Dyslipidemia Fact Sheet in South Korea, 2022

Background@#This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. @*Methods@#We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. @*Results@#In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL. @*Conclusion@#Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.

Dyslipidemia Fact Sheet in South Korea, 2022

Objective@#This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. @*Methods@#We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. @*Results@#In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia (more than one out of three conditions [low-density lipoprotein-cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein-cholesterol (men and women) <40 mg/ dL]) was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-high-density lipoprotein-cholesterolemia in women changed from <40 to <50 mg/dL. @*Conclusion@#Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.

Public Awareness of Dyslipidemia Among the Korean Population:A Survey Study

Objective@#We aimed to assess the level of public awareness regarding dyslipidemia and its management among the Korean population. @*Methods@#We conducted a web- or mobile-based survey study targeting the general population, using various recruitment methods, between July 25, 2022 and August 26, 2022.The questionnaire consisted of 12 questions designed to collect demographic information and evaluate participants’ awareness and knowledge about dyslipidemia. @*Results@#In total, 2,882 participants who completed the survey were included in the analysis.Among the participants, a substantial majority (89.1%) were familiar with the concepts of “good cholesterol” and “bad cholesterol,” while a comparatively lower percentage (just 46.7%) were acquainted with the term “dyslipidemia.” Noticeable variations in understanding were observed when examining specific aspects of dyslipidemia management, including diet, exercise, and pharmacotherapy. @*Conclusion@#The results of this survey underscore the significance of enhancing public awareness about dyslipidemia within the context of health literacy, demonstrating the necessity for a more comprehensive approach that includes education and policymaking to effectively manage dyslipidemia.

Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction

Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake–response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong.However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

Higher food literacy scores are associated with healthier diet quality in children and adolescents: the development and validation of a two-dimensional food literacy measurement tool for children and adolescents

BACKGROUND/OBJECTIVES@#Most child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8–12 years old) and adolescents (13–18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed. @*SUBJECTS/METHODS@#First, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha. @*RESULTS@#As a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents. @*CONCLUSIONS@#Based on this integrated conceptual framework, a two-dimensional 19-item food literacy measurement tool was developed and verified for practical use to improve the diet quality and food-related environmental sustainability awareness of children and adolescents.

Smoking May Affect Pulmonary Function through DNA Methylation:an Epigenome-Wide Association Study in Korean Men

Smoking is a risk factor for various disease outcomes and is one of the modifiers of DNA methylation. We aimed to identify smoking-related DNA methylation sites (CpG-sites) and test whether one identified CpG-site is associated with smoking-related traits and pulmonary function. We obtained DNA methylation data of 209 men from the Korean Genome and Epidemiology Study analyzed by Illumina's HumanMethylation450 array. To identify smoking-related DNA methylation sites, epigenome-wide association analysis of smoking status was conducted, adjusting for age, area, current drinking status, and body mass index. We assessed the association between smoking intensity and DNA methylation of cg05951221 (AHRR), the CpG showing the strongest largest difference in DNA methylation among the 5 hypomethylated CpGs in current smokers compared to never smokers. The association between DNA methylation and pulmonary function was examined longitudinally resulting in a positive association between DNA methylation and forced expiratory volume in 1 second/forced vital capacity, regardless of adjustment for smoking status. This suggests that DNA methylation associates with long-term pulmonary function. Our study contributes to explaining the relationship between smoking and pulmonary function via DNA methylation.

