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Hyeon Young KO ; Jung Kwon LEE ; Jin Young SHIN ; Euni JO

Korean Journal of Family Medicine.2015;36(6):349-356. doi:10.4082/kjfm.2015.36.6.349

BACKGROUND: Health-related quality of life (HRQoL) is considered an important outcome measure in chronic diseases, in particular cardiovascular disease (CVD), which is known to be associated with impaired HRQoL. However, few studies have examined HRQoL in individuals at high risk of CVD. METHODS: Using the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, we analyzed data from 10,307 adults aged > or =30 years. The study subjects were stratified into 3 groups on the basis of their Framingham risk score-a 10-year estimate of CVD risk: <10.0% (low risk), 10.0%-19.9% (moderate risk), and > or =20.0% (high risk). The EuroQol-5D (EQ-5D) was used to evaluate HRQoL. RESULTS: A significantly higher proportion of high-risk subjects than low-risk participants had impaired HRQoL (defined as the lowest quartile of the EQ-5D index); this held true even after adjustment for confounding factors in multivariable logistic regression analysis (men: odds ratio [OR], 1.62; 95% confidence interval [CI], 1.24-2.11; women: OR, 1.46; 95% CI, 1.02-2.08). In terms of the 5 EQ-5D dimensions, a 10-year CVD risk > or =20.0% was significantly associated with self-reported problems of mobility in men (OR, 3.15; 95% CI, 2.02-4.90), and of mobility (OR, 1.56; 95% CI, 1.09-2.24), self-care (OR, 2.14; 95% CI, 1.09-4.22), and usual activity problems (OR, 1.80; 95% CI, 1.17-2.78) in women. CONCLUSION: A high CVD risk is associated with impaired HRQoL. After adjustment for demographic and clinical factors, a 10-year CVD risk > or =20.0% is an independent predictor of impaired HRQoL in the general population; in particular, of mobility problems in men, and of mobility, self-care, and usual activity problems in women.
Adult* ; Cardiovascular Diseases* ; Chronic Disease ; Female ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Odds Ratio ; Outcome Assessment (Health Care) ; Quality of Life* ; Risk Assessment ; Self Care

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Association between Parity and Blood Pressure in Korean Women: Korean National Health and Nutrition Examination Survey, 2010-2012.

Miae JANG ; Yeonji LEE ; Jiho CHOI ; Beomseok KIM ; Jayeon KANG ; Yongchae KIM ; Sewook CHO

Korean Journal of Family Medicine.2015;36(6):341-348. doi:10.4082/kjfm.2015.36.6.341

BACKGROUND: Pregnancy considerably alters cardiovascular dynamics, and thereby affects the transition of blood pressure after delivery in women. We aimed to analyze the association between parity and blood pressure in Korean adult women. METHODS: We included 8,890 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We divided the population according to the menopause status and analyzed the association between parity and blood pressure by using multiple regression analysis, and on hypertension, by using logistic regression analysis. RESULTS: Systolic and diastolic blood pressures were significantly associated with parity in premenopausal women (beta=-0.091 [P<0.001] and beta=-0.069 [P<0.001], respectively). In the analysis that excluded women receiving antihypertensive medication, the systolic and diastolic blood pressure of postmenopausal women were significantly associated with parity (beta=-0.059 [P=0.022] and beta=-0.054 [P=0.044], respectively). Parity was found to prevent hypertension after adjustment for confounders in postmenopausal women (odds ratio, 0.55; 95% confidence interval, 0.310-0.985). CONCLUSION: We found that parity prevented hypertension in Korean women.
Adult ; Blood Pressure* ; Female ; Humans ; Hypertension ; Logistic Models ; Menopause ; Nutrition Surveys* ; Parity* ; Pregnancy

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The Correlation between the Triglyceride to High Density Lipoprotein Cholesterol Ratio and Computed Tomography-Measured Visceral Fat and Cardiovascular Disease Risk Factors in Local Adult Male Subjects.

