PURPOSE: The objective of this study was to determine whether the progressive increase of metabolic syndrome (MetS) score, the number of components of MetS, is correlated significantly with increasing pulse pressure (PP). MATERIALS AND METHODS: 4,034 subjects were enrolled from the Cardiovascular Genome Center of Yonsei University (M:F=2344:1690, 55.2 +/- 10.5). Most of the study population were recruited from hypertension clinics, controlled with medications according to JNC7 guidelines. The Asian modified criteria of MetS were applied and MetS score was estimated. The HOMA index for insulin resistance, cholesterol profiles, and anthropometric measurements were assessed. RESULTS: Among 4034 participants, 1690 (41.9%) were classified as MetS. Progressive increase in PP was demonstrated for increasing components of the MetS score. Multiple linear regression analysis with PP as the dependent variable showed that age (beta=0.311, p < 0.001), MetS score (beta=0.226, p < 0.001), male gender (beta=-0.093, p < 0.001) and HOMA index IR (beta=0.033, p=0.03) are significantly associated with PP (R(2)=0.207, p < 0.001). CONCLUSION: The present results from this study demonstrate that increasing MetS score is an independent determinant of increasing PP. The results also demonstrate the independent role of MetS in increasing arterial stiffness and PP.
Adult ; Age Distribution ; Aged ; Blood Pressure ; Female ; Humans ; Male ; Metabolic Syndrome X/*epidemiology/physiopathology ; Middle Aged

OBJECTIVES: This study was performed to assess the association between physical activity and the clustering of metabolic abnormalities among Korean children. The effect of substituting moderate to vigorous physical activity for the time spent in inactivity was examined as well. METHODS: The study subjects were comprised of 692 (354 boys, 338 girls) 4th grade elementary school students. We used a modified form of the physical activity questionnaire that was developed in the Five-City Project. The subjects with clustering of metabolic abnormalities were defined as having two or more of the following five characteristics: waist circumference > or =90 %, systolic or diastolic blood pressure > or =90 %, fasting glucose > or =110 mg/dl, triglycerides > or =110 mg/dl and HDL cholesterol < or =40 mg/dl. We calculated the odds ratios to assess the effect of substituting moderate to vigorous physical activity for time spent in inactivity. RESULTS: The risk of clustered metabolic abnormalities was inversely correlated with the increased time spent on moderate to vigorous physical activity, but the correlation was not significant. The odds ratio for clustering of metabolic abnormalities that represented the effect of substituting moderate to vigorous physical activity for 30minutes of sedentary activity was 0.87 (95% CI=0.76-1.01). CONCLUSIONS: These findings suggest that substituting moderate to vigorous physical activity for sedentary activity could decrease the risk of clustered metabolic abnormalities.
Blood Glucose/metabolism ; Blood Pressure ; Child ; Cholesterol, HDL ; *Exercise ; Female ; Humans ; Male ; Metabolic Syndrome X/diagnosis/*epidemiology ; Questionnaires ; Risk Factors ; Triglycerides/blood ; Urban Population ; Waist Circumference

Obese individuals are less able to oxidize fat than non-obese individuals. Caloric reduction or fasting can detect ketonuria. We investigated the differences of metabolic parameters in the presence of ketonuria after a minimum 8 hr fast in a cross-sectional analysis of 16,523 Koreans (6,512 women and 10,011 men). The relationship between the presence of ketonuria of all subjects and prevalence of obesity, central obesity, metabolic syndrome, and obesity-related metabolic parameters were assessed. The ketonuria group had lower prevalence of obesity, central obesity, and metabolic syndrome than the non-ketonuria group. In addition, all metabolic parameters (including body weight, waist circumference, blood glucose, high-density lipoprotein, triglyceride, blood pressure, and insulin) were favorable in the ketonuria group than in the non-ketonuria group, even after adjustment for age, tobacco use, and alcohol consumption. The odds ratios of having obesity (odds ratio [OR]=1.427 in women, OR=1.582 in men, P<0.05), central obesity (OR=1.675 in women, OR=1.889 in men, P<0.05), and metabolic syndrome (OR=3.505 in women, OR=1.356 in men, P<0.05) were increased in the non-ketonuria group compared to the ketonuria group. The presence of ketonuria after at least an 8 hr fast may be indicative of metabolic superiority.
Blood Glucose/analysis ; Blood Pressure ; Body Weight ; Cross-Sectional Studies ; *Fasting ; Female ; Humans ; Insulin/blood ; Ketosis/*complications/diagnosis ; Lipoproteins, HDL/blood ; Male ; Metabolic Syndrome X/*complications/epidemiology ; Obesity/complications/epidemiology ; Odds Ratio ; Time Factors ; Triglycerides/blood ; Waist Circumference

