The Relationship between Serum Gamma-glutamyltransferase Level and Overweight in Korean Urban Children / 가정의학회지

BACKGROUND: Recently, it has been reported that gamma-glumyltransferase (GGT) is associated with various cardiovascular risk factors including overweight in adults. However, there are few studies on the relationship between GGT and cardiovascular risk factors in children. The aim of this study was to assess the relationship between serum GGT level and overweight in Korean urban children. METHODS: This study was a cross-sectional study using data on 390 4th grade students of elementary schools in Gunpo, Korea. Children were divided into 4 groups according to gender-specific quartiles of serum GGT level. Body mass index, waist circumference and body fat percentage were quantified as adiposity indices. RESULTS: All adiposity indices in children of the highest GGT level quartile were higher than those in children of the lowest quartile. Adjusted odd ratios on overweight of the highest quartile of GGT level compared to the lowest quartile were 14.40 (95% confidence interval [CI], 4.43 to 46.83) in boys and 2.94 (95% CI, 1.06 to 8.16) in girls. CONCLUSION: This study shows that high serum GGT level is related with overweight in Korean urban children and this relationship is stronger in boys compared to girls.

Changes of Body Weight and Inflammatory Markers after 12-Week Intervention Trial: Results of a Double-Blind, Placebo-Control Pilot Study

PURPOSE: Low grade inflammation is a well-known characteristic in obese subjects. We investigated body weight changes and inflammatory markers after 12-week intervention trial. MATERIALS AND METHODS: Twenty-six obese subjects were enrolled and 19 (13 men and 6 women) completed the study. Sibutramine is an FDA-approved drug for body weight control; therefore, we chose this drug as the standard treatment medication in this study. Patients were randomly allocated to receive an anti-inflammatory agent (Diacerein treatment group; n = 12) or placebo (n = 7) for 12 weeks. Anthropometry, body proportion by dual-energy X-ray absorptiometry, and metabolic parameters at the beginning and end of study were measured and compared. RESULTS: The treatment group had a tendency towards more reduction in anthropometry as compared to the placebo group, in body weight reduction (- 7.0 kg vs. - 4.6 kg), body mass index (- 2.51 kg/m2 vs. - 1.59 kg/m2), and waist circumference (- 7.3 cm vs. - 4.4 cm). These reductions were not statistically significant. Changes in levels of high-sensitivity C-reactive protein and adiponectin in the treatment group were more favorable than in the placebo group. CONCLUSION: This small pilot study showed no statistical difference for changes in anthropometry, and inflammatory markers between the two groups. Therefore, we could not find any additional effects of Diacerein on weight loss and inflammatory variables in this study.

Application of Protein-Rich Oriental Diet in a Community-Based Obesity Control Program

PURPOSE: To evaluate the efficacy, safety and availability of a 12-week, community-based obesity control program called the Protein-Rich Oriental Diet (PRO Diet) and to compare it to a conventional diet. MATERIALS AND METHODS: A total of 515 overweight people (55 men and 460 women; mean age 41.9 +/- 9.8 years; body mass index (BMI) 28.1 +/- 3.6 kg/m2) participated in the program at two public health centers. PRO Diet was offered as the main diet recommendation for 12 weeks. As a control group, we selected a population who had followed a conventional diet program conducted at a public health center in 2006. RESULTS: 177 subjects (34.3%) completed the 12-week PRO Diet program. In a per protocol (PP) analysis, the mean changes in anthropometry were (conventional program vs. PRO Diet; weight, - 2.3 kg vs. - 4.7 kg, p < 0.001; BMI, - 1.1 kg/m2 vs. - 1.9 kg/m2, p < 0.001; waist circumference, - 3.3 cm vs. - 6.8 cm, p < 0.001; fat mass, - 2.0 kg vs. - 4.2 kg, p < 0.001; fat % mass, - 1.8% vs. - 3.9%, p < 0.001). The triglyceride reduction was significantly greater (- 30.16 mg/dL, p < 0.001) in the PRO Diet group after intervention compared to the conventional group. CONCLUSION: The PRO Diet was an effective tool for weight loss in a community-based weight control program and well-tolerated.

Ketonuria after Fasting may be Related to the Metabolic Superiority

Obese individuals are less able to oxidize fat than non-obese individuals. Caloric reduction or fasting can detect ketonuria. We investigated the differences of metabolic parameters in the presence of ketonuria after a minimum 8 hr fast in a cross-sectional analysis of 16,523 Koreans (6,512 women and 10,011 men). The relationship between the presence of ketonuria of all subjects and prevalence of obesity, central obesity, metabolic syndrome, and obesity-related metabolic parameters were assessed. The ketonuria group had lower prevalence of obesity, central obesity, and metabolic syndrome than the non-ketonuria group. In addition, all metabolic parameters (including body weight, waist circumference, blood glucose, high-density lipoprotein, triglyceride, blood pressure, and insulin) were favorable in the ketonuria group than in the non-ketonuria group, even after adjustment for age, tobacco use, and alcohol consumption. The odds ratios of having obesity (odds ratio [OR]=1.427 in women, OR=1.582 in men, P<0.05), central obesity (OR=1.675 in women, OR=1.889 in men, P<0.05), and metabolic syndrome (OR=3.505 in women, OR=1.356 in men, P<0.05) were increased in the non-ketonuria group compared to the ketonuria group. The presence of ketonuria after at least an 8 hr fast may be indicative of metabolic superiority.

