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2.
Int Heart J ; 61(1): 15-20, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32009122

RESUMEN

Body weight gain in middle age is thought to be mainly attributable to body fat gain. However, the association between the change in body weight and change in fat weight is not fully understood. In this study, we aimed to clarify the association between the changes in body weight and fat weight in a middle-aged general population using a community-based cohort. We studied 3,193 subjects who underwent health check-ups. Fat weight was measured using a TANITA DC-270A body composition analyzer (Tanita Corporation, Tokyo). Good correlation was observed between the changes in body weight and fat weight (Pearson r = 0.88, P < 0.001). Among the study subjects, 408 (13%) were categorized in the weight loss group (weight loss ≥ 5%), 2,442 (76%) in the weight stable group, and 343 (11%) in the weight gain group (weight gain ≥ 5%). The percentage of change in fat weight in relation to the change in body weight was 65% on average in subjects with body weight loss, and 70% on average in those with body weight gain. Good correlation between changes in body weight and fat weight was observed regardless of age, gender, and baseline body mass index. A change in body weight was closely correlated with a change in fat weight among the middle-aged general population. Body weight change in the middle-age population appears to be mainly attributable to the change in fat weight.


Asunto(s)
Tejido Adiposo/crecimiento & desarrollo , Peso Corporal/fisiología , Aumento de Peso/fisiología , Tejido Adiposo/fisiología , Anciano , Composición Corporal , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología
3.
Int Heart J ; 61(1): 103-108, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31956154

RESUMEN

Waist circumference (WC) is measured for the assessment of abdominal obesity, whereas carotid intima-media thickness (IMT) is a marker of preclinical atherosclerosis. The relationship between WC and carotid IMT in the general population is not fully understood. In this study, we examined 1,182 subjects (658 men and 524 women, 62.3 ± 11.7 years on average) who underwent voluntary health check-ups and sought to determine the optimal cut-off value of WC for predicting carotid IMT thickness. Receiver operating characteristic curve analysis of WC was utilized to predict high carotid IMT (defined as carotid IMT ≥ 1.1 mm). We determined that the appropriate WC cut-off value was a WC ≥ 79 cm for men and women. There was a statistically significant difference in the prevalence of high carotid IMT between WC ≥ 79 cm and WC < 79 cm in both men and women. However, multivariable logistic regression analysis demonstrated that the WC category was independently associated with high carotid IMT in men, but not in women. Our study indicates that the optimal cut-off value of WC to identify preclinical atherosclerosis may be lower than the current Japanese diagnostic criteria for metabolic syndrome (MetS) in both men and women. Compared to women, the association between WC and preclinical atherosclerosis may be more pronounced in men.


Asunto(s)
Aterosclerosis/diagnóstico , Obesidad Abdominal/diagnóstico , Anciano , Aterosclerosis/epidemiología , Grosor Intima-Media Carotídeo , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/epidemiología , Prevalencia , Curva ROC , Factores Sexuales , Circunferencia de la Cintura
4.
Heart Vessels ; 35(1): 22-29, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31222551

RESUMEN

Cigarette smoking is closely associated with the development of cardiovascular diseases. However, the relationship between cigarette smoking and subclinical atherosclerosis has not been fully studied. We sought to clarify the association between cigarette smoking and carotid intima-media thickness (cIMT) in a general Japanese population. Among 1,209 participants who received a medical check-up with cardiovascular examination at our institution, 450 participants (37.2%) were smokers (including both past and current smokers). We evaluated cIMT as a marker of subclinical atherosclerosis. The value of cIMT and rate of carotid plaque defined as IMT ≥ 1.1 mm did not differ between smokers and never smokers. However, the rate of carotid high-risk atheroma, defined as carotid artery atheroma including hypoechoic dominant and ulceration, was significantly higher among smokers than never smokers (30.4%, vs 23.6%, p = 0.009). Even after adjustment for covariates, cigarette smoking was independently associated with high-risk atheroma formation (odds ratio 1.384, 95% CI 1.019-1.880; p = 0.038). The value of cIMT and the rate of high-risk atheroma were significantly higher in smokers than never smokers in the subgroup of participants aged ≥ 60 years, whereas the rate of high-risk atheroma only was higher in smokers than never smokers in the subgroup of participants aged < 60 years. In conclusion, the development of high-risk carotid artery atheroma may precede the thickening of cIMT in cigarette smokers, which suggests the novel insight for the pathological mechanism underlying cardiovascular events and cigarette smoking.

