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Li H, Zhu L, Zhang J, Xue J. Prevalence, sociodemographic, and clinical correlates of underweight in a sample of Chinese male alcohol-dependent patients. Alcohol Alcohol 2024; 59:agae033. [PMID: 38773873 DOI: 10.1093/alcalc/agae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/22/2024] [Accepted: 05/09/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Underweight is a significant symptom in alcohol-dependent patients, yet few studies have examined underweight in Chinese male patients. The current study aimed to identify the prevalence, sociodemographic, and clinical correlates of underweight in Chinese male patients with alcohol dependency. METHODS In this cross-sectional study, 405 male inpatients with alcohol dependence and 383 healthy male controls were recruited. Participants' demographic and clinical data, including anthropometric data, were collected. We first conducted univariate analysis to identify seven variables with significant differences between groups: smoking behavior, hospitalization, alcohol consumption, cerebral infarction, hypertension, Hamilton Depression Scale (HAMD) score, and Scale for Assessment of Negative Symptom (SANS) score. Then, binary logistic regression was used to assess their relationship with underweight, with a significance level of .05. RESULTS The prevalence of underweight was significantly higher in the study population than in the control group (2.99% vs. 2.87%; P < .001). Patients with underweight had significantly higher rates of smoking behavior and cerebral infarction, as well as higher scores of SANS and HAMD than non-underweight patients. The non-underweight patients had higher daily alcohol consumption and times of hospitalization. Furthermore, logistic regression analysis showed that smoking behavior [odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.03-7.80, P = .043)], cerebral infarction (OR = 5.20, 95% CI = 1.13-23.85, P = .036), SANS score (OR = 1.22, 95% CI = 1.16-1.28, P < .001), and HAMD score (OR = 1.06, 95% CI = 1.02-1.11, P = .005) were associated with underweight. CONCLUSIONS More than 20% of male alcohol-dependent patients in a Chinese sample were underweight. Some demographic and clinical variables independent correlates for underweight in alcohol-dependent patients. We need to focus on alcohol-dependent patients with smoking, cerebral infarction, depression, and more prominent negative symptoms.
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Affiliation(s)
- Huanfen Li
- Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Lifang Zhu
- Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Jie Zhang
- Department of Addiction, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Jun Xue
- Department of Social Affairs, Henan Normal University, 46 Jianshe Road E, Xinxiang MI453007, Henan, China
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Yi W, Wu H, Fu W, Feng H, Huang J, Li H, Song Z, Chen Y, Zheng Y, She S. Prevalence and Risk Factors of Non-Alcoholic Fatty Liver Disease (NAFLD) in Non-Obese Patients with Schizophrenia: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:841-849. [PMID: 38406266 PMCID: PMC10893889 DOI: 10.2147/dmso.s437811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 02/27/2024] Open
Abstract
Background To assess the prevalence and risk factors of NAFLD in non-obese patients with schizophrenia in a public psychiatric hospital in China. Methods A total of 1,305 adult inpatients with schizophrenia in 2019 were included in this retrospective study. Body mass index (BMI) ≥ 25 kg/m2 was considered obese, and BMI < 25 kg/m2 was considered non-obese. We obtained the data from electronic records of the Affiliated Brain Hospital of Guangzhou Medical University. Results A total of 1,045 non-obese patients and 260 obese patients were included in this study. The prevalence of NAFLD in non-obese patients was 25.0%, and it was much lower that in the obese patients (25.0% vs 64.6%, p < 0.001). Among the non-obese patients, there were significant differences in age, BMI, alanine aminotransferase (ALT), metabolic indices, and the prevalence of diabetes and hypertension between patients with NAFLD and patients without NAFLD. According to the results of binary logistic regression analysis, age, BMI, ALT, triglyceride (TG) and diabetes were significantly related to NAFLD among non-obese patients with schizophrenia. In contrast, HDL-C was was negatively associated with NAFLD among non-obese patients. Conclusion This study suggested that NAFLD was common in patients with schizophrenia, even in non-obese patients with schizophrenia. In non-obese patients with schizophrenia, age, BMI, ALT, TG and diabetes are significantly associated with NAFLD. Moreover, HDL-C level was an independent protective factor against NAFLD. Given the adverse outcomes of NAFLD, it is necessary to increase awareness of NAFLD in patients with schizophrenia, especially in non-obese patients with schizophrenia.
