[show abstract][hide abstract] ABSTRACT: Waist circumference (WC) is used as a risk assessment for metabolic syndrome, diabetes, and cardiovascular disease (CVD). WC consists of visceral fat area (VFA), subcutaneous fat area (SFA), muscle, intramuscular fat, viscera, and bone. Each component of the WC may differ between the sexes and generations, even if they have the same WC. However, this has not been measured in an epidemiological study.
Between 2004 to 2009, employees and their spouses working at a Japanese company underwent a health examination after more than 12 hours of fasting. We analyzed the data of 11,570 subjects (9,874 men and 1,696 women), aged from 20 to 76 years, who underwent a computed tomography (CT) examination. VFA, SFA, WC, muscle, intramuscular fat, viscera, and bone were measured using a CT scanner. We conducted stratified analyses by generational age, and calculated the Pearson's correlation coefficients between the VFA and WC, BMI, and VFA plus SFA. To establish the equations for converting the WC to the corresponding VFA and VFA plus SFA, linear regression analyses were used to obtain the regression coefficients and intercepts.
As the generations increased in age, the VFA tended to increase. However, the differences in the WC values of each generation did not coincide with the VFA values in men (r = -0.275 and 0.979 for men and women, n = 5 generations), but did correlate with the difference in the sum of the VFA plus SFA for both sexes (r = 0.915 and 0.996 for men and women, n = 5 generations). Older generations had lower WC values when they had the same VFA values as the younger generations.
The WC value corresponding to a certain VFA value differed significantly by generational age. Thus, revised optimal cutoff values for the WC may be needed for each generation.
Diabetology and Metabolic Syndrome 01/2014; 6(1):11. · 1.92 Impact Factor
[show abstract][hide abstract] ABSTRACT: Influences of alcohol use on glucose metabolism may depend on alcohol flushing response. We investigated the effect of alcohol flushing response on the associations between alcohol consumption and markers of glucose metabolism in Japanese men and women.
The subjects were 979 employees (885 men and 94 women), aged 18 to 69 years, of a manufacturing company in Japan. Flushing response and alcohol consumption were determined using a self-administered questionnaire. Homeostasis model assessment-insulin resistance (HOMA-IR) and homeostasis model assessment for β-cell function (HOMA-β) were computed using fasting plasma glucose and insulin. For each group of flushers and nonflushers, multiple regression analysis was used to estimate means of fasting plasma glucose, hemoglobin A1c (HbA1c), and HOMAs for each category of alcohol consumption, with adjustments for potential confounders.
In flushers, alcohol consumption was associated with HbA1c levels in a U-shaped manner, with the lowest HbA1c levels being observed at an alcohol consumption level of 23.0 to <34.5 g ethanol/d (p for quadratic trend = 0.002). In nonflushers, alcohol consumption was linearly and inversely associated with HbA1c levels (p for linear trend = 0.001). Decreases in HbA1c were more evident among flushers compared with nonflushers at moderate alcohol consumption levels (p for interaction = 0.049). An increase of fasting glucose associated with highest alcohol consumption was observed in both flushers and nonflushers. A statistically significant decrease in HOMA-IR with increasing alcohol consumption was observed in flushers (p for trend = 0.007), whereas HOMA-IR levels slightly decreased at higher alcohol consumption in nonflushers. HOMA-β similarly decreased with increasing alcohol consumption in both flushers and nonflushers (both p for trend < 0.001).
The results suggest that the alcohol flushing response may improve glucose metabolism and insulin resistance at moderate alcohol use levels in apparently healthy Japanese adults.
Alcoholism Clinical and Experimental Research 01/2014; · 3.42 Impact Factor
[show abstract][hide abstract] ABSTRACT: Although dietary patterns have been linked to depression, a frequently observed precondition for suicide, no study has yet examined the association between dietary patterns and suicide risk.
To prospectively investigate the association between dietary patterns and death from suicide.
Participants were 40 752 men and 48 285 women who took part in the second survey of the Japan Public Health Center-Based Prospective Study (1995-1998). Dietary patterns were derived from principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Hazard ratios of suicide from the fourth year of follow-up to December 2005 were calculated.
