Sex differences in prognosis factors in patients with lung cancer: A nationwide retrospective cohort study in Korea.

Large-scale studies elucidating sex differences in factors impacting prognosis and sex-specific prognossis factors scoring in patients with lung cancer are insufficient. The present study aimed to develop a model to predict sex-specific prognosis factors in Korean patients with lung cancer. This nationwide cohort study included 96,255 patients aged ≥19 years diagnosed with lung cancer and underwent Korean National Health Insurance Service health examinations between January 1, 2005 and December 31, 2015 and followed until 2020. Factors associated with prognosis were estimated using multivariable Cox proportional hazards regression analyses, and separate prognosis scores were calculated for male and female patients. The sex-specific risk scoring models were validated with Kaplan-Meier survival curves and c-statistic. During a mean follow-up of 2.8 years, 60.5% of the patients died. In male patients with lung cancer, age ≥ 65 years (24 points) had the highest mortality risk score, followed by chemotherapy in combination with radiotherapy (16 points), chemotherapy (14 points), and radiotherapy (11 points). In female patients with lung cancer, chemotherapy in combination with radiotherapy (19 points) had the highest mortality risk score, followed by chemotherapy (16 points), age ≥ 65 years (13 points), and radiotherapy (13 points). The analysis of patients categorized into three risk groups based on risk scores revealed that the fatality rates within 5 years were 7%, 54%, and 89% in the low-, intermediate-, and high-risk groups for male patients and 3%, 46%, 85% in the low-, intermediate-, and high-risk groups for female patients, respectively. The c-statistic was 0.86 for male patients and 0.85 for female patients. The strongest fatality risk factors in lung cancer were age ≥ 65 years in male patients and chemotherapy in female patients. The present study developed sex-specific prognosis scoring models to predict fatality risk in patients with lung cancer.

Association of decreased estimated glomerular filtration rate with lung cancer risk in the Korean population.

Objectives: Inconsistent results are available regarding the association between low estimated glomerular filtration rate (eGFR) and lung cancer risk. We aimed to explore the risk of lung cancer according to eGFR category in the Korean population. Methods: We included 358,293 adults who underwent health checkups between 2009 and 2010, utilizing data from the National Health Insurance Service-National Sample Cohort. Participants were categorized into 3 groups based on their baseline eGFR, as determined using the Chronic Kidney Disease Epidemiology Collaboration equation: group 1 (eGFR ≥90 mL/min/1.73m2), group 2 (eGFR ≥60 to <90mL/min/1.73m2), and group 3 (eGFR <60 mL/min/1.73m2). Incidences of lung cancer were identified using the corresponding codes from the International Classification of Diseases, 10th Revision. Multivariate Cox proportional hazard models were employed to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for lung cancer incidence up to 2019. Results: In multivariate analysis, group 2 exhibited a 26.5% higher risk of developing lung cancer than group 1 (HR, 1.265; 95% CI, 1.189 to 1.346). Furthermore, group 3 demonstrated a 72.5% elevated risk of lung cancer relative to group 1 (HR, 1.725; 95% CI, 1.577 to 1.887). Among participants with dipstick proteinuria of 2+ or greater, group 3 faced a significantly higher risk of lung cancer than group 1 (HR, 2.928; 95% CI, 1.375 to 6.237). Conclusion: Low eGFR was significantly associated with increased lung cancer risk within the Korean population. A particularly robust association was observed in individuals with severe proteinuria, emphasizing the need for further investigation.

Decreased estimated glomerular filtration rate increase the risk of pancreatic cancer: A nationwide retrospective cohort study.

