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Ito T, Kamei F, Sonoda H, Oba M, Kawanishi M, Yoshimura R, Fukunaga S, Egawa M. Effectiveness of CKD Exacerbation Countermeasures in Izumo City. J Pers Med 2021; 11:jpm11111104. [PMID: 34834456 PMCID: PMC8622121 DOI: 10.3390/jpm11111104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 12/01/2022] Open
Abstract
To diagnose chronic kidney disease (CKD) at an early stage, it is important to promote appropriate health guidance and consultation recommendations through regular medical examinations and implementation of continuous high-quality and appropriate treatment. From fiscal year (FY) 2018, Izumo City has initiated the “Izumo City CKD Exacerbation Countermeasures” program. In this study, we aimed to report on the methods undertaken and the effects of this program. Residents aged 40–74 years who underwent specific health checkups from the Izumo City National Health Insurance in FY2018 and FY2019 were included. The rates of CKD re-examination candidates, re-examinations implementation, nephrologist referrals, and health guidance referrals between FY2018 and FY2019 were compared. The rate of CKD re-examination candidates in both years remained unchanged at approximately 7%. The rate of re-examination implementation in FY2019 significantly increased relative to that in FY2018 (p < 0.001). Subsequent re-examination candidate trends showed that the rate of nephrologist referrals did not increase. However, the rate of city health guidance referrals significantly increased (p < 0.001). Increase in the re-examination and health guidance examination rates indicate improved awareness of CKD among the public and family doctors, and it is expected to prevent CKD exacerbation in the future.
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Kodani E, Kaneko T, Fujii H, Nakamura H, Sasabe H, Tamura Y, Shimizu W. Impact of Chronic Kidney Disease Classification on New-Onset Atrial Fibrillation in the General Population ― The TAMA MED Project-AF and CKD ―. Circ J 2020; 84:1693-1700. [DOI: 10.1253/circj.cj-20-0329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital
| | - Tomohiro Kaneko
- Department of Nephrology, Nippon Medical School Tama-Nagayama Hospital
| | | | | | | | | | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
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Kodani E, Kaneko T, Fujii H, Nakamura H, Sasabe H, Tamura Y, Shimizu W. Prevalence and Incidence of Atrial Fibrillation in the General Population Based on National Health Insurance Special Health Checkups ― TAMA MED Project-AF ―. Circ J 2019; 83:524-531. [DOI: 10.1253/circj.cj-18-1038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Eitaro Kodani
- Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital
- TAMA CITY Medical Association
| | - Tomohiro Kaneko
- Department of Nephrology, Nippon Medical School Tama-Nagayama Hospital
| | - Hitomi Fujii
- Tama-center Mirai Clinic
- TAMA CITY Medical Association
| | | | | | | | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
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Nakai K, Watari J, Tozawa K, Tamura A, Hara K, Yamasaki T, Kondo T, Kono T, Tomita T, Ohda Y, Oshima T, Fukui H, Sakurai J, Kim Y, Hayakawa Y, Fujisawa T, Morimoto T, Miwa H. Sex differences in associations among metabolic syndrome, obesity, related biomarkers, and colorectal adenomatous polyp risk in a Japanese population. J Clin Biochem Nutr 2018. [PMID: 30279628 DOI: 10.3164/jcbn.18.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To investigate sex differences in the associations among metabolic syndrome, obesity, adipose tissue-related biomarkers, and colorectal adenomatous polyps, a cross-sectional, multicenter study was conducted on 489 consecutive individuals who underwent their first colonoscopy at 3 hospitals. Plasma concentrations of adiponectin and leptin, as well as homeostatic model assessment of insulin resistance were also evaluated. The presence and number of adenomatous polyps, including advanced adenoma, were higher in men than in women. Metabolic syndrome was a risk factor for adenomatous polyps in both sexes. Large waist circumference was an independent risk factor for adenomatous polyps in men, and high BMI and large waist circumference were risk factors for adenomatous polyps in women. Interestingly, low BMI was associated with large adenomatous polyps (≥10 mm) and advanced adenoma, and waist-hip ratio was involved in proximal adenomatous polyp development only in women. In contrast, the highest quartile of leptin concentration had a 3.67-fold increased adenomatous polyp risk compared with the lowest quartile only in men. These results indicate that regarding colorectal pathogenesis, sex differences were identified in obesity but not in metabolic syndrome. Visceral obesity and a high serum leptin level may be risk factors for colorectal adenomatous polyp development in Japanese men.
