Association between triglyceride-glucose index and low-density lipoprotein particle size in korean obese adults.

BACKGROUND: Small dense low-density lipoprotein cholesterol (sdLDL-C) is the lipoprotein marker among the various lipoproteins that is most strongly related to atherosclerosis. Insulin resistance (IR) can alter lipid metabolism, and sdLDL-C is characteristic of diabetic dyslipidemia. Therefore, this study sought to inspect the relationship between the triglyceride-glucose (TyG) index and mean low-density lipoprotein (LDL) particle size. METHODS: In this study, a total of 128 adults participated. The correlation coefficients between various lipoproteins and the TyG index were compared using Steiger's Z test and the Spearman correlation. The independent link between the TyG index and mean LDL particle size was demonstrated by multiple linear regression analysis. To identify the TyG index cutoff value for the predominance of sdLDL particles, receiver operating characteristic curves were plotted. RESULTS: Mean LDL particle size correlated more strongly with the TyG index than did very low-density lipoprotein, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Regression analysis demonstrated that mean LDL particle size had a strong association with the TyG index (ß coefficient = -0.038, P-value < 0.001). The TyG index optimal cutoff value for sdLDL particle predominance and the corresponding area under the curve (standard error: 0.028, 95% confidence interval: 0.842-0.952) were 8.72 and 0.897, respectively, which were close to the cutoff value of diabetes risk in Koreans. CONCLUSIONS: Mean LDL particle size is more strongly correlated with the TyG index than do other lipid parameters. After correcting for confounding variables, mean LDL particle size is independently linked with the TyG index. The study indicates that the TyG index is strongly related to atherogenic sdLDL particles predominance.

Novel Neohesperidin Dihydrochalcone Analogue Inhibits Adipogenic Differentiation of Human Adipose-Derived Stem Cells through the Nrf2 Pathway.

Obesity, characterized by excess lipid accumulation, has emerged as a leading public health problem. Excessive, adipocyte-induced lipid accumulation raises the risk of metabolic disorders. Adipose-derived stem cells (ASCs) are mesenchymal stem cells (MSCs) that can be obtained from abundant adipose tissue. High fat mass could be caused by an increase in the size (hypertrophy) and number (hyperplasia) of adipocytes. Reactive oxygen species (ROS) are involved in the adipogenic differentiation of human adipose-derived stem cells (hASCs). Lowering the level of ROS is important to blocking or retarding the adipogenic differentiation of hASCs. Nuclear factor erythroid 2-related factor-2 (Nrf2) is a transcription factor that mediates various antioxidant enzymes and regulates cellular ROS levels. Neohesperidin dihydrochalcone (NHDC), widely used as artificial sweetener, has been shown to have significant free radical scavenging activity. In the present study, (E)-3-(4-chlorophenyl)-1-(2,4,6-trimethoxyphenyl)prop-2-en-1-one (CTP), a novel NHDC analogue, was synthesized and examined to determine whether it could inhibit adipogenic differentiation. The inhibition of adipogenic differentiation in hASCs was tested using NHDC and CTP. In the CTP group, reduced Oil Red O staining was observed compared with the differentiation group. CTP treatment also downregulated the expression of PPAR-γ and C/EBP-α, adipogenic differentiation markers in hASCs, compared to the adipogenic differentiation group. The expression of FAS and SREBP-1 decreased in the CTP group, along with the fluorescent intensity (amount) of ROS. Expression of the Nrf2 protein was slightly decreased in the differentiation group. Meanwhile, in both the NHDC and CTP groups, Nrf2 expression was restored to the level of the control group. Moreover, the expression of HO-1 and NQO-1 increased significantly in the CTP group. Taken together, these results suggest that CTP treatment suppresses the adipogenic differentiation of hASCs by decreasing intracellular ROS, possibly through activation of the Nrf2 cytoprotective pathway. Thus, the use of bioactive substances such as CTP, which activates Nrf2 to reduce the cellular level of ROS and inhibit the adipogenic differentiation of hASCs, could be a new strategy for overcoming obesity.

Trends in Blood Pressure and Prevalence of Hypertension in Korean Adults Based on the 1998-2014 KNHANES.

