Jee-Yon Lee

Serum carcinoembryonic antigen is associated with abdominal visceral fat accumulation in female Korean nonsmokers.

Background Carcinoembryonic antigen (CEA) is a tumor marker overexpressed in adenocarcinoma that has proinflammatory properties. Recent studies have reported that CEA is positively associated with carotid atherosclerosis and metabolic syndrome. Because visceral obesity is a known risk factor for cardiometabolic diseases, CEA may also be associated with visceral adiposity. Therefore, we investigated the relationship between serum CEA concentration and visceral obesity in female Korean nonsmokers. Methods A total of 270 Korean female nonsmokers were enrolled during their routine health check-ups. Biomarkers of metabolic risk factors were assessed along with body composition by computed tomography. Serum CEA levels were measured by using a chemiluminescence immunoassay analyzer. Results Serum CEA levels correlated with visceral fat area, fasting glucose, and triglyceride levels after adjusting for age and BMI. The mean visceral fat area increased significantly with the increasing CEA tirtiles. In a step-wise multiple regression analysis, age (β = 0.26, p<0.01) and visceral fat area (β = 0.19, p = 0.03) were identified as explanatory variables for serum CEA level. Conclusions This study suggested that CEA may be a mediator that links metabolic disturbance and tumorigenesis in visceral obesity. Further studies are required to better understand the clinical and pathophysiological significance of our findings.

The Relationship between Metabolic Syndrome and Childhood Maternal Education Level, Job Status Findings from the Korean National Health and Nutrition Examination, 2007-2009.

Background Childhood socioeconomic status (SES) is known to affect cardio-metabolic disease risk. However, the relationship between childhood SES and metabolic syndrome (MetS) remains uncertain. Therefore, we investigated the relationship between childhood SES, as measured by maternal education and occupational status and adult-onset MetS in the Korean population. Methods We examined the association between childhood SES, as measured by maternal education level and occupational status during an individuals childhood, and MetS in Korean adults aged 20 to 79 years who participated in the 2007-2009 Korean National Health Examination and Nutrition Survey. The components of MetS, including waist circumference, fasting glucose, lipid profiles, and blood pressure, were measured. Adjusted odds ratios (ORs) for MetS were calculated using multiple logistic regression models. Results Significant differences in the association between maternal education level, occupational status, and MetS were found between males and females. In females, the adjusted MetS OR for the highest maternal education quartile relative to the lowest quartile was 0.46 (0.21-0.99). Similarly, in females, the adjusted OR for individuals whose mothers worked when they were children relative to those whose mothers did not work was 1.23 (1.04-1.44). In males, no significant associations between maternal education, maternal occupational status, and MetS were found. Conclusion We found independent, positive associations between maternal education and occupational status and MetS in Korean females. These findings suggest that public health education targeting MetS prevention should be considered, especially among children with less opportunity for maternal support.

Association between serum osteocalcin and insulin resistance in postmenopausal, but not premenopausal, women in Korea.

Objective Menopause is known to compound cardiometabolic disease risk factors, and a deeper understanding of the mechanism of this effect is needed. Recently, the osteoblast-derived protein osteocalcin was found to function as a regulator of glucose and fat metabolism. However, there is a lack of studies comparing the extent of association between osteocalcin and glucose metabolism in postmenopausal versus premenopausal women. Methods To examine the relationship between serum osteocalcin and glucose metabolism in premenopausal versus postmenopausal women, we identified well-balanced pairs of premenopausal and postmenopausal women matched on propensity score. The interactions between serum osteocalcin levels and menopause status on fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and the associations of these parameters with serum osteocalcin levels in premenopausal and postmenopausal women were statistically analyzed. Results Among the 61 matched pairs of premenopausal and postmenopausal women, significant interactions of menopause status and serum osteocalcin levels were observed for fasting insulin (P = 0.031) and HOMA-IR (P = 0.019). Furthermore, after logarithmical transformation for each variable, significant relationships between serum osteocalcin levels and fasting insulin (r = −0.307, P = 0.016) and HOMA-IR (r = −0.298, P = 0.019) were found in postmenopausal women, but no significant correlation was seen in premenopausal women (r = 0.002, P = 0.989 and r = 0.062, P = 0.633, respectively). Conclusions Our study shows that the association between serum osteocalcin and insulin resistance varies according to menopause status, and that serum osteocalcin is associated with insulin resistance in postmenopausal women but not in premenopausal women. As postmenopausal women have a higher prevalence of obesity and other cardiac risk factors, the potential endocrine actions of osteocalcin may serve as a marker of metabolism in menopause status. Further studies are needed to define the precise nature of the relationship between osteocalcin and insulin resistance in postmenopausal women.

