Hand Grip Strength according to the Smoking Status in Korean Adults: The 7th Korea National Health and Nutrition Examination Survey 2016–2017

Background@#Smoking is a well-known risk factor for respiratory diseases, cardiovascular diseases, and many types of cancers, but there is little information about the effects of smoking on muscle strength. Hand grip strength (HGS) is a simple way to measure muscle power. We compared the mean HGS according to smoking status and smoking level in Korean male and female smokers. @*Methods@#We obtained data from the Korea National Health and Nutrition Examination Survey VII and included adults aged 20–79 years. We identified factors that affect HGS and after adjusting for these factors, we compared the mean HGS of smokers, ex-smokers, and nonsmokers. We also compared the mean HGS of smokers according to the smoking level. ANOVA and ANCOVA analyses were performed to compare the mean HGS. In addition, we examined the relationship between smoking, and mean main HGS, which is the mean HGS of the dominant hand. @*Results@#A total of 9,848 people were analyzed after excluding those with uncertain smoking status and those who did not respond to the study variables. After adjusting for all cofactors, the mean HGS and the mean main HGS were higher in smokers and ex-smokers than in both male and female nonsmokers with no previous history of smoking. In smokers, the amount of smoking did not affect the mean HGS or mean main HGS. @*Conclusion@#Smokers and ex-smokers have higher mean HGS and mean main HGS than nonsmokers, and the amount of smoking does not affect the mean HGS and mean main HGS in smokers.

Association between Body Weight Perception and Metabolic Syndrome in Korean Adults: The Korea National Health and Nutrition Examination Survey 2015–2016

Background@#Obesity has become a concern globally. The incidence of metabolic syndrome has increased rapidly in Korea over the past decades.Previous studies have reported obesity as a major cause of metabolic syndrome. Body mass index (BMI) and body weight perception have beenwidely used as indirect predictors of the risk of metabolic syndrome. Therefore, we aimed to evaluate subjective body weight perception and therisk of metabolic syndrome in adults over 20 years of age and confirm the gap between body weight perception and the objective measure of BMI. @*Methods@#This study was conducted aming 9,842 Korean adults over 20 years of age using data from the VI-3 (2015) and VII-1 (2016) Korea NationalHealth and Nutrition Survey. The BMI criteria were set according to the WHO Asia Pacific Standard criteria. Perceived body weight status wasmeasured according to the question, “How would you describe your body shape?”. The patients were grouped as “obese,” “slightly obese,” “rightweight,” and “under weight” according to the original responses (“very obese,” “slightly obese,” “normal,” “slightly thin,” and “very thin”). Data analysiswas performed using chi-square test, analysis of variance, and logistic regression. @*Results@#Among the participants, the risk of metabolic syndrome was progressively higher with the body weight perception as obese. Additionally, therisk of metabolic syndrome was higher in those with a higher BMI than in those with subjective body weight perception. @*Conclusion@#In this Korean population, increased risk of metabolic syndrome showed higher associated with higher BMI than with body weightperception.

Association between Physical Activity and Health-Related Quality of Life in Korean Patients with Diabetes Mellitus

Background@#It is well known that physical activity has various health benefits. Therefore, this study was conducted to demonstrate the association between physical activity and health-related quality of life (HRQoL) among Korean patients with diabetes mellitus. @*Methods@#Our study is based on VI phases (2014–2015) of the Korea National Health and Nutrition Examination Survey. Subjects were divided into two groups according to high and low levels of physical activity. HRQoL was measured by using the Euro quality of life-5 dimension (EQ-5D). Impaired HRQoL was defined as the score within the lowest 20% of the EQ-5D index and some or extreme problems in the EQ-5D domains. Logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) for the effects of physical activity on impaired HRQoL. @*Results@#The adjusted OR for impaired HRQoL for individuals that were more physically active compared to those who were less physically active was higher for the EQ-5D index (OR, 2.85; 95% CI, 1.82–4.44). Furthermore, compared to less physically active individuals, the adjusted ORs were higher for more physically active individuals in mobility (OR, 1.97; 95% CI, 1.28–3.02), self-care (OR, 2.20; 95% CI, 1.20–4.03), usual activities (OR, 2.83; 95% CI, 1.81–4.45), and pain/discomfort (OR, 1.75; 95% CI, 1.19–2.57) among the various EQ-5D domains. @*Conclusion@#A lack of physical activity is associated with lower HRQoL among Korean patients with diabetes, particularly when compared with Koreans engaged in frequent physical activity.

