Health status of workers approximately 60 years of age and the risk of early death after compulsory retirement: A cohort study.

OBJECTIVES: The increasing number of working elderly people has enhanced the importance of workplace health promotion activities. We investigated the association between the health status of workers approximately 60 years of age and the risk of all-cause mortality after compulsory retirement in Japan. METHODS: The 2026 participants (1299 males and 727 females) had retired from a metal-products factory at ≥60 years of age. Baseline health examinations were conducted at 60 years of age and included questions about medical history and lifestyle factors; the participants also underwent a physical examination. The participants were followed up annually by mail for an average of 7.4 years. The association between health status at age 60 years and the risk of all-cause mortality was assessed by Cox proportional hazards regression analysis. RESULTS: During the study, 71 deaths were reported. The age- and sex-adjusted hazard ratio (HR [95% confidence interval]) for all-cause mortality was higher for males (HR, 3.41 [1.73-6.69]) compared with females, participants with a low body mass index (<18.5 kg/m2 ; HR 3.84 [1.91-7.73]) compared with normal body weight, smokers (HR, 2.63 [1.51-4.58]) compared with nonsmokers, and those with three or more of four metabolic abnormalities (obesity, high blood pressure, dyslipidemia, and glucose intolerance) (HR 2.29 [1.04-5.02]) compared with no metabolic abnormalities. The associations were unaffected by adjustment for these factors. CONCLUSION: Maintenance of an appropriate body weight, smoking cessation, and elimination of metabolic syndrome are required for older workers to prevent early death after retirement.

HOMA-IR and the risk of hyperuricemia: a prospective study in non-diabetic Japanese men.

AIMS: To examine the relation of insulin resistant status determined by homeostasis model assessment of insulin resistance (HOMA-IR) with the risk of incident hyperuricemia. METHODS: The study participants included 2071 Japanese men without hyperuricemia and diabetes, aged 35-54 years. The participants had undergone annual heath examinations for 6 years to compare incident hyperuricemia (serum uric acid >416.4µmol/L (7.0mg/dL) and/or taking medication for hyperuricemia) in four groups based on quartiles of baseline HOMA-IR. RESULTS: During follow-up there were 331 incident cases of hyperuricemia. The hazard ratios for hyperuricemia, compared with HOMA-IR ≤0.66, were 1.42 (95% confidence interval 1.02-1.98) for HOMA-IR 0.67-0.98, 1.20 (0.86-1.68) for HOMA-IR 0.99-1.49 and 1.44 (1.04-1.98) for HOMA-IR ≥1.50 after adjustment for baseline serum uric acid, creatinine, hypercholesterolemia and hypertension status, age, alcohol intake, and smoking and exercise habits. The hazard ratio associated with an increase of one standard deviation in lnHOMA-IR (1.85 as one geometric standard deviation of HOMA-IR) was 1.14 (1.03-1.28) (p for trend=0.02). CONCLUSIONS: Increased HOMA-IR independently predicted the subsequent development of hyperuricemia. Insulin resistance itself or compensatory hyperinsulinemia may contribute to the development of hyperuricemia.

Association between a serum thyroid-stimulating hormone concentration within the normal range and indices of obesity in Japanese men and women.

OBJECTIVE: This cross-sectional study investigated the associations between the serum thyroid-stimulating hormone (TSH) concentration and indices of obesity in middle-aged Japanese men and women. METHODS: The participants were 2,037 employees (1,044 men and 993 women; age, 36-55 yr) of a metal products factory in Japan. Clinical examinations were conducted in 2009. We obtained a medical history and anthropometric measurements (body weight, body mass index [BMI] and waist circumference) and measured the serum TSH concentrations. The anthropometric indices were compared across serum TSH quartiles. The associations were evaluated separately according to the smoking status in men. RESULTS: The mean body weight (kg), BMI (kg/m(2)) and waist circumference (cm) were 69.2, 23.7 and 83.2 in men and 55.3, 22.3 and 74.3 in women, respectively. Men with a higher TSH concentration had higher body weight and BMI values (p for trend=0.016 and 0.019, respectively), and these significant associations were observed even after adjusting for age, smoking status and other potential confounders. The TSH level was not associated with waist circumference. We found a significant interaction between the TSH level and the smoking status on body weight (p for interaction=0.013) and a significant association between the TSH level and body weight in nonsmokers, but not in current smokers. No significant associations were observed between the TSH level and the anthropometric indices in women. CONCLUSION: Significant positive associations between the serum TSH concentration, body weight and BMI were detected in men only, and an interaction with the smoking status was observed for this association.

Mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium exposure of the polluted Jinzu River basin, Toyama, Japan; a 26-year follow-up.

