ABSTRACT
INTRODUCTION: Many previous studies have reported a positive relationship between alcohol and bone mineral density (BMD). However, the causality between alcohol and BMD has not been fully evaluated. MATERIALS AND METHODS: This study enrolled 8892 participants from the Dong-gu study. Mendelian randomization (MR) using two-stage least-squared regression was used to evaluate the association between the genetically predicted amount of alcohol consumption per day and BMD. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as instrumental variables for alcohol consumption. Age, smoking history, and BMI were adjusted in the multivariate model. RESULTS: Self-reported alcohol consumption was positively related to total hip and lumbar spine BMD in both sexes. In multivariate Mendelian randomization analysis, the genetically predicted amount of alcohol consumption was positively associated with both total hip and lumbar spine BMD in men. Total hip BMD and lumbar spine BMD increased by 0.004 g/cm2 (95% confidence interval [CI] 0.002-0.007) and 0.007 g/cm2 (95% CI 0.004-0.011) with doubling of alcohol consumption. However, in women, genetically predicted alcohol consumption was not significantly associated with BMD. CONCLUSION: In our MR study, genetically predicted alcohol consumption was positively associated with BMD in men. This result suggests that the association between alcohol consumption and BMD is causal.
Subject(s)
Bone Density , Mendelian Randomization Analysis , Aldehyde Dehydrogenase, Mitochondrial/genetics , Bone Density/genetics , Causality , Female , Humans , Lumbar Vertebrae , Male , Polymorphism, Single Nucleotide/geneticsABSTRACT
BACKGROUND: Several studies have reported conflicting results regarding the relationship between alcohol consumption and cortisol levels. However, the causality between alcohol consumption and cortisol levels has not been evaluated. METHODS: This study examined 8,922 participants from the Dong-gu Study. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol consumption. The association between the genetically predicted alcohol consumption and cortisol level was evaluated with Mendelian randomization (MR) using two-stage least squares regression. RESULTS: Alcohol consumption was positively associated with the serum cortisol level in both sexes in the observational analysis. In the MR analysis, the genetically predicted alcohol consumption was positively related to the cortisol level in men, with cortisol levels increasing by 0.18 µg/dL per drink per day. However, there was no relationship in women in the MR analysis. CONCLUSION: The predicted alcohol consumption according to the ALDH2 rs671 polymorphism was positively related to the cortisol levels, suggesting a causal relationship between alcohol consumption and cortisol levels.
Subject(s)
Alcohol Drinking/genetics , Aldehyde Dehydrogenase, Mitochondrial/genetics , Asian People/genetics , Hydrocortisone/blood , Polymorphism, Single Nucleotide , Adult , Aged , Alcohol Drinking/epidemiology , Causality , Female , Genetic Predisposition to Disease , Genotype , Humans , Male , Mendelian Randomization Analysis , Middle AgedABSTRACT
BACKGROUND: Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 (ALDH2) polymorphism is common in Eastern Asians, and inactive ALDH2 genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the ALDH2 genotypes. METHODS: This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and ALDH2 genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed. RESULTS: In men, alcohol consumption was positively associated with both SBP and DBP in active ALDH2 carriers, but not in inactive ALDH2 carriers. In active ALDH2 carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91-1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15-1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between ALDH2 genotypes and hypertension and blood pressure in women. CONCLUSION: ALDH2 genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active ALDH2 carriers, but no significant relationship in inactive ALDH2 carriers.
