Insights from the COCOA birth cohort: The origins of childhood allergic diseases and future perspectives.

The ongoing COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study is a prospective birth cohort investigating the origin and natural courses of childhood allergic diseases, including atopic dermatitis, food allergy, allergic rhinitis and asthma, with long-term prognosis. Initiated under the premise that allergic diseases result from a complex interplay of immune development alterations, environmental exposures, and host susceptibility, the COCOA study explores these dynamic interactions during prenatal and postnatal periods, framed within the hygiene and microbial hypotheses alongside the developmental origins of health and disease (DOHaD) hypothesis. The scope of the COCOA study extends to genetic predispositions, indoor and outdoor environmental variables affecting mothers and their offsprings such as outdoor and indoor air pollution, psychological factors, diets, and the microbiomes of skin, gut, and airway. We have embarked on in-depth investigations of diverse risk factors and the pathophysiological underpinnings of allergic diseases. By employing multi-omics approaches-proteomics, transcriptomics, and metabolomics-we gain deeper insights into the distinct pathophysiological processes across various endotypes of childhood allergic diseases, incorporating the exposome using extensive resources within the COCOA study. Integration with large-scale datasets, such as national health insurance records, enhances robustness and mitigates potential limitations inherent to birth cohort studies. As part of global networks focused on childhood allergic diseases, the COCOA study fosters collaborative research across multiple cohorts. The findings from the COCOA study are instrumental in informing precision medicine strategies for childhood allergic diseases, underpinning the establishment of disease trajectories.

Combined effect of hygienic and polygenic risk scores in children with allergic rhinitis.

BACKGROUND: Although the development of allergic rhinitis (AR) is associated with multiple genetic and hygienic environmental factors, previous studies have focused mostly on the effect of a single factor on the development of AR. OBJECTIVE: This study aimed to investigate the combined effect of multiple genetic and hygienic environmental risk factors on AR development in school children. METHODS: We conducted a cross-sectional study, comprising 1,797 children aged 9-12 years. Weighted environmental risk score (ERS) was calculated by using four hygienic environmental factors, including antibiotic use during infancy, cesarean section delivery, breast milk feeding, and having older siblings. Weighted polygenic risk score (PRS) was calculated by using four single nucleotide polymorphisms (SNPs), including interleukin-13 (rs20541), cluster of differentiation 14 (rs2569190), toll-like receptor 4 (rs1927911), and glutathione S-transferase P1 (rs1695). Multivariable logistic regression analysis was used. RESULTS: More than three courses of antibiotic use during infancy increased the risk of current AR (adjusted odd ratio [aOR], 2.058; 95% confidence interval [CI]: 1.290-3.284). Having older siblings, especially > 2 (aOR, 0.526; 95%Cl: 0.303-0.913) had a protective effect. High ERS ( > median; aOR, 2.079; 95%Cl: 1.466-2.947) and PRS ( > median; aOR, 1.627; 95%Cl: 1.117-2.370) increased the risk of current AR independently. Furthermore, children who had both high ERS and PRS showed a higher risk of current AR (aOR, 3.176; 95%Cl: 1.787-5.645). CONCLUSIONS: Exposure to multiple hygienic risk factors during infancy increases the risk of AR in genetically susceptible children.

Impact of cardiovascular comorbidity on increased neutrophil-lymphocyte ratio in pseudoexfoliation syndrome.

BACKGROUND: The purpose of this study was to compare neutrophil-to-lymphocyte ratios (NLRs) of patients with pseudoexfoliation syndrome (PEX) according to the presence of cardiovascular disease (CVD) with those without CVD as controls. METHODS: A total of 197 participants (97 patients with PEX and 100 participants without PEX regarded as the control group) were included in this retrospective study. The PEX group was divided into 2 subgroups, PEX with CVD (group 1) and PEX without CVD (group 2). NLRs were then compared to those of the control group. RESULTS: The incidence of CVD was significantly (P = .015) higher in the PEX group than in the control group. NLR was significantly higher in the group 1 and group 2 compared with that of the control group (P = .048 and P = .002, respectively). In the PEX group, group 1 showed higher NLR than group 2 (P = .023). CONCLUSION: Although the PEX group showed a higher incidence of CVD, the NLR was higher in the PEX group regardless of cardiovascular comorbidity than that in the control group.

