Publications by authors named "Ju-Mi Lee"

27 Publications

  • Page 1 of 1

Incidence Hypertension and Fasting Blood Glucose from Real-World Data: Retrospective Cohort for 7-Years Follow-Up.

Int J Environ Res Public Health 2021 Feb 21;18(4). Epub 2021 Feb 21.

Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju-si 38066, Korea.

This retrospective cohort study was done to investigate the incidence of hypertension and its relation to the fasting blood glucose level in Korea. The eligible non-hypertensive subjects ( = 3,396,187) among the National Health Insurance Service-National Health Screening (NHIS-HEALS) examinees ( = 10,644,911) in 2009 were followed up until 2015. A Cox proportional hazards regression was used to estimate the risk of the high blood glucose level for the incident hypertension while controlling for covariates' confounding effect. The cumulative incidence rate was 10.6% for seven years (11.6% in men and 8.3% in women). The incidence density was 1474.8 per 100,000 person-years. High fasting blood glucose (adjusted Hazard Ratio (aHR), 1.836; 95% confidence interval (CI), 1.810 to 1.862), prediabetes (aHR, 1.249; 95% CI, 1.237 to 1.260), a history of diabetes mellitus (aHR, 1.635; 95% CI, 1.605 to 1.666), high triglyceride (aHR, 1.292; 95% CI, 1.280 to 1.303), a history of dyslipidemia (aHR, 1.279; 95% CI, 1.253 to 1.305) and prehypertension group (aHR, 1.964; 95% CI, 1.948 to 1.979) were significantly related to the incident hypertension after adjusting for covariates. Among real-world data in Korea, high blood glucose level was the independent risk factor for developing hypertension.
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http://dx.doi.org/10.3390/ijerph18042085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924835PMC
February 2021

Risk Factors Influencing the Occurrence and Severity of Symptomatic Dry Eye Syndrome: A Cross-sectional Study.

Ophthalmic Epidemiol 2021 Jan 31:1-7. Epub 2021 Jan 31.

Department of Preventive Medicine, Yonsei University College of Medicine , Seoul, Republic of Korea.

: We aimed to investigate the prevalence and risk factors of dry eye syndrome (DES) among a population-based cohort study.: This cross-sectional study was conducted on 475 subjects (184 men and 291 women) enrolled in the Study Group for Environmental Eye Disease at July 2013. Using the ocular surface disease index (OSDI), we measured the DES severity and defined DES as OSDI score ≥13. Current symptoms of DES and possible risk factors such as body mass index, occupations, comorbidities, exercise, smoking and drinking status were assessed by multivariate logistic regression.: Prevalence of DES was significantly higher in women (52.6%) than in men (41.9%) ( < .001). Compared to white-collar workers, blue-collar workers and unemployed persons showed significantly higher DES prevalence and severity. Compared to those with low BMI (<23.0 kg/m), people with extremely high BMI (≥30.0 kg/m) had significantly higher odds ratio (OR) of having DES after fully adjusted for sex, age, hypertension, diabetes, menopausal status, hormone replacement therapy, occupation, and lifestyle factors (OR: 2.83, 95% confidence interval: 1.04-7.71).: We found some novel factors which have been unknown to the relationship with DES through the five years observation of the cohort. The positive associations of unemployment status, blue-collar work, alcohol habit, and obesity with DES suggests a person's comprehensive condition, not individual factors, contribute significantly in developing DES. Further studies will be helpful to understand the underlying mechanisms.
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http://dx.doi.org/10.1080/09286586.2021.1879172DOI Listing
January 2021

A Clofazimine-Containing Regimen Confers Improved Treatment Outcomes in Macrophages and in a Murine Model of Chronic Progressive Pulmonary Infection Caused by the Complex.

Front Microbiol 2020 14;11:626216. Epub 2021 Jan 14.

Department of Microbiology, Institute for Immunology and Immunological Disease, Brain Korea 21 Program for Leading Universities and Students (PLUS) Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.

Treatment outcomes using the standard regimen (a macrolide, ethambutol, and rifampicin) for complex-pulmonary disease (MAC-PD) remain unsatisfactory. Thus, improved treatment regimens for MAC-PD are required. Clofazimine has recently been revisited as an effective drug against mycobacterial infection. We performed a comparison between the standard regimen and an alternative regimen (replacing the rifampicin of the standard regimen with clofazimine) based on the intracellular anti-MAC activities of the individual drugs in a murine model of chronic progressive MAC-pulmonary infection (MAC-PI). The intracellular anti-MAC activities of the individual drugs and their combinations in murine bone marrow-derived macrophages (BMDMs) were determined. The treatment efficacies of the standard and clofazimine-containing regimens were evaluated in mice chronically infected with by initiating 2- and 4-week treatment at 8 weeks post-infection. Bacterial loads in the lung, spleen, and liver were assessed along with lung inflammation. Insufficient intracellular anti-MAC activity of rifampicin in BMDMs was recorded despite its low minimum inhibitory concentrations (MICs), whereas optimal intracellular killing activity against all tested MAC strains was achieved with clofazimine. Compared to the standard regimen, the clofazimine-containing regimen significantly reduced CFUs in all organs and achieved marked reductions in lung inflammation. The replacement of rifampicin with clofazimine in the treatment regimen resulted in more favorable outcomes in an animal model of chronic progressive MAC-PI. Intriguingly, 2 weeks of treatment with the clofazimine-containing regimen reduced bacterial loads more effectively than 4 weeks of treatment with the standard regimen in -infected mice. Thus, the clofazimine-containing regimen also had a treatment-shortening effect.
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http://dx.doi.org/10.3389/fmicb.2020.626216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841306PMC
January 2021

The association of cortisol curve features with incident diabetes among whites and African Americans: The CARDIA study.

