Efficacy and safety of first-line or second-line selective laser trabeculoplasty for normal-tension glaucoma: a multicentre cohort study.

BACKGROUND/AIMS: This study aimed to investigate and compare the efficacy and safety of first-line and second-line selective laser trabeculoplasty (SLT) in Japanese patients with normal-tension glaucoma (NTG). METHODS: 100 patients with NTG were enrolled in this study. Patients were treated with SLT as a first-line or second-line treatment for NTG. Main outcome measures were intraocular pressure (IOP) reduction rate, outflow pressure improvement rate (ΔOP), success rate at 1 year and complications. Success was defined as ΔOP≥20% (criterion A) or an IOP reduction ≥20% (criterion B) without additional IOP-lowering eye-drops, repeat SLT or additional glaucoma surgeries. The incidence of transient IOP spike (>5 mm Hg from the pretreatment IOP), conjunctival hyperaemia, inflammation in the anterior chamber and visual impairment due to SLT were assessed. RESULTS: A total of 99 patients (99 eyes) were initially enrolled in this study, including 74 eyes assigned to the first-line SLT group and 25 eyes to the second-line SLT group. The mean IOP of 16.3±2.1 mm Hg before SLT decreased by 17.1%±9.5% to 13.4±1.9 mm Hg at 12 months after SLT in the first-line group (p<0.001), and the mean IOP of 15.4±1.5 mm Hg before SLT decreased by 12.7%±9.7% to 13.2±2.0 mm Hg at 12 months after SLT (p=0.005) in the second-line group. Both groups showed significant reductions in IOP. Higher pre-SLT IOP and thinner central corneal thickness were associated with greater IOP reduction. The success rate at 1 year was higher in the first-line compared with the second-line group, with lower pretreatment IOP and the use of IOP-lowering medication before SLT being associated with treatment failure. Most post-treatment complications were minor and transient. CONCLUSIONS: SLT may be an effective and safe treatment option for NTG, as either a first-line or second-line treatment. TRIAL REGISTRATION NUMBER: The study was registered in the UMIN-CTR (UMIN Test ID: UMIN R000044059).

Effectiveness of mHealth interventions to promote physical activity and reduce sedentary behaviours on work-related productivity and performance: a systematic review protocol.

INTRODUCTION: Technologies such as health and fitness applications (apps) and wearable activity trackers have recently gained popularity and may play a key role in promoting physical activity and reducing sedentary behaviours. Although several systematic reviews have investigated their efficacy in physical activity and sedentary behaviours, few studies have focused on their impact on work-related outcomes among workers. Here, to explore the effects of mHealth interventions designed to encourage physical activity and decrease sedentary behaviours on work-related outcomes, including absenteeism, presenteeism, productivity, work performance and workability among workers, we will conduct a systematic review based on recent articles and an extensive literature search. METHODS AND ANALYSIS: The literature search will be performed using PubMed, Web of Science, the Cochrane Library and the Japan Medical Abstracts Society from inception to 23 September 2023. We will select studies that (1) investigated the impact of mHealth interventions to promote physical activity and reduce sedentary behaviours on work-related outcomes such as absenteeism, presenteeism, productivity, work performance and workability; (2) were designed as a randomised controlled trial (RCT) or non-randomised study of interventions (NRSI); (3) were conducted among workers and (4) were published as full-text original articles in Japanese or English. We will assess the review quality with the AMSTAR 2 tool. The risk of bias will be assessed with the RoB tool 2.0 and ROBINS-I. ETHICS AND DISSEMINATION: Ethical approval is unnecessary as the study will rely solely on previously published articles. The research results will be submitted for publication in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: The study protocol has been registered with the UMIN Clinical Trials Registry (ID=UMIN000052290).

Potentially compromised systemic and local lactate metabolic balance in glaucoma, which could increase retinal glucose and glutamate concentrations.

