Hiroyasu Iso

Osaka City University, Ōsaka, Ōsaka, Japan

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Publications (431)1951.77 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Accurate high-density lipoprotein cholesterol (HDL-C) measurements are important for management of cardiovascular diseases. The US Centers for Disease Control and Prevention (CDC) and Cholesterol Reference Method Laboratory Network (CRMLN) perform ultracentrifugation (UC) reference measurement procedure (RMP) to value assign HDL-C. Japanese CRMLN laboratory (Osaka) concurrently runs UC procedure and the designated comparison method (DCM). Osaka performance of UC and DCM was examined and compared with CDC RMP. CDC RMP involved UC, heparin-MnCl2 precipitation, and cholesterol analysis. CRMLN DCM for samples containing <200mg/dl triglycerides involved 50-kDa dextran sulfate-MgCl2 precipitation and cholesterol determination. HDL-C regression equations obtained with CDC (x) and Osaka (y) were y=0.992x+0.542 (R(2)=0.996) for Osaka UC and y=1.004x-0.181 (R(2)=0.998) for DCM. Pass rates within ±1mg/dl of the CDC target value were 91.9 and 92.1% for Osaka UC and DCM, respectively. Biases at 40mg/dl HDL-C were +0.22 and -0.02mg/dl for Osaka UC and DCM, respectively. Osaka UC and DCM were highly accurate, precise, and stable for many years, assisting manufacturers to calibrate products for clinical laboratories to accurately measure HDL-C for patients, calculate non-HDL-C, and estimate low-density lipoprotein cholesterol with the Friedewald equation. Copyright © 2014 Elsevier B.V. All rights reserved.
    01/2015; 439:185-90.
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    ABSTRACT: Sleep duration could affect glucose tolerance and mortality. However, the impact that sleep duration has on prognosis of people with diabetes is unclear. A cohort of Japanese self-reported diabetic people (1674 men and 1240 women) aged 40 to 79 years without a history of cardiovascular disease, cancer, renal diseases or pulmonary tuberculosis at baseline (1988 to 1990) were followed until 2009. The average sleep duration was grouped into the following five categories: ≤5 (≤5.4), 6 (5.5–6.4), 7 (6.5–7.4, reference), 8 (7.5–8.4), and ≥9 (≥8.5) hours. Multivariable hazard ratios were calculated for total and cause-specific mortality in each category by using Cox proportional hazard model. During 45 329 person-years of follow-up, 1315 deaths from all-cause (785 men and 530 women), 389 from cardiovascular disease (210 men and 179 women), 359 from cancer (244 men and 115 women), and 138 from infectious disease (87 men and 51 women) were documented. Multivariable hazard ratios (95% CI) were as follows; for men, 1.49 (1.02–2.17) for all-cause in ≤5 h sleepers; 1.53 (1.22–1.91) for all-cause in ≥9 h sleepers; 1.56 (1.01–2.41) for cardiovascular disease in ≥9 h sleepers; 3.08 (1.17–8.12) for infectious disease in ≤5 h sleepers; 2.23 (1.13–4.39) for infectious disease in ≥9 h sleepers; for women, 1.44 (1.09–1.90) for all-cause in ≥9 h sleepers; 2.03 (1.05–3.94) for cancer in ≤5 h sleepers. In conclusion, diabetic people with ≤5 h or ≥9 h of sleep had significantly higher risks of mortality than 7-hour diabetic sleepers.
