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"Risk"

Original Articles

Body mass index variability and pancreatic cancer risk in South Korean adults: a nationwide cohort study
Huy Young Kim, Ju Hyun Kang, Sinyoung Cho, Sun Jae Park, Jina Chung, Hye Jun Kim, Jiwon Yu, Sangwoo Park, Jaewon Kim, Hyeokjong Lee, Ahryoung Ko, Kyae Hyung Kim, Sang Min Park
Received December 15, 2025  Accepted February 13, 2026  Published online June 17, 2026  
DOI: https://doi.org/10.4082/kjfm.25.0377    [Epub ahead of print]
Background
Although obesity is a known risk factor for pancreatic cancer, the role of dynamic weight fluctuations remains unclear. We examined whether body mass index (BMI) variability is associated with pancreatic cancer risk in a large South Korean cohort.
Methods
We analyzed data from 232,322 participants in the Korean National Health Insurance Service database who underwent three health examinations between 2002 and 2007. Participants were followed from 2008 until pancreatic cancer diagnosis, death, or the end of the study period in 2019. BMI variability, assessed using average successive variability, was categorized into tertiles. We used Cox proportional hazards models to calculate adjusted hazard ratios and 95% confidence intervals after adjusting for potential confounders. Sensitivity analyses were performed to verify the robustness of our findings.
Results
In the overall cohort, BMI variability showed no significant association with pancreatic cancer risk. However, a statistically significant interaction by sex was observed (P for interaction=0.029), yielding higher risk estimates among male participants.
Conclusion
Although BMI variability lacked a significant overall association with pancreatic cancer risk, the attenuation of this risk after longer washout periods suggests the potential influence of preclinical weight changes. Nevertheless, the observed effect modification by sex indicates that BMI variability may retain clinical relevance for specific demographic groups, particularly male participants. Therefore, BMI variability should be interpreted not as a direct causal risk factor or intervention target, but as a potential clinical marker that warrants closer monitoring in these specific groups.
  • 689 View
  • 10 Download
Background
Metabolic dysfunction-associated steatotic liver disease (SLD) emphasizes that metabolic dysfunction is a key driver of hepatic steatosis. Although menopause is characterized by substantial hormonal and metabolic shifts, population-based evidence on its association with the probability of SLD under the updated diagnostic framework remains limited. Therefore, this study investigated the association between menopausal status and probability of SLD in middle-aged Korean women.
Methods
We analyzed data of 15,106 women aged 40 to 59 years who participated in the Korea National Health and Nutrition Examination Survey (2007–2023). The probability of SLD was assessed using the hepatic steatosis index (≥36) in the presence of at least one metabolic abnormality. Menopausal status was self-reported. Weighted multivariate logistic regression was performed after adjusting for age, body mass index, waist circumference, and major metabolic risk factors. Effect modification was evaluated through subgroup analysis.
Results
Among the 15,106 women, 31.5% were postmenopausal and 22.1% met the criteria for SLD probability. Post-menopausal women exhibited higher metabolic risk profiles and a higher probability of SLD than premenopausal women. Menopausal status remained independently associated with SLD probability after multivariable adjustment (adjusted odds ratios, 1.22; P=0.035). The association varied by age; it was strongest among women aged 40 to 49 years and progressively attenuated in older age groups (P for interaction=0.001).
Conclusion
Menopausal status is independently associated with a higher probability of SLD among middle-aged Korean women, an association most pronounced in the early midlife. These findings highlight the importance of proactive metabolic screening and timely intervention during this critical period.
  • 673 View
  • 23 Download
Association between substance use disorder and risky behavior among students in Indonesia: a cross-sectional study
Rachmalina Soerachman, Irfan Ardani, Oktarina Oktarina, Dwi Hapsari Tjandrarini, Setia Pranata, Tin Afifah, Betty Roosihermiatie, Diah Yunitawati, Anissa Rizkianti, Yurika Fauzia Wardhani
Received August 1, 2025  Accepted November 12, 2025  Published online March 18, 2026  
DOI: https://doi.org/10.4082/kjfm.25.0237    [Epub ahead of print]
Background
Substance use is prohibited in Indonesia; however, adolescents continue to consume these substances, creating a significant public health challenge. This study examines behavioral and demographic factors associated with general drug use, including cannabis and amphetamine use, among Indonesian adolescents, using nationally representative data.
Methods
A cross-sectional study used data from the 2023 Indonesia Global School-based Student Health Survey, which included 10,059 students aged 13 to 17 years. A two-stage cluster sampling was applied, and descriptive and regression analyses were conducted to identify factors associated with substance use.
Results
Overall, 3.03% of students reported drug use, 1.45% reported cannabis use, and 1.33% reported amphetamine use. Age and school level were not significantly associated with substance use. However, male sex, residence outside the Java-Bali region, alcohol use, and tobacco use were consistently linked to higher odds of drug, cannabis, and amphetamine use. Alcohol consumption was the strongest predictor for all types of substance use. These findings indicate that risky behaviors tend to cluster, supporting the pattern of polysubstance use among youth.
Conclusion
The study findings highlight the need for risk-specific, gender-responsive, school-based prevention programs that actively involve parents and regulate adolescents’ access to alcohol and tobacco. Enhancing life skills and character education in both school and family settings may also help students avoid risky behaviors.
  • 1,635 View
  • 58 Download
Association between parental consanguineous marriage and the incidence, age of onset, and severity of coronary artery disease: a cross-sectional study in Iran
Hamid Khederlou, Arash Jalali, Vanoushe Azimi Pirsaraei, Fatemeh Shokoeizadeh, Nasrin Hamidabadi, Somayeh Yadangi, Saeed Sadeghian
Received July 25, 2025  Accepted October 29, 2025  Published online February 25, 2026  
DOI: https://doi.org/10.4082/kjfm.25.0224    [Epub ahead of print]
Background
The relationship of consanguineous marriage (CM) with cardiovascular conditions, particularly structural congenital heart diseases, has been well established. Although CM may influence genetic predisposition by increasing oligogenicity and genetic homogeneity, its association with coronary artery disease (CAD) remains uncertain. This study aimed to investigate the relationship between parental CM and the prevalence, age of onset, and severity of CAD.
Methods
In this cross-sectional study conducted between May 2021 and August 2022, a total of 13,151 patients undergoing coronary angiography at the Tehran Heart Center were enrolled. A structured questionnaire was used to collect demographic and anthropometric data, medical history, cardiovascular risk factors, previous angiographic findings, and parental kinship information. Analyses were performed using IBM SPSS ver. 23.0.
Results
Among 11,986 participants, 66.0% were male, with a mean age of 58.9±10.7 years. CAD was diagnosed in 9,083 individuals (75.8%). In total, 1,515 participants (12.6%) reported a history of parental CM. The prevalence of CAD was 3.2 percentage points higher in individuals with parental CM (P<0.001). Additionally, parental CM was associated with an earlier CAD by 2.4 years. However, no significant correlation was observed between parental CM and CAD severity.
Conclusion
Parental consanguinity is associated with a higher prevalence and earlier onset of CAD. These findings suggest that parental CM may be relevant in the context of CAD risk and should be considered in comprehensive CAD risk assessments, particularly in regions where consanguinity is common.
  • 820 View
  • 20 Download

Review Article

Current guidelines and future directions in comprehensive obesity assessment
Sinyoung Cho, Hyuktae Kwon
Korean J Fam Med 2026;47(1):4-11.   Published online December 4, 2025
DOI: https://doi.org/10.4082/kjfm.25.0275
Obesity is a chronic systemic disease with multifactorial causes that poses a substantial health and economic burden worldwide. In Korea, obesity is a significant public health concern owing to the increasing prevalence of obesity-related comorbidities and mortality. Obesity is defined as excess adiposity that poses health risks. Adiposity can be assessed using direct and indirect methods, among which body mass index (BMI) is the most widely used anthropometric measurement in epidemiological studies and clinical practice. However, limitations of BMI-centric obesity assessments have been noted in previous studies. Simple adiposity measures cannot capture obesity-related medical conditions, daily functional status, or mental health. Therefore, medical associations worldwide have increasingly emphasized the need for comprehensive obesity assessments, including the 2020 Canadian Adult Obesity Clinical Practice Guidelines, American Association of Clinical Endocrinologists/American College of Endocrinology 2023 Guidelines, 2024 European Association for the Study of Obesity diagnostic framework, and 2025 Lancet Commission’s Clinical Obesity Diagnostic Criteria. Recent perspectives have emphasized multidimensional approaches to obesity assessment to capture individuals’ overall health status. This review aims to evaluate the limitations of BMI-centric obesity diagnosis, summarize emerging recommendations from recent international guidelines, and highlight potential alternative approaches for improving the assessment of obesity and related health outcomes.

