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Tsao CL, Lee YH, Dong C, Chang CS, Ma KSK. Effect of metabolic syndrome and obesity on the progression of knee osteoarthritis. Int J Rheum Dis 2023; 26:391-392. [PMID: 36445828 DOI: 10.1111/1756-185x.14476] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Chia-Ling Tsao
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Yung-Heng Lee
- Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan, Republic of China
| | - Chen Dong
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Cheng-Siu Chang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China.,Department of Neurosurgery, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan, Republic of China.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Park MC, Yoon JH, Park S, Kim SC, Park S, Moon KH, Cheon SH, Kwon T. Effects of metabolic syndrome on renal stone progression. World J Urol 2022; 40:1845-1851. [PMID: 35622116 DOI: 10.1007/s00345-022-04047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Studies on howmetabolic syndrome affects renal stone progression in untreated asymptomatic patients are lacking. Therefore, we investigated the effect of metabolic syndrome on changes in renal stone size. MATERIALS AND METHODS We retrospectively analyzed 820 patients with renal stones incidentally detected on CT during regular health examinations and who underwent follow-up CT evaluations for > 1 year. The patients were divided into two groups according to the presence of metabolic syndrome. Changes in stone size during the follow-up were assessed, and differences were compared according to various factors. Predictors of stone size change on CT were assessed using linear regression analysis. RESULTS Overall, 820 asymptomatic patients without a history of stone treatments and with a mean follow-up of 52.4 months were included. Of these, 104 (12.7%) had metabolic syndrome and 335 (40.9%) showed stone size increase during the follow-up. The stone size at diagnosis was not significantly different between patients with and without metabolic syndrome (225.3 ± 332.6 vs. 183.9 ± 310.2 mm3, p = 0.159); however, a significant difference was observed in the change in stone size at follow-up (148.5 ± 352.0 vs. 81.5 ± 222.4 mm3, p = 0.001). Multivariable analysis showed that age (β = - 0.11; - 5.92 to -0.69; p = 0.013), fasting glucose level ≥ 100 mg/dl (β = 0.11; 9.78-99.73; p = 0.017), and metabolic syndrome (β = 0.10; 9.78-99.73; p = 0.017) were factors predictive of stone size changes. CONCLUSION Metabolic syndrome, fasting glucose level ≥ 100 mg/dl and young age are positively related to renal stone size changes. Therefore, periodic follow-up and metabolic syndrome management are required in asymptomatic patients with renal stones, especially in young age.
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Affiliation(s)
- Myeong Chan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Ji Hyung Yoon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Sejun Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Seong Cheol Kim
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Sungchan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Kyung Hyun Moon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Sang Hyeon Cheon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Taekmin Kwon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea.
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An S, Ahn C, Jang J, Lee J, Kang D, Lee JK, Park SK. Comparison of the Prevalence of Cardiometabolic Disorders and Comorbidities in Korea and the United States: Analysis of the National Health and Nutrition Examination Survey. J Korean Med Sci 2022; 37:e149. [PMID: 35535376 PMCID: PMC9091432 DOI: 10.3346/jkms.2022.37.e149] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Comparison of the prevalence of cardiometabolic disorders (CMDs) and comorbidities in Korea and the United States (US) can be an important indicator for forecasting future risk of cardiovascular events in Korea. This study aimed to estimate and compare the prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, obesity, and metabolic syndrome (MetS) in Korea and the US. METHODS A total of 15,872 individuals from the US National Health and Nutrition Examination Survey (NHANES) 2003-2014 and 26,492 from the Korea NHANES (KNHANES) 2007-2014 were included. Additionally, 164,339 (139,345 from the Health Examinees-Gem Study and 24,994 from the Cardiovascular Disease Association Study) participants enrolled in the Korea Genome and Epidemiology Study were included to investigate the differences of CMDs between urban and rural regions. To estimate the age-standardized prevalence of CMDs in individuals aged 40-69 years, direct standardization using the World Health Organization standard population was performed. RESULTS The prevalence of CMDs was lower in Korea than the US (hypertension 49.9% vs. 56.8%; DM 13.4% vs. 14.3%; hypercholesterolemia 16.8% vs. 17.8%; obesity 36.2% vs. 38.6%; and MetS 29.4% vs. 36.5%). According to the median survey years, dyslipidemia has become more prevalent in Korea than in the US since 2010. The prevalence of CMDs was greater in rural than that in urban areas in Korea. CONCLUSION The prevalence of dyslipidemia in Korea exceeded that of the US after 2010, which was associated with increasing burden of cardiovascular events. The present study suggests that further preventive strategies are needed to mitigate the prevalence of CMDs in Korea.
