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Lee S, Chang JS, Park KS, Koh SB, Kim MY, Lim JS. Sex-specific association of low-renin hypertension with metabolic and musculoskeletal health in Korean older adults. Front Public Health 2024; 12:1250945. [PMID: 38410670 PMCID: PMC10894919 DOI: 10.3389/fpubh.2024.1250945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Low-renin hypertension (LRH) accounts for approximately one-third of patients with hypertension and are more prevalent in women and the older adult population. Previous study has found a link between the renin-angiotensin-aldosterone system (RAAS) and sex hormones. However, there are insufficient data on the relationship between LRH and metabolic or musculoskeletal outcomes in older adults. Methods and materials Among the 343 participants from a population-based cohort study conducted between May 2018 and August 2019, a total of 256 (86 men older than 50 years and 170 postmenopausal women) were included. The presence of LRH was defined as plasma renin activity (PRA) <1 ng/mL/h and systolic blood pressure (BP) ≥130 or diastolic BP ≥80 mmHg based on the 2017 ACC/AHA guidelines. Individuals with missing data, and those who had used medications that could affect PRA within the past six months were excluded. Bone mineral density (BMD), trabecular bone score (TBS), and appendicular lean mass (ALM) index were assessed using dual-energy X-ray absorptiometry; degraded TBS was defined as partially degraded to degraded levels (≤1.350). Muscle function was assessed according to the Asian Working Group for Sarcopenia guidelines. PRA was measured using radioimmunoassay. Results The median age was 66 [61-72] years, and the body mass index (BMI) was 24.7 [23.0-26.4] kg/m2. Individuals with LRH, accounting for 34.8%, had lower diabetes mellitus; more dyslipidemia; and poorer muscle function, BMD, and TBS than those in the non-LRH group. In addition, PRA was positively correlated with C-peptide, HOMA-IR, TBS, and ALM index. After adjusting for covariates including age and BMI, LRH was negatively associated with femur neck T-score (adjusted β = -0.30, 95% CI [-0.55 to -0.05], p = 0.021) and the presence of LRH was significantly associated with degraded TBS in women (adjusted odds ratio = 3.00, 95% CI [1.36-6.58], p = 0.006). Conclusion Our findings suggest that LRH can influence clinical features and metabolic risk in older adults. Notably, LRH in postmenopausal women was linked to lower femur neck T-scores and degraded TBS, indicating sex-specific effects of LRH on bone health. Larger prospective studies are required to elucidate how changes in the RAAS affect metabolic and musculoskeletal outcomes in older adults.
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Affiliation(s)
- Seunghyun Lee
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jae Seung Chang
- Department of Sports Science, Hannam University, Daejeon, Republic of Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyu-Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Moon Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
- Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung Soo Lim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Liu W, Das S, Olson RA, Baker S, Dunne EM, Chang JS, Schellenberg D, Berrang T, Hsu F, Jiang W, Mou B, Lefresne S, Tyldesley S, Liu M. Polymetastatic Recurrence-Free Survival in Patients with Repeat Oligometastases on the SABR-5 Trial. Int J Radiat Oncol Biol Phys 2023; 117:S59. [PMID: 37784532 DOI: 10.1016/j.ijrobp.2023.06.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To determine polymetastatic recurrence-free survival (PMRFS) in patients with repeat oligometastases (OM) on the SABR-5 trial. MATERIALS/METHODS SABR-5 is a prospective, multi-center trial that evaluated the safety of stereotactic ablative radiotherapy (SABR) in patients with 1-5 OM or oligoprogressive lesions. On SABR-5, patients were followed post-SABR according to standardized protocols. Patients with repeat extra-cranial OM after metastasis-directed therapy (MDT; SABR, surgery, or thermoablation) to all initial OM (including those treated before enrolment on SABR-5) were identified. Exclusion criteria included history of multiple primary malignancies and incomplete re-staging. PMRFS was defined as time from presentation of repeat oligometastases to death or presentation of 6 or more progressing metastases, leptomeningeal metastases, lymphangitic carcinomatosis, malignant ascites, or malignant pleural effusion. PMRFS, overall survival (OS), and progression-free survival (PFS) were calculated using the Kaplan-Meier method. RESULTS Seventy-six patients with repeat OM were included, of which 44 (58%) received second MDT to all OM. The most common histology in patients who received second MDT was colorectal cancer (10/44 [23%]) and in those who did not was prostate cancer (17/32 [53%]). Patients who did vs. did not receive second MDT had fewer metastases at repeat OM (mean 1.3 vs 2.2; p<0.001) and no difference in time between initial OM and repeat OM (16 vs. 17 months; p = 0.74). For patients who received second MDT, median follow-up from presentation of repeat OM was 2.6 years. Median PFS after first and second MDT were 15 months (95% CI 11-18) and 11 months (95% CI 7-17), respectively. At last follow-up, 22/44 patients (50%) were alive without polymetastatic recurrence. 3-year PMRFS and OS from presentation of repeat OM were 51% (95% CI 33-66%) and 66% (95% CI 47-79%), respectively. CONCLUSION Patients presenting with repeat OM after MDT may still have favorable 3-year PMRFS and OS, which may justify exploring aggressive local treatments in this subpopulation. Further randomized trials in this space are needed.
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Affiliation(s)
- W Liu
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - S Das
- BC Cancer Victoria, Victoria, BC, Canada
| | - R A Olson
- BC Cancer - Prince George, Prince George, BC, Canada
| | - S Baker
- BC Cancer - Surrey, Surrey, BC, Canada
| | - E M Dunne
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - J S Chang
- Department of Radiation Oncology, Gangnam Severance Hospital, Seoul, Korea, Republic of (South) Korea
| | | | - T Berrang
- BC Cancer Victoria, Victoria, BC, Canada
| | - F Hsu
- BC Cancer Abbotsford, Abbotsford, BC, Canada
| | - W Jiang
- BC Cancer - Surrey, Surrey, BC, Canada
| | - B Mou
- BC Cancer Kelowna, Kelowna, BC, Canada
| | - S Lefresne
- BC Cancer Vancouver, Vancouver, BC, Canada
| | | | - M Liu
- BC Cancer Vancouver, Vancouver, BC, Canada
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Li ZH, Kong T, Dunne EM, Liu M, Chang JS, Zhang TW, Chan M, McDermott R. Examining the Efficacy and Safety Profile of Palliative Radiotherapy Using 30 Gy in 5 Fractions. Int J Radiat Oncol Biol Phys 2023; 117:e129. [PMID: 37784686 DOI: 10.1016/j.ijrobp.2023.06.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Higher biological equivalent doses of radiotherapy (RT) can improve symptom palliation and local control in select tumor sites. However, not all patients meet criteria for treatment with stereotactic ablative radiotherapy (SABR). Furthermore, SABR is a resource intensive technique which may limit its use in many centers. The 30 Gray in 5 fractions regimen (30/5) stems from a modification of 5-fraction SABR regimens. It is a conformal, homogenous hypo-fractionated regimen that delivers higher dose than conventional palliative RT while still respecting the normal tissue constraints for 5-fraction SABR. It uses streamlined contouring and planning with less stringent requirements for immobilization and image guidance, compared to what is required for SABR. This study evaluates the clinical outcomes of patients receiving 30/5. MATERIALS/METHODS A single institution retrospective review of clinical and treatment data was performed for patients who received 30/5 from October 2020 to August 2022. Local control (LC) was calculated for all treatment courses. Distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were calculated for all patients. Survival analyses were analyzed by the Kaplan-Meier method and curves compared by log-rank test. Univariate and multivariate analyses were performed using cox-regression analysis. RESULTS A total of 77 patients and 92 courses of 30/5 were available for analysis. The most common primary tumor was lung (44%), followed by gastrointestinal (GI; 20%), breast (10%), and genitourinary (10%). The median age of patients was 64 years (range: 37-93). The median tumor size treated was 11.4 cm^3 (range: 0.3 - 210.9 cm^3). Treatment sites included lung (31%), lymph nodes (22%), non-spine bone (20%), and spine (15%). At median follow-up of 10.1 months (mo), 25 deaths occurred. Median LC after receiving 30/5 was 18.5 mo (95% CI: 15.7-21.3 mo), median DMFS was 6.6 months (95% CI: 4.6-8.6 mo), median PFS was 6.4 mo (95% CI: 4.9-8.0 mo), and median OS was 18.1 mo (95% CI: 13.1-23.1 mo). Median time to initiating, restarting, or changing systemic therapy was 12.8 mo (95% CI: 7.6-18.0 mo). Radiosensitive (lung, prostate, breast, gynecological, and head/neck) tumors had better LC than radioresistant (GI, renal cell, sarcoma, melanoma) tumors (median 20.9 vs 12.1 mo, p < 0.02). Six grade 2 toxicities occurred (6.5% of all treatments). No grade 3 or higher toxicities occurred. CONCLUSION The 30/5 regimen is a safe, well-tolerated, and resource efficient regimen with effective local control. This may serve as a practical alternative for patients who require palliative RT but not optimal candidates for SABR. As expected, radiosensitive tumors had better local control than radioresistant tumors. Future research can further explore the safety, efficacy, and indications of 30/5 as a palliative RT option.
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Affiliation(s)
- Z H Li
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - T Kong
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - E M Dunne
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - M Liu
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - J S Chang
- BC Cancer Vancouver, Vancouver, BC, Canada; Yonsei Cancer Center, Seoul, Korea, Republic of (South) Korea
| | - T W Zhang
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - M Chan
- BC Cancer Vancouver, Vancouver, BC, Canada
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Park HJ, Kim K, Kim YB, Chang JS, Shin KH. Patterns and Longitudinal Changes in The Practice of Breast Cancer Radiotherapy in Korea: Korean Radiation Oncology Group 22-01. Int J Radiat Oncol Biol Phys 2023; 117:e197-e198. [PMID: 37784841 DOI: 10.1016/j.ijrobp.2023.06.1069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To analyze contemporary practice patterns in breast cancer radiotherapy (RT) and to assess longitudinal changes therein over 5 years in Korea. MATERIALS/METHODS A nationwide survey was conducted among board-certified radiation oncologists in Korea by the Division for Breast Cancer of the Korean Radiation Oncology Group in March 2022. The survey consisted of 44 questions related to six domains: hypofractionated (HypoFx) whole breast RT, accelerated partial breast RT (APBI), regional nodal irradiation (RNI), RT for ductal carcinoma in situ (DCIS), postmastectomy RT (PMRT), and tumor bed boost. RESULTS In total, 70 radiation oncologists from 61 of 101 (60%) institutions participated in the survey. HypoFx RT was used by 62 respondents (89%), which has significantly increased from 36% in 2017. The HypoFx RT was commonly administered at 40-42.5 Gy in 15-16 fractions. APBI was used by 12 respondents (17%), which has increased from 5% in 2017. The use of RNI did not change significantly: ≥ pN2 (6%), ≥ pN1 (33%), and ≥ pN1 with pathological risk factors (61%). However, the indications for use of internal mammary lymph node (IMN) irradiation have expanded. In particular, the rates of routine treatment of IMN (11% from 6% in 2017) and treatment in cases of ≥ pN2 (27% from 14% in 2017) have doubled; however, the rate of treatment for only IMN involvement, identified on imaging, has decreased to 31% from 47% in 2017. With regard to DCIS, the use of hypoFx RT increased to 75% from 25%, and the rate of omission on of RT after breast-conserving surgery decreased to 38% from 48% in 2017. The use of hypoFx RT for PMRT also increased to 36% from 8% in 2017. CONCLUSION The adoption of HypoFx RT after breast-conserving surgery in invasive breast cancer and DCIS has increased significantly, whereas that for PMRT has increased moderately, compared to 2017. Further studies are required to determine the optimal use of RNI.