Subject(s)
Alcohol Drinking , Aldehyde Dehydrogenase, Mitochondrial/genetics , Asian People/genetics , Blood Pressure/physiology , Hypertension/diagnosis , Alleles , Female , Gene Frequency , Genotype , Humans , Hypertension/epidemiology , Hypertension/genetics , Life Style , Male , Middle Aged , Odds Ratio , Polymorphism, Genetic , Republic of Korea/epidemiology , Risk FactorsABSTRACT
Levels of vitamin D and parathyroid hormone (PTH) are closely associated with renal function. We evaluated the associations among 25-hydroxyvitamin D (25OHD) levels, PTH levels, and mortality, and whether these associations varied by renal function. We used data from the Dong-gu Study, a population-based cohort in Korean adults. We analyzed the associations among intact PTH, 25OHD levels and mortality in 8580 participants. Hazard ratios (HRs) for mortality were calculated using Cox proportional hazards regression after adjusting for age, sex, month of sampling, lifestyle, and comorbidities. We also evaluated the effects of chronic kidney disease (CKD). A total of 860 deaths occurred during the follow-up period of 7.6 years. Compared to the first 25OHD quartile, the HRs of the second, third, and fourth quartiles were 0.96 [95% confidence interval (CI) 0.79-1.16], 0.84 (95% CI 0.68-1.02), and 0.71 (95% CI 0.57-0.89), respectively. The association between intact PTH levels and mortality varied by renal function, and was both nonlinear and significant only in subjects with CKD. Compared to the second intact PTH quartile in such subjects, the HRs for the first, third, and fourth quartiles were 1.61 (95% CI 0.92-2.81), 1.97 (95% CI 1.17-3.31), and 2.19 (95% CI 1.33-3.59), respectively. In conclusion, we demonstrated that low serum levels of 25OHD are associated with an increased risk of mortality. Serum levels of intact PTH are nonlinearly associated with mortality only in subjects with CKD, with the lowest risk for mortality being evident in the second quartile.
Subject(s)
Parathyroid Hormone/blood , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/mortality , Vitamin D/blood , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Proportional Hazards Models , Risk Factors , Vitamin D/analogs & derivatives , Vitamin D Deficiency/bloodABSTRACT
BACKGROUND: Apolipoprotein E (APOE) gene polymorphism is associated with neurodegenerative and cardiovascular diseases. Although the effects of the gene differ by ethnic group, few studies have examined Asians. Therefore, the association between APOE polymorphism and mortality in Koreans was evaluated in this study. METHODS: This study population included participants from the Dong-gu and Namwon Studies. APOE genotypes were categorized as E2 (E2/E2 and E2/E3), E3 (E3/E3), and E4 (E3/E4 and E4/E4). Multivariate Cox proportional hazard models were constructed using the E3 allele as a reference. RESULTS: In the model adjusting for study site, age, gender, and lifestyle, the hazard ratio (HR) of mortality for those with the E4 allele was 1.08 (95% confidence interval [CI], 0.97-1.20), while that for those with the E2 allele was 0.84 (95% CI, 0.74-0.96). After adjusting for blood lipids to evaluate their mediating effects, the HRs of mortality for those with E4 and E2 alleles were 1.08 (95% CI, 0.97-1.20) and 0.80 (95% CI, 0.70-0.92), respectively. These associations were more evident in younger groups, with HRs of 0.70 (95% CI, 0.52-0.92) for the E2 allele and 1.25 (95% CI, 1.03-1.53) for the E4 allele. CONCLUSION: In two large population-based cohort studies, the E2 allele was associated with a lower risk of mortality compared with the E3 allele, whereas the E4 genotype was not associated with mortality in Koreans.
Subject(s)
Apolipoproteins E/genetics , Asian People/genetics , Polymorphism, Genetic , Aged , Alleles , Cause of Death , Cohort Studies , Female , Genotype , Humans , Kaplan-Meier Estimate , Lipids/blood , Male , Middle Aged , Proportional Hazards Models , Protein Isoforms/genetics , Republic of Korea , Risk FactorsABSTRACT
OBJECTIVE: Accurate understanding of the extent of disease, treatment goal, and prognosis is a prerequisite for patients with cancer and their caregivers to make informed decision. We sought to evaluate patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure taking their own physician's evaluation as reference. METHODS: A national survey was performed with 750 patient-caregiver dyads (75.5% participation rate) recruited by 134 oncologists in 13 cancer centers (93% participation rate) in South Korea. Both patients and caregivers were asked to report their knowledge of patient's cancer stage, treatment goal, and chance of cure. Concordance was evaluated with percentage agreement and weighted κ, and predictors of discordance of patient and caregiver's response with that of physician's were explored by multivariate regression analyses with mixed effect model. RESULTS: The agreement rates between patient-physician and caregiver-physician were 63.0% and 65.9% for disease stage, 69.0% and 70.0% for treatment goal, and 41.4% and 45.1% for chance of cure. When discordance occurs, patients and caregivers often had an optimistic view. Distant stage, older age, female sex, and absence of depression were associated with optimistic view of patients, and there was significant between-physician variance for all 3 outcomes. CONCLUSION: The discordance revealed that our study suggests the need for better communication between physician and patients, as well as the caregivers. Research is needed to develop a comprehensive strategy to improve the understanding of the patients and family so that treatment decisions are made based on realistic estimation.
