Association between Homocysteine and Vitamin D Levels in Asymptomatic Korean Adults.

An increased homocysteine level is a risk factor for cardiovascular disease, venous thromboembolism, cerebrovascular disease, and chronic kidney disease. In addition, vitamin D deficiency is associated with coronary artery disease and metabolic disorders. The present study included data from 1375 adults (895 men and 480 women) with a mean age of 52.62 ± 9.94 years who visited the Health Promotion Center of the University Hospital in Gyeonggi-do, Republic of Korea from January 2018 to December 2022 for routine checkups that included assessments of their homocysteine and vitamin D levels. Homocysteine levels were positively associated with age, a history of hypertension, a history of diabetes, current smoking habits, and levels of low-density lipoprotein cholesterol, creatinine, uric acid, and high-sensitivity C-reactive protein. By contrast, vitamin D levels were negatively associated with serum levels of homocysteine after adjusting for covariates (ß = -0.033, p < 0.001). Additional long-term prospective studies are needed to elucidate the presence of a causal relationship between vitamin D status and serum levels of homocysteine in asymptomatic Korean adults. An intervention trial is warranted to determine whether the administration of vitamin D is helpful for the primary prevention of cardiovascular disease by lowering the homocysteine level in this population.

Sunflower seed extract supplementation reduces body fat in adults with obesity: A double-blind, randomized, placebo-controlled trial.

Obesity is an important public health problem and socioeconomic burden. We hypothesized that an intake of sunflower seed extract (SUN-CA) would decrease body fat and then investigated the effects and safety of SUN-CA intake on body fat in adults with obesity as an option for obesity treatment. In this double-blind, randomized, placebo-controlled study, 100 adults with body mass indices of 25 to 31.9 kg/m2 were assigned to groups that received SUN-CA (n = 50) or a placebo (n = 50) and received 1 tablet/day containing 500 mg of SUN-CA or the placebo over a 12-week period. The primary endpoint was the change in mass and percentage of body fat. The group that received SUN-CA daily showed decreases in body fat mass greater than those in the placebo group (-0.9 ± 1.8 kg vs. -0.1 ± 1.4 kg, P = .043). In addition, body weight, body mass index, and hip circumference improved after the intake of SUN-CA relative to the changes in the placebo group. There was no intergroup differences in the prevalence of adverse events. The accumulation of excess body fat improved through the intake of 500 mg/day of SUN-CA containing 100 mg of chlorogenic acids for 12 weeks in adults with obesity without causing serious adverse side effects. SUN-CA could be an effective and safe management option for obesity. The trial was registered at Clinical Research Information Service (CRIS: https://cris.nih.go.kr/cris/index/index.do) as KCT0005733.

Associations between Dietary Patterns and Metabolic Syndrome: Findings of the Korean National Health and Nutrition Examination Survey.

Metabolic syndrome (MetS) is a multifactorial cluster of metabolic disorders related to cardiovascular disease and type 2 diabetes mellitus. Diet and dietary patterns are significant factors in the development and management of MetS. The associations between dietary patterns (i.e., high-carbohydrate [HCHO], high-fat [HF], and high-protein [HP] diets) and the prevalence of MetS in Koreans were examined using data from the Korean National Health and Nutrition Examination Survey, collected between 2018 and 2020. The study included data from 9069 participants (3777 men and 5292 women). The percentage of participants with MetS was significantly higher in the HCHO diet group than in the normal diet group in women. Women with HCHO diet were positively associated with elevated blood pressure and triglyceride levels based on a comparison with the normal diet group (p = 0.032 and p = 0.005, respectively). Men with an HF diet were negatively associated with elevated fasting glucose levels based on a comparison with the normal diet group (p = 0.014). Our findings showed that HCHO intake was strongly associated with a higher risk of MetS, especially elevated blood pressure and triglyceride levels in women, and an HF diet was negatively associated with elevated fasting glucose levels in men. Further prospective studies of the impact of dietary carbohydrate, fat, and protein proportions on metabolic health are needed. The optimal types and proportions of these dietary components, as well as the underlying mechanisms through which suboptimal proportions can lead to MetS, should also be investigated.

Sarcopenia in community-dwelling older adults is associated with the diversity and composition of the gut microbiota.

