Isoflavone and soy food intake and risk of lung cancer in never smokers: report from prospective studies in Japan and China.

PURPOSE: Evidence from several cohorts has suggested that a higher intake of isoflavone is associated with lower risk of lung cancer in never smokers, but the association has not been investigated by histologic type of lung cancer. Adenocarcinoma is a common histologic type found in never smokers. We hypothesized that a higher intake of isoflavone is associated with a lower risk of lung adenocarcinoma among never smokers. Here, we examined the associations of isoflavone and soy food intake with lung cancer and its histologic types in never smokers. METHODS: We performed a pooled analysis using data from the Japan Public Health Center-based Prospective Study, Shanghai Women's Health Study and Shanghai Men's Study with 147,296 never smokers aged 40-74 years with no history of cancer. During 1,990,040 person-years of follow-up, 1247 lung cancer cases were documented. Dietary isoflavone and soy food intake were assessed using a food-frequency questionnaire. Multivariable Cox proportional hazards models assessed the associations between isoflavone and soy intake with incidence of lung cancer by histologic type. RESULTS: A higher intake of dietary isoflavone and soy food were associated with reduced risk of lung adenocarcinoma. The multivariable hazard ratios (HRs) (95% CI) of risk of lung adenocarcinoma for the highest versus lowest intakes of isoflavone and soy food were 0.74 (0.60-0.92) and 0.78 (0.63-0.96), respectively. The multivariable HRs of risk of lung adenocarcinoma associated with each 10 mg/day increase in isoflavone and each 50 g/day increase in soy food intake were 0.81 (0.70-0.94) and 0.84 (0.73-0.96), respectively. CONCLUSION: Higher intake of isoflavone and soy food was associated with lower risk of lung adenocarcinoma in never smokers.

The relationship between sodium concentrations in spot urine and blood pressure increases: a prospective study of Japanese general population: the Circulatory Risk in Communities Study (CIRCS).

BACKGROUND: Although several cross-sectional and intervention studies showed that sodium intake or excretion was associated with blood pressure levels, no prospective study has examined the long-term association between sodium excretion in spot urine and blood pressure changes. METHODS: We conducted a prospective study of 889 normotensive subjects (295 men and 594 women, mean age 57.3 years) who underwent the baseline survey including spot urine test in 2005 and the follow-up survey in 2009 to 2011 (mean follow-up period: 5.8 years). We examined the association between sodium concentration in spot urine, a validated index of sodium excretion occurring over 24-h, and blood pressure changes between baseline and follow-up survey in all, non-overweight (body mass index(BMI) ≤ 25 kg/m(2)) and overweight normotensives. RESULTS: For all subjects, sodium concentrations in spot urine were not associated with either systolic or diastolic blood pressure changes. When stratified by BMI at baseline survey, sodium concentrations were positively associated with systolic blood pressure changes in non-overweight subjects, but not in overweight subjects. After adjustment for age, sex, BMI, alcohol intake status, current smoking and estimated glomerular filtration rate, the multivariable-adjusted mean values of the systolic blood pressure change among non-overweight subjects was +7.3 mmHg in the highest quartiles of sodium concentrations, while it was +3.9 mmHg in the lowest quartile (P for difference = 0.021, P for trend = 0.040). After further adjustment of baseline blood pressure levels, the association was slightly weakened; the multivariable-adjusted mean values of the systolic blood pressure changes were +7.0 mmHg and +4.2 mmHg (P for difference = 0.047, P for trend = 0.071). CONCLUSIONS: High sodium concentrations in spot urine were associated with subsequent systolic blood pressure increases among non-overweight normotensive individuals. (272 words).

Vitamin D levels and cognition in elderly adults in China.