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Affiliation(s)
- Keisuke Nakai
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Akio Tamura
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Sakurai
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yongmin Kim
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yuji Hayakawa
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Takashi Fujisawa
- Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo 671-1122, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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Nakai K, Watari J, Tozawa K, Tamura A, Hara K, Yamasaki T, Kondo T, Kono T, Tomita T, Ohda Y, Oshima T, Fukui H, Sakurai J, Kim Y, Hayakawa Y, Fujisawa T, Morimoto T, Miwa H. Sex differences in associations among metabolic syndrome, obesity, related biomarkers, and colorectal adenomatous polyp risk in a Japanese population. J Clin Biochem Nutr 2018; 63:154-163. [PMID: 30279628 PMCID: PMC6160732 DOI: 10.3164/jcbn.18-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 12/14/2022] Open
Abstract
To investigate sex differences in the associations among metabolic syndrome, obesity, adipose tissue-related biomarkers, and colorectal adenomatous polyps, a cross-sectional, multicenter study was conducted on 489 consecutive individuals who underwent their first colonoscopy at 3 hospitals. Plasma concentrations of adiponectin and leptin, as well as homeostatic model assessment of insulin resistance were also evaluated. The presence and number of adenomatous polyps, including advanced adenoma, were higher in men than in women. Metabolic syndrome was a risk factor for adenomatous polyps in both sexes. Large waist circumference was an independent risk factor for adenomatous polyps in men, and high BMI and large waist circumference were risk factors for adenomatous polyps in women. Interestingly, low BMI was associated with large adenomatous polyps (≥10 mm) and advanced adenoma, and waist-hip ratio was involved in proximal adenomatous polyp development only in women. In contrast, the highest quartile of leptin concentration had a 3.67-fold increased adenomatous polyp risk compared with the lowest quartile only in men. These results indicate that regarding colorectal pathogenesis, sex differences were identified in obesity but not in metabolic syndrome. Visceral obesity and a high serum leptin level may be risk factors for colorectal adenomatous polyp development in Japanese men.
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Affiliation(s)
- Keisuke Nakai
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Akio Tamura
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Sakurai
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yongmin Kim
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yuji Hayakawa
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Takashi Fujisawa
- Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo 671-1122, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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Watari J, Hori K, Toyoshima F, Kamiya N, Yamasaki T, Okugawa T, Asano H, Li ZL, Kondo T, Ikehara H, Sakurai J, Tomita T, Oshima T, Fukui H, Miwa H. Association between obesity and Barrett's esophagus in a Japanese population: a hospital-based, cross-sectional study. BMC Gastroenterol 2013; 13:143. [PMID: 24070185 PMCID: PMC3849380 DOI: 10.1186/1471-230x-13-143] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 09/20/2013] [Indexed: 02/06/2023] Open
Abstract
Background The association between obesity and Barrett’s esophagus (BE) in the Japanese population remains unclear. The prevalence of BE and its associated risk factors was examined. Methods A cross-sectional study of 1581 consecutive individuals who underwent upper gastrointestinal endoscopy was conducted. The prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m2) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Because endoscopic diagnosis of ultra-short ESBE (<1 cm in extent) is difficult and highly unreliable, this type of ESBE was excluded from the study. Results In proton pump inhibitor (PPI) non-users, the prevalence of ESBE ≥ 1 cm was 5.6%. In univariate analysis, male sex and reflux esophagitis (RE) were significantly associated with BE, but BMI, WC, and reflux symptoms were not. In multivariate logistic regression analysis, only RE (odds ratio [OR] = 3.48, 95% confidence interval [CI] 1.89-6.41, p < 0.0001) was an independent risk factor for BE; obesity and the other factors were not. In contrast, RE (OR 5.67, p = 0.0004) and large WC (OR 5.09, p = 0.0005) were significant risk factors for ESBE ≥ 1 cm in PPI users. Only male sex, but not obesity or the other risk factors, was associated with an increased risk of RE in patients not taking PPIs. Conclusions RE, but not obesity, may have an independent association with the risk of ESBE in the Japanese population. Furthermore, obesity measures were not independent risks for RE. Interestingly, PPI-refractory RE and large WC were risk factors for ESBE ≥1 cm in patients taking PPIs.
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Affiliation(s)
- Jiro Watari
- Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya 663-8501, Japan.
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Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol. Heart Vessels 2013; 29:35-41. [PMID: 23516028 DOI: 10.1007/s00380-013-0330-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
Abstract
Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C <100 mg/dl. Patients were stratified into two groups according to HDL-C levels (low HDL-C group, baseline HDL-C <40 mg/dl; high HDL-C group, ≥40 mg/dl). Major adverse cardiac events (MACE) that included all-cause death, acute coronary syndrome, and target lesion revascularization were evaluated between the two groups. The median follow-up period was 946 days. The rate of MACE was significantly higher in diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.
