Association of a New Measure of Obesity with Hypertension and Health-Related Quality of Life.

BACKGROUND:Despite its shortcomings, body mass index (BMI) has traditionally been used to define obesity. Another recently introduced obesity measure, A Body Shape Index (ABSI), has been introduced to focus on abdominal obesity, but its applicability remains limited. We analyzed the statistical properties of the ABSI and propose a modified ABSI, the z-score of the log-transformed ABSI (LBSIZ), to improve its applicability. We also examined the sensitivity of the newly introduced index in diagnosing obesity based on the percentage of body fat and its ability to predict hypertension and impaired health-related quality of life (HRQOL). METHODS AND RESULTS:We transformed the ABSI to the LBSIZ in order to create a standard normalized obesity measure. All available data from the Korea National Health and Nutrition Examination Survey (KNHANES) (1998-2012) have shown BMI to be highly correlated with weight (r = 0.85 for women, r = 0.87 for men) and waist circumference (WC) (r = 0.86 for women, r = 0.85 for men), but the LBSIZ was found to be weakly correlated with weight (r = 0.001 for women, r = 0.0001 for men) and moderately correlated with WC (r = 0.51 for women, r = 0.52 for men). BMI showed an inverted U-shaped pattern when plotted against age, but a linear pattern was observed for the LBSIZ, indicating they are different kinds of obesity measures. Logistic regression showed that the odds ratio of obesity for the LBSIZ was 1.86 (95% confidence interval [CI] = 1.73-2.00) for males and 1.32 (95% CI = 1.24-1.40) for females after adjusting for weight, height, age, and year of participation in the KNHANES. While both BMI and the LBSIZ were significantly related to hypertension, the LBSIZ alone was significantly associated with impaired HRQOL. CONCLUSIONS:The LBSIZ is a standard normalized obesity measure independent of weight, height, and BMI. LBSIZ is a new measure of abdominal obesity with the ability to predict hypertension and impaired HRQOL, irrespective of BMI

Age-Related Changes in the Prevalence of Osteoporosis according to Gender and Skeletal Site: The Korea National Health and Nutrition Examination Survey 2008-2010

BackgroundThe incidence of osteoporosis and its related fractures are expected to increase significantly in the rapidly aging Korean population. Reliable data on the prevalence of this disease is essential for treatment planning. However, sparse data on Korean patients is available.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2010. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine using dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed according to the World Health Organization T-score criteria. We analyzed the BMD data of 17,208 people (men, 7,837; women, 9,368).ResultsThe adjusted prevalence of osteoporosis was 7.8% in men versus 37.0% in women. No significant difference was observed in the prevalence of osteopenia between genders (men, 47.0%; women, 48.7%). The prevalence of osteoporosis in men in their 50s was 4.0%, in their 60s was 7.2%, in their 70s was 15.1%, and in their 80s was 26.7%. The figures in women were 15.2%, 36.5%, 62.7%, and 85.8%, respectively. The age group with the maximal BMD differed between genders. In the men, 20s had the highest value in all the skeletal sites. However, in the women, the maximal BMD in the femoral neck, lumbar spine, and the total hip was observed in their 20s, 30s, and 40s, respectively. The onset age of osteoporosis differed between genders. Osteoporosis in the femoral neck began at 55 years in the women and at 60 years in the men.ConclusionThe prevalence of osteoporosis in Korea was significantly high. In addition, the age-related changes in the prevalence of osteoporosis differed according to gender and skeletal site

Inverted U-Shaped Relationship between Obesity Parameters and Bone Mineral Density in Korean Adolescents

As the association between obesity and bone health remains controversial in children and adolescents, we investigate the effects of obesity parameters on bone mineral density (BMD) in 2060 Korean adolescents who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple regression analysis and analysis of covariance (ANCOVA) were conducted to examine both the linear and non-linear associations between total-body-less-head (TBLH) BMD and four obesity parameters: body mass index, waist circumference, waist-to-height ratio, and total-body fat mass (FM). In a multiple linear regression analysis adjusted for age, menarcheal status (in females only), and total-body lean mass, there was no significant linear association between obesity parameters and TBLH BMD, except for total-body FM in males. However, upon adding a second-order polynomial term for each obesity parameter, a significant quadratic relationship between all obesity parameters and TBLH BMD was observed, with the corresponding quadratic term being negative. The results of ANCOVA also revealed an inverted U-shaped relationship between each obesity parameter and TBLH BMD. Our findings suggest the existence of an optimal range of obesity parameters for developing or maintaining optimal bone health in Korean Adolescents. Deviation from this range, in either direction (being underweight or having obesity), may compromise bone health

Odds ratios of obesity defined by percentage of body fat (>25% for males, >30% for females).

<p>Odds ratios of obesity defined by percentage of body fat (>25% for males, >30% for females).</p

Correlation coefficients between obesity measures and anthropometric measures by sex.

<p>Correlation coefficients between obesity measures and anthropometric measures by sex.</p

Odds ratios of hypertension and health-related quality of life.

<p>Odds ratios of hypertension and health-related quality of life.</p

Mean values of body mass index (BMI), z-score of the log-transformed A Body Shape Index (LBSIZ), and waist circumference (WC) with increasing age.

<p>Mean values of body mass index (BMI), z-score of the log-transformed A Body Shape Index (LBSIZ), and waist circumference (WC) with increasing age.</p

Characteristics of Korean Patients with Primary Adrenal Insufficiency: A Registry-Based Nationwide Survey in Korea

BackgroundPrimary adrenal insufficiency (PAI) is a rare, potentially life-threatening condition. There are few Korean studies on PAI, and most have had small sample sizes. We aimed to examine the etiology, clinical characteristics, treatment, and mortality of PAI in Korean patients.MethodsA nationwide, multicenter, registry-based survey was conducted to identify adults diagnosed with or treated for PAI at 30 secondary or tertiary care institutions in Korea between 2000 and 2014.ResultsA total of 269 patients with PAI were identified. The prevalence of PAI was 4.17 per million. The estimated incidence was 0.45 per million per year. The mean age at diagnosis was 49.0 years, and PAI was more prevalent in men. Adrenal tuberculosis was the most common cause of PAI in patients diagnosed before 2000; for those diagnosed thereafter, adrenal metastasis and tuberculosis were comparable leading causes. The etiology of PAI was not identified in 34.9% of cases. Of the patients receiving glucocorticoid replacement therapy, prednisolone was more frequently administered than hydrocortisone (69.4% vs. 26.5%, respectively), and only 27.1% of all patients received fludrocortisone. We observed an increased prevalence of metabolic disease and osteoporosis during the follow-up period (median, 60.2 months). The observed overall mortality and disease-specific mortality rates were 11.9% and 3.1%, respectively.ConclusionThe prevalence of PAI is significantly lower in Koreans than in reports from Western countries. The high frequency undetermined etiology in patients with PAI suggests the need to reveal accurate etiology of PAI in Korea