Korean Journal of Family Medicine

"Ji Won Lee"

Original Articles

Association between the Urine Cotinine Level and Blood Pressure in Korean Adults with Secondhand Smoke Exposure: Korea National Health and Nutritional Examination Survey 2016–2018: Joon Hyung Lee, Jae Yong Shim, Ji Won Lee; Korean J Fam Med 2023;44(4):205-214. Published online May 30, 2023; DOI: https://doi.org/10.4082/kjfm.22.0153

Abstract
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Background
Similar to smoking, exposure to secondhand smoke is a risk factor for developing hypertension and cardiovascular diseases; however, there is no standardized method for measuring smoke exposure. Measuring urine cotinine levels is one possible means for determining the degree of exposure to secondhand smoke. This study investigated the association between urinary cotinine levels and blood pressure in Korean adults exposed to secondhand smoke.
Methods
Data from the Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018 were used. A total of 9,273 participants aged ≥19 years self-reported as current non-smokers, which was cotinine- verified. A complex sample general linear model regression analysis was performed to analyze the association between urine cotinine and blood pressure. A P-value of <0.05 was considered statistically significant.
Results
Corrected urine cotinine levels were positively associated with systolic and diastolic blood pressure in female participants (P<0.001 and P=0.040, respectively). Furthermore, a 10-fold increase in the corrected urine cotinine level of those in contact with secondhand smoke was independently associated with 2.085 mm Hg and 0.575 mm Hg increases in systolic and diastolic blood pressure, respectively. However, there was no association between systolic and diastolic blood pressure in male participants (P=0.226 and P=0.256, respectively).
Conclusion
Urinary cotinine levels were positively associated with increased blood pressure in females exposed to secondhand smoke. Therefore, urinary cotinine may be used as an indicator to quantify and monitor the effects of blood pressure elevation in females exposed to secondhand smoke.

Citations

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Association between the urine tobacco metabolite levels and physical health in Chinese primary school students with secondhand smoke exposure
Menghan Cheng, Miao Zhang, Wen Fang, Hong Qin, Yue Pan, Shengyi Chen, Guiqi Cao, Yao Zhang, Yu Lu
Frontiers in Public Health.2025;[Epub] CrossRef
Assessment of smoking exposure by urine cotinine levels in severe COVID-19 patients: a case-control study
Medeni Arpa, Bayram Şen, Leyla Kazancıoğlu, Hülya Kılıç
Scientific Reports.2025;[Epub] CrossRef

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Relationship between Decreased Estimated Glomerular Filtration Rate and Sarcopenic Obesity among Postmenopausal Women: Korea National Health and Nutrition Examination Survey (2008–2011): Changbin Hong, Jae Yong Baek, Ji Won Lee, Ji Hoon Lee, Kayoung Lee, Tae-jin Park, Jinseung Kim; Korean J Fam Med 2020;41(5):332-338. Published online May 21, 2020; DOI: https://doi.org/10.4082/kjfm.19.0032

Abstract
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Background
Previous studies have shown that body composition is associated with chronic kidney disease (CKD), and perimenopause is associated with increased fat mass and decreased lean body mass. Muscle wasting is common among patients with CKD. Sarcopenic obesity (SO) refers to excess adiposity with decreased muscle mass. However, little is known about the relationship between SO and renal function decline. Here, we identified the relationship between SO and decreased estimated glomerular filtration rate (eGFR) in postmenopausal women.
Methods
We conducted a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Survey (2008–2011). We analyzed 4,560 postmenopausal women who underwent dual energy X-ray absorptiometry. Sarcopenia was defined based on weight-adjusted appendicular skeletal muscle mass. Obesity was defined based on body mass index. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were classified into four groups: normal, obese, sarcopenic, and sarcopenic obese. Logistic regression analysis was performed to examine the association between SO and decreased eGFR. The results were adjusted for variable confounders.
Results
In the unadjusted model, the odds ratio (OR) of decreased eGFR for SO was 1.67 (95% confidence interval [CI], 1.23–2.26). The obese and sarcopenic groups had ORs of 0.67 (95% CI, 0.44–1.03) and 0.70 (95% CI, 0.44–1.10), respectively. After controlling for confounding variables, there was also a significant association between SO and decreased eGFR (adjusted OR, 1.48; 95% Cl, 1.05–2.07).
Conclusion
SO was independently associated with decreased eGFR in postmenopausal Korean women.

