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Association of insomnia and daytime napping with metabolic syndrome and its components in a Korean population: an analysis of data from the Korean Genome and Epidemiology Study
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Da-Been Lee, Dae-Wui Yoon, Inkyung Baik
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Epidemiol Health. 2024;46:e2024031. Published online February 20, 2024
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DOI: https://doi.org/10.4178/epih.e2024031
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Abstract
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Abstract
OBJECTIVES We investigated the association between metabolic syndrome (MetS) and the coexistence of insomnia and daytime napping, because limited data have been reported regarding this association.
METHODS The study population was 8,440 participants aged 40-65 years, who were from the Korean Genome and Epidemiology Study. Self-reported information on insomnia symptoms and nap duration was used to define exposure variables. Data on waist circumference (WC), blood pressure (BP), and fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein cholesterol levels in blood were used to define MetS. Multivariate logistic regression analysis was performed to obtain odds ratio (OR) and 95% confidence interval (CI).
RESULTS In multivariate logistic regression analysis, the coexistence of insomnia and napping was not significantly associated with MetS. However, the insomnia and non-napping group showed higher ORs of high TG (OR, 1.19; 95% CI, 1.02 to 1.39) and high BP (OR, 1.28; 95% CI, 1.10 to 1.49) than the non-insomnia and non-napping group. The combination of non-insomnia and napping and that of insomnia and napping showed higher ORs of high TG (OR, 1.13; 95% CI, 1.00 to 1.29) and high FBG (OR, 1.59; 95% CI, 1.14 to 2.21), respectively. In analyses of insomnia symptoms, only the combination of difficulty in maintaining sleep (DMS) and non-napping showed a higher OR for MetS (OR, 1.25; 95% CI, 1.03 to 1.52) than the non-DMS and non-napping group.
CONCLUSIONS Individuals with insomnia, particularly those who do not take naps, were disproportionately likely to have MetS components, especially TG or BP. Information on these variables may help predict individuals’ vulnerability to specific MetS components.
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Summary
Korean summary
- 불면증과 대사증후군 구성요소와의 유의한 연관성은 낮잠의 유무에 따라 달라진다.
- 낮잠을 자지 않는 불면증 환자는 대사증후군의 구성요소 중 특히 고중성지방이나 고혈압의 위험성이 높아진다.
Key Message
• The significant association of insomnia with MetS components varies with the presence or absence of napping.
• Individuals with insomnia who do not take naps were likely to have MetS components, especially TG or BP.
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Gender-specific associations among neck circumference, the rs9939609 FTO gene polymorphism, and the 14-year risk of metabolic syndrome in the Korean adult population
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Inkyung Baik
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Epidemiol Health. 2024;46:e2024072. Published online August 23, 2024
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DOI: https://doi.org/10.4178/epih.e2024072
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Abstract
OBJECTIVES Limited data exist on the relation between neck circumference (NC) and the risk of developing metabolic syndrome (MS). This study investigated gender-specific associations between NC and the 14-year risk of MS and explored the impact of the FTO rs9939609 polymorphism on these associations.
METHODS This population-based prospective cohort study involved 2,666 participants (1,301 men and 1,365 women), who were free of MS at baseline (2005-2006). Incident MS cases, defined by the presence of 3 or more criteria regarding blood pressure and blood levels of glucose, triglycerides, and high-density lipoprotein cholesterol, were identified through biennial examinations until 2020. NC measurements taken at baseline and between 2013 and 2014 were analyzed using Cox proportional hazard regression to determine gender-specific associations with MS risk.
RESULTS Controlling for potential confounders such as waist circumference (WC), significant associations were observed in both genders. Individuals in the highest NC quartile exhibited more than a 2-fold higher MS risk than those in the lowest quartile; with hazard ratios of 2.37 (95% confidence interval [CI], 1.74 to 3.22) for men and 2.65 (95% CI, 1.89 to 3.72) for women (p for trend <0.001). No significant interaction was found between the <i>FTO</i> polymorphism and NC. In diagnostic test analyses, NC and WC demonstrated comparable area under the curve values in both genders.
CONCLUSIONS The findings suggest that NC is as effective as WC for predicting the incidence of MS.
