Hem 780

Fieldwork activities and procedures of the CRONICAS Cohort Study have been described in detail elsewhere.¹⁵ Trained community health workers applied face-to-face questionnaires. After completing the questionnaire, an appointment for a clinical assessment was arranged to ensure an adequate fasting period, between 8 and 12 hours, where a total of 13.5 mL of blood was drawn. Standing height was measured using standardized techniques. After a 5-minute resting period, blood pressure was measured using an automatic monitor OMRON HEM-780 (OMRON, Tokyo, Japan) validated for adult population.
For laboratory procedures, Cobas Modular Platform automated analyzer and reagents from Roche Diagnostics were used to measure triglycerides, total cholesterol, and HDL-c. Also, LDL-c was measured using this method in participants with triglycerides ≥400 mg/dL. However, if participants had triglycerides below 400 mg/dL, the Friedewald equation was used to calculate LDL-c in mg/dL. Non-HDL-c was also estimated by subtracting HDL-c from total cholesterol. Serum glucose was measured using an enzymatic colorimetric method (GOD-PAP; Modular P-E/Roche-Cobas, Grenzach-Wyhlen, Germany).

Systolic and diastolic blood pressure were taken using a HEM-780 automatic monitor (Omron Healthcare, Inc., Mississauga, Ontario, Canada). Blood pressure measurements were taken in triplicate and the final two measurements were averaged to obtain the final values. Participant standing height was measured in triplicate using standardized methods and weight was measured using the TBF-300A body composition analyser (TANITA Corporation, Tokyo, Japan). eCO was assessed using the Micro CO meter (Micro Direct, Lewiston, ME, USA) and monitors were calibrated monthly. A trained technician collected 13.5 ml of venous blood after 8–12 h of participant fasting. Highly sensitive C-reactive protein was assessed using Latex (Tina-quant CRP-HS Roche/Hitachi analyser, Indianapolis, IN, USA) and haemoglobin A1C (HbA1c) was analysed using high performance liquid chromatography (D10, BioRad, Munich, Germany). Detailed information on the clinical assessment, blood sampling, and laboratory analysis has been previously published [29 (link)].

School nurses measured the participants’ body height and weight near 0.1 cm and 0.1 kg, respectively. Body mass index (BMI; kg/m²) was calculated as the weight divided by the square of height. The standard deviation score of BMI (zBMI) was calculated based on the Japanese reference in 2000 [34 (link)] using the Lambda–Mu–Sigma method [35 (link)]. Blood pressure (BP) was measured twice using auto-sphygmomanometers (HEM-707, HEM-757, or HEM-780, OMRON, Kyoto, Japan) after 5 min of sitting. Mean systolic and diastolic blood pressure (SBP and DBP, respectively) measurements were used. The participants were asked to fast 10–12 h before the blood extraction. Triglyceride (TG), low-density and high-density lipoprotein serum cholesterol (LDL-C and HDL-C, respectively), and plasma glucose levels were measured from blood specimens. Cardiometabolic risks were defined based on the definition of the International Diabetes Federation (32): zBMI ≥ 1; TG ≥ 150 mg/dL; LDL-C ≥ 120 mg/dL; HDL-C < 40 mg/dL; fasting plasma glucose ≥ 100 mg/dL; and SBP ≥ 130 mmHg and/or DBP ≥ 85 mmHg. Cardiometabolic risks were summed up as a metabolic syndrome score (MS score) ranging from 0 to 6.

The morphological characteristics of the participants were measured in the morning and always at the same time and under identical conditions. Body height was measured to the nearest 0.1 cm using a wall-mounted stadiometer (Seca 220. Hamburg. Germany). Body weight was measured to the nearest 0.01 kg using calibrated electronic digital scales (Seca 769. Hamburg. Germany) in nude, barefoot conditions. Body fat content was estimated from the sum of 6 skinfolds (∑6) (abdominal, suprailiac, tricipital, subscapular, thigh and calf skinfolds). Skinfold thicknesses were measured with a Harpenden caliper (Holtain Skinfold Caliper. Crosswell, UK). All measurements were made by the same operator, skilled in kinanthropometric techniques, in accordance with the International Society for the Advancement of Kinanthropometry recommendations. Heart rate and blood pressure were determined using an automatic sphygmomanometer (Omron HEM-780. Osaka. Japan) by a skilled technician, always after a five-minute rest period in a supine position.

The procedures of the ENINBSC have been described previously [18 ]. Briefly, after consent, two different visits were scheduled. The first one lasted on average 40 minutes and was carried out to apply a face-to-face questionnaire regarding data about household characteristics, demographics, lifestyles behaviors, risk factors, and blood pressure measurements. The second visit lasted 30 minutes on average and was planned to have an appropriate period of fasting for blood sampling for glucose, total cholesterol, HDL-cholesterol, and the remaining anthropometric measures (height, weight, and waist circumference) using standard procedures.
Similarly, the procedures of the CRONICAS study has been published elsewhere [19 (link)]. In brief, participants responded to a face-to-face questionnaire applied by trained community health workers. Data collected comprised risk factors for cardiovascular disease based on a modified version of the WHO STEP approach questionnaire for surveillance of noncommunicable disease [20 ]. A period of 8 to 12 hours of fasting was required for blood sampling to collect fasting glucose, total cholesterol, and HDL-cholesterol. Height, weight, and waist circumference were also assessed, and blood pressure was measured in triplicate after five minutes of resting using an automatic monitor (OMRON HEM-780) previously validated in adult's population [21 (link)].

Participants used a self-report questionnaire to document medical history and lifestyle. They answered whether they had ever been treated with any of the followings: diabetes mellitus, hypertension, and hyperlipidemia. They answered alcohol intake (drinker or non-drinker), smoking habit (smoker or non-smoker). Systolic and diastolic blood pressures were measured by using an automatic oscillometric method using HEM-780 (OMRON Corporation, Kyoto, Japan) in the sitting position after at least 5 minutes rest. Measurement was performed twice, and the mean value was used for statistical analysis. Body mass index was calculated by dividing weight (kg) by height (m) squared.