Association between Sarcopenic Obesity and Metabolic Syndrome in Postmenopausal Women: A Cross-sectional Study Based on the Korean National Health and Nutritional Examination Surveys from 2008 to 2011

BACKGROUND: Menopause contributes to an increase in visceral fat mass and a decrease in muscle protein synthesis. Therefore, we performed this study to examine their relationship how effect the changes of body composition as obesity and sarcopenia on metabolic syndrome (MS) as a predictor of cardiovascular disease in postmenopausal women. METHODS: Using data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011, we estimated that 4,183 postmenopausal women underwent dual energy X-ray absorptiometry scans. Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight that was less than 1 standard deviation below the sex specific mean for the young reference group. After classification into four groups, the results were adjusted with menopausal age and hormonal treatment. The relationship between sarcopenic obesity (SO) and MS in postmenopausal women was analyzed by logistic regression analysis in a complex sampling. RESULTS: In an unadjusted model, the odds ratio (OR) of MS for sarcopenia was 1.94 (95% confidence interval [CI], 1.52-2.49); the obesity group had an OR of 4.55 (95% CI, 3.63-5.71); and distinctly, the SO group had an OR of 6.26 (95% CI, 5.10-7.70). Even though there was controlling for variable adjustment, no definite difference was seen in the results. CONCLUSIONS: Sarcopenia and obesity were associated with MS independent of other metabolic impairment risk factors in both early menopausal and postmenopausal women. The results showed that, in particular, the prevalence of MS has increased more in postmenopausal women compared with previous research.

The Association between Chronic Diseases and Active Patient Participation

BACKGROUND: Active patient participation in health care decision-making can results in better medical outcomes. This study's purpose is to investigate the association between the patient participation and the diseases often encountered in primary care. METHODS: We used the data from the Korean National Health and Nutrition Examination Survey conducted in 2015 which included 4,158 adults aged older than 19 and who had no missing data. The association between the presence of disease or the number of accompanying diseases and the active patient participation in the treatment decision was studied. Logistic regression analysis was conducted using complex sampling design in each sex. RESULTS: After adjusting for confounding variables, the relationship between active patient participation and the diagnosis of hypertension, odds ratio (OR) was 1.95 (95% confidence interval [CI], 1.25-3.04) for men and 1.83 (95% CI, 1.27-2.65) for women. In women diagnosed with diabetes, OR was 0.58 (95% CI, 0.35-0.97). Between active patient participation and increasing number of accompanying diseases have positive tendency but not statistically significant. CONCLUSIONS: This study suggests that active patient participation is related to the diagnosis of hypertension, and the number of accompanying diseases and active patient participation were not significantly associated. This is a rare study related to the active patient participation in the Korean population, that it may be helpful in establishing further relevant research and strategies to increase the patient participation rate.

The Relationship between Smoking and Suicidal Behavior in Korean Adolescents: 12th Korea Youth Risk Behavior Web-based Survey

BACKGROUND: Suicide is the first leading cause of death among teenagers in Korea, and smoking is reported to be one of the risk factors for suicide. The purpose of this study is to investigate the relationship between smoking and smoking amount and suicidal behavior using data from the Korea Youth Risk Behavior Web-based Survey (KYRBS). METHODS: Using the 12th KYRBS 2016, we surveyed smoking, smoking amount, suicidal ideation, suicidal planning, and suicidal attempt of adolescents. And a total of 65,528 respondents were divided into current smoker, former smokers, and non-smoker, and 4,012 smokers were classified into ≤9 cigarettes/day group, 10–19 cigarettes/day group, and ≥20 cigarettes/day group according to the amount of smokers. We analyzed the relationship between smoking and smoking amount and suicidal ideation, suicidal planning, and suicidal attempt using multivariate logistic regression analysis. RESULTS: As a result of adjusting for all confounding variables, the current smoker has an odds ratio of 1.143 (confidence interval 1.020–1.281) with suicidal ideation compared to non-smoker and the odds ratio of suicidal planning and suicidal attempt is also statistically significant, respectively. And the odds ratio of all suicidal behaviors was significantly higher in ≥20 cigarettes/day group than in ≤9 cigarettes/day group, respectively. CONCLUSIONS: We found that smoking and smoking amount was related to suicidal ideation, suicidal planning, and suicidal attempts in adolescents. Therefore, suicidal prevention strategies considering this relationship should be established.

Secular Trends for Body-shape Perception, Weight-loss Efforts, and Weight-loss Behaviors in Korean Adults Using the Korea National Health and Nutrition Examination Survey from 2001 to 2014

BACKGROUND: The objective of study was to investigate secular trends for body-shape perception, weight-loss efforts, and weight-loss behaviors from 2001 to 2014 in Korean adults and factors related to those weight-related attitude. METHODS: Self-reported body-shape perception, weight-loss efforts, and weight-loss behaviors were used in 26,480 men and 35,051 women aged 19 or older using the Korean National Health and Nutrition Survey from 2001 to 2014 (from 2005 to 2014 for weight-loss behaviors). Multivariable logistic regression analysis was conducted using complex sampling design in each sex. RESULTS: Body-shape misperception tended to decrease from 2001 to 2014 and weight-loss efforts tended to increase over the period in all subjects, whereas unhealthy weight-loss behaviors tended to increase over the period in women. In multivariable logistic regression model, body-shape misperception in men was inversely associated with survey year, while positively associated with age and weight status. In women, body-shape misperception was inversely associated with survey year, education, and income, while positively associated with age and weight status. Weight-loss efforts in both sexes were inversely associated with age, while positively associated with survey year, education, income, and weight status. Healthy weight-loss behaviors were positively associated with education but inversely associated with age in men. In women, those behaviors were positively associated with education and weight status, while inversely associated with survey year. CONCLUSIONS: We found decreased body-shape misperception and increased weight-loss efforts in Korean men and women from 2001 to 2014, and decreased healthy weight-loss behaviors in women from 2005 to 2014.