Association of depressive symptoms with incident fractures: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT).

This 5-year longitudinal study investigated the relationship between depressive symptoms and fracture risk in a large Japanese cohort. Depressive symptoms were a significant risk factor for hip fractures in women. PURPOSE: A relationship between depressive symptoms and fractures has not been clearly demonstrated. We aimed to investigate the relationship between depressive symptoms and 5-year fracture risk in the Japan Public Health Center-based Prospective Study for the Next Generation. METHODS: From 2011 to 2016, 114,092 participants were enrolled, and a follow-up survey was conducted 5 years later. We analyzed 30,552 men and 38,063 women aged 40-74 years who had no past fractures at baseline. Presence of depressive symptoms was defined as a modified 11-item Center for Epidemiological Studies Depression Scale score of 8 or higher, a history of depression, or use of antidepressants. Subjects were asked to report vertebral, upper limb, and/or hip fractures, except for traffic or work accidents, that occurred during the follow-up period. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for fracture were analyzed via logistic regression analysis to evaluate the relationship between depressive symptoms and fracture. RESULTS: Women with depressive symptoms demonstrated a high AOR for hip fractures (AOR: 2.78, 95% CI: 1.30 - 5.92); this result was consistent in post menopause women. In men, this association was not found for any age group or any type of fracture. CONCLUSIONS: Depressive symptoms in women may increase the risk of hip fractures. Further studies are required to explore this relationship in more detail.

A point system to predict the future risk of obesity in 10-year-old children.

BACKGROUND: A 4-year longitudinal study was conducted to develop a model and a point system for predicting childhood obesity. METHODS: This study included 1,504 Japanese 10-year-old children who underwent health check-ups between 2011 and 2015. Multivariable logistic regression analysis was conducted using the explanatory variables overweight and lifestyle. Obesity was defined as percentage overweight (POW) ≥ 20% calculated by the following equation: (actual weight - standard weight by height and sex)/standard weight by height and sex × 100 (%). The model was validated using the Hosmer-Lemeshow test on 10-year-olds. RESULTS: Our prediction model for development of childhood obesity was based on seven binary variables: sex, lack of sleep, ≥2-h use of television/ games/ smartphone, hypertension, dyslipidemia, hepatic dysfunction, and being overweight. The area under the curve of the receiver operating characteristic curve was 0.803 (95% confidence interval, 0.740 to 0.866). When validated in non-obese children (n = 415), there was no significant difference between actual and predicted numbers of children with obesity (Hosmer-Lemeshow chi-square = 7.90, p = 0.18). CONCLUSIONS: The validated prediction model and point score for obesity development were shown to be useful tools for predicting the future 4-year risk of developing obesity among 10 years-old children. The point system may be useful for reducing the occurrence of childhood obesity and promoting better health.

Pulse rate variability and health-related quality of life assessment with the Short Form-8 Japanese version in the general Japanese population.

We aimed to investigate the association between pulse rate variability (PRV) and health-related quality of life (HRQOL) in the general population. A cross-sectional study was conducted with 5908 Japanese men and women aged 30-79 years. PRV was assessed at rest using 5-min recordings of pulse waves with a photoplethysmographic signal from a fingertip sensor, and the time and frequency domains of PRV were determined. HRQOL was assessed with the Short Form-8 (SF-8) Japanese version, and poor HRQOL was defined as an SF-8 sub-scale score < 50. A test for nonlinear trends was performed with the generalized additive model with a smoothing spline adjusted for confounders. The lowest multivariable-adjusted odds ratios for poor physical component score were found in those who had second or third quartile levels of standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive difference (RMSSD), and high-frequency (HF) power and trended slightly upward in the higher levels. PRV-derived parameters were nonlinearly associated with poor physical component scores. In conclusion, reduced PRV-derived SDNN, RMSSD and HF power were associated with poor HRQOL in the domain of physical function. Higher levels of these parameters did not necessarily translate into better HRQOL.

C-reactive protein levels, airflow obstruction, and chronic kidney disease.

OBJECTIVES: There is some evidence that chronic obstructive pulmonary disease and chronic kidney disease (CKD) may be related, perhaps through systemic inflammation, which is common to both. However, this relationship has not yet been clearly demonstrated. The aim of this study was to investigate the association between airflow obstruction, CKD, and C-reactive protein (CRP) levels in Japanese men. METHODS: The study included 11,587 men, aged 40-88 years, who underwent a health check-up. Airflow obstruction was defined as a forced expiratory volume in 1 s/forced vital capacity of <70%, and its severity was based on the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD). CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m(2). RESULTS: Airflow obstruction was present in 7.9% of the participants, and 10.6% of the participants had CKD. The average CRP levels were 0.11 ± 0.36, 0.13 ± 0.41, and 0.18 ± 0.41 mg/L for subjects with normal lung function, GOLD stage I, and GOLD stage II-IV, respectively. With regard to CKD, the average CRP levels were 0.11 ± 0.32 and 0.18 ± 0.6 mg/L for subjects without and with CKD, respectively. Analysis of covariance showed no significant differences between the CRP level and lung function status or CKD after age was adjusted for. Logistic regression analysis showed no association among subjects with the three different lung function statuses after age, body mass index, hypertension, diabetes, hyper-low-density-lipoprotein-cholesterolemia, smoking, physical activity, and alcohol intake were controlled for. CONCLUSIONS: Based on the results of this study, we conclude that there is no interrelationship between CRP level, airflow obstruction, and CKD.

