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Published in: Endocrine 3/2018

01-03-2018 | Original Article

Metabolic syndrome and its components among Korean submariners: a retrospective cross-sectional study

Authors: Jihun Kang, Yun-Mi Song

Published in: Endocrine | Issue 3/2018

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Abstract

Purpose

Metabolic syndrome (MetS) is a cluster of inter-related risk factors for cardiovascular disease and diabetes. Although submariners tend to be exposed to unhealthy environmental factors, such as a confined work environment, physical inactivity, and circadian disruption, little is known regarding whether the risks of MetS and its components are associated with submarine service. The present study aimed to evaluate the risks of MetS and its components among submariners.

Methods

A total of 5090 subjects (513 submariners and 4577 non-submariners) were included in the present study. We calculated the age-standardized and age-specific prevalences of MetS. The associations between submarine service and the risks of MetS and its components were evaluated using logistic regression analysis after adjusting for age, service rank, and lifestyle factors.

Results

The age-standardized prevalences of MetS were 17.6 and 15.1% among submariners and non-submariners, respectively. Compared to non-submariners, submariners had higher risks of MetS (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.02, 1.68), low high-density lipoprotein cholesterol (OR 1.73, 95% CI 1.36, 2.20), and impaired fasting glucose (OR 1.46, 95% CI 1.21, 1.76). When we stratified the subjects according to physical activity, an increased risk of elevated blood pressure associated with submarine service was evident only in the subgroup with moderate or vigorous physical activity (P for interaction = 0.006).

