• Journal of Preventive Medicine and Public Health
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• v.41 no.2
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• pp.107-114
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• 2008

Objectives : The aim of this study is to investigate the association between obesity indices(body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. Methods : This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescence") and 25 years-old in 2005 (defined as "early adulthood"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. Results : In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. Conclusions : This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.

• Journal of Sasang Constitutional Medicine
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• v.19 no.1
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• pp.148-159
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• 2007

1. Objectives The purpose of this study was to investigate the correlation of Metabolic syndrome(MetS) and Intima-media thickness(IMT) of common carotid artery with Sasang constitution. 2. Methods 197 subjects who had taken health examinations and diagnosis of Sasang constitution from Jan 1, 2006 to Dec 31, 2006 at East-west health examination center of Kyung-Hee medical center were included and underwent B-mode ultrasonography for measurement of intima-media thickness of common carotid arteries. MetS was defined by the criteria of the criteria of the National Cholesterol Education Program Adult Treatment Panel III. 3. Results and Conclusions Mean intima-media thickness of common carotid artery was significantly higher in subjects with MetS compared with control subjects($0.070{\pm}0.017$ vs $0.063{\pm}0.014cm$) and a significant trend towards increased IMT was observed with increasing numbers of metabolic syndrome components(r=0.331, p=0.000). After adjustment for age and sex, IMT of common carotid arteries was significantly different among three constitutional groups (Soyangin:$0.065{\pm}0.015cm$, Taeumin:$0.068{\pm}0.016cm$, Soeumin:$0.056{\pm}0.010cm$), however, after adjustment for age, sex and existence of metabolic syndrome, there was no significant different. But, factor of Taeumin was the effective determinant of the increase of mean IMT of common carotid arteries.

• Journal of Sasang Constitutional Medicine
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• v.23 no.2
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• pp.218-229
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• 2011

1. Objectives: This study is to investigate the relationship between Intima Media Thickness(IMT) of common carotid artery and Sasang Constitution. 2. Methods: 839 persons, over 40 years old, participated in community-based cohort of Korea Genome and Epiedemiology Study (KOGES) in Wonju City and Pyeongchang City of South Korea from June 2006 to February 2008. The diagnosis of Common carotid Intima Media Thickness was evaluated by B Mode ultrasonography, cardiovascular risk factors were checked using questionnaire and blood samples. Constitution was verified by a Sasang constitution specialist according to the results of PSSC(Phonetic System for Sasang Constitution), facial photos and a simplified Sasang constitutional questionnaire. Multiple regression analysis and logistic regression analysis were performed with SPSS. 3. Results: There were significantly high values in waist circumference, fasting blood sugar, systolic blood pressure, diastolic blood pressure, triglyceride, HOMA-IR and hsCRP in Taeeumin and low in HDL-cholesterol and adiponectin in Taeeumin. There were significantly high value in Common Carotid Intima Media Thickness in Taeeumin. Age was the significant cardiovascular risk factor irrespective of Sasang constitution in all participants. There was a positive correlation between smoking and Soyangin in all participants and men. There were positive correlations between LDL-cholesterol, BMI and Taeeumin in all participants and men. There were positive correlations between hsCRP and Soeumin in all participants and men. There was significantly high odds ratio of Taeeumin over Soeumin in common carotid Intima Media Thickness. 4. Conclusions: Regimens on cardiovascular diseases should be considered according to Sasang constitution. There are more sensitive risk factor in each constitution; smoking in Soyangin, LDL-cholesterol and BMI in Taeeumin, hsCRP in Soeumin.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.36-43
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• 2009

urpose : The renin-angiotensin system (RAS) has been demonstrated to play a major role in regulating blood pressure. Therefore, components of the RAS are likely candidate genes that may predispose an individual to essential hypertension and cardiovascular complications. Among them, the M235T polymorphism of the angiotensinogen gene has been speculated to be associated with elevated circulating angiotensinogen concentrations and essential hypertension. This study aimed to analyze the angiotensinogen M235T polymorphism in hypertensive adolescents and investigate its relationship with cardiovascular risks. Methods : Forty Korean hypertensive adolescents (aged 16-17, systolic $BP{\geq}140 mmHg$ and/or diastolic $BP{\geq}90 mmHg$) and fifty seven normal adolescents were included. Obesity index (OI), body mass index (BMI) were calculated. BP was measured by oscillometric methods in resting state. Polymerase chain reaction (PCR) technique was performed on DNA from the hypertensives subjects to analyze the M235T polymorphism. Serum homocysteine, insulin, renin, aldosterone and angiotensin converting enzyme (ACE) were tested according to each genotype. The carotid intima-media thickness (IMT) and carotid artery diameter, Pulse wave velocity (PWV) and ankle-brachial index (ABI) were measured according to each genotype. Results : Genotype frequencies of T/T, M/T and M/M were 62.5%, 35.0%, 2.5%, respectively in hypertensive adolescents. The results were not significantly different compared to control group. Serum insulin, renin levels, BMI and OI were significantly higher in thoses with the M/M genotype as compared to those with the T/T of M/T genotype. Conclusion : This study showed that the M235T polymorphism was not associated with essential hypertension or any cardiovascular risks. Further clinical research is required to ascertain the relationship between this polymorphism and cardiovascular complications in Korean hypertensive adolescents.

