論文

目的:本研究は,更生保護施設を利用する薬物事犯者の特徴を明らかにし,健康格差との関連を調査すること目的とする.方法:本研究は,保護観察中の薬物犯罪者を対象にした地域コホート調査,Voice Bridges Project(VBP)のデータを用いて,VBP協力地域の23の保護観察所からリクルートされた20歳以上で主に覚醒剤を使用する677人の保護観察中の個人を分析した.調査開始時点における,更生保護施設利用者と非利用者を分類し,人口統計,健康,犯罪関連の特徴を比較した.更生保護施設利用者の健康格差を探るために,生活の質(QOL),健康満足度,薬物使用症の治療・支援プログラムの利用の3つのアウトカムとし,多変量分析を行った.結果:更生保護施設利用者は,非利用者と比較して,女性,高齢,離死別による単身者,教育水準が低い傾向にあった.再犯率が高く,身体的・精神的健康状態が悪い傾向にあった.社会保障制度や薬物使用症の治療・支援プログラムの利用は低かった.多変量分析では,更生保護施設利用とQOL,健康満足度,治療・支援のアクセスとの間に統計的に有意な負の関連があり,健康格差との関係が示された.結論:薬物事犯者の中で更生保護施設を利用する者は,非利用者と比べて,健康格差がある集団であることが明らかにされた.施設を利用する薬物事犯者に対して,健康格差を是正するための特別な措置と支援を提供するサポートシステムの検討が必要である.(著者抄録)

目的 塩味味覚閾値の高値は高血圧との関連が指摘されているが,その規定要因は明らかではない。都市部地域住民集団で塩味味覚閾値の規定要因を明らかにするとともに,複数の規定要因が同時に存在した場合の塩味味覚閾値との関連を明らかにすることを目的とした。方法 がんや循環器疾患の既往歴がなく,高血圧,糖尿病,脂質異常症の治療中ではない40～74歳の健康な都市部住民を対象としたコホート研究である神戸研究のベースライン調査参加者1,117人のうち,塩味味覚閾値検査を実施し,尿検査から推定一日食塩摂取量の結果が把握できる1,116人を対象者とした。塩味味覚閾値調査はソルセイブを用いて塩味味覚閾値0.6%を正常群,0.8%以上を高値群と定義した。塩味味覚閾値高値を目的変数,問診票から得られた生活状況,家族状況,教育歴,喫煙状況,飲酒状況,塩干物摂取状況,ストレス指標,推定一日食塩摂取量を説明変数として,二項ロジスティック回帰モデルにて検討した。さらに,説明変数を塩味味覚閾値に影響を与える要因,目的変数を塩味味覚閾値(正常/高値)として強制投入法を用いた多変量解析にて二項ロジスティック回帰分析を実施した。この分析では,推定一日食塩摂取量との多重共線性を考慮して,尿中ナトカリ比を除いて実施した。結果 平均年齢は男性60.9±9.0歳,女性58.0±8.7歳であった。塩味味覚閾値の正常群は80.9%(903人)(男性73.6%(251人),女性84.1%(652人)),高値群は19.1%(213人)(男性26.3%(90人),女性15.9%(123人))であった。多変量解析の結果,全対象者において現在喫煙習慣がある群は喫煙習慣が無い群と比較し,塩味味覚閾値高値となるオッズ比(95%信頼区間)が2.51(1.33-4.74)と有意な関連が認められた。また,推定一日食塩摂取量上位25%群では下位75%群と比較してオッズ比(95%信頼区間)が1.45(1.03-2.03)と塩味味覚閾値高値との有意な関連を認めた。男女別の解析では,男女ともに現在喫煙習慣と塩味味覚閾値高値との関連を認め,推定一日食塩摂取量は男性のみ関連を認めた。結論 健康な都市住民において,喫煙習慣と推定一日食塩摂取量の多さが塩味味覚閾値高値と関連していた。(著者抄録)

