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1.
Article in English | WPRIM | ID: wpr-915699

ABSTRACT

Objective@#To validate the criteria for the extreme risk category for atherosclerotic cardiovascular disease (ASCVD). @*Methods@#An observational cohort study of 35,464 individuals with established ASCVD was performed using the National Health Information Database. Incident myocardial infarction (MI), ischemic stroke, and death in patients with established ASCVD was investigated to validate the criteria for the extreme risk category of ASCVD defined as the presence of diabetes mellitus (DM), chronic kidney disease (CKD), and history of premature ASCVD. @*Results@#Among 35,464 patients, 77.97% of them were classified into the extreme risk group of ASCVD. A total of 28.10%, 39.61%, and 32.12% had DM, CKD, and a history of premature ASCVD, respectively. During a mean follow-up of 8.39 years, MI, ischemic stroke, and all-cause death were found in 3.87%, 8.51%, and 23.98% of participants, respectively. In multivariate analysis, patients with DM had higher risk for MI (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.45–1.81), ischemic stroke (HR, 1.39; 95% CI, 1.29–1.50), and all-cause death (HR, 1.52; 95% CI, 1.45–1.59) than those without DM. Patients with CKD had 1.56 times higher risk for MI, 1.12 times higher risk for ischemic stroke, and 1.34 times higher risk for death than those without CKD. However, the risk for MI, ischemic stroke, and all-cause death was not different between patients with and without a history of premature ASCVD. @*Conclusion@#DM and CKD, but not a history of premature ASCVD, could be considered as reasonable criteria of an extreme risk for ASCVD.

2.
Article in English | WPRIM | ID: wpr-914215

ABSTRACT

Background@#It is not known which type 2 diabetes mellitus (T2DM) patients would most benefit from dipeptidyl peptidase-4 (DPP-4) inhibitor treatment. We aimed to investigate the predictors of response to DPP-4 inhibitors considering degree of DPP-4 inhibition. @*Methods@#This study is a post hoc analysis of a 24-week, randomized, double-blind, phase III trial that compared the efficacy and safety of a DPP-4 inhibitor (gemigliptin vs. sitagliptin) in patients with T2DM. Subjects were classified into tertiles of T1 <65.26%, T2=65.26%–76.35%, and T3 ≥76.35% by DPP-4 inhibition. We analyzed the change from baseline in glycosylated hemoglobin (HbA1c) according to DPP-4 inhibition with multiple linear regression adjusting for age, ethnicity, body mass index, baseline HbA1c, and DPP-4 activity at baseline. @*Results@#The mean age was greater in the high tertile group compared with the low tertile group (T1: 49.8±8.3 vs. T2: 53.1±10.5 vs. T3: 55.3±9.5, P<0.001) of DPP-4 inhibition. Although HbA1c at baseline was not different among tertiles of DPP-4 inhibition (P=0.398), HbA1c after 24-week treatment was lower in the higher tertile compares to the lower tertile (T1: 7.30%±0.88% vs. T2: 7.12%±0.78% vs. T3: 7.00%±0.78%, P=0.021). In multiple regression analysis, DPP-4 enzyme inhibition rate was not a significant determent for HbA1c reduction due to age. In subgroup analysis by tertile of DPP-4 inhibition, age was the only significant predictor and only in the highest tertile (R2=0.281, B=–0.014, P=0.024). @*Conclusion@#This study showed that HbA1c reduction by DPP-4 inhibitor was associated with increasing age, and this association was linked with higher DPP-4 inhibition.

