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Clinical Translationality of KCNJ5 Mutation in Aldosterone Producing Adenoma. Int J Mol Sci 2022; 23:ijms23169042. [PMID: 36012306 PMCID: PMC9409469 DOI: 10.3390/ijms23169042] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Hypertension due to primary aldosteronism poses a risk of severe cardiovascular complications compared to essential hypertension. The discovery of the KCNJ5 somatic mutation in aldosteroene producing adenoma (APA) in 2011 and the development of specific CYP11B2 antibodies in 2012 have greatly advanced our understanding of the pathophysiology of primary aldosteronism. In particular, the presence of CYP11B2-positive aldosterone-producing micronodules (APMs) in the adrenal glands of normotensive individuals and the presence of renin-independent aldosterone excess in normotensive subjects demonstrated the continuum of the pathogenesis of PA. Furthermore, among the aldosterone driver mutations which incur excessive aldosterone secretion, KCNJ5 was a major somatic mutation in APA, while CACNA1D is a leading somatic mutation in APMs and idiopathic hyperaldosteronism (IHA), suggesting a distinctive pathogenesis between APA and IHA. Although the functional detail of APMs has not been still uncovered, its impact on the pathogenesis of PA is gradually being revealed. In this review, we summarize the integrated findings regarding APA, APM or diffuse hyperplasia defined by novel CYP11B2, and aldosterone driver mutations. Following this, we discuss the clinical implications of KCNJ5 mutations to support better cardiovascular outcomes of primary aldosteronism.
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Tani T, Imai S, Fushimi K. Rehabilitation of Patients With Acute Ischemic Stroke Who Required Assistance Before Hospitalization Contributes to Improvement in Activities of Daily Living: A Nationwide Database Cohort Study. Arch Rehabil Res Clin Transl 2022; 4:100224. [PMID: 36545520 PMCID: PMC9761257 DOI: 10.1016/j.arrct.2022.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To assess the effect of early implementation of and longer daily duration of rehabilitation on patients with acute ischemic stroke who require assistance with activities of daily living (ADL) before hospital admission. DESIGN Nationwide, cohort, observational study from April 2018 to March 2019. SETTING Acute care hospitals in Japan. PARTICIPANTS The Japanese national Diagnosis Procedure Combination database was searched for the period between April 2018 and March 2019. Of the 330,672 patients with ischemic strokes identified, 53,523 met the inclusion criteria of being older than 20 years, having a prehospital modified Rankin Scale score of 3, 4, or 5, and having undergone rehabilitation (N=53,523). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Improvement in ADL from admission to discharge using the Barthel Index. The effects of the following 3 rehabilitation variables on ADL improvement were evaluated: (1) average daily duration of rehabilitation; (2) rehabilitation started within 3 days after admission (early rehabilitation); and (3) rehabilitation started 1 day after admission (very early rehabilitation). RESULTS Early rehabilitation was significantly associated with improvements in ADL (odds ratio, 1.19; 95% confidence interval, 1.10-1.28; P≤.001). A longer duration of rehabilitation was also significantly associated with ADL improvement (≥2.0 hours: odds ratio, 2.49; 95% confidence interval, 2.26-2.75; P≤.001) compared with a ≤1 hour of rehabilitation (1.1-2.0 hours: odds ratio, 1.35; 95% confidence interval, 1.29-1.42; P≤.001). CONCLUSIONS Early implementation of rehabilitation and a longer duration of rehabilitation per day improved the ADL of patients who required assistance before the onset of cerebral infarction.