Prenatal PM2.5 affects atopic dermatitis depending on maternal anxiety and gender: COCOA study.

BACKGROUND: The prevalence of atopic dermatitis (AD) is increasing worldwide. Prenatal particulate matter with an aerodynamic diameter <2.5 µm (PM2.5) and maternal anxiety during pregnancy has been suggested as a potential causes of AD. This study investigated the effects of prenatal PM2.5 and maternal anxiety on AD and identified the critical period of PM2.5 exposure for AD in infants. METHODS: This study included 802 children from the COCOA birth cohort study with follow-up data at 1 year of age. PM2.5 was estimated by land-use regression models and prenatal anxiety was measured with a questionnaire. AD was diagnosed by doctor at 1 year of age. Logistic regression analysis and Bayesian distributed lag interaction models were applied. RESULTS: Higher PM2.5 during the first trimester of pregnancy, higher prenatal maternal anxiety, and male gender were associated with AD at 1 year of age (adjusted odds ratio [aOR] and 95% confidence interval [CI]: 1.86 [1.08-3.19], 1.58 [1.01-2.47], and 1.54 [1.01-2.36], respectively). Higher PM2.5 during the first trimester and higher maternal anxiety during pregnancy showed an additive effect on the risk of AD (aOR: 3.13; 95% CI: 1.56-6.28). Among boys exposed to higher maternal anxiety during pregnancy, gestational weeks 5-8 were the critical period of PM2.5 exposure for the development of AD. CONCLUSIONS: Higher PM2.5 exposure during gestational weeks 5-8 increased the probability of AD in infancy, especially in boys with higher maternal anxiety. Avoiding PM2.5 exposure and maternal anxiety from the first trimester may prevent infant AD.

Vegetable dietary pattern may protect mild and persistent allergic rhinitis phenotype depending on genetic risk in school children.

BACKGROUND: The effect of diet on allergic rhinitis (AR), its severity in children, and whether it modifies AR depending on genetic susceptibility are unknown. We investigated the association between dietary patterns and AR in school children and the influence of diet on AR according to a genetic risk score (GRS). METHODS: Totally, 435 7-year-old school children were recruited from the Panel Study on Korean Children. We used dietary patterns (vegetable, sugar, and meat) and dietary inflammatory index (DII) as dietary parameters. AR and its severity were defined by questionnaires about treatment in the previous 12 months and the Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, respectively. A GRS was calculated using 6 single nucleotide polymorphisms for allergic diseases. RESULTS: A vegetable diet containing a lot of anti-inflammatory nutrients and higher vitamin D level in blood were negatively correlated, while DII was positively correlated with triglyceride level and triglyceride/HDL cholesterol. Vegetable diet (aOR, 95% CI = 0.73, 0.58-0.94) and DII (1.13, 1.01-1.28) were associated with AR risk. In particular, a high-vegetable diet resulted in a lower risk of mild and persistent AR (aOR, 95% CI = 0.24, 0.10-0.56) while a high DII represented a higher risk (2.33, 1.06-5.10). The protective effect of vegetable diet on AR appeared only among children with a lower GRS (adjusted P = .018). CONCLUSIONS: A vegetable dietary pattern characterized by high intake of anti-inflammatory nutrients and higher vitamin D level in blood might be associated with a lower risk of mild and persistent AR. This beneficial effect is modified by a genetic factor.

