Levels In Korean Adults Research Articles

Association between exposure to ambient particulate matter and high sensitivity C-reactive protein: A nationwide study in South Korea, 2015–2018

Existing evidence suggests that exposure to ambient particulate matter (PM) causes various adverse health outcomes through systemic inflammation. We explored the association between PM exposure and high-sensitivity C-reactive protein (hs-CRP) levels in a Korean population. This cross-sectional study included a representative sample of 21,154 Korean individuals, linked to modeled air quality data from 2015 to 2018. Concentrations of PM10 and PM2.5 were estimated for 1-week (short-term), 2-month, 4-month, 6-month (medium-term), and 1-year (long-term) moving averages before the survey date for each participant. The association between log-transformed hs-CRP levels and PM exposure was assessed using linear regression. The effect sizes were expressed as percent changes with 95% confidence intervals (CIs). The percent change (95% CI) in hs-CRP levels per a 10-μm/m3 increase in PM10, according to moving averages, was 0.47 (−1.13, 2.10) for 1-week, 4.87 (2.50, 7.29) for 2-month, 8.21 (4.89, 11.64) for 4-month, 11.26 (6.81, 15.89) for 6-month, and 7.15 (2.54, 11.98) for 1-year. The percent change (95% CI) in hs-CRP levels per a 10-μm/m3 increase in PM2.5, according to moving averages, was 0.66 (−2.38, 3.79) for 1-week, 7.51 (2.86, 12.36) for 2-month, 14.26 (8.23, 20.62) for 4-month, 20.29 (12.42, 28.70) for 6-month, and 17.76 (8.51, 27.79) for 1-year. The relationship between PM exposure and hs-CRP levels remained independent even after adjusting for sociodemographic characteristics and other co-pollutants. Exposure to PM10 and PM2.5, particularly over longer periods, showed positive association with hs-CRP levels in Korean adults. These findings highlight the necessity for policy efforts aimed at enhancing air quality and mitigating the health impacts of PM exposure.

Association between Uric Acid Levels and the Consumption of Sugar-Sweetened Carbonated Beverages in the Korean Population: The 2016 Korea National Health and Nutrition Examination Survey.

Elevated uric acid levels are linked with obesity and diabetes. Existing research mainly examines the relationship between sugar-sweetened carbonated beverage (SSB) consumption and uric acid levels. This study explored the association between the quantity and frequency of SSB consumption and elevated uric acid levels in Korean adults. Data from 2881 participants aged 19-64 years (1066 men and 1815 women) in the 2016 Korea National Health and Nutrition Examination Survey were analyzed. Serum uric acid levels were categorized into quartiles, with the highest defined as high uric acid (men, ≥6.7 mg/dL; women, ≥4.8 mg/dL). SSB consumption was classified into quartiles (almost never, <1 cup (<200 mL), 1-3 cups (200-600 mL), ≥3 cups (≥600 mL)) and frequency into tertiles (almost never, ≤1/week, ≥2/week). Multivariate logistic regression assessed the association, with separate analyses for men and women. Increased daily SSB consumption and frequency were significantly associated with high uric acid levels in men but not in women. After adjusting for sociodemographic and health characteristics, consuming ≥3 cups (≥600 mL) of SSBs per day and SSBs ≥ 2/week were significantly associated with high serum uric acid levels in men, but this association was not observed in women. The study concludes that increased SSB intake is linked to elevated uric acid levels in Korean men, but not in women.

Association between handgrip strength and physical activity: A nationwide population-based study in Korea.

