Relationship between socioeconomic and lifestyle factors and cataracts in Koreans: the Korea National Health and Nutrition Examination Survey 2008-2011.

PURPOSE: Cataracts are the leading cause of visual impairment and blindness, and therefore early identification and modification of the risk factors for cataracts are meaningful. This study aimed to investigate the relationship between socioeconomic status (SES) and lifestyle factors, and age-related cataracts in South Korea. METHODS: This cross-sectional study was based on data collected in the 2008-2011 Korea National Health and Nutrition Examination Survey. A total of 15 866 subjects, aged ≥40 years, were included. SES was defined using household income and education level. Sociodemographic, lifestyle, and other associated factors were assessed by health interviews and examinations. Cataracts were diagnosed via slit-lamp examination using the Lens Opacities Classification System III. RESULTS: The prevalence of any cataract was 38.9% in men and 42.3% in women (P<0.001). In women, the risk of cataracts increased with decreases in household income (P-value for trend=0.016 and 0.041 in any, and cortical cataract, respectively) and education level (P-value for trend=0.009, 0.027, and 0.016 in any, nuclear, and cortical cataract, respectively) after adjusting for confounding factors. Current smoking was correlated with nuclear cataracts in men (OR 1.21; 95% CI: 1.00, 1.46 in age-adjusted analysis) and cataract surgery in women (OR 2.25; 95% CI: 1.00, 5.04 in multivariate-adjusted analysis). CONCLUSIONS: Socioeconomic disparities in cataract prevalence were observed in women; current smoking increased the risk of nuclear cataracts in men and surgery in women. Public health interventions focusing on gender differences are warranted to prevent and treat cataracts.

Posttraumatic stress disorder, alone or additively with early life adversity, is associated with obesity and cardiometabolic risk.

BACKGROUND AND AIMS: There is some evidence that posttraumatic stress disorder (PTSD) and early life adversity may influence metabolic outcomes such as obesity, diabetes, and cardiovascular disease. However, whether and how these interact is not clear. METHODS: We analyzed data from a cross-sectional and longitudinal study to determine how PTSD severity influences obesity, insulin sensitivity, and key measures and biomarkers of cardiovascular risk. We then looked at how PTSD and early life adversity may interact to impact these same outcomes. RESULTS: PTSD severity is associated with increasing risk of obesity, diabetes, and cardiovascular disease, with higher symptoms correlating with higher values of BMI, leptin, fibrinogen, and blood pressure, and lower values of insulin sensitivity. PTSD and early life adversity have an additive effect on these metabolic outcomes. The longitudinal study confirmed findings from the cross sectional study and showed that fat mass, leptin, CRP, sICAM-1, and sTNFRII were significantly increased with higher PTSD severity during a 2.5 year follow-up period. CONCLUSIONS: Individuals with early life adversity and PTSD are at high risk and should be monitored carefully for obesity, insulin resistance, and cardiometabolic risk.

Levels of circulating selenoprotein P, fibroblast growth factor (FGF) 21 and FGF23 in relation to the metabolic syndrome in young children.

BACKGROUND/OBJECTIVES: Circulating selenoprotein P (SeP), fibroblast growth factor (FGF) 21 and FGF23 have been associated with metabolic syndrome (MetS) in adults but not in children. We sought to evaluate the association among SeP, FGF21, FGF23 and MetS in young children. SUBJECTS/METHODS: A cross-sectional study conducted during a school health examination on 210 children aged 9 years. We measured serum SeP, FGF21 and FGF23 levels, and assessed anthropometric and cardiometabolic variables. MetS was defined as the presence of ⩾3 of the following five criteria: high blood pressure, low high-density lipoprotein cholesterol (HDL-C), high triglyceride, high fasting glucose and abdominal obesity. RESULTS: SeP was correlated positively with HDL-C and negatively with body mass index, waist circumference (WC), blood pressure, transaminases, triglyceride and homeostasis model assessment of insulin resistance (HOMA-IR). FGF21 was directly correlated with WC, triglyceride and HOMA-IR, and FGF23 was inversely correlated with fasting glucose and alanine aminotransferase. Children with MetS had lower SeP and FGF23 levels and higher HOMA-IR than children without MetS. The highest tertile of SeP had decreased odds for MetS (odds ratio 0.05, 95% confidence interval (CI) 0.00-0.96, P for trend=0.042), whereas FGF21 and FGF23 did not relate to the risk for MetS after controlling for confounders. CONCLUSIONS: Elevated SeP concentrations are independently associated with a reduced risk of MetS in children. The associations between FGF21, FGF23 and metabolic parameters are not of comparable significance.

Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys.

BACKGROUND/OBJECTIVES: We studied the relationship between socioeconomic status (SES), represented by household income, and the prevalence of anemia and iron deficiency anemia (IDA) among adolescent girls in Korea. SUBJECTS/METHODS: The samples were based on the data from a four-year (2008-2011) collection for the Korea National Health and Nutrition Examination Survey (1312 girls, age 10-18 years). The survey included demographic, anthropometric, biochemical and nutritional parameters. A multiple regression analysis after adjusting for age, body mass index (BMI), red blood cell count, white blood cell count and red meat intake was performed. Anemia was defined as hemoglobin level lower than 11.5 g/dl for ages 10-11 years and 12.0 g/dl for ages 12-14 years. Iron deficiency was defined as serum ferritin level below 15 µg/l. RESULTS: The prevalences of anemia and IDA in Korean girls were 5.3 and 4.2%, respectively. Girls with anemia were older, taller, weighed more, had higher BMI, had higher portion of menarche experience and consumed less red meat than girls without anemia. Girls with higher income had lower anemia prevalence and consumed more iron and vitamins. Logistic regression analysis showed a decreasing trend in anemia prevalence as household income increased. Correlation analysis demonstrated that there is a relationship between household income and serum hemoglobin and ferritin levels (P=0.003 and P=0.026, respectively). CONCLUSIONS: Higher SES leads to lower prevalence of anemia and IDA in Korean adolescent girls. This may be due to the fact that higher SES individuals consume more iron and vitamin C.

Serum 25-hydroxyvitamin D levels, obesity and the metabolic syndrome among Korean children.

BACKGROUND AND AIM: Evidence of the relationship between serum vitamin D levels and cardiovascular risk factors in children is limited. We investigated the associations between serum vitamin D levels (25-hydroxyvitamin D [25(OH)D]) and obesity and metabolic syndrome and its components in Korean children. METHODS AND RESULTS: We recruited 1660, nine-year-old, Korean children (904 boys and 756 girls) who voluntarily participated in this study while being examined during school-based health examinations. We measured anthropometric variables (height and weight), metabolic parameters (blood pressure, fasting plasma glucose, triglyceride, and HDL cholesterol levels) and serum vitamin D levels. We analyzed the data using multivariate logistic regression models. Mean 25(OH)D levels were lower in children defined as obese or abdominally obese (P <0.001). When serum levels of 25(OH)D were divided into quartiles, BMI, waist circumference, and triglyceride levels were lower, and HDL cholesterol levels were higher, as vitamin D levels increased. Using children from the highest quartile of 25(OH)D levels as a referent, the adjusted ORs (95% CI) for obesity in those in the third, second, and lowest quartiles of 25(OH)D levels were 1.55 (1.01-2.40), 1.87 (1.22-2.85), and 2.59 (1.71-3.90), respectively (P for trend <0.001). For abdominal obesity the ORs (CI) were 2.08 (1.20-3.60), 2.32 (1.36-3.95), and 2.96 (1.75-5.00) (P for trend<0.001), and for metabolic syndrome they were 2.60 (1.08-6.30), 4.00 (1.73-9.26), and 4.25 (1.84-9.85), respectively (P for trend <0.05). CONCLUSIONS: We found low vitamin D levels in Korean children to be associated with obesity and metabolic syndrome. Insufficient serum vitamin D levels in children may be a risk factor of obesity and metabolic syndrome.