Epidemiological Evidence of Type 2 Diabetes Mellitus, Metabolic Syndrome, and Cardiovascular Disease in Japan

Saito, Isao

doi:10.1253/circj.cj-11-1519

Cited by 78 publications

(46 citation statements)

References 81 publications

(52 reference statements)

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“…Furthermore, a previous Japanese prospective study showed that overweight subjects with metabolic syndrome did not have elevated CVD mortality compared with non-overweight subjects who had ≥2 other conventional CVD risk factors. 19, 20 Waist circumference had a non-linear association with CVD mortality risk in middle-aged men, with this association being U-shaped. 10 When compared with the fourth quintile, risk was increased at a waist circumference greater than approximately 90 cm, which corresponded to the upper 20% of the entire distribution.…”

Section: Discussionmentioning

confidence: 98%

Prospective Study on Waist Circumference and Risk of All-Cause and Cardiovascular Mortality

Saito

Kokubo

Kiyohara

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ecently, a prospective study in more than 1 million Asian subjects has confirmed that there is a U-shaped association between body mass index (BMI) and the risk of death from cancer, cardiovascular disease (CVD), and other causes. 1 But previous epidemiological studies in Japan suggested that increased BMI was unlikely to influence mortality risk, 2,3 whereas a lower BMI or weight loss markedly raised this risk. 4 In contrast, it has been reported that Japanese overweight or obese subjects have an increased risk for incident coronary heart disease or ischemic stroke. 5, 6 The Hisayama study in Japan documented that increased BMI was associated with an increased risk of stroke in women, but not in men. 7 An enhanced risk for incident CVD and stroke associated with increased waist circumference was also found only in women in the Suita study. 8 Taken together, these findings indicate that overweight or obesity has an impact on incident CVD in Japanese men and women, except for stroke in men.A large European prospective study documented that abdominal obesity, as indexed by waist circumference, had a Jshaped association with mortality risk. 9 That study showed that overweight or obesity, assessed by BMI or waist circumference, was associated closely with increased risk of CVD mortality in Caucasian subjects. Compared with indices of adiposity, a waist circumference signifying central obesity was a stronger marker for predicting CVD mortality than BMI. 10 A recent meta-analysis in Caucasian subjects found increased all-cause and CVD mortality risks for elderly people (65-74 years old) with an increased waist circumference across BMI categories and for underweight elderly people. 11 The association of waist circumference levels with CVD mortality risk, however, remains to be determined in Japanese adults. Therefore, to better Background: The aim of the present study was to clarify the association between waist circumference and all-cause and cardiovascular disease (CVD) mortality risk in relatively lean Japanese subjects.

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Section: Discussionmentioning

confidence: 98%

Prospective Study on Waist Circumference and Risk of All-Cause and Cardiovascular Mortality

Saito

Kokubo

Kiyohara

et al. 2012

Circ J

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“…9, 10 It is well-recognized that gender differences exist in the prevalence and levels of these CV diseases and risk factors. [11][12][13][14][15][16][17][18][19][20][21][22] Despite accumulating data, there is still no evidence on how gender influences the effects of exercise training with body weight (BW) loss on hsCRP levels. A meta-analysis study demonstrated the effects of aerobic exercise on CRP, 23 but did not present separate data for exercise-derived CRP lowering in each gender.…”

Section: Subjectsmentioning

confidence: 99%

Is Gender a Factor in the Reduction of Cardiovascular Risks With Exercise Training?

Morita

Okita

2013

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp for confounding factors, we matched body fat changes and exercise frequency during the intervention period and age, and then analyzed data from both genders. MethodsWe conducted a randomized controlled trial that examined the effects of exercise training on CV risk factors in overweight subjects with other risk factors. 2 Full details of the intervention study design and methods are reported elsewhere. 2, 27 The study was approved by the Institutional Review Board of Sapporo Medical University and was conducted between April, 2003 and October, 2004. Each participant gave informed consent. SubjectsWe examined data from 131 subjects (60 men and 71 women aged 61-79 years) who were exercisers in our previous intervention study. 2,27 Participants in that particular study were aged 40-89 years with a body mass index (BMI) between 24.2 and 34.9 kg/m 2 , with 2 or more of the following CV risk factors: resting systolic BP of 130-179 mmHg, fasting blood glucose level of 110-139 mg/dl or HbA1c (%) >5.8 when non-fasting hysical activity and exercise training reduce the incidence of cardiovascular (CV) diseases by improving almost all risk factors, such as obesity, lack of fitness, and hypertension. 1-8 In addition, aerobic exercise has been shown to lower the level of a potent vascular inflammatory marker, high-sensitivity C-reactive protein (hsCRP), through loss of body fat. 9,10 It is well-recognized that gender differences exist in the prevalence and levels of these CV diseases and risk factors. 11-22Despite accumulating data, there is still no evidence on how gender influences the effects of exercise training with body weight (BW) loss on hsCRP levels. A meta-analysis study demonstrated the effects of aerobic exercise on CRP, 23 but did not present separate data for exercise-derived CRP lowering in each gender. Moreover, there is still no consensus as to gender differences in the efficacy of exercise training in lowering the blood pressure (BP) of individuals with multiple CV risk factors. 24-26To provide more information, we directly compared the effects of a 6-month exercise training intervention on hsCRP, BP and other conventional CV risk factors in older men and women with elevated BP and other CV risk factors. Background: This study compared older men and women with cardiovascular (CV) risk factors in terms of the effects of a 6-month exercise intervention on high-sensitivity C-reactive protein (hsCRP) levels, blood pressure (BP) and other risk factors.

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“…2 Indeed, the prevalence of type 2 diabetes and the population attributable fraction for cardiovascular disease in Japan were estimated to be markedly increased, despite a low body mass index (BMI). 3 Prospective epidemiological studies have reported that reduced heart rate variability (HRV) was associated with an increased risk of diabetes, 4,5 hypertension, 6 and cardiovascular disease. 7,8 HRV is regulated by the combined activity of the sympathetic and parasympathetic nervous systems and is assessed by the beat-to-beat regulation of the heart rate.…”

Section: Introductionmentioning

confidence: 99%

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

Saito

Maruyama

Nishida

et al. 2015

International Journal of Epidemiology

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Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods: Between 2009-2012, the Toon Health Study recruited 1899 individuals aged 30-79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF:HF ratio. Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in nonoverweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41-3.10). Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

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Epidemiological Evidence of Type 2 Diabetes Mellitus, Metabolic Syndrome, and Cardiovascular Disease in Japan

Cited by 78 publications

References 81 publications

Prospective Study on Waist Circumference and Risk of All-Cause and Cardiovascular Mortality

Prospective Study on Waist Circumference and Risk of All-Cause and Cardiovascular Mortality

Is Gender a Factor in the Reduction of Cardiovascular Risks With Exercise Training?

Heart Rate Variability, Insulin Resistance and Insulin Sensitivity in Japanese Adults: The Toon Health Study.

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