• Biomedical Science Letters
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• v.18 no.3
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• pp.260-267
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• 2012

Obesity is associated with cardiovascular risk factors, such as dyslipidemia, hypertension and diabetes. However the presence of the obesity related deranged metabolic profiles varies widely among obese individuals. These individuals, known as 'metabolically healthy obese phenotype (MHO)', despite having excessive body fatness, display favorable metabolic profiles characterized by insulin sensitivity, no hypertension, as well as less dyslipidemia, less inflammation. The purpose of this study was to compare cardiac characterization and clinical profile of MHO and Non-MHO (nonmetabolically healthy obese) subjects in men. We measured treadmill exercise capacity (METs) and maximum blood pressure (BP) in 210 subjects through a medical checkup at J General Hospital. Metabolic syndrome was defined according to the modified Adult Treatment Panel III definition criteria. Both MHO and Non-MHO subjects showed statistically significant changes in the left ventricular mass index (P<.001, P<.01, respectively), A-velocity (P<.01, P<.001, respectively), E/A ratio (P<.01, P<.001, respectively), E'-velocity (P<.001, P<.001, respectively), HOMA-IR (P<.01, P<.001, respectively) and maximum systolic BP (P<.01, respectively) compared with the MH-NO (metabolically healthy non obese) subjects. In conclusion, MHO participants were at increased risk of cardiovascular disease and partly metabolic disorder.

• Journal of Korean Academy of Nursing
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• v.37 no.4
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• pp.519-528
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• 2007

Purpose: The purpose of this study was to examine the effect of a moderate-intensity, walking exercise program on the body composition, blood lipids and psychosocial outcomes in postmenopausal obese women. Methods: With a quasi-experimental pre- and post-test design, a total of 36 postmenopausal obese women was recruited in 2 metropolitan areas by convenience sampling. Sixteen women participated in 1 hour of moderate-intensity walking exercise 5 days per week for 3 months and 20 women did not. Cardiovascular risk factors include body composition and blood lipids. Body composition was measured as body mass index, % body fat, and waist/hip ratio; Blood lipids were measured with total cholesterol, triglyceride, HDL and LDL; psychosocial outcomes were evaluated by self-esteem and depression. Results: Over 3 months, the score of self-esteem increased and depression decreased in the exercise group relative to the control group. However, there were no significant differences in body composition and blood lipids. Conclusions: This study suggests that 3 months of moderate-intensity exercise training can improve psychosocial outcomes but further studies are needed to replicate walking exercise on physiologic variables among postmenopausal obese women. These findings are of public health relevance and add a new facet to the growing literature on the health benefits of moderate exercise.

• Korean Journal of Health Education and Promotion
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• v.26 no.2
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• pp.149-155
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• 2009

Metabolically obese but normal weight(MONW) syndrome is characterized, with potentially increased risks for development of the insulin resistance or metabolic syndrome despite their normal body mass index(BMI) < 25 kg/m2. Such characteristics could confer upon MONW individuals a type 2 diabetes mellitus and cardiovascular diseases(CVD) risk however, research on MONW is scarce. MONW individuals have metabolic disturbances typical of obese persons and are identified by having a high amount of visceral fat, a low BMI, a high fat mass, a low lean body mass, low insulin sensitivity, and high triglyceride concentrations. The purpose of this study is to review several markers as potential modulators in individuals displaying the "MONW". Body fat appears to be functionally comparable with a dynamic endocrine organ, producing and secreting various adipocy tokines, such as leptin, adiponectin, CRP, tumor necrosis factor(TNF-), interleukin(IL)-6, all of which play an important role in the onset of cardiovascular disease, and insulin resistance. Otherwise, physical activity and a lower inflammation state might be helped to reduce the number of persons at risk of diabetes, CVD complications, or premature mortality. We should provide a method to optimal treatments resolving the emerging public health problem to prevention of MONW by providing guideline for physical activity as an optimal treatment for the MONW Korean. Furthermore we expect to develop a new strategy to manage MONW Korean in this society in terms of reducing medical costs and enhancing public health care for uprising population with MONW.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.399-405
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• 2011

Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.325-331
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• 2020

Background: We evaluated the association between tricuspid annular dilatation and the development of moderate or severe tricuspid regurgitation (TR). Additionally, we determined the optimal tricuspid annular dilatation threshold to use as an indicator for tricuspid annuloplasty in patients with less-than-moderate functional TR (FTR). Methods: Between August 2007 and December 2014, 227 patients with less-than-moderate TR underwent mitral valve surgery without a tricuspid valve (TV) procedure. The TV annular diameter was measured via transthoracic echocardiography. The TV annular index (TVAI) was calculated as the TV annular diameter divided by the body surface area. The mean duration of echocardiographic follow-up was 42.0 months (interquartile range, 9.3-66.6 months). Results: Eight patients (3.5%) developed moderate or severe TR. The rate of freedom from development of moderate or severe TR at 5 years was 96.2%. TV annular diameter, left atrial diameter, preoperative atrial fibrillation, and TVAI were found to be associated with the development of moderate or severe TR in the univariate analysis. A cut-off TVAI value of 19.8 mm/㎡ was found to predict the development of moderate or severe TR, and a significant difference was observed in the development of TR of this severity based on this cut-off (p<0.001). Conclusion: The progression of TR was not infrequent in patients with untreated lessthan-moderate FTR. An aggressive treatment approach can be helpful to prevent the progression of FTR for patients with risk factors, especially TVAI greater than 19.8 mm/㎡.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.13-23
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• 2012

Object : The aim of this study was to assess the relationship between left ventricular hypertrophy and Dampness-Phlegm diagnosis in cerebral infarction patients. Methods : Among 227 of the total recruited patients, 59 patients were diagnosed as left ventricular hypertrophy. We assessed their general characteristics, risk factors, lab findings and Korean medical diagnosis. We compared the assessed variables between left ventricular hypertrophy group and non left ventricular group. We analyzed the relationship between left ventricular hypertrophy and risk factors. And we also analyzed the relationship between left ventricular hypertrophy and dampness-phlegm diagnosis. Results : 1. The rate of left ventricular hypertrophy in female patients was larger than the rate of male patients. 2. There were more patients finally diagnosed hypertension in left ventricular hypertrophy group. 3. According to the analysis about the rate of Dampness-phlegm related Index for Pattern Identification by left ventricular hypertrophy, Sallow complexion and obesity were significantly higher in the left ventricular hypertrophy than in the non left ventricular hypertrophy group. 4. In multivariate analysis, Dampness-phlegm group showed close relationship with left ventricular hypertrophy. Conclusions : According to the analysis, significance between dampness-phlegm diagnosis diagnosed group and left ventricular hypertrophy were clarified. These results can be utilized in the future as a basic material to be used for diagnosis and management of dampness-phlegm diagnosis on cardiovascular diseases.

• Korean Journal of Community Nutrition
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• v.24 no.2
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• pp.152-162
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• 2019

Objectives: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. Methods: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. Results: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin $B_2$ levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin $B_2$ was inadequately consumed by all groups. Conclusions: These results suggest that it is necessary to increase the intake of vitamin $B_2$ and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

• Clinical Nutrition Research
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• v.12 no.3
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• pp.199-217
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• 2023

