Upcoming Aging Society and Men's Health: Focus on Clinical Implications of Exercise and Lifestyle Modification

Recent epidemiological research has indicated that men have increased health risks due to biological and social factors. Research in the area of men's health has been focused on disease events and subsequent disabilities. In future aging societies, more attention should be paid to the importance of men's health because a decreased quality of life and increased social burden are impending unless proper maneuvers are taken to slow the development and progression of morbidity through the use of preventive strategies. The adoption of a healthier lifestyle and the early identification and management of risk factors are very important and can be an initiative for prevention and for slowing the progression of morbidities with related quality of life issues. Males are rather vulnerable in terms of health, and conscious and active efforts are required to promote their health in an aging society. Here, we hope to shed light on the influence of lifestyle modifications and their clinical implications on men's health.ope

Effect of Achyranthes bidentata Blume on 3T3-L1 Adipogenesis and Rats Fed with a High-Fat Diet

The present study investigated the antiobesity effect of Achyranthes bidentata Blume root water extract in a 3T3-L1 adipocyte differentiation model and rats fed with a high-fat diet. To investigate the effect of Achyranthes bidentata Blume on adipogenesis in vitro, differentiating 3T3-L1 cells in adipocyte-induction media were treated every two days with Achyranthes bidentata Blume at various concentrations (1 to 25  μ g/mL) for eight days. We found that Achyranthes bidentata Blume root inhibited 3T3-L1 adipocyte differentiation without affecting cell viability, and Western blot analysis revealed that phospho-Akt expression was markedly decreased, whereas there was no significant change in perilipin expression. Furthermore, administration of Achyranthes bidentata Blume root (0.5 g/kg body weight for six weeks) to rats fed with a high-fat diet significantly reduced body weight gain without affecting food intake, and the level of triglyceride was significantly decreased when compared to those in rats fed with only a high-fat diet. These results suggest that Achyranthes bidentata Blume root water extract could have a beneficial effect on inhibition of adipogenesis and controlling body weight in rats fed with a high-fat diet.ope

Sex Difference in the Relationship between Evening Meal-Sharing and Prevalence of Metabolic Syndrome: The 2013-2014 Korean National Health and Nutrition Examination Survey

Background: The rapid socioeconomic growth in Korea has resulted in profound lifestyle changes, such as the Westernization of diet or single-person household, which may be related to metabolic alterations. We examined the relationship between evening meal sharing and the prevalence of metabolic syndrome by using representative data for Korean men and women. Methods: We analyzed data from the 2013–2014 Korea National Health and Nutrition Examination Survey. To investigate outcome variables in the relationship between evening meal sharing and the risk factors for metabolic syndrome, weighted chi-square and simple linear analyses were used. Logistic regression models were used to assess the associations between evening meal sharing and the prevalence of metabolic syndrome according to sex. Results: In the complex sample logistic analysis, metabolic syndrome was significantly associated with having dinner alone, after adjustment for age, sex, body mass index, smoking status, regular exercise, marital status, systolic blood pressure, diastolic blood pressure, triglyceride level, high-density lipoprotein-cholesterol level, and total energy intake in men (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.08–3.24). However, the risk of metabolic syndrome was lower with evening meal sharing than with having dinner alone in women (OR, 0.49; 95% CI, 0.28–0.86). Conclusion: Our study suggests that evening meal sharing may have a sex-related difference in influence on metabolic syndrome.ope

Association between Copper-Zinc Ratio in Hair and Neutrophil-Lymphocyte Ratio within the Context of a Normal White Blood Cell Count among Overweight or Obese Korean Individuals: A Pilot Study

Background: Obesity is considered a state of enhanced oxidative stress as well as chronic and low-grade inflammation. The copper-zinc ratio in obese individuals has been reported to reflect systemic oxidative stress and inflammatory status. We investigated whether the neutrophil-lymphocyte ratio is related to the copper-zinc ratio in hair, within the context of a normal white blood cell count among overweight or obese Korean individuals. Methods: We included 56 participants aged older than 20 years who voluntarily sought weight reduction treatment and met the inclusion criterion of body mass index of 23 kg/m2 or greater. Intra-abdominal visceral adipose tissue was measured by computed tomography imaging, while the copper and zinc levels were measured by hair mineral analysis. Using multiple linear regression analysis, we examined the associations between the neutrophil-lymphocyte ratio and the copper-zinc ratio. Results: The mean age, body mass index, and visceral adipose tissue were 46.0±10.5 years, 29.0±4.1 kg/cm2 , and 142.9±68.8 cm2 , respectively. Pearson's correlation analysis revealed the association of the neutrophil-lymphocyte ratio with copper level (r=0.475, P<0.001) and copper-zinc ratio (r=0.494, P<0.001). After adjusting for confounding variables, we found the neutrophil-lymphocyte ratio was significantly associated with the level of copper and the copper-zinc ratio in hair (regression coefficient: 0.055±0.015; P<0.001 and regression coefficient: 0.761±0.185; P<0.001, respectively). Conclusion: A higher copper-zinc ratio in hair is positively and independently associated with the neutrophil-lymphocyte ratio. Thus, a high hair copper-zinc ratio could be a useful parameter for oxidative burden of individuals predisposed to obesity-related comorbidity.ope

