• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.481-487
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• 2005

Purpose : Adiponectin, adipose tissue-specific protein, has anti-inflammatory and anti-atherogenic properties. It has been found to have a negative correlation with obesity and to play a role in modulating glucose tolerance and insulin sensitivity. Serum adiponectin concentrations are decreased in adults with obesity and type 2 diabetes. We investigated the difference in adiponectin levels between obese and non-obese children, and evaluated the relationship of serum adiponectin with body mass index(BMI), serum fasting insulin, lipid profiles and homeostasis model assessment(HOMA) in children. Methods : We measured serum adiponectin levels by radioimmunoassay in 113 children(82 obese children and 31 non-obese controls) from 8 to 15 years of age, and also checked BMI, fasting serum glucose, insulin and lipid profiles. Fasting and postprandial serum adiponectin concentrations were compared by oral glucose tolerance tests in 27 obese children. The correlations of adiponectin with BMI, insulin, low density lipoprotein(LDL)-cholesterol and HOMA were analyzed by Pearson's correlation. Results : The serum adiponectin levels were significantly lower in the obese group(19.7 mg/mL) than in the non-obese group(27.5 mg/mL)(P<0.01). Serum adiponectin concentrations were negatively correlated with BMI(r=-0.39, P<0.01), serum insulin(r=-0.28, P<0.01), LDL-C(r=-0.20, P<0.01) and HOMA(r=-0.22, P<0.01). At oral glucose tolerance tests in obese children, postprandial 2 hours adiponectin level(19.8 mg/mL) was decreased compared to fasting level(25.8 mg/mL)(P<0.01). Conclusion : Serum adiponectin concentrations were inversely related to adiposity and insulin resistance in children. We suggest the serum adiponectin level could be used as an early marker of insulin resistance in obese children.

• Journal of Nutrition and Health
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• v.49 no.2
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• pp.99-110
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• 2016

Purpose: The current study was conducted in order to identify health and nutritional status of Korean underweight women in their twenties by comparing with normal, overweight, and obese women. Methods: Data from the 2010~2012 Korea National Health and Nutrition Examination Survey were used in this study. Subjects were 897 women aged 20~29 years. Subjects were classified according to underweight, normal weight, overweight, and obese groups based on body mass index. Health status was assessed using data from the health questionnaire and examination. Nutritional status was assessed using data from 24-hour dietary recall and a food frequency questionnaire. Results: The underweight group had higher education and exercised less than the obese group. Means of blood chemistry and blood pressure of the underweight group did not differ from those of the normal weight group. Means of fasting glucose, insulin, lipid profiles, blood cell counts, and blood pressure in the underweight group were different from those of the overweight or obese group. Proportions of delivery, breast feeding, and irregular menstruation in the underweight group were lower compared with the other groups. Except retinol intake, means of nutrient intake did not differ among four groups. There were significant differences among four groups in the intakes of cereals and eggs and frequency of consumption of dairy products. Conclusion: The current findings showed that health and nutritional status of underweight women in their twenties did not differ from those of normal weight women. In particular, health status of underweight women in their twenties was better than that of obese women of the same ages. Further study on health and nutritional status of extremely underweight women is necessary.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.277-283
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• 2003

