Sat-Byul Park

Serum Total Bilirubin Concentration Is Inversely Correlated with Framingham Risk Score in Koreans

BACKGROUND AND AIMS Compelling evidence suggests that bilirubin, via its antioxidant potential, has anti-atherogenic properties, and that serum bilirubin concentrations within the reference range for the general population may provide some protection against coronary artery disease (CAD). This study examined the association between serum total bilirubin concentration and Framingham risk score (FRS) in the Korean population. METHODS This cross-sectional study was performed on 19,792 Koreans. In addition to FRS, data on body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid, gamma glutamyltransferase, high-sensitive C-reactive protein and total bilirubin were used. RESULTS Negative correlations were established between log-transformed total bilirubin concentration and FRS (females; r = -0.067, p <0.001, males; r = -0.128, p <0.001). Analyses relating total bilirubin to FRS ≥10% utilized multiple confounder adjusted logistic regression. Unadjusted odd ratios for FRS ≥10% were 0.325 (95% CI: 0.160-0.659, p = 0.002) and 0.342 (95% CI: 0.281-0.417, p <0.001) for log-transformed total bilirubin in females and males, respectively. These inverse relationships remained significant after adjustments for multiple confounders in both genders. CONCLUSIONS Increased total bilirubin concentrations are associated with the decrease in FRS. Serum total bilirubin may be helpful to decrease the future risk of CAD.

Women with Fibromyalgia Have Lower Levels of Calcium, Magnesium, Iron and Manganese in Hair Mineral Analysis

Little is known about hair mineral status in fibromyalgia patients. This study evaluated the characteristics of hair minerals in female patients with fibromyalgia compared with a healthy reference group. Forty-four female patients diagnosed with fibromyalgia according to the American College of Rheumatology criteria were enrolled as the case group. Ageand body mass index-matched data were obtained from 122 control subjects enrolled during visit for a regular health check-up. Hair minerals were analyzed and compared between the two groups. The mean age was 43.7 yr. General characteristics were not different between the two groups. Fibromyalgia patients showed a significantly lower level of calcium (775 µg/g vs 1,093 µg/g), magnesium (52 µg/g vs 72 µg/g), iron (5.9 µg/g vs 7.1 µg/g), copper (28.3 µg/g vs 40.2 µg/g) and manganese (140 ng/g vs 190 ng/g). Calcium, magnesium, iron, and manganese were loaded in the same factor using factor analysis; the mean of this factor was significantly lower in fibromyalgia group in multivariate analysis with adjustment for potential confounders. In conclusion, the concentrations of calcium, magnesium, iron, and manganese in the hair of female patients with fibromyalgia are lower than of controls, even after adjustment of potential confounders.

Vitamin K supplement along with vitamin D and calcium reduced serum concentration of undercarboxylated osteocalcin while increasing bone mineral density in Korean postmenopausal women over sixty-years-old.

There are inconsistent findings on the effects of vitamin K on bone mineral density (BMD) and undercarboxylated osteocalcin (UcOC). The present intervention study evaluated the effect in subjects over 60-yr-old. The vitamin K group (vitamin K + vitamin D + calcium supplement; 15 mg of vitamin K2 [menatetrenone] three times daily, 400 IU of vitamin D once a day, and 315 mg of calcium twice daily) and the control group (vitamin D + calcium supplement) were randomly assigned. During the six months of treatment, seventy eight women participated (38 in the vitamin K group and 40 in the control group) and 45 women completed the study. The baseline characteristics of study participants did not differ between the vitamin K and the control groups. In a per protocol analysis after 6 months, L3 bone mineral density has increased statistically significantly in the vitamin K group compared to the control group (0.01 ± 0.03 g/cm2 vs -0.008 ± 0.04 g/cm2, P = 0.049). UcOC concentration was also significantly decreased in the vitamin K group (-1.6 ± 1.6 ng/dL vs -0.4 ± 1.1 ng/dL, P = 0.008). In conclusion, addition of vitamin K to vitamin D and calcium supplements in the postmenopausal Korean women increase the L3 BMD and reduce the UcOC concentration.

Efficacy and Safety of Human Placental Extract Solution on Fatigue: A Double-Blind, Randomized, Placebo-Controlled Study

Introduction. Fatigue is a common symptom, but only a few effective treatments are available. This study was conducted to assess the efficacy and safety of the human placental extract solution, which has been known to have a fatigue recovery effect. Methods. A total of 315 subjects were randomly assigned to three groups: group 1 (with Unicenta solution administration), group 2 (with exclusively human placental extract administration, excluding other ingredients from the Unicenta solution), and the placebo group. Subsequently, solutions were administered for four weeks. Results. The fatigue recovery rate was 71.00% in group 1, 71.72% in group 2, and 44.21% in the placebo group, which show statistically significant differences between the group 1 and the placebo group (P value = 0.0002), and between group 2 and the placebo group (P value = 0.0001). Conclusion. The human placental extract solution was effective in the improvement of fatigue.

