Metabolic Syndrome In Japanese Research Articles

The associations of eating behavior and dietary intake with metabolic syndrome in Japanese: Saku cohort baseline study

BackgroundThe prevention of metabolic syndrome (MetS) is a major public health concern in Japan. The effects of the relationship between eating behavior and nutritional intake on MetS remained unclear.To evaluate nutrition’s role in preventing or exacerbating MetS, we examined the associations among eating behavior, nutritional intake, and MetS for the baseline study in the cohort subjects undergone health checkups.MethodsFour thousand and four hundred forty-seven Japanese men and women were enrolled at the Saku Central Hospital. They received an anthropometric and clinical examination and were assessed for present illness, lifestyle factors such as physical activity, smoking, drinking, and dietary habits at the enrollment. Eating behavior was analyzed by the Sakata’s Eating Behavior Questionnaire. Dietary assessment was made using a brief self-administered diet history questionnaire. Two thousand and six hundred two men and 1844 women aged more than 20 were analyzed.ResultsThe mean age in men and women were 59.2 and 58.4 years old and the mean body mass index (BMI) were 23.7 and 22.3 kg/m2, respectively. The percentages of MetS were 20.6 in men and 6.1 in women. In some nutrients, significantly higher energy-adjusted intakes in subjects without MetS than with Mets appeared both in men and women after age adjustment. After adjusting by age, energy-adjusted intake beverages in men and cereals in women were significantly higher in subjects with MetS than those without MetS. The scores of all the categories in eating behavior were significantly worse in subjects with MetS than those without MetS.ConclusionsThe differences in dietary intake between subjects with Mets and without Mets were relatively small. The scores of all the categories in eating behavior were worse in subjects with MetS than without MetS. It was suggested that the problem lay in the quality of diet, not in the quantity, caused by bad eating habits. The potential influence of eating behavior and nutritional intake on MetS was presented in men and women.

Visceral Fat Area Cutoff for the Detection of Multiple Risk Factors of Metabolic Syndrome in Japanese: The Hitachi Health Study.

Visceral Fat Area Cutoff for the Detection of Multiple Risk Factors of Metabolic Syndrome in Japanese: The Hitachi Health Study.

Identification of rs7350481 at chromosome 11q23.3 as a novel susceptibility locus for metabolic syndrome in Japanese individuals by an exome-wide association study.

We have performed exome-wide association studies to identify genetic variants that influence body mass index or confer susceptibility to obesity or metabolic syndrome in Japanese. The exome-wide association study for body mass index included 12,890 subjects, and those for obesity and metabolic syndrome included 12,968 subjects (3954 individuals with obesity, 9014 controls) and 6817 subjects (3998 individuals with MetS, 2819 controls), respectively. Exome-wide association studies were performed with Illumina HumanExome-12 DNA Analysis BeadChip or Infinium Exome-24 BeadChip arrays. The relation of genotypes of single nucleotide polymorphisms to body mass index was examined by linear regression analysis, and that of allele frequencies of single nucleotide polymorphisms to obesity or metabolic syndrome was evaluated with Fisher's exact test. The exome-wide association studies identified six, 11, and 40 single nucleotide polymorphisms as being significantly associated with body mass index, obesity (P <1.21 × 10−6), or metabolic syndrome (P <1.20 × 10−6), respectively. Subsequent multivariable logistic regression analysis with adjustment for age and sex revealed that three and five single nucleotide polymorphisms were related (P < 0.05) to obesity or metabolic syndrome, respectively, with one of these latter polymorphisms—rs7350481 (C/T) at chromosome 11q23.3—also being significantly (P < 3.13 × 10−4) associated with metabolic syndrome. The polymorphism rs7350481 may thus be a novel susceptibility locus for metabolic syndrome in Japanese. In addition, single nucleotide polymorphisms in three genes (CROT, TSC1, RIN3) and at four loci (ANKK1, ZNF804B, CSRNP3, 17p11.2) were implicated as candidate determinants of obesity and metabolic syndrome, respectively.

