- Guideline/Fact Sheet
- Dyslipidemia Fact Sheet in South Korea, 2022
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Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong, on Behalf of the Committee of Public Relation of the Korean Society of Lipid and Atherosclerosis
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Diabetes Metab J. 2023;47(5):632-642. Published online August 2, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0135
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Abstract
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- Background
This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022.
Methods We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020.
Results In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL.
Conclusion Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
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- Complications
- Association of Snoring with Prediabetes and Type 2 Diabetes Mellitus: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort
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So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
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Diabetes Metab J. 2020;44(5):687-698. Published online April 16, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0128
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Background
Evidence suggests that habitual snoring is an independent risk factor for poor glycemic health. We examined the associations between snoring with prediabetes and diabetes in Korean population.
Methods
Self-reported snoring characteristics were collected from 3,948 middle-aged adults without prior cardiovascular diseases. Multivariable linear regression assessed the association of snoring intensity, frequency, disruptiveness, and disrupted breathing with fasting glucose and glycosylated hemoglobin (HbA1c) level. Then, multinomial regression evaluated how increasing snoring symptoms are associated with the risk for prediabetes and diabetes, adjusting for socioeconomic and behavioral risk factors of diabetes, obesity, hypertension, and other sleep variables.
Results
Higher snoring intensity and frequency were positively associated with fasting glucose and HbA1c levels. Participants presenting the most severe snoring were at 1.84 times higher risk (95% confidence interval [CI], 1.09 to 2.29) for prediabetes and 2.24 times higher risk (95% CI, 1.84 to 2.95) for diabetes, compared to non-snorers. Such graded association was also observed amongst the most frequent snorers with higher risk for prediabetes (odds ratio [OR], 1.78; 95% CI, 1.29 to 2.22) and diabetes (OR, 2.03; 95% CI, 1.45 to 2.85). Disruptive snoring (OR, 1.60; 95% CI, 1.12 to 2.28) and near-daily disruptive breathing (OR, 2.18; 95% CI, 1.02 to 4.19) were associated with higher odds for diabetes. Such findings remained robust after additional adjustment for sleep duration, excessive daytime sleepiness, unwakefulness, and sleep-deprived driving.
Conclusion
Snoring is associated with impaired glucose metabolism even in otherwise metabolically healthy adults. Habitual snorers may require lifestyle modifications and pharmacological treatment to improve glycemic profile.
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Ping Wang, Cai Chen, Xingwei Wang, Ningling Zhang, Danyang Lv, Wei Li, Fulai Peng, Xiuli Wang Sleep and Breathing.2023; 27(4): 1297. CrossRef - Association Between Snoring and Diabetes Among Pre- and Postmenopausal Women
Yun Yuan, Fan Zhang, Jingfu Qiu, Liling Chen, Meng Xiao, Wenge Tang, Qinwen Luo, Xianbin Ding, Xiaojun Tang International Journal of General Medicine.2022; Volume 15: 2491. CrossRef - Elevated fasting insulin results in snoring: A view emerged from causal evaluation of glycemic traits and snoring
Minhan Yi, Quanming Fei, Kun Liu, Wangcheng Zhao, Ziliang Chen, Yuan Zhang European Journal of Clinical Investigation.2022;[Epub] CrossRef - Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar
Hiba Bawadi, Asma Al Sada, Noof Al Mansoori, Sharifa Al Mannai, Aya Hamdan, Zumin Shi, Abdelhamid Kerkadi International Journal of Environmental Research and Public Health.2021; 18(8): 4017. CrossRef - Changes in creatinine‐to‐cystatin C ratio over 4 years, risk of diabetes, and cardiometabolic control: The China Health and Retirement Longitudinal Study
Shanhu Qiu, Xue Cai, Yang Yuan, Bo Xie, Zilin Sun, Tongzhi Wu Journal of Diabetes.2021; 13(12): 1025. CrossRef - Association Between Self-Reported Snoring and Metabolic Syndrome: A Systematic Review and Meta-Analysis
Jinsha Ma, Huifang Zhang, Hui Wang, Qian Gao, Heli Sun, Simin He, Lingxian Meng, Tong Wang Frontiers in Neurology.2020;[Epub] CrossRef - Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes
Yongin Cho Diabetes & Metabolism Journal.2020; 44(5): 668. CrossRef
- Metabolic Risk/Epidemiology
- Sex-, Age-, and Metabolic Disorder-Dependent Distributions of Selected Inflammatory Biomarkers among Community-Dwelling Adults
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So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
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Diabetes Metab J. 2020;44(5):711-725. Published online April 16, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0119
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Background
Inflammatory cytokines are increasingly utilized to detect high-risk individuals for cardiometabolic diseases. However, with large population and assay methodological heterogeneity, no clear reference currently exists.
