789946PMC
January 2021

Serum amino acid profiles and risk of type 2 diabetes among Japanese adults in the Hitachi Health Study.

Sci Rep 2019 05 7;9(1):7010. Epub 2019 May 7.

Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.

Amino acids have emerged as novel biomarkers for predicting type 2 diabetes (T2D), but the epidemiologic data linking circulating amino acid profiles with T2D are sparse in Asian populations. We conducted a nested case-control study within a cohort of 4,754 nondiabetic Japanese employees who attended a comprehensive health checkup in 2008-2009 and agreed to provide blood samples. During a 5-year follow-up, incident T2D cases were ascertained based on plasma glucose, glycated hemoglobin, and self-report. Two controls matched to each case on sex, age, and the date of serum sampling were randomly selected by using density sampling, resulting in 284 cases and 560 controls with amino acid measures. High concentrations of valine, leucine, isoleucine, phenylalanine, tyrosine, alanine, glutamate, ornithine, and lysine were associated with an increased risk of incident T2D, in a linear manner. High glutamine concentrations were associated with a decreased risk of incident T2D. Further adjustment for the homeostasis model assessment of insulin resistance attenuated these associations. Overall, these amino acids may be novel useful biomarkers in the identification of people at risk of T2D before overt symptoms. Insulin resistance may account for or mediate the relationship between these amino acids and risk of incident T2D.
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http://dx.doi.org/10.1038/s41598-019-43431-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6504928PMC
May 2019

Personal and Social Environmental Correlates of Square Dancing Habits in Chinese Middle-Aged and Older Adults Living in Communities.

J Aging Phys Act 2019 09 1;27(5):696–702. Epub 2019 Sep 1.

This study aimed to examine personal and social environmental correlates of the physical activity habit of middle-aged and older adults, using Chinese square dancing as a natural exploratory example. Participants were 385 adults aged ≥45 years (93% female), who habitually danced on squares or parks of three old districts of Guangzhou. Multinomial logistic regression was used to identify personal, social, psychological, and behavioral correlates of multiyear dance. Old age, high education, sufficient leisure time, and stable social environmental factors were associated with persistent dancing, whereby education (relative risk ratio [RRR] = 1.64, 95% confidence interval [1.05, 2.57]) and social engagement (RRR = 1.66, 95% confidence interval [1.05, 2.63]) showed the largest effects. Participants dancing ≤1 year were least satisfied with their social relationships than their counterparts dancing 1-5 years (RRR = 0.68) or over 5 years (RRR = 0.58). Physical activity promotion for older adults should adapt from culturally appropriate group activities and leverage community social resources to encourage voluntary participation, particularly for low-educated older women.
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http://dx.doi.org/10.1123/japa.2018-0310DOI Listing
September 2019

Health-related quality of life and influencing factors among migrant children in Shaoxing, China.

Health Qual Life Outcomes 2017 Aug 30;15(1):100. Epub 2017 Aug 30.

Department of Nursing, School of Medicine, Shaoxing University, No.900 Chengnan Avenue Shaoxing, Zhejiang Province, 312000, China.

Background: Due to increasing export of labor service, many children following their parents leave from rural areas to urban areas in China. These migrant children might have psychological stress and lower quality of life. However, even up to this day, little is known about the health-related quality of life (HRQoL) of the migrant children. This study aims at investigating their living conditions and exploring the influencing factors of migrant children's HRQoL.

Methods: A cross-sectional survey of 856 migrant children, aged between 7 and 17, was conducted in Shaoxing. The 4 PedsQL 4.0 Generic Core Scales (Physical, Emotional, Social, School) were administered to reveal migrant children's quality of life, while demographic data questionnaire, Egna Minnen av. Barndoms Uppfostran and Social Support Rating Scale were used to reflect the influencing factors.

