Search

Background : Obesity is a widespread disease and is caused mainly by excessive adipocyte differentiation and fat accumulation. Peroxisome proliferation-activated receptor γ (PPARγ) and CCAAT/enhancer-binding proteins (C/EBP) are major components for regulating adipocyte differentiation. Uncoupling protein 1 (UCP1) is a transmembrane protein that can convert white fat to brown adipose tissue. Artemisia annua L. has long been used in East Asia as an herbal drug for anti-oxidant, anti-bacterial, and anti-obesity purposes. Methods : We investigated the effects of water extracts of A. annua (WEAA) in C3H10T1/2, a mesenchymal stem cell line, by measuring the level of intracellular fat accumulation and the expression of genes associated with adipocyte differentiation. We also evaluated anti-obesity effects of WEAA in Zucker rats, a genetic model for the study of obesity, and in Sprague Dawley rats with high-fat diet (HFD)-induced obesity. Results : In this study, WEAA reduced the expression levels of PPARγ and C/EBPα in C3H10T1/2 cells, as well as the expression of enzymes that regulate fatty acid metabolism. In the Zucker fatty rat model and the HFD-induced obesity rat model, WEAA significantly decreased adipogenic differentiation and white fat accumulation between the scapulae, in contrast to the brown fat that remained unchanged between the groups. A. annua suppressed the expression of the adipocyte differentiation-promoting genes, while increasing the expression of UCP1. Conclusion : These results indicated that WEAA could reduce adipocyte differentiation and fat accumulation in in vitro and in vivo model systems, resulting in suppression of obesity and the occurrence of fatty liver due to a HFD.

OBJECTIVE Obesity and type 2 diabetes are risk factors for cardiovascular diseases and mortality, and they commonly result in weight variabilities. We aimed to investigate the association between body weight variability and risk of major cardiovascular outcomes and mortality in individuals with type 2 diabetes using large-scale, nationwide cohort data on the Korean population. RESEARCH DESIGN AND METHODS We enrolled 624,237 individuals with type 2 diabetes who underwent health examinations provided by the Korean National Health Insurance System between 2009 and 2010, with three or more body weight measurements within 5 years since enrollment and followed up until the end of 2017. We assessed body weight variability using four indices, including variability independent of the mean (VIM). A multivariate-adjusted Cox proportional hazards regression analysis was performed. RESULTS During the follow-up, 15,832, 25,038, and 44,716 cases of myocardial infarction (MI), stroke, and all-cause mortality, respectively, were recorded. Body weight variability was associated with increased risks of major cardiovascular outcomes after adjusting for confounding variables. Compared with the hazard ratios (HRs) of the lowest quartile group, the HRs (95% CIs) of the highest quartile group of VIM for body weight were 1.15 (1.10–1.20), 1.22 (1.18–1.26), and 1.58 (1.53–1.62) for MI, stroke, and all-cause mortality, respectively. CONCLUSIONS Body weight variability was associated with increased risks of MI, stroke, and all-cause mortality in patients with type 2 diabetes and may be a predictor of cardiovascular outcomes in such patients. Appropriate interventions to maintain stable weight could positively influence health outcomes in patients with type 2 diabetes.

BACKGROUND Recently, single-person households have increased in Korea and this trend may have potential public health implications and affect various health behaviors. This study investigated the associations between living alone and health behaviors such as smoking and alcohol consumption among Korean adults. METHODS We used data from the 6th Korea National Health and Nutrition Examination Survey between 2013 and 2015 and a total of 17,088 adults were included. We performed a multivariable logistic regression analysis and calculated odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Single-person households accounted for about 10% of the total participants. The proportions of currently smoking and heavy alcohol consumption were higher among individuals living alone than those living together among younger women and middle-aged and elderly men and women. In the multivariable logistic regression analysis, living alone was associated with increased odds of currently smoking compared to living together among middle-aged men and women (OR, 7.37; 95% CI, 2.33-23.32 in men and OR, 2.36; 95% CI, 1.04-5.36 in women) after adjusting for confounding variables. CONCLUSION From this nationwide, population-based study, we found that living alone is associated with increased odds of currently smoking, especially in middle-aged people. Public health concerns may be warranted for middle-aged single-person households to reduce health risks related to smoking.