Citations

Citations to this article as recorded by  
  • A year of significant progress for the Korean Journal of Family Medicine
    Seung-Won Oh
    Korean Journal of Family Medicine.2026; 47(1): 1.     CrossRef
  • Obesity Management in Primary Care: Clinical Approaches and Policy Implications in the Era of Incretin-Based Therapies
    Chung-woo Lee
    Korean Journal of Family Practice.2026; 16(2): 81.     CrossRef
  • 2,214 View
  • 113 Download
  • 1 Web of Science
  • 2 Crossref

Original Articles

Association between changes in systolic blood pressure and the incidence of diabetes mellitus: a retrospective study based on the Korean National Health Screening Cohort
Hyo-Sun You, Jeong Sook Kim, Joungyoun Kim, Hee-Taik Kang
Korean J Fam Med 2026;47(3):258-266.   Published online November 18, 2025
DOI: https://doi.org/10.4082/kjfm.25.0101
Background
As the global prevalence of diabetes mellitus continues to increase, it is important to identify its risk factors and implement preventive approaches. This study aimed to investigate the association between changes in systolic blood pressure (SBP) and the incidence of diabetes.
Methods
Data from 152,547 participants, who underwent two consecutive health checkups between 2002 and 2003, and 2004 and 2005, and included in the Korean National Health Insurance Service Health Screening Database, were reviewed. Participants were divided into three groups according to change in SBP: decrease (≥10 mm Hg); no change (<10 mm Hg); and increase (≥10 mm Hg). Cox proportional hazard regression models for diabetes incidence were constructed to evaluate adjusted hazard ratio (HR) with corresponding 95% confidence interval (CI).
Results
The median follow-up was 14.3 years, and 26,352 patients with diabetes were identified. Compared to those with no change in SBP, the adjusted HRs for decrease and increase among males were 1.06 (95% CI, 1.02–1.10) and 1.10 (95% CI, 1.06–1.14), and 1.06 (95% CI, 1.00–1.12) and 1.08 (95% CI, 1.02–1.13) for females, respectively. After stratifying data according to SBP at baseline, the HRs for decrease in males and females were as follows: normotensive group, 1.16 (95% CI, 1.08–1.24) and 1.11 (95% CI, 1.02–1.21); and prehypertensive group, 1.14 (95% CI, 1.09–1.20) and 1.19 (95% CI, 1.10–1.29), respectively.
Conclusion
Changes in SBP were associated with a risk for diabetes.
  • 1,404 View
  • 47 Download
Vaccine uptake pre- and post-COVID-19 in American adults: a retrospective observational study using the Behavioral Risk Factor Surveillance System
Thomas A. Beltran, Cristóbal S. Berry-Cabán, Sean M. Rogers, Bryson K. Merrill
Korean J Fam Med 2026;47(3):237-245.   Published online September 19, 2025
DOI: https://doi.org/10.4082/kjfm.25.0098
Background
This study examined the impact of the COVID-19 pandemic on adult vaccination uptake, specifically recombinant zoster vaccine (RZV), influenza (FLU), and pneumococcal vaccines (PnV), and explored factors influencing COVID-19 vaccine receipt in US adults.
Methods
We conducted a retrospective analysis of nationally representative cross-sectional data from the 2019 and 2022 Behavioral Risk Factor Surveillance Systems (n=777,807). Multivariable regression models assessed vaccination status for COVID-19, RZV, FLU, and PnV, adjusting for sociodemographic factors, geography, and healthcare coverage.
Results
Among insured adults, RZV vaccination increased from 31.9% in 2019 to 41.5% in 2022, and FLU vaccination increased from 42.7% to 45.0%. Among uninsured individuals, FLU vaccination rates declined 3.2%, while RZV remained unchanged. PnV rates remained stable among the insured but decreased by 15.4% among the uninsured. Individuals with healthcare coverage were 2.9 times more likely (95% confidence interval, 2.6–3.2) to have received ≥1 dose of the COVID- 19 vaccine. Minorities reported higher uptake for 1 to 2 doses of the COVID-19 vaccine but lower uptake for FLU, RZV, and PnV than non-Hispanic Whites, who had higher rates of >4 doses of COVID-19 vaccine.
Conclusion
Despite free access to the COVID-19 vaccine, healthcare coverage significantly influenced its uptake. Increases in RZV and FLU vaccination among the insured, in contrast to minimal changes or decreases among the uninsured, highlight the critical role of healthcare access. While RZV and FLU uptake improved post-pandemic, PnV uptake remained stable. We found no evidence that COVID-19 vaccine safety affected RZV, FLU, and PnV vaccination rates.
  • 2,469 View
  • 59 Download
Association between mothers’ working hours and metabolic syndrome in children and adolescents: data from the Korea National Health and Nutrition Examination Survey, 2016–2020
Myoung-hye Lee, Joo-Eun Jeong, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park
Korean J Fam Med 2025;46(2):84-91.   Published online May 8, 2024
DOI: https://doi.org/10.4082/kjfm.23.0157
Background
Prevention and management of metabolic syndrome (MetS) during childhood are crucial. Recently, obesity among children and adolescents has increased with an increase in mothers’ working hours. The present study was conducted to determine the relationship between mothers’ working hours and MetS in their children.
Methods
Data from the 2016–2020 National Health and Nutrition Examination Survey were used, and 2,598 children and adolescents aged 10–18 years were included. Logistic regression analysis was conducted to confirm the association between MetS and mothers’ working hours for each risk factor. Linear regression analysis was conducted to confirm the association between mothers’ working hours and the number of risk factors for MetS.
Results
Abdominal obesity in children was higher when the mothers’ working hours were 53 hours or more (odds ratio [OR], 2.267; 95% confidence interval [CI], 1.21–4.25). In the trend analysis, the OR of children’s abdominal obesity increased significantly as mothers’ working hours increased (P-value <0.05). Additionally, sex-stratified analysis revealed a significant trend between maternal work hours and the presence of MetS in female children (P=0.016). The adjusted OR of the presence of MetS in female children with mothers working 53 hours or more weekly was 6.065 (95% CI, 1.954–18.822).
Conclusion
Mothers’ working hours were highly correlated with the risk of abdominal obesity in their children. The OR of the presence of MetS significantly increased in female children with mothers having longer working hours compared with those with stay-at-home mothers.

Citations

Citations to this article as recorded by  
  • A year of significant progress for the Korean Journal of Family Medicine
    Seung-Won Oh
    Korean Journal of Family Medicine.2026; 47(1): 1.     CrossRef
  • No, either or both parents with metabolic syndrome: comparative study of its impact on sons and daughters
    Jun-Hong Park, Min Hyung Cho, Hae Sang Lee, Young Suk Shim
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
  • 5,330 View
  • 105 Download
  • 2 Web of Science
  • 2 Crossref
Background
Sickness presenteeism (SP) refers to the phenomenon where employees attend work while sick, a decision that impacts both their physical and mental well-being and can lead to burnout. This study aimed to determine the prevalence of and factors influencing SP among Thai and foreign teachers following the end of the coronavirus disease 2019 public health emergency of international concern (PHEIC).
Methods
A sample of 400 individuals was analyzed using chi-square tests and logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CI).
Results
Post-PHEIC, a significant proportion of teachers (51.9%) perceived an increase in their workload, and 62.1% reported having taken health-related leave of absence. The prevalence of SP was high (35.0%). Factors significantly associated with SP (P<0.05) included being younger than 37 years (OR, 1.825; 95% CI, 1.108–3.006), facing monthly financial challenges (OR, 1.627; 95% CI, 1.028–2.575), doing school-related work on holidays (OR, 1.920; 95% CI, 1.180–3.122), and experiencing sleep disturbances owing to work-related stress (OR, 1.910; 95% CI, 1.203– 3.033). No discernible difference existed in SP rates between Thai and foreign teachers.
Conclusion
As a course of action, we recommend the provision of appropriate financial planning resources for teachers. Policywise, school events and activities should be scheduled on working days to ensure that teachers maintain a work-life balance. Additionally, task allocation that caters to individual strengths and limitations can mitigate the effects of SP.