Conclusion

Submariners had higher risks of MetS and some MetS components, compared to non-submariners. These findings suggest that special efforts are needed to prevent and manage MetS among individuals who are expected to be exposed to submarine environment.
Literature
1.
go back to reference A.M. McNeill, W.D. Rosamond, C.J. Girman, S.H. Golden, M.I. Schmidt, H.E. East, C.M. Ballantyne, G. Heiss, The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care 28, 385–390 (2005)CrossRef A.M. McNeill, W.D. Rosamond, C.J. Girman, S.H. Golden, M.I. Schmidt, H.E. East, C.M. Ballantyne, G. Heiss, The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care 28, 385–390 (2005)CrossRef
2.
go back to reference P.W. Wilson, R.B. D’Agostino, H. Parise, L. Sullivan, J.B. Meigs, Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 112, 3066–3072 (2005)CrossRef P.W. Wilson, R.B. D’Agostino, H. Parise, L. Sullivan, J.B. Meigs, Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 112, 3066–3072 (2005)CrossRef
3.
go back to reference H.-M. Lakka, D.E. Laaksonen, T.A. Lakka, L.K. Niskanen, E. Kumpusalo, J. Tuomilehto, J.T. Salonen, The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288, 2709–2716 (2002)CrossRef H.-M. Lakka, D.E. Laaksonen, T.A. Lakka, L.K. Niskanen, E. Kumpusalo, J. Tuomilehto, J.T. Salonen, The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288, 2709–2716 (2002)CrossRef
4.
go back to reference J.-P. Després, I. Lemieux, Abdominal obesity and metabolic syndrome. Nature 444, 881–887 (2006)CrossRef J.-P. Després, I. Lemieux, Abdominal obesity and metabolic syndrome. Nature 444, 881–887 (2006)CrossRef
5.
go back to reference T. Kadowaki, T. Yamauchi, N. Kubota, K. Hara, K. Ueki, K. Tobe, Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome. J. Clin. Invest. 116, 1784–1792 (2006)CrossRef T. Kadowaki, T. Yamauchi, N. Kubota, K. Hara, K. Ueki, K. Tobe, Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome. J. Clin. Invest. 116, 1784–1792 (2006)CrossRef
6.
go back to reference H.S. Park, S.W. Oh, S.-I. Cho, W.H. Choi, Y.S. Kim, The metabolic syndrome and associated lifestyle factors among South Korean adults. Int. J. Epidemiol. 33, 328–336 (2004)CrossRef H.S. Park, S.W. Oh, S.-I. Cho, W.H. Choi, Y.S. Kim, The metabolic syndrome and associated lifestyle factors among South Korean adults. Int. J. Epidemiol. 33, 328–336 (2004)CrossRef
7.
go back to reference Y.-W. Park, S. Zhu, L. Palaniappan, S. Heshka, M.R. Carnethon, S.B. Heymsfield, The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch. Intern. Med. 163, 427–436 (2003)CrossRef Y.-W. Park, S. Zhu, L. Palaniappan, S. Heshka, M.R. Carnethon, S.B. Heymsfield, The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch. Intern. Med. 163, 427–436 (2003)CrossRef
8.
go back to reference M.T. Hamilton, D.G. Hamilton, T.W. Zderic, Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 56, 2655–2667 (2007)CrossRef M.T. Hamilton, D.G. Hamilton, T.W. Zderic, Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 56, 2655–2667 (2007)CrossRef
9.
go back to reference K. Rennie, N. McCarthy, S. Yazdgerdi, M. Marmot, E. Brunner, Association of the metabolic syndrome with both vigorous and moderate physical activity. Int. J. Epidemiol. 32, 600–606 (2003)CrossRef K. Rennie, N. McCarthy, S. Yazdgerdi, M. Marmot, E. Brunner, Association of the metabolic syndrome with both vigorous and moderate physical activity. Int. J. Epidemiol. 32, 600–606 (2003)CrossRef
10.
go back to reference D. De Bacquer, M. Van Risseghem, E. Clays, F. Kittel, G. De Backer, L. Braeckman, Rotating shift work and the metabolic syndrome: a prospective study. Int. J. Epidemiol. 38, 848–854 (2009)CrossRef D. De Bacquer, M. Van Risseghem, E. Clays, F. Kittel, G. De Backer, L. Braeckman, Rotating shift work and the metabolic syndrome: a prospective study. Int. J. Epidemiol. 38, 848–854 (2009)CrossRef
11.
go back to reference S.-W. Choi, J.-H. Lee, Y.-K. Jang, J.-R. Kim, Assessment of ambulatory activity in the Republic of Korea Navy submarine crew. Undersea Hyperb. Med. 37, 413 (2010)PubMed S.-W. Choi, J.-H. Lee, Y.-K. Jang, J.-R. Kim, Assessment of ambulatory activity in the Republic of Korea Navy submarine crew. Undersea Hyperb. Med. 37, 413 (2010)PubMed
12.
go back to reference T.L. Kelly, J.T. Grill, P.D. Hunt, D.F. Neri, Submarines and 18-hour work shift work schedules. Defense Technical Information Center (1996), http://www.dtic.mil/docs/citations/ADA306497. Accessed 1 June 2017 T.L. Kelly, J.T. Grill, P.D. Hunt, D.F. Neri, Submarines and 18-hour work shift work schedules. Defense Technical Information Center (1996), http://​www.​dtic.​mil/​docs/​citations/​ADA306497.​ Accessed 1 June 2017