HDL2-cholesterol/HDL3-cholesterol ratio was associated with insulin resistance, high-molecular-weight adiponectin, and components for metabolic syndrome in Japanese

AimsRecent data have suggested a relationship between the high-density lipoprotein (HDL) subclass ratio and metabolic syndrome (MetS). However, limited information is available regarding the relationships between the HDL subclass ratio and insulin resistance, associated adipocytokine levels, and MetS components. The associations of the high-density lipoprotein 2 cholesterol (HDL2-C) to high-density lipoprotein 3 cholesterol (HDL3-C) ratio with the homeostasis model assessment of insulin resistance (HOMA-IR) index, high-molecular-weight adiponectin (HMW-Ad) levels, and MetS components were examined. MethodsThe study included 1155 Japanese subjects who met our inclusion criteria and underwent an annual health examination that included an HDL subclass analysis. ResultsThe HDL2-C/HDL3-C ratio and the HMW-Ad level gradually decreased as the number of MetS components increased. In contrast, HOMA-IR gradually increased as the number of MetS components increased. The HDL2-C/HDL3-C ratio correlated inversely with HOMA-IR and positively with the HMW-Ad level. A strong positive correlation was observed between the HDL2-C/HDL3-C ratio and the HDL-C level. The HDL2-C/HDL3-C ratio exhibited moderate negative correlations with the body mass index, waist circumference, and triglyceride level. Weak negative correlations were observed for the HDL2-C/HDL3-C ratio with the systolic and diastolic blood pressure and fasting plasma glucose levels. ConclusionsOur data indicated that the HDL2-C/HDL3-C ratio was associated with insulin resistance, the HMW-Ad level, and MetS components, and it was useful for evaluating MetS in Japanese individuals.

Dietary patterns and metabolic syndrome in a Japanese working population

BackgroundMetabolic syndrome has become a major public health concern, but the role of diet in the etiology of this syndrome is not well understood. This study investigated the association between major dietary patterns and prevalence of metabolic syndrome in a Japanese working population.MethodsThis cross-sectional study was conducted among 460 municipal employees (284 men and 176 women), aged 21–67 years, who participated in a health survey at the time of periodic checkup. Dietary patterns were derived by using the principal component analysis of the consumption of 52 food and beverage items, which were assessed by a validated brief diet history questionnaire. Metabolic syndrome was defined according to the modified NCEP-ATP III criteria. Logistic regression was used to examine the association between dietary patterns and metabolic syndrome with adjustment of potential confounding variables.ResultsThree dietary patterns were identified. Westernized breakfast pattern characterized by high intakes of bread, confectionaries, and milk and yogurt but low intakes of rice and alcoholic beverages was inversely associated with prevalence of metabolic syndrome and high blood pressure (P for trend = 0.02 and 0.049, respectively). Animal food pattern characterized by high intakes of fish and shellfish, meat, processed meat, mayonnaise, and egg was not associated with prevalence of metabolic syndrome, but was positively associated with high blood glucose (P for trend = 0.03). Healthy Japanese dietary pattern characterized by vegetables and fruits, soy products, mushrooms, and green tea was not appreciably associated with prevalence of metabolic syndrome or its components.ConclusionsThe results suggest that westernized breakfast pattern may confer some protection against metabolic syndrome in Japanese. The causality of these associations needs to be confirmed.

Visceral Fat Area Cutoff for the Detection of Multiple Risk Factors of Metabolic Syndrome in Japanese: The Hitachi Health Study

The relationships between metabolic risk factors and abdominal fat distribution determined using computed tomography (CT) are poorly defined in large populations. We investigated the cutoff values of the visceral fat area (VFA) to detect subjects with multiple risk factors of metabolic syndrome (MS) by sex and age groups, and attempted to examine whether sex- and age-specific cutoff values are needed. The subjects of this study were 11,561 Japanese men and women who participated in the Hitachi Health Study, received CT examination, and answered questionnaires on lifestyles between 2004 and 2009. VFA and waist circumference were measured using CT. The VFA cutoff values yielding an 80% sensitivity for the detection of multiple risk factors of MS were typically smaller among men under the age of 40 years (<40 years vs. ≥40 years; 86.4 cm(2) vs. 103.9 cm(2)). The area under the receiver operator characteristic curve of VFA for the detection tended to decrease according to age (P = 0.056 and P = 0.020 for trends in men and women). Age- and sex-specific cutoff values are needed. The sensitivity of the subjects under the age of 40 years is relatively smaller (70.0% for men and 60.0% for women) compare to other age groups when the same cutoff value is used regardless of age (e.g., cutoff value calculated to correspond to 80% sensitivity for subjects of all ages). Therefore, a smaller VFA cutoff point should be used among men under the age of 40 years.

