• 한국임상약학회지
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• 제16권1호
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• pp.14-22
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• 2006

Purpose: To determine the short (1 year of transplant) and long-term (1-5 years of transplantation) risk factors affecting the graft and patient survival in kidney transplantation recipients. Methods: Records of 149 patients who received kidney transplantation in 1996 from Asan Medical Center were followed for 5 years retrospectively. Results: All patients initiated triple immunosuppressive therapy with cyclosporine, prednisone and azathioprine. One, two, three, four, five year patient and graft survival rates were 98.7%, 98.0%, 98.0%, 97.3%, 97.3%, and 96.6%, 95.2%, 94.6%, 92.5%, 91.8%, respectively. There were 30 cases of acute rejection (AR) and 6 cases of chronic rejection (CR) within $2.1{\pm}3.2$ months and $42.1{\pm}13.2$ months of transplantation, respectively. The risk factors for AR were donor's age older than 30 years (p=0.02) and cardiovascular disease (p=0.05). The risk factors for CR were AR (p=0.0169) and episode of complications (p=0.0330). Increasing period of dialysis (p=0.0473), episodes of AR (p<0.0001) and complication (p=0.0317) were significant factors for graft loss. Seven grafts were lost from noncompliance during 1-5 year period. The most com- mon cause of the graft loss for both periods was the graft rejection. The graft survival rate was significantly lower in patients with than without rejection episodes (77.4% vs. 90.0%, p=0.002). Conclusions: Survival rate of the graft with rejection was significantly lower. The risk factors affecting AR were donor's age older than 30years and CVD. AR and episode of complications within 1year were the risk factors for CR and graft loss.

• Journal of Yeungnam Medical Science
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• 제20권1호
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• pp.62-70
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• 2003

정상체중을 가진 성인 남성에서 지방과다(adiposity)와 심혈관계 질환의 위험요인과의 관련성을 알아보고자 하였다. 2001년 1월 3일부터 12월 31일까지 영남대 학교의료원에서 종합검진을 받은 만 28~69세 성인 남성 129명을 대상으로 연령, 신체계측, 혈압, 공복 혈당, 혈청 지질대사치와 체성분 검사를 실시하였다. 체질량지수(BMI)가 18.5~23 $kg/m^2$(76명)인 정상체중군과 23~25 $kg/m^2$(53명)인 과체중군으로 분류하고, 체지방률, 체지방량과 위험인자들(수축기혈압, 이완기혈압, 공복시 혈당, 중성 지방, 저밀도지단백, 고밀도지단백)의 상관관계를 분석하고, 정상체중군을 지방과다에 따라 3군으로 나누고, 각 군과 과체중군에서 심혈관 질환의 위험인자를 평가하였다. 정상체중의 제1군을 기준으로 제2, 3군과 과체중군의 위험인자 존재에 대한 비차비(odds ratio)를 조사하였다. 정상체중군에서 지방과다 변수들(adiposity variables: 체지방량, 체지방률)과 수축기 및 이완기 혈압, 저밀도지단백, 고밀도지단백, 중성 지방에서 유의한 상관관계가 있었다(P<0.01). 나이를 보정하고 난 뒤 제1군을 기준으로 제3군(체지방율: 3.7, 체지방양: 4.7)과 과체중군(체지방율: 6.6, 체지방양 11.5)에서 위험인자에 대해 더 높은 비차비를 가졌다. 지방이 많은 정상체중의 성인남성은 적은 지방을 가진 성인 남성보다 심혈관 질환에서 더 높은 유병 위험도를 가졌다. 지방 측정은 정상체중군에서 심혈관계 질환의 위험인자외에 추가적인 정보를 제공할 수 있었다.

• Nutrition Research and Practice
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• 제4권6호
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• pp.492-498
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• 2010

Both metabolic syndrome (MetS) and elevated LDL cholesterol (LDL-C) increase the risk for cardiovascular disease (CVD). We hypothesized that low HDL cholesterol (HDL-C) would further increase CVD risk in women having both conditions. To assess this, we recruited 89 women with MetS (25-72 y) and LDL-C ${\geq}$ 2.6 mmol/L. To determine whether plasma HDL-C concentrations were associated with dietary components, circulating atherogenic particles, and other risk factors for CVD, we divided the subjects into two groups: high HDL-C (H-HDL) (${\geq}$ 1.3 mmol/L, n=32) and low HDL-C (L-HDL) (< 1.3 mmol/L, n=57). Plasma lipids, insulin, adiponectin, apolipoproteins, oxidized LDL, Lipoprotein(a), and lipoprotein size and subfractions were measured, and 3-d dietary records were used to assess macronutrient intake. Women with L-HDL had higher sugar intake and glycemic load (P< 0.05), higher plasma insulin (P< 0.01), lower adiponectin (P< 0.05), and higher numbers of atherogenic lipoproteins such as large VLDL (P < 0.01) and small LDL (P<0.001) than the H-HDL group. Women with L-HDL also had larger VLDL and both smaller LDL and HDL particle diameters (P<0.001). HDL-C was positively correlated with LDL size (r=0.691, P<0.0001) and HDL size (r=0.606, P<0.001), and inversely correlated with VLDL size (r=-0.327, P<0.01). We concluded that L-HDL could be used as a marker for increased numbers of circulating atherogenic lipoproteins as well as increased insulin resistance in women who are already at risk for CVD.

