Recently, obesity (BMI > or =25 kg/m2) and type II diabetes mellitus have reached epidemic proportions in Korea, and rates of nonalcoholic fatty liver disease (NAFLD) are between 10% and 25% of the general population. NAFLD in Korea is as closely associated with several components of metabolic syndrome including, obesity, hypertension, diabetes and dyslipidemia as it is in Western countries. Insulin resistance and hyperinsulinemia may play a role in the pathogenesis of fatty liver in patients with normal body weight as well as in patients with obesity. And, obesity induced accumulation of fat in the adipose tissue leads to an imbalance in the regulation of adipokines, such as downregulation of adiponectin and upregulation of retinol-binding protein 4 (RBP4) and ghrelin. High BMI, the AST/ALT ratio, and ALT levels could be used to distinguish NASH from simple steatosis in Korean patients. In large number of NAFLD patients who underwent a voluntary medical checkup, even a small weight reduction was associated with improvements in their hepatic steatosis grade on ultrasonography, serum aminotransferase levels, and related metabolic abnormalities. Subjects with fatty liver disease should be advised to lose weight through lifestyle modifications. Small animal and human studies of treatment with PPAR agonists and betaine have been reported in the Korean literature. It is now acknowledged that NAFLD is the most common liver disease in Korea, largely due to the considerable increase in metabolic abnormalities such as obesity and diabetes. Future studies should continue to focus both on the pathogenesis and the treatment of NAFLD in order to accumulate more of our own data.
*Fatty Liver/complications/physiopathology/therapy ; Humans ; Korea ; Metabolic Syndrome X/complications ; Risk Factors

Recently, obesity (BMI > or =25 kg/m2) and type II diabetes mellitus have reached epidemic proportions in Korea, and rates of nonalcoholic fatty liver disease (NAFLD) are between 10% and 25% of the general population. NAFLD in Korea is as closely associated with several components of metabolic syndrome including, obesity, hypertension, diabetes and dyslipidemia as it is in Western countries. Insulin resistance and hyperinsulinemia may play a role in the pathogenesis of fatty liver in patients with normal body weight as well as in patients with obesity. And, obesity induced accumulation of fat in the adipose tissue leads to an imbalance in the regulation of adipokines, such as downregulation of adiponectin and upregulation of retinol-binding protein 4 (RBP4) and ghrelin. High BMI, the AST/ALT ratio, and ALT levels could be used to distinguish NASH from simple steatosis in Korean patients. In large number of NAFLD patients who underwent a voluntary medical checkup, even a small weight reduction was associated with improvements in their hepatic steatosis grade on ultrasonography, serum aminotransferase levels, and related metabolic abnormalities. Subjects with fatty liver disease should be advised to lose weight through lifestyle modifications. Small animal and human studies of treatment with PPAR agonists and betaine have been reported in the Korean literature. It is now acknowledged that NAFLD is the most common liver disease in Korea, largely due to the considerable increase in metabolic abnormalities such as obesity and diabetes. Future studies should continue to focus both on the pathogenesis and the treatment of NAFLD in order to accumulate more of our own data.
*Fatty Liver/complications/physiopathology/therapy ; Humans ; Korea ; Metabolic Syndrome X/complications ; Risk Factors

Visceral fat has been reported to be associated with nonalcoholic fatty liver disease (NAFLD) and the metabolic syndrome (MetS). We assessed the prevalence of both NAFLD and the MetS, measured visceral fat thickness VFT), and estimated the physical activity indexes of 224 relatively healthy hospital workers. We also investigated the associations between both VFT and physical activity index and each of NAFLD and the MetS. The MetS was diagnosed according to the guidelines outlined by the Adult Treatment Panel III, and NAFLD was diagnosed by ultrasonography. Subjects with hepatitis B and C infections and those reporting moderate alcohol consumption were excluded from the study. The prevalence of the MetS was 11.6% and that of NAFLD was 41.5%. Many subjects with the MetS had NAFLD (73.1%), and some subjects with NAFLD (20.4%) also had several components of the MetS (p=0.001). VFT was significantly increased by both the addition of components of the MetS and the severity of NAFLD (p<0.001). In addition, VFT was independently associated with NAFLD (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.19) in subjects with more than 2 components of the MetS. In contrast, habitual physical activity was reversely associated with NAFLD (OR, 0.29; 95% CI, 0.10-0.87). In conclusion, an increased visceral fat content and reduced physical activity could be not only biological markers but also therapeutic targets in the treatment of NAFLD and the MetS.
Adult ; Alcohol Drinking ; Blood Pressure ; Comorbidity ; Fatty Liver/*physiopathology ; Female ; Humans ; Hyperinsulinism/complications ; *Intra-Abdominal Fat ; Male ; Metabolic Syndrome X/*physiopathology ; Middle Aged ; Multivariate Analysis ; Odds Ratio

