Lower Relative Handgrip Strength is Significantly Associated with a Higher Prevalence of the Metabolic Syndrome in Adults.

Purpose: In previous studies, there were debates on the association between handgrip strength (HGS) and prevalence of metabolic syndrome. Since body weight is associated with both HGS and prevalence of metabolic syndrome, whether HGS is corrected with body weight (relative HGS) or not (absolute HGS) can directly influence outcome of the study. Therefore, this study analyzed the relationship between HGS and prevalence of metabolic syndrome using both relative and absolute HGS. Methods: A total of 1009 Korean adults (488 men and 521 women) were analyzed. Participants were categorized into three groups according to HGS levels. Logistic regression analysis was used to calculate odds ratio (OR) and 95% confidence interval (CI) of metabolic syndrome associated with both relative and absolute HGS. Results: Lower absolute HGS was associated with lower prevalence of having abnormal blood pressure (OR: 0.60, 95% CI: 0.37-0.97) and glucose levels (OR: 0.54, 95% CI: 0.34-0.88) in men. However, no association was found between absolute HGS and prevalence of metabolic syndrome. However, a significant inverse association was found between relative HGS and prevalence of metabolic syndrome. Compared with participants in the highest tertile, those in the lowest tertile of relative HGS had 2.52 times (95% CI: 1.43-4.46) and 5.01 times (95% CI: 1.66-15.08) higher prevalence of metabolic syndrome in men and women, respectively. Conclusion: Lower relative HGS but not absolute HGS was associated with higher prevalence of metabolic syndrome. Our study showed that there are evident discrepancies in the association between HGS and prevalence of metabolic syndrome whether HGS is corrected by body weight or not.

Relationship between non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance in Korean adults: A cross-sectional study.

BACKGROUND: We investigated the independent and combined impact of obesity and nonalcoholic fatty liver disease (NAFLD) on components and prevalence of metabolic syndrome in Korean adults. METHODS: This study included 1695 adults (500 males and 1,195 females), who took part in a regular health check-up at the community-based health promotion center. Participants were divided according to degree of adiposity and the presence of NAFLD. The components and prevalence of metabolic syndrome were compared. RESULTS: Fasting glucose was significantly higher in nonobese participants with NAFLD compared to obese participants without NAFLD. Logistic regression analysis revealed that the presence of NAFLD was associated with 3.63 times increased prevalence of metabolic syndrome (95% CI: 1.21-10.86) while obesity without NAFLD was associated with 3.84 times increased prevalence of metabolic syndrome (95% CI: 1.57-9.36) in male. In female, the presence of NAFLD was associated with 5.56 times higher prevalence of metabolic syndrome (95% CI: 2.53-12.23) while obesity without NAFLD had 3.46 times increased prevalence of metabolic syndrome (95% CI: 1.64-7.33). CONCLUSIONS: NAFLD is associated with the prevalence of metabolic syndrome, independent of adiposity. In females, NAFLD may be a more important factor than obesity for risk of metabolic syndrome.

Association between cardiorespiratory fitness and the prevalence of metabolic syndrome among Korean adults: a cross sectional study.

BACKGROUND: The purpose of the current study was to investigate the association between cardiorespiratory fitness (CRF), measured by a simple step test, and the prevalence of metabolic syndrome among Korean adults, in a cross sectional design. METHODS: A total of 1,007 Korean adults (488 men and 519 women) who underwent routine health checkups were recruited. CRF was measured by Tecumseh step test. The National Cholesterol Education Program's Adult Treatment Panel III guideline was used to determine the prevalence of metabolic syndrome. A logistic regression was performed to reveal possible associations. RESULTS: The results of the study showed that a lower level of CRF was significantly associated with a higher prevalence of metabolic syndrome in men, but not in women. On the other hand, higher BMI was associated with a higher prevalence of metabolic syndrome in both men and women. However, BMI was not associated with fasting glucose nor hemoglobinA1c in men. When the combined impact of BMI and CRF on the prevalence of metabolic syndrome was analyzed, a significantly increased prevalence of metabolic syndrome was found in both men (odds ratio [OR]: 18.8, 95% Confidence Interval [CI]: 5.0-70.5) and women (OR: 8.1, 95% CI: 2.8-23.9) who had high BMI and low cardiorespiratory fitness. On the other hand, the prevalence of metabolic syndrome was only increased 7.9 times (95% CI: 2.0-31.2) in men and 5.4 times (95% CI: 1.9-15.9) in women who had high level of CRF and high BMI. CONCLUSION: In conclusion, the current study demonstrated the low CRF and obesity was a predictor for metabolic syndrome in Korean adults.

