Korean Journal of Family Medicine

"Yun Jin Kim"

Original Articles

Association between e-cigarette smoking and insulin resistance using the triglyceride-glucose index in Korean adults: Korea National Health and Nutrition Examination Survey: Dahae Lim, Jung In Choi, Ryuk Jun Kwon, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Youngin Lee, Sae Rom Lee, Soo Min Son, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra; Korean J Fam Med 2025;46(5):327-332. Published online August 20, 2024; DOI: https://doi.org/10.4082/kjfm.23.0141

Abstract
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Background
Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.
Methods
This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.
Results
E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=9.35; never: mean=9.18; P<0.001). The ecigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03–1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03–2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14–12.30).
Conclusion
Our findings suggest that e-cigarette use is significantly associated with insulin resistance.

Citations

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Comparison of e-Cigarette and Cigarette Use and Dual Use Associations With Disease: Updated Systematic Review and Meta-Analysis
Stanton A. Glantz, Andre Luiz Oliveira da Silva
Public Health Reports®.2026;[Epub] CrossRef
E-cigarette aerosols as systemic metabolic disruptors: integrated mitochondrial, circadian, and neurobehavioral mechanisms
Ardie Barry Sailis
Toxicology Mechanisms and Methods.2026; : 1. CrossRef
Association Between Electronic Cigarette Use and Risk of Obstructive Sleep Apnea Among Korean Adults: A Cross-Sectional Nationwide Population-Based Study
Wonseok Jeong, Min Ji Song, Ji Hye Shin, Ji Hyun Kim
Journal of Clinical Medicine.2025; 14(11): 3616. CrossRef
Unveiling the risks of noncombustible nicotine or tobacco products
Su-Min Jeong
Korean Journal of Family Medicine.2025; 46(5): 297. CrossRef

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Association between breakfast consumption frequency and chronic inflammation in Korean adult males: Korea National Health and Nutrition Examination Survey 2016–2018: Eun Ji Han, Eun Ju Park, Sae Rom Lee, Sang Yeoup Lee, Young Hye Cho, Young In Lee, Jung In Choi, Ryuk Jun Kwon, Soo Min Son, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra; Korean J Fam Med 2025;46(2):92-97. Published online July 5, 2024; DOI: https://doi.org/10.4082/kjfm.23.0151

Abstract
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Background
Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker.
Methods
A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests.
Results
Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036).
Conclusion
Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

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Cumulative circadian disruption factors and metabolic syndrome
Jungun Lee
Korean Journal of Family Medicine.2025; 46(3): 125. CrossRef

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Association between Sleep Duration and Presbycusis in Korean Adults: Korea National Health and Nutrition Examination Survey: Min Ju Kang, Youngin Lee, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Eun Ju Park, Seung Hun Lee, Gyu Lee Kim, Jung In Choi, Young Jin Ra, Sae Rom Lee, Ryuk Jun Kwon, Soo Min Son, Yea Ji Lee, Young Eun Choi; Korean J Fam Med 2023;44(2):117-123. Published online March 20, 2023; DOI: https://doi.org/10.4082/kjfm.22.0137

Abstract
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Background
Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years.
Methods
We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and <40 dB, whereas moderate-to-severe presbycusis was defined as >40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates.
Results
The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration.
Conclusion
Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Citations

Citations to this article as recorded by

Prevalence and sex differences in moderate-to-severe hearing loss among older adults: a cross-sectional study
Chunhao Li, Yue Fan, Fangxu Yan, Haibo Huang, Xin Xia, Shuwen Guan, Zijun Yue, Guangliang Shan, Xingming Chen
BMC Geriatrics.2026;[Epub] CrossRef
Joint association of sleep duration and depression with new-onset hearing loss: a national cohort study
Fang Wang, Yu-Jun Xiong, Da-Ming Shao, Tian Lv, Shiqin Chen, Qian-Yuan Zhu
Frontiers in Nutrition.2025;[Epub] CrossRef
Sleep characteristics and hearing loss in middle-aged and older adults: The National Health and Nutrition Examination Survey 2015–2018
Kening Jiang, Adam P. Spira, Nicholas S. Reed, Frank R. Lin, Jennifer A. Deal
Sleep Epidemiology.2024; 4: 100082. CrossRef
Age-related hearing loss and its potential drug candidates: a systematic review
Shiyu Hu, Qingru Sun, Fei Xu, Ninghua Jiang, Jianli Gao
Chinese Medicine.2023;[Epub] CrossRef

5,857 View
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Association between Serum Folic Acid Levels and Asthma in the Korean Population: A Study Based on the 2016–2018 Korea National Health and Nutrition Examination Survey: So Ra Kim, Eun Ju Park, Young Hye Cho, Sang Yeoup Lee, Jung-In Choi, Young-In Lee, Sae Rom Lee, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra; Korean J Fam Med 2022;43(4):241-245. Published online July 19, 2022; DOI: https://doi.org/10.4082/kjfm.21.0143

Abstract
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Background
Folic acid is involved in inflammatory reactions; however, the association between folic acid and allergic diseases, particularly asthma, remains unclear. Thus, this study aimed to evaluate the association between serum folic acid levels and asthma in Koreans.
Methods
This study analyzed the serum folic acid levels of 6,615 individuals included in the 2016–2018 Korea National Health and Nutrition Examination Survey. The prevalence of asthma was determined using a questionnaire that identified cases of physician-diagnosed asthma. The relationship between serum folic acid levels and asthma was analyzed using logistic regression analysis.
Results
Multiple logistic regression analysis showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of asthma after adjusting for confounding factors including sex, age, household income, current smoking, current alcohol use, and body mass index (odds ratio [OR], 0.930; 95% confidence interval [CI], 0.876– 0.987; P=0.017). The relationship between the adjusted odds of asthma and serum folic acid levels were consistently inverse (OR, 2.266; 95% CI, 1.126–4.420; P for trend=0.038).
Conclusion
Serum folic acid levels are inversely associated with physician-diagnosed asthma in the Korean population.

Citations

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The anti-inflammatory effects of folic acid
Mengmeng Song, Benjamin P. Xu
Precision Nutrition.2024; 3(2): e00070. CrossRef
Association between serum folate levels and blood eosinophil counts in American adults with asthma: Results from NHANES 2011–2018
Jun Wen, Changfen Wang, Mohan Giri, Shuliang Guo
Frontiers in Immunology.2023;[Epub] CrossRef

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Association between Near Work Time and Depression among Workers in South Korea: Na Rae Jeong, Seung Hun Lee, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Yougn Jin Tak, Hye Rim Hwang, Gyu Lee Kim, Sang Yeoub Lee, Young Hye Cho, Eun Ju Park, Young In Lee, Jung In Choi; Korean J Fam Med 2021;42(5):390-394. Published online September 20, 2021; DOI: https://doi.org/10.4082/kjfm.20.0217

Abstract
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Background
The aim of this study was to evaluate the association between near work time and depression.
Methods
Data of 1,551 workers aged 19–49 years from the sixth Korea National Health and Nutrition Examination Survey were examined. The Patient Health Questionaire-9 scores were used to screen for depression. Participants who scored a total of 10 or above, which is suggestive of the presence of depression, were classified as the depression group; the rest were classified as normal. The correlation between daily near work time and depression was analyzed using multivariate logistic analysis after adjusting for other sociodemographic and health behavior-related variables.
Results
Multivariate logistic analysis found that workers with 3 or more hours of near work were more likely to report depression compared to the reference group who had 2 or fewer hours per day of near work (adjusted odds ratio, 2.471; 95% confidence interval, 1.062–5.747).
Conclusion
Longer near work time was associated with depression among South Korea’s workers. Therefore, it is necessary to reduce near work time to prevent depression.

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Low Vision Rehabilitation and Eye Exercises: A Comprehensive Guide to Tertiary Prevention of Diabetic Retinopathy
Tibor Rák, Andrea Kovács-Valasek, Etelka Pöstyéni, Róbert Gábriel, Adrienne Csutak
Life.2025; 15(6): 857. CrossRef

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Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea: Sung Eun Jo, Hye Rim Hwang, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Seung Hun Lee, Eun Ju Park, Youngin Lee; Korean J Fam Med 2021;42(3):225-231. Published online August 4, 2020; DOI: https://doi.org/10.4082/kjfm.19.0103

Abstract
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Background
Although many studies have demonstrated that the first cigarette in the morning increases the prevalence of smoking-related morbidity, limited studies have examined the impact of time to first cigarette (TTFC) on the health-related quality of life (HRQoL). Thus, we assessed this relationship using nationally-representative data from the Korea National Health and Nutrition Examination Survey VII-1 (2016).
Methods
We conducted a cross-sectional study using data from 577 current male smokers aged 30–59 years, after excluding those with a certain disease. Participants were divided into four categories according to TTFC (≤5 min, 6–30 min, 31–60 min, >60 min). HRQoL was measured using self-reported EuroQol-5 (EQ-5D). The relationship between TTFC and EQ-5D index was analyzed using a multivariate-adjusted generalized linear model to assess how HRQoL varies according to TTFC. After adjusting for confounders, a multivariate-adjusted logistic regression analysis was performed to identify which of the five dimensions of the EQ-5D affected the HRQoL according to TTFC.
Results
The generalized linear analysis indicated that as TTFC decreased (6–30 min, 31–60 min vs. >60 min), the EQ-5D index score decreased significantly (P=0.037). Shorter TTFC (≤5 min vs. >60 min) was associated with higher pain/discomfort (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.39–10.48) and anxiety/depression (OR, 7.58; 95% CI, 1.75–32.88).
Conclusion
Higher nicotine dependence was associated with impaired HRQoL. These results may be used to improve smoking cessation treatment outcomes.

Citations

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Current status of tobacco use, cessation and control policy in Korea
Cheol Min Lee
Journal of the Korean Medical Association.2022; 65(12): 789. CrossRef

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Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014–2015 Korea National Health and Nutrition Examination Survey: Bo Mi Kim, Yu Hyeon Yi, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Young Hye Cho, Young Jin Tak, Hye Rim Hwang, Seung Hun Lee, Eun Ju Park, Youngin Lee; Korean J Fam Med 2020;41(6):404-411. Published online February 12, 2020; DOI: https://doi.org/10.4082/kjfm.19.0073

Abstract
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Background
Grip strength is a convenient method to measure muscle strength. Recently, relative handgrip strength (HGS) was recommended as a clinical predictor of metabolic health and disease, such as dyslipidemia, which is considered a risk factor for cardiovascular disease. The purpose of this study was to characterize the association between relative HGS and dyslipidemia.
Methods
We included 6,027 adults (2,934 men, 3,093 women) aged 30–69 years who participated in the Korea National Health and Nutrition Examination Survey in 2014 and 2015. Relative HGS was obtained by dividing the HGS by body mass index. Complex sampling analysis was conducted to compare the general characteristics of participants according to the quartiles of relative HGS. Logistic regression analysis was used to examine the association between quartiles of relative HGS and dyslipidemia.
Results
After adjustment for age, prevalence of diabetes mellitus, prevalence of hypertension, alcohol consumption, smoking status, exercise, income, and education level, relative HGS was inversely associated with dyslipidemia in both men and women. In multivariable logistic regression analysis, the odds ratios (95% confidence intervals) for dyslipidemia in quartiles 1, 2, and 3 relative to quartile 4 were 1.36 (1.00–1.83), 1.29 (0.98–1.70), 1.23 (0.95– 1.60) in men and 1.81 (1.30–2.50), 1.81 (1.32–2.47), 1.39 (1.07–1.81) in women, respectively.
Conclusion
Relative HGS was inversely associated with dyslipidemia risk in Korean adults. Muscle-strengthening exercise is recommended to enhance health outcomes.

