title: Hba1c, Blood Pressure, and Lipid Control in People with Diabetes: Japan Epidemiology Collaboration on Occupational Health Study.
abstract: OBJECTIVE
  The control of blood glucose levels, blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) levels reduces the risk of diabetes complications; however, data are scarce on control status of these factors among workers with diabetes. The present study aimed to estimate the prevalence of participants with diabetes who meet glycated hemoglobin (HbA1c), BP, and LDL-C recommendations, and to investigate correlates of poor glycemic control in a large working population in Japan.
  
  
  METHODS
  The Japan Epidemiology Collaboration on Occupational Health (J-ECOH) Study is an ongoing cohort investigation, consisting mainly of employees in large manufacturing companies. We conducted a cross-sectional analysis of 3,070 employees with diabetes (2,854 men and 216 women) aged 20-69 years who attended periodic health examinations. BP was measured and recorded using different company protocols. Risk factor targets were defined using both American Diabetes Association (ADA) guidelines (HbA1c < 7.0%, BP < 140/90 mmHg, and LDL-C < 100 mg/dL) and Japan Diabetes Society (JDS) guidelines (HbA1c < 7.0%, BP < 130/80 mmHg, and LDL-C < 120 mg/dL). Logistic regression models were used to explore correlates of poor glycemic control (defined as HbA1c ≥ 8.0%).
  
  
  RESULTS
  The percentages of participants who met ADA (and JDS) targets were 44.9% (44.9%) for HbA1c, 76.6% (36.3%) for BP, 27.1% (56.2%) for LDL-C, and 11.2% (10.8%) for simultaneous control of all three risk factors. Younger age, obesity, smoking, and uncontrolled dyslipidemia were associated with poor glycemic control. The adjusted odds ratio of poor glycemic control was 0.58 (95% confidence interval, 0.46-0.73) for participants with treated but uncontrolled hypertension, and 0.47 (0.33-0.66) for participants with treated and controlled hypertension, as compared with participants without hypertension. There was no significant difference in HbA1c levels between participants with treated but uncontrolled hypertension and those with treated and controlled hypertension.
  
  
  CONCLUSIONS
  Data from a large working population, predominantly composed of men, suggest that achievement of HbA1c, BP, and LDL-C targets was less than optimal, especially in younger participants. Uncontrolled dyslipidemia was associated with poor glycemic control. Participants not receiving antihypertensive treatment had higher HbA1c levels.
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Hu
authors.affiliation: Tokyo Gas Co., Ltd., Tokyo, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Hori
authors.affiliation: Tokyo Gas Co., Ltd., Tokyo, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Nishiura
authors.affiliation: Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Okazaki
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Honda
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Mitsubishi Plastics, Inc., Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Nippon Steel & Sumitomo Metal Corporation Kimitsu Works, Chiba, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: All Japan Labour Welfare Foundation, Tokyo, Japan.
authors.forename: Satsue
authors.initials: S
authors.lastname: Nagahama
authors.affiliation: YAMAHA CORPORATION, Shizuoka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uehara
authors.affiliation: YAMAHA CORPORATION, Shizuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan.
authors.forename: Chii
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Eguchi
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kochi
authors.affiliation: Azbil Corporation, Tokyo, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Imai
authors.affiliation: Azbil Corporation, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Okino
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.|Teikyo University Graduate School of Public Health, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kuwahara
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kashino
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Kurotani
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nanri
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Kabe
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: National Institute of Public Health, Saitama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kunugita
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Dohi
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D006442:Glycated Hemoglobin; D000960:Hypolipidemic Agents; D008055:Lipids