BACKGROUNDS: The Third Report of the Adult Treatment Panel (NCEP-ATP III) has newly introduced the clinical diagnosis guideline of the metabolic syndrome which is characterized by clustering of the CHD risk factors. The purpose of this study was to estimate the prevalence of the metabolic syndrome in Korean adults by the newly introduced guideline and to evaluate possible risk factors with the syndrome. METHODS: The subject of this study included 3,873 adults (males 2,144, females 1,729) aged 20 years or older who visited the Health Promotion Center of SNUH. Among the subjects, we excluded those who did not have records of physical parameters, blood test results and who were on current medications except antihypertensives and oral hypoglycemic agents. We estimated the prevalence of the metabolic syndrome in Korean adults according to the ATP III waist-circumference guideline, Asia-Pacific waist- circumference, and Body Mass Index (BMI), respectively, and calculated the age-adjusted prevalence of the metabolic syndrome using the direct standardized method. While applying the Asia-Pacific waist circumference, we estimated the prevalence of the metabolic syndrome by age group and the prevalence of the individual abnormalities of the metabolic syndrome. To identify variables associated with the metabolic syndrome, we used the multiple logistic regression method to estimate the prevalence odds ratios for the metabolic syndrome vs. the non-metabolic syndrome. RESULTS: The age-adjusted prevalence of the metabolic syndrome in Korean adults was 9.3% when ATP III waist-circumference was applied, 15.4% for Asia-Pacific waist-circumference, and 18.6% for body mass index (BMI). The highest prevalence of the individual criteria among the metabolic syndrome diagnostic criteria in men was hypertension, followed by hypertriglyceridemia, abdominal obesity, high fasting blood glucose, and low HDL-cholesterolemia. And in women, it was also hypertension, followed by abdominal obesity, low HDL- cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. The prevalence increased from 3.8% among participants aged 20 through 29 years to 27.1% for ages 60 through 69 years and 31.6% for ages above 70 years. Females, increasing age, increased BMI, current smoking, physical inactivity were higher risk factors for the metabolic syndrome, but mild drinking was a lower risk factor for the metabolic syndrome. CONCLUSION: These results show that the metabolic syndrome is highly prevalent although less prevalent than in American adults. The family physician should focus on the screening and comprehensive management of the metabolic syndrome.
Adenosine Triphosphate ; Adult ; Antihypertensive Agents ; Blood Glucose ; Body Mass Index ; Diagnosis ; Drinking ; Fasting ; Female ; Health Promotion ; Hematologic Tests ; Humans ; Hypertension ; Hypertriglyceridemia ; Hypoglycemic Agents ; Logistic Models ; Male ; Mass Screening ; Obesity, Abdominal ; Odds Ratio ; Physicians, Family ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Waist Circumference

This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P < 0.001). The additional consultation led to improvements in the stage of health behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program.
Adult ; Aged ; *Counseling ; Demography ; Female ; *Health Behavior ; Health Promotion ; Humans ; Male ; Odds Ratio

We found two errors, title and author affiliation in our published article.

BACKGROUND: This study was done to determine whether the Osteoporosis Self-assessment Tool (OST) can predict central bone mineral density in Korean men above 50 years, as defined by dual energy X-ray absorptionmetry (DXA). METHODS: We applied the OST index to Korean men aged over 50 in Health Promotion Center of Konkuk University Hospital from September 2005 to September 2008. The calculated OST risk index was based on weight and age, truncated to an integer. RESULTS: The study population was 276 men. The mean age, height and weight of the men were 59.7 +/- 6.69 years, 167.6 +/- 6.14 cm and 67.5 +/- 8.93 kg respectively. By DXA, 4.7% of the men had a T score of -2.5 or less, and 46.4% had a T score of -2 or less at the spine, total hip, or femoral neck. The OST index ranged from -4 to 7. Using a cutoff score of 0, we predicted osteoporosis with a sensitivity of 85% and a specificity of 62%. The receiver operating characteristic curve showed an area under the curve of 0.77. When the subjects were analyzed by age and smoking status, the predictive value of the OST was maintained. CONCLUSION: The OST is a simple and useful method to predict osteoporosis in Korean men.
Aged ; Bone Density ; Femur Neck ; Health Promotion ; Hip ; Humans ; Male ; Mass Screening ; Osteoporosis ; ROC Curve ; Self-Assessment ; Sensitivity and Specificity ; Smoke ; Smoking ; Spine