    Sleep and Biological Rhythms 12/2014; · 1.05 Impact Factor
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    ABSTRACT: South Asian individuals have an increased prevalence of type 2 diabetes, but little is known about the development of glycaemic traits in this ethnic group. We compared age-related changes in glycaemic traits between non-diabetic South Asian and white participants. In a prospective British occupational cohort with 5-yearly clinical examinations (n = 230/5,749 South Asian/white participants, age 39-79 years at baseline), age-related trajectories of fasting glucose (FG) and 2 h post-load glucose (PLG), log-transformed fasting insulin (FINS) and 2 h post-load insulin (PLINS), HOMA insulin sensitivity (HOMA2-%S) and HOMA insulin secretion (HOMA2-%B) were fitted for South Asian and white individuals who remained free of diabetes between 1991 and 2009. In sex-adjusted multilevel models, FG was stable in white participants but increased with age in South Asians (0.12 [SE = 0.04] mmol/l per decade). PLG, FINS and PLINS levels were lower among white participants (by 0.271 [SE = 0.092] mmol/l, 0.306 [SE = 0.046] log pmol/l, 0.707 [SE = 0.059] log pmol/l at age 50, respectively) compared with South Asians, although their age-related trajectories were parallel. HOMA2-%S was higher (0.226 [SE = 0.038] at age 50) and HOMA2-%B lower (by 0.189 [SE = 0.026] at age 50) among white than South Asian participants. The age-related decline in HOMA2-%S was similar in these groups, but the age-related increase in HOMA2-%B was greater in white participants (0.04 [SE = 0.02] per decade). This difference was explained by obesity, lifestyle and social status. Findings from a diabetes-free population suggest an inadequate pancreatic beta cell reserve in South Asians, as a significantly steeper age-related increase in FG was observed in this ethnic group compared with white individuals.
    Diabetologia 11/2014; · 6.49 Impact Factor
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    ABSTRACT: The purpose of this study is to explore neighborhood contextual factors in terms of smoking behaviors among middle-aged Japanese, by using a multilevel analysis. Subjects were Japanese men and women, between 40 and 59 years of age (40,961 for the cross-sectional analysis, and 9,177 for the longitudinal analysis), nested in 39 neighborhoods (Kyuson). The results showed that women in a less residentially stable neighborhood were more likely to be smokers. No associations were seen between current smoking and neighborhood deprivation; however, women in the most deprived neighborhood were more likely to quit smoking. This study is the first to demonstrate the associations between neighborhood environment and current smoking or smoking cessation, in a Japanese setting. The findings imply that policy makers should consider targeting neighborhood conditions in order to help reduce smoking prevalence, especially among women. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Health & Place 11/2014; 31C:17-23. · 2.42 Impact Factor
  • Kaori Honjo, Hiroyasu Iso
    11/2014;
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    ABSTRACT: Non-fasting triglycerides were reported to have a greater impact on risk of ischemic cardiovascular events than fasting triglycerides. However, evidence from Asia, where the prevalence of dyslipidemia is generally lower, has been limited. We used 1975-1986 baseline surveys to investigate cohort data of 10,659 (4264 men and 6395 women) residents aged 40-69 years, initially free from ischemic heart disease and stroke, in four Japanese communities. Serum triglyceride concentrations at baseline were obtained for 2424 fasting (≥8 h after meal) and 8235 non-fasting (<8 h after meal) participants. During the 22-year follow-up, 284 (165 men and 119 women) developed ischemic heart disease and 666 (349 men and 317 women) ischemic stroke. After adjustment for age, sex and known cardiovascular risk factors, multivariable hazard ratios (95%CI) of ischemic cardiovascular disease (ischemic heart disease and ischemic stroke) for the highest versus lowest quartiles of triglycerides were 1.71 (1.14-2.59), P for trend = 0.013, for fasting participants and 1.60 (1.25-2.05), P for trend <0.001, for non-fasting participants. The positive associations did not differ between fasting and non-fasting men, while they were strong for non-fasting women. They were stronger for ischemic heart disease than for ischemic stroke. After further adjustment for HDL-cholesterol, these associations were slightly attenuated, but remained statistically significant. Non-fasting as well as fasting triglycerides are predictive of risk of ischemic cardiovascular disease for Japanese men, as are non-fasting triglycerides for women. Copyright © 2014. Published by Elsevier Ireland Ltd.
