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1.
Child Obes ; 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429685

RESUMO

Background: The purpose of this study was to examine the association between sedentary time and obesity in youth according to meeting physical activity guidelines. Methods: A total of 1991 youth (10-17 years) from the 2003 to 2006 National Health and Nutrition Examination Survey were included in the analysis. Physical activity was categorized into two levels: (1) daily engagement in ≥60 minutes of moderate and vigorous physical activity (MVPA) and (2) <60 minutes per day of MVPA. Sedentary time was categorized into four levels using quartiles. BMI was categorized into two levels using sex-specific BMI for age percentiles from the CDC: (1) obese group: BMI ≥90 percentile and (2) nonobese group: BMI <90 percentile. Results: After adjusting for covariates, among those meeting physical activity guidelines, there was a statistically significant relationship between sedentary time and obesity for Q1 (sedentary time <383.5 min/day) vs. Q4 (sedentary time >523.5 min/day) [odds ratio (OR) = 0.14, 95% confidence interval (CI): 0.02-0.87] and Q2 (sedentary time = 383.5-451.83 min/day) vs. Q4 (sedentary time >523.5 min/day) (OR = 0.16, 95% CI: 0.03-0.99). Among youth not meeting physical activity guidelines, however, sedentary time was not associated with obesity [OR = 0.72 (Q1 vs. Q4), OR = 0.88 (Q2 vs. Q4), OR = 1.08 (Q3 vs. Q4)]. Conclusions: These results indicate that sedentary time is associated with obesity among those meeting physical activity guidelines. However, the relationship between sedentary time and obesity in a low physical activity group is not obvious. Therefore, to confirm the role of low-level physical activity on the relationship between sedentary time and health outcomes, further investigation is required.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32244339

RESUMO

The purpose of this study was to assess trends in physical education and physical activity among U.S. high school students from 2011 to 2017, respectively, and to evaluate temporal trends in the relationship between physical education class participation and physical activity levels. Data from a total of 51,616 high school students who participated in the Youth Risk Behavior Surveillance System (YRBSS) from 2011 to 2017 were analyzed for this study. Physical education was measured as follows: In an average week when you are in school, on how many days do you go to physical education classes? Physical activity was measured as follows: During the past 7 days, on how many days were you physically active for a total of at least 60 min per day? Meeting physical activity guideline was defined as engaging in 7 days per week of at least 60 min per day. Across the 2011-2017 YRBSS, there were no linear (p = 0.44)/quadratic trends (p = 0.37) in physical education and linear (p = 0.27)/quadratic trends (p = 0.25) in physical activity, respectively. Regarding the trends in the association between physical education and physical activity, there were no statistically significant linear (unstandardized regression coefficient (b) = 0.013, p = 0.43) or quadratic (p = 0.75) trends; however, at the sample level, there was a slight increase in the odds ratio effect sizes from 2011 to 2017 (ES = 1.80-1.98). The pooled association between physical education participation and physical activity was statistically significant, OR = 1.88, 95% CI = 1.75-2.03, p < 0.001. That is, on average across the four YRBSS cycles, students who participated in physical education had 1.88 times higher odds of meeting physical activity guideline when compared to students who did not participate in physical education. The trends of physical education and physical activity did not change between 2011 and 2017. Overall, we observed a significant relationship between participation in physical education and physical activity. There was a non-significant yet stable trend of association between participation in physical education and physical activity over time.

3.
Andrology ; 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32329181

RESUMO

BACKGROUND: Serum testosterone assays are an important tool in the clinical evaluation of a number of endocrine disorders including male hypogonadism. However, serum testosterone has a limited role in real clinical use due to its inaccuracy. We aimed to assess the association between prostate-specific antigen (PSA) and testosterone as well as the effects of various types of testosterone replacement therapy (TRT) for PSA level. METHODS: Two electronic databases were screened: PubMed (1966 through December 2018) and Cochrane Library (1993 through December 2018). The first strategy compared the overall increase in PSA following testosterone treatment compared with placebo. The second strategy analyzed the overall association between PSA and testosterone among the observational studies. RESULTS: In the first strategy, 22 articles were included in the final analysis. In the second strategy, 18 studies were included. Testosterone replacement therapy (TRT) showed a significant change in PSA level compared to that in the placebo group (mean difference [MD]: 0.13, 95% CI: 0.01-0.25, P = .04). Compared to placebo, only intramuscular (IM) TRT shows a significant change in PSA level group (MD: 0.16, 95% CI: 0.01-0.30, P = .04), as neither the oral nor topical type showed a significant change in PSA. In the second strategy analysis, there was no overall correlation found between PSA and testosterone (z = 0.04, 95% CI: -0.04 to 0.12, P = .04; r = 0.039). However, in the subgroup of non-BPH (benign prostate hyperplasia), a significant correlation between PSA and testosterone (z = 0.07, 95% CI: 0.01-0.13, P = .009; r = 0.089) was found. CONCLUSIONS: We found that TRT, particularly IM TRT, significantly changed the PSA level compared with the placebo group. Furthermore, there was a significant correlation between PSA and testosterone in patients with non-BPH. According to these findings, we suggest the possibility of PSA as a surrogate marker of testosterone.

