Association between cardiorespiratory fitness and the prevalence of metabolic syndrome among Korean adults: a cross sectional study.

BACKGROUND: The purpose of the current study was to investigate the association between cardiorespiratory fitness (CRF), measured by a simple step test, and the prevalence of metabolic syndrome among Korean adults, in a cross sectional design. METHODS: A total of 1,007 Korean adults (488 men and 519 women) who underwent routine health checkups were recruited. CRF was measured by Tecumseh step test. The National Cholesterol Education Program's Adult Treatment Panel III guideline was used to determine the prevalence of metabolic syndrome. A logistic regression was performed to reveal possible associations. RESULTS: The results of the study showed that a lower level of CRF was significantly associated with a higher prevalence of metabolic syndrome in men, but not in women. On the other hand, higher BMI was associated with a higher prevalence of metabolic syndrome in both men and women. However, BMI was not associated with fasting glucose nor hemoglobinA1c in men. When the combined impact of BMI and CRF on the prevalence of metabolic syndrome was analyzed, a significantly increased prevalence of metabolic syndrome was found in both men (odds ratio [OR]: 18.8, 95% Confidence Interval [CI]: 5.0-70.5) and women (OR: 8.1, 95% CI: 2.8-23.9) who had high BMI and low cardiorespiratory fitness. On the other hand, the prevalence of metabolic syndrome was only increased 7.9 times (95% CI: 2.0-31.2) in men and 5.4 times (95% CI: 1.9-15.9) in women who had high level of CRF and high BMI. CONCLUSION: In conclusion, the current study demonstrated the low CRF and obesity was a predictor for metabolic syndrome in Korean adults.

Visceral adiposity is associated with SIRT1 expression in peripheral blood mononuclear cells: a pilot study.

Sirtuin1 (SIRT1) is activated during calorie restriction and appears to be related to energy balance through glucose or lipid metabolism and insulin signaling. These findings suggest that SIRT1 may play a role in the pathophysiology of visceral obesity. Therefore, we investigated the relationship between SIRT1 gene expression in circulating peripheral blood mononuclear cells (PBMCs) and abdominal visceral adiposity as measured by computed tomography. We recruited 43 men and women without history of diabetes or cardiovascular disease Biomarkers of metabolic disease and body composition by computed tomography were assessed. SIRT1 gene expression was determined using isolated PBMCs. SIRT1 expression levels negatively correlated with body mass index, waist circumference, abdominal visceral fat area, and homeostasis model of assessment of insulin resistance (HOMA-IR) and positively correlated with adiponectin levels. Results of step-wise multiple regression analysis revealed that abdominal visceral fat area and HOMA-IR were independently associated with SIRT1 expression. The significant association between abdominal visceral fat accumulation and SIRT1 gene expression in PBMCs suggests that SIRT1 may be a new therapeutic target for the prevention of disease related to obesity, especially visceral obesity.

High-sensitivity C-reactive protein is independently associated with arterial stiffness in women with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is associated with higher incidences of cardiovascular events and with increased mortality from coronary heart disease. There is increasing evidence that MetS presents as a proinflammatory and prothrombotic state. OBJECTIVES: The purposes of this study were to investigate the relationships among adiponectin (a marker for adipocytokines), high-sensitivity C-reactive protein (hs-CRP, a marker for inflammation), and brachial-ankle pulse-wave velocity (ba-PWV, a marker for arterial stiffness) in MetS and to identify predictors of ba-PWV, which indicates subclinical atherosclerosis. METHODS: The present study is a cross-sectional, secondary analysis of data collected as part of a longitudinal, randomized controlled trial that tested the effectiveness of a therapeutic lifestyle modification for Korean women with MetS (N = 52). We used the definition for MetS suggested by the National Cholesterol Education Program Adult Treatment Panel III. RESULTS: Adiponectin was negatively correlated with hs-CRP (r = -0.316, P = .027) and ba-PWV (r = -0.284, P = .048), and hs-CRP was positively correlated with ba-PWV (r = 0.341, P = .016). Women with high hs-CRP and low adiponectin levels also had greater ba-PWV levels (P = .041). Levels of hs-CRP were independently associated with ba-PWV after adjusting for age, body mass index, and number of MetS components, whereas no independent association was identified for adiponectin. CONCLUSION: Levels of hs-CRP may provide important prognostic information in terms of future cardiovascular risk in women with MetS.

