Noninvasive Serum Fibrosis Markers are Associated with Coronary Artery Calcification in Patients with Nonalcoholic Fatty Liver Disease

BACKGROUND/AIMS: Advanced hepatic fibrosis is associated with cardiovascular disease (CVD) in patients with nonalcoholic fatty liver disease (NAFLD). We investigated the association between noninvasive serum fibrosis markers and the coronary artery calcium score (CACS) in subjects with NAFLD. METHODS: We analyzed 665 NAFLD subjects without chronic liver disease or heart disease between 2011 and 2015. The noninvasive fibrosis markers that were used to evaluate the severity of hepatic fibrosis included the NAFLD fibrosis score (NFS), fibrosis-4 (FIB-4) score, Forn's index, and the aspartate aminotransferase to platelet ratio index (APRI). RESULTS: The areas under the receiver operating characteristics curves for the NFS, FIB-4 score, Forn's index and APRI for predicting CACS >100 were 0.689, 0.683, 0.659, and 0.595, respectively. According to the multivariate analysis, older age, increased body mass index (BMI), and decreased estimated glomerular filtration rate (eGFR) were significant factors associated with CACS >100. The NFS, FIB-4 score and APRI were significantly associated with CACS >100 after adjusting for age and gender (p=0.006, p=0.012, and p=0.012, respectively) and after adjusting for age, gender, BMI and eGFR (p=0.013, p=0.022, and p=0.027, respectively). Scores integrating noninvasive fibrosis markers and other risk factors improved the predictive accuracy. CONCLUSIONS: The NFS and FIB-4 score were associated with coronary atherosclerosis in subjects with NAFLD. Furthermore, scores integrating these noninvasive scores and risk factors for CVD showed good discriminatory power in predicting CACS >100. Therefore, noninvasive serum fibrosis markers may be useful tools for identifying NAFLD subjects at a high risk for CVD.

Waist Circumference-to-Height Ratio and Coronary Artery Calcification

BACKGROUND: Many studies have demonstrated that the waist-to-height ratio (WHtR) is more correlated with coronary artery disease (CAD) than the body mass index (BMI). Coronary artery calcification (CAC) is an independent risk factor of atherosclerotic heart disease. However, the association between the WHtR and the coronary artery calcification score (CACS) still needs to be studied. The purpose of this study was to investigate the relationship between WHtR and CACS in healthy adults. METHODS: A total of 1,111 adults without a history of cardiovascular disease who visited the Health Promotion center at the University Hospital were included in this study. All subjects hadtheir CACS measured via multi-detector computed tomography (MDCT). RESULTS: Participants with a CACS > 0 had a greater WHtR than those with a CACS of 0 (0.535±0.006 vs 0.517±0.005, p=0.007, 95% CI: 1.01-1.04). CONCLUSION: In this study of adults without heart disease, WHtR was an independent predictor of CAC. These results suggest that WHtR may be a useful marker of CAD.

The Association between Oxidative Stress and Metabolic Syndrome in Adults / 가정의학회지

BACKGROUND: In this Study, we investigated the effects of lifestyle and metabolic syndrome on free oxygen radical levels in men and women in Korea. METHODS: A total of 254 adults were included in this study from February 2011 to June 2012 at a health promotion center. Information of the lifestyles and presence of metabolic syndrome factors was obtained. Biochemical markers were measured and free oxygen radicals test (FORT) was performed on the blood. RESULTS: Of the 254 subjects, 86 (33.9%) had metabolic syndrome, and 187 (73.6%) were men. Between the subjects with and without metabolic syndrome, there was a significant increase in alanine aminotransferase and serum FORT values in the subjects with metabolic syndrome. Multiple linear regression analysis showed that high-sensitivity C-reactive protein (hs-CRP) (P = 0.004), metabolic syndrome (P = 0.037), and female gender (P = 0.030) were independent predictors of serum FORT values. The subjects with high fasting blood sugar level or low high density lipoprotein cholesterol levels showed high serum FORT values. CONCLUSION: High hs-CRP, the presence of metabolic syndrome, and female gender were associated with the high oxidative stress. High oxidative stress was associated with the presence of metabolic syndrome.