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Affiliation(s)
- Seokyung An
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Choonghyun Ahn
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Jieun Jang
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Juyeon Lee
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-Koo Lee
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea.
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Chaudhari HE, Patil SD. Assessment of hazardous elements of metabolic syndrome in hypertensive patients to defend them from cardiovascular risk in tribal region. Diabetes Metab Syndr 2019; 13:925-931. [PMID: 31336546 DOI: 10.1016/j.dsx.2018.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/19/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hypertension is an exceptionally common condition which every now and again remains undiscovered until generally late in its course, prompting an assortment of other hazardous conditions. Around 91.3% of the hypertensive patients had no less than one related cardiovascular hazard factor. Our investigation plans to estimate the relationship of hazard factor with cardiovascular Disease. MATERIALS AND METHODS This is observational and follows up investigation which focused 145 patients from Indira Gandhi Memorial Hospital over a time of one year (July 2016 to October 2017). Out of 145, 127 Patients could enrolled in the study for actual biochemical Estimation. We followed the modified NCEP ATP-III criteria of metabolic Syndrome for categorization of the patients. RESULT Among 127 patients, 90 (78.26%) patients were found to be having metabolic disorder and without metabolic disorder were 25 (21.73%) and frequency rate was high in the age assemble between 51 and 60. Prevalence rate was high in farmer housewives having 4-6 years length of hypertension. Most common combination of lifted levels of parameters found to be HbA1c, triglyceride and waist circumference and it was 33.33% in both male and female. Lipid profile and was abnormal during baseline, and significant variation was found during follow up after patient counseling and proper treatment. CONCLUSION The study justifies the view that all hypertensive patients should be screened for metabolic syndrome and those who diagnosed as a positive should be put on the proper treatment to protect them from CVS risk.
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Affiliation(s)
- Hemakshi E Chaudhari
- Department of Clinical Pharmacy, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, 425405, India
| | - Sativa D Patil
- Department of Clinical Pharmacy, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, 425405, India.
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Lee JH, Seo DH, Nam MJ, Lee GH, Yang DH, Lee MJ, Choi UR, Hong S. The Prevalence of Obesity and Metabolic Syndrome in the Korean Military Compared with the General Population. J Korean Med Sci 2018; 33:e172. [PMID: 29915523 PMCID: PMC6000597 DOI: 10.3346/jkms.2018.33.e172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/13/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Obesity and related metabolic disorders are growing health challenges worldwide and individuals at military service are not exceptions. The purpose of this study was to examine the prevalence of obesity and metabolic syndrome (MS) in the Korean military and to compare with the general population. METHODS This was a cross-sectional study of 4,803 young military participants who underwent a corporal health-screening program between October 2013 and October 2014. The National Cholesterol Education Program Adult Treatment Panel III criteria was used to identify MS. We also sampled 1,108 men aged 19-29 years from the Korea National Health and Nutritional Examination Survey from 2010 to 2013 to compare with their military counterparts. RESULTS The mean age of military participants was 20.8 ± 1.1 years, and 20.6% (n = 988) were obese. The prevalence of MS was 0.8% in military participants, while 7.9% in general population. The risk factors of MS were less prominent among military participants relative to civilians, with the exception of high blood pressure, of which prevalence was higher among military participants (21.5% vs. 18.2%, respectively). In multiple logistic analysis, high physical activity conferred lower odds of MS and obesity in military participants (odds ratios, 0.19 and 0.81, respectively). Age older than 25 years increased risk of most components of MS among civilians. CONCLUSION The prevalence of obesity and MS is lower in military participants compared with civilians of similar age. Monitoring of high blood pressure and proper stress management are warranted in those at military service.