【目的】脂肪肝は内臓脂肪蓄積の肝臓における表現型とされており、過量飲酒は脂肪肝のリスク因子であることが知られている。Fatty liver index(FLI)は脂肪肝の予測能に優れ、特定健診の測定項目のみで算出可能であるため健診での活用が期待される。本研究では、地域住民における飲酒習慣およびインスリン抵抗性の指標であるHOMA-IRとFLI高値との関連について検討した。【方法】循環器疾患の既往がなく生活習慣病の治療を受けていない40～74歳の男女を対象とした神戸研究のベースライン調査参加者1,078名のデータを用いた横断研究である。飲酒習慣は現在飲酒の有無と1日飲酒量に基づき、男性を4群(なし、1合未満/日、1-2合/日、2合以上/日)、女性を3群(なし、1合未満/日、1合以上/日)に分類し、脂肪肝の存在が疑われるFLI30以上をFLI高値と定義した。飲酒習慣・HOMA-IRとFLI高値との関連は多変量ロジスティック回帰分析により検討し、オッズ比と95%信頼区間を算出した。【結果】全解析対象者1,078名(男性323名、女性755名、平均年齢58.9歳)のうち、FLI高値を認める者は172名(16.0%)であった。飲酒習慣とFLIとの関連において、男性では1-2合/日および≧2合/日の群でFLI高値と有意な正の関連を認め、女性では1合以上/日の群でFLI高値と有意な正の関連を認めた。また、HOMA-IRは男女ともにFLI高値と有意な正の関連を認めた。非肥満者に限定した解析でも同様の結果となった。【結論】非肥満者を中心とした地域住民において、1合以上/日の現在飲酒は男女ともFLI高値と有意な正の関連を認めた。非肥満者であっても日常的な飲酒量が多い者では脂肪肝に伴うインスリン抵抗性の増大が循環器疾患の発症につながる可能性があるため、減酒を推奨することが望ましい。また、FLIは非肥満者でもインスリン抵抗性を反映していることが示唆された。(著者抄録)

ABSTRACT: Previous studies from various countries have reported anti-dense fine speckled pattern (DFS)70 antibody prevalence but few studies have been from Asia. We investigated the prevalence of anti-DFS70 autoantibodies in a Japanese cohort of healthy individuals (HI) and patients with antinuclear antibody-associated autoimmune rheumatic diseases (AARD).Enzyme-linked immunosorbent assay and indirect immunofluorescence were performed using samples from 250 HI and 276 AARD patients.The overall anti-DFS70 antibody prevalence in HI was 16.4%, with 12.8% for males and 20.0% for females (sex difference; P = .12). In AARD patients, the anti-DFS70 antibody prevalence in systemic lupus erythematosus, mixed connective tissue disease, systemic sclerosis, dermatomyositis and polymyositis (DM/PM), Sjögren syndrome, and rheumatoid arthritis (RA) was 22.1%, 14.3%, 14.3%, 3.0%, 21.3%, and 18.1%, respectively (no significant difference between AARD patients except DM/PM and HI). The prevalence of isolated anti-DFS70 antibody in HI and all AARD patients excluding RA was 14.8% (37/250) and 4.4% (9/204), respectively (P  < .01 vs HI). Among anti-DFS70 antibody-positive cases, 63.4% (26/41) were DFS pattern by IIF and 23.5% (8/34) were HI and AARD patients excluding RA, respectively.The anti-DFS70 antibody prevalence in HI and AARD patients in Japan was similar. Furthermore, the anti-DFS70 antibody prevalence in HI and AARD in Japan is higher than in HI and AARD in regions other than Asia. This makes AARD differential diagnosis by antinuclear antibody screening difficult.

