Lipid-lowering treatment practice patterns in korea: comparison with the data obtained from the CEPHEUS Pan-Asian study.

AIM: The Pan-Asian CEPHEUS study assessed low-density lipoprotein cholesterol (LDL-C) goal attainment among patients under lipid-lowering therapy. We compared Korean and other Asian data in order to investigate international variations in clinical practice in the field of cardiology. METHODS: Hypercholesterolemic patients ≥18 years of age who had been on lipid-lowering treatment for ≥3 months were recruited from eight Asian countries. The lipid concentrations were measured, and demographic and other relevant data were collected. In addition, the cardiovascular risk was determined using criteria established in the updated 2004 NCEP guidelines. RESULTS: In Korea, 92 cardiologists enrolled 1,584 patients. The data of these patients were compared with those for 2,060 patients enrolled by 135 cardiologists from other Asian countries in the CEPHEUS study. The proportion of high-risk patients, frequency of use of more potent LDL-C-lowering regimens and rate of LDL-C goal attainment were significantly greater in the Korean subjects than those observed in the other Asian populations. In addition, the Korean patients were more likely to achieve the LDL-C target (odds ratio=1.37, 95% confidence interval 1.11-1.70) after adjusting for the LDL-C target level, use of potent LDL-C-lowering regimens, the baseline LDL-C level, age and systolic blood pressure. CONCLUSIONS: There was a significant difference in the goal attainment rate between Korea and the other Asian countries. Korean cardiologists appear to be relatively more aggressive with lipid-lowering treatment than other Asian cardiologists.

Socioeconomic costs of overweight and obesity in Korean adults.

This study was conducted to estimate the socioeconomic costs of overweight and obesity in a sample of Korean adults aged 20 yr and older in 2005. The socioeconomic costs of overweight and obesity include direct costs (inpatient care, outpatient care and medication) and indirect costs (loss of productivity due to premature deaths and inpatient care, time costs, traffic costs and nursing fees). Hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, colon cancer and osteoarthritis were selected as obesity-related diseases. The population attributable fraction (PAF) of obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation (NHIC) cohort data and the 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Direct costs of overweight and obesity were estimated at approximately U$1,081 million equivalent (men: U$497 million, women: U$584 million) and indirect costs were estimated at approximately U$706 million (men: U$527 million, women: U$178 million). The estimated total socioeconomic costs of overweight and obesity were approximately U$1,787 million (men: U$1,081 million, women: U$706 million). These total costs represented about 0.22% of the gross domestic product (GDP) and 3.7% of the national health care expenditures in 2005. We found the socioeconomic costs of overweight and obesity in Korean adults aged 20 yr and older are substantial. In order to control the socioeconomic burden attributable to overweight and obesity, effective national strategies for prevention and management of obesity should be established and implemented.

Relation between alanine aminotransferase concentrations and visceral fat accumulation among nondiabetic overweight Korean women.

BACKGROUND: Alanine aminotransferase (ALT) is used as a surrogate marker for nonalcoholic fatty liver disease (NAFLD), which is frequently observed among obese subjects. Reported data were scanty about the relation between ALT concentrations and visceral fat accumulation measured by computed tomographic (CT) scanning in a large sample. OBJECTIVE: We investigated the association between ALT concentrations and visceral fat accumulation measured by CT scanning, among nondiabetic overweight Korean women. DESIGN: A cross-sectional study was performed in 903 nondiabetic overweight [body mass index (BMI; in kg/m(2)) > or = 25] Korean women aged 20-80 y. The area of abdominal visceral adipose tissue (VAT) was measured by CT scan. Anthropometric and cardiometabolic variables were measured. RESULTS: Elevated ALT (> 40 IU/L) concentrations were found in 14.9% of the subjects. ALT concentrations were significantly correlated with all anthropometric and cardiometabolic variables after adjustment for age and alcohol consumption (P < 0.05). The adjusted odds ratios for elevated ALT concentrations according to the quartiles of VAT were 1.51 (95% CI: 0.83, 2.76), 3.16 (95% CI: 1.55, 6.49), and 15.15 (95% CI: 4.57, 50.00) in the second (76.9-102.6 cm(2)), the third (102.7-135.0 cm(2)), and the fourth (135.1-382.7 cm(2)) quartiles, respectively, compared with the first quartile (23.0-76.8 cm(2)) (P for trend < 0.001). In the multiple linear regression model, the VAT was significantly positively associated with ALT concentrations (standardized beta = 0.206, P < 0.001), whereas the regression coefficients of other anthropometric and cardiometabolic variables were not significant. CONCLUSIONS: ALT concentrations have a strong association with visceral fat accumulation, and VAT is the main predictor of elevated ALT concentrations in the context of NAFLD among nondiabetic overweight Korean women.