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Song H, Zhang D, Chen Z, Wang R, Tang S, Bishwajit G, Chen S, Feng D, Wu T, Wang Y, Su Y, Feng Z. Utilisation of national community-based blood pressure monitoring service among adult Chinese and its association with hypertension treatment and blood pressure control-a mediation analysis. BMC Geriatr 2019; 19:162. [PMID: 31182039 PMCID: PMC6558874 DOI: 10.1186/s12877-019-1176-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/31/2019] [Indexed: 12/20/2022] Open
Abstract
Background Community-based blood pressure (BP) monitoring plays an important role in national hypertension management in China. However, the utilisation of this service, together with its associations on hypertension treatment and BP control has not been fully investigated. Methods The study population was from the China Health and Retirement Longitudinal Study (CHARLS) in 2015. Cross-sectional data of 2487 hypertensive persons were included as subjects. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Finally, 21,097 individuals were interviewed successfully. The main outcome was hypertension control (having average BP under 140-90 mmHg). The main independent variable was utilisation of community-based BP monitoring service (having BP examination once a season or more). The mediators were hypertension treatment (currently taking any antihypertensive medicine) and lifestyle factors (alcohol intake, physical activity, smoke). We performed chi-square and binary logistic regression to analyse associations of BP monitoring with hypertension treatment and blood pressure control. The mediation model was examined by the Sobel test. Results Mean age of the population was 64.2 (0.24). The percentage of males was 42.8%. Prevalence of community-based BP monitoring was 32.1%. Patients who used this service had higher odds of hypertension treatment (β = 1.259, P < 0.01, OR = 3.52, CI = 2.467–5.030), and BP control (β = 0.220, P < 0.05, OR = 1.246, CI = 1.035–1.499). Medication treatment played a complete mediating role between monitoring and hypertension control in this study (t = 4.51, P < 0.001). Those who underwent BP monitoring tended to be those who did not finish primary school education (χ2 = 30.300, P < 0.001), had poorer household income (χ2 = 18.298, P < 0.05), and lived in rural areas rather than in urban areas (χ2 = 40.369, P < 0.001). Conclusions Although the use of BP monitoring service had no direct effect on BP control, it had a positive effect on BP control through the full mediation effect of hypertension treatment. Termly BP monitoring by community-based health expertise among hypertensive persons, for instance, once a season, can be recommended to public health policymakers for BP control through instructions on medication treatment and health behaviours.
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Affiliation(s)
- Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Donglan Zhang
- College of Public Health, University of Georgia, 305B Wright Hall, Health Sciences Campus, 100 Foster Road, Athens, Georgia
| | - Zhuo Chen
- College of Public Health, University of Georgia, 305B Wright Hall, Health Sciences Campus, 100 Foster Road, Athens, Georgia
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, 75 Laurier Avenue East, Ottawa, ON, Canada
| | - Shanquan Chen
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Sha Tin, N.T, Hong Kong, SAR, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Tailai Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Yang Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Yanwei Su
- School of Nursing, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China.
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Inequalities in Structural Social Capital and Health between Migrant and Local Hypertensive Patients. Ann Glob Health 2019; 85. [PMID: 30924617 PMCID: PMC6634561 DOI: 10.5334/aogh.2398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Inequality in health between migrant and local hypertensive patients is an important public health concern. This study aims to examine the associations of registration status with structural social capital and health of hypertensive patients, as well as how structural social capital operates in the relationship between registration status and health. METHODS We conducted an on-site based cross-sectional study in Shenzhen, China. A total of 1046 participants completed the survey. Information with respect to structural social capital, subjective and objective health outcomes was collected. Multiple logistic or linear regression models were used to test the associations across registration status, structural social capital and health outcomes. RESULTS The findings show that migrant hypertensive patients have lower structural social capital in terms of social contacts (10.87 vs. 10.41; β = -0.457, 95% CI: -0.866, -0.048) and poorer health outcomes, i.e., blood pressure control (56.4 vs. 43.6%; OR = 0.557, 95% CI: 0.364, 0.852) when compared to the local individuals. Meanwhile, individuals with lower structural social capital report poorer self-rated health. However, the differences in structural social capital between migrant and local hypertensives explain only a small proportion of the large inequalities in blood pressure control. CONCLUSIONS Inequalities exist between migrant and local hypertensives in objective but not subjective health outcomes. Structural social capital associates with subjective health outcomes of hypertensive patients only. A modest extent of medication is found by structural social capital of registration health inequalities. Our study suggests that growing contacts providing support for migrant hypertensive patients should be an important goal of future strategies and policies. It also highlights the need for more research on mediating and moderating mechanisms in order to understand the relationship between registration status and health outcomes among hypertensive patients.
