• Nutrition Research and Practice
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• v.14 no.6
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• pp.621-636
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• 2020

BACKGROUND/OBJECTIVES: The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants. SUBJECTS/METHODS: Data of 54,385 participants aged 20-64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1-2; healthy group, none). Adherence to dietary guidelines was determined from the number of "yes" responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines. RESULTS: In the MetS group, MetS prevalence decreased after the SMESY program (men, -41.9%p; women, -48.7%p), and all risk factors were significantly improved (P < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation (P < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by -44.1%p for men and -49.5%p for women, whereas the prevalence in those with negative changes decreased by -38.1%p for men and -48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61-0.80 for men; OR, 0.88; 95% CI, 0.79-0.99 for women). CONCLUSIONS: The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.

• Korean Journal of Biological Psychiatry
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• v.15 no.3
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• pp.186-193
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• 2008

Objectives : The authors tried to investigate the characteristics of Heart Rate Variability(HRV) among the subjects with metabolic syndrome for testing the possibility of clinical application of HRV in evaluating metabolic syndrome. Methods : We examined the difference of the means of HRV between 122 subjects of metabolic syndrome and 1057 healthy controls using T-test, and the change of means in HRV according to increasing risk factors of metabolic syndrome. Using multiple regression analysis, we examined the association of HRV with the risk factors of metabolic syndrome. Results : The HRV indices including SDNN(Standard Deviation of all normal NN intervals), RMSSD(the square Root of the Mean Squared Differences of successive all normal NN interval), TP(Total Power), LF(Low Freuency), and HF(High Frequency) were significantly lower in the metabolic syndrome group than in the normal control group, and the means of all HRV indices except LF/HF were decreased consistently according to increasing risk factors of metabolic syndrome. The fasting glucose, triglyceride, and waist circumference were dependent factors that contributed significantly to the change of HRV. Conclusion : These findings suggest metabolic syndrome adversely affects cardiac autonomic system and HRV could be a useful method for evaluating metabolic syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.189-230
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• 2020

The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.71-79
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• 2019

Purpose : Several studies suggest that smoking and vitamin D level is a risk factor of metabolic syndrome. The objective of this study is to evaluate the association between smoking status, vitamin D levels and the Korean adult male and female metabolic syndrome. Methods : We assessed 3796 participants aged 19 years and older from the Korean National Health and Nutritional Examination Survey 2013, 2014. Smoking statuses were collected from self-reported questionnaires. Subjects were divided into three categories: non-smokers, former smokers, and current smokers. Vitamin D was tested by Radioimmunoassay method and the value of serum 25-hydroxyvitamin D, which is an index of vitamin D status in the body, was used. The diagnosis of metabolic syndrome was made using criteria modified NCEP-ATP III. Logistic regression analysis was used to calculate odds ratios between smoking status, vitamin D levels, and metabolic syndrome. Results : The overall prevalence of metabolic syndrome was 23.0 % in men and 15.4 % in women. After adjusting for smoking, the odds ratio for men's metabolic syndrome in current smokers was 1.77 (95 % CI, 1.30~2.41), while for former smokers OR was 1.63 (95 % CI, 1.15~2.31) compared with nonsmokers. After adjustment vitamin D, the odds ratio for women's metabolic syndrome in vitamin D deficiency was 1.44 (95 % CI, 1.11~1.87) compared with normal. Conclusion : Smoking status was associated with an increased risk of metabolic syndrome in Korean adult males and decreased vitamin D level was associated with an increased risk of metabolic syndrome in Korean adult females.