Helicobacter pylori Infection Enhances Gastric Mucosal Inflammation in Individuals Carrying the 260-T Allele of the CD14 Gene

BACKGROUND/AIMS: We aim to evaluate the association between promoter polymorphism of the clusters of differentiation 14 (CD14) gene and Helicobacter pylori-induced gastric mucosal inflammation in a healthy Korean population. METHODS: The study population consisted of 267 healthy subjects who visited our hospital for free nationwide gastric cancer screening. Promoter polymorphism at -260 C/T of the CD14 gene was determined by polymerase chain reaction and restriction fragment length polymorphism analysis. The severity of gastric mucosal inflammation was estimated by a gastritis score based on the sum of the values of the grade and activity of the gastritis. Expression of soluble CD14 (sCD14) was assessed by quantitative sandwich ELISA. RESULTS: CD14 polymorphism was not associated with H. pylori infection. There were no significant differences in gastritis scores among the genotype subgroups, but subjects carrying the CD14 -260 CT/TT genotype had significantly higher sCD14 levels than those carrying the CC genotype. Subjects with the 260-T allele of the CD14 gene and H. pylori infection had significantly higher sCD14 levels than those with the same genotype but without infection. CONCLUSIONS: In individuals with the T allele at the -260 site of the promoter region of the CD14 gene, H. pylori infection accentuates gastric mucosal inflammation.

Assessment of Lifestyle Effects on the Levels of Free Oxygen Radicals in the Korean Population / 가정의학회지

BACKGROUND: As many studies revealed that oxidative stress due to the imbalance of reactive oxygen species (ROS) and antioxidant capacity is related with pathologic processes such as cardiovascular diseases, diabetes, as well as aging and obesity, the relationship between lifestyle and oxidative stress has recently gained much medical attention. However, little information exists on the effects of lifestyle on ROS in Korea. In this study, we investigated the effects of lifestyle on free oxygen radical levels in men and women in Korea. METHODS: A total of 138 adults participated in this study from September 2007 to June 2010 at a health promotion center and department of family medicine. Information on the lifestyle of each participant was obtained by questionnaire. Biochemical markers and a free oxygen radical test (FORT) were also measured. RESULTS: The average age was 47.28 +/- 10.85 years and 79.7% were male. High sensitivity C-reactive protein (hs-CRP; r = 0.418, P = 0.012), triglycerides (r = -0.243, P = 0.008), hemoglobin (r = -0.445, P < 0.001), total protein (r = 0.210, P = 0.036), creatinine (r = -0.294, P = 0.001), fruit intake per day (P = 0.047), and smoking (P = 0.003) were related to the FORT levels in univariate analysis. Multiple linear regression analysis showed that hs-CRP (P = 0.039) was an independent predictor of serum FORT values. This statistical model can explain 78% of the variance in FORT values. CONCLUSION: This result suggests that hs-CRP showed a statistically significant positive association with FORT values. Further studies on the relationship between lifestyle and antioxidant capacity as well as ROS seem to be warranted to evaluate the overall effect of oxidative stress.

Relationship between Irritable Bowel Syndrome, Worry and Stress in Adolescent Girls

The aim of this study is to investigate prevalence of irritable bowel syndrome (IBS) among adolescents and difference in worry and stress between normal and IBS groups. Questionnaire survey was conducted at a girl's middle and high school. Students from seventh to eleventh grade participated in the examination on Rome II criteria, lifestyle and dietary habits. Worry and stress were measured with the Korean version Penn State Worry Questionnaire-Children and the Korean version Brief Encounter Psychosocial Instrument. Worry score was significantly higher in the IBS group (22.07 +/- 9.38, P < 0.001) than in the normal group (18.65 +/- 8.99) and was higher in high school students than in middle school students (P = 0.02). Stress score also was higher in the IBS group than in the normal group (P < 0.001) and was higher in the high school girls than in the middle school ones (P = 0.04). Of all the lifestyle factors influencing IBS preference for fatty foods, preference for salty foods, drinking alcohol and sleeping for less than six hours a day were found to be significant. Worry and stress seem to be associated with IBS symptoms. The findings of this study draw a clue that less worry and stress will help decrease IBS symptoms.

