• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.158-165
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• 2024

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

• Journal of Nutrition and Health
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• v.52 no.6
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• pp.540-551
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• 2019

Purpose: Dietary fiber is a component of carbohydrate that is linked closely with the carbohydrate quality, but few studies have investigated the association of high fiber intake with the cardiometabolic risk factors in Koreans. This study examined the association of high fiber and high carbohydrate intake with the cardiometabolic risk factors among Korean adults. Methods: This study included 15,095 adults aged ≥20 years, who participated in the 2013 ~ 2017 KNHANES. The dietary intake was obtained using a 24-h dietary recall method. The associations of high fiber and high carbohydrate intake with metabolic syndrome and dyslipidemia were examined by sex using multiple logistic regression analysis. Results: The median of dietary fiber was 23.6 g/day in men and 20.0 g/day in women. Dietary fiber intake increased gradually as dietary carbohydrate groups increased except for ≥80% of energy from the carbohydrate group. Women in the highest quintile of fiber intake showed a 33% lower risk of metabolic syndrome compared with those in the third quintile. When stratified into low fiber (LF) and high fiber (HF) groups using Adequate Intake of fiber for Koreans, men in the third quartile of carbohydrate intake showed a 44% and 51% higher risk of metabolic syndrome and atherogenic dyslipidemia than in the first quartile, respectively, but only in the LF group. Women in the second quartile of carbohydrate intake showed an 83% higher risk of hypercholesterolemia than in the first quartile in the LF group. On the other hand, as no significant association was observed between the carbohydrate intake and metabolic diseases among the HF groups in both sexes. Conclusion: These findings suggest that a high fiber intake might be associated with a reduced risk of metabolic syndrome and high carbohydrate intake with a low dietary fiber intake might be associated with an increased risk of several metabolic abnormalities among Korean adults. Further prospective studies will be needed to confirm the effects of high fiber and high carbohydrate intake on the cardiometabolic risk factors among Koreans.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.2
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• pp.69-76
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• 2017

Citrin deficiency is an autosomal recessive disorder caused by mutations in the SLC25A13 gene on chromosome 7q21.3, and a type of urea cycle disorder that causes hyperammonemia. Although neonatal intrahepatic cholestasis and adult-onset type II citrullinemia, a type of citrin deficiency, have been described well in many articles for several decades, failure to thrive and dyslipidemia caused by citrin deficiency (FTTDCD), the other type of citrin deficiency, has been only identified recently. There was previously no case report about FTTDCD in Korea. Patients with FTTDCD could present with loss of appetite, fatigue, failure to thrive, hypoglycemia, hypercitrullinemia, dyslipidemia, and an increased lactate/pyruvate ratio. Routine evaluation may not reveal the cause of hypoglycemia caused by citrin deficiency. We recently had a case that presented with recurrent hypoglycemia in a 30-month-old boy. Chemistry profiling, urine organic acid analysis, plasma acylcarnitine analysis, and hormone studies indicated values within the normal range or non-specific findings. Mutation analysis to identify the cause of hypoglycemia identified the subject as a compound heterozygote carrying each of the c.852_855del ($p.Met285Profs^*2$), and c.1177+1G>A mutant alleles. We report here on this unusual case of citrin deficiency presenting with FTTDCD for the first time in Korea.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.3
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• pp.2089-2099
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• 2015

This study examined the relationships between the blood heavy metal (Pb, Hg and Cd) concentration and exposure-related factors. The subjects were 2,042 (male: 953, female: 1,089) who were recruited through a National Health and Nutrition Examination Survey. Differences in the concentrations of mercury were observed in males, whereas females showed differences in lead and cadmium. Analyses of the blood concentrations according to body mass index and waist circumference showed significantly higher concentrations of mercury. In males, high-density lipoprotein cholesterol of dyslipidemia was higher than normal in the blood lead concentration. In females, low-density lipoprotein cholesterol of dyslipidemia was higher than normal in the blood lead concentration. The blood lead and cadmium concentrations of male smokers was higher than non-smokers, and cadmium showed the same results in females. The blood lead levels were higher in male alcohol consumers than non-drinkers. The blood concentrations of mercury and cadmium showed significant differences according to household income. Blood concentrations of heavy metals were closely related to exposure-related factors, and age, smoking, drinking alcohols, obesity, hyperlipidemia, and household income were found to be relevant.