Reduced serum total osteocalcin is associated with central obesity in Korean children.

BACKGROUND: Recently, osteocalcin (OC), an osteoblast-derived hormone, has been suggested as a new link between obesity and insulin resistance in humans. However, few studies regarding the relationship between OC and obesity in Asian children have been published. We investigated the association of OC with adiposity, insulin resistance and metabolic syndrome (MetS) in Korean children. METHODS: Two hundred and nine (100 boys, 109 girls) children (age: 9.78 ± 1.05 years, body mass index (BMI): 22.27 ± 5.34 kg/m(2)) participated in this cross-sectional study. Anthropometric parameters, insulin resistance, lipid profiles, total OC, and an inflammatory marker, C-reactive protein (CRP), were measured. MetS phenotype was also determined. RESULTS: Serum total OC levels were significantly lower in overweight or obese children (76.96 ± 27.08 ng/ml vs. 66.91 ± 21.39 ng/ml, p = 0.020) and it was negatively associated with body fat after controlling for age, gender and BMI. Serum total OC concentrations were significantly lower in participants with central obesity or at least two components of MetS driven by waist circumference than they were in those with none. Stepwise linear regression results also showed that serum total OC was partially explained by age, gender, waist-to-hip ratio, and fasting glucose. CONCLUSIONS: This study supported a negative association between serum total OC and adiposity in children. OC may be associated with childhood central obesity; however, further research using more accurate measurements is needed to identify the association between these variables.

Mitochondrial DNA copy number in peripheral blood is independently associated with visceral fat accumulation in healthy young adults.

Aims. Visceral obesity is associated with an increased risk of cardiometabolic diseases and it is important to identify the underlying mechanisms. There is growing evidence that mitochondrial dysfunction is associated with metabolic disturbances related to visceral obesity. In addition, maintaining mitochondrial DNA (mtDNA) copy number is important for preserving mitochondrial function. Therefore, we investigated the relationship between mtDNA copy number and visceral fat in healthy young adults. Methods. A total of 94 healthy young subjects were studied. Biomarkers of metabolic risk factors were assessed along with body composition by computed tomography. mtDNA copy number was measured in peripheral leukocytes using real-time polymerase chain reaction (PCR) methods. Results. The mtDNA copy number correlated with BMI (r = -0.22, P = 0.04), waist circumference (r = -0.23, P = 0.03), visceral fat area (r = -0.28, P = -0.01), HDL-cholesterol levels (r = 0.25, P = 0.02), and hs-CRP (r = 0.32, P = 0.02) after adjusting for age and sex. Both stepwise and nonstepwise multiple regression analyses confirmed that visceral fat area was independently associated with mtDNA copy number (ß = -0.33, P < 0.01, ß = 0.32, and P = 0.03, resp.). Conclusions. An independent association between mtDNA content and visceral adiposity was identified. These data suggest that mtDNA copy number is a potential predictive marker for metabolic disturbances. Further studies are required to understand the causality and clinical significance of our findings.

Effect of Active Hexose Correlated Compound (AHCC) in alcohol-induced liver enzyme elevation.

To investigate the effects of Active Hexose Correlated Compound (AHCC) supplementation and the mechanism action of AHCC in patients with alcohol-induced mildly elevated liver enzyme levels, participants were randomly allocated to the placebo, 1 g AHCC, or 3 g AHCC group and took the supplement for 12 wk. Subjects visited the hospital for clinical and biochemical measurements, for examination of adverse events, to return unused supplements, and to obtain their next supplements. Biochemical tests including liver enzymes, a questionnaire survey, and anthropometric measurements were collected at baseline and every 4 wk thereafter. Adherence and adverse events were evaluated. After 12 wk of supplementation, the percentage change in alanine aminotransferase (ALT) level was significantly different between the placebo (4.02±59.07%) and both AHCC groups (1 g AHCC: 223.89±20.59%, 3 g AHCC: 224.09±30.73%) (p=0.04). Serum levels of tumor necrosis factor-α (p<0.05) and interleukin-1ß (p<0.01) were significantly lower, while those of adiponectin were higher in both AHCC groups than in the placebo group (p<0.01). AHCC supplementation for 12 wk may improve the levels of liver enzymes and circulating pro-inflammatory and anti-inflammatory cytokines in patients with alcohol-induced liver enzyme elevation with mildly elevated liver enzyme levels.

