Adolescent Build Plotting on Body Composition Chart and the Type of Diabetes Mellitus

Although the prevalence of type 2 diabetes is increasing, there are cases difficult to categorize into certain type in pediatric diabetic patients. The aims of this study were to detect and choose a proper treatment modality for atypical cases of diabetes mellitus, using the body composition chart. We conducted a retrospective study from August 2005 to 2012 with patients who visited Konkuk University Medical Center, and were diagnosed with diabetes mellitus. The medical records were reviewed for the anthropometric data and indices of body composition. The subjects were grouped by the type of diabetes and gender. We constructed a body composition chart plotting fat free mass index and fat mass index (FMI). Body mass index and all body composition indices were higher in type 2 diabetes, in each gender in analysis with Mann-Whitney test. Significant determinant of diabetes type was revealed as FMI and contributing factors on FMI were analyzed with regression analysis. Six atypical cases were identified by a body composition chart including non-obese type 2 diabetes showing suboptimal growth with lower BMI related to relatively lower insulin secretion and type 1 diabetes with insulin resistance resulted from obesity. Body composition chart analysis might be useful in characterization of diabetes type and detection of atypical cases and early adjustment of diabetes management strategy.     

On the body composition of the Eskimo

The body composition of 74 adult Eskimos (33 males, 41 females) has been determined by a Deuterium oxide dilution method. The figures for lean mass are comparable with those for the white population when reported on an absolute basis, but are larger if expressed per unit of standing height. Percentages of body fat (average 13.4% in males, 22.6% in females) are at least as high as encountered in many series of college students, despite very low skinfold readings; the possibility is suggested that body fat has a different regional distribution in the Eskimo. Blood volumes as measured by a carbon monoxide method are in the high normal range (95.7 ml/kg in the males, 91.0 ml/kg in the females); however, lower values in hunters (83.6 ml/kg) than in settlement Eskimos (94.6 ml/kg) suggests that dehydration may be incurred during hunting trips. If so, the deuterium method may over-estimate the body fat of the hunters.Blood volumes are related to body water in the females, but not in the males. Perhaps because skinfold readings are so low, there is no relationship between skinfold thickness and body fat in the male Eskimos. In the females, the best equation accounts for only 25% of the variance in the data:% Body fat=12.8–0.245 (triceps, mm)+0.690 (subscapular, mm)+0.475 (suprailiac, mm).     

Diagnostic Performance of Body Mass Index Using the Western Pacific Regional Office of World Health Organization Reference Standards for Body Fat Percentage

Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic performance of BMI using the Western Pacific Regional Office of World Health Organization reference standard for BF%-defined obesity by sex and age and identified the optimal BMI cut-off for BF%-defined obesity using receiver operating characteristic curve analysis. BMI-defined obesity (≥25 kg/m²) was observed in 38.7% of men and 28.1% of women, with a high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72% women) for BF%-defined obesity (25.2%, men; 31.1%, women). The optimal BMI cut-off (24.2 kg/m²) had 78% sensitivity and 71% specificity. BMI demonstrated limited diagnostic accuracy for adiposity in Korea. There was a -1.3 kg/m² difference in optimal BMI cut-offs between Korea and America, smaller than the 5-unit difference between the Western Pacific Regional Office and global World Health Organization obesity criteria.

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Body cell mass and physical performance capacity (W170) of school children

Summary The physical working capacity (W ₁₇₀) of 38 boys and 27 girls at the age between 8 and 16 years was investigated. Simultaneously the potassium content of the body representing the body cell mass was determined using the⁴⁰ K-method.W ₁₇₀ was correlated with the results thus obtained, as well as with body weight and body height. The best correlations were found betweenW ₁₇₀ and the potassium content. Minimal differences between the sexes were observed. Possible causes for these differences are discussed.     