Among both men and women, a 'prudent' dietary pattern characterised by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweed and fish was associated with a decreased risk of suicide. The multivariable-adjusted hazard ratio of suicide for the highest v. lowest quartiles of the dietary pattern score was 0.46 (95% CI 0.28-0.75) (P for trend, 0.005). Other dietary patterns (Westernised and traditional Japanese) were not associated with suicide risk.
Our findings suggest that a prudent dietary pattern may be associated with a decreased risk of death from suicide.
The British journal of psychiatry: the journal of mental science 10/2013; · 6.62 Impact Factor
[show abstract][hide abstract] ABSTRACT: Background:Previous research has studied the rate of hepatitis C virus (HCV) coinfection among HIV-positive people regardless of their antiretroviral therapy (ART) status. Our objectives were to measure the seroprevalence of HCV both in HIV-positive people receiving ART and in those not receiving ART and to describe the characteristics of coinfected people in the Kathmandu Valley, Nepal.Methods:We conducted a cross-sectional survey of 319 HIV-positive people residing in the Kathmandu Valley, Nepal. We screened the participants' serum samples for HCV antibodies using the Latex Photometric Immunoassay based on third-generation assay.Results:A total of 138 (43.3%) participants were HCV positive. The prevalence of HCV coinfection was 96.2% (125 of 130) among participants with lifetime injection drug use (IDU). Among participants not receiving ART, the coinfection rate was 58.1% (50 of 86) compared with 37.8% (88 of 233) among those receiving ART. In multivariable analysis, participants who reported lifetime IDU and were current smokers were more likely to have HCV coinfection. The adjusted odds ratio (AOR) of HCV coinfection for ART was decreased, although it was not statistically significant (AOR = 0.45; 95% confidence interval = 0.13-1.48).Conclusion:The high prevalence of HCV coinfection among both individuals receiving ART and those not receiving ART suggests that screening for HCV among HIV-positive people would be useful, in particular, for those with lifetime IDU and soon after their HIV diagnosis.
Journal of the International Association of Providers of AIDS Care. 09/2013;
[show abstract][hide abstract] ABSTRACT: Higher vitamin B status has been linked to a lower risk for cancer, but the underlying mechanism remains elusive. The aim of the present study was to examine the association of pyridoxal, folate, and homocysteine (Hcy) with urinary 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative DNA damage.
The participants were 500 employees (293 men and 207 women), ages 21 to 66 y, of two municipal offices in Japan. Serum pyridoxal and Hcy concentrations were measured using high-performance liquid chromatography (HPLC) method, and serum folate concentrations were measured using chemiluminescent immunoassay. Urinary 8-OHdG concentrations were measured using HPLC method. Multiple regression was used to estimate means of 8-OHdG for each tertile of pyridoxal, folate, and Hcy with adjustment for potential confounders.
In multivariate analysis, 8-OHdG concentration was inversely associated with pyridoxal concentration in men (P for trend = 0.045) but not in women. The association in men was confined to non-smokers (P for trend = 0.033) or those who consumed no or < 20 g/d of ethanol (P for trend = 0.048). 8-OHdG concentrations were not appreciably associated with folate and Hcy concentrations.
The results suggest that vitamin B6, but not folate and homocysteine, plays a role against oxidative DNA damage in Japanese men.
[show abstract][hide abstract] ABSTRACT: Beneficial effects of dairy consumption in preventing obesity and metabolic syndrome have been suggested, but the association between dairy intake and insulin resistance (IR) is not clear. To test the hypothesis that higher dairy consumption is associated with lower insulin resistance, the authors investigated the association between dairy intake (taking fat content into consideration) and markers of IR in a Japanese working population. A cross-sectional study was conducted in 2009 among 496 subjects aged 20-68 years who participated in a health survey during a periodic checkup. Dairy consumption was assessed using a validated brief dietary history questionnaire. Multiple regression analysis was used to assess the association between fasting serum insulin, plasma glucose, and the homeostatic model assessment of IR (HOMA-IR) and dairy consumption with adjustment for potential confounding variables. The subjects in the highest quartile for total dairy intake showed the lowest mean IR markers compared to those in other categories, although the difference was not statistically significant. Intake of full-fat dairy products was inversely associated with HOMA-IR (P for trend = 0.02). The multivariable adjusted mean HOMA-IR values (with 95% confidence intervals) for the four groups, from those who consumed the fewest to those who consumed the most servings of full-fat dairy products, were 1.04 (0.96-1.12), 1.04 (0.96-1.13), 1.00 (0.91-1.08), and 0.86 (0.76-0.96), respectively. Low-fat dairy intake was not significantly associated with any IR markers. The results suggest that the consumption of full-fat dairy products may be associated with lower IR among Japanese adults.