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Affiliation(s)
- Takuaki Tani
- Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan,Clinical Research Center National Hospital Organization, Tokyo, Japan
| | - Shinobu Imai
- Clinical Research Center National Hospital Organization, Tokyo, Japan,Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Kiyohide Fushimi
- Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan,Clinical Research Center National Hospital Organization, Tokyo, Japan,Corresponding author Kiyohide Fushimi, MD, PhD, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
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Ono K, Murakami M, Tsubokura M. Was there an improvement in the years of life lost (YLLs) for non-communicable diseases in the Soma and Minamisoma cities of Fukushima after the 2011 disaster? A longitudinal study. BMJ Open 2022; 12:e054716. [PMID: 35383063 PMCID: PMC8984045 DOI: 10.1136/bmjopen-2021-054716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to determine cause-specific years of life lost (YLL) changes between predisaster and postdisaster in disaster-affected municipalities, compared with the national average. We estimated the YLL in Soma and Minamisoma cities (the subject area) in Fukushima, Japan, where the tsunami and the nuclear accident hit in 2011. PARTICIPANTS We used vital registration records from a national survey conducted between January 2006 and December 2015. We analysed 6369 death data in the predisaster period (2006-2010) and 6258 death data in the postdisaster period (2011-2015). METHODS We incorporated vital statistics data as follows: age-based, sex-based and International Classification of Diseases, 10th Revision-based cause-specific deaths and calculated YLLs by ages 0, 40, 65 and 75 and sex for attributable causes of death for heart diseases, cerebrovascular diseases, pneumonia, all cancers and specific cancers; breast cancer, colorectal cancer, leukaemia, lung cancer, stomach cancer and uterine cancer for predisaster and postdisaster in the subject area. RESULTS YLL attributed to heart diseases for males showed no decrease and YLL postdisaster was 0.37 years larger than that of the national average at age 0. The difference was -0.17 (95% uncertainty interval: -0.40 to 0.05) years at age 65. It decreased for females; the difference was 0.37 (0.18-0.57) years after the disaster. YLL decrease (that is, difference) in cerebrovascular diseases at age 0 was 0.27 (0.09-0.44) years and 0.18 (0.04-0.32) years; however, the YLLs postdisaster were still 0.24 and 0.25 years larger than those for the national average for males and females, respectively. YLL attributed to cancer did not increase even after the nuclear disaster. CONCLUSIONS We specified the causes of death to be reduced in disaster-affected areas in the future. This study emphasised the importance of understanding how the health situation changed for the whole society of the area from a comprehensive perspective, rather than focusing only on small mortality increases.
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Affiliation(s)
- Kyoko Ono
- Research Institute of Science for Safety and Sustainability, National Institute of Advanced Industrial Science and Technology Tsukuba West, Tsukuba, Ibaraki, Japan
| | - Michio Murakami
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
- Center for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan (current address)
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
- Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
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Dyson H, Van Gestel R, van Doorslaer E. The relative importance and stability of disease burden causes over time: summarizing regional trends on disease burden for 290 causes over 28 years. Popul Health Metr 2021; 19:30. [PMID: 34112193 PMCID: PMC8190735 DOI: 10.1186/s12963-021-00257-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since the Global Burden of Disease study (GBD) has become more comprehensive, data for hundreds of causes of disease burden, measured using Disability Adjusted Life Years (DALYs), have become increasingly available for almost every part of the world. However, undergoing any systematic comparative analysis of the trends can be challenging given the quantity of data that must be presented. METHODS We use the GBD data to describe trends in cause-specific DALY rates for eight regions. We quantify the extent to which the importance of 'major' DALY causes changes relative to 'minor' DALY causes over time by decomposing changes in the Gini coefficient into 'proportionality' and 'reranking' indices. RESULTS The fall in regional DALY rates since 1990 has been accompanied by generally positive proportionality indices and reranking indices of negligible magnitude. However, the rate at which DALY rates have been falling has slowed and, at the same time, proportionality indices have tended towards zero. These findings are clearest where the focus is exclusively upon non-communicable diseases. Notably, large and positive proportionality indices are recorded for sub-Saharan Africa over the last decade. CONCLUSION The positive proportionality indices show that disease burden has become less concentrated around the leading causes over time, and this trend has become less prominent as the DALY rate decline has slowed. The recent decline in disease burden in sub-Saharan Africa is disproportionally driven by improvements in DALY rates for HIV/AIDS, as well as for malaria, diarrheal diseases, and lower respiratory infections.
