Association of frailty with fall events in older adults: A 12-year longitudinal study in Korea.

BACKGROUND: Evidence has shown that frailty is associated with the risk of falls in older people. However, the components of frailty that have the highest association with fall events are largely unknown. METHODS: This study analyzed panel data from the Korean Longitudinal Study of Aging. We used the Korean Frailty Instrument, which includes domains for social isolation, exhaustion and weakness estimated by grip strength, to assess frailty. Fall event data were collected during follow-up visits. RESULTS: A total of 3122 community-dwelling adults aged 65 years or older were included at baseline in 2006 and were followed up every 2 years until 2018. The participants with frailty had a higher risk of falls than those without frailty (OR=1.31, 95% CI=1.11-1.54, P = 0.001; fully adjusted model). We found that three components of frailty, namely, social isolation, exhaustion, and weakness, were independently and significantly related to fall events in the unadjusted model. In the fully adjusted model, social isolation and exhaustion were significantly associated with fall events (OR=1.38, 95% CI=1.18-1.61, P < 0.001 and OR=1.28, 95% CI=1.10-1.51, P = 0.006, respectively), and there was no significant association between weakness and the risk of falls (OR=1.11, 95% CI=0.91-1.34, P = 0.307). CONCLUSIONS AND IMPLICATIONS: Frailty was associated with more fall events in Korean older adults. Social isolation and exhaustion but not weakness were significantly associated with fall events. Our study suggests that interventions should be tailored to older adults with social and psychological frailty.

Type of tea consumption and depressive symptoms in Chinese older adults.

BACKGROUND: Existing research indicates that tea drinking may exert beneficiary effects on mental health. However, associations between different types of tea intake and mental health such as depression have not been fully examined. The purpose of this study was to examine the associations of green tea, fermented tea, and floral tea consumption with depressive symptoms. METHODS: We used data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, a nationwide survey on older adults in mainland China. A total of 13,115 participants (mean age 83.7 years, 54.2% were women) with valid responses were included in the analysis. The type (green, fermented [black, Oolong, white, yellow, dark, and compressed teas], and floral) and the frequency of tea consumption were recorded, and depressive symptoms were assessed using 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10). We examined the associations between the type and the frequency of tea intake and depression, controlling for a set of demographic, socioeconomic, psychosocial, behavioral, and health-related variables. RESULTS: Overall, intakes of green tea, fermented tea, and floral tea were all significantly associated with lower prevalence of depressive symptoms, independent of other risk factors. Compared with the group of no tea intake, the adjusted ORs of depressive symptoms for daily green tea, fermented tea, and floral tea intake were 0.85 (95% CI: 0.76-0.95), 0.87 (95% CI: 0.76-0.99), and 0.70 (95% CI: 0.59-0.82), respectively. Linear associations were observed between the frequencies of all three types of tea intake and depressive symptoms (P < 0.05 for trends for all three types). The associations of the type and the frequency of tea intake and depressive symptoms were robust in several sensitivity analyses. CONCLUSIONS: Among Chinese older adults, regularly consumed any type of tea (green, fermented, or floral) were less likely to show depressive symptoms, the associations seemed more pronounced among floral tea and green tea drinkers.

Interaction between APOE ε4 and dietary protein intake on cognitive decline: A longitudinal cohort study.