This study investigated the association between handgrip strength (HGS) and physical activity (PA) at different levels in Korean adults for the purpose of providing direction for increasing HGS, which represents muscular strength, and increasing understanding of PA and HGS. This study targeted adults aged ≥30 years from the Korean National Health and Nutrition Examination Survey (2014-2019), including 31,888 participants for analysis. HGS was defined as the maximum value of the three measurements of the dominant hand. PA was defined as an activity that causes shortness of breath or a fast heartbeat. Data were weighted according to survey district and household data; p<.05 was considered statistically significant. In men, HGS in those aged 30-64 years was significantly associated with high-intensity PA and in those aged ≥65 years was associated with moderate-intensity PA. In women, HGS in those aged 30-64 years was also significantly associated with high-intensity PA, and in those aged ≥65 years, it was significantly associated with both moderate- and high-intensity PA. Moreover, compared to participants who did not participate in weight training, those who participated showed higher HGS in both sexes. This study demonstrated age- and sex-specific characteristics of the association between HGS and PA in Koreans. The findings suggest the importance of managing health by considering differences in age- and sex-related PA. In particular, this study suggests that adequate PA is necessary despite its importance of PA for elderly individuals.

Association between the Korean Healthy Eating Index and Serum Vitamin D Level in Korean Adults: 2013–2015 Korea National Health and Nutrition Examination Survey

Association between the Korean Healthy Eating Index and Serum Vitamin D Level in Korean Adults: 2013–2015 Korea National Health and Nutrition Examination Survey

Association between coffee consumption and high C-reactive protein levels in Korean adults.

The findings of studies investigating the relationship between coffee consumption and C-reactive protein (CRP) levels have been inconsistent, and few researchers considered the type of coffee. We examined the association between coffee consumption and high CRP levels, using data from the Korea National Health and Nutrition Examination Survey, 2016-2018, with 9337 adults aged 19-64 years. A 24-h diet recall was used to assess diet, including the amount and type of coffee consumed. We classified coffee into black coffee and coffee with sugar and/or cream (non-drinkers, or ≤ 1, 2-3, > 3 cups/d) and used multivariable logistic regression models with high CRP levels (≥ 2·2 mg/l). After the adjustment for potential confounders, 2-3 cups/d of coffee consumption were inversely associated with high CRP levels, compared with no consumption (OR = 0·83, 95 % CI 0·69, 0·99). By type of coffee, the inverse association was stronger in subjects consuming black coffee (OR = 0·61, 95 % CI 0·45, 0·84), while the inverse association was much weaker in those consuming coffee with sugar and/or cream (OR = 0·92, 95 % CI 0·74, 1·14). By sex, the inverse association of 2-3 cups of black coffee was found both in men (OR = 0·65, 95 % CI 0·41, 1·03) and women (OR = 0·55, 95 % CI 0·36, 0·83). More than three cups/d of heavy coffee consumption were not significantly associated with high CRP levels. Our findings indicate that moderate black coffee consumption of 2-3 cups/d is inversely associated with high CRP levels in Korean adults. Further prospective studies are warranted to provide definitive evidence.

Association of NAFLD with FGF21 Polygenic Hazard Score, and Its Interaction with Protein Intake Level in Korean Adults.

Fibroblast growth factor 21 (FGF21) is a hormone that participates in the regulation of energy homeostasis and is induced by dietary protein restriction. Preclinical studies have suggested that FGF21 induction exerts a protective effect against non-alcoholic fatty liver disease (NAFLD), while human studies have revealed elevated levels of and potential resistance to FGF21 in patients with NAFLD. However, whether the FGF21 pathway also contributes to NAFLD risk at the genetic level remains uncertain. A few attempts to investigate the impact of individual genetic variants at the loci encoding FGF21 and its receptors on NAFLD risk have failed to establish a clear association due to a limited effect size. Therefore, this study aimed to (1) develop a polygenic hazard score (PHS) for FGF21-related loci that are associated with NAFLD risk and (2) investigate the effect of its interaction with protein intake level on NAFLD risk. Data on 3501 participants of the Korean Genome Epidemiology Study (Ansan-Ansung) were analyzed. Eight single-nucleotide polymorphisms of fibroblast growth factor receptors and beta-klotho were selected for PHS determination using forward stepwise analysis. The association between the PHS and NAFLD was validated (p-trend: 0.0171 for men and <0.0001 for women). Moreover, the association was significantly modulated by the protein intake level in all participants as well as women (p-interaction = 0.0189 and 0.0131, respectively) but not in men. In particular, the women with the lowest PHS values and a protein intake lower than the recommended nutrient intake (RNI) exhibited a greater NAFLD risk (HR = 2.021, p-trend = 0.0016) than those with an intake equal to or greater than the RNI; however, those with higher PHS values had a high risk, regardless of protein intake level. These findings demonstrate the contribution of FGF21-related genetic variants and restricted protein intake to NAFLD incidence.