Salivary cortisol levels, but not salivary α‐amylase levels, are elevated in patients with rheumatoid arthritis irrespective of depression

Stress is recognized as an important factor in the etiology of rheumatoid arthritis (RA). Therefore, we explored multiple aspects of stress in RA patients.

Serum Gamma-Glutamyltransferase as a Risk Factor for General Cardiovascular Disease Prediction in Koreans

Objective Gamma-glutamyltransferase (GGT) is a novel cardiovascular disease (CVD) risk factor, but its use as an independent factor for general CVD risk prediction remains unclear in general population. This study examined the association between serum GGT concentration and 10-year CVD risk in Koreans. Methods This cross-sectional study was performed on 27,270 Koreans. Besides individual components of 10-year CVD risk, body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid and high sensitive C-reactive protein data were used. The study subjects were grouped into quartiles according to the levels of GGT. Analyses relating GGT to 10-year CVD risk greater than 20% used multiple confounders-adjusted logistic regression. Results Positive correlations were established between log-transformed GGT concentration and 10-year CVD risk (Spearman’s rho = 0.51; P < 0.001). Compared to the lowest baseline GGT category, unadjusted odds ratios for 10-year CVD risk greater than 20% were significantly increased from the lowest to the highest GGT quartiles; these results remained significant after adjustments for multiple confounders. Conclusion Increased GGT concentration is associated with the increase in 10-year CVD risk. Serum GGT may be helpful to predict the future risk of general CVD.

Erosive esophagitis may be related to small intestinal bacterial overgrowth

Abstract Objectives. Erosive esophagitis (EE) may be related to small intestinal bacterial overgrowth (SIBO) because gastro-esophageal reflux disease has been a comorbid condition of irritable bowel syndrome (IBS), which has been associated with SIBO. We conducted a pilot study to investigate whether EE was associated with SIBO. Material and methods. Twenty-eight patients with EE according to the Los Angeles classification criteria and 29 sex- and age-matched subjects without EE were enrolled. All subjects underwent esophagogastroduodenoscopy and a lactulose hydrogen breath test. A peak of H2 values >20 ppm above the basal value after 10 g of lactulose ingestion was considered abnormal and suggestive of SIBO. Results. Abnormal lactulose hydrogen breath test results were found in 67% of EE patients, as compared with 37% in the control group; the difference was statistically significant (p = 0.024). Among the subjects without IBS, subjects with EE and controls had 65% and 31% abnormal lactulose hydrogen breath test results, respectively; the difference was also statistically significant (p = 0.032). Conclusions. Subjects with EE had a higher prevalence of SIBO, as assessed by the lactulose hydrogen breath test, with respect to a control group. These findings may suggest that EE is associated with SIBO.

Efficacy and safety of ursodeoxycholic acid composite on fatigued patients with elevated liver function and/or fatty liver: a multi-centre, randomised, double-blinded, placebo-controlled trial.

The aim of this study was to assess the effects of ursodeoxycholic acid composite (URSA‐S) on fatigue in patients with elevated liver function tests and/or fatty liver disease.

The Efficacy and Safety of a Combined Alendronate and Calcitriol Agent (Maxmarvil): A Postmarketing Surveillance Study in Korean Postmenopausal Women with Osteoporosis

Background Combined therapy with alendronate and calcitriol may have additive effects on bone density. An observational study was performed to evaluate the efficacy and safety of Maxmarvil, a combinative agent of alendronate (5 mg) and calcitriol (0.5 µg), and to identify factors associated with efficacy. Methods A total of 568 postmenopausal women with osteoporosis were enrolled by family physicians in 12 hospitals. The study subjects took Maxmarvil daily for 12 months. Questionnaires about baseline characteristics, socioeconomic status, and daily calcium intake were completed at the first visit. Adverse events were recorded every 3 months and bone mineral density (BMD) in the lumbar spine was measured using dual-energy X-ray absorptiometry at baseline and after 12 months. We evaluated the efficacy and safety of Maxmarvil, and the factors related to BMD improvement. Results A total of 370 patients were included in final analysis. The median BMD was 0.81 ± 0.12 g/cm2 at pre-treatment and 0.84 ± 0.13 g/cm2 after one year. The average BMD improvement was 3.4% ± 6.4% (P < 0.05), and 167 (45.1%) patients showed improvement. Factors associated with improved BMD were continuation of treatment (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.15 to 5.07) and good compliance (OR, 2.54; 95% CI, 1.29 to 5.00). Adverse events were reported by 35 of the 568 patients, with the most common being abdominal pain and dyspepsia. Conclusion Maxmarvil was found to be safe, well tolerated and effective in osteoporosis treatment. Continuation of treatment and good compliance were the factors associated with efficacy.