Monocyte chemoattractant protein-1 is related to metabolic syndrome and homocysteine in subjects without clinically significant atherosclerotic cardiovascular disease.

BACKGROUND: The features of the metabolic syndrome include glucose intolerance, hypertension, dyslipidemia, and central obesity, all of which are risk factors for diabetes and cardiovascular disease. Monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) play a key role in atherosclerosis. We examined the association between chemokines, such as MCP-1 and IL-8, and metabolic syndrome. METHODS: The present study was comprised of 54 men and 126 women. Subjects with cardiovascular disease such as myocardial infarction, TIA and cerebral infarction were excluded. RESULTS: MCP-1 was positively correlated with homeostasis model assessment of insulin resistance, homocysteine, and mean pulse wave velocity, but IL-8 was not. In multiple regression analysis, age, HOMA-IR and homocysteine were found to be an independent factor associated with MCP-1 adjusted by gender, waist, systolic blood pressure, triglyceride, HDL-cholesterol, and hs-CRP. After adjustment for age and gender, mean MCP-1 was higher in subjects with metabolic syndrome and in subject with high blood pressure among the individual components of the metabolic syndrome. CONCLUSION: MCP-1 was associated with a low-grade systemic inflammatory reaction which is often found in the metabolic syndrome.

Increased γ-glutamyltransferase and decreased total bilirubin are associated with metabolic syndrome in Korean postmenopausal women.

BACKGROUND: The objective of this study was to determine if there is an association between serum hepatic markers and the metabolic syndrome in postmenopausal women. METHODS: This study involved 1229 postmenopausal women aged 44-85 years, who visited the Center for Health Promotion for a health check-up. We excluded subjects from the analysis if they had a daily alcohol consumption of more than 1.5 drinks (alcohol consumption ≥20 g/day) or had chronic viral hepatitis. We also excluded subjects who had abnormal hepatic function, as defined by serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >100 IU/L, serum γ-glutamyltransferase (GGT) >100 IU/L, or serum total bilirubin concentrations >2 mg/dL. RESULTS: Serum ALT and GGT concentrations increased in proportion to the number of elements of the metabolic syndrome (p<0.01). However, total bilirubin concentrations decreased (p=0.01). After adjusting for age, body mass index, and the presence of fatty liver in the patients with metabolic syndrome, the odds ratios (95% confidence interval) were 1.38 (0.89-2.15) for log (ALT), 1.69 (1.30-2.20) for log (GGT), and 0.53 (0.33-0.86) for log (total bilirubin). CONCLUSIONS: We found that an increase in GGT and a decrease in total bilirubin was associated with metabolic syndrome in postmenopausal women. Hepatic enzymes could be proposed as simple clinical metabolic markers that identify the metabolic syndrome.

Lower Relative Handgrip Strength is Significantly Associated with a Higher Prevalence of the Metabolic Syndrome in Adults.

