Lack of Association between Insufficient Intake of Multiple Vitamins and Frailty in Older Adults Who Consume Sufficient Energy and Protein: A Nationwide Cross-Sectional Study.

Frailty is a complex condition that intensifies with age and is marked by decreased physiological function. We rigorously investigated the effects of lower vitamin intake on frailty using data from 665 adults aged over 65 years who consumed sufficient recommended daily energy and protein intakes from the Korean Nutrition and Health Survey, 2016-2019. The definition of frailty was modified based on Fried et al.'s definition of weight loss, exhaustion, weakness, slowness, and low energy expenditure. Based on daily intake, we analyzed vitamins such as vitamin A, thiamine, riboflavin, niacin, folic acid, and vitamin C. Our results of logistic regression showed that increasing multiple deficiencies in several kinds of vitamins (mild to moderate to severe) is not associated with frailty (odds ratio: 1, 1.24 (0.24-3.10), 0.82 (0.28-2.39), p for trend = 0.626) in older adults who consumed sufficient calories and proteins. A subgroup analysis of age and sex, which may interfere with the relationship between vitamin intake and frailty, showed that vitamin intake was not associated with frailty when sufficient energy and proteins were consumed. Furthermore, there was no difference in the prevalence of frailty between the groups with sufficient and insufficient intakes of individual vitamins.

Perception of Nutrition Education and Subjective Competency in Nutrition Topics among Korean Family Medicine Residents.

BACKGROUND: Appropriate nutrition is necessary for maintaining good health in the general population. During primary physician training, it is important to educate residents on the basic concepts of nutrition and methods to manage nutritional aspects according to various disease. However, little is known about the perception of nutritional education among Korean family medicine residents. This study analyzed the recognition of the importance of nutritional education, the amount received, and satisfaction with it as well as self-perceived competency in various nutrition topics among residents. METHODS: Web-based questionnaires were sent via mobile messages to all the residents registered with the Korean Academy of Family Medicine (KAFM). Out of 566 residents, 68 voluntarily participated in the study. The questionnaire consisted of 41 items related to perceptions of nutrition education, self-perceived competency in nutrition topics, and demographic characteristics. RESULTS: The response rate was 12.01%. Residents rated their satisfaction with nutrition education at 4.78 out of 10, and 83.3% considered it important. However, only 13.24% of the participants felt that it was adequate. The most common training method for nutrition education was lectures at KAFM conferences. Among the 29 nutritional topics, the residents reported highest confidence in subjects related to chronic diseases such as obesity (77.94%), diabetes (75%), cardiovascular disease (67.65%), gastrointestinal disorders (67.65%), and weight loss management (67.65%). Conversely, topics related to women (36.76%), children and adolescents (38.23%), drug-nutrient interactions (39.7%), eating disorders (42.64%), and food labels (42.64%) showed low self-perceived confidence rates. CONCLUSION: Korean family medicine residents value nutrition education but believe that more education is necessary and they demonstrate differences in self-perceived competency in various nutrition topics.

Visit-to-visit variability of metabolic parameters and progression of atherosclerosis in computed tomography: follow up of an asymptomatic cohort.

Background: We aimed to examine whether intra-individual variability in traditional risk factors affects the progression of atherosclerosis on subsequent coronary computed tomography angiography (CCTA). Methods: We conducted a retrospective cohort study using asymptomatic health examination cohort data from Haeundae Paik Hospital in Korea collected between 2010-2020. A total of 387 adults met the inclusion criteria of having at least two CCTAs without specific symptoms with an interval of more than one year and having completed three or more health examinations. Visit-to-visit variability was evaluated using the average real variability (ARV) of body mass index, waist circumference, systolic and diastolic blood pressure, and plasma glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol. Progression of coronary artery atherosclerosis was defined as worsening of coronary artery stenosis from baseline to final CCTA. ARV values for various metabolic parameters were stratified into quartiles, and hazard ratios (HRs) and 95% confidence intervals (CIs) for coronary atherosclerosis progression were analyzed using multiple Cox proportional hazards models. Results: There were 126 cases of coronary artery stenosis progression (32.56%) assessed using the Coronary Artery Disease Reporting and Data System during a mean follow up of 3.91 (range, 1-9) years. In the multivariate analysis comparing ARV quartiles for LDL-cholesterol after adjusting for covariates, individuals with higher variability showed an increased risk of stenosis progression: HR 2.23 (95% CI: 1.33-3.73) for the third quartile, HR 1.56 (95% CI: 0.91-2.66) for the fourth quartile (P for trend =0.005). Triglycerides also showed a significant linear trend (P for trend =0.04), and Q4 had a greater risk of stenosis progression (HR, 2.09; 95% CI: 1.24-3.52). Meanwhile, the risk of stenosis progression was significantly reduced as the ARV of HDL-cholesterol increased: HR 0.56 (95% CI: 0.35-0.89) for the third quartile, HR 0.47 (95% CI: 0.27-0.81) for the fourth quartile (P for trend =0.01). Conclusions: High variability in LDL-cholesterol and triglyceride was an independent predictor of coronary artery stenosis progression on subsequent CCTA in our cohort. This finding highlights the importance of maintaining stable state to effectively prevent the progression of coronary artery stenosis in clinical settings.

