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Objectives The distribution of serum 25-hydroxyvitamin D [25(OH)D] levels among reproductive age Japanese perinatal (prepartum, intrapartum, postpartum) and non-perinatal women remains unknown. In addition to this, vitamin D deficiency cut-off values, which consider the effects of these levels during the perinatal period and infant development, have not been determined. Thus, we systematically reviewed the distribution of serum 25(OH)D levels among reproductive age Japanese women, in order to provide basic data to determine vitamin D deficiency cut-off values.Methods A systematic literature review was conducted on research published between 1963 and 2015, using PubMed web and Japan Medical Abstracts Society web. The key words "Japan," "Vitamin D," "women," and "pregnant women," were used. After filtering for age, sex, race, indication of numerical number, and duplications, 18 papers were extracted and categorized into reproductive age non-perinatal women (13 papers/22 groups), and reproductive age perinatal women (6 papers/8 groups). The mean serum 25(OH)D levels were grouped by age, test period, and measuring methods.Results Mean serum 25(OH)D levels among reproductive age non-perinatal women were lower than 20 ng/ml in 10 out of 22 groups (45.4%), and lower than 30 ng/ml in 21 groups (95.5%). The mean serum 25(OH)D level among reproductive age perinatal women was lower than those among reproductive age non-perinatal women. Among reproductive age perinatal women, except for one group that included women in the first trimester of pregnancy (5-10 weeks), the mean serum 25(OH)D levels of the other groups were lower than 20 ng/ml.Conclusion Serum 25(OH)D levels among reproductive age Japanese women, especially perinatal women, appear to be low. Studies of serum 25(OH)D levels among reproductive age Japanese women are limited; hence, further investigation is required.

To develop diabetes risk scores and to produce a diabetes risk prediction sheet that can be used throughout Japan as a tool for health guidance.A total of 16,289 men and 37,099 women aged 40-69 years who had underwent health check-ups in Ibaraki prefecture, Japan, in 1993, were followed through 2003 (mean follow-up duration; 5.0 yr in men, 5.5 yr in women). Relative risk (RR) of newly developed diabetes (determined by fasting blood glucose/ = 126 mg/dL, resting blood glucose/ = 200 mg/dL, or treatment of diabetes) was calculated according to blood glucose, triglycerides (log-transformed), systolic blood pressure, body mass index (BMI), treatment for hypertension, dyslipidemia, smoking habits, alcohol consumption, and fasting status using Cox's proportional hazards model. Diabetes risk scores were calculated by multiplying RRs of individual variables. In addition, we attempted to develop a diabetes risk prediction sheets for specific health guidance of the larger general Japanese population.During the follow-up, there were 3,654 new cases of diabetes in 1,667 men and 1,987 women. In both men and women, the significant factors included in the risk scores were BMI, blood glucose, systolic blood pressure, treatment for hypertension, triglycerides and smoking habits. Based on the computed risk scores, a 12-page diabetes risk prediction sheet was produced. The sheet includes a scoring protocol for diabetes risk scores consisting of a representative value and RR for each risk factor as well as advice for achieving a healthy lifestyle.The diabetes risk prediction sheet developed in this study may be an effective tool to guide individuals at high risk for lifestyle-related disease such as diabetes.