Purpose: In previous studies, there were debates on the association between handgrip strength (HGS) and prevalence of metabolic syndrome. Since body weight is associated with both HGS and prevalence of metabolic syndrome, whether HGS is corrected with body weight (relative HGS) or not (absolute HGS) can directly influence outcome of the study. Therefore, this study analyzed the relationship between HGS and prevalence of metabolic syndrome using both relative and absolute HGS. Methods: A total of 1009 Korean adults (488 men and 521 women) were analyzed. Participants were categorized into three groups according to HGS levels. Logistic regression analysis was used to calculate odds ratio (OR) and 95% confidence interval (CI) of metabolic syndrome associated with both relative and absolute HGS. Results: Lower absolute HGS was associated with lower prevalence of having abnormal blood pressure (OR: 0.60, 95% CI: 0.37-0.97) and glucose levels (OR: 0.54, 95% CI: 0.34-0.88) in men. However, no association was found between absolute HGS and prevalence of metabolic syndrome. However, a significant inverse association was found between relative HGS and prevalence of metabolic syndrome. Compared with participants in the highest tertile, those in the lowest tertile of relative HGS had 2.52 times (95% CI: 1.43-4.46) and 5.01 times (95% CI: 1.66-15.08) higher prevalence of metabolic syndrome in men and women, respectively. Conclusion: Lower relative HGS but not absolute HGS was associated with higher prevalence of metabolic syndrome. Our study showed that there are evident discrepancies in the association between HGS and prevalence of metabolic syndrome whether HGS is corrected by body weight or not.

Retinol-binding protein in nonobese women with polycystic ovary syndrome.

OBJECTIVE: Although polycystic ovary syndrome (PCOS) is frequently associated with insulin resistance, cardiovascular disease and various metabolic diseases, the mechanisms linking PCOS to metabolic changes are not fully understood. Retinol-binding protein (RBP) was recently reported as an adipocytokine that may link insulin resistance and lipid metabolism. The aim of this study was to investigate the potential role of RBP in women with PCOS. RESEARCH DESIGN AND METHODS: Fifty women with PCOS and 40 healthy women, all of whom were age- and weight-matched, were studied. Blood was obtained to determine RBP levels as well as metabolic and hormonal parameters, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated for each subject. RESULTS: The RBP levels were higher (P < 0.01) in women with PCOS after adjusting for age, body mass index (BMI), mean blood pressure, triglyceride (TG), high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, fasting glucose, fasting insulin, estimated glomerular filtration rate (GFR), LH/FSH, total testosterone and SHBG levels. PCOS status was the strongest predictor of elevated RBP levels. In both the PCOS and control groups, RBP levels were significantly correlated with HOMA-IR (P = 0.03 in the PCOS group; P = 0.01 in controls). In addition, RBP levels were significantly correlated with total cholesterol, LDL-cholesterol and TG levels in PCOS (P < 0.01, P < 0.01 and P = 0.01, respectively). CONCLUSIONS: Higher RBP levels in the PCOS group, when compared to the non-PCOS group, were observed, and this difference may play a role in the pathophysiology found in women with PCOS. Further studies are needed to clarify the role of RBP in these women.

Relationship between osteocalcin and glucose metabolism in postmenopausal women.

BACKGROUND: Recently, osteocalcin was found to regulate blood glucose, insulin secretion, and fat deposition in mice. However, the relationship between osteocalcin levels and factors related to glucose metabolism in humans has not yet been investigated. We investigated the relationship between osteocalcin and glucose metabolism in postmenopausal women. METHODS: Three hundred thirty-nine postmenopausal women were recruited for this study. Glucose metabolism related substance and serum osteocalcin were assayed. RESULTS: There was a significant reduction in osteocalcin levels among type 2 diabetes mellitus patients compared with the normal glucose and impaired fasting glucose groups. Next, the subjects in the highest quartile for osteocalcin were observed to have significantly decreased fasting glucose and HbA1c levels compared with subjects in the lowest quartile. In addition, osteocalcin levels were inversely correlated with glucose, insulin, HbA1c, and insulin resistance. Moreover, multivariate analysis showed that serum osteocalcin was found to be an independent factor associated with glucose and HbA1c. CONCLUSIONS: There is a potential role of osteocalcin in regulating blood glucose levels in postmenopausal women. This finding indicates that in humans the skeleton may be involved in energy metabolism by functioning as part of the endocrine system.