BACKGROUND The roles of chronic kidney disease and proteinuria in the development of Parkinson's disease have not been widely studied. The objective of this study was to examine the associations of chronic renal dysfunction and proteinuria with the risk of PD in older adults using cohort data of the whole South Korean population. METHODS We included 3,580,435 individuals aged ≥65 years who had undergone health checkups provided by the National Health Insurance Service of South Korea between 2009 and 2012 and were followed until 2015. Multivariable Cox proportional hazards regression models were performed. RESULTS During a mean follow-up of 5.2 ± 1.3 years, 30,813 individuals (0.86% of the total population) developed PD. Lower estimated glomerular filtration rate and a higher degree of proteinuria on a dipstick test were associated with higher incidence probability of PD (log-rank P < 0.001). In Cox regression models, chronic renal dysfunction graded by estimated glomerular filtration rate (mL/min/1.73 m2 ) was associated with increased risk of PD after adjusting for potential confounding variables; hazard ratio (95% confidence interval) was 1.13 (1.10-1.17) for estimated glomerular filtration rate 60-90, 1.36 (1.31-1.42) for estimated glomerular filtration rate 30-60, and 1.47 (1.32-1.63) for estimated glomerular filtration rate

We studied the association between living alone and the risk of incident type 2 diabetes in middle-aged individuals using nationwide cohort data from the Korean population. 11,686, 677 middle-aged individuals aged 40–64 years who underwent health examinations by the Korean National Health Insurance System between 2009 and 2012 were followed up until December 31, 2015. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression analysis. During the median follow-up duration of 5.6 years, 393,438 individuals developed type 2 diabetes. Living alone was significantly associated with incident type 2 diabetes in all adjusted models (HR 1.08; 95% CI 1.07–1.09 in model 4). Individuals who lived alone for

Background: Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality.Methods: We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses.Results: During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability.Conclusion: This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

Background Obesity is a widespread disease and is caused mainly by excessive adipocyte differentiation and fat accumulation. Peroxisome proliferation-activated receptor γ (PPARγ) and CCAAT/enhancer-binding proteins (C/EBP) are major components for regulating adipocyte differentiation. Uncoupling protein 1 (UCP1) is a transmembrane protein that can convert white fat to brown adipose tissue. Artemisia annua L. has long been used in East Asia as an herbal drug for anti-oxidant, anti-bacterial, and anti-obesity purposes. Methods We investigated the effects of water extracts of A. annua (WEAA) in C3H10T1/2, a mesenchymal stem cell line, by measuring the level of intracellular fat accumulation and the expression of genes associated with adipocyte differentiation. We also evaluated anti-obesity effects of WEAA in Zucker rats, a genetic model for the study of obesity, and in Sprague Dawley rats with high-fat diet (HFD)-induced obesity. Results In this study, WEAA reduced the expression levels of PPARγ and C/EBPα in C3H10T1/2 cells, as well as the expression of enzymes that regulate fatty acid metabolism. In the Zucker fatty rat model and the HFD-induced obesity rat model, WEAA significantly decreased adipogenic differentiation and white fat accumulation between the scapulae, in contrast to the brown fat that remained unchanged between the groups. A. annua suppressed the expression of the adipocyte differentiation-promoting genes, while increasing the expression of UCP1. Conclusion These results indicated that WEAA could reduce adipocyte differentiation and fat accumulation in in vitro and in vivo model systems, resulting in suppression of obesity and the occurrence of fatty liver due to a HFD.

