Search

OBJECTIVE--To examine whether the patterns of insulin concentration during the oral glucose tolerance test (OGTT) predict type 2 diabetes. RESEARCH DESIGN AND METHODS--We followed 400 nondiabetic Japanese Americans for 10-11 [...]

OBJECTIVE--It has been reported that moderate alcohol consumption decreased the risk of type 2 diabetes but that elevated liver enzymes increased it. The comparative importance of alcohol consumption and liver [...]

OBJECTIVE--Visceral adiposity is generally considered to play a key role in the metabolic syndrome. We sought to determine whether greater visceral adiposity directly measured by computed tomography (CT) is associated with increased future insulin resistance independent of other adipose depots. RESEARCH DESIGN AND METHODS--We followed 306 nondiabetic Japanese Americans over 10-11 years. Baseline variables included BMI; waist circumference; and abdominal, thoracic, and thigh fat areas measured by CT. Total fat area was estimated by the sum of all of these fat areas. Visceral adiposity was measured as intra-abdominal fat area at the umbilicus level. Total subcutaneous fat area was defined as total fat area minus intra-abdominal fat area. Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR), fasting plasma insulin level, Matsuda index, and area under the oral glucose tolerance test curve (AUC) of insulin. RESULTS--Both baseline intra-abdominal fat area (P = 0.002) and HOMA-IR (P < 0.001) were independently associated with increased HOMA-IR at 10-11 years in a multiple linear regression model after adjustment for abdominal subcutaneous fat area, age, sex, 2-h plasma glucose level, and incremental insulin response. Intra-abdominal fat area remained a significant predictor of increased HOMA-IR at 10-11 years even after adjustment for total subcutaneous fat area, total fat area, BMI, or waist circumference, but no other measure of CT-measured regional or total adiposity was significantly related with HOMA-IR at 10-11 years in models that contained intra-abdominal fat area. Similar results were obtained for predicting future fasting plasma insulin level, Matsuda index, and AUC of insulin. CONCLUSIONS--Greater visceral adiposity is associated with an increase in future insulin resistance. Diabetes 57:1269-1275, 2008, Although the pathogenesis of the metabolic syndrome and each of its components is complex and not fully understood, both insulin resistance and central adipose tissue appear to be important. Moreover, [...]

OBJECTIVE--Japanese American is an ethnic group with a high risk for type 2 diabetes, which is linked to the metabolic syndrome. Central adiposity is considered to play a key role [...]

Background: Visceral adiposity is generally considered to play a key role in the metabolic syndrome. Objective: To examine the relationship between directly measured visceral adiposity and the risk for incident hypertension, independent of other adipose depots and fasting plasma insulin levels. Design: Community-based prospective cohort study with 10-to 11-year follow-up. Setting: King County, Washington. Participants: 300 Japanese Americans with a systolic blood pressure less than 140 mm Hg and a diastolic blood pressure less than 90 mm Hg who were not taking antihypertensive medications, oral hypoglycemic medications, or insulin at study entry. Measurements: Abdominal, thoracic, and thigh fat areas were measured by using computed tomography. Total subcutaneous fat area was calculated as the sum of these fat areas excluding the intra-abdominal fat area. Hypertension during follow-up was defined as having a systolic blood pressure of 140 mm Hg or greater, having a diastolic blood pressure of 90 mm Hg or greater, or taking antihypertensive medications. Results: There were 92 incident cases of hypertension during the follow-up period. The intra-abdominal fat area was associated with an increased risk for hypertension. Multiple-adjusted odds ratios of hypertension for quartiles of intra-abdominal fat area (1 = lowest; 4 = highest) were 5.07 (95% Cl, 1.75 to 14.73) for quartile 3 and 3.48 (Cl, 1.01 to 11.99) for quartile 4 compared with quartile 1 after adjustment for age, sex, fasting plasma insulin level, 2-hour plasma glucose level, body mass index, systolic blood pressure, alcohol consumption, smoking status, and energy expenditure through exercise (P = 0.003 for quadratic trend). The intra-abdominal fat area remained a significant risk factor for hypertension, even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, or waist circumference; however, no measure of these fat areas was associated with risk for hypertension in models that contained the intra-abdominal fat area. Limitations: It is not known whether these results pertain to other ethnic groups. Conclusions: Greater visceral adiposity increases the risk for hypertension in Japanese Americans.