Psychoneuroendocrinology 2021 Jan 4;123:105041. Epub 2020 Nov 4.

The Ohio State University College of Medicine, Columbus, OH, United States. Electronic address:

Introduction: A flatter diurnal cortisol curve has been associated with incident diabetes among older white adults. However, this relationship has not been examined among middle-aged individuals or African Americans [AA]. We analyzed the longitudinal association of baseline diurnal cortisol curve features with incident diabetes over a 10 year period in a cohort of AA and white participants who were, on average, 40 years old.

Methods: Salivary cortisol was collected immediately post-awakening, then subsequently 45 min, 2.5 h, 8 h, and 12 h later, as well as at bedtime. Cortisol curve features included wake-up cortisol; cortisol awakening response (CAR); early, late, and overall decline slopes; bedtime cortisol; and 16 -h area under the curve (AUC). Salivary cortisol (nmol/L) was log-transformed due to positively skewed distributions. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dL or taking diabetes medication. Logistic regression models were used to investigate the association of log-transformed cortisol curve features with incident diabetes. The analysis was stratified by race and adjusted for age, sex, education, depressive symptoms, smoking status, beta-blocker and steroid medication use and BMI.

Results: Among 376 AA and 333 white participants (mean age 40 years), 67 incident diabetes cases occurred over 10 years. After full adjustment for additional covariates, a 1-unit log increase in CAR was associated with a 53 % lower odds of incident diabetes among whites (Odds Ratio [OR] 0.47, 95 % CI: 0.24, 0.90). A 1-SD increase in late decline slope was associated with a 416 % higher odds of incident diabetes among whites (OR 5.16, 95 % CI: 1.32, 20.20). There were no significant associations in AAs.

Conclusion: A robust CAR and flatter late decline slope are associated with lower and higher odds of incident diabetes, respectively, among younger to middle-aged whites and may provide a future target for diabetes prevention in this population.
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http://dx.doi.org/10.1016/j.psyneuen.2020.105041DOI Listing
January 2021

Metabolic biomarkers and long-term blood pressure variability in military young male adults.

World J Clin Cases 2020 Jun;8(11):2246-2254

Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan.

Background: Metabolic syndrome is a cluster of cardiovascular risk factors, including central obesity, high blood pressure, elevated plasma glucose, reduced high-density lipoprotein and elevated triglyceride levels.

Aim: To investigate the relationship between metabolic biomarkers and long-term blood pressure variability (BPV) in young males.

Methods: A cohort of 1112 healthy military males aged 18-40 years from the cardiorespiratory fitness and hospitalization events in armed forces study in eastern Taiwan was prospectively included. The following metabolic biomarkers were used: Waist circumference, serum uric acid (SUA), triglycerides, high density lipoprotein, triglycerides, and fasting glycose. BPV was assessed by average real variability (ARV) and standard deviation (SD) across 4 clinic visits during the study period (2012-14, 2014-15, 2015-16, and 2016-18). Multivariable linear regression analysis was used to determine the association after adjusting for age, body mass index, systolic and diastolic blood pressure (SBP and DBP), lipid profiles, physical activity, alcohol intake and tobacco smoking status.

Results: In the unadjusted model, waist circumference was significantly and positively correlated with ARV and SD [β (standard errors) = 0.16 (0.049) and 0.22 (0.065), respectively], as was SUA [β = 0.022 (0.009) and 0.038 (0.012), respectively]. High-density lipoprotein was negatively correlated with ARV [β = -0.13 (0.063)]. There were no associations with the other metabolic biomarkers. In contrast, only SUA was significantly correlated with SD and SD [β = 0.019 (0.011) and 0.027 (0.010), respectively] in the adjusted model.

Conclusion: Our findings showed that of traditional metabolic biomarkers, SUA had the strongest positive correlation with long-term systolic and diastolic BPV in young male adults, and the clinical relevance needs further investigation.
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http://dx.doi.org/10.12998/wjcc.v8.i11.2246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281053PMC
June 2020

Are Traditional Holidays (Seollal and Chuseok) Harmful for Cardiac Arrest?

Authors:
Ju Mi Lee

Korean Circ J 2019 Oct 20;49(10):957-959. Epub 2019 Jun 20.

Department of Preventive Medicine, Eulji College of Medicine, Daejeon, Korea.

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http://dx.doi.org/10.4070/kcj.2019.0159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753027PMC
October 2019

Triglyceride to high density lipoprotein cholesterol ratio among adolescents is associated with adult hypertension: the Kangwha study.

Lipids Health Dis 2018 Sep 10;17(1):212. Epub 2018 Sep 10.

Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Background: The triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio associated with hypertension in adults. However, whether the TG/HDL-C ratio in adolescents predicts future hypertension remains unclear. Here, we evaluated the prospective association between the TG/HDL-C ratio in adolescents and hypertension in early adulthood.

Methods: The Kangwha Study is an ongoing prospective cohort study that has tracked the blood pressure of first grade elementary school students since 1986. We followed up 272 participants who completed health examinations at the age of 16 and 35 years. We excluded 27 participants with adolescent hypertension, defined as those whose blood pressures were above the age- and sex-specific 95th percentiles of the Korean population, and finally analysed 245 participants. We defined high and low TG/HDL-C ratio groups according to the age- and sex-specific 75th percentile of the TG/HDL-C ratio (1.04 for boys and 0.81 for girls) of the Korean population. Adult hypertension was defined by a systolic/diastolic blood pressure ≥ 140/90 mmHg or by taking antihypertensive medication at the age of 35 years. Logistic regression analysis was performed to evaluate the association between adolescent TG/HDL-C ratio and adult hypertension after adjusting for age at follow-up, sex, baseline systolic blood pressure, waist circumference, and total cholesterol and fasting glucose levels.

