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Cardiovascular Risk/Epidemiology
Metabolic Syndrome Severity Score for Predicting Cardiovascular Events: A Nationwide Population-Based Study from Korea
Yo Nam Jang, Jun Hyeok Lee, Jin Sil Moon, Dae Ryong Kang, Seong Yong Park, Jerim Cho, Jang-Young Kim, Ji Hye Huh
Diabetes Metab J. 2021;45(4):569-577.   Published online January 30, 2021
DOI: https://doi.org/10.4093/dmj.2020.0103
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  • 13 Web of Science
  • 14 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population.
Methods
From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve.
Results
Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III.
Conclusion
The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.

Citations

Citations to this article as recorded by  
  • Metabolic syndrome awareness in the general Korean population: results from a nationwide survey
    Hyun-Jin Kim, Mi-Seung Shin, Kyung-Hee Kim, Mi-Hyang Jung, Dong-Hyuk Cho, Ju-Hee Lee, Kwang Kon Koh
    The Korean Journal of Internal Medicine.2024; 39(2): 272.     CrossRef
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    Miao Wang, Chi Wang, Maoxiang Zhao, Shouling Wu, Hao Xue, Hongbin Liu
    Nutrition, Metabolism and Cardiovascular Diseases.2024;[Epub]     CrossRef
  • Omics biomarkers and an approach for their practical implementation to delineate health status for personalized nutrition strategies
    Jaap Keijer, Xavier Escoté, Sebastià Galmés, Andreu Palou-March, Francisca Serra, Mona Adnan Aldubayan, Kristina Pigsborg, Faidon Magkos, Ella J. Baker, Philip C. Calder, Joanna Góralska, Urszula Razny, Malgorzata Malczewska-Malec, David Suñol, Mar Galofr
    Critical Reviews in Food Science and Nutrition.2023; : 1.     CrossRef
  • Development and validation of a continuous metabolic syndrome severity score in the Tehran Lipid and Glucose Study
    Mohammadjavad Honarvar, Safdar Masoumi, Ladan Mehran, Davood Khalili, Atieh Amouzegar, Fereidoun Azizi
    Scientific Reports.2023;[Epub]     CrossRef
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    Yuqi Yang, Qian Li, Yanjun Long, Jing Yuan, Yan Zha
    Diabetology & Metabolic Syndrome.2023;[Epub]     CrossRef
  • Resistin serum levels and its association with clinical profile and carotid intima-media thickness in psoriasis: a cross-sectional study
    Sofia Makishi Schlenker, Sofia Inez Munhoz, André Rochinski Busanello, Matheus Guedes Sanches, Barbara Stadler Kahlow, Renato Nisihara, Thelma Larocca Skare
    Anais Brasileiros de Dermatologia.2023; 98(6): 799.     CrossRef
  • Cholecystectomy Increases the Risk of Type 2 Diabetes in the Korean Population
    Ji Hye Huh, Kyong Joo Lee, Yun Kyung Cho, Shinje Moon, Yoon Jung Kim, Eun Roh, Kyung-do Han, Dong Hee Koh, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm
