Disturbances of glucose and lipid metabolism in first and second generation Japanese-Brazilians. Japanese-Brazilian Diabetes Study Group.

Increased prevalence of self-reported NIDDM in Japanese-Brazilians was reported when compared to Japan. This study aimed at determining the prevalence of NIDDM and IGT in Japanese-Brazilians living in the city of Bauru, São Paulo, Brazil. The impact of western environment on the frequency of obesity, dyslipidemia and hypertension was investigated. All Issei (first generation; n = 238) and a random sample of Nisei (second generation; n = 292), aged 40-79 years, were selected for clinical examination and OGTT (WHO criteria). Age-adjusted prevalence of NIDDM did not differ between men and women for Issei (12.4 vs. 11.6%, respectively), but it became different for Nisei (21.7 vs. 11.4%, P < 0.03) due to an increased rate among men. Increased IGT prevalence was also observed between Issei and Nisei men (8.5 vs. 19.3%, P < 0.03). Issei women had a higher IGT rate than Issei men (27. 3 vs. 8.5%, P < 0.0005). Body mass index (BMI) was higher in the second generation (24.1 +/- 3.6 vs. 23.3 +/- 3.1 kg/m2, P < 0.00005) and also the frequency of obesity, defined as BMI > 25 kg/m2. Comparison of waist/hip ratio by gender showed that only among women, Nisei had lower ratio than Issei (0.90 vs. 0.88, P < 0.05). Nisei had a lower total and LDL-cholesterol than Issei but triglyceride and HDL-cholesterol did not differ. Nisei women (younger than the Issei) had lower triglyceride and total cholesterol. This pattern was not seen between the two generations of men. Considering the mean blood pressure values, Issei and Nisei groups with normal glucose tolerance were not hypertensive. Systolic blood pressure was lower in Nisei and the inverse was found concerning diastolic levels. NIDDM prevalence in Japanese-Brazilians is higher than in Japan and in the general Brazilian population. Besides environment, genetic factors may confer susceptibility to NIDDM when they are exposed to a western environment. Before developing glucose intolerance, disturbances of lipid profile and blood pressure could be detected. Nisei may be more affected due to a longer exposure to an unfavorable environment and these changes seem to occur earlier among men than women.