RESUMEN
The aim of this study was to determine the effect of metabolic syndrome on brachial-ankle pulse wave velocity (baPWV) by using the new guidelines for diagnosis of this syndrome in Japan. We examined 525 men and women without a history of cardiovascular disease or cancer, and an ankle-brachial index < 0.9. The baPWV was measured using a device (Form PWV/ABI) that simultaneously monitored bilateral brachial and ankle pressure wave forms. Metabolic syndrome was defined as a waist circumference > or = 85 (90) cm in men (women) and two or more of the following risk factors: hypertension, dyslipidemia, and glucose intolerance diagnosed by a 75 g oral glucose tolerance test. The baPWV showed a significant linear relationship with waist circumference, waist-to-hip ratio, body fat, systolic and diastolic blood pressure, triglycerides, fasting glucose, 2-h-postload glucose, fasting insulin, and glycosylated hemoglobin-A1c, after adjusting for sex and age. These factors were also strongly related to fasting insulin levels. When subjects were classified into six groups based on waist circumference and the number of risk factors for metabolic syndrome (0, 1, and > or =2), we found that more risk factors clearly increased the odds ratios for an elevated baPWV in those subjects in the highest quartile of the baPWV distribution in multivariate logistic models. An increase in odds ratio was observed despite a normal waist circumference and may well have been due to increased fasting insulin and blood pressure levels. An increase in the number of risk factors for metabolic syndrome was highly correlated with an increased baPWV, probably due to insulin resistance.
Asunto(s)
Tobillo/irrigación sanguínea , Plexo Braquial/irrigación sanguínea , Síndrome Metabólico/diagnóstico por imagen , Adulto , Anciano , Tobillo/diagnóstico por imagen , Antropometría , Glucemia/metabolismo , Presión Sanguínea/fisiología , Plexo Braquial/diagnóstico por imagen , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/sangre , Japón , Lípidos/sangre , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Flujo Sanguíneo Regional/fisiología , Factores de Riesgo , UltrasonografíaRESUMEN
Diabetes may impact on health-related quality of life (HRQOL). The aim of this population-based study was to confirm this influence. We examined 2135 residents aged > or =30 years in an entire community, who had no history of cancer or cardiovascular disease and did not require care for daily activity. The response rate was 87.8%. The status of diabetes, other chronic diseases and life practices were assessed by self-reported questionnaires, in which HRQOL was evaluated by the Japanese version SF-36, based on five sub-scales of the domain. Diabetes had been diagnosed in 165 (7.7%) of the study population. Comparison of data, adjusted for sex, age, living alone and employment status between non-diabetics and subjects with diabetes treated by pharmacological therapy had odds ratios (ORs) between the lowest quartiles of sub-scale scores of 1.90 for physical role, 2.51 for general health, and 1.79 for emotional role. The OR for lower general health was also increased in people using only lifestyle modification for treatment of diabetes. Although the OR for mental health was worse in the lifestyle modification group it was not increased in people with diabetes on pharmacological therapy. These associations remained almost unchanged after adjustment for the covariates. The sub-scales of physical and emotional roles and general health were decreased significantly in diabetics with duration of disease between 10 and 19 years or > or =20 years. Our study showed treatment of diabetes clearly influenced HRQOL, with this influence being dependent on the duration of diabetes and primarily affecting physical rather than mental health.