Evaluation of Adiposity-Related Biomarkers as Metabolic Syndrome Indicators

Recent studies have suggested a relationship of the increased circulating adipokines and inflammatory cytokine, and the risk of metabolic syndrome (MetS). The objective of this study was to identify adiposity-related factors that reflect MetS in order to establish early intervention targets. We performed a cross-sectional study which included 108 MetS subjects and 91 controls. Blood adiponectin, leptin, vascular-, and intercellular adhension molecules (VCAM, ICAM), monocyte chemoattractant protein 1 (MCP1), high-sensitivity C-reactive protein (hsCRP), oxidized LDL (oxLDL), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured. The correlation analysis indicated that the MetS score (sum of the number of MetS risk factors) had an inverse relationship with adiponectin (p < 0.0001), and positive correlations with leptin (p < 0.05), ICAM (p < 0.01), MCP1 (p < 0.05), oxLDL (p < 0.05), TNF-alpha (p < 0.0001), IL-6 (p < 0.05) and hsCRP (p < 0.01). In multivariate logistic regression analyses, plasma triglyceride (TG) was independently associated with adiponectin, ICAM and TNF-alpha with the standardized beta coefficients of -0.213, 0.197, and 0.193, respectively. Plasma HDL-cholesterol was independently associated with ICAM and hsCRP with the standardized beta coefficients of -0.150 and -0.173. Adiponectin, TNF-alpha, and hsCRP were the most proximate markers reflecting MetS. Among MetS components, TG and HDL-cholesterol concentrations displayed the relationship with inflammatory markers measured in this study.

Letter to the Editor: Visceral Fat and Liver Fat as Risk Factors of Metabolic Syndrome

No abstract available.

Validity of Cyriax's Test in Young Male with Shoulder Pain Compared to Ultrasonographic Findings

BACKGROUND: This study was designed to evaluate the validity of the Cyriax's selective tension examination as a diagnostic tool in young male with shoulder pain compared to ultrasonographic findings. METHODS: Twenty young male patients with 26 shoulder pain cases were prospectively included in this study. All had a physical examination performed by Cyriax's selective tension method. As a diagnostic gold standard, ultrasonographic examination was carried out within one week of the physical examination by two specialists. RESULTS: The most common findings by sonographic evaluation were sub-deltoid bursitis (65.4%). Sub-deltoid bursal effusion without rotator cuff injury were 10 cases (58.8%) and 17 cases (41.2%) showed combined rotator cuff lesion. The most common diagnoses by physical examination were sub-deltoid bursitis (46.2%) followed by supraspinatus tendon lesion (19.2%). Clinical assessment by physical examination showed low sensitivity in the diagnosis of rotator cuff lesion (42.9%) and sub-deltoid bursitis (70.6%) but high sensitivity and specificity in the diagnosis of shoulder joint instability (sensitivity 100%, specificity 91.7%). CONCLUSION: This study suggest that the validity of Cyriax's selective tension test for the diagnosis of shoulder pain are questionable.

Recognition of Family Practitioners on Cold Hands/Feet Syndrome and Raynaud's Disease

BACKGROUND: Many patients with "cold hands/feet syndrome" have been taking herbal medicine or medicine to improve blood circulation without proven evidence. Raynaud's disease had been neglected in primary care. This study was conducted to investigate the recognition for Raynaud's disease and "cold hands/feet syndrome" by family doctors. METHODS: A questionnaire was posted to 905 family doctors who were in practice from January to July 2003. RESULTS: Among the 274 respondents, 58 (21%) reported that they have seen patients with "sensitive to cold" frequently and 208 (76%) doctors have seen such patients sometimes. Only 8 (3%) doctors answered that they have never seen patients with such symptoms. When such patients see a doctor and complain of "cold hands/feet syndrome", most doctors (60%) prescribed medicine that improved blood circulation (83%) or calcium channel blockers (9%). In case of questions like 'Do you suspect "cold hands/feet syndrome" or "sensitive to cold" contain Raynaud's disease?', 132 (48%) doctors answered 'yes'. And among the 132 doctors, only 15 (11.2%) doctors thought that those patients with "cold hands/feet syndrome" had Raynaud's disease. In addition when the doctors diagnosed the condition as Raynaud's disease, 54% prescribed medicine that improved blood circulation (52%) or calcium channel blockers (40%). CONCLUSION: Most doctors prescribe medicine that improves blood circulation for cold hands/feet syndrome. Many doctors also prescribe medicine to improve blood circulation for Raynaud's disease frequently. The result of our study suggests that there is a need to train doctors so that recognized and diagnosed Raynaud's disease can be correctly.

Recognition of Family Practitioners on Cold Hands/Feet Syndrome and Raynaud's Disease

BACKGROUND: Many patients with "cold hands/feet syndrome" have been taking herbal medicine or medicine to improve blood circulation without proven evidence. Raynaud's disease had been neglected in primary care. This study was conducted to investigate the recognition for Raynaud's disease and "cold hands/feet syndrome" by family doctors. METHODS: A questionnaire was posted to 905 family doctors who were in practice from January to July 2003. RESULTS: Among the 274 respondents, 58 (21%) reported that they have seen patients with "sensitive to cold" frequently and 208 (76%) doctors have seen such patients sometimes. Only 8 (3%) doctors answered that they have never seen patients with such symptoms. When such patients see a doctor and complain of "cold hands/feet syndrome", most doctors (60%) prescribed medicine that improved blood circulation (83%) or calcium channel blockers (9%). In case of questions like 'Do you suspect "cold hands/feet syndrome" or "sensitive to cold" contain Raynaud's disease?', 132 (48%) doctors answered 'yes'. And among the 132 doctors, only 15 (11.2%) doctors thought that those patients with "cold hands/feet syndrome" had Raynaud's disease. In addition when the doctors diagnosed the condition as Raynaud's disease, 54% prescribed medicine that improved blood circulation (52%) or calcium channel blockers (40%). CONCLUSION: Most doctors prescribe medicine that improves blood circulation for cold hands/feet syndrome. Many doctors also prescribe medicine to improve blood circulation for Raynaud's disease frequently. The result of our study suggests that there is a need to train doctors so that recognized and diagnosed Raynaud's disease can be correctly.

