Background: Recently, there has been an increase of emerging concerns between dietary fiber and diabetics. Increasing intake of dietary fiber leads to delaying absorption of glucose, and lowering of serum insulin levels. In the past studies, there were inconsistent glycemic control effect of beta-glucan. Our purpose was to assess the glycemic control effect of beta-glucan in adults. Methods: Electronic searches (Cochrane, PubMed, EMBase), hand-searching and review of reference were done. The search term for beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw], with no language restriction were used. All RCT that included available data of beta-glucan or that could impute dose of beta-glucan, at least one relevant outcome of glycemic control, run-in period more than 2 weeks, and intervention period of more than 2 weeks or greater were selected. A fixed-effect model was used to assess the summary effect of studies. Results: A total of 43 articles were identified, 4 studies met our inclusion criteria and then analyzed. In pooled analysis, the effect size of fasting glucose level was 0.13 (95%CI: −1.25 to 1.51), and serum insulin level was −0.95 (95%CI, −2.37 to 0.47). It was impossible to adjust for sex and age owing to the lack of raw data. Conclusion: In this review, the results suggested that there were negative impacts of beta-glucan on fasting glucose and serum insulin level in adults, but we concluded that there was insufficient evidence to confirm about glycemic control effect. More powerful and well-designed RCT were required to confirm about glycemic control effect of beta-glucan. (J Korean Acad Fam Med 2008;29:475-483)
Background: Obesity and metabolic syndrome are closely correlated where previous studies showed that adipocytes release many inflammatory substances. HsCRP is an indicator of an independent risk factor in coronary heart disease. The aim of this study was to investigate the difference of hsCRP in different types of obese patients.Methods: We analyzed the data of 7,183 middle-aged Korean adults between the ages of 40 and 60 (men 4,147 and women 3,036) by using a cross-sectional approach. We divided study subjects into 4 different groups; Normal Group (NG; normal waist and normal body mass index), Centrally Obese Group (OB1; Non-obese group with central obestiy), Obese Group without central obesity (OB2) and Obese Group with central obesity (OB3). We compared the difference of anthropometry, metabolic parameters, and hsCRP. Results: Waist circumference (r=0.230, P<.001) and body mass index (r=0.222, P<.001) positively corresponded with high levels of hsCRP. Higher values of hsCRP were found in the OB3 compared to the NG. However, there was no difference between the OB1 and the OB2. The subjects who had central obesity or the metabolic syndrome showed high hsCRP values. The hsCRP values were the highest in subjects who had central obesity with the metabolic syndrome. But, the value of hsCRP was not significantly different in central obesity subjects with or without the metabolic syndrome. Conclusion: The highest value of hsCRP was significantly shown in the obese group with central obesity. However, there were no differences found in the hsCRP levels between the non-obese group with central obesity and the obese group without central obesity. (J Korean Acad Fam Med 2008;29: 484-491)
Background: Childhood obesity is becoming more prevalent, associated with a variety of adverse consequences which leads to adulthood obesity. Although diagnosis is usually made by body mass index, there is neither a cutoff point for the percentage body fat nor abdominal circumference. The aim of this study was to identify each cutoff point for both measures. Methods: The measurement of height, weight, abdominal circumference and percentage body fat was performed through manual assessment and bioelectrical impedance analysis for 4,242 subjects aged 11 in Gunpo City, South Korea. The cutoff point for body fat percentage and abdominal circumference is set to maximize the sum of sensitivity and specificity for detecting obesity and overweight using the Receiver Operating Characteristics (ROC) curve. Results: The mean percentage body fat was 13.6±6.9% for boys and 19.4±5.3% for girls. The mean abdominal circumference of boys was 68.0±9.1 cm, and that of girls was 64.3±7.7 cm. The cutoff point of percentage body fat for obesity was 21.8% in boys and 24.5% in girls. The prevalence of obesity was 15.2%, 16.7% for males and females, respectively. The abdominal circumference cutoff for obesity was 76.9 cm in boys and 70.7cm in girls. Based on that, the prevalence of obesity was 19.7% for boys and 20.0% for girls, which was higher than what was identified by body mass index, as in the case of body fat percentage. Conclusion: The cutoffs of body fat percentage and abdominal circumference in one city of Gyeonggi Province were lower than those suggested in the previous studies. (J Korean Acad Fam Med 2008;29:492-498)
