Adiponectin is an adipocyte-specific protein that plays a role in obesity, insulin resistant, lipid metabolism, and anti-inflammation. Hypoadiponectinemia may be associated with a higher risk for type 2 diabetes and cardiovascular disease. Some studies suggest that adiponectin levels are modulated by lifestyle factors, but little is known about the associations between lifestyle factors and plasma adiponectin levels in Japanese people. We therefore investigated the associations between lifestyle factors and plasma adiponectin levels in general Japanese men.
The subjects were 202 Japanese male workers who participated in an annual health check. They provided details about anthropometrical data, blood collection, their use of prescribed medication, and the clinical history of their families. They also completed a self-administered questionnaire about their lifestyles.
Subjects with plasma adiponectin levels below 4.0 μg/ml had significantly lower levels of HDL cholesterol and higher levels of BMI, SBP, DBP, total cholesterol, FBG, and platelets than did subjects with higher adiponectin levels. In multiple logistic regression after multiple adjustment, a plasma adiponectin level below 4.0 μg/ml was significantly associated with smoking (odds ratio [OR] = 2.08, 95% confidence interval [CI] = 1.01–4.30), a daily diet rich in deep-yellow vegetables (OR = 0.25, 95% CI= 0.07–0.91), frequent eating out (OR = 2.45, 95% CI = 1.19–5.08), and physical exercise two or more times a week (OR = 0.21, 95% CI = 0.06–0.74).
Our findings show that adiponectin levels in general Japanese men are independently related to smoking, dietary factors, and physical exercise. We think that lifestyle habits might independently modulate adiponectin levels and that adiponectin might be the useful biomarker helping people to avoid developing type 2 diabetes and cardiovascular disease by modifying their lifestyles.
adiponectin; smoking; dietary factor; physical exercise; general Japanese men
The frequency of Japanese subjects over 20 years old with metabolic syndrome is 45.6% in men but just 16.7% in women. The reason why Japanese male subjects are more susceptible to metabolic syndrome than women is unknown. One possibility is the higher frequency of Japanese male subjects (40–70 years old) who had a drinking habit (67%), while that of female subjects was only 25%. In addition, daily fat intake was markedly increased in Japanese subjects (from 9% to 25%), and cholesterol cholelithiasis is one of the most rapidly increasing digestive diseases during the past 50 years. The object of this study is to examine whether a potential sex-related risk factor exists in the manifestation of metabolic syndrome as well as gallstone formation.
Gallbladder dysmotility accerelates gallstone formation and gallbladder contraction depends on cholecystokinin (CCK) and its receptor (CCK-1R). We developed CCK-1R gene knockout (-/-) mice. The effects of the fat- and protein- enriched diet OA-2 on body weight, hyperlipidemia, and frequencies of sludge and gallstone formation were examined, and compared between wild-type and CCK-1R(-/-) male and female mice. The OA-2 diet contains slightly higher protein and fat (7.9 % fat and 27.6 % protein) compared with a standard diet (CRF-1) (5.6 % fat and 22.6 % protein), but their total energies are similar. After weaning, CRF-1 was provided until 3 months of age in all animals. Administration of an OA-2 diet was started when age-matched CCK-1R(-/-) and wild-type male and female mice reached maturity, at 3 months of age. Administration of CRF-1 was continued in the rest of the animals. Mice were sacrificed by guillotine at 6 and 12 months of age and the blood was collected to measure plasma levels of triglyceride and cholesterol. The gallbladder was removed and classified as normal (clear gallbladder), clouded (sludge formation), and/or containing gallstone formations.
As long as CRF-1 was provided, the frequency of sludge and/or gallstone formation in CCK-1R(-/-) male mice was 3 of 8 (35%) and 4 of 9 (45%) in females at 12 months of age, whereas no gallstone formation was observed at 6 months of age. On the other hand, male mice fed OA-2 increased their body weight and plasma lipid concentrations, compared with those fed CRF-1 regardless of genotype. Under the OA-2 diet, sludge and gallstone formation was observed at 6 months of age, not only in CCK-1R(-/-) male mice but also in wild-type male mice. In contrast, parameters in female mice did not differ between the two diets.
Male mice were more susceptible to protein- and fat-enriched diet-induced obesity than female mice, and hyper-nutritional status accelerated sludge and gallstone formation in male mice.
