Duck-Joo Lee

Prevalence of Sarcopenia and Sarcopenic Obesity in the Korean Population Based on the Fourth Korean National Health and Nutritional Examination Surveys

BACKGROUND Sarcopenia is an important factor of functional impairment related to aging. This study is conducted to investigate the prevalence of sarcopenia and sarcopenic obesity in Korean population. METHODS Representative Korean men (4,486) and women (5,999) aged 20 years or older were analyzed from the Fourth Korean National Health and Nutritional Examination Surveys. Sarcopenia was classified into Class I defined relative skeletal muscle mass loss within 1-2 SD of the gender-specific mean for healthy young adults and Class II below 2 SD. Relative skeletal muscle mass was represented by the appendicular skeletal muscle mass adjusted by height and body weight. Sarcopenic obesity was considered present in Class II sarcopenic participants whose waist circumference was more than or equal to 90 cm for men and more than or equal to 85 cm for women, respectively. RESULTS The prevalence of Class II sarcopenia in the Korean elderly population was 12.4% for men and 0.1% for women by height-adjusted definition and 9.7% for men and 11.8% for women by weight-adjusted definition. The prevalence of sarcopenic obesity was 7.6% for men and 9.1% for women by weight-adjusted definition but nearly zero for men and women by height-adjusted definition. The prevalence of sarcopenia increased with age for men but for women only when applied with weight-adjusted definition. CONCLUSIONS The prevalence of sarcopenia and sarcopenic obesity differs by gender and definition criteria. The height-adjusted definition may tend to underestimate the prevalence of sarcopenia and sarcopenic obesity, especially in women.

Total testosterone and sex hormone-binding globulin are associated with metabolic syndrome independent of age and body mass index in Korean men.

OBJECTIVE The purpose of this study is to investigate the relationship between sex hormones and metabolic syndrome independent of age and BMI in Korean men. STUDY DESIGN We conducted a cross-sectional study with data from a health promotion center during the period from March 2007 to February 2010. 2172 Korean men aged 21-79 were enrolled. Total testosterone, sex hormone-binding globulin (SHBG), high density lipoprotein (HDL) cholesterol, triglyceride (TG), and glucose were assessed with overnight fasting serum samples. MAIN OUTCOME MEASURES Sex hormones were divided into quartiles; odds ratios for metabolic syndrome and each component were analyzed. RESULTS Total testosterone showed negative associations with waist circumference (WC), fasting glucose, TG, blood pressure and body mass index (BMI), and a positive relationship with HDL cholesterol (P for trend <0.001, respectively). SHBG was negatively associated with WC, fasting glucose, TG, and BMI, and positively associated with total testosterone and age. Comparing with the highest quartile, odds ratios of lowest quartile of total testosterone and SHBG for metabolic syndrome were 3.01 (95% CI, 2.11-4.28) and 6.34 (95% CI, 2.29-17.58), respectively, after adjusting for age, smoking status, alcohol intake, exercise, and BMI. Total testosterone was significantly associated with each metabolic component and SHBG was associated with glucose and TG after adjustment for age, smoking status, alcohol intake, and BMI. Calculated free testosterone had no significant relationship with metabolic syndrome or its components. CONCLUSION Total testosterone and SHBG are negatively associated with prevalence of metabolic syndrome independent of age and BMI in Korean men.

Effect of sunlight exposure on serum 25-hydroxyvitamin d concentration in women with vitamin d deficiency: using ambulatory lux meter and sunlight exposure questionnaire.

Background Vitamin D is an important factor in human health. Yet, vitamin D deficiency is very common. We aimed to confirm serum 25-hydroxyvitamin D (25OHD) concentration change after sunlight exposure and to elucidate the relationship between the amount of sunlight exposure and serum 25OHD level change by ambulatory lux meter and sunlight exposure questionnaire. Methods Twenty healthy young women were enrolled. They were educated to obtain 20 minutes of sunlight exposure during weekdays from October to November, 2010, during which they were to wear an ambulatory lux meter on an arm. All subjects completed a one-week recall sunlight exposure questionnaire at the end of the study. Before and after sunlight exposure, serum 25OHD level was measured. Results Mean pre-exposure serum 25OHD concentration was 11.01 ng/mL. The mean change of pre- and post-exposure 25OHD level was -0.62 ng/mL, but it was not statistically significant. The mean personal sunlight exposure recorded by ambulatory lux meter, 292.6 lux/s, showed no significant relationship with average change of 25OHD and average weekly sunlight exposure score, 11.9, calculated by the sunlight exposure questionnaire. However, the mean change of serum 25OHD level and weekly sunlight exposure score showed significant negative correlation (r = -0.469, P = 0.037). Conclusion Change of serum 25OHD concentration after four weeks of sunlight exposure was not statistically significant in women with vitamin D deficiency. However, serum 25OHD concentration change was significantly negatively correlated with the sunlight exposure score by the questionnaire.

