Effect of chronic alcohol consumption on plasma lipid, vitamins A, and E in Korean alcoholics

This human study was conducted to evaluate the effect of chronic alcohol consumption on plasma concentrations of lipid and the antioxidative system in 44 Korean alcoholics and 45 age-, sex-, and nationality-matched nonalcoholic subjects. Plasma triacylglycerols and atherogenic index were higher in alcoholics than in control subjects. Plasma total cholesterol was not different among groups, but plasma high-density lipoprotein cholesterol was lower in alcoholics. There were positive correlations between ethanol consumption and plasma lipid peroxide and atherogenic index in all subjects; there were negative correlations between ethanol consumption and plasma high-density lipoprotein cholesterol in all subjects. There were no significant differences between alcoholics and control subjects in plasma concentrations of α-tocopherol, although plasma α-tocopherol/lipid tended to be lower in alcoholics. Plasma retinol was lower in alcoholics. These results suggest that chronic ethanol consumption can contribute to increased risk for vascular diseases in Korean alcoholics.     

Association of renal function with muscle strength in Korean adults: A population-based study using the Korea National Health and Nutrition Examination Surveys (KNHANES) from 2014 to 2018

Hand grip strength (HGS), a simple measure of upper limb muscle function, can be used to assess overall muscular strength, and reduced HGS in patients with poor renal functions has been observed. This study examined the associations between renal function and HGS, a surrogate marker of muscular strength, among a stratified sample of Korean adults. This study obtained data from the Korea National Health and Nutrition Examination Survey from 2014 to 2018, a cross-sectional and nationally representative survey conducted by the Korea Centers for Diseases Control and Prevention. In men, low muscle strength (LMS) and normal muscle strength (NMS) were defined as HGS < 28.9 kg and HGS ≥ 28.9 kg, respectively. In women, LMS and NMS were considered as HGS < 16.8 kg and HGS ≥ 16.8 kg, respectively. Of the 25,746 subjects in this study, there were 3603 (14.0%) and 22,143 (86.0%) subjects who displayed LMS and NMS, respectively. Subjects with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² had a higher risk of developing LMS than those with eGFR ≥ 60 mL/min/1.73 m² after adjusting for age (odds ratio, 1.772; 95% CI, 1.498–2.096); the significant differences remained after adjusting for other factors including age. Similar tendencies were shown in men and women when analyzed according to gender; however, the risk of developing LMS was higher in men than in women. Results showed that decreased renal function was likely to contribute to an increased prevalence of LMS based on HGS. This association may assist in developing better strategies to estimate renal function in clinical or public health practice.     

Identification of HLA-DRB1 Alleles Associated with Graves' Disease in Koreans by Sequence-Based Typing

The human leukocyte antigen (HLA) region, particularly class II genes, plays a primary role in the susceptibility to development of GD. We investigated the allelic polymorphism of HLA class II DRB1 genes to examine its association with GD in Koreans. We performed the high resolution polymerase chain reaction-sequence based typing (PCR-SBT) of HLA-DRB1 in 133 patients with GD and 200 healthy controls. Compared to healthy controls, the patients with GD had increased frequencies of DRB1*030101 (4.9% vs.1.8%, p = 0.034), DRB1*080201 (5.3% vs. 2.3%, p = 0.050) and DRB1*140301 (3.4% vs. 1.0%, p = 0.043). In contrast, the frequencies of DRB1*070101 (3.0% vs. 7.3%, p = 0.024) and DRB1*130201 (4.1% vs. 9.0%, p = 0.010) were decreased in the patients with GD. However, the corrected p values were not significant in above all alleles. Patients with DRB1*040301 were significantly older than controls (45 years vs. 35 years, p = 0.017). DRB1*040301, DRB1*150201, DRB1*120101 and DRB1*120201 were associated with male predominance, strong familial associations, thyroid ophthalmopathy and radioactive iodine therapy, respectively. In conclusion, there were no significant HLA-DRB1 alleles associated with GD in Koreans, although some alleles were correlated with the clinical characteristics.     