• 한국식품영양과학회지
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• 제28권5호
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• pp.1164-1171
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• 1999

In this study, we investigated the effects of obesity index on the risk factors of chronic diseases in obese children. The subjects were male and female children aged 9 to 12. The average obesity index was 147.7$\pm$13.8% in boys and 147.6$\pm$16.5% in girls. The average percentages of body fat was significantly higher in boys(33.9$\pm$5.7%) than in girls(30.7$\pm$4.4%). It was found that 26% of subjects had abnormal serum GOT and GPT values. Percentages of subjects at risk of cardiovascular disease(CVD) based on corresponding criteria of TG, T chol, HDL chol, and LDL chol were 28.6%, 28.6%, 45.5% and 42.7%, respectively. The risk of CVD was increased with the degree of obesity, which was not significant. The AI(atherogenic index) was higher in boys(4.6$\pm$2.3) than in girls(3.6$\pm$1.2). The serum T chol and LDL chol levels of subjects whose mother are in thirties were significantly higher than those of subjects whose mother are in fourties. The T chol levels of subjects who had mother with job were significantly higher compaired to those of subjects who had housewife mother. The results indicated the urgent need of nu tritional management for the obese children to prevent further devel opment of childhood obesity and hyperlipidemia. Based upon this study, devising method and media for the mother nutritional education as well as for the children nutritional education is required for better growth and health promotion of primary school children.

• Journal of Preventive Medicine and Public Health
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• 제42권5호
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• pp.337-342
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• 2009

Background : Many previous studies have shown that elevated homocysteine in the serum is a well known risk factor for cardiovascular disease and this is associated with other risk factors for cardiovascular disease, but any Korean data on this is limited. Objectives : This study aimed to calculate the prevalence of hyperhomocysteinemia and to analyze the relation between elevated homocysteine and the lifestyle factors of Korean adults. Methods : We conducted a cross-sectional survey that included 650 men and 743 women (age range, 20 to 79 years) who were residents of Gwangju City in Gyeonggi-do. These subjects participated in the health interview and examination survey from November to December 2005. The total homocysteine, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride in the serum were measured. All the participants had their body composition measured such as height and weight, and we obtained health-related behavioral information through the self-entry questionnaire. Results : Very right-handed skewed distributions of homocysteine were shown in men and women. The prevalence of hyperhomocysteinemia was 22.6% in men and 13.7% in women in Gwangju city. On the multiple logistic regression analysis, hyperhomocysteinemia was associated with age (OR=1.02, 95% CI=1.01-1.04), male gender (OR=1.60, 95% CI=1.02-2.52), severe general physical activity (OR=0.32, 95% CI=0.15-0.69) and nutrient consumption (OR=0.49, 95% CI=0.31-0.76). Conclusions : There is a great prevalence of hyperhomocysteinemia in adults of Gwangju City, Korea and it was associated with both genetic factors and lifestyle risk factors. This study can suggest that comprehensive lifestyle modification is needed in order to diminish the prevalence of hyperhomocysteinemia and to prevent CVD.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.208-217
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• 2018

당뇨병 유병기간에 따른 심혈관 질환의 혈청학적, 합병증의 양상을 국민건강영양조사 6기(2013-2015)의 모든 가용 데이터를 사용하여 당뇨병 환자의 치료뿐 아니라 향후 관리에 대한 정보를 제공함에 목적을 두고 있다. 국민건강영양조사는 건강 설문, 검진, 영양조사로 이루어져 있으며, 18~80세 미만으로 나이를 제한하였고, 당뇨병 유병기간을 응답한 1,316명을 조사 대상으로 하였다. 당뇨병 유병기간에 따라 0-5, 6-10, 11-15, 16-20, 20년 이상으로 구분하였다. 당뇨병 유병기간이 길어질수록 나이는 많아지고, BMI는 낮고, 흡연자의 비율은 떨어지며, HbA1c는 상승하고 사구체 여과율은 낮아졌다. 총 콜레스테롤, LDL-C, 중성 지방 수치는 낮고, HDL-C 수치는 비슷하였다. 인슐린 및 경구용 항고혈당제제를 치료 받는 환자의 비율은 증가하였다. 당뇨병 기간이 길수록 혈당 조절이 악화되었고, 미세혈관 및 대혈관합병증의 위험도는 상승하였다. 이러한 합병증을 예방하기 위해 집중적인 치료와 모니터링으로 위험요인을 통제해야 할 것이다.

