• Journal of Korean Biological Nursing Science
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• v.25 no.1
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• pp.73-85
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• 2023

Purpose: This study focused on identifying the interaction effects of genetic and lifestyle-environmental factors on the development of type 2 diabetes mellitus (T2D). Methods: Study subjects were selected from the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014. Data on genetic variations, anthropometric measurements, biochemical data, and seven lifestyle factors (diet, physical activity, alcohol drinking, smoking, sleep, depression, and stress) were obtained from 4,836 Koreans aged between 40 and 59 years, including those with T2D at baseline (n = 1,209), newly developed T2D (n= 1,298) and verified controls (n = 3,538). The genetic risk score (GRS) was calculated by using 11 single-nucleotide polymorphisms (SNPs) related to T2D development and the second quartile was used as the reference category. A Cox proportional hazards regression model was used to evaluate the associations of GRS and lifestyle factors with T2D risk, controlling for covariates. Results: Multivariate regression analysis revealed that GRS was the strongest risk factor for T2D, and body mass index (BMI), smoking, drinking, and spicy food preference also increased the risk. Lifestyle/environmental factors that showed significant interactions with GRS were BMI, current smoking, current drinking, fatty food preference, and spicy food preference. Conclusions: Interactions between genetic factors and lifestyle/environmental factors were associated with an increased risk of T2D. The results will be useful to provide a new perspective on genetic profiling for the earlier detection of T2D risk and clues for personalized interventions, which might be more effective prevention strategies or therapies in individuals with a genetic predisposition to T2D.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.108-115
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• 2012

Purpose: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. Materials and Methods: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. Results: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. Conclusion: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.

• Korean Journal of Adult Nursing
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• v.21 no.3
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• pp.314-323
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• 2009

Purpose: This descriptive study was conducted to identify the level of knowledge of stroke symptoms and risk factors among older adults. Methods: A total of 200 older adults over 65 years of age were conveniently recruited from out patient departments of two hospitals and a health care center from October to November 2008. The level of knowledge was assessed using both open-ended questions and a structured questionnaire based on semi-structured interviews. Data were analyzed by t-tests and ANOVA using the SPSS program. Results: 52.5% of the sample had hypertension and 30% had diabetes. The mean knowledge scores for symptoms and risk factors were $8.4{\pm}3.1$ (out of 15) and $9.5{\pm}3.9$ (out of 16), respectively. The older adults who had lower education, lower family income, and who lived in rural areas were more likely to have less knowledge of stroke symptom and risk factors (p < .05). There was no significant knowledge difference between the older adults who had at least one risk factor and those who had no risk factor for stroke. Conclusions: Educational intervention should be focused on informing older adults who are at risk for stroke about the early symptoms and management of risk factors, especially those who have low education and low social status.

• Journal of Korean society of Dental Hygiene
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• v.14 no.6
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• pp.805-812
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• 2014

Objectives: The purpose of the study was to examine the association between diabetes mellitus and community periodontal index in Korean adults. Methods: The study populations were recruited by the Fifth Korea National Health and Nutrition Examination Survey. Study subjects were 10,411 who were examined oral examination, blood test, and aged over 19 years. Using multiple logistic regression analyses, the variables were adjusted for gender, age, household income, family history of diabetes, body mess index, smoking habit, and frequency of tooth brushing. Periodontal tissue examination of the subjects was performed and scored by Community periodontal index(CPI). Using probe, six teeth were examined for hemorrhage, plaque, and pocket depth and classified into $CPI_0$, $CPI_1$, $CPI_2$, $CPI_3$ and $CPI_4$. Healthy periodontal groups($CPI_{0-2}$) and periodontal disease groups($CPI_{3-4}$) were divided by the periodontal disease status. The definition of diabetes mellitus(DM) was decided by the diagnosis by the doctors and fasting blood sugar level. Those who were diagnosed as DM were included in DM group. The DM variables included normal blood sugar level, increased fasting blood sugar level, and DM blood sugar level. The DM variables were compared to periodontal disease blood sugar level and analyzed. Results: The periodontitis prevalence rate was 23.2%. Those who had diabetes mellitus accounted for 5.5% of the subjects. Those who had impaired fasting glucose accounted for 17.7% and 7.9% of subjects were diabetes mellitus by blood test. In the confirmed diabetes group by doctor, the periodontitis prevalence rate was significantly higher than the non-diabetic group. Diabetic group by blood test had the highest prevalence rate of periodontitis than those who had impaired fasting glucose group or normal group. After adjusting for gender, age, household income, family history of diabetes, body mass index, smoking habit, and frequency of tooth brushing, the risk of periodontitis in diagnosed diabetes mellitus was 1.57 times(95% CI; 1.27-1.94) higher than the normal group. In impaired fasting glucose group and diabetes mellitus group by blood test, the risk of periodontitis was 1.11 times(95% CI; 0.95-1.30) and 1.45 times(95% CI; 1.45-2.12) higher, respectively. Conclusions: There was a significant relationship between diabetes mellitus and periodontitis in Korean adults. These results suggest that diabetes mellitus is a risk factor for periodontitis.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.9-20
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• 2017

