Life style intervention in metabolically obese with normal-weight subject selected in general population of Mihama district.

代谢综合征是一种可能导致心肌梗死和脑梗死等血管并发症的病理状态。内脏脂肪堆积是最重要的致病因素，是日本代谢综合征诊断标准的基础。最近，我们报道了非肥胖受试者（BMI < 25 kg/m^2），通过CT扫描在脐水平测量的内脏脂肪面积大于100 cm 2，显示出类似于肥胖代谢综合征的代谢异常。这一组通常被称为“正常体重的代谢性肥胖（MONW）”。在我们的研究中，人口是从三重县美滨镇MONW科目和研究的目的是调查生活方式的影响。我们在饮食和运动改变前后检查了腹围和代谢参数。829人（男性/女性：288/541）在美滨参加了我们的糖尿病检查，32名男性被选为MONW受试者，但没有女性MONW受试者。我们举办了一个关于代谢综合征的工作坊，以进行生活方式的干预计划。7名MONW和2名肥胖受试者入组该项目。干预前，调查他们的生活方式。能量消耗、盐和铁的摄入量适宜。但蛋白质和脂肪摄入过多，碳水化合物、膳食纤维和钙摄入不足。此外，我们还调查了脂肪摄入量、脂肪能量百分比、饱和脂肪酸摄入量、n3和n6脂肪酸摄入量等细节，发现所有这些都是合适的。基于上述数据的干预方案目前正在实施中。此外，我们正在尽一切努力增加MONW和肥胖代谢综合征组的受试者数量，以阐明通过改变生活方式改善代谢异常的效果是否影响氧化应激和不平衡的脂肪因子网络。

Metabolic syndrome is a pathological condition that may cause vascular complications such as myocardial infarction and cerebral infarction. Accumulation of visceral fat is the most important causative factor and it is essential for its diagnosis by the Japanese criteria of metabolic syndrome. Recently we have reported that non-obese subjects (BMI < 25 kg/m^2) with visceral fat area measured by CT scan at the umbilical level are more than 100 cm2 show metabolic abnormalities similar to obese metabolic syndrome. This group is commonly called 'metabolically obese with normal-weight (MONW)'. In our study, the population was MONW subjects from Mihama town of Mie prefecture and the purpose of the study was to investigate influence on life style. We examined abdominal circumference and metabolic parameters before and after the modification of their diet and exercise.Eight hundred and twenty nine people (male/female: 288/541) visited our diabetic examination in Mihama, and 32 men were selected as MONW subjects, but there were no women with MONW. We held a workshop about metabolic syndrome to perform an intervention program in life style. 7 MONW and 2 obese subjects were enrolled in this program. Before intervention, their life styles were examined. Energy expenditure, salt and iron intake were appropriate. However, protein and fat intake were excessive, and carbohydrate and dietary fiber and calcium intake were deficient. Furthermore, we investigated the details regarding fat intake, energy % of fat, saturated fatty acid intake, n3 and n6 fatty acid intake, all of them were found to be appropriate. This intervention program based on the above data is now in progress. Moreover, we are making all possible effort to increase the number of the subjects in MONW and obese metabolic syndrome group to elucidate whether the effect of improvement of metabolic abnormalities by modifying life style affects oxidative stress and the unbalanced adipokine network.