Reference Intervals for Plasma Amyloid ß in Korean Adults Without Cognitive Impairment.

Amyloid ß (Aß) peptides are important components of plaques in patients with Alzheimer's disease (AD). Recent studies suggest that a low plasma ratio of Aß42 to Aß40 may precede the development of the sporadic form of AD. The aim of this study was to establish reference intervals for plasma Aß in Korean adults. A total of 370 apparently healthy individuals (181 males and 189 females aged 40-69 yr) without cognitive impairment were enrolled. Plasma concentrations of Aß40 and Aß42 were measured by using a human amyloid ß assay kit (Immuno-Biological Laboratories, Japan). Reference intervals were established according to the "CLSI guidelines for defining, establishing, and verifying reference intervals in the clinical laboratory". There was no need to partition the data with respect to gender or age group. The 95th percentile reference intervals for Aß40 and Aß42 were 127-331 pg/mL and 2.31-19.84 pg/mL, respectively. The reference interval for the Aß42/Aß40 ratio was 0.011-0.092. Plasma Aß concentrations obtained in this study could be used as reference intervals for clinical purposes.

The Effects of Mind Subtraction Meditation on Depression, Social Anxiety, Aggression, and Salivary Cortisol Levels of Elementary School Children in South Korea.

This study analyzed the effects of a school-based mind subtraction meditation program on depression, social anxiety, aggression, and salivary cortisol levels of 42 elementary school children in South Korea. The research design was a nonequivalent group comparison with pretest and post-test. The experimental group was given 8weeks of the meditation program. The results showed social anxiety, aggression, and salivary cortisol levels were significantly lowered in the experimental group. This demonstrated that the school-based mind subtraction meditation program could be effective in improving psychosocial and behavioral aspects of mental health in elementary school children.

Technical skills and training of upper gastrointestinal endoscopy for new beginners.

The incidence of gastric cancer remains high in South Korea. Upper gastrointestinal (GI) endoscopy, i.e., esophagogastroduodenoscopy (EGD), has a higher diagnostic specificity and sensitivity than the upper GI series. Additionally, EGD has the ability to biopsy, through taking a tissue of the pathologic lesion. Successful training of EGD procedural skills require a few important things to be learned and remembered, including the posture of an examinee (e.g., left lateral decubitus and supine) and examiner (e.g., one-man standing method vs one-man sitting method), basic skills (e.g., tip deflection, push forward and pull back, and air suction and infusion), advanced skills (e.g., paradoxical movement, J-turn, and U-turn), and intubation techniques along the upper GI tract (e.g., oral cavity, pharynx, larynx including vocal cord, upper and middle and lower esophagus, gastroesophageal junction, gastric fundus, body, and antrum, duodenal bulb, and descending part of duodenum). In the current review, despite several limitations, we explained the intubation method of EGD for beginners. We hope this will be helpful to beginners who wish to learn the procedure.

Colonoscopy procedural skills and training for new beginners.

The incidence of colorectal cancer has been increasing in the developed world including South Korea and China. Colonoscopy allows for greater diagnostic specificity and sensitivity compared with other types of examinations, such as the stool occult blood test, barium enema, and computed tomography colonography. Therefore, in recent years, the demand for colonoscopies has grown rapidly. New beginners including primary care physicians may help meet the increasing demand by performing colonoscopies. However, it is a challenge to learn the procedure due to the long learning-curve and the high rate of complications, such as perforation and bleeding, as compared to gastroscopy. Thus, considerable training and experience are required for optimal performance of colonoscopies. In order to perform a complete colonoscopic examination, there were a few important things to learn and remember, such as the position of examinee (e.g., left and right decubitus, supine, and prone) and examiner (two-man method vs one-man standing method vs one-man sitting method), basic skills (e.g., tip deflection , push forward and pull back, torque, air suction and insufflation), advanced skills (e.g., jiggling and shaking, right and left turn shortening, hooking, and slide-by technique), assisting skills (e.g., position change of examinee, abdominal compression, breathing-holding, and liquid-infusion technique), and intubation techniques along the lower gastrointestinal tract. In this article, we attempt to describe the methods of insertion and advancement of the colonoscope to the new beginners including primary care physician. We believe that this article may be helpful to the new beginners who wish to learn the procedure.

Derivation and implementation of the boundary integral formula for the convective acoustic wave equation in time domain.

