Association between hepatic steatosis and fibrosis and arthritis among US adults: A population-based study

Abstract Background: Lipid metabolism factors may play a role in the development of arthritis and hepatic steatosis and fibrosis. The aim of this study was to explore the potential association between arthritis and hepatic steatosis and liver fibrosis. Materials and methods: The nationally representative sample from the National Health and Nutrition Examination Survey was analyzed, with data on arthritis diagnosis, subtype, and liver status obtained. Liver status was assessed using transient elastography. Hepatic steatosis was defined as a Controlled Attenuation Parameter (CAP) score ≥263 dB/m, and liver fibrosis status was defined as F0‒F4. Logistic regression models and subgroup analyses stratified by sex were used to evaluate the associations. Smooth curve fitting was used to describe the associations. Results: The present study of 6,840 adults aged 20 years or older found a significant positive correlation between arthritis and CAP in multivariate logistic regression analysis (β = 0.003, 95 % CI 0.001 to 0.0041, p < 0.001). Participants with arthritis had a higher risk of hepatic steatosis (OR = 1.248, 95 % CI 1.036 to 1.504, p = 0.020), particularly those with osteoarthritis or degenerative arthritis, but not rheumatoid arthritis (p = 0.847). The positive correlation was maintained in females (β = 0.004, 95 % CI 0.002 to 0.006, p < 0.001), but not in males. There was no significant relationship between arthritis and liver fibrosis (p = 0.508). Conclusion: This study indicates that there is a positive correlation between arthritis and hepatic steatosis, particularly in females. Nonetheless, there is no significant relationship between arthritis and the risk of liver fibrosis.

Association of serum 25-hydroxyvitamin D with cardiovascular and all-cause mortality in patients with chronic kidney disease: NHANES 2007-2018 results

Abstract Background: Vitamin D insufficiency is a prevalent issue in patients suffering from CKD. The purpose of this study was to determine whether serum 25(OH)D levels are associated with all-cause and cardiovascular mortality in patients with CKD. Methods: To examine the associations between 25(OH)D levels and cardiovascular mortality, this retrospective cohort study used the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007‒2018 database. A total of 2,668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. The associations were assessed using Cox proportional hazards regression, restricted cubic splines, Kaplan-Meier survival curves, and competing risks survival analysis. Furthermore, subgroup and sensitivity analyses were performed. Results: During a median follow-up of 72 months in a weighted population of 11,715,452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause mortality (HR= 0.85, 95 % CI 0.77~0.94) and cardiovascular mortality (SHR= 0.80, 95 % CI 0.67~0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile). Compared to group Q1, both group Q3 (HR = 0.71, 95 % CI 0.54‒0.93) and group Q4 (HR = 0.72, 95 % CI 0.55‒0.94) exhibited a significantly reduced mortality risk. Weighted restricted cubic splines revealed an inverse J-shaped linear association between levels of 25(OH) D and all-cause mortality ((PNonliner > 0.05). Subgroup analysis and sensitivity analysis yielded similar findings. Conclusions: All-cause mortality and cardiovascular disease-related mortality were significantly increased by lower 25(OH)D levels, both as continuous and categorical variables. 25(OH)D has an inverse J-shaped linear association with all-cause and cardiovascular mortality.

Relationship between cadmium exposure and pulmonary function level and chronic obstructive pulmonary disease / 中华劳动卫生职业病杂志

Objective: To analyze the levels and distribution characteristics of blood cadmium and urinary cadmium in American adults, to analyze the relationship between blood cadmium and urinary cadmium and pulmonary function dose response, and to explore the effect of this index on the risk of chronic obstructive pulmonary disease. Methods: In March 2022, 3785 patients from 2007 to 2012 in NHANES database were selected as the subjects. Collect demography data such as gender and age, and test data such as lung function, blood cadmium concentration and Urine cadimium concentration. The relationship between blood and urine cadmium levels and lung function and pulmonary function and chronic obstructive pulmonary diease (COPD) was analyzed by Mann-Whitney U test or Kruskal-Wallis H test, multivariate linear regression and restricted cubic spline method. Results: The geometric mean of blood cadmium and urine cadmium in American adults was 0.37 g/L and 0.28 g/L, FEV(1) and FEV(1)/FVC among different cadmium exposure groups was statistically significant, and there was a negative linear dose-response relationship between serum Cd and urine Cd concentrations and FEV(1)/FVC levels (P(overall)<0.001, P(non-linear)=0.152; P(overall)<0.001, P(non-linear)=0.926). Compared with the lowest quartile concentration (Q1), the highest quartile blood cadmium concentration (Q4) (OR=1.934, P(trend)=0.000) and urinary cadmium concentration (OR=1.683, P(trend)=0.000) may increased the risk of chronic obstructive pulmonary disease. Conclusion: There is a negative correlation between blood cadmium, urinary cadmium levels and lung function in American adults, and cadmium may increase the risk of chronic obstructive pulmonary disease.