To investigate the association between lactate metabolism and glaucoma, we conducted a multi-institutional cross-sectional clinical study and a retinal metabolomic analysis of mice with elevated intraocular pressure (IOP) induced by intracameral microbead injection. We compared lactate concentrations in serum and aqueous humor in age-matched 64 patients each with primary open-angle glaucoma (POAG) and cataract. Neither serum nor aqueous humor lactate concentrations differed between the two groups. Multiple regression analysis revealed that only body mass index showed a significant positive correlation with serum and aqueous humor lactate concentration in POAG patients (rs = 0.376, P = 0.002, and rs = 0.333, P = 0.007, respectively), but not in cataract patients. L-Lactic acid was one of the most abundantly detected metabolites in mouse retinas with gas chromatography and mass spectrometry, but there were no significant differences among control, 2-week, and 4-week IOP elevation groups. After 4 weeks of elevated IOP, D-glucose and L-glutamic acid ranked as the top two for a change in raised concentration, roughly sevenfold and threefold, respectively (ANOVA, P = 0.004; Tukey-Kramer, P < 0.05). Glaucoma may disrupt the systemic and intraocular lactate metabolic homeostasis, with a compensatory rise in glucose and glutamate in the retina.

Association of body mass index and weight change with pneumonia mortality in a Japanese population: Japan Public Health Center-based Prospective Study.

BACKGROUND: Accumulating evidence suggests that pneumonia mortality is lower for individuals with high body mass index (BMI) compared to normal BMI, but it remains unclear whether weight change during adulthood influences subsequent mortality due to pneumonia in Asian populations, who have a relatively lean body mass. This study aimed to examine the association of BMI and weight change over 5 years with the subsequent risk of pneumonia mortality in a Japanese population. METHODS: The present analysis included 79,564 Japan Public Health Center (JPHC)-based Prospective Study participants who completed a questionnaire between 1995 and 1998 were followed for death through 2016. BMI was categorized into four groups: underweight (<18.5 kg/m2), normal weight (BMI: 18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (BMI: ≥30.0 kg/m2). Weight change was defined as the difference of body weight between questionnaire surveys with a 5-year interval. Cox proportional hazards regression was used to estimate hazard ratios of baseline BMI and weight change for pneumonia mortality. RESULTS: During a median follow-up of 18.9 y, we identified 994 deaths from pneumonia. Compared with participants with normal weight, an elevated risk was observed among those who were underweight (hazard ratio = 2.29, 95% confidence interval [CI]: 1.83-2.87), whereas a decreased risk was found among those who were overweight (hazard ratio = 0.63, 95% CI: 0.53-0.75). Regarding weight change, the multivariable-adjusted hazard ratio (95% CI) of pneumonia mortality for a weight loss of 5 kg or more versus a weight change of less than 2.5 kg was 1.75 (1.46-2.10), whereas that for a weight gain of 5 kg or more was 1.59 (1.27-2.00). CONCLUSION: Underweight and greater weight change was associated with an increase in the risk of pneumonia mortality in Japanese adults.

Heated tobacco product use and abnormal glucose metabolism: a working population-based study.

AIMS: We aimed to assess the cross-sectional association of heated tobacco product (HTP) use with prediabetes and diabetes. METHODS: The present analysis included 8950 workers from 5 companies (Study I) and 31,341 workers from another large company (Study II), who participated in the Japan Epidemiology Collaboration on Occupational Health Study. The participants were divided into five groups: never smokers, past smokers, exclusive HTP users, dual users of cigarettes and HTPs, and exclusive cigarette smokers. Diabetes and prediabetes were defined according to the fasting blood glucose and HbA1c levels and self-reported diabetes treatment, using the American Diabetes Association criteria. We analyzed the data of Study I and II separately, and then pooled these estimates using the fixed-effect models, with adjustment for a wide range of covariates. RESULTS: In this study that included 40,291 participants (mean age, 46.6 years; men, 84.3%), about half of the current tobacco-related product users reported using HTPs. Exclusive HTP users had higher odds of prediabetes (pooled odds ratio 1.36; 95% CI 1.25-1.47) and diabetes (1.68; 95% CI 1.45-1.94) than never smokers. Similarly, dual users also had increased odds of prediabetes (pooled odds ratio, 1.26; 95% CI 1.13-1.39) and diabetes (1.93; 95% CI 1.63-2.29). The strength of these associations was comparable to that of cigarette smokers. We observed significantly higher HbA1c and fasting blood glucose levels among both exclusive HTP users and dual users compared to never smokers. CONCLUSION: HTP use was associated with an increased likelihood of prediabetes and diabetes. Prospective studies are warranted to confirm the cross-sectional association.

Surgical Results of Trabeculectomy among Groups Stratified by Prostaglandin-Associated Periorbitopathy Severity.