Changes in bone markers after once-weekly low-dose alendronate in postmenopausal women with moderate bone loss.

BACKGROUND: High bone turnover, with bone resorption exceeding bone formation, is a major mechanism of postmenopausal osteoporosis. Therefore, inhibition of bone resorption is a rational approach for the prevention of bone loss. The objective of the current study was to determine the short-term efficacy of once-weekly low-dose alendronate in the prevention of bone loss, via bone turnover markers, in early postmenopausal Korean women with moderate bone loss. METHODS: This study involved a 12-week, randomized, double-blind clinical trial that compared the effects of placebo with alendronate 20mg once weekly. All subjects received supplemental calcium 600 mg and vitamin D 400IU daily. We recruited 63 postmenopausal women (ranging from 50 to 65 years of age) with the lowest lumbar spine bone mineral density (BMD) at least 2.0 S.D. below the mean value for young healthy adults. BMD was measured at baseline and serum alkaline phosphatase (ALP), osteocalcin, C-terminal telopeptide of type I collagen (CTX), and osteoprotegerin (OPG) were measured at baseline and 12 weeks after treatment. RESULTS: We randomly assigned 63 women to either placebo or alencronate 20 mg once a week for 3 months. Forty-nine women continued and completed all 3 months. After 3 months, bone resorption markers were significantly decreased in the alendronate group than in the placebo group: CTX -47.2% vs. 15% (p<0.01), ALP 1.6% vs. 25.9% (p=0.01), osteocalcin -29.2% vs. -13.6 (p=0.06). Women who received alendronate showed similar results to those who received placebo with regard to adverse events. CONCLUSION: Once-weekly low-dose alendronate may be a cost-effective and safe method of suppressing bone turnover in early postmenopausal women with moderate bone loss.

Abdominal visceral fat reduction is associated with favorable changes of serum retinol binding protein-4 in nondiabetic subjects.

The adipocytokine retinol binding protein-4 (RBP4) has recently been shown to link obesity and insulin resistance, although their relationship remains controversial in human studies. The influence of weight reduction with changes of fat distribution on serum RBP4 concentration in nondiabetics is also unknown. We assessed the effect of weight reduction (especially abdominal visceral fat loss) on serum RBP4 levels after a structuralized weight-reduction program. We conducted a prospective intervention study consisting of a 16-week weight reduction program, including lifestyle modification and adjuvant appetite suppressants. A total of 52 nondiabetic subjects aged 37.4 +/- 11 years with a body mass index of 27.4 +/- 4 kg/m (2) were included. Serum RBP4 concentrations with other metabolic parameters and abdominal adipose tissue areas as determined by computed tomography scan were measured both before and 16 weeks after the weight reduction program. Subjects had a 10.9% loss of body weight accompanied by a 25.5% decrease in serum RBP4 levels, with improved ( ) insulin sensitivity after the program. The changes in RBP4 levels were significantly correlated with the amounts of abdominal visceral fat loss (r = 0.38, p<0.01) but were not associated with the amount of total body fat loss or abdominal subcutaneous fat loss. Weight reduction, especially the loss of abdominal visceral fat, lowers serum RBP4 concentrations in nondiabetic subjects. The relationship between individual changes in RBP4 and abdominal visceral fat indicated that RBP4 may be involved in the beneficial effect of visceral fat reduction on the improvement of insulin resistance and metabolic syndrome.

Association between brachial-ankle pulse wave velocity and cardiovascular risk factors in healthy adolescents.