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Could calisthenic exercises improve maximal exercise capacity, peripheral muscle strength and quality of life in dyslipidemia?
Furkan Özdemir, Melda Sağlam, Aydan Aslı Aksel Uylar, Oğuz A. Uyaroğlu, Nursel Çalik Başaran, Mine Durusu Tanriöver, Naciye Vardar Yağli, Hasan Sozen
PLOS One.2025; 20(6): e0326026. CrossRef
COMPARAÇÃO DAS EXPRESSÕES DA FORÇA DE PREENSÃO MANUAL COM OS COMPONENTES DA SÍNDROME METABÓLICA EM ADULTOS
João José Albuquerque de Sousa Júnior, Thatiana Lameira Maciel Amaral, Gina Torres Rego Monteiro, Cledir de Araújo Amaral, Maurício Teixeira Leite de Vasconcellos, Joaquim Reverter-Masia
Revista Contemporânea.2025; 5(10): e9386. CrossRef
Relative Grip Strength as a Predictor of Nonalcoholic Fatty Liver Disease Incidence: A Longitudinal Study by Metabolic Syndrome Status and Risk Factors Aged 51 to 88 Years
DooYong Park, Buseok Kim, On Lee, Yeon Soo Kim
The Korean Journal of Sports Medicine.2025; 43(4): 238. CrossRef
Association between handgrip strength and metabolic syndrome in relation to gender and adiposity among middle aged and older Saudi populations
Shaea A. Alkahtani, Ghedeir M. Alshammari, Aishah Alzuwaydi, Abdulaziz Alfuhaid, Abeer A. Al-Masri, Rizwan Qaisar, Syed Shahid Habib
The Aging Male.2024;[Epub] CrossRef
Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults
Letícia Martins Cândido, Núbia Carelli Pereira de Avelar, Eleonora D’Orsi, Ana Cristina Rodrigues Lacerda, Vanessa Amaral Mendonça, Gabriella Tringali, Alessandro Sartorio, Ana Lúcia Danielewicz
Journal of Aging and Physical Activity.2024; 32(2): 225. CrossRef
Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries
Rizwan Qaisar, M. Azhar Hussain, Fabio Franzese, Asima Karim, Firdos Ahmad, Atif Awad, Abeer A. Al-Masri, Shaea A. Alkahtani
Aging Clinical and Experimental Research.2024;[Epub] CrossRef
Increasing muscular strength to improve cardiometabolic risk factors
Patricio Lopez-Jaramillo, Jose P. Lopez-Lopez, Maria Camila Tole, Daniel D. Cohen
Clínica e Investigación en Arteriosclerosis.2023; 35(3): 144. CrossRef
Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people
Wonjeong Jeong, Jong Youn Moon, Jae-Hyun Kim
BMC Geriatrics.2023;[Epub] CrossRef
Identification of subgroups with poor lipid control among patients with dyslipidemia using decision tree analysis: the Korean National Health and Nutrition Examination Survey from 2019 to 2021
Hee Sun Kim, Seok Hee Jeong
Journal of Korean Biological Nursing Science.2023; 25(2): 131. CrossRef
Increasing muscular strength to improve cardiometabolic risk factors
Patricio Lopez-Jaramillo, Jose P. Lopez-Lopez, Maria Camila Tole, Daniel D. Cohen
Clínica e Investigación en Arteriosclerosis (English Edition).2023; 35(3): 144. CrossRef
Association between Relative Handgrip Strength and Insulin Resistance in Korean Elderly Men without Diabetes: Findings of the 2015 Korea National Health Nutrition Examination Survey
Kwang-Chae Joo, Da-Hye Son, Jae-Min Park
Korean Journal of Family Medicine.2022; 43(3): 199. CrossRef
Association Between C-Reactive Protein and Relative Handgrip Strength in Postmenopausal Korean Women Aged 45–80 Years: A Cross-Sectional Study
Da-Hye Son, Seung-Ah Song, Yong-Jae Lee
Clinical Interventions in Aging.2022; Volume 17: 971. CrossRef
Relationship Between Relative Grip Strength and Serum Total Cholesterol, High-Density Lipoprotein Cholesterol, Low-Density Lipoprotein Cholesterol, and Triglyceride Levels in Korean Middle-Aged or Older Adults: A Panel Regression Model
DooYong Park, Duck-Chul Lee, YeonSoo Kim
Metabolic Syndrome and Related Disorders.2022; 20(9): 517. CrossRef
Stroke-Related Sarcopenia among Two Different Developing Countries with Diverse Ethnic Backgrounds (Cross-National Study in Egypt and China)
Marwa Mohammed, Jianan Li
Healthcare.2022; 10(11): 2336. CrossRef
Importance of Handgrip Strength as a Health Indicator in the Elderly
Soo Young Kim
Korean Journal of Family Medicine.2021; 42(1): 1. CrossRef
Handgrip Strength: An Irreplaceable Indicator of Muscle Function
Sang Yoon Lee
Annals of Rehabilitation Medicine.2021; 45(3): 167. CrossRef
Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population
Iris Paola Guzmán-Guzmán, Pedro Delgado-Floody, Ilse Adriana Gutiérrez-Pérez, Felipe Caamaño-Navarrete, Daniel Jerez-Mayorga, Óscar Zaragoza-García, Isela Parra-Rojas
Nutrición Hospitalaria.2021;[Epub] CrossRef
Grip Strength as a Cardiometabolic Marker
Jungun Lee
Korean Journal of Family Medicine.2020; 41(5): 271. CrossRef

10,037 View
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Association between Serum-Ferritin Levels and Sleep Duration, Stress, Depression, and Suicidal Ideation in Older Koreans: Fifth Korea National Health and Nutrition Examination Survey 2010–2012: Kyung Mi Kim, Hye Rim Hwang, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Sung In Chung; Korean J Fam Med 2019;40(6):380-387. Published online November 20, 2019; DOI: https://doi.org/10.4082/kjfm.18.0097

Abstract
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Background
Serum-ferritin levels may be associated with psychiatric symptoms among the elderly; however, this association has not been extensively studied. The aim of this study was to evaluate the association between serumferritin levels and mental health issues in older Koreans.
Methods
This cross-sectional study included large-scale national data from the Korea National Health and Nutrition Examination Survey 2010–2012. In total, 1,802 older Koreans (≥65 years old) were included. The assessed psychiatric symptoms included short sleep duration, stress, depressed mood, and suicidal ideation. Any association between serum-ferritin levels and mental health issues according to sex was examined using logistic regression analysis.
Results
The prevalence of short sleep duration, stress, depressed mood, and suicidal ideation was 50.9%, 21.7%, 18.2%, and 22.5%, respectively. In men, suicidal ideation decreased with increased serum-ferritin levels after multivariate adjustment for sociodemographic and lifestyle factors and comorbidities. The odds ratios (OR) and 95% confidence interval (CI) of suicidal ideation by quartiles of serum-ferritin level were 1 (reference), 1.132 (95% CI, 0.569–2.252), 0.453 (95% CI, 0.217–0.945), and 0.608 (95% CI, 0.295–1.253), respectively, (P for trend=0.039). In women, no trend was observed. However, compared to the lowest quartile, short sleep duration (<7 h) and stress perception were significantly decreased in the third quartile, with odds ratios of 0.601 (95% CI, 0.461–0.888), and 0.606 (95% CI, 0.386–0.952), respectively.
Conclusion
Moderate serum-ferritin levels were associated with decreased risk for suicide ideation in men, and were associated with decreased short sleep duration and stress perception in women.

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Association between suicide attempts and anemia in late-life depression inpatients
Jie Li, Lan Wang, Ziyi Wang, Fengxue Zhao, Yadi Sun, Ying Lu, Lei Yang
BMC Geriatrics.2024;[Epub] CrossRef
Sleep quality and Laboratory Findings in Patients with Varicose Vein Leg Pain
Ibrahim Acır, Zeynep Vildan Okudan Atay, Mehmet Atay, Vildan Yayla
Journal of Neuroscience and Neurological Disorders.2023; 7(1): 022. CrossRef
Alteration of Inflammatory Parameters and Psychological Post-Traumatic Syndrome in Long-COVID Patients
Irma Clemente, Gaia Sinatti, Antonio Cirella, Silvano Junior Santini, Clara Balsano
International Journal of Environmental Research and Public Health.2022; 19(12): 7103. CrossRef
Psychological and Cognitive Effects of Long COVID: A Narrative Review Focusing on the Assessment and Rehabilitative Approach
Rosaria De Luca, Mirjam Bonanno, Rocco Salvatore Calabrò
Journal of Clinical Medicine.2022; 11(21): 6554. CrossRef
Suicidal Ideation in Major Depressed Individuals: Role of Type D Personality
Mokhtar Abdelhakim Laoufi, Benjamin Wacquier, Tristan Lartigolle, Gwenolé Loas, Matthieu Hein
Journal of Clinical Medicine.2022; 11(22): 6611. CrossRef

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The Association of Body Fat and Arterial Stiffness Using the Brachial-Ankle Pulse Wave Velocity: Gyu Lee Kim, Hye Rim Hwang, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Dong Wook Jeong, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, A Rum Park; Korean J Fam Med 2018;39(6):347-354. Published online October 31, 2018; DOI: https://doi.org/10.4082/kjfm.17.0045

Abstract
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Background
BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI.
Methods
This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately.
Results
For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P<0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables.
Conclusion
Lower pBF in obese men may be associated with improved cardiovascular risk.

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Improved fatty acid profile reduces body fat and arterial stiffness in obese adolescents upon combinatorial intervention with exercise and dietary restriction
Lei Xu, Xiaoyu Zou, Zhiqiang Gao, Caifeng Mao, Hang Su, Chunyan Li, Ning Chen
Journal of Exercise Science & Fitness.2021; 19(4): 234. CrossRef
Borderline-High Mean Corpuscular Volume Levels Are Associated with Arterial Stiffness among the Apparently Healthy Korean Individuals
Haneul Kwon, Byoungjin Park
Korean Journal of Family Medicine.2020; 41(6): 387. CrossRef

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Shift Work Is Associated with Metabolic Syndrome in Young Female Korean Workers: Kyoung Hwa Yu, Yu Hyeon Yi, Yun Jin Kim, Byung Mann Cho, Sang Yeoup Lee, Jeong Gyu Lee, Dong Wook Jeong, So Yeon Ji; Korean J Fam Med 2017;38(2):51-56. Published online March 22, 2017; DOI: https://doi.org/10.4082/kjfm.2017.38.2.51

Abstract
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Background

Shift work is associated with health problems, including metabolic syndrome. This study investigated the association between shift work and metabolic syndrome in young workers.

Methods

A total of 3,317 subjects aged 20–40 years enrolled in the 2011–2012 Korean National Health and Nutrition Examination Survey were divided into shift and day workers. We conducted a cross-sectional study and calculated odds ratios using multivariate logistic regression analysis in order to examine the association between shift work and metabolic syndrome.

Results

The prevalence of metabolic syndrome was 14.3% and 7.1% among male and female shift workers, respectively. After adjusting for confounding factors, shift work was associated with metabolic syndrome in female workers (odds ratio, 2.53; 95% confidence interval, 1.12 to 5.70).

Conclusion

Shift work was associated with metabolic syndrome in young women. Timely efforts are necessary to manage metabolic syndrome in the workplace.

