Byoung-Jin Park

Relationship of neutrophil-lymphocyte ratio with arterial stiffness and coronary calcium score

BACKGROUND Emerging evidence suggests that the neutrophil/lymphocyte ratio (NLR) may be a useful marker of cardiovascular disease and a more powerful predictor than any other leukocyte subtypes. We determined whether NLR is related to atherosclerosis measured by brachial-ankle pulse wave velocity (baPWV) and coronary calcium score (CCS). METHODS We examined the relationship of NLR with baPWV and CCS in 849 Korean adults in a health examination program. The odds ratios for a high baPWV or a high CCS were calculated using multivariate logistic regression analysis across NLR quartiles. A high baPWV was defined as >1500 cm/s (>75th percentile) and a high CCS was defined as over 100 (at least moderate atherosclerotic plaque burden). RESULTS The ORs (95% CIs) for a high baPWV by NLR quartiles were 1.00, 0.76 (0.41-1.39), 1.08 (0.61-1.90), and 2.12 (1.18-3.83) after adjusting for confounding variables. Similarly, positive associations between NLR and a high CCS were also observed after adjusting for the same co-variables. CONCLUSION A higher NLR was independently associated with arterial stiffness and CCS. Accordingly, a higher NLR may be a useful additional measure in assessing cardiovascular risks in clinical practice.

Association between screen time and metabolic syndrome in children and adolescents in Korea: The 2005 Korean National Health and Nutrition Examination Survey

OBJECTIVE To examine the association between screen time and the metabolic syndrome (MetS) in a nationally representative sample of children and adolescents. METHODS A cross-sectional survey was conducted in 845 children and adolescents (10-18 years of age) from the 2005 Korean National Health and Nutrition Examination Surveys (KNHANES). Screen time was defined as TV time+computer time. The definition of MetS was based on the modified criteria used by the National Cholesterol Education Program-Adult Treatment Panel III, using age- and sex-specific values for some of the criteria. RESULTS In comparison with the children and adolescents in the ST-Q1 (<or=16h for a week), the odds ratio (95% confidence interval) for MetS of subjects in the ST-Q4 (>or=35h for a week) was 2.23 (95% CI, 1.02-4.86) after the adjustment for age, household income, and residence area. Moreover, screen time for a weekend day was also strongly associated with the prevalence of MetS, but not for a weekday. CONCLUSIONS Screen time was independently associated with an increased prevalence risk of MetS in children and adolescents in Korea. Public health intervention to reduce screen time particularly for a weekend may be needed to prevent pediatric MetS in Korea.

Association between resting heart rate and arterial stiffness in Korean adults

BACKGROUND Higher resting heart rate, a simple and useful indicator of autonomic balance and metabolic rate, has emerged as an independent predictor for atherosclerotic cardiovascular disease. AIM To determine the association between resting heart rate and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). METHODS We examined the association between resting heart rate and baPWV in 641 Korean adults (366 men, 275 women) in a health examination program. A high baPWV was defined as greater than 1450 cm/s (>75th percentile). The odds ratios for high baPWVs were calculated using multivariable logistic regression analysis after adjusting for confounding variables across heart rate quartiles (Q1<or=56, Q2=57-62, Q3=63-68, Q4>or=69 beats/min). RESULTS Age-adjusted baPWV mean values increased gradually with heart rate quartile (Q1=1281, Q2=1285, Q3=1354, Q4=1416 cm/s). The odds ratios (95% confidence intervals) for high baPWVs in each heart rate quartile were 1.00, 1.28 (0.57-2.86), 2.63 (1.20-5.79) and 3.66 (1.66-8.05), respectively, after adjusting for age, sex, smoking status, alcohol intake, exercise, body mass index, hypertension medication, diabetes medication, hyperlipidaemia medication, mean arterial blood pressure, fasting plasma glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, white blood cell count, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase and uric acid. CONCLUSION These findings indicate that a higher resting heart rate is independently associated with arterial stiffness. Accordingly, early detection of increased resting heart rate is important for preservation of arterial function and assessment of cardiovascular risk.

Trends in Prevalence of Overweight and Obesity in Korean Adults, 1998–2009: The Korean National Health and Nutrition Examination Survey

Background Although obesity is increasing worldwide and becoming a major public health problem, some countries report a trend toward stabilization. We investigated prevalence trends in overweight/obesity and obesity among Korean adults during a 12-year period. Methods This study was based on the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998), II (2001), III (2005), and IV (2007–2009). The χ2 and ANOVA tests were used to compare the prevalence and mean values for age and BMI, respectively. P-values for trends were determined by linear and logistic regression analyses, with KNHANES phase as the continuous variable. Results The prevalences of overweight/obesity in KNHANES I through IV were 50.8%, 57.4%, 62.5%, and 62.6%, respectively, among men (P for trend = 0.002, β = 0.021) and 47.3%, 51.9%, 50.0%, and 48.9% among women (P for trend = 0.017, β = −0.015). The respective prevalences of obesity were 26.0%, 32.4%, 35.1%, and 36.3% among men (P for trend = 0.006, β = 0.018) and 26.5%, 29.3%, 28.0%, and 27.6% among women (P for trend = 0.143, β = −0.008). During the same period, the respective prevalences of grade 2 obesity (BMI ≥30 kg/m2) were 1.7%, 2.8%, 3.6%, and 3.8% among men (P for trend = 0.075, β = 0.005) and 3.0%, 3.5%, 3.4%, and 4.0% among women (P for trend = 0.398, β = 0.003). Conclusions The prevalences of overweight/obesity and obesity showed an upward trend among men during the 12-year period, whereas the prevalence of overweight/obesity slightly decreased among women from 2001.

