| Jee Hye Han | 12 Articles |
Different regional fat depots have different effects on lipid and glucose metabolism. The purpose of this study is to examine the relationship between body fat distribution as measured by dual-energy X-ray absorptiometry (DEXA) and metabolic risk factors and to disclose whether there is any difference between groups with and without metabolic syndrome (MS). A total of 292 participants (98 men, 194 women) over 19 years old underwent whole-body DEXA to evaluate body composition with respect to the whole body, leg, arm, and android regions. Anthropometry and blood tests for metabolic risks were measured. One hundred and seven participants were diagnosed with MS. The MS group had significantly higher android fat (%) and had lower leg fat (%), arm fat (%), and appendicular (arms + legs) fat (%) than the non-MS group. Android fat (%) had a positive correlation with waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, log insulin, hemoglobin A1c (HbA1c), triglyceride (TG), and low density lipoprotein cholesterol, and had a negative correlation with high density lipoprotein (HDL) cholesterol. Appendicular fat (%) had a negative correlation with WC, SBP, DBP, glucose, log insulin, HbA1c, and TG, and had a positive correlation with HDL cholesterol. The association of appendicular fat with metabolic risk was consistently observed in non-MS, but the association was not observed except for SBP, glucose and log insulin in MS. In contrast with the adverse effects of android fat, appendicular fat distribution was associated with decreased risks of MS. The protective effect of appendicular fat against metabolic risk factors in non-MS was less characteristic in MS. Citations Citations to this article as recorded by
Background
: As the metabolic syndrome represents a constellation of cardiovascular risk factors,its prevention is very important. Especially, child and adolescent obesity and metabolic abnormalities track into adulthood and it may promote the development of the metabolic syndrome in adults. however, in Korea there are only few studies about the metabolic syndrome of children and adolescents. Therefore, the objective of this study was to determine the prevalence and distribution of the metabolic syndrome in Korean children and adolescents. Methods : The Korean National Health and Nutrition Survey (KNHNS) 2001 was a nation representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood sample were obtained from 1,090 Korean children and adolescents (567 boys, 523 girls), aged 10 to 19 years. The metabolic syndrome was determined by using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition modified for age. Results : The prevalence of the metabolic syndrome in Korean children and adolescents was 7.1% (9.2% in boys, 4.8% in girls). The syndrome was present in 36.6% of overweight children and adolescents (body mass index [BMI] ≥ 95th percentile) compared with 11.2% of at-risk children and adolescents (BMI 85th to ＜95th percentile) and 2.5% of those with a BMI below the 85th percentile (P＜0.001). A multivariate logistic regression model showed a significant increase in risk of the metabolic syndrome in association with gender and BMI. Conclusion : Overall, 7.1% of children and adolescents and 36.6% of overweight children and adolescents in Korea met the criteria for the metabolic syndrome. These findings emphasize the need for both public health and clinical interventions to improve the detection, prevention, and treatment of the metabolic syndrome, especially in obese children and adolescents.
Background
: To investigate the relationship between adiposity and risk factors for cardiovascular disease (CVD) in normal weight individuals. Methods : The study subjects were those over 19 years old, less than 23 kg/m2 of body mass index (BMI). They were examined in a health promotion center of a general hospital from June to November, 2001 (309 men and 369 women). Height, weight, BMI, blood pressure (BP), serum lipids and fasting blood glucose (FBS) were checked. Percent body percent (%BF) was obtained by bioelectrical method. Normal weight subjects were divided into two groups according to their %BF; then, the groups were evaluated for the presence of CVD risk factors. Results : The average age of the study subjects was 43.66±11.26 years old in men and 41.11±10.90 years old in women. The average BMI was 21.15±1.47 kg/m2 in men and 20.68±1.53 kg/m2 in women. High %BF group showed significantly increased frequency of higher BP, FBS, total cholesterol (TC), triglyceride (TG) and LDL- cholesterol (LDL-C) compared with low %BF group in both sexes. In men, odds ratios (ORs) of the high %BF group with respect to the low %BF group were significantly high for BP and TG elevation. ORs of the high %BF group were significantly high for FBS, TC, LDL-C and TG elevation in women. ORs for more than one CVD risk factor was 2.46 (1.38∼4.38) in men and 1.50 (0.95∼2.36) in women. Conclusion : Increased %BF was related to cardiovascular risk factors in normal weight subjects. The result was more significant for normal weight men than normal weight women.