OBJECTIVE: To exam the association of cognitive decline with APOE ε4 allele carriage and dietary protein intake and investigate whether there is a gene-diet (GxD) interaction of APOE ε4 allele carriage and dietary protein intake on cognitive decline in a nationwide cohort of older adults. METHODS: A cohort study of participants from Chinese Longitudinal Healthy Longevity Survey was conducted from 2008 to 2014. A total of 3029 participants (mean age of 77.0 years, SD = 9.0; 49.3% were women) was enrolled. We genotyped APOE ε4 allele for each participant and calculated the diversity of dietary protein intake (DDPI) by summing up the frequency of intake of the 6 protein-rich foods (meats, fish, eggs, nuts, dairy products, and bean products). We assessed cognitive function using the Mini-Mental State Examination (MMSE). We used ordinal regression model to estimate the independent and joint effects of APOE ε4 carrier and dietary protein intake on cognitive decline, adjusting for potential confounders of age, sex, education, socio-economic status, lifestyles, BMI, and cardiometabolic conditions. RESULTS: There was significant association between carrying APOE ε4 allele and faster cognitive decline (Odds ratio: 1.19, 95% CI = 1.00-1.42), independent of potential confounders. While the associations of DDPI and the intake of 6 protein-rich foods with cognitive decline did not reach any statistical significance. We observed significant interactions of APOE ε4 with DDPI and fish intake, at multiple correction-adjusted Ps < 0.05. In those who were APOE ε4 carriers rather than non-carriers, both high DDPI (OR = 0.54, 95% CI: 0.34-0.88) and daily fish intake (OR = 0.43, 95% CI: 0.22-0.78) were significantly associated with slower cognitive decline, respectively. We also found that frequent intake of fish benefits women more than men regarding the mitigating of cognitive decline among APOE ε4 allele carriers (P for interaction = 0.016). CONCLUSIONS: The results of this study support the hypothesis that diversified protein food intake in addition to frequent fish intake may reduce the detrimental effect of APOE ε4 on cognitive health.

Heart rate variability and inflammatory bowel disease in humans: A systematic review and meta-analysis.

The autonomic nervous system (ANS) maintains homeostasis in the gastrointestinal tract, including immunity, inflammation and motility, through the brain-gut axis. To date, the associations between ANS function and inflammatory bowel disease (IBD) have been controversial and inconclusive in human studies. PubMed, Cochrane Library, and Embase were searched through February 2020 for articles reporting these association between heart rate variability (HRV), an indirect measure of ANS activity, and IBD. The standardized mean differences and 95% confidence intervals (CIs) were calculated. Ten eligible studies involving 273 ulcerative colitis patients, 167 Crohn's disease patients and 208 healthy controls were included. The values of the total power (SMD = -0.83, 95% CI = -1.44, -0.21), high frequency (SMD = -0.79, 95% CI = -1.20, -0.38), RR interval (SMD = -0.66, 95% CI = -1.04, -0.27), standard deviation of the RR intervals (SMD = -1.00, 95% CI = -1.73, -0.27), percentage of RR intervals with a greater than 50-millisecond variation (SMD = -0.82, 95% CI = -1.33, -0.30) and the square root of the mean squared differences in successive RR intervals (SMD = -0.71, 95% CI = -1.15, -0.26) of the IBD patients were lower than those of the healthy controls, and moderate to large effect sizes were observed in all HRV indices, except for low frequency (SMD = -0.41, 95% CI = 0.95, 0.13). IBD was strongly associated with an overall decrease in HRV, indicating substantially decreased ANS activity. Furthermore, the parasympathetic nerve displayed a stronger inverse association with ANS activity than the sympathetic nerve, indicating ANS dysfunction in patients with IBD.

Serum 25-Hydroxyvitamin D, Albumin, and Mortality Among Chinese Older Adults: A Population-based Longitudinal Study.