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Affiliation(s)
- Wenying Yi
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Haibo Wu
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Weibin Fu
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Huimei Feng
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Jie Huang
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Haijing Li
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Zhen Song
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Yuwei Chen
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Yingjun Zheng
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Shenglin She
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of China
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3
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Ma S, Ju P, Xia Q, Pan Z, Gao J, Zhang L, Gao H, Yan J, Zhang J, Wang K, Li C, Xie W, Zhu C. Automatic Thoughts, Self-Stigma, and Resilience Among Schizophrenia Patients with Metabolic Syndrome: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2023; 19:1195-1206. [PMID: 37220563 PMCID: PMC10200106 DOI: 10.2147/ndt.s407662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/28/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose The study aims to clarify the negative psychological state and resilience impairments of schizophrenia (SCZ) with metabolic syndrome (MetS) while evaluating their potential as risk factors. Patients and Methods We recruited 143 individuals and divided them into three groups. Participants were evaluated using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD)-24, Hamilton Anxiety Rating Scale (HAMA)-14, Automatic Thoughts Questionnaire (ATQ), Stigma of Mental Illness scale and Connor-Davidson Resilience Scale (CD-RISC). Serum biochemical parameters were measured by automatic biochemistry analyzer. Results The score of ATQ was highest in the MetS group (F = 14.5, p < 0.001), and the total score of CD-RISC, subscale tenacity score and subscale strength score of CD-RISC were lowest in the MetS group (F = 8.54, p < 0.001; F = 5.79, p = 0.004; F = 10.9, p < 0.001). A stepwise regression analysis demonstrated that a negative correlation was observed among the ATQ with employment status, high-density lipoprotein (HDL-C), and CD-RISC (β=-0.190, t=-2.297, p = 0.023; β=-0.278, t=-3.437, p = 0.001; β=-0.238, t=-2.904, p = 0.004). A positive correlation was observed among the ATQ with waist, TG, WBC, and stigma (β=0.271, t = 3.340, p = 0.001; β=0.283, t = 3.509, p = 0.001; β=0.231, t = 2.815, p = 0.006; β=0.251, t=-2.504, p = 0.014). The area under the receiver-operating characteristic curve analysis showed that among all independent predictors of ATQ, the TG, waist, HDL-C, CD-RISC, and stigma presented excellent specificity at 0.918, 0.852, 0.759, 0.633, and 0.605, respectively. Conclusion Results suggested that the non-MetS and MetS groups had grievous sense of stigma, particularly, high degree of ATQ and resilience impairment was shown by the MetS group. The TG, waist, HDL-C of metabolic parameters, CD-RISC, and stigma presented excellent specificity to predict ATQ, and the waist showed excellent specificity to predict low resilience level.
