The Association of Hemoglobin A1c and Fasting Glucose Levels with hs-CRP in Adults Not Diagnosed with Diabetes from the KNHANES, 2017.

PURPOSE: High sensitivity C-reactive protein (hs-CRP) has been used as a biomarker to assess the risk of cardiovascular accidents (CVA) and to measure general inflammation in the body. This study investigated the relationship and extent of correlation between serum glucose level markers and hs-CRP as a means to assess CVA risk through hemoglobin A1c (HbA1c) and fasting glucose levels. METHODS: This cross-sectional, population-based study used data from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). From the total sample of 8,127 people, 4,590 subjects were excluded due to age (<19 years) (n = 1,505), diabetes mellitus (DM) diagnosis or medication (n = 596), inactivity (n = 424), pregnancy (n = 17), hypoglycemia (<70 mg/dL) (n = 8), smoking history (n = 1,077), and missing data (n = 963). In total, 3,537 adults not diagnosed with diabetes were selected. Their hs-CRP levels were compared with the glucose level markers using a complex sample general linear regression analysis. RESULTS: We adjusted for sedentary hours, smoking, binge drinking frequency, age, sex, mean SBP, triglycerides, and waist circumference. Increases in HbA1c correlated with hs-CRP levels (B coefficient (95%CI) = 0.185, p = 0.001, and R 2 = 0.087). Changes in the fasting glucose levels were also associated with the hs-CRP levels (B coefficient (95%CI) = 0.005, p = 0.006, and R 2 = 0.086). CONCLUSION: This study showed a linear association between HbA1c and fasting glucose levels and hs-CRP. It also showed that changes in the hs-CRP level were better correlated with those in the HbA1c levels than in the fasting glucose levels.

Black rice with giant embryo ameliorates serum C-reactive protein in adults with metabolic syndrome.

Metabolic syndrome is well known to increase the risk of cardiovascular diseases. We have reported that phytochemicals rich black rice with giant embryo reduced fat mass and metabolic disorders in an animal model. However, such effects have not been evaluated in humans. Subjects with metabolic syndrome (n = 49, 38 male, 44.3 ± 6.1 years) were randomly assigned into two groups and ingested roasted black-rice with giant embryo (BR, n = 26, 20 male) or white-rice (WR, n = 23, 18 male) powders mixed with water for breakfast for three months. Subjects were evaluated for various metabolic parameters before and after intervention. All parameters were not significantly different between groups before starting the intervention. After three months of consumption of either BR or WR, changes of body weight in BR vs WR groups (-1.54 kg vs -1.29 kg, p = 0.649) as well as waist circumference (-1.63 cm vs -1.02 cm, p = 0.365) were not significantly different between groups. However, changes in highly-sensitive C reactive proteins in BR vs WR groups (-0.110 mg/dl vs 0.017 mg/dl, p = 0.003) had significant differences. Three months of meal replacement with BR had a significant reduction of highly-sensitive C reactive protein compared to those with WR in adults with metabolic syndrome.

Association between Abdominal Obesity and Oxidative Stress in Korean Adults.

BACKGROUND: Obesity causes several changes in the body and is associated with both inflammation and oxidative stress. However, the relationship between abdominal obesity, diacron-reactive oxygen metabolites (d-ROMs), and biological antioxidant potential (BAP) levels in Korean adults has not yet been proved. The aim of this study was to evaluate the association between d-ROMs, BAP levels, and abdominal obesity in the Korean adult population using clinical data. METHODS: A total of 2,367 individuals, aged 18-86 years, were identified from health check-up examination records at a university hospital, between January 2015 and August 2016. Clinical and biochemical parameters, including waist circumference, lipid profile, alcohol drinking status, and smoking status, were investigated. Oxidative stress levels, viz., d-ROM concentration and antioxidant capacity, viz., BAP, were measured. RESULTS: Subjects with abdominal obesity presented significantly higher levels of d-ROMs compared to those with a normal waist circumference (P<0.001). After adjusting for age, sex, alcohol drinking status; smoking status; and triglyceride, low-density lipoprotein levels were found to have a significant positive correlation with abdominal obesity (P<0.001). BAP did not significantly correlate with abdominal obesity. CONCLUSION: We observed a positive association between abdominal obesity and d-ROM concentration. This result indicates that abdominal obesity can increase oxidative stress and may affect the pathways involved in obesity, such as the inflammatory pathway. Such correlation analyses were helpful in revealing the causes, as well as methods to reduce, oxidative stress.