OBJECTIVE -- Greater visceral adiposity, higher insulin resistance, and impaired insulin secretion increase the risk of type 2 diabetes. Whether visceral adiposity increases risk of impaired glucose tolerance (IGT) independent [...]

OBJECTIVE--To investigate the relationship between daily alcohol consumption and the risk of type 2 diabetes in a large Japanese cohort. RESEARCH DESIGN AND METHODS--We enrolled 6,362 Japanese men aged 35-61 [...]

OBJECTIVE--We prospectively assessed whether the combined measurements of fasting plasma glucose (FPG) and AIC were effective for predicting type 2 diabetes. RESEARCH DESIGN AND METHODS--Study participants included 6,736 nondiabetic Japanese [...]

OBJECTIVE--Because skeletal muscle is one of the target tissues for insulin, skeletal muscle mass might be associated with type 2 diabetes. Serum creatinine is a possible surrogate marker of skeletal [...]

Previous epidemiological studies have shown that vigorous physical activity reduces the development of type 2 diabetes (1-3). A recommendation from the Centers for Disease Control and Prevention reported that individuals [...]

The Osaka Health Survey OBJECTIVE -- To investigate the relationship between high normal blood pressure or hypertension and the risk of developing type 2 diabetes in a large Japanese cohort. [...]

Recently moderate alcohol consumption among healthy people is reported to be associated with increased insulin sensitivity and a decreased plasma level of fasting insulin. Previous epidemiological findings on the association [...]

We examined prospectively which of the four blood pressure (BP) components (systolic BP [SBP], diastolic BP [DBP], pulse pressure [PP], and mean arterial pressure [MAP]) was best in predicting the risk of proteinuria.

To examine cross‐sectionally whether intraabdominal fat area (IAFA), i.e., visceral fat, and liver fat assessed by computed tomography (CT) are independently associated with hyperuricemia. Subjects were 801 Japanese men not taking antidiabetic, antihypertensive, or urate‐lowering medications, without any history of renal disease, cardiovascular disease, or cancer, and with serum creatinine <1.5 mg/dl. Abdominal, thoracic, and thigh fat areas were measured by CT. Total fat area (TFA) was the sum of these fat areas. Total subcutaneous fat area (TSFA) was TFA minus IAFA. Liver fat was assessed by liver‐to‐spleen (L/S) ratio measured by CT. Hyperuricemia was defined as serum uric acid level >7.0 mg/dl. Its association with adiposity was tested using logistic regression. The prevalence of hyperuricemia was 19.6% (157 men). Both greater IAFA and lower L/S ratio were independently associated with hyperuricemia in models that simultaneously included IAFA and L/S ratio: multiple‐adjusted odds ratios of hyperuricemia for quintiles 3, 4, and 5 of IAFA were 2.16 (95% confidence interval [95% CI] 1.02–4.59), 2.41 (95% CI 1.13–5.16), and 4.00 (95% CI 1.81–8.85), respectively, compared to quintile 1, and the L/S ratios for quintiles 3, 2, and 1 were 2.34 (95% CI 1.16–4.75), 2.15 (95% CI 1.06–4.34), and 2.79 (95% CI 1.35–5.76), respectively, compared to quintile 5. Both IAFA and L/S ratio remained significant even after adjusting for abdominal subcutaneous fat area, TFA, TSFA, body mass index, or waist circumference. Of all fat measurements, IAFA had the strongest association with hyperuricemia by Akaike's information criteria. Greater amounts of both visceral fat and liver fat were independently associated with hyperuricemia.

