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Journal of Epidemiology


Volume 27, Issue 12 (December 2017)

1) Review Article
Smoking and the risk of type 2 diabetes in Japan: A systematic review and meta-analysis
● This meta-analysis examined smoking and diabetes risk among Japanese.
● Current and former smokers showed a higher risk of diabetes than non-smokers.
● Diabetes risk linearly increased with higher consumption of cigarettes.
● Diabetes risk steadily decreased after smoking cessation.

2) Platelet count and indoor cold exposure among elderly people: A cross-sectional analysis of the HEIJO-KYO study
● Lower daytime indoor temperature was associated with higher PLT count in winter.
● The association was independent of outdoor temperature and socioeconomic status.
● The 1,095 elderly participants spent the majority of their time at home (87.3%).

3) The prevalence and risk factor control associated with noncommunicable diseases in China, Japan, and Korea
● The prevalence of hypertension, diabetes, and hyperlipidemia were highest in China.
● The prevalence of hypertension, diabetes, and hyperlipidemia were lowest in Japan.
● Some dietary behaviors improved hypertension, diabetes, and hyperlipidemia.
● These dietary behaviors differed by sex, age, and marital status.

4) Hemorrhoid is associated with increased risk of peripheral artery occlusive disease: A nationwide cohort study
● This study is a nationwide population-based cohort study.
● This study aimed to evaluate the association between hemorrhoid and risk of PAOD.
● Increased risk of PAOD in patients with hemorrhoids was found in this study.

5) The ratio of serum eicosapentaenoic acid to arachidonic acid and risk of cancer death in a Japanese community: The Hisayama Study
● Lower serum EPA:AA ratio was significantly associated with higher cancer mortality.
● The risk of death from liver cancer increased with lower serum EPA:AA ratio.
● No significant association was found between serum DHA:AA ratio and cancer death.

6) Acute effects of ambient temperature and particulate air pollution on fractional exhaled nitric oxide: A panel study among diabetic patients in Shanghai, China
● Both low and high temperatures were significantly associated with FeNO.
● The increases of fine and coarse PM concentrations were associated with FeNO.
● Both fine and coarse PM had stronger effects in cool days.

7) Statistical data
Age-, sex-, and diagnosis-specific incidence rate of medically certified long-term sick leave among private sector employees: The Japan Epidemiology Collaboration on Occupational Health (J-ECOH) study
● Incidence rate of sick-leave lasting ≥30 days was studied in 12 Japanese companies.
● The major causes were mental disorder, neoplasms, and pregnancy-related disease.
● Mental disorder and pregnancy-related disease were common in women aged 30–39 years.

Volume 27, Issue 11 (November 2017)

1) Blood pressure components and the risk for proteinuria in Japanese men: The Kansai Healthcare Study
● We examined which blood pressure (BP) components increased risk of proteinuria.
● We used systolic BP, diastolic BP, pulse pressure, and mean arterial pressure.
● Systolic and diastolic BP were the best predictors of persistent proteinuria.

2) Relationship between pulmonary function and elevated glycated hemoglobin levels in health checkups: A cross-sectional observational study in Japanese participants
● Participants with FEV1/FVC values <70% had significantly elevated HbA1c levels.
● Age, HbA1c, and current or former smoking were associated with FEV1/FVC values < 70%.
● Elderly ever smokers with elevated HbA1c should undergo screened for COPD.

3) Prenatal and childhood exposure to phthalate diesters and sex steroid hormones in 2-, 5-, 8-, and 11-year-old children: A pilot study of the Taiwan Maternal and Infant Cohort Study
● Prenatal phthalate exposure was associated with decreased PG levels in girls.
● Postnatal DEHP exposure was related to decreased free TT in boys and PG in girls.
● Use of phthalate-containing products in developing children should be limited.

4) Development of the Japanese version of the Council on Nutrition Appetite Questionnaire and its simplified versions, and evaluation of their reliability, validity, and reproducibility
● We translated the CNAQ and SNAQ into Japanese (CNAQ-J and SNAQ-J).
● The CNAQ-J was found to be constructed of one factor (appetite).
● We developed the SNAQ-JE according to an exploratory factor analysis.
● The CNAQ-J and SNAQ-JE showed acceptable reliability, reproducibility, and validity.
● The CNAQ-J and SNAQ-JE may be applied to assess Japanese elderly's appetite.

5) Prevalence of adiposity and its association with sleep duration, quality, and timing among 9–12-year-old children in Guangzhou, China
● Longer sleep duration was inversely associated with obesity in Chinese children.
● Later bedtime was positively associated with obesity in this population.
● No association between sleep quality and obesity was observed.