Association between Serum Uric Acid and Oxidative Stress in Korean Adults.

BACKGROUND: Oxidative stress is implicated in the pathogenesis and development of lifestyle-related diseases. In the present study, we evaluated the correlation between the serum uric acid (UA) levels and oxidative status in Korean adults. METHODS: The subjects were 5,093 individuals (2,041 women and 3,052 men) who underwent a health checkup between June 2012 and December 2016. Oxidative stress levels (derivatives of reactive oxygen metabolites [d-ROMs]) and antioxidant potential (biological antioxidant potential [BAP]) were measured. Metabolic markers, including UA, were also examined. RESULTS: Higher serum UA levels were associated with decreased levels of d-ROMs (P<0.05). The UA levels were positively associated with BAP levels (P<0.001). CONCLUSION: Serum UA is related to oxidative status, especially antioxidant capacity, in Korean adults; UA may play a role in antioxidant defense systems in humans.

Human Placental Extract as a Subcutaneous Injection Is Effective in Chronic Fatigue Syndrome: A Multi-Center, Double-Blind, Randomized, Placebo-Controlled Study.

Chronic fatigue (CF) is a common reason for consulting a physician due to affecting quality of life, but only a few effective treatments are available. The aim of this study was to examine the effectiveness of subcutaneous injection of the human placental extract (HPE) on medically indescribable cases of CF and safety in a randomized, double-blind, placebo-controlled clinical trial. A total of 78 subjects with CF were randomly assigned to either a HPE group or a placebo group. Subjects in the HPE group were treated with HPE three times a week subcutaneously for 6 weeks, whereas those in the placebo group with normal saline. Then, the fatigue severity scale (FSS), visual analog scale (VAS) and multidimensional fatigue inventory (MFI) were measured in both CF group and chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF) subgroup. The FSS, VAS and MFI score at baseline were not different between the HPE and placebo group in total subjects with CF. In CFS group, the FSS (p=0.0242), VAS (p=0.0009) and MFI (p=0.0159) scores measured at the end of the study period decreased more in the HPE group than in the placebo group when compared with those at the baseline. There were no significant differences between the HPE group and placebo group in the mean change from baseline in FSS, VAS, and MFI in subjects with ICF during the study period. The subcutaneous injection of HPE was effective in the improvement of CFS.

Salivary cortisol levels, but not salivary α-amylase levels, are elevated in patients with rheumatoid arthritis irrespective of depression.

OBJECTIVES: Stress is recognized as an important factor in the etiology of rheumatoid arthritis (RA). Therefore, we explored multiple aspects of stress in RA patients. METHODS: Salivary cortisol and α-amylase levels were measured as markers of the hypothalamic-pituitary-adrenal axis activity and sympatho-adrenomedullary system activity, respectively. Depression was assessed by the Beck Depression Inventory (BDI) and short-term analysis of the heart rate variability (HRV) was performed to evaluate the autonomic nervous system. RESULTS: The salivary cortisol levels of the RA patients were significantly higher than those of the normal controls (NC; 0.12 ± 0.162 µg/dL vs. 0.068 ± 0.052 µg/dL, P = 0.006). There was no difference in salivary α-amylase levels between the RA and the NC. The BDI levels of the RA patients were significantly higher than the NC (13.7 ± 8.9 vs. 6.4 ± 6.9, P < 0.001). Depression was more prevalent in RA patients than in the NC. The salivary cortisol levels were still significantly higher in the RA than the NC after controlling BDI by logistic regression analysis (P = 0.002). There was no significant difference in the HRV of RA patients and the NC. The evaluation of relationship between stress measures and disease activity markers of RA revealed that only BDI was positively correlated with the visual analogue pain scale. CONCLUSION: Salivary cortisol levels and the BDI of RA patients were higher than those of the NC, and elevated salivary cortisol levels were independent of depression. However, the level of stress may not be correlated with disease activity in RA.