Effects on ocular discomfort and tear film dynamics of suturing 23-gauge pars plana vitrectomies / Efeito da sutura da vitrectomia via pars plana de calibre 23 no desconforto ocular e na dinâmica do filme lacrimal

ABSTRACT Purpose: To evaluate the effects of suturing 23-gauge pars plana vitrectomies on ocular discomfort and tear film dynamics. Methods: This retrospective chart review involved data from 50 procedures in 50 patients who underwent 23-gauge pars plana vitrectomy from January to November 2016. We divided the eyes into two groups according to the presence or absence of sutures; 35 eyes underwent sutureless vitrectomies (Group 1), and 15 eyes underwent vitrectomy with at least one sclerotomy suture site (Group 2). In each group, we assessed objective variables including tear film break-up time, Schirmer test I, corneal surface grading with Oxford system, and a quantitative method evaluating subjective dry eye symptoms using ocular surface disease index questionnaires preoperatively 1 week, and 1 and 3 months after surgery. Results: The tear film break-up time showed a significant difference at the 3-months follow-up (p=0.026). The Schirmer test I and corneal surface staining score showed no statistically significant differences between two groups at any time after the operations. The ocular surface disease index score was significantly lower in Group 1 than in Group 2 at 1 week (p=0.032), 1 month (p=0.026), and 3 months (p=0.041) after the operation. Conclusion: Sclerotomy suturing caused ocular discomfort and had a negative effect on tear film dynamics during the late postoperative period. Sclerotomies without suturing seem to reduce the ocular surface changes.

RESUMO Objetivo: Avaliar os efeitos da sutura da vitrectomia via pars plana de 23-gauge sobre o desconforto ocular e a dinâmica do filme lacrimal. Métodos: Esta revisão retrospectiva de prontuários envolveu dados de 50 casos em 50 pacientes submetidos à vitrectomia via pars plana de 23-gauge, de janeiro a novembro de 2016. Dividimos os olhos em dois grupos de acordo com a presença ou ausência de suturas; 35 olhos foram submetidos à vitrectomia sem sutura (Grupo 1) e 15 olhos foram submetidos à vitrectomia com pelo menos um ponto de sutura no local da esclerotomia (Grupo 2). Em cada grupo, avaliamos variáveis objetivas incluindo tempo de ruptura do filme lacrimal, teste de Schirmer I, gradação da superfície corneana com o sistema Oxford e um método quantitativo avaliando sintomas subjetivos de olho seco usando questionários de índice de doença da superfície ocular nos períodos: 1 semana do pré-operatório, 1 mês e 3 meses após a cirurgia. Resultados: O tempo de ruptura do filme lacrimal apresentou diferença significativa no seguimento de 3 meses (p=0,026). O teste de Schirmer I e o escore da coloração da superfície da córnea não mostraram diferenças estatisticamente significativas entre os dois grupos em nenhum momento após as operações. O escore do índice de doença da superfície ocular foi significativamente menor no Grupo 1 em relação ao Grupo 2 no período de 1 semana (p=0,032), 1 mês (p=0,026) e 3 meses (p=0,041) após a cirurgia. Conclusão: A sutura da esclerotomia causou desconforto ocular e teve um efeito negativo na dinâmica do filme lacrimal durante o período pós-operatório. Esclerotomias sem sutura parecem reduzir as alterações da superfície ocular.

Effects on ocular discomfort and tear film dynamics of suturing 23-gauge pars plana vitrectomies.

PURPOSE: To evaluate the effects of suturing 23-gauge pars plana vitrectomies on ocular discomfort and tear film dynamics. METHODS: This retrospective chart review involved data from 50 procedures in 50 patients who underwent 23-gauge pars plana vitrectomy from January to November 2016. We divided the eyes into two groups according to the presence or absence of sutures; 35 eyes underwent sutureless vitrectomies (Group 1), and 15 eyes underwent vitrectomy with at least one sclerotomy suture site (Group 2). In each group, we assessed objective variables including tear film break-up time, Schirmer test I, corneal surface grading with Oxford system, and a quantitative method evaluating subjective dry eye symptoms using ocular surface disease index questionnaires preoperatively 1 week, and 1 and 3 months after surgery. RESULTS: The tear film break-up time showed a significant difference at the 3-months follow-up (p=0.026). The Schirmer test I and corneal surface staining score showed no statistically significant differences between two groups at any time after the operations. The ocular surface disease index score was significantly lower in Group 1 than in Group 2 at 1 week (p=0.032), 1 month (p=0.026), and 3 months (p=0.041) after the operation. CONCLUSION: Sclerotomy suturing caused ocular discomfort and had a negative effect on tear film dynamics during the late postoperative period. Sclerotomies without suturing seem to reduce the ocular surface changes.