Results: During the 20-year follow-up, 11 (18.3%) individuals developed hypertension in the high TG/HDL-C ratio group and 10 (5.4%) individuals developed hypertension in the low TG/HDL-C ratio group. The adjusted odds ratio for incident hypertension in the high TG/HDL-C ratio group, compared with the low TG/HDL-C ratio group, was 3.40 (95% confidence interval 1.24-9.31).

Conclusions: High TG/HDL-C ratio in adolescence is associated with hypertension in early adulthood.
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http://dx.doi.org/10.1186/s12944-018-0861-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131866PMC
September 2018

Aminotransferase levels, body mass index, and the risk of diabetes: a prospective cohort study.

Ann Epidemiol 2018 10 19;28(10):675-680.e6. Epub 2018 Jul 19.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

Purpose: To investigate whether the relationship between body mass index (BMI) and incident diabetes is modified by different alanine or aspartate aminotransferases (ALT or AST) levels.

Methods: We carried out an analysis of 6484 participants aged 40 years or older using data from the Korean Genome Epidemiology Study. The serum aminotransferase levels were stratified into low and high groups according to the median values and classified into three groups: both low, either high, and both high. To assess the association between BMI and incident diabetes according to the serum aminotransferase levels, multiple logistic regression models were used.

Results: In participants with high levels of both ALT and AST, compared with the first BMI quartile, the adjusted odds ratios for incident diabetes of the second, third, and fourth BMI quartiles were 1.72 (95% confidence interval, 0.84-3.55), 2.19 (1.11-4.33), and 3.08 (1.60-5.90), respectively (P trend < .001). In participants with either high ALT or AST, the adjusted odds ratios were 3.58 (1.23-10.41), 2.65 (0.90-7.76), and 5.28 (1.86-15.02), respectively (P trend = .005). However, in participants with both low ALT and AST levels, high BMI was not independently associated with the risk of incident diabetes.

Conclusions: There was a strong association between BMI and incident diabetes among individuals with high aminotransferase levels, whereas no association was observed among those with low aminotransferase levels.
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http://dx.doi.org/10.1016/j.annepidem.2018.07.009DOI Listing
October 2018

Serum high-density lipoprotein cholesterol concentration and functional state: The Korean Urban Rural Elderly (KURE) Study.

Arch Gerontol Geriatr 2017 Jul 7;71:115-121. Epub 2017 Apr 7.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

Background: Functional state and cholesterol metabolism are important for older adults; however, this association has not been fully investigated among community-dwelling older adults. Thus, we investigated the association of HDL cholesterol with multiple functional state measures in an elderly Korean population.

Methods: This cross-sectional analysis included 3514 participants, aged 65 years or older, who participated in baseline health assessment for the Korean Urban Rural Elderly cohort study from 2012 to 2015. HDL cholesterol concentration was analyzed using both continuous and categorical variables. Functional state was assessed by the mini-mental state examination (MMSE), activities of daily living (ADL) scale, instrumental activities of daily living (IADL) scale, timed up-and go (TUG) test, and chair-rise test (CRT). Multiple logistic regression models were used to investigate independent association between HDL cholesterol and functional state, after adjusting for sex, age, body mass index, systolic blood pressure, fasting glucose, lipid-lowering drug, history of cancer and cardiovascular disease, and health behaviors.

Results: HDL cholesterol concentration was significantly associated with MMSE, ADL, IADL, TUG, and CRT in the unadjusted model. After adjustment for covariates, the association remained significant for MMSE (standardized β=0.059, p=0.001), ADL (standardized β=-0.053, p=0.004), and CRT (standardized β=-0.037, p=0.037). In fully-adjusted model, Participants who had a lower HDL concentration (<40mg/dL) showed significantly increased odds for having MMSE decline (OR 1.451, 95% CI 1.119-1.883) and ADL dependency (OR 2.251, 95% CI 1.119-4.526), compared reference group (≥60mg/dL).

Conclusions: Higher HDL cholesterol concentration was associated with better functional state among Korean older adults.
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http://dx.doi.org/10.1016/j.archger.2017.04.002DOI Listing
July 2017

Association between Mean Corpuscular Hemoglobin Concentration and Future Depressive Symptoms in Women.

Tohoku J Exp Med 2017 03;241(3):209-217

Department of Preventive Medicine, Yonsei University College of Medicine.

Insufficient hemoglobin and depression share several symptoms and often occur in the same patients. Here, we sought to clarify their relationship by investigating two indices of oxygenation at the tissue level: mean corpuscular hemoglobin concentration (MCHC) and hemoglobin level. We hypothesized that MCHC would be more informative than hemoglobin levels. This prospective, longitudinal, community-based study included 337 participants (108 men and 229 women; age range, 38-87 years) who received evaluations of MCHC, hemoglobin levels and depressive symptom scores (DSS) during baseline and follow-up examinations, which were performed in 2008-2011 and 2010-2012, respectively. MCHC and hemoglobin levels were measured as part of complete blood counts, while DSS was evaluated using the Beck Depression Inventory. Associations were analyzed using linear regression. We found a statistically significant association between baseline MCHC and follow-up DSS (β = -0.69, p = 0.026), which remained statistically significant after controlling for potential confounders (β = -0.71, p = 0.011). Further, when we analyzed the relationship separately for men and women, we observed that it remained stable for women before (β = -1.00, p = 0.014) and after (β = -1.09, p = 0.003) adjusting for confounders. The stable association indicates that MCHC may be superior to hemoglobin level as a prognostic factor for future depressive symptoms in women. MCHC is easy to measure and low MCHC is usually treatable. Therefore, screening and intervention efforts could be targeted at women with low MCHC, who appear to have elevated risks of developing depressive symptoms.
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http://dx.doi.org/10.1620/tjem.241.209DOI Listing
March 2017

Association between changes in systolic blood pressure and incident diabetes in a community-based cohort study in Korea.

