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Aim: A prospective cohort study in a Japanese urban general population was performed to investigate whether triglyceride (TG) and its related indices were associated with the risk for the incidence of ischemic cardiovascular disease (CVD) after the adjustment for low-density lipoprotein cholesterol (LDL-C) in Asian community dwellers. Methods: A 15.1-year prospective cohort study was performed in 6,684 Japanese community dwellers aged 30–79 years without a history of CVD and whose fasting TG levels were ＜400 mg/dL. After adjusting for covariates, including LDL-C, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the deciles (D) of TG and those of 1-standard deviation (SD) increment of log-transformed TG (1-SD of TG) according to LDL-C level (≥ 140 and ＜140 mg/dL) for ischemic CVD incidence were estimated. The multivariable-adjusted HRs and 95%CIs of the quintiles (Q) of TG, TG/HDL-C, and the cardiometabolic index (CMI) for ischemic CVD were also estimated. Results: In 101,230 person-years, 464 ischemic CVD cases occurred. For D 10 of TG, the HR (95%CI) was 1.56 (1.05–2.32), and for 1-SD of TG, it was 1.30 (1.00–1.70) in participants with LDL-C ＜140 mg/dL and 1.07 (0.77–1.50) in those with LDL-C ≥ 140 mg/dL. For Q 5 of the CMI, the multivariable-adjusted HR was higher than those of TG and TG/HDL-C. Conclusions: Fasting TG was an independent predictor for ischemic CVD incidence after adjusting for LDL-C in Japanese community dwellers with TG ＜400 mg/dL. Among TG, TG/HDL-C, and the CMI, the CMI could be the most powerful predictor for ischemic CVD.

Aim: We investigated the relationships of serum uric acid levels with the progression of atherosclerosis in patients with peripheral arterial disease (PAD) after treatment. Methods: Subjects were male patients diagnosed with PAD. Atherosclerosis at the common carotid artery was evaluated based on its intima-media thickness (IMT). Leg arterial flow was evaluated by measuring ankle-brachial index (ABI) and exercise-induced decrease in ABI. Results: Among various risk factors including age, blood pressure, adiposity, estimated glomerular filtration rate, and blood lipid, blood glucose, uric acid, fibrinogen and C-reactive protein levels, only uric acid levels showed significant correlations with ABI [Pearson's correlation coefficient, −0.292 (p < 0.01)] and leg exercise-induced decrease in ABI [Pearson's correlation coefficient, 0.236 (p < 0.05)]. However, there was no significant correlation between uric acid levels and maximum or mean IMT. Odds ratios of subjects with the 3rd tertile versus subjects with the 1st tertile for uric acid levels were significantly higher than the reference level of 1.00 for low ABI [4.44 (95% confidence interval, 1.45–13.65, p < 0.01)] and for high % decrease in ABI after exercise [4.31 (95% confidence interval, 1.34–13.82, p < 0.05)]. The associations of uric acid levels with the indicators of leg ischemia were also found after adjustment for age, history of revascularization therapy, diabetes, smoking, alcohol consumption, body mass index, triglyceride levels, and renal function. Conclusion: Uric acid levels are associated with the degree of leg ischemia in patients with PAD. Further interventional studies are needed to determine whether the correction of uric acid levels is effective in preventing the progression of PAD.

Aims Lectin-like oxidized low-density lipoprotein (LDL) receptor-1 ligands containing apolipoprotein B (LAB) and lectin-like oxidized LDL receptor-1 (LOX-1) are known as LOX-1-related modified LDL indicators. These indicators play an important role in the early phase atherosclerosis, but the relationship between these indicators and subclinical atherosclerosis, as represented by the cardio-ankle vascular index (CAVI), has not been assessed. We herein investigated the association of LOX-1- related modified LDL indicators and the CAVI in healthy, Japanese urban community inhabitants who were considered to be at low risk for cardiovascular disease (CVD). Methods The participants were 515 healthy Japanese (310 men and 205 women) without a history of CVD, cancer or the use of medication for hypertension, diabetes or dyslipidaemia. To estimate the association between LOX-1-related modified LDL indicators (LAB, soluble form of LOX-1 (sLOX-1)) and the CAVI, we performed multivariable linear regression analyses with possible confounders such as the serum LDL cholesterol level. Results The plasma LAB showed a positive association with the CAVI in men (standardized coefficient: 0.11, p = 0.04). This relationship was not observed in women. On the other hand, no clear association was observed between the CAVI and the plasma sLOX-1 level in either sex. Conclusions The plasma LAB levels may represent a useful marker for detecting potential atherosclerosis in healthy individuals considered to be at low risk for atherosclerosis and CVD. Further studies are needed to confirm the present findings.

Aim Lipid accumulation product (LAP) is a new continuous marker of lipid overaccumulation that predicts cardiovascular risk. The aim of this study was to determine the cutoff value for LAP and evaluate its usefulness. Methods Using a database of results of health checkup examinations for 10,170 Japanese workers (35-40 years of age) conducted at their workplaces, the cutoff value for a high LAP was calculated by analyzing receiver-operating characteristic (ROC) curves for the relationships of LAP with hyperglycemia and diabetes. Results The cutoff value for LAP was 21.1 for women and 37.2 for men. The values were similar when calculated by analyzing the ROC curves for the relationships with hyperglycemia and diabetes. Using these cutoff values, the prevalence of a high LAP was calculated to be 23.7% in women and 28.8% in men. The odds ratio for diabetes in the subjects with vs. those without a high LAP, calculated after adjusting for age, smoking, alcohol consumption and regular exercise, was 19.09 (95% CI: 6.57-55.50) in women and 7.40 (95% CI: 5.10-10.75) in men. High odds ratios for hypertension (10.66 [95% CI: 7.77-14.63] in women and 7.31 [95% CI: 6.20-8.62] in men) were also obtained in the subjects with vs. those without a high LAP. Conclusions Cutoff values for a high LAP in women and men were determined, and high odds ratios for diabetes and hypertension were obtained using the cutoff values for LAP. Further studies are needed to elucidate whether the proposed cutoff values are applicable to people of other ages, races and ethnicities.