Kirchhoff's formula for the convective wave equation is derived using the generalized function theory. The generalized convective wave equation for a stationary surface is obtained, and the integral formulation, the convective Kirchhoff's formula, is derived. The formula has a similar form to the classical Kirchhoff's formula, but an additional term appears due to a moving medium effect. For convenience, the additional term is manipulated to a final form as the classical Kirchhoff's formula. The frequency domain boundary integral can be obtained from the current time domain boundary integral form. The derived formula is verified by comparison with the analytic solution of source in the uniform flow. The formula is also utilized as a boundary integral equation. Time domain boundary element method (BEM) analysis using the boundary integral equation is conducted, and the results show good agreement with the analytical solution. The formula derived here can be useful for sound radiation and scattering by arbitrary bodies in a moving medium in the time domain.

Comparison of the efficacy and safety of sodium phosphate tablets and polyethylene glycol solution for bowel cleansing in healthy Korean adults.

PURPOSE: Bowel cleansing is generally regarded as time-consuming and unpleasant among patients. Patients commonly state that bowel preparation provokes more discomfort than the actual colonoscopic examination. The purpose of this study was to compare two regimens of sodium phosphate (NaP) tablets versus polyethylene glycol (PEG) solution for bowel preparation in healthy Korean adults. MATERIALS AND METHODS: This was a single center, prospective, open-label, investigator-blinded, randomized, controlled-pilot study. A total of 62 healthy Korean subjects were randomly assigned to two groups (NaP vs. PEG). Efficacy, safety, and patient-related outcomes, as well as procedural parameters, were evaluated. RESULTS: Although there were no significant differences in total Ottawa bowel quality score, fluid scores and the rate of adequate bowel preparation were significantly better in the NaP group than the PEG group. Additionally, the NaP group showed better results regarding patient tolerance, satisfaction, preference, and rate of adverse events than the PEG group. Significant fluctuations in specific serum electrolytes were common and of a greater magnitude in the NaP group than the PEG group. However, these abnormalities were transient and did not result in serious complications and side effects. CONCLUSION: In this study, NaP tablets were shown to be an effective, well-tolerated, and acceptable regimen for bowel preparation. Also, our study suggests that NaP tablets may be safe and can be used as a bowel cleansing agent in healthy adults undergoing elective colonoscopy. Further multicenter, large scale studies are needed to confirm these findings.

Carotid Artery FDG Uptake May Serve as a Biomarker for Cardiovascular Risk Stratification in Asymptomatic Adults.

PURPOSE: We investigated the relation between carotid artery FDG uptake and cardiovascular risk based on the Framingham risk score (FRS) and evaluated the possible role of FDG uptake in terms of risk stratification of asymptomatic adults. METHODS: We evaluated 290 adults who underwent FDG PET/CT as part of general health screens. We calculated target-to-background ratios, corrected for pre-scan blood glucose levels, and obtained "TBRglu" values for both common carotid arteries. The FRS and the presence/absence of metabolic syndrome were recorded for each subject. Relationships among TBRglu values, metabolic syndrome status, and clinical parameters were assessed. RESULTS: Carotid artery FDG uptake was significantly associated with clinical risk factors. Stepwise multiple regression analysis revealed that triglyceride levels, diabetes, and metabolic syndrome were independent determinants of high TBRglu. Of subjects with metabolic syndrome, those exhibiting high carotid artery FDG uptake had significantly higher levels of high sensitivity C-reactive protein (hsCRP). In subjects who did not have metabolic syndrome, FRSs were significantly elevated in those exhibiting high carotid artery FDG uptake compared to those with low uptake (13.1 ± 7.0 vs. 8.2 ± 7.4), as was also true of subjects with the syndrome (21.8 ± 16.0 vs. 13.5 ± 11.9). CONCLUSION: High carotid FDG uptake is significantly associated with clinical risk factors and a greater FRS. Of subjects with metabolic syndrome, those with high carotid uptake had significantly higher hsCRP concentrations and FRSs. Therefore, carotid artery FDG activity may serve as a possible biomarker allowing cardiovascular risk stratification of asymptomatic populations.

Ectopic sebaceous glands in the oesophagus: a case report and review of literature.

