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Both sodium intake and sleep have an important effect on cardiovascular health. However, few studies have looked at the association between sodium intake and sleep. Therefore, we analysed the association of sodium intake with sleep quality, sleep duration and nocturnal urination. The data for the present study were obtained from the Kangbuk Samsung Health Study. Study participants were 156 696 working‐aged Korean adults (average age 38.0 years ±8.0 in men and 36.0 years ±8.1 in women). They were categorised into five groups by quintile of sodium intake, measured by food frequency questionnaire. Poor sleep quality and short sleep duration were determined by Pittsburgh Sleep Quality Index >5, and sleep duration <7 h, respectively. Nocturnal urination was defined as awakening to urinate more than three times a week. Multivariable adjusted logistic regression analysis was used in calculating the odds ratio (OR) and 95% confidence interval (CI) for poor sleep quality, short sleep duration and nocturnal urination (adjusted OR [95% CI]) across five study groups. In all study participants, increased sodium intake was significantly associated with poor sleep quality (quintile 1: reference, quintile 2: 1.07 [1.04–1.11], quintile 3: 1.12 [1.08–1.16], quintile 4: 1.15 [1.11–1.19] and quintile 5: 1.13 [1.09–1.18]). This pattern of relationship was similarly observed in association of sodium intake with short sleep duration (p for trend <0.001) and nocturnal urination (p for trend <0.001). In gender subgroup analysis, increased sodium intake had a significant association with poor sleep quality and short sleep duration in men and with poor sleep quality and nocturnal urination in women. In conclusion, high sodium intake is associated with an increased likelihood of poor sleep quality, short sleep duration and nocturnal urination. [ABSTRACT FROM AUTHOR]

Background: The number of patients with diabetes and impaired fasting blood glucose in Korea is rapidly increasing compared to the past, and other metabolic indicators of population are also changed in recent years. To clarify the mechanism more clearly, we investigated the association between fasting blood glucose and incidence of pancreatic cancer in this retrospective cohort study. Methods: In Korea National Health Information Database, 19,050 participants without pancreatic cancer in 2009 were enrolled, and followed up until 2013. We assessed the risk of incident pancreatic cancer according to the quartile groups of fasting blood glucose level (quartile 1: <88 mg/dL, quartile 2: 88–97 mg/dL, quartile 3: 97–109 mg/dL and quartile 4: ≥109 mg/dL). Multivariate Cox-proportional hazard model was used in calculating hazard ratios (HRs) and 95% confidence interval (CI) for incident pancreatic cancer. Results: Compared with quartile1 (reference), unadjusted HRs and 95% CI for incident pancreatic cancer significantly increased in order of quartile2 (1.39 [1.01–1.92]), quartile3 (1.50 [1.09–2.07]) and quartile4 (2.18 [1.62–2.95]), and fully adjusted HRs and 95% CI significantly increased from quartile2 (1.47 [1.05–2.04]), quartile3 (1.61 [1.05–2.04]) to quartile4 (2.31 [1.68–3.17]). Conclusion: Fasting blood glucose even with pre-diabetic range was significantly associated with the incident pancreatic cancer in Korean. [ABSTRACT FROM AUTHOR]

There are reports that nut consumption provides potential benefit for gastric pathologies including stomach cancer and Helicobacter pylori infection. However, there are no studies investigating the effect of nut consumption on gastric intestinal metaplasia (GIM). In a Korean cohort of 53 424 men (average age 38.7 ± 7.0 years) and 33 024 women (average age 38.0 ± 7.0 years), we analysed the risk of GIM according to the frequency of nut consumption (peanuts, pine nuts and almonds only) as the following: rare (<1 serving/month), ≤1 serving/month and <1 serving/week, ≤1 serving/week and <3 serving/week, ≤3 serving/week and <5 serving/week and ≥5 serving/week where one serving is 15 g. Cox proportional hazards model was used to calculate the multivariable‐adjusted hazard ratio (HR) for GIM and their 95% confidence intervals (CI) in each group (adjusted HR [95% CI]). Subgroup analysis was conducted by body mass index (BMI, non‐obesity <25 and obesity ≥25). The models were adjusted for age, regular exercise, BMI, smoking, alcohol intake (g/day), diabetes mellitus, hypertension, dietary fibre intake, sodium intake and total calorie intake. After 5.3 years (median 5.9 years) of follow‐up, GIM was observed in 5073 subjects. In men, compared with rare nuts consumption, greater nuts consumption was associated with a lower risk of GIM (rare consumption: reference, 1/month–1/week: 0.85 [0.79–0.91], 1–3/week: 0.81 [0.72–0.91], 3–5/week: 0.70 [0.57–0.86] and ≥5/week: 0.59 [0.48–0.73]). Subgroup analysis indicated that the inverse relationship between nuts consumption and the risk of GIM is more distinct in men without obesity (rare consumption: reference, 1/month–1/week: 0.83 [0.76–0.91], 1–3/week: 0.78 [0.67–0.91], 3–5/week: 0.68 [0.51–0.89] and ≥5/week: 0.51 [0.37–0.69]). However, this association was not observed in women. In conclusion, increased nuts consumption was associated with a decreased risk of GIM in working aged Korean men. [ABSTRACT FROM AUTHOR]