Citations

Citations to this article as recorded by

Sarcopenic obesity in predialysis chronic kidney disease: Muscle strength is a predictor of mortality and disease progression in a six-year prospective cohort
Dílmerson Oliveira, Viviane Angelina de Souza, Guilherme Cardenaz Souza, Lucas Fernandes Suassuna, Marcus Gomes Bastos, Maycon Moura Reboredo, Natália Maria da Silva Fernandes, Jeremy P Loenneke
PLOS ONE.2025; 20(3): e0318773. CrossRef
Obesity paradox in older sarcopenic adults ― a delay in aging: A systematic review and meta-analysis
Szimonetta Eitmann, Peter Matrai, Peter Hegyi, Marta Balasko, Balint Eross, Kira Dorogi, Erika Petervari
Ageing Research Reviews.2024; 93: 102164. CrossRef
Association of skeletal muscle index with postoperative acute kidney injury in living donor hepatectomy: A retrospective single‐centre cohort study
Ji‐Hoon Sim, Hye‐Mee Kwon, In‐Gu Jun, Sung‐Hoon Kim, Kyoung‐Sun Kim, Young‐Jin Moon, Jun‐Gol Song, Gyu‐Sam Hwang, YouSun Ko, Kyung‐Won Kim
Liver International.2022; 42(2): 425. CrossRef
Dynapenic-abdominal obesity as an independent risk factor for chronic kidney disease in postmenopausal women: a population-based cohort study
Youngju Choi, Jinkyung Cho, Jiyeon Kim, Jun Hyun Bae, Eun-Jeong Cho, Eunwook Chang, Kyung-Lim Joa, Junghoon Kim, Dong-Ho Park, Ju-Hee Kang, Hyo-Bum Kwak
Menopause.2022; 29(9): 1040. CrossRef
Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef
Global prevalence of sarcopenic obesity in older adults: A systematic review and meta-analysis
Qianqian Gao, Fan Mei, Yi Shang, Kaiyan Hu, Fei Chen, Li Zhao, Bin Ma
Clinical Nutrition.2021; 40(7): 4633. CrossRef

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Comparison of Surrogate Markers as Measures of Uncomplicated Insulin Resistance in Korean Adults: Tae Jong Kim, Hye Jung Kim, Young Bae Kim, Jee Yon Lee, Hye Sun Lee, Jung Hwa Hong, Ji Won Lee; Korean J Fam Med 2016;37(3):188-196. Published online May 26, 2016; DOI: https://doi.org/10.4082/kjfm.2016.37.3.188

Abstract
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Background

Metabolic syndrome (MS) is known to increase the risk of various cardiometabolic diseases and in-sulin resistance (IR) has known to have central role in the development of MS. Many surrogate indices of IR have been proposed and the detection of MS might be a suitable model for assessing the accuracy of surrogate indices. The aims of our study are to invest the most appropriate index by assessment of the diagnostic capacity of IR among each surrogate index and identifying cut-off values for discriminating uncomplicated MS in Korean adults.

Methods

A cross-sectional study was performed, assessing 294 Korean adults, 85 of whom were diagnosed with uncomplicated MS. The sensitivities and specificities of five surrogate IR indices were compared to discriminate MS from healthy subjects; these included fasting serum insulin, homeostasis model assessment–insulin resistance index, quantitative insulin sensitivity check index, McAuley index, and Disse index. Correlations between each index value were assessed using Pearson's and Spearman's correlation methods.

Results

The McAuley index showed the highest area under the curve (0.85), specificity (86.12%), accuracy (82.31%), positive predictive value (68.13%), and negative predictive value (88.67%) to distinguish MS, with a cut-off point of 5.3 defined. Correlation coefficients of the five indices showed that the McAuley index had the strongest correlation with IR.

Conclusion

The McAuley index showed the best accuracy in the detection of MS as a surrogate marker of IR. To establish more effective and accurate standards of measuring IR, comprehensive and multi-scaled studies are required.

