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Comparing Validity of Body Mass Index, Waist to Hip Ratio, and Waist Circumference to Cardiovascular Disease Risk Factors in Korean Elderly (한국노인에서 심장혈관계 질환 위험인자에 대한 비만지표인 체질량지수, 허리-엉덩이둘레비, 및 허리둘레의 타당도 비교)

  • Moon Hyun-Kyung;Kim Eu-Gene
    • Journal of Nutrition and Health
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    • v.38 no.6
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    • pp.445-454
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    • 2005
  • The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular disease (CVD) risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n=1017). Anthropometric indices and CVD risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p<0.05). Among life style factors the current smokers were prevalent in obese male (p<0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p<0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p<0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p<0.05). Among 7 CVD risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC>WHR>BMI in male and BMI>WHR>WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also CVD risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of CVD risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.

Maternal and fetal outcomes of pregnancies in kidney donors: A 30-year comparative analysis of matched non-donors in a single center

  • Yoo, Kyung Don;Lee, Hajeong;Kim, Yaerim;Park, Sehoon;Park, Joong Shin;Hong, Joon Seok;Jeong, Chang Wook;Kim, Hyeon Hoe;Lee, Jung Pyo;Kim, Dong Ki;Oh, Kook-Hwan;Joo, Kwon Wook;Kim, Yon Su
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.356-365
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    • 2018
  • Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

Comparison of the National Early Warning Score+Lactate score with the pre-endoscopic Rockall, Glasgow-Blatchford, and AIMS65 scores in patients with upper gastrointestinal bleeding

  • Kim, Daejin;Jo, Sion;Lee, Jae Baek;Jin, Youngho;Jeong, Taeoh;Yoon, Jaechol;Park, Boyoung
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.219-229
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    • 2018
  • Objective We compared the predictive value of the National Early Warning Score+Lactate (NEWS+L) score with those of other parameters such as the pre-endoscopic Rockall score (PERS), Glasgow-Blatchford score (GBS), and albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 years score (AIMS65) among patients with upper gastrointestinal bleeding (UGIB). Methods We conducted a retrospective study of patients with UGIB during 2 consecutive years. The primary outcome was the composite of in-hospital death, intensive care unit admission, and the need for ${\geq}5$ packs of red blood cell transfusion within 24 hours. Results Among 530 included patients, the composite outcome occurred in 59 patients (19 inhospital deaths, 13 intensive care unit admissions, and 40 transfusions of ${\geq}5$ packs of red blood cells within 24 hours). The area under the receiver operating characteristic curve of the NEWS+L score for the composite outcome was 0.76 (95% confidence interval, 0.70 to 0.82), which demonstrated a significant difference compared to PERS (0.66, 0.59-0.73, P=0.004), but not to GBS (0.70, 0.64-0.77, P=0.141) and AIMS65 (0.76, 0.70-0.83, P=0.999). The sensitivities of NEWS+L scores of 3 (n=34, 6.4%), 4 (n=92, 17.4%), and 5 (n=171, 32.3%) were 100%, 98.3%, and 96.6%, respectively, while the sensitivity of an AIMS65 score of 0 (n=159, 30.0%) was 91.5%. Conclusion The NEWS+L score showed better discriminative performance than the PERS and comparable discriminative performance to the GBS and AIMS65. The NEWS+L score may be used to identify low-risk patients among patients with UGIB.