BACKGROUND AND AIM: Decreased kidney function is a putative risk factor for various cancers. However, few studies have investigated the association between a decreased estimated glomerular filtration rate (eGFR) and incident pancreatic cancer. We aimed to investigate the risk of incident pancreatic cancer according to eGFR categories. METHODS: In this retrospective cohort study, we included 359 721 adults who underwent health checkups in 2009 or 2010 by using the Korean National Health Insurance Database. The study population was categorized into four groups by eGFR (mL/min/1.73 m2 ) using the Chronic Kidney Disease Epidemiology Collaboration equation: group 1 (eGFR < 45), group 2 (eGFR ≥ 45 to < 60), group 3 (eGFR ≥ 60 to < 90), and group 4 (eGFR ≥ 90). Multivariate Cox proportional hazards models were used to determine the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of pancreatic cancer until 2019 by comparing the eGFR groups. RESULTS: During the 3 493 589.05 person-years of follow-up, 1702 pancreatic cancer cases were identified. Compared with group 4 (eGFR ≥ 90), HRs and 95% CIs for the incidence of pancreatic cancer were 1.39 (1.24-1.56) for group 3 (eGFR ≥ 60 to < 90), 1.79 (1.47-2.16) for group 2 (eGFR ≥ 45 to < 60), and 2.05 (1.62-2.60) for group 1 (eGFR < 45) in the multivariate adjusted model. CONCLUSIONS: Decreased eGFR was significantly associated with an increased risk of pancreatic cancer in Korean population. Further studies are needed to investigate the relationship between a decreased eGFR and the risk of pancreatic cancer in other ethnic groups.

Assessment of nutrient adequacy in undergraduate students during the undertaking shipboard internship: using 12-day dietary recall through smartphone photography.

BACKGROUND: This study aimed to investigated nutritional status and estimated the adequacy of dietary intake of university students during shipboard internships. METHODS: In this cross- sectional study, data were collected from 25 students out of 42 participants who attended in the research information session in the department of maritime at a university located in Jeonbook, South Korea. The dietary intake data was obtained using the 12-day dietary recall through smartphone photography during the shipboard internships. The data on dietary intake were used to calculate acceptable macronutrient distribution ranges (AMDRs), frequency of inappropriate intake of the 2020 Dietary Reference Intakes for Koreans (KDRIs) as a reference, intake ratio to the nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ). RESULTS: The average age of subjects was 21.68 years and average BMIs in men and women were 25.67 kg/m2 and 23.44kg/m2, respectively. The average energy of men and women was 2018.66 kcal and 1727.87 kcal, respectively. More than half of the subjects did not meet the inappropriate range of the AMDRs for carbohydrates and fat. The NAR of vitamin A, vitamin C, and calcium among all 10 nutrients tended to be lower in both men and women. The MAR were 0.71 and 0.769. On the other hand, in both men and women, vitamin C had the lowest INQ (0.5 and 0.39). For men, grains and potatoes were the major contributors to energy and carbohydrates, and calcium contributed in the order of meat, fish and eggs and vegetables and fruits. Although the highest contributors to energy and carbohydrates for women were grains and potatoes, the contributions from meat, fish, and eggs were similar, and the major contributors to calcium were vegetables and fruits. CONCLUSIONS: To improve the inadequate nutritional status of university students engaged in shipboard internships with the aim of pursuing careers as seafarers, there is a need to provide additional nutritional education tailored to their specific circumstances. Additionally, professional health guidance should be provided to maintain optimal nutritional status.

High intake of sweet foods and low life satisfaction can act as risk factors for acute coronary syndrome through synergistic interaction.

