Mayumi Nagano

Relative contributions of cardiorespiratory fitness and visceral fat to metabolic syndrome in patients with diabetes mellitus.

The objective of this study was to examine the contribution of endurance fitness and visceral fat accumulation on the prevalence of metabolic syndrome in Japanese male patients with either an impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM). The subjects of this cross-sectional study consisted of 135 Japanese male patients with either IGT or type 2 DM who had not taken any medication or intervention. They were classified into three fitness categories (low, moderate, and high) based on the tertiles of their maximal oxygen uptake ( [Formula: see text] O(2)max) predicted by the Astrand nomogram using a cycle ergometer. Metabolic syndrome was defined based on the WHO criteria. The visceral fat area (VFA) was determined using a computed tomography scan. The age- and VFA-adjusted odds ratio was 3.49 (95% CI, 1.13-10.82) for subjects in the low fitness category in comparison to those in the high fitness category. We calculated the odds ratio for the prevalence of metabolic syndrome in the nine categories classified based on the three VFA and three [Formula: see text] (2)max levels. In Moderate- and Low- [Formula: see text] (2) max categories, the odds ratios increased in line with increases in the VFA level. The highest odds ratios were observed in the low fitness and high visceral fat group. In the High- [Formula: see text] O(2)max category, no significant odds ratios were observed in the Moderate- and High-VFA categories. These results indicate that a high degree of cardiorespiratory fitness positively contributed to the low prevalence of metabolic syndrome in Japanese male patients with IGT and type 2 DM.

Cardiorespiratory Fitness and Visceral Fat Impact the Relationship between Psychological Fitness and Metabolic Syndrome in Japanese Males with Type 2 Diabetes Mellitus

BACKGROUND It has been unclear whether psychological distress and prevalence of metabolic syndrome (MS) is associated independent of cardiorespiratory fitness and/or visceral fat area in patients with type 2 diabetes mellitus (type 2 DM). METHODS Ninety-seven newly diagnosed Japanese men with type 2 DM (aged 26-81) who did not receive any intervention or pharmacological therapy were divided into two groups of highly distressed (HD) and less distressed (LD) by the cutoff point of the General Health Questionnaire (GHQ). In addition, cardiorespiratory fitness (estimated oxygen uptake: [Formula: see text] O(2)max), visceral fat area (VFA), glucose and lipid metabolism, and resting blood pressure were assessed. MS was defined based on the criteria proposed by the World Health Organization (WHO). The odds-ratios (OR) for the frequency of a low level of fitness, extremely accumulated VFA, metabolic abnormalities, and MS in both groups were calculated using a logistic regression model. RESULTS The OR for the frequency of a low level of fitness, the top quartile of VFA, hyperinsulinemia, and MS were significantly higher in the HD than in the LD. The significantly high OR of hyperinsulinemia and MS in the HD disappeared after adjusting for [Formula: see text] O(2)max and/or VFA. CONCLUSIONS Our study suggests that the association of psychological distress with hyperinsulinemia and MS might depend on cardiorespiratory fitness and/or VFA in Japanese men with type 2 DM.