Nutrition research (New York, N.Y.) 04/2013; 33(4):286-92. · 1.20 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Metabolic syndrome has become a major public health concern, but the role of diet in the etiology of this syndrome is not well understood. This study investigated the association between major dietary patterns and prevalence of metabolic syndrome in a Japanese working population. METHODS: This cross-sectional study was conducted among 460 municipal employees (284 men and 176 women), aged 21--67 years, who participated in a health survey at the time of periodic checkup. Dietary patterns were derived by using the principal component analysis of the consumption of 52 food and beverage items, which were assessed by a validated brief diet history questionnaire. Metabolic syndrome was defined according to the modified NCEP-ATP III criteria. Logistic regression was used to examine the association between dietary patterns and metabolic syndrome with adjustment of potential confounding variables. RESULTS: Three dietary patterns were identified. Westernized breakfast pattern characterized by high intakes of bread, confectionaries, and milk and yogurt but low intakes of rice and alcoholic beverages was inversely associated with prevalence of metabolic syndrome and high blood pressure (P for trend = 0.02 and 0.049, respectively). Animal food pattern characterized by high intakes of fish and shellfish, meat, processed meat, mayonnaise, and egg was not associated with prevalence of metabolic syndrome, but was positively associated with high blood glucose (P for trend = 0.03). Healthy Japanese dietary pattern characterized by vegetables and fruits, soy products, mushrooms, and green tea was not appreciably associated with prevalence of metabolic syndrome or its components. CONCLUSIONS: The results suggest that westernized breakfast pattern may confer some protection against metabolic syndrome in Japanese. The causality of these associations needs to be confirmed.
[show abstract][hide abstract] ABSTRACT: OBJECTIVE: To examine the association between the consumption of green tea, coffee and caffeine and depressive symptoms. DESIGN: Cross-sectional study. Consumption of green tea and coffee was ascertained with a validated dietary questionnaire and the amount of caffeine intake was estimated from these beverages. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Multiple logistic regression analysis was performed to compute odds ratios and 95 % confidence intervals for depressive symptoms with adjustments for potential confounders. SETTING: Two workplaces in north-eastern Kyushu, Japan, in 2009. SUBJECTS: A total of 537 men and women aged 20-68 years. RESULTS: Higher green tea consumption was associated with a lower prevalence of depressive symptoms. Compared with participants consuming ≤1 cup/d, those consuming ≥4 cups green tea/d had a 51 % significantly lower prevalence odds of having depressive symptoms after adjustment for potential confounders, with significant trend association (P for trend = 0·01). Further adjustment for serum folate slightly attenuated the association. Coffee consumption was also inversely associated with depressive symptoms (≥2 cups/d v. <1 cup/d: OR = 0·61; 95 % CI 0·38, 0·98). Multiple-adjusted odds for depressive symptoms comparing the highest with the lowest quartile of caffeine consumption was OR = 0·57 (95 % CI 0·30, 1·05; P for trend = 0·02). CONCLUSIONS: Results suggest that higher consumption of green tea, coffee and caffeine may confer protection against depression.
Public Health Nutrition 03/2013; · 2.25 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate the content of school textbooks as a tool to prevent tobacco use in developing countries.
Content analysis was used to evaluate if the textbooks incorporated the following five core components recommended by the WHO: (1) consequences of tobacco use; (2) social norms; (3) reasons to use tobacco; (4) social influences and (5) resistance and life skills.
Nine developing countries: Bangladesh, Cambodia, Laos, Nepal, Sri Lanka, Benin, Ghana, Niger and Zambia. TEXTBOOKS ANALYSED: Of 474 textbooks for primary and junior secondary schools in nine developing countries, 41 were selected which contained descriptions about tobacco use prevention.
