1.Impact of Meal Frequency on Insulin Resistance in Middle-Aged and Older Adults: A Prospective Cohort Study
Ha-Eun RYU ; Jong Hee LEE ; Byoungjin PARK ; Seok-Jae HEO ; Yu-Jin KWON
Diabetes & Metabolism Journal 2025;49(2):311-320
		                        		
		                        			 Background:
		                        			Insulin resistance (IR) is central to metabolic disorders and significantly influenced by diet. Studies on meal frequency (MF) and metabolic indicators have shown mixed results. This study explores the link between MF and IR in middle-aged and older adults. 
		                        		
		                        			Methods:
		                        			This prospective cohort study included 4,570 adults aged 40 to 69 years from the Korean Genome and Epidemiologic Study. MF were divided into two groups based on whether they consumed three or more, or fewer than three, meals daily. IR was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR); participants were classified as IR if their HOMA-IR value was ≥2.5. Multiple Cox proportional hazard regression analyses were conducted to examine the association between MF and the incidence of IR. 
		                        		
		                        			Results:
		                        			After adjusting for all variables, individuals in the MF ≥3 group showed a reduced incidence of IR compared to those in the MF <3 group (hazard ratio, 0.880; 95% confidence interval, 0.782 to 0.990). Additionally, subgroup analyses by sex, diabetes mellitus (DM), and body mass index (BMI) showed that this association persisted only in men, individuals without DM, and those with a BMI <25. 
		                        		
		                        			Conclusion
		                        			Our findings indicate that a higher MF among middle-aged and older adults is associated with a reduced incidence of IR. However, this association was maintained only in men, individuals without DM, and those without obesity. 
		                        		
		                        		
		                        		
		                        	
2.Impact of Meal Frequency on Insulin Resistance in Middle-Aged and Older Adults: A Prospective Cohort Study
Ha-Eun RYU ; Jong Hee LEE ; Byoungjin PARK ; Seok-Jae HEO ; Yu-Jin KWON
Diabetes & Metabolism Journal 2025;49(2):311-320
		                        		
		                        			 Background:
		                        			Insulin resistance (IR) is central to metabolic disorders and significantly influenced by diet. Studies on meal frequency (MF) and metabolic indicators have shown mixed results. This study explores the link between MF and IR in middle-aged and older adults. 
		                        		
		                        			Methods:
		                        			This prospective cohort study included 4,570 adults aged 40 to 69 years from the Korean Genome and Epidemiologic Study. MF were divided into two groups based on whether they consumed three or more, or fewer than three, meals daily. IR was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR); participants were classified as IR if their HOMA-IR value was ≥2.5. Multiple Cox proportional hazard regression analyses were conducted to examine the association between MF and the incidence of IR. 
		                        		
		                        			Results:
		                        			After adjusting for all variables, individuals in the MF ≥3 group showed a reduced incidence of IR compared to those in the MF <3 group (hazard ratio, 0.880; 95% confidence interval, 0.782 to 0.990). Additionally, subgroup analyses by sex, diabetes mellitus (DM), and body mass index (BMI) showed that this association persisted only in men, individuals without DM, and those with a BMI <25. 
		                        		
		                        			Conclusion
		                        			Our findings indicate that a higher MF among middle-aged and older adults is associated with a reduced incidence of IR. However, this association was maintained only in men, individuals without DM, and those without obesity. 
		                        		
		                        		
		                        		
		                        	
3.Impact of Meal Frequency on Insulin Resistance in Middle-Aged and Older Adults: A Prospective Cohort Study
Ha-Eun RYU ; Jong Hee LEE ; Byoungjin PARK ; Seok-Jae HEO ; Yu-Jin KWON
Diabetes & Metabolism Journal 2025;49(2):311-320
		                        		
		                        			 Background:
		                        			Insulin resistance (IR) is central to metabolic disorders and significantly influenced by diet. Studies on meal frequency (MF) and metabolic indicators have shown mixed results. This study explores the link between MF and IR in middle-aged and older adults. 
		                        		