PURPOSE: To investigate trends in blood pressure (BP) and hypertension prevalence in Korea. MATERIALS AND METHODS: Based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), IV (2007-2009), V (2010-2012), and VI (2013-2014), 56077 participants (23974 men and 32103 women) were included. RESULTS: Mean systolic BP (SBP) and diastolic BP (DBP) decreased in both sexes (male SBP: 128.1 to 120.2 mm Hg, male DBP: 82.0 to 78.5 mm Hg; female SBP: 125.7 to 116.0 mm Hg and female DBP: 77.4 to 73.2 mm Hg from the KNHANES I-VI). The age-standardized prevalence of hypertension was significantly decreased in both sexes (male; 33.3% to 30.3%, female; 28.7% to 22.7%, all p for trend <0.001). Regardless of taking anti-hypertensive medication or not, SBP and DBP declined universally in both sexes. Compared to the KNHANES I, the odds ratios (95% confidence intervals) of the KNHANES II to VI for less-than-normotensive and less-than-hypertensive BP increased in both sexes. CONCLUSION: Mean BP levels in both sexes and hypertension prevalence showed downward trends during the 16-year period.

Relationship between Coffee Consumption and Metabolic Syndrome in Korean Adults: Data from the 2013-2014 Korea National Health and Nutrition Examination Survey.

BACKGROUND: The gradually increasing demand for coffee worldwide has prompted increased interest in the relationship between coffee and health issues as well as a need for research on metabolic syndrome in adults. METHODS: Data from 3,321 subjects (1,268 men and 2,053 women) enrolled in the 2013-2014 Korean National Health and Nutrition Examination Survey were analyzed. The subjects were divided into three groups according to their daily coffee consumption. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome in the coffee-drinking groups were calculated using multiple logistic regression analysis by adjusting for confounding variables. RESULTS: The prevalence of metabolic syndrome was 15.5%, 10.7%, and 9.7% in men and 3.0%, 7.1%, and 6.5% in women according to their coffee consumption (less than one, one or two, or more than three cups of coffee per day), respectively. Compared with the non-coffee consumption group, the ORs (95% CIs) for metabolic syndrome in the group that consumed more than three cups of coffee was 0.638 (0.328-1.244) for men and 1.344 (0.627-2.881) for women after adjusting for age, body mass index, household income, education, smoking, alcohol, regular exercise, and daily caloric intake. CONCLUSION: The OR of metabolic syndrome was not statistically significant in both men and women.

Effects of inhaled corticosteroids /long-acting agonists in a single inhaler versus inhaled corticosteroids alone on all-cause mortality, pneumonia, and fracture in chronic obstructive pulmonary disease: A nationwide cohort study 2002-2013.

BACKGROUND: Both inhaled corticosteroids (ICS) and long-acting ?-agonists (LABA) have been recommended for the treatment of severe/moderate chronic obstructive pulmonary disease (COPD), but mild COPD has not been frequently studied. METHODS: We performed a prospective cohort study to compare the effect of inhaled corticosteroid (ICS) and ICS/long-acting ?-agonist (LABA) in a single inhaler on all-cause mortality and adverse events, such as pneumonia and fracture, in patients with newly diagnosed chronic obstructive pulmonary disease (COPD). We used representative nationwide cohort data from the Korean National Health Insurance claims database (2002-2013). Patients who were at least 40-years-old, newly diagnosed with COPD, and prescribed ICS or ICS/LABA in a single inhaler (N = 1995). To analyze the data, we utilized a Cox's proportional hazard regression. RESULTS: Among the total of 1995 patients, 807 had severe COPD (FEV1 < 50%) and 1188 had mild/moderate COPD (FEV1 ? 50%). The cumulative incidence and 5-year cumulative incidence of all-cause mortality was 59.5% and 29.6% for ICS users, and 35.8% and 20.2% for single inhaler ICS/LABA users, respectively. The adjusted hazard ratio (HR) of all-cause mortality for new ICS/LABA users, compared with that in new ICS users, was 0.77 (95% CI: 0.62-0.95) for the total population. For the severe and non-severe COPD groups, the adjusted HRs of all-cause mortality for new ICS/LABA users were 1.07 (95% CI: 0.65-1.76) and 0.70 (95% CI: 0.55-0.89), respectively. There was no difference in the risk for the first hospitalization due to pneumonia between new ICS and ICS/LABA users among the total population (HR: 1.02; 95% CI: 0.79-1.34). The adjusted HR of the first hospitalization for fractures in new ICS/LABA users, compared with that in new ICS users, was 0.60 (95% CI: 0.39-0.92) for the total population. CONCLUSIONS: Among newly diagnosed COPD patients and new users of ICS or ICS/LABA, use of ICS/LABA in a single inhaler was associated with lowered risk of all-cause mortality and delayed first hospitalization for fracture, as compared with use of ICS alone. However, there was no significant difference in terms of first hospitalization for pneumonia.

