2003 年 30 巻 4 号 p. 472-475
Objectives To demonstrate the relationships between multiple risk factor syndrome (MRFS) and atherosclerotic events, comparing with hypercholesterolemia group (hTC), in male Japanese, by conducting a work-site cohort study.
Methods From 1986 to 1992, 163 male subjects (MRFS group: n=87; hTC group: n=76) aged 30 years or more, working at a single department store in Tokyo were enrolled, and followed-up until 1998 to observe the occurrence of atherosclerotic events (coronary heart diseases, cerebral infarctions and retinal artery hemorrhages) . By using annual health-checkups data in Automatic Multiphasic Health Testing and Service (AMHTS), we defined MRFS group as subjects who met the following criteria: high blood pressure (diastolic blood pressure≥90 mmHg and/or systolic blood pressure≥150 mmHg, or the initiation of hypertension therapy), hypertriglyc-eridemia (serum triglycerides≥160 mg/dl), hyperglycemia (defined by the criteria by Japan Diabetes Society, 1970), and obesity (BMI: ≥24.0 kg/m2) at baseline. To compare MRFS group, we also defined hTC group as subjects whose serum total cholesterol level at baseline was 280 mg/dl or more.
Results Eight coronary heart disease cases, 3 cerebral infarction cases and 4 retinal artery hemorrhage cases were observed in MRFS group. On the other hand, no atherosclerotic case was observed in hTC group during the period. Mantel-Haenszel procedure showed that age-adjusted atherosclerosis incidence was significantly higher in MRFS group than that in hTC group (p<0.05) . In MRFS group, proportion of both glucose intolerance (fast plasma glucose≥140 mg/dl) and obesity (BMI≥25 kg/m2) showed significant difference between atherosclerotic cases and non-cases.
Conclusions MRFS group are more likely to experience atherosclerotic events compared with hTC group. Moreover, since proportion of both glucose intolerance and obesity in atherosclerotic cases is higher than those in non-cases among MRFS group, improved control of both plasma glucose level and body weight (BMI) are strongly recommended in MRFS in terms of preventing atherosclerotic outcome.