Subject(s)
Caregivers/psychology , Health Knowledge, Attitudes, Practice , Neoplasms/therapy , Oncologists , Physician-Patient Relations , Professional-Family Relations , Adult , Aged , Female , Goals , Humans , Male , Middle Aged , Motivation , Neoplasm Staging , Neoplasms/pathology , Republic of KoreaABSTRACT
From May through July 2015, a total of 26 cases of Middle East Respiratory Syndrome were reported from 2 hospitals in Daejeon, South Korea, including 1 index case and 25 new cases. We examined the epidemiologic features of these cases and found an estimated median incubation period of 6.1 days (8.8 days in hospital A and 4.6 days in hospital B). The overall attack rate was 3.7% (4.7% in hospital A and 3.0% in hospital B), and the attack rates among inpatients and caregivers in the same ward were 12.3% and 22.5%, respectively. The overall case-fatality rate was 44.0% (28.6% in hospital A and 63.6% in hospital B). The use of cohort quarantine may have played a role in preventing community spread, but additional transmission occurred among members of the hospital cohort quarantined together. Caregivers may have contributed in part to the transmission.
Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Hospitals , Adult , Aged , Aged, 80 and over , Coronavirus Infections/pathology , Coronavirus Infections/virology , Disease Outbreaks , Female , Humans , Male , Middle Aged , Quarantine , Republic of Korea/epidemiologyABSTRACT
PURPOSE: Portland cement contains carcinogens such as chromium and free silica, and hence, inhalation of cement dust can cause respiratory tract cancers. The purpose of this study was to determine whether living near a cement plant increases the risk of respiratory tract cancers. METHODS: The study population consisted of 341,793 people, all of whom lived in administrative districts within 3-km radius of ten cement plants in Korea. The respiratory tract cancer incidence data (International Classification of Diseases, ten revision code C00-C14 and C30-C34) for 2008-2012 were obtained from regional cancer registries. Standardized incidence ratios (SIRs) for each cancer site in the respiratory tract were calculated using an indirect standardization method. RESULTS: Compared with the general Korean population, the incidence of lung and bronchus cancer (C33-C34) was significantly higher in all subjects [SIR 1.15, 95% confidence interval (CI) 1.02-1.29] and especially in the men subjects (SIR 1.47, 95% CI 1.29-1.68) in our study population. In addition, the incidence of larynx cancer in men (SIR 1.64, 95% CI 0.97-2.59) and salivary gland cancer in women (SIR 3.03, 95% CI 0.98-7.07) living near cement plants was marginally increased. CONCLUSIONS: These results suggest that environmental exposure to Portland cement dust is a risk factor for respiratory tract cancers.
Subject(s)
Construction Materials/adverse effects , Environmental Exposure/adverse effects , Head and Neck Neoplasms/epidemiology , Respiratory Tract Neoplasms/epidemiology , Adult , Female , Humans , Incidence , Male , Republic of Korea/epidemiology , SmokingABSTRACT
The primary objective of the present study was to investigate the relationship between 25-hydroxyvitamin D (25[OH]D) and areal bone mineral density (aBMD) in Korean subjects from the general population aged ≥50 years. This study included 8,857 individuals who completed the baseline survey of the Dong-gu study, which was conducted in Korea from 2007-2010. The participants who fulfilled the detailed inclusion criteria underwent assessment of the femoral neck and lumbar spine aBMD as well as measurement of serum 25(OH)D and parathyroid hormone (PTH) levels. After adjusting for other covariates and log-PTH values, the mean aBMD of the femoral neck exhibited a significant increase with increasing 25(OH)D levels in both males (p < 0.001) and females (p = 0.005). Additionally, the mean aBMD of the lumbar spine exhibited a significant increase with increasing 25(OH)D levels in males (p = 0.011) but not females (p = 0.252). After adjusting for covariates and log-25(OH)D values, the mean aBMD values of the femoral neck and lumbar spine showed significant decreases with increasing PTH levels in both males and females (p < 0.001). The present findings demonstrate that the aBMD of the femoral neck was significantly associated with 25(OH)D levels independent of PTH in both males and females and that the aBMD of the lumbar spine was significantly associated with 25(OH)D levels independent of PTH in males, but not females.
