Using a national database, we found that the rate of TKR increased steadily from 2002 to 2005 in South Korea. The TKR rate in women was much higher than that in men. Risk factors that account for such disparity in TKR utilization need to be further investigated.

This study aimed to develop a multidisciplinary lifestyle intervention program targeted at children and adolescents with moderate to severe obesity, and assess the additional effects of exercise intervention when compared to usual care. Overall, the 103 enrolled participants were ≥85th percentile of age and sex-specific body mass index (BMI). Participants were divided into groups that received 16 weeks of either usual care or exercise intervention. The BMI z-score of the overall completers decreased by about 0.05 after the 16-week intervention (p = 0.02). After the intervention, only the exercise group had a significantly lower BMI z-score than the baseline score by about 0.1 (p = 0.03), but no significant group by time interaction effects were observed. At the 16-week follow-up, significant group by time interaction effects were observed in percentage body fat (%BF) (β = −1.52, 95%CI = −2.58–−0.45), lean body mass (LM) (β = 1.20, 95%CI = 0.12–2.29), diastolic blood pressure (β = −5.24, 95%CI = −9.66–−0.83), high-sensitivity C-reactive protein (β = −1.67, 95%CI = −2.77–−1.01), and wall sit test score (β = 50.74, 95%CI = 32.30–69.18). We developed a moderate-intensity intervention program that can be sustained in the real-world setting and is practically applicable to both moderate and severe obesity. After interventions, the exercise group had lower %BF and cardiometabolic risk markers, and higher LM and leg muscle strength compared to the usual care group.

Moderate or severe NAFLD exerted a detrimental effect on FN BMD in men. However, moderate or severe NAFLD had a positive effect on lumbar spine BMD in postmenopausal women. Potential sex-specific differences of the effect of NAFLD on BMD need to be elucidated further.

The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA with clinically diagnosed PATB syndrome. A linear array 7 MHz transducer was used for US examination of the knee. Seventeen patients were injected locally with tramcinolone acetonide in the anserine bursa area. Response to local corticosteroid injection was evaluated by pain visual analog scale (VAS), Western Ontario and MacMaster (WOMAC) osteoarthritis index and Global patient/physician assessment using Likert scale. On US examination, only 2 patients (8.7%) showed evidence of PATB. Pain VAS, WOMAC pain index and WOMAC physical function index improved significantly after corticosteroid injection. Global patient assessment revealed that 2 patients showed best response, 6 good, 1 fair, 8 the same, and none worse. It is of note that the 2 patients who showed the best response were those who showed US evidence of PATB. This finding shows that US can serve as a useful diagnostic tool for guiding treatment in PATB syndrome of OA patients.

Background The present study evaluated the associations of the fat‐to‐muscle ratio (FMR) with metabolic syndrome (MetS) and insulin resistance (IR) in Korean adults using nationally representative survey data. Methods A two‐stage stratified sampling method was reflected in a cross‐sectional study involving a total of 13 032 participants aged ≥ 19 years who participated in the fourth and fifth Korea National Health and Nutrition Examination Surveys. The homeostasis model assessment for IR (HOMA‐IR) was used to evaluate IR and was calculated as follows: [fasting plasma glucose level (mg/dL) × fasting plasma insulin level (uIU/mL)]/405. MetS was defined using the 2006 International Diabetes Federation criteria, and FMR was measured using whole‐body dual‐energy X‐ray absorptiometry and calculated as follows: total fat mass (kg) divided by total lean mass (kg). In addition, the optimal FMR cut‐off values for detecting MetS and the odds ratios (ORs) for MetS risk were determined according to the FMR quartile and sex. Results Among all participants, the proportion of women was 58.4%, and the mean age was 44.22 ± 0.26 years. The FMR significantly differed between men and women (0.30 ± 0.002 vs. 0.53 ± 0.003, respectively, P < 0.001), and the prevalence of MetS and IR gradually increased as FMR increased (P for trend: <0.001). The optimal FMR cut‐off value for detecting MetS was higher in women than in men (0.555 vs. 0.336, respectively). The negative predictive value was the highest in normal‐weight participants (0.9992 in women and 0.9986 in men), while the positive predictive value was the highest in obese participants (0.5994 in women and 0.5428 in men). Based on the derived cut‐off FMR, a high FMR was associated with poor outcomes in terms of cardiometabolic risk markers (P < 0.001). The multivariable‐adjusted ORs for MetS, abdominal obesity, and IR (HOMA‐IR ≥ 3) were 5.35 [95% confidence interval (CI): 4.39–6.52], 7.67 (95% CI: 6.33–9.30), and 3.25 (95% CI: 2.70–3.92), respectively, in men and 5.59 (95% CI: 4.66–6.72), 7.48 (95% CI: 6.35–8.82), and 2.55 (95% CI: 2.17–3.00), respectively, in women. Conclusions In the present study, a high FMR was significantly associated with the prevalence of MetS and IR. The present findings also showed that FMR can be a novel indicator for detecting the absence or presence of MetS, particularly in metabolically healthy normal‐weight individuals and metabolically obese obese‐weight individuals.

