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1.
Nutr Metab Cardiovasc Dis ; 32(4): 973-980, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35168828

RESUMO

BACKGROUND AND AIMS: Nonalcoholic fatty liver disease (NAFLD) is a serious liver disease. Recent studies have shown that both visceral adipose tissue (VAT) quantity and density (as an indirect measure of quality) are associated with metabolic profiles. Therefore, we investigated the association between VAT quantity and quality, and the prevalence and incidence of NAFLD. METHODS AND RESULTS: In this cross-sectional, retrospective cohort study, the prevalence and incidence of NAFLD were analyzed in 627 and 360 middle-aged subjects, respectively. VAT was evaluated using an unenhanced computed tomography scan, while NAFLD was evaluated using ultrasonography. The VAT area was normalized to the square value of the subjects' height in meters, the visceral fat area (VFA) index. The VAT density was described as the visceral fat density (VFD). The VFA index and VFD had an interaction effect on the prevalence of NAFLD (P = 0.0059). The VFA index (adjusted odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.07; P = 0.0145, per 1.0 cm2/m2) and the VFD (OR, 0.90; 95% CI, 0.84-0.96; P = 0.0026, per 1.0 Hounsfield unit [HU]) were independently associated with the prevalence of NAFLD. In our cohort, 36 subjects developed NAFLD. The VFD (adjusted hazards ratio [HR], 0.84; 95% CI, 0.77-0.91; P < 0.0001, per 1.0 HU) was independently associated with the incidence of NAFLD, whereas the VFA index was not. CONCLUSION: Both the VFA index and VFD were independently associated with NAFLD prevalence. The VFD might be more related to the incidence of NAFLD than the VFA index.


Assuntos
Gordura Intra-Abdominal , Hepatopatia Gordurosa não Alcoólica , Estudos Transversais , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Estudos Retrospectivos , Ultrassonografia
2.
Int Heart J ; 63(6): 1055-1062, 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36372410

RESUMO

Metabolic syndrome (MetS) is one focus of healthcare system reform in Japan. We examined the effects of changes in individual risk factors over time on the incidence of major adverse cardio-cerebrovascular events (MACCE) in adults under the age of 50 years. Study participants under the age of 50 with neither hypertension nor hyperglycemia at baseline were analyzed. We used a parametric proportional hazard model to determine the effect of changes in abdominal circumference, blood pressure, serum lipids, and blood glucose on the incidence of MACCE.A total of 6,125 women and 6,403 men were subject to the analyses. The incidence rate of MACCE per 1,000 person-years was 1.17 for women and 2.42 for men. In men under the age of 50, an increase in abdominal circumference was associated with an increase in MACCE incidence (hazard ratio per 1 cm increase: 1.10; 95% confidence interval [CI], 1.04-1.17), whereas no statistically significant association was observed in women. Compared with Visit 1, if the abdominal circumference increased by 4 cm at Visit 3, the hazard ratio for developing MACCE was approximately 1.5 (hazard ratio 1.48; 95% CI, 1.18-1.86). In men under the age of 50, increases in abdominal circumference and systolic blood pressure were associated with an increased risk of developing MACCE, regardless of the degree of obesity at baseline. Therefore, encouraging young adults to improve their health before developing MetS may reduce the risk of MACCE.


Assuntos
Transtornos Cerebrovasculares , Síndrome Metabólica , Masculino , Adulto Jovem , Feminino , Humanos , Pessoa de Meia-Idade , Incidência , Fatores de Risco , Síndrome Metabólica/epidemiologia , Estilo de Vida , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/etiologia
3.
Circ J ; 85(3): 243-251, 2021 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-33487604

