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BACKGROUND/OBJECTIVES@#The purpose of this study was to establish a database (DB) of foods containing vitamin D that were investigated in the Korea National Health and Nutrition Examination Survey (KNHANES), to estimate the dietary vitamin D intake, to evaluate the dietary adequacy of this intake, and to identify the major food sources of Koreans that contain vitamin D. @*SUBJECTS/METHODS@#This study used data from the KNHANES 2016–2019. Individuals aged ≥ 1 year who participated in the nutrition survey (n = 28,418) were included. The dietary intake was assessed by the 24-h dietary recall method and individual dietary vitamin D intake was estimated using a newly established vitamin D DB. Dietary adequacy was evaluated by comparing the dietary intake of the participants with adequate intake (AI) as defined by Dietary Reference Intakes for Koreans (KDRIs) 2020. @*RESULTS@#The average dietary vitamin D intake for all the subjects was 3.13 μg/d, which was 33.1% of AI. Dietary vitamin D intake was lower in rural residents, the elderly, and those with low income. The major food groups that contributed to the total dietary vitamin D intake were fish and shellfish (61.59%), eggs (17.75%), meat (8.03%), milk (4.25%), legumes (3.93%), and grains (3.84%). The top 10 individual food items that contributed to the total vitamin D intake were eggs (17.44%), squid (8.5%), eels (7.44%), salmon (5.35%), mackerel (5.27%), anchovies (4.65%), yellow croakers (4.58%), pork meat (4.47%), soymilk (4.46%), and skipjack tuna (3.80%). @*CONCLUSION@#These results show that the mean dietary vitamin D intake of Koreans is lower than the reference AI level. Nutritional policies need to be put in place to increase the vitamin D intake of Koreans in the future. In addition, comprehensive research on all the sources of vitamin D, including intake of supplements and biosynthesis in the skin, is required.
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BACKGROUND/OBJECTIVES@#Zinc is an essential trace mineral which is important for the growth and development of the human body and immunological and neurological functions.Inadequate zinc intake may cause zinc deficiency with its adverse consequences. In this study, we aimed to estimate the dietary zinc intake levels and sources among Koreans. @*SUBJECTS/METHODS@#For this secondary analysis, we obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2019. Individuals aged ≥ 1 yr who had completed a 24-h recall were included. The dietary zinc intake of each individual was calculated by applying data from a newly developed zinc content database to the KNHANES raw data. We also compared the extracted data with the sex-, age-specific reference values suggested in the Korean Dietary Reference Intakes 2020. The prevalence of adequate zinc intake was then evaluated by the proportion of the individuals who met the estimated average requirement (EAR). @*RESULTS@#The mean zinc intake of Koreans aged ≥ 1 yr and adults aged ≥ 19 yrs were 10.2 and 10.4 mg/day, equivalent to 147.4% and 140.8% of the EAR, respectively. Approximately 2 in 3 Koreans met the EAR for zinc, but the zinc intake differed slightly among the different age and sex groups. In children aged 1–2 yrs, 2 out of 5 exceeded the upper level of intake, and nearly half of the younger adults (19–29 yrs) and the elders (≥ 75 yrs) did not meet the EAR. The major contributing food groups were grains (38.9%), meats (20.4%), and vegetables (11.1%). The top 5 food contributors to zinc intake were rice, beef, pork, egg, and baechu kimchi, which accounted for half of the dietary intake. @*CONCLUSION@#The mean zinc intake among Koreans was above the recommended level, but 1 in 3 Koreans had inadequate zinc intake and some children were at risk of excessive zinc intake. Our study included zinc intake from diet only, thus to better understand zinc status, further research to include intake from dietary supplements is needed.
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Objective@#This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. @*Methods@#We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. @*Results@#In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia (more than one out of three conditions [low-density lipoprotein-cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein-cholesterol (men and women) <40 mg/ dL]) was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-high-density lipoprotein-cholesterolemia in women changed from <40 to <50 mg/dL. @*Conclusion@#Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
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Background@#This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. @*Methods@#We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. @*Results@#In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL. @*Conclusion@#Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
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Background@#This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults. @*Methods@#We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity). @*Results@#Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared. @*Conclusion@#Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.
