Erdembileg Anuurad

The New BMI Criteria for Asians by the Regional Office for the Western Pacific Region of WHO are Suitable for Screening of Overweight to Prevent Metabolic Syndrome in Elder Japanese Workers

The New BMI Criteria for Asians by the Regional Office for the Western Pacific Region of WHO are Suitable for Screening of Overweight to Prevent Metabolic Syndrome in Elder Japanese Workers: Erdembileg Anuurad, et al. Department of Environmental and Preventive Medicine, Shimane University School of Medicine—Obesity occurs less frequently in Japanese than in various other ethnic populations. A person with abnormal glucose tolerance is often found to have one or more of the other cardiovascular disease risk factors, such as obesity, hypertension and hyperlipidemia. This clustering has been labeled as metabolic syndrome (WHO, 1998). It was suggested that Japanese, categorized as having normal weight (BMI of less than 25.0), as defined by the WHO (2000), have an increasing tendency toward metabolic syndrome. Our objective was to analyze metabolic syndrome in “Overweight” with BMI of 23.0–24.9 in Japanese workers, and to assess the suitability for Asians of the Regional Office for the Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000). We conducted a cross‐sectional study in the workplace setting and investigated the relationship between BMI classification based on WPRO criteria and metabolic syndrome by gender and age group (18–44 yr vs. 45–60 yr). Three hundred seventy‐nine men and 432 women Japanese workers participated in this study. BMI were categorized as 20% “Overweight” (23.0–24.9 BMI), 20% “Obese I” (25.0–29.9 BMI) and 2% “Obese II” (over 30.0 BMI), based on WPRO criteria. Graded increases in BMI were positively associated with body fat percentage, waist circumference, hip circumference and waist/hip ratio in both genders and age groups. A progressively increasing BMI category in the elder group aged 45– 60 yr in both genders was positively related with parameters constituting metabolic syndrome. Graded increases in BMI classes in elder workers based on WPRO criteria were positively associated with prevalence of metabolic syndrome, and “Overweight” elder women had significantly higher prevalence of metabolic syndrome. The present investigation, based on the increasing risks of “Overweight” with a BMI of 23.0–24.9, suggests that WPRO criteria are suitable for Japanese workers aged over 45 yr.

Overweight Japanese with body mass indexes of 23.0-24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians.

OBJECTIVE: The degree of obesity of Asians is less than that of Caucasians. It has been suggested that Japanese, categorized as having normal weight (BMI<25.0), as defined by WHO (2000), have a tendency toward increased incidences of dyslipidemia and diabetes. Our objective was to analyze parameters constituting obesity-associated disorders in overweight Japanese and Mongolians with a body mass index (BMI) of 23.0–24.9, and to assess the suitability for Asians of the Regional Office for Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000).DESIGN: Cross-sectional study in a workplace setting.SUBJECTS: A total of 386 Japanese men and 363 Japanese women, and 102 Mongolian men and 155 Mongolian women.MEASUREMENTS: Anthropometric measurements (weight, height, waist circumference, hip circumference and blood pressure) and metabolic measurements (plasma levels of total cholesterol, HDL cholesterol, triglyceride, glucose and insulin).RESULTS: Graded increases in BMI of Japanese and Mongolians were positively associated with body fat percent, waist circumference, hip circumference and waist/hip ratio. The Japanese were categorized as 22% overweight, 22% obese I, 3% obese II; the Mongolians rated as 18% overweight, 34% obese I, 19% obese II, based on the WPRO BMI criteria. The Mongolians had a higher prevalence of obesity and a higher body fat percent, but a lesser gradation of dyslipidemia, than did the BMI-matched Japanese groups. Overweight Japanese (BMI 23.0–24.9), in comparison to normal Japanese (BMI 18.5–22.9), had significant differences in systolic blood pressure, HDL-choresterol and triglyceride in men, and in systolic and diastolic blood pressure, HDL-choresterol, triglyceride, insulin and Homoeostasis model assessment-insulin resistance in women. In contrast, the Mongolians showed no significant differences in metabolic parameters between overweight and normal subjects, except for diastolic blood pressure.CONCLUSION: Since the relationship between abdominal fat mass and BMI is ethnic-specific, a universal BMI cutoff point is inappropriate for Asian populations such as the Japanese and Mongolians. The present investigation suggests that, while the WPRO criteria are suitable for Japanese, the WHO criteria are more appropriate for Mongolians.