Background: Elevated plasma homocysteine is an independent risk factor for cardiovascular diseases caused by atherosclerosis. Previous studies have shown that plasma homocysteine is associated with components of the metabolic syndrome such as hypertension, insulin resistance, and dyslipidemia. In this study, we investigated the association between the plasma homocysteine levels and the metabolic syndrome on Korean adults. Methods: Thestudy group with the metabolic syndrome and the control group without the metabolic syndrome were selected from the examinees of equivalent age and gender in the Health Promotion Center. Among the subjects, 107 adults with the metabolic syndrome and 123 adults without the metabolic syndrome were categorized into the study and the control groups, respectively. Medical history, medication, and life style were recorded through a questionnaire and physical examination was performed on all subjects. We measured fasting glucose, total cholesterol, triglycerides, high-density lipoprotein, hs-CRP, homocysteine levels and others by blood sampling. The metabolic syndrome was defined by the criteria for clinical diagnosis of the metabolic syndrome by AHA/NHLBI. Results: The mean ages in the study group and the control group were 54.6±9.3 and 54.6±8.7 years, respectively, and the numbers of males 29 (27.1%) and 39 (31.7%), respectively. The plasma homocysteine was observed to be positively correlated with age, waist circumference, diastolic blood pressure, apolipoprotein A-1, fasting glucose, fasting insulin, HOMA-IR, and hs-CRP. Among the components of the metabolic syndrome, hypertension showed a strong correlation with the levels of the plasma homocysteine (10.62±3.92 ųmol/L vs. 9.09± 2.63 ųmol/L, P=0.001), whereas hyperglycemia, abdominal obesity, and dyslipidemia did not correlate with the levels of plasma homocysteine. Adjusted homocysteine levels to age, gender, alcohol drinking history, and smoking history was still higher in the study group compared to those in the control group (10.320±0.290 ųmol/L vs. 10.320±0.290 ųmol/L, P=0.017). Conclusion: The results indicate that the metabolic syndrome leads to a higher level of homocysteine in adults after adjustment to age, gender, alcohol drinking history, and smoking history. (J Korean Acad Fam Med 2008;29:499-505)
Background: This study was carried out to determine the usefulness of regional body fat measured by dual energy X-ray absorptiometry (DEXA) by examining the relationship between regional body fat and metabolic risk factors. Methods: A total of 98 women aged 18∼65 years with central obesity (waist circumference ≥80 cm) took the evaluation for metabolic risk factors (blood pressure, fasting glucose, insulin, high sensitive c-reactive protein (hs-CRP), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR)) and the anthropometric measurement, and regional body fat measurement using DEXA. The relationship of regional body fat with the metabolic risk factors, the metabolic syndrome (MS) defined by the International Diabetes Federation and insulin resistance (IR, defined by HOMA-IR≥2.48) were assessed. The analyses were conducted using regression and logistic regression analyses. Results: After adjustment for age and total body fat (%), legs fat (%) was significantly and negatively associated with LDL-C, triglyceride, HOMA-IR, and hs-CRP, while positively with HDL-C. The 1% increase of legs fat was associated with the MS by odds ratio of 0.82 (95% C.I 0.71∼0.96) and with the IR by odds ratio of 0.80 (95% C.I. 0.67∼0.95). Trunk fat (%) was significantly and positively associated with LDL-C, triglycerides, and HOMA-IR. The 1% increase of trunk fat was associated with the MS by odds ratio of 1.32 (95% C.I. 1.03∼1.71) and with the IR by odds ratio of 1.33 (95% C.I. 1.01∼1.77). The ratio of android fat to gynoid fat was significantly and positively associated with LDL-C, triglycerides, glucose, and HOMA- IR, while negatively with HDL-C. The 0.1 increase of the ratio was associated with the MS by odds ratio of 1.66 (95% C.I. 1.07∼2.60). Conclusion: The trunk fat, and legs fat, the ratio of android fat to gynoid fat assessed by DEXA seemed to be useful indicators to predict the metabolic risk factors in women with central obesity. (J Korean Acad Fam Med 2008;29:506-512)
Background: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. Methods: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. Results: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P＜0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07∼0.77, P＜0.05]). Conclusion: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease. (J Korean Acad Fam Med 2008;29:513-519)
The prevalence of osteoporosis was increased. Bisphosphonates are effective medications for osteoporosis because these are increasing bone mineral density and lowering the risk of fractures. Recently, bisphosphonate associated osteonecrosis of the jaws has been well documented. Most reports relate to complications resulting from intravenous bisphosphonate therapy. Oral bisphosphonates have a good safety profile in the treatment of osteoprosis. A few cases were reported about oral bisphosphonates associated osteonecrosis, and we could not find Korean case in literatures. The aim of this repot is to present a Korean women case of osteonecrosis of the jaw associated with oral bisphosphonate treatment for osteoprosis. (J Korean Acad Fam Med 2008;29:520-524)
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