This study aimed to examine whether the characteristics of mental health and sleep duration, alone or in combination, are associated with menstrual cycle irregularity. This population-based, cross-sectional study analyzed the data from 4445 women aged 19-49 years, who participated in the Korea National Health and Nutrition Examination Survey 2010-2012. A structured questionnaire was used to assess mental health characteristics, sleep duration, and menstrual cycle irregularity. A multivariable logistic regression analysis was performed. High stress, depressive mood, and suicidal ideation were associated with increased risk of menstrual cycle irregularity after adjusting for confounding variables (odds ratio [95% confidence interval] = 1.33 [1.07-1.65], 1.56 [1.17-2.07], and 1.37 [1.01-1.87], respectively). Short sleep duration (≤ 5 h a day) was significantly associated with higher odds of severe menstrual cycle irregularity with menstrual interval of greater than 3 months (2.67 [1.35-5.27]). Participants with sleep duration of ≤ 5 h a day with psychological stress, depressive mood, or suicidal ideation had higher odds of menstrual cycle irregularity (1.96 [1.26-3.05], 2.86 [1.50-5.44], and 2.25 [1.18-4.29]). This study suggests positive associations of mental health problems and short sleep duration with menstrual cycle irregularity among Korean female adults. Therefore, strategies to deal with psychological stress, depressive mood, and sleep duration are needed for improving the reproductive health of women suffering from menstrual disturbances.

There is limited information regarding the impact of body mass index (BMI) and body weight (BWt) variabilities on mortality. This study aimed to investigate the association between BMI, BWt variabilities and subsequent mortality in the Korean population. This study used a representative sample cohort enrolled in the national health examination program conducted by the Korean National Health Insurance Service, and 125,391 individuals were included and followed up until 2013 (mean follow-up period = 84 months). BMI and BWt variabilities were estimated as the standard deviation (SD) and coefficient of variation (CV) of serial measurements of BMI and BWt (BMI_SD, BWt_SD, BMI_CV, and BWt_CV). Cox proportional hazard regression models were used to evaluate the all-cause and cause-specific mortality according to variability indices. Baseline BMI showed a non-linear association with all-cause mortality. The highest quartile (Q4) groups of variability indices were associated with increased all-cause mortality risk compared to the lowest quartile (Q1) groups after adjusting for confounding factors (hazard ratio [95% confidence interval] = 1.23 [1.11–1.37] for BMI_SD; 1.25 [1.06–1.47] for BMI_CV; 1.33 [1.20–1.48] for BWt_SD; 1.42 [1.28–1.58] for BWt_CV). The hazard ratios of all-cause mortality increased from the Q2 to the Q4 groups of variability indices, in each sex group and among individuals aged ≥40 years. Furthermore, Q4 groups of variability indices were positively associated with cause-specific mortality compared to groups with Q1–Q3 of the indices (1.28 [1.05–1.56] for BWt_SD, 1.21 [1.001–1.47] for BMI_CV, 1.29 [1.06–1.56] for BWt_CV regarding cardiovascular diseases mortality; 1.18 [1.03–1.36] for BWt_SD, 1.21 [1.06–1.39] for BMI_CV, 1.26 [1.10–1.44] for BWt_CV regarding cancer mortality). Our results suggest that BMI and BWt variabilities are independent risk factors for all-cause and cause-specific mortality.

This study investigated the awareness, treatment, and control of type 2 diabetes mellitus (T2DM), lifestyle factors, and cardiometabolic parameters according to age groups among patients with T2DM. Data of 1507 patients with T2DM aged &ge, 35 years in the Korea National Health and Nutrition Examination Survey VI (2013&ndash, 2015) were analyzed. Multivariable logistic regression models were used to compare the awareness, treatment, and control rate of T2DM and lifestyle and cardiometabolic parameters according to age groups. The adjusted odds ratios (ORs) for lack of awareness about and non-treatment of T2DM, as well as poor glycemic control, were significantly increased with younger age in both men and women. ORs for heavy drinkers and current smokers also significantly increased with younger age in both men and women. The adjusted ORs for high low-density lipoprotein cholesterol (&ge, 100 mg/dL), hypertriglyceridemia (&ge, 150 mg/dL), and obesity significantly increased with younger age in men, but not in women. Among Korean adults with T2DM, awareness, treatment, and control rates of the condition were poorer in younger patients than in older patients. Education regarding the control of glycemia, cardiovascular risk factors, and improvement of lifestyles should be reinforced among younger-aged adults for the long-term management of T2DM.