CONTEXT: The associations between serum 25-hydroxyvitamin D concentrations [25(OH)D] and all-cause mortality have been inconsistent in existing literatures. One plausible reason is the interaction of intrinsic vitamin D with other biological conditions such as malnutrition and chronic inflammation. OBJECTIVE: To explore the associations between serum levels of 25(OH)D, albumin, and all-cause mortality and further evaluate their interactions in elderly people. DESIGN: Population-based longitudinal study. SETTING AND PARTICIPANTS: Data were obtained from 1834 people aged 65 to 112 who had their serum 25(OH)D and albumin assayed at baseline in 2011. Participants' survival status was ascertained at the 2014 and 2018 follow-up survey waves. MAIN OUTCOME MEASURES: All-cause mortality. RESULTS: Among the 1834 participants, both serum 25(OH)D and albumin concentrations were inversely associated with all-cause mortality (Ps < 0.001). In addition, the interaction effect of 25(OH)D and albumin on all-cause mortality was observed among the participants (P = 0.001). In the group with a higher albumin level (≥40 g/L), participants with a lower level of 25(OH)D (<50 nmol/L) had higher risk of mortality than their counterparts (hazard ratio, 1.92; 95% confidence interval, 1.45-2.56), and the association was more pronounced in women. In the group with a lower albumin level (<40 g/L), the associations failed to reach statistical significance in all participants as well as in women and in men. CONCLUSIONS: Serum 25(OH)D and albumin levels were inversely associated with all-cause mortality in Chinese older adults. The association between 25(OH)D and mortality was more pronounced in participants with higher albumin levels.

High C-reactive protein to albumin ratio and the short-term survival prognosis within 30 days in terminal cancer patients receiving palliative care in a hospital setting: A retrospective analysis.

Survival estimates are very important to patients with terminal cancer. The C-reactive protein (CRP)/albumin ratio is associated with cancer outcomes. However, few studies have investigated the dose-response association in terminal cancer patients. Therefore, we aimed to evaluate the association between the CRP/albumin ratio and mortality in terminal cancer patients using a longitudinal analysis. We retrospectively investigated the electronic medical records of 435 inpatients with terminal cancer admitted to the palliative care unit of Yeouido St. Mary's Hospital between October 8, 2015, and January 17, 2018. In total, 382 patients with terminal cancer were enrolled in the study. The serum CRP/albumin ratio measured at admission had a linear dose-response relationship with the risk of death among the terminal cancer patients (P for linearity = .011). The multivariate analyses showed that the CRP/albumin ratio was an independent prognostic factor (Model 1, CRP/albumin ratio >48.53 × 10: HR = 2.68, 95% CI = 1.82-3.93; Model 2, tertile 2: HR = 1.91, 95% CI = 1.31-2.82 and tertile 3: HR = 3.66, 95% CI = 2.24-5.97). The relationship between a high CRP/albumin ratio and poor survival was a flat L-shape for survival time with an inflection point at approximately 15 days, while the relationship was not significant in terminal cancer patients who survived beyond 30 days. This study demonstrated that high CRP/albumin ratios are significantly and independently associated with the short-term survival prognosis of terminal cancer patients within 30 days.

Short Chain Fatty Acids and Fecal Microbiota Abundance in Humans with Obesity: A Systematic Review and Meta-Analysis.

There have been mixed results regarding the relationship among short chain fatty acids (SCFAs), microbiota, and obesity in human studies. We selected studies that provided data on SCFA levels or fecal microbiota abundance in obese and nonobese individuals and then combined the published estimates using a random-effects meta-analysis. Obese individuals had significantly higher fecal concentrations of acetate (SMD (standardized mean differences) = 0.87, 95% CI (confidence interva) = 0.24-1.50, I2 (I-squared) = 88.5), propionate (SMD = 0.86, 95% CI = 0.35-1.36, I2 = 82.3%), and butyrate (SMD = 0.78, 95% CI = 0.29-1.27, I2 = 81.7%) than nonobese controls. The subgroup analyses showed no evidence of heterogeneity among obese individuals with a BMI >30 kg/m2 (I2 = 0.0%). At the phylum level, the abundance of fecal microbiota was reduced in obese compared to nonobese individuals, but the difference was not statistically significant (Bacteroidetes phylum, SMD = -0.36, 95% CI = -0.73-0.01; Firmicutes phylum, SMD = -0.10, 95% CI = -0.31-0.10). The currently available human case-control studies show that obesity is associated with high levels of SCFA but not gut microbiota richness at the phylum level. Additional well-designed studies with a considerable sample size are needed to clarify whether this association is causal, but it is also necessary to identify additional contributors to SCFA production, absorption, and excretion in humans.

