High-sensitivity C-reactive protein is quite low in Japanese men at high coronary risk.

BACKGROUND: Although numerous studies have demonstrated a positive association of high-sensitivity C-reactive protein (CRP) with the incidence of coronary heart disease (CHD), little information exists regarding this issue in Japanese. METHODS AND RESULTS: The association between CRP and the Framingham Risk Score (FRS) was investigated in 2,523 middle-aged Japanese men without a medical history of CHD. CRP was significantly associated with this score obtained from all FRS factors. After dividing subjects into 4 categories of relative risk estimate for CHD, the geometric mean of CRP (mg/L) increased gradually with the CHD risk (below average: 0.39 [95% confidence interval, 0.37-0.41], average: 0.58 [0.50-0.67], moderately above average: 0.70 [0.57-0.86], high: 0.79 [0.58-1.09], trend p<0.001). However, it should be noted that the mean CRP concentration of the high-risk group was only 0.79 mg/L and a greater proportion (63.8%) of the high-risk subjects was in the low-risk range of CRP (<1 mg/L). CONCLUSIONS: Circulating CRP well reflect the estimated CHD risk, indicating that CRP may be useful for coronary risk stratification in Japanese also. However, the details of the CRP level in Japanese must be investigated further by prospective studies to determine the Japanese-specific cutoff points for CHD risk evaluation.

The transition to menopause reinforces adiponectin production and its contribution to improvement of insulin-resistant state.

OBJECTIVE: To evaluate the influence of menopausal status on the serum adiponectin concentration and investigate whether the contribution of adiponectin to insulin resistance is modified by menopausal status. SUBJECTS: We conducted a population-based, cross-sectional study of 207 premenopausal and 206 postmenopausal Japanese women. MEASUREMENTS: Data on anthropometric characteristics, fasting serum adiponectin, glucose and insulin concentrations were used. Insulin resistance (homeostasis model assessment of insulin resistance: HOMA-IR) was calculated. RESULTS: Postmenopausal women had significantly higher HOMA-IRs than premenopausal women [1.50 (1.42, 1.59) vs 1.18 (1.12, 1.24), geometric mean (1 standard error range), P = 0.005]. Paradoxically, adiponectin levels in postmenopausal women were also significantly higher than those in premenopausal women [10.3 (9.95, 10.7) vs 9.04 (8.71, 9.39), P = 0.028]. Multiple regression analysis showed that body mass index (BMI) was the only significantly independent predictor [standardized partial regression coefficients (sbeta) = 0.319, P < 0.001] for HOMA-IR among premenopausal women, whereas both BMI and adiponectin were the significant predictors among postmenopausal (sbeta = 0.334 and -0.141, P < 0.001 and < 0.05, respectively). When the subjects were restricted to those without metabolic disorders including high blood pressure, hypertriglyceridaemia, hypo-HDL cholesterolaemia and high fasting glucose, adiponectin (sbeta = -0.249, P < 0.05) was the only significant predictor for HOMA-IR among postmenopausal women but BMI was not significant (sbeta = 0.223, P = 0.075). CONCLUSIONS: The transition to menopause increases serum adiponectin concentrations. And the significant and negative association between adiponectin and HOMA-IR was observed only after menopause. Therefore, adiponectin may play a role in the improvement of an incipient insulin-resistant state after, rather than before, menopause.

Birth weight and adult hypertension: cross-sectional study in a Japanese workplace population.

BACKGROUND: Low birth weight has been associated with adult hypertension in several Western populations. This association needs to be evaluated in Japanese people. METHODS AND RESULTS: A population-based cross-sectional study of 3,107 subjects (2,303 males and 804 females) aged 35-66 years was conducted. The participants responded to a questionnaire about their birth weights, blood pressure, medical history, parental history, and lifestyle factors. Hypertension was defined as systolic blood pressure > or =140 mmHg and/or diastolic blood pressure > or =90 mmHg and/or under treatment by anti-hypertensives. Multiple logistic regression analysis adjusted for age, sex, body mass index, parental history, and lifestyle revealed the adjusted odds ratios for hypertension were 1.26 (95% confidence interval: 0.88-1.80), 1.00 (reference), 0.89 (0.73-1.08) and 0.70 (0.49-1.00) in subjects in birth weight categories of <2,500 g, 2,500-<3,000 g, 3,000-<3,500 g, 3,500- g, respectively (p-value for trend =0.009). Furthermore, this inverse association was clearly pronounced in normal-weight subjects. CONCLUSION: Low birth weight was independently associated with adult hypertension in the Japanese workplace population. Our results support the inverse association observed previously in Western populations and suggest that intrauterine environmental insults might lead to permanent changes in the metabolism and structure of the fetal organs influencing the regulation of blood pressure.