Association between duration of reproductive lifespan and Framingham risk score in postmenopausal women.

CONTEXT: The benefit of estrogen therapy in postmenopausal women is still uncertain. Based upon extensive observational data, it was believed that estrogen was cardioprotective. The relationship between the period of exposure to endogenous estrogens and the risk of cardiovascular disease (CVD) has not been studied in Korean women. OBJECTIVE: To assess associations between reproductive lifespan and CVD by using the Framingham risk score (FRS) in postmenopausal Korean women. DESIGN AND SETTING: This cross-sectional, population-based study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) for the five years 2008-2012,after adjustment for relevant variables using complex sample analysis and data weighting. PARTICIPANTS: Among 25,534 women, 1973 women were enrolled, after excluding those <20 or >80 years of age (n=6194), those with diabetes, CVD or cancer (n=491), those with unrecorded physical measurements (n=7335), those with menarche age ≤8 years or ≥20 years (n=6194), and premenopausal women (n=3347). RESULTS: The FRS tended to show a significant negative correlation with the reproductive lifespan (p<0.001). In multiple linear regression analysis, a negative correlation was observed between the reproductive lifespan and FRS (adjusted relative risk [RR] for <28 reproductive years [shortest lifespan group] compared with 28-33 reproductive years [moderate lifespan group], 1.2, p<0.001 and adjusted RR for >33 reproductive years [longest lifespan group] compared with 28-33 reproductive years [moderate lifespan group], -0.42, p=0.011). CONCLUSION: A longer reproductive lifespan is associated with a lower estimated risk of CVD in the next 10 years in postmenopausal women. This result suggests that estrogen has a long-term protective effect against CVD.

A coronary heart disease prediction model: the Korean Heart Study.

OBJECTIVE: The objectives of this study were to develop a coronary heart disease (CHD) risk model among the Korean Heart Study (KHS) population and compare it with the Framingham CHD risk score. DESIGN: A prospective cohort study within a national insurance system. SETTING: 18 health promotion centres nationwide between 1996 and 2001 in Korea. PARTICIPANTS: 268 315 Koreans between the ages of 30 and 74 years without CHD at baseline. OUTCOME MEASURE: Non-fatal or fatal CHD events between 1997 and 2011. During an 11.6-year median follow-up, 2596 CHD events (1903 non-fatal and 693 fatal) occurred in the cohort. The optimal CHD model was created by adding high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides to the basic CHD model, evaluating using the area under the receiver operating characteristic curve (ROC) and continuous net reclassification index (NRI). RESULTS: The optimal CHD models for men and women included HDL-cholesterol (NRI=0.284) and triglycerides (NRI=0.207) from the basic CHD model, respectively. The discrimination using the CHD model in the Korean cohort was high: the areas under ROC were 0.764 (95% CI 0.752 to 0.774) for men and 0.815 (95% CI 0.795 to 0.835) for women. The Framingham risk function predicted 3-6 times as many CHD events than observed. Recalibration of the Framingham function using the mean values of risk factors and mean CHD incidence rates of the KHS cohort substantially improved the performance of the Framingham functions in the KHS cohort. CONCLUSIONS: The present study provides the first evidence that the Framingham risk function overestimates the risk of CHD in the Korean population where CHD incidence is low. The Korean CHD risk model is well-calculated alternations which can be used to predict an individual's risk of CHD and provides a useful guide to identify the groups at high risk for CHD among Koreans.

