• Genomics & Informatics
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• v.16 no.4
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• pp.31.1-31.7
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• 2018

The prevalence of metabolic syndrome (MS) in the nonobese population is not low. However, the identification and risk mitigation of MS are not easy in this population. We aimed to develop an MS prediction model using genetic and clinical factors of nonobese Koreans through machine learning methods. A prediction model for MS was designed for a nonobese population using clinical and genetic polymorphism information with five machine learning algorithms, including naïve Bayes classification (NB). The analysis was performed in two stages (training and test sets). Model A was designed with only clinical information (age, sex, body mass index, smoking status, alcohol consumption status, and exercise status), and for model B, genetic information (for 10 polymorphisms) was added to model A. Of the 7,502 nonobese participants, 647 (8.6%) had MS. In the test set analysis, for the maximum sensitivity criterion, NB showed the highest sensitivity: 0.38 for model A and 0.42 for model B. The specificity of NB was 0.79 for model A and 0.80 for model B. In a comparison of the performances of models A and B by NB, model B (area under the receiver operating characteristic curve [AUC] = 0.69, clinical and genetic information input) showed better performance than model A (AUC = 0.65, clinical information only input). We designed a prediction model for MS in a nonobese population using clinical and genetic information. With this model, we might convince nonobese MS individuals to undergo health checks and adopt behaviors associated with a preventive lifestyle.

• Journal of Korean Medicine for Obesity Research
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• v.18 no.2
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• pp.57-63
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• 2018

Objectives: Metabolic syndrome is defined by a cluster of major cardiovascular risk factors: obesity, insulin resistance, dyslipidemia, and arterial hypertension. Several members of a large family of nonselective cation entry channels, e.g., transient receptor potential vanilloid 4 (TRPV4) channels have been associated with the development of dyslipidemia and hypertension. The purpose of this study was to investigate the effects of Leejung-tang (Lizhong-tang), Rikkunshito, and Bojungikgi-tang (Buzhongyiqi-tang) on TRPV4 channel. Methods: Human embryonic kidney 293 cells stably transfected with the TRPV4 expression vectors were maintained in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 1% penicillin/streptomycin, $5{\mu}g/mL$ blasticidin, and 0.4 mg/mL zeocin in a humidified 20% $O_2/10%$ $CO_2$ atmosphere at $37^{\circ}C$. Whole-cell patch clamp recordings were obtained using an Axopatch 700B amplifier and pClamp v.10.4 software (Molecular Devices, San Jose, CA, USA), and signals were digitalized at 5 kHz using Digidata 1422A. Results: Leejung-tang and Rikkunshito (10, 30 and 50 mg/mL) had no effects on the TRPV4 whole-cell currents at dose dependent manner. However, Bojungikgi-tang (10, 30, and 50 mg/mL) inhibited the TRPV4 whole-cell currents in a dose dependent manner and the half maximal inhibitory concentration (IC50) of Bojungikgi-tang was 18.2 mg/mL. Conclusions: These results suggest that Bojungikgi-tang plays an important roles to inhibit the TRPV4 channel, suggesting that Bojungikgi-tang is considered one of the candidate agents for the treatment of metabolic syndrome such as dyslipidemia and hypertension.

• Nutrition Research and Practice
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• v.15 no.3
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• pp.329-345
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• 2021

BACKGROUD/OBJECTIVES: Evidence has suggested an association between serum vitamin D and metabolic syndrome (MetS), but prospective studies are very limited. The objective was to assess the dose-response association between serum vitamin D concentration and MetS risk using a systematic review and meta-analysis of updated observational studies. MATERIALS/METHODS: Using MEDLINE, PubMed, and Embase, a systematic literature search was conducted through February 2020 and the references of relevant articles were reviewed. A random-effects model was used to estimate the summary odds ratio/relative risk and 95% confidence interval (CI). Heterogeneity among studies was evaluated with I² statistic. In total, 23 observational studies (19 cross-sectional studies, and four cohort studies) were included in the meta-analysis. RESULTS: The pooled estimates (95% CI) for MetS per 25-nmol/L increment in serum vitamin D concentration were 0.80 (95% CI, 0.76-0.84; I² = 53.5) in cross-sectional studies, and 0.85 (95% CI, 0.72-0.98; I² = 85.8) in cohort studies. Similar results were observed, irrespectively of age of study population, study location, MetS criteria, and adjustment factors. There was no publication bias for the dose-response meta-analysis of serum vitamin D concentrations and MetS. CONCLUSIONS: Dose-response meta-analysis demonstrated that a 25-nmol/L increment in the serum vitamin D concentration was associated with 20% and 15% lower risks of MetS in cross-sectional studies and cohort studies, respectively.

