Kyung Do Han

Sarcopenia and sarcopenic obesity and their association with dyslipidemia in Korean elderly men: the 2008–2010 Korea National Health and Nutrition Examination Survey

BackgroundRecently, aging has been shown to be associated with sarcopenic obesity (SO), of which decreased muscle mass and increased fat mass are features. Sarcopenia and obesity alone are known to be associated with abnormal lipid metabolism. However, it remains unclear whether SO has greater adverse effects on dyslipidemia than on sarcopenia or obesity alone.AimWe aimed to investigate the association between SO and dyslipidemia in elderly Koreans.Subjects and methodsThis study was based on data collected during the 2008–2010 Korea National Health and Nutrition Examination Survey. We included 1,466 men and 2,017 women aged 65xa0years and over. Sarcopenia was indicated in participants with height- or weight-adjusted appendicular skeletal muscle that was 1 standard deviation below the sex-specific mean for the young reference group, and obesity was defined as a body mass index ≥25xa0kg/m2. Dyslipidemia was defined according to the National Cholesterol Education Program-Adult Treatment Panel III.ResultsAfter adjusting for confounding factors, the SO group had a higher risk for dyslipidemia [odds ratio (OR) 2.82 (95xa0% confidence interval 1.76–4.51)] than the obese group [2.12 (1.11–4.07)] and sarcopenic group [1.46 (1.01–2.11)] (pxa0<xa00.001) only in men. Furthermore, the SO group in men had the highest OR for hypercholesterolemia, hypertriglyceridemia, hypo-high-density lipoprotein cholesterolemia, hyper-low-density lipoprotein cholesterolemia, and a high ratio of triglyceride to high-density lipoprotein cholesterol even after further adjustments.ConclusionsIn Korean elderly men, SO was associated with an increased risk for dyslipidemia compared with sarcopenia or obesity alone.

Low bone mineral density is associated with metabolic syndrome in South Korean men but not in women: The 2008–2010 Korean National Health and Nutrition Examination Survey

SummaryWe examined the relationships between bone mineral density (BMD) and metabolic syndrome in 6,659 men and 7,826 women from South Korean. After adjusting for age, body mass index (BMI), tobacco and alcohol use, and regular exercise, low BMD is especially associated with metabolic syndrome in South Korean men.PurposeThis study examined the relationships between BMD and metabolic syndrome (MS) in South Korean adults.MethodsA total of 14,485 adults (6,659 men and 7,826 women) in the Korea National Health and Nutrition Examination Survey conducted from 2008 to 2010 were analyzed. We used multivariable regression models to examine the relationship between low BMD and MS. We calculated homeostasis model assessment and insulin resistance (HOMA-IR). MS was defined according to AHA/NHLBI criteria for Asians. BMD was measured at the lumbar spine (LS), femur neck (FN), total hip (TH), trochanter, and intertrochanter.ResultsAfter adjustment for age, BMI, tobacco and alcohol use, and regular exercise, the TH and FN BMD were significantly lower in men with MS than in men without MS (pu2009<u20090.05). However, there were no differences in premenopausal and postmenopausal women. In men, BMD was positively correlated with BMI, and high density lipoprotein cholesterol, but was negatively correlated with insulin, HOMA-IR, and triglyceride at all three sites (pu2009<u20090.05). Along with an increase of BMD (0.1xa0g/cm2), the odds ratios (ORs) for obesity and abdominal obesity were all greater than 1 at all sites in both genders. The ORs for hypertension and MS were 0.937 (0.879–0.998) and 0.899 (0.840–0.962), respectively at FN, and the OR for diabetes mellitus was 1.103 (1.017–1.196) at LS in men. In postmenopausal women, the OR for hypertension was 1.133 (1.029–1.246) at LS.ConclusionsLow BMD was especially associated with MS in South Korean men.

Socioeconomic status and dyslipidemia in Korean adults: The 2008-2010 Korea National Health and Nutrition Examination Survey

OBJECTIVEnThis study investigated the relationship between socioeconomic status (SES) and dyslipidemia and various parameters of dyslipidemia among Korean adults.nnnMETHODSnData from the 2008-2010 Korea National Health and Nutrition Examination Survey were used in this study. A total of 19,041 Korean adults greater than 19years old participated in the study. The SES was assessed by monthly household income and education level. The relationship of SES to the risk of dyslipidemia was assessed with multivariate logistic regression analysis after adjusting for potential confounders.nnnRESULTSnThe prevalence of dyslipidemia was 37.4% among Korean adults. In men, household income level was positively associated with prevalence and risks of several parameters of dyslipidemia, and education level had positive associations with the risks of dyslipidemia and parameters of dyslipidemia. However, low SES was linked to increased prevalence and risks of dyslipidemia (P for trend<0.05) and parameters of dyslipidemia in women.nnnCONCLUSIONSnSocioeconomic disparities in dyslipidemia were found in the Korean population. Also, there were gender differences in the relationship between SES and dyslipidemia. These disparities should be considered when performing risk calculations and screening for dyslipidemia, which will ultimately help prevent cardiovascular disease.