Of the 41 textbooks, the consequences of tobacco use component was covered in 30 textbooks (73.2%) and the social norms component was covered in 19 (46.3%). The other three components were described in less than 20% of the textbooks.
A rather limited number of school textbooks in developing countries contained descriptions of prevention of tobacco use, but they did not fully cover the core components for tobacco use prevention. The chance of tobacco prevention education should be seized by improving the content of school textbooks.
[show abstract][hide abstract] ABSTRACT: Objective
Higher coffee and green tea consumption has been suggested to decrease risk of type 2 diabetes, but their roles in insulin resistance (IR) and insulin secretion remain unclear. This study examined the association between habitual consumption of these beverages and markers of glucose metabolism in a Japanese working population.
Participants were 1440 Japanese employees (1151 men and 289 women) aged 18–69 years. Consumption of coffee and green tea was ascertained via a validated brief diet history questionnaire. Multilevel linear regression was used to estimate means (95% confidence intervals) of fasting insulin, fasting plasma glucose, homeostatic model assessment of IR (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β) and glycated hemoglobin (HbA1c) with adjustment for potential confounding variables.
Coffee consumption was significantly, inversely associated with HOMA-IR (P for trend = 0.03), and the association appeared to be confined to overweight subjects (BMI ≥ 25 kg/m2) (P for trend = 0.01, P for interaction = 0.08). Unexpectedly, green tea consumption was positively associated with HOMA-IR (P for trend = 0.02), though there was no dose–response relationship among daily consumers of green tea. Neither coffee nor green tea consumption was associated with HOMA-β and HbA1c.
Our findings indicate that coffee consumption may be associated with decreased IR, but not with insulin secretion. The positive association between green tea consumption and IR warrants further investigation.
Metabolism: clinical and experimental 01/2013; · 3.10 Impact Factor
[show abstract][hide abstract] ABSTRACT: Lower serum total (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein cholesterols (LDL-C) have been linked to an increased risk of cancer in various sites, but its underlying mechanism remains unclear. In an attempt to clarify the association between cholesterol levels and oxidative DNA damage, we investigated the relationship between serum cholesterol and urinary 8-hydroxydeoxyguanosine levels in a Japanese working population.
The study subjects were 294 men and 209 women aged 21-66 years in two Japanese municipal offices. Urinary 8-hydroxydeoxyguanosine (8-OHdG) was measured using an automated high-pressure liquid chromatography. Linear regression analysis was used to examine the associations of urinary 8-OHdG with TC, HDL-C and LDL-C levels with adjustment for sex, age, smoking and body mass index. Subgroup analyses were conducted by smoking status in men and age in women. Analysis of covariance was employed to estimate adjusted means of urinary 8-OHdG across TC category.
After multivariate adjustment, urinary 8-OHdG levels were inversely associated with serum TC levels (β = -0.0015, p < 0.05) and LDL-C levels (β = -0.0012, p = 0.07). The inverse association with TC was apparent among smoking men (β = -0.0017, p < 0.05) and among women aged less than 48 years (β = -0.0040, p < 0.01). 8-OHdG decreased as TC increased (up to 219 mg/dL); subjects with TC levels of <160 mg/dL had a 17.4% higher adjusted mean of 8-OHdG than did those with TC levels of 200-219 mg/dL.
Results suggest that circulating low TC levels are associated with higher oxidative DNA damage.
[show abstract][hide abstract] ABSTRACT: The avoidance of inhaled allergens or tobacco smoke has been known to have favorable effects on asthma control. However, it remains unclear whether other lifestyle-related factors are also related to asthma control. Therefore, a comprehensive study to examine the associations between various lifestyle factors and asthma control was conducted in Japanese asthmatic patients.
The study subjects included 437 stable asthmatic patients recruited from our outpatient clinic over a one-year period. A written, informed consent was obtained from each participant. Asthma control was assessed using the asthma control test (ACT), and a structured questionnaire was administered to obtain information regarding lifestyle factors, including tobacco smoking, alcohol drinking, physical exercise, and diet. Both bivariate and multivariate analyses were conducted.