Effects of Body Composition, Leptin, and Adiponectin on Bone Mineral Density in Prepubertal Girls

Body weight is positively associated with bone mineral density but the relationship between obesity and bone mineral density is unclear. Leptin and adiponectin are potential independent contributors to bone mineral density. We assessed the correlations of body composition, leptin and adiponectin with bone mineral density, and whether leptin, adiponectin and body composition determine bone mineral density independently in prepubertal girls. Forty-eight prepubertal girls were classified into obese and control groups by body mass index. Serum leptin and adiponectin levels were determined by enzyme immunoassay. Bone mineral density was measured using dual energy radiography absorptiometry and body composition was measured using bioelectrical impedance analysis. Lean and fat mass, and leptin were positively correlated with bone mineral density. Lean mass was a positive independent predictor of femoral and L-spine bone mineral density. Serum leptin was a postivie independent predictor of femoral bone mineral density. Fat mass was a negative independent predictor of femoral bone mineral density. In prepubertal girls, lean mass has a favorable effect on bone mineral density. Fat mass seems not to protect the bone structure against osteoporosis, despite increased mechanical loading. Serum leptin may play a biological role in regulating bone metabolism.     

Body mass index and waist circumference according to glucose tolerance status in Korea: the 2005 Korean Health and Nutrition Examination Survey

The purpose of this study was to investigate the stage of glucose intolerance in which persons showed a maximum obesity in Korea. A total of 4,479 participants, who were involved in the 2005 Korean National Health and Nutrition Examination Survey, was examined. The participants were divided into 5 groups by fasting plasma glucose (FPG); normal fasting glucose (NFG)1, FPG < 90 mg/dL; NFG2, FPG 90-99 mg/dL; impaired fasting glucose (IFG)1, FPG 100-109 mg/dL; IFG2, FPG 110-125 mg/dL; and diabetes mellitus, FPG ≥ 126 mg/dL or with anti-diabetes drugs. In those with FPG < 110 mg/dL, body mass index (BMI) and waist circumference (WC) were increased with increase of FPG (BMI in men; NFG1, 23.3 ± 0.1; NFG2, 24.4 ± 0.1; IFG1, 25.0 ± 0.2 kg/m(2), in women; NFG1, 23.0 ± 0.1; NFG2, 24.0 ± 0.1; IFG1, 24.8 ± 0.2 kg/m(2), WC in men; NFG1, 82.1 ± 0.3; NFG2, 85.3 ± 0.3; IFG1, 86.7 ± 0.5 cm, in women; NFG1, 77.1 ± 0.2; NFG2, 79.4 ± 0.3; IFG1, 81.8 ± 0.6 cm). In IFG2 and diabetes range, there was no more increase of BMI and WC with increase of FPG in each sex. The data suggest that degree of obesity increases with an increase of FPG in range of FPG < 100 mg/dL, peaked in FPG of 100-109 mg/dL, and then plateaus in higher FPG range in general Korean population.     

Body Fat Percentile Curves for Korean Children and Adolescents: A Data from the Korea National Health and Nutrition Examination Survey 2009-2010

A valid assessment of obesity in children and adolescents is important due to significant change in body composition during growth. This study aimed to develop percentile curves of body fat and fat free mass using the Lambda, Mu, and Sigma method, and to examine the relationship among body mass index (BMI), fat mass and fat free mass in Korean children and adolescents, using the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. The study subjects were 834 for boys and 745 for girls aged between 10 and 18 yr. Fat mass and fat free mass were measured by dual-energy x-ray absorptiometry. The patterns of development in body fat percentage, fat mass and fat free mass differed for boys and girls, showing a decreased fat mass with an increased fat free mass in boys but gradual increases with age in girls. The considerable proportion of boys and girls with relatively normal fat mass appeared to be misclassified to be at risk of overweight based on the BMI criteria. Therefore, the information on the percentiles of body fat and fat free mass with their patterns would be helpful to complement assessment of overweight and obesity based on BMI for Korean children and adolescents.     