PURPOSE: Reduced heart rate variability significantly increases cardiovascular mortality. Metabolic syndrome increases the cardiac autonomic dysfunction. Recently, increasing cardiovascular mortality has been reported in patients with schizophrenia. This study was done to compare heart rate variability between adults with and without schizophrenia and to compare the relationship of heart rate variability to metabolic syndrome in hospitalized patients with schizophrenia. METHODS: This was a descriptive and correlational study in which 719 adults without schizophrenia and 308 adults with schizophrenia took part between May and June 2008. We measured the following: five-minute heart rate variability; high-frequency, low-frequency, the ratio of low-frequency to high-frequency, and the Standard Deviation of all the normal RR intervals. Data was also collected on metabolic syndrome, abdominal obesity, triglycerides, HDL cholesterol, blood pressure and fasting glucose. RESULTS: The Standard Deviation of all the normal RR intervals values of heart rate variability indices were 1.53+/-0.18. The low-frequency and high-frequency values of heart rate variability indices were significantly higher in hospitalized patients with schizophrenia (3.89+/-1.36; 3.80+/-1.20) than those in the healthy participants (2.20+/-0.46; 2.10+/-0.46). There were no significant differences between the schizophrenic patients with and without metabolic syndrome. CONCLUSION: The results of this study indicate that schizophrenia patients have significantly lower cardiac autonomic control, but they have significantly higher low-frequency and high-frequency values than those of healthy adults. Use of antipsychotic drug may affect the autonomic nervous system in schizophrenic patients. Metabolic syndrome was not associated with cardiac autonomic control in schizophrenia patients.
Adult ; Autonomic Nervous System/physiopathology ; Blood Glucose/analysis ; Blood Pressure ; Cardiovascular Diseases/complications/diagnosis/mortality ; Cholesterol, HDL/blood ; Female ; *Heart Rate ; Hospitalization ; Humans ; Male ; Metabolic Syndrome X/*complications/*physiopathology ; Middle Aged ; Obesity/etiology ; Schizophrenia/*complications/mortality/*physiopathology ; Triglycerides/blood

Although metabolic syndrome (MetS) is associated with increased cardiovascular mortality and the development of atherosclerosis, consensus is still lacking on the status of cardiovascular function and geometry in MetS patients. We investigated the relation between MetS and left ventricle (LV) geometry and function, carotid intima-media thickness (IMT) and arterial stiffness in a community-based cohort of 702 adult subjects. Subjects were categorized into three groups according to the number of MetS components present, as defined by the Adult Treatment Panel III guidelines: 1) Absent (0 criteria), 2) Pre-MetS (1-2 criteria) or 3) MetS (> or =3 criteria). In female subjects, LV mass, LV mass/height(2.7), deceleration time, and aortic pulse wave velocity increased, and E/A ration decreased in a stepwise manner across the three groups. These changes were not observed in male subjects. The mean carotid IMT was higher in the MetS group than in the other two groups. The degree of MetS clustering is found to be strongly correlated with geometric eccentricity of LV hypertrophy, diastolic dysfunction and arterial changes irrespective of age and blood pressure status, particularly in females. Waist circumference is found to have the most powerful effect on cardiovascular parameters.
Adult ; Aged ; Cardiovascular Diseases/etiology/*physiopathology ; Cardiovascular System/pathology/*physiopathology ; Carotid Arteries/anatomy & histology/physiology ; *Cohort Studies ; Female ; Heart Ventricles/anatomy & histology ; Humans ; Korea ; Male ; Metabolic Syndrome X/complications/*physiopathology ; Middle Aged ; *Rural Population ; Ventricular Function, Left/physiology

OBJECTIVES: The current study was performed to assess the distribution of intraocular pressure (IOP) and its association with metabolic syndrome (MS) in a community. METHODS: We measured IOP and MS components from 446 adults, age 20 or more years old, who reside in a community in Kyunggi Province, South Korea. We compared the level of IOP according to the number of metabolic abnormalities and between normal and abnormal metabolic components. Linear regression analyses were used to determine the relationship between IOP and metabolic components. RESULTS: No significant difference in IOP (mean +/- SE) was found between men (12.24 +/- 2.42) and women (12.55 +/- 2.41 mmHg, p > 0.1), while IOP of men tended to decrease as age increased (p for trend < 0.01). After adjusting for age, IOP of subjects with abdominal obesity in men and high blood pressure in women were significantly higher than those without abdominal obesity or high blood pressure (p < 0.05). Female subjects with MS showed significantly higher IOP than those without MS. Participants with more metabolic disturbances tended to have a greater IOP elevation with a linear trend after adjusting for age and sex. In the univariate regression analysis, age and waist circumference were significantly associated with IOP in men, but systolic and diastolic blood pressure were associated with IOP in women. In final multiple regression model, age, systolic blood pressure, and triglyceride were associated with IOP in women, and age in men. CONCLUSIONS: These findings suggest that MS and its components may be important determinants of elevated IOP.
Adult ; Age Factors ; Body Mass Index ; Female ; Health Behavior ; Humans ; Hypertension/physiopathology ; Insulin Resistance/physiology ; *Intraocular Pressure ; Linear Models ; Lipids/blood ; Male ; Metabolic Syndrome X/*complications/epidemiology/physiopathology ; Middle Aged ; Republic of Korea/epidemiology ; Sex Factors

