Metabolic syndrome and incidence of liver and breast cancers in Japan.

AIM OF THE STUDY: To clarify the relationship between the presence of metabolic syndrome and the incidence of cancer in a general Japanese population. METHODS: A retrospective cohort study was conducted among 8329 male and 15,386 female subjects between 1992 and 2000. The analysis used five definitions of metabolic syndrome. The information on the site-specific cancer was obtained from the population-based cancer registry. A Cox proportional hazard model was adapted for the statistical analyses. The average follow-up period was 9.1 years. RESULTS: The National Cholesterol Education Program Adult Treatment Panel III 2001 criteria of metabolic syndrome revealed that the hazard ratio of metabolic syndrome for liver cancer was 1.89 (95% confidence interval (CI) 1.11-3.22) for males, and 3.67 (CI 1.78-7.57) for females. The hazard ratio for female breast cancer was 2.87 (CI 1.67-4.94). When the analysis was limited to postmenopausal women (55 years of age or older), the ratio increased to 6.73 (CI 2.93-15.43). The NCEP-ATPIII 2001 criteria were superior to the other four proposed criteria for predicting the incidence of cancer. In the statistical model, which included all components of the metabolic syndrome and the metabolic syndrome (present or absent), high blood glucose was a significant associated factor for all sites and liver cancers, whereas the metabolic syndrome was found to be a significant associated factor for breast cancer. CONCLUSION: Metabolic syndrome may play an important role in the incidence of breast cancer. High fasting plasma glucose level is considered to be useful as an associated factor for the incidence of all-sites and liver cancer.

Influence of beta 3-adrenergic receptor Trp64Arg polymorphism on the improvement of metabolic syndrome by exercise-based intervention in Japanese middle-aged males.

OBJECTIVES: To date, there have been few intervention studies concerning the association of metabolic syndrome with beta 3-adrenergic receptor (ADRB3) Trp64Arg polymorphism, although ADRB3 Trp64Arg polymorphism has been reported to be associated with weight gain and insulin resistance by several intervention programs. We examined the influence of ADRB3 Trp64Arg polymorphism on the improvement of metabolic syndrome by an exercise-based intervention program. METHODS: Thirty-six male employees who satisfied the metabolic syndrome criteria participated in a three-month exercise-based intervention program (average age, 49 ± 6 years old). The improvement rate of metabolic syndrome after the intervention was compared between subjects with and without ADRB3 Trp64Arg polymorphism. The Mantel-Haenszel test was employed to adjust the age, diet, and exercise in analysis of the influence of ADRB3 Trp64Arg polymorphism on metabolic syndrome. The Trp64Arg genotype of the ß3-adrenoceptor gene was examined in peripheral blood leukocyte DNA by TaqMan PCR assay. RESULTS: The distribution of polymorphism was 23 (Trp/Trp), 13 (Trp/Arg), and 0 (Arg/Arg). The metabolic syndrome improvement rates after intervention were 21.7% (Trp/Trp) and 53.8% (Trp/Arg) (p = 0.050). After adjustment individually for age, calorie limitation, and 10,000 or more and 12,000 or more steps of walking per day during intervention, the odds ratios of the Trp/Arg genotype for improvement of metabolic syndrome relative to that of the Trp/Trp genotype were 5.1 (p = 0.043), 4.9 (p = 0.051), 3.7 (p = 0.074), and 5.0 (p = 0.045), respectively. CONCLUSION: The results suggested that ADRB3 Trp64Arg polymorphism influences the metabolic syndrome improvement rate by exercise-based intervention program.

Effect of the ß3-adrenergic receptor gene polymorphism Trp64Arg on BMI reduction associated with an exercise-based intervention program in Japanese middle-aged males.

