Impact of ENPP1 K121Q on Change of Insulin Resistance after Web-Based Intervention in Korean Men with Diabetes and Impaired Fasting Glucose

Ectoenzyme nucleotide pyrophosphate phosphodiesterase 1 (ENPP1) gene has been studied in relation to type 2 diabetes mellitus (T2DM) and insulin resistance (IR). We hypothesized that the difference in genotype may be one of the factors that affect the outcome of intervention. We genotyped 448 men with fasting glucose> or =5.6 mM/L, including 371 in subjects with K allele (KK) (69 control group [CG]; and 302 intervention group [IG]) and 77 in subjects with Q allele (KQ+QQ) (13 CG and 64 IG). The web-based intervention based on a lifestyle modification was delivered by e-mail once a month for 10 months. In the KK, IG demonstrated significantly decreased levels of fasting serum insulin (FSI) as compared to CG and homeostasis model of assessment of insulin resistance (HOMA-IR). In the KQ+QQ IG group, hemoglobin A1c (HbA1c), FSI and HOMA-IR were significantly decreased, and showed further reduction in the HOMA-IR than KQ+QQ CG. After analysis of covariance, K121Q did significantly influence the change of HbA1c in CG after appropriate adjustment. In a multivariate model, BMI change predicted HOMA-IR change (adjusted beta=0.801; P=0.022) in KK IG subjects with T2DM. ENPP1 K121Q did not influence the change in IR. However, individuals with T2DM carrying the K121 variant are very responsive to the effect of BMI reduction on HOMA-IR.

Comparison of health outcomes according to intervention compliance in male Korean workers with metabolic syndrome

This study examined how achievement of session goals contributes to outcomes of subjects after participation in a 12-week lifestyle intervention program in men with metabolic syndrome (MetS). Thirty office workers with MetS, aged 47.2 +/- 6.6 years, participated in this study, from March to July, 2011. The intervention program included face-to-face counseling five times during the 12-week period. Counselors and subjects designed session goals for each round. The average of the goal achievement rate was calculated based on compliance for each round. The subjects were divided into three groups according to their tertiles of achievement rate: Low-compliance group (LC, 70%). Anthropometry, biochemical index, and nutrient intake were examined at baseline and at the end of the 12-week intervention program. After the intervention, diastolic blood pressure (DBP) showed a significant decrease in the LC group, and waist circumference (WC) showed a significant decrease in the MC group. Systolic blood pressure (SBP), DBP, and low-density lipoprotein cholesterol (LDL) showed a significant decrease in the HI group. Changes in SBP and DBP were significantly lower in the HC group than in the MC group (p < 0.05, p < 0.01). Changes in LDL were significantly lower in the HC group than in the MC group (p < 0.05). Results for intake of total energy, protein, fat, and sodium, as well as rates of carbohydrate and fat intake, showed a significant decrease in all participants (p < 0.05). The change in fiber was significantly higher in the HC group than in the MC group (p < 0.05). The change of fruit serving size showed a significant increase in the HC group (p < 0.01). The number of risk factors for MetS showed a significant decrease in the LC and HC groups (p < 0.05), however, no significant mean differences were observed among the three groups. In conclusion, participation in this intervention program resulted in positive effects on risk factors for MetS, nutrient intake, and dietary habits, especially in the High-compliance group.

Dietary iodine intake and the association with subclinical thyroid dysfunction in male workers