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Affiliation(s)
- Henry Dyson
- Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Raf Van Gestel
- Erasmus School of Health Policy and Management & Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Eddy van Doorslaer
- Erasmus School of Health Policy and Management & Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Kuwabara Y, Kinjo A, Fujii M, Imamoto A, Osaki Y, McNeill A, Beckley-Hoelscher N. Comparing Factors Related to Any Conventional Cigarette Smokers, Exclusive New Alternative Product Users, and Non-Users among Japanese Youth: A Nationwide Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093128. [PMID: 32365873 PMCID: PMC7246444 DOI: 10.3390/ijerph17093128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 12/27/2022]
Abstract
The impact of heated-tobacco-products (HTPs) and electronic cigarettes (e-cigarettes) on youth is a controversial public health issue, as it is unknown whether alternative products result in more youth using such products or smoking. In Japan, e-cigarettes with nicotine are prohibited, but e-cigarettes without nicotine are available. HTPs are marketed as tobacco products. Within this unique context, we aimed to compare any conventional cigarette smokers (including those who also used alternative products) with exclusive users of alternative products and examine factors relating to their use in Japan. In 2017, 22,275 students in grades 7–9 (age 12–15) and 42,142 in grades 10–12 (age 15–18) nationwide were surveyed. Overall, 1.8% were current users of any of the three products over the last month. Multivariable analysis revealed that risk factors for alternative product use were the same as those for cigarette use. Among all users, exclusive new product users were more likely to participate in club activities and intend to continue to higher education; any conventional cigarette users (including those who also used alternative products) were more likely to be exposed to secondhand smoke at home and to drink alcohol. Reducing adult smoking and disseminating health education remain relevant as strategies for preventing adolescents’ future tobacco use.
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Affiliation(s)
- Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (A.K.); (M.F.); (A.I.); (Y.O.)
- Correspondence: ; Tel.: +81-859-38-6103
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (A.K.); (M.F.); (A.I.); (Y.O.)
| | - Maya Fujii
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (A.K.); (M.F.); (A.I.); (Y.O.)
| | - Aya Imamoto
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (A.K.); (M.F.); (A.I.); (Y.O.)
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori 683-8503, Japan; (A.K.); (M.F.); (A.I.); (Y.O.)
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London SE5 8BB, UK;
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Association between Cardiovascular Mortality and Economic Development: A Spatio-Temporal Study for Prefectures in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041311. [PMID: 32085501 PMCID: PMC7068662 DOI: 10.3390/ijerph17041311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/22/2022]
Abstract
In this paper, we use a bivariate choropleth map to investigate the relationship between mortality from cardiovascular disease (CVD) and gross domestic product (GDP) per capita, by sex, in Japanese prefectures from 1996 to 2015. The overall results show a decline in age-standardized CVD mortality rates in all prefectures, for both men and women, and suggest that GDP per capita has varied over the period. We also observed that the relationship between CVD mortality rates and GDP per capita at the prefecture level does not have an overall pattern of the same or inverse association, but is instead a heterogeneous relationship. We argue that this study provides useful clues to policy makers for establishing effective measures for public health planning and the prevention of deaths from CVD. As demonstrated by this study, mapping of the CVD burden in Japan helps to clarify regional differences in life expectancy and health status across regions and identify prefectures where more targeted policy attention may be needed.