• Biomedical Science Letters
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• v.15 no.1
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• pp.9-15
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• 2009

Early age at menarche, which is indicator of early biological maturity, has been shown to be associated with increased adult body mass index. Early menarche has also been associated with many cardiovascular disease risk factors and metabolic syndrome. To evaluate the impact of menarche to cardiovascular risk factor, we assessed by age at menarche, brachial-ankle pulse wave velocity (baPWV), which represents arterial stiffness, in women with or without metabolic syndrome. The subjects recruited for this study were three hundred one women. Relatively early menarche and relatively late menarche were classified according to less than $50^{th}$ percentile for relatively early menarche, and great than the $50^{th}$ percentile for relatively late menarche. Subject were divided four group, 1) women who had not adulthood metabolic syndrome and relatively early menarche, 2) women who had not adulthood metabolic syndrome and relatively late menarche, 3) women who had adulthood metabolic syndrome and relatively early menarche, 4) women who had adulthood metabolic syndrome and relatively late menarche. Women who had a relatively early menarche with adulthood metabolic syndrome had significantly high levels of blood pressure, triglyceride, fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels than women with late menarche with adulthood metabolic syndrome, and had significantly lower HDL-cholesterol levels. And also, women who underwent a relatively early menarche with metabolic syndrome had highest level of baPWV in adult. In this study we found effect of age at menarche on adulthood metabolic risk factors for cardiovascular disease (e.g., baPWV, insulin resistance, hyperlipidemia) in Korean women.

• Journal of Korean Biological Nursing Science
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• v.21 no.2
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• pp.123-132
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• 2019

Purpose: The purpose of this study was to identify influencing factors of metabolic index and cardiovascular risk factors, on depressive and non-depressive groups, in vulnerable diabetic elderly women. Methods: Participants were 137 vulnerable diabetic elderly women, using health centers in D city. Data were collected through interviews September though December 2017. The metabolic index was measured using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), and cardiovascular risk factors were measured using Framingham Risk Score (FRS). Depressive and non-depressive groups were divided by the score of Geriartric Depress Scale Short Korea Version (GDSSF). Collected data were analyzed using a x2 test, independent t-test, and binary logistic regression, with the SPSS/WIN 25.0 program. Results: Vulnerable diabetic elderly women, did not exercise in the depressive groups, and had higher triglyceride (TG), total cholesterol (TC) and larger waists, than in the non-depressive group. Results show that lack of exercise (OR= 6.30), is the highest risk factor, influencing the depressive symptom in vulnerable diabetic elderly women. Conclusion: These results suggest that to reduce depressive symptom levels among vulnerable diabetic elderly women, nursing interventions are needed to increase exercise and decrease TG, TC, and waist size, particularly in improving exercise of vulnerable diabetic elderly women.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.261-269
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• 2018

Purpose: The purpose of this study was to investigate the prevalence of metabolic syndrome and diagnostic components in adult women. Methods: The subjects of this study were 12,016 women that were aged twenty years or older and underwent an annual health check-up for National Health Insurance Service (NHIS) from 2009 to 2013. Data including blood pressure, waist circumstance, fasting glucose, triglyceride, and high density lipoprotein cholesterol (HDL-C) were received from the NHIS. This data was analyzed through the use of descriptive statistics, ${\chi}^2$-test, and multiple logistic regression. Results: The prevalence of metabolic syndrome and diagnostic components increased with age. In the five diagnostic components of the metabolic syndrome, the prevalence of low HDL-C was highest in 20s to 40s. The prevalence of high blood pressure was highest in the people aged fifty or older. The risk of metabolic syndrome in 2013 was higher in women with abnormal diagnostic component of metabolic syndrome in 2009 and highest in women with abnormal waist circumstance in 2009. Conclusion: There was a need to investigate the prevalence of metabolic syndrome components according to age. Education on metabolic syndrome was required for those that had one or two abnormal diagnostic components. The risk of abdominal obesity related to metabolic syndrome needs to be emphasized. Moreover the education for management of abdominal obesity also needs to be emphasised.

