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Macrovascular disease in a Japanese–Brazilian population of high prevalence of metabolic syndrome: Associations with classical and non-classical risk factors

  • Antonela F.A. Siqueira
    Affiliations
    Division of Endocrinology, Department of Internal Medicine, Federal University of Sao Paulo, Brazil
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  • Laercio J. Franco
    Affiliations
    Department of Social and Preventive Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
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  • Suely G.A. Gimeno
    Affiliations
    Department of Preventive Medicine, Federal University of Sao Paulo, Brazil
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  • Luiza K. Matsumura
    Affiliations
    Division of Endocrinology, Department of Internal Medicine, Federal University of Sao Paulo, Brazil
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  • Dulcinéia S.P. Abdalla
    Affiliations
    Department of Clinical and Toxicological Analysis, University of Sao Paulo, Brazil
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  • Newton de Barros Jr.
    Affiliations
    Department of Nutrition, School of Public Health, University of Sao Paulo, Brazil
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  • Sandra R.G. Ferreira
    Correspondence
    Corresponding author at: Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Nutrição, Av. Dr. Arnaldo, 715, CEP 01246-904, São Paulo, SP, Brazil. Tel.: +55 11 3066 7771; fax: +55 11 3066 3062.
    Affiliations
    Department of Surgery, Federal University of Sao Paulo, Brazil
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  • on behalf of the JBDSG
    Author Footnotes
    1 Alcides Hirai, MD; Amelia T. Hirai, MD; Helena Harima, MD; Katsumi Osiro, MD; Mario Kikuchi, PhD; Suely G.A. Gimeno, PhD (Preventive Medicine Department, Federal University of Sao Paulo, Brazil); Vania D’Almeida, PhD (Pedriatrics Department, Genetics Laboratory, Federal University of Sao Paulo, Brazil); Laercio J. Franco, MD, PhD (Social and Preventive Medicine Department, Ribeirao Preto Medical School, University of Sao Paulo, Brazil); Luiza K. Matsumura, MD, PhD; Regina S. Moises, MD, PhD (Internal Medicine Department, Federal University of Sao Paulo, Brazil); Marly A. Cardoso, PhD (Nutrition Department, Faculty of Public Health, Sao Paulo University, Brazil); Newton de Barros Jr, MD, PhD (Surgery Department, Federal University of Sao Paulo, Brazil); Nilce Tomita, PhD (Faculty of Odontology of Bauru, Sao Paulo University, Brazil); Katsunori Wakisaka (Japanese–Brazilians Study Center, Brazil); Rita Chaim (Nutrition Department, Sagrado Coraçao de Jesus University, Bauru, Brazil); Sandra R.G. Ferreira, MD, PhD (Nutrition Department, School of Public Health, University of Sao Paulo State, Brazil).
  • Author Footnotes
    1 Alcides Hirai, MD; Amelia T. Hirai, MD; Helena Harima, MD; Katsumi Osiro, MD; Mario Kikuchi, PhD; Suely G.A. Gimeno, PhD (Preventive Medicine Department, Federal University of Sao Paulo, Brazil); Vania D’Almeida, PhD (Pedriatrics Department, Genetics Laboratory, Federal University of Sao Paulo, Brazil); Laercio J. Franco, MD, PhD (Social and Preventive Medicine Department, Ribeirao Preto Medical School, University of Sao Paulo, Brazil); Luiza K. Matsumura, MD, PhD; Regina S. Moises, MD, PhD (Internal Medicine Department, Federal University of Sao Paulo, Brazil); Marly A. Cardoso, PhD (Nutrition Department, Faculty of Public Health, Sao Paulo University, Brazil); Newton de Barros Jr, MD, PhD (Surgery Department, Federal University of Sao Paulo, Brazil); Nilce Tomita, PhD (Faculty of Odontology of Bauru, Sao Paulo University, Brazil); Katsunori Wakisaka (Japanese–Brazilians Study Center, Brazil); Rita Chaim (Nutrition Department, Sagrado Coraçao de Jesus University, Bauru, Brazil); Sandra R.G. Ferreira, MD, PhD (Nutrition Department, School of Public Health, University of Sao Paulo State, Brazil).

      Abstract

      Background

      The Japanese–Brazilian Diabetes Study detected high prevalence of metabolic syndrome (MS) in a population of Japanese ancestry living in Brazil. We describe the prevalence of macrovascular disease (MVD) and its association with classical and non-classical cardiovascular risk factors in this population.

      Methods

      An overall of 1163 individuals were studied; diagnosis of MVD was based on a score obtained from medical history, ankle-brachial pressure index and electrocardiogram, defining three groups: no MVD, possible MVD and definite MVD.

      Results

      Prevalence of MVD was 14.3% (possible MVD: 11.2%; definite MVD: 3.1%). Individuals with MS had higher rates of MVD (16.9% versus 11.2%; p < 0.05). Comparing to no MVD, age, 2 h plasma glucose, anti-LDL(+) and anti-LDL(−) levels, and urinary albumin-to-creatinine ratio were higher in both categories with MVD; waist-to-hip ratio, fasting plasma glucose, HbA1c, total-to-HDL cholesterol ratio and triglycerides were higher in that with definite MVD; systolic blood pressure and homocysteine were higher in that with possible MVD. Using logistic regression, systolic blood pressure, smoking habit and anti-LDL(+) were independently associated with MVD.

      Conclusion

      MVD is highly prevalent in Japanese–Brazilians and its association with MS was confirmed. A novel marker of lipoprotein modifications – anti-LDL(+) antibody – could be useful in identifying individuals at higher risk.

      Keywords

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