Methods
Among participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort, of community-dwelling adults aged 30 to 64 without overt cardiovascular diseases, we presented distributions of tumor necrosis factor (TNF)-α and -β, interleukin (IL)-1α, -1β, and 6, monocyte chemoattractant protein (MCP)-1 and -3 and high sensitivity C-reactive protein (hsCRP) with and without non-detectable (ND) measurements using multiplex enzyme-linked immunosorbent assay. Then, we compared each markers by sex, age, and prevalence of type 2 diabetes mellitus, hypertension, and dyslipidemia, using the Wilcoxon Rank-Sum Test.
Results
In general, there were inconsistencies in direction and magnitude of differences in distributions by sex, age, and prevalence of cardiometabolic disorders. Overall, the median and the 99th percentiles were higher in men than in women. Older participants had higher TNF-α, high sensitivity IL-6 (hsIL-6), MCP-1, hsCRP, TNF-β, and MCP-3 median, after excluding the NDs. Participants with type 2 diabetes mellitus had higher median for all assayed biomarkers, except for TNF-β, IL-1α, and MCP-3, in which the medians for both groups were 0.00 due to predominant NDs. Compared to normotensive group, participants with hypertension had higher TNF-α, hsIL-6, MCP-1, and hsCRP median. When stratifying by dyslipidemia prevalence, the comparison varied significantly depending on the treatment of NDs.
Conclusion
Our findings provide sex-, age-, and disease-specific reference values to improve risk prediction and diagnostic performance for inflammatory diseases in both population- and clinic-based settings.
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Fei Zhang, Qintao Ge, Jialin Meng, Jia Chen, Chaozhao Liang, Meng Zhang ImmunoTargets and Therapy.2024; Volume 13: 111. CrossRef - Within-subject variation of C-reactive protein and high-sensitivity C-reactive protein: A systematic review and meta-analysis
Alex Gough, Alice Sitch, Erica Ferris, Tom Marshall, Andreas Zirlik PLOS ONE.2024; 19(11): e0304961. CrossRef - Association between physical activity and inflammatory markers in community-dwelling, middle-aged adults
So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Justin Y. Jeon, Hyeon Chang Kim Applied Physiology, Nutrition, and Metabolism.2021; 46(7): 828. CrossRef - The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges
Thomas S. Buttle, Claire Y. Hummerstone, Thippeswamy Billahalli, Richard J. B. Ward, Korina E. Barnes, Natalie J. Marshall, Viktoria C. Spong, Graham H. Bothamley, Selvakumar Subbian PLOS ONE.2021; 16(8): e0247745. CrossRef
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- Association between the Thigh Muscle and Insulin Resistance According to Body Mass Index in Middle-Aged Korean Adults
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Ji Eun Heo, Jee-Seon Shim, Hokyou Lee, Hyeon Chang Kim
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Diabetes Metab J. 2020;44(3):446-457. Published online April 16, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0110
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- Background
We examined the associations between thigh muscle area (TMA) and insulin resistance (IR) according to body mass index (BMI) in middle-aged Korean general population. MethodsTMA was measured using quantitative computed tomography and corrected by body weight (TMA/Wt) in 1,263 men, 788 premenopausal women, and 1,476 postmenopausal women all aged 30 to 64 years. The tertiles of TMA/Wt were calculated separately for men and for premenopausal and postmenopausal women. Homeostatic model assessment for insulin resistance (HOMA-IR) was performed using fasting blood glucose and insulin levels, and increased IR was defined according to sex-specific, top quartiles of HOMA-IR. Associations between the TMA/Wt tertiles and increased IR according to the BMI categories (<25 and ≥25 kg/m2) were assessed using multivariable logistic regression analysis. ResultsIn men with higher BMIs, but not in those with lower BMIs, the presence of an increased IR had significantly higher odds ratios in the lower TMA/Wt tertiles, even after adjustment for visceral fat area. However, in premenopausal and postmenopausal women, there was no significant inverse association between TMA/Wt tertiles and increased IR, regardless of BMI category. ConclusionOur findings suggest that the thigh muscle is inversely associated with IR in men, particularly in those with higher BMIs.