Citations

Citations to this article as recorded by  
  • Influence of low back pain on absenteeism and presenteeism among academics in public universities
    Noordiyana Izyanti Mohamad Saufi, Eva Nabiha Zamri, Hazwani Ahmad Yusof, Nurul Izzah Shari
    WORK: A Journal of Prevention, Assessment & Rehabilitation.2026; 83(1): 250.     CrossRef
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Comprehensive Health Strategies for the Post-pandemic Era: Integrating Physical Health, Psychological Resilience, Lifestyle Choices, and Occupational Well-being
    Su Hwan Cho
    Korean Journal of Family Medicine.2024; 45(6): 303.     CrossRef
  • 6,065 View
  • 115 Download
  • 4 Web of Science
  • 3 Crossref
Background
This study aimed to examine the effects of different types of skipped meals on cardiometabolic risk factors (CMRF) in Korean adults.
Methods
We analyzed 14,062 adults from the Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018. The irregularity of breakfast, lunch, and dinner consumption was assessed using 24-hour recall data, and we categorized the habit of skipping regular meals into eight types. Multiple linear regression was used to estimate the association between each type of meal skipping and the CMRF. We also presented the estimated effects of individual types of meal skipping on the CMRF based on their predicted values and mean differences.
Results
Korean adults tended to have irregular meal consumption habits when they had one or more of the following characteristics: female sex, under the age of 50 years, middle-high to high household income, high school or college or higher education levels, alcohol consumption, and current smoking. Compared to regular eaters, we have observed significantly higher total cholesterol in the following types of meal skipping: irregular breakfast (IB) (P<0.001), irregular lunch (P=0.005), irregular breakfast and lunch (IBL) (P=0.001), irregular breakfast and dinner (P=0.001); higher low-density lipoprotein-cholesterol in IB (P=0.009); higher triglyceride in IB (P=0.005) and IBL (P=0.034); and higher fasting glucose in IB (P=0.046).
Conclusion
Different types of meal skipping were associated with CMRF. Regular breakfast and lunch consumption should be emphasized to prevent and manage cardiometabolic disorders. However, skipping dinner showed no significant association with CMRF.

Citations

Citations to this article as recorded by  
  • Associations between Meal Regularity and Generalized Anxiety Disorder Risk in Korean Adults
    Soo Jin Lee
    Journal of the Korean Society of Food Science and Nutrition.2026; 55(6): 559.     CrossRef
  • A Biochemical View on Intermittent Fasting’s Effects on Human Physiology—Not Always a Beneficial Strategy
    Willian F. Zambuzzi, Marcel Rodrigues Ferreira, Zifan Wang, Maikel P. Peppelenbosch
    Biology.2025; 14(6): 669.     CrossRef
  • Past Meal-Skipping Habits Associate With Physical Frailty in Later Life: A Retrospective Cohort Study
    Chiharu Nishijima, Kenji Harada, Satoshi Kurita, Masanori Morikawa, Kazuya Fujii, Daisuke Kakita, Hiroyuki Shimada
    Journal of the American Medical Directors Association.2025; 26(12): 105893.     CrossRef
  • Primary Care Physicians’ Important Role: Lifestyle Modification for Chronic Disease Management
    Su-Min Jeong
    Korean Journal of Family Medicine.2024; 45(5): 237.     CrossRef
  • 7,970 View
  • 118 Download
  • 3 Web of Science
  • 4 Crossref
Application of Machine Learning Algorithms to Predict Osteoporotic Fractures in Women
Su Jeong Kang, Moon Jong Kim, Yang-Im Hur, Ji-Hee Haam, Young-Sang Kim
Korean J Fam Med 2024;45(3):144-148.   Published online January 29, 2024
DOI: https://doi.org/10.4082/kjfm.23.0186
Background
Predicting the risk of osteoporotic fractures is vital for prevention. Traditional methods such as the Fracture Risk Assessment Tool (FRAX) model use clinical factors. This study examined the predictive power of the FRAX score and machine-learning algorithms trained on FRAX parameters.
Methods
We analyzed the data of 2,147 female participants from the Ansan cohort study. The FRAX parameters employed in this study included age, sex (female), height and weight, current smoking status, excessive alcohol consumption (>3 units/d of alcohol), and diagnosis of rheumatoid arthritis. Osteoporotic fracture was defined as one or more fractures of the hip, spine, or wrist during a 10-year observation period. Machine-learning algorithms, such as gradient boosting, random forest, decision tree, and logistic regression, were employed to predict osteoporotic fractures with a 70:30 training-to-test set ratio. We evaluated the area under the receiver operating characteristic curve (AUROC) scores to assess and compare the performance of these algorithms with the FRAX score.
Results
Of the 2,147 participants, 3.5% experienced osteoporotic fractures. Those with fractures were older, shorter in height, and had a higher prevalence of rheumatoid arthritis, as well as higher FRAX scores. The AUROC for the FRAX was 0.617. The machine-learning algorithms showed AUROC values of 0.662, 0.652, 0.648, and 0.637 for gradient boosting, logistic regression, decision tree, and random forest, respectively.
Conclusion
This study highlighted the immense potential of machine-learning algorithms to improve osteoporotic fracture risk prediction in women when complete FRAX parameter information is unavailable.