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Yang Y, Hozawa A, Kogure M, Narita A, Hirata T, Nakamura T, Tsuchiya N, Nakaya N, Ninomiya T, Okuda N, Kadota A, Ohkubo T, Okamura T, Ueshima H, Okayama A, Miura K. Dietary Inflammatory Index Positively Associated With High-Sensitivity C-Reactive Protein Level in Japanese From NIPPON DATA2010. J Epidemiol 2019; 30:98-107. [PMID: 30745493 PMCID: PMC6949183 DOI: 10.2188/jea.je20180156] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background It has been reported that chronic inflammation may play an important role in the pathogenesis of several serious diseases and could be modulated by diet. Recently, the Dietary Inflammatory Index (DII®) was developed to assess the inflammatory potential of the overall diet. The DII has been reported as relevant to various diseases but has not been validated in Japanese. Thus, in the present study, we analyzed the relationship between DII scores and high-sensitivity C-reactive protein (hs-CRP) levels in a Japanese population. Methods Data of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010), which contained 2,898 participants aged 20 years or older from the National Health and Nutrition Survey of Japan (NHNS2010), were analyzed. Nutrient intakes derived from 1-day semi-weighing dietary records were used to calculate DII scores. Energy was adjusted using the residual method. Levels of hs-CRP were evaluated using nephelometric immunoassay. Multiple linear regression analyses were performed. Results After adjusting for age, sex, smoking status, BMI, and physical activity, a significant association was observed between DII scores and log(CRP+1) (standard regression coefficient = 0.05, P < 0.01). Although it was not statistically significant, the positive association was consistently observed in almost all age-sex subgroups and the non-smoker subgroup. Conclusions The current study confirmed that DII score was positively associated with hs-CRP in Japanese.
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Affiliation(s)
- Yunqing Yang
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine
| | - Atsushi Hozawa
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Mana Kogure
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Akira Narita
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Takumi Hirata
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Tomohiro Nakamura
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Naho Tsuchiya
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Naoki Nakaya
- Division of Personalized Prevention and Epidemiology, Tohoku University Graduate School of Medicine.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Toshiharu Ninomiya
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | | | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science
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Wang L, Hou J, Hu C, Zhou Y, Sun H, Zhang J, Li T, Gao E, Wang G, Chen W, Yuan J. Mediating factors explaining the associations between polycyclic aromatic hydrocarbons exposure, low socioeconomic status and diabetes: A structural equation modeling approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 648:1476-1483. [PMID: 30340292 DOI: 10.1016/j.scitotenv.2018.08.255] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/19/2018] [Accepted: 08/19/2018] [Indexed: 06/08/2023]
Abstract
Exposure to polycyclic aromatic hydrocarbons (PAHs) is linked with increased risk of diabetes, whereas socioeconomic status (SES) may contribute to the development of diabetes. However, the mechanisms underlying the relationships between them are unclear. We used structural equation modeling (SEM) to identify mediating factors in the associations of PAHs exposure, low SES with diabetes risk. Data were collected from 2751 Wuhan participants at baseline from the Wuhan-Zhuhai Cohort Study (n = 3053). They answered the questionnaires regarding socio-demographic, participated physical examinations and provided urine samples for measurements of urinary monohydroxy-polycyclic