Citations

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Association between circadian rhythm-disturbing factors and metabolic syndrome in Korean adults: Korea National Health and Nutrition Examination Survey (2016–2020)
Sujin Lee, Junhee Park, Hyunjin Cho, Jun Hyun Yoo
Korean Journal of Family Medicine.2025; 46(3): 162. CrossRef
Cumulative circadian disruption factors and metabolic syndrome
Jungun Lee
Korean Journal of Family Medicine.2025; 46(3): 125. CrossRef
Association between metabolic risk, oxidative stress and psychological parameters amongst sample of nurses working in Doha, Qatar
Kirti S. Prabhu, Ummu Habeeba, Mohammad Usman Asad Rahman, Maria Salvador Perez, Salam AlMoghrabi Ramirez, Bilal Uddin Khan, Shilpa Kuttikrishnan, John Paul Ben Tabar Silang, Noora Ahmed Kh A. Al Kaabi, Abdul Quaiyoom Khan, Afsheen Raza, Mohamed Izham Moh
Clinical Epidemiology and Global Health.2025; 34: 102088. CrossRef
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Shih-Chieh Lin, Wei-Chung Yeh, Zhu-Xuan Liu, Hui-Fang Hsu, Jau-Yuan Chen
Medicine.2025; 104(31): e43598. CrossRef
AGE, HEAT STRESS, AND SHIFT WORK AS DETERMINANTS OF METABOLIC SYNDROME IN INDUSTRIAL WORKERS: A CROSS-SECTIONAL STUDY
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Association between metabolic syndrome and shift work in chemical plant workers
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Michiru Kakinuma, Hiroo Ide, Kyoko Nakao, Daisuke Ichikawa, Ryozo Nagai, Yuji Furui
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Heeja Jung, Hyunju Dan, Yanghee Pang, Bohye Kim, Hyunseon Jeong, Jung Eun Lee, Oksoo Kim
International Journal of Environmental Research and Public Health.2020; 17(20): 7697. CrossRef
Shift work and metabolic syndrome: A multi‑center cross‑sectional study on females of reproductive age
Maryam Nikpour, Aram Tirgar, Mahmod Hajiahmadi, Akram Hosseini, Behzad Heidari, Fatemeh Ghaffari, Abbas Ebadi, Fatemh Nasiri, Mojgan Firouzbakht
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Ramin Mehrdad, Gholamreza Pouryaghoub, Mahboubeh Moradi
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The Relationship between Workplace Environment and Metabolic Syndrome
Hwee-Soo Jeong
The International Journal of Occupational and Environmental Medicine.2018; 9(4): 176. CrossRef
Circadian and Metabolic Effects of Light: Implications in Weight Homeostasis and Health
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Shift Work and Health Problems
Jungun Lee
Korean Journal of Family Medicine.2017; 38(2): 49. CrossRef

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Vitamin-Mineral Supplement Use Patterns in Elderly Koreans: Data from the 2007–2008 Korean National Health and Nutrition Examination Survey: So Young Park, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Hye Rim Hwang, Dong Wook Jeong, Young Hye Cho, Eun Jung Choi, Yu Hyeon Yi, Young Jin Tak, A Ra Jo, Seung Hoon Lee, Jeong Suk Jeon, Bo Wha Lee; Korean J Fam Med 2016;37(2):123-129. Published online March 25, 2016; DOI: https://doi.org/10.4082/kjfm.2016.37.2.123

Abstract
PDF

Background

Vitamin-mineral supplements are the most popular dietary supplements in Korea. However, few studies have assessed the relationship between vitamin-mineral supplementation and associated factors among the Korean elderly. The purpose of this study was to assess the use of vitamin-mineral supplements among elderly in Korea as well as its association with sociodemographic factors, health-related behaviors, medical conditions, and nutrient intake.

Methods

This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008 to 2009. Data from 3,294 elderly men and women (65 years of age and older) were analyzed. Multivariable-weighted logistic regression model analysis was used to evaluate the association between vitamin-mineral supplement use and sociodemographic factors, health-related habits, and medical conditions.

Results

Vitamin-mineral supplementation was reported by 16.3% of the participants. The most common reason for using dietary supplements was recommendations from friends and acquaintances. Highly educated person, female participants had a greater likelihood of taking vitamin-mineral supplements. In addition, analysis of nutrient intake from food sources alone revealed a lower proportion of vitamin-mineral supplement users with nutrient intakes below the estimated average requirements for vitamin A, vitamin C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus, compared to nonusers. However, vitamin-mineral supplementation was not associated with health-related behaviors or medical conditions.

Conclusion

Highly educated person, elderly Korean women had a greater likelihood of using vitamin-mineral supplements. In addition, nutrient intakes from food sources alone were significantly higher among vitamin-mineral supplement users. Finally, vitamin-mineral supplementation may be an indicator of healthier diet in elderly Koreans.

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Azli Baharudin, Fatimah Othman, Syafinaz Mohd Sallehuddin, Suhaila Abd Ghafar, Khairul Hasnan Amali, Norazizah Ibrahim Wong, Ahmad Ali Zainuddin
Matrix Science Pharma.2023; 7(2): 52. CrossRef
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Jeffrey Blumberg, Balz Frei, Victor Fulgoni, Connie Weaver, Steven Zeisel
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Case Reports

Pyogenic Liver Abscess Following Acupuncture and Moxibustion Treatment: Eun Jung Choi, Sangyeoup Lee, Dong Wook Jeong, Young Hye Cho, Su Jin Lee, Jeong Gyu Lee, Yun Jin Kim, Yu Hyun Yi, Ji Yong Lim; Korean J Fam Med 2013;34(5):364-368. Published online September 26, 2013; DOI: https://doi.org/10.4082/kjfm.2013.34.5.364

Abstract
PDF

Acupuncture treatment is generally regarded as a relatively safe procedure. However, most procedures have some complications and acupuncture treatment is no exception. Reported complications of acupuncture treatment were mostly mild or temporary symptoms, but certain severe adverse effects were also observed. We report here for the first time a case of liver abscess following acupuncture and moxibustion treatment.

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Yo Ishihara, Sayaka Kaneshiro, Yasukazu Ikehara
IDCases.2023; 31: e01662. CrossRef
Publication status and reporting quality of case reports on acupuncture-related adverse events: A systematic reviews of case studies
Tae-Hun Kim, Myeong Soo Lee, Stephen Birch, Terje Alræk, Arne Johan Norheim, Jung Won Kang
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A Case of Multiple Abscesses with Methicillin-resistant Staphylococcus Aureus Bacteremia following Acupuncture
Yoshiyuki SHIROUZU, Shozo FUJIWARA, Katsuhiro ANAMI, Fumihiko FUJITA, Yoshito AKAGI
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2021; 82(2): 478. CrossRef
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Srujana Mohanty, Manas Kumar Panigrahi, Jyotirmayee Turuk, Sagarika Dhal
Journal of the National Medical Association.2018; 110(6): 591. CrossRef
Literature Review on Adverse Events (2012-2015) associated with Acupuncture and Moxibustion
Nobutatsu FURUSE, Akihito UEHARA, Masaaki SUGAWARA, Toshiya YAMAZAKI, Hisashi SHINBARA, Hitoshi YAMASHITA
Zen Nihon Shinkyu Gakkai zasshi (Journal of the Japan Society of Acupuncture and Moxibustion).2017; 67(1): 29. CrossRef
The Reporting Quality of Acupuncture-Related Infections in Korean Literature: A Systematic Review of Case Studies
Tae-Hun Kim, Jung Won Kang, Wan-Soo Park
Evidence-Based Complementary and Alternative Medicine.2015; 2015: 1. CrossRef
Safety of Moxibustion: A Systematic Review of Case Reports
Ji Xu, Hongyong Deng, Xueyong Shen, Cheng Ke
Evidence-Based Complementary and Alternative Medicine.2014;[Epub] CrossRef

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A Case of Scrub Typhus Complicated by Acute Calculous Cholecystitis: Su Jin Lee, Young Hye Cho, Sang Yeoup Lee, Dong Wook Jeong, Eun Jung Choi, Yun Jin Kim, Jeong Gyu Lee, Yu Hyun Lee; Korean J Fam Med 2012;33(4):243-246. Published online July 25, 2012; DOI: https://doi.org/10.4082/kjfm.2012.33.4.243

Abstract
PDF

We report a case of acute calculous cholecystitis through scrub typhus. A 69-year-old woman presented with a history of general myalgia, fever, and right abdominal pain. She referred to our hospital for surgical treatment of clinically suspected acute cholecystitis. Physicians concluded the cause of cholecystitis as gall bladder (GB) stone and proper antibiotics treatment of scrub typhus was started later. The patient developed acute respiratory distress syndrome and multi organ failure through scrub typhus. Five days after admission, the patient was treated with proper antibiotics and discharged on the 13th day after starting doxycycline treatment without any sequelae. In areas endemic for tsutsugamushi disease, even though a patient with GB stone presents with symptoms of acute cholecystitis, careful history and physical examination are required to reveal the existence of eschars or skin eruptions.

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Acalculous Cholecystitis in a Young Adult with Scrub Typhus: A Case Report and Epidemiology of Scrub Typhus in the Maldives
Hisham Ahmed Imad, Aishath Azna Ali, Mariyam Nahuza, Rajan Gurung, Abdulla Ubaid, Aishath Maeesha, Sariu Ali Didi, Rajib Kumar Dey, Abdullah Isneen Hilmy, Aishath Hareera, Ibrahim Afzal, Wasin Matsee, Wang Nguitragool, Emi. E. Nakayama, Tatsuo Shioda
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Senaka Rajapakse, Praveen Weeratunga, Sriharan Sivayoganathan, Sumadhya Deepika Fernando
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Acute Cholecystitis in Patients with Scrub Typhus
Hyun Lee, Misuk Ji, Jeong-Hwan Hwang, Ja-Yeon Lee, Ju-Hyung Lee, Kyung Min Chung, Chang-Seop Lee
Journal of Korean Medical Science.2015; 30(11): 1698. CrossRef
Outcome of Intravenous Azithromycin Therapy in Patients with Complicated Scrub Typhus Compared with That of Doxycycline Therapy Using Propensity-Matched Analysis
Mi-Ok Jang, Hee-Chang Jang, Uh Jin Kim, Joon Hwan Ahn, Seung-Ji Kang, Sook-In Jung, Hee-Young Shin, Kyung-Hwa Park
Antimicrobial Agents and Chemotherapy.2014; 58(3): 1488. CrossRef

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Brief Communications

Changes in Skin Color after Smoking Cessation: Young Hye Cho, Dong Wook Jeong, Sang Hee Seo, Sang Yeoup Lee, Eun Jung Choi, Yun Jin Kim, Jeong Gyu Lee, Yu-Hyun Lee, Mi Jin Bae, Hyun Woo Chin; Korean J Fam Med 2012;33(2):105-109. Published online March 30, 2012; DOI: https://doi.org/10.4082/kjfm.2012.33.2.105

Abstract
PDF

This study was performed to assess changes in skin color over 1 month after smoking cessation. The study population consisted of 49 men who participated in a smoking cessation program from March 2010 to June 2010 at a public health centre in Yangsan, South Korea. Thirty-four men who stop smoking completely were included in our study. Instrumental evaluations of skin color were performed using Mexameter (MX 18; Courage and Khazaka Electronic GmbH) at the beginning of the study and at 1-week and 4-week follow-up visits. Skin color was evaluated by measurement of 2 main color bases-melanin and haemoglobin-with the results expressed as melanin index (MI) and erythema index (EI). Both MI and EI were significantly reduced at the 4-week follow-up visit on all 7 sites measured. We anticipate that desirable effects on skin color after smoking cessation will play a positive role in maintaining smoking abstinence in routine clinical practice.