Association of mercury exposure with the serum high-sensitivity C-reactive protein level in Korean adults.

Although there is evidence that mercury (Hg) exposure may be a potential risk factor for cardiovascular disease (CVD), few nationwide epidemiological researches have analyzed the association between blood Hg concentration and serum high-sensitivity C-reactive protein (hs-CRP) level as a biomarker of CVD. The present population-based national study was performed with data from the 2016-2017 National Health and Nutrition Examination Survey. In the total sample of 3,773 adults aged ≥20 years, the serum hs-CRP concentrations were 1.03 mg/L among participants in the lowest quartile of blood Hg level and 1.18 mg/L among those in highest quartile. The trend for the prevalence of a risky (>1.0 mg/L) hs-CRP level (moderate risk and high risk) was significantly related to an increased quartile blood Hg concentration. After adjustment for confounders, participants with the highest quartiles of blood Hg had increased odds of a risky (>1.0 mg/L) hs-CRP level (adjusted odds ratio = 1.34; 95% confidence interval, 1.02-1.77) compared with those with the lowest quartile of blood Hg. These findings demonstrate that a high blood Hg level increases the concentration of serum hs-CRP, a sensitive marker of chronic low-grade inflammation, and imply that the increased body burden associated with high blood Hg is a potential risk factor in the development of many inflammatory diseases, including CVD.

Association between Neck Circumference and Serum Uric Acid Level in Korean Adults over 40 Years Old: Based on the 2019 Korea National Health and Nutrition Examination Survey

Association between Neck Circumference and Serum Uric Acid Level in Korean Adults over 40 Years Old: Based on the 2019 Korea National Health and Nutrition Examination Survey

Association between obesity and high-sensitivity C-reactive protein in Korean adults without cardiovascular disease

Purpose: This study aimed to investigate the association between obesity and high-sensitivity C-reactive protein (hs-CRP) levels in Korean adults without cardiovascular disease (CVD). Methods: The subjects were 3,634 adults, and data were extracted from the seventh Korea National Health and Nutrition Examination Survey (KNHANES Ⅶ-3). A complex sampling design analysis was applied to reflect the stratified and clustered weights. The data were analyzed using the complex sample Rao-Scott chi-square test and multiple logistic regression analysis (in SPSS for Windows version 26.0). Obesity, according to body mass index (BMI), was defined as obesity (BMI=25-29.9 kg/m²), high obesity (BMI=30-34.9 kg/m²), and super-high obesity (BMI≥35 kg/m²), and abdominal obesity (AO) was defined as a waist circumference (WC) ≥90 cm in males and WC ≥85 cm in females.Results: The odds ratios for moderate CVD risk (hs-CRP; 1-3 mg/dL) were 2.21, 4.16, and 7.13 in the obesity, high obesity, and super-high obesity groups, respectively, compared to the normal BMI group. The odds ratio for moderate CVD risk was 2.18 in males with AO and 1.88 in females with AO. The odds ratios for high CVD risk (hs-CRP&gt;3mg/L) were 4.40 and 17.55 in the high obesity and super-high obesity groups, respectively, compared to the normal BMI group.Conclusion: This study provides evidence that early detection and prevention programs for CVD should include obesity-related interventions aiming to modulate hs-CRP.