5.
J Atheroscler Thromb ; 27(2): 155-163, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31231080

RESUMEN

AIM: Obesity and metabolic syndrome (MetS) frequently coexist and are both important risk factors for cardiovascular disease. However, the pathophysiological role of obesity without MetS, also referred to as metabolically healthy obesity (MHO), remains unclear. In this study, we aim to clarify the effect of MHO on the development of carotid plaque using a community-based cohort. METHODS: We examined 1,241 subjects who underwent health checkups at our institute. Obesity was defined as body mass index of ≥ 25.0 kg/m2. Subjects were divided into three groups: non-obese, MHO, and metabolically unhealthy obesity (MUO). RESULTS: The prevalence of carotid plaque, defined as intima-media thickness (IMT) ≥ 1.1 mm, was higher in subjects with MUO and MHO than in non-obese subjects. Multivariable analysis demonstrated that MHO (odds ratio 1.6, p=0.012) and MUO (odds ratio 1.9, p=0.003) as well as age of ≥ 65 years, male sex, hypertension, and diabetes mellitus were independently associated with carotid plaque formation. A similar trend was observed in each subgroup according to age and sex. CONCLUSIONS: MHO increased the prevalence of carotid plaque when compared with non-obese subjects, suggesting the potential significance of MHO in the development of subsequent cardiovascular diseases.

6.
J Cardiol ; 75(5): 578-582, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31874723

RESUMEN

BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for hypertension have lowered the threshold of normal blood pressure (BP). However, how this updated guideline should be applied to the general population is still under debate, and may depend on gender because of a substantial gender difference in the risk of cardiovascular disease. We aimed to clarify the gender difference in the association between BP category and cardio-ankle vascular index (CAVI), as a marker of subclinical atherosclerosis, using a community-based cohort. METHODS: We examined 1,241 subjects (699 males and 542 females) who underwent health check-ups at our institute. We defined normal pressure as systolic (s)BP <130 mmHg and diastolic (d)BP <80 mmHg, stage 1 hypertension as 130 mmHg ≤ sBP < 140 mmHg or 80 mmHg ≤ dBP <90 mmHg and stage 2 hypertension as sBP ≥140 mmHg or dBP ≥90 mmHg, including subjects on antihypertensive medications. High CAVI was defined as CAVI ≥9.0. RESULTS: Age and the prevalence of most of atherosclerotic risk factors increased with increasing BP category in both male and female subjects. A linear relationship between the prevalence of high CAVI and high BP category was observed in males, but not in females. Multivariable logistic regression analysis revealed that BP category was independently associated with high CAVI in males but not in females. CONCLUSION: There was a difference seen between males and females in the association between BP category, according to the updated ACC/AHA guideline, and CAVI, suggesting that the optimal management strategy for hypertension may depend on not only age, obesity, and diabetes mellitus, but also gender.

8.
Int Heart J ; 60(6): 1381-1386, 2019 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-31735787

RESUMEN

The association between changes in body weight and blood pressure (BP) in overweight people in the general population still remains unclear. We sought to clarify the effect of body weight change on BP using a community-based cohort. We studied 1,170 overweight subjects with a body mass index (BMI) ≥ 22 kg/m2 who underwent health check-ups. Among the study subjects, 175 (15%) were categorized in the weight loss group (weight loss ≥ 5%), 869 (74%) in the weight stable group, and 126 (11%) in the weight gain group (weight gain ≥ 5%). There were no significant differences in baseline BP between the 3 groups. In the weight loss group, systolic and diastolic BP, and the rates of stage 2 (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) and stage 1 hypertension (130 mmHg≤ systolic BP < 140 mmHg or 80 mmHg≤ diastolic BP < 90 mmHg) decreased. In contrast, in the weight gain group, systolic and diastolic BP and the rate of stage 2 hypertension increased. Subgroup analysis showed that the correlation between change in body weight and BP was seen in each subgroup according to age, sex, and BMI. The results of the present study suggest the significance of body weight control for BP control in subjects with BMI ≥ 22 kg/m2.