PURPOSE: To report the role of prostaglandin-associated periorbitopathy (PAP) severity in the surgical effectiveness of trabeculectomy (LEC). DESIGN: Retrospective observational case series. PARTICIPANTS: A total of 139 consecutive eyes of 139 Japanese subjects (74 men, 65 women; mean age ± standard deviation, 65.7 ± 10.6 years) who underwent LEC were included. All had primary open-angle glaucoma (POAG), no history of conjunctival incisional surgery, completed all postoperative visits for 12 months, and information on the PAP severity using the Shimane University PAP Grading System (SU-PAP). METHODS: Data were collected from a medical chart review at 2 hospitals. MAIN OUTCOME MEASURES: Comparison of surgical success rates among groups stratified by SU-PAP grades 0 to 3 by survival curve analysis using the definitions of failure based on surgical intervention other than laser suture lysis (LSL), intraocular pressure (IOP) reduction below 20%, postoperative IOP exceeding 15 mmHg (definition A) or 12 mmHg (definition B), and a postoperative IOP below 6 mmHg. RESULTS: Twelve months postoperatively, the success rates of grades 0, 1, 2, and 3 were 86%, 68%, 40%, and 0%, respectively, for definition A (P < 0.0001, log-rank test) and 86%, 61%, 36%, and 0%, respectively, for definition B (P < 0.0001). Interventions other than LSL (P < 0.0001, Cochran-Armitage trend test), IOP reduction less than 20% (P = 0.010), and IOP exceeding 15 mmHg (P = 0.016) or 12 mmHg (P < 0.0001) were associated with surgical failure; IOP under 6 mmHg was not (P = 0.31). The proportional hazard model for definition A showed that compared with grade 0, grade 2 (risk ratio [RR], 5.82, P = 0.0043) and grade 3 (RR, 12.2, P = 0.0003) were associated with surgical failure. For definition B, grade 1 (RR, 3.53, P = 0.040), grade 2 (RR, 6.65, P = 0.0021), and grade 3 (RR, 12.0, P = 0.0003) were associated with surgical failure. Differences in age, gender, preoperative IOP and medications, refractive error, and simultaneous cataract surgery were not associated with surgical failure in both models. CONCLUSIONS: The preoperative presence of severe PAP worsens the 1-year success rate of LEC in patients with POAG. To retain the surgical effectiveness, treating physicians should prevent patients from progressing to severe PAP, an avoidable side effect, by switching or stopping the causative medications. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

Heated tobacco products and circulating high-density lipoprotein cholesterol concentrations.

We aimed to assess the association between heated tobacco product (HTP) use and high-density lipoprotein cholesterol (HDL-C) concentration. Our study included 12,268 workers from five companies (Study I) and 36,503 workers from another large company (Study II). Participants were categorized into five groups: never smokers, past smokers, exclusive HTP users, dual users of cigarettes and HTPs, and exclusive cigarette smokers. We analyzed the data of Studies I and II separately and then pooled these estimates using a fixed-effect model. Of the 48,771 participants, 9.3% were exclusive HTP users, and 6.0% were dual users. Exclusive HTP users had modestly but significantly lower concentrations of HDL-C than never smokers, with the pooled mean difference being - 1.1 (95% CI - 1.5 to - 0.6) mg/dL. Dual users showed a further reduction (mean difference - 3.7 (- 4.2 to - 3.2) mg/dL), which was comparable to that of exclusive cigarette smokers versus never smokers (mean difference - 4.3 (- 4.7 to - 3.9) mg/dL). The pooled odds ratios (95% CIs) of having low HDL-C (< 40 mg/dL for men and 50 mg/dL for women) were 1, 0.99 (0.90-1.11), 1.25 (1.09-1.43), 2.02 (1.76-2.32), and 2.09 (1.88-2.32) for never smokers, past smokers, exclusive HTP users, dual users, and exclusive cigarette smokers, respectively. In conclusion, exclusive HTP users had lower HDL-C concentrations than never smokers, although higher than exclusive cigarette smokers. Moreover, dual users had HDL-C concentrations similar to those in exclusive cigarette smokers.

Infection prevention practices and its associated factors among hospital workers in a national medical center designated for COVID-19 in Tokyo, Japan.

