Helena Harima

Effects of an intervention in eating habits and physical activity in Japanese-Brazilian women with a high prevalence of metabolic syndrome in Bauru, São Paulo State, Brazil

We evaluated the impact of a lifestyle intervention on the cardiometabolic risk profile of women participating in the Study on Diabetes and Associated Diseases in the Japanese-Brazilian Population in Bauru. This was a non-controlled experimental study including clinical and laboratory values at baseline and after a 1-year intervention period. 401 Japanese-Brazilian women were examined (age 60.8+/-11.7 years), and 365 classified for metabolic syndrome (prevalence = 50.6%). Subjects with metabolic syndrome were older than those without (63.0+/-10.0 vs. 56.7+/-11.6 years, p < 0.01). After intervention, improvements in variables were found, except for C-reactive protein. Body mass index and waist circumference decreased, but adiposity reduction was more pronounced in the abdominal region (87.0+/-9.7 to 84.5+/-11.2cm, p < 0.001). Intervention-induced differences in total cholesterol, LDL, and post-challenge glucose were significant; women who lost more than 5% body weight showed a better profile than those who did not. The lifestyle intervention in Japanese-Brazilian women at high cardiometabolic risk improved anthropometric and laboratory parameters, but it is not known whether such benefits will persist and result in long-term reduction in cardiovascular events.

Associação do eletrocardiograma com diabete melito e síndrome metabólica em nipo-brasileiros

FUNDAMENTO: Al migrar hacia las Americas, los japoneses se sometieron a un proceso de occidentalizacion, con estilo de vida, y especialmente dieta, muy diferente, lo que puede explicar el aumento de diabetes mellitus (DM), sindrome metabolico (SM) y enfermedades cardiovasculares. OBJETIVO: Analizar la presencia de necrosis miocardica e hipertrofia ventricular izquierda (HVI), indicada en ECG, y su relacion con DM y SM en poblacion de nipobrasilenos. METODOS: Estudio transversal que evaluo a 1.042 nipobrasilenos con edad superior a 30 anos: 202 nacidos en Japao (iseis) y 840 nacidos en Brasil (niseis), provenientes de la segunda fase del estudio Japanese-Brazilian Diabetes Study Group iniciado en 2000. Se definio el SM desde los criterios de la NCEP-ATP III, modificados para los japoneses. La presencia de DM y SM se asocio a la formacion de necrosis miocardica, segun el de Minnesota, y de HVI segun el criterio de Perugia, ambas reveladas en el ECG. Se utilizo el metodo estadistico del Chi-cuadrado para rechazo de la hipotesis de nulidad. RESULTADOS: De los 1.042 participantes, el 35,3% presentaba DM (el 38,6% entre los iseis y el 34,5% en niseis); el 51,8% tenian SM (el 59,4% entre iseis y el 50,0% en niseis). La presencia de zona inactiva en los iseis diabeticos no se mostro estadisticamente significante, si se la compara a los no diabeticos; sin embargo, entre los niseis diabeticos la zona inactiva se presentaba en el 7,5%. Hubo correlacion estadisticamente significante entre el SM y la HVE entre iseis y niseis. CONCLUSION: Disturbios metabolicos tuvieron alta prevalencia en nipobrasilenos con correlaciones significantes con necrosis e hipertrofia reveladas por el ECG.BACKGROUND When the Japanese immigrated to the Americas, they were subjected to Westernization, with a great change in lifestyle, specially in dietary habits, and this may explain the increase in the incidence of diabetes mellitus (DM), metabolic syndrome (MS) and cardiovascular disease among them. OBJECTIVE To study the presence of myocardial necrosis and left ventricular hypertrophy (LVH) in a population of Japanese-Brazilians, using the ECG and its relationship with DM and MS. METHODS This was a cross-sectional study which evaluated 1,042 Japanese-Brazilians aged 30 or over, 202 of them born in Japan (Issei) and 840 of them born in Brazil (Nissei), from the second phase of the Japanese-Brazilian Diabetes Study Group initiated in 2000. MS was defined according to the NCEP-ATP III criteria modified for the Japanese. DM and MS were associated with the presence of myocardial necrosis (according to the Minnesota criteria) and LVH (according the Perugia score on the ECG). The statistic chi square method was used to reject the null hypothesis. RESULTS Of the 1,042 participants, 35.3% had DM (38.6% of the Issei and 34.5% of the Nissei); 51.8% had MS (59.4% of the Issei and 50.0% of the Nissei). The presence of an inactive zone in the diabetic Issei group was not statistically significant when compared to the non-diabetic group, but among the diabetic Nissei group an inactive zone was present in 7.5% of them. There was a statistically significant correlation between MS and LVH in the Issei and Nissei groups. CONCLUSION Metabolic disorders presented a high prevalence in Japanese-Brazilians with significant correlations with necrosis and hypertrophy on the ECG.

