Oxidative balance score and serum γ-glutamyltransferase level among Korean adults: a nationwide population-based study.

PURPOSE: The oxidative balance score (OBS) comprises dietary and non-dietary lifestyle pro-oxidants and antioxidants. Elevated serum γ-glutamyltransferase (GGT) level has currently emerged as a biomarker of oxidative stress. In this study, we examined whether OBS was inversely associated with serum GGT level and whether OBS could be a useful marker to predict GGT among Korean adults. METHODS: This cross-sectional study was based on data obtained from the 2010 and 2011 Korea National Health and Nutrition Examination Survey. 2087 men and 2071 women were included in final analysis. The OBS was divided into five equal interval categories, and GGT was dichotomized into low and high using its sex-specific median value. Multiple logistic regression analysis was conducted to assess the association between OBS categories and high GGT. RESULTS: Compared with the lowest OBS category as reference, the multivariable adjusted ORs (95% CIs) for the highest OBS category of men and women were 0.05 (0.01-0.19) and 0.27 (0.09-0.78), respectively (p for trend <0.01). CONCLUSION: A higher OBS that indicates a predominance of antioxidant over pro-oxidant exposure was strongly inversely associated with GGT level among Korean adults.

Smokers With Adequate Vitamin C Intake Show a Preferable Pulmonary Function Test.

OBJECTIVE: Airflow obstruction often results from the chronic inflammation caused by cigarette smoke. It has been concluded that cigarette smoke-induced oxidative damage is prevented by ascorbic acid on a cellular level. The purpose of the current study was to explore the effect of vitamin C intake on pulmonary function in established smokers (100 or more cigarettes) and never-smokers in a Korean population. METHODS: The 2974 enrolled men and women over the age of 40 in the Korea National Health and Nutrition Examination Survey IV 2008 were divided into 4 groups based on smoking patterns (never-smoker vs established smoker) and vitamin C intake from dietary assessment (higher vs lower; median value: 77.18 mg/day). RESULTS: Univariate analysis showed associations between forced expiratory volume in 1 second (FEV1), FEV/forced vital capacity (FVC) and age, gender, body mass index (BMI), pack-years, vitamin C intake, and additional micronutrient intake. On multiple logistic regression analysis, the odds ratios (95% confidence interval) for FEV1 < 80% predicted were 1.000 (never-smokers, higher vitamin C intake), 1.067 (0.823, 1.383; never-smokers, lower vitamin C intake), 1.224 (0.871, 1.721; established smokers, higher vitamin C intake), and 1.479 (1.057, 2.072; established smokers, lower vitamin C intake). The odds ratios for FEV1/FVC < 0.70 were 1.177 (0.821, 1.687; never-smokers, lower vitamin C intake), 1.637 (1.094, 2.445; established smokers, higher vitamin C intake), and 2.093 (1.403, 3.122; established smokers, lower vitamin C intake) after adjusting for confounding factors (p < 0.001). CONCLUSIONS: Korean smokers with adequate vitamin C intake showed a preferable pulmonary function test.

Trends in prevalence of overweight and obesity in Korean adults, 1998-2009: the Korean National Health and Nutrition Examination Survey.

BACKGROUND: Although obesity is increasing worldwide and becoming a major public health problem, some countries report a trend toward stabilization. We investigated prevalence trends in overweight/obesity and obesity among Korean adults during a 12-year period. METHODS: This study was based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), and IV (2007-2009). The χ(2) and ANOVA tests were used to compare the prevalence and mean values for age and BMI, respectively. P-values for trends were determined by linear and logistic regression analyses, with KNHANES phase as the continuous variable. RESULTS: The prevalences of overweight/obesity in KNHANES I through IV were 50.8%, 57.4%, 62.5%, and 62.6%, respectively, among men (P for trend = 0.002, ß = 0.021) and 47.3%, 51.9%, 50.0%, and 48.9% among women (P for trend = 0.017, ß = -0.015). The respective prevalences of obesity were 26.0%, 32.4%, 35.1%, and 36.3% among men (P for trend = 0.006, ß = 0.018) and 26.5%, 29.3%, 28.0%, and 27.6% among women (P for trend = 0.143, ß = -0.008). During the same period, the respective prevalences of grade 2 obesity (BMI ≥30 kg/m(2)) were 1.7%, 2.8%, 3.6%, and 3.8% among men (P for trend = 0.075, ß = 0.005) and 3.0%, 3.5%, 3.4%, and 4.0% among women (P for trend = 0.398, ß = 0.003). CONCLUSIONS: The prevalences of overweight/obesity and obesity showed an upward trend among men during the 12-year period, whereas the prevalence of overweight/obesity slightly decreased among women from 2001.