Hypertens Res 2017 Jul 2;40(7):710-716. Epub 2017 Mar 2.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

An association between hypertension and diabetes has been reported; however, the temporal relationship of blood pressure changes and incident diabetes has not been fully investigated in the general population. We examined whether increasing blood pressure is associated with the risk of developing diabetes among community-dwelling Korean adults. This study included 2225 participants (859 men and 1366 women) aged 27-87 years from the Korean Genome Epidemiology Study. The participants were free of diabetes and cardiovascular disease at baseline. Incident diabetes was defined as fasting blood glucose⩾126 mg dl or hemoglobin a1c ⩾6.5% (48 mmol mol) at follow-up examination and/or a physician's diagnosis of diabetes during the follow-up period. The effects of the baseline level and change in blood pressure on the risk of incident diabetes were assessed by multivariate logistic regression analysis. During the mean follow-up of 2.6 years, new-onset diabetes was observed in 5.0% (43/859) of the men and 3.4% (47/1366) of the women. In the multivariate model, the baseline systolic blood pressure was not significantly associated with incident diabetes (adjusted odds ratio 0.93 per 10 mmHg, P=0.747). However, an increase in systolic blood pressure during the follow-up period was independently associated with incident diabetes (adjusted odds ratio 5.53 per 5 mmHg per year, P=0.002) after adjusting for the baseline blood pressure and other potential confounders. Increasing blood pressure, but not a high baseline blood pressure, was independently associated with the risk of diabetes in Korean adults.
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http://dx.doi.org/10.1038/hr.2017.21DOI Listing
July 2017

Sleep duration and chronic kidney disease: The Korean Genome and Epidemiology Study (KoGES)-Kangwha study.

Korean J Intern Med 2017 Mar 15;32(2):323-334. Epub 2017 Feb 15.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

Background/aims: Sleep duration affects health in various ways. The objective of this study was to investigate the associations of sleep duration with chronic kidney disease (CKD) in a Korean adult population.

Methods: This cross-sectional analysis was conducted for total of 1,360 participants who completed baseline health examinations for the Korean Genome and Epidemiology Study-Kangwha study in 2010 to 2011. Sleep habits were measured by an interviewer-assisted questionnaire. Sleep duration was calculated based on the number of hours per day participants had slept over the past 1 year. CKD was defined as either proteinuria or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m. Multiple logistic regression models were applied to examine associations between sleep duration and CKD.

Results: Women with very long sleep duration (≥ 9 hours/day) were at significantly increased odds for having high serum creatinine (odds ratio [OR], 2.936; 95% confidence interval [CI], 1.176 to 7.326), low eGFR (OR, 3.320; 95% CI, 1.372 to 8.034), and CKD (OR, 3.112; 95% CI, 1.315 to 7.363), compared those with a typical sleep duration (7 to < 8 hours/day), after adjusting for sociodemographic status, socioeconomic status, health behaviors, comorbidities, and sleep quality. Among women, for every 1 hour increase in sleep duration per day, there was a 24.6% increase in the presence of CKD (OR, 1.246; 95% CI, 1.019 to 1.523). However, among men, sleep duration was not significantly associated with CKD.

Conclusions: Very long sleep duration was independently associated with a higher prevalence of CKD among Korean women. Gender may influence this association.
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http://dx.doi.org/10.3904/kjim.2015.400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339469PMC
March 2017

Comparative Analysis of Clinical Samples Showing Weak Serum Reaction on AutoVue System Causing ABO Blood Typing Discrepancies.

Ann Lab Med 2017 Mar;37(2):117-123

Department of Laboratory Medicine, School of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

Background: ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing.

Methods: In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol.

Results: The AutoVue system confirmed ABO blood typing of 12,816 samples (97.7%), and these results were concordant with those of the manual method. The remaining 297 samples (2.3%) showed discrepant results in the AutoVue system and were confirmed by the manual method. The discrepant results involved weak serum reactions (<2+ reaction grade), extra serum reactions, samples from patients who had received stem cell transplants, ABO subgroups, and specific system error messages. Among the 98 samples showing ≤1+ reaction grade in the AutoVue system, 70 samples (71.4%) showed a normal serum reaction (≥2+ reaction grade) with the manual method, and 28 samples (28.6%) showed weak serum reaction in both methods.

Conclusions: ABO blood tying of 97.7% samples could be confirmed by the AutoVue system and a small proportion (2.3%) needed to be re-evaluated by the manual method. Samples with a 2+ reaction grade in serum typing do not need to be evaluated manually, while those with ≤1+ reaction grade do.
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http://dx.doi.org/10.3343/alm.2017.37.2.117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203988PMC
March 2017

Cross-sectional and longitudinal association between hemoglobin concentration and hypertension: A population-based cohort study.

Medicine (Baltimore) 2016 Oct;95(41):e5041

Department of Public Health, Yonsei University Graduate School Department of Preventive Medicine Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea.