The proportions of total control (ACT = 25), well controlled (ACT = 20-24), and poorly controlled (ACT < 20) were 27.5%, 48.1%, and 24.5%, respectively. The proportions of patients in the asthma treatment steps as measured by Global Initiative for Asthma 2007 in step 1, step 2, step 3, step 4, and step 5 were 5.5%, 17.4%, 7.6%, 60.2%, and 9.4%, respectively. Body mass index, direct tobacco smoking status and alcohol drinking were not associated with asthma control. On the other hand, younger age (< 65 years old), passive smoking, periodical exercise (> 3 metabolic equivalents-h/week), and raw vegetable intake (> 5 units/week) were significantly associated with good asthma control by bivariate analysis. Younger age, periodical exercise, and raw vegetable intake were significantly associated with good asthma control by multiple linear regression analysis.
Periodical exercise and raw vegetable intake are associated with good asthma control in Japanese patients.
PLoS ONE 01/2013; 8(7):e68290. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Background & Aims
Fatty acid composition in diet and serum has been linked to depression, but the evidence on this issue is limited among Japanese, who consume large amounts of fish rich in n-3 polyunsaturated fatty acids. We examined the association between fatty acid composition in serum and depressive symptoms in Japanese men and women.
The subjects were 496 participants aged 21-67 years in a cross-sectional study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Free, cholesterol ester, and phospholipid fatty acids in serum were measured by gas-liquid chromatography. Multiple logistic regression was used to assess the association between serum fatty acid and depressive symptoms.
A higher free alpha-linolenic acid level was marginally significantly associated with a decreased prevalence of depressive symptoms (CES-D≥16) (P for trend = 0.07). When a cut-off of CES-D≥19 was used, the association was strengthened; the multivariable-adjusted odds ratios (95% confidence interval) of depressive symptoms for the lowest through highest tertile of alpha-linolenic acid levels were 1.00 (reference), 0.49 (0.29-0.84), and 0.47 (0.26-0.83), respectively (P for trend = 0.007). A higher n-6 PUFA in cholesterol esters and free linoleic acid were also significantly associated with a decreased prevalence of depressive symptoms (CES-D≥19) (P for trend = 0.03 and 0.048, respectively). The other polyunsaturated fatty acids including marine-derived n-3 PUFA were not associated with depressive symptoms.
Fatty acid composition with high levels of serum alpha-linolenic and linoleic acids might be protectively associated with depressive symptoms in Japanese adults.
[show abstract][hide abstract] ABSTRACT: Supplementation studies have suggested a role of n-3 polyunsaturated fatty acids (PUFAs) in homocysteine metabolism, but the evidence is limited and inconsistent among studies that measured blood levels of n-3 and n-6 PUFAs. We examined the association between blood levels of PUFAs and homocysteine in Japanese men and women.
The subjects were 496 employees (290 men and 206 women) of 2 municipal offices in Japan. Fatty acid composition in serum phospholipids and cholesterol ester (CE) was measured using gas-liquid chromatography. Multiple regression was used to calculate means of homocysteine concentrations according to PUFA tertile with adjustment for potential confounders.
Serum homocysteine concentration decreased with increasing levels of total n-3 PUFA, eicosapentaenoic acid and docosahexaenoic acid (DHA) in serum phospholipids and CE with adjustment for age, sex and workplace. However, only DHA in serum phospholipids remained statistically significant after additional adjustment for other potential confounders including serum folate (P-trend = 0.04). N-6 PUFAs were not significantly associated with homocysteine concentrations.
Higher proportion of DHA in serum phospholipids may be associated with lower homocysteine concentrations in Japanese men and women.