RESUMO

BACKGROUND: The associations between body mass index (BMI) and incidence of atrial fibrillation (AF) in young men are scarce, especially in Asian countries, given the differences in BMI between Asians and Western populations.Methods and Results:This study analyzed 17,865 middle-aged Japanese men without AF from a cohort of employees undergoing annual health examinations. AF incidence was evaluated during a follow-up period (median 4.0 years, interquartile range 2.0-7.1 years). Among young men aged 30-49 years, AF incidence was 0.64/1,000 person-years, whereas it was 2.54/1,000 and 7.60/1,000 person-years among men aged 50-59 and ≥60 years, respectively. Multivariable Cox regression analysis among young men revealed age (hazard ratio [HR] 3.28 by 10-years' increase, 95% confidence interval [CI] 1.72-6.25, P<0.001), BMI (BMI-quadratic, HR 1.01, 95% CI 1.00-1.01, P<0.001, BMI-linear, HR 0.95, 95% CI 0.86-1.05, P=0.33), and electrocardiogram (ECG) abnormalities, such as PQ prolongation, supraventricular beat, and p wave abnormality (HR 8.79, 95% CI 3.05-25.32, P<0.001), were significantly associated with AF incidence. There was a reverse J-shaped association between BMI and AF incidence in young men, whereby the presence of ECG abnormality inversely influenced the BMI-incident AF relationship. A linear association between BMI and AF incidence in men aged 50-59 and ≥60 years was present. CONCLUSIONS: AF incidence displays a reverse J-shaped relationship with BMI in young men, but a linear association in men aged ≥50 years. The paradoxical relationship seen in young men only may reflect atrial electrical or structural abnormalities.


Assuntos
Fibrilação Atrial , Índice de Massa Corporal , Fibrilação Atrial/epidemiologia , Inquéritos Epidemiológicos , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco
4.
Liver Int ; 40(1): 120-130, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31518481

RESUMO

BACKGROUND & AIMS: Sarcopenia is reported to be associated with nonalcoholic fatty liver disease (NAFLD). Evaluation of skeletal muscle attenuation and area by computed tomography (CT) may represent a promising approach for evaluation of the risk of NAFLD. We examined the association between skeletal muscle characteristics and NAFLD and investigated the combined effect of these parameters on the prevalence of NAFLD. METHODS: In this cross-sectional study, we analysed data from 632 middle-aged Japanese subjects without daily alcohol intake (353 men and 279 women) from a cohort of employees undergoing annual health examinations. The cross-sectional skeletal muscle area was evaluated on the basis of CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. The subjects were divided into four study groups according to their SMI and SMD relative to median values. RESULTS: One hundred forty men and forty-three women had NAFLD. Total SMI (odds ratio [OR] per 1.0 cm2 /kg/m2 increase 0.43, 95% confidence interval [CI] 0.29-0.64 in men and OR 0.21, 95% CI 0.10-0.42 in women) and total SMD (OR, per 1.0 Hounsfield Unit increase 0.88, 95% CI 0.83-0.93 in men and 0.88, 0.82-0.95 in women) were significantly associated with the prevalence of NAFLD after adjusting for covariates. The subgroup with simultaneous presence of low SMI and low SMD was associated with a significantly higher prevalence of NAFLD compared with other groups. CONCLUSIONS: Both SMI and SMD are independently associated with the prevalence of NAFLD.


Assuntos
Composição Corporal , Músculo Esquelético/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Tomografia Computadorizada por Raios X , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Fatores de Risco
5.
Nutr Metab Cardiovasc Dis ; 30(7): 1161-1168, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32448718