BACKGROUND: Hearing impaired people have a lot of difficulty in communicating when they visit medical institutions. This study was to reveal the family physicians' perception and attitude for the hearing impaired people, and the effect of those factors on the actual physicians' practice behavior for the disabled. METHODS: We sent questionnaires by post mail to 1,000 members listed in the 2007 address book of the Korean Association of Family Medicine. RESULTS: Among the total of 90 family physicians who had answered, 72 (80.8%) had willing attitude to treat the hearing impaired people, and the most important reason was that it was essentially a doctor's duty. In the group who were unwilling to treat the disabled, the most principal reason was that they were not equipped with sufficient facility and medical system. Gender was the only factor affecting the physicians' attitude significantly and the female doctors had a higher intention to treat the hearing impaired people than male doctors (P=0.035). Age, location of hospital, number of patients, practical experience of hearing impaired people had no significant effect on doctors' attitude. The number of physicians who volunteered to participate for the hearing impaired people's health promotion personally was significantly higher in the group of treatment intention (P=0.007). Nevertheless, few physicians had the willingness to equip the hospital facility for the hearing disabled, even in the group of willingness to treat the disabled. The most important reason was that very few disabled patients visit their clinic, and so forth they felt no necessity to improve and re-organize their clinical environment. CONCLUSION: Most family physicians are willing to treat hearing impaired people. But even in the willing group, almost all of them are unwilling to improve or equip the medical facilities for the hearing impaired people personally, because only a few disabled people visit the primary care hospital in the real practice.
Female ; Health Promotion ; Hearing ; Humans ; Intention ; Male ; Physicians, Family ; Postal Service ; Primary Health Care ; Surveys and Questionnaires

BACKGROUND: Metabolic syndrome has been introduced to increase the incidence of cardiovascular diseases and type 2 diabetes mellitus. Our aim of this study was to investigate the association of fasting plasma glucose levels and metabolic syndrome in normoglycemic adults. METHODS: We examined lifestyle factors, anthropometric and laboratory measurement of adults with no personal history of diabetes and normal fasting glucose from the Korean National Health and Nutrition Examination Survey 2001. We categorized the fasting plasma glucose levels below 100 mg/dl into the quintiles and assessed the association of metabolic syndrome with increasing glycemia in normoglycemic adults. RESULTS: Quintiles of normal fasting plasma glucose levels showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, and obesity in normoglycemic adults (P<0.001). Hypertriglyceridemia, low HDL-cholesterolemia, smoking, heavy drinking, and physical activity were of no significance. A multivariate model, adjusted for age, sex, smoking status, physical activity, and heavy drinking, revealed a progressively increased odds ratio of metabolic syndrome, 1.05 (95% CI, 0.76~1.44), 1.15 (95% CI, 0.84~1.58), 1.33 (95% CI, 0.99~1.80), 1.55 (95% CI, 1.14~2.10), with increasing fasting plasma glucose levels, as compared with fasting plasma glucose level of 81 mg/dl or less (P<0.001). CONCLUSION: Higher fasting plasma glucose levels within the normoglycemic range may constitute a risk of metabolic syndrome in normoglycemic adults.
Adult ; Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Drinking ; Fasting ; Glucose ; Humans ; Hypertension ; Hypertriglyceridemia ; Incidence ; Life Style ; Motor Activity ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Odds Ratio ; Plasma ; Risk Factors ; Smoke ; Smoking