Insulin Resistance and the Development of Cardiovascular Disease in a Japanese Community: the Hisayama Study

Although several surrogate measures of insulin resistance have been proposed, their associations with cardiovascular disease (CVD) have not been evaluated sufficiently. A total of 2,356 community-dwelling Japanese individuals aged 40 to 79 years who underwent a 75 g oral glucose tolerance test were followed up for 14 years. The status of insulin resistance was estimated by using the Matsuda index or homeostasis model assessment of insulin resistance (HOMA-IR). During follow-up, 260 subjects developed CVD. The age- and sex-adjusted hazard ratios of CVD significantly decreased with an increasing Matsuda index and rose with increasing HOMA-IR levels (both p for trend <0.05). After adjustment for age, sex, serum total cholesterol, electrocardiogram abnormalities, proteinuria, smoking habits, alcohol intake, and regular exercise, the risk of CVD was significantly lower in the third to fifth quintiles of the Matsuda index and higher in the fifth quintile of HOMA-IR values compared with the first quintile of the corresponding index (Matsuda index Q3: hazard ratio (HR)= 0.59 [95% confidence interval 0.40-0.87]; Q4: HR= 0.66 [0.45-0.97]; and Q5: HR= 0.67 [0.47-0.97]; HOMA-IR Q5: HR= 1.55 [1.05-2.29]); however, these associations were attenuated after further adjustment for the metabolic syndrome status. In regard to CVD subtypes, the risks for stroke and coronary heart disease significantly decreased with an increasing Matsuda index, while elevated HOMA-IR levels were a significant risk factor for stroke, but not for coronary heart disease. Our findings suggest that insulin resistance significantly increases the risk of incident CVD through metabolic syndrome in Japanese.

Associations Between Muscular Fitness And Metabolic Syndrome In Japanese Women And Men

The metabolic syndrome is a complex interrelated risk factor for cardiovascular disease and type 2 diabetes mellitus. High cardiorespiratory fitness was known to contribute a prevention of metabolic syndrome. However, a little is known regarding the association between muscular fitness and metabolic syndrome in Japanese. PURPOSE: To examine the associations between muscular fitness and metabolic syndrome in Japanese women and men. METHODS: This cross-sectional study included 335 women and 209 men, aged 30-79 years. Metabolic syndrome was determined according to the criteria of International Diabetes Federation (IDF). Muscular fitness was evaluated by muscular fitness score (MFS) which was determined using Z-scores from hand grip strength and sit-ups. Participants were classified by tertile of MFS such as low, middle and high MFS group. We used logistic regression to estimate odds ratios for the incidence of metabolic syndrome in each group. RESULTS: The prevalence of metabolic syndrome was 27.2% in women and 27.3% in men. The odds ratios for incident metabolic syndrome in the low, middle, and upper thirds of MFS groups, after adjusting for age, smoking status, alcohol intake and exercise habit, were 1.0 (referent), 0.90 (95% confidence interval (Cl), 0.50 to 1.62), and 0.49 (95% CI, 0.25 to 0.94) (linear trend P = 0.03) in women; in men, these were 1.0 (referent), 0.49 (95% CI, 0.23 to 1.04), and 0.42 (95% CI, 0.18 to 0.97) (linear trend P = 0.04), respectively. These results were attenuated after adjustment for cardiorespiratory fitness (linear trend P = 0.67 in women, and P=0.96 in men). CONCLUSION: Muscular fitness is inversely associated with the incidence of metabolic syndrome in Japanese women and men.