Relationship of Forced Vital Capacity with Chronic Kidney Disease among Middle-Aged and Elder Korean Men

Background: It is unclear whether impaired pulmonary function serves as a risk factor for decreased renal function. This study investigated the association between the forced vital capacity (FVC) and chronic kidney disease (CKD) in middle-aged and elderly men. Methods: We investigated the association between FVC and CKD in 412 Korean men aged ≥50 years, without diabetes, who have not received treatment for chronic lung disease. CKD was defined based on evidence of renal tissue damage or reduced renal function indicated by estimated glomerular filtration rate <60 mL/min/1.73 m2 or proteinuria level ≥1+. We assessed the association between FVC and CKD using multivariate logistic regression analysis after adjusting for confounders. Results: The overall prevalence of CKD was 29.2% in the study population. Multivariate logistic regression analysis showed that the odds ratio with a 95% confidence interval for CKD was 0.96 (0.92–0.99) with a 1% increment in FVC after adjusting for age, body mass index, smoking status, alcohol intake, regular exercise, systolic and diastolic blood pressures, fasting plasma glucose, triglyceride, and high-density lipoprotein-cholesterol levels, as well as antihypertensive and antidyslipidemic medications. Conclusion: We observed that FVC was independently and inversely associated with CKD. This finding suggests that careful monitoring of renal function is necessary to evaluate possible kidney dysfunction in patients with decreased FVC.ope

Association between Resting Heart Rate and Borderline Ankle-Brachial Index Among the Health Screen Examinees

Background: The ankle-brachial index (ABI) is a simple, noninvasive clinical test that is useful in the diagnosis of peripheral artery disease (PAD). The borderline ABI value is 0.91–0.99 and has also been reported in endothelial dysfunction and preclinical PAD. We investigated the relationship between resting heart rate as a surrogate marker of autonomic balance and borderline ABI in apparently healthy individuals. Methods: We evaluated the association between resting heart rate and borderline ABI in 618 participants (348 male and 270 female) in a health examination program. The odds ratios for borderline ABI were calculated using a multivariable logistic regression analysis after adjusting for confounding variables across heart rate quartiles (Q1≤56, Q2=57–62, Q3=63–68, and Q4≥69 beats/min). Results: The overall prevalence of borderline ABI was 13.9%. The age- and sex-adjusted resting heart rate was significantly higher in the borderline ABI group than in the control group (66.9±0.9 vs. 63.0±0.4 beats/min, P<0.001). The odds ratios (95% confidence intervals) for the borderline ABI in each heart rate quartile were 1.00, 1.04 (0.43–2.52), 1.69 (0.73–3.93), and 3.52 (1.55–7.97) after adjusting for age, sex, smoking status, alcohol intake, regular exercise, body mass index, systolic blood pressure, fasting plasma glucose level, triglyceride level, high-density lipoprotein-cholesterol level, white blood cell count, C-reactive protein level, uric acid level, γ-glutamyltransferase level, hypertension medication, diabetes medication, and dyslipidemia medication. Conclusion: These findings indicate that a higher resting heart rate is independently associated with borderline ABI.ope

Borderline-High Mean Corpuscular Volume Levels Are Associated with Arterial Stiffness among the Apparently Healthy Korean Individuals

Background: High mean corpuscular volume (MCV) has been implicated in various health problems, such as anemia, liver disease, and thyroid disease. However, the clinical significance of borderline-high MCV is poorly understood in the primary care setting. This study aimed to investigate whether borderline-high MCV was related to arterial stiffness in Korean adults as measured by brachial-ankle pulse wave velocity (baPWV). Methods: This cross-sectional study comprised 582 participants aged >30 years who underwent routine health examinations. Borderline-high MCV was defined as over 95.0 fl (>90th percentile) after excluding participants with MCV of ≥100 fl or ≤80 fl, and high baPWV was defined as >1,600 cm/s (>90th percentile). The odds ratios (ORs) and 95% confidence intervals (CIs) for high baPWV according to borderline-high MCV were calculated using multiple logistic regression analyses after adjusting for the confounding variables. Results: The mean age of the study population was 47.8±11.7 years, and 56.9% of the participants were male. Compared to that in the control group, the OR (95% CI) of high baPWV in those with a borderline-high MCV was 3.68 (1.39-9.74) after adjusting for age, sex, body mass index, alcohol intake, smoking status, regular exercise, mean blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein cholesterol, C-reactive protein, γ-glutamyltransferase, uric acid, hypertension medication, and diabetes medication. Conclusion: Borderline-high MCV was independently associated with arterial stiffness among apparently healthy Korean individuals.ope

