PURPOSE: This study determined which obesity measurement correlates the best with diabetes and prediabetes. MATERIALS AND METHODS: This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines. RESULTS: After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity. CONCLUSION: Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.
Absorptiometry, Photon ; *Adiposity ; Adult ; Anthropometry ; Asian Continental Ancestry Group/*statistics & numerical data ; Biomarkers/blood ; Body Mass Index ; Cross-Sectional Studies ; Diabetes Mellitus/*ethnology ; Female ; Humans ; *Intra-Abdominal Fat ; Male ; Middle Aged ; Obesity/complications/*ethnology ; Odds Ratio ; Prediabetic State/*ethnology ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Waist Circumference

PURPOSE: The association between the red cell distribution width (RDW) and vasospastic angina (VSA) has not been elucidated. We investigated the association of the RDW with the incidence and angiographic subtypes of VSA in Korean patients. MATERIALS AND METHODS: A total of 460 patients who underwent intracoronary ergonovine provocation tests were consecutively enrolled and classified into two groups: the VSA group (n=147, 32.0%) and non-VSA group (n=313, 68.0%). The subjects were classified into 3 subgroups (tertiles) according to the baseline level of RDW assessed before the angiographic provocation test. RESULTS: The VSA group had a higher RDW than the non-VSA group (12.9±0.8% vs. 12.5±0.7%, p=0.013). The high RDW level demonstrated an independent association with the high incidence of VSA [second tertile: hazard ratio (HR) 1.96 (1.13-2.83), third tertile: HR 2.33 (1.22-3.47), all p<0.001]. Moreover, the highest RDW tertile level had a significant association with the prevalence of the mixed-type coronary spasm [HR 1.29 (1.03-1.59), p=0.037]. CONCLUSION: The high level of RDW was significantly associated with the prevalence of VSA and the high-risk angiographic subtype of coronary spasm, suggesting that a proactive clinical investigation for VSA could be valuable in Korean patients with an elevated RDW.
Aged ; Aged, 80 and over ; Angina Pectoris/*blood/ethnology ; Coronary Angiography/methods ; Coronary Vasospasm/*blood/ethnology ; Erythrocyte Indices/*physiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Republic of Korea/epidemiology

We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ2 tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ2=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.
Adult ; Age of Onset ; Aged ; Alcohol Drinking ; Bipolar Disorder/*diagnosis/*ethnology/psychology ; Character ; Cost of Illness ; Depression ; Depressive Disorder, Major/*diagnosis/*ethnology/psychology ; Female ; Humans ; Male ; Middle Aged ; Personality Inventory/statistics & numerical data ; *Quality of Life ; Republic of Korea/epidemiology ; *Seasons ; Temperament

PURPOSE: The aim of the present study was to develop an osteoporosis risk-assessment model to identify high-risk individuals among Korean men. MATERIALS AND METHODS: The study used data from 1340 and 1110 men > or =50 years who participated in the 2009 and 2010 Korean National Health and Nutrition Examination Survey, respectively, for development and validation of an osteoporosis risk-assessment model. Osteoporosis was defined as T score < or =-2.5 at either the femoral neck or lumbar spine. Performance of the candidate models and the Osteoporosis Self-assessment Tool for Asian (OSTA) was compared with sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). A net reclassification improvement was further calculated to compare the developed Korean Osteoporosis Risk-Assessment Model for Men (KORAM-M) with OSTA. RESULTS: In the development dataset, the prevalence of osteoporosis was 8.1%. KORAM-M, consisting of age and body weight, had a sensitivity of 90.8%, a specificity of 42.4%, and an AUC of 0.666 with a cut-off score of -9. In the validation dataset, similar results were shown: sensitivity 87.9%, specificity 39.7%, and AUC 0.638. Additionally, risk categorization with KORAM-M showed improved reclassification over that of OSTA up to 22.8%. CONCLUSION: KORAM-M can be simply used as a pre-screening tool to identify candidates for dual energy X-ray absorptiometry tests.
Aged ; Asian Continental Ancestry Group/*statistics & numerical data ; Bone Density ; Female ; Humans ; Male ; Middle Aged ; *Models, Biological ; Nutrition Surveys ; Osteoporosis/*diagnosis/ethnology ; Predictive Value of Tests ; Prevalence ; ROC Curve ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment/*methods ; Sensitivity and Specificity ; Surveys and Questionnaires/*standards