Results: For 824 effective questionnaires(all items were completed without any inconsistency in a questionnaire and all the information in the questionnaire is believable), the average age of these children was 12.80 ± 1.91.The average years that they stayed in Shaoxing were 6.41 years. The average score of HRQoL was 81.13 ± 10.77, Physical Functioning was 84.83 ± 12.49, Emotional Functioning was 71.32 ± 18.34, Social Functioning was 86.28 ± 14.12, and School Functioning was79.28 ± 13.16. There was no obvious difference (F = 0.138, P = 0.711) between boys and girls as for PedsQL. The score of PedsQL did not show significant association with migrant children's gender and their school records, while school grade, the relationships with classmates, parental rearing style and social support showed significant correlations. Linear regression analysis showed that mother's rejection, subjective support, father's rejection, relationships with classmates, mother's overprotection and level of using social support were influencing factors on PedsQL of migrant children.

Conclusions: Migrant children scored lower on health-related quality of life, which was associated with parental rejection, mother's overprotection, less subjective support, badly getting along with classmates and that they cannot use social support well.
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http://dx.doi.org/10.1186/s12955-017-0679-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576309PMC
August 2017

Metal-Organic Frameworks Derived Okra-like SnO Encapsulated in Nitrogen-Doped Graphene for Lithium Ion Battery.

ACS Appl Mater Interfaces 2017 Apr 13;9(16):14309-14318. Epub 2017 Apr 13.

School of Metallurgy and Environment, Central South University , Changsha 410083, China.

A facile process is developed to prepare SnO-based composites through using metal-organic frameworks (MOFs) as precursors. The nitrogen-doped graphene wrapped okra-like SnO composites ([email protected]) are successfully synthesized for the first time by using Sn-based metal-organic frameworks (Sn-MOF) as precursors. When utilized as an anode material for lithium-ion batteries, the [email protected] composites possess a remarkably superior reversible capacity of 1041 mA h g at a constant current of 200 mA g after 180 charge-discharge processes and excellent rate capability. The excellent performance can be primarily ascribed to the unique structure of 1D okra-like SnO in [email protected] which are actually composed of a great number of SnO primary crystallites and numerous well-defined internal voids, can effectively alleviate the huge volume change of SnO, and facilitate the transport and storage of lithium ions. Besides, the structural stability acquires further improvement when the okra-like SnO are wrapped by N-doped graphene. Similarly, this synthetic strategy can be employed to synthesize other high-capacity metal-oxide-based composites starting from various metal-organic frameworks, exhibiting promising application in novel electrode material field of lithium-ion batteries.
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http://dx.doi.org/10.1021/acsami.7b04584DOI Listing
April 2017

Age-related cognitive decline and associations with sex, education and apolipoprotein E genotype across ethnocultural groups and geographic regions: a collaborative cohort study.

PLoS Med 2017 Mar 21;14(3):e1002261. Epub 2017 Mar 21.

Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia.

Background: The prevalence of dementia varies around the world, potentially contributed to by international differences in rates of age-related cognitive decline. Our primary goal was to investigate how rates of age-related decline in cognitive test performance varied among international cohort studies of cognitive aging. We also determined the extent to which sex, educational attainment, and apolipoprotein E ε4 allele (APOE*4) carrier status were associated with decline.

Methods And Findings: We harmonized longitudinal data for 14 cohorts from 12 countries (Australia, Brazil, France, Greece, Hong Kong, Italy, Japan, Singapore, Spain, South Korea, United Kingdom, United States), for a total of 42,170 individuals aged 54-105 y (42% male), including 3.3% with dementia at baseline. The studies began between 1989 and 2011, with all but three ongoing, and each had 2-16 assessment waves (median = 3) and a follow-up duration of 2-15 y. We analyzed standardized Mini-Mental State Examination (MMSE) and memory, processing speed, language, and executive functioning test scores using linear mixed models, adjusted for sex and education, and meta-analytic techniques. Performance on all cognitive measures declined with age, with the most rapid rate of change pooled across cohorts a moderate -0.26 standard deviations per decade (SD/decade) (95% confidence interval [CI] [-0.35, -0.16], p < 0.001) for processing speed. Rates of decline accelerated slightly with age, with executive functioning showing the largest additional rate of decline with every further decade of age (-0.07 SD/decade, 95% CI [-0.10, -0.03], p = 0.002). There was a considerable degree of heterogeneity in the associations across cohorts, including a slightly faster decline (p = 0.021) on the MMSE for Asians (-0.20 SD/decade, 95% CI [-0.28, -0.12], p < 0.001) than for whites (-0.09 SD/decade, 95% CI [-0.16, -0.02], p = 0.009). Males declined on the MMSE at a slightly slower rate than females (difference = 0.023 SD/decade, 95% CI [0.011, 0.035], p < 0.001), and every additional year of education was associated with a rate of decline slightly slower for the MMSE (0.004 SD/decade less, 95% CI [0.002, 0.006], p = 0.001), but slightly faster for language (-0.007 SD/decade more, 95% CI [-0.011, -0.003], p = 0.001). APOE*4 carriers declined slightly more rapidly than non-carriers on most cognitive measures, with processing speed showing the greatest difference (-0.08 SD/decade, 95% CI [-0.15, -0.01], p = 0.019). The same overall pattern of results was found when analyses were repeated with baseline dementia cases excluded. We used only one test to represent cognitive domains, and though a prototypical one, we nevertheless urge caution in generalizing the results to domains rather than viewing them as test-specific associations. This study lacked cohorts from Africa, India, and mainland China.