Background: Non-fasting triglycerides (TG) are considered a better predictor of cardiovascular disease (CVD) than fasting TG. However, the effect of non-fasting TG on fatal CVD events remains unclear. In the present study, we aimed to explore the relationship between non-fasting TG and CVD mortality in a Japanese general population. Methods: A total of 6,831 participants without a history of CVD, in which those who had a blood sampling over 8 hours or more after a meal were excluded, were followed for 18.0 years. We divided participants into seven groups according to non-fasting TG levels: ≤59 mg=dL, 60–89 mg=dL, 90–119 mg=dL, 120–149 mg=dL, 150–179 mg=dL, 180–209 mg=dL, and ≥210 mg=dL, and estimated the multivariable-adjusted hazard ratios (HRs) of each TG group for CVD mortality after adjusting for potential confounders, including high density lipoprotein cholesterol. Additionally, we performed analysis stratified by age <65 and ≥65 years. Results: During the follow-up period, 433 deaths due to CVD were detected. Compared with a non-fasting TG of 150–179 mg=dL, non-fasting TG ≥210 mg=dL was significantly associated with increased risk for CVD mortality (HR 1.56: 95% CI, 1.01–2.41). Additionally, lower levels of non-fasting TG were also significantly associated with increased risk for fatal CVD. In participants aged ≥65 years, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality, while higher levels of non-fasting TG had a stronger impact in those aged <65 years. Conclusion: In a general Japanese population, we observed a U-shaped association between non-fasting TG and fatal CVD events.

Currently, large-scale cohort studies for metabolome analysis have been launched globally. However, only a few studies have evaluated the reliability of urinary metabolome analysis. This study aimed to establish the reliability of urinary metabolomic profiling in cohort studies. In the Tsuruoka Metabolomics Cohort Study, 123 charged metabolites were identified and routinely quantified using capillary electrophoresis-mass spectrometry (CE-MS). We evaluated approximately 750 quality control (QC) samples and 6,720 participants’ spot urine samples. We calculated inter- and intra-batch coefficients of variation in the QC and participant samples and technical intraclass correlation coefficients (ICC). A correlation of metabolite concentrations between spot and 24-h urine samples obtained from 32 sub-cohort participants was also evaluated. The coefficient of variation (CV) was less than 20% for 87 metabolites (70.7%) and 20–30% for 19 metabolites (15.4%) in the QC samples. There was less than 20% inter-batch CV for 106 metabolites (86.2%). Most urinary metabolites would have reliability for measurement. The 96 metabolites (78.0%) was above 0.75 for the estimated ICC, and those might be useful for epidemiological analysis. Among individuals, the Pearson correlation coefficient of 24-h and spot urine was more than 70% for 59 of the 99 metabolites. These results show that the profiling of charged metabolites using CE-MS in morning spot human urine is suitable for epidemiological metabolomics studies.

Purpose: This study aimed to examine the association between sleep duration and quality and sarcopenia, assessed by factors such as low muscle mass (LMM), low muscle strength (LMS), and low physical performance (LPP) among older community-dwellers in Japan. Methods: In this cross-sectional study, a total of 2,069 (men, 902; women, 1,167) participants aged 65 to 80 years were included. Sarcopenia and each low physical function were defined using the definitions of the Asian Working Groups of Sarcopenia 2019. Sleep duration was stratified into three categories: short sleep (<6 h), normal sleep (6-8 h), and long sleep (>8 h). Sleep quality was classified into two groups based on 8-item Athens Insomnia Scale score: insomnia (≥6), and non-insomnia (<6). We analyzed the association between sleep parameters and sarcopenia, including low physical functions, by logistic regression analysis. Results: Compared to normal sleepers, long sleepers had a positive association with sarcopenia (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.25-3.58). In particular, long sleep was strongly associated with LMS (OR 1.77, 95%CI 1.07-2.94) and LPP (OR 1.90, 95%CI 1.25-2.88). On the other hand, poor sleep quality was not associated with sarcopenia in long sleepers, but in normal sleepers. Conclusions: Long sleep was associated with sarcopenia, including LMS and LPP. However, in long sleepers, insomnia was not associated with sarcopenia or any of its components.

