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Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity

  • Ozcabi, Bahar;Demirhan, Salih;Akyol, Mesut;Akay, Hatice Ozturkmen;Guven, Ayla
    • Clinical and Experimental Pediatrics
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    • v.62 no.12
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    • pp.450-455
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    • 2019
  • Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods: Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis. Results: LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005). Conclusion: LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

The Relation of Onset-Age and ${\beta}$-Endorphin Levels in Alcohol Dependence (주정의존 환자에서 초발연령에 따른 ${\beta}$-Endorphin의 반응)

  • Jeong, Hee-Yeon;Park, In-Joon;Kim, In-Man;Jin, Hyuk-Hee
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.107-113
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    • 1998
  • Objectives : To evaluate the relation of onset-age and plasma level of ${\beta}$-endorphin, Ethanol, ${\beta}$-endorphin, cortisol and blood glucose were compared in 48 male alcoholics and 29 normal controls Methods : Alcoholics are divided into two groups by onset-age of alcoholism. Blood samples were obtained before and after 0.75gm/kg of ethanol consumption at the 7th admission day. Results : 1) The ratio of onset-age before 25 years to after 25 years of the patient group was 2 to 3. 2) There was no significant difference in age at admission between two patient groups. 3) There was no significant difference in change of plasma ethanol levels among three groups. 4) There was no significant difference in change of plasma ${\beta}$-endorphin levels among three groups. 5) There was no significant difference in change of plasma cortisol level among three groups. 6) There was no significant difference in change of fasting blood sugar level among two patient groups.

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The Relation of Family History and ${\beta}$-Endorphin Levels in Alcohol Dependence (주정의존 환자에서 가족력 유무에 따른 ${\beta}$-endorphine의 반응)

  • Jeong, Hee-Yeon;Park, In-Joon;Kwon, Young-Joon
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.102-106
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    • 1998
  • Objectives : To evaluate the relation of familial history of alcoholism and plasma level of ${\beta}$-endorphin, ethanol, ${\beta}$-endorphin, cortisol and blood glucose were compared in 48 male alcoholics and 29 normal controls. Methods : Subjects are divided into two groups by family history of alcoholism. Blood samples were obtained before and after 0.75mg/kg of ethanol consumption at 7th admission day. Results : 1) The ratio of family history positive to negative of the patient group was 2 to 1. 2) The age at admission of positive family history group was younger than negative group. 3) There was no significant difference in change of plasma ethanol level among three groups. 4) There was no significant difference in change of plasma ${\beta}$-endorphin level among three groups. 5) There was no significant difference in change of plasma cortisol level among three groups. 6) There was no significant difference in change of fasting blood sugar level between two patient groups.

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Age and Gender Differences in the Relationship of Cognitive Impairment, Vascular Risk Factors, and Subclinical Carotid Atherosclerosis from Community-based Elderly (나이와 성별에 따른 지역사회 거주 노인에서 무증상 경동맥 죽상경화증에 대한 혈관위험인자 및 인지장애와의 관련성)

  • Kim, Ji-Hee;Park, Hyun-Young;Kim, Dae-Won;Byun, Seung-Jae;Moon, Hyo-Jeong;Lee, In;Yang, Chung-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.3
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    • pp.399-407
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    • 2012
  • To evaluate age and gender differences in the relation of cardiovascular risk factors, cognitive impairment, and subclinical carotid atherosclerosis from aged people using by a cross sectional method. Sixty-nine healthy elders living in the community who had not previously undergone carotid ultrasonography were included. We conducted life style surveys, and cognitive function tests including Korean-mini-mental state examination (K-MMSE) and clinical dementia rating-Korean. Various biomarkers from blood were assessed; fasting insulin-like growth factor-1, lipid-profile, high sensitivity C-reactive protein, total homocysteine, glucose, insulin, Homeostasis model assessment (HOMA) for insulin resistance index, vitamin B12, and folate level. Carotid intima-media thickness (C-IMT), and plaques were measured using carotid ultrasonography and aortic ultrasonography, a valid index of atherosclerosis. For the elderly subjects (aged 65-82 years), cognition impairment was more prevalent in females while subclinical atherosclerosis was more prevalentin males. Increased C-IMT has been kept in males, and C-IMT shows increasing trend and the peak at about 80 year-old in females with increasing age. The significant correlations between C-IMT and many vascular risk factors including age, triglyceride, abnormal homocysteinein male, and K-MMSE, insulin, HOMA index and abnormal aortic ultrasonography in female were different in each gender, with the exception of homocysteine (p<0.05). This data suggests that there were differences of age and gender characteristics in terms of subclinical atherosclerosis, cognitive impairment and vascular risk factors in community-living elders. Further larger and longitudinal studies across entire age are required to better understand the effects of risk factors on subclinical atherosclerosis.

