Disparities of metabolic syndrome prevalence by age, gender and occupation among Korean adult workers

Occupation can influence the prevalence of metabolic syndrome. Age and gender could interact with the association between occupation and metabolic syndrome. This study aimed to investigate the prevalence of metabolic syndrome among the Korean working population and determine whether the prevalence differed according to occupation, age and gender. We conducted a cross-sectional study in Korean adults using the Third Korean National Health and Nutrition Examination Survey (KNHANES III). The analysis included 3,288 workers over 19 yr old. The prevalence odds ratios (PORs) of metabolic syndrome among representative types of occupations were estimated after stratification for age and gender by logistic regression. Female manual workers had a higher prevalence of metabolic syndrome than female non-manual workers among those younger than age 50 (POR=1.95, 95%CI=1.12-3.40). However, female manual workers aged 50 and older had a lower prevalence of metabolic syndrome than female non-manual workers (POR=0.36, 95%CI=0.22-0.59). Manual occupations can be a risk factor for metabolic syndrome, but this correlation is limited to younger female workers. The effects of occupation on the prevalence of metabolic syndrome were different between older and younger workers, which could be due to longitudinal transition of socio-cultural structure.     

Blood cadmium and moderate-to-severe glomerular dysfunction in Korean adults: analysis of KNHANES 2005–2008 data

Purpose

The objective of this study was to evaluate the association between blood cadmium (Cd) and moderate-to-severe glomerular dysfunction in a Korean population using a representative sample.

Methods

A cross-sectional study was used to evaluate the association between blood Cd and glomerular dysfunction. Based on the Korean National Health and Nutrition Examination Survey (2005–2008), individual blood Cd was measured in 2,992 adults, aged between 20 and 65.

Results

After adjusting for survey years, age, sociodemographic factors, and health behaviors, the odds ratio for moderate-to-severe glomerular dysfunction (<60?mL/min per 1.73?m²) was 1.97 (95% CI: 1.28–3.07) when comparing the highest with the lowest blood Cd quartile in Korean women. However, in Korean men, there was no association between blood Cd and moderate-to-severe glomerular dysfunction.

Conclusions

These findings support the consideration of Cd as a risk factor for glomerular dysfunction in the female population. Furthermore, environmental heavy metal monitoring and an institutional strategy should be implemented to reduce Cd exposure in the general population.     

A case of complete resolution of mediastinal pseudocyst and pleural effusion by endoscopic stenting of pancreatic duct

We report a case of a mediastinal pseudocyst with a pleural effusion that developed in a patient suffering from alcohol- related chronic pancreatitis. A 53-year-old man was admitted to another institution complaining of pleuritic chest pain and coughing. A chest X-ray revealed a pleural effusion with a collapse of the right middle and lower lobes. Pleural fluid taken by thoracentesis was exudative, and the patient was transferred to our institution. A CT scan showed a loculated cystic lesion in the mediastinum and pancreatic changes that were consistent with chronic pancreatitis. The endoscopic retrograde cholangiopancreatography (ERCP) findings were compatible with chronic pancreatitis showing severe pancreatic ductal stricture at the head with an upstream dilation and distal bile duct stricture. After a one week of treatment with fasting and octreotide without improvement, both pancreatic and biliary stents were placed endoscopically. After stenting, the pleural effusion and pseudocyst rapidly resolved. The stents were changed 3 months later, at which time a repeated CT demonstrated a complete resolution of the pseudocyst. Since the initial stenting, he has been followed up for 7 months and is doing well with no recurrence of the symptoms, but he will need to undergo regular stent changes. Overall, endoscopic pancreatic stenting appears to be a good option for managing selected cases of mediastinal pancreatic pseudocysts.     

CT Characteristics of Pleural Plaques Related to Occupational or Environmental Asbestos Exposure from South Korean Asbestos Mines

Objective

This study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups.

Materials and Methods

This study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups.

