OBJECTIVES: Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene early B-cell factor 1 (EBF1), which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults. METHODS: A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling. RESULTS: The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model (p(int)<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model (p(int)<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05). CONCLUSIONS: These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.
Adiposity* ; Adult ; B-Lymphocytes* ; Cardiovascular Diseases ; Chronic Disease ; Gene-Environment Interaction ; Genome-Wide Association Study ; Genotype ; Humans ; Intra-Abdominal Fat ; Linkage Disequilibrium ; Models, Genetic ; Obesity ; Obesity, Abdominal ; Polymorphism, Single Nucleotide ; Waist-Hip Ratio

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

OBJECTIVES: This study was intended to examine the seasonal differences in outdoor activity times and dietary vitamin D intakes, and explicates their relative impact on improving serum 25-(OH) vitamin D status among Korean young women. METHODS: A cross-sectional study was conducted with 135 free-living women aged 19-39 years in Daegu-Kyungbook, Korea. We compared the results from 52 women for the summer and 83 women for the winter. Dietary intake of vitamin D was assessed by 24 hour recall method for non-consecutive three days as well as by food frequency method. Daily outdoor activity times were derived from 24 hour physical activity diary. RESULTS: The average dietary intake of vitamin D of the participants by 24 hour recall method was 3.1 microg during the summer, 3.3 microg during the winter, showing no significant difference between the two seasons. Times spent on outdoor activities (p < 0.01) in the summer (= 23.8 +/- 23.6 min) were much longer than that in the winter (= 10.8 +/- 13.4 min). The serum 25-(OH) vitamin D levels of participants were 17.5 +/- 7.5 ng/mL in the summer and 13.4 +/- 4.3 ng/mL in the winter, showing that the latter was significantly lower than that of the former (p < 0.001). The serum 25-(OH) vitamin D levels of subjects were positively related to outdoor activities (r = 0.315, p < 0.05) during the summer, while related to dietary intake (r = 0.252, p < 0.05) during the winter. CONCLUSIONS: In order to improve the current vitamin D status of Korean young women, nutrition education programs should focus on increasing more dietary intake especially during the winter, and performing more outdoor activities in other seasons.
Cross-Sectional Studies ; Education ; Female ; Humans ; Korea ; Motor Activity ; Seasons* ; Vitamin D*

OBJECTIVES: The purpose of this study was to examine the relative impact of seasonal differences and age on dietary vitamin D intakes, outdoor activity time and serum vitamin D status among Korean postmenopausal women. METHODS: A cross-sectional study was conducted with 164 free-living postmenopausal women (mean age=55.4 years) in Daegu, Korea. Dietary intake, daily physical activity patterns and fasting blood samples were collected during summer and winter. We compared the results from 75 women during summer and 89 women during winter. Dietary intake of vitamin D was assessed by 24-hour recall method. Daily outdoor activity time was derived from physical activity diary. RESULTS: The average dietary intake of vitamin D of the participants was 3.7 microg during summer, 3.3 microg during winter, showing no significant difference between the two seasons. The average time spent on outdoor activities was not significantly different between summer (=35.1 +/- 75.0 min/d) and winter (=48.5 +/- 76.8 min/d). The average serum 25-(OH) vitamin D concentrations of participants was 17.5 +/- 7.5 ng/mL in the summer and 13.4 +/- 4.3 ng/mL in the winter, showing no significant differences by season. Dietary intake of vitamin D was not related to age. When total subjects were divided into two groups by age, the average serum 25-(OH) vitamin D concentration was significantly higher in older group (p=0.047) and time spent on outdoor activities was also (p=0.018) significantly higher in the older group. CONCLUSIONS: In order to improve the current vitamin D status of Korean postmenopausal women, nutrition education programs should focus more on adequate intake of vitamin D, while maintaining enough outdoor activities over the season.
Cross-Sectional Studies ; Daegu ; Education ; Fasting ; Female ; Humans ; Korea ; Motor Activity ; Seasons* ; Vitamin D*

Premature infants with respiratory distress syndrome may have clinically significant shunting through a patent ductus arteriosus (PDA). Left-to-right shunting through the PDA may lead to left ventricular volume overload and pulmonary edema. We present a case of perioperative management for severe respiratory distress syndrome in a premature infant who underwent surgical closure of PDA. Under general anesthesia, the infant was successfully managed by inhaled nitric oxide, high frequency oscillation ventilation with intermittent mandatory ventilation despite intermittent hypoxia. The operation was performed safely in the neonatal intensive care unit.
Anesthesia, General ; Anoxia ; Ductus Arteriosus, Patent* ; High-Frequency Ventilation ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Nitric Oxide ; Pulmonary Edema ; Ventilation

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that is characterized by inflammation of the synovial tissue and deterioration of the joint and bone. A recent study reported a potential gene-environment interaction between HLA-DR and smoking. The present study investigated whether a specific gene was related to the association between smoking and the severity of RA (rheumatoid factor levels > 20 IU/ml). We used the resources of the NARAC family collection of GAW 15 databases, and 1139 subjects with RF > 20 IU/ml were included in the current analysis. The linkage panel contained 5858 SNP markers, and 5744 SNPs passed quality control criteria. Linear regression analyses, using PLINK software and generalized estimating equation regression models, were used to test for associations between the SNPs and the severity of RA according to smoking groups. Two major findings were established. First, the severity of RA in smokers was associated with rs703618 (p=6x10(-5)), which lies in the intronic region of the stabilin 2 (STAB2) gene on chromosome 12. Second, there were significant differences in the levels of RF between 'ever smokers' and 'never smokers' according to the rs703618 genotype (G/G, A/G, A/A). We investigated whether a specific gene acts as a mediator between smoking and the severity of RA and found that the STAB2 gene could affect this relationship. Our finding indicates that smoking may mediate RA severity by affecting the expression level of a specific gene.
Arthritis ; Arthritis, Rheumatoid ; Chromosomes, Human, Pair 12 ; Gene-Environment Interaction ; Genotype ; HLA-DR Antigens ; Humans ; Hyaluronic Acid ; Inflammation ; Introns ; Joints ; Linear Models ; Polymorphism, Single Nucleotide ; Quality Control ; Smoke ; Smoking

Objectives: Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population. Methods: In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index. Results: The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively. Conclusions Chronic exposure to cadmium showed positive associations with liver damage.

Adult ; Cross-Sectional Studies ; Dermatitis, Atopic ; Diagnosis ; Epidemiologic Studies ; Health Surveys ; Humans ; Immune System ; Information Services ; Korea ; Odds Ratio ; Parks, Recreational ; Rhinitis, Allergic

BACKGROUND: Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults. METHODS: In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service. RESULTS: The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively. CONCLUSIONS We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.

BACKGROUND: Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults. METHODS: In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service. RESULTS: The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively. CONCLUSIONS We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.