Relationship between Irritable Bowel Syndrome, Worry and Stress in Adolescent Girls

The aim of this study is to investigate prevalence of irritable bowel syndrome (IBS) among adolescents and difference in worry and stress between normal and IBS groups. Questionnaire survey was conducted at a girl's middle and high school. Students from seventh to eleventh grade participated in the examination on Rome II criteria, lifestyle and dietary habits. Worry and stress were measured with the Korean version Penn State Worry Questionnaire-Children and the Korean version Brief Encounter Psychosocial Instrument. Worry score was significantly higher in the IBS group (22.07 +/- 9.38, P < 0.001) than in the normal group (18.65 +/- 8.99) and was higher in high school students than in middle school students (P = 0.02). Stress score also was higher in the IBS group than in the normal group (P < 0.001) and was higher in the high school girls than in the middle school ones (P = 0.04). Of all the lifestyle factors influencing IBS preference for fatty foods, preference for salty foods, drinking alcohol and sleeping for less than six hours a day were found to be significant. Worry and stress seem to be associated with IBS symptoms. The findings of this study draw a clue that less worry and stress will help decrease IBS symptoms.

The Relationship between Metabolic Syndrome and Cognitive Function / 가정의학회지

BACKGROUND: Metabolic syndrome has been reported to have adverse effects on cognitive function, although the results are conflicting. The purpose of this study was to examine the relationship between metabolic syndrome and cognitive function in elderly Korean participants older than 60 years. METHODS: We examined elderly participants who visited the health promotion center in Gyeonggi-do province. We categorized the participants into two groups based on the presence of metabolic syndrome (48 participants in the metabolic syndrome group and 45 in the control group). Cognitive function was assessed in all participants using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K). RESULTS: Compared with those without metabolic syndrome, participants with metabolic syndrome had lower mean total CERAD-K scores (64.2 +/- 11.1 vs. 69.8 +/- 9.2, P = 0.010). In the comparison of CERAD-K items, significantly lower scores were observed in the verbal fluency test, the construction recall test, the word list learning test, and trail making B in the group with metabolic syndrome. After controlling age, sex, education, smoking, alcohol, physical activity and the Korean version of the Short Geriatric Depression Scale of Korean, multiple regression analysis showed that metabolic syndrome was independently associated with cognitive function (P = 0.014). Alcohol intake (P = 0.002) and education years (P = 0.001) were also contributing factors to cognitive function. CONCLUSION: This study found a significant relationship between cognitive function and metabolic syndrome. It will be necessary to perform a prospective study to determine whether metabolic syndrome causes cognitive dysfunction or if the correction of metabolic syndrome can improve cognitive function.

The Relationship between Menopausal Symptoms and Heart Rate Variability in Middle Aged Women / 가정의학회지

BACKGROUND: The study of the correlation of menopausal symptoms with heart rate variability (HRV) has not been adequate. The aim of this study was to investigate the relationship between postmenopausal symptoms measured by the menopause rating scale (MRS) and HRV. METHODS: We assessed postmenopausal symptoms (using MRS) with age, BMI, educational status, occupation, marital status, alcohol and caffeine consumption, smoking history, exercise, duration of sleep and amenorrhea, degree of anxiety and depression, menarcheal age, and heart rate variability. For evaluation of HRV, the record of electrocardiogram for 5 minutes in the resting state was divided into temporal categories and frequency categories, and analyzed. RESULTS: No significant differences in age, BMI, duration of amenorrhea, heart rate, systolic blood pressure, diastolic blood pressure, fasting blood sugar, triglyceride, and high-density lipoprotein were observed between two groups, which were divided according to menopausal symptoms. Low frequency/high frequency (LF/HF) ratio was significantly higher in symptomatic women, compared with asymptomatic women (P < 0.05). No significant differences of HRV index by the severity of postmenopausal symptoms were observed. LF/HF ratio of HRV parameters showed a significant increase in moderate or severe degree of "hot flashes" and "sleep problem" score (P < 0.05). Anxiety scale in symptomatic women was significantly higher than in asymptomatic women (P < 0.05). CONCLUSION: The above data suggest that postmenopausal symptoms are associated with altered autonomic control of heart rate. In particular, hot flashes and sleep problems in moderate or severe degree are related to increase of sympathetic nerve activity.