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Melanin levels in relation to vitamin D among first-generation immigrants from different ethnic groups and origins: A comparative national Canadian cross-sectional study
Said Yousef, Manny Papadimitropoulos, MoezAlIslam Faris, Hayder Hasan, Alomgir Hossain, Ian Colman, Douglas Manuel, George A. Wells
Frontiers in Medicine.2023;[Epub] CrossRef
Promoting New Approach Methodologies (NAMs) for research on skin color changes in response to environmental stress factors: tobacco and air pollution
Katherine Virginia Bouchard, Gertrude-Emilia Costin
Frontiers in Toxicology.2023;[Epub] CrossRef
Engaging with still-smokers

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The systemic influence of chronic smoking on skin structure and mechanical function
Abigail K Langton, Evridiki Tsoureli‐Nikita, Holly Merrick, Xuegen Zhao, Christina Antoniou, Alexander Stratigos, Riaz Akhtar, Brian Derby, Michael J Sherratt, Rachel EB Watson, Christopher EM Griffiths
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Joshua J.X. Li, Joanna K.M. Ng, Amy B.W. Chan
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Alex L. Jones
Evolution and Human Behavior.2018; 39(1): 19. CrossRef
Constitutive melanin density is associated with higher 25-hydroxyvitamin D and potentially total body BMD in older Caucasian adults via increased sun tolerance and exposure
M.J.W. Thompson, G. Jones, D.A. Aitken
Osteoporosis International.2018; 29(8): 1887. CrossRef
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Matthew T. Palmer, Casey T. Weaver
Inflammatory Bowel Diseases.2013; 19(10): 2245. CrossRef

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The Impact of Bladder Distension on Blood Pressure in Middle Aged Women: Eun Jung Choi, Dong Wook Jeong, Jeong Gyu Lee, Sangyeoup Lee, Yun Jin Kim, Yu Hyone Yi, Young Hye Cho, Sun Ju Im, Mi Jin Bae; Korean J Fam Med 2011;32(5):306-310. Published online July 28, 2011; DOI: https://doi.org/10.4082/kjfm.2011.32.5.306

Abstract
PDF

Background

The purpose of the present study was to investigate the relation between the extent of bladder distention and the rise of blood pressure in middle aged women.

Methods

In a cross-sectional, descriptive observational study, we obtained data from 172 middle aged women at a health promotion center of Pusan National University Hospital. We measured duration of urine-holding as the degree of the extension of bladder distention. Blood pressure was measured twice while holding urine and immediately after urination. Urine holding with full bladder was confirmed by abdominal ultrasound.

Results

Difference in systolic blood pressure was 4.2 ± 10.7 (P < 0.001), and that in diastolic blood pressure was 2.8 ± 7.7 mm Hg (P < 0.001) between holding urine and immediately after urination. There was no significant correlation between the urine-holding duration and differences in systolic and diastolic blood pressure.

Conclusion

Our findings suggest that systolic and diastolic blood pressure is increased by urine-holding at least 3 hours after the last urination in middle aged women. Thus in practice, blood pressure should be measured after the bladder is emptied.

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Jian Liu, Yumin Li, Jianqing Li, Dingchang Zheng, Chengyu Liu
Physiological Measurement.2022; 43(9): 09TR02. CrossRef
Nutritive and Phytochemical Composition of Aromatic Microgreen Herbs and Spices Belonging to the Apiaceae Family
Maria Giordano, Spyridon A. Petropoulos, Marios C. Kyriacou, Giulia Graziani, Armando Zarrelli, Youssef Rouphael, Christophe El-Nakhel
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Sally Thompson
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Noa Kallioinen, Andrew Hill, Mark S. Horswill, Helen E. Ward, Marcus O. Watson
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Original Article

Usefulness of Sagittal Abdominal Diameter for Evaluation of Metabolic Syndrome and Insulin Resistance.: Yu Hyeon Yi, Dong Wook Jung, Jeong Gyu Lee, Yun Jin Kim, Sang Yeoup Lee, Yeong Joo Kim, Han Chul Son, Ha Lin Lee, Young Hye Cho; Korean J Fam Med 2011;32(1):46-55. Published online January 20, 2011; DOI: https://doi.org/10.4082/kjfm.2011.32.1.46

Abstract
PDF

Background
We studied the association of sagittal abdominal diameter (SAD) and metabolic syndrome and insulin resistance in Korean adults.Methods: This is a cross-sectional study by 190 patients who visited a Health Promotion Center of National University of Pusan from 11 November to 14 November, 2008. We analyzed the association of anthropometry (waist circumference, BMI, SAD), insulin resistance (homeostatic model assessment-insulin resistance, HOMA-IR), insulin sensitivity (quantitative insulin sensitivity check index, QUICKI), and plasma concentrations of glucose, insulin, total cholesterol, LDL, HDL, triglyceride. SAD was categorized into quartiles and assessed odds ratio of metabolic syndrome adjusted for age, sex, lifestyle factors.Results: SAD showed significance correlation to HOMA-IR than BMI. Quartiles of SAD showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, HOMA-IR and obesity but hypertriglyceridemia, low HDL-cholesterolemia did not show signifi cant association. In men QUICKI was signifi cantly high. A multivariate model, adjusted for age, sex, smoking status, physical activity, heavy drinking, HOMA-IR and QUICKI, revealed a progressively increased odds ratio of metabolic syndrome, 3rd quartile (odds ratio [OR]; 9.467; 95% confi dence interval [CI], 3.225 to 27.789; P < 0.001) and 4th quartile (OR, 7.253; 95% CI, 2.437 to 21.586; P < 0.001), with increasing SAD.Conclusion: As shown above, SAD was a strong anthropometric marker of insulin resistance, risk of metabolic syndrome and decreased insulin sensitivity in Korean adults.

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Han-Gyo Choi, Hye-Jin Kim
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A. Ra Cho, Sang Yeoup Lee
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Kyung-A Shin
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Hye-Rin Park, Sae-Ron Shin, A Lum Han, Yong Joon Jeong
Korean Journal of Family Medicine.2015; 36(6): 335. CrossRef
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Case Report

A Case of Co-infection of Salmonella typhi and Viral Hepatitis A after Traveling Abroad.: Young Hye Cho, Dong Wook Jeong, Sang Yeoup Lee, Son Ki Park, Ah Ra Cho, Su Jin Lee, Hee Kyoung Choi, Yun Jin Kim, Jeong Ku Lee, Yu Hyun Lee; Korean J Fam Med 2010;31(12):937-940. Published online December 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.12.937

Abstract
PDF

Infectious diseases imported from other countries have increased. Feco-oral route is the most common mode of transmission for both typhoid fever and hepatitis A, and thus infection by these agents have an association with poor sanitation. A 30-year-old male was visited to the hospital because of high fever after traveling in Thailand. The level of hepatic transaminases were mildly elevated and viral serological marker for hepatitis was negative. The blood culture was reported positive for Salmonella typhi. After a few days, the level of hepatic transaminases rapidly increased and viral serological marker for hepatitis became positive with anti-hepatitis A viral IgM at follow-up. Therefore we report a case of co-infection of S. typhi and viral hepatitis A after traveling abroad.

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Original Articles

Changes in Blood Pressure, Blood Glucose, and Lipid Profile Caused by Changes of Weight, Percent Body Fat, and Waist Circumference in Adult Men with Normal Weight and Waist Circumference.: Ho Chun Choi, Hyun Jin Kim, Seong Jun Min, Kiheon Lee, Kyung Woo Kim, Seung Min Oh, Tae Woo Yoo; Korean J Fam Med 2010;31(6):430-436. Published online June 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.6.430

Abstract
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Background
Metabolic indexes (blood pressure, blood glucose, and lipid) differ depending on lower or upper normal value of obesity indexes (weight, percent-body-fat, and waist circumference) despite normal value. Therefore, we examined metabolic indexes changes across obesity indexes changes. Methods: We analyzed 344 adult men who received routine-checkups with normal weight and waist circumference before and after follow-up. We used multiple-linear-regression to examine associations between changes of obesity indexes and metabolic indexes before and after follow-up. We examined differences of metabolic indexes by t-test and odds ratios of normal or abnormal metabolic indexes by multiple-logistic-regression in groups where obesity indexes were increased and decreased.Results: The mean follow-up was 1.38 ± 0.32 years and there were associations between weight change rate and changes in systolic-blood-pressure (SBP), diastolic-blood-pressure (DBP), triglyceride (TG), and high–density-lipoprotein (HDL) (P = 0.001, 0.03, 0.001, 0.01), associations between percent-body-fat change and changes in SBP, DBP, fasting-blood-glucose (FBG) and TG (P = 0.02, 0.002, < 0.001, 0.03), and associations between waist circumference change rate and changes in FBG, TG, HDL (P = 0.01, 0.01, 0.02). There were significant SBP and HDL differences in weight decrease and increase groups (P = 0.04, < 0.001), FBG difference in percent-body-fat decrease and increase groups (P = 0.01), and FBG and TG differences in waist circumference decrease/increase groups (P = 0.03, 0.03). As compared with percent-body-fat decrease group, percent-body-fat increase group had odds ratio of FBG ≥ 100 of 2.98 (95% confidential interval [CI], 1.18 to 7.51) with a significance on only FBG of initially normal metabolic components and conversely percent-body-fat decrease group had odds ratio of FBG < 100 of 3.22 (95% CI, 1.21 to 8.60) with a significance on only FBG of initially abnormal metabolic components. Conclusion: Increased obesity indexes even within normal range, could change metabolic indexes.

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Influencing Factors on Cardio-cerebrovascular Disease Risk Factors in Young Men: Focusing on Obesity Indices
Chul-Gyu Kim, Shi Hyang Lee, Sun Kyung Cha
Journal of Korean Biological Nursing Science.2017; 19(1): 1. CrossRef

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The Relationship between Self-Efficacy and Body Weight Reduction after Educational Program for Health Care.: Seung Jun Lee, Yun Jin Kim, Sangyeoup Lee, Jeong Gyu Lee, Young Joo Kim; Korean J Fam Med 2010;31(4):294-301. Published online April 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.4.294

Abstract
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Background
Obesity is one of the health problems with high risk of metabolic and physiologic morbidity worldwide. Obesity increases cardiovascular disease risk and death as well as psychological and emotional health problems. Self-efficacy and physical self-efficacy are important evaluation tools for successful diet and exercise in obesity diet practice and it is directly associated with health behaviors. This study conducted to evaluate the effect of weight loss on self-efficacy and life quality.Methods: The 39 adults who joined in weight control program in one public health center were recruited into this study. Quality of life, depression scale, anxiety scale, self-efficacy and physical self-efficacy were examined. Also physical performance ability and weight and lipid profile were examined. Statistical analysis obtained by SPSS.Results: Quality of life and anxiety scale were significantly diminished in obese subjects than non-obese subjects. Quality of life was increased after weight control program in obese subjects. Physical self-efficacy was improved in weight reduction group with much more than 5% of initial weight.Conclusion: Weight reduction has positive impact on psychological aspects in obese subjects. Therefore, we should be more concerned about psychological and functional aspect of obese individuals during weight control treatment.

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The Effect of Pre-operative Information through Audiovisual Media on Self-Care Knowledge, Self-Efficacy, and State Anxiety of Patients before Bariatric Surgery
Ho Im Lee, Jung Suk Park
Korean Journal of Adult Nursing.2020; 32(4): 421. CrossRef

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The Role of C-reactive Protein as a Inflammation-related Factor in Metabolic Syndrome.: Jeon Su Park, Yun Jin Kim, Jeong Gyu Lee, Young Joo Kim, Sangyeoup Lee, Hong Gi Min, Byung Mann Cho; Korean J Fam Med 2009;30(6):449-456. Published online June 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.6.449

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Background
The metabolic syndrome has been known as the cluster of insulin resistance, dyslipidemia, hypertension, and abdominal obesity. There have been many studies about the infl ammatory role in atherosclerosis and cardiovascular diseases, also. We aimed to elucidate the role of high sensitivity C-reactive protein (hs-CRP) as a infl ammation-related factor in metabolic syndrome in Korean adults by correlation and factor analysis. Methods: A cross sectional study was carried out in 1,512 men and 1,836 women (over 20 years old) who had an examination at a center for health promotion of an university hospital from May 2004 through March 2005. The NCEP-ATP III definition and Asian-Pacific adjusted criteria were used to obtain the metabolic syndrome group. And we evaluated the role and gender difference of hs-CRP in metabolic syndrome by correlation and factor analysis.Results: In women, hs-CRP was statistically correlated with most metabolic variables, especially insulin resistance. In factor analysis, 3 factors (obesity, blood pressure, and insulin resistance) were obtained in men and 4 factors (obesity, blood pressure, insulin resistance, and dyslipidemia) in women, respectively. In women, hs-CRP was a part of dyslipidemia factor.Conclusion: In factor anaylsis of metabolic syndrome factors with hs-CRP, hs-CRP was not a signifi cant factor in men, but was included as a part of dyslipidemia factor in women.