Visceral adiposity is associated with SIRT1 expression in peripheral blood mononuclear cells: a pilot study.

Sirtuin1 (SIRT1) is activated during calorie restriction and appears to be related to energy balance through glucose or lipid metabolism and insulin signaling. These findings suggest that SIRT1 may play a role in the pathophysiology of visceral obesity. Therefore, we investigated the relationship between SIRT1 gene expression in circulating peripheral blood mononuclear cells (PBMCs) and abdominal visceral adiposity as measured by computed tomography. We recruited 43 men and women without history of diabetes or cardiovascular disease Biomarkers of metabolic disease and body composition by computed tomography were assessed. SIRT1 gene expression was determined using isolated PBMCs. SIRT1 expression levels negatively correlated with body mass index, waist circumference, abdominal visceral fat area, and homeostasis model of assessment of insulin resistance (HOMA-IR) and positively correlated with adiponectin levels. Results of step-wise multiple regression analysis revealed that abdominal visceral fat area and HOMA-IR were independently associated with SIRT1 expression. The significant association between abdominal visceral fat accumulation and SIRT1 gene expression in PBMCs suggests that SIRT1 may be a new therapeutic target for the prevention of disease related to obesity, especially visceral obesity.

Association between serum osteocalcin and insulin resistance in postmenopausal, but not premenopausal, women in Korea.

OBJECTIVE: Menopause is known to compound cardiometabolic disease risk factors, and a deeper understanding of the mechanism of this effect is needed. Recently, the osteoblast-derived protein osteocalcin was found to function as a regulator of glucose and fat metabolism. However, there is a lack of studies comparing the extent of association between osteocalcin and glucose metabolism in postmenopausal versus premenopausal women. METHODS: To examine the relationship between serum osteocalcin and glucose metabolism in premenopausal versus postmenopausal women, we identified well-balanced pairs of premenopausal and postmenopausal women matched on propensity score. The interactions between serum osteocalcin levels and menopause status on fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and the associations of these parameters with serum osteocalcin levels in premenopausal and postmenopausal women were statistically analyzed. RESULTS: Among the 61 matched pairs of premenopausal and postmenopausal women, significant interactions of menopause status and serum osteocalcin levels were observed for fasting insulin (P = 0.031) and HOMA-IR (P = 0.019). Furthermore, after logarithmical transformation for each variable, significant relationships between serum osteocalcin levels and fasting insulin (r = -0.307, P = 0.016) and HOMA-IR (r = -0.298, P = 0.019) were found in postmenopausal women, but no significant correlation was seen in premenopausal women (r = 0.002, P = 0.989 and r = 0.062, P = 0.633, respectively). CONCLUSIONS: Our study shows that the association between serum osteocalcin and insulin resistance varies according to menopause status, and that serum osteocalcin is associated with insulin resistance in postmenopausal women but not in premenopausal women. As postmenopausal women have a higher prevalence of obesity and other cardiac risk factors, the potential endocrine actions of osteocalcin may serve as a marker of metabolism in menopause status. Further studies are needed to define the precise nature of the relationship between osteocalcin and insulin resistance in postmenopausal women.

The association between chemerin and homeostasis assessment of insulin resistance at baseline and after weight reduction via lifestyle modifications in young obese adults.

