Primary Prevention of Life-style Related Diseases By Utilizing Annual Health Check-up Data at Worksite ; Computerized Database Construction and a Nested Case-Control Study.

对于心血管事件，如中风、心肌梗死或与生活方式相关的慢性疾病，如高血压、二脂血症或糖尿病等被认为是危险因素的初级预防，有必要获得与这些疾病相关或导致这些疾病的证据。1997年，我们在日本爱知县的两种职业环境中建立了一个大约11700名男女工人的队列，他们的年龄在34岁到69岁之间。其中，那些表示书面知情同意参加研究的人被跟踪。参与者的血液样本也被收集和保存。在对高胆固醇血症和饮食之间关系的横断面分析中，那些意识到胆固醇水平升高或接受过药物治疗的参与者，如果他们报告吃饱了，患这种疾病的几率比就会降低。这种反向关联表明，由于意识到他们的病情，饮食模式可能会发生变化。在另一项关于钠摄入量与高血压之间关系的横断面分析中，钠摄入量仅在50岁以上的女性中与高血压显著相关。这表明更年期可能影响血压与饮食生活方式的关系。我们还揭示了20多岁时的体重以及随后的体重变化与多重危险因素综合征的风险之间的关系。截至2000年8月底，共有9例中风病例和19例心脏病病例被记录在案。从初步的巢式病例对照研究来看，病例更容易吃饱，每天吃早餐的可能性更小。卒中病例与高血压、心脏事件、高胆固醇血症、糖尿病和胰岛素抵抗相关。目前仍在进一步分析与生活方式有关的慢性病与胰岛素抵抗、体重变化或特别是妇女的生殖史之间的联系。

For the primary prevention of cardiovascular events such as stroke, myocardial infarction or lifestyle-related chronic diseases recognized as risk factors like hypertension, dislipidemia or diabetes, it is necessary to obtain the evidence about what kind of lifestyle is associated with or causative of these conditions. In 1997, we established a cohort of about 11,700 workers of both sex, in two occupational settings, in Aichi, Japan, who were 34 to 69 years of age. Of them those who expressed written informted consent to participate in the study have been followed. Blood samples of the participants were also collected and stored.In the cross-sectional analysis on the association between hypercholesterolemia and diet, participants who had been aware of elevated cholesterol levels or given medical treatment had a decreased odds ratio for the disease if they had reported to eat to satiety. This inverse associaton suggests a possible change in dietary pattern due to the awareness of their condition. In another cross-sectional analysis on the association between sodium intake and hypertension, sodium intake was significantly associated with hypertension only in the women older than 50. This suggests possible effct of menopause on the association of blood pressure with dietary lifestyles. We also revealed the association of weight at twenties as well as subsequent weight change with the risk of multiple risk factor syndrome.By the end of August 2000, nine cases of stroke and 19 cases of cardiac events were documented. From the preliminary nested case-control study, cases were more likely to eat to satiety and less likely to eat breakfast everyday. Stroke cases were associated with hypertension and cardiac events cases, with hypercholesterolemia, diabetes and insulin resistance. Further analyses on the detail of the association of lifestyle-related chronic diseases with insulin resistance, body weight change or, especially in women, reproductive history are still on going.