Citations

Citations to this article as recorded by  
  • Moderate-intensity exercise reduces osteoporotic fracture risk in older women: a dose-response analysis from a nationwide Korean cohort
    Dojoon Park, Hae-Seok Koh, Song-Beom Kim, Ju-Yeong Park, Kyungdo Han, Youn-Ho Choi
    Osteoporosis International.2026; 37(2): 469.     CrossRef
  • Systematic Review of Osteoporotic Fracture Risk Prediction Models: Algorithm Comparison, Clinical Applicability, and Development Pathways
    钟 王
    Advances in Clinical Medicine.2026; 16(03): 3553.     CrossRef
  • In silico augmentation strategies for enhanced machine learning performance in fracture recognition
    Ming Xu, Zhiqiang Wang, Guanhong Liu, Chenxi Wu, Hong Jiang, Xiangqi Meng
    Scientific Reports.2026;[Epub]     CrossRef
  • Machine learning is changing osteoporosis detection: an integrative review
    Yuji Zhang, Ming Ma, Xingchun Huang, Jinmin Liu, Cong Tian, Zhenkun Duan, Hongyin Fu, Lei Huang, Bin Geng
    Osteoporosis International.2025; 36(8): 1313.     CrossRef
  • Artificial intelligence in nutrition and ageing research – A primer on the benefits
    Pol Grootswagers, Tijl Grootswagers
    Maturitas.2025; 200: 108662.     CrossRef
  • Assessing the risk of osteoporotic fracture recurrence using CT-based radiomics and machine learning
    Xiaoyang Zheng, Caihong Zhu, Rui Zhang, Hongyu Sun
    Current Problems in Surgery.2025; 72: 101876.     CrossRef
  • AI-driven Technologies for Wrist Fracture Prediction: A Narrative Review of Emerging Approaches
    Stefania Briano, Maria Cesarina May, Giacomo Demontis, Giulia Pachera, Vittoria Mazzola, Federico Vitali, Alessandra Galuppi, Emanuela Dapelo, Andrea Zanirato, Matteo Formica
    Journal of Wrist Surgery.2025; 14(06): 500.     CrossRef
  • Interpretable machine learning model for low bone density screening in older adults using demographic and anthropometric data: findings from 2005 to 2020 NHANES
    Weiyan Huang, Qimou Pan, Jiewei Peng, Yufeng Wu, Dawei Gao
    BMC Medical Informatics and Decision Making.2025;[Epub]     CrossRef
  • Clinical Applicability of Machine Learning in Family Medicine
    Jungun Lee
    Korean Journal of Family Medicine.2024; 45(3): 123.     CrossRef
  • Integrating Machine Learning for Personalized Fracture Risk Assessment: A Multimodal Approach
    Sheikh Mohd Saleem, Shah Sumaya Jan
    Korean Journal of Family Medicine.2024; 45(6): 356.     CrossRef
  • 7,824 View
  • 111 Download
  • 10 Web of Science
  • 10 Crossref
Comparison of Metabolic Risk Factors Based on the Type of Physical Activity in Korean Adolescents: Results from a Nationwide Population-Based Survey
Min-Hyo Kim, Yaeji Lee, John Alderman Linton, Youhyun Song, Ji-Won Lee
Korean J Fam Med 2024;45(3):164-175.   Published online January 23, 2024
DOI: https://doi.org/10.4082/kjfm.23.0164
Background
Physical activity (PA) is associated with a favorable metabolic risk profile in adults. However, its role in adolescents remains unclear. In this study, using data (2019–2021) from the 8th Korea National Health and Nutrition Examination Survey, we investigated the optimal exercise type for preventing metabolic complications in adolescents.
Methods
A total of 1,222 eligible adolescent participants (12–18-year-old) were divided into four groups as follows: aerobic exercise (AE), resistance exercise (RE), combined aerobic and resistance exercise (CE), and no exercise (NE). Daily PA was assessed using the international PA questionnaire. Blood samples were collected to measure lipid, glucose, and insulin levels. Additionally, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglyceride-glucose (TyG) indices were measured. Multivariate regression analysis was used to compare the metabolic risk factors across the PA groups before and after propensity score matching (PSM) adjustment for confounding variables.
Results
The CE group exhibited improved fasting glucose levels, lower TyG index, reduced white blood cell count, and higher high-density lipoprotein (HDL) cholesterol levels than the NE group. The RE group exhibited lower mean blood pressure, triglyceride, fasting insulin, HOMA-IR, TyG index and a reduced risk of metabolic syndrome than the NE group. The AE group had higher total and HDL cholesterol levels. In detailed comparison of the AE and RE groups, the RE group consistently exhibited favorable metabolic parameters, including lower blood pressure and total and low-density cholesterol levels, which persisted after PSM.
Conclusion
These findings highlight the positive effects of PA on cardiovascular risk factors in adolescents. Thus, RE may have a more favorable metabolic effect than AE. Further studies are needed to validate the benefits of exercise according to the exercise type.

Citations

Citations to this article as recorded by  
  • Triglyceride-glucose index and the progression of chronic obstructive pulmonary disease, panvascular disease, and multimorbidity: a prospective cohort study
    Shuo Zhang, Xiaotian Li, Jiajing Li, Siwei Xie, Zongbin Wang, Zhijie Zheng, Jie Huang, Shuduo Zhou
    Frontiers in Cardiovascular Medicine.2026;[Epub]     CrossRef
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Lifestyle interventions for hypertension management in primary care: a narrative review
    Byoungduck Han, Gyu Bae Lee, Jihyun Yoon, Yang-Hyun Kim
    Ewha Medical Journal.2025; 48(4): e56.     CrossRef
  • 6,190 View
  • 107 Download
  • 3 Web of Science
  • 3 Crossref

Review Article

RoBANS 2: A Revised Risk of Bias Assessment Tool for Nonrandomized Studies of Interventions
Hyun-Ju Seo, Soo Young Kim, Yoon Jae Lee, Ji-Eun Park
Korean J Fam Med 2023;44(5):249-260.   Published online July 7, 2023
DOI: https://doi.org/10.4082/kjfm.23.0034
Assessment of the risk of bias is an essential component of any systematic review. This is true for both nonrandomized studies and randomized trials, which are the main study designs of systematic reviews. The Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) was developed in 2013 and has gained wide usage as a risk-of-bias assessment tool for nonrandomized studies. Four risk-of-bias assessment experts revised it by reviewing existing assessment tools and user surveys. The main modifications included additional domains of selection and detection bias susceptible to nonrandomized studies of interventions, a more detailed consideration of the comparability of participants, and more reliable and valid outcome measurements. A psychometric assessment of the revised RoBANS (RoBANS 2) revealed acceptable inter-rater reliability (weighted kappa, 0.25 to 0.49) and construct validity in which intervention effects of studies with an unclear or high risk of bias were overestimated. The RoBANS 2 has acceptable feasibility, fair-to-moderate reliability, and construct validity. It provides a comprehensive framework for allowing authors to assess and understand the plausible risk of bias in nonrandomized studies of interventions.

Citations

Citations to this article as recorded by  
  • Nursing care services to address unmet supportive care needs among cancer survivors: a systematic review
    Hyun Jin Song, Hyun-Ju Seo, Eun Jeong Choi, Ji Sung Lee, Yumi Choi
    Journal of Cancer Survivorship.2026; 20(2): 427.     CrossRef
  • Smaller hamstrings autograft size after primary ACL reconstruction is associated with higher odds for graft failure: A meta‐analysis on autografts sizes covering 46,268 patients
    Rebecca Hamrin Senorski, Johan Högberg, Kevin Teow, Anna Nordenholm, Janina Kaarre, Thorkell Snaebjörnsson, Volker Musahl, Kristian Samuelsson, Eric Hamrin Senorski
    Knee Surgery, Sports Traumatology, Arthroscopy.2026; 34(9): 3212.     CrossRef
  • Percutaneous aspiration and sclerotherapy for simple hepatic cysts: a systematic review and meta-analysis
    Tomohiro Matsumoto, Rika Yoshimatsu, Marina Osaki, Junki Shibata, Kana Miyatake, Tomoaki Yamanishi, Takuji Yamagami
    Japanese Journal of Radiology.2026; 44(1): 168.     CrossRef
  • The impact of emotional face distractors on working memory performance: a meta-analysis of behavioural studies
    Chenxiao Wu, Chenyuan Zhang, Xueqiao Li, Piia Astikainen
    Cognition and Emotion.2026; 40(5): 993.     CrossRef
  • Hypofractionated vs. conventional fractionated radiotherapy in the temozolomide era for elderly patients with glioblastoma: a systematic review and meta-analysis by the Korean Society for Neuro-Oncology
    Eunji Kim, Hye In Lee, Tae Hoon Roh, Young Zoon Kim, Do Hoon Lim, Se Jin Cho, Kihwan Hwang, Chan Woo Wee
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    Nicole Del Bianco, Anita Borsati, Linda Toniolo, Christian Ciurnielli, Lorenzo Belluomini, Jessica Insolda, Marco Sposito, Michele Milella, Federico Schena, Sara Pilotto, Alice Avancini
    Critical Reviews in Oncology/Hematology.2024; 198: 104350.     CrossRef
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    Seungeun Ryoo, Miyoung Choi, Nam-Kyong Choi, Hyoung-Shik Shin, Jun Hee Woo, Byung-Joo Park, Sanghoon Oh
    Osong Public Health and Research Perspectives.2024; 15(2): 107.     CrossRef
  • A Systematic Review on Health Impact of Electronic Cigarettes in South Korea
    Eunsil Cheon, Hana Kim, Naeun Kang, Susan Park, Sung-il Cho, Jieun Hwang
    Journal of the Korean Society for Research on Nicotine and Tobacco.2024; 15(2): 29.     CrossRef
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    Yujin Park, Sun Ju Chang, Hee Jung Kim, Ha Na Jeong
    Journal of Korean Gerontological Nursing.2024; 26(3): 234.     CrossRef
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    Francisco A. Ferreira, Catarina C. Santos, António L. Palmeira, Ricardo J. Fernandes, Mário J. Costa
    Journal of Functional Morphology and Kinesiology.2024; 9(3): 158.     CrossRef
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    Elena Bayly-McCredie, Maxine Treisman, Salvatore Fiorenza
    International Journal of Molecular Sciences.2024; 25(17): 9736.     CrossRef
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    Seung-Kyu Lim, Kyomin Choi, Nam Hun Heo, Younji Kim, Jae-Young Lim
    The Journal of nutrition, health and aging.2024; 28(10): 100357.     CrossRef
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    Nurfatima Azzahra Fadli, Mariati Abdul Rahman, Saiful Anuar Karsani, Roszalina Ramli
    Diagnostics.2024; 14(19): 2184.     CrossRef
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    Jin Hui Han, Hee Joo Oh
    Journal of Korean Public Health Nursing.2024; 38(2): 115.     CrossRef
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    European Radiology.2024; 35(5): 2569.     CrossRef
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    Judith J M Rijnhart, Ava Rabbers, Santina Rizzuto
    International Journal of Epidemiology.2024;[Epub]     CrossRef
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    Abdulrahim Saleh Alrasheed, Taif Mansour Almaqboul, Reem Ali Alshamrani, Noor Mohammad AlMohish, Majed Mohammad Alabdali
    Journal of Clinical Medicine.2024; 13(22): 6713.     CrossRef
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    Hepatology Communications.2024;[Epub]     CrossRef
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    Moonjung Bae
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Original Articles