3.
Article in English | WPRIM | ID: wpr-924949

ABSTRACT

Background@#The role of aspirin in primary cardiovascular disease prevention in patients with diabetes remains controversial. However, some studies have suggested beneficial effects of cilostazol on cardiovascular disease in patients with diabetes. We prospectively investigated the antiplatelet effects of cilostazol compared with aspirin in patients with diabetes and cardiovascular risk factors. @*Methods@#We randomly assigned 116 patients with type 2 diabetes and cardiovascular risk factors but no evident cardiovascular disease to receive aspirin at a dose of 100 mg or cilostazol at a dose of 200 mg daily for 14 days. The primary efficacy outcome was antiplatelet effects of aspirin and cilostazol assessed with the VerifyNow system (aspirin response units [ARU]) and PFA-100 (closure time [CT]). Secondary outcomes were changes of clinical laboratory data (ClinicalTrials.gov Identifier: NCT02933788). @*Results@#After 14 days, there was greater decrease in ARU in aspirin (–28.9%±9.9%) compared cilostazol (–0.4%±7.1%, P<0.001) and was greater increase in CT in aspirin (99.6%±63.5%) compared cilostazol (25.7%±54.1%, P<0.001). The prevalence of aspirin resistance was 7.5% according to VerifyNow (defined by ARU ≥550) and 18.9% according to PFA-100 (CT <192 seconds). Compared with aspirin, cilostazol treatment was associated with increased high density lipoprotein cholesterol (7.1%±12.7% vs. 4.2%±18.0%, P=0.006) and decreased triglycerides (–9.4%±33.7% vs. 4.4%±17.57%, P=0.016). However, there were no significant changes in total and low density lipoprotein cholesterol, C-reactive protein level, and cluster of differentiation 40 ligand between cilostazol and aspirin groups. @*Conclusion@#Aspirin showed better antiplatelet effects assessed with VerifyNow and PFA-100 compared with cilostazol. However, there were favorable changes in atherogenic dyslipidemia only in the cilostazol.

4.
Article in English | WPRIM | ID: wpr-898231

ABSTRACT

Background@#To investigate the clinical characteristics of gestational diabetes mellitus (GDM) in Korea, using a nationwide database. @*Methods@#We analyzed 417,139 women who gave birth between 2011 and 2015 using the Korean National Health Information Database. They underwent the Korean National Health Screening Program within one year before pregnancy and were not prescribed drugs for diabetes nor diagnosed with diabetes mellitus before 280 days antepartum. Patients with GDM were defined as those who visited the outpatient clinic more than twice with GDM codes. @*Results@#The prevalence of GDM was 12.70% and increased with increasing maternal age, prepregnancy body mass index (BMI), waist circumference (WC), and fasting plasma glucose (FPG) (P for trend <0.05). As compared with those aged <25 years, the odds ratio for women with GDM aged ≥40 years were 4.804 (95% confidence interval [CI], 4.436 to 5.203) after adjustment for covariates. Women with prepregnancy BMI ≥30 kg/m2 were at 1.898 times (95% CI, 1.736 to 2.075) greater risk for GDM than those with prepregnancy BMI <18.5 kg/m2. Women with WC of ≥95 cm were at 1.158 times (95% CI, 1.029 to 1.191) greater risk for GDM than women with WC of less than 65 cm. High FPG, high income, smoking, and drinking were associated with an elevated risk of GDM. @*Conclusion@#The prevalence of GDM in Korean women increased up to 12.70% during 2011 to 2015. These data suggest the importance of GDM screening and prevention in high-risk groups in Korea.

5.
Article in English | WPRIM | ID: wpr-898197

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

6.
Article in Korean | WPRIM | ID: wpr-918916

ABSTRACT

Metformin has been used clinically more than 60 years in type 2 diabetes as the first-line drug for treatment. Metformin has been prescribed in more than 80% of Korean patients with diabetes. Despite long-term use and wide prescription of metformin in patients with type 2 diabetes, many questions remain. Recent advances have revealed a new mechanism of action and new benefits of metformin. In this article, we review recent advances regarding metformin treatment.

