Association of Proteinuria with Metabolic Syndrome in Korean Adults / 가정의학회지

BACKGROUND: Proteinuria is a predictor of chronic kidney disease and a common risk factor for cardiovascular disease. Previous studies have reported that a urinary albumin-creatinine ratio and a glomerular filtration rate was related to the metabolic syndrome. However, there have been few studies on association between the metabolic syndrome and proteinuria by the urine dip-stick test. We examined the association between the metabolic syndrome and the proteinuria by the urine dip-stick test. METHODS: The subject of this study included 20,075 adults aged more than 18 years old who visited the Health Promotion Center of the Seoul National University Hospital from April 2001 to March 2007. The metabolic syndrome was defined according to the criteria of the American Heart Association and National Heart, Lung and Blood Institute, and proteinuria was defined as a dipstick test above the '1+' level. The crude and multivariated-adjusted odds ratios of proteinuria were calculated by using logistic regression models with each component of the metabolic syndrome. RESULTS: Proteinuria was noticed in 5.7% of the subjects with metabolic syndrome, and 2.7% without metabolic syndrome. The multivariate-adjusted odds ratios of proteinuria in participants with elevated blood pressure level, elevated plasma glucose level and high triglyceride level were 2.23 (95% confidence interval [CI], 1.95 to 2.55), 2.33 (95% CI, 2.06 to 2.62), 1.64 (95% CI, 1.45 to 1.84). The multivariate-adjusted odds ratio of proteinuria in participants with the metabolic syndrome compared with participants without the metabolic syndrome was 2.30 (95% CI, 1.91 to 2.76), respectively. CONCLUSION: These findings suggest that proteinuria by the urine dip-stick test might be an important predictor in the metabolic syndrome.

Self-Reported Exposure to Second-Hand Smoke and Positive Urinary Cotinine in Pregnant Nonsmokers

PURPOSE: This cross-sectional study aimed to examine the association between self-reported exposure status to second-hand smoke and urinary cotinine level in pregnant nonsmokers. MATERIALS AND METHODS: We recruited pregnant nonsmokers from the prenatal care clinics of a university hospital and two community health centers, and their urinary cotinine concentrations were measured. RESULTS: Among a total of 412 pregnant nonsmokers, the proportions of self-reported exposure to second-hand smoke and positive urinary cotinine level were 60.4% and 3.4%, respectively. Among those, 4.8% of the participants who reported exposure to second-hand smoke had cotinine levels of 40 ng/mL (the kappa value = 0.029, p = 0.049). Among those who reported living with smokers (n = 170), "smoking currently permitted in the whole house" (vs. not permitted at home) was associated with positive urinary cotinine in the univariable analysis. Furthermore, this variable showed a significant association with positive urinary cotinine in the stepwise multiple logistic regression analysis [Odds ratio (OR), 15.6; 95% Confidence interval (CI) = 2.1-115.4]. CONCLUSION: In the current study, the association between self-reported exposure status to second-hand smoke and positive urinary cotinine in pregnant nonsmokers was poor. "Smoking currently permitted in the whole house" was a significant factor of positive urinary cotinine in pregnant nonsmokers. Furthermore, we suggest that a complete smoking ban at home should be considered to avoid potential adverse effects on pregnancy outcomes due to second-hand smoke.

Childhood Obesity and Familial Environmental Factor according to the Developmental Stages: the Korea NHANES Study

BACKGROUND: To investigate the association between childhood obesity and its risk factors according to specific childhood developmental stages. METHODS: We performed an analysis of data for 1922 children and adolescents aged 2 to 18 years obtained from the Third Korea National Health and Nutrition Examination Survey conducted in 2005. Weight and height were measured by trained interviewers. Childhood obesity was defined as BMI > or =95th percentile of the BMI cut-off point based on the Korean child growth curve. Data on socioeconomic characteristics such as age, education, occupation, income, physical activity and time spent watching television were collected using a well-established questionnaire and/or interview. RESULTS: The prevalence of obesity defined by using the Korean child growth curve was 4.1% in children aged 2 to 6, 6.3% in children aged 7 to 12, and 8.7% in adolescents aged 13 to 18. In the multiple logistic regression model, parental obesity, and time spent watching television were associated with increased risk of obesity in children aged 2~6. Parental obesity, family income level, birth weight, and time spent watching television were positively associated with obesity in children aged 7~12. In adolescents aged 13~18, participation in vigorous physical activity and attempts to control weight were associated with adolescent obesity. CONCLUSION: The prevalence and risk factors of childhood obesity vary substantially according to developmental stage. Differential approaches are needed for effective control of childhood obesity.