The Association between Pulmonary Function and Metabolic Syndrome in Koreans: A Cross-Sectional Study

Usefulness of hemoglobin A1c as a criterion of dysglycemia in the definition of metabolic syndrome in Koreans

Background/Aims: Low socioeconomic status (SES) is linked to higher incidence/mortality of cardiovascular disease, but emerging evidence inconsistently reported that education level, a proxy for SES, is related to cardiovascular risk and metabolic syndrome (MetS) in Koreans. Furthermore, limited information is available on whether dietary components would mediate the relationship between education level and cardiovascular risk. We hypothesized that selected food consumption mediates the association between education level and MetS prevalence. Methods: Data from the Korea National Health and Nutritional Examination Survey (2008-2011) were included in cross-sectional analyses (n = 11,029, 30-64 years). The possible mediating effect of selected food groups (fruits, raw vegetables, red meat, milk, and soft drinks) on the association between education level and MetS was tested using a multiple mediation model. Results: Education level was negatively associated with MetS prevalence. The association between lower education level and higher MetS prevalence was partially mediated by selected food consumption (lower intakes of fruit, red meat and milk; higher intakes of vegetable and soft drink) after adjusted for covariates. Gender also modified the association between education level and MetS prevalence that was more prominent in women than in men. Conclusions: Selected food consumption substantially contributes to the association between education level and MetS in Korean adults, especially among women.

Background/Aims: The association of socioeconomic status with metabolic syndrome could differ according to cultural and social background. This study examined the potential influence of gender. Methods: A total of 3,291 middle-aged Korean subjects who participated in the 2005 Korean National Health and Nutrition Examination Survey were included. Socioeconomic status was measured using educational background (no school or graduated elementary school, and graduated middle school, high school, or college). Results: The prevalence of metabolic syndrome was 34.5% in men and 29.8% in women. After adjusting for age, women with more education had a lower prevalence (no school or graduated elementary school, mean ± SEM, 35.5 ± 2.3%; middle school, 37.3 ± 2.4; high school, 26.0 ± 1.8; college, 21.5 ± 2.6; p for trend < 0.001). In contrast, in men, there was no difference in the prevalence of metabolic syndrome according to educational background. This result could not be explained by smoking, alcohol consumption, exercise, or diet. Conclusions: The data suggest that socioeconomic status is closely related to the prevalence of metabolic syndrome in Korean middle-aged women, but not in men. (Korean J Med 2012;82:569-575)

The purpose of this study was to determine the relationship between combined poor lifestyle factors and metabolic syndrome (MetS) in Korean men. Data from the Korean National Health and Nutrition Examination Survey 2010 were classified according to the number and combination patterns of poor lifestyle factors, namely, current smoking, high-risk alcohol use, low physical activity and poor dietary habits. We analyzed the association between the combined poor lifestyle factors and MetS. The definition of MetS was based on the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention in 2009. A total of 1408 men aged 20-75 were included in this study. Approximately one-third of the 30-49 age group had ≥3 combined poor lifestyle factors. Compared with those with no poor lifestyle factors, the ORs for MetS were 3.57 (95% CI 1.16-11.02), 3.62 (95% CI 1.18-11.08) and 6.31 (95% CI 2.08-19.26) in subjects with one, two and three or more poor lifestyle factors, respectively. When current smoking, high-risk alcohol use and low physical activity were concurrently present, the ORs for MetS, hyperglycemia, and hypertriglyceridemia were 14.32 (95% CI 3.64-56.30), 4.49 (95% CI 1.62-12.40), and 5.07 (95% CI 2.18-11.81), respectively. Comprehensive lifestyle modifications need to be stressed in public health programs.

