PURPOSE: This study determined which obesity measurement correlates the best with diabetes and prediabetes. MATERIALS AND METHODS: This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines. RESULTS: After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity. CONCLUSION: Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.
Absorptiometry, Photon ; *Adiposity ; Adult ; Anthropometry ; Asian Continental Ancestry Group/*statistics & numerical data ; Biomarkers/blood ; Body Mass Index ; Cross-Sectional Studies ; Diabetes Mellitus/*ethnology ; Female ; Humans ; *Intra-Abdominal Fat ; Male ; Middle Aged ; Obesity/complications/*ethnology ; Odds Ratio ; Prediabetic State/*ethnology ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Waist Circumference

In our recently published article, there were some missing contents in the Acknowledgments section, which should be properly added as follows.

No abstract available.
Calcium/*analysis ; Coronary Artery Disease/*epidemiology ; Coronary Vessels/*chemistry ; Female ; Humans ; Male ; Metabolic Syndrome X/*epidemiology ; Vascular Calcification/*epidemiology

Diabetes mellitus is a leading cause of mortality and increased disability-adjusted life years worldwide. In Korea, the prevalence of diabetes increased from 8.6% to 11.0% in 2001 to 2013 and the prevalence of adult obesity, which is the most important risk factor of diabetes, increased from 29.2% to 31.8% during the same period. There has been a dramatic increase in the number of obese Koreans with diabetes in recent decades and the prevalence of diabetes in people aged 40 years and older also increased in 2001 to 2013. Nevertheless, the mean age at the first diagnosis of diabetes was very similar for men in 2005 and 2013, while the mean age for women decreased slightly. There is an inverse linear relationship between body mass index and age at the diagnosis of diabetes among those who are newly diagnosed. Accordingly, the prevalence of diabetes is increasingly shifting to younger individuals and those who are obese. Therefore, public efforts should focus on healthy lifestyle changes, primary prevention measures, screening for the early detection of diabetes, and long-term management.
Adult ; Body Mass Index ; Diabetes Mellitus ; Diagnosis ; Epidemiology ; Female ; Humans ; Korea ; Life Style ; Male ; Mass Screening ; Mortality ; Obesity ; Prevalence ; Primary Prevention ; Risk Factors

Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes.
Blood Pressure ; Cholesterol, LDL ; Diabetes Mellitus* ; Education ; Global Health ; Health Promotion ; Humans ; Korea* ; Life Style ; Mass Screening ; Nutrition Surveys ; Prevalence ; Risk Factors ; Self Care

Thirty-two dacryocystorhinostomies were performed in the chronic dacryocystitis and obstruction of the nasolacrimal duct between 1971 and 1976. A routine dacryocystography was performed prior to operation in all cases. A modified Toti's method was applied as a surgical technique; vaseline gauze was used as a plugging agent and both posterior flaps of sac ans nasal mucous membrane was not sutured because of technical difficuty and for prevention of granulation tissue due to suture materials Ranging in age from 22 to 66 years of age; 3 were men and 29 were women. Success was achieved in 29 of 32 cases initially. One of three initial failured cases, which was due to formation of obstructing granulation tissue by suture materials in posterior flap, was turn into succes by secondary operation. We attempted to make this method in 3 cases of shrunken sac: Two were failed. In these cases, if vaseline gauze should removed after more than 10 days, it will be possible to expansion of shrunken sac and to obtained successful result. We also attempted to make this method in 3 cases of macerted sac, and gained successful result. In such a case, it is possible by suturing of anterior flaps of sac and nasal mucous mem brane only. In conclusion, this operation is simple to do and within the range of any ophthalmic surgeon. It is possible in case of macerated sac and shrunken sac.
Dacryocystitis ; Dacryocystorhinostomy* ; Female ; Granulation Tissue ; Humans ; Male ; Mucous Membrane ; Nasolacrimal Duct ; Petrolatum ; Sutures

Over the past several decades, the prevalence of obesity has increased dramatically worldwide and is increasing not only in developed countries, but also in developing countries. This increase may lead to an increase in the incidence of chronic diseases throughout the lifespan. In Korean children and adolescents, the prevalence of obesity increased from 6.8% in 1998 to 10.0% in 2013. Obesity is a state that more commonly influences children and adolescents of lower socioeconomic status (SES) than those with a higher SES. However, the prevalence of metabolic syndrome in a nationally representative sample of Korean adolescents decreased from 1998 to 2012. According to the Diabetes Fact Sheet of the Korean Diabetes Association, the prevalence of type 2 diabetes among children aged 18 years or younger was 153.5 per 100,000 in 2006 and 205.0 per 100,000 in 2013. Obesity is a complex disease influenced by many interacting factors, such as adipocytokines, lipopolysaccharide-binding protein, adenovirus 36 infection, birth weight, lifestyle, and endocrine-disrupting chemicals. Obesity in youth can adversely impact practically every organ system and lead to serious consequences, such as metabolic, gastrointestinal, pulmonary, cardiovascular, and psychosocial complications. Therefore, coordinated efforts by governments, organizations, communities, and individuals are needed to prevent and treat childhood obesity. In particular, a long-term policy to improve the social environment will also be necessary.
Adenoviridae ; Adipokines ; Adolescent ; Birth Weight ; Child ; Chronic Disease ; Developed Countries ; Developing Countries ; Diabetes Mellitus ; Epidemiology* ; Humans ; Incidence ; Korea* ; Life Style ; Obesity ; Pediatric Obesity* ; Prevalence ; Republic of Korea ; Social Class ; Social Environment