6) Leisure-time physical activity and risk of disability incidence: A 12-year prospective cohort study among young elderly of the same age at baseline
● We examined associations between physical activity and disability incidence.
● We quantified amount of leisure-time physical activity.
● A dose–response relationship was found for the risk of disability with dementia.

7)Association of food access and neighbor relationships with diet and underweight among community-dwelling older Japanese
● Low food access was associated with infrequent eating of foods in older Japanese.
● Low level of relationship with neighbors was also associated with infrequent eating.
● Interaction between food access and neighbor relationships was significant in men.

Volume 27, Issue 10 (October 2017)

1) Review Article
Epidemiology of ebolavirus disease (EVD) and occupational EVD in health care workers in Sub-Saharan Africa: Need for strengthened public health preparedness
● Recent EVD outbreaks in Africa (as of September 2015) claimed 12,933 lives.
● Health care workers (HCW) were severely impacted.
● We observed 890 cases of occupational EVD in HCW and a case fatality rate of 57%.
● Use of protective and safety-engineered medical devices should be expanded.
● Periodic training and improving EVD risk communication would enhance preparedness.

2) Alterations in physique among young children after the Great East Japan Earthquake: Results from a nationwide survey
● We obtained anthropometric data from 93,538 children aged 3.5–4.5 years.
● Anthropometric data were measured before and after the Great East Japan Earthquake.
● We compared the data in Iwate, Miyagi, and Fukushima vs. the other prefectures.
● Incident overweight was higher in the three prefectures than the other prefectures.

3) Concordance among methods of nutritional assessment in patients included on the waiting list for liver transplantation
● Malnutrition prevalence in patients waiting for a liver transplant is high.
● The prevalence of malnutrition varied depending on the method of evaluation.
● The overall agreement among the malnutrition assessment methods was low.
● PNI-O was the method of assessment malnutrition with the highest overall agreement.
● NRI obtained the highest positive likelihood ratio for the diagnosis of malnutrition.

4) Validity of diagnoses, procedures, and laboratory data in Japanese administrative data
● Validity of DPC and SS-MIX data was tested using chart review results as references.
● Specificity of DPC diagnoses was high; sensitivity was low and varied by conditions.
● Procedure records in DPC data were highly sensitive and specific.
● Accuracy of SS-MIX laboratory data exceeded 95% in all 13 items examined.

5) Relationship between nutrition knowledge and dietary intake among primary school children in Japan: Combined effect of children's and their guardians' knowledge
● Nutrition knowledge questionnaires were developed for Japanese children and adults.
● Higher nutrition knowledge was associated with healthier dietary habits in children.
● Both children's and guardians' nutrition knowledge affected food intakes in children.
● Sex differences in the effect of nutrition knowledge were suggested.

6) Pre-pregnancy BMI-specific optimal gestational weight gain for women in Japan
● We estimated gestational weight gain that optimizes pregnancy outcomes in Japanese.
● Optimal gain was 12.2 kg/40 weeks for pre-pregnancy BMI 17.0–18.4 kg/m2.
● Optimal gain was 4.3 kg/40 weeks for pre-pregnancy BMI 25.0–27.4 kg/m2.
● Current national guidelines are too low for women with pre-pregnancy BMI < 18.5 kg/m2.
● BMI > 23 kg/m2 should be defined as overweight if applying IOM recommendations.

7) Short Communication
Relationship between 8-year weight change, body size, and health in a large cohort of adults in Thailand
● This study investigated 8-year weight change and overall health among Thai adults.
● Weight gain was associated with poor emotional well-being and lower levels of energy.
● Findings highlight the importance of monitoring weight change and health effects.

Volume 27, Issue 9 (September 2017)

1) Gender disparity in the associations of overweight/obesity with occupational activity, transport to/from work, leisure-time physical activity, and leisure-time spent sitting in working adults: A cross-sectional study
● Physical activity and sitting with overweight/obesity in employees were studied.
● Heavy occupational activity had a lower overweight/obesity risk.
● Active LTPA and cycling to work were associated with lower overweight/obesity risk.
● Reducing leisure sitting time can reduce the risk of abdominal overweight/obesity.
● The significant results were observed in male employees but not in females.

2) Metabolic syndrome components and diabetes incidence according to the presence or absence of impaired fasting glucose: The Japan Epidemiology Collaboration on Occupational Health Study
● We examined diabetes risk by the number and combination of metabolic abnormalities.
● Diabetes risk increased with the number of abnormalities for a given glucose status.
● The combinations that included central obesity were strongly associated with diabetes.

