• Journal of Nutrition and Health
• /
• v.52 no.2
• /
• pp.206-216
• /
• 2019

Purpose: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. Methods: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. Results: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. Conclusion: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.

• Nutrition Research and Practice
• /
• v.10 no.5
• /
• pp.516-523
• /
• 2016

BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS: When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits ($73.1{\pm}83.2g$ vs. $230.9{\pm}202.1g$, P < 0.001), vegetables ($221.1{\pm}209.0g$ vs. $561.7{\pm}306.6g$, P < 0.001), and antioxidants, including vitamins C, E, $B_6$, ${\beta}$-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, $B_6$, $B_{12}$, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin $B_{12}$ intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS: When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.45 no.7
• /
• pp.1049-1056
• /
• 2016

The prevalence of diabetes is increasing worldwide, particularly in Asian regions such as Korea. It is estimated that the number of diabetic patients will exceed 5 million by 2030 and that about 30% of people with diabetes are unaware of their condition. A comparative analysis was conducted to determine the relationship between dairy food intake and pre-diabetes risk factors in subjects that visited the health examination center of Sunhan Hospital, Republic of Korea. Subjects were classified into two groups according to fasting blood glucose concentrations: 1) normal (fasting blood glucose <100 mg/dL, n=57) and 2) pre-diabetes (100 mg/dL${\leq}$ fasting blood glucose ${\leq}125mg/dL$, n=56). Total dairy food intake tended to be lower in females and subjects with pre-diabetes compared with males and normal subjects, respectively; however, differences between groups were not significant due to a wide range of variations. HbA1c, systolic and diastolic blood pressures were significantly associated with the prevalence of pre-diabetes. Odds ratios for pre-diabetes were significantly reduced per incremental increases in dairy food intakes after adjusting for confounding factors. Findings in the current study suggest that appropriate intake of dairy foods may need to be considered for the prevention of pre-diabetes.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.12
• /
• pp.6299-6303
• /
• 2012

Insulin-like growth factor-binding protein-3 (IGFBP3) has been identified as a putative tumor suppressor with multifunctional roles in the IGF axis. Recently, there have been a growing body of studies investigating the relation between the IGFBP3 A-202C polymorphism, circulating IGFBP3 and prostate cancer risk, but their outcomes varied leading to controversy. Hence, it is necessary to perform a meta-analysis covering all eligible studies to shed a light on the association of IGFBP3 A-202C and cancer risk. Finally, we included a total of 11 relevant articles between 2003 and 2010 covering 14 case-control studies including 9,238 cases and 8,741 controls for our analysis. Our results showed that A-202C was a marginal risk factor of prostate cancer (allele contrast: OR=1.08, 95% CI :1.01-1.16; dominant model: OR=1.11, 95% CI :1.01-1.22; heterozygote codominant model: OR=1.11, 95% CI :1.03-1.18; homozygote contrast: OR=1.19, 95% CI :1.03-1.37). Stratification analysis revealed that sample size and control source were two major heterogeneous meta-factors especially in the recessive model (source: Population-based control group :p=0.30,I2=16.7%, Hospital-based control group: p=0.20, I2=30.3%; sample size: Small: p=0.22,I2= 32.8%, Medium: p=0.09,I2=48%, Large p=0.60,I2=0.0%); However, contrary to previous findings, no significance was found in racial subgroups. No significant publication bias was found in our analysis. Considering the robustness of the results and the discrepancy among some studies, there might be some unsolved confounding factors, and further more critical large studies are needed for confirmation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.7
• /
• pp.3151-3156
• /
• 2014

Background: Sorafenib is a promising drug for advanced hepatocellular carcinoma (HCC); however, treatment may be discontinued for multiple reasons, such as progressive disease, adverse events, or the cost of treatment. The consequences of sorafenib discontinuation and continuation are uncertain. Materials and Methods: We retrospectively analyzed 88 HCC patients treated with sorafenib from July 2007 to January 2013. Overall survival (OS), post-disease progression overall survival (pOS), and time to disease progression (TTP) were compared for survival analysis. Cox proportional hazard regression was performed to assess the effect of important factors on OS in the overall patient population and on pOS in patients who continued sorafenib treatment. Results: Sorafenib was discontinued and continued in 24 and 64 patients, respectively. The median OS (355 vs 517 days respectively; p=0.015) and median post-PD OS (260 vs 317 days, respectively; p=0.020) were statistically different between the discontinuation and continuation groups. Neither the median time to first PD nor the time to second PD were significantly different between the 2 groups. In the discontinuation group, 3 of the 24 patients (12.5%) suffered disease outbreaks. In Cox proportional hazard regression analysis after correction for confounding factors, BCLC stage (p=0.002) and PD site (p=0.024) were significantly correlated with pOS in patients who continued sorafenib treatment. Conclusions: Sorafenib discontinuation may cause HCC flares or outbreaks. It is advisable to continue sorafenib treatment after first PD, particularly in patients with Barcelona Clinic Liver Cancer stage B disease or only intrahepatic PD.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.2 s.46
• /
• pp.217-225
• /
• 1994

The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age- and sex-matched 165 controls in hospital for ophthalmologic, otologic, or nasopharyngeal problems. Significant association were observed for liver deseases occurring 5 or more years before liver cancer diagnosis [OR,4.9;95% confidence interval (CI), $1.6{\sim}14.0$) and family history of liver disease(OR, 9.0;95% CI, $2.1{\sim}38.8$). These associations were not appreciably modified by allowance for major identified potential confounding factors. From these results, it is possible to speculate that liver cell injuries caused by various factors might be a common pathway to developing primary liver carcinoma. Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.

