No abstract available.
Mass Screening ; Alcohol Drinking ; Alcohol-Related Disorders Alcohols ; Alcohols ; Diagnostic and Statistical Manual of Mental Disorders ; Reproducibility of Results ; Sensitivity and Specificity

BACKGROUND: The purpose of this study was to examine whether facial flushing after drinking influences the relationship between alcohol consumption and prostatic hyperplasia among Korean men. METHODS: The subjects were 957 Korean men (180 non-drinkers, 389 with drinking-related facial flushing, 388 without facial flushing) in the 40–69 age group, who underwent prostate ultrasound at the health promotion center of Chungnam National University Hospital between 2008 and 2014. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. In terms of the amount consumed, 14 g of alcohol was considered a standard drink. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and prostatic hyperplasia in the flushing and non-flushing groups, with adjustment for confounding factors such as age, body mass index, smoking, and exercise patterns. RESULTS: Individuals aged 50–59 years who experienced drinking-related facial flushing had a significantly lower risk of prostatic hyperplasia than the non-drinker group, depending on alcohol consumption: ≤4 standard drinks (adjusted odds ratio [OR], 0.38; 95% confidence interval [CI], 0.16 to 0.86); >4 ≤8 standard drinks (OR, 0.35; 95% CI, 0.13 to 0.95); >8 standard drinks (OR, 0.33; 95% CI, 0.13 to 0.84). However, no significant relationship was observed between the number of drinks consumed and the risk of prostate hyperplasia in the non-flushing group. CONCLUSION: The risk of prostatic hyperplasia appears to be reduced by alcohol consumption among Korean men aged 50–59 years who exhibit drinking-related facial flushing.
Alcohol Drinking* ; Alcohols ; Body Mass Index ; Chungcheongnam-do ; Drinking* ; Flushing* ; Health Promotion ; Humans ; Hyperplasia ; Logistic Models ; Male ; Odds Ratio ; Prostate ; Prostatic Hyperplasia* ; Smoke ; Smoking ; Ultrasonography

The aim of this study was to investigate the association between macronutrient composition and metabolic syndrome (MetS) incidence in Korean adults. Data were obtained from a cohort of 10,030 members aged 40 to 69 years who were enrolled from the 2 cities (Ansung and Ansan) between 2001 and 2002 to participate in the Korean Genome Epidemiology Study. Of these members, 5,565 participants, who were free of MetS and reported no diagnosis of cardiovascular disease at baseline, were included in this study. MetS was defined using the criteria of the National Cholesterol Education Program-Adult Treatment Panel III and Asia-Pacific criteria for waist circumference. MetS incidence rate were identified during a 2-year follow-up period. Baseline dietary information was obtained using a semi-quantitative food frequency questionnaire. Multivariate logistic regression analysis was used to evaluate the association between the quartiles of percentages of total calorie from macronutrients consumed and MetS incidence. In analyses, baseline information, including age, sex, body mass index, income status, educational status, smoking status, alcohol drinking status, and physical activity level was considered as confounding variables. Participants with the second quartile of the percentages of carbohydrate calorie (67%–70%) had a 23% reduced odds ratio (95% confidence interval, 0.61–0.97) for MetS incidence compared with those with the fourth quartile after adjusting for confounding variables. The findings suggest that middle aged or elderly Korean adults who consume approximately 67%–70% of calorie from carbohydrate have a reduced risk of MetS.
Adult* ; Aged ; Alcohol Drinking ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Cohort Studies ; Confounding Factors (Epidemiology) ; Diagnosis ; Education ; Educational Status ; Epidemiology ; Follow-Up Studies ; Genome ; Humans ; Incidence* ; Logistic Models ; Middle Aged ; Motor Activity ; Odds Ratio ; Smoke ; Smoking ; Waist Circumference

OBJECTIVES: The aim of this study was to investigate associations between skeletal muscle mass and bone mineral density according to gender and skeletal sites. METHODS: Using the data from Korean National Health and Nutrition Examination Survey (KNHANES IV) 2009, a total of 711 males and 847 females over 65 years of age were evaluated. Bone mineral density (BMD) and body composition were assessed using dual-energy X-ray absorptiometry. RESULTS: Relative appendicular skeletal muscle (RASM) was positively related with the femur BMD with a stronger relationship in males (r = 0.207, p < 0.001) than in females (r = 0.095, p < 0.05). However, lumbar spine BMDs in both males and females did not show any significant associations with the RASM value. In the logistic regression for osteoporosis expressed as a decrease of risk per increase of RASM by 1 standard deviation (SD) of the same sex healthy reference group, the age- and BMI-adjusted odds ratio (OR) for osteoporosis was 0.42 (95% CI 0.12–0.76) in the femur neck and 0.24 (95% CI 0.07–0.76) in the total hip for males. Among females, the age- and BMI-adjusted OR for osteoporosis was 0.65 (95% CI 0.33–1.00), which showed importance only in the total hip. CONCLUSIONS: Higher RASM was significantly associated with lower risk for osteoporosis and the areas at the femur neck and total hip appeared to more likely be affected positively by muscle. Moreover, because males showed faster muscle loss with aging than females, the bones of males may be more prone to favorable effects of muscle.
Absorptiometry, Photon ; Aging ; Body Composition ; Bone Density ; Female ; Femur ; Femur Neck ; Hip ; Humans ; Logistic Models ; Male ; Muscle, Skeletal* ; Nutrition Surveys ; Odds Ratio ; Osteoporosis ; Sarcopenia ; Spine