    Atherosclerosis 11/2014; 237(1):361-8. · 3.71 Impact Factor
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    ABSTRACT: Since few studies have developed food frequency questionnaires (FFQs) and examined their reliability for Japanese urban populations, FFQ developed for urban Japanese population may show reasonable reliability for estimating intakes of nutrients and food groups. Therefore, the objective of this study was to examine the reliability of an FFQ developed for a prospective cohort study in a Japanese urban area. A total of 29 men and 29 women aged 47–78 years were from participants in the Suita Study from February 1997 to February 1998. Seven-consecutive-day dietary records (DRs) were collected in each season (28-day DRs). The FFQs were administered three times in total in each season, except in autumn. We calculated Spearman correlation coefficients to assess the validation of the first and third FFQs compared with 28-day DRs and to assess the repeatability for three-, six-, and nine-month intervals. Reasonable validity of each FFQ compared with 28-day DRs was observed for energy intake and for 27 nutrients, and 11 food groups were selected. Median (range) Spearman rank correlation coefficients for energy-adjusted nutrient and food group intakes of the first FFQs were 0.52 (0.14–0.88) and 0.53 (0.24–0.74), and those of the third FFQs were 0.51 (0.07–0.84) and 0.57 (0.16–0.75), respectively. The repeatability of each interval was relatively good; median (range) Spearman correlation coefficients of nutrients for three-, six-, and nine-month intervals were 0.67 (0.40–0.85), 0.63 (0.25–0.93), and 0.62 (0.31–0.87), respectively; those for food groups were 0.58 (0.42–0.76), 0.56 (0.24–0.80), and 0.65 (0.30–0.76), respectively. In conclusion, this FFQ is useful for evaluating the associations of nutrient and food intakes with cardiovascular diseases and their risk factors in Japanese urban populations.
    Nutrition Research. 10/2014;
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    ABSTRACT: The long-term prognosis of subjects with supraventricular premature complexes (SVPCs) remains unclear in the general population. The aim of this study was to examine the prognostic significance of SVPCs in community-based health checkups.
    European heart journal. 10/2014;
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    ABSTRACT: To investigate the hypothesis that postmenopausal women demonstrate greater cardiovascular stress reactivity during mental stress tasks than do both premenopausal women and men.
    Psychosomatic medicine. 10/2014;
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    ABSTRACT: Objective Studies have shown that elevated high-sensitivity C-reactive protein (hs-CRP) predicts stroke, which is a risk factor for dementia. It remains, however, unclear whether hs-CRP increases risk of dementia. Methods A prospective nested case–control study of Japanese 40–69 years of age was conducted using frozen serum samples collected from approximately 7531men and women who participated in cardiovascular risk surveys from 1984 to 1994 in one community and 1989–1995 in another community under the Circulatory Risk in Communities Study (CIRCS). Two control subjects per case were matched by sex, age, community, and year of serum storage. The hs-CRP was measured using a latex particle-enhanced immunonephelometric assay. Results Between 1999 and 2013, we identified 275 disabling dementia cases (96 cases with history of stroke and 179 without it). There was a positive association between hs-CRP levels and risk of dementia with history of stroke. No significant association was observed between hs-CRP levels and risk of dementia without history of stroke. After adjustment for hypertension, diabetes and other confounding variables, the positive association remained statistically significant. The multivariable odds ratios associated with 1-SD increment of log hs-CRP were 1.02 (0.87–1.20) for total dementia, 1.35 (1.02–1.79) for dementia with history of stroke, and 0.89 (0.72–1.10) for dementia without history of stroke. Conclusion Elevated hs-CRP levels were associated with increased risk of disabling dementia in individuals with history of stroke but not in those without it.