Subject(s)
Bone Density , Vitamin D/analogs & derivatives , Aged , Female , Femur Neck/diagnostic imaging , Humans , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Parathyroid Hormone/blood , Prospective Studies , Republic of Korea , Vitamin D/bloodABSTRACT
We evaluated the association of the APOE polymorphism with serum C-reactive protein levels and white blood cell count in two large population-based studies in Korean. The datasets included the Dong-gu study (n = 8,893) and the Namwon Study (n = 10,032). APOE genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism. Multivariable linear regression analysis was performed to evaluate the relationship of APOE genotypes with C-reactive protein levels and white blood cell count with adjustments for age, sex, body mass index, smoking, diabetes, hypertension, and serum lipids. In the multivariate model, carriers of E3E4 or E4E4 genotype had significantly lower C-reactive protein levels compared with carriers of E3E3 genotype group (0.50 mg/L vs. 0.67 mg/L; 0.37 mg/L vs. 0.67 mg/L, respectively, for the Dong-gu Study and 0.47 mg/L vs. 0.66 mg/L; 0.45 mg/L vs. 0.66 mg/L, respectively, for the Namwon Study). However, there was no difference in white blood cell count among APOE genotypes. We found that the APOE E4 allele is associated with lower C-reactive protein levels, but not white blood cell count. Our results suggest that APOE genotype may influence C-reactive protein levels through non-inflammatory pathway.
Subject(s)
Apolipoproteins E/genetics , C-Reactive Protein/metabolism , Inflammation/blood , Aged , Female , Genetic Association Studies , Genotype , Humans , Inflammation/immunology , Leukocyte Count , Male , Middle Aged , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Polymorphism, Single Nucleotide/genetics , Prospective Studies , Republic of KoreaABSTRACT
BACKGROUND: Recent cross-sectional studies indicate that obesity is a risk factor for periodontal disease. Exercise training in high fat mice or rats can inhibit gingival inflammation effectively. The objective of this human intervention study was to investigate whether short-term weight control could affect periodontal indexes and serum and gingival crevicular fluid (GCF) biomarkers in young Koreans. METHODS: Forty-one obese volunteers (body mass index (BMI) > 25.0) and 12 normal weight subjects (18.5 ≤ BMI ≤ 23.0) participated in a four-week weight control program to analyze the changes in anthropometric criteria, the concentrations of C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides in serum, gingival index, bleeding on probing, periodontal biomarkers in GCF, and dental plaque index at the first and the 27th days. RESULTS: The means of obesity measures decreased significantly more in the obese group (BMI 2.53 ± 0.96, waist-to-hip ratio (WHR) 4.88 ± 1.58 %, LDL 35.85 ± 21.74 mgdL(-1)) than in the normal weight group (BMI 0.78 ± 0.72, WHR 2.00 ± 0.95 %, LDL 15.58 ± 18.07 mgdL(-1)). While the obese group showed significant decreases in the biomarkers in GCF (IL-1ß 58.38 ± 65.55 pgmL(-1), MMP-8 4.19 ± 5.61 ngmL(-1), MMP-9 3.36 ± 6.30 ngmL(-1)), the mean changes for the normal weight group (IL-1ß 10.07 ± 21.08 pgmL(-1), MMP-8 1.49 ± 4.61 ngmL(-1), MMP-9 -1.52 ± 9.71 ngmL(-1)) were not statistically significant. Anthropometric measures and the amounts of GCF biomarkers had weak positive correlations (0.242 ≤ r ≤ 0.340), and LDL in serum correlated with MMP-8 (r = 0.332) and IL-1ß (r = 0.342) in the obese group. Stepwise multiple linear regression analysis in the obese group showed that the relationship between the amount of IL-1ß in GCF and predictor variables including LDL and BMI was highly significant and accounted for 19.1 % of the variance in IL-1ß in GCF. CONCLUSIONS: In periodontally healthy subjects, weight control could reduce the amounts of MMP-8, MMP-9, and IL-1ß in GCF of the obese subjects. Further studies with periodontally unhealthy and obese people are needed to identify the mechanism of decreases in inflammation biomarkers in GCF through weight control. TRIAL REGISTRATION: ISRCTN86753073 (2015.08.14).