Changes in Vitamin D Status in Korean Adults during the COVID-19 Pandemic.

The aim of this study was to investigate changes in 25(OH)D (25-hydroxyvitamin D) levels and in the vitamin D status of Korean adults before and during the coronavirus disease (COVID-19) pandemic. This study compared serum 25(OH)D levels before and after the pandemic in 1483 adults aged 19 years and older who were screened at a university hospital. Subjects were selected only from participants tested in the same season before and after the pandemic. The pre-COVID-19 testing period was from 1 March 2018 to 31 November 2019; the testing period in the COVID-19 era was from 1 June 2020 to 31 November 2021. The mean 25(OH)D level for all participants was 21.4 ± 10.2 ng/mL prior to the outbreak of COVID-19, which increased to 23.6 ± 11.8 ng/mL during the COVID-19 lockdown period (p &lt; 0.001). The increase was particularly dramatic in elderly females (28.8 ± 12.3 ng/mL to 37.7 ± 18.6 ng/mL, p = 0.008). The prevalence of vitamin D deficiency decreased in both males (48.4% to 44.5%, p = 0.005) and females (57.0% to 46.0%, p &lt; 0.001). In conclusion, 25(OH)D levels in Korean adults increased during the COVID-19 era, and the prevalence of vitamin D deficiency decreased accordingly.

Association of Duration of Smoking Cessation or Cumulative Smoking Amount with Serum hs-CRP Level in Korean Adults: A Nationwide Population-Based Cross-Sectional Study.

This study investigates the association between the duration of smoking cessation or cumulative smoking amount with serum high-sensitivity C-reactive protein (hs-CRP) levels. We assessed the decreasing risk for cardiovascular disease (CVD) and cancer following smoking cessation in Korean adults who were former smokers compared with current smokers. This study used data from the 2016–2018 Korea National Health and Nutrition Examination Survey. A total of 5411 participants were included. The duration of smoking cessation and cumulative smoking amount were classified into cut-offs for 6 and 17 months, and 5 and 20 pack-years, respectively, using tertile values. Elevated serum hs-CRP level was defined as ≥1 mg/L. Multivariate logistic regression analysis was performed. The odds ratio (OR) for elevated serum hs-CRP level was 0.73 times lower in the group whose duration of smoking cessation was 17 months or more than that in the group who were current smokers after adjusting for confounding variables (95% confidence interval (CI): 0.57–0.92; p < 0.01). The OR for elevated serum hs-CRP level was 0.71 and 0.67 times lower in the groups whose cumulative smoking amounts were less than 5 and 5–20 pack-years than that in the group who were current smokers (95% CI: 0.50–0.99 and 0.50–0.92, respectively; both p < 0.05). This study reveals that a duration of smoking cessation of more than 17 months and a cumulative smoking amount of less than 20 pack-years were significantly associated with a decreased risk of elevated serum hs-CRP levels in Korean adults who were former smokers. Therefore, quitting smoking early and a low cumulative smoking amount are a potential preventive strategy for CVD and cancer that can be easily accessible using serum hs-CRP.

Dietary vitamin D intake in low ultraviolet irradiation seasons is associated with a better nutritional status of vitamin D in Korean adults according to the 2013-2014 National Health and Nutrition Examination Survey

