• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.5
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• pp.252-261
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• 2023

Objectives: Patients undergoing oral surgery exhibit high anxiety, which may elevate their cortisol levels and affect postoperative recovery. Overweight patients are often encountered in the dental clinic due to the increasing prevalence of overweight. We aimed to investigate the relationships between preoperatively assessed body mass index (BMI), serum cortisol and high-sensitivity C-reactive protein (hs-CRP) levels, and visual analog scale (VAS) scores and preoperative anxiety in patients undergoing mandibular third molar (MM3) extraction and to identify predictors of postoperative complications. Patients and Methods: We analyzed 43 patients (age, 20-42 years) undergoing MM3 extraction. At the first visit, patients completed the Modified Dental Anxiety Scale (MDAS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires. Their BMI and VAS scores were also calculated. The participants underwent blood tests 1 hour before MM3 extraction. On the first postoperative day, the participants' VAS scores and serum hs-CRP levels were reevaluated. Results: We found that BMI was significantly correlated with preoperative VAS scores. Further, BMI and preoperative hs-CRP levels were significantly correlated among women and patients undergoing extractions of fully impacted MM3s. No correlations were found between serum cortisol and other variables. The preoperative MDAS and VAS scores were significantly positively correlated, especially among patients undergoing extractions of fully impacted MM3s. Multiple linear regression showed that BMI and the eruption status of the MM3 were significant predictors of postoperative hsCRP levels and VAS scores, respectively. Conclusion: In MM3 removals, patients with higher BMI showed elevated hs-CRP and higher VAS scores before surgery. Patients with higher anxiety among those undergoing extractions of fully impacted MM3s showed higher preoperative VAS scores. The two main predictors of postoperative complications were BMI and MM3 eruption status.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.617-622
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• 2006

Purpose : High-Sensitivity C-reactive protein(hs-CRP) has been recognized as a very useful and sensitive predictor of the future risk of myocardial infarction. But the clinical significance of hs-CRP in children remains uncertain. To confirm the existence of obesity-induced vascular inflammation and the association between metabolic syndromes and elevation of CRP in children, we investigated the relationship among CRP, obesity, blood pressure(BP), and serum lipids in schoolboys. Methods : Twenty-eight obese(BMI $29.61{\pm}3.29kg/m^2$) and 93 non-obese(BMI $18.99{\pm}2.21kg/m^2$) boys aged 14 years were examined. Serum CRP levels was measured by the high sensitive latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dL were adopted to avoid the influence of acute infection. Results : Obese children had significantly higher hs-CRP levels than their non-obese group($0.104{\pm}0.075$ vs. $0.054{\pm}0.005mg/dL$). In the obese group, BMI, systolic blood pressure, diastolic blood pressure, apolipoprotein B, atherogenic index, and triglyceride were significantly higher than in nonobese. The BMI, diastolic blood pressure, apolipoprotein E, atherognic index, and triglyceride showed positive correlation with log CRP by simple regression. Multiple regression analysis indicated that BMI and apolipoprotein E were strongly related to CRP. Conclusion : This study revealed that obese children tended to have higher levels of serum hsCRP, BP elevation and dyslipidemia than the control group and that BMI and apolipoprotein E were strongly related to CRP. These results indicate that obesity related metabolic syndrome can be developed in children.

• The Korean Journal of Food And Nutrition
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• v.31 no.3
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• pp.425-434
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• 2018

Metabolic syndrome is a risk factor for cardiovascular and type 2 diabetes. This study was conducted to examine the relevance between nutrition intake, meal quality, and high-sensitivity C-reactive protein in Koreans with metabolic syndrome. The 2,536 subjects, aged 19~64, who participated in 2015 National Nutrition Survey were included in this study. The 24-hour recall method was employed to analyze nutrition intake and dietary quality. Subjects were grouped into either the non-metabolic syndrome group (n=1,938) or the metabolic syndrome group (n=598). Total males and females were divided into 3 groups according to the high-sensitivity C-reactive protein (hs-CRP) level to study its relationship to metabolic syndrome and its components, including odds ratio (OR) and confidence interval (CI). Results showed the homeostasis model assessment of insulin resistance (HOMA-IR) value was higher in the metabolic syndrome group (3.37) than non-metabolic syndrome group (1.57) (p<0.001). In the Index of Nutrition Quality, males in the non-metabolic syndrome group showed higher niacin (p<0.05) than males in metabolic syndrome group. Females in the non-metabolic syndrome group had higher vitamin $B_1$ (p<0.01), vitamin $B_2$ (p<0.001), niacin (p<0.05), calcium (p<0.001), and phosphate (p<0.01). Female in the high hs-CRP group showed high OR in blood glucose component (OR 2.488, 95% CI: 1.269~4.879) and metabolic syndrome risk (OR 2.856, 95% CI: 1.292~6.314). Females in the middle hs-CRP group had high triglycerides component (OR 2.956, 95% CI: 1.920~4.551), compared to the low hs-CRP group. The study showed females with higher hs-CRP had a higher risk of metabolic syndrome.