Hye Rin PARK ; Sae Ron SHIN ; A Lum HAN ; Yong Joon JEONG

Korean Journal of Family Medicine.2015;36(6):335-340. doi:10.4082/kjfm.2015.36.6.335

BACKGROUND: We studied the association between the triglyceride to high-density lipoprotein cholesterol ratio and computed tomography-measured visceral fat as well as cardiovascular risk factors among Korean male adults. METHODS: We measured triglycerides, high density lipoprotein cholesterol, body mass, waist circumference, fasting plasma glucose, hemoglobin A1c, systolic blood pressure, diastolic blood pressure, visceral fat, and subcutaneous fat among 372 Korean men. The visceral fat and subcutaneous fat areas were measured by computed tomography using a single computed tomography slice at the L4-5 lumbar level. We analyzed the association between the triglyceride to high density lipoprotein cholesterol ratio and visceral fat as well as cardiovascular risk factors. RESULTS: A positive correlation was found between the triglyceride to high density lipoprotein cholesterol ratio and variables such as body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, visceral fat, and the visceral-subcutaneous fat ratio. However, there was no significant correlation between the triglyceride to high density lipoprotein cholesterol ratio and subcutaneous fat or blood pressure. Multiple logistic regression analyses revealed significant associations between a triglyceride to high density lipoprotein cholesterol ratio > or =3 and diabetes, a body mass index > or =25 kg/m2, a waist circumference > or =90 cm, and a visceral fat area > or =100 cm2. The triglyceride to high density lipoprotein cholesterol ratio was not significantly associated with hypertension. CONCLUSION: There were significant associations between the triglyceride to high density lipoprotein cholesterol ratio and body mass, waist circumference, diabetes, and visceral fat among a clinical sample of Korean men. In the clinical setting, the triglyceride to high density lipoprotein cholesterol ratio may be a simple and useful indicator for visceral obesity and cardiovascular disease.
Adult* ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Cholesterol, HDL* ; Fasting ; Humans ; Hypertension ; Intra-Abdominal Fat* ; Lipoproteins ; Logistic Models ; Male* ; Obesity, Abdominal ; Risk Factors* ; Subcutaneous Fat ; Triglycerides* ; Waist Circumference

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Factors Associated with Fatigue in Korean Gastric Cancer Survivors.

Wan PARK ; Jung Kwon LEE ; Cho Rong KIM ; Jin Young SHIN

Korean Journal of Family Medicine.2015;36(6):328-334. doi:10.4082/kjfm.2015.36.6.328

BACKGROUND: Gastric cancer is the second most common cancer in Korea. Fatigue is a common symptom among cancer survivors. The aim of this study was to identify factors associated with fatigue in gastric cancer survivors. METHODS: Data were analyzed from 199 gastric cancer survivors who visited a cancer survivor outpatient clinic from July 2013 to June 2014. Patients were surveyed using a questionnaire containing a fatigue severity scale (FSS) and questions regarding associated symptoms. Participants were divided into fatigue (FSS) and non-fatigue groups based on FSS scores (> or =4 and <4, respectively). Age, sex, weight, body mass index, cancer stage, pathology, surgery type, chemotherapy, radiotherapy, comorbid disease, family history of cancer, smoking, alcohol consumption, exercise, and laboratory results were investigated. RESULTS: The fatigue and non-fatigue groups contained 42 and 157 survivors, respectively. Their mean age was 58 years, and the mean post-operative period was 6.58 years. Arthralgia (odds ratio [OR], 12.95; 95% confidence interval [CI], 3.21-52.34), dyspnea (OR, 10.54; 95% CI, 2.94-37.80), dyspepsia (OR, 8.26; 95% CI, 2.63-25.96), changed bowel habits (OR, 4.56; 95% CI, 1.09-19.11), anemia (OR, 3.18; 95% CI, 1.26-8.05), and regular exercise (OR, 0.31; 95% CI, 0.12-0.77) were significantly associated with fatigue in gastric cancer survivors, while weight, treatment, and depressive mood were not. CONCLUSION: Arthralgia, dyspnea, dyspepsia, bowel habit change, anemia, and regular exercise are associated with fatigue in gastric cancer survivors.
Alcohol Drinking ; Ambulatory Care Facilities ; Anemia ; Arthralgia ; Body Weight ; Drug Therapy ; Dyspepsia ; Dyspnea ; Fatigue* ; Humans ; Korea ; Pathology ; Radiotherapy ; Smoke ; Smoking ; Stomach Neoplasms* ; Survivors*

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Correlation of Arterial Stiffness and Bone Mineral Density by Measuring Brachial-Ankle Pulse Wave Velocity in Healthy Korean Women.

