Naoyuki Takashima

Publications (32)157.83 Total impact

• Article: Wake-Up Stroke: Incidence, Risk Factors and Outcome of Acute Stroke during Sleep in a Japanese Population. Takashima Stroke Registry 1988-2003.

  Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
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  ABSTRACT: Characterization of the time of stroke onset has been plagued by the problem of determining the time of the onset of events that are detected when the patient awakens. Our aim was to evaluate the characteristics, risk factors and acute fatality associated with wake-up stroke. Data was obtained from Takashima Stroke Registry covering approximately 55,000 residents in central Japan. During the period 1988-2003, information about the situation at stroke onset was available for 897 cerebral infarction (CI) and 335 intracerebral hemorrhage (ICH) events. Differences in characteristics and outcome between stroke during sleep and stroke while awake were explored. Among CI and ICH cases, 9.7 and 11.9% suffered from stroke during sleep, respectively. Hypertension and experiencing a severe event were associated with stroke during sleep among CI. Smoking and experiencing a severe event were associated with stroke during sleep and a drinking history reduced the chance of stroke during sleep among ICH. Acute fatality risks did not differ between stroke during sleep and stroke while awake among both CI and ICH cases. About 1 in 10 stroke patients had an onset of stroke during sleep. Hypertensive, smoker and clinically more severely affected patients had a higher prevalence of stroke during sleep. There were no differences between the 2 groups with respect to acute-case fatality.
  European Neurology 04/2013; 69(6):354-359. · 1.81 Impact Factor
• Article: Genome-wide association study of the genetic factors related to confectionery intake: potential roles of the ADIPOQ gene.

  Kenji Wakai, Keitaro Matsuo, Fumihiko Matsuda, Ryo Yamada, Meiko Takahashi, Takahisa Kawaguchi, Yasushi Yatabe, Hidemi Ito, Satoyo Hosono, Kazuo Tajima, [......], Naoyuki Takashima, Sadao Suzuki, Noriko Nakahata, Haruo Mikami, Keizo Ohnaka, Yoshiyuki Watanabe, Kokichi Arisawa, Michiaki Kubo, Nobuyuki Hamajima, Hideo Tanaka
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  ABSTRACT: OBJECTIVE: The excessive consumption of confectionery might have adverse effects on human health. To screen genetic factors associated with confectionery-intake frequency, we conducted a genome-wide association study (GWAS) in Japan. DESIGN AND METHODS: For the discovery phase (stage 1), we conducted a GWAS of 939 non-cancer patients in a cancer hospital. Additive models were used to test associations between genotypes of approximately 500,000 single-nucleotide polymorphisms (SNPs) and the confectionery-intake score (based on intake frequency). We followed-up association signals with P < 1 × 10(-5) and minor allele frequency > 0.01 in stage 1 by genotyping the SNPs of 4,491 participants in a cross-sectional study within a cohort (replication phase [stage 2]). RESULTS: We identified 12 SNPs in stage 1 that were potentially related to confectionery intake. In stage 2, this association was replicated for one SNP (rs822396; P = 0.049 for stage 2 and 4.2 × 10(-5) for stage 1+2) in intron 1 of the ADIPOQ gene, which encodes the adipokine adiponectin. CONCLUSIONS: Given the biological plausibility and previous relevant findings, the association of an SNP in the ADIPOQ gene with a preference for confectionery is worthy of follow-up and provides a good working hypothesis for experimental testing.
  Obesity 02/2013; · 4.28 Impact Factor
• Article: Association Between J-Point Elevation and Death From Coronary Heart Disease.