The Korean Heart Study: rationale, objectives, protocol, and preliminary results for a new prospective cohort study of 430,920 men and women.

BACKGROUND: To describe the rationale, objectives, protocol, and preliminary results for a new prospective cohort study of cardiovascular disease (CVD) risk factors in South Korea. METHODS: Study members were recruited from participants in routine health assessments at health promotion centres across South Korea. Established and emerging CVD risk factors were measured. Eighteen centres holding electronic health records agreed to linkage of participants' records to future health insurance claims for monitoring of disease events. The recruitment of 430,920 participants (266,782 men, 164,138 women), aged 30-74 years, provides broad geographical reach across South Korea. RESULTS: Risk factor prevalence was more favourable in women than men, and, in general, in the younger rather than older study members. There was also close similarity between the characteristics of the present sample and the Korean National Health and Nutrition Examination Survey. The expected associations between risk factors and both CVD and death were also apparent. CONCLUSIONS: Data from the present sample, based on data linkage, show close agreement with South Korea-wide surveys (for risk factor prevalence) and the extant literature (for risk factor associations). These findings gives confidence in future results anticipated from this cohort study of east Asians - a group that has been traditionally under-researched.

Dietary patterns and functional disability in older Korean adults.

OBJECTIVES: This study examined the relationship between dietary patterns and disability in the Korean elderly. STUDY DESIGN: We used data from a cross-sectional study of 327 men and 460 women aged ≥65 years who completed the 2005 Korea National Health and Nutrition Examination Survey. MAIN OUTCOME MEASURES: A single 24-h dietary recall method was used to assess dietary intake and dietary patterns were identified by cluster analysis. Functional disability was assessed by the activities of daily living (ADL) and instrumental ADL (IADL) scales. The association of dietary patterns with ADL and IADL disability was analyzed by logistic regression adjusting for age, marital status, education, household income, region, chronic conditions, body mass index, smoking, alcohol drinking, physical activity, and energy intake. RESULTS: Two dietary patterns were identified in both men and women: the modified traditional dietary pattern, characterized by a relatively lower consumption of white rice, but higher consumption of fruits, dairy products, and legumes, and the traditional dietary pattern, characterized by high consumption of white rice. After controlling for covariates, in men, those who engaged in modified traditional dietary pattern, compared with traditional dietary pattern, showed a lower likelihood of ADL disability (odds ratio [OR]=0.17, 95% confidence interval [CI]: 0.05-0.56). In women, the modified traditional dietary pattern compared with the traditional pattern was associated with a significantly decreased risk of ADL (OR=0.45, 95% CI: 0.23-0.90) and IADL disability (OR=0.45, 95% CI: 0.28-0.72). CONCLUSIONS: The modified traditional dietary pattern is associated with a decreased risk of functional disability in older Korean adults.

Changes in body composition predict homocysteine changes and hyperhomocysteinemia in Korea.

Cardiovascular disease (CVD) is the primary cause of death in Korea. Hyperhomocysteinemia confers an independent risk for CVD comparable to the risk of smoking and hyperlipidemia. The purpose of this study was to assess the effect of cardiovascular risk factors and body composition change on homocysteine (Hcy) levels in Korean men and women. The association between body composition and Hcy levels was investigated in a 2-yr prospective cohort study of 2,590 Koreans (mean age 45.5±9.6 yr). There were 293 cases of hyperhomocysteinemia (>14 µM/L) at follow-up. Increases in total body fat proportion and decreases in lean body mass (LBM) were significantly associated with increases in Hcy concentration after controlling for confounding factors. Further adjustments for behavioral factors showed that decreases in LBM were associated with Hcy increase. Decrease in LBM also predicted hyperhomocysteinemia at follow-up, after controlling for confounding factors. There was no significant association between change in body mass index (BMI) and Hcy concentrations over time. Hcy changes over time were related to change in LBM and body fat content, whereas BMI or weight change did not predict change in Hcy levels. Changes in ratio of LBM to total fat mass may contribute to hyperhomocysteinemia.