4.
J Sport Health Sci ; 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32325144

RESUMO

PURPOSE: This study aimed to examine (1) the independent effects of hypoxia on cognitive function and (2) the effects of exercise on cognition while under hypoxia. METHODS: Design: Systematic review with meta-analysis. DATA SOURCES: PubMed, Scopus, Web of Science, PsychInfo, and SPORTDiscus were searched. Eligibility criteria for selecting studies: randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered (Aim 2), as were studies investigating the effects of hypoxia on cognition (Aim 1). RESULTS: In total, 18 studies met our inclusionary criteria for the systematic review, and 12 studies were meta-analyzed. Exposure to hypoxia impaired attentional ability (standardized mean difference [SMD = -0.4), executive function (SMD = -0.18), and memory function (SMD = -0.26) but not information processing (SMD = 0.27). Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement (SMD = 0.3, 95%CI: 0.14 - 0.45, I2 = 54%, p < 0.001). Various characteristics (e.g., age, cognitive task type, exercise type, exercise intensity, training type, and hypoxia level) moderated the effects of hypoxia and exercise on cognitive function. CONCLUSIONS: Exercise during exposure to hypoxia improves cognitive function. This association appears to be moderated by individual and exercise/hypoxia-related characteristics.

5.
Diabetes Care ; 43(6): 1336-1343, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32300048

RESUMO

OBJECTIVE: The objective of this study was to examine whether altered heart rate variability (HRV) could predict the risk of diabetes in Asians. RESEARCH DESIGN AND METHODS: A cohort study was conducted in 54,075 adults without diabetes who underwent 3-min HRV measurement during health checkups between 2011 and 2014 at Kangbuk Samsung Hospital. We analyzed the time domain (SD of the normal-to-normal interval [SDNN] and root mean square differences of successive normal-to-normal intervals [RMSSD]) and the frequency domain (total power, normalized low-frequency power [LF], and normalized high-frequency power [HF] and LF/HF ratio). We compared the risk of diabetes until 2017 according to tertiles of heart rate and HRV variables, with tertile 1 serving as the reference group. RESULTS: During 243,758.2 person-years, 1,369 subjects were diagnosed with diabetes. Both time and frequency domain variables were lower in the group with diabetes, with the exception of those with normalized LF and LF/HF ratio. In Cox analysis, as SDNN, RMSSD, and normalized HF tertiles increased, the risk of diabetes decreased (hazard ratios [95% CIs] of tertile 3: 0.81 [0.70-0.95], 0.76 [0.65-0.90], and 0.78 [0.67-0.91], respectively), whereas the risk of diabetes increased in the case of heart rate, normalized LF, and LF/HF ratio (hazard ratios [95% CIs] of tertile 3: 1.41 [1.21-1.65], 1.32 [1.13-1.53], and 1.31 [1.13-1.53), respectively) after adjusting for age, sex, BMI, smoking, drinking, systolic blood pressure, lipid level, CRP, and HOMA of insulin resistance. CONCLUSIONS: Abnormal HRV, especially decreased vagal activity and deviation in sympathovagal imbalance to sympathetic activity, might precede incident diabetes.