Aim. To assess in adults from Benin changes in cardiometabolic risk (CMR) using both the Framingham risk score (FRS) and metabolic syndrome (MetS) and to examine the effects of diet, and lifestyles, controlling for location and socioeconomic status. Methods. Apparently healthy subjects (n = 541) aged 25–60 years and randomly selected in the largest city, a small town, and rural areas were included in the four-year longitudinal study. Along with CMR factors, socioeconomic, diet and lifestyle data were collected in individual interviews. A food score based on consumption frequency of four “sentinel” food groups (meat and poultry, dairy, eggs, and vegetables) was developed. Lifestyle included physical activity, alcohol and tobacco use. Education and income (proxy) were the socioeconomic variables. Results. Among the subjects with four-year follow-up data (n = 416), 13.5% were at risk at baseline, showing MetS or FRS ≥ 10%. The incidence of MetS and FRS ≥ 10% during follow-up was 8.2% and 5%, respectively. CMR deteriorated in 21% of subjects. Diet and lifestyle mediated location and income effects on CMR evolution. Low food scores and inactivity increased the likelihood of CMR deterioration. Conclusion. Combining MetS and FRS might be appropriate for surveillance purposes in order to better capture CMR and inform preventive measures.
We investigated the relationships of adiponectin/leptin (A/L) ratio with cardiovascular risk factors, insulin resistance index, and metabolic syndrome (MS) in apparently healthy Korean male adults.
Sixty-eight male subjects were enrolled among the participants of an annual health check-up program (mean age, 55.1 years). Percent body fat (%) was measured using a bioelectric impedance analyzer. Serum leptin level was measured via radioimmunoassay, and adiponectin level was measured using an enzyme-linked immunosorbent assay. Homeostasis model assessment (HOMA)-insulin resistance (IR) index was calculated, and the presence of metabolic syndrome was assessed.
Adiponectin, leptin, and A/L ratio showed significant correlations with percent body fat, lipid profile, and HOMA-IR. Mean leptin and HOMA-IR levels were significantly higher, while A/L ratio was significantly lower in subjects with MS. With increasing number of MS components, the mean values of leptin and HOMA-IR increased and the A/L ratio decreased. In multiple regression analysis, HOMA-IR was significantly correlated with triglyceride, fasting glucose, and A/L ratio, while A/L ratio was significantly correlated with body mass index and HOMA-IR. HOMA-IR and A/L ratio were significant predictors for each other after adjustment for other factors.
A/L ratio correlated well with lipid profile, HOMA-IR, and the presence and number of MS components in Korean male subjects.
Adiponectin/leptin ratio; Insulin resistance; Metabolic syndrome
Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients’ electronic records and health information systems have become a source for hackers.
This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts’ points of view.
Results and discussion
Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of “verification and system design, user access management, access control system”, Al Zahra Hospital in two indicators of “access management and network access control” and Amin Hospital in “equipment safety and system design”. In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place.
Information Security; Health Information Systems; fuzzy AHP; TOPSIS
Metabolic 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.
This 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.
Three 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.
The results suggest that westernized breakfast pattern may confer some protection against metabolic syndrome in Japanese. The causality of these associations needs to be confirmed.
Cross-sectional study; Metabolic syndrome; Dietary pattern; Japanese
Metabolic syndrome (MS) is an important current public health problem faced worldwide. To prevent an "epidemic" of this syndrome, it is important to develop an easy single-parameter screening technique (such as waist circumference (WC) determination recommended by the International Diabetes Federation). Previous studies proved that age is a chief factor corresponding to central obesity. We intended to present a new index based on the linear combination of body mass index, and age, which could enhance the area under the receiver operating characteristic curves (AUCs) for assessing the risk of MS.
The labour law of the Association of Labor Standard Law, Taiwan, states that employers and employees are respectively obligated to offer and receive routine health examination periodically. Secondary data analysis and subject's biomarkers among five high-tech factories were used in this study between 2007 and 2008 in northern Taiwan. The subjects included 4712 males and 4196 females. The first principal component score (FPCS) and equal-weighted average (EWA) were determined by statistical analysis.