围绝经期妇女体成分及静息能量代谢变化

背景：女性绝经后雌激素水平下降、年龄增长、活动水平下降都可能引起静息能量消耗的降低,进而引起绝经后女性体成分变化,导致疾病,如肥胖、骨折。 目的：观察绝经前、围绝经期、绝经后妇女体成分及静息代谢率的变化。 方法：收集门诊就诊的2 312例妇女,其中绝经前1 310例、围绝经期790例、绝经后212例,测定体成分和静息能量消耗。 结果与结论：①围绝经期和绝经后女性的全身脂肪百分比显著高于绝经前女性。②3组间的静息代谢率无显著差异,经体质量校正后围绝经期女性的每千克体质量静息代谢率显著低于绝经前女性。③绝经后女性的骨密度、股骨颈抗骨折能力、下肢最大肌力、下肢肌肉分布系数显著低于围绝经期女性和绝经前女性(P < 0.05)。④体质量、下肢肌肉分布系数与每千克体质量静息代谢率呈正相关,身高、体质量指数、全身脂肪含量与每千克体质量静息代谢率呈负相关。以上结果表明,绝经后女性体成分发生变化,身体脂肪含量增加,肌肉含量减少,骨量减少;骨骼、肌肉、关节功能处于退行性变;体成分改变与静息能量消耗之间存在一定的相互关系。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

A U-shaped Association between Body Mass Index and Psychological Distress on the Multiphasic Personality Inventory: Retrospective Cross-sectional Analysis of 19-year-old Men in Korea

Objective personality tests, such as the Minnesota Multiphasic Personality Inventory (MMPI), might be more sensitive to reflect subclinical personality and be more state-dependent in an individual''s lifetime, so they are good scales to predict the psychological distress regarding certain states. The aim of this study was to identify the specific pattern between body mass index (BMI) and psychological distress using the objective personality test. For this study, we investigated BMI and the Korean Military Multiphasic Personality Inventory (MPI). A retrospective cross-sectional study was conducted with 19-yr-old examinees who were admitted to the Military Manpower Administration in Korea from February 2007 to January 2010. Of 1,088,107 examinees, we enrolled 771,408 subjects who were psychologically apparent healthy possible-military-service groups. Afterwards, we reviewed and analyzed directly measured BMI and MPI results. In terms of the validity scales, the faking-good subscale showed an inverted U-shaped association, and faking-bad and infrequency subscales showed a U-shaped association with BMI groups. In terms of the neurosis scales, all clinical subscales (anxiety, depression, somatization, and personality disorder) also showed a U-shaped association with BMI groups. For the psychopath scales, the schizophrenia subscale showed a U-shaped association, and the paranoia subscale showed a near-positive correlation with BMI. In conclusion, a specific U-shaped pattern was observed between BMI and the MPI in 19-yr-old men in Korea. Underweight and obesity are related to psychological distress, so supportive advice and education are needed to them.

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Hyperhomocysteinemia,lipid and lipoprotein disturbances in patients with primary hypertension

PurposesThe main aim of the study was to answer two questions: what are the concentrations of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apo A-I (apolipoprotein A-I), apo B (apolipoprotein B) and Lp(a) (lipoprotein(a)) in serum of patients with primary hypertension and with hyperhomocysteinemia? Is there any correlation between the concentration of homocysteine in blood serum and investigated lipid and lipoprotein parameters in patients with primary hypertension?Material/methodsWe investigated 42 patients with primary hypertension, aged 22–57. The control group consisted of 20 healthy volunteers. The concentration of homocysteine in serum was evaluated using immunochemical method (FPIA – Fluorescence Polarization Immunoassay). The concentration of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides in blood serum were estimated using enzymatic method. Apo A-I, apo B and lipoprotein(a) were assessed using nephelometric method.ResultsThe analysis of the results revealed statistically significant lower concentrations of HDL-cholesterol and apo A-I in blood serum of patients with primary hypertension and hyperhomocysteinemia than in the population with hypertension and normohomocysteinemia. Negative correlation between homocysteine and HDL-cholesterol as well as apo A-I has been revealed.ConclusionQuantitative analysis of the concentration of lipids and lipoproteins in blood serum in patients with primary hypertension and hyperhomocysteinemia may suggest that this type of human population might be more susceptible to atherosclerosis than those with primary hypertension and normal values of homocysteine.     