aromatic hydrocarbons (OH-PAHs) levels. SEM was used to identify the mediating factors (such as hypertension, body mass index (BMI), triglycerides (TG) and total cholesterol (TCHO)) in the associations of low SES or PAHs exposure with diabetes risk. We observed that partial effect of PAHs exposure (β = 0.281, p = 0.034), BMI (β = 0.182, p = 0.000), TG (β = 0.358, p = 0.000), TCHO (β = 0.203, p = 0.009) or hypertension (β = 0.385, p = 0.000) on diabetes was directive. Moreover, low SES also exhibited a directive effect on PAHs exposure (β = -0.084, p = 0.000), BMI (β = 0.301, p = 0.000), hypertension (β = 0.134, p = 0.003) and TG (β = 0.087, p = 0.001). PAHs exposure directly affected TCHO levels (β = 0.080, p = 0.002) and TG (β = 0.076, p = 0.017). The proportion of the effect of PAHs exposure on diabetes mediated by TG and TCHO was 15.6%. The proportion of the effect of low SES on diabetes mediated by BMI, hypertension and TG was 89.1%. The results suggested that low SES increased diabetes risk, which may be partially explained by BMI, hypertension and triglycerides, and exposure to high levels of PAHs may have indirect contribution to increased risk for diabetes with dyslipidemia.
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Affiliation(s)
- Lu Wang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Jian Hou
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Chen Hu
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Yun Zhou
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Huizhen Sun
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Jiafei Zhang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Tian Li
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Erwei Gao
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Guiyang Wang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Weihong Chen
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Jing Yuan
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China..
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Goto R, Tanigawa T, Maruyama K, Tomooka K, Eguchi E, Osawa H, Saito I. Associations of snoring frequency with blood pressure among the lean Japanese population: the Toon Health Study. J Hum Hypertens 2019; 34:271-277. [PMID: 30622368 DOI: 10.1038/s41371-018-0148-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 01/10/2023]
Abstract
To date, there are few studies in Asian populations on the association between snoring (a major clinical symptom of sleep apnea) and hypertension. This study aims to examine whether snoring frequency is associated with blood pressure and hypertension in the general Japanese population, after adjustment for major confounding factors. A cross-sectional study of 2021 middle-aged Japanese men and women enrolled in the Toon Health Study between 2009-2012 was conducted. Snoring frequency was assessed using a self-reported questionnaire, and was classified into four categories: never, ≤2 times/week, ≥3 times/week, and unknown. Multivariable regression coefficients for each snoring category were calculated for systolic and diastolic blood pressure, and their odds ratios (ORs) and 95% confidence intervals (95% CIs) for hypertension were calculated after adjusting for major confounding factors. The same analyses were also conducted after stratification by several major confounding factors. Multivariable-adjusted means of systolic and diastolic blood pressure among individuals who snored ≥3 times/week were 4.57 mmHg and 2.58 mmHg higher, respectively, than in individuals who never snored (p < 0.05). The multivariable-adjusted OR (95% CI) for hypertension in the group that snored ≥3 times/week was 1.79 (1.29-2.48), compared with the group that never snored. We also found a significant positive association between snoring frequency and hypertension not only in normal and overweight individuals, but also in lean individuals (body mass index ≤22.8 kg/m2). Higher snoring frequency was associated with higher blood pressure and hypertension among both lean and non-lean Japanese.