Prevalence of the metabolic syndrome using the modified ATP III definitions for workers in Japan, Korea and Mongolia.

Prevalence of the Metabolic Syndrome using the Modified ATP III Definitions for Workers in Japan, Korea and Mongolia: Kuninori Shiwaku, et al. Department of Environmental and Preventive Medicine, Shimane University School of Medicine— A clustering of insulin resistance, hypertension and dyslipidemia has been labeled as the metabolic syndrome. Asians have a lower frequency of obesity than do Caucasians, but have an increasing tendency toward metabolic syndrome. Most data on metabolic syndrome are based on studies from Western countries with only limited information derived from Asian populations. We conducted a cross‐sectional study of individuals aged 30–60 yr in workplace settings. We examined and analyzed the health data of 1,384 Japanese, Koreans and Mongolians for metabolic syndrome based on the modified definitions of the working definition proposed by the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III definition). The prevalence of metabolic syndrome using the ATP III‐BMI30 and ATP III‐BMI25 definitions was 7% and 12% for Japanese, 7% and 13% for Koreans, and 12% and 16% for Mongolians, respectively. With the exception of obesity, the prevalences of individual metabolic abnormalities within each of the three Asian groups were similar to each other and to reported rates of prevalence in the U.S.A. Nevertheless, the values of sensitivity and specificity by the metabolic syndrome definitions are remarkably different relative to ethnicity. A universal metabolic syndrome definition is inappropriate for comparisons of metabolic syndrome among Asian ethnic groups. We believe that the ATP III‐BMI25 definition is suitable for the determination of metabolic syndrome among Japanese and Koreans, and that the ATP III‐BMI30 is more appropriate for Mongolians.

Difficulty in losing weight by behavioral intervention for women with Trp64Arg polymorphism of the β3-adrenergic receptor gene

OBJECTIVE: Trp64Arg mutation in the β 3-adrenergic receptor (β 3AR) gene is relatively common in Japanese people. However, it has not been clear whether persons with Trp64Arg mutation in the β 3AR gene tend to have obesity and difficulty in losing weight even with a restricted diet and exercise. We investigated the response of body weight and metabolic factors to behavioral intervention in Japanese women with Trp64Arg mutation in the β 3AR gene.DESIGN: A 3-month behavioral intervention study using a combination of diet and exercise programs.SUBJECTS: A total of 76 perimenopausal women with no clinical symptoms (age: 54.7±7.7 y, body mass index (BMI): 21.0–33.0 kg/m2).MEASUREMENTS: Anthropometric measurements (weight, height, body fat, waist circumference, hip circumference, skin fold, resting energy expenditure and blood pressure) and metabolic measurements (serum levels of cholesterol, triglyceride, phospholipid, nonesterified fatty acid, glucose, insulin and leptin) and determination of the β 3AR genotype by polymerase chain reaction followed by BstNI digestion.RESULTS: At the baseline of BMI, body weight, body fat, waist circumference, hip circumference, the arm skin fold, resting energy expenditure, or blood lipid and glucose profiles, there was no significant difference in participants with/without mutation of the β 3AR gene. The intervention yielded a body weight reduction in 69 and 48%, and induced a significant difference in weight loss (−0.74 and −0.01 kg) for women with wild-type and Trp64Arg mutation, respectively. Significant differences of anthropometric parameters were found in body weight, BMI, waist and hip circumferences and blood pressure of wild type by the intervention. However, women with Trp64Arg mutation did not show significant changes in these anthropometric parameters, except for hip circumference. A significant difference was found in high-density lipoprotein cholesterol (HDL-C) and in the low-density lipoprotein cholesterol/HDL-C ratio in both genotypes.CONCLUSION: The results of the present study suggest that the Trp64Arg mutation of the β 3AR gene is associated with difficulty in losing weight through behavioral intervention, although it is not related to obesity-related phenotypes and resting energy expenditure before the intervention.

Ethnic differences in the formation of small LDL particles in Asians: a comparison of Koreans, Japanese and Mongolians

Background  The presence of small, dense LDL particles has been recognized as an independent risk factor for coronary heart disease (CHD) but is not directly representative of CHD mortality rate beyond any given population. We investigated whether such inconsistency between three Asian ethnic groups might have arisen from anthropometric and metabolic factors.