Effect of a Single Multi-Vitamin and Mineral Supplement on Nutritional Intake in Korean Elderly: Korean National Health and Nutrition Examination Survey 2018-2020.

Inadequate nutritional intake is common, especially among elderly individuals. Although micronutrient intake may help fill nutritional gaps, the effects of multi-vitamin and mineral supplements (MVMS) among the Korean elderly are not well known. Therefore, we investigated the nutrition-improving effects of a single MVMS. A total of 2478 people aged ≥65 years who participated in the Korea National Health and Nutrition Survey 2018-2020 were analyzed. Nutrient intake from food and supplements was measured using the 24 h recall method. We compared the nutritional intake and insufficiency between the food-only group (n = 2170) and the food and MVMS group (n = 308). We also evaluated the differences in inadequate nutritional intake after taking MVMS with food. The analysis included vitamins A and C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus. The proportion of insufficient intake ranged from 6.2% to 80.5% for men and from 21.2% to 82.4% for women, depending on the nutrients. Intake of MVMS with food was associated with lower rates of inadequacy (3.8-68.5% for men and 3.3-75.5% for women) compared to the food-only group. The results suggest that micronutrient deficiency frequently occurs in the Korean elderly population and can be improved by MVMS intake.

Trend in Prevalence of Smoking and Motivation to Quit among Korean Adult Male Cancer Survivors over the Last 8 Years: The Korea National Health and Nutrition Examination Survey V-VII (2010-2017).

BACKGROUND: This study aimed to investigate trends in the prevalence of current smokers and motivation to quit among Korean male cancer survivors. METHODS: Out of 20,012 men who participated in the Korea National Health and Nutrition Examination Survey V (2010-2012), VI (2013-2015), and VII (2016-2017), 742 cancer survivors were included. A cancer survivor was defined as a person who concurred to the item, "The cancer has been diagnosed by a doctor" in the health questionnaire. Smoking status was classified as current, former, and never smokers. Regarding motivation to quit smoking, we defined those who had a willingness to quit within 6 months as the willing group. Logistic regression analysis was conducted to examine trends in the prevalence of current smokers and the proportion of the willing group among current smokers. RESULTS: Overall, 3.7% of Korean men who participated in the study were cancer survivors. Current smokers constituted 19.5%, 19.1%, and 15.3% of cancer survivors in phases V, VI, and VII respectively which did not show significant changes (P for trend=0.33). However, the proportion of current smokers in the non-cancer group was significantly reduced to 46.6%, 41.2%, and 38.9% in phases V, VI, and VII, respectively (P for trend <0.001). The proportion of those with a motivation to quit smoking did not show a significant trend in the cancer survivors (P for trend=0.964) and non-cancer group (P for trend=0.884). CONCLUSION: Prevalence of current smokers and motivation to quit in Korean male cancer survivors did not show significant trends.

Cancer Survivors with Low Hand Grip Strength Have Decreased Quality of Life Compared with Healthy Controls: The Korea National Health and Nutrition Examination Survey 2014-2017.