Background: Individuals living alone may have a higher risk of several metabolic diseases, including type 2 diabetes which is also common in younger individuals. We studied the association between living alone and the risk of incident type 2 diabetes in middle-aged individuals using nationwide cohort data of the South Korean population. Methods: We selected 11,686,677 middle-aged individuals aged 40-64 years who underwent health examinations by the South Korean National Health Insurance System between 2009 and 2012. Participants were followed-up until December 31, 2015. The hazard ratios (HRs) and 95% confidence intervals (CIs) of type 2 diabetes were estimated using multivariable Cox proportional hazards regression analysis. Findings: During the median follow-up duration of 5·6 years (interquartile range, 4·6-6·2 years), 393,438 individuals developed type 2 diabetes. Living alone was significantly associated with incident type 2 diabetes in all adjusted models (HR, 1·08; 95% CI, 1·07-1·09 in model 4). Individuals who lived alone for

Background Limited evidence exists regarding associations between obesity and kidney cancer among Asians. We examined the associations between obesity measures and risk of kidney cancer. Methods We included 23,313,046 adults who underwent health examinations provided by the Korean National Health Insurance Service 2009–2012 and performed multivariable Cox proportional hazards regression analyses. Results During 5.4 years of follow-up, 18,036 cases of kidney cancer were recorded, and cumulative incidence was 0.12%. General and abdominal obesity were associated with 1.32-fold increased risk of kidney cancer compared with groups without either obesity status. Underweight individuals showed decreased adjusted hazard ratio (HR) for kidney cancer (0.76, 95% confidence interval: 0.68–0.85) compared to those with normal body mass index (BMI), while the HRs increased among individuals with BMI 23–24.9 kg/m2 (1.23, 1.18–1.28), 25–29.9 kg/m2 (1.41, 1.36–1.46) and ≥30 kg/m2 (1.77, 1.65–1.90) (P for trend

We investigated associations between breastfeeding duration and number of children breastfed and type 2 diabetes mellitus (T2DM) and glycemic control among parous women. We performed a cross-sectional analysis of data for 9,960 parous women from the Korea National Health and Nutritional Examination Survey (2010 to 2013). Having ever breastfed was inversely associated with prevalent T2DM (adjusted odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87). All ranges of total and average breastfeeding duration showed inverse associations with T2DM. Even short periods of breastfeeding were inversely associated with T2DM (adjusted OR, 0.61; 95% CI, 0.38 to 0.99 for a total breastfeeding duration ≤12 months; adjusted OR, 0.65; 95% CI, 0.42 to 0.99 for an average breastfeeding duration per child ≤6 months). A longer duration of breastfeeding was associated with better glycemic control in parous women with T2DM (P trend=0.004 for total breastfeeding duration; P trend

Cataracts are the leading cause of visual impairment and blindness, and therefore early identification and modification of the risk factors for cataracts are meaningful. This study aimed to investigate the relationship between socioeconomic status (SES) and lifestyle factors, and age-related cataracts in South Korea.This cross-sectional study was based on data collected in the 2008-2011 Korea National Health and Nutrition Examination Survey. A total of 15 866 subjects, aged ≥40 years, were included. SES was defined using household income and education level. Sociodemographic, lifestyle, and other associated factors were assessed by health interviews and examinations. Cataracts were diagnosed via slit-lamp examination using the Lens Opacities Classification System III.The prevalence of any cataract was 38.9% in men and 42.3% in women (P0.001). In women, the risk of cataracts increased with decreases in household income (P-value for trend=0.016 and 0.041 in any, and cortical cataract, respectively) and education level (P-value for trend=0.009, 0.027, and 0.016 in any, nuclear, and cortical cataract, respectively) after adjusting for confounding factors. Current smoking was correlated with nuclear cataracts in men (OR 1.21; 95% CI: 1.00, 1.46 in age-adjusted analysis) and cataract surgery in women (OR 2.25; 95% CI: 1.00, 5.04 in multivariate-adjusted analysis).Socioeconomic disparities in cataract prevalence were observed in women; current smoking increased the risk of nuclear cataracts in men and surgery in women. Public health interventions focusing on gender differences are warranted to prevent and treat cataracts.