The Cognitive Subscale of Alzheimer's Disease Assessment Scale (ADAS-Cog) for Patients with Alzheimer's Disease in Korea

BACKGROUND: This study was designed to examine the utility of the ADAS-Cog, Korean version (ADAS-K-cog) for staging of dementia in Alzheimer disease (AD). We also studied the possible influence of age, sex, and education on a ADAS-K-cog. METHODS: A total of 70 patients with AD meeting the NINCDS-ADRDA criteria of probable AD were recruited. The ADAS-K-cog was administered to all AD subjects. Each patient was also rated on the Global Deterioration Scale (GDS). The probable AD patients were divided into three groups based on their GDS stage to evaluate the sensitivity of ADAS-K-cog to disease severity and their mean scores on ADAS-K-cog were compared. RESULTS: The subjects' age range was 65~93 years and their education range was 0~16 years. The total score of ADAS-K-cog and each item score differed significantly between each groups. The item score of orientation, expressive language, word finding difficulty, comprehension of spoken language and the ADAS-K-cog total score could classify severity of early AD patients efficiently. ADAS-K-cog had high correlations with scores on the GDS (Pearson's r=0.732) and the Mini-Mental State Examination (Pearson's r=-0.755). Multiple regression analysis revealed that performance on the Korean ADAS- Cog was uninfluenced by age or gender, and neither by education level. It's language items were best for monitoring the progression of dementia. CONCLUSION: Our results indicated that the ADAS-K-cog is useful for staging of AD and uninfluenced by education level, sex and age.

Factors Associated with Left Ventricular Hypertrophy on ECG in Middle-aged Normotensive Healthy Men

BACKGROUND: This study was designed to elucidate which factors affected left ventricular hypertrophy (LVH) on ECG in middle-aged normotensive healthy men. METHODS: A total of 436 normotensive office workers who visited the health examination center of St. Mary's Hospital of Catholic University in Korea from August 1 to October 30, 2002, were divided into two groups; 138 with LVH on ECG were grouped as LVH and 298 who showed no LVH on ECG were grouped as non-LVH. Questionnaires on history of smoking, drinking and exercise were filled out, and body fat, body mass index, blood pressure and biochemical markers were measured. Related factors with LVH on ECG were statistically analyzed with Chi-square test, t-test and logistic regression. RESULTS: The mean systolic and diastolic blood pressure and mean alcohol intake (g/day) were significantly elevated in the LVH group (P0.1). On logistic regression analysis, there was a significant increase in odds ratio for LVH with increase in diastolic blood pressure (adjusted OR 1.048, 95% CI 1.019~1.077), with exercise more than 3 times a week (adjusted OR 2.317, 95% CI 1.258~4.269) and with increased alcohol intake (adjusted OR 1.010, 95% CI 1.001~1.019). In contrast, odds ratio for LVH decreased as the pulse rate per minute increased (adjusted OR 0.974, 95% CI 0.952~0.997). In detailed analysis comparing those who exercised regularly more than 3 times a week with those who exercised less than 3 times a week, the increase in diastolic blood pressure was a significant factor which increased the odds ratio for LVH in both groups. A significant increase in the odds ratio by mean alcohol intake per day was shown only in a group who exercised less than 3 times a week. CONCLUSION: As a result of this study, in normotensive middle-aged men with LVH on ECG, patients should be monitored for regular exercise and increase in diastolic blood pressure should be regarded as a risk factor for LVH on ECG irrespective of exercise. In those who do not do exercise regularly, diastolic blood pressure as well as alcohol intake should be evaluated as risk factors for LVH

Effects of Dietary Antioxidant Vitamins and Fiber on the Risk of Myocardial Infarction

BACKGROUND: Even though antioxidant vitamins and fiber have been hypothesized to reduce the risk of coronary heart disease, few observational studies have been done in Korea. METHODS: The study sample consisted of 102 myocardial infarction (MI) patients and 112 control subjects admitted in Medical College of Catholic University in Korea. Dietary habits and nutrient intakes were assessed by a semi-quantitative food frequency questionnaire. RESULTS: Dietary consumptions of antioxidant vitamins, such as vitamin C, vitamin A, and fiber per energy were significantly higher in the controls than in the myocardial infarction patients. Odds ratios of vitamin A, vitamin C, vitamin E and fiber in the 4th quartile compared with the 1st quartile were 0.41 (95% CI 0.18~0.90), 0.33 (95% CI 0.15~0.75), 0.89 (95% CI 0.41~1.94), 0.27 (95% CI 0.12~0.63), respectively. CONCLUSION: These findings suggest that higher intake of foods rich in antioxidant vitamins and fiber can substantially reduce the risk of MI in middle-aged men.