3) Recent trends in the prevalence of underweight, overweight, and obesity in Korean adults: The Korean National Health and Nutrition Examination Survey from 1998 to 2014
● We conducted this study using the KNHANES from 1998 to 2014.
● Male obesity showed upward trends in overweight/obesity and grade 1 and 2 obesity.
● Overweight/obesity, grade 1, and abdominal obesity were leveling off in females.
● The prevalence of underweight decreased in men but increased in women.

4) Interactions between inflammatory gene polymorphisms and HTLV-I infection for total death, incidence of cancer, and atherosclerosis-related diseases among the Japanese population
● We observed death and incidence risk with HTLV-I and SNPs in a matched cohort study.
● An increased risk for total death with HTLV-I was observed in the island region.
● Inflammatory SNP interacted with HTLV-I for atherosclerosis-related disease risk.

5) Impact of birth weight on adult-onset diabetes mellitus in relation to current body mass index: The Japan Nurses' Health Study
● Association of birth weight and adult-onset DM was analyzed using JNHS study data.
● Odds ratio for developing DM per 100 g increase in birth weight was 0.93.
● The link was also observed when birth weight percentile for gestational age was used.
● Low birth weight was associated with adult-onset DM, even with normal current BMI.

6) Online version of the self-administered food frequency questionnaire for the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) protocol: Relative validity, usability, and comparison with a printed questionnaire
● We examined validity of intakes using web-FFQ compared with those for the print-FFQ.
● Moderate validities were shown for many estimates based on the web-FFQ.
● These CCs (with 12-day food record) were closely similar to those of the print-FFQ.
● Good concordance between individual rankings were obtained with the two FFQs.
● Mixing of these FFQs for diet survey in epidemiological studies appears acceptable.

7) Nationwide epidemiological survey of Leber hereditary optic neuropathy in Japan
● The incidence of Leber hereditary optic neuropathy (LHON) is unknown in Japan.
● A nationwide questionnaire survey has been done to estimate its annual incidence.
● About 120 cases of molecularly confirmed incident LHON were estimated in 2014.

Volume 27, Issue 8 (August 2017)

1) Review Article
Prevalence of frailty in Japan: A systematic review and meta-analysis
● Frailty is an important priority in Japan, where the population is aging rapidly.
● Japan is a good example of a rapidly aging society for frailty research.
● Five studies were included in this systematic review and meta-analysis study.
● Pooled prevalence of frailty in Japanese in the community aged >65 years is 7.4%.

2) Impact and attribute of each obesity-related cardiovascular risk factor in combination with abdominal obesity on total health expenditures in adult Japanese National Health insurance beneficiaries: The Ibaraki Prefectural health study
● The highest population attributable fraction was for hypertension without obesity.
● The total population attributable fraction of hypertension was 11.7%.
● Hypertension could impose the greatest attribute on Japanese health expenditures.

3) Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: Results from a five-year prospective cohort study of Japanese community dwellers
● Incidence rates for stroke and HF were estimated in Japanese community dwellers.
● Subjects were divided into AF and non-AF groups separately by age (40–69 and ≥70).
● AF increased the risk of stroke by the same magnitude as in Western populations.
● AF increased the risk of HF more than that in Western populations.
● The absolute risk differences of outcomes were larger in the elderly individuals.

4) It takes a village: Fixed-effects analysis of neighborhood collective efficacy and children's development
● The fixed-effects model can control for time-invariant confounding factors.
● Neighborhood social cohesion was inversely associated with child total problems.
● Neighborhood informal social control was inversely associated with child problems.
● Neighborhood collective efficacy prevents child psychosocial problems.

5) Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: An exploratory descriptive study using a nationwide claims database
● Benzodiazepines were prescribed to ≥59% of overdose patients aged ≥19 years.
● Cardiovascular drugs were frequently ingested among overdose patients aged ≥75 years.
● The proportions of patients with recent psychiatric treatments decreased with age.
● Overdose prevention should be optimized according to the age-related differences.

6) Cross-level interaction between individual socioeconomic status and regional deprivation on overall survival after onset of ischemic stroke: National health insurance cohort sample data from 2002 to 2013
● Regional socioeconomic status (SES) may differently affect mortality by income.
● Impact of area SES on morality among cerebrovascular patients was evaluated.
● Among middle-income patients, poor SES area is associated with poor mortality.
● Poor SES area is associated with better mortality among low-income patients.

