Weight gain and risk of impaired fasting glucose after smoking cessation.

BACKGROUND: Observation of early changes in fasting plasma glucose level induced by post-smoking cessation weight gain is useful in predicting the risks of diabetes mellitus (DM) and impaired fasting glucose (IFG). We investigated the effect of post-smoking cessation weight gain on early changes in the risk of a high fasting plasma glucose (IFG) level (≥100 mg/dL). METHODS: In 946 subjects who underwent repeated health examinations after smoking cessation, changes in body mass index (BMI) and the odds ratio (OR) for IFG risk (adjusted for sex, age, BMI, fasting plasma glucose at year 1, and alcohol consumption) were calculated every year for 3 years after smoking cessation. RESULTS: After smoking cessation, the rate of BMI increase significantly increased in quitters: 2.36% at year 2 (never smokers: 0.22%, current smokers: 0.39%) and 0.46% at year 3 (never smokers: 0.14%, current smokers: 0.32%). However, it decreased by 0.15% at year 4 (never smokers: 0.12%, current smokers: 0.26%). The ORs for quitters did not significantly increase at any time during the follow-up period. However, among quitters who had smoked at least 20 cigarettes per day, it was significantly higher (OR 1.51, 95% confidence interval 1.1-2.01 at year 1 and 1.71, 1.23-2.38 at year 2). CONCLUSIONS: The time course of the risk of IFG after smoking cessation was similar to that for the rate of BMI increase. In contrast to the findings of previous reports, the increase in IFG risk after smoking cessation was brief and disappeared in the absence of a significant increase in BMI.

Lifestyle modification in metabolic syndrome and associated changes in plasma amino acid profiles.

BACKGROUND: Although lifestyle modification is the key treatment of metabolic syndrome (MetS), clinical data on the dynamical relationship between metabolic state and MetS has been limited. This study investigated the mutual correlations between demographic and biochemical variables, and the metabolic state based on the plasma amino acid (AA) concentrations, during a lifestyle modification for MetS. METHODS AND RESULTS: Japanese subjects, consisting of 54 patients with MetS [MetS(+)] and 35 persons without MetS [MetS(-)] were included in the study. Before a lifestyle modification program, the levels of glutamate metabolism-related AA (Glu-mAA), aromatic AA metabolism-related AA (Aromatic-mAA) and alanine metabolism-related AA (Ala-mAA) were significantly higher, while those of glycine-serine-threonine metabolism-related AA (Gly-Ser-Thr-mAA) were significantly lower compared to those in MetS(-). After a lifestyle modification, significant reductions (P<0.05) in the BMI (-1.4 kg/m(2)), mean blood pressure (-7.9 mmHg), hemoglobin A(1c) (-0.4%), and triglycerides (-30.6 mg/dl) were observed, and significant differences in the plasma AA levels between MetS(+) and MetS(-) were resolved. In addition, the diagnostic items of MetS were positively correlated with the levels of Glu-mAA, Ala-mAA, branched chain AA (BCAA)-mAA, Aromatic-mAA, and negatively correlated with the levels of Gly-Ser-Thr-mAA. CONCLUSIONS: As MetS subsided, the abnormality of mean plasma AA levels of the MetS(+) group returned to similar values as those in the MetS(-) group, suggesting a novel viewpoint regarding the metabolic mechanism of lifestyle modification.

[Evaluation of a guidance method for reducing lifestyle-related diseases by the self-monitoring of blood collection in small- and medium-sized enterprises].

As a method of reducing lifestyle-related diseases and guidance in small- and medium-sized enterprises where blood examination by blood collection from the upper arm cannot be performed, we developed a program for reducing lifestyle-related diseases by blood analysis using a fingertip collection kit and a small centrifuge, and evaluated this program in small- and medium-sized enterprises. During a 6-month period, a total of 7 interviews and a total of 3 own blood collections were performed by workers showing abnormalities in items associated with lifestyle-related diseases, such as lipids and glucose, in a periodic medical examination. Many of the participants in this program showed improvement in blood analysis data (triglyceride), abdominal circumference, and body weight. The cost of the examination was low. This self-monitoring method, which is based on objective data and can be readily and easily performed in the workplace, may be useful for reducing lifestyle-related diseases.

[A novel method for the self-collection of blood, "thenar lancing phlebotomy" and investigation of its accuracy].

"Thenar lancing phlebotomy" is a novel method for the self-collection of blood using a special phlebotomy device for the thenar and a self-collection blood kit. The thenar is punctured with a special lancet, the vein is subjected to automatic avascularization at the wrist and at the same time, a small centrifuge tube, attached to the suction cylinder of the device, is applied to the puncture and the blood is collected by suction. The small centrifuge tube containing the whole blood is centrifuged with a portable centrifugal separator to obtain plasma. In comparison with conventional finger prick phlebotomy, there is less pain and sufficient blood may be obtained. To investigate the accuracy of the method, we collected blood from the antecubital vein of 140 subjects and thenar lancing phlebotomy was simultaneously carried out on the same 140 subjects. The results of many blood tests currently included in medical check-ups were almost identical in the blood samples of both groups, suggesting that this method can be utilized in medical check-ups using self-collected blood sampies.