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Affiliation(s)
- Ryoji Goto
- Ehime University School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Koutatsu Maruyama
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime, 790-8566, Japan
| | - Kiyohide Tomooka
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Eri Eguchi
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, 700-8558, Japan
| | - Haruhiko Osawa
- Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Oita, 879-5593, Japan
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Matei Ș, Cutler SJ, Preda M, Dorobanțu M, Ilinca C, Gheorghe-Fronea O, Rădulescu L, Oprescu N, Deaconu A, Zorilă C, Dorobanțu B. The Relationship Between Psychosocial Status and Hypertensive Condition. Curr Hypertens Rep 2018; 20:102. [DOI: 10.1007/s11906-018-0902-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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57
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Fujiyoshi N, Arima H, Satoh A, Ojima T, Nishi N, Okuda N, Kadota A, Ohkubo T, Hozawa A, Nakaya N, Fujiyoshi A, Okamura T, Ueshima H, Okayama A, Miura K. Associations between Socioeconomic Status and the Prevalence and Treatment of Hypercholesterolemia in a General Japanese Population: NIPPON DATA2010. J Atheroscler Thromb 2018; 25:606-620. [PMID: 29321397 PMCID: PMC6055037 DOI: 10.5551/jat.42531] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/09/2017] [Indexed: 01/16/2023] Open
Abstract
AIM To investigate associations between socioeconomic status (SES) and the prevalence and treatment status of hypercholesterolemia in a general Japanese population. METHODS In 2010, we established a cohort study of 2417 adults (age 20-91 yr) from 300 randomly selected areas across Japan who participated in the National Health and Nutrition Survey of Japan. We cross-sectionally examined an association between SES and (1) prevalence of hypercholesterolemia in 2417 participants (999 men and 1418 women) and (2) not receiving medication for hypercholesterolemia in 654 participants (215 men and 439 women). SES included employment status, marital status, length of education, and household expenditures. Hypercholesterolemia was defined as a total serum cholesterol level of ≥6.21 mmol/L (240 mg/dL) or the use of lipid-lowering medications. RESULTS The overall prevalence of hypercholesterolemia was 21.5% in men and 31.0% in women. In men, the lowest quintile of household expenditures was associated with a higher prevalence of hypercholesterolemia (28.3%) compared with the upper 4 quintiles (19.9%) (multivariable-adjusted odds ratio 1.66; 95% confidence interval [CI] 1.16-2.38). Among participants with hypercholesterolemia, 55.4% of men and 55.1% of women were not receiving medication. Unmarried men were more likely to be untreated (75.0%) than married men (50.9%) (multivariable-adjusted odds ratio 2.53;95%CI 1.05-6.08). SES had no significant effects in women. CONCLUSION In a general population of Japanese men, low household expenditures were associated with a higher prevalence of hypercholesterolemia, and unmarried men with hypercholesterolemia were less likely to receive medication.
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Affiliation(s)
- Naoko Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Hisatomi Arima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Atsushi Satoh
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
| | - Akira Okayama
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
| | - NIPPON DATA2010 Research Group
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
- Department of Hygiene and Public Health Teikyo University School of Medicine, Tokyo, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
- Research Institute of Strategy for Prevention, Tokyo, Japan
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Kadota A, Okuda N, Ohkubo T, Okamura T, Nishi N, Ueshima H, Okayama A, Miura K. The National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010): Objectives, Design, and Population Characteristics. J Epidemiol 2018; 28 Suppl 3:S2-S9. [PMID: 29503381 PMCID: PMC5825689 DOI: 10.2188/jea.je20170240] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The structure and risk factors for cardiovascular diseases (CVD) in Japan may change because lifestyle, particularly nutrition, socioeconomic status, and medical care, which affect CVD, may markedly change over time. Therefore, a new prospective cohort study on a representative general Japanese population based on national surveys is required. Methods In November 2010, the baseline survey of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010) was performed with the National Health and Nutrition Survey of Japan (NHNS2010) in 300 randomly selected districts throughout Japan. The survey included a questionnaire, electrocardiogram, urinalysis, and blood biomarkers added to the NHNS2010 examinations. Physical measurements, blood biomarkers, and dietary data were also obtained in NHNS2010. Socioeconomic factors were obtained by merging with the Comprehensive Survey of Living Conditions 2010 (CSLC2010) dataset. Participants are followed annually for the incidence of diabetes mellitus, CVD events (acute coronary events, heart failure, atrial fibrillation, and stroke), and cause-specific mortality. The activities of daily living are followed every 5 years. Results A total of 2,898 individuals aged 20 years or older agreed to participate in the baseline survey of NIPPON DATA2010. The participation rate was 74.6%. Of these, data from NHNS2010 was merged for 2,891 participants (1,236 men and 1,655 women). The data of 2,807 participants were also merged with CSLC2010 data. Conclusions We established NIPPON DATA2010 as a cohort study on a representative general Japanese population that covers all of Japan.