Homocysteine and age-associated disorders

There are numerous theories of aging, a process which still seems inevitable. Aging leads to cancer and multi-systemic disorders as well as chronic diseases. Decline in age- associated cellular functions leads to neurodegeneration and cognitive decline that affect the quality of life. Accumulation of damage, mutations, metabolic changes, failure in cellular energy production and clearance of altered proteins over the lifetime, and hyperhomocysteinemia, ultimately result in tissue degeneration. The decline in renal functions, nutritional deficiencies, deregulation of methionine cycle and deficiencies of homocysteine remethylation and transsulfuration cofactors cause elevation of homocysteine with advancing age. Abnormal accumulation of homocysteine is a risk factor of cardiovascular, neurodegenerative and chronic kidney disease. Moreover, approximately 50% of people, aged 65 years and older develop hypertension and are at a high risk of developing cardiovascular insufficiency and incurable neurodegenerative disorders. Increasing evidence suggests inverse relation between cognitive impairment, cerebrovascular and cardiovascular events and renal function. Oxidative stress, inactivation of nitric oxide synthase pathway and mitochondria dysfunction associated with impaired homocysteine metabolism lead to aging tissue degeneration. In this review, we examine impact of high homocysteine levels on changes observed with aging that contribute to development and progression of age associated diseases.     

Hyperhomocysteinemia and myocardial remodeling in the sand rat,Psammomys obesus

ObjectiveNumerous studies have shown that a methionine-rich diet induces hyperhomocysteinemia (Hhcy), a risk factor for cardiovascular diseases. The objective of the present study was to determine the involvement of Hhcy in cardiac remodeling in the sand rat Psammomys obesus.Materials and methodsAn experimental Hhcy was induced, in the sand rat Psammomys obesus, by intraperitoneal injection of 300 mg/kg of body weight/day of methionine for 1 month. The impact of Hhcy on the cellular and matricial structures of the myocardium was analyzed with histological techniques (Masson trichrome and Sirius red staining). Immunohistochemistry allowed us to analyze several factors involved in myocardial remodeling, such as fibrillar collagen I and III, metalloproteases (MMP-2 and -9) and their inhibitors (TIMP-1 and -2), TGF-β1 and activated caspase 3.ResultsOur results show that Hhcy induced by an excess of methionine causes, in the myocardium of Psammomys obesus, a significant accumulation of fibrillar collagens I and III at the interstitial and perivascular scales, indicating the appearance of fibrosis, which is associated with an immuno-expression increase of TGF-β1, MMP-9 and TIMP-2 and an immuno-expression decrease of MMP-2 and TIMP-1. Also, Hhcy induces apoptosis of some cardiomyocytes and cardiac fibroblasts by increasing of activated caspase 3 expression. These results highlight a remodeling of cardiac tissue in hyperhomocysteinemic Psammomys obesus.     

Change in Body Compositions of Asian Recipients after Kidney Transplantation

Kidney transplantation and accompanying medical conditions may result in changes in body composition. Such changes have been evaluated in Caucasian recipients, but not in Asian recipients. Herein, we conducted a study on Asian recipients because Asians have a different body composition from Caucasians. A total of 50 Asian recipients was enrolled as a prospective cohort. Using bioelectrical impedance analysis, body composition (muscle and fat mass) was assessed after 2 weeks (baseline), and at 1, 3, 6, 9, and 12 months following kidney transplantation. To find predictors related to changes, the data were analyzed by multivariate analysis using forward selection. All of the patients had good graft function during the study period. Patients gained approximately 3 kg within 1 yr of kidney transplantation. The proportion of muscle mass significantly decreased (P_trend = 0.001) and the proportion of fat mass significantly increased over time (P_trend = 0.002). The multivariate results revealed that male recipients, deceased donor type, and low protein intake were associated with an increase in fat mass and a decrease in muscle mass. The results from this study may help to investigate differences in body composition changes between races, as well as the factors related to these changes.     

