Journal of Preventive Medicine and Public Health

Original Articles

Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study: Somi Heo, Seyoung Kwon, Yu-Mi Lee, Ji-Yeon Shin, Duk-Hee Lee; J Prev Med Public Health. 2020;53(1):45-55. Published online November 20, 2019; DOI: https://doi.org/10.3961/jpmph.19.198

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Abstract Summary PDF Supplementary Material

Objectives
This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.
Methods
This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.
Results
Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.
Conclusions
Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

Summary

Korean summary
본 연구에서는 새로운 소아청소년 고혈압 기준을 이용하여, 최근 한국과 미국 소아청소년들의 혈압 및 고혈압 유병률의 변화 추이를 비교하였다. 비만과 고혈압간의 높은 관련성에도 불구하고 한국과 미국 소아청소년의 고혈압 유병률과 비만율은 서로 다른 변화 추이를 나타내었으며, 고혈압 발생에 있어서 한국 소아청소년들이 미국 소아청소년들보다 비만에 더 취약할 가능성을 나타내고 있어 이에 관한 후속연구가 필요하다.

Citations

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Association Between Obesity and Blood Pressure Among Iranian Children and Adolescents: A Sub-analysis from the SHED LIGHT Study
Avisa Tabib, Akbar Nikpajouh, Maryam Aryafar, Niloufar Samiei, Yousef Rezaei, Hassan Ziaodini, Azam Goodarzi, Bahareh Kazemborji, Nasim Naderi, Sepideh Taghavi, Hooman Bakhshandeh, Saeid Hosseini
Pediatric Cardiology.2024; 45(6): 1192. CrossRef
Body Mass Index, Waist Circumference, Hip Circumference, Waist-To-Height Ratio: Which Affects Adolescent Hypertension More?
Melike TELLİOĞLU, Muammer YILMAZ, İnci ARIKAN, Yaşar ÇAKMAKÇI
Phoenix Medical Journal.2023; 5(1): 17. CrossRef
Combined associations of general obesity and central obesity with hypertension stages and phenotypes among children and adolescents in Zhejiang, China
Dong Zhao, Jiali Zhou, Danting Su, Yun Li, Weidi Sun, Boren Tan, Shuting Li, Ronghua Zhang, Peige Song
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Association of Homocysteine Levels With Blood Lead Levels and Micronutrients in the US General Population: Yu-Mi Lee, Mi-Kyung Lee, Sang-Geun Bae, Seon-Hwa Lee, Sun-Young Kim, Duk-Hee Lee; J Prev Med Public Health. 2012;45(6):387-393. Published online November 29, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.6.387

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Abstract PDF

Objectives

Even though several epidemiological studies have observed positive associations between blood lead levels and homocysteine, no study has examined whether this association differs by the levels of micronutrients, such as folate, vitamin B6, and vitamin B12, which are involved in the metabolism of homocysteine. In this study, we examined the interactions between micronutrients and blood lead on homocysteine levels.

Methods

This study was performed with 4089 adults aged ≥20 years old in the US general population using the National Health and Nutrition Examination Survey 2003-2004.

Results

There were significant or marginally significant interactions between micronutrients and blood lead levels on mean homocysteine levels. Positive associations between blood lead and homocysteine were clearly observed among subjects with low levels of folate or low vitamin B6 (p-trend <0.01, respectively). However, in the case of vitamin B12, there was a stronger positive association between blood lead and homocysteine among subjects with high levels of vitamin B12, compared to those with low levels of vitamin B12. In fact, the levels of homocysteine were already high among subjects low in vitamin B12, irrespective of blood lead levels. When we used hyperhomocysteinemia (homocysteine>15 µmol/L) as the outcome, there were similar patterns of interaction, though p-values for each interaction failed to reach statistical significance.

Conclusions

In the current study, the association between blood lead and homocysteine differed based on the levels of folate, vitamin B6, or vitamin B12 present in the blood. It may be important to keep sufficient levels of these micronutrients to prevent the possible harmful effects of lead exposure on homocysteine levels.

Summary

Citations

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Associations of Serum Ferritin and Transferrin % Saturation With All-cause, Cancer, and Cardiovascular Disease Mortality: Third National Health and Nutrition Examination Survey Follow-up Study: Ki-Su Kim, Hye-Gyeong Son, Nam-Soo Hong, Duk-Hee Lee; J Prev Med Public Health. 2012;45(3):196-203. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.196

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Abstract PDF

Objectives

Even though experimental studies have suggested that iron can be involved in generating oxidative stress, epidemiologic studies on the association of markers of body iron stores with cardiovascular disease or cancer remain controversial. This study was performed to examine the association of serum ferritin and transferrin saturation (%TS) with all-cause, cancer, and cardiovascular mortality.

Methods

The study subjects were men aged 50 years or older and postmenopausal women of the Third National Health and Nutrition Examination Survey 1988-1994. Participants were followed-up for mortality through December 31, 2006.

Results

Serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality for either men or postmenopausal women. However, all-cause, cancer, and cardiovascular mortality were inversely associated with %TS in men. Compared with men in the lowest quintile, adjusted hazard ratios for all-cause, cancer, and cardiovascular mortality were 0.85, 0.86, 0.76, and 0.74 (p for trend < 0.01), 0.82, 0.73, 0.75, and 0.63 (p for trend < 0.01), and 0.86, 0.81, 0.72, and 0.76 (p for trend < 0.01), respectively. For postmenopausal women, inverse associations were also observed for all-cause and cardiovascular mortality, but cancer mortality showed the significantly lower mortality only in the 2nd quintile of %TS compared with that of the 1st quintile.

Conclusions

Unlike speculation on the role of iron from experimental studies, %TS was inversely associated with all-cause, cancer and cardiovascular mortality in men and postmenopausal women. On the other hand, serum ferritin was not associated with all-cause, cancer, or cardiovascular mortality.

Summary

Citations

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Interaction Between Persistent Organic Pollutants and C-reactive Protein in Estimating Insulin Resistance Among Non-diabetic Adults: Ki-Su Kim, Nam-Soo Hong, David R Jacobs, Duk-Hee Lee; J Prev Med Public Health. 2012;45(2):62-69. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.62

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Abstract PDF

Objectives

Chronic inflammation is now thought to play a key pathogenetic role in the associations of obesity with insulin resistance and diabetes. Based on our recent findings on persistent organic pollutants (POPs) including the lack of an association between obesity and either insulin resistance or diabetes prevalence among subjects with very low concentrations of POPs, we hypothesized that POP concentrations may be associated with inflammation and modify the associations between inflammation and insulin resistance in non-diabetic subjects.

Methods

Cross-sectional associations among serum POPs, C-reactive protein (CRP), and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated in 748 non-diabetic participants aged ≥20 years. Nineteen types of POPs in 5 subclasses were selected because the POPs were detectable in ≥60% of the participants.

Results

Among the five subclasses of POPs, only organochlorine (OC) pesticides showed positive associations with CRP concentrations, while polychlorinated biphenyls (PCBs) showed inverse associations with CRP concentrations. There were statistically significant interactions between CRP and OC pesticides and between CRP and PCBs, in estimating HOMA-IR (P for interaction <0.01 and <0.01, respectively). CRP was not associated with HOMA-IR among subjects with low concentrations of OC pesticides or PCBs, while CRP was strongly associated with HOMA-IR among subjects with high concentrations of these POPs.

Conclusions

In the current study, OC pesticides were associated with increased levels of CRP, a marker of inflammation, and both OC pesticides and PCBs may also modify the associations between CRP and insulin resistance.

Summary

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