BACKGROUND: While healthcare workers (HCWs) are at risk of occupational exposure to SARS-CoV-2 infection, the virus transmission involving them might be exceeding in the non-occupational settings. This study examined the extent of adherence to infection prevention practices (IPPs) against COVID-19 in their daily life and its associated factors among staff members in a national medical center designated for COVID-19 treatment in Tokyo, Japan. METHODS: This cross-sectional study was conducted in July 2020 among 1,228 staff of National Center for Global Health and Medicine (NCGM). We asked participants about their adherence on six IPPs recommended by the WHO in their daily lives, which included wearing masks, maintaining hand and respiratory hygiene, avoiding 3Cs and social distancing. We defined 100% adherence (6 points) to IPPs as good adherence and run logistic regression model to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of IPPs. RESULTS: Nearly 100% of NCGM staff members adhered to four out of six IPPs assessed in this study: washing or sanitizing hands (99.6%), good cough etiquette (99.6%), wearing mask (98.9%), and avoiding 3Cs (98.3%). Doctors (AOR = 2.18, CI: 1.36-3.49) and female staff members (AOR = 1.95, CI: 1.36-3.49) were more likely to adhere to IPPs compared with non-clinical staffs and male counterparts. Good adherence to IPPs tended to increase with older age, with highest adherence among those who were 50 years or above (AOR = 2.53, CI: 1.49-4.29). CONCLUSION: This study revealed that the IPPs among NCGM staff was remarkably good. Older and female staff members, and doctors showed a higher adhere to IPPs compared with their counterparts. Additional effort to improve adherence to IPPs among the younger and male staff members could contribute to reduce infection risk in their daily life, which can eventually prevent nosocomial infection.

Associations of serum amino acids with insulin resistance among people with and without overweight or obesity: A prospective study in Japan.

BACKGROUND & AIMS: Limited evidence exists regarding the prospective associations between amino acids and insulin resistance. In addition, amino acids have been suggested to promote insulin resistance with the requirement of obesity in animal studies, but the interaction between amino acids and obesity on the development of insulin resistance has not been examined in epidemiological studies. We aimed to investigate the differences in the prospective associations of serum amino acids with insulin resistance among adults with and without overweight or obesity. METHODS: Fasting serum concentrations of 25 amino acids were quantified in 1131 non-diabetic Japanese workers aged 22-71 years at baseline. The homeostasis model assessment of insulin resistance (HOMA-IR) was estimated at baseline and the 3-year follow-up. Generalized linear models were used to assess the associations between amino acids at baseline and HOMA-IR at follow-up with adjustment for potential confounding factors. A Bonferroni-corrected threshold of p = 0.001 was considered significant for multiple tests. RESULTS: The associations for the following amino acids with HOMA-IR at the 3-year follow-up significantly varied by obesity status: isoleucine, valine, tyrosine, alanine, and methionine (all p for interaction <0.05). Higher concentrations of serum isoleucine, valine, tyrosine, and alanine (per 1SD) were significantly associated with higher HOMA-IR levels in overweight/obese participants (multivariable-adjusted ß coefficients ranging from 0.09 to 0.12; all p < 0.001), but no association was observed in the underweight/normal-weight participants. The associations for serum methionine were direct among overweight/obese participants, but inverse among underweight/normal-weight participants (all p < 0.001). CONCLUSIONS: This study demonstrated the prospective associations of different individual serum amino acids with insulin resistance, with most pronounced associations being for overweight/obese adults. Our findings support the possibility of heterogeneous effects of individual amino acids, as well as their interplay with obesity in the progression of insulin resistance.

Relationship of chronotype and social jetlag with adherence to the Japanese dietary guidelines among workers.

While late chronotype and greater social jetlag have been associated with poor dietary behavior among the general population, these associations have not been investigated among workers, who struggle to align their sleep timings with work schedules. We aimed to explore the cross-sectional association of social jetlag and a late chronotype with adherence to a healthy diet among Japanese workers. Participants were 1,435 non-shift workers (18-78 years) who attended a nutritional survey. Social jetlag was defined as the difference in the midpoint of sleep times between weekdays and weekends, while chronotype was estimated using the mid-sleep time on weekends that was corrected with sleep debt on weekdays. We calculated the adherence score of the Japanese Food Guide Spinning Top (JFGST) - healthy diet guidelines for Japanese. Multivariable linear regression analyses were used to calculate the adjusted means and 95% confidence intervals (CI) for adherence scores of social jetlag and chronotype. We found that greater social jetlag was associated with a lower JFGST score. The multivariable-adjusted mean (95% CI) of JFGST scores were 39.7 (39.1-40.2), 38.7 (37.9-39.6), and 38.1 (36.6-39.7) for <1 hour, 1 to <2 hours, and ≥2 hours of social jetlag, respectively (P-trend = 0.02). Workers with late chronotypes had significantly lower adherence scores on JFGST [36.3 (34.7-37.8); P-trend = 0.002]. Results suggest that a late chronotype and social jetlag are inversely associated with adherence to a healthy diet among Japanese workers.