The prevalence rate of thyroid dysfunction (hypothyroidism and hyperthyroidism) has increased within the Korean population and seems to be affected by iodine dietary habits. Some studies reported that the prevalence of thyroid dysfunction increase both in the area of iodine deficiency and excess. In this study, we tried to discover the difference in iodine intake, anthropometric measurements, and blood parameters between male subjects with or without subclinical thyroid dysfunction. A total of 5,249 subjects (Euthyroid: 4706, SubHypo: 454, SubHyper: 89) were used in this study. There were no significant differences in BMI, body fat, visceral fat, waist circumference, SBP, DBP, total cholesterol, HDL-cholesterol, LDL-cholesterol, TG, fasting serum glucose, HbA1c, alcohol intake, however significant differences were noticed in both age and smoking status. Through a food frequency questionnaire (FFQ), iodine intake per day was estimated. The average iodine intake was similar (SubHypo 392.9 +/- 279.0 microg, Euthyroid 376.5 +/- 281.7 microg, SubHyper 357.3 +/- 253.8 microg) among groups. The main source of iodine intake was eggs (52.8%, 54.2%, 52.4%) followed by milk (16.3%, 15.8%, 17.8%), then sea mustard & sea tangle (12.4%, 11.9%, 11.6%). The prevalence of subclinical hypothyroidism and subclinical hyperthyroidism was higher in subjects whose intake was higher than the recommended nutrient intake (RNI). These results suggest that the excess consumption of iodine intake may act as one of the risk factors regarding thyroid dysfunction in Korea. Therefore, an adequate amount of iodine intake is necessary in order to prevent subclinical thyroid dysfunction and clinical thyroid dysfunction.

Use of Serum Homocysteine to Predict Cardiovascular Disease in Korean Men with or without Metabolic Syndrome

The aim of this study was to examine whether serum homocysteine (Hcy) levels correlated with cardiovascular disease (CVD) depending on the presence or absence of metabolic syndrome (MetS) in Korean men. We conducted a case-control study, including 138 CVD and 290 non-CVD age-matched control subjects. The subjects were divided into four subgroups: 34 CVD/MetS, 104 CVD, 77 MetS, and 213 normal subgroups. The mean Hcy was significantly higher, whereas HDL and intake of vitamin B1 and B2 were lower in the CVD group (P < 0.05) than non-CVD group. When compared to the control group, subjects with CVD/MetS, CVD and MetS exhibited high Hcy levels, with the highest observed in the CVD/MetS subgroup (P < 0.001). Multivariate stepwise linear regression between CVD and markers of CVD showed Hcy significantly correlated with CVD (P < 0.05). To predict CVD based on Hcy, Hcy threshold of 11.72 microM in non-MetS subjects had an area under the curve (AUC) of 0.664 (95% CI 0.598-0.731). In MetS subjects, the AUC was 0.618 and Hcy threshold was 13.32 microM (95% CI 0.509-0.726). The results of our study show that the presence of MetS needs to be considered when using Hcy levels for predicting CVD.

The Effects of 12-Weeks Intensive Intervention Program on Cardiovascular Risk Factors, Adipocytokines and Nutrients Intakes in Industrial Male Workers

Adipocytokines (adiponectin, leptin and resistin) are known to play a major role in development of cardiovascular disease (CVD) and intervention program is effective in reducing CVD risk factors. However, intervention program to improve the CVD risk factors including adipocytokines has been less studied. This study investigated the effects of 12-weeks worksite intervention program on cardiovascular risk factors, adipocytokines and nutrients intakes in industrial workers. 157 industrial male workers (32 metabolic syndrome (MS) subjects, 125 healthy subjects using age-matched stratified random sampling) received 5 face-to-face counseling based on their health profiles. Anthropometry, biochemical parameters and nutrients intakes were measured. The diagnosis of MS was adapted from modified NCEP-ATP III criteria (2001) and Asia-Pacific definition criteria (2000) for waist circumference (WC). After the intervention program, WC, BMI, SBP, insulin, leptin and intakes of total energy and fiber were significantly decreased (p < 0.05), while adiponectin was significantly increased (p < 0.05) in MS subjects. The WC, BMI, SBP, total cholesterol, LDL and HDL-cholesterol, HbA1c, leptin and intakes of total energy, protein and fat were significantly decreased (p < 0.05) and adiponectin was significantly increased (p < 0.05) in normal subjects. Multiple linear regression revealed that adiponectin was positively correlated with HDL-cholesterol (p < 0.01). Leptin was positively correlated with WC (p < 0.01), and resistin was positively correlated with HbA1c (p < 0.05) and intakes of total energy (p < 0.05), and negatively correlated with HDL-cholesterol (p < 0.05). The results of the 12 weeks intervention showed a positive impact on adipocytokines and nutrients intakes of industrial workers to reduce cardiovascular risk factors. Further research is needed to verify a tailored long-term worksite intervention program including adipocytokines as a protective factor for the CVD.

