Lipid Profiles and Prevalence of Dyslipidemia in Korean Adolescents

BACKGROUND: The aim of this study is to investigate the distribution of plasma cholesterol and triglyceride levels as well as the prevalence of dyslipidemia among Korean adolescents. METHODS: We analyzed data for 3,045 adolescents aged 10-18 years (1,622 boys and 1,423 girls) who participated in the Korea National Health and Nutrition Examination Surveys from 2007 to 2010. RESULTS: The mean values of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were 159, 89, 89, and 52 mg/dL, respectively. Plasma cholesterol levels were significantly higher in girls than those in boys (162.1 mg/dL vs. 155.6 mg/dL, P < 0.0001). The 90th percentile values of total cholesterol, triglycerides, and LDL-C were 192, 149, 117 mg/dL for boys, and 195, 147, 119 mg/dL for girls. The 10th percentile value of HDL-C was 38 mg/dL for boys and 40 mg/dL for girls. Triglyceride, LDL-C cholesterol levels increased, whereas plasma HDL-C levels decreased with increasing the body mass index (P < 0.0001) in both genders. Total cholesterol levels significantly increased with increasing the body mass index, especially in boys (P < 0.0001). The prevalence of dyslipidemia was 25.2% for boys and 21.7% for girls; this value significantly increased with overweight (37-40%) and obesity (53-56%). Independent predictors (odds ratio) of dyslipidemia were age (1.49), overweight (2.06), and obesity (5.11) for boys; overweight (1.95) and obesity (3.22) for girls. CONCLUSION: Adolescent dyslipidemia is strongly associated with obesity. Lipid screening for overweight or obese youths should be emphasized. Further, longitudinal studies examining the impact of childhood obesity and dyslipidemia on subsequent cardiovascular diseases are needed.

Dietary patterns and metabolic syndrome risk factors among adolescents / 소아과

PURPOSE: Unbalanced diets and decreased physical activity have contributed to increased prevalence of obesity and metabolic syndrome in adolescents. We have performed a systematic review and data analysis to examine the association between dietary pattern and metabolic syndrome risk factors in adolescents. METHODS: We searched the PubMed and BioMedLib databases for appropriate articles published during the past 10 years and selected 6 articles. The studies reviewed applied factor analysis or cluster analysis to extract dietary patterns. For data analysis, we examined the association between dietary patterns and the prevalence of metabolic syndrome risk factors using data of 3,168 adolescents (13 to 18 years) obtained from 4 consecutive Korean Nutrition Health and Nutrition Examination Surveys (1998, 2001, 2005, and 2007 to 2009). RESULTS: Our systematic review confirmed that western dietary patterns are positively associated with metabolic syndrome risk factors such as obesity and elevated triglycerides, while traditional dietary patterns were negatively associated. Data analysis found that the number of adolescents aged 16 to 18 years who had "Rice & Kimchi" dietary pattern decreased, while the number having western dietary patterns increased during the 1998 to 2009 time frame. There were no changes in the dietary patterns in adolescents aged 13 to 15 years. The risk of elevated serum triglycerides and reduced serum high density lipoprotein cholesterol was high in the "Rice & Kimchi" dietary pattern compared to the other dietary pattern groups. CONCLUSION: Because adolescents' dietary patterns are changing continuously and have long-term effects, further studies on the dietary patterns of adolescents and their health effects into adulthood are necessary.

Awareness and perceived necessity of dietary guidelines among urban Koreans by gender

We examined an urban population's awareness of dietary guidelines to determine whether they perceived them to be necessary, and identified the factors affecting this awareness and perceived necessity. Data were collected via physical examinations and face-to-face interviews. Health indicators were collected from health examinations, and information on individual characteristics, including awareness, perceived necessity, and dietary status were obtained from the interviews. The subjects' sociodemographic, health and dietary status were examined as potential factors influencing awareness and perceived necessity. Descriptive statistics, contingency tables, and logistic regression modeling were used in the analysis. Low awareness of the dietary guidelines was displayed by the elderly and poorly educated individuals, and those without a spouse. Most people who were not aware of the dietary guidelines thought the guidelines unnecessary. Males with hypertension and lower hemoglobin levels, and females with less education had low awareness. Elderly females with lower bone density had less perceived necessity. Males and females with poor dietary status reported low perceived necessity.