BACKGROUND: Bone strength is impaired in patients with type 2 diabetes mellitus despite an increase in bone mineral density (BMD). Thiazolidinedione (TZD), a peroxisome proliferator activated receptor γ agonist, promotes adipogenesis, and suppresses osteoblastogenesis. Therefore, its use is associated with an increased risk of fracture. The aim of this study was to examine the in vitro and in vivo effects of lobeglitazone, a new TZD, on bone. METHODS: MC3T3E1 and C3H10T1/2 cells were cultured in osteogenic medium and exposed to lobeglitazone (0.1 or 1 µM), rosiglitazone (0.4 µM), or pioglitazone (1 µM) for 10 to 14 days. Alkaline phosphatase (ALP) activity, Alizarin red staining, and osteoblast marker gene expression were analyzed. For in vivo experiments, 6-month-old C57BL/6 mice were treated with vehicle, one of two doses of lobeglitazone, rosiglitazone, or pioglitazone. BMD was assessed using a PIXImus2 instrument at the baseline and after 12 weeks of treatment. RESULTS: As expected, in vitro experiments showed that ALP activity was suppressed and the mRNA expression of osteoblast marker genes RUNX2 (runt-related transcription factor 2) and osteocalcin was significantly attenuated after rosiglitazone treatment. By contrast, lobeglitazone at either dose did not inhibit these variables. Rosiglitazone-treated mice showed significantly accelerated bone loss for the whole bone and femur, but BMD did not differ significantly between the lobeglitazone-treated and vehicle-treated mice. CONCLUSION: These findings suggest that lobeglitazone has no detrimental effects on osteoblast biology and might not induce side effects in the skeletal system.
Adipogenesis ; Alkaline Phosphatase ; Animals ; Biology ; Bone and Bones ; Bone Density* ; Diabetes Mellitus, Type 2 ; Femur ; Gene Expression ; Humans ; In Vitro Techniques ; Infant ; Mice* ; Osteoblasts ; Osteocalcin ; Peroxisomes ; RNA, Messenger ; Thiazolidinediones ; Transcription Factors

BACKGROUND/AIMS: The adoption of colonoscopy as a primary colorectal cancer (CRC) screening technique has been argued for in Korea, without evidence of patient preferences. This study aimed to investigate patients’ preferences for the primary CRC screening test for the National Cancer Screening Program (NCSP). METHODS: Between June and August 2016, 414 individuals aged ≥50 years who participated in the NCSP were prospectively invited to complete a questionnaire regarding their preferences for the primary CRC screening test and the reasons for their selection. RESULTS: Among the 396 respondents who completed the questionnaire, 124 individuals (31.3%) preferred the fecal immunochemical test (FIT), whereas 272 individuals (68.7%) preferred colonoscopy. Elderly participants preferred the FIT (p < 0.001), whereas participants with a higher education level (p=0.030), a higher income level (p=0.009), or individuals with a family member (p=0.028) or acquaintance (p=0.013) with a history of CRC preferred colonoscopy. Only 12.9% of participants had a bad experience with a previous FIT; however, 39.3% of participants had a bad experience with a previous colonoscopy. CONCLUSIONS: Colonoscopy was preferred to FIT in a 2.2:1 ratio as the primary CRC screening test for the NCSP. Patients’ preference for colonoscopy should be considered for the NCSP in Korea.
Aged ; Colonoscopy ; Colorectal Neoplasms* ; Early Detection of Cancer ; Education ; Humans ; Korea* ; Mass Screening* ; Patient Preference ; Prospective Studies ; Surveys and Questionnaires

BACKGROUND: The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline for the treatment of blood cholesterol recommends statin therapy for individuals at high risk of atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to investigate serial trends in the percentages of Korean adults considered eligible for statin therapy according to the new ACC/AHA cholesterol guideline. METHODS: Data from the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998, n=7,698), II (2001, n=5,654), III (2005, n=5,269), IV (2007 to 2009, n=15,727), and V (2010 to 2012, n=16,304), which used a stratified, multistage, probability sampling design, were used as representative of the entire Korean population. RESULTS: The percentage of adults eligible for statin therapy according to the ACC/AHA cholesterol guideline increased with time: 17.0%, 19.0%, 20.8%, 20.2%, and 22.0% in KNHANES I, II, III, IV, and V, respectively (P=0.022). The prevalence of ASCVD was 1.4% in KNHANES I and increased to 3.3% in KNHANES V. The percentage of diabetic patients aged 40 to 75 years with a low density lipoprotein cholesterol levels of 70 to 189 mg/dL increased from 4.8% in KNHANES I to 6.1% in KNHANES V. People with an estimated 10-year ASCVD risk ≥7.5% and aged 40 to 75 years accounted for the largest percentage among the four statin benefit groups: 9.1% in KNHANES I and 11.0% in KNHANES V. CONCLUSION: Application of the 2013 ACC/AHA guideline has found that the percentage of Korean adults in the statin benefit groups has increased over the past 15 years.
Adult ; American Heart Association ; Atherosclerosis ; Cardiovascular Diseases ; Cholesterol* ; Cholesterol, LDL ; Heart* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Korea ; Nutrition Surveys ; Prevalence