Most of the metabolic and clinical characteristics were significantly higher in males than in females, except high-density lipoprotein cholesterol level. The older group (>45 years) had significantly lower values for height and high-density lipoprotein cholesterol level than the younger group. The AUCs of FPCS and EWA were significantly larger than those of WC and waist-to-height ratio. The low specificities of EWA and FPCS were compensated for by their substantially high sensitivities. FPCS ≥ 0.914 (15.4%) and EWA ≥ 8.8 (6.3%) were found to be the most prevalent cut off points in males and females, respectively.
The Bureau of Health Promotion, Department of Health, Taiwan, had recommended the use of WC ≥ 90 cm for males and ≥ 80 cm for females as singular criteria for the determination of central obesity instead of multiple parameters. The present investigation suggests that FPCS or EWA is a good predictor of MS among the Taiwanese. However, the use of FPCS is not computationally feasible in practice. Therefore, we suggest that EWA be used in clinical practice as a simple parameter for the identification of those at risk of MS.
To determine the prevalence of metabolic syndrome and related factors in bank employees in the city of Vitoria/ES, Brazil.
This was a cross-sectional study that included 521 working men and women ≥20 years of age. Sociodemographic, lifestyle, anthropometric, biochemical, and hemodynamic characteristics were collected. Metabolic syndrome was diagnosed using the criteria of the National Cholesterol Education Program-ATPIII and the International Diabetes Federation. A logistic regression model was used to calculate the crude and adjusted OR of the variables, and the statistical level of significance was set at 5.0%.
We identified 86 (17.2%) and 113 (22.6%) subjects with metabolic syndrome according to the criteria of the National Cholesterol Education Program-ATPIII and the International Diabetes Federation, respectively. The risk of developing metabolic syndrome was higher in individuals with a high school education (OR 2.6 [CI95%, 1.1-6.1]). In overweight and obese subjects, the risks were also higher (OR 12.6 [CI95%, 4.8-33.2, p = 0.000] and OR 43.7% [CI95%, 16.1-118.9, p = 0.000], respectively).
A large number of bank employees have metabolic syndrome, which can be associated with an increased risk of developing cardiovascular disease. Individuals who had college degrees had a higher prevalence of metabolic syndrome; this finding can be explained by the high rates of overweight and obesity found in subjects with college and graduate school educations.
Metabolic Syndrome; Employees; Obesity; Insulin Resistance
Serotonin mediates vasoconstriction and induces the activation of platelets, which may promote atherosclerosis. The aim of this study was to investigate whether plasma 5-hydroxyindole-3-acetic acid (5-HIAA; a derivative end product of serotonin) concentrations are high in subjects with metabolic syndrome (MetS) and to investigate the relationship between plasma 5-HIAA concentrations and clinical and biochemical metabolic parameters.
RESEARCH DESIGN AND METHODS
Plasma 5-HIAA concentrations were measured in 311 subjects (152 men and 159 women) recruited from the Oike Clinic, which provides regular health check-ups for employees. We evaluated the relationship between plasma 5-HIAA concentrations and clinical and biochemical metabolic parameters, including waist circumference, serum lipid concentrations, fasting plasma glucose, or blood pressure.
Plasma 5-HIAA concentrations were higher in subjects with MetS than in those without, in both men (6.5 ± 4.4 vs. 4.9 ± 1.3 ng/mL, P < 0.005) and women (7.9 ± 6.5 vs. 5.2 ± 1.6 ng/mL, P < 0.005). In men, fasting plasma glucose (r = 0.197, P = 0.0146) was positively correlated, whereas HDL cholesterol (r = −0.217, P = 0.0071) was negatively correlated, with logarithmic (log) (plasma 5-HIAA concentrations). In women, triglycerides (r = 0.252, P = 0.0013) and fasting plasma glucose (r = 0.344, P < 0.0001) were positively correlated, whereas HDL cholesterol (r = −0.328, P < 0.0001) was negatively correlated, with log (5-HIAA concentrations). Furthermore, log (plasma 5-HIAA concentrations) were higher in subjects with more components of MetS.
Plasma 5-HIAA concentrations are high in subjects with MetS, suggesting the potential importance of serotonin in the development of cardiovascular disease in MetS.
To clarify predictive values of C-reactive protein (CRP) and high-molecular-weight (HMW) adiponectin for development of metabolic syndrome.