The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: A focus on gender differences

Metabolic syndrome (MS) is becoming globally prevalent and it is clinically important because of its association with type 2 diabetes and cardiovascular disease, and some cancers. Recently, platelet count has been linked to insulin resistance and MS in addition to being a marker of hemostasis. Also, mean platelet volume (MPV) has been known to represent platelet activity. Platelet counts and MPV are modified by various biosocial and lifestyle factors such as race, age, gender, smoking habit, alcohol consumption, and physical activity. Thus, the direction and magnitude of this association may differ by gender. In this regard, proper interpretion of platelet counts and MPV by gender could be important in the people with MS. We examined the relationship between platelet counts, MPV, and MS through gender-specific analyses for 3827 Korean adults (2169 men and 1658 women) in a health examination program. In women, platelet counts were significantly higher in subjects with MS compared to in those without MS (p < 0.001), whereas MPV was significantly lower (p = 0.001). However, no such trend was observed in men. Multiple regression analyses also showed that MS is positively associated with platelet counts and inversely associated with MPV, independently of confounding variables only in women. The results suggest that platelet counts and MPV might be a surrogate marker associated with clustered MS in women.

Chronic liver inflammation: Clinical implications beyond alcoholic liver disease

Chronic alcohol exposure can lead to alcoholic liver disease, including hepatitis, cirrhosis and hepatocellular carcinoma, and chronic inflammation can simultaneously cause systemic medical illness. Recent evidence suggests that alcoholic liver disease is a predictor for liver-related diseases, cardiovascular disease, immunologic disease, and bone disease. Chronic inflammation in alcoholic liver disease is mediated by a direct inflammatory cascade from the alcohol detoxification process and an indirect inflammatory cascade in response to gut microflora-derived lipopolysaccharides (LPS). The pathophysiology of alcoholic liver disease and its related systemic illness is characterized by oxidative stress, activation of the immune cascade, and gut-liver interactions. Integrative therapeutic strategies for alcoholic liver disease include abstaining from alcohol consumption; general anti-inflammatories such as glucocorticoid, pentoxifylline, and tumour necrosis factor-α antagonist; antioxidants such as N- acetylcysteine; gut microflora and LPS modulators such as rifaximin and/or probiotics. This review focuses on the impact of chronic liver inflammation on systemic health problems and several potential therapeutic targets.

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

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

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

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

Reading nutrition labels is associated with a lower risk of metabolic syndrome in Korean adults: the 2007-2008 Korean NHANES.

BACKGROUND AND AIMS Several studies demonstrated that reading nutrition labels was associated with healthier food choices, despite some controversy. This study investigated the association between the use of nutrition labels and metabolic syndrome (MetS) in Korean adults. METHODS AND RESULTS This cross-sectional study included 7756 individuals who participated in the 2007-2009 Korean National Health and Nutrition Examination Survey (KNHANES). A self-reported questionnaire was used to determine participants awareness of nutrition labels. Modified Asian criteria based on a harmonizing definition of MetS were adopted. Individuals in the group that read nutrition labels (the Reading Group) were youngest and leanest, but their daily caloric intake fell between that of the group that did not read nutrition labels (the Non-Reading Group) and the group that did not know about them (the Not-Knowing Group). The prevalence of MetS was 16.8% in the Reading Group, 27.2% in the Non-Reading Group, and 47.3% in the Not-Knowing Group. In comparison to participants in the Reading Group, the odds ratios (95% confidence interval) for MetS in the participants in the Non-Reading Group and Not-Knowing Group were 1.85 (1.60-2.14) and 4.44 (3.79-5.20), respectively, when not adjusted. The relationship between the use of nutrition labels and MetS remained statistically significant even after adjusting for covariates such as age, sex and socioeconomic status including household income and education level [1.27 (1.05-1.53) in the Non-Reading Group and 1.34 (1.05-1.70) in the Not-Knowing Group]. CONCLUSION Reading nutrition labels appeared to be associated with a lower prevalence of MetS in a nationally representative sample of Korean adults.

Effects of Korean Red Ginseng on Cardiovascular Risks in Subjects with Metabolic Syndrome: a Double-blind Randomized Controlled Study.

Background This study investigated the effects of Korean red ginseng (KRG) supplementation on metabolic parameters, inflammatory markers, and arterial stiffness in subjects with metabolic syndrome. Methods We performed a randomized, double-blind, placebo-controlled, single-center study in 60 subjects who were not taking drugs that could affect metabolic and vascular functions. Subjects were randomized into either a KRG (4.5 g/d) group or a placebo group for a 12-week study. We collected anthropometric measurements, blood for laboratory testing, and brachial-ankle pulse wave velocity (baPWV) at the initial (week 0) and final (week 12) visits. Results A total of 48 subjects successfully completed the study protocol. Oral administration of KRG did not significantly affect blood pressure, oxidative or inflammatory markers, or baPWV. Conclusion We found no evidence that KRG had an effect on blood pressure, lipid profile, oxidized low density lipoprotein, fasting blood glucose, or arterial stiffness in subjects with metabolic syndrome. These findings warrant subsequent longer-term prospective clinical investigations with a larger population. Trial Registration ClinicalTrials.gov Identifier: NCT00976274