Association between chronic physical conditions and depressive symptoms among hospital workers in a national medical institution designated for COVID-19 in Japan.

OBJECTIVE: This study aimed to investigate the cross-sectional association between the presence of chronic physical conditions and depressive symptoms among hospital workers at a national medical institution designated for COVID-19 treatment in Tokyo, Japan. We also accounted for the combined association of chronic physical conditions and SARS-CoV-2 infection risk at work in relation to depressive symptoms, given that occupational infection risk might put additional psychological burden among those with chronic physical conditions with risk of severe COVID-19 outcome. METHODS: The study sample consisted of 2,440 staff members who participated in a health survey conducted at the national medical institution during period between October 2020 and December 2020. Participants who reported at least one chronic physical condition that were deemed risk factors of severe COVID-19 outcome were regarded as having chronic physical conditions. Depressive symptoms were assessed using the patient health questionnaire-9 (PHQ-9). We performed logistic regression analysis to assess the association between chronic physical conditions and depressive symptoms. RESULTS: Our results showed that the presence of chronic physical conditions was significantly associated with depressive symptoms (odds ratio (OR) = 1.49, 95% confidence interval (CI) = 1.10-2.02). In addition, the prevalence of depressive symptoms was significantly higher among healthcare workers with chronic physical conditions who were at a higher occupational infection risk (OR = 1.81, 95% CI = 1.04-3.16). CONCLUSION: Our findings suggest the importance of providing more assistance to those with chronic physical conditions regarding the prevention and control of mental health issues, particularly among frontline healthcare workers engaging in COVID-19-related work.

Association between eating balanced meals and depressive symptoms in Japanese hospital workers during the COVID-19 pandemic.

AIM: While accumulating evidence suggests a protective role of healthy diet against depression, evidence on this issue is limited among healthcare workers combating COVID-19 pandemic. The aim of this study was to determine the cross-sectional association between frequency of balanced meal consumption and depressive symptoms among Japanese hospital workers during the COVID-19 pandemic. METHODS: Participants were 2,457 workers of the National Center for Global Health and Medicine who responded to a questionnaire survey in October or December 2020. Depressive symptoms were assessed using the patient health questionnaire-9 (PHQ-9). The number of days per week of eating two or more balanced meals was categorized into four from ≤1 day/week to daily. The association between frequency of balanced meal consumption and depressive symptoms was assessed using logistic regression analysis, with adjustment for lifestyle and COVID-19-related factors. RESULTS: The prevalence of depressive symptoms was 14.8%. The odds of depressive symptoms increased with decreasing frequency of balanced meal consumption. The multivariable-adjusted odds ratios (95% confidence intervals) of depressive symptoms were 1.00 (reference), 1.09 (0.75-1.58), 1.62 (1.17-2.24), and 2.21 (1.54-3.17) for balanced meal consumption categories of daily, 4-5 days/week, 2-3 days/week, and ≤1 day/week, respectively (P for trend<0.001). CONCLUSIONS: Our results suggest that infrequent consumption of well-balanced meal is associated with increased depressive symptoms among hospital workers during the COVID-19 pandemic.

Serum sodium and risk of hypertension: a cohort study.