Serum carbohydrate antigen 125 (CA-125) is a marker of ovarian cancer and obesity that is related with an increased risk of ovarian cancer. Obesity is a key factor of metabolic syndrome. We evaluated the relationship between CA-125 concentration and metabolic syndrome. The data from subjects who had any cancer and chronic infection were excluded. The data of 12,196 healthy Korean women were analyzed. After CA-125 concentration was divided by quartiles, the prevalence of metabolic syndrome and its components were compared. The lowest quartile of CA-125 compared with the highest quartile showed elevated values of most of metabolic parameters. In addition, as the quartile of CA-125 increased, metabolic derangement decreased. Increased numbers of metabolic syndrome components showed an inverse association with CA-125 levels (P < 0.001). The odds ratio (OR) for the lowest CA-125 quartile vs the highest CA-125 quartile significantly increased in the presence of metabolic syndrome (OR = 1.202, 95% Confidence Interval [CI] 1.013-1.423), elevated triglyceride (OR = 1.381, 95% CI 1.167-1.633), and low high-density lipoprotein cholesterol (OR = 1.168, 95% CI 1.039-1.312). The presence of metabolic syndrome, elevated triglyceride, or low high-density lipoprotein cholesterol negatively correlates with CA-125 concentration.
Adult ; Aged ; Aged, 80 and over ; CA-125 Antigen/*blood ; Cholesterol, HDL/*blood ; Female ; Humans ; Membrane Proteins/*blood ; Metabolic Syndrome X/*blood/complications/epidemiology ; Middle Aged ; Obesity/complications/epidemiology ; Republic of Korea ; Risk Factors ; Triglycerides/*blood

The objective of this study was to examine the relationship between dairy product intake and the incidence of metabolic syndrome (MetS) and its components among middle-aged Koreans. We examined 7,240 adults aged 40-69 yr without MetS at baseline over a 45.5-month follow-up period. They were taken from the Anseong and Ansan cohort of the Korean Genome and Epidemiology Study. Dairy product intake including milk, yogurt, and cheese was assessed with food frequency questionnaire. At the follow-up, the incidence of MetS was 17.1%. The incidences of MetS components were as follows: low HDL cholesterol (16.2%), abdominal obesity (14.0%), hypertriglyceridemia (13.8%), hyperglycemia (13.3%), and hypertension (13.1%). Adjusting for potential confounders, dairy product consumption frequency was inversely associated with the risk of MetS and abdominal obesity. Hazard ratio (HR) (95% confidence interval) for dairy product consumption more than 7 times/week compared to never was 0.75 (0.64-0.88, P for trend < 0.001) for MetS and 0.73 (0.61-0.88, P for trend < 0.001) for abdominal obesity. HR for milk intake was 0.79 for MetS and 0.82 for abdominal obesity. The results of this study suggest that daily intake of dairy products protects against the development of MetS, particularly abdominal obesity, in middle-aged Koreans.
Adult ; Aged ; Cholesterol, HDL/blood ; Cohort Studies ; *Dairy Products ; *Diet ; Female ; Follow-Up Studies ; Humans ; Hypertension/epidemiology ; Hypertriglyceridemia/epidemiology ; Incidence ; Male ; Metabolic Syndrome X/*epidemiology ; Middle Aged ; Obesity, Abdominal/epidemiology ; Proportional Hazards Models ; Questionnaires ; Republic of Korea/epidemiology ; Risk Factors