An Artificial Neural Network Model Combined with Dietary Retinol Intake from Different Sources to Predict the Risk of Nonalcoholic Fatty Liver Disease / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to develop an artificial neural network (ANN) model combined with dietary retinol intake from different sources to predict the risk of non-alcoholic fatty liver disease (NAFLD) in American adults.@*METHODS@#Data from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) 2007-2014 were analyzed. Eligible subjects ( n = 6,613) were randomly divided into a training set ( n 1 = 4,609) and a validation set ( n 2 = 2,004) at a ratio of 7:3. The training set was used to identify predictors of NAFLD risk using logistic regression analysis. An ANN was established to predict the NAFLD risk using a training set. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the accuracy of the model using the training and validation sets.@*RESULTS@#Our study found that the odds ratios ( ORs) and 95% confidence intervals ( CIs) of NAFLD for the highest quartile of plant-derived dietary retinol intake (i.e., provitamin A carotenoids, such as β-carotene) ( OR = 0.75, 95% CI: 0.57 to 0.99) were inversely associated with NAFLD risk, compared to the lowest quartile of intake, after adjusting for potential confounders. The areas under the ROC curves were 0.874 and 0.883 for the training and validation sets, respectively. NAFLD occurs when its incidence probability is greater than 0.388.@*CONCLUSION@#The ANN model combined with plant-derived dietary retinol intake showed a significant effect on NAFLD. This could be applied to predict NAFLD risk in the American adult population when government departments formulate future health plans.

The weight-adjusted-waist index predicts all-cause and cardiovascular mortality in general US adults

Abstract Background The authors examined the relationship between Weight-adjusted Waist Index (WWI) and all-cause and cardiovascular mortality among adults in the US. Methods This prospective cohort study included 26,882 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2014. WWI was calculated as waist circumference divided by the square root of weight. The main outcomes of this study were all-cause mortality and cardiovascular mortality. Mortality status and cause of death were determined by NHANES-linked National Death Index records through December 31, 2015. Cox proportional hazard models and Kaplan-Meier analysis were used to estimate Hazard Ratios (HR) and 95% CIs for mortality for all causes and cardiovascular diseases. Results A total of 26,882 participants with a mean WWI of 10.89 ± 0.01, of whom 49.23% were male. The average follow-up time was 68.95 ± 1.07 months, and 1870 participants were determined as deceased (4.99%), including 349 cardiovascular death (0.88%). The Kaplan-Meier analysis demonstrated a significant difference in all-cause and cardiovascular mortality between patients with WWI <11.33 and ≥11.33 (both log-rank testp < 0.0001). The fully adjusted Cox proportional hazard model indicated that a higher WWI level (≥ 11.33) was associated with an increased 95% risk for cardiovascular mortality (HR = 1.95, 95% CI 1.30‒2.93) and 68% risk for all-cause death (HR = 1.68, 95% CI 1.41‒2.00) compared with the counterparts. Conclusions Elevated WWI levels were associated with a higher risk of cardiovascular mortality and all-cause mortality independently.

The Study of Factors Affecting Oral Health in a Sample from NHANES Survey in the United States

Aims: Oral health problems include dental caries, gum diseases, loss of natural teeth, and other mucosal diseases. The present research aimed to study the factors affecting periodontal health in the residents of the United States of America. This study examined if there were significant differences in the health of teeth and gums with respect to last visit to the dentist, intake of fluoride drops or tablets, gender, and educational level. Materials & Methods: The study analyzed secondary data from the National Health and Nutrition Examination Survey 2017-18. This study examined a population of 9,254 residents aged 1 and older. The Chi-Square Test of Independence was used to test significance among the variables of last visit to the dentist, received fluoride drops or tablets, gender, and educational level. Results: The study found no statistically significant differences in health of teeth and gums with respect to intake of fluoride drops or tablets, gender, and educational level. However, the study did find a statistically significant difference in the health of teeth and gums with regard to the last visit to the dentist among residents of the US. Individuals who have visited the dentist in the last six months have rated their health of teeth and gums as excellent as compared to those who did not visit the dentist in the last six months. Conclusions: Future studies should review other factors affecting oral health such as high sugar intake, diabetes, chronic diseases, and genetics. Emphasis should be given to the identification of inequities associated with periodontal health among various cultural and ethnic groups in the United States of America.