BACKGROUND: Cancer survivors experience decreased physical function and reduced muscle strength, which leads to lower quality of life (QOL). The hand grip strength (HGS) can be a predictor of poor health-related QOL as a parameter of sarcopenia. The purpose of this study was to investigate the relationship between low HGS and QOL in cancer survivors and healthy controls. METHODS: We analyzed 392 cancer survivors and 1,176 healthy controls from the Korea National Health and Nutrition Examination Survey, 2014-2017. We defined low HGS as 2 standard deviation values for healthy young Korean adults from a previous study. QOL was evaluated using the European Quality of Life Scale-Five Dimensions. A complex sample logistic regression model was used to assess the relationship between each dimension of low HGS and QOL. RESULTS: The odds ratios (ORs) for decreased QOL were significantly higher in male cancer survivors with low HGS on self-care (OR, 8.51; 95% confidence interval [CI], 1.69-42.83) and usual activities (OR, 6.63; 95% CI, 1.22-36.03). The ORs for problems in mobility (OR, 5.87; 95% CI, 2.04-16.91), usual activities (OR, 14.46; 95% CI, 3.84-54.44), pain/discomfort (OR, 4.90; 95% CI, 2.00-12.01), and anxiety/depression (OR, 6.43; 95% CI, 2.16-19.12) were significantly high in female cancer survivors with low HGS. However, healthy controls showed no significant relationship between low HGS and QOL. CONCLUSION: For cancer survivors, low HGS was associated with poor QOL in some domains. Strategies to increase muscle strength must be considered to improve the QOL of cancer survivors.

Effect of Increasing Tobacco Prices on Stages of Smoking Cessation: A Korean Nationwide Data Analysis.

BACKGROUND: In 2015, tobacco prices significantly increased in Korea as part of the government's smoking cessation policy. This study examined the changes in the stages of smoking cessation among Korean male smokers before and after the implementation of the tobacco price policy, and identified the predictors of such changes. METHODS: The study population comprised 3,533 male current smokers (age ≥19 years) who participated in the Korea National Health and Nutrition Survey in 2012, 2013, 2015, and 2016. Current smokers were defined as persons who had smoked ≥100 cigarettes during their lifetime and are continuing to smoke. In accordance with the transtheoretical model, smokers were classified into the precontemplation stage (no plan to quit), contemplation stage, and preparation stage (planning to quit within 6 months). We examined the changes in the smoking cessation stages before and after the implementation of the policy. Multivariate logistic regression analysis was conducted to identify factors related to the likelihood of continuing smoking, after adjustments for potential confounders. RESULTS: Immediately after the policy implementation, the percentage of smokers in the precontemplation stage decreased from 65.6% to 60.8% (P=0.014). However, this effect was temporary. Significant risk factors for remaining in the precontemplation stage were older age (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.002-1.018; P=0.004), being in the lowest income quartile (OR, 1.226; 95% CI, 1.001-1.502; P=0.049), and manual worker or unemployed status (OR, 1.256; 95% CI, 1.036-1523; P=0.020). CONCLUSION: Increasing tobacco prices only temporarily change the stage of smoking cessation among Korean male smokers.

Young cancer survivors have lower bone mineral density compared with healthy controls: a nationwide population-based study in Korea.

Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors. The aim of this study was to assess the risk of bone loss in Korean cancer survivors, and the relationship between body composition and bone mineral density (BMD). We hypothesized that cancer survivors would have lower BMD than healthy people, and increased muscle mass has a protective effect on BMD. We measured BMD and body composition in 259 cancer survivors (99 men and 160 women). Subjects were selected from the Korean National Health and Nutrition Survey conducted from 2008 to 2011. Body composition and BMD were measured by dual-energy X-ray absorptiometry. We examined the linear trend of lumbar BMD according to tertiles of lean mass (LM) and fat mass (FM) by linear regression, adjusting for age, alcohol consumption, smoking, exercise, 25-hydroxyvitamin D, height, protein intake, and menopausal status. Cancer survivors under 50 years of age had lower lumbar BMD compared with healthy controls (0.93 ± 0.04 g/cm2 vs. 1.02 ± 0.01 g/cm2, p = 0.032 in males; 0.95 ± 0.02 g/cm2 vs. 0.98 ± 0.01 g/cm2, p = 0.015 in females). Lumbar BMD significantly increased from the lowest to highest tertiles of LM in male (p for trend < 0.001) and marginally significantly increased in female survivors (p for trend = 0.060). In this study of Korean cancer survivors, young survivors were at higher risk of having low lumbar BMD. Higher LM had beneficial effects on BMD in cancer survivors. To prevent osteoporosis and fractures, efforts to increase lean body mass, including bone, are needed for young cancer survivors.

