• Korean Journal of Community Nutrition
• /
• v.25 no.3
• /
• pp.236-245
• /
• 2020

Objectives: Cardiovascular disease is a major cause of death in the elderly in Korea. Increased arterial stiffness is linked to risk of cardiovascular disease and mortality. The purpose of this study was to investigate the relationship between arterial stiffness and physical activity in the elderly. Methods: A total of 209 older adults (110 men and 99 women) participated in this study. Arterial stiffness of subjects such as brachial-ankle pulse wave velocity (baPWV) and ankle brachial pressure index (ABI) was measured using a non-invasive vascular screening device (VP-1000 Plus, Omron, Kyoto, Japan). The interviewed Korean version of the international physical activity questionnaire short form (IPAQ-SF) was used to evaluate subject's physical activity level and classify subjects as active or inactive group based on the time spent doing moderate to vigorous physical activity (MVPA). Results: The mean age of total subjects was 75.3 ± 5.6 years. There was no significant difference in sex distribution between the active group (39.7%) and inactive group (60.3%). The baPWV (1,758.1 ± 375.2 cm/sec) of the active group was significantly lower than that (1,969.7 ± 372.3 cm/sec) of the inactive group (P < 0.05). There was a significant inverse association between time spent in MVPA and baPWV (r = -0.245, P < 0.01). Conclusions: This study suggests that physical activity programs for older adults are needed to prevent arteriosclerosis.

• Biomedical Science Letters
• /
• v.15 no.1
• /
• pp.9-15
• /
• 2009

Early age at menarche, which is indicator of early biological maturity, has been shown to be associated with increased adult body mass index. Early menarche has also been associated with many cardiovascular disease risk factors and metabolic syndrome. To evaluate the impact of menarche to cardiovascular risk factor, we assessed by age at menarche, brachial-ankle pulse wave velocity (baPWV), which represents arterial stiffness, in women with or without metabolic syndrome. The subjects recruited for this study were three hundred one women. Relatively early menarche and relatively late menarche were classified according to less than $50^{th}$ percentile for relatively early menarche, and great than the $50^{th}$ percentile for relatively late menarche. Subject were divided four group, 1) women who had not adulthood metabolic syndrome and relatively early menarche, 2) women who had not adulthood metabolic syndrome and relatively late menarche, 3) women who had adulthood metabolic syndrome and relatively early menarche, 4) women who had adulthood metabolic syndrome and relatively late menarche. Women who had a relatively early menarche with adulthood metabolic syndrome had significantly high levels of blood pressure, triglyceride, fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels than women with late menarche with adulthood metabolic syndrome, and had significantly lower HDL-cholesterol levels. And also, women who underwent a relatively early menarche with metabolic syndrome had highest level of baPWV in adult. In this study we found effect of age at menarche on adulthood metabolic risk factors for cardiovascular disease (e.g., baPWV, insulin resistance, hyperlipidemia) in Korean women.

• Korean Journal of Family Medicine
• /
• v.39 no.6
• /
• pp.347-354
• /
• 2018

Background: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. Methods: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. Results: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. Conclusion: Lower pBF in obese men may be associated with improved cardiovascular risk.

• Journal of Korean Foot and Ankle Society
• /
• v.23 no.2
• /
• pp.58-66
• /
• 2019

Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.

• Journal of Korean Foot and Ankle Society
• /
• v.20 no.2
• /
• pp.78-83
• /
• 2016

Purpose: This study examined the factors affecting the treatment of diabetes mellitus foot patients who had undergone a Syme amputation. Materials and Methods: This study included 17 patients diagnosed with a diabetes mellitus foot and who had undergone a Syme amputation from January 2010 to January 2014. Some of the risk factors (age, body mass index [BMI], disease duration, smoking, ankle brachial index [ABI], HbA1c, serum albumin, total lymphocyte, C-reactive protein [CRP], and serum creatine) that affect the successful Syme amputation were analyzed. Results: The healing rate of a Syme amputation was significantly higher when the lymphocyte count was above $1,500mm^3$ (p=0.029). The factors affecting the surgical outcome according to multivariate analysis were HbA1c and the BMI (p=0.014, p=0.013). Regarding reamputation, there was a significant difference with HbA1c, lymphocyte, and BMI (p=0.01, p=0.03, and p=0.01). No significant differences were observed with age, disease duration of diabetes mellitus, smoking, ABI, serum albumin, CRP, and serum creatine. Conclusion: The HbA1c level, BMI and total lymphocyte count are risk factors that must be considered for successful Syme amputation in patients with diabetic foot disease.

• Clinical and Experimental Pediatrics
• /
• v.50 no.11
• /
• pp.1078-1084
• /
• 2007

Purpose : The prevalence of childhood obesity has doubled over the last 30 years. Obesity-associated sequelae in the vasculature begins in the early stages of life. The purpose of this study was to investigate how pulse wave velocity (PWV) and ankle brachial index (ABI) change with height, weight and body mass index (BMI) in obese adolescents. Methods : Seventy-nine obese adolescents (group 1: $85th{\leq}BMI<95th$ percentile, n=40; group 2 ($BMI{\geq}95th$ percentile, n=39) were included. The control group(group 3) included 99 healthy adolescents. Brachial- ankle (ba) PWV and ABI were estimated with blood pressure from four extremities. Heart rate (HR), and pre-ejection period/ejection time (PEP/ET) were also estimated. BMI was calculated from individual height and weight. Linear regression analysis was performed to evaluate the correlations between BMI and PWV. Results : Blood pressure and baPWV were significantly higher in group 2, compared to either group 1 or group 3. However, there was no significant difference in ABI, HR and PEP/ET between the groups. PWV showed linear correlation with both BMI and body weight. Conclusion : Obesity was associated with higher arterial stiffness in adolescents, which was demonstrated by an increase in PWV. There was no significant correlation between obesity and ABI.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.11
• /
• pp.56-65
• /
• 2019