Difference of Body Compositional Changes According to the Presence of Weight Cycling in a Community-based Weight Control Program

Many obese people who try to control body weight experience weight cycling (WC). The present study evaluated the importance of WC in a community-based obesity intervention program. We analyzed the data of 109 Korean participants (86% women) among 177 subjects who had completed a 12-week intervention program at two public health centers in Korea from April to December, 2007. Completion of a self-administrated questionnaire at baseline was used to obtain anthropometric measurements, and laboratory testing was done before and after the program. Differences in body composition change and obesity-related life style between the two groups were compared with respect to WC and non-weight cycling (NWC). After 12 weeks, both groups showed reductions in weight, waist circumference, and body mass index. The group differences were not significant. However, significant differences were evident for the WC group compared to the NWC group in fat percent mass (WC vs. NWC, -3.49+/-2.31% vs. -4.65+/-2.59%, P=0.01), fat free mass (WC vs. NWC, -0.95+/-1.37 kg vs. -0.38+/-1.05 kg, P=0.01), and total cholesterol (WC vs. NWC, -3.32+/-14.63 vs. -16.54+/-32.39, P=0.005). In conducting a community-based weight control program that predominantly targets women, changes of body composition and total cholesterol may be less effective in weight cyclers than in non-weight cyclers.

Association between the Total Homocysteine Concentration and the Bone Marrow Density and Bone Turnover Rate in Postmenopausal Women / 대한폐경학회지

OBJECTIVES: Hyperhomocysteinemia is related to fractures in the elderlies. We assessed the relationship between serum homocysteine and bone mass, size, and bone turnover rate. METHODS: This study included 2,670 postmenopausal women who underwent periodic health examinations in Ajou University Health Promotion Center, between January 2002 and December 2003. Serum homocysteine, bone turnover markers and bone mineral density were measured RESULTS: Patient age, osteocalcin, 25-vit D, total lumbar BMD, total lumbar T-score, the lowest lumbar BMD, the lowest lumbar T-score, femur neck BMD, femur neck T-score, femur trochanteric BMD and femur trochanteric T-score showed a significant correlation with the serum total homocysteine. However, after adjusting for age, the only osteocalcin was significantly correlated with the serum total homocysteine, At the 3rd lumbar vertebra, the BMC, volumetric BMD and areal BMD had a significant correlation with the serum total homocysteine but the bony size and the volume were not significant. After adjusting for age, the 3rd lumbar BMD was significantly correlated with the serum total homocysteine. CONCLUSION: Serum homocysteine level is correlated significantly with bone turnover rate, less with bone mass but not with bone size.

Association between Depression and Cardiovascular Risk Factors in Workers Undergoing Comprehensive Medical Examination in a University-based Hospital

BACKGROUND: Depression increases the risk of cardiovascular risk factors in adults. However, the association between depression and cardiovascular risk factors was not well evaluated in South Korea. Our study was done to evaluate the association between depression and cardiovascular risk factors in workers. METHODS: The study population was selected among adults working in several industries that had more than 50 employees. They had received their medical examinations at the Health Promotion Center of Hallym University Sacred Heart Hospital between March and November 2005. We estimated the odds ratio to determine whether depression (Korean Center for Epidemiologic Studies Depression Scale score > or =21) was associated with each cardiovascular risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity). RESULTS: The prevalence of depression was 15.5%. Depression was significantly associated with hypertension (P<0.001), obesity (P=0.03) and hypercholesterolemia (P=0.004). The adjusted odds ratio for hypertension and hypercholesterolemia were 1.41 (95% CI 1.04~1.91) and 1.59 (95% CI 1.05~2.40), respectively. The association between depression and obesity was eliminated after adjustment (1.25, 95% CI: 0.97~1.61). CONCLUSION: Depression was significantly associated with hypertension and hypercholesterolemia in workers. Further long-term study on the association of depression with cardiovascular risk factors is necessary.

Percent Body Fat and Abdominal Circumference Cutoff Points Accounted for 85th and 95th Percentile of Body Mass Index in One City of Gyeonggi Province

BACKGROUND: Childhood obesity is becoming more prevalent, associated with a variety of adverse consequences which leads to adulthood obesity. Although diagnosis is usually made by body mass index, there is neither a cutoff point for the percentage body fat nor abdominal circumference. The aim of this study was to identify each cutoff point for both measures. METHODS: The measurement of height, weight, abdominal circumference and percentage body fat was performed through manual assessment and bioelectrical impedance analysis for 4,242 subjects aged 11 in Gunpo City, South Korea. The cutoff point for body fat percentage and abdominal circumference is set to maximize the sum of sensitivity and specificity for detecting obesity and overweight using the Receiver Operating Characteristics (ROC) curve. RESULTS: The mean percentage body fat was 13.6+/-6.9% for boys and 19.4+/-5.3% for girls. The mean abdominal circumference of boys was 68.0+/-9.1 cm, and that of girls was 64.3+/-7.7 cm. The cutoff point of percentage body fat for obesity was 21.8% in boys and 24.5% in girls. The prevalence of obesity was 15.2%, 16.7% for males and females, respectively. The abdominal circumference cutoff for obesity was 76.9 cm in boys and 70.7cm in girls. Based on that, the prevalence of obesity was 19.7% for boys and 20.0% for girls, which was higher than what was identified by body mass index, as in the case of body fat percentage. CONCLUSION: The cutoffs of body fat percentage and abdominal circumference in one city of Gyeonggi Province were lower than those suggested in the previous studies.