Social innovation for life expectancy extension utilizing a platform-centered system used in the Iwaki health promotion project: A protocol paper.

INTRODUCTION: We are trying to create a platform for social innovation to extend life span. METHODS: Since 2005, health data (approximately 3000 items per person as of 2020) of approximately 1000 adults have been collected each year during the Iwaki Health Promotion Project. The industry, government, academia, and citizens have involvements in data collection, aiming to build a platform that encourages societal innovation and subsequently extends life expectancy in Aomori. The Iwaki Health Promotion Project has been supported financially by the Japanese government since it was selected as the Center of Innovation program in 2013. RESULTS: Since the numbers of academia, industries, governments, and citizens involved in the Iwaki Health Promotion Project increased over the years, the big data produced during the project has become increasingly pluripotent and adaptable. It has been used to promote public health, which has also created a stronger partnership among companies and research organizations. Consequently, the amount of data collected from the project has gained attention and became more open to companies and researchers participating in the Iwaki Health Promotion Project, resulted in establishing a larger platform. It also led to the acquisition of external funding, publications of numerous research papers, creation of new health examinations, and the establishment of the Health Promotion Center (an institution for cultivating health volunteers). CONCLUSION: The Iwaki Health Promotion Project aims not only to produce a pluripotent big data but also to improve the average life expectancy of Aomori by creating a large platform in the society. Its positive impact in the future is infinite and will keep growing as long as it is maintained by the society.

Lower serum calcium levels are a risk factor for a decrease in eGFR in a general non-chronic kidney disease population.

Association between serum calcium (Ca) levels and kidney dysfunction progression in a non-chronic kidney disease (CKD) population has not been well elucidated, especially in consideration for classical metabolic risk conditions such as hypertension, dyslipidemia, and diabetes, and those related to Ca metabolism. Among participants of the population-based Iwaki study of Japanese people, those with an estimated glomerular filtration rate (eGFR) ≧60 ml/min/1.73 m2 and age ≧40 years, and who attended the study consecutively in 2014 and 2015 were enrolled (gender (M/F): 218/380; age: 58.9 ± 10.2). Regression analysis showed a significant correlation between serum Ca levels and a change in eGFR in the 1-year period (∆eGFR) after adjustment with multiple factors including those related to Ca metabolism (ß = 0.184, p < 0.001). When subjects were stratified into tertiles based on their serum Ca levels (higher >9.6 mg/dL, middle 9.4-9.6 mg/dL, lower <9.4 mg/dL), lower serum Ca levels were a significant risk for a rapid decliner of eGFR designated as the lower one third of ∆eGFR (<-4.40 ml/min/1.73 m2) (odds ratio 2.41, 95% confidence interval 1.47-3.94). Lower serum Ca levels are a significant risk for rapid decrease in eGFR, independent of previously reported metabolic risk factors in this general population with non-CKD, or eGFR ≧60 ml/min/1.73 m2.

Relationship Between Serum Eicosapentaenoic Acid Levels and J-Waves in a General Population in Japan.

We previously showed that J-waves were found more frequently in patients with low levels of serum eicosapentaenoic acid (EPA) in the acute phase of myocardial infarction, and were associated with the incidence of ischemia-related ventricular arrhythmias. However, the relationship between J-waves and serum EPA levels in a general population remains to be elucidated.The Iwaki Health Promotion Project is an ongoing community-based health promotion study in Iwaki, Hirosaki, which is in northern Japan. A total of 1,052 residents (mean age, 53.9 ± 15.4 years; 390 men) who participated in this project in 2014 were studied. A standard 12-lead electrocardiogram (ECG) was recorded and serum EPA levels were measured to evaluate the relationship between J-waves and serum EPA levels. J-waves were found in 52 (5%) subjects and were observed more frequently in male than female subjects (44 [11%] versus 8 [1%], P < 0.0001). More than half of the J-waves were the notched type (60%), and J-waves were detected most frequently in inferior leads on ECG (52%). The RR interval was longer and QTc duration shorter in subjects with J-waves than those without. No significant difference was found in serum EPA levels between subjects with and without J-waves (70 [49-116] versus 65 [41-106] µg/mL, P = 0.40). In multivariate analysis, male gender and RR interval were independent factors associated with the presence of J-waves.There was no significant relationship between J-waves and serum EPA levels in this general population in Japan. Various mechanisms for manifestation of the J-waves are suggested.

