Obstructive sleep apnea is a common sleep disorder that predominantly affects adult men than women. However, the prevalence in women increases with menopause dramatically. Menopause has long been described as a risk factor for obstructive sleep apnea. Recent large well-designed population studies support that menopause increases the risk for sleep-disordered breathing. The mechanism of that hypothesis is not yet clear. But, the decline in progesterone has been thought to influence the development of obstructive sleep apnea because progesterone is a respiratory stimulant and plays a protective role against sleep apnea. Increased visceral obesity and hypertension as major symptoms of metabolic syndrome are also associated with menopause and place women at increased risk for obstructive sleep apnea and other serious health problem. Hormone replacement therapy has been associated with a lower prevalence of sleep apnea. But, relative risk and benefits of hormone replacement therapy compared with other treatment options will require thorough consideration for each individual woman. Finally, attention should be drawn to the need for obstructive sleep apnea evaluation in perimenopausal and postmenopausal women.
Purpose: To assess the relationship between lifestyle and metabolic syndrome in obese children and adolescents. Methods: We retrospectively reviewed the medical records and laboratory results of 109 subjects (7~15 years of age) who visited our pediatric obesity clinic between January 2004 and December 2007. They completed the parent- and self-report questionnaire developed by the Committee on Nutrition of the Korean Pediatric Society to assess lifestyle. The metabolic syndrome was defined as having 3 or more of the following metabolic risk factors: obesity, hypertension, serum triglycerides ${\geq}$110 mg/dL, HDL-cholesterol ${\leq}$40 mg/dL, fasting glucose ${\geq}$110 mg/dL, and insulin ${\geq}20{\mu}IU/mL$. Results: All subjects had at least 1 risk factor (obesity). Sixty-three percent of subjects had 2 or more risk factors, 32% of subjects had 3 or more risk factors, and 10% had 4 or more metabolic risk factors. Hypertriglyceridemia (36%), hypertension (32%), hyperinsulinemia (24%), and HDL-hypocholesterolemia (20%) were observed. Fasting blood glucose levels were normal in all subjects. Hypertension was significantly associated with an unbalanced diet and hyperinsulinemia was significantly associated with parental obesity (p<0.05). Those who ate after 8 PM were at a risk of hypertension (odds ratio, 2.5; 95% CI, 1.0~6.1). Those who did not have a preference for exercise were at a risk of hyperinsulinemia (odds ratio, 10.4; 95% CI, 2~54.1). Those who watched TV for ${\geq}$3 hours/day were at a risk of metabolic syndrome (odds ratio, 4.8; 95% CI, 1.2∼18.8). Conclusion: Lifestyle, such as eating late, no preference for exercise, and TV watching ${\geq}$3 hours/day, were related to metabolic syndrome in obese children and adolescents.
Journal of agricultural medicine and community health
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v.30
no.1
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pp.29-38
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2005
Objectives: Hypertension is the most important risk factors for the cerebrovascular diseases, and also for coronary heart diseases, it is therefore very important that the people have a knowledge on nature of hypertension and it's high risk in order to prevent and detect the hypertension as early as possible. Methods: This study was done to find out the knowledge on hypertension of 434 parents of elementary school students from Kimjae city, Jonbuk province, they were parents in grade 4, 5 and 6 attending two elementary schools. The survey took 10 days from November 20 to November 30, 2003. Results: first, The highest correct answer(94.5%) was "obesity is risk factors for hypertension", followed by "hypertension is closely related with hereditary factors(91.0%) and "high sodium intake is associated with high blood pressure"(85.7%). The lowest correct answer(77.4%) was the classification of blood pressure level between normal and high. Second, Rate of blood pressure measurement for fathers was 53.7% and 54.8% in mothers. Awareness of own blood pressure by fathers was 84.1 %, while 91.1% by mothers. Third, According to blood pressure level reported by parents, fathers with normal blood pressure was 59.2%, high normal blood pressure was 12.2%, while hypertension was 28.6%. It revealed that prevalence of hypertension of fathers was higher than mother (normal: 74.5%, high normal: 7.7%, hypertension: 18.2%). Conclusions: From the results of this study, it is important to strengthen the health education about hypertension for community people and also school students.
This study aimed to examine associations between milk intake and metabolic syndrome. The subjects included 1,928 males and 3,103 females, aged 19 to 64 years, from the data of 'The Korean National Health and Nutrition Survey 2007-2010'. Daily intake of milk and dairy products was obtained by a 24 hour dietary recall method and divided into two categories by equivalent weight of one serving. The average individual intakes of milk and dairy products were 59.4 g and 74.1 g per day respectively. Milk intake was inversely associated with metabolic syndrome (OR: 0.69, 95% CI: 0.54~0.89), central obesity (OR: 0.75, 95% CI: 0.62~0.91), and hypertriglyceridemia (OR: 0.73, 95% CI: 0.59~0.90). The total intake of dairy products was also inversely associated with metabolic syndrome (OR: 0.74, 95% CI 0.60~0.92), central obesity (OR: 0.73, 95% CI: 0.62~0.86), hypertension (OR: 0.80, 95% CI: 0.65~0.99). The association between intakes of milk and dairy products and metabolic syndrome was significant in women, but not in men. These results indicate that increased consumption of milk and its products is associated with a reduced likelihood of metabolic syndrome and metabolic syndrome risk factors. Further research on causal relationship and dose-response association between milk intake and metabolic syndrome risk is necessary prior to applying the observed results in nutrition policies and programs to prevent the metabolic syndrome.