INTRODUCTION: Most ectopic sebaceous glands have been reported in the tissues of ectodermal origin. However, there are relatively a few reports of ectopic sebaceous glands in the oesophagus, an organ of endodermal origin. CASE PRESENTATION: We report the case of an asymptomatic 54-year-old man with ectopic oesophageal sebaceous glands. These lesions were incidentally observed in the distal oesophagus during screening endoscopy of gastric neoplasm and confirmed by histologic analysis. CONCLUSION: Surveillance or resection with regard to ectopic sebaceous glands in the oesophagus is generally not required since there is no known malignant potential. However, anti-reflux treatment may be sometimes needed, if such symptoms are present in patients. Also, these lesions should be differentiated from other pathologic lesions of oesophagus that need to be treated. Thus, greater attention of endoscopists is required for detection and differential diagnosis of these lesions. The narrow-band imaging mode and/or endoscopic biopsy may be helpful.

Epiglottic cyst incidentally discovered during screening endoscopy: a case report and review of literature.

From the endoscopists' point of view, although the main focus of upper gastrointestinal endoscopic examination is the esophagus, stomach, and duodenum (usually bulb and 2nd portion including ampulla of Vater), the portions of the upper airway may also be observed during insertion and withdrawal of the endoscope, such as pharynx and larynx. Thus, a variety of pathologic lesions of the upper airway can be encountered during upper endoscopy. Among these lesions, an epiglottic cyst is relatively uncommon. The cyst has no malignant potential and mostly remains asymptomatic in adults. However, if large enough, epiglottic cysts can compromise the airway and can be potentially life-threatening when an emergency endotracheal intubation is needed. Thus, patients may benefit from early detection and treatment of these relatively asymptomatic lesions. In this report, we present a case of epiglottic cyst in an asymptomatic adult incidentally found by family physician during screening endoscopy, which was successfully removed without complication, using a laryngoscopic carbon dioxide laser.

Combined effect of serum gamma-glutamyltransferase and uric acid on Framingham risk score.

BACKGROUND AND AIMS: Gamma-glutamyltransferase (GGT) and uric acid (UA) are novel coronary heart disease (CHD) risk factors. In the present study we investigated the combined effects of GGT and UA on Framingham risk score (FRS) in a Korean population. METHODS: A total of 10,096 subjects (5,124 females and 4,972 males) were enrolled in this study. A 10-year coronary heart disease (CHD) risk was calculated using the FRS modified by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Levels of circulating GGT and UA were measured using validated assays. RESULTS: The 10-year CHD risk gradually augmented with increase in the circulating levels of GGT and UA. For the highest quartile of GGT and UA, odds ratio (OR) of intermediate-risk and beyond for CHD (10-year risk ≥10%) compared with the lowest quartile was 3.44 (95% CI: 2.60-4.55, p <0.001) and 1.97 (95% CI: 1.56-4.55, p <0.001) after adjusting for confounders, respectively. OR of intermediate-risk and beyond for CHD in both 3(rd) and 4(th) quartile of GGT and UA was 9.9 (95% CI: 5.2-18.6) compared with the first quartile of those. CONCLUSIONS: GGT and UA levels are well associated with the 10-year CHD risk estimated using NCEP ATP III in Koreans after adjusting for confounders and combination of GGT and UA levels can have a strong synergy in predicting the development of CHD.

Higher Serum Heavy Metal May Be Related with Higher Serum gamma-Glutamyltransferase Concentration in Koreans: Analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1, 2, 2010, 2011).

BACKGROUND: Abnormal serum gamma-glutamyltransferase (γ-GT) may be an early and sensitive marker for oxidative stress. This study was performed to evaluate the association between serum heavy metals and γ-GT concentration. METHODS: This study is a cross-sectional analysis based on data from Korean National Health and Nutrition Examination Survey (V-1, 2, 2010, 2011) regarding serum heavy metal concentrations (lead, mercury, and cadmium) as well as serum γ-GT. Serum heavy metals were categorized into tertiles, and serum γ-GT concentration was compared using an analysis of covariance test after relevant variable adjustments. In addition, we evaluated the odds ratio (OR) of having the highest tertile of serum γ-GT in each heavy metal tertile using logistic regression. RESULTS: The mean serum lead, mercury, and cadmium concentrations were 2.67, 5.08, and 1.02 µg/dL in men and 1.95, 3.60, and 1.21 µg/dL in women, respectively. Partial correlation showed a significant positive relation between each heavy metal and serum γ-GT concentration. Comparing serum γ-GT concentration by the tertile of each heavy metal, serum γ-GT concentration showed a significant increase as the tertiles of serum mercury and cadmium in men and that of serum mercury in women increased, but not with lead. The OR of having the highest tertile of serum γ-GT was significant for cadmium in men (OR, 4.02; 95% confidence interval [CI], 2.54 to 6.35) and mercury in women (OR, 2.00; 95% CI, 1.29 to 3.10) in the top tertile of each heavy metal. CONCLUSION: Higher serum heavy metal concentration may be related with higher serum γ-GT concentration. In particular, serum cadmium in men and mercury in women showed significant correlation with serum γ-GT concentration.