Long Sleep Duration is Associated With Sarcopenia in Korean Adults Based on Data from the 2008-2011 KNHANES.

STUDY OBJECTIVES: Sarcopenia, or loss of muscle mass, occurs with aging and results in frailty, disability, cardiovascular disease, and insulin resistance. Recently, researchers have asserted that sarcopenia is not an inevitable process, but is a modifiable condition. Adequate sleep duration is also important to maintain good physical and mental health. Therefore, the aim of our study was to examine the association between sleep duration and sarcopenia in Korean adults. METHODS: Data from 16,148 participants (7,158 men and 8,990 women) were analyzed from the 2008-2011 Korean National Health and Nutrition Examination Survey (KNHANES). We defined sarcopenia as one standard deviation below the sex-specific means of the appendicular skeletal muscle/height-squared values of a young reference group. Participants were categorized into 5 groups according to sleep duration. The odds ratios (OR) and 95% confidence intervals (95% CI) for sarcopenia according to sleep duration were calculated using multiple logistic regression analysis. RESULTS: The prevalence of sarcopenia was 14.3% in the total population (males 18.7%, females 9.7%). Compared to the 7 hours of sleep group, the OR (95% CI) for sarcopenia of the long sleep duration group (9 hours or more) was 1.589 (1.100-2.295) after controlling for confounding factors. From the results of subgroup analysis, high-risk groups for sarcopenia are as follows: 40-64 years old (OR = 1.868), normal body mass index (OR = 1.516), smoking (OR = 2.219), no regular exercise (OR = 1.506) in long sleepers. CONCLUSIONS: Long sleep duration (9 hours or longer) is independently associated with sarcopenia in Korean adults.

Associations between high-risk alcohol consumption and sarcopenia among postmenopausal women.

OBJECTIVE: Sarcopenia is an age-related process, leading to cardio-metabolic diseases and disabilities. High-risk drinking is also closely related to diabetes, hypertension, and dyslipidemia, which are modifiable risk factors for sarcopenia. In the present study, we aimed to investigate the association between alcohol-drinking patterns and sarcopenia in Korean postmenopausal women. METHODS: Data from 2,373 postmenopausal women were analyzed from the 2008 to 2011 Korean National Health and Nutrition Examination Survey. We defined sarcopenia as two standard deviations below the sex-specific means of the appendicular skeletal muscle/weight (percentage) values of a young reference group. Participants were categorized into three groups according to alcohol-drinking patterns, as assessed by the Alcohol Use Disorders Identification Test questionnaire. The odds ratios and 95% confidence intervals for sarcopenia were calculated using multiple logistic regression analyses. RESULTS: In total, 8.2% of Korean postmenopausal women met criteria for sarcopenia. The prevalence of sarcopenia increased from low-risk to high-risk alcohol-drinking groups as follows: 7.6, 11.0, and 22.7%, respectively. Compared with the low-risk group, the odds ratio (95% confidence interval) for the high-risk group was 4.29 (1.87-9.82) after adjusting for age, body mass index, systolic blood pressure, total cholesterol, fasting blood glucose, household income, education level, daily calorie intake, current smoking and regular exercise, and household food security status CONCLUSIONS:: High-risk alcohol drinking was associated with a higher risk of sarcopenia in postmenopausal Korean women.

Visceral adiposity and expression of clock genes in peripheral blood mononuclear cells: A pilot study.