We investigated the cross-sectional and longitudinal associations between hemoglobin concentration and hypertension in a Korean population.Between 2006 and 2013, we examined 4899 participants with mean age of 56.6 years (range 35-88 years) from a rural community. We excluded 298 participants with a history of myocardial infarction or stroke and 264 participants with very low hemoglobin levels (men: <13.3 g/dL; women: <11.6 g/dL). Finally, we performed a cross-sectional analysis on 1629 men and 2708 women. Longitudinal associations were evaluated in 654 men and 1099 women, after excluding 2584 people with hypertension at baseline and those who did not participate in follow-up examinations. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive treatment.The mean hemoglobin level was significantly higher in people with hypertension than in those without hypertension (P = 0.002 for men, P = 0.006 for women). On cross-sectional analysis, the odds ratio (95% confidence interval) for hypertension per 1 standard deviation increase in hemoglobin concentration (1.2 g/dL) was 1.11 (1.05-1.18) before adjustment and 1.20 (1.09-1.32) after adjusting for age, sex, body mass index, kidney markers, lifestyle factors, and comorbidities. On longitudinal analysis, the relative risk (95% confidence interval) for incident hypertension per 1 standard deviation increase in hemoglobin concentration was 1.09 (0.96-1.23) before adjustment and 0.91 (0.78-1.08) after adjusting for age, sex, body mass index, lifestyle factors, baseline blood pressure, baseline comorbidities, and baseline kidney markers.This study suggests that hemoglobin per se does not cause hypertension development.
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http://dx.doi.org/10.1097/MD.0000000000005041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072940PMC
October 2016

Hemostatic Markers and Long-Term Risk of Intracerebral Hemorrhage in Postmenopausal Women.

J Stroke Cerebrovasc Dis 2016 Jul 7;25(7):1639-1643. Epub 2016 Apr 7.

Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address:

Background: Known risk factors for intracerebral hemorrhage (ICH) include age, hypertension, smoking, alcohol intake, and anticoagulant use. Some previous reports have indicated that hemostatic factors measured many years before the onset of ICH might predict the later occurrence of ICH. The objective of this analysis was to test whether selected hemostatic factors measured years before the onset of ICH could identify patients at higher risk for future ICH.

Methods: We performed a nested case-control study within the Women's Health Initiative (WHI) cohort. Postmenopausal women aged 50-79 years (mean 68) at baseline (1993-1998) were enrolled at 40 Clinical Centers in the United States and followed for adjudicated ICH for a mean of 11.4 years. ICH cases (N = 75) and controls (N = 75) were matched on age, ethnicity, blood pressure, anticoagulant use, and treated hypertension. Stored blood samples from the baseline WHI examination were tested for von Willebrand factor (vWF), a disintegrin-like and metalloprotease domain with thrombospondin type-1 motif, number 13 (ADAMTS13), tissue plasminogen activator (t-PA), and urokinase plasminogen activator (u-PA). Platelet count, white blood cell count, and hemoglobin concentration were also measured.

Results: Mean baseline levels of vWF (1.03 and .95 U/mL), ADAMTS13 (1.0 and 1.1 µg/mL), vWF : ADAMTS13 ratio (.99 and .92), t-PA (14.75 and 14.80 IU/mL), and u-PA (.09 and .10 IU/mL) were not significantly different by case-control status. Significant differences were also not identified for platelet count, hemoglobin, white blood count, or reported alcohol use.

Conclusion: None of the 4 baseline hemostatic factors nor the platelet count was predictive of future ICH risk in this long-term study of older postmenopausal women.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.03.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912397PMC
July 2016

Associations of cortisol/testosterone and cortisol/sex hormone-binding globulin ratios with atherosclerosis in middle-age women.

Atherosclerosis 2016 May 22;248:203-9. Epub 2016 Mar 22.

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address:

Background And Aims: The cortisol/testosterone (C/T) ratio has been hypothesized to be a better predictor of atherosclerosis than cortisol alone. No study has assessed whether the C/T and C/sex hormone-binding globulin (SHBG) ratios are associated with atherosclerosis in a U.S. population sample.

Methods: This substudy included 367 women who had both cortisol from year 15 and testosterone and SHBG at year 16 of the Coronary Artery Risk Development in Young Adults study, an ongoing observational cohort in the United States. Of these, intima-media thickness (IMT) was available at follow-up year 20 in 339 (n = 332 with measurement at carotid bulb), and 303 were free of prevalent coronary artery calcium (CAC) at year 15. Area under the curve (AUC) of salivary cortisol was available in 302 individuals. Ratios of AUCs of cortisol to total testosterone, free testosterone, and SHBG were categorized into tertiles. Associations with CAC and IMT were assessed by regression models adjusted for age, race, body mass index, systolic blood pressure, menopause, oral contraceptive use, diabetes, alcohol, and smoking.

Results: Only the highest tertile of the AUC/free testosterone ratio was positively associated with carotid bulb IMT (β = 0.088, P = 0.006). This tertile was also positively associated with new onset CAC between year 15 and 25 (OR 3.45, 95% CI 1.18-10.06). Tertiles of cortisol or testosterone alone were not associated with new onset CAC.

Conclusion: AUC/Free testosterone ratio may be more associated with atherosclerosis in women than either indicator alone. The ratio may serve as a suitable biomarker of cortisol-linked stress.
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http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819892PMC
May 2016

Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study.

