Integrative Korean Medicine Treatment for Obesity and Overweight in Children and Adolescents: A Multicenter Retrospective Chart Review Study

Introduction

Integrative Korean medicine treatment (IKM), including herbal medicine (HM) and acupuncture, has been widely used for obesity and overweight in children and adolescents in South Korea. We investigated the real-world usage status and the potential effect of the IKM for obesity and overweight in children and adolescents.

Methods

Multicenter medical charts were retrospectively reviewed of obese and overweight children and adolescents who visited Korean medicine institutions with the goal of weight control for the first time and received IKM, to analyze the usage status and effect of IKM. We defined IKM responders as those with an improved obesity grade on the body mass index (BMI) percentile and analyzed their characteristics.

Results

Medical charts of 209 patients (183 obese and 26 overweight) with a mean age of 11.45 years were examined. Patients visited the institution a mean of 5.95 times, and HM alone and HM plus acupuncture were frequently used IKM. HM was prescribed to 205 patients, 167 of whom received an HM prescription containing Ephedrae Herba. An HM of the decoction type was prescribed to 189 patients, and the average treatment duration was 76.54 days. After IKM, the percentile and z-score of BMI and weight significantly declined and height percentile and z-score were significantly enhanced, without serious adverse events. In the IKM responders, age, and the proportion of girls and overweight were significantly higher, and the percentile and z-score of height, weight, and BMI were significantly lower.

Conclusion

This is the first study to examine the real-world usage of IKM for obesity and overweight in children and adolescents. A significant improvement in obesity-related outcome measures after IKM, illustrated the potential effect of IKM.

Factors affecting the use of herbal medicines for weight loss in overweight and obese adolescents

Objectives

Herbal medicine (HM) is widely used to treat obesity in adolescents worldwide since the currently available interventions have low compliance and lack long-term effects and safety data. This study aimed to analyze the factors affecting HM use for weight loss in overweight and obese adolescents.

Methods

A total of 46,336 adolescents were included in this cross-sectional study based on the Korea Youth Risk Behavior Web-Based Survey. Three models of HM use for weigh loss were developed by sequentially adding predisposing, enabling, and need factors according to Andersen's model using multiple logistic regression analyses considering the complex sampling design.

Results

Male and female high school students and students from low perceived household economic status were less likely to use HM for weight loss. Students whose fathers had a college degree or higher, depressed mood, and two or more chronic allergic diseases were more likely to use HM. Male students who perceived their body image as fat or very fat tended to use HM less than those who perceived their body image as very thin, thin, or moderate. Obese female students tended to use HM more than overweight female students.

Conclusion

These results can be used as the bases to promote HM use, provide ideas for future research, and strengthen the health insurance coverage extension for weight loss interventions.

A nationwide survey on the management of the COVID-19 pandemic and respiratory disease in South Korea

Background

This study aimed to explore individual prevalence of respiratory symptoms and to describe the Korean population's treatment approaches, preventive health behaviors, and mental health conditions during the pandemic.

Methods

We analyzed responses from an online nationwide survey, conducted between February 2021 to May 2021, about people's experiences during the pandemic. Statistical analysis was also performed to see if there were any significant differences in treatment and prevention strategies between different groups of respondents (between those had respiratory symptoms, compared with those who did not, and between those tested positive for COVID-19, compared with those who did not).

Results

A total of 2,177 survey respondents completed the survey and, of these, only 142 had experienced symptoms. The most frequently reported respiratory infections related symptoms were runny or blocked nose (47.6%), cough (45.5%), fever (44.1%), sore throat (42.0%), and fatigue (30.1%). More than half of the respondents (53.1%) used complementary and alternative medicine (CAM) approaches as means of preventive measures. In terms of preventive behaviors, the more emphasized behaviors were mask-wearing (58.9%) and hand-washing after coming home (42.7%). The majority of the respondents (64.9%) did not show signs of mental health issues.