Purpose: Dietary and psychological status contributes to the development of coronary artery disease. However, these lifestyle factors may vary depending on ethnic and environmental background, and secondary prevention programs dealing with these factors in a specific population are not well-established. We aimed to assess dietary and psychological characteristics in Korean patients with acute coronary syndrome (ACS) and analyze their interactions as independent risk factors for ACS. Methods: Ninety-two patients with ACS (29 acute myocardial infarction and 63 unstable angina) and 69 controls were subjected to dietary and psychological analyses. Dietary intake was assessed by a food frequency questionnaire. Psychological depression and perceived stress were assessed using the Patient Health Questionnaire-9 and the Perceived Stress Scale, respectively. Eight domains of life satisfaction (marital/love relationship, leisure, standard of living, job, health, family life, sex life, and self) were assessed using the Domain Satisfaction Questionnaire (DSQ). Results: The ACS group had a higher consumption of sweets and fish/seafood, as well as higher levels of depressive symptoms. Additionally, they had lower DSQ scores in total, and all eight individual domains compared with the control group. In multivariate logistic regression analysis, sweet intake (OR 4.57, 95% CI: 1.94-11.40) and total DSQ scores (OR 0.34, 95% CI: 0.14-0.81) were identified as independent risk factors for ACS. Furthermore, these factors, which displayed a significant inverse correlation (ρ = -0.23, p = 0.01), were determined as having a synergistic contribution to the development of ACS. Conclusion: High sweet food intake and low life satisfaction can act as risk factors for ACS through a synergistic interaction, which emphasizes a demand for a more comprehensive approach to secondary prevention of ACS. In addition, these data highlight the role of positive psychological wellbeing factors in cardiovascular health.

Sleep Quality in Women with Premenstrual Syndrome Is Associated with Metabolic Syndrome-Related Variables.

In this study, we examined whether metabolic syndrome (MetS)-related variables are simultaneously affected by sleep quality, premenstrual syndrome (PMS) and dietary consumption. In this cross-sectional study, data for 307 premenopausal women were available. The results showed that women experiencing PMS had significantly lower sleep quality and were more depressed and anxious (p < 0.001 for all). After the subjects were divided into groups according to PMS, the effect of sleep quality on MetS-related variables or MetS components significantly differed; only among women who experienced PMS were poor sleepers significantly higher in waist circumference (p = 0.018) and diastolic blood pressure (p = 0.012) than good sleepers. Among the MetS components, abdominal obesity in women with poor sleep quality was approximately three (16.9% vs. 3.0%, p= 0.020) times more common than in those with good sleep quality. However, these findings were not observed among those who did not experience PMS. Poor sleepers among women experiencing PMS consumed 2.8 times more alcoholic drinks than good sleepers (p = 0.006). The MetS-related variables in Korean women experiencing PMS are associated with sleep quality, and these associations may be modified by dietary habits.

Effects of Consuming Heat-Treated Dodamssal Brown Rice Containing Resistant Starch on Glucose Metabolism in Humans.

Rice is a major source of carbohydrates. Resistant starch (RS) is digested in the human small intestine but fermented in the large intestine. This study investigated the effect of consuming heat-treated and powdered brown rice cultivars 'Dodamssal' (HBD) and 'Ilmi' (HBI), with relatively high and less than 1% RS content, respectively, on the regulation of glucose metabolism in humans. Clinical trial meals were prepared by adding ~80% HBI or HBD powder to HBI and HBD meals, respectively. There was no statistical difference for protein, dietary fiber, and carbohydrate content, but the median particle diameter was significantly lower in HBI meals than in HBD meals. The RS content of HBD meals was 11.4 ± 0.1%, and the HBD meals also exhibited a low expected glycemic index. In a human clinical trial enrolling 36 obese participants, the homeostasis model assessment for insulin resistance decreased by 0.05 ± 0.14% and 1.5 ± 1.40% after 2 weeks (p = 0.021) in participants in the HBI and HBD groups, respectively. The advanced glycation end-product increased by 0.14 ± 0.18% in the HBI group and decreased by 0.06 ± 0.14% in the HBD group (p = 0.003). In conclusion, RS supplementation for 2 weeks appears to have a beneficial effect on glycemic control in obese participants.

The Risk of Cardiovascular Disease According to Chewing Status Could Be Modulated by Healthy Diet in Middle-Aged Koreans.

