Kumiko Furuki

Higher heart rate may predispose to obesity and diabetes mellitus: 20-year prospective study in a general population.

BACKGROUND Emerging evidence indicates an association between sympathetic activation and metabolic syndrome. However, sympathetic activation in metabolic syndrome may be a cause, consequence, or just epiphenomenon. To elucidate this issue, the predictive power of resting heart rate for the development of abnormal glucose and lipid metabolisms after 20 years was evaluated in a general population. METHODS A total of 637 participants (>20 years old) underwent a health examination in 1979 including measurements of blood chemistries. Resting heart rate (bpm) was measured by an electrocardiogram. In 1999, all of the study participants again underwent a health examination, including electrocardiogram and blood chemistries. Because four of them had atrial fibrillation, and 19 subjects were taking antihypertensive medication in 1979, they were excluded from analysis. Therefore, a complete dataset of 614 subjects was available. RESULTS As was reported in our previous article, in 1999 we found a linear and significant (P < 0.05) cross-sectional relationship between resting heart rate and a cluster of cardiometabolic risk factors (blood pressure (BP), free fatty acid (FFA), plasma glucose, and homeostasis model assessment (HOMA) index). Baseline higher heart rate (heart rate >or=80 bpm in 1979) predicted the development of obesity, diabetes mellitus (DM), and insulin resistance in 1999 after adjustments for age, sex, and other confounders. CONCLUSION This is one of the first prospective reports demonstrating that higher heart rate may predispose to the development of obesity and DM, suggesting that the sympathetic nerve system may play a role in the development of obesity and DM.

Plasma Level of Asymmetric Dimethylarginine (ADMA) as a Predictor of Carotid Intima-Media Thickness Progression: Six-Year Prospective Study Using Carotid Ultrasonography

This study was designed to determine the relationship between plasma asymmetric dimethylarginine (ADMA) and the development of carotid atherosclerosis. Cross-sectional studies have revealed that plasma ADMA concentration is correlated with the intima-media thickness (IMT) of the carotid artery, but no prospective studies have appeared. Therefore we prospectively investigated whether or not plasma ADMA level can predict IMT progression. In a community-based cohort, we enrolled 712 subjects who were over 40 years old and who had no apparent cardiovascular diseases according to high-resolution carotid ultrasonography. Blood chemistries including ADMA were measured at baseline. In 575 subjects, IMT was re-measured 6 years later. The value of baseline ADMA for predicting IMT changes was investigated by multivariable analysis. At baseline, there was a significant (β=0.321; p<0.001) relationship between IMT and ADMA levels. Multiple linear regression analysis revealed that baseline ADMA (β=0.241; p<0.01) was the only predictor of IMT progression after adjustments for age, sex, baseline IMT, and four major risk factors (hypertension, hypercholesterolemia, diabetes mellitus, and smoking) plus hyperuricacidemia. Plasma ADMA was a predictor of carotid IMT progression.

Serum Dehydroepiandrosterone Sulfate Levels Predict Longevity in Men: 27‐Year Follow‐Up Study in a Community‐Based Cohort (Tanushimaru Study)

OBJECTIVES: To determine whether serum dehydroepiandrosterone sulfate (DHEAS) levels could predict longevity in residents.

P-240 Strong Association Between Plasma Aldosterone and Metabolic Syndrome. An Epidemiologic Study in Japanese General Population

ratio, 1.9 (95%CI: 1.09 3.33), 2.04 (956%CI:1.01 4.15) and 2.98 (95%CI: 1.36 6.55) respectively. This association of the ECG abnormalities with coronary death was independent of age, body mass index, systolic blood pressure, serum cholesterol level, blood sugar level, smoking and drinking. Conclusion: ST-segment depression, T-wave abnormality and ST-T abnormality in ECG are associated with significantly higher risk for CVD and CHD mortality in women.

P-206 Serum MCP-1 Levels Are Strongly Associated with Higher Ratio of LDL- to HDL-Cholestrol Levels and Lower Estimated GFR

cholesterol, triglyceride (TG), and high density lipoprotein (HDL) cholesterol at baseline and four weeks after treatment with the statin. Results: The total cholesterol and LDL levels in both groups were significantly decreased four weeks later, and HDL level was significantly increased in both groups, but not TG level in vytorin group. In addition, the change of LDL cholesterol in vytorin group was significantly higher than it in lipitor (52.4% vs 44.1% respectively p < 0.05). The central PWV (cfPWV) and peripheral PWV (cfPWV) in lipitor group was significantly decreased compared with those in vytorin group (p < 0.05). Conclusions: Although co-administration of simvastatin and ezetimibe might show much more lipid lowering effect compared with atorvastatin, only atorvastatin might show pleiotrophic effect for short-term treatment in hypercholesterolemia.

P-227 LDL-C/HDL-C Ratio Predicts IMT Progression More than HDL-C or LDL-C alone: 8-Year Follow-Up Study in a General Population

Purpose: Cyanotic congenital heart disease (CCHD) induces secondary erythrocytosis and CCHD is thought to be one of the risk factors for cholelithiasis, but the frequency of cholelithiasis and/or gallstones in patients with CCHD is unknown. Materials and Methods: A hundred and two patients with CHD were divided into 4 groups: group A 22 CCHD without reparative surgery or with palliative surgery; group B 35 CCHD after repair who were eliminated cyanosis; group C 17 acyanotic CHD without repair; and group D 28 acyanotic CHD after repair. Gallstones were studied by abdominal ultrasonography or CT in each patient. For analysis of risk factors, patient records regarding cyanotic period, family history and past abdominal surgery were reviewed and blood pressures, lipid profiles, blood sugar and liver enzyme were evaluated. Results: Cholecystectomy due to cholelithiasis was underwent in 7 of 279 CCHD patients (2.5%). In group A, 7 patients (31%) underwent cholecystectomy, and 3 patients (18%) have gallstones. In group B, 11 patients (37%) had gallstones. In group C, nobody had gallstones, and in group D 2 patients (7%) had gallstones. SPO2 was significantly lower and red blood cell, hemoglobin, hematocrit, HbA1C and total bilirubin levels were significantly higher in group A (p 19.8, 95%CI 1.30 300.1). Conclusions: The incidence of cholelithiasis and gallstones is significantly high in CCHD regardless of repair. The most important factor related to gallstones was having CCHD even after desaturation was improved by surgical repair.