Nakamura Iori, Kato Satoshi, Suda Akari, Kiyoshige Eri, Nakatsuka Kiyomasa, Nakaoku Yuriko, Teramoto Kanako, Yoshikawa Yusuke, Takegami Misa, Ogata Soshiro, Hagihara Akihito, Nishimura Kunihiro
H.U. Group Research Institute G.K., 50 Fuchigami, Akiruno, Tokyo, Japan.
Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Simmachi, Suita, Osaka, Japan.
BMC Public Health. 2025 Apr 14;25(1):1400. doi: 10.1186/s12889-025-22403-1.
In Japan, type 2 diabetes mellitus (T2DM) is a major health concern due to its increasing prevalence and associated complications, including diabetic nephropathy and dialysis. Although the positive relationship between annual health checkups and health outcomes is well-documented, the impact of skipping health checkups on T2DM and its progression to dialysis remains unclear. This study aimed to explore the association between the frequency of annual health checkups and DM-related indices and the potential impact of early intervention in preventing dialysis.
The study included citizens aged ≥ 40 years from Nobeoka City, Japan (n = 22,094). Health checkup data from 2021 were analyzed, and participants were categorized into four groups based on their health checkup attendance between 2018 and 2020. Logistic regression analyses evaluated the association between health checkup frequency and DM-related indices, such as hemoglobin A1c and estimated glomerular filtration rate. These indices are used to diagnose DM and evaluate its severity. The time to dialysis for citizens without health checkups was estimated under untreated and treated scenarios using a previously published model.
Among the 3,472 participants who underwent health checkups in 2021, 2,098 (60.4%) were women, and 1,374 (39.6%) were men. Citizens who missed health checkups for 3 consecutive years had a higher risk of T2DM than those who had annual checkups (odds ratio = 4.69, 95% confidence interval: 2.78-7.94). No significant difference was observed in T2DM rates between those who attended once or twice and those who attended annually. Simulations for high-risk citizens showed that 32 of 39 individuals may require dialysis during their lifetime; however, early intervention could prevent dialysis in 31 of them.
Citizens who skipped health checkups for 3 consecutive years or longer had a higher risk of T2DM, highlighting the need for targeted public interventions to prevent DM in this population.
在日本，2型糖尿病（T2DM）因其患病率不断上升以及相关并发症（包括糖尿病肾病和透析）而成为主要的健康问题。尽管年度健康检查与健康结果之间的正向关系已有充分记录，但跳过健康检查对T2DM及其进展为透析的影响仍不明确。本研究旨在探讨年度健康检查频率与糖尿病相关指标之间的关联，以及早期干预在预防透析方面的潜在影响。
该研究纳入了日本延冈市年龄≥40岁的市民（n = 22,094）。分析了2021年的健康检查数据，并根据参与者在2018年至2020年期间的健康检查出勤情况将其分为四组。逻辑回归分析评估了健康检查频率与糖尿病相关指标（如糖化血红蛋白和估计肾小球滤过率）之间的关联。这些指标用于诊断糖尿病并评估其严重程度。使用先前发表的模型在未治疗和治疗的情况下估计未进行健康检查的市民的透析时间。
在2021年接受健康检查的3472名参与者中，2098名（60.4%）为女性，1374名（39.6%）为男性。连续3年错过健康检查的市民患T2DM的风险高于每年进行检查的市民（优势比 = 4.69，95%置信区间：2.78 - 7.94）。参加一次或两次检查的人与每年参加检查的人之间的T2DM发病率没有显著差异。对高危市民的模拟显示，39人中有32人可能在其一生中需要透析；然而，早期干预可以预防其中31人的透析。
连续3年或更长时间跳过健康检查的市民患T2DM的风险更高，这凸显了针对该人群预防糖尿病进行有针对性的公共干预的必要性。