Purpose: Some but not all randomized controlled trials (RCTs) of soy isoflavones showed their beneficial effect on arterial stiffness, a predictor of cardiovascular events, dementia, and all-cause mortality, independent of traditional risk factors. To test the hypothesis that supplementation of soy isoflavones reduces arterial stiffness, we performed a systematic review and meta-analysis of RCTs of soy isoflavones on arterial stiffness. Methods: The protocol of this systematic review was registered with PROSPERO (CRD42019126128) and written in accordance with PRISMA. The PubMed, Embase, and clinicaltrials.gov databases were searched using the following criteria: human subjects, soy isoflavones as intervention, and arterial stiffness as primary outcome. A random-effects meta-analysis was used to pool estimates across studies. Standardized mean difference (SMD) was used to synthesize quantitative results. Results: Among 998 articles retrieved, 8 articles met our criteria. Duration of intervention was relatively short (maximum of 12 weeks). Outcome measurements extracted were pulse wave velocity (PWV), systemic arterial compliance (SAC), augmentation index (AI), and cardio-ankle vascular index (CAVI). Soy isoflavones reduced arterial stiffness compared to placebo (standardized mean difference − 0.33, 95% confidence interval − 0.47, − 0.19). Subgroup analyses showed no difference between treatment effects for intervention duration (< 6 weeks vs. ≥ 6 weeks) or gender (women only vs. men only vs. combined). Sensitivity analysis showed no difference in the effect of soy isoflavones between PWV, CAVI, SAC, and AI. Conclusion: Supplementation of soy isoflavones reduced arterial stiffness. Longer duration trials with larger number of participants are warranted.

Introduction: Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan. Methods: Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency. Results: The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out—halfway-house residency and suicide attempts in the past year, and two protective factors—higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men. Conclusions: Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM.

The Tsuruoka Metabolomics Cohort Study (TMCS) is an ongoing population-based cohort study being conducted in the rural area of Yamagata Prefecture, Japan. This study aimed to enhance the precision prevention of multi-factorial, complex diseases, including non-communicable and aging-associated diseases, by improving risk stratification and prediction measures. At baseline, 11,002 participants aged 35–74 years were recruited in Tsuruoka City, Yamagata Prefecture, Japan, between 2012 and 2015, with an ongoing follow-up survey. Participants underwent various measurements, examinations, tests, and questionnaires on their health, lifestyle, and social factors. This study uses an integrative approach with deep molecular profiling to identify potential biomarkers linked to phenotypes that underpin disease pathophysiology and provide better mechanistic insights into social health determinants. The TMCS incorporates multi-omics data, including genetic and metabolomic analyses of 10,933 participants, and comprehensive data collection ranging from physical, psychological, behavioral, and social to biological data. The metabolome is used as a phenotypic probe because it is sensitive to changes in physiological and external conditions. The TMCS focuses on collecting outcomes for cardiovascular disease, cancer incidence and mortality, disability and functional decline due to aging and disease sequelae, and the variation in health status within the body represented by omics analysis that lies between exposure and disease. It contains several sub-studies on aging, heated tobacco products, and women’s health. This study is notable for its robust design, high participation rate (89%), and long-term repeated surveys. Moreover, it contributes to precision prevention in Japan and East Asia as a well-established multi-omics platform.

目的 「過去からの体重増加と肥満の有無の組み合わせ」と,糖尿病との関連について検討した報告は少ない。そこで,「20歳からの体重増加10kg以上」の有無と肥満の有無の組み合わせが糖尿病の新規発症に与える影響を縦断的に検証した。方法 大阪府羽曳野市の国民健康保険加入者で2013年度の特定健診受診者8,704人をベースラインとして設定し,当初から糖尿病であった者,追跡不能,その他欠損値がある者を除外した5,708人を解析対象とした。厚生労働省の標準的な質問票による20歳からの体重10kg以上の増加の有無と,BMI 25kg/m^2以上か未満かを用いて,「体重増加無し・非肥満」群,「体重増加無し・肥満」群,「体重増加有り・非肥満」群,「体重増加有り・肥満」群の4群に分類し,糖尿病の新規発症リスクをCoxの比例ハザードモデルを用いて検討した。結果 平均年齢は64.3±7.9歳,平均追跡年数3.14±1.13年間の糖尿病の新規発症は男性126人(6.0%),女性は133人(3.7%)であった。「体重増加無し・非肥満」群を参照群とした糖尿病新規発症ハザード比(95%信頼区間[CI])は,着目群「体重増加有り・非肥満」群:1.77(95%CI:1.26-2.49)と「体重増加有り・肥満」群:2.76(95%CI:2.05-3.72)が有意に高かった。男女別では,男性は「体重増加有り・肥満」群:2.06(95%CI:1.34-3.18)であった。一方,女性では「体重増加有り・肥満」群:3.68(95%CI:2.44-5.53)に加えて,「体重増加有り・非肥満」群:2.19(95%CI:1.35-3.55)でもハザード比が高かった。結論 非肥満者にとって体重増加は糖尿病発症のリスクであることが示された。さらに女性でその傾向が強く見られ,BMI 25kg/m2未満でも,20歳から10kg以上の体重増加がある場合は,糖尿病の新規発症のリスクが高かった。これに該当する者は,特定保健指導の対象外であっても,生活習慣改善指導などの対応が必要であることが示唆された。(著者抄録)