Knowledge and Risk Behaviors Regarding Human Immunodeficiency Virus Transmission among Portuguese Healthcare Students
Bárbara Joana Alvarenga Carvalho, António Miguel da Cruz-Ferreira
Korean J Fam Med 2023;44(1):35-43.   Published online January 19, 2023
DOI: https://doi.org/10.4082/kjfm.22.0012
Background
Human immunodeficiency virus (HIV), the agent responsible for acquired immunodeficiency syndrome, remains a worldwide public health problem. Therefore, this study aimed to assess Portuguese healthcare students’ knowledge of HIV, identify risk behaviors for HIV transmission, and assess the frequency of HIV testing and its dissemination by general practitioners.
Methods
A cross-sectional observational study was conducted using an anonymous questionnaire published online. The questionnaire was administered to Portuguese healthcare students who voluntarily agreed to participate in the study after clarifying its objectives and procedures.
Results
Most students were aware of the three main HIV transmission routes; however, 66.3% were unaware of the level A recommendation for HIV screening in adolescents and adults. In addition, 59.6% of the students were never informed by their general practitioner about HIV screening tests or risk behaviors for HIV transmission. Of the sample, 78.9% had never been tested for HIV infection. Of the 74.6% of sexually active students, 82.0% had or had already had unprotected sex (without a condom). Men showed riskier sexual behaviors than women. None of the inquiries reported intravenous drug use, and most students (69.9%) never shared personal objects.
Conclusion
General practitioners and awareness campaigns need to alert and disseminate HIV screening tests. Sexual health and risk behaviors should be addressed more frequently in schools to educate this population because prevention is the best strategy against HIV transmission/contraction.

Citations

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  • Evaluation of community pharmacy outreach events to promote screening for human immunodeficiency virus
    Destanie Truman, Robert Nichols, Stevie Veach, Enas M. Yehya, Matthew Witry
    JAPhA Practice Innovations.2026; 3(3): 100107.     CrossRef
  • Sexual awareness, high-risk sexual behaviors and HIV testing: a cross-sectional survey among university students in Xuzhou, Jiangsu
    Hualing Li, Qi Wu, Qinghan Li, Enze Gao, Dehui Yin
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • 4,738 View
  • 83 Download
  • 1 Web of Science
  • 2 Crossref
Correlates of Sedentary Behavior among Bhutanese Adults: Findings from the 2014 Bhutan STEPS Survey Data
Tashi Dendup, Yun Zhao, I Gusti Ngurah Edi Putra, Tandin Dorji, Chador Tenzin
Korean J Fam Med 2021;42(4):288-296.   Published online July 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0059
Background
Sedentary behavior is associated with several adverse health outcomes. Data on factors that influence sedentary behavior are lacking in Bhutan. This study examined factors associated with increased sedentary behavior in Bhutan, with a focus on exploring sex differences.
Methods
Data of 2,796 adults from the nationally representative 2014 Bhutan STEP-wise surveillance (STEPS) survey were analyzed. Factors associated with sedentary behavior were identified using backward elimination multiple logistic regression analysis, disaggregated by sex. The analysis accounted for the complex survey design used in the primary survey.
Results
The overall prevalence of sedentary behavior was 8.2%, with a higher proportion among women than men (10.3% vs. 4.9%). In the full sample, female sex, being single, high education and income, urban residence, inadequate physical activity, and high blood sugar were associated with increased odds of sedentary behavior. Among females, those who had high education and income, were single, physically less active, and urban residents were more likely to be sedentary. Self-employment was related to reduced odds of sedentary behavior among women and in the overall sample population. In males, being single, higher education level, and urban residence were associated with sedentariness.
Conclusion
The findings suggest that interventions targeting females, especially those who are physically less active and from higher socioeconomic groups, urban residents, and those with hyperglycemia can potentially help reduce sedentary behavior and avert the associated detrimental impacts.

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  • High sedentary behavior and low physical activity among adults in Afghanistan: results from a national cross-sectional survey
    Supa Pengpid, Ahmad Siyar Noormal, Karl Peltzer
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Status of Sedentary Time and Physical Activity of Rural Residents: A Cross-Sectional Population-Based Study in Eastern China
    Jiayuan Wang, Ya Wang, Mallikarjuna Korivi, Xi Chen, Rong Zhu
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Trends in sedentary behaviour and associated factors among adults in Mongolia: results from national cross-sectional surveys in 2009, 2013 and 2019
    Supa Pengpid, Karl Peltzer
    BMJ Open.2022; 12(6): e058330.     CrossRef
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    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
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  • 81 Download
  • 4 Web of Science
  • 4 Crossref

Case Report

Avascular Necrosis of the Hip in Primary Care
Nurul Nadia Baharum, Farnaza Ariffin, Mohammad Hanafiah, Shahrul Hisham Sulaiman
Korean J Fam Med 2021;42(1):84-87.   Published online May 25, 2020
DOI: https://doi.org/10.4082/kjfm.19.0021
Avascular necrosis, or osteonecrosis of the femoral head, is a debilitating condition which leads to the destruction of the hip joint due to an interruption in the blood supply to the bony region and is most commonly due to trauma. The case discussed here has been highlighted as it presented as non-traumatic osteonecrosis of the femoral head with an absence of risk factors in a healthy adult male. A 37-year-old male presented with a 4-month history of recurrent left hip pain, which worsened with initiation of movement and weightbearing on the affected side. The patient was overweight but normotensive with a full range of movement of the hips bilaterally. There were no abnormalities detected on initial X-ray images of the left hip. However, due to the persistent pain and sclerotic changes in a subsequent X-ray, a magnetic resonance image of the bilateral hips was obtained, leading to the diagnosis of osteonecrosis of the bilateral femoral heads. Due to the lack of improvement with physiotherapy and analgesia, the patient was subjected to conservative surgery of the symptomatic left hip with concurring evidence of avascular necrosis based on intraoperative anatomical biopsy. This case emphasizes the importance of identifying underlying issues during history taking and physical examination in adults without risk factors. The early diagnosis of osteonecrosis assists in preventing joint collapse and can delay the requirement of joint replacements. High levels of suspicion are necessary to instigate investigation in persistent cases without the presence of risk factors.
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  • 1 Web of Science