Functional approach to sleep disturbance in chronic fatigue: chronic fatigue and sleep disturbance

Sleep is closely related to health behaviors and is also a crucial lifestyle in itself. In this regard, sleep health should be a part of assessing and managing chronic fatigue in the clinical field. First, it is vital to get in the early morning sun and improve sleep hygiene for proper melatonin secretion. Second, relaxation, meditation, or nutritional supplementation can be helpful to prevent sympathetic nervousness in the evening. Third, it is important to re-recognize and regain the health blessings of rapid eye movement sleep in the early morning. Lastly, meals tailored according to the biological clock (chrono-nutrition) can facilitate gut microbiota s healthy flourishing and the 24-hour circadian rhythm. When assessing and treating patients with chronic fatigue, functional medicine approaches are another essential step for improving the quality of life and advanced health care, based on a broad understanding of sleep science.ope

Relationship of Heart Rate Variability with Triglyceride-Glucose Index among Korean Men and Women in a Primary Care Clinic

Background: Reduced heart rate variability (HRV) can be a predictor of all causes of death. Few studies have analyzed the association between HRV and the triglyceride-glucose (TyG) index in a primary care setting rather than in specific high-risk patients. This study aimed to investigate the relationship between HRV and the TyG index among Koreans at a primary care clinic. Methods: This cross-sectional study included 1,991 participants who underwent HRV assessments and blood tests after fasting for more than 8 hours. Common HRV indices such as the standard deviation of normal-to-normal intervals (SDNN), the root mean square of successive difference (RMSSD), total power (TP), low frequency (LF), high frequency (HF), and the LF/HF ratio were measured. Individuals with a TyG index greater than 9.1 (≥75th percentile) were subclassified into a “high TyG index” group. Associations between the TyG index and HRV were investigated using multiple logistic regression analysis. Results: The individuals’ mean age was 46.6 years, and the high TyG index group included 244 of all 1,991 participants. Among the assessed HRV indices, the SDNN, RMSSD, and HF showed associations with the high TyG index group, with odd ratios of 0.98 (0.97–0.99), 0.98 (0.96–0.99), and 0.99 (0.99–1.00), respectively, after adjusting for age, sex, white blood cell count, total cholesterol, high density lipoprotein cholesterol, alanine aminotransferase, γ-glutamyltransferase, uric acid, creatinine, hypertension, and diabetes. Conclusion: Among the common HRV indices, the SDNN, RMSSD, and HF were decreased in a subgroup of individuals with a high TyG index.ope

Relationship of Calcium–Magnesium Ratio in Hair with Triglyceride-Glucose Index and Triglyceride/High-Density Lipoprotein-Cholesterol Ratio among Overweight or Obese Korean Individuals: A Pilot Study

Background: The interaction between calcium and magnesium as a risk modifier for insulin resistance may be largely overlooked because the strict regulatory system in blood has been thought to maintain such homeostatic interactions under tight control. This study aimed to investigate the relationship between the calcium-magnesium ratio in hair with the triglyceride glucose index (TyG index) and triglyceride/HDL-cholesterol ratio (TG/ HDL ratio) among overweight or obese Korean individuals. Methods: This cross-sectional study included 56 participants fulfilling the inclusion criterion of a body mass index of 23 kg/m2 or more. Intra-abdominal visceral adipose tissue (VAT) was measured by fat measurement computed tomography, while calcium and magnesium levels were measured by hair mineral analysis. A high TyG index and a high TG/HDL ratio were defined as >9.3 and >4.0, respectively (>75th percentile). Using multiple logistic regression analysis, we examined the associations between the TyG index, TG/HDL ratio, and calcium–magnesium ratio in hair. Results: The mean age, body mass index, and VAT were 45.3 years, 28.5 kg/cm2, and 137.4 cm2, respectively. Compared to the controls, the odds ratios (95% confidence intervals) for a high TyG index and a high TG/HDL ratio were 16.03 (1.32–194.23) and 9.98 (1.05–94.98) per one increment of log (calcium-magnesium ratio), respectively, after adjusting for age, sex, body mass index, visceral adipose tissue, white blood cell count, total cholesterol, hypertension medication, diabetes medication, and dyslipidemia medication. Conclusion: We found that the calcium-magnesium ratio in hair was positively and independently associated with the TyG index and TG/HDL ratio.ope