• 제목/요약/키워드: Risk Adjustment

검색결과 389건 처리시간 0.024초

국민건강영양조사를 이용한 성인의 혈중 중금속 농도와 생선 섭취 및 심혈관 질환과의 관련성-국민건강영양조사 (2008~2010년) (The association of heavy metals in blood, fish consumption frequency, and risk of cardiovascular diseases among Korean adults: The Korean National Health and Nutrition Examination Survey (2008-2010))

  • 신지예;김지명;김유리
    • Journal of Nutrition and Health
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    • 제45권4호
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    • pp.347-361
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    • 2012
  • Limited studies are available concerning the effect of heavy metal exposure on cardiovascular diseases. As environmental pollution increases, food contamination, including heavy metal contamination of fish, also increases. However, researches based on the intake of heavy metals, cardiovascular disease, and fish intakes are inconclusive. We assessed an association of heavy metal exposure with cardiovascular disease and fish intake in a nationally representative group of general Korean adults. We used data from the combined 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES), and analyzed the data of 5,139 Koreans who participated in KNHANES. All participants were older than 20 years, and were diagnosed with stroke, ischemic heart disease, or hypertension. The mean blood cadmium, lead concentration, and mercury concentration of subjects were $1.07{\pm}0.01{\mu}g/L$, $2.49{\pm}0.02{\mu}g/dL$, and $5.19{\pm}0.08{\mu}g/L$, respectively. We used the survey logistic regression model to account for the complex sample design of the cardiovascular disease risk in order to estimate the odds ratios (OR). After adjusting for age, education, income, alcohol, smoking, and BMI, the increase of serum cadmium in blood was associated with the increase in the prevalence of hypertension. Further, the increase in blood cadmium concentration was associated with the increase of both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Although higher fish intakes were significantly associated with higher blood mercury concentration (p for trend < 0.0001), fish intakes did not affect either blood cadmium or lead concentration. Comparing the highest fish intake group with the lowest intake group, the OR of hypertension was 0.31 (95% CI: 0.19-0.59) in the crude model for total fish. However, these associations were no longer significant after the adjustment for potential confounding factors. In conclusion, cadmium in blood was associated with an increased risk of hypertension in the general Korean adult population. However, we found no evidence of a clear relationship between cardiovascular disease and frequency of fish consumption.

RPSA Gene Mutants Associated with Risk of Colorectal Cancer among the Chinese Population

  • Zhang, Shan-Chun;Jin, Wen;Liu, Hui;Jin, Ming-Juan;Chen, Ze-Xin;Ding, Zhe-Yuan;Zheng, Shuang-Shuang;Wang, Li-Juan;Yu, Yun-Xian;Chen, Kun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7127-7131
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    • 2013
  • The primary aim of this study was to evaluate the relationship of single nucleotide polymorphisms (SNPs) in ribosomal protein SA (RPSA) gene with colorectal cancer (CRC). A case-control study including 388 controls and 387 patients with CRC was conducted in a Chinese population. Information about socio-demography and living behavior factors was collected by a structured questionnaire. Three SNPs (rs2133579, rs2269349, rs7641291) in RPSA gene were genotyped by Illumina SnapShot method. Multiple logistic regression models were used for assessing the joint effects between tea consumption and SNPs on CRC. The subjects with rs2269349 CC genotype had a decreased risk for CRC (OR=0.60; 95%CI = 0.37-0.99), compared with TT/CT genotype after adjustment for covariates. A similar association of rs2269349 with rectal cancer was observed (OR=0.49; 95%CI=0.24-1.00). Further analyses indicated that this SNP could modify the protective effect of tea drinking on CRC. Among the subjects with rs2269349 TT/CT or rs2133579 AA/GA, there was a marginal significantly lower risk of CRC (OR and 95%CI: 0.63 and 0.39-1.01 for rs2269349; 0.64 and 0.40-1.02 for rs2133579) in tea-drinking subjects in comparison to non-tea-drinking subjects. Mutants in the RPSA gene might be associated with genetic susceptibility to CRC and influence the protective effect of tea consumption in the Chinese population.