Sarcopenia is a prognostic indicator of negative consequences in older adults, including physical disability, frailty, and mortality. Few studies have investigated the associations between sarcopenia and the gut microbiota. We sought such associations in community-dwelling older adults aged ≥60 years. Sarcopenia was defined as low muscle mass, plus reduced physical performance, and/or low skeletal muscle strength. 16S rRNA next-generation sequencing was used to identify the components of the gut microbiota in fecal samples from 27 older adults with sarcopenia and 33 without sarcopenia. Relationships between sarcopenia and the diversity and composition of the gut microbiota were analyzed. Diversities at the species level were detected between the sarcopenia and control groups (P = 0.049). The abundance of Prevotella and Prevotella copri was significantly lower (P = 0.021 and P = 0.018 respectively) and that of Parabacteroides sp. higher in the sarcopenia than the control group (P = 0.010). Linear discriminant analysis of effect size revealed differences in the microbiota composition between the two groups. Sarcopenia was related with the presence of Anaerotruncus and Phascolarctobacterium sp. and the absence of Prevotella sp. and Prevotella copri. Further research is warranted to clarify whether changes in the gut microbiota cause sarcopenia onset or development.

Fat-to-muscle Ratio: A New Indicator for Coronary Artery Disease in Healthy Adults.

Background: Coronary artery disease (CAD) is an important issue in public health. Previous studies have shown that the ratio of fat to muscle mass is a significant predictor of metabolic disease, and it is known to be associated with atherosclerosis. In this study, we evaluated the association between the fat-to-muscle ratio (FMR) and CAD in healthy adults. Methods: A total of 617 participants without diabetes mellitus, hypertension, known CAD, or stroke who visited the Health Promotion Center from 2009 to 2018 were included in this study. Computed tomography imaging and bioelectrical impedance analysis were used to ascertain the coronary artery calcium (CAC) score, degree of CAD, and FMR. Results: Univariate logistic regression analysis showed that old age, male sex, smoking history, creatinine, aspartate aminotransferase, gamma-glutamyl transferase, uric acid, total cholesterol, and low-density lipoprotein cholesterol were significantly associated with CAC. After adjusting for potential confounding covariates, the presence of CAC was independently associated with FMR (OR, 1.014; 95% CI, 1.002-1.026; p = 0.019. The association was maintained even after adjusting for body mass index and waist circumference (odds ratio, 1.019; 95% confidence interval, 1.004 -1.034; P = 0.012). Conclusion: In this study, a high FMR was significantly associated with CAC. A large-scale prospective study on the association with FMR and cardiovascular diseases is necessary to confirm this relationship.

Are There Differences in Hair Mineral Concentrations Between Metabolically Healthy and Unhealthy Obese Adults?

Obesity is a risk factor for metabolic syndrome, dyslipidemia, hypertension, insulin resistance, type 2 diabetes mellitus, and cardiovascular disease. However, obesity is not a homogenous state and not all subjects in an obese population are at an increased risk for metabolic abnormalities. Thus, obesity types can be subdivided into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) according to metabolic status. Body minerals are important and are involved in various metabolic processes that may be related to obesity. Thus, this study determined whether hair mineral concentrations differ between MHO and MUO adults. The associations between metabolic risk factors and hair mineral concentrations were analyzed in 141 obese Korean adults (62 MHO subjects and 79 MUO subjects). The MUO subjects showed significantly higher triglyceride levels, systolic blood pressure, waist circumference and body mass index, lower high-density lipoprotein cholesterol levels, and greater insulin resistance as reflected by the homeostasis model assessment-insulin resistance (HOMA-IR) index compared with MHO subjects. No significant differences in hair mineral concentrations were detected between MHO and MUO adults. Hair iron and cobalt concentrations were significantly negatively correlated with blood pressure in subjects with MHO. In addition, hair zinc concentration was associated with decreased systolic blood pressure. The results of this study suggest that mineral status in obese adults may play a role in metabolic abnormalities. Further studies with a larger number of subjects are warranted to identify the nature of the relationship between hair mineral status and metabolic risk in MHO and MUO subjects.

The effects of repetitive transcranial magnetic stimulation on body weight and food consumption in obese adults: A randomized controlled study.

