Journal of Sasang Constitutional Medicine (사상체질의학회지)

The Society Of Sasang Constitutional Medicine (사상체질의학회)
권호 표지
DOI QR코드

DOI QR Code

A Relationship of Constitution Type, Lifestyle Status and Metabolic Syndrome Incidence in Korean Adults

우리나라 성인의 사상체질과 생활습관 상태에 따른 대사증후군 발생 위험 상관성

  • Jieun Kim (Korean Medicine Data Division, Korea Institute of Oriental Medicine) ;
  • Kyoungsik Jeong (Korean Medicine Data Division, Korea Institute of Oriental Medicine) ;
  • Younghwa Baek (Korean Medicine Data Division, Korea Institute of Oriental Medicine) ;
  • Siwoo Lee (Korean Medicine Data Division, Korea Institute of Oriental Medicine)
  • 김지은 (한국한의학연구원 한의약데이터부 ) ;
  • 정경식 (한국한의학연구원 한의약데이터부 ) ;
  • 백영화 (한국한의학연구원 한의약데이터부) ;
  • 이시우 (한국한의학연구원 한의약데이터부 )
  • Received : 2024.02.21
  • Accepted : 2024.05.08
  • Published : 2024.07.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives We aimed to identify the incidence of metabolic syndrome (MetS) and its clustering components according to constitution type and lifestyle risk factors in Korean adults. Methods This study included 1,978 adults aged 30-55 years from the Korean Medicine Daejeon Citizen Cohort (KDCC) study. We defined lifestyle factors including smoking, alcohol consumption, physical activity, sleep, dietary quality, and weight status. Total lifestyle scores were created based on the six lifestyle factors (ranging from 0 to 5 factors) and classified into two groups: unhealthy (0-2 factors), or healthy (3-5 factors). Cox proportional hazard regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of primary endpoints: MetS events and their clustering components. Results During a median follow-up of 2.2 years, we documented 125 new onsets of MetS. Compared with participants with healthy, the HR of unhealthy participants was 2.401 (95% CI: 1.497-3.851) for MetS incidence. After adjusting for covariates, TE type with unhealthy was higher HR values of abdominal obesity (HRs: 1.499, 95%CI: 1.061-2.117) and hypertension (HRs: 1.840, 95%CI: 1.032-3.277), respectively. Conclusion Unfavorable lifestyle factors were highly associated with the prevalence of MetS and its clustering such as abdominal obesity and hypertension in Korean adults with TE. Tailored health management is needed to consider individual traits and healthy lifestyles to prevent cardiometabolic diseases.

Keywords

Acknowledgement

이 연구는 2024년도 한국한의학연구원의 '빅데이터 기반 한의 예방 치료 원천기술 개발'(KSN1732121)의 지원을 받아 수행되었습니다.

