Metabolic syndrome and risk of isolated ST-T abnormalities and type 2 diabetes in Japanese male office workers.

Using a modified National Cholesterol Education Program (NCEP) definition of the metabolic syndrome (MS) with body mass index instead of waist circumference, we examined the associations of the MS with the risk of developing ST-T abnormalities in 3405 Japanese men aged 35-59 yr who did not have a history of cardiovascular disease or ST-T abnormalities. Of 3405 participants, 3166 men without type 2 diabetes (as diagnosed with the revised criteria of American Diabetes Association) also constituted a non-diabetic cohort. Examinations including electrocardiogram and fasting plasma glucose were repeated annually for 7 subsequent years. The subjects were classified as having ST-T abnormalities or type 2 diabetes when evidence of either of these disorders was found during at least 2 consecutive annual examinations. After adjustment for potential risk factors, the relative risks of ST-T abnormalities were 1.0 (referent), 2.66, 3.07, 4.27, and 8.40 for the presence of 0, 1, 2, 3, and > or =24 components of the MS, respectively (P for trend <0.001). The corresponding results for the risk of type 2 diabetes were 1.0 (referent), 3.49, 7.45, 15.00, and 24.04 (P for trend <0.001). The estimated incident rates for men in the low-WBC count (<7.3 x 10(9) cells/L)/no MS, high-WBC count (> or =7.3 x 10(9) cells/L)/no MS, low-WBC count/yes MS, and high-WBC count/yes MS were 3.4%, 4.6%, 7.4%, and 13.1% for ST-T abnormalities, respectively and were 3.6%, 7.1%, 18.0%, and 27.2% for type 2 diabetes, respectively. The respective multivariate-adjusted relative risks were 1.0 (referent), 1.26, 2.07, and 3.45 for ST-T abnormalities and were 1.0 (referent), 1.75, 5.14, and 6.90 for type 2 diabetes. A modified NCEP MS definition predicts ST-T abnormalities and type 2 diabetes. WBC count adds clinically important information to new-onset ST-T abnormalities and type 2 diabetes.

[Relationship between the white blood cell count and development of electrocardiographic ST-T abnormalities. Insights from annual health examinations of urban residents].

OBJECTIVE: Inflammation has been shown to play a role in atherosclerosis and coronary heart disease. This study was designed to examine the relationship between the baseline white blood cell (WBC) count and development of electrocardiographic ST-T abnormalities. METHODS: The results of annual health examinations conducted in the city of A, Osaka Prefecture, from 1985 to 1997 were evaluated. At the initial examination, carried out during the period 1985-1988, 1,213 women and 201 men, who were current non-smokers without hypertension, were free from ST-T abnormalities. We focused on cases with new ST-T abnormalities identified during the 12-year period. WBC counts were categorized as low (< 50th percentile) or high (> or = 50th percentile), and were divided into quintiles. Cox proportional hazards models were used to test for correlations. RESULTS: The age-adjusted mean WBC count in both men and women were higher for cases with new ST-T abnormalities than for those with normal ECG findings. For men, the percentage of positive cases with a high WBC count was significantly greater. Multivariate models showed that the relative risk (RR) of new ST-T abnormalities for cases with a high WBC count as compared with those with a low WBC count was 7.16 (P<0.001) for men and 1.50 (P< 0.001) for women. The quintiles for men showed a step-wise increment in the rate per 1,000 person-years but no such tendency was observed for women. The higher the quintile in men, the higher the RR was, and the RR in the highest quintile was approximately ten times that in the lowest quintile. For women, a similar trend was observed, but the association between the RR and the WBC count was weaker. CONCLUSIONS: These results confirm that the WBC count is significantly associated with development of ST-T abnormalities, and that an elevated WBC count is a marker for an increased risk of ST-T abnormalities. In women, this relationship appears less prevalent than in men.

Clustering of components of the metabolic syndrome and risk for development of type 2 diabetes in Japanese male office workers.