The Association between Atopic Dermatitis and Depressive Symptoms in Korean Adults: The Fifth Korea National Health and Nutrition Examination Survey, 2007-2012

Background Atopic dermatitis (AD) is characterized by pruritic and eczematous skin lesions, which often cause depressive symptoms, anxiety, stress, sleep disturbances, social withdrawal, and stigmatization. Methods In total, 23,442 subjects (434 AD patients and 23,008 control subjects) aged 19 years or older and without a history of major medical illness or depressive disorders were selected from The Fifth Korea National Health and Nutrition Examination Survey 2007-2012. Following the initial selection, 2,170 age- and sex-matched control subjects were selected using 1:5 propensity score matching. Multiple logistic regression analysis was performed to identify the presence of depressive symptoms of at least 2 weeks in duration. Results The demographic, socioeconomic, and clinical characteristics of AD patients and control subjects were presented and compared, and some variables differed significantly between groups. Presence of depressive symptoms was set as dependent variable, and multiple logistic regression analysis was performed as follows: (1) unadjusted; (2) with alcohol use, exercise status, smoking status, and body mass index (BMI) adjusted for; and (3) with alcohol use, exercise status, smoking status, marital status, occupation, BMI, total caloric intake, history of hypertension, and history of diabetes mellitus adjusted for. Depressive symptoms were significantly higher (odds ratios, 1.46, 1.40, and 1.36; 95% confidence intervals, 1.09-1.95, 1.0.4-1.88, and 1.01-1.85, respectively) in AD patients relative to those of matched controls. Conclusion AD and clinical depression interact closely, and causal relationships between the two conditions have frequently been observed. Physicians should consider mental health interventions cautiously. It is particularly important that primary care physicians provide comprehensive, continuous long-term care.

Visceral Fat Accumulation Is Associated with Colorectal Cancer in Postmenopausal Women

Background Obesity is a known risk factor for colorectal cancer (CRC), and emerging data suggest that this association is mediated by visceral fat rather than total body fat. However, there is a lack of studies evaluating the association between visceral fat area and the prevalence of CRC. Methods To investigate the relationship between visceral adiposity and prevalence of CRC, data of 497 women diagnosed with CRC and 318 apparently healthy women were analysed and data of well-balanced 191 pairs of women with CRC and healthy women matched based on propensity scores were additionally analysed. Diagnosis of CRC was confirmed by colonoscopy and histology. Metabolic parameters were assessed, along with body composition, using computed tomography. Results The median visceral fat area was significantly higher in the CRC group compared with the control group before and after matching. The prevalence of CRC increased significantly with increasing visceral fat tertiles after matching (p for trend <0.01). A multivariate analysis showed that mean visceral fat area of individuals in the 67th percentile or greater group was associated with an increased prevalence of CRC (adjusted odds ratio: 1.80; 95% confidence interval: 1.12–2.91 before matching and adjusted odds ratio: 2.96; 95% confidence interval: 1.38–6.33) compared with that of individuals in the 33th percentile or lower group. Conclusion Thus, we conclude that visceral fat area is positively associated with the prevalence of CRC. Although we could not determine the causality, visceral adiposity may be associated with the risk of CRC. Further prospective studies are required to determine the benefits of controlling visceral obesity for reducing CRC risk.