ObjectivesThis study aimed to evaluate the association between sodium intake and metabolic syndrome (MetS) in Korean boys.MethodsA total of 1,738 boys aged 10–18 years were included in this study from the Korea National Health and Nutrition Examination Survey (KNHANES) during the years 2010–2013. Sodium intake was assessed using the urinary sodium excretion to urinary specific gravity ratio (U-Na to U-SG ratio).ResultsThe median U-Na to U-SG ratio was 133.27 mmol/L (interquartile range: 95.66–178.50 mmol/L). Significant positive associations were found between the U-Na to U-SG ratio and the TG (P = 0.001 for trend) and TG concentrations, and these concentrations were significantly higher in boys with a U-Na to U-SG ratio in the highest quartile compared with those with a ratio in the lowest (P = 0.001) and second (P = 0.033) quartiles, as demonstrated through analysis of covariance (ANCOVA) after adjustment for possible confounders, including age, BMI standard deviation score, ferritin, vitamin D, house income, smoking, alcohol intake, physical activity, season, total intake, total energy intake, protein intake, fat intake, carbohydrate intake, and water intake. Significant inverse associations were found for the U-Na to U-SG ratio with the HDL-C (P = 0.033 for trend) and HDL-C levels, and these values were significantly lower in boys with a ratio in the highest quartile compared with those with a ratio in the second quartile (P = 0.020), as demonstrated through an ANCOVA. Although the trends did not reach statistical significance, a higher U-Na to U-SG ratio tended to be associated with higher SBP (P = 0.086 for trend), DBP (P = 0.063 for trend), and glucose levels (P = 0.099 for trend), as illustrated through ANCOVA. Boys with a ratio in the highest quartile exhibited a 1.73-fold increased risk for elevated TG (95% CI, 1.19–2.51) and a 2.66-fold increased risk for MetS (95% CI, 1.11–6.35) compared with those with a ratio in the lowest quartile, as demonstrated through multivariate logistic regression analyses after adjusting for confounders.ConclusionsOur results suggest that high sodium intake may be significantly independently associated with MetS in Korean boys aged 10–18 years.

Diet quality, physical activity, and their association with metabolic syndrome in Korean adults.

BackgroundThe prevalence of metabolic syndrome is increasing in Korea, particularly among young adults. This trend will increase the incidence of cardiovascular and metabolic diseases in the future. Therefore, it is imperative to detect and prevent metabolic abnormalities early in life. Here, we established a hospital-based biobank cohort to identify the most prevalent dysmetabolic phenotype. The aim of this report was to inform other researchers of our protocol and to share our data for future collaboration.MethodsThe baseline examination comprised health-related questionnaires, anthropometric and handgrip strength measurements, bioelectrical impedance analysis of body composition, and nutritional assessment. Relevant biochemical parameters were measured, and oral glucose tolerance tests were performed. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria with Asian waist circumference criteria.ResultsFrom a total of about 3,000 employees aged 20 to 59 years working at Seoul National University Bundang Hospital, 1,017 were enrolled from 2015 to 2016. The mean age was 34.5±8.4 years for men (n=311, 30.6%) and 30.9±8.5 years for women (n=706, 69.4%). The overall prevalence of metabolic syndrome was 7.6% (17.7% in men and 3.1% in women). Among the five components of metabolic syndrome, high blood pressure was the most prevalent in both men (51.4%) and women (13.8%).ConclusionAlthough further follow-up data are needed, we expect that more adverse cardiovascular events may occur in men than in women. This hospital-based cohort will serve as the foundation for a comprehensive evaluation of metabolic syndrome and future cardiometabolic disease risk in middle-aged Koreans.

Results from studies investigating the association between coffee consumption and the metabolic syndrome in Koreans have been inconsistent and remain controversial. We examined coffee intake in relation to the metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey 2012-2015, with 8387 adults aged 19-64 years. Furthermore, we conducted a stratified analysis by obesity status (BMI <25 v. ≥25 kg/m2) to examine whether the association varied by obesity status. A 112-item FFQ was used to assess diet. Multivariable logistic regression models were used to determine the association of coffee consumption (<1, 1-2, 3-4 and ≥5 times/d) and the metabolic syndrome. Compared to people who consumed <1 time/d of coffee, the OR for the metabolic syndrome in those who consumed 3-4 times/d of coffee was 0·75 (95 % CI 0·58, 0·97). However, ≥5 times/d of coffee consumption was not significantly associated with the metabolic syndrome. By obesity status, in non-obese people, those consuming more coffee had lower odds of the metabolic syndrome, showing a significant linear trend (P-trend=0·0248). In obese people, the OR for the metabolic syndrome in people with 3-4 times/d of coffee consumption v. <1 time/d was 0·68 (95 % CI 0·50, 0·93), but ≥5 times/d of coffee consumption showed a non-significant positive association. Our findings suggest that moderate coffee consumption of 3-4 times/d is inversely associated with the metabolic syndrome in Korean adults. The association between heavy coffee consumption of ≥5 times/d and the metabolic syndrome varied by obesity status.