  Takashi Hisamatsu, Takayoshi Ohkubo, Katsuyuki Miura, Takashi Yamamoto, Akira Fujiyoshi, Naoko Miyagawa, Aya Kadota, Naoyuki Takashima, Shin-Ya Nagasawa, Yoshikuni Kita, Yoshitaka Murakami, Akira Okayama, Minoru Horie, Tomonori Okamura, Hirotsugu Ueshima
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  ABSTRACT: Background: An early repolarization pattern, characterized by an elevation of the QRS-ST junction (J-point) on 12-lead electrocardiography (ECG) is associated with cardiac and sudden death. However, little is known about the prognostic significance of J-point elevation for various disease-specific cardiovascular outcomes, including coronary heart disease (CHD). Methods and Results: To investigate the association between the presence of J-point elevation ≥0.1mV and various disease-specific cardiovascular outcomes, we conducted a 15-year prospective study in a representative general Japanese population of 7,630 individuals (41% men, mean age 52.4 years) who participated in the National Survey of Circulatory Disorders. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. J-point elevation was present in 264 individuals (3.5%) and was associated with an increased risk of cardiac death (adjusted HR, 2.54; 95% confidence interval [CI] 1.40-4.58; P=0.002) and death from CHD (adjusted HR, 4.66; 95% CI 2.30-9.46; P<0.001). In a subgroup analysis by age, the association between J-point elevation and cardiovascular outcomes was more remarkable in middle-aged (<60 years) than in older individuals (≥60 years) (all P for interaction <0.05). Conclusions: J-point elevation on standard 12-lead ECG was an independent predictor of cardiac death and death from CHD in a representative sample of the general Japanese population, particularly among the middle-aged.
  Circulation Journal 01/2013; · 3.77 Impact Factor
• Article: Long-term risk of BP values above normal for cardiovascular mortality: a 24-year observation of Japanese aged 30 to 92 years.

  Naoyuki Takashima, Takayoshi Ohkubo, Katsuyuki Miura, Tomonori Okamura, Yoshitaka Murakami, Akira Fujiyoshi, Shin-Ya Nagasawa, Aya Kadota, Yoshikuni Kita, Naoko Miyagawa, Takashi Hisamatsu, Takehito Hayakawa, Akira Okayama, Hirotsugu Ueshima
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  ABSTRACT: OBJECTIVE:: In Western populations, blood pressure (BP) measured at baseline has been reported to predict long-term (over 20 years) risk of mortality from cardiovascular diseases (CVDs). However, corresponding evidence is scarce in Asia where stroke is dominant. We investigated the association between baseline BP and 24-year mortality risk due to CVD, in a representative Japanese general population. METHODS:: We followed up a nationwide sample of 8592 Japanese, aged 30 years or above without a history of CVD and antihypertensive medication at baseline, for 24 years. Hazard ratios for CVD mortality in BP categories defined according to JCN7 criteria were estimated using Cox model adjusted for potential confounding factors with normal BP treated as the reference category. RESULTS:: We observed 689 CVD deaths. Hazard ratios for CVD mortality were progressively and significantly increased from the category of prehypertension. Population-attributable fraction (PAF) demonstrated that 43 and 48% of CVD and stroke deaths were explained by non-normal BP at baseline. Hazard ratios and PAF were remarkably higher in younger participants (aged 30-59 years) than those in the elderly (aged 60 years or above). Particularly, in younger men, 81% of CVD deaths were explained by non-normal BP. In sensitivity analysis, participants with antihypertensive medication showed the highest hazard ratio for CVD morality compared with the other categories. CONCLUSIONS:: BP levels above normal at baseline retained significant relative and absolute risks of CVD and stroke mortality during 24 years. Long-lasting burden of non-normal BP particularly in younger individuals suggests the importance of primary prevention of high BP from younger generation.
  Journal of hypertension 10/2012; · 4.02 Impact Factor
• Article: Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988-2004).

  Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Kayo Ueda, Naoyuki Takashima, Hideki Sugihara, Yutaka Morita, Masaharu Ichikawa, Kunihiko Hirose, Hiroshi Nitta, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
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  ABSTRACT: Background: Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low. Methods: We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference. Results: There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988-2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 µg/m(3), SO(2) 3.9 ppb, NO(2) 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO(2) showed increased fatality risk. In multi-pollutant model, the highest quartile of NO(2) was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO(2). In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06-2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality. Conclusion: We observed association between NO(2) levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities.
  Cerebrovascular Diseases 08/2012; 34(2):130-9. · 2.72 Impact Factor
• Article: Associations of apolipoprotein A5 (APOA5), glucokinase (GCK) and glucokinase regulatory protein (GCKR) polymorphisms and lifestyle factors with the risk of dyslipidemia and dysglycemia in Japanese - a cross-sectional data from the J-MICC Study.