RESUMO

BACKGROUND AND AIMS: The metabolic syndrome has been reported by cross-sectional studies to have an association with skeletal muscle quality and quantity. Using a longitudinal study design, this study aimed to explicate the association between muscle characteristics assessed with computed tomography (CT) and the incidence and progression of metabolic syndrome. METHODS AND RESULTS: In this retrospective study on a cohort of employees undergoing annual physical examinations, we evaluated data from 554 participants without metabolic syndrome. The cross-sectional skeletal muscle area was determined based on CT data at the level of the third lumbar vertebra, and the skeletal muscle density (SMD) and skeletal muscle index (SMI) were measured. The participants were divided into four study groups according to the sex-specific median values for SMI and SMD. We followed the participants for a mean period of 3.1 years. In the sex- and age-adjusted model, SMI and SMD had an interaction effect on the longitudinal change in number of metabolic syndrome components (ß = -0.074, p = 0.0727). Multiple regression analyses revealed that both low SMI and SMD was significantly associated with the change (ß = 0.131, p = 0.0281), whereas the low SMI and high SMD, and high SMI and low SMD were not. Both low SMI and SMD (hazard ratio (HR), 2.42; 95% confidence interval, 1.28-4.78) showed an increased adjusted HR for incident metabolic syndrome. CONCLUSION: The participants with both low quality and quantity of skeletal muscles were associated with the incidence and progression of metabolic syndrome, whereas those with only low quantity or quality of skeletal muscles were not.


Assuntos
Composição Corporal , Síndrome Metabólica/epidemiologia , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Progressão da Doença , Feminino , Nível de Saúde , Humanos , Incidência , Japão/epidemiologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Tronco
6.
Clin Kidney J ; 16(12): 2597-2604, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38046018

RESUMO

Background: Renal disease is a major problem in terms of community health and the economy. Skeletal muscle is involved in crosstalk with the kidney. We therefore investigated the relationship between muscle quality and quantity, and renal parenchymal volume (RPV). Methods: The association between the parameters of skeletal muscle and RPV/body surface area (BSA) was analyzed by computed tomography in 728 middle-aged participants without kidney disease or diabetes mellitus in a cross-sectional study. A retrospective cohort study of 68 participants was undertaken to analyze the association between changes in RPV/BSA and muscle parameters. Parameter change was calculated as follows: parameter at the follow-up examination/parameter at the baseline examination. The normal attenuation muscle (NAM) and low attenuation muscle (LAM) were identified by Hounsfield Unit thresholds of +30 to +150, and -29 to +29, respectively. Results: Positive correlations were found between estimated glomerular filtration rate and RPV/BSA (r = 0.451, P < .0001). Multiple regression analyses revealed that the NAM index was positively related to RPV/BSA (ß = 0.458, P < .0001), whereas the LAM index was negatively related to RPV/BSA (ß = -0.237, P < .0001). In this cohort study, a change in the LAM index was independently associated with a change in RPV/BSA (ß = -0.349, P = .0032). Conclusion: Both trunk muscle quantity and quality were associated with renal volume related to renal function in nondiabetic people. An increase in low quality muscle volume might be related to a decrease in renal volume.

7.
Clin Nutr ; 40(5): 3479-3484, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33298333

RESUMO

BACKGROUND & AIMS: Metabolic syndrome (MS) is associated with adverse outcomes, and visceral adipose tissue (VAT) is associated with MS. Recently, VAT has been classified into intraperitoneal VAT (IVAT) and retroperitoneal VAT (RVAT). This study aimed to evaluate the association of IVAT and RVAT with the prevalence of MS or its components. METHODS: In our cross-sectional study, the prevalence of MS or its components was analyzed in 803 middle-aged Japanese participants. The cross-sectional area of the abdominal adipose tissue was evaluated from an unenhanced computed tomography scan at the third lumbar vertebra, and IVAT or RVAT was analyzed using a specialized software. The areas were normalized for the square of the participants' height in meters and described as the IVAT or RVAT area index. RESULTS: In age, sex, and BMI adjusted model, the IVAT, or RVAT area index was independently associated with the prevalence of MS. After simultaneous inclusion of IVAT, RVAT, and deep and superficial subcutaneous adipose tissue area indices for multivariate logistic regression analysis, the IVAT area index was found to be independently associated with the prevalence of MS (adjusted odds ratio [OR], 1.03; 95% confidence intervals [CI], 1.02-1.08) and its components, including waist circumference (OR, 1.07; 95% CI, 1.03-1.10), glucose (1.03; 1.01-1.05), triglycerides (1.03; 1.00-1.05), and high-density lipoprotein cholesterol (1.03; 1.00-1.05), whereas the RVAT area index was not. The RVAT area index was independently associated with the prevalence of component-blood pressure (1.06; 1.02-1.11), whereas the IVAT area index was not. CONCLUSIONS: IVAT and RVAT are associated differently with the prevalence of MS and its components.