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Angiotensin II receptor blockers improve endothelial dysfunction associated with sympathetic hyperactivity in metabolic syndrome. J Hypertens 2012; 30:1646-55. [DOI: 10.1097/hjh.0b013e328355860e] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Abnormality of risk factors for atherosclerotic disease among young Japanese aged 19-39 years old: an evaluation of health checkup data. Environ Health Prev Med 2012; 18:165-70. [PMID: 22760262 DOI: 10.1007/s12199-012-0289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Accepted: 06/03/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Japanese public health policies on the prevention of atherosclerotic diseases have focused on controlling obesity. The aim of this study was to assess the prevalence of abnormality in risk factors for atherosclerotic disease among young Japanese classified according to body mass index (BMI). METHODS Data were obtained from 359 men (mean age 32 ± 5 years) and 1,108 women (mean age 33 ± 4 years) between 2005 and 2010. Abnormal levels of aspartate aminotransferase, alanine aminotransferase, and/or gamma-glutamyltranspeptidase were considered to indicate liver dysfunction, and abnormal levels of low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and/or triglycerides were considered to indicate dyslipidemia. The cutoff points for high blood pressure (HBP) and hyperglycemia were set as a reference in the high-normal range. RESULTS No significant difference was observed in both sexes in all items among each year. In men, HBP (12.9 %), liver dysfunction (33.9 %), dyslipidemia (29.9 %), and hyperglycemia (2.7 %) were observed in the normal BMI group (18.5 < BMI ≤ 25 kg/m(2)). In women, these abnormalities were observed in both the normal BMI group and lean group. CONCLUSIONS Asymptomatic abnormalities, particularly liver dysfunction and dyslipidemia, were observed in a substantial percentage of subjects without obesity. Therefore, we recommend that the comprehensive public health policy should be directed at all individuals, including the non-obese group, for the early prevention/detection against atherosclerotic diseases.
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Very short bouts of non-exercise physical activity associated with metabolic syndrome under free-living conditions in Japanese female adults. Eur J Appl Physiol 2012; 112:3525-32. [PMID: 22311069 DOI: 10.1007/s00421-012-2342-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 01/28/2012] [Indexed: 10/14/2022]
Abstract
To assess the association between very short daily non-exercise physical activity (PA) lasting <5 min and metabolic syndrome (MS). A total of 42 females (50 ± 6 years) wore a pedometer with a one-axial accelerometer (Lifecorder, Kenz, Japan) to determine the time and the frequency of PA and the moderate to vigorous intensity PA (MVPA). In addition to the PA and the MVPA (PA(all) and MVPA(all)), the PA and MVPA were analyzed based on the bout duration, such as >32 s, >1 min, >3 min, and >5 min (PA(32S), PA(1M), PA(3M), PA(5M); MVPA(32S), MVPA(1M), MVPA(3M), MVPA(5M)). MS was defined according to the Japanese standard based on waist circumfluence, blood lipids, blood glucose, and blood pressure. The frequency of the MVPA(1M) was significantly lower in subjects with MS compared with that in subjects without MS (P < 0.05). The frequency of MVPA(32S) and MVPA(1M) was significantly associated with the HDL cholesterol (P < 0.05). The frequency of PA(3M) and PA(5M) was significantly associated with the fasting glucose level (P < 0.05). In contrast, we could not find any significant relationships between MS and the components of MS and the frequency of PA lasting <32 s. These results demonstrated that very short non-exercise PA, such as MVPA lasting >32 s to 3 min, has significantly associated with the components of MS. The specific advantages with regard to PA lasting <32 s remain unclear.
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Hamada R, Muto S, Otsuka N, Sato E, Zhang Y. Prevalence of preexisting metabolic syndrome as defined by Japanese original criteria among patients with non-fatal myocardial infarction. Intern Med 2011; 50:2749-57. [PMID: 22082886 DOI: 10.2169/internalmedicine.50.5976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We aimed to clarify the prevalence of preexisting Metabolic Syndrome (MetS) defined by the Japanese original criteria among patients with non-fatal myocardial infarction (MI). METHODS This is a retrospective cohort study using the computer database obtained by the preliminary health checkup from April 2003 to December 2008. We extracted the subjects with newly developed non-fatal MI from the study population. The newly non-fatal MI was diagnosed by the history of coronary heart disease (CHD) and new appearance of abnormal Q wave on electrocardiograms. MetS was diagnosed by using the Japanese original criteria. If waist circumference was not available, BMI was used alternatively. We evaluated the prevalence of preexisting MetS and other risk factors of CHD among the subjects. We compared the prevalence of preexisting risk factors between MetS group and non-MetS group. RESULTS From a study population of 298,455 subjects, 446 subjects with a history of CHD were found. Among the 446, 92 subjects (85 men and 7 women) with abnormal Q wave on electrocardiogram were found. The prevalence of preexisting MetS with non-fatal MI was 19.6% (95% CI; 15.5-23.7%). The prevalence of other preexisting risk factors were 60.0% with smoking history, 55.6% with over-work, 53.3% with stressful life and 36.1% with impaired glucose tolerance. These prevalence rates were not significantly different between MetS group and non-MetS group. Only the prevalence (22.3%) of elevated LDL-cholesterol in the non-MetS group was significantly higher than in the MetS group (14.4%). CONCLUSION Preexisting MetS may be able to predict only 20% of future MI. To prevent future myocardial infarction, precaution guidance may be required for people with not only preexisting MetS but also other preexisting risk factors of CHD.
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Affiliation(s)
- Riichiro Hamada
- Seirei Center for Health Promotion and Preventive Medicine, Seirei Social Welfare Community, Japan.