Research Design and Methods
We conducted a prospective cohort study of Japanese workers who had participated in an annual health checkup in 2007 and 2011. A total of 750 subjects (558 men and 192 women, age 46±8 years) who had not met the criteria of metabolic syndrome and whose CRP and HMW-adiponectin levels had been measured in 2007 were enrolled in this study. Associations between CRP, HMW-adiponectin and development of metabolic syndrome after 4 years were assessed by logistic regression analysis and their predictive values were compared by receiver operating characteristic analysis.
Among 750 subjects, 61 (8.1%) developed metabolic syndrome defined by modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria and 53 (7.1%) developed metabolic syndrome defined by Japan Society for the Study of Obesity (JASSO) in 2011. Although CRP and HMW-adiponectin were both significantly correlated with development of metabolic syndrome, multivariate logistic regression analysis revealed that HMW-adiponectin but not CRP was associated with metabolic syndrome independently of BMI or waist circumference. Adding these biomarkers to BMI or waist circumference did not improve the predictive value for metabolic syndrome.
Our findings indicate that the traditional markers of adiposity such as BMI or waist circumference remain superior markers for predicting metabolic syndrome compared to CRP, HMW-adiponectin, or the combination of both among the Japanese population.
Metabolic syndrome is a cluster of metabolic risk factors including dyslipidemia, impaired glucose tolerance, hypertension and central obesity. BDNF (Brain-derived neurotrophic factor) and leptin have been implied in the energy homeostasis. The purposes of this study were to examine concentrations of leptin, BDNF and biochemical parameters in metabolic-syndrome subjects and healthy controls, and also to search for associations of leptin gene (LEP) G2548A, leptin receptor gene (LEPR) Gln223Arg, and BDNF gene (BDNF) Val66Met polymorphisms with leptin levels, BDNF levels and metabolic syndrome among Thais.
The case-controlled design was performed using 322 Thai volunteers (160 metabolic-syndrome subjects; 162 controls) during the health screening program. Metabolic syndrome was assessed by using the modified National Cholesterol Education Program, Adult Treatment Panel III criteria. The levels of leptin, BDNF, insulin, glucose and lipids were measured in samples. Genotyping of LEP G2548A, LEPR Gln223Arg and BDNF Val66Met was carried out using polymerase chain reaction-restriction fragment length polymorphism technique.
Serum leptin levels were significantly higher in the metabolic-syndrome group than the control group (p < 0.01), but the BDNF difference between them was not significant. Significant associations of LEPR Gln223Arg polymorphism were found with leptin and glucose levels (p < 0.05), after adjusting for potential covariates. This LEPR polymorphism in the metabolic-syndrome group was also significantly more frequent than in the control group (p < 0.05). However, other gene polymorphisms, LEP G2548A and BDNF Val66Met, showed no significant relationship with leptin levels, BDNF levels or metabolic syndrome.
These findings suggest leptin levels are linked with metabolic syndrome. LEPR Gln223Arg polymorphism impacted leptin concentrations, and this gene polymorphism may influence susceptibility to metabolic syndrome among Thais.
Leptin; BDNF; Gene polymorphisms; Metabolic syndrome
Metabolic syndrome has become a major worldwide public health problem. We examined the relationship between coffee consumption and the prevalence of metabolic syndrome among Japanese civil servants.
The study participants were 3284 employees (2335 men and 948 women) aged 20 to 65 years. Using data from their 2008 health checkup records, we analyzed the relationship between coffee consumption and the prevalence of metabolic syndrome. Metabolic syndrome was defined according to the Japanese criteria.
Metabolic syndrome was diagnosed in 374 of the 2335 men (16.0%) and 32 of the 948 women (3.4%). In univariate and multiple logistic regression analyses, the odds ratios (ORs) among men for the presence of metabolic syndrome were 0.79 (95% CI: 0.56–1.03) and 0.61 (0.39–0.95), respectively, among moderate (≥4 cups of coffee per day) coffee drinkers as compared with non-coffee drinkers. Among all components of metabolic syndrome, high blood pressure and high triglyceride level were inversely associated with moderate coffee consumption in men, after adjusting for age, body mass index, smoking status, drinking status, and exercise. However, in women, moderate coffee consumption was not significantly associated with the prevalence of metabolic syndrome or its components.