		                        			Methods:
		                        			This prospective cohort study included 4,570 adults aged 40 to 69 years from the Korean Genome and Epidemiologic Study. MF were divided into two groups based on whether they consumed three or more, or fewer than three, meals daily. IR was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR); participants were classified as IR if their HOMA-IR value was ≥2.5. Multiple Cox proportional hazard regression analyses were conducted to examine the association between MF and the incidence of IR. 
		                        		
		                        			Results:
		                        			After adjusting for all variables, individuals in the MF ≥3 group showed a reduced incidence of IR compared to those in the MF <3 group (hazard ratio, 0.880; 95% confidence interval, 0.782 to 0.990). Additionally, subgroup analyses by sex, diabetes mellitus (DM), and body mass index (BMI) showed that this association persisted only in men, individuals without DM, and those with a BMI <25. 
		                        		
		                        			Conclusion
		                        			Our findings indicate that a higher MF among middle-aged and older adults is associated with a reduced incidence of IR. However, this association was maintained only in men, individuals without DM, and those without obesity. 
		                        		
		                        		
		                        		
		                        	
4.Impact of Meal Frequency on Insulin Resistance in Middle-Aged and Older Adults: A Prospective Cohort Study
Ha-Eun RYU ; Jong Hee LEE ; Byoungjin PARK ; Seok-Jae HEO ; Yu-Jin KWON
Diabetes & Metabolism Journal 2025;49(2):311-320
		                        		
		                        			 Background:
		                        			Insulin resistance (IR) is central to metabolic disorders and significantly influenced by diet. Studies on meal frequency (MF) and metabolic indicators have shown mixed results. This study explores the link between MF and IR in middle-aged and older adults. 
		                        		
		                        			Methods:
		                        			This prospective cohort study included 4,570 adults aged 40 to 69 years from the Korean Genome and Epidemiologic Study. MF were divided into two groups based on whether they consumed three or more, or fewer than three, meals daily. IR was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR); participants were classified as IR if their HOMA-IR value was ≥2.5. Multiple Cox proportional hazard regression analyses were conducted to examine the association between MF and the incidence of IR. 
		                        		
		                        			Results:
		                        			After adjusting for all variables, individuals in the MF ≥3 group showed a reduced incidence of IR compared to those in the MF <3 group (hazard ratio, 0.880; 95% confidence interval, 0.782 to 0.990). Additionally, subgroup analyses by sex, diabetes mellitus (DM), and body mass index (BMI) showed that this association persisted only in men, individuals without DM, and those with a BMI <25. 
		                        		
		                        			Conclusion
		                        			Our findings indicate that a higher MF among middle-aged and older adults is associated with a reduced incidence of IR. However, this association was maintained only in men, individuals without DM, and those without obesity. 
		                        		
		                        		
		                        		
		                        	
5.Clinical Practice Guidelines for Managing Frailty in Community-Dwelling Korean Elderly Adults in Primary Care Settings
Hyo-Sun YOU ; Yu-Jin KWON ; Sunyoung KIM ; Yang-Hyun KIM ; Ye-seul KIM ; Yonghwan KIM ; Yong-kyun ROH ; Byoungjin PARK ; Young Kyu PARK ; Chang-Hae PARK ; Joung Sik SON ; Jinyoung SHIN ; Hyun-Young SHIN ; Bumjo OH ; Jae-woo LEE ; Jae Yong SHIM ; Chang Won WON ; Ji Won YOO ; Sang-Hyun LEE ; Hee-Taik KANG ; Duk Chul LEE
Korean Journal of Family Medicine 2021;42(6):413-424
		                        		
		                        			
		                        			 Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness. 
		                        		