Oral health behaviors and metabolic syndrome: the 2008–2010 Korean National Health and Nutrition Examination Survey

ObjectivesThis study examined whether oral health behaviors are associated with metabolic syndrome (MetS) in Korean adults involved in the 2008–2010 Korea National Health and Nutrition Examination Survey (KNHANES).Materials and methodsA total of 18,742 subjects (8,034 men and 10,708 women) were included. MetS was defined according to the criteria of the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement for Asians. Oral health behavior was assessed using a questionnaire included in the KNHANES.ResultsSubjects with MetS brushed their teeth less frequently and used fewer secondary oral products than subjects without MetS (pu2009<u20090.01). As frequency of toothbrushing and number of secondary oral products increased, body mass index, waist circumference, diastolic blood pressure, fasting plasma glucose, triglyceride, and white blood cell count decreased, but high-density lipoprotein–cholesterol increased (all p for trend <0.01). In the multivariable logistic regression models, as frequency of toothbrushing increased, the odds ratios (ORs) for MetS, abdominal obesity, and hyperglycemia are more than one after adjusting for age, gender, education, income, alcohol and tobacco use, physical activity, and the components of MetS. The ORs for MetS, abdominal obesity, and high blood pressure were more than one in subjects who do not use dental floss after adjusting for all covariates.ConclusionMetS is associated with infrequent daily toothbrushing and disuse of dental floss in South Korean.Clinical relevanceDentists may recommend evaluation for MetS in the patients with infrequent daily toothbrushing and disuse of dental floss.

Serum ferritin levels are positively associated with bone mineral density in elderly Korean men: the 2008–2010 Korea National Health and Nutrition Examination Surveys

A possible negative effect of iron overload on bone metabolism has been suggested by the fact that patients with hemochromatosis, thalassemia, and sickle cell anemia have lower bone mineral density than the general population. However, the influence of iron overload on bone health in the general population is uncertain. The aim of this study was to investigate the relationship between serum ferritin levels and bone mineral density (BMD) in elderly Koreans. A total of 2,943 subjects aged 65xa0years and over who participated in the 2008–2010 Korea National Health and Nutrition Examination Surveys were included in this study. Age, physical activity, current smoking status, alcohol consumption, education level, household income, and dietary assessment were surveyed by a face-to-face interview. BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry, and other biochemical markers, including serum ferritin, 25-hydroxyvitamin D3, serum alkaline phosphatase, and parathyroid hormone, were assayed. After adjusting for age and body mass index, we found an association between BMD of the total lumbar spine, total femur, and femur neck and levels of alkaline phosphatase, parathyroid hormone, vitamin D3, and daily intake of calcium and protein. Serum ferritin levels were positively associated with BMD of the total lumbar spine, total femur, and femur neck after adjusting for all covariates in men, but not in women. This study suggests a positive association between serum ferritin levels and BMD in elderly South Korean men without hematologic disorders. Further study is warranted to verify the effects of iron on bone metabolism.

Tooth loss and bone mineral density in postmenopausal South Korean women: The 2008–2010 Korea National Health and Nutrition Examination Survey

PURPOSEnThe current study aimed to investigate the association between the number of remaining teeth and bone mineral density (BMD) using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2010.nnnMETHODSnThis study enrolled 7315 Korean subjects (3364 men over 50 years of age and 3951 postmenopausal women). BMD was measured using dual-energy X-ray absorptiometry at three sites: the total femur (TF), femur neck (FN), and lumbar spine (LS). The number of teeth present was categorized into four groups (≤10, 11-20, 21-25, and ≥26 teeth).nnnRESULTSnMore remaining teeth were significantly associated with a higher BMD at the TF, FN, and LS in postmenopausal women after adjusting for all the covariates, but not in elderly men. In both sexes, subjects with a normal BMD tended to have more remaining teeth than those who were diagnosed with osteopenia and osteoporosis. A lower prevalence of osteoporosis was also significantly associated with more remaining teeth (number of teeth ≥26) in postmenopausal women. This trend was statistically significant in osteoporosis at the FN (p for trend=0.019).nnnCONCLUSIONnThe number of remaining teeth was associated with osteoporosis, especially at the FN, in postmenopausal women.

Normal range albuminuria and metabolic syndrome in South Korea: The 2011-2012 Korean National Health and Nutrition Examination Survey

Background It is well-known that there is a close relationship between metabolic syndrome (MetS) and microalbuminuria. However, some recent studies have found that even normal range albuminuria was associated with MetS and cardiometabolic risk factors. The purpose of this study is to analyze the relationship between MetS and normal range albuminuria and to calculate the cutoff value for albuminuria that correlates with MetS in the representative fraction of Korean population. Methods Data were obtained from the 2011–2012 Korea National Health and Nutrition Examination Survey and included 9,650 subjects aged ≥19 years. We measured metabolic parameters: fasting blood glucose, waist circumference, blood pressure, and lipids, and albumin-to-creatinine ratio (ACR). The optimal ACR cutoff points for MetS were examined by the receiver operating characteristic curve. Multivariate logistic regression was used to obtain the prevalence of MetS and its components according to the ACR levels. Results The first cutoff value of ACR were 4.8 mg/g for subjects with ≥3 components of MetS. There was a graded association between ACR and prevalence of MetS and its components. If ACR was <4 mg/g, there was no significant increase in the prevalence of MetS or its components. From the ACR level of 4–5 mg/g, the prevalence of MetS significantly increased after adjusting for age, sex, body mass index, smoking, alcohol intake, exercise, and medications for diabetes mellitus and hypertension (odds ratio; 95% confidence intervals = 1.416; 1.041–1.926). Conclusions Albuminuria within the normal range (around 5 mg/g) was associated with prevalence of MetS in the Korean population.