OBJECTIVES: To evaluate the association between vitamin D level and cognitive impairment in individuals aged 60 and older. DESIGN: Cross-sectional cohort study. SETTING: Chinese Longitudinal Healthy Longevity Survey, a community-based cohort study in areas in China where the density of centenarians is exceptionally high. PARTICIPANTS: Individuals with mean age of 84.9 ± 12.7 (N = 2,004). MEASUREMENTS: Participants' cognitive state was evaluated using the Mini-Mental State Examination (MMSE). Vitamin D was measured in plasma using an enzyme-linked immunoassay. RESULTS: The cross-sectional association between quartiles of plasma vitamin D level and cognitive impairment (MMSE score <18) was modeled using logistic regressions. Plasma vitamin D levels were lower in individuals with cognitive impairment (31.9 ± 15.3 nmol/L) than in those without (45.6 ± 19.6 nmol/L). There was a reverse association between plasma vitamin D and cognitive impairment. After adjusting for age, sex, chronic conditions, smoking and drinking habits, outdoor activities, depression, and activity of daily living limitations, the association remained significant. The multivariable-adjusted odds ratio for lowest versus highest vitamin D levels was 2.15 (95% confidence interval (CI) = 1.05-4.41) for cognitive impairment, and the multivariable odds ratio associated with a 1-standard deviation decrement in plasma vitamin D was 1.32 (95% CI = 1.00-1.74) for cognitive impairment. CONCLUSION: Low plasma vitamin D levels were associated with greater odds of cognitive impairment. Further prospective studies in Asian populations are needed to examine the causal direction of this association.

C-reactive protein levels and risk of disabling dementia with and without stroke in Japanese: the Circulatory Risk in Communities Study (CIRCS).

OBJECTIVE: Studies have shown that elevated high-sensitivity C-reactive protein (hs-CRP) predicts stroke, which is a risk factor for dementia. It remains, however, unclear whether hs-CRP increases risk of dementia. METHODS: A prospective nested case-control study of Japanese 40-69 years of age was conducted using frozen serum samples collected from approximately 7531men and women who participated in cardiovascular risk surveys from 1984 to 1994 in one community and 1989-1995 in another community under the Circulatory Risk in Communities Study (CIRCS). Two control subjects per case were matched by sex, age, community, and year of serum storage. The hs-CRP was measured using a latex particle-enhanced immunonephelometric assay. RESULTS: Between 1999 and 2013, we identified 275 disabling dementia cases (96 cases with history of stroke and 179 without it). There was a positive association between hs-CRP levels and risk of dementia with history of stroke. No significant association was observed between hs-CRP levels and risk of dementia without history of stroke. After adjustment for hypertension, diabetes and other confounding variables, the positive association remained statistically significant. The multivariable odds ratios associated with 1-SD increment of log hs-CRP were 1.02 (0.87-1.20) for total dementia, 1.35 (1.02-1.79) for dementia with history of stroke, and 0.89 (0.72-1.10) for dementia without history of stroke. CONCLUSION: Elevated hs-CRP levels were associated with increased risk of disabling dementia in individuals with history of stroke but not in those without it.

C-reactive protein levels and risk of stroke and its subtype in Japanese: The Circulatory Risk in Communities Study (CIRCS).

BACKGROUND: Epidemiological studies have shown high-sensitive C-reactive protein (hs-CRP) to predict cardiovascular disease. However, there are only limited studies on the effects of hs-CRP levels on risk of stroke especially stroke subtypes. We examined associations of hs-CRP levels with risks of total stroke and its subtypes. METHODS: A prospective nested case-control study of Japanese 40-85 years of age was conducted using frozen serum samples collected from 13,521 men and women who participated in cardiovascular risk surveys from 1984 to 2001 for one community and 1989 to 1998 for the other two communities under the Circulatory Risk in Communities Study (CIRCS). Three control subjects per case were matched by sex, age, community, year of serum storage, and fasting status. RESULTS: By the end of 2005, we identified 261 incident strokes (165 ischemic strokes and 96 hemorrhagic strokes). There was a positive association between hs-CRP and incidence of incidence of total stroke, ischemic stroke and lacunar infarction. After further adjustment for known cardiovascular risk factors, these relationships remained statistically significant. The multivariable conditional odds ratios associated with 1-SD increment of log-transformed hs-CRP were 1.17(1.01-1.35) for total stroke, 1.27(1.06-1.52) for ischemic stroke, and 1.24(1.00-1.55) for lacunar infarction. The association between hs-CRP levels and incidence of ischemic stroke did not vary by sex, age, body mass index and smoking. No associations were found between hs-CRP levels and risk of hemorrhagic stroke. CONCLUSIONS: hs-CRP predicts the incidence of total and ischemic strokes among middle-aged Japanese men and women.