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Affiliation(s)
- Jung Hwan Lee
- The 5th Division the Medical Battalion of the Republic of Korea Armed Forces, Yeoncheon, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Da Hea Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Min Jung Nam
- The 5th Division the Medical Battalion of the Republic of Korea Armed Forces, Yeoncheon, Korea
| | - Geon Hui Lee
- The 5th Division the Medical Battalion of the Republic of Korea Armed Forces, Yeoncheon, Korea
| | - Dong Hee Yang
- The 5th Division the Medical Battalion of the Republic of Korea Armed Forces, Yeoncheon, Korea
| | - Min Joo Lee
- The 5th Division the Medical Battalion of the Republic of Korea Armed Forces, Yeoncheon, Korea
| | - Ung-Rim Choi
- The 5th Division the Medical Battalion of the Republic of Korea Armed Forces, Yeoncheon, Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
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Suh S, Cho YR, Park MK, Kim DK, Cho NH, Lee MK. Relationship between serum bilirubin levels and cardiovascular disease. PLoS One 2018; 13:e0193041. [PMID: 29447261 PMCID: PMC5814053 DOI: 10.1371/journal.pone.0193041] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 02/02/2018] [Indexed: 01/31/2023] Open
Abstract
We tested the hypothesis that higher levels of bilirubin, a bile pigment with antioxidant properties, are associated with a decreased risk of cardiovascular disease (CVD). This study analyzed data from the Korean Health and Genome Study to examine the association between serum total bilirubin (TB) on CVD and CVD death. Serum TB was measured in a total of 8,844 subjects (4,196 males and 4,648 females) and evaluated for the development of new onset CVD from 2001 to 2012 (mean 8.1 years of follow-up). During the follow-up period, 689 cases of incident CVD (7.8%) were identified, and the prevalence of metabolic syndrome (MetS) at baseline was 26.1%. The prevalence of MetS decreased across bilirubin tertile categories. In addition to MetS itself, individual components of MetS significantly decreased with increased bilirubin tertiles. Moreover, the incidence of CVD decreased across bilirubin tertile categories. The hazard ratios (HRs) for developing coronary heart disease (CHD, HR 0.769, 95% CI 0.655–1.000) and CVD death (HR 0.513, 95% CI 0.267–0.985) was significantly lower in the highest tertile group (> 0.63 mg/dL) in comparison to the lowest tertile group (< 0.44 mg/dL) after adjusting for all confounding variables. In the present longitudinal study, a significant negative relationship was demonstrated between baseline bilirubin levels and incident CHD and CVD death.
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Affiliation(s)
- Sunghwan Suh
- Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Young Rak Cho
- Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Mi Kyoung Park
- Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Duk Kyu Kim
- Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Nam H. Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
- * E-mail: (NHC); (MKL)
| | - Moon-Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail: (NHC); (MKL)
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Kim SK, Hong SH, Chung JH, Cho KB. Association Between Alcohol Consumption and Metabolic Syndrome in a Community-Based Cohort of Korean Adults. Med Sci Monit 2017; 23:2104-2110. [PMID: 28465500 PMCID: PMC5424649 DOI: 10.12659/msm.901309] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The relationship between alcohol consumption and metabolic syndrome (MetS) remains controversial. This study investigated the relationship between alcohol consumption and MetS components and prevalence. Material/Methods We analyzed 10 037 subjects (3076 MetS and 6961 non-MetS) in a community-based cohort. MetS was defined according to the ATP III Guidelines. Subjects were divided according to amount of alcohol consumption; non-drinker, very light (0.1–5.0 g/day), light (5.1–15.0 g/day), moderate (15.1–30.0 g/day), and heavy drinker (>30 g/day). Multiple logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The analyses were performed in men and women separately. SPSS statistical software was used for analyses. Results The prevalence of MetS in both males and females was associated with alcohol drinking status (p<0.0001). Amount of alcohol consumption (0.1–5.0 g/day) was significantly associated with lower prevalence of MetS in both genders compared to non-drinkers. Amount of alcohol consumption (>30.0 g/day) did not show a significant association with prevalence of MetS. However, alcohol consumption (>30.0 g/day) showed an association with glucose and HDL cholesterol among the components of MetS. Conclusions Our results indicate that alcohol drinking (0.1–5.0 g/day) contributed to decrease prevalence of MetS and components, including triglyceride and HDL cholesterol.