Association between dietary sodium intake and disease burden and mortality in Koreans between 1998 and 2016: The Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES@#Sodium intake is positively associated with blood pressure, which may increase the risk for cardiovascular disease (CVD). Therefore, we assessed the disease burden of CVD attributable to sodium intakes above 2,000 mg/day and prospectively investigated the association between dietary/urinary sodium levels and the risk of all-cause and CVD-mortality using the Korea National Health and Nutrition Examination Survey (KNHNES). @*SUBJECTS/METHODS@#A total of 68,578 and 33,113 participants were included for comparative risk assessment (CRA) analysis and mortality analysis, respectively, and mean follow-up time for mortality was 5.4 years. CRA analysis was used to quantify attributable incidences of stroke, ischemic heart disease (IHD), and deaths attributable to sodium intake between 1998 and 2016. Cox proportional hazard regression model was used to determine the association between sodium intake and all-cause and CVD-mortality. @*RESULTS@#Mean dietary sodium intake decreased over time, reaching 3,647 mg/day in 2016.Similarly, the population attributable fractions of stroke and IHD, and the number of CVDassociated deaths attributable to high sodium intake/excretion also decreased. In terms of association with mortality, when participants were grouped into quartiles (Q) by energyadjusted sodium intake, those in Q2 had a lower risk of all-cause mortality than those in Q1 with lower intakes. The risk of CVD-associated mortality was higher only in females with high sodium intake in Q4 than those in Q1. @*CONCLUSIONS@#This nationwide data indicates that, in line with previous studies of multiple cohorts, both low and high sodium intakes may be associated with an increased risk of mortality; therefore, the optimal sodium intake for Koreans needs to be revised.

Impact of dietary risk factors on cardiometabolic and cancer mortality burden among Korean adults: results from nationally representative repeated cross-sectional surveys 1998–2016

BACKGROUND/OBJECTIVES@#Dietary factors are important contributors to cardiometabolic and cancer mortality. We examined the secular trends of nine dietary factors (fruits, vegetables, whole grains, nuts and seeds, milk, red meat, processed meat, sugar-sweetened beverages, and calcium) and the associated burdens of cardiometabolic and cancer mortality in Korea using representative cross-sectional survey data from 1998 to 2016. @*SUBJECTS/METHODS@#Using dietary data from Korean adults aged ≥ 25 years in the Korea National Health and Nutrition Examination Survey (KNHANES), we characterized secular trends in intake levels. We performed comparative risk assessment to estimate the population attributable fraction and the number of cardiometabolic and cancer deaths attributable to each dietary factor. @*RESULTS@#A total of 231,148 cardiometabolic and cancer deaths were attributable to nine dietary risk factors in Korea from 1998 to 2016. Suboptimal intakes of fruits and whole grains were the leading contributors. Although the intakes of fruits, vegetables, and whole grains moderately improved over time, the intake levels in 2016 (192.1 g/d, 225.6 g/d, and 10.9 g/d, respectively) remained far below the optimal levels. Deaths attributable to the low intakes of nuts and seeds (4.5 g/d), calcium (440.5 mg/d), and milk (37.1 g/d) and the high intakes of red meat (54.7 g/d), processed meat (4.7 g/d), and sugar-sweetened beverages (33.0 g/d) increased since 1998. Compared with older age groups (≥ 45 years), more unfavorable changes in dietary patterns were observed in the younger population aged 25–44 years, including more sharply increased intakes of processed meat. @*CONCLUSIONS@#We observed improvement in the intakes of fruits, vegetables, and whole grains and unfavorable changes in the intakes of processed meat and sugar-sweetened beverages over the past few decades. Our data suggest that to reduce the chronic disease burden in Korea, more effective nutritional policies and interventions are needed to target these dietary risk factors.

Association of circulating 25-hydroxyvitamin D levels with hypertension and blood pressure values in Korean adults: A Mendelian randomization study on a subset of the Korea National Health and Nutrition Survey 2011–2012 population

BACKGROUND/OBJECTIVES: Lower circulating 25-hydroxyvitamin D [25(OH)D] levels are associated with a higher risk of hypertension (HTN); however, it remains unclear whether the relationship is causal. We aimed to evaluate the causal effects of circulating 25(OH)D levels on the prevalence of HTN in the Korean population using the Mendelian randomization (MR) approach. SUBJECTS/METHODS: Epidemiological data, serum 25(OH)D data, and genomic DNA biospecimens were obtained from 2,591 participants, a subset of the study population in the Korea National Health and Nutrition Survey 2011-2012. Five 25(OH)D-related single nucleotide polymorphisms (SNPs; DHCR7 rs12785878, CYP2R1 rs10741657, CYP2R1 rs12794714, CYP24A1 rs6013897, and GC rs2282679), identified a priori from genome-wide association studies, were used as instrument variables (IVs) for serum 25(OH)D levels. In the MR analysis, we performed IV analyses using the two-stage least squares method. RESULTS: In the observational analysis, circulating 25(OH)D levels were found to be inversely associated with the HTN prevalence in ordinary least squares models (odds ratio: 0.97, 95% confidence interval: 0.96, 0.99) after adjusting for the potential confounders. There were differences in the circulating 25(OH)D levels across genotypes of individual SNPs. In the MR analysis, using individual SNPs as IVs, 25(OH)D levels were not associated with the HTN prevalence. CONCLUSIONS: We found no association between genetically determined circulating 25(OH)D levels and HTN in Korean adults. Our results are listed owing to the relatively small sample size and possible weak instrument bias; therefore, further studies are needed to confirm these results.

