Visceral Adiposity and Mortality in Japanese Americans

描述（由申请方提供）：日裔美国人社区糖尿病研究（JACDS）始于1983年，旨在描述西化的代谢影响，与日本本土和美国非西班牙裔白人相比，这可能导致日裔美国人中观察到的2型糖尿病风险较高。这项前瞻性研究共招募了735名100%日本血统的男性和女性。在基线、2.5年、5-6年和10- 11年进行研究访视。733例受试者的1次访视关键变量的完整数据可用，70%的受试者的3次访视数据完整。在每次访视时，获得有关病史、药物使用、家族史、饮食和体力活动的信息，并测量体重、身高、血压、空腹血液检查（胰岛素、葡萄糖和脂质）和通过计算机断层扫描测量的内脏（腹腔内）脂肪面积。每次访视时还进行了75 g口服葡萄糖耐量试验。这项研究的总体目标是利用这一丰富的纵向数据库来提高对内脏脂肪过多（内脏肥胖）临床意义的认识。我们的具体目标是在考虑年龄、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相关性。将通过检索国家死亡指数，查明截至2005年12月31日死亡证明中的死亡率和死亡原因。我们预计，在18年的平均随访期内，在733例具有1次访视完整数据的受试者中，将有111例CVD死亡和250例全因死亡。这项研究的结果将导致更清楚地了解内脏肥胖对心血管疾病死亡率和全因死亡率的临床影响，在考虑常用的肥胖指标（如体重指数）后。 公共卫生相关性：该项目与公共卫生有关，因为它将确定腹部内多余的身体脂肪（内脏脂肪）是否会导致死亡风险。我们还将看到，即使在考虑了基于身高和体重、饮食和体育活动的肥胖之后，内脏脂肪更多的人的死亡风险是否更高。这项研究还将提高对亚裔美国人健康风险的认识。

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.