A comparison of the prevalence of the metabolic syndrome and its components among native Japanese and Japanese Brazilians residing in Japan and Brazil

Cardiometabolic risk profile and diet quality among internal migrants in Brazil: a population-based study

PURPOSE

Studies of migrants can improve understanding of the environmental influence on the risk of chronic diseases. In continental countries, internal migration has been associated with changes in diet and health status. The objective of this study is to assess differences in diet quality and the cardiometabolic risk profile between migrants and the host population.

METHODS

A cross-sectional, population-based study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 537) was divided into three groups: natives of São Paulo (45.5%), migrants from the Southeast (26.9%) and migrants from the Northeast (27.5%). The joint interim statement consensus criteria were used for diagnosing MetSyn. Diet quality was estimated using the revised version of the Brazilian Healthy Eating Index (BHEI-R). Comparisons between the data of BHEI-R, cardiometabolic risk factors and MetSyn in migrants and natives were performed using generalized linear models adjusted for confounding factors, respectively.

RESULTS

Southeastern and Northeastern migrants younger than 60 years had a higher average of for whole fruit and oil components, respectively. Northeastern migrants older than 60 years had higher systolic and diastolic blood pressure, atherogenic ratio concentrations, lower HDL-C and were more likely to present metabolic syndrome compared to those born in São Paulo of the same age group.

CONCLUSION

Native and internal migrants from Brazil resident in São Paulo exhibited differences in diet quality and cardiometabolic risk factors.

Association between non-obesity and health state among young Japanese male university students

[Purpose] The obesity rate in both males and females has been lower in Japan than in other countries. However, the prevalence of metabolic syndrome-related risk factors is not low when compared with that in Western countries. In this study, we aimed to evaluate the health state of young, non-obese adults in Japan. [Participants and Methods] We recruited 20 young, non-obese Japanese male university students and examined the maximum oxygen consumption, physical activity, and components of metabolic syndrome. We evaluated the physical activity level and dietary habits of the participants through a questionnaire survey. [Results] The questionnaire survey revealed that 70% participants had non-standard dietary habits, 55% did not engage in any regular exercise, and 25% were inactive. On examination, 20% participants had at least one positive risk factor for metabolic syndrome. The homeostatic model assessment of insulin resistance and triglyceride values did not correlate with the body mass index of the participants; however, the values were inversely related to the maximum oxygen consumption levels. [Conclusion] Even participants with normal body mass index had poor dietary habits and a lack of exercise. Our results confirmed that even non-obese Japanese individuals have certain health risks and that having higher maximum oxygen consumption has beneficial effects in preventing the risk factors of severe and life-threatening diseases.

Detecting overweight and obesity among young Syrian boys based on skinfold thickness

There is no data on the prevalence of overweight and obesity in young Syrian boys. Therefore, the present study aimed to provide baseline and reference data on the prevalence of overweight and obesity among young Syrian boys using skin-fold thickness measurements and deuterium dilution (DD) as a reference method. The sample of 2470 healthy Syrian 18- to 19-year-old boys were enrolled in this study. SFTs were measured at the biceps (B), triceps (T), subscapular (SI) and suprailiac locations (SS) were done and validated using the DD technique as a reference method. Receiver operating characteristics (ROC) curve was drawn to determine appropriate cut-off points of the Σ2 limb SFT (T+B), Σ2 trunk SFT (SI+SS), Σ4 SFT (T+B+SI+SS) and Log Σ4 SFT for defining overweight and obesity. The overall prevalence of overweight and obesity in young Syrian boys, based on biceps SFT, triceps SFT, subscapular SFT, suprailiac SFT, Σ2 limb SFT, Σ2 trunk SFT, Σ4 SFT, logarithm Σ4 SFT, and DDT were 35.3%, 32%, 31.6%, 14.8%, 32.9%, 26.6%, 28.1%, 24.1%, 46.5%, respectively. Strongly positive correlation was found between SFT and total body fat in adolescents. For diagnosing overweight on the basis of Σ2 limb SFT, Σ2 trunk SFT, Σ4 SFT and logarithm Σ4 SFT, we propose the following cut-off points: 17.25 mm, 23.50 mm, 39.25 mm and 1.60, respectively. To predict obesity, Σ2 limb SFT, Σ2 trunk SFT, Σ4 SFT and logarithm Σ4 SFT threshold were increased to 23.25 mm, 32.50 mm, 55.25 and 1.75, respectively. Basing on SFT clearly leads to underestimates of the prevalence of weight problems among young boys. SFT measurement screen missed 11.2 to 31.7% of overall overweight and obesity cases.

Prevalence of metabolic syndrome in elderly Japanese-Brazilians

Background

Prevalence of individuals with a high cardiovascular risk is elevated in elderly populations. Although metabolic syndrome (MS) increases cardiovascular risk, information is scarce on the prevalence of MS in the elderly. In this study we assessed MS prevalence in a population of elderly Japanese-Brazilians using different MS definitions according to waist circumference cutoff values.