Background
: C-reactive protein is an acute phase reactant, which can be increased by either (both) infectious or (and) non-infectious and non-specific reaction of cells and tissue metabolism. Also C-reactive protein is known to have a relationship between changes in lipid and glucose metabolism. In recent studies, the possibility of being a prognostic factor of cardiovascular risk factors and serum C- reactive protein concentration within conventional reference ranges in otherwise normal people has also received little attention. Therefore, in the study, we tried to look for the relationship between C-reactive protein and cardiovascular risk factors of a healthy adult. Methods : We analyzed the results of the surveys and general chemistries given to 3,548 healthy men and women who have visited the health promotion center in a certain university hospital. We assayed the C-reactive protein by means of rate nephelometry. We omitted the case of 123 people who went over 1mg/dL. We compared C-reactive protein of normal and abnormal range of each risk factor and went through the multiple regression analysis for the factors with significant differences. Results : When C-reactive protein concentration of normal and abnormal range of cardiovascular risk factors were compared by t-test, there were differences according to age (p<0.001), sex(p<0.001), body mass index (p<0.001), WBC (p<0.001), systolic blood pressure (p<0.001), diastolic pressure (p<0.001), total cholesterol (p<0.01), HDL-cholesterol (p<0.05) and smoking (p<0.001). We could not find any significant difference of triglycerides. After going through multiple regression analysis for the risk factors, which showed a significant difference by t-test, we found out that the C-reactive protein increased as cholestrol (p<0.01), body mass index (p<0.01) and WBC (p<0.001) increased. As for HDL-cholesterol (p<0.001), the C-reactive protein increased as it decreased. Age, sex, smoking history, systolic blood pressure, and diastolic blood pressure did not show significant relationship we were looking for. Conclusion : C-reactive protein was not related to age, smoking history, blood pressure, and triglycerides among cardiovascular risk factors, bot was related to body mass index, cholesterol, HDL-cholesterol and WBC. This relationship indicated that even if the C-reactive protein was in normal range a person with C-reactive protein should be aware of the risk involved for cardiovascular diseases.
Background
: Body weight is a well known factor of bone density. However, studies for correlation between body fat, lean body mass and bone density are inconsistent in premenopausal women. We reviewed the relations of body weight, body mass index(BMI), body fat, body fat percent, fat free mass and spinal bone density. Methods : We collected data of healthy young women of 20-39 years old who visted a health promotion center of a general hospital from March to August, 2000. and examined the correlation of body weight, BMI, body fat, body fat percent, fat free mass and spinal bone density. Results : The total number of observation was 309, the average age was 34±4 year old, the average body weight was 55.4±7.7 kg, the height was 158±5 cm, the BMI was 22.05±2.80 kg/m², the body fat percent was 25.5±5.3%, and the spinal bone density was 1.007±0.116g/cm² The incidence of normal bone weight group, 72.6%, 26.8%, 0.5%, respectively, in the normal weight group, and 90.9%, 9.1%, 0%, respectively, in the obese group. In linear regression analysis, the spinal bone density correlated with age, height, weight, BMI, body fat, and fat free mass. In stepwise multiple regression analysis, the fat free mass was a significant factor(R2=0.065(p<0.001)) of the spinal bone density. Conclusion : The spinal bone density was correlated with age, height, body weight, BMI, fat mass, and fat free mass. The multiple regression analysis suggested that only fat ree mass was significantly correlated with spinal bone density.
