BACKGROUND: Body mass index (BMI) and waist circumference (WC) are associated with cardiovascular (CV) risk factors. The aim of this study was to investigate the correlation of CV risk factors by cross-tabulating central obesity with multiple BMI categories in Korea. METHODS: A total of 328,789 adults aged 30–84 years who completed health assessments for National Health Insurance in 2012–2013 in Korea were examined. The participants were divided into two WC and five BMI groups to investigate CV risk factors, including metabolic syndrome (MetS), hypertension, diabetes, and dyslipidemia. RESULTS: The proportions of central obesity and obesity were 24.2% and 39.5% in men and 19.4% and 28.1% in women, respectively, according to the Korean Society for the Study of Obesity and World Health Organization Asia-Pacific Guideline criteria. The odds ratios (ORs) of CV risk factors in all sexes increased with increases in BMI and WC. Compared to the group with a normal WC and BMI, the adjusted ORs (95% confidence intervals) for having MetS and diabetes in the centrally obese and highest BMI group (BMI ≥30.0 kg/m²) were 35.95 (33.75–38.30) and 3.51 (3.26–3.77) in men and 29.22 (27.36–31.20) and 4.35 (4.02–4.70) in women, respectively. Participants who were centrally obese and obese (BMI ≥25.0 kg/m²) had the strongest correlation with all CV risk factors compared with those who were not centrally obese or obese. CONCLUSION: The presence of central obesity in multiple BMI categories may significantly identify individuals at increased risk of CV risk factors.
Adult ; Body Mass Index* ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Female ; Humans ; Hypertension ; Korea* ; Male ; National Health Programs ; Obesity ; Obesity, Abdominal* ; Odds Ratio ; Risk Factors* ; Waist Circumference ; World Health Organization

Postmenopausal women aged 50s generally experience gradual changes in body such as decline in antioxidant and estrogen levels as the body ages. To overcome these aging-associated changes, the needs for health functional foods are increasing. Dendropanax morbifera (DM) have antioxidant effects, anti-inflammatory against cancer cells, antidiabetic, and antiatherogenic effect which are associated with postmenopausal symptoms. We analyzed clinical effects of DM on aging-related symptoms by reporting their antioxidant, anticancer and inflammatory activity, etc. and their bioactivity. Data sources EMBASE, SCOPUS, PubMed, Web of Science, and Google Scholar databases were searched up to August 2016 for studies investigating medicinal plants in prevention and treatment of diabetes. The search terms were “Dendropanax morbifera”. The reference lists of articles were also reviewed for additional relevant studies. Extracts of DM have various efficacy such as antioxidant, anti-cancer, anti-inflammatory activity and anti-thrombotic effect.
Aging ; Antioxidants ; Estrogens ; Female ; Functional Food ; Humans ; Information Storage and Retrieval ; Menopause ; Plant Extracts ; Plants, Medicinal

The prevalence and progression of non-alcoholic fatty liver disease (NAFLD) is mediated via several factors correlating with hepatic necroinflammation (adipokines/cytokines). This study was performed to analyze the level of inflammatory markers according to the presence of NAFLD and to identify related nutritional factors. A total of 80 adults were classified into 2 groups (healthy and NAFLD), and their body composition, blood tests, and eating habits were evaluated. In addition, inflammatory markers (adiponectin, high-sensitivity C-reactive protein [CRP], and tumor necrosis factor-alpha [TNF-α]), nutrient intake status, and dietary quality were compared. The quality of diet was assessed according to the nutrient adequacy ratio and the mean adequacy ratio (MAR). The NAFLD group had a higher body mass index (p < 0.001) than the healthy group and also carried significantly higher CRP levels (p < 0.001) but lower adiponectin (p = 0.001). TNF-α levels increased significantly with fatty liver grade (p = 0.023). The NAFLD group showed significantly higher intake of energy, carbohydrates, iron, sodium, vitamin A and saturated fatty acids, but significantly lower intake of zinc and vitamin E than the healthy group. The MAR values were slightly higher in the NAFLD group but without any significant difference. The levels of adiponectin and vitamin E showed a significant inverse correlation (p < 0.05). Nutritional management of NAFLD patients is important, and the intake of antioxidant and anti-inflammatory nutrients such as zinc and vitamin E should be emphasized.