The Relationship between Serum 25-Hydroxyvitamin D, Parathyroid Hormone and the Glomerular Filtration Rate in Korean Adults: The Korea National Health and Nutrition Examination Survey between 2009 and 2011.

BACKGROUND: The glomerular filtration rate (GFR) decreases with age, while parathyroid hormone (PTH) increases. There are a few reports only on the relationship between GFR and PTH under the category of serum 25-hydroxyvitamin D (25[OH]D) concentration. METHODS: Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, a cross-sectional study was conducted on the association between serum 25(OH)D concentration, GFR and PTH in Korean adults aged 50 years or older. Serum PTH concentration was compared to the tertiles of GFR after adjustment for relevant variables. In addition, the serum PTH concentration was compared with the GFR under the category of serum 25(OH) D concentration (<20, 20-30, >30 ng/mL). RESULTS: The mean estimated GFR (eGFR) was 74.8 mL/min in men and 73.1 mL/min in women. The mean PTH and 25(OH) D was 66.8 pg/mL, 20.5 ng/mL in men and 69.0 pg/mL, 18.2 ng/mL in women. The serum PTH concentration showed a significant negative correlation with the serum 25(OH) D and eGFR in both genders. The serum PTH concentration significantly increased at the lower tertile of eGFR in male adults In addition, a decrease of serum PTH concentration was marked in the vitamin D sufficient male adults (>30 ng/mL). CONCLUSION: This present study demonstrated that serum PTH concentration showed negative correlation with eGFR, however, serum PTH increase may be minimized by maintaining proper serum 25(OH)D concentrations under similar eGFR status in Korean adults aged 50 and above.

Comparison on colonoscopic parameters according to length of adult-colonoscope.

BACKGROUND: High success rate of intubation and short intubation time have been needed to endoscopists for a complete and comfortable colonoscopy, if possible. The purpose of present study was to compare procedure efficiencies according to adult-colonoscope length. METHODS: This was a prospective, randomized, single-blinded controlled trial. A total of 239 healthy Korean subjects were randomly assigned to two groups: one group receiving intermediate-length adult-colonoscope (n = 119), and the other group receiving long-length adult-colonoscope (n = 120). Cecal intubation time and rate, and terminal ileal intubation time and rate as well as other procedure-related outcomes (adenoma detection rate, withdrawal time, and total procedure time) were evaluated. RESULTS: There were significant differences in cecal intubation time and terminal ileal intubation rate according to colonoscope length. The time of cecal intubation was shorter in the intermediate-scope group than that in the long-scope group ((222.13 ± 101.67) s vs. (253.85 ± 109.40) s, P = 0.014). However, the rate of terminal ileal intubation was higher in the long-scope group than that in the intermediate-scope group (94.2% vs. 83.2%, P = 0.007). In addition, terminal ileal intubation time was also shorter in the long-scope group than that in the intermediate-scope group ((35.21 ± 38.89) s vs. (44.09 ± 33.87) s, P < 0.001). There were no significant differences in other procedure-related outcomes between the two groups. CONCLUSIONS: The intermediate-length adult-colonoscope had an advantage over the long-length adult-colonoscope regarding cecal intubation time, whereas the long-scope had an advantage over the intermediate-scope regarding the rate and time of terminal ileal intubation. These results suggest that it is rational to prepare and use these two types of colonoscope properly, instead of employing only one type of colonoscope.

A randomized controlled trial of comparison on time and rate of cecal and termianl Ileal intubation according to adult-colonoscope length: intermediate versus long.