		                        		
		                        		
		                        	
6.Association between Copper–Zinc Ratio in Hair and Neutrophil–Lymphocyte Ratio within the Context of a Normal White Blood Cell Count among Overweight or Obese Korean Individuals: A Pilot Study
Sun Young JEONG ; Hyo Young SHIM ; Yong Jae LEE ; Byoungjin PARK
Korean Journal of Family Medicine 2021;42(3):240-244
		                        		
		                        			Background:
		                        			Obesity is considered a state of enhanced oxidative stress as well as chronic and low-grade inflammation. The copper–zinc ratio in obese individuals has been reported to reflect systemic oxidative stress and inflammatory status. We investigated whether the neutrophil–lymphocyte ratio is related to the copper–zinc ratio in hair, within the context of a normal white blood cell count among overweight or obese Korean individuals. 
		                        		
		                        			Methods:
		                        			We included 56 participants aged older than 20 years who voluntarily sought weight reduction treatment and met the inclusion criterion of body mass index of 23 kg/m2 or greater. Intra-abdominal visceral adipose tissue was measured by computed tomography imaging, while the copper and zinc levels were measured by hair mineral analysis. Using multiple linear regression analysis, we examined the associations between the neutrophil–lymphocyte ratio and the copper–zinc ratio. 
		                        		
		                        			Results:
		                        			The mean age, body mass index, and visceral adipose tissue were 46.0±10.5 years, 29.0±4.1 kg/cm2 , and 142.9±68.8 cm2 , respectively. Pearson’s correlation analysis revealed the association of the neutrophil–lymphocyte ratio with copper level (r=0.475, P<0.001) and copper–zinc ratio (r=0.494, P<0.001). After adjusting for confounding variables, we found the neutrophil–lymphocyte ratio was significantly associated with the level of copper and the copper–zinc ratio in hair (regression coefficient: 0.055±0.015; P<0.001 and regression coefficient: 0.761±0.185; P<0.001, respectively). 
		                        		
		                        			Conclusion
		                        			A higher copper–zinc ratio in hair is positively and independently associated with the neutrophil–lymphocyte ratio. Thus, a high hair copper–zinc ratio could be a useful parameter for oxidative burden of individuals predisposed to obesity-related comorbidity.
		                        		
		                        		
		                        		
		                        	
7.Association between Copper–Zinc Ratio in Hair and Neutrophil–Lymphocyte Ratio within the Context of a Normal White Blood Cell Count among Overweight or Obese Korean Individuals: A Pilot Study
Sun Young JEONG ; Hyo Young SHIM ; Yong Jae LEE ; Byoungjin PARK
Korean Journal of Family Medicine 2021;42(3):240-244
		                        		
		                        			Background:
		                        			Obesity is considered a state of enhanced oxidative stress as well as chronic and low-grade inflammation. The copper–zinc ratio in obese individuals has been reported to reflect systemic oxidative stress and inflammatory status. We investigated whether the neutrophil–lymphocyte ratio is related to the copper–zinc ratio in hair, within the context of a normal white blood cell count among overweight or obese Korean individuals. 
		                        		
		                        			Methods:
		                        			We included 56 participants aged older than 20 years who voluntarily sought weight reduction treatment and met the inclusion criterion of body mass index of 23 kg/m2 or greater. Intra-abdominal visceral adipose tissue was measured by computed tomography imaging, while the copper and zinc levels were measured by hair mineral analysis. Using multiple linear regression analysis, we examined the associations between the neutrophil–lymphocyte ratio and the copper–zinc ratio. 
		                        		
		                        			Results:
		                        			The mean age, body mass index, and visceral adipose tissue were 46.0±10.5 years, 29.0±4.1 kg/cm2 , and 142.9±68.8 cm2 , respectively. Pearson’s correlation analysis revealed the association of the neutrophil–lymphocyte ratio with copper level (r=0.475, P<0.001) and copper–zinc ratio (r=0.494, P<0.001). After adjusting for confounding variables, we found the neutrophil–lymphocyte ratio was significantly associated with the level of copper and the copper–zinc ratio in hair (regression coefficient: 0.055±0.015; P<0.001 and regression coefficient: 0.761±0.185; P<0.001, respectively). 
		                        		
