etabolic syndrome is a cluster of metabolic abnormalities related to an increased risk of cardiovascular disease, 1 and recent research has demonstrated that adipocytokines, especially adiponectin, are associated with metabolic syndrome. 2 In terms of the evaluation and management of hypercholesterolemia (a risk factor of cardiovascular disease and a causative factor of death in more than 40% of heart-related deaths) according to the recommendations of the 2001 Third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Guidelines, the risk factors for the development of metabolic syndrome are visceral obesity, hypertension, hypertriglyceridemia, a low level of high-density lipoprotein cholesterolemia, and an impaired glucose tolerance. 3 Hyperuricemia is also considered by some investigators to be a component of metabolic syndrome that reflects insulin resistance. 4,5 In several epidemiological studies, a close relationship between hyperuricemia and hypertension, heart failure and other cardiovascular diseases has been reported, [6][7][8][9] and correlations between hyperuricemia and obesity, dyslipidemia, and diabetes have also been recently reported. [10][11][12] However, studies of Asians, who differ physically from Caucasians, are relatively rare. In Korea, knowledge of the general adult population without type 2 diabetes, hypertension and other diseases is inadequate, and no study has been performed on the association between the newly defined metabolic syndrome and hyperuricemia in the Korean population. Hence, this study investigated Korean adults who had undergone health screening to assess the correlation between increased serum uric acid concentration and hypertension, insulin resistance, and other risk factors of metabolic syndrome. Methods Study PopulationThe study group comprised 53,477 individuals (34,169 males, 19,308 females), who underwent health screening at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea between January 1, 2002, and December 31, 2002. Subjects who were taking diuretics, antihypertensive or antidiabetic agents, lipid-lowering agents, hyper-or hypouricemic agents, and those with any clinical suspicion of malignancy, acute infectious disease, acute inflammatory disease or renal disease were excluded. Physical Examination and Blood Pressure (BP)Height, weight, waist -hip circumference and systolic and diastolic BP were measured. According to the Hypertension Detection and Follow-up Program protocol, 13 BP was measured using a sphygmomanometer after the subjects had rested for more than 5 min. For those with a systolic BP >140 mmHg and a diastolic BP >90 mmHg (defined as hypertension by the 2003 JNC-7 14 ) BP was measured on a further 2 occasions after resting, and average Seung Ho Ryu, MD*; Dong Geuk Keum, MD** Background Associations between hyperuricemia, cardiovascular diseases and diabetes have been reported, but few of the studies have been conducted in the Korean population. The present study examined ...

BackgroundThyroid abnormalities affect a considerable portion of the population, and overt hypothyroidism is associated with an elevated risk of cardiovascular disease and adverse changes in blood lipids. Subclinical hypothyroidism is also associated with an increase risk of cardiovascular disease. So, we undertook this study to investigate the prevalence of overt and subclinical thyroid disorders and their associations with cardiovascular risk factors.Methods:This study involved 66260 subjects (43588 men, 22672 women; between 20–80 years of age, mean age 41.5±9.6). Serum free thyroxine (FT4), thyroid stimulating hormone (TSH), total cholesterol, low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were measured by RIA using commercial kits. High sensitivity C-reactive protein (hsCRP) levels were determined by nephelometry.Results:The prevalences of overt thyrotoxicosis, subclinical thyrotoxicosis, overt hypothyroidism and subclinical hypothyroidism were 5/1000 (334 subjects), 6.4/1000 (426 subjects), 1.6/1000 (108 subjects), and 6.4/1000 (375 subjects). Mean plasma total cholesterol and LDL-C were elevated in overt hypothyroidism than in normal controls (202.1 mg/dL and 121.8 mg/dL versus 197.1 mg/dL and 120.1 mg/dL, respectively) (p<0.05). In subclinical hypothyroidism, mean total cholesterol and LDL-C levels were also elevated (201.9 mg/dL and 123.7 mg/dL)(p=0.015, p=0.047). Waist-to-hip ratio (WHR) was lower in overt thyrotoxicosis and higher in hypothyroidism.Conclusion:The prevalence of thyroid dysfunction in Korea is not significantly different from that reported by other countries. It was also age dependent and higher in women, but this elevation in women was lower than expected. Patients with hypothyroidism exhibited higher waist-to-hip ratios, an index of obesity. Patients with subclinical hypothyroidism exhibited elevated atherogenic parameters (Total cholesterol, LDL-C). Therefore screening and treatment for subclinical hypothyroidism may be warranted due to its adverse effects on lipid metabolism.

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Our results suggest that the CRP level may be an independent risk factor for the development of hypertension in Korean persons. However, because of the cross-sectional nature of our study, this finding should be confirmed in prospective cohort studies, aimed at elucidating the role of CRP in the prediction, diagnosis, and management of hypertension.

Background: Apolipoprotein B (apo B) has been reported to be a better predictor of coronary artery disease than cholesterol indices. The objectives of this study were to evaluate concordances/discordances between cholesterol indices and apo B and to assess the factors that influence them. Methods: For this study, 11 816 individuals (6965 males, 4851 females), none of whom had a past history of coronary artery disease, were selected from among visitors to the health promotion center at Kangbuk Samsung Hospital between January and December 2002. We assessed concordances between the biochemical indices of atherogenicity and evaluated factors associated with discordances. Results: Apo B and various cholesterol indices were correlated, although concordance fell within the range 47%-56%. Multinomial logistic regression analysis showed an increasing risk of a disproportionately higher apo B than LDL-cholesterol in males, the elderly, smokers, individuals with metabolic syndrome, in those with high HDL-cholesterol or triglyceride (TG) concentrations or larger waist circumferences, and in those with low total cholesterol (TC). Conclusions: The introduction of apo B to standard lipid profile testing could improve the evaluation of risk factors of coronary artery disease and aid more accurate assessment of the effects of cholesterol-lowering therapy, particularly in males, the elderly, smokers, or in individuals with metabolic syndrome, high HDL-cholesterol, high TGs, larger waist circumferences, or low TC.

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