Hyperuricemia and associated factors: a cross-sectional study of Japanese-Brazilians

This cross-sectional study aimed to estimate the prevalence of hyperuricemia and associated risk factors among Japanese-Brazilians. We obtained data on demographic, health history, food intake, and laboratory variables. Chi-square and prevalence ratios were used as measures of association. 35.3% of the subjects presented hyperuricemia, which was more frequent in smokers, males, age > 55 years, with co-morbidities, individuals on uric acid-increasing medication, serum creatinine > 1.4 mg/dL, high alcohol consumption, and low consumption of milk and dairy products. In the multivariate analysis, the associations remained significant with gender, overweight, central obesity, hypertriglyceridemia, and use of specific drugs. Among males, low intake of saturated fat was associated with hyperuricemia. Individuals with hypertension showed a negative association with dairy product consumption. The high hyperuricemia prevalence suggests that changes in nutritional profile and control of associated co-morbidities could help minimize occurrence of this condition.

Effect of glucan on murine lupus evolution and on host resistance to Klebsiella pneumoniae

Glucan is a polysaccharide from the yeast Saccharomyces cerevisiae that stimulates the mononuclear phagocytic system (MPS). NZB/NZW F1 mice were divided into two groups: one group received a subcutaneous injection of 0.5 mg glucan/animal for 1 week, and the other received the same dose for 3 months. No changes were observed in those animals submitted to short‐term glucan treatment, whereas animals with active lupus and submitted to long‐term glucan administration presented early death, with significant differences in accumulated mortality rates over 33–37 weeks, when compared to controls. No deaths were observed in lupus mice treated with glucan 24 hours before the induction of septic shock by Klebsiella pneumoniae, in contrast to mortality of 95.3% in the control group during the follow‐up period of 12 days. We conclude that although glucan is able to exacerbate lupus activity, it enhances resistance to infection in lupus mice. J. Clin. Lab. Anal. 11:175–178, 1997.

Predictive factors of non-deterioration of glucose tolerance following a 2-year behavioral intervention.

AimTo identify predictive factors associated with non-deterioration of glucose metabolism following a 2-year behavioral intervention in Japanese-Brazilians.Methods295 adults (59.7% women) without diabetes completed 2-year intervention program. Characteristics of those who maintained/improved glucose tolerance status (non-progressors) were compared with those who worsened (progressors) after the intervention. In logistic regression analysis, the condition of non-progressor was used as dependent variable.ResultsBaseline characteristics of non-progressors (71.7%) and progressors were similar, except for the former being younger and having higher frequency of disturbed glucose tolerance and lower C-reactive protein (CRP). In logistic regression, non-deterioration of glucose metabolism was associated with disturbed glucose tolerance - impaired fasting glucose or impaired glucose tolerance - (p < 0.001) and CRP levels ≤ 0.04 mg/dL (p = 0.01), adjusted for age and anthropometric variables. Changes in anthropometry and physical activity and achievement of weight and dietary goals after intervention were similar in subsets that worsened or not the glucose tolerance status.ConclusionThe whole sample presented a homogeneous behavior during the intervention. Lower CRP levels and diagnosis of glucose intolerance at baseline were predictors of non-deterioration of the glucose metabolism after a relatively simple intervention, independent of body adiposity.

União interétnica de nipo-brasileiros associada a hábitos alimentares menos saudáveis e ao pior perfil de risco cardiometabólico

OBJECTIVE: Interethnic marriage between nikkey Brazilians and non-nikkey Brazilians may favor the westernization of diet. Dietary consumption, clinical data and frequencies of metabolic diseases were compared in a Japanese-Brazilian population, with intraethnic or interethnic marriage. METHODS: T test, Mann-Whitney, chi-square and Person coefficient were used. RESULTS: Among 1009 Japanese-Brazilians there were 18.9% of interethnic marriage, being more frequent among nikkey men. These showed higher means of BMI, waist, blood pressure, glycemia and triglyceridemia than women. Overall frequencies of obesity, hypertrigliceridemia and metabolic syndrome were 47.7%, 68.1% and 45.2%, being higher in interethnic than intraethnic marriage. Comparing individuals with interethnic marriages, hypertriglyceridemia was more common among men while low-HDL among women. Energy, fat, groups of alcohol, sweets and oils were higher in interethnic marriage. Individuals with intraethnic marriage consumed more carbohydrate, proteins, fibers, vitamins, minerals, vegetables, fruits/juice, cereals and missoshiru. Comparing individuals with interethnic marriages, nikkey men showed a more westernized dietary pattern than nikkey women. CONCLUSION: Interethnic marriage was associated with less healthy food habits and worse cardiometabolic profile.