7.
Article in English | WPRIM | ID: wpr-890527

ABSTRACT

Background@#To investigate the clinical characteristics of gestational diabetes mellitus (GDM) in Korea, using a nationwide database. @*Methods@#We analyzed 417,139 women who gave birth between 2011 and 2015 using the Korean National Health Information Database. They underwent the Korean National Health Screening Program within one year before pregnancy and were not prescribed drugs for diabetes nor diagnosed with diabetes mellitus before 280 days antepartum. Patients with GDM were defined as those who visited the outpatient clinic more than twice with GDM codes. @*Results@#The prevalence of GDM was 12.70% and increased with increasing maternal age, prepregnancy body mass index (BMI), waist circumference (WC), and fasting plasma glucose (FPG) (P for trend <0.05). As compared with those aged <25 years, the odds ratio for women with GDM aged ≥40 years were 4.804 (95% confidence interval [CI], 4.436 to 5.203) after adjustment for covariates. Women with prepregnancy BMI ≥30 kg/m2 were at 1.898 times (95% CI, 1.736 to 2.075) greater risk for GDM than those with prepregnancy BMI <18.5 kg/m2. Women with WC of ≥95 cm were at 1.158 times (95% CI, 1.029 to 1.191) greater risk for GDM than women with WC of less than 65 cm. High FPG, high income, smoking, and drinking were associated with an elevated risk of GDM. @*Conclusion@#The prevalence of GDM in Korean women increased up to 12.70% during 2011 to 2015. These data suggest the importance of GDM screening and prevention in high-risk groups in Korea.

8.
Article in English | WPRIM | ID: wpr-890493

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

10.
Article in English | WPRIM | ID: wpr-760734

ABSTRACT

The authors regret that the standardized incidence rate for age (70–79) in Table 1 published in this paper was incorrect.

11.
Article in English | WPRIM | ID: wpr-760731

ABSTRACT

OBJECTIVES: Osteoporotic hip fractures are associated with high mortality in the older population. Few population studies have reported the long-term trends of incidence and mortality rate of hip fracture among the older in Korea. This study assessed the incidence and mortality rate within 1 year after hip fracture from 2006 to 2015 in South Korea. METHODS: The National Health Information Database was used to identify adults aged 60 years and older with a diagnosis of hip fracture and died within 1 year from hip fracture. Regression analyses were performed to estimate the change of the incidence of hip fracture and the related mortality rate. RESULTS: The events causing hip fracture increased 1.85 times (1.91 times in women and 1.71 times in men), and the incidence of hip fracture increased 1.23 times (1.30 times in women and 1.11 times in men) from 2006 to 2015. The mortality rate after hip fracture decreased by 10% in women; however, it increased by 13% in men. These trends were more prominent in the older population. CONCLUSIONS: Although the mortality rate after hip fracture in women decreased, other parameters associated with hip fracture have worsened during the last decade. Nationwide programs were urgently needed to reduce the future socioeconomic burdens of hip fractures.


Subject(s)
Adult , Cohort Studies , Diagnosis , Female , Hip Fractures , Hip , Humans , Incidence , Korea , Male , Mortality , Osteoporosis
12.
Article in Korean | WPRIM | ID: wpr-741035

ABSTRACT

OBJECTIVES: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). METHODS: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. RESULTS: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18–4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. CONCLUSIONS: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.


Subject(s)
Brassica , Demography , Diet , Education , Eggs , Emigrants and Immigrants , Epidemiologic Studies , Female , Humans , Korea , Linear Models , Linguistics , Logistic Models , Male , Mental Competency , Odds Ratio , Ovum , Social Class , Spouses
13.
Article in Korean | WPRIM | ID: wpr-740945

ABSTRACT

OBJECTIVES: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). METHODS: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. RESULTS: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18–4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. CONCLUSIONS: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.