Women with Fibromyalgia Have Lower Levels of Calcium, Magnesium, Iron and Manganese in Hair Mineral Analysis

Little is known about hair mineral status in fibromyalgia patients. This study evaluated the characteristics of hair minerals in female patients with fibromyalgia compared with a healthy reference group. Forty-four female patients diagnosed with fibromyalgia according to the American College of Rheumatology criteria were enrolled as the case group. Ageand body mass index-matched data were obtained from 122 control subjects enrolled during visit for a regular health check-up. Hair minerals were analyzed and compared between the two groups. The mean age was 43.7 yr. General characteristics were not different between the two groups. Fibromyalgia patients showed a significantly lower level of calcium (775 µg/g vs 1,093 µg/g), magnesium (52 µg/g vs 72 µg/g), iron (5.9 µg/g vs 7.1 µg/g), copper (28.3 µg/g vs 40.2 µg/g) and manganese (140 ng/g vs 190 ng/g). Calcium, magnesium, iron, and manganese were loaded in the same factor using factor analysis; the mean of this factor was significantly lower in fibromyalgia group in multivariate analysis with adjustment for potential confounders. In conclusion, the concentrations of calcium, magnesium, iron, and manganese in the hair of female patients with fibromyalgia are lower than of controls, even after adjustment of potential confounders.

Vitamin K supplement along with vitamin D and calcium reduced serum concentration of undercarboxylated osteocalcin while increasing bone mineral density in Korean postmenopausal women over sixty-years-old.

There are inconsistent findings on the effects of vitamin K on bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC). The present intervention study evaluated the effect in subjects over 60-yr-old. The vitamin K group (vitamin K + vitamin D + calcium supplement; 15 mg of vitamin K2 [menatetrenone] three times daily, 400 IU of vitamin D once a day, and 315 mg of calcium twice daily) and the control group (vitamin D + calcium supplement) were randomly assigned. During the six months of treatment, seventy eight women participated (38 in the vitamin K group and 40 in the control group) and 45 women completed the study. The baseline characteristics of study participants did not differ between the vitamin K and the control groups. In a per protocol analysis after 6 months, L3 bone mineral density has increased statistically significantly in the vitamin K group compared to the control group (0.01 ± 0.03 g/cm2 vs -0.008 ± 0.04 g/cm2, P = 0.049). UcOC concentration was also significantly decreased in the vitamin K group (-1.6 ± 1.6 ng/dL vs -0.4 ± 1.1 ng/dL, P = 0.008). In conclusion, addition of vitamin K to vitamin D and calcium supplements in the postmenopausal Korean women increase the L3 BMD and reduce the UcOC concentration.

Whole body vibration effects on body composition in the postmenopausal korean obese women: pilot study.

Background Whole body vibration (WBV) confers a continuous vibration stimuli to the body. While some reports have described the effects of WBV on bone mineral density, muscle mass, muscle power, study of WBV effects on body composition in postmenopausal women is rare. The aim of this pilot study was to examine the effect of WBV on the changes of body weight and body composition in postmenopausal women. Methods Fifteen postmenopausal healthy and obese women who were on staff of one university hospital staff located in Suwon, Korea were voluntarily recruited. Inclusion criteria were age over 50 years, and body mass index (BMI) ≥25 kg/m2. WBV group training was performed in 10 minute sessions twice weekly for 8 weeks. Before and after training, anthropometric measurements and body composition analysis were performed. Results Weight (-1.18 ± 1.61 kg), BMI (-0.49 ± 0.66 kg/m2), waist circumference (-2.34 ± 2.48 cm) and muscle mass (-0.54 ± 0.59 kg) decreased significantly the 8 week intervention. Decrease of muscle mass was correlated with weight (r = 0.621, P = 0.013), BMI (r = 0.596, P = 0.019) and percent body fat (r = -0.518, P = 0.048). Linear regression analysis revealed that the changes of muscle mass had negative relationship with percent body fat change and a positive relationship with body weight changes. Conclusion WBV might display a weak but positive effect on body weight and waist circumference reduction in healthy postmenopausal obese women. However, attention must be given to avoid a decrease of muscle mass.

Serum gamma-glutamyltransferase concentration correlates with Framingham risk score in Koreans.

Gamma-glutamyltransferase (GGT) is a novel coronary artery disease (CAD) risk factor, but its use as an independent factor for CAD risk prediction remains unclear in Asian population. This study examined the association between serum GGT concentration and Framingham risk score (FRS) in the Korean population. This cross-sectional study was performed on 30,710 Koreans. Besides FRS, body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid and high sensitive C-reactive protein data were used. The study subjects were grouped into quartiles according to the levels of GGT. Analyses relating GGT to FRS ≥ 20% utilized multiple confounders adjusted logistic regression. Positive correlations were established between log-transformed GGT concentration and FRS (r = 0.38; P < 0.001). Increasing the quartile of serum GGT concentration was significantly associated with linear increasing trends in FRS (P-trend < 0.001). Compared to the lowest baseline GGT category, age-gender adjusted odd ratios for FRS ≥ 20% were significantly increased from the lowest to highest GGT quartiles; these results remained significantly after adjustments for multiple confounders. Increased GGT concentration is associated with the increase in FRS. Serum GGT may be helpful to predict the future risk of CAD.