Objetivos: Los problemas de salud oral incluyen la caries dental, las enfermedades de las encías, la pérdida de los dientes naturales y otras enfermedades de las mucosas. El presente estudio tuvo como objetivo examinar los factores que afectan la salud periodontal en los residentes de los Estados Unidos de América. Este estudio examinó si había diferencias significativas en la salud de los dientes y de las encías con respecto a la última visita al dentista, ingesta de gotas o tabletas de flúor, género y nivel educativo. Materiales y Métodos: El estudio se analizó con datos provenientes de la Encuesta y Examinación Nacional de Salud y Nutrición NHANES del 2017-2018. Este estudio examinó una población de 9.254 residentes de 1 año o de mayor edad. Se usó la prueba de independencia Chi-Cuadrado para probar la significancia entre variables como la última visita al dentista, ingesta de gotas o tabletas de flúor, sexo y nivel educativo. Resultados: El estudio no encontró diferencias estadísticamente significativas en la salud de los dientes y de las encías con respecto a la ingesta de gotas o tabletas de flúor, sexo y nivel educativo. Sin embargo, el estudio encontró una diferencia estadísticamente significativa en la salud de los dientes y de las encías con respecto a la última visita al dentista entre los residentes de los Estados Unidos. Las personas que visitaron al dentista en los últimos seis meses calificaron la salud de sus dientes y encías como excelente en comparación con quienes no visitaron al dentista en los últimos 6 meses. Conclusiones: Los estudios futuros deberían revisar otros factores que afectan la salud bucal como la ingesta de alto contenido de azúcar, la diabetes, al igual que las enfermedades crónicas y factores de genética. Se debe hacer énfasis en la identificación de inequidades asociadas con la salud periodontal entre diversas culturas y grupos étnicos en los Estados Unidos.

Associations of exposure to secondhand smoke with hypertension risk and blood pressure values in adults

BACKGROUND@#The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown.@*METHODS@#Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels.@*RESULTS@#Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP.@*CONCLUSIONS@#Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms.

Sex differences in the link between blood cobalt concentrations and insulin resistance in adults without diabetes

BACKGROUND@#Little is known about the effects of environmental cobalt exposure on insulin resistance (IR) in the general adult population. We investigated the association between cobalt concentration and IR.@*METHODS@#A total of 1281 subjects aged more than 20 years with complete blood cobalt data were identified from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 cycle. Blood cobalt levels were analyzed for their association with IR among all populations and subgroups by sex. Regression coefficients and 95% confidence intervals (CIs) of blood cobalt concentrations in association with fasting glucose, insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were estimated using multivariate linear regression after adjusting for age, sex, ethnicity, alcohol consumption, body mass index, education level, and household income. A multivariate generalized linear regression analysis was further carried out to explore the association between cobalt exposure and IR.@*RESULTS@#A negative association between blood cobalt concentration (coefficient = - 0.125, 95% CI - 0.234, - 0.015; P = 0.026) and HOMA-IR in female adults in the age- and sex-adjusted model was observed. However, no associations with HOMA-IR, fasting glucose, or insulin were found in the overall population. In the generalized linear models, participants with the lowest cobalt levels had a 2.74% (95% CI 0.04%, 5.50%) increase in HOMA-IR (P for trend = 0.031) compared with subjects with the highest cobalt levels. Restricted cubic spline regression suggested that a non-linear relationship may exist between blood cobalt and HOMA-IR.@*CONCLUSIONS@#These results provide epidemiological evidence that low levels of blood cobalt are negatively associated with HOMA-IR in female adults.

Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents

Abstract Backgrounds: It is important to improve our understanding of the roles of calcium and vitamin D in bone health for preventing osteoporosis. We aimed at exploring the associations between serum calcium, vitamin D level, and bone mineral density (BMD) in adolescents included in the National Health and Nutrition Examination Survey (NHANES) 2001 - 2006. Methods: Weighted multivariate linear regression models were used to estimate the associations of serum calcium, 25(OH)D level with total BMD. Smooth curve fitting was used to explore the potential non-linear relationship. Results: A total of 5990 individuals aged between 12 and 19 years were included in this study. The fully-adjusted model showed serum calcium positively correlated with total BMD. However, an inverted U-shaped relationship was found when we performed the smooth curve fitting method, and the inflection point was calculated at 9.6 mg/dL using the two-piecewise linear regression model. In contrast, there was a positive correlation between serum 25(OH)D and total BMD after adjusting for potential confounders. Conclusions: The present study revealed a positive correlation between serum 25(OH)D level and total BMD, and an inverted U-shaped relationship between serum calcium and total BMD.(AU)

Breastfeeding for One Month or Longer is Associated with Higher Risk of Osteoarthritis in Older Adults: NHANES 1999–2012

Breastfeeding is associated with many health benefits to the mother but the association between osteoarthritis (OA) is not known. Menopause, a state of rapid estrogen loss, is associated with OA. To test whether lactation, another physiological state of low estrogen status, is associated with OA, a nationally representative dataset National Health and Nutrition Examination Survey (NHANES) 1999–2012 was analyzed. Information of OA diagnosis history and lactation for at least one month was self-reported by women 50 years and older that had given birth to at least one child. Women that breastfed for less than one month had a higher proportion of those that were 60 years and older, Hispanic (than non-Hispanic Black), and higher current/self-reported greatest body mass index. Women that breastfed for one month or longer had a higher proportion of those that had 3 or more children, higher poverty-income ratio, were post-menopausal and performed vigorous physical activity. Weighted percentage of OA patients was 22%, and did not differ between the two groups. However, when logistic regression was performed adjusting for multiple covariates, lactation for one month or longer was positively associated with OA. Women that breastfed for one month or longer had an adjusted odds ratio of 1.21 (95% confidence interval, 1.05–1.40) for OA compared to those that breastfed for less than one month. The results indicate that women that breastfed for at least one month have a higher risk of OA than women that delivered a child but breastfed for less than one month.

Prevalence of ACS and Causal Relation of Hypomagnesaemia.

Magnesium is an important intracellular cation [1], actually the second most abundant cation after Potassium, which has gained an essential role in normal human homeostasis. Low serum magnesium has been detected commonly in around 12% hospitalized patients and even more commonly in Intensive Care Patients as high as 60 to 65%. The link of low serum magnesium with acute coronary syndrome is being discussed widely and its actual role is being scrutinized [2,3]. Recently, Hypomagnesaemia has also been found to play an important role in the pathogenesis of a variety of clinical disorders including Hypertension, Diabetes Mellitus, Atherosclerosis and Acute Coronary Syndromes [4-8]. Acute coronary syndrome (ACS) has been defined as a group of conditions due to decreased blood flow in the coronary arteries. Acute coronary syndrome includes a vast spectrum like: ST elevation myocardial infarction (STEMI / 30%), non ST elevation myocardial infarction (NSTEMI / 25%), or unstable angina (U.A. / 38%).These are described according to ECGs and Cardiac Biomarkers of myocardial necrosis (troponin T, troponin I, and CK MB), in patients presenting with acute cardiac chest pain (Medscape). Aim: To look for any association between Hypomagnesaemia and Acute Coronary Syndrome. Materials and Methods: It’s a retrospective study involving 1198 patients who presented to the Accident and Emergency department (A & E), Trauma Center, Rashid Hospital, Dubai, with Acute Coronary Syndrome (ACS) between April 2010 and May 2013. We reviewed the records of all patients including their clinical history and presentation. The Magnesium levels of all the patients in the ACS pathway were checked along with, Cardiac biomarkers - Troponin, CPK and CK MB and Lipid profiles were also analyzed. A Chi-Square test was performed at 5% level of significance to test the null hypothesis of no association between cardiac markers, lipid profile and magnesium level. Inclusion Criteria: All new patients presenting to A & E Department at Rashid Hospital with an acute coronary syndrome (both NSTEMI & STEMI). All new patients presenting with non-specific chest pain who test positive for cardiac markers. All the age groups presenting to A & E Department at Rashid Hospital from 11/04/2010- 30/05/2013 were included. Both the genders were included. Exclusion Criteria: Patients diagnosed initially with acute coronary syndrome that eventually had negative cardiac markers. Results: Out of 1198, 1087(91%) patients were male. 49% were between 50 and 75 years of age group whereas 46% were between 25 years and 50 years of age. 77% patients were Asians and 17% belonged to Arabic peninsula. The Magnesium level was normal in 1097(92%), low in 63(5.3%). Troponin was negative in 431(36%) and positive in 767(64%) patients with low, medium and high levels in 338(28.2%), 426(35.5%) and 03(0.3%) respectively. These results indicate that there is no statistically significant association between Magnesium levels and Troponin groups (positive and negative) (chi-square with two degree of freedom = 3.30, p = 0.192). Conclusion: Our study proves that there is no significant association between Hypomagnesaemia and Acute Coronary Syndrome.