Background and Aim: Cholelithiasis is one of the most common gastrointestinal diseases worldwide. The metabolic syndrome (MetS), a combination of various metabolic abnormalities, is also common with a continually increasing prevalence. These diseases are associated with several risk factors. However, data on the association between MetS components and cholelithiasis are insufficient. This study aimed to analyze the association of MetS and its components with the incidence of cholelithiasis using national data from the Korean population. Methods: Data were obtained from the National Health Insurance Corporation of Korea, and 207 850 individuals without cholelithiasis in 2009 were enrolled and followed up until 2013. A multivariate Cox proportional hazard model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of cholelithiasis according to the presence of MetS and the number of MetS components. Furthermore, the risk of cholelithiasis was evaluated in individuals with a single metabolic component. Results: The multivariate adjusted HRs and 95% CIs for incident cholelithiasis according to 1, 2, 3, and 4–5 MetS components were 1.08 (0.93–1.24), 1.22 (1.06–1.41), 1.35 (1.17–1.57), and 1.35 (1.15–1.57), respectively (P < 0.001). This increasing trend was observed in both sexes. Compared with participants with no metabolic components, those with low high‐density lipoprotein (HDL) cholesterol had a significantly increased risk for cholelithiasis (adjusted HR, 1.39 [95% CI, 1.05–1.85]). Conclusions: Metabolic syndrome is a potential risk factor for cholelithiasis. Low HDL cholesterol level is the most relevant factor among MetS components for incident cholelithiasis. [ABSTRACT FROM AUTHOR]

Aims: Obesity is an established risk factor for type 2 diabetes mellitus (T2DM). However, there is limited information on the pattern of relationship between the risk for T2DM and body mass index (BMI) categories including underweight and overweight. Thus, this study was to evaluate the risk of T2DM according to BMI categories defined by Asian-specific cutoff of BMI. Methods: 7660 non-diabetic Koreans were grouped into five BMI categories (underweight, normal, overweight, obese and severe obese) defined by Asian-specific cutoff of BMI and followed up for 10 years to monitor the development of T2DM. With a reference of normal BMI group, Cox proportional hazards assumption was used to calculate hazard ratios (HRs) and their 95% confidence intervals for T2DM in five groups. Subgroup analysis was conducted by gender and age (40-59 years and 60-69 years).Results: Baseline mean value of metabolic factors like fasting glucose, HOMA-IR, total cholesterol and the proportion of impaired fasting glucose increased proportionally to the level of BMI categories. Underweight group had the higher proportion of impaired glucose tolerance than normal and overweight group. In all subgroups, underweight, overweight, obese and severe obese group had the higher HRs for T2DM than normal group, but statistical significance was only found in overweight, obese and severe obese group.Conclusions: The risk of T2DM tends to increase proportionally to the level of BMI categories from overweight to severe obese group. Further studies should be considered to identify the incidental relationship between underweight and T2DM. [ABSTRACT FROM AUTHOR]