Subject(s)
Biomarkers , Caloric Restriction , Obesity , Periodontal Diseases , Periodontal Index , Periodontal Pocket , Adult , Biomarkers/analysis , Body Mass Index , Dental Plaque Index , Female , Gingival Crevicular Fluid , Gingivitis/metabolism , Humans , Male , Obesity/diet therapy , Periodontal Diseases/immunology , Periodontal Pocket/metabolism , Pilot Projects , Waist-Hip RatioABSTRACT
BACKGROUND: The results of epidemiologic studies of the association between serum γ-glutamyltransferase (GGT) and brachial-ankle pulse wave velocity (baPWV) have been inconsistent. We examined the association between serum GGT and arterial stiffness in a general population of Korean adults. METHODS: The study population consisted of 6314 community-dwelling Koreans who participated in the baseline survey of the Namwon Study. We analyzed sex-specific association between serum GGT and arterial stiffness, as measured by baPWV. RESULTS: There was a significant progressive increase in age-adjusted mean baPWV across quartiles of GGT in both sexes. In fully adjusted analysis, as compared with the lowest quartile, the odds ratios (95% CI) for high baPWV (ie, sex-specific fifth quintile) were 1.51 (1.03-2.23), 1.82 (1.22-2.72), and 2.80 (1.79-4.40) among men (P-trend <0.001), and 1.11 (0.81-1.52), 1.29 (0.94-1.76), and 1.47 (1.04-2.08) among women (P-trend <0.001), for the second, third, and fourth quartiles of GGT, respectively. CONCLUSIONS: This population-based study examined the dose-response relationship between GGT and arterial stiffness as measured by baPWV in both sexes. The association between GGT and arterial stiffness was stronger among men. Additional longitudinal studies are needed to examine the relationship between GGT and arterial stiffness and clarify the mechanism underlying the association.
Subject(s)
Vascular Stiffness/physiology , gamma-Glutamyltransferase/blood , Aged , Ankle Brachial Index , Female , Humans , Male , Middle Aged , Prospective Studies , Pulse Wave Analysis , Republic of Korea/epidemiology , Sex DistributionABSTRACT
OBJECTIVE: We aimed to evaluate whether clinical attachment loss (CAL), a measure of the severity of periodontal disease or number of teeth present is associated with bone mineral density (BMD). METHODS: The study population consisted of 5383 people aged 50 years and older who participated in the Dong-gu Study. BMD at the lumbar spine and femoral neck was measured by dual-energy X-ray absorptiometry. Oral examination included assessments of the number of teeth present and CAL. Number of teeth present was categorized into three equal categories. CAL values were divided into tertiles in terms of the percentage of sites with CAL ≥4 mm. Analysis of covariance was used to compare the adjusted means of BMD according to the tooth number and the tertiles of CAL. RESULTS: There was a significant association between the number of teeth present and BMD in men. Compared with men with 22 or more teeth, men with 10 and less teeth had lower BMD. CAL was significantly associated with lower BMD at the lumbar spine in women. CONCLUSION: Our data indicate that tooth loss and CAL were associated with low BMD. However, the magnitude of these associations was relatively small and the clinical significance was unclear.
Subject(s)
Bone Density/physiology , Periodontal Diseases/complications , Tooth Loss/complications , Absorptiometry, Photon/methods , Aged , Antihypertensive Agents/therapeutic use , Blood Glucose/analysis , Body Mass Index , Educational Status , Female , Femur Neck/pathology , Humans , Hypoglycemic Agents/therapeutic use , Lumbar Vertebrae/pathology , Male , Menopause/physiology , Middle Aged , Osteoporosis/complications , Periodontal Attachment Loss/complications , Prospective Studies , Sex Factors , SmokingABSTRACT
BACKGROUND: Large waist circumference is linked to poor health. Investigations of the relationship between waist circumference, as an index of abdominal fat, and bone mineral density (BMD) have yielded inconsistent results. We investigated the association between abdominal obesity measured using waist circumference and BMD in a large-scale population-based study. METHODS: We enrolled 8981 Korean (3592 males and 5389 females) community-dwelling individuals aged ≥50 years from 2007 to 2010. BMD was measured using dual-energy X-ray absorptiometry at lumbar spine and femoral neck skeletal sites. A multiple linear regression analysis was used to evaluate the relationship between waist circumference quartiles and BMD after adjusting for age, height, weight, and regular exercise. RESULTS: The adjustment for age, height, weight, and regular exercise revealed a negative linear association between quartile of waist circumference and BMD at the femoral neck and lumbar spine sites in males and females. Waist circumference was more strongly correlated with BMD in males than in females. Although the correlations were slightly attenuated following further adjustment for percent body fat, they remained statistically significant. CONCLUSIONS: Our results revealed that waist circumference is independently and inversely associated with BMD after adjusting for age, weight, height, regular exercise and percent body fat, suggesting that waist circumference is a potential predictor of osteoporosis in middle-aged and older Korean males and females.