Senior Center Based Diabetes Self-management Program: An Action Research Approach (노인복지관 당뇨병 자기관리 프로그램의 과정과 평가: 실행연구방법)

  • Ko, Hana;Song, Misoon
    • 한국노년학
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    • v.38 no.1
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    • pp.169-185
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    • 2018
  • The purpose of this study examined the feasibility and efficacy of a senior center-based diabetes self-management program applying action research approach. The cyclical action research method was applied for this study: plan, act, evaluate, and reflect in delivering three waves of the intervention program. Three waves of a 12 weeks-length small group diabetes self-management program were offered during the period of 15 months in a senior center in Seoul. Planning of $2^{nd}$ and $3^{rd}$ wave program were based on reflection of $1^{st}$ and $2^{nd}$ program evaluation respectively. Among the 46 participants, 93.48% (N=43) completed the program. The quantitative evaluation showed statistically significant improvement in HbA1C(p<.001), fasting plasma glucose(p<.001), BMI(p=.016), waist circumference(p=.001), systolic blood pressure(p=.036), diabetes self-management behavior(p<.001) and health knowledge(p=.008). Qualitative data revealed that individual management was very helpful in empowering and adhering for own diabetes care for the participants. Participants reported high satisfaction towards the program with mean satisfaction score of 65.12. Application of the Diabetes Self-management program with action study strategy was successful in community setting for improving participants' subjective and objective outcomes. Action research method guides the practitioner to tailor the program to respond for the participants and field needs.

Factors Associated with Ruptured Intracranial Aneurysm in a Hospital (일개 병원의 뇌동맥류 파열의 위험요인)

  • Lee, En-Ha;Yun, So-Young;Choi, Ja-Yun
    • Journal of the Korea Convergence Society
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    • v.10 no.1
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    • pp.339-351
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    • 2019
  • This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

Hemodynamic, Autonomic, and Vascular Function Changes after Sleep Deprivation for 24, 28, and 32 Hours in Healthy Men

  • Slomko, Joanna;Zawadka-Kunikowska, Monika;Kozakiewicz, Mariusz;Klawe, Jacek J.;Tafil-Klawe, Malgorzata;Newton, Julia L.;Zalewski, Pawel
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1138-1142
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    • 2018
  • This study aimed to analyze the impact of sleep deprivation (SD) on cardiac, hemodynamic, and endothelial parameters and to determine whether these are sustained with increased periods of SD. The study included 60 healthy men (mean: age $31.2{\pm}6.3years$; body mass index $24.6{\pm}2.6kg/m^2$). Hemodynamic parameters, parameters of myocardial contractility, spectral analysis of heart rate (HR) and blood pressure (BP) variability, and the sensitivity of arterial baroreflex function were evaluated. Biochemical tests were performed to assess L-arginine (L-Arg) and asymmetric dimethylarginine (ADMA) levels in reflection of endothelial nitric oxide synthase ability. Measurements of cardiovascular system parameters were obtained at 9 a.m. (baseline) on the first day of the study and 9 a.m. (24-h SD), 1 p.m. (28-h SD), and 5 p.m. (32-h SD) on the second day. Blood samples for evaluating biochemical parameters were obtained at baseline and after 24-h SD. ANOVA Friedman's test revealed a significant effect for time in relation to HR (${\chi}^2=26.04$, df=5, p=0.000), systolic BP (${\chi}^2=35.98$, df=5, p=0.000), diastolic BP (${\chi}^2=18.01$, df=5, p=0.003), and mean BP (${\chi}^2=28.32$, df=5, p=0.000). L-Arg and ADMA levels changed from $78.2{\pm}12.9$ and $0.3{\pm}0.1$ at baseline to $68.8{\pm}10.2$ and $0.4{\pm}0.1$ after 24-hr SD, respectively (p=0.001, p=0.004). SD in healthy men is associated with increases in BP, which appear to occur after 24 hours of SD and are maintained over increasing periods of SD. The observed hemodynamic changes may have resulted due to disordered vascular endothelial function, as reflected in alterations in L-Arg and ADMA levels.