Relationship between estimated glomerular filtration rate (eGFR) and metabolic syndrome in Japanese.

We investigated the link between renal function as evaluated by estimated glomerular filtration rate (eGFR) and metabolic syndrome in Japanese. A total of 11,711 Japanese subjects, aged 20-79 years, were recruited in a cross-sectional clinical investigation. From this group, we further investigated the data on 1,576 subjects. eGFR was calculated using serum creatinine (Cr), age and sex. The diagnosis of metabolic syndrome was based on the Japanese criteria. In the first analysis, 288 men (7.8%) and 498 women (6.2%) were diagnosed with reduced eGFR (<60ml/min). eGFR was not correlated with anthropometric, body composition parameters in either sex. In the second analysis, in subjects without medications, 132 men (20.8%) and 15 women (1.6%) were diagnosed with metabolic syndrome. eGFR was lower in men with abdominal obesity and in women with hypertension was than in those without. Among Japanese not taking medications, lower eGFR may be a characteristic of men with abdominal obesity and of women with hypertension.

Reproducibility of High-Sensitivity C-Reactive Protein as an Inflammatory Component of Metabolic Syndrome in Japanese

Cutoff points for high-sensitivity C-reactive protein (hs-CRP) as a component of metabolic syndrome (MetS) in Japanese have been proposed as 0.40-0.45 mg/L for men and 0.25-0.35 mg/L for women. However, there are some concerns about the reproducibility of hs-CRP. Reproducibility of hs-CRP as a component of MetS was examined using receiver-operating characteristic (ROC) curves for diagnosing MetS in 1,274 men and 673 women whose serum levels of hs-CRP were measured twice at annual health screening tests. The Spearman's correlation coefficient between baseline hs-CRP and hs-CRP at the next year's test was 0.68 in men and 0.71 in women. The area under the ROC curves of baseline hs-CRP, hs-CRP at the next year's test, and the mean of the 2 hs-CRP tests for diagnosing baseline MetS were 0.71, 0.71, and 0.72, respectively, in men and 0.75, 0.74, and 0.74, respectively, in women. Optimal cutoff points of baseline hs-CRP, hs-CRP at the next year's test, and the mean of 2 tests for diagnosing baseline MetS were all 0.40 mg/L in men and 0.35 mg/L in women. The serum level of hs-CRP was stable enough for use as a measure of the inflammatory component of MetS, and the optimal cutoff point of hs-CRP was 0.40 mg/L for men and 0.35 mg/L for women in a Japanese health-screening population.

Relationship of the Polyunsaturated to Saturated Fatty Acid Ratio to Cardiovascular Risk Factors and Metabolic Syndrome in Japanese: the INTERLIPID Study

There have been few studies on the relationships of the dietary polyunsaturated to saturated fatty acid ratio (P/S) to cardiovascular risk factors and metabolic syndrome. We hypothesized that there would be favorable relationships. Metabolic cardiovascular risk factors from dietary nutrient intake were investigated in 1,004 men and women aged 40-59 years from 4 population samples of Japanese. Multiple linear regression analysis was used to examine the relationship of the dietary P/S ratio to the following risk factors: hemoglobin A1c, blood pressure, serum triglycerides, LDL and total cholesterol, and HDL-cholesterol. Adjusted odds ratio of having metabolic syndrome was also calculated. The dietary P/S ratio was significantly and inversely related to serum total and LDL cholesterol with control for possible confounding variables. We did not find any significant relationship between the P/S ratio and single metabolic risk factors or the prevalence of metabolic syndrome. Managing the P/S ratio is important to control serum LDL-cholesterol; however, increasing the P/S ratio may not improve metabolic risk factors. Other countermeasures, such as weight control, greater physical activity, and smoking cessation should be recommended to prevent and control metabolic syndrome.

