Epidemiological research on the etiology of Multiple Risk Factor Syndrome

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We conducted the cohort study of about 7,000 male workers in 1997. In this study, we examined the role of obesity most likely lying in the upstream of insulin resistance in the genesis of Multiple risk factor syndrome recently called as Metabolic syndrome (MS). We obtained the new knowledge that obesity probably caused insulin resistance syndrome and that weight variability from adolescence probably caused insulin resistance and MS. Furthermore, we found that t each component of MS (obesity, hypertension, hypertrigriceridemia, hyper-LDL cholesterolemia, hypo-HDL cholesterolemia, hyperinsulinemia, hyperuricemia) was associated with the systemic low-grade inflammation defined as elevated C-reactive protein and that CRP increased as the number of coexisting MS components increased. From these results, we speculated the cascade of events arriving at cardiovascular disease as follows : obesity→insulin resistance→components of MS other than obesity→Atherosclerosis→systemic low-grade inflammation→progression atherosclerosis→cardiovascular event.In the view of our results, obesity plays an important role in the etiology of MS. In recent years, leptin attracts attention as hormone related to obesity. Our future research is to elucidate the role of hyperleptinemia, leptin resistance in the etiology of MS.