[show abstract][hide abstract] ABSTRACT: Fatty acid has been suggested to be involved in development of diabetes. However, its association is unclear among Japanese populations, which consume large amounts of fish rich in n-3 polyunsaturated fatty acids. The present cross-sectional study examined the association of individual dietary fatty acids and dietary fatty acid patterns with abnormal glucose metabolism among 1065 Japanese employees, aged 18-69 years. Impaired glucose metabolism is defined if a person has a history of diabetes, current use of anti-diabetic drug, fasting plasma glucose of 110 mg/dl (≥6.1 mmol/L) or greater, or hemoglobin A1C of 6.0% (≥42 mmol/mol) or greater. Dietary intake was assessed with a self-administered diet history questionnaire. Dietary fatty acid patterns were extracted by principal component analysis. Odds ratios of impaired glucose metabolism according to tertile categories of each fatty acids and dietary fatty acid patterns were estimated using logistic regression with adjustment for potential confounding variables. A higher intake of polyunsaturated fatty acid, n-6 fatty acid, linoleic acid, and oleic acid were significantly associated with a decreased prevalence of impaired glucose metabolism (P for trend = 0.03, 0.01, 0.02, and 0.04, respectively). Alpha-linolenic acid was marginally significantly associated with a decreased prevalence of impaired glucose metabolism (P for trend = 0.12). Of three fatty acid patterns identified, a higher plant oil pattern score, which characterized by high intake of alpha-linolenic acid, linoleic acid, and oleic acid, was associated with a decreased prevalence of impaired glucose metabolism (P for trend = 0.03). No association was observed for other patterns. In conclusion, plant source fatty acids might be protectively associated with development of diabetes in Japanese adults.
PLoS ONE 01/2013; 8(5):e64758. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Resistance of Mycobacterium tuberculosis (MTB) to anti-tuberculosis (TB) drugs presents a serious challenge to TB control worldwide. We investigated the status of drug resistance, including multidrug-resistant (MDR) TB, and possible risk factors among newly diagnosed TB patients in Hanoi, the capital of Viet Nam.
Clinical and epidemiological information was collected from 506 newly diagnosed patients with sputum smear- and culture-positive TB, and 489 (96.6%) MTB isolates were subjected to conventional drug susceptibility testing, spoligotyping, and 15-locus variable numbers of tandem repeats typing. Adjusted odds ratios (aORs) were calculated to analyze the risk factors for primary drug resistance.
Of 489 isolates, 298 (60.9%) were sensitive to all drugs tested. Resistance to isoniazid, rifampicin, streptomycin, ethambutol, and MDR accounted for 28.2%, 4.9%, 28.2%, 2.9%, and 4.5%, respectively. Of 24 isolates with rifampicin resistance, 22 (91.7%) were MDR and also resistant to streptomycin, except one case. Factors associated with isoniazid resistance included living in old urban areas, presence of the Beijing genotype, and clustered strains [aOR = 2.23, 95% confidence interval (CI) 1.15-4.35; 1.91, 1.18-3.10; and 1.69, 1.06-2.69, respectively). The Beijing genotype was also associated with streptomycin resistance (aOR = 2.10, 95% CI 1.29-3.40). Human immunodeficiency virus (HIV) coinfection was associated with rifampicin resistance and MDR (aOR = 5.42, 95% CI 2.07-14.14; 6.23, 2.34-16.58, respectively).
Isoniazid and streptomycin resistance was observed in more than a quarter of TB patients without treatment history in Hanoi. Transmission of isoniazid-resistant TB among younger people should be carefully monitored in urban areas, where Beijing strains and HIV coinfection are prevalent. Choosing an optimal treatment regimen on the basis of the results of drug susceptibility tests and monitoring of treatment adherence would minimize further development of drug resistance strains.
PLoS ONE 01/2013; 8(8):e71867. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: In Niger, insecticide-treated bed nets (ITNs) have been distributed to the target group of households with young children and/or pregnant women at healthcare facilities in the course of antenatal/immunization clinics. With the aim of universal coverage, ITNs were additionally distributed to households through strengthened community health committees in 2009. This study assessed the impact of the community-based net distribution strategy involving community health committees in the ITN coverage in Boboye Health District, Niger. A cross-sectional survey was carried out on 1,034 households drawn from the intervention area (the co-existence of the community-based system together with the facility-based system) and the control area (the facility-based system alone). In the intervention area, 55.8% of households owned ITNs delivered through the community-based system, and 29.6% of households exclusively owned ITNs obtained through the community-based system. The community-based system not only reached households within the target group (54.6% ownership) but also those without (59.1% ownership). Overall, household ITN ownership was significantly higher in the intervention area than in the control area (82.5% vs. 60.7%). In combination, the community-based system and the facility-based system achieved a high ITN coverage. The community-based system contributed to reducing leakage in the facility-based system.