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Affiliation(s)
- H J Park
- Hanyang University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - K Kim
- Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - Y B Kim
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J S Chang
- Department of Radiation Oncology, Gangnam Severance Hospital, Seoul, Korea, Republic of (South) Korea
| | - K H Shin
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Min J, Chang JS, Kong ID. Domain-specific physical activity, sedentary behavior, subjective health, and health-related quality of life among older adults. Health Qual Life Outcomes 2023; 21:52. [PMID: 37248513 DOI: 10.1186/s12955-023-02136-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 05/22/2023] [Indexed: 05/31/2023] Open
Abstract
PURPOSE This study aims to investigate the association between domain-specific physical activity (PA), sedentary behavior, subjective health perception, and health-related quality of life (HR-QoL) in Korean adults aged ≥ 65 years. METHODS This cross-sectional study analyzed 6,004 older adults from the Korean National Health and Nutrition Examination Survey 2017-2020. PA and sedentary behavior were measured using a global PA questionnaire, and HR-QoL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Multiple logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for confounding parameters. RESULTS Older adults who were physically active at work showed a negative association with subjectively good health and HR-QoL, whereas those physically active in transport or leisure time showed a positive association with subjectively good health and HR-QoL. Older adults highly engaged in sedentary behavior showed a worse perception of health and HR-QoL. Compared to high sedentary behavior and physical activity during leisure time or transport, the EQ-5D index was higher than that of their counterparts. CONCLUSION Both domain-specific PA and sedentary behavior were significantly associated with older adults' perception of health and HR-QoL. Interventions are needed to improve HR-QoL by reducing sedentary behavior and encouraging physical activity in transportation or leisure time among adults aged 65 years and above.
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Affiliation(s)
- Jihee Min
- Department of Convergence Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
- Yonsei Institute of Sports Science and Exercise Medicine, Wonju, Republic of Korea
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Jae Seung Chang
- Department of Sports Science, Hannam University, Daejeon, Republic of Korea
| | - In Deok Kong
- Department of Convergence Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
- Yonsei Institute of Sports Science and Exercise Medicine, Wonju, Republic of Korea.
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Su YY, Chiang NJ, Chang JS, Wang YW, Shen BN, Li YJ, Hwang DY, Shan YS, Chen LT. The association between UGT1A1 polymorphisms and treatment toxicities of liposomal irinotecan. ESMO Open 2023; 8:100746. [PMID: 36527823 PMCID: PMC10024091 DOI: 10.1016/j.esmoop.2022.100746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Initial dose adjustment is recommended for patients with known UGT1A1∗28 homozygosity for both conventional irinotecan and liposomal irinotecan (nal-IRI). A recent population pharmacokinetic (PK) study showed that Asian patients had a lower prevalence of UGT1A1∗28 homozygosity but a significantly higher maximum blood concentration of SN-38 (SN-38 Cmax) and a higher incidence of grade ≥3 neutropenia after nal-IRI administration than Caucasian patients. The current study investigated the association of UGT1A1 polymorphisms, including the Asian prevalent UGT1A1∗6, PK and toxicities of nal-IRI-based therapy in the Asian population. PATIENTS AND METHODS A total of 162 patients with nal-IRI-based therapy and available UGT1A1∗6 and UGT1A1∗28 genotyping were included, with 82 Asian patients from six previous phase I or II studies of nal-IRI (cohort 1) and another 80 patients with nal-IRI + 5-fluorouracil/leucovorin every 2 weeks as real-world practice in a single institute in Taiwan (cohort 2). RESULTS The frequency of UGT1A1∗6 or UGT1A1∗28 homozygosity/compound heterozygosity was 9.3%, with UGT1A1∗6/∗6 in 2.5%, UGT1A1∗28/∗28 in 1.9% and UGT1A1∗6/∗28 in 4.9%. Among the 53 patients in cohort 1 with available PK data, all 7 patients with homozygosity/compound heterozygosity harbored UGT1A1∗6 and had a significantly higher level of median dose-normalized area under the concentration-time curve (AUC) and Cmax of SN-38 than those with single heterozygosity/wild type. Of the entire study population, the incidence of grade ≥3 neutropenia and diarrhea was significantly higher in patients with homozygosity/compound heterozygosity than in those with single heterozygosity/wild type, 73.3% versus 38.1% (P = 0.012, Fisher's exact test) and 33.3% versus 9.5% (P = 0.018, Fisher's exact test), respectively. CONCLUSION The results suggest that the recommendation of a lower starting dose of nal-IRI for patients with UGT1A1∗28 homozygosity should be extended to include patients with UGT1A1∗6 homozygosity/compound heterozygosity.
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Affiliation(s)
- Y-Y Su
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - N-J Chiang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - J S Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Y-W Wang
- PharmaEngine, Inc., Taipei, Taiwan
| | - B-N Shen
- PharmaEngine, Inc., Taipei, Taiwan
| | - Y-J Li
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - D-Y Hwang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Y-S Shan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - L-T Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Chang JS, Ahn JH, Kang SH, Koh SB, Kim JY, Baik SK, Huh JH, Lee SS, Kim MY, Park KS. Metabolic Stress Index Including Mitochondrial Biomarker for Noninvasive Diagnosis of Hepatic Steatosis. Front Endocrinol (Lausanne) 2022; 13:896334. [PMID: 35663311 PMCID: PMC9160793 DOI: 10.3389/fendo.2022.896334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mitochondrial dysfunction with oxidative stress contributes to nonalcoholic fatty liver disease (NAFLD) progression. We investigated the steatosis predictive efficacy of a novel non-invasive diagnostic panel using metabolic stress biomarkers. METHODS Altogether, 343 subjects who underwent magnetic resonance imaging-based liver examinations from a population-based general cohort, and 41 patients enrolled in a biopsy-evaluated NAFLD cohort, participated in the development and validation groups, respectively. Serologic stress biomarkers were quantitated by enzyme-linked immunosorbent assay. RESULTS Multivariate regression showed that waist-to-hip ratio, fibroblast growth factor (FGF) 21, FGF19, adiponectin-to-leptin ratio, insulin, albumin, triglyceride, total-cholesterol, and alanine-aminotransferase were independent predictors of steatosis (rank-ordered by Wald). The area under receiver-operator characteristics curve [AUROC (95%CI)] of the metabolic stress index for steatosis (MSI-S) was 0.886 (0.85-0.92) and 0.825 (0.69-0.96) in development and validation groups, respectively. MSI-S had higher diagnostic accuracy (78.1%-81.1%) than other steatosis indices. MSI-S notably differentiated steatosis severities, while other indices showed less discrimination. CONCLUSION MSI-S, as a novel non-invasive index, based on mitochondrial stress biomarker FGF21 effectively predicted steatosis. Furthermore, MSI-S may increase the population that could be excluded from further evaluation, reducing unnecessary invasive investigations more effectively than other indices.
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Affiliation(s)
- Jae Seung Chang
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jhii-Hyun Ahn
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Seong Hee Kang
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jang-Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Soon Koo Baik
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Ji Hye Huh
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Samuel S. Lee
- Liver Unit, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Moon Young Kim
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Regeneration Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
- *Correspondence: Moon Young Kim, ; Kyu-Sang Park,
| | - Kyu-Sang Park
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea
- *Correspondence: Moon Young Kim, ; Kyu-Sang Park,
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Abstract
OBJECTIVES The present study aimed to investigate the incidence of and risk factors for postoperative pneumonia and aspiration pneumonia after hip fracture surgery. DESIGN Retrospective cohort study from 2005 to 2021. SETTING Asan Medical Center in Seoul, Republic of Korea. PARTICIPANTS A total 1,208 patients aged ≥ 65 years who underwent hip fracture surgery. MEASUREMENTS Postoperative pneumonia was defined as cases with new infiltration on chest x-ray or chest computed tomography (CT) after surgery or confirmed by a pulmonologist's consultation and diagnosis. Aspiration pneumonia was defined as: 1) radiologic findings of hospital-acquired pneumonia on chest radiographs or CT, medical record of aspiration pneumonia confirmed by a pulmonologist's consultation, and history of vomiting or aspiration, or 2) gravity-dependent opacity on chest CT when the history of vomiting or aspiration is ambiguous. Patient demographics, past medical history, pre-injury Koval score, Charlson Comorbidity Index (CCI), blood test results, length of hospital stay, and in-hospital mortality were evaluated. A comparison analysis and binary logistic regression were performed to identify the incidence and risk factors for postoperative pneumonia and aspiration pneumonia. RESULTS Postoperative pneumonia was diagnosed in 47 patients (3.9%), including 20 with aspiration pneumonia (1.7%). In the multivariate analysis, postoperative delirium (odds ratio [OR], 3.42; P < 0.001), American Society of Anesthesiologists (ASA) scores ≥ 3 (OR, 2.11; P = 0.021), and CCI (OR, 1.21; P = 0.013) were significant risk factors for postoperative pneumonia. Male sex (OR, 3.01; P = 0.017), postoperative delirium (OR, 3.16; P = 0.014), and preoperative serum albumin levels < 3.5 g/dL (OR, 7.00; P = 0.010) were significant risk factors for aspiration pneumonia. CONCLUSION ASA classification ≥ 3, higher CCI, and postoperative delirium were the risk factors for postoperative pneumonia. Male sex, postoperative delirium, and lower preoperative serum albumin level were the risk factors for aspiration pneumonia. Thus, physicians should pay attention to patients with the risk factors.
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Affiliation(s)
- J Ahn
- Ji Wan Kim, Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea, Phone: +82-2-3010-3530, Fax: +82-2-2045-4542, Email address: , ORCID: 0000-0002-3524-8706
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Min J, Chang JS, Choi JY, Kong ID. Association Between Skeletal Muscle Mass, Physical Activity, and Metabolic Syndrome: the Korean National Health and Nutrition Examination Survey 2008-2011. Metab Syndr Relat Disord 2021; 20:156-165. [PMID: 34941432 DOI: 10.1089/met.2021.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Skeletal muscle mass (SM) and physical activity (PA) are major modifiable factors that can moderate and prevent the occurrence of metabolic syndrome (MetS). However, the joint association between SM and PA guidelines in MetS remains unclear. Therefore, we aimed to examine the relationship between SM and PA with MetS among Korean adults. Methods: This cross-sectional study analyzed 18,090 adults from the Korean National Health and Nutrition Examination Survey 2008-2011. We used the value of appendicular skeletal muscle mass divided by body mass index as SM. We decided on the PA guidelines using the American College of Sports Medicine guidelines. After adjusting for confounding factors, we performed logistic regression analysis to calculate the odds ratio and 95% confidence interval of MetS associated with SM and PA guidelines. Results: Participants from the highest SM quartile showed a decreased MetS risk of 58%-75%. Those who met both aerobic and resistance exercise guidelines were more likely to have lower MetS risk than those who neither. In addition, even with the same PA guideline status, participants with the highest muscle mass decreased MetS risk by 29%-81% compared with participants with the lowest muscle mass. Conclusions: Our results showed that increased SM and meeting PA guidelines are significantly associated with a decreased risk of MetS. To prevent MetS, customized strategies are needed for improving muscle mass and PA according to age and gender.
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Affiliation(s)
- Jihee Min
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Wonju, South Korea
| | - Jae Seung Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Wonju, South Korea.,Mitohormesis Research Center, Wonju College of Medicine, Yonsei University, Wonju, South Korea
| | - Ji Yeong Choi
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Wonju, South Korea
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Wonju, South Korea
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10
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Lee HJ, Chang JS, Ahn JH, Kim MY, Park KS, Ahn YS, Koh SB. Association Between Low Muscle Mass and Non-alcoholic Fatty Liver Disease Diagnosed Using Ultrasonography, Magnetic Resonance Imaging Derived Proton Density Fat Fraction, and Comprehensive NAFLD Score in Korea. J Prev Med Public Health 2021; 54:412-421. [PMID: 34875824 PMCID: PMC8655369 DOI: 10.3961/jpmph.21.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/15/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Methods This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations. Results According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD. Conclusions Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.