Aberrant N-Glycosylation Profile of Serum Immunoglobulins is a Diagnostic Biomarker of Urothelial Carcinomas.

The aim of this study to determine whether the aberrant N-glycosylated serum immunoglobulins (Igs) can be applied as a diagnostic marker of urothelial carcinoma (UC). Between 2009 and 2016, we randomly obtained serum available from 237 UC and also 96 prostate cancer as other cancer controls from our serum bank and also obtained-from 339 healthy volunteers (HV)-controls obtained from community-dwelling volunteers in Iwaki Health Promotion Project. A total of 32 types of N-glycan levels on Igs were determined by high-throughput N-glycomics and analyzed by multivariable discriminant analysis. We found five UC-associated aberrant N-glycans changes on Igs and also found that asialo-bisecting GlcNAc type N-glycan on Igs were significantly accumulated in UC patients. The diagnostic N-glycan Score (dNGScore) established by combination of five N-glycans on Igs discriminated UC patients from HV and prostate cancer (PC) patients with 92.8% sensitivity and 97.2% specificity. The area under the curve (AUC) for of the dNGScore was 0.969 for UC detection that was much superior to that of urine cytology (AUC, 0.707) and hematuria (AUC, 0.892). Furthermore, dNGScore can detect hematuria and urine cytology negative patients. The dNGscore based on aberrant N-glycosylation signatures of Igs were found to be promising diagnostic biomarkers of UCs.

Dominance of the hypothalamus-pituitary-adrenal axis over the renin-angiotensin-aldosterone system is a risk factor for decreased insulin secretion.

How the association between the hypothalamus-pituitary-adrenal (HPA) axis and the renin-angiotensin-aldosterone system (RAAS) affects glucose metabolism were not well examined in a general population. Participants of the population-based 2015 Iwaki study were enrolled (n: 1,016; age: 54.4 ± 15.1 years). Principal component (PC) analysis identified two PCs: PC1 represented levels of the HPA axis (serum cortisol) and the RAAS (plasma aldosterone) as a whole, and PC2 represented the HPA axis relative to the RAAS (HPA axis dominance). We examined the association between these PCs and glucose metabolism using homeostasis model assessment indices of reduced insulin sensitivity (HOMA-R) and secretion (HOMA-ß). Univariate linear regression analyses showed a correlation between PC2 and HOMA-ß (ß = -0.248, p < 0.0001), but not between PC1 and HOMA-ß (ß = -0.004, p = 0.9048). The correration between PC2 and HOMA-ß persisted after adjustment for multiple factors (ß = -0.101, p = 0.0003). No correlations were found between the PCs and HOMA-R. When subjects were tertiled based on PC2, the highest tertile was at greater risk of decreased insulin secretion (defined as the lower one third of HOMA-ß (≤68.9)) than the lowest tertile after adjustment for multiple factors (odds ratio, 2.00; 95% confidence interval, 1.35-2.97). The HPA axis dominance is associated with decreased insulin secretion in a Japanese population.

Characteristics of reactive oxygen metabolites in serum of early teenagers in Japan.

OBJECTIVES: The relationship between the incidence of cardiovascular disease and the state of oxidative stress in blood has been studied to some extent. Several lines of evidence underscore the importance of primary prevention of cardiovascular disease beginning in childhood. However, little is known about the current state of oxidative stress in childhood. This study was carried out to determine the current state of the level of reactive oxygen metabolites (ROM) in serum of early teenagers. METHODS: This study enrolled 595 healthy junior high school students from the town of Nanbu located in northern Japan. Oxidative stress was evaluated by measuring the serum level of ROM, and antioxidant capacity was evaluated by measuring the serum level of biological antioxidant potential (BAP). RESULTS: Although the ROM level in female students [308.6 ± 63.1 Carratelli units (U.CARR)] was slightly higher than that in males (299.9 ± 55.2 U.CARR), the difference was not statistically significant. The BAP level in males was significantly higher than that in females. The levels of ROM and BAP detected in males in the first grade were higher than those in the other grades. In females, only first-graders' BAP was higher than that in other grades. CONCLUSIONS: The current study found that the ROM level in males was negatively correlated with grade. These results suggest the presence of factor(s) that increase oxidative stress in Japanese puberty.