Asunto(s)
Presión Sanguínea , Índice de Masa Corporal , Hipertensión/epidemiología , Sobrepeso/fisiopatología , Aumento de Peso , Pérdida de Peso , Adulto , Anciano , Estudios de Cohortes , Femenino , Frecuencia Cardíaca , Humanos , Japón , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones
9.
J Nephrol ; 32(5): 843-846, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31429048

RESUMEN

After the online first publication of their research, the authors realized they made several mistakes in the data conversion process from the original data of health check-up at the Center for Preventive Medicine at The University of Tokyo Hospital to the datasheet which was used for the statistical analysis by SPSS. Particularly, the prevalence of hypertension, diabetes mellitus, and hypercholesterolemia was not appropriately analyzed. Therefore, the authors re-analyzed the data according to the corrected database.

11.
Am J Cardiol ; 124(3): 396-401, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31171318

RESUMEN

American College of Cardiology/American Heart Association recently updated their guidelines for hypertension, and lowered the threshold of normal blood pressure (BP). However, the validity of the updated guidelines remains controversial. We investigated the relation between the revised BP classification and carotid intima-media thickness, using a community-based cohort. We examined 1,241 subjects who underwent health check-ups at our institute. They were divided into 3 groups based on their BP levels: normal blood pressure (sBP <130 mm Hg and dBP <80 mm Hg, n = 556); stage 1 hypertension (130 mm Hg ≤sBP <140 mm Hg or 80 mm Hg ≤ dBP <90 mm Hg, n = 236); and stage 2 hypertension (sBP ≥140 mm Hg or dBP ≥90 mm Hg, including subjects prescribed with antihypertensive medications, n = 449). With an increase in BP, increase in the mean age, proportion of males, and prevalence of CVD risk factors was seen. The prevalence of carotid plaque, defined as intima-media thickness ≥1.1 mm, also increased with increase in BP. After adjustment with covariates, higher BP was seen to be associated with carotid plaque presence. Atherosclerotic changes are present in stage 1 hypertension even in the healthy population, suggesting the importance of aggressive antihypertensive treatment based on the updated American College of Cardiology/American Heart Association guidelines.


Asunto(s)
Grosor Intima-Media Carotídeo , Hipertensión/clasificación , Hipertensión/diagnóstico , Guías de Práctica Clínica como Asunto , Factores de Edad , American Heart Association , Estenosis Carotídea/diagnóstico , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Japón/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Estados Unidos
12.
J Nephrol ; 32(5): 775-781, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30955155

RESUMEN

BACKGROUND: Risk factors for renal function deterioration in the general population are not fully understood. We aimed to clarify the determinants of estimated glomerular filtration rate (eGFR) decline using a community-based cohort. METHODS AND RESULTS: Among 3217 subjects who underwent repeated health check-ups, we excluded 478 subjects with eGFR ≤ 60 mL/min/1.73 m2 and examined 2739 subjects. EGFR decline rate was calculated from the difference in eGFR between the first and last visits. EGFR decline, which was defined as a drop in GFR accompanied by a 25% or greater drop in eGFR from baseline and/or a sustained decline of more than 5 mL/min/1.73 m2/year, was observed in 209 subjects (7.6%). Anemia according to the WHO definition (16.7% vs. 11.7%, p = 0.03), and proteinuria (3.3% vs. 0.8%, p < 0.001) at baseline were more commonly observed in subjects with eGFR decline. Multivariable logistic regression analysis showed that anemia and proteinuria were independently associated with eGFR decline. CONCLUSION: Anemia and proteinuria were closely related to eGFR decline, which suggests that we should consider these parameters as risk factors of the development of renal function deterioration even in the general population.

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