A Pilot Study of HRV(Heart Rate Variability) in Patient with Urinary Incontinence

PURPOSE: To compare autonomic dysfunction in patients with urge urinary incontinence(UUI), patients with stress urinary incontinence(SUI) and normal group, we measured and analyzed heart rate variability to compare among the three groups. MATERIALS AND METHODS: We studied heart rate variability(HRV) in 30 patients with UUI(mean age, 47.7+/-10.0 years old), 40 patients with SUI(mean age, 47.6+/-8.7 years old), 120 healthy controls(mean age 45.2+/-6.9 years old). The parameters of HRV of the three groups were compared. RESULTS: There was no difference in uroflowmetry and heart rate among the three groups. In time domain, square root of the mean squared difference of successive N-N interval(RMSSD) in UUI was higher than that of the others, and standard deviation of N-N interval(SDNN) showed no difference. In frequency domain, low frequency(LF) in UUI, an indicator of cardiac sympathetic tone, was higher than thar of the others. Very low frequency(VLF), LF, low-frequency/high-frequency ratio(LF/HF ratio) didn't show difference. CONCLUSION: All parameters of HRV analysis in UUI were not same as those of SUI and controls. The increase in RMSSD and HF means that there could be imbalance in autonomic nervous system and it could be the cause of detrusor overactivity in UUI.

Socioeconomic Cost of Obesity in Korea

With dramatic transitions from a traditionally food-insecure to a food-sufficient society, over weight and/or obesity are an increasing health concern in Korea. In 2000, 35.9% of Korean adults were over weight (BMI>25) with increasing trends. It is well known that obesity is highly correlated with chronic diseases, such as diabetes, hypertension, cardiovascular disease, cancer and high cholesterol. In 2003, the social cost of obesity is estimated at 529.5~799.3 billion won (direct cost) and at 1,200~1,817 billion won (including indirect cost). The share of the direct cost is estimated at 2.6~3.9% of total medical bill 20,742 billion won. These costs are underestimated and would surely be higher if the expenditures outside of the official medical insurance system of Korea were included. Based on the rapid increase of obesity rate among the Korean youth, it is crucial to develop and implement appropriate policies to curb the obesity epidemic.

Needs Assessment of Nutrition Programs in Public Health Center by General Characteristics and Body Mass Index of Community Residents / 대한지역사회영양학회지

The purpose of this study was to assess the needs for nutrition programs in the public health centers by general characteristics and body mass index (BMI) of community residents. Information of general characteristics of study participants including age, education, income, marital status, residence, and job, and resident's interest in nutrition programs, the preferred educational methods and the willingness to participate in nutrition programs were collected by an interview. Weight and height were measured and were used to calculate the BMI. The program that resident's were most interested in was 'diet therapy for chronic disease and counseling' (28.5%), followed by 'nutritional management for the elderly' (21.1%), and 'obesity and weight control' (17.1%). 'Education and counseling by nutrition professionals' was the most preferred educational method. Among the programs that the subjects would participate in, if they were offered in public health centers, 65.8% subjects would participate in 'diet therapy for chronic disease and counseling' programs, 64.9% would participate in 'nutritional management for the elderly' programs and 52.2% would participate in 'obesity and weight control' programs. The contents of programs that the subjects were interested in, the preferred methods and their willingness to participate nutrition programs differed significantly by age, income, education, marital status, and body mass index. The results imply that the planning of nutrition interventions in the public health centers must be tailored and targeted group specific by taking the participants general characteristics and body mass index into consideration. This would surely increase the nutrition program's effectiveness

Cerebrovascular Reserve Measured by Acetazolamide-challenged Tc-99m ECD Brain Perfusion SPECT in Symptomatic Internal Carotid Artery and Middle Cerebral Artery Disease

BACKGROUND: Hemodynamic evaluation of the brain may be helpful for the identification of a risk of stroke in patients with middle cerebral artery (MCA) or internal carotid artery (ICA) steno-occlusive disease. The aim of this study was to evaluate the hemodynamic state in patients with steno-occlusive disease of ICA or MCA on the base of MRI/MRA and acetazolamide (ACZ)-challenged Tc-99m ECD brain perfusion SPECT findings. METHODS: An analysis of 68 patients who underwent MRI/MRA and ACZ-challenged Tc-99m ECD brain perfusion SPECT was performed. We divided these patients into two groups - MCA and ICA steno-occlusions. RESULTS: The cerebrovascular reserve (CVR) was impaired in 18 of 32 (56.3%) MCA disease patients (20 stenosis and 12 occlusions), and in 19 of 36 (52.8%) ICA disease patients (20 stenosis and 16 occlusion). The CVR was impaired in 22 of 28 (78.6%) occlusive patient, whereas in 15 of 40 (37.5%) stenotic patient (p< 0.01). The insular lesion was more commonly involved in the occlusion group (54%) than in the stenosis group (15%) (p< 0.01). CONCLUSIONS: There was no difference in CVR between MCA and ICA steno-occlusion groups. Incidence of impaired CVR was higher in occlusion group than stenosis group.

