• Journal of Korean Biological Nursing Science
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• v.21 no.2
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• pp.123-132
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• 2019

Purpose: The purpose of this study was to identify influencing factors of metabolic index and cardiovascular risk factors, on depressive and non-depressive groups, in vulnerable diabetic elderly women. Methods: Participants were 137 vulnerable diabetic elderly women, using health centers in D city. Data were collected through interviews September though December 2017. The metabolic index was measured using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), and cardiovascular risk factors were measured using Framingham Risk Score (FRS). Depressive and non-depressive groups were divided by the score of Geriartric Depress Scale Short Korea Version (GDSSF). Collected data were analyzed using a x2 test, independent t-test, and binary logistic regression, with the SPSS/WIN 25.0 program. Results: Vulnerable diabetic elderly women, did not exercise in the depressive groups, and had higher triglyceride (TG), total cholesterol (TC) and larger waists, than in the non-depressive group. Results show that lack of exercise (OR= 6.30), is the highest risk factor, influencing the depressive symptom in vulnerable diabetic elderly women. Conclusion: These results suggest that to reduce depressive symptom levels among vulnerable diabetic elderly women, nursing interventions are needed to increase exercise and decrease TG, TC, and waist size, particularly in improving exercise of vulnerable diabetic elderly women.

• Journal of radiological science and technology
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• v.41 no.4
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• pp.313-319
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• 2018

The purpose of this study was to investigate the influence of metabolic syndrome (MS) on the lower urinary tract symptoms (LUTS), prostate specific antigen (PSA), and prostate volume in Korean men. We analyzed the data from 2654 men over the age of 40 who visited our health promotion center for regular health checkups. Of the total 2654 men, mean age, PSA level, International Prostate Symptom Score (IPSS), and prostate volume were 54.6 years, 1.21ng/ml, 6.2 points, and 27.8ml, respectively. All examinees were divided into MS group (46.5%, 1235 men) and non-MS group (53.5%, 1419). Age and prostate volume were significantly higher in the MS group. The patients were divided into three groups according to their ages: 40's, 50's, and over 60 years old. Prostate volume of the MS group in the younger age groups (40-49 years and 50-59 years) was significantly larger than that of the non-MS group. However, no difference was revealed in the age group of 60-69 years. No significant differences were found in the PSA level and LUTS between the MS and non-MS groups. In the multivariate regression analysis, central obesity was the strongest risk factor for the enlargement of prostate over 30ml among the metabolic components.

• Journal of Nutrition and Health
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• v.55 no.1
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• pp.120-140
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• 2022

Purpose: The purpose of the study was to investigate whether adherence to the Korea Healthy Eating Index (KHEI) was associated with metabolic syndrome and risk markers. Methods: The participants included 8,345 adults, aged 20-59 years, who took part in the 7th Korea National Health and Nutrition Examination Survey (KNHANES). The data were analyzed using a complex-sample t-test, the Rao Scott χ²-test, and logistic regression analysis on the SPSS v. 26.0 software. The participants were divided into four groups by quartiles of KHEI scores. Results: The average KHEI score was 61.06 points out of 100, and the women's score (62.50 points) was significantly higher than that of men (59.63 points). The KHEI quartiles status showed significant differences by age (p < 0.001), household income (p < 0.001), smoking status (p < 0.001), and food security. Specifically, the KHEI quartiles in the men showed significant differences in education (p < 0.001) and economic activity (p < 0.001) whereas those of women showed significant differences in alcohol-consumption (p < 0.001), depression (p < 0.01) and eating-out (p < 0.001). As the KHEI scores increased, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower, and significantly better levels of intake were observed for carbohydrate, protein, vitamin C, calcium, vitamin B₁, vitamin B₂, and niacin. The incidence of the metabolic syndrome risk factors, hypertriglyceridemia and hyperglycemia for men and hypertension, and hyperglycemia for women showed significant differences. The KHEI scores were inversely associated with abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, hypertension, and metabolic syndrome. Conclusion: Based on these results, we conclude that higher adherence to the KHEI was associated with lower metabolic syndrome risk factors and incidence of the metabolic syndrome.

