BACKGROUND: Bone mineral density (BMD) screening guidelines for women younger than 65 years are inconsistent. We investigated BMD-related factors in postmenopausal women younger than 65 years to help clinicians identify which women in this age group should undergo this investigation. METHODS: The study subjects included 108 postmenopausal women, younger than 65 years, who visited one university hospital from January to June 2007 and had a BMD by DEXA. Information on socio-demographic characteristics, menarche, menopause, smoking, alcohol use, past history of fracture and diet were gathered using a self-reported questionnaire. Height and weight were measured. The association between each risk factor and BMD was assessed using Pearson's correlation and ANOVA test. Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. RESULTS: In our subjects, age was negatively and body weight was positively correlated with BMD of lumbar spine and femur. The reproductive years was positively correlated with BMD of lumbar spine and past history of fragility fracture was negatively associated with BMD of femur. Moderate alcohol users had higher BMDs of lumbar spine and femur. CONCLUSIONS: In postmenopausal women younger than 65 years, age and body weight are major determinants of BMD of lumbar spine and femur, negatively and positively, respectively. Our data suggest women younger than 65 years with low lean body mass, past history of fracture, and premature menopause could be good candidates for BMD.
Body Weight ; Bone Density ; Diet ; Female ; Femur ; Humans ; Mass Screening ; Menarche ; Menopause ; Menopause, Premature ; Risk Factors ; Smoke ; Smoking ; Spine ; Surveys and Questionnaires

BACKGROUND: Bone mineral density (BMD) screening guidelines for women younger than 65 years are inconsistent. We investigated BMD-related factors in postmenopausal women younger than 65 years to help clinicians identify which women in this age group should undergo this investigation. METHODS: The study subjects included 108 postmenopausal women, younger than 65 years, who visited one university hospital from January to June 2007 and had a BMD by DEXA. Information on socio-demographic characteristics, menarche, menopause, smoking, alcohol use, past history of fracture and diet were gathered using a self-reported questionnaire. Height and weight were measured. The association between each risk factor and BMD was assessed using Pearson's correlation and ANOVA test. Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. RESULTS: In our subjects, age was negatively and body weight was positively correlated with BMD of lumbar spine and femur. The reproductive years was positively correlated with BMD of lumbar spine and past history of fragility fracture was negatively associated with BMD of femur. Moderate alcohol users had higher BMDs of lumbar spine and femur. CONCLUSIONS: In postmenopausal women younger than 65 years, age and body weight are major determinants of BMD of lumbar spine and femur, negatively and positively, respectively. Our data suggest women younger than 65 years with low lean body mass, past history of fracture, and premature menopause could be good candidates for BMD.
Body Weight ; Bone Density ; Diet ; Female ; Femur ; Humans ; Mass Screening ; Menarche ; Menopause ; Menopause, Premature ; Risk Factors ; Smoke ; Smoking ; Spine ; Surveys and Questionnaires

BACKGROUND: The prevalence of alcohol use disorder (AUD) is very high in Korea. To identify AUD in the busy practice setting, brevity of screening tools is very important. We derived the brief Alcohol Use Disorders Identification Test (AUDIT) and evaluated its performance as a brief screening test. METHODS: One hundred male drinkers from Kangbuk Samsung Hospital primary care outpatient clinic and psychiatric ward for alcoholism treatment completed questionnaires including the AUDIT, cut down, annoyed, guilty, eye-opener (CAGE), and National Alcoholism Screening Test (NAST) from April to July, 2007. AUD (alcohol abuse and dependence), defined by a physician in accordance with Diagnostic and Statistical Manual of Mental Disorders-IV, was used as a diagnostic criteria. To derive the brief AUDIT, factor analysis was performed using the principal component extraction method with a varimax rotated solution. Receiver operating characteristic (ROC) curve analysis was performed to investigate the discrimination ability of the brief AUDIT. Areas under the ROC curve were compared performance of screening questionnaires with 95% confidence intervals. RESULTS: The derived brief AUDIT consists of 4 items: frequency of heavy drinking (item 3), impaired control over drinking (item 4), increased salience of drinking (item 5), and alcohol-related injury (item 9). Brief AUDIT exhibited an AUD screening accuracy better than CAGE, and equally to that of NAST. Areas under the ROC curves were 0.87 (0.80-0.94), 0.76 (0.66-0.85), and 0.81 (0.73-0.90) for the brief AUDIT, CAGE, and NAST for AUD, and 0.97 (0.95-0.99), 0.93 (0.88-0.98) and 0.93 (0.88-0.98) for alcohol dependence. CONCLUSION: The new brief AUDIT seems to be effective in detecting male AUD in the primary care setting in Korea. Further evaluation for women and different age groups is needed.
Alcoholism ; Ambulatory Care Facilities ; Discrimination (Psychology) ; Drinking ; Female ; Humans ; Korea ; Male ; Mass Screening ; Prevalence ; Primary Health Care ; ROC Curve