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Nakamura K, Nanri H, Hara M, Higaki Y, Imaizumi T, Taguchi N, Sakamoto T, Horita M, Shinchi K, Tanaka K. Optimal cutoff values of waist circumference and the discriminatory performance of other anthropometric indices to detect the clustering of cardiovascular risk factors for metabolic syndrome in Japanese men and women. Environ Health Prev Med 2010; 16:52-60. [PMID: 21432217 DOI: 10.1007/s12199-010-0165-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 07/06/2010] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To evaluate the pertinent cutoffs of waist circumference (WC) and the discriminatory performance of other anthropometric indices to detect clustering cardiovascular risk factors for metabolic syndrome (MetS) in Japan, where the current WC cutoffs for MetS (85 cm for men and 90 cm for women) remain controversial. METHODS We analyzed the baseline data from 844 subjects (330 men and 514 women) aged 40-69 years who participated in a cohort study in Saga city, Japan, between November 2005 and December 2007. Receiver operating characteristic (ROC) analyses were performed to find an appropriate cutoff (defined as the point nearest to the upper left corner of the ROC curve) of each anthropometric index for the presence of multiple risk factors among dyslipidemia, hypertension, and hyperglycemia [which was defined as hemoglobin A1c (HbA1c) levels at and above 5.2, 5.5, or 5.8%, values approximately corresponding to fasting plasma glucose levels of 100, 110, and 120 mg/dL, respectively]. RESULTS The optimal WC cutoff was 88 cm (sensitivity 60%, specificity 70%) for men and 82 cm (sensitivity 78%, specificity 62%) for women; changing the HbA1c cutoff affected the results in women only (~85 cm). For the currently defined WC cutoffs in Japan, specificity was low (53-57%) in men, whereas sensitivity was very low (32-42%) in women. Body mass index, proportion of body fat, waist-to-height ratio, and waist-to-hip ratio showed area under the curve values similar to that of WC. CONCLUSION The current Japanese criteria of WC for MetS may be low for men and too high and insensitive for women in our study population. Other anthropometric indices such as waist-to-height ratio did not confer an improved discriminatory performance compared with WC.
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Affiliation(s)
- Kazuyo Nakamura
- Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
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Nakagomi A, Sasaki M, Ishikawa Y, Morikawa M, Shibui T, Kusama Y, Atarashi H, Mizuno K. Upregulation of Monocyte Tissue Factor Activity Is Significantly Associated With Low-Grade Chronic Inflammation and Insulin Resistance in Patients With Metabolic Syndrome. Circ J 2010; 74:572-7. [DOI: 10.1253/circj.cj-09-0835] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Akihiro Nakagomi
- Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School
| | - Mihoko Sasaki
- Department of Pharmaceutical, Tokyo University of Pharmacy and Life Science
| | - Youhei Ishikawa
- Department of Pharmaceutical, Tokyo University of Pharmacy and Life Science
| | - Masako Morikawa
- Department of Pharmaceutical, Tokyo University of Pharmacy and Life Science
| | - Toshiyuki Shibui
- Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School
| | - Yoshiki Kusama
- Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School
| | - Hirotsugu Atarashi
- Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School
| | - Kyoichi Mizuno
- Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Nippon Medical School
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Sakamoto A, Ishizaka Y, Toda EI, Nagai R, Koike K, Yamakado M, Ishizaka N. Impact of Changes in Obesity Parameters on Glucose Metabolism and Insulin Resistance Over a One-Year Period. J Atheroscler Thromb 2010; 17:1246-55. [DOI: 10.5551/jat.5959] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Sakurai M, Takamura T, Miura K, Kaneko S, Nakagawa H. Middle-aged Japanese women are resistant to obesity-related metabolic abnormalities. Metabolism 2009; 58:456-9. [PMID: 19303964 DOI: 10.1016/j.metabol.2008.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 11/04/2008] [Indexed: 11/26/2022]
Abstract
We attempted to determine sex differences in obesity-related metabolic abnormalities in a relatively large middle-aged Japanese population. The study population consisted of 2935 men and 1622 women who were 35 to 59 years old. Metabolic abnormalities were determined using the Japanese criteria for metabolic syndrome, and we evaluated the number of metabolic abnormalities discriminated by waist circumference. In men, the mean number of metabolic abnormalities increased as the waist circumference increased. In women, although the mean number of metabolic abnormalities increased as the waist circumference increased, the mean number was less than 1 even in those with a waist circumference of at least 95 cm. According to the receiver operating characteristic curve, the cutoff levels yielding the maximal sensitivity plus specificity for predicting the prevalence of one or more obesity-related metabolic abnormalities were 80 cm in men and 73 cm in women. However, the positive predictive value was as low as 28.8% in men and 7.1% in women, which may not be suitable for a screening test, especially in women. Middle-aged Japanese women seem to be resistant to obesity-induced metabolic abnormalities, and waist circumference would not effectively predict the existence of metabolic syndrome. In setting the cutoff points in guidelines, a greater emphasis should be placed on the absolute risk of having abnormalities or diseases.
