書式設定,書式設定,第 2,第 3,第 4,第 5,*,The 4th Shino-Japan Cardiovascular Forum on October 23-24,2008 in Beijing,Frequency of Metabolic Syndrome and its Absorption Abnormality by Plant Sterols in General Population,Japan,Toshio Shimada,Yo Murakami,Nobuyuki Oyake,Hiroyuki Yoshitomi,Nobuhiro Kodani,Akira Matsumori*,Division of Cardiovascular Medicine,Department of Internal Medicine,Shimane University Faculty of Medicine,Department of Cardiovascular Medicine,Kyoto University,Graduate School of Medicine*,Background,Health problems on aged people have been growing bigger in Japan because with advancing age,a variety of diseases especially on vascular diseases,such as cardio-and cerebro-vascular diseases have been increasing.And therefore,early detection of vascular diseases is a very important issue for vascular prevention and reduction of mortality.,Diagnostic Criteria for Metabolic Syndrome,(8 Japanese Medical Associations Joint-Committee),Fat accumulation in the intra-abdominal cavity,Abdominal Circumference at the WaistMale85cm,Female90cm(80cm recommended by me),（Visceral fat areaMale and Female 100 cm,2,),Hypertriglyceridemia,150 mg/,dL,Low HDL-,cho,40 mg/,dL,Systolic Blood Pressure,130 mmHg,Diastolic Blood Pressure,85 mmHg,Fasting Blood Sugar,110 mg/,dL,Lipoprotein abnormality,High Blood Pressure,High Blood Sugar,At least,more than following 2 items,and/or,and/or,modified and translated into English by Toshio Shimada,Major Criteria,Minor Criteria,Obesity,Insulin Resistance,DM,Dyslipidemia,Hypertension,Atherosclerosis,Arteriosclerosis,Pathophysiology of Metabolic Syndrme,Over-eating,Poor Exercise,Inheritance,LDL,I,Synthesis of Cholesterol in the Liver and Absorption of Cholesterol in the Intestine-Two Important Supply Sources of Cholesterol in Vivo-,Bile,Food,Liver,Vessels,Cholesterol,Small Intestine,Biliary,800,2000mg/day,Dietary,400,500mg/day,Aim,Our purpose is to investigate the frequency of metabolic syndrome(MS)and life style related diseases and also to examinewhether any difference in absorption of cholesterol from the digestive system is present in participants between with metabolic syndrome(MS)and non-MS randomly selected,using plant sterols in general population.,Subjects and method,In 2007,1980 participants for annual health check-up were subjected for this cohort study.Average age is 6610.8 years,and female is 1260(64%)；male is 720(36%).All subjects underwent routine blood examinations,insulin,remnant like particle cholesterol(RemLC),hs-CRP,cystatin C,plasma brain natriuretic peptide(BNP)and N-terminal proBNP(NT-proBNP)measurements.Blood pressure,abdominal circumference,and electrocardiography were measured at the same time.Abdominal circumference was measured at the navel level in the supine position like CT for visceral fat.Evaluation of cholesterol absorption was done by plant sterols in each 30 participants chosen randomly from the participants.BNP and NT-proBNP were measured for heart failure screening by immunoluminesence method.Plant sterols were measured by gas chromatography.,In 1964 participants,218 participants(11%)were diagnosed as MS,using,80cm waist circumference in female and,85cm in male as major criterion.,From each group,30 participants were randomly chosen to check plant sterol levels for the evaluation of absorption of cholesterol and,lathosterol,for the evaluation of cholesterol synthesis.,Each sterol level was measured by gas chromatography.,The Measurement of Serum Plant Sterols to Evaluate Cholesterol Absorptionin Okuizumo Cohort,2007,Abnormal and Normal Proportion of Clinical Paramerers,in General Population,Japan,Okuizumo Cohort 2007,0%,10%,20%,30%,40%,50%,60%,70%,80%,90%,100%,Syst BP(130mmHg),Diast BP(85mmHg),Gender(F/M),Waist Circum90-85,Waist Circum80-85,Metabo90-85,Metabo80-85,CKD,normal,abnormal,N=1972,N=1972,N=1972,N=1972,N=1972,N=1972,N=1972,N=1980,N=1964,N=1964,N=1964,N=1964,N=1980,DM(HbA1c 5.8%,220mg/dL,TG(150mg/dL,LowHDL(40mg/dL,Obesity(BMI 25,True Positive,Sensitivity,0.00,0.10,0.20,0.30,0.40,0.50,0.60,0.70,0.80,0.90,1.00,.00,.10,.20,.30,.40,.50,.60,.70,.80,.90,1-Specificity,False Positive,Using MSF90M85-Dx=0 to be the positive level,Area Under Curve=,0.93304,Receiver Operating Characteristic,Metabolic Syndrome and its,Influential Factors Analyzed,by Multivariate Logistic Regression,Female Waist Circumference,90cm,Influential Parameters,BMI,Hb,Cystatin,C,Insulin,Rem,LC,Tcho,True Positive,Sensitivity,0.00,0.10,0.20,0.30,0.40,0.50,0.60,0.70,0.80,0.90,1.00,.00,.10,.20,.30,.40,.50,.60,.70,.80,.90,1-Specificity,False Positive,Using Abd-CF80M85=0 to be the positive level,Area Under Curve=,0.89483,Receiver Operating Characteristic,Metabolic Syndrome,and its,Influential Factors Analyzed,by Multivariate Logistic Regression,Female Waist Circumference,80cm,Influential Parameters,BMI,Hb,Cystatin,C,Rem,LC,Tcho,True Positive,Sensitivity,0.00,0.10,0.20,0.30,0.40,0.50,0.60,0.70,0.80,0.90,1.00,.00,.10,.20,.30,.40,.50,.60,.70,.80,.90,1-Specificity,False Positive,Sensitivity 0.81,Specif