    Atherosclerosis 10/2014; 236(2):438–443. · 3.71 Impact Factor
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    ABSTRACT: Objective: To examine whether coenzyme Q10, a potent antioxidant, is associated with risk of dementia, which has not yet been elucidated. Approach and results: We performed a case-control study nested in a community-based cohort of approximately 6000 Japanese aged 40-69 years at baseline (1984-1994). Serum coenzyme Q10 was measured in 65 incident cases of disabling dementia with dementia-related behavioral disturbance or cognitive impairment incident between 1999 and 2004, and in 130 age-, sex- and baseline year-matched controls. Serum coenzyme Q10 was inversely associated with dementia: the multivariate odds ratios (95% confidence intervals) were 0.68 (0.26-1.78), 0.92 (0.33-2.56), and 0.23 (0.06-0.86) for individuals with the second, third, and highest quartiles of coenzyme Q10, respectively, as compared with the lowest quartile (P for trend = 0.05). A similar association was found for the coenzyme Q10/total cholesterol ratio: the respective ORs were 0.67 (0.25-1.78), 0.73 (0.28-1.92), and 0.21 (0.05-0.90) (P for trend = 0.04). Conclusions: Serum coenzyme Q10 levels were inversely associated with risk of disabling dementia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Atherosclerosis 09/2014; 237(2):400-403. · 3.71 Impact Factor
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    ABSTRACT: Having a small social network and lack of social support have been associated with incident coronary heart disease; however, epidemiological evidence for incident stroke is limited. We assessed the longitudinal association of a small social network and lack of social support with risk of incident stroke and evaluated whether the association was partly mediated by vital exhaustion and inflammation.
    08/2014;
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    ABSTRACT: Aim: Patients with peripheral artery disease (PAD) are at a high risk of cardiovascular disease (CVD) among Western populations. However, evidence for an elevated risk in Asian populations is limited. Methods: This prospective cohort study examined 939 Japanese men 60-74 years of age at the time of the baseline survey. A total of 115 cases of CVD were detected during a median 9.3 years of follow-up, and the ankle brachial blood pressure index (ABI) functioned as a surrogate measurement of PAD. Results: The age-adjusted risks of coronary heart disease, ischemic stroke and ischemic CVD (coronary heart disease and ischemic stroke) were higher among men in the lowest ABI tertile compared with that observed in the men in the highest tertile (<1.08 vs. >1.17). These associations did not change substantially after adjusting for cardiovascular risk factors. The respective multivariable hazard ratios (HRs, 95% CI) for the three conditions were as follows: 2.48 (1.08-5.71), p for trend=0.03; 1.95 (0.94-4.02), p for trend=0.04; and 2.16 (1.25-3.72), p for trend=0.004. These results did not vary based on a comparison of the three ABI categories: ≤0.90, 0.91-1.10 and >1.10. The multivariable HRs (95% CI) for an ABI ≤0.90 versus >1.10 were as follows: 2.04 (0.67-6.20), p for trend=0.14 for coronary heart disease; 3.39 (1.10-10.5), p for trend=0.006 for ischemic stroke; and 2.61 (1.19-5.76), p for trend=0.003 for ischemic CVD. There were no associations between the ABI and the risk of hemorrhagic stroke. Conclusions: A low ABI is associated with the risk of coronary heart disease, ischemic stroke and ischemic CVD in elderly Japanese men.
    Journal of atherosclerosis and thrombosis 07/2014; · 2.93 Impact Factor
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    ABSTRACT: Aim: The levels of lipids, especially triglycerides (TG), and obesity are associated with diabetes mellitus (DM). Although typically measured in fasting individuals, non-fasting lipid measurements play an important role in predicting future DM. This study compared the predictive efficacy of lipid variables according to the fasting status and body mass index (BMI) category. Methods: Data were collected for 39,196 nondiabetic men and 87,980 nondiabetic women 40-79years of age who underwent health checkups in Ibaraki-Prefecture, Japan in 1993 and were followed through 2007. The hazard ratios (HRs) for DM in relation to sex, the fasting status and BMI were estimated using a Cox proportional hazards model. Results: A total of 8,867 participants, 4,012 men and 4,855 women, developed DM during a mean follow-up of 5.5 years. TG was found to be an independent predictor of incident DM in both fasting and non-fasting men and non-fasting women. The multivariable-adjusted HR for DM according to the TG quartile (Q) 4 vs. Q1 was 1.18 (95% confidence interval (CI): 1.05, 1.34) in the non-fasting men with a normal BMI (18.5-24.9). This trend was also observed in the non-fasting women with a normal BMI. That is, the multivariable-adjusted HRs for DM for TG Q2, Q3 and Q4 compared with Q1 were 1.07 (95% CI: 0.94, 1.23), 1.17 (95%CI: 1.03, 1.34) and 1.48 (95%CI: 1.30, 1.69), respectively. Conclusions: The fasting and non-fasting TG levels in men and non-fasting TG levels in women are predictive of future DM among those with a normal BMI. Clinicians must pay attention to those individuals at high risk for DM.