PURPOSE: This study was conducted to assess predictor variables of husbands in multicultural families and examine the relationship among variables after setting up a hypothetical model including influencing factors, so as to provide a framework necessary for developing nursing interventions of domestic violence. METHODS: The participants were 260 husbands in multicultural families in four cities in Korea. Data were analyzed using SPSS 22.0 and AMOS 20.0. RESULTS: Self-control, social support, family of origin violence experience and stress on cultural adaptation directly affected to dysfunctional communication, and the explanatory power of the variables was 64.7%. Family of origin violence experience in domestic stress on cultural adaptation, and dysfunctional communication were directly related to domestic violence in multicultural families, and the explanatory power of the variables was 64.6%. We found out that all variables in the model had mediation effects to domestic violence through dysfunctional communication. In other words, self-control and social support had complete mediation effects, and family of origin violence experience in domestic violence and stress on cultural adaptation had partial mediation effects. CONCLUSIONS: The variables explained in this study should be considered as predictive factors of domestic violence in multicultural families, and used to provide preventive nursing intervention. Our resutls can be taken into account for developing and implementing programs on alleviating dysfunctional communication in multicultural families in Korea.
Acculturation ; Communication ; Cross-Sectional Studies ; *Cultural Diversity ; Domestic Violence/ethnology/*statistics & numerical data ; Emigrants and Immigrants/psychology/statistics & numerical data ; Female ; Humans ; Male ; Models, Psychological ; Republic of Korea/epidemiology ; Self-Control/psychology ; Social Support ; Spouses/ethnology/psychology/statistics & numerical data ; Stress, Psychological/ethnology/etiology

PURPOSE: This study investigated prediction of North Korean refugees' adaptation to the South Korean society and verified the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 445 North Korean refugees living in a metropolitan area. Data were collected from September 1st to November 20th, 2012, and analyzed using SPSS Windows 18.0 and AMOS 17.0. RESULTS: Traumatic experiences of North Korean refugees increased self-efficacy and psychological trauma. Acculturation stress decreased self-efficacy and increased passive coping. Self-efficacy affected active and passive coping, decreased psychological trauma, and increased resilience. Resilience is successful adaptation and refers to North Korean refugees' abilities to adapt effectively to stress. In particular, self-efficacy as the main parameter affecting resilience was confirmed. CONCLUSIONS: The results suggest that resilience can be improved through self-efficacy. It was the most significant factor decreasing psychological trauma and increasing resilience. Therefore, we need to develop programs for self-efficacy. The results also provide basic data for policy making for North Korean refugees.
Acculturation ; Adaptation, Psychological/*physiology ; Adult ; Aged ; Democratic People's Republic of Korea/ethnology ; Female ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Personal Satisfaction ; Psychological Trauma/*ethnology ; Refugees/*psychology ; Republic of Korea/epidemiology ; Resilience, Psychological ; Self Efficacy ; Young Adult

PURPOSE: This study examined the effects of health status and health behaviors on depression in married female immigrants in South Korea. METHODS: Sampling 316 immigrant women from the Philippines, Vietnam, China, and other Asian countries, a cross-sectional research design was used with self-report questionnaires that assessed sociodemographic characteristics, health status, health behaviors, and depression. RESULTS: There were significant differences in stillbirth experience, induced abortion, morbidity, perceived health status, meal skipping, and physical activity between depressed and nondepressed immigrant women. After adjusting for sociodemographic variables, stillbirth experience, poorer perceived health status, more meal skipping, and less physical activity were associated with greater depressive symptoms. CONCLUSIONS: Both health status and health behaviors had significant impacts on depression, suggesting that development of nursing interventions and educational programs should be targeted towards improving maternal health, healthy lifestyle, and subjective health perception to promote married female immigrants' psychological well-being.
Adult ; Asian Continental Ancestry Group/ethnology ; Cross-Sectional Studies ; Depressive Disorder/*epidemiology ; Emigrants and Immigrants/statistics & numerical data ; Female ; *Health Behavior ; *Health Status ; Humans ; Logistic Models ; *Marriage ; Republic of Korea/epidemiology ; Risk Factors ; Rural Health ; Socioeconomic Factors ; Surveys and Questionnaires ; Urban Health ; Young Adult