• Journal of Community Nutrition
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• 제2권1호
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• pp.5-11
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• 2000

Populations both in the US and worldwide are aging. It is projected that by the year 2030 the population of Americans over 65 will increase to 70 million, more than twice their number in 1998. About one-third of elderly over the age of 65 have debilitating chronic health conditions that greatly impede their activities. Age-associated chronic diseases are believed to be associated with free radicals and the imbalance in antioxidant and oxidative stress contributes to development of several chronic health conditions. Diet and nutrients can have great impact in the health status of elderly. Several factors may contributor to the inadequate consumption of nutrients in elderly, including an inability to chew food adequately, polypharmacy, living along and limited income. Low intake of energy and several micronutrients are common among the elderly. Although overt deficiency of nutrients among the elderly is not common. a recent study showed that while elderly consume more fat, the total energy intake is low among the elderly. Inadequate intake of antioxidant nutrients such as vitamin E in elderly may contribute to the development of chronic health problems. Intake of higher than normal RDA levels of vitamin E for long periods of time has been shown to reduce the risk of many degenerative diseases, such as cardiovascular diseases(CVD) and cancer, and improve immune response in elderly. High intake of other antioxidants is also associated with reduced risk chronic diseases. Dietary antioxidants are abundant in fruits and vegetables. However, due to variety of factors, the elderly may not be able to receive these and other micronutrients through diet. Therefore, supplemental intake of micronutrients in the form of multi vitamins/minerals and/or specific micronutrients is a more practical approach to the maintenance of health status in the elderly.

• Journal of Nutrition and Health
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• 제46권6호
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• pp.521-530
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• 2013

Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake < 1.0 g/kg IBW, 11 men and 19 women) and adequate protein intake group (API, protein intake ${\geq}$ 1.0g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.

• Journal of Ginseng Research
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• 제45권5호
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

• Journal of Nutrition and Health
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• 제42권6호
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• pp.559-566
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• 2009

본 연구에서 직장 남성 근로자 739명 (39세 이하 그룹: 240명, 40대 그룹: 276명, 50대 그룹: 223명)을 대상으로 e-mail 영양교육이 신체계측치, 체구성 및 심혈관 질환 위험인자에 미치는 영향을 조사하고자 하였다. 검진 시 1회, 약 10분의 면대면 영양상담 후 15개 주제의 영양교육자료를 월 1회, 10회에 걸쳐 e-mail을 통해 제공하였으며, 그 결과를 요약하면 다음과 같다. 1) 1년간의 e-mail 영양교육 후, 전체 연구대상자의 체지방률 (p < 0.001), 복부지방률 (p < 0.001), 총 콜레스테롤(p < 0.01), 수축기 혈압 (p < 0.01), 이완기 혈압 (p < 0.05)이 유의적으로 감소하였다. 2) 연령 그룹별로 살펴보면, 체지방률과 수축기 혈압은 세군 모두에서 유의적으로 감소하였고, 총 콜레스테롤은 39세 이하 그룹에서만 유의적으로 감소하였다 (p < 0.01). 3) 영양교육 전, 39세 이하 그룹의 대사증후군 유병률은 25%, 40대 그룹은 27.2%, 50대 그룹은 36.3%의 분포를 보였다. E-mail 영양교육 후, 39세 이하 그룹의 대사증후군 유병률은 18.3%, 40대 그룹은 27.5%, 50대 그룹은 35.4%로 교육 전에 비해 영양교육 후 39세 이하 그룹에서의 대사증후군 유병률이 유의적으로 감소하였다 (p < 0.05). 이상과 같이 본 연구에서 e-mail교육 프로그램은 직장인들에게 신체계측치 및 심혈관 질환 위험인자 감소에 효과가 있음이 확인되었다. 따라서 종합검진 후 1년의 자기관리를 위한 e-mail 영양교육 자료를 개발하여 적용했다는데 본 연구의 의의가 있다고 본다. 본 연구의 결과를 토대로 e-mail 교육 프로그램의 효과를 평가하기 위한 확대연구와 효과의 지속기간에 대한 장기적인 추적연구를 통해 직장인의 건강증진 및 사내 복지향상과 의료비 절감을 위해 회사 지원 하에 질환에 따른 적절한 영양관리 프로그램으로 적용 될 수 있기를 기대한다.