Visceral Adiposity and Mortality in Japanese Americans

描述(申请人提供)：日裔美国人社区糖尿病研究(JACDS)始于1983年，旨在描述西方化对代谢的影响，这可能导致日裔美国人比日本原住民和美国非西班牙裔白人患2型糖尿病的风险更高。这项前瞻性研究共招募了735名100%日本血统的男性和女性。研究访问发生在基线、2.5岁、5-6岁和10-11岁。733名受试者1次就诊有完整的关键变量数据，70%的受试者有3次就诊的完整数据。在每次就诊时，获取有关病史、用药情况、家族史、饮食和体力活动的信息，并通过计算机断层扫描测量体重、身高、血压、空腹血液检查(胰岛素、血糖和血脂)和内脏(腹内)脂肪面积。每次就诊时还进行75克口服葡萄糖耐量试验。拟议研究的总体目标是利用这个丰富的纵向数据库来提高对内脏脂肪过多(内脏肥胖)的临床意义的认识。我们的具体目标是在考虑了年龄、性别、吸烟、体重指数、饮食和体力活动的差异后，确定内脏肥胖、心血管疾病(CVD)死亡率和全因死亡率之间的关系。死亡证明的死亡率和死因将通过搜索国家死亡索引确定到2005年12月31日。我们预计，在平均18年的随访期内，在1次访问的733名受试者中，将有111人死于心血管疾病，250人死于各种原因。这项研究的结果将使人们更清楚地了解内脏肥胖症对心血管疾病死亡率和全因死亡率的临床影响，在考虑了体重指数等常用肥胖指标后。与公共健康相关：该项目与公共健康相关，因为它将确定腹部内过多的体脂(内脏脂肪)是否会增加死亡风险。我们还将观察，即使在考虑了基于身高和体重、饮食和体力活动的肥胖因素后，内脏脂肪较多的人的死亡风险是否也更高。这项研究还将提高对亚裔美国人健康风险的理解。

DESCRIPTION (provided by applicant): The Japanese American Community Diabetes Study (JACDS) began in 1983 to describe the metabolic effects of westernization that may contribute to the higher risk for type 2 diabetes observed in Japanese Americans compared with native Japanese and US non-Hispanic whites. This prospective study enrolled a total of 735 men and women of 100% Japanese ancestry. Study visits occurred at baseline, 2.5 years, 5-6 years and 10- 11 years. Complete data for key variables is available for 733 subjects for 1 visit, and 70% of subjects have complete data for 3 visits. At each visit information about medical history, medication use, family history, diet, and physical activity was obtained, and weight, height, blood pressure, fasting blood tests (insulin, glucose and lipids), and visceral (intra-abdominal) fat area by computed tomography were measured. A 75-g oral glucose tolerance test was also performed at each visit. The overall aim of the proposed research is to use this rich longitudinal database to improve knowledge about the clinical significance of excess visceral fat (visceral adiposity). Our specific aim is to determine the associations between visceral adiposity, cardiovascular disease (CVD) mortality and all-cause mortality after accounting for differences in age, sex, smoking, body mass index, diet and physical activity. Mortality and cause of death from death certificates will be ascertained through December 31, 2005 by searching the National Death Index. We project that during the average follow-up period of 18 years there will be 111 deaths from CVD and 250 deaths from all causes among the 733 subjects with complete data for 1 visit. The results of this study will lead to a clearer understanding of the clinical impact of visceral adiposity on cardiovascular disease mortality and all-cause mortality after accounting for commonly used measures of obesity, such as body mass index. PUBLIC HEALTH RELEVANCE: This project is relevant to the public health because it will determine whether excess body fat inside the abdomen (visceral fat) contributes to the risk of death. We will also see whether the risk of death is higher in people who have more visceral fat even after accounting for obesity based on height and weight, diet and physical activity. This study also will improve understanding of the health risks for Asian Americans.