For a complete colonoscopic examination, a high intubation rate and a short intubation time have been demanded to colonoscopists, if possible. The aim of the present study was to compare these examination parameters, intubation time and rate, according to the length of colonoscope. A total of 507 healthy Korean subjects were randomly assigned into two groups: intermediate length adult-colonoscope (n=254) and long length adult-colonoscope (n=253). There were significant differences in cecal intubation time and in terminal ileal intubation rate according to the length of the colonoscope. Time-to-cecal intubation was shorter for the intermediate-scope group than for the long-scope group (234.2 ± 115.0 sec vs 280.7 ± 135.0 sec, P < 0.001). However, the success rate of terminal ileal intubation was higher in the long-scope group than in the intermediate-scope group (95.3% vs 84.3%, P < 0.001). There were no significant differences in other colonoscopic parameters between the two groups. The intermediate length adult-colonoscope decreased the time to reach the cecum, whereas the long-scope showed a success rate of terminal ileal intubation. These findings suggest that it is reasonable to prepare and use these two types of colonoscope appropriate to the needs of the patient and examination, instead of employing only one type of colonoscope.

Colonic mucosa-associated lymphoid tissue lymphoma identified by chromoendoscopy.

Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are a rare occurrence and the definitive treatment has not been established. Solitary or multiple, elevated or polypoid lesions are the usual appearances of MALT lymphoma in the large intestine and sometimes the surface may reveal abnormal vascularity. Herein, we report a case of MALT lymphoma and review the relevant literature. Upon colonoscopy, a suspected pathologic lesion was observed in the proximal transverse colon. The lesion could be distinguished more prominently after using narrow-band imaging mode and indigo carmine-dye spraying chromoendoscopy. Histopathologic examination of this biopsy specimen revealed lymphoepithelial lesions with diffuse proliferation of atypical lymphoid cells effacing the glandular architecture and centrocyte-like cells infiltrating the lamina propria. Immunohistochemical analyses showed that tumor cells were positive for CD20 and Bcl-2e, and negative for CD10, CD23, and Bcl-6. According to Ann-Arbor staging system, the patient had stage IIE. A partial colectomy with dissection of the paracolic lymph nodes was performed. Until now, there is no recurrence of lymphoma at follow-up.

Total testosterone and sex hormone-binding globulin are associated with metabolic syndrome independent of age and body mass index in Korean men.

OBJECTIVE: The purpose of this study is to investigate the relationship between sex hormones and metabolic syndrome independent of age and BMI in Korean men. STUDY DESIGN: We conducted a cross-sectional study with data from a health promotion center during the period from March 2007 to February 2010. 2172 Korean men aged 21-79 were enrolled. Total testosterone, sex hormone-binding globulin (SHBG), high density lipoprotein (HDL) cholesterol, triglyceride (TG), and glucose were assessed with overnight fasting serum samples. MAIN OUTCOME MEASURES: Sex hormones were divided into quartiles; odds ratios for metabolic syndrome and each component were analyzed. RESULTS: Total testosterone showed negative associations with waist circumference (WC), fasting glucose, TG, blood pressure and body mass index (BMI), and a positive relationship with HDL cholesterol (P for trend <0.001, respectively). SHBG was negatively associated with WC, fasting glucose, TG, and BMI, and positively associated with total testosterone and age. Comparing with the highest quartile, odds ratios of lowest quartile of total testosterone and SHBG for metabolic syndrome were 3.01 (95% CI, 2.11-4.28) and 6.34 (95% CI, 2.29-17.58), respectively, after adjusting for age, smoking status, alcohol intake, exercise, and BMI. Total testosterone was significantly associated with each metabolic component and SHBG was associated with glucose and TG after adjustment for age, smoking status, alcohol intake, and BMI. Calculated free testosterone had no significant relationship with metabolic syndrome or its components. CONCLUSION: Total testosterone and SHBG are negatively associated with prevalence of metabolic syndrome independent of age and BMI in Korean men.

Effect of sunlight exposure on serum 25-hydroxyvitamin d concentration in women with vitamin d deficiency: using ambulatory lux meter and sunlight exposure questionnaire.