Correlation between nonverbal communication and objective structured clinical examination score in medical students.

PURPOSE: Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE. METHODS: A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated. RESULTS: Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score. CONCLUSION: Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.

Relationship between Dry Eye Syndrome and Frequency of Coffee Consumption in Korean Adults: Korea National Health and Nutrition Examination Survey V, 2010-2012.

BACKGROUND: Dry eye syndrome is a common health problem in the adult population. Many risk factors including age, sex, prior eye surgery, various chronic diseases, and lifestyle factors can affect its development. We have evaluated the risk of dry eye syndrome based on the frequency of coffee consumption among Korean adult population. METHODS: A total of 9,752 adults with age 19 years and older were randomly selected between 2010 and 2012. They have all participated in the National Health and Nutrition Examination Survey V of Korea. Dry eye syndrome was being diagnosed by the physicians at some points in the participant's lifetime. The average daily coffee intake was divided into the following: less than 1 cup, 1 to 2 cups, and 3 cups or more. Various physio-environmental factors and medical conditions were used as correction variables to assess the risk of dry eye syndrome in relation to the frequency of coffee consumption. RESULTS: The prevalence of dry eye syndrome decreased to 9.2%, 8.8%, and 6.3% as coffee consumption increased from less than 1 cup to 1-2 cups and more than 3 cups, respectively. However, there was no significant relationship between the frequency of coffee consumption and the risk of dry eye syndrome after adjusting various risk factors. CONCLUSION: There is no relationship between the frequency of coffee consumption and risk of dry eye syndrome.

Relationship between Age at Menarche and Metabolic Syndrome in Premenopausal Women: Korea National Health and Nutrition Examination Survey 2013-2014.

BACKGROUND: Early menarche may be associated with increased risk of cardiovascular disease. The aim of this study was to evaluate the relationship between age at menarche and metabolic syndrome (MetS) in Korean premenopausal women. METHODS: We used nationally representative data from the Korea National Health and Nutrition Examination Survey from 2013 to 2014, and 3,023 premenopausal women aged 20-55 years were our subjects. We defined early menarche as age at first menstrual period less than 12 years. Multivariable logistic regression analysis was used to evaluate the relationship between age at menarche and MetS after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables. RESULTS: MetS was much more common in women aged 40-55 years than in women aged 20-39 years (4.1% vs. 15.1%). Compared with women who experienced menarche at age 12-15 years, the risk of MetS in the early menarche group was not higher in either age group, after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables (odds ratio [OR], 1.767; 95% confidence interval [CI], 0.718-4.351 in those aged 20-39 years; OR, 1.780; 95% CI, 0.775-4.085 in those aged 40-55 years). The risk of MetS in women with menarche at age ≥16 years was not higher than in women with menarche at age 12-15 years. CONCLUSION: Early or late menarche was not associated with an increased risk of MetS in premenopausal Korean women. Even before menopause, current age has a major influence on the development of MetS.

The effect of communication training using standardized patients on nonverbal behaviors in medical students.

PURPOSE: Nonverbal communication (NVC) is important in the patient-physician relationship, but the effect of NVC education is not well kown. In this study, we try to identify if students' NVC abilities are improved through communication training. METHODS: First-year medical students conducted medical interviews, which were performed with standardized patients (SPs) before and after communication skill education, and recorded in video. Fifty-one students were enrolled for this study. Two researchers used the NVC checklist, which consists of 12 nonverbal behaviors, to analyze and compare the students' nonverbal expressions in the interviews recorded before and after the education. RESULTS: After the students participated in communication training, open body position and adequate facial expression were increased while unnecessary silence, un-purposive movements, and giggling were decreased. These results can be interpreted as positive effects of the education. However, hand gesture was increased as a negative effect of the education. The total NVC score of the 12 nonverbal behaviors in the NVC checklist improved significantly, rising from 8.56 to 10.03. CONCLUSION: Communication skill education using SPs can improve nonverbal behaviors of medical students, especially facial expression, un-purposive movement, body position, unnecessary silence, and giggle, but not hand gesture. Further research is needed on a variety of teaching methods to improve NVCs.