Population and forensic genetic analyses of mitochondrial DNA control region variation from six major provinces in the Korean population

We generated complete mitochondrial DNA (mtDNA) control region sequences from 704 unrelated individuals residing in six major provinces in Korea. In addition to our earlier survey of the distribution of mtDNA haplogroup variation, a total of 560 different haplotypes characterized by 271 polymorphic sites were identified, of which 473 haplotypes were unique. The gene diversity and random match probability were 0.9989 and 0.0025, respectively. According to the pairwise comparison of the 704 control region sequences, the mean number of pairwise differences between individuals was 13.47 ± 6.06. Based on the result of mtDNA control region sequences, pairwise F_ST genetic distances revealed genetic homogeneity of the Korean provinces on a peninsular level, except in samples from Jeju Island. This result indicates there may be a need to formulate a local mtDNA database for Jeju Island, to avoid bias in forensic parameter estimates caused by genetic heterogeneity of the population. Thus, the present data may help not only in personal identification but also in determining maternal lineages to provide an expanded and reliable Korean mtDNA database. These data will be available on the EMPOP database via accession number EMP00661.     

Risk Factors for Falls in Older Korean Adults: The 2011 Community Health Survey

Falls are a major health problem for elderly populations worldwide. We analyzed data from the 2011 Korean Community Health Survey to identify potential risk factors for falls in a representative population-based sample of community-dwelling older Korean adults. Risk factors for falls were assessed by multivariate survey logistic regression models. The prevalence of falls was 36.5% in males and 63.5% in females. Age and female sex were associated with a higher risk of falls. Similarly, living alone, living in an urban area, poor self-rated health, and high stress were associated with a high risk of falls. Subjects with diabetes mellitus, stroke, osteoarthritis, osteoporosis, urinary incontinence, cataracts, or depression had a high risk of falls. However, subjects with hypertension were at low risk for falls. In conclusion, age, female sex, marital status, residence location, self-rated health, stress, and several chronic conditions were significantly associated with the risk for falls in the older Korean adults. Our findings suggest that these risk factors should be addressed in public health policies for preventing falls.

Graphical Abstract

     

Development and Progression of Diabetic Retinopathy and Associated Risk Factors in Korean Patients with Type 2 Diabetes: The Experience of a Tertiary Center

The aim of this study was to evaluate the incidence of and risk factors for the development of diabetic retinopathy (DR) and progression to proliferative DR (PDR) in Korean patients. Patients diagnosed with type 2 diabetes and followed for more than 5 years at a university-based clinic since 2000 were consecutively enrolled in this retrospective cohort study. Based on the DR classification at the initial and final visits, the incidence and progression of DR was determined and patient characteristics were compared according to DR progression. Hazard ratios of each putative risk factor for DR progression were calculated with a multivariate Cox proportional hazard model. Rate of DR development and progression to PDR were 32.1/1,000 and 26.2/1,000 person-years, respectively. A longer duration of diabetes and higher mean HbA1c level were significant risk factors for the development of DR. Regarding progression to PDR, higher mean HbA1c level, higher standard deviation of HbA1c, and higher urine albumin-to-creatinine ratio were significant risk factors. The rates of development of DR and progression to PDR in Koreans with type 2 diabetes are lower than those reported over the last decade. An inadequate blood glycemic control is the common risk factor for development and progression of DR.

Graphical Abstract

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The Chinese and Korean American immigrant experience: a mixed-methods examination of facilitators and barriers of colorectal cancer screening

Objective: Among Asian Americans, colorectal cancer (CRC) is the second leading cause of cancer deaths. Despite strong evidence that screening can reduce CRC-related mortality, fewer Chinese and Koreans receive screening as compared to non-Hispanic whites and blacks. The objective of this study was to examine facilitators and barriers as well as strategies to promote CRC screening in this population.