Cerebrovascular Reserve Measured by Acetazolamide-challenged Tc-99m ECD Brain Perfusion SPECT in Symptomatic Internal Carotid Artery and Middle Cerebral Artery Disease

BACKGROUND: Hemodynamic evaluation of the brain may be helpful for the identification of a risk of stroke in patients with middle cerebral artery (MCA) or internal carotid artery (ICA) steno-occlusive disease. The aim of this study was to evaluate the hemodynamic state in patients with steno-occlusive disease of ICA or MCA on the base of MRI/MRA and acetazolamide (ACZ)-challenged Tc-99m ECD brain perfusion SPECT findings. METHODS: An analysis of 68 patients who underwent MRI/MRA and ACZ-challenged Tc-99m ECD brain perfusion SPECT was performed. We divided these patients into two groups - MCA and ICA steno-occlusions. RESULTS: The cerebrovascular reserve (CVR) was impaired in 18 of 32 (56.3%) MCA disease patients (20 stenosis and 12 occlusions), and in 19 of 36 (52.8%) ICA disease patients (20 stenosis and 16 occlusion). The CVR was impaired in 22 of 28 (78.6%) occlusive patient, whereas in 15 of 40 (37.5%) stenotic patient (p< 0.01). The insular lesion was more commonly involved in the occlusion group (54%) than in the stenosis group (15%) (p< 0.01). CONCLUSIONS: There was no difference in CVR between MCA and ICA steno-occlusion groups. Incidence of impaired CVR was higher in occlusion group than stenosis group.

Intracranial Inflammatory Pseudotumors: MRI and CT Findings

PURPOSE: The purpose of this study was to describe the MR imaging and CT findings of intracranial inflammatory pseudotumors. MATERIALS AND METHODS: We reviewed the MR imaging (n=8) and CT (n=4) studies of eight patients (M:F = 4:4, mean age: 41 years) with pathologically proven intracranial inflammatory pseudotumor. The findings were then evaluated with regard to location, shape, MR signal intensity, CT density and degree of contrast enhancement of the lesion, surrounding parenchymal edema, adjacent bone change and the location of accompanying extracranial lesion. RESULTS: In two patients, the parietal convexity was involved unilaterally, with no extracranial mass, and in the other six, the middle cranial fossa was involved unilaterally and extracranial mass was present. The lesion also involved the tentorium in four cases, the cavernous sinus in four, the anterior cranial fossa in one, and the posterior cranial fossa in one. The location of extracranial mass was the mastoid and middle ear cavity in two cases, the infratemporal fossa in two, both the infratemporal fossa and paranasal sinuses in one, and the orbit in one. MR images showed diffuse dural thickening in all eight cases, leptomeningeal thickening in four, and focal meningeal-based mass in two. As seen on T1-weighted images, the lesions were isointense to gray matter in eight cases, and on T2-weighted images were hypointense in seven cases and isointense in one. Marked homogeneous contrast enhancement was seen in all eight cases. The lesions seen on brain CT, performed in two cases, were isodense. Adjacent brain parenchymal edema and the destruction of adjacent bones were each seen in five cases. CONCLUSION: The characteristic MR findings of intracranial inflammatory pseudotumors are(1) diffuse dural thickening;(2) a focal meningeal-based mass which on T2-weighted images is seen as hypointense; and marked (3) contrast enhancement : these findings are, however, nonspecific. In order to differentiate these tumors, an awareness of these findings is, however, useful.

Pathophysiologic Approach by Proximal Peroneal Nerve Conduction Study in Diabetic Neuropathy

BACKGROUND AND OBJECTIVES: Diabetes mellitus is known as a common cause of peripheral neuropathy. However, there is a continuous argument about the pathophysiologic mechanism of diabetic polyneuropathy : axonal degeneration versus segmental demyelination. We studied the patients with diabetic polyneuropathy by peroneal nerve conduction study using identical segments recording from proximal and distal peroneal muscles. METHODS: We studied 18 diabetic patients who were confirmed to have diffuse symmectrical sensorimotor polyneuropathy by conventional nerve conduction study. We also studied 18 healthy subjects. We measured peroneal motor conduction velocities across the same nerve segment, recording from proximal and distal muscles in both lower extremities. Compound muscle action potentials(CMAP) were simultaneously recorded from extensor digitorum brevis(EDB) and tibialis anterior(TA) muscles using the tendon-belly method. RESULTS: There was no significant difference in conduction velocities recorded from proximal and distal muscles in healthy subjects(EDB 50.5 m/s, TA 53.3 m/s). However, in patients with diabetic polyneuropathies, there was a significant decrease in conduction velocity obtained from distal recording, compared with that from proximal recording(EDB 36.8 m/s, TA 47.0 m/s, p<0.05, paired t-test). CONCLUSION: These results of proximal peroneal nerve conduction study are considered as another supporting evidence that axonal degeneration is the main pathomechanism of diabetic polyneuropathy.