Association between Exercise and Metabolic Syndrome in Koreans

Association of Exercise Intensity with the Prevalence of Glaucoma and Intraocular Pressure in Men: A Study Based on the Korea National Health and Nutrition Examination Survey

Adequate exercise is essential for maintaining a healthy lifestyle and preventing ageing-related diseases. The purpose of this study was to assess the associations between exercise and glaucoma, as well as exercise and intraocular pressure (IOP) levels. This study used data from the Korea National Health and Nutrition Examination Surveys 2008–2012, which in total included 10,243 men aged ≥40 years. The presence of glaucoma and the higher IOP of each eye (IOPmax) taken from the health examination survey and the ophthalmic examination were used for analyses. A questionnaire was used to assess exercise activity, which was analysed regarding intensity, frequency, and duration. Regression analyses were used to determine the relationships of exercise parameters with the odds of glaucoma and IOPmax. The prevalence of glaucoma was significantly lower in men who engaged in moderate-to-vigorous intensity exercise compared to those who did not exercise (p = 0.012). The odds for glaucoma were the lowest in men engaged in vigorous intensity exercise (p = 0.009). However, IOPmax was highest in the vigorous intensity exercise group (p = 0.026) with no linear trend pattern. These results suggest that exercise decreased the odds of glaucoma via several factors including non-IOP mechanisms.

Acculturation, Physical Activity, and Metabolic Syndrome in Asian American Adults

INTRODUCTION

Asian Americans (AsAms) have a high prevalence of metabolic syndrome (MetS) and are one of the least physically active racial groups in America. The purpose of this study was to examine the relationship between MetS and moderate-to-vigorous physical activity (MVPA) among AsAm adults and whether acculturation modifies this relationship.

METHOD

Data were from 2,259 AsAms participating in the 2011-2016 National Health and Nutrition Examination Survey. Physical activity (PA) was self-reported as minutes of weekly MVPA. Acculturation included nativity, length of residency in America, and language preference. The International Diabetes Federation criteria was used to determine the presence of MetS.

RESULTS

About 64.4% of AsAms did not meet the PA recommendation (MVPA ≥150 min/week). The prevalence of MetS was 39.2%. The odds of having MetS were greater among AsAms who did not meet MVPA recommendations compared with those who did meet MVPA recommendations (odds ratio [OR] = 1.5, 95% confidence interval [CI] = [1.11, 2.07]). When stratified by acculturation, this association remained statistically significant in the groups who immigrated to America more than 15 years ago and who spoke English only.

CONCLUSION

MVPA reduces MetS risk in AsAm adults, especially among more acculturated AsAms. Culturally adapted programs are warranted to promote PA and adequate knowledge of disease prevention in this population.

Association between Cardiorespiratory Fitness and Metabolic Syndrome in Korean Older Adults

BACKGROUND

Little is known about the relationship between non-exercise-based estimation of cardiorespiratory fitness (eCRF) and metabolic syndrome (MetS) in Korea. The current study examined the prognostic role of eCRF in the risk stratification of MetS in a representative sample of Korean older adults (1822 men and 3069 women).

METHODS

The data used in the current study were extracted from the Korea National Health and Nutrition Examination Surveys IV and V. eCRF was obtained using a previously validated algorithm. MetS was defined according to the National Cholesterol Education Program definition with the acceptance of a Korean-specific waist circumference cutoff point.

RESULTS

Lower eCRF was significantly correlated with abnormalities in several components of MetS, including abdominal obesity, elevated glucose, elevated triglycerides, and decreased high-density lipoprotein cholesterol. Furthermore, there was an inverse linear relationship between MetS prevalence and eCRF levels; higher eCRF was significantly and independently associated with lower prevalence of MetS.

CONCLUSION

The current findings suggest that eCRF can be adopted as a prognostic measure in determining the risk for MetS for elderly persons.

Association of physical activity with sarcopenia evaluated based on muscle mass and strength in older adults: 2008-2011 and 2014 - 2018 Korea National Health and Nutrition Examination Surveys

Background

Adequate physical activity (PA) is essential for preventing sarcopenia in older adults. However, there are insufficient epidemiological data on the intensity of PA needed to prevent age-related sarcopenia. The purpose of this study was to investigate the association of PA intensity with skeletal muscle mass and muscle strength.

Methods

This was a population-based study with a cross-sectional design that was conducted using data from the 2008 − 2011 and 2014 − 2018 Korea National Health and Nutrition Examination Surveys, which included a total of 11,162 participants aged ≥ 60 years. PA was assessed using the results of a questionnaire and organized by intensity, frequency, and duration. The study population was divided into the following groups based on PA intensity: no exercise, walking only, moderate PA, and vigorous PA. To assess sarcopenia, skeletal muscle index (SMI) and hand grip strength (HGS) were measured as indicators of muscle mass and strength, respectively. Logistic regression analysis was used to explore the relationship between PA intensity and sarcopenia.

Results

SMI and HGS were significantly higher in men and women engaged in moderate to vigorous PA than in those who did not exercise. The odds ratios (ORs) for sarcopenia defined based on SMI and HGS were lowest in men engaged in vigorous PA (0.444, 95% confidence interval [CI]: 0.242 − 0.818 and 0.450, 95% CI: 0.228 − 0.890, respectively). In women, the OR for sarcopenia defined based on HGS was the lowest in the group engaged in vigorous PA (0.441, 95% CI: 0.199 − 0.975), while there was no risk reduction for sarcopenia defined based on SMI.