Conclusions: Cognitive performance declined with age, and more rapidly with increasing age, across samples from diverse ethnocultural groups and geographical regions. Associations varied across cohorts, suggesting that different rates of cognitive decline might contribute to the global variation in dementia prevalence. However, the many similarities and consistent associations with education and APOE genotype indicate a need to explore how international differences in associations with other risk factors such as genetics, cardiovascular health, and lifestyle are involved. Future studies should attempt to use multiple tests for each cognitive domain and feature populations from ethnocultural groups and geographical regions for which we lacked data.
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http://dx.doi.org/10.1371/journal.pmed.1002261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360220PMC
March 2017

Influence of social support and rearing behavior on psychosocial health in left-behind children.

Health Qual Life Outcomes 2017 Jan 19;15(1):13. Epub 2017 Jan 19.

Department of Nursing, School of Medicine, Shaoxing University, No.900 Chengnan Avenue, Shaoxing, 312000, Zhejiang Province, China.

Background: The purpose of this study is to examine psychological health of left-behind children (LBC), social support and rearing behavior towards LBC as well as their correlations in the city of Shaoxing, China.

Methods: By stratified sampling, 401 LBC and 527 non-left-behind children (NLBC) had completed the questionnaires in 2014. Spearman's correlation was performed to clarify the relationship between psychological health, social support and rearing behavior in LBC. Multiple linear regression analytical methods were used to identify the variables that were associated with psychological health.

Results: Compared to NLBC, LBC got lower scores in psychological health, general social support, subjective support and emotional warmth, but higher in rejection. Psychological health was positively correlated with social support, and negatively with rearing behavior (rejection, overprotection) in LBC. It was also closely connected with the subjective support, rejection and general health status.

Conclusion: These data show that LBC suffer significant impairment on psychological health, and receive less social support and worse rearing behavior than NLBC. Psychological health may be affected by subjective support, rejection, and general health status. Urgent government assessment and support from the community, school, mental health systems are warranted.
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http://dx.doi.org/10.1186/s12955-017-0592-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5248492PMC
January 2017

Association between participation in social activity and physical fitness in community-dwelling older Japanese adults.

Nihon Koshu Eisei Zasshi 2016 ;63(12):727-737

Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University.

Purpose This study aimed to examine the relationship between participation in social activity and both, composite and individual measures of physical fitness in community-dwelling older adults.Methods This study was conducted using baseline data from the Sasaguri Genkimon Study (SGS), a longitudinal cohort study conducted in 2011. Participants were 1,365 community-dwelling men and women aged 65 years or above, who did not require certified nursing care and who resided in Sasaguri, a town located east of the Fukuoka metropolitan area. Participation in social activity was assessed by asking participants whether they engaged in any of eight social activities. Physical fitness tests assessed participants' handgrip strength and knee extension strength as measures of muscle strength, and their one-leg standing time, 5-m maximum gait speed, and 5-repetition sit-to-stand rate as measures of their physical performance. Multiple linear regression and logistic regression analyses were conducted to assess the relationship between participation in social activity and each measure of physical fitness, adjusting for sex; age; body mass index; socioeconomic status; solitary living; exercise, habitual drinking and smoking; accelerometer-measured, moderate-to-vigorous physical activity; cognitive function; instrumental activities of daily living; distress; social network; and comorbidities.Results A total of 83.6% of the participants were engaged in at least one social activity. After adjusting for potential confounders, engagement in social activity was positively associated with a higher composite physical fitness score, faster gait speed and 5-repetition sit-to-stand rate, and longer one-leg standing time (P=0.008, P=0.030, P=0.034, and P=0.009, respectively).Conclusion Participation in social activity was significantly associated with physical fitness, specifically those related to locomotive function. These associations were independent of various confounders including socioeconomic status, and comorbidities.
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http://dx.doi.org/10.11236/jph.63.12_727DOI Listing
March 2018

Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study.

BMC Public Health 2016 08 26;16:888. Epub 2016 Aug 26.

Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.

Background: This study aimed to examine the associations between time spent in prolonged and non-prolonged sedentary bouts and the development of metabolic syndrome.

Methods: We used data from a prospective study of Japanese workers. Baseline examination was conducted between 2010 and 2011. A total of 430 office workers (58 women) aged 40-64 years without metabolic syndrome were followed up by annual health checkups until 2014. Metabolic syndrome was defined as having ≥ 3 out of 5 diagnostic criteria from the Joint Interim Statement 2009 definition. Sedentary time was assessed using a tri-axial accelerometer. Time spent in total, prolonged (accumulated ≥ 30 min) and non-prolonged sedentary bouts (accumulated < 30 min) was calculated. Cox proportional hazards models were used to estimate the risk of developing metabolic syndrome.

Results: During a median follow-up of 3 years, 83 participants developed metabolic syndrome. After adjustment for age, sex, education, smoking, and family income, positive associations were observed between time spent in prolonged sedentary bouts and the development of metabolic syndrome. After additional adjustment for moderate-to-vigorous physical activity, those in the three highest quartiles of time spent in prolonged sedentary bouts showed higher risk of metabolic syndrome compared to the lowest quartile group, with adjusted hazard ratios (95 % confidence intervals) of 2.72 (1.30 - 5.73), 2.42 (1.11 - 5.50), and 2.85 (1.31 - 6.18), respectively. No associations were seen for time spent in total and non-prolonged sedentary bouts.

Conclusions: Sedentary behavior accumulated in a prolonged manner was associated with an increased risk of metabolic syndrome. In devising public health recommendations for the prevention of metabolic disease, the avoidance of prolonged uninterrupted periods of sedentary behavior should be considered.
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http://dx.doi.org/10.1186/s12889-016-3570-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000401PMC
August 2016

Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study.

BMC Public Health 2016 08 26;16:888. Epub 2016 Aug 26.

Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.

Background: This study aimed to examine the associations between time spent in prolonged and non-prolonged sedentary bouts and the development of metabolic syndrome.

Methods: We used data from a prospective study of Japanese workers. Baseline examination was conducted between 2010 and 2011. A total of 430 office workers (58 women) aged 40-64 years without metabolic syndrome were followed up by annual health checkups until 2014. Metabolic syndrome was defined as having ≥ 3 out of 5 diagnostic criteria from the Joint Interim Statement 2009 definition. Sedentary time was assessed using a tri-axial accelerometer. Time spent in total, prolonged (accumulated ≥ 30 min) and non-prolonged sedentary bouts (accumulated < 30 min) was calculated. Cox proportional hazards models were used to estimate the risk of developing metabolic syndrome.

Results: During a median follow-up of 3 years, 83 participants developed metabolic syndrome. After adjustment for age, sex, education, smoking, and family income, positive associations were observed between time spent in prolonged sedentary bouts and the development of metabolic syndrome. After additional adjustment for moderate-to-vigorous physical activity, those in the three highest quartiles of time spent in prolonged sedentary bouts showed higher risk of metabolic syndrome compared to the lowest quartile group, with adjusted hazard ratios (95 % confidence intervals) of 2.72 (1.30 - 5.73), 2.42 (1.11 - 5.50), and 2.85 (1.31 - 6.18), respectively. No associations were seen for time spent in total and non-prolonged sedentary bouts.

