Jae-Ouk Ahn

High carbohydrate diets are positively associated with the risk of metabolic syndrome irrespective to fatty acid composition in women: the KNHANES 2007–2014

Abstract We evaluated that carbohydrates and fatty acids intake modifies the prevalence of metabolic syndrome (MetS) and we also determined gender–nutrient interaction in 38,766 adults in KNHANES (2007–2014). Carbohydrate intake was positively associated, and fat intake inversely associated, with the incidence of MetS. The association exhibited a gender interaction with the macronutrient intake; this association was significant in females. Furthermore, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) intakes were inversely associated with MetS risk and only females showed the positive association. Both n-3 and n-6 fatty acids intake showed inverse associations with MetS risk, similar to PUFA intake. Among the MetS components, serum triglyceride levels and blood pressure had significant inverse associations with fatty acid intake irrespective of fatty acid types and exhibited a gender interaction. In conclusions, high carbohydrate intakes (≥74.2 En%) may increase the MetS risk and moderate fat intakes (≥20.7 En%), irrespective of fat types, may decrease it. These associations were significant only in women.

Association of Blood Pressure with Exposure to Lead and Cadmium: Analysis of Data from the 2008–2013 Korean National Health and Nutrition Examination Survey

We examined the association of blood pressure with blood levels of cadmium, lead, and their combination in a representative sample of adults from South Korea (Korean National Health and Nutrition Examination Survey, 2008–2013). This cross-sectional study enrolled subjects who were at least 19 years-old, completed a health examination survey, and had blood measurements of lead and cadmium. We estimated the adjusted mean differences in diastolic and systolic blood pressure associated with doubling of blood lead and cadmium by regression of blood pressure against log2-transformed blood metals and their tertiles after covariate adjustment. Adjusted odds ratios for hypertension and prehypertension were calculated for log2-transformed blood levels of lead and cadmium and their tertiles. In the general population of Korea, blood lead level was associated with increased BP and risk of hypertension. Blood cadmium levels had a stronger association with elevated blood pressure and risk of hypertension than blood lead levels, and these associations remained significant after statistical adjustment for blood lead. The combination of blood lead and cadmium was more strongly associated with elevated blood pressure than exposure to each individual metal. In females, there was a stronger relationship between blood pressure and blood levels of these metals by analyzing interaction model. After adjustment for confounding factors, there were significant associations of blood pressure with the level of blood lead, cadmium, and their combination in adults from South Korea.

Self-rated subjective health status is strongly associated with sociodemographic factors, lifestyle, nutrient intakes, and biochemical indices, but not smoking status: KNHANES 2007-2012

Despite advertised health warnings regarding the deadly hazards of smoking, many people have not heeded recommendations to quit smoking. We examined factors that affect self-rated subjective health status (SRH) scores among lifestyle, nutrient intake and biochemical parameters, and the association of SRH scores and smoking status in a large Korean adult population. Adjusted odd ratios for SRH were calculated for smoking status, selected biochemical data, and food and nutrient intake obtained using the 24-hr recall method after covariate adjustment in the 2007-2012 Korean National Health and Nutrition Examination Survey (27,534 men and women aged ≥ 20 yr). Age, sex, income, education, drinking, exercise and stress levels were associated with SRH scores, regardless of smoking status (P < 0.001). Interestingly, people in any smoking status groups considered the well-known indicators for metabolic diseases (HDL cholesterol, glucose, aspartate aminotransferase, and alanine aminotransferase in the circulation), and the intake of fiber, total vitamins A, and vitamin C as indicators of SRH. Especially in current smokers, higher intake of nutritious food groups such as grains (OR = 1.227), vegetables (OR = 1.944), and milk (OR = 2.26) significantly increased the adjusted odds ratio of SRH. However, smoking status was not associated with SRH scores. In conclusion, SRH is affected by the indices related to health but not smoking status in Korean adults. The development of a new indicator of the direct adverse effects of smoking at regular health check-ups might be required to modulate the SRH in smokers and a nutritional education should not include the possible attenuation of adverse effects of smoking by good nutrition.

Environmental exposures to lead, mercury, and cadmium among South Korean teenagers (KNHANES 2010–2013): Body burden and risk factors

Introduction: Limited information is available on the association of age and sex with blood concentrations of heavy metals in teenagers. In addition, factors such as a shared family environment may have an association. We analyzed data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2010–2013) to determine whether blood levels of heavy metals differ by risk factors such as age, sex, and shared family environment in a representative sample of teenagers. Methods: This study used data obtained in the KNHANES 2010–2013, which had a rolling sampling design that involved a complex, stratified, multistage, probability‐cluster survey of a representative sample of the non‐institutionalized civilian population in South Korea. Our cross‐sectional analysis was restricted to teenagers and their parents who completed the health examination survey, and for whom blood measurements of cadmium, lead, and mercury were available. The final analytical sample consisted of 1585 teenagers, and 376 fathers and 399 mothers who provided measurements of blood heavy metal concentrations. Results: Male teenagers had greater blood levels of lead and mercury, but sex had no association with blood cadmium level. There were age‐related increases in blood cadmium, but blood lead decreased with age, and age had little association with blood mercury. The concentrations of cadmium and mercury declined from 2010 to 2013. The blood concentrations of lead, cadmium, and mercury in teenagers were positively associated with the levels in their parents after adjustment for covariates. Conclusion: Our results show that blood heavy metal concentrations differ by risk factors such as age, sex, and shared family environment in teenagers. HighlightsThis study was based on data obtained by KNHANES 2010–2013.Male had greater blood levels of lead and mercury, and there were age‐related increases in blood cadmium in Korean adolescents.The blood concentrations of lead, cadmium, and mercury in adolescents were positively associated with the levels in their parents.