従来品より侵襲性の低い採尿シートを開発し,その性能を検証した.対象は食後3時間以上経過し,水・茶以外の飲食をしていない18歳以上の100名(成人)および4～6歳の48名(幼児)とした.提出された中間尿を二分し,直接測定した尿と,採尿シートを通して再採取した尿を比較した.分析には級内相関係数および重み付けKappa係数を用いた.尿蛋白(CRE補正)および尿クレアチニンは成人・幼児ともに高い相関を示し,尿定性蛋白はalmost perfectであった.一方,尿沈渣は成人がmoderate,幼児が不一致であり,培養検査は不一致であった.以上より,一般定性検査における有用性が示唆されたが,尿沈渣については改良が必要と考えられた.(著者抄録)

目的 本研究の目的は,地方自治体の統括保健師等を対象にした全国調査により,保健師活動におけるICT活用やデジタル化(以下,ICT活用)の実態や課題等を把握し,今後の保健師活動におけるICT活用推進にむけた示唆を得ることである。方法 47都道府県および1,741市区町村に勤務する統括保健師およびそれに準じる立場の保健師を対象に,オンライン無記名自記式調査を実施した。調査内容は,自治体種別(都道府県・政令指定都市・保健所設置市区・その他市町村),保健師活動におけるICT活用の積極度・順調度,実際の取組状況,進める上での課題等であった。調査期間は2023年10月から2024年1月であった。結果 本調査の回収数は577件(回収率32.3%)であり,524件を有効回答とした。積極度・順調度について,回答した自治体の55.9%が積極的に推進しているとの認識を示した一方で,順調に進んでいるとの認識は26.7%に留まった。実際の取組状況について,最も高い割合で実施されていたのは「オンライン通話による会議の実施」83.0%であった。取組の内容や自治体種別によって,実施状況は異なっていた。保健師の課題について「保健師活動の対象のうち,デジタルへの対応が難しい対象者への懸念がある」89.1%が最も多く,「保健師活動におけるICT活用に関するビジョン・方針を定めることが難しい」86.1%,「保健師活動におけるICT活用を推進する手順がわからない」82.8%のいずれも8割を超える自治体が課題と認識していた。組織の課題について「保健師活動におけるICT活用を進めるための予算確保が難しい」52.7%が最も多く,自治体種別にみると「保健師が活用できるインターネット環境が十分でない」では都道府県の約6割,「保健師が利用可能なICT機器が不足している」では都道府県・政令指定都市等において約6割が課題と認識していた。結論 多くの自治体が積極的にICT活用を推進する一方,その進捗については順調ではないとの認識であることが明らかになった。また自治体種別によって進捗状況や取組内容は異なっていたが,課題は共通するものもあった。ICT活用の推進に向けては,保健師のICT活用にむけた人材育成を進めるとともに,自治体間での事例やノウハウの共有が必要である。(著者抄録)

Globally, residents of long-term care facilities (LTCFs) often experience adverse events (AEs) and corresponding lawsuits that result in suffering among the residents, their families, and the facilities. Hence, we conducted a study to clarify the factors related to the facilities’ liabilities for damages for the AEs that occur at LTCFs in Japan. We analyzed 1,495 AE reports from LTCFs in one Japanese city. A binomial logistic regression analysis was conducted to identify factors associated with liability for damages. The independent variables were classified as: residents, organizations, and social factors. In total, 14% of AEs resulted in the facility being liable for damages. The predictors of liability for damages were as follows: for the resident factors, the increased need for care had an adjusted odds ratio (AOR) of 2.00 and care levels of 2–3; and AOR of 2.48 and care levels of 4–5. The types of injuries, such as bruises, wounds, and fractures, had AORs of 3.16, 2.62, and 2.50, respectively. Regarding the organization factors, the AE time, such as noon or evening, had an AOR of 1.85. If the AE occurred indoors, the AOR was 2.78, and if it occurred during staff care, the AOR was 2.11. For any follow-ups requiring consultation with a doctor, the AOR was 4.70, and for hospitalization, the AOR was 1.76. Regarding the type of LTCF providing medical care in addition to residential care, the AOR was 4.39. Regarding the social factors, the reports filed before 2017 had an AOR of 0.58. The results of the organization factors suggest that liability tends to arise in situations where the residents and their family expect high quality care. Therefore, it is imperative to strengthen organizational factors in such situations to avoid AEs and the resulting liability for damages.