Nam Lee KIM ; Heuy Sun SUH

Korean Journal of Family Medicine.2015;36(6):323-327. doi:10.4082/kjfm.2015.36.6.323

BACKGROUND: An association between arterial stiffness and osteoporosis has previously been reported. Therefore, we investigated the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and bone mineral density in a sample of healthy women undergoing routine medical checkup. METHODS: We retrospectively reviewed the medical charts of 135 women who had visited the Health Promotion Center (between May 2009 and December 2012). Brachial-ankle pulse wave velocity was measured using an automatic wave analyzer. Bone mineral density of the lumbar spine (L1-L4) and femur was measured by dual-energy X-ray absorptiometry. Metabolic syndrome was defined according to National Cholesterol Education Program-Adult Treatment Panel III criteria, using body mass index >25 kg/m2 instead of waist circumference >88.9 cm. RESULTS: Pearson's correlation analysis revealed significant inverse relationships between pulse wave velocity and bone mineral density of the lumbar spine (r=-0.335, P<0.001), femur neck (r=-0.335, P<0.001), and total femur (r=-0.181, P=0.04). Pulse wave velocity showed the strongest association with age (r=0.586, P<0.001). Multiple regression analysis identified an independent relationship between pulse wave velocity and lumbar spine bone mineral density in women after adjusting for age, metabolic syndrome, body mass index, smoking status, alcohol intake, and exercise (r=-0.229, P=0.01). CONCLUSION: This study confirmed an association between arterial stiffness and bone mineral density in women.
Absorptiometry, Photon ; Body Mass Index ; Bone Density* ; Cholesterol ; Education ; Female ; Femur ; Femur Neck ; Health Promotion ; Humans ; Osteoporosis ; Pulse Wave Analysis* ; Retrospective Studies ; Smoke ; Smoking ; Spine ; Vascular Stiffness* ; Waist Circumference

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Differences in Factors Associated with Albuminuria according to Gender and Comorbidities of Hypertension and Diabetes.

Miae JANG ; Sohee OH ; Hye Mi NOH ; Sunyoung CHUN ; Hye Young OH ; Kyung Hee PARK ; Yu Jin PAEK ; Hong Ji SONG

Korean Journal of Family Medicine.2015;36(6):316-322. doi:10.4082/kjfm.2015.36.6.316

BACKGROUND: This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM). METHODS: We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables. RESULTS: The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR. CONCLUSION: The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.
Albuminuria* ; Blood Pressure ; Comorbidity* ; Diabetes Mellitus ; Fasting ; Female ; gamma-Glutamyltransferase ; Gender Identity ; Glucose ; Humans ; Hypertension* ; Kidney Failure, Chronic ; Korea ; Linear Models ; Male ; Nutrition Surveys ; Waist Circumference

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Association of 10-Year Atherosclerotic Cardiovascular Disease Risk Score with Carotid Intima-Media Thickness and Plaque.

Dong Goo LEE ; Jee Hye HAN ; Kil Young KWON ; Jung Hwan KIM ; Kun Hee HAN ; Eun Ji LEE

Korean Journal of Family Medicine.2015;36(6):310-315. doi:10.4082/kjfm.2015.36.6.310

BACKGROUND: The aim of this study was to determine the association between carotid intima-media thickness (IMT) and newly developed 10-year atherosclerotic cardiovascular disease (ASCVD) risk score. METHODS: Participants were 201 Korean adults who underwent carotid ultrasonography at the Health Promotion Center of the Eulji General Hospital. We obtained information about medical history and lifestyle, and conducted laboratory tests. Carotid IMT by B-mode ultrasonography was measured. Carotid injury was considered present when the maximum carotid IMT was > or =0.9 mm or when arteriosclerotic plaques were detected. The 10-year ASCVD risk score was calculated using the 2013 American College of Cardiology/American Heart Association guidelines. RESULTS: Men had higher 10-year ASCVD risk score than did women (mean+/-standard deviation: 7.15+/-6.04 vs. 2.53+/-3.67, respectively; P<0.001). Ten-year ASCVD risk was significantly correlated with right maximum carotid IMT (r=0.307), left maximum carotid IMT (r=0.230), right mean carotid IMT (r=0.322), and left mean carotid IMT (r=0.264). The group with high 10-year ASCVD risk were at even higher risk of carotid injury than were the group with low 10-year ASCVD risk (odds ratio, 2.201; 95% confidence interval, 1.162-4.1706; P=0.019). Only 10-year ASCVD risk score was significantly associated with carotid injury (odds ratio, 4.104; 95% confidence interval, 1.570-10.729). Variables that were not included in the 10-year ASCVD risk score were not significantly associated with carotid injury. CONCLUSION: The findings of this study suggest that 10-year ASCVD risk score is associated with carotid injury.
Adult ; Atherosclerosis ; Cardiovascular Diseases* ; Carotid Intima-Media Thickness* ; Carotid Stenosis ; Female ; Health Promotion ; Heart ; Hospitals, General ; Humans ; Life Style ; Male ; Ultrasonography

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The Association between Stress Level in Daily Life and Age at Natural Menopause in Korean Women: Outcomes of the Korean National Health and Nutrition Examination Survey in 2010-2012.