13.
go back to reference J. Hartwell, N. Durocher, J. Gertner, J. Vanderweele, K. Marvin, W. Horn, A comparison of the prevalence of metabolic syndrome among fast-attack submariners with us civilian males (2009). Defense Technical Information Center. http://www.dtic.mil/docs/citations/ADA505928. Accessed 28 May 2017 J. Hartwell, N. Durocher, J. Gertner, J. Vanderweele, K. Marvin, W. Horn, A comparison of the prevalence of metabolic syndrome among fast-attack submariners with us civilian males (2009). Defense Technical Information Center. http://​www.​dtic.​mil/​docs/​citations/​ADA505928.​ Accessed 28 May 2017
14.
go back to reference G.M. Sandal, G. Leon, L. Palinkas, Human challenges in polar and space environments. Rev. Environ. Sci. Bio/Technol. 5, 281–296 (2006)CrossRef G.M. Sandal, G. Leon, L. Palinkas, Human challenges in polar and space environments. Rev. Environ. Sci. Bio/Technol. 5, 281–296 (2006)CrossRef
15.
go back to reference S.A. Reini, Hypercortisolism as a potential concern for submariners. Aviat. Space Environ. Med. 81, 1114–1122 (2010)CrossRef S.A. Reini, Hypercortisolism as a potential concern for submariners. Aviat. Space Environ. Med. 81, 1114–1122 (2010)CrossRef
16.
go back to reference H.G. Gasier, C.R. Young, E. Gaffney-Stomberg, D.C. McAdams, L.J. Lutz, J.P. McClung, Cardiometabolichealth in submariners returning from a 3-month patrol. Nutrients 8, 85 (2016)CrossRef H.G. Gasier, C.R. Young, E. Gaffney-Stomberg, D.C. McAdams, L.J. Lutz, J.P. McClung, Cardiometabolichealth in submariners returning from a 3-month patrol. Nutrients 8, 85 (2016)CrossRef
17.
go back to reference K. Bush, D.R. Kivlahan, M.B. McDonell, S.D. Fihn, K.A. Bradley, The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch. Intern. Med. 158, 1789–1795 (1998)CrossRef K. Bush, D.R. Kivlahan, M.B. McDonell, S.D. Fihn, K.A. Bradley, The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch. Intern. Med. 158, 1789–1795 (1998)CrossRef
18.
go back to reference C.L. Craig, A.L. Marshall, M. Sjöström, A.E. Bauman, M.L. Booth, B.E. Ainsworth, M. Pratt, U. Ekelund, A. Yngve, J.F. Sallis, International physical activity questionnaire: 12-country reliability and validity. Med. Sci. Sports Exerc. 35, 1381–1395 (2003)CrossRef C.L. Craig, A.L. Marshall, M. Sjöström, A.E. Bauman, M.L. Booth, B.E. Ainsworth, M. Pratt, U. Ekelund, A. Yngve, J.F. Sallis, International physical activity questionnaire: 12-country reliability and validity. Med. Sci. Sports Exerc. 35, 1381–1395 (2003)CrossRef
19.
go back to reference S.W. Oh, Obesity and metabolic syndrome in Korea. Diabetes Metab. J. 35, 561–566 (2011)CrossRef S.W. Oh, Obesity and metabolic syndrome in Korea. Diabetes Metab. J. 35, 561–566 (2011)CrossRef
20.
go back to reference K. Alberti, R.H. Eckel, S.M. Grundy, P.Z. Zimmet, J.I. Cleeman, K.A. Donato, J.-C. Fruchart, W.P.T. James, C.M. Loria, S.C. Smith, Harmonizing the metabolic syndrome. Circulation 120, 1640–1645 (2009)CrossRef K. Alberti, R.H. Eckel, S.M. Grundy, P.Z. Zimmet, J.I. Cleeman, K.A. Donato, J.-C. Fruchart, W.P.T. James, C.M. Loria, S.C. Smith, Harmonizing the metabolic syndrome. Circulation 120, 1640–1645 (2009)CrossRef
21.
go back to reference E. Park, J. Kim, Gender-and age-specific prevalence of metabolic syndrome among Korean adults: analysis of the Fifth Korean National Health and Nutrition Examination Survey. J. Cardiovasc. Nurs. 30, 256–266 (2015)CrossRef E. Park, J. Kim, Gender-and age-specific prevalence of metabolic syndrome among Korean adults: analysis of the Fifth Korean National Health and Nutrition Examination Survey. J. Cardiovasc. Nurs. 30, 256–266 (2015)CrossRef
22.
go back to reference M.H. Ebrahimi, M. Delvarianzadeh, S. Saadat, Prevalence of metabolic syndrome among Iranian occupational drivers. Diabetes Metab. Syndr. Clin. Res. Rev. 10, S46–S51 (2016)CrossRef M.H. Ebrahimi, M. Delvarianzadeh, S. Saadat, Prevalence of metabolic syndrome among Iranian occupational drivers. Diabetes Metab. Syndr. Clin. Res. Rev. 10, S46–S51 (2016)CrossRef
23.
go back to reference J.H. Chang, P.T. Huang, Y.K. Lin, C.E. Lin, C.M. Lin, Y.H. Shieh, Y.-C. Lin, Association between sleep duration and sleep quality, and metabolic syndrome in Taiwanese police officers. Int. J. Occup. Med. Environ. Health 28, 1011–1023 (2015)CrossRef J.H. Chang, P.T. Huang, Y.K. Lin, C.E. Lin, C.M. Lin, Y.H. Shieh, Y.-C. Lin, Association between sleep duration and sleep quality, and metabolic syndrome in Taiwanese police officers. Int. J. Occup. Med. Environ. Health 28, 1011–1023 (2015)CrossRef