Conclusions

Moderate to vigorous PA was highly correlated with SMI and HGS in men and women. Intensive PA was positively correlated with sarcopenia prevention, which can be monitored using HGS.

Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study

BACKGROUND

Metabolic syndrome (MetS) status changes over time, but few studies have investigated the relationship between the extent or duration of exposure to MetS and the risk of cardiovascular disease (CVD). We investigated the cumulative effects of MetS and its components on the risk of myocardial infarction (MI) and stroke.

METHODS

From the Korean National Health Insurance database, 2,644,851 people who received annual health examinations from 2010 to 2013 were recruited. Exposure-weighted scores for MetS during this 4-year period were calculated in two ways: cumulative number of MetS diagnoses (MetS exposure score, range: 0-4) and the composite of its five components (MetS component exposure score, range: 0-20). The multivariable Cox proportional-hazards model was used to assess CVD risk according to the exposure-weighted scores for MetS.

RESULTS

MetS was identified at least once in 37.6% and persistent MetS in 8.2% of subjects. During the follow-up (median, 4.4 years), 10,522 cases of MI (0.4%) and 10,524 cases of stoke (0.4%) occurred. The risk of MI and stroke increased gradually with increasing exposure scores of MetS and its components (each P for trend < 0.0001). The hazard ratio [(HR) (95% CI)] of MI and stroke were 5.27 (4.20-6.62) and 3.90 (3.09-4.93), respectively, in those with a score of 20 compared with those with a MetS component exposure score of 0. People fulfilling only two MetS components out of 20 already had 22% increased risk of MI, and those with three MetS components had 24% increased risk of stroke. These associations were consistent in the subgroup and sensitivity analyses.

CONCLUSIONS

A dose-response relationship between the cumulative exposure to metabolic disturbances and incident MI or stroke was evident. Even minimal exposure to MetS components was sufficient to increase the risk of CVD significantly, highlighting the importance of intensive risk management for the prevention of CVD.

Effects of physical activity on bone mineral density in older adults: Korea National Health and Nutrition Examination Survey, 2008-2011

We compared the relationship between physical activity (PA) and bone mineral density (BMD) in men and women aged over 50 years. Only moderate-to-vigorous PA was positively associated with hip BMD in men. There was no association between PA and BMD at any site in women.

INTRODUCTION

Physical activity (PA) is widely recommended for osteoporosis. However, epidemiological data regarding the intensity or volume of PA required for bone health are lacking. We aimed to investigate and compare the relationship between PA and bone mineral density (BMD) in men and women.

METHODS

This population-based cross-sectional study used data from the 4th and 5th Korea National Health and Nutrition Examination Surveys and included 2767 men and 2753 women aged > 50 years. The intensity, frequency, and duration of PA were assessed using a questionnaire, and the participants were divided into the no activity, walking-only, moderate PA, and vigorous PA groups. BMD was measured at the lumbar spine (LS), femur neck (FN), and total hip (TH) using dual-energy X-ray absorptiometry.

RESULTS

Adjusted-BMDs of the hip were higher in men and women in the moderate and vigorous PA groups than those in men and women in the walking-only and no activity groups, while frequency and duration of PA were not associated with BMD at any site. The odds ratios for osteoporosis were the lowest at the FN and TH in men in the vigorous PA group (0.354, 95% confidence interval (CI) 0.139-0.901, P < 0.002, and 0.072, 95% CI 0.007-0.766, P < 0.003, respectively), while it was not significant in women.

CONCLUSION

Only moderate-to-vigorous PA was positively associated with the hip BMD in men. There was no association between PA and BMD at any site in women. It is necessary to assess the PA intensity for bone health based on the site and sex.

Association of Relative Handgrip Strength and Metabolic Syndrome in Korean Older Adults: Korea National Health and Nutrition Examination Survey VII-1

BACKGROUND

The prevalence of metabolic syndrome (MetS) is rapidly increasing with advanced age. Since aging affects sarcopenia and muscle strength, which could, in turns, affect MetS, it is critical to examine the association between MetS and muscle strength in this population. Handgrip strength (HGS) has been introduced as a simple assessment tool for muscular strength. Several studies investigating the association between HGS and the risk of MetS have yield conflicting results. Therefore, this study aimed to investigate the association of MetS and relative handgrip strength (RHGS) in elderly Koreans.

METHODS

A total of 1,244 (male, 589; female, 655) elderly subjects (age ≥65 years), who participated in the Seventh Korea National Health and Nutrition Examination Survey VII-1 (2016) were analyzed. Participant's HGS, body mass index (BMI), MetS, and its five criteria were measured. Subjects were categorized into four groups based on their RHGS, which was defined as absolute HGS divided by BMI.

RESULTS

The highest quartile RHGS group has a significantly lower prevalence of MetS in both men and women (F=35.16, P<0.001 vs. F=31.78, P<0.001, respectively). Moreover, the odds ratio of MetS was 0.52 times lower (0.52; 95% confidence interval [CI], 0.31-0.85) in the third quartile RHGS than that of the lowest RHGS, and 0.28 times lower (0.28; 95% CI, 0.17-0.47) in the highest RHGS group in women than that of the lowest RHGS group.

CONCLUSION

Maintaining a high level of HGS may reduce the incidence rate of MetS in elderly Koreans.