Prevalence of metabolic syndrome in children and adolescents - the recent trends in South Korea.

BACKGROUND: Although the metabolic syndrome (MetS) in childhood is increasing worldwide and becoming a significant public health problem, some countries report trends for stabilization. After 2005, the Health Plan 2010 of the Korean Ministry of Health and Welfare has carried out the standardization of school lunch provisions for all students and reinforced nutritional and physical education in schools. Thus, an investigation of changes in the prevalence of MetS in Korean children and adolescents is important and intriguing in the aspect of evaluating the national public health intervention. METHODS: We investigated trends in the prevalence of MetS among a nationally representative sample of 5652 children and adolescents aged 10-18 years from the Korean National Health and Nutrition Examination Surveys (KNHANES) I (1998), II (2001), III (2005), and IV (2008). RESULTS: Prevalence trends in MetS were 7.5%, 9.8%, 10.9%, and 6.7% in the KNHANES I through IV, respectively (p<0.001). Among the five components of MetS, the prevalence of low high-density lipoprotein (HDL) cholesterol increased most over the 1998-2005 period and decreased over the 2005-2008 period. CONCLUSION: The prevalence of MetS has decreased since 2005 mainly because of changes in the prevalence of low levels of HDL cholesterol.

Significance of high-normal serum uric acid level as a risk factor for arterial stiffness in healthy Korean men.

A high serum uric acid (SUA) level is a known risk factor for cardiovascular disease. However, little is known about the relationship between arterial stiffness and uric acid in healthy subjects with a normal SUA level. We assessed whether a high-normal uric acid level increased arterial stiffness by measuring brachial-ankle pulse wave velocity (ba-PWV) in healthy subjects. Among 779 subjects who visited the health promotion center, 393 men and 234 women with normal SUA levels (male: 3.5-8.0 mg/dl, female: 2.5-5.4 mg/dl) were divided into quartiles: in men, Q1 (n = 90, 3.5-4.3 mg/dl), Q2 (n = 94, 4.4-5.1 mg/dl), Q3 (n = 106, 5.2-5.9 mg/dl) and Q4 (n = 103, 6.0-8.0 mg/dl); in women, Q1 (n = 57, 2.5-3.6 mg/dl), Q2 (n = 49, 3.7-4.1 mg/dl), Q3 (n = 61, 4.2-4.6 mg/dl) and Q4 (n = 67, 4.7-5.4 mg/dl). The mean values of ba-PWV increased gradually by SUA quartile. The men's SUA had an independent, positive association with ba-PWV after correcting for age, glucose, body mass index, blood pressure, resting heart rate, high-sensitivity C-reactive protein (hs-CRP), high-density lipoprotein (HDL)-cholesterol and triglyceride (R (2) = 0.39, adjusted R (2) = 0.37, p < 0.001). The odds ratios (95% CI) for high ba-PWVs (> 75th percentile, 1473 cm/s) in men were 1.89 (0.69-5.20, Q2), 2.36 (1.10-5.08, Q3), and 2.91 (1.39-6.11, Q4), after adjusting for confounding factors (p < 0.001). In women, SUA showed no independent association with ba-PWV (p = 0.186). After adjusting for confounding factors, the mean ba-PWV values of Q3 (1418 cm/s) and Q4 (1421 cm/s) in men were higher than those of Q1 (1355 cm/s) (p < 0.05). Above the SUA level of 5.2 mg/dl, arterial stiffness was increased in healthy Korean men.

The relationship between arterial stiffness and nonalcoholic fatty liver disease.