• Genomics & Informatics
• /
• v.3 no.4
• /
• pp.166-171
• /
• 2005

Background: Smoking effects are relatively well-documented, especially on cancers and cardiovascular diseases. However, the direction and magnitude of association between smoking and obesity remain unclear. Conflicting results so far are thought to stem from the multiple confounding structure of smoking and other obesogenic life style characteristics. Methods: Cotwin control study is a genomic epidemiology design, in which the other twin (=cotwin) serves as a control of the twin. Cotwin control study, discordant for smoking habits can provide powerful evidence of association between smoking and obesity by completely matching genomic information, intrauterine environment, and almost all environmental factors. We selected 3,697 like-sex twin pairs (2,762 male and 935 female pairs) out of 63,666 pairs of adult twins in the existing Korea Twin and Family Register, whose smoking habits are discordant. We used the information of obesity as body mass index (BMI, $kg/m^2$) blood pressure, and blood cholesterol level at the time or later than the smoking information. Paired t-test was done to compare the smoking effects. Results: Lifetime smoking rate was 80.1 % (47.9 current smoker) for men and 10% (1.7% current smoker) for women. Among 2,762 and 935 male and female like-sex twin pairs, 363 male pairs and 20 female pairs correspond to the definition of smoker-nonsmoker pair. The male smokers demonstrated increase in BMI by 0.47, while female smokers show slight decrease (by 0.13), which were not statistically significant. Diastolic and systolic blood pressure, and cholesterol level were slightly increased among smokers by 1.85 mmHg, 0.62 mmHg, and 1.28 mg/dl for men. For women, the results show increase in diastolic blood pressure (3.42mmHg) and cholesterol level (1.25 mg/dl), and systolic pressure (8.17 mmHg). Conclusion: The results refute the possibility that smoking can reduce BMI. Considering the direct adverse effect of smoking, it should be emphasized that smoking do not decrease obesity and thus increase overall metabolic syndrome.

• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.2
• /
• pp.217-226
• /
• 2016

Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

• Korean Journal of Clinical Laboratory Science
• /
• v.53 no.4
• /
• pp.342-352
• /
• 2021

We used data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES) (2016~2018) to investigate an association between high sensitivity C-reactive protein (hsCRP) and uric acid in the obese. Obesity was defined as a body mass index (BMI) of 25 kg/m² or more, severe obesity as a BMI of 30 kg/m² or more, and morbid obesity as a BMI of 35 kg/m² or more. In the complex samples multiple logistic regression, despite adjustment by adding major risk factors, the odds ratio (OR) for obesity was higher in the group with high levels of both, hsCRP and uric acid than the reference group at all stages (obesity, OR 1.89, P<0.001 vs. severe obesity, OR 5.04, P<0.001 vs. morbid obesity, OR 8.20, P<0.001). The association between hsCRP and uric acid in obese patients increased from 1.89 to 8.20 as the obesity level increased, suggesting that participants with increased BMI were significantly affected by hsCRP and uric acid. Moreover, the interaction between hsCRP and uric acid was statistically significant even in the model corrected for major confounding factors (P for interaction=0.009).

• Journal of Environmental Health Sciences
• /
• v.47 no.2
• /
• pp.131-143
• /
• 2021

Objectives: This study aims to investigate the atmospheric concentration of polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) and the urinary concentration of biomarkers in residents near the Shinpyeong·Jangrim Industrial Complex to compare them with those of residents in a control area. Methods: Hazardous air pollutants (PAHs and VOCs) were measured in an exposure area (two sites) and a control area (one site). Urine samples were collected from residents near the industrial complex (184 persons) and residents in the control area (181 persons). Multiple linear regression analysis was used to identify which factors affected the concentration of PAHs and VOCs metabolites. Results: The average atmospheric concentration of PAHs in Shinpyeong-dong and Jangrim-dong was 0.45 and 0.59 ppb for pyrene, 0.15 and 0.16 ppb for benzo[a]pyrene, and 0.29 and 0.35 ppb for dibenz[a,h]anthracene. The average atmospheric concentration of VOCs was 1.10 and 0.99 ppb for benzene, 8.22 and 11.30 ppb for toluene, and 1.91 and 3.05 ppb for ethylbenzene, respectively. The concentrations of PAHs and VOCs in residents near the Shinpyeong·Jangrim Industrial Complex were higher than those of residents in the control area. Geometric means of urinary 2-hydroxyfluorene, 1-hydroxypyrene, methylhippuric acid, and mandelic acid concentrations were 0.45, 0.22, 391.51, and 201.36 ㎍/g creatinine, respectively. Those levels were all significantly higher than those in the control area (p<0.05). In addition, as a result of multiple regression analysis, even after adjusting for potential confounding factors such as gender and smoking, the concentration of metabolites in urine was high in residents near the Shinpyeong·Jangrim Industrial Complex. Conclusion: The results of this study show the possibility of human exposure to VOCs in residents near the Shinpyeong·Jangrim Industrial Complex. Therefore, continuous monitoring of the local community is required for the management of environmental pollutant emissions.