• 대한지역사회영양학회지
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• 제25권3호
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• pp.236-245
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• 2020

Objectives: Cardiovascular disease is a major cause of death in the elderly in Korea. Increased arterial stiffness is linked to risk of cardiovascular disease and mortality. The purpose of this study was to investigate the relationship between arterial stiffness and physical activity in the elderly. Methods: A total of 209 older adults (110 men and 99 women) participated in this study. Arterial stiffness of subjects such as brachial-ankle pulse wave velocity (baPWV) and ankle brachial pressure index (ABI) was measured using a non-invasive vascular screening device (VP-1000 Plus, Omron, Kyoto, Japan). The interviewed Korean version of the international physical activity questionnaire short form (IPAQ-SF) was used to evaluate subject's physical activity level and classify subjects as active or inactive group based on the time spent doing moderate to vigorous physical activity (MVPA). Results: The mean age of total subjects was 75.3 ± 5.6 years. There was no significant difference in sex distribution between the active group (39.7%) and inactive group (60.3%). The baPWV (1,758.1 ± 375.2 cm/sec) of the active group was significantly lower than that (1,969.7 ± 372.3 cm/sec) of the inactive group (P < 0.05). There was a significant inverse association between time spent in MVPA and baPWV (r = -0.245, P < 0.01). Conclusions: This study suggests that physical activity programs for older adults are needed to prevent arteriosclerosis.

• 대한의생명과학회지
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• 제15권1호
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• pp.9-15
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• 2009

Early age at menarche, which is indicator of early biological maturity, has been shown to be associated with increased adult body mass index. Early menarche has also been associated with many cardiovascular disease risk factors and metabolic syndrome. To evaluate the impact of menarche to cardiovascular risk factor, we assessed by age at menarche, brachial-ankle pulse wave velocity (baPWV), which represents arterial stiffness, in women with or without metabolic syndrome. The subjects recruited for this study were three hundred one women. Relatively early menarche and relatively late menarche were classified according to less than $50^{th}$ percentile for relatively early menarche, and great than the $50^{th}$ percentile for relatively late menarche. Subject were divided four group, 1) women who had not adulthood metabolic syndrome and relatively early menarche, 2) women who had not adulthood metabolic syndrome and relatively late menarche, 3) women who had adulthood metabolic syndrome and relatively early menarche, 4) women who had adulthood metabolic syndrome and relatively late menarche. Women who had a relatively early menarche with adulthood metabolic syndrome had significantly high levels of blood pressure, triglyceride, fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels than women with late menarche with adulthood metabolic syndrome, and had significantly lower HDL-cholesterol levels. And also, women who underwent a relatively early menarche with metabolic syndrome had highest level of baPWV in adult. In this study we found effect of age at menarche on adulthood metabolic risk factors for cardiovascular disease (e.g., baPWV, insulin resistance, hyperlipidemia) in Korean women.

• 가정의학회지
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• 제39권6호
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• pp.347-354
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• 2018

Background: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. Methods: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. Results: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. Conclusion: Lower pBF in obese men may be associated with improved cardiovascular risk.

• Korean Journal of Radiology
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• 제2권3호
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• pp.145-150
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• 2001

Objective: To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions. Materials and Methods: Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty. Results: In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63 0.30 to 0.99 0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8 8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed. Conclusion: The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.

• 대한족부족관절학회지
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• 제23권2호
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• pp.58-66
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• 2019

Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.

• 대한족부족관절학회지
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• 제20권2호
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• pp.78-83
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• 2016

Purpose: This study examined the factors affecting the treatment of diabetes mellitus foot patients who had undergone a Syme amputation. Materials and Methods: This study included 17 patients diagnosed with a diabetes mellitus foot and who had undergone a Syme amputation from January 2010 to January 2014. Some of the risk factors (age, body mass index [BMI], disease duration, smoking, ankle brachial index [ABI], HbA1c, serum albumin, total lymphocyte, C-reactive protein [CRP], and serum creatine) that affect the successful Syme amputation were analyzed. Results: The healing rate of a Syme amputation was significantly higher when the lymphocyte count was above $1,500mm^3$ (p=0.029). The factors affecting the surgical outcome according to multivariate analysis were HbA1c and the BMI (p=0.014, p=0.013). Regarding reamputation, there was a significant difference with HbA1c, lymphocyte, and BMI (p=0.01, p=0.03, and p=0.01). No significant differences were observed with age, disease duration of diabetes mellitus, smoking, ABI, serum albumin, CRP, and serum creatine. Conclusion: The HbA1c level, BMI and total lymphocyte count are risk factors that must be considered for successful Syme amputation in patients with diabetic foot disease.