AIM: Nonalcoholic fatty liver disease (NAFLD) is currently the most common form of chronic liver disease and some studies have documented its link with cardiovascular risk factors. This study aimed to investigate the association between arterial stiffness and NAFLD. METHODS: Among 1,442 health check-up subjects (955 men, 487 women), we examined the association between brachial-ankle pulse wave velocity (baPWV) as a measurement of arterial stiffness and the presence of NAFLD based on abdominal sonographic findings. Multivariate linear and logistic regression analyses were conducted to examine the independent association between baPWV and the presence of NAFLD in gender-specific manners. RESULTS: In multivariate regression analysis, NAFLD was found to be independently associated with baPWV in both men and women. Moreover, in multivariate logistic regression analysis, a graded independent relation was found between higher levels of baPWV and the prevalence risk of NAFLD. Odds ratios (95% CI) for the highest vs. the lowest quartile of baPWV were 1.85 (range, 1.13-2.62) in men and 3.32 (1.45-7.62) in women after adjusting for age, smoking status, regular exercise, body mass index, blood pressure, fasting plasma glucose, triglyceride, HDL-cholesterol, hypertension and diabetes. CONCLUSION: Arterial stiffness was independently associated with the prevalence risk for NAFLD regardless of classical CVD risk factors.

High prevalence of vitamin D insufficiency or deficiency in young adolescents in Korea.

Recent studies suggest that vitamin D insufficiency or deficiency is not only a problem of older generations anymore but also an important health concern among younger generations. However, comprehensive data are lacking in Korean adolescents. We investigated the vitamin D (25-hydroxy vitamin D [25(OH)D]) status, the prevalence of vitamin D insufficiency or deficiency, and the association between vitamin D levels and insulin resistance and lipid profiles in a sample of 188 Korean adolescents aged 12-13 years who participated in a general health check-up at a tertiary hospital. Vitamin D deficiency was considered as serum concentrations <20 ng/mL (50 nmol/L); a level of 21-29 ng/mL (52-72 nmol/L) was considered to indicate vitamin D insufficiency, whereas a level of 30 ng/mL or greater (>75 nmol/L) was considered sufficient or optimum. In this cross-sectional study, vitamin D insufficiency or deficiency was found in 98.9 % of boys and 100 % of girls, whereas only 1.1 % of boys and 0 % of girls had a serum 25(OH)D level of greater than 30 ng/mL. In multivariate linear regression analysis, HOMA-IR, triglyceride, and LDL cholesterol were inversely associated with 25(OH)D concentrations. We found that vitamin D insufficiency or deficiency is a very common health problem in Korean adolescents, particularly in girls, and that serum 25(OH)D levels are inversely associated with insulin resistance and lipid profiles. These results suggest that more time spent in outdoor activity for sunlight exposure and higher vitamin D intake may be needed in younger adolescents in South Korea.

The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences.

Metabolic syndrome (MS) is becoming globally prevalent and it is clinically important because of its association with type 2 diabetes and cardiovascular disease, and some cancers. Recently, platelet count has been linked to insulin resistance and MS in addition to being a marker of hemostasis. Also, mean platelet volume (MPV) has been known to represent platelet activity. Platelet counts and MPV are modified by various biosocial and lifestyle factors such as race, age, gender, smoking habit, alcohol consumption, and physical activity. Thus, the direction and magnitude of this association may differ by gender. In this regard, proper interpretion of platelet counts and MPV by gender could be important in the people with MS. We examined the relationship between platelet counts, MPV, and MS through gender-specific analyses for 3827 Korean adults (2169 men and 1658 women) in a health examination program. In women, platelet counts were significantly higher in subjects with MS compared to in those without MS (p < 0.001), whereas MPV was significantly lower (p = 0.001). However, no such trend was observed in men. Multiple regression analyses also showed that MS is positively associated with platelet counts and inversely associated with MPV, independently of confounding variables only in women. The results suggest that platelet counts and MPV might be a surrogate marker associated with clustered MS in women.

Comparison of lipid-related ratios for prediction of chronic kidney disease stage 3 or more in Korean adults.