PURPOSE: The purpose of this study was to compare metabolic syndrome (MS) risk factor prevalence by obesity and age in middle-aged women. METHOD: Two hundred and fifty-one subjects were recruited from the health promotion center of a tertiary care hospital in an urban city. MS was defined by the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)(ATPIII), and obesity was determined by body mass index(BMI)> or = 25kg/m2. RESULTS: The mean blood pressure, fasting glucose, total cholesterol, and triglyceride were significantly higher in the obese group than in the non-obese group. The prevalence of MS, hypertension, and impaired fasting glucose were significantly higher in the obese group than in the non-obese group. In the forties, blood pressure was significantly higher in the obese group than in the non-obese group. In the fifties, body fat, systolic blood pressure, fasting glucose, total cholesterol, and triglyceride were significantly higher in the obese group than in the non-obese group. CONCLUSIONS: These results show that the nurse should focus on the obese fifty year old female patients for improvement of the MS risk factors.
Women's Health ; Adult ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cholesterol/blood ; Female ; Health Surveys ; Humans ; Metabolic Syndrome X/*epidemiology/etiology ; Middle Aged ; Models, Nursing ; Obesity/*complications/epidemiology/physiopathology ; Prevalence ; Risk Factors

The aim of this study was done to assess the association of lung function with insulin resistance (IR), systemic inflammation, and metabolic syndrome (MetS). In 9,581 apparently healthy non-smoking male adults, pulmonary function, fasting glucose, insulin, lipid profiles and serum high-sensitivity C-reactive protein (hs-CRP) levels were measured, and homeostatic model assessment (HOMA) was used to assess IR. The presence of MetS was defined according to the AHA/NHLBI criteria. The prevalence of MetS was 19.3%. The odds ratio of MetS for restrictive ventilatory pattern was 1.55 (95% confidence interval, 1.12-2.14), and that for obstructive ventilatory pattern was 1.39 (0.66-2.94) after adjustment for confounders. When subjects were divided in 4 groups according to quartiles of FVC or FEV1 (% predicted [pred]), HOMA-IR significantly increased as the FVC or FEV1 (% predicted [pred]) decreased. Individuals in the lowest FVC or FEV1 quartile had the highest hs-CRP level. Prevalence of MetS increased as FVC or FEV1 (% predicted [pred]) quartiles decreased. The abdominal obesity, hs-CRP and HOMA-IR were the independent predictors for the lowest FVC and FEV1 (% predicted [pred]) even after adjustment for confounders. These results indicate that MetS, IR, and systemic inflammation are important risk factors for reduced lung function in nonsmoking Korean males.
Adult ; C-Reactive Protein/analysis ; Forced Expiratory Volume/physiology ; Glucose/metabolism ; Humans ; Inflammation/complications/*physiopathology ; Insulin/blood ; *Insulin Resistance ; Male ; Metabolic Syndrome X/complications/*physiopathology ; Middle Aged ; Obesity/complications ; Odds Ratio ; Pulmonary Ventilation/*physiology ; Republic of Korea ; Respiratory Function Tests ; Risk Factors ; Vital Capacity/physiology

We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction Registry, a total of 1,990 patients suffered from acute ST-elevation myocardial infarction (STEMI) between November 2005 and December 2006 were categorized according to the National Cholesterol Education Program-Adult Treatment Panel III criteria of MS. Primary study outcomes included major adverse cardiac events (MACE) during one-year follow-up. Patients were grouped based on existence of MS: group I: MS (n=1,182, 777 men, 62.8+/-12.3 yr); group II: Non-MS (n=808, 675 men, 64.2+/-13.1 yr). Group I showed lower left ventricular ejection fraction (LVEF) (P=0.005). There were no differences between two groups in the coronary angiographic findings except for multivessel involvement (P=0.01). The incidence of in-hospital death was higher in group I than in group II (P=0.047), but the rates of composite MACE during one-year clinical follow-up showed no significant differences. Multivariate analysis showed that low LVEF, old age, MS, low high density lipoprotein cholesterol and multivessel involvement were associated with high in-hospital death rate. In conclusion, MS is an important predictor for in-hospital death in patients with STEMI.
Acute Disease ; Age Factors ; Aged ; C-Reactive Protein/analysis ; Cholesterol, LDL/blood ; Coronary Angiography ; Female ; Humans ; Male ; Metabolic Syndrome X/*complications/epidemiology ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/*complications/mortality/therapy ; Predictive Value of Tests ; Prognosis ; Treatment Outcome ; Ventricular Dysfunction, Left/complications/physiopathology