OBJECTIVE: To investigate the associations between cardiovascular risk factors and arterial stiffness, measured as brachial-ankle pulse wave velocity (baPWV), in healthy adolescents. STUDY DESIGN: In this cross-sectional study, 178 male and 84 female adolescents, aged 12 to 18 years, were recruited. Total homocysteine levels, serum lipid profiles, high-sensitivity C-reactive protein (hs-CRP) levels, fasting glucose levels, fasting insulin levels, and baPWV were measured. RESULTS: baPWV was significantly higher in male adolescents than in female adolescents. In both sex groups, baPWV was positively correlated with body mass index (BMI), waist circumference, waist-hip ratio, systolic and diastolic blood pressures, fasting insulin levels, homeostatic model assessment of insulin resistance, triglyceride levels, hs-CRP levels, and total homocysteine levels. In male adolescents, age, total cholesterol level, low-density lipoprotein cholesterol levels, and white blood cell counts were positively correlated with baPWV, and, in female adolescents, high-density lipoprotein cholesterol levels were negatively correlated with baPWV. In multivariate analysis, sex, mean blood pressure, BMI, and total homocysteine levels were found to be independent factors associated with baPWV. CONCLUSION: Blood pressure, BMI, sex, and total homocysteine levels were independently associated with arterial stiffness, measured as baPWV, in healthy adolescents, suggesting that these risk factors may be associated with an increased risk of atherosclerosis in adolescents.

Association of serum retinol binding protein 4 and insulin resistance in apparently healthy adolescents.

Insulin resistance constitutes a pathophysiologic link between obesity, atherosclerosis, and/or cardiovascular complications. Retinol binding protein 4 (RBP4) is a newly discovered adipocyte product that modulates glucose metabolism and consequently induces insulin resistance. We investigated the association between serum RBP4 levels and insulin resistance in obese and nonobese adolescents. A total of 87 nonobese (60 males and 27 females) and 85 obese (62 males and 23 females) apparently healthy adolescents, 12 to 18 years old, were included in this study. A questionnaire was used to obtain participant medical history and lifestyle information, such as smoking and alcohol ingestion habits. Subjects' anthropometric measurements were taken to calculate for body mass index and waist-to-hip ratio. Serum RBP4 levels were measured by an enzyme immunoassay kit. High-sensitivity C-reactive protein, fasting glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and fasting insulin were measured. Low-density lipoprotein cholesterol level and homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. Males had significantly higher RBP4 levels than females. Serum RBP4 levels were significantly higher in the obese group compared with the nonobese group. In all subjects, RBP4 was positively correlated with adiposity index (body mass index, waist circumference, waist-to-hip ratio), systolic and diastolic blood pressures, glucose tolerance index (fasting glucose, insulin, HOMA-IR), lipid profile (total cholesterol, triglycerides), and inflammatory indices (high-sensitivity C-reactive protein, white blood cell count). In multiple linear regression analysis, RBP4 was independently associated with age, HOMA-IR, and triglyceride levels in the nonobese group and with sex and triglyceride levels in the obese group. These results suggest that serum RBP4 might have clinical implications for lipid metabolism and insulin action in adolescents.

Insulin resistance is associated with arterial stiffness independent of obesity in male adolescents.

To determine the relationship between insulin resistance (IR) and arterial stiffness independent of obesity in male adolescents, we evaluated body fat, lipid parameters, indices of IR (fasting insulin, and the homeostasis model assessment of insulin resistance [HOMA-IR]), indices of insulin sensitivity (IS) (fasting glucose/fasting insulin [GF/IF], and the quantitative insulin sensitivity check index [QUICKI]), and lifestyle parameters in 256 male adolescents. We divided the study group into the following four subgroups based on the median value of HOMA-IR and obesity: non-obese with IS, non-obese with IR, obese with IS, and obese with IR. In order to estimate arterial stiffness, we measured brachial ankle pulse wave velocity (baPWV). Despite having a high body mass index (BMI), obese-IS adolescents showed a significantly lower fasting insulin and baPWV, but had higher IS indices than non-obese-IR adolescents. After an adjustment for age, BMI, waist-to-hip ratio, mean blood pressure, heart rate, total cholesterol level, triglyceride, alanine aminotransferase (ALT) level, physical activity, and television and computer usage, multiple regression models showed that baPWV was independently correlated with IR and IS indices. In conclusion, our results demonstrate an association between IR and baPWV independent of weight, suggesting that IR is a risk factor for the development of early atherosclerosis. Interventions that decrease IR in addition to weight reduction may be necessary to alter the early development of cardiovascular risk.

