• Title/Summary/Keyword: confounding factors

Search Result 258, Processing Time 0.025 seconds

Sleep Duration, Comorbidities, and Mortality in Korean Health Examinees: A Prospective Cohort Study

  • Sukhong Min;Woo-Kyoung Shin;Katherine De la Torre;Dan Huang;Hyung-Suk Yoon;Aesun Shin;Ji-Yeob Choi;Daehee Kang
    • Journal of Preventive Medicine and Public Health
    • /
    • v.56 no.5
    • /
    • pp.458-466
    • /
    • 2023
  • Objectives: The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea. Methods: The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted. Results: Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status. Conclusions: Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.

Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study

  • Keisuke Harada;Noritaka Imamachi;Yuhei Matsuda;Masato Hirabayashi;Yoji Saito;Takahiro Kanno
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.50 no.2
    • /
    • pp.86-93
    • /
    • 2024
  • Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

Cigarette Smoking and other Risk Factors for Kidney Cancer Death in a Japanese Population: Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC study)

  • Washio, Masakazu;Mori, Mitsuru;Mikami, Kazuya;Miki, Tsuneharu;Watanabe, Yoshiyuki;Nakao, Masahiro;Kubo, Tatsuhiko;Suzuki, Koji;Ozasa, Kotaro;Wakai, Kenji;Tamakoshi, Akiko
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.11
    • /
    • pp.6523-6528
    • /
    • 2013
  • Background: Cigarette smoking is the largest single recognized cause of human cancers. In Western countries, many epidemiologists have reported risk factors for kidney cancer including smoking. However, little is known about the Japanese population. Materials and Methods: We evaluated the association of smoking with the risk of kidney cancer death in the Japan Collaborative Cohort (JACC) Study. Participants included 46,395 males and 64,190 females. The Cox proportional hazards model was used to determine age-and-sex adjusted relative risks. Results: A total of 62 males and 26 females died from kidney cancer during the follow-up of 707,136 and 1,025,703 person-years, respectively. Heavy smokers (Brinkman index >1200), fondness of fatty foods, hypertension, diabetes mellitus (DM), and obesity were suggested to increase the risk of renal cell carcinoma while walking was suggested to decrease the risk. Even after controlling for age, sex, alcohol drinking and DM, heavy smoking significantly increased the risk. Conclusions: The present study suggests that six factors including smoking may increase and/or reduce the risk of kidney cancer in the Japanese population. Because of the small number of outcomes, however, we did not evaluate these factors after adjusting for all possible confounding factors. Further studies may be needed to confirm the findings in this study.

Analysis of Long Term Hospitalization in Korean Medical Hospital and Its Affecting Factors - Based on Usage and consumption of Korean medicine Report In 2014 - (전국 한방병원의 장기입원과 이에 영향을 미치는 요인 - 2014년 한방의료이용 및 한약소비실태조사(보건복지부)를 중심으로 -)

  • Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
    • /
    • v.22 no.2
    • /
    • pp.41-53
    • /
    • 2018
  • Objectives : It was to classify and its affecting factors to the patients of Korean medicine hospital with short term and long term hospitalization. Methods : I focused on long-term hospitalized patients. I was conducted on 344 hospitalized patients among the original data of usage and consumption of Korean medical report in 2014. Among those patients, I have classified them into long term inpatients(131 patients) and short term inpatients(213 patients) based on 16 days of hospitalization. Also multiple regression analysis was conducted to investigate the characteristics of the hospitalization, treatment satisfaction and dissatisfaction, the characteristics of long term hospitalization according to the sociodemographic of the subjects, the top 21 diseases and the distribution of human bodies, side effects and kinds of Korean medicine. Results : There was a statistically significant difference between the short term and long term hospitalized patients due to age, occupation, marital status, all 21 diseases and institutional fees, experience of Korean medical treatment due to traffic accidents. There was no significant difference in gender, education level, residence, income level, type of medical insurance, whether private insurance, type of medical treatment for Korean medicine, medical expenses for car accidents, reason for dissatisfaction with treatment. The number of long term patients at Korean medicine hospitals increased by a statistically significant by age in model 1 where confounding factors were differently controlled. In model 2, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases. The number of long term patients at Korean medicine hospitals decreased by a statistically significant amount among the unemployed and others in model 2. In model 3, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases, while the number decreased by a statistically significant amount among the married. Conclusions : These results suggest that the factors affecting the short term and long term hospitalization of patients with Korean medicine hospital are different from each other. Especially it was significant by age, over 5,000,000won Income per month, nerve disease, but decrease significant married.