This study aimed to investigate the cross-sectional association between serum sodium and blood pressure at baseline and, more importantly, investigate the prospective association between serum sodium and the risk of incident hypertension. We used data from 1 638 workers aged 18 to 71 years who participated in 2015-2016 survey of the Furukawa Nutrition and Health Study. During a maximum follow-up of 3 years, 229 participants developed hypertension. Multivariable linear regression models were used to evaluate the cross-sectional association. The Cox proportional hazards model was used to calculate the hazard ratio and 95% confidence interval of incident hypertension across quartiles of serum sodium (137-140, 141-142, 143, and 144-147 mmol/L). In the cross-sectional analysis, we did not observe a significant association between serum sodium and blood pressure at baseline. In the prospective analysis, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident hypertension were 1.03 (0.71-1.51), 1.35 (0.87-2.08), and 1.46 (0.97-2.20) for the upper three quartiles of the serum sodium levels compared with the lowest quartile (P for trend=0.02). When serum sodium was treated as a continuous variable, the multivariable-adjusted hazard ratio for hypertension was 1.10 (1.03-1.18). The association was slightly attenuated after additionally adjusting for baseline blood pressure, with a hazard ratio of 1.08 (1.00-1.16) for a 1 mmol/L increase in serum sodium. In conclusion, an elevated serum sodium level was associated with an increased risk of developing hypertension, suggesting that serum sodium could be a potential risk factor for hypertension.

Prospective study on the association between serum amino acid profiles and depressive symptoms among the Japanese working population.

OBJECTIVE: Accumulating evidence suggests that amino acids, particularly tryptophan and glutamate, play an important role in the pathology of depression, but prospective epidemiologic data on this issue is scarce. We examined the association between circulating amino acids and the risk of depressive symptoms in a Japanese working population. METHODS: Participants were 841 workers who were free from depressive symptoms and provided blood at baseline and completed 3-yr follow-up survey. 30 varieties of amino acid concentrations in serum were measured using liquid chromatography/mass spectrometry. Depressive symptoms were defined using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to calculate the odds ratios of depressive symptoms according to serum amino acids with adjustment for lifestyle factors. RESULTS: A total of 151 (18.0%) workers were newly identified as having depressive symptoms at the follow-up. Baseline tryptophan and glutamate concentrations in serum were not appreciably associated with the risk of depressive symptoms. Risk of depressive symptoms tended to increase with increasing arginine concentrations; the multivariable-adjusted odds ratio for the highest versus lowest tertile of serum arginine was 1.65 (95% confidence interval: 0.96-2.83; P for trend = 0.07). No clear association was found for other amino acids. CONCLUSIONS: Results of the present study do not support a significant role of circulating amino acids in the development of depressive symptoms among Japanese.

Is there an association between ABO blood types and depressive symptoms among Japanese healthcare workers during the COVID-19 pandemic?

ABO blood types could be a biological predisposition for depression. The present cross-sectional analysis was conducted amid the second wave of COVID-19 in Japan during July 2020. We wanted to investigate the association between ABO blood types and depressive symptoms among workers (352 men and 864 women, aged 21-73 years) of a medical institution in Tokyo, Japan, which took a leading role in the response to COVID-19 in the country. A Poisson regression model with a robust variance estimator was used to estimate the prevalence ratio (PR) and 95% confidence interval (CI) for depressive symptoms associated with ABO blood types. Overall, the prevalence of depressive symptoms (using two questions employed from a Two-question case-finding instrument) was 22.0%. The adjusted PRs (95% CI) for depressive symptoms, comparing the carriers of blood type O, A, and AB with those of type B, were 0.88 (0.66, 1.18), 0.81 (0.62, 1.07), and 1.07 (0.74, 1.53), respectively. There was no difference in the prevalence of depressive symptoms between non-B and B carriers. The present study did not support the association of ABO blood types with depressive symptoms.

Leisure-time, occupational, and commuting physical activity and the risk of chronic kidney disease in a working population.

Physical activity has been linked to a lower risk of chronic kidney disease (CKD); however, evidence on the relationship between domain-specific physical activity and CKD is scarce. This study aimed to examine the risk of CKD in relation to leisure-time, occupational, and commuting physical activities in a large occupational cohort in Japan. Participants were 17,331 workers (20-65 years old) without CKD and were followed-up for a maximum period of 13 years. Incident CKD was defined as an estimated glomerular filtration rate of < 60 mL/min/1.73 m2 and/or proteinuria determined using the dipstick test. The Cox proportional hazards models were used to examine the associations. During 147,752 person-years of follow-up, 4013 participants developed CKD. Workers who were standing or walking at work and those who were fairly active at work had adjusted hazard ratios of 0.88 (95% confidence interval 0.86-0.96) and 0.89 (95% confidence interval 0.78-1.02), respectively, for developing CKD than sedentary workers. Leisure-time physical activity and walking for commute were not associated with CKD risk. Our findings suggest that occupational, but not leisure-time and commuting physical activities, is associated with a lower CKD risk.