Dyslipidemia is implicated in increased cardiovascular risk associated with chronic kidney disease (CKD) and in the progression of renal damage. This study compared 4 different lipid-related ratios (total cholesterol [TC]/high-density lipoprotein cholesterol [HDL-C], triglyceride [TG]/HDL-C, calculated low-density lipoprotein cholesterol [c-LDL-C]/HDL-C, and non-HDL-C/HDL-C ratio) for prediction of CKD stage 3 or more to investigate the association between them. This cross-sectional study included 8,650 adults who participated in the 2007-2008 Korean National Health and Nutrition Examination Survey. The overall prevalence of CKD stage 3 or more was 6.4%. For TG/HDL-C, the prevalence with CKD stage 3 or more increased with increasing quartile group in both sexes (P value for trend = 0.046 in men, 0.002 in women) while other lipid-related ratios showed increasing prevalence only in women. In comparison with the lowest quartile of the lipid-related ratios, only the fourth quartile of TG/HDL-C was associated with the prevalence of CKD stage 3 or more in both sexes after adjustment for multiple covariates (odds ratio [OR] for TG/HDL-C-Q(4), 1.82; 95% CI [confidence interval], 1.09-3.03 in men, OR 2.45; 95% CI, 1.52-3.95 in women). In conclusion, TG/HDL-C is the only lipid-related ratio that is independently associated with CKD stage 3 or more in both sexes of Koreans.

Low-grade inflammation, metabolic syndrome and the risk of chronic kidney disease: the 2005 Korean National Health and Nutrition Examination Survey.

Either chronic inflammation or metabolic syndrome (MetS) is associated with renal impairment. This cross-sectional study was designed to investigate the relationship between elevated white blood cell (WBC) counts and chronic kidney disease (CKD) stage 3 or more according to the presence of MetS in adult Koreans. In total, 5,291 subjects (≥ 20 yr-old) participating in the 2005 Korean National Health and Nutrition Examination were included. CKD stage 3 or more was defined as having an estimated glomerular filtration rate below 60 mL/min/1.73 m(2), as calculated using the formula from the Modification of Diet in Renal Disease study. The odds ratio (95% confidence interval) for CKD stage 3 or more in the highest WBC quartile (≥ 7,200 cells/µL) was 1.70 (1.17-2.39) after adjusting for MetS and other covariates, compared with the lowest WBC quartile (< 5,100 cells/µL). In subjects with MetS, the prevalence risk for CKD stage 3 or more in the highest WBC quartile was 2.25 (1.28-3.95) even after fully adjusting for confounding variables. In contrast, this positive association between WBC quartile and CKD stage 3 or more disappeared in subjects without MetS. Low-grade inflammation is significantly associated with CKD stage 3 or more in subjects with MetS but not in those without MetS.

Increased arterial stiffness in healthy subjects with high-normal glucose levels and in subjects with pre-diabetes.

BACKGROUND: Increased fasting plasma glucose (FPG), which includes impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes, is a risk factor for arterial stiffness. While IFG is widely accepted as a cardiovascular risk factor, recent studies have argued that subjects with high-normal glucose level were characterized by a high incidence of cardiovascular disease. The purpose of this study is to investigate the relationship between FPG and arterial stiffness in non-diabetic healthy subjects. METHODS: We recruited 697 subjects who visited the health promotion center of a university hospital from May 2007 to August 2008. Age, sex, body mass index (BMI), resting heart rate, smoking habits, alcohol intake, exercise, blood pressure, medical history, FPG, lipid profile, high sensitivity C-reactive protein (hs-CRP), and Brachial-ankle pulse wave velocity (ba-PWV) were measured. We performed correlation and multiple linear regression analyses to divide the research subjects into quartiles: Q1(n=172), 65 mg/dL≤FPG<84 mg/dL; Q2(n=188), 84 mg/dL≤FPG<91 mg/dl; Q3(n=199), 91 mg/dL≤FPG<100 mg/dL; Q4(n=138), 100 mg/dL≤FPG<126 mg/dL. RESULTS: FPG has an independent, positive association with ba-PWV in non-diabetic subjects after correcting for confounding variables, including age, sex, BMI, blood pressure, resting heart rate, hs-CRP, lipid profile, and behavioral habits. The mean ba-PWV of the high-normal glucose group (Q3, 1384 cm/s) was higher than that of the low-normal glucose group (1303±196 cm/s vs.1328±167 cm/s, P<0.05). The mean ba-PWV value in the IFG group (1469±220 cm/s) was higher than that in the normoglycemic group (P<0.05, respectively). CONCLUSIONS: An increase in FPG, even within the normal range, was associated with aggravated arterial stiffness. Further research is needed to determine the glycemic target value for the prevention of arterial stiffness in clinical and public health settings.