Assuntos
Gordura Intra-Abdominal/diagnóstico por imagem , Síndrome Metabólica , Adulto , Idoso , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Síndrome Metabólica/diagnóstico por imagem , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Triglicerídeos/sangue
8.
J Diabetes Investig ; 12(7): 1287-1292, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33206465

RESUMO

AIMS/INTRODUCTION: Sarcopenia and visceral obesity are major global public health issues, and higher mean corpuscular volume (MCV) levels are related to adverse outcomes. Nevertheless, no study has determined the association between MCV and body composition. Therefore, we evaluated the association between MCV levels and trunk muscle quality, muscle quantity and visceral fat area. MATERIALS AND METHODS: In our cross-sectional study, we investigated 702 middle-aged Japanese individuals without anemia and with normal MCV levels who underwent physical checkups. The cross-sectional area of skeletal muscle or visceral fat was analyzed by computed tomography. RESULTS: In the adjusted model, the MCV was independently associated with the visceral fat area index (ß = -0.107, P = 0.0007), total skeletal muscle index (ß = 0.053, P = 0.0341) and total skeletal muscle density (ß = 0.099, P = 0.0012). MCV as a continuous variable was related to the prevalence of sarcopenia (odds ratios [OR] 0.93, 95% confidence intervals (CI) 0.88-0.98, per 1.0 fL increment; P = 0.0097) and visceral obesity (OR 0.91, 95% CI 0.86-0.97, per 1.0 fL increment; P = 0.0046). The highest MCV quartile was independently associated with the prevalence of sarcopenia (OR 0.48, 95% CI 0.27-0.83; P = 0.0089) and visceral obesity (OR 0.49, 95% CI 0.27-0.88; P = 0.0170), compared with the lowest quartile. CONCLUSIONS: In individuals without anemia and with normal MCV levels, a lower MCV was associated with unfavorable body composition, including lower muscle quality, lower muscle quantity, sarcopenia and visceral obesity.


Assuntos
Composição Corporal , Índices de Eritrócitos , Obesidade Abdominal/sangue , Sarcopenia/sangue , Sarcopenia/epidemiologia , Idoso , Estudos Transversais , Feminino , Humanos , Gordura Intra-Abdominal/fisiopatologia , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Obesidade Abdominal/complicações , Razão de Chances , Prevalência , Fatores de Risco , Sarcopenia/etiologia , Tomografia Computadorizada por Raios X , Tronco/fisiopatologia
9.
Clin Nutr ; 39(6): 1818-1825, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31439352

RESUMO

BACKGROUND & AIMS: Metabolic syndrome is a cluster of metabolic abnormalities. Skeletal muscle attenuation and area evaluated by computer tomography (CT) may provide valuable information about patients with metabolic disorder. Therefore, we examined the association between skeletal muscle characteristics and metabolic syndrome, and investigated the combined effect of quantitative and qualitative muscle parameters. METHODS: In this cross-sectional study, we analyzed 808 middle-aged Japanese subjects. The cross-sectional area of skeletal muscle was evaluated based on CT at the third lumbar vertebrae. The subjects were divided into four groups according to the median levels of skeletal muscle index (SMI) and density (SMD). RESULTS: Eighty-five men and twenty-two women had metabolic syndrome. In the adjusted model, SMI and SMD had an interaction effect on the number of metabolic syndrome components (p = 0.0398 in men and p = 0.0306 in women). When SMI and SMD were considered as independent variables for multiple regression analysis, SMI (ß = -0.155, p = 0.0019 in men and ß = -0.295, p < 0.0001 in women) and SMD (ß = -0.355, p < 0.0001 in men and ß = -0.324, p < 0.0001 in women) were both independently associated with the number of metabolic syndrome components. The subgroup with presence of low SMI and low SMD levels had a significantly higher prevalence of metabolic syndrome than that observed in other groups. CONCLUSIONS: Therefore, we suggest that not only muscle quantity but also quality is independently associated with metabolic syndrome.