Leukocyte telomere length is independently associated with gait speed in elderly women.

OBJECTIVES Declining gait speed is common in the elderly population and is associated with age-related conditions. Because telomere length is a reflection of aging and known to affect degenerative changes in organ systems, gait speed may be associated with telomere length. We therefore investigated the relationship between gait speed and leukocyte telomere length in elderly Korean women. STUDY DESIGN Cross-sectional study. MAIN OUTCOME MEASURES A total of 117 Korean elderly women participated. Metabolic variables were assessed along with gait speed calculated as walking distance (6m) divided by time. Leukocyte telomere length was measured by real-time quantitative polymerase chain reaction. RESULTS Gait speed correlated with telomere length (r=0.38, p<0.01), fasting insulin (r=-0.19, p=0.04), homeostasis model assessment of insulin resistance index (HOMA-IR; r=-0.22, p=0.02), triglyceride (r=-0.20, p=0.03), and Korean Mini-Mental State Examination (K-MMSE; r=0.20, p=0.03) after adjusting for age. On step-wise multiple regression analysis, telomere length (β=0.35, p<0.01), K-MMSE (β=0.16, p=0.02), age (β=-0.23, p=0.01), and HOMA-IR (β=-0.19, p=0.03) were identified as independent variables associated with gait speed. CONCLUSIONS This study suggested that telomere length may have a role in maintaining overall health status as well as preserving gait speed in the elderly population. Further studies are required to better understand the significance of our findings.

Muscle strength and quality are associated with severity of menopausal symptoms in peri- and post-menopausal women

OBJECTIVES Menopausal symptoms are common and affect the quality of life of menopausal women. Menopausal symptoms are associated with age-related conditions. Sarcopenia, loss of muscle mass and/or function, is also associated with several age-related conditions, suggesting that the severity of menopausal symptoms may be associated with sarcopenia. Therefore, we investigated the relationship between Kupperman index scores, a measure of menopausal symptom severity, and muscle strength and quality in peri- and post-menopausal women. STUDY DESIGN Cross-sectional study. MAIN OUTCOME MEASURES A total of 148 women participated. Biomarkers of metabolic risk factors were assessed along with muscle mass as measured with Dual-energy X-ray Absorptiometry. Handgrip strength was measured with isometric dynamometry. Muscle quality was calculated as the ratio of strength to muscle mass in upper extremities. RESULTS Kupperman index scores correlated with the depression scale, handgrip strength, and specific force after adjusting for age and body mass index. Mean handgrip strength and specific force decreased gradually according to menopausal symptom severity. Multivariate logistic regression analysis showed that the fourth handgrip strength and specific force quartiles were associated with the prevalence of severe menopausal symptoms with adjusted odds ratios of 0.14 (95% confidence interval 0.03-0.68) and 0.09 (95% confidence interval 0.03-0.47), respectively. CONCLUSIONS Lower handgrip strength was associated with severe menopausal symptoms. Although we could not determine causality, muscle strength and quality during menopause may be related to the severity of menopausal symptoms. Further interventional and experimental studies are required to understand the clinical and pathophysiological significance of our findings.

Urine melatonin levels are inversely associated with sarcopenia in postmenopausal women.