폐경 후 정상여성과 폐경 후 류마티스 관절염환자의 골밀도 및 골다공증 위험요인 비교 (Comparison of Bone Mineral Density and Risk Factors of Osteoporosis between Normal and Rheumatoid Arthritis in Postmenopausal women)

  • 이은남
    • 근관절건강학회지
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    • 제7권1호
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    • pp.89-101
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    • 2000
  • This study was carried out to compare the bone mineral density and risk factors of osteoporosis between normal and rheumatoid arthritis in postmenopausal women. Sixty-eight postmenopausal patients with rheumatoid arthritis(RA) were compared with 124 postmenopausal normal women. Data were collected from october, 1998 to April, 1999 at Dong-a university hospital in Pusan. From all subjects, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption, exercise, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of osteoporosis by questionnaire. From RA patients, health assessment score, Ritchie articular index, erythrocyte sedimentation rate, C-reactive protein and steroid dosage were measured by rheumatologist on measuring bone mineral density. Bone mineral density was measured at the Lumbar spine, femoral neck, femur Ward's triangle, and femur trochanter using dual x-ray absorptiometry. The data was analyzed by using a frequency, t-test, Chi-square, ANCOVA with SPSS PC program. The results could be summarized as follows : 1) There was a significant difference in age and breast feeding period between RA patients and normal women. 2) RA patients took less calcium in the past and practiced less regular exercise in past and present than normal women. 3) There was no difference in lumbar bone mineral density between RA patients and normal women. 4) There was a significant difference in femur Ward's triangle and femur trochanter between RA patients and normal women after adjustment for age and breast feeding period. 5) The prevalence of osteoporosis of all subjects was the highest in femur Ward's triangle. In summary, our findings suggest that the bone mineral densities of femur Ward's triangle and trochanter in postmenopausal women with RA is significantly lower than normal women. Also the exercise participation rate of postmenopausal women with RA is lower than normal women. For the further study, we recommend to develop exercise program that improve the bone mineral density in femur Ward's triangle and trochanter and to test the effect of that exercise program.

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XRCC1 Gene Polymorphism, Clinicopathological Characteristics and Stomach Cancer Survival in Thailand

  • Putthanachote, Nuntiput;Promthet, Supannee;Suwanrungruan, Krittika;Chopjitt, Peechanika;Wiangnon, Surapon;Chen, Li-Sheng;Yen, Ming-Fang;Chen, Tony Hsiu-Hsi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.6111-6116
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    • 2015
  • Background: Stomach cancer is one of leading causes of death worldwide. In Thailand, the incidence and mortality of stomach cancer are in the top ten for cancers. Effects of DNA repair gene X-ray repair cross complementary protein 1 (XRCC1) polymorphisms and clinicopathological characteristics on survival of stomach cancer in Thailand have not been previously reported. The aim of this study was to investigate the effects of XRCC1 gene and clinicopathological characteristics on survival of stomach cancer patients in Thailand. Materials and Methods: Data and blood samples were collected from 101 newly diagnosed stomach cancer cases pathologically confirmed and recruited during 2002 to 2006 and followed-up for vital status until 31 October 2012. Genotype analysis was performed using real-time PCR-HRM. The data were analyzed using the Kaplan-Meier method to yield cumulative survival curve, log-rank test to assess statistical difference of survival and Cox proportional hazard models to estimate adjusted hazard ratio. Results: The total followed-up times were 2,070 person-months, and the mortality rate was 4.3 per 100 person-months. The median survival time after diagnosis was 8.07 months. The cumulative 1-, 3-, 5-years survival rates were 40.4%, 15.2 % and 10.1 % respectively. After adjustment, tumour stage were associated with an increased risk of death (p= 0.036). The XRCC1 Gln339Arg, Arg/Arg homozygote was also associated with increased risk but statistically this was non-significant. Conclusions: In addition to tumour stage, which is an important prognostic factor affecting to the survival of stomach cancer patients, the genetic variant Gln339Arg in XRCC1 may non-significantly contribute to risk of stomach cancer death among Thai people. Larger studies with different populations are need to verify ours findings.

Parathyroid Hormone Gene rs6256 and Calcium Sensing Receptor Gene rs1801725 Variants are not Associated with Susceptibility to Colorectal Cancer in Iran

  • Mahmoudi, Touraj;Karimi, Khatoon;Arkani, Maral;Farahani, Hamid;Nobakht, Hossein;Dabiri, Reza;Asadi, Asadollah;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6035-6039
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    • 2014
  • Background: Substantial evidence from epidemiological studies has suggested that increased levels of calcium may play a protective role against colorectal cancer (CRC). Given the vital role of calcium sensing receptor (CaSR) and parathyroid hormone (PTH) in the maintenance of calcium homeostasis, we explored whether the rs1801725 (A986S) variant located in exon 7 of the CaSR gene and the rs6256 variant located in exon 3 of PTH gene might be associated with CRC risk. Materials and Methods: In this study 860 subjects including 350 cases with CRC and 510 controls were enrolled and genotyped using PCR-RFLP methods. Results: We observed no significant difference in genotype or allele frequencies between the cases with CRC and controls for both CaSR and PTH genes either before or after adjustment for confounding factors including age, BMI, sex, smoking status, and family history of CRC. Furthermore, no evidence for effect modification of any association of rs1801725 and rs6256 variants and CRC by BMI, sex, or tumor site was observed. In addition, there was no significant difference in genotype and allele frequencies between the normal weight (BMI < $25kg/m^2$) cases and overweight/obese (BMI ${\geq}25kg/m^2$) cases for the two SNPs. Conclusions: These data indicated that the CaSR gene A986S variant is not a genetic contributor to CRC risk in the Iranian population. Furthermore, our results suggest for the first time that PTH gene variant does not affect CRC risk. Nonetheless, further studies with larger sample size are needed to validate these findings.