Behavioral factors associated with serum gamma-glutamyl transferase activity in a male rural population (농촌 지역 남성들의 혈청 gamma-glutamyl transferase 활성도와 관련된 행태적 요인에 관한 연구)

  • Cho, Byung-Mann
    • Journal of agricultural medicine and community health
    • /
    • v.23 no.2
    • /
    • pp.287-293
    • /
    • 1998
  • Although serum gamma-glutamyl transferase(GGT) has been widely used as a marker of alcoholic hepatic dysfunction, little is known as to behavioral correlates in the normal population. To examine the association between serum GGT activity and some behavioral factors in male rural population, data un health examination in a rural population (248 males aged 40 years and older) was analyzed Multiple linear regression and analysis of convariance were used to control the effect of confounding factors. Adjusted average differences in the level of serum GGT according to body mass index(BMI: $kg/m^2$) and alcohol intake(ml/day) were statistically significant(p=0.051 0<0.001 respectively). Serum GGT activity for BMII$\geq$25 was significantly higher than for BMI<25 in non-drinkers(p=0.007), but not significantly different in drinkers(p=0.892). Alcohol intake was significantly associated with elevated serum GGT activity for both BMI$\geq$25 and BMI<25(p<0.001, p=0.002 respectively). These findings suggest that alcohol drinking, obesity in non-drinkers are important factors associated with serum GGT in male rural population.

  • PDF

Relationship between fruit and fish intakes and cardiovascular disease risk factors in Korean women with type 2 diabetes mellitus: Based on the 4th and 5th Korea National Health and Nutrition Examination Surveys (한국인 제2형 당뇨병 여성환자에서 심혈관질환 위험인자와 과일류 및 생선류 섭취와의 관련성: 제4기와 제5기 국민건강영양조사 자료를 이용하여)

  • Oh, Ji Soo;Kim, Hyesook;Kim, Ki Nam;Chang, Namsoo
    • Journal of Nutrition and Health
    • /
    • v.49 no.5
    • /
    • pp.304-312
    • /
    • 2016
  • Purpose: The purpose of the study was to investigate the association between food intakes and cardiovascular disease (CVD) risk factors in Korean women with type 2 diabetes mellitus (T2DM). Methods: The data were collected from the 2007~2012 Korea National Health and Nutrition Examination Survey (KNHANES). In this study, subjects were divided into two groups, the normal fasting glucose (NFG) group (n = 7,738) and the T2DM group (n = 225). Dietary intake was derived from the nutrition survey, which was collected by trained dietitians using 24-hour dietary recall through the face-to-face interview method in the sample person's home. Results: After adjustment for confounding factors, mean fruit (p = 0.0265), fruit and vegetable without kimchi (p = 0.0295), and fish (p = 0.0112) intakes were significantly lower in the T2DM group than in the NFG group. In the multiple logistic regression analysis, odds ratio (OR) for risk of high systolic blood pressure (${\geq}140mmHg$) was lower in the over the median compared to under the median for fruit intakes (OR; 0.657, 95% CI; 0.523~0.824). The OR for the risk of hypertriglyceridemia was lower in the over the median compared to under the median for fruit and vegetable without kimchi (OR; 0.828, 95% CI; 0.7111~0.963) and fish (OR; 0.783, 95% CI; 0.673~0.910) intakes. Conclusion: These results show that intakes of fruits, fish, and fruits and vegetables without kimchi have beneficial effects on CVD in Korean women with T2DM.