24.
go back to reference R. McLaughlin, L. Nielsen, M. Waller, An evaluation of the effect of military service on mortality: quantifying the healthy soldier effect. Ann. Epidemiol. 18, 928–936 (2008)CrossRef R. McLaughlin, L. Nielsen, M. Waller, An evaluation of the effect of military service on mortality: quantifying the healthy soldier effect. Ann. Epidemiol. 18, 928–936 (2008)CrossRef
25.
go back to reference S. Lim, H. Shin, J.H. Song, S.H. Kwak, S.M. Kang, J.W. Yoon, S.H. Choi, S.I. Cho, K.S. Park, H.K. Lee, Increasing prevalence of metabolic syndrome in Korea the Korean national health and nutrition examination survey for 1998–2007. Diabetes Care 34, 1323–1328 (2011)CrossRef S. Lim, H. Shin, J.H. Song, S.H. Kwak, S.M. Kang, J.W. Yoon, S.H. Choi, S.I. Cho, K.S. Park, H.K. Lee, Increasing prevalence of metabolic syndrome in Korea the Korean national health and nutrition examination survey for 1998–2007. Diabetes Care 34, 1323–1328 (2011)CrossRef
26.
go back to reference S. Kodama, S. Tanaka, K. Saito, M. Shu, Y. Sone, F. Onitake, E. Suzuki, H. Shimano, S. Yamamoto, K. Kondo, Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch. Intern. Med. 167, 999–1008 (2007)CrossRef S. Kodama, S. Tanaka, K. Saito, M. Shu, Y. Sone, F. Onitake, E. Suzuki, H. Shimano, S. Yamamoto, K. Kondo, Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch. Intern. Med. 167, 999–1008 (2007)CrossRef
27.
go back to reference A. Gille, R. Easton, D. D’andrea, S.D. Wright, C. Shear, CSL112 enhances biomarkers of reverse cholesterol transport after single and multiple infusions in healthy subjects. Arterioscler. Thromb. Vasc. Biol. 114, 303720 (2014) A. Gille, R. Easton, D. D’andrea, S.D. Wright, C. Shear, CSL112 enhances biomarkers of reverse cholesterol transport after single and multiple infusions in healthy subjects. Arterioscler. Thromb. Vasc. Biol. 114, 303720 (2014)
28.
go back to reference B. Walker, Cortisol—cause and cure for metabolic syndrome? Diabet. Med. 23, 1281–1288 (2006)CrossRef B. Walker, Cortisol—cause and cure for metabolic syndrome? Diabet. Med. 23, 1281–1288 (2006)CrossRef
29.
go back to reference P. Anagnostis, V.G. Athyros, K. Tziomalos, A. Karagiannis, D.P. Mikhailidis, The pathogenetic role of cortisol in the metabolic syndrome: a hypothesis. J. Clin. Endocrinol. Metab. 94, 2692–2701 (2009)CrossRef P. Anagnostis, V.G. Athyros, K. Tziomalos, A. Karagiannis, D.P. Mikhailidis, The pathogenetic role of cortisol in the metabolic syndrome: a hypothesis. J. Clin. Endocrinol. Metab. 94, 2692–2701 (2009)CrossRef
30.
go back to reference M.S. Tremblay, R.C. Colley, T.J. Saunders, G.N. Healy, N. Owen, Physiological and health implications of a sedentary lifestyle. Appl. Physiol. Nutr. Metab. 35, 725–740 (2010)CrossRef M.S. Tremblay, R.C. Colley, T.J. Saunders, G.N. Healy, N. Owen, Physiological and health implications of a sedentary lifestyle. Appl. Physiol. Nutr. Metab. 35, 725–740 (2010)CrossRef
31.
go back to reference D.W. Dunstan, J. Salmon, N. Owen, T. Armstrong, P.Z. Zimmet, T.A. Welborn, A.J. Cameron, T. Dwyer, D. Jolley, J.E. Shaw, Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults. Diabetologia 48, 2254–2261 (2005)CrossRef D.W. Dunstan, J. Salmon, N. Owen, T. Armstrong, P.Z. Zimmet, T.A. Welborn, A.J. Cameron, T. Dwyer, D. Jolley, J.E. Shaw, Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults. Diabetologia 48, 2254–2261 (2005)CrossRef
32.
go back to reference J. Salmon, A. Bauman, D. Crawford, A. Timperio, N. Owen, The association between television viewing and overweight among Australian adults participating in varying levels of leisure-time physical activity. Int. J. Obes. 24, 600 (2000)CrossRef J. Salmon, A. Bauman, D. Crawford, A. Timperio, N. Owen, The association between television viewing and overweight among Australian adults participating in varying levels of leisure-time physical activity. Int. J. Obes. 24, 600 (2000)CrossRef
33.
go back to reference F.B. Hu, T.Y. Li, G.A. Colditz, W.C. Willett, J.E. Manson, Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 289, 1785–1791 (2003)CrossRef F.B. Hu, T.Y. Li, G.A. Colditz, W.C. Willett, J.E. Manson, Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 289, 1785–1791 (2003)CrossRef
Metadata
Title
Metabolic syndrome and its components among Korean submariners: a retrospective cross-sectional study
Authors
Jihun Kang
Yun-Mi Song
Publication date
01-03-2018
Publisher
Springer US
Published in
Endocrine / Issue 3/2018
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-017-1518-8

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