Non-alcoholic fatty liver disease (NAFLD), known to be related to insulin resistance, has been the focus of intensive research efforts due to its increasing prevalence and clinical significance. Rapid eating behavior is another emerging health issue associated with insulin resistance. We aimed to clarify the correlation between self-reported eating speed and NAFLD, both known to be related to insulin resistance. A cross-sectional study was conducted during routine medical checkups on 7,917 consecutively enrolled participants. Anthropometric, biochemical, nutritional, and social parameters were checked. The self-reported eating speed per their usual meal (

Background/Aims: Albuminuria is known to be associated with an increased risk for cardiovascular morbidity and mortality even in the general population. We aimed at investigating the prevalence and related risk factors of albuminuria among Korean adults. Methods: This study was based on data collected during the 2011 Korea National Health and Nutrition Examination Survey. A total of 5,365 Korean adults were included in the general population group, and 3,282 of these participants were included in the nondiabetic, nonhypertensive population group. Albuminuria was defined by a urine albumin-to-creatinine ratio value within the range of 3.4-34 mg/mmol (30-300 µg/mg). Results: The overall prevalence of albuminuria was 5.2% of the general population and 2.1% of the nondiabetic, nonhypertensive population. Factors associated with the risk of albuminuria in the general population were age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) level in men, and SBP and HbA1c level in women. In the nondiabetic, nonhypertensive population, age and fasting plasma glucose levels were significantly associated with an increased risk for albuminuria in men, and with central obesity, triglyceride level and smoking status in women. Conclusion: Albuminuria is prevalent in the nondiabetic, nonhypertensive population as well as general population of Korea. The increased risk of albuminuria was independently associated with several cardiovascular risk factors in the general population, and also in the nondiabetic, nonhypertensive population.

Recently, aging has been shown to be associated with sarcopenic obesity (SO), of which decreased muscle mass and increased fat mass are features. Sarcopenia and obesity alone are known to be associated with abnormal lipid metabolism. However, it remains unclear whether SO has greater adverse effects on dyslipidemia than on sarcopenia or obesity alone.We aimed to investigate the association between SO and dyslipidemia in elderly Koreans.This study was based on data collected during the 2008-2010 Korea National Health and Nutrition Examination Survey. We included 1,466 men and 2,017 women aged 65 years and over. Sarcopenia was indicated in participants with height- or weight-adjusted appendicular skeletal muscle that was 1 standard deviation below the sex-specific mean for the young reference group, and obesity was defined as a body mass index ≥ 25 kg/m(2). Dyslipidemia was defined according to the National Cholesterol Education Program-Adult Treatment Panel III.After adjusting for confounding factors, the SO group had a higher risk for dyslipidemia [odds ratio (OR) 2.82 (95 % confidence interval 1.76-4.51)] than the obese group [2.12 (1.11-4.07)] and sarcopenic group [1.46 (1.01-2.11)] (p0.001) only in men. Furthermore, the SO group in men had the highest OR for hypercholesterolemia, hypertriglyceridemia, hypo-high-density lipoprotein cholesterolemia, hyper-low-density lipoprotein cholesterolemia, and a high ratio of triglyceride to high-density lipoprotein cholesterol even after further adjustments.In Korean elderly men, SO was associated with an increased risk for dyslipidemia compared with sarcopenia or obesity alone.

Objective This study investigated the relationship between socioeconomic status (SES) and dyslipidemia and various parameters of dyslipidemia among Korean adults. Methods Data from the 2008–2010 Korea National Health and Nutrition Examination Survey were used in this study. A total of 19,041 Korean adults greater than 19 years old participated in the study. The SES was assessed by monthly household income and education level. The relationship of SES to the risk of dyslipidemia was assessed with multivariate logistic regression analysis after adjusting for potential confounders. Results The prevalence of dyslipidemia was 37.4% among Korean adults. In men, household income level was positively associated with prevalence and risks of several parameters of dyslipidemia, and education level had positive associations with the risks of dyslipidemia and parameters of dyslipidemia. However, low SES was linked to increased prevalence and risks of dyslipidemia (P for trend Conclusions Socioeconomic disparities in dyslipidemia were found in the Korean population. Also, there were gender differences in the relationship between SES and dyslipidemia. These disparities should be considered when performing risk calculations and screening for dyslipidemia, which will ultimately help prevent cardiovascular disease.