Increasing evidence suggests a close interrelationship between disrupted circadian rhythms and obesity and metabolic disturbances. In particular, abdominal obesity, which contributes to the pathogenesis of metabolic disease, is associated with disrupted clock gene expression. However, little is known about the relationship between clock gene expression and accurate computed tomography (CT)-based measurements of visceral adiposity. Therefore, we examined the relationship between expression of clock genes in peripheral blood mononuclear cells (PBMCs) with visceral and subcutaneous adiposity in 75 healthy overweight or obese individuals. PBMCs were obtained from blood samples collected at 8 AM, and gene expression was analyzed by real-time reverse transcription polymerase chain reaction. Visceral and subcutaneous adiposity were measured by CT. Our results showed that visceral fat area was significantly positively correlated with BMAL1 and CRY1 mRNA levels and significantly negatively correlated with CLOCK, PER2, PER3 and CRY2 mRNA levels. In contrast, subcutaneous fat area was not correlated with the expression of any of the clock genes analyzed. After adjusting for multiple variables, visceral fat area was significantly associated with the expression of BMAL1, PER2 and CRY1. Taken together, our results indicate that visceral adiposity, but not subcutaneous adiposity, correlates with expression of clock genes in PBMCs.

Ferritin Level Is Positively Associated with Chronic Kidney Disease in Korean Men, Based on the 2010-2012 Korean National Health and Nutrition Examination Survey.

(1) Background: Oxidative stress and inflammation are associated with higher risk of chronic kidney disease (CKD). Serum ferritin concentrations correlate with total iron levels and systemic inflammation. (2) Methods: This study was cross-sectionally designed, based on the 2010-2012 Korean National Health and Nutrition Examination Survey (KNHANES). According to ferritin values, 13,462 participants (6082 men and 7380 women) were categorized into the normal- and high-ferritin groups (cut-off points: 200 ng/mL in men, 150 ng/mL in women). (3) Results: The mean ages of men and women were 44.5 and 48.4 years, respectively. The percentage of participants categorized into the high-ferritin group was 15.1% for men and 3.6% for women. The estimated glomerular filtration rate levels in the normal- and high-ferritin groups were 93.2 and 93.8 mL/min/1.73 m² for men and 97.1 and 87.7 mL/min/1.73 m² for women, respectively. The prevalence of CKD in the normal- and high-ferritin groups was 2.6% and 3.9% for men and 3.2% and 8.1% for women, respectively. Compared with the normal-ferritin group, the odds ratios (95% confidence intervals) for CKD of the high-ferritin group were 1.573 (1.014-2.441) in men and 1.061 (0.381-2.955) in women, after adjustments for age and other covariates. (4) Conclusions: High ferritin levels were associated with a higher risk of CKD in men but not in women.

High-risk drinking is associated with a higher risk of diabetes mellitus in Korean men, based on the 2010-2012 KNHANES.

We examined the association between alcohol-drinking pattern and diabetes mellitus (DM) in Korean adults. This cross-sectional study included 12,486 participants (5551 men and 6935 women) who participated in the 2010-2012 Korean National Health and Nutrition Examination Survey. We categorized alcohol-drinking pattern into three groups based on the alcohol-use disorders identification test (AUDIT): low-risk (score: 0-7), intermediate-risk (score: 8-14), and high-risk (score: ≥15). DM was defined as having fasting plasma glucose ≥126 mg/dL or taking glucose-lowering medication, including insulin therapy. In the study population, 25.2% of men and 4.7% of women were high-risk drinkers. DM prevalence was 9.2% in men and 5.4% in women. DM prevalence was 9.0% and 5.7% in the low-risk drinking group, 7.6% and 4.1% in the intermediate-risk drinking group, and 11.2% and 3.5% in the high-risk drinking group in men and women, respectively. Compared to the low-risk drinking group, odds ratios (95% confidence intervals) of men and women in the intermediate-risk drinking group for DM were 1.043 (0.779-1.396) and 1.139 (0.712-1.824), respectively, and 1.480 (1.133-1.933) and 0.827 (0.296-2.311) in the high-risk drinking group, after adjusting for age and other confounding factors. In conclusion, high-risk drinking appears to be associated with a higher risk of DM in men, but not in women.

Cancer survivors aged 40 years or elder are associated with high risk of chronic kidney disease: the 2010-2012 Korean National Health and Nutrition Examination Survey.