BACKGROUND: Although some studies have reported significant reductions in food cravings following the single-session of repetitive transcranial magnetic stimulation (rTMS), there is little research on the effects of multi-session of rTMS on food consumption and body weight in obese subjects. OBJECTIVE: We conducted 4-week randomized, sham-controlled, single-blind, parallel-group trial to examine the effect of rTMS on body weight in obese adults. METHODS: Forty-three obese patients (body mass index [BMI] ≥25 kg/m2) aged between 18 and 70 years were randomized to the sham or real treatment group (21 in the TMS group and 22 in the sham treatment group). A total of 8 sessions of rTMS targeting the left dorsolateral prefrontal cortex (DLPFC) was provided over a period of 4 weeks. The primary outcome measure was weight change in kilograms from baseline to 4 weeks. Secondary endpoints included changes in anthropometric measures, cardiovascular risk factors, food intake, and appetite. RESULTS: Participants in the rTMS group showed significantly greater weight loss from baseline following the 8 session of rTMS (-2.75 ±â€¯2.37 kg vs. 0.38 ±â€¯1.0 kg, p < 0.01). Consistent with weight loss, there was a significant reduction in fat mass and visceral adipose tissue at week 4 in the rTMS group compared with the control group (p < 0.01). After the 8 sessions of rTMS, the TMS group consumed fewer total kilocalories and carbohydrates per day than the control group (p < 0.05). CONCLUSIONS: 8 sessions of HF rTMS delivered to the left DLPFC were effective in inducing weight loss and decreasing food intake in obese patients. TRIAL REGISTRATION: Clinical trial registered with the Clinical Trials Registry at http://cris.cdc.go.kr (KCT0002548).

The effects of repetitive transcranial magnetic stimulation on eating behaviors and body weight in obesity: A randomized controlled study.

BACKGROUND: Although some studies have reported significant reductions in food cravings following repetitive transcranial magnetic stimulation (rTMS), none have examined changes in body weight. OBJECTIVE: We conducted 2-week randomized, sham-controlled, single-blind, parallel-group trial to examine the effect of rTMS on body weight in obese patients. METHODS: Sixty obese patients (body mass index [BMI] ≥25 kg/m2) aged between 18 and 65 years were recruited. A total of 4 sessions of rTMS targeting the left dorsolateral prefrontal cortex (DLPFC) was provided over a period of 2 weeks, with a follow-up assessment conducted two weeks after treatment had finished. The primary outcome measure was weight change in kilograms from baseline to 4 weeks. Secondary endpoints included changes in anthropometric measures, cardiovascular risk factors, food intake, and appetite. RESULTS: Of the 60 volunteers, 57 completed the 4-week follow-up (29 in the TMS group and 28 in the sham treatment group). Participants in the rTMS group showed significantly greater weight loss from baseline following the 4 session of rTMS (p = 0.002). Consistent with weight loss, there was a significant reduction in BMI, fat mass and VAT at week 4 in the rTMS group compared with the control group (p < 0.05). After the 4 sessions of rTMS, the TMS group consumed fewer total kilocalories per day than the control group (p < 0.01). CONCLUSIONS: rTMS delivered to the left DLPFC was effective in decreasing food intake and facilitating weight loss in obese patients. The results of this study suggest that rTMS could be an effective treatment option for obesity. TRIAL REGISTRATION: Clinical trial registered with the Clinical Trials Tegistry at https://cris.nih.go.kr (KCT0001455).

Association between the Time of Length since Smoking Cessation and Insulin Resistance in Asymptomatic Korean Male Ex-Smokers.

AIM: Smoking is a major risk factor for diabetes mellitus, mainly due to decreased insulin secretion and increased insulin resistance. However, there has been little research on the effects of smoking cessation period on changes in insulin resistance. In this study, we investigated the relationships between the length of time since smoking cessation period and insulin resistance in asymptomatic Korean male ex-smokers. METHODS: A total of 851 male adults were included in this study. We considered several factors that can affect insulin resistance, and through multiple linear regression analysis, we assessed the effect the length of time since smoking cessation on insulin resistance in ex-smokers. Insulin resistance was represented as the insulin resistance index estimated by homeostasis model assessment. RESULTS: HOMA-IR values showed a statistically significant negative correlation with the length of time since smoking cessation (p = 0.009) in ex-smokers. After performing multiple linear regression analysis using factors that could potentially influence insulin resistance, we found that waist circumference (p = 0.026) and the length of time since smoking cessation (p = 0.039) were independent predictors of HOMA-IR in asymptomatic male ex-smokers. CONCLUSION: The longer the smoking cessation period, the more the insulin resistance tended to decrease in asymptomatic Korean male ex-smokers.

