OBSERVATIONS and a Signed Informed Consent Form Was IICHIRO SHIMOMURA, MD, PHD Obtained from Each Participant

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5 ethics committee of Osaka University, YUJI MATSUZAWA, MD, PHD 1 OBSERVATIONS and a signed informed consent form was IICHIRO SHIMOMURA, MD, PHD obtained from each participant. The 1 registration number of the trial at the From the Department of Metabolic Medicine, Graduate School of Medicine, Osaka Univer- One-Year Reductions UMIN is 000002391 (the Amagasaki sity, Suita, Osaka, Japan; the 2Amagasaki City in Body Weight and Visceral Fat Study). Height, weight, and Office, Environment and Civic Affairs Bureau, waist circumference (WC) at the umbil- Health Support Promotion Section, Ama- 3 Blood Pressure, but ical level were measured in standing gasaki, Hyogo, Japan; the Toyonaka Munici- pal Hospital, Osaka, Japan; the 4Kawasaki Not in Visceral Fat position. Serum concentrations of adi- Hospital, Kobe, Hyogo, Japan; and the 5Sumi- Accumulation and ponectin were measured by the latex tomo Hospital, Osaka, Japan. particle-enhanced turbidimetric assay. Corresponding author: Ken Kishida, kkishida@ Adiponectin, UACR was calculated from a single spot imed2.med.osaka-u.ac.jp. Improve Urinary urine specimen. ⌬UACR correlated DOI: 10.2337/dc10-0739 ⌬ ϭ ϭ © 2010 by the American Diabetes Association. Albumin-to- with BMI (r 0.077, P 0.0036) and Readers may use this article as long as the work is ⌬systolic blood pressure (SBP, r ϭ properly cited, the use is educational and not for Creatinine Ratio in 0.063, P ϭ 0.0127), but not ⌬HbA1c profit, and the work is not altered. See http:// Middle-Aged (P ϭ 0.0705), ⌬triglyceride (P ϭ creativecommons.org/licenses/by-nc-nd/3.0/ for 0.0524), ⌬HDL cholesterol (P ϭ 0.9906), details. Japanese Men ⌬LDL cholesterol (P ϭ 0.5761), ⌬estimated glomerular filtration rate (eGFR, Acknowledgments— This research was sup- Modification of Diet in Renal Disease ϭ ⌬ ϭ ported in part by a Grant-in-Aid for Scientific icroalbuminuria has been recog- [MDRD], P 0.1724), eVFA (P Research no. (C) 21591177 (to K.K.), a re- nized recently as a risk factor for 0.3026), and ⌬adiponectin (P ϭ search grant (KH21AI005a) from the Ministry M cardiovascular diseases as well 0.9860). Stepwise multiple regression of Health, Labor and Welfare (to T.F.), a grant as renal failure and is often found in analysis identified ⌬BMI (F ϭ 6.341) from Takeda Medical Research Foundation (to subjects with metabolic syndrome. The and ⌬SBP (F ϭ 4.053) as significant de- T.F.), a grant from the Japan Heart Foundation relationship between visceral fat accu- terminants of ⌬UACR. with Astellas Pharma and Pfizer Grant for Re- mulation and microalbuminuria, uri- The present study demonstrated search on Atherosclerosis Update (to K.K.), nary albumin-to-creatinine ratio that, unlike ⌬BMI and ⌬SBP, 1-year re- and a grant from Manpei Suzuki Diabetes Foundation (to T.N.). (UACR), has not been fully clarified. duction of eVFA only was not sufficient No other potential conflicts of interest rele- Our cross-sectional study demonstrated to improve UACR. This meant a signif- vant to this article were reported. that visceral fat accumulation is associ- icant reduction in blood pressure, H.N. and K.K. researched data, analyzed ated with increases in UACR. However, which is downstream of visceral fat ac- data, and wrote the manuscript. K.K. re- the accompanying obesity-related risk cumulation, should be required. We viewed/edited the manuscript. M.N. and T.O. factors, especially hemoglobin A1c could not find a significant relationship researched