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Affiliation(s)
- Su Kang Kim
- Kohwang Medical Institute, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung-Hee Hong
- Division of Food Science and Culinary Arts, Food and Nutrition Major, Shinhan University, Gyeonggi, South Korea
| | - Joo-Ho Chung
- Kohwang Medical Institute, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Kyu Bong Cho
- Department of Biomedical Laboratory Science, Shinhan University, Gyeonggi, South Korea
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Lee KW, Cho Y, Jo G, Park YK, Shin MJ. Association of dietary intakes of total and subtypes of fat substituted for carbohydrate with metabolic syndrome in Koreans. Endocr J 2016; 63:991-999. [PMID: 27534813 DOI: 10.1507/endocrj.ej16-0056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Amount of fat consumption has gradually increased among Koreans, which is relatively lower than western countries. In the current study, we examined the association between dietary fat and metabolic syndrome (MetS) prevalence among Korean adults. 3,212 participants who are aged 30-74 years from the Korea National Health and Nutritional Examination Survey (KNHANES) VI (2013) were included for cross-sectional analyses. Dietary intake data was assessed using 24-hour recall method, and MetS was defined using guideline of the National Cholesterol Education Program Adult Treatment panel III (NCEP-ATP III). Multivariate logistic regression analysis was used to estimate MetS odds ratios, using nutrient density model, according to 5% percent unit of dietary fat intake. The prevalence of MetS was significantly associated with dietary intake of total fat and saturated fatty acid (SFA) after adjustment (odds ratio [OR] 0.984 95% confidence interval [CI] 0.972-0.996; OR 0.946 95% CI 0.915-0.979). When dietary intake of total fat and SFA were substituted for carbohydrate (CHO), ORs for MetS were 0.985 (95% CI 0.972-0.998) and 0.948 (95% CI 0.907-0.990), respectively, after adjusting for potential covariates. In summary, MetS was significantly associated with dietary intakes of total fat and SFA, and when substituting dietary fat for carbohydrate among Koreans.
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Affiliation(s)
- Kyong Won Lee
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea
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Okatan EN, Durak AT, Turan B. Electrophysiological basis of metabolic-syndrome-induced cardiac dysfunction. Can J Physiol Pharmacol 2016; 94:1064-1073. [DOI: 10.1139/cjpp-2015-0531] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Myocardial contractility is controlled by intracellular Ca2+ cycling with the contribution of sarcoplasmic reticulum (SR). In this study, we aimed to investigate the role of altered SR function in defective regulation of intracellular Ca2+ levels in rats with metabolic syndrome (MetS) induced by a 16-week high-sucrose drinking-water diet. Electric-field stimulated transient intracellular Ca2+ changes in MetS cardiomyocytes exhibited significantly reduced amplitude (∼30%) and prolonged time courses (2-fold), as well as depressed SR Ca2+ loading (∼55%) with increased basal Ca2+ level. Consistent with these data, altered ryanodine receptor (RyR2) function and SERCA2a activity were found in MetS cardiomyocytes through Ca2+ spark measurements and caffeine application assay in a state in which sodium calcium exchanger was inhibited. Furthermore, tetracaine application assay results and hyperphosphorylated level of RyR2 also support the “leaky RyR2” hypothesis. Moreover, altered phosphorylation levels of phospholamban (PLN) support the depressed SERCA2a-activity thesis and these alterations in the phosphorylation of Ca2+-handling proteins are correlated with altered protein kinase and phosphatase activity in MetS cardiomyocytes. In conclusion, MetS-rat heart exhibits altered Ca2+ signaling largely due to altered SR function via changes in RyR2 and SERCA2a activity. These results point to RyR2 and SERCA2a as potential pharmacological targets for restoring intracellular Ca2+ homeostasis and, thereby, combatting dysfunction in MetS-rat heart.
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Affiliation(s)
- Esma N. Okatan
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Aysegul Toy Durak
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Belma Turan
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
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Pourfarzam M, Zadhoush F, Sadeghi M. The difference in correlation between insulin resistance index and chronic inflammation in type 2 diabetes with and without metabolic syndrome. Adv Biomed Res 2016; 5:153. [PMID: 27713874 PMCID: PMC5046740 DOI: 10.4103/2277-9175.188489] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/15/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Insulin resistance (IR) is associated with low-grade systemic inflammation. It plays an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in patients with metabolic syndrome (MetS). It is unclear whether diabetic patients with MetS confer elevated CVD risk and outcomes beyond the impact of individual's components of MetS. The aim of this study is to highlight the central role of IR, inflammation, triglyceride/high-density lipoprotein- cholesterol (TG/HDL-C) ratio, and atherogenic index of plasma (AIP) in T2DM with MetS. MATERIALS AND METHODS This cross-sectional study comprised 130 men distributed into three groups, namely Controls: 40 nondiabetic healthy volunteers; Group I: 40 T2DM patients without MetS, and Group II: 50 T2DM patients with MetS. Fasting blood samples were collected for the measurement of blood lipid profile, glucose, insulin, hemoglobin A1c, and high-sensitivity C-reactive protein (hs-CRP). TG/HDL-C ratio, AIP, and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. RESULTS Significant positive association was observed between HOMA-IR and hs-CRP only in Group II and between HOMA-IR and TG/HDL-C ratio in all subjects. Significant differences were seen in waist and hip circumferences, waist/hip ratio, body mass index, systolic blood pressure, fasting blood glucose, TGs, HDL-C, insulin, hs-CRP, HOMA-IR, TG/HDL ratio, and AIP between Controls and Group I with Group II. CONCLUSIONS In T2DM with MetS, coexistence of elevated atherogenic indices, systemic inflammation, and association between HOMA-IR and TG/HDL-C ratio were seen. These factors are considered having important role in elevated CVD risk beyond MetS components in these patients.
