Metabolic Syndrome and the Risk of Ischemic Heart Disease and Stroke Among Japanese Men and Women

Iso, Hiroyasu; Sato, Shinichi; Kitamura, Akihiko; Imano, Hironori; Kiyama, Masahiko; Yamagishi, Kazumasa; Cui, Renzhe; Tanigawa, Takeshi; Satō, Takashi

doi:10.1161/strokeaha.106.469072

Cited by 185 publications

(141 citation statements)

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“…8 Traditionally, the metabolic syndrome involves obesity, 9 leads to a cluster of other cardiovascular risk factors and increases the risk of cardiovascular disease. [10][11][12][13][14][15][16][17] The American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) defined the metabolic syndrome as a constellation of cardiovascular risk factors including obesity, 5 whereas the criteria of the International Diabetes Federation (IDF) 6 were based on the presence of obesity. The metabolic syndrome, by the IDF criteria, is defined as a condition of obese persons with certain cardiovascular risk factors; thus, non-obese persons are not diagnosed with the metabolic syndrome, even if they have any of these cardiovascular risk factors.…”

Section: Introductionmentioning

confidence: 99%

The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study

et al. 2009

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In this study, we aimed to examine the impact of the metabolic syndrome and its components on the risk of cardiovascular disease among a relatively less-obese population. A total of 8249 men and 15 064 women, aged 40-69 years, with no history of ischemic heart disease, stroke and/or cancer completed a risk-factor survey between 1993 and 1995. The metabolic syndrome was defined based on modified criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF). Systematic cardiovascular surveillance was carried out throughout 2003, and 693 events of ischemic heart disease and stroke were identified. We observed significant associations of the metabolic syndrome with the risk of ischemic heart disease and ischemic stroke, but not with hemorrhagic stroke. The multivariable hazard ratio (95% confidence interval) of ischemic heart disease among men for the metabolic syndrome based on the AHA/NHLBI criteria was 2.25 (1.44-3.51) and that of ischemic stroke was 1.88 (1.40-2.52). The respective hazard ratios for the metabolic syndrome based on the IDF criteria were 1.61 (0.99-2.64) for ischemic heart disease and 1.94 (1.41-2.68) for ischemic stroke. The population-attributable fraction (PAF) of the metabolic syndrome based on the AHA/NHLBI criteria was higher than that based on the IDF criteria: 19 vs. 12% (P for difference¼0.003) for ischemic cardiovascular disease among men, because non-overweight men with X2 risk factors were also at high risk (20% of the PAF). Our data suggest that the metabolic syndrome based on the AHA/NHLBI criteria predicts ischemic cardiovascular disease better than the syndrome based on the IDF criteria, because of the exclusion of non-overweight high-risk individuals from the reference group.

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Section: Introductionmentioning

confidence: 99%

The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study

et al. 2009

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“…Although metabolic syndrome has been recognized as a risk factor for atherosclerotic diseases such as coronary heart disease (2,3) and ischemic stroke (4)(5)(6)(7)(8), genetic risk for ischemic stroke in individuals with metabolic syndrome has remained uncharacterized. Given that stroke is the leading cause of severe disability and the third leading cause of death, after heart disease and cancer, in western countries and Japan (9), the identification of biomarkers for stroke risk is important both for risk prediction and for intervention to avert future events.…”

Section: Introductionmentioning

confidence: 99%

Association of genetic variants with atherothrombotic cerebral infarction in Japanese individuals with metabolic syndrome

Yamada

Kato²,

Oguri³

et al. 2008

Int J Mol Med

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Abstract. Metabolic syndrome is a risk factor for cardiovascular disease. The aim of the present study was to identify genetic variants that confer susceptibility to atherothrombotic cerebral infarction among individuals with metabolic syndrome in order to allow prediction of genetic risk for this condition. The study population comprised 1284 unrelated Japanese individuals with metabolic syndrome, including 313 subjects with atherothrombotic cerebral infarction and 971 controls. The genotypes for 296 polymorphisms of 202 candidate genes were determined with a method that combines the polymerase chain reaction and sequence-specific oligonucleotide probes with suspension array technology. The Chisquare test, multivariable logistic regression analysis with adjustment for age, sex, body mass index, and the prevalence of hypertension, hypercholesterolemia, and diabetes mellitus, as well as a stepwise forward selection procedure revealed that the 2445G¨A (Ala54Thr) polymorphism (rs1799883) of FABP2, the -108/3G¨4G polymorphism of IPF1 (S82168), the A¨G (Thr94Ala) polymorphism (rs2241883) of FABP1, the G¨A (Asp2213Asn) polymorphism (rs529038) of ROS1, the -11377C¨G polymorphism (rs266729) of ADIPOQ, the 162A¨C polymorphism (rs4769055) of ALOX5AP, the -786T¨C polymorphism (rs2070744) of NOS3, and the 3279C¨T polymorphism (rs7291467) of LGALS2 were associated (P<0.05) with the prevalence of atherothrombotic cerebral infarction. Among these polymorphisms, the 2445G¨A (Ala54Thr) polymorphism of FABP2 was most significantly associated with this condition. Our results suggest that FABP2, IPF1, FABP1, ROS1, ADIPOQ, ALOX5AP, NOS3, and LGALS2 are susceptibility loci for atherothrombotic cerebral infarction among Japanese individuals with metabolic syndrome. Genotypes for these polymorphisms, especially for the 2445G¨A (Ala54Thr) polymorphism of FABP2, may prove informative for the prediction of genetic risk for atherothrombotic cerebral infarction among such individuals.