The prevalence and progression of non-alcoholic fatty liver disease (NAFLD) is mediated via several factors correlating with hepatic necroinflammation (adipokines/cytokines). This study was performed to analyze the level of inflammatory markers according to the presence of NAFLD and to identify related nutritional factors. A total of 80 adults were classified into 2 groups (healthy and NAFLD), and their body composition, blood tests, and eating habits were evaluated. In addition, inflammatory markers (adiponectin, high-sensitivity C-reactive protein [CRP], and tumor necrosis factor-alpha [TNF-α]), nutrient intake status, and dietary quality were compared. The quality of diet was assessed according to the nutrient adequacy ratio and the mean adequacy ratio (MAR). The NAFLD group had a higher body mass index (p < 0.001) than the healthy group and also carried significantly higher CRP levels (p < 0.001) but lower adiponectin (p = 0.001). TNF-α levels increased significantly with fatty liver grade (p = 0.023). The NAFLD group showed significantly higher intake of energy, carbohydrates, iron, sodium, vitamin A and saturated fatty acids, but significantly lower intake of zinc and vitamin E than the healthy group. The MAR values were slightly higher in the NAFLD group but without any significant difference. The levels of adiponectin and vitamin E showed a significant inverse correlation (p < 0.05). Nutritional management of NAFLD patients is important, and the intake of antioxidant and anti-inflammatory nutrients such as zinc and vitamin E should be emphasized.

OBJECTIVES: The association between smoking and obesity is a significant public health concern. Both are preventable risk factors of cardiovascular disease and a range of other conditions. However, despite numerous previous studies, no consensus has emerged regarding the effect of smoking on obesity. We therefore carried out a novel study evaluating the relationship between smoking and obesity. METHODS: A total of 5,254 subjects aged 19 years or older drawn from the 2010-2013 Korea National Health and Nutrition Examination Survey were included in this cross-sectional study. Smoking was examined both in terms of smoking status and the quantity of cigarettes smoked by current smokers. Multiple logistic regression analysis was used to assess the association between smoking and obesity. Overall obesity was defined as a body mass index (BMI) ≥25 kg/m2, and central obesity was defined as a waist circumference ≥90 cm for males and ≥85 cm for females. We adjusted for the possible confounding effects of age, sex, physical activity, alcohol consumption, and the presence of hypertension or diabetes. RESULTS: A statistically significant difference in central obesity according to smoking status was identified. Current smokers were more likely to be centrally obese than never-smokers (adjusted odds ratio,1.30; 95% confidence interval, 1.02 to 1.67). However, no significant association was found between smoking and obesity defined by BMI. Moreover, among current smokers, no statistically significant association was found between the daily amount of smoking and obesity or central obesity. CONCLUSIONS: Smoking was positively associated with central obesity. Current smokers should be acquainted that they may be more prone to central obesity.
Alcohol Drinking ; Body Mass Index ; Cardiovascular Diseases ; Consensus ; Cross-Sectional Studies* ; Female ; Humans ; Hypertension ; Korea* ; Logistic Models ; Male ; Motor Activity ; Nutrition Surveys* ; Obesity* ; Obesity, Abdominal* ; Public Health ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products ; Waist Circumference

Dysphagia secondary to peripheral cranial nerve injury originates from weak and uncoordinated contraction-relaxation of cricopharyngeal muscle. We report on two patients who suffered vagus nerve injury during surgery and showed sudden dysphagia by opening dysfunction of upper esophageal sphincter (UES). Videofluoroscopy-guided balloon dilatation of UES was performed. We confirmed an early improvement of the opening dysfunctions of UES, although other neurologic symptoms persisted. While we did not have a proper comparison of cases, the videofluoroscopy-guided balloon dilatation of UES is thought to be helpful for the early recovery of dysphagia caused by postoperative vagus nerve injury.
Cranial Nerve Injuries ; Deglutition Disorders ; Dilatation* ; Esophageal Sphincter, Upper* ; Humans ; Muscles ; Neurologic Manifestations ; Vagus Nerve Injuries* ; Vagus Nerve*

BACKGROUND: Nefopam is a centrally acting, non-opioid analgesic drug used to reduce opioid consumption and so reduce the prevalence of postoperative nausea and vomiting (PONV). This study compared and assessed the effects of nefopam and ketorolac on postoperative pain and PONV after thyroid surgery. METHODS: Two hundred patients underwent total thyroidectomy with central compartment neck dissection in our hospital during a 5 month enrollment period. Group N and Group T was administered nefopam 20 mg and ketorolac 30 mg, respectively, during the last 30 minutes of surgery. Pain was measured using a 10-point numerical rating scale. Pain scores and PONV were assessed 30 min, 1, 6, and 24 h postoperatively. RESULTS: Pain scores and episodes of vomiting and shivering did not differ significantly between the two groups. Group N patients experienced fewer episodes of nausea at 30 min, 1 h and 6 h after the operation. CONCLUSIONS: Nefopam and ketorolac are similarly effective in reducing postoperative pain after thyroid surgery. Postoperative nausea was less in Group N patients within 6 h postoperatively, especially 1 h. Nefopam is favored for pain management after thyroidectomy.
Double-Blind Method* ; Humans ; Ketorolac* ; Nausea ; Neck Dissection ; Nefopam* ; Pain Management ; Pain, Postoperative* ; Postoperative Nausea and Vomiting ; Prevalence ; Shivering ; Thyroid Gland ; Thyroidectomy* ; Vomiting