Differential Association of Metabolic Risk Factors with Open Angle Glaucoma according to Obesity in a Korean Population.

The associations of the metabolic syndrome (MetS) with intraocular pressure and primary open angle glaucoma (OAG) have been reported. This study aimed to determine whether a difference in association exists between OAG and metabolic risk factors according to obesity status among Korean adults. A total of 8,816 participants (≥40 years) in the Korea National Health and Nutrition Examination Survey were classified into obese, body mass index (BMI) ≥ 25 kg/m2 and non-obese, BMI < 25 kg/m2. The prevalence of MetS was 40.1% in non-obese OAG and 66.0% in obese OAG. The prevalence of OAG increased with increasing number components for MetS in total population and in non-obese subjects (P < 0.001, respectively), while the prevalence of OAG was not associated with number of components for MetS in obese subjects (P = 0.14). In non-obese individuals, subjects with high triglycerides, high blood pressure (BP), and MetS were more likely to have OAG compared with those without high triglycerides, high BP, and MetS after adjusting for potential confounders. However, MetS or its components exhibited no significant association with glaucoma status in obese individuals. Our study provides understanding on the differences in association of OAG with MetS and its components according to obesity status.

Relationship between deep subcutaneous abdominal adipose tissue and metabolic syndrome: a case control study.

BACKGROUND: The deep subcutaneous adipose tissue (dSAT) is closely related to the obesity-associated complications similarly to the characteristics of visceral adipose tissue (VAT). However, the association between dSAT and metabolic syndrome (MS) is unclear. The purpose of our study was to evaluate the association of distinct abdominal adipose tissue with the cardiometabolic risk factors and MS. METHODS: Abdominal computed tomography (CT) images were obtained in 365 asymptomatic subjects (187 subjects with MS and 178 without MS). The axial images segmented into superficial and deep SAT by manually tracing the fascia superficialis at L4-5 levels. The concentrations of serum inflammatory cytokines and adipokines were also measured. RESULTS: The MS group had significantly lower adiponectin levels but significantly higher levels of resistin, leptin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), intercellular adhesion molecule (ICAM), monocyte chemotactic protein-1 (MCP-1), and oxLDL than the control group (p < 0.05). All inflammatory cytokines and adipokines were associated with the sum of VAT and dSAT areas (VDAT) (P for trend < 0.05), but no significant correlation was found between inflammatory cytokines and sSAT. dSAT was significantly associated with MS in both men and women (OR 2.371; p < 0.001) whereas the ORs between sSAT and MS were not significant (p = 0.597). The age-adjusted ORs between VDAT and MS (OR of 8.359 in men and 3.183 in women, p < 0.001) were higher than those of VAT (OR of 7.941 in men and 2.570 in women, p < 0.05) and dSAT (OR of 2.954 in men and 1.856 in women, p < 0.05). CONCLUSIONS: We demonstrated that dSAT was associated with increased inflammation and oxidative stress, suggesting that dSAT is an important determinant of MS. Therefore, abdominal subcutaneous fat should be considered as two functionally distinct compartments rather than a single entity.

Association of Metabolic Syndrome with the Cardioankle Vascular Index in Asymptomatic Korean Population.

AIM: Metabolic syndrome is characterized by a cluster of atherosclerotic cardiovascular risk factors. The cardioankle vascular index (CAVI) reflects arterial stiffness and may be used as an indicator of atherosclerotic cardiovascular disease. In this study, we investigated the association of CAVI with metabolic syndrome. METHODS: A total of 1,144 adults were included in this study. We measured CAVIs and examined blood samples to identify metabolic syndrome according to WHO Asia Pacific criteria and NCEP-ATPIII criteria. AST, ALT, r-GTP, BUN, creatinine, high sensitivity C-reactive protein, and uric acid were also measured. RESULTS: CAVI values were significantly higher in subjects with metabolic syndrome than those without metabolic syndrome and increased according to the number of metabolic syndrome components present. Subjects with high fasting blood sugar levels or high blood pressure showed high CAVI values. Multiple regression analysis showed that age, sex, diastolic blood pressure, and uric acid were independent predictors of CAVI. CONCLUSION: Subjects with metabolic syndrome had high CAVIs, which indicated arterial stiffness, and were closely associated with an increase in the number of metabolic risk factors. The individual risk factors for metabolic syndrome have the synergistic effect of elevating arterial stiffness in asymptomatic Korean population.