Background: Elevated resting heart rate (RHR) is associated with an increased risk of cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum albumin (ALB) levels in a Japanese general population. Methods: In total, 8,363 individuals without a history of CVD were followed for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1–Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated. Results: We found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR 1.27; 95% confidence interval [CI], 1.02–1.57) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR 0.61; 95% CI, 0.47–0.79) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (P < 0.001). Conclusion: The impact of RHR on CVD mortality differed according to ALB levels in a general Japanese population.

Purpose: Hypertension (HT), dyslipidemia (DL), and diabetes mellitus (DM) are major risk factors for cardiovascular diseases. Despite the wide availability of medications to reduce this risk, poor adherence to medications remains an issue. The aim of this study is to evaluate medication adherence of prevalent users in these disease medications (HT, DL, DM) using claims data. Factors associated with non-adherence were also examined. Methods: Of 7538 participants of the Tsuruoka Metabolomics Cohort Study, 3693 (HT: 2702, DL: 2112, DM: 661) were identified as prevalent users of these disease medications. Information on lifestyle was collected through a questionnaire. Adherence was assessed by a proportion of days covered (PDC) and participants with PDC ≥0.8 were defined as adherent. Predictors of non-adherence were determined by performing multivariable logistic regression. Results: Medication adherence differed by treatment status. Among those without comorbidities, those with HT-only showed the highest adherence (90.2%), followed by those with DM-only (81.2%) and those with DL-only (80.8%). Factors associated with non-adherence in each medication group were skipping breakfast and poor understanding of medications among those with HT medications, females, having comorbidities, having a history of heart disease, and drinking habit among those with DL medications, and good sleep quality and skipping breakfast among those with DM medications. Conclusion: While participants showed high medication adherence, differences were observed across medication groups. The identified predictors of non-adherence could help target those in need of adherence support.

Background: Heated tobacco products (HTPs) have gained global popularity, but their health risks remain unclear. Therefore, the current study aimed to identify plasma metabolites associated with smoking and HTP use in a large Japanese population to improve health risk assessment. Methods: Metabolomics data from 9,922 baseline participants of the Tsuruoka Metabolomics Cohort Study (TMCS) were analyzed to determine the association between smoking habits and plasma metabolites. Moreover, alterations in smoking-related metabolites among HTP users were examined based on data obtained from 3,334 participants involved from April 2018 to June 2019 in a follow-up survey. Results: Our study revealed that cigarette smokers had metabolomics profiles distinct from never smokers, with 22 polar metabolites identified as candidate biomarkers for smoking. These biomarker profiles of HTP users were closer to those of cigarette smokers than those of never smokers. The concentration of glutamate was higher in cigarette smokers, and biomarkers involved in glutamate metabolism were also associated with cigarette smoking and HTP use. Network pathway analysis showed that smoking was associated with the glutamate pathway, which could lead to endothelial dysfunction and atherosclerosis of the vessels. Conclusion: Our study showed that the glutamate pathway is affected by habitual smoking. These changes in the glutamate pathway may partly explain the mechanism by which cigarette smoking causes cardiovascular disease. HTP use was also associated with glutamate metabolism, indicating that HTP use may contribute to the development of cardiovascular disease through mechanisms similar to those in cigarette use.