Moderate coffee consumption was significantly associated with lower prevalence of metabolic syndrome in Japanese male civil servants.
metabolic syndrome; coffee; cross-sectional study; Japan
Prevalence of the metabolic syndrome is now a very serious health problem in Japan and a public preventive strategy is essential to reduce morbidity. A systematic interventional strategy for the metabolic syndrome remains to be established. In order to address this issue, a multi-center study; Japanese Study to Organize Proper lifestyle modification for the metabolic syndrome (J-STOP-MetS), has been established by nine preventive medical centers among Rosai hospital groups. This study comprises a cross-sectional study (J-STOP-MetS 1) and a prospective randomized control study (J-STOP-MetS 2). J-STOP-MetS 1 examines the causes of the metabolic syndrome by means of a questionnaire in a large cohort of patients with the metabolic syndrome and control subjects matched for age and sex. J-STOP-MetS 2 examines the hypothesis that guidance on lifestyle modifications will help at risk patients to reduce abdominal fat and cardiovascular risk factors. The metabolic syndrome patients are randomly assigned either to a single visit to a guidance group or multiple visits every two months. The individualized guidance is provided by the coordination of physician, trained nurse, dietician and exercise trainer. Several parameters are measured before and six months after the first guidance session, including, body weight, waist circumference, blood pressure, several blood markers and arterial stiffness. The J-STOP-MetS is the first large-scale clinical study of the metabolic syndrome in Japan and should provide important evidence for the practical management of the metabolic syndrome.
metabolic syndrome; J-STOP-MetS; hypertension; diabetes; dyslipidemia
Waist circumference (WC) is used as a risk assessment for metabolic syndrome, diabetes, and cardiovascular disease (CVD). WC consists of visceral fat area (VFA), subcutaneous fat area (SFA), muscle, intramuscular fat, viscera, and bone. Each component of the WC may differ between the sexes and generations, even if they have the same WC. However, this has not been measured in an epidemiological study.
Between 2004 to 2009, employees and their spouses working at a Japanese company underwent a health examination after more than 12 hours of fasting. We analyzed the data of 11,570 subjects (9,874 men and 1,696 women), aged from 20 to 76 years, who underwent a computed tomography (CT) examination. VFA, SFA, WC, muscle, intramuscular fat, viscera, and bone were measured using a CT scanner. We conducted stratified analyses by generational age, and calculated the Pearson’s correlation coefficients between the VFA and WC, BMI, and VFA plus SFA. To establish the equations for converting the WC to the corresponding VFA and VFA plus SFA, linear regression analyses were used to obtain the regression coefficients and intercepts.
As the generations increased in age, the VFA tended to increase. However, the differences in the WC values of each generation did not coincide with the VFA values in men (r = -0.275 and 0.979 for men and women, n = 5 generations), but did correlate with the difference in the sum of the VFA plus SFA for both sexes (r = 0.915 and 0.996 for men and women, n = 5 generations). Older generations had lower WC values when they had the same VFA values as the younger generations.
The WC value corresponding to a certain VFA value differed significantly by generational age. Thus, revised optimal cutoff values for the WC may be needed for each generation.
The abundance of gene expression microarray data has led to the development of machine learning algorithms applicable for tackling disease diagnosis, disease prognosis, and treatment selection problems. However, these algorithms often produce classifiers with weaknesses in terms of accuracy, robustness, and interpretability. This paper introduces fuzzy support vector machine which is a learning algorithm based on combination of fuzzy classifiers and kernel machines for microarray classification.
Experimental results on public leukemia, prostate, and colon cancer datasets show that fuzzy support vector machine applied in combination with filter or wrapper feature selection methods develops a robust model with higher accuracy than the conventional microarray classification models such as support vector machine, artificial neural network, decision trees, k nearest neighbors, and diagonal linear discriminant analysis. Furthermore, the interpretable rule-base inferred from fuzzy support vector machine helps extracting biological knowledge from microarray data.
Fuzzy support vector machine as a new classification model with high generalization power, robustness, and good interpretability seems to be a promising tool for gene expression microarray classification.
Evidence is limited on the relation between metabolic syndrome and depressive symptoms. The aim of this cross-sectional study was to investigate the association between metabolic syndrome and depressive symptoms in a Japanese working population.