Hair mercury level in smokers and its influence on blood pressure and lipid metabolism.

OBJECT: Smoking is a major risk factor for the development and progression of cardiovascular disease and cigarettes contain a slight amount of mercury. Mercury has been causally linked to cardiovascular diseases. This study evaluated the mercury content in hair according to smoking exposure status and the influence of the mercury level on blood pressure and lipid metabolism. METHODS: We examined mercury concentration in the hair samples from 236 healthy people 16-75-years-of-age who had visited the health promotion center of a university hospital from January 2004 to January 2007. Self-reported cigarette smoking status and baseline health information were obtained using a questionnaire. Blood pressure and serum lipid level according to the mercury concentration were assessed. RESULTS: The mean systolic blood pressure in the smoking exposure group and non-exposure group were 123.2±15.4mmHg and 117.2±15.9mmHg, respectively (p=0.005). The mean diastolic pressure in the smoking exposure group and non-exposed group were 80.2±10.9mmHg and 75.1±11.3mmHg, respectively (p<0.001). Mercury concentration had a positive relationship with systolic and diastolic blood pressure. Compared with the normal and high mercury groups, the normal mercury group demonstrated lower blood pressure, lower triglyceride, and lower smoking amount, but higher high density lipoprotein cholesterol than the high mercury group. There was an increase of mercury concentration in the smoking exposure group. The 20-29 packyear group showed significantly increased odds ratio of mercury content, compared with the non-exposure group (14.00, 95% confidence interval, 5.03-38.96). CONCLUSIONS: Smoking is positively associated with mercury accumulation, and high mercury concentration is associated with increased blood pressure and abnormal lipid metabolism.

The efficacy and safety of a combined alendronate and calcitriol agent (maxmarvil): a postmarketing surveillance study in korean postmenopausal women with osteoporosis.

BACKGROUND: Combined therapy with alendronate and calcitriol may have additive effects on bone density. An observational study was performed to evaluate the efficacy and safety of Maxmarvil, a combinative agent of alendronate (5 mg) and calcitriol (0.5 µg), and to identify factors associated with efficacy. METHODS: A total of 568 postmenopausal women with osteoporosis were enrolled by family physicians in 12 hospitals. The study subjects took Maxmarvil daily for 12 months. Questionnaires about baseline characteristics, socioeconomic status, and daily calcium intake were completed at the first visit. Adverse events were recorded every 3 months and bone mineral density (BMD) in the lumbar spine was measured using dual-energy X-ray absorptiometry at baseline and after 12 months. We evaluated the efficacy and safety of Maxmarvil, and the factors related to BMD improvement. RESULTS: A total of 370 patients were included in final analysis. The median BMD was 0.81 ± 0.12 g/cm(2) at pre-treatment and 0.84 ± 0.13 g/cm(2) after one year. The average BMD improvement was 3.4% ± 6.4% (P < 0.05), and 167 (45.1%) patients showed improvement. Factors associated with improved BMD were continuation of treatment (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.15 to 5.07) and good compliance (OR, 2.54; 95% CI, 1.29 to 5.00). Adverse events were reported by 35 of the 568 patients, with the most common being abdominal pain and dyspepsia. CONCLUSION: Maxmarvil was found to be safe, well tolerated and effective in osteoporosis treatment. Continuation of treatment and good compliance were the factors associated with efficacy.

Serum gamma-glutamyltransferase as a risk factor for general cardiovascular disease prediction in Koreans.