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The Relationship between Metabolic Syndrome Risk Factors and High Sensitive C-reactive Protein in Abdominal Obesity Elderly Women
Kyung-A Shin
The Korean Journal of Clinical Laboratory Science.2017; 49(2): 121. CrossRef
Clinical Outcomes after Modified Fasting Therapy Supplied with Gamrosu: A Retrospective Observational Study
Seung-Uoo Shin, Dong-Hwan Kim, Hyun-Taeg Shin, Dal-Seok Oh
Journal of Korean Medicine for Obesity Research.2016; 16(1): 36. CrossRef

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Health Behavior and Metabolic Syndrome.: Jeong Dae Oh, Sangyeoup Lee, Jeong Gyu Lee, Young Joo Kim, Yun Jin Kim, Byung Mann Cho; Korean J Fam Med 2009;30(2):120-128. Published online February 10, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.2.120

Abstract
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Background
Life style has been shown to improve risk factor comprising the metabolic syndrome. Metabolic syndrome is prime candidate for lifestyle modification utilizing the tools of exercise, nutritional therapy so on. Therefore, we examined the prevalence of metabolic syndrome according to health behaviors. Methods: The 1,240 adults were recruited into this cross-sectional study. Subjects examined body mass index, waist circumference, blood pressure, lipid profile. Medical history was reviewed and daily calorie intake examined by food frequency questionnaire. Six healthy behavior-sleeping hours, smoking, drinking, exercise, calorie intake and boey weight of subjects were examined. Each heathy behaviors were categorized as a three groups. Metabolic syndrome were diagnosed by ATP III criteria. Results: The study subjects were consisted of 57.1% men and 42.9% women. The prevalence of metabolic syndrome was 14.3%. The prevalence of metabolic syndrome was lower in group with good healthy behaviors. Subjects with more good healthy behaviors had lower prevalence of metabolic syndrome than with less good healthy behaviors(0, 50.0%; 1, 41.0%; 2, 30.6%; 3, 13.8%; 4, 8.5%; 5, 5.3%; and 6, 4.3%). Relative to subjects with high good health behavior score, those with low good health behavior score were at significantly increased risk of metabolic syndrome (odds ratio=4.25, 95% CI 2.97-6.08). Conclusion: Subjects with greater good healthy behaviors had a substantially lower risk of being diagnosed with the metabolic syndrome compared those with lower good healthy behaviors. This finding suggests that lifestyle modification may be appropriate as a first-line intervention to metabolic syndrome.

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Jung-Hwa Kim, Kyung-Hee Kim, Gyu Bin Park, Won Kee Lee
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Health Behavior Profiles Among Midlife Women: Identifying At-Risk Subgroups for Metabolic Syndrome Using Latent Class Analysis
Se Hee Min, Sharron L Docherty, Eun-Ok Im, Qing Yang
Annals of Behavioral Medicine.2022; 56(9): 946. CrossRef
Does Metabolic Syndrome Affect the Incidence and Prognosis of Sudden Sensorineural Hearing Loss?
Joong Su Park, Seung Ho Kim, Ikhee Kim, Hantai Kim, Ji Hyun Kim, Jong Bin Lee
Life.2022; 12(7): 930. CrossRef
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Hyun Ah Park
Korean Journal of Family Medicine.2021; 42(1): 9. CrossRef
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Ho Lee, Seong-yong Cho, Jin-seok Kim, Seong-yong Yoon, Bu-il Kim, Jong-min An, Ki-beom Kim
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Kyoung Yun Kim, Jung-Mi Yun
Nutrition Research and Practice.2019; 13(5): 444. CrossRef
Infuence of Metabolic Syndrome on Hearing Outcome in Sudden Sensorineural Hearing Loss
Jong Joong Choi, Myeong Hee Kim, Jong Won Lee, Do Young Jung, Jong Bin Lee
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2018; 61(10): 514. CrossRef
Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women
Hye-Jin Lee, Kyung-Hea Lee
Korean Journal of Community Nutrition.2018; 23(4): 277. CrossRef
Effectiveness of lifestyle interventions to prevent diabetes and cardiovascular diseases in a health promoting hospital
Hyekyeong Kim, Eunhee Nah
Korean Journal of Health Education and Promotion.2015; 32(4): 37. CrossRef
Relationship between Physical Activity Level, Amount of Alcohol Consumption and Metabolic Syndrome in Korean Male Drinkers
Byung-Sung Kim, Myeong-Jin Kim, Hyun-Rim Choi, Cahng-Won Won, Sun-Young Kim
The Korean Journal of Sports Medicine.2014; 32(2): 97. CrossRef
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Sun-Young Choi, Na-Eun Kang, Sung-Hee Kim
The Korean Journal of Food And Nutrition.2013; 26(4): 975. CrossRef
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Dae-Sik Ko, Bu-Yeon Park, Gyeong-Hyu Seok
The Journal of the Korea institute of electronic communication sciences.2013; 8(12): 1941. CrossRef
The Association between Helicobacter Pylori Infection and Metabolic Syndrome in Korean Men and Women
Tae-Heum Chung, Moon-Chan Kim, Chung-Hun Choi, Chang-Sup Kim
Korean Journal of Family Medicine.2010; 31(2): 124. CrossRef
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Kiwon Kang, Joohon Sung, Chang-yup Kim
Journal of Preventive Medicine and Public Health.2010; 43(1): 73. CrossRef
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Jun Pyo Myong, Hyoung Ryoul Kim, Yong Kyu Kim, Jung-Wan Koo, Chung Yill Park
Journal of Preventive Medicine and Public Health.2009; 42(5): 331. CrossRef

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Relations of Serum gamma-glutamyltransferase Levels to Incidence of the Metabolic Syndrome.: Shin Woong Oh, Jeong Gyu Lee, Min Seok Kim, Dong Wook Jung, Young Joo Kim, Sangyeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2008;29(11):838-843. Published online November 10, 2008

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Background: The metabolic syndrome is a cluster of risk factors for cardiovascular diseases. Recently, serum gamma-glutamyltransferase (GGT) has been suggested as a predictor for development of the metabolic syndrome. Therefore, we investigated the association between serum GGT levels and the incidence of the metabolic syndrome in the Korean healthy adults with normal serum GGT with a 3 year follow-up. Methods: The study subjects consisted of 741 individuals who visited the Center for Health Promotion in Pusan National University Hospital for a medical checkup in 2002 to 2005. Among 741 subjects, 312 were excluded: 71 were positive for HBsAg, 17 were positive for Anti-HCV Ab, 40 showed GGT higher levels than limit of reference range, and 224 had metabolic syndrome. The final subjects were 429 individuals. We measured serum GGT levels, lipid profiles, fasting glucose, blood pressure and their metabolic components. Results: As the quartile of serum GGT increased, 3 year follow-up incidence of the metabolic syndrome was increased. Logistic regression analysis adjusting for sex, age, and alcohol drinking status showed that the odds ratio (95% confidence Interval, P-value) of each GGT quartile was 2.28 (0.58∼9.01, P=0.240), 1.53 (0.36∼6.66, P=0.564), 4.56 (1.08∼19.32, P=0.040), respectively. Conclusion: These results showed that the serum GGT was closely related to the metabolic syndrome. In Korean adults without the metabolic syndrome, the serum GGT levels within normal limit were associated with an increased risk of incident, metabolic syndrome. (J Korean Acad Fam Med 2008;29:838-843)

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Regional Fat Measured by DEXA and Metabolic Risk Factors among Women with Central Obesity.: Jin Seung Kim, Kayoung Lee, Jun Su Kim, Tae Jin Park, Sangyeoup Lee, Young Joo Kim, Yun Jin Kim; J Korean Acad Fam Med 2008;29(7):506-512. Published online July 10, 2008

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Background: This study was carried out to determine the usefulness of regional body fat measured by dual energy X-ray absorptiometry (DEXA) by examining the relationship between regional body fat and metabolic risk factors. Methods: A total of 98 women aged 18∼65 years with central obesity (waist circumference ≥80 cm) took the evaluation for metabolic risk factors (blood pressure, fasting glucose, insulin, high sensitive c-reactive protein (hs-CRP), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR)) and the anthropometric measurement, and regional body fat measurement using DEXA. The relationship of regional body fat with the metabolic risk factors, the metabolic syndrome (MS) defined by the International Diabetes Federation and insulin resistance (IR, defined by HOMA-IR≥2.48) were assessed. The analyses were conducted using regression and logistic regression analyses. Results: After adjustment for age and total body fat (%), legs fat (%) was significantly and negatively associated with LDL-C, triglyceride, HOMA-IR, and hs-CRP, while positively with HDL-C. The 1% increase of legs fat was associated with the MS by odds ratio of 0.82 (95% C.I 0.71∼0.96) and with the IR by odds ratio of 0.80 (95% C.I. 0.67∼0.95). Trunk fat (%) was significantly and positively associated with LDL-C, triglycerides, and HOMA-IR. The 1% increase of trunk fat was associated with the MS by odds ratio of 1.32 (95% C.I. 1.03∼1.71) and with the IR by odds ratio of 1.33 (95% C.I. 1.01∼1.77). The ratio of android fat to gynoid fat was significantly and positively associated with LDL-C, triglycerides, glucose, and HOMA- IR, while negatively with HDL-C. The 0.1 increase of the ratio was associated with the MS by odds ratio of 1.66 (95% C.I. 1.07∼2.60). Conclusion: The trunk fat, and legs fat, the ratio of android fat to gynoid fat assessed by DEXA seemed to be useful indicators to predict the metabolic risk factors in women with central obesity. (J Korean Acad Fam Med 2008;29:506-512)

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Case Report

A Case of Tsutusgamushi Disease with Atypical Symptom.: Dae Woo Kim, Kook Huyng Lee, Sang Yeoup Lee, Hong Gi Min, Young Joo Kim, Yun Jin Kim; J Korean Acad Fam Med 2006;27(9):741-745. Published online September 10, 2006

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A 59 year old woman visited the hospital complaining of sore throat, chill, myalgia and whole body skin rash. There was abnormal finding of fever, sinus tachycardia, increased lactic dehydrogenase and elongation prothrombin time. We started treatment with acetaminophen and fluid because she had not specific history of visiting to the mountain or field, etc. After treatment increased aspartate aminotransferase/alanine aminotransferase and thrombocytopenia appeared without symptomatic improvement so that we investigated tsutsugamushi antibodies and diagnosed her condition as Tsutsugamushi disease with polyuria. But the clinical manifestation in our case showed atypical symptom which had polyuria. There is no report on that in Korea and over the world therefore the author et al. report of case of Tsutsugamushi disease with polyuria, atypical symptom.