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Affiliation(s)
- Morteza Pourfarzam
- Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fouzieh Zadhoush
- Department of Clinical Biochemistry, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Lee SK, Yoon DW, Choi KM, Lee SW, Kim JY, Kim JK, Hong JH, Cho NH, Shin C. The association of Sasang constitutional types with metabolic syndrome: A pooled analysis of data from three cohorts. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kim YJ, Lee YH, Lee YJ, Kim KJ, An JH, Kim NH, Kim HY, Choi DS, Kim SG. Prevalence of metabolic syndrome and its related factors among North Korean refugees in South Korea: a cross-sectional study. BMJ Open 2016; 6:e010849. [PMID: 27251685 PMCID: PMC4893935 DOI: 10.1136/bmjopen-2015-010849] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To determine the prevalence of metabolic syndrome (MetS) and its related factors among North Korean refugees (NKR) in South Korea. DESIGN Cross-sectional study conducted using a questionnaire and anthropometric and biochemical data on NKR in South Korea. SETTING Seoul, South Korea. PARTICIPANTS A sample of NKR who voluntarily underwent medical examinations in Anam Hospital of Korea University, Seoul, South Korea (N=708, consisting of 161 males and 547 females). To compare the prevalence of MetS, 1416 age- and gender-matched individuals from the South Korean population (SKP, at a ratio of 1:2 to NKR) were randomly selected from the fifth Korean National Health and Nutrition Examination Survey. MAIN OUTCOME MEASURES The prevalence of MetS and its related factors among NKR in South Korea and comparison with its prevalence among the general SKP. RESULTS The prevalence of MetS among male and female NKR in South Korea was 19.7% and 17.2%, respectively. Although obesity is more prevalent in South than in North Korea, we found no difference in the prevalence of MetS between the female NKR and SKP groups (17.2% vs 16.6%, respectively; p=0.830). As regards the males, the small sample size of the NKR group yielded insufficient evidence of any difference in MetS prevalence between the NKR and SKP groups (19.7% vs 26.2%, respectively; p=0.134). We found that excess weight gain (≥5%) in South Korea was significantly associated with MetS among NKR. CONCLUSIONS The prevalence of MetS among NKR did not differ from that in the SKP group despite the lower prevalence of obesity in NKR than in the general SKP. The fact that excess weight gain in South Korea was associated with the risk of MetS suggests that public health policy makers should focus on preventing excess weight gain in NKR during resettlement in South Korea.
