Hiroaki Ikezaki1, Masumi Ai2, Ernst J Schaefer3, Seiko Otokozawa4, Bela F Asztalos3, Katsuyuki Nakajima5, Yanhua Zhou6, Ching-Ti Liu6, Paul F Jacques7, L Adrienne Cupples6, Norihiro Furusyo8. 1. Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA, USA; Nutritional Epidemiology Program, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA, USA; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. Electronic address: hiroaki.ikezaki@tufts.edu. 2. Department of Insured Medical Care Management, Tokyo Medical and Dental University Hospital, Tokyo, Japan. 3. Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA, USA. 4. Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan. 5. Faculty of Medicine, School of Health Science, Gunma University, Gunma, Japan. 6. Department of Biostatistics, School of Public Health, Boston University, Boston, MA, USA. 7. Nutritional Epidemiology Program, Human Nutrition Research Center on Aging at Tufts University and Tufts University School of Medicine, Boston, MA, USA. 8. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Abstract
BACKGROUND: Age-adjusted cardiovascular disease (CVD) prevalence rates are significantly lower in Japan than in the United States. OBJECTIVE: Our aim was to compare CVD risk in participants in Fukuoka and Framingham. METHODS: We measured glucose, insulin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), small dense LDL-C, and triglycerides in men and women from Fukuoka (n = 1108), and age (median, 53 years) and gender-matched subjects from Framingham (n = 1101). Blood pressure, body mass index, use of medications, and history of CVD were also assessed. RESULTS: CVD prevalence rates were more than 6-fold higher in Framingham men and women than their Fukuoka counterparts (P < .001). Median body mass index, LDL-C, insulin levels, and insulin resistance assessment in Fukuoka men and women were significantly (P < .01) lower than in Framingham; however, diabetes prevalence in Fukuoka men was significantly (P < .01) higher than in Framingham men, whereas female rates were similar, as were levels of systolic blood pressure. High-density lipoprotein cholesterol and surprisingly small dense LDL-C levels were significantly (P < .001) higher in Fukuoka than in Framingham. Standard risk factors do not account for the large differences in CVD prevalence rates between the 2 populations, and population differences in insulin resistance may explain some of these differences. CONCLUSIONS: Our data are consistent with the concept that the CVD prevalence rate in a Japanese population is much lower than those observed in the United States, and that these differences cannot be explained by standard CVD risk factors, but may relate to marked population differences in insulin resistance.
BACKGROUND: Age-adjusted cardiovascular disease (CVD) prevalence rates are significantly lower in Japan than in the United States. OBJECTIVE: Our aim was to compare CVD risk in participants in Fukuoka and Framingham. METHODS: We measured glucose, insulin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), small dense LDL-C, and triglycerides in men and women from Fukuoka (n = 1108), and age (median, 53 years) and gender-matched subjects from Framingham (n = 1101). Blood pressure, body mass index, use of medications, and history of CVD were also assessed. RESULTS: CVD prevalence rates were more than 6-fold higher in Framingham men and women than their Fukuoka counterparts (P < .001). Median body mass index, LDL-C, insulin levels, and insulin resistance assessment in Fukuoka men and women were significantly (P < .01) lower than in Framingham; however, diabetes prevalence in Fukuoka men was significantly (P < .01) higher than in Framingham men, whereas female rates were similar, as were levels of systolic blood pressure. High-density lipoprotein cholesterol and surprisingly small dense LDL-C levels were significantly (P < .001) higher in Fukuoka than in Framingham. Standard risk factors do not account for the large differences in CVD prevalence rates between the 2 populations, and population differences in insulin resistance may explain some of these differences. CONCLUSIONS: Our data are consistent with the concept that the CVD prevalence rate in a Japanese population is much lower than those observed in the United States, and that these differences cannot be explained by standard CVD risk factors, but may relate to marked population differences in insulin resistance.