    Journal of atherosclerosis and thrombosis 07/2014; · 2.93 Impact Factor
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    ABSTRACT: Background and Purpose—Little research has been conducted to examine the effect of inconsistencies in socioeconomic status on cardiovascular health. In particular, no studies have been reported in Asian countries, including Japan, which is thought to have high socioeconomic status inconsistency among women. Methods—We examined the effect of status inconsistency between education level and occupation on stroke risk in a prospective 20-year study of 14 742 middle-aged Japanese women included in the prospective Japan Public Health Centerbased (JPHC) Study Cohort I in 1990. Status inconsistency between education level and occupation was determined (qualified, overqualified, and underqualified), and the association with risk of stroke was examined. Cox proportional regression analysis was used to determine hazard ratios, which were adjusted for age, marital status, and geographical area. Results—Adjusted hazard ratio for stroke in overqualified compared with qualified women was 2.06 (95% confidence interval, 1.13–3.78). Adjusted hazard ratios for stroke among highly educated manual workers and workers in service industry were 3.47 (95% confidence interval, 1.54–7.84) and 3.21 (95% confidence interval, 1.49–6.90), respectively, when compared with highly educated professionals/managers. Conclusions—High academic qualifications without an appropriate job could be a risk factor for stroke among Japanese women. Our result suggests that status inconsistency could be a potential explanation for the increased stroke risk among highly educated women.
    Stroke 07/2014; · 6.16 Impact Factor
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    ABSTRACT: Background: The present study examined the prevalence of diabetes in Japan during the late 1990s and early 2000s using the Japan Public Health Center-based Prospective Diabetes cohort. We also investigated the distributions of HbA1c values in noncompliant diabetic participants in the cohort.Methods: A total of 28 183 registered inhabitants aged 46-75 years from 10 public health center areas were included in the initial survey. The 5-year follow-up survey included 20 129 participants. The prevalence of diabetes was estimated using both a self-reported questionnaire and laboratory measurements. Among the participants who reported the presence of diabetes on the questionnaire (self-reported diabetes), the distributions of HbA1c values were described according to their treatment status.Results: The age-standardized prevalence of diabetes in 55- to 74-year-old adults was 8.2% at the initial survey and 10.6% at the 5-year follow-up. At the initial survey, among participants with self-reported diabetes, the mean HbA1c values in the participants who had never and who had previously received diabetes treatment were 7.01% (standard deviation [SD] 1.56%) and 6.56% (SD 1.46%), respectively. Approximately 15% of the participants who had self-reported diabetes but had never received diabetes treatment had an HbA1c ≥ 8.4%.Conclusions: The prevalence of diabetes increased in the JPHC cohort between the late 1990s and early 2000s. A certain proportion of participants who were aware of their diabetes but were not currently receiving treatment had poor diabetic control. Efforts to promote continuous medical attendance for diabetes care may be necessary.
    Journal of Epidemiology 07/2014; · 2.11 Impact Factor
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    ABSTRACT: Purpose: To examine the relationship between body mass index (BMI) and the risk of stage ≥3 chronic kidney disease (CKD) in a general Japanese population.Methods: A total of 105 611 participants aged 40-79 years who completed health checkups in Ibaraki Prefecture, Japan, and were free of CKD in 1993 were followed-up through 2006. Stage ≥3 CKD was defined by an estimated glomerular filtration rate <60 mL/min/1.73 m(2) reported during at least 2 successive annual surveys or as treatment for kidney disease. Hazard ratios (HRs) for the development of stage ≥3 CKD relative to the BMI categories were calculated using the Cox proportional hazards regression model, which was adjusted for possible confounders and mediators.Results: During a mean follow-up of 5 years, 19 384 participants (18.4%) developed stage ≥3 CKD. Compared to a BMI of 21.0-22.9 kg/m(2), elevated multivariable-adjusted HRs were observed among men with a BMI ≥23.0 kg/m(2) and women with a BMI ≥27.0 kg/m(2). Significant dose-response relationships between BMI and the incidence of stage ≥3 CKD were observed in both sexes (P for trend <0.001).Conclusions: Obesity was associated with the risk of developing stage ≥3 CKD among men and women.