OBJECTIVES: The ß3-Adrenergic receptor gene polymorphism Trp64Arg (ADRB3 Trp64Arg) may be associated with weight gain, especially in the East Asian populations. To date, however, the results of various investigations aimed at determining whether ADRB3 Trp64Arg has any effect on weight reduction after intervention have been inconsistent. The aim of this study was to assess the effect of ADRB3 Trp64Arg on weight reduction in a non-pharmacological intervention program. METHODS: Fifty-seven Japanese men (average age 48.1 ± 5.9 years) whose body mass index (BMI) was >23.0 kg/m(2) participated in an intervention program in which they were encouraged to exercise by walking with a pedometer for 12 weeks. The BMI was measured at the start of the intervention program and on weeks 4, 8, and 12 (end) of the intervention period. The reduction in the BMI (ΔBMI) was calculated as the BMI value obtained at each point in comparison to the baseline (initial) BMI. The participants were classified into two groups: Arg allele non-carriers (Trp/Trp) and Arg allele carriers (Trp/Arg or Arg/Arg), respectively. RESULTS: Among the participants, 61.4% were Trp/Trp homozygous, 38.6% were Trp/Arg heterozygous, and 0.0% were Arg/Arg homozygous. There was no significant difference in the ΔBMI between Arg allele non-carriers and Arg allele carriers at week 4 [non-carrier mean ± standard deviation (SD) vs. carrier mean ± SD: 0.25 ± 0.43 vs. 0.24 ± 0.35, respectively; p = 0.954], week 8 (0.56 ± 0.68 vs. 0.58 ± 0.61, respectively; p = 0.913), and week 12 (0.70 ± 0.86 vs. 0.84 ± 0.80, respectively; p = 0.545). CONCLUSIONS: Our results suggest that ADRB3 Trp64Arg does not influence BMI reduction after an exercise-based intervention program.

The current status of hand washing and glove use among care staff in Japan: its association with the education, knowledge, and attitudes of staff, and infection control by facilities.

OBJECTIVE: Hand hygiene is a basic measure to prevent infections. The purpose of this study was to obtain suggestions for the improvement of hand hygiene by evaluating the education, knowledge, and attitudes of care staff at facilities for the elderly in regard to hand washing and glove use, as well as infection control policies by those facilities. METHODS: Among a total of 147 special nursing homes and health service facilities for the elderly in Yamaguchi Prefecture, Japan, questionnaires were sent from October to November 2007 to 56 facilities which had agreed to participate in this survey. Two types of questionnaire, one for the facility manager and the other for care staff, were sent to each facility. RESULTS: The questionnaire was responded to by 42 managers (response rate 28.6%) and 1,323 staff members (response rate 26.3%). The rate of compliance with hand hygiene among them was 34.0%. Personal factors promoting hand hygiene were education and attitudes, while facility-related factor was the implementation of hand-washing evaluation. CONCLUSION: Since the hand hygiene compliance rate is low among care staff at facilities for the elderly, it is necessary to take measures to improve hand hygiene. Educational programs for hand hygiene should be developed in view of the conditions of individual facilities.

Relation of the Glu298Asp polymorphism of the nitric oxide synthase gene to hypertension and serum cholesterol in Japanese workers.

OBJECTIVE: To assess whether the Glu298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene possibly mediates the relation of blood pressure and serum cholesterol. METHOD: Regular health examination in 2003 of 1,694 Japanese workers from the Shimane Prefecture, Japan. RESULTS: The frequencies of the Glu/Glu, Glu/Asp, and Asp/Asp genotypes were 85.9%, 13.4%, and 0.7%, respectively. After adjustment for age, sex, BMI, and lifestyle (drinking, smoking, exercise and stress), the odds ratio (OR) of hypertension associated with high (> or = 220 mg/dl or under treatment) total cholesterol was 2.08 (95% Confidence Interval (CI) 1.02-4.24) among carriers of the eNOS 298Asp allele versus 1.18 (95% CI 0.89-1.55, p for interaction=0.50) among non-carriers. Similarly, the ORs of hypertension associated with counseling-need (120-139 mg/dl) and high (> or = 140 mg/dl) levels of LDL cholesterol among carriers of the eNOS 298Asp allele were significantly higher than those among non-carriers, at 2.65 (95% CI 1.16-6.01) versus 1.03 (95% CI 0.77-1.39, p for interaction=0.01), and 2.80 (95% CI 1.33-5.89) versus 0.95 (95% CI 0.71-1.26, p for interaction=0.04), respectively. CONCLUSION: These results indicate that the eNOS 298Asp allele, which is weakly associated with hypertension, may increase the risk of hypertension when associated with high serum lipid levels.