  Asahi Hishida, Emi Morita, Mariko Naito, Rieko Okada, Kenji Wakai, Keitaro Matsuo, Kazuyo Nakamura, Naoyuki Takashima, Sadao Suzuki, Toshiro Takezaki, Haruo Mikami, Keizo Ohnaka, Yoshiyuki Watanabe, Hirokazu Uemura, Michiaki Kubo, Hideo Tanaka, Nobuyuki Hamajima
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  ABSTRACT: This study examined the associations of the APOA5 T-1131C (rs662799), G553T (Cys185Gly, rs2075291), GCK G-30A (rs1799884), GCKR A/G at intron 16 (rs780094) and T1403C (Leu446Pro, rs1260326) polymorphisms with serum lipid and glucose levels in Japanese, considering lifestyle factors. Study subjects were 2,191 participants (aged 35-69 years, 1,159 males) enrolled in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. Dyslipidemia was defined as fasting serum triglycerides (FTG) ≥ 150 mg/dL and/or HDL-cholesterol (HDL-C) < 40 mg/dL, while dysglycemia was as fasting blood sugar (FBS) ≥ 110 mg/dL. When those with APOA5 -1131 T/T or 553 G/G were defined as references, those with APOA5 -1131 T/C, C/C or 553 G/T, T/T demonstrated significantly elevated risk of dyslipidemia (age- and sex-adjusted odds ratio: 1.77 [95% confidence interval:1.39-2.27], 3.35 [2.41-4.65], 2.23 [1.64-3.02] and 13.78 [3.44-55.18], respectively). Evaluation of FTG, HDL-C or FBS levels according to the genotype revealed that FTG and HDL-C levels were significantly associated with the APOA5 T-1131C and G553T polymorphisms, FTG with the GCKR rs780094 and rs1260326 polymorphisms, and FBS with the GCKR rs780094 and rs1260326 polymorphisms. Moreover, a significant positive interaction between APOA5 553 G/T+T/T genotypes and fat intake ≥ 25% of total energy for the risk of dyslipidemia was observed. Our cross-sectional study confirmed the essential roles of the polymorphisms of the APOA5, GCK and GCKR in the lipid or glucose metabolism disorders, and suggested the importance of fat intake control in the individualized prevention of dyslipidemia.
  Endocrine Journal 04/2012; 59(7):589-99. · 2.03 Impact Factor
• Article: Gene variants in PPARD and PPARGC1A are associated with timing of natural menopause in the general Japanese population.

  Hirokazu Uemura, Mineyoshi Hiyoshi, Kokichi Arisawa, Miwa Yamaguchi, Mariko Naito, Sayo Kawai, Nobuyuki Hamajima, Keitaro Matsuo, Naoto Taguchi, Naoyuki Takashima, Sadao Suzuki, Kazuyo Hirasada, Haruo Mikami, Keizo Ohnaka, Aya Yoshikawa, Michiaki Kubo, Hideo Tanaka
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  ABSTRACT: Timing of menopause affects postmenopausal health risks. The objective of this study was to evaluate the associations of the single nucleotide polymorphisms (SNPs) in peroxisome proliferator-activated receptor (PPAR)-related genes (PPARD, PPARG, and PPARGC1A) and environmental factors with timing of natural menopause among the general Japanese population. We analyzed cross-sectional data from 1758 women aged 40-69 years who were enrolled in the baseline surveys of the Japan Multi-institutional Collaborative Cohort (J-MICC) Study. Associations of timing of natural menopause with its probable covariates and with target gene variants were evaluated by univariate and multivariate Cox proportional hazards models. Lower body mass index and later age at menarche were significantly associated with earlier natural menopause. Women with minor alleles at T-48444C in PPARD showed a significantly higher adjusted hazard ratio of 1.57 (95% confidence interval: 1.18-2.10) for earlier natural menopause. In contrast, women with minor alleles at Thr394Thr in PPARGC1A showed a significantly lower adjusted hazard ratio of 0.86 (0.76-0.97) for earlier natural menopause. These associations did not substantially alter when re-analyzed after excluding the subjects who self-reported a history of diabetes or the subjects whose age was more than 65 years. Gene variants in PPARD and PPARGC1A might be associated with timing of natural menopause, probably through direct actions on the ovaries, among the general Japanese population.
  Maturitas 04/2012; 71(4):369-75. · 2.77 Impact Factor
• Article: Short-term exposure to air pollution and incidence of stroke and acute myocardial infarction in a Japanese population.

  Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Kayo Ueda, Naoyuki Takashima, Hideki Sugihara, Yutaka Morita, Masaharu Ichikawa, Kunihiko Hirose, Hiroshi Nitta, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
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  ABSTRACT: Exposure to high levels of air pollution can increase the risk of cardiovascular events. However, there is no clear information in Japan on the effect of pollution on the incidence of stroke and acute myocardial infarction (AMI). Therefore, we investigated the effects of air pollution on the incidence of stroke and AMI in a setting where pollutant levels are rather low. Data were obtained from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County in central Japan. We applied a time-stratified, bidirectional, case-crossover design to estimate the effects of air pollutants, which included suspended particulate matter (SPM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and photochemical oxidants (Ox). We used the distributed lag model to estimate the effect of pollutant exposure 0-3 days before the day of event onset and controlled for meteorological covariates in all of the models. There were 2,038 first-ever strokes (1,083 men, 955 women) and 429 first-ever AMI cases (281 men, 148 women) during 1988-2004. The mean pollutant levels were as follows: SPM 26.9 μg/m(3); SO(2) 3.9 ppb; NO(2) 16.0 ppb, and Ox 28.4 ppb. In single-pollutant and two-pollutant models, SO(2) was associated with the risk of cerebral hemorrhage. Other stroke subtypes and AMI were not associated with air pollutant levels. We observed an association between SO(2) and hemorrhagic stroke; however, we found inconclusive evidence for a short-term effect of air pollution on the incidence of other stroke types and AMI.
  Neuroepidemiology 02/2012; 38(2):84-92. · 2.31 Impact Factor
• Source

  Available from: Mariko Naito

  Article: Pro-/anti-inflammatory cytokine gene polymorphisms and chronic kidney disease: a cross-sectional study.

  Rieko Okada, Kenji Wakai, Mariko Naito, Emi Morita, Sayo Kawai, Nobuyuki Hamajima, Megumi Hara, Naoyuki Takashima, Sadao Suzuki, Toshiro Takezaki, Keizo Ohnaka, Kokichi Arisawa, Hiroshi Hirohata, Keitaro Matsuo, Haruo Mikami, Michiaki Kubo, Hideo Tanaka
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  ABSTRACT: The aim of this study was to explore the associations between common potential functional promoter polymorphisms in pro-/anti-inflammatory cytokine genes and kidney function/chronic kidney disease (CKD) prevalence in a large Japanese population. A total of 3,323 subjects aged 35-69 were genotyped for all 10 single nucleotide polymorphisms (SNPs) in the promoter regions of candidate genes with minor allele frequencies of > 0.100 in Japanese populations. The estimated glomerular filtration rate (eGFR) and CKD prevalence (eGFR < 60 ml/min/1.73 m2) of the subjects were compared among the genotypes. A higher eGFR and lower prevalence of CKD were observed for the homozygous variants of IL4 -33CC (high IL-4 [anti-inflammatory cytokine]-producing genotype) and IL6 -572GG (low IL-6 [pro-inflammatory cytokine]-producing genotype). Subjects with IL4 CC + IL6 GG showed the highest mean eGFR (79.1 ml/min/1.73 m2) and lowest CKD prevalence (0.0%), while subjects carrying IL4 TT + IL6 CC showed the lowest mean eGFR (73.4 ml/min/1.73 m2) and highest CKD prevalence (17.9%). The functional promoter polymorphisms IL4 T-33C (rs2070874) and IL6 C-572G (rs1800796), which are the only SNPs that affect the IL-4 and IL-6 levels in Japanese subjects, were associated with kidney function and CKD prevalence in a large Japanese population.
  BMC Nephrology 01/2012; 13:2. · 2.18 Impact Factor
• Source

  Available from: Ryosuke Ando

  Article: Detailed analysis of Japanese population substructure with a focus on the southwest islands of Japan.

  Takeshi Nishiyama, Hirohisa Kishino, Sadao Suzuki, Ryosuke Ando, Hideshi Niimura, Hirokazu Uemura, Mikako Horita, Keizo Ohnaka, Nagato Kuriyama, Haruo Mikami, Naoyuki Takashima, Keitaro Mastuo, Yin Guang, Kenji Wakai, Nobuyuki Hamajima, Hideo Tanaka
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  ABSTRACT: Uncovering population structure is important for properly conducting association studies and for examining the demographic history of a population. Here, we examined the Japanese population substructure using data from the Japan Multi-Institutional Collaborative Cohort (J-MICC), which covers all but the northern region of Japan. Using 222 autosomal loci from 4502 subjects, we investigated population substructure by estimating F(ST) among populations, testing population differentiation, and performing principal component analysis (PCA) and correspondence analysis (CA). All analyses revealed a low but significant differentiation between the Amami Islanders and the mainland Japanese population. Furthermore, we examined the genetic differentiation between the mainland population, Amami Islanders and Okinawa Islanders using six loci included in both the Pan-Asian SNP (PASNP) consortium data and the J-MICC data. This analysis revealed that the Amami and Okinawa Islanders were differentiated from the mainland population. In conclusion, we revealed a low but significant level of genetic differentiation between the mainland population and populations in or to the south of the Amami Islands, although genetic variation between both populations might be clinal. Therefore, the possibility of population stratification must be considered when enrolling the islander population of this area, such as in the J-MICC study.
  PLoS ONE 01/2012; 7(4):e35000. · 4.09 Impact Factor
• Article: Prognostic value of ST-T abnormalities and left high R waves with cardiovascular mortality in Japanese (24-year follow-up of NIPPON DATA80).