• Nutrition Research and Practice
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• v.6 no.3
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• pp.246-253
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• 2012

The Framingham risk score (FRS) has been used to assess the risk of a cardiovascular event and to identify patients for risk factor modifications. Therefore, the purpose of this study was to evaluate the relationship of the FRS with dietary intake and inflammatory biomarkers. We conducted a cross-sectional study of 180 men ($49.2{\pm}10.2$ years) with MS. Serum levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and adiponectin were examined. Participants were asked to complete the food frequency questionnaire (FFQ) using the previous 1 year as a reference point. The absolute cardiovascular disease (CVD) risk percentage over 10 years was calculated to estimate the FRS, which was classified as low risk (< 10%), intermediate risk (10-20%), and high risk (> 20%). Mean intake of polyunsaturated fatty acids was lower in subjects who had > 20% FRS than in subjects who had < 10% FRS ($3.7{\pm}1.9$ g/day vs. $4.7{\pm}1.9$ g/day; P < 0.05). Significant differences in the Index of Nutritional Quality of protein, phosphorus, iron, vitamin A, vitamin $B_1$, niacin, vitamin $B_6$, and vitamin C were observed between the > 20% FRS group and the < 10% FRS group (P < 0.05). IL-6 concentrations were significantly lower in subjects with a < 10% FRS than in subjects who were 10-20% FRS or > 20% FRS ($0.91{\pm}0.26$ vs. $1.48{\pm}033$ vs. $2.72{\pm}0.57$ pg/mL, respectively; P < 0.05). IL-6 and dietary intake of polyunsaturated fatty acids together explained 6.6% of the variation in FRS levels in a stepwise multiple regression model. Our results provide some evidence that dietary intake in the higher CVD risk group was inferior to that in the lower risk group and that dietary fat intake and IL-6 were associated with FRS and MS in Korean men.

• Korean Journal of Community Nutrition
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• v.23 no.4
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• pp.277-288
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• 2018

Objectives: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. Methods: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value <0.05 was considered to be statistically significant. Results: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p<0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p<0.001). Conclusions: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

• Journal of Nutrition and Health
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• v.38 no.8
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• pp.672-681
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• 2005

Metabolic syndrome (MS) was defined as condition in which the subjects have two or more abnormalities among obesity, hyperlipidemia, hypertension and hyperglycemia. To develop a nutritional education program for MS, this study was performed to compare the dietary habits and nutrients intake of complex symptoms of MS with obesity or hyper-glycemia. The participants in this study were 84 normal adults,62 MS with obesity, 33 MS with hyperglycemia and 54 MS with obesity and hyperglycemia (OB + HG). A dietary survey was conducted using 24-hour recall method. Total cholesterol level of MS with obesity group was significantly higher than other groups. WHR and systolic blood pressure showed no significant difference among MS with obesity, hyperglycemia and OB+HG groups. Dietary intakes of energy, Fe, Vit A, Vit $B_2$ and Ca were less than $75\%$ of 7th Korean RDA in the all groups. Especially, dietary intakes of Vit $B_2$, Vit A and Ca were less than $50\%$ of RDA in MS with hyperglycemia and OB+HG groups. The other nutrient intakes of each group were also below the RDA level except for P, Vit C. It appeared that most of the nutrient intakes in MS with hyperglycemia and OB + HG groups were significantly lower than normal group. In MS with obesity group, each consumption of sweet, organ meat and soup was higher than other groups. Each consumption of garlic and onion in MS with obesity, hyperglycemia and OB + HG groups was lower than normal group. Also, each consumption of soup in MS with hyperglycemia and OB + HG groups was higher than normal group. Indices of nutritional quality (INQ) for Ca, Vit A and Vit $B_2$ were below 1 in all the groups. Food composition group score of MS with hyperglycemia group was significantly lower than normal and MS with obesity groups. Our results indicated that nutritional education program for MS with obesity or hyperglycemia should include specific strategies to modify unsound dietary habits and inappropriate food intake for health.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.138-153
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• 2023