7) The association between changes in lifestyle behaviors and the incidence of chronic kidney disease (CKD) in middle-aged and older men
● The lack of exercise habit is associated with the incidence of CKD.
● Late-night dinner and bedtime snacking increase the risk of CKD.
● Early lifestyle intervention is necessary to prevent CKD incidence.

Volume 27, Issue 7 (July 2017)

1) Difference of stage at cancer diagnosis by socioeconomic status for four target cancers of the National Cancer Screening Program in Korea: Results from the Gwangju and Jeonnam cancer registries
● Advanced stage was more frequent in cancer patients with lower economic status.
● Differences of stage by SES were found in stomach, colorectal, and breast cancer.
● Disparities still exist after the National Cancer Screening program in Korea.

2) Smoking and subsequent risk of leukemia in Japan: The Japan Public Health Center-based Prospective Study
● The first report based on cohort study to evaluate smoking and leukemia risk in Japan.
● This study indicates that cigarette smoking increases the risk of AML among men.
● Larger studies are needed on the association of smoking with AML for women.
● Associations with CML and ALL for both sexes also need further study.

3) Coexisting infectious diseases on admission as a risk factor for mechanical ventilation in patients with Guillain–Barre syndrome
● Subjects of this study were 4132 inpatients with Guillain–Barre syndrome.
● Data were derived from the Japanese Diagnosis Procedure Combination (DPC) database.
● Association between comorbidities and mechanical ventilation use was evaluated.
● Cytomegaloviral and herpes simplex viral infections were associated with ventilation.

4) Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey
● The timeliness and completeness of measles vaccination was low.
● The median delay period of measles vaccination was long among Guangxi children.
● Regions with higher measles incidence had higher rates of untimely coverage.

5) Body mass index and stroke incidence in Japanese community residents: The Jichi Medical School (JMS) Cohort Study
● The association of body mass index (BMI) with stroke remains controversial in Japan.
● Our large cohort study examined the association of interest in a Japanese population.
● Low BMI increased the risk of all-stroke and cerebral infarction incidence in men.
● In contrast, high BMI increased the risk of all-stroke incidence in women.

6) Comparison of weighed food record procedures for the reference methods in two validation studies of food frequency questionnaires
● The procedures of weighed food records in two independent studies were compared.
● General procedures of the dietary records were the mostly same for both studies.
● Differences were found in the setting of survey days and the survey sheet.
● Setting of survey days did not influence the intra- and inter-individual variation.
● Differences in survey sheets did not influence the portion sizes.

7) Self-perception of weight status and its association with weight-related knowledge, attitudes, and behaviors among Chinese children in Guangzhou
● Over one third of children misperceived their weight status in Guangzhou, China.
● Underestimation of body weight was much more prevalent than overestimation.
● Underestimation was common in younger children, girls, and those with obese parents.
● Children perceived as underweight/overweight had a higher intention to change weight.
● Children perceived as normal weight behaved more healthily on certain behaviors.

Volume 27, Issue 6 (June 2017)

1) Review Article
Factors affecting sustainable iodine deficiency elimination in Pakistan: A global perspective
● Since 1880, 58.9% of 56 studies reported goiter/iodine deficiency prevalence ≥30%.
● Seventy five percent of studies reported ≥30% goiter prevalence before 1994.
● From 1994 onwards, 32.1% of studies reported goiter/iodine deficiency prevalence ≥30%.

2) Suicide rates across income levels: Retrospective cohort data on 1 million participants collected between 2003 and 2013 in South Korea
● Suicide showed an increasing trend as income levels decreased.
● Suicide was most frequent in Medicaid recipients.
● Suicide showed different trends across gender and age groups.

3) Growth charts for Brazilian children with Down syndrome: Birth to 20 years of age
● We constructed growth charts for Brazilian youth with Down syndrome aged 0–20 years.
● Brazilian youth with Down syndrome showed substantial growth restriction.
● There were cross-national differences in growth among youth with Down syndrome.

4) Infectious diarrheal disease caused by contaminated well water in Chinese schools: A systematic review and meta-analysis
● School children were susceptible to waterborne disease in China.
● Attack rates of rural or primary schools were high.
● Boys trended toward higher risk than girls.
● Unsanitary conditions of water wells were reported frequently.

5) Prevalence of abdominal obesity among Chinese adults in 2011
● In 2011, the mean waist circumference in China was 85.9 cm (men) and 80.7 cm (women).
● In 2011, the prevalence of abdominal obesity was 35.3% in men and 51.7% in women.
● The prevalence in China was lower than in Japan and the United States.