Purpose: Excess intake of sodium is a major diet-related risk factor for human diseases including hypertension and cancer as well as obesity and inflammation. However, findings are still controversial, and evidence is lacking in Koreans. Therefore, for better understanding of the role of dietary sodium intake in disease etiology, this study investigated the effects of dietary sodium intake on adiposity, inflammation, and hormones in Koreans. Methods: A total of 80 males and females joined the study. The general characteristics and dietary intake data were investigated by trained interviewers using a questionnaire and 24-h dietary recall, respectively. For the markers of adiposity, body weight, body mass index, percent of body fat, visceral fat area, and waist and hip circumference were measured. For the inflammation and hormone markers, leptin, adiponectin, insulin, tumor necrosis $factor-{\alpha}$, and interleukin-6 were also analyzed. Results: Multivariate linear regression analyses suggested that dietary sodium intake was not associated with adiposity. However, dietary sodium showed a significant association with insulin level: Plasma insulin concentration increased with sodium intake independent of other dietary intake or percent of body fat (${\beta}=0.296$, adjusted $r^2=0.276$, p < 0.01). Other markers for inflammation and hormonal responses were not associated with dietary sodium intake. Conclusion: Findings suggested that dietary sodium intake may be a critical modifying factor in the level of plasma insulin. However, it showed a limited effect on obesity and other inflammation markers and hormone levels. These findings should be confirmed in larger, well-designed investigations.
Objectives: The purpose of this study is to identify prevalence and related factors of the elderly, who took health examination, with metabolic syndrome. Methods: The health examination and lifestyle survey were performed for 21,512 adults at 60 years of age or older who took health examination in H health promotion center during January-March 2009. Results: The prevalence of metabolic syndrome for the subject was 24.0%. Of the subject with metabolic syndrome, the prevalence of the diseases was obesity 60%, abdominal obesity 78.5%, hypertension 82.6%, dyslipidemia 89.7% and diabetes 51.9%. In comparison of the relationship between metabolic syndrome and other diseases, the male subject with metabolic syndrome were significantly higher in BMI, waist circumference, systolic/diastolic blood pressure, hemoglobin, AST, ALT, $\gamma$-GTP, TG, AC glucose, creatinine than normal male(p<0.001). In comparison of the relationship between metabolic syndrome and lifestyle, more drinking frequency and amount in male and more drinking frequency in female were associated with increased risk of metabolic syndrome(p<0.01). Regardless of exercise intensity, practice of exercise contributed to reduce the risk of metabolic syndrome(p<0.01). Conclusion: In conclusion, TLC program, focused on lifestyle behaviors which is strongly associated with the prevalence of metabolic syndrome, should be developed for the improvement of life quality in the elderly with metabolic syndrome.
This study was performed to determine the prevalence and associated risk factors of osteoarthritis in the elderly using the Korea National Health and Nutrition Examination Survey (2013~2014 KNHANES VI). A total of 2,148 (936 males, 1212 females) elderly participants aged 65 years or older were selected. Prevalence of osteoarthritis was higher in 460 female (80.7%) and 167 rural (29.1%) groups, than in 110 male (19.3%) and 404 urban (70.9%) groups. While the mean values of LDL-cholesterol, triglyceride level, and waist circumference were significantly higher in the osteoarthritis group than the normal group, other parameters including height, HDL-cholesterol, fasting blood glucose, hemoglobin and hematocrit values were not. Quality of life (EQ-5D) was also significantly lower in the osteoarthritis group. The results of logistic regression analysis showed that smoking, alcohol intake, obesity, hypercholesterolemia and energy intakes were significantly different in regards to the prevalence of osteoarthritis. This study suggests that obesity and energy intakes were associated with osteoarthritis, whereas risk factors of chronic disease, such as hypertension, Hypo-high density lipoprotein, hypertrigly-ceridemia, anemia, diabetes, vigorous physical activity, moderate physical activity and walking were not. Long-term prospective study is necessary to investigate the effects of these factors on osteoarthritis.
The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.
Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.
Kim, Yoomi;Cho, Daegon;Hong, Sungok;Kim, Eunju;Kang, Sunghong
Journal of the Korean Geographical Society
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v.49
no.6
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pp.935-948
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2014
As chronic diseases have become more prevalent and problematic, effective cares for major chronic diseases have been a locus of the healthcare policy. In this regard, this study examines how region-specific characteristics affect the prevalence of hypertension in South Korea. To analyze, we combined a unique multi-year data set including key indicators of health conditions and health behaviors at the 237 small administrative districts. The data are collected from the Annual Community Health Survey between 2009 and 2011 by Korea Centers for Disease Control and Prevention and other government organizations. For the purpose of investigating regional variations, we estimated using Geographically Weighted Regression (GWR) and decision tree model. Our finding first suggests that using the multi-year data is more legitimate than using the single-year data for the geographical analysis of chronic diseases, because the significant annual differences are observed in most variables. We also find that the prevalence of hypertension is more likely to be positively associated with the prevalence of diabetes and obesity but to be negatively associated with population density. More importantly, noticeable geographical variations in these factors are observed according to the results from the GWR. In line with this result, additional findings from the decision tree model suggest that primary influential factors that affect the hypertension prevalence are indeed heterogeneous across regional groups. Taken as a whole, accounting for geographical variations of health conditions, health behaviors and other socioeconomic factors is very important when the regionally customized healthcare policy is implemented to mitigate the hypertension prevalence. In short, our study sheds light on possible ways to manage the chronic diseases for policy makers in the local government.
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