Urinary cadmium and mortality among inhabitants of a cadmium-polluted area in Japan.

The influence of cadmium (Cd) body burden on mortality remains controversial. Excess mortality and the dose-response relationship between mortality and urinary cadmium excretion were investigated in this study among environmentally exposed subjects. A 15-year follow-up study was carried out on 3119 inhabitants (1403 men and 1716 women) of the Cd-polluted Kakehashi River basin, whose urinary Cd concentration was examined in a 1981-1982 health impact survey. The mortality risk of high urinary Cd (> or = 10 microg/g Cr) subjects after adjustment for age using Cox's proportional hazard model was higher than that of moderate urinary Cd (< 10 microg/g Cr) subjects in both sexes. When the subjects were divided into five groups according to the amount of urinary Cd (<3, 3-5, 5-10, 10-20, > or = 20 microg/g Cr), the mortality risk was significantly increased among the subjects with urinary Cd > or = 3 microg/g Cr in proportion to the increases in the amount of urinary Cd concentration after adjustment for age, especially in women. Furthermore, special causes of death among high and moderate urinary Cd were investigated, and mortality risk ratio for heart failure, which is a cause of death often diagnosed in cases with a gradual deterioration culminating in death, was significantly increased in both sexes, compared with the moderate urinary Cd subjects. Also, in women the mortality risk for renal diseases in the high urinary Cd subjects was significantly higher than that in the moderate urinary Cd subjects. These results suggest that a causal association between Cd body burden and mortality exists among inhabitants environmentally exposed to Cd but that no special disease may be induced except renal diseases.

[Relationship of childhood obesity to adult obesity: a 20-year longitudinal study from birth in Ishikawa Prefecture, Japan].

OBJECTIVE: Evidence regarding the relationship between childhood obesity and adult obesity in Japan is limited. This study was conducted to determine the relationship between childhood mass index (BMI) at 3 months, 12 months, 3 years and 20 years in a general population. METHODS: Data obtained from men and women aged 20 years (born between 1968-1974), who had received medical examinations in Ishikawa Prefecture, Japan, were linked to data of medical examinations of the same individuals as infants (3 months, 12 months, and 3 years). The relationship between childhood BMI (or Kaup index) and adult BMI was analyzed for a total of 2,314 participants (1,080 men and 1,234 women), whose data could be followed for 20 years. RESULTS: BMI at 20 years displayed significant positive correlations with BMI at 3 months, 12 months, and 3 years; this correlation was strongest with respect to BMI at 3 years (r = 0.33, p < 0.001 in men; r = 0.42, p < 0.001 in women). In terms of percentages of obese participants (BMI 25 kg/m2 or over) at 20 years in accordance with BMI categories at each age, the rates were 4.6% in men and 1.0% in women with a BMI less than 15 kg/m2 at 3 years, but 29.1% and 29.5%, respectively, with a BMI of 18 kg/m2 or over (6.3 and 29.5 times higher, respectively). Percentages of obese participants at 20 years were highest in those exhibiting an above average BMI at 3 years, regardless of the BMI at 3 months. CONCLUSIONS: Body mass in young adults is strongly related to body mass in childhood, especially with that at 3 years. About 30 percent of obese children at 3 years remain obese into adulthood. These results are of interest with respect to assessment of future risk of adulthood obesity at medical examinations for infants in Japan.