Material/Methods

We studied 339 elderly subjects, 44.8% males, aged between 60 to 88 years (70.1±6.8). MS was defined according to criteria proposed by the Joint Interim Statement in 2009. As waist circumference cutoff point values remain controversial for Asian and Japanese populations, we employed 3 different cutoffs that are commonly used in Japanese epidemiological studies: 1) ≥90 cm for men and ≥80 cm for women; 2) ≥85 cm for men and ≥90 cm for women; 3) ≥85 cm for men and ≥80 cm for women.

Results

MS prevalence ranged from 59.9% to 65.8% according to the different definitions. We observed 90% concordance and no statistical difference (p>0.05) in MS prevalence between the 3 definitions. MS diagnosis according to all 3 cutoff values was found in 55.8% of our population, while in only 34.2% was MS discarded by all cutoffs. The prevalence of altered MS components was as follows: arterial blood pressure 82%, fasting glycemia 65.8%, triglyceride 43.4%, and HDL-C levels 36.9%.

Conclusions

Elderly Japanese-Brazilians present high metabolic syndrome prevalence independent of waist circumference cutoff values. Concordance between the 3 definitions is high, suggesting that all 3 cutoff values yield similar metabolic syndrome prevalence values in this population.

Changing patterns of tobacco consumption in Mozambique: evidence from a migrant study

Background

Maputo, the Mozambique capital, contrasts with the rest of the country with regard to its sociodemographic characteristics and patterns of tobacco exposure. We conducted a migrant study to compare the prevalence of manufactured-cigarette smoking and traditional forms of tobacco use among dwellers in the capital who were also born in Maputo City (MC/MC) with those born in southern (SP/MC) and northern (NP/MC) provinces, and additionally with inhabitants in the latter regions.

Methods

In 2003, a representative sample of 12,902 Mozambicans aged 25-64 years was evaluated. We computed age- and education-adjusted prevalence ratios (PR) with 95%-confidence intervals (95%CI) using Poisson regression.

Results

The prevalence of any type of tobacco consumption among Maputo City inhabitants born in other provinces contrasted with the pattern observed in locally born inhabitants (SP/MC vs. MC/MC: men, PR, 0.61; 95%CI, 0.44-0.85; women, PR, 0.38, 95%CI, 0.18-0.79; NP/MC vs. MC/MC: men, PR, 0.66; 95%CI, 0.34-1.29; women, PR, 4.56, 95%CI, 1.78-11.69); the prevalence among city inhabitants born in other provinces resembled the pattern seen in inhabitants of their provinces of origin. Traditional forms of tobacco consumption among men were rare in Maputo City, which is in stark contrast to the situation in other provinces.

Conclusions

Cultural background, affordability, and availability of different types of tobacco in urban Mozambique need to be considered when developing strategies to control the tobacco epidemic.

Cardiovascular risk profiles and outcomes of Chinese living inside and outside China

AIM

To assess whether cardiovascular risk differs among the Chinese living inside and outside mainland China.

METHODS AND RESULTS

Three thousand, four hundred and eighty-two East Asians were enrolled in the REduction of Atherothrombosis for Continued Health Registry in mainland China, Hong Kong/Singapore/Taiwan, Western Europe, and North America. Baseline demographics, medication use, risk factor control, and 30-month cardiovascular outcomes of the 2938 patients with atherothrombotic disease were compared. Rates of hypertension, hypercholesterolemia, diabetes, abdominal obesity, and body mass index ≥25 kg/m² were lowest in mainland China, were increased in Hong Kong/Singapore/Taiwan, and were highest in Western Europe and North America. Diabetes prevalence was 23% in mainland China, approximately two-fold lower than the other regions. Antihypertensive, antidiabetic, and antiplatelet agent use was similar in all regions. Risk factor control was significantly poorer in Western Europe and, except for glucose control, significantly better in North America. Thirty-month nonfatal stroke rates were highest in mainland China and fell in a stepwise manner in more westernized societies. Conversely, nonfatal myocardial infarction rates increased in more westernized societies.

CONCLUSION

Obesity and other risk factors progressively worsen as patients move from mainland China to Hong Kong/Singapore/Taiwan and overseas. Despite similar medication use, risk factor control and cardiovascular outcomes were significantly different. The magnitude of these changes is larger than formerly estimated, suggesting population differences in cardiovascular risk and disease prevalence, likely to be more closely associated with lifestyle and cultural habits than genetic differences.

