• Clinical and Experimental Pediatrics
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• v.62 no.8
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• pp.317-323
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• 2019

Purpose: Investigating the prevalence of hyperuricemia and its association with metabolic syndrome (MetS) and cardiometabolic risk factors (CMRFs) in Korean children and adolescents. Methods: This cross-sectional survey used data from the 7th Korea National Health and Nutrition Examination Survey (2016-2017); 1,256 males and females aged 10-18 years were included. Hyperuricemia was defined as serum uric acid levels were >6.6 mg/dL at 10-11 years of age (both sexes), >7.7 mg/dL for males at 12-18 years of age and >5.7 mg/dL for females at 12-18 years of age. MetS was defined by the International Diabetes Federation criteria. Logistic regression analysis was used to analyze hyperuricemia-associated risk factors. Results: The prevalence of hyperuricemia was 9.4% (male, 8.4%; female, 10.5%) (P<0.281). After adjusting for sociodemographic factors and health behaviors in multivariate analysis (model 1), the odds ratio (OR) for hyperuricemia of MetS was 3.05 (95% confidence interval [CI], 1.17-7.92; P=0.022). After adjusting for the same variables in model 1 plus obesity and all MetS components (model 2), only abdominal obesity was significant, and the OR for hyperuricemia was 3.38 (95% CI, 1.72-6.63; P<0.001) After adjusting for the same variables in model 1 plus body mass index (BMI) z scores and all MetS components except abdominal obesity (model 3), only BMI z scores was significant, and the OR for hyperuricemia was 1.59 (95% CI, 1.34-1.89; P<0.001). Conclusion: MetS, abdominal obesity, and BMI z scores were CMRFs significantly associated with hyperuricemia in Korean children and adolescents. Therefore, attention should be paid to hyperuricemia in patients with obesity or MetS.

• Journal of the Korea Convergence Society
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• v.9 no.1
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• pp.233-240
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• 2018

The aim of this study was to investigate the cardiometabolic risk factors (CRF) of community dwelling women based on a combination of body mass index (BMI) and waist circumference (WC). This cross-sectional study was based on 1,447 subjects between 30 and 60 years of age. Subjects were categorized into 4 groups by BMI and WC [group 1, BMI<$25kg/m^2$ and WC<85 cm; group 2, BMI<$25kg/m^2$ and WC>85 cm; group 3, BMI>$25kg/m^2$ and WC<85 cm; and group 4 (BMI>$25kg/m^2$ and WC>85 cm. Logistic regression analyses showed that subjects in group 2 had 1.75 times increased risk of clustering of 2 or more CRFs compared with subjects in group 1 (p<0.001). In conclusion, early detection of people with normal weight but high waist circumference may prevent them from getting worse by implementation of lifestyle intervention, consisting of regular exercise and healthy eating. In addition, further studies on appropriate exercise contents for them should be examined.

• Annals of Pediatric Endocrinology and Metabolism
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• v.23 no.4
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• pp.196-203
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• 2018

Purpose: The hemoglobin glycation index (HGI) represents the degree of nonenzymatic glycation and has been positively associated with cardiometabolic risk factors (CMRFs) and cardiovascular disease in adults. This study aimed to investigate the association between HGI, components of metabolic syndrome (MS), and alanine aminotransferase (ALT) in a pediatric nondiabetic population. Methods: Data from 3,885 subjects aged 10-18 years from the Korea National Health and Nutrition Examination Survey (2011-2016) were included. HGI was defined as subtraction of predicted glycated hemoglobin ($HbA1_c$) from measured $HbA1_c$. Participants were divided into 3 groups according to HGI tertile. Components of MS (abdominal obesity, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure), and proportion of MS, CMRF clustering (${\geq}2$ of MS components), and elevated ALT were compared among the groups. Results: Body mass index (BMI) z-score, obesity, total cholesterol, ALT, abdominal obesity, elevated triglycerides, and CMRF clustering showed increasing HGI trends from lower-to-higher tertiles. Multiple logistic regression analysis showed the upper HGI tertile was associated with elevated triglycerides (odds ratio, 1.65; 95% confidence interval, 1.18-2.30). Multiple linear regression analysis showed HGI level was significantly associated with BMI z-score, $HbA1_c$, triglycerides, and ALT. When stratified by sex, age group, and BMI category, overweight/obese subjects showed linear HGI trends for presence of CMRF clustering and ALT elevation. Conclusion: HGI was associated with CMRFs in a Korean pediatric population. High HGI might be an independent risk factor for CMRF clustering and ALT elevation in overweight/obese youth. Further studies are required to establish the clinical relevance of HGI for cardiometabolic health in youth.