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Affiliation(s)
- Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | | | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
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Prevalence, awareness, treatment, and control of hypertension among Chinese working population: results of a workplace-based study. ACTA ACUST UNITED AC 2018; 12:311-322.e2. [PMID: 29483001 DOI: 10.1016/j.jash.2018.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/18/2018] [Accepted: 01/30/2018] [Indexed: 12/21/2022]
Abstract
We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18-60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%-23.7%). Among the hypertensives, 47.8% (95% CI: 46.8%-48.8%) were aware of their condition, 20.6% (95% CI: 19.8%-21.4%) were in treatment, but only 8.5% (95% CI: 7.9%-9.1%) had controlled hypertension. White-collar employees had a lower odds of hypertension compared with the blue-collar (odds ratio: 0.77, 95% CI: 0.71-0.84), whereas the state-owned enterprise employees had a higher odds compared with their private enterprise counterparts (odds ratio: 1.69, 95% CI: 1.07-2.65). Lower awareness and treatment were associated with being younger, higher education, and those from workplace without affiliated hospital. Higher occupation status individuals were more likely to be treated but no sign of better control. There is substantial room for improvement in hypertension diagnosis and treatment among the employees. Effective intervention programs are urgently needed at the workplaces.
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60
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Nguyen M, Nishi N, Kadota A, Okuda N, Arima H, Fujiyoshi A, Nakano Y, Ohkubo T, Ueshima H, Okayama A, Miura K. Passive Smoking at Home by Socioeconomic Factors in a Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S40-S45. [PMID: 29503385 PMCID: PMC5825692 DOI: 10.2188/jea.je20170243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Long-term passive exposure to cigarette smoke has been reported to affect the health of non-smokers. This study aims to investigate the relationships among socioeconomic factors and passive smoking at home in the non-current smokers of a representative sample from a general Japanese population. METHODS Data are from NIPPON DATA2010. Among 2,891 participants, 2,288 non-current smokers (1,763 never smokers and 525 past smokers) were analyzed in the present study. Cross-sectional analyses were performed on the relationships among socioeconomic factors and passive smoking at home (several times a week or more) in men and women separately. Socioeconomic factors were employment, length of education, marital status, and equivalent household expenditure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a multivariable logistic regression model. RESULTS The multivariable-adjusted model showed that employed women had a higher risk of passive smoking than unemployed women (OR 1.44; 95% CI, 1.06-1.96). Women with 9 years or less of education had a higher risk of passive smoking at home than women with 13 years and more of education (OR 2.37; 95% CI, 1.49-3.78). Single women had a lower risk of passive smoking at home (OR 0.53; 95% CI, 0.37-0.77) than married women. No significant associations were observed in men. CONCLUSIONS An employed status, lower education, and being single were associated with passive smoking at home in the non-current smoking women of a representative Japanese population.