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Affiliation(s)
- Shenglan Ma
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Peijun Ju
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, People’s Republic of China
| | - Qingrong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Zhongde Pan
- Shanghai Key Laboratory of Forensic Medicine, Academy of Forensic Science, Shanghai, People’s Republic of China
| | - Jianliang Gao
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Loufeng Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Hua Gao
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Junwei Yan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Jie Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Keming Wang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Chao Li
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Wen Xie
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
| | - Cuizhen Zhu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
- Clinical Center for Psychiatry and Mental Health, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei, People’s Republic of China
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Chen CC, Nakano T, Hsu LW, Chu CY, Huang KT. Early Lipid Metabolic Effects of the Anti-Psychotic Drug Olanzapine on Weight Gain and the Associated Gene Expression. Neuropsychiatr Dis Treat 2022; 18:645-657. [PMID: 35355504 PMCID: PMC8958728 DOI: 10.2147/ndt.s345046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/09/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Atypical antipsychotics such as olanzapine often cause metabolic side effects such as obesity and diabetes, leading to an increased risk of nonalcoholic fatty liver disease. The aim of the present study was to investigate the effects of olanzapine treatment on hepatic lipid metabolism and its possible relationship with adipose tissue status. METHODS Using a female rat model, we investigated the effects of chronic olanzapine administration on the regulation of carbohydrate and lipid metabolism including lipid biosynthesis, oxidation, efflux, and lipolysis in liver and adipose tissue. RESULTS The body weight, liver mass and visceral adiposity after olanzapine treatment (2 mg/kg) for five weeks were not significantly different compared with vehicle controls. The serum level of triglycerides was higher in the vehicle controls than in olanzapine-treated rats. Unexpectedly, olanzapine treatment did not reduce glucose tolerance in our model. The expression of functional thermogenic protein uncoupling protein 1 (UCP1) was increased in brown adipose tissue (BAT) of the olanzapine group. Additionally, olanzapine treatment also reduced adipose inflammation in white adipose tissue (WAT). The transcription factor sterol regulatory element-binding protein (SREBP)-1c, a key early regulator of lipogenesis, was downregulated following olanzapine treatment. The expression of genes related to the triglycerides synthesis apparatus in the liver was upregulated in the olanzapine group. Olanzapine treatment induced genes involved in PPAR-α signaling and mitochondrial fatty acid oxidation in response to increased ATGL-mediated lipolysis in the liver. CONCLUSION Together, our findings suggest a complicated link between olanzapine therapy and metabolic disturbance and may garner interest in assessing the action of antipsychotic-induced metabolic disturbances.
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Affiliation(s)
- Chien-Chih Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Toshiaki Nakano
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Li-Wen Hsu
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia Yi Chu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuang-Tzu Huang
- Liver Transplantation Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Akamine Y, Kikuchi Y, Miura M. Effects on monotherapy and reduction of antipsychotic drugs by clozapine therapy in Japanese patients with treatment-resistant schizophrenia. J Clin Pharm Ther 2021; 46:1312-1318. [PMID: 33959995 DOI: 10.1111/jcpt.13432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/30/2021] [Accepted: 04/15/2021] [Indexed: 12/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The schizophrenia guidelines in Japan and many other countries describe clozapine as the first-choice drug for patients with treatment-resistant schizophrenia. However, there have been no reports to date on the effects of the introduction of clozapine on the prescription of other antipsychotics and concomitant drugs. METHODS In this study, we retrospectively investigated the prescription of antipsychotics and concomitant drugs before vs 6 months after and 12 months after switching to clozapine. RESULTS AND DISCUSSION Clozapine was introduced to 62 patients with treatment-resistant schizophrenia, and 51 patients continued on clozapine therapy. Six months after switching to clozapine, there was a significant decrease in the mean number of antipsychotic drugs (2.04 ± 0.75 vs 1.10 ± 0.30: p < 0.001) and in the mean chlorpromazine equivalent value (1024 ± 73 mg/day vs 781 ± 391 mg/day: p < 0.001) compared to before switching. Moreover, antipsychotic monotherapy increased from 24% to 90% after switching to clozapine. In addition, the number of concomitant benzodiazepines, anti-parkinson drugs and antidepressants also significantly decreased 6 and 12 months after switching to clozapine (p < 0.001 for benzodiazepines and anti-parkinson drugs, and p < 0.05 for antidepressants). WHAT IS NEW AND CONCLUSION Our study suggests that switching to clozapine may reduce the use of antipsychotic combination therapy, and may also reduce the number of concomitant drugs.