Relationship between Metabolic Syndrome and Aging Male Symptoms in Middle-Aged Males in Korea / 가정의학회지

BACKGROUND: Metabolic syndrome is regarded as a risk factor of cardiovascular disease. We observed and compared aging males symptoms (AMS) between healthy and metabolic syndrome patients in middle-aged Korean men to evaluate clinical significance of AMS. METHODS: From May 2009 to July 2009, 171 middle-aged men (over 40 years-old) who visited a health promotion center of a university hospital in Gyeonggi Province were enrolled in study. The subjects were divided into two groups; metabolic syndrome (N = 87) vs. control (N = 84) and measured the aging male symptoms (AMS) scale. AMS were also grouped according to its severity. RESULTS: There were no significant differences except, weight, body mass index between two groups. In AMS severity, 'severe' group show higher prevalence of metabolic syndrome. And the group of metabolic syndrome gets higher AMS score than control. Among the five constitutive factors of metabolic syndrome, the prevalence of fasting blood sugar (> or = 100 mg/dL) and triglyceride (> or = 150 mg/dL) level is higher 'moderates' and 'severe' groups in AMS severity. In the subscale analysis of AMS, there are significant differences between two groups in sexual and somato-vegitative axis, but are not in psychological axis. With age-adjusted analysis, the results still show same trend. CONCLUSION: It might be necessary to approach aging males symptoms comprehensively during the management of metabolic syndrome in middle-aged men. And it could be helpful in treatment to recognize and control metabolic syndrome factors for the patients with severe aging males symptoms.

Reliability and Validity of the Korean Version of the Penn State Worry Questionnaire in Primary School Children

Worry is a generalized psychological phenomenon seen among most people. When worry is excessive and nearly uncontrollable, people usually suffer psychological pain. The Penn State Worry Questionnaire for Children (PSWQ-C) was developed to measure worry objectively. It comprises 14 items for measuring excessive, generalized, and uncontrollable worry in children. This study, conducted with a large group of elementary children (3rd through 6th graders, ages 8-12 yr; N=973), investigated the reliability and validity of the Korean version of the Penn State Worry Questionnaire for Children (PSWQ-CK). The PSWQ-CK showed high reliability by test-retest and also excellent internal consistency results. To examine the validity of the PSWQ-CK, we calculated its correlation with the Revised Children's Manifest Anxiety Scale (RCMAS). The PSWQ-CK had a higher correlation with the worry/oversensitivity factor than with other subscales of the RCMAS, and it showed no correlation with the lie factor. When 3 reversed PSWQ-CK items were eliminated, the instrument showed higher internal consistency. However, this did not improve its correlation with other anxiety-measuring tools. In conclusion, the PSWQ-CK's reliability and validity were satisfactory, and it is a useful tool for objectively measuring the worry of Korean children of this age group.

Relationship between Sleep Quality and Metabolic Syndrome and Infl ammatory Markers in Middle-aged Men in Korea / 가정의학회지

BACKGROUND: As many studies revealed that sleep restriction is associated with obesity and insulin resistance and blood pressure elevation, the relationship between sleep and metabolic syndrome has been concerned. But little information exists on correlation between sleep quality and metabolic syndrome. In this study, we investigated the relationship between sleep quality measured by Pittsburgh Sleep Quality Index (PSQI) and metabolic syndrome. METHODS: A total of 100 middle-aged male adults were included in this study from March to May 2008 at a health promotion center. The subjects were divided into two groups of poor sleeper group (N = 47) vs. good sleeper group (N=53) by PSQI global score. The components of metabolic syndrome and inflammatory markers were measured. The metabolic syndrome criterion of the AHA/NHLBI 2005 was adopted. RESULTS: There was no significant differences in baseline characteristics between the two groups. HDL-cholesterol was significantly lower in the poor sleeper group compared to the good sleeper group (P < 0.05). The negative correlation was noted between subjective sleep quality score with HDL-cholesterol (P < 0.05). There was a positive correlation between sleep latency and triglyceride and a negative correlation with HDL-cholesterol (P < 0.05). The longer sleep latency, the higher level of white blood cell count was observed (P = 0.001). CONCLUSION: The above data suggest that a possible causal interaction between poor sleep quality and lower HDL-cholesterol of metabolic syndrome components and higher level of white blood cell counts. Further prospective studies regarding the change in the components of metabolic syndrome and the risk factors of cardiovascular diseases after relieving sleep disturbance seem to be warranted.