To investigate the effects of the clustering of components of the metabolic syndrome (MS) on development of diabetes, we examined 3298 Japanese male office workers aged 35-59 years who did not have type 2 diabetes (a fasting plasma glucose level of > or =7.0 mmol/l or receipt of hypoglycemic medication) or a history of cardiovascular disease. Fasting plasma glucose levels were measured at periodic annual health examinations from May 1994 through May 2001. After adjustment for potential risk factors for diabetes, the multivariate-adjusted relative risk of type 2 diabetes compared with the subjects without components of the MS was 1.58 (95% CI: 1.08-2.32), 2.48 (95% CI: 1.69-3.63), 3.10 (95% CI: 2.05-4.68), and 5.22 (95% CI: 3.49-7.83) (P-value for trend <0.001) for those with 1, 2, 3, and > or =4 components, respectively. Even after the subjects were stratified according to fasting plasma glucose level, the clustering of components of the MS was associated with an increased risk of type 2 diabetes for subjects in all three categories of low-normal fasting glucose (a fasting plasma glucose level of <5.1 mmol/l), high-normal fasting glucose (a fasting plasma glucose level of 5.0-6.0 mmol/l), and impaired fasting glucose (a fasting plasma glucose level of 6.1-6.9 mmol/l). These results indicate that clustering of components of the MS associated with diabetes precedes an increase in the risk of type 2 diabetes in Japanese men.

Associations of psychological distress with metabolic syndrome among Japanese urban residents.

AIMS: To examine and evaluate the association between psychological distress and metabolic syndrome (MetS). METHODS: Between 2005 and 2006, 1,613 men and women aged 30-79 participated in annual health examinations at Takarazuka City Health Promotion Center in Takarazuka, Japan. Psychological stress was assessed with the General Health Questionnaire (GHQ) and MetS was evaluated using three criteria based on those of the Japanese Society of Internal Medicine as the Japanese counterpart of the third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Cholesterol in Adults (NCEP/ATPIII) and the International Diabetes Federation (IDF). RESULTS: The mean depression score after adjustment for age, smoking, alcohol intake and serum total cholesterol levels was higher for men with than without MetS as defined by Japanese criteria as well as for men with than without fasting glucose ≥ 110 mg/dL. Multivariable-adjusted, odds ratio associated with increments of one standard deviation in the depression score was 1.48 (1.19-1.84) for MetS, and anxiety and depression scores were 1.32 (1.08-1.61) and 1.24 (1.03-1.50) for fasting glucose ≥ 110 mg/dL, respectively. Similar trends were observed for the depression score and MetS as defined by NCEP/ATPIII and IDF. For women, somatic symptoms, anxiety, and depression were not associated with MetS and its components. CONCLUSIONS: Depressive symptoms are considered to be associated with MetS and, more specifically, glucose abnormality among urban Japanese men.

Relationship of light to moderate alcohol consumption and risk of hypertension in Japanese male office workers.

BACKGROUND: A close relationship between alcohol consumption and hypertension has been established, but the effect of light to moderate alcohol consumption on blood pressure (BP) remains unclear. METHODS: A total of 5275 Japanese male office workers aged 23 to 59 years partook in a survey. Subjects were classified as nondrinkers or current drinkers who averaged less than 12, 12 to 22, 23 to 45, or > or =46 g/day of ethanol. BPs were measured at annual health examinations from May 1996 through May 2000. A total of 3784 hypertension-free (systolic BP <140 mm Hg, diastolic BP <90 mm Hg, no medication for hypertension, and no history of hypertension) men were observed for 4 years. Men in whom hypertension (systolic BP > or =140 mm Hg, diastolic BP > or =90 mm Hg, or both or receipt of antihypertensive medication) was found during repeated surveys were defined as incident cases of hypertension. RESULTS: After controlling for potential predictors of hypertension, systolic and diastolic BP levels and the incidence of hypertension were lowest in nondrinkers in all three age ranges (23-35, 36-47, and 45-59 years) and increased in a dose-dependent manner as alcohol consumption increased. For individuals aged 23 to 35 years, systolic and diastolic BP levels and the incidence of hypertension were significantly higher among those who drank an average of > or =23 g/day of ethanol than among nondrinkers. For those aged 36 to 59, the diastolic BP level was significantly higher among those who drank any alcohol at all than among nondrinkers, and the systolic BP level and the incidence of hypertension were significantly higher among those who drank an average of > or =12 g/day of ethanol than among nondrinkers. CONCLUSIONS: Light to moderate alcohol consumption seems to have an important influence on BP in both young and middle-aged Japanese men.