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Affiliation(s)
- Hun Ju Lee
- Department of Preventive Medicine, Yonsei Wonju University College of Medicine, Wonju, Korea
| | - Jae Seung Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jhii Hyun Ahn
- Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Moon Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyu-Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yeon-Soon Ahn
- Department of Preventive Medicine, Yonsei Wonju University College of Medicine, Wonju, Korea
| | - Sang Baek Koh
- Department of Preventive Medicine, Yonsei Wonju University College of Medicine, Wonju, Korea
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11
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Chang E, Chang JS, Kong ID, Baik SK, Kim MY, Park KS. Multidimensional Biomarker Analysis Including Mitochondrial Stress Indicators for Nonalcoholic Fatty Liver Disease. Gut Liver 2021; 16:171-189. [PMID: 34420934 PMCID: PMC8924798 DOI: 10.5009/gnl210106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 11/22/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is accompanied by a complex and multifactorial pathogenesis with sequential progressions from inflammation to fibrosis and then to cancer. This heterogeneity interferes with the development of precise diagnostic and prognostic strategies for NAFLD. The current approach for the diagnosis of simple steatosis, steatohepatitis, and cirrhosis mainly consists of ultrasonography, magnetic resonance imaging, elastography, and various serological analyses. However, individual dry and wet biomarkers have limitations demanding an integrative approach for the assessment of disease progression. Here, we review diagnostic strategies for simple steatosis, steatohepatitis and hepatic fibrosis, followed by potential biomarkers associated with fat accumulation and mitochondrial stress. For mitochondrial stress indicators, we focused on fibroblast growth factor 21 (FGF21), growth differentiation factor 15 (GDF15), angiopoietin-related growth factor and mitochondrial-derived peptides. Each biomarker may not strongly indicate the severity of steatosis or steatohepatitis. Instead, multidimensional analysis of different groups of biomarkers based on pathogenic mechanisms may provide decisive diagnostic/prognostic information to develop a therapeutic plan for patients with NAFLD. For this purpose, mitochondrial stress indicators, such as FGF21 or GDF15, could be an important component in the multiplexed and contextual interpretation of NAFLD. Further validation of the integrative evaluation of mitochondrial stress indicators combined with other biomarkers is needed in the diagnosis/prognosis of NAFLD.
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Affiliation(s)
- Eunha Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Seung Chang
- Department of Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Soon Koo Baik
- Department of Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Moon Young Kim
- Department of Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyu-Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
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12
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Ahn JH, Yu JS, Park KS, Kang SH, Huh JH, Chang JS, Lee JH, Kim MY, Nickel MD, Kannengiesser S, Kim JY, Koh SB. Effect of hepatic steatosis on native T1 mapping of 3T magnetic resonance imaging in the assessment of T1 values for patients with non-alcoholic fatty liver disease. Magn Reson Imaging 2021; 80:1-8. [PMID: 33798658 DOI: 10.1016/j.mri.2021.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 02/09/2023]
Abstract
PURPOSE This study investigated whether T1 values in native T1 mapping of 3T magnetic resonance imaging (MRI) of the liver were affected by the fatty component. METHODS This prospective study involved 340 participants from a population-based cohort study between May 8, 2018 and August 8, 2019. Data obtained included: (1) hepatic stiffness according to magnetic resonance elastography (MRE); (2) T1 value according to T1 mapping; (3) fat fraction and iron concentration from multi-echo Dixon; and (4) clinical indices of hepatic steatosis including body mass index, waist circumference, history of diabetes, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, and triglycerides. The correlations between T1 value and fat fraction, and between T1 value and liver stiffness were assessed using Pearson's correlation coefficient. The independent two-sample t-test was used to evaluate the differences in T1 values according to the presence or absence of hepatic steatosis, and the one-way analysis of variance was used to evaluate the difference in T1 value by grading of hepatic steatosis according to MRI-based proton density fat fraction (PDFF). In addition, univariate and multivariate linear regression analyses were performed to determine whether other variables influenced the T1 value. RESULTS T1 value showed a positive correlation with the fat fraction obtained from PDFF (r = 0.615, P < 0.001) and with the liver stiffness obtained from MRE (r = 0.370, P < 0.001). Regardless of the evaluation method, the T1 value was significantly increased in subjects with hepatic steatosis (P < 0.001). When comparing hepatic steatosis grades based on MRI-PDFF, the mean T1 values were significantly different in all grades, and the T1 value tended to increase as the grade increased (P < 0.001, P for trend <0.001). On multiple linear regression analysis, the T1 value was influenced by MRI-PDFF, calculated liver iron concentration, liver stiffness, and serum aspartate aminotransferase level. CONCLUSION The T1 value obtained by current T1 mapping of 3T MRI was affected by the liver fat component and several other factors such as liver stiffness, iron concentration, and inflammation.
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Affiliation(s)
- Jhii-Hyun Ahn
- Department of Radiology, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Republic of Korea
| | - Jeong-Sik Yu
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Kyu-Sang Park
- Mitohormesis Research Center, Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seong Hee Kang
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Ji Hye Huh
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jae Seung Chang
- Mitohormesis Research Center, Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jong-Han Lee
- Department of Laboratory Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Moon Young Kim
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | | | | | - Jang-Young Kim
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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13
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Magan AA, Kayani B, Chang JS, Roussot M, Moriarty P, Haddad FS. Artificial intelligence and surgical innovation: lower limb arthroplasty. Br J Hosp Med (Lond) 2020; 81:1-7. [PMID: 33135934 DOI: 10.12968/hmed.2020.0309] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The number of patients requiring hip and knee arthroplasty continues to rise each year. Patients are living longer and expecting to remain active into later life following joint replacement. Developments in computer-assisted surgery and robotic technology may optimise surgical outcomes and patient satisfaction following lower limb arthroplasty. The use of artificial intelligence in healthcare is rapidly growing and has gained momentum in lower limb arthroplasty. This article reviews the use of artificial intelligence and surgical innovation in lower limb arthroplasty, with a particular focus on robotic-assisted surgery in total knee arthroplasty.
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Affiliation(s)
- A A Magan
- Department of Trauma and Orthopaedics, University College London Hospital NHS Foundation Trust, London, UK.,Department of Orthopaedics, The Princess Grace Hospital, London, UK
| | - B Kayani
- Department of Trauma and Orthopaedics, University College London Hospital NHS Foundation Trust, London, UK
| | - J S Chang
- Department of Trauma and Orthopaedics, University College London Hospital NHS Foundation Trust, London, UK
| | - M Roussot
- Department of Trauma and Orthopaedics, University College London Hospital NHS Foundation Trust, London, UK
| | - P Moriarty
- Department of Trauma and Orthopaedics, University College London Hospital NHS Foundation Trust, London, UK
| | - F S Haddad
- Department of Trauma and Orthopaedics, University College London Hospital NHS Foundation Trust, London, UK.,Department of Trauma and Orthopaedics, The Princess Grace Hospital, London, UK
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14
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Jung D, Shim EJ, Park H, Lee K, Lee S, Kim EY, Chang JS, Jeong SH, Kim Y, Ahn YM, Hahm BJ. The Association between Excessive Internet Gaming Behavior and Immersive Tendency, Mediated by Attention Deficit/Hyperactivity Disorder Symptoms, in Korean Male University Students. Psychiatry Investig 2020; 17:403-411. [PMID: 32295328 PMCID: PMC7265032 DOI: 10.30773/pi.2019.0173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/19/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Problematic online gaming (POG) and problematic Internet use (PIU) have become a serious public mental health problem, with Internet gaming disorder (IGD) included in "Conditions for further study" section of DSM-5. Although higher immersive tendency is observed in people affected by POG, little is known about the simultaneous effect of immersive tendency and its highly comorbid mental disorder, attention deficit/hyperactivity disorder (ADHD). This study aimed to assess the relationship between immersive tendency, ADHD, and IGD. METHODS Cross-sectional interview study was conducted in Seoul, Korea with 51 male undergraduate students; 23 active gamers and 28 controls. RESULTS Current ADHD symptoms showed partial mediation effect on the path of immersive tendency on POG and PIU. The mediation model with inattention explained variance in both POG and PIU better than other current ADHD symptom models (R2=69.2 in POG; 69.3 in PIU). Childhood ADHD symptoms models demonstrated mediation effect on both POG and PIU which explained less variance than current ADHD symptom models (R2=53.7 in POG; 52.1 in PIU). Current ADHD symptoms, especially inattention, appear to mediate the effect of immersive tendency on POG/PIU. CONCLUSION Immersive tendencies may entail greater susceptibility to IGD, and comorbidity with ADHD may mediate the effect of immersive tendency on IGD.
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Affiliation(s)
- Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Hyeonggyu Park
- Korea Transportation Safety Authority, Gimcheon, Republic of Korea
| | - Kwanglo Lee
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Sangil Lee
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Eun-Young Kim
- Mental Health Center, Seoul National University Health Care Center, Seoul, Republic of Korea.,Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Seong-Hoon Jeong
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - Yeni Kim
- National Center for Mental Health, Seoul, Republic of Korea.,Department of Psychiatry, Dongguk University International Hospital, Institute of Clinical Psychopharmacology, Dongguk University School of Medicine, Goyang, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
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15
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Namkung J, Sohn JH, Chang JS, Park SW, Kim JY, Koh SB, Kong ID, Park KS. Increased Serum Angiopoietin-Like 6 Ahead of Metabolic Syndrome in a Prospective Cohort Study. Diabetes Metab J 2019; 43:521-529. [PMID: 30968619 PMCID: PMC6712233 DOI: 10.4093/dmj.2018.0080] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/21/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite being an anti-obesity hepatokine, the levels of serum angiopoietin-like 6 (ANGPTL6) are elevated in various metabolic diseases. Thus, ANGPTL6 expression may reflect metabolic burden and may have compensatory roles. This study investigated the association between serum ANGPTL6 levels and new-onset metabolic syndrome. METHODS In total, 221 participants without metabolic syndrome were randomly selected from a rural cohort in Korea. Baseline serum ANGPTL6 levels were measured using an enzyme-linked immunosorbent assay. Anthropometric and biochemical markers were analyzed before and after follow-up examinations. RESULTS During an average follow-up period of 2.75 (interquartile range, 0.76) years, 82 participants (37.1%) presented new-onset metabolic syndrome and had higher ANGPTL6 levels before onset than those without metabolic syndrome (48.03±18.84 ng/mL vs. 64.75±43.35 ng/mL, P=0.001). In the multivariable adjusted models, the odds ratio for the development of metabolic syndrome in the highest quartile of ANGPTL6 levels was 3.61 (95% confidence interval, 1.27 to 10.26). The use of ANGPTL6 levels in addition to the conventional components improved the prediction of new-onset metabolic syndrome (area under the receiver operating characteristic curve: 0.775 vs. 0.807, P=0.036). CONCLUSION Increased serum ANGPTL6 levels precede the development of metabolic syndrome and its components, including low high density lipoprotein, high triglyceride, and high glucose levels, which have an independent predictive value for metabolic syndrome.
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Affiliation(s)
- Jun Namkung
- Department of Biochemistry, Yonsei University Wonju College of Medicine, Wonju, Korea
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Joon Hyung Sohn
- Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Seung Chang
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sang Wook Park
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jang Young Kim
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sang Baek Koh
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In Deok Kong
- Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyu Sang Park
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea.
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16
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Kim JH, Kim H, Hwang KH, Chang JS, Park KS, Cha SK, Kong ID. WNK1 kinase is essential for insulin-stimulated GLUT4 trafficking in skeletal muscle. FEBS Open Bio 2018; 8:1866-1874. [PMID: 30410865 PMCID: PMC6212645 DOI: 10.1002/2211-5463.12528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 09/04/2018] [Accepted: 09/10/2018] [Indexed: 12/15/2022] Open
Abstract
With‐no‐lysine 1 (WNK1) kinase is a substrate of the insulin receptor/Akt pathway. Impaired insulin signaling in skeletal muscle disturbs glucose transporter 4 (GLUT4) translocation associated with the onset of type 2 diabetes (T2D). WNK1 is highly expressed in skeletal muscle. However, it is currently unknown how insulin signaling targeting WNK1 regulates GLUT4 trafficking in skeletal muscle, and whether this regulation is perturbed in T2D. Hereby, we show that insulin phosphorylates WNK1 at its activating site via a phosphatidylinositol 3‐kinase‐dependent mechanism. WNK1 promotes the cell surface abundance of GLUT4 via regulating TBC1D4. Of note, we observed insulin resistance and decreased WNK1 phosphorylation in T2D db/db mice as compared to the control mice. These results provide a new perspective on WNK1 function in the pathogenesis of hyperglycemia in T2D.