		                        			Conclusion
		                        			A higher copper–zinc ratio in hair is positively and independently associated with the neutrophil–lymphocyte ratio. Thus, a high hair copper–zinc ratio could be a useful parameter for oxidative burden of individuals predisposed to obesity-related comorbidity.
		                        		
		                        		
		                        		
		                        	
9.Clinical oral health and adult perceptions of oral health in a dental hospital in Gwangju, Korea
Journal of Korean Academy of Oral Health 2020;44(2):109-116
		                        		
		                        			 Objectives:
		                        			The purposes of the present study were to (1) analyze the relationship between clinical oral health status and subjective oral health status, (2) explore the association between perceived oral symptoms and subjective oral health status, and (3) investigate the effects of factors on subjective oral health status. 
		                        		
		                        			Methods:
		                        			A total of 771 subjects, aged over 35 years of age, from a dental hospital in Gwangju metropolitan city, were surveyed cross-sectionally using a self-report questionnaire. We investigated the relationship of subjective oral health status with clinical oral health status, and with perceived oral symptoms using a Chi-squared test (P<0.05). To investigate the effects of factors on subjective oral health status relationship, a logistic regression analysis was performed. 
		                        		
		                        			Results:
		                        			The odds ratios of subjective oral health status between ‘Bad’ vs ‘Good’ were as follows: frequent oral concern, 43.41; occasional oral concern, 2.94; toothache, 6.08; hypersensitivity to coldness, 2.13; 1-3 year’s periodic preventive oral care, 0.19; 4-7 and periodic preventive oral care, 0.14. 
		                        		
		                        			Conclusions
		                        			Periodic preventive oral care appears to be associated with self-rated subjective oral health status. 
		                        		
		                        		
		                        		
		                        	
10.Relationship of Calcium–Magnesium Ratio in Hair with Triglyceride-Glucose Index and Triglyceride/High-Density Lipoprotein-Cholesterol Ratio among Overweight or Obese Korean Individuals: A Pilot Study
Hyo Young SIM ; Sun Young JUNG ; Yong Jae LEE ; Byoungjin PARK
Korean Journal of Family Practice 2020;10(6):443-447
		                        		
		                        			 Background:
		                        			The interaction between calcium and magnesium as a risk modifier for insulin resistance may be largely overlooked because the strict regulatory system in blood has been thought to maintain such homeostatic interactions under tight control. This study aimed to investigate the relationship between the calcium-magnesium ratio in hair with the triglyceride glucose index (TyG index) and triglyceride/HDL-cholesterol ratio (TG/ HDL ratio) among overweight or obese Korean individuals. 
		                        		
		                        			Methods:
		                        			This cross-sectional study included 56 participants fulfilling the inclusion criterion of a body mass index of 23 kg/m2 or more. Intra-abdominal visceral adipose tissue (VAT) was measured by fat measurement computed tomography, while calcium and magnesium levels were measured by hair mineral analysis. A high TyG index and a high TG/HDL ratio were defined as >9.3 and >4.0, respectively (>75th percentile). Using multiple logistic regression analysis, we examined the associations between the TyG index, TG/HDL ratio, and calcium–magnesium ratio in hair. 
		                        		
		                        			Results:
		                        			The mean age, body mass index, and VAT were 45.3 years, 28.5 kg/cm2 , and 137.4 cm2 , respectively. Compared to the controls, the odds ratios (95% confidence intervals) for a high TyG index and a high TG/HDL ratio were 16.03 (1.32–194.23) and 9.98 (1.05–94.98) per one increment of log (calcium-magnesium ratio), respectively, after adjusting for age, sex, body mass index, visceral adipose tissue, white blood cell count, total cholesterol, hypertension medication, diabetes medication, and dyslipidemia medication. 
		                        		
		                        			Conclusion
		                        			We found that the calcium-magnesium ratio in hair was positively and independently associated with the TyG index and TG/HDL ratio. 
		                        		
		                        		
		                        		
		                        	
            
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