Vitamin D deficiency poses a global public health burden; however, there are limited studies on the relationship between vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) concentration in Koreans with a special focus on seasonal variables. We hypothesized that the relationship between serum 25(OH)D and vitamin D intake levels in Korean adults would change with the seasons, and that the distribution of food sources for vitamin D would vary according to sex and age. We established a new version of the food vitamin D database, analyzed the Korean National Health and Nutrition Examination Survey 2013 to 2014 data (n = 3257), and calculated the vitamin D intake of Koreans using a complex sample model. We found that the daily vitamin D intakes of men and women were 4.09 ± 0.26 µg and 2.87 ± 0.17 µg and their 25(OH)D levels were 16.98 ± 0.24 ng/mL and 15.62 ± 0.21 ng/mL, respectively. A significant positive correlation was observed between vitamin D intake and serum 25(OH)D levels in all participants. Serum 25(OH)D levels in the spring and winter (low ultraviolet irradiation seasons) were significantly higher in the 3rd tertile of vitamin D intake than in the first tertile. Fish and shellfish were the main sources of vitamin D for Koreans, the consumption of which was the least in the 19- to 29-year-old group; additionally, their serum 25(OH)D level was the lowest. In conclusion, insufficient vitamin D intake during low ultraviolet irradiation seasons is associated with lower levels of serum 25(OH)D.

Association between Phytochemical Index and Inflammation in Korean Adults.

While the relationship between phytochemicals and inflammation has been confirmed by in vivo or in vitro studies, large-scale epidemiological studies comprehensively analyzing phytochemical-rich food groups remain scarce. Therefore, we evaluated the association between the phytochemical index (PI) and the inflammation levels in Korean adults. The data were derived from the 2015–2018 Korea National Health and Nutrition Examination Survey, and a total of 18,699 participants were analyzed. High-sensitivity C-reactive protein (hs-CRP) levels >3.0 mg/L and white blood cell (WBC) counts >10 × 103/μL were defined as “elevated.” The PI was calculated based on eight food groups using a 24-h dietary recall. The odds ratio (OR) and confidence interval (CI) for elevated hs-CRP levels and WBC counts, according to the PI quintile, were calculated using the multivariable logistic regression analysis. Participants in the higher PI group had lower means of hs-CRP levels and WBC counts than those in the lower PI group (all p for trend <0.001). In fully adjusted logistic regression models, elevated hs-CRP levels and WBC counts in the highest PI group were lower by 40% (OR: 0.61, 95% CI: 0.49–0.76) and 34% (OR: 0.66, CI: 0.47–0.93), respectively. Conclusions: A high consumption of phytochemical-rich foods is associated with lower inflammation. This suggests that adopting phytochemical-rich dietary patterns may be an effective approach for reducing inflammation.

Association of Sleep Duration with Serum Uric Acid Levels in Korean Adults: An Analysis of the 2016–2018 Korea National Health and Nutrition Examination Survey Data

Association of Sleep Duration with Serum Uric Acid Levels in Korean Adults: An Analysis of the 2016–2018 Korea National Health and Nutrition Examination Survey Data

Validation of multiple equations for estimating low-density lipoprotein cholesterol levels in Korean adults

BackgroundLimited data are available for validation of low-density lipoprotein cholesterol (LDL) calculation (LDLcal) in the adult Korean population. The aim of this study was to develop and validate a new equation for LDLcal and to compare it with previous such equations in a Korean population.MethodsA new equation for LDLcal was developed (LDLChoi). LDLChoi and 11 other previously published equations were applied and compared with directly measured LDL concentration (LDLdirect) in a development cohort (population 1), an independent validation cohort in the same laboratory (population 2), and the Korea National Health and Nutrition Examination Survey 2017 cohort (population 3).ResultsAmong the 12 equations, the newly-developed equation (LDLChoi = total cholesterol – 0.87 x high-density lipoprotein cholesterol – 0.13 x triglycerides) had the highest intraclass correlation coefficient (ICC) and the lowest mean systemic difference and median absolute percentage error in populations 1 and 2 but not in population 3. Subgroup analysis showed good agreement between LDLChoi and LDLdirect (ICC > 0.75) in population 2, whose LDLdirect < 70 mg/dL. For samples with high triglycerides (> 400 mg/dL), equation accuracy varied. Categorization concordance according to the National Cholesterol Education Program Adult Treatment Panel III criteria with the other 11 equations were less than 80%; that of LDLChoi was 87.6 and 87.4% in populations 1 and 2, respectively.ConclusionsAccuracy of 12 equations for LDLcal varied by cohort and subgroup based on LDLdirect and triglycerides. A laboratory-specific equation for LDLcal and/or LDLdirect may be needed for accurate evaluation of LDL status.