Context:Atherogenic dyslipidemia is frequently observed in persons with a greater amount of visceral adipose tissue (VAT). However, it is still uncertain whether VAT is independently associated with the future development of atherogenic dyslipidemia.Objectives:The aim of this study was to determine whether baseline and changes in VAT and subcutaneous adipose tissue (SAT) are associated with future development of atherogenic dyslipidemia independent of baseline lipid levels and standard anthropometric indices.Design and Setting:Community-based prospective cohort study with 5 years of follow-up.Participants:A total of 452 Japanese Americans (240 men, 212 women), aged 34–75 years were assessed at baseline and after 5 years of follow-up.Main Outcome Measures:Abdominal fat areas were measured by computed tomography. Atherogenic dyslipidemia was defined as one or more abnormalities in high-density lipoprotein (HDL) cholesterol, triglycerides, or non-HDL cholesterol levels.Results:Baseline VAT and change in VAT over 5 years were independently associated with log-transformed HDL cholesterol, log-transformed triglyceride, and non-HDL cholesterol after 5 years (standardized β = −0.126, 0.277, and 0.066 for baseline VAT, respectively, and −0.095, 0.223, and 0.090 for change in VAT, respectively). However, baseline and change in SAT were not associated with any future atherogenic lipid level. In multivariate logistic regression analysis, incremental change in VAT (odds ratio [95% confidence interval], 1.73 [1.20–2.48]; P= .003), triglycerides (4.01 [1.72–9.33]; P= .001), HDL cholesterol (0.32 [0.18–0.58]; P< .001), and non-HDL cholesterol (7.58 [4.43–12.95]; P< .001) were significantly associated with the future development of atherogenic dyslipidemia independent of age, sex, diastolic blood pressure, homeostasis model assessment insulin resistance, body mass index (BMI), change in BMI, SAT, and baseline atherogenic lipid levels.Conclusion:Baseline and change in VAT were independent predictors for future development of atherogenic dyslipidemia. However, BMI, waist circumference, and SAT were not associated with future development of atherogenic dyslipidemia.

Risk of bile duct cancer among printing workers exposed to 1,2‐dichloropropane and/or dichloromethane: Tomotaka Sobue, et al. Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University We conducted a retrospective cohort study to examine the risk of bile duct cancer among current and former workers in the offset color proof printing department at a printing company in Osaka, Japan. Standardized incidence ratios (SIRs) between January 1, 1985, and December 31, 2012, were estimated for the cumulative years of exposure to two chemicals, dichloromethane (DCM) and 1,2‐dichloropropane (1,2‐DCP), using the national incidence level as a reference. In addition, we examined risk patterns by the calendar year in which observation started. Among 106 workers with a total of 1,452.4 person‐years of exposure, 17 bile duct cancer cases were observed, resulting in an estimated overall SIR of 1,132.5 (95% confidence interval (CI): 659.7−1,813.2). The SIR was 1,319.9 (95% CI: 658.9−2,361.7) for those who were exposed to both DCM and 1,2‐DCP, and it was 1,002.8 (95% CI: 368.0−2,182.8) for those exposed to 1,2‐DCP only. SIRs tended to increase according to years of exposure to 1,2‐DCP but not DCM when a 5year lag time was assumed. The SIRs were higher for the cohorts in which observation started in 1993−2000, particularly in cohorts in which it started in 1996−1999, compared with those in which it started before or after 1993−2000. We observed an extraordinarily high risk of bile duct cancer among the offset color proof printing workers. Elevated risk may be related to cumulative exposure to 1,2‐DCP, but there remains some possibility that a portion of the risk is due to other unidentified substances.

Unlike the n-6 polyunsaturated fatty acid (PUFA) arachidonic acid (AA), n-3-PUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) appear to have beneficial effects on inflammation, thrombosis, and cardiovascular disease (CVD). We examined possible alterations in serum PUFA profiles in patients on maintenance hemodialysis therapy and its association with CVD risk.