Association between frequency of drinking alcohol and chronic kidney disease in men.

OBJECTIVES: Chronic kidney disease (CKD) is a major public health problem. Epidemiological studies of the relationship between alcohol intake and CKD are scarce in Japan. This cross-sectional study aims to investigate the relationship between frequency of drinking alcohol and CKD in Japanese men. METHODS: The subjects were 9,196 men (mean ± standard deviation age, 57.9 ± 5.1 years) who underwent a health check-up. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m(2). Frequency of alcohol drinking was obtained from questionnaire and divided into five categories: nondrinkers, once or twice a week, three or four times a week, five or six times a week, and everyday drinkers. RESULTS: Multivariable-adjusted [age, body mass index, hypertension, diabetes, hyper-low-density lipoprotein (LDL) cholesterolemia, smoking, and physical activity] odds ratios and 95% confidence intervals (CIs) were calculated using logistic regression analysis. Compared with the results for the nondrinkers, the multivariable-adjusted odds ratios of CKD were as follows: 0.76 (95% CI 0.60-0.95) for 1-2 drinks per week, 0.74 (95% CI 0.59-0.93) for 3-4 drinks per week, 0.79 (95% CI 0.64-0.97) for 5-6 drinks per week, and 0.60 (95% CI 0.51-0.71) for everyday drinkers. There was a significant inverse trend across increasing frequency of drinking alcohol (p = 0.001 for trend). CONCLUSIONS: An inverse association was found between frequency of drinking alcohol and CKD in apparently healthy men.

Development of the Psychiatric Nurse Job Stressor Scale (PNJSS).

AIMS: The aim of the present study was to develop a tool, the Psychiatric Nurse Job Stressor Scale (PNJSS), for measuring the stress of psychiatric nurses, and to evaluate the reliability and validity of the PNJSS. METHODS: A total of 302 psychiatric nurses completed all the questions in an early version of the PNJSS, which was composed of 63 items and is based on past literature of psychiatric nurses' stress. RESULTS: A total of 22 items from four factors, 'Psychiatric Nursing Ability', 'Attitude of Patients', 'Attitude Toward Nursing' and 'Communication', were extracted in exploratory factor analysis. With regard to scale reliability, the item-scale correlation coefficient was r = 0.265-0.570 (P < 0.01), the Cronbach alpha coefficient was 0.675-0.869, and the test-retest correlation coefficient was r = 0.439-0.771 (P < 0.01). With regard to scale validity, the convergent validity of the 'job stressor' scale was r = 0.172-0.420 (P < 0.01), and the predictive validity of the 'job reaction' scale was r = 0.201-0.453 (P < 0.01). The compatibility of the factor model to the data was 1.750 (χ(2) /d.f., 343.189/196, P < 0.01), the goodness of fit index was 0.910, the adjusted goodness of fit index was 0.883, the comparative fit index was 0.924, and the root mean square error of approximation was 0.050. CONCLUSIONS: The PNJSS has sufficient reliability and validity as a four-factor structure containing 22 items, and is valid as a tool for evaluating psychiatric nurse job stressors.

A1330V polymorphism of the low-density lipoprotein receptor-related protein 5 gene and bone mineral density in Japanese male workers.

OBJECTIVES: Both genetic and lifestyle factors have been shown to influence bone mineral density (BMD). We investigated the correlations between BMD and low-density lipoprotein receptor-related protein 5 (LRP5) A1330V (rs3736228) polymorphism, exercise, smoking, and alcohol intake in Japanese male workers. METHODS: The subjects were 829 male employees (aged 20-59 years) of a large-scale integrated manufacturing facility in Japan. BMD was measured at the nondominant radius by dual-energy X-ray absorptiometry. Lifestyle information was obtained by a questionnaire at the same time, and genomic DNA was isolated from peripheral leukocytes. RESULTS: Mean ± standard deviation (SD) BMD was 0.557 ± 0.059 g/cm(2). The genotype frequencies of LRP5 gene polymorphism were 51, 42, and 7% for AA, AV, and VV, respectively. Analysis of variance and post hoc Tukey test indicated that mean BMD was significantly lower in subjects with VV genotype than in those with AA genotype (0.540 ± 0.048 versus 0.562 ± 0.062 g/cm(2)). According to multiple linear regression analysis, LRP5 A1330V polymorphism was an independent determinant of BMD, after adjusting for age, body mass index (BMI), and lifestyle variables. Exercise (past or current) also influenced BMD. CONCLUSIONS: These findings suggest that LRP5 A1330V polymorphism and exercise may influence BMD in Japanese male workers.