Comparison between High-Sensitivity C-Reactive Protein (hs-CRP) and White Blood Cell Count (WBC) as an Inflammatory Component of Metabolic Syndrome in Japanese

To compare two systemic inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC), as a component of metabolic syndrome (MetS). Data of hs-CRP and WBC from 2,185 Japanese men and 1,383 Japanese women were examined using receiver operating characteristic (ROC) curve for diagnosing MetS and Spearman's correlation coefficients. The area under ROC curve (AUC) of hs-CRP was 0.71 in men and 0.74 in women. The AUC of WBC was 0.65 in men and 0.69 in women. The optimal cutoff point (sensitivity; specificity) of hs-CRP was 0.40 mg/L (0.69; 0.65) in men and 0.35 mg/L (0.67; 0.72) in women. The optimal cutoff point (sensitivity; specificity) of WBC was 5,600/L(-6) (0.61; 0.61) in men and 5,000/L(-6) (0.65; 0.63) in women. Correlations between obesity parameters, blood pressure, and liver function tests were stronger with hs-CRP than with WBC. But, no correlation between MetS-related risk factors was stronger with WBC than with hs-CRP. Hs-CRP is superior to WBC as an inflammatory component of MetS in Japanese. However, WBC may be useful when hs-CRP is not available because WBC is routinely measured in clinical practice.

An Optimal Cut Point of Hemoglobin A1c for Diagnosing Metabolic Syndrome in Japanese

An Optimal Cut Point of Hemoglobin A1c for Diagnosing Metabolic Syndrome in Japanese

High Attendance at a Lifestyle Intervention Program Is Important to Reduce Risks Related to Metabolic Syndrome in Middle-Aged Japanese

Evaluating attendance at health education programs is important to obtain a more comprehensive evaluation of the program impact. This study investigated whether attendance at a lifestyle intervention program in a community setting would reduce risks related to metabolic syndrome. Of 545 subjects with risks related to metabolic syndrome, i.e. overweight, hypertension, dyslipidemia or diabetes, participated in this non-randomized control study, 389 subjects aged 40-71 years completed the surveys at baseline and 27 months. Intervention group (39 males and 168 females) was provided 3 individual counseling plus 28 group sessions conducted monthly on average, whereas control group (64 males and 118 females) received only 7 health information newsletters by mail. Intervention group was subcategorized into two groups according to the median attendance (87.1%): 106 subjects with high attendance (93.8 +/- 4.7%) and 101 subjects with low attendance (68.6 +/- 16.0%). Logistic regression analyses adjusted for age and baseline value showed that among males, the proportion with dyslipidemia risk was lower only in high attendance group compared with that in control group at 27 months [Odds ratio (OR): 0.11 (95%CI 0.02 - 0.51)] and among females, the proportion of overweight was lower only in high attendance group [OR: 0.24 (95%CI 0.07 - 0.81)]. In females, the mean total risk score calculated by adding the number of the 4 risks present decreased only in high attendance group (p < 0.001). In conclusion, high attendance at a lifestyle intervention program impacts the reduction of risks related to metabolic syndrome in a Japanese community setting.

Of the Three Classifications of Healthy Lifestyle Habits, Which One is the Most Closely Associated with the Prevention of Metabolic Syndrome in Japanese?

Metabolic syndrome is associated with a high risk of cardiovascular morbidity and mortality. The predominant cause of metabolic syndrome is an unhealthy lifestyle. Healthy habits are represented by Breslow's 7 healthy practices, Morimoto's 8 items and Ikeda's 6 healthy habits. This study was done to determine which set of healthy habits was most likely to result in a reduced risk of developing the metabolic syndrome. From April 1, 2000 through March 31, 2007, 6,765 males and 2,789 females underwent a medical check-up at Jikei University Hospital in Japan. They completed a simple, self-administered lifestyle questionnaire based on the 3 classifications of healthy habits. The responses were divided into 3 groups (poor, moderate and favorable) according to each of the healthy habit criteria. The incidence of metabolic syndrome was defined in participants who were newly diagnosed during the follow-up using Japanese-specific diagnostic criteria. The Kaplan-Meier cumulative 7-year incidence was calculated. Kaplan-Meier curves were compared using the long-rank test adjusted for age. In females, Breslow's, Morimoto's and Ikeda's healthy habits showed significant differences in the incidence between poor and moderate groups, and between poor and favorable groups. In males, a significant difference was observed among the poor, moderate and favorable groups for Ikeda's healthy habits. However, no significant difference was observed for Breslow's healthy practices. Morimoto's items only showed a significant difference between the poor and moderate groups. Among the 3 models tested, Ikeda's healthy habits were the most useful for decreasing the risk of metabolic syndrome in Japanese.