• Journal of Biomedical Engineering Research
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• v.30 no.5
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• pp.401-411
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• 2009

In this paper, we correct pulse wave velocity(PWV) with heart-rate and derive regression equations to estimate intima-media thickness(IMT). Widely used methods for diagnosis of arteriosclerosis are IMT and PWV. Arterial wall stiffness determines the degree of energy absorbed by the elastic aorta and its recoil in diastole but there is not correlation between sclerosis and IMT in an existing study. In this study, we will correct PWV with heart-rate and get regression equation to estimate IMT using heart-rate correction index(HCI). We executed experiments for this study. Made up question of physical condition and measured electrocardiogram(ECG), photoplethysmogram (PPG) of finger-tip and toe-tip and ultrasound image of carotid artery. Calculated PWV and IMT using ECG, PPG and ultrasound image. We found that every p-value between PWV and IMT is not significant(<0.05). But p-value between IMT and HCI which is a corrected PWV using heart-rate is significant(>0.01). We use HCI and various measured parameter for estimating regression equation and apply backward estimation to select parameters for regression analysis. Result of backward estimation, found that only HCI is possible to derive proper regression equation of IMT. Relationship between PWV and IMT is the second order. Result of regression equation of E-H PWV is $R^2$=0.735, adj $R^2$=0.711. This is the best correlation value. We calculate error of its analysis for verification of earlobe PWV regression equation. Its result is RMSEP=0.0328, MAPE(%) = 4.7622. Like this regression analysis, we know that HCI is useful parameter and relationship between PWV, HCI and IMT. In addition, we are able to suggest possibility which is that we can get different parameter of prediction throughout just one measurement.

• Journal of Preventive Medicine and Public Health
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• v.39 no.6
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• pp.477-484
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• 2006

Objectives : This study was conducted to examine the association between the carotid artery intima-media thickness (IMT), plaque and cardiovascular risk factors according to gender and age. Methods : The data used for this study were obtained from 1,507 subjects (691 men, 816 women), aged 20-74 years, who participated in 'Prevalence study of thyroid diseases' in two counties of Jeollanam-do Province during July and August of 2004. The body mass index (BMI) and waist hip ratio (WHR) were calculated by anthropometry The blood pressure, pulse rate, pulse pressure, total cholesterol, triglyceride, HDL cholesterol and fasting blood sugar level were also measured. Ultrasonography was used to measure the carotid artery IMT and plaque. IMT measurements were performed at 6 sites, including both common carotid arteries, and the bulb and internal carotid arteries. The definition of the 'mean IMT' was mean value obtained from these 6 sites. Results : The ${\pm}$ standard deviation IMT values were $0.65{\pm}0.14\;and\;0.60{\pm}0.13mm$ in men and women (p<0.001), respectively. The data were analyzed according to gender and the 50 year age groups. In a multiple linear regression analysis, age and hypertension were positively associated with the mean IMT in both men and women, aged<50 years. Age, total cholesterol and smoking (current) were positively associated with the mean IMT in men $(\geq50\;years)$. Age was positively associated with the mean IMT in women $(\geq50\;years)$, but the HDL cholesterol level was negatively associated. The prevalence of plaques was 44.2%(196/443) in men and 19.4%(89/459) in women, for those greater than 50 years of age. In a multiple logistic regression analysis, age (OR=1.090, 95%CI=1.053-1.129), HDL cholesterol (OR=0.964, 95%CI=0.944-0.984), total cholesterol (OR=1.009, 95%CI=1.002-1.017)and BMI (OH=0.896, 95%CI=0.818-0.983) were independently associated with plaques in men; whereas, age (OR=1.057, 95%CI=1.012-1.103), HDL cholesterol (OR=0.959, 95%CI=0.932-0.986), pulse pressure (OR=1.029, 95%CI=1.007-1.050) and triglycerides (OR=0.531, 95%CI=0.300-0.941) were independently associated with plaques in women. Conclusions: There were significant gender and aging differences in the association between the IMT, plaque and cardiovascular risk factors. Therefore, for the prevention of atherosclerosis, selective approaches should be considered with regard to gender and age factors.

• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.298-304
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• 2009

Objectives : The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. Methods : Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives ($\geq$140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. Results : Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT$\geq$1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. Conclusions : Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.729-737
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• 2019

Fatty pancreas is an abnormal process of lipid deposition in cells, resulting in increased fat tissue and obesity. The result is a risk factor for cardiovascular and metabolic diseases. The aim of this study was to evaluate the usefulness of pancreatic fat as a predictor of cardiovascular disease and metabolic syndrome in pancreatic ultrasonography. In 407 patients who underwent a comprehensive screening at the W Health Care Center in Busan from September 2. 2018 to December 31, 2018, the degree of fat deposition in the pancreas was evaluated as the degree of mild, moderate. Data on non-obstructive atherosclerosis, BMI, hyperlipidemia, hypertension, and diabetes were collected to assess the association of pancreatic fat deposition with cardiovascular disease and metabolic syndrome. In addition, we tried to analyze the correlation between liver dysfunction and thyroid dysfunction as the degree of fat pancreas increased. We examined the relationship between six parameters including atherosclerosis, BMI, hyperlipidemia, hypertension, diabetes, liver dysfunction, and thyroid dysfunction among patients with fatty pancreas. We concluded that the carotid intima-media thickness of atherosclerosis, which is a risk factor of cardiovascular disease, is most closely related to fatty pancreas.