Association between metabolic syndrome, smoking status and coronary artery calcification.

Coronary artery calcification (CAC), an indicator of coronary artery stenosis, is an independent risk factor of ischemic heart disease. Smoking increases the risk of metabolic syndrome (MS) and cardiovascular disease. Almost no previous studies have evaluated the combined effect of MS and smoking status on CAC. Therefore, in this study we examined the relationships between CAC, MS, and smoking. This study included 775 adult males without histories of cardiovascular disease who visited the Health Promotion Center at the University Hospital in Gyeonggi-do, Republic of Korea from January 2, 2010 to December 31, 2012. All subjects were screened for CAC by multi-detector computed tomography (MDCT). CAC increased significantly with age and body mass index (BMI). Among MS components, abdominal obesity and elevated fasting blood glucose were correlated with CAC. After adjusting for age and BMI, MS was associated with a 1.46-fold increase in CAC (95% CI:1.02-2.09), abdominal obesity was associated with a 1.45-fold increase (95% CI:1.04-2.04), elevated fasting blood glucose was associated with a 2-fold increase (95% CI:1.36-2.94), and MS and smoking combined were associated with 2.44-fold increase in CAC. Thus, the combination of smoking and MS had a greater impact on CAC than any single factor alone. MS is correlated with an increased risk of CAC, and a combination of MS and smoking is associated with even greater risk. These findings can be used to prevent cardiovascular disease in adults.

Regional cortical thickness and subcortical volume changes in patients with metabolic syndrome.

Although previous studies have demonstrated an association between metabolic syndrome (MS) and changes in the integrity of cerebral white matter, no study has evaluated cortical thickness or subcortical volumes in MS with MRI. The purpose of our study was to investigate changes in cortical thickness and subcortical volume in an asymptomatic MS population. A total of 86 asymptomatic subjects (40 patients with MS and 46 subjects without MS) underwent 3T brain MRI scanning, and cortical thickness was compared between the groups across multiple locations. The subcortical volumes were also compared on a structure-by-structure basis. ANCOVA adjusted for age, education, total intracranial volume (TIV), and gender revealed significant volume reductions in the right nucleus accumbens in the MS group compared with the control group. The MS group showed a significant reduction in mean cortical thickness and volume in both hemispheres compared with controls. A group comparison analysis of the regional cortical thickness between the two groups also revealed significant reductions in cortical thickness in the MS group in the left insular, superior parietal, postcentral, entorhinal, and right superior parietal cortices compared with those of the control group (all comparisons p < 0.05, FDR corrected). We demonstrated a significant reduction in cortical and subcortical areas in MS patients, especially in areas involved in body weight control and cognitive function. Our results suggest an initial neurodegenerative process according to metabolic syndrome even in the preclinical stage, and further prospective studies are required to evaluate this process.

The Association between Oxidative Stress and Metabolic Syndrome in Adults.

BACKGROUND: In this Study, we investigated the effects of lifestyle and metabolic syndrome on free oxygen radical levels in men and women in Korea. METHODS: A total of 254 adults were included in this study from February 2011 to June 2012 at a health promotion center. Information of the lifestyles and presence of metabolic syndrome factors was obtained. Biochemical markers were measured and free oxygen radicals test (FORT) was performed on the blood. RESULTS: Of the 254 subjects, 86 (33.9%) had metabolic syndrome, and 187 (73.6%) were men. Between the subjects with and without metabolic syndrome, there was a significant increase in alanine aminotransferase and serum FORT values in the subjects with metabolic syndrome. Multiple linear regression analysis showed that high-sensitivity C-reactive protein (hs-CRP) (P = 0.004), metabolic syndrome (P = 0.037), and female gender (P = 0.030) were independent predictors of serum FORT values. The subjects with high fasting blood sugar level or low high density lipoprotein cholesterol levels showed high serum FORT values. CONCLUSION: High hs-CRP, the presence of metabolic syndrome, and female gender were associated with the high oxidative stress. High oxidative stress was associated with the presence of metabolic syndrome.