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Arai H, Mortaki K, Rane P, Quinn C, Zhao Z, Qian Y. Estimating Years of Life Lost Due to Cardiovascular Disease in Japan. Circ J 2019; 83:1006-1010. [PMID: 30918222 DOI: 10.1253/circj.cj-18-1216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In Japan, the burden associated with myocardial infarction (MI) and ischemic stroke as well as atherosclerotic cardiovascular disease (ASCVD) generally is high. One key element in measuring disease burden is years of life lost (YLL). The aim of this study was to understand the burden of these diseases by estimating YLL at an overall disease level and average person-YLL (PYLL), a measure of disease burden also used in prior studies. Methods and Results: Because calculation of YLL and PYLL involves inputs such as disease prevalence, disease-related mortality by age, and general population mortality by age and sex, we searched public databases of disease surveillance to identify comprehensive Japanese-specific inputs. For our reference analysis, disease-specific prevalence and mortality were taken from the Institute for Health Metrics and Evaluation Global Disease Burden study, and background mortality data were from the Japanese life tables published by the Ministry of Health, Labour and Welfare. The average age of patients with MI or stroke was 74 and 70 years, respectively. On average, men comprised 59% and 54% of the MI and stroke population, respectively. The disease-level burden of ASCVD (inclusive of MI, stroke, and peripheral artery disease) was 2,703,711 YLL in 2017. The patient-level burden was 11.99 PYLL for MI and 9.39 PYLL for stroke. CONCLUSIONS The burden of ASCVD, MI, and stroke in terms of premature mortality is substantial in Japan, both on a population disease level and an individual patient level.
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Yoon SJ, Go DS, Park H, Jo MW, Oh IH, Kim YE. The Korean National Burden of Disease Study: from Evidence to Policy. J Korean Med Sci 2019; 34:e89. [PMID: 30923492 PMCID: PMC6434148 DOI: 10.3346/jkms.2019.34.e89] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/27/2018] [Indexed: 01/26/2023] Open
Abstract
Following the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), disability-adjusted life years (DALYs) have been widely used as a summary measure of population health. The DALY metric is a comprehensive measurement of population health, enabling comparison among groups. However, the available data and reliance on estimates to supplement the data gap require contextualization at the national level, and the outcomes of which are more appropriate for national policymakers. The Korean National Burden of Disease (KNBD) study was initiated by the Research and Development Project of the Ministry of Health and Welfare, funded by a 5-year grant from 2013, to contextualize the GBD method to the Korean population. Here, we provide a comprehensive overview of the KNBD study with its achievements and challenges and discuss the implications for public health policies.
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Affiliation(s)
- Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dun-Sol Go
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Tanaka A, Takeuchi K, Furuta M, Takeshita T, Suma S, Shinagawa T, Shimazaki Y, Yamashita Y. Relationship of toothbrushing to metabolic syndrome in middle-aged adults. J Clin Periodontol 2018; 45:538-547. [PMID: 29421856 DOI: 10.1111/jcpe.12876] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 01/05/2023]
Abstract
AIM To examine the effect of toothbrushing on the development of metabolic syndrome (MetS), including assessment of periodontal status, in middle-aged adults. METHODS This 5-year follow-up retrospective study was performed in 3,722 participants (2,897 males and 825 females) aged 35-64 years who underwent both medical check-ups and dental examinations. Metabolic components included obesity, elevated triglycerides, blood pressure, fasting glucose and reduced high-density lipoprotein. Toothbrushing frequency was assessed using a questionnaire. Periodontal disease was defined as having at least one site with a pocket depth of ≥4 mm. Logistic regression analysis was performed to evaluate the relationship between toothbrushing frequency at the baseline examination and the development of MetS (≥3 components). RESULTS During follow-up, 11.1% of participants developed MetS. After adjusting for potential confounders including periodontal disease, participants with more frequent daily toothbrushing tended to have significantly lower odds of developing MetS (p for trend = .01). The risk of development of MetS was significantly lower in participants brushing teeth ≥3 times/day than in those brushing teeth ≤1 time/day (odds ratio = 0.64, 95% confidence interval = 0.45-0.92). CONCLUSIONS Frequent daily toothbrushing was associated with lower risk of development of MetS.