    Annals of Surgery.2023; 278(2): e264.     CrossRef
  • Cardiorespiratory Endurance is Associated with Metabolic Syndrome Severity in Men
    V. V. Sverchkov, E. V. Bykov
    Journal Biomed.2023; 19(2): 61.     CrossRef
  • Effect of a Wearable Device–Based Physical Activity Intervention in North Korean Refugees: Pilot Randomized Controlled Trial
    Ji Yoon Kim, Kyoung Jin Kim, Kyeong Jin Kim, Jimi Choi, Jinhee Seo, Jung-Been Lee, Jae Hyun Bae, Nam Hoon Kim, Hee Young Kim, Soo-Kyung Lee, Sin Gon Kim
    Journal of Medical Internet Research.2023; 25: e45975.     CrossRef
  • Independent association between age- and sex-specific metabolic syndrome severity score and cardiovascular disease and mortality
    Mohammadjavad Honarvar, Ladan Mehran, Safdar Masoumi, Sadaf Agahi, Shayesteh Khalili, Fereidoun Azizi, Atieh Amouzegar
    Scientific Reports.2023;[Epub]     CrossRef
  • Optimal Low-Density Lipoprotein Cholesterol Levels in Adults Without Diabetes Mellitus: A Nationwide Population-Based Study Including More Than 4 Million Individuals From South Korea
    Ji Hye Huh, Sang Wook Park, Tae-Hwa Go, Dae Ryong Kang, Sang-Hak Lee, Jang-Young Kim
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Triglyceride-Glucose Index for the Diagnosis of Metabolic Syndrome: A Cross-Sectional Study of 298,652 Individuals Receiving a Health Check-Up in China
    Mingfei Jiang, Xiaoran Li, Huan Wu, Fan Su, Lei Cao, Xia Ren, Jian Hu, Grace Tatenda, Mingjia Cheng, Yufeng Wen, Hou De Zhou
    International Journal of Endocrinology.2022; 2022: 1.     CrossRef
  • Changes in body composition, body balance, metabolic parameters and eating behavior among overweight and obese women due to adherence to the Pilates exercise program
    Hyun Ju Kim, Jihyun Park, Mi Ri Ha, Ye Jin Kim, Chaerin Kim, Oh Yoen Kim
    Journal of Nutrition and Health.2022; 55(6): 642.     CrossRef
  • Metabolic Syndrome Severity Score, Comparable to Serum Creatinine, Could Predict the Occurrence of End-Stage Kidney Disease in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
    Pil Gyu Park, Jung Yoon Pyo, Sung Soo Ahn, Jason Jungsik Song, Yong-Beom Park, Ji Hye Huh, Sang-Won Lee
    Journal of Clinical Medicine.2021; 10(24): 5744.     CrossRef
Obesity and Metabolic Syndrome
Impact of Longitudinal Changes in Metabolic Syndrome Status over 2 Years on 10-Year Incident Diabetes Mellitus
Ji Hye Huh, Sung Gyun Ahn, Young In Kim, Taehwa Go, Ki-Chul Sung, Jae Hyuk Choi, Kwang Kon Koh, Jang Young Kim
Diabetes Metab J. 2019;43(4):530-538.   Published online February 20, 2019
DOI: https://doi.org/10.4093/dmj.2018.0111
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  • 20 Web of Science
  • 23 Crossref
AbstractAbstract PDFPubReader   
Background

Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM.

Methods

We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models.

Results

During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group (P for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later.

Conclusion

We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.

Citations

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  • 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association
    Seth S. Martin, Aaron W. Aday, Zaid I. Almarzooq, Cheryl A.M. Anderson, Pankaj Arora, Christy L. Avery, Carissa M. Baker-Smith, Bethany Barone Gibbs, Andrea Z. Beaton, Amelia K. Boehme, Yvonne Commodore-Mensah, Maria E. Currie, Mitchell S.V. Elkind, Kelly
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    Journal of Medical Psychology.2023; 25(1): 7.     CrossRef
  • Gender differences in the impact of 3-year status changes of metabolic syndrome and its components on incident type 2 diabetes mellitus: a decade of follow-up in the Tehran Lipid and Glucose Study
    Farzad Hadaegh, Amir Abdi, Karim Kohansal, Parto Hadaegh, Fereidoun Azizi, Maryam Tohidi
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
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    Yu Ho Lee, Sang Heon Song, Seung Hwan Song, Ho Sik Shin, Jaeseok Yang, Myoung Soo Kim, Hyeon Seok Hwang, Curie Ahn, Jaeseok Yang, Jin Min Kong, Oh Jung Kwon, Deok Gie Kim, Cheol-Woong Jung, Yeong Hoon Kim, Joong Kyung Kim, Chan-Duck Kim, Ji Won Min, Sung
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  • Trajectory patterns of metabolic syndrome severity score and risk of type 2 diabetes
    Atieh Amouzegar, Mohammadjavad Honarvar, Safdar Masoumi, Davood Khalili, Fereidoun Azizi, Ladan Mehran
    Journal of Translational Medicine.2023;[Epub]     CrossRef
  • Differential association of metabolic syndrome and low-density lipoprotein cholesterol with incident cardiovascular disease according to sex among Koreans: a national population-based study
    Su Yong Kim, Tae-Hwa Go, Jun Hyeok Lee, Jin Sil Moon, Dae Ryong Kang, Se Jin Bae, Se-Eun Kim, Sang Jun Lee, Dong-Hyuk Cho, Young Jun Park, Young Jin Youn, Jang Young Kim, Sung Gyun Ahn
    European Journal of Preventive Cardiology.2022; 28(18): 2021.     CrossRef
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    Ji Eun Jun, You-Cheol Hwang, Kyu Jeung Ahn, Ho Yeon Chung, Se Young Choung, In-Kyung Jeong
    Nutrition Research and Practice.2022; 16(1): 60.     CrossRef
  • Stability and Transformation of Metabolic Syndrome in Adolescents: A Prospective Assessment in Relation to the Change of Cardiometabolic Risk Factors
    Pei-Wen Wu, Yi-Wen Lai, Yu-Ting Chin, Sharon Tsai, Tun-Min Yang, Wei-Ting Lin, Chun-Ying Lee, Wei-Chung Tsai, Hsiao-Ling Huang, David W. Seal, Tsai-Hui Duh, Chien-Hung Lee
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    Pezhman Bagheri, Davood Khalil, Mozhgan Seif, Esmaeil Khedmati Morasae, Ehsan Bahramali, Fereidoun Azizi, Abbas Rezaianzadeh
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    Salim S. Virani, Alvaro Alonso, Hugo J. Aparicio, Emelia J. Benjamin, Marcio S. Bittencourt, Clifton W. Callaway, April P. Carson, Alanna M. Chamberlain, Susan Cheng, Francesca N. Delling, Mitchell S.V. Elkind, Kelly R. Evenson, Jane F. Ferguson, Deepak K
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    Journal of Diabetes & Metabolic Disorders.2021; 20(1): 95.     CrossRef
  • Metabolic Syndrome Fact Sheet 2021: Executive Report
    Ji Hye Huh, Dae Ryong Kang, Jang Young Kim, Kwang Kon Koh
    CardioMetabolic Syndrome Journal.2021; 1(2): 125.     CrossRef
  • The Incidence of Metabolic Syndrome and the Valid Blood Pressure Cutoff Value for Predicting Metabolic Syndrome Within the Normal Blood Pressure Range in the Population Over 40 Years Old in Guiyang, China
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  • Metabolic Syndrome Severity Score for Predicting Cardiovascular Events: A Nationwide Population-Based Study from Korea
    Yo Nam Jang, Jun Hyeok Lee, Jin Sil Moon, Dae Ryong Kang, Seong Yong Park, Jerim Cho, Jang-Young Kim, Ji Hye Huh
    Diabetes & Metabolism Journal.2021; 45(4): 569.     CrossRef
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    You-Bin Lee, Da Hye Kim, Seon Mee Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Yong Gyu Park, Kyungdo Han, Hye Jin Yoo
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Complications
Glycated Albumin Is a More Useful Glycation Index than HbA1c for Reflecting Renal Tubulopathy in Subjects with Early Diabetic Kidney Disease
Ji Hye Huh, Minyoung Lee, So Young Park, Jae Hyeon Kim, Byung-Wan Lee
Diabetes Metab J. 2018;42(3):215-223.   Published online May 2, 2018
DOI: https://doi.org/10.4093/dmj.2017.0091
  • 4,381 View
  • 52 Download
  • 9 Web of Science
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AbstractAbstract PDFPubReader   
Background

The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-D-glucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR).

Methods

We classified 1,061 participants with T2DM into two groups according to uNAG level—normal vs. high (>5.8 U/g creatinine)—and measured their biochemical parameters.

Results

Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=−0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%).