Inorganic and Organic Mercury Levels in the United States National Health and Nutrition Examination Survey (NHANES) 2005-2010.

Aims: Mercury is an environmental hazard. Therefore, we studied recent trends in the blood level of organic and inorganic mercury in the United States (US). Methodology: We analyzed newly available data on blood inorganic mercury levels in NHANES 2005-2010. Organic mercury level was calculated by subtracting inorganic mercury level from the total mercury level. As complex sampling was used in NHANES, appropriate weights were used to adjust for oversampling of minorities and sampling from the same location. Results: There were 8364, 8161 and 8727 participants in NHANES 2005-6, 2007-8 and 2009-10 respectively. Inorganic mercury levels (geometric mean [95% confidence intervals]) were 0.31 [0.30-0.32], 0.30 [0.30-0.31], 0.28 [0.27-0.28] μg/L and organic mercury levels were 0.24 [0.19- 0.30], 0.19 [0.14-0.25], 0.27 [0.22-0.33] μg/L in 2005-6, in 2007-8, in 2009-10, respectively. Inorganic mercury levels showed a significant decreasing trend (P<.05). Organic mercury levels were significantly lower in participants aged <20 compared to those ≥20 years. The adjusted proportion (mean±SE) of participants with a total mercury level ≥5.8μg/L was 3.0±0.2%, 3.5±0.6%, and 4.0±0.4% (P<.05) in NHANES 2005-6, 2007-8, and 2009-10, respectively. Conclusions: Inorganic mercury level has been decreasing during the study period. Organic mercury level was lower in 2007-2008 but increased in 2009-10. The significant increase in organic mercury level in the US general population in 2009-10 is of concern, suggesting that continual monitoring of mercury levels is needed.

Relationship of Edentulism, Sleep Disordered Breathing and Cardiovascular Disease: NHANES, 2007-2008.

Background: Edentulism, though declining in younger adults, remains prevalent in the U.S. older adult population. Poorer health outcomes, including cardiovascular outcomes have been associated with edentulism. Sleep disorders are also common in older adults and have been associated with cardiovascular disease. The purpose of this study is to determine if edentulism is associated with cardiovascular disease when sleep disorders are included in the analyses. Methods: Data from the National Health and Nutrition Examination Survey, 2007-2008 were used in this study. Adjusted logistic regression analyses were performed with cardiovascular disease as the dependent variable and dental status (edentulism, dentate) as the key independent variable and sleep variables introduced as potential confounders. Results: In multivariable analyses, edentulism was independently associated with cardiovascular disease with an adjusted odds ratio of 2.15 (95% CI: 1.54, 3.00). The model included a sleep summary variable, race, sex, education, smoking status, and drinking status, physical activity, body mass index, conditions or disease count, family poverty index, and insurance status. Conclusions: Edentulism was associated with cardiovascular disease independent of sleep disordered breathing.

Association between Respiratory Function and Albuminuria among Korean Male according to Smoking Status: The 2011 Korea National Health and Nutrition Examination Survey (KNHANES)

BACKGROUND: Several studies have found an association between decreased respiratory function and renal impairment in those with chronic kidney disease. The relationship has not been investigated for healthy smokers. The aim of this study was to examine the association between respiratory function and renal function according to smoking status in Korean male population. METHODS: From the 5th Korean National Health and Nutrition Examination Survey (KNHANES), we enrolled 1246 male participants who were 40 years or older. As a cross-sectional study, the association between respiratory function and renal function were analysed depending on the' smoking status. Pearson correlation analysis was used to find the association between respiratory function and renal impairment. Covariance Analysis allowed to compare renal function (albuminuria, eGFR) with respiratory function (FEV1, FVC) according to smoking status. RESULTS: Regardless of smoking status, there was a negative correlation between respiratory function (FEV1 and FVC) and urinary albumin to creatinine ratio (LogUACR), and positive correlation between respiratory function (FEV1 and FVC) and estimated glomerular filtration rate (eGFR). Smokers have lower FEV1 and FVC in case they have albuminuria, after adjusting for covariant (P=0.012, P=0.010, respectively). CONCLUSIONS: Respiratory function was significantly lower in male smokers with albuminuria. Primary care physicians need to recognize that albuminuria may accompany with decreased respiratory function and to detect renal function impairment earlier in male smokers.