data. Y.O., H.N., T.N. and Y.M. (HbA1c) and elevated blood pressure, between 1-year changes in UACR and contributed to discussion. T.F. and I.S. con- strongly increased the risk of UACR (1). HbA1c, probably because the number tributed to discussion and wrote the We have reported that reductions in of subjects with abnormal HbA1c values manuscript. both body weight and estimated visceral (Ն5.8%) was small (n ϭ 130 of 1,539, We thank all members of the Amagasaki Study Group, Department of Metabolic fat area (eVFA) measured by the bioel- 8.4%). Although previous studies re- Medicine, Osaka University, including the ectrical impedance analysis method (2) ported a relationship between serum medical staff, for the helpful discussion and were accompanied by reductions in the levels of adiponectin and albuminuria comments. number of obesity-related cardiovascu- in obese subjects (5) and general men lar risk factors (3) and increases in se- (1), we could not observe a relationship ●●●●●●●●●●●●●●●●●●●●●●● rum levels of adiponectin (4) in our between 1-year changes in UACR and longitudinal Amagasaki Visceral Fat adiponectin in general men. Monitoring References Study, in which intensive risk factor– 1. Tamba S, Nakatsuji H, Kishida K, Nogu- over a longer period of time might be chi M, Ogawa T, Okauchi Y, Nishizawa H, oriented health promotion programs needed. To our knowledge, this is the Imagawa A, Nakamura T, Matsuzawa Y, were provided. The present study inves- first report demonstrating the relation- Funahashi T, Shimomura I. Relationship tigated the relationship between 1-year ship between 1-year changes in UACR between visceral fat accumulation and ⌬ changes in UACR (⌬UACR) and the and visceral fat accumulation and urinary albumin-creatinine ratio in mid- estimated visceral fat area (⌬eVFA), and adiponectin. dle-aged Japanese men. Atherosclerosis. other parameters in these subjects. In press The study subjects were 1,539 Jap- 2. Ryo M, Maeda K, Onda T, Katashima M, 1 anese males (mean Ϯ SD age 45.8 Ϯ HIDEAKI NAKATSUJI, MD Okumiya A, Nishida M, Yamaguchi T, 1 Funahashi T, Matsuzawa Y, Nakamura 10.4 years [range 20–68 years]) who KEN KISHIDA, MD, PHD 1 T, Shimomura I. A new simple method were employees of the Amagasaki City TOHRU FUNAHASHI, MD, PHD 2 for the measurement of visceral fat ac- Office, had undergone an annual health MIDORI NOGUCHI, RN 2 cumulation by bioelectrical impedance. checkup in both 2006 and 2007, and TOMOKO OGAWA, RN 1 Diabetes Care 2005;28:451–453 were not taking any medications for di- YUKIYOSHI OKAUCHI, MD, PHD 3. Okauchi Y, Nishizawa H, Funahashi T, 3 abetes, hypertension, and dyslipidemia. HITOSHI NISHIZAWA, MD, PHD Ogawa T, Noguchi M, Ryo M, Kihara S, 4 The study was approved by the human TADASHI NAKAMURA, MD, PHD Iwahashi H, Yamagata K, Nakamura T,

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Shimomura I, Matsuzawa Y. Reduction hashi H, Imagawa A, Nakamura T, Matsu- 5. Sharma K, Ramachandrarao S, Qiu G, of visceral fat is associated with decrease zawa Y, Shimomura I. Changes in serum Usui HK, Zhu Y, Dunn SR, Ouedraogo in the number of metabolic risk factors adiponectin concentrations correlate with R, Hough K, McCue P, Chan L, Falkner in Japanese men. Diabetes Care 2007; changes in BMI, waist circumference, and B, Goldstein BJ. Adiponectin regulates 30:2392–2394 estimated visceral fat area in middle-aged albuminuria and podocyte function in 4. Okauchi Y, Kishida K, Funahashi T, general population. Diabetes Care 2009;32: mice. J Clin Invest 2008;118:1645- Noguchi M, Ogawa T, Ryo M, Okita K, Iwa- e122 56

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