Association between thigh circumference and carotid intima-media thickening

Dept. of Public Health/박사Objective: Currently, studies have reported relationships between the different anthropometric indices of obesity and risk for atherosclerosis. Specifically, there are few studies of the relationship between lower-body composition parameters such as thigh circumference and atherosclerosis. Therefore, this study aims to assess the association between thigh circumference and carotid intima-media thickness (IMT) as a marker of atherosclerosis. Methods: This study used data from the Korean Genome and Epidemiology Study (KoGES)？Kangwha, a community-based prospective cohort study with 779 men, 393 premenopausal, and 839 postmenopausal women, without history of stroke, angina, and cancer. Maxima of carotid IMT (CIMT) measured by ultrasonography were used as continuous variables. CIMT thickening was defined when CIMT ≥ 1.0 mm. Independent association between thigh, waist circumference, and waist-to-thigh ratio (WTR) and CIMT by sex and menopause status was assessed by cross-sectional and prospective analysis. Results: Thigh circumference at baseline was inversely associated with change of CIMT even after adjustment for potential confounders such as baseline age, body mass index, waist circumference, systolic blood pressure, ratio of total cholesterol to high-density lipoprotein, alcohol intake, regular exercise, and follow-up period in premenopausal women (standardized ？ for CIMT = ？0.154, p = 0.013) and postmenopausal women (standardized ？ for CIMT = ？0.153, p < 0.001). But there is no significant association between thigh circumference and change of CIMT in men (standardized ？ for CIMT = ？0.070, p = 0.166). The odds ratio (OR) for having CIMT thickening among baseline without CIMT thickening that decreased per 5 cm of thigh circumference at baseline was 1.74 (95% CI = 1.28？2.35) in postmenopausal women when adjusted for potential confounds, but not significant in men (OR = 0.95, 95% CI = 0.69？1.32) and premenopausal women (OR = 1.22, 95% CI = 0.82？1.82). Also, the OR for having CIMT thickening (OR = 1.58, 2.44, and 2.80, respectively; p for trend = 0.012) increased with decreasing quartile of thigh circumference. This trend was not shown in men or premenopausal women. Conclusion: In postmenopausal women, a low thigh circumference seems to be associated with an increased risk of CIMT thickening. These results suggest that measure of thigh circumference might be a new anthropometric marker of early identification of individuals at an increased risk of atherosclerosis.ope

Association between Pulse Pressure and Carotid Intima-Media Thickness in Healthy Adolescents: Jangseong High School Study.

BACKGROUND: Wide pulse pressure associates with atherosclerosis, but it is unclear whether pulse pressure within a relatively normal range is associated with atherosclerosis in younger populations. The aim of this study was to investigate the association between pulse pressure and the carotid intima-media thickness (IMT) in healthy adolescents. METHODS: Study participants included 250 (129 males and 121 females) adolescents who were 17 to 19 years old and in the third grade of a high school in Jangseong, Korea between November 20 and December 1, 2009. Pulse pressure was determined as the difference between systolic blood pressure and diastolic blood pressure which were measured with an oscillometric sphygmomanometer. IMT values were ultrasonographically measured at right and left common carotid arteries, and average of the mean IMT at each artery was used for analysis. RESULTS: There was a significant correlation between pulse pressure and carotid IMT before (Pearson coefficient r = 0.2037, p = 0.001) and after (r = 0.1479, p = 0.020) adjustment for sex. When adjusted for sex, age, waist circumference, fasting blood glucose, and total/high-density lipoprotein cholesterol ratio, 10 mm Hg increase in pulse pressure was associated with increase of IMT in total (beta = 10.9 microm, p = 0.003), in males (beta = 17.3 microm, p < 0.001), but not in females (beta = 3.609 microm, p = 0.518). CONCLUSIONS: This study suggests that higher pulse pressure may be associated with increased carotid IMT even in healthy male adolescents.ope

Association between Serum 25-Hydroxyvitamin D Level and Insulin Resistance in a Rural Population

PURPOSE: A low serum 25-hydroxyvitamin D [25(OH)D] level in the blood has been correlated with an increased risk of diabetes mellitus; however, the association between serum 25(OH)D level and insulin resistance has not been established in a Korean rural population. The aim of this study was to investigate the independent association between serum 25(OH)D level and insulin resistance in rural Korean adults. MATERIALS AND METHODS: This study used data from the Korean Genome Epidemiology Study-Kangwha Study. In the 2011 study, 1200 adults completed health examinations. In an ancillary study, serum 25(OH)D level was measured in a subsample (n=813). After excluding those taking vitamin D supplements, a cross-sectional analysis was carried out on 807 participants (324 men and 483 women) aged 40 to 89 years old. Measured from overnight fasting blood samples, glucose and insulin levels were used to calculate the homeostasis model assessment for insulin resistance (HOMA-IR). Measures of glucose, insulin, and HOMA-IR were log-transformed for parametric tests. RESULTS: Serum 25(OH)D level was inversely associated with HOMA-IR (β=-0.003, p=0.039) in a univariate analysis. However, the association was not significant after adjustment for sex and age (β=-0.002, p=0.123) or after adjustment for sex, age, body mass index, smoking status, alcohol intake, and regular exercise (β=-0.003, p=0.247). CONCLUSION: Our findings suggest that vitamin D is not independently associated with insulin resistance in Korean men and women.ope

Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea

Mortalities from cardiovascular disease in Korea have decreased markedly over the past three decades. The major cardiovascular and metabolic risk factors, however, remain prevalent, and their burden on health is large. The Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) planned a cohort study in order to identify novel risk factors and to develop evidence-based prevention strategies of cardiovascular and metabolic diseases. The CMERC deliberately designed two prospective cohorts, a community-based general population cohort (the CMERC cohort) and its sister cohort (a hospital-based high-risk patient cohort), covering a broad spectrum of cardiovascular and metabolic diseases. This paper describes the CMERC cohort study of community-dwelling adults aged 30 to 64 years. A total of 8097 adults completed baseline measurement between 2013 and 2018. Baseline measurements assessed socio-demographic factors, medical history, health-related behaviors, psychological health, social network and support, anthropometry, body composition, and resting blood pressure and comprised electrocardiography, carotid artery ultrasonography, fasting blood analysis, and urinalysis. Both active follow-up through an annual telephone survey and a 5-year on-site health examination survey and passive follow-up through secondary data linkage with national databases, such as national death records, have been applied. Researchers interested in collaborative research may contact the corresponding author.ope

Prevalence of Dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005.

BACKGROUND: Dyslipidemia is a disorder of lipid metabolism, including elevated total cholesterol, elevated triglyceride, elevated low density lipoprotein cholesterol (LDL-C), and decreased high density lipoprotein cholesterol (HDL-C). The objective of this study was to investigate recent changes in the prevalence of dyslipidemia and also the rates of awareness, treatment, and control of dyslipidemia among Korean adults. METHODS: Dyslipidemia is defined according to the National Cholesterol Education Program-Adult Treatment Panel III as total cholesterol ≥240 mg/dL, LDL-C ≥160 mg/dL, HDL-C <40 mg/dL, and triglyceride ≥200 mg/dL. The prevalence of dyslipidemia was estimated for adults aged ≥20 years using the Korea National Health and Nutrition Survey (KNHANES) in 1998 (n=6,923), 2001 (n=4,882), and 2005 (n=5,323). Rates of awareness, treatment and control of dyslipidemia were calculated for adults aged ≥30 years using the KNHANES in 2005 (n=4,654). RESULTS: The prevalence of dyslipidemia (aged ≥20 years) increased from 32.4% in 1998 to 42.6% in 2001 and 44.1% in 2005. Compared with the KNHANES in 1998, the prevalence of dyslipidemia was 47% (95% confidence interval [CI], 35% to 59%) higher in 2001 and 61% (95% CI, 49% to 75%) higher in 2005. In 2005, only 9.5% of people with dyslipidemia were aware of the disease, 5.2% used lipid-lowering medication, and 33.2% of patients with treatment reached treatment goals. CONCLUSION: The prevalence of dyslipidemia in Korea gradually increased between 1998 and 2005. These findings suggest that more intense efforts for the prevention and treatment of dyslipidemia may lead to further improvement in the management of dyslipidemia.ope

Effects of age, sex, and menopausal status on blood cholesterol profile in the korean population

BACKGROUND AND OBJECTIVES: To investigate age-specific and sex-specific distributions of blood cholesterol in the general Korean population. SUBJECTS AND METHODS: We analyzed data for 8284 men and 9246 women aged ≥10 years who participated in the fifth (2010-2012) Korea National Health and Nutrition Examination Survey. Age-specific means, medians, and selected percentiles were calculated for men, premenopausal women, and postmenopausal women. RESULTS: Median total cholesterol (TC) level increased with age across all age groups, from 147 to 196 mg/dL in males and from 159 to 210 mg/dL in females. Triglyceride (TG) levels increased with age in females; however, in males, TG levels rapidly increased during young adulthood, peaked at 50-54 years, and then decreased. High density lipoprotein-cholesterol (HDL-C) levels were higher in females than in males and decreased with increasing age in both males and females. Low density lipoprotein-cholesterol (LDL-C) levels increased with age across all age groups, from 89 to 127 mg/dL in males and from 82 to 113 mg/dL in females. Lipoprotein-cholesterol fraction (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, non-HDL-C) levels increased with age in females, but increased more rapidly in males during young adulthood and decreased after middle age. CONCLUSION: Blood cholesterol levels and lipoprotein-cholesterol fractions present different distributions by age, sex, and menopausal status.ope

Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey

OBJECTIVES: The low-sodium diet is a known preventive factor for hypertension and cardiovascular disease. Factors associated with low-sodium diets should be identified to reduce sodium intake effectively. This study was conducted to identify factors correlated with a low-sodium diet. METHODS: This cross-sectional study analyzed data from a total of 14,539 Koreans aged 20 years or older, who participated in the Fourth (2007-2009) Korean National Health and Nutrition Examination Survey. A low-sodium diet was defined as having ≤2,000 mg/day based on 24-hour recalls. Multiple logistic regression models were used to assess sex, age, education, number of family members, household income, occupation, alcohol drinking, total energy intake, frequency of eating out, and hypertension management status for their associations with low-sodium diets. RESULTS: Among all participants, only 13.9% (n=2,016) had low-sodium diets. In the multivariate analysis, 40-49 years of age, clerical work jobs, higher total energy intake, and frequent eating out were inversely associated with low-sodium diets. And female sex and living-alone were associated with low-sodium diets. Lower frequency of eating out was significantly associated with low-sodium diets, even after adjusting for total energy intake and other potential confounders. Adjusted odds ratios (95% confidence interval) for a low-sodium diet were 1.97 (1.49-2.61), 1.47 (1.13-1.91), 1.24 (0.96-1.61), and 1.00 (reference) in people who eat out <1 time/month, 1-3 times/month, 1-6 times/week, and ≥1 time/day, respectively. CONCLUSIONS: Our study suggests that sex, age, number of family members, occupation, total energy intake, and lower frequency of eating out were associated with a low-sodium diet in Korean adults.ope

The association between serum albumin levels and metabolic syndrome in a rural population of Korea

OBJECTIVES: A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults. METHODS: This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value (≥90 cm for men and ≥85 cm for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis. RESULTS: Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men. CONCLUSIONS: These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.ope

Serum 25-Hydroxyvitamin D and Insulin Resistance in Apparently Healthy Adolescents

PURPOSE: Vitamin D deficiency is a common condition that is associated with diabetes and insulin resistance. However, the association between vitamin D and insulin resistance has not been fully studied, especially in the general adolescent population. Therefore, we assessed the association between serum 25-hydroxyvitamin D [25(OH)D] level and insulin resistance among apparently healthy Korean adolescents. METHODS: A total of 260 (135 male and 125 female) adolescents in a rural high school were assessed for serum 25(OH)D, fasting plasma glucose, and insulin. All of the participants were aged 15 to 16 years old, and without known hypertension or diabetes. Serum 25(OH)D was analyzed both as a continuous and categorical variable in association with insulin resistance. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Increased insulin resistance was operationally defined as a HOMA-IR value higher than the sex-specific 75th percentile. RESULTS: In male adolescents, every 10 ng/ml decrease in 25(OH)D level was associated with a 0.25 unit increase in HOMA-IR (p = 0.003) after adjusting for age and BMI. Compared to those in the highest quartile, male adolescents in the lowest 25(OH)D quartile were at significantly higher risk for insulin resistance: unadjusted odds ratio 4.06 (95% CI, 1.26 to 13.07); age and BMI adjusted odds ratio 3.59 (95% CI, 1.03 to 12.57). However, 25(OH)D level, either in continuous or categorical measure, was not significantly associated with insulin resistance among female adolescents. CONCLUSIONS: This study suggests that serum 25(OH)D level may be inversely associated with insulin resistance in healthy male adolescents.ope

Association between hypertension and pulmonary function in rural adults in Korea

OBJECTIVES: Whilst hypertension exerts a negative effect on several organs there have been few studies regarding its effect on pulmonary function. The objective of this study was to examine the relationship between hypertension and pulmonary function in rural Korean adults. METHODS: In 2006, 2534 people were recruited, aged 40 to 70, in Kangwha County. We selected 1454 (male: 624, female: 830) participants whose pulmonary function results were repeatable. Blood pressure (BP) was measured twice and the average calculated. Participants were divided into two groups (hypertensive group and non-hypertensive group) in accordance with The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Pulmonary function was measured by dry rolling seal spirometry. Forced expiratory volume in the one second and forced vital capacity were converted into percent-predicted values based on average pulmonary function amongst Koreans. RESULTS: The number of hypertensive participants in the present study was 460 (male: 205, female: 255) and the number of non-hypertensive participants was 994 (male: 419, female: 575). Our findings have shown that the mean values for expiratory volume in the one second and forced vital capacity were significantly lower for hypertensive people than for non-hypertensive people, among women (P=0.002 for forced expiratory volume in the one second, P<0.001 for forced vital capacity volume). Odds ratio analysis revealed that hypertensive participants were more likely to have lower pulmonary function than non-hypertensive participants, again significantly among women. CONCLUSIONS: The pulmonary function of hypertensive women was significantly lower than that of non-hypertensive women aged 40-70ope