The study subjects comprised 458 municipal employees (age range 21–67 years) from two municipal offices in Japan. A modified version of the criteria of the National Cholesterol Education Program Adult Treatment Panel III was used to define metabolic syndrome. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES_D) scale.
Depressive symptoms (CES_D ≥ 16) in both the male and female subjects were not significantly associated with metabolic syndrome nor with each component of metabolic syndrome. In men, high fasting glucose was associated with increased prevalence of severe depressive state (CES_D ≥ 23).
Metabolic syndrome may not be associated with depressive status among Japanese employees.
Metabolic syndrome; Depressive symptoms; CES_D; NCEP-ATP III; Hyperglycemia
AIM: To examine whether shift work accelerates metabolic syndrome (MetS) development among early middle-aged males with elevated alanine aminotransferase (e-ALT).
METHODS: A retrospective, observational follow-up study on MetS development at a 5-year interval was conducted using health examination data. Nine hundred and ninety six male employees not fulfilling MetS criteria at screening were enrolled. Age, MetS-components, liver enzymes, serological markers for viral hepatitis, abdominal ultrasound, insulin resistance status, lifestyles, and workplace factors were analyzed.
RESULTS: The prevalence of elevated serum ALT (> 40 U/L, e-ALT) at baseline was 19.1%. There were 381 (38.3%) workers with long-term exposures to day-night rotating shift work (RSW). 14.2% of subjects developed MetS during follow-up. After 5 years, the workers with e-ALT had significantly unfavorable changes in MetS-components, and higher rates of MetS development, vs subjects with normal baseline ALT levels. Workers with both baseline e-ALT and 5-year persistent RSW (pRSW) exposure had the highest rate of MetS development. Also, e-ALT-plus-pRSW workers had a significant increase in MetS-components at follow-up, compared with the other subgroups. After controlling for potential confounders, e-ALT-plus-pRSW workers posed a significant risk for MetS development (odds ratio, 2.7; 95% confidence interval, 1.4-5.3, vs workers without baseline e-ALT nor pRSW).
CONCLUSION: We suggest that all early middle-aged male employees with e-ALT should be evaluated and managed for MetS. Particularly in terms of job arrangements, impacts of long-term RSW on MetS development should be assessed for all male employees having baseline e-ALT.
Alanine aminotransferase; Early middle aged; Male; Metabolic syndrome; Shift work
Background. Insulin resistance (IR) is part of the metabolic syndrome (Mets) that develops after lifestyle changes and obesity. Although the association between Mets and myocardial injury is well known, the effect of IR on myocardial damage remains unclear. Methods and Results. We studied 2200 normal subjects who participated in a community-based health check in the town of Takahata in northern Japan. The presence of IR was assessed by homeostasis model assessment ratio, and the serum level of heart-type fatty acid binding protein (H-FABP) was measured as a maker of silent and ongoing myocardial damage. H-FABP levels were significantly higher in subjects with IR and Mets than in those without metabolic disorder regardless of gender. Multivariate logistic analysis showed that the presence of IR was independently associated with latent myocardial damage (odds ratio: 1.574, 95% confidence interval 1.1–2.3) similar to the presence of Mets. Conclusions. In a screening of healthy subjects, IR and Mets were similarly related to higher H-FABP levels, suggesting that there may be an asymptomatic population in the early stages of metabolic disorder that is exposed to myocardial damage and might be susceptible to silent heart failure.
The metabolic syndrome has received worldwide recognition and is useful clinical aid in early-preventing atherosclerosis. Visceral adiposity is the main component of the metabolic syndrome in Japan, based on ethnic and racial difference in the pattern of adiposity. In the Amagasaki Visceral Fat Study, subjects had undergone annual health check-ups and then received health education by medical personnel. Visceral fat reduction improved hypoadiponectinemia and the number of obesity-related cardiovascular risk factors, and effectively prevented cardiovascular events. The health education that includes voluntary lifestyle modification aimed at reducing visceral fat could be useful in preventing cardiovascular events in the metabolic syndrome.