Clinical risk factors associated with the development of wheezing in children less than 2 years of age who required hospitalization for viral lower respiratory tract infections

  • Kim, Joon Hwan;Choi, Ji-Yeon;Kim, Na Yeon;Kim, Jin Woo;Baek, Ji Hyeon;Baek, Hye Sung;Yoon, Jung Won;Jee, Hye Mi;Choi, Sun Hee;Kim, Hyeung Yoon;Kim, Ki Eun;Shin, Youn Ho;Han, Man Yong
    • Clinical and Experimental Pediatrics
    • /
    • v.58 no.7
    • /
    • pp.245-250
    • /
    • 2015
  • Purpose: Wheezing following viral lower respiratory tract infections (LRTIs) in children <2 years of age is an important risk factor for the development of asthma later in life; however, not all children with viral LRTIs develop wheezing. This study investigated risk factors for the development of wheezing during viral LRTIs requiring hospitalization. Methods: The study included 142 children <2 years of age hospitalized for LRTIs with at least one virus identified as the cause and classified them into children diagnosed with LRTIs with wheezing (n=70) and those diagnosed with LRTIs without wheezing (n=72). Results: There were no significant differences in the viruses detected between the two groups. Multivariate logistic regression analysis showed that, after adjusting for potentially confounding variables including sex and age, the development of wheezing was strongly associated with parental history of allergic diseases (adjusted odds ratio [aOR], 20.19; 95% confidence interval [CI], 3.22-126.48), past history of allergic diseases (aOR, 13.95; 95% CI, 1.34-145.06), past history of hospitalization for respiratory illnesses (aOR, 21.36; 95% CI, 3.77-120.88), exposure to secondhand smoke at home (aOR, 14.45; 95% CI, 4.74-44.07), and total eosinophil count (aOR, 1.01; 95% CI, 1.01-1.02). Conclusion: Past and parental history of allergic diseases, past history of hospitalization for respiratory illnesses, exposure to secondhand smoke at home, and total eosinophil count were closely associated with the development of wheezing in children <2 years of age who required hospitalization for viral LRTIs. Clinicians should take these factors into consideration when treating, counseling, and monitoring young children admitted for viral LRTIs.

Relationship between dairy products, fish and shellfish intake and metabolic syndrome risk factors in prediabetes: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-3) 2015 (전당뇨병 대상자의 유제품 및 어패류 섭취와 대사증후군 위험인자와의 관련성 연구 : 2015년 제 6기 국민건강영양조사 자료를 바탕으로)

  • Park, Jeong Seop;Kim, Kyoung Yun
    • Journal of Nutrition and Health
    • /
    • v.50 no.5
    • /
    • pp.447-459
    • /
    • 2017
  • Purpose: Metabolic Syndrome (MetS) is defined as a cluster of inter-connected metabolic disorders involving the glucose metabolism, dyslipidaemia, high blood pressure, and abdominal obesity. The worldwide prevalence has been rapidly increasing to approximately 20~25%, and the prevalence in Korea as of 2012 was reported to be 31.3%. The association of MetS with various diseases needs to be analyzed by conducting an investigation of frequently consumed foods, such as dairy products, fish, and shellfish in prediabetic subjects. Methods: The dietary intake of subjects who met the criteria of the study from January to December 2015 was assessed using the 24-hour recall method. After adjusting the age, sex, BMI, and total energy intake, which are confounding factors that may affect the dietary intake of the subjects, the associations of dairy products, fish, and shellfish intake with the MetS risk factors was analyzed. Results: In prediabetes, the intake of subjects who consumed more than the dairy products median (187.0 g) and the elevation risk of TC [OR, 2.369; 95% CI, 1.057 to 5.312] showed a significant positive association. In prediabetes, the intake of subjects who consumed more than the fish and shellfish median (44.0 g) and the elevation risk of BP showed a significantly weak negative association [OR, 0.073; 95% CI, 0.010 to 0.520]. The probability that the blood LDL cholesterol was ${\geq}100mg/dL$ decreased 0.397 times [95% CI, 0.189 to 0.832]. Conclusion: To control the metabolic risk factors of pre-diabetic and vascular disease subjects, proper dairy, fish and shellfish intake will be important.

