Associations between Blood Lead Levels and Coronary Artery Stenosis Measured Using Coronary Computed Tomography Angiography.

BACKGROUND: Lead exposure is a risk factor for increased blood pressure and cardiovascular disease, even when blood lead levels (BLLs) are within the normal range. OBJECTIVE: This study aimed to investigate the association between BLL and coronary artery stenosis (CAS) in asymptomatic adults using 128-slice dual-source coronary computed tomography (CT) angiography. METHODS: We analyzed medical records data from 2,193 adults (1,461 men and 732 women) who elected to complete a screening health examination, coronary CT angiography, and BLL measurement during 2011-2018 and had no history of CAS symptoms, cardiovascular disease, or occupational exposure to lead. Logistic regression models were used to estimate associations between moderate-to-severe CAS (≥25% stenosis) and a 1-µg/dL increase in blood lead, with and without adjustment for age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, regular exercise, smoking status, and alcohol drinking. RESULTS: BLLs ranged from 0.12 to 10.14µg/dL, with an arithmetic mean of 2.71±1.26µg/dL. The arithmetic mean was higher for men than for women (2.98±1.26µg/dL vs. 2.18±1.08µg/dL, p<0.001) and higher in the moderate-to-severe CAS group than in the no-CAS or <25% stenosis group (3.02±1.44µg/dL vs. 2.67±1.23µg/dL, p<0.001). Moderate-to-severe CAS was significantly associated with BLL before and after adjustment, with an adjusted odds ratio for a 1-µg/dL increase in BLL of 1.14 (95% CI: 1.02, 1.26), p=0.017. CONCLUSIONS: BLL was positively associated with the prevalence of moderate-to-severe CAS in Korean adults who completed an elective screening examination for early cardiovascular disease, 94% of whom had a BLL of <5µg/dL. More efforts and a strict health policy are needed to further reduce BLLs in the general population. https://doi.org/10.1289/EHP7351.

Association Between Serum Uric Acid and Prediabetes in the Korean General Population.

The purpose of this study is to examine the relation of serum uric acid with prediabetes in Korea. We conducted a cross-sectional study in 4633 individuals aged 20 to 81 years who participated in the 2016 Korean National Health and Nutrition Examination Survey. Participants are considered to have prediabetes if they have one or more of the following: impaired fasting glucose (fasting blood glucose levels between 5.6 and 6.9 mmol/L); impaired hemoglobin A1c (hemoglobin A1c ranges of 5.7% to 6.4% [39-46 mmol/mol]). Multiple logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). Prediabetes was more prevalent in the hyperuricemia group compared with the normal-range group among men (OR = 1.51; 95% CI = 1.11-2.05; P < .01) and women (OR = 1.84; 95% CI = 1.01-3.37; P = .04) after adjustment for age, body mass index, abdominal obesity, blood pressure, triglyceride, high-density lipoprotein cholesterol, renal function, alcohol consumption, smoking, and physical activity level. For a standard deviation increment in uric acid, the odds of having prediabetes as compared with that of not having prediabetes increased about 114% in men (P = .05) and 116% in women (P = .01). Higher levels of uric acid were associated with an increased risk of prediabetes among the general Korean population.

Association between high sensitivity CRP and suicidal ideation in the Korean general population.

Inflammation has been linked with a potential critical role in suicide. The purpose of this study is to examine the relation of CRP with suicidal behavior in the Korean population. We conducted a cross-sectional study in 4693 Korean adults aged 20-81 years who participated in the 2015 Korea National Health and Nutrition Examination Survey. High sensitivity CRP levels were measured by immunoturbidimetric method. Suicidal ideation and suicide attempt were assessed by using a questionnaire. Data were analyzed in 2017. Multiple logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of suicidal ideation was 4.9% and that of suicide attempt was 0.4%. Suicidal ideation was more prevalent in the highest compared with the lowest serum CRP quartile (OR, 1.79; 95% CI, 1.11-2.89) after adjustment for age, sex, household income, educational level, marital status, employment status, alcohol dependency, current smoking, physical activity, BMI, sleep duration, number of chronic diseases, restriction on activity, subjective health status, perceived stress, depression and depressive mood (p for trend<0.05). In conclusion, elevated levels of CRP were associated with an increased risk of suicidal ideation among South Korean adults.