Subject(s)
Brassica , Demography , Diet , Education , Eggs , Emigrants and Immigrants , Epidemiologic Studies , Female , Humans , Korea , Linear Models , Linguistics , Logistic Models , Male , Mental Competency , Odds Ratio , Ovum , Social Class , Spouses
14.
Article in English | WPRIM | ID: wpr-32573

ABSTRACT

BACKGROUND: Immigration to South Korea from neighboring Asian countries has risen dramatically, primarily due to marriage between Korean men and foreign women. Although Filipino women rank fourth among married immigrant women, little is known about the health condition of this population. This manuscript focuses on the design and methods of Filipino women's diet and health study (FiLWHEL). SUBJECTS/METHODS: FiLWHEL is a cohort of Filipino women married to Korean men, aged 19 years old or over. The data collection comprised three parts: questionnaire, physical examination, and biospecimen collection. Questionnaires focused on demographic factors, diet, other health-related behaviors, acculturation and immigration-related factors, medical history, quality of life, and children's health information. Participants visited the recruitment site and answered the structured questionnaires through a face-to-face interview. We also measured their anthropometric features and collected fasting blood samples, toenails, and DNA samples. Recruitment started in 2014. RESULTS/CONCLUSIONS: Collection of data is ongoing, and we plan to prospectively follow our cohort participants. We expect that our study, which is focused on married Filipino women immigrants, can elucidate nutritional/health status and the effects of transitional experiences from several lifestyle factors.


Subject(s)
Acculturation , Asians , Child Health , Cohort Studies , Data Collection , Demography , Diet , DNA , Emigrants and Immigrants , Emigration and Immigration , Fasting , Female , Humans , Korea , Life Style , Male , Marriage , Methods , Nails , Physical Examination , Prospective Studies , Quality of Life
15.
Article in English | WPRIM | ID: wpr-148707

ABSTRACT

OBJECTIVE: We aimed to clarify the relationship between fat, muscle, and bone in elderly men and women. METHODS: We analyzed 1373 men and 1803 women who were older than 65 years from the 2008-2010 Korea National Health and Nutritional Examination Surveys. Body composition and femur neck bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as an appendicular skeletal muscle index (SMI) below one standard deviation (SD). Obesity was classified by fat mass index (FMI). Osteoporosis was defined as a BMD of 2.5 SD below that of femur neck BMD. RESULTS: SMI and FMI were positively correlated with femur neck BMD. In multiple regression analysis, SMI (β = 0.302 in men, β = 0.154 in women; p < 0.001 each) and FMI (β = 0.079 in men, β = 0.179 in women; p = 0.003 and p < 0.001 respectively) had a positive relationship with femur neck BMD. Men with sarcopenia were 3.89 times more likely to develop osteoporosis. Women with sarcopenia were 1.87 times more likely to develop osteoporosis. Sarcopenia was more clinically significant in the development of osteoporosis in men with a fat deficit and women with excess fat CONCLUSIONS: Muscle mass and fat mass were identified as determinants of femur neck BMD in men and women. Among them, muscle mass of men and fat mass of women are the most important determinants of femur neck osteoporosis.


Subject(s)
Absorptiometry, Photon , Aged , Body Composition , Bone Density , Female , Femur Neck , Femur , Humans , Korea , Male , Muscle, Skeletal , Obesity , Osteoporosis , Sarcopenia
16.
Article in English | WPRIM | ID: wpr-15194

ABSTRACT

We aimed to estimate the threshold level of glycosylated hemoglobin (HbA1c) for the fasting plasma glucose of 100 and 126 mg/dL in the Korean adult population, using the 2011 Korea National Health and Nutrition Examination Survey. A total of 4,481 participants over 19 years of age without diabetic medications and conditions to influence the interpretation of HbA1c levels, such as anemia, renal insufficiency, liver cirrhosis, and cancers, were analyzed. A point-wise area under the receiver operating characteristic curve was used to estimate the optimal HbA1c cutoff value. A HbA1c threshold of 6.35% was optimal for predicting diabetes with a sensitivity of 86.9% and a specificity of 99.1%. Furthermore, the threshold of HbA1c was 5.65% for prediabetes, with a sensitivity of 69.3% and a specificity of 71%. Further prospective studies are needed to evaluate the HbA1c cutoff point for diagnosing prediabetes and diabetes in the Korean population.


