OBJECTIVE: To explore the association of single nucleotide polymorphisms (SNPs) of the vitamin D receptor gene ( VDR) with circulating lipids considering gender differences. METHODS: Of the Han Chinese adults recruited from a health examination center for inclusion in the study, the circulating lipids, 25-hydroxyvitamin D (25OHD), and other parameters were measured. The VDR SNPs of Cdx2 (rs11568820), Fok1 (rs2228570), Apa1 (rs7975232), and Taq1 (rs731236) were genotyped with a qPCR test using blood DNA samples, and their associations with lipids were analyzed using logistic regression. RESULTS: In the female participants ( n = 236 with dyslipidemia and 888 without dyslipidemia), multiple genotype models of Fok1 indicated a positive correlation of B (not A) alleles with LDLC level ( P < 0.05). In the male participants ( n = 299 with dyslipidemia and 564 without dyslipidemia), the recessive model of Cdx2 and the additive and recessive models of Fok1 differed ( P < 0.05) between the HDLC-classified subgroups, respectively, and Fok1 BB and Cdx2 TT presented interactions with 25OHD in the negative associations with HDLC ( P < 0.05). CONCLUSION In the Chinese Han adults included in the study, the Fok1 B-allele of VDR was associated with higher LDLC in females, and the Fok1 B-allele and the Cdx2 T-allele of VDR were associated with lower HDLC in males. The interaction of VD and Fok1 BB or Cdx2 TT in males synergistically decreased HDLC levels.
Adult ; Alleles ; Asians/genetics* ; China/ethnology* ; Dyslipidemias/genetics* ; Female ; Genetic Predisposition to Disease/genetics* ; Genotype ; Humans ; Lipids/blood* ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Receptors, Calcitriol/genetics* ; Sex Factors ; Vitamin D/blood*

Blood Pressure ; China/epidemiology* ; Consensus ; Dyslipidemias/therapy* ; Humans ; Hypertension/therapy*

Objective To investigate the association between total homocysteine (tHcy) level in plasma and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C genetic polymorphisms in a Chinese Han nationality population with type 2 diabetes mellitus (T2DM) accompanied by dyslipidemia. Methods This case-control study enrolled T2DM patients with dyslipidemia and without dyslipidemia respectively. Sanger dideoxy-mediated chain-termination method was used to detect the gene polymorphisms of MTHFR C677T and A1298C. Plasma tHcy and lipid levels were measured as well. The genotype frequency and allele frequency between the dyslipidemia and non-dyslipidemia groups were compared by using Chi-square test. Plasma tHcy level of T2DM patients who carried the different genotypes was compared by Student's t test. Results Finally, 82 T2DM patients with dyslipidemia and 94 ones without dyslipidemia were included in this study. There was a significant correlation between tHcy level and MTHFR C677T gene polymorphism in T2DM patients (t=2.27, P=0.02). Moreover, the plasma tHcy level in the dyslipidemia patients who carried MTHFR 677 TT genotype was significantly higher than that in those with CT+CC genotype (13.62±6.97 vs. 10.95±3.62 μmol/L, t=2.20, P=0.03); while for patients without dyslipidemia, comparison of the tHcy level between those who carried the above two alleles showed no significantly difference (13.34±6.03 vs. 12.04±5.09 μmol/L, t=1.08, P=0.29). Conclusion MTHFR 677TT genotype might associate with higher tHcy level in T2DM patients with dyslipidemia.
Adult ; Aged ; Alleles ; Asian People/genetics* ; Base Sequence ; Case-Control Studies ; China ; Diabetes Mellitus, Type 2/genetics* ; Dyslipidemias/genetics* ; Gene Frequency ; Genotype ; Homocysteine/blood* ; Humans ; Linkage Disequilibrium ; Methylenetetrahydrofolate Reductase (NADPH2)/genetics* ; Middle Aged ; Polymorphism, Single Nucleotide

BACKGROUND: The prevalence of hypertension reaches 29% in adults over 30 years of age in the Korean population; however, the control rate is merely 44%. The aim of this study was to investigate the associated factors for target blood pressure achievement after triple combination therapy in hypertensive patients. METHODS: From February 2016 to May 2018, 10 family physicians recruited 348 patients, who newly started a triple combination antihypertensive medication. Target blood pressure was defined as a systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg after 6 months of triple combination therapy. Multivariate logistic regression analyses were performed to analyze the associated factors for target blood pressure achievement. RESULTS: Among the 348 study participants, 317 completed 6 months of treatment. The target achievement rate was 76.3% (242/317). The mean absolute difference and 95% confidence interval (CI) for the SBP and DBP were 10.8 mmHg (8.8 to 12.7) and 6.4 mmHg (5.1 to 7.8), respectively (P<0.05). The odds ratio (OR) for the target blood pressure achievement increased in those with college education or higher (OR, 2.69; 95% CI, 1.22–5.92), those with dyslipidemia (OR, 1.74; 95% CI, 1.01–2.99), and those who were satisfied with the medication (OR, 29.91; 95% CI, 3.70–241.92). CONCLUSIONS: The presence of dyslipidemia and patient's satisfaction with the medication were associated with target blood pressure achievement in our analyses. Our findings suggest the importance of patient's factor in the control of blood pressure.
Adult ; Blood Pressure ; Drug Therapy, Combination ; Dyslipidemias ; Education ; Humans ; Hypertension ; Logistic Models ; Odds Ratio ; Physicians, Family ; Prevalence