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Original Articles

Application of Abdominal Circumference Presented by Body Composition Analyzer according to Gender and Body Mass Index.: Sang Do Seo, Sangyeoup Lee, Hong Gi Min, Young Joo Kim, Jeong Ik Hong, Yun Jin Kim; J Korean Acad Fam Med 2006;27(8):612-619. Published online August 10, 2006

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Background
: Recently, body composition analyzer has been used widely clinically. Various indirectly measured values of body are calculated without direct measuring. The abdominal circumference that is presented by such instrument may be used for diagnosing abdominal obesity, but the reliable evidence of the accuracy and the validity may be not be enough for application to general population. For this reason, the author investigated the usefulness of automatically produced abdominal circumference for diagnosing abdominal obesity.

Methods : The medical records of 5,555 outpatients who had undergone body composition analysis in a tertiary hospital was collected. The usefulness of the automatically presented abdominal circumference for diagnosing abdominal obesity among general population was investigated.

Results : There was a significant positive correlation between abdominal circumference measured by body composition analyzer and measuring tape in the normal, the overweight, and the obese groups of both gender. But, the results were the same only in females in the underweight group. The most significant difference between the two values were 4.8±5.0 cm in normal male group and -5.7±5.5 cm in female obese group. The difference of the male obese group was lesser than that of the overweight, the normal and the underweight groups. The difference of the male overweight group was lesser than that of the normal group. The difference of the female obese group was lesser than that of the overweight, the normal and the underweight groups. The sensitivity and specificity to detect abdominal obese person among the total subjects was 76.3% and 79.1%, respectively. The specificity was higher in all male and the normal female groups, wheras the sensitivity was higher in the obese and the overweight female groups.

Conclusion : Physicians should confirm the accuracy of abdominal circumference, especially in normal males and obese female group, although the automatically presented value is convenient and reflects the manually measured one very well which is useful to diagnose abdominal obesity.

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Effect of 8-week Therapy with Rabeprazole on Presenting Symptoms in Korean Patients with Gastroesophageal Reflux Disease.: Yun Jin Kim, Joo Sung Park, Sangyeoup Lee, Hong Gi Min, Young Joo Kim, Sang Han Choi, Hye Mi Jeong; J Korean Acad Fam Med 2006;27(6):449-455. Published online June 10, 2006

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Background
: Gastroesophageal reflux disease (GERD) is common in Western civilization and comprises 75% of esophageal diseases. However, there are only few studies of GERD in Korea. The aim of the study was to evaluate the clinical symptoms of GERD in Koreans and the effect of Rabeprazole on the symptoms.

Methods : The study subjects were included 353 patients who were diagnosed endoscopically with reflux esophagitis (316) or non-erosive reflux disease who have complained of intermittent heartburn during the past 3 months or more. All patients received Rabeprazole 20 mg daily for 8 weeks. Symptoms according to 8 symptom categories of GERD were evaluated. Patients recorded the severity of GERD associated symptoms at baseline, 4 weeks and 8 weeks after treatment. Presenting symptoms in Korean, frequency and severity of each symptom was evaluated. Efficacy of Rabeprazole treatment was analyzed.

Results : The most common symptoms of GERD were regurgitation (60.9%), heartburn (52.7%), epigastric pain/ soreness (49.6%) and other epigastric discomfort (47.0%). Symptom severity was rated in order of epigastric pain/ soreness, epigastric discomfort, and heartburn. The proportion of all symptoms, except for heart burn and cough, increased in relation to the severity of endoscopic grading, but the severity of symptoms was not significantly different between subgroups according to endoscopic findings. Symptoms, except for hoarseness, globus sensation and cough, significantly improved in 4 weeks after treatment. Cough did not improve after 4 weeks irrespective of smoking status, All symptoms significantly improved after 8 weeks.

Conclusion : Regurgitation was more common, and epigastric symptoms were more severe than heartburn in Koreans. The 8-week Rabeprazole treatment was effective on all symptoms associated with GERD.

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Prevalence of Mental Disorders in Family Practice Centers in Korea and the Utility of a Diagnostic Tool.: Young Sik Kim, Yeong Sook Yoon, Jeong Yeol Oh, Hee Tak Ryu, Dae Hyun Kim, Young Sung Suh, Byung Sung Kim, Yun Jin Kim, Sang Wook Song, Jungkwon Lee; J Korean Acad Fam Med 2005;26(11):699-705. Published online November 10, 2005

Abstract
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Background
: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ).

Methods : Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ.

Results : The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P＜0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49∼82) in major depressive disorders, 70% (50∼90) in panic disorders, 70% (56∼83) in somatoform disorders, 84% (75∼92) in alcohol abuse, and 68% (62∼74) in any mental disorders. Patients' response to the PHQ was overall very receptive.

Conclusion : One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.

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The Correlation between Vitamin C Intake and Plasma High-Sensitive C-reactive Protein Concentration.: Jung Gyu Lee, Sangyeoup Lee, Hong Gi Min, Yong Joo Kim, Sang Han Choi, Yun Jin Kim; J Korean Acad Fam Med 2004;25(4):314-321. Published online April 10, 2004

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Background
: There are several reports that vitamin C is one of antioxidants and can be used to protect cardiovascular diseases. Inflammation plays a major role in atherosclerosis, and the measurement of inflammatory markers such as high-sensitivity C-reactive protein (hs- CRP) may provide methods for risk prediction and reveal independent risk factors of cardiovascular diseases. The purpose of our study was to assess the correlation between vitamin C intake and plasma hs-CRP concentration.

Methods : The study subjects consisted of 2,012 individuals who underwent periodic health examination in a university hospital in Busan from June 2002 to January 2003. The subjects were questioned concerning their past medical history, alcohol intake, smoking status, physical activity. Body mass index, abdominal circumference, blood pressure, fasting glucose, lipid profile, general blood test, and hs-CRP were measured. The exclusive responsible dietitian evaluated the average calorie intake and vitamin C intake by food frequency questionnaire. To quantify the correlation between vitamin C intake and plasma hs-CRP concentration, Pearson correlation coefficient and Spearman correlation coefficient were presented.

Results : The vitamin C index (r=-0.051, P＜0.05) and the vitamin C intake per calorie intake (r=-0.075, P＜0.01) showed a significant correlation with the plasma hs-CRP level. The vitamin C intake and the vitamin C intake per calorie intake were significantly correlated with the plasma hs-CRP level after adjusting for sex, age, body mass index and smoking status.

Conclusion : These findings suggest that there was a significant correlation between the vitamin C intake and the hs-CRP concentration. Therefore, inflammatory status is higher in a person who takes small amount of vitamin C than a person who takes it plentifully. The former is presumed to have a higher risk of cardiovascular diseases thereafter.

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Case Reports

A Case of Porphyria Presented During Management of Acute Upper Respiratory Infection.: Sang Do Seo, Sangyeoup Lee, Hong Ki Min, Young Ju Kim, Sangan Choi, Yun Jin Kim; J Korean Acad Fam Med 2004;25(1):59-65. Published online January 10, 2004

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A 34-year old woman visited the hospital complaining severe general pain which had onset on the way of improvement of sore throat, cough with sputum as symptoms of acute upper respiratory infection for 3 days. The facts that her younger sister also had a history of porphyria and the color of the patient's urine changed to dark black after it had exposed to sunlight made us to rule out porphyria strongly. Therefore, we measured the level of δ-ALA and porphobilinogen in the collected urine during 24 hours, and confirmed her diagnosis as acute intermittent porphyria. The SIADH was complicated and the sleep disturbance, disorientation and hallucination onset during the hospital days. She had taken high dose dextrose IV and hematin IV therapy for porphyria and improved gradually. Therefore, authors et al. report a case of acute intermittent porphyria with various clinical symptoms on the way of treatment of upper respiratory infection as well as review the previous literatures.

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Gastrointestinal Stromal Tumor in a Patient Complaining about Less Decreasing Abdominal Obesity.: Hae Gyun Lee, Sang Yeop Lee, Yun Jin Kim, Hong Gi Min, Young Joo Kim, Sang Han Choi; J Korean Acad Fam Med 2003;24(11):1033-1036. Published online November 10, 2003

Abstract

The gastrointestinal stromal tumor was finded in a female patient complaining continous abdominal obesity without any gastrointestinal symptoms. The tumor was sized 5.5~7~10 cm and expanded from stomach to the space between stomach and pancreas. The surgical resection was carried out for treatment. This case means that careful physical examinations should be done when there are no gastrointestinal complains in a abdominal obesity patient.

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Original Article

Change of Body Weight and Body ComPosition after Smoking Cessation in Males.: Sung Ryul Ahn, Sangyeoup Lee, Hong Gi Min, Sang Han Choi, Young Joo Kim, Yun Jin Kim; J Korean Acad Fam Med 2003;24(11):994-1002. Published online November 10, 2003

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Background
: There are very few studies on change in body composition after smoking cessation. The purpose of our study was to assess the change in body composition as well as body weight after smoking cessation in men.

Methods : The subjects were 203 men who had received health examination from May in 2000 to April in 2001 on their first visit, and then from May in 2001 to May in 2002 on their second visit, at the department of family medicine of a university hospital. They were divided into groups of non-smokers, current smokers, and former smokers by smoking status. Their past medical history, obesity indexes, smoking status, physical activity, and nutrition intake were reviewed. Body composition of the study subjects was assessed by bioelectrical impedance analysis.

Results : After adjustment for age, nutrition intake, and physical activity as confounding factors, former smokers' body weight was significantly increased by 1.8±0.4 kg on second visit compared to non-smokers and current smokers. There was a significant difference in body muscle change between first and second visit, but not in body fat change among former smokers. Former smokers' body fat and muscle were significantly increased by 0.9±0.3 kg and 0.8±0.4 kg, respectively, compared to non-smokers. Former smokers' waist circumference was significantly increased by 2.5±0.7 cm on second visit compared with non-smokers and current smokers.

Conclusion : In former smokers, body weight was increased by 1.8 kg after smoking cessation, which was attributed to increase of body muscle as well as body fat. Compared with non-smokers, former smokers' body muscle and fat were significantly increased on second visit.

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Review

A Brief Discussion on Family Medicine in Edmonton, Alberta, Canada.: Lina Bohee Kim, Chang Won Won, Yun Jin Kim; J Korean Acad Fam Med 2003;24(7):605-611. Published online July 10, 2003

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In early May 2003, a small group of four, including three family physicians and a media person, visited various family medicine education and training facilities in Edmonton, Alberta, Canada. This paper is a brief discussion of what knowledge and insight was gained during this trip.

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Original Articles

Influence of HMG-CoA Reductase Inhibitors on Bone Mass in Postmenopausal Women.: Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2003;24(5):451-455. Published online May 10, 2003

Abstract
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Background
: It is controversial whether the use of HMG CoA reductase inhibitors (statins) is associated with an increased bone mineral density (BMD) in humans. The purpose of this study was to assess the influence of statins on BMD in Korean postmenopausal women.

Methods : Forty-four postmenopausal women (aged 54.3±5.8 years) were included. The statin users (n=24) were administered either simvastain, atorvastatin, pravastatin, or lovastatin. The control group (n=20) did not take statins. BMD of the spine were measured by dual-energy X-ray absorptiometry. Alkaline phosphatase (ALP) was tested as a bone marker. The data were analysed with two-sample t test and paired t-test.

Results : The mean annual spinal BMD changes of the study groups were -1.5±5.6% for statin users and -0.2±4.2% for control group. There was no statistically significant difference in mean annual spinal BMD changes (P=0.696). The mean annual ALP changes of the study groups were -5.6±18.1% for the statin users and -0.4±13.9% for the control group. There was no statistically significant difference in mean annual ALP changes (P=0.246). In each group, the spinal BMD significantly was not changed after 1 year (P＞0.05).

Conclusion : This study suggest that statins do not protect from bone loss in Korean postmenopausal women.