Aim: Results of previous studies on the relationship between habitual alcohol drinking and metabolic syndrome in a general population are not consistent, and this relationship in patients with diabetes is unknown. The aim of this study was to clarify the relationship of alcohol consumption with meta-bolic syndrome in patients with diabetes.Methods: Japanese male workers with diabetes (n = 1960) were divided into non-, light (< 22 g ethanol/day), heavy (≥ 22 and < 44 g ethanol/day) and very heavy (≥ 44 g ethanol/day) drinkers. Re-lationships of alcohol consumption with visceral obesity evaluated by waist circumference, high blood pressure, dyslipidemia (high triglycerides and/or low HDL cholesterol), hyperglycemia, and metabolic syndrome (3 or more of these risk factors by the NCEP-ATP III criteria) were investigated.Results: Odds ratio vs. nondrinkers for high blood pressure was significantly high in all drinker groups, while odds ratio vs. nondrinkers for low HDL cholesterol was significantly low in all drinker groups. Odds ratio vs. nondrinkers for high triglycerides was significantly low in light drinkers and was significantly high in very heavy drinkers. Odds ratio vs. the nondrinker group for large waist circumference was not significant in any drinker groups. Odds ratio vs. nondrinkers for metabolic syndrome was significantly high in very heavy drinkers but was not significant in light and heavy drinkers.Conclusion: Excessive alcohol intake is associated with a higher risk for metabolic syndrome through elevations of blood pressure and triglycerides in Japanese male patients with diabetes.

Aim: The aim of this study was to clarify the relationship between alcohol intake and metabolic syn-drome in Japanese men and women.Methods: Japanese female subjects (n=11,187) were divided into non-, light (

AIM High-sensitivity C-reactive protein (hs-CRP) identifies individuals at risk for cardiovascular disease (CVD) without an increased level of low-density lipoprotein cholesterol (LDL-C). The present study was performed to compare hs-CRP and LDL-C in association with the cardio-ankle vascular index (CAVI) in Japanese community dwellers considered to be at low risk for atherosclerosis from their level of traditional CVD risk factors. METHODS A community-based study involving 386 healthy Japanese (261 men and 125 women) without a history of CVD and medications for hypertension, diabetes, and dyslipidemia was performed. Multiple adjustments were performed with linear regression models to estimate the association between CAVI and hs-CRP or LDL-C levels. The participants were divided into four groups on the basis of whether they were above or below the median hs-CRP and LDL-C values, and CAVI was compared among the four groups by analysis of covariance after adjusting for confounders. RESULTS In multiple linear regression models, hs-CRP showed a significant positive association with CAVI; however, no clear association was observed between CAVI and LDL-C. These results were similar in the analyses among the participants with LDL-C

To clarify the significance of increased blood sialic acid in atherosclerotic cardiovascular disease, we investigated the relationship between serum sialic acid level and atherosclerotic risk factors such as serum uric acid, fasting blood glucose, systolic and diastolic blood pressure, atherogenic index, and white blood cell count. By simple regression analysis, the serum sialic acid level was found to correlate significantly with these parameters. The mean sialic acid level was significantly higher in the highest quartile for serum uric acid than in its lowest quartile and also for fasting blood glucose concentration in comparison with its other three quartiles. A tendency was noted for the mean serum sialic acid level of each quartile to become higher with an increase in the quartiles of systolic or diastolic blood pressure, atherogenic index, and white blood cell count. Multiple regression analysis showed the correlations to be significant for the relationship of serum sialic acid to atherogenic index, mean arterial pressure and white blood cell count. From these results and previous findings of higher serum sialic acid levels in smokers, patients with diabetic angiopathies, and patients with hyperlipidemia, it is suggested that serum sialic acid reflects the degree of atherosclerotic progress involving inflammation processes.

In order to clarify the significance of obesity in atherosclerotic risk at different ages, the relationship between the body-mass index, serum sialic acid concentration, and various atherosclerotic risk factors were investigated for healthy subjects in three different age groups, 35-39, 40-49 and 50-59 years old. The body-mass index correlated significantly with mean arterial blood pressure, fasting blood sugar, serum triglycerides, atherogenic index and serum uric acid in all age groups. The magnitudes of the association of body-mass index with mean arterial blood pressure, fasting blood sugar and serum triglycerides decreased with age, while those of the association with atherogenic index and serum uric acid were not different among the three age groups. Body-mass index did not show significant correlation with white blood cell count, platelet count or smoking in any of the age groups. Simple and multiple regression analyses showed that body-mass index was significantly correlated with serum sialic acid in the 35-39-year-old group, but not in the other two groups. Neither the percentage of obese subjects (body-mass index > 26.4) nor the mean values of body-mass index were different among the three groups. These results suggest that for younger people, the body-mass index is related more closely with some atherosclerotic risk factors (e.g. blood pressure, blood sugar and serum triglycerides), and obesity may be possibly more involved in the progression of atherosclerosis, compared to more elderly people.