Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults

Baik Inkyung,Kim Nan Hee,김성환,신철 한국역학회 2023 Epidemiology and Health Vol.45 No.-

OBJECTIVES This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk. METHODS This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression. RESULTS Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years. CONCLUSIONS BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.

A healthy dietary pattern consisting of a variety of food choices is inversely associated with the development of metabolic syndrome

Inkyung Baik,Myoungsook Lee,Nu-Ri Jun,Jae-Yeon Lee,Chol Shin 한국영양학회 2013 Nutrition Research and Practice Vol.7 No.3

There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietary patterns among middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort study included 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, and known cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and their factor scores were generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimate multivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietary patterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods, fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. After controlling for confounding factors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthy dietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjusted RR [95% CI] of 0.76 [0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominal obesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommended to prevent MetSyn.

Forecasting obesity prevalence in Korean adults for the years 2020 and 2030 by the analysis of contributing factors

Inkyung Baik 한국영양학회 2018 Nutrition Research and Practice Vol.12 No.3

BACKGROUND/OBJECTIVES: There are few studies that forecast the future prevalence of obesity based on the predicted prevalence model including contributing factors. The present study aimed to identify factors associated with obesity and construct forecasting models including significant contributing factors to estimate the 2020 and 2030 prevalence of obesity and abdominal obesity. SUBJECTS/METHODS: Panel data from the Korea National Health and Nutrition Examination Survey and national statistics from the Korean Statistical Information Service were used for the analysis. The study subjects were 17,685 male and 24,899 female adults aged 19 years or older. The outcome variables were the prevalence of obesity (body mass index ≥ 25 ㎏/㎡) and abdominal obesity (waist circumference ≥ 90 ㎝ for men and ≥ 85 ㎝ for women). Stepwise logistic regression analysis was used to select significant variables from potential exposures. RESULTS: The survey year, age, marital status, job status, income status, smoking, alcohol consumption, sleep duration, psychological factors, dietary intake, and fertility rate were found to contribute to the prevalence of obesity and abdominal obesity. Based on the forecasting models including these variables, the 2020 and 2030 estimates for obesity prevalence were 47% and 62% for men and 32% and 37% for women, respectively. CONCLUSIONS: The present study suggested an increased prevalence of obesity and abdominal obesity in 2020 and 2030. Lifestyle factors were found to be significantly associated with the increasing trend in obesity prevalence and, therefore, they may require modification to prevent the rising trend.

Interactions between the FTO rs9939609 polymorphism, body mass index, and lifestyle-related factors on metabolic syndrome risk

Inkyung Baik,Chol Shin 한국영양학회 2012 Nutrition Research and Practice Vol.6 No.1

Whether the FTO polymorphisms interact with environmental factors has not yet been evaluated in associations with metabolic syndrome (MS) risk. The present study investigated the association of the FTO rs9939609 genotypes, body mass index (BMI), and lifestyle-related factors including smoking, alcohol drinking, physical activity, and diet with MS incidence. A population-based prospective cohort study comprised 3,504 male and female Koreans aged 40 to 69 years. At the beginning of the study, all individuals were free of MS and known cardiovascular disease. Incident cases of MS were identified by biennial health examinations during a follow-up period from April 17, 2003 to April 15, 2009. Pooled logistic regression analysis was applied to obtain relative odds (RO) of MS with its 95% confidence interval (CI). After controlling for potential MS risk factors, we observed no association between the rs9939609 genotypes and MS incidence. In analysis stratified by BMI, however, carriers with the FTO risk allele whose BMI is 29 kg/㎡ or greater showed an approximately 6-fold higher RO (95% CI: 3.82 to 9.30) compared with non-carriers with BMI less than 25 kg/㎡. In particular, the association between the rs9939609 variants and MS risk was significantly modified by high BMI (P-value for interaction < 0.05). Such significant interaction appeared in associations with central obesity and high blood pressure among the MS components. Because carriers of the FTO risk alleles who had BMI of 29 kg/㎡ or greater are considered a high risk population, we suggest that they may need intensive weight loss regimens to prevent MS development.

Dietary and modifiable factors contributing to hyper-LDL-cholesterolemia prevalence in nationwide time series data and the implications for primary prevention strategies

Inkyung Baik 한국영양학회 2020 Nutrition Research and Practice Vol.14 No.1

BACKGROUND/OBJECTIVES: A number of studies examined secular trends in blood lipid profiles using time series data of national surveys whereas few studies investigated individual-level factors contributing to such trends. The present study aimed to examine secular trends in dietary and modifiable factors and hyper-LDL-cholesterolemia (HC) prevalence and evaluate their associations using time series data of nationwide surveys. SUBJECTS/METHODS: The study included 41,073 Korean adults aged ≥ 30 years from the 2005, 2007-2009, 2010-2012, 2013-2015, and 2016 Korea National Health and Nutrition Examination Surveys. Stepwise logistic regression analysis was performed to select significant factors associated with HC, which was defined as serum LDL cholesterol levels ≥130 ㎎/dL. RESULTS: The following factors showed a positive association with HC (P < 0.05): for men having higher body mass index (BMI), being married, having an office job, and consuming higher dairy and vegetable oil products; for women having higher age or BMI, having no job or a non-office job, not in a low-income household, and consuming higher dairy products. In the given model, the 2016 survey data showed that a 2 ㎏/㎡ reduction in BMI of obese persons resulted in a decreased HC prevalence from 30.8% to 29.3% among men and from 33.6% to 32.5% among women. CONCLUSIONS: Based on these findings, it is suggested that primary prevention programs should advocate having proper BMI for Korean adults with a high-risk of HC. However, whether discouraging consumption of dairy and vegetable oil products can reduce HC prevalence warrants further studies with a prospective longitudinal design.