Background The association of metabolic syndrome (MetS) with the development of Parkinson disease (PD) is currently unclear. We sought to determine whether MetS and its components are associated with the risk of incident PD using large-scale cohort data for the whole South Korean population. Methods and findings Health checkup data of 17,163,560 individuals aged ≥40 years provided by the National Health Insurance Service (NHIS) of South Korea between January 1, 2009, and December 31, 2012, were included, and participants were followed up until December 31, 2015. The mean follow-up duration was 5.3 years. The hazard ratio (HR) and 95% confidence interval (CI) of PD were estimated using a Cox proportional hazards model adjusted for potential confounders. We identified 44,205 incident PD cases during follow-up. Individuals with MetS (n = 5,848,508) showed an increased risk of PD development compared with individuals without MetS (n = 11,315,052), even after adjusting for potential confounders including age, sex, smoking, alcohol consumption, physical activity, income, body mass index, estimated glomerular filtration rate, and history of stroke (model 3; HR, 95% CI: 1.24, 1.21–1.27). Each MetS component was positively associated with PD risk (HR, 95% CI: 1.13, 1.10–1.16 for abdominal obesity; 1.13, 1.10–1.15 for hypertriglyceridemia; 1.23, 1.20–1.25 for low high-density lipoprotein cholesterol; 1.05, 1.03–1.08 for high blood pressure; 1.21, 1.18–1.23 for hyperglycemia). PD incidence positively correlated with the number of MetS components (log-rank p < 0.001), and we observed a gradual increase in the HR for incident PD with increasing number of components (p < 0.001). A significant interaction between age and MetS on the risk of incident PD was observed (p for interaction < 0.001), and people aged ≥65 years old with MetS showed the highest HR of incident PD of all subgroups compared to those, In a cohort study using data from the South Korean National Health Insurance Service, Seon Mee Kim and colleagues investigate associations between components of metabolic syndrome and risk of Parkinson's disease., Author summary Why was this study done? Recent evidence has indicated that components of metabolic syndrome (MetS) may contribute to the pathophysiology of Parkinson disease (PD). Longitudinal studies regarding the association between MetS and the development of PD are limited. Several prospective studies investigating associations between each component of MetS and incident PD have reported inconsistent results. What did researchers do and find? We analyzed the health checkup data of the entire South Korean population aged ≥40 years provided by the Korean National Health Insurance Service between 2009 and 2012. Multivariable Cox proportional hazards regression models were used to evaluate the association of MetS and its components with the risk of incident PD, with mean follow-up duration of 5.3 years. Our analysis indicated that individuals with MetS had a 24% higher risk of incident PD than individuals without MetS, and each MetS component was positively associated with PD risk. Incidence and risk of PD increased gradually with the number of MetS components individuals had. What do these findings mean? MetS and its components might be considered risk factors for PD development. Our results show that MetS components are positively associated with increased PD risk and that as the number of components increases, so does the PD risk. Optimal control of MetS and its components may reduce the risk of incident PD, and this possibility warrants further investigation.

PURPOSE:We investigated the association between seasonal influenza vaccination in South Korea and socioeconomic status (SES) as well as other potential related factors. METHODS:The study was based on data obtained in the Korea National Health and Nutrition Examination Survey from 2010 to 2011. Education level and household income were used as indicators for SES. Univariate and multiple logistic regression analyses were used to evaluate SES and other demographic variables as related factors for influenza vaccination, the primary outcome. RESULTS:Higher household income was positively associated with higher vaccine uptake in the younger (19-49 years) group [adjusted odds ratio (aOR) 1.55, 95% confidence interval (CI) 1.08-2.23], whereas the low-income and low-education group had increased vaccination coverage than the middle-income and middle-education group in the older (≥ 50 years) group (aOR 1.36, 95% CI 1.09-1.69). Current smokers tend to be unvaccinated in all age groups. Among individuals aged ≥ 50, older age, mild to moderate alcohol consumption, regular exercise, and having co-morbidities were positively associated with vaccination, while those who self-reported their health status as good were less likely to be vaccinated. CONCLUSIONS:The relationship between SES and seasonal influenza vaccination coverage differed between the age groups throughout the adult South Korean population. Public health policies need to address these inequalities.