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BACKGROUND/OBJECTIVES@#Magnesium is an essential nutrient for human health.However, inadequate intake is commonly reported worldwide. Along with reduced consumption of vegetables and fruits and increased consumption of refined or processed foods, inadequate magnesium intake is increasingly reported as a serious problem.This study aimed to assess magnesium intake, its dietary sources, and the adequacy of magnesium intake in Korean populations. @*SUBJECTS/METHODS@#Data was obtained from the Korea National Health and Nutrition Examination Survey 2016–2019 and included individuals aged ≥1 yr who had participated in a nutrition survey (n=28,418). Dietary intake was assessed by 24-h recall, and dietary magnesium intake was estimated using a newly established magnesium database. Diet adequacy was evaluated by comparing dietary intake with the estimated average requirement (EAR) suggested in the Korean Dietary Reference Intakes 2020. @*RESULTS@#The mean dietary magnesium intake of Koreans aged ≥1 yr was 300.4 mg/d, which was equivalent to 119.8% of the EAR. The prevalence of individuals whose magnesium intake met the EAR was 56.8%. Inadequate intake was observed more in females, adolescents and young adults aged 12–29 yrs, elders aged ≥65 yrs, and individuals with low income. About four-fifths of the daily magnesium came from plant-based foods, and the major food groups contributing to magnesium intake were grains (28.3%), vegetables (17.6%), and meats (8.4%). The top 5 individual foods that contributed to magnesium intake were rice, Baechu (Korean cabbage) kimchi, tofu, pork, and milk. However, the contribution of plant foods and individual contributing food items differed slightly by sex and age groups. @*CONCLUSIONS@#This study found that the mean dietary magnesium intake among Koreans was above the recommended intake, whereas nearly one in 2 Koreans had inadequate magnesium intake. To better understand the status of magnesium intake, further research is required, which includes the intake of dietary supplements.
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Background and Objectives@#There is growing evidence supporting the association between ultra-processed food (UPF) consumption and metabolic disease risk. However, little is known about the association between UPF consumption and blood pressure (BP). Thus, this study examined the association between UPF consumption and elevated BP in Korean adults. @*Methods@#This study used data from the Korea National Health and Nutrition Examination Survey (2016–2018) and included 9,188 participants aged 30–79 years without a history of hypertension diagnosis. Food items reported in a one-day 24-hour recall were categorized on the basis of the NOVA (not an acronym) food classification criteria. UPF consumption was estimated as the contribution to total energy intake. Elevated BP was defined as systolic BP ≥120 mmHg or diastolic BP ≥80 mmHg. The independent association between UPF consumption and elevated BP was assessed by multivariable logistic regression analysis. @*Results@#The upper tertile of UPF consumption was significantly associated with elevated BP compared with the lower tertile, after adjusting for potential confounders. A linear trend was observed for elevated BP across the tertiles of the dietary energy contribution of UPF. Similar results were found in stratified analyses by age group, smoking, obesity, and overall dietary quality. However, a marginal level of association was found in some subgroups, current smokers, and non-obese adults. @*Conclusions@#The dietary energy contribution of UPF consumption was positively associated with increased prevalence of elevated BP, and these findings suggest that lowering UPF consumption might help prevent BP elevation.