This study elucidated mental health changes in 39 nurses in Fukushima Prefecture one to two years after the Great East Japan Earthquake. Posttraumatic stress disorder symptoms improved, but posttraumatic negative cognitions worsened significantly. Factors including stress during the disaster, nursing-related stressors, and lack of disaster nursing experience contributed to negative cognitions. However, higher resilience and social support were associated with fewer negative cognitions. The complexity and uniqueness of radiation disasters may have influenced the nurses' negative thoughts. To address these issues, hospital administrators should reduce occupational stress, provide flexibility in work choices during disasters, and offer organizational support for nurses.

Although COVID-19 vaccination was approved for younger children in Japan in October 2022, uptake rates remain critically low. This study aimed to investigate Japanese parents’ intentions, hesitators’ probability of positive intention change, and factors that motivate COVID-19 vaccination. Parents with a 6-month to 4-year-old child living in Japan participated in this internet-based, cross-sectional survey conducted from December 19, 2022, to January 4, 2023. The modified Poisson regression analysis was used to assess the probabilities of changing intention by each motivator when comparing the degree of hesitancy among hesitators, and the Poisson generalized estimating equations were used to compare the probabilities of changing intentions by potential motivators within hesitant individuals. Among 12,502 participants, 10,008 (80.1%) were hesitators. Parents with lower hesitancy levels were more likely to be motivated to vaccinate their children through potential motivators. Vaccine hesitators were motivated to vaccinate their children, particularly by proven vaccine effectiveness (including “protecting children from getting sick” with a probability ratio [PR] of 3.7 [95% confidence interval (CI) 3.5–3.9] and “less likely to infect adults” with a PR of 2.9 [95% CI 2.8–3.1]), as well as vaccine safety (including “safe vaccination of millions of children” with a PR of 3.1 [95% CI 3.0–3.3]) compared to injunctive norm (including “community leader recommendation”). Therefore, initially addressing parents with low hesitancy levels is an effective strategy that motivates COVID-19 vaccination. Also, providing evidence-based information about COVID-19 vaccine efficacy and safety that is consistent with parents’ needs is crucial.

Background: Obesity has been linked to progressive loss of kidney function, but the independent and combined associations of body mass index (BMI) and visceral fat accumulation remain uncertain in healthy individuals. This study aimed to clarify the longitudinal relationship between BMI, visceral fat area (VFA), and chronic kidney disease (CKD), defined as an estimated glomerular filtration rate based on serum cystatin C (eGFRcys) < 60 mL/min/1.73 m² among the Kobe Study participants targeting healthy urban residents in Japan. Methods: A total of 897 participants (267 men, 630 women) without CKD and with a mean age of 61.4 years were analyzed. VFA was measured using the impedance method, and participants were followed for a median of 8.3 years. Participants were classified into four groups based on baseline BMI (kg/m²) and VFA (cm²): G1 (VFA < 100 and BMI < 25), G2 (VFA < 100 and BMI ≥ 25), G3 (VFA ≥ 100 and BMI < 25), G4 (VFA ≥ 100 and BMI ≥ 25). Multivariable linear regression models were used to estimate adjusted mean annual changes in eGFRcys, and Cox proportional hazards models were applied to calculate hazard ratios (HRs) for incident CKD, adjusting for potential confounders (age, sex, smoking status, alcohol consumption, dyslipidemia, diabetes, hypertension and eGFRcys at baseline). Results: During follow-up, 85 participants (9.5%) developed CKD. The adjusted mean annual decline in eGFRcys was − 2.17% in G1, − 3.29% in G2, − 2.81% in G3, and − 3.81% in G4. Compared with G1, both G3 and G4 showed an elevated risks of CKD incidence (G3: HR 2.40, 95% CI 1.14–5.05; G4: HR 3.89, 95% CI 2.17–6.98), whereas the confidence interval crossed 1 for G2 (HR 0.88, 95% CI 0.12–6.47). Participants in G4 exhibited the steepest decline in kidney function and the highest CKD incidence rate (49.2 per 1,000 person-years). Conclusions: In healthy adults, the combination of elevated BMI and VFA was associated with accelerated kidney function decline. These findings underscore the importance of evaluating visceral fat in addition to BMI for early identification of individuals at increased risk of CKD and enable preventive strategies. Clinical trial number: Not applicable.