BACKGROUND: The detection of thyroid nodules through ultrasonography (US) has improved with the development of imaging technologies and thyroid cancer screening in Korea. We evaluated the relationship between the presence of thyroid nodules on US and thyroid function test (TFT) results in healthy individuals.METHODS: We performed a retrospective review of data from 449 adults (313 men and 136 women) who underwent tests to evaluate serum thyrotropin (TSH) and free thyroxine levels, thyroid US, and if needed, fine needle aspiration cytology (FNAC).RESULTS: Of the 449 subjects, 144 subjects (32.1%) had thyroid nodules. Among the 144 with thyroid nodules, 24 (16.7%) were advised to undergo FNAC, and all of them showed normal serum TSH levels. Logistic regression analysis showed that the presence of thyroid nodules was not related to abnormalities noted on TFTs after adjusting for age, sex, smoking status, and presence of risky drinking behavior and hypertension (P=0.647).CONCLUSION: The presence of thyroid nodules on US in healthy adults was not associated with abnormal TFT results. Serum TSH check-ups during the evaluation of thyroid nodules discovered through US in asymptomatic individuals living in areas with a low prevalence of autonomous functioning thyroid nodules might not be necessary from the perspective of cost-effectiveness and subject convenience.
Adult ; Biopsy, Fine-Needle ; Drinking Behavior ; Humans ; Hypertension ; Korea ; Logistic Models ; Male ; Mass Screening ; Prevalence ; Retrospective Studies ; Smoke ; Smoking ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyrotropin ; Thyroxine ; Ultrasonography

BACKGROUND: We evaluated the timing and route of arrival of patients with cancer referred to a hospital near their residence for end-of-life care.METHODS: The medical records of patients with cancer receiving palliative systemic treatment at other hospitals who were transferred to our hospital for terminal care were reviewed retrospectively.RESULTS: Records of 60 patients (mean age, 57.4 years) were reviewed. The median survival after transfer was 40 days; 56.3% and 43.3% of the patients were referred to the outpatient and emergency departments of our hospital, respectively. Only 45% of the patients were enrolled in the hospice palliative care system. The most common reason for not enrolling was rejection of the patients or their families for hospice palliative care.CONCLUSION: For end-of-life care, the time from the referral to death was short, and many patients were transferred to the emergency department of our hospital.
Emergency Service, Hospital ; Hospices ; Humans ; Medical Records ; Outpatients ; Palliative Care ; Referral and Consultation ; Retrospective Studies ; Terminal Care

BACKGROUND: Bioelectrical impedance analysis (BIA) can be used to estimate body composition. To achieve the best results, the manufacturer's guidelines advise that individuals should restrict intake of food or caffeine, avoid vigorous exercise for 4 hours, and drink 2–4 glasses of water 2 hours before testing. We evaluated the appropriacy of drinking 2–4 glasses of water 2 hours before the BIA, as the validity of this indication has not been specifically demonstrated, by comparing intracellular water (ICW), extracellular water (ECW), total body water (TBW) in the fasting state, and after 1 and 2 hours of ingesting 500 mL of water.METHODS: Twenty-nine healthy adult men (n=10) and women (n=19) were recruited for the study. In the fasting state, the InBody 720 analyzer was used as multi-frequency (MF)-BIA and the output was recorded to determine the exact weight. Subsequently, Medinex BIA 450 analyzer was used as single-frequency (SF)-BIA, and the output was recorded. After drinking 500 mL of water 1 or 2 hours before assessment, the BIA tests were repeated as indicated above, and the ICW, ECW, TBW were compared by repeated measures ANOVA.RESULTS: SF-BIA measurements showed that compared to fasting state, the ICW decreased by approximately 0.56 L after 1 hour of drinking (P=0.001). The ECW was increased by about 0.62 L, 1 hour after drinking water compared to the fasting state (P=0.002). There were no significant differences between the results of BIA testing at 1 and 2 hours of fluid intake. The MF-BIA measurements indicated that testing after fasting, or 1 or 2 hours after fluid intake, did not result in significantly different ICW and ECW values. TBW showed no significant differences in the fasting state, or after 1 or 2 hours of fluid intake for both SF and MF.CONCLUSION: Several studies have shown that bioelectrical impedance should be measured in the fasting state. But not the food intake, drinking 500 mL of water may be permitted when measuring MF-BIA. However, for SF-BIA measurements, fluid intake resulted in an increase in the ECW level and a decrease in ICW.
Adult ; Body Composition ; Body Water ; Caffeine ; Drinking ; Drinking Water ; Eating ; Electric Impedance ; Eyeglasses ; Fasting ; Female ; Glass ; Humans ; Male ; Water