Arch Gerontol Geriatr 2016 May-Jun;64:51-8. Epub 2016 Jan 13.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Epidemiologic studies have demonstrated that elevated serum uric acid concentration is an independent risk factor for metabolic syndrome. However, few studies have focused on elderly populations. Thus, we investigated the association of serum uric acid concentration with metabolic syndrome in community-dwelling elderly Koreans.

Methods: This cross-sectional analysis included 2940 participants (986 men and 1954 women) aged 65 years or older who participated in a baseline health assessment for the Korean Urban Rural Elderly cohort study from 2012 to 2014. Serum uric acid concentration was analyzed using both continuous and dichotomous variables. Hyperuricemia was defined as a uric acid concentration ≥7.0 mg/dL in men and ≥6.0 mg/dL in women. Metabolic syndrome was defined according to the 2009 harmonizing definition. Multiple logistic regression models were used to investigate independent association between serum uric acid and metabolic syndrome, after adjusting for age, body mass index, LDL cholesterol, glycated hemoglobin, blood urea nitrogen, estimated glomerular filtration rate health behaviors, and medications.

Results: Prevalence of metabolic syndrome and its components increased significantly according to uric acid concentration in both sexes. The adjusted odds ratios for having metabolic syndrome per 1.0mg/dL higher uric acid concentration were 1.16 (95% CI: 1.03-1.31) in men and 1.27 (95% CI: 1.13-1.42) in women. Hyperuricemia was also associated with metabolic syndrome, with adjusted odds ratios of 1.71 (95% CI: 1.11-2.63) in men and 1.55 (95% CI: 1.05-2.29) in women.

Conclusions: Elevated serum uric acid concentration was independently associated with an increased prevalence of metabolic syndrome in community-dwelling elderly Koreans.
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http://dx.doi.org/10.1016/j.archger.2016.01.005DOI Listing
September 2016

Active and Passive Smoking and Serum Total Bilirubin in a Rural Korean Population.

Nicotine Tob Res 2016 May 7;18(5):572-9. Epub 2015 Nov 7.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;

Introduction: Serum bilirubin is an endogenous antioxidant biomarker and its low level is a potential risk factor for smoking related health disorders. This study investigated the association of cigarette smoke with serum total bilirubin among Koreans.

Methods: Between 2006 and 2011, we examined 4899 Korean adults living in a rural community. After excluding 38 participants with serum bilirubin more than 2mg/dL, 75 participants who did not report their smoking status or who had liver or bile duct disorders, and 711 participants with liver enzymes exceeding the upper reference values, we performed a cross-sectional analysis on 4075 participants. Participants were classified into four groups: never-smokers without secondhand smoke exposure (SHSE), never-smokers with SHSE, former smokers, and active smokers. Serum total bilirubin concentration was measured using the enzyme method.

Results: Compared to never-smokers without SHSE, never-smokers with SHSE (β = -0.025 mg/dL), former smokers (β = -0.049 mg/dL), and active smokers (β = -0.149 mg/dL) had significantly lower serum bilirubin even after adjusting for demographic factors, study year, alanine aminotransferase, gamma-glutamyl transferase, hemoglobin, lifestyle factors, and chronic diseases. A sex-stratified analysis indicated that for men, former smokers and active smokers were significantly associated with having lower bilirubin when compared to never-smokers without SHSE. However, for women, never-smokers with SHSE and active smokers were significantly associated with having lower bilirubin when compared to never-smokers without SHSE.

Conclusion: Our findings suggest that both active and passive cigarette smoking are associated with low serum bilirubin among Korean adults.

Implications: Our results suggest that not only active smoking but also passive smoking including SHSE can have an influence on decreasing serum bilirubin levels. With this different point of view, our study supports efforts to create smoke-free environments in order to foster more favorable serum bilirubin profiles, which may improve endothelial function and reduce the risk of cardiovascular disease.
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http://dx.doi.org/10.1093/ntr/ntv251DOI Listing
May 2016

Association between environmental tobacco smoke and depression among Korean women.

BMJ Open 2015 Jun 22;5(6):e007131. Epub 2015 Jun 22.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objective: To evaluate the association between environmental tobacco smoke (ETS) exposure and depression among Korean women.

Methods: Between 2008 and 2011, we examined 731 men and 1249 women (aged 39-85 years) for the Korean Genome and Epidemiology Study (KoGES)-Kangwha. Among 1208 never-smoking women, we excluded two women taking antidepressants and five women who did not complete the Beck Depression Inventory (BDI). Therefore, we performed a cross-sectional analysis on 1201 women. ETS exposure was assessed using a self-reported questionnaire, and was classified into three groups: no exposure, occasional exposure and regular exposure. Depression was assessed using the BDI score, which ranged from 0 to 63, and the presence of depression was defined as a BDI score ≥ 10.

Results: Women exposed to ETS were more likely to have depression than those without ETS exposure (p=0.019). When BDI was analysed as a continuous variable, women exposed to ETS had significantly higher BDI scores after full adjustment (overall exposure: β=1.36, p=0.013; occasional exposure: β=1.15, p=0.063; regular exposure: β=1.90, p=0.039). ETS exposure was significantly associated with depression in a dose-response manner even after adjusting for age, body mass index, menopause, socioeconomic status, lifestyle and prevalent chronic diseases. The adjusted OR for depression (95% CI) was 1.72 (1.25 to 2.37) for overall ETS exposure, 1.56 (1.09 to 2.24) for occasional exposure and 2.19 (1.30 to 3.69) for regular exposure, when compared to no exposure.