Conclusions: Sedentary behavior accumulated in a prolonged manner was associated with an increased risk of metabolic syndrome. In devising public health recommendations for the prevention of metabolic disease, the avoidance of prolonged uninterrupted periods of sedentary behavior should be considered.
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http://dx.doi.org/10.1186/s12889-016-3570-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000401PMC
August 2016

Tri-Axial Accelerometer-Determined Daily Physical Activity and Sedentary Behavior of Suburban Community-Dwelling Older Japanese Adults.

J Sports Sci Med 2015 Sep 11;14(3):507-14. Epub 2015 Aug 11.

Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan ; Faculty of Arts and Science, Kyushu University , Fukuoka, Japan.

Knowledge regarding accelerometer-derived physical activity (PA) and sedentary behavior (SED) levels is scarce for Japanese older adults. The aims of this study were therefore to 1) describe levels of PA and SED in Japanese community-dwelling older adults, using tri-axial accelerometer; 2) examine the variation of PA and SED with respect to sex, age, and body mass index (BMI). Participants of this study were from the baseline survey of the Sasaguri Genkimon Study, who were 65 years or older and not certified as those requiring long-term care. PA was assessed objectively for seven consecutive days using tri-axial accelerometer. A total of 1,739 participants (median age: 72 years, men: 38.0%) with valid PA data were included. Overall, participants in the present study spent 54.5% of their waking time being sedentary and 45.5% being active, of which 5.4% was moderate-to-vigorous physical activity (MVPA). Women accumulated more minutes of light physical activity (LPA) and MVPA compared with men. In contrast, men spent more time being sedentary. Mean steps per day did not differ between sexes. Furthermore, participants with higher BMI (BMI ≥25) had lower PA levels, and longer SED compared with those with lower BMI (BMI <). PA levels were lower and SED was longer with age. The present study is the first to demonstrate that the levels of PA and SED differed by sex, age, and BMI in Japanese community-dwelling older adults. In particular, women were more active compared with men, providing unique insight into the current level of PA in older adults. Data presented in the study will enable further investigation of additional determinants of PA and SED in order to develop effective population-based intervention strategies to promote PA and reduce prolonged SED in the Japanese population and possibly other rapidly aging societies. Key pointsAccelerometer, that is capable to assess PA more precisely in large scale epidemiological studies, provides opportunity for improving understanding of daily PA in older adults.This study first demonstrated that the levels of PA and SED differed by sex, age, and BMI in Japanese community-dwelling older people.Women were more active compared with men, in terms of more minutes of MVPA.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541113PMC
September 2015

Associations of Sedentary Time and Breaks in Sedentary Time With Disability in Instrumental Activities of Daily Living in Community-Dwelling Older Adults.

J Phys Act Health 2016 Mar 14;13(3):303-9. Epub 2015 Jul 14.

Dept of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan.

Background: This cross-sectional study was performed to examine associations of objectively measured sedentary time (ST) and breaks in sedentary time (BST) with instrumental activities of daily living (IADL) disability in Japanese community-dwelling older adults.

Methods: The sample comprised 1634 older adults (mean age: 73.3 y, men: 38.4%). Sedentary behavior was measured using a triaxial accelerometer. Disability was defined as inability in at least 1 of the IADL tasks using the Tokyo Metropolitan Institute of Gerontology Index of Competence.

Results: After adjusting for potential confounders and moderate-to-vigorous physical activity (MVPA), longer ST was significantly associated with higher likelihood of IADL disability, whereas a greater number of BST was associated with lower likelihood of IADL disability. ST and BST remained statistically significant after mutual adjustment with odds ratio of 1.30 (95% confidence interval [CI)], 1.00-1.70) and 0.80 (95% CI, 0.65-0.99), respectively.

Conclusions: This study first demonstrated that shorter ST and more BST were associated with lower risk of IADL disability independent of MVPA and that the association for ST was independent of BST and vice versa. These findings suggest not only total ST but also the manner in which it is accumulated may contribute to the maintenance of functional independence in older adults.
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http://dx.doi.org/10.1123/jpah.2015-0090DOI Listing
March 2016