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Affiliation(s)
- Ji-Hee Kim
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Department of Global Medical Science Yonsei University Wonju College of Medicine Korea.,Mitohormesis Research Center Yonsei University Wonju College of Medicine Korea.,Institute of Lifestyle Medicine Yonsei University Wonju College of Medicine Korea.,Institute of Mitochondrial Medicine Yonsei University Wonju College of Medicine Korea
| | - Hanul Kim
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Department of Global Medical Science Yonsei University Wonju College of Medicine Korea
| | - Kyu-Hee Hwang
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Department of Global Medical Science Yonsei University Wonju College of Medicine Korea.,Mitohormesis Research Center Yonsei University Wonju College of Medicine Korea.,Institute of Lifestyle Medicine Yonsei University Wonju College of Medicine Korea.,Institute of Mitochondrial Medicine Yonsei University Wonju College of Medicine Korea
| | - Jae Seung Chang
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Mitohormesis Research Center Yonsei University Wonju College of Medicine Korea.,Institute of Lifestyle Medicine Yonsei University Wonju College of Medicine Korea.,Institute of Mitochondrial Medicine Yonsei University Wonju College of Medicine Korea
| | - Kyu-Sang Park
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Department of Global Medical Science Yonsei University Wonju College of Medicine Korea.,Mitohormesis Research Center Yonsei University Wonju College of Medicine Korea.,Institute of Lifestyle Medicine Yonsei University Wonju College of Medicine Korea.,Institute of Mitochondrial Medicine Yonsei University Wonju College of Medicine Korea
| | - Seung-Kuy Cha
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Department of Global Medical Science Yonsei University Wonju College of Medicine Korea.,Mitohormesis Research Center Yonsei University Wonju College of Medicine Korea.,Institute of Lifestyle Medicine Yonsei University Wonju College of Medicine Korea.,Institute of Mitochondrial Medicine Yonsei University Wonju College of Medicine Korea
| | - In Deok Kong
- Department of Physiology Yonsei University Wonju College of Medicine Korea.,Institute of Lifestyle Medicine Yonsei University Wonju College of Medicine Korea.,Institute of Mitochondrial Medicine Yonsei University Wonju College of Medicine Korea
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17
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Kim MJ, Namkung J, Chang JS, Kim SJ, Park KS, Kong ID. Leptin regulates the expression of angiopoietin-like 6. Biochem Biophys Res Commun 2018; 502:397-402. [PMID: 29852166 DOI: 10.1016/j.bbrc.2018.05.180] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 05/26/2018] [Indexed: 09/30/2022]
Abstract
Angiopoietin-like 6 (ANGPTL6) is a hepatokine that antagonizes obesity and insulin resistance by increasing energy expenditure. Despite its beneficial effects on metabolism, human studies have shown a paradoxical increase in ANGPTL6 level in the serum of patients with metabolic diseases, which has been interpreted as a compensatory upregulation. However, the regulatory mechanism of ANGPTL6 remains unclear. Since upregulation of ANGPTL6 is induced on metabolic stress, we investigated the hepatic expression of ANGPTL6 by leptin, a representative adipokine of obesity. Mice on a high-fat diet showed increased serum leptin levels and hepatic Angptl6 expression, which were attenuated by exercise training. A single leptin injection also induced hepatic ANGPTL6 expression and increased serum ANGPTL6 levels. In an in vitro model using primary hepatocytes, leptin treatment significantly upregulated ANGPTL6 expression at the mRNA and protein levels, as well as the amount of secreted ANGPTL6 protein in conditioned media. Similarly, exercise training on human participants also showed diminished serum levels of leptin and ANGPTL6. Altogether, these results strongly indicated that hepatic ANGPTL6 expression was determined by leptin.
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Affiliation(s)
- Min-Jeong Kim
- Institute of Medical Research, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jun Namkung
- Department of Biochemistry, Yonsei University Wonju College of Medicine, Wonju, South Korea; Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jae Seung Chang
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea; Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Soo-Jin Kim
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea; Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Kyu-Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea; Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, South Korea; Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, South Korea; Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
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18
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Choi JW, Chang JS, Lim JS, Kong ID. Circulating Irisin Levels And Bone Strength In Korean Adults. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535200.94194.7e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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Lee YK, Kim TY, Ha YC, Song SH, Kim JW, Shon HC, Chang JS, Koo KH. Atypical subtrochanteric fractures in Korean hip fracture study. Osteoporos Int 2017; 28:2853-2858. [PMID: 28612307 DOI: 10.1007/s00198-017-4112-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 06/04/2017] [Indexed: 12/18/2022]
Abstract
UNLABELLED In Korean, atypical subtrochanteric fractures (ASF) were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF. INTRODUCTION Recently, ASF have been reported to increase among patients on bisphosphonate. However, the incidence of ASF and the association between ASF and bisphosphonate use have not been well defined in Asian population. Our purposes are (1) to estimate the proportion of ASF among Korean patients with proximal femur fracture and (2) to determine the associated risk factors of ASF in the Korean patients. METHODS We conducted a multicenter (16 academic hospitals), prospective Korean hip fracture study on hip fracture in a cohort of patients aged 50 years or older from South Korea between July 2014 and May 2016. As a part of Korean hip fracture study, primary analysis examined the proportion of ASF among proximal femur fracture. To identify ASF, according to the definition by ASBMR task force, all radiographs of subtrochanteric fracture were reviewed. Associated risk factors for occurrence of ASF were also evaluated by using multivariable logistic regression analysis. RESULTS Among 1361 patients with proximal femoral fractures due to low-energy trauma, 17 fractures (1.2%) were identified as ASF. Higher BMI and use of bisphosphonate before injury were independent risk factors of ASF. CONCLUSION In Korean, ASF were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF.
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Affiliation(s)
- Y-K Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - T-Y Kim
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Y-C Ha
- Department of Orthopaedic Surgery, College of Medicine, Chung-Ang University, 224-1 Heukseok-dong, Dongjak-gu, Seoul, 156-755, South Korea.
| | - S-H Song
- Department of Orthopaedic Surgery, Myongji Hospital, Goyang, South Korea
| | - J W Kim
- Department of Orthopedic Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea
| | - H C Shon
- Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - J S Chang
- Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - K-H Koo
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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Lee DY, Won EK, Choi JW, Min HJ, Kim J, Ha K, Lee Y, Chang JS, Kim Y. Feasibility of the Korean version of the Bipolar Depression Rating Scale in Adolescents with Early-Onset Bipolar Disorder. Psychiatry Investig 2017; 14:585-594. [PMID: 29042883 PMCID: PMC5639126 DOI: 10.4306/pi.2017.14.5.585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 08/03/2016] [Accepted: 10/25/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study explores the feasibility and psychometric properties of the Korean version of the Bipolar Depression Rating Scale (BDRS) in adolescents with Early-onset bipolar disorders. METHODS Fifty-three participants (aged 13-18) with early-onset bipolar disorders (40 depressed and 18 euthymic, 5 patients were assessed at depressed state and reassessed after remission) were recruited. All participants were assessed using the BDRS, the Hamilton Depression Rating Scale (HAM-D), the Montgomery-Asperg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Modified Overt Aggression scale (MOAS). RESULTS BDRS exhibited good internal validity and significant correlations with the HAM-D and the MADRS. In item to scale correlations, all items on the BDRS were significantly correlated with the BDRS total scores except for 'increased motor drive' and 'increased speech', 'depressed mood' and 'worthlessness' showed the highest mean scores and endorsement rates. BDRS score of the depressed group was significantly higher compared with the euthymic group. Three factors (i.e., psychosomatic, mood, and mixed) were identified in the principal component analysis and hierarchical cluster analysis of the BDRS. CONCLUSION In this study, we report that the Korean version of BDRS is a feasible and reliable tool for the assessment of depression in adolescents with Early-onset bipolar disorders.
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Affiliation(s)
- Da-Young Lee
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Eun-Kyung Won
- Department of Child Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Jung-Won Choi
- Department of Adolescent Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Hye Ji Min
- Department of Adolescent Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Jayoun Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yunglyul Lee
- National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Jae Seung Chang
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yeni Kim
- Department of Child Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
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Kim TH, Chang JS, Kong ID. Effects of Exercise Training on Physical Fitness and Biomarker Levels in Breast Cancer Survivors. J Lifestyle Med 2017; 7:55-62. [PMID: 29026725 PMCID: PMC5618735 DOI: 10.15280/jlm.2017.7.2.55] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 06/13/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Exercise has been identified as a beneficial intervention to enhance quality of life in breast cancer survivors. In addition, there has been a noteworthy increase in studies emphasizing the benefits of exercise in cancer. We sought to summarize the empirical literature concerning the effects of exercise on physical fitness and biomarker levels in breast cancer survivors according to the type of exercise. METHODS We searched PubMed and PubMed Central for studies on the association of exercise with the levels of various biomarkers and physical fitness in breast cancer survivors. We investigated the effects of different types of exercise (aerobic, resistance, or combined) on breast cancer survivors, with changes in physical fitness and biomarker levels as the primary outcomes. RESULTS In total, 118 research papers published from 2012 to July 2016 were retrieved from PubMed and PubMed Central. Of these, 24 papers met our inclusion criteria. All types of exercise were found to improve physical fitness in breast cancer survivors. However, the results with regard to biomarkers were controversial. CONCLUSION The findings of this review suggest that combined exercise is associated with better outcomes than aerobic or resistance exercise alone in breast cancer survivors.
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Affiliation(s)
- Tae Ho Kim
- Department of Physiology, Yonsei University Wonju College of Medicine, Yonsei Institute of Sports Science & Exercise Medicine, Wonju, Korea
| | - Jae Seung Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Yonsei Institute of Sports Science & Exercise Medicine, Wonju, Korea
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Yonsei Institute of Sports Science & Exercise Medicine, Wonju, Korea
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22
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Kim TH, Chang JS, Kong ID. Effects of Exercise Training on Circulating Level of Sclerostin in Breast Cancer Survivors. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000519444.95296.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Chang JS, Kim TH, Deok Kong I. Low Estimated Glomerular Filtration Rate (eGFR) is Associated with Skeletal Muscle Function Deficit in Elderly Persons. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518745.55002.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Chang JS, Kim TH, Nguyen TT, Park KS, Kim N, Kong ID. Circulating irisin levels as a predictive biomarker for sarcopenia: A cross-sectional community-based study. Geriatr Gerontol Int 2017; 17:2266-2273. [PMID: 28394089 DOI: 10.1111/ggi.13030] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/26/2016] [Accepted: 01/25/2017] [Indexed: 12/25/2022]
Abstract
AIM Myokines are peptides released by the skeletal muscle, and have gained popularity as potential biomarkers for sarcopenia. Irisin is a recently identified myokine, but its role in pathological sarcopenia remains unclear. We investigated the validity and accuracy of circulating irisin levels as a potential biomarker for sarcopenia. METHODS We evaluated the anthropometrics, body composition, sarcopenia-related parameters and serum irisin levels of 715 community-dwelling Koreans. Sarcopenia was determined on the basis of the clinical diagnostic criteria of muscle atrophy and weakness, which were proposed by the Asian Working Group for Sarcopenia. RESULTS Circulating irisin levels were correlated with appendicular lean mass/height2 (rmen = 0.275; rwomen = 0.321) and handgrip strength (rmen = 0.219; rwomen = 0.312) in both sexes (all P < 0.01). Furthermore, the mean circulating irisin levels were lower in the sarcopenia group than in the normal group (all P < 0.05). In the logistic regression models, the association between serum irisin concentration and incident sarcopenia persisted even after adjusting for potential confounders, such as sex, age and fat indices (odds ratio 0.20, 95% CI 0.07-0.60; P for trend <0.01). The predictive values of serum irisin for sarcopenia were <1.0 μg/mL in men and <1.16 μg/mL in women, with the area under the receiver operating characteristic curves of 0.87 (95% CI 0.77-0.99) and 0.68 (95% CI 0.55-0.81), respectively (all P < 0.01). CONCLUSIONS A low level of circulating irisin is a sensitive marker for muscle weakness and atrophy. Irisin is a potential biomarker for muscle dysfunction that could help predict the onset of sarcopenia and provide new avenues for monitoring age-related muscle changes. Geriatr Gerontol Int 2017; 17: 2266-2273.