• Nutrition Research and Practice
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• v.6 no.3
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• pp.221-225
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• 2012

Zinc deficiency is known to be associated with insulin resistance in obese individuals. This study was performed to evaluate the effect of zinc supplementation on insulin resistance and metabolic risk factors in obese Korean women. Forty obese women (body mass index (BMI) ${\geq}25kg/m^2$) aged 19-28 years were recruited for this study. Twenty women of the study group took 30 mg/day of supplemental zinc as zinc gluconate for 8 weeks and 20 women of control group took placebo. Usual dietary zinc intake was estimated from 3-day diet records. Insulin resistances were measured using Homeostasis model assessment (HOMA) indices, and insulin sensitivities Matsuda indices, which were calculated using oral glucose tolerance test data. Metabolic risk factors, such as waist circumference, blood pressure, fasting glucose, triglyceride, high density lipoprotein (HDL) cholesterol, and adipocyte hormones such as leptin, and adiponectin were also measured. At the beginning of study, dietary zinc averaged 7.31 mg/day and serum zinc averaged $12.98{\mu}mol/L$ in the study group. Zinc supplementation increased serum zinc by 15% and urinary zinc by 56% (P < 0.05). HOMA values tended to decrease and insulin sensitivity increased slightly in the study group, but not significantly so. BMI, waist circumference, blood pressure, blood glucose, triglyceride, HDL cholesterol, and adipocyte hormones did not change in either the study or control group. These results suggest that zinc status may not affect insulin resistance and metabolic risk factors in obese Korean women. Further research is required on a larger cohort with a longer follow-up to determine the effects of zinc status on insulin resistance and metabolic variables.

• The Journal of the Korea Contents Association
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• v.15 no.6
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• pp.314-325
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• 2015

The goal of this study was to evaluate the relationship between metabolic syndrome risk factors and health promotion behavior in general hospital nurses. Data were conducted using a structured questionnaire survey with 450 registered nurses in a general hospital in Gyeonggido. Data were collected from October 6 to October 31, 2014. The data were analyzed using SPSS/WIN 21.0. version. The overall prevalence of metabolic syndrome was 8.0% for nurses at a general hospital. The mean score of Health promotion lifestyle profile was 2.53( range: 1.22~3.44). The high prevalence risk groups for metabolic syndrome was between 26 and 30 yr of age, ICU nurses and drinking one or two times/1wk. The study indicates that hospital administrators should focus on job circumstances of nurses(especially nurses classified as high prevalence risk for metabolic syndrome) for improvement and prevention of MS prevalence risk.

• Clinical and Experimental Pediatrics
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• v.55 no.4
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• pp.128-135
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• 2012

Purpose: Unbalanced diets and decreased physical activity have contributed to increased prevalence of obesity and metabolic syndrome in adolescents. We have performed a systematic review and data analysis to examine the association between dietary pattern and metabolic syndrome risk factors in adolescents. Methods: We searched the PubMed and BioMedLib databases for appropriate articles published during the past 10 years and selected 6 articles. The studies reviewed applied factor analysis or cluster analysis to extract dietary patterns. For data analysis, we examined the association between dietary patterns and the prevalence of metabolic syndrome risk factors using data of 3,168 adolescents (13 to 18 years) obtained from 4 consecutive Korean Nutrition Health and Nutrition Examination Surveys (1998, 2001, 2005, and 2007 to 2009). Results: Our systematic review confirmed that western dietary patterns are positively associated with metabolic syndrome risk factors such as obesity and elevated triglycerides, while traditional dietary patterns were negatively associated. Data analysis found that the number of adolescents aged 16 to 18 years who had "Rice & Kimchi" dietary pattern decreased, while the number having western dietary patterns increased during the 1998 to 2009 time frame. There were no changes in the dietary patterns in adolescents aged 13 to 15 years. The risk of elevated serum triglycerides and reduced serum high density lipoprotein cholesterol was high in the "Rice & Kimchi" dietary pattern compared to the other dietary pattern groups. Conclusion: Because adolescents' dietary patterns are changing continuously and have long-term effects, further studies on the dietary patterns of adolescents and their health effects into adulthood are necessary.