Association between the ratio of triglycerides to high-density lipoprotein cholesterol and chronic kidney disease in Korean adults: the 2005 Korean National Health and Nutrition Examination Survey.

BACKGROUND: The ratio of triglycerides (TG, mg/dl) to high-density lipoprotein cholesterol (HDL-C, mg/dl) is a reliable indicator of insulin resistance and atherosclerotic diseases. The purpose of this study was to examine the association between TG/HDL-C and chronic kidney disease (CKD) in a nationally representative sample of Korean adults. METHODS: This cross-sectional study included 5,503 subjects (≥19 years of age) who participated in the 2005 Korean National Health and Nutrition Examination Survey. CKD was defined as an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m(2) as calculated by the abbreviated formula from the Modification of Diet in Renal Disease study. RESULTS: The overall prevalence of CKD in our sample was 9.0%. eGFR was negatively correlated with logarithm-transformed TG/HDL-C in Pearson's correlation. The prevalence of CKD in increasing TG/HDL-C quintiles was 4.4, 6.6, 9.5, 11.9, and 12.8%. In comparison with the lowest quintile of TG/HDL-C (<1.38), the odds ratio (95% confidence interval) for CKD in the highest quintile of TG/HDL-C (≥4.50) was 2.15 (1.38-3.37), after adjustment for multiple covariates (p value for trend = 0.036). CONCLUSIONS: TG/HDL-C was independently associated with increased prevalence of CKD in a sample of Korean adults.

The association between non-alcoholic hepatic steatosis and mean platelet volume in an obese Korean population.

Non-alcoholic fatty liver disease (NAFLD) is now the most common liver disease. Since the prevalence of NAFLD in overweight/obese people is rather high, there is a general concern about the possibility that NAFLD may have an association with cardiovascular risk factors and atherosclerosis. Mean platelet volume (MPV) is becoming of increasing interest as a new independent cardiovascular risk factor. Accordingly, the aim of our study was to evaluate the relationship between NAFLD and MPV in obese patients. The study was performed at the health promotion center in Gangnam Severance Hospital between July 2007 and June 2008. A total of 6499 healthy subjects (age range, 20-65 years) were recruited in Seoul. We performed a cross-sectional study to evaluate the association with non-alcoholic hepatic steatosis (NAHS) and MPV in 628 obese subjects. The population was divided into three groups according to MPV values. (T1 : MPV ≤ 7.7 fL, T2 : 7.7 < ≤ 8.4, T3 : > 8.4) The odds ratios (ORs) for NAHS were calculated across all three groups. The prevalence of NAHS was significantly higher according to increased MPV values after adjustment for confounding variables. The adjusted OR for NAHS according to the three groups were 1.00, 2.01(1.14 ∼ 3.56), and 2.12(1.11 ∼ 4.06) in obese subjects. In summary, there was a significant association between NAHS and MPV in obese study population.

The association between coronary artery calcification and mean platelet volume in the general population.

Patients with coronary artery calcification have an increased risk of coronary vascular events and mortality. Coronary artery calcification can be quantified using the coronary calcium score (CCS) from multi-detected row computed tomography (MDCT), and the score is proportionally related to the severity of atherosclerotic disease. Mean platelet volume (MPV) is gaining interest as a new independent cardiovascular risk factor. Accordingly, the aim of our study was to evaluate the relationship between CCS and MPV in the general population. A total of 2116 individuals were enrolled from a health promotion center between July 2007 and June 2010. Among them, 259 subjects were included in the final analysis. MDCT was used to measure CCS and CCS > 1 was defined as the presence of coronary calcification. The MPV value was significantly higher in the coronary artery calcification group than in the control group. Multivariate analyses showed that MPV was positively associated with coronary calcification (OR, 1.61; 95% CI 1.02-2.55). In summary, there was a significant association between coronary artery calcification and MPV in the general population. Therefore, the detection of elevated MPV should alert clinicians to the coexistence of multiple underlying CVD risk factors warranting early evaluation and treatment.