Conclusion

In South Korea, conventional medicine was mainly used for COVID-19 treatment whereas CAM was commonly used as preventive measures. COVID-19 was also found to have less impact on the general population's mental health. The findings of this study may shed light on how the pandemic impacted the general population.

Comparison of anthropometric and body composition indices in the identification of metabolic risk factors

Whether anthropometric or body composition indices are better indicators of metabolic risk remains unclear. The objectives of this study were to compare the association of metabolic risk factors with anthropometric and body composition indices and to identify the better indicators for risk factors in a large-scale Korean population. In this cross-sectional study, the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) as anthropometric indices and trunk fat mass (TFM), percent trunk fat mass (%TFM), whole-body total fat mass (WBTFM), and percent whole-body total fat mass (%WBTFM) as body composition indices with metabolic risk factors were compared by complex-samples multiple logistic regression models based on complex-sample survey data. In men, WHtR, BMI, and TFM were similarly associated with hypertension. Diabetes, hyperlipidemia, and hypo-high-density lipoprotein (HDL) cholesterolemia tended to be more strongly associated with WHtR and WC than body composition indices. Hypertriglyceridemia and hypercholesterolemia were more strongly associated with WHtR and %TFM than other indices. In women, hypertension tended to be more strongly associated with WHtR than other indices. TFM, %TFM, and WHtR were similarly associated with hyperlipidemia. Diabetes and hypo-HDL cholesterolemia were more strongly associated with WHtR and WC than body composition indices. Hypertriglyceridemia and hypercholesterolemia were more strongly associated with WHtR and %TFM than other indices. Among six metabolic risk factors, the validity and utility of the anthropometric indices in identifying risk factors tended to be similar to or better than those of the body composition indices, except for hypertension and hypercholesterolemia in men and hyperlipidemia and hypercholesterolemia in women.

Prediction of Hypertension Based on Facial Complexion

This study aims to investigate the association between hypertension and facial complexion and determine whether facial complexion is a predictor for hypertension. Using the Commission internationale de l'éclairage L*a*b* (CIELAB) color space, the facial complexion variables of 1099 subjects were extracted in three regions (forehead, cheek, and nose) and the total face. Logistic regression was performed to analyze the association between hypertension and individual color variables. Four variable selection methods were also used to assess the association between hypertension and combined complexion variables and to compare the predictive powers of the models. The a* (green-red) complexion variables were identified as strong predictors in all facial regions in the crude analysis for both genders. However, this association in men disappeared, and L* (lightness) variables in women became the strongest predictors after adjusting for age and body mass index. Among the four prediction models based on combined complexion variables, the Bayesian approach obtained the best predictive in men. In women, models using three different methods but not the stepwise Akaike information criterion (AIC) obtained similar AUC values between 0.82 and 0.83. The use of combined facial complexion variables slightly improved the predictive power of hypertension in all four of the models compared with the use of individual variables.

The number of household members as a risk factor for peptic ulcer disease

Peptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.

Test-retest reliability of the questionnaire in the Sasang constitutional analysis tool (SCAT)

Background

The Sasang constitutional analysis tool (SCAT) is an integrated Sasang constitutional analysis system developed by the Korea Institute of Oriental Medicine. This study aimed to evaluate the reliability of a questionnaire for measuring personality and pathophysiological symptoms that is one of the components of the SCAT.

Methods

In this study, data were collected from university students in their twenties. Tests were administered twice, with an interval of 4 weeks between tests. Test-retest data from 176 students were collected and used for analysis. Internal consistency reliability was analyzed by using Cronbach's alpha coefficient, and test-retest reliability was analyzed by using Spearman's rank correlation coefficient.

Results

Cronbach's alpha coefficient was 0.788 for personality, 0.511 for eating habits, 0.718 for digestion, 0.667 for heat- or cold-wise penchant, and 0.612 for water ingestion. Spearman's rank correlation coefficients, which were used to assess correlations between test and retest results, ranged from 0.444 to 0.828.

Conclusion

The internal consistency and test-retest reliability of the SCAT questionnaire were found to be satisfactory.