OBJECTIVE: Fitz-Hugh-Curtis syndrome (FHCS) is characterized by perihepatitis in patients with pelvic inflammatory disease. Hepatic capsular enhancement in arterial phase of abdominal computed tomography (CT) is usually required for definite diagnosis. The objective of this study was to assess clinical significance of intensity of hepatic capsular enhancement in CT of patients with FHCS. METHODS: A total of 86 patients who had hepatic capsular enhancement in CT due to FHCS were retrospectively enrolled. The hepatic capsular enhancement was divided into three patterns according to the intensity of enhancement by an expert radiologist: A, partial weak enhancement; B, partial strong or diffuse weak enhancement; and C, diffuse strong enhancement. Other clinical and laboratory parameters such as duration of admission were also evaluated. RESULTS: Hepatic capsular enhancement in CT was classified into pattern A (n=28), pattern B (n=35), and pattern C (n=23). Hospital stay was significantly shorter in pattern A (6.1±2.4 days, P<0.001) than that in pattern B (7.2±2.9 days) or pattern C (7.7±2.2 days). Subjective perihepatic pain duration was well correlated with the degree of hepatic capsular enhancement (P<0.001). In multivariate analysis, the intensity of capsular enhancement was significantly associated with hospital stay after adjusting other factors. However, laboratory inflammation marker was not directly correlated with hepatic capsular enhancement. CONCLUSION Enhancement pattern of CT scan in patients with FHCS is closely related to its clinical severity and the course of this disease.

Background/Aims: Several noninvasive scoring systems have been developed to determine the risk of advanced fibrosis in nonalcoholic fatty liver disease (NAFLD). We examined the diagnostic accuracy of the fibrosis-4 (FIB-4) score and NAFLD fibrosis score (NFS) in patients with biopsy-proven NAFLD. Methods: For this meta-analysis, various databases including PubMed (MEDLINE), EMBASE, OVID Medline and the Cochrane Library were systematically searched. After the acquired abstracts were reviewed by two investigators, manuscripts were chosen for a full-text examination. Results: Thirty-six studies evaluating biopsy-proven NAFLD were selected for meta-analysis. A total of 14,992 patients were analyzed. The lower cutoff sensitivity of the FIB-4 score predicting histological fibrosis stage 3 or more (≥F3) was 69%, with specificity of 64%, positive likelihood ratio (LR+) of 1.96, and negative likelihood ratio (LR–) of 0.47. The low baseline sensitivity of the NFS score predicting ≥F3 was 70%, with a specificity of 61%, LR+ of 1.83, and LR– of 0.48. The area under the receiver operating characteristic curve (AUC) values of the FIB-4 score predicting ≥F3 and ≥F2 were 76% and 68%, respectively. The AUC values of the NFS score predicting ≥F3 and ≥F2 were 74% and 60%, respectively. Conclusions The FIB-4 or NFS test can be used to predict the degree of liver fibrosis in NAFLD, and the diagnostic accuracy resulted as relatively high in fibrosis stages of F3 or higher.

Background: To evaluate the incidence of fractures and fracture risk factors in Korean patients with polymyalgia rheumatica (PMR). Methods: All PMR patients who visited a rheumatology clinic at a tertiary referral hospital between March 2005 and March 2018 were retrospectively assessed. We estimated bone mineral density (BMD) screening rate within 6 months of the first visit and classified the patients according to the performance and results of BMD screening. Incidence rates (IRs) of fractures were calculated in each group and risk factors for fractures were identified using Poisson regression analysis. Results: A total of 95 PMR patients with median (interquartile range) age of 64.0 (56.0–72.0) years were included. Baseline BMD was assessed in only 55.8% of these patients (n = 53); 24 patients with osteoporosis, 20 with osteopenia, and 9 with normal BMD. During 433.1 person-years (PYs) of observation, 17 fractures occurred in 12 patients (IR, 3.93 [95% confidence interval (CI), 2.46–6.26]/100 PYs); 8.32 (95% CI, 4.09–16.90)/100 PYs in the osteopenia group, 3.40 (95% CI, 1.30–8.90)/100 PYs in the osteoporosis group, and 3.37 (95% CI, 1.53–7.39)/100 PYs in the no BMD test group. Risk factors for fractures were female sex, advanced age (≥ 65 years), longer follow-up duration, initial glucocorticoid dose ≥ 10 mg/day, and higher cumulative glucocorticoid dose over the first 6 months. Conclusion The incidence rate of fractures in Korean patients with PMR was 3.93/100 PYs. Female sex, advanced age, longer follow-up duration, and increased glucocorticoid dose are risk factors for osteoporotic fracture.