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Affiliation(s)
- Yumiko Akamine
- Department of Pharmacy, Akita University Hospital, Akita, Japan
| | - Yuka Kikuchi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Masatomo Miura
- Department of Pharmacy, Akita University Hospital, Akita, Japan
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Sugawara N, Yasui-Furukori N, Yamazaki M, Shimoda K, Mori T, Sugai T, Matsuda H, Suzuki Y, Ozeki Y, Okamoto K, Sagae T, Someya T. Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan. Neuropsychiatr Dis Treat 2020; 16:2229-2236. [PMID: 33061393 PMCID: PMC7533264 DOI: 10.2147/ndt.s269619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Reliable and easy screening for metabolic syndrome (MetS) is important for patients with schizophrenia. The aim of this study was to assess the predictive utility of body mass index (BMI) for MetS among patients with schizophrenia in Japan. METHODS In total, 8468 patients (4705 males, 3763 females) with schizophrenia or schizoaffective disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), or the International Classification of Diseases, tenth revision (ICD-10), were assessed for MetS using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (ATP III-A). We applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease. RESULTS The mean (± standard deviation) age of these patients was 57.4 ± 13.5 years. The prevalence of MetS was 20.4%. Among males, the SSLRs predicting MetS were 0.03 (95% CI 0.02-0.06), 0.54 (95% CI 0.48-0.60), 2.77 (95% CI 2.44-3.14) and 8.75 (95% CI 7.40-10.36) for BMI <20 kg/m2, 20 kg/m2 ≤ BMI < 25 kg/m2, 25 kg/m2≤ BMI < 28 kg/m2, and 28 kg/m2≤BMI, respectively. For females, the SSLRs predicting MetS were 0.08 (95% CI 0.05-0.12), 0.73 (95% CI 0.66-0.82), 2.50 (95% CI 2.16-2.90) and 4.83 (95% CI 4.12-5.67) for the same BMI categories, respectively. CONCLUSION The predictive utility of BMI is confirmed, and BMI has more predictive value in males than in females. Patients with a BMI of 28 kg/m2 or greater had a significantly higher SSLR than those with a BMI less than 28 kg/m2.
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Affiliation(s)
- Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.,Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.,Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan
| | - Manabu Yamazaki
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.,Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan
| | - Takao Mori
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Takuro Sugai
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan
| | - Hiroshi Matsuda
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Yutaro Suzuki
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan
| | - Yuji Ozeki
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2134, Japan
| | - Kurefu Okamoto
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan
| | - Toyoaki Sagae
- Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan.,Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Yamagata 992-0025, Japan
| | - Toshiyuki Someya
- Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan.,Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan
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7
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Kim SW, Park WY, Jhon M, Kim M, Lee JY, Kim SY, Kim JM, Shin IS, Yoon JS. Physical Health Literacy and Health-related Behaviors in Patients with Psychosis. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:279-287. [PMID: 30905128 PMCID: PMC6478081 DOI: 10.9758/cpn.2019.17.2.279] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/03/2018] [Accepted: 10/09/2018] [Indexed: 12/30/2022]
Abstract
Objective This study compared the levels of knowledge of physical illnesses and patterns of health behaviors between patients with psychosis and the general population. Methods A total of 712 participants were included in the study; 292 patients with a schizophrenia spectrum disorder and 420 healthy controls matched for age and gender. Questionnaires were administered to study participants to determine the level of knowledge of chronic physical illnesses such as cancer, hypertension, and diabetes mellitus and health-related behavior. Results from the two study groups were compared to identify differences in knowledge of physical illness and health-related behaviors. Results Compared with healthy controls, patients with psychosis were less likely to undergo regular medical check-ups and engage in exercise. Patients with psychosis had poorer knowledge of physical illnesses, and were more likely to smoke, be overweight, or have diabetes. Patients with psychosis were significantly less likely to acknowledge the importance of early detection of cancer and controlling hypertension and diabetes, independent of education and type of medical insurance. Patients who smoked were significantly less likely to agree with the statement on the relationship between smoking and physical illnesses. Patients not undergoing regular medical check-ups were significantly less likely to agree with statements concerning the need for cancer screening. Conclusion Patients with psychosis demonstrated lower levels of knowledge of physical illnesses and a lack of understanding of preventive behaviors. Low levels of knowledge were associated with poor health-related behaviors. Education of physical health should be provided to patients with psychosis.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School.,Gwangju Mental Health and Welfare Commission.,MindLink, Gwangju Bukgu Community Mental Health Center
| | | | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School.,MindLink, Gwangju Bukgu Community Mental Health Center
| | - Mina Kim
