• Title/Summary/Keyword: Risk Adjustment

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Famine exposure in early life and type 2 diabetes in adulthood: findings from prospective studies in China

  • Feng Ning ;Jing Zhao ;Lei Zhang ;Weijing Wang ;Xiaohui Sun ;Xin Song ;Yanlei Zhang ;Hualei Xin ;Weiguo Gao;Ruqin Gao ;Dongfeng Zhang ;Zengchang Pang
    • Nutrition Research and Practice
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    • v.17 no.4
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    • pp.780-788
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    • 2023
  • BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

Recent outcome of extremely low birth weight infants - The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate - (초극소 저출생 체중아의 최근 치료 성적 - CRIB(clinical risk index for babies) II 점수를 이용한 생존율 분석 -)

  • Kim, Do-Hyeon;Shim, So-Yeon;Kim, Jae-Ri;Shin, Seung-Han;Kim, Eun Sun;Joung, Kyoung-Eun;Kim, Sang Duk;Lee, Jin A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.952-958
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    • 2006
  • Purpose : The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. Methods : A total of 99 infants were divided into three groups(period I: 2000 to 2001, period II: 2002 to 2003, period III : 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. Results : Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III : 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants <750 g at birth(period I: 10 percent, period II: 46.2 percent, period III : 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. Conclusion : In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing <750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

Characteristics of the Factor Structure of the Child Behavior Checklist Dysregulation Profile for School-aged Children (학령기 아동의 CBCL 조절곤란프로파일(Child Behavior Checklist Dysregulation Profile)의 요인구조와 특성)

  • Kim, Eun-young;Ha, Eun-hye
    • Korean Journal of School Psychology
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    • v.17 no.1
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    • pp.17-38
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    • 2020
  • This study examined the factor structure of the Child Behavior Checklist Dysregulation Profile(CBCL-DP) for school-aged children in Korea identified differences in the level of maladjustment and problematic behaviors between the clinical group which had characteristics of CBCL-DP and the control group which did not. Confirmative factor analysis was performed on three alternative models from the literature to determine which was the most appropriate factor structure for the CBCL-DP. The result showed that the bi-factor model fit the sample data better than both the one and second-factor models. To confirm that the bi-factor model was the most appropriate factor structure, regression paths with relevant variables examined. The showed that CBCL-DP with the bi-factor model was associated with executive function difficulty as reported by parents and with school adjustment and all sub-factors of strength and difficulty as reported by teachers. The results also showed that this model had a different relationship with anxiety/depression, aggressive behavior, and attention problems than the other models. The clinical group was shown to have more executive function difficulty, worse adjustment of school life and to be less likely to engage in desired behaviors than the control group. These results indicate the CBCL-DP is more related to negative outcomes than any other factor, and that the bi-factor model was found to best fit the sample data, consistent with other studies. The early discovery of CBCL-DP can be used to provide interventions for high-risk children who exhibit emotional and behavioral problems, making its detection a significant diagnostic tool. The implications of these result, the limitations of this study, and areas for future research are discussed in this paper.

The Impact of BIS Regulation on Bank Behavior in Asset Management (신 BIS 자기자본규제가 은행자산운용행태에 미치는 영향)

  • Oh, Hyun-Tak;Choi, Seok-Gyu
    • The Korean Journal of Financial Management
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    • v.26 no.3
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    • pp.171-198
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    • 2009
  • The primary purpose of this study is to examine the impact of new BIS regulation, which is the preparations to incorporate not only credit risk but also market and operation risk, on the bank behaviors. As methodology, SUR(seemingly unrelated regression) and pool unit test are used in the empirical analysis of banks survived in Korea. It is employed that quarterly data of BIS capital ratio, ratio of standard and below loans to total loans, ratio of liquid assets to liquid liabilities, allowances for credit losses, real GDP, yields of corporate bonds(3years, AA) covering the period of 2000Q1~2009Q1. As a result, it could be indicated that effectiveness and promoting improvements of BIS capital regulation policy as follows; First, it is explicitly seen that weight of lending had decreased and specific gravity of international investment had increased until before BIS regulation is built up a step for revised agreement in late 2001. Second, after more strengthening of BIS standard in late 2002, banks had a tendency to decrease the adjustment of assets weighted risk through issuing of national loan that is comparatively low profitability. Also, it is implicitly sought that BIS regulation is a bit of a factor to bring about credit crunch and then has become a bit of a factor of economic stagnation. Third, as the BIS regulation became hard, it let have a effort to raise the soundness of a credit loan because of selecting good debtor based on its credit ratings. Fourth, it should be arranged that the market disciplines, the effective superintendence system and the sound environment to be able to raise enormous bank capital easily, against the credit stringency and reinforce the soundness of banks etc. in Korea capital market.