Conclusions: Exposure to ETS was associated with depression among middle aged and elderly Korean women.
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http://dx.doi.org/10.1136/bmjopen-2014-007131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480025PMC
June 2015

Association between C reactive protein level and depressive symptoms in an elderly Korean population: Korean Social Life, Health and Aging Project.

BMJ Open 2015 Feb 23;5(2):e006429. Epub 2015 Feb 23.

Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

Objective: The relationship between inflammatory markers and depressive symptoms has been reported inconsistently. Moreover, there were only a few studies conducted in an Asian population. The purpose of this study was to examine the association between C reactive protein (CRP) and depressive symptoms in an elderly Korean population.

Design, Setting And Participants: This study used data from the Korean Social Life, Health and Aging Project Health Examination Cohort, which started in 2011. Among participants aged 60 or over recruited from a rural community, 569 (224 men and 345 women) without a history of stroke, angina pectoris, myocardial infarction or CRP≥20 mg/L were employed for cross-sectional analyses. As a marker of systemic inflammation, CRP was measured. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) scale. Multiple linear regression analysis was used to investigate the relationship between CRP and depressive symptoms.

Results: In men, CRP levels had significant associations with depressive symptoms before (β=0.420, p=0.010) and after (β=0.336, p=0.025) adjusting for age, body mass index, systolic blood pressure, number of comorbidities, smoking status, alcohol intake, marital status, education and sleep duration. However, in women, the association between CRP and depressive symptoms was not significant before (p=0.250) and after (p=0.256) adjustment.

Conclusions: Our findings suggest that elevated CRP levels are independently associated with the presence of depressive symptoms in elderly Korean men.
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http://dx.doi.org/10.1136/bmjopen-2014-006429DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342593PMC
February 2015

Association between stressful life events and resting heart rate.

BMC Psychol 2014 8;2:29. Epub 2014 Sep 8.

Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu 120-752, Seoul, Republic of Korea.

Background: Despite a diverse literature, the association between stress and various cardiovascular conditions remains controversial. Moreover, a direct association between stressful life events (SLEs) and heart rate (HR) have not been fully investigated. This study evaluated the association between SLEs and resting HR in middle-aged Koreans.

Methods: A cross-sectional analysis was conducted for 1,703 men and 2,730 women aged 27-87 years from the community-based Korean Genome and Epidemiology Study-Kanghwa study. All participants completed a baseline health examination. The life experience survey questionnaire was administered to measure SLEs experienced during the past 3 months. Resting blood pressure and HR were measured twice over a 5 minute interval. If the difference in blood pressure was more than 10 mmHg, then a third blood pressure and HR measurement was taken after 5 minutes of rest. The average of the last two measurements was used for analysis. The association between SLEs and HR was assessed by correlation and multiple linear regression analysis.

Results: Compared with people with no SLEs (mean HR of 67.30 beats/min), HR was significantly lower in those who experienced one (mean HR of 65.64 beats/min, p = 0.002), two (mean HR of 63.73 beats/min, p < 0.001), and 3+ SLEs (mean HR of 64.17 beats/min, p < 0.001). This association was observed even after adjustment for sex, age, body mass index, hypertension treatment, oral contraceptive use, postmenopausal hormone therapy, thyroid disease, liver disease, cigarette smoking use, alcohol drinking use, and blood urea nitrogen to creatinine ratio. Compared with people with no SLEs, those with 1, 2, and 3+ SLEs had a lower resting HR by 1.485 (p = 0.005), 3.718 (p < 0.001), and 3.176 (p < 0.001), respectively.

Conclusion: Our findings suggest that the experience of a recent SLEs are associated with a lower resting HR in Korean adults. Although further investigation is required, people who have experienced recent SLEs and have a lower HR than usual may need attention for their stress level.
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http://dx.doi.org/10.1186/s40359-014-0029-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306127PMC
January 2015

Urban-rural differences explain the association between serum 25-hydroxyvitamin D level and insulin resistance in Korea.

Nutrients 2014 Dec 11;6(12):5806-18. Epub 2014 Dec 11.

Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul 120-752, Korea.

An increasing number of studies report associations between low serum 25-hydroxyvitamin D [25(OH)D] level and insulin resistance; however, whether low vitamin D levels directly contribute to increased insulin resistance is unclear. We investigated the impact of residential area on the association between 25(OH)D and insulin resistance in elderly Koreans. Using data from the Korean Urban Rural Elderly study, we conducted cross-sectional analyses in 1628 participants (505 men and 1123 women). Serum 25(OH)D was analyzed as both continuous and categorized variables. Homeostasis model assessment for insulin resistance (HOMA-IR) was calculated using fasting blood glucose and insulin levels. In men, 25(OH)D level was inversely associated with HOMA-IR (standardized β = -0.133, p < 0.001) after adjustment for age, body mass index, waist circumference, smoking, alcohol intake, exercise, and study year. However, we noted significant urban-rural differences in 25(OH)D level (43.4 versus 65.6 nmol/L; p < 0.001) and HOMA-IR (1.2 versus 0.8 mmol · pmol/L2; p < 0.001). When we additionally adjusted for residential area, the association between 25(OH)D and HOMA-IR was attenuated (standardized β = -0.063, p = 0.115). In women, the association between 25(OH)D and HOMA-IR was not significant before or after adjustment for residential area. Environmental or lifestyle differences in urban and rural areas may largely explain the inverse association between serum 25(OH)D and insulin resistance.
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http://dx.doi.org/10.3390/nu6125806DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277000PMC
December 2014

Serum 25-hydroxyvitamin D and insulin resistance in apparently healthy adolescents.

PLoS One 2014 29;9(7):e103108. Epub 2014 Jul 29.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.