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Affiliation(s)
- Jae Seung Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Korea
| | - Tae Ho Kim
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Korea
| | - Tuyet Thi Nguyen
- Department of Physiology, Tan Tao University College of Medicine, Long An, Vietnam
| | - Kyu-Sang Park
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Nahyun Kim
- Keimyung University College of Nursing, Daegu, Korea
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Korea
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Lee YH, Lee JH, Kim SH, Yi D, Oh KJ, Kim JH, Park TJ, Kim H, Chang JS, Kong ID. Hemodynamic Adaptations to Regular Exercise in People With Spinal Cord Injury. Ann Rehabil Med 2017; 41:25-33. [PMID: 28289632 PMCID: PMC5344823 DOI: 10.5535/arm.2017.41.1.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/14/2016] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the real-time cardiovascular response to the progressive overload exercise in different levels of spinal cord injury (SCI), and to find out whether regular exercise has effect on these cardiovascular responses. Methods The study enrolled 8 able-bodied individuals in the control group plus 15 SCI subjects who were divided into two groups by their neurological level of injury: high-level SCI group (T6 or above) and low-level SCI group (T7 or below). Also, subjects were divided into exercise group and non-exercise group by usual exercise habits. We instructed the subjects to perform exercises using arm ergometer according to the protocol and checked plethysmograph for the real time assessment of blood pressure, heart rate, and cardiac output. Results Six subjects were included in high-level SCI group (3 cervical, 3 thoracic injuries), 9 subjects in low-level SCI group (9 thoracic injuries), and 8 able-bodied individuals in control group. During arm ergometer-graded exercise, mean arterial pressure (MAP) was significantly lower in high-level SCI subjects of non-exercise group, compared with high-level SCI subjects of exercise group. In addition, HR was significantly higher in low-level SCI group compared with control group. Conclusion There are significant differences in mean arterial pressure of high-level SCI group according to usual exercise habits. We discovered that even in non-athlete high-level SCI, regular exercise can bring cardiac modulation through blood pressure control.
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Affiliation(s)
- Young Hee Lee
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.; Center for Exercise Medicine, Yonsei University, Wonju, Korea
| | - Jin Hyeong Lee
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dongsoo Yi
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyung Joon Oh
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji Hyun Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Tae Jun Park
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hanul Kim
- Center for Exercise Medicine, Yonsei University, Wonju, Korea
| | - Jae Seung Chang
- Center for Exercise Medicine, Yonsei University, Wonju, Korea
| | - In Deok Kong
- Center for Exercise Medicine, Yonsei University, Wonju, Korea.; Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
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Chang JS, Kim KH, Yoon HI, Hyung WJ, Rha SY, Kim HS, Lee YC, Lim JS, Noh SH, Koom WS. Locoregional relapse after gastrectomy with D2 lymphadenectomy for gastric cancer. Br J Surg 2017; 104:877-884. [PMID: 28245053 DOI: 10.1002/bjs.10502] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/09/2016] [Accepted: 01/09/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Risk for and site of locoregional relapse have not been well studied in patients undergoing gastrectomy with D2 lymphadenectomy for gastric cancer. METHODS Patients who had undergone gastrectomy with D2 lymphadenectomy for gastric cancer between 2004 and 2007 were identified from an institutional database. The locoregional relapse rate was estimated by competing risk analysis, and risk groups were derived according to locoregional relapse risk using recursive partitioning analysis (RPA). The locations of nodal relapses were evaluated according to Japanese Classification of Gastric Carcinoma criteria. RESULTS Some 2618 patients were included. With a median follow-up of 78·0 (range 28·5-122·6) months, relapse was diagnosed in 471 of 2618 patients (18·0 per cent). The cumulative incidence of locoregional relapse at 5 years was 8·5 (95 per cent c.i. 7·4 to 9·6) per cent. The 5-year locoregional recurrence rates for high-risk (N3), intermediate-risk (N1-2) and low-risk (N0) groups were 32·4, 12·3 and 1·7 per cent respectively (P < 0·001). Among patients with regional relapse, 90·4 per cent had involvement outside the D2 dissected area, and the most commonly involved site was station 16b1. This pattern was maintained in the RPA risk groups (P = 0·329). CONCLUSION Locoregional relapse at 5 years after gastrectomy with D2 lymphadenectomy was 8·5 per cent, and was most often seen outside the D2 dissected area.
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Affiliation(s)
- J S Chang
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - K H Kim
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - H I Yoon
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - W J Hyung
- Department of Surgery, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Rha
- Division of Medical Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - H S Kim
- Division of Medical Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - Y C Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - J S Lim
- Department of Radiology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - S H Noh
- Department of Surgery, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - W S Koom
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
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Kim TH, Chang JS, Park KS, Park J, Kim N, Lee JI, Kong ID. Effects of exercise training on circulating levels of Dickkpof-1 and secreted frizzled-related protein-1 in breast cancer survivors: A pilot single-blind randomized controlled trial. PLoS One 2017; 12:e0171771. [PMID: 28178355 PMCID: PMC5298304 DOI: 10.1371/journal.pone.0171771] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/25/2017] [Indexed: 12/02/2022] Open
Abstract
Background Wingless and integration site growth factor (Wnt) signaling is a tumorigenesis-related signaling pathway. Dickkpof-1 (DKK1) and secreted frizzled-related protein-1 (SFRP1) are endogenous negative regulators of Wnt/β-catenin signaling. Accumulating evidence indicates that higher serum levels of DKK1 are correlated with poor prognosis of various types of cancer. Here, we investigated whether exercise training causes changes in the serum levels of DKK1 and SFRP1 in patients with breast cancer. Methods Twenty-four breast cancer survivors, after chemo- or radiotherapy, participated in this single-blind randomized, controlled pilot study. Subjects were randomized to either an exercise program or a control group for 12 weeks and completed pre- and post-training tests for health-related fitness and body composition as well as blood biomarkers. The serum levels of DKK1 and SFRP1 were measured using enzyme-linked immunosorbent assay as the primary outcome. Results Exercise training for 12 weeks remarkably increased muscle strength, endurance, and flexibility and decreased body fat percentage, waist circumference, and visceral fat area (all p < 0.05). Exercise training lowered serum insulin levels and leptin/adiponectin ratios (all p < 0.05). The levels of DKK1 and SFRP1 were also significantly decreased by exercise training in breast cancer survivors (all p < 0.01). Conclusions Our results indicate that DKK1 and SFRP1 may be potentially useful biomarkers for evaluating the beneficial effects of long-term exercise on physical fitness and metabolism as well as the prognosis of patients with cancer. Trial registration ClinicalTrials.gov NCT02895178
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Affiliation(s)
- Tae Ho Kim
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
- Yonsei Institute of Sports Science & Exercise Medicine, Wonju, Republic of Korea
| | - Jae Seung Chang
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
- Yonsei Institute of Sports Science & Exercise Medicine, Wonju, Republic of Korea
| | - Kyu-Sang Park
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Jeeyeon Park
- Department of Nursing Science, Kyungsung University, Busan, Republic of Korea
| | - Nahyun Kim
- Department of Basic Nursing Science, Keimyung University College of Nursing, Daegu, Republic of Korea
| | - Jong In Lee
- Department of Hematology-Oncology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - In Deok Kong
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
- Yonsei Institute of Sports Science & Exercise Medicine, Wonju, Republic of Korea
- * E-mail:
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Kang TK, Woo JY, Chang JS, Lee SY. THE ROLE OF PLANTAR CUTANEOUS SENSATION AND THE PROXIMAL JOINT POSTURAL CONTROL STRATEGY TO MAINTAIN BALANCE IN CAI PATIENTS. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Park J, Lee YH, Kong ID, Park TJ, Chang JS, Kim T, Lee HC. ULTRASONOGRAPHIC CHANGES OF UPPER EXTREMITY TENDONS IN RECREATIONAL BADMINTON PLAYERS: THE EFFECT OF HAND DOMINANCE AND COMPARISON WITH CLINICAL FINDINGS. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chang JS, Lee YH, Kong ID. THE PROTECTIVE EFFECTS OF VARIOUS WARM-UP MODALITIES ON EXERCISE-INDUCED BRONCHOSPASM (EIB) IN NON-ASTHMATIC ATHLETES. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wang SH, Chang JS, Hsiao JR, Yen YC, Jiang SS, Liu SH, Chen YL, Shen YY, Chang JY, Chen YW. Tumour cell-derived WNT5B modulates in vitro lymphangiogenesis via induction of partial endothelial-mesenchymal transition of lymphatic endothelial cells. Oncogene 2016; 36:1503-1515. [PMID: 27593938 DOI: 10.1038/onc.2016.317] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/03/2016] [Accepted: 07/25/2016] [Indexed: 12/22/2022]
Abstract
Metastasis of the cervical lymph nodes frequently leads to poor survival of patients with oral squamous cell carcinoma (OSCC). The underlying mechanisms of lymph node metastasis are unclear. Wingless-type MMTV integration site family, member 5B (WNT5B), one component of the WNT signal pathway, was markedly up-regulated in OSCC sublines with high potential of lymphatic metastasis compared to that in OSCC cells with low nodal metastasis. Increased WNT5B mRNA was demonstrated in human OSCC tissues in comparison with adjacent non-tumorous tissues. Interestingly, the high level of WNT5B protein in serum was associated with lymph node metastasis in OSCC patients. Knockdown of WNT5B expression in OSCC sublines did not affect tumour growth but impaired lymph node metastasis and tumour lymphangiogenesis of orthotopic transplantation. Conditioned medium from WNT5B knockdown cells reduced the tube formation of lymphatic endothelial cells (LECs). In contrast, recombinant WNT5B enhanced the tube formation, permeability and migration of LECs. In LECs stained with phalloidin, the morphology of those treated with recombinant WNT5B changed from flat to spindle-like. Recombinant WNT5B also increased α-smooth muscle actin and inhibited the expression of vascular endothelial-cadherin but retained characteristics of endothelial cells. The results suggest that WNT5B functions in the partial endothelial-mesenchymal transition (EndoMT). Furthermore, WNT5B-induced tube formation was impaired in the LECs following the knockdown of EndoMT-related transcription factor, SNAIL or SLUG. The WNT5B-induced expression of Snail or Slug was abolished by IWR-1-endo and Rac1 inhibitors, which are involved in the WNT/β-catenin and planar cell polarity pathways, respectively. Collectively, the data suggest that WNT5B induces tube formation by regulating the expression of Snail and Slug proteins through activation of canonical and non-canonical WNT signalling pathways.
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Affiliation(s)
- S-H Wang
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan
| | - J S Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - J-R Hsiao
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Y-C Yen
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan
| | - S S Jiang
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan
| | - S-H Liu
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan
| | - Y-L Chen
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan
| | - Y-Y Shen
- Pathology Core Laboratory, National Health Research Institutes, Miaoli, Taiwan
| | - J-Y Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Y-W Chen
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan.,PhD Program for Aging, Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
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Kim BJ, Shin KO, Kim H, Ahn SH, Lee SH, Seo CH, Byun SE, Chang JS, Koh JM, Lee YM. The effect of sphingosine-1-phosphate on bone metabolism in humans depends on its plasma/bone marrow gradient. J Endocrinol Invest 2016. [PMID: 26219613 DOI: 10.1007/s40618-015-0364-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although recent studies provide clinical evidence that sphingosine-1-phosphate (S1P) may primarily affect bone resorption in humans, rather than bone formation or the osteoclast-osteoblast coupling phenomenon, those studies could not determine which bone resorption mechanism is more important, i.e., chemorepulsion of osteoclast precursors via the blood to bone marrow S1P gradient or receptor activator of NF-κB ligand (RANKL) elevation in osteoblasts via local S1P. AIM To investigate how S1P mainly contributes to increased bone resorption in humans, we performed this case-control study at a clinical unit in Korea. METHODS Blood and bone marrow samples were contemporaneously collected from 70 patients who underwent hip surgery due to either osteoporotic hip fracture (HF) (n = 10) or other causes such as osteoarthritis (n = 60). RESULTS After adjusting for sex, age, BMI, smoking, alcohol, previous fracture, diabetes, and stroke, subjects with osteoporotic HF demonstrated a 3.2-fold higher plasma/bone marrow S1P ratio than those without HF, whereas plasma and bone marrow S1P levels were not significantly different between these groups. Consistently, the risk of osteoporotic HF increased 1.38-fold per increment in the plasma/bone marrow S1P ratio in a multivariate adjustment model. However, the odds ratios for prevalent HF according to the increment in the plasma and bone marrow S1P level were not statistically significant. CONCLUSION Our current results using simultaneously collected blood and bone marrow samples suggest that the detrimental effects of S1P on bone metabolism in humans may depend on the S1P gradient between the peripheral blood and bone marrow cavity.