Long-term effect of bariatric surgery versus conventional therapy in obese Korean patients: a multicenter retrospective cohort study

PURPOSE: Long-term results following bariatric surgery compared to conventional treatments has never been reported in morbidly obese Korean patients. This study aimed to evaluate the long-term efficacy of bariatric surgery in morbidly obese Korean patients compared to conventional medical treatments. METHODS: In this multicenter retrospective cohort study, we reviewed 137 obese subjects between January 2008 and February 2011 with a body mass index (BMI) > 30 kg/m2 who had more than 5 years of follow-up clinical data after bariatric surgery (surgery group, n = 49) or conventional treatment (conventional treatment group, n = 88). Anthropometric data and the status of comorbidities were compared between the 2 groups. RESULTS: The median follow-up period was 72.1 months (range 19.3–109.7 months). At the last follow-up, the surgery group showed a greater amount of total weight loss than the conventional treatment group (24.9% vs. 2.8%, P < 0.001). The prevalence of diabetes and hypertension significantly decreased in the surgery group, while the conventional treatment group showed a marked increase in these comorbidities. In the surgery group, Roux-en-Y gastric bypass and sleeve gastrectomy achieved comparable long-term weight loss (26.5% vs. 22.4%, respectively; P = 0.087). CONCLUSION: In the long-term, bariatric surgery achieved and maintained significantly greater weight reduction, as well as a decrease in obesity-related comorbidities, than did conventional medical therapy in morbidly obese Korean patients.

Leisure Time Physical Activity and Metabolic Syndrome in Mid-Aged and Elderly Korean Women

BACKGROUND: Metabolic syndrome is a cluster of metabolic disorders, including increased blood pressure, high blood glucose level, abdominal obesity, and abnormal cholesterol or triglyceride levels. When these metabolic disorders occur concurrently, the risk for developing diabetes, cardiovascular disease, and stroke increases. According to Korean National Health and Nutrition Examination Survey V (KNHANES V), about one in four adults have a metabolic syndrome. The prevalence is even higher in the older, female population. Sedentary lifestyle is one of the major risk factors of metabolic syndrome. The World Health Organization (WHO) recommends that adults aged >18 years perform at least 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous-intensity aerobic physical activity throughout the week. This study aimed to examine the association between leisure-time physical activity and metabolic syndrome.METHODS: A total of 3,453 Korean women aged >50 years who participated in KNHANES VI and VII were evaluated. By using the WHO recommendations, the leisure time physical activity levels were divided into three groups as follows: none, insufficient, and sufficient. The National Cholesterol Education Program-Adult Treatment Panel III was used to define metabolic syndrome.RESULTS: In this study, leisure-time physical activity level and prevalence of metabolic syndrome were inversely related.CONCLUSION: Leisure time physical activity can be beneficial in reducing the prevalence of metabolic syndrome. More studies on the types and performance duration of physical activities must be conducted to set an appropriate guideline for the middle-aged and elderly female populations.

Association between Weight Control Methods and Depressive Symptoms among Korean Adults according to Age and Sex

BACKGROUND: Unhealthy weight control methods such as fasting and meal skipping can harm the mental health of individuals engaging in these methods. But this relationship has not been studied in Korean individuals. The aim of this study was to investigate the relationship between weight control methods and depressive symptoms among Korean adults.METHODS: We used data from the Korean National Health and Nutrition Examination Survey in 2014, 2016, which included 10,447 adults. Patient Health Questionnaire was used for the assessment of depressive symptoms. Multiple logistic regression analysis was conducted according to age and sex.RESULTS: Attempting to follow a one-food diet was higher among depressed men. There was a significant association between depressive symptoms and weight control methods such as fasting and skipping meals among women. Among women >30 years and <50 years, depressive symptoms were related to a high likelihood of fasting, prescribed drugs for weight loss and one-food diet.CONCLUSION: Our findings indicate that the correlation between the symptoms of depression and weight control methods varies depending on age and sex of the individuals. Our results could help formulate healthy weight management measures based on the on the depressive mood, age and sex of the individuals.