Clinical Characteristics and Risk Factors of Acute Kidney Injury in Patients with Glyphosate Poisoning (글리포세이트 중독 환자에서 급성 신손상 발생의 임상 양상과 위험 인자)

  • Park, Hyung Hun;Choi, Kyu Ill;Lee, Je Won;Park, Jung Min;Park, Jinwook;Noh, Sang Moon;Cho, Jaekyung;Lee, Daero;Cho, Jae Chul;Park, Dong Chan;Kim, Yang Hun;Lee, Joo Hwan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.110-115
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    • 2020
  • Purpose: Acute kidney injury (AKI) in patients with glyphosate poisoning has a poor prognosis. This study aimed to predict the risk factors for AKI in patients with glyphosate poisoning at the emergency department (ED). Methods: Clinical data on glyphosate poisoning patients at ED who were older than 18 years were collected retrospectively between January 2013 and December 2019. The clinical characteristics and clinical outcomes of the AKI group in patients with glyphosate poisoning were compared with the non-AKI (NAKI) group. Results: Of 63 glyphosate poisoning patients, AKI was observed in 15 (23.8%). The AKI patients group showed the following: old age (p=0.038), low systolic blood pressure (p=0.021), large amount of ingestion (p=0.026), delayed hospital visits (p=0.009), high white blood cells (WBC) (p<0.001), high neutrophil counts (p<0.001), high neutrophil-lymphocyte (LN) ratios (p<0.001), high serum potassium (p=0.005), low arterial blood pH (p=0.015), and low pO2 (p=0.021), low bicarbonate (p=0.009), and high Poisoning Severity Score (PSS) (p<0.001). AKI patients required hemodialysis, ventilator care (p<0.001, p=0.002), and inotropics (p<0.001). They also showed more intensive care unit admission (p<0.001), longer hospitalization (p<0.001), and high mortality (p<0.001). Logistic multivariate regression analysis showed that high WBCs (OR, 1.223) and increased LN ratios (OR, 1.414) were independently associated with the occurrence of AKI. Conclusion: In patients with glyphosate poisoning at ED, high WBCs and increased LN ratios can help predict the occurrence of AKI.

The Association between Regular Physical Activity Types And Metabolic Syndrome in Fertile Women (가임기 여성의 규칙적 운동 및 운동종류에 따른 대사증후군 간의 관련성)

  • Lee, Guna
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.94-103
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    • 2021
  • The purpose of this study was to identify the association between regular physical activity (PA) types and metabolic syndrome (MetS) in fertile women. Data were obtained from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-3, 2018). The sample consisted of 4,172 fertile women over 19 years of age. The data were analyzed using an independent t-test, χ2 test, and multiple logistic regression analysis for examining the association of regular PA and MetS. The prevalence of MetS in fertile women was 3.1% (n =128), and 1,972 fertile women (47.2%) practiced regular PA. Compared to the non-regular PA group, regular PA resulted in a significantly lower systolic blood pressure (p =.002), lower waist circumference (p <.001), lower fasting blood sugar (p =.007), and higher high-density lipoprotein cholesterol (p <.001). After controlling the confounding variables, multiple logistic regression showed that the regular PA group (odds ratio 0.59, 95% confidence interval 0.35-0.98, p =.040) and the regular muscle-strengthen PA group (odds ratio 0.34, 95% confidence interval 0.14-0.80, p =.013) were associated with a decreased risk of MetS. Therefore, regular PA, including muscle-strengthen PA should be considered to develop effective MetS intervention in fertile women.

The efficacy and safety of Dendropanax morbifera leaf extract on the metabolic syndrome: a 12-week, placebo controlled, double blind, and randomized controlled trial