Assuntos
Composição Corporal , Síndrome Metabólica/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Valor Preditivo dos Testes , Prevalência , Estudos Retrospectivos , Tronco
10.
Clin Nutr ESPEN ; 40: 314-319, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183556

RESUMO

BACKGROUND & AIMS: Higher hemoglobin levels are associated with incident metabolic syndrome (MetS), and higher mean corpuscular volume (MCV) is associated with adverse outcomes. The objective of this study is to evaluate the combined effect of MCV and hemoglobin levels on incident MetS. METHODS: In our cross-sectional study, we analyzed the prevalence of MetS in 20,162 middle-aged Japanese subjects without anemia and with normal MCV levels, as they underwent physical checkups. We subsequently analyzed incident MetS in 11,110 subjects. In order to evaluate the combined effect on incident MetS, the subjects were divided into four study groups according to cutoff values of hemoglobin and MCV for identifying the prevalence of MetS. RESULTS: In the cross-sectional study, hemoglobin (adjusted odds ratio [aOR], 1.02; P < 0.0001 in men and OR, 1.04; P < 0.0001 in women, per 1.0 g/L) and MCV (aOR, 0.93; P < 0.0001 in men and OR, 0.94; P = 0.0005 in women, per 1.0 fL) were independently associated with the prevalence of MetS. In the longitudinal cohort study, hemoglobin (adjusted hazards ratio [aHR, 1.12; P = 0.0006, per 1.0 g/L) and MCV (aHR, 0.96; P < 0.0001, per 1.0 fL) were independently associated with incident MetS in men but not in women. Then, the lower hemoglobin/higher MCV group showed decreased HRs for incidence of MetS compared with other groups of men but not of women. CONCLUSIONS: Among the subjects without anemia and with normal MCV levels, higher hemoglobin or lower MCV levels were associated with higher prevalence of MetS in men and women. In addition, lower hemoglobin with higher MCV showed a decreased risk of MetS in men. We suggested that the assessment of hemoglobin and MCV levels could be used as practical screening tool for MetS.


Assuntos
Índices de Eritrócitos , Síndrome Metabólica , Estudos de Coortes , Estudos Transversais , Feminino , Hemoglobinas , Humanos , Estudos Longitudinais , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade
11.
Diabetol Metab Syndr ; 12(1): 103, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33292449

RESUMO

AIM: Diabetes mellitus (DM) is associated with adverse outcomes, and visceral adipose tissue (VAT), classified into intraperitoneal VAT (IVAT) and retroperitoneal VAT (RVAT), is associated with insulin resistance. This study aimed to evaluate the association of IVAT and RVAT with the prevalence or incidence of DM. METHODS: In this cross-sectional, retrospective, cohort study, the prevalence and incidence of DM was analyzed in 803 and 624 middle-aged Japanese participants, respectively. The cross-sectional area of the abdominal adipose tissue was evaluated from an unenhanced computed tomography scan at the third lumbar vertebrae, and the IVAT or RVAT was analyzed using specialized software. The areas were normalized for the square value of the participants' height in meters and described as the IVAT or RVAT area index. RESULTS: The IVAT area index (adjusted odds ratio [OR], 1.04; 95% confidence intervals [CI], 1.02-1.07, per 1.0 cm2/m2) or IVAT/RVAT area ratio (1.89; 1.23-2.85, per 1.0) was independently associated with the prevalence of DM, whereas the RVAT area index was not. During a follow-up (mean) of 3.7 years, 30 participants were diagnosed with DM. The IVAT area index (adjusted hazards ratio [HR], 1.02; 95% CI 1.003-1.04, per 1.0 cm2/m2) or IVAT/RVAT area ratio (2.25; 1.40-3.43, per 1.0) was independently associated with the incidence of DM, whereas the RVAT area index was not. CONCLUSIONS: IVAT, but not RVAT, is associated with the prevalence or incidence of DM.