Food Literacy in South Korea: Operational Definition and Measurement Issues

Since chronic diseases have emerged as a major cause of death worldwide, people has been exposed to large amounts of information on healthy eating practices that are important aspects of its prevention and management. Food literacy, the functional, interactive, and critical ability to manage dietary information with the aim of improving health, is of global interest. In South Korea (hereafter Korea), there is currently a lack of food literacy research, despite its pertinence for the development of public health policies that are tailored to recipients' ability to understand and address health and nutrition issues. In this study, the research trend and policy implications of food literacy are derived through reviewing preceding studies related to food literacy in Korea and elsewhere. Existing literature on food literacy in Korea placed much emphasis on the functional ability of food literacy. Future research on the operational definitions of interactive and critical food literacy and their health effects in Korea is necessary. In addition, there is a lack of research on the development and validation of measurement tools that evaluate integrative concepts of food literacy. To accurately examine the relationships among food literacy, diet, and health, standardized measurement tools that can comprehensively evaluate food literacy frameworks for various Korean sub-population groups should be developed. Based on such future studies, an investigation of health promotion programs or policies on reducing the cognitive burden of food literacy would contribute to improving heathy eating practices in Korea.

Glycated Hemoglobin and Cancer Risk in Korean Adults: Results from Korean Genome and Epidemiology Study

The purpose of this study was to test whether elevated glycated hemoglobin A1c (HbA1c) levels are associated with cancer incidence in the Korean population. In cohorts of the Korea Genome and Epidemiology Study (KoGES) consortium, we tested whether plasma levels of HbA1c were associated with all-site cancer incidence in 7,822 participants without any known history of cancer or diabetes. Cancer developed in 117 participants during the follow-up period. Subjects were subdivided into 3 categories according observed levels of HbA1c (< 5.7%, low; ≥ 5.7% and < 6.5%, mid; and ≥ 6.5%, high). The adjusted hazard ratio for all-site cancer was 3.03 (95% confidence intervals, 1.54–5.96) for the high HbA1c group relative to the low HbA1c group after adjusting for covariates. Higher circulating HbA1c levels were associated with an increased risk of all-site cancer in Korean population.

Apolipoprotein A5 3'-UTR variants and cardiometabolic traits in Koreans: results from the Korean genome and epidemiology study and the Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES: This study aimed to test the association between APOA5 3'-UTR variants (rs662799) and cardiometabolic traits in Koreans. SUBJECTS/METHODS: For this study, epidemiological data, Apolipoprotein A5 (APOA5) genotype information, and lymphoblastoid cell line (LCL) biospecimens from a subset of the Ansung-Ansan cohort within the Korean Genome and Epidemiology study (KoGES-ASAS; n = 7,704) as well as epidemiological data along with genomic DNA biospecimens of participants from a subset of the Korea National Health and Nutrition Examination Survey (KNHANES 2011-12; n = 2,235) were obtained. APOA5 mRNA expression was also measured. RESULTS: APOA5 rs662799 genotype distributions in both the KoGES-ASAS and KNHANES groups were 50.6% for TT, 41.3% for TC, and 8.1% for CC, which are similar to those in previous reports. In both groups, minor C allele carriers, particularly subjects with CC homozygosity, had lower high-density lipoprotein (HDL) cholesterol and higher triglyceride levels than TT homozygotes. Linear regression analysis showed that the minor C allele significantly contributed to reduction of circulating HDL cholesterol levels [β = −2.048, P < 0.001; β = −2.199, P < 0.001] as well as elevation of circulating triglyceride levels [β = 0.053, P < 0.001; β = 0.066, P < 0.001] in both the KoGES-ASAS and KNHANES groups. In addition, higher expression levels of APOA5 in LCLs of 64 healthy individuals were negatively associated with body mass index (r = −0.277, P = 0.027) and circulating triglyceride level (r = −0.340, P = 0.006) but not significantly correlated with circulating HDL cholesterol level. On the other hand, we observed no significant difference in the mRNA level of APOA5 according to APOA5 rs662799 polymorphisms. CONCLUSIONS: The C allele of APOA5 rs662799 was found to be significantly associated with cardiometabolic traits in a large Korean population from the KoGES-ASAS and KNHANES. The effect of this genotype may be associated with post-transcriptional regulation, which deserves further experimental confirmation.