BACKGROUND: The number of cancer survivors is increasing globally and recently, higher rates of comorbidities in cancer survivors have been reported. However, no studies have investigated whether cancer survivors have a higher risk of chronic kidney disease (CKD). Accordingly, our study evaluated the association between cancer survivors and the risk of CKD using the 2010-2012 Korean National Health and Nutrition Examination Survey. MATERIALS AND METHODS: A total of 11,407 participants aged 40 years and over were categorized into two groups according to cancer experience. Multiple variables were compared and the odds ratios (ORs) for CKD prevalence were calculated using a weighted logistic regression analysis between the two groups. RESULTS: Cancer survivors were older than were those in the non-cancer group, on average, the percentages of glomerular filtration rate(GFR) lower than 60mL/min/1.73m2, proteinuria, and CKD were significantly higher in cancer survivors when compared to controls. Weighted logistic regression analyses demonstrated that cancer survivors had a higher risk for CKD after adjusting for multiple variables (OR (95% confidence interval), 2.88 (1.48- 5.59)). CONCLUSIONS: Our study demonstrated a possible association between CKD and cancer survival in Korean adults. Identifying and correcting risk factors for cancer survivors would positively affect prevention of CKD and result in a better cancer prognosis.

Association between fasting serum glucose levels and incidence of colorectal cancer in Korean men: the Korean Cancer Prevention Study-II.

INTRODUCTION: The incidence of colorectal cancer (CRC) is steadily increasing worldwide. Numerous studies have demonstrated that diabetes mellitus is related to an increased risk of CRC; however, the association between impaired fasting glucose and CRC is unclear. Therefore, we evaluated the correlation between fasting serum glucose (FSG) levels and the incidence of CRC, which can be used to develop novel methods for preventing CRC. METHODS: A total of 175,677 individuals from the Korean Metabolic Syndrome Research Initiative study were enrolled between 2004 and 2011. The incidence of CRC was assessed during a mean follow-up of 4.7 years. Hazard ratios (HR) for CRC according to FSG levels were calculated with the Cox proportional hazard model adjusted for age, sex, body mass index, smoking status, alcohol consumption, and regular exercise. RESULTS: The risk of developing CRC in subjects with high FSG was significant (HR, 1.45; 95% confidence interval [CI], 1.10-1.90), and the risk was higher in men (HR, 1.51; 95% CI, 1.12-2.05). The HR of rectal cancer, but not colon cancer, was significantly higher both in the total population and in men in the high FSG group. CONCLUSIONS: The incidence of CRC positively correlated with FSG levels in men. Rectal cancer incidence was especially correlated with high FSG in the site-specific analysis. Therefore, serum glucose levels maybe a potential marker of colorectal cancer. Early detection and intervention for controlling elevated glucose levels may be indicated as a way to prevent carcinogenesis.

Trends in prevalence of overweight and obesity in Korean adults, 1998-2009: the Korean National Health and Nutrition Examination Survey.

BACKGROUND: Although obesity is increasing worldwide and becoming a major public health problem, some countries report a trend toward stabilization. We investigated prevalence trends in overweight/obesity and obesity among Korean adults during a 12-year period. METHODS: This study was based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), and IV (2007-2009). The χ(2) and ANOVA tests were used to compare the prevalence and mean values for age and BMI, respectively. P-values for trends were determined by linear and logistic regression analyses, with KNHANES phase as the continuous variable. RESULTS: The prevalences of overweight/obesity in KNHANES I through IV were 50.8%, 57.4%, 62.5%, and 62.6%, respectively, among men (P for trend = 0.002, ß = 0.021) and 47.3%, 51.9%, 50.0%, and 48.9% among women (P for trend = 0.017, ß = -0.015). The respective prevalences of obesity were 26.0%, 32.4%, 35.1%, and 36.3% among men (P for trend = 0.006, ß = 0.018) and 26.5%, 29.3%, 28.0%, and 27.6% among women (P for trend = 0.143, ß = -0.008). During the same period, the respective prevalences of grade 2 obesity (BMI ≥30 kg/m(2)) were 1.7%, 2.8%, 3.6%, and 3.8% among men (P for trend = 0.075, ß = 0.005) and 3.0%, 3.5%, 3.4%, and 4.0% among women (P for trend = 0.398, ß = 0.003). CONCLUSIONS: The prevalences of overweight/obesity and obesity showed an upward trend among men during the 12-year period, whereas the prevalence of overweight/obesity slightly decreased among women from 2001.

Employment is associated with a lower prevalence of metabolic syndrome in postmenopausal women based on the 2007-2009 Korean National Health Examination and Nutrition Survey.