PURPOSE: Although interest in the role played by vitamin D in bone health is increasing, little is known about the role of this vitamin in musculoskeletal pain in children. This study aimed to assess the prevalence of vitamin D deficiency in children presenting with nonspecific lower extremity pains. MATERIALS AND METHODS: From 2011 to 2012, 183 children underwent evaluation for nonspecific lower-extremity pains. Patients with valid causes, such as fractures or transient synovitis, were excluded, as were those with underlying medical conditions, such as cerebral palsy and metabolic disease. Ultimately, 140 patients met the inclusion criteria. Levels of serum 25-hydroxy vitamin D [25-(OH)D], the ideal indicator of vitamin D status, were measured in these children. RESULTS: Eighty-seven boys (62.1%) and 53 girls (37.9%) were included. The mean age at presentation was 5.2 years (range, 2-15). Serum 25-(OH)D levels were <10 ng/mL in 5.7% of patients, 10 to <20 ng/mL in 51.4%, 20 to <30 ng/mL in 37.9%, and > or =30 ng/mL in only 5.0%. Most patients visited the hospital in the winter (41.4%) (summer, 12.9%), and serum 25-(OH)D levels were also lowest in the winter (17.2+/-5.5 ng/mL). CONCLUSION: This study found a high prevalence of vitamin D deficiency or insufficiency in Korean children with nonspecific lower-extremity pains, indicating a positive association between vitamin D deficiency and growing pains. More attention should be directed toward vitamin D and its role in the optimization of bone health.
Adolescent ; Asian Continental Ancestry Group/*statistics & numerical data ; Calcifediol/administration & dosage ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Male ; Musculoskeletal Pain/drug therapy/etiology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Seasons ; Vitamin D/*analogs & derivatives/blood ; Vitamin D Deficiency/blood/complications/*ethnology ; Vitamins/administration & dosage

Polycythemia vera, essential thrombocythemia, and primary myelofibrosis are collectively known as 'Philadelphia-negative classical myeloproliferative neoplasms (MPNs).' The discovery of new genetic aberrations such as Janus kinase 2 (JAK2) have enhanced our understanding of the pathophysiology of MPNs. Currently, the JAK2 mutation is not only a standard criterion for diagnosis but is also a new target for drug development. The JAK1/2 inhibitor, ruxolitinib, was the first JAK inhibitor approved for patients with intermediate- to high-risk myelofibrosis and its effects in improving symptoms and survival benefits were demonstrated by randomized controlled trials. In 2011, the Korean Society of Hematology MPN Working Party devised diagnostic and therapeutic guidelines for Korean MPN patients. Subsequently, other genetic mutations have been discovered and many kinds of new drugs are now under clinical investigation. In view of recent developments, we have revised the guidelines for the diagnosis and management of MPN based on published evidence and the experiences of the expert panel. Here we describe the epidemiology, new genetic mutations, and novel therapeutic options as well as diagnostic criteria and standard treatment strategies for MPN patients in Korea.
Antineoplastic Agents/*therapeutic use ; Asian Continental Ancestry Group/genetics ; Humans ; Janus Kinase 2/*antagonists & inhibitors/genetics/metabolism ; Molecular Targeted Therapy ; Mutation ; Myeloproliferative Disorders/diagnosis/drug therapy/enzymology/ethnology/genetics ; Protein Kinase Inhibitors/*therapeutic use ; Republic of Korea/epidemiology ; Risk Factors ; Signal Transduction/drug effects ; Treatment Outcome

The incidence rate of gastric cancer in Korean Americans is over five times higher than that in non-Hispanic whites, and is similar to the incidence of colorectal cancer in the overall United States population. In Korea, the National Cancer Screening Program recommends endoscopy or upper gastrointestinal series for people aged 40 years and older every 2 years. However, the benefit of gastric cancer screening in Korean Americans has not been evaluated. Based on epidemiologic studies, Korean Americans appear to have more similar gastric cancer risk factors to Koreans as opposed to Americans of European descent, though the risk of gastric cancer appears to decrease for subsequent generations. Therefore, in accordance with recent recommendations regarding screening for gastric cancer in Korea, endoscopic screening for gastric cancer in Korean Americans should be considered, especially in those with known atrophic gastritis/intestinal metaplasia or a family history of gastric cancer. In the future, additional studies will needed to assess whether a screening program for gastric cancer in Korean Americans will result in a survival benefit.
*Asian Americans ; Early Detection of Cancer/*methods ; *Endoscopy, Gastrointestinal ; Humans ; Incidence ; Predictive Value of Tests ; Prognosis ; Program Development ; Republic of Korea/ethnology ; Risk Assessment ; Risk Factors ; Stomach Neoplasms/*diagnosis/*ethnology ; United States/epidemiology