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Gender difference in the association between social support and metabolic syndrome in Japan: the ‘enkai’ effect?
  1. Ai Ikeda1,2,
  2. Ichiro Kawachi1,
  3. Hiroyasu Iso2,
  4. Manami Inoue3,
  5. Shoichiro Tsugane3,
  6. JPHC Study Group
  1. 1Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
  2. 2Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
  3. 3Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
  1. Correspondence to Professor Hiroyasu Iso, Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita-shi, Osaka 565-0871, Japan; fvgh5640{at}


Background Recent reports have found an association between social support and reduced prevalence of metabolic syndrome (or its components) in the West; however, no study has been carried out in Asian populations.

Methods The authors examined 12 537 men and women who were part of the Japan Public Health Center-based Prospective Study initiated in 1993. Perceived emotional support was assessed through questionnaire as receipt of confidant support and esteem support from family members or friends. Metabolic syndrome was defined based on the modified criteria of the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF), while its components were obtained through health examinations conducted during the same year as the questionnaire.

Results The authors found an association between social support and metabolic syndrome among Japanese men that was in the opposite direction to what has previously been reported in western studies. Among men, the multivariate ORs and 95% CIs for metabolic syndrome in the lowest versus highest level of social support was 0.75 (0.58 to 0.97) based on AHA/NHLBI criteria and 0.69 (0.51 to 0.92) based on IDF criteria. Among women, the authors found no association between social support and metabolic syndrome.

Conclusions In this study, men with higher social support appeared to engage in heavier drinking and also reported a higher fat intake pattern, both of which may increase the risk of metabolic syndrome mainly through overweight. Our findings lend weight to the notion that the pattern of association between social support and health outcomes is both culturally contingent and gender-specific.

  • Social support
  • metabolic syndrome
  • gender difference

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  • Members of the Japan Public Health Center-based Prospective Study (JPHC Study, principal investigator: S Tsugane) Group are: S Tsugane, M Inoue, T Sobue and T Hanaoka, National Cancer Center, Tokyo; J Ogata, S Baba, T Mannami, A Okayama and Y Kokubo, National Cardiovascular Center, Osaka; K Miyakawa, F Saito, A Koizumi, Y Sano, I Hashimoto and T Ikuta, Iwate Prefectural Ninohe Public Health Center, Iwate; Y Miyajima, N Suzuki, S Nagasawa, Y Furusugi and N Nagai, Akita Prefectural Yokote Public Health Center, Akita; H Sanada, Y Hatayama, F Kobayashi, H Uchino, Y Shirai, T Kondo, R Sasaki, Y Watanabe, Y Miyagawa and Y Kobayashi, Nagano Prefectural Saku Public Health Center, Nagano; Y Kishimoto, E Takara, T Fukuyama, M Kinjo, M Irei and H Sakiyama, Okinawa Prefectural Chubu Public Health Center, Okinawa; K Imoto, H Yazawa, T Seo, A Seiko, F Ito and F Shoji, Katsushika Public Health Center, Tokyo; A Murata, K Minato, K Motegi and T Fujieda, Ibaraki Prefectural Mito Public Health Center, Ibaraki; K Matsui, T Abe, M Katagiri and M Suzuki, Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Niigata; M Doi, A Terao, Y Ishikawa and T Tagami, Kochi Prefectural Chuo-higashi Public Health Center, Kochi; H Sueta, H Doi, M Urata, N Okamoto and F Ide, Nagasaki Prefectural Kamigoto Public Health Center, Nagasaki; H Sakiyama, N Onga, H Takaesu and M Uehara, Okinawa Prefectural Miyako Public Health Center, Okinawa; F Horii, I Asano, H Yamaguchi, K Aoki, S Maruyama, M Ichii and M Takano, Osaka Prefectural Suita Public Health Center, Osaka; Y Tsubono, Tohoku University, Miyagi; K Suzuki, Research Institute for Brain and Blood Vessels Akita, Akita; Y Honda, K Yamagishi and S Sakurai, Tsukuba University, Ibaraki; M Kabuto, National Institute for Environmental Studies, Ibaraki; M Yamaguchi, Y Matsumura, S Sasaki and S Watanabe, National Institute of Health and Nutrition, Tokyo; M Akabane, Tokyo University of Agriculture, Tokyo; T Kadowaki, Tokyo University, Tokyo; M Noda, International Medical Center of Japan, Tokyo; Y Kawaguchi, Tokyo Medical and Dental University, Tokyo; Y Takashima, Kyorin University, Tokyo; K Nakamura, Niigata University, Niigata; S Matsushima and S Natsukawa, Saku General Hospital, Nagano; H Shimizu, Sakihae Institute, Gifu; H Sugimura, Hamamatsu University, Shizuoka; S Tominaga, Aichi Cancer Center Research Institute, Aichi; H Iso, Osaka University, Osaka; M Iida, W Ajiki and A Ioka, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka; S Sato, Osaka Medical Center for Health Science and Promotion, Osaka; E Maruyama, Kobe University, Hyogo; M Konishi, K Okada and I Saito, Ehime University, Ehime; N Yasuda, Kochi University, Kochi; S Kono, Kyushu University, Fukuoka.

  • Funding A Grant-in-Aid for Cancer Research and by the Third-Term Comprehensive Control Research for Cancer from the Ministry of Health, Labor and Welfare, Tokyo, Japan. AI was also supported by the postdoctoral fellowship for Research Abroad of Japan Society for the Promotion of Science (Tokyo, Japan).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by The National Cancer Center, Tokyo, Japan.

  • Provenance and peer review Commissioned; not externally peer reviewed.