A Cross-Sectional Study of Socioeconomic Status and the Metabolic Syndrome in Korean Adults

The proportion of noodles in the Korean diet is increasing, but the effect of noodle intake on metabolic syndrome has not been sufficiently investigated. Therefore, we investigated noodle consumption and its relation to metabolic syndrome in Korean adults. This study was conducted on 10,505 adults using the combined data of the 2012-2016 Korea National Health and Nutrition Examination Survey (KNHANES). Noodle intake was evaluated with a food frequency question-naire (FFQ) based on 112 food items. To compute odds ratios (ORs) and their 95% confidence intervals (CIs) controlled for confounders, multivariable logistic regression models were used. Compared to people in the lowest levels of noodle intake, the OR of the metabolic syndrome of those in the highest levels was 1.48 (95% CI, 1.16-1.90; p-trend = 0.002). This positive association was also found for hypertriglyceridemia and abdominal obesity, which were metabolic syndrome components. Specifically, the odds of having hypertriglyceridemia were 38% (OR, 1.38; 95% CI, 1.14-1.66; p-trend < 0.001) higher for people with high noodle consumption compared to those with low noodle consumption in the overall population. The tendency for people who consume a lot of noodles to have raised odds of metabolic syndrome was observed when analyzed by the type of noodles. This study suggested noodle intake was positively related to met-abolic syndrome and its components in Korean adults. Further clinical trials and prospective cohort studies are required to identify a causal relationship between noodle intake and metabolic syndrome in Koreans.

Helicobacter pylori (H. pylori) infection causes extra-gastrointestinal as well as gastric diseases. This analytical cross-sectional study was performed to investigate the association between H. pylori infection and metabolic syndrome in a Korean population. Anthropometric and metabolic data, as well as anti-H. pylori IgG antibodies, were measured in 21,106 subjects who participated in a health checkup between January 2016 and June 2017. The classification of metabolic syndrome followed the revised National Cholesterol Education Program criteria. After excluding subjects with a history of H. pylori eradication therapy, or gastric symptoms, the seropositivity of H. pylori was 43.2% in 15,195 subjects. H. pylori-positive participants had significantly higher body mass index (BMI), waist circumference, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and lower high-density lipoprotein (HDL-C) than did seronegative participants (P < 0.05). After adjusting for confounders, high TC, low HDL-C, and high LDL-C were associated with H. pylori seropositivity. Finally, the prevalence of metabolic syndrome was higher in H. pylori-seropositive subjects than in negative ones (27.2% vs. 21.0%, P < 0.05), and H. pylori seropositivity increased the likelihood of metabolic syndrome (OR 1.19, 95% CI 1.09-1.31, P < 0.001) after adjusting for sex, age, BMI, smoking, residence, household income, and education level. However, the association between H. pylori seropositivity and metabolic syndrome disappeared in those ≥ 65years old. H. pylori infection plays an independent role in the pathogenesis of metabolic syndrome in Koreans under 65years old.

BACKGROUND/OBJECTIVESThe aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults.SUBJECTS/METHODSStudy subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged ≥ 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables.RESULTSNutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001).CONCLUSIONSLow intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