Low dietary energy intake is associated with sarcopenia in cancer survivors: An analysis based on the Korean National Health and Nutrition Examination Survey 2008-2011.

As cancer survivors increase, management of their long-term health consequences becomes important. Sarcopenia could negatively affect on their clinical outcome and quality of life. We hypothesized that sarcopenia would be more prevalent in cancer survivors and that are associated with dietary intake. This study was conducted to compare nutritional intake and body composition, considering sarcopenia, between cancer survivors and healthy individuals using Korean National Health and Nutrition Examination Surveys conducted from 2008 to 2011. The participants were 259 adult cancer survivors and 1,295 healthy counterparts who underwent body composition tests and had no chronic diseases. Sarcopenia was defined as a condition with a skeletal muscle mass below the cut-off value (men < 6.58 kg/m2 and women < 4.59 kg/m2) adjusted for height. The prevalence of sarcopenia was higher in non-obese male cancer survivors (32.6% vs 16.0%, P=0.034) compared with healthy individuals. On the contrary, sarcopenia was more common in obese female survivors (35.1% vs 15.0%, P=0.005) than their healthy counterparts. Multivariable logistic analyses revealed that age increase by 1 year (aOR=1.025; 95% CI: 1.001-1.049), male gender (aOR=3.688; 95% CI: 6.061-90.910), and a lower BMI (aOR=33.201; 95% CI: 13.639-80.823) were significantly associated with the increased risk of sarcopenia. Increased energy intake by 100 kcal/day (aOR=0.930; 95% CI: 0.869-0.995) had a protective effect against sarcopenia. Our results suggest that male cancer survivors are high risk group of sarcopenia, especially when they are non-obese. More dietary energy intake may be needed to prevent sarcopenia.

Health inequalities in hypertension and diabetes management among the poor in urban areas: a population survey analysis in south Korea.

BACKGROUND: This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. In addition, the rate of good hypertension or diabetes control was examined separately in men and women, and in urban and rural areas. METHODS: This study used Korea National Health and Nutrition Examination V (2010-2012) data, a nationwide cross-sectional survey of general South Korean population. Residential areas were categorized into urban and rural areas. To examine differences between the residential areas in terms of prevalence, awareness, treatment, and control of hypertension and diabetes we performed a multivariate logistic regression adjusting for age, body mass index, physical activity, alcohol use, smoking, marital status, monthly income, and educational level. To investigate control of hypertension or diabetes within each residential area, we performed a subgroup analysis in both urban and rural areas. RESULTS: The prevalence of hypertension is higher among men in urban areas than among those in rural areas (OR = 0.80; 95 % CI = 0.67-0.96, reference group = urban areas). However, the subgroups did not differ in terms of diabetes prevalence, awareness, treatment, and control. Regardless of both sex and residential area, participants in good control of their hypertension and diabetes were younger. Inequality in good control of hypertension was observed in men who lived in urban (≤Elementary school, OR 0.74, 95 % CI 0.60-0.92) and rural areas (≤Elementary school, OR 0.67, 95 % CI 0.46-0.99). Inequality in health status was found in women who resided in urban areas (≤Elementary school, OR 0.53, 95 % CI 0.37-0.75). Good control of diabetes also showed inequalities in health status for both men (≤Elementary school, OR 0.61, 95 % CI 0.40-0.94; Middle/High school, OR 0.69, 95 % CI 0.49-0.96) and women in urban areas (≤1 million won, OR 0.56, 95 % CI 0.33-0.93) (Reference group = '≥College' for education and '>3 million' Korean won for income). CONCLUSIONS: After correction for individual socioeconomic status, differences by residential area were not observed. However, when the participants with good disease control were divided by region, inequality was confirmed in urban residents. Therefore, differentiated health policies to resolve individual and regional health inequalities are necessary.

Influenza Vaccination Coverage Rate according to the Pulmonary Function of Korean Adults Aged 40 Years and Over: Analysis of the Fifth Korean National Health and Nutrition Examination Survey.