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Affiliation(s)
- Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Yo Han Lee
- Department of Public Healthcare Services, Seoul Bukbu Hospital, Seoul, Korea
| | - Yun Jeong Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Anyang Sam Hospital, Anyang, Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Jee Hyun An
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hee Young Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Dong Seop Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
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13
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Cebron Lipovec N, Beijers RJ, van den Borst B, Doehner W, Lainscak M, Schols AMWJ. The Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review. COPD 2016; 13:399-406. [DOI: 10.3109/15412555.2016.1140732] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nanca Cebron Lipovec
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
- University Clinic of Pulmonary and Allergic Diseases Golnik, Slovenia
| | - Rosanne J.H.C.G. Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bram van den Borst
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wolfram Doehner
- Center for Stroke Research Berlin, Charité Medical School, Berlin, Germany
| | - Mitja Lainscak
- Department of Cardiology, General Hospital Celje, Celje, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Annemie M. W. J. Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
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14
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Lee SL, Daimon M, Di Tullio MR, Homma S, Nakao T, Kawata T, Kimura K, Shinozaki T, Hirokawa M, Kato TS, Mizuno Y, Watanabe M, Yatomi Y, Yamazaki T, Komuro I. Relationship of Left Ventricular Diastolic Function to Obesity and Overweight in a Japanese Population With Preserved Left Ventricular Ejection Fraction. Circ J 2016; 80:1951-6. [DOI: 10.1253/circj.cj-16-0381] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Seitetsu L. Lee
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
| | - Masao Daimon
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
- Department of Clinical Laboratory, the University of Tokyo Hospital
| | | | | | - Tomoko Nakao
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
- Department of Clinical Laboratory, the University of Tokyo Hospital
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
| | - Koichi Kimura
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
| | | | - Megumi Hirokawa
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
| | - Tomoko S. Kato
- Department of Clinical Laboratory, the University of Tokyo Hospital
- Heart Center, Juntendo University School of Medicine
| | - Yoshiko Mizuno
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
- Department of Clinical Epidemiology and Systems, the University of Tokyo Hospital
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
| | - Yutaka Yatomi
- Department of Clinical Laboratory, the University of Tokyo Hospital
| | - Tsutomu Yamazaki
- Clinical Research Support Center, the University of Tokyo Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, the University of Tokyo Hospital
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15
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Al Mamun M, Rumana N, Pervin K, Azad MC, Shahana N, Choudhury SR, Zaman MM, Turin TC. Emerging Burden of Cardiovascular Diseases in Bangladesh. J Atheroscler Thromb 2015; 23:365-75. [PMID: 26686566 DOI: 10.5551/jat.30445] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
As a result of an epidemiological transition from communicable to non-communicable diseases for last few decades, cardiovascular diseases (CVD) are being considered as an important cause of mortality and morbidity in many developing countries including Bangladesh. Performing an extensive literature search, we compiled, summarized, and categorized the existing information about CVD mortality and morbidity among different clusters of Bangladeshi population. The present review reports that the burden of CVD in terms of mortality and morbidity is on the rise in Bangladesh. Despite a few non-communicable disease prevention and control programs currently running in Bangladesh, there is an urgent need for well-coordinated national intervention strategies and public health actions to minimize the CVD burden in Bangladesh. As the main challenge for CVD control in a developing country is unavailability of adequate epidemiological data related to various CVD events, the present review attempted to accumulate such data in the current context of Bangladesh. This may be of interest to all stakeholder groups working for CVD prevention and control across the country and globe.
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Affiliation(s)
- Mohammad Al Mamun
- Department of Public Health, General Directorate of Health Affairs in Tabuk Region, Ministry of Health
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16
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Kang Y, Kim J. Gender difference on the association between dietary patterns and metabolic syndrome in Korean population. Eur J Nutr 2015; 55:2321-30. [PMID: 26659071 DOI: 10.1007/s00394-015-1127-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/29/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Dietary patterns are found to be associated with metabolic risk factors. We explored gender difference on the association between dietary patterns and the risk of metabolic syndrome (MetS) in the general Korean population. METHOD A total of 13,410 Korean adults (aged ≥19 years, 5384 men and 8026 women) who participated in the fifth KNHANES were studied. Dietary intake was assessed by the 24-h recall method. MetS was defined by the joint interim statement of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Multivariable-adjusted logistic regression analysis was performed to identify the relationship between dietary pattern and MetS and its components by gender. RESULTS Three dietary patterns were derived using factor analysis by sex: traditional, Westernized, and healthy. The traditional pattern was positively associated with hypertriglyceridemia (P for trend = 0.0098), low high-density lipoprotein cholesterol (P for trend = 0.0007), elevated blood pressure (P for trend = 0.0328), and MetS (P for trend = 0.0003) in women only after adjusting for age, body mass index, socioeconomic status, and lifestyle factors. In contrast, the healthy pattern (HP) was negatively associated with abdominal obesity (P for trend = 0.0051) in women. For men, the HP was negatively associated with hypertriglyceridemia (P for trend = 0.0025) after adjustment for potential confounders. The Westernized pattern was not associated with MetS or its components in either men or women. CONCLUSION There may be gender differences on the relationship between dietary patterns and metabolic risk factors in Korean population.
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Affiliation(s)
- Y Kang
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, 17104, South Korea
| | - J Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, 17104, South Korea.