Dietary taurine intake and serum taurine levels of women on Jeju Island

The purpose of this study was to investigate the dietary taurine intake and serum taurine levels of women on Jeju Island in Korea. Sixty six married women aged 43.5 +/- 7.1 volunteered for this study: 34 from the city area and 32 from two fishing-farming areas. Diet samples were collected from the participants; the samples included three meals (breakfast, lunch and supper), including snacks, drinks and whatever else the participants had eaten for 24 hours. Taurine levels in the diet and serum were determined as the dabsyl derivative by HPLC with a Rf-detector. The intake of taurine ranged from 8.4 to 767.6 mg/day and its mean value was 163.9 +/- 150.2 mg/day (mean +/- SD). There was a significant difference between the two groups: 114.9 +/- 78.7 for the women from the city area and 215.9 +/- 187.9 mg/day for the women from the fishing-farming areas (p<0.001). The taurine intake of the total diet, including all snacks and drinks, was 2300 +/- 584 g/day for the city area and 2342 +/- 528 g/day for the fishing-farming areas. The daily protein intake was 58.8 +/- 16.4 g for the women of the city area and 65.5 +/- 17.1 g for the women of the fishing-farming areas. There was a significant correlation between the intake of fish/shellfish and taurine (p=0.001) while there was no correlation between the intake of protein and taurine (p=0.057). The taurine levels in serum ranged from 68.6 to 261.6 micromol/L and the mean value was 169.7 +/- 41.5 micromol/L. There was no significant difference between the women from the city area and the women from the fishing-farming areas in serum taurine levels. The correlations of serum taurine levels with serum retinol levels (p=0.016) and alpha-tocopherol (p=0.014) levels were significant. These results suggest that taurine intake is dependent on the fish/shellfish intake and that taurine may play an important role in the retention of antioxidative nutrients.

Temporal integration of the pi 1/pi 3 pathway in normal and dichromatic vision

Stiles' pi 1 and pi 3 mechanisms are thought to reflect adaptation events at two sites in a single pathway, the first site controlled by the short-wavelength cones alone, the second site controlled by opposing signals from these cones vs the other cone classes. We examined this pathway's temporal integration under conditions that yield the full gamut of possible adaptation states at the two sites. Critical duration of the pi 1/pi 3 pathway was always about 200 msec. In addition, we examined the pi 1 and pi 3 mechanisms of dichromatic vision. Our results suggest that protanopic and deuteranopic vision are characterized by a pi 1/pi 3 pathway similar to that in normal color vision.

Formation and Purification of Serratia marcescens Arylsulfatase

The effects of culture conditions on arylsulfatase production by six strains of the genus Serratia were studied. Synthesis of arylsulfatases in all six strains was repressed in media with inorganic sulfate or methionine as the sole source of sulfur and derepressed by the addition of tyramine. Serratia marcescens IFO 3046 grew most rapidly and produced a high level of arylsulfatase when cultured on mannitol with inorganic sulfate and tyramine. The derepressed synthesis of arylsulfatase in S. marcescens was not subject to strong catabolite repression. The molecular weight of purified arylsulfatase was determined to be between 46,000 and 49,000. Arylsulfatase from S. marcescens differed in K m and V max values, substrate specificities, fluoride inhibition, and electrophoretic mobility from the enzyme from K. aerogenes , but had the same molecular weight as the latter.

Affinity chromatography od Klebsiella arylsulfatase on tyrosyl-hexamethylenediamine-beta-1,3-glucan and immunoadsorbent

A simple and convenient method for preparation of a highly purified arylsulfatase (EC 3.1.6.1) from Klebsiella aerogenes has been developed. Specificity of purification was achieved by using affinity chromatography on a tyrosyl-hexamethylenediamino-beta-1,3-glucan or on a solid phase immunoadsorbent. By using affinity chromatography a homogeneous enzyme was obtained with high yield. It is also proposed that the beads of curdlan type polysaccharide consisting of beta-1,3-glucan can be used as a good matrix for affinity chromatography.