Effects of Workplace Nutrition Education Program Tailored for the Individual Chronic Disease Risks

The incidence of chronic disease is continuously increasing in Korea. Especially, office workers have higher risk of chronic disease because of their dietary habit and lifestyle. The study aimed to investigate the effect of tailored nutrition counseling on improving chronic disease risk factors. Ninety-nine male workers (age 46.9 +/- 7.0 yrs) volunteered for 12 weeks of nutrition program containing dietary intake and physical activity adjustment. Five individualized programs were performed with the main theme of weight loss (WL, n = 16), blood pressure lowering (BL, n = 34), normalizing blood glucose (GL, n = 21), lipid lowering (LL, n = 13) and reducing MS risk factors (ML, n = 15). Anthropometric data, blood-pressure, self-reported questionnaire, blood profiles were measured before and after 12weeks of nutrition education. The education program included 5 times of 1:1 interview. Compared to 0 week, anthropometric data (weight, BMI, fat, visceral fat, waist, SBP, DBP) were significantly decreased after 12 weeks (p < 0.001). Fasting blood glucose and total cholesterol were decreased (p < 0.05). The primary outcomes with individually tailored programs showed to be more effective than one general nutrition program.

The Effects of a Worksite On-line Health Education Program on Metabolic Syndrome Risk Factors and Nutrient Intakes of Male Workers

Worksite health promotion programs have been associated with reductions in health risks but are labor-intensive and costly to implement. Therefore, innovative strategies to provide a cost-effective approach to health education program are needed. The purpose of this study was to investigate the effects of a worksite on-line health education program by e-mail on metabolic syndrome risk factors and dietary intakes in male workers with metabolic syndrome. Anthropometric and biochemical parameters were measured and the nutrient intakes were assessed through FFQ. The diagnosis of metabolic syndrome was adapted from NCEP-ATP III with blood pressure, fasting blood glucose, triglyceride, HDL cholesterol, and Asia-Pacific definition with waist circumference. The education group consisted of 212 male workers and the non-education group of 236 age-matched male workers. The on-line health education program provided 10 sessions by e-mail. After a worksite on-line health education program, systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001) and fasting blood glucose (p < 0.001) were significantly decreased and HDL cholesterol (p < 0.001) was significantly increased in the education group. Intakes of total energy (p < 0.05), carbohydrate (p < 0.05), sodium (p < 0.05) were significantly decreased in the education group, but there were no significant differences in dietary intakes in the non-education group after a worksite on-line health education program. The results indicate that online health education program by e-mail is effective for improving metabolic syndrome risk factors and dietary intakes in male workers and show potential for use in the working setting.

The Effect of Repeated Nutrition Education on Health Improvement Program by Diet Quality Index-International (DQI-I) Evaluation in Office Workers / 대한지역사회영양학회지

The purpose of this study was to investigate the effect of 3-month nutrition education (First Time Intervention, FI) + additional 3-month nutrition education (Repeated Intervention, RI) which was performed after the 8-month follow-up. FI was conducted during 0-3 months and RI for 11-14 months. Ninety-two subjects completed FI program, and 38 out of 92 subjects who received FI finished the RI. Anthropometric data, dietary assessment (24hr recall) and fasting blood analysis were measured at 0 month, 3 months, 11 months and 14 months time points. After FI (3 mo), waist circumference, triglycerides, total cholesterol were significantly decreased. At 11 month follow-up, body weight, BMI, hip circumference, SBP, DBP were significantly rebounced and HDL cholesterol was significantly decreased. Therefore, the effect of short-term nutrition education was not being sustained. After the secondary nutrition intervention (14 mo), waist circumference and hip circumference were again significantly decreased. Total diet quality index-international (DQI-I) score was significantly increased in both FI group and RI group. The changes in DQI-I scores were significantly correlated with the changes in body weight (r = -0.129, p < 0.05) and counts of nutrition education (r = 0.159, p < 0.05), indicating that effective nutrition education helps improve the diet quality leading to a possible role in CVD prevention among male workers. Although a short-term intervention seems to be a success, the effect was not retained in this study. Therefore, we suggest incorporating nutrition education as a routine program for male worker at worksite.