  Nahid Rumana, Tanvir Chowdhury Turin, Katsuyuki Miura, Yasuyuki Nakamura, Yoshikuni Kita, Takehito Hayakawa, Sohel Reza Choudhury, Aya Kadota, Shin-Ya Nagasawa, Akira Fujioshi, Naoyuki Takashima, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
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  ABSTRACT: Little is known about the prognostic value of ST-segment depression and/or T wave (ST-T abnormalities) with or without left high R waves on electrocardiogram recorded at rest for death from cardiovascular disease (CVD) in Asian populations. Japanese participants without a history of CVD and free of major electrocardiographic (ECG) abnormalities were followed for 24 years. Subjects were divided into 4 groups based on baseline ECG findings: isolated left high R waves, isolated ST-T abnormalities, ST-T abnormalities with left high R waves, and normal electrocardiogram. Cox proportional hazard model was used to estimate risk of CVD mortality in groups with ECG abnormalities compared to the normal group. Of 8,572 participants (44.4% men, mean age 49.5 years; 55.6% women, mean age 49.4 years), 1,142 had isolated left high R waves, 292 had isolated ST-T abnormalities, and 128 had ST-T abnormalities with left high R waves at baseline. Multivariable-adjusted hazard ratios of ST-T abnormalities with left high R waves for CVD mortality were 1.95 (95% confidence interval 1.25 to 3.04) in men and 2.68 (95% confidence interval 1.81 to 3.97) in women. Isolated ST-T abnormalities increased the risk for CVD death by 1.66 times (95% confidence interval 1.01 to 2.71) in men and 1.62 times (95% confidence interval 1.18 to 2.24) in women. Association of ECG abnormalities with CVD mortality was independent of age, body mass index, systolic blood pressure, serum cholesterol, blood glucose, smoking and drinking, and antihypertensive medication. In conclusion, ST-T abnormalities with or without left high R waves on electrocardiogram recorded at rest constitute an independent predictor of CVD mortality in Japanese men and women.
  The American journal of cardiology 06/2011; 107(12):1718-24. · 3.58 Impact Factor
• Article: Profile of participants and genotype distributions of 108 polymorphisms in a cross-sectional study of associations of genotypes with lifestyle and clinical factors: a project in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study.

  Kenji Wakai, Nobuyuki Hamajima, Rieko Okada, Mariko Naito, Emi Morita, Asahi Hishida, Sayo Kawai, Kazuko Nishio, Guang Yin, Yatami Asai, [......], Satoko Mitani, Kokichi Arisawa, Hirokazu Uemura, Mineyoshi Hiyoshi, Hidenobu Takami, Miwa Yamaguchi, Mariko Nakamoto, Hideo Takeda, Michiaki Kubo, Hideo Tanaka
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  ABSTRACT: Most diseases are thought to arise from interactions between environmental factors and the host genotype. To detect gene-environment interactions in the development of lifestyle-related diseases, and especially cancer, the Japan Multi-institutional Collaborative Cohort (J-MICC) Study was launched in 2005. We initiated a cross-sectional study to examine associations of genotypes with lifestyle and clinical factors, as assessed by questionnaires and medical examinations. The 4519 subjects were selected from among participants in the J-MICC Study in 10 areas throughout Japan. In total, 108 polymorphisms were chosen and genotyped using the Invader assay. The study group comprised 2124 men and 2395 women with a mean age of 55.8 ± 8.9 years (range, 35-69 years) at baseline. Among the 108 polymorphisms examined, 4 were not polymorphic in our study population. Among the remaining 104 polymorphisms, most variations were common (minor allele frequency ≥0.05 for 96 polymorphisms). The allele frequencies in this population were comparable with those in the HapMap-JPT data set for 45 Japanese from Tokyo. Only 5 of 88 polymorphisms showed allele-frequency differences greater than 0.1. Of the 108 polymorphisms, 32 showed a highly significant difference in minor allele frequency among the study areas (P < 0.001). This comprehensive data collection on lifestyle and clinical factors will be useful for elucidating gene-environment interactions. In addition, it is likely to be an informative reference tool, as free access to genotype data for a large Japanese population is not readily available.
  Journal of Epidemiology 03/2011; 21(3):223-35. · 1.86 Impact Factor
• Article: Relationship of moderate metabolic risk factor clustering to cardiovascular disease mortality in non-lean Japanese: a 15-year follow-up of NIPPON DATA90.