6.
Sci Rep ; 10(1): 3826, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32123241

RESUMO

Although self-rated health (SRH), a subjective measure of overall health status, associates with metabolic abnormalities, studies on the relationship between SRH and non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, are limited. In this study, we evaluated whether or not SRH predicts the risk of incident NAFLD. This cohort study was performed in a sample of 148,313 Korean adults free of ultrasound-diagnosed NAFLD at baseline with annual or biennial follow-up for a median of 3.7 years. SRH and NAFLD were measured at baseline and follow-up visits. NAFLD was determined based on the ultrasound-diagnosed fatty liver without excessive alcohol consumption or any other cause. Hazard ratios with 95% confidence intervals were estimated via a parametric proportional hazards model. During 522,696.1 person-years of follow-up, 23,855 individuals with new-onset NAFLD were identified (incidence rate, 45.6 per 1,000 person-years). After adjustments for possible confounders including total calorie intake, sleep duration, and depressive symptoms, the multivariate-adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing good, fair, and poor or very poor SRH to very good SRH were 1.06 (0.97-1.14), 1.18 (1.09-1.27), and 1.24 (1.13-1.37), respectively. This association of SRH with incident NAFLD remained significant after accounting for changes in SRH and confounders during follow-up and was similar across clinically relevant subgroups. In a large-scale cohort study of apparently healthy Korean adults, poor SRH was independently and positively associated with incident NAFLD risk, indicating a predictive role of SRH as a health measure in NAFLD.

7.
Endocrinol Metab (Seoul) ; 35(1): 165-176, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32207277

RESUMO

BACKGROUND: We evaluated the association of visceral-to-subcutaneous fat ratio (VSR) with nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis degree based on noninvasive serum fibrosis markers in the general population with NAFLD. METHODS: This is a cross-sectional study, in 7,465 Korean adults who underwent health screening examinations. NAFLD was defined as fatty liver detected on ultrasonography, and visceral and subcutaneous abdominal fat was measured using computed tomography. We predicted fibrosis based on the fibrosis-4 (FIB-4) score and aspartate aminotransferase-to-platelet ratio index (APRI) and categorized the risk for advanced fibrosis as low, indeterminate, or high. RESULTS: The multivariable-adjusted prevalence ratios for indeterminate to high risk of advanced fibrosis based on FIB-4, determined by comparing the second, third, and fourth quartiles with the first quartile of VSR, were 3.38 (95% confidence interval [CI], 0.64 to 17.97), 9.41 (95% CI, 1.97 to 45.01), and 19.34 (95% CI, 4.06 to 92.18), respectively. The multivariable-adjusted prevalence ratios for intermediate to high degree of fibrosis according to APRI also increased across VSR quartiles (5.04 [95% CI, 2.65 to 9.59], 7.51 [95% CI, 3.91 to 14.42], and 19.55 [95% CI, 9.97 to 38.34], respectively). High VSR was more strongly associated with the prevalence of NAFLD in nonobese subjects than in obese subjects, and the associations between VSR and intermediate to high probability of advanced fibrosis in NAFLD were stronger in obese subjects than in nonobese subjects. CONCLUSION: High VSR values predicted increased NAFLD risk and advanced fibrosis risk with NAFLD, and the predictive value of VSR for indeterminate to high risk of advanced fibrosis was higher in obese subjects than in nonobese subjects.

8.
Korean J Gastroenterol ; 75(3): 132-140, 2020 Mar 25.
Artigo em Coreano | MEDLINE | ID: mdl-32209801

RESUMO

Background/Aims: An association between obesity and erosive esophagitis has been reported, but the effects of sarcopenia and obesity on erosive esophagitis are unknown. This study examined the relationship between obesity, sarcopenia, sarcopenic obesity, and erosive esophagitis in a large population of asymptomatic men and women. Methods: This study analyzed 32,762 subjects who underwent a comprehensive health check-up, which included upper gastrointestinal endoscopy, from August 2006 to December 2011 by a cross-sectional study. Sarcopenia was defined as a decrease in the appendicular skeletal muscle mass (ASM)/body weight value of two SD or more below the normal means for a younger reference group. Results: The study was carried out on four groups according to obesity and sarcopenic status: normal, obesity, sarcopenic, and sarcopenic obese group. In a multivariable model, the risk of erosive esophagitis was higher in the obese (adjusted OR [aOR] 1.35, 95% CI 1.22-1.49), sarcopenic (aOR 2.12, 95% CI 1.40-3.19), and sarcopenic obese groups (aOR 1.54, 95% CI 1.27-1.87) than in the normal group. The risk of erosive esophagitis was higher in the sarcopenic and sarcopenic obese groups than the obese group; the ORs were 1.63 (95% CI 1.08-2.47) and 1.22 (95% CI 1.01-1.46), respectively. In dose-response analysis, increasing sarcopenia severity showed a positive and graded relationship with the overall, Los Angeles (LA)-B or higher grade, and LA-C erosive esophagitis. Conclusions: This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.