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“…Abdominal obesity was not an important factor for coronary plaque vulnerability in Japanese women with ACS, although it is important for Japanese ACS men. 20 Although MetS has been acknowledged as a risk factor for cardiovascular disease and mortality, [1][2][3] it occurs more frequently in men than in women. We recently demonstrated that MetS and carotid artery remodeling were independent predictors of multiple complex coronary plaques in Japanese ACS men, 20 and among the components of MetS, abdominal obesity and low HDL-C level were significant in Japanese ACS men with multiple complex plaques.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] The third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) specifically underscores the importance of MetS and provides a working definition of this syndrome. 4 However, measuring waist circumference might be inappropriate for Japanese, so 8 Japanese societies established a definition of MetS for Japanese subjects, 5 but a recent study demonstrated that MetS, as defined by WHO, NCEP, NCEP revised, and the International Diabetes Federation, predicted cardiovascular mortality in men, but the prediction was weak for women.…”

mentioning

confidence: 99%

Impact of Metabolic Syndrome on Coronary Plaque Vulnerability in Japanese Women With Acute Coronary Syndrome

Kato

Dote

Sasaki

et al. 2008

Circ J

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etabolic syndrome (MetS), also referred to as insulin resistance syndrome, has been recently acknowledged as a risk factor for cardiovascular disease and mortality. [1][2][3] The third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) specifically underscores the importance of MetS and provides a working definition of this syndrome. 4 However, measuring waist circumference might be inappropriate for Japanese, so 8 Japanese societies established a definition of MetS for Japanese subjects, 5 but a recent study demonstrated that MetS, as defined by WHO, NCEP, NCEP revised, and the International Diabetes Federation, predicted cardiovascular mortality in men, but the prediction was weak for women. 2 On the other hand, type 2 diabetes mellitus (DM) showed a pronounced predominance in women in the first half of the last century. 6 Diabetic women have a greater relative risk for cardiovascular disease than diabetic men, and newly diagnosed diabetic women show a higher relative risk for cardiovascular death than diabetic men. 7 High-resolution B-mode ultrasonography has proven to be a reliable method for detecting initial structural changes of the arterial walls consistent with atherosclerosis. The carotid intima -media thickness (IMT) has been proposed as a clinically useful marker for the development of atherosclerosis and may also serve as a marker of the response to therapy for atherosclerosis, as a predictor of acute cardiovascular events, and as a marker of advanced cardiovascular disease. 8,9 Our previous study demonstrated that patients with acute coronary syndrome (ACS) with multiple complex coronary plaques have a significantly larger carotid IMT and interadventitial diameter, and increased prevalence of carotid plaques than patients with solitary plaques. 10 The association between multiple complex coronary plaques and carotid artery remodeling suggests that plaque vulnerability may be a systemic phenomenon. Indeed, previous studies have shown an association between MetS and chronic subclinical inflammation. [11][12][13] The aim of this study was to clarify the predictors of multiple complex coronary lesions, suggesting overall coronary plaque vulnerability, and the impact of MetS in Japanese women with ACS. Background Previous study has demonstrated that metabolic syndrome (MetS) can predict cardiovascular mortality in men, but the prediction was weak for women. In the present study predictors for multiple complex coronary lesions were investigated to clarify the impact of MetS in Japanese women with acute coronary syndrome (ACS). Methods and ResultsSubjects were Japanese women with ACS (n=81) who underwent emergency coronary angiography and B-mode carotid ultrasonography. They were divided into 2 groups based on the number of complex plaques. Although the MetS prevalence identified using the Japanese criteria was similar between the 2 groups, using the modified ATP III criteria it was more in patients...

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Metabolic Syndrome and the Risk of Ischemic Heart Disease and Stroke Among Japanese Men and Women

Abstract: The metabolic syndrome is a major determinant of ischemic cardiovascular disease among middle-aged Japanese men and women, in particular among smokers.

Cited by 185 publications

References 22 publications

The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study

The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study

Association of genetic variants with atherothrombotic cerebral infarction in Japanese individuals with metabolic syndrome

Impact of Metabolic Syndrome on Coronary Plaque Vulnerability in Japanese Women With Acute Coronary Syndrome

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