Hayase Ayaka, Onoue Takeshi, Nishida Kazuki, Nakata Yoshio, Hayashi Fumi, Marutani Miki, Sakane Naoki, Okamura Tomonori, Matsuzaki Keiichi, Kawamura Takashi, Tsushita Kazuyo
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan.
Environ Occup Health Pract. 2024 Sep 25;6(1). doi: 10.1539/eohp.2024-0011-OA. eCollection 2024.
Metabolic syndrome (MS) is a significant health concern in the working-age population. Since 2008, Japan has mandated health insurers to implement Specific Health Checkups to identify individuals with MS and preliminary groups, making Specific Health Guidance (SHG) compulsory for these groups. People receiving SHG multiple times is increasing as it is conducted as an annual public program. Therefore, we evaluated the influence of a health guidance history on the effectiveness of subsequent guidance.
Using data from 10,191 participants in the 2017 Motivational Health Guidance (a type of SHG involving a single session), this longitudinal study assessed the changes in health checkup findings from 2017 to 2018. Participants were categorized based on their previous year's (2016) SHG eligibility and participation: Group 1 (n=3,903) met the 2016 SHG criteria and participated, Group 2 (n=2,305) met the criteria but did not participate, and Group 3 (n=3,983) had no MS risk factors and did not need to participate in the 2016 SHG.
The entire cohort and Groups 2 and 3 exhibited significant weight loss after 1 year. Group 1 showed a significant negative association, with a 3% (odds ratio [OR] 0.64; 95% confidence interval [CI], 0.55-0.75) and 5% body weight loss (OR 0.66; 95% CI, 0.54-0.81) than Group 3. Men in Group 1 showed a significant association with new-onset MS (OR 2.56; 95% CI, 1.93-3.40).
The findings suggest that participants with a history of health guidance in the previous year may have low rates of achieving weight loss and a high incidence of new-onset MS after 1 year.
代谢综合征（MS）是工作年龄人群中一个重大的健康问题。自2008年以来，日本已要求健康保险公司实施特定健康检查，以识别患有MS的个体和初步人群，并对这些人群强制实施特定健康指导（SHG）。由于SHG作为一项年度公共项目开展，接受多次SHG的人数正在增加。因此，我们评估了健康指导史对后续指导效果的影响。
本纵向研究使用了2017年动机性健康指导（一种单次SHG）中10191名参与者的数据，评估了2017年至2018年健康检查结果的变化。参与者根据上一年（2016年）的SHG资格和参与情况进行分类：第1组（n = 3903）符合2016年SHG标准并参与，第2组（n = 2305）符合标准但未参与，第3组（n = 3983）没有MS风险因素，无需参与2016年SHG。
整个队列以及第2组和第3组在1年后体重显著减轻。第1组显示出显著的负相关，与第3组相比，体重减轻了3%（优势比[OR]0.64；95%置信区间[CI]，0.55 - 0.75）和5%（OR 0.66；95%CI，0.54 - 0.81）。第1组中的男性与新发MS存在显著关联（OR 2.56；95%CI，1.93 - 3.40）。
研究结果表明，上一年有健康指导史的参与者在1年后实现体重减轻的比例可能较低，新发MS的发生率较高。