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BACKGROUND/OBJECTIVES@#Dietary sugars intake worldwide is stable or decreasing, but overall sugars intake remains above the recommended level. Some studies suggest that ultraprocessed foods (UPFs) drive excessive sugars intake. However, UPF consumption in Korea and its association with sugars intake have not yet been studied. This study aimed to estimate the contribution of UPF consumption to total sugars intake and to investigate the association between UPF consumption and total sugars intake in Koreans. @*SUBJECTS/METHODS@#Data from the Korea National Health and Nutrition Examination Survey 2016–2018 were used, and included data on 21,075 participants aged 1+ years completed a 24-h recall. Food items reported in the 24-h recall were classified according to the NOVA system as UPFs, processed foods, processed culinary ingredients, or unprocessed or minimally processed foods. @*RESULTS@#The average daily energy intake was 1,996 kcal, and UPFs accounted for 26.2% of the total energy intake (% TE). The average total sugars intake was 63.1 g (13.0% TE), and 44.9% of total sugars intake came from UPFs. Among the entire population, 15.8% exceeded the recommended limit for total sugars within 20% TE, and excessive total sugars intake was more prevalent among females (19.5%) and children (21.1%). The prevalence of excessive total sugars intake showed a significantly increasing tendency across the quartiles of UPF energy contribution, ranging from 11.9% in the lowest quartile to 23.2% in the highest quartile. Even after adjustment for sociodemographic variables, UPF consumption was positively associated with the prevalence of excessive total sugars intake (P for trend < 0.001). This association was similar in subgroup analyses by sex and age. @*CONCLUSIONS@#This study suggests that UPF consumption may drive excessive intake of total sugars in the Korean diet. Our findings conclusively establish that restricting UPF consumption may be an efficient way to reduce sugars intake in Korean population.
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OBJECTIVES@#This study explored the association between dietary and suicidal behaviors of Korean adolescents and investigated differences in this association in children of immigrant parents. @*METHODS@#The sample (n=368,138) was collected from the Korea Youth Risk Behavior Survey from 2015 to 2020. Participants who agreed to provide family information (n=313,689) were classified according to their parents’ nationality. The study variables were 11 self-reported dietary behaviors, and their composite dietary behaviors (i.e., nutrient deprivation and unhealthy food consumption) that resulted from principal component analysis. The association between study variables and suicide-related outcomes (i.e., suicidal ideation, suicide planning, and suicide attempts) was analyzed by multiple logistic regression with adjustment for covariates. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. @*RESULTS@#Participants who skipped key meals and foods were more likely to have attemped suicide (aOR [95% CI]: skipping breakfast ≥5 days/wk, 1.28 [1.21 to 1.35]; consuming fruits <1 times/wk: 1.42 [1.32 to 1.52]; consuming vegetables <1 times/wk: 1.72 [1.53 to 1.93]; consuming milk <3 times/wk: 1.07 [0.99 to 1.16]). The associations were prominent in third culture kids (TCKs) (aOR [95% CI]: 2.23 [1.61 to 3.09]; 2.32 [1.61 to 3.35]; 2.63 [1.50 to 4.60]; 1.69 [1.09 to 2.63], respectively). Participants who consumed unhealthy foods (fast food, caffeinated and sugary drinks) more frequently were more likely to have attempted suicide (aOR, 1.55; 95% CI, 1.38 to 1.73). This association was also more prominent in TCKs (aOR, 2.08; 95% CI, 1.08 to 4.01). @*CONCLUSIONS@#Our findings indicate a positive association between unfavorable dietary behaviors and outcomes related to suicide, and this association appears to be notable in adolescents with immigrant parents.
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OBJECTIVES@#Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population. @*METHODS@#We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positiveegative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL. @*RESULTS@#Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men. @*CONCLUSIONS@#Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.