Lack of Associations between Vitamin D Metabolism-Related Gene Variants and Risk of Colorectal Cancer

  • Mahmoudi, Touraj;Karimi, Khatoon;Arkani, Maral;Farahani, Hamid;Nobakht, Hossein;Dabiri, Reza;Asadi, Asadollah;Vahedi, Mohsen;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.957-961
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    • 2014
  • Purpose: With regard to the protective effect of vitamin D against colorectal cancer (CRC), we evaluated genetic variants that might influence vitamin D metabolism: vitamin D receptor (VDR), vitamin D binding protein (GC), vitamin D 25-hydroxylase (CYP2R1), and vitamin D 25-hydroxy 1-alpha hydroxylase (CYP27B1). Materials and Methods: A total of 657 subjects, including 303 cases with CRC and 354 controls were enrolled in this case-control study. All 657 were genotyped for the four gene variants using PCR-RFLP methods. Results: In this study, no significant difference was observed for VDR (rs2238136), GC (rs4588), CYP2R1 (rs12794714), and CYP27B1 (rs3782130) gene variants in either genotype or allele frequencies between the cases with CRC and the controls and this lack of difference remained even after adjustment for age, BMI, sex, smoking status, NSAID use, and family history of CRC. Furthermore, no evidence for effect modification of the variants and CRC by BMI, sex, or tumor site was observed. Conclusions: Our findings do not support a role for VDR, GC, and CYP27B1 genes in CRC risk in our Iranian population. Another interesting finding, which to our knowledge has not been reported previously, was the lack of association with the CYP2R1 gene polymorphism. Nonetheless, our findings require confirmation and possible roles of vitamin D metabolism-related genes in carcinogenesis need to be further investigated.

비만에 이환된 아동청소년에서 보이는 정신건강문제 (Mental Health Problems in Child and Adolescent Obesity)

  • 강나리;이지선;강기수;곽영숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제27권2호
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    • pp.119-129
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    • 2016
  • Objectives: The purpose of this study was to investigate mental health problems in obese child and adolescent patients. We assess the frequency of mental health problems and their differences according to sex, school grade and severity of obesity. Methods: The sample consisted of 106 children and adolescents aged 8-16 years (61 boys with mean age $10.98{\pm}2.26$, 45 girls with mean age $9.74{\pm}1.96$, p=.004) who were diagnosed with obesity and recruited at the Department of Pediatrics of Jeju National University Hospital. The participants completed the Korean-Child Behavior Checklist (K-CBCL), Children's Depression Inventory (CDI), Korean version of the Eating Attitude Test-26 (KEAT-26), and somatotype drawings. Results: The percentage of participants having a T-score in clinical range on one or more CBCL subscale was 37.7%. The percentage of participants in the high risk group for depression (CDI score above 17) was 20.8% and that in the high risk group for eating disorder (EAT-26 score above 20) was 6%. The girls showed significantly lower CBCL T-scores in social competence ($48.39{\pm}15.66$ vs. $38.91{\pm}22.04$, p=.011), adjustment function ($49.51{\pm}17.35$ vs. $40.38{\pm}22.58$, p=.020) and school competence ($53.34{\pm}10.47$ vs. $48.22{\pm}15.11$, p=.042) than the boys, but the percentages of boys and girls in clinical range were not significantly different. The middle school students showed (significantly) higher CBCL T-scores in somatic symptoms ($60.86{\pm}9.44$ vs. $55.74{\pm}6.76$, p=.005), aggressive behavior ($58.81{\pm}6.74$ vs. $54.68{\pm}6.22$, p=.009), total problems ($59.86{\pm}9.91$ vs. $54.88{\pm}9.76$, p=.039) and externalizing problems ($57.90{\pm}10.57$ vs. $52.44{\pm}9.38$, p=.022) than the elementary school students. The severe obesity group showed significantly higher CBCL T-scores in attention problems ($59.18{\pm}9.45$ vs. $54.15{\pm}5.34$, p=.001), social problems ($59.25{\pm}8.59$ vs. $55.96{\pm}6.50$, p=.038), delinquent behavior ($58.07{\pm}6.97$ vs. $54.73{\pm}6.00$, p=.017) and total problems ($59.21{\pm}11.65$ vs. $54.67{\pm}9.03$, p=.037) than the mild to moderate obesity group. Conclusion: Significant proportions of obese children and adolescents suffer from mental health problems. Clinicians need to pay attention to the mental health risk, especially in obese adolescents and severely obese children and adolescents.