6) Living status and frequency of eating out-of-home foods in relation to nutritional adequacy in 4,017 Japanese female dietetic students aged 18–20 years: A multicenter cross-sectional study
● Young women living with their family had more nutrients not meeting dietary goals.
● Eating out was associated with not meeting dietary goals in those living with family.
● Young women living alone had more inadequate intakes of nutrients.
● Eating out-of-home did not affect nutritional adequacy in those living alone.

7) Short Communication
Sources of heterogeneity in studies of the BMI-mortality association
● The BMI-mortality association varies considerably between study cohorts.
● We found ethnicity alone to account for 36% of the heterogeneity.
● Age and length of follow-up accounted for 56% of the remaining heterogeneity.

Volume 27, Issue 5 (May 2017)

1) Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy
● The validity of FFQ for Japanese pregnant women was shown.
● The FFQ estimated nutritional intake in the early pregnancy period.
● This FFQ was valid even if women had nausea and vomiting during pregnancy.

2) Personal status of general health checkups and medical expenditure: A large-scale community-based retrospective cohort study
● To clarify the association between General Health Checkups and Medical Expenditures.
● A retrospective cohort study was conducted in a middle-aged Japanese population.
● Non-, low-, and high-frequency utilizers were divided based on the 6-year GHCs.
● 3-year MEs were analyzed using Tweedie distribution for a generalized linear model.
● Outpatient MEs rise when GHCs are frequent, but inpatient and total MEs are lower.

3) Association of IL4, IL13, and IL4R polymorphisms with gastrointestinal cancer risk: A meta-analysis
● This meta-analysis included 27 eligible case–control studies.
● IL4 rs2070874 T allele may increase the risk of gastrointestinal cancer.
● IL4R rs1801275 variant may reduce the risk of gastrointestinal cancer.
● Polymorphisms in IL4 and IL4R may affect susceptibility to gastrointestinal cancer.

4) Development of an instrument for community-level health related social capital among Japanese older people: The JAGES Project
● Most study failed to capture multiple dimensions of community-level social capital.
● We developed and validated 11-item health related community social capital scale.
● The scale assessed civic participation, social cohesion, and reciprocity.

5) Gender differences in the associations between urinary bisphenol A and body composition among American children: The National Health and Nutrition Examination Survey, 2003–2006
● Associations between urinary BPA and body composition were examined in U.S. children.
● Gender differences existed in the associations of BPA and body composition.
● BPA levels were positively associated with lean body mass in boys but not in girls.
● BPA levels were positively associated with fat mass in girls but not in boys.

6) A population-based cohort study suggests an increased risk of multiple sclerosis incidence in patients with type 2 diabetes mellitus
● Risk ratio of incident multiple sclerosis (MS) in T2DM patients was 1.44.
● Risk ratio of incident MS was highest in women aged <50 years.
● The PAR% for T2DM in the MS incidence was estimated at 2.55%.

7) Short Communication
Validity and reliability of a self-administered food frequency questionnaire for the JPHC study: The assessment of amino acid intake
● The Japanese database for food amino acid compositions was revised in 2010.
● We evaluated the validity and reliability of amino acid intakes assessed via a FFQ.
● The estimation via a new database had better validity than via the former database.
● The estimation using the new database indicated good reliability.

Volume 27, Issue 4 (April 2017)

1) BMI, reproductive factors, and breast cancer molecular subtypes: A case-control study and meta-analysis
● For East Asian women, overweight increases risk of both luminal and ER-PR- tumors.
● For East Asian women, early menarche increases luminal tumor risk.
● For East Asian women, nulliparity increases luminal tumor risk.

2) Fruit and vegetable intake and the risk of overall cancer in Japanese: A pooled analysis of population-based cohort studies
● We conducted a pooled analysis of large-scale cohort studies in Japan.
● A total of 17,681 cases of overall cancers were identified among 191,519 subjects.
● Fruit and vegetable consumption was not associated with the risk of overall cancer.

3) Handling missing Mini-Mental State Examination (MMSE) values: Results from a cross-sectional long-term-care study
● Mini Mental State Examination items were not missing completely at random.
● Regression and descriptive analyses have different optimum missing-data techniques.
● Some techniques approximated results obtained using a “gold standard”.