• Journal of Ginseng Research
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• v.45 no.5
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

• Clinical and Experimental Pediatrics
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• v.62 no.7
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• pp.261-268
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• 2019

Purpose: This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. Methods: We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6-18 years who were included in the third to sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2005-2015). Linear regression analyses were used to identify secular changes in WC and WHR by age, sex, and KNHANES waves. A receiver operating characteristic curve analysis was used to determine the optimal WHR cutoff values for abdominal obesity and cardiometabolic risk factors. Results: The mean WC and WHR distributions from 2005 to 2015 showed no significant secular changes between the KNHANES 4 waves (P for trend ${\geq}0.05$ in all ages and both sexes). The mean WCs in the present study were lower than those in the 2007 Korean National Growth Charts. The mean WHR at ages <13 years was statistically higher in the boys than in the girls, but did not significantly differ between the sexes among those aged 13 to 18 years. The optimal WHR cutoff for abdominal obesity was 0.48 (area under the curve, 0.985; 95% confidence interval, 0.985-0.985) in the 13- to 18-year-old adolescents. Conclusion: WC and WHR showed no secular changes over 10 years. The optimal WHR cutoff for abdominal obesity of 0.48 is useful for diagnosing and managing obesity and thus preventing obesity-related cardiometabolic complications in 13- to 18-year-old Korean adolescents.

• Clinical Nutrition Research
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• v.12 no.4
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• pp.320-335
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• 2023

Literature showed that soluble fiber has beneficial effects on cardiometabolic risk factors and leptin and adiponectin serum levels. Our aim in this meta-analysis was to determine the effect of soluble fiber supplementation on leptin and adiponectin serum levels. A systematic search was conducted using PubMed, Scopus, and ISI Web of Science for eligible trials up to December 2021. A random-effects model was used to pool calculated effect sizes. Our analysis showed that soluble fiber supplementation did not significantly affect adiponectin (standardized mean difference [SMD], -0.49 Hedges's, 95% confidence interval [CI], -1.20, 0.21, p value = 0.167; I² = 95.4, p value < 0.001) and leptin (SMD, -0.8 Hedges's, 95% CI, -1.70, 0.08, p value = 0.076; I² = 94.6, p value < 0.001) concentrations in comparison with placebo. However, in the subgroup, soluble fiber supplementation had a significant improvement in leptin concentration in overweight and obese patients (SMD, -0.22 Hedges's, 95% CI, -0.43, -0.01, p value = 0.048) and a non-significant beneficial effect in adiponectin level in female (SMD, 0.29 Hedges's, 95% CI, -0.13, 0.71, p value = 0.183) and diabetic patients (SMD, 0.32 Hedges's, 95% CI, -0.67, 1.32, p value = 0.526). A non-linear association between soluble fiber dosage and adiponectin (p_{non-linearity} < 0.001) was observed. Soluble fiber supplementation could not change the circulatory leptin and adiponectin levels. However, beneficial effects were seen in overweight and obese leptin, and increases in adiponectin may also be observed in female and diabetic patients. Further studies are needed to confirm this results.

• Nutrition Research and Practice
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• v.12 no.2
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• pp.173-173
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• 2018

• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.150-157
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• 2024

The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.

• Archives of Obesity and Metabolism
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• v.3 no.1
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• pp.14-26
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• 2024

Ultra-processed foods, falling under group 4 of the Nova classification system, are manufactured from processed food ingredients such as oils, fats, sugars, starch, and protein isolates, containing minimal to no whole food. They commonly incorporate flavorings, colorings, emulsifiers, and various cosmetic additives to enhance their palatability. Ultra-processed foods have become increasingly prevalent in contemporary society owing to their convenience, affordability, extended shelf life, and enhanced taste and aroma through additives. This surge in the consumption of ultra-processed foods has sparked discussions regarding its adverse health effects. Numerous studies have highlighted that an increased intake of ultra-processed foods elevates the risk of metabolic disorders, such as cardiovascular diseases, obesity, and diabetes, along with an increased risk of various cancers. Moreover, its association with an increased mortality risk underscores the importance of recognizing that opting for these foods based solely on taste and convenience is risky. Thus, by recognizing dietary habits as modifiable factors that can prevent health issues, maintaining a balanced diet with diverse nutrient intakes is crucial for overall health. Therefore, raising awareness and understanding of ultra-processed food consumption can significantly contribute to promoting healthy lifestyles.

• Journal of Sasang Constitutional Medicine
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• v.36 no.2
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• pp.12-26
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• 2024

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.