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Affiliation(s)
- Akihiko Tanaka
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shino Suma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | | | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Wong JQ, Uy J, Haw NJL, Valdes JX, Bayani DBS, Bautista CAP, Haasis MA, Bermejo RA, Zeck W. Priority Setting for Health Service Coverage Decisions Supported by Public Spending: Experience from the Philippines. Health Syst Reform 2017. [DOI: 10.1080/23288604.2017.1368432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | - Jhanna Uy
- EpiMetrics, Inc., Parañaque City, Philippines
| | | | | | | | - Charl Andrew P. Bautista
- Health Policy Development and Planning Bureau, Department of Health, Santa Cruz, Manila, Philippines
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Nomura S, Sakamoto H, Glenn S, Tsugawa Y, Abe SK, Rahman MM, Brown JC, Ezoe S, Fitzmaurice C, Inokuchi T, Kassebaum NJ, Kawakami N, Kita Y, Kondo N, Lim SS, Maruyama S, Miyata H, Mooney MD, Naghavi M, Onoda T, Ota E, Otake Y, Roth GA, Saito E, Tabuchi T, Takasaki Y, Tanimura T, Uechi M, Vos T, Wang H, Inoue M, Murray CJL, Shibuya K. Population health and regional variations of disease burden in Japan, 1990-2015: a systematic subnational analysis for the Global Burden of Disease Study 2015. Lancet 2017; 390:1521-1538. [PMID: 28734670 PMCID: PMC5613077 DOI: 10.1016/s0140-6736(17)31544-1] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Japan has entered the era of super-ageing and advanced health transition, which is increasingly putting pressure on the sustainability of its health system. The level and pace of this health transition might vary across regions within Japan and concern is growing about increasing regional variations in disease burden. The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides a comprehensive, comparable framework. We used data from GBD 2015 with the aim to quantify the burden of disease and injuries, and to attribute risk factors in Japan at a subnational, prefecture-level. METHODS We used data from GBD 2015 for 315 causes and 79 risk factors of death, disease, and injury incidence and prevalence to measure the burden of diseases and injuries in Japan and in the 47 Japanese prefectures from 1990 to 2015. We extracted data from GBD 2015 to assess mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), life expectancy, and healthy life expectancy (HALE) in Japan and its 47 prefectures. We split extracted data by prefecture and applied GBD methods to generate estimates of burden, and attributable burden due to known risk factors. We examined the prefecture-level relationships of common health system inputs (eg, health expenditure and workforces) to the GBD outputs in 2015 to address underlying determinants of regional health variations. FINDINGS Life expectancy at birth in Japan increased by 4·2 years from 79·0 years (95% uncertainty interval [UI] 79·0 to 79·0) to 83·2 years (83·1 to 83·2) between 1990 and 2015. However, the gaps between prefectures with the lowest and highest life expectancies and HALE have widened, from 2·5 to 3·1 years and from 2·3 to 2·7 years, respectively, from 1990 to 2015. Although overall age-standardised death rates decreased by 29·0% (28·7 to 29·3) from 1990 to 2015, the rates of mortality decline in this period substantially varied across the prefectures, ranging from -32·4% (-34·8 to -30·0) to -22·0% (-20·4 to -20·1). During the same time period, the rate of age-standardised DALYs was reduced overall by 19·8% (17·9 to 22·0). The reduction in rates of age-standardised YLDs was very small by 3·5% (2·6 to 4·3). The pace of reduction in mortality and DALYs in many leading causes has largely levelled off since 2005. Known risk factors accounted for 34·5% (32·4 to 36·9) of DALYs; the two leading behavioural risk factors were unhealthy diets and tobacco smoking in 2015. The common health system inputs were not associated with age-standardised death and DALY rates in 2015. INTERPRETATION Japan has been successful overall in reducing mortality and disability from most major diseases. However, progress has slowed down and health variations between prefectures is growing. In view of the limited association between the prefecture-level health system inputs and health outcomes, the potential sources of regional variations, including subnational health system performance, urgently need assessment. FUNDING Bill & Melinda Gates Foundation, Japan Ministry of Education, Science, Sports and Culture, Japan Ministry of Health, Labour and Welfare, AXA CR Fixed Income Fund and AXA Research Fund.