해외건설공사 수익성 영향인자의 계층구조 및 사레적용에 관한 연구 (The hierarchical structures of cause-and-effect relationships on the profit factors in overseas construction projects)

  • 한승헌;선승민;박상혁;정도영
    • 한국건설관리학회논문집
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    • 제7권5호
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    • pp.64-76
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    • 2006
  • 지난 10여 년 동안 해외 건설시장은 급속도로 변화되어 왔다. 우루과이 라운드 협정과 WTO의 출범은 건설시장의 구조 및 질서를 국제화의 방향으로 변화시켜 왔으며, 이와 더불어 해외건설 프로젝트도 과거의 단순도급형에서 기술력과 자금동원력 및 고도의 관리능력을 요구하는 복잡화, 전문화, 고도화의 방향으로 변화하고 있다. 이러한 세계 건설시장의 환경 변화에 따라 해외건설시장의 기회는 계속 확대되고 있는 반면에, 이에 못지 않게 국내건설시장에 비해 매우 높은 수준의 리스크를 감수해야 하는 양면성을 띄고 있다. 이에 본 연구는 해외건설사업의 수익성에 영향을 미치는 리스크에 대한 체계적인 대응 전략을 마련하기 위해 국내업체가 수행한 136개 해외건설공사를 대상으로 사례조사 및 방문조사를 실시하여 해외건설공사의 수익성에 영향을 미치는 주요 인자를 수행단계별 50개와 부문별 104개 인자로 규명하고, 각 인자의 중요도를 분석하여 중점 관리인자를 도출하였다. 그리고 수익성 영향인자의 통계분석 결과와 문헌조사를 바탕으로 이들 인자간의 인과관계를 사업환경, 수주입찰, 계약협상, 참여주체, 공사관리의 5개 최상위 인자 이하 3단계에 걸쳐 총 340개 인자를 포함하는 계층구조로 정형화구축 해외공사 참여자들이 입찰단계 등 프로젝트 초기 단계에서 보다 체계적으로 리스크를 예측 분석할 수 있는 준거틀을 제공하였다. 또한 도출된 계층구조를 실제 수행되었던 해외공사 30건에 적용시켜 사례분석 함으로써 수익성 정도와 수익성인자 간의 관련성을 유추하여 해외건설공사 실무자가 공사 사전단계에서 리스크를 보다 효과적으로 관리하는데 도움이 될 수 있는 시사점을 제시하였다.

건강근로자효과 보정 전후의 메타 분석 결과 비교 -직업적 트리클로로에틸렌 노출과 암의 연관성- (Comparison of Meta-analysis Results with and Without Adjustment for Healthy Worker Effect on the Association Between Occupational Exposure to Trichloroethylene and Cancer Risk)

  • 박태원;황성호;이경무
    • 한국환경보건학회지
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    • 제40권5호
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    • pp.385-396
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    • 2014
  • Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.

한 대학병원 건강검진센터에 내원한 성인 여성의 지방간과 관상동맥질환위험인자와의 관련성 (Relationship Between Fatty Liver and Coronary Risk Factors among Health Examined Adult Women in an University Hospital)

  • 이광성;박재영;조영채
    • 한국산학기술학회논문지
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    • 제12권7호
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    • pp.3130-3137
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    • 2011
  • 본 연구는 복부초음파검사를 통하여 얻은 건강진단 결과로부터 지방간의 유소견자 비율을 파악하고, 지방간이 어느 정도 관상동맥질환위험인자와 관련하고 있는가를 검토하는 것을 목적으로 2009년 7월부터 2010년 6월까지의 기간에 한 대학병원 건강검진센터에서 종합건강검진을 받았던 30세 이상 여성 665명을 대상으로 하였다. 연구결과 전체 조사대상 여성의 지방간 유소견율은 11.6%이었으며, 저연령군보다 고연령군에서, 비만도가 증가할수록, 유소견율은 유의하게 증가하였다. 연령과 BMI를 보정한 상태에서의 체지방율, 중성지질, 총콜레스테롤, LDL-콜레스테롤, 공복시 혈당 및 ALT는 지방간군이 비지방간군보다 유의하게 높았으며, HDL-콜레스테롤은 비지방간군이 지방간군보다 유의하게 높았다. 연령과 BMI를 조정한 관상동맥질환위험인자와 혈액 검사치에 따른 지방간의 위험비는 TG, TC, LDL-C 및 ALT치가 정상군보다 비정상군에서 유의하게 높게 나타났다.