Association between Depression and hs-CRP Blood Levels in Korean Adults: Using the National Health and Nutrition Survey 2018

Association between Depression and hs-CRP Blood Levels in Korean Adults: Using the National Health and Nutrition Survey 2018

Relationship between urinary cotinine and serum vitamin A levels in Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES), 2016-2018.

ObjectiveTo examine the relationship between urinary cotinine and serum vitamin A levels in Korean adults.MethodsA total of 4445 adults (age ≥19 years) participating in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 to 2018 were classified by sex and as smokers/electronic cigarette users (SE) or non-smokers (NS). Data were analyzed using complex sample general linear models.ResultsThere were no differences in dietary intake of vitamin A, carotene, or retinol between the SE and NS groups. Adjusted mean serum vitamin A levels were higher in the SE group compared with those in the NS group (0.63 mg/L vs 0.60 mg/L among men; 0.55 mg/L vs 0.51 mg/L among women). Among all participants, urinary cotinine and serum vitamin A levels were positively correlated (R2 = 0.037). However, no correlation was observed in either the SE or NS groups individually. In a model adjusted for age, body mass index, sex, frequency of binge drinking, and dyslipidemia, a stronger correlation was observed (R2 = 0.244).ConclusionIn Korean adults, urinary cotinine levels were positively associated with serum vitamin A levels. Mean serum vitamin A levels were significantly higher in the SE group compared with the NS group.

Association between Dietary Carbohydrate Intake and Cardiovascular Risk Factors According to Low-Density Lipoprotein Cholesterol Levels in Korean Adults

Background: Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets.Methods: A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels.Results: Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol &lt;130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol &lt;130 mg/dL.Conclusions: High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

Correlation Analysis of Ascorbic Acid Intake and Blood Lead Levels in Korean Adults: Results from the Korean National Health and Nutritional Examination Survey, 2016

Correlation Analysis of Ascorbic Acid Intake and Blood Lead Levels in Korean Adults: Results from the Korean National Health and Nutritional Examination Survey, 2016

Interaction between visceral adiposity and ambient air pollution on LDL cholesterol level in Korean adults.

Although previous reports have found that obesity intensifies the negative impact of long-term air pollution exposure on the low-density lipoprotein-cholesterol (LDL-C) level, few studies have examined whether the type of abdominal adiposity, such as visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and the visceral-to-subcutaneous fat ratio (VSR) affects this relationship. We investigated the association between ambient air pollution and LDL-C in Korean adults and identified whether this association is different by the type of abdominal adiposity. A total of 2737 adults were included. Abdominal fat areas were quantified by computed tomography, and the annual average concentration of air pollutants was included in this analysis. In the total sample, none of the air pollutants was associated with LDL-C level in either the crude or adjusted model (all p > 0.05). The association was not significant even in subgroups stratified according to the obesity status defined by body mass index, and no interaction on the LDL-C level was also found (all pint > 0.05). In the subgroup analysis stratified according to adiposity level, particulate matter with an aerodynamic diameter of ≤10 μm (PM10) [β (SE) = 3.58 (1.59); p = 0.0245] and sulfur dioxide (SO2) exposures [β (SE) = 2.71 (1.27); p = 0.0330] in the high-VAT group were associated with the increased LDL-C level. Interactions on LDL-C level were also found between VAT level and ambient air pollutants such as PM10 and SO2 (both pint < 0.05). In the analysis of the VSR, PM10 exposure showed a significant interaction on LDL level (pint = 0.0032). However, the strength of these associations was not significant across all SAT subgroup (all pint > 0.05). In conclusion, we found that association between air pollution exposure and LDL-C level is different by abdominal fat distribution.