Interpersonal and Community Factors Related to Food Sufficiency and Variety: Analysis of Data from the 2017 Community Health Survey (식품충분성과 다양성의 개인간 및 지역사회 관련 요인: 2017년 지역사회건강조사 자료 분석)

  • Hong, Jiyoun;Hyun, Taisun
    • Korean Journal of Community Nutrition
    • /
    • v.25 no.5
    • /
    • pp.416-429
    • /
    • 2020
  • Objectives: This study examined the personal, interpersonal and community factors related to food sufficiency and variety among Korean adults using data from the 2017 Community Health Survey. Methods: A total of 228,310 adults aged ≥ 19 years were classified into three groups: food sufficiency with variety, food sufficiency without variety and food insufficiency. Personal factors included sociodemographic characteristics, health behavior and health status. Interpersonal factors included social networking and social activities, and community factors included safety, natural environment, living environment, availability of public transportation and health care services. The association of food sufficiency and variety with interpersonal and community factors was assessed using multivariable logistic regression analyses. Results: Of the total sample, the food-sufficiency-without-variety group and food insufficiency group accounted for 31.5% and 3.2%, respectively. The sociodemographic factors associated with food insufficiency and non-variety were women, ≥ 65 years of age, with low education level, low household income, unemployed, single, and living in areas of small population sizes. There were significant differences in health behavior and health status, interpersonal and community factors among the three groups. Multivariable logistic regression analyses conducted after adjusting for confounding factors showed that lack of social networking and social activities and lower satisfaction derived from community environments were associated with the risk of food insufficiency and non-variety. Conclusions: Our results showed that interpersonal and community factors as well as personal factors were related to food sufficiency and variety. Therefore, public policies to help build social networks and participation in social activities, and improve community environment are needed together with food assistance to overcome the problems of food insufficiency and non-variety.

Polyunsaturated/saturated Fatty Acid Ratios and Antioxidant Supplementation under the Control of Dietary Peroxidizability Index Value: Impact on Serum Lipid Profiles in Young and Adult Rats

  • Kang, Min Jeong;Lee, Eun Kyung;Lee, Sang Sun
    • Nutritional Sciences
    • /
    • v.8 no.1
    • /
    • pp.10-15
    • /
    • 2005
  • An increase in serum cholesterol is directly associated with high incidences of cardiovascular diseases (CVD) and atherosclerosis. Serum lipid profiles are highly dependent on dietary fatty acids and age. The purpose of this study was to examine the age-related effects of polyunsaturated/saturated fatty acid ratios and antioxidant supplementation under the control of the dietary peroxidizability index (PI) value on serum lipid profiles in rats. While the PI level of dietary fatty acids was controlled at 81.22, the P/S ratios of fatty acids were 0.38 and 4.81 (LP and HP). The diets were supplemented with a vitamin E 1000 mg/kg diet and a selenium 2.5 mg/kg diet (LPS and HPS). Female Sprague-Dawley rats ages 3 weeks (young) and 16 weeks (adult) were fed four different experimental diets for 4 weeks. The serum triglyceride concentration of LPS was significantly higher in young rats than in adult rats. The total-cholesterol concentration of LP and HPS were higher in young rats than in adult rats. The high-density lipoprotein-cholesterol (HDL-C) concentration of LP, LPS and HP was higher in adult rats than in young rats. The low-density lipoprotein-cholesterol (LDL-C) concentration was higher in young rats than in adult rats. T-C/HDL-C and LDL-C/HDL-C ratios were much higher in young rats than in adult rats. In conclusion, P/S ratios and antioxidant supplementation did not affect T-C/HDL-C and LDL-C/HDL-C ratios as risk factors of CVD in adult rats when we controlled the PI value in the diet Probably, the invisible and confounding effects of dietary PI value implicate the beneficial roles of dietary P/S ratios and antioxidants in CVD. Accordingly, controlling the dietary PI value may be advantageous to lower the risk of CVD in adult rats.