BACKGROUND: Chemerin is a recently discovered adipocytokine, associated with adiposity and insulin sensitivity. The current study investigated the effects of lifestyle intervention on circulating chemerin level and its association with insulin resistance and adiponectin in human. METHODS: Forty male and 20 female obese adults (mean age: 29.7±5.7 y, mean BMI: 29.3±4.5 kg/m(2)) completed an 8-week lifestyle intervention program, which consisted of a home-based diet and exercise program. Anthropometric measurements and biomarkers were assessed at the baseline and at the end of the study. RESULTS: Eight weeks of lifestyle intervention reduced body weight, visceral fat and subcutaneous fat by 3.8%, 15.3% and 11.5%, respectively. The lifestyle intervention further reduced fasting insulin (10.9±6.6 vs. 7.6±5.3 µU/ml, p<0.001) and homeostasis assessment of insulin resistance (HOMA-IR) (2.3±1.5 vs. 1.6±1.2, p<0.001), chemerin (103.3±20.7 vs. 96.5±19.5 ng/ml, p<0.001) and hs-CRP levels (1.3±1.8 vs. 0.2±0.2 mg/dl, p<0.001) while it increased fasting pentraxin (PTX) 3 (0.6±0.7 vs. 0.7±0.4 ng/ml, p=0.049) level. The Δ chemerin levels correlated with Δ insulin (r=0.349, p=0.024) and HOMA-IR (r=0.333, p=0.36) even after adjusting for age and gender. CONCLUSION: The lifestyle intervention reduced circulating chemerin levels independent of visceral fat mass and adiponectin. Chemerin levels are associated with insulin resistance at the baseline and after the lifestyle intervention.

Therapeutic lifestyle modification program reduces plasma levels of the chemokines CRP and MCP-1 in subjects with metabolic syndrome.

OBJECTIVE: The purpose of this study was to examine the effects of a 6-month therapeutic lifestyle modification (TLM) program on chemokines related to oxidative stress, inflammation, endothelial dysfunction, and arterial stiffness in subjects with metabolic syndrome (MetS). METHODS: The authors performed a randomized controlled trial, assigning 52 women (mean age 62.7 ± 9.0 years) with MetS to a TLM intervention group (n = 31) or a control group (n = 21). The authors provided the TLM intervention group with health screening, exercise, low-calorie diet, and health education and counseling for 6 months and instructed the control group to maintain their usual lifestyle behaviors. Outcome variables included levels of myeloperoxidase (MPO), oxidized low-density lipoprotein (LDL), adiponectin, leptin, resistin, high-sensitivity C-reactive protein (hs-CRP), interleukin-1ß, interleukin-6, tumor necrosis factor-alpha (TNF-α), CD40L, monocyte chemotactic protein-1 (MCP-1), retinol-binding protein 4 (RBP-4), endothelin-1, and brachial-ankle pulse wave velocity. The authors used generalized estimating equation (GEE) analyses to estimate the effects of the TLM program. RESULTS: After the 6-month TLM program, hs-CRP levels decreased significantly, and MCP-1 levels increased at a significantly slower rate in the TLM group than they did in the control group (all p < .05). CONCLUSION: These results indicate that a TLM program could be effective for improving patient inflammatory states and may also be effective in preventing cardiovascular complications in subjects with MetS.

Serum Ferritin Is Differentially Associated with Anti-oxidative Status and Insulin Resistance in Healthy Obese and Non-obese Women.

BACKGROUND: Ferritin is known to be associated with insulin resistance (IR) and oxidative stress; however, recent studies have shown that there is an association between ferritin and anti-oxidative status. To date, the biphasic response of ferritin to oxidative stress has not been fully evaluated. Thus, we investigated the association between ferritin and IR and anti-oxidative status in obese and non-obese women. METHODS: We evaluated the homeostasis model assessment of insulin resistance (HOMA-IR) and total anti-oxidant status (TAS) in a total of 111 healthy women between the ages of 32 and 68 years. RESULTS: In all of the study subjects, ferritin levels were positively correlated with age (r = 0.38, P < 0.001), body mass index (r = 0.24, P = 0.01), TAS (r = 0.38, P < 0.001) and HOMA-IR (r = 0.20, P = 0.04). In the subgroup analysis, ferritin levels were correlated with age (r = 0.39, P < 0.001) and TAS (r = 0.43, P < 0.001) in the non-obese group and with insulin (r = 0.50, P = 0.02) and HOMA-IR (r = 0.52, P = 0.01) levels in the obese group. On stepwise multiple linear regression analysis, ferritin was found to be independently associated with TAS (B = 177.16, P < 0.0001) in the non-obese group and independently associated with HOMA-IR (B = 30.36, P = 0.01) in the obese group. CONCLUSION: Our findings suggest ferritin is associated with IR in obese women and with anti-oxidative status in non-obese women. Further studies are warranted to elucidate the precise role of ferritin in obesity.