The Relationship between Serum Insulin-Like Growth Factor-1 Levels and Body Composition Changes after Sleeve Gastrectomy

IntroductionWe previously reported that preoperative serum insulin-like growth factor-1 (IGF-1) is a predictor of total weight loss percentage (%TWL) after laparoscopic sleeve gastrectomy (LSG). IGF-1 may suppress muscle loss after surgery. IGF-1 almost accurately reflects the growth hormone (GH) secretion status, and GH has lipolytic effects. Therefore, IGF-1 may influence both the maintenance of skeletal muscle and the reduction of adipose tissue after LSG. The identification of the relationship between preoperative serum IGF-1 and body composition changes after LSG can help in understanding the pathophysiology of obesity.MethodsWe retrospectively reviewed 72 patients with obesity who underwent LSG and were followed up for 12 months. We analyzed the relationship between preoperative serum IGF-1 levels and body composition changes after LSG. A multiple regression model was used.ResultsLSG led to a significant reduction in body weight. Both body fat mass and skeletal muscle mass decreased after LSG. Preoperative serum IGF-1 levels significantly correlated with %TWL, changes in skeletal muscle mass, and body fat mass after LSG. The multiple regression model showed that preoperative serum IGF-1 levels were related to decreased body fat mass and maintaining skeletal muscle mass after LSG.Discussion/ConclusionPreoperative IGF-1 measurement helps predict not only successful weight loss but also decreases body fat mass and maintains skeletal muscle mass after LSG.     

Body mass index and C-reactive protein in the healthy Korean aged men

The purpose of this study was to determine the relationship between plasma C-reactive protein (CRP) and body mass index (BMI) in elderly Korean men. A review of routine health examination records were done. Out of 671 eligible elderly men, who had their routine health examination in 2001 at a Health Promotion Center of a university hospital, 367 subjects were included after excluding inflammatory conditions. Subgroup analyses were performed on those who did not smoke and exercised regularly. Body composition, blood pressure, blood samples and radiologic examinations including chest radiography and abdominal ultrasound were obtained from each subject. Age, BMI, current smoking, regular exercise, WBC count, HDL-cholesterol, gamma glutamyl transferase were independently associated with logCRP. BMI subgroups according to the Asia-Pacific guideline did not show any difference in CRP level from each other by ANCOVA (p>0.05). However, BMI groups subdivided according to our criteria showed an association with CRP; the CRP level was lowest in the group of BMI between 18.5-19.4 and showed significant difference from BMI group of the highest BMI group (>or=29.0). Since elevated CRP levels are associated with higher risk for cardiovascular disease, lower BMI (18.5-19.4) levels may be advised for healthy elderly men in Korea.     

高同型半胱氨酸兔软脑膜微循环血栓形成与血管内皮功能

目的观察高同型半胱氨酸（HHcy）模型兔软脑膜微血管口径、白色微小血栓（白微栓）数量和血管内皮功能变化及其相关分析。方法采用L-蛋氨酸皮下注射法建立HHcy家兔模型,应用“颅骨窗口法”和微循环闭路检测系统观察其软脑膜微血管中自微栓数量及微血管口径变化;采用柱前衍生反相高效液相色谱-荧光法检测同型半胱氨酸（Hey）浓度;平行观测血管内皮功能指标血管性血友病因子抗原（vWF,用酶联免疫吸附法）、血浆内皮素-1（ET-1,用ELISA）、血清-氧化氮（NO,用化学比色法）水平;并对HHcy所致ET-1、NO血液浓度变化和微血管口径变化进行相关分析。结果与正常对照组比较,HHcy模型兔软脑膜微血管中白微栓数量增加（23．00±6．00个／min VS4．00±1．00个／min,P〈0．01）,伴微血管口径缩小（80．80±6．30／μmVS110．20±7．20μm,P〈0．01）,ET-1明显增加（168．40±13．20ng／Lvs93．25±13．20ng／L,P〈0．01）,NO明显降低（22．83±3．53μmol／Lvs38．31±3．20μmol／L,P〈0．01）;vWF有所增加,但无显著性差异（127．10±32．33％VS119．55±43．56％,P〉0．05）。相关分析显示,模型兔Hcy水平升高与ET-1血浆浓度成正相关（r=0．727,P〈0．01）;与NO血清浓度成负相关（r=-0．48,P〈0．05）。模型组ET-1含量升高时,微血管收缩明显,两者呈明显负相关（r=-0．56,P〈0．05）;而NO与ET-1的变化相反,微血管收缩时,NO含量降低,微血管扩张时,NO含量升高,两者呈良好正相关关系（r=0．613,P〈0．05）。结论HHcy兔软脑膜微血管口径变化及白微栓增多与HHcy引起的微血管内皮功能紊乱、ET-1／NO等活性物质的合成与分泌失调有关。     