We aimed to predict mortality rate from the findings of annual health checkups for men and women.The subjects were 31,053 men and 61,224 women who were living in Ibaraki prefecture (Japan), aged 40 to 79 years, without history of any stroke and coronary heart disease, and who participated in annual health checkups in 1993. They were followed until the end of 2001, with a systemic review of resident registration and death certificates. The Cox's proportional hazards model with step-down procedure was used to estimate predictive model.During the 8.0 years follow-up, there were 5260 deaths (710 from stroke, 389 from coronary heart disease and 2,322 from cancer). The predictive factors for all causes were advanced age, high systolic blood pressure, medication for hypertension, low serum HDL cholesterol, high or low serum creatinine, high AST or ALT, diabetes, low body mass index, current smoking, heavy drinking, and urinary protein among men. The predictive factors for cardiovascular disease were advanced age, high systolic blood pressure, medication for hypertension, low or high serum total cholesterol, low serum HDL cholesterol, high serum creatinine, diabetes, low body mass index, current smoker, and urinary protein, and those for cancer were advanced age, medication for hypertension, low serum HDL cholesterol, low serum creatinine, high AST or ALT, diabetes, low body mass index, current smoking, heavy drinking and urinary protein. Furthermore, those for stroke were advanced age, high systolic blood pressure, medication for hypertension, low serum HDL cholesterol, high serum creatinine, high AST or ALT, low body mass index, current smoking, while for coronary heart disease they were advanced age, high systolic blood pressure, high serum total cholesterol, low serum HDL cholesterol, diabetes, current smoking, and urinary protein among men. For women, similar predictive factors were obtained, although some of them did not reach statistical significance.We could construct predictive models for 5-year mortality rate from results of annual health checkups. These findings should prove useful for computerized health education on the prevention of stroke, coronary heart disease, and cancer.

A tool was developed for assessment of health status in communities to help formulate health policy of local governments and allow estimates of magnitude of changes in mortality with modification of selected risk variables.A total of 25,201 men and 51,776 women aged 40-69 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for all cause, cardiovascular disease, cerebrovascular disease, ischemic heart disease, all cancer, and lung cancer deaths were calculated according to smoking, heavy alcohol consumption, obesity, hypertension, hypercholesterolemia, low high-density lipoprotein cholesterol, and diabetes using a Cox proportional hazards model. Regression coefficients for body mass index, systolic blood pressure, serum total cholesterol, serum high-density lipoprotein cholesterol, and plasma glucose were also calculated by the model with quadratic terms. On the basis of the results, we developed a tool using Microsoft EXCEL, allowing estimation of the magnitude of changes in death rates according to variation in mean and standard deviation values for risk factors by impact fraction.The developed tool facilitates estimation of magnitude of changes in death rates with alteration in exposure rates and means/standard deviations of risk variables with intervention. The best magnitude of decline for all cause mortality with a 50% reduction of exposure to smoking was 10% in men. The magnitudes of decline in cardiovascular disease mortality with a 50% reduction in hypertension were 12% in men and 11% in women. Furthermore, the magnitude of decline in cardiovascular disease mortality if a 10% lowering of mean systolic blood pressure were achieved would be 22% in men and 18% in women.Our developed tool may be useful to assess health status in communities with cooperation between municipal and prefectural governments.

To clarify relationships between BMI (body mass index) and the incidence of hypertension, diabetes and hypercholesterolemia among a community-based sample.A 4.3-year follow-up study was conducted of 1,427 men and women aged 40-69 to examine the relationships between BMI (kg/m2) and the incidence of hypertension, diabetes and hypercholesterolemia.During the follow-up, there were 118 cases of incident hypertension diagnosed, 56 of diabetes and 136 of hypercholesterolemia. After adjusting for sex, age, cognitive physical activity, food intake, alcohol intake, smoking, and blood pressure level, blood glucose level and serum total cholesterol level at the baseline, excess risks with the BMI category ofor = 27.0 versus 21.0-22.9 were found for hypertension [relative risk (95% CI) = 1.9(1.0-3.6)] and diabetes [2.9(1.2-7.4)]. However, no excess risk was evident for the 23.0-24.9 or 25.0-26.9 categories. Multivariate relative risks (95%CI) of hypercholesterolemia compared with the BMI category of 21.0-22.9 were 1.5 (0.9-2.6) for 23.0-24.9, 1.7(0.9-3.2) for 25.0-26.9 and 1.6 (0.8-3.1) foror = 27.0, none of which reached statistical significance. When we combined all three diseases, the relative risks (95%CI) compared with the BMI category of 21.0-22.9 were 0.9(0.6-1.5) for 23.0-24.9, 1.2(0.7-2.1) for 25.0-26.9 and 1.8 (1.0-3.3) foror = 27.0.Increased risks of hypertension, diabetes and lifestyle-related disease were only evident with the BMI categoryor = 27.0. Education for weight reduction should be less emphasized for persons with a BMI of 25.0-26.9 than for these with a value ofor = 27.0.