BACKGROUND: Calcium plays an important role in the metabolism of essential nutrients in the human body; recently, it became one of the significant causes of various metabolic disorders including hypertension, obesity, diabetes mellitus, and dyslipidemia. However, data regarding the association between calcium and metabolic disorders in Koreans are limited. The present study aimed to assess the association between serum calcium and elevated blood pressure, overweight, and obesity in Koreans.METHODS: A total of 719 Korean adults who visited the outpatient department of a university hospital were included in this study. The association between serum calcium and obesity and elevated blood pressure in men and women was evaluated separately using multiple regression analysis. Odds ratio was calculated to determine the association between serum calcium levels and overweight, obesity, and elevated blood pressure in men and women.RESULTS: Multiple regression analysis showed that body mass index was significantly increased in men with higher serum calcium levels (β=0.156, P=0.043). In men, the odds ratio for obesity and elevated blood pressure by serum calcium level were 2.04 (95% confidence interval [CI]: 1.02–4.06) and 2.26 (95% CI: 1.09–4.69), respectively. In women, the odds ratio for elevated blood pressure by serum calcium level was 1.86 (95% CI: 1.03–3.34).CONCLUSION: In this study, there was a significant positive association between serum calcium level and obesity and elevated blood pressure in men. In women, there was a significant positive association between serum calcium level and elevated blood pressure.
Adult ; Blood Pressure ; Body Mass Index ; Calcium ; Diabetes Mellitus ; Dyslipidemias ; Female ; Human Body ; Humans ; Hypertension ; Male ; Metabolism ; Obesity ; Odds Ratio ; Outpatients ; Overweight

BACKGROUND: Serum uric acid (UA) has been found to be associated with hypertension, obesity, dyslipidemia, and metabolic syndrome; however, its role as an independent risk factor of cardiovascular disease (CVD) is still controversial. There have been very few studies reporting an association between UA levels and carotid intima-media thickness (CIMT), especially in women.METHODS: The study included 245 subjects whose CIMT was evaluated between February 2016 and December 2017 at a health promotion center. We divided the population into two groups on the basis of menopausal status: premenopausal women (n=78) and postmenopausal women (n=167). We measured blood pressure, serum lipid profile, fasting blood glucose (FBG), and creatinine and UA levels. CIMT was measured using high-resolution B-mode ultrasonography.RESULTS: UA levels and CIMT were higher in postmenopausal women (P=0.029, P < 0.001). In premenopausal women, age (r=0.438), body mass index (r=0.373), UA (r=0.205), and FBG (r=0.336) were associated with CIMT, whereas in postmenopausal women, age (r=0.326), body mass index (r=0.167), UA (r=0.166), systolic blood pressure (r=0.200), and HDL-cholesterol (r=−0.140) were associated with CIMT. The UA level was independently associated with CIMT in premenopausal women (β=0.208, P=0.031), whereas age was the only factor independently associated with CIMT in postmenopausal women (β=0.253, P=0.002). Women in the highest tertile of uric acid level exhibited a higher CIMT than did those in the lowest tertile after age adjustment (P for trend < 0.001).CONCLUSION: UA may be an independent risk factor for CIMT, suggesting that UA is a risk factor for the early detection of CVD, especially in premenopausal women.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Creatinine ; Dyslipidemias ; Fasting ; Female ; Health Promotion ; Humans ; Hypertension ; Menopause ; Obesity ; Risk Factors ; Ultrasonography ; Uric Acid

BACKGROUND: It is unclear whether impaired pulmonary function serves as a risk factor for decreased renal function. This study investigated the association between the forced vital capacity (FVC) and chronic kidney disease (CKD) in middle-aged and elderly men.METHODS: We investigated the association between FVC and CKD in 412 Korean men aged ≥50 years, without diabetes, who have not received treatment for chronic lung disease. CKD was defined based on evidence of renal tissue damage or reduced renal function indicated by estimated glomerular filtration rate < 60 mL/min/1.73 m² or proteinuria level ≥1+. We assessed the association between FVC and CKD using multivariate logistic regression analysis after adjusting for confounders.RESULTS: The overall prevalence of CKD was 29.2% in the study population. Multivariate logistic regression analysis showed that the odds ratio with a 95% confidence interval for CKD was 0.96 (0.92–0.99) with a 1% increment in FVC after adjusting for age, body mass index, smoking status, alcohol intake, regular exercise, systolic and diastolic blood pressures, fasting plasma glucose, triglyceride, and high-density lipoprotein-cholesterol levels, as well as antihypertensive and antidyslipidemic medications.CONCLUSION: We observed that FVC was independently and inversely associated with CKD. This finding suggests that careful monitoring of renal function is necessary to evaluate possible kidney dysfunction in patients with decreased FVC.
Aged ; Blood Glucose ; Body Mass Index ; Fasting ; Glomerular Filtration Rate ; Humans ; Kidney ; Logistic Models ; Lung Diseases ; Male ; Odds Ratio ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic ; Respiratory Function Tests ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Vital Capacity