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Affiliation(s)
- Minh Nguyen
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Yasutaka Nakano
- Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
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61
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Goryoda S, Nishi N, Hozawa A, Yoshita K, Arai Y, Kondo K, Miyagawa N, Hayakawa T, Fujiyoshi A, Kadota A, Ohkubo T, Okamura T, Okuda N, Ueshima H, Okayama A, Miura K. Differences in Lifestyle Improvements With the Intention to Prevent Cardiovascular Diseases by Socioeconomic Status in a Representative Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S35-S39. [PMID: 29503384 PMCID: PMC5825687 DOI: 10.2188/jea.je20170254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/17/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The relationships among socioeconomic status and lifestyle improvements have not yet been examined in a representative Japanese population. METHODS We analyzed data from 2,647 participants (1,087 men and 1,560 women) who participated in NIPPON DATA2010. This survey inquired about lifestyle improvements and socioeconomic status. Education was categorized as low (≤9 years), middle (10-12 years), and high (≥13 years). Marital status was categorized as married, divorced, widowed, and never married/other. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of lifestyle improvements with the intention of preventing cardiovascular diseases for educational attainment and marital status, with adjustments for age and awareness of cardiovascular disease risk factors. RESULTS Overall, 1,507 (56.9%) participants practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome, and the OR of lifestyle improvements was significantly higher with a high education than with a low education in men (OR 2.86; 95% CI, 1.96-4.17) and women (OR 2.36; 95% CI, 1.67-3.33). The number of participants who practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome was significantly lower in divorced than in married men (OR 0.46; 95% CI, 0.22-0.95) and women (OR 0.53; 95% CI, 0.33-0.86). CONCLUSIONS Specific differences caused by educational attainment and marital status may exist in lifestyle improvements.
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Affiliation(s)
- Sayuri Goryoda
- The Disease Prevention Science Course, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Takehito Hayakawa
- Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Japan
| | - Akira Fujiyoshi
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
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Ota A, Yatsuya H, Nishi N, Okuda N, Ohkubo T, Hayakawa T, Kadota A, Okayama A, Miura K. Relationships among Socioeconomic Factors and Self-rated Health in Japanese Adults: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S66-S72. [PMID: 29503389 PMCID: PMC5825690 DOI: 10.2188/jea.je20170246] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The distributions of socioeconomic status (SES) factors have been changing in Japan. We examined the relationships among SES and self-rated health (SRH) in Japanese adults. METHODS We analyzed 1,178 men and 1,555 women. We showed the distribution of SRH by sex and age and examined cross-sectional relationships among educational attainment, marital/living statuses, working status, household income and expenditure, and fine SRH (defined as excellent, very good, or good). We adjusted for age, subjective symptoms, visiting doctors, monthly equivalent household expenditure (EHE), and living in their own house. RESULTS The age-standardized prevalence of fine SRH was 79% and 73% among men and women, respectively. Among men, graduating from high school (adjusted odds ratio [aOR] 1.53; 95% confidence interval [CI], 1.07-2.19, relative to graduating from elementary or junior high school) and university or junior college (aOR 1.74; 95% CI, 1.15-2.62) was associated with fine SRH. Among women, graduating from university or junior college was associated with fine SRH (aOR 1.65; 95% CI, 1.12-2.46). Neither marital/living status nor working status was associated with SRH after adjustments for age in either sex. Among women, high EHE and income were associated with fine SRH (the highest expenditure group: aOR 1.80; 95% CI, 1.22-2.65; the highest income group: aOR 2.15; 95% CI, 1.34-3.46, relative to the corresponding lowest group). These simple relationships were not observed for men. CONCLUSIONS High educational attainment was associated with fine SRH. Relationships among household income, EHE, and fine SRH differed by sex.
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Affiliation(s)
- Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Takehito Hayakawa
- Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
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Nakamura T, Nakamura Y, Saitoh S, Okamura T, Yanagita M, Yoshita K, Kita Y, Murakami Y, Yokomichi H, Nishi N, Okuda N, Kadota A, Ohkubo T, Ueshima H, Okayama A, Miura K. Relationship Between Socioeconomic Status and the Prevalence of Underweight, Overweight or Obesity in a General Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S10-S16. [PMID: 29503379 PMCID: PMC5825685 DOI: 10.2188/jea.je20170249] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20-64 or ≥65 years) in Japan. METHODS In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. We divided 2,491 participants (1,081 men and 1,410 women) according to the WHO definitions of underweight, overweight or obesity and performed multinomial logistic analyses using BMI <18.5 kg/m2 (underweight), BMI 25.0-29.9 kg/m2 (overweight), and BMI ≥30.0 kg/m2 (obese) versus BMI 18.5-24.9 kg/m2 (normal) as the outcome, with SES groups as the main explanatory variables. RESULTS In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio [OR] 0.41; 95% confidence interval [CI], 0.18-0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07-2.49 for overweight and OR 2.66; 95% CI, 1.01-7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36-17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY). CONCLUSIONS In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.