• The Korea Journal of Herbology
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• v.27 no.2
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• pp.69-75
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• 2012

Objectives : We investigated the effects of mountain cultivated ginseng water boiled extract(MCG) on blood glucose and insulin levels, and examined whether lipid metabolism are improved by it in male db/db mice(a murine model of type 2 diabetes mellitus). Methods : 9 weeks old, male db/db mice were divided into 5 groups : C57BL/6J normal, control, MCG-250mg/kg (MCG-1), MCG-500mg/kg(MCG-2) and MCG-1000mg/kg(MCG-3). After mice were treated with MCG for 8 weeks, we measured body weight, food intake, fat weight, visceral organ weight and blood glucose, insulin and lipid levels. Results : 1. We found no difference in body weight, food intake, fat weight and visceral organ weight among the animal groups. 2. Compared with controls, MCG-treated mice had lower blood glucose level and higher blood insulin levels, the magnitude of which was prominent in MCG-2. 3. Compared with controls, MCG-treated mice had lower LDL-cholesterol and higher HDL-cholesterol levels. 4. Compared with controls, MCG-treated mice had blood triglyceride and free fatty acid levels, the magnitude of which was prominent in MCG-2. 5. Blood AST and ALT concentrations were not changed by MCG, indicating MCG do not show any toxic effects. Conclusions : These results demonstrate that MCG effectively increases blood insulin level and decreases blood glucose level, blood lipid levels, and prevents and improves diabetic dyslipidemia and cardiovascular disease.

• The Journal of Korean Medicine
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• v.29 no.3
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• pp.38-49
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• 2008

Objectives: Though overt thyroid dysfunction is well recognized to affect serum lipid profiles and obesity, there are conflicting reports on the effect of subclinical hypothyroidism on serum lipid profiles and obesity. In most reports, the definition of the upper normal limit of serum thyroid stimulation hormone (TSH) of 4.0${\sim}$5.0mU/L has been used to diagnose. However, recent studies have suggested a much lower TSH cut off with an upper limit of 2.5mU/L, because >95% of rigorously screened normal euthyroid volunteers had serum TSH values between 0.4 and 2.5mU/L. Therefore we defined subclinical hypothyroidism as a TSH level greater than 2.5mU/L. We sought to evaluate the correlations of subclinical hypothyroidism with obesity index and serum lipid profiles Methods: TSH levels were measured in 6190 men and 4223 women that participated in health examination and free T4, lipid profiles (total-cholesterol, triglyceride, LDL-C), and obesity index (body mass index, body fat, waist circumference, C-reactive protein) were also measured. Results: There were significant differences of triglyceride between subclinical hypothyroidism men and normal control subjects. In women, there were also significant differences of triglyceride and LDL-C between subclinical hypothyroidism and normal control subjects. Subclinical hypothyroidism women showed significant correlations of TSH with total cholesterol, LDL-C, triglyceride, and C-reactive protein. Subclinical hypothyroidism men and women with a TSH level 2.5${\sim}$4.0mU/L had significant differences of triglyceride and body fat. In men, there were significant differences of waist circumference andC-reactive protein. In women, there were significant differences of LDL-C. Conclusions: We have demonstrated correlations of subclinical hypothyroidism with serum lipid profiles and obesity index. These findings suggested that subclinical hypothyroidism people had an increased risk of dyslipidemia and obesity. Subclinical hypothyroidism people with a TSH level 2.5${\sim}$4.0mU/L may be also considered suspect since it may signal a case of evolving thyroid underactivity eligible to be prevented.