Low 25-hydroxyvitamin D levels and the risk of frailty syndrome: a systematic review and dose-response meta-analysis.

BACKGROUND: Vitamin D deficiency and frailty are common with aging. Previous studies examining vitamin D status and frailty have produced mixed results, and in particular, the shape of the association has not been well established. We examined the association between 25-hydroxyvitamin D (25OHD) serum levels and frailty by performing a systematic review and dose-response meta-analysis. METHODS: We searched the PubMed, EMBASE and Cochrane Library databases of Elsevier through February 2017. Cross-sectional and cohort studies that reported adjusted risk ratios with 95% confidence intervals (CI) for frailty with ≥3 categories of 25OHD serum levels were selected. Data extraction was performed independently by two authors. The reported risk estimates for 25OHD categories were recalculated, employing a comprehensive trend estimation from summarized dose-response data. RESULTS: The pooled risk estimate of frailty syndrome per 25 nmol/L increment in serum 25OHD concentration was 0.88 (95% CI = 0.82-0.95, I2 = 86.8%) in the 6 cross-sectional studies and 0.89 (95% CI = 0.85-0.94, I2 = 0.0%) in the 4 prospective cohort studies. Based on the Akaike information criteria (AIC), a linear model was selected (AIC for the nonlinear model: - 5.4, AIC for the linear model: - 6.8 in the prospective cohort studies; AIC for the linear model: - 13.6, AIC for the nonlinear model: - 1.77 in the cross-sectional studies). CONCLUSIONS: This dose-response meta-analysis indicates that serum 25OHD levels are significantly and directly associated with the risk of frailty. Further studies should address the underlying mechanisms to explain this relationship and to determine whether vitamin D supplementation is effective for preventing frailty syndrome.

Association of metabolic syndrome and its components with all-cause and cardiovascular mortality in the elderly: A meta-analysis of prospective cohort studies.

There is increasing evidence regarding the relationship between metabolic syndrome and mortality. However, previous research examining metabolic syndrome and mortality in older populations has produced mixed results. In addition, there is a clear need to identify and manage individual components of metabolic syndrome to decrease cardiovascular disease (CVD) mortality. In this meta-analysis, we searched the MEDLINE databases using PubMed, Cochrane Library, and EMBASE databases. Based on 20 prospective cohort studies, metabolic syndrome was associated with a higher risk of all-cause mortality [relative risk (RR), 1.23; 95% confidence interval (CI), 1.15-1.32; I = 55.9%] and CVD mortality (RR, 1.24; 95% CI, 1.11-1.39; I = 58.1%). The risk estimates of all-cause mortality for single components of metabolic syndrome were significant for higher values of waist circumference or body mass index (RR, 0.94; 95% CI, 0.88-1.00), higher values of blood glucose (RR, 1.19; 95% CI, 1.05-1.34), and lower values of high-density lipoprotein (HDL) cholesterol (RR, 1.11; 95% CI, 1.02-1.21). In the elderly population, metabolic syndrome was associated with an increased risk of all-cause and CVD mortality. Among the individual components of metabolic syndrome, increased blood glucose and HDL cholesterol levels were significantly associated with increased mortality. However, older obese or overweight individuals may have a decreased mortality risk. Thus, the findings of the current meta-analysis raise questions about the utility of the definition of metabolic syndrome in predicting all-cause mortality and CVD mortality in the elderly population.

Relationship between Serum Ferritin Levels and Dyslipidemia in Korean Adolescents.