    Journal of Epidemiology 07/2014; · 2.11 Impact Factor
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    ABSTRACT: No large population-based prospective study has investigated the risks of suicide and death by other externally caused injuries (ECIs) among stroke patients. The purpose of this study was to examine whether stroke increases the risks of suicide and ECI deaths.
    Psychosomatic medicine. 06/2014;
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    ABSTRACT: Background: Despite evidence that neighbourhood conditions affect residents’ health, no prospective studies of the association between neighbourhood socio-demographic factors and all-cause mortality have been conducted in non-Western societies. Thus, we examined the effects of areal deprivation and population density on all-cause mortality in Japan. Methods: We employed census and survival data from the Japan Public Health Center-based Prospective Study, Cohort I (n = 37,455), consisting of middle-aged residents (40 to 59 years at the baseline in 1990) living in four public health centre districts. Data spanned between 1990 and 2010. A multilevel parametric proportional-hazard regression model was applied to estimate the hazard ratios (HRs) of all-cause mortality by two census-based areal variables —areal deprivation index and population density—as well as individualistic variables such as socioeconomic status and various risk factors. Results: We found that areal deprivation and population density had moderate associations with all-cause mortality at the neighbourhood level based on the survival data with 21 years of follow-ups. Even when controlling for individualistic socioeconomic status and behavioural factors, the HRs of the two areal factors (using quartile categorical variables) significantly predicted mortality. Further, this analysis indicated an interaction effect of the two factors: areal deprivation prominently affects the health of residents in neighbourhoods with high population density. Conclusions: We confirmed that neighbourhood socio-demographic factors are significant predictors of all-cause death in Japanese non-metropolitan settings. Although further study is needed to clarify the cause-effect relationship of this association, the present findings suggest that health promotion policies should consider health disparities between neighbourhoods and possibly direct interventions towards reducing mortality in densely populated and highly deprived neighbourhoods.
    PLoS ONE 06/2014; 9(6). · 3.53 Impact Factor
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    ABSTRACT: Rice consumption has been associated with risk of type 2 diabetes, but its relation with cardiovascular disease (CVD) is limited. We examined the association between rice consumption and risk of CVD incidence and mortality in a Japanese population. This was a prospective study in 91,223 Japanese men and women aged 40-69 y in whom rice consumption was determined and updated from 3 self-administered food-frequency questionnaires, each 5 y apart. Follow-up for incidence was from 1990 to 2009 in cohort I and 1993 to 2007 in cohort II and for mortality was from 1990 to 2009 in cohort I and 1993-2009 in cohort II. HRs and 95% CIs of CVD incidence and mortality were calculated according to quintiles of cumulative average rice consumption. In 15-18 y of follow-up, we ascertained 4395 incident cases of stroke, 1088 incident cases of ischemic heart disease (IHD), and 2705 deaths from CVD. Rice consumption was not associated with risk of incident stroke or IHD; the multivariable HR (95% CI) in the highest compared with lowest rice consumption quintiles was 1.01 (0.90, 1.14) for total stroke and 1.08 (0.84, 1.38) for IHD. Similarly, there was no association between rice consumption and risk of mortality from CVD; the HR (95% CI) for mortality from total CVD was 0.97 (0.84, 1.13). There were no interactions with sex or effect modifications by body mass index for any endpoint. Rice consumption is not associated with risk of CVD morbidity or mortality.