- Gwangju Mental Health and Welfare Commission.,Department of Nursing, Graduate School, Chonnam National University
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School.,Gwangju Mental Health and Welfare Commission.,MindLink, Gwangju Bukgu Community Mental Health Center
| | - Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School
| | - Jin-Sang Yoon
- Department of Psychiatry, Chonnam National University Medical School
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8
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Teasdale SB, Ward PB, Samaras K, Firth J, Stubbs B, Tripodi E, Burrows TL. Dietary intake of people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry 2019; 214:251-259. [PMID: 30784395 DOI: 10.1192/bjp.2019.20] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Severe mental illness (SMI) is thought to be associated with lower diet quality and adverse eating behaviours contributing towards physical health disparities. A rigorous review of the studies looking at dietary intake in psychotic disorders and bipolar disorder is lacking.AimsTo conduct a systematic, comprehensive evaluation of the published research on dietary intake in psychotic disorders and bipolar disorder. METHOD Six electronic databases were searched for studies reporting on dietary intakes in psychotic disorders and bipolar disorder. Dietary-assessment methods, and dietary intakes, were systematically reviewed. Where possible, data was pooled for meta-analysis and compared with healthy controls. RESULTS In total, 58 eligible studies were identified. People with SMI were found to have significantly higher dietary energy (mean difference 1332 kJ, 95% CI 487-2178 kJ/day, P = 0.002, g = 0.463) and sodium (mean difference 322 mg, 95% CI 174-490 mg, P < 0.001, g = 0.414) intake compared with controls. Qualitative synthesis suggested that higher energy and sodium intakes were associated with poorer diet quality and eating patterns. CONCLUSIONS These dietary components should be key targets for preventative interventions to improve weight and other physical health outcomes in people with SMI.Declaration of interestS.B.T. and E.T. have clinical dietitian appointments within the South Eastern Sydney Local Health District and do not receive any further funding.
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Affiliation(s)
- Scott B Teasdale
- Senior Mental Health Dietitian,Keeping the Body in Mind Program,South Eastern Sydney Local Health District; andSchool of Psychiatry,University of New South Wales,Australia
| | - Philip B Ward
- Professor of Psychiatry,School of Psychiatry,University of New South Wales;Schizophrenia Research Unit,South Western Sydney Local Health District; and Ingham Institute for Applied Medical Research,Australia
| | - Katherine Samaras
- Senior Staff Specialist (Endocrinology),Department of Endocrinology,St Vincent's Hospital; Diabetes and Metabolism Division,Garvan Institute of Medical Research; andSt Vincent's Clinical School,University of New South Wales,Australia
| | - Joseph Firth
- Senior Research Fellow, NICM Health Research Institute, Western Sydney University, Australia; andDivision of Psychology and Mental Health, Faculty of Biology, Medicine and Health,University of Manchester,UK
| | - Brendon Stubbs
- Head of Physiotherapy,Physiotherapy Department,South London and Maudsley NHS Foundation Trust; andHealth Service and Population Research Department and Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience,King's College London,UK
| | - Elise Tripodi
- Mental Health Dietitian,Keeping the Body in Mind Program,South Eastern Sydney Local Health District,Australia
| | - Tracy L Burrows
- Associate Professor in Nutrition and Dietetics,School of Health Sciences and Priority Research Centre for Physical Activity and Nutrition,University of Newcastle,Australia
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Oniki K, Saruwatari J. [A Multifaceted Approach regarding the Association of the DsbA-L Gene with the Risk of Obesity-related Diseases Based on Clinical Pharmacogenetics]. YAKUGAKU ZASSHI 2019; 139:53-60. [PMID: 30606929 DOI: 10.1248/yakushi.18-00163-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Adiponectin, the most abundant adipose tissue-derived adipocytokine, improves insulin sensitivity and has anti-inflammatory properties. Disulfide-bond A oxidoreductase-like protein (DsbA-L) is a key molecule in the multimerization of adiponectin (i.e., activation of adiponectin). In mice, liver-specific knockout of the Dsba-L gene impaired the mitochondrial function in hepatocytes and exacerbated the high-fat-diet-induced fatty liver. In addition, the DsbA-L mRNA level is negatively correlated with body mass index (BMI) in humans. We recently investigated the clinical impact of the DsbA-L gene on lifestyle-related diseases in Japanese subjects. We confirmed the influence of the common DsbA-L rs1917760 polymorphism on the multimerization of adiponectin, as well as the association of the polymorphism with the risk of obesity and non-alcoholic fatty liver disease, using prediction models based on a non-linear mixed effect model and/or structural equation models among elderly participants in a health screening program. We also observed a decreasing effect of DsbA-L polymorphism on the DsbA-L mRNA level in peripheral blood mononuclear cells, and an increasing effect of the polymorphism on the prevalence of excessive weight among schizophrenia patients at a high risk for obesity. These findings suggest that DsbA-L may be a key molecule associated with the development and progression of obesity and its related diseases. Therefore, genotyping the DsbA-L polymorphism and identifying patients at a high risk of developing obesity may help prevent obesity and its complications by facilitating targeted prevention and treatment programs for high-risk individuals.