Subject(s)
Body Mass Index , Bone Density/physiology , Obesity, Abdominal/diagnosis , Obesity, Abdominal/epidemiology , Sex Characteristics , Waist Circumference/physiology , Aged , Body Weight/physiology , Female , Humans , Male , Middle Aged , Population Surveillance/methods , Prospective Studies , Republic of Korea/epidemiologyABSTRACT
We investigated the association of depressive symptoms with carotid intima-media thickness (IMT) and plaques in the general Korean population. A total of 7,554 Korean males and females aged 45-74 yr who were free from cardiovascular diseases were included in the analyses. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Subjects with a score of ≥16 were classified as having clinically significant depressive symptoms. Carotid ultrasonography was used to measure mean carotid IMT (C-IMT) and to determine the presence of plaques. A significant association between depressive symptoms and C-IMT was observed only in females. After adjustment for established cardiovascular risk factors, females with depressive symptoms had significantly greater C-IMT than females without depressive symptoms (mean difference 0.011±0.004 mm; 95% confidence interval, 0.003-0.019 mm). Compared with controls, the fully adjusted risk of females with depressive symptoms for abnormal C-IMT (≥1.0 mm) was significant (odds ratio, 1.63; 95% confidence interval, 1.16-2.30). No significant association between depressive symptoms and carotid plaques was observed in either gender. This study shows a significant association between depressive symptoms and C-IMT in middle-aged and older females.
Subject(s)
Carotid Artery Diseases/diagnosis , Depression/diagnosis , Aged , Alcohol Drinking , Asian People , Carotid Artery Diseases/complications , Carotid Artery Diseases/diagnostic imaging , Carotid Intima-Media Thickness , Cross-Sectional Studies , Depression/etiology , Depression/pathology , Female , Humans , Male , Middle Aged , Odds Ratio , Psychiatric Status Rating Scales , Republic of Korea , Risk Factors , Sex Factors , Smoking , Surveys and QuestionnairesABSTRACT
The reference interval for plasma total homocysteine (tHcy) and serum folate concentrations were estimated. Total of 3,154 reference individuals (1,029 men and 2,125 women) were selected based on stringent exclusion criteria. For plasma tHcy concentration (µM/L), reference values (median [5-95 percentile]) were 7.72 (5.03 to 13.80) and 6.09 (3.95-10.19) in men and women, respectively. For serum folate concentration (nM/L), reference values were 23.71 (11.73-38.44) and 28.95 (15.23-40.44) in men and women, respectively. The tHcy levels of both genders in the present study were lower than those in previous reports from other countries and Korea.
Subject(s)
Folic Acid/blood , Homocysteine/blood , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Age Factors , Aged , Aging , Cohort Studies , Female , Genotype , Humans , Male , Middle Aged , Reference Values , Republic of Korea , Sex FactorsABSTRACT
Vitamin D plays an important role in bone metabolism and maintaining bone health. Recently, new evidence has revealed that vitamin D affects chronic diseases such as autoimmune diseases, cardiovascular diseases and certain cancers. The aim of this study was to evaluate the vitamin D status and the prevalence of vitamin D deficiency in an urban Korean population. This study included 8,976 participants (3,587 men and 5,389 women) aged 50 yr and older. Serum 25(OH)D level was measured by chemiluminescent microparticle immunoassay. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] was 59.7% and 86.5% in men and women, respectively. The prevalence of vitamin D deficiency increased significantly with age in men, but not in women and it decreased from April to July, more prominently in men than in women. These results suggest that sun exposure, intake of vitamin D supplement, and regular physical activities is recommended in an urban Koreans, especially in women.