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Affiliation(s)
- Masaru Sakurai
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8641, Japan
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Circulating malondialdehyde-modified low-density lipoprotein is strongly associated with very small low-density lipoprotein cholesterol concentrations in healthy men. Clin Chim Acta 2009; 399:74-8. [DOI: 10.1016/j.cca.2008.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Revised: 09/14/2008] [Accepted: 09/15/2008] [Indexed: 11/20/2022]
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Oda E, Kawai R. Tentative Cut Point of High-Sensitivity C-Reactive Protein for a Component of Metabolic Syndrome in Japanese. Circ J 2009; 73:755-9. [DOI: 10.1253/circj.cj-08-0848] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Eiji Oda
- Medical Check-up Center, Tachikawa Medical Center
| | - Ryu Kawai
- Medical Check-up Center, Tachikawa Medical Center
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Oda E, Kawai R, Sukumaran V, Watanabe K. LDL cholesterol is more strongly associated with metabolic syndrome in Japanese women than in men. Intern Med 2009; 48:1607-14. [PMID: 19755762 DOI: 10.2169/internalmedicine.48.2398] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE LDL cholesterol is not usually considered as a component of metabolic syndrome (MetS) but rather it is associated with MetS components. METHODS Data from 2,449 men and 1,448 women were examined using receiver operating characteristic (ROC) curve for diagnosing MetS and correlation coefficients. RESULTS Blood levels of LDL cholesterol increased more steeply in women than in men as the number of MetS components increased. The area under ROC curve (AUC) and its 95% confidence interval (CI) of LDL cholesterol for diagnosing MetS were 0.57 and 0.53-0.60 in men and 0.66 and 0.61-0.71 in women. The optimal cut-off point (sensitivity; specificity) of LDL cholesterol was 127 mg/dL (0.50; 0.60) in men and 125 mg/dL (0.64; 0.61) in women. Correlations between LDL cholesterol and systolic blood pressure, diastolic blood pressure, gamma glutamyltransferase, and hemoglobin A1c were stronger in women than in men even after adjustment for age. The correlation between LDL cholesterol and blood pressure was significant in women, but not in men, even after adjusting for age. CONCLUSION LDL cholesterol was more strongly associated with MetS in Japanese women than in men. The correlation between LDL cholesterol and blood pressure was significant in women, but not in men.
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Affiliation(s)
- Eiji Oda
- Medical Check-up Center, Tachikawa Medical Center, Nagaoka, Japan.
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The metabolic syndrome in Japan. ACTA ACUST UNITED AC 2008; 5 Suppl 1:S15-8. [PMID: 18580861 DOI: 10.1038/ncpcardio0808] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2006] [Accepted: 01/04/2007] [Indexed: 12/17/2022]
Abstract
Since its conception, the metabolic syndrome has received worldwide recognition as a useful clinical aid for predicting cardiovascular risk. The earliest definition, which included risk factors such as insulin resistance, hyperglycemia, hypertension, and cholesterol, has undergone many transformations. Two revisions have focused on visceral adiposity as an essential component of the syndrome, particularly in Asian populations. The Japanese national guidelines have also suggested that abnormalities in adipose tissue metabolism are an underlying molecular cause of the syndrome. In addition, emerging evidence suggests that lowering the threshold of waist circumference in Asian populations increases the prevalence of the metabolic syndrome. Inevitably, this widening of the threshold will capture more patients at risk of cardiovascular events. The aim of this Article is to consider the country-specific impact of the metabolic syndrome, using the evolution of the definition in Japan as a model.
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Sakurai M, Takamura T, Miura K, Kaneko S, Nakagawa H. BMI may be better than waist circumference for defining metabolic syndrome in Japanese women. Diabetes Care 2008; 31:e12. [PMID: 18308675 DOI: 10.2337/dc07-0309] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Masaru Sakurai
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Toshinari Takamura
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Katsuyuki Miura
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Shuichi Kaneko
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
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Niwa Y, Ishikawa S, Gotoh T, Kayaba K, Nakamura Y, Kajii E. Metabolic syndrome mortality in a population-based cohort study: Jichi Medical School (JMS) Cohort Study. J Epidemiol 2008; 17:203-9. [PMID: 18094519 PMCID: PMC7058464 DOI: 10.2188/jea.17.203] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Metabolic syndrome is known to increase morbidity and mortality of cardiovascular disease. The National Cholesterol Education Program Adult Treatment Expert Panel III in 2001 (revised in 2005) and the Japanese definition of metabolic syndrome were launched in 2005. No study regarding the association between metabolic syndrome by Japanese definition and mortality has been performed. The aim of this study was to clarify the prevalence of metabolic syndrome and its effects to mortality in a population-based cohort study. METHODS A total of 2176 subjects who satisfied the necessary criteria for metabolic syndrome were examined between 1992 and 1995 as a part of Jichi Medical School Cohort Study by Japanese definition. Cox's proportional hazard models were used to analyze the association of metabolic syndrome with mortality. RESULTS The prevalence of metabolic syndrome was 9.0% in males and 1.7% in females. There were 17 deaths (14 males), including 6 cardiovascular deaths (5 males), during a 12.5-year follow-up period among metabolic syndrome subjects. After adjusting for age, smoking status, and alcohol drinking status, the hazard ratio (95% confidence interval) for all-cause mortality was 1.13 (0.64-1.98) in males and 1.31 (0.41-4.18) in females, and HR for cardiovascular mortality was 1.84 (0.68-4.96) in males, and 1.31 (0.17-9.96) in females. CONCLUSION No statistical significant relationship between metabolic syndrome by Japanese definition and all-cause mortality was observed in a population-based cohort study.