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Zhiming Lu, Yaoda Hu, Huijing He, Xingming Chen, Qiong Ou, Yawen Liu, Tan Xu, Ji Tu, Ang Li, Binbin Lin, Qihang Liu, Tianshu Xi, Weihao Wang, Haibo Huang, Da Xu, Zhili Chen, Zichao Wang, Guangliang Shan Diabetes Research and Clinical Practice.2024; 214: 111783. CrossRef - The Correlation Between Visceral Fat Area to Skeletal Muscle Mass Ratio and Multiorgan Insulin Resistance in Chinese Population With Obesity
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- Response: Association between Non-Alcoholic Steatohepatitis and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus (Diabetes Metab J 2020;44:267–76)
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Hokyou Lee, Gyuri Kim, Yong-ho Lee
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Diabetes Metab J. 2020;44(3):486-487. Published online June 29, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0127
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[Original]
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- Association of Metabolic Dysfunction-Associated Fatty Liver Disease With Left Ventricular Diastolic Function and Cardiac Morphology
Dandan Peng, Zhenqiu Yu, Mingwei Wang, Junping Shi, Lei Sun, Yuanyuan Zhang, Wenbin Zhao, Chen Chen, Jiake Tang, Chunyi Wang, Jie Ni, Wen Wen, Jingjie Jiang Frontiers in Endocrinology.2022;[Epub] CrossRef
- Metabolic Risk/Epidemiology
- Association between Non-Alcoholic Steatohepatitis and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus
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Hokyou Lee, Gyuri Kim, Young Ju Choi, Byung Wook Huh, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Yong-ho Lee, Kap Bum Huh
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Diabetes Metab J. 2020;44(2):267-276. Published online February 28, 2019
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DOI: https://doi.org/10.4093/dmj.2019.0001
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- Background
Impaired diastolic heart function has been observed in persons with non-alcoholic fatty liver disease (NAFLD) and/or with type 2 diabetes mellitus (T2DM). However, it is unclear whether NAFLD fibrotic progression, i.e., non-alcoholic steatohepatitis, poses an independent risk for diastolic dysfunction in T2DM. We investigated the association between liver fibrosis and left ventricular (LV) diastolic dysfunction in T2DM. MethodsWe analyzed 606 patients with T2DM, aged ≥50 years, who had undergone liver ultrasonography and pulsed-wave Doppler echocardiography. Insulin sensitivity was measured by short insulin tolerance test. Presence of NAFLD and/or advanced liver fibrosis was determined by abdominal ultrasonography and NAFLD fibrosis score (NFS). LV diastolic dysfunction was defined according to transmitral peak early to late ventricular filling (E/A) ratio and deceleration time, using echocardiography. ResultsLV diastolic dysfunction was significantly more prevalent in the NAFLD versus non-NAFLD group (59.7% vs. 49.0%, P=0.011). When NAFLD was stratified by NFS, subjects with advanced liver fibrosis exhibited a higher prevalence of diastolic dysfunction (49.0%, 50.7%, 61.8%; none, simple steatosis, advanced fibrosis, respectively; P for trend=0.003). In multivariable logistic regression, liver fibrosis was independently associated with diastolic dysfunction (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.34; P=0.022) after adjusting for insulin resistance and cardiometabolic risk factors. This association remained significant in patients without insulin resistance (OR, 4.32; 95% CI, 1.73 to 11.51; P=0.002). ConclusionsLiver fibrosis was associated with LV diastolic dysfunction in patients with T2DM and may be an independent risk factor for diastolic dysfunction, especially in patients without systemic insulin resistance.
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