• Clinical and Experimental Pediatrics
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• 제64권10호
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• pp.511-518
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• 2021

The prevalence of childhood obesity is increasing worldwide at an alarming rate. While obesity is known to increase a variety of cardiovascular and metabolic diseases, it also acts as a risk factor for the development and progression of chronic kidney disease (CKD). During childhood and adolescence, severe obesity is associated with an increased prevalence and incidence of the early stages of kidney disease. Importantly, children born to obese mothers are also at increased risk of developing obesity and CKD later in life. The potential mechanisms underlying the association between obesity and CKD include hemodynamic factors, metabolic effects, and lipid nephrotoxicity. Weight reduction via increased physical activity, caloric restriction, treatment with angiotensin-converting enzyme inhibitors, and judicious bariatric surgery can be used to control obesity and obesity-related kidney disease. Preventive strategies to halt the obesity epidemic in the healthcare community are needed to reduce the widespread deleterious consequences of obesity including CKD development and progression.

• 한국직업건강간호학회지
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• 제21권3호
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• pp.209-220
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• 2012

Purpose: This study examined the influencing factors for metabolic syndrome and the annual medical expenditures of metabolic syndrome among public officials. Methods: The National Health Insurance data in 2009 were collected for 364,932 public officials and the heath examination results and annual medical expenditures were analyzed using PASW 18.0 program. Results: The prevalence of metabolic syndrome is 17.6%, and it was higher in male officials than that of females in all age groups. In men, the influencing factors for metabolic syndrome were: age, family history of stroke, cardiovascular disease, hypertension, and diabetes mellitus, smoking, alcohol consumption, exercise, and obesity. However, in women, health-related behaviors such as smoking, alcohol consumption and exercise did not affect metabolic syndrome. People who had metabolic syndrome showed significantly higher medical expenditures than those without metabolic syndrome. The odds ratios of having the highest quartile in medical expenditures were 1.372 (95% CI 1.252~1.504, p<.001) in women with metabolic syndrome and 1.213 (95% CI: 1.184~1.243, p<.001) in men. Conclusion: The results implied that health-related behaviors were associated with metabolic syndrome, and resulted in higher medical expenditures. In order not only to decrease the risk of metabolic syndrome but also reduce medical expenditures, nurses should plan health promotion strategies to educate public officials about healthy life strategies.

• Clinical and Experimental Pediatrics
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• 제64권5호
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• pp.196-207
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• 2021

Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
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• pp.458-459
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• 2001

• 치위생과학회지
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• 제20권3호
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• pp.178-186
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• 2020

Background: The purpose of this study was to evaluate the association between metabolic syndrome and periodontal disease in Korean adults. Methods: This study analyzed the screening data of 12,686 adults aged ≥19 years, including demographic characteristics, lifestyle habits, and each component of metabolic syndrome, obtained from the sixth Korea National Health and Nutrition Examination Survey database. Periodontal health status was measured by the community periodontal index. Subjects with three or more risk factors were considered as having metabolic syndrome. The Rao-Scott chi-square test was performed to assess the relationships between demographic characteristics, lifestyle habits, components of metabolic syndrome, and periodontal disease. Logistic regression analysis was performed based on the complex sample to evaluate the relationship between metabolic syndrome and periodontal disease. Results: The prevalence of periodontal disease was higher among the subjects with advancing age, lower average household income and education level, those working in production, residents of eup-myeon areas, in past or current smoker, those with excessive alcohol consumption habit in a week, and reduced brushing frequency and the use of oral care products (p<0.001). Each component of metabolic syndrome was associated with higher prevalence of periodontitis in the subjects with abnormal than in those with normal levels (p<0.001). The prevalence of periodontal disease in subjects with metabolic syndrome was approximately 1.443 times higher than that in normal subjects (odds ratio,1.443; p<0.001). Conclusion: This study confirmed the association between metabolic syndrome and periodontitis in Korean adults, and further studies will be needed to determine the causal relationship between the two conditions.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.370-375
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• 2009

