Kyung Shik Lee

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.

Abdominal Obesity Is Associated with Albuminuria in Women: The 2011 Korea National Health and Nutrition Examination Survey

BACKGROUND The effects of obesity on the kidney, apart from diabetes or hypertension, have not drawn much attention. Moreover, only a few studies have reported the relationship between obesity status and albuminuria in Asian countries, including South Korea. Therefore, this study aimed to investigate the association between obesity status and albuminuria in Korean adults. METHODS We analyzed data from the 2011 Korea National Health and Nutrition Examination Survey. Of the 4,979 subjects included in the general-population group, 3,274 were sorted into a nondiabetic and nonhypertensive population group. Obesity status was measured by body mass index and waist circumference. Albuminuria was defined as a urine albumin-to-creatinine ratio ≥30 mg/g. RESULTS Abdominally obese women were at higher risk for albuminuria than were women without abdominal obesity both in the general population (odds ratio [OR], 95% confidence interval [CI]: 2.08 [1.04-4.16]) and in the nondiabetic and nonhypertensive population (OR [95% CI]: 6.96 [2.34-20.64]) after further adjustment for confounders. Among generally nonobese women, abdominally obese women were at higher risk for albuminuria than were women without abdominal obesity both in the general population (OR [95% CI]: 2.82 [1.51-5.29]) and in the nondiabetic and nonhypertensive population (OR [95% CI]: 5.32 [1.47-19.22]). CONCLUSION Abdominal obesity is associated with an increased risk for albuminuria in Korean women, independently of diabetes or hypertension. Screening for abdominal obesity, especially in women, may therefore provide earlier identification of individuals at risk for developing renal disease and cardiovascular disease, even those who are nondiabetic and nonhypertensive.

An increase in serum uric acid concentrations is associated with an increase in the Framingham risk score in Korean adults.

Abstract Background: Uric acid is a novel cardiovascular disease (CVD) factor, but its use as an independent risk factor for CVD remains controversial. Here, we examined the correlation between Framingham risk score (FRS) and serum uric acid concentrations in asymptomatic Korean adults. Methods: This cross-sectional study was performed on 8035 Korean adults. Besides FRS, we measured body mass index, fasting blood glucose, homeostasis model assessment of insulin resistance, creatinine, γ-glutamyltransferase, the lipid profile, uric acid, high-sensitive C-reactive protein, and the white blood cell count. All subjects were placed into one of three risk groups according to their FRS. Results: All CVD related factors were significantly different in the three FRS groups. The increments of uric acid in-creased significantly FRS from the 10-year risk 0%–9% group to the >10% group after adjusting for other CVD-related factors using ordinal logistic regression analysis. Analyses of the three age groups showed similar effects. Conclusions: An increased uric acid concentration is associated with an increase in coronary heart disease risk calculated from the FRS, and doctors need to pay attention to this CVD risk in apparently healthy adults with hyperuricemia.

Prevalence and Related Risk Factors of Albuminuria in Korean Adults: The 2011 Korea National Health and Nutrition Examination Survey

Background/Aims: Albuminuria is known to be associated with an increased risk for cardiovascular morbidity and mortality even in the general population. We aimed at investigating the prevalence and related risk factors of albuminuria among Korean adults. Methods: This study was based on data collected during the 2011 Korea National Health and Nutrition Examination Survey. A total of 5,365 Korean adults were included in the general population group, and 3,282 of these participants were included in the nondiabetic, nonhypertensive population group. Albuminuria was defined by a urine albumin-to-creatinine ratio value within the range of 3.4-34 mg/mmol (30-300 µg/mg). Results: The overall prevalence of albuminuria was 5.2% of the general population and 2.1% of the nondiabetic, nonhypertensive population. Factors associated with the risk of albuminuria in the general population were age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) level in men, and SBP and HbA1c level in women. In the nondiabetic, nonhypertensive population, age and fasting plasma glucose levels were significantly associated with an increased risk for albuminuria in men, and with central obesity, triglyceride level and smoking status in women. Conclusion: Albuminuria is prevalent in the nondiabetic, nonhypertensive population as well as general population of Korea. The increased risk of albuminuria was independently associated with several cardiovascular risk factors in the general population, and also in the nondiabetic, nonhypertensive population.

Dose-related association between urinary cotinine-verified smoking status and dyslipidemia among Korean men: the 2008-2010 Korea National Health and Nutrition Examination Survey.

This cross-sectionally designed study was based on data collected during the 2008–2010 Korea National Health and Nutrition Examination Survey. A total 3231 South Korean men aged more than 19 years were included. Urinary cotinine concentrations were measured. Smoking status was defined using questionnaire responses and urinary cotinine concentrations. Hierarchical multivariate logistic regression analyses were used to assess the association of urinary cotinine concentrations with the prevalence of dyslipidemia and various parameters of dyslipidemia. There is a significant dose-related association between smoking as assessed by urinary cotinine concentration and dyslipidemia and various parameters of dyslipidemia among South Korean men.

Contents Vol. 124, 2013

Chronic Kidney Disease and Hypertension A. Levin, Vancouver, B.C. R. Gansevoort, Groningen Acute Kidney Injury R. Mehta, San Diego, Calif. N. Kolhe, Derby Dialysis J. Daugirdas, Chicago, Ill. C. Hutchison, Hawkes Bay C. Fraansen, Groningen Patient Subjective Experience, Healthcare Delivery and Innovation in Practice R. Fluck, Derby E. Brown, London Crossover States with Non-Renal Organ Systems C. Chan, Toronto, Ont. T. Breidthardt, Basel N. Selby, Derby Transplantation A. Chandraker, Boston, Mass. A. Salama, London Editor-in-Chief