Dietary Issues and Challenges on Cardiometabolic Health in Korea: From a Viewpoint of a National Nutrition Surveillance System

A national nutrition surveillance system is an essential instrument for the detection of nutrition and nutrition-related health problems that can assist on policy implementation. The role of nutritional surveillance in detecting trends of nutritional problems and predicting their risks has become more important as its strong scientifically based method and evidences may provide insights on chronic disease risks. In this review, we attempted to identify dietary issues of Korean cardiometabolic disease (CMD) based on the national nutrition surveillance system and addressed gaps and limitations in the system. In addition, an alternative way on how the system can overcome these problems with the view of ultimately improving public health in Korea was discussed.

Alcohol Consumption, Aldehyde Dehydrogenase 2 Gene Polymorphisms, and Cardiovascular Health in Korea

Alcohol consumption is a serious health issue in Korea in terms of the amount consumed and the behavior related to its consumption. Aldehyde dehydrogenase 2 (ALDH2) is a key enzyme in alcohol metabolism that degrades acetaldehyde to nontoxic acetic acid. The enzyme is coded by the ALDH2 gene, which is commonly polymorphic in East Asian populations. A point mutation in the ALDH2 gene (the rs671 allele) yields an inactive form of ALDH2 that causes acetaldehyde accumulation in the body after alcohol consumption, thereby inhibiting normal alcohol metabolism. Individuals who are homozygous for polymorphism in ALDH2 tend to refrain from drinking alcohol, decreasing their chances of developing alcoholism and exposure to the associated risks. Mendelian randomization (MR) studies have demonstrated that alcohol consumption predicted by ALDH2 genotype is causally related to cardiovascular risks. Moreover, recent MR studies suggest that the ALDH2 variant has mechanistic effects on some disease outcomes or mortality through increased blood levels of acetaldehyde, showing differences therein between heterozygotes (ALDH2*2*2) and homozygotes (ALDH2*1*2) in those who consume alcohol. Accordingly, consideration of ALDH2 genotype in alcohol prevention programs is warranted. In conclusion, strategies that incorporate genetic information and provide an evidential basis from which to help people make informed decisions on alcohol consumption are urgently required.

Burdens of Cardiometabolic Diseases Attributable to Dietary and Metabolic Risks in Korean Adults 2012–2013

PURPOSE: In line with epidemiological and sociocultural changes in Korea over the past decades, reliable estimation of diseases as a result of dietary and metabolic risks is required. In this study, we aimed to evaluate the contributions of dietary and metabolic factors to cardiometabolic diseases (CMDs) in Korean adults (25–64 years old) during 2012–2013. MATERIALS AND METHODS: Distribution of risk factors and cause-specific mortality by gender and age per year was obtained from the Korea National Health and Nutrition Examination Survey and Statistics Korea, respectively. The association between the two was obtained from published meta-analyses. The population-attributable fraction attributable to the risk factors was calculated across gender and age strata (male and female, age groups 25–34, 35–44, 45–54, and 55–64) in 2012 and 2013. RESULTS: The results showed that during the period studied, high body mass index [5628 deaths; uncertainty intervals (UIs): 5473–5781] and blood pressure (4202 deaths; UIs: 3992–4410) were major metabolic risks for CMD deaths, followed by dietary risks such as low intake of whole grain (4107 deaths; UIs: 3275–4870) and fruits (3886 deaths; UIs: 3227–4508), as well as high intake of sodium (2911 deaths, UIs: 2406–3425). Also, males and the younger population were seen more prone to be exposed to harmful dietary risk than their female and older counterparts. CONCLUSION: The findings provide the necessary information to develop targeted government interventions to improve cardiometabolic health at the population level.