Association between hypoadiponectinemia and cardiovascular risk factors in nonobese healthy adults.

Adiponectin levels are significantly lower in obese adult patients with type 2 diabetes mellitus, essential hypertension, dyslipidemia, and cardiovascular disease. However, the role of hypoadiponectinemia in nonobese healthy adults has not been fully elucidated. In this study, we examined the association between hypoadiponectinemia and cardiovascular risk factors and estimated plasma adiponectin values in nonobese, apparently healthy adults. A total of 204 male and 214 female healthy individuals aged 20 to 80 years, with a body mass index (BMI) of less than 25 kg/m2, were included in this study. We measured patients' plasma adiponectin levels, serum lipid profiles, high-sensitivity C-reactive protein (hs-CRP) levels, fasting glucose levels, and fasting insulin levels. Mean values of plasma adiponectin were 5.45 +/- 3.3 microg/mL in male and 8.16 +/- 4.6 microg/mL in female subjects. The hypoadiponectinemia group (< 4.0 microg/mL) had significantly higher levels (P < .01) of BMI, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and triglycerides, but lower levels of high-density lipoprotein cholesterol (HDL-C). In males, plasma adiponectin levels were inversely correlated with BMI (r = -0.32, P < .01), HOMA-IR (r = -0.14, P < .05), triglyceride levels (r = -0.17, P < .05), and hs-CRP levels (r = -0.15, P < .05), and positively correlated with HDL-C (r = 0.24, P < .01). In females, plasma adiponectin levels were negatively correlated with BMI (r = -0.31, P < .01), fasting glucose (r = -0.18, P < .01), fasting insulin (r = -0.23, P < .01), HOMA-IR (r = -0.24, P < .01), and triglyceride (r = -0.18, P < .01) levels, and positively correlated with HDL-C (r = 0.37, P < .01). Sex, age, BMI, and HDL-C (P < .01 for each) were found to be independent factors associated with plasma adiponectin levels in multivariate analysis. Hypoadiponectinemia is significantly associated with cardiovascular risk factors such as insulin resistance and atherogenic lipid profiles in nonobese, apparently healthy subjects.

Plasma adiponectin levels in postmenopausal women with or without long-term hormone therapy.

OBJECTIVE: Recent large, prospective, randomized studies show that hormone therapy (HT) does not confer a protective effect against cardiovascular disease (CVD) but may in fact increase cardiovascular events. Low plasma adiponectin levels are considered to be related to the development of atherosclerosis and CVD. The purpose of this study was to determine the effect of long-term hormone therapy on plasma adiponectin levels in postmenopausal women. METHODS: We recruited a total of 88 postmenopausal women aged 55-69 years old. Our sample consisted of 44 women who had undergone estrogen plus progestogen therapy (EPT) for more than 5 years and 44 age-matched women who had not received HT. We measured plasma adiponectin levels, the serum levels of their lipid profiles, high-sensitivity C-reactive protein (hs-CRP), fasting glucose levels, fasting insulin levels and estradiol levels. Their medical histories including their age at menopause, vitamin use, exercise, alcohol ingestion and cigarette smoking were also assessed by a questionnaire. RESULTS: The mean duration (mean+/-S.D.) of HT was 8.4+/-2.4 years. The mean serum estradiol level (mean+/-S.D.) of the HT group was 47.9+/-36.8 pg/L, significantly higher than that of the non-HT group (p<0.01). Plasma adiponectin levels were significantly lower in the HT group than in the non-HT group (p<0.05). Plasma adiponectin levels were inversely correlated to cholesterol, triglycerides and HOMA-IR (r=-0.33, p<0.05; r=-0.40, p<0.01 and r=-0.30, p<0.05, respectively) in the non-HRT group, but such correlations were not seen in the HT group. In the multivariate analysis, hormone therapy and serum estradiol levels were the independent factors associated with plasma adiponectin levels after adjustments were made for potential confounders. CONCLUSION: Plasma adiponectin levels were significantly lower in postmenopausal women with long-term HT than in those without HT, suggesting that long-term HT may modulate plasma adiponectin level in postmenopausal women.