Calcium Intakes in Korean and American Populations

Calcium intake has been insufficient in all age groups in previous Korean national surveys. This study was conducted to investigate calcium intake in Korean and American populations at different ages. We analyzed two national survey data: the 2007~2009 Korean National Health and Nutrition Examination Survey (KNHANES) and the 2007~2008 National Health and Nutrition Examination Survey (NHANES). Statistically, survey procedures were applied using the weight, cluster, and strata variables. The mean calcium intake of Koreans at ages of 1~2 y, 3~5 y, 6~11 y, 12~18 y, 19~64 y, and 65+y was lower than American populations at those ages. The sufficient proportions based on Korean Estimated Average Requirement (EAR) of 1~2 y, 3~5 y, 6~11 y, 12~18 y, 19~64 y, and 65+y in Koreans were 45.5%, 33.1%, 24.3%, 16.6%, 32.7%, and 19.0%. While the sufficient rates based on American EAR of 1~3 y, 4~8 y, 9~13 y, 14~18 y, 19~30 y, 31~50 y, 51~70 y, and 71+y in US population were 88.5%, 54.4%, 35.2%, 35.8%, 55.3%, 55.2%, 40.6%, and 24.5%. Overall, the major foods contributing to calcium intakes in Koreans were milk, baechukimchi, and anchovies, whereas, milk products, pasta, or bread were major contributions to calcium in American populations. The calcium supplement intakes in the American population were 5.5 mg (1~2 y), 15.5 mg (3~5 y), 13.9 mg (6~11 y), 35.7 mg (12~18 y), 150.3 mg (19~64 y) and 334.4 mg (> or =65 y). These results suggest that Korean adolescents and older adults are the most insufficient in dietary calcium intakes among Koreans. In order to accurately estimate calcium intakes in Korean populations, calcium supplements and calcium-fortified foods should be considered.

Consumption of Sugar-Sweetened Beverages and Blood Pressure in the United States: The National Health and Nutrition Examination Survey 2003-2006

High sugar intake has been suggested to be related to hypertension. To examine the associations between intakes of sugar and sugar-sweetened beverages (SSBs) and the prevalence of hypertension, we used the US National Health and Nutrition Examination Survey (NHANES) 2003-2006. A total of 3,044 participants aged > or =19 years were included. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate logistic regression model. Prevalent hypertension cases were defined as systolic blood pressure (SBP) of > or =140 mmHg or diastolic blood pressure (DBP) of > or =90 mmHg. In the multivariate adjusted models, we observed no association between sugar consumption and the prevalence of hypertension. In the model where we adjusted for age, gender, NHANES period and BMI, those who consumed > or =3 times per day of sugar-sweetened beverages had an OR of 1.87 (95% confidence interval, CI = 1.06-3.26) for the prevalence of hypertension compared with those who consumed or =3 times per day of sugar-sweetened beverages compared to the <1 time per month (p for trend = 0.33). In conclusion, we found that sugar consumption was not associated with the prevalence of hypertension, however there was suggestion that high sugar-sweetened beverage consumption was associated with high prevalence of hypertension in the US.

Characteristics of Body Fat, Body Fat Percentage and Other Body Composition for Koreans from KNHANES IV

Accurate measurement of fat mass has become increasingly important with the increasing incidence of obesity. We assessed fat and muscle mass of Koreans with the Korea National Health and Nutrition Examination Survey IV (KNHANES IV). We studied 10,456 subjects (aged 20 to 85 yr; 4,476 men, 5,980 women). Fat and muscle mass were measured by dual-energy x-ray absorptiometry. Reference values of body compositions were obtained using the LMS method. The fat mass index (FMI, body fat mass/height2; kg/m2) of Korean men did not correlate with age (P = 0.452), but those of Korean women (P 9 kg/m2) in men and 2.7% (FMI > 13 kg/m2) in women. It is concluded that the muscle mass decreases and obesity increases with aging in Korean men, whereas both fat mass and obesity increase with aging in Korean women.