Murine hepatic miRNAs expression and regulation of gene expression in diet-induced obese mice

MicroRNAs are short, non-coding RNA molecules that regulate gene expression primarily by translational repression or by messenger RNA degradation. MicroRNAs play crucial roles in various biological processes. However, little is known regarding their role in obesity. We investigated differences of microRNA (miRNA) expression in liver tissue from diet-induced obese mice and potential effects of them on gene and protein expression. We used a miRNA microarray and quantitative RT-PCR to determine miRNA expression in murine liver tissue. Gene and protein expression were determined by qRT-PCR and Western blot analysis. Effects of miRNA by knock-down using RNAi or overexpression on putative target genes and/or proteins in a murine hepatic cell line were also investigated. MicroRNA array and qRT-PCR analsysis revealed that > 50 miRNAs were down- or upregulated more than 2-fold in the liver of diet-induced obese mice. While changes in expression of many genes were observed at the mRNA level, some were only altered at the protein level. Overexpression or knock-down of miR-107 in murine hepatic cells revealed that the expression of its putative target, fatty acid synthase, was dramatically decreased or increased, respectively. In conclusion, more than 50 hepatic miRNAs were dysregulated in diet-induced obese mice. Some of them regulate protein expression at translation level and others regulate mRNA expression at transcriptional level. MiR-107 is downregulated while FASN, a putative target of miR-107, was increased in diet-induced obese mice. These findings provide the evidence of the correlation of miRNAs and their targets in diet-induced obese mice.

Comparison of prevalence of metabolic syndrome between korean emigrants and host country residents in Japan and china-the korean emigrant study

OBJECTIVES

This study aims to compare the prevalence of metabolic syndrome between Korean emigrants (KEs) and their host country residents in Japan and China.

METHODS

The Korean Emigrant Study (KES) is a cohort study initiated in 2005 to elucidate the effect of genetic susceptibility and environmental change on hypertension, diabetes, and metabolic syndrome. Equal numbers of KEs and host country residents, aged 30 or over, were recruited from three regions; Kobe-Osaka in Japan (total number=965), Yanbian in China (n=1,019), and Changchun in China (n=949).

RESULTS

The age-adjusted prevalences of metabolic syndrome among KEs in Kobe-Osaka were significantly higher than those among Japanese (in men 24.0% vs. 15.6%, p=0.04, in women 8.4% vs. 2.7%, p=0.01), while the age-adjusted prevalences among KEs in Changchun were similar to those among Chinese (in men 11.7% vs. 16.1%, p=0.37, in women 28.3% vs. 30.1%, p=0.91). The age-adjusted prevalences were generally higher in Yanbian than other regions, and KEs had higher prevalence than Chinese in men but not in women (in men 37.9% vs. 28.3%, p=0.03, women 46.0% vs. 50.6%, p=0.44). The components with significant ethnic differences in prevalence were high blood pressure and abdominal obesity in Japan, and triglyceride in China. The most influential component in diagnosing metabolic syndrome was abdominal obesity in men and triglyceride in women.

CONCLUSION

The prevalence of metabolic syndrome was higher in KEs than in host country residents in Japan but not in China. Abdominal obesity and triglyceride are both discriminating and influential components in metabolic syndrome.

High blood pressure in Latin America: a call to action

High blood pressure (BP) is an enormous global problem, and is especially challenging for low- and middle-income countries such as those of Latin America. Although developed countries have benefited from significant reductions in cardiovascular and cerebrovascular disease in recent decades, comparable reductions have not been achieved in Latin America. In fact, the prevalence of high BP is increasing in many Latin American countries, and the situation will worsen without definitive efforts to correct it. The growing preponderance of hypertension and chronic diseases, coupled with expected increases in population growth, present a mounting threat to Latin American economies. This report provides a comprehensive overview of the burden of high BP throughout Latin America, and presents recommendations for change. The dismal observations warrant a call to action for improved control of high BP and other cardiovascular risk factors across Latin America. Achieving these ambitious goals will require collaborative efforts by many groups, including policymakers, international organizations, healthcare providers, schools and society as a whole.

The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome

Similar to the healthcare systems in other industrialized countries, the Japanese healthcare system is facing the problem of increasing medical expenditure. In Japan, this situation may be primarily attributed to advanced technological developments, an aging population, and increasing patient demand. Japan also faces the problem of a declining youth population due to a low birth rate. Taken together, these problems present the healthcare system with a very difficult financial situation. Several reforms have been undertaken to contain medical expenditure, such as increasing employee copayment for health insurance from 10% to 20% in 1997 and from 20% to 30% in 2003 in order to curb unnecessary visits to medical institutions. Since the aging of the Japanese population is inevitable, a suitable method to contain medical expenditure may be to screen individuals who are likely to develop lifestyle-related diseases and conduct early intervention programs for them to prevent the development of diseases such as myocardial infarction or stroke that are costly to treat. If this goal is attained, it may contribute to the containment of medical expenditure as well as to improving the quality of life of the elderly. Therefore, the Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008. Here, we discuss (1) the background of the Japanese healthcare system and the problems facing it, (2) the underlying objective and details of the new screening program, and (3) the expected impact of the program.