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Purpose@#Key Foods refers to foods that have a high contribution in the nutrient intake of individuals, and exert important effects on their health. This study was undertaken to identify Korean Key Foods, using data from the 7th Korea National Health and Nutrition Examination Survey (KNHNES). @*Methods@#The data source for the extraction of Key Foods was the 24-hour dietary survey data obtained from the 7th KNHNES (2016–2018), and 21,271 subjects were evaluated. A total of 17 nutrients were selected as the key nutrients for identifying the Key Foods, including energy, carbohydrates, protein, lipid, dietary fiber, calcium, phosphorus, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, vitamin C, cholesterol, and sugars. The nutrient consumption approach was applied to generate a list of potential Key Foods. Foods included in 85% of the cumulative intake contribution from one or more key nutrients, were subsequently selected as Key Foods. @*Results@#Of the 1,728 foods consumed by survey respondents, we extracted 728 Key Foods. These Key Foods explained 94% key nutrient intakes of the subjects. Based on the contribution rate to key nutrient intake, the top 10 Key Foods identified were multigrain rice (5.32%), plain white rice (4.23%), milk (3.3%), cabbage kimchi (2.82%), grilled pork belly (1.56%), apples (1.52%), fried eggs (1.49%), cereal (1.36%), instant coffee mix (1.21%), and sweet potatoes (1.12%). These 10 foods accounted for 23.93% total key nutrient intake of the survey respondents. @*Conclusion@#Seven hundred and twenty-eight foods were extracted and identified as the 2020 Korean Key Foods. These Key Foods can be considered the priority foods to be analyzed for establishing a national nutrient database.
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OBJECTIVES@#Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population. @*METHODS@#We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positiveegative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL. @*RESULTS@#Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men. @*CONCLUSIONS@#Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.
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Purpose@#This study examined the effects of nutritional education related to sugar in elementary school children on nutritional knowledge, attitude, and dietary behavior. @*Methods@#A questionnaire survey on the knowledge, attitudes, and intake related to sugar was conducted on 572 students in grades 4–5, who were attending five elementary schools in Seoul and Gyeonggi-do. @*Results@#Among the survey subjects, 270 (49.8%) were cognitive in education, and 302 (50.2%) were non-cognitive. The sugar-related knowledge score was 3.67 points in the cognitive education group, which was significantly higher than the 3.55 points in the non-cognitive group. The rate of checking the sugar content in the nutrition label was 31.2% in the cognitive education group, which was significantly higher than in the non-cognitive group, 15.4%. The cognitive education group had a higher intake frequency of unsweetened candy, jelly, and raw fruits, and higher sugar intake of unsweetened bread, white milk, and raw fruits than the non-cognitive group. In the case of the cognitive education group, the total knowledge score showed a positive correlation with the food behavior scores, and a negative correlation with the frequency of purchasing snacks after school, and the average sugar intake per day. In the cognitive education group only, the education of nutrition teachers was analyzed as a factor to reduce the total sugar intake. The cognitive group of sugar education tried to eat foods with a lower sugar content than the non-cognitive group, and nutrition education was an important factor affecting the sugar intake. @*Conclusion@#To reduce the sugar intake of elementary school students, it will be necessary to practice oriented-nutrition education by nutrition teachers continuously. In addition, it is important to develop and disseminate various types of nutrition education materials related to sugar that can be utilized easily by nutrition teachers.
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Objectives@#We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. @*Methods@#The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. @*Results@#VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. @*Conclusions@#Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.
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BACKGROUND AND OBJECTIVES@#Although dietary management is strongly recommended in patients with hypertension, little is known about how many manage their diet and follow the guidelines for hypertension. We investigated the prevalence of dietary management among adults with known hypertension and evaluated their compliance to the dietary guidelines.@*METHODS@#Data from the Korea National Health and Nutrition Examination Survey 2013–2016 were used. Among 15,870 adults aged 30–79 years, 4,162 reported a physician-diagnosed hypertension. Diet management behavior was defined by self-report response. Actual dietary intake was assessed by a 24-hour dietary recall. Dietary quality was evaluated using the Korean Healthy Eating Index (KHEI).@*RESULTS@#Among adults with hypertension, 28.0% reported that they were managing their diet. Those with hypertension consumed significantly less dietary sodium (p value<0.01), but also less potassium (p value<0.01), resulting in no difference of sodium-to-potassium ratio compared to those without hypertension (p value=0.66). Among those with hypertension, diet-managing adults had better KHEI score (66.9, p value<0.01) and consumed less sodium (3,354.3 mg, p value<0.01) than not-managing adults (63.6 score and 3,554.5 mg, respectively). However, total KHEI score was rather lower in those with hypertension (p value<0.01) than those without hypertension and their sodium intake was still over the recommended amount.@*CONCLUSIONS@#More than two-thirds of Korean adults with hypertension did not manage their diet in daily life. More effective strategies are needed to increase the level of compliance with dietary recommendations for people with high blood pressure.