The objective of this study was to compare aortic (the common carotid to femoral artery) PWV, arm (the brachial to radial artery) PWV, and leg (the femoral to dorsalis pedis artery) PWV in people with or without component of the metabolic syndrome. We analyzed 3345 Korean subjects (1907 men, age 44.6 ± 8.5, 1438 women, age 43.3 ± 8.9). Unpaired t-test was used to compare mean values of various metabolic parameters between subjects with and without Metabolic Syndrome (MetS), and one-way analysis of variance was used to compare these variables among groups satisfying different numbers of the components of MetS. In addition, we compared of Pearson correlation coefficient between age and PWV (arotic PWV, arm PWV and leg PWV) levels of according to whether the subject had components of the metabolic syndrome or not. The present study shows that leg PWV level was found to be significantly associated with the features of the metabolic syndrome in Korean men and women. And, we confirmed that blood pressure is significantly associated with the PWV values at three locations. And, this study shows that Pearson correlation coefficient of arotic PWV and leg PWV were about 10% higher than without diabetes according to age. Further studies need to be performed to evaluate the optimal cut-off value of PWV for diabetes, hypertension, and MetS in Korean.Implications for RehabilitationPulse wave velocity (PWV) reflects arterial stiffness, and it is a marker of both the severity of vascular damage and the prognosis of cardiovascular diseases in selected subjects, such as patients with hypertension or with abnormal glucose metabolism.Metabolic syndrome might be involved in the pathogenesis of PWV.Leg (the femoral to dorsalis pedis artery) PWV level was found to be significantly associated with the features of the metabolic syndrome in Korean.

Although previous studies have shown that milk intake has some protective effects on metabolic syndrome (MS), there are few data on the relation between MS and milk consumption in Korean. To evaluate the association between milk intake frequency and MS, 4,890 subjects (2,052 men and 2,838 women) were included in the analysis, based on the national data from representative random sample of the third Korea National Health and Nutrition Examination Survey (KNHANES III) in 2005. We conducted both univariate and multivariate logistic regression analysis with adjustment for confounding factors associated with MS. Mean (±SD) age of subjects was 47.1±15.5 yr. In univariate analysis, the risk of MS was inversely associated with the frequency of milk intake, but this relation was attenuated in multivariate regression. In the individuals with BMI ≥23 kg/m2, those with highest quartile of milk consumption (once daily or more) had significantly lower risk of MS (OR [95% CI] 0.72 [0.57-0.92] compared with lowest quartile [those rarely consumed]) after adjustment, but not among leaner individuals (BMI <23 kg/m2). Korean overweight adults who drink milk more frequently may be protected against MS. But it seems that this relation is somewhat different among MS components.

BackgroundThe epidemiological evidence regarding nut consumption and metabolic diseases focuses on Western populations. Nut consumption among Koreans is relatively low, and the prevalence of metabolic syndrome is rapidly increasing, highlighting the need for more focused studies in this population. This cross-sectional study aimed to investigate the relationship between nut consumption and metabolic syndrome in Korean adults.MethodsA total of 112,501 adults (39,481 men and 73,020 women) aged 40–79 years were selected from baseline data of the Korean Genome and Epidemiology Study–Health Examinees. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized as non-consumers, &amp;lt;1 serving/week, ≥1 to &amp;lt;2 servings/week, or ≥2 servings/week (15 g per serving). Metabolic syndrome and its components were defined according to the Korean Society of CardioMetabolic Syndrome criteria. Associations between nut consumption and metabolic syndrome and its components were examined using multiple logistic regression with adjustments for potential confounders.ResultsIn the study population, the prevalence of metabolic syndrome was 21.4% (26.9% in men and 18.4% in women), and the mean nut intake was 0.8 serving/week (0.7 serving/week in men and 0.8 serving/week in women). After adjusting for confounders, higher nut consumption was associated with a lower odds ratio (OR) of metabolic syndrome in individuals consuming ≥2 servings/week compared with non-consumers [OR = 0.85, 95% confidence interval (CI) = 0.80–0.91, p for trend &amp;lt;0.001]. Specifically, in men, this level of consumption was associated with a 14% reduction in the OR of metabolic syndrome (OR = 0.86, 95% CI = 0.77–0.95, p for trend = 0.028). In women, a similar reduction of 14% was observed (OR = 0.86, 95% CI = 0.80–0.93, p for trend &amp;lt;0.001). Among the metabolic syndrome components, nut consumption was inversely associated with abdominal obesity, low high-density lipoprotein-cholesterol, and elevated triglycerides in men and women, whereas no associations were observed for elevated blood pressure or elevated fasting blood glucose.ConclusionOur findings suggest that higher nut consumption is inversely associated with metabolic syndrome and its components in Korean adults. Further studies are needed to examine the longitudinal association between nut consumption and metabolic diseases in this population.