Citations

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Ehsan Mir, Alireza Shamseddini, Najmeh Rahimi, Behzad Bazgir
International Journal of Diabetes in Developing Countries.2025; 45(1): 175. CrossRef
Association between plasma leptin/adiponectin ratio and insulin resistance indexes in prepubertal children
Carolina Bravo, Verónica Mericq, Ana Pereira, Camila Corvalán, Hugo E. Tobar, José Patricio Miranda, José Luis Santos
Archives of Endocrinology and Metabolism.2024;[Epub] CrossRef
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Arghavan Niyazi, Seyed Mohammad Ali Yasrebi, Mohtaram Yazdanian, Gholam Rasul Mohammad Rahimi
Biological Research For Nursing.2024; 26(3): 449. CrossRef
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Shaghayegh Hosseinkhani, Katayoon Forouzanfar, Nastaran Hadizadeh, Farideh Razi, Somayeh Darzi, Fatemeh Bandarian
Endocrine, Metabolic & Immune Disorders - Drug Targets.2024; 24(11): 1291. CrossRef
The effect of dietary carbohydrate restriction and aerobic exercise on retinol binding protein 4 (RBP4) and fatty acid binding protein 5 (FABP5) in middle-aged men with metabolic syndrome
Bahloul Ghorbanian, Alexei Wong, Asgar Iranpour
British Journal of Nutrition.2023; 130(4): 553. CrossRef
Knowledge and Attitude of Medical Students about Insulin Resistance Symptoms, Effect, and Treatment
Alaa Saber Shihab
Journal for Research in Applied Sciences and Biotechnology.2023; 2(5): 44. CrossRef
A Brief Review of Commonly Used Indices for the Assessment of Insulin Sensitivity and Resistance
Mudhafar S. Khazaal, Rawaa Hamid Abdulshahed, Alaa Khalid Ali Alabbas
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Gastro Hep Advances.2022; 1(3): 299. CrossRef
Correlation of advanced glycation end products and heme oxygenase-1 in Korean diabetic patients
Ha-Neul Choi, Da-Hye Koo, Jung-Eun Yim
Journal of Nutrition and Health.2022; 55(3): 348. CrossRef
Link between Insulin Resistance and Obesity—From Diagnosis to Treatment
Jakub Gołacki, Małgorzata Matuszek, Beata Matyjaszek-Matuszek
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The insulin sensitivity Mcauley index (MCAi) is associated with 40-year cancer mortality in a cohort of men and women free of diabetes at baseline
Yonatan Moshkovits, David Rott, Angela Chetrit, Rachel Dankner, Antonio De Vincentis
PLOS ONE.2022; 17(8): e0272437. CrossRef
Obesity and COVID-19: what makes obese host so vulnerable?
Sameer Mohammad, Rafia Aziz, Saeed Al Mahri, Shuja Shafi Malik, Esraa Haji, Altaf Husain Khan, Tanvir Saleem Khatlani, Abderrezak Bouchama
Immunity & Ageing.2021;[Epub] CrossRef
Deciphering Biochemical and Molecular Signatures Associated with Obesity in Context of Metabolic Health
Daisy Masih, Jitendra Kumar Tripathi, Gurseen Rakhra, Annu Vats, Saroj Kumar Verma, Prabhash Kumar Jha, Manish Sharma, Mohammad Zahid Ashraf, Som Nath Singh
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The association between insulin sensitivity indices, ECG findings and mortality: a 40-year cohort study
Yonatan Moshkovits, David Rott, Angela Chetrit, Rachel Dankner
Cardiovascular Diabetology.2021;[Epub] CrossRef
Screening for Glucose Metabolism Disorders, Assessment the Disse Insulin Resistance Index and Hospital Prognosis of Coronary Artery Bypass Surgery
Alexey N. Sumin, Natalia A. Bezdenezhnykh, Andrey V. Bezdenezhnykh, Anastasia V. Osokina, Anastasiya A. Kuz’mina, Anna V. Tsepokina, Olga L. Barbarash
Journal of Personalized Medicine.2021; 11(8): 802. CrossRef
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TaoreedAdegoke Azeez
Hamdan Medical Journal.2021; 14(4): 184. CrossRef
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Róza Ádány, Péter Pikó, Szilvia Fiatal, Zsigmond Kósa, János Sándor, Éva Bíró, Karolina Kósa, György Paragh, Éva Bácsné Bába, Ilona Veres-Balajti, Klára Bíró, Orsolya Varga, Margit Balázs
International Journal of Environmental Research and Public Health.2020; 17(13): 4833. CrossRef
Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults
Chiranjeevi Kumar Endukuru, Girwar Singh Gaur, Dhanalakshmi Yerrabelli, Jayaprakash Sahoo, Balasubramaniyan Vairappan
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The Association between Height and Cognitive Function in Community Dwelling Old Women.: Moo Young Kim, Ji Won Lee, Jee Aee Im, Duk Chul Lee; Korean J Fam Med 2010;31(2):108-114. Published online February 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.2.108