• Journal of Korean society of Dental Hygiene
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• v.20 no.3
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• pp.303-312
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• 2020

Objectives: The purpose of this study was to investigate the relationship between periodontal disease, number of remaining teeth with high-sensitivity C-Reactive protein in Korean adults aged 40 and older. Methods: The study used the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-3), 2015. The study sample consisted of 3,883 aged 40 years or older who had completed the health survey and the health examination. Logistic regression analyses were performed to examine the odds ratios of high-sensitivity C-Reactive protein by periodontal disease and number of remaining teeth, adjusting for demographic characteristics, chronic diseases and oral health behavior-related variables. Results: When the demographic and chronic diseases were adjusted, the risk of high-sensitivity C-Reactive protein (hs-CRP) average 1.23 mg/L or higher was 1.36 times higher in patients with periodontal disease between the ages of 40 and 49, but it was not significant (OR=1.36; 95% CI=0.82-2.23). In addition, in the group of 0~23 remaining teeth aged 40~49 years, the risk of higher than the average 1.23 mg/L of high-sensitivity C-Reactive protein was 2.03 times higher (OR=2.03; 95% CI=1.10-3.74), and 1.49 times higher in 60~69 years (OR=1.07; 95% CI=1.04-2.76). Conclusions: This study found that periodontal disease and tooth loss in Korean adults aged 40 and older was significantly associated with high-sensitivity C-reactive protein.

• Journal of Preventive Medicine and Public Health
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• v.48 no.5
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• pp.249-256
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• 2015

Objectives: Epidemiological studies have reported that vitamin D deficiency is associated with inflammatory disease. Smoking is a well-known risk factor for inflammation. However, few studies have investigated the interactive effect of vitamin D deficiency and smoking on inflammation. This study aims to investigate the interaction of vitamin D and smoking with inflammatory markers in the urban elderly. Methods: We used data from the Korean Elderly Environmental Panel Study, which began in August 2008 and ended in August 2010, and included 560 Koreans ${\geq}60$ years old living in Seoul. Data was collected via questionnaires that included items about smoking status at the first visit. Vitamin D levels, high-sensitivity C-reactive protein (hs-CRP), and white blood cell (WBC) counts were repeatedly measured up to three times. Results: The association of vitamin D and hs-CRP was significant after adjusting for known confounders (${\beta}=-0.080$, p=0.041). After separate analysis by smoking status, the association of vitamin D deficiency and hs-CRP in smokers was stronger than that in nonsmokers (smokers: ${\beta}=-0.375$, p=0.013; non-smokers: ${\beta}=-0.060$, p=0.150). Smoking status was an effect modifier that changed the association between vitamin D deficiency and hs-CRP (interaction estimate: ${\beta}=-0.254$, p=0.032). Vitamin D was not significantly associated with WBC count (${\beta}=0.003$, p=0.805). Conclusions: Vitamin D deficiency was associated with hs-CRP in the urban elderly. Smoking status was an effect modifier of this association. Vitamin D deficiency was not significantly associated with WBC count.

• Journal of Preventive Medicine and Public Health
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• v.41 no.6
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• pp.413-418
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• 2008

Objectives: This study was performed to investigate the associations between the metabolic syndrome (MetS) and inflammatory markers. Methods: This cross-sectional analysis was performed using data from 1578 Koreans aged 40-69 years residing in a rural area. We investigated associations between MetS and circulating high sensitivity C-reactive protein (hs-CRP), white blood cells (WBC) and adiponectin. MetS was defined using the criteria proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). Results: Increased WBC counts and hs-CRP levels and decreased adiponectin levels were observed in subjects with MetS. WBC, hs-CRP and adiponectin levels linearly deteriorated with an increase in the number of MetS components (all ptrend <0.005). Finally, adjusted odds ratios (ORs) for the risk of MetS by increase/decrease in 3 inflammatory markers were calculated by multivariate logistic regression analyses. In terms of changes in inflammation markers, in men, the adjusted ORs (95% confidence interval) were 1.15 (1.01-1.31) for WBC, 1.64 (1.02-2.64) for hs-CRP, and 0.19(0.08-0.45) for adiponectin, whereas corresponding adjusted ORs (95% Cls) in women were 1.27 (1.15-1.40), 0.98 (0.67-1.42), 0.09 (0.04-0.18), respectively. Conclusions: Serum adiponectin levels and WBC counts were found to be strongly associated with MetS in both sexes. However, hs-CRP lost its significance after adjusting for BMI and other inflammatory markers in women. This study shows that inflammatory response is associated with MetS in the Korean population. Further prospective studies are necessary to confirm the contribution made by inflammatory markers to the development of MetS.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.565-577
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• 2017