The metabolic syndrome (MetS) is the clustering of cardiovascular risk factors and known as a powerful predictor of diabetes and cardiovascular disease. Glycated hemoglobin (HbA1c) is used as one of the diagnostic criteria for diabetes and category of increased risk for diabetes. We examined the usefulness of HbA1c as a diagnostic tool for MetS and to determine the cut-off value of HbA1c as a criterion for MetS, in non-diabetic Korean subjects. We analyzed 7,307 participants (male: 4,181, 57%) in a medical check-up program, and applied the newly recommended guidelines of the International Diabetes Federation for diagnosis of MetS. The mean HbA1c was 5.54% in all subjects and showed no significant difference between genders. Using receiver-operating characteristic curve, HbA1c value corresponding to the fasting plasma glucose value of 100 mg/dL was 5.65% (sensitivity 52.3%, specificity 76.7%). The prevalence of MetS was 8.5% according to the IDF guideline and 10.9% according to HbA1c value of 5.7%, showing 69.5% agreement rate. The detection rate of MetS increased to 25.7% using the HbA1c criterion of 5.7% instead of fasting hyperglycemia. This study suggests that HbA1c might be used as a diagnostic criterion for MetS and the appropriate cut-off value of HbA1c may be 5.65% in this Korean population.
Adult ; Blood Glucose/analysis ; Chromatography, High Pressure Liquid ; Female ; Hemoglobin A, Glycosylated/*analysis ; Humans ; Male ; Metabolic Syndrome X/*diagnosis/epidemiology ; Middle Aged ; Prevalence ; ROC Curve ; Risk Factors

PURPOSE: Considerable amount of interest has been focused on the positive relationship between inflammation and the metabolic syndrome (MS). However, few studies have been performed to evaluate the relationship between baseline white blood cell (WBC) count and future risk for developing MS. Therefore, we investigated whether the baseline plasma levels of WBC count could be associated with future risk for MS in apparently healthy Korean. MATERIALS AND METHODS: A total of 1135 subjects (781 men and 354 women with a mean age of 49 years), who underwent health examinations at Kangbuk Samsung Hospital in both 2002 and 2005 were enrolled. The presence of MS was defined using the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III using BMI instead of waist circumference. RESULTS: The baseline levels of WBC count were significantly higher among incident MS cases than among subjects without MS. The relative risks of incident MS were 1.4, 3.2 and 2.7 for WBC quartiles 2, 3, and 4, respectively, when compared with the first quartile (p-value for trend <0.001). These positive associations persisted after adjustment for baseline body mass index, blood pressure, fasting glucose, high density lipoprotein-cholesterol, triglyceride and homeostatic model assessment-insulin resistance; adjusted relative risk of incident MS for the 2nd, 3rd and 4th quartile groups vs. the lowest quartile were 1.2, 2.4 and 1.7, respectively (p-value for trend =0.011). CONCLUSION: This retrospective cohort study suggests that an elevated WBC count could be associated with incident MS, suggesting that baseline inflammation mirrored by WBC level can impact future MS development.
Adult ; Body Mass Index ; Female ; Humans ; Leukocyte Count ; Male ; Metabolic Syndrome X/*blood ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors

OBJECTIVES: The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). METHODS: We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings: elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. RESULTS: The MS was more common in those persons with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval ; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. CONCLUSIONS: Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.
Adult ; Aged ; Blood Glucose ; Blood Pressure ; Body Weights and Measures ; Cohort Studies ; Cross-Sectional Studies ; Female ; Ferritins/*blood ; Health Behavior ; Humans ; Korea/epidemiology ; Lipids/blood ; Male ; Metabolic Syndrome X/*epidemiology ; Middle Aged ; Risk Factors ; *Rural Health