Association between serum uric acid and non-alcoholic fatty liver disease in Korean adults.

BACKGROUND: Increased uric acid is associated with the metabolic syndrome, conditions linked to oxidative stress and insulin resistance. Non-alcoholic fatty liver disease (NAFLD) is now considered a hepatic manifestation of insulin resistance. However, little has been written regarding the association between uric acid and NAFLD. METHODS: We examined the association between uric acid and the presence of NAFLD in 3768 Koreans (2133 men, 1635 women; aged 20-75 years) in a health examination program. Uric acid quartiles were categorized separately as follows: Q1: or=380.8 micromol/L for men; Q1: or=267.8 micromol/L for women. Hepatic steatosis was diagnosed based on abdominal ultrasonographic findings by hyperechogenicity of liver tissue, difference of echogenicity between the liver and diaphragm, and visibility of vascular structures. The odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were calculated across each quartile of serum uric acid. RESULTS: The prevalence of NAFLD was 25.8% (32.2% in men and 17.4% in women). After adjustment for age, body mass index (BMI), smoking, regular exercise, blood pressure, fasting plasma glucose (FPG), triglycerides, and high-density lipoprotein (HDL) cholesterol, the ORs (95% CIs) for NAFLD according to each quartile of uric acid were 1.00, 1.55 (1.13-2.14), 1.77 (1.30-2.41), and 2.01 (1.45-2.78) for men and 1.00, 0.69 (0.40-1.20), 1.12 (0.67-1.88), and 1.94 (1.21-3.13) for women. CONCLUSIONS: Serum uric acid is independently associated with the presence of NAFLD, and uric acid may be a useful additional measure in assessing the risk of NAFLD in the clinical setting.

Relationship of hepatic steatosis and alanine aminotransferase with coronary calcification.

BACKGROUND: It has been observed that hepatic steatosis is related to an increased risk of cardiovascular disease (CVD). Alanine aminotransferase (ALT), an indicator of the severity of hepatic steatosis is also associated with CVD. This study focused on the relationship between hepatic steatosis and ALT with coronary calcification. METHODS: We performed a cross-sectional study to examine the association between hepatic steatosis and serum ALT with coronary calcification in 1218 subjects (772 men, 446 women; ages 30-75 years). We evaluated hepatic steatosis and ALT as categorical variables, and constructed four groups (reference group; only with hepatic steatosis; only with ALT >30 U/L; with both hepatic steatosis and ALT >30 U/L), which did not overlap. Multi-detected row computed tomography (MDCT) was used to measure coronary calcium score. RESULTS: The adjusted ORs (95% CIs) for coronary calcification in the four groups were 1.00 (reference), 1.24 (0.68-2.26), 1.82 (0.78-4.23), and 2.12 (1.08-4.20) after adjusting for confounding variables. In addition, an increase in serum ALT activity of 10 U/L was associated with an increased risk of coronary atherosclerosis. CONCLUSIONS: In summary, patients with both hepatic steatosis and increases in ALT are associated with coronary calcification as a marker of coronary atherosclerosis determined by MDCT. This finding suggested that subjects with both hepatic steatosis and increased ALT should be considered for further evaluation of coronary atherosclerosis.

Association of renal manifestations with serum uric acid in Korean adults with normal uric acid levels.

Several studies have reported that hyperuricemia is associated with the development of hypertension and cardiovascular disease. Increasing evidences also suggest that hyperuricemia may have a pathogenic role in the progression of renal disease. Paradoxically, uric acid is also widely accepted to have antioxidant activity in experimental studies. We aimed to investigate the association between glomerular filtration rate (GFR) and uric acid in healthy individuals with a normal serum level of uric acid. We examined renal function determined by GFR and uric acid in 3,376 subjects (1,896 men; 1,480 women; aged 20-80 yr) who underwent medical examinations at Gangnam Severance Hospital from November 2006 to June 2007. Determinants for renal function and uric acid levels were also investigated. In both men and women, GFR was negatively correlated with systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, uric acid, log transformed C reactive protein, and log transformed triglycerides. In multivariate regression analysis, total uric acid was found to be an independent factor associated with estimated GFR in both men and women. This result suggests that uric acid appears to contribute to renal impairment in subjects with normal serum level of uric acid.