Design: This study employed a mixed-methods design. We conducted 17 key informant interviews and 12 focus groups in the Washington, D.C. metropolitan area. 120 Chinese and Korean focus group participants, aged 50 to 85, also provided quantitative data through self-administered surveys. All participants were asked to discuss facilitators and barriers of CRC screening, including in relation to culture.

Results: Participants who had a regular physician and doctor’s recommendation for CRC screening were more likely to ever receive a colonoscopy (adjusted odds ratio (aOR)?=?3.51; 95% confidence interval (CI): 1.26, 9.79 and aOR?=?6.61; 95% CI: 2.63, 16.65, respectively). A doctor’s recommendation was also significantly associated with receipt of a fecal occult blood test (FOBT) (aOR?=?4.00; 95% CI: 1.43, 11.15). In terms of barriers, those who reported having no time and not having symptoms were less likely to have a colonoscopy (aOR?=?0.15; 95% CI: 0.03, 0.82 and aOR?=?0.02; 95% CI: 0.002, 0.23, respectively) than those who had time and symptoms. Preventive healthcare was often not viewed as a priority, particularly for those living the‘immigrant life,’ who gave precedence to work. Cultural barriers to CRC screening included language (e.g. limited English proficiency and low health literacy); fear of finding CRC and burdening the family especially children; fatalism; and stigma towards cancer.

Conclusions: Future interventions and programs aiming to increase CRC screening among Chinese and Korean Americans should address both cultural and non-cultural factors that influence CRC screening uptake.     

Muscle Strength Moderates the Relationship between Nutritional Health Risk and Depression in Korean Older Adults

Background: Little is known about the relationships between muscle strength and nutritional health risk with late-in-life depression. This study aimed to investigate the moderating effect of lower-extremity muscle strength on the relationship between nutritional health risk and depression in Korean older adults. Methods: Data obtained from 5949 women and 3971 men aged ≥ 65 years in the 2020 Korea Longitudinal Study on Aging were used in this study. Exposures included lower-extremity muscle strength and nutritional health risk. Lower-extremity muscle strength was measured with a modified sit-to-stand test. The nutritional health risk was assessed using a screening tool. Depression was defined as a score ≥ 8 points on the Geriatric Depression Scale (GDS). Results: Logistic regression analyses showed that depression was positively associated with nutritional health risk (p < 0.001) and inversely associated with lower-extremity muscle strength (p < 0.001). A moderation analysis with Andrew Hayes’ PROCESS macro showed a significant moderating effect of lower-extremity muscle strength (β = −0.119; 95% confidence interval, −0.172 to −0.066; p < 0.001) on the relationship between nutritional health risk and depression; the weaker was the muscle strength, the steeper was the slope of the GDS score for nutritional health risk. Conclusions: The current findings suggest the need for an intervention targeting both high nutritional risk and weak muscle strength as a therapeutic strategy against depression in Korean older adults.     

Genetic susceptibility to ischemic cerebrovascular disease in Koreans

Ischemic cerebrovascular disease (ICVD) is a multifactorial disease caused by the interactions of several genetic and environmental factors. Tobacco smoke is a major cause of both cancer and vascular disease. Although its carcinogenic role via induction of DNA damage and mutation is well established, the mechanisms involved in vascular disease remain unclear. One possibility is that DNA damage causes smooth muscle cell proliferation in the intima of arteries, thereby contributing to atherothrombotic processes. The binding of chemicals to DNA is modulated by detoxification enzymes, including glutathione S-transferase (GST). We examined whether polymorphisms in this gene, as well as the angiotensin-converting enzyme (ACE) gene influence the risk of ICVD on smoking status. DNA was analyzed for deletions in the GST M1, T1, and ACE genes by polymerase chain reaction (PCR). No significant association was observed between GST null genotype and ICVD, even in smokers. However, a significant association between ACE and ICVD was observed only in smokers (X ²=0.023, p<0.05). We conclude that GST polymorphism is not a risk factor for the development of ICVD through smoking and suggest a high probability that ACE polymorphism may contribute to the odds of ICVD in smokers.