This study examined effects of 12 weeks of body weight based combined exercise training (resistance training for 30 min, aerobic training for 30min) on body composition (% body fat, lean body mass, fat mass and BMI (body mass index)) and cardiovascular factors (ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV)) in elderly women. A total of 32 subjects participated in this study, and were randomly divided into either exercise group (n = 16, EG) or control group (n = 16, CG). All variables at pre-test were analyzed by independent t-test for baseline test, and all data post the study period were analyzed by two-way repeated measures ANOVA with contrast testing (α = 0.05). Our results indicate that body composition (% body fat, lean body mass, fat mass and BMI) in both EG and CG do not differ significantly. However, the right and left sides of baPWV in EG was significantly reduced, as compared to CG. Taken together, these results indicate that combined exercise training for 12 weeks positively influences the cardiovascular factors, and may prevent cardiovascular diseases in elderly females (over 65 years), thereby resulting in increased quality of life for the elderly.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.1
• /
• pp.362-370
• /
• 2019

This study was conducted to investigate effects of 12 weeks of combined exercise training with blood flow restriction (BFR) on body composition (weight, %body fat, lean body mass, body mass index (BMI)) and cardiovascular responses (brachial-ankle pulse wave velocity (ba PWV) and ankle-brachial index (ABI)) in elderly women. Participants (N = 43, Females) were randomly assigned into a combined exercise with BFR (n = 14, BFR), only combined exercise (n =14, EX) or non-exercise control group (n = 15, CON). Two-way repeated measures ANOVA with contrast testing was utilized for data analysis. Alpha was set at p < 0.05. Body composition (weight, %body fat, BMI) in BFR was significantly changed, and %body fat in EX was significantly decreased, but there was no change in the CON. In addition, the right and left ba PWV values in the BFR were significantly decreased, while only the left side ba PWV in EX was significantly decreased and there was no change in the CON. Moreover, the % change and effect size of most variables in the BFR were higher than the EX. Taken together, the results indicate that even though BFR and EX groups performed the same combined exercise training, BFR had additional stimulations of the sympathetic nerve system due to blood flow restriction. Thus, BFR training is more beneficial and has greater effects on body composition and cardiovascular responses in elderly females.

• Journal of Genetic Medicine
• /
• v.14 no.1
• /
• pp.8-17
• /
• 2017

Purpose: Pulse wave velocity (PWV) is an indicator of arterial stiffness, and is considered a marker of vascular damage. However, a genome-wide association study analyzing single nucleotide polymorphisms (SNPs) associated with brachial-ankle PWV (baPWV) has not been conducted in healthy populations. We performed this study to identify SNPs associated with baPWV in healthy populations in Korea. Materials and Methods: Genomic SNPs data for 2,407 individuals from three sites were analyzed as part of the Korean Genomic Epidemiologic Study. Without replication samples, we performed multivariable analysis as a post hoc analysis to verify the findings in site adjusted analysis. Healthy subjects aged between 40 and 70 years without self-reported history or diagnosis of hypertension, diabetes, hyperlipidemia, heart disease, cerebrovascular disease and cancer were included. We excluded subjects with a creatinine level >1.4 mg/dL (men) and 1.2 mg/dL (women). Results: In the site-adjusted association analysis, significant associations (P<$5{\times}10^{-8}$) with baPWV were detected for only 5 SNPs with low minor allele frequency. In multivariable analysis adjusted by age, sex, height, body mass index, mean arterial pressure, site, smoking, alcohol, and exercise, 11 SNPs were found to be associated (P<$5{\times}10^{-8}$) with baPWV. The 5 SNPs (P<$5{\times}10^{-8}$) linked to three genes (OPCML, PRR35 and RAB40C) were common between site-adjusted analysis and multivariable analysis. However, meta-analysis of the result from three sites for the 11 SNPs showed no significant associations. Conclusion: Using the recent standard for genome-wide association study, we did not find any evidence of significant association signals with baPWV.

• Korean Journal of Adult Nursing
• /
• v.20 no.1
• /
• pp.102-112
• /
• 2008

Purpose: The purpose of this study was to examine self care behaviors according to the risk levels of vascular complications in elderly women with hypertension. Methods: The subjects of this study were 162 women living in the community who had been diagnosed with hypertension in clinics. The data were analysed by the SPSS 10.0 program using descriptive statistics, t-test, and ANOVA with Scheff$\dot{e}$ post-hoc test. Results: The average self care behavior score of the elderly women was 2.79. Total self care behavior was significantly different depending on the risk levels of vascular complications such as systolic blood pressure, diastolic blood pressure, ankle-brachial index, and the framingham point score. Among sub-scores of self care behaviors, exercise management was the poorest performance compared with other self care behaviors. Conclusion: This study proved the differences in self care behaviors according to the risk levels of vascular complications. To decrease the prevalence of vascular complication, it is necessary to develop programs specifically to enhance self care behaviors of elderly women with hypertension.