Relationship between Sleep Quality and Metabolic Syndrome and Infl ammatory Markers in Middle-aged Men in Korea / 가정의학회지

BACKGROUND: As many studies revealed that sleep restriction is associated with obesity and insulin resistance and blood pressure elevation, the relationship between sleep and metabolic syndrome has been concerned. But little information exists on correlation between sleep quality and metabolic syndrome. In this study, we investigated the relationship between sleep quality measured by Pittsburgh Sleep Quality Index (PSQI) and metabolic syndrome. METHODS: A total of 100 middle-aged male adults were included in this study from March to May 2008 at a health promotion center. The subjects were divided into two groups of poor sleeper group (N = 47) vs. good sleeper group (N=53) by PSQI global score. The components of metabolic syndrome and inflammatory markers were measured. The metabolic syndrome criterion of the AHA/NHLBI 2005 was adopted. RESULTS: There was no significant differences in baseline characteristics between the two groups. HDL-cholesterol was significantly lower in the poor sleeper group compared to the good sleeper group (P < 0.05). The negative correlation was noted between subjective sleep quality score with HDL-cholesterol (P < 0.05). There was a positive correlation between sleep latency and triglyceride and a negative correlation with HDL-cholesterol (P < 0.05). The longer sleep latency, the higher level of white blood cell count was observed (P = 0.001). CONCLUSION: The above data suggest that a possible causal interaction between poor sleep quality and lower HDL-cholesterol of metabolic syndrome components and higher level of white blood cell counts. Further prospective studies regarding the change in the components of metabolic syndrome and the risk factors of cardiovascular diseases after relieving sleep disturbance seem to be warranted.

Relations between Worry, Attachment Styles and Perceived Parental Rearing in Primary School Children

BACKGROUND: Worry, a core feature of anxiety disorder, is shown in not only children with anxiety disorder but also normal children. This study was conducted to determine the relationship between worry and family environment factors, especially, perceived parental rearing and attachment styles among children. METHODS: Five hundred and nine children participated in this study among 549 children in third, fourth, fifth and sixth grades in two primary schools located in Seoul and Seongnam from October 2007 to December 2007. Forty children did not agree with participation (rejection rate: 7.3%). Their degrees of worry, attachment styles and perceived parental rearing were investigated with questionnaires. RESULTS: The reliability of a questionnaire asking children's worry, PSWQ-C and a questionnaire asking perceived parental rearing, modified EMBU-C was appropriate with internal consistency (Cronbach's alpha of PSWQ-C: 0.92, Cronbach's alpha of modified EMBU-C: 0.68~0.89). Around 22.4% of children had insecure attachment (avoidant or ambivalent attachment) and scores of worry were high in both girls and boys. When children perceived their parental rearing behavior as anxious rearing, they were classified to have ambivalent attachment in many cases by themselves. And when they perceived the rearing as rejection many of them were classified to have avoidant or ambivalent attachment by themselves. Worry showed a significantly negative correlation in the cases where children answered their perceived parental rearing as emotional warmth and showed a significantly positive correlation with rejective and anxious rearing. CONCLUSION: This study found that children's worry was closely related with their perceived parental rearing and attachment styles. If the children's attachment, which has been developed while they have grown up, was insecure and they did not perceive parental rearing as emotional warmth, the intensity of worry, a core symptom of anxiety disorder, increased.

Relationship between Mammographic Dense Breast and Other Risk Factors of Breast Cancer in Korean Women

BACKGROUND: Several studies have demonstrated that mammographic dense breast is related to the risk of breast cancer and is associated with decreased mammographic sensitivity and specificity. In contrast, studies concerning women with dense breast are virtually non-existent. This study was conducted to evaluate the relationship between mammographic dense breast and other risk factors of breast cancer, and to make a plan for individualized strategies in high risk populations. METHODS: The study subjects were 565 women, aged 20~70 years, who had a screening mammogram from April 2005 to August 2005 at a health promotion center. Data of demographic factors, breast caner risk factors and menstrual status were collected by the self-administered questionnaire. Mammographic breast density was classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) fours categories, as measured by the proportion of glandular tissues within the total breast tissue. RESULTS: By BI-RADS categories, 'entirely fat' were 46, 'scattered fibroglandular' were 96, 'heterogenous dense' were 332 and 'extremely dense' were 91 (16.1%). Univariate analysis showed that age, occupation, education level, body mass index, age at menarche, parity, breast feeding, menopausal status and triglyceride had significantly related to dense breast (P<0.05). In the multivariate logistic analysis, only low body mass index (P<0.001), low parity (P=0.009, 0.038) and premenopausal status (P=0.001) were significantly associated with dense breast. CONCLUSION: In Korean women, dense breast was significantly associated with low body mass index, low parity and premenopausal status. Therefore, if women with dense breast have these risk factors, they need to be managed more intensively with regular screening, breast sonogram, and lifestyle modification.

Expression and Function of Calcineurin in Inflammatory Arthritis

BACKGROUND: Calcineurin plays a crucial role in T cell activation, cell growth, apoptosis, and angiogenesis, and its over-expression has been implicated in the pathogenesis of cardiomyopathy and stroke. However, the expression and function of calcineurin in the pathologic lesion of chronic inflammatory diseases, like rheumatoid synovium, remain to be defined. This study was aimed to determine the role of calcineurin in inflammatory arthritis and investigate the expression and function of calcineurin in the rheumatoid synovium and synoviocytes, the actual site of chronic inflammation. METHODS: Immunohistochemical staining using specific antibody to calcineurin was perfomed in the synovium of rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) from RA and osteoarthritis (OA) patients were isolated from RA and OA patients, and cultured with IL-1beta and TNF-alpha in the presence or absence of cyclosporin A, a calcineurin inhibitor. The calcineurin expression was assessed by phosphatase assay and Western blotting analysis. IL-6, -10, -17, matrix metalloproteinase (MMP)-1, -2, -3, and -9 released into the culture supernatants were measured by ELISA. After transfection with GFP-Cabin 1 gene into synoviocytes, the levels of IL-6 and MMPs were measured by ELISA. RESULTS: Calcineurin was highly expressed in the lining layer of synovium and cultured synoviocytes of RA patients. The elevated calcineurin activity in the rheumatoid synoviocytes was triggered by proinflammatory cytokines such as IL-1beta and TNF-alpha. In contrast, IL-10, an anti-inflammatory cytokine, failed to increase the calcineurin activity. The targeted inhibition of calcineurin by the over-expression of Cabin 1, a natural calcineurin antagonist, inhibited the production of IL-6 and MMP-2 by rheumatoid synoviocytes in a similar manner to the calcineurin inhibitor, cyclosporin A. CONCLUSION: These data suggest that abnormal activation of calcineurin in the synoviocytes may contribute to the pathogenesis of chronic arthritis, and thus provide a potential target for controlling inflammatory arthritis.