Distúrbios no perfil lipídico são altamente prevalentes em população nipo-brasileira

High prevalence of diabetes has been previously reported in Japanese-Brazilians. In an attempt to better estimate the cardiometabolic risk, this study evaluated lipid disorders in 1,330 Japanese-Brazilians (46% men) aged >30 years. Hypercholesterolemia was defined as serum cholesterol > 240 mg/dL, hypertriglyceridemia as values > 150 mg/dL and low-HDL-C as values <40 mg/dL and <50 mg/dl for men and women respectively. The prevalence of dyslipidemias was compared by the chi-square test between gender and glycemic category. Mean and Standard Deviation of lipids and lipoproteins were compared by the Student t-Test between gender. Hypertriglyceridemia was detected in 66.0% [95% CI: 63.5-68.5] of the population, being more common in men and increasing with deterioration of glucose metabolism. Mean level of triglycerides was 235.7±196.3 mg/dL. The prevalence of hypercholesterolemia was 24.4% [95% CI: 22.1- 26.7]. Low HDL-C was observed in 17.5% [95% CI: 14.5-20.5] of men and 43.0% [95% CI: 39.4- 46.6] of women but total / HDL-cholesterol ratio was lower in women (4.23 ± 0.68 vs. 4.40 ± 0.73, p<0.001). In Japanese-Brazilians, hypertriglyceridemia is the commonest dyslipidemia, in agreement with the high prevalence of diabetes. Men showed a worse lipid profile than women; it was suggested that the Western diet and living habits could be deteriorating their health.

Asociación del electrocardiograma con diabetes mellitus y síndrome metabólico en nipobrasileños

FUNDAMENTO: Al migrar hacia las Americas, los japoneses se sometieron a un proceso de occidentalizacion, con estilo de vida, y especialmente dieta, muy diferente, lo que puede explicar el aumento de diabetes mellitus (DM), sindrome metabolico (SM) y enfermedades cardiovasculares. OBJETIVO: Analizar la presencia de necrosis miocardica e hipertrofia ventricular izquierda (HVI), indicada en ECG, y su relacion con DM y SM en poblacion de nipobrasilenos. METODOS: Estudio transversal que evaluo a 1.042 nipobrasilenos con edad superior a 30 anos: 202 nacidos en Japao (iseis) y 840 nacidos en Brasil (niseis), provenientes de la segunda fase del estudio Japanese-Brazilian Diabetes Study Group iniciado en 2000. Se definio el SM desde los criterios de la NCEP-ATP III, modificados para los japoneses. La presencia de DM y SM se asocio a la formacion de necrosis miocardica, segun el de Minnesota, y de HVI segun el criterio de Perugia, ambas reveladas en el ECG. Se utilizo el metodo estadistico del Chi-cuadrado para rechazo de la hipotesis de nulidad. RESULTADOS: De los 1.042 participantes, el 35,3% presentaba DM (el 38,6% entre los iseis y el 34,5% en niseis); el 51,8% tenian SM (el 59,4% entre iseis y el 50,0% en niseis). La presencia de zona inactiva en los iseis diabeticos no se mostro estadisticamente significante, si se la compara a los no diabeticos; sin embargo, entre los niseis diabeticos la zona inactiva se presentaba en el 7,5%. Hubo correlacion estadisticamente significante entre el SM y la HVE entre iseis y niseis. CONCLUSION: Disturbios metabolicos tuvieron alta prevalencia en nipobrasilenos con correlaciones significantes con necrosis e hipertrofia reveladas por el ECG.BACKGROUND When the Japanese immigrated to the Americas, they were subjected to Westernization, with a great change in lifestyle, specially in dietary habits, and this may explain the increase in the incidence of diabetes mellitus (DM), metabolic syndrome (MS) and cardiovascular disease among them. OBJECTIVE To study the presence of myocardial necrosis and left ventricular hypertrophy (LVH) in a population of Japanese-Brazilians, using the ECG and its relationship with DM and MS. METHODS This was a cross-sectional study which evaluated 1,042 Japanese-Brazilians aged 30 or over, 202 of them born in Japan (Issei) and 840 of them born in Brazil (Nissei), from the second phase of the Japanese-Brazilian Diabetes Study Group initiated in 2000. MS was defined according to the NCEP-ATP III criteria modified for the Japanese. DM and MS were associated with the presence of myocardial necrosis (according to the Minnesota criteria) and LVH (according the Perugia score on the ECG). The statistic chi square method was used to reject the null hypothesis. RESULTS Of the 1,042 participants, 35.3% had DM (38.6% of the Issei and 34.5% of the Nissei); 51.8% had MS (59.4% of the Issei and 50.0% of the Nissei). The presence of an inactive zone in the diabetic Issei group was not statistically significant when compared to the non-diabetic group, but among the diabetic Nissei group an inactive zone was present in 7.5% of them. There was a statistically significant correlation between MS and LVH in the Issei and Nissei groups. CONCLUSION Metabolic disorders presented a high prevalence in Japanese-Brazilians with significant correlations with necrosis and hypertrophy on the ECG.