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BACKGROUND AND OBJECTIVES@#Cigarette smoking has been reported to be associated with arterial stiffness. However, the clinical relevance of smoking cessation on arterial stiffness is debatable. Thus, we evaluated whether smoking cessation is associated with arterial stiffness.@*METHODS@#A total of 1,169 male participants aged 30–64 years with absence of cardiovascular diseases in 2013–2017 were selected from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study. The subjects were classified into the following 5 groups based on self-reporting: non-smokers, former smokers (<1, 1 to <10, and ≥10, years after cessation), and current smokers. Arterial stiffness was assessed using the augmentation index (AIx). The radial artery AIx was obtained from the peripheral artery waveform. The association was explored cross-sectionally.@*RESULTS@#The AIx of former smokers did not differ from that of non-smokers (p=0.089). However, after former smokers were stratified by duration of smoking cessation, we noted a linear trend according to the smoking status (p<0.001). Men who quit smoking <1 year ago showed an elevated AIx (β=3.94, standard error=1.54, p=0.011) as much as ones of current smokers (β=4.39, standard error=0.74, p<0.001), while those who quit more than a decade ago showed an AIx similar to that of non-smokers (β=0.35, standard error=0.82, p=0.670) after controlling covariates.@*CONCLUSIONS@#A dose-response association between smoking cessation and AIx was revealed, which implies the possibility of a reversible effect of smoking cessation on arterial stiffness. Therefore, our findings may motivate current smokers to modify their smoking habits to delay or reverse disease progression.
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Background@#Evidence suggests that habitual snoring is an independent risk factor for poor glycemic health. We examined the associations between snoring with prediabetes and diabetes in Korean population. @*Methods@#Self-reported snoring characteristics were collected from 3,948 middle-aged adults without prior cardiovascular diseases. Multivariable linear regression assessed the association of snoring intensity, frequency, disruptiveness, and disrupted breathing with fasting glucose and glycosylated hemoglobin (HbA1c) level. Then, multinomial regression evaluated how increasing snoring symptoms are associated with the risk for prediabetes and diabetes, adjusting for socioeconomic and behavioral risk factors of diabetes, obesity, hypertension, and other sleep variables. @*Results@#Higher snoring intensity and frequency were positively associated with fasting glucose and HbA1c levels. Participants presenting the most severe snoring were at 1.84 times higher risk (95% confidence interval [CI], 1.09 to 2.29) for prediabetes and 2.24 times higher risk (95% CI, 1.84 to 2.95) for diabetes, compared to non-snorers. Such graded association was also observed amongst the most frequent snorers with higher risk for prediabetes (odds ratio [OR], 1.78; 95% CI, 1.29 to 2.22) and diabetes (OR, 2.03; 95% CI, 1.45 to 2.85). Disruptive snoring (OR, 1.60; 95% CI, 1.12 to 2.28) and near-daily disruptive breathing (OR, 2.18; 95% CI, 1.02 to 4.19) were associated with higher odds for diabetes. Such findings remained robust after additional adjustment for sleep duration, excessive daytime sleepiness, unwakefulness, and sleep-deprived driving. @*Conclusion@#Snoring is associated with impaired glucose metabolism even in otherwise metabolically healthy adults. Habitual snorers may require lifestyle modifications and pharmacological treatment to improve glycemic profile.