高同型半胱氨酸血症对2型糖尿病视网膜病变的影响

目的:探讨高同型半胱氨酸( HHcy)对2型糖尿病视网膜病变(DR)发生发展的影响。方法:检测152例2型糖尿病(T2DM)患者,包括DR组和非视网膜病变(NDR)组各76例以及50例同期健康体检者(对照组)血浆总Hcy(t Hcy)浓度、空腹血糖(FBG)、空腹胰岛素(FI NS)、糖化血红蛋白( HbA1c)、血脂等,并对上述指标及临床资料进行回顾性分析。结果:DR组血浆t Hcy水平高于NDR组及对照组(P<0 .01) ;DR组中增值型视网膜病变(PDR)亚组t Hcy水平高于背景型视网膜病变(BDR)亚组(P<0 .05) ;Logistic回归分析示,DR的发生与病程、HbA1c、t Hcy和胆固醇有关,血浆t Hcy水平是DR的独立危险因素。结论:HHcy血症是T2DM患者DR发生发展的重要的危险因子之一。     

The Effect of Body Mass Index on Survival in Advanced Epithelial Ovarian Cancer

Controversy remains regarding the effect of obesity on the survival of patients with ovarian cancer in Asia. This study examined the impact of obesity on the survival outcomes in advanced epithelial ovarian cancer (EOC) using Asian body mass index (BMI) criteria. The medical records of patients undergoing surgery for advanced (stage III and IV) EOC were reviewed. Statistical analyses included ANOVA, chi-square test, Kaplan-Meier survival and Cox regression analysis. Among all 236 patients, there were no differences in overall survival according to BMI except in underweight patients. In a multivariate Cox analysis, surgical optimality and underweight status were independent and significant prognostic factors for survival (HR, 2.302; 95% CI, 1.326-3.995; P=0.003 and HR, 8.622; 95% CI, 1.871-39.737; P = 0.006, respectively). In the subgroup of serous histology and optimal surgery, overweight and obese I patients showed better survival than normal weight patients (P = 0.012). We found that underweight BMI and surgical optimality are independent risk factors for the survival of patients with advanced ovarian cancer. High BMI groups (overweight, obese I and II) are not associated with the survival of advanced EOC patient. However, in the subgroup of EOC patients with serous histology and after optimal operation, overweight and obese I group patients show better survival than the normal weight group patients.

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高同型半胱氨酸血症和胰岛素抵抗与糖尿病血管性并发症之间关系探讨

为探讨血浆同型半胱氨酸(tHCY)浓度和胰岛素抵抗(IR)与糖尿病慢性血管并发症之间的关系,将100例2型糖尿病(DM)患者按其有无血管并发症分为A组和B组并以50名正常人作对照组,分别测定tHCY、Insulin、C肽、胰岛素抗体(IAb)、空腹血糖(FBG)、叶酸和VitB12等7项指标。结果显示,A组的前五项指标明显高于B组,后两项指标低于B组。结论:高tHCY浓度和高胰岛素血症与糖尿病血管并发症之间密切相关。     

血浆同型半胱氨酸水平与再发脑梗死的相关性研究

目的:探讨再发脑梗死与血浆同型半胱氨酸水平的关系,并研究高半胱氨酸血症(Hhcy)与再发脑梗死传统危险因素之间的相关性.方法:应用双抗体夹心ELISA法检测153例急性脑梗死患者血浆同型半胱氨酸水平,其中首发性脑梗死77例,复发性脑梗死76例.比较两组患者血浆HCY水平,并对Hhcy与脑梗死传统危险因素进行相关与回归分析.结果:脑梗死首次发作组(FCS组)血浆Hcy水平明显低于复发组(RCS组)(P＜0.05),Hhcy发生率比较,RCS组明显高于FCS组(P＜0.05).结论:Hhcy是脑梗死的独立危险因素,脑梗死患者普遍存在Hhcy,在复发性脑梗死患者中更为明显.