Differences between One-Person and Multi-Person Households on Socioeconomic Status, Health Behavior, and Metabolic Syndrome Across Gender and Age Groups

BACKGROUND: The rising popularity of one-person households makes the health hazards they are prone to, highly relevant in epidemiological studies. This study aimed at comparing health-related characteristics like the socioeconomic status, health behavior, and metabolic syndrome of one-person households, to multi-person households in Korea.METHODS: The participants required for this study included 9,423 Koreans aged 19 and above, who took the Sixth Korean National Health and Nutrition Examination Survey. The household types were classified into “one-person” and “multi-person.” The differences between the two, based on their annual socioeconomic status, health behavior, anthropometric variables, and blood test results were analyzed.RESULTS: The percentage of men and women in one-person households was 7.2% and 10.5%, respectively. Such households had a lower annual income and education than multi-person households. The odds ratios (OR) for alcohol consumption (OR, 1.69; 95% confidence interval [CI], 1.16–2.46) and smoking (OR, 3.24; 95% CI, 1.77–5.95) were significantly higher for one-person households of women, aged 60 and above, compared to multiperson households. The OR for metabolic syndrome was considerably higher in one-person households of middle-aged people in contrast to multiperson households for both men (OR, 1.84; 95% CI, 1.14–2.95) and women (OR, 1.90; 95% CI, 1.21–2.99).CONCLUSION: The socioeconomic status was lower, and the health behaviors were worse in one-person households as compared to multi-person households. Considering the growing popularity of one-person households, it is suggested that medical plans be customized to suit the characteristics of the specific group.

The Association between High Sensitivity C-Reactive Protein and Homeostasis Model Assessment of Insulin Resistance in Non-Diabetetic Korean Men

BACKGROUND: Insulin resistance syndrome is recognized as a risk factor for cardiovascular disease (CVD) and type 2 diabetes mellitus (DM). Even though early management and prevention during the pre-DM stage is emphasized, few studies have investigated the risk of insulin resistance and CVD in individuals with normal blood glucose. This study investigates the effectiveness of the high sensitivity C-reactive protein (hs-CRP) test as a preventative measure by examining the relationship between hs-CRP and a homeostasis model assessment of insulin resistance (HOMA-IR) in adult men without DM.METHODS: Our study included 1,924 men who were ≥20 years of age, from the 2015 Korean National Health and Nutrition Examination Survey. Based on fasting glucose levels, subjects were divided into two categories: normal and impaired fasting glucose (IFG).RESULTS: Student's t-test was used to compare the means of the normal and IFG categories, and hs-CRP and HOMA-IR showed significantly lower values for all variations, except height and smoking, at a significance level of 0.001. All subjects were classified into quadrant groups according to hs-CRP values, and ANCOVA was performed to compare the HOMA-IR average of each group. The mean IR did not significantly differ between cohorts, except for in the IFG category of one group.CONCLUSION: In adult men without DM, hs-CRP did not significantly correlate with HOMA-IR, except in the IFG category. This indicates that the risk of CVD increases continuously in the normal blood sugar range. Further studies are needed to improve the usefulness of the high sensitivity hs-CRP test.

Effects of Intermittent Leisure Time Physical Activity on Glycemic Control in Korean Adult Men with Diabetes and Prediabetes

BACKGROUND: Although less frequent activity might be fit into patients, little is known about the benefits of the low frequency physical activity. With the increasing prevalence of diabetes, the objective of the present study was to investigate the effect of physical activity patterns on glycemic control in Korean adult men with diabetes and prediabetes.METHODS: We obtained data from the Korean National Health and Nutrition Examination Survey VI (2014 to 2015), which included 14,930 participants. We analyzed the data for 1,297 male individuals aged 40–80 years, with diabetes or prediabetes. Physical activity patterns were classified into physical activity (Metabolic Equivalents [MET]·minutes) and frequency.RESULTS: Among the 1,297 respondents, 846 were in the “Inactive”, 98 were in the “Insufficiently Active 1” ( < 600 MET·minutes, 1 or 2 sessions/wk), 54 were in the “Insufficiently Active 2” ( < 600 MET·minutes, 3 or more sessions/wk), and 299 were in the “Sufficiently Active” (≥600 MET·minutes). Those in the “Insufficiently Active 1” had a significantly lower HbA1c than “inactive” (0.27%; 5.98±0.07 vs. 6.25±0.05). In contrast, those in the “Insufficiently Active 2” (6.66±0.28) exhibited higher HbA1c as compared to “inactive”. Finally, those in the “Sufficiently Active” (6.21±0.06) exhibited lower HbA1c as compared to “inactive” (0.04%) (all P-values < 0.05). A similar trend was observed in the relationship between physical activity and fasting blood glucose levels.CONCLUSION: Though engaging in physical activity once or twice a week does not meet the World Health Organization-recommended frequency, it has a significant positive effect on glycemic control in patients with diabetes and prediabetes.

