The Association Between Obesity Measures and Metabolic Syndrome Risk in Korean Adolescents Aged 10-18 Years.

Introduction: Childhood obesity is strongly linked to an increased risk of metabolic syndrome (MetS), type 2 diabetes, and cardiovascular disease in adulthood, endangering the global healthcare system. No single tool for detecting MetS is suitable for all pediatric populations. This study aimed to investigate the association between obesity measures and MetS in Korean children and adolescents. Method and Materials: The data were obtained from 1663 children and adolescents aged 10-19 years (771 girls) who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHtR) were included as obesity measures. Fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and resting blood pressure were included as metabolic risk factors. MetS was defined as the clustering of metabolic risk factors such as elevated fasting blood glucose, elevated mean arterial pressure, elevated triglycerides, and low high-density lipoprotein cholesterol. Results: Regardless of the obesity measures used, obese children and adolescents were more likely to have a clustering of metabolic risk factors compared to their non-obese counterparts: BMI-based obesity (odds ratio, OR=4.151, 95% confidence interval, CI=2.763~6.238, p<0.001), WC-based obesity (OR=1.917, 95% CI=1.066~3.446, p=0.010), and WHtR-based obesity (OR=2.160 and 95% CI=1.203~3.878, p=0.003). A receiver operating curve analysis showed that BMI (area under the curve, AUC=0.849, 95% CI=0.8270.871) outperformed WC (AUC=0.833, 95% CI=0.8090.856) and WHtR (AUC=0.794, 95% CI=0.7670.821) in detecting the presence of MetS. Conclusion and Recommendation: Study findings suggest that obese teenagers are more likely to have metabolic syndrome than non-obese teens. Concerning accuracy, convenience, and ease of use and calculation, BMI is the best screening tool for detecting MetS in Korean children and adolescents.

Association between normal-weight obesity and bone mineral density in older Korean adults: A population-based cross-sectional study.

The effects of normal-weight obesity, which is defined as having a high level of body fat despite a normal body mass index, on the health of bones in older adults are poorly understood. This cross-sectional study examined the relationship between normal-weight obesity and bone mineral density in Korean adults aged 50 years or more (2815 men and 2744 women) from the 2008-2011 Korea National Health and Nutrition Examination Surveys. Between the ages of 50 and 69 years, individuals with normal-weight obesity had a higher risk of low bone mineral density (odds ratio = 1.596, 95 % confidence interval = 1.189-2.141, p = 0.002) compared with individuals with normal-weight non-obesity. However, no significant association between normal-weight obesity and bone mineral density was observed among people between the ages of 70 and 89 years. The study findings support the clinical significance of normal-weight obesity as a proxy biomarker to identify in primary care settings people who are at increased risk of developing osteoporosis at an early stage of aging.

Normal-Weight Obesity and Metabolic Syndrome in Korean Adults: A Population-Based Cross-Sectional Study.

BACKGROUND: The disadvantage of using body mass index (BMI) as an obesity diagnostic tool is that it cannot distinguish between fat mass and lean mass, which may understate the impact of obesity on metabolic complications. This population-based cross-sectional study aimed to investigate the relationship between normal-weight obesity (NWO) and metabolic syndrome in Korean adults aged 20 years (5962 males and 6558 females) who took part in the Korea National Health and Nutrition Examination Surveys from 2008 to 2011. METHODS: NWO was defined as having a BMI of 18.5 to 24.9 kg/m2 and a body fat percentage of 26.0% in males or 36.0% in females. Metabolic syndrome (MetS) was defined using the revised National Cholesterol Education Program definition, with a Korean-specific waist circumference threshold of >90 cm for males and >85 cm for females. RESULTS: NWO males and females were 2.7 times (p < 0.001) and 1.9 times (p < 0.001) more likely to develop metabolic syndrome than normal-weight non-obese males and females, respectively. Additionally, NWO females were 1.3 times (p = 0.027) more likely to develop MetS even after adjustments for all measured covariates. CONCLUSIONS: The current findings of the study show that NWO is a proxy biomarker of MetS to be considered for early intervention.

Associations of Physical Activity and Handgrip Strength with Health-Related Quality of Life in Older Korean Cancer Survivors.

Background: Uncertainty exists regarding the associations between physical activity (PA), relative handgrip strength (RHGS), and health-related quality of life (HRQoL) among elderly Korean cancer survivors. This study investigated the moderating effect of RHGS on the relationship between PA and HRQoL in 308 cancer survivors aged ≥65 years using the data from the Korean National Health and Nutrition Examination Survey in 2014−2019. Methods: HRQoL was evaluated with the EuroQol-5-dimension instrument. PA and handgrip strength were assessed with the Global Physical Activity Questionnaire and a hand dynamometer, respectively. Age, sex, body mass index, income, marital status, educational background, heavy alcohol consumption, smoking status, multimorbidity, and hemoglobin were included as covariates. Results: Bivariate logistic regression showed that insufficient PA and no PA were associated with higher odds of a low HRQoL (odds ratio, OR = 2.6, 95% confidence interval, CI = 1.3~5.1, p = 0.005; OR = 2.4, 95% CI = 1.1~5.0, p = 0.024, respectively), compared with sufficient PA (OR = 1). Weak RHGS was associated with high odds of a low HRQoL (OR = 2.6, 95%= 1.530~4.6, p < 0.001) compared with normal RHGS (OR = 1). Particularly, RHGS (ß = −0.0573, 95% CI = −0.1033~−0.0112) had a significant moderating effect on the relationship between PA and HRQoL even after adjustments for all the covariates. The negative influence of physical inactivity on HRQoL was observed in cancer survivors with weak RHGS but not in cancer survivors with normal RHGS. Conclusions: The current findings suggest that maintaining or promoting muscular strength through regular exercise is critical for the HRQoL of elderly Korean cancer survivors.