4) Availability of two self-administered diet history questionnaires for pregnant Japanese women: A validation study using 24-hour urinary markers
● The DHQ and the BDHQ can assess energy-adjusted protein, sodium, and potassium intake.
● The DHQ can be a useful tool to estimate energy intake during pregnancy.
● Estimating energy intake during pregnancy with the BDHQ is difficult.

5) Effect of evacuation on liver function after the Fukushima Daiichi Nuclear Power Plant accident: The Fukushima Health Management Survey
● Prevalence of liver dysfunction increased after the Great East Japan Earthquake.
● The change in prevalence of liver dysfunction was greatest in evacuees.
● Evacuation is one risk factor associated with liver dysfunction.

6) Educational inequalities in smoking among Japanese adults aged 25–94 years: Nationally representative sex- and age-specific statistics
● Educational inequalities in smoking were larger in the young than the old in Japan.
● Junior high school graduates had the highest smoking prevalence among both sexes.
● Graduate school graduates had the lowest smoking prevalence among both sexes.
● A steeper educational gradient in smoking was observed in women than in men.

7) Study Profile
Rationale, design, and profile of the Three-Prefecture Cohort in Japan: A 15-year follow-up
● The Three-Prefecture Cohort had about 100,000 participants in urban and rural areas.
● This cohort collected detailed information on participants' lifestyles.
● This cohort had data on participants' cancer incidence and mortality.

Volume 27, Issue 3 (March 2017)

1) Editorial
Why we should worry less about predatory publishers and more about the quality of research and training at our academic institutions
● Predatory journals claim to be peer reviewed but actually publish all submissions.
● Most work published in predatory journals is of low quality.
● Researchers should be trained to identify predatory and legitimate journals.
● The growth of predatory journals reflects problems with research institutions.
● Efforts should be made to improve research quality and training.
2) Dietary antioxidant vitamins intake and mortality: A report from two cohort studies of Chinese adults in Shanghai
● Dietary vitamin C and carotene were inversely associated with total deaths in China.
● These associations were more pronounced for cardiovascular disease mortality.
● Dietary antioxidant vitamins might not be associated with cancer mortality risk.

3) Initiators and promoters for the occurrence of screen-detected breast cancer and the progression to clinically-detected interval breast cancer
● Identify state-dependent initiators and promoters for breast cancer.
● Build a multistage risk assessment model for individual risk stratification.
● Facilitate individually-tailored screening and clinical surveillance.

4) The association between alcohol use and problematic internet use: A large-scale nationwide cross-sectional study of adolescents in Japan
● Association between alcohol and Internet addiction or excessive use was examined.
● Survey subjects: 100,050 randomly selected high school students throughout Japan.
● Significant association of drinking with problematic Internet use was recognized.

5) Maternal smoking during pregnancy and rapid weight gain from birth to early infancy
● Maternal smoking in pregnancy is associated with Rapid Weight Gain in early infancy.
● The association of maternal smoking with rapid weight gain was dose-dependent.
● This study was based on a large population-based dataset in Japan.

6) Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan
● Two-thirds of patients with myxedema coma were female, and the mean age was 77 years.
● The mortality rate was 29.5%, and the incidence was 1.08/million people/year.
● Older age and use of catecholamines, with or without steroids, were related to death.

7) Age-specific impact of diabetes mellitus on the risk of cardiovascular mortality: An overview from the evidence for Cardiovascular Prevention from Observational Cohorts in the Japan Research Group (EPOCH-JAPAN)
● We conducted meta-analysis of individual data from 8 Japanese cohorts (n = 38,854).
● Diabetes raised cardiovascular mortality in Japan.
● Impact of diabetes on cardiovascular death was similar across 10-year age groups.

8) Short Communication
Metabolic syndrome among non-obese adults in the teaching profession in Melaka, Malaysia
● The prevalence of metabolic syndrome among the non-obese teachers was 17.7%.
● The odds of metabolic syndrome increased exponentially from a BMI of 23.0 kg/m2.
● Metabolic syndrome was more prevalent among males, Indians, and older teachers.

9) Study Profile
Design of the health examination survey on early childhood physical growth in the Great East Japan Earthquake affected areas
● We conducted surveys on physical growth among children in relation to the disaster.
● We acquired one of the largest longitudinal datasets of Japanese preschool children.
● We will provide epidemiological evidence on children's health after the disaster.

Volume 27, Issue 3, Supplement (March 2017)

1) Preface
BioBank Japan project: Epidemiological study
● For precision medicine, genetic, clinical and environmental information is crucial.
● Biobank Japan project constructed a clinical database of 200,000 patients.
● This supplement reported the epidemiological studies in the Biobank Japan.