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The Association of Prostate Volume with Obesity Index.: Hong Gi Min, Sang Yeoup Lee, Sung Ryul Ahn, Yong Ju Kim, Sang Han Choi, Yun Jin Kim; J Korean Acad Fam Med 2002;23(12):1453-1461. Published online December 10, 2002

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Case Report

A Case of Nonthyroidal Illness Syndrome in a Patient with Severe Liver Cirrhosis with Difficult Differential Diagnosis from Central Hypothyroidism.: Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2002;23(9):1141-1147. Published online September 10, 2002

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Original Article

The Association between Blood Pressure and Bone Mineral Loss in Perimenopausal Women; A Cross Sectional Study.: Nam Wook Yoo, Sang Yeoup Lee, Young Joo Kim, Sang Han Choi, Yun Jin Kim; J Korean Acad Fam Med 2002;23(6):787-793. Published online June 30, 2002

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Note

Incidence of Influenza-like Illness after Influenza Vaccination in the Elderly.: Sang Yeoup Lee, Won Hee Choi, Sang Han Choi, Yun Jin Kim, Byeung Man Cho; J Korean Acad Fam Med 2002;23(5):652-656. Published online May 31, 2002

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Original Articles

The association of obesity with erectile dysfunction.: Jung Ho Han, Seok Woo Ryu, Hyun Ho Kim, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2001;22(7):1112-1118. Published online July 1, 2001

Abstract
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Background
: Many studies have shown that obesity is associated with sexual dysfunction and causes erectile dysfunction particularly, but these studies are mainly about chronic diseases caused by obesity. Therefore, we conducted a study to evaluate the association of obesity in itself with erectile dysfuntion.

Methods : The study sample consisted of men, aged over 20 who visited in a university hospital in Pusan from December 1999 to March 2000, who responded to the Korean version of the international index of erectile function(IIEF). The patients having obesity-related diseases were excluded from the subject group. The subjects were classified into 'obese', 'normal' group according to body mass index(BMI) and erectile function was classified into 'erectile dysfunction', 'normal' according to IIEF-5 score. Chi-square test and Fisher's exact test were performed for statistic analysis.

Results : The mean age was 42.1. In total 160 subjects. 109 men(68.1%)belonged to the normal group and 51(31.9%) to the obese group. and 100 men(62.5) had erectile dysfunction. In normal group, 43(39.4%) had normal erectile function and 66(60.6%) and erectile dysfunction. In obese group, 17(3.3%) were normal and 34(66.7%) had erectile dysfunction. No significant difference between two groups was noted in erectile function (P>0.05).

Conclusion : There was no significant association of obesity in itself with erectile dysfunction in this study after excluding effects of other obesity-related problems.

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A prospective study on the antihypertensive monotherapy in family practice.: Young Sik Kim, Byung Sung Kim, Kyung Soo Kim, Hoon Ki Park, Yoo Seock Cheong, Esther Yeo, Tae Hee Jun, Seung Pil Jung, Ji Ho Choi, Sang Yeoup Lee, Yun Jin Kim, Young Kyu Park; J Korean Acad Fam Med 2001;22(6):828-839. Published online June 1, 2001

Abstract
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Background
: There are very few cohort studies on the hypertension in family practice. In order to investigate epidemiological characteristics of hypertensive patients and assess the safety and tolerabiliy of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out.

Methods : A total of 1,181 patients were observed from July 1997 to August 1999. At 2,4,8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment is continued and development of any adverse reactions.

Results : Calcium channel blockers(CCBs) were the most commonly prescribed initial drug class(44.2%) in family practice, followed by angiotensin converting enzyme inhibitors(ACEI) (21.0%), angiotensin II receptor antagonists(ARA) (11.8%), B-blockers(9.6%), a-blockers(3.9%), and diuretics(3.6%), During the first 12 weeks, the percentage of subjects continuing their initial ACEIs(40.7%) was substantially lower than the percentages that of subjects continuing ARAs(66.2%), a- blockers*(63.0%), CCBs(61.3%), B-blockers(55.8%), and diuretics(53.5%), respectively(P<0.001), The following adverse reactions were detected: cough(7.5%), headache(6.1%), dizziness(3.9%), flushing(3.7%), and impotence(2.4%). The incidence of cough associated with ACEI(27.9%), was higher than those of other classes(P<0.01)

Conclusion : CCBs were the most commonly prescribed initial drug class in family practice, followed by ACEIs, ARAs, B-blockers, a-blockers, and diuretics. The tolerability of antihypertensive medication was the highest in Korean patients treated with ARAs, followed by CCBs, B-blockers, diuretic, a-blocker, and ACEIs.

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Serum lipoprotein(a) and lipid concentrations in patients with subclinical hypothyroidism.: Kyoung Eun Kim, Ok Hee Lee, Ji Hyun Moon, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2001;22(3):345-353. Published online March 1, 2001

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Background
: There are no agreement for abnormalities in serum lipid concentrations and lipoprotein(a) (Lp(a)) in patients with subclinical hypothyroidism. But there are no reports for consideration of postmenopausal state and hormone replacement therapy(HRT). Therefore, we anayzed serum Lp(a) and lipid concentrations in patients with subclinical hypothyroidism considering menopause and HRT and the correlation between serum Lp(a) level and thyroid-stimulating hormone (TSH) concentration.

Methods : We undertook this study in 99 patients with subclinical hypothyroidism (TSH>5uIU/mL) and 297 age- and sex-matched normal control. They and no abnormalities in liver and renal function, fasting blood glucose and medical and drug histories. We excluded who were receiving HRT. Serum free thyroxine, triiodothyronine, TSH were measured by radioimmune assay using commercial kits, and Lp(a), total cholesterol, TG and HDL by Latex and enzyme method, respectively.

Results : There were no significant differences of serum Lp(a), total cholesterol, LDL, TG, HDL concentrations in patients with subclinical hypothyroidism and control subjects, analyzing after dividing into men, premenopausal and postmenopausal women. In patients with subclinical hypothyroidism, there was no correlation between serum Lp(a) and TSH concentraions(r=0.06, P>0.05).

Conclusion : Considering menopause and HRT, there were no increase in serum Lp(a) and lipid concentrations in subclinical hypothyroidism. There was no correlation between serum Lp(a) and TSH concentration in patients with subclinical hypothyroidism.

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Family physician's roles in health promotion, what patients want.: Jae Ho Choi, Jong Wha Lee, Seong Woong Jeong, Song Yee Han, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2001;22(2):230-240. Published online February 1, 2001

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Background
: Family physicians are interested in health promotion for maintaining one's sound health. But there is little information on what patients think about the practice of health promotion by family physicians. Therefore, we found out whether patiens think that it is appropriate for family physicians to be concerned about problems relating to four health risk factors, and the patients' perception both of their own health problems and of the concern actually shown by their family physicians.

Methods : Patients who had visited our two family medicine offices from March to August 1998 was asked to complete a self-administered questionnaire. Questions on attitudes towards and perceptions of family physicians' interest in weight, smoking, drinking, and fitness problems were included. 586 questionnaires with adequare response were analyzed using chi-square test and Mantel-Haenszel's linear trend test.

Results : A total of 586 respondents consisted of 230 men and 356 women. Of the respondents, the proportion of people who thought that family physicians should be concerned about the health risk factors ranged from 83.6% in the case of smoking to 86.5% of fitness, but 76.6% thought their family physicians had in fact been interested in smoking and 72.2% thought so about fitness. There was a significant age-group trend in the case of attitudes towards family physician concern for smoking with larger proportions of older patients (P<0.01). Significantly more women than men thought that their family physicians seemed interested in health risk factor with 62.2% to 70.0% in men and 78.6% to 80.9% in women (P<0.001). There were significant age-group differences in proportions who thought that their family physiciants seemed interested in weight(P<0.001), smoking(P<0.001), and drinking (P<0.05) problems except for fitness problem. 31.6% of the respondents thought that they had a weight problem, 20.5% smoking problem, 14.0% drinking problem, and 28.2% fitness problem.

Conclusion : These results suggest that many patients thought that most of their family physicians seemed interested in health promotion, but felt the need that should be come more interested.

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The association between indicators of central obesity and bone mineral density in women.: Ji Hyun Moon, Jin Kyu Lee, Ok Hee Lee, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2001;22(2):192-199. Published online February 1, 2001

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Background
: Obesity is a protecitive factor of osteoporosis, which is one of the important health proplems in the elderly. The purpose of this study was to determine the association between indicators of central obesity and bone mineral density (BMD) in women.

Methods : Among the healthy people who visited a tertiary hospital in Pusan for health exam from January to May 1999, we selected 303 women. We measured body mass index(BMI), waist, waist-to-hip ratio(WHR), menopausal period, and BMD. The SPSS statistical program was used for statistical analysis and the following test used: correlation and partial correlation adjusted for age and menopausal period.

Results : The total subjects consisted of 162 premenopausal and 141 postmenopausal women. In all subjects, BMI and WHR were positively correlated with spinal BMDs, but after controlling for age and menopausal period, BMI (r=0.322, P<0.01) and waist (r=0.220, P<0.01) were related to spinal BMDs. In the premenopausal group, spinal BMDs were correlated with BMI, waist, but after controlling for age, they were related to BMI (r=0.270, P<0.01) and waist(r=0.193, p<0.05). In the postmenopausal group, BMI, waist and menopausal period were correlated with spinal BMDs, and after controlling for age and menopausal period, BMI(r=0.365, p<0.01) and waist(r=0.251, p<0.01) remained related to spinal BMDs. In women of BMI below 25kg/m², spinal BMDs were correlated with waist(r=0.163, P=0.02)and not WHR.

Conclusion : These results suggest that waist, not WHR was associated with spinal BMDs in women.

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The pattern of urinary deoxypyridinoline and serum osteocalcin across menopausal transition in women.: Sang Han Choi, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2000;21(12):1552-1559. Published online December 1, 2000

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Background
: Biochemical markers have been proposed as sensitive indicators of high bone turnover and for monitoring response to osteoporosis treatment. We conducted a retrospective study to investigate the pattern of biochemical markers of bone metabolism (urinary deoxypryridinoline (D-PYD), serum osteocalcin) across menopausal transition in women.

Methods : We measured the urinary excretion of D-PYD, serum osteocalcin and BMD in 44 premenopausal and age-matched 44 postmenopausal women who visited a tertiary hospital from May 1, 1997 to July 31, 1997. Each values between premenopausal and postmenopausal women were anaysed with paired t-tests. Pearson's correlation coefficients were performed to assess the relationships between the three values.

Results : Urinary excretion of D-PYD in postmenopausal women (12.103±2.27 nM/mM creatinine) was higher than in premenopausal women (9.322±.53 nM/mM creatinine) (P<0.05). Serum osteocalcin in postmenopausal women (12.8698±3.1 ng/ml) was higher than in premenopausal women (9.0949±2.7 ng/ml) (P<0.01). BMD in postmenopausal women (0.9979±0.1863 g/cm2) was lower than in postmenopausal women (1.1845±0.1591 g/cm2)(P<0.01). The serum osteocalcin level was positively correlated with D-PYD (r=0.547, p<0.01). Urine excretion of D-PYD was negatively correlated with BMD (r=-0.36, p<0.01). Serum osteocalcin was negatively correlated with BMD (r=-0.427, P<0.01).

Conclusion : Urinary D-PYD excretion and serum osteocalcin were increased, by BMD was decreased significantly in postmenopausal women. Urinary D-PYD, serum osteocalcin, and BMD were significantly correlated with each other in women.

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Factors associated with fatigue in middle-aged male workers.: Yun Jin Kim, Sang Yeoup Lee; J Korean Acad Fam Med 2000;21(10):1277-1287. Published online October 1, 2000

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Background
: Fatigue is a common complaint of the middle-aged male. Some studies show that fatigue is associated with depression, anxiety, or stress and caused by physical or psychological factors. The impact of these factors with fatigue severity is not, known. The purpose of this study was to evaluate the association of above factors with fatigue severity in middle-aged male workers.