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BackgroundThe prevalence of knee osteoarthritis(OA) in East Asia is as common for men and even higher for women than that reported in the Caucasian population. Since both population aging and economic growth have taken place at a much faster pace in Asian countries, such as South Korea, one would expect knee OA to become a major public health problem. However, few studies have examined the influence of knee OA on the quality of life (QoL) and physical function in Asia. The aim of this cross-sectional study is to investigate the influence of knee osteoarthritis (OA) on the quality of life (QoL), function and lower extremity physical performance and the gender difference in its influence in elderly community residents in Korea.MethodsParticipants were from the population-based Hallym Aging Study (HAS). The mean age of the 504 study subjects was 70.2 years and 274 (54%) were women. Demographic information was obtained by questionnaire, and radiographic evaluations consisted of weight-bearing semi-flexed knee radiographs. Self-reported QoL and function were assessed using Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and Short Form 12-item (SF-12). Performance-based lower extremity function was assessed using the tests consisting of standing balance, usual walk and chair stands. The odds ratios(ORs) for belonging to the worst quartile of WOMAC and physical performance test were calculated by logistic regression analysis in radiographic knee OA compared to non-OA after adjustment of confounders. Scores for SF-12 items were analyzed using general linear models and means adjusted for age, BMI and OA severity were compared.ResultsSubjects with radiographic knee OA had significantly increased OR for belonging to the worst WOMAC quartile(for pain, 2.13,95% confidence interval[CI], 1.33-3.40, for stiffness, 2.94,95% CI,1.78-4.86, and for function, 2.97, 95% CI,1.83-4.81) and significantly worse SF-12 scores compared to non-OA after adjustment of age, BMI and sex. Women had worse WOMAC and SF-12 scores compared to men, regardless of the presence of radiographic knee OA after adjustment of age, BMI and OA severity. OA subjects had significantly worse performance score for usual walk and chair stands compared to non-OA subjects, but the ORs were no more significant after adjustment of sex.ConclusionsKnee OA negatively affects the QoL and physical function in both genders, but women are more adversely affected than men.

The objectives of this study were to identify ultrasonographic (US) abnormalities and to compare physical examination with US findings, especially of rotator cuff abnormalities in patients with shoulder pain. A total of 120 patients with shoulder pain were prospectively studied. The physical examination of shoulders was performed as follows: (1) the area of tenderness; (2) the range of passive and active motion for abduction, forward flexion, external rotation, and internal rotation; (3) Neer and Hawkins's tests for shoulder impingement; and (4) maneuvers for determining the location of the tendon lesions. Transverse and longitudinal planes from the long head of the biceps, supraspinatus, infraspinatus, and subscapularis tendons, the subacromial-subdeltoid bursa, and the glenohumeral and acromioclavicular joints were included for US examination. The range of motion most affected by shoulder pain was abduction, followed by external rotation and forward flexion. The most frequent US finding was effusion in the long head of the biceps tendon. Among the rotator cuff tendons, supraspinatus was the most frequently involved. Physical examination had low sensitivity and specificity for the detection of tendon tear. US examination leads to an anatomical diagnosis of shoulder pain in many patients. Whether the US examination of the painful shoulder improves its treatment should be investigated.