To assess whether a healthy diet could change the risk of cardiovascular disease (CVD)-related chewing difficulty (CD) in relation to age distribution. In a cross-sectional study of 9411 middle-aged Koreans from the KNHANES VII. In this study, the Framingham 10-year general CVD risk prediction equations and the Korean Heathy Eating index (KHEI) were used to assess the 10-year estimated risk of CVD and dietary quality, respectively. CD was experienced by 16.7% of the total subjects. Among subjects with CD, the 10-year estimated CVD risk was 8.71% of the subjects in the 30−49 years age group and 30.38% of those in the 50−64 years age group, which is a difference of approximately 3.5 times. Regardless of age distribution, the total score of the KHEI in subjects who had CD was significantly lower than in those who had no CD (NCD) (p = 0.004 for the 30−49 years age group and p < 0.001 for the 50−64 years age group, respectively). Among the subjects with poor KHEI in the 30−49-year age group, the adjusted odds ratio for the 10-year estimated CVD risk of the subjects with CD was 2.204-fold (95% CI = 1.385−3.506) higher using NCD as a reference. The findings showed that dietary quality could modify the risk for CVD according to chewing status.

Factors Related to Depression Associated with Chewing Problems in the Korean Elderly Population.

Unlike younger adults, depression in older adults is sometimes related to chewing problems. This study examined the risk factors related to depression associated with chewing problems in 3747 elderly individuals using the Korean National Health and Nutrition Examination Survey. Approximately 41.2% of the total subjects reported chewing problems. There were significant differences in age, education, marital status, individual income, current smoking status, and aerobic physical activity in relation to chewing problems (p < 0.001 for all). The subjects who experienced chewing problems showed a higher score on the EuroQoL 5 Dimension index (p < 0.001) but a lower health-related quality of life than those with no chewing problems (p < 0.001). The prevalence of depression, which was classified by the patient health questionnaire-9, in subjects with chewing problems was approximately 2 times higher than that in those with no chewing problems (p < 0.001). Subjects with chewing problems were found to have a 1.945-fold higher adjusted risk of depression than those who did not have chewing problems (95% CI = 1.583-2.390, p < 0.001), and subjects with high protein consumption showed a 1.410-fold greater risk of depression (95% CI = 1.144-1.739, p = 0.001) than those with low protein consumption.

Urine organic acids may be useful biomarkers for metabolic syndrome and its components in Korean adults.

OBJECTIVES: Although metabolic syndrome (MetS) and its components are defined clinically, those with MetS may have various derangements in metabolic pathways. Thus, this study aimed to evaluate the traits of urine organic acid metabolites indicating the metabolic intermediates of the pathways in the subjects with MetS. METHODS: This cross-sectional study included 246 men and 283 women in a hospital health check-up setting. Urine organic acid metabolites were assayed via high-performance liquid chromatography-mass spectrometry analyses. A high level of each metabolite was defined as the fifth quintile of the distribution. RESULTS: The subjects with MetS had high levels of pyruvate, α-ketoglutarate, α-ketoisovalerate, α-ketoisocaproate, formiminoglutamate, and quinolinate (odds ratios from 1.915 to 2.809 in logistic models adjusted for age and sex). Among the metabolites, pyruvate, formiminoglutamate, and quinolinate were not independent of homeostatic model assessment of insulin resistance (HOMA2-IR). Several metabolites were associated with one or more components of MetS and HOMA2-IR. CONCLUSIONS: Urine organic acid metabolites in MetS are characterized in altered carbohydrate and amino acid metabolism. MetS shared some traits in insulin resistance. These findings may promote the understanding of the pathophysiology of MetS.

Potentially inappropriate prescribing of cardiovascular system and antiplatelet/anticoagulant drugs among elderly patients: a Korean population-based national study.

OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) for cardiovascular system (CVS) and antiplatelet/anticoagulant (AP/AC) drugs among Korean elderly patients, using the Screening Tool of Older Persons' Prescriptions (STOPP) criteria version 2 and to identify the risk factors related to PIP. METHODS: The 2016 National Aged Patient Sample data, comprising National Health Insurance claim records for a random sample of 20% of patients aged ≥ 65 years, were used to calculate PIP prevalence of outpatient prescriptions. For criteria including drug-disease interactions, PIP prevalence per indication was estimated. RESULTS: Among 1,274,148 elderly patients and 27,062,307 outpatient prescription claims, 100,085 patients (7.85%) and 341,664 claims (1.27%) had one or more PIP. The most frequent PIP was "non-steroidal anti-inflammatory drug with concurrent antiplatelet agent (s) without proton-pump inhibitor prophylaxis" in the claim-level (0.97%) and patient-level (6.33%) analyses. "Beta-blocker with bradycardia" (16.47% of claims) and "angiotensin receptor blockers in patients with hyperkalaemia" (23.89% of claims) showed the highest PIP prevalence per indication. Logistic regression analysis revealed that, among the patient and health care provider characteristics, female, older age, more severe comorbidities, polypharmacy, higher level of healthcare organization, and specialty of prescriber were significantly associated with a higher risk of PIP. CONCLUSIONS: Our findings of a high prevalence of PIP for CVS and AP/AC drugs among the elderly suggest that an effective strategy is urgently needed to improve the prescription practices of these drugs.

Elevated levels of urine isocitrate, hydroxymethylglutarate, and formiminoglutamate are associated with arterial stiffness in Korean adults.

Recent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with L-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-ß-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.

Differences in the Association Among the Vitamin D Concentration, Dietary Macronutrient Consumption, and Metabolic Syndrome Depending on Pre- and Postmenopausal Status in Korean Women: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: To assess whether the consumption of dietary macronutrient could change metabolic syndrome (MetS) related to vitamin D deficiency according to menopausal status. METHODS AND STUDY DESIGN: In a cross-sectional study of 8326 Korean women from the Korean National Health and Nutrition Examination Survey V (2010-2012), we investigated the combined interaction effect of serum 25-hydroxyvitamin D [25(OH)D] concentration and menopausal status on MetS-related variables. RESULTS: The prevalence rates of 25(OH)D deficiency (vitamin D <50 nmol/L) among premenopausal and postmenopausal women were 84.5% and 67.9%, respectively. Significant differences in MetS-related variables such as body mass index (P<0.001), waist circumference (P=0.005), fast glucose (P=0.048), triglycerides (P=0.001), and high-density lipoprotein cholesterol (P=0.027) based on 25(OH)D concentration were observed among postmenopausal women but not among premenopausal women. Among the postmenopausal women with high consumption of dietary carbohydrate, the adjusted odds ratios (ORs) [95% confidence intervals (95% CIs)] of MetS among participants with 25(OH)D deficiency increased 1.380-fold (95% CI = 1.086-1.753) using the 25(OH)D-sufficient group as a reference. In contrast, the participants with 25(OH)D deficiency showed an increased risk of MetS [OR (95% CI) = 1.313 (1.041-1.655)] with low-fat consumption. However, the aforementioned findings did not differ among premenopausal women. CONCLUSION: Thus, MetS due to 25(OH)D deficiency among postmenopausal women may be modified by the consumption of dietary macronutrient.

Associations Among BMI, Dietary Macronutrient Consumption, and Climacteric Symptoms in Korean Menopausal Women.

Many postmenopausal women individually experience varying degrees of climacteric symptoms. Among the many influencing factors, body weight and diet are recognized as important contributors to the incidence and severity of these symptoms. This study was performed to investigate the interaction effect of BMI (body mass index) and dietary consumption on the risk of climacteric symptoms among Korean women. Approximately half of the subjects (48.8%) experienced climacteric symptoms. After adjusting for the covariates, the subjects who are overweight or obese showed significantly greater total scores of climacteric symptoms (p = 0.010) and subscales of symptoms (p = 0.027 for physical climacteric symptoms and p = 0.007 for psychological climacteric symptoms), except for urogenital climacteric symptoms (p = 0.085), than those subjects at a normal weight. When subjects were divided into groups according to dietary macronutrient consumption, those who are overweight or obese were 2.84-fold (adjusted odds ratio, 95% CI = 1.18-6.80, p = 0.019) more likely to experience climacteric symptoms than those at a normal weight among the subjects with high fat consumption. However, the BMI category did not affect the adjusted odds ratio for experiencing climacteric symptoms among subjects who consumed a low-fat diet.