BACKGROUND: Ferritin is associated with various cardiometabolic risk factors such as dyslipidemia, hypertension, obesity, and insulin resistance in adults. We aimed to study the association between serum ferritin levels and dyslipidemia in adolescents, because dyslipidemia is considered an important modifiable cardiovascular risk factor in the young. METHODS: We analyzed 1,879 subjects (1,026 boys and 853 girls) from the 2009-2010 Korean National Health and Nutrition Examination Survey IV. Subjects were categorized into quartiles according to their lipid parameters, which were classified according to age and gender. Those in the highest quartile groups for total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations were diagnosed as having dyslipidemia. Those in the lowest quartile for high-density lipoprotein cholesterol (HDL-C) values were diagnosed with abnormal levels. RESULTS: In boys, total cholesterol, LDL-C, and triglyceride concentrations were significantly correlated with serum ferritin levels. In both boys and girls, serum ferritin levels were negatively associated with HDL-C values, even after adjusting for all covariates. Furthermore, there was no significant correlation between serum ferritin levels and total cholesterol, LDL, and triglyceride concentrations in girls. CONCLUSION: Serum ferritin levels were significantly associated with major dyslipidemia parameters, more prominently in boys than in girls, and this association represents a cardiometabolic risk factor.

Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults: A Nationwide Population-Based Study.

This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06-2.21], 1.21 [1.02-1.45], and 1.78 [1.21-2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67-0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria.

Low Magnesium Levels in Adults with Metabolic Syndrome: a Meta-Analysis.

UNLABELLED: There is conflicting evidence regarding the relationship between magnesium deficiency and metabolic syndrome, and a systematic assessment of the literature has not been performed. Our objective was to clarify the association between magnesium levels and metabolic syndrome by performing a meta-analysis. Based on 13 eligible studies involving 14 analyses and 5496 enrolled participants, magnesium levels were significantly lower in adults with metabolic syndrome than in controls (standardized mean difference [SMD] = -0.98, 95 % confidence interval [CI] = -1.44 to -0.52). There was marked heterogeneity when all comparisons were considered (I (2) = 98 %, p < 0.001). In the subgroup meta-analysis and meta-regression model, a significant difference in magnesium levels was noted by geographic location and study quality. Magnesium levels were lower in the experimental cases than in the controls in West Asia (SMD = -3.80, 95 % CI = -5.36, -2.23) and Latin America (SMD = -1.38, 95 % CI = -1.88, -0.87), but not in East Asia (SMD = -0.01, 95 % CI = -0.30, 0.29) or Europe/Oceania (SMD = -0.25, 95 % CI = -0.53, 0.03). Moreover, the inverse association was greater in high-quality studies (SMD = -2.52, 95 % CI = -3.72, -1.32) than in low-quality studies (SMD = -0.33, 95 % CI = -0.57, -0.08). In conclusion, although there was a high level of heterogeneity, this meta-analysis provided convincing evidence of reduced magnesium levels in adults with metabolic syndrome based on the findings of observational studies. However, the present findings should be validated by additional prospective studies or trans-regional multicenter randomized controlled trials, which generally yield higher-level evidence than case-control studies and cross-sectional studies. CLINICAL TRIAL REGISTRATION NUMBER: NCT02151227 ( ClinicalTrials.gov Protocol Registration System); CRD42015017946 ( www.crd.york.ac.uk/PROSPERO ).

Serum Ferritin Levels Are Positively Associated With Metabolically Obese Normal Weight: A Nationwide Population-Based Study.

