Epidemiological studies on multiple risk factor syndrome in occupational populations

本研究由三个部分组成：一是对职业人群中影响体重增加和肥胖的工作相关因素的文献综述；二是对适度饮酒可抑制代谢综合征发展的假设进行检验；三是酒精性高血压与胰岛素抵抗和代谢综合征增加有关。结果总结如下：超过20%的日本成年人体重指数在25以上。肥胖多发生在社会底层，可能是由于对生活和工作的不满或不健康的行为。长时间工作、加班和轮班工作与体重或腰围增加有关。繁重的工作负荷可能导致暴饮暴食、久坐不动、饮酒和吸烟。在中年男性和女性中，不饮酒者、适度饮酒者和过度饮酒者之间IGT和高甘油三酯血症的患病率没有差异，这表明适度饮酒并不能抑制代谢综合征的发展。然而，GGT升高的受试者在高血压、IGT、高甘油三酯血症和低高密度脂蛋白胆固醇血症方面的优势比高于GGT正常的受试者。在敏感人群中，即使适度饮酒也会有代谢综合征的风险。在中年健康男性中，空腹血清胰岛素随着饮酒量的增加而下降，而在饮酒者中，摄入60毫升或更多的酒精，血糖较高，导致饮酒者的HOMA-IR和HOMA-BC值较低。然而，在饮酒者中，较高的HOMA-IR与较高的血压有关，血清GGT中度升高与高HOMA-IR有关，进一步升高与低HOMA-BC有关。这些结果提示，酒精消费者的高血压与血清胰岛素和葡萄糖的关系变化有关，从而增加了胰岛素抵抗。

This research is composed of three parts : a literature review on work-related factors affecting weight gain and obesity in occupational populations, testing hypotheses that moderate alcohol consumption could suppress the development of metabolic syndrome and that alcohol-induced hypertension is related to increased insulin resistance and metabolic syndrome. The results are summarized as follows.More than 20% of adult Japanese show a body mass index of 25 or more. Obesity is found more in lower social classes, probably due to dissatisfactions with life and work or unhealthy behaviors. Long work, overtime and shift work are related to weight or waist circumference gain. Heavy work load may result in overeating, sedentary, alcohol and cigarette consumption.In middle-aged men and women, there were no differences in the prevalence of IGT and hypertriglyceridemia between nondrinkers, moderate drinkers and excessive drinkers, showing that moderate alcohol consumption does not suppress the development of metabolic syndrome. However, subjects showing elevated scrum GGT showed a higher odds ratio in hypertension, IGT, hypertriglyceridemia and low HDL-cholesterolemia than those with normal serum GGT. Even moderate alcohol consumption will be a risk of metabolic syndrome in sensitive subjects.In middle-aged healthy men, fasting serum insulin showed a decrease with increases in alcohol consumption, while blood glucose was higher in drinkers consuming 60 ml or more of alcohol, resulting lower values of HOMA-IR and HOMA-BC in alcohol consumers. In alcohol consumers, however, higher HOMA-IR was related higher blood pressure, and moderate elevations in serum GGT were related to a high HOMA-IR and the further elevations were related to a low HOMA-BC. These results suggested that high blood pressure in alcohol consumers is related to changes in serum insulin and glucose relationship, and thus increased insulin resistance.