Acupuncture, ST-36 Electroacupuncture and Moxa Treatment of Abdominal Pain due to Bowel Obstruction in Cancer Patients : Case Report (말기 암 환자의 장폐색성 복통에 대한 침구 및 족삼리 전침 치험 2례)

  • Kim, So Yeon;Choi, Jun Yong;Park, Seong Ha;Kwon, Jung Nam;Lee, In;Hong, Jin Woo;Han, Chang Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.238-242
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    • 2014
  • Here we described 2 cancer patients treated by acupuncture for abdominal pain as a complication of bowel obstruction. The patient 1, 43-year-old man was treated with surgery, radiotherapy and chemotherapy for rectal cancer. Two years after surgery, he complained of acute abdominal pain due to small bowel adhesion band. Bowel obstruction and symptoms were not improved by conservative therapy like as fasting, keeping Levin tube, and fluid therapy. 4 months later, he could eat a little rice water, but ileus and abdominal pain persisted despite of applying opiod drug and patch. Got started on acupuncture, electroacupuncture(ST-36) and moxa treatment, pain was relived gradually. He could stop opioids 1 month later and ileus was improved after acupuncture therapy for 2 months. The patient 2, 65-year-old woman got hepatectomy, cholecystectomy, and chemotherapy with cholangiocarcinoma. 6 months after surgery, she got laparotomy again for biopsy of new mass around ascending colon. She started eating after gas passing, but felt abdominal distension. Diffuse paralytic ileus was diagnosed by abdominal X-ray, and she got started conservative therapy. During ST-36 electroacupuncture therapy, symptoms like abdominal pain and distension were improved and could stop opiod patch. But eating aggravated ileus again and clinical finding of mechanical bowel obstruction was appeared. Based on these cases, acupuncture and moxa therapy could be helpful for improving abdominal pain and ileus, but possibility of malignant bowel obstruction should be considered especially in cancer patients.

Childhood Obesity and Physical Activity (소아비만과 운동)

  • Kim, Jee Youn
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup1
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    • pp.102-108
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    • 2008
  • More children today are overweight or obese than ever before. childhood obesity results from an imbalance between the amount of energy consumed and the amount of energy expended. Whether child want to lose weight or maintain a healthy weight, it's important to balance between the calories body takes in and uses. Obesity treatment programs for children and adolescents is to slow or halt weight gain so the child will grow into his or her body weight over a period of months to years. Fasting or extreme caloric restriction is not advisable for children. More physical activity is a key element in the prevention and treatment of obesity. Children can't change their exercise and eating habits by themselves. They need the help and support of their families and parents. Children and adolescents who are just beginning to be physically active should start out slowly and gradually build to higher levels in order to prevent the risk of injury or feel defeated from unrealistic goals. It is important that children and adolescents are encouraged to be physically active by doing things that interest them. FUN physical activities that kids choose to do on their own are often best. Kids need about 60 minutes of physical activity a day, but this does not have to happen all at once. Several short 10- or even 5-minute periods of activity throughout the day are just as good. FUN physical activities will help them establish an active lifestyle early on. Obese people need care not for a short period, but throughout their lives.

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Effect of cigarette smoking on air-conduction hearing threshold level in adult men (성인 남성에서 흡연이 기도청력역치에 미치는 영향)

  • Kim, Jin-Seok;Yeh, Min-Hae;Chun, Byung-Yeol;Woo, Kuck-Hyeun;Kang, Yune-Sik;Kim, Keon-Yeop;Lee, Young-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.285-292
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    • 1998
  • To investigate the effect of smoking on the hearing threshold, 1,887 adult male workers who visited health care center during the period 1 January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.

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Associations between Carotid Intima-media Thickness, Plaque and Cardiovascular Risk Factors (경동맥 내중막 두께 및 죽종과 심 혈관 질환 위험요인과의 관련성)

