Vitamin D and Exercise Are Major Determinants of Natural Killer Cell Activity, Which Is Age- and Gender-Specific

BackgroundThe coronavirus-19 disease (COVID-19) pandemic reminds us of the importance of immune function, even in immunologically normal individuals. Multiple lifestyle factors are known to influence the immune function.ObjectiveThe aim was to investigate the association between NK cell activity (NKA) and multiple factors including vitamin D, physical exercise, age, and gender.MethodsThis was a cross-sectional association study using health check-up and NKA data of 2,095 subjects collected from 2016 to 2018 in a health check-up center in the Republic of Korea. NKA was measured using the interferon-γ (IFN-γ) stimulation method. The association of NKA with 25-(OH)-vitamin D (25(OH)D) and other factors was investigated by multiple logistic regression analysis.ResultsThe average age of subjects was 48.8 ± 11.6 years (52.9% of subjects were female). Among 2,095 subjects, 1,427 had normal NKA (NKA ≥ 500 pg IFN-γ/mL), while 506 had low NKA (100 ≤ NKA < 500 pg/mL), and 162 subjects had very low NKA (NKA < 100 pg/mL). Compared to men with low 25(OH)D serum level (< 20 ng/mL), vitamin D replete men (30–39.9 ng/mL) had significantly lower risk of very low NKA (OR: 0.358; 95% CI: 0.138, 0.929; P = 0.035). In women, both low exercise (OR: 0.529; 95% CI: 0.299, 0.939; P = 0.030) and medium to high exercise (OR: 0.522; 95% CI: 0.277, 0.981; P = 0.043) decreased the risk compared to lack of physical exercise. Interestingly, in men and women older than 60 years, physical exercise significantly decreased the risk. Older-age was associated with increased risk of very low NKA in men, but not in women.ConclusionPhysical exercise and vitamin D were associated with NKA in a gender- and age-dependent manner. Age was a major risk factor of very low NKA in men but not in women

Trends in the management levels of metabolic risk factors in middle-aged and elderly patients with type 2 diabetes mellitus: The Korean National Health and Nutrition Examination Survey 1998-2014.

The present study examined the temporal trends in the management of blood pressure, glucose, and lipid levels among middle-aged and elderly patients with type 2 diabetes using data from the Korean National Health and Nutrition Examination Survey (1998-2014). A total of 3,689 patients with diabetes were included and divided into middle-aged (30-64 years old) and elderly (≥65 years old) groups. Demographic and lifestyle data were obtained using a self-reported questionnaire, and trained medical staff obtained fasting blood samples and blood pressure data. Laboratory testing was performed to determine blood glucose, cholesterol, and triglyceride levels. In the multivariable adjusted models, significant decreasing trends in the prevalences of hyperglycemia and hypertension were observed in both age groups during 1998-2014, although no trends were observed for lipid levels. Based on the most recent survey, approximately 50% of patients with diabetes had hyperglycemia, and one-third of patients with diabetes and hypertension did not appropriately manage their blood pressure. In addition, 50% of the patients in both age groups did not manage their lipid profiles, and the management of lipid profiles did not improve in recent years. These results suggest that continuous follow-up is needed to effectively manage metabolic risk factors, especially lipid profiles, among patients with diabetes

Changes in Adherence to Non-Pharmacological Guidelines for Hypertension.

This study aimed to compare levels of adherence to non-pharmacological guidelines between patients with and without hypertension diagnoses, and examined temporal changes in adherence during recent decades. We used data from the Korean National Health and Nutrition Examination Survey (1998-2012), including 13,768 Korean hypertensive patients aged ≥ 30 years who were categorized according to the presence or absence of a hypertension diagnosis, based on blood pressure and self-reported information. Adherence to the guidelines was calculated for 6 components, including dietary and lifestyle habits. A multivariable generalized linear regression model was used. The proportion of hypertensive patients aware of their condition increased from 33.4% in 1998 to 74.8% in 2012 (p < 0.001), although these increments plateaued during recent survey years. Patients with hypertension diagnoses were older, and more likely to be female,and have lower education levels than those without hypertension diagnoses, for most survey years. Overall adherence levels were poor (mean score 2 of 6), and levels of adherence to non-pharmacological habits did not significantly differ between patients with and without hypertension diagnoses. However, overall adherence levels improved significantly among patients with hypertension diagnoses: from 2.09 in 1998 to 2.27 in 2012 (p = 0.007), particularly regarding sufficient vegetable/seaweed consumption (p = 0.03), maintaining a normal weight (p = 0.03), and avoidance of smoking (p < 0.001). Awareness of hypertension is increasing, but hypertensive Korean patients demonstrate poor overall adherence to non-pharmacological hypertension management guidelines. These findings suggest that well-planned education programs should be continued after hypertension is diagnosed

The prevalences of uncontrolled blood pressure and hypertension among patients with diabetes mellitus according to age group and survey period.

<p>Values are adjusted for sex, medication use, smoking status (current smoker, previous smoker, or never smoker), alcohol consumption (<1 vs. ≥1 drink/day for women or <2 vs. ≥2 drinks/day for men), body mass index (<23 kg/m² or ≥23 kg/m²), education level (less than high school or more than high school), duration of diabetes, and psychosocial stress. *p < 0.05.</p

The prevalences of hyperglycemia among patients with diabetes mellitus according to age group and survey period.

<p>Values are adjusted for sex, medication use, smoking status (current smoker, previous smoker, or never smoker), alcohol consumption (<1 vs. ≥1 drink/day for women or <2 vs. ≥2 drinks/day for men), body mass index (<23 kg/m² or ≥23 kg/m²), education level (less than high school or more than high school), duration of diabetes, and psychosocial stress. *p < 0.05, **p < 0.01, ***p < 0.001.</p

Mean adherence levels and 95% confidence intervals for each recommendation, after adjusting for age, sex, education, household income, alcohol consumption (except for e), and smoking status (except for f) during 1998–2012.

<p>Each point ranges from 0 (non-adherence) to 1 (perfect adherence); dark grey bars are for patients with hypertension diagnoses (HD) and light grey bars are for those without diagnoses (UD). Multivariable general linear models were used to test differences in levels of adherence to each recommendation between the HD and UD patients for all survey years. * Adjusted means are significantly different at <i>p</i> < 0.05.</p

Characteristics of patients with diabetes mellitus according to age group.

<p>Characteristics of patients with diabetes mellitus according to age group.</p

Study flow chart using data from the Korean National Health and Nutrition Examination Survey (1998–2014).

<p>The final participants (3,689 patients) was selected from 177,056 individuals who participated in the six surveys, and the participants for each KNHANES survey are shown.</p

Changes in overall mean adherence levels between patients with and without hypertension diagnoses from 1998 to 2012.

<p>Estimates were adjusted for age, sex, education, and household income. * Adjusted means are significantly different at <i>p</i> < 0.05; ** adjusted means are significantly different at <i>p</i> < 0.01; *** Adjusted means are significantly different at <i>p</i> < 0.001.</p

Trends in diagnosed hypertension (weighted proportion) among persons aged 30 years or older with self-reported hypertension or blood pressure ≥ 140/90 mmHg: KNHANES 1998–2012.

<p>Trends in diagnosed hypertension (weighted proportion) among persons aged 30 years or older with self-reported hypertension or blood pressure ≥ 140/90 mmHg: KNHANES 1998–2012.</p