BACKGROUND: Magnetic resonance imaging (MRI) findings of white-matter lesions are different from those of lacunar infarcts; however, both these conditions are related to cardiovascular risk factors. This study was performed to investigate the differences in the relationships of white-matter lesions and lacunar infarcts with cardiovascular risk factors and differences between the metabolic characteristics of patients with these conditions. METHODS: We included 4,255 patients who showed neurological deficits during health checkups. These individuals were classified into the following 3 groups on the basis of MRI findings: normal, white-matter lesion, and lacunar infarct. The groups were compared for age; weights; prevalence of metabolic syndrome; and levels of blood pressure, blood glucose, lipid, high sensitivity C-reactive protein, and HbA1c. RESULTS: Age, body mass index (BMI); waist circumference; levels of blood pressure, blood glucose, triglycerides and HbA1c; and prevalence of metabolic syndrome and its components were the highest in lacunar infarct group, followed by white matter lesion group, and normal group. Age and diastolic blood pressure level were related to white matter lesions, and age, systolic blood pressure level, and blood glucose level were related to lacunar infarcts. Further, the prevalence of the above-mentioned lesions increased with increase of the number of the components of metabolic syndrome. CONCLUSIONS: This study suggests that lacunar infarct is more advanced lesion than white matter lesion. Among all the cardiovascular risk factors, high blood pressure and impaired fasting blood glucose levels were significantly related to white-matter lesions and lacunar infarct.
Blood Glucose ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Fasting ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Prevalence ; Risk Factors ; Stroke, Lacunar ; Triglycerides

BACKGROUND: Hemoglobin A1c (HbA1c) level is an indicator of the average blood glucose concentration of the past 2 to 3 months. Studies on the association of HbA1c levels with cardiovascular disease have reported inconsistent findings groups stratified by gender, age, and race. Therefore we conducted this study to determine the relationship between HbA1c levels and metabolic syndrome in a Korean population participating in medical check-up programs. METHODS: The study population comprised 7,301 nondiabetic Korean subjects (3,384 men and 3,917 women) who had enrolled for a medical check-up program. All subjects were divided into 5 groups on the basis of their HbA1c levels. Age, blood pressure, abdominal obesity, fasting glucose levels, lipid profile and high sensitivity C-reactive protein (hsCRP) levels were compared among the groups. In addition, we also investigated the association of HbA1c levels with cardiovascular risk factors and metabolic syndrome. RESULTS: Age, waist circumference, body mass index, blood pressure, hsCRP levels, lipid profile and fasting glucose levels differed significantly among the 5 HbA1c groups, both in men and women. The possibility of the occurrence of metabolic syndrome increased as HbA1c levels increased, both in men and women. Abdominal obesity was the most common component of metabolic syndrome and more prominently occurred in women. CONCLUSIONS: HbA1c levels were significantly correlated to metabolic syndrome among these Korean subjects and abdominal obesity was the most frequently observed component of metabolic syndrome. Thus, abdominal obesity should be treated when high HbA1c levels are detected, particularly in women, even though the patient is not diabetic.
Blood Glucose ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Continental Population Groups ; Fasting ; Female ; Glucose ; Hemoglobins ; Humans ; Male ; Obesity, Abdominal ; Risk Factors ; Waist Circumference

BACKGROUND: Prediabetes is the condition associated with the development of type 2 diabetes and a risk of cardiovascular disease. Abnormal homocysteine levels have been found to be associated with atherosclerosis in diabetes, but not well studied in pre-diabetes. In this study we investigated the relationship between blood homocysteine levels and subclinical atherosclerosis in the individuals with impaired fasting glucose. METHOD: Individuals with impaired fasting glucose with fasting blood glucose concentrations of 100-125 mg/dL (1,537 men and 1,563 women) were selected from 10,848 health examinees who underwent an ultrasonographic examination of carotid artery during health check-up over 20 yr. The subjects were divided into 4 quartile groups depending on homocysteine levels. We investigated the association of each homocysteine quartile with abnormal carotid intima-media thickness (CIMT) and carotid plaque by using logistic regression analysis. RESULTS: Factors associated with abnormal CIMT and carotid plaque were age, homocysteine levels, blood pressure, and fasting blood glucose levels. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth- quartile homocysteine level groups had higher odds ratios ([OR]-95% confidence interval [CI])- for abnormal CIMT (1.656 [1.11-2.47], P=0.013, 1.966 [1.32-2.93], P=0.001, respectively) and for carotid plaque (1.608 [1.01-2.56], P=0.045, 1.913 [1.22-3.00], P=0.005, respectively) than did the first quartile group. CONCLUSION: Blood homocysteine levels showed a statistically significant correlation with subclinical atherosclerosis in individuals with impaired fasting glucose.
Atherosclerosis ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Intima-Media Thickness ; Fasting ; Glucose ; Homocysteine ; Humans ; Logistic Models ; Male ; Odds Ratio ; Prediabetic State