PURPOSE: Previous studies have highlighted that the nutritional behaviors among South Korean workers are far from ideal. This study examined the organizational influences affecting the eating practices of office workers in South Korea.METHODS: We conducted in-depth interviews with 22 office workers at 12 companies in South Korea. The interviewer inquired about the employees' daily routines on food and beverage intake. The various factors that influence their food choices in their work environments were also explored. The interviews were transcribed and then analyzed using a content analysis.RESULTS: A framework analysis revealed 7 key recurring themes, and these were grouped under three levels: team-, company-, and corporate group-levels. First, team dinners are core social events for all the workers and they tend to include high-caloric food and alcoholic beverages. The frequency of team meals and the food associated with them depend on various team characteristics such as gender composition, the nature of a team's work and the team leaders' emphasis on group meals. Second, the company's policies and practices regarding budget allocation for team meals and subsidies for cafeteria meals affect the workers' food intake practices. In addition, the physical environment of the worksite cafeterias can influence the choices of foods. Third, various corporate group policies that were not designed to target food intake had additional positive effects on the workers' eating behaviors.CONCLUSION: This study provides important insights into the broader organizational influences on the food consumption of employees in their workplace. These insights can be used to design and implement more effective intervention strategies for improving the nutritional behaviors of office workers.
Alcoholic Beverages ; Beverages ; Budgets ; Diet ; Eating ; Feeding Behavior ; Korea ; Meals ; Qualitative Research ; Workplace

BACKGROUND: Pediatric obesity is an important global issue in public health. However, previous efforts for childhood obesity prevention have sporadically been implemented in Korea, neither evidence-based nor with proper evaluation. We aimed to investigate the characteristics of an effective intervention for prevention of pediatric obesity by reviewing previous systematic reviews and Meta-analyses. METHODS: PubMed was searched for articles published frombetween January 2005 to November 2015. Inclusion criteria were as follows: (1) articles published in English; (2) child and/or adolescents (between 2 and 18 years of age) as subjects; and (3) systematic reviews or meta-analyses concerning the preventive intervention of pediatric/adolescent obesity. Each study was evaluated via the Assessment of Multiple Systematic Reviews for quality assessment. We conducted a quantitative analysis to evaluate the implications, strengths, and limitations of each study. RESULTS: Our final analysis included 35 articles, of which 15 were systematic reviews and 20 were meta-analyses. Among these, 24 studies (69%) advocated the efficacy of preventive intervention for pediatric obesity. Multidimensional approach including diet, exercise, and environmental factors conducted in schools with a parent and community involvement wasis more effective at preventing obesity. The efficacy of intervention varied depending on the age, sex, region, and socioeconomic characteristics of participantssubjects. CONCLUSIONS: Preventive intervention of pediatric obesity demonstrated smallminor improvements in body mass index and had positive effects on behavioral and clinical variables, which are associated with obesity. For the efficient prevention of pediatric obesity, it is necessary to consider efforts for developing various intervention programs, with active as well as the participation of school, family, and social community groups.
Adolescent* ; Body Mass Index ; Child* ; Diet ; Humans ; Korea ; Obesity* ; Parents ; Pediatric Obesity ; Public Health

INTRODUCTION: Identification of individuals at high risk for coronary heart disease (CHD) is a challenge, though essential, for the prevention of future events. Thus, early detection of CHD has been a priority in research and practice. We conducted a study to evaluate the relationship between metabolic syndrome (MS) and its components with coronary artery calcium (CAC) as a surrogate of CHD in a large Korean adult population. METHODS: The study subjects (n=14,429) were individuals who visited a health promotion center in Seoul, Korea from Jan. 2010 to Dec. 2010. Personal and family medical histories were collected and smoking status, anthropometric measurements, and laboratory tests were measured. CAC scores were measured by the multi-detector computed tomography. RESULTS: The study population consisted of 11,884 men (mean age 41.9+/-6.6 years) and 2,544 women (mean age 42.9+/-8.0 years). The total prevalence of MS was 19.6%, with 21% in men and 13.2% in women. CAC (CAC>0) was found in 15.0% of men and 5.4% of women. When compared to the non-MS group, the MS group had a higher prevalence of CAC after adjusting for age, smoking, and family history of stroke and CHD in both men (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.62-2.05; P<0.001) and women (OR, 2.23; 95% CI, 1.49-3.33; P<0.001). All individual components of MS, except high density lipoprotein cholesterol level, were associated with a high risk for CAC presence. CONCLUSIONS: Individuals with MS had a greater prevalence of CAC compared with individuals without this condition.
Adult ; Calcium ; Cholesterol ; Cholesterol, HDL ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Female ; Health Promotion ; Humans ; Korea ; Lipoproteins ; Male ; Metabolic Syndrome X ; Prevalence ; Smoke ; Smoking ; Stroke