Background: Proteinuria is a risk factor for cerebral infarction. It is known that proteinuria can change over time. However, published data is scarce for the association between changes in proteinuria and the risk of cerebral infarction.Method: Study participants were 276,861 Koreans who were assessed for urine dipstick proteinuria both in 2003-2004 and 2007-2008. They were categorized into four groups by changes in proteinuria over 4 years (negative: negative → negative, resolved: proteinuria ≥ 1+ → negative, incident: negative → proteinuria ≥ 1+, persistent: proteinuria ≥ 1+ → proteinuria ≥ 1 + ). We used multivariate adjusted Cox-proportional hazard model in calculating the adjusted hazard ratios (HR) and 95% confidence interval (CI) for cerebral infarction until 2013 according to changes in proteinuria.Result: Adjusted HR and 95% CI for cerebral infarction significantly increased in order of persistent, incident, and resolved proteinuria, compared with negative proteinuria (negative: reference, resolved: 1.166 [1.009-1.347], incident: 1.345 [1.188-1.522], and persistent: 1.443 [1.089-1.912]). In gender subgroup analysis, men showed the more clear association between changes in proteinuria and the risk of cerebral infarction (negative: reference, resolved: 1.284 [1.057-1.560], incident: 1.351 [1.149-1.589], and persistent: 1.428 [1.014-2.012]).Conclusion: All types of proteinuria changes were associated with the increased risk of cerebral infarction, even in participants with once manifested but vanishing proteinuria. [ABSTRACT FROM AUTHOR]

Abstract Background and aims Our study aimed to investigate the association between high-density lipoprotein cholesterol (HDL-C) and all-cause and cause-specific mortality in Korean adults. Methods A total of 365,457 participants aged ≥40 years were selected from the Korean National Health Insurance Service–National Sample Cohort from 2009 to 2015. HDL-C level was categorized into <1.0, 1.0–1.19, 1.2–1.39, 1.4–1.59, 1.6–1.79 (reference), 1.8–1.99, 2.0–2.19 and ≥ 2.20 mmol/L. Cox proportional hazard models were used to examine the association between HDL-C level and mortality risk. Results In a median 3.5-year follow-up period, 9,350 participants (2.6%) died. Men with HDL-C level of 1.6–1.79 mmol/L and women with HDL-C level of 1.4–1.59 mmol/L had the lowest age-standardized mortality rates for all-cause death. However, for cardiovascular death, men with HDL-C level ≥2.20 mmol/L and women with HDL-C level of 1.8–1.99 mmol/L showed the lowest mortality rate. After adjusting for multiple covariates, the hazard ratios for all-cause and cancer deaths showed a U-shaped relationship with HDL-C level for both sexes. However, there were heterogenetic associations between HDL-C level and mortality risk of subtypes of cardiovascular disease by sex. For other causes of death except for cardiovascular and cancer death, elevated mortality risk was mainly due to external causes (ICD-10 code, S00-T98). Conclusions In South Korea, very high HDL-C level was associated with increased risk of all-cause death. However, the increased all-cause mortality risk in people with very high HDL-C level was partly due to mortality risk from external causes. Graphical abstract Image 1 Highlights • Although people with very high HDL cholesterol had higher risk of all-cause mortality compared to control group, it seems to be partly attributed to increased mortality from external causes. • Very high HDL cholesterol was not associated with increased cardiovascular mortality in Korean people, unlike western counterparts, suggesting ethnic differences. [ABSTRACT FROM AUTHOR]

Background: Previous studies showed that the insulin resistance (IR) could be related to depression. However, this association is still equivocal in the general population. Herein, we aimed to investigate the association between IR and depressive symptoms in a large sample in South Korea.Methods: A cross-sectional study was carried out for 165,443 Korean men and women who received a health checkup including various clinical parameters and the Center for Epidemiologic Studies Depression scales (CES-D). Subjects were stratified into subgroups by CES-D score, sex, age, and presence of diabetes. The odd ratios (ORs) for homeostasis model assessment of insulin resistance (HOMA-IR) were compared between groups using multivariable logistic regression analyses.Results: After adjusting covariates (e.g. smoking, family income, marriage state, unemployment status, average alcohol use, BMI, physical activity, systolic blood pressure, diabetes), increased IR was weakly associated with greater depressive symptoms (adjusted OR=1.01 [95% CI 1.0001-1.03]). Subgroup analysis revealed this association was statistically significant in females (adjusted OR=1.03, [95% CI 1.001-1.06]), non-diabetic group (adjusted OR=1.04, [95% CI 1.02-1.06]), and young participants under the age of thirty (adjusted OR=1.17, [95% CI 1.07-1.27]). But we couldn't find significant association in diabetic and middle to elderly participants.Conclusions: This study demonstrates that there is a relationship between IR and depressive symptoms in the Korean general population. Results from this epidemiological study revealed that young adults and non-diabetic individuals with increased IR may be related with depressive symptoms. [ABSTRACT FROM AUTHOR]