Combined Effect of Secondhand Smoking and Alcohol Drinking on Risk of Persistent Human Papillomavirus Infection.

Tobacco smoking is established as a cofactor of human papillomavirus (HPV) for cervical cancer risk. However, the role of secondhand smoking in cervical carcinogenesis is controversial. We aimed to assess the association between secondhand smoking and high risk- (HR-) HPV persistence, a pivotal event in development of cervical cancer. In total, 9,846 women who underwent health-screening examinations from 2002 to 2011 at the National Cancer Center, Korea, were included. Secondhand smoking was defined as being exposed to secondhand smoke at home or in the workplace. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (CIs) for risks of HR-HPV infection at baseline (N, 9,846, negative vs. positive), 1-year persistence (n, 1,237, 1-year negative vs. 1-year persistence), and 2-year persistence (n, 481, 2-year negative vs. 2-year persistence). Active smoking, secondhand smoking, and secondhand smoking in nonactive smokers had no association with these risks. Among alcohol drinkers, secondhand smoking in nonactive smokers had higher risks of HR-HPV infection at baseline (OR = 1.25, 95% CI = 1.05-1.48, p for multiplicative interaction = 0.003), 1-year persistence (1.75, 1.14-2.68, 0.004), and 2-year persistence (2.96, 1.42-6.15, 0.006), when compared to HR-HPV negative, 1-year negative, and 2-year negative categories, respectively. However, among nonalcohol drinkers, there was no association between smoking or secondhand smoking status and these risks. These findings suggest that women exposed to secondhand smoking at home or in the workplace might be at high risk of HR-HPV persistence when it is combined with alcohol drinking, even though neither active smoking nor secondhand smoking independently affects the risk.

High Prevalence of Leptotrichia amnionii, Atopobium vaginae, Sneathia sanguinegens, and Factor 1 Microbes and Association of Spontaneous Abortion among Korean Women.

Objective. The purpose of this study was to (i) determine the cervical microbial composition in different abortion samples and to (ii) investigate the correlation between spontaneous abortion and cervical microbes in Korean women. Methods. We collected cervical swabs from women who had never undergone abortion (N = 36), had spontaneous abortion (N = 23), and had undergone induced abortion (N = 88) and subjected those samples to 16S rRNA pyrosequencing. Further, factor analysis and correlation between cervical microbiota and spontaneous abortion were evaluated by logistic regression analysis. Results. In spontaneous abortion women, 16 S rRNA gene sequences showed significant increases in Atopobium vaginae, Megasphaera spp., Gardnerella vaginalis, Leptotrichia amnionii, and Sneathia sanguinegens compared to women in nonabortion group. In multivariate logistic regression analysis, A. vaginae (OD = 11.27; 95% = 1.57-81), L. amnionii (OD = 11.47; 95% = 1.22-107.94), S. sanguinegens (OD = 6.89; 95% = 1.07-44.33), and factor 1 microbes (OD = 16.4; 95% = 1.88-42.5) were strongly associated with spontaneous abortion. Conclusions. This study showed a high prevalence of L. amnionii, A. vaginae, S. sanguinegens, and factor 1 microbes in spontaneous abortion and association with spontaneous abortion in Korean women.

Combined effect of diet and cervical microbiome on the risk of cervical intraepithelial neoplasia.