INTRODUCTION: Identification of individuals at high risk for coronary heart disease (CHD) is a challenge, though essential, for the prevention of future events. Thus, early detection of CHD has been a priority in research and practice. We conducted a study to evaluate the relationship between metabolic syndrome (MS) and its components with coronary artery calcium (CAC) as a surrogate of CHD in a large Korean adult population. METHODS: The study subjects (n=14,429) were individuals who visited a health promotion center in Seoul, Korea from Jan. 2010 to Dec. 2010. Personal and family medical histories were collected and smoking status, anthropometric measurements, and laboratory tests were measured. CAC scores were measured by the multi-detector computed tomography. RESULTS: The study population consisted of 11,884 men (mean age 41.9+/-6.6 years) and 2,544 women (mean age 42.9+/-8.0 years). The total prevalence of MS was 19.6%, with 21% in men and 13.2% in women. CAC (CAC>0) was found in 15.0% of men and 5.4% of women. When compared to the non-MS group, the MS group had a higher prevalence of CAC after adjusting for age, smoking, and family history of stroke and CHD in both men (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.62-2.05; P<0.001) and women (OR, 2.23; 95% CI, 1.49-3.33; P<0.001). All individual components of MS, except high density lipoprotein cholesterol level, were associated with a high risk for CAC presence. CONCLUSIONS: Individuals with MS had a greater prevalence of CAC compared with individuals without this condition.
Adult ; Calcium ; Cholesterol ; Cholesterol, HDL ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Female ; Health Promotion ; Humans ; Korea ; Lipoproteins ; Male ; Metabolic Syndrome X ; Prevalence ; Smoke ; Smoking ; Stroke

Objective: It is uncertain why a b-value range of 1500–2000 s/mm2 is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000–3000 s/mm2 using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm2 . We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses.For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRIsuggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI.The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761–1805 s/mm2 and 1640– 1771 s/mm2 (median, 1790 s/mm2 vs. 1705 s/mm2 ; p = 0.003) for reader 1, and 1835–1895 s/mm2 and 1705–1841 s/mm2 (median, 1872 s/mm2 vs. 1763 s/mm2 ; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735–1873 s/mm2 and 1573–1867 s/mm2 for reader 1, and 1775–1945 s/mm2 and 1591–1955 s/mm2 for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm2 between qualitatively and quantitatively selected optimal b-values. Conclusion b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500–2000 s/mm2 .

Objective: It is uncertain why a b-value range of 1500–2000 s/mm2 is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000–3000 s/mm2 using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm2 . We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses.For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRIsuggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI.The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761–1805 s/mm2 and 1640– 1771 s/mm2 (median, 1790 s/mm2 vs. 1705 s/mm2 ; p = 0.003) for reader 1, and 1835–1895 s/mm2 and 1705–1841 s/mm2 (median, 1872 s/mm2 vs. 1763 s/mm2 ; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735–1873 s/mm2 and 1573–1867 s/mm2 for reader 1, and 1775–1945 s/mm2 and 1591–1955 s/mm2 for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm2 between qualitatively and quantitatively selected optimal b-values. Conclusion b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500–2000 s/mm2 .

It remains unclear as to whether insulin resistance alone or in the presence of wellknown risk factors, such as diabetes or obesity, is associated with gallstones in men. The aim of this study was to determine whether insulin resistance is associated independently with gallstone disease in non-diabetic men, regardless of obesity. Study subjects were 19,503 Korean men, aged 30-69 yr, with fasting blood glucose level <126 mg/dL and without a documented history of diabetes. Gallbladder status was assessed via abdominal ultrasonography after overnight fast. Body mass index and waist circumference were measured. Insulin resistance was estimated by the Homeostasis Model Assessment of insulin resistance (HOMA-IR). The prevalence of obesity, abdominal obesity, and metabolic syndrome in the subjects with gallstones were higher than in those without. The prevalence of elevated HOMA (>75 percentile) in subjects with gallstones was significantly higher than in those without, and this association remained even after the obesity stratification was applied. In multiple logistic regression analyses, only age and HOMA proved to be independent predictors of gallstones. Insulin resistance was positively associated with gallstones in non-diabetic Korean men, and this occurred regardless of obesity. Gallstones appear to be a marker for insulin resistance, even in non-diabetic, nonobese men.
Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Gallstones/*etiology ; Humans ; *Insulin Resistance ; Logistic Models ; Male ; Middle Aged ; Obesity/complications ; Risk Factors