Visceral fat syndrome; adipocyte dysfunction; health education; Hokenshido; metabolic syndrome
In the last few decades, a large number of studies have produced compelling evidence that patients with schizophrenia are at increased risk for developing several medical conditions and diseases, including obesity, metabolic disturbances, and cardiovascular diseases. Several protocols have been designed with the aim of reducing such risk.
To investigate current physical health status in a population of outpatients with schizophrenia.
A cross-sectional study was conducted in our outpatient clinic, selecting subjects who met DSM-IV diagnosis criteria for schizophrenia. Data were collected regarding clinical characteristics, lifestyle, medication in use, and biometric and laboratory parameters.
A total of 261 patients were included. We found a high prevalence of elevated body mass index (BMI . 25) (70%), dyslipidemia (73.2%), and metabolic syndrome (28.7%). Patients’ ages were associated with worsened lipid profiles, but other variables, such as disorder duration or type of antipsychotic in use, were not associated with any metabolic disturbance. Despite the increased prevalence of these conditions, only a small portion of the sample was under regular medical treatment.
Outpatients with schizophrenia show signs of poor physical health conditions. These findings reinforce the need for an intensive and appropriate approach to assure that these patients receive adequate clinical referral and treatment.
psychosis; obesity; public health; antipsychotic drugs; cardiovascular disorders
The metabolic syndrome consists of a cluster of atherosclerotic risk factors, many of which also have been implicated in the genesis of atrial fibrillation (AF). However, the precise role of the metabolic syndrome in the development of AF is unknown.
Methods and Results
This prospective, community-based, observational cohort study was based on an annual health check-up program in Japan. We studied 28 449 participants without baseline AF. We used 2 different criteria for the metabolic syndrome—the guidelines of the National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III) and those of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI)—to study the risk of development of new-onset AF. The metabolic syndrome was present in 3716 subjects (13%) and 4544 subjects (16%) using the NCEP-ATP III and AHA/NHLBI definitions, respectively. During a mean follow-up of 4.5 years, AF developed in 265 subjects (105 women). Among the metabolic syndrome components, obesity (age- and sex-adjusted hazard ratio [HR], 1.64), elevated blood pressure (HR, 1.69), low high-density lipoprotein cholesterol (HR, 1.52), and impaired insulin tolerance (HR, 1.44 [NCEP-ATP III] and 1.35 [AHA/NHLBI]) showed an increased risk for AF. The association between the metabolic syndrome and AF remained significant in subjects without treated hypertension or diabetes by the NCEP-ATP III definition (HR, 1.78) but not by the AHA/NHLBI definition (HR, 1.28).
The metabolic syndrome was associated with increased risk of AF. The metabolic derangements of the syndrome may be important in the pathogenesis of AF.
arrhythmia; diabetes mellitus; hypercholesterolemia; hypertension; metabolic syndrome X; risk factors; obesity
To elucidate the prevalence rate of metabolic disorders among subjects with asymptomatic colonic diverticulum.
We carried out a cross-sectional analysis of the association between colonic diverticulum and selected metabolic disorders among the male personnel of the Self-Defense Forces who underwent total colonoscopy as part of their retirement check-up (age range, 51–59 years).
The prevalence rate of colonic diverticulum was 10.2% among the population studied. The scores of lifestyle factors including those of cigarette smoking and alcohol consumption were similar between the subjects with colonic diverticulum and those without it. Type 2 diabetes (21.6% vs 14.0%, P=0.047) and hypertension (30.9% vs 19.8%, P=0.011) were more prevalent among the subjects with colonic diverticulum than those without it. The prevalence rates of obesity, dyslipidemia, hyperuricemia, and impaired glucose tolerance were similar between the two groups.
The prevalence rates of type 2 diabetes and hypertension are elevated among the middle-aged male subjects with asymptomatic colonic diverticulum. The results may partly explain the reported association between colonic diverticulum and cardiovascular disease.
colonic diverticulum; cardiovascular risk factor; diabetes
Maintaining a healthy and productive workforce is essential for employers in public and private sectors. Poor nutrition and obesity contribute to chronic diseases and influence health care costs and productivity. Research indicates that eating a healthy diet is associated with lower body mass index and reduced risk for developing chronic disease.