Influenza vaccination is an effective strategy to reduce morbidity and mortality, particularly for those who have decreased lung functions. This study was to identify the factors that affect vaccination coverage according to the results of pulmonary function tests depending on the age. In this cross-sectional study, data were obtained from 3,224 adults over the age of 40 who participated in the fifth National Health and Nutrition Examination Survey and underwent pulmonary function testing in 2012. To identify the factors that affect vaccination rate, logistic regression analysis was conducted after dividing the subjects into two groups based on the age of 65. Influenza vaccination coverage of the entire subjects was 45.2%, and 76.8% for those aged 65 and over. The group with abnormal pulmonary function had a higher vaccination rate than the normal group, but any pulmonary dysfunction or history of COPD did not affect the vaccination coverage in the multivariate analysis. The subjects who were 40-64 years-old had higher vaccination coverage when they were less educated or with restricted activity level, received health screenings, and had chronic diseases. Those aged 65 and over had significantly higher vaccination coverage only when they received regular health screenings. Any pulmonary dysfunction or having COPD showed no significant correlation with the vaccination coverage in the Korean adult population.

Medical students' agenda-setting abilities during medical interviews.

PURPOSE: Identifying patients' agendas is important; however, the extent of Korean medical students' agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students' agenda solicitation. METHODS: A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients' reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient's initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. RESULTS: The medical students did not explore the patients' concerns and did not negotiate an agenda. Interruption of the patient's opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. CONCLUSION: Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students' ability to set an agenda.

Effect of central obesity on prostate specific antigen measured by computerized tomography: related markers and prostate volume.

PURPOSE: We assessed the effects of central adiposity represented by visceral adipose tissue on prostate volume, prostate specific antigen, and prostate specific antigen mass and mass ratio. MATERIALS AND METHODS: This cross-sectional study included 6,389 Asian men 30 to 79 years old. Prostate volume was estimated by transrectal ultrasound. Visceral and subcutaneous adipose tissue was measured by computerized tomography. Multivariate linear regression analysis was done between prostate specific antigen related variables and obesity indexes such as body mass index, waist circumference, and visceral and subcutaneous adipose tissue after adjusting for age. RESULTS: Body mass index, waist circumference and subcutaneous adipose tissue were inversely associated with prostate specific antigen (p for trend <0.001) but visceral adipose tissue showed no associations with prostate specific antigen (p for trend = 0.740). Waist circumference, and visceral and subcutaneous adipose tissue were positively associated with prostate specific antigen mass (p for trend = 0.014, <0.001 and 0.036, respectively). However, body mass index did not show this association (p for trend = 0.372). Body mass index, waist circumference and subcutaneous adipose tissue negatively affected the prostate specific antigen mass ratio (each p for trend <0.05) but there was no such significant correlation for visceral adipose tissue (p for trend = 0.187). When adjusted for visceral adipose tissue body mass index was not associated with prostate volume (p for trend = 0.152) but visceral adipose tissue remained positively associated with prostate volume even after adjusting for body mass index (p for trend = 0.005). CONCLUSIONS: Visceral adiposity is the main determining factor of the prostate volume increase and prostate specific antigen production.

Lower urinary tract symptoms have negative associations with glomerular filtration rate irrespective of prostate volume in Korean men.

OBJECTIVE: To understand the relationship between lower urinary tract symptoms (LUTS) and renal function by prostate volume (PV) in Korean men. LUTS can be related to early renal dysfunction, irrespective of bladder outlet obstructive lesions, few studies have been conducted. METHODS: We conducted a cross-sectional survey of 3713 men, aged≥40 years, who received routine comprehensive health evaluations, including transrectal ultrasonography and the International Prostate Symptom Score questionnaire. We used the estimated glomerular filtration rate (GFR) for the assessment of renal function and the IPSS for LUTS severity. We compared LUTS and GFR using multivariate regression analysis after adjusting for age and/or PV. RESULTS: An increasing severity of LUTS, especially voiding LUTS, was associated with a decreasing GFR in the older age group (≥55 years). In a stratified analysis by PV of 30 cm3, voiding LUTS showed a negative association with GFR, irrespective of the PV (P for trend<.01 and P for trend<.02), but total LUTS did so only in the small PV group. CONCLUSION: In men without known urinary tract disease, LUTS and renal function had a negative association, especially in older men with a normal PV. Although the underlying mechanism is uncertain, physicians who treat patients with moderate or severe LUTS should monitor renal function, even in patients with a normal PV.