The association between pentraxin 3 and insulin resistance in obese children at baseline and after physical activity intervention.

BACKGROUND: The role of pentraxin-3 (PTX3) in the development of insulin resistance is still not clear. We aimed to test 1) whether circulating PTX3 levels are associated with insulin resistance and 2) whether changes in PTX3 levels after the physical activity are associated with changes in insulin resistance. METHODS: Fifty-seven overweight or obese children (39 boys, 18 girls; age: 12.04±0.82y, BMI: 26.5±1.2 kg/m²) participated in the study. All participants were housed together and their amount of physical activity (1823.5±1.34 kcal/day) and food intake (1882±68.8 kcal/day) were tightly controlled. RESULTS: Circulating PTX3 levels at baseline were negatively associated with fasting insulin (r=-.336, p=0.012) and homeostasis model assessment of insulin resistance (HOMA-IR) (r=-.334, p=0.014) even after adjustment for BMI and Tanner stage. The degree of change in PTX3 levels notably associated with changes in fasting insulin (r=-.280, p=0.035) and HOMA-IR (r=-.281, p=.034) in response to the physical activity intervention. Subgroup analysis further indicates that HOMA-IR was improved more in subjects whose PTX3 levels were increased compared with subjects who PTX3 levels were decreased (HOMA-IR delta: -2.33±1.3 vs -1.46±0.70, p=0.004). CONCLUSION: PTX3 is negatively associated with insulin resistance and associated with changes in insulin resistance induced by physical activity in overweight and obese children.

Chemerin and adiponectin contribute reciprocally to metabolic syndrome.

Obesity and metabolic syndrome (MetS) are considered chronic inflammatory states. Chemerin, a novel adipokine, may play an important role in linking MetS and inflammation. We investigated the association of chemerin with inflammatory markers and with characteristics of MetS in apparently healthy overweight and obese adults. We studied 92 adults; 59 men and 33 women whose average body mass index (BMI) was 28.15 ± 5.08 kg/m(2). Anthropometric parameters, insulin resistance indices, lipid profiles, and inflammatory markers including high sensitivity C-reactive protein (hsCRP), pentraxin 3 (PTX3), adiponectin, and chemerin were measured. Controlling for age, gender, and BMI, serum chemerin level was positively correlated with body fat and serum triglyceride, and negatively correlated with adiponectin and high density lipoprotein cholesterol (HDL- C), and was not correlated with altered hsCRP or PTX3 levels. Among the low, moderate and high chemerin groups, high chemerin individuals are more likely to have lower HDL-C. Conversely, individuals in the low adiponectin group are more likely to have lower HDL-C and show more MetS phenotypic traits than moderate and high adiponectin subjects. To determine the relationships of chemerin and adiponectin to MetS and its components, participants were stratified into four groups based on their chemerin and adiponectin levels (high chemerin/high adiponectin, high chemerin/low adiponectin, low chemerin/high adiponectin, or low chemerin/low adiponectin). Participants who were in the high chemerin/low adiponectin group more likely to have dyslipidemia and MetS (OR: 5.79, 95% CI:1.00-33.70) compared to the other three group. Our findings suggest that chemerin and adiponectin may reciprocally participate in the development of MetS.

The relationship between leukocyte mitochondrial DNA contents and metabolic syndrome in postmenopausal women.

OBJECTIVE: Menopause is associated with increased risk of metabolic syndrome. There is growing evidence that mitochondrial dysfunction may lead to obesity and insulin resistance, which are major components of metabolic syndrome. The purpose of this study was to illuminate the relationship between mitochondrial function using leukocyte mitochondrial DNA copy number and metabolic syndrome in postmenopausal women. METHODS: The present study included 144 postmenopausal women. Women with cardiovascular disease were excluded from the study sample. Anthropometric evaluation and biochemical tests were performed. Leukocyte mitochondrial DNA copy numbers were then measured. RESULTS: The levels of leukocyte mitochondrial DNA copy number were lower among participants with metabolic syndrome than among those without metabolic syndrome (P < 0.01). As the number of components of metabolic syndrome increased, the concentration of leukocyte mitochondrial DNA copy number decreased (P = 0.02). Leukocyte mitochondrial DNA copy number was negatively correlated with waist circumference (r = -0.19, P = 0.03), fasting insulin (r = -0.19, P = 0.03), total cholesterol (r = -0.22, P < 0.01), and triglyceride (r = -0.37, P < 0.01). Leukocyte mitochondrial DNA copy number was positively associated with serum 25-hydroxyvitamin D levels (r = 0.94, P = <0.01). Multiple logistic regression analysis showed that leukocyte mitochondrial DNA copy number (odds ratio, 0.030; 95% CI, 0.002-0.437, P = 0.01) was independently associated with metabolic syndrome after adjustment for potential confounding variables including age, body mass index, homeostasis model assessment of insulin resistance, 25-hydroxyvitamin D, adiponectin, and high-sensitivity C-reactive protein. CONCLUSIONS: Leukocyte mitochondrial DNA copy number was independently associated with metabolic syndrome in postmenopausal women.