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Affiliation(s)
- B-J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - K-O Shin
- College of Pharmacy and MRC, Chungbuk National University, Cheongju, 361-763, Korea
| | - H Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - S H Ahn
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - C-H Seo
- College of Pharmacy and MRC, Chungbuk National University, Cheongju, 361-763, Korea
| | - S-E Byun
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, 463-712, Korea
| | - J S Chang
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
| | - J-M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea.
| | - Y-M Lee
- College of Pharmacy and MRC, Chungbuk National University, Cheongju, 361-763, Korea.
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Chang JS, Kim TH, Kim H, Choi EH, Kim N, Kong ID. Qualitative muscle mass index as a predictor of skeletal muscle function deficit in Asian older adults. Geriatr Gerontol Int 2015; 17:99-107. [PMID: 26711225 DOI: 10.1111/ggi.12681] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 12/25/2022]
Abstract
AIM The present cross-sectional study was carried out among community-dwelling Koreans to determine the validity of various muscle mass indices and to propose more clinically relevant diagnostic criteria. METHODS This study measured the anthropometrics, body composition and physical capability of 415 older Koreans. Skeletal muscle indices were calculated by dividing appendicular lean mass by height or weight. Apart from this, we adjusted appendicular lean mass for body mass index, body surface area or waist-to-height ratio, which we then named the qualitative muscle mass index. Skeletal muscle function deficit was defined as a combination of weakness and slowness. RESULTS Qualitative muscle indices were closely associated with physical capabilities. Receiver operating characteristic and logistic analyses showed that qualitative muscle indices had significantly greater discriminatory powers regarding low muscle function than did the height-adjusted index in both men and women, and even showed higher discriminatory potentials than the weight-adjusted index in men (all P < 0.05). The cut-off values of qualitative muscle indices of body mass index-, body surface area-, and waist-to-height ratio-adjusted indices for identifying functional deficits were 0.760, 11.40 and 34.18 for men, and 0.530, 8.91 and 23.07 for women, respectively. CONCLUSIONS The present study suggests that qualitative muscle indices are more accurate in predicting low muscle function than are height- and weight-adjusted indices, because they consider anthropometric characteristics as part of the definition. The results might provide new avenues for conceptualizations of sarcopenia accompanied by obesity, and can be used as ethnic-specific reference values of muscle mass indices based on functional outcome in an elderly Korean/Asian population. Geriatr Gerontol Int 2017; 17: 99-107.
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Affiliation(s)
- Jae Seung Chang
- Department of Physiology, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea.,Institute of Lifestyle Medicine, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea
| | - Tae Ho Kim
- Department of Physiology, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea
| | - Hanul Kim
- Department of Physiology, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea
| | - Eun Hee Choi
- Institute of Lifestyle Medicine, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea
| | - Nahyun Kim
- Keimyung University College of Nursing, Daegu, Korea
| | - In Deok Kong
- Department of Physiology, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea.,Institute of Lifestyle Medicine, Yonsei Univeristy Wonju College of Medicine, Wonju, Korea
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Choi SJ, Chang JS, Kong ID. Effects of a Social Welfare Program for Health Promotion on Cardiovascular Risk Factors. J Lifestyle Med 2015; 5:76-82. [PMID: 26770894 PMCID: PMC4711962 DOI: 10.15280/jlm.2015.5.2.76] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/12/2015] [Indexed: 11/23/2022] Open
Abstract
Background Socioeconomic status is closely associated with an individual’s health status. However, there are few studies examining the role of exercise-training as part of a community-based social welfare program in socially vulnerable groups. Given this, our aim was to measure whether long-term exercise training as a social welfare program affects the prevalence of depressive symptoms, metabolic syndrome and peripheral blood vessel condition among participants with low household income. Methods Twenty-nine adults and twenty-two older adults were recruited into this study with non-radomized, pre/post-test design. The subjects underwent a combined training consisting of aerobic and muscle strengthening exercises for 6 months or more. Depressive symptoms were evaluated using the Beck Depression Inventory and the Korean version of Geriatric Depression Scale. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Blood vessel condition was assessed using non-invasive accelerated photoplethysmograph. Results Mean skeletal muscle mass increased after exercise-training, but body mass index and percent body fat were unchanged. Overall age-specific physical fitness and performance increased markedly among both adult and elderly subjects, respectively. The proportion of depressive symptoms was significantly reduced by 33% after exercise-training among all participants. The prevalence of individuals having metabolic syndrome was significantly reduced by 19.6% and the number of individual components of metabolic syndrome decreased after the exercise intervention. Among components of metabolic syndrome, waist circumference, HDL cholesterol and systolic blood pressure significantly improved. In addition, the proportions of moderate and severe arteriosclerotic progression significantly decreased. Conclusion Long-term exercise-training as a social welfare program is beneficial for health promotion and effective in simultaneously improving psychological and physiological health status in a low income population. This suggests that the development and expansion of an exercise intervention as a health-promoting welfare program are needed to address the inequality of exercise participation among socially vulnerable groups.
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Affiliation(s)
- Seong-Jin Choi
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Seung Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea; Center for Exercise Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In Deok Kong
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea; Center for Exercise Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Chang JS, Kim EY, Jung D, Jeong SH, Kim Y, Roh MS, Ahn YM, Hahm BJ. Altered cardiorespiratory coupling in young male adults with excessive online gaming. Biol Psychol 2015; 110:159-66. [PMID: 26253868 DOI: 10.1016/j.biopsycho.2015.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 07/10/2015] [Accepted: 07/30/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This study aimed to investigate changes in heart rate variability and cardiorespiratory coupling in male college students with problematic Internet use (PIU) excessive gaming type during action video game play to assess the relationship between PIU tendency and central autonomic regulation. METHOD Electrocardiograms and respiration were simultaneously recorded from 22 male participants with excessive online gaming and 22 controls during action video game play. Sample entropy (SampEn) was computed to assess autonomic regularity, and cross-SampEn was calculated to quantify autonomic coordination. RESULTS During video game play, reduced cardiorespiratory coupling (CRC) was observed in individuals with PIU excessive gaming type compared with controls, implicating central autonomic dysregulation. The PIU tendency was associated with the severity of autonomic dysregulation. CONCLUSION These findings indicate impaired CRC in PIU excessive gaming type, which may reflect alterations of central inhibitory control over autonomic responses to pleasurable online stimuli.
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Affiliation(s)
- Jae Seung Chang
- Department of Psychiatry and Institute of Clinical Psychopharmacology, Dongguk University Ilsan Medical Center, 27 Dongguk-Ro, Ilsandong-Gu, Goyang, Gyeonggi 410-773, Republic of Korea
| | - Eun Young Kim
- Mental Health Clinic, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi 410-769, Republic of Korea
| | - Dooyoung Jung
- Department of Psychiatry, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea
| | - Seong Hoon Jeong
- Department of Psychiatry, Eulji University Hospital, 1306 Seo-Gu, Dunsan-Dong, Daejeon 302-799, Republic of Korea
| | - Yeni Kim
- Department of Adolescent Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, 398 Neungdong-Ro, Gwangin-Gu, Seoul 143-711, Republic of Korea
| | - Myoung-Sun Roh
- Department of Medicine, Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-Gu, Seoul 110-799, Republic of Korea
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea.
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Kim EY, Kim SH, Rhee SJ, Huh I, Ha K, Kim J, Chang JS, Yoon DH, Park T, Ahn YM. Relationship between thyroid-stimulating hormone levels and risk of depression among the general population with normal free T4 levels. Psychoneuroendocrinology 2015; 58:114-9. [PMID: 25973566 DOI: 10.1016/j.psyneuen.2015.04.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study assessed the relationship between thyroid-stimulating hormone (TSH) level and risk of depressive symptom in a population with no clinical or laboratory evidence of thyroid dysfunction. METHODS This retrospective cohort study included 13,017 subjects (7913 males and 5104 females), 17-84 years of age, who underwent health examinations at the hospital. Subjects had a Beck Depression Inventory (BDI) total score of ≤9 and fell within the normal range of free T4 levels at baseline. The association between gender-specific serum TSH tertile at baseline and the development of clinically significant depressive symptom (i.e., ≥19 BDI total score) on the follow-up visit was evaluated using the Cox proportional hazards model, with adjustment for demographic and life style factors. RESULTS The risk of depressive symptom was increased among subjects with the highest tertile TSH level (adjusted hazard ratio [HR], 2.236; 95% confidence interval [CI], 1.443-3.466; p<0.001) as compared with subjects with the lowest tertile in females, but not in males. Even among patients with normal TSH levels, females in the lowest-normal TSH tertile had a higher risk of depressive symptoms (adjusted HR, 2.279; 95% CI, 1.456-3.567; p<0.001) than did those in the highest tertile. The TSH level as a continuous variable significantly predicted the depressive symptoms in females (adjusted HR, 1.402; 95% CI, 1.002-1.812; p=0.027). CONCLUSIONS Our finding suggests that suboptimal thyroid function increases vulnerability to the occurrence of depressive symptom and represents a modifiable risk factor for depression in females.
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Affiliation(s)
- Eun Young Kim
- Mental Health Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Se Hyun Kim
- Department of Neuropsychiatry, Dongguk University Medical School, Dongguk University International Hospital, Goyang, Republic of Korea
| | - Sang Jin Rhee
- Mental Health Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Iksoo Huh
- Department of Statistics, Seoul National University, Seoul, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Seoul National Hospital, Seoul, Republic of Korea
| | - Jayoun Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Seung Chang
- Department of Psychiatry and Institute of Clinical Psychopharmacology, Dongguk University College of Medicine, Goyang, Republic of Korea
| | - Dae Hyun Yoon
- Department of Psychiatry, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Republic of Korea.
| | - Yong Min Ahn
- Mental Health Clinic, National Cancer Center, Goyang, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Li OL, Guo Y, Chang JS, Saito N. Thermal plasma treatment of stormwater sediments: comparison between DC non-transferred and partially transferred arc plasma. Environ Technol 2015; 36:1672-1679. [PMID: 25566678 DOI: 10.1080/09593330.2014.1003981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The disposal of enormous amount of stormwater sediments becomes an emerging worldwide problem. Stormwater sediments are contaminated by heavy metals, phosphorus, trace organic and hydrocarbons, and cannot be disposed without treatment. Thermal plasma decontamination technology offers a high decomposition rate in a wide range of toxic organic compound and immobilization of heavy metal. In this study, we compared the treatment results between two different modes of thermal plasma: (1) a non-transferred direct current (DC) mode and (2) a partial DC-transferred mode. The reductions of total organic carbon (TOC) were, respectively, 25% and 80% for non-transferred and partially transferred plasma, respectively. Most of the toxic organic compounds were converted majorly to CxHy. In the gaseous emission, the accumulated CxHy, CO, NO and H2S were significantly higher in partially transferred mode than in non-transferred mode. The solid analysis demonstrated that the concentrations of Ca and Fe were enriched by 500% and 40%, respectively. New chemical compositions such as KAlSi3O8, Fe3O4, NaCl and CaSO4 were formed after treatment in partially DC-transferred mode. The power inputs were 1 and 10 kW, respectively, for non-transferred DC mode and a partially DC-transferred mode. With a lower energy input, non-transferred plasma treatment can be used for decontamination of sediments with low TOC and metal concentration. Meanwhile, partially transferred thermal plasma with higher energy input is suitable for treating sediments with high TOC percentage and volatile metal concentration. The organic compounds are converted into valuable gaseous products which can be recycled as an energy source.