[Current state of research on occupational stress of psychiatric nurses and insight into its future].

In this report, we surveyed the occupational stress of psychiatric department nurses who said that the burnout rate was high and the turnover rate of nurses who quit shortly after being hired. Insight into the future of such research is described. In previous research, the occupational stress of psychiatric department nurses varied by each ward function, such as the wards of psychiatric department acute period, the psychiatric department recuperation period and the psychiatric department geriatric period, in which much research concerning the stress of psychiatric department nurses has been reported. However, at present, many of the questionnaire investigations used to measure and evaluate the occupational stress of psychiatric department nurses have not used a standard set up based on knowledge concerning the occupational stress of psychiatric department nurses. Hereafter, in research on the stress of psychiatric department nurses, standards with enough reliability and validity to measure and evaluate the occupational stress of psychiatric department nurses are still being searched for. Also, the development of mental health care in the psychiatric department ward according to these standards is expected.

Association between bone mineral density and lifestyle factors or vitamin D receptor gene polymorphism in adult male workers: a cross-sectional study.

OBJECTIVES: The aim of this cross-sectional study was to investigate the association between bone mineral density (BMD) and lifestyle factors, as well as the influence of vitamin D receptor (VDR) gene polymorphism, in adult male workers. METHODS: The subjects were 524 male employees aged 23-49 years (37.3 +/- 5.4 years, mean +/- standard deviation) working at a large-scale integrated manufacturing facility in Japan. BMD was measured at the nondominant radius by dual-energy X-ray absorptiometry. Lifestyle information was obtained by a questionnaire at the same time, and genomic DNA was isolated from peripheral leukocytes. RESULTS: The genotype frequencies of VDR gene polymorphism detected by Taq I digestion were 81.3%, 17.9%, and 0.8% for TT, Tt, and tt, respectively. BMD was 0.56 +/- 0.06 g/cm(2). Analysis of covariance with adjustment for age and body mass index (BMI) revealed that subjects who had a past history of exercise, current exercise from 3 to 7 days a week or daily alcohol intake showed significantly higher BMD than subjects without these features (0.56 +/- 0.06 versus 0.54 +/- 0.06, 0.58 +/- 0.06 versus 0.55 +/- 0.06, and 0.57 +/- 0.06 versus 0.55 +/- 0.06, respectively) (P < 0.05). Subjects who ate only 2 meals a day or smoked >/=21 cigarettes a day showed significantly lower BMD if they had the Tt or tt genotype than if they had the TT genotype (0.51 +/- 0.04 versus 0.56 +/- 0.06 and 0.51 +/- 0.05 versus 0.57 +/- 0.06, respectively) (P < 0.05). CONCLUSIONS: These findings suggest that the influence of lifestyle on BMD differs according to VDR gene polymorphism in adult male workers.

Efficient quantification of the health-relevant anthocyanin and phenolic acid profiles in commercial cultivars and breeding selections of blueberries ( Vaccinium spp.).

Anthocyanins and phenolic acids are major secondary metabolites in blueberry with important implications for human health maintenance. An improved protocol was developed for the accurate, efficient, and rapid comparative screening for large blueberry sample sets. Triplicates of six commercial cultivars and four breeding selections were analyzed using the new method. The compound recoveries ranged from 94.2 to 97.5 ± 5.3% when samples were spiked with commercial standards prior to extraction. Eighteen anthocyanins and 4 phenolic acids were quantified in frozen and freeze-dried fruits. Large variations for individual and total anthocyanins, ranging from 201.4 to 402.8 mg/100 g, were assayed in frozen fruits. The total phenolic acid content ranged from 23.6 to 61.7 mg/100 g in frozen fruits. Across all genotypes, freeze-drying resulted in minor reductions in anthocyanin concentration (3.9%) compared to anthocyanins in frozen fruits. However, phenolic acids increased by an average of 1.9-fold (±0.3) in the freeze-dried fruit. Different genotypes frequently had comparable overall levels of total anthocyanins and phenolic acids, but differed dramatically in individual profiles of compounds. Three of the genotypes contained markedly higher concentrations of delphinidin 3-O-glucoside, cyanidin 3-O-glucoside, and malvidin 3-O-glucoside, which have previously been implicated as bioactive principles in this fruit. The implications of these findings for human health benefits are discussed.

Twelve-year cumulative incidence of airflow obstruction among Japanese males.