Association between engagement in COVID-19-related work and depressive symptoms among hospital workers in a designated COVID-19 hospital in Japan: a cross-sectional study.

OBJECTIVES: To examine whether engagement in COVID-19-related work was associated with an increased prevalence of depressive symptoms among the staff members working in a designated medical institution for COVID-19 in Tokyo, Japan. DESIGN: A cross-sectional study. SETTING: Data were obtained from a health survey conducted in July 2020 among the staff members of a designated medical institution for COVID-19 in Tokyo, Japan. PARTICIPANTS: A total of 1228 hospital workers. EXPOSURE OF INTEREST: Engagement in COVID-19-related work (qualitatively (ie, the risk of SARS-CoV-2 infection at work or affiliation to related departments) as well as quantitatively (ie, working hours)) and job categories. OUTCOME MEASURES: Depressive symptoms. RESULTS: There was no significant association between depressive symptoms and engagement in work with potential exposure to SARS-CoV-2 or affiliation to COVID-19-related departments. However, working for longer hours in March/April, when Japan witnessed a large number of infected cases, was significantly associated with depressive symptoms (≥11 hours/day: prevalence ratio (PR)=1.45, 95% CI=1.06 to 1.99, compared with ≤8 hours/day). Nurses were more likely to exhibit depressive symptoms than did doctors (PR=1.70, 95% CI=1.14 to 2.54). CONCLUSIONS: This study suggests that the risk of SARS-CoV-2 infection at work or having an affiliation to related departments might not be linked with a higher prevalence of depressive symptoms among Japanese hospital workers; contrarily, long working hours appeared to increase the prevalence of depressive symptoms.

Association Between Adherence to Healthy Lifestyles and Depressive Symptoms Among Japanese Hospital Workers During the COVID-19 Pandemic.

The objective of this study was to investigate the association between adherence to healthy lifestyles (as measured by the healthy lifestyle index [HLI]) and depressive symptoms among staff members at a large national medical institution in Tokyo, Japan, during the coronavirus disease 2019 (COVID-19) pandemic. The study sample consisted of 1228 staff members aged between 21 and 73 years who participated in a cross-sectional survey conducted in July 2020. We constructed the HLI by assigning one point to each healthy lifestyle factor: normal body mass index, sufficient physical activity, non-smoking status, non-to-moderate alcohol consumption, and sufficient sleep duration. The multivariate adjusted odds ratios for depressive symptoms were 1.00 (reference), 0.71, 0.66, and 0.56 for participants with HLI scores of 0 to 2, 3, 4, and 5, respectively. The present study suggests the role of healthy lifestyles in mental health among hospital staff working during the pandemic.

Nightly fasting duration is not associated with the prevalence of metabolic syndrome among non-shift workers: The Furukawa Nutrition and Health Studymx.

OBJECTIVES: While several experimental studies in animals and humans have suggested the protective effect of nightly fasting duration (NFD) against cardiometabolic risk factors, few population-based studies have been conducted. This study aimed to investigate the association between NFD and metabolic syndrome (MetS) among Japanese non-shift workers. METHODS: A subset of 1054 non-shift workers from the Furukawa Nutrition and Health Study were included in this analysis. Participants completed dietary and lifestyle surveys during a periodic checkup. NFD was defined as the time between dinner and breakfast and was categorized into four groups (ie, ≥12 hours, 11 hours, 10 hours, and ≤9 hours). MetS was defined as ≥3 of the following components: high waist circumference (≥90 cm [men] and ≥80 cm [women]), high triglycerides (≥150 mg/dL), low high-density lipoprotein cholesterol (<40 mg/dL [men] and <50 mg/dL [women]), hypertension (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg), and high fasting glucose (fasting plasma glucose ≥100 mg/dL or hemoglobin A1c ≥5.6%). A multivariable logistic regression model was used to examine the association between NFD and MetS. RESULTS: The odds ratios (95% confidence intervals) of MetS for the highest (≥12 hours) through lowest (≤9 hours) NFD categories were 1.00 (reference), 0.83 (0.51-1.35), 0.83 (0.48-1.43), and 0.80 (0.43-1.48) (P for trend = 0.50) after adjusting for covariates. Further analyses on the relationship between NFD and each MetS component found no significant associations. CONCLUSIONS: We did not find any evidence of a significant association between NFD and MetS among non-shift workers in Japan.