BACKGROUND: Vitamin D is an important factor in human health. Yet, vitamin D deficiency is very common. We aimed to confirm serum 25-hydroxyvitamin D (25OHD) concentration change after sunlight exposure and to elucidate the relationship between the amount of sunlight exposure and serum 25OHD level change by ambulatory lux meter and sunlight exposure questionnaire. METHODS: Twenty healthy young women were enrolled. They were educated to obtain 20 minutes of sunlight exposure during weekdays from October to November, 2010, during which they were to wear an ambulatory lux meter on an arm. All subjects completed a one-week recall sunlight exposure questionnaire at the end of the study. Before and after sunlight exposure, serum 25OHD level was measured. RESULTS: Mean pre-exposure serum 25OHD concentration was 11.01 ng/mL. The mean change of pre- and post-exposure 25OHD level was -0.62 ng/mL, but it was not statistically significant. The mean personal sunlight exposure recorded by ambulatory lux meter, 292.6 lux/s, showed no significant relationship with average change of 25OHD and average weekly sunlight exposure score, 11.9, calculated by the sunlight exposure questionnaire. However, the mean change of serum 25OHD level and weekly sunlight exposure score showed significant negative correlation (r = -0.469, P = 0.037). CONCLUSION: Change of serum 25OHD concentration after four weeks of sunlight exposure was not statistically significant in women with vitamin D deficiency. However, serum 25OHD concentration change was significantly negatively correlated with the sunlight exposure score by the questionnaire.

Reduction of the nailfold capillary blood velocity in cigarette smokers.

BACKGROUND: Cigarette smoking causes cardiovascular disease and activates markers of endothelial dysfunction or injury. We investigated the nailfold capillary blood velocity (NCV) in cigarette smokers compared to non-smokers. METHODS: Forty-eight men (eighteen non-smokers and thirty smokers) were recruited. We measured NCV using nailfold capillary microscopy and exhaled carbon monoxide (ECO) concentration three times (before smoking; NCV(0min) and ECO(0min), and after smoking; NCV(5min), ECO(5min), NCV(30min), and ECO(30min)), in a condition of fasting in the case of smokers. In non-smokers, the same measurements were taken without smoking. Additionally, personal cigarette smoking and alcohol drinking history were acquired by a self-administrated questionnaire. RESULTS: Mean age, waist circumference, ECO(0min), ECO(5min), and ECO(30min) was higher and NCV(5min) and NCV(30min) were significantly lower in smokers compared to non-smokers. Total smoking years were negatively correlated with NCV(5min). Average pack of the daily smoking, total pack-years, as well as total smoking years were also negatively correlated with NCV(30min) by regression analysis. After adjustment of significantly different variables, NCV(30min) was significantly lower in smokers. In the subgroup analysis, the interleukin-6 level was significantly increased in subjects with a long period of cigarette smoking compared with non-smokers. CONCLUSION: Reduction of NCV in smokers is associated with personal smoking history, not with body composition or certain oxidative stress markers.

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.

Relationship of plasminogen activator inhibitor 1 gene 4G/5G polymorphisms to hypertension in Korean women.

BACKGROUND: Hypertension (HTN) is a major determinant of various cardiovascular events. Plasma levels of plasminogen activator inhibitor 1 (PAI-1) modulate this risk. A deletion/insertion polymorphism within the PAI-1 loci (4G/4G, 4G/5G, 5G/5G) affects the expression of this gene. The present study investigated the association between PAI-1 loci polymorphisms and HTN in Korean women. METHODS: Korean women (n = 1312) were enrolled in this study to evaluate the association between PAI-1 4G/5G gene polymorphisms and HTN as well as other metabolic risk factors. PAI-1 loci polymorphisms were investigated using polymerase chain reaction amplification and single-strand conformation polymorphism analysis. RESULTS: The three genotype groups differed with respect to systolic blood pressure (P = 0.043), and diastolic blood pressure (P = 0.009) but not with respect to age, body mass index, total cholesterol, low or high density lipoprotein cholesterol, triglycerides, or fasting blood glucose. Carriers of the PAI-1 4G allele had more hypertension significantly (PAI-1 4G/5G vs. PAI-1 5G/5G, P = 0.032; PAI-1 4G/4G vs. PAI-1 5G/5G, P = 0.034). When stratified according to PAI-1 4G/5G polymorphism, there was no significant difference in all metabolic parameters among PAI-1 genotype groups in patients with HTN as well as subjects with normal blood pressure. The estimated odds ratio of the 4G/4G genotype and 4G/5G for HTN was 1.7 (P = 0.005), and 1.6 (P = 0.015), respectively. CONCLUSION: These findings might indicate that PAI-1 loci polymorphisms independently contribute to HTN and that gene-environmental interaction may be not associated in Korean women.