Bom Taeck Kim

2014 clinical practice guidelines for overweight and obesity in Korea.

The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index ≥25 kg/m2 in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5% to 10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity.

The influence of exogenous fat and water on lumbar spine bone mineral density in healthy volunteers.

Purpose Changes in human body composition can affect the accuracy of spine bone mineral density (BMD) measurements. The purpose of this study was to evaluate whether fat and water in the soft tissue of the abdomen influence lumbar spine BMD measurements obtained using dual energy X-ray absorptiometry (DXA). Materials and Methods Duplicate BMD measurements were carried out on healthy volunteers (10 men and 10 women) and the Hologic anthropomorphic spine phantom had on the same day before and after placement of following 3 materials in the abdominal area: lard 900 g, 1.5 cm thick; oil 1.4 liters in a vinyl bag; and water 1.2 liters in a vinyl bag. Results In the case of human participants, following the placement of exogenous water to mimic extracellular fluid (ECF), there was a significant decrease in lumbar spine BMD (-0.012 g/cm2, p=0.006), whereas the placement of exogenous lard and oil to mimic abdominal fat produced a slight increase in lumbar spine BMD (0.006 g/cm2, p=0.301; 0.008 g/cm2, p=0.250, respectively). The average percentage of lumbar spine BMD change with and without exogenous lard, oil, and water showed increase of 0.51%, and 0.67%, and decrease of 1.02%, respectively. Using the phantom, BMD decreased with the placement of both lard (-0.002 g/cm2, p=0.699) and water (-0.006 g/cm2, p=0.153); however, there was no difference in BMD after oil placement. Conclusion These results suggest that in cases where changes in fat and ECF volume are similar, ECF exerts a greater influence than fat on DXA lumbar BMD measurements.

Different Waist Circumferences, Different Metabolic Risks in Koreans

Objective: We investigated the difference in metabolic parameters by waist circumference (WC) and body mass index (BMI) in a population of Korean men and women. Method: We collected data on 69,535 Korean men and women and performed a cross-sectional analysis of the data. Study subjects were grouped by BMI and WC. We measured metabolic parameters for each group and compared the differences in the metabolic abnormalities. Subjects were grouped as follows: normal group (NG; normal WC and normal BMI); centrally obese group (COG; high WC and normal BMI); generally obese group (GOG; normal WC and high BMI); and combined obese group (COM; high WC and high BMI). Results: Subjects in the COM group showed more metabolic parameter abnormalities in comparison to the other groups. In men, triglyceride (TG) and fasting blood glucose (FBG) levels were higher in the COG than in the GOG. Correspondingly, total cholesterol (TC), TG, and FBG levels were higher in the female COG than in the female GOG. In addition, the mean numbers of abnormal metabolic parameters in the COG were higher than in the GOG for both men and women. More men and women developed metabolic syndrome in the COG (39.1% in men, 33.0% in women) than in the GOG (9.7% in men, 7.8% in women). Conclusion: Among Koreans, the COG had more metabolic abnormalities and metabolic syndrome than the GOG.

cAMP/PKA Agonist Restores the Fasting-Induced Down-Regulation of nNOS Expression in the Paraventricular Nucleus

Gene expression of neuronal nitric oxide synthase (nNOS) changes in the hypothalamic paraventricular nucleus (PVN) depending on feeding conditions, which is decreased during food deprivation and restored by refeeding, and phosphorylated cAMP response element binding protein (pCREB) was suggested to play a role in its regulation. This study was conducted to examine if the fasting-induced down-regulation of the PVN-nNOS expression is restored by activation of cAMP-dependent protein kinase A (cAMP/PKA) pathway. Freely moving rats received intracerebroventricular (icv) injection of cAMP/PKA activator Sp-cAMP (40 nmol) or vehicle (sterilized saline) following 48 h of food deprivation. One hour after drug injections, rats were transcardially perfused with 4% paraformaldehyde, and the PVN tissues were processed for nNOS or pCREB immunohistochemistry. Sp-cAMP significantly increased not only nNOS but also pCREB immunoreactivities in the PVN of food deprived rats. Fasting-induced down-regulation of the PVN-nNOS was restored by 1 h after the icv Sp-cAMP. Results suggest that cAMP/PKA pathway may mediate the regulation of the PVN-nNOS expression depending on different feeding conditions.