OBJECTIVE: This study aims to investigate the association between employment status and metabolic syndrome (MetS) in adult Korean women after stratification by menopause status. METHODS: We examined the relationship between employment status and the prevalence of MetS in 5,256 Korean women (3,141 premenopausal women and 2,115 postmenopausal women) who participated in the 2007-2009 Korean National Health Examination and Nutrition Survey. Employment status was classified as unemployed, employed part time, and employed full time based on a self-reported questionnaire. A modified Asian criterion based on a harmonized definition of MetS was adopted. Sampling weights were used to take the complex sampling method into account. RESULTS: The prevalences of MetS in the unemployed group, part-time employment group, and full-time employment group were 14.5%, 11.8%, and 12.7% in premenopausal women and 54.9%, 44.0%, and 41.8% in postmenopausal women, respectively. Compared with the unemployed group, the odds ratios (95% CIs) for MetS in the part-time and full-time employment groups were 0.79 (0.52-1.22) and 0.80 (0.56-1.16) in premenopausal women and 0.67 (0.46-0.97) and 0.66 (0.51-0.84) in postmenopausal women, respectively, after adjusting for covariates such as age, inflammatory marker, socioeconomic status, and lifestyle factors. CONCLUSIONS: Employment seems to be significantly related to a lower prevalence of MetS in postmenopausal women, but not in premenopausal women. However, there may not have been adequate statistical power to detect relations in premenopausal women. Further research is warranted to clarify the menopause-specific relationship between employment status and MetS risk.

Relationship between employment status and obesity in a Korean elderly population, based on the 2007-2009 Korean National Health and Nutrition Examination Survey (KNHANES).

We investigated the relationship between employment status and obesity prevalence in an elderly Korean, using a nationally representative sample. This cross-sectional study included 2991 participants (1396 men and 1595 women) aged 60 years or older. Employment status was categorized into full-time employees, part-time employees, and an unemployed group, based on a self-reported questionnaire. According to Asia Pacific regional guidelines from the World Health Organization (WHO) and International Obesity Task Force (IOTF), obesity was defined as a body mass index (BMI)≥25kg/m(2). Mean BMI in women was highest in the unemployed group, whereas the mean BMI in men did not differ significantly between employment groups. The obesity prevalence in full-time employees, part-time employees, and the unemployed group were 25.1%, 25.5%, and 27.1% in men and 36.0%, 37.9%, and 40.4% in women, respectively. Compared to the full-time employees, the odds ratios (ORs) (95% confidence intervals) for obesity were 1.172 (0.765-1.795) and 1.164 (0.843-1.609) in the part-time employees, and 1.451 (1.054-1.999) and 1.399 (1.090-1.795) in the unemployed group, for men and women, respectively, after adjusting for age, lifestyle factors (physical activity, alcohol consumption, smoking status, daily calorie intake), socioeconomic factors (education level and household income), and inflammatory factor (white blood cell (WBC) counts). Unemployment appears to be significantly related to a higher prevalence risk of obesity in an elderly Korean population, regardless of age, lifestyle, socioeconomic factors, and inflammatory factor.

Fasting glucose level and the risk of incident atherosclerotic cardiovascular diseases.

OBJECTIVE: Although diabetes increases the risk of cardiovascular disease (CVD) and mortality, the dose-response relationship between fasting glucose levels below those diagnostic of diabetes with cardiovascular events has not been well characterized. RESEARCH DESIGN AND METHODS: A prospective cohort study of more than one million Koreans was conducted with a mean follow-up of 16 years. A total of 1,197,384 Korean adults with no specific medical conditions diagnosed were classified by baseline fasting serum glucose level. Associations of fasting glucose level with CVD incidence and mortality, stroke incidence and mortality, and all-cause mortality were analyzed using multivariate proportional hazards regression. RESULTS: The relationships between fasting glucose levels and CVD risks generally followed J-shape curves, with lowest risk in the glucose range of 85-99 mg/dL. As fasting glucose levels increased to >100 mg/dL, risks for CVD, ischemic heart disease, myocardial infarction, and thrombotic stroke progressively increased, but risk for hemorrhagic stroke did not. Fasting glucose levels <70 mg/dL were associated with increased risk of all stroke (hazard ratio 1.06, 95% CI 1.01-1.11) in men and (hazard ratio 1.11, 1.05-1.17) in women. CONCLUSIONS: Both low glucose level and impaired fasting glucose should be considered as predictors of risk for stroke and coronary heart disease. The fasting glucose level associated with the lowest cardiovascular risk may be in a narrow range.

