[Optimal search conditions for identification of patients with chronic myeloid leukemia from Japanese National Health Insurance data].

This study investigated which conditions could be used to identify patients with chronic myeloid leukemia (CML) from a National Health Insurance claims dataset. During April 2012 and September 2018, 1,789,462 employees were enrolled in the dataset for Shizuoka Prefecture residents. The number of patients with the ICD-10 code for CML was 761. Among them, 246 who had been prescribed a tyrosine kinase inhibitor were considered as having true CML. The positive predictive value was calculated as 32.3% when CML was identified by ICD-10 code alone. Combination of ICD-10 code with prescribed drugs was required to accurately identify patients with CML from the insurance database.

Data Resource Profile of Shizuoka Kokuho Database (SKDB) Using Integrated Health- and Care-insurance Claims and Health Checkups: The Shizuoka Study.

BACKGROUND: Analyzing real-world data, including health insurance claims, may help provide insights into preventing and treating various diseases. We developed a database covering Shizuoka Prefecture (Shizuoka Kokuho Database [SKDB]) in Japan, which included individual-level linked data on health- and care-insurance claims and health checkup results. METHODS: Anonymized claims data on health insurance (National Health Insurance [age <75 years] and Latter-Stage Elderly Medical Care System [age ≥75 years]), care insurance, subscriber lists, annual health checkups, and all dates of death were collected from 35 municipalities in Shizuoka Prefecture. To efficiently link claims and health checkups, unique individual IDs were assigned using a novel procedure. RESULTS: From April 2012 to September 2018, the SKDB included 2,230,848 individuals (men, 1,019,687; 45.7%). The median age (min-max) of men and women was 60 (0-106) and 62 (0-111) years, respectively. During the study period, the median subscription time was 4.4 years; 40.8% of individuals continuously subscribed for the 6.5 years; 213,566 individuals died. Health checkup data were available for 654,035 individuals, amounting to 2,469,648 records. Care-service recipient data were available for 283,537 individuals; they used care insurance to pay for care costs. CONCLUSION: SKDB, a population-based longitudinal cohort, provides a comprehensive dataset covering health checkups, disorders, medication, and care service. This database may provide a robust platform to identify epidemiological problems and generate hypotheses for preventing and treating disorders in the elderly.

Relationship between Intraocular Pressure and Coffee Consumption in a Japanese Population without Glaucoma: The Nagahama Study.

PURPOSE: To evaluate the association between daily coffee consumption and intraocular pressure (IOP) in healthy persons without glaucoma and the association between daily coffee consumption and history of glaucoma. DESIGN: Cross-sectional study. PARTICIPANTS: A total of 9850 individuals participated in the first follow-up of the Nagahama Prospective Cohort for Comprehensive Human Bioscience (the Nagahama Study) conducted between 2013 and 2016. METHODS: All participants underwent a standardized ophthalmic examination. Self-reporting questionnaires were completed by all participants. First, the association between habitual coffee consumption and IOP among nonglaucoma individuals was evaluated by a multivariate linear regression analysis, adjusting for possible confounders. Second, the association between habitual coffee consumption and history of glaucoma also was evaluated using a multivariate logistic regression analysis. MAIN OUTCOME MEASURES: The association between habitual coffee consumption and IOP among nonglaucoma individuals. RESULTS: Of 9850 participants, 9418 did not have history of glaucoma. Among these participants, the mean ± standard deviation IOP of both eyes was 14.7 ± 2.9 mmHg. The multivariate regression analysis revealed that habitual coffee consumption was associated significantly with IOP (P < 0.001): the higher the consumption of coffee, the lower the IOP of an individual. The IOP of the group who consumed coffee most frequently (3 times daily or more) was 0.4 mmHg lower (95% confidence interval, 0.2-0.5 mmHg lower) than that of the group that consumed coffee least frequently (less than once daily). However, the logistic regression analysis showed that habitual coffee consumption was not associated significantly with history of glaucoma (P = 0.53). CONCLUSIONS: Frequent coffee consumption was associated with a slightly lower IOP in people without glaucoma but was not associated with a decreased risk of glaucoma developing. Additional experimental studies are needed to examine the effects of coffee on IOP and glaucoma risk.