The Arkansas Department of Health implemented the Healthy Employee Lifestyle Program to encourage wellness among state health employees. During the pilot year, participants completed a health risk assessment at baseline and again after 1 year that assessed diet and physical activity, other health risk factors, and readiness to make behavioral changes. Participants were encouraged to eat healthfully, participate in regular exercise, report health behaviors using a Web-based reporting system, accumulate points for healthy behaviors, and redeem points for incentives. Differences in participants' (n = 214) reported dietary behaviors between baseline and follow-up were assessed using χ2 analyses and tests of symmetry.
Consumption of sweets/desserts, fats, protein, grains, processed meats, and dairy did not differ significantly from baseline to follow-up. However, at follow-up more participants reported eating 3 or more fruits and vegetables per day than at baseline and being in the action and maintenance stages of readiness to change for eating 5 or more fruits and vegetables per day and for eating a diet low in fat.
Further study is needed to examine physical activity and other health risk factors to determine whether the program merits a broader dissemination.
Prevention of chronic kidney disease (CKD) is a major public health issue. Although several studies have been performed on the association between alcohol consumption and CKD or renal function, it remains controversial. Numerous genetic polymorphisms have been reported to be associated with CKD and kidney function. Mitochondrial DNA cytosine/adenine (Mt5178 C/A) polymorphism is associated with longevity in Japanese. This polymorphism modifies the effects of alcohol consumption on blood pressure, risk of hypertension, serum triglyceride levels, risk of hyper-LDL cholesterolemia and serum uric acid levels. The objective of this study was to investigate whether Mt5178 C/A polymorphism modifies the effects of alcohol consumption on renal function in male Japanese health check-up examinees.
A total of 394 male subjects aged 29–76 years were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the combined effects of Mt5178 C/A polymorphism and habitual drinking on the risk of mildly decreased estimated glomerular filtration rate (eGFR) (<90 ml/min/1.73 m2) was conducted.
For Mt5178A genotypic men, habitual drinking may increase eGFR (P for trend = 0.003) or reduce the risk of mildly decreased eGFR (P for trend = 0.003). Daily drinkers had a significantly higher eGFR than non-drinkers (P = 0.005). The crude odds ratio for decreased eGFR was significantly lower in daily drinkers than in non-drinkers (odds ratio = 0.092, 95% confidence interval: 0.012-0.727, P = 0.024). On the other hand, for Mt5178C genotypic men, habitual drinking does not appear to affect eGFR.
The present results suggest a joint effect of Mt5178 C/A polymorphism and alcohol consumption on eGFR and the risk of mildly decreased eGFR in male Japanese subjects.
Alcohol; Chronic kidney disease; Estimated glomerular filtration rate; Mitochondrial DNA polymorphism
Metabolic syndrome (MetS) is proposed as a predictor for cardiovascular disease (CVD). It involves the mechanisms of insulin resistance, obesity, inflammation process of atherosclerosis, and their complex relationship in the metabolic network. Therefore, more cardiovascular risk-related biomarkers within this network should be considered as components of MetS in order to improve the prediction of CVD.
Factor analysis was performed in 5311 (4574 males and 737 females) Han Chinese subjects with MetS to extract CVD-related factors with specific clinical significance from 16 biomarkers tested in routine health check-up. Logistic regression model, based on an extreme case-control design with 445 coronary heart disease (CHD) patients and 890 controls, was performed to evaluate the extracted factors used to identify CHD. Then, Cox model, based on a cohort design with 1923 subjects followed up for 5 years, was conducted to validate their predictive effects. Finally, a synthetic predictor (SP) was created by weighting each factor with their risks for CHD to develop a risk matrix to predicting CHD.
Eight factors were obtained from both males and females with a similar pattern. The AUC to classify CHD under the extreme case-control suggested that SP might serve as a useful tool in identifying CHD with 0.994 (95%CI 0.984-0.998) for males and 0.998 (95%CI 0.982-1.000) for females respectively. In the cohort study, the AUC to predict CHD was 0.871 (95%CI 0.851-0.889) for males and 0.899 (95%CI 0.873-0.921) for females, highlighting that SP was a powerful predictor for CHD. The SP-based 5-year CHD risk matrix provided as convenient tool for CHD risk appraisal.
Eight factors were extracted from sixteen biomarkers in subjects with MetS and the SP adds to new insights into studies of prediction of CHD risk using data from routine health check-up.