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Affiliation(s)
- O L Li
- a Green Mobility Collaborative Research Centre, Nagoya University , Furo-cho, Chikusa-ku, Nagoya 464 8603 , Japan
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Chang JS, Hwang SSH, Yi SH, Kim Y, Lee YS, Kim YS, Jung HY. Evaluating subjective domains of antipsychotic-induced adverse effects using heart rate variability. Psychiatry Clin Neurosci 2015; 69:283-91. [PMID: 25066617 DOI: 10.1111/pcn.12226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 06/18/2014] [Accepted: 07/23/2014] [Indexed: 11/26/2022]
Abstract
AIMS Antipsychotic-induced autonomic dysregulation may lead to a wide range of subjective side-effects in schizophrenia patients. Using heart rate variability (HRV) measures, we prospectively examined the relationship between subjective side-effects and cardiac autonomic regulation in unmedicated schizophrenia patients. METHODS Forty-five unmedicated schizophrenia patients were assessed for antipsychotic-associated side-effects and HRV parameters at baseline and after 6 weeks of treatment. Psychiatric symptoms and subjective side-effects were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Liverpool University Neuroleptic Side-effect Rating Scale (LUNSERS). RESULTS Correlations between subjective adverse effects and HRV measures at baseline and at week 6 varied. Nonetheless, the changes in the psychic side-effects domain were significantly correlated with the changes in time-domain HRV measures and sample entropy (SampEn). In addition, the change in SampEn was significantly associated with that in the scores of extrapyramidal, anticholinergic, miscellaneous, and red herring domains as well as the mean total LUNSERS score. CONCLUSION Baseline HRV measures may predict clinical response and adverse events associated with treatment adherence. Also, subjective side-effects may correspond well with the changes in neurocardiac dynamics, and the changes in SampEn may effectively reflect subjective discomfort in patients receiving antipsychotic treatment.
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Affiliation(s)
- Jae Seung Chang
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
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Chang JS, Kim H, Kim T, Cha S, Kong ID. Qualitative muscle mass index as the prognostic value of low muscle functions in the elderly. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jae Seung Chang
- Department of PhysiologyYonsei University Wonju College of Medicine
- Center for Exercise Medicine Yonsei UniversityKorea
| | - Hanul Kim
- Department of PhysiologyYonsei University Wonju College of Medicine
- Center for Exercise Medicine Yonsei UniversityKorea
| | - Tae‐Ho Kim
- Department of PhysiologyYonsei University Wonju College of Medicine
- Center for Exercise Medicine Yonsei UniversityKorea
| | - Seung‐Kuy Cha
- Department of PhysiologyYonsei University Wonju College of Medicine
| | - In Deok Kong
- Department of PhysiologyYonsei University Wonju College of Medicine
- Center for Exercise Medicine Yonsei UniversityKorea
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Chang JS, Kim Y, Kim SH, Hwang S, Kim J, Chung IW, Kim YS, Jung HY. Differences in the internal structure of hallucinatory experiences between clinical and nonclinical populations. Psychiatry Res 2015; 226:204-10. [PMID: 25619435 DOI: 10.1016/j.psychres.2014.12.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 12/30/2014] [Accepted: 12/31/2014] [Indexed: 10/24/2022]
Abstract
We investigated differential patterns of hallucinatory experiences between nonclinical and clinical samples. A total of 223 nonclinical individuals (108 females) and 111 subjects with schizophrenia (54 females) completed the Launay-Slade Hallucination Scale-Revised (LSHS-R) and Perceptual Aberration Scale (PAS). The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) was used for the nonclinical group, and the Positive and Negative Syndrome Scale (PANSS) hallucination item was used for the clinical group. Cronbach's alpha values showed good internal consistency for the LSHS-R. In the two groups, significant associations were found between LSHS-R and PAS scores. Two factors were extracted through a principal component analysis (PCA) in the nonclinical group, and three factors were identified in the clinical group. The results of a hierarchical cluster analysis (HCA) revealed that a perception-cognition dimension was clear cluster discriminating element for the nonclinical group, whereas alterations in perception-cognition dimension were characteristic in cluster structure of the clinical group. Our findings suggest that the nature of hallucinatory experiences may differ qualitatively between a nonclinical population and subjects with schizophrenia. Perceptual or cognitive aberrations may add a psychopathologic dimension to hallucinatory experiences. Exploring the internal structure of hallucinatory experiences may provide explanatory insight into these experiences in the general population.
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Affiliation(s)
- Jae Seung Chang
- Department of Psychiatry and Institute of Clinical Psychopharmacology, Dongguk University Ilsan Hospital, Goyang, Gyeonggi, Republic of Korea
| | - Yeni Kim
- Department of Adolescent Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Se Hyun Kim
- Department of Psychiatry and Institute of Clinical Psychopharmacology, Dongguk University Ilsan Hospital, Goyang, Gyeonggi, Republic of Korea
| | - Samuel Hwang
- Department of Psychology, Chonnam University, Gwangju, Republic of Korea
| | - Jayoun Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - In-Won Chung
- Department of Psychiatry and Institute of Clinical Psychopharmacology, Dongguk University Ilsan Hospital, Goyang, Gyeonggi, Republic of Korea
| | - Yong Sik Kim
- Department of Psychiatry and Institute of Clinical Psychopharmacology, Dongguk University Ilsan Hospital, Goyang, Gyeonggi, Republic of Korea
| | - Hee-Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Science and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Abstract
Background Insulin-like growth factor (IGF-1) is associated with chronic diseases such as diabetes, cardiovascular disease, and hypertension, as well as muscle dysfunction. Previous studies of exercise interventions yield controversial results regarding plasma IGF-1, IGFBP3, and IGF-1/IGFBP3 ratio. In this study, we examined whether 100 km walking exercise affects serum levels of IGF-1 and IGFBP3 and IGF-1/IGFBP3 ratio. We also investigated several metabolic-related blood parameters before and after walking. Methods Participants were 14 healthy middle aged men (41.0 ± 6.78 years of age). We assessed body composition and measured metabolic-related blood indicators, such as such as lipid profiles, glucose, renal and hepatic metabolic bio-markers before and after a 100 km walking race. Blood samples from all participants were taken before and immediately after the walkathon. We also analyzed serum levels of IGF-1 and IGFBP3, and calculated the IGF-1/IGFBP3 ratio. Results After participants completed a 100 km walking race, some of their metabolic profiles were markedly changed. Serum levels of IGF-1 and IGFBP3 were significantly decreased, and therefore the IGF-1/IGFBP3 ratio also decreased before and after 100 km of walking. Conclusion Our results indicate that intense walking exercise affects serum levels of IGF-1 and IGFBP3 as well as metabolic bio-markers including high density cholesterol, glucose and triglycerides.
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Affiliation(s)
- TaeHo Kim
- Department of Physiology and Center for Exercise Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Seung Chang
- Department of Physiology and Center for Exercise Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hanul Kim
- Department of Physiology and Center for Exercise Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kwang Ho Lee
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In Deok Kong
- Department of Physiology and Center for Exercise Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Lee YH, Oh KJ, Kong ID, Kim SH, Shinn JM, Kim JH, Yi D, Lee JH, Chang JS, Kim TH, Kim EJ. Effect of regular exercise on cardiopulmonary fitness in males with spinal cord injury. Ann Rehabil Med 2015; 39:91-9. [PMID: 25750877 PMCID: PMC4351500 DOI: 10.5535/arm.2015.39.1.91] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/26/2014] [Indexed: 12/05/2022] Open
Abstract
Objective To evaluate the cardiopulmonary endurance of subjects with spinal cord injury by measuring the maximal oxygen consumption with varying degrees of spinal cord injury level, age, and regular exercise. Methods We instructed the subjects to perform exercises using arm ergometer on healthy adults at 20 years of age or older with spinal cord injury, and their maximal oxygen consumption (VO2max) was measured with a metabolic measurement system. The exercise proceeded stepwise according to the exercise protocol and was stopped when the subject was exhausted or when VO2 reached an equilibriu Results Among the 40 subjects, there were 10 subjects with cervical cord injury, 27 with thoracic cord injury, and 3 with lumbar cord injury. Twenty-five subjects who were exercised regularly showed statistically higher results of VO2max than those who did not exercise regularly. Subjects with cervical injury showed statistically lower VO2max than the subjects with thoracic or lumbar injury out of the 40 subjects with neurologic injury. In addition, higher age showed a statistically lower VO2max. Lastly, the regularly exercising paraplegic group showed higher VO2max than the non-exercising paraplegic group. Conclusion There are differences in VO2max of subjects with spinal cord injury according to the degree of neurologic injury, age, and whether the subject participates in regular exercise. We found that regular exercise increased the VO2max in individuals with spinal cord injury.
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Affiliation(s)
- Young Hee Lee
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. ; Center for Exercise Medicine, Yonsei University, Wonju, Korea
| | - Kyung Joon Oh
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In Deok Kong
- Center for Exercise Medicine, Yonsei University, Wonju, Korea. ; Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong Mock Shinn
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong Heon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dongsoo Yi
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jin Hyeong Lee
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Seung Chang
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Tae-Ho Kim
- Center for Exercise Medicine, Yonsei University, Wonju, Korea. ; Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Eun Ju Kim
- Center for Exercise Medicine, Yonsei University, Wonju, Korea
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Henagan TM, Cefalu WT, Ribnicky DM, Noland RC, Dunville K, Campbell WW, Stewart LK, Forney LA, Gettys TW, Chang JS, Morrison CD. In vivo effects of dietary quercetin and quercetin-rich red onion extract on skeletal muscle mitochondria, metabolism, and insulin sensitivity. Genes Nutr 2014; 10:451. [PMID: 25542303 DOI: 10.1007/s12263-014-0451-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 12/04/2014] [Indexed: 12/01/2022]
Abstract
Red onions and low doses of the flavonoid, quercetin, increase insulin sensitivity and improve glucose tolerance. We hypothesized that dietary supplementation with red onion extract (RO) would attenuate high fat diet (HFD)-induced obesity and insulin resistance similar to quercetin supplementation by increasing energy expenditure through a mechanism involving skeletal muscle mitochondrial adaptations. To test this hypothesis, C57BL/6J mice were randomized into four groups and fed either a low fat diet (LF), HFD (HF), HFD + quercetin (HF + Q), or HFD + RO (HF + RO) for 9 weeks. Food consumption and body weight and composition were measured weekly. Insulin sensitivity was assessed by insulin and glucose tolerance tests. Energy expenditure and physical activity were measured by indirect calorimetry. Skeletal muscle incomplete beta oxidation, mitochondrial number, and mtDNA-encoded gene expression were measured. Quercetin and RO supplementation decreased HFD-induced fat mass accumulation and insulin resistance (measured by insulin tolerance test) and increased energy expenditure; however, only HF + Q showed an increase in physical activity levels. Although quercetin and RO similarly increased skeletal muscle mitochondrial number and decreased incomplete beta oxidation, establishing mitochondrial function similar to that seen in LF, only HF + Q exhibited consistently lower mRNA levels of mtDNA-encoded genes necessary for complexes IV and V compared to LF. Quercetin- and RO-induced improvements in adiposity, insulin resistance, and energy expenditure occur through differential mechanisms, with quercetin-but not RO-induced energy expenditure being related to increases in physical activity. While both treatments improved skeletal muscle mitochondrial number and function, mtDNA-encoded transcript levels suggest that the antiobesogenic, insulin-sensitizing effects of purified quercetin aglycone, and RO may occur through differential mechanisms.
