[Effect of the national lifestyle modification project conducted in Japan on the parameters of metabolic syndrome].
OBJECTIVE
Although the national lifestyle modification project targeting metabolic syndrome in the general population conducted by the Japanese government started in 2008, the project's long-term effects have not yet been evaluated. Associations of taking the project's lifestyle modification guidance with improvement of parameters related to metabolic syndrome after 1, 2, 3, and 4 years were assessed in participants who met the metabolic syndrome criteria for the guidance.


METHODS
While improvement was defined when the parameters had met the criteria for metabolic syndrome at the initial checkup but did not at the time of evaluation without medication, deterioration was defined when they had not met the criteria at the initial checkup but, at the time of evaluation, they did or the subjects received the medication. Logistic regression analyses were used to evaluate improvement by the guidance adjusted for age, sex, systolic blood pressure, HDL cholesterol level, and hemoglobin (Hb)A1c level at baseline.


RESULTS
From 2008 to 2011, 3742 participants (mean age 61±10 years, men 62%) met the criteria for the lifestyle modification guidance. Numbers of participants eligible for evaluation were 2690, 1894, 1330, and 779 at 1, 2, 3, and 4 years after the initial checkup, respectively. Based on the multivariate logistic regression analyses, receiving the guidance was significantly associated with improvement of body mass index (BMI) (odds ratio (OR)=1.66, 95% confidence interval (CI)=1.17-2.37), waist (OR=1.77, 95%CI=1.35-2.31), and HbA1c (OR=1.82, 95%CI=1.05-3.13) at the 1-year evaluation; improvement of BMI (OR=1.51, 95%CI=1.01-2.26) and waist (OR=1.61, 95%CI=1.18-2.20) at the 2-year evaluation; and improvement of waist (OR=1.67, 95%CI=1.12-2.48) at the 3-year evaluation. However, BMI, waist, and HbA1c at other evaluations including the 4-year evaluation and the remaining parameters at any evaluations were not significantly improved by the guidance. In addition, receiving the guidance was significantly associated with deterioration of HbA1c at the 4-year evaluation (OR=2.49, 95%CI=1.18-5.24).


CONCLUSIONS
Although HbA1c at the 1-year evaluation and parameters related to overweight were improved at the 1-, 2-, and 3-year evaluations, no parameters of metabolic syndrome were significantly improved by the guidance at the 4-year evaluation.
Health Examination Center of Moriguchi City.
Hisako
H
Tsuji
Ichiro
I
Shiojima
D000368:Aged; D005260:Female; D006801:Humans; D007564:Japan; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000628:therapy*; D008875:Middle Aged; D009313:National Health Programs