PURPOSE: The prevalence of metabolic syndrome (MetS) generally varies depending on its diagnostic definition, and many different definitions inevitably lead to substantial confusion and lack of comparability between studies. Despite extensive research, there is still no gold standard for the definition of MetS, which continues to be a matter of debate. In this study, we investigate whether and to what extent its individual components are related to the risk of cardiovascular disease (CVD) in Korean population. MATERIALS AND METHODS: We used data from the 2005 Korea National Health and Nutrition Examination Survey, which is a nationally representative survey of the noninstitutionalized civilian population. The study sample consisted of 1,406 Korean adults (587 men, 819 women) who were diagnosed with MetS based on the revised National Cholesterol Education Program (NCEP) criteria. Central obesity is defined as a waist circumference cutoff point reported in Asia-Pacific criteria for obesity based on waist circumference by the World Health Organization. CVD was defined as presence of stroke, myocardial infarction, or angina pectoris on a medical history questionnaire. RESULTS: The CVD prevalence among the subjects was 6.8% for men and 8.6% for women. Besides age, the components of MetS showing a significant difference in the number of CVD events were high fasting glucose (FG) in men and high blood pressure (BP) and high FG in women. After adjusting for gender and age, high FG was shown to yield a significant difference (odds ratio: unadjusted 2.08, adjusted 1.81), alone among all MetS components. However, after adjusting for only age, no significant difference was found. CONCLUSION: Fasting glucose level is the highest predicting factor for CVD in Korean patients with MetS based on the revised NECP definition.
Age Factors ; Blood Glucose/analysis ; Cardiovascular Diseases/epidemiology/*etiology ; Chi-Square Distribution ; Female ; Health Promotion ; Health Surveys ; Humans ; Hypertension/complications/epidemiology ; Male ; Metabolic Syndrome X/complications/*diagnosis/epidemiology ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors

BACKGROUND/AIMS: Reports of the prevalence of and trends in metabolic syndrome in Korea have been inconsistent. Thus, we investigated the reasons underlying these inconsistencies. METHODS: We estimated the prevalence of metabolic syndrome using different diagnostic criteria, exclusion criteria, and sampling weights among 5,509 respondents, aged 20-79, who participated in the 2001 Korean National Health and Nutrition Examination Surveys (KNHANES). Trends in metabolic syndrome were assessed by examining the 1998 (n = 6,747), 2001 (n = 4,337), and 2005 (n = 5,139) KNHANES. RESULTS: The estimated prevalence of metabolic syndrome in 2001 ranged from 1.6 to 29.6% in males and from 10.1 to 32.8% in females, depending on the diagnostic criteria used. The exclusion criteria and sampling weights did not significantly affect the prevalence estimates. The prevalence of metabolic syndrome first significantly increased and then decreased between 1998, 2001, and 2005 in males (26.2, 29.6, and 27.2%, respectively) and females (29.2, 32.8, and 24.7%, respectively). Among the individual metabolic variables, triglyceride levels in 2001 were significantly higher than in 1998 and 2005, whereas other variables remained relatively constant during the same period. The exceptionally high triglyceride levels in 2001 might have contributed to the increased prevalence of metabolic syndrome between 1998 and 2001. CONCLUSIONS: Different diagnostic criteria for metabolic syndrome represent a major cause of the inconsistent estimates of prevalence, and the absence of standardized laboratory methods might have affected the trend estimates.
Adult ; Aged ; Body Mass Index ; Cholesterol, HDL/blood/metabolism ; Cholesterol, LDL/blood/metabolism ; Epidemiologic Methods ; Female ; Health Surveys ; Humans ; Korea/epidemiology ; Male ; Metabolic Syndrome X/*epidemiology ; Middle Aged ; Prevalence ; Risk Assessment/methods ; Triglycerides/blood/metabolism ; Young Adult