    American Journal of Clinical Nutrition 04/2014; · 6.50 Impact Factor

Publication Stats

9k Citations
1,951.77 Total Impact Points

Institutions

  • 2006–2014
    • Osaka City University
      • • Department of Public Health
      • • Graduate School of Medicine
      • • Department of Nephrology
      Ōsaka, Ōsaka, Japan
    • Kyoto Women's University
      Kioto, Kyōto, Japan
  • 2005–2014
    • Osaka University
      • • Graduate School of Medicine
      • • Department of Social and Environmental Medicine
      Suika, Ōsaka, Japan
    • University of Leeds
      • Institute of Psychological Sciences
      Leeds, ENG, United Kingdom
    • Nagoya University
      Nagoya, Aichi, Japan
  • 2013
    • Hokkaido University
      • Department of Public Health
      Sapporo-shi, Hokkaido, Japan
    • Fukushima Medical University
      • Radiation Medical Science Center for the Fukushima health management survey
      Hukusima, Fukushima, Japan
    • Peking University Health Science Center
      Peping, Beijing, China
    • Fujita Health University
      • Department of Public Health
      Nagoya, Aichi, Japan
  • 2008–2013
    • Dokkyo Medical University
      Totigi, Tochigi, Japan
    • Tokyo University of Science
      • Department of Management Science
      Edo, Tōkyō, Japan
    • Nankai University
      T’ien-ching-shih, Tianjin Shi, China
  • 2007–2013
    • National Cerebral and Cardiovascular Center
      Ōsaka, Ōsaka, Japan
  • 1999–2013
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States
  • 1998–2013
    • Ibaraki Prefectural University of Health Sciences
      Ibaragi, Ōsaka, Japan
    • Aichi Prefectural Institute of Public Health
      Nagoya, Aichi, Japan
  • 1990–2013
    • University of Tsukuba
      • Institute of Community Medicine
      Tsukuba, Ibaraki-ken, Japan
  • 2012
    • Tokyo Medical and Dental University
      • Department of Oral Health Care Promotion
      Edo, Tōkyō, Japan
    • University College London
      • Department of Epidemiology and Public Health
      London, ENG, United Kingdom
    • Kanazawa Medical University
      Kanazawa, Ishikawa, Japan
    • Toho University
      • Department of Environmental and Occupational Health
      Edo, Tōkyō, Japan
  • 2009–2012
    • Kyoto University
      • Department of Health and Environmental Sciences
      Kioto, Kyōto, Japan
    • Harvard University
      • Department of Society, Human Development, and Health
      Boston, MA, United States
    • Kyoto Prefectural University of Medicine
      • Department of Social Medicine and Cultural Sciences
      Kioto, Kyōto, Japan
  • 2011
    • Aichi Medical University
      • Department of Public Health
      Masaki-chō, Ehime, Japan
  • 2009–2011
    • Ehime University
      Matuyama, Ehime, Japan
  • 2005–2011
    • University of Occupational and Environmental Health
      • • Department of Preventive Medicine and Community Health
      • • Department of Clinical Epidemiology
      Kitakyūshū, Fukuoka, Japan
  • 2004–2011
    • National Cancer Center, Japan
      • Research Center for Cancer Prevention and Screening
      Edo, Tōkyō, Japan
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
  • 2010
    • Tezukayama University
      Nara, Nara, Japan
  • 2009–2010
    • Niigata University
      • Division of Health Promotion
      Niahi-niigata, Niigata, Japan
  • 2005–2007
    • University of Shizuoka
      • School of Food and Nutritional Sciences
      Shizuoka-shi, Shizuoka-ken, Japan
  • 2001
    • Yamaguchi Prefectural University
      Yamaguti, Yamaguchi, Japan
  • 2000–2001
    • Brigham and Women's Hospital
      • • Division of Preventive Medicine
      • • Department of Medicine
      Boston, MA, United States
  • 1994–2001
    • Osaka Medical Center for Cancer and Cardiovascular Diseases
      Ōsaka, Ōsaka, Japan
  • 1989–1990
    • University of Minnesota Duluth
      Duluth, Minnesota, United States