Database profile of the Fukuoka-City Information Platform for Community-based Integrated Care.

BACKGROUND: The Fukuoka-City Information Platform for Community-based Integrated Care is an advanced big data platform that aggregates information on the health and medical services of Fukuoka citizens. Fukuoka City is engaged in a joint project with Kyushu University to promote policy making through a large-scale real-world data analysis. This paper describes the framework for this cooperative effort and the features of the analytical platform. METHODS: Fukuoka City is the fifth most populous ordinance-designated city in Japan, with an estimated population of approximately 1.6 million. Under an agreement with Fukuoka City, Kyushu University was granted access to a portion of the city's anonymized healthcare database as secondary-use information. The database contains information on resident registration, health insurance claims, specific health checkups and health checkups for the older adults, specific health guidance, long-term care insurance data, and cancer screenings collected after fiscal year 2012. Each of these constituent datasets can be interlinked using anonymized hashed key variables, allowing individuals to be followed across databases and over time. CONCLUSIONS: The platform allows longitudinal investigation of the complex association between various aspects of healthcare, such as medical procedures, examinations, interviews, medical costs, long-term care certifications, and care costs. The platform can provide valuable public-health information because it is relatively large for a single database, and because it allows analysis of data across multiple domains and tracing of individuals over time.

Serum lipopolysaccharide-binding protein levels and the incidence of metabolic syndrome in a general Japanese population: the Hisayama Study.

BACKGROUND: The association between chronic lipopolysaccharide exposure and the development of metabolic syndrome (MetS) is unclear. In this study we examined the association between serum lipopolysaccharide-binding protein (LBP) levels, an indicator of lipopolysaccharide exposure, and the development of MetS in a general Japanese population. METHODS: 1,869 community-dwelling Japanese individuals aged ≥40 years without MetS at baseline examination in 2002-2003 were followed up by repeated examination in 2007-2008. MetS was defined according to the Japanese criteria. Serum LBP levels were classified into quartiles (quartiles 1-4: 2.20-9.56, 9.57-10.78, 10.79-12.18, and 12.19-24.34 µg/mL, respectively). Odds ratios (ORs) for developing MetS were calculated using a logistic regression model. RESULTS: At the follow-up survey, 159 participants had developed MetS. Higher serum LBP levels were associated with greater risk of developing MetS after multivariable adjustment for age, sex, smoking, drinking, and exercise habits (OR [95% confidence interval] for quartiles 1-4: 1.00 [reference], 2.92 [1.59-5.37], 3.48 [1.91-6.35], and 3.86 [2.12-7.03], respectively; P for trend <0.001). After additional adjustment for homeostasis model assessment of insulin resistance, this association was attenuated but remained significant (P for trend=0.007). On the other hand, no significant association was observed after additional adjustment for serum high-sensitivity C-reactive protein (P for trend=0.07). CONCLUSIONS: In the general Japanese population, our findings suggest that higher serum LBP levels are associated with elevated risk of developing MetS. Low-grade endotoxemia could play a role in the development of MetS through systemic chronic inflammation and insulin resistance.