title: [Changes in measurements related to metabolic syndrome among individuals with national health insurance after specific health guidance].
abstract: OBJECTIVE
  In 2008, "Specific health checkup and guidance," a policy that focused on improving the status of metabolic syndrome (MetS), was launched in Japan. The aim of the present study was to evaluate the effects of a 6-month intervention based on this policy on the participants' metabolic syndrome, obesity risk factors, and lifestyles.
  
  
  METHODS
  A quasi-experimental design was used between 2008 and 2009. In total, 500 subjects and 1,483 residents of Soka city, Saitama Prefecture were judged to require an active and motivational support (ACS and MOS, respectively) based on a specific health guidance standard in Japan. Of these residents, 72 and 275 individuals attended a program that included individual counseling and a 6-month intervention, respectively. Those who did not attend any intervention and received only information concerning MetS were classified as the control group. Changes in the risk factors related to obesity and MetS were analyzed using the analysis of covariance and multiple logistic models.
  
  
  RESULTS
  Of the 347 participants, 62 (86.1%) and 41 (56.900) receiving ACS and 266 (96.700) and 210 (76.400) receiving MOS finished the 6-month intervention program and subsequent follow-up, respectively. After the 6-month intervention, improvement in obesity-related risk factors with ACS was significantly greater than that with MOS. Compared to the control group, those receiving ACS demonstrated significant improvements in the waist circumference (-3.1 cm, P < 0.001), body mass index (BMI; -0.8 kg/m2, P < 0.001), weight (-2.3 kg, P < 0.001), and HbA1c levels (-0.18%, P = 0.016). Those receiving MOS showed significant improvements in the waist circumference (-1.3 cm, P = 0/001), BMI (-0.5 kg/m2, P < 0.001), weight (-1.2 kg, P < 0.001), systolic and diastolic blood pressure (-2.4 mmHg, P = 0.018; -1.8 mmHg, P = 0.005), and HbA1c levels (-0.06%, P = 0.025) after adjusting for sex, age, and baseline values. The proportion of participants receiving ACS and MOS who met the definition of Mets or pre-Mets at the baseline, but did not achieve this threshold after 1 year, was significantly higher than those participants in the control group. The odds ratio with 9500 confidence intervals was 1.41 (1.05-1.90) for combined ACS and MOS, and 1.39 (1.00-1.94) for MOS, respectively. Conclusion Thus, our program helped in improving factors associated with MetS.
authors.affiliation: Department of Public Health, Dokkyo Medical University, School of Medicine.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Haruyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Muto
authors.forename: Makiko
authors.initials: M
authors.lastname: Nakate
authors.forename: Akiko
authors.initials: A
authors.lastname: Yamasaki
authors.forename: Fumiko
authors.initials: F
authors.lastname: Tarumi
mesh_terms: D000368:Aged; D003376:Counseling; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D024821:Metabolic Syndrome / Q000628:therapy*; D008875:Middle Aged; D009042:Motivation; D009313:National Health Programs; D009765:Obesity / Q000628:therapy