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Internet World Congress '98 - Health practices and survival among middle-aged men and women in Japan -Gunma 9towns'cohort study-
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Health practices and survival
among middle-aged men and women in Japan
-Gunma 9towns'cohort study-

Tomoyuki KAWADA(1), M.I. Zulkarnain DUKI(1), Shosuke SUZUKI(1),
Kiyomi OKANIWA(2), Akiko KANEKO(2), Mayumi HARADA(2), Hiroko KONDO(2)
(1)Department of Public Health, Gunma University School of Medicine
Showa 3-39-22, Maebashi 371-8511, Japan
(2)Gunma Health Foundation
Horinoshita 16-1, Maebashi 371-0005, Japan
--- Internet address kawada@akagi.sb.gunma-u.ac.jp---


A cohort study was conducted to know the effect of health behavior and status on survival. Public health nurse conducted an interview on health practices. Health examination data of 9 towns' inhabitants in Gunma Prefecture, Japan, were also used. Among 8,410 subjects who participated in health examination, 7,694 (91.5%) subjects responded. Death certificates of inhabitants in these 9 towns have been continuously checked according to the formal procedure of Management and Coordination Agency. The average of follow-up period of the target population since the date of health examination until March 31, 1998, was 1,678 days.
Among the subjects, 64 inhabitants were deceased (36 men and 28 women) and 114 moved out. Death by cancer occupied about half of all the cause (15 men and the same number of women). The mean value of triglyceride of the dead group in men was significantly lower than that of alive ones (p<0.01). The mean values of BMI, creatinine, GOT, GPT, Gamma-GTP of the dead group in men were significantly lower than those of alive ones (p<0.05). In women, the mean values of age in years at baseline (p<0.01), DBP (p<0.05), GOT (p<0.01), GPT (p<0.05), Gamma-GTP (p<0.05) and triglyceride (p<0.05) were significantly higher than those of alive group. Using the above mentioned variables, Cox proportional hazard regression analysis was conducted and triglyceride was found to be a significant contributing factor on survival in men (0.994, 0.989-0.999, p<0.05). In women, the significant factors were age in years at baseline (HR=1.15, 95% CI=1.060-1.239, p<0.01), GPT (HR=1.01, 95% CI=1.000-1.027, p<0.05) and Gamma-GTP (HR=1.01, 95% CI=1.001-1.012, p<0.05). When 7 health practices and age in years at baseline were used as covariates, age (HR=1.15, 95% CI=1.073-1.242, p<0.01), no-smoking (HR=0.26, 95% CI=0.100-0.690, p<0.01) and exercise (HR=2.32, 95% CI=1.083-4.977, p<0.05) contributed significantly on survival in women .
Liver dysfunction, no-smoking and exercise as well as age in years at baseline were closely associated with survival in women. As for the men, low level of triglyceride was a risk factor for survival.


HPI=health practices index; SBP=systolic blood pressure; DBP=diastolic blood pressure; BMI=body mass index; TC=serum total cholesterol; HDLC=high density lipoprotein cholesterol; AI=Atherogenic index; GOT=glutamic oxaloacetic transaminase; GPT=glutamic pyruvic transaminase; CRE=serum creatinine; Gamma-GTP=Gamma-glutamyl transpeptidase; HR=hazard ratio; 95% CI=95% confidence interval


The authors are thankful to the members of Silver Science Projects in Gunma Prefecture, Japan.

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