Association between Genetic Variations Affecting Mean Telomere Length and the Prevalence of Hypertension and Coronary Heart Disease in Koreans

In this study, we investigated whether the single nucleotide polymorphisms (SNPs) associated with telomere length (TL) were associated with the incidence of hypertension (HTN)/coronary heart disease (CHD) and cardiovascular risk factors in the Korean population. Data from 5,705 (ages 39–70) participants in the Korean Genome Epidemiology Study (rural Ansung and urban Ansan cohorts) were studied. Twelve SNPs known to be associated with telomere biology were tested for an association with HTN/CHD. As results, no significant associations were found between the selected TL-related SNPs and prevalence of HTN and CHD. Among non-alcohol users, subjects with minor alleles in rs1269304 and rs10936601 (TERC and LRRC34, respectively) exhibited a higher rate of CHD occurrence (odds ratio [OR], 1.862; 95% confidence intervals [CIs], 1.137, 3.049; OR, 1.855; 95% CIs, 1.111, 2.985; respectively). However, alcohol users with minor alleles in rs398652 (PELI2) were significantly associated with higher HTN prevalence (OR, 1.179; 95% CIs, 1.040, 1.336). Of the 3 SNPs related to disease outcomes, rs1296304 was significantly associated with increased levels of diastolic blood pressure (β estimate, 0.470; 95% CIs, 0.013, 0.926). The minor allele in rs398652 was significantly associated with higher levels of body mass index (OR, 0.128; 95% CIs, 0.010, 0.246) and γ-glutamyl transpeptidase (OR, 0.013; 95% CIs, 0.001, 0.024). In conclusion, there were no significant associations between the selected TL-related SNPs and the occurrence of HTN/CHD in Koreans. However, the results suggest the presence of a possible interaction between related SNPs and alcohol behavior associated with HTN/CHD occurrence.

Low-Density-Lipoprotein Particle Size Predicts a Poor Outcome in Patients with Atherothrombotic Stroke

BACKGROUND AND PURPOSE: Low-density lipoprotein (LDL) particle size is considered to be one of the more important cardiovascular risk factors, and small LDL particles are known to have atherogenic potential. The aim of this study was to determine whether LDL particle size is associated with stroke severity and functional outcome in patients with atherothrombotic stroke. METHODS: Between January 2009 and May 2011, 248 patients with first-episode cerebral infarction who were admitted to our hospital within 7 days after symptom onset were prospectively enrolled. LDL particle size was measured using the nondenaturing polyacrylamide gradient gel electrophoresis assay. Stroke severity was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was investigated at 3 months after the index stroke using the modified Rankin Scale (mRS), and poor functional outcome was defined as an mRS score of > or =3. RESULTS: The LDL particle size in the 248 patients was 25.9+/-0.9 nm (mean+/-SD). LDL particle size was inversely correlated with the degree of cerebral artery stenosis (p=0.010). Multinomial multivariate logistic analysis revealed that after adjustment for age, sex, and variables with p or =5; reference, NIHSS score 0-2; odds ratio=0.38, p=0.028) and poor functional outcome (odds ratio=0.44, p=0.038). CONCLUSIONS: The results of this study demonstrate that small LDL particles are independently correlated with stroke outcomes. LDL particle size is thus a potential biomarker for the prognosis of atherothrombotic stroke.

Glycated Hemoglobin is a Better Predictor than Fasting Glucose for Cardiometabolic Risk in Non-diabetic Korean Women