9.
J Health Psychol ; : 1359105320904769, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32022589

RESUMO

Rasch modeling was used to examine the 25-item Connor-Davidson Resilience Scale within adults (n = 410) in a weight management program. Rasch analysis assessed model-data fit, item difficulty and person's resilience level, an item-person map to evaluate relative distribution items and persons, and rating scale function. Four misfit items were identified and removed. Item difficulty ranged from 1.25 to 1.19 logits (higher logit values indicate more difficult items). Persons' resilience level had wide distribution (resilience = 2.27 ± 1.56 logits). Item difficulty levels did not adequately assess higher resilience levels. An improved inventory that measures a wider range of resilient behaviors would improve measurement quality.

10.
Sci Rep ; 10(1): 38, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31913326

RESUMO

Psychological stress may have adverse metabolic effects and induce unhealthy behaviors, but the role of stress in the development of non-alcoholic fatty liver disease (NAFLD) is largely unexplored. We investigated the association between perceived stress and the prevalence of NAFLD in a large sample of apparently healthy men and women. We performed a cross-sectional study of 171,321 adults who underwent health screening examination between 2011 and 2013 in one health screening center. Perceived stress was assessed using the short version of the Perceived Stress Inventory (PSI). NAFLD was assessed using ultrasonography in the absence of excessive alcohol use or any other identifiable cause of liver disease. The prevalence of NAFLD was 27.8%. In fully-adjusted multivariable models, the odds ratio (95% confidence intervals) for NAFLD comparing participants in the 5th quintile of PSI score (≥23) with those in the lowest quintile (<12) was 1.17 (1.11, 1.22), with a moderately increased prevalence of NALFD across quintiles of PSI score. The positive association between PSI score and NAFLD was observed in all subgroups analyzed, although the association was stronger in men compared to women (p interaction <0.001), and in obese compared to non-obese (p interaction 0.005). In this large study of apparently healthy men and women, higher perceived stress was independently associated with an increased prevalence of NAFLD, supporting a possible relationship between perceived stress and NAFLD. Prospective study is needed to elucidate mediating mechanisms to warrant stress management to reduce NAFLD.

11.
Clin Gastroenterol Hepatol ; 18(1): 205-215.e7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31085337

RESUMO

BACKGROUND & AIMS: We compared the associations of nonalcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (AFLD) with risk of incident hospitalization for liver and cardiovascular diseases. METHODS: We collected data from the Kangbuk Samsung Health Study on 218,030 men and women in Korea who underwent a health examination from 2011 through 2016. Fatty liver disease (FLD) was detected by ultrasound during the initial examination. The Fibrosis-4 index was used to identify individuals with liver fibrosis. Participants were followed up for as long as 5.9 years and data on hospitalizations for liver and cardiovascular diseases were collected. RESULTS: The prevalence of NAFLD was 22.0% and the prevalence of AFLD was 6.4%. Over a median follow-up period of 4.2 years, we observed 51 and 1097 incident cases of liver disease- or cardiovascular disease-related hospitalizations, respectively. After adjustment for potential confounders, the multivariable-adjusted hazard ratios for liver disease-related hospitalization, comparing NAFLD and AFLD with the reference category (no excessive alcohol intake and no FLD), were 1.73 (95% CI, 0.76-3.96) and 5.00 (95% CI, 2.12-11.83), respectively. The corresponding hazard ratios for cardiovascular disease hospitalization were 1.20 (95% CI, 1.02-1.40) and 1.08 (95% CI, 0.86-1.34), respectively. Among participants with FLD, the risk of liver disease-related hospitalization increased with high Fibrosis-4 index scores, whereas the risk of incident cardiovascular disease did not. CONCLUSIONS: In a large cohort study, we found an increased risk of liver disease-related hospitalizations for patients with NAFLD or AFLD, especially among those with Fibrosis-4 index scores. An increased risk of cardiovascular disease-associated hospitalization was observed in patients with NAFLD but not AFLD.

