Kyung Hwan Cho

Prevalence of prehypertension and hypertension in a Korean population : Korean National Health and Nutrition Survey 2001

Objective The present study aimed to determine the prevalence of prehypertension and hypertension, and their association with the risk factors in a Korean population. Design The Korean Nation Health and Nutrition Survey 2001, a cross-sectional survey, was a nationally representative survey in which a stratified multistage sampling design was used. Methods Data from a comprehensive questionnaire, together with a physical examination and blood sample, were obtained from 6074 Korean adults (2620 men and 3454 women) aged ≥ 20 years, and analysed. Results The estimated age-adjusted prevalence of hypertension and prehypertension was 22.9% (26.9% in men, 20.5% in women) and 31.6% (41.9% in men, 25.9% in women), respectively, in the Korean population according to Joint National Committee 7 criteria. Multivariate analysis revealed that age, gender, body mass index, fasting plasma glucose, total-cholesterol and alcohol consumption were significantly associated with hypertension. Overall, only 30.2% of the hypertensive individuals had been previously diagnosed. Furthermore, 22.9% of the hypertensive individuals were being treated with antihypertensive medication, but only 10.7% had their blood pressure adequately controlled. The rates of awareness, treatment and control were higher for the women than for the men, and these rates increased with age. Conclusion Hypertension and prehypertension are common in Korea, and more than one-half of the hypertensive patients have not been diagnosed. These results place great emphasis on the urgent need for a public health program to improve the detection, prevention and treatment of hypertension and prehypertension.

Adiponectin Induces Growth Arrest and Apoptosis of MDA-MB- 231 Breast Cancer Cell

Recently, it was reported that reduction in serum adiponectin levels is correlated with the incidence of breast cancer. As an effort to explain this, we screened various human breast cancer cell lines to identify those in which proliferation is directly controlled by adiponectin. Among the five tested cell lines, proliferation of MDA-MB-231 cancer cell was significantly suppressed by adiponectin within the range of physiological concentration. Furthermore, prolonged adiponectin treatment caused cell growth arrest and even apoptosis of MDA-MB-231. This result is the first to show that adiponectin can directly control cancer cell growth and provides a rationale for the theory that reduction in plasma adiponectin levels could be a risk factor for breast cancer.

Use of selective serotonin reuptake inhibitors and risk of fracture: a systematic review and meta-analysis

Previous studies have reported inconsistent findings regarding the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of fracture. We identified relevant studies by searching three electronic databases (MEDLINE, EMBASE, and the Cochrane Library) from their inception to October 20, 2010. Two evaluators independently extracted data. Because of heterogeneity, we used random‐effects meta‐analysis to obtain pooled estimates of effect. We identified 12 studies: seven case‐control studies and five cohort studies. A meta‐analysis of these 12 observational studies showed that the overall risk of fracture was higher among people using SSRIs (adjusted odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.51–1.90, I2 = 89.9%). Subgroup analysis by adjusted number of key risk factors for osteoporotic fracture showed a greater increased fracture risk in those adjusted for fewer than four variables (adjusted OR = 1.83, 95% CI 1.57–2.13, I2 = 88.0%) than those adjusted for four or more variables (adjusted OR = 1.38, 95% CI 1.27–1.49, I2 = 46.1%). The pooled ORs anatomical site of fracture in the hip/femur, spine, and wrist/forearm were 2.06 (95% CI 1.84–2.30, I2 = 62.3%), 1.34 (95% CI 1.13–1.59, I2 = 48.5%), and 1.51 (95% CI 1.26–1.82, I2 = 76.6%), respectively. Subgroup analysis by exposure duration revealed that the strength of the association decreased with a longer window of SSRI administration before the index date. The risk of fracture was greater within 6 weeks before the index date (adjusted OR = 3.83, 95% CI 1.96–7.49, I2 = 41.5%) than 6 weeks or more (adjusted OR = 1.60, 95% CI 0.93–2.76, I2 = 63.1%). Fracture risk associated with SSRI use may have a significant clinical impact. Clinicians should carefully consider bone mineral density screening before prescribing SSRIs and proper management for high‐risk populations.

Hypoadiponectinemia and insulin resistance are associated with nonalcoholic fatty liver disease

We investigated the association between nonalcoholic fatty liver disease (NAFLD) and plasma adiponectin levels and insulin resistance. We recruited study subjects among one hundred and eighty one persons who were examined abdominal ultrasound at routine screening tests. A standard interview (consumption of alcohol and medical history), physical examination (height, weight, waist circumference, and blood pressure), and biochemical study (lipid parameters, aminotransferases, fasting plasma glucose, fasting insulin, and plasma adiponectin) were performed. Subjects who consumed alcohol more than moderate, evidence of viral hepatitis, toxic hepatitis, and serious cardiac, renal, or hepatic disease were excluded. Thirty-eight NAFLD patients and 53 control subjects diagnosed by ultrasound were finally analyzed. The plasma adiponectin level was significantly correlated with HDL-cholesterol (r=0. 38, p<0.001), triglycerides (r=-0.22, p=0.04), fasting insulin (r=-0.37, p<0.01), and insulin resistance by homeostasis model of assessment-insulin resistance (HOMA-IR) (r=-0.39, p<0.01), after adjusting for age, sex, and adiposity. Multiple logistic regression analysis indicated that HOMA-IR was a significant predictor of having NAFLD (odds ratio [OR]=2.38; 95% confidence interval [CI]: 1.52-5.74), while adiponectin had a protective effect against NAFLD (OR=0.22; 95% CI: 0.09-0.55). We demonstrated that hypoadiponectinemia and insulin resistance are associated with NAFLD independent of obesity.