Methods : The subjects were middle-aged male workers seen for health check up at a university hospital in Pusan from Sep. 1998 to Dec. 1998. Subjects completed questionnaire about fatigue severity, fatigue type, depression, anxiety, stress and activity level. Subjects were divided into 4 groups in the order of fatigue severity ; No Fatigue Group, Fatigue Group I , Fatigue Group II, Fatigue Group III.

Results : Among 218 subjects, 90 (41.3%) were No fatigue Group, 44 (20.2%) were Fatigue Group I, 50 (22.9%) were Fatigue Group II, and 34 (15.6%) were Fatigue Group III. Fatigue severity was significantly different between the 5th and 6th decade age groups(P=0.018). As fatigue severity was increased, depression, anxiety, and stress were increased, but activity level was decreased (P<0.01). Depression, anxiety, stress and activity level were significantly different between No Fatigue Group and Fatigue Group III. Depression, anxiety and stress were significantly different by fatigue severity. fatigue severity had a positive correlation with total fatigue, physical fatigue, psychological fatigue, depression, anxiety, and stress, but a negative correlation with activity level(P<0.01).

Conclusion : Fatigue is common among middle-age male workers. Fatigue severitys was associated with an increase in depression, anxiety, and stress, but was decreased with activity level. The influence of physical fatigue was in proportion to fatigue severity. Therefore, understanding fatigue as a continuous variable may be useful in patient care.

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The relationship between nutrient intake and bone mineral density by use of a semiquantitative food frequency questionnaire.: Seong Woong Jeong, Song Yee Han, Kyung Mi Kim, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2000;21(4):523-532. Published online April 1, 2000

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Background
: To determine the relationship between nutrient intake and bone mineral density (BMD), we have investigated this issue by the use of a semiquantitative food-frequency questionnaire.

Methods : A total 312 women aged 33-77 was divided into two groups, 187 premenopausal and 125 postmenopausal women, Dietary intake was assessed with a food-frequency questionnaire. DMD was assessed with dual-energy X-ray absorptiometry at the lumbar spine (lumbar vertebrae 2-4). Pearson correlation and partial correlation coefficients were calculated for each nutrient at the lumbar spine MBD.

Results : The mean age of the 32 participants was 48 years, and their mean body mass index (BMI) was 23.7±2.8 kg/m² . Forty percent of the women were in postmenopausal state. The mean lumbar BMD was 1.117g/cm2. Age was negatively correlated with BMD in postmenopausal women, but smoking and exercise were not correlated with BMD. In premenopausal women, nutrient intakes were not associated with BMD. A significant association was found between intakes of fat, iron, vitamin A, vitamin C and BMD in postmenopausal women, but after adjusting for age, body mass index, energy intake, smoking, exercise, and use of hormone replacement therapy, there was no association.

Conclusion : There was no significant association between nutrient intakes and BMD of the lumbar spine.

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Comparison of the medical counseling by PC communication between family medicine and internal medicine according to ICPC.: Kyung Mi Kim, Young Kwon Song, yu Heon Huh, Kwang Woo Bae, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 2000;21(3):367-375. Published online March 1, 2000

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Background
: The purpose of this survey was to assess knowledge of the public on family medicine through the analysis of medical counseling by PC communication and compare them with that of internal medicine.

Methods : This survey analyzed the content of medical counseling by PC communication according to ICPC from Oct. 1996 to Jun. 1998. The survey was done by means of E-mail in Nownuri eyes and the selected medical departments were those of family medicine and internal medicine in Pusan National University Hospital.

Results : The total number of questions was 342, including 181 in the department of family medicine and 161 in internal medicine. In the analysis of medical counseling according to ICPC, there was a significant difference between family medicine and internal medicine in the reasons for questions by components(P<0.001). In family medicine, the reasons were symptoms, complaints(66.9%), diagnoses, diseases(18.8%), treatment, procedure, medication(17.2%), and diagnostic, screening, prevention(5.5%). In internal medicine, the reasons for questions were symptoms, complaints(64.6%), diagnoses, diseases(21.1%), treatment, procedure, medication(9.3%), and test results(4.3%).
There was a significant difference between family medicine and internal medicine in the questions by chapters(P<0.05). In family medicine, the questions about digestive system were 28 cases(15.5%), neurological system were 26 cases(14.4%), musculoskeletal system were 25 cases(13.8%), and unspecified were 25 cases(13.8%). In internal medicine, the questions about digestive system were 76 cases(47.2%), circulatory system were 21 cases(13.0%), and respiratory system were 15 cases(9.3%). The most common symptom was headache in family medicine and generalized abdominal pain in internal medicine.

Conclusion : There were significant differences in the age distribution, the reasons for questions, and the contents of questions between family medicine and internal medicine.

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Factors related to awareness of hypertension.: Yu Heon> Huh, Kyung Mi Kim, Ung Kwan Song, Jae Ho Choi, Jong Wha Lee, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 1999;20(12):1761-1769. Published online December 1, 1999

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Background
: Hypertension is a common disease and one of the most important risk factors of cardiovascular diseases. Majority of patients with hypertension are unaware of their conditions until complications develop. Awareness of hypertension is important in treating and controlling of hypertension. Therefore, we conducted a study o the factors related to awareness of hypertension.

Methods : Awareness of hypertension was evaluated by measuring blood pressure(BP) in 3,344 subjects visiting a health promotion center in Pusan National University Hospital from June 1996 to May 1997. All subjects completed a questionnaire including socio-demographic factors and family history. Hypertension was defined as systolic BP above 140mmHg and/or diastolic BP above 90mmHg. 135 subjects were diagnosed as hypertension.

Results : Among 315 hypertensive, only 135 subjects(42.9%) were aware of their conditions. With respect to sex, women had a getter awareness of hypertension than men(51.6% vs. 36.9%, P<0.005). The awareness was greater for the subjects aged over 60 years than for the subjects aged 30-49 years(53.3% vs. 36.5%), and it was statistically significant(P<0.005). The subjects with stage III hypertension had a better awareness of hypertension than the subjects with stage I (65.5% vs. 32.6%, P<0.005). In the occupation-types, the awareness was highest in the group without occupations. But except the group without occupations(56.2%), the awareness was highest in the group of domestic affairs (housewives, 53.2%). Education level and monthly mean income were not related to awareness of hypertension. With respect to marital state, the rate of awareness is highest in the group of widows or widowers(55.8%, P<0.05). The subjects with family history of hypertension had a better awareness of hypertension than the subjects without(59.6% vs. 35.7%, P<0.05). The rate of alcohol drinking(47.4% vs. 66.7%), smoking(21.5% vs. 31.6%) and high salt intake(17.0% vs. 25.0%) were lower and the performance rate of regular exercise(24.4% vs. 13.3%) was higher in those who were aware of their hypertension than those who were not.

Conclusion : The awareness of hypertension was also associated with sex, age, marital state, occupation, stage of hypertension, family history of hypertension, and was related too the performance of life-style modification (alcohol drinking, smoking, salt intake, exercise).

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The effect of urine-holding on blood pressure.: Kwang Woo Bae, Jae Ho Choi, Seong Woong Jeong, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 1999;20(10):1255-1259. Published online October 1, 1999

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Background
: For diagnosis of hypertension, prompt, blood pressure measurement is necessary. In a clinical setting, increased blood pressure is often recorded during urine-holding. The aim of this study was to assess the effect of urine-holding on blood pressure.

Methods : We analyzed 172 subjects who visited a hospital in Pusan for examination of pelvic ultrasonography. We measured urine-holding time, blood pressure in a urine-holding stat, and blood pressure immediately after urination when pelvic ultrasonography was examined. Paired t-test was performed to compare the pre-voiding blood pressure. The relationship between urine holding time and difference in blood pressure were assessed by Pearson's correlation coefficients.

Results : In subjects who held urine for no less than 3hours, mean pre-voiding systolic blood pressure was 124.2±20.8 mmHg, mean pre-voiding diastolic blood pressure was 78.3±13.3 mmHg. Mean difference in systolic blood pressure was 4.2±10.7 mmHg, and mean difference in diastolic blood pressure was 2.8±7.7 mmHg(P<0.05). The correlation between urine holding time and differences in systolic and diastolic blood pressure was not significant(P>0.05)

Conclusion : Urine-holding for no less than 3 hours made systolic and diastolic blood pressure rise. However, the rise in blood pressure was not proportional to urine-holding time.

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The differences of opinion on Boramae incident between physiscians and common people.: Woong Kwang Song, Jong Wha Lee, Kwang Woo Bae, Sang Yeoup Lee, Yun Jin Kim; J Korean Acad Fam Med 1999;20(10):1224-1231. Published online October 1, 1999

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Background
: Without available medical policy, up until now discharges against medical advice have occurred in the field of medicine in Korea. Seoul district court had convicted two physicians of crime because they had allowed a patient to discharge against medical advice, referred to as the Boramae incident in May of 1998. This shocked people in medical field as wee as people and appeared in almost all newspapers and created a debate especially to physicians. The purpose of this study was to evaluate the differences of opinion of opinion of this incident between physicians and common people.

Methods : Ninety-nine physicians and ninety-nine common people were questioned from September 1 to September 30, 1998 about sociodemographic characteristics and opinion of this event.

Results : The mean age of the physician group, the non-physician group was 38.12±11.2, 385.±11.1, respectively. Each group consisted of 87.9 percent, men and 12.1 percent, women. There were no differences between physicians and common people in experiences of discharges against medical advice in their families, decisions on Boramae-like incidents that could occur in the near future, and causes of discharges against medical advice. The physician group had more awareness rate of this incident than the non-physician group, and insisted more on the needs of methods to prevent recurrence. In opinion of the judgment, 5.1 percent of non-physician group agreed to conviction of Seoul district court.22.2 percent of the non-physician group was of the opinion that this incident will affect patient care positively. about patient wife's decision, 21.1 percent of non-physician group considered that she made an imprudent decision.

Conclusion : There were significant between physicians and common people in the awareness of this incident, opinion on the judgment, needs of methods to prevent recurrence, the influence of this incident on patient care in the future, opinion of patient wife's decision, exceptional experiences of discharges against medical advice in a family, decisions on Boramae-like incidents that can occur in the near future, and causes of discharges against medical advice.

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Factors related symptoms of video disply terminal users.: Yun Jin Kim, Sang Yeoup Lee; J Korean Acad Fam Med 1999;20(9):1091-1098. Published online September 1, 1999

Abstract
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Background
: The use of video display terminal(VDT) is growing rapidly. The purpose of this study was to examine detailed symptoms related to VDT use, factors related to symptoms of VDT users.

Methods : 352 bank clerks using VDT who visited to a hospital in Pusan were enrolled in this study. Collected data included age, sex, symptoms associated VDT, weekly VDT, weekly VDT usage time, distance from head to hard, distance from eyes to VDT angle to VDT.

Results : The prevalence of symptoms related to VDT use was 27.0 percent. Symptoms involved visual(19.9%), musculoskeletal(10.8%), neurological system(0.5%). The prevalence of musculoskeletal years of age was higher than those of 3 years and over. The prevalence of subjects with more than one symptom was 33.7 percent; subjects with visual and musculoskeletal symptoms were most common.
Angle to VDT of group having symptoms relate to VDT use was 5.1±22.6 degrees while those without was -0.5±17.0 degrees(P,0.05), Weekly mean VDT usage time of group having symptoms related of frequency subjects having visual, musculoskeletal, and neurological symptoms, angle to VTD and weekly mean VDT usage time were increased.

Conclusion : Factors related to symptoms of VDT users was weekly VDT usage time and angle to VDT. The prevalence of symptoms related to VDT use was 27.0 percent.