A Non-Randomized Combined Program of Walking and Low-Load Resistance Exercise Improves Cognitive Function and Cardiometabolic Risk Factors in Community-Dwelling Elderly Women.

Background: This study examines whether changes in cardiometabolic risk factors, functional fitness, and depressive symptoms following a six-month exercise intervention were associated with cognitive function in Korean women aged 65 years and older. Methods: A non-randomized study design was used to compare post-intervention changes in measured variables between control (n = 30) and exercise (n = 30) groups. The exercise intervention consisted of three days of low-load resistance exercise and two days of walking. Cognitive function and depressive symptoms were assessed with the Korean version of the Mini−Mental State Examination and the Korean version of the Geriatric Depression Scale, respectively. Functional fitness was measured using a senior fitness test battery. Results: The exercise group showed a significant improvement in cognitive function (p < 0.001) in conjunction with significant decreases in blood glucose (p = 0.052), triglycerides (p = 0.011), insulin (p = 0.002), tumor necrosis factor-α (p = 0.043), and depressive symptoms (p = 0.006) and an increase in interleukin-10 (p = 0.037), compared with the control group. Multivariate stepwise regression showed that changes in depressive symptoms (p < 0.001), insulin resistance (p < 0.001), and upper body muscle strength (p = 0.003) were positively associated with cognitive function. Conclusion: A six-month exercise intervention consisting of walking and low-load/high-repetition elastic band resistance exercise has the potential to improve cognitive function, as well as physical function and cardiometabolic risk factors, and to decrease depressive symptoms in older women.

Muscle Strength Moderates the Relationship between Nutritional Health Risk and Depression in Korean Older Adults.

Background: Little is known about the relationships between muscle strength and nutritional health risk with late-in-life depression. This study aimed to investigate the moderating effect of lower-extremity muscle strength on the relationship between nutritional health risk and depression in Korean older adults. Methods: Data obtained from 5949 women and 3971 men aged ≥ 65 years in the 2020 Korea Longitudinal Study on Aging were used in this study. Exposures included lower-extremity muscle strength and nutritional health risk. Lower-extremity muscle strength was measured with a modified sit-to-stand test. The nutritional health risk was assessed using a screening tool. Depression was defined as a score ≥ 8 points on the Geriatric Depression Scale (GDS). Results: Logistic regression analyses showed that depression was positively associated with nutritional health risk (p < 0.001) and inversely associated with lower-extremity muscle strength (p < 0.001). A moderation analysis with Andrew Hayes' PROCESS macro showed a significant moderating effect of lower-extremity muscle strength (ß = −0.119; 95% confidence interval, −0.172 to −0.066; p < 0.001) on the relationship between nutritional health risk and depression; the weaker was the muscle strength, the steeper was the slope of the GDS score for nutritional health risk. Conclusions: The current findings suggest the need for an intervention targeting both high nutritional risk and weak muscle strength as a therapeutic strategy against depression in Korean older adults.

Individual and Synergistic Relationships of Low Muscle Mass and Low Muscle Function with Depressive Symptoms in Korean Older Adults.

This study examined the relationship of low appendicular skeletal muscle mass and low muscle function with depressive symptoms in Korean older adults. Community-dwelling Korean older adults aged 65 years and older (n = 521) participated in this study. Appendicular muscle mass (ASM) and muscle function (MF) scores were assessed using dual-energy X-ray absorptiometry (DXA) scanning and sit-to-stand mean power based on a 30 s chair stand test, respectively. Depressive symptoms were evaluated using the Korean form of the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms according to ASM- and MF-based subgroups; normal ASM/normal MF, low ASM/normal MF, normal ASM/low MF, and low ASM/low MF. The prevalence of depressive symptoms was 21.3% in all patients: 20.7% in women and 21.5% in men. Compared to the normal ASM/normal MF participants (OR = 1), the risk of depressive symptoms rose incrementally in subjects with low ASM/normal MF (OR = 2.963, p = 0.019), normal AMS/low MF (OR = 3.843, p = 0.002), and low ASM/low MF (OR = 7.907, p < 0.001), respectively. The current findings suggest that the coexistence of low ASM and low MF is significantly and independently associated with an increased risk for depressive symptoms, with dynapenia having a stronger relationship.