Original Articles

Spousal Concordance regarding Lifestyle Factors and Chronic Diseases among Couples Visiting Primary Care Providers in Korea
Seung Yup Jun, Mina Kang, Seo Young Kang, Jung Ah Lee, Young Sik Kim
Korean J Fam Med 2020;41(3):183-188.   Published online May 20, 2020
DOI: https://doi.org/10.4082/kjfm.18.0104
Background
Few studies have been conducted in Korea on concordance regarding chronic diseases and lifestyle factors among couples. We, therefore, evaluated spousal concordance regarding lifestyle factors and chronic diseases among Korean couples.
Methods
A total 1,040 participants (520 couples) who visited family physicians were recruited from 22 hospitals. All participants were aged ≥40 years. Participants completed questionnaires on smoking, drinking, physical activity, and irregular eating habits, including skipping breakfast. We estimated the spousal concordance regarding lifestyle factors and chronic diseases using McNemar tests and logistic regression analysis.
Results
The concordance rate was high among couples who shared unhealthy behaviors, such as low physical activity, irregular diet, and skipping breakfast (P<0.05). When cardiovascular risk factors such as overweight (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.14–2.63), hypertension (OR, 1.88; 95% CI, 1.23–2.86), or hyperlipidemia (OR, 2.41; 95% CI, 1.60–3.64) were prevalent among husbands, the odds that their wives also had the same risk factors at the same time was significantly high. The odds of being depressed when the spouse was depressed were also significantly high in both men (OR, 5.54; 95% CI, 2.19–13.96) and women (OR, 4.52; 95% CI, 1.77–11.53).
Conclusion
There was a high level of concordance regarding lifestyle factors among couples, which could lead to an increase in the prevalence of chronic diseases among couples. In addition, if a spouse has depression, the odds of their partner also having depression was high.

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    Dong Gao, Wei Zou, Junmin Chen
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    Takeshi Makiuchi, Masako Kakizaki, Tomotaka Sobue, Tetsuhisa Kitamura, Hiroshi Yatsuya, Taiki Yamaji, Motoki Iwasaki, Manami Inoue, Shoichiro Tsugane, Norie Sawada
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    Scientific Reports.2025;[Epub]     CrossRef
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    Lara Brieger, Sara Schramm, Börge Schmidt, Ulla Roggenbuck, Raimund Erbel, Andreas Stang, Bernd Kowall
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    Xueli Yuan, Wei Liu, Wenqing Ni, Yuanying Sun, Hongmin Zhang, Yan Zhang, Peng Yin, Jian Xu
    International Journal of Environmental Research and Public Health.2023; 20(2): 1426.     CrossRef
  • Spousal Similarities in Cardiovascular Risk Factors in Northern China: A Community-Based Cross-Sectional Study
    Binbin Lin, Li Pan, Huijing He, Yaoda Hu, Ji Tu, Ling Zhang, Ze Cui, Xiaolan Ren, Xianghua Wang, Jing Nai, Guangliang Shan
    International Journal of Public Health.2023;[Epub]     CrossRef
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    Tanya B. Horwitz, Jared V. Balbona, Katie N. Paulich, Matthew C. Keller
    Nature Human Behaviour.2023; 7(9): 1568.     CrossRef
  • Association between behavioral patterns and depression symptoms: dyadic interaction between couples
    Qianhui Yang, Xin Gao, Ying Tang, Hong Gan, Baoling Wang, Mengdie Li, Guixia Pan, Shuangshuang Bao, Peng Zhu, Shanshan Shao, Fangbiao Tao
    Frontiers in Psychiatry.2023;[Epub]     CrossRef
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    Caroline Laranjeira da Silva, Amine Farias Costa, Alex Oliveira da Camara, Lidiane Araújo Cezário, Ana Luisa Kremer Faller, Gabriela Villaça Chaves
    Nutrition and Cancer.2022; 74(3): 927.     CrossRef
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    Maryam Rahmati, Marzieh Saei Ghare Naz, Fereidoun Azizi, Fahimeh Ramezani Tehrani
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    Manh Thang Hoang, Hokyou Lee, Hyeon Chang Kim
    Clinical Hypertension.2022;[Epub]     CrossRef
  • Gender differences in the longitudinal association between husbands' and wives' depressive symptoms among Korean older adults: the moderating effects of the spousal relationship
    Jiwon Baek, Yoosik Youm, Hyeon Chang Kim
    Quality of Life Research.2021; 30(12): 3535.     CrossRef
  • Spousal Concordance in Dietary Behaviors and Metabolic Components, and Their Association: A Cross-Sectional Study
    Dann-Pyng Shih, Chu-Ting Wen, Hsien-Wen Kuo, Wen-Miin Liang, Li-Fan Liu, Chien-Tien Su, Jong-Yi Wang
    Nutrients.2020; 12(11): 3332.     CrossRef
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  • 20 Web of Science
  • 20 Crossref
Risk Factors of Cardiovascular Disease according to Alcohol Behavioral Change after Cancer Diagnosis
Eun Mi Bae, In Young Cho, Ji-Hye Jun, Kiheon Lee, Ju Young Kim, Woo Kyung Bae, Hyejin Lee, Jong Soo Han, Se Young Jung, Kee Hyuck Lee, Sarah Kim, Hye Yeon Koo, Sang Jin Cho, Houbuem Lee, Chuelmin Paek
Korean J Fam Med 2020;41(4):222-228.   Published online April 22, 2020
DOI: https://doi.org/10.4082/kjfm.18.0119
Background
Problem drinking increases the incidence of all-cause mortality and specific cancers, and persistent drinking is associated with cardiovascular disease in certain cancer survivors. This study analyzed the cardiovascular risk factors before and after diagnosis in Korean cancer survivors.
Methods
Data for the period between 2002 and 2013 were collected from the National Health Insurance Service Health-Examinee Cohort Database. Among the 27,835 patients included, those with moderate alcohol consumption before and after cancer diagnosis were excluded. Problem drinking was defined as males under 65 years consuming over 14 glasses a week, and males over 65 years or females consuming over seven glasses a week. A t-test, chi-square test, and linear regression analysis were performed for differences in cardiovascular risk factors and differences according to cancer types.
Results
There was a difference in the body mass index, systolic and diastolic blood pressure, and total cholesterol among patients who became moderate drinkers after diagnosis, but fasting blood glucose did not show any significant changes. Risk factors for cardiovascular disease were analyzed in patients with liver, stomach, rectal, and breast cancer with improved drinking behavior, and there were significant differences in body mass index, systolic and diastolic blood pressure, fasting blood glucose, and total cholesterol in stomach cancer patients.
Conclusion
Moderate drinking can lower cardiovascular risk in cancer survivors, and among the many drinking-related cancers, stomach cancer patients demonstrated significantly reduced cardiovascular risk factors.

Citations

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  • Problem Drinking in Cancer Survivors
    Seung-Won Oh
    Korean Journal of Family Medicine.2020; 41(4): 205.     CrossRef
  • 8,094 View
  • 118 Download
  • 1 Web of Science
  • 1 Crossref
The Influence of Negative Mental Health on the Health Behavior and the Mortality Risk: Analysis of Korean Longitudinal Study of Aging from 2006 to 2014
Eun Ryeong Jun, Sung Hi Kim, Yoon Jeong Cho, Yun-A Kim, Joo Young Lee
Korean J Fam Med 2019;40(5):297-306.   Published online September 11, 2019
DOI: https://doi.org/10.4082/kjfm.18.0068
Background
Several studies have shown that negative mental health increases risky health behavior and mortality risk. We investigated the relationship between mental health and health behavior, and the causal association between mental health and mortality risk.
Methods
We used data from the 8-year (2006–2014) Korean Longitudinal Study of Aging with a cohort of 10,247 individuals (whom we divided into a younger group aged <65 years and an older group aged ≥65 years). Mental health was assessed with the following factors: depression, social engagement, and satisfaction of life. Health behavior was assessed with smoking, alcohol use, and regular exercise. Mortality risk was calculated using survival status and survival months as of 2014. Multiple logistic regression and Cox proportional hazard analysis were performed.
Results
Negative mental health was associated with current smoking and sedentary life style, but not with alcohol consumption. In addition, it was associated with an increase in all-cause mortality risk. The increase in mortality risk in the highest quartile (vs. lowest) was 1.71 times (hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.12– 2.62) and 2.07 times (HR, 2.07; 95% CI, 1.60–2.67) for the younger and older group, respectively.
Conclusion
Our results show that mental health affects health behavior and mortality risk. A key inference from this study is that improving mental health can lead to positive changes in health behavior and reduce the risk of mortality.

