A cluster of certain metabolic abnormalities has been recognized as metabolic syndrome, which is characterized by resistance to insulin-stimulated glucose uptake, glucose intolerance, hyperinsulinemia, hypertriglyceridemia, hypo- HDL cholesterolemia (HDL-C) and hypertension, with or without hyperglycemia. These multiple metabolic disorders put a person at high risk for cardiovascular disease. With the goal to eliminate all adverse consequences of multiple metabolic disorders, the optimal approach would be through its prevention. Since visceral obesity has been proposed as the most important determinant of multiple metabolic disorders by the International Diabetes Federation and the Japanese Association of Internal Medicine in 2005, health practitioners were thrown into confusion to use any definitions of metabolic syndrome. The Japanese Ministry of Health, Labor and Welfare has decided to introduce a new policy for the prevention of metabolic syndrome and type 2 diabetes mellitus from April 2008. The Ministry of Health, Labor and Welfare conducts to establish a screening system and guidance of the metabolic syndrome. We review the history and concept of metabolic syndrome, insulin resistance and central obesity, pathophysiology and definition, and countermeasures against the metabolic syndrome, to improve the community health care system for the metabolic syndrome and cardiovascular disease.
Syndrome ; seconds ; Metabolic Diseases ; Health ; Prevention

Recently, people are interested in visceral obesity and metabolic syndrome (MS). The Japanese Ministry of Health, Labor and Welfare has decided to introduce a new MS screening system and health promotion guidance on the prevention of type 2 diabetes mellitus (diabetes) and cardiovascular disease from 2008. We analyzed the prevalence of MS and estimated the number of candidates for MS in a rural community based on the new criteria provided by the Japanese Association of Internal Medicine and the Ministry of Health, Labor and Welfare. Data obtained from 393 males and 526 females aged over 20 years were studied for the prevalence of MS and diabetes. The prevalence of MS was 14% for males and 6% for females. It was a remarkable lower prevalence than the reported prevalence in urban communities. We calculated again the prevalence of MS with the exclusion of diabetes, because diabetes was usually preceded by MS. The prevalence of diabetes and MS was 10% and 10% for males and 8% and 6% for females, respectively. Diabetes increased with age, but MS prevailed among younger people aged 20-59 years. We think that countermeasures against MS should be taken targeted on younger people, and those against diabetes on elder people. We also estimated the member of people with MS using the Ministry of Health, Labor and Welfare criteria. In 2012, the health organizations, both public and private, will be providing service to 3,470 thousand adults with MS and encouragement to 3,950 thousand adults to have a motivation for healthy lifestyle.
Morphine Sulfate ; Prevalence aspects ; Diabetes ; Labor (Childbirth) ; Health

Obesity is an important public health problem in Japan and many other countries. There is a need for simple and reliable anthropometric measurement tools for visceral obesity to facilitate the prevention of metabolic syndrome (MS). Although studies have so far suggested waist circumference (WC) is the best indicator of visceral obesity, there is no reportof predictive value for improvement of MS. We conducted to analyze the relationship between anthropometric measurements and metabolic disorders in an interventional study of 358 subjects who participated in our program for visceral obesity based on health education and self-determination from 2000 to 2006. The intervention induced significant decreases in calorie intake and increases in physical activity of the participants, and resulted in significant decreases of 1.7 kg (3% of body weight at the baseline) of weight and 2.4 cm (3%) of WC, but body fat percent using bioelectrical impedance analysis found their body fat percentage increased 0.5% at the baseline. Weight-loss was significantly associated with improvement of metabolic measurements by our intervention. Weight and body mass index (BMI) showed the highest correlation coefficient for improvement of metabolic measurements, while WC and body fatpercentage showed lower values for improvement of metabolic measurements. In conclusion, weight-loss is the suitable indicator for the evaluation of the educational program, and 3-7% weight-loss for three months is recommended to improve visceral obesity and MS.
Obesity ; Weight ; Body fat ; Morphine Sulfate ; Syndrome

Objective: To compare effects of the fluoropyrimidines S-1 and capecitabine on prothrombin time international normalized ratios (PT-INR) of warfarin following coadministration and after discontinuation of each fluoropyrimidine treatment.
Methods: Medical records of patients receiving warfarin with either S-1 (6 patients) or capecitabine (7 patients) were obtained from four hospitals.
Results: Increased PT-INR was observed until peak levels of warfarin were achieved in all patients in S-1 and capecitabine treatment groups.　Moreover, PT-INR significantly changed after coadministration within each group (p＜0.05).　Specifically, ratios of peak PT-INR after coadministration of each fluoropyrimidine and those following administration of warfarin alone (PT-INR elevation ratio) were 3.31 and 3.29 in S-1 and capecitabine coadministration groups, respectively.　Moreover, numbers of days to peak PT-INR were 38.3 and 31.3 days, respectively, and did not significantly differ between the treatment groups.　Furthermore, PT-INR returned to pretreatment levels by 17.5 and 15.1 days after discontinuation of S-1 and capecitabine, respectively, and did not significantly differ between the treatment groups.
Conclusion: Coadministration of S-1 and capecitabine similarly prolongs PT-INR by approximately 3-fold compared with administration of warfarin alone; therefore, these drug-drug interactions were clinically suggested to be of high risk for episodes of bleeding and remarkable alterations in coagulation parameters.　Therefore, blood coagulation ability should be more carefully monitored with regard to PT-INRs in patients receiving warfarin with S-1 or capecitabine not only during coadministration but also after discontinuation of fluoropyrimidine treatments.