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Summary
Korean summary
허리둘레는 고혈압, 고혈당, 고지혈증의 위험과 밀접한 관련성을 나타내므로, 대사증후군의 구성 요소로 사용되어 왔다. 하지만 허리둘레 측정 시 피험자의 복장, 자세, 공복 및 식후 상태, 호흡 상태에 따라 측정 오차가 발생한다고 알려졌다. 본 연구는 한국 성인을 대상으로 14년간 진행된 전향적 코호트 연구 자료를 분석하여 목둘레가 허리둘레를 대신해서 대사증후군 위험을 예측할 수 있다는 결과를 확인하였다.
Key Message
Waist circumference has served as an anthropometric component of metabolic syndrome based on data regarding close associations with high blood pressure, hyperglycemia, and dyslipidemia. However, measurement errors of waist circumference due to the subject’s clothing, posture, fasting or postprandial state, and respiratory phase have been pointed out. This 14-year prospective cohort study including Korean adults has revealed that neck circumference can serve as a comparative indicator to waist circumference for predicting metabolic syndrome risk.
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Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults
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Inkyung Baik, Nan Hee Kim, Seong Hwan Kim, Chol Shin
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Epidemiol Health. 2023;45:e2023055. Published online June 8, 2023
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DOI: https://doi.org/10.4178/epih.e2023055
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Abstract
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Abstract
OBJECTIVES This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.
METHODS This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.
RESULTS Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.
CONCLUSIONS BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.
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Summary
Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.
Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.
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- Safety of midodrine in patients with heart failure with reduced ejection fraction: a retrospective cohort study
Ming-Ju Wu, Cheng-Hsu Chen, Shang-Feng Tsai Frontiers in Pharmacology.2024;[Epub] CrossRef
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Association between body temperature and leukocyte telomere length in Korean middle-aged and older adults
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Carolina García-García, Chol Shin, Inkyung Baik
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Epidemiol Health. 2021;43:e2021063. Published online September 8, 2021
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DOI: https://doi.org/10.4178/epih.e2021063
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Abstract
OBJECTIVES Data on associations between body temperature (BT) and leukocyte telomere length (LTL), which has been widely used as a biomarker of cellular senescence in recent epidemiological studies, are limited. Therefore, this study aimed to explore the associations between a normal BT range (35.0-37.5°C) and LTL via 6-year longitudinal observations of 2,004 male and female adults aged 50 or older.
METHODS BT was obtained by measuring the tympanic temperature, and relative LTL was determined by real-time polymerase chain reaction. Robust regression analysis was used to evaluate the association between the baseline and follow-up LTL values and their differences.
RESULTS A significant inverse association was found between BT and LTL at baseline. The regression coefficient estimate was -0.03 (95% confidence interval, -0.07 to -0.001; p<0.05). This association was stronger in participants with a body mass index >25 kg/m<sup>2</sup> and males (p<0.01). However, there were no associations between BT and LTL at follow-up or BT and 6-year longitudinal differences in LTL.
CONCLUSIONS These findings suggest that having a high BT between 35°C and 37.5°C (95°F and 99°F) may be detrimental for obese individuals in terms of biological aging.
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Summary
Korean summary
본 역학 연구는 한국 성인 2,004명을 연구대상자로 하여 2011-2012년에 고막 체온을 측정하고 전혈을 채취하여 백혈구 텔로미어 길이를 분석하였으며 이러한 분석을 2017-2018년에 반복하여 6년 동안의 백혈구 텔로미어 길이 변화를 계산하였다. 고막 체온과 초기 텔로미어 길이의 관련성을 분석한 결과, 정상 체온 범위 내 체온이 높을수록 텔로미어 길이가 유의적으로 짧아지는 생리적 노화 상태와 관련된 것으로 나타났으며, 이러한 결과는 비만할 경우 더욱 분명하게 나타났다. 본 연구 결과를 통해 비만 시 체내 열발생과 관련된 노화 진행이 체중 감소를 통해 지연될 수 있는 가능성이 제시되었다.
Key Message
In an epidemiological study including Korean adults, a relatively higher normal body temperature between 35°C to 37.5°C was found to be associated with shorter leukocyte telomere length, a cellular senescence biomarker. In particular, this association was observed to be stronger among obese participants, suggesting that attaining normal body weight may be beneficial for anti-aging.
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- Higher Daily Air Temperature Is Associated with Shorter Leukocyte Telomere Length: KORA F3 and KORA F4
Wenli Ni, Kathrin Wolf, Susanne Breitner, Siqi Zhang, Nikolaos Nikolaou, Cavin K. Ward-Caviness, Melanie Waldenberger, Christian Gieger, Annette Peters, Alexandra Schneider Environmental Science & Technology.2022; 56(24): 17815. CrossRef
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