Abstract
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Background
There are growing evidences that structural and functional brain reserves may be crucial in cognitive function of late life. In old men, height as an important marker of growth and development, is related to late life cognitive decline or dementia. The purpose of this study is to examine the relationship of height to cognitive function in community dwelling old women. Methods: A total of 150 community dwelling old women who can carry out daily life independently were recruited in this study. We measured height, weight and blood pressure with an automatic device and investigated medical history and behavioral habits. We obtained fasting blood samples for the glucose and lipid profile tests and measured physical performance. The Korean version of Mini Mental State Examination (K-MMSE) was used for the assessment of cognitive function. Results: The acceptable cognition group (K-MMSE score ≥ 24) was taller than the impaired cognition group (K-MMSE score < 24) (mean height 150.9 ± 6.1, 148.0 ± 5.4, respectively, P-value < 0.01). In Pearson correlation analysis, height was positively associated with K-MMSE score (r = 0.342, P < 0.01). Multiple linear regression analysis showed that height independently related to K-MMSE score after adjustment of age, waist circumference, systolic blood pressure, diabetes, hyperlipidemia, alcohol drinking, residential district, education, gait speed ( = 0.102, P = 0.03). Conclusion: Height was independently associated with cognitive function in community dwelling old women. For the evaluation of the relationship between height and cognition in diverse cohorts, many studies will be necessary.

Citations

Citations to this article as recorded by

Is Obesity Associated with Lower Mini Mental Test Scores among Elderly? A Cross Sectional Study
Nezire İnce, Müjgan Öztürk, Reci Meseri, Halit Tanju Besler
Journal of the American Nutrition Association.2022; 41(6): 600. CrossRef
The Relationship between Height and Cognitive Function among Community-dwelling Elderly: Hallym Aging Study
Shan Ai Quan, Jin-Young Jeong, Dong-Hyun Kim
Epidemiology and Health.2013; 35: e2013002. CrossRef

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The Relationship between Serum Ferritin and High Sensitivity C-reactive Protein among Adults in a Health Promotion Center .: Eun Sil Oh, Hyun Sik Shin, Ji Won Lee, Ji Ae Lim, Duk Chul Lee, Hye Ree Lee; J Korean Acad Fam Med 2008;29(12):908-914. Published online December 10, 2008

Abstract
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Background: More attention is given to oxidative hypothesis which causes atherosclerosis to be recognized as inflammatory response. The relationship between serum ferritin which catalyzes lipid peroxidation and high sensitivity C-reactive protein which reflects vascular inflammation was investigated among adults in a health promotion center. Methods: The study group consisted of 297 men and women (men 86, women 211) who visited the health promotion center of a hospital in Seoul to have a health checkup from October 1, 2004 to April 1, 2005. These subjects answered the questionnares and were measured in the following; blood tests, brachial-ankle pulse wave velocity and several anthropometric measurements. Statistical analysis was performed on 111 subjects after exclusion of those subjects who were taking antihypertensive agents or antidiabetic agents, and who had acute inflammatory diseases, acute liver diseases, anemia, and who had a WBC ≥11,000×10³/mm³or a serum ferritin ≥200 ug/L or a ABI (Ankle Brachial Index) <0.9. Results: The average serum ferritin concentration of men against women was 132.57±43.12 ng/ml to 78.23±38.10 ng/ml which means that men have about 1.7 times as high concentration than women (P<0.001). Serum ferritin was significantly correlated with high sensitivity C-reactive protein (r=0.332). Even in multiple stepwise regression analysis, there was a independent relationship between serum ferritin and high sensitivity C-reactive protein (Ղ=0.138, P=0.010). When we analyzed with distinction of sex, this relationship in women was constant (Ղ=0.131, P=0.031), but serum ferritin in men just showed the trend of correlation with BMI (Ղ=9.510, P=0.059). Conclusion: There is a significant relationship between the increase of serum ferritin and high sensitivity C- reactive protein in healthy women; furthermore, studies in men need to be confirmed. (J Korean Acad Fam Med 2008;29:908-914)

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Effect of Short-term Obesity Management Program for Local Community Residents.: Ji Won Lee, Jee Aee Im, Duk Chul Lee; J Korean Acad Fam Med 2008;29(2):121-133. Published online February 10, 2008