ObjectiveMainly secreted in the pineal gland, melatonin is a neurohormone that has versatile functions, including cellular protection. Decreased melatonin levels are associated with the aging process and age-related conditions. Melatonin may be associated with sarcopenia because it is one of the most common age-related diseases and because disrupted cellular vitality in skeletal muscle is known to be involved in its pathogenesis. Therefore, we investigated the relationship between first-morning-urine 6-sulfatoxymelatonin (aMT6s) levels and sarcopenia in Korean postmenopausal women. MethodsSeventy-eight Korean postmenopausal women participated. Biomarkers of metabolic risk factors, along with the presence of sarcopenia, were assessed using dual-energy x-ray absorptiometry. Urine aMT6s levels were measured using enzyme-linked immunosorbent assay. ResultsThe prevalence of sarcopenia increased significantly with increasing aMT6s quartiles. Furthermore, multivariate logistic regression analysis showed that the fourth aMT6s quartile was associated with sarcopenia, with an adjusted odds ratio of 0.13 (95% CI, 0.03-0.70; P = 0.02). ConclusionsOur study shows an inverse association between urine melatonin and sarcopenia, suggesting that melatonin may have a protective role in the pathophysiology of sarcopenia. Further studies are required to better understand the clinical significance of our findings.

Serum carcinoembryonic antigen is associated with non-alcoholic fatty liver disease in healthy Korean non-smokers.

Abstract Background: Carcinoembryonic antigen (CEA), a biomarker overexpressed in malignant tumors, exhibits increased levels in certain non-malignant conditions, including chronic inflammatory status. The elevation of CEA in chronic inflammatory conditions suggests that this marker may also be associated with non-alcoholic fatty liver disease (NAFLD). Therefore, we investigated the relationship between serum CEA concentrations and NAFLD in healthy Korean non-smokers. Methods: A total of 200 healthy Korean non-smokers were enrolled during their routine health check-ups. Biomarkers of metabolic risk factors were assessed along with the presence of NAFLD using the liver Fibroscan®. Serum CEA levels were measured using a chemiluminescence immunoassay analyzer. Results: The prevalence of NAFLD increased significantly with increasing CEA quartiles; the mean log CEA level increased gradually according to the grade of hepatic steatosis. Multivariate logistic regression analysis adjusted for age, gender, body mass index, exercise, blood pressure, fasting glucose, insulin, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, white blood cell counts, aspartate aminotransferase, alanine aminotransferase and γ-glutamyltransferase showed that the fourth CEA quartile was associated with NAFLD, with an odds ratio of 2.98 (95% confidence interval 1.10–8.05, p<0.01). Conclusions: Our study showed independent associations between CEA and NAFLD by analyzing data from 200 healthy Korean non-smokers, suggesting that CEA functions in the pathophysiology of fatty liver disease. Further studies are required to better understand the clinical and pathophysiological significance of our findings.

Serum Ferritin Is Differentially Associated with Anti-oxidative Status and Insulin Resistance in Healthy Obese and Non-obese Women.

Background Ferritin is known to be associated with insulin resistance (IR) and oxidative stress; however, recent studies have shown that there is an association between ferritin and anti-oxidative status. To date, the biphasic response of ferritin to oxidative stress has not been fully evaluated. Thus, we investigated the association between ferritin and IR and anti-oxidative status in obese and non-obese women. Methods We evaluated the homeostasis model assessment of insulin resistance (HOMA-IR) and total anti-oxidant status (TAS) in a total of 111 healthy women between the ages of 32 and 68 years. Results In all of the study subjects, ferritin levels were positively correlated with age (r = 0.38, P < 0.001), body mass index (r = 0.24, P = 0.01), TAS (r = 0.38, P < 0.001) and HOMA-IR (r = 0.20, P = 0.04). In the subgroup analysis, ferritin levels were correlated with age (r = 0.39, P < 0.001) and TAS (r = 0.43, P < 0.001) in the non-obese group and with insulin (r = 0.50, P = 0.02) and HOMA-IR (r = 0.52, P = 0.01) levels in the obese group. On stepwise multiple linear regression analysis, ferritin was found to be independently associated with TAS (B = 177.16, P < 0.0001) in the non-obese group and independently associated with HOMA-IR (B = 30.36, P = 0.01) in the obese group. Conclusion Our findings suggest ferritin is associated with IR in obese women and with anti-oxidative status in non-obese women. Further studies are warranted to elucidate the precise role of ferritin in obesity.