Subject(s)
Adult , Anemia , Blood Glucose , Diabetes Mellitus , Diagnosis , Fasting , Hemoglobin A , Glycated Hemoglobin A , Humans , Korea , Liver Cirrhosis , Nutrition Surveys , Prediabetic State , Prospective Studies , Renal Insufficiency , ROC Curve , Sensitivity and Specificity
17.
Korean Journal of Medicine ; : 444-454, 2012.
Article in Korean | WPRIM | ID: wpr-101021

ABSTRACT

Sarcopenia is defined the loss of muscle mass and strength with aging. Although the etiology and the pathogenesis, the diagnosis of sarcopenia are obscure, the sequel of sarcopenia, i.e. morbidity and mortality, metabolic complications, are a major public health problem. Particularly, aged people in Korea are increasing rapidly more than expected; therefore the interest of sarcopenia is also increasing rapidly. This article provides an overview of the pathogenesis, and diagnosis, epidemiology, clinical results.


Subject(s)
Aged , Aging , Body Composition , Humans , Korea , Muscle Weakness , Muscles , Public Health , Sarcopenia
18.
Korean Journal of Medicine ; : 351-358, 2011.
Article in Korean | WPRIM | ID: wpr-78411

ABSTRACT

BACKGROUND/AIMS: Type 2 diabetes with microvascular complications is often accompanied by macrovascular complications. However, the relationship between the two complications is unclear. In this study, we determined the relationship between diabetic retinopathy and morphological changes of the carotid artery. METHODS: We analyzed the presence of plaque and mean carotid intima-media thickness (CIMT) in patients with type 2 diabetes (n = 133) using high-resolution ultrasound. The presence and severity of retinopathy were graded according to fundus photographs. RESULTS: The mean CIMT of the diabetic retinopathy (DR) group (0.111 +/- 0.048 cm) was significantly greater than that of the nondiabetic retinopathy (No DR) group (0.074 +/- 0.039 cm, p = 0.007). An abnormal mean CIMT (> 0.08 cm) was more frequently observed in the DR group (76%) than that in the No DR group (23.1%; odds ratio, 10.609; 95% confidence interval, 3.072-36.639; adjusted by age, body mass index, hypertension, and diabetes duration). Although the mean CIMT in patients with plaque was significantly greater than that of patients without plaque, no significant difference was observed between the DR (36%, 17 patients) and NoDR (18.5%, 20 patients) groups in the presence of plaque. CONCLUSIONS: Diabetic retinopathy was associated with an increased CIMT but not with atherosclerotic plaques. However, the increases in IMT were associated with the presence of plaques, which predispose patients to cardiovascular disease. These results imply that the microvascular complications of diabetes have indirect relationships with the cardiovascular complications of diabetes.


Subject(s)
Atherosclerosis , Body Mass Index , Cardiovascular Diseases , Carotid Arteries , Carotid Intima-Media Thickness , Diabetes Mellitus , Diabetic Retinopathy , Humans , Hypertension , Odds Ratio , Plaque, Atherosclerotic
19.
Article in English | WPRIM | ID: wpr-129426