The Association Between Apolipoprotein E Genotype and Lipid Profiles in Healthy Woman Workers / 예방의학회지

OBJECTIVES: Plasma lipid profiles and Apolipoprotein E (ApoE) are established risk factors for cardiovascular disease (CVD). The knowledge of lipid profile may estimate the potential victims of cardiovascular disease before its initiation and progression and offers the opportunity for primary prevention. The most common ApoE polymorphism has been found to influence plasma lipid concentrations and its correlation with CVD has been extensively investigated in the last decade. METHODS: The ApoE polymorphism and its influence on plasma lipid were investigated in healthy woman workers. The information on confounding factors was obtained through a self-administered questionnaire and ApoE polymorphism was investigated using PCR. RESULTS: The relative frequencies of alleles E2, E3 and E4 for the study population (n=305) were 0.127, 0.750 and 0.121, respectively. ApoE polymorphism was associated with variations in plasma HDL-cholesterol lipid profile. In order to estimate the independent effects of alleles E2 and E4, as compared with E3, on lipid profile, multiple regression was performed after adjustment for confounding variables such as age, BMI, blood pressure, education status, insulin, fasting glucose, HOMA-IR, menopause. ApoE2 had a negative association with HDL cholesterol and ApoE4 had a positive association with LDL cholesterol. CONCLUSIONS: This study identified that the ApoE and CVD risk factors contribute to the lipid profiles, similar to other studies. The analysis including dietary intake and other gene in further studies may help to identify clear effects on lipid profiles as risk factor for CVD.

Effect of 1 Year E-mail Nutrition Education after Face-to-Face Encounter at Worksite: Changes in Cardiovascular Risk Factors

Effective nutrition educations for prevention of chronic diseases for the general population are of great importance these days. The purpose of this study was to evaluate the feasibility of nutrition education for cardiovascular risk factor reduction by e-mail education in male workers. The participants were divided into three groups by age; 28-39 age group, 40-49 age group, and 50-59 age group who got regular checkups for anthropometry and biochemistry. The 1 year program consisted of 15 topics containing information about metabolic syndrome (MS) and healthy eating behavior (intake of salt, fat and alcohol). Seven hundred thirty nine participants volunteered for the study [28-39 age group, n = 240; body mass index (BMI) = 24.9 +/- 2.7 kg/m2: 40' group, n = 276; BMI = 24.8 +/- 2.6 kg/m2: 50' group, n = 223; BMI = 24.9 +/- 2.7 kg/m2]. Percentage body fat (p<0.05) and percentage of abdominal fat (p<0.05), total cholesterol (p<0.05), systolic blood pressure (p<0.05), and diastolic blood pressure (p<0.05) were significantly decreased in all participants after the 1 year program. The total number of participants who had MS was decreased from 216 to 199 and especially the incidence of MS was decreased 27% in the group of subjects who were under the age 39. The e-mail worksite nutrition education program shows a substantial contribution to the development of effective CVD and chronic disease control and lifestyle nutrition educations that are applicable to and attractive for the large population at risk.

Apolipoprotein E Phenotypes and the Relationship Among Lipid Levels, Nutrient Intakes, Lifestyles and Risk Factors Between Subjects with and without Hyperlipidemic Risk