BACKGROUND/AIMS: The aim of this study was to compare the clinical features and outcomes of ulcerative colitis (UC) according to the age of onset in Korea. METHODS: A total of 1,141 patients who were diagnosed with UC between July 1987 and November 2013 at 11 tertiary hospitals were enrolled. The baseline disease characteristic and disease state at onset, treatment during the disease course were retrospectively reviewed among patients with young-onset (YO, < 20 years) and adult-onset (AO, ≥ 20 years). Severe outcome was defined as use of intravenous (IV) steroids, infliximab, immunosuppressant, or UC-related operation. RESULTS: There were 55 YO patients (mean age, 17.8 ± 2.4) and 1,086 AO patients (mean age, 43.0 ± 13.6). High Mayo scores (7.7 ± 3.0 vs. 5.6 ± 2.7, p = 0.000), extensive UC (52.7% vs. 25.8%, p = 0.000) and IV steroid (41.8% vs. 18.0%, p = 0.000), immunosuppressant (47.3% vs. 26.9%, p = 0.002), and infliximab (20.0% vs. 7.2%, p = 0.001) use were more frequent in the YO than in the AO group. According to multivariate analysis, severe outcomes were related to YO disease (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.27 to 3.71), body mass index < 23 kg/m² (HR, 1.46; 95% CI, 1.07 to 2.00), severe (HR, 2.29; 95% CI, 1.36 to 3.38), and moderate (HR, 2.48; 95% CI, 1.67 to 3.67) disease, extensive UC (HR, 2.90; 95% CI, 1.79 to 4.69), UC-related admission (HR, 63.89; 95% CI, 20.41 to 200.02), and oral steroid use (HR, 0.51; 95% CI, 0.39 to 0.67). CONCLUSIONS: UC with YO presented with more advanced clinical features at onset and more severe outcomes than the AO. YO cases require careful management and intense treatment strategies.
Age of Onset ; Body Mass Index ; Colitis, Ulcerative* ; Humans ; Infliximab ; Intestinal Diseases* ; Korea ; Multivariate Analysis ; Retrospective Studies ; Steroids ; Tertiary Care Centers ; Ulcer*

Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.
Body Mass Index ; Breast Feeding ; Diabetes Mellitus, Type 2* ; Diabetes, Gestational* ; Diet ; Epidemiology ; Female ; Glucose ; Glucose Intolerance ; Humans ; Incidence ; Insulin ; Life Style ; Maternal Age ; Motor Activity ; Postpartum Period ; Pregnancy ; Risk Factors

BACKGROUND: The aim of this multicenter, randomized, double-blind study was to examine the effect of lobeglitazone, a novel thiazolidinedione, on the changes in bone mineral density (BMD) in patients with type 2 diabetes mellitus. METHODS: A 24-week, double-blinded phase was followed by a 28-week, open-label phase, in which the placebo group also started to receive lobeglitazone. A total of 170 patients aged 34 to 76 years were randomly assigned in a 2:1 ratio to receive lobeglitazone 0.5 mg or a matching placebo orally, once daily. BMD was assessed using dual-energy X-ray absorptiometry at week 24 and at the end of the study (week 52). RESULTS: During the double-blinded phase, the femur neck BMD showed decreasing patterns in both groups, without statistical significance (−0.85%±0.36% and −0.78%±0.46% in the lobeglitazone and placebo groups, respectively). The treatment difference between the groups was 0.07%, which was also not statistically significant. Further, minimal, nonsignificant decreases were observed in both groups in the total hip BMD compared to values at baseline, and these differences also did not significantly differ between the groups. During the open-label phase, the BMD was further decreased, but not significantly, by −0.32% at the femur neck and by −0.60% at the total hip in the lobeglitazone group, and these changes did not significantly differ compared with the original placebo group switched to lobeglitazone. CONCLUSION: Our results indicate that treatment with lobeglitazone 0.5 mg over 52 weeks showed no detrimental effect on the BMD compared to the placebo.
Absorptiometry, Photon ; Bone Density* ; Diabetes Mellitus, Type 2* ; Double-Blind Method ; Femur Neck ; Hip ; Humans ; Thiazolidinediones