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Background: The prevalence of obesity has been continuously increasing, especially in rural areas of South Korea. Therefore, it is important to examine various genetic, behavioral, and environmental factors associated with obesity in these rural areas. The Korean Society for the Study of Obesity commenced a community-based prospective cohort study of the Gangwon area called the Gangwon Obesity and Metabolic Syndrome (GOMS) study to investigate longitudinal changes in the status of obesity and its related factors. Methods: A total of 317 adults 40-69 years of age were recruited from Hongcheon and Inje districts, Gangwon province, as part of the first wave of this cohort study. Information on participants' demographic, behavioral, psychological, dietary, and environmental factors and past medical histories were collected by self-administered questionnaires and interviewer-administered questionnaires. Anthropometric measurements, blood tests, and a hand grip strength test were performed, and skin keratin and stool samples were collected. Among the 317 enrolled subjects, two participants who did not have anthropometric data were excluded from the data analyses, resulting in an inclusion of a total of 315 participants. Results: The mean age of the 315 participants in the GOMS initial baseline survey was 58.5 years old, 87 of them were men, and the mean body mass index was 24.7±3.7 kg/m2. Among all participants, 48.9% had hypertension, 21.4% had diabetes mellitus (DM), 55.6% had dyslipidemia, and 46.0% had metabolic syndrome (MS). Both the prevalence rates of DM and MS were significantly higher in men. Conclusion: The first baseline survey of the GOMS study was initiated, and a more detailed analysis of respondents' data is expected to be continued. Further follow-up and additional recruitment will allow the investigation of risk factors and the etiology of obesity and its comorbidities in rural areas of Gangwon province. [ABSTRACT FROM AUTHOR]

Background: We investigated whether low high-density lipoprotein cholesterol (HDL-C) and isolated and non-isolated low HDL-C levels are associated with the risk of cardiovascular diseases and all-cause mortality among Korean adults. Methods: We included 8,665,841 individuals aged ≥20 years who had undergone a health examination provided by the Korean National Health Insurance Service (NHIS) in 2009 and were followed up until the end of 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for study outcomes were calculated using multivariable Cox proportional hazard regression analysis. Results: During the 8.2 years of mean follow-up, myocardial infarction (MI), stroke, and all-cause mortality occurred in 81,431, 110,996, and 244,309 individuals, respectively. After adjusting for confounding variables (model 3), individuals with low HDL-C and lower HDL quartiles were associated with significantly increased risks of all three outcomes, compared to those with normal HDL-C and highest HDL-C quartile (all P<0.001), respectively. HRs for incident MI (1.28; 95% CI, 1.26 to 1.30), stroke (1.13; 95% CI, 1.11 to 1.15), and all-cause mortality (1.07; 95% CI, 1.05 to 1.08) increased in the non-isolated low HDL-C group compared to the normal HDL-C group. Isolated low HDL-C also showed an increase in the HRs of incident stroke (1.06; 95% CI, 1.04 to 1.08) and all-cause mortality (1.30; 95% CI, 1.28 to 1.32). Conclusion: Low HDL-C and non-isolated low HDL-C were associated with increased risk of MI, stroke, and all-cause mortality, and isolated low HDL-C was associated with incident stroke and all-cause mortality risk. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is associated with an increased risk of dementia. We aimed to comprehensively analyze the incidence and risk factors for dementia and young-onset dementia (YOD) in diabetic patients in Korea using the National Health Insurance Service data. Methods: Between January 1, 2009 and December 31, 2012, a total of 1,917,702 participants with diabetes were included and followed until the date of dementia diagnosis or until December 31, 2015. We evaluated the incidence and risk factors for all dementia, Alzheimer's disease (AD), and vascular dementia (VaD) by Cox proportional hazards analyses. We also compared the impact of risk factors on the occurrence of YOD and late-onset dementia (LOD). Results: During an average of 5.1 years of follow-up, the incidence of all types of dementia, AD, or VaD was 9.5, 6.8, and 1.3/1,000 person-years, respectively, in participants with diabetes. YOD comprised 4.8% of all dementia occurrence, and the ratio of AD/VaD was 2.1 for YOD compared with 5.5 for LOD. Current smokers and subjects with lower income, plasma glucose levels, body mass index (BMI), and subjects with hypertension, dyslipidemia, vascular complications, depression, and insulin treatment developed dementia more frequently. Vascular risk factors such as smoking, hypertension, and previous cardiovascular diseases were more strongly associated with the development of VaD than AD. Low BMI and a history of stroke or depression had a stronger influence on the development of YOD than LOD. Conclusion: The optimal management of modifiable risk factors may be important for preventing dementia in subjects with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals. Methods: We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO. Results: During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain. Conclusion: Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index. [ABSTRACT FROM AUTHOR]