2) Overview of the BioBank Japan Project: Study design and profile
● The BioBank Japan Project (BBJ) enrolled 200,000 patients with 47 target diseases.
● The BBJ is one of the largest patient-based biobanks in the world.
● The BBJ may allow for personalized medicine in the future.

3) Cross-sectional analysis of BioBank Japan clinical data: A large cohort of 200,000 patients with 47 common diseases
● The BioBank Japan Project (BBJ) annually collected clinical information.
● Analysis of the clinical information at enrollment characterized the BBJ cohort.
● Analysis of family history revealed impacts of host genetic factors on the diseases.

4) Overview of BioBank Japan follow-up data in 32 diseases
● 141,612 participants with any of 32 diseases were included in the follow-up survey.
● Subject characteristics at enrollment for the follow-up survey were identified.
● The relative survival analysis showed the worst prognosis in pancreatic cancer.
● The most common cause of death in all subjects was malignant neoplasms.

5) Demographic and lifestyle factors and survival among patients with esophageal and gastric cancer: The Biobank Japan Project
● Among ESCC patients, alcohol drinkers had a poor prognosis.
● Underweight gastric cancer patients had a poor prognosis.
● Gastric cancer patients who exercised had a good prognosis.
● No association between esophageal or gastric cancer and smoking was observed.

6) Characteristics and prognosis of Japanese colorectal cancer patients: The BioBank Japan Project
● More than 95% were adenocarcinoma both in colon and rectal cancer.
● Rectal cancer patients ate more meat and less green vegetables than colon cancer.
● Eating green vegetables and drinking alcohol moderately decreased the mortality risk.

7) Characteristics of patients with liver cancer in the BioBank Japan project
● Liver cancer is the second leading cause of death worldwide.
● We aimed to provide an overview of patients with liver cancer.
● Based on liver cancer histology, 91.9% had hepatocellular carcinoma.
● The 10-year relative survival rates were 34% in men and 38% in women.
● Future studies will help develop preventive programs for liver cancer.

8) Characteristics and prognosis of Japanese male and female lung cancer patients: The BioBank Japan Project
● Nearly one-tenth of Japanese lung cancer patients were diagnosed as stage IV.
● Adenocarcinoma was the most common histological type in both males and females.
● Some characteristics would affect all-cause mortality in lung cancer patients.

9) Characteristics and prognosis of Japanese female breast cancer patients: The BioBank Japan project
● About 1% of Japanese female breast cancer patients were diagnosed as stage IV.
● Invasive carcinoma was much more common than non-invasive carcinoma.
● Papillotubular carcinoma was the most common type of invasive carcinoma.
● About 75% were positive for estrogen receptor and 60% for progesterone receptor.
● Some characteristics would affect all-cause mortality in breast cancer patients.

10) Clinical and histopathological characteristics of patients with prostate cancer in the BioBank Japan project
● Prostate cancer represents the second leading cause of cancer incidence worldwide.
● We aimed to provide an overview of patients with prostate cancer.
● Based on prostate cancer histology, 99.3% had adenocarcinoma.
● The 5- and 10-year relative survival rates were 96.3% and 100.5%.
● Future studies will help develop preventive programs for prostate cancer.

11) Risk prediction models for mortality in patients with cardiovascular disease: The BioBank Japan project
● We developed risk prediction models for death after cardiovascular disease (CVD). ● Performances of these models were validated in an independent cohort. ● Our models may be used to estimate mortality risk in chronic CVD patients.

12) Cholesterol levels of Japanese dyslipidaemic patients with various comorbidities: BioBank Japan
● Evidence of serum cholesterol control in Japanese dyslipidaemic patients is scarce.
● We analysed data for a large-scale population in hospital settings.
● Our findings provide serum cholesterol levels by different risk profiles.
● Serum lipid levels were the lowest in the youngest patients. • Data should be carefully applied to patients with mild hyperlipidaemia.

13) Statin use and all-cause and cancer mortality: BioBank Japan cohort
● Statin-mediated reduction of low-density lipoprotein levels reduces mortality.
● Little is known on the effect of non-statin hyperlipidaemia medicines on mortality.
● Statin monotherapy is safe in terms of cancer mortality.
● Statin use may reduce colorectal cancer-related mortality.
● Resin monotherapy was associated with the lowest mortality.