High-sensitivity C-reactive protein is independently associated with arterial stiffness in women with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is associated with higher incidences of cardiovascular events and with increased mortality from coronary heart disease. There is increasing evidence that MetS presents as a proinflammatory and prothrombotic state. OBJECTIVES: The purposes of this study were to investigate the relationships among adiponectin (a marker for adipocytokines), high-sensitivity C-reactive protein (hs-CRP, a marker for inflammation), and brachial-ankle pulse-wave velocity (ba-PWV, a marker for arterial stiffness) in MetS and to identify predictors of ba-PWV, which indicates subclinical atherosclerosis. METHODS: The present study is a cross-sectional, secondary analysis of data collected as part of a longitudinal, randomized controlled trial that tested the effectiveness of a therapeutic lifestyle modification for Korean women with MetS (N = 52). We used the definition for MetS suggested by the National Cholesterol Education Program Adult Treatment Panel III. RESULTS: Adiponectin was negatively correlated with hs-CRP (r = -0.316, P = .027) and ba-PWV (r = -0.284, P = .048), and hs-CRP was positively correlated with ba-PWV (r = 0.341, P = .016). Women with high hs-CRP and low adiponectin levels also had greater ba-PWV levels (P = .041). Levels of hs-CRP were independently associated with ba-PWV after adjusting for age, body mass index, and number of MetS components, whereas no independent association was identified for adiponectin. CONCLUSION: Levels of hs-CRP may provide important prognostic information in terms of future cardiovascular risk in women with MetS.

Mitochondrial DNA copy number in peripheral blood in polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is associated with insulin resistance and various metabolic diseases; and recently, elevated oxidative stress has been detected in PCOS. Mitochondria are highly susceptible to oxidative damage; and disordered mitochondrial function at the cellular level can impact whole-body metabolic homeostasis, leading to the hypothesis that abnormalities in markers of mitochondrial metabolism are related to PCOS. We compared mitochondrial DNA (mtDNA) copy number in women with and without PCOS and investigated the independent relationship between mtDNA copy number and PCOS after adjustment for metabolic parameters. Fifty women with PCOS and 60 age- and body mass index-matched healthy women were studied. Mitochondrial DNA copy numbers as well as metabolic parameters and indices of insulin resistance were assessed. Mitochondrial DNA copy numbers were significantly lower in women with PCOS (P < .01). In the PCOS group, mtDNA copy number was negatively correlated with indices of insulin resistance, waist circumference, and triglyceride levels and positively correlated with sex hormone-binding globulin levels. In multiple logistic regression, the corresponding odds ratios (95% confidence interval) for PCOS by log-transformed mtDNA copy number and homeostasis model assessment of insulin resistance were 0.15 (0.04-0.56) and 4.26 (1.43-12.68), respectively, after adjustment for age, body mass index, and other metabolic factors. We report decreased mtDNA copy numbers in PCOS patients in relation to controls independently of insulin resistance or other metabolic factors. The pathophysiological and clinical significance of this finding requires further investigation.

Serum carcinoembryonic antigen is associated with metabolic syndrome in female Korean non-smokers.