Relationship between non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance in Korean adults: A cross-sectional study.

BACKGROUND: We investigated the independent and combined impact of obesity and nonalcoholic fatty liver disease (NAFLD) on components and prevalence of metabolic syndrome in Korean adults. METHODS: This study included 1695 adults (500 males and 1,195 females), who took part in a regular health check-up at the community-based health promotion center. Participants were divided according to degree of adiposity and the presence of NAFLD. The components and prevalence of metabolic syndrome were compared. RESULTS: Fasting glucose was significantly higher in nonobese participants with NAFLD compared to obese participants without NAFLD. Logistic regression analysis revealed that the presence of NAFLD was associated with 3.63 times increased prevalence of metabolic syndrome (95% CI: 1.21-10.86) while obesity without NAFLD was associated with 3.84 times increased prevalence of metabolic syndrome (95% CI: 1.57-9.36) in male. In female, the presence of NAFLD was associated with 5.56 times higher prevalence of metabolic syndrome (95% CI: 2.53-12.23) while obesity without NAFLD had 3.46 times increased prevalence of metabolic syndrome (95% CI: 1.64-7.33). CONCLUSIONS: NAFLD is associated with the prevalence of metabolic syndrome, independent of adiposity. In females, NAFLD may be a more important factor than obesity for risk of metabolic syndrome.

Effect of long-term hormone therapy on telomere length in postmenopausal women.

Telomeres undergo attrition with each cell division, and telomere length is associated with age-related diseases and mortality in the elderly. Estrogen can influence the attrition of telomeres by diverse mechanisms. This is a retrospective case control study that investigated the influence of long-term hormone therapy (HT) on telomere length in postmenopausal women. We recruited 130 postmenopausal women from 55 to 69 years of age for this study, and divided them into two groups. The first group included 65 women who had been on estrogen and progesterone therapy for more than five years (HT group). The other group was composed of 65 women matched in age to the HT group who had never had HT (non- HT group). The relative ratios of telomere length of study subjects to a reference DNA from a healthy young female were measured using quantitative PCR. Plasma levels of lipid profiles, total antioxidant status (TAS), C-reactive proteins (CRP), fasting glucose levels, and estradiol levels were measured. Age at menopause, vitamin use, and exercise, alcohol, and cigarette smoking histories were also assessed in a questionnaire. Mean duration (+/- SD) of HT was 8.4 +/- 2.3 years. Prevalence of vitamin use and regular exercise were higher in the HT group than in the non-HT group (p < 0.01). Relative telomere length ratios in the HT group were significantly greater than those in the non-HT group (p < 0.01). HT was significantly correlated with the relative telomere length ratio in multivariate analysis when potential confounding variables were controlled for (p < 0.05). In conclusion, telomere lengths were longer in postmenopausal women who had a history of long-term HT than in postmenopausal women without HT. Long-term HT in postmenopausal women may alleviate telomere attrition.

Effect of Active Hexose Correlated Compound (AHCC) in alcohol-induced liver enzyme elevation.