Primary pulmonary Ewing's sarcoma/primitive neuroectodermal tumor in a 67-year-old man

Extraskeletal Ewings sarcoma (EES) is a branch of neuroectodermal tumor (PNET), which is very rare soft tissue sarcoma. We report a case of EES/PNET arising is the lung of a 67-yr-old man. Computed tomography, bone scintigraphy, and positron emission tomography confirmed the mass to have a primary pulmonary origin. The mass showed positive reactivity in the Periodic Acid Schiff (PAS) stain and MIC-2 immunoreactivity in immunohistochemical stain. Fluorescence in situ hybridization (FISH) was performed, which revealed an EWSR1 (Ewing sarcoma breakpoint region 1) 22q12 rearrangement. The diagnosis was confirmed both pathologically and genetically. The mass lesion was resected, and the patient is currently undergoing chemotherapy.

Eating rate is associated with cardiometabolic risk factors in Korean adults

BACKGROUND AND AIM Eating slowly is a crucial concept in behavioural nutrition and is recommended for weight management as it is believed to have an important effect on satiety control. This study aimed to determine whether or not eating rate is associated with cardiometabolic risk factors. METHODS AND RESULTS This was a cross-sectional study involving 8775 Korean adults, who visited the Center for Health Promotion of Korea University Anam Hospital in Seoul, Korea. In male study participants, weight and body mass index (BMI) were found to depend on eating rate after adjusting for age, alcohol consumption, smoking, exercise and total energy intake. When adjusted for age, alcohol consumption, smoking, exercise and BMI, differences were found between the eating rate groups with respect to high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase (ALT) and alkaline phosphatase (ALP) values, white blood cell (WBC) count and total energy intake. Female participants were found to be different from males in that diastolic blood pressure and low-density lipoprotein (LDL)- and HDL-cholesterol values were significantly different between each eating rate group, while ALT and ALP values, WBC count and total energy intake were not. Compared with the slow eating rate group (>15 min), the fastest eating rate group (<5 min) had significantly increased odds ratios for cardiometabolic risk factors such as high glucose and low HDL-cholesterol levels in males, even after adjusting for BMI. CONCLUSION Fast eating rates are associated with obesity and other cardiometabolic risk factors, particularly in men. Thus, eating slowly is recommended for weight reduction and to decrease cardiovascular risk factors.

Estimate of a predictive cut-off value for serum 25-hydroxyvitamin D reflecting abdominal obesity in Korean adolescents ☆

Vitamin D deficiency is a serious global issue. Although the serum 25-hydroxyvitamin D [25(OH)D] test is generally the most accurate way to assess vitamin D levels, the optimal range of 25(OH)D has yet to be established. Moreover, the optimal level may vary according to race, region, and age. Suboptimal vitamin D status is associated with obesity and metabolic syndrome, which are the major risk factors for cardiovascular disorders; however, these relationships in children and adolescents have yet to be clearly determined. Therefore, we identified the best predictive cut-off value for reflecting abdominal obesity and, based on this value, we investigated the relationship between suboptimal 25(OH)D status and the risk for having abdominal obesity, being overweight or obese, and having metabolic syndrome in Korean adolescents. We performed a cross-sectional analysis of 713 Korean adolescents, between 12-19 years of age, and used data collected from the 2008 Korea National Health and Nutrition Examination Survey (KNHANES). Receiver operation characteristic curve analysis was used to identify the cut-off value that reflected abdominal obesity. The cut-off value of serum 25(OH)D that reflected abdominal obesity in Korean adolescents was 17.6 ng/mL. After making adjustments for gender, age, and regular physical exercise, the group that had lower levels of serum 25(OH)D compared to the cut-off value had a significantly higher risk for abdominal obesity, obesity, and metabolic syndrome than the group with 25(OH)D levels higher than the cut-off value. Suboptimal vitamin D status based on this value is associated with increased risk for abdominal obesity, obesity, and metabolic syndrome among Korean adolescents.

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

OBJECTIVE This study investigated the relationship between socioeconomic status (SES) and dyslipidemia and various parameters of dyslipidemia among Korean adults. METHODS Data 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. RESULTS The 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. CONCLUSIONS Socioeconomic 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 (p < 0.01). 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.

Soy Isoflavones Mitigate Long-Term Femoral and Lumbar Vertebral Bone Loss in Middle-Aged Ovariectomized Mice

We evaluated the protective effects of soy isoflavones (SIF) against osteoporosis in middle-aged ovariectomized (OVX) mice. SIF (30 mg/kg or 60 mg/kg) or 17beta-estradiol (E(2)) was administered to OVX mice for 4 months after bilateral ovariectomy. We observed the biochemical markers of bone turnover, e.g., alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP), in serum. We also observed the bone mineral density (BMD) in femurs and lumbar vertebrae. In addition, we examined trabecular bone and interstitial cells in the femur using hematoxylin and eosin staining. The decrease in ALP levels and the increase in TRAP levels normally resulting from ovariectomy were suppressed by administration of 60 mg/kg SIF or E(2). Administration of 60 mg/kg SIF or E(2) also maintained the BMD, trabecular bone, and interstitial cells in OVX mice compared to those in pre-OVX mice. These results suggest that 60 mg/kg SIF effectively mitigates ovariectomy-induced osteoporosis in middle-aged mice.