Conclusion

GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

Citations

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  • Glucagon-Like Peptide 1 Receptor Agonist Improves Renal Tubular Damage in Mice with Diabetic Kidney Disease
    Ran Li, Dunmin She, Zhengqin Ye, Ping Fang, Guannan Zong, Yong Zhao, Kerong Hu, Liya Zhang, Sha Lei, Keqin Zhang, Ying Xue
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Obesity and Metabolic Syndrome
Relationship between Regional Body Fat Distribution and Diabetes Mellitus: 2008 to 2010 Korean National Health and Nutrition Examination Surveys
Soo In Choi, Dawn Chung, Jung Soo Lim, Mi Young Lee, Jang Yel Shin, Choon Hee Chung, Ji Hye Huh
Diabetes Metab J. 2017;41(1):51-59.   Published online December 21, 2016
DOI: https://doi.org/10.4093/dmj.2017.41.1.51
  • 4,119 View
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  • 35 Web of Science
  • 36 Crossref
AbstractAbstract PDFPubReader   
Background

The aim of this study was to investigate the association between regional body fat distribution, especially leg fat mass, and the prevalence of diabetes mellitus (DM) in adult populations.

Methods

A total of 3,181 men and 3,827 postmenopausal women aged 50 years or older were analyzed based on Korea National Health and Nutrition Examination Surveys (2008 to 2010). Body compositions including muscle mass and regional fat mass were measured using dual-energy X-ray absorptiometry.

Results

The odds ratios (ORs) for DM was higher with increasing truncal fat mass and arm fat mass, while it was lower with increasing leg fat mass. In a partial correlation analysis adjusted for age, leg fat mass was negatively associated with glycosylated hemoglobin in both sexes and fasting glucose in women. Leg fat mass was positively correlated with appendicular skeletal muscle mass and homeostasis model assessment of β cell. In addition, after adjusting for confounding factors, the OR for DM decreased gradually with increasing leg fat mass quartiles in both genders. When we subdivided the participants into four groups based on the median values of leg fat mass and leg muscle mass, higher leg fat mass significantly lowered the risk of DM even though they have smaller leg muscle mass in both genders (P<0.001).

Conclusion

The relationship between fat mass and the prevalence of DM is different according to regional body fat distribution. Higher leg fat mass was associated with a lower risk of DM in Korean populations. Maintaining leg fat mass may be important in preventing impaired glucose tolerance.

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1,5-Anhydroglucitol as a Useful Marker for Assessing Short-Term Glycemic Excursions in Type 1 Diabetes
Hannah Seok, Ji Hye Huh, Hyun Min Kim, Byung-Wan Lee, Eun Seok Kang, Hyun Chul Lee, Bong Soo Cha
Diabetes Metab J. 2015;39(2):164-170.   Published online March 9, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.2.164
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AbstractAbstract PDFPubReader   
Background

Type 1 diabetes is associated with more severe glycemic variability and more frequent hypoglycemia than type 2 diabetes. Glycemic variability is associated with poor glycemic control and diabetic complications. In this study, we demonstrate the clinical usefulness of serum 1,5-anhydroglucitol (1,5-AG) for assessing changes in glycemic excursion in type 1 diabetes.

Methods

Seventeen patients with type 1 diabetes were enrolled in this study. A continuous glucose monitoring system (CGMS) was applied twice at a 2-week interval to evaluate changes in glycemic variability. The changes in serum glycemic assays, including 1,5-AG, glycated albumin and hemoglobin A1c (HbA1c), were also evaluated.

Results

Most subjects showed severe glycemic excursions, including hypoglycemia and hyperglycemia. The change in 1,5-AG level was significantly correlated with changes in the glycemic excursion indices of the standard deviation (SD), mean amplitude of glucose excursion (MAGE), lability index, mean postmeal maximum glucose, and area under the curve for glucose above 180 mg/dL (r=-0.576, -0.613, -0.600, -0.630, and -0.500, respectively; all P<0.05). Changes in glycated albumin were correlated with changes in SD and MAGE (r=0.495 and 0.517, respectively; all P<0.05). However, changes in HbA1c were not correlated with any changes in the CGMS variables.

Conclusion

1,5-AG may be a useful marker for the assessment of short-term changes in glycemic variability. Furthermore, 1,5-AG may have clinical implications for the evaluation and treatment of glycemic excursions in type 1 diabetes.

Citations

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