Purpose : Craniopharyngiomas are often accompanied by severe endocrine disorders. Although there is universal growth hormone deficiency(GHD), the resulting growth pattern is very heterogeneous. We report the growth and endocrine outcome of 44 children with craniopharyngioma, with emphasis on initial symptoms, growth before and during growth hormone(GH) treatment and spontaneous growth in spite of GHD. Methods : We performed a retrospective study of 44 children treated at our centre between 1984 and 2002. Results : About 30% of patients had symptoms suggesting endocrine disorder at diagnosis. After surgery, multiple endocrinopathies were almost universal. Before GH therapy, height velocity was $8.00{\pm}2.71cm/yr$ in the normal growth group(n=11) and $1.79{\pm}1.10cm/yr$ in the subnormal growth group(n=7) during the first year and during the second year, $6.76{\pm}2.49cm/yr$ and $2.29{\pm}1.33cm/yr$, respectively. There was no difference of body mass index(BMI) change between before and after surgery in the two groups. Height standard deviation score(SDS) was $-1.46{\pm}0.74$ in the normal growth group and $-0.43{\pm}0.97$ in the subnormal growth group. Before GH treatment height SDS was $-1.31{\pm}1.25$ and BMI was $20.46{\pm}3.60$. During GH treatment, height SDS increased to $-0.60{\pm}1.37$ in the first, and to $-0.41{\pm}1.54$ in the second year(P<0.05), but BMI did not change significantly. Conclusion : The endocrine morbidity could develop in most children with craniopharyngioma before and after the operation and should be managed properly. Although all treated patients benefit from GH therapy, further studies are necessary to find out the possible mechanism of growth regulation in normally growing children, despite GH deficient.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.220-226
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• 2009

Purpose : Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. Methods : Seventy-two patients ($23.9{\pm}2.4$ years) with T1DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. Results : Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects ($0.43{\pm}0.06$ mm vs $0.39{\pm}0.06$ mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). Conclusion : Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.343-350
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• 2008

Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

• Journal of Nutrition and Health
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• v.53 no.5
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• pp.476-487
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• 2020

Purpose: This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method. Methods: The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/㎡. The total energy expenditure (TEE_DLW) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days. Results: TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEE_DLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by -533.9 ± 228.0 kcal/day (-25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEE_DLW, showed that the agreement between them was negatively skewed, ranging from -980.8 kcal/day to -86.9 kcal/day. Conclusion: This study showed that the energy intake of elderly women was underreported. Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.552-564
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• 2017

Purpose: The purpose of this study was to measure energy expenditure (EE) the metabolic equivalents (METs) of 13 common physical activities by using a portable telemetry gas exchange system ($K4b^2$) and to assess the accuracy of the accelerometer (Actigraph $GT3X^+$) by gender in Korean adults. Methods: A total of 109 adults (54 males, 55 females) with normal BMI (body mass index) participated in this study. EE and METs of 13 selected activities were simultaneously measured by the $K4b^2$ portable indirect calorimeter and predicted by the $GT3X^+$ Actigraph accelerometer. The accuracy of the accelerometer was assessed by comparing the predicted with the measured EE and METs. Results: EE (kcal/kg/hr) and METs of treadmill walking (3.2 km/h, 4.8 km/h and 5.6 km/h) and running (6.4 km/h) were significantly higher in female than in male participants (p < 0.05). On the other hand, the accelerometer significantly underestimated the EE and METs for all activities except descending stairs, moderate walking, and fast walking in males as well as descending stairs in females. Low intensity activities had the highest rate of accurate classifications (88.3% in males and 91.3% females), whereas vigorous intensity activities had the lowest rate of accurate classifications (43.6% in males and 27.7% in females). Across all activities, the rate of accurate classification was significantly higher in males than in females (75.2% and 58.3% respectively, p < 0.01). Error between the accelerometer and $K4b^2$ was smaller in males than in females, and EE and METs were more accurately estimated during treadmill activities than other activities in both males and females. Conclusion: The accelerometer underestimated EE and METs across various activities in Korean adults. In addition, there appears to be a gender difference in the rate of accurate accelerometer classification of activities according to intensity. Our results indicate the need to develop new accelerometer equations for this population, and gender differences should be considered.