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Cross-Sectional Relations of Arterial Stiffness and Inflammatory Markers in Korean Adults Aged 50 Years and Older (지역사회 거주 50세 이상 성인의 동맥경직도와 염증반응인자와의 관련성)

  • Ryu, So-Yeon;Shin, Min-Ho;Lee, Young-Hoon;Rhee, Jung-Ae;Choi, Jin-Su;Park, Kyeong-Soo;Nam, Hae-Sung;Jeong, Seul-Ki;Kweon, Sun-Seog
    • Journal of agricultural medicine and community health
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    • v.36 no.2
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    • pp.101-112
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    • 2011
  • Objectives: The aim of this study is to determine arterial stiffness levels as measured by brachial-ankle pulse wave velocity (baPWV) and to identify the association between arterial stiffness and inflammatory markers, in healthy adults over 50 years old. Methods: The study population consisted of 4617 persons over the age of 50 years who participated in the baseline survey of the Dong-gu Study, which was conducted in 2007 and 2008. Arterial stiffness was measured using baPWV. A multiple regression analysis was performed to assess the relationship between conventional cardiovascular risk factors and inflammatory markers, including white blood cell (WBC) counts, high-sensitive C-reactive protein (hs-CRP), and gamma glutamyltransferase (GGT). Results: After adjustment for conventional cardiovascular risk factors including sex, age, smoking status, body mass index, systolic blood pressure, fasting glucose, hypertension or diabetic medication, total cholesterol, triglycerides, uric acid, and alanine aminotransferase, baPWV was significantly associated with WBC counts (${\beta}$=0.158, p<0.0001), hs-CRP (${\beta}$=0.244, p=0.026), and GGT (${\beta}$=0.003, p<0.0001). Conclusion: This study shows that arterial stiffness correlates with inflammatory markers. Arterial stiffness may be used as a composite risk factor to identify persons with higher risk for cardiovascular disease. Additionally, arterial stiffness may be a marker for future cardiovascular disease and a target for prevention.

Association between consumption of milk and dairy products, calcium and riboflavin, and periodontitis in Korean adults: Using the 2007-2010 Korea National Health and Nutrition Examination Surveys (한국 성인의 우유 및 유제품과 칼슘 및 리보플라빈 섭취량과 치주염 간의 연관성: 2007~2010년 국민건강영양조사 자료를 이용하여)

  • Koo, Sang Mi;Seo, Deog-Gyu;Park, Yoon Jung;Hwang, Ji-Yun
    • Journal of Nutrition and Health
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    • v.47 no.4
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    • pp.258-267
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    • 2014
  • Purpose: The current study was designed to investigate the relationship of dietary calcium and riboflavin and their main dietary source (milk and dairy products) with the risk of periodontitis using data from 2007 to 2010 Korea National Health and Nutrition Examination Surveys. Methods: A total of 1,690 adults aged ${\geq}40$ years were included. We used results of dental examination regarding all sextant information on probing depth of at least two index teeth, nutritional assessment by a single 24-hour dietary recall, and demographic and medical information. The periodontitis group was defined as those who had 3-4 points, and the normal group was defined as those who had 0 points of Community Periodontal Index at all locations of six examination sites using a probe. Results: Using multiple logistic regression analysis, after adjustment for age, body mass index, energy intake, income, smoking, and alcohol drinking, we found an inverse relationship between consumption of dairy products and risk for periodontitis (OR: 0.465, 95% CI: 0.224-0.964) and between dietary riboflavin intake more than the estimated average requirements and risk for periodontitis (OR: 0.535, 95% CI: 0.300-0.954) in males. Conclusion: Adequate intake of milk dairy products and riboflavin may be recommended for prevention of periodontitis in the Korean male population.

