Diabetes and Cardiovascular Disease in a Prospective Population Survey in Japan: The Hisayama Study

Fujishima, Masatoshi; Kiyohara, Yutaka; Kato, Ikunoshin; Ohmura, Takao; Iwamoto, Hisao; Nakayama, Katsuhiro; Ohmori, Susumu; Yoshitake, Taketo

doi:10.2337/diab.45.3.s14

Cited by 231 publications

(164 citation statements)

References 4 publications

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“…28 The rate of severe obesity (body mass index greater than 35 kg/m 2 ) in patients of North America and Europe is higher than Japanese patients, and Kouchoukos et al 29 reported 18.6% (274 of 1566) severe obesity in CABG patients at Washington University in the United States, whereas severe obesity was only 0.4% (4 of 1131) in our study. Diabetic patients in Japan are rather thin, and this racial difference may influence the prognosis of ischemic heart disease in diabetic patients.…”

Section: Endo Et Al Bilateral Imas For Diabetes 1347contrasting

confidence: 45%

Bilateral Versus Unilateral Internal Mammary Revascularization in Patients With Diabetes

2003

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Background-This historical cohort study evaluated the benefit of bilateral internal mammary artery (BIMA) grafts in coronary bypass grafting (CABG) for patients with diabetes. Methods and Results-We performed elective, isolated, primary, multiple CABG using skeletonized internal mammary artery (IMA) grafts for multivessel disease in 1131 patients, 467 (41.3%) of whom had type 2 diabetes mellitus. The early and long-term results were compared between 277 patients with diabetes using single IMA (SIMA) grafts and 190 using BIMA grafts (median follow-up, 8.1 years). Hospital mortality was similar in both groups. Early patency rate of all grafts was significantly higher using BIMA than using SIMA (97.7% versus 93.8%, Pϭ0.0012). Survival rates were not significantly different between SIMA and BIMA groups. Late cardiac mortality was significantly higher in patients with low ejection fraction (0.4 or lower) compared with preserved ejection fraction (higher than 0.4) (Pϭ0.0001). In patients with preserved ejection fraction, 10-year survival rate was significantly higher using BIMA than using SIMA (87.8Ϯ3.5% versus 75.2Ϯ3.4%, Pϭ0.04), and 10-year all death-free or repeat CABG or recurrent myocardial infarction-free rate was significantly higher using BIMA than using SIMA (86.6Ϯ3.6% versus 69.0Ϯ3.7%, Pϭ0.0086).The hazard ratio for all death or repeated CABG or recurrent myocardial infarction in patients with preserved ejection fraction was markedly lower in the BIMA group (0.53; 95% CI, 0.31 to 0.9; Pϭ0.019). Conclusions-Skeletonized

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Section: Endo Et Al Bilateral Imas For Diabetes 1347contrasting

confidence: 45%

Bilateral Versus Unilateral Internal Mammary Revascularization in Patients With Diabetes

2003

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“…Various studies have shown the harmful effect of arterial hypertension, dysplipidemia, and diabetes mellitus on the circulatory system; these same diseases have insulin resistance in common and comprise the metabolic syndrome 41 . Other cohort studies on Asian populations have indicated that pre-diabetic individuals have an increased risk of both all-cause and cardiovascular mortality 42,43,44 .…”

Section: Discussionmentioning

confidence: 99%

All-cause mortality among Japanese-Brazilians according to nutritional characteristics

2007

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The aim of this study was to verify the association between nutritional variables and mortality in a Japanese-Brazilian cohort. In 1993, 647 subjects were interviewed with food frequency questionnaires and scheduled for physical procedures (weight, height, blood pressure) and biochemical tests (oral glucose tolerance test). Student's t test was used to compare the mean values of target variables between living and deceased subjects. Mortality rate and hazard ratios were obtained (crude and adjusted) according to the nutritional variables. Overall mortality rates were 21.4 and 11.7/1,000 person-years for males and females, respectively. Smoking, diabetes, sedentary lifestyle, hypertension, higher mean age, high blood pressure, high blood glucose, and higher percent weight gain and rate of weight gain were observed in the history of deceased subjects. After adjusting for control variables, an increase was observed in mortality among individuals with lower carbohydrate and cholesterol intake. The results suggest that mortality risk factors like age, chronic diseases, sedentary lifestyle, smoking, and inadequate diet must also be acting in the Japanese-Brazilian population.

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“…Thus, the question of whether a casual blood glucose (CBG) level, whose value can be obtained at any time of the day regardless of time since last meal, can predict CHD or CVD mortality is of great interest. Only one prospective study has reported this relationship between CBG and CHD [6], though some prospective studies have reported the relationship between CHD and fasting blood glucose or OGTT [7][8][9]. We investigated the relationship of CBG with CHD, CVD and all-cause mortality in a 17.3-year follow-up study with a representative sample from the Japanese population.…”

Section: Introductionmentioning

confidence: 99%

Relationship of elevated casual blood glucose level with coronary heart disease, cardiovascular disease and all-cause mortality in a representative sample of the Japanese population. NIPPON DATA80

et al. 2008

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Aims/hypothesis High fasting blood glucose is one of the well-known risk factors for CHD. However, in certain settings, patients cannot always be expected to fast. For example, community screenings for cardiovascular disease (CVD) risk factors in Japan are performed under non-fasting conditions to achieve high participation rates. Thus, we examined a representative cohort of the Japanese population (n=9,444, follow-up period 17.3 years) to clarify whether high casual blood glucose (CBG) can predict CVD mortality. Methods We defined CBG groups as follows: high CBG≥ 11.1 mmol/l or participants with a history of diabetes mellitus; borderline high, 7.77≤CBG<11.1 mmol/l; higher normal, 5.22≤CBG<7.77 mmol/l); and lower normal, CBG<5.22 mmol/l. The multivariate-adjusted hazard ratios (HRs) for CHD, CVD and all-cause mortality were calculated. Results The crude CHD mortality rate was 0.84 per 1,000 person-years. Age-and sex-adjusted HRs for CHD mortality were high among participants with CBG levels ≥7.77 mmol/l, regardless of time since last meal. Multivariate-adjusted HRs (95% CI) of CHD mortality in high and borderline high CBG groups were 2.62 (1.46-4.67) and 2.43 (1.29-4.58), respectively. Similar results were observed for both CVD Diabetologia (2008) and all-cause mortality. Even within the normal blood glucose range, each 1 mmol/l increase in CBG was associated with a statistically significant increase in the HR for CVD mortality (1.12, 95% CI 1.02-1.22). Population-attributable fractions of the combined groups of high and borderline high CBG for CHD, CVD and all-cause mortality were 12.0, 4.9 and 3.5%, respectively. Conclusions/interpretation Increases in CBG, even within the normal range, predict CVD mortality.51:575-582 DOI 10.1007/s00125-007-0915-6 Electronic supplementary

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Diabetes and Cardiovascular Disease in a Prospective Population Survey in Japan: The Hisayama Study

Cited by 231 publications

References 4 publications

Bilateral Versus Unilateral Internal Mammary Revascularization in Patients With Diabetes

Bilateral Versus Unilateral Internal Mammary Revascularization in Patients With Diabetes

All-cause mortality among Japanese-Brazilians according to nutritional characteristics

Relationship of elevated casual blood glucose level with coronary heart disease, cardiovascular disease and all-cause mortality in a representative sample of the Japanese population. NIPPON DATA80

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