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  • Lifestyles, leisure activities, subjective well-being and long-term survival after age 80 in China: a population-based cohort study
    Xinye Zou, Siyu Zou, Ruolin Zhang, Carol Brayne, Frank Qian, Zhiyuan Wu, Jin Zheng, Jinhui Zhou, Deqiang Zheng, Xiuhua Guo, Haibin Li, Zongsheng Guo
    QJM: An International Journal of Medicine.2026;[Epub]     CrossRef
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    Stephanie Misono, Jesse R. Fann, Nosayaba Osazuwa‐Peters, Schelomo Marmor
    Psycho-Oncology.2026;[Epub]     CrossRef
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    Galina Opikova, Rainer Reile, Kenn Konstabel, Kristjan Kask
    Nordic Journal of Psychiatry.2025; 79(8): 588.     CrossRef
  • Effect of Lifestyle Counselling via a Mobile Application on Disease Activity Control in Inflammatory Arthritis: A Single-Blinded, Randomized Controlled Study
    Türker Kurt, Diana Vossen, Falk Schumacher, Johannes Strunk, Dmytro Fedkov, Christine Peine, Felix Lang, Abdullah Khalil, Ralph Brinks, Stefan Vordenbäumen
    Nutrients.2024; 16(10): 1488.     CrossRef
  • The Moderating Effect of Mental Health on the Relationship Between Cardiovascular Disease Awareness and Health Behaviors of Middle-Aged Korean Chinese Workers With Cardiovascular Risk Factors in Korea
    Yu Zhu Zhang, Seon Young Hwang
    Journal of Transcultural Nursing.2023; 34(2): 131.     CrossRef
  • Combined Effects of Depression and Chronic Disease on the Risk of Mortality: The Korean Longitudinal Study of Aging (2006-2016)
    Hyunji Kim, Sung Hi Kim, Yoon Jeong Cho
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • KLoSA—Korean Longitudinal Study of Aging
    Jungun Lee
    Korean Journal of Family Medicine.2020; 41(1): 1.     CrossRef
  • Mortality and cause of death in physical activity and insufficient physical activity participants: a longitudinal follow-up study using a national health screening cohort
    Chanyang Min, Dae Myoung Yoo, Jee Hye Wee, Hyo-Jeong Lee, Soo Hwan Byun, Hyo Geun Choi
    BMC Public Health.2020;[Epub]     CrossRef
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  • 100 Download
  • 9 Web of Science
  • 8 Crossref
Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study
Tolga Vural, Makbule Neslişah Tan, Mehtap Kartal, Azize Dilek Güldal
Korean J Fam Med 2020;41(1):61-67.   Published online May 13, 2019
DOI: https://doi.org/10.4082/kjfm.18.0066
Background
Peripheral arterial disease (PAD) can progress silently without any clinical symptoms. Ankle-brachial index (ABI) is the recommended method used in primary care. We aimed to determine the prevalence of PAD and its related risk factors in primary care.
Methods
In this cross-sectional study, 250 participants aged ≥45 years were recruited randomly from the registered patients of family health center in a district of Izmir, Turkey. Patients’ demographic data, PAD symptoms, and PAD risk factors were obtained. The PAD group consisted of patients with ABI levels <0.9; the non-compressible artery (NCA) group consisted of patients with ABI levels >1.3.
Results
The prevalence of PAD was 17.6% (22.5% in women and 11.1% in men), while that of NCA was 15.2% (12.7% in women and 25.0% in men). About 27.3% and 54.5% of patients with PAD did not have claudication and problems with walking distance, respectively. Of the NCA patients, 15.8% had problems with walking distance and 39.5% had claudication. Regression analysis revealed two predictors of PAD (age ≥65 years: odds ratio [OR], 3.51; 95% confidence interval [CI], 1.65–7.47; claudication: OR, 3.41; 95% CI, 1.58–7.39) and three predictors of NCA (age <65 years: OR, 2.55; 95% CI, 1.01–6.45; male sex: OR, 2.40; 95% CI, 1.10–5.25; triglyceride [TG] >200 mg/dL: OR, 4.11; 95% CI, 1.58–10.67).
Conclusion
PAD had a prevalence of 17.6% and was associated with age ≥65 years and claudication. NCA had a prevalence of 15.2% and was associated with age <65 years, TG >200 mg/dL, and male sex.

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  • Peripheral Artery Disease Prevalence: Scoping Review with ☸️SAIMSARA

    SAIMSARA Journal.2026;[Epub]     CrossRef
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    Konuralp Tıp Dergisi.2024; 16(3): 225.     CrossRef
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    Cindy P. Porras, Michiel L. Bots, Martin Teraa, Sander van Doorn, Robin W.M. Vernooij
    European Journal of Vascular and Endovascular Surgery.2022; 63(4): 602.     CrossRef
  • The Frequency of Primary Healthcare Contacts Preceding the Diagnosis of Lower-Extremity Arterial Disease: Do Women Consult General Practice Differently?
    Cindy P. Porras, Martin Teraa, Michiel L. Bots, Annemarijn R. de Boer, Sanne A. E. Peters, Sander van Doorn, Robin W. M. Vernooij
    Journal of Clinical Medicine.2022; 11(13): 3666.     CrossRef
  • Ankle-brachial Index and associated factors in individuals with coronary artery disease
    Saulo Henrique Salgueiro de Aquino, Isabelle Tenório Melo, Carlos Dornels Freire de Souza, Francisco de Assis Costa
    Revista da Associação Médica Brasileira.2020; 66(4): 407.     CrossRef
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  • 5 Web of Science
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Association between Physical Fitness and Cardiometabolic Risk of Children and Adolescents in Korea
Hyun-Suk Lee, Won-Wook Jeong, Yu-Jeong Choi, Young-Gyun Seo, Hye-Mi Noh, Hong-Ji Song, Yu-Jin Paek, Yoon-Myung Kim, Hyun-Jung Lim, Hye-Ja Lee, Han-Byul Jang, Sang-Ick Park, Kyung-Hee Park
Korean J Fam Med 2019;40(3):159-164.   Published online November 23, 2018
DOI: https://doi.org/10.4082/kjfm.17.0085
Background
This study aimed to investigate the association between physical fitness and cardiometabolic health of Korean children and adolescents.
Methods
In total, 168 participants (89 boys and 79 girls) aged 10–16 years were recruited for the Intervention for Childhood and Adolescent Obesity via Activity and Nutrition Study in 2016. The subjects were categorized into two groups using the definition of metabolic syndrome by the International Diabetes Federation: metabolically unhealthy (with at least two of the five criteria) and healthy groups (with less than one criterion). Correlation analysis of the participants’ general characteristics was performed. Odds ratios (ORs) of physical fitness for cardiometabolic risk were evaluated via logistic regression.
Results
Metabolically unhealthy children showed greater weight, height, and body mass index, higher Children’s Depression Inventory score, and longer screen time than did the metabolically healthy children. Metabolically healthy children showed greater upper and lower extremity muscular strength than did the metabolically unhealthy children (P=0.04 and P<0.001, respectively). In the multiple logistic regression analysis, lower extremity muscle strength was inversely related to the clustered cardiometabolic risk of the children and adolescents with or without adjustment for confounders (OR, 4.32; 95% confidence interval [CI], 1.87–9.97; OR, 7.64; 95% CI, 1.55– 37.74, respectively).
Conclusion
Physical fitness, especially lower extremity muscle strength, is significantly inversely associated with individual and clustered cardiometabolic risks in Korean children and adolescents.