OBJECTIVE To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. METHODS Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. RESULTS The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend < 0.001). CONCLUSION Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.
Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Cross-Sectional Studies ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypercholesterolemia ; epidemiology ; Male ; Middle Aged ; Prevalence ; Triglycerides ; blood ; Young Adult

BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10–12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19–64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58–7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07–10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.
Adult ; Blood Glucose ; Cardiovascular Diseases ; Cholesterol ; Diabetes Complications ; Diagnosis ; Dyslipidemias ; Early Diagnosis ; Female ; Humans ; Hypertension ; Korea ; Male ; Mass Screening ; Nutrition Surveys ; Prevalence ; Young Adult

Diabetes mellitus is associated with a high frequency of complications related to cardiovascular disease as well as microvascular complications such as nephropathy, retinopathy, and neuropathy. Prevention of these vascular complications is the main issue for diabetic patients. Hyperglycemia, hypertension, and dyslipidemia are well-known risk factors for complications in diabetic patients. Moreover, these chronic conditions are often seen in many diabetic patients. So, multifactorial interventions are needed to manage these risk factors and prevent diabetic complications. However, there is still a debate about the optimal level required for glycemic control, the appropriate blood pressure target, and dyslipidemia management. Although many countries have written their own guidelines, there are some discrepancies between these different guidelines. Recently, the Korean Diabetic Association issued new guidelines for Korean diabetic patients. Here, I will introduce these new guidelines and discuss the optimal management of risk factors such as hyperglycemia, hypertension, and dyslipidemia in diabetic patients.
Blood Pressure ; Cardiovascular Diseases ; Diabetes Complications ; Diabetes Mellitus ; Dyslipidemias ; Humans ; Hyperglycemia ; Hypertension ; Risk Factors ; Risk Management

There is not a set percentage of calories from carbohydrate, protein, and fat for all people with diabetes. It is recommended that diet be individualized according to each patient's eating patterns, preferences, and metabolic goals. Overweight or obese patients with diabetes could improve their insulin sensitivity, glycemia, blood pressure and dyslipidemia via weight loss. Therefore, various dietary patterns have been tried for weight and glucose control. The Ketogenic diet includes very low-carbohydrate and high fat and is known to be effective for weight loss in a short period of time. Short-term studies have demonstrated the effects of the Ketogenic diet on weight loss and glycemic control improvement, but long-term studies are not yet sufficient. In addition, various side effects such as hypoglycemia and nutritional imbalances are concerns, so there is a lack of evidence with respect to recommending this diet as nutrition therapy for diabetics.
Blood Pressure ; Diet ; Dyslipidemias ; Eating ; Glucose ; Humans ; Hypoglycemia ; Insulin Resistance ; Ketogenic Diet ; Nutrition Therapy ; Overweight ; Weight Loss

Tight control of dyslipidemia and hypertension in elderly diabetic patients aged 65 years or older are considered to be very important for the secondary prevention of cardiovascular disease and control of severe diseases associated with macrovascular complications. In addition, in elderly diabetes with risk factors for cardiovascular disease, it is important to control all of the accompanying risk factors together to accomplish the primary prevention of cardiovascular disease. In elderly diabetic patients, thorough control of blood glucose level by itself prevents macrovascular complications. However, it is recommended to perform tight blood glucose control along with other risk factors in consideration of the function and life of the patient. In particular, insulin resistance progresses before the onset of diabetes mellitus and other risk factors for cardiovascular disease. It is important to suppress and prevent the progression of macrovascular complications.
Aged ; Blood Glucose ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Humans ; Hypertension ; Insulin Resistance ; Primary Prevention ; Risk Factors ; Secondary Prevention

BACKGROUND: Calcium plays an important role in the metabolism of essential nutrients in the human body; recently, it became one of the significant causes of various metabolic disorders including hypertension, obesity, diabetes mellitus, and dyslipidemia. However, data regarding the association between calcium and metabolic disorders in Koreans are limited. The present study aimed to assess the association between serum calcium and elevated blood pressure, overweight, and obesity in Koreans.METHODS: A total of 719 Korean adults who visited the outpatient department of a university hospital were included in this study. The association between serum calcium and obesity and elevated blood pressure in men and women was evaluated separately using multiple regression analysis. Odds ratio was calculated to determine the association between serum calcium levels and overweight, obesity, and elevated blood pressure in men and women.RESULTS: Multiple regression analysis showed that body mass index was significantly increased in men with higher serum calcium levels (β=0.156, P=0.043). In men, the odds ratio for obesity and elevated blood pressure by serum calcium level were 2.04 (95% confidence interval [CI]: 1.02–4.06) and 2.26 (95% CI: 1.09–4.69), respectively. In women, the odds ratio for elevated blood pressure by serum calcium level was 1.86 (95% CI: 1.03–3.34).CONCLUSION: In this study, there was a significant positive association between serum calcium level and obesity and elevated blood pressure in men. In women, there was a significant positive association between serum calcium level and elevated blood pressure.
Adult ; Blood Pressure ; Body Mass Index ; Calcium ; Diabetes Mellitus ; Dyslipidemias ; Female ; Human Body ; Humans ; Hypertension ; Male ; Metabolism ; Obesity ; Odds Ratio ; Outpatients ; Overweight