BACKGROUND & AIMS: Several food groups or dietary factors and the cervical microbiota may be involved in cervical carcinogenesis, but the evidence is not clear yet. We aimed to assess the association between dietary pattern and cervical intraepithelial neoplasia (CIN) and the combined effect of dietary pattern and cervical microbiome on the risk of CIN. METHODS: The cervical microbiota and diet assessed by pyrosequencing and a food-frequency questionnaire, respectively, of 65 women with CIN and 72 control women were used in this study. Principal component analysis and cluster analysis were used to identify dietary patterns and microbiome community types, respectively. The association between dietary pattern and CIN risk was assessed using multivariable logistic regression analysis. The combined effect of dietary pattern and microbiome on CIN risk was determined using relative excess risk due to interaction (RERI) and synergy index (S). RESULTS: Two dietary patterns and four community types were identified: prudent diet characterized by higher intake of vegetables and fishes; semi-Western diet characterized by higher intake of bread, dairy products, eggs, and soft drinks and relatively higher fat intake ratio; and Lactobacillus crispatus-, L. iners-, Atopobium vaginae-, and Prevotella bivia-dominant types. The high-scoring group of participants with a semi-Western diet had a higher risk of CIN (odds ratio [OR] 3.44, 95% confidence interval [CI] 1.11-10.7, p = 0.03), compared with the low or medium-scoring group of those with a semi-Western diet. L. iners-dominant (OR 6.39, 95% CI 1.52-26.7, p = 0.01) and A. vaginae-dominant (OR 4.99, 95% CI 1.17-21.3, p = 0.03) dominant types had a higher risk of CIN, compared with the L. crispatus-dominant type. The synergistic effect of semi-Western diet and A. vaginae-dominant type on CIN risk was observed (OR 20.8, 95% CI 2.21-195.6, p = 0.01, RERI/S 9.64/1.96). CONCLUSIONS: Our findings suggest that semi-Western diet and its combination with A. vaginae-dominant microflora may represent an important risk factor for cervical neoplasia.

Association of Combined Tobacco Smoking and Oral Contraceptive Use With Cervical Intraepithelial Neoplasia 2 or 3 in Korean Women.

BACKGROUND: Cigarette smoking and oral contraceptive (OC) use have been associated with cervical neoplasia, and the combination of smoking and OC use could influence cervical carcinogenesis. We aimed to assess the joint effect of smoking and OC use on the risk of cervical intraepithelial neoplasia (CIN). METHODS: From a cohort of human papillomavirus-positive subjects recruited from 6 hospitals in Korea from March 2006 to November 2012, a total of 678 subjects (411 control, 133 CIN 1, and 134 CIN 2 or 3 cases) were selected for this study (mean age, 43 years). The risk of CIN associated with smoking and OC use on additive and multiplicative scales was estimated via multinomial logistic regression after adjustment for potential confounding factors. The relative excess risk due to interaction (RERI) and the synergy index (S) were used to evaluate the additive interaction. RESULTS: OC users (odds ratio [OR] 1.98; 95% confidence interval [CI], 1.07-3.69) and long-term OC use (≥20 months; OR 2.71; 95% CI, 1.11-6.59) had a higher risk of CIN 2/3, but had no association with CIN 1, compared to non-OC users. Smokers and heavy smoking (≥8 cigarettes/day) were not associated with any CIN grade. Combined smoking and OC use (OR 4.91; 95% CI, 1.68-14.4; RERI/S, 3.77/27.4; P for multiplicative interaction = 0.003) and combined heavy smoking and long-term OC use (OR 11.5; 95% CI, 1.88-70.4; RERI/S, 9.93/18.8; P for multiplicative interaction = 0.009) had a higher risk of CIN 2/3 but had no association with CIN 1 compared to combined non-smoking and non-OC use. CONCLUSIONS: OC use and smoking acted synergistically to increase the risk of CIN 2 or 3 in Korean women.