Relations between Worry, Attachment Styles and Perceived Parental Rearing in Primary School Children

BACKGROUND: Worry, a core feature of anxiety disorder, is shown in not only children with anxiety disorder but also normal children. This study was conducted to determine the relationship between worry and family environment factors, especially, perceived parental rearing and attachment styles among children. METHODS: Five hundred and nine children participated in this study among 549 children in third, fourth, fifth and sixth grades in two primary schools located in Seoul and Seongnam from October 2007 to December 2007. Forty children did not agree with participation (rejection rate: 7.3%). Their degrees of worry, attachment styles and perceived parental rearing were investigated with questionnaires. RESULTS: The reliability of a questionnaire asking children's worry, PSWQ-C and a questionnaire asking perceived parental rearing, modified EMBU-C was appropriate with internal consistency (Cronbach's alpha of PSWQ-C: 0.92, Cronbach's alpha of modified EMBU-C: 0.68~0.89). Around 22.4% of children had insecure attachment (avoidant or ambivalent attachment) and scores of worry were high in both girls and boys. When children perceived their parental rearing behavior as anxious rearing, they were classified to have ambivalent attachment in many cases by themselves. And when they perceived the rearing as rejection many of them were classified to have avoidant or ambivalent attachment by themselves. Worry showed a significantly negative correlation in the cases where children answered their perceived parental rearing as emotional warmth and showed a significantly positive correlation with rejective and anxious rearing. CONCLUSION: This study found that children's worry was closely related with their perceived parental rearing and attachment styles. If the children's attachment, which has been developed while they have grown up, was insecure and they did not perceive parental rearing as emotional warmth, the intensity of worry, a core symptom of anxiety disorder, increased.

Relationship between Mammographic Dense Breast and Other Risk Factors of Breast Cancer in Korean Women

BACKGROUND: Several studies have demonstrated that mammographic dense breast is related to the risk of breast cancer and is associated with decreased mammographic sensitivity and specificity. In contrast, studies concerning women with dense breast are virtually non-existent. This study was conducted to evaluate the relationship between mammographic dense breast and other risk factors of breast cancer, and to make a plan for individualized strategies in high risk populations. METHODS: The study subjects were 565 women, aged 20~70 years, who had a screening mammogram from April 2005 to August 2005 at a health promotion center. Data of demographic factors, breast caner risk factors and menstrual status were collected by the self-administered questionnaire. Mammographic breast density was classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) fours categories, as measured by the proportion of glandular tissues within the total breast tissue. RESULTS: By BI-RADS categories, 'entirely fat' were 46, 'scattered fibroglandular' were 96, 'heterogenous dense' were 332 and 'extremely dense' were 91 (16.1%). Univariate analysis showed that age, occupation, education level, body mass index, age at menarche, parity, breast feeding, menopausal status and triglyceride had significantly related to dense breast (P<0.05). In the multivariate logistic analysis, only low body mass index (P<0.001), low parity (P=0.009, 0.038) and premenopausal status (P=0.001) were significantly associated with dense breast. CONCLUSION: In Korean women, dense breast was significantly associated with low body mass index, low parity and premenopausal status. Therefore, if women with dense breast have these risk factors, they need to be managed more intensively with regular screening, breast sonogram, and lifestyle modification.

