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We developed a new Physical Score (PS) consisting of comprehensive physical fitness indicators and elucidated the association between the resultant PS and metabolic diseases, i.e., diabetes, hypertension, dyslipidemia, fatty liver, and metabolic syndrome (MetS), among Japanese. Analyzed were 49,850 persons (30,039 men) aged 30 to 69 y who underwent physical fitness tests. Principal component analysis was performed on the correlation matrix of the physical fitness test results (relative grip strength, single-leg balance with eyes closed, and forward bending) according to sex and age. We defined the PS as the first principal component score. A formula was developed for various age groups comprised of men and women from 30 to 69 years of age from which the PS for each age and sex was calculated. The PS for both men and women was normally distributed with a value of 0 ± 1.15-1.16. Multivariate logistic regression analysis showed that the risk of metabolic diseases increased approximately 1.1-1.6 times per each 1-point reduction in the PS. The association between PS and MetS was particularly strong in that a 1-point reduction in the PS increased the risk of MetS by 1.54 times (95% confidence interval 1.46 to 1.62) in men and by 1.21 times (1.15 to 1.28) in women. The association between a lower PS and disease risk was stronger in younger men for fatty liver and in older men for MetS. Conversely, in women, the association between a lower PS and disease risk was stronger in older women for fatty liver and in younger women for MetS. For diabetes, hypertension, and dyslipidemia, the change in the impact of PS reductions across age groups was small. The PS is a useful and simple non-invasive tool for screening Japanese people for metabolic diseases.

Background: Although the impact of a history of coronary artery disease (CAD), cerebrovascular disease (CVD) or both and diabetes mellites (DM) on cardiovascular disease is essential for cardiovascular risk management in clinical practice, little is known about such an impact. Therefore, we investigated the association of prior CAD, prior CVD, DM and their combinations with the risk of subsequent cardiovascular disease. Methods: This historical cohort study included 342,033 participants aged 18-72 years followed for ≥5 years between 2008-2016. Eight groups were created according to whether they were with or without prior CAD, prior CVD and/or DM. DM was defined by fasting plasma glucose, HbA1c and antidiabetic drug prescription. Prior and subsequent CAD and CVD were identified by claims using ICD-10 codes, medical procedures and questionnaires. Cox regression models evaluated the risk of cardiovascular events. Results: Median follow-up period was 6.4 years. Incidence of composite cardiovascular events due to CAD and/or CVD in CAD-/CVD-, CAD+/CVD-, CAD-/CVD+ and CAD+/CVD+ groups were 1.92, 6.94, 25.14 and 31.98 per 1,000 person-years in non-DM and 8.66, 18.04, 39.98 and 60.72 in DM, respectively. Hazard ratio of cardiovascular events compared to CAD-/CVD-/non-DM were 1.66 (95% CI 1.55-1.78) in CAD-/CVD-/DM and 1.84 (1.56-2.18) in CAD+/CVD-/non-DM. CVD+ increased the risk of cardiovascular events approximately 4- to 7- fold regardless of CAD+ or DM. Conclusions:DM increase the risk of cardiovascular disease as high as a history of CAD, while prior CVD alone increased the risk of future cardiovascular disease without additional effects by DM.