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This study examined the differences in mortality rate among the three ethnic groups aged 35 to 69: 1) Japanese living in Kawasaki city, 2) Koreans living in Kawasaki city, 3) Koreans living in Korea. Three different measures were used for analysis: 1) mortality rate by sex and age, 2) Mantel-Haenszel Rate Ratio (MHRR), 3) Standardized Proportional Mortality Ratio (SPMR). Major findings were as follows: 1) In terms of mortality rate by sex and age, Koreans in both Kawasaki and Korea showed higher mortality rates than Japanese in Kawasaki for both sexes and for all of the age categories. Koreans living in Kawasaki and Koreans living in Korea showed nearly identical levels of mortality rate for both sexes and for all of the age categories. 2) Calculation of MHRR utilizing a mortality rate for Japanese living in Kawasaki as 1 yielded the following: For all causes of death, MHRR of Korean males living in Kawasaki aged 35 to 59 was 2.59, and 2.37 for ages 60 to 69. For females MHRR for those age groups were 1.91 and 2.06 respectively. All of these MHRRs were statistically significantly high (p less than 0.05). 3) Among the causes for the high MHRR for Korean males living in Kawasaki aged 35 to 59 compared in Japanese living in Kawasaki were the following: all Malignant neoplasms (ICD 9, 140-208), Malignant neoplasm of liver (155), Hypertensive disease (401-405), Ischemic heart disease (410-414), Pneumonia (480-486), Liver Cirrhosis (571). For males aged 60 to 69, causes were Tuberculosis (010-018), all Malignant neoplasms, Malignant neoplasm of liver, Ischemic heart disease, Disease of the pulmonary circulation and other forms of heart disease (415-429), Cerebrovascular disease (430-438), and Liver Cirrhosis. In the case of females, Tuberculosis, Disease of the pulmonary circulation and other forms of heart disease, Malignant neoplasm of trachea, bronchus and lung were causes for high MHRR for Koreans in Kawasaki aged 35 to 59. All Malignant neoplasms, Malignant neoplasm of liver, Malignant neoplasm of trachea, bronchus and lung, Accidental causes of death except motor vehicle accidents (E800-807, E826-848, E850-949) were causes for females aged 60 to 69. 4) The mortality rates for ages 35 to 69 for both sexes are similar for both Koreans living in Kawasaki and in Korea.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A mortality study of middle-aged and elderly Koreans in Kawasaki City in comparison with Koreans in Korea and Japanese in Kawasaki City]. 213 81

A follow-up study of 1939 diabetic patients with a mean observation period of 9.4 years was carried out in Osaka, Japan. The mortality rates per 1000 person-years were 31.35 for males and 21.99 for females, and the ratios of observed to expected number of deaths were 1.69 for males and 1.74 for females, indicating an excess mortality for diabetic patients of both sexes and higher mortality in males than in females in Japan. Factors related to the prognosis of the patients were age, elevated fasting glucose level, lower obesity index, hypertension, diabetic retinopathy, and albuminuria at entry to the study. Insulin treatment was also associated with poor prognosis. Cerebro-cardiovascular and renal disease were the major causes of death in diabetic patients; heart disease killed 19.5%, cerebrovascular disease 16.7% and renal disease 13.1%. The relatively high frequency of renal disease as a cause of death in type 2 diabetes, especially in patients with a lower age of onset, was noteworthy, suggesting some difference in the clinical manifestations of diabetes between Japan and Western countries. Malignant neoplasms accounted for 25% of deaths, and cirrhosis of the liver for 6.4%.
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PMID:Mortality and causes of death in type 2 diabetic patients. A long-term follow-up study in Osaka District, Japan. 275 88

Death certificates filed between 1960 and 1979 in Osaka, Japan were analyzed to study causes of death in diabetic patients. It was observed that diseases of the circulatory system increased continuously from 15.2% in 1960-1964 to 27.2% in 1975-1979. Cerebrovascular disease and disease of heart were the leading causes of death throughout the study period. The rate of increase was much faster for disease of heart than for cerebrovascular disease, and there was only a small difference between them as cause of death in diabetic patients at the end of the observation period. Malignant neoplasms, cirrhosis of the liver, and pneumonia and bronchitis increased, whereas tuberculosis decreased sharply according to age-adjusted mortality rate during the 20-year period. Analysis based on O/E ratios suggested higher risk of dying from ischemic heart disease, tuberculosis and cirrhosis of the liver in Japanese diabetics than in the general population in this country.
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PMID:Causes of death in Japanese diabetics. A 20-year study of death certificates. 401 2