BACKGROUND: We aimed to investigate the mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium (Cd) exposure caused by heavy environmental contamination. METHODS: We conducted a 26-year follow-up survey targeting 7529 inhabitants of the Cd-polluted Jinzu River basin and 2149 controls from non-polluted areas who participated in urinary examinations for proteinuria and glucosuria conducted in 1979 to 1984. When the residents were divided into 4 groups, no finding group, glucosuria group, proteinuria group, glucoproteinuria group, mortality risk ratios for all and specific causes of these groups in the polluted area were compared with that of controls without glucosuria and/or proteinuria after adjustments for age at baseline, smoking status, and history of hypertension using Cox's proportional hazard model. RESULTS: The mortality risk ratios for all causes of proteinuria and glucoproteinuria in men and glucosuria, proteinuria, and glucoproteinuria in women of the polluted areas significantly increased compared with those of the controls with no urinary findings. Respiratory, renal, and cardiovascular diseases and diabetes in men, and all diseases except cerebrovascular diseases in women contributed toward an increased mortality of exposed glucoproteinuria groups, which involved chronic Cd toxicosis with renal tubular dysfunction. In women, the mortality risks for cancer of the colon and rectum, uterus and kidney and urinary tract were significantly higher in the exposed proteinuria and glucoproteinuria groups, suggesting associations between renal damage and cancer risk. In exposed women, the no finding group and glucoproteinuria group also showed increased mortality from ischemic heart diseases, indicating that all exposed women may be at risk for ischemic heart diseases. Although the control glucosuria and/or proteinuria group also showed high mortality for diabetes and renal diseases, the increased risk ratio for renal disease mortality was much higher in exposed subjects with urinary findings, particularly in women. CONCLUSIONS: These findings indicate that inhabitants with renal effects caused by Cd exposure had a poor life prognosis over long-term observation in both genders. Particularly in women, renal tubular dysfunction indicated by glucoproteinuria may increase mortality from cancer, ischemic heart diseases, and renal diseases.

Dietary glycemic index, glycemic load and blood lipid levels in middle-aged Japanese men and women.

AIMS: This study investigated the association between dietary glycemic index (GI)/glycemic load (GL) and serum lipids in middle-aged Japanese men and women. METHODS: The study participants were employees of a metal products factory in Japan: 2,257 men and 1,598 women aged 35 years or older. Dietary GI and GL were assessed using a self-administered diet history questionnaire. Serum lipid levels, adjusted for age, body mass index, alcohol consumption, smoking, physical activity, menopause status, and dietary intake of total energy, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol and fiber, were compared among GI/GL quintiles for each gender. RESULTS: No significant associations were observed between GI and adjusted serum lipids in men or women. In contrast, GL was inversely associated with HDL-cholesterol in men and women (p for trend=0.001 for men and < 0.001 for women), and positively associated with non-HDL-cholesterol (p for trend=0.010), LDL-cholesterol (p for trend=0.035) and triglycerides (p for trend=0.011) in women; however, alcohol drinking affected these associations; there was no association between GL and serum lipids in male nondrinkers and between GL and LDL-cholesterol in female nondrinkers. CONCLUSION: GL was inversely associated with HDL-cholesterol and positively associated with non-HDL-cholesterol in Japanese women. These associations in men were not observed in nondrinkers. A high-GL diet for women may have an atherogenic effect through these serum lipid abnormalities.

[Effect of smoke-free medical school on smoking behavior of medical students].

PURPOSE: The purpose of this study was to investigate the effect of designating a medical school environment as smoke-free on the smoking behavior of medical students. METHODS: The total environment of a medical school in Japan was designated as smoke-free in 2004. Smoking behavior was surveyed among approximately 640 students in each year during the period 2001-2007 (response rate 91.2%). Smoking rates were also monitored among each year's freshmen during their time at the school, before and after 2004. Attitudes to smoking among both current smokers and those who had quit smoking were also investigated. RESULTED: Smoking rates among all students declined after the medical school was declared smoke-free in 2004; the rates were highest in 2002 (41.2%) and lowest in 2007 (22.1%) among men. Smoking rates among each year's freshmen tended to increase as the school year progressed before 2004, but they tended to decrease after 2004. Comparison of smoking rates among identical students showed a decline from 36.0% in 2003 to 25.6% in 2004 (P < 0.05). The rate of smokers wishing to quit smoking increased significantly from 39.1% in 2003 to 60.2% in 2004 (P < 0.01). 20.8% of students who had quit smoking and 50.0% of students who had continued to smoke felt that they would not be confident about educating their patients in smoking cessation (P < 0.01). CONCLUSIONS: Making a medical school environment smoke-free could be very effective means to motivating medical students to change their attitudes to smoking and to quit.