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Affiliation(s)
- Kentaro Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | - Junji Saruwatari
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University.,Center for Clinical Pharmaceutical Sciences, Kumamoto University
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Sugawara N, Maruo K, Sugai T, Suzuki Y, Ozeki Y, Shimoda K, Someya T, Yasui-Furukori N. Prevalence of underweight in patients with schizophrenia: A meta-analysis. Schizophr Res 2018; 195:67-73. [PMID: 29054486 DOI: 10.1016/j.schres.2017.10.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/02/2017] [Accepted: 10/09/2017] [Indexed: 11/19/2022]
Abstract
AIMS Although the relationship between body mass index and all-cause mortality is U-shaped, underweight has received comparatively less attention than obesity. There is only limited evidence to date regarding underweight among patients with schizophrenia. This is the first meta-analysis to address the prevalence of underweight in these patients. METHODS We conducted database searches (PubMed, PsycINFO) to identify studies examining underweight in patients with schizophrenia. In total, 17 studies (18 groups) with 45,474 patients were included; data were extracted independently by two authors. A meta-analysis was performed to calculate the pooled prevalence of underweight in patients. RESULTS The pooled prevalence of underweight was 6.2% (95% CI=4.5-8.6) for the 18 groups, which included 45,474 patients with schizophrenia. The heterogeneity was I2=98.9% (95% Cl=98.7-99.1%). Four studies with 4 groups, consisting of 30,014 individuals, focused on Japanese inpatients with schizophrenia. The pooled prevalence of underweight among inpatients in these 4 groups was 17.6% (95% CI=15.5-20.0). Fourteen studies were conducted with non-Japanese inpatients and included 14 groups of 15,460 patients with schizophrenia. The pooled prevalence of underweight in non-Japanese inpatients was 4.6% (95% CI=3.9-5.4). The proportion of underweight in the 18 groups significantly varied between Japanese inpatients and other patients. CONCLUSIONS The results indicated that Japanese inpatients with schizophrenia have a high proportion of underweight. Future research should focus on evaluating interventions that target underweight.
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Affiliation(s)
- Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan.
| | - Kazushi Maruo
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takuro Sugai
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaro Suzuki
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
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Clerici M, de Bartolomeis A, De Filippis S, Ducci G, Maremmani I, Martinotti G, Schifano F. Patterns of Management of Patients With Dual Disorder (Psychosis) in Italy: A Survey of Psychiatrists and Other Physicians Focusing on Clinical Practice. Front Psychiatry 2018; 9:575. [PMID: 30483161 PMCID: PMC6243108 DOI: 10.3389/fpsyt.2018.00575] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/19/2018] [Indexed: 12/18/2022] Open
Abstract
Patients with severe psychotic disorders such as schizophrenia, schizoaffective, and bipolar disorders frequently suffer from concomitant substance use disorders (SUDs)-Dual Disorder (DD) patients. In order to better understand current practices for management of patients with psychotic episodes and concomitant SUD in Italy, we carried out a survey of psychiatrists on current routine practice among prescribers. These aspects can help to identify at-risk patients, improve current prescribing practices, and favor early intervention. An ad hoc survey of 17 questions was administered to psychiatrists via electronic polling and on-line distribution; 448 completed questionnaires were collected. Comorbid substance abuse was most frequently diagnosed within the context of anxiety disorder (46%), followed by bipolar disorder (25%), and schizophrenia/schizoaffective disorder (12%). The vast majority of respondents felt that patient management was becoming more complex due to substance abuse. The areas reported to be most affected in patients with SUD were functioning, interpersonal relations, and impulsivity, while sensory perception disorders, ideation, agitation, and impulsivity were the most frequently reported symptoms. In the acute setting, haloperidol was used as the first-line agent of choice followed by aripiprazole and olanzapine. In the maintenance phase, aripiprazole was the dominantly used first-line agent, followed by olanzapine. Almost half of respondents used long-acting agents, while about one-third did not. Among those prescribing long-acting agents, efficacy, control of impulsivity, and control of specific symptoms were cited as motivators, while in the maintenance phase, better adherence, and tolerability were mainly cited. From the responses to the present survey, it is clear that the respondents are aware of the problem of SUD in psychotic patients. While treatment be optimized in terms of the choice and formulation of antipsychotics, greater emphasis should be placed on efficacy, tolerability, and the negative metabolic consequences of some antipsychotics. When considering the ideal antipsychotic, long-acting agents were considered to be superior in reducing relapse, even if current treatment guidelines often give preference to oral formulations.