This study was performed to investigate Apolipoprotein E phenotypes and the relationship among lipid levels, nutrient intakes, lifestyles and risk factors between subjects with and without hyperlipidemic risk. The data were collected from 675 industrial male workers who had completed annual medical examination. Compared to the normal group, the hyperlipidemic risk group in Apo E3 and E4 had significantly higher BMI (p < 0.05) and showed significantly higher body fat (%), waist circumference and WHR in all types of Apo E (p < 0.05). In addition, the hyperlipidemic risk group had significantly higher total cholesterol, LDL-cholesterol, triglyceride and AI than the normal group in all types of Apo E (p < 0.05). Intakes of protein, calcium, phosphorus, iron, vitamin A, vitamin B1, vitamin B2, vitamin C and niacin in Apo E3 were significantly lower in the hyperlipidemic risk group than in the normal group (p < 0.05). In the logistic regression analysis, after adjustment for other factors, Apo E2 + E4, waist and WHR were the significant risk factors associated with hyperlipidemia, but protein intakes were associated with significantly lower risks of hyperlipidemia (p < 0.05). In conclusion, genetic factor (Apo E2 or Apo E4), anthropometric index and nutrient intake seem to influence hyperlidemic risk. Further studies and efforts will be needed to evaluate the independent relationships among hyperlipidemic risk factors.

Effects of Worksite Nutrition Counseling for Health Promotion; Twelve-Weeks of Nutrition Counseling Has Positive Effect on Metabolic Syndrome Risk Factors in Male Workers / 대한지역사회영양학회지

The purpose of this study was to investigate the effect of nutrition counseling on improving metabolic syndrome (MS) risk factors. Sixty-eight subjects were grouped according to their numbers of MS risk factors. Subjects who have three or more risk factors of MS were defined as "High risk", subjects who have two risk factors of MS were defined as "low risk", and subjects who have below two risk factors of MS were defined as "no risk" group. All groups finished nutrition counseling every three weeks for 12 weeks. Anthropometric, dietary assessments (24 hr-recall) and blood samples were measured at 0 and 12 weeks nutrition counseling. After 12 weeks of intervention, anthropometric data (weight, BMI, body fat (%), and waist/hip ratio) were significantly decreased (p < 0.05) in all groups. Daily consumption of calorie was decreased significantly (p < 0.05) in the group of low risk and high risk. Blood level of fasting plasma glucose was significantly decreased (p < 0.001) in all groups after 12 weeks of intervention. Significantly, the fasting plasma glucose level was returned to normal range in the high risk group. The number of people who have three or more risk factors of MS (high risk group) was decreased from 25 to 12. Sum of MS Criteria decreased from 85 to 52 in the group of MS and decreased from 143 to 99 in all groups. These results indicate that nutrition counseling for male workers at the worksite proved to be helpful by reducing the risk factors of MS and thereby reducing the risk of cardiovascular disease. Continuing and systematic nutritional management programs should be developed and implemented for male workers at the worksites.

Blood Lipid Levels, Nutrient Intakes and Health-Related Lifestyles of Industrial Male Workers According to Apolipoprotein E Polymorphisms / 대한지역사회영양학회지

The purpose of this study was to investigate the association among nutrient intakes and health-related lifestyles with cardiovascular disease risk assessed by blood lipid profile according to Apolipoprotein E genotypes. Middle-aged industrial male workers who had completed their annual medical examination were recruited and data of 675 subjects who finished the nutrient survey were used in the analysis. Anthropometric parameters, dietary assessment (FFQ), health-related lifestyles and blood profiles were used for statistical analyses. Apo E genotype groups were classified into the following three genotypes: Apo E2 group (including E2/E2, E2/E3, E2/E4), Apo E3 group (including E3/E3), Apo E4 group (including E3/E4, E4/E4). The frequency of Apo E2, E3, and E4 allele were 13.3%, 75.0% and 11.7% respectively. There were no significant differences in the anthropometric parameters depending on different Apo E genotypes. Also, no significant differences in the nutrient intakes were found according to the genotype groups. The nutrient intakes of all subjects were similar to or higher than the level of KDRIs (Dietary Reference Intakes For Koreans) except for intakes of calcium (67.44% of KDRIs), vitamin A (73.83% of KDRIs) and vitamin B2 (78.02% of KDRIs). Also, there were no significant differences of health-related lifestyles according to Apo E genotype groups. As for the lipid profiles, Apo E4 group had significantly higher total and LDL-cholesterol concentrations than the Apo E2 group (p < 0.05). We confirmed that plasma total and LDL-cholesterol concentrations were greatly influenced by Apo E genotypes. However, nutrient intakes and health-related lifestyles were not associated with Apo E genotypes.