Aims/Introduction: Reduced insulin sensitivity and secretion are important in the pathogenesis of type 2 diabetes. Their relationships to prediabetes, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) have been previously studied with the oral glucose tolerance test (OGTT). We investigated whether or not baseline measures of insulin secretion and sensitivity obtained from fasting blood specimens were related to the development of prediabetes and how these measures compared with those based on the OGTT.

Objective— The reflection waveform in the ascending aortic pressure has been reported to reflect systemic arterial stiffness, and increase the risk of coronary heart disease.The purpose of this study is to evaluate prospectively whether the reflection waveform in the ascending aortic pressure is associated with the risk of major adverse cardiac events (MACE) after successful coronary stenting in acute myocardial infarction (AMI).Methods and results— One hundred and twenty-five patients with AMI and undergoing successful coronary stenting were enrolled in this study.We measured the inflection time to determine the reflection waveform in the ascending aortic pressure at angioplasty. Inflection time was defined as the time interval from initiation of a systolic pressure waveform to the inflection point. During a period of 2945 person-months, we confirmed 42 cases of MACE. Shorter inflection time increased incident MACE. Kaplan-Meier analysis demonstrated a significantly reduced event-free rate in patients with inflection time ≤ 86 ms (MACE; p < 0.01, cardiovascular death; p < 0.001 by log-rank test).The multiple-adjusted hazard ratio for a 1 standard deviation (SD) magnitude decrease in inflection time was 1.46 (95% confidence interval, 1.03 to 2.05) for MACE, and 5.76 (95% confidence interval, 1.78 to 18.67) for cardiovascular death.Conclusions— Shorter inflection time increased the risk of MACE after successful coronary stenting in patients with AMI.

To investigate the relationship between blood pressure at 4 min after exercise using a Master's two-step and the risk for hypertension.

The purpose of this study was to evaluate whether the pulsatility of brachial artery pressure is related to an increased risk of coronary artery disease (CAD). On the basis of vascular mechanics, we recently reported that relative pulse pressure can predict the occurrence of restenosis after percutaneous transluminal coronary angioplasty. We also hypothesized that relative pulse pressure of the brachial arterial pressure waveform is associated with an increased risk of CAD.

OBJECTIVES

To investigate the association of serum uric acid level with the risk for hypertension and Type 2 diabetes.

No useful predictor of risk of acute heart failure in peripheral-blood stem-cell transplantation (PBSCT) regimens, including high-dose cyclophosphamide, has previously been available. Corrected QT dispersion can predict acute heart failure after high-dose cyclophosphamide chemotherapy used in PBSCT.

Background: Although it was reported that pulse pressure of the peripheral artery could differentiate patients with coronary heart disease (CHD) from those without CHD, it is not known whether pulsatility of the ascending aortic pressure waveform differentiates patients with CHD from those without CHD. The purpose of this study was to evaluate whether the pulsatility of ascending aortic pressure is associated with an increased risk of CHD. Methods: For this study, we enrolled 293 subjects who had chest pain, normal contractions, no local asynergy, and no history of myocardial infarction. We measured the ascending aortic pressure using a fluid-filled system. To quantify the relative magnitude of the pulsatile to mean artery pressure, we normalized the pulse pressure to the mean pressure and referred to this value as the fractional pulse pressure (PPf). We investigated the association between the PPf and the risk of CHD. Results: The PPf of the ascending aorta was associated with an increased risk of CHD. The multiple-adjusted odds ratio of CHD was 2.93 (95% CI, 1.44 to 5.94) for the middle tertile of the PPf level and was 3.93 (95% CI, 1.74 to 8.85) for the highest tertile compared with the lowest tertile. Conclusion: Ascending aortic pulsatility is related to an increased risk of CHD.