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Affiliation(s)
- Massimo Clerici
- School of Medicine and Surgery-University of Milano Bicocca, Milan, Italy.,Psychiatric Department, Azienda Socio Sanitaria Territoriale (ASST) di Monza, Monza, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Sergio De Filippis
- Department of Neuropsychiatry, Villa von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Giuseppe Ducci
- Mental Health Department, Azienda Sanitaria Locale Roma 1, Rome, Italy
| | - Icro Maremmani
- Santa Chiara University Hospital, University of Pisa, Pisa, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio" Chieti-Pescara, Chieti, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Franch Pato CM, Molina Rodríguez V, Franch Valverde JI. Síndrome metabólico y antipsicóticos atípicos. Posibilidad de predicción y control. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:38-44. [DOI: 10.1016/j.rpsm.2016.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 09/02/2016] [Accepted: 09/27/2016] [Indexed: 12/19/2022]
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Sado J, Kitamura T, Noma N, Saito M, Azuma H, Azuma T, Sobue T, Kitamura Y. Socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan. Environ Health Prev Med 2016; 21:460-469. [PMID: 27448295 DOI: 10.1007/s12199-016-0550-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/03/2016] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE This study aimed to examine epidemiologically socio-environmental factors associated with diabetes mellitus among patients hospitalized with schizophrenia in Japan. METHODS This was a cross-sectional study from a single psychiatric hospital. Study patients were adults aged ≥20 years who were hospitalized with schizophrenia one or more times between January 2013 and December 2014. From electronic medical records or health insurance claims, we extracted schizophrenia patients with an F2 code according to ICD-10, and assessed the association of various factors with diabetes mellitus among these patients in a multivariable analysis. RESULTS During the 2-year period, there were 1899 patients hospitalized with a psychiatric disorder one or more times. Of them, a total of 770 adults with schizophrenia (285 men and 485 women) were eligible for our analysis. The standardized prevalence ratio of diabetes mellitus was 2.0 [95 % confidence interval (CI) 1.6-2.5] among men and 3.0 (95 % CI 2.5-3.6) among women in this hospital. There were no socio-environmental factors associated with diabetes mellitus among men. Among women, factors such as a 730-day hospitalization [adjusted odds ratio (OR) 3.82: 95 % confidence interval (CI) 1.52-9.64], and a medical protection/compulsory/discrimination hospitalization (adjusted OR 0.60, 95 % CI 0.36-0.99) were associated with diabetes mellitus. Compared with women living alone, those who were unmarried and lived together with someone had a significantly lower adjusted OR (0.41, 95 % CI 0.21-0.81). CONCLUSIONS Socio-environmental factors such as length of hospitalization, type of hospitalization, and marital status and living arrangement were associated with diabetes mellitus among hospitalized women with schizophrenia.
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Affiliation(s)
- Junya Sado
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan
| | - Norio Noma
- Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan
| | - Makiko Saito
- Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan
| | - Hitoshi Azuma
- Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan
| | - Tsukasa Azuma
- Social Welfare Corporation, Kosaka Hospital, 2-7-30 Eiwa, Higashi-Osaka, 577-0809, Osaka, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan
| | - Yuri Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, 565-0871, Osaka, Japan.
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