The purpose of this study was to examine the association between oral health behaviors and bone mineral density (BMD) by using data from the Korean National Health and Nutrition Examination Survey conducted in 2008–2010. We included 6,620 subjects (3,140 men aged more than 50 years and 3,480 postmenopausal women). BMD was measured at three sites—namely, the lumbar spine, total femur, and femur neck. Oral health behaviors were assessed by use of a self-administered questionnaire in the Korean National Health and Nutrition Examination Survey. After adjustment for all covariates, BMD of the lumbar spine and femur neck tended to increase as the frequency of tooth brushing increased in men (p trend = 0.020 and p trend = 0.028, respectively). Women using secondary oral products had increased lumbar spine BMD compared with women who did not use secondary oral products. However, after adjustment for all covariates, no significant relationship was observed between BMD and the use of secondary oral products. As the frequency of tooth brushing and the number of secondary oral products used increased, the prevalence of osteoporosis decreased. The frequency of tooth brushing is associated with increased lumbar spine and femur neck BMD in South Korean men.

Purpose Osteoporosis poses a great threat to the aging society. Hypochlorhydric or achlorhydric conditions are risk factors for osteoporosis. Atrophic gastritis also decreases gastric acid production; however, the role of atrophic gastritis as a related factor for osteoporosis is unclear. We investigated the relationship between atrophic gastritis and osteoporosis in postmenopausal women over 60 years of age. Subjects and Methods A total of 401 postmenopausal women were included in this cross-sectional study, which was conducted during their medical check-ups. Bone mineral densitometry was measured using a dual energy X-ray absorptiometry. Atrophic gastritis was defined endoscopically if gastric mucosa in the antrum and the body were found to be atrophied and thinned and submucosal vessels could be well visualized. Results The proportion of people with atrophic gastritis was higher in the osteoporotic group than in the group without osteoporosis. A linear relationship was observed in the proportion of atrophic gastritis according to the categories of normal, osteopenia, and osteoporosis at the lumbar spine (p for trend = 0.039) and femur (p for trend = 0.001). A multiple logistic regression analysis revealed that the presence of atrophic gastritis was associated with an increased odds of osteoporosis after adjusting for age, body mass index, triglyceride, high-density lipoprotein cholesterol, alcohol consumption, and smoking status (odds ratio 1.89, 95% confidence interval 1.15–3.11). Conclusions Atrophic gastritis is associated with an increased likelihood of osteoporosis in Korean elderly women.

A possible negative effect of iron overload on bone metabolism has been suggested by the fact that patients with hemochromatosis, thalassemia, and sickle cell anemia have lower bone mineral density than the general population. However, the influence of iron overload on bone health in the general population is uncertain. The aim of this study was to investigate the relationship between serum ferritin levels and bone mineral density (BMD) in elderly Koreans. A total of 2,943 subjects aged 65 years and over who participated in the 2008–2010 Korea National Health and Nutrition Examination Surveys were included in this study. Age, physical activity, current smoking status, alcohol consumption, education level, household income, and dietary assessment were surveyed by a face-to-face interview. BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry, and other biochemical markers, including serum ferritin, 25-hydroxyvitamin D3, serum alkaline phosphatase, and parathyroid hormone, were assayed. After adjusting for age and body mass index, we found an association between BMD of the total lumbar spine, total femur, and femur neck and levels of alkaline phosphatase, parathyroid hormone, vitamin D3, and daily intake of calcium and protein. Serum ferritin levels were positively associated with BMD of the total lumbar spine, total femur, and femur neck after adjusting for all covariates in men, but not in women. This study suggests a positive association between serum ferritin levels and BMD in elderly South Korean men without hematologic disorders. Further study is warranted to verify the effects of iron on bone metabolism.

Background Fast eating or overeating can induce gastrointestinal diseases such as gastritis. However, the association between gastritis and speed of eating is unclear. The aim of this study was to determine whether eating speed is associated with increased risk of endoscopic erosive gastritis (EEG). Methods We carried out a cross-sectional study involving 10,893 adults who underwent a general health checkup between 2007 and 2009. Two groups, EEG patients and EEG-free patients, were compared by using the t-test and the chi-square test. Multiple logistic regression analyses were performed to investigate the association between eating speed and EEG. Results The group with EEG had a higher proportion of males, average age, body mass index, and percentages of current smokers and risky drinkers than those without EEG. After adjusting for anthropometric, social, and endoscopic parameters, the group with the highest eating speed (