• Journal of Sasang Constitutional Medicine
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• v.34 no.1
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• pp.1-12
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• 2022

Objectives This study aimed to examine the differences in the distribution of metabolic syndrome(MetS) and cold hypersensitivity in the hands and feet(CHHF) according to Sasang constitution, and to determine whether CHHF and MetS have an inverse association. Methods MetS and its components, CHHF, Sasang constitution data from 1,998 participants in the Korean medicine Daejeon Citizen Cohort study(KDCC) were obtained. The participants were divided into a non-CHHF(n = 1,270, 63.6%), intermediate(n = 220, 11.0%) and CHHF(n = 508, 25.4%) group according to the thermal sensitivity questionnaire. Sasang constitution was diagnosed by Korea Sasang Constitutional Diagnostic Questionnaire(KS-15). One-way ANOVA and the chi-square test were used for participants' general characteristics and thermal sensitivity and MetS related factors. ANCOVA and logistic regression were used to compare the differences and the odds ratios(ORs) for MetS and its components. Results The MetS and CHHF prevalence rates of the Taeeumin, Soeumin, and Soyangin were 27.6%, 3.8%, 7.7%, and 18.3%, 42.3%, 26.4% respectively. The ANCOVA for MetS components showed that the waist circumference was significantly lower in the CHHF group as compared to the non-CHHF group in total and Soyangin. The logistic regression for MetS prevalence showed that CHHF had a significant inverse association in total(OR = 0.611) and Taeeumin(OR = 0.521). Conclusions The MetS prevalence had the highest in Taeeumin, followed by Soyangin and Soeumin, while the prevalence of CHHF was highest in Soeumin, followed by Soyangin and Taeeumin. In addition, it was confirmed that CHHF and MetS had an inverse association independently.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.13-20
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• 2005

Purpose : Obesity is, along with metabolic syndrome, closely related with nonalcoholic fatty liver disease. This study tried to evaluate the prevalence of nonalcoholic liver disease in obese children and verify the factors associated with the disease. Methods : Two hundred and seventy nine children who showed a body mass index of 95 percentile over the baseline in health examinations of surrounding schools were evaluated. Questionnaires, body measurements, blood examinations, and ultrasonographic measurements of abdominal fat were examined. Results : Out of 279 children enrolled for the study, 27 children were found to possess nonalcoholic liver disease(9.7%). Among those found to be positive for nonalcoholic liver disease, it's prevalence increased to 15.2%(22 out of 144 children) among children with severe obesity. Factors known to be involved with metabolic syndrome, namely waist/hip circumference ratio and thickness of abdominal fat, were found to be closely related to nonalcoholic fatty liver as well. Conclusion : The prevalence of nonalcoholic fatty liver in obese children was 9.7%, with higher incidence observable in severer obesity. Factors responsible for metabolic syndrome were closely associated with nonalcoholic fatty liver disease, and the level of insulin resistance, which is an useful index in both diseases, can be utilized in evaluation of the effect of treatment and control of risk factors.

• Journal of Nutrition and Health
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• v.49 no.6
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• pp.459-470
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• 2016

Purpose: The purpose of the present study is to identify the relationship between practicing healthy diet and metabolic syndrome indicators in Koreans. Methods: This research is a cross-sectional study based on the 2013~2014 Korea National Health and Nutritional Examination Survey. This study investigated 6,748 adults aged 19 to 64 yr (19~49 yr: n = 4,230, 50~64 yr: n = 2,518) to examine practice of healthy diet and metabolic syndrome indicators. In this study, according to practicing healthy diet, we classified subjects into the "Practicing healthy diet (PHD)" group (19~49 yr: n = 1,782, 50~64 yr: n = 937) and "Non-practicing healthy diet (NPHD)" group (19~49 yr: n = 2,448, 50~64 yr: n = 1,581). PHD score was determined by adding the number of practicing factors: adequate fat intake, sodium intake ${\leq}2,000mg/day$, fruit & vegetable intake ${\geq}500g/day$, and using nutrition label information in food selection. Results: Female adults had a larger proportion of subjects who practiced a healthy diet compared to male adults (p < 0.001), and the percentages of 19~49 yr and 50~64 yr were 40.46% and 37.07%, respectively. The PHD group consumed significantly more calcium, vitamin $B_1$, $B_2$, and vitamin C density compared to the NPHD group. In 50~64 yr females, the subjects practicing healthy diet (PHD score ${\geq}2$) was inversely associated with risk of abdominal obesity (OR: 0.71, 95% CI: 0.54~0.93, p value = 0.0131) and metabolic syndrome (OR: 0.70, 95% CI: 0.52~0.94, p value = 0.0166) after adjustments for multiple confounding factors, compared with the lower PHD score (PHD score ${\leq}1$). Conclusion: Good dietary practice such as adequate fat intake, sodium intake ${\leq}2,000mg/day$, sufficient fruit & vegetable intake, and using nutrition label information in food selection could be useful in decreasing metabolic syndrome risk of Korean adults.