12.
Aust N Z J Psychiatry ; 54(2): 150-158, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31595770

RESUMO

OBJECTIVES: Subsyndromal depression is prevalent and associated with poor outcomes in late life, but its epidemiological characteristics have barely been investigated. The aim of this prospective cohort study is to compare the prevalence, incidence and risk factors of subsyndromal depression with those of syndromal depression including major and minor depressive disorders in community-dwelling elderly individuals. METHODS: In a nationwide community-based study of randomly sampled Korean elderly population aged 60 years or older (N = 6640), depression was assessed with standardized diagnostic interviews. At baseline and at 2-year and 4-year follow-ups, the authors diagnosed subsyndromal depression by the operational criteria and syndromal depression by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnostic criteria. Multivariate logistic regression analyses were conducted to identify the risk factors for incident depression. RESULTS: The age- and gender-adjusted prevalence rate of subsyndromal depression was 9.24% (95% confidence interval = [8.54, 9.93]), which was 2.4-fold higher than that of syndromal depression. The incidence rate of subsyndromal depression was 21.70 per 1000 person-years (95% confidence interval = [19.29, 24.12]), which was fivefold higher than that of syndromal depression. The prevalence to incidence ratio of subsyndromal depression was about half that of syndromal depression. The risk for subsyndromal depression was associated with female gender, low socioeconomic status, poor social support and poor sleep quality, while that of syndromal depression was associated with old age and less exercise. CONCLUSION: Subsyndromal depression should be validated as a clinical diagnostic entity, at least in late life, since it has epidemiological characteristics different from those of syndromal depression.

13.
J Clin Endocrinol Metab ; 105(3)2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545359

RESUMO

BACKGROUND: The benefit of weight loss for reducing cardiovascular disease (CVD) risk in metabolically healthy obese people is unknown. OBJECTIVES: We evaluated the association between weight change and incident subclinical carotid atherosclerosis (SCA) in metabolically healthy but overweight or obese subjects. METHODS: Cohort study of 3117 metabolically healthy overweight or obese adults who did not have any metabolic syndrome components or insulin resistance at baseline. SCA was assessed using carotid artery ultrasonography. The study outcome was the development of incident SCA among participants free of the disease at baseline. RESULTS: During 12 248 person-years of follow-up (median 3.42 years), 747 participants developed SCA. The proportions of participants with no reduction or increased weight, reduction in weight from 0.1% to 4.9%, and reduction in weight ≥ 5% during follow-up were 47.0%, 44.4%, and 8.6%, respectively. The fully-adjusted hazard ratios (HRs) for incident SCA in participants with a reduction in weight of 0.1% to 4.9% and ≥ 5% compared with those with no reduction or increased weight were 0.84 (95% CI, 0.72-0.98) and 0.66 (95% CI, 0.50-0.87), respectively. CONCLUSIONS: In a large cohort study of metabolically healthy but overweight or obese adult men and women, weight reduction was associated with a lower incidence of SCA. Our findings suggest that metabolically healthy overweight or obese subjects may benefit from weight reduction in terms of CVD risk.

14.
Gastric Cancer ; 23(3): 382-390, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31853749

RESUMO

BACKGROUND: Diabetes mellitus (DM) has been considered a potential risk factor for gastric cancer, but the evidence is conflicting. We evaluated the association of DM with incident gastric cancer in a large cohort of men and women with endoscopic assessment at baseline and during follow-up. METHODS: We performed a retrospective cohort study of 195,312 adult men and women who underwent upper endoscopy at baseline and during follow-up between 2003 and 2014. DM was defined as fasting serum glucose ≥ 126 mg/dL, self-reported history of DM or current use of antidiabetic medications. Gastric cancer was confirmed histologically. RESULTS: The prevalence of DM at baseline was 3.0% (n = 5774). Over 865,511 person-years of follow-up, 198 participants developed gastric cancer. The fully adjusted hazard ratio (HR) for incident gastric cancer comparing participants with and without DM at baseline was 1.76 [95% confidence interval (CI) 1.04-2.97; P = 0.033). When we evaluated DM as a time-varying covariate, the fully adjusted HR was 1.66 (95% CI 1.04-2.68; P = 0.036). The association between DM and incident gastric cancer did not differ by the presence of intestinal metaplasia (P for interaction = 0.61). CONCLUSIONS: In this large cohort with endoscopic follow-up, DM was independently associated with increased gastric cancer incidence. The increased risk was independent of mucosal atrophy and intestinal metaplasia and was consistent in participants with newly developed DM during follow-up. Patients with DM may require more intensive endoscopic follow-up for gastric cancer screening.