Tropical Medicine and Health 12/2012; 40(4):125-31.
[show abstract][hide abstract] ABSTRACT: The objective of this study was to examine the associations between students' perception of physical and psychosocial school environment and satisfaction with life among secondary school students in Colombo District, Sri Lanka. Data were collected from 20 Sinhala-medium secondary schools between January and February in 2010. A questionnaire-based survey was conducted with students in grade seven (n = 342) and grade ten (n = 446). Multivariate logistic regression analysis, adjusted for confounding variables, was used to assess the associations between students'satisfaction with life measured by Cantril ladders, and scores of perceived physical and psychosocial school environment that focused on school cleanliness and attractiveness, relations with teachers and peers, satisfaction with school and bullying. Students in the highest quartile of school environment score were significantly more likely to have high life satisfaction, compared to those in the lowest quartile (adjusted odds ratio 2.32; 95% confidence interval 1.35-3.99). Odds ratio of high life satisfaction increased with increasing school environment scores (p for trend<0.001). In conclusion, students who perceived positive school environment were significantly more likely to have high life satisfaction. Positive changes in the focused areas of school environment have the potential to lead to improved life satisfaction of students.
The Southeast Asian journal of tropical medicine and public health 11/2012; 43(6):1568-76. · 0.61 Impact Factor
[show abstract][hide abstract] ABSTRACT: OBJECTIVE: Several epidemiological studies have reported that high concentrations of circulating ferritin, a marker of iron stores, are related to insulin resistance (IR); however, questions remain regarding inconsistent data between Asian men and women and the inadequate consideration of potential confounding effects on the relationship between ferritin and IR. Our aim was to examine the relationship between serum ferritin concentrations and IR markers in the Japanese population. MATERIALS/METHODS: We analyzed data (n=493) from a cross-sectional survey conducted in 2009 among a Japanese working population aged 20-68years. Fasting serum ferritin and insulin levels and fasting plasma glucose levels were determined, and the homeostatic model assessment of IR (HOMA-IR) was calculated. Multiple regression analysis was performed with adjustments for demographic and lifestyle factors, body mass index and serum C-reactive protein. RESULTS: Fasting insulin and HOMA-IR significantly increased with increasing levels of serum ferritin after adjustment for covariates in men (P for trend=.005 and .001, respectively). Compared with men in the lowest tertile of serum ferritin, those in the highest tertile had a 24% higher HOMA-IR score. Additional data suggested a positive association between iron intake and HOMA-IR (P for trend=.07) in men. Neither serum ferritin nor iron intake was related to IR markers in women, even in postmenopausal women. CONCLUSIONS: Serum ferritin concentrations were positively associated with fasting insulin and HOMA-IR in men but not in women, suggesting an important role of iron storage in the pathogenesis of IR in Japanese men.
Metabolism: clinical and experimental 10/2012; · 3.10 Impact Factor
[show abstract][hide abstract] ABSTRACT: Recent US clinical trial demonstrated that CT screening prevents lung cancer death among high risk individuals. However, it remains unclear whether wide implementation of low-dose CT screening for lung cancer can decrease mortality in the community. Among residents in Hitachi City (Japan), where nearly 40% of inhabitants aged 50-69 years were estimated to have participated in the screening at least once from 1998 through 2009, the trend of lung cancer mortality was described in relation to the timing of implementation of the CT screening. Cancer mortality data were obtained from regional cancer registry and standardized mortality ratio (SMR) of lung cancer was calculated for each 5-year period during 1995-2009. In both men and women aged 60 years or older, age-specific lung cancer mortality rates were generally lower during 2005-2009 as compared with those during 1995-2004. For combined men and women aged 50-79 years, SMR was nearly unity prior to or during introductory phase of CT screening and during early period of implementation; however, it was significantly decreased during 2005-2009, well after the implementation of CT screening, with SMR (95% confidence interval) being 0.76 (0.67-0.86). Results suggest that wide implementation of low-dose chest CT screening may decrease lung cancer mortality in the community 4-8 years after introduction of the screening.
Lung cancer (Amsterdam, Netherlands) 10/2012; · 3.14 Impact Factor