• Journal of Nutrition and Health
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• v.47 no.3
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• pp.186-192
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• 2014

Purpose: The prevalence of metabolic syndrome has increased in both the adult population and in adolescents. However, few studies have been conducted for adolescents. The aim of this study was to examine the association of metabolic syndrome and its risk factors with high carbohydrate diet and high fat diet using data from the Korea National Health and Nutrition Examination Survey (1998-2009). Methods: Using the Acceptable Macronutrient Distribution Range for Korean Dietary Reference Intakes, subjects whose energy intake from carbohydrate was greater than 70% and from fat was less than 15% were classified as the 'High-carbohydrate & low-fat diet (HCLF)' group and subjects whose energy intake from carbohydrate was less than 60% and from fat was 25% or more were classified as the 'Low-carbohydrate & high-fat Diet (LCHF)' group. Among 5,931 eligible subjects, HCLF included 853 subjects and LCHF included 1,084 subjects. Results: The mean age in both groups was 14 years and significant difference in age, BMI, sex, physical activity, and household income was observed between the HCLF and LCHF groups. Regarding the energy intake compared to Estimated Energy Requirement, the HCLF group met 79.0% and the LCHF group met 100.3%. Regarding nutrient intake per 1,000 kcal, carbohydrate, iron, potassium, and vitamin C intake in the HCLF group were significantly higher, but protein, fat, calcium, phosphorus, vitamin A, thiamin, riboflavin, and niacin intakes were significantly lower in the HCLF group compared to the LCHF group. After adjusting for age, sex, BMI, study year, household income, physical activity, and energy intake, the serum triglycerides level and systolic blood pressure were slightly higher, while the serum HDL-cholesterol level was significantly lower in HCLF than LCHF. The odds ratio of metabolic syndrome did not differ significantly between HCLF and LCHF. Conclusion: Our findings indicate an association of a high carbohydrate diet with increased risks for metabolic syndrome components. Conduct of future studies would be necessary in order to explore the underlying mechanism and to confirm our findings in a prospective study.

• Journal of Nutrition and Health
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• v.50 no.3
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• pp.257-269
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• 2017

Purpose: This study was conducted to evaluate the risk of metabolic factors in adults consuming 3-in-1 coffee from the 2012~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 5,872 subjects (male = 2,253, female = 3,619) aged 19~64 yrs were presented with food frequency questionnaires, and they were classified according to coffee consumption level and types of coffee consumed (black coffee, ${\leq}1$ time/day of 3-in-1 coffee, > 1 and ${\leq}2$ times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee). Analysis was conducted by gender for age-stratified groups: 19~39 (male = 968 and female = 1,285) and 40~64 (male = 1,468, female = 2,151) yrs old. Results: Black coffee consumption was associated with a significantly higher education level and household income compared to 3-in-1 coffee consumption in both males and females. The > 2 times/day group had significantly more smokers compared to other patterns of coffee consumption in both males and females. In the 40~64 yrs age group, males and females in the > 2 times/day group had significantly lower density of micronutrients such as fiber, niacin, vitamin C, calcium, phosphorus, and potassium compared with black coffee consumption. In the 40~64 yrs age group, males (OR: 2.03, 95% CI: 1.13~3.64) in the > 2 times/day group were at a higher risk of metabolic syndrome compared with black coffee consumption after multivariable adjustment. Conclusion: We found that frequency of 3-in-1 coffee consumption may be associated with prevalence of metabolic syndrome in males aged 40~64 yrs.

• Journal of Nutrition and Health
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• v.38 no.3
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• pp.219-225
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• 2005

The objective of the study was to define dietary patterns in the representative Korean adult population and to explore their associations with other factors. The Korean National Health and Nutrition Survey was conducted on a stratified random sample (n = 9,968) of the Korean population in 2001. This study analyzed data of 5,721 adult population aged 30 and over. Demographic and lifestyle factors were assessed by questionnaires and food consumption by a 24-h recall method. Cluster analysis identified two dietary patterns with 22 food groups: the larger group that included $85\%$ of total subjects was named as the 'traditional' pattern due to greater intakes of white rice, kimchi, and vegetables, and the smaller group was named as the 'modified' pattern which had greater intakes of noodles, bread, snack, and fast foods. The modified pattern had significantly higher proportion in younger age, higher educational level, residing in metropolitan area, and higher household income. The modified group showed significantly higher intake of all nutrients except carbohydrate. Percent of energy from fat intake, $22\%$ was significantly higher in the modified group than $14\%$ in the traditional group. There were no differences in prevalence of metabolic syndrome and its 5 components among patterns. In conclusion, there were two distinctive patterns that were associated with socio-demographic, nutrient intake, and health risk factors in Korea. It should be considered when designing nutrition policy and intervention program.

• Journal of Preventive Medicine and Public Health
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• v.53 no.5
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• pp.313-322
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• 2020

Objectives: This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models. Methods: The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years). Results: In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort. Conclusions: Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.