The purpose of this study was to examine the relationship between serum ferritin levels and metabolically obese normal weight (MONW) and to determine the appropriate cut-off value of serum ferritin for the prediction of clinical metabolic status in nonobese Korean adults. Data from 9411 participants in the fourth (2008) and fifth (2010) annual Korea National Health and Nutrition Examination Surveys were used in this study. MONW was determined by combining National Cholesterol Education Program Adult Treatment Panel III criteria, Wildman criteria, and homeostatic model assessment criteria for metabolic healthy obesity. The mean serum ferritin level was 103.5 ±â€Š1.2 ng/mL in men and 45.5 ±â€Š0.6 ng/mL in women. The estimated cutoff value of serum ferritin for the prediction of MONW was 127.03 ng/mL in men and 46.87 ng/mL in women. Both men and women who had higher serum ferritin levels than the cutoff value had a higher prevalence of MONW than those individuals who had lower serum ferritin levels than the cutoff value. In the final multivariable adjusted logistic regression model, the odds ratio (95% confidence interval) of MONW in the subjects who had higher serum ferritin levels than the cutoff value was 1.631 (1.312-2.028) in men and 1.298 (1-1.685) in women. In this study, serum ferritin levels were positively associated with MONW, and those subjects who had higher serum ferritin levels than the cutoff value had a higher prevalence and a higher adjusted odds ratio for MONW despite being nonobese.

Serum Gamma-Glutamyltransferase Levels are Associated With Concomitant Cardiovascular Risk Factors in Korean Hypertensive Patients: A Nationwide Population-Based Study.

Previous studies suggested that serum gamma-glutamyltransferase (GGT) levels were associated with the prevalence of cardiovascular disease (CVD) risk factors including hypertension, diabetes mellitus (DM), and metabolic syndrome (MetS) in the general population. We aimed to investigate the relationship between serum GGT levels and CVD risk factors in Korean hypertensive patients. This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2011 to 2012. The analysis included 1541 hypertensive participants. Study participants were divided into groups according to tertiles of serum GGT with cutoff points of 20 and 35 U/L. Serum GGT levels were positively associated with the components of MetS (P value < 0.05, except for systolic blood pressure and high-density lipoprotein cholesterol). After adjusting for possible confounders, serum GGT levels were associated with an increased risk of MetS, high waist circumference, high triglyceride level, fasting plasma glucose, DM, and the urinary albumin-to-creatinine ratio (P = 0.001). In hypertensive patients, serum GGT levels are positively associated with major cardiovascular risk factors such as MetS, DM, and urinary albumin excretion.

Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings.

OBJECTIVES: Although the prevalence of depressive disorders in South Korea's general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. METHODS: Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. RESULTS: The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. CONCLUSIONS: As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

Trends in lipid profiles among South Korean adults: 2005, 2008 and 2010 Korea National Health and Nutrition Examination Survey.

BACKGROUND: This study aimed to investigate recent trends in the prevalence and parameters of dyslipidemia and rates of lipid-lowering medication use in Korean adults. Trends in lipid profiles in subjects with hypertension, diabetes or obesity were also studied. METHODS: Data from the Korea National Health and Nutrition Examination Survey in 2005, 2008 and 2010 were used in this study. A total of 17 009 subjects participated in this study. RESULTS: There was a declining trend in the prevalence of dyslipidemia and an increasing trend in the rates of use of lipid-lowering medication among Korean adults. In both men and women, the age-adjusted mean high-density lipoprotein cholesterol level linearly increased. There was a significantly decreasing trend in the age-adjusted mean triglycerides in women and age-adjusted mean lipid-related ratios in both sexes. The age-adjusted mean total cholesterol level showed a slightly increasing trend and the age-adjusted mean low-density lipoprotein cholesterol level was not changed in both sexes. These patterns persisted among subjects not taking lipid-lowering medication. The favorable trends were also observed in subjects with hypertension, diabetes and obesity. CONCLUSIONS: Our study showed favorable trends in the prevalence of dyslipidemia and in several lipid profiles among Korean adults.

