Knee osteoarthritis (OA) is associated with high insulin resistance, particularly in individuals with metabolic syndrome and type 2 diabetes. In this cross-sectional study, we aimed to explore the relationship between insulin resistance indices and the prevalence of knee OA using data from 4,209 participants of the 2009-2010 Korea National Health and Nutrition Examination Survey. We used several insulin resistance indices in our analysis: Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), triglyceride-glucose (TyG) index, TyG-body mass index (TyG_BMI), TyG-waist circumference (TyG_WC), and visceral adiposity index (VAI). Without adjusting for confounding variables, the TyG_index increased the risk of knee OA by 1.056. After adjusting for confounders, the risk increased significantly by 1.082. Similarly, the TyG_BMI, TyG_WC, and VAI showed significant associations with knee OA. However, the association between HOMA-IR and knee OA was not significant. BMI (with and without confounding variable adjustments) was significantly associated with knee OA, whereas no significant associations were found for hypertension, dyslipidemia, diabetes, or WC. These results suggest that insulin resistance indices, particularly TyG-related indices, are significantly associated with knee OA. This highlights the potential benefits of managing knee OA in the context of metabolic syndrome, which is often associated with increased insulin resistance.

Background: Menopause results in complex climacteric symptoms that significantly compromise quality of life in postmenopausal women. Here, we specifically evaluated the dual synergistic effects of Gochujang, a traditional Korean fermented food containing fermentation-enhanced isoflavone aglycones and red pepper-derived capsaicinoids, in alleviating menopause-associated symptoms and metabolic dysregulation. Methods: This was a pioneering 8-week, randomized, double-blind, controlled clinical trial designed to assess the therapeutic effects of different Gochujang preparations (high-Gochujang [HGC] and low-Gochujang [LGC]) in postmenopausal women, against a control group (CG). The primary efficacy endpoint was a change in the total Kupperman Menopausal Index (KMI) score. Secondary outcomes included body composition, metabolic marker levels, and safety evaluations. Results: We observed a comprehensive, statistically significant decrease in the total KMI score in both the HGC and LGC groups, with the CG group exhibiting no significant overall improvement, indicating that Gochujang supplementation significantly alleviated climacteric symptoms. Furthermore, we confirmed the anti-obesity effects of Gochujang: a statistically significant decrease in percent body fat was observed in all three groups. The LGC group exhibited beneficial body composition modulation, exhibiting a significant increase in fat-free mass and a corresponding increase in basal metabolic rate without significant changes in overall weight. Moreover, the intervention was well-tolerated, with no adverse changes observed in blood pressure or vital signs. Conclusion: Gochujang supplementation is a safe and effective non-hormonal nutritional strategy. This study provides clinical evidence that Gochujang is suitable for the concurrent management of climacteric symptoms and favorable modulation of metabolic health in postmenopausal women.