• Clinical and Experimental Pediatrics
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• 제50권11호
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• pp.1078-1084
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• 2007

목 적 : 맥파 속도는 동맥 경직도를 측정할 수 있는 유용하고 비침습적인 방법이다. 비만은 여러 가지 기전에 의하여 동맥 경직도를 증가시킨다고 알려졌다. 그러나 소아 비만에서 맥파 속도에 대한 연구는 매우 적은 실정이다. 저자들은 비만 청소년에서 비만이 맥파 속도와 발목 상완 지수에 미치는 영향을 알아보고자 본 연구를 실시하였다. 방 법 : 1군은 15-16세 사이의 체질량지수가 85-95 백분위수 사이인 비만 위험군 청소년 40명(남자 22명, 여자 18명)으로 하였고, 2군은 체질량지수가 95백분위수 이상인 비만 청소년 39명(남자 26명, 여자 13명)을 대상으로 하였다. 정상 청소년 99명(남자 54명, 여자 45명)을 대조군으로 하였다. 신장, 체중을 이용하여 체질량지수를 산출하였고, VP-1000 기기(Colin Medical Technology Company, Komaki, Japan)를 이용하여 사지 수축기, 이완기, 평균 혈압, 양측 맥파 속도, 발목-상완 동맥압 지수, 박출 시간, 전구출기를 측정 후 비교 분석하였다. 체질량지수와 좌우 상완-발목 맥파 속도, 발목-상완 동맥압 지수, 혈압을 비교 분석하였고, 각 변수 간의 상관성을 연구하였다. 결 과 : 우상완-발목 맥파 속도는 1군(944.8 cm/sec)이나 3군(941.0 cm/sec)에 비하여 2군(1,012.8 cm/sec)에서 유의하게 높은 값을 보여 주었고, 좌상완-발목 맥파 속도도 2군(1,015.3 cm/ sec)에서 1군(940.1 cm/sec)이나 3군(942.2 cm/sec)에 비해 유의하게 높은 값을 보였다. 발목-상완 동맥압 지수, 심박동수, 전구출기/박동 시간 값은 각 군 간에 유의한 차이가 없었다. 상완-발목 맥파 속도와 혈압은 체질량지수가 증가할수록 증가하는 양의 상관관계를 보였으나 발목-상완 동맥압 지수는 체중, 신장, 체질량지수 어느 것과도 유의한 상관관계가 없었다. 결 론 : 체질량지수가 증가함에 따라 맥파 속도가 증가하는 점을 볼 때, 비만이 동맥 경직도의 증가와 밀접한 연관성이 있음을 알 수 있었다. 맥파 속도를 이용하여 청소년의 비만군 및 위험군을 조기에 발견하여 관리하는 것이 성인기에 심혈관 질환으로 이환되는 것을 예방하는 데 도움이 되리라 생각한다.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.56-65
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• 2019

본 연구는 12주간 여성노인이 체중을 이용한 복합운동(저항운동 30분, 유산소운동(30)) 참여가 그들의 신체구성(체중, 체지방률, 제지방, 신체질량지수, 근육량)과 심혈관요인(상완-발목 맥파속도, 동맥협착도)에 미치는 영향을 연구하였다. 연구의 목적을 달성하기 위해 연구에 참여한 대상자는 총 32명으로 운동그릅 16명, 통제그룹 16명으로 무선할당하였다. 운동집단은 주3회 60분씩 복합운동을 실시 하였으며, 통제그룹은 같은 기간 동안 평소와 동일한 환경에서 생활하였다. 본 연구의 통계분석은 동질성을 확보하기 위해서 모든 사전 변인들에 t-검증을 실시하였고 동질성이 확보되서 분산분석방법을 사용하였으며 유의수준은 0.05로 하였다. 연구결과 복합운동에 참여한 운동그룹과 통제그룹간에 신체구성에 대한 것은 통계적으로 유의한 차이를 보이지 않았다. 하지만 심혈관계 요인 중 복합운동 그룹의 상완-발목맥파속도 오른쪽(baPWV-Right(p=.001)), 상완-발목맥파속도 왼쪽(baPWV-Left(p=.001))은 통계적으로 유의한 감소를 나타냈고, 통제그룹은 통계적으로 유의한 차이를 보이지 않았다. 이상의 결과를 살펴보면 65세이상 여성노인이 12주간 체중을 이용한 복합운동에 참여하면 맥파속도(baPWV-Right)가 감소하고 심혈관 질환을 예방하여 노인들의 삶의 질을 높일 수 있을 것이다.