Cardiovascular disease is a major cause of mortality and disability worldwide and in Korea as well. Dyslipidemia is considered as a major and modifiable risk factor of cardiovascular disease. In Korea, the prevalence of dyslipidemia in people aged 30 years or older was 47.8% in 2013, with prevalence increasing as age increases. Men had higher prevalence of dyslipidemia than women (men, 57.6%; women, 38.3%). However, the prevalence of dyslipidemia in women increased rapidly after menopause. Furthermore, dyslipidemia is also rising in childhood and adolescents. The prevalence of hypo-HDL cholesterolemia and hypertriglyceridemia were higher than hyper-LDL cholesterolemia. However, hyper-LDL cholesterolemia also has been increasing due to the westernized diet and other lifestyle changes. Atherogenic dyslipidemia, which is the combination of these lipoprotein abnormalities, seems to be increasing. The prevalence of dyslipidemia was higher in obese people, and the prevalence of the metabolic syndrome, which included dyslipidemia as a component of abnormalities, also increased in accordance with dyslipidemia. Also, dyslipidemia in patients with diabetes increased from 27.8% in 2006 to 49.5% in 2013. The awareness and treatment rate of dyslipidemia were lower in comparison with other chronic diseases. By providing information about the risk of dyslipidemia, primary prevention such as weight loss, dietary treatment, and quit smoking and secondary prevention such as early detection and drug treatment are required for reducing the development of cardiovascular disease.
Adolescent ; Cardiovascular Diseases ; Chronic Disease ; Diet ; Dyslipidemias* ; Epidemiology ; Female ; Humans ; Hypertriglyceridemia ; Korea* ; Life Style ; Lipoproteins ; Male ; Menopause ; Mortality ; Obesity ; Prevalence ; Primary Prevention ; Risk Factors ; Secondary Prevention ; Smoke ; Smoking ; Weight Loss

BACKGROUND: Few studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults. METHODS: A total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT) was measured using dual-energy X-ray absorptiometry (DXA). RESULTS: All subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI), waist circumference (WC), and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs) for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05). CONCLUSION: The blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.
Absorptiometry, Photon ; Adiposity* ; Adult* ; Blood Pressure ; Body Mass Index ; Fasting ; Glucose ; Healthy Volunteers ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Male ; Obesity ; Odds Ratio ; Risk Factors ; Waist Circumference

The sodium-glucose cotransporter-2 inhibitor (SGLT2i) is a new anti-hyperglycemic agent that have function to concomitantly inhibit the reabsorption of glucose and sodium in the renal proximal convoluting tubule. Recent two cardiovascular outcome trials showed that a lower risk of cardiovascular events with SGLT2i in people with type 2 diabetes. In addition, prior real-world data demonstrated similar SGLT2i effects, but these studies were limited to the United States and Europe. Thus, the CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors) 2 Study was investigated cardiovascular outcomes in those initiated on SGLT2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. In Korea, 336,644 episodes of initiation in SGLT2i or oGLD group between September 2014 and December 2016 were identified in Korea National Health Insurance database after propensity score matching. SGLT2i users was associated with a lower risk of all-cause death (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.67~0.77), hospitalization for heart failure (HHF) (HR, 0.87; 95% CI, 0.82~0.92), all-cause death or HHF (HR, 0.81; 95% CI, 0.78~0.85), myocardial infarction (HR, 0.81; 95% CI, 0.74~0.89), and stroke (HR, 0.82; 95% CI, 0.78~0.86) compared with oGLD users. In conclusion, initiation of SGLT2i had a lower risk of cardiovascular events in people with type 2 diabetes compared with oGLDs.
Asia ; Cardiovascular Diseases* ; Diabetes Mellitus, Type 2 ; Europe ; Glucose ; Heart Failure ; Hospitalization ; Korea ; Middle East ; Myocardial Infarction ; National Health Programs ; Observational Study* ; Propensity Score ; Sodium ; Stroke ; United States