OBJECTIVE: Gamma-glutamyltransferase (GGT) is a novel cardiovascular disease (CVD) risk factor, but its use as an independent factor for general CVD risk prediction remains unclear in general population. This study examined the association between serum GGT concentration and 10-year CVD risk in Koreans. METHODS: This cross-sectional study was performed on 27,270 Koreans. Besides individual components of 10-year CVD risk, body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid and high sensitive C-reactive protein data were used. The study subjects were grouped into quartiles according to the levels of GGT. Analyses relating GGT to 10-year CVD risk greater than 20% used multiple confounders-adjusted logistic regression. RESULTS: Positive correlations were established between log-transformed GGT concentration and 10-year CVD risk (Spearman's rho = 0.51; P < 0.001). Compared to the lowest baseline GGT category, unadjusted odds ratios for 10-year CVD risk greater than 20% were significantly increased from the lowest to the highest GGT quartiles; these results remained significant after adjustments for multiple confounders. CONCLUSION: Increased GGT concentration is associated with the increase in 10-year CVD risk. Serum GGT may be helpful to predict the future risk of general CVD.

Serum total bilirubin concentration is inversely correlated with Framingham risk score in Koreans.

BACKGROUND AND AIMS: Compelling evidence suggests that bilirubin, via its antioxidant potential, has anti-atherogenic properties, and that serum bilirubin concentrations within the reference range for the general population may provide some protection against coronary artery disease (CAD). This study examined the association between serum total bilirubin concentration and Framingham risk score (FRS) in the Korean population. METHODS: This cross-sectional study was performed on 19,792 Koreans. In addition to FRS, data on body mass index, fasting blood glucose, liver enzymes, lipid profile, uric acid, gamma glutamyltransferase, high-sensitive C-reactive protein and total bilirubin were used. RESULTS: Negative correlations were established between log-transformed total bilirubin concentration and FRS (females; r = -0.067, p <0.001, males; r = -0.128, p <0.001). Analyses relating total bilirubin to FRS ≥10% utilized multiple confounder adjusted logistic regression. Unadjusted odd ratios for FRS ≥10% were 0.325 (95% CI: 0.160-0.659, p = 0.002) and 0.342 (95% CI: 0.281-0.417, p <0.001) for log-transformed total bilirubin in females and males, respectively. These inverse relationships remained significant after adjustments for multiple confounders in both genders. CONCLUSIONS: Increased total bilirubin concentrations are associated with the decrease in FRS. Serum total bilirubin may be helpful to decrease the future risk of CAD.

Erosive esophagitis may be related to small intestinal bacterial overgrowth.

OBJECTIVES: Erosive esophagitis (EE) may be related to small intestinal bacterial overgrowth (SIBO) because gastro-esophageal reflux disease has been a comorbid condition of irritable bowel syndrome (IBS), which has been associated with SIBO. We conducted a pilot study to investigate whether EE was associated with SIBO. MATERIAL AND METHODS: Twenty-eight patients with EE according to the Los Angeles classification criteria and 29 sex- and age-matched subjects without EE were enrolled. All subjects underwent esophagogastroduodenoscopy and a lactulose hydrogen breath test. A peak of H2 values >20 ppm above the basal value after 10 g of lactulose ingestion was considered abnormal and suggestive of SIBO. RESULTS: Abnormal lactulose hydrogen breath test results were found in 67% of EE patients, as compared with 37% in the control group; the difference was statistically significant (p = 0.024). Among the subjects without IBS, subjects with EE and controls had 65% and 31% abnormal lactulose hydrogen breath test results, respectively; the difference was also statistically significant (p = 0.032). CONCLUSIONS: Subjects with EE had a higher prevalence of SIBO, as assessed by the lactulose hydrogen breath test, with respect to a control group. These findings may suggest that EE is associated with SIBO.

Effect of human placental extract on health status in elderly koreans.