References

  1. Lobene AJ. The Increasing Prevalence of Metabolic Syndrome in Korea. JACC: Asia. 2023;3(3_Part_2):503-505. doi.org/10.1016/j.jacasi.2023.05.004 
  2. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men. NEJM 2011;364(25):2392-2404. doi.org/10.1056/NEJMoa1014296 
  3. Guembe MJ, Fernandez-Lazaro CI, Sayon-Orea C, Toledo E, Moreno-Iribas C. Risk for cardiovascular disease associated with metabolic syndrome and its components: a 13-year prospective study in the RIVANA cohort. Cardiovasc Diabetol. 2020;19(1):195. doi.org/10.1186/s12933-020-01166-6 
  4. Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health. 2017;17(1):101. doi.org/10.1186/s12889-017-4041-1 
  5. Yim E, Lee K, Park I, Lee S. The Prevalence of Metabolic Syndrome and Health-Related Behavior Changes: The Korea National Health Examination Survey. Healthcare. 2020;8(2):134. doi.org/10.3390/healthcare8020134 
  6. Song KH, Yu S-G, Kim JY. Prevalence of Metabolic Syndrome according to Sasang Constitutional Medicine in Korean Subjects. eCAM. 2012;2012:646794. doi.org/10.1155/2012/646794 
  7. Lee S, Lee SK, Kim JY, Cho N, Shin C. Sasang constitutional types for the risk prediction of metabolic syndrome: a 14-year longitudinal prospective cohort study. BMC Complement Altern Med. 2017;17(1):438. doi.org/10.1186/s12906-017-1936-4 
  8. Cho NH, Kim JY, Kim SS, Shin C. The relationship of metabolic syndrome and constitutional medicine for the prediction of cardiovascular disease. Diabetes Metab Syndr. 2013;7(4):226-232. doi.org/10.1016/j.dsx.2013.08.003 
  9. Jang E, Baek Y, Park K, Lee S. Could the Sasang constitution itself be a risk factor of abdominal obesity? BMC Complement Altern Med. 2013;13(1):72. doi.org/10.1186/1472-6882-13-72 
  10. Lee SK, Yoon DW, Lee SW, Kim JY, Kim JK, Cho NH, et al. Association of Sasang Constitutional Types with Incident Hypertension: A 12-Year Follow-Up Study. J Altern Complement Med 2016;22(9):706-712. doi.org/10.1089/acm.2015.0052 
  11. Cho NH, Kim JY, Kim SS, Lee SK, Shin C. Predicting type 2 diabetes using Sasang constitutional medicine. J. Diabetes Investig. 2014;5(5):525-532. doi.org/10.1111/jdi.12189 
  12. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. doi.org/10.1016/S0140-6736(20)30925-9 
  13. Safiri S, Karamzad N, Kaufman JS, Bell AW, Nejadghaderi SA, Sullman MJ, et al. Prevalence, Deaths and Disability-Adjusted-Life-Years (DALYs) Due to Type 2 Diabetes and Its Attributable Risk Factors in 204 Countries and Territories, 1990-2019: Results From the Global Burden of Disease Study 2019. Front Endocrinol. 2022;13. doi.org/10.3389/fendo.2022.838027 
  14. Afshin A, PJ Sur, Fay KA, Cornaby L, Ferrara, G, Salama JS, et al. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019;393(10184):1958-1972. doi.org/10.1016/S0140-6736(19)30041-8 
  15. World Health Organization. Tackling NCDs: 'best buys' and other recommended interventions for the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2017 2017. https://creativecommons.org/licenses/by-nc-sa/3.0/igo 
  16. Zhang YB, Pan XF, Lu Q, Wang YX, Geng TT, Zhou YF, et al. Association of Combined Healthy Lifestyles With Cardiovascular Disease and Mortality of Patients With Diabetes: An International Multicohort Study. Mayo Clin. Proc. 2023;98(1):60-74. doi.org/10.1016/j.mayocp.2022.08.012 
  17. Lee DH, Nam JY, Kwon S, Keum NN, Lee JT, Shin MJ, et al. Lifestyle risk score and mortality in Korean adults: a population-based cohort study. Sci. Rep 2020;10(1):10260. doi.org/10.1038/s41598-020-66742-y 
  18. Khan TA, Field D, Chen V, Ahmad S, Mejia SB, Kahleova H, et al. Combination of Multiple Low-Risk Lifestyle Behaviors and Incident Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies. Diabetes Care 2023;46(3):643-656. doi.org/10.2337/dc22-1024 
  19. Shin S, Lee S. Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults. kjcn. 2020;25(1):61-70. (Korean) doi.org/10.5720/kjcn.2020.25.1.61 
  20. Park S, Kim K, Lee B-K, Ahn J. Association of the Healthy Eating Index with Estimated Cardiovascular Age in Adults from the KNHANES 2013-2017. Nutrients 2020;12(10):2912. doi:10.3390/nu12102912 
  21. Lee JS, Kim HY, Hwang JY, Kwon S, Chung HR, Kwak TK, et al. Development of Nutrition Quotient for Korean adults: item selection and validation of factor structure. jnh. 2018;51(4):340-356. (Korean) doi.org/10.4163/jnh.2018.51.4.340 
  22. Kim J, Jeong K, Lee S, Seo BN, Baek Y. Low nutritional status links to the prevalence of pre-metabolic syndrome and its cluster in metabolically high-risk Korean adults: A cross-sectional study. Medicine. 2021;100(20):e25905. DOI: 10.1097/MD.0000000000025905 
  23. Kim J, Jeong K, Lee S, Baek Y. Relationship between Low Vegetable Consumption, Increased High-Sensitive C-Reactive Protein Level, and Cardiometabolic Risk in Korean Adults with Tae-Eumin: A Cross-Sectional Study. eCAM 2021;2021:3631445. doi.org/10.1155/2021/3631445 
  24. Kim J, Jeong K, Baek Y, Lee S. A relationship of healthy eating status and body composition in Korean adults by their constitution type: A cross-sectional study. J. Sasang const. medicine 2022;34(1):46-57. (Korean) DOI: 10.7730/JSCM.2022.34.1.46 