Trends in the prevalence of chronic kidney disease in Korean adults: the Korean National Health and Nutrition Examination Survey from 1998 to 2009.

BACKGROUND: Chronic kidney disease (CKD) is associated with a poor quality of life and cardiovascular events and is a great threat to public health. METHODS: We investigated the trends of CKD prevalence over 12 years in Korean adults at least 20 years old using sampling weight methods based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005) and IV (2007-09). Of the 135 954 subjects participating in KNHANES I-IV, 33 276 (14 307 men, 18 969 women) were included in the present study. RESULTS: The percentage of glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) in KNHANES I-IV was 1.0, 5.4, 3.1 and 2.6% in men and 3.4, 9.7, 10.2 and 4.6% in women, respectively. The percentage of proteinuria ≥ 1+ measured by a dipstick method across KNHANES phases gradually declined in men (3.1, 3.0, 2.8 and 2.2% in KNHANES I-IV, respectively), while those in women rebounded in KNHANES IV after reduction through KNHANES III (3.3, 2.3, 1.4 and 1.9%, respectively). The prevalence of CKD (GFR <60 mL/min/1.73 m(2) or proteinuria ≥ 1+) in KNHANES I-IV was 3.9, 7.9, 5.4 and 4.5% in men and 6.4, 11.3, 12.0 and 6.3% in women, respectively. After stratification by age (20-39 years, 40-59 years and ≥ 60 years), the prevalence trends were similar to those before the stratification by sexes. CONCLUSIONS: The prevalence of CKD in Korean adults has decreased since 2001 in men and since 2005 in women.

Low-grade inflammation, metabolic syndrome and the risk of chronic kidney disease: the 2005 Korean National Health and Nutrition Examination Survey.

Either chronic inflammation or metabolic syndrome (MetS) is associated with renal impairment. This cross-sectional study was designed to investigate the relationship between elevated white blood cell (WBC) counts and chronic kidney disease (CKD) stage 3 or more according to the presence of MetS in adult Koreans. In total, 5,291 subjects (≥ 20 yr-old) participating in the 2005 Korean National Health and Nutrition Examination were included. CKD stage 3 or more was defined as having an estimated glomerular filtration rate below 60 mL/min/1.73 m(2), as calculated using the formula from the Modification of Diet in Renal Disease study. The odds ratio (95% confidence interval) for CKD stage 3 or more in the highest WBC quartile (≥ 7,200 cells/µL) was 1.70 (1.17-2.39) after adjusting for MetS and other covariates, compared with the lowest WBC quartile (< 5,100 cells/µL). In subjects with MetS, the prevalence risk for CKD stage 3 or more in the highest WBC quartile was 2.25 (1.28-3.95) even after fully adjusting for confounding variables. In contrast, this positive association between WBC quartile and CKD stage 3 or more disappeared in subjects without MetS. Low-grade inflammation is significantly associated with CKD stage 3 or more in subjects with MetS but not in those without MetS.

Sex differences in the relationship between socioeconomic status and metabolic syndrome: the Korean National Health and Nutrition Examination Survey.

AIMS: To investigate sex differences in the relationship between socioeconomic status (SES) and the prevalence of metabolic syndrome (MetS) in Korean adults. METHODS: We examined the relationship between SES, as measured by household income or education level, and the prevalence of MetS in Korean adults who participated in the 2007-2008 Korean National Health Examination and Nutrition Survey (KNHANES). The adjusted odds ratios (ORs) for MetS were calculated using multivariate logistic regression analysis across household income and education level quartiles. RESULTS: We found significant differences between men and women in the association between SES and MetS, with a positive association for men and an inverse association for women. The adjusted OR and 95% confidence interval (95% CI) for MetS for the highest vs. lowest quartile of household income was 1.59 (1.15-2.20) in men. The adjusted ORs for MetS for the highest vs. lowest quartile of household income and education level were 0.54 (0.41-0.72) and 0.26 (0.17-0.38) in women, respectively. CONCLUSIONS: We found sex differences in the relationship between SES and the prevalence of MetS in Korea. These findings suggest that sex-specific public health interventions that consider SES are needed for the prevention and treatment of MetS.