Association between Timed Up and Go Test and Subsequent Functional Dependency.

BACKGROUND: This study aimed to evaluate the association between baseline results of the Timed Up and Go (TUG) test and subsequent functional dependency occurrence. METHODS: From the National Health Insurance Service-Senior Cohort database, we identified 39,519 people who participated in the National Screening Program for Transitional Ages at the age of 66 during 2007-2008. Impaired mobility was defined as taking 10 seconds or longer to perform the TUG test. Functional dependency occurrence was defined as the initiation of receiving national Long-Term Care Insurance services-home care or admission to long-term care facilities. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) for dependency occurrence according to baseline TUG test results. RESULTS: The mean follow-up period was 5.7 years. Occurrence rates of dependency were 2.0 and 3.4 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. Impaired mobility was associated with a higher risk of functional dependency occurrence (adjusted HR [aHR], 1.65; 95% confidence interval [CI], 1.40-1.95; P < 0.001). Additionally, in the subgroup analysis for the participants with intact baseline activities of daily living, impaired mobility was associated with a higher risk of dependency occurrence (aHR, 1.65; 95% CI, 1.33-2.04; P < 0.001). CONCLUSION: The TUG test might be a useful predictive marker of subsequent functional dependency occurrence. Intervention to prevent functional dependency may be helpful for older adults with impairment on the TUG test.

Characteristics of metabolic factors related to arterial stiffness in young and old adults.

It has not been adequately studied which biomarkers for cardiovascular risk indicate changes of atherosclerosis by aging process. The current study aimed to investigate the characteristics of metabolic factors related to arterial stiffness in young and old adults. Our cross-sectional study enrolled 851 healthy young adults and 719 old adults. Metabolic biomarkers included glucose, lipid profiles, and liver enzymes. In young adults, additional biomarkers such as C-reactive protein, apolipoproteins, lipoprotein(a), ferritin, and 25-hydroxycholecalciferol were measured. Arterial stiffness was evaluated by measuring brachial-ankle pulse wave velocity (baPWV). The mean age was 37.8 and 65.1 years old in the young and old groups, respectively. Without adjustment, most parameters were significantly correlated with baPWV in both young and old groups. Mean baPWV was significantly different according to metabolic syndrome (MetS) in both groups (13.1 and 12.1 m/s in the young subjects with and without MetS, respectively; 17.4 and 15.8 m/s, respectively, in the old group). After adjusting for age, sex, and hemodynamic factors, the difference in baPWV according to MetS was significant only in the old group. The relationship between most biomarkers and baPWV was influenced by metabolic disorders such as hypertension and diabetes in old adults. Total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), and apolipoprotein B were significant in young group. In conclusion, the metabolic biomarkers related to arterial stiffness were different between young and old adults. Contrary to old adults, TC, LDLC, and apolipoprotein B were independent biomarkers for arterial stiffness in healthy young adults.

Low levels of total and high-molecular-weight adiponectin may predict non-alcoholic fatty liver in Korean adults.

OBJECTIVES: While weight gain is known as a predictor of non-alcoholic fatty liver disease (NAFLD) incidence, it remains controversial whether adipokine levels predict the development of NAFLD. We aimed to investigate the relationship of total adiponectin, high-molecular-weight (HMW) adiponectin, and leptin with the development and improvement of non-alcoholic fatty liver (NAFL) independent of sex and weight change over a maximum of 8.5 years. METHODS: This prospective study enrolled 2735 participants in a hospital health check-up setting. Adipokine levels were measured at baseline. NAFL was assessed with liver ultrasonography, and the development or improvement of NAFL was determined by repeated ultrasonography at follow-ups. RESULTS: Cross-sectional analyses revealed that total and HMW adiponectin levels were inversely associated with NAFL prevalence. In longitudinal analyses, the incidence of NAFL was 5.6 per 100-person-years during the observation period. The hazard ratios (HRs) per 1 µg/mL increase in the levels of total and HMW adiponectin were 0.900 (0.836-0.969) and 0.846 (0.754-0.948), respectively. Sex-stratified analyses showed that total and HMW adiponectin levels were significantly related to NAFL incidence only in women. In the subgroup of minimal weight change, only HMW adiponectin was a significant predictor for NAFL. Leptin predicted NAFL in the subgroup with weight gain. The improvement of NAFL was influenced by weight change, but not by adipokine levels. CONCLUSIONS: Low levels of total and HMW adiponectin may predict the development of NAFL independent of pathophysiological factors including obesity and insulin resistance. This predictability was evident in women. Leptin was a significant predictor for NAFL in the subjects with weight gain.