Implication of ADAM-8, -9, -10, -12, -15, -17, and ADAMTS-1 in Implantational Remodeling of a Mouse Uterus

In the present study, whether the ADAM-8, -9, -10, -12, -15, -17, and ADAMTS-1 proteins might play a role in mouse uterus during periimplantation period was investigated. Immunoblotting analyses demonstrated that all ADAM proteins consistently appeared throughout days 1 to 8 of pregnancy but with a variation depending on the species of ADAM gene, the progression of pregnancy, and the site of the uterus. Immunohistochemical analyses indicated that ADAM proteins were localized in the luminal or glandular epithelial layers with a varying intensity depending on the species of ADAM and the progression of pregnancy. Particularly ADAM-8, -12, and -15, were predominantly located in the implantation site of the uterine tissues, whereas little or no protein was localized in the interimplantation site. Based upon these observations, it is suggested that the ADAMs might play an important role in the remodeling of the mouse uterus during the periimplantation period.

The Influence of Depression on Cardiac Autonomous Control in the Thirties Male Workers

BACKGROUND: The purpose of this study was to investigate the relationship between depression and heart rate variability in the thirties male workers. METHODS: Subjects were 85 thirties male workers who had routine health examination from June to July in 2002. They were classified as the depressed group (n=15) or the non-depressed group (n=70) on the basis of Zung Self-rating Depression Scale (SDS) index. 5- minute electrocardiographic (ECG) recordings were analyzed with time and frequency domain methods of heart rate variability (HRV). Standard Deviation of NN intervals (SDNN), Root-Mean-Square of Successive Differences (RMSSD), Total Power (TP), Low Frequency (LF: 0.04~0.15 Hz) power, High Frequency (HF: 0.15~0.4 Hz) power, LF/HF ratio were used as the indices of HRV. The data were analyzed using SPSS 11.0/PC program. RESULTS: There were no significant differences among the groups in drinking, smoking, body mass index (BMI), or exercise. Heart rate variability (SDNN, rMSSD, TP, LF, HF) was significantly lower in the depressed group than in the non-depressed group. Mean heart rate was also higher in the depressed group compared with the non-depressed group, but these differences did not attain statistical significance. CONCLUSIONS: The association of depressed mood with reduced heart rate variability in the thirties male workers reflect dysregulation of cardiac autonomous control and may explain their increased risk for cardiovascular disease. However, we should confirm those effects through the well-designed prospective study.

cDNA Array Analysis of Genes Expressed in the Rat Polycystic Ovary Induced by Dehydroepiandrosterone / 대한산부인과학회잡지

OBJECTIVE: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder. Chronic anovulation, hyperandrogenism, hirsutism, obesity, infertility and polycystic ovaries (PCO) are clinical hallmarks of PCOS. PCO can be induced in prepubertal rats by daily injection of dehydroepiandrosterone (DHEA). The aims of this study is to investigate cDNA array analysis of genes expressed in the rat PCO induced by DHEA. METHODS: To induce the hyperandrogenic PCO condition, 22-day old rats were injected each day s.c. with DHEA for 15 days. Total ovarian RNA was isolated from the DHEA induced rat PCO and control, and used to prepare radiolabeled cDNA probes, which were hybridized to cDNA arrays. Some of selected genes were further analyzed by reverse transcription-polymerase chain reaction (RT-PCR) or in situ hybridization. RESULTS: Quantitative analysis identified differential expression profiles of 31 genes including leukemia inhibitor factor receptor alpha (LIFR-alpha), alpha 1A adrenergic receptor (ADRA1A), heat shock 90-kDa protein A (HSP90A) and platelet-derived growth factor receptor alpha (PDGFR-alpha) genes. RT-PCR analysis was used to validate the changes in above four gene expressions by the cDNA array. The levels of ADRA1A and LIFR-alpha gene expressions were incresed in DHEA induced rat PCO than control, but HSP90A and PDGFR-alpha gene expressions were decresed in PCO. The mRNA of ADRA1A gene was mainly localized in granulosa cells of cystic follicles. CONCLUSION: Rat hyperandrogenic PCO was induced by daily injection of DHEA for 15 days. ADRA1A, LIFR-alpha, HSP90A and PDGFR-alpha gene expressions were differentially expressed in PCO induced by DHEA. The above four genes may be involved in the mechanism of follicular growth and ovulation processes. The precise relationship between the altered gene expressions and PCO is a matter of further investigation.

The expression of subcloned human immunodeficiency virus genes microinjected into the amphibian oocyte / 대한산부인과학회잡지

No abstract available.