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Background@#Inflammatory cytokines are increasingly utilized to detect high-risk individuals for cardiometabolic diseases. However, with large population and assay methodological heterogeneity, no clear reference currently exists. @*Methods@#Among participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort, of communitydwelling adults aged 30 to 64 without overt cardiovascular diseases, we presented distributions of tumor necrosis factor (TNF)-α and -β, interleukin (IL)-1α, -1β, and 6, monocyte chemoattractant protein (MCP)-1 and -3 and high sensitivity C-reactive protein (hsCRP) with and without non-detectable (ND) measurements using multiplex enzyme-linked immunosorbent assay. Then, we compared each markers by sex, age, and prevalence of type 2 diabetes mellitus, hypertension, and dyslipidemia, using the Wilcoxon Rank-Sum Test. @*Results@#In general, there were inconsistencies in direction and magnitude of differences in distributions by sex, age, and prevalence of cardiometabolic disorders. Overall, the median and the 99th percentiles were higher in men than in women. Older participants had higher TNF-α, high sensitivity IL-6 (hsIL-6), MCP-1, hsCRP, TNF-β, and MCP-3 median, after excluding the NDs.Participants with type 2 diabetes mellitus had higher median for all assayed biomarkers, except for TNF-β, IL-1α, and MCP-3, in which the medians for both groups were 0.00 due to predominant NDs. Compared to normotensive group, participants with hypertension had higher TNF-α, hsIL-6, MCP-1, and hsCRP median. When stratifying by dyslipidemia prevalence, the comparison varied significantly depending on the treatment of NDs. @*Conclusion@#Our findings provide sex-, age-, and disease-specific reference values to improve risk prediction and diagnostic performance for inflammatory diseases in both population- and clinic-based settings.
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Background@#We examined the associations between thigh muscle area (TMA) and insulin resistance (IR) according to body mass index (BMI) in middle-aged Korean general population. @*Methods@#TMA was measured using quantitative computed tomography and corrected by body weight (TMA/Wt) in 1,263 men, 788 premenopausal women, and 1,476 postmenopausal women all aged 30 to 64 years. The tertiles of TMA/Wt were calculated separately for men and for premenopausal and postmenopausal women. Homeostatic model assessment for insulin resistance (HOMA-IR) was performed using fasting blood glucose and insulin levels, and increased IR was defined according to sex-specific, top quartiles of HOMA-IR. Associations between the TMA/Wt tertiles and increased IR according to the BMI categories (<25 and ≥25 kg/m2 ) were assessed using multivariable logistic regression analysis. @*Results@#In men with higher BMIs, but not in those with lower BMIs, the presence of an increased IR had significantly higher odds ratios in the lower TMA/Wt tertiles, even after adjustment for visceral fat area. However, in premenopausal and postmenopausal women, there was no significant inverse association between TMA/Wt tertiles and increased IR, regardless of BMI category. @*Conclusion@#Our findings suggest that the thigh muscle is inversely associated with IR in men, particularly in those with higher BMIs.
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Background/Aims@#Cigarette smoking and abnormal blood lipids are major risk factors for cardiovascular disease. The results of previous studies on the relationship between cigarette smoking and dyslipidemia are controversial. In the present study, we investigated the independent association between cigarette smoking and blood lipid levels in a male Korean population. @*Methods@#A total of 1,932 men aged from 30 to 64 years old participated in the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study. Smoking history was obtained by in-person interviews. In all regression models, measurements of triglyceride levels were log-transformed. @*Results@#Triglyceride levels were higher in current smokers than in never-smokers (median: 149 mg/dL vs. 115 mg/dL, p < 0.001) even after adjusting age, body mass index, alcohol intake, systolic blood pressure, fasting glucose, physical activity, and nutrition intake (β = 0.14, p < 0.001). We further divided people into heavy and light smokers using 20 pack-years as the cut-off. Higher triglyceride were found in current heavy smokers (β = 0.18, p < 0.001), current light smokers (β = 0.13, p < 0.001), as well as in past heavy smokers (β = 0.08, p = 0.037), as compared to never-smokers. Moreover, significantly lower high-density lipoprotein cholesterol (HDL-C) were observed in current heavy smokers (β = –2.27 mg/dL, p = 0.009). @*Conclusions@#Cigarette smoking is associated with higher triglyceride in Korean men, with the most dramatic effect seen in current smokers with a smoking history of more than 20 pack-years. HDL-C were also lower in current smokers with more than 20 pack-years.