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Affiliation(s)
- Yasunori Niwa
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
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Kasai T, Miyauchi K, Kubota N, Tamura H, Kojima T, Yokoyama K, Kurata T, Daida H. The relationship between the metabolic syndrome defined by various criteria and the extent of coronary artery disease. Atherosclerosis 2007; 197:944-50. [PMID: 18096168 DOI: 10.1016/j.atherosclerosis.2007.08.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Revised: 08/16/2007] [Accepted: 08/22/2007] [Indexed: 01/10/2023]
Abstract
The association between the severity of coronary artery disease (CAD) and metabolic syndrome (MS) as defined by recently proposed criteria remains unknown. Therefore, we investigated the association between the severity of CAD and MS based on four sets of criteria. The frequency of MS and the severity of CAD determined using the Gensini score (GS) were assessed in 656 consecutive patients who underwent elective coronary angiography for the first time. Using the various criteria, 25.4% of males and 25.6% of females fulfilled the NCEP-ATPIII criteria, 46.6% of males and 21.3% of females fulfilled the International Diabetes Federation (IDF) criteria, 44.0% of males and 41.9% of females fulfilled the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria, and 42.5% of males and 18.8% of females fulfilled the Japanese definition. On multivariate analysis, MS defined according to the AHA/NHLBI criteria was related to an increased risk of extensive CAD in males [odds ratio (OR) 1.89, p=0.001]. MS defined according to the IDF criteria was associated with the highest risk for extensive CAD in females (OR 2.83, p=0.019). In conclusion, MS was found to be associated with the extent of CAD. However, gender-specific differences and MS definition-specific differences exist.
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Affiliation(s)
- Takatoshi Kasai
- Department of Cardiology, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Japan
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Oda E, Abe M, Veeraveedu PT, Watanabe K. Considerable disagreement among definitions of metabolic syndrome for Japanese. Circ J 2007; 71:1239-43. [PMID: 17652888 DOI: 10.1253/circj.71.1239] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The purpose of the present study is to examine the agreement of various existing definitions of metabolic syndrome for Japanese. METHODS AND RESULTS One hundred thirty-two apparently healthy men and 147 apparently healthy women underwent testing and diagnosis for metabolic syndrome using 5 different definitions of metabolic syndrome for Japanese, including a newly proposed definition: a modified National Cholesterol Education Program definition replacing abdominal obesity with C-reactive protein. The agreement of these various definitions of metabolic syndrome was studied using an agreement index defined as the number of subjects who met both definitions divided by the number of subjects who met either of the 2 definitions. Agreement indices among these various definitions of metabolic syndrome for Japanese were between 0.19 and 0.6 in men and between 0.31 and 0.89 in women. The average agreement index was 0.41 in men and 0.51 in women, and the overall agreement index was 0.15 in men and 0.21 in women. CONCLUSIONS There was considerable disagreement among various definitions of metabolic syndrome for Japanese. Therefore, diagnosis with this syndrome should not be made until a truly consensual definition of metabolic syndrome can be established.
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Affiliation(s)
- Eiji Oda
- Department of Internal Medicine, Niigata Prefectural Yoshida Hospital, Tsubame, and Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Japan.
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Song Y, Miyaki K, Araki J, Zhang L, Omae K, Muramatsu M. The interaction between the interleukin 6 receptor gene genotype and dietary energy intake on abdominal obesity in Japanese men. Metabolism 2007; 56:925-30. [PMID: 17570254 DOI: 10.1016/j.metabol.2007.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2006] [Accepted: 02/08/2007] [Indexed: 01/22/2023]
Abstract
Previous reports have shown that the Asp358Ala (T/G) polymorphism of the interleukin 6 receptor (IL6R) gene is associated with obesity and type 2 diabetes mellitus, but few studies have examined this association in the Japanese population. We performed the current study to investigate the relationship between the IL6R Asp358Ala (T/G) polymorphism and obesity in healthy Japanese men. Two hundred eighty-five healthy Japanese men (age, 46.1 +/- 11.5 years [mean +/- SD]; waist circumference [WC], 83.9 +/- 9.3 cm; body mass index, 23.3 +/- 3.3 kg/m(2)) employed by a Japanese company were enrolled in this study. Height, weight, and WC were measured, and daily energy intake levels were assessed by self-reported questionnaires. Genotyping of polymorphisms was performed by using melting curve analysis; no association was found between IL6R genotype and WC or body mass index. However, when the subjects were stratified by IL6R genotype, an association between WC and dietary energy intake level was found in the TT + GT-type subjects (P for linear regression = .048), but not in GG subjects (P for linear regression = .555). In addition, logistic regression analysis revealed that the interaction of IL6R (GG vs TT + GT) genotypes and dietary energy intake levels affected risk for abdominal obesity (P for interaction = .030). We concluded that the IL6R Asp358Ala (T/G) polymorphism appears to interact with energy intake and affect abdominal obesity in Japanese men. The interaction of this genotype and energy intake warrants further study.