14) Serum glucose, cholesterol and blood pressure levels in Japanese type 1 and 2 diabetic patients: BioBank Japan
● Detailed glycaemic control data of diabetic patients are necessary.
● Few studies have compared the survival times between type 1 and 2 diabetes.
● Higher glycated HbA1c was observed in type 1 than in type 2 diabetes.
● Data showed higher hazard ratio of mortality in type 1 than in type 2 diabetes.
● Fewer macrovascular complications accompany type 1 than type 2 diabetes.

15) Survival of macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking in patients with type 2 diabetes: BioBank Japan cohort
● Fatal diseases frequently accompany diabetes.
● Data for survival of Asian patients with diabetes with comorbidities are scarce.
● Comorbid chronic kidney disease was associated with the most fatalities.
● Current smoking was as fatal as 10 years of ageing in diabetic patients.
● Values of 1% HbA1c and 10 mmHg blood pressure confer 11% excess mortality risk.

Volume 27, Issue 2 (February 2017)

1) Review Article
A typology of four notions of confounding in epidemiology

● Confounding depends not only on the target population but also on its four notions.
● It would be helpful to use the total population as the target population.
● Simple examples can be powerful tools for understanding complex causal concepts.

2) Change in household income and risk for attention deficit hyperactivity disorder during childhood: A nationwide population-based cohort study
● Childhood ADHD is more prevalent among socioeconomically disadvantaged groups.
● We examined the association between household income and childhood ADHD occurrence.
● The occurrence was higher in lower income households during early childhood.

3) Association between serum concentrations of persistent organic pollutants and smoking in Koreans: A cross-sectional study
● For women, serum PCB levels were higher in ever-smokers than in never-smokers.
● The risk of high level of POPs was higher in ever-smokers than in never-smokers.
● Subjects who smoked <15 cigarettes/day had a high risk of having high POP levels.

4) Is there an occupational status gradient in the development of periodontal disease in Japanese workers? A 5-year prospective cohort study
● The first cohort study to evaluate occupational status and periodontal disease.
● Revealed occupational status affects developing periodontal disease over 5 years.
● Skilled workers, sale persons, and drivers had higher risks of periodontal disease.

5) Orthopedic, ophthalmic, and psychiatric diseases primarily affect activity limitation for Japanese males and females: Based on the Comprehensive Survey of Living Conditions
● Healthy Life Expectancy consists of activity limitation and mortality in Japan.
● We calculated the odds ratio and PAF between activity limitation and every disease.
● Orthopedic, ophthalmic, and psychiatric diseases affect activity limitation primarily.

6) Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries
● A comprehensive health literacy survey tool was validated in several countries.
● Health literacy was significantly associated with education and social status.
● The tool was shown to be reliable for public health survey in Asia.

Volume 27, Issue 1 (January 2017)

1) Progression from prehypertension to hypertensi non and risk of cardiovascular disease
● We analyzed 2227 subjects for this study from the Jichi Medical Cohort study.
● Progression from pre-HT to HT had 2.95 times higher cardio vascular disease risk.
● The cardio vascular disease risk with pre-HT might increase after progression to HT.

2) Evacuation after the Great East Japan Earthquake was associated with poor dietary intake: The Fukushima Health Management Survey
● Evacuation was associated with poor dietary intake after the earthquake.
● Living at home was associated with higher non-juice fruit and vegetable intake.
● Living at home was associated with higher meat, soybean, and dairy product intake.

3) Validation of a novel claims-based stroke severity index in patients with intracerebral hemorrhage
● Claims data lack stroke severity, a crucial predictor of outcomes after ICH.
● The claims-based stroke severity index correlates well with stroke severity in ICH.
● Stroke severity index is valid for risk adjustment in studies using claims data.

4) Validity of a food frequency questionnaire to estimate long-chain polyunsaturated fatty acid intake among Japanese women in early and late pregnancy
● FFQ has good validity for LC-PUFA among Japanese women in early and late pregnancy.
● High correlations observed for EPA and DHA intake estimated using dietary records.
● High correlations observed for EPA and DHA in serum phospholipid composition.

5) Green tea consumption and cause-specific mortality: Results from two prospective cohort studies in China
● Green tea intake was inversely associated with risk of all-cause mortality in China.
● The inverse association was mainly driven by cardiovascular disease mortality.
● No significant association was found between green tea intake and cancer mortality.

6) Independent and combined relationship of habitual unhealthy eating behaviors with depressive symptoms: A prospective study
● Snacking after dinner was associated with incident depressive symptoms.
● Interaction of snacking after dinner and late night dinner on depressive symptoms.
● Subjects with ≥2 unhealthy eating habits had higher risk of depressive symptoms.

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