  • Lee, Young-Hoon;Cui, Lian-Hua;Shin, Min-Ho;Kweon, Sun-Seog;Park, Kyeong-Soo;Jeong, Seul-Ki;Chung, Eun-Kyung;Choi, Jin-Su
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.477-484
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    • 2006
  • Objectives : This study was conducted to examine the association between the carotid artery intima-media thickness (IMT), plaque and cardiovascular risk factors according to gender and age. Methods : The data used for this study were obtained from 1,507 subjects (691 men, 816 women), aged 20-74 years, who participated in 'Prevalence study of thyroid diseases' in two counties of Jeollanam-do Province during July and August of 2004. The body mass index (BMI) and waist hip ratio (WHR) were calculated by anthropometry The blood pressure, pulse rate, pulse pressure, total cholesterol, triglyceride, HDL cholesterol and fasting blood sugar level were also measured. Ultrasonography was used to measure the carotid artery IMT and plaque. IMT measurements were performed at 6 sites, including both common carotid arteries, and the bulb and internal carotid arteries. The definition of the 'mean IMT' was mean value obtained from these 6 sites. Results : The ${\pm}$ standard deviation IMT values were $0.65{\pm}0.14\;and\;0.60{\pm}0.13mm$ in men and women (p<0.001), respectively. The data were analyzed according to gender and the 50 year age groups. In a multiple linear regression analysis, age and hypertension were positively associated with the mean IMT in both men and women, aged<50 years. Age, total cholesterol and smoking (current) were positively associated with the mean IMT in men $(\geq50\;years)$. Age was positively associated with the mean IMT in women $(\geq50\;years)$, but the HDL cholesterol level was negatively associated. The prevalence of plaques was 44.2%(196/443) in men and 19.4%(89/459) in women, for those greater than 50 years of age. In a multiple logistic regression analysis, age (OR=1.090, 95%CI=1.053-1.129), HDL cholesterol (OR=0.964, 95%CI=0.944-0.984), total cholesterol (OR=1.009, 95%CI=1.002-1.017)and BMI (OH=0.896, 95%CI=0.818-0.983) were independently associated with plaques in men; whereas, age (OR=1.057, 95%CI=1.012-1.103), HDL cholesterol (OR=0.959, 95%CI=0.932-0.986), pulse pressure (OR=1.029, 95%CI=1.007-1.050) and triglycerides (OR=0.531, 95%CI=0.300-0.941) were independently associated with plaques in women. Conclusions: There were significant gender and aging differences in the association between the IMT, plaque and cardiovascular risk factors. Therefore, for the prevention of atherosclerosis, selective approaches should be considered with regard to gender and age factors.

Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort (공복 혈당과 간암 발생 위험에 관한 코호트 연구)

  • Gwack, Jin;Hwang, Seung-Sik;Ko, Kwang-Pil;Jun, Jae-Kwan;Park, Sue-Kyung;Chang, Soung-Hoon;Shin, Hai-Rim;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.1
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    • pp.23-28
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    • 2007
  • Objectives : Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. Methods : Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. Results : The RRs of serum glucose for liver caner were 1.20 (95% CI = 0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI = 1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI = 1.09-18.28) for those with glucose levels >100 mg/dL. Conclusions : The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.

Apolipopretein A-I and B Distribution among the Employees and their Partners in Korea (한국인 직장성인과 그 배우자의 Aplipoprotein A-I & B 분포)

  • Kim, Won-Sool;Kim, Dong-Il;Suh, Byung-Sung
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.1
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    • pp.71-76
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    • 2007
  • Objectives : This study was performed to investigate the distribution of apolipoproteins A-I and B among Korean employees and their partners. Methods : The study population consisted of 7,633 men and women (4,578 men and 3,054 women) residing in Seoul and Kyung-gee Do, with an average age of $43.5{\pm}8.3$ years. Blood samples were collected following at least 12 hours of fasting. Apolipoproteins A-I and B were measured using a Behring Nephelometer analyzer. The body mass index (BMI) for each participant was calculated as weight (kg) divided by height squared $(m^2)$. Information on health-related behaviors such as exercise, alcohol intake, and smoking habits was collected through self-administrated questionnaires. Results : The mean concentrations of Apo A-I were $132.6{\pm}22.3mg/dL$ and $142.9{\pm}24.8mg/dL$ in the men and women, respectively. The concentration of Apo A-I increased significantly across all age categories of men. The mean concentrations of Apo B were $101.7{\pm}23.2mg/dL$ and $87.8{\pm}23.5mg/dL$ in the men and women, respectively, and Apo B increased significantly across all age categories for both the men and women. Exercise and BMI were major determinants for Apo A-I and B levels. The 10th percentile of Apo A-I concentration was 109 mg/dL in the men and 113 mg/dL in the women, and the 90th percentile of Apo B concentration was 131 mg/dL in the men and 118 mg/dL women. Conclusions : For the prevention of coronary artery disease, we recommend that for individuals in the 10th percentile of concentration for Apo A-I and the 90th percentile of concentration for Apo B, active preventive interventions such as weight loss and exercise should be taken. This study, within its limitations, may be useful for evaluating apolipoprotein A-I and B concentrations in Korean adults.