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Affiliation(s)
- Yixuan Song
- Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, Chiyoda-ku, Tokyo 101-0062, Japan
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Abstract
BACKGROUND Bariatric surgery is the only treatment that can provide effective long-term weight loss for morbid obesity. However, animal models of bariatric surgery have not yet been well established. The aims of this study were to establish an obese rat model of gastric banding and to determine whether the model would replicate the procedure of human gastric banding in terms of weight loss and metabolic parameters. METHODS 27 male Zucker fatty rats were divided into 3 groups: the sham-operated control, gastric banding, and diet treatment groups. They were followed for 8 weeks after surgery, and their body weight change, cumulative food intake and metabolic parameters were examined. RESULTS For the sham-operated control, gastric banding, and diet treatment groups, the mean body weights were 644 +/- 28 g, 511 +/- 77 g, and 339 +/- 15 g; % change of weight at 8 weeks after operaion were +63.7 +/- 8.3%, +33.2 +/- 20%, -12.0 +/- 2.0%, respectively. Absolute weekly food intake amounts were 233.8 +/- 38.1 g, 157.3 +/- 64 g, 80 g, and cumulative food intakes were 1862 +/- 111 g, 1258 +/- 375 g and 640 g, respectively. The gastric banding rats showed significant decreases in weight gain, % change of weight, absolute weekly food intake, and cumulative food intake compared to sham-operated control rats (P < 0.05). The banding group also had lower levels of all metabolic parameters compared with controls (P < 0.01), and these levels were equal to those of the diet-treated group. CONCLUSION The present study provides a new animal model of gastric banding using obese rats. This model may be useful in research on the biochemical and molecular mechanisms of morbid obesity.
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Affiliation(s)
- Yuichi Endo
- Department of Surgery I, Oita University Faculty of Medicine, Oita, Japan.
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Oda E. Minimum waist and visceral fat values for identifying Japanese Americans at risk for the metabolic syndrome: response to Hayashi et al. Diabetes Care 2007; 30:e40; author reply e41. [PMID: 17468368 DOI: 10.2337/dc07-0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Kasai T, Miyauchi K, Kurata T, Ohta H, Okazaki S, Miyazaki T, Kajimoto K, Kubota N, Daida H. Prognostic value of the metabolic syndrome for long-term outcomes in patients undergoing percutaneous coronary intervention. Circ J 2007; 70:1531-7. [PMID: 17127794 DOI: 10.1253/circj.70.1531] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The prevalence of metabolic syndrome (MS), regarded as an important risk factor for coronary artery disease, is growing. However, the relationship between MS and long-term outcomes after percutaneous coronary intervention (PCI) in the Japanese patient population remains unknown. METHODS AND RESULTS Seven-hundred and forty-eight consecutive patients who underwent PCI were assessed. Patients were categorized by the presence or absence of MS using the NCEP-ATPIII definition (for obesity, a body mass index >or=25 kg/m(2) was used). Kaplan-Meier estimation and Cox proportional hazards model were used for unadjusted and adjusted analyses for all cause mortality and cardiac events. The progress of 318 (42.5%) patients with MS and 430 (57.5%) patients without MS was analyzed. The mean follow-up was 12.0+/-3.6 years. Overall, there were 88 (11.8%) deaths from all causes, and there were no significant differences between the 2 groups. The occurrence of cardiac events was significantly higher in the MS group than that in the no MS group (25.5% vs 15.6%, hazard ratio 2.23; 95% confidence interval 1.59-3.11; p<0.001). CONCLUSIONS The presence of MS significantly increased the risks of subsequent cardiac events among patients who underwent PCI.