The prevalence of metabolic syndrome (MetS) and its cost are increasing due to lifestyle changes and aging. This study aimed to develop a deep neural network model for prediction and classification of MetS according to nutrient intake and other MetS-related factors. This study included 17,848 individuals aged 40-69 years from the Korea National Health and Nutrition Examination Survey (2013-2018). We set MetS (3-5 risk factors present) as the dependent variable and 52 MetS-related factors and nutrient intake variables as independent variables in a regression analysis. The analysis compared and analyzed model accuracy, precision and recall by conventional logistic regression, machine learning-based logistic regression and deep learning. The accuracy of train data was 81.2089, and the accuracy of test data was 81.1485 in a MetS classification and prediction model developed in this study. These accuracies were higher than those obtained by conventional logistic regression or machine learning-based logistic regression. Precision, recall, and F1-score also showed the high accuracy in the deep learning model. Blood alanine aminotransferase (β = 12.2035) level showed the highest regression coefficient followed by blood aspartate aminotransferase (β = 11.771) level, waist circumference (β = 10.8555), body mass index (β = 10.3842), and blood glycated hemoglobin (β = 10.1802) level. Fats (cholesterol [β = -2.0545] and saturated fatty acid [β = -2.0483]) showed high regression coefficients among nutrient intakes. The deep learning model for classification and prediction on MetS showed a higher accuracy than conventional logistic regression or machine learning-based logistic regression.

• Korean Journal of Community Nutrition
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• v.26 no.2
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• pp.122-133
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• 2021

Objectives: This study evaluated the dietary habits and health behaviors of Korean adults according to their physical activity. Methods: Adults aged 19~64 years, who participated in the 2016~2018 National Health and Nutrition Examination Survey, were enrolled in this study. The subjects were classified into the physical inactivity group, aerobic physical activity group, strength exercise group, and combined exercise group. Results: Significant differences in skipping breakfast, frequency of eating out, dietary supplements, and alcohol drinking status were observed among physical activity groups (P < 0.001). The combined exercise group had the highest % KDRI of protein, vitamin A, thiamin, riboflavin, niacin, calcium, potassium, and iron (P < 0.001). The physical inactivity group had the highest obesity rate (35.1%), and they perceived their body image type to be obese. In the combined exercise group, 47.8% of respondents said they were in good health (P < 0.001). The health-related quality of life score of the physical inactivity group was the lowest, with a score of 0.94. The metabolic syndrome risk rate of the combined exercise group was lower at 0.62 times (95% CI, 0.51-0.75) than the physical inactivity group. Conclusions: The physical activity type was associated with metabolic syndrome. These results can be useful for supporting dietary education and physical activity programs for adults.

• Journal of Nutrition and Health
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• v.47 no.3
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• pp.176-185
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• 2014

Purpose: The purpose of this study was to investigate the relationship between dietary flavonoids intake and metabolic syndrome (MetS) in Korean women with polycystic ovary syndrome (PCOS). Methods: A total of 223 subjects (mean age; $27.3{\pm}4.2$ yrs, range; 17-38 yrs) were divided into the MetS group (n = 27) and non-MetS group (n = 196). Dietary intake data were assessed by 24-hour recall method for two non-consecutive days and the average of the two days was used to estimate the usual dietary intake. Dietary habits were assessed using the Mini Dietary Assessment (MDA) score. We analyzed the intakes of six flavonoid classes (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and iso-flavones) using a flavonoids database. Results: After adjustment for age, total energy intake, alcohol consumption, smoking, regular exercise, and oral contraceptive use, dietary flavonols intake was significantly lower in the MetS group ($5.1{\pm}2.4$ mg/d) than in the non-MetS group ($8.9{\pm}2.8$ mg/d) (p = 0.0472). Intakes of other flavonoids except for flavonols did not differ between the two groups. In MDA scores, significant differences were observed only for that related to daily consumption of fruit or fruit juice (p = 0.0180). A significant inverse relationship was observed between flavonols intake and the risk of MetS (4th vs. 1st quartile, OR = 0.11, 95% CI = 0.02-0.62, p for trend = 0.0131). Conclusion: These results suggest that higher intake of flavonols may be beneficial for MetS in PCOS women.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.33-42
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• 2004

Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.