15.
Korean J Intern Med ; 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31671930

RESUMO

Background/Aims: Effect of proton pump inhibitor (PPI) use on the risk of hip fracture is controversial. This study aimed to clarify the association between PPI use and hip fracture risk using a large cohort. Methods: This study recruited participants from the nationwide cohort (n = 1,025,340). After exclusion of participants who had hip fractures or were aged less than 40 years during the baseline period (2002 to 2004), 371,806 participants were followed to 2013. Participants prescribed PPIs for more than 90 days during baseline period were defined as users. Fracture cases were defined when participants were hospitalized with claims of a hip fracture. Results: During 4,159,343 person-years of follow-up, fractures developed more often in PPI users than in nonusers (relative risk [RR], 1.787; 95% confidence interval [CI], 1.260 to 2.534; p = 0.002). The results persisted after adjusting for age, sex, and many drugs relevant to osteoporosis or influential in bone health. Furthermore, fracture risk associated with PPI use increased with duration of use (p trend < 0.001). The fully adjusted RRs of hip fracture development were 1.350 (95% CI, 1.203 to 1.515) for 1- to 90-day users, 1.487 (95% CI, 0.957 to 2.311) for 91- to 180-day users, and 1.771 (95% CI, 0.931 to 3.368) for > 180-day users. The positive association between PPI use and fracture was also confirmed in a subgroup with health screening data where further adjustment for body mass index, smoking status, alcohol consumption, and physical activity was available (adjusted RR, 2.025; 95% CI, 1.151 to 3.564, p = 0.014). Conclusions: PPI use is associated with hip fracture development.

16.
BMC Geriatr ; 19(1): 294, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666029

RESUMO

BACKGROUND: Subjective memory complaint (SMCs) is a common trait amongst older population. The subjective cognition about their memory could depend on objective cognition. The aim of the current study was to examine the interaction between subjective memory cognition (i.e., SMC) and objective cognition on cognitive functions in participants from older generation. METHODS: A total of 219 patients, 181 normal control (NC) patients and 38 patients with mild cognitive impairment (MCI), were examined through standardized and comprehensive clinical evaluation and neuropsychological assessment. The Subjective Memory Complaints Questionnaire was used to assess SMCs along with five cognitive tasks were used to evaluate cognitive decline over following areas: verbal memory, visuospatial memory, attention, fluency, and language. RESULTS: The results of 2 × 2 two-way analysis of variance (ANOVA) showed that there were significant interactions between SMCs and cognitive status (NC, MCI) on memory performances. NC with SMCs showed significantly lower performance in verbal memory and visuospatial memory compared to NCs without SMCs. Conversely, no effect was observed in the MCI group. CONCLUSION: There are interactions between subjective cognition (i.e., SMC) and objective cognition (i.e., cognitive status) on memory performances in older adults. The roles of SMCs on memory performances should be interpreted with older adults' objective cognitive status.

17.
Sci Rep ; 9(1): 14360, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31591475

RESUMO

Differentiating between inherited renal hypouricemia and transient hypouricemic status is challenging. Here, we aimed to describe the genetic background of hypouricemia patients using whole-exome sequencing (WES) and assess the feasibility for genetic diagnosis using two founder variants in primary screening. We selected all cases (N = 31) with extreme hypouricemia (<1.3 mg/dl) from a Korean urban cohort of 179,381 subjects without underlying conditions. WES and corresponding downstream analyses were performed for the discovery of rare causal variants for hypouricemia. Two known recessive variants within SLC22A12 (p.Trp258*, pArg90His) were identified in 24 out of 31 subjects (77.4%). In an independent cohort, we identified 50 individuals with hypouricemia and genotyped the p.Trp258* and p.Arg90His variants; 47 of the 50 (94%) hypouricemia cases were explained by only two mutations. Four novel coding variants in SLC22A12, p.Asn136Lys, p.Thr225Lys, p.Arg284Gln, and p.Glu429Lys, were additionally identified. In silico studies predict these as pathogenic variants. This is the first study to show the value of genetic diagnostic screening for hypouricemia in the clinical setting. Screening of just two ethnic-specific variants (p.Trp258* and p.Arg90His) identified 87.7% (71/81) of Korean patients with monogenic hypouricemia. Early genetic identification of constitutive hypouricemia may prevent acute kidney injury by avoidance of dehydration and excessive exercise.