BACKGROUND: Carcinoembryonic antigen (CEA), a serological marker of malignant tumors, demonstrates a modest increase under nonmalignant conditions and the pro-inflammatory features of CEA suggest that CEA may be related to insulin resistance and metabolic syndrome. METHODS: A total of 7075 female Korean non-smokers who underwent health check-ups were analyzed in the present study. The interquartile cutoff values for serum CEA concentrations were 0.39, 0.84, and 1.40 ng/ml. RESULTS: The prevalence of metabolic syndrome increased significantly with the increasing CEA quartiles, and the age-adjusted mean CEA concentration increased consistently with each additional component of metabolic syndrome. Logistic regression analysis adjusted for age, alcohol intake, exercise, body mass index, total cholesterol, WBC count, and hsCRP showed that the third and fourth CEA quartiles were associated with metabolic syndrome with odds ratios of 1.29 (95% CI 1.07 to 1.63 P<0.001) and 1.39 (95% CI 1.10 to 1.66, P<0.001), respectively. CONCLUSION: In female Korean non-smokers, serum CEA was independently associated with metabolic syndrome. The pathophysiologic and clinical significance of these findings requires further investigation.

Monocyte chemoattractant protein-1 is related to metabolic syndrome and homocysteine in subjects without clinically significant atherosclerotic cardiovascular disease.

BACKGROUND: The features of the metabolic syndrome include glucose intolerance, hypertension, dyslipidemia, and central obesity, all of which are risk factors for diabetes and cardiovascular disease. Monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) play a key role in atherosclerosis. We examined the association between chemokines, such as MCP-1 and IL-8, and metabolic syndrome. METHODS: The present study was comprised of 54 men and 126 women. Subjects with cardiovascular disease such as myocardial infarction, TIA and cerebral infarction were excluded. RESULTS: MCP-1 was positively correlated with homeostasis model assessment of insulin resistance, homocysteine, and mean pulse wave velocity, but IL-8 was not. In multiple regression analysis, age, HOMA-IR and homocysteine were found to be an independent factor associated with MCP-1 adjusted by gender, waist, systolic blood pressure, triglyceride, HDL-cholesterol, and hs-CRP. After adjustment for age and gender, mean MCP-1 was higher in subjects with metabolic syndrome and in subject with high blood pressure among the individual components of the metabolic syndrome. CONCLUSION: MCP-1 was associated with a low-grade systemic inflammatory reaction which is often found in the metabolic syndrome.

Effects of a therapeutic lifestyle modification program on inflammatory chemokines and insulin resistance in subjects with metabolic syndrome.

BACKGROUND: Although therapeutic lifestyle modification (TLM) effectively improves the values of diagnostic biomarkers of metabolic syndrome, less is known about its effects on inflammatory chemokines and insulin resistance (IR) in patients with this syndrome. Objectives. To examine the effects of a short-term TLM program on inflammatory chemokines (monocyte chemoattractant protein-1 [MCP-1], retinol binding protein-4 [RBP-4]) and IR in subjects with metabolic syndrome. METHOD: Twenty-nine women (aged 66.5 ± 9.5 years) with metabolic syndrome were randomly assigned to the TLM intervention group (n = 16) or control group (n = 13). The TLM intervention group was provided with 4 weeks of health screening, education, exercise, diet, and counseling. Participants in the control group were instructed to maintain their usual lifestyle behavior. Outcome variables measured included MCP-1, RBP-4, fasting glucose, fasting insulin, and homeostasis model assessment (HOMA). An intention-to-treat strategy was not followed, and the final number of subjects in the analysis was 22 (14 in the TLM group and 8 in the control group). RESULTS: After a 4-week TLM program, MCP-1, fasting insulin, and HOMA were significantly decreased in the TLM group compared to those in the control group (all p < .05). CONCLUSIONS: We conclude that a short-term TLM program could be effective for improving inflammatory state and IR, which are significant preceding biomarkers for cardiovascular complications in subjects with metabolic syndrome.

Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women.

PURPOSE: The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. MATERIALS AND METHODS: A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. RESULTS: After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p < 0.001) whereas body weight was still positively related to BMD of all sites (p < 0.001). Percentage body fat and waist circumference were much higher in the fracture group than the non-fracture group (p = 0.0383, 0.082 respectively). Serum glucose levels were positively correlated to lumbar BMD (p = 0.016), femoral neck BMD (p = 0.0335), and femoral trochanter BMD (p = 0.0082). Serum high density lipoprotein cholesterol (HDLC) was positively related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). CONCLUSION: In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.