• Journal of the Korean Society of Food Science and Nutrition
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• v.42 no.2
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• pp.212-222
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• 2013

We studied the eating habits and sleeping patterns of 682 middle and high school students in their third year in Gwangju. According to the body mass index (BMI) of the subjects, obesity (over weight) was significantly higher in the third graders of high school students ($20.8{\pm}4.0$, 32.9%) than middle school students ($19.4{\pm}3.8$, 14.2%) (p<0.001). In addition, 71.1% of high school students experienced a lack of sleep compared to 48.8% of middle school students (p<0.001). There was a difference between good and bad sleepers in the number of times they ate snacks and the quantity of their snacks. Good sleepers had more fruit and dairy products (e.g. fruit juice 2~4 times (p<0.05), milk 2~4 times (p<0.001), apples 2~4 times, strawberries 2~4 times (p<0.01), and bananas 2~4 times a week), while bad sleepers consumed more beverages, frozen desserts, flour-based foods, fast food, bread, and rice cake. Bad sleepers clearly consumed snacks more frequently. From analyzing the correlations between sleep quality and snack intake, eating fruits 2~4 times a week (30 g~200 g/once) and drinking dairy products 2~4 times a week (120 mL~400 mL/once) appears to promote better sleeping habits.

• Journal of Gastric Cancer
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• v.10 no.1
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• pp.13-18
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• 2010

Purpose: Omental infarction (OI) following laparoscopy-assisted gastrectomy (LAG) for gastric cancer could become more common in the future because the indications for LAG are expected to expand. The aim of this study was to determine the clinical characteristics of OI following LAG. Materials and Methods: Three hundred ninety patients who underwent LAG for T1 or T2 gastric cancer from April 2003 to November 2007 were enrolled. OI was diagnosed by two radiologists using the patients' abdominal 16 row-detector CT scans. The clinicopathologic characteristics were retrospectively evaluated in the omental infarction (OI) group and the non-omental infarction (non-OI) group using the gastric cancer database of Dong-A University Medical Center and the medical record. Results: Nine omental infarctions (2.3%) of 390 LAGs were diagnosed. All the OIs could be discriminated from omental metastasis on the initial or follow up CT images. The location of the omental infarctions was on the epigastrium in 3 patients and in the left upper quadrant in 3 patients. The mean size of the OIs was 4.1 cm. Most patients with OI had no signs or symptoms. The body mass index of the OI group was higher than that of the non-OI group (P=0230), and OI was more common in patients who underwent total gastrectomy than in the patients who underwent subtotal gastrectomy (P=0.0011). Conclusion: Laparoscopy-assisted gastrectomy (LAG) with partial omentectomy for gastric cancer can be a cause of secondary OI. Omental infarction after LAG has different clinical characteristics and CT findings that those of other omental infarctions or postoperative omental metastases. Further multicenter study will be needed to evaluate in detail the clinical features of omental infarction after LAG.

• Journal of Gastric Cancer
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• v.9 no.4
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• pp.200-206
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• 2009

Purpose: The incidence of upper gastric cancer and especially the diffuse type have increased in western countries. The aim this study was to investigate the chronologic changes of the clinicopathological features and survival rates of Korean upper gastric cancer patients. Materials and Methods: 1,638 gastric cancer patients who underwent gastrectomy were included in this study and they were divided into two groups; the 1990's (1991~1999, n=987) and the early 2000's (2000~2003, n=651). We evaluated the differences of the clinicopathologic features and the factors that affected the survival rates by univariative and multivariative analysis. Results: The older age (>60) patients increased from 42.7% to 50.7% respectively. Being overweight (body mass index$\geq$23) also increased from 31.5% to 43.2%. For the pathology, the incidence of stage Ia gastric cancer increased (29.8% to 44.5%) and the incidence of stage IV gastric cancer decreased (23.5% to 11.8%). Yet there was no difference according to the WHO classification, Lauren's classification and the location of tumor between the groups. The 5 year survival rates increased 67.7% to 83.7%, according to the group. Multivariative analysis showed that the odd ratios of the early 2000s was 0.715 (95% CI; 0.555~0.921) as compared to that of the 1990s. Conclusion: There were no changes of the clinicopathologic features, like the pattern in western countries, although the incidence early gastric cancer, old age patients and overweight patients increased. The survival rate of early 2000s was better that that of the 1990s.