  • Jun, Ji Eun;Hwang, You-Cheol;Ahn, Kyu Jeung;Chung, Ho Yeon;Choung, Se Young;Jeong, In-Kyung
    • Nutrition Research and Practice
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    • v.16 no.1
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    • pp.60-73
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    • 2022
  • BACKGROUND/OBJECTIVES: The extract from Dendropanax morbifera exhibited diverse therapeutic potentials. We aimed to evaluate the efficacy and safety of D. morbifera leaf extract for improving metabolic parameters in human. SUBJECTS/METHODS: A 12-week, double blind, placebo-controlled and randomized trial included a total of 74 adults, and they were assigned to the placebo group (n = 38) or 700 mg/day of D. morbifera group (n = 36). The efficacy endpoints were changes in glycemic, lipid, obesity, and blood pressure (BP) parameters, in addition to the prevalence of metabolic syndrome (MetS) and the numbers of MetS components. Safety was assessed by monitoring adverse events (AEs). RESULTS: After 12 weeks of treatment, the hemoglobin A1c (HbA1c) level significantly decreased in the D. morbifera group compared to that of the placebo group (difference: -0.13 ± 0.20% vs. 0.00 ± 0.28%, P = 0.031; % of change: -2.27 ± 3.63% vs. 0.10 ± 5.10%, P = 0.025). The homeostatic model assessment for insulin resistance level also decreased significantly from its baseline in the D. morbifera group. The systolic BP of D. morbifera group decreased significantly than that of placebo group (difference: -3.9 ± 9.8 mmHg vs. 3.3 ± 11.7 mmHg, P = 0.005; % of change: -2.8 ± 7.7% vs. 3.3 ± 10.2%, P = 0.005). However, the lipid parameters and body composition including body weight did not differ between the groups. The prevalence of MetS (36.8% vs. 13.9%, P = 0.022) and the incidence of MetS (10.5% vs. 13.9%, P = 0.027) at 12 weeks was significantly lower in the D. morbifera group than it was in the placebo group. No serious AEs occurred in either group. CONCLUSIONS: Supplementation with D. morbifera extracts over a 12-week period improved metabolic parameters such as HbA1c and BP and reduced the prevalence of MetS.

Anti-diabetic and Anti-Inflammatory Effects of Water Extract of Ligustrum japonicum Leaves in db/db Mouse (당뇨병 동물모델에서 여정엽(女貞葉) 추출물의 항당뇨 및 항염증 효과)

  • Lee, Yun Jung;Lee, Yun Jae;Yoon, Jung Joo;Lee, So Min;Kim, Hye Yoom;Shin, Sun Ho;Kang, Dae Gill;Lee, Ho Sub
    • The Korea Journal of Herbology
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    • v.27 no.6
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    • pp.107-114
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    • 2012
  • Objectives : In this study, we investigated the anti-diabetic and anti-inflammatory effects of water extract from leaves of Ligustrum japonicum (WLJ) in db/db mouse. Methods : The db/db mice were treated orally with WLJ (300 mg/kg/day) for 10 weeks to examine the long-term effects on hyperglycemia and glomerular tissue as well as biochemical and functional abnormalities in the kidney. Results : WLJ treatment markedly reduced plasma levels of glucose, triglyceride, creatinine, and systolic blood pressure in diabetic db/db mouse. Treatment of WLJ significantly increased plasma level of high density lipoprotein (HDL)-cholesterol. We also found that overexpressions of vascular cellular adhesion molecule (VCAM)-1 and endothelin (ET)-1 were observed in aortic tissue of db/db mouse, whereas, WLJ suppressed both expression of VCAM-1 and ET-1 in aorta. In renal tissue, overexpressions of ICAM-1 and TGF-${\beta}1$ were found in untreated db/db mouse, however, significantly decreased those levels by WLJ treatment. The insulin immunoreactivity of the pancreatic islets remarkably increased in WLJ treated db/db mouse compared with untreated db/db mouse. Taken together, WLJ treatment ameliorated hyperglycemia and hyperlipidemia via improvement of insulin secretion and lipid metabolism, respectively. Furthermore, WLJ treatment also ameliorated hypertension via inhibition of inflammatory process in vascular and renal tissues. Conclusions : Ligustrum japonicum has an anti-diabetic and anti-inflammatory effects in db/db mouse. Thus, these results suggested a beneficial effect of Ligustrum japonicum in treatment with diabetes and diabetic vasculopathy.