Association between Age at Natural Menopause with Diabetes and Prediabetes

BACKGROUND: Previous studies have reported that fasting insulin and blood glucose levels are higher in postmenopausal than in premenopausal women and that insulin resistance was more serious in postmenopausal women. The effects of menopause on glucose metabolism have been well studied, but it is unclear whether age at menopause onset is associated with fasting blood sugar and HbA1c levels. The purpose of this study is to determine the effect of menopause age on diabetes and prediabetes.METHODS: We retrospectively analyzed data from the Sixth Korea National Health and Nutrition Examination Survey (2013–2015). The participants were 2,156 naturally menopausal women, except diabetes, stroke, coronary artery disease and cancer patients. The study population was divided into four groups according to the age of natural menopause onset ( < 40, 40–44, 45–55, and ≥56 years). Diagnosis of diabetes and prediabetes was based on the American Diabetes Association guideline. The association between menopause age and diabetes or prediabetes was analyzed by multiple logistic regression.RESULTS: Women reaching menopause at 40–44 years were 4.901 times more likely to have diabetes (odds ratio [OR], 4.901; 95% confidence interval [95% CI], 1.353–17.756, P=0.016) than those who reached menopause at an age of ≥56 years. Women with menopause at age < 40 years were 2.839 times more likely to have diabetes or prediabetes (OR, 2.839; 95% CI, 1.012–7.968, P=0.047).CONCLUSION: Women with premature menopause (< 40 years) have high risk of developing diabetes or prediabetes, and women with a menopause age of 40–44 years have high risk of developing diabetes.

The Association between Urinary Sodium Excretion and Metabolic Syndrome in Korean Adults from the 2010–2011 Korean National Health and Nutrition Examination Survey / 가정의학회지

BACKGROUND: The sodium intake of Koreans was higher than that recommended by the World Health Organization. Urinary sodium, which is correlated with sodium intake, can be easily calculated by the Tanaka's equation. This study aimed to evaluate the association between urinary sodium and metabolic syndrome in Korean adults using the 2010–2011 Korean National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 5,870 participants from the 2010–2011 KNHANES were included in this study. Twenty-four hour urinary sodium was calculated by the Tanaka's equation using spot urine. Participants were divided into tertiles based on urinary sodium levels. The association between urinary sodium and metabolic syndrome was analyzed using multivariate logistic regression analysis. RESULTS: The odds ratios (ORs) and 95% confidence intervals (CIs) of metabolic syndrome for the 2nd and 3rd tertile of urinary sodium levels was 1.51 (1.16–1.97) and 1.56 (1.23–1.97) compared to the lowest tertile of urinary sodium in men. The ORs and 95% CIs of metabolic syndrome in women were 1.20 (0.95–1.51) for the 2nd tertile and 2.16 (1.68–2.78) for the 3rd tertile. These associations remained statistically significant, even after adjusting for multiple covariates such as age, education, regular exercise, smoking, and alcohol consumption. CONCLUSION: These findings indicate that urinary sodium is significantly associated with metabolic syndrome in Korean adults.

Roux-en-Y Gastric Bypass vs. Sleeve Gastrectomy vs. Gastric Banding: The First Multicenter Retrospective Comparative Cohort Study in Obese Korean Patients