  Aya Kadota, Katsuyuki Miura, Tomonori Okamura, Atsushi Hozawa, Yoshitaka Murakami, Akira Fujiyoshi, Naoyuki Takashima, Takehito Hayakawa, Yoshikuni Kita, Akira Okayama, Yasuyuki Nakamura, Hirotsugu Ueshima
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  ABSTRACT: The individual components of metabolic syndrome are defined as levels ranging from moderate to high level as to require medication. We investigated the impact of moderate metabolic risk factor clustering on cardiovascular disease (CVD) mortality. We followed up 6758 non-lean Japanese in randomly selected areas from all over the country who had no history of CVD for 15 years. The multivariate-adjusted hazards ratio (HR) and 95% confidence interval (CI) for CVD mortality according to the number of moderate metabolic risk factors (BMI≥25 kg/m2, 130/85 mmHg≤systolic/diastolic BP<140/90 mmHg, 140 mg/dl≤casual blood glucose<200 mg/dl, triglycerides≥150 mg/dl and/or HDL cholesterol<40 mg/dl [men], 50 mg/dl [women]) were estimated using the Cox proportional hazards model. The population-attributable risk fraction of moderate metabolic risk factor clustering was also estimated. During the follow-up, 282 participants died of CVD. CVD mortality tended to increase with the number of moderate metabolic risk factors. However, they were not statistically significant. The multivariate-adjusted HRs were 1.82 (95%CI: 0.89-3.73) for having any moderate metabolic risk factors and 2.87 (95%CI: 1.46-5.64) for having any medication-required metabolic risk factors, compared with participants without any moderate metabolic risk factors. The population-attributable risk fractions were 7.3% and 52.4% for any moderate and medication-required metabolic risk factors, respectively. We did not find the statistically significant increase of CVD mortality for moderate metabolic risk factor clustering. Its attribution was relatively small in this Japanese population. More efforts would be required to detect and control medication-required risk factors.
  Atherosclerosis 12/2010; 215(1):209-13. · 3.79 Impact Factor
• Article: Time lag to hospitalisation and the associated determinants in patients with acute myocardial infarction: the Takashima AMI Registry, Japan.

  Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Naoyuki Takashima, Hideki Sugihara, Yutaka Morita, Kenji Matsui, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
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  ABSTRACT: Prompt initiation of treatment is the cornerstone in the management of patients with acute myocardial infarction (AMI). The time lags for AMI hospitalisations were examined to identify the factors influencing the interval. Time lag information was available for 273 men and 148 women from the Takashima AMI Registry during 1988-2006. Multivariate regression analyses were performed to evaluate the factors influencing early and late admission. The median time to hospitalisation was 2 h (mean 6.1, SD 18.7). Within 2 h of onset, 59.8% patients arrived and 20.6% arrived during the 2-6 h interval. A substantial number of patients (19.6%) arrived after 6 h and onwards. A time lag of >2 h in hospital admission was significantly influenced by history of hypertension, angina, presence of syncope as an initial symptom and time of AMI onset. A time lag of >6 h shared similar characteristics except for presence of history of angina. About one-fifth of patients with AMI have prolonged time lag in the study population. Future research intervention and health promotion activities should focus on achieving a reduction in presentation delays.
  Emergency Medicine Journal 10/2010; 28(3):239-41. · 1.44 Impact Factor
• Source

  Available from: Atsushi Tajima

  Article: Common variants in the ATP2B1 gene are associated with susceptibility to hypertension: the Japanese Millennium Genome Project.

