Iseki Kunitoshi, Asahi Koichi, Yamagata Kunihiro, Fujimoto Shouichi, Tsuruya Kazuhiko, Narita Ichiei, Konta Tsuneo, Kasahara Masato, Shibagaki Yugo, Yoshida Hisako, Moriyama Toshiki, Kondo Masahide, Iseki Chiho, Watanabe Tsuyoshi
Clinical Research Support Center, Tomishiro Central Hospital, 25 Ueda, Tomigusuku, Okinawa, 901-0243, Japan.
Members for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Check", Fukushima, Japan.
Clin Exp Nephrol. 2017 Dec;21(6):978-985. doi: 10.1007/s10157-017-1392-y. Epub 2017 Mar 3.
In Japan, the Specific Health Check and Guidance (Tokutei-Kenshin) has started in 2008. However, the relationship between the baseline characteristics and mortality has not been examined.
Subjects were those who participated at the 2008 Tokutei-Kenshin in six districts with baseline data of serum creatinine. Using National database of death certificate from 2008 to 2012, we identified those who might have died and confirmed further with the collaborations of the regional National Health Insurance agency and public health nurses. The data was released to the research team supported by the Ministry of Health, Labor, and Welfare of Japan, and is governed by strict regulation and is completely encrypted with the individual's name and residence. Causes of death were classified by ICD-10.
Among the total of 295,297 subjects, we identified 3764 fatal cases by end of 2012. The median BMI was 23.8 kg/m in men and 22.5 kg/m in women, respectively. Proteinuria, dipstick 1+ and over, was positive in 5.3%. The median eGFR was 73.8 ml/min/1.73 m among those with data available in 81% of the total cohort (N = 239,274). The leading cause of death was neoplasm in both genders. It was 51.6% of the total, 50.4% in men and 53.7% in women. The second cause of death was circulatory; 20.4% of the total, 21.1% in men and 19.2% in women.
Half of the causes of death was related to neoplasm among the cohort of the Tokutei-Kenshin. Effects of baseline demographics such as lifestyle and CKD remained to be studied.
在日本,特定健康检查与指导(Tokutei-Kenshin)于2008年启动。然而,基线特征与死亡率之间的关系尚未得到研究。
研究对象为2008年参加Tokutei-Kenshin且在六个地区有血清肌酐基线数据的人群。利用2008年至2012年的国家死亡证明数据库,我们确定了可能已经死亡的人员,并通过地区国民健康保险机构和公共卫生护士的合作进行了进一步确认。数据提供给了由日本厚生劳动省支持的研究团队,数据受到严格监管,且使用个人姓名和住址进行了完全加密。死亡原因按照国际疾病分类第10版(ICD-10)进行分类。
在总共295,297名研究对象中,到2012年底我们确定了3764例死亡病例。男性的中位体重指数(BMI)为23.8kg/m²,女性为22.5kg/m²。尿蛋白试纸检测1+及以上呈阳性的比例为5.3%。在占总队列81%(N = 239,274)且有可用数据的人群中,估算肾小球滤过率(eGFR)的中位数为73.8ml/min/1.73m²。男女的主要死亡原因均为肿瘤。肿瘤占总死亡原因的51.6%,男性为50.4%,女性为53.7%。第二大死亡原因是循环系统疾病;占总死亡原因的20.4%,男性为21.1%,女性为19.2%。
在Tokutei-Kenshin队列中,一半的死亡原因与肿瘤有关。生活方式和慢性肾脏病等基线人口统计学因素的影响仍有待研究。