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Affiliation(s)
- Takatoshi Kasai
- Department of Cardiology, Juntendo University, School of Medicine, Tokyo, Japan
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Baba R, Koketsu M, Nagashima M, Inasaka H, Yoshinaga M, Yokota M. Adolescent Obesity Adversely Affects Blood Pressure and Resting Heart Rate. Circ J 2007; 71:722-6. [PMID: 17456998 DOI: 10.1253/circj.71.722] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Obesity is associated with hypertension (HT) and high resting heart rate (HR), as well as metabolic disturbances. However, little is known about how strongly these hemodynamic abnormalities are associated with the degree of obesity in adolescents. METHODS AND RESULTS Height, body weight, resting HR, and systolic and diastolic blood pressures were measured in 20,165 male and 19,683 female high-school students. Adiposity levels were classified into 6 groups by body mass index: group 1 (<20th percentile), group 2 (20th-39.9th percentile), group 3 (40th-59.9th percentile), group 4 (60th-79.9th percentile), group 5 (80th-98.9th percentile), and group 6 (> or =99th percentile). Systolic and diastolic hypertensions were defined as > or =140 mmHg and > or =85 mmHg, respectively. Resting tachycardia was defined as the corresponding 95th percentile or greater. Resting HR and systolic and diastolic blood pressures increased with adiposity level in both sexes (p<0.0001). Both systolic HT and diastolic HT were associated with high resting HR, and the clustering of these unfavorable conditions increased with the degree of obesity. CONCLUSION Hemodynamic abnormalities, such as HT and a high resting HR, are closely associated with adolescent obesity and are probably explained by impaired autonomic nerve function.
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Affiliation(s)
- Reizo Baba
- Committee for Cardiovascular Screening, Department of School Health, Aichi Medical Association, Nagoya, Japan.
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Kobayashi J, Nishimura K, Matoba M, Maekawa N, Mabuchi H. Generation and Gender Differences in the Components Contributing to the Diagnosis of the Metabolic Syndrome According to the Japanese Criteria. Circ J 2007; 71:1734-7. [DOI: 10.1253/circj.71.1734] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Junji Kobayashi
- Department of Lipidology, Kanazawa University Graduate School of Medical Science
| | - Kouji Nishimura
- Center for Clinical Laboratory, Ishikawa Medical Association
| | | | | | - Hiroshi Mabuchi
- Department of Lipidology, Kanazawa University Graduate School of Medical Science
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Kato M, Dote K, Sasaki S, Ueda K, Matsuda O, Nakano Y, Naganuma T, Sugiura T. Coronary Plaque Vulnerability in Metabolic Syndrome Assessment of Carotid Artery Morphology in Acute Coronary Syndrome. Circ J 2007; 71:1229-33. [PMID: 17652886 DOI: 10.1253/circj.71.1229] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of the present study was to investigate the clinical implication of metabolic syndrome and carotid artery morphologies on coronary plaque vulnerability in Japanese men with acute coronary syndrome (ACS). METHODS AND RESULTS Consecutive ACS Japanese men (n=225) underwent emergent coronary angiography and B-mode ultrasonography within 1 week of the acute coronary event. With a 11.3-MHz linear array transducer, the morphologies of common carotid artery were examined. Common carotid arteries with an intima-media thickness>1.1 mm and interadventitial diameter>8.0 mm were considered to be undergoing carotid artery remodeling. Patients were divided into 2 groups based on the number of complex plaques identified by coronary angiography. Abdominal obesity, low level of high-density lipoprotein and carotid artery remodeling were more often observed in patients with multiple, complex coronary plaques than in patients with a single, complex plaque (p<0.03, p<0.03 and p=0.0001, respectively). Metabolic syndrome and carotid artery remodeling were independent predictors of multiple, complex coronary plaques (odds ratio 1.86, p<0.05; odds ratio 5.96, p<0.0001). CONCLUSION Metabolic syndrome and carotid artery remodeling might be useful indicators to assess the efficacy of aggressive treatments for secondary prevention of cardiovascular events in ACS Japanese men.
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Affiliation(s)
- Masaya Kato
- Department of Cardiology, Hiroshima City Asa Hospital, Japan.
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Ishikawa S, Kayaba K, Gotoh T, Nakamura Y, Kajii E. Metabolic Syndrome and C-Reactive Protein in the General Population JMS Cohort Study. Circ J 2007; 71:26-31. [PMID: 17186974 DOI: 10.1253/circj.71.26] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In recent years some studies have shown that metabolic syndrome (MS) is associated with inflammation, indicated by high-sensitivity C-reactive protein (hsCRP), but there have been few population-based studies, especially in Japan. METHODS AND RESULTS The study subjects were 2,191 men and women examined between 1992 and 1995 with the necessary data to ascertain MS as part of the Jichi Medical School Cohort Study. CRP was measured by nephelometry. There were 109 subjects defined as having MS (5.0%), and the proportion of MS cases was higher in men (9.4%) than in women (1.8%). Geometric mean and median CRP in the MS group was higher than that in the non-MS (geometric mean; p<0.001, median: 0.312 mg/L in MS and 0.122 mg/L). Proportion of MS increased with CRP, after the subjects were divided by tertile of CRP (odds ratio, 95% confidence interval 1st tertile as a reference; 2nd tertile: 2.9, 1.5-5.9, 3rd tertile: 5.7, 3.1-11.1). CONCLUSION Inflammation, measured by the concentration of hsCRP, was elevated in cases of MS in the general Japanese population. Longitudinal data should be examined in the future.
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Affiliation(s)
- Shizukiyo Ishikawa
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
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