  25. Baek Y, Seo BN, Jeong K, Yoo H, Lee S. Lifestyle, genomic types and non-communicable diseases in Korea: a protocol for the Korean Medicine Daejeon Citizen Cohort study (KDCC). BMJ Open. 2020;10(4):e034499. doi.org/10.1136/bmjopen-2019-034499 
  26. Baek YH, Jang ES, Park KH, Yoo JH, Jin HJ, Lee S. Development and validation of brief KS-15 (Korea Sasang constitutional diagnostic questionnaire) based on body shape, temperament and symptoms. J. Sasang const. medicine 2015;27(2):211-221. (Korean) doi.org/10.7730/JSCM.2015.27.2.211 
  27. Bae KH, Kim SH, Go HY, Park KH, Lee S, Lee S One year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students. J. Sasang const. medicine 2019;31(2):12-21. (Korean) doi.org/10.7730/JSCM.2019.31.2.12 
  28. Kim Y, Jang E. Test-retest reliability of brief KS-15-Korean Sasang constitutional diagnostic questionnaire. J Physiol & Pathol Korean Med. 2016;30(3):177-183. (Korean) doi.org/10.15188/kjopp.2016.06.30.3.177 
  29. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). Jama. 2001;285(19):2486-2497. 10.1001/jama.285.19.2486 
  30. Yook SM, Park S, Moon HK, Kim K, Shim JE, Hwang JY. Development of Korean healthy eating index for adults using the Korea national health and nutrition examination survey data. J. Nutr. Health. 2015;48(5):419-428. doi.org/10.4163/jnh.2015.48.5.419 
  31. Park YS, Kang SH, Jang SI, Park EC. Association between lifestyle factors and the risk of metabolic syndrome in the South Korea. Sci. Rep. 2022;12(1):13356. doi.org/10.1038/s41598-022-17361-2 
  32. Zhu N, Yu C, Guo Y, Bian Z, Han Y, Yang L, et al. Adherence to a healthy lifestyle and all-cause and cause-specific mortality in Chinese adults: a 10-year prospective study of 0.5 million people. Int. J. Behav. 2019;16(1):98. doi.org/10.1186/s12966-019-0860-z 
  33. Nishimoto M, Tagawa M, Matsui M, Eriguchi M, Samejima KI, Iseki K, et al. A Prediction Model with Lifestyle in Addition to Previously Known Risk Factors Improves Its Predictive Ability for Cardiovascular Death. Sci. Rep. 2019;9(1):12953. doi.org/10.1038/s41598-019-49003-5 
  34. Jang ES, Kim YY, Baek YH, Lee S. The Association between Seven Health Practices and Self Rated Health by Sasang Constitution. J. Sasang const. medicine. 2018;30(1):32-42. (Korean) doi.org/10.7730/JSCM.2018.30.1.32 
  35. Park JE, Shin C, Lee S. Effect of Lifestyle Factors on Hypertension by Constitution Type: A Large Community-Based Study. eCAM. 2019;:3231628. doi.org/10.1155/2019/3231628 
  36. Kivimaki M, Kuosma E, Ferrie JE, Luukkonen R, Nyberg S, Alfredsson L, et al. Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe. The Lancet Public Health. 2017;2(6):e277-e285. doi.org/10.1016/S2468-2667(17)30074-9 
  37. Lee J, Jang H, Park B, Lee E, Koh B, Lee J. Can the Sasang Constitutional Type Trait Act as an Independent Risk Factor for Dyslipidemia? J Korean Med Obes Res 2014;14(2):63-71. doi.org/10.15429/jkomor.2014.14.2.63 
  38. Lee SK, Yoon DW, Kim JK, Lee SW, Kim JY, Jee SH, et al. Association of adiponectin, ghrelin, and leptin with metabolic syndrome and its metabolic components in Sasang constitutional type. Eur. J. Integr. Med. 2018;22:16-21. doi.org/10.1016/j.eujim.2018.07.007 
  39. Cha S, Koo I, Park BL, Jeong S, Choi SM, Kim KS, et al. Genetic Effects of FTO and MC4R Polymorphisms on Body Mass in Constitutional Types. eCAM. 2011;2011:106390. doi.org/10.1093/ecam/nep162 
  40. Jeong K, Park K, Lee S, Hwang JY, Baek Y. Evaluation of Dietary Behaviors According to Sasang Constitution Using a Nutrition Quotient: A Korean Medicine Daejeon Citizen Cohort Study. J. Sasang const. medicine 2020;32(4):86-95. (Korean) doi.org/10.7730/JSCM.2020.32.4.86 
  41. Kim J, Lee S, Baek Y. Effects of life style on metabolic syndrome stage according to the sasang constitution. J. Sasang const. medicine 2017;29(3):232-241. (Korean) doi.org/10.7730/JSCM.2017.29.3.232 
  42. Maimaitiyiming M, Yang H, Li H, Xu C, Li S, Zhou L, et al. The association of obesity-related dietary patterns and main food groups derived by reduced-rank regression with cardiovascular diseases incidence and all-cause mortality: findings from 116,711 adults. Eur J Nutr. 2023;62(6):2605-2619. doi.org/10.1007/s00394-023-03177-x 
  43. Rodriguez-Monforte M, Sanchez E, Barrio F, Costa B, Flores-Mateo G. Metabolic syndrome and dietary patterns: a systematic review and meta-analysis of observational studies. Eur J Nutr. 2017;56(3):925-947. doi: 10.1007/s00394-016-1305-y 
  44. Giugliano D, Ceriello A, Esposito K. The effects of diet on inflammation: emphasis on the metabolic syndrome. J Am Coll Cardiol 2006;48(4):677-685. doi.org/10.1016/j.jacc.2006.03.052 
  45. Calle MC, Andersen CJ. Assessment of dietary patterns represents a potential, yet variable, measure of inflammatory status: a review and update. Dis. Markers 2019; doi.org/10.1155/2019/3102870 
  46. Eichelmann F, Schwingshackl L, Fedirko V, Aleksandrova K. Effect of plant based diets on obesity related inflammatory profiles: a systematic review and meta analysis of intervention trials. Obes. Rev. 2016;17(11):1067-1079. doi.org/10.1111/obr.12439.