Results

Concerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, 5.4 ± 2.7 mm) and lengths (5-310 mm; 72.6 ± 54.8 mm). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05).

Conclusion

Pleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals.     

Impact of age and metabolic syndrome-like components on prostate cancer development: a nationwide population-based cohort study

BackgroundBecause of the contradictory results, more epidemiologic data is needed to determine if metabolic syndrome is a risk factor for developing prostate cancer. This study investigated whether metabolic syndrome-like components affect the incidence of prostate cancer in a Korean population.MethodsMen over 50 years of age who underwent health examinations in 2009 were followed until December 2015 (n=1,917,430) using National Health Insurance System data. Subjects were divided into three groups according to the number of metabolic syndrome-like components. The predictive accuracy of age for prostate cancer was assessed by the Youden index and multivariate adjusted Cox regression analysis was used to analyze the effect of metabolic syndrome-like components on prostate cancer development.ResultsThe risk of prostate cancer increases with age, and the best cutoff age for prostate cancer detection was 62 years (the maximum value of the Youden index). When stratified by the number of metabolic syndrome-like components, the age with the highest Youden index of each group is still 61 or 62 years. In multivariate adjusted Cox regression analysis, there was no statistically significant difference in the incidence rate among the non-component group, the group with 1 or 2 components, and the group with ≥3 components.ConclusionsThe current study found that there was no statistically significant association between metabolic syndrome and prostate cancer development in a Korean population. However, results of this study should be interpreted with consideration due to several limitations including the diversity of definitions of metabolic syndrome components.     

The Effect of Socioeconomic Position on Bone Health Among Koreans by Gender and Menopausal Status

While studies suggest that socioeconomic position (SEP) influences bone health and risk of osteoporotic fracture in postmenopausal women, few studies have simultaneously examined gender and menopause differences as they relate to SEP and bone health. Here, we investigated the relationship between SEP and bone mineral density (BMD) among Korean men, premenopausal women, and postmenopausal women using the BMD data set (n = 9,995) of the Korean National Health and Nutrition Examination Survey IV. The relationship between SEP and BMD was estimated using analysis of covariance (ANCOVA); adjustments were made for age and body mass index (BMI) in the multivariate models. The relationship between SEP and osteoporosis prevalence was estimated using logistic regression. Relative index of inequality (RII) in osteoporosis was estimated using log-binomial regression. ANCOVA (adjusted for age and for age plus BMI) showed a significant positive association between SEP and BMD among men and postmenopausal women. Logistic regression showed a significant negative association between SEP and osteoporosis prevalence among men and postmenopausal women but not in premenopausal women. The RII, estimated by log-binomial regression, showed the impact of SEP on osteoporosis to be significant in men and postmenopausal women (p < 0.05) but not in premenopausal women. Overall, low SEP was associated with both low BMD and high risk of osteoporosis among men and postmenopausal women. Efforts to reduce the economic burden of morbidity and mortality from osteoporosis should target men and postmenopausal women with low SEP.     

IgG Sensitization to Extracellular Vesicles in Indoor Dust Is Closely Associated With the Prevalence of Non-Eosinophilic Asthma,COPD, and Lung Cancer