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Affiliation(s)
- Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Scott Glenn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Yusuke Tsugawa
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Sarah K Abe
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Md M Rahman
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jonathan C Brown
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Satoshi Ezoe
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA
| | - Tsuyoshi Inokuchi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Nicholas J Kassebaum
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington, Seattle, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Norito Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yosuke Kita
- Health Promotion Division, Yamaguchi Prefectural Government, Yamaguchi, Japan
| | - Naoki Kondo
- Department of Health and Social Behaviour, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Satoshi Maruyama
- Department of Health Services Research and Policy, Stanford University, Stanford, CA, USA
| | - Hiroaki Miyata
- Department of Global Health Systems and Innovation, Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Meghan D Mooney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Tomoko Onoda
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Yuji Otake
- Health and Welfare Bureau, Hokkaido Prefectural Government, Hokkaido, Japan
| | - Gregory A Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Eiko Saito
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan; Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Yohsuke Takasaki
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Tadayuki Tanimura
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Manami Uechi
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Manami Inoue
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, School of Public Health, The University of Tokyo, Tokyo, Japan; Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
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12
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Kassebaum N, Smith A, Bernabé E, Fleming T, Reynolds A, Vos T, Murray C, Marcenes W. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017; 96:380-387. [PMID: 28792274 PMCID: PMC5912207 DOI: 10.1177/0022034517693566] [Citation(s) in RCA: 1003] [Impact Index Per Article: 143.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Global Burden of Disease 2015 study aims to use all available data of
sufficient quality to generate reliable and valid prevalence, incidence, and
disability-adjusted life year (DALY) estimates of oral conditions for the period
of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY
estimates were based on years lived with disability, which are estimated only on
those persons with unmet need for dental care. We used our data to assess
progress toward the Federation Dental International, World Health Organization,
and International Association for Dental Research’s oral health goals of
reducing the level of oral diseases and minimizing their impact by 2020. Oral
health has not improved in the last 25 y, and oral conditions remained a major
public health challenge all over the world in 2015. Due to demographic changes,
including population growth and aging, the cumulative burden of oral conditions
dramatically increased between 1990 and 2015. The number of people with
untreated oral conditions rose from 2.5 billion in 1990 to 3.5 billion in 2015,
with a 64% increase in DALYs due to oral conditions throughout the world.
Clearly, oral diseases are highly prevalent in the globe, posing a very serious
public health challenge to policy makers. Greater efforts and potentially
different approaches are needed if the oral health goal of reducing the level of
oral diseases and minimizing their impact is to be achieved by 2020. Despite
some challenges with current measurement methodologies for oral diseases,
measurable specific oral health goals should be developed to advance global
public health.
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Affiliation(s)
- N.J. Kassebaum
- Department of Anesthesiology and
Pain Medicine, University of Washington, Seattle, WA, USA
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - A.G.C. Smith
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - E. Bernabé
- Division of Population and Patient
Health, King’s College London Dental Institute, London, UK
| | - T.D. Fleming
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - A.E. Reynolds
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - T. Vos
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - C.J.L. Murray
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - W. Marcenes
- Division of Population and Patient
Health, King’s College London Dental Institute, London, UK
- W. Marcenes, Division of Population and
Patient Health, King’s College London Dental Institute, Bessemer Road, Demark
Hill, London SE5 9RW, UK.
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13
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The secular trends of disease burden attributed to tobacco smoke in Taiwan 1990-2013. J Formos Med Assoc 2017; 117:3-5. [PMID: 28549590 DOI: 10.1016/j.jfma.2017.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/30/2017] [Accepted: 05/05/2017] [Indexed: 11/22/2022]
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14
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Lee WK, Lim D, Park H. Disability-Adjusted Life Years (DALYs) for Injuries Using Death Certificates and Hospital Discharge Survey by the Korean Burden of Disease Study 2012. J Korean Med Sci 2016; 31 Suppl 2:S200-S207. [PMID: 27775258 PMCID: PMC5081302 DOI: 10.3346/jkms.2016.31.s2.s200] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/05/2016] [Indexed: 01/27/2023] Open
Abstract
A system for assessing the burdens imposed by disease and injury was developed to meet healthcare, priority setting, and policy planning needs. The first such system, the Global Burden of Disease (GBD), was implemented in 1990. However, problems associated with limited data and assumed disability weightings remain to be resolved. The purpose of the present study was to estimate national burdens of injuries in Korea using more reliable data and disability weightings. The incidences of injuries were estimated using the Korean National Hospital Discharge Survey and the mortality data from the Korean National Statistical Office in 2010. Additionally, durations of injuries and age at injury onset were used to calculate disability-adjusted life years (DALY) using disability weightings derived from the Korean Burden of Disease (KBD) study. Korea had 1,581,072 DALYs resulting from injuries (3,170 per 100,000), which was 22.9% higher than found by the GBD 2010 study. Males had almost twice as heavy an injury burden as females. Road injury, fall, and self-harm ranked 1st, 2nd, and 3rd in terms of burden of injury in 2010. Total injury burden peaked in the forties, while burden per person declined gradually from early adulthood. We hope that this study contributes to the reliable evaluation of injury burden and a better understanding of injury-related health status using nation-specific, dependable data.