High dose concentration administration of ascorbic acid inhibits tumor growth in BALB/C mice implanted with sarcoma 180 cancer cells via the restriction of angiogenesis.

To test the carcinostatic effects of ascorbic acid, we challenged the mice of seven experimental groups with 1.7 x 10(-4) mol high dose concentration ascorbic acid after intraperitoneal administrating them with sarcoma S-180 cells. The survival rate was increased by 20% in the group that received high dose concentration ascorbic acid, compared to the control. The highest survival rate was observed in the group in which 1.7 x 10(-4) mol ascorbic acid had been continuously injected before and after the induction of cancer cells, rather than just after the induction of cancer cells. The expression of three angiogenesis-related genes was inhibited by 0.3 times in bFGF, 7 times in VEGF and 4 times in MMP2 of the groups with higher survival rates. Biopsy Results, gene expression studies, and wound healing analysis in vivo and in vitro suggested that the carcinostatic effect induced by high dose concentration ascorbic acid occurred through inhibition of angiogenesis.

Gender difference and determinants of C-reactive protein level in Korean adults.

BACKGROUND: C-reactive protein (CRP) has emerged as an important predictor for cardiovascular disease (CVD). To facilitate clinical and public health interventions, CRP thresholds have been defined as follows: low-risk (<1.0 mg/L), average-risk (1.0-3.0 mg/L), and high-risk (>3.0 mg/L). However, these cut-off thresholds are based on distributions in Western populations, and do not distinguish between men and women. METHODS: We examined CRP distribution, gender difference, and determinants of CRP concentrations ranging from 0.02 mg/L to 10.0 mg/L, in 4923 Korean adults (2248 men; 2675 women) who received health checkups at Gangnam Severance Hospital from March 2006 to May 2007. RESULTS: The distribution of CRP was highly skewed toward lower concentrations. CRP was higher in men than women, and the cut-off thresholds for the high-risk tertile of CRP concentrations corresponded to 1.01 mg/L in men and 0.62 mg/L in women, based on the current study population. Age, male gender, cigarette smoking, physical activity, body mass index, total cholesterol, high density lipoprotein cholesterol, gamma-glutamyltransferase, and uric acid were independently associated with CRP concentrations. CONCLUSIONS: CRP distribution and gender difference in Korean adults were found to be different from previous Western studies, although similar risk factors influence CRP concentrations. Our results suggest that ethnicity and gender specific cut-off thresholds for CRP concentrations should be taken into consideration in CVD risk assessment.

Elevated white blood cell count is associated with arterial stiffness.

BACKGROUND AND AIMS: White blood cell (WBC) count, a usual marker of systemic inflammation, is known to be associated with atherosclerotic cardiovascular disease. The aim of the present study was to determine the association of WBC count with arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS: We examined the association between WBC count and baPWV in 788 Korean adults (375 men, 413 women) in a health examination program. The odds ratios for a high baPWV were calculated using multivariate logistic regression analysis after adjusting for confounding variables across WBC count quartiles (Q1: or=7320 cells/mm(3)). A high baPWV was defined as more than 1440 cm/s (>75th percentile). Age-adjusted baPWV mean values gradually increased with WBC quartiles (Q1=1294, Q2=1322, Q3=1347, and Q4=1367 cm/s). The odds ratios (95% CI) for a high baPWV in each WBC count quartile were 1.00, 1.34 (0.61-3.00), 2.20 (0.96-5.06), and 2.69 (1.15-6.47) after adjusting for age, sex, cigarette smoking, alcohol intake, regular exercise, body mass index (BMI), mean arterial blood pressure, fasting plasma glucose, triglyceride, HDL-cholesterol, gamma-glutamyltransferase (GGT), and uric acid. CONCLUSION: These findings indicate that elevated WBC count is associated with arterial stiffness. Accordingly, early detection of an elevated WBC count is important for arterial function and the assessment of cardiovascular risk.