Dietary Patttern and Telomere Length

Inkyung Baik,Chol Shin,Nu-Ri Jun,Dae-Wui Yoon,Jae-Yeon Lee 한국식품영양과학회 2012 한국식품영양과학회 학술대회발표집 Vol.2012 No.10

A Lipoprotein Lipase Gene Polymorphism Interacts with Consumption of Alcohol and Unsaturated Fat to Modulate Serum HDL-Cholesterol Concentrations

Baik, Inkyung,Lee, SeungKu,Kim, Seong Hwan,Shin, Chol American Society for Nutrition 2013 The Journal of nutrition Vol.143 No.10

<P>There are limited data from prospective studies regarding interactions between lipoprotein lipase gene (<I>LPL</I>) and lifestyle factors in association with HDL-cholesterol (HDL-C) concentrations, a biomarker of coronary heart disease risk. Our prospective cohort study investigated the interactive effects of a common <I>LPL</I> polymorphism and lifestyle factors, including obesity, smoking, alcohol consumption, physical activity, and dietary intake, on follow-up measurements of HDL-C and triglyceride (TG) concentrations. A total of 5314 Korean men and women aged 40–69 y participated in the study. Serum HDL-C and TG concentrations were measured in all participants at baseline and 6-y follow-up examinations. On the basis of genome-wide association data for HDL-C and TG concentrations, we selected the most significant polymorphism (rs10503669), which was in high linkage disequilibrium with the serine 447 stop (<I>S447×</I>) mutation (D′ = 0.99) of <I>LPL</I>. We found that carrying the T allele reflecting the <I>LPL ×447</I> allele was positively associated with follow-up measurement of HDL-C concentrations (<I>P</I> < 0.001). In the linear regression model adjusted for baseline HDL-C concentration and potential risk factors, we observed interactive effects of the polymorphism and consumption of alcohol (<I>P</I>-interaction < 0.01) and unsaturated fat (<I>P</I>-interaction < 0.05) on follow-up measurement of HDL-C concentrations. We also observed interactive effects of the polymorphism and body mass index (<I>P</I>-interaction < 0.01) on follow-up measurement of TG concentrations after adjusting for the baseline level and potential risk factors. Our findings suggest that carriers of the <I>LPL ×447</I> allele benefit from moderate alcohol consumption and a diet high in unsaturated fat to minimize reduction of blood HDL-C concentrations and that obese persons who do not carry the <I>LPL ×447</I> allele need to control body weight to prevent hypertriglyceridemia.</P>

Associations of a Ten-Year Trend in Hypertension Prevalence with Sodium, Potassium, and Calcium Intake in Korean Adults

Inkyung Baik 한국식품영양과학회 2019 한국식품영양과학회 학술대회발표집 Vol.2019 No.10

열량 및 열량영양소 섭취량과 관련된 유전자 변이에 대한 전장유전체 연관성 분석연구

백인경(Baik Inkyung),안윤진(Ahn Younjhin),이승구(Lee Seung Ku),김소리울(Kim Soriwul),한복기(Han Bok-Ghee),신철(Shin Chol) 韓國營養學會 2010 Journal of Nutrition and Health Vol.43 No.4

There has been no genome-wide association study (GWAS) for macronutrient intake as a quantitative trait. To explore genetic loci associated with total calorie and macronutrient intake, genome-wide association data of autosomal single nucleotide polymorphisms (SNPs) from Korean adults were analyzed. We conducted a GWAS in 3,690 men and women aged 40 to 60 years from an urban population-based cohort. At the baseline examination (June 18, 2001 through January 29, 2003), DNA samples of the study subjects were collected and analyzed for genotyping. The information of average daily consumption of total calorie, carbohydrate, protein, and fat was obtained from a semi-quantitative food frequency questionnaire and transformed by natural logarithm for analyses after adjustment of calorie intake. Using multivariate linear regression analysis adjusted for age, sex, and height, we tested for 352,021 SNPs and found weak associations, which do not reach genome-wide association significance, with calorie and macronutrient intake. However, a number of SNPs were found to have potential associations with macronutrient intake; in particular, signals in SORBS1 and those in PRKCB1 were likely associated with carbohydrate and fat intake, respectively. We observed an inverse association between the minor allele of the SNPs in these genes and the amount of consumption of carbohydrate or fat. Our GWAS identified loci and minor alleles weakly associated with macronutrient intake. Because SORBS1 and PRKCB1 are reportedly associated with the metabolism of glucose and lipid as well as with obesity-related diseases, further investigations on biological and functional roles of polymorphism of these genes in the relation to macronutrient intake are warranted.

대사증후군을 예방하는 한국인 건강 식사패턴 연구

백인경(Inkyung Baik) 한국식품영양과학회 2011 식품산업과 영양 Vol.16 No.2