Objectives. Human placental extract (HPE) has begun to be used in Korea in various ways to improve health, even though evidence-based data is insufficient. This study investigated the effects of HPE on health status in elderly Koreans. Design. Randomized, single-blind, and case-control study design. Setting and Participants. Thirty-nine community-dwelling healthy Koreans ≥65 years of age. Intervention. The participants were randomly categorized into a placebo group (n = 17) and HPE group (n = 22). The HPE group received abdominal subcutaneous injections of HPE for 8 weeks. The placebo group was injected with normal saline. Measurements. The degree of health status was surveyed by the Korean health status measure for the elderly (KoHSME V1.0) at baseline and the end of the study. Results. In the HPE group, the scores of physical function, sexual life, and general heath perception at the end of the study period were significantly improved from baseline (P = .007, .020, and .005, resp.), while the health status of the placebo group remained unchanged during the study period. There was a significant difference over the study period between the two groups in the mean change of the physical function score (P = .036). Conclusion. A HPE injection regimen can improve the health status in elderly Koreans.

The influence of exogenous fat and water on lumbar spine bone mineral density in healthy volunteers.

PURPOSE: Changes in human body composition can affect the accuracy of spine bone mineral density (BMD) measurements. The purpose of this study was to evaluate whether fat and water in the soft tissue of the abdomen influence lumbar spine BMD measurements obtained using dual energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: Duplicate BMD measurements were carried out on healthy volunteers (10 men and 10 women) and the Hologic anthropomorphic spine phantom had on the same day before and after placement of following 3 materials in the abdominal area: lard 900 g, 1.5 cm thick; oil 1.4 liters in a vinyl bag; and water 1.2 liters in a vinyl bag. RESULTS: In the case of human participants, following the placement of exogenous water to mimic extracellular fluid (ECF), there was a significant decrease in lumbar spine BMD (-0.012 g/cm², p=0.006), whereas the placement of exogenous lard and oil to mimic abdominal fat produced a slight increase in lumbar spine BMD (0.006 g/cm², p=0.301; 0.008 g/cm², p=0.250, respectively). The average percentage of lumbar spine BMD change with and without exogenous lard, oil, and water showed increase of 0.51%, and 0.67%, and decrease of 1.02%, respectively. Using the phantom, BMD decreased with the placement of both lard (-0.002 g/cm², p=0.699) and water (-0.006 g/cm², p=0.153); however, there was no difference in BMD after oil placement. CONCLUSION: These results suggest that in cases where changes in fat and ECF volume are similar, ECF exerts a greater influence than fat on DXA lumbar BMD measurements.

Efficacy and safety of human placental extract solution on fatigue: a double-blind, randomized, placebo-controlled study.

Introduction. Fatigue is a common symptom, but only a few effective treatments are available. This study was conducted to assess the efficacy and safety of the human placental extract solution, which has been known to have a fatigue recovery effect. Methods. A total of 315 subjects were randomly assigned to three groups: group 1 (with Unicenta solution administration), group 2 (with exclusively human placental extract administration, excluding other ingredients from the Unicenta solution), and the placebo group. Subsequently, solutions were administered for four weeks. Results. The fatigue recovery rate was 71.00% in group 1, 71.72% in group 2, and 44.21% in the placebo group, which show statistically significant differences between the group 1 and the placebo group (P value = 0.0002), and between group 2 and the placebo group (P value = 0.0001). Conclusion. The human placental extract solution was effective in the improvement of fatigue.

A population-based cohort study of HRT use and breast cancer in Korea.

The incidence of breast cancer has recently been ranked first in Korea. This is a population-based cohort study that aims to evaluate the risk of breast cancer from the use of hormone replacement therapy (HRT). A total of 9579 participants were observed between January 1998 and June 2004; 6108 women who took HRT constituted the HRT group, and 3471 women who did not take HRT constituted the non-HRT group. Using the database from the Korea Central Cancer Registry, the authors examined the incidence of breast cancer from HRT. A total of 26 cases of breast cancer developed in the HRT group as compared with the 13 cases in the non-HRT group, during the follow-up period. The relative risk of developing breast cancer in the HRT group was 1.16 times higher than in the non-HRT group, with a population attributable risk of 29.9%. The risk of breast cancer in the HRT group increased when the risk factors were adjusted in the model.