12.
Nutrition ; 74: 110752, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32203879

RESUMO

OBJECTIVES: Diabetes mellitus is a major global public health issue. Cross-sectional studies have demonstrated that skeletal muscle quality and quantity by computed tomography (CT) is related to glucose metabolism. However, to our knowledge, no longitudinal study has yet to elucidate the association between muscle quality determined by CT and glucose metabolism. Thus, the aim of this study was to evaluate the association between muscle quality and glucose metabolism. METHODS: In this retrospective study, we evaluated data from 621 middle-aged Japanese individuals without diabetes mellitus from a cohort of employees undergoing annual physical examinations. The cross-sectional skeletal muscle area was determined based on CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. Low-attenuation muscle (LAM) and normal-attenuation muscle (NAM) were identified and quantified using thresholds of -29 to +29 HU and +30 to +150 HU, respectively. RESULTS: We followed the individuals for a mean period of 3 y, and 27 of them developed diabetes mellitus during this period. Multiple Cox regression analyses revealed that, even after adjustment for visceral fat area index, the LAM index (hazard ratio [HR], 3.07; 95% confidence interval [CI], 1.00-7.52) showed an increased adjusted HR for incident diabetes mellitus. When total SMI and SMD were used in the same models, only total SMD (HR, 0.90; 95% CI, 0.81-0.99) showed a decreased adjusted HR for incident diabetes mellitus. CONCLUSIONS: Both LAM index and total SMD were associated with a higher risk for incident diabetes mellitus, whereas NAM index and total SMI were not.


Assuntos
Diabetes Mellitus , Músculo Esquelético , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus/epidemiologia , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Estudos Retrospectivos
13.
Diabetol Metab Syndr ; 11: 12, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30740147

RESUMO

BACKGROUND: Metabolic syndrome is characterized by the clustering of different metabolic abnormalities. Total bilirubin and gamma-glutamyltransferase (GGT) levels have been reported to be associated with this condition. However, the extent to which the interaction between these parameters affects metabolic syndrome is unknown. Therefore, we examined the association of total bilirubin and GGT levels with metabolic syndrome, and investigated the combined effect of the two parameters. METHODS: In this retrospective cohort study, we analyzed 8992 middle-aged Japanese subjects (4586 men, 4406 women; mean age, 44.8 ± 9.3 years) without metabolic syndrome from a cohort of employees undergoing annual health examinations. They were divided into four groups according to median total bilirubin and GGT levels: both-low, GGT-high, total bilirubin-high, and both-high. The incident of metabolic syndrome was evaluated during a follow-up of 2.8 ± 1.2 years. RESULTS: The incident rate of metabolic syndrome during the follow-up was 4.6% in the both-low group, 12.1% in the GGT-high group, 2.7% in the total bilirubin-high group, and 10.6% in the both-high group. Total bilirubin and GGT have an interaction effect on the risk of incident metabolic syndrome (p = 0.0222). The both-low [hazard ratio (HR), 1.37; 95% confidence interval (CI) 1.002-1.89], GGT-high (HR, 1.88; 95% CI 1.42-2.52), and both-high (HR, 2.07; 95% CI 1.56-2.80) groups showed an increased adjusted HR for incident metabolic syndrome after adjusting for covariates compared with the total bilirubin-high group. CONCLUSIONS: The simultaneous presence of high total bilirubin and low GGT levels may be associated with a lower incidence of metabolic syndrome.

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