Purpose: Vitamin D deficiency is a common condition that is associated with diabetes and insulin resistance. However, the association between vitamin D and insulin resistance has not been fully studied, especially in the general adolescent population. Therefore, we assessed the association between serum 25-hydroxyvitamin D [25(OH)D] level and insulin resistance among apparently healthy Korean adolescents.

Methods: A total of 260 (135 male and 125 female) adolescents in a rural high school were assessed for serum 25(OH)D, fasting plasma glucose, and insulin. All of the participants were aged 15 to 16 years old, and without known hypertension or diabetes. Serum 25(OH)D was analyzed both as a continuous and categorical variable in association with insulin resistance. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Increased insulin resistance was operationally defined as a HOMA-IR value higher than the sex-specific 75th percentile.

Results: In male adolescents, every 10 ng/ml decrease in 25(OH)D level was associated with a 0.25 unit increase in HOMA-IR (p = 0.003) after adjusting for age and BMI. Compared to those in the highest quartile, male adolescents in the lowest 25(OH)D quartile were at significantly higher risk for insulin resistance: unadjusted odds ratio 4.06 (95% CI, 1.26 to 13.07); age and BMI adjusted odds ratio 3.59 (95% CI, 1.03 to 12.57). However, 25(OH)D level, either in continuous or categorical measure, was not significantly associated with insulin resistance among female adolescents.

Conclusions: This study suggests that serum 25(OH)D level may be inversely associated with insulin resistance in healthy male adolescents.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0103108PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114462PMC
November 2015

The korean social life, health and aging project-health examination cohort.

Epidemiol Health 2014 13;36:e2014003. Epub 2014 May 13.

Department of Sociology, Yonsei University College of Social Sciences, Seoul, Korea.

The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr).

The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr).
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http://dx.doi.org/10.4178/epih/e2014003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030701PMC
May 2014

The Korean urban rural elderly cohort study: study design and protocol.

BMC Geriatr 2014 Mar 19;14:33. Epub 2014 Mar 19.

Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea.

Background: Korea is one of the fastest aging countries and is expected to become a super-aged society within 12 years. The Korean Urban Rural Elderly (KURE) study was developed to evaluate the epidemiological characteristics and establish the prevention and management of major disorders of the elderly in Korea.

Methods/design: The KURE study is a community-based prospective cohort study on health, aging, and common geriatric disorders of Korean elderly persons aged at least 65 years. To construct a cohort reflecting both urban and rural areas, we selected 2 representative communities in the country. To establish multidisciplinary approaches to geriatric health, this study was performed by researchers in the divisions of geriatrics, preventive medicine, endocrinology, and sociology. The baseline examinations began in 2012; the study will follow more than 4,000 elderly Koreans over 10 years. The first and second follow-up health examinations will be performed every 4 years. Every 2 years after each health examination, inter-assessment interview will be conducted to improve participant retention.

Discussion: The KURE study will provide longitudinal epidemiologic data on health, aging, and common geriatric disorders of the elderly in Korea. This is a comprehensive, multidisciplinary study of the elderly with respect to biological, physical, socio-economic, and environmental factors. The results of this study will contribute to improve public health and welfare policies for the aging society in Korea.
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http://dx.doi.org/10.1186/1471-2318-14-33DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995180PMC
March 2014

Association between serum uric acid level and metabolic syndrome.

J Prev Med Public Health 2012 May 31;45(3):181-7. Epub 2012 May 31.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

Objectives: Serum uric acid levels have been reported to be associated with a variety of cardiovascular conditions. However, the direct association between uric acid levels and metabolic syndrome remains controversial. Thus, we evaluated the association of serum uric acid levels and metabolic syndrome in a community-based cohort study in Korea.

Methods: We performed cross-sectional analysis of baseline data of 889 males and 1491 females (aged 38 to 87) who participated in baseline examinations of the Korean Genome and Epidemiology Study: Kanghwa study. Blood samples were collected after at least an 8 hour fast. Uric acid quartiles were defined as follows: <4.8, 4.8-<5.6, 5.6-<6.5, ≥6.5 mg/dL in males; and <3.8, 3.8-<4.3, 4.3-<5.1, ≥5.1 mg/dL in females. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III Criteria with adjusted waist circumference cutoffs (90 cm for males; 80 cm for females). The association between serum uric acid quartiles and metabolic syndrome was assessed using multivariate logistic regression.

Results: The odds ratio for having metabolic syndrome in the highest versus lowest quartiles of serum uric acid levels was 2.67 (95% confidence interval [CI], 1.60 to 4.46) in males and 2.14 (95% CI, 1.50 to 3.05) in females after adjusting for age, smoking, alcohol intake, body mass index, total cholesterol, HbA1c, albumin, γ-glutamyltransferase, blood urea nitrogen, and log C-reactive protein. The number of metabolic abnormalities also increased gradually with increasing serum uric acid levels (adjusted p for trend < 0.001 in both sexes).

Conclusions: Higher serum uric acid levels are positively associated with the presence of metabolic syndrome in Korean males and females.
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http://dx.doi.org/10.3961/jpmph.2012.45.3.181DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374968PMC
May 2012

The association between serum albumin levels and metabolic syndrome in a rural population of Korea.

J Prev Med Public Health 2012 Mar 31;45(2):98-104. Epub 2012 Mar 31.

Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

Objectives: A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults.

Methods: This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value (≥90 cm for men and ≥85 cm for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis.

Results: Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men.

Conclusions: These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.
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http://dx.doi.org/10.3961/jpmph.2012.45.2.98DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324721PMC
March 2012