Purpose: There have been limited studies investigating the relationship between high-sensitivity C-reactive protein (hsCRP), metabolic diseases, and dietary factors in Korean adults. Here, we examined the association between nutrient intake and serum hsCRP among Korean adults. Methods: Using data on 2,624 healthy Korean adults (1,537 women and 1,087 men) from the 2015 Korea National Health and Nutrition Examination Survey, demographic, anthropometric, biochemical, and dietary factors were analyzed once the subjects were grouped into either sex, age, or BMI. Nutrient intake was evaluated using the dietary data obtained by one-day 24-hour recall. Based on the guidelines of the US Centers for Disease Control and Prevention and the American Heart Association, hsCRP level was classified as HCRPG (High CRP Group, hsCRP > 1 mg/L) and LCRPG (Low CRP Group, hsCRP ${\leq}1mg/L$). Proc surveyreg procedure was performed to examine the associations between nutrient intake and hsCRP after adjustment for potential confounding variables. Results: The average hsCRP level of healthy Korean adults was $0.95{\pm}0.03mg/L$ ($0.97{\pm}0.04mg/L$ in men, $0.92{\pm}0.05mg/L$ in women). Obese subjects had significantly higher hsCRP than non-obese subjects in both sexes. The hsCRP level was positively associated with current smoking, physical inactivity, BMI, waist circumference, fasting blood glucose, triglycerides, total cholesterol, LDL-cholesterol, and blood pressure and inversely associated with HDL-cholesterol. LCRPG had significantly higher intake of dietary fiber compared to HCRPG in women. High hsCRP level was associated with more dietary cholesterol intake but less omega-3 fatty acid intake among subjects aged ${\geq}50y$. HCRPG of obese subjects had higher intakes of fat and saturated fatty acid than LCRPG. Conclusion: The hsCRP level is closely associated with several lifestyle variables and nutrient intake in healthy Korean adults. Individuals with high hsCRP level show low intakes of dietary fiber and omega-3 fatty acids but high intakes of dietary fat and cholesterol. Our findings suggest that a potential anti-inflammatory role for nutrients and lifestyle in the Korean adult population.

• Journal of the Korean Dietetic Association
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• v.25 no.2
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• pp.83-104
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• 2019

Elevated high-sensitivity C reactive protein (hs-CRP) levels and metabolic syndrome are considered important predictors of cardiovascular mortality. This study examined the influence of the alcohol consumption level on the hs-CRP level and the prevalence of metabolic syndrome in South Koreans. The study subjects were 3,884 participants (${\geq}19$ years) from the KNHANES in 2015. The subjects were divided into four groups according to their alcohol consumption; None (none-alcohol consumption), Low (less than 15 g/day), Medium (15~29.9 g/day), and High (over than 30 g/day). The odds ratio for high-risk hs-CRP of men was significantly lower in the Low or Medium groups compared to the None group. In women, the odds ratio for high-risk hs-CRP was not decreased in the Low or Medium groups but was significantly higher in the High group than in the None group. Compared to nondrinkers, the prevalence of metabolic syndrome was lower in the Low group and Medium group in both men and women, whereas it was significantly higher in the High group in men only. In particular, the prevalence of low HDL-cholesterol was lower in all drinking groups. When the confounding factors were adjusted, the odds ratio for low HDL-cholesterol appeared to decline in the Low groups in both men and women. On the other hand, in the Medium group, women showed an elevated odds ratios of high blood pressure (HBP) and high fasting plasma glucose but men showed an elevated odds ratios of HBP and high triglyceride levels. The overall results suggest that low alcohol consumption is more appropriate than medium alcohol consumption. Nevertheless, more study will be needed to evaluate the appropriate alcohol consumption level.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.38.1-38.10
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• 2023

Background: Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs. Methods: We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age. Results: In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02-1.34); the OR was 0.99 (95% CI: 0.80-1.22) in those under 40 and 1.28 (1.08-1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92-1.19); the OR was 1.10 (95% CI: 0.90-1.35) in those under 40 and 1.20 (1.01-1.43) in those over 40. Conclusions: This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.227-232
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• 2017

Although water is an essential component of the human body and is involved in many physiological processes, the effect of a steady and sufficient water intake on blood components has not well elucidated. Therefore, we investigated the changes in hematological parameters, high-sensitivity C-reactive protein (hs-CRP), and immunoglobulin G (IgG) after water intake in 13 healthy adults. They were divided into two groups: The control group (N=4), which consumed water ad libitum, and the experimental group (N=9), which consumed 2 L of water per day. Two weeks later, blood cell counts, hematocrit, and hemoglobin content had increased in the experimental group, although not significantly (p>0.05); however, there was a significant increase in the mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) (p<0.05; and p<0.01, respectively), and a significant decrease in the mean platelet volume (MPV) (p<0.05). Of the immunologic parameters, a non-significant decrease in the concentration of hs-CRP, an indicator of cardiovascular disease risk, was observed (p>0.05). However, there was a dramatic and significant increase in the concentration of IgG (p<0.05). In conclusion, a steady and sufficient water intake may contribute to alleviate anemia by increasing hemoglobin. Additionally, it may decrease the risk of cardiovascular disease by decreasing platelet activation and concentration of hs-CRP. Furthermore, a steady intake of water may improve immune function by increasing the concentration of the components of humoral immunity.