BACKGROUND: Baseline prostate volume (PV) is related with the progression of benign prostatic hyperplasia (BPH). Although recent studies have reported the relationship between BPH and metabolic syndrome, the findings are inconsistent. Thus, this study was performed to investigate the association of PV with metabolic factors and prostate-specific antigen (PSA) in individuals with normal PV and clarify the factors associated with benign prostate enlargement (BPE), including PSA. METHODS: We selected 3,915 health examinees aged >40 yr with a PSA level <4 ng/mL who underwent ultrasonography of the prostate as part of a routine health check-up. These individuals were classified into two groups according to PV: normal PV (PV <30 mL) and BPE (PV > or =30 mL). We investigated the association of PV with metabolic factors and PSA using multiple linear regression analysis, and clarified the factors associated with BPE using logistic regression analysis. RESULTS: The factors associated with PV were PSA, age, and waist circumference in individuals with normal PV. The factors associated with BPE were age, body mass index (BMI), and PSA. The logistic regression analysis adjusted for age and confounding factors showed that individuals with a BMI of 23-24.9 kg/m2, 25-29.9 kg/m2, and > or =30 kg/m2 had higher odds ratios of 1.580 (95% confidence interval, 1.171-2.131; P=0.003), 1.767 (1.332-2.344; P<0.001), and 2.024 (1.042-3.933; P=0.038), respectively, for BPE than individual with a BMI <23 kg/m2. CONCLUSIONS: Abdominal obesity was significantly associated with PV in individuals with normal PV, whereas obesity was an associated metabolic factor of BPE. PSA level was positively associated with PV.
Body Mass Index ; Linear Models ; Logistic Models ; Obesity ; Obesity, Abdominal ; Odds Ratio ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Hyperplasia ; Ultrasonography ; Waist Circumference

BACKGROUND: Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement. METHODS: A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D2 and 25(OH)D3 were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit. RESULTS: The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions. CONCLUSIONS: Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.
Female ; Gyeonggi-do ; Health Promotion ; Humans ; Korea ; Male ; Mass Spectrometry ; Prevalence* ; Seasons* ; Seoul ; Tandem Mass Spectrometry ; Vitamin D Deficiency* ; Vitamin D*

BACKGROUND: Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement. METHODS: A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D2 and 25(OH)D3 were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit. RESULTS: The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions. CONCLUSIONS: Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.
Female ; Gyeonggi-do ; Health Promotion ; Humans ; Korea ; Male ; Mass Spectrometry ; Prevalence* ; Seasons* ; Seoul ; Tandem Mass Spectrometry ; Vitamin D Deficiency* ; Vitamin D*

OBJECTIVES: The purpose of this study was to analyze the discriminant validity and the clinical cut off scores of the Child Behavior Checklist 1.5-5 (CBCL 1.5-5) in the diagnosis of autism spectrum disorder (ASD) and non-ASD. METHODS: In total, 104 ASD and 441 non-ASD infants were included in the study. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. RESULTS: The discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, and Total problems, along with the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC analysis showed that the following subscales significantly separated ASD from normal infants: Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. Moreover, the clinical cut off score criteria adopted in the Korean-CBCL 1.5-5 were shown to be valid for the subscales Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. CONCLUSION: The subscales of Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems significantly discriminated infants with ASD.
Autism Spectrum Disorder ; Autistic Disorder ; Checklist ; Child ; Child Behavior ; Child ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Infant ; Odds Ratio ; ROC Curve ; Weights and Measures