ABSTRACT

BACKGROUND AND OBJECTIVES: The extent of coronary artery calcification (CAC) is closely related to total atherosclerotic plaque burden. However, the pathogenesis of CAC is still unclear. Conditions such as diabetes mellitus, renal failure, smoking, and chronic inflammation have been suggested to link vascular calcification and bone loss. In the present study, we hypothesized that bone loss can contribute to the pathogenesis of CAC in patients with the chronic inflammatory condition that accompanies metabolic syndrome (MetS). The objective of this study was to investigate the relationship between CAC and bone mineral density (BMD) in patients with MetS and in patients without MetS, by using coronary multidetector-row computed tomography (MDCT). SUBJECTS AND METHODS: Data from 395 consecutive patients was analyzed retrospectively. From the MDCT database, only those patients who underwent both coronary MDCT and dual-energy X-ray absorptiometry within an interval of one month, were selected. The presence of MetS was determined by the updated criteria as defined by the Third Adult Treatment Panel Report of the National Cholesterol Education Program. RESULTS: In patients with MetS, a significant correlation was found between CAC and age {odds ratio (OR)=1.139, 95% confidence interval (CI) 1.080 to 1.201, p<0.001}, CAC and male sex (OR=3.762, 95% CI 1.339 to 10.569, p=0.012), and CAC and T-score of L-spine (OR=0.740, 95% CI 0.550 to 0.996, p=0.047) using a forward multiple logistic regression analysis model including clinical variables of gender, age, lipid profile, body mass index, diabetes mellitus, hypertension, smoking, and BMD. But in patients without MetS, BMD by itself was not found to contribute to CAC. CONCLUSION: BMD was inversely correlated with CAC only in patients with MetS. This finding suggests that low BMD accompanied by MetS, may have significant clinical implications.


Subject(s)
Absorptiometry, Photon , Adult , Aluminum Hydroxide , Body Mass Index , Bone Density , Carbonates , Cholesterol , Coronary Artery Disease , Coronary Vessels , Diabetes Mellitus , Humans , Hypertension , Inflammation , Logistic Models , Male , Metabolic Syndrome , Multidetector Computed Tomography , Plaque, Atherosclerotic , Renal Insufficiency , Retrospective Studies , Smoke , Smoking , Vascular Calcification
20.
Article in English | WPRIM | ID: wpr-129411

ABSTRACT

BACKGROUND AND OBJECTIVES: The extent of coronary artery calcification (CAC) is closely related to total atherosclerotic plaque burden. However, the pathogenesis of CAC is still unclear. Conditions such as diabetes mellitus, renal failure, smoking, and chronic inflammation have been suggested to link vascular calcification and bone loss. In the present study, we hypothesized that bone loss can contribute to the pathogenesis of CAC in patients with the chronic inflammatory condition that accompanies metabolic syndrome (MetS). The objective of this study was to investigate the relationship between CAC and bone mineral density (BMD) in patients with MetS and in patients without MetS, by using coronary multidetector-row computed tomography (MDCT). SUBJECTS AND METHODS: Data from 395 consecutive patients was analyzed retrospectively. From the MDCT database, only those patients who underwent both coronary MDCT and dual-energy X-ray absorptiometry within an interval of one month, were selected. The presence of MetS was determined by the updated criteria as defined by the Third Adult Treatment Panel Report of the National Cholesterol Education Program. RESULTS: In patients with MetS, a significant correlation was found between CAC and age {odds ratio (OR)=1.139, 95% confidence interval (CI) 1.080 to 1.201, p<0.001}, CAC and male sex (OR=3.762, 95% CI 1.339 to 10.569, p=0.012), and CAC and T-score of L-spine (OR=0.740, 95% CI 0.550 to 0.996, p=0.047) using a forward multiple logistic regression analysis model including clinical variables of gender, age, lipid profile, body mass index, diabetes mellitus, hypertension, smoking, and BMD. But in patients without MetS, BMD by itself was not found to contribute to CAC. CONCLUSION: BMD was inversely correlated with CAC only in patients with MetS. This finding suggests that low BMD accompanied by MetS, may have significant clinical implications.


Subject(s)
Absorptiometry, Photon , Adult , Aluminum Hydroxide , Body Mass Index , Bone Density , Carbonates , Cholesterol , Coronary Artery Disease , Coronary Vessels , Diabetes Mellitus , Humans , Hypertension , Inflammation , Logistic Models , Male , Metabolic Syndrome , Multidetector Computed Tomography , Plaque, Atherosclerotic , Renal Insufficiency , Retrospective Studies , Smoke , Smoking , Vascular Calcification
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