Background: The prevalence of childhood obesity has significantly increased in Korea. This study aimed to use data from the 2010 Korea National Health and Nutrition Examination Survey (KNHANES) to investigate the association between sodium (Na) intake and insulin resistance in children and adolescents with obesity. Methods: The study population consisted of 578 adolescents aged 12-18 years who were enrolled in the 2010 KNHANES. Subjects were classified into the following four groups based on their body mass index (BMI) and homeostatic model assessment-insulin resistance (HOMAIR) values: normal BMI and HOMA-IR (Group 1), normal BMI and =75% HOMA-IR (Group 2), =85% BMI and normal HOMA-IR (Group 3) and =85% BMI and =75% HOMA-IR (Group 4). The groups were further divided into four quartiles (Q1-Q4) based on urinary sodium-creatinine ratios (UNa/Cr) to analyze the association between obesity and metabolic abnormality as a result of increased Na intake. Results: There were significant differences among the four groups in terms of abdominal obesity (p < 0.000), waist circumference (WC) (p < 0.000) blood glucose levels (p < 0.000), insulin levels (p < 0.000) and UNa/Cr, with Groups 2, 3 and 4 having significantly higher UNa/Cr than Group 1 (p = 0.002). In addition, there was a significant positive correlation between UNa/Cr and obesity (Q1 = 1 vs. Q4 = 3.23, p = 0.019) and metabolic abnormality (Q1 = 1 vs. Q4 = 2.25, p = 0.167). Conclusions: Increased Na intake showed a positive statistical correlation with insulin resistance and is associated with an increased risk of insulin resistance and other metabolic abnormalities in obese children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Concerns regarding weight gain after smoking cessation may interfere with quitting smoking. This study investigated the association between smoking cessation plans and body mass index (BMI, kg/m²) in Korean adult smokers. Methods: Using data from the sixth Korea National Health and Nutrition Examination Survey (2013-2015), 3,000 current smokers aged 19 years or older were selected and divided into four weight groups. The cohorts included an underweight group (BMI, <18.5 kg/m²), normal weight group (BMI, ≥18.5 to <23 kg/m²), overweight group (BMI, ≥23 to <25 kg/m²), and obese group (BMI, ≥25 kg/m²). The relationship between BMI and smoking cessation plans in Korean adults was analyzed using multiple logistic regression analysis. Results: Multiple logistic regression analysis showed sex (odds ratio [OR], 0.723; 95% confidence interval [CI], 0.556-0.939), high-risk drinking (OR, 0.796; 95% CI, 0.634-0.998), aerobic physical activity (OR, 1.326; 95% CI, 1.092-1.612), and hypertension (OR, 1.387; 95% CI, 1.034-1.860) were the significant factors related to smoking cessation plans. According to the BMI categories, the ORs of smoking cessation plans were numerically higher in the normal weight group than the other three groups. However, the difference was not statistically significant. Conclusion: Normal weight subjects tended to have a greater number of smoking cessation plans than the other three weight groups, but the difference was not statistically significant. In the clinic, it is necessary to consider not only BMI but also other factors associated with a smoking cessation plans. [ABSTRACT FROM AUTHOR]

Background This study aimed to investigate recent trends in the prevalence and parameters of dyslipidemia and rates of lipid-lowering medication use in Korean adults. Trends in lipid profiles in subjects with hypertension, diabetes or obesity were also studied. Methods Data from the Korea National Health and Nutrition Examination Survey in 2005, 2008 and 2010 were used in this study. A total of 17 009 subjects participated in this study. Results There was a declining trend in the prevalence of dyslipidemia and an increasing trend in the rates of use of lipid-lowering medication among Korean adults. In both men and women, the age-adjusted mean high-density lipoprotein cholesterol level linearly increased. There was a significantly decreasing trend in the age-adjusted mean triglycerides in women and age-adjusted mean lipid-related ratios in both sexes. The ageadjusted mean total cholesterol level showed a slightly increasing trend and the age-adjusted mean low-density lipoprotein cholesterol level was not changed in both sexes. These patterns persisted among subjects not taking lipid-lowering medication. The favorable trends were also observed in subjects with hypertension, diabetes and obesity. Conclusions Our study showed favorable trends in the prevalence of dyslipidemia and in several lipid profiles among Korean adults. [ABSTRACT FROM AUTHOR]

Purpose: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. Methods: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. Results: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). Conclusion: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents. [ABSTRACT FROM AUTHOR]

The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index (BMI) ≥25 kg/m2 in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5-10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity. [ABSTRACT FROM AUTHOR]

The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index ≥25 kg/m² in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5% to 10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity. [ABSTRACT FROM AUTHOR]

Background: Concern is growing about nonalcoholic fatty liver disease, not only because it is a common liver disorder but also because it is one of the leading causes of chronic liver disease. Unexplained elevations in aminotransferase concentrations have been strongly associated with adiposity and thus may represent nonalcoholic fatty liver disease. Objective: We investigated the relation between nonviral or nonalcoholic elevations in alanine aminotransferase (ALT) and the metabolic syndrome in Korean adolescents. Design: Data were obtained from 1594 subjects aged 10-19 y from the Korean National Health and Nutrition Examination Survey 1998, a cross-sectional health survey of a nationally representative sample of noninstitutionalized civilian South Koreans. Body mass index, waist circumference, blood pressure, fasting glucose, lipid profiles, and serum ALT were measured. Results: The prevalence of elevated ALT (>40 U/L) was 3.6% in boys and 2.8% in girls. The prevalence of metabolic syndrome was 3.3% in both boys and girls. The components of the metabolic syndrome were significantly worse in the group with elevated ALT concentrations than in the group with normal ALT concentrations. The odds ratios (95% CIs) for elevated ALT were 6.6 (3.7,11.8), 2.3 (1.2, 4.6), and 3.0 (1.6, 5.8) in the adolescents with abdominal obesity, high triacylglycerol concentrations, and low HDL-cholesterol concentrations, respectively. The odds ratios for elevated ALT were 1.5 (0.7,3.1), 2.6 (1.1,6.2), and 6.2 (2.3,16.8) in the adolescents with 1, 2, and ⩾3 risk factors (metabolic syndrome), respectively. Conclusion: The metabolic syndrome was strongly associated with elevated ALT concentrations in Korean adolescents, and this association existed in a graded fashion across the number of metabolic components. [ABSTRACT FROM AUTHOR]