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17
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Suh S, Kim DK. Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinol Metab (Seoul) 2015; 30:246-51. [PMID: 26248862 PMCID: PMC4595347 DOI: 10.3803/enm.2015.30.3.246] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 01/07/2023] Open
Abstract
Subclinical hypothyroidism (SCH) is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV) system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy.
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Affiliation(s)
- Sunghwan Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Duk Kyu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea.
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18
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Okatan EN, Tuncay E, Hafez G, Turan B. Profiling of cardiac β-adrenoceptor subtypes in the cardiac left ventricle of rats with metabolic syndrome: Comparison with streptozotocin-induced diabetic rats. Can J Physiol Pharmacol 2015; 93:517-25. [DOI: 10.1139/cjpp-2014-0507] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Little is known about metabolic syndrome (MetS)-associated cardiomyopathy, especially in relation to the role and contribution of beta-adrenoceptor (β-AR) subtypes. Therefore, we examined the roles of β-AR subtypes in the cardiac function of rats with MetS (MetS group) and compared it with that of rats with streptozotocin (STZ)-induced diabetes (STZ group). Compared with the normal control rats, the protein levels of cardiac β1- and β2-AR in the MetS group were significantly decreased and with no changes in their mRNA levels, whereas the protein levels of β3-AR were similar to those of the controls. However, as shown previously, the protein levels of cardiac β1- and β2-AR in the STZ group were decreased, whereas the β3-AR levels were significantly increased by comparison with the controls. Additionally, the mRNA levels of β2- and β3-AR were increased, but β1-AR mRNA was decreased in the STZ group. Furthermore, left ventricular developed pressure responses to β3-AR agonist BRL37344 were increased in the STZ group but not in the MetS group, whereas for both groups, the responses to noradrenaline were not different from those of the controls. However, the response to stimulation with high concentrations of fenoterol was depressed in the MetS group, compared with the controls, but not in the STZ group. Consequently, our data suggest that the contribution of the β-AR system to cardiac dysfunction in the rats with MetS is not the same as that in the STZ group, although they have similar cardiac dysfunction with similar ultrastructural changes to the myocardium.
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Affiliation(s)
- Esma N. Okatan
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Erkan Tuncay
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Gaye Hafez
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Belma Turan
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
- Department of Biophysics, Ankara University, Faculty of Medicine, 06100 Ankara, Turkey
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19
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Cintosun U, Safer U, Tasci I. Comment on "metabolic syndrome and elevated C-reactive protein levels in elderly patients with newly diagnosed depression". PSYCHOSOMATICS 2015; 56:214-215. [PMID: 25749716 DOI: 10.1016/j.psym.2014.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 04/01/2014] [Accepted: 04/01/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Umit Cintosun
- Department of Geriatrics, Gulhane School of Medicine, Ankara, Turkey.
| | - Umut Safer
- Department of Geriatrics, Gulhane School of Medicine, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
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20
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Lee JK, Ryoo JH, Choi JM, Park SK. Serum uric acid level and the incidence of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study. J Prev Med Public Health 2014; 47:317-26. [PMID: 25475199 PMCID: PMC4263007 DOI: 10.3961/jpmph.14.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/29/2014] [Indexed: 12/31/2022] Open
Abstract
Objectives: Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS. Methods: A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed. Results: During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses. Conclusions: Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.
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Affiliation(s)
- Jong-Keun Lee
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae-Hong Ryoo
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Joong-Myung Choi
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sung Keun Park
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea ; Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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21
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Park KT, Kim HL, Kim SH, Kim MA, Lee E, Park J, Jo SH, Kim SR, Kim J, Kim CJ, Lee MK, Shin HH. Prevalence and Gender-Related Characteristics of Metabolic Syndrome in Korean Community. J Lipid Atheroscler 2014. [DOI: 10.12997/jla.2014.3.2.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kyung-Taek Park
- Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hack-Lyoung Kim
- Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-A Kim
- Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Euijae Lee
- Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jonghanne Park
- Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Ho Jo
- Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sung Rae Kim
- Bucheon St. Mary's Hospital, Catholic University College of Medicine, Bucheon, Korea
| | - Jaetaek Kim
- Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Chee Jeong Kim
- Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Moon-Kyu Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Ho Shin
- Cheil Hospital and Women's Health Care Center, Catholic Kwandong University College of Medicine, Seoul, Korea
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