To investigate the effect of elevated serum lipoprotein (a)[kLp (a)]land other risk factors on the progression of abdominal aortic atherosclerosis, 104 subjects (76 men and 28 women), ranging from 27 to 82 years old were prospectively examined by angiography. The subjects were clinically suspected of having a cardiovascular disease. Moreover, we determined their coronary index using the modified Balcon's method and their aortic “elongation ratio” using a method developed by us and examined the association between these parameters and abdominal aortic atherosclerosis.
The subjects were divided into two groups based on the results of abdominal aortography. Fifty eight subjects showed normal abdominal aortography (normal group). While 46 subjects showed abnormal abdominal aortography (abnormal group). There was a significant difference in age between the two groups, so we also examined the correlation between Lp (a) and age.
There was no correlation between Lp (a) and age.
We examined the impact of coronary index, elongation ratio and risk factors, inculuding serum Lp(a), total cholesterol, triglycerides, ApoB/ApoA-I ratio, RLP cholesterol, smoking, hypertension, diabetes mellitus, and hyperuricemia in both groups.
Furthermore, we performed a logistic regression analysis using abdominal aortic atherosclerosis as the dependent variable and risk factors, including age, male sex, total cholesterol, triglycerides, Lp (a), ApoB/ApoA-I ratio, RLP cholesterol, smoking, hypertension, diabetes mellitus, and hyperuricemia, as the independent variables. No significant correlation was observed between Lp (a) and age. The levels of serum Lp (a) were significantly higher in the abnormal group than in the normal one. The coronary index was significantly higher in the normal group. No significant difference between the two groups was observed with regard to the other variables. By logistic regression analysis, serum Lp (a) and age were significant by predictors of abdominal aortic atherosclerosis (p=0.0194 and p=0.0003, respectively). Our results suggest that elevated serum levels of Lp (a) and age are independent risk factors for abdominal aortic atherosclerosis.

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We have investigated the influence of westernized lifestyle on insulin resistance and it's association with risk factors of atherosclerosis in the Japanese. 1, 047 Japanese in Hiroshima, 700 Japanese-American in Hawaii and Los Angeles were surveyed during 1980 to 1996. In 1989, 328 Japanese in Kitaaiki area (rural area but their eating habit have acutely westernized) were surveyed. Serum total cholesterol (TCH), triglyceride (TG), fasting serum insulin (F-IRI) levels were significantly higher in Japanese-Americans as compared to Japanese in Hiroshima. F-IRI correlated positively with TG and negatively with HDL-CH even after adjustment for age and body mass index. These relationships were more prominent in order of Japanese in Hiroshima, first generation of Japanese-Americans and second or more later generation of Japanese-American.
Japanese-American revealed significantly higher serum lipids and IRI responses during 75 gGTT than Japanese in Hiroshima and Kitaaiki. Japanese in Kitaaiki showed a higher TG levels than Hiroshima but had the lowest IRI responses on 75 gGTT. F-IRI correlated positively with TG and negatively with HDL-CH in Japanese-Americans. In Japanese in Hiroshima, F-IRI showed a positive correlation with TG but no significant correlations were observed between F-IRI and serum lipids in Japanese in Kitaaiki.
Thes data indicated that westernized lifestyle aggravate insulin resistance and reveal a impact on the development of abnormal lipid metabolism associated with insulin resistance in the Japanese. Furthermore our results showed that westernized lifestyle influence on lipid metabolism prior to occurrence of insulin resistance.

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It is well known that patient with obesity has a frequent complication of impaired glucose tolerance, hyperlipidemia, hypertension and so on. However the degree of obesity does not necessarily account for the severity of those diseases. In this study we investigated the mechanism for hypertriglyceridemia in visceral obesity evaluated using computed tomography (CT), from the aspects of lipolytic enzymes lipoprotein lipase (LPL) and hepatic lipase (HL), which play a pivotal role in the hydrolysis of plasma triglycerides-rich lipoproteins.
The visceral fat area (V) was found to be negatively correlated with LPL mass (n=31, V vs LPL mass, r=-0.37, p=0.04) in the post-heparin plasma (PHP) and had a tendency toward negative correlation with the LPL activity in the PHP (n=31, V vs LPL activity, r=-0.29, p=0.12). Body mass index (BMI) was not correlated with LPL mass or activity. The HL activity from PHP of the patients did not show significant correlation with any of these factors. Next we investigated the correlation between postprandial lipoprotein metabolism and abdominal fat accumulation (n=83). The ratio of visceral fat area/subcutaneous fat area (V/S), or V was positively correlated to serum retinyl palmitate area under curve (RP-AUC) from the subjects (V/S vs RP-AUC: n=83, r=0.285, p=0.009; V vs RP-AUC:r=0.27, p=0.013). The BMI of the subjects did not show any correlation to RP-AUC.
These results suggest that abdominal fat distribution, instead of degree of fat accumulation, affects LPL mass and activity in the PHP, possibly leading to a delayed postprandial lipoprotein metabolisms

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