Dietary magnesium intake and metabolic syndrome in the adult population: dose-response meta-analysis and meta-regression.

ncreasing evidence has suggested an association between dietary magnesium intake and metabolic syndrome. However, previous research examining dietary magnesium intake and metabolic syndrome has produced mixed results. Our objective was to determine the relationship between dietary magnesium intake and metabolic syndrome in the adult population using a dose-response meta-analysis. We searched the PubMed, Embase and the Cochrane Library databases from August, 1965, to May, 2014. Observational studies reporting risk ratios with 95% confidence intervals (CIs) for metabolic syndrome in ≥ 3 categories of dietary magnesium intake levels were selected. The data extraction was performed independently by two authors, and the quality of the studies was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). Based on eight cross-sectional studies and two prospective cohort studies, the pooled relative risks of metabolic syndrome per 150 mg/day increment in magnesium intake was 0.88 (95% CI, 0.84-0.93; I(2) = 36.3%). The meta-regression model showed a generally linear, inverse relationship between magnesium intake (mg/day) and metabolic syndrome. This dose-response meta-analysis indicates that dietary magnesium intake is significantly and inversely associated with the risk of metabolic syndrome. However, randomized clinical trials will be necessary to address the issue of causality and to determine whether magnesium supplementation is effective for the prevention of metabolic syndrome.

Blood vitamin D status and metabolic syndrome in the general adult population: a dose-response meta-analysis.

CONTEXT: Increasing evidence has suggested an association between blood vitamin D levels and metabolic syndrome. OBJECTIVE: Our objective was to determine the relationship between blood vitamin D status and metabolic syndrome in the general adult population, using a dose-response meta-analysis. DATA SOURCE: We searched the PubMed, EMBASE, Web of Science, and Cochrane Library databases through July 2013 to identify relevant studies. STUDY SELECTION: Observational studies, reporting risk ratios with a 95% confidence interval (CI) for metabolic syndrome in ≥3 categories of blood 25-hydroxyvitamin D [25(OH)D] levels, were selected. DATA EXTRACTION: Data extraction was performed independently by 2 authors, and the quality of the studies was evaluated using the risk of bias assessment tool for nonrandomized studies. DATA SYNTHESIS: The pooled odds ratio of metabolic syndrome per 25 nmol/L increment in the serum/plasma 25(OH)D concentration was 0.87 (95% CI = 0.83-0.92, I(2) = 85%), based on 16 "cross-sectional studies" and 1.00 (95% CI = 0.98-1.02, I(2) = 0%) for 2 "cohort and nested case-control studies." The dose-response meta-analysis showed a generally linear, inverse relationship between 25(OH)D levels and metabolic syndrome in the cross-sectional studies (P for linear trend < .001). CONCLUSIONS: Blood vitamin D levels were associated with a risk of metabolic syndrome in cross-sectional studies but not in longitudinal studies. Randomized, clinical trials will be necessary to address the issue of causality and to determine whether vitamin D supplementation is effective for the prevention of metabolic syndrome.

Serum magnesium level is negatively associated with fasting serum glucose level in Korean adults.

Several studies have observed an inverse association between serum magnesium and fasting glucose levels. However, there have been sparse data on Koreans. The present study was designed to evaluate the association between serum magnesium and fasting serum glucose levels in Korean adults. A total of 949 Korean adults who visited an outpatient at a university hospital were included in this study. We compared mean values of clinical data according to the tertile of serum magnesium level using analysis of covariance. Association between serum magnesium and fasting glucose levels was evaluated using multiple regression analysis. Odds ratio (OR) was calculated to determine the association between hypomagnesemia and abnormal glucose metabolism. Fasting serum glucose levels decreased significantly from the lowest to the highest tertile of serum magnesium level (108.0±1.4, 106.5±2.1, 102.5±1.7 mg/dl, respectively, p=0.015), whereas blood pressure and lipid profile showed no significant associations. Serum magnesium level was negatively associated with fasting serum glucose level (ß=-0.114, p=0.001). Participants with hypomagnesemia had significantly higher OR for abnormal glucose metabolism compared to those with normomagnesaemia (OR=2.28, 95%CI 1.29-4.02). There was a negative association between serum magnesium and fasting glucose levels in Korean adults. In addition, hypomagnesemia was associated with abnormal glucose metabolism.