| Research Abstract |
Using cross-sectional and follow-up data from 2,480 residents aged 40 to 79 years old of Hisayama Town in Japan, who underwent a 75-g oral glucose tolerance test in 1988, we performed the following studies :
1) To elucidate whether hyperinsulinemia plays a significant part in the initiation and development of renal dysfunction, we examined the relationship between serum insulin and renal function on data from the cross-sectional survey. The findings of this study suggested that hyperinsulinemia is a significant relevant factor of renal function in the general population. 2) A cross-sectional analysis of 2,103 non-diabetic men and women showed that regular alcohol consumption dose-dependently increased insulin sensitivity, but the insulin-mediated beneficial effects of alcohol on lipid concentrations were relatively small. 3) To investigate the impact of dietary factors on the development of glucose intolerance (GI) including diabetes and impaired glucose tolerance, we studied 933 subjec
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ts of normal glucose tolerance and followed them for at least five years. In a multiple logistic regression analysis, alcohol intake at baseline for men and increased saturated fatty acid intake during the follow-up for women remained a significant risk factor for GI independent of other dietary and non-dietary factors as well. 4) In a 5-year follow-up survey of 1,133 non-hypertensive non-diabetic subjects, we found a close association between insulin resistance and the incidence of hypertension. However, alcohol modified and reduced this relationship. 5) A 5-year follow-up study of 1,097 subjects aged 60 years or over revealed that hyperinsulinemia was a major risk factor for the development of coronary heart disease but was not for that of cerebral infarction. In addition, a clustering of constituents of insulin resistance syndrome, such as hyperinsulinemia, hypertension, glucose intolerance, dyslipidemia, and obesity, also increased the risk of coronary heart disease.
In conclusion, hyperinsulinemia and insulin resistance are considered to be major contributors to cardiovascular disease as well as to its risk factors, such as hypertension and glucose intolerance, in the recent Japanese population. Less
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