| Research Abstract |
In the prospective cohort study of residents of Hisayama Town in Japan (the Hisayama study), we studied the following issues :
1)To elucidate whether hyperglycemia plays a significant part in the development of cerebral infarction, we examined the relationship between glucose categories according to baseline fasting and 2-hour post-load glucose levels as well as the 1998 WHO criteria and the incidence of cerebral infarction in a 11-year prospective study of 2,424 Hisayama residents aged 40-79 years who underwent a 75g oral glucose tolerance test in 1988. The findings of this study suggest that diabetes is an independent risk factor for the development of cerebral infarction in men, while impaired fasting glycemia increases the risk of cerebral infarction in women in a general Japanese population. 2)Compared the results of follow-up survey of the first(1961) and second cohort (1974) of the Hisayama study, we studied secular trends in the association between glucose intolerance and the ri
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sk of cancer death. Our findings revealed that glucose intolerance was a significantly independent risk factor for cancer death among men in the second cohort, but was not among men in the first cohort. This association was not observed for women in either cohort. 3)In a 5-year follow-up study of 2,487 subjects aged 40 to 79 years who underwent 75g OGTT in 1988, we examined the impact of diabetes on cancer death. The mortality from cancer significantly increased in subjects with diabetes than in normal subjects for both men and women, suggesting increased risk of cancer among subjects with diabetes in the recent general population. 4)A total of 2,466 Hisayama residents aged 40 years or older were stratified into three groups according to fasting plasma glucose levels and followed up prospectively for 9 years. The risks of gastric cancer in modest and high plasma glucose groups were 'significantly higher than that in the low plasma glucose group even after adjusting for other comprehensive risk factors including Helicobacter (H) pylon status in multivariate analysis. Furthermore, a stratified analysis showed that this glucose-cancer association was observed only among H.pylori-seropositive subjects; it was not observed in any H.pyloni-seronegative subjects.
In conclusion, our findings suggest that hyperglycemia as well as diabetes is a major risk factor for cardiovascular disease and cancer in the recent general Japanese population. Less
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