  Yasuharu Tabara, Katsuhiko Kohara, Yoshikuni Kita, Nobuhito Hirawa, Tomohiro Katsuya, Takayoshi Ohkubo, Yumiko Hiura, Atsushi Tajima, Takayuki Morisaki, Toshiyuki Miyata, [......], Naoharu Iwai, Toshio Ogihara, Itsuro Inoue, Katsushi Tokunaga, Toby Johnson, Mark Caulfield, Patricia Munroe, Satoshi Umemura, Hirotsugu Ueshima, Tetsuro Miki
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  ABSTRACT: Hypertension is one of the most common complex genetic disorders. We have described previously 38 single nucleotide polymorphisms (SNPs) with suggestive association with hypertension in Japanese individuals. In this study we extend our previous findings by analyzing a large sample of Japanese individuals (n=14 105) for the most associated SNPs. We also conducted replication analyses in Japanese of susceptibility loci for hypertension identified recently from genome-wide association studies of European ancestries. Association analysis revealed significant association of the ATP2B1 rs2070759 polymorphism with hypertension (P=5.3×10(-5); allelic odds ratio: 1.17 [95% CI: 1.09 to 1.26]). Additional SNPs in ATP2B1 were subsequently genotyped, and the most significant association was with rs11105378 (odds ratio: 1.31 [95% CI: 1.21 to 1.42]; P=4.1×10(-11)). Association of rs11105378 with hypertension was cross-validated by replication analysis with the Global Blood Pressure Genetics consortium data set (odds ratio: 1.13 [95% CI: 1.05 to 1.21]; P=5.9×10(-4)). Mean adjusted systolic blood pressure was highly significantly associated with the same SNP in a meta-analysis with individuals of European descent (P=1.4×10(-18)). ATP2B1 mRNA expression levels in umbilical artery smooth muscle cells were found to be significantly different among rs11105378 genotypes. Seven SNPs discovered in published genome-wide association studies were also genotyped in the Japanese population. In the combined analysis with replicated 3 genes, FGF5 rs1458038, CYP17A1, rs1004467, and CSK rs1378942, odds ratio of the highest risk group was 2.27 (95% CI: 1.65 to 3.12; P=4.6×10(-7)) compared with the lower risk group. In summary, this study confirmed common genetic variation in ATP2B1, as well as FGF5, CYP17A1, and CSK, to be associated with blood pressure levels and risk of hypertension.
  Hypertension 10/2010; 56(5):973-80. · 6.21 Impact Factor
• Article: Ischemic stroke subtypes in a Japanese population: Takashima Stroke Registry, 1988-2004.

  Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
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  ABSTRACT: Population-based information on the epidemiology of ischemic stroke (IS) subtypes is scant. In this study, we characterized IS subtypes in terms of incidence, time trend, and risk factor profiles in a community-based population. We obtained data from the Takashima Stroke Registry on approximately 55 000 residents of Takashima County in central Japan and calculated age-adjusted stroke incidence rates for different IS subtypes. We determined the incidence time trend by calculating the average annual change across years and also compared risk factors between subtypes. There were 1389 first-ever ischemic strokes registered during 1988 to 2004. Lacunar infarction was the most frequent etiology (54.1%) followed by cardioembolic infarction (22.9%). Age-adjusted incidence rates for different IS subtypes were lacunar, 77.1; cardioembolic, 31.5; and nonlacunar, 29.7/10(5) person-years. The average annual change was not significant for the IS subtypes except for nonlacunar infarction, which showed a decreasing trend. Risk factor analysis showed that patients with lacunar infarctions were younger and less likely to have a history of transient ischemic attack or a drinking habit than patients with nonlacunar infarctions. Lacunar infarct was the most common IS subtype in our population. We found no significant change in the incidence of subtypes during the study, except a decrease in nonlacunar infarction.
  Stroke 09/2010; 41(9):1871-6. · 5.73 Impact Factor
• Article: Cigarette smoking in middle age and a long-term risk of impaired activities of daily living: NIPPON DATA80.

  Naoyuki Takashima, Katsuyuki Miura, Atsushi Hozawa, Tomonori Okamura, Takehito Hayakawa, Nagako Okuda, Takashi Kadowaki, Yoshitaka Murakami, Yoshikuni Kita, Yasuyuki Nakamura, Akira Okayama, Hirotsugu Ueshima
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  ABSTRACT: Few studies have reported the relationship between smoking in middle age and long-term risk of impaired activities of daily living (ADL). We analyzed 2,276 men and women aged 47-59 years at the baseline survey of NIPPON DATA80 in 1980. At the follow-up survey in 1999, ADL was surveyed among 1890 survivors. Multivariate-adjusted odds ratio (AOR) and 95% CI of impaired ADL or of composite outcome of either death or impaired ADL according to baseline smoking status were calculated by multiple logistic regression analyses. In 1999, 386 participants were dead, and 75 participants had impaired ADL. Compared with nonsmokers, AOR (95% CI) of impaired ADL was significantly higher in current smokers at baseline (odds ratio [OR] 2.11 [1.09-4.06]). Compared with nonsmokers, AOR of impaired ADL was higher as the number of cigarettes increased (OR 2.04 [1.02-4.06] for <20 cigarettes/day and OR 2.35 [0.94-5.88] for >20 cigarettes/day; p for trend = .04). AOR of composite outcome for current smoking was 1.83 (1.37-2.41). Smoking in middle age would increase future risks of impaired ADL. Smoking cessation may be important to prevent future impairment of ADL as well as death.
  Nicotine & Tobacco Research 09/2010; 12(9):944-9. · 2.58 Impact Factor
• Article: Brachial-ankle pulse wave velocity predicts all-cause mortality in the general population: findings from the Takashima study, Japan.

  Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Naoyuki Takashima, Aya Kadota, Kenji Matsui, Hideki Sugihara, Yutaka Morita, Yasuyuki Nakamura, Katsuyuki Miura, Hirotsugu Ueshima
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  ABSTRACT: Brachial-ankle pulse wave velocity (baPWV) is a relatively new non-invasive measure of arterial stiffness obtained using an automated system. We assessed the relationship between baPWV and 6.5-year overall mortality from the Takashima cohort study. The baPWV was measured in 2642 participants at baseline. When participants were divided into tertiles, all-cause mortality increased significantly as baPWV increased (P<0.001). Participants in the highest baPWV tertile showed an increased risk of all-cause mortality evidenced by a multivariable adjusted hazard ratio of 6.8 (95% confidence interval: 1.4-32.8) as compared with the lowest tertile. The present study demonstrated that increased baPWV is an independent predictor of all-cause mortality in the Japanese population.
  Hypertension Research 09/2010; 33(9):922-5. · 2.58 Impact Factor
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  Available from: Atsushi Hozawa

  Article: Population attributable fraction of smoking and metabolic syndrome on cardiovascular disease mortality in Japan: a 15-year follow up of NIPPON DATA90.

  Naoyuki Takashima, Katsuyuki Miura, Atsushi Hozawa, Aya Kadota, Tomonori Okamura, Yasuyuki Nakamura, Takehito Hayakawa, Nagako Okuda, Akira Fujiyoshi, Shin-Ya Nagasawa, Takashi Kadowaki, Yoshitaka Murakami, Yoshikuni Kita, Akira Okayama, Hirotsugu Ueshima
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  ABSTRACT: Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan. A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios. During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women). Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.
  BMC Public Health 01/2010; 10:306. · 2.00 Impact Factor
• Article: Dietary salt intake and blood pressure in a representative Japanese population: baseline analyses of NIPPON DATA80.

  Katsuyuki Miura, Nagako Okuda, Tanvir Chowdhury Turin, Naoyuki Takashima, Hideaki Nakagawa, Koshi Nakamura, Katsushi Yoshita, Akira Okayama, Hirotsugu Ueshima
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  ABSTRACT: The relationship between dietary salt intake and blood pressure (BP) has been rarely investigated in a large population of Japanese. The characteristics of nutrients intake and foods intake in Japanese people with high salt intake have also not investigated well. Data of 10,422 participants (4585 men and 5837 women) aged 30 or older who participated in both the National Survey on Circulatory Disorders and National Nutrition Survey in Japan conducted in 1980 were used. The nutrition surveys were performed with weighing record method for three consecutive days to each household. BP and intakes of nutrients and foods were compared by the quintiles of estimated individual salt intake per day. Analyses of covariance were used to calculate multivariate-adjusted mean BP values by the quintiles. Participants with higher salt intake showed higher intakes of soy beans/legume, fruit, other vegetables, and fish/shellfish. Intakes of protein, potassium, calcium, iron, magnesium, and fiber were higher in higher quintiles of salt intake. In men, adjusted systolic BPs were higher in the higher salt intake quintiles; there was 4.3 mm Hg difference in multivariate-adjusted systolic BP between the lowest quintile (mean salt intake 8.7 g/day) and the highest quintile (mean salt intake 23.5 g/day) (P < 0.001). In women, adjusted mean systolic BPs were not statistically different among the quintile of salt intake. A positive relationship of dietary salt intake to BP was observed, especially in men, in this large-scale representative Japanese population.
  Journal of Epidemiology 01/2010; 20 Suppl 3:S524-30. · 1.86 Impact Factor