Assessment of lifestyle effects on the levels of free oxygen radicals in the korean population.

BACKGROUND: As many studies revealed that oxidative stress due to the imbalance of reactive oxygen species (ROS) and antioxidant capacity is related with pathologic processes such as cardiovascular diseases, diabetes, as well as aging and obesity, the relationship between lifestyle and oxidative stress has recently gained much medical attention. However, little information exists on the effects of lifestyle on ROS in Korea. In this study, we investigated the effects of lifestyle on free oxygen radical levels in men and women in Korea. METHODS: A total of 138 adults participated in this study from September 2007 to June 2010 at a health promotion center and department of family medicine. Information on the lifestyle of each participant was obtained by questionnaire. Biochemical markers and a free oxygen radical test (FORT) were also measured. RESULTS: The average age was 47.28 ± 10.85 years and 79.7% were male. High sensitivity C-reactive protein (hs-CRP; r = 0.418, P = 0.012), triglycerides (r = -0.243, P = 0.008), hemoglobin (r = -0.445, P < 0.001), total protein (r = 0.210, P = 0.036), creatinine (r = -0.294, P = 0.001), fruit intake per day (P = 0.047), and smoking (P = 0.003) were related to the FORT levels in univariate analysis. Multiple linear regression analysis showed that hs-CRP (P = 0.039) was an independent predictor of serum FORT values. This statistical model can explain 78% of the variance in FORT values. CONCLUSION: This result suggests that hs-CRP showed a statistically significant positive association with FORT values. Further studies on the relationship between lifestyle and antioxidant capacity as well as ROS seem to be warranted to evaluate the overall effect of oxidative stress.

Role of the SUMO-interacting motif in HIPK2 targeting to the PML nuclear bodies and regulation of p53.

Homeodomain-interacting protein kinase 2 (HIPK2) is a key regulator of various transcription factors including p53 and CtBP in the DNA damage signaling pathway. PML-nuclear body (NB) is required for HIPK2-mediated p53 phosphorylation at Ser46 and induction of apoptosis. Although PML-NB targeting of HIPK2 has been shown, much is not clear about the molecular mechanism of HIPK2 recruitment to PML-NBs. Here we show that HIPK2 colocalizes specifically with PML-I and PML-IV. Mutational analysis showed that HIPK2 recruitment to PML-IV-NBs is mediated by the SUMO-interaction motifs (SIMs) of both PML-IV and HIPK2. Wild-type HIPK2 associated with SUMO-conjugated PML-IV at a higher affinity than with un-conjugated PML-IV, while the association of a HIPK2 SIM mutant with SUMO-modified PML-IV was impaired. In colony formation assays, HIPK2 strongly suppressed cell proliferation, but HIPK2 SIM mutants did not. In addition, activation and phosphorylation of p53 at the Ser46 residue were impaired by HIPK2 SIM mutants. These results suggest that SIM-mediated HIPK2 targeting to PML-NBs is crucial for HIPK2-mediated p53 activation and induction of apoptosis.

Covalent conjugation of Groucho with SUMO-1 modulates its corepressor activity.

Groucho is a corepressor that forms a macromolecular complex for its corepressor activity, in which HDAC1 is an essential component for the modulation of chromatin structure and transcriptional repression of target genes. Here, we show that Groucho is covalently conjugated with small ubiquitin-related modifier-1 (SUMO-1) in vitro and in vivo. SUMO conjugations of Groucho occur at four different lysine residues. Substitutions of all these residues abolished sumoylation of Groucho and inhibited its corepressor activity. In addition, Groucho corepressor activity was reduced by inhibition of SUMO-1 conjugation via Ubc9 knockdown through expression of short-hairpin RNA against Ubc9. Furthermore, interactions between Groucho and HDAC1 are enhanced by sumoylation of Groucho, which is mediated by the SUMO-interaction motif of HDAC1. Taken together, these findings indicate that Groucho sumoylation increases its corepressor activity by enhancing the recruitment of HDAC1 to Groucho corepressor complex.