PURPOSE: Bariatric surgery is relatively new in Korea, and studies comparing different bariatric procedures in Koreans are lacking. This study aimed to compare the clinical outcomes of laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) for treating morbidly obese Korean adults. MATERIALS AND METHODS: In this multicenter retrospective cohort study, we reviewed the medical records of 261 obese patients who underwent different bariatric procedures. Clinical outcomes were measured in terms of weight loss and resolution of comorbidities, such as diabetes, hypertension, and dyslipidemia. Safety profiles for the procedures were also evaluated. RESULTS: In terms of weight loss, the three procedures showed similar results at 18 months (weight loss in 52.1% for SG, 61.0% for LAGB, and 69.2% for RYGB). Remission of diabetes, hypertension, and dyslipidemia was more frequent in patients who underwent RYGB (65.9%, 63.6%, and 100% of patients, respectively). Safety profiles were similar among groups. Early complications occurred in 26 patients (9.9%) and late complications in 32 (12.3%). In the LAGB group, five bands (6.9%) were removed. Among all patients, one death (1/261=0.38%) occurred in the RYGB group due to aspiration pneumonia. CONCLUSION: The three bariatric procedures were comparable in regards to weight-loss outcomes; nevertheless, RYGB showed a higher rate of comorbidity resolution. Bariatric surgery is effective and relatively safe; however, due to complications, some bands had to be removed in the LAGB group and a relatively high rate of reoperations was observed in the RYGB group.

Cancer Prevalence among Physicians in Korea: A Single Center Study / 가정의학회지

BACKGROUND: There is little research regarding whether working as a physician affects cancer risk. Moreover, there is no research on cancer prevalence among physicians in Korea. This study utilized the Korea National Cancer Incidence Database to determine whether the prevalence of cancer among physicians differs from the prevalence of cancer within the general population. METHODS: We analyzed the medical records of a representative sample of 382 doctors who underwent a health examination between 2010 and 2013 at a health examination center in a Ewha Womans University Medical Center.Cancer incidence was measured as cases that were eventually diagnosed as cancer according to a biopsy. RESULTS: We collected medical records from 382 physicians (mean age, 51.9±8.1 years) and calculated the standardized prevalence ratios compared to the general population. Thirty physicians (9 male and 21 female) were identified as having cancer. Physicians had a significantly higher prevalence of cancer compared to the general population.Cancer prevalence in male physicians was found to be 2.47 times higher than the prevalence expected within the general population (P=0.006). Among female physicians, cancer prevalence was 3.94 times higher than that in the general population (P<0.001). CONCLUSION: This study revealed that physicians had a higher prevalence of cancer compared to the general population in Korea, which suggests that there may be a problem present in the health care of physicians. Changes to the working environment of physicians will be needed to reduce the high prevalence of cancer among physicians.

The Association of Lung Age with Smoking Status in Korean Men / 가정의학회지

BACKGROUND: Lung age, calculated from sex, forced expiratory volume in one second (FEV1), and height, was developed to illustrate premature changes to the lungs and could be used to motivate smoking cessation. However, this method has not been tested in association with smoking in Korea. The purpose of this study was to investigate the association of lung age with smoking and other factors in Korean males. METHODS: We reviewed the records of 1,100 healthy men who visited a health promotion center at Ewha Womans University Medical Center from January 2008 to June 2009. Lung age was calculated from FEV1 and normal predictive values of spirometry according to age in the Korean population. The difference between lung age and chronological age was evaluated in relation to smoking status, weight, body mass index, waist, muscle mass, fat mass, and exercise. RESULTS: The age difference was significantly higher in current smokers than in non-smokers (12.47 +/- 19.90 vs. 7.30 +/- 19.52, P < 0.001). Additionally, the age difference was positively correlated with life time pack-year (beta = 0.223; P < 0.001) and fat mass (beta = 0.462; P < 0.001). Lung age increased 1 year for 4.48 pack-year increase or for 2.16% increase in fat mass. CONCLUSION: We found a significant relationship between lung age and both smoking status and fat mass in healthy Korean males. Lung age may be a useful tool for motivating cessation of cigarette smoking and management of risk factors related to obesity.

The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men

BACKGROUND: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently, there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. METHODS: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol. RESULTS: The mean age of the participants was 44.9+/-8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2: 0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). CONCLUSIONS: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.