BACKGROUND: Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. METHODS: Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. RESULTS: The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of <30, 30-300, and >300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. CONCLUSIONS: The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.
Adult ; Aged ; Aged, 80 and over ; Albumins/*analysis ; Creatinine/*urine ; Diabetes Mellitus, Type 2/pathology/urine ; Female ; Humans ; *Immunoassay ; Male ; Middle Aged ; Prediabetic State/pathology/urine ; Reagent Strips/chemistry

BACKGROUND: The prevalence and genotype distribution of Human papillomavirus (HPV) infection vary depending on geographical region and the immunity provided by vaccines. This study aimed to clarify the recent prevalence and genotype distribution of HPV according to age and cervical cytology findings in Korea. METHODS: This study included 18,815 health examinees that underwent cervical cytology and HPV genotyping tests at 16 centers of Korean Association of Health Promotion in 13 cities in Korea, between January 2014 and October 2015. HPV was genotyped by using multiplex PCR (Anyplex II HPV 28, Seegene, Korea), which detects 19 high-risk HPVs (HR-HPV) and nine low-risk HPVs (LR-HPV). RESULTS: Overall HPV prevalence was 27.8%, with 22.2% HR-HPV and 11.4% LR-HPV. The five most common carcinogens were HPV 52 (3.2%), 58 (2.7%), 16 (2.0%), 56 (1.9%), and 51 (1.8%). The five most common HR-HPVs in normal cytology samples were HPV 53, 68, 70, 52, and 58, while HPV 16, 52, 58, 33, and 31 were prevalent in high grade squamous intraepithelial lesions (HSIL). In atypical squamous cells of undetermined significance (ASCUS), the prevalence of HR-HPV varied with age; it was highest in those aged <30 yr, declining to a minimum at age 50–59 yr, and then increasing in older women (P<0.05). CONCLUSIONS: The prevalence and distribution of HR-HPV varied with age and cervical cytology findings. This information would be helpful in the development of cervical cancer prevention policies.
Atypical Squamous Cells of the Cervix ; Carcinogens ; Female ; Genotype* ; Health Promotion ; Human papillomavirus 16 ; Humans* ; Korea ; Multiplex Polymerase Chain Reaction ; Prevalence ; Squamous Intraepithelial Lesions of the Cervix ; Uterine Cervical Neoplasms ; Vaccines

BACKGROUND: The syphilis diagnostic algorithms applied in different countries vary significantly depending on the local syphilis epidemiology and other considerations, including the expected workload, the need for automation in the laboratory and budget factors. This study was performed to investigate the efficacy of traditional and reverse syphilis diagnostic algorithms during general health checkups. METHODS: In total, 1,000 blood specimens were obtained from 908 men and 92 women during their regular health checkups. Traditional screening and reverse screening were applied to the same specimens using automatic rapid plasma regain (RPR) and Treponema pallidum latex agglutination (TPLA) tests, respectively. Specimens that were reverse algorithm (TPLA) reactive, were subjected to a second treponemal test performed by using the chemiluminescent microparticle immunoassay (CMIA). RESULTS: Of the 1,000 specimens tested, 68 (6.8%) were reactive by reverse screening (TPLA) compared with 11 (1.1%) by traditional screening (RPR). The traditional algorithm failed to detect 48 specimens [TPLA(+)/RPR(−)/CMIA(+)]. The median TPLA cutoff index (COI) was higher in CMIA-reactive cases than in CMIA-nonreactive cases (90.5 vs 12.5 U). CONCLUSIONS: The reverse screening algorithm could detect the subjects with possible latent syphilis who were not detected by the traditional algorithm. Those individuals could be provided with opportunities for evaluating syphilis during their health checkups. The COI values of the initial TPLA test may be helpful in excluding false-positive TPLA test results in the reverse algorithm.
Agglutination ; Automation ; Budgets ; Epidemiology ; Female ; Humans ; Immunoassay ; Latex ; Male ; Mass Screening* ; Plasma ; Syphilis* ; Syphilis, Latent ; Treponema pallidum