This study aimed to investigate if glycated hemoglobin (HgbA1C) as compared to fasting blood glucose is better for reflecting cardiometabolic risk in non-diabetic Korean women. Fasting glucose, HgbA1C and lipid profiles were measured in non-diabetic women without disease (n = 91). The relationships of fasting glucose or HgbA1C with anthropometric parameters, lipid profiles, and liver and kidney functions were analyzed. Both fasting glucose and HgbA1C were negatively correlated with HDL-cholesterol (r = -0.287, p = 0.006; r = -0.261, p = 0.012), and positively correlated with age (r = 0.202, p = 0.008; r = 0.221, p = 0.035), waist circumference (r = 0.296, p = 0.005; r = 0.304, p = 0.004), diastolic blood pressure (DBP) (r = 0.206, p = 0.050; r = 0.225, p = 0.032), aspartate transaminase (AST) (r = 0.237, p = 0.024; r = 0.368, p < 0.0001), alanine transaminase (ALT) (r = 0.296, p = 0.004; r = 0.356, p = 0.001), lipid profiles including triglyceride (r = 0.372, p < 0.001; r = 0.208, p = 0.008), LDL-cholesterol (r = 0.315, p = 0.002; r = 0.373, p < 0.0001) and total cholesterol (r = 0.310, p = 0.003; r = 0.284, p = 0.006). When adjusted for age and body mass index, significant relationships of DBP (r = 0.190, p = 0.049), AST (r = 0.262, p = 0.018), ALT (r = 0.277, p = 0.012), and HDL-cholesterol (r = -0.202, p = 0.049) with HgbA1C were still retained, but those with fasting glucose disappeared. In addition, the adjusted relationships of LDL-cholesterol and total cholesterol with HgbA1C were much greater than those with fasting glucose. These results suggest that glycated hemoglobin may be a better predictor than fasting glucose for cardiometabolic risk in non-diabetic Korean women.

Low Plasma Proportion of Omega 3-Polyunsaturated Fatty Acids Predicts Poor Outcome in Acute Non-Cardiogenic Ischemic Stroke Patients / 대한뇌졸중학회지

BACKGROUND AND PURPOSE: Alterations in blood fatty acid (FA) composition are associated with cardiovascular diseases. We investigated whether plasma FA composition was related to stroke severity and functional outcome in acute ischemic stroke patients. METHODS: We prospectively enrolled 156 patients with first-episode cerebral infarction, within 7 days of symptom onset. The proportion of FAs was analyzed using gas chromatography, and the summation of the omega-3 polyunsaturated fatty acids (omega3-PUFA), 18:3 omega3 alpha-linolenic acid, 20:3 omega3 eicosatrienoic acid, 20:5 omega3 eicosapentaenoic acid (EPA), and 22:6 omega3 docosahexaenoic acid (DHA) was reported as Sigmaomega3-PUFAs. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score on admission. Poor functional outcome was defined by modified Rankin scale (mRS) > or =3 at three months after the index stroke. RESULTS: Lower proportions of EPA (beta=-0.751), DHA (beta=-0.610), and Sigmaomega3-PUFAs (beta=-0.462) were independently associated with higher NIHSS score, after adjusting for stroke subtype, hemoglobin, high density lipoprotein, high sensitivity C-reactive protein, fasting glucose, 16:0 palmitic acid, and Sigmasaturated fatty acids. Moreover, a lower proportion of DHA (odds ratio [OR]: 0.20, 95% confidence interval [CI]: 0.04-0.88), and Sigmaomega3-PUFAs (OR: 0.22, 95% CI: 0.05-0.84) showed an independent relationship with poor functional outcome after adjusting for age, sex, smoking status, NIHSS score, stroke subtype, and 16:0 palmitic acid. CONCLUSIONS: Our results demonstrate that omega3-PUFAs correlated with stroke severity on admission and functional outcomes at 3 months. omega3-PUFAs are potential blood biomarkers for prognosis of acute non-cardiogenic ischemic stroke patients.

Dietary Very Long Chain Saturated Fatty Acids and Metabolic Factors: Findings from the Korea National Health and Nutrition Examination Survey 2013

The present study was aim to evaluate the association between very long chain saturated fatty acids (VLSFAs) and metabolic syndrome (MetS) in Korean population. The study population were recruited from the Korea National Health and Nutrition Examination Survey VI (2013). Using the cross-sectional study design, socio-demographic factors, medical history, and clinical measurements were investigated according to quartiles of VLSFAs intake. The associations between each and sum of VLSFAs intake and MetS were assessed by logistic regression. The result indicated that higher intake of VLSFAs was significantly associated with favorable metabolic status, including lower levels of circulating triglyceride (TG) (p < 0.05). Additionally, subjects with higher intake of arachidic acid and total VLSFAs were negatively associated with MetS risk compared to subjects with lower intake of those fatty acids (p < 0.05). In conclusion, dietary VLSFAs intake was associated with metabolic risk factors and lower risk of MetS in Korean population.