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is known to be related to various factors. The aim of this study was to evaluate the association between the risk of ASCVD and sleep duration or carbohydrate intake using the Pooled Cohort Risk Assessment equations, which estimate a patient's 10-year primary risk.METHODS: A total of 7,781 adults were selected from the 6th Korean National Health and Nutrition Examination Survey, with no missing data as the inclusion criteria for analysis. The 10-year estimated risk of ASCVD risk was calculated using the Pooled Cohort Risk Assessment Equations. The χ² test was used to analyze the difference in the rates of ASCVD high-risk groups due to sleep duration and carbohydrate intake. Multiple logistic regression analysis was performed to verify the effects of sleep duration and carbohydrate intake on ASCVD risk.RESULTS: Shorter sleep duration (≤5 hours) was 1.166-times more likely in the ASCVD high-risk group than was optimal sleep duration (6–8 hours) (odds ratio [OR], 1.166; P < 0.05). Excessive sleep duration (≥9 hours) was also 1.504-times more likely in the ASCVD high-risk group than was optimal sleep duration (OR, 1.504; P < 0.001). Excessive carbohydrate intake (>65%) was 1.185-times more likely in the ASCVD high-risk group than was recommended carbohydrate intake (55%–65%) (OR, 1.185; P < 0.05).CONCLUSION: Inappropriate sleep duration and excessive carbohydrate intake increase the risk of ASCVD.
Adult ; Cardiovascular Diseases ; Cohort Studies ; Dietary Carbohydrates ; Humans ; Logistic Models ; Nutrition Surveys ; Retrospective Studies ; Risk Assessment

BACKGROUND: Osteoporosis is a systemic skeletal disease characterized by reduced bone mineral density and skeletal microstructural abnormalities. We investigated the correlation between serum uric acid (SUA) levels and bone mineral content (BMC) values as a surrogate marker of bone health. Additionally, we assessed whether the correlation, if any, was evident even after classifying the study population into two groups based on a diagnosis of obesity in these individuals.METHODS: This study included 936 women who visited the healthcare centers that participated in this study. Fasting blood samples were obtained from all women to measure SUA, BMC of the lumbar spine was measured using dual-energy X-ray absorptiometry. We evaluated the correlation between SUA and BMC in obese and non-obese groups.RESULTS: SUA concentration and BMC were positively correlated (β=0.257, P=0.001); however, this correlation was significant only in the obese group (β=0.203, P=0.001).CONCLUSION: SUA concentration and BMC are positively correlated in women diagnosed obesity.
Absorptiometry, Photon ; Biomarkers ; Body Mass Index ; Bone Density ; Delivery of Health Care ; Diagnosis ; Fasting ; Female ; Humans ; Obesity ; Osteoporosis ; Spine ; Uric Acid

BACKGROUND: Previous studies have reported that fasting insulin and blood glucose levels are higher in postmenopausal than in premenopausal women and that insulin resistance was more serious in postmenopausal women. The effects of menopause on glucose metabolism have been well studied, but it is unclear whether age at menopause onset is associated with fasting blood sugar and HbA1c levels. The purpose of this study is to determine the effect of menopause age on diabetes and prediabetes.METHODS: We retrospectively analyzed data from the Sixth Korea National Health and Nutrition Examination Survey (2013–2015). The participants were 2,156 naturally menopausal women, except diabetes, stroke, coronary artery disease and cancer patients. The study population was divided into four groups according to the age of natural menopause onset ( < 40, 40–44, 45–55, and ≥56 years). Diagnosis of diabetes and prediabetes was based on the American Diabetes Association guideline. The association between menopause age and diabetes or prediabetes was analyzed by multiple logistic regression.RESULTS: Women reaching menopause at 40–44 years were 4.901 times more likely to have diabetes (odds ratio [OR], 4.901; 95% confidence interval [95% CI], 1.353–17.756, P=0.016) than those who reached menopause at an age of ≥56 years. Women with menopause at age < 40 years were 2.839 times more likely to have diabetes or prediabetes (OR, 2.839; 95% CI, 1.012–7.968, P=0.047).CONCLUSION: Women with premature menopause (< 40 years) have high risk of developing diabetes or prediabetes, and women with a menopause age of 40–44 years have high risk of developing diabetes.
Blood Glucose ; Coronary Artery Disease ; Diabetes Mellitus ; Diagnosis ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Metabolism ; Nutrition Surveys ; Prediabetic State ; Retrospective Studies ; Stroke

BACKGROUND: Eating breakfast is important for optimal growth and development in adolescence, and is associated with academic achievement as well as nutrition and health status. This study aimed to investigate the relationship between breakfast consumption frequency and high school students' academic achievement.METHODS: We used data from the 2017 Korea Youth's Risk Behavior Web-Based Study, conducted by the Korean Center for Disease Control (64,991 students). The relationship between academic achievement and breakfast consumption frequency was examined using logistic regression.RESULTS: Students who consumed breakfast frequently exhibited higher academic achievement as compared to their counterparts. There was a significant correlation between awareness of appropriate eating habits and breakfast consumption frequency. Further, students who had not received any education about eating habits exhibited low academic achievement.CONCLUSION: To improve the academic achievement of students, they should be motivated to eat breakfast every day. Additionally, appropriate education about eating habits need to be implemented at schools and at home to increase students' breakfast consumption frequency.
Adolescent ; Breakfast ; Centers for Disease Control and Prevention (U.S.) ; Eating ; Education ; Feeding Behavior ; Growth and Development ; Humans ; Korea ; Logistic Models ; Risk-Taking