Prevalence and control of hypertension and albuminuria in South Korea: focus on obesity and abdominal obesity in the Korean National Health and Nutrition Examination Survey, 2011-2012.

Background Albuminuria is associated with cardiovascular disease, and the relationship between albuminuria and hypertension is well established in many studies. So the control of hypertension is critical for decreasing cardiovascular events and albuminuria. Obesity and abdominal obesity are also associated with hypertension and albuminuria. Therefore, we analyzed the relationship between albuminuria and the prevalence and control of hypertension in the general Korean population according to obesity status. Methods We analyzed data from the 2011–2012 Korea National Health and Nutrition Examination Survey, and 9,519 subjects were included. Subjects were divided into four groups: non-obese/normal waist circumference, non-obese/high waist circumference, obese/normal waist circumference, and obese/high waist circumference. Results Systolic blood pressure and diastolic blood pressure were positively associated with albumin–creatinine ratio in all groups (all p values <0.005). Non-obese/normal waist circumference group were more likely to have hypertension (odds ratios [95% confidential intervals (CIs)] were 3.20 [2.21–4.63] in microalbuminuria level and 3.09 [1.05–9.14] in macroalbuminuria level), and less likely to have controlled hypertension (odds ratios <1 for both albuminuria levels) after adjusting for all covariates. Obese/normal waist circumference group were also more likely to have hypertension (odds ratio [95% CI] were 3.10 [1.56–6.15] in microalbuminuria level and 21.75 [3.66–129.04] in macroalbuminuria level), and less likely to have controlled hypertension in macroalbuminuria level (odds ratio [95% CI], 0.04 [0.01–0.15]). Conclusions Non-obese and normal waist circumference subjects have an increased prevalence and decreased control of hypertension in microalbuminuria and macroalbuminuria levels. Screening for albuminuria may provide helpful information about hypertension and blood pressure control, particularly in the non-obese and normal waist circumference subjects.

The impact of parity and age at first and last childbirth on the prevalence of delayed-onset asthma in women: The Korean National Health and Nutrition Examination Survey

OBJECTnAsthma is a chronic inflammatory airway disease. The aim of this study was to investigate the relationships between asthma and reproductive factors, including age at first childbirth and parity, in a representative sample of Korean women.nnnMAIN OUTCOME MEASURESnWe analyzed data from the Korean National Health and Nutrition Examination Survey (2010-2012). A total of 7837 adults who completed a questionnaire and examination were evaluated. The presence of asthma was based on the Health Interview Survey. Reproductive factors were estimated by trained interviewers using participant recall.nnnRESULTSnThe women with asthma were significantly older than those without asthma. BMI, hypertension, education level, income level, occupation, alcohol consumption, and age at menarche and first birth were significantly associated with the diagnosis of asthma. Higher parity was positively associated with later-onset asthma. In addition, women who were younger at first birth had a greater prevalence of later-onset asthma. After controlling for confounders, being aged under 20 at first birth was significantly associated with an asthma diagnosis compared with women aged 25-29 at first birth (OR [95% CI]: 1.81 [1.14-2.89]).nnnCONCLUSIONSnAlthough higher parity was associated with asthma in women, its significance disappeared after adjustment. These results warrant future studies to explore the mechanisms responsible for the association between reproductive factors and asthma.

Oral health behaviors and bone mineral density in South Korea: the 2008–2010 Korean National Health and Nutrition Examination Survey

The purpose of this study was to examine the association between oral health behaviors and bone mineral density (BMD) by using data from the Korean National Health and Nutrition Examination Survey conducted in 2008–2010. We included 6,620 subjects (3,140 men aged more than 50xa0years and 3,480 postmenopausal women). BMD was measured at three sites—namely, the lumbar spine, total femur, and femur neck. Oral health behaviors were assessed by use of a self-administered questionnaire in the Korean National Health and Nutrition Examination Survey. After adjustment for all covariates, BMD of the lumbar spine and femur neck tended to increase as the frequency of tooth brushing increased in men (ptrendxa0=xa00.020 and ptrendxa0=xa00.028, respectively). Women using secondary oral products had increased lumbar spine BMD compared with women who did not use secondary oral products. However, after adjustment for all covariates, no significant relationship was observed between BMD and the use of secondary oral products. As the frequency of tooth brushing and the number of secondary oral products used increased, the prevalence of osteoporosis decreased. The frequency of tooth brushing is associated with increased lumbar spine and femur neck BMD in South Korean men.