Prevalence of the metabolic syndrome in elderly and middle-aged Japanese

AbstractBackground/PurposeDiagnosis and management of the metabolic syndrome (MetS) are beneficial for successful aging. In spite of several criteria for MetS, there is little information on cardiometabolic risk clustering in elderly Japanese. The purpose of this study was, therefore, to determine the relationship between age-associated changes in obesity and metabolic components in the Japanese.MethodsWe analyzed data from the nationwide survey conducted in 2000. Using Adult Treatment Panel III (ATP III) and Japanese diagnostic criteria for MetS, we analyzed 2366 people aged from 40 to 79 years (men, 1425 and women, 941) from the total participants.ResultsThe prevalence of MetS was almost three fold higher by modified ATP III, International Diabetes Federation, and Japanese criteria, in elderly women than in middle-aged women, whereas no difference was found between middle-aged and elderly men by the three criteria. A marked increase in the prevalence of MetS was found by modified ATP III and International Diabetes Federation criteria compared with that by the Japanese criteria in women. Among the risk factors, the prevalence of central obesity and dyslipidemia increased only in women and that of high fasting glucose and high blood pressure increased in both genders with aging. Among the MetS subjects who fulfilled the modified ATP III criteria, more clustering of risk was observed in elderly than in middle-aged subjects, especially in women. Blood pressure increased and triglyceride decreased in both genders, and non-high-density-lipoprotein cholesterol decreased in elderly men. The prevalence of dyslipidemia decreased in elderly men.ConclusionAging is an important factor that affects the metabolic abnormality, and aging of the population would lead to increase in the prevalence of MetS. Therefore, the development of better approaches to the prevention and management of MetS is necessary for successful aging in our society

Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance

Q1Q1Objectives: To examine the specific distribution of liver fat content, visceral and subcutaneous adiposity in normal glucose tolerance (NGT/NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined conditions (IFG+IGT), as well as with newly diagnosed type 2 diabetes (nT2D). Design: Multicenter, international observational study: cross-sectional analysis. Subjects: Two thousand five hundred and fifteen patients (50.0% women, 54.5% non-Caucasian) without previously known diabetes were recruited from 29 countries. Abdominal fat distribution was measured by computed tomography (CT). Liver fat was estimated using the CT-liver mean attenuation. Results: Compared with NGT/NGT patients, increased visceral adiposity was found in iIFG, iIGT, IFG+IGT and nT2D; estimated liver fat progressively increased across these conditions. A one-s.d. increase in visceral adiposity was associated with an increased risk of having iIFG (men: odds ratio (OR) 1.41 (95% confidence interval (CI) 1.15–1.74), women: OR 1.62 (1.29–2.04)), iIGT (men: OR 1.59 (1.15–2.01), women: OR 1.30 (0.96–1.76)), IFG+IGT (men: OR 1.64 (1.27–2.13), women: OR 1.83 (1.36–2.48)) and nT2D (men: OR 1.80 (1.35–2.42), women: OR 1.73 (1.25–2.41)). A one-s.d. increase in estimated liver fat was associated with iIGT (men: OR 1.46 (1.12–1.90), women: OR 1.81 (1.41–2.35)), IFG+IGT (men: OR 1.42 (1.14–1.77), women: OR 1.74 (1.35–2.26)) and nT2D (men: OR 1.77 (1.40–2.27), women: OR 2.38 (1.81–3.18)). Subcutaneous abdominal adipose tissue showed an inverse relationship with nT2D in women (OR 0.63 (0.45–0.88)). Conclusions: Liver fat was associated with iIGT but not with iIFG, whereas visceral adiposity was associated with both. Liver fat and visceral adiposity were associated with nT2D, whereas subcutaneous adiposity showed an inverse relationship with nT2D in women

Gaps in beliefs and practice in dyslipidaemia management in Japan, Germany, Colombia and the Philippines : insights from a web-based physician survey

Q3Q1Artículo completo1-9Background: Implementing evidence-based management of dyslipidaemia is a challenge worldwide. Objectives: To understand physician beliefs and behaviour and identify uncertainties in dyslipidaemia management across four world regions. Methods: Web-based survey of 1758 physicians in Japan, Germany, Colombia and the Philippines who were selected randomly from existing databases. Key inclusion criteria were 1) for cardiologists and diabetes/ endocrinology specialists: ≥50 dyslipidaemia patients examined in the last month; 2) for specialists in neurology/ neurosurgery/stroke medicine: ≥50 dyslipidaemia patients and ≥ 20 patients with a history of ischaemic stroke examined in the last month; and 3) for specialists in nephrology and general medicine: based at centres with ≥20 beds and ≥ 50 dyslipidaemia patients examined in the last month. The self-report survey covered dyslipidaemia management, target low-density lipoprotein cholesterol (LDL-C) levels in different patient groups, and statin safety. All physicians gave voluntary consent and all data were anonymised. Analysis was solely descriptive. Results: The survey highlighted key areas of uncertainty in dyslipidaemia management in the four countries. These related to LDL-C targets in different patient groups, the safety of low LDL-C levels, the safety of statins, especially for effects on cognitive, renal and hepatic function and for haemorrhagic stroke risk, and lipid management strategies in patients with chronic kidney disease, including those with concomitant hypertriglyceridaemia. Conclusions: This survey of physicians in Japan, Germany, Colombia and the Philippines has identified key gaps in knowledge about dyslipidaemia management. These relate to the safety of low LDL-C levels, the safety of statins, and lipid management of chronic kidney disease. The findings from this survey highlight the need for further education to improve the implementation of guideline recommendations for dyslipidaemia managemen