Association Between Osteoporosis/Osteopenia and Vestibular Dysfunction in South Korean Adults.

OBJECTIVE: The associations of osteoporosis/osteopenia with vestibular dysfunction have not been well evaluated and conflicting results have been reported. The purpose of this study is to examine the relation of low bone mineral density (BMD) with vestibular dysfunction. DESIGN: The authors conducted a cross-sectional study in 3579 Korean adults aged 50 years and older who participated in the 2009 to 2010 Korea National Health and Nutrition Examination Survey. BMD was measured by dual energy X ray absorptiometry. Vestibular dysfunction was evaluated using the modified Romberg test of standing balance on firm and compliant support surfaces. Data were analyzed in 2015. Multiple logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The prevalence of vestibular dysfunction was 4.3 ± 0.5%. After adjustment for potential confounders, the adjusted ORs for vestibular dysfunction based on BMD were 1.00 (reference) for normal BMD, 2.21 (95% CI: 1.08, 4.50) for osteopenia, and 2.47 (95% CI: 1.05, 5.81) for osteoporosis (p < 0.05). We also observed relationships within each age group. The adjusted ORs were as follows: for age <65 years, the values were 1.00 (reference) for normal BMD, 2.91 (95% CI: 1.02, 8.31) for osteopenia, and 2.12 (95% CI: 0.28, 16.14) for osteoporosis (p < 0.05). For age ≥65 years, the values were 1.00 (reference) for normal BMD, 2.17 (95% CI: 0.96, 4.90) for osteopenia, and 2.77 (95% CI: 1.18, 6.47) for osteoporosis (p < 0.05). CONCLUSION: Osteoporosis or osteopenia were associated with an increased risk of vestibular dysfunction among South Korean adults, especially in older ones.

Prevalence of and risk factors associated with dry eye: the Korea National Health and Nutrition Examination Survey 2010-2011.

PURPOSE: To investigate the prevalence of and risk factors associated with dry eye syndrome (DES) in South Korea. DESIGN: Cross-sectional study. METHODS: In 2010 and 2011, 11,666 subjects, ranging in age from 19 to 95, were randomly selected as nationally representative participants in the Korea National Health and Nutrition Examination Survey (KNHANES). Subjects were divided into 2 groups: 1 with clinically diagnosed DES and 1 with symptoms of dry eye. We determined the prevalence of and risk factors for dry eyes in a Korean population. Health-related quality of life (HRQoL), measured by the EuroQoL-5 dimension (EQ-5D), was evaluated in patients with dry eyes. RESULTS: The mean age was 49.9 years. The overall prevalence of diagnosed DES was 8.0% (95% confidence interval [CI], 7.3% to 8.7%), and of dry eye symptoms the prevalence was 14.4% (95% CI, 13.1 to 15.7). Age (adjusted odds ratio [aOR] = 1.8, 1.6), female (aOR = 2.8, 1.9); history of eye surgery (aOR = 2.6, 2.2); stress (aOR = 1.7, 1.6); thyroid disease (aOR = 1.7, 1.5); and high education level (aOR = 1.6, 1.5) were common risk factors in the groups. Subjects who had undergone ptosis, cataract or refractive surgery were more likely to have dry eye than subjects with no history of eye surgery. Means of pain and anxiety dimensions in the EQ-5D and the Euro Quality of Life Visual Analog Scale (EQ-VAS) were significantly higher in the group with diagnosed DES than in the normal group. CONCLUSIONS: The risk factors were mostly similar in both groups. It is thought there are more patients with DES who have not been diagnosed by doctors. Doctors should identify whether a patient has any risk factors for dry eye. Patients need to be educated about the modifiable factors of DES.