Mortality among employees of selected enterprises in which excellent health care programmes are carried on, was observed to evaluate employees' health levels and to establish objectives for future health care programmes. Also, these data were compared with those for all Japanese and for Japanese employees belonging to the corresponding occupational groups. Seventy-three enterprises which continuously participated in the mortality survey implemented by the Japan Research Organization of Industrial Health Care for the period between 1976 and 1980, were subjected to this study. The observed employees amounted to 3,502,580 person-years. Sex and age distributions of the employees were available for 47 enterprises and the observed employees totalled 2,598,672 person-years. The main results are as follows: Mortality rate (per 100,000) is stable between 140 and 150 throughout the observed period and the average value is 145.0. The average mortality rate for males, aged 40 to 54, is 272.6. Malignant neoplasms were the main cause of death and account for 37-38%. In second place and below are heart diseases, cerebrovascular diseases, accidents, suicide and liver cirrhosis. Malignant neoplasms, especially of the stomach, lung and pancreas, show a trend to increase, and cerebrovascular diseases and liver cirrhosis show a trend to decrease. Among heart diseases, ischemic heart disease accounts for about 40% and shows no marked fluctuation. Among cerebrovascular diseases, the relative frequency of subarachnoid hemorrhage is increasing. Comparing the mortality rates for males aged 40 to 54 by industry, "Iron, steel & nonferrous metal manufacturing" and "Electricity and gas supply" show significantly higher values, and "Finance & insurance" and "Communications" show significantly lower values than the total. The distribution of main causes of death for males, aged 40 to 54, was compared by major occupational groups using Proportional Mortality Ratio (PMR). A significantly high frequency of malignant neoplasms (especially of the stomach) is observed for "Professional & technical workers, managers and officials" and that of suicide for "Craftmen, production process workers and labourers" and that of cerebrovascular diseases (especially cerebral hemorrhage) for "Protective service workers." Standardized Mortality Ratio (SMR) for males, aged 20 to 54, from all causes of death, calculated on the basis of all Japanese males in 1978 is 0.57. SMR for this population from malignant neoplasms is 0.89.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Observations on mortality in selected working populations]. 653 Aug 14

A systematic 20-year follow-up study of 1,221 diabetic patients was carried out in Osaka, Japan. The mean annual mortality rates were 2.55% for men and 1.64% for women. The ratios of observed to expected numbers of deaths were 1.50 for men and 1.39 for women, indicating an excess mortality for diabetic patients of both sexes, and higher mortality in men than in women. Factors that predisposed diabetic patients to premature death were early age of onset, albuminuria, diabetic retinopathy and fasting glucose level greater than 11.1 mmol/l at the initial examination. Insulin dependence was also associated with poor prognosis. Cerebro-cardiovascular and renal diseases were the major causes of death in the diabetic patients; heart disease was the cause of death in 16.9%, cerebrovascular disease in 16.4% and renal disease in 11.9%. The relatively high incidence of renal disease as cause of death in diabetic patients was striking. Malignant neoplasms of liver and of pancreas and cirrhosis were also associated with increased ratio of observed to expected number of deaths in the patients.
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PMID:A long-term follow-up study of Japanese diabetic patients: mortality and causes of death. 664 95

A long-term follow-up study of diabetic patients was carried out in Osaka, Japan. The subjects were 1,850 diabetics, who were first seen at our hospital between 1960-1979, and they were followed up until the end of 1980. Both the mean annual mortality rate and the O/E ratio indicated an excess mortality in diabetic patients compared to the general population, and a higher mortality in males than in females. Factors related to the prognosis of the subjects were elevated systolic blood pressure, albuminuria and elevated fasting glucose levels at the baseline, and poor metabolic control and insulin treatment during the follow-up period. Cerebrocardiovascular and renal diseases accounted for nearly half of all deaths. When compared to the expected death rate, the increase in the number of deaths due to renal disease was remarkable. Malignant neoplasms also exhibited an increase in the O/E ratio, and were responsible for one quarter of all deaths. In particular, an increase in cancer of the liver and of the pancreas was noted. In addition, an increased O/E ratio was observed for cirrhosis of the liver.
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PMID:A long-term follow-up study of diabetic patients in Osaka, Japan: mortality and causes of death. 668 May 41

As reported previously, we have conducted studies on causes of death among diabetic patients during the 25-year period, from 1960 to 1984, in Osaka District, Japan. We have now added the most recent 5-year data, for 1985-1989, and analyzed changes in causes of death during the entire 30-year period as a whole. The subjects studied were those for whom a total of 32,222 death certificates had been filed in Osaka Prefecture, from 1960 to 1989, with diabetes mentioned either as the underlying cause or as a contributory condition. The relative number of death certificates mentioning diabetes as the underlying cause, which had been decreasing during the 25-year study period, showed a further decrease, reaching the lowest value, 33.4%, for the period 1985-1989. The mean age at death exceeded 70 years for all causes of death, showing a continuous increasing trend. An increase in disease of the heart and a decrease in cerebrovascular disease were observed, making the difference between the two causes greater since 1980-1984. Malignant neoplasms, ischemic heart disease, and pneumonia and bronchitis also showed steady increases. The O/E ratios (ratio of observed/expected number of deaths) for cirrhosis of the liver and tuberculosis were markedly increased, while that for malignant neoplasms was only about 0.5, suggesting extreme underestimation of the number of diabetic cases with cancer. Among malignant neoplasms, an increasing trend in liver cancer was remarkable and was associated with a relatively high O/E ratio.
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PMID:Changes in causes of death in diabetic patients based on death certificates during a 30-year period in Osaka District, Japan, with special reference to cancer mortality. 795 7