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Affiliation(s)
- T M Henagan
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA,
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Lim M, Kim SW, Nam YY, Moon E, Yu J, Lee S, Chang JS, Jhoo JH, Cha B, Choi JS, Ahn YM, Ha K, Kim J, Jeon HJ, Park JI. Reasons for desiring death: examining causative factors of suicide attempters treated in emergency rooms in Korea. J Affect Disord 2014; 168:349-56. [PMID: 25103630 DOI: 10.1016/j.jad.2014.07.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 07/11/2014] [Accepted: 07/11/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Suicide attempters treated in emergency rooms were studied in order to understand the motives behind this behavior. Disparities between the etiological contributions to suicidal ideation, intention, and action were examined in order to characterize motives in these categories. METHODS Suicide attempters who visited the emergency departments of seven university hospitals were analyzed. Attempts leading to mortality were excluded from the analysis. Participants were assessed using semi-structured questionnaires, the results of which were noted on their medical records. These were analyzed retrospectively. RESULTS Attempter self-report assessment revealed that participants chose external sources of stress (75.4%) and psychiatric symptoms (19.1%) as their main reasons for attempting suicide. However, assessments by interviewers indicated that stressors contributed to suicide attempts to a lesser degree (52.8%) while psychiatric symptoms were more etiologically relevant (36.6%). Compared to those with stressors that was identified as causal in both self-report and clinician assessed evaluation, the participants-regardless of their self-report evaluation-who identified with causal psychiatric symptoms by psychiatrist had more severe and intense suicidal ideation and more determined suicidal intention. LIMITATIONS We collected samples from only university hospitals, resulting in selection bias. In addition, we did not use psychiatric scales to evaluate the participants׳ symptoms. CONCLUSIONS Stress was the greatest motive for attempting suicide, affirmed in both self-report and clinician assessed evaluation. A fair proportion of people were objectively identified as being motivated by psychiatric symptoms, yet were unaware of what they suffered from. Furthermore, suicide severity, intensity, and suicidal intention were stronger in psychiatrically driven cases.
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Affiliation(s)
- Meerae Lim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | | | - Eunsoo Moon
- Department of Psychiatry, Busan National University Hospital Medical Research Institute, Busan, Republic of Korea
| | - Jechun Yu
- Department of Psychiatry, School of Medicine, Eulgi University, Daejeon, Republic of Korea
| | - Soojung Lee
- Korea Suicide Prevention Center, Seoul, Republic of Korea
| | - Jae Seung Chang
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jin-Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Jung-Seok Choi
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; National Seoul Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jayoun Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong-Ik Park
- Korea Suicide Prevention Center, Seoul, Republic of Korea; Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
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Baek JH, Cha B, Moon E, Ha TH, Chang JS, Kim JH, Choi JE, Kang BJ, Hong KS, Ha K. The effects of ethnic, social and cultural factors on axis I comorbidity of bipolar disorder: results from the clinical setting in Korea. J Affect Disord 2014; 166:264-9. [PMID: 25012440 DOI: 10.1016/j.jad.2014.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Ethnic, social and cultural factors contribute to axis I comorbid conditions in bipolar disorder (BPD). Korea has strict laws against illicit drugs and a relatively permissive prevailing attitude toward alcohol. The present study aimed to explore the lifetime axis I comorbidity rate in patients with BPD in Korea. METHODS Clinically stable patients with bipolar I (n=222) and bipolar II (n=194) disorders were recruited from four tertiary medical centers in Korea. The subjects׳ diagnoses and axis I comorbid conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Korean version of the Diagnostic Interview for Genetic Studies (K-DIGS). The lifetime prevalence of anxiety disorders, substance use disorders and eating disorders was explored. The prevalence of these axis I comorbid conditions was compared with data from prior studies in other countries and to data concerning the general Korean population. RESULTS A total of 45.1% of all subjects had at least one axis I comorbid condition. Anxiety disorders (30.2%) were the most common comorbidity, followed by alcohol use disorders (16.8%). Males with BPD showed a higher rate of alcohol dependence compared to the general male population and females with BPD showed a greater risk of having alcohol use disorder compared to the general female population. The rate of drug use disorder was extremely low (1.7%), and only one subject had an illicit-drug-related problem. LIMITATION Cross-sectional studies. CONCLUSION Comorbid conditions of Korean patients with BPD showed a distinct pattern, which is associated with the ethnic, social and cultural characteristics in Korea.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Eunsoo Moon
- Department of Psychiatry, Pusan National University College of Medicine, Pusan, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea
| | - Jae Seung Chang
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea
| | - Jeong Hyun Kim
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea
| | - Jung Eun Choi
- Department of Psychiatry, Seoul Municipal Eunpyeong Hospital, San6 Eungam2-Dong, Eunpyeong-Gu, Seoul 122-913, Republic of Korea
| | - Bong Jin Kang
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyooseob Ha
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Kyunggi-Do, Republic of Korea; Seoul National Hospital, Seoul, Republic of Korea.
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Moon E, Chang JS, Choi S, Ha TH, Cha B, Cho HS, Park JM, Lee BD, Lee YM, Choi Y, Ha K. Characteristics of stress-coping behaviors in patients with bipolar disorders. Psychiatry Res 2014; 218:69-74. [PMID: 24803186 DOI: 10.1016/j.psychres.2014.03.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 01/29/2014] [Accepted: 03/30/2014] [Indexed: 11/17/2022]
Abstract
Appropriate stress-coping strategies are needed to improve the outcome in the treatment of bipolar disorders, as stressful life events may aggravate the course of the illness. The aim of this study was to compare stress-coping behaviors between bipolar patients and healthy controls. A total of 206 participants comprising 103 bipolar patients fulfilling the Diagnostic and Statistical Manual for Axis I disorder fourth edition (DSM-IV) diagnostic criteria for bipolar I and II disorders and controls matched by age and sex were included in this study. Stress-coping behaviors were assessed using a 53-item survey on a newly-designed behavioral checklist. The characteristics of stress-coping behaviors between the two groups were compared by using t-test and factor analysis. Social stress-coping behaviors such as 'journey', 'socializing with friends', and 'talking something over' were significantly less frequent in bipolar patients than controls. On the other hand, pleasurable-seeking behaviors such as 'smoking', 'masturbation', and 'stealing' were significantly more frequent in bipolar patients than controls. These results suggest that bipolar patients may have more maladaptive stress-coping strategies than normal controls. It is recommended to develop and apply psychosocial programs to reduce maladaptive stress-coping behaviors of bipolar patients.
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Affiliation(s)
- Eunsoo Moon
- Department of Psychiatry, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jae Seung Chang
- Mood Disorder Clinic and Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sungwon Choi
- Department of Psychology, Duksung Women׳s University, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Mood Disorder Clinic and Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hyun Sang Cho
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Je Min Park
- Department of Psychiatry, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Byung Dae Lee
- Department of Psychiatry, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Young Min Lee
- Department of Psychiatry, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Yoonmi Choi
- Department of Psychiatry, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyooseob Ha
- Mood Disorder Clinic and Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Institute of Human Behavioral Medicine, Medical Research Center, Seoul, Republic of Korea; Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea.
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Ha TH, Chang JS, Oh SH, Kim JS, Cho HS, Ha K. Differential patterns of neuropsychological performance in the euthymic and depressive phases of bipolar disorders. Psychiatry Clin Neurosci 2014; 68:515-23. [PMID: 24612064 DOI: 10.1111/pcn.12158] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/07/2013] [Accepted: 12/28/2013] [Indexed: 01/12/2023]
Abstract
AIMS Patients with bipolar disorders (BD) show a broad range of neurocognitive impairments. We compared the patterns of neuropsychological performance in depressed and euthymic patients with BD, and explored the state-dependent cognitive markers of bipolar depression. METHODS The study participants included 32 BD patients (15 depressed and 17 euthymic) and 42 healthy controls. All of the subjects completed tests that assessed attention, psychomotor speed, verbal and visual memory, and executive functions. Between-group neuropsychological performance differences were examined. Multidimensional scaling (MDS) was used to compare the patterns of cognitive variables in euthymic and depressed BD patients. RESULTS Compared to the euthymic BD patients and healthy controls, the depressed BD patients performed lower in verbal memory and executive functions. No significant differences were found between the three groups in attention, psychomotor speed, and visual memory. The depressed BD patients showed a lower level of association between psychomotor speed and the time to initial concept formation than the healthy controls and euthymic BD patients. In contrast, the correlation between word association and verbal memory was stronger in the depressed group than either the control or euthymic groups. CONCLUSION The depressed BD patients showed greater impairments in verbal memory and executive functions than the euthymic BD patients. In addition, our study identified a differential pattern of correlations between the cognitive domains of euthymic and depressed BD patients, which suggests the potential role of verbal memory and executive functions as cognitive markers of BD.
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Affiliation(s)
- Tae Hyon Ha
- Bipolar Disorder Translational Research Center & Department of Psychiatry, Seoul National University Bundang Hospital, Gyeonggi, Korea
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Kim J, Min B, Lee J, Chang JS, Ha TH, Ha K, Park T. A Prediction Model for Depression Risk. Korean Journal of Applied Statistics 2014. [DOI: 10.5351/kjas.2014.27.2.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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49
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Lee WT, Huang CC, Chen KC, Wong TY, Ou CY, Tsai ST, Yen CJ, Fang SY, Lo HI, Wu YH, Hsueh WT, Yang MW, Lin FC, Hsiao JR, Huang JS, Chang JY, Chang KY, Wu SY, Lin CL, Wang YH, Weng YL, Yang HC, Chang JS. Genetic polymorphisms in the prostaglandin pathway genes and risk of head and neck cancer. Oral Dis 2014; 21:207-15. [PMID: 24724948 DOI: 10.1111/odi.12244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 03/05/2014] [Accepted: 03/31/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Previous studies examining the association between genetic variations in prostaglandin pathway and risk of head and neck cancer (HNC) have only included polymorphisms in the PTGS2 (COX2) gene. This study investigated the association between genetic polymorphisms of six prostaglandin pathway genes (PGDS, PTGDS, PTGES, PTGIS, PTGS1 and PTGS2), and risk of HNC. METHODS Interviews regarding the consumption of alcohol, betel quid, and cigarette were conducted with 222 HNC cases and 214 controls. Genotyping was performed for 48 tag and functional single-nucleotide polymorphisms (SNPs). RESULTS Two tag SNPs of PTGIS showed a significant association with HNC risk [rs522962: log-additive odds ratio (OR) = 1.42, 95% confidence interval (CI): 1.01-1.99 and dominant OR = 1.58, 95% CI: 1.02-2.47; rs6125671: log-additive OR = 1.49, 95% CI: 1.08-2.05 and dominant OR = 1.96, 95% CI: 1.16-3.32]. In addition, a region in PTGIS tagged by rs927068 and rs6019902 was significantly associated with risk of HNC (global P = 0.007). Finally, several SNPs interacted with betel quid and cigarette to influence the risk of HNC. CONCLUSIONS Genetic variations in prostaglandin pathway genes are associated with risk of HNC and may modify the relationship between use of betel quid or cigarette and development of HNC.
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Affiliation(s)
- W-T Lee
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Kim JW, Jeon YJ, Baek DH, Kim TN, Chang JS. Percentage of the population at high risk of osteoporotic fracture in South Korea: analysis of the 2010 Fifth Korean National Health and Nutrition Examination survey data. Osteoporos Int 2014; 25:1313-9. [PMID: 24345885 DOI: 10.1007/s00198-013-2595-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED Osteoporosis and high-risk osteopenia (high-risk of osteoporotic fractures) are highly prevalent in South Korean postmenopausal women and men aged 50 years and over. INTRODUCTION This study determined the percentages of the population at high risk of osteoporotic fractures according to the World Health Organization (WHO) criteria and the Fracture Risk Assessment (FRAX) model. METHODS Data collected from the 2010 Fifth Korean National Health and Nutrition Examination Survey, a cross-sectional survey of the general South Korean general population, were analyzed. The percentages of the population with high-risk osteopenia according to the US National Osteoporosis Foundation (NOF) and Japanese treatment guidelines were subsequently determined and compared. RESULTS Based on the WHO criteria and FRAX model, 37.7% of the menopausal women and 12.7% of the men aged 50 years and older are at high risk of osteoporotic fracture. According to the Japanese and NOF guidelines, 10.9 (10.6% of men and 11.2% of women) and 10.7% (10.6% of men and 10.9% of women), respectively, of the study population with osteopenia are at high risk of fracture. By age group, 49.3% of Korean women aged 55 years and older, 67.7% of Korean women aged 65 years and older, and 33.5% of Korean men aged 75 years and older are at high risk. CONCLUSION As a very large percentage of the South Korean postmenopausal population has osteoporosis or high-risk osteopenia, greater effort at identifying and treating this population should be expended to prevent osteoporotic fracture.
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Affiliation(s)
- J W Kim
- Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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