목 적 : 터너증후군 환자에서 대사증후군과 심혈관 질환의 위험성이 높다. 성인 연령의 터너증후군 환자들에서 대사증후군 관련요인을 분석하고, 인슐린 저항성의 대사위험성을 알아보기 위한 연구를 시행하였다. 방 법 : 43명의 성인 터너증후군 환자에서 대사증후군의 빈도와 관련 요인 값들을 분석하였다. HOMA-IR을 이용하여 인슐린 저항성군과 비저항성군으로 분류한 후 각 집단을 분석하고, HOMA- IR과 대사 증후군 관련요인의 상관관계를 알아보았다. 결 과 : 대사증후군은 터너증후군 환자의 7%에서 보였고 각 항목에 대해서 인슐린 저항성은 16.3%, 복부 비만이 15.4%, 고중성지방이 2.3%, 저HDL 콜레스테롤이 9.3%였고, 고혈압이 36.8 %였다. 체질량지수, 허리둘레, 공복 혈당, HOMA-IR, 수축기 혈압은 인슐린 저항성군에서 의미 있게 높게 나왔으며, HOMA-IR은 체질량지수, 허리둘레, 공복 혈당, 수축기 혈압과 양의 상관관계를 보였다(P<0.05). 결 론 : 터너증후군 성인 환자들에서 대사증후군의 위험성이 있으며, 인슐린 저항성과 대사증후군 관련요인 간에 상관관계를 보인다. 터너증후군 환자들에게서 대사관련 요인을 일정기간 마다 검사하여 대사증후군 또는 인슐린 저항성으로의 진행여부를 감시하고 심혈관 합병증을 예방하는 것이 필요하다.

• Nutrition Research and Practice
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• 제12권1호
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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 Nutrition and Health
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• 제38권4호
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• pp.267-278
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• 2005

Postmenopausal women or ovariectomized rats are associated with increased cholesterol levels, which are risk factors of metabolic syndrome and cardiovascular diseases. Increased prevalence of metabolic syndrome after menopause might be associated with estradiol deficiency. Harmful effect of estradiol hampers the casual usage of hormone to prevent the metabolic syndrome. Soy protein has been reported to show several beneficial effects on health, however it is unclear which components of soy protein is responsible for anti-obesity and hypocholesterolemic effects. Soy isoflavones, gem-stein and daizein, are suggested to have anti-obesity and hypocholesterolemic effects but with inconsistency. The present study investigated the effect of supplementation of genistein (experiment I) and soy protein containing isoflavones (experiment II) to high fat diet on body weight gain, food intake, liver and fat tissue weight and the lipid levels in ovariectomized rats. Plasma and hepatic lipid contents and the mRNA levels of genes encoding lipid metabolism related proteins, such as CPT1 and HMGR were measured. Ovariectomy increased body weight, fat tissue weight and plasma and hepatic lipid levels which increase the risk of metabolic syndrome. Soy protein could improve plasma and hepatic lipids levels. Soy protein also increased hepatic CPT1 and HMGR mRNA levels. Plasma and hepatic lipids levels could not be decreased by dietary genistein alone. In contrast, lipids levels could be decreased by isoflavone-fortified soy protein, suggesting that the ingestion of soy protein enriched with isoflavone gives more benefit for protecting postmenopausal women from metabolic syndrome.

• Kidney Research and Clinical Practice
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• 제36권1호
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• pp.48-57
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• 2017

Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

• 한국융합학회논문지
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• 제7권6호
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• pp.317-325
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• 2016

본 연구의 목적은 30세 이상의 보건소 건강교실에 자발적으로 참여한 여성을 대상으로 대사증후군 개선을 위한 운동과 영양 프로그램으로서 교육 중재프로그램의 제공 효과를 검증하는 것이다. 서울시 동북부 지역에 위치한 보건소 비만클리닉 참여자 400명 중 12주간의 비만 클리닉 프로그램을 이수한 120명의 여성을 대상으로 하였다. 운동 및 영양 프로그램으로 구성된 건강교실 프로그램을 매주 1일, 운동과 영양 각 1시간씩 12주간 실시하여 보건소 건강교실 참여자의 대사증후군 위험요인에 미치는 영향을 평가하였다. 중재 전, 후의 대사증후군 위험인자와 형태요인 변화량과 변화율 분석을 통하여 대사증후군과 질병발병 위험율의 개선 여부를 검증하였다. 주1회, 회당 2시간, 12주간의 건강교실 프로그램 제공을 통해 참가자들의 허리둘레(p<.001), 수축기혈압(p<.001), 이완기혈압(p<.001), 체질량지수(p<.001) 감소를 확인하였다. 또한 50대 이후 연령대에 비해 50대 이전 연령대에서 체중(p<.01), 허리둘레(p<.05), BMI(p<.01), 지방량(p<.05)가 더 많이 감소하였다.