The improvement of quality of life in patients treated with bariatric surgery in Korea / 대한외과학회지

PURPOSE: Bariatric surgery is considered an efficient treatment for severe obesity, but postoperative complications and psychosocial problems may impact quality of life (QoL). Although QoL is an important aspect of bariatric surgery, few studies have evaluated the changes in QoL. We examined whether severely obese patients who had undergone bariatric surgery had better QoL compared with severely obese adults who had not undergone bariatric surgery in Korea. METHODS: Data were obtained from 78 participants in two groups; bariatric surgery group (n = 53) and nonsurgery group (n = 25). EuroQoL-5D (EQ-5D), the impact of weight on quality of life-lite (IWQoL-lite) and the obesity-related psychosocial problem scale (OP-scale) were used to assess the improvement of QoL. RESULTS: A total of 78 patients completed the QoL forms as part of their surgical consultation. In the EQ-5D, the changes of EQ-5D 3 level and EQ-5D visual analogue scale in the surgery group was 0.174 and 24.6 versus 0.017 and 17.8 in the nonsurgery group (P = 0.197 and P = 0.179). The changes of IWQoL-lite and OP-scale were significantly improved after bariatric surgery. In the IWQoL-lite, the mean changes in the surgery group was 33.4 versus 14.3 points in the nonsurgery group (P = 0.000). In the OP-scale, the mean changes in the surgery group patients scored 39.3 versus 9.0 points in the nonsurgery group (P = 0.000). CONCLUSION: We demonstrated significant improvement of QoL observed after bariatric surgery compared to nonsurgical procedure. The results of this comparative study favor bariatric surgery for the treatment of severe obesity.

The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men

BACKGROUND: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently, there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. METHODS: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol. RESULTS: The mean age of the participants was 44.9+/-8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2: 0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). CONCLUSIONS: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.

The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men

BACKGROUND: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently, there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. METHODS: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol. RESULTS: The mean age of the participants was 44.9+/-8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2: 0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). CONCLUSIONS: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.

Association between Metabolic Syndrome and Gallbladder Polyps in Healthy Korean Adults

The goal of this study was to evaluate the association between gallbladder (GB) polyps and metabolic syndrome. A total of 5,685 healthy subjects were included, and 485 of these subjects had GB polyps and 744 had metabolic syndrome. In this study, metabolic syndrome was diagnosed according to standards suggested by the AHA/NHLBI ATP III 2005, and abdominal obesity (> or = 90 cm in men and > or = 85 cm in women for Korean) was diagnosed according to standards set forth by the Korean Society for Study of Obesity. Biphasic logistic regression adjusted for age and gender was used to evaluate the association between metabolic syndrome and GB polyps. Subjects who were male (OR, 1.493; 95% CI, 1.11-2.00) and hepatitis B suface Ag (HBsAg) positive (OR, 1.591; 95% CI, 1.06-2.38) were significantly more likely to have GB polyps. The metabolic syndrome group had a higher risk of GB polyps (OR, 1.315; 95% CI, 1.01-1.69) than the group without metabolic syndrome. In conclusion, subjects who were HBsAg positive and male appear to be associated with the risk of GB polyps. The presence of metabolic syndrome also appears to be associated with the risk of GB polyps in Koreans.

Bariatric surgery versus conventional therapy in obese Korea patients: a multicenter retrospective cohort study / 대한외과학회지

PURPOSE: In Korea, the results of bariatric surgery have not been compared with those of nonsurgical treatment. The purpose of this study was to evaluate the effectiveness and safety of bariatric surgery vs. conventional nonsurgical treatment in severely obese Koreans. METHODS: In this retrospective cohort study, we reviewed the medical charts of 261 consecutive subjects who underwent bariatric surgery and 224 subjects who were treated with weight control medication and lifestyle modification therapy between January 2008 and February 2011. Measures of clinical effectiveness, including change in weight (%) and comorbid diseases, and occurrence of complications, were investigated for 18 months after bariatric surgery. RESULTS: Body mass index (BMI) was higher in the surgery group than in the conventionally treated group (mean +/- standard deviation, 39.0 +/- 6.2 vs. 34.3 +/- 3.8). Diabetes was more prevalent in the surgery group than in the conventionally treated group (39.1% vs. 12.9%). The change in weight (%) between baseline and 18 months posttreatment was significantly greater in the surgery group (22.6%) than in the conventional therapy group (6.7%). While 57%, 47%, and 84% of subjects recovered from diabetes, hypertension, and dyslipidemia, respectively, in the surgery group, 10%, 20%, and 24% of subjects recovered from these conditions in the conventional group. Fifty-one subjects (19.5%) in the surgery group reported 61 complications (23.4%). CONCLUSION: Bariatric surgery in Korea was significantly more effective than conventional treatment for weight loss and recovery from comorbidities such as diabetes, hypertension, and dyslipidemia, with a reasonable complication rate.