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Affiliation(s)
- Tomiyo Nakamura
- Department of Food Science and Human Nutrition, Ryukoku University, Shiga, Japan
| | - Yasuyuki Nakamura
- Department of Food Science and Human Nutrition, Ryukoku University, Shiga, Japan
| | - Shigeyuki Saitoh
- School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Masahiko Yanagita
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan
| | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Yoshikuni Kita
- Faculty of Nursing Science, Tsuruga Nursing University, Fukui, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, University of Yamanashi, Yamanashi, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
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Tsuji M, Arima H, Ohkubo T, Nakamura K, Takezaki T, Sakata K, Okuda N, Nishi N, Kadota A, Okamura T, Ueshima H, Okayama A, Miura K. Socioeconomic Status and Knowledge of Cardiovascular Risk Factors: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S46-S52. [PMID: 29503386 PMCID: PMC5825694 DOI: 10.2188/jea.je20170255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The relationship between socioeconomic status (SES) and knowledge of cardiovascular risk factors remains unknown in a general Japanese population. METHODS Of 8,815 participants from 300 randomly selected areas throughout Japan, 2,467 participants who were free of cardiovascular disease and who provided information on SES in the National Health and Nutrition Survey of Japan 2010 were enrolled in this cross-sectional analysis. SES was classified according to the employment status, length of education, marital and living statuses, and equivalent household expenditure (EHE). Outcomes were ignorance of each cardiovascular risk factor (hypertension, diabetes, hypercholesterolemia, low high-density lipoprotein [HDL] cholesterol, arrhythmia, and smoking) and insufficient knowledge (number of correct answers <4 out of 6). RESULTS A short education and low EHE were significantly associated with a greater ignorance of most cardiovascular risk factors. A short education (<10 years) was also associated with insufficient knowledge of overall cardiovascular risk factors: age- and sex-adjusted odds ratios (OR) were 1.92 (95% confidence interval [CI], 1.51-2.45) relative to participants with ≥13 years of education. Low EHE was also associated with insufficient knowledge (age- and sex-adjusted OR 1.24; 95% CI, 1.01-1.51 for the lowest quintile vs the upper 4 quintiles). These relationships remained significant, even after further adjustments for regular exercise, smoking, weekly alcohol consumption, body mass index, hypertension, diabetes mellitus, hypercholesterolemia, and low HDL cholesterol. CONCLUSION Participants with a short education and low EHE were more likely to have less knowledge of cardiovascular risk factors.
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Affiliation(s)
- Masayoshi Tsuji
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Koshi Nakamura
- Department of Public Health, Hokkaido University, Hokkaido, Japan
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University, Kagoshima, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Iwate, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
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Nagahata T, Nakamura M, Ojima T, Kondo I, Ninomiya T, Yoshita K, Arai Y, Ohkubo T, Murakami K, Nishi N, Murakami Y, Takashima N, Okuda N, Kadota A, Miyagawa N, Kondo K, Okamura T, Ueshima H, Okayama A, Miura K. Relationships among Food Group Intakes, Household Expenditure, and Education Attainment in a General Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S23-S28. [PMID: 29503382 PMCID: PMC5825688 DOI: 10.2188/jea.je20170248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population. METHODS This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance. RESULTS When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment. CONCLUSIONS Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits.
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Affiliation(s)
- Tomomi Nagahata
- Department of Nutrition, School of Health and Nutrition, Tokaigakuen University, Aichi, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Imako Kondo
- Department of Food and Nutritional Sciences, College of Bioscience and Biotechnology, Chubu University, Aichi, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Keiko Murakami
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
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