Relationship Between Serum Cholesterol and the Risk of Acute Myocardial Infarction in a Screened Cohort in Okinawa, Japan
Open accessAbstract
Coronary heart disease (CHD) is rare in Japanese subjects and serum cholesterol levels are low. However, no data have been published relating the effect of serum cholesterol levels to the incidence of acute myocardial infarction (AMI) in Japan. Data from a large community-based mass screening registry are available for the geographically isolated island of Okinawa, Japan (1980 census, 1.11 million). A total of 38,053 participants (17,859 men and 20,194 women) whose serum cholesterol levels were determined in the 1983 mass screening were examined to determine whether they had experienced AMI. Every case of AMI that occurred during a 3-year period (1 April 1988 to March 1991) throughout Okinawa was recorded in a separate registry. The total number of cases of AMI was 1,021 (674 men and 347 women). Of these, 65 patients (41 men and 24 women) were identified by name, sex, birth date, and zip code in the mass screening registry. The cumulative incidence of AMI increased with the serum level of cholesterol: 42.1 (serum cholesterol < or = 167 mg/dl), 133.5 (serum cholesterol 168-191 mg/dl), 188.9 (serum cholesterol 192-217 mg/dl), and 323.0 (serum cholesterol > or = 218 mg/dl) per 100,000 screened subjects. Multiple logistic analysis was conducted to examine the effect of serum cholesterol on the risk of AMI with adjustment for other variables such as sex, age, systolic and diastolic blood pressure, and proteinuria. The adjusted odds ratio (95% confidence interval) of the observed serum levels of cholesterol was 1.66 (1.29-2.15) with a reference serum cholesterol level of < or = 167 mg/dl. The risk of AMI increased in proportion to the serum level of cholesterol. Serum cholesterol is an independent predictor of AMI in Okinawa, Japan.
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Japanese cohort studies reported an increase in CAD incidence and mortality following TC elevation.
“a number of cohort studies conducted in Japan have reported an increase in the incidence and mortality rates of CAD following an elevation in TC level48–54).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [52]
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- Authors
- wakugami, K., Iseki, K., Kimura, Y., Okumura, K., lkemiya, Y., Muratani, H., & Fukiyama, K.
- Affiliations
- Third Department of Internal Medicine
- University of the Ryukyus (JP)
- Okinawa General Health Maintenance Association
- ORCID
- Iseki, Kunitoshi
- Venue
- Japanese Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 1998
- Volume
- 62
- Issue
- 1
- Pages
- 7-14
- ISSN
- 0047-1828 (ISSN-L)
- 1347-4839
- OpenAlex
- W2027433622
- Cited by
- 51
- References
- 38
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 1 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 1 · 2013: 2 · 2012: 1
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Japanese Circulation Journal-english Edition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- serum cholesterol, acute myocardial infarction, coronary artery disease, cardiovascular risk factors, Okinawa, Japanese population, incidence, blood pressure, proteinuria
- MeSH terms
- Adolescent, Adult, Aged, Cholesterol, Female, Humans, Japan, Male, Mass Screening, Middle Aged, Myocardial Infarction, Registries, Risk Factors, Cohort Studies, Incidence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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