Correlation of Undercarboxylated Osteocalcin (ucOC) Concentration and Bone Density with Age in Healthy Korean Women

Uncarboxylated osteocalcin (ucOC) is important in evaluating vitamin K status and it is inversely associated with bone mineral density (BMD). We studied the correlationship between ucOC and BMD in healthy Korean women. This study recruited 337 healthy women between ages 20-70 were recruited. Serum ucOC, calcium, alkaline phosphatase, body mass index (BMI), and BMD were measured and compared. Mean BMI was lowest (20.3±1.9 kg/m2) in the 20 yr old group and highest (24.8±2.6 kg/m2) in the 60 yr old group. Women age 20-70 yr old had ucOC inversely related to BMD independent of other factors that may influence BMD. Serum ucOC concentration and BMD of lumbar spine showed a significant inverse relationship. Serum mean alkaline phosphatase was lowest (122±30 IU/L) in the age 30 group and highest (190.3±55.8 IU/L) in the age 60 group. Serum ucOC was inversely associated with BMI, and positively associated with alkaline phosphatase. Uncarboxylated osteocalcin (ucOC) was inversely associated with spinal BMD in healthy Korean women. Serum mean ucOC was highest in the age 20 group, followed by age 50 group, which may indicate vitamin K insufficiency could be related to high bone turnover in these groups. These results suggest that vitamin K supplement may be considered to help both bone growth and bone loss during these periods.

Effects of short-term chromium supplementation on insulin sensitivity and body composition in overweight children: randomized, double-blind, placebo-controlled study ☆

Excessive body weight is inversely associated with insulin sensitivity in children and adults. Chromium supplementation produces modest improvement in insulin sensitivity in adults. The aim of this study was to examine the beneficial effects of chromium supplementation on insulin sensitivity and body composition in overweight children simultaneously modifying lifestyle. Twenty-five overweight children aged 9-12 years were randomized to receive either 400 μg of chromium chloride or placebo in double-blind fashion, during a 6-week lifestyle modification regimen that included nutritional education and 3×90 min of aerobic physical activity weekly. Insulin sensitivity was demonstrated using homeostasis model assessment-insulin resistance and quantitative insulin sensitivity check index (QUICKI). Changes in body mass index (BMI; kg/m(2)), BMI Z-score, waist circumference, body composition and fasting plasma glucose were measured. Although no significant benefit of chromium supplementation over placebo was evident for BMI, BMI Z-score and fasting insulin level, children who received chromium chloride demonstrated more positive changes versus the placebo group in HOMA (-1.84±1.07 vs. 0.05±0.42, P=.05), QUICKI (0.02±0.01 vs. -0.002±0.01, P=.05), lean body mass (2.43±0.68 kg vs. 1.36±1.61 kg, P=.02) and percentage body fat (-3.32±1.29% vs. 0.65±1.05%, P=.04). The desirable effects of chromium supplementation on insulin sensitivity and body composition were more apparent in pre-pubertal children. These results suggest that short-term chromium supplementation can improve insulin sensitivity and body composition in overweight children.

ApoE Polymorphism May Determine Low-Density Lipoprotein Cholesterol Level in Association with Obesity and Metabolic Syndrome in Postmenopausal Korean Women

Purpose We investigated how serum low-density lipoprotein (LDL) level is related to various isoforms of apolipoprotein (ApoE) polymorphism in association with obesity and metabolic syndrome. Materials and Methods We gathered total 332 sample of postmenopausal Korean women and analyzed ApoE isoforms, serum lipid level including LDL, blood pressure, fasting glucose, and anthropometry. The relationship between ApoE isoforms and serum lipid level, metabolic syndrome, and obesity was investigated. Results Six ApoE isoforms were found, ApoE2 [E2/2 (n=1), E2/3 (n=54), E2/4 (n=14)], ApoE3 (E3/3, n=200), ApoE4 [E3/4 (n=55), and E4/4 (n=8)]. The prevalence of metabolic syndrome and obesity showed higher ApoE3 isoform than that of other isoforms. In additon, ApoE3 isoform was related to higher serum LDL and total cholesterol level than to ApoE2 isoform. The odds ratio of having the highest LDL cholesterol quartile in ApoE3 with obesity, compared to ApoE2 without obesity, was 3.46 [95% confidence interval (CI); 1.07-11.14, p=0.037], and odds ratio of ApoE3 with metabolic syndrome compared to ApoE2 without metabolic syndrome was 5.06 (95% CI; 1.14-22.29, p=0.037). Serum LDL cholesterol was positively associated with obesity or metabolic syndrome in ApoE3 isoform. Conclusion This study suggests that obesity or metabolic syndrome risk should be effectively managed in ApoE3 isomform groups to reduce serum LDL in postmenopausal Korean women.