Prevalence and Risk Factors of Fatty Liver among Industrial Male Workers / 재활간호학회지

PURPOSE: This Study was conducted to estimate the prevalence rate, and related factors,of fatty liver in male industrial workers. METHOD: Fatty liver was diagnosed using ultrasonography. The data for abdominal ultrasonography, BMI, smoking, alcohol drinking, exercise, liver enzymes, and lipid profiles were collected in 4,604 male who were examined with a health screening program in 2005. Prevalence rate and associated factors of fatty liver were analyzed using SPSS v. 12.0. RESULTS: Overall prevalence of fatty liver was 34.1% and higher in the 30-39 year male group. Age, body mass index(BMI), hypertriglyceridemia, hypercholesterolemia, HDL cholesterol, r-GTP level were independently associated factors with presence of fatty liver in logistic regression analysis. CONCLUSION: The prevalence of fatty liver and tendency of associated factors were similar to those in the western world. To prevent development of this hepatic disorder, which may result in end-stage liver disease, risk factors such as obesity and dyslipidemia must be monitored and controlled within normal levels. The results of this study suggested maintenance of a healthy lifestyle, including diet, exercise, and behavioral change, as fundamental rehabilitation nursing implications.

The Prevalence of Obesity and Obesity-related Metabolic Complications in Korean Adolescents

BACKGROUND: Obesity in adolescence is a serious health problem because it may proceed to adulthood, cause metabolic complications, and thereby increase mortality. The main purpose of this study was to investigate the prevalence of obesity and other metabolic complications related to obesity among Korean adolescents. METHODS: The subjects of the study were 3,615 adolescents recruited from 12 middle schools nationwide. We measured their height, weight, obesity indices, fasting blood glucose, serum total cholesterol, triglyceride, HDL- cholesterol, ALT, AST, and uric acid levels. The risk factors of obesity were assessed by self-administered questionnaires. RESULTS: Obesity was evident in 16.2% of the subjects (20.7% in boys, 11.0% in girls). Adolescent obesity was closely related to parental obesity (Odds Ratio 2.9, 95% CI (Confidence Interval) 1.7~2.5). Obese adolescents were at higher risk of elevated AST (OR 10.2, 95% CI, 5.2 ~19.9), elevated ALT (OR 12.9, 95% CI, 6.9~24.2), hypercholesterolemia (OR 1.5 95% CI, 1.2~1.8, P<0.05), hypertriglyceridemia (OR 4.0, 95% CI, 3.1~5.3), and hyperuricemia (OR 2.2, 95% CI, 1.7~3.0). More than 70% of obese adolescents had one or more metabolic complications related to obesity. CONCLUSION: Adolescent obesity was closely related to parental obesity and metabolic complications related to the obesity were common among both obese boys and girls.

The Prevalence of Childhood Obesity, Risk Factors, and Obesity Related Disease in Elementary Students

BACKGROUND: Recently, childhood obesity has been increased and has resulted in serious health problems. The main purpose of this study was to investigate the prevalence of childhood obesity and its risk factors in elementary students. METHODS: One thousand nine hundred and eleven children were selected from an elementary school in Seoul. We measured children's height, weight, waist to hip ratio, and the obesity rate (%). The risk factors associated with childhood obesity were assessed by a self-written questionnaire answered by their parents. In moderate and severe obese children, we checked their blood pressure, fasting blood glucose, ALT, AST, uric acid, total cholesterol, and triglycerides. RESULTS: The prevalence of childhood obesity was 14.0%. We found that the factors associated with childhood obesity were the number of siblings, class, parent's obesity, and the preference for fish and meat (P=0.030, 0.022, <0.001, 0.003, respectively). In moderate and severe obese children, the prevalence of obesity related diseases was 77.6% and 92.3%, respectively. CONCLUSION: The childhood obesity was strongly associated with parent's obesity and the preference for fish and meat. The prevalence of obesity related diseases was very high in moderate and severe obese children.