Abdominal Obesity in Relation to the Incidence of Type 2 Diabetes Mellitus and Impaired Fasting Glucose among some Korean Adults: A Retrospective Cohort Study (복부비만이 제2형 당뇨병 및 공복혈당장애 발생에 미치는 영향: 후향적 코호트 연구)

  • Ryu, Seung-Ho;Beck, Sung-Ho;Kim, Dong-Il;Suh, Byung-Seong;Kim, Woon-Sool;Sung, Ki-Chul;Chang, Yoo-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.4
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    • pp.359-365
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    • 2004
  • Objectives : This study was performed to determine whether an increase in abdominal obesity is an independent risk factor for impaired fasting glucose and type 2 DM. Methods : Among 24,212 adults over 30 years who undertook comprehensive medical screening examinations from Jan to Dec 1999, in a university hospital in Seoul, a total of 11,183 subjects were selected who had no DM at baseline and who were followed up more than once by Dec 2002. The average follow up period was 2.4 (${\pm}0.5$) years. DM was defined as having a fasting glucose level $\geq$ 126mg/dl, and impaired fasting glucose as showing a fasting glucose level between 110 and 125 mg/dl. Body weight, height and waist circumference (WC) were simultaneously measured with blood sampling. The relative risks (RRs) for DM and impaired fasting glucose by WC were calculated using Cox proportional hazard model. Ageadjusted rates were estimated by direct standardization using a reference population of 2000 from 30 to 80 years. Results : The average age of the subjects was 41.7 (${\pm}7.0$) years; males 41.2 (${\pm}6.5$) and females 45.6 (${\pm}9.2$). RRs for type 2 DM by WC with the reference group of WC < 80cm were as follows: 2.66 (95%, CI $0.55{\sim}12.8$) for WC of $80{\sim}89cm$ in men, 5.92 (95%, CI $1.08{\sim}32.3$) for WC $\geq$ 90 cm in men, and 2.64 (95%, CI $0.23{\sim}29.8$) for WC of $80{\sim}89cm$ in females. RRs for impaired fasting glucose by WC were 3.03 (95%, CI $2.18{\sim}4.22$) for WC $80{\sim}89cm$ in men, 6.10 (95%, CI $4.25{\sim}8.75$) for WC $\geq$ 90cm in men, and 1.56 (95%, CI $0.43{\sim}5.67$) for WC $80{\sim}89cm$ in women, and 8.08 (95%, CI $2.22{\sim}29.4$) for WC $\geq$ 90cm in females. These results remained significant after adjustment for age, BMI and fasting glucose concentrations at baseline in both sexes. Annual increment of more than 1 cm in WC was associated with the development of DM and impaired fasting glucose independently of age, sex, BMI, or presence of abdominal obesity. Conclusion : In Korean adults, abdominal obesity increased the risk for the development of type 2 diabetes and impaired fasting glucose. This result supports many other prospective studies suggesting abdominal obesity as a risk factor for type 2 diabetes.

Research on the influence of web celebrity live broadcast on consumer's purchase intention - Adjusting effect of web celebrity live broadcast contextualization

  • Zou, Ji-Kai;Guo, Han-Wen;Liu, Zi-Yang
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.6
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    • pp.239-250
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    • 2020
  • The purpose of this paper is to explore the influence of the "contextualization" effect of web celebrity live broadcast on the e-commerce platform on consumers' perception of product value, risk and purchase intention. Live in this paper, using Taobao shopping consumers as the research object, the survey method, questionnaire survey is adopted, the form through the questionnaire and distributed network, a live in order to further validation of web celebrity effect of contextualized actual influence on consumer purchase intention, questionnaire design the Likert scale, seven and recycling questionnaire analysis using the statistical software SPSS 23.0 and AMOS 22.0 after processing the data. After determining the reliability and validity of the questionnaire, the exploratory factor analysis was used to verify the hypothesis and calculate the actual adjustment degree of the "contextualization" effect of web celebrity live broadcasting on consumers' purchase intention. The research results of this paper are summarized as follows :(1) consumers' perceived value of products can significantly positively affect their purchase intention, while perceived risk has a significantly negative impact on their purchase intention; (2) consumers' trust and purchase intention to products are regulated by the "contextualization" of web celebrity live broadcast. Specifically, for web celebrity live broadcasting with good "contextualization" effect, the perceived value of consumer products has a positive impact on product trust, which is higher than that of web celebrity live broadcasting with poor "contextualization" effect. In terms of resolving consumers' perceived risks to products, web celebrity live broadcast with good "contextualization" effect is also significantly better than web celebrity live broadcast with poor "contextualization" effect. Based on empirical analysis, this paper concludes that web celebrity live broadcasting will become a new breakthrough for the sustainable growth of the e-commerce industry, and puts forward Suggestions on the e-commerce marketing mode and the transformation of web celebrity live broadcasting industry.