Risks and Cough-Aggravating Factors in Prolonged Cough. Epidemiological Observations from the Nagahama Cohort Study.

RATIONALE: Chronic cough hypersensitivity, a potentially important concept of chronic or prolonged cough, is featured by heightened cough response to low-intensity stimuli, which may be generated in the absence of airflow limitations or allergic conditions. However, there is little epidemiological evidence to support this. OBJECTIVES: In this large-scale community survey, we aimed to determine risks and cough-aggravating factors of prolonged cough while focusing on serum IgE levels. METHODS: Prevalence of prolonged cough, defined as cough lasting 3 weeks or longer, was determined in 9,804 residents from a baseline measurement of the Nagahama Cohort Study, conducted from 2008 to 2010. Risk assessment of prolonged cough was confined to subjects without asthma (n = 9,402). A follow-up measurement of the Nagahama Study was successively conducted from 2013 to 2015, recruiting the same residents living in Nagahama City, Japan (n = 8,292). Validation analysis was performed in the follow-up measurement. RESULTS: In a baseline measurement, prolonged cough was reported by 9.5% of subjects without asthma and 32.3% of subjects with asthma. In subjects without asthma, various cough-aggravating factors were associated with prolonged cough. On the multivariate analysis, several cough-aggravating factors, including nighttime or early morning, weather, pollen season, and common cold, were associated with prolonged cough, independent of female sex, younger age, chronic obstructive pulmonary disease, postnasal drip, daytime sputum, and lower serum total IgE. Serum-specific IgE levels against Japanese cedar pollen were significantly higher in subjects who responded "yes" to "cough in the pollen season" than in those who did not respond, whereas, among subjects who responded "yes" to "cough in the pollen season," prolonged coughers showed lower serum IgE levels against Japanese cedar pollen than temporal coughers. Validation analysis in a follow-up measurement confirmed the associations between prolonged cough and cough-aggravating factors observed in the baseline measurement. CONCLUSIONS: The presence of several cough-aggravating factors in the absence of severe allergic conditions may support the presence of cough hypersensitivity.

Genotype risk score of common susceptible variants for prediction of type 2 diabetes mellitus in Japanese: the Shimanami Health Promoting Program (J-SHIPP study). Development of type 2 diabetes mellitus and genotype risk score.

Recent genomewide association studies have successfully identified several genotypes susceptible to type 2 diabetes mellitus (T2DM). However, only a few studies have investigated whether these variations confer a risk of the future development of T2DM. We conducted a longitudinal genetic epidemiological study to clarify the prognostic significance of the T2DM-associated variants. The sample population consisted of 2037 middle-aged to elderly community residents. Personal health records were obtained from a clinical database administered by the local government. Genotype risk score was calculated by the following variants, namely, KCNQ1, TCF7L2, CDKAL1, HHEX, IGF2BP2, CDKN2AB, SLC30A8, KCNJ11, PPARG, and GCKR. Susceptibility of these variants in Japanese has been confirmed by association analysis. Among the 1824 subjects who did not have T2DM at baseline, 95 cases of T2DM were newly diagnosed during the 9.4-year follow-up period. Mean genotype risk score in these subjects was significantly higher than that in the subjects who remained nondiabetic (9.5 ± 1.8 vs 9.1 ± 2.0, P = .042). Although the initial mean body mass index (24.7 ± 3.2 vs 23.0 ± 2.8, P < .001) and initial glucose (106 ± 18 vs 90 ± 13, P < .001) were also significantly higher in those subjects who developed T2DM, the genotype risk score remained an independent determinant of the development of T2DM even after adjustment for these parameters and possible confounding factors. Per-allele odds ratio for the development of T2DM was 1.12 (95% confidence interval, 1.00-1.25; P = .049). Type 2 diabetes mellitus-susceptible genetic variants identified by a cross-sectional genomewide association study were significantly associated with the future development of T2DM in a general population sample.