Subject(s)
Vitamin D Deficiency/epidemiology , Vitamin D/blood , Aged , Aging , Bone and Bones/metabolism , Female , Humans , Male , Middle Aged , Prevalence , Republic of Korea/epidemiology , Risk Factors , Sex Factors , Vitamin D Deficiency/bloodABSTRACT
Objectives: This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices' predictive ability with that of the body mass index (BMI). Methods: We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell c-index. Results: Adding anthropometric indices to the basic mortality model (c-index 0.7723; 95% CI, 0.7647-0.7799) significantly increased the predictive power of BMI (c-index 0.7735; 95% CI, 0.7659-0.7811), a body shape index (ABSI, c-index 0.7735; 95% CI, 0.7659-0.7810), weight-adjusted waist index (WWI, c-index 0.7731; 95% CI, 0.7656-0.7807), and waist to hip index (WHI, c-index 0.7733; 95% CI, 0.7657-0.7809). The differences between the BMI model and the other 3 models were not statistically significant. Conclusion: In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.
ABSTRACT
The epidemiologic information regarding international differences in bone mineral density (BMD) in women is currently insufficient. We compared BMD in older women across five racial/ethnic groups in four countries. The femoral neck, total hip, and lumbar spine BMD were measured in women (aged 65-74 years) from the Study of Osteoporotic Fractures (SOF) (5,035 Caucasian women and 256 African American women in the US), the Tobago Women's Health Study (116 Afro-Caribbean women), the Ms Os Hong Kong Study (794 Hong Kong Chinese women) and the Namwon Study (1,377 South Korean women). BMD was corrected according to the cross-site calibration results for all scanners. When compared with US Caucasian women, the age adjusted mean BMD measurements at the hip sites were 21-31 % higher among Tobago Afro-Caribbean women and 13-23 % higher among African American women. The total hip and spine BMD values were 4-5 % lower among Hong Kong Chinese women and 4-7 % lower among South Korean women compared to US Caucasians. The femoral neck BMD was similar in Hong Kong Chinese women, but higher among South Korean women compared to US Caucasians. Current/past estrogen use was a significant contributing factor to the difference in BMD between US versus non-US women. Differences in body weight partially explained the difference in BMD between Asian versus non-Asian women. These findings show substantial racial/ethnic differences in BMD even within African or Asian origin individuals, and highlight the contributing role of body weight and estrogen use to the geographic and racial/ethnic variation in BMD.
Subject(s)
Asian People/ethnology , Black People/ethnology , Bone Density/physiology , White People/ethnology , Aged , Aging/physiology , Body Weight , Demography , Female , Humans , Life StyleABSTRACT
BACKGROUND: We investigated the sex-dependent associations of testosterone and sex hormone-binding globulin (SHBG) levels with metabolic syndrome (MetS). METHODS AND RESULTS: We conducted a cross-sectional study of 9,424 community-dwelling adults aged 45-74 years (median age, 63.7 years). MetS was defined according to the updated version of the National Cholesterol Education Program Adult Treatment Panel III criteria. Serum total testosterone (TT) and SHBG levels were determined using a chemiluminescent microparticle immunoassay, and free testosterone (FT) concentrations were calculated. In a multivariate analysis, TT levels were inversely associated with MetS in men (odds ratio [OR] of each standard deviation increase in the logarithmic value, 0.70; 95% confidence interval [CI], 0.65-0.76), whereas they were positively associated in women (OR, 1.17; 95% CI, 1.10-1.24). FT levels were positively associated with MetS in women only (OR, 1.39; 95% CI, 1.30-1.49). However, SHBG levels were negatively associated with MetS in both men (OR, 0.57; 95% CI, 0.52-0.61) and women (OR, 0.61; 95% CI, 0.57-0.66). CONCLUSIONS: Our data showed that higher TT levels were associated with a reduced prevalence of MetS in men and an elevated prevalence of MetS in women. Higher SHBG levels were associated with decreased prevalence of MetS in both sexes. These results suggest sex differences in the associations of endogenous testosterone and SHBG with MetS.