Factors Associated with Depressive Symptoms in Patients with Chronic Low Back Pain

OBJECTIVE: To investigate depressive symptoms and their related factors in patients with chronic low back pain in Korea. METHOD: A cross-sectional study using data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2009 was undertaken. The sample consisted of 1,426 participants with chronic low back pain. Multifactorial regression analysis was used to identify the association between depressive symptoms and socioeconomic demographics and other chronic diseases. RESULTS: Among the 371 (26.0%) patients with depression, significant factors associated with depressive symptoms were female gender (odds ratio [OR], 2.691; 95% confidence interval [CI], 1.724-4.199), medical aid beneficiary (OR, 1.371; 95% CI, 1.039-1.810), a dependent group for activities of daily living (OR, 1.570; 95% CI, 1.180-2.087), 'not good' in the perceived health category (OR, 2.309; 95% CI, 1.730-3.081) and in a cancer group (OR, 1.803; 95% CI, 1.051-3.093). CONCLUSION: This study provides the foundation for managing patients with chronic low back pain and depressive symptoms. Clinicians managing chronic low back pain should consider risk factors for depressive symptoms.

Noodle consumption patterns of American consumers: NHANES 2001-2002

Although noodles occupy an important place in the dietary lives of Americans, up until the present time research and in-depth data on the noodle consumption patterns of the US population have been very limited. Therefore, this study aimed to analyze the food consumption and diet patterns of noodle consumers and non-consumers according to age, gender, income, and ethnicity. The 2001-2002 NHANES databases were used. The NHANES 2001-2002 data showed that noodle consumers reporting noodle consumption in their 24-h recall were 2,035 individuals (23.3% of total subjects). According to the results, the mean noodle consumption was 304.1 g/day/person, with 334.3 g for males and 268.0 g for females. By age, the intake of those in the age range of 9-18 years old ranked highest at 353.0 g, followed by the order of 19-50 year-olds with 333.5 g, 51-70 year-olds with by 280.4 g, older than 71years old with 252.3 g, and 1-8 year-olds with 221.5 g. By gender, males consumed more noodles than females. Also, according to income, the intake amount for the middle-income level (PIR 1~1.85) of consumers was highest at 312.5 g. Noodle intake also showed different patterns by ethnicity in which the "other" ethnic group consumed the most noodles with 366.1 g, followed by, in order, Hispanics with 318.7 g, Whites with 298.6 g, and Blacks with 289.5 g. After comparing food consumption by dividing the subjects into noodle consumers and non-consumers, the former was more likely to consume milk, fish, citrus fruits, tomatoes, and alcoholic beverages while the latter preferred meat, poultry, bread, and non-alcohol beverages.

Preliminary analysis of metabolic syndrome components in Korean adolescents by using Korean national health and nutrition examination Survey pooling data (1998, 2001, and 2005) / 소아과

PURPOSE: This study aimed to estimate age-and gender-specific cut points for metabolic syndrome (MS) components, including body mass index (BMI), blood pressure (BP), triglycerides, high-density lipoprotein (HDL) cholesterol, and glucose. METHODS: Data from the 1998, 2001, and 2005 Korean NHANES (National Health and Nutrition Examination Survey) were analyzed (n=4164;2,139 boys and 2,025 girls, aged 10-19 years). Height, weight, waist circumference (WC), BP, triglycerides, HDL cholesterol, and fasting glucose were measured. RESULTS: BMI over 25 kg/m2 represents the 85thP (percentile) in 17-year-old boys and the 90thP in 17-year-old girls. A level of WC higher than that of the cutoff points of Asian adults was found in the 90thP of 17-year-old boys and girls. The 90thP of boys aged 15 years old and the 95thP of 13-year-old were included in the range of systolic BP over 130 mm Hg. Over the 75thP of the group showed triglycerides greater than 110 mg/dL, (criterion of MS presented by NCEP-ATP III) and the 90thP of the group showed triglycerides greater than 150 mg/dL by IDF. An HDL cholesterol level of 40 mg/dL represents the 25thP in boys and the 10thP in girls. A glucose level greater than 110 mg/dL represents the 95thP and greater than 100 mg/dL represents the 90thP. CONCLUSION: Values of the 90thP of MS components in late adolescent boys (WC, BP, and triglycerides) and girls (WC and triglycerides) were very high and in close proximity to the diagnostic criteria of adult MS.