PURPOSE: The purpose of this study is to understand the difference in the risk factors of coronary artery disease (CAD) between Korean and American CAD patients to determine the discriminant factor for each group, as well as to provide useful information to be reflected in the national concern of health. METHODS: Data were collected from 248 Korean and 107 American CAD patients who underwent either percutaneous coronary intervention or coronary artery bypass grafting. By using t-test and $X^2$-test, risk factors were compared between the Koreans and Americans. To elucidate which risk factor was the most discriminant for each group, logistic regression analysis was performed. RESULTS: All risk factors, except diastolic blood pressure, showed a significant difference between the two groups. $X^2$-test showed statistical significance with respect to the smoking rate between the female groups. Moreover, there was a statistically significant difference between the two groups regarding blood total cholesterol (TC) and triglyceride, and between the male groups, here was a statistically significant difference with respect to blood high-density lipoprotein cholesterol (HDL). Diabetes mellitus (DM) was the most discriminant factor for Korean patients while TC/HDL is the most discriminant for the Americans. CONCLUSION: The characteristics of CAD risk factors were determined to be different between Koreans and Americans in this study. TC/HDL was a discriminant factor for Americans while DM was a discriminant factor for Koreans. This result implies that DM should primarily be given attention to prevent CAD in Korean adults.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.513-518
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• 2018

Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.3
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• pp.188-193
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• 2020

Stroke is a major cause of death and disorder, and diabetes mellitus (DM) is a significant risk factor of stroke. This study examined the importance of target blood pressure (<140/<90 mmHg) management in patients with DM. Based on the data of the 6th National Health and Nutrition Examination Survey, a total of 16,389 patients aged 18 to under 80 were assessed through regression analysis to estimate the risk of stroke through blood pressure control. The prevalence of stroke according to the presence or absence of DM was higher in the diabetic group, and a longer duration of DM indicated a higher risk of hypertension and stroke. The hazard ratio of stroke was lower in the maintenance group (0.57) of target blood pressure (<140/<90 mmHg) compared to the high blood pressure group(>140/>90 mmHg). Despite the accompanying treatment for DM and hypertension, the frequency of hypertension increased, and the prevalence of stroke increased after five years of DM. Hence, effective blood pressure management at this time is important. The risk of stroke should be reduced by continuously managing blood pressure in DM.

• The Korea Journal of Herbology
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• v.31 no.2
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• pp.39-45
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• 2016

Objectives : Abnormal regulation of glucose and impaired lipid metabolism that result from a defective or deficient insulin are the key etiological factor in type 2 diabetes mellitus. The our study investigated the effects of Gamioknyeo-jeon (GO) on blood glucose and lipid metabolism improved by it in db/db mice (a murine model of type 2 diabetes mellitus).Methods : The animals were divided into 3 groups: Normal groups were not-treated C57BL/6 mice; Control groups were treated orally with DW in db/db mice; GO groups were treated orally with GO (200 ㎎/㎏/day) in db/db mice. After mice were treated with GO for 5 weeks, we measured AST, ALT, creatinine, BUN, body weight, food intake, blood glucose, insulin and lipid levels (total cholesterol, HDL cholesterol, and LDL cholesterol and atherogenic index(AI) and cardiac risk factor(CRF).Results : Serum AST, ALT, creatinine, BUN levels were not changed by GO do not show any toxic effects. GO groups were decreased in body weight, food intake and blood glucose level among compared to Control groups. Also, GO groups were found to have atherogenic Index and cardiac risk factor as well as lipid metabolism improvement (total cholesterol and LDL cholesterol decrease). Finally, GO groups were increased the insulin compared to Normal and control groups.Conclusions : We suggest that GO may have the control effects of diabetes mellitus by improving blood glucose control and lipid metabolism.

• Journal of Korean Medicine for Obesity Research
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• v.2 no.1
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• pp.25-36
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• 2002

Objective: The purposes of this study are to know the relations of abdominal obesity and ischemic stroke and to know what index could represent the abdominal obesity appropriately. Methods. We have done case-control study and recruited 97 ischemic stroke patients and 117 controls. Case is matched by control by individual matching. All participants had questionnaire, interview and then were examined waist-hip ratio, waist circumference and body mass index. Results : WC, WHR and Hypertension history had differences in two groups, case and control groups. But BMI and other factors weren't significant. According to Quartile of Waist Circumference, the two groups had the differences in hypertension history, diabetes history, smoking status, WHR, BMI, and weight and in the Quartile of Waist-Hip Ratio Quartile, past history of hypertension and diabetes, WC, BMI and weight had the significances. Sex, Age Adjusted and Multivariate Odds Ratio (95% Confidence Interval) of WC Quartile are 2.083, 1.628, 4.491 and 4.418, 4.964, 12.306, and in WHR, the Ors are 2.252, 5.743, 15.776 and 2.632, 8.918, 23.596. Conclusions: We knew from these results that abdominal obesity is very important risk factor of ischemic stroke and WHR more than WC is a good indicator of abdominal obesity, so we should reduce the WHR to prevent of ischemic stroke.

• Journal of Preventive Medicine and Public Health
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• v.47 no.4
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• pp.216-229
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• 2014

Objectives: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for ${\beta}$-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.