Byoung O CHOI ; Yeon Ji LEE ; Ji Ho CHOI ; Se Wook CHO ; Hyun Jung IM ; Jee Eun AN

Korean Journal of Family Medicine.2015;36(6):305-309. doi:10.4082/kjfm.2015.36.6.305

BACKGROUND: Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women. METHODS: Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (beta) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM. RESULTS: Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17+/-3.7 and 50.58+/-3.5 years, respectively), with a statistically significant correlation (P<0.05). This correlation was still observed after adjusting for age, body mass index, menstrual regularity, and personal income (P<0.05 for variables). CONCLUSION: In Korean women between 40 and 70 years of age who are in natural menopause, there is a statistically significant correlation between stress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
Body Mass Index ; Female ; Humans ; Menopause* ; Mental Health ; Nutrition Surveys* ; Risk Factors

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Fast Eating Speed Increases the Risk of Endoscopic Erosive Gastritis in Korean Adults.

Min Kyung KIM ; Byung Joon KO ; E Yeon KIM ; Byoung Duck HAN ; Kyung Hwan CHO

Korean Journal of Family Medicine.2015;36(6):300-304. doi:10.4082/kjfm.2015.36.6.300

BACKGROUND: Fast eating or overeating can induce gastrointestinal diseases such as gastritis. However, the association between gastritis and speed of eating is unclear. The aim of this study was to determine whether eating speed is associated with increased risk of endoscopic erosive gastritis (EEG). METHODS: We carried out a cross-sectional study involving 10,893 adults who underwent a general health checkup between 2007 and 2009. Two groups, EEG patients and EEG-free patients, were compared by using the t-test and the chi-square test. Multiple logistic regression analyses were performed to investigate the association between eating speed and EEG. RESULTS: The group with EEG had a higher proportion of males, average age, body mass index, and percentages of current smokers and risky drinkers than those without EEG. After adjusting for anthropometric, social, and endoscopic parameters, the group with the highest eating speed (<5 min/meal) had 1.7 times higher risk for EEG than the group with the lowest eating speed (> or =15 min/meal) (odds ratio, 1.71; 95% confidence interval, 1.20-2.45). CONCLUSION: High eating speed is an independent risk factor for EEG. Our results indicate the need for further studies to clarify the role of eating speed in gastritis.
Adult* ; Body Mass Index ; Cross-Sectional Studies ; Eating* ; Electroencephalography ; Feeding Behavior ; Gastritis* ; Gastrointestinal Diseases ; Helicobacter pylori ; Humans ; Hyperphagia ; Logistic Models ; Male ; Risk Factors

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The Effects of Alcohol on Quality of Sleep.

Soon Yeob PARK ; Mi Kyeong OH ; Bum Soon LEE ; Haa Gyoung KIM ; Won Joon LEE ; Ji Ho LEE ; Jun Tae LIM ; Jin Young KIM

Korean Journal of Family Medicine.2015;36(6):294-299. doi:10.4082/kjfm.2015.36.6.294

BACKGROUND: Alcohol is traditionally known to have a relaxing effect. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia. In this study, we aimed to evaluate the effects of alcohol use on sleep quality. METHODS: A questionnaire-based cross-sectional survey was conducted with 234 men and 159 women who had visited a general hospital. We used structured questionnaires, including Alcohol Use Disorder Identification Test-Korean revised version (AUDIT-KR) and the Pittsburgh Sleep Quality Index-Korean version (PSQI-K). We analyzed the association between scores for all subcategories of the PSQI-K and the AUDIT-KR and then analyzed the correlation between AUDIT-KR and global PSQI-K scores. RESULTS: The global PSQI-K score for men was positively correlated with the AUDIT-KR score (P=0.008) after adjusting for age, chronic disease, tobacco use, exercise, depression, and anxiety. The AUDIT-KR score was significantly associated with subjective sleep quality (P=0.005), sleep duration (P=0.047), and sleep disturbance (P=0.048); it was not associated with sleep latency, sleep efficiency, or daytime dysfunction. Sleep disturbances due to snoring were significantly associated with total AUDIT-KR score (P=0.008). There was no correlation between the global PSQI-K and AUDIT-KR scores for women (P=0.333). However, daytime dysfunction showed a significant association with total AUDIT-KR score (P=0.048). CONCLUSION: Men with higher AUDIT-KR scores tended to suffer from poor sleep quality. AUDIT-KR scores showed significant correlations with subjective sleep quality, sleep duration, and sleep disturbances in men.
Alcohol Drinking ; Anxiety ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Female ; Hospitals, General ; Humans ; Male ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring ; Tobacco Use

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