To investigate the effects of Active Hexose Correlated Compound (AHCC) supplementation and the mechanism action of AHCC in patients with alcohol-induced mildly elevated liver enzyme levels, participants were randomly allocated to the placebo, 1 g AHCC, or 3 g AHCC group and took the supplement for 12 wk. Subjects visited the hospital for clinical and biochemical measurements, for examination of adverse events, to return unused supplements, and to obtain their next supplements. Biochemical tests including liver enzymes, a questionnaire survey, and anthropometric measurements were collected at baseline and every 4 wk thereafter. Adherence and adverse events were evaluated. After 12 wk of supplementation, the percentage change in alanine aminotransferase (ALT) level was significantly different between the placebo (4.02±59.07%) and both AHCC groups (1 g AHCC: 223.89±20.59%, 3 g AHCC: 224.09±30.73%) (p=0.04). Serum levels of tumor necrosis factor-α (p<0.05) and interleukin-1ß (p<0.01) were significantly lower, while those of adiponectin were higher in both AHCC groups than in the placebo group (p<0.01). AHCC supplementation for 12 wk may improve the levels of liver enzymes and circulating pro-inflammatory and anti-inflammatory cytokines in patients with alcohol-induced liver enzyme elevation with mildly elevated liver enzyme levels.

Mitochondrial DNA copy number in peripheral blood is independently associated with visceral fat accumulation in healthy young adults.

Aims. Visceral obesity is associated with an increased risk of cardiometabolic diseases and it is important to identify the underlying mechanisms. There is growing evidence that mitochondrial dysfunction is associated with metabolic disturbances related to visceral obesity. In addition, maintaining mitochondrial DNA (mtDNA) copy number is important for preserving mitochondrial function. Therefore, we investigated the relationship between mtDNA copy number and visceral fat in healthy young adults. Methods. A total of 94 healthy young subjects were studied. Biomarkers of metabolic risk factors were assessed along with body composition by computed tomography. mtDNA copy number was measured in peripheral leukocytes using real-time polymerase chain reaction (PCR) methods. Results. The mtDNA copy number correlated with BMI (r = -0.22, P = 0.04), waist circumference (r = -0.23, P = 0.03), visceral fat area (r = -0.28, P = -0.01), HDL-cholesterol levels (r = 0.25, P = 0.02), and hs-CRP (r = 0.32, P = 0.02) after adjusting for age and sex. Both stepwise and nonstepwise multiple regression analyses confirmed that visceral fat area was independently associated with mtDNA copy number (ß = -0.33, P < 0.01, ß = 0.32, and P = 0.03, resp.). Conclusions. An independent association between mtDNA content and visceral adiposity was identified. These data suggest that mtDNA copy number is a potential predictive marker for metabolic disturbances. Further studies are required to understand the causality and clinical significance of our findings.

Reduced serum total osteocalcin is associated with central obesity in Korean children.

BACKGROUND: Recently, osteocalcin (OC), an osteoblast-derived hormone, has been suggested as a new link between obesity and insulin resistance in humans. However, few studies regarding the relationship between OC and obesity in Asian children have been published. We investigated the association of OC with adiposity, insulin resistance and metabolic syndrome (MetS) in Korean children. METHODS: Two hundred and nine (100 boys, 109 girls) children (age: 9.78 ± 1.05 years, body mass index (BMI): 22.27 ± 5.34 kg/m(2)) participated in this cross-sectional study. Anthropometric parameters, insulin resistance, lipid profiles, total OC, and an inflammatory marker, C-reactive protein (CRP), were measured. MetS phenotype was also determined. RESULTS: Serum total OC levels were significantly lower in overweight or obese children (76.96 ± 27.08 ng/ml vs. 66.91 ± 21.39 ng/ml, p = 0.020) and it was negatively associated with body fat after controlling for age, gender and BMI. Serum total OC concentrations were significantly lower in participants with central obesity or at least two components of MetS driven by waist circumference than they were in those with none. Stepwise linear regression results also showed that serum total OC was partially explained by age, gender, waist-to-hip ratio, and fasting glucose. CONCLUSIONS: This study supported a negative association between serum total OC and adiposity in children. OC may be associated with childhood central obesity; however, further research using more accurate measurements is needed to identify the association between these variables.