Association between Health Behaviors and a Family History of Cancer among Korean Women.

PURPOSE: The aim of this study was to examine the health-related behaviors related to a family history of cancer (FHCA) among Korean women underwent cancer screening. MATERIALS AND METHODS: A total of 8,956 women who underwent cancer screenings during 2001-2011 at the National Cancer Center, Korea, were analyzed. The association between health-related behaviors and a FHCA were assessed using multivariate logistic regression. RESULTS: Compared to women with no FHCA, women with FHCA were more likely to smoke (adjusted odds ratio [aOR], 1.32; 95% confidence interval [CI], 1.06 to 1.65), to be exposed to passive smoking (aOR, 1.21; 95% CI, 1.15 to 1.65), and less likely to engage in regular exercise (aOR, 1.20; 95% CI, 1.01 to 1.41). Combined effects of selected health behaviors for FHCA were significant, although no statistically significant interactions were observed between selected health behaviors. Compared to women with no FHCA, women with FHCA were more likely to simultaneously smoke and be exposed to passive smoking (aOR, 1.65; 95% CI, 1.17 to 2.31) and to simultaneously smoke and be physically inactive (aOR, 1.62; 95% CI, 1.00 to 2.64). CONCLUSION: The study found that women with a FHCA exhibited unhealthy behaviors compared to women without FHCA. Higher emphasis on lifestyle modifications using a new standardized tool is strongly recommended for those with a FHCA, as well as individuals who are at high risk, together with their family members.

Association between Obesity and Cervical Microflora Dominated by Lactobacillus iners in Korean Women.

Lactobacillus spp. are associated with the maintenance of reproductive health, but obesity reduces fertility and is a risk factor for obstetric and neonatal complications. We assessed the association between obesity and the cervical Lactobacillus composition, which has not been examined previously. Pyrosequencing was performed using cervical swabs collected from 76 normal participants with negative results for cervical intraepithelial neoplasia (CIN) and 57 participants with CIN, based on histological examinations. Cluster analysis of nine Lactobacillus spp. was performed, and five cluster types were identified. The association between obesity and the Lactobacillus community was assessed by logistic regression analysis after adjustment for confounding factors. The proportion of Lactobacillus iners increased and that of Lactobacillus crispatus decreased according to body mass index (BMI) categories, i.e., underweight (BMI of <18.5 kg m(-2)), normal weight (BMI of 18.5 to 22.9 kg m(-2)), overweight (BMI of 23.0 to 24.9 kg m(-2)), and obese (BMI of ≥25 kg m(-2)). The L. iners-dominant type had a significant association with obesity (odds ratio [OR], 7.55 [95% confidence interval [CI], 1.18 to 48.2]), compared to the L. crispatus-dominant type. The group with high values for the ratio obtained by dividing the relative abundance of L. iners by that of L. crispatus had a significant association with obesity (OR, 6.54 [95% CI, 1.22 to 35.1]), compared to the low-ratio group. Associations between obesity and the L. iners/L. crispatus ratio were observed among young women (OR, 6.26 [95% CI, 1.15 to 33.9]) but not older women and in the normal group (OR, 6.97 [95% CI, 1.20 to 70.4]) but not the CIN group. Obesity was associated with cervical microflora dominated by L. iners in reproductive-age women without dysplasia.

Synergistic effect of viral load and alcohol consumption on the risk of persistent high-risk human papillomavirus infection.