Risk factors for fatigue and stress among Korean police officers

[Purpose] This study investigated factors that affect the health of police officers by analyzing job stress, psychosocial stress, and fatigue faced by police officers in order to provide basic data for the efficient management of police officers and future comparative research. [Subjects and Methods] Police officers admitted to the National Police Hospital from March to May 2013 were surveyed to investigate their degree of stress. The questionnaire consisted of 4 areas related to patient characteristics: general and demographic characteristics factors, job stress, psychosocial stress, and fatigue. [Results] The analysis of the relationships among job stress, psychosocial health, and fatigue showed the 0%, 44.7%, and 82% of those with healthy, potential, and high risks of stress had high job stress, respectively. Meanwhile, 40.8% and 77.9% of subjects with normal and high risks of fatigue had high job stress. [Conclusion] The studies can be used as basic and comparative data for the prevention and early control of job-related diseases for police officers.

Associations between Sympathetic Activity, Plasma Concentrations of Renin, Aldosterone, and Parathyroid Hormone, and the Degree of Intractability of Blood Pressure Control in Hemodialysis Patients

This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, β2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.

Carbohydrate Intake Exhibited a Positive Association with the Risk of Metabolic Syndrome in Both Semi-Quantitative Food Frequency Questionnaires and 24-Hour Recall in Women

We compared the usual nutrient intake in both the semi-quantitative food frequency questionnaire (SQFFQ) and 24-hour recall methods and determined the association between metabolic syndrome (MetS) risk and nutrient intake calculated by both methods in Korea National Health and Nutrition Examination Survey (KNHANES; 2012–2014) data. Adjusted odds ratios for MetS were calculated according to the intake of macronutrients, measured by the 2 methods in 10,286 adults, while controlling for covariates associated with MetS. Fat and carbohydrate intake (energy percent) calculated by 24-hour recall and SQFFQ was significantly different between the MetS and non-MetS groups, particularly in women. The differences in other nutrient intakes determined by both methods were mainly non-significant. The correlation coefficients between the 2 methods were about 0.4 for most nutrients except total vitamin A and iron (Fe). Energy intake according to gender and MetS presence was similar between the 2 methods. Carbohydrate intake exhibited a positive association with the MetS risk, while fat intake showed a negative association in both methods. The association exhibited a gender interaction with carbohydrate and fat intake calculated by 24-hour recall: women exhibited a significant association. However, for the SQFFQ a gender interaction was evident only for carbohydrate intake. In diet quality index of SQFFQ the adequacy of vegetables and total fat intake was higher in the non-MetS than the MetS. In conclusion, the MetS prevalence exhibited a positive association with carbohydrate intake only in women, as assessed by 24-hour recall and SQFFQ. The SQFFQ can be used to assess the association between usual food intake and MetS risk in large population studies.

Blood levels related to the Z-score of bone mineral density in young males and females.

[Purpose] The purpose of this study was to investigate the blood levels related to the bone mineral density by using the dual energy X-ray absorption for females before menopause and males younger than 50 years old. [Subjects and Methods] Between August 1, and September 15, 2013, the Z-score was measured in females before menopause and males younger than 50 years old using a bone mineral density measuring instrument. After the measurement, the subjects were classified into two groups, that is, the below expectations and within expectations groups. Next, we analyzed and compared the differences in age, body mass index, and blood levels between the 2 groups. [Results] The results showed a correlation of 0.212 for total protein, −0.317 for alanine aminotransferase, −0.199 for gamma-glutamyl transferase, −0.358 for alkaline phosphatase, 0.266 for uric acid, −0.313 for lactate dehydrogenase, 0.244 for creatinine, −0.234 for the red blood cell count, and −0.230 for the red cell distribution width in patients with less than expected level for their age. [Conclusion] In conclusion, osteoporosis may occur in females before menopause and males younger than 50 years old, and aggressive attention is required for prevention and treatment.

Influence of Iodinated Magnetic Resonance Contrast Media and Isotope 99m Tc on Changes of Computed Tomography Number

The purpose of the study was to identify how isotope and magnetic resonance imaging (MRI) contrast media impact on noise to computed tomography (CT) examination. For the study, divide the phantoms to two groups: 1) saline, saline + different kinds of contrast agent without 99m Tc administration; 2) 99m Tc administration: saline, saline + different kinds of contrast agent with 99m Tc administration. CT contrast agent was used for Iopamidol ® and Dotarem. And MRI contrast agent was used for Primovist ® and Gadovist ® . To obtain an image, we used CT scanner. With an obtained image, we set the 1 cm² region of interest in the middle of bottle to measure the noise and CT number. As a result, there was no difference in CT number before and after inserting 99m Tc into all contrast media including Normal Saline. However, when it comes to Noise, there was a difference before and after inserting 99m Tc into every contrast media except MRI contrast media such as Primovist ® and Gadovist ® .

Risk Factors for Musculoskeletal Symptoms Among Korean Radiation Workers

The first aim of this study was to determine the prevalence of musculoskeletal symptoms. The second aim was to study the association between musculoskeletal symptoms and factors in radiation workers from the active lists of clinics and hospitals and then to provide basic data for a systematic and effective resource management of radiation workers’ musculoskeletal problems in the future. A questionnaire survey was conducted on radiation workers in clinics, general hospitals, and Dong-A university hospitals around the Korean city Buscan from July 10 to 31, 2011. The results showed that the rate of musculoskeletal symptoms was higher in the shoulder, waist, neck, leg/foot, hand/wrist/finger than arm/elbow. The probability of neck pain was 2 times higher in patients with a disease.