Abstract
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Background
The incidence of obesity is acutely increasing resulting in increased mortality rate and medical expenses among Koreans. But it is rare to find effective obesity management program, that are readily accessible by general local community residents. This study was aimed to develop and evaluate an effective and specialized obesity management program utilizing the local public health institutes. Methods: One hundred forty nine obese adults residing in Kwangju were enrolled in a tentative, 12-week scheduled obesity management program from August 2006 to October 2006. The program constituted of weekly education and practice by specialists, and exercise for more than an hour for 5 days a week. The effectiveness of the program was evaluated according to the change of body weight, body component, blood pressure, and serum lipid concentration. After the program was completed, each participant was surveyed on the degree of satisfaction and lifestyle changes. Results: Ninety participants (60.4%) completed the program to the end. The average decrement of body weight after the program was 1.9±1.5 kg. Eleven participants (12.2%) lost more than 5% of the initial body weight. The waist circumference and average blood pressure significantly decreased among the group who lost more than 5% of the initial body weight. The total cholesterol and triglycerides also slightly decreased among this group. Overall 87.3% of the participants were satisfied with the results of the program. The lifestyle of the participants had also changed by the program. Conclusion: The authors expect that establishing easily- approachable obesity management program in local public health institutes will make a great contribution to the maintenance of proper body weight and decrement of cardiovascular diseases among local community residents. (J Korean Acad Fam Med 2008;29:121-133)

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Relationship between Serum Uric Acid and Metabolic Syndrome.: Hyun Ju Oh, Sang Hoon Moon, Ji Won Lee, Hye Youn Hyun, Duk Chul Lee, Hye Ree Lee; J Korean Acad Fam Med 2006;27(9):699-705. Published online September 10, 2006

Abstract
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Background
: Although many studies have focused on the association of hyperuricemia with components of metabolic syndrome, there are only few studies of independent relation between uric acid and metabolic syndrome itself. In this study, we evaluated healthy subjects and assessed the relationship of serum uric acid with metabolic syndrome.

Methods : Between January and February of 2005, we evaluated 164 healthy patients who visited a health evaluation center. Patients were evaluated for metabolic syndrome and risk factors were assessed using a questionaire, blood test and physical examination.

Results : Metabolic risk factors significantly increased as uric acid level markedly increased (P＜0.05). Even after limiting the variables such as age, sex, smoking, exercise, total cholesterol, low-density lipoprotein cholesterol, and LogCRP, the group with metabolic syndrome had markedly increased uric acid levels than those without metabolic syndrome [Odds ratio 1.494 (95% CI, 1.072∼2.084)].

Conclusion : The number of components of metabolic syndrome increased according to serum uric acid level. Uric acid level was significantly higher in metabolic syndrome than normal. Even after considering health behavior variables such as smoking, alcohol status, and exercise, they showed an independent relationship. Further massive prospective studies on whether collecting serum uric acid level can be used as a screening test or predictor of mortality for early metabolic syndrome and cardiovascular disease will be needed.

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The Relationship between Breast-Feeding and Obesity in Children of Elementary Schools in Seoul.: Sang Hwan Kim, Ji Won Lee, Duk Chul Lee; J Korean Acad Fam Med 2005;26(8):470-480. Published online August 10, 2005

Abstract
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Background
: The purpose of this study was to examine the prevalence of obesity based on body mass index data and to assess the long-term effect of breast feeding on obesity among children in elementary schools.

Methods : A total of 997 children in 1st grade were recruited from 3 public primary schools in Gangdong-gu and 1 private primary school in Nowon-gu, Seoul. A questionnaire was used to gather demographic background and lifestyle-related information infant feeding methods and duration.

Results : There were 101 boys (24.6%) and 100 girls (25.0%) identified as an obese group (BMI ≥85 percentile). The birth weight was higher in the obese group (3.34±0.46kg) than in the normal body mass index group (3.24±0.43kg). The parental body mass index was higher in the obese group than the normal group. Average hours of daily watching TV, video or computer use was higher in the obese group (2.2±1.2) than in the normal body mass index group (2.0±1.0). In the obese group, children ate more than the normal group. After adjusting for potential confounding factors, there seemed to be some risk reduction for obesity in the breast fed group for at least 7 months, compared to the never breast fed group, but had no statistical significance.

Conclusion : Whether child was breast fed or not nor the duration of breast feeding did not seem to reduce the risk of developing obesity.