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Affiliation(s)
- Won Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Dohee Lim
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
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15
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Whiteford H, Ferrari A, Degenhardt L. Global Burden Of Disease Studies: Implications For Mental And Substance Use Disorders. Health Aff (Millwood) 2016; 35:1114-20. [DOI: 10.1377/hlthaff.2016.0082] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Harvey Whiteford
- Harvey Whiteford ( ) is a professor of population mental health in the School of Public Health, University of Queensland, in Brisbane, Australia
| | - Alize Ferrari
- Alize Ferrari is a research fellow at the Queensland Centre for Mental Health Research, in Brisbane
| | - Louisa Degenhardt
- Louisa Degenhardt is a professor at the National Drug and Alcohol Research Center at the University of New South Wales, in Sydney, Australia
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16
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Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386:743-800. [PMID: 26063472 PMCID: PMC4561509 DOI: 10.1016/s0140-6736(15)60692-4] [Citation(s) in RCA: 4310] [Impact Index Per Article: 478.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. METHODS Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. FINDINGS Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. INTERPRETATION Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries. FUNDING Bill & Melinda Gates Foundation.
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17
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Devleesschauwer B, Maertens de Noordhout C, Smit GSA, Duchateau L, Dorny P, Stein C, Van Oyen H, Speybroeck N. Quantifying burden of disease to support public health policy in Belgium: opportunities and constraints. BMC Public Health 2014; 14:1196. [PMID: 25416547 PMCID: PMC4246467 DOI: 10.1186/1471-2458-14-1196] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 10/24/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To support public health policy, information on the burden of disease is essential. In recent years, the Disability-Adjusted Life Year (DALY) has emerged as the most important summary measure of public health. DALYs quantify the number of healthy life years lost due to morbidity and mortality, and thereby facilitate the comparison of the relative impact of diseases and risk factors and the monitoring of public health over time. DISCUSSION Evidence on the disease burden in Belgium, expressed as DALYs, is available from international and national efforts. Non-communicable diseases and injuries dominate the overall disease burden, while dietary risks, tobacco smoking, and high body-mass index are the major risk factors for ill health. Notwithstanding these efforts, if DALYs were to be used for guiding health policy, a more systematic approach is required. By integrating DALYs in the current data generating systems, comparable estimates, rooted in recent local data, can be produced. This might however be hampered by several restrictions, such as limited harmonization, timeliness, inclusiveness and accessibility of current databases. SUMMARY Routine quantification of disease burden in terms of DALYs would provide a significant added value to evidence-based public health policy in Belgium, although some hurdles need to be cleared.
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Affiliation(s)
- Brecht Devleesschauwer
- />Institute of Health and Society (IRSS), Faculty of Public Health, Université catholique de Louvain, Brussels, Belgium
- />Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | | | - G Suzanne A Smit
- />Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Luc Duchateau
- />Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pierre Dorny
- />Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
- />Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Claudia Stein
- />Division of Information, Evidence, Research, and Innovation, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Herman Van Oyen
- />Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Niko Speybroeck
- />Institute of Health and Society (IRSS), Faculty of Public Health, Université catholique de Louvain, Brussels, Belgium
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