Background
: There has been no systematic investigation of the necessary core procedures in primary care in Korea. The purpose of this study is to examine the core procedures necessary in primary care and to have the results reflected in residency programs. Methods : A mail survey was conducted from May 2, to August 20, 1997 among 478 physicians who qualified as a family physician specialist since 1989. The contents of the questionnaire included 1) sex, age, location and size of the hospital 2) of the 93 procedures that should be taught during residency programs as suggested by the [American Academy of Family Physicians] and the [Korean Academy of Family Physicians] a) procedures taught in residency programs, b) procedures performed by practicing family physicians, and, c) procedures considered as necessary in primary care. Results : 1) Of the 93 procedures, 78 were taught in residency programs, 35 were performed by practicing family physicians, and 77 were considered necessary in primary care. 2) All of the 35 procedures performed by family physicians were taught in the residency programs. Of the 77 procedures considered necessary in primary care, 71 were taught but the remaining 6 were infrequently taught. 3) 7 procedures were taught but were considered unnecessary ; Procedures taught but not actually performed amount-ed to a total of 43. 4) 42 procedures were considered necessary but not performed. 5) More procedures were performed by male doctors(p<0.05). Surgical procedures were performed more often in regional hospitals than those in Seoul and in the larger cities(p<0.05), and more were performed in private practice(p<0.05). Conclusion : Although almost all of the procedures considered necessary in primary care were taught in residency programs, many procedures were not being performed in current medical practice. We suggest that it would be more effective to intensively train the core procedures than to provide exposure to a wide array of procedures. As the procedures performed were found to vary in relation to sex, location and size of the attending hospital, it would be desirable for training programs to accommodate individual needs, giving residents access to specific procedures needed for their future.
Background
: HBsAg carriers are 6-12% of population in Korea. The patients' knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram. Methods : From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctor's recommendation. Results : Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positive, 10% answered HBsAg negative, and 26% answered 'I don't know'. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% form carrier mother at birth, 29% by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctor's recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%). Conclusion : The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctor's recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.
Background
: Spinal cord injured patients are increased due to occupational and traffic accidents. To give them a comprehensive and continuous medical service, the authors investigated the factors that could influence the psychopathology and functional level and the relationship of psychopathology and functional level. Methods : 56 spinal cord injured patients ranging in age from 18 to 57 years who were under treatmtnet at rehabilitation centers were completed the study. Results : The depression scale of the patients who got religion was significantly lower than that of the patients who did not. Somatization scale was higher in patients of duration of more than 1 year. Other demographic factors did not influence the psychopathology. Barthel index was influenced by the level of injury and the duration, but there was no relation between the psychopathology and Barthel score. Conclusion : The authors expected that psychopthology could influence the functional level of spinal cord injured patients, but the results we got from this study was not. There was no significant relation between the level of injured cord and the phychopathology.
Background
: Inspite of the significance of early detection for glaucoma, the majrity of primary care physician does not mesure intraocular pressure in their setting due to limitation of technique for conventional tonometry. The purpose of this study was to compare the effectiveness of noncontact tonometry(NCT) using the air-puff noncontact tonometer(CT-50, Topcon, Ltd, Japan) with that of conventional tonometry using the Goldmann applanation tonometer as a screening tool for glaucoma. Methods : Intraocular pressure was measured by a technician using the air-puff NCT 3 times and by a skillful ophthalmologist using the Goldmann applanation tonometry once in both eyes of 153 patients who visited eye clinic from June, 1993 to July. 1993. Results : Air-puff NCT correctly identified 12 of the 13 eyes with an intraocular pressure above 21mmHg measured by Goldmann applanation tonometry for a sensitivity of 92.3%, and 267 of the 268 eyes with an intraocular pressure less than 21mmHg for a specificity of 91.1%. The two methods of intraocular pressure measurement yielded similar pressure readings. The correlation coefficinet is 0.91(Y=0.80X +1.81). Conclusion : Air-puff NCT is an easy, safe, and practical method of intraocular pressure measurement. So we suppose that air-puff NCT can availably be used in primary care setting to detect glaucoma.
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