Tentative Cut Point of High-Sensitivity C-Reactive Protein for a Component of Metabolic Syndrome in Japanese

High-sensitivity C-reactive protein (hs-CRP) is an independent risk factor of diabetes and cardiovascular disease, and is proposed as a component of metabolic syndrome (MetS). An optimal cut point of hs-CRP as a component of MetS was previously reported as 0.65 mg/L based on data from a small-sized study. Medical check-up data of 1,062 men and 647 women whose plasma levels of hs-CRP were <10 mg/L were examined using a receiver-operating characteristic (ROC) curve for diagnosing MetS, which was defined by revised NCEP criteria for Japanese. An optimal cut point was defined as the point on a ROC curve nearest to the point where both sensitivity and specificity were 1. The area under the ROC curve of hs-CRP was 0.74 (95% confidence interval (CI) 0.70-0.79) in men and 0.73 (95%CI 0.66-0.79) in women. The optimal cut point of hs-CRP and its sensitivity-specificity were, respectively, 0.45 mg/L and 0.67-0.72 in men and 0.25 mg/L and 0.71-0.62 in women. Among Japanese patients, a tentative cut point of hs-CRP as a component of MetS may be 0.45 mg/L in men and 0.25 mg/L in women. However, standardization of the measurement of hs-CRP is required.

A New Proposal of Waist Circumference for the Diagnostic Criteria of Metabolic Syndrome in Japanese

A New Proposal of Waist Circumference for the Diagnostic Criteria of Metabolic Syndrome in Japanese

メタボリックシンドロームとストレスとの関連―岡山県南部健康づくりセンター利用者での検討―

We compared the status of stress with and without metabolic syndrome in Japanese. We used data for 774 men and 1,136 women who had received annual health checkups at Okayama Southern Institute of Health. Status of stress was evaluated using a stress check provided by the Department of Public Health, Nihon University. Metabolic syndrome is defined by new criteria in Japan. Physical stress was significantly higher in men with metabolic syndrome than in men without it. However, the ability of coping with stress in men with metabolic syndrome was significantly higher than that in men without it. Thus a linkage between metabolic syndrome and the status of stress was characteristic in Japanese men.

Tu-P10:435 The association of leukocyte count, C-reactive protein and metabolic syndrome in Japanese

Tu-P10:435 The association of leukocyte count, C-reactive protein and metabolic syndrome in Japanese

Metabolic syndrome in Japanese men and women with special reference to the anthropometric criteria for the assessment of obesity: Proposal to use the waist-to-height ratio

Backgrounds. Obesity is one of the criteria for defining metabolic syndrome. However, overt obesity in Asians is relatively low despite high prevalence of metabolic risks. Methods. We investigated the effectiveness of various anthropometric indices {body mass index (BMI), waist circumference, waist-to-height ratio (W/Ht)} for the evaluation of coronary risk factors (hypertension, hyperglycemia, hypertriglyceridemia, and low HDL cholesterol) and as one of the criteria for metabolic syndrome (clustering of three or more from one obesity and four coronary risk factors) in Japanese on 6141 men and 2137 women. Results. (1) The areas under the receiver operating characteristic curves for the different anthropometric indices to identify any one and two or more coronary risk factors were highest for W/Ht. (2) The sensitivities for the identification of any one and two or more coronary risk factors were greater for W/Ht ≥0.5 than BMI ≥25, ≥23, and indices of waist circumference (Adult Treatment Panel III and Japan Society for the Study of Obesity). (3) The prevalence of metabolic syndrome varied greatly by different anthropometric indices, and the percentages of obesity risk factors in metabolic syndrome were highest for W/Ht ≥0.5 in both genders (approximate 95%). Conclusions. W/Ht ≥0.5 may be the most effective anthropometric index for screening Japanese people for metabolic syndrome.