PurposeRecent experimental evidence shows that extracellular vesicles (EVs) in indoor dust induce neurtrophilic pulmonary inflammation, which is a characteristic pathology in patients with severe asthma and chronic obstructive pulmonary disease (COPD). In addition, COPD is known to be an important risk factor for lung cancer, irrespective of cigarette smoking. Here, we evaluated whether sensitization to indoor dust EVs is a risk for the development of asthma, COPD, or lung cancer.MethodsSerum IgG antibodies against dust EVs were measured in 90 healthy control subjects, 294 asthmatics, 242 COPD patients, and 325 lung cancer patients. Serum anti-dust EV IgG titers were considered high if they exceeded a 95 percentile value of the control subjects. Age-, gender-, and cigarette smoke-adjusted multiple logistic regression analyses were performed to determine odds ratios (ORs) for asthma, COPD, and lung cancer patients vs the control subjects.ResultsIn total, 4.4%, 13.6%, 29.3%, and 54.9% of the control, asthma, COPD, and lung cancer groups, respectively, had high serum anti-dust EV IgG titers. Adjusted multiple logistic regression revealed that sensitization to dust EVs (high serum anti-dust EV IgG titer) was an independent risk factor for asthma (adjusted OR, 3.3; 95% confidence interval [CI], 1.1-10.0), COPD (adjusted OR, 8.0; 95% CI, 2.0-32.5) and lung cancer (adjusted OR, 38.7; 95% CI, 10.4-144.3).ConclusionsIgG sensitization to indoor dust EVs appears to be a major risk for the development of asthma, COPD, and lung cancer.     

Assessing real-time performances of N95 respirators for health care workers by simulated workplace protection factors

To assess performances of N95 respirators for Health Care Workers (HCWs) in a simulated health-care setting, we measured the Simulated Workplace Protection Factors (SWPFs) in real-time from the volunteers. A total of 49 study subjects, wearing 3 M respirator Model N95 1860 and 1860S, were fit tested using the OSHA Exercise Regimen. The test subjects were asked to perform simulated scenarios, including patient assessments, suction, and intravenous injection (IV) treatment. Two TSI PortaCount instruments continuously measured concentrations in the respirator and the room concentration. For Quantitative Fit Testing (QNFT), 36 out of 49 (73.5%) passed the fit factor (FF) criteria set at 100 and 13 (26.5%) failed. The results of QNFT were found to have a low correlation with SWPF, with R²=0.32. The geometric means (GM) and geometric standard deviations (GSD) of SWPF were 68.8 (1.1) for those subjects who passed and 39.6 (1.3) for those who failed. Real-time assessments of SWPF showed that lower SWPFs were; moving head up and down, and bending at the waist. This study identifies the needs for providing different sizes of respirators for HCWs and the importance of performing fit tests for HCWs regularly. And particular movements were identified as attributing factors affecting more on SWPFs.     

Factors associated with participation in colorectal cancer screening in Korea: the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV)

Purpose

Despite the Government’s National Cancer Screening Program for colorectal cancer (CRC), the number of individuals participating in screening in Korea is low. Therefore, the aim of this study was to identify associations between relevant risk factors and the uptake of screening in Korea.

Methods

The Health Interview Survey sub-dataset derived from the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) was used to evaluate participation in CRC screening and factors associated with attendance in individuals aged ≥50. Those that completed the questionnaire and not previously diagnosed with CRC were enrolled (8,042 subjects). Multi-dimensional covariates were considered as potential predictors for CRC screening in multivariate analyses.

Results

A total of 33.2% complied with the CRC screening recommendations. The following were associated with participation: age (aged 70 or older [ref], aged 70 or over; odds ratio (OR) 1.81, 95% confidence interval (CI) 1.54–2.14), marital status (OR 1.43, 95%CI 1.23–1.66), urban-dwelling (OR 1.16, 95%CI 1.02–1.32), education level (elementary school or less [ref], high school (OR 1.29, 95%CI 1.09–1.53), university or higher (OR 1.53, 95%CI 1.23–1.91)), household income (fourth quartile [ref], first quartile (OR 1.29, 95%CI 1.07–1.56)), private health insurance (OR 1.38, 95%CI 1.21–1.58), smoking (OR 1.35, 95%CI 1.43–1.60), self-reported depression (OR 0.79, 95%CI 0.68–0.92), and number of chronic diseases (0–3 [ref], ≥4 (OR 1.41, 95%CI 1.22–1.62)).

Conclusion

To improve participation in CRC screening, appropriate strategies must be directed toward vulnerable populations, such as those with low socioeconomic status.