Body fat distribution after menopause and cardiovascular disease risk factors: Korean National Health and Nutrition Examination Survey 2010.

BACKGROUND: The prevalence of cardiovascular disease in women increases sharply after menopause. The purpose of this study was to clarify the relationship between menopause and body fat distribution and to investigate their association with cardiovascular disease risk factors. METHODS: We analyzed 2035 women 20-79 years of age using the National Health and Nutrition Examination Survey (KNHANES) 2010 database. Body fat was measured using dual-energy X-ray absorptiometry. RESULTS: The percentage of total body fat and the body fat distribution (BFD) index (the ratio of the trunk fat mass to leg fat mass) are significantly higher in postmenopausal women than in premenopausal women (all p<0.001). When adjusted for age, menopause was associated with higher total body fat percentage (adjusted ß=1.082, 95% confidence interval [CI] 0.074-2.090, p=0.035). In women with a body mass index<25 kg/m(2), the higher BFD index was also independently associated with menopause (adjusted ß=14.408, 95% CI 1.672-27.145, p=0.027). After adjusting for age and body fat percentage, the BFD index showed significant and independent associations with systolic and diastolic blood pressure (adjusted ß=0.060 and 0.042, all p<0.001, respectively), fasting glucose (adjusted ß=0.007, p<0.001), total and high density lipoprotein cholesterol (adjusted ß=0.001 and -0.002, p<0.05 and p<0.001, respectively), and triglyceride levels (adjusted ß=0.007, p<0.001- except for low density lipoprotein cholesterol. CONCLUSIONS: After menopause, women have not only higher total body fat percentage but also its different distribution, which independently correlates with cardiovascular disease risk factors. Therefore, this change in body fat may cause the sharp increase in cardiovascular disease incidence in middle-aged women, especially after menopause.

Changes in body fat distribution through menopause increase blood pressure independently of total body fat in middle-aged women: the Korean National Health and Nutrition Examination Survey 2007-2010.

Blood pressure in women increases sharply in middle age, especially after menopause. As the menopausal transition is known to induce changes in body fat distribution, the aim of this study was to investigate the effect of body fat distribution as compared with the effect of total body fat on blood pressure through the menopausal transition. We analyzed 1422 subjects aged 45-55 years using the database from the Korean National Health and Nutrition Examination Survey 2007-2010. The waist circumference (WC) of post-menopausal women was larger than that of pre-menopausal women (80.44 cm, 95% confidence interval (CI) 79.36-81.52 vs. 78.94 cm, 95% CI 78.27-79.61, P=0.013), but there was no statistically significant difference in body mass index (BMI). Systolic and diastolic blood pressure (SBP and DBP) were significantly higher in post-menopausal women than in pre-menopausal women: SBP was 118.33 mm Hg, 95% CI 116.52-120.15 vs. 115.22 mm Hg, 95% CI 114.17-116.28 (P=0.003) and DBP was 76.94 mm Hg, 95% CI 75.88-77.99 vs. 75.25 mm Hg, 95% CI 74.57-75.93 (P=0.009). BMI and WC were positively correlated with BP. After adjustment for BMI, the correlation of WC with SBP remained significant (ß=0.250, 95% CI 0.024-0.476, P=0.030). In a stratified analysis, WC correlated with SBP in women with BMI<25 kg m(-2) (ß=0.358, 95% CI 0.138-0.579, P=0.001), but not in women with BMI25 kg m(-2). We conclude that the changes in body fat distribution through the menopausal transition are associated with SBP, independent of total body fat. This finding indicates that alterations in the localization of body fat are another cause of menopause-related changes in BP.

A comparison of cornell and sokolow-lyon electrocardiographic criteria for left ventricular hypertrophy in korean patients.

BACKGROUND AND OBJECTIVES: Electrocardiography (ECG) is a cost-effective and useful method for diagnosing left ventricular hypertrophy (LVH) in a large-scale study or in clinical practice. Among ECG criteria, the Cornell product (Cor P) and Sokolow-Lyon criteria were adopted by the European Society of Hypertension-European Society of Cardiology Guidelines but have different performances among races. The aim of this study was to compare the diagnostic performance of two voltage criteria in Korean patients. SUBJECTS AND METHODS: Electrocardiography and echocardiographic LV mass of 332 (159 male, 173 female) consecutive patients were analyzed. Cornell voltage criteria and the Cor P were compared with Sokolow-Lyon voltage (Sok V) and the Sokolow-Lyon product (Sok P). The sensitivities and specificities were estimated using a receiver-operating characteristics (ROC) curve in relation to the LVH diagnosis. The sensitivities and revised cut-off values were derived at specificity levels of 90, 95, and 100%. RESULTS: The Cornell-based criteria generally showed better performance than that of the Sok V criteria and Sok P in the area under the ROC curve analysis. The revised cut-off values for the Cornell voltage criteria (20 and 16 mm for males and females, respectively) showed an improved sensitivity (19.7 and 30.3% for males and females, respectively), with a high specificity of 95%. CONCLUSION: The Cornell-based criteria had better performance than that of the Sokolow-Lyon criteria in both Korean men and women. However, revised cut-off values are needed to improve accuracy.

The timing of intra-coronary infusion of G-CSF mobilized peripheral blood stem cells influences cardiac function and in-stent restenosis in patients with myocardial infarction.

We hypothesized that delaying the timing of intra-coronary infusion of G-CSF mobilized stem cell until at least 4 weeks after coronary stenting should avoid the stimulation of vascular smooth muscle cells during the early active cellular proliferative phase, thus decreases in-stent restenosis while preserving the beneficial effect of stem cell therapy on cardiac function in patients with myocardial infarction (MI). 25 patients with ST-elevation myocardial infarction (STEMI) treated with stenting were enrolled in this pilot study. The ages of MI at the time of cell treatment were from 1 month to 59 months. At 6 months follow-up, the left ventricular ejection fraction (LVEF) increased from 32% to 37.7% and the stress thallium perfusion defect decreased from 31.4% to 28.1%. Cell treatment-related complications such as arrhythmias were not observed. 9 patients who underwent cell treatment less than 3 months after coronary stenting were evaluated for in-stent restenosis; it was found in only 1 patient. This pilot study shows that delayed more than 4 weeks after coronary stenting but less than 3 months after MI, intra-coronary infusion of G-CSF mobilized PBSCs may improve cardiac function without triggering in-stent restenosis.