• Nutrition Research and Practice
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• v.12 no.1
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.139-145
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• 2005

Background: There were very few reports on long-term survival after coronary artery bypass graft (CABG) in this country. The aim of this study is to investigate the long-term result in patients undergoing CABG in the early period in this hospital. Material and Method: One-hundred and fourteen patients (male/female, 79/35) who had undergone CABG from December 1990 to December 1995 were identified. Most of the patients had undergone CABG using left internal thoracic artery and vein grafts under cardiopulmonary bypass and cardiopulmonary arrest, and the proximal and distal anastomoses of the grafts were performed during the single aortic cross clamping period. Result: During the mean follow-up period of $135.5\pm17.9$ months, 37 patients $(32.5\%)$ were dead and only 10 patients $(27\%)$ of them died of cardiac cause. Risk-unadjusted survival after CABG was $95.6\%,\;85.1\%,\;71.8\%,$ and $57.9\%$ at 1, 5, 10, and 13 years, respectively, and cardiac death-free survival was $97.4\%,\;94.5\%,\;92.1\%$, and $81.3\%$ at 1, 5, 10, and 13 years, respectively. Predictable factors of long-term survival were sex and age. Predictable factors of postoperative coronary angiography and intervention were hypertension, diabetes, and dyslipidemia. Conclusion: Long-term survival after CABG in the early operative period was comparable to the previous outcomes, and females showed the better long-term survival. Postoperative coronary intervention was more common in patients with preoperative dyslipidemia.

• The Journal of Internal Korean Medicine
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• v.22 no.3
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• pp.423-430
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• 2001

Objects: The purpose of this case-control study was done to examine the relationship between stroke prevalence and the anthropometric indices(body mass index(BMI), modified Broca's method(Broca's index), waist circumference(WC), waist-hip ratio(WHR)), dyslipidemia, past medical history(heart disease, hypertension, diabetes mellitus(DM)), life-style factors(smoking, drinking) in Korean adults. Methods : The study group consisted of neurologically confirmed 116 stroke patients as the case group and 116 non-stroke patients as control group. Obesity were defined as $BMI{\geq}25kg/m^2,\;Broca's\;index{\geq}30%$, WC >94cm in male and WC >80cm in female, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Oyslipidemia were defined as total $cholesterol{\geq}200mg/dl,\;triglyceride{\geq}200mg/dl,\;HDL-cholesterol {\leq}35mg/dl,\;LDL-cholesterol{\geq}160mg/dl$. Information on life-style factors and past medical history was obtained from personal interview. The analysis of the data was done by means of chi-square test(Pearson's chi-square test, Fisher's exact test) and student t-test. Results: The results were as follow. In the study group: Hypertension had a 4:05 odds ratio, Broca's $index{\geq}30%$ had a 1.98 odds ratio, WC >94cm in male had a 2.17 odds ratio, WC >80cm in female had a 2.80 odds ratio, $WHR{\geq}0.9$ in male had a 4.66 odds ratio, $WHR{\geq}0.8$ in female had a 5.35 odds ratio, but heart disease, DM, life-style factors, serum lipid and 8MI had no direct relationship with odds ratio(nonsignificant). By student t-test, risk factors for stroke were found to be total cholesterol(p=0,025), LDL-cholesterol(p=0.013), WC(p=0.000) and WHR(p=0.000). Conclusions: This study suggests that people should be advised to control hyperlitension, hyperlipidemia and obesity since these carry a risk of stroke.

• KIPS Transactions on Software and Data Engineering
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• v.8 no.11
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• pp.433-440
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• 2019

Recently, machine learning and data mining have been used for many disease prediction and diagnosis. Chronic diseases account for about 80% of the total mortality rate and are increasing gradually. In previous studies, the predictive model for chronic diseases use data such as blood glucose, blood pressure, and insulin levels. In this paper, world's first research, verifies the relationship between dyslipidemia and facial characteristics, and develops the predictive model using machine learning based facial characteristics. Clinical data were obtained from 5390 adult Korean men, and using hypertriglyceridemia and facial characteristics data. Hypertriglyceridemia is a measure of dyslipidemia. The result of this study, find the facial characteristics that highly correlated with hypertriglyceridemia. FD_43_143_aD (p<0.0001, Area Under the receiver operating characteristics Curve(AUC)=0.652) is the best indicator of this study. FD_43_143_aD means distance between mandibular. The model based on this result obtained AUC value of 0.662. These results will provide a basis for predicting various diseases with only facial characteristics in the screening stage of disease epidemiology and public health in the future.