18.
Int J Chron Obstruct Pulmon Dis ; 14: 2037-2046, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564851

RESUMO

Purpose: Chronic obstructive pulmonary disease (COPD) is associated with systemic inflammation. We investigated whether elevated baseline serum C-reactive protein (CRP) levels in healthy individuals are associated with the risk of incident COPD by smoking status. Patients and methods: This was a cohort study of 63,260 adult men and women who were older than 40 years, free of COPD at baseline, and underwent health screening from 2002 to 2016 with at least one follow-up visit through December 2016. We investigated the association between baseline high-sensitivity CRP (hsCRP) levels and incident COPD by smoking status, using flexible parametric proportional hazards models and pooled logistic regression analyses. Results: The multivariable-adjusted hazard ratio (95% confidence interval) comparing participants in the 90th to those in the 10th percentile of hsCRP was 1.19 (1.08, 1.31). The corresponding hazard ratio in never, former, and current smokers were 1.07 (0.89, 1.29), 1.22 (1.05, 1.42), and 1.22 (1.05, 1.41), respectively. The association between hsCRP levels and incident COPD had a similar dose-response pattern in former and current smokers, but not in never smokers. Conclusion: Higher baseline hsCRP is associated with an increased risk to develop COPD in ever smokers but not in never smokers.

19.
J Clin Med ; 8(10)2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31581520

RESUMO

We aimed to test the association between low-density lipoprotein cholesterol (LDL-C) and cardiovascular disease (CVD), cancer, and all-cause mortality in non-statin users. A total of 347,971 subjects in Kangbuk Samsung Health Study (KSHS.57.4% men, mean follow up: 5.64 ± 3.27 years) were tested. To validate these associations, we analyzed data from another cohort (Korean genome and epidemiology study, KoGES, 182,943 subjects). All subjects treated with any lipid-lowering therapy and who died during the first 3 years of follow up were excluded. Five groups were defined according to baseline LDL-C concentration (<70, 70-99, 100-129, 130-159, ≥160 mg/dL). A total of 2028 deaths occurred during follow-up in KSHS. The lowest LDL-C group (LDL < 70 mg/dL) had a higher risk of all-cause mortality (HR 1.95, 1.55-2.47), CVD mortality (HR 2.02, 1.11-3.64), and cancer mortality (HR 2.06, 1.46-2.90) compared to the reference group (LDL 120-139 mg/dL). In the validation cohort, 2338 deaths occurred during follow-up. The lowest LDL-C group (LDL < 70 mg/dL) had a higher risk of all-cause mortality (HR 1.81, 1.44-2.28) compared to the reference group. Low levels of LDL-C concentration are strongly and independently associated with increased risk of cancer, CVD, and all-cause mortality. These findings suggest that more attention is needed for subjects with no statin-induced decrease in LDL-C concentrations.

20.
Artigo em Inglês | MEDLINE | ID: mdl-31512278

RESUMO

BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is a multisystem disease associated with an increased risk of cardiovascular disease (CVD), diabetes, and chronic kidney disease. Indeed, CVD is the most common cause of death in NAFLD patients. This study aimed to evaluate the association between NAFLD and the risk of incident myocardial infarction. METHODS: This is a retrospective cohort study involving 111 492 adults over 40 years old without history of CVD, liver disease, or cancer at baseline who participated in a regular health screening exam between 2003 and 2013. Fatty liver was diagnosed by ultrasonography. RESULTS: During 725 706.9 person-years of follow-up, 183 participants developed myocardial infarction (incidence rate 0.3 cases per 1000 person-years). The age, sex, and year of visit-adjusted hazard ratio (HR) for incident myocardial infarction comparing participants with NAFLD with those without it was 2.14 (95% confidence interval 1.59, 2.89). This association remained significant in fully adjusted models (HR 1.54; 95% confidence interval 1.11, 2.14). Compared with participants without NAFLD, in participants with low NAFLD fibrosis score (NFS) (< -1.455) and with intermediate-to-high NFS (≥ -1.455), the fully adjusted HRs for incident myocardial infarction were 1.70 (1.22, 2.36) and 1.88 (1.24, 2.87), respectively. CONCLUSION: In this large cohort study, NAFLD was associated with an increased incidence of myocardial infarction independently of established risk factors. In addition, this association was similar in participants with and without evidence of more advanced NAFLD as indicated by the NFS. NAFLD patients may need to be carefully monitored and managed early to prevent myocardial infarction.

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