BACKGROUND: To date, there is very limited longitudinal data on COPD and incidence estimates in Japan. The aim of this study was to investigate the 12-year cumulative incidence of airflow obstruction (COPD) in Japanese males. METHODS: This study included 913 male subjects, aged 30-76 years, who underwent lung function tests at a medical check-up in 1994 (baseline), 1999, and 2006. The study group consisted of 263 persistent never smokers, 296 early quitters, 117 late quitters, and 237 persistent smokers without airflow obstruction at baseline. The 12-year cumulative incidence of airflow obstruction was estimated. The spirometric criteria for diagnosis of airflow obstruction were forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) of <0.7 and 5th percentile lower limit of normal (FEV(1)/FVC

Relation of bone mineral density to vitamin D receptor gene polymorphism and lifestyle factors in Japanese female workers aged 22-44 years: a cross-sectional study.

Bone mineral density (BMD) reflects both genetic and lifestyle factors. The aim of this cross-sectional study was to investigate the influence of vitamin D receptor (VDR) gene polymorphism and lifestyle factors on BMD in premenopausal female workers. The subjects were 162 premenopausal female employees aged 22-44 y who worked at a large-scale integrated manufacturing facility in Japan. BMD was measured at the nondominant radius by dual energy X-ray absorptiometry. Lifestyle information was obtained by a questionnaire at the same time and genomic DNA was isolated from peripheral leukocytes. BMD was positively correlated with age, weight, and body mass index (BMI). The genotype frequencies of VDR gene polymorphism detected by TaqI analysis were 77.2, 22.8, and 0.0% for TT, Tt, and tt, respectively. Analysis of covariance with adjustment for age and BMI showed that the mean BMD was significantly lower in subjects with the Tt genotype than in those with the TT genotype. Subjects who drank alcohol also showed a significantly lower BMD if they had the Tt genotype than if they had the TT genotype. According to multiple linear regression analysis, the independent determinants of BMD were age, BMI, and VDR gene polymorphism. Our data show that BMD is negatively correlated with the Tt genotype of the VDR gene, but positively correlated with age and BMI. These findings suggest that analysis of VDR gene polymorphism may be useful for identifying individuals who are susceptible to osteoporosis so that early preventive measures can be provided.

Relationship between changes of bone mineral density over seven years and A1330V polymorphism of the low-density lipoprotein receptor-related protein 5 gene or lifestyle factors in Japanese female workers.

A longitudinal study was conducted to investigate the relation between the changes of bone mineral density (BMD) over a seven-year period and A1330V polymorphism of the low-density lipoprotein receptor-related protein 5 (LRP5) gene or lifestyle factors. The subjects were 113 premenopausal female employees from a large-scale integrated manufacturing facility in Japan aged 25.6 ± 4.2 years (mean ± standard deviation) at baseline. BMD was measured at the radius by dual energy X-ray absorptiometry. Lifestyle information was obtained by a questionnaire. The genotype frequencies of LRP5 gene polymorphism were 52%, 39%, and 9% for AA, AV, and VV, respectively. After seven years, BMD showed a significant decrease (from 0.463 ± 0.045 to 0.456 ± 0.046 g/m²) in subjects with the AV or VV genotypes, but not in subjects with the AA genotype. Analysis of covariance with adjustment for age and body mass index showed that subjects who drank alcohol displayed a significantly greater change of BMD if they had the AV or VV genotype than if they had the AA genotype (F=4.547, p=0.036). Investigation of LRP5 A1330V polymorphism may be useful for identifying individuals who are susceptible to osteoporosis, allowing early preventive measures to be provided.

Association between airflow obstruction and the metabolic syndrome or its components in Japanese men.

BACKGROUND: The aim of this cross-sectional study was to investigate the association between airflow obstruction and the metabolic syndrome (MS) or its components in Japanese men. METHODS: The study included 7,189 male subjects, aged 45-88 years, who underwent spirometric lung function tests at a medical check-up. The spirometric criteria for diagnosis of airflow obstruction were forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) <70%. The severity of airflow obstruction was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. RESULTS: The prevalence of airflow obstruction was 9.0% and the frequency of MS was 25.6%. In logistic regression models adjusting for age, body mass index, smoking, and alcohol, the risk of MS was higher in subjects with airflow obstruction of GOLD stage II-IV compared to those with normal lung function [odds radio (OR), 1.33; 95% confidence interval (95% CI), 1.01-1.76)]. Of the MS components, waist circumference (OR, 1.76; 95% CI, 1.24-2.50) and blood pressure (OR, 1.37; 95% CI, 1.08-1.74) were associated with airflow obstruction of GOLD stage II-IV, after controlling for potential confounders. CONCLUSION: Airflow obstruction of GOLD stage II-IV might be associated with MS, waist circumference and blood pressure components in Japanese men.