PURPOSE: This prospective study aimed to examine the combined effect of viral load and alcohol consumption on the risk of persistent high-risk (HR) human papillomavirus (HPV) infection. METHODS: Among women undergoing health screening between 2002 and 2011 at the National Cancer Center, 284 and 122 women with HR-HPV infection and cytological findings of low-grade squamous intraepithelial or lower-grade lesions were followed up for 1 and 2 years, respectively. Multivariate logistic regression analysis was performed, and the relative excess risk due to interaction (RERI) and synergy index (S) were calculated. RESULTS: Among drinkers, the risks of 1-year (odds ratio [OR] 4.09, 95% confidence interval [CI] 2.05-8.18) and 2-year persistence (OR 8.08, CI 2.36-27.6) were significantly higher for high HPV loads than for low HPV loads; this association was not seen for non-drinkers. The risks for 1-year (OR 4.14, CI 1.89-9.05) and 2-year persistence (OR 6.61, CI 2.09-20.9) were significantly higher in subjects with a high HPV load who were also drinkers than in those who were non-drinkers. A high HPV load together with a longer drinking duration or higher alcohol consumption was associated with increased risks of 1-year (OR 3.07, CI 1.40-6.75 or OR 2.05, CI 0.87-4.83) and 2-year persistence (OR 6.40, CI 1.72-23.8 or OR 4.14, CI 1.18-14.6). The synergistic effect of alcohol consumption and HR-HPV load was stronger on the risk of 2-year persistence (RERI = 3.26, S = 2.38) than on the risk of 1-year persistence (RERI = 1.21, S = 1.63). CONCLUSIONS: The synergistic effect of HR-HPV load and alcohol consumption was associated with the risk of HR-HPV persistence and was stronger for longer-term HR-HPV infection. Limiting alcohol consumption might be an important measure to prevent the development of cervical cancer in women with a high HR-HPV load.

Macronutrient composition and sodium intake of diet are associated with risk of metabolic syndrome and hypertension in Korean women.

Hypertension and hypertriglycemia are the most important contributors to metabolic syndrome (MetS) and cardiovascular disease risk in South Koreans with a relatively lean body mass. These major contributors differ from those identified in Western populations. This study aimed to identify the characteristics of the Korean diet associated with increased risk of MetS, whose prevalence has been steadily increasing in South Korea. On the basis of data collected from 5,320 subjects by the 2007-2008 Korean National Health and Nutrition Examination Survey, 3 dietary patterns were identified using factor analysis and their association with the risk of MetS and its components was examined. The balanced Korean diet, a typical Korean diet of rice and kimchi intake supplemented by a variety of foods had a desirable macronutrient composition and was associated with a lower risk of elevated blood pressure (OR=0.61, 95% CI=0.45-0.84) and hypertriglyceridemia (0.69, 0.49-0.88) in men and a lower risk of elevated blood pressure (0.59, 0.41-0.85) and MetS (0.67, 0.47-0.96) in women. The unbalanced Korean diet, characterized by a high intake of carbohydrates and sodium and little variety, was associated with a higher risk of MetS (1.44, 1.03-2.01) and elevated blood pressure (1.41, 1.00-1.98) in women. The semi-western diet, characterized by a relatively high intake of meat, poultry, and alcohol, was associated with a lower risk of low high-density lipoprotein cholesterol (0.70, 0.54-0.89) in women. Thus, macronutrient composition and sodium intake are associated with the risk of MetS and prehypertension in women. Maintaining a desirable macronutrient composition and avoiding excessive consumption of carbohydrates and sodium should be emphasized for prevention of MetS and hypertension in South Korean women.

Maternal and grandmaternal obesity and environmental factors as determinants of daughter's obesity.

Obesity may be the consequence of various environmental or genetic factors, which may be highly correlated with each other. We aimed to examine whether grandmaternal and maternal obesity and environmental risk factors are related to obesity in daughters. Daughters (n = 182) recruited from female students, their mothers (n = 147) and their grandmothers (n = 67) were included in this study. Multivariable logistic regression was used to analyze the association between the daughter's obesity and maternal, grandmaternal, and environmental factors. Maternal heights of 161-175cm (OD: 8.48, 95% CI: 3.61-19.93) and 156-160 cm (2.37, 1.14-4.91) showed positive associations with a higher height of daughter, compared to those of 149-155 cm. Mothers receiving a university or a higher education had a significant OR (3.82, 1.27-11.50) for a higher height of daughter compared to those having a low education (elementary school). Mother having the heaviest weight at current time (59-80 kg, 3.78, 1.73-8.28) and the heaviest weight at 20 years of age (51-65 kg, 3.17, 1.53-6.55) had significant associations with a higher height of daughters, compared to those having the lightest weight at the same times. There was no association between the height, weight, and BMI of daughters and the characteristics and education of her grandmothers. In conclusion, although genetic factors appear to influence the daughter's height more than environmental factors, the daughter's weight appears to be more strongly associated with individual factors than the genetic factors.