People with higher genetic predisposition to obesity are more susceptible to cardiovascular diseases (CVDs) and healthy plant-based foods may be associated with reduced risks of obesity and other metabolic markers. We investigated whether healthy plant-foods-rich dietary patterns might have inverse associations with cardiometabolic risk factors in participants at genetically elevated risk of obesity. For this cross-sectional study, 377 obese and overweight women were chosen from health centers in Tehran, Iran. We calculated a healthy plant-based diet index (h-PDI) in which healthy plant foods received positive scores, and unhealthy plant and animal foods received reversed scores. A genetic risk score (GRS) was developed based on 3 polymorphisms. The interaction between GRS and h-PDI on cardiometabolic traits was analyzed using a generalized linear model (GLM). We found significant interactions between GRS and h-PDI on body mass index (BMI) (p = 0.02), body fat mass (p = 0.04), and waist circumference (p = 0.056). There were significant gene-diet interactions for healthful plant-derived diets and BMI-GRS on high-sensitivity C-reactive protein (p = 0.03), aspartate aminotransferase (p = 0.04), alanine transaminase (p = 0.05), insulin (p = 0.04), and plasminogen activator inhibitor 1 (p = 0.002). Adherence to h-PDI was more strongly related to decreased levels of the aforementioned markers among participants in the second or top tertile of GRS than those with low GRS. These results highlight that following a plant-based dietary pattern considering genetics appears to be a protective factor against the risks of cardiometabolic abnormalities.

• Korean Journal of Community Nutrition
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• v.5 no.4
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• pp.624-632
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• 2000

Nutrition related factors were investigated in one hundred and two hypertensive patients(Male : 44, female : 58) before they started drug treatment or diet therapy. The mean age of men and women were 49.9 and 53.5, respectively. Among the men, their mean SBP and DBP were 165.8 mmHg/108.4 mmHg. Fifty six point eight percent of men was classified as having in stage 3 hypertension(SBP $\geq$ 180 mmHg, or DBP $\geq$ 110 mmHg) and 45.5% was classified as having low renin hypertension (serum renin < 2.5 ng/ml/h). The proportion of overweight or obesity assessed by BMI($\geq$ 25) or body fat percent( $\geq$ 21%) was 47.7% or 80.9%, respectively. Men showed 19.1% of hypertriglyceridemia(serum TG $\geq$ 200 mg/dl), 42.6% of hypercholesterolemia(serum cholesterol $\geq$ 220 mg/dl), and 17.0% was observed as having serum cholesterol higher than 240 mg/dl. The proportion of men with high risk of cardiovascular disease was 72.3% assessed by atherogenic index( $\geq$3.4). The prevalence of drinking was 86.4% including a daily drinking proportion of 15.8%. Among women, their mean SBP and DBP were 162.6 mmHg/104.3 mmHg. Less women(43.1%) were classified as having stage 3 hypertension and more women were observed in low renin hypertension(55.1%). The prevalence of obesity or overweight assessed by BMI( $\geq$ 25) was 31.0% and 76.3% with body At percent($\geq$28%). Women revealed 24.1% of hypertriglyceridemia and 36.2% of hypercholesterolemia. The proportion of women who showed high risk of cardiovascular disease(atherogenic index $\geq$ 3.4) was 63.8%. The smoking rate was 8.6% and drinking rate was 43.1%.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.329-338
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• 2017

Background: The clinical value of 3-field lymph node dissection (3FLND) in esophageal squamous cell carcinoma (ESCC) remains controversial. This study aimed to identify the patterns and prognostic significance of cervical lymph node metastasis (CLNM) in ESCC. Methods: A retrospective review of 77 patients with E SCC who underwent esophagectomy and 3FLND between 2002 and 2016 was conducted. For each cervical node level, the efficacy index (EI), overall survival, recurrence rate, and complication rate were compared. Results: CLNM was identified in 34 patients (44.2%) who underwent 3FLND. Patients with CLNM had a significantly lower overall survival rate (22.7% vs. 58.2%) and a higher recurrence rate (45.9% vs. 16.3%) than patients without CLNM. CLNM was an independent predictor of recurrence in ESCC patients. Moreover, in patients with pathologic N3 tumors, the odds ratio of CLNM was 10.8 (95% confidence interval, 2.0 to 57.5; p=0.005). Level IV dissection had the highest EI, and level IV metastasis was significantly correlated with overall survival (p=0.012) and recurrence (p=0.001). Conclusion: CLNM was a significant prognostic factor for ESCC patients and was more common among patients with advanced nodal stages. Level IV exhibited the highest risk of metastasis, and dissection at level IV may be crucial when performing 3FLND, especially in advanced nodal stage disease.