• 한국산학기술학회논문지
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• 제20권1호
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• pp.362-370
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• 2019

이 연구는 12주간 여성노인 실험참가자들의 혈류제한 복합운동 프로그램 참가 여부가 신체조성(몸무게, 체지방률, 근육량, 신체질량지수)와 심혈관인자(맥파속도와 혈관협착도)에 어떠한 영향을 미치는가에 대하여 연구 하고자 총 43명의 실험참가자가 혈류제한 복합운동(14명), 일반복합운동(14명)과 통제집단(15명)으로 무선할당 배분되어 본 연구를 참여하였다. 본 연구는 반복측정분산분석(Repeated Measure ANOVA)과 대비검증(contrast)을 이용하여 통계를 분석하였고, 모든 자료의 유의수준은 ${\alpha}=0.5$로 설정하였다. 연구결과 혈류제한 복합운동 집단의 신체조성(몸무게, 체지방률, BMI)에 통계적으로 유의한 변화가 나타났고, 일반복합운동 집단의 체지방률만 통계적으로 유의하게 감소하였다. 그리고 혈류제한 복합운동 집단의 오른쪽과 왼쪽의 맥파속도가 통계적으로 유의하게 감소하였고, 일반 복합운동 집단의 왼쪽 맥파속도만 통계적으로 유의하게 감소되었다. 또한 혈류제한 복합운동 집단의 사전과 사후 변화량($%{\Delta}$)과 효과크기(effect size)가 높이나왔다. 이는 동일한 운동(복합운동)을 수행하였지만 혈류제한 방법을 추가한 집단이 더욱 교감신경이 활성화된 운동을 실시하게 되어 여성노인들에게 신체조성과 심혈관 요인에 일반 복합운동 보다 더욱 긍정적인 영향을 미쳤음을 나타내고 있다.

• Journal of Genetic Medicine
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• 제14권1호
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• pp.8-17
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• 2017

Purpose: Pulse wave velocity (PWV) is an indicator of arterial stiffness, and is considered a marker of vascular damage. However, a genome-wide association study analyzing single nucleotide polymorphisms (SNPs) associated with brachial-ankle PWV (baPWV) has not been conducted in healthy populations. We performed this study to identify SNPs associated with baPWV in healthy populations in Korea. Materials and Methods: Genomic SNPs data for 2,407 individuals from three sites were analyzed as part of the Korean Genomic Epidemiologic Study. Without replication samples, we performed multivariable analysis as a post hoc analysis to verify the findings in site adjusted analysis. Healthy subjects aged between 40 and 70 years without self-reported history or diagnosis of hypertension, diabetes, hyperlipidemia, heart disease, cerebrovascular disease and cancer were included. We excluded subjects with a creatinine level >1.4 mg/dL (men) and 1.2 mg/dL (women). Results: In the site-adjusted association analysis, significant associations (P<$5{\times}10^{-8}$) with baPWV were detected for only 5 SNPs with low minor allele frequency. In multivariable analysis adjusted by age, sex, height, body mass index, mean arterial pressure, site, smoking, alcohol, and exercise, 11 SNPs were found to be associated (P<$5{\times}10^{-8}$) with baPWV. The 5 SNPs (P<$5{\times}10^{-8}$) linked to three genes (OPCML, PRR35 and RAB40C) were common between site-adjusted analysis and multivariable analysis. However, meta-analysis of the result from three sites for the 11 SNPs showed no significant associations. Conclusion: Using the recent standard for genome-wide association study, we did not find any evidence of significant association signals with baPWV.