BACKGROUND: In these days the metabolic syndrome threatens many people of Korea. Several studies have suggested that the dietary habits are associated with the risk of the metabolic syndrome. The purpose of this study was to find out relations between the components of the metabolic syndrome and the dietary habits. METHODS: The subjects of this study included 1,005 non-smoking premenopausal females aged from 20 to 49 years old who visited the health promotion center of a university hospital. Dietary questionnaire was composed of dietary habits and specific food intake frequency during the past 3 months. RESULTS: The subjects who had more than one metabolic components were 361 (36%), and those who had the metabolic syndrome was 35 (3.5%). After multivariate logistic analysis adjusted with age, BMI, smoking status, alcohol intake, and exercise, the abdominal obesity risk was significantly increased in those who had irregular meals (P for trend= 0.049), skip meals (P for trend=0.050), faster meal time (P=0.017), and intake of saturated fat more frequently (P=0.043). The abdominal obesity risk was significantly increased in those who overate or binged eating 7gt; or =3 times/week than <1 time/week {OR (95% CI), 2.49 (1.07~5.80)}, intake fruit <1 time/week than 6~7 times/week {OR (95% CI), 4.46 (1.20~16.54)}. A risk for high blood pressure was significantly increased in those who had breakfast 1~2 times/week than those had it 6~7 times/week {OR (95% CI), 1.91 (1.07~3.42)}. The risk for impaired fasting glucose was significantly increased in those had breakfast <1 time/week than those who had 6~7 times/week {OR (95% CI), 2.27 (1.20~4.28), P for trend=0.018}. CONCLUSION: There was a correlation between dietary habits and metabolic syndrome components. Among the dietary habits, irregular meals, skipping breakfast, skipping meals, fast meal time, overeating or binge eating tendency, low intake of fruits and high intake of saturated fat were associated with the risk of the metabolic syndrome components.
Aged ; Breakfast ; Bulimia ; Eating ; Fasting ; Female ; Food Habits ; Fruit ; Glucose ; Health Promotion ; Humans ; Hyperphagia ; Hypertension ; Korea ; Meals ; Obesity, Abdominal ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: In the busy primary care setting, there are several limitations in applying Alcohol Use Disorders Identification Test in Korea (AUDIT-K) to screen problem drinking. Thus, for primary healthcare practice, we evaluated AUDIT-C, which covers questions from 1 to 3 in AUDIT-K, and AUDIT-K Question 3 Alone to present cut points for these two screening questionnaire according to AUDIT-K test scores. METHODS: In a university hospital, we surveyed 302 males with a drinking history via self-administered questionnaire including AUDIT-K, from November 2007 to April 2008. On the basis of total score in AUDIT-K, we divided them into four groups: normal, problem drinking, alcohol use disorder, and alcohol dependence. For each alcohol drinking behavior pattern, we drew the receiver operating characteristics (ROC) curves to present cut points for appropriate sensitivity and specificity. In addition, we compared the performance of AUDIT-C and AUDIT-K Question 3 Alone through area under the curve (AUC). RESULTS: For AUDIT-C, we designated the score 8 or more as problem drinking, 9 or more as alcohol use disorder, and 11 or more as dependence. The results of sensitivity/specificity for each group were 82%/76%, 76%/79%, 80%/86%, respectively, which were suitable for screening. For AUDIT-K Question 3 Alone, we defined the score 3 or more as problem drinking or alcohol use disorder and the score 4 as dependence. The results of sensitivity/specificity for each group were 79%/80%, 84%/67%, 85%/77%, which were appropriate for screening. For every drinking behavior group, AUDIT-C was superior to AUDIT-K Question 3 Alone in screening performance (problem drinking: 0.88 vs. respectively 0.85, alcohol use disorder: 0.86 vs. 0.82, alcohol dependence: 0.88 vs. 0.81) CONCLUSION: We confirmed that both AUDIT-C and AUDIT-K Question 3 Alone, which are more convenient and have fewer time con-straints than AUDIT-K, are reasonable screening methods for problem drinking. Thus, we recommend further drinking assessment and proper intervention for male drinkers who have scores 8 or more in AUDIT-C or 3 or more in AUDIT-K Question 3 Alone.
Alcohol Drinking ; Alcoholism ; Drinking ; Drinking Behavior ; Humans ; Korea ; Male ; Mass Screening ; Primary Health Care ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Overactive bladder syndrome (OAB) is a common disorder in primary care that affects negatively on the quality of life of outpatients. However, little information is available on related factors and the quality of life in adults with overactive bladder. The purpose of this study was to find related factors of overactive bladder and to measure the quality of life in adults with overactive bladder. METHODS: Among the people who visited a hospital in Seoul and Chung-ju for a health examination or primary care between October 1 and December 31, 2008, we selected 327 participants over 20 years old. We measured their Overactive Bladder Questionnaire (OAB-q), took medical history and reviewed their demographic data. The relationship between OAB, other independent variables and health related quality of life (HRQL) were analyzed. RESULTS: Of 327 respondents, the prevalence of OAB in adults was 38 (11.6%). The factors related to OAB were age (P = 0.007), history of prescription for congestive heart failure (P = 0.023), benign prostatic hyperplasia (BPH) (P = 0.002), and depression (P = 0.008). OAB was significantly associated with BPH medication (P = 0.042; OR = 8.757) and depression medication (P = 0.005; OR = 9.977) in multivariable logistic regression analysis. In each T-test analysis, OAB decreased in HRQL. CONCLUSION: OAB is a common disorder in adults, history of BPH medication and depression medication is more common in OAB. The symptoms that were suggestive of OAB were affected negatively on the quality of life in adults. Effective health care polices and prompt management of OAB should be implemented.
Adult ; Surveys and Questionnaires ; Delivery of Health Care ; Depression ; Heart Failure ; Humans ; Logistic Models ; Outpatients ; Prescriptions ; Prevalence ; Primary Health Care ; Prostatic Hyperplasia ; Quality of Life ; Urinary Bladder, Overactive

BACKGROUND: Diabetic neuropathy is a common complication of diabetes. Since neuropathy leads to ulceration and amputation, efforts to detect early and to elucidate its risk factors are ongoing. The goal of this study was to check the validity of Michigan neuropathy screening instrument (MNSI) as a screening test and its risk factors for diabetic neuropathy. METHODS: A total of 75 subjects with type II diabetes mellitus, who visited a university hospital, were investigated. We measured their duration of diabetes, height, weight, systolic blood pressure, diastolic blood pressure, fasting glucose, glycosylated hemoglobin, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, serum creatinine, and 24-h urine albumin. MNSI tested and electrophysiological test were performed. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of MNSI was 63.5%, 78.3%, 86.8%, and 48.6%, respectively. Statistically significant relationships were found between neuropathy and the duration of diabetes and total cholesterol. CONCLUSION: MNSI seemed to be an appropriate screening test for diabetic neuropathy. More attention must be paid to the duration of diabetes and the total cholesterol of type 2 diabetic patients with peripheral neuropathy.
Amputation ; Blood Pressure ; Cholesterol ; Creatinine ; Diabetes Mellitus ; Diabetic Neuropathies ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Lipoproteins ; Mass Screening* ; Michigan* ; Peripheral Nervous System Diseases* ; Risk Factors* ; Sensitivity and Specificity ; Triglycerides ; Ulcer