Association with obesity and abdominal obesity according to the kind and amount of coffee intake in Korean adults: 2013~ 2016 Korea National Health and Nutrition Examination Survey (한국 성인의 커피 섭취 유형에 따라 비만 및 복부비만에 미치는 영향 연구 : 2013 ~ 2016 국민건강영양조사 자료 활용)

  • Park, Hyoung-seop;Lee, Jung-Sug
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.369-382
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    • 2019
  • Purpose: We evaluate the influence of the types of coffee beverage on obesity and abdominal obesity in Korean adults who were aged 19 years or over by using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Specific questions were asked about frequency of coffee intake, the type of coffee beverage, the addition of milk and/or sugar to coffee by using the food frequency questionnaire of the 2013 ~ 2016 KNHANES. Results: We found that coffee intake increased the prevalence of obesity and abdominal obesity. After multivariable adjustment, coffee consumption increased the risk of obesity by 1.30 (95% CI: 1.08 ~ 1.57) in the group that drank coffee twice a day, and 1.33 (95% CI: 1.11 ~ 1.60) in the people who drank coffee ${\geq}3$ times a day as compared to that of the non-coffee intake group. The risk of abdominal obesity increased to 1.27 (95% CI: 1.02 ~ 1.57) in the < 1 time/day coffee drinking group, 1.34 (95% CI: 1.08 ~ 1.66) in the 1 time/day coffee drinking group, 1.35 (95% CI: 1.09 ~ 1.67) in the 2 times/day coffee drinking group, and 1.40 (95% CI: 1.14 ~ 1.72) in the ${\geq}3$ times/day coffee drinking group as compared to that of the non-coffee drinking group. The influence of black coffee intake was different according to gender: males showed a high prevalence of abdominal obesity and females showed a high prevalence of obesity. Mixed coffee consumption increased the risk of obesity and abdominal obesity by more than 34% in men who consumed coffee more than 3 times a day and in women who consumed coffee more than 2 times per day. Conclusions: We found that coffee intake, regardless of the type of coffee, increased the prevalence of obesity and abdominal obesity. It is necessary to refrain from drinking coffee to prevent obesity.

Social Networks and hypertension in Some rural residents Aged 60-64 (일부 60~64세 농촌 인구에서 사회조직망과 고혈압)

  • Lee, Choong-Won;Cho, Hee-Young;Lee, Mi-Young;Kim, Gui-Yeon;Park, Jong-Won;Kang, Mi-Jung;Suh, Suk-Kwon
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.229-242
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    • 1998
  • Face-to-face interviews were carried out to investigate the relationship between social networks and hypertension in 958 rural residents(males=440, females=518) aged 60-64 of a community-dwelling sample of Dalsung County from April to September in 1996. Eight elements of social network were measured : marital status, regular religious attendance, membership in groups, number of friends, relatives, siblings, children, grandchildren. Hypertensives were defined as meeting at least one of following criteria : hypertension history, systolic blood pressure more than 160 mmHg, diastolic blood pressure more than 95 mmHg. In univariate logistic regression for males, having 1-4 friends vs. none showed odds ratio 0.43 (95% Confidence interval CI 0.19-0.96) and having 2-3, 4 and more than 5 children had reduced prevalence of hypertension with odds ratios 0.21 (95% CI 0.06-0.72), 0.14 (95% CI 0.04-0.49), 0.24 (95% CI 0.07-0.82), respectively when compared with persons without children. In females, there was no elements of social network statistically significant. Having 5-9 grandchildren vs. none showed a marginally significant odds ratio 0.42. In multivariate logistic regression models for males with adjustment for age, education, body mass index, smoking and drinking, number of friends and children showed increased odds ratios and number of close relatives gained a statistically significant odds ratios (0.44-0.50). In females, the adjustment yielded little changes of odds ratios except number of grandchildren which gained a statistically significance. These results suggest that only a certain elements of social network may be associated with reduced risk of hypertension and they may be different between genders in rural resident aged 60-64.

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