Bowel preparation for colonoscopy may decrease the levels of testosterone in Korean men.

Although colonoscopy is commonly conducted for medical check-ups in Korea, investigations for the influence of bowel preparation on various health conditions are insufficient. This cross-sectional study investigated whether bowel preparation has an influence on serum levels of testosterone. A total of 1114 men were divided into the bowel preparation group and control groups. The median total and free testosterone levels were significantly lower in the bowel preparation group (14.89 and 0.26 nmol/L, respectively) than in the control groups (15.72 and 0.28 nmol/L, respectively). The level of total testosterone significantly increased with age in the bowel preparation group (r = 0.103). The differences in the levels of total and free testosterone between the 2 groups were more prominent in younger men than in older men. In multivariate regression models, bowel preparation was independently associated with the levels of total and free testosterone. In these models, the interaction between age and bowel preparation was significant for the levels of total and free testosterone. In conclusion, bowel preparation may independently decrease the serum levels of total and free testosterone. The decline in testosterone was more evident in younger men than in older men.

Low hair copper concentration is related to a high risk of nonalcoholic fatty liver disease in adults.

Copper, an essential micronutrient, is required for lipid metabolism, mitochondrial function, iron metabolism, and antioxidant defense. Copper deficiency has been linked to alterations in lipid metabolism and various metabolic processes of the liver, including nonalcoholic fatty liver disease (NAFLD); however, most of these studies relied on copper measurements in the blood or tissues. In this study, we investigated the association between hair copper concentration and NAFLD in Korean adults, independent of metabolic syndrome status. Clinical and laboratory parameters, including factors of metabolic syndrome, were analyzed in 751 Korean adults divided into quintiles, according to hair copper concentration. Lower hair copper concentration was significantly correlated with higher body mass index, waist circumference, blood pressure, and lower levels of high-density lipoprotein cholesterol. Subjects with NAFLD showed significantly lower hair copper concentrations, and the risk of NAFLD was significantly higher for the lower hair copper quintile groups even after adjusting for metabolic syndrome-related factors. Overall, this study suggests that lower hair copper concentration could be associated with NAFLD, independent of metabolic syndrome factors.

Low Levels of Sex Hormone-Binding Globulin Constitute an Independent Risk Factor for Arterial Stiffness in Korean Women.

The association between sex hormone-binding globulin (SHBG) and arterial stiffness in women is not conclusive. In addition, obesity might also be involved in the relationship between SHBG and atherosclerosis. The aim of this study was to determine the relationship between SHBG and arterial stiffness in association with central obesity in women. This cross-sectional study included 381 women who participated in the health checkup programs in one hospital. The brachial-ankle pulse wave velocity (baPWV) was measured as a marker for arterial stiffness. A negative correlation was observed between SHBG levels and baPWV (rho = -0.281). The relationship was significant even after adjusting for potential confounders (beta = -0.087 in fully adjusted model). After considering the interaction between central obesity and SHBG levels, the significant association was evident only in obese women (P for interaction = 0.025). Adjustment for a 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores, instead of each cardiovascular risk factor individually, did not affect the significance of the relationship between SHBG levels and baPWV. Serum levels of SHBG were negatively associated with arterial stiffness independent of cardiovascular risk factors or 10-year ASCVD risk scores in Korean women. The relationship may be potentiated by central obesity.