Development of a Korean Diet Score (KDS) and its application assessing adherence to Korean healthy diet based on the Korean Food Guide Wheels.

The most critical point in the assessment of adherence to dietary guidelines is the development of a practical definition for adherence, such as a dietary pattern score. The purpose of this study was to develop the Korean Diet Score (KDS) based on the Korean Food Balance Wheel and to examine the association of KDS with various lifestyle characteristics and biochemical factors. The dietary data of 5,320 subjects from the 4th Korean National Health and Nutritional Examination Survey were used for the final analysis. The food guide was composed of six food group categories; 'grain dishes', 'fish and meat dishes', 'vegetable dishes', 'fruits', 'milk' and 'oils and sugars'. Based on the recommended serving numbers for each group, the scores measuring adherence to this food guide were calculated from the dietary information from the 24-hour dietary recall questionnaire, and then its correlation with various characteristics was assessed. KDS was significantly associated with several clinical, lifestyle and socioeconomic factors as well as diagnosed disease history. The higher quintile group of KDS showed a significantly lower level in fasting blood glucose, systolic blood pressure, triglycerides, current smoking and drinking as well as higher leisure time activity, house income and education. Furthermore, the KDS quintile group of women was inversely associated with hypertension, osteoporosis and diabetes. A higher KDS quintile was characterized with a higher intake of several critical nutrients, such as Ca, Fe and vitamins as well as a desirable nutrition balance such as the ratio of macronutrients. Our results demonstrate that KDS is a beneficial tool in assessing the adherence to a healthy diet based on the Korean dietary guidelines. We suggest that KDS could be a useful indicator for evaluating the dietary balance of the Korean population.

Biological features of core networks that result from a high-fat diet in hepatic and pulmonary tissues in mammary tumour-bearing, obesity-resistant mice.

We previously demonstrated that the chronic consumption of a high-fat diet (HFD) promotes lung and liver metastases of 4T1 mammary carcinoma cells in obesity-resistant BALB/c mice. To examine early transcriptional responses to tumour progression in the liver and lungs of HFD-fed mice, 4-week-old female BALB/c mice were divided into four groups: sham-injected, control diet (CD)-fed; sham-injected, HFD-fed (SH); 4T1 cell-injected, CD-fed (TC); 4T1 cell-injected, HFD-fed (TH). Following 16 weeks of either a CD or HFD, 4T1 cells were injected into the mammary fat pads of mice in the TC and TH groups and all mice were continuously fed identical diets. At 14 d post-injection, RNA was isolated from hepatic and pulmonary tissues for microarray analysis of mRNA expression. Functional annotation and core network analyses were conducted for the TH/SH Unique gene set. Inflammation in hepatic tissues and cell mitosis in pulmonary tissues were the most significant biological functions in the TH/SH Unique gene set. The biological core networks of the hepatic TH/SH Unique gene set were characterised as those genes involved in the activation of acute inflammatory responses (Orm1, Lbp, Hp and Cfb), disordered lipid metabolism and deregulated cell cycle progression. Networks of the pulmonary Unique gene set displayed the deregulation of cell cycle progression (Cdc20, Cdk1 and Bub1b). These HFD-influenced alterations may have led to favourable conditions for the formation of both pro-inflammatory and pro-mitotic microenvironments in the target organs that promote immune cell infiltration and differentiation, as well as the infiltration and proliferation of metastatic tumour cells.