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Background
The blood level of alanine aminotransferase (ALT) is associated with increased coronary heart disease (CHD) risk. However, its use as an independent factor for CHD risk prediction remains unclear in Asian populations. The purpose of this study was to examine the association between serum ALT levels and CHD risk in Koreans.
Methods
This was a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011). The ALT levels of 3,215 individuals were analyzed. The Framingham Risk Score (FRS) modified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) was used to compute the 10-year CHD risk prediction.
Results
Positive correlations were established between log-transformed ALT concentration and FRS (r=0.433, P<0.001). After adjusting for body mass index, low-density lipoprotein cholesterol, the amount of alcohol intake, and gamma-glutamyl transferase, the odds ratio (95% confidence interval) for intermediate or greater risk of 10- year CHD prediction (10-year risk ≥10%) for the lowest quartile of participants was 2.242 (1.405–3.577) for the second quartile, 2.879 (1.772–4.679) for the third quartile, and 3.041 (1.789–5.170) for the highest quartile.
Conclusion
In Koreans, a higher serum ALT concentration was significantly correlated with 10-year CHD risk prediction according to NCEP ATP III guidelines.

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The Prevalence of Osteoarthritis and Risk Factors in the Korean Population: The Sixth Korea National Health and Nutrition Examination Survey (VI-1, 2013)
Seokhan Lee, Yeongkeun Kwon, Nojin Lee, Keun-Joo Bae, Jihyun kim, Seokwon Park, Yang Hyun Kim, Kyung-Hwan Cho
Korean J Fam Med 2019;40(3):171-175.   Published online November 8, 2018
DOI: https://doi.org/10.4082/kjfm.17.0090
Background
Knee osteoarthritis is highly prevalent, especially among the elderly. However, its risk factors have not been well identified, especially in the Korean population. This study aimed to assess the epidemiologic characteristics and risk factors of knee osteoarthritis in the Korean population.
Methods
Data of 2,280 (1,295 women) participants of the 2013 Korea National Health and Nutrition Examination Survey aged ≥50 years who underwent knee radiography were analyzed. According to the American College of Rheumatology clinical/radiographic classification criteria, knee osteoarthritis was defined as knee pain and radiographic knee osteoarthritis. The association between risk factors and knee osteoarthritis was analyzed using the chi-square test and binominal logistic regression.
Results
The participants had an average age of 62.6 years; 56.8% of them were women. The average body mass index was 24.2 kg/m2 , and 296 (13%) participants were diagnosed with knee osteoarthritis. After adjustment for multiple risk factors, age of ≥65 years (adjusted odds ratio [OR], 2.552; 95% confidence interval [CI], 1.868–3.486), female sex (OR, 2.050; 95% CI, 1.275–3.295), obesity (body mass index, ≥25.0 kg/m2 ; OR, 1.563; 95% CI, 1.191–2.051), hypertension (OR, 1.394; 95% CI, 1.052–1.846), low educational level (lower than or equal to elementary school: OR, 4.761; 95% CI, 2.131–10.635; middle school: OR, 3.184; 95% CI, 1.375–7.369), and low strength exercise frequency (<2 times/wk; OR, 1.829; 95% CI, 1.202–2.784) increased the risk of knee osteoarthritis.
Conclusion
Old age, sex, obesity, hypertension, low educational level, and low strength exercise frequency were found to be risk factors for knee osteoarthritis.

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Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study
Sunyoung Park, Doh Kwan Kim, Woojae Myung, Jun Hyun Yoo, Su Jeong Shin, Duk L. Na, Sang Yun Kim, Jae-Hong Lee, Seong Yoon Kim, Seol-Heui Han, Seong Hye Choi, Jinyoung Shin
Korean J Fam Med 2019;40(1):16-21.   Published online October 29, 2018
DOI: https://doi.org/10.4082/kjfm.17.0061
Background
Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data.
Methods
This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiatric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted.
Results
The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P<0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P<0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P<0.001), Clinical Dementia Rating Sum of Box (P<0.001), Global Deterioration Scale score (P<0.001), abnormality of free T4 level (P<0.001), anemia (P<0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers.
Conclusion
Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.

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Factors Associated with Dry Eye Symptoms in Elderly Koreans: the Fifth Korea National Health and Nutrition Examination Survey 2010–2012
Kyong In Kim, Yong Soon Park, Ryoung Hee Kim, Jeong Hyeon Kim
Korean J Fam Med 2019;40(1):22-30.   Published online October 29, 2018
DOI: https://doi.org/10.4082/kjfm.17.0058
Background
Dry eye disease is an aging-related ophthalmic disease that not only affects the daily activities but also causes deterioration in the quality of life. This study aimed to evaluate the factors associated with dry eye symptoms in elderly Koreans.
Methods
We investigated 4,185 subjects (men=1,787 and women=2,398) aged ≥65 years from the fifth Korea National Health and Nutrition Examination Survey 2010−2012. Data were analyzed using multiple logistic regressions to identify the relationships between dry eye symptoms and other factors.
Results
The prevalence of dry eye symptoms was 17.9%. After adjustment for confounding factors, dry eye symptoms were significantly associated with female sex (adjusted odds ratio [aOR], 1.806; 95% confidence interval [CI], 1.410−2.313), a history of cataract (aOR, 1.683; 95% CI, 1.255−2.255), suicidal ideation (aOR, 1.414; 95% CI, 1.070−1.870), hypercholesterolemia (aOR, 1.289; 95% CI, 1.025−1.621), age ≥80 years (aOR, 0.538; 95% CI, 0.337−0.859), and sleep duration ≥9 h/d (aOR, 0.524; 95% CI, 0.330−0.834).
Conclusion
Among elderly Koreans, female sex, a history of cataract, suicidal ideation, and hypercholesterolemia may be the risk factors for dry eye symptoms, whereas sleep duration ≥9 h/d can be a protective factor against dry eye symptoms.

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    Jinsoo Kim, Mee Kum Kim, Yuseung Ha, Hae Jung Paik, Dong Hyun Kim
    BMC Ophthalmology.2021;[Epub]     CrossRef
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    Dimitra Makrynioti, Zoi Zagoriti, Constantinos Koutsojannis, Philip B. Morgan, George Lagoumintzis
    Contact Lens and Anterior Eye.2020; 43(3): 277.     CrossRef
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Use of Hypnotics and Risk of Cancer: A Meta-Analysis of Observational Studies
Do-Hyoung Kim, Hong-Bae Kim, Young-Hyo Kim, Ja-Young Kim
Korean J Fam Med 2018;39(4):211-218.   Published online July 5, 2018
DOI: https://doi.org/10.4082/kjfm.17.0025
Background
Previous observational epidemiological studies have shown inconsistent results on the relationship between hypnotics use and risk of cancer. To determine the association between hypnotics use and risk of cancer, we conducted a meta-analysis of available literature.
Methods
We searched databases PubMed, EMBASE, and the bibliographies of relevant articles to locate additional publications in February 2016. Three evaluators independently reviewed and selected eligible studies based on pre-determined selection criteria.
Results
A total of six observational epidemiological studies including three case-control studies and three cohort studies, which involved 1,830,434 participants (202,629 hypnotics users and 1,627,805 non-users), were included in the final analyses. In a random-effects meta-analysis, compared with non-use of hypnotics, the odds ratio for overall hypnotics use was 1.29 for various cancers (95% confidence interval, 1.08–1.53). Subgroup meta-analyses by various factors such as study design, type of case-control study, study region, and methodological quality of study revealed consistent findings.
Conclusion
Our findings from a meta-analysis of low-biased epidemiological studies suggested evidence linking the use of hypnotics to an increased risk of cancers. The results should be cautiously interpreted because of considerable heterogeneity with a high I square value.

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  • Benzodiazepine Use and Long-Term Mortality in South Korean Adult Population: A Cohort Study
    Tak Kyu Oh, Hye Youn Park, In-Ae Song
    Yonsei Medical Journal.2021; 62(6): 528.     CrossRef
  • Hypnotics and Risk of Cancer: A Meta-Analysis of Observational Studies
    Tzu-Rong Peng, Li-Jou Yang, Ta-Wei Wu, You-Chen Chao
    Medicina.2020; 56(10): 513.     CrossRef
  • Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit
    Daniel F. Kripke
    F1000Research.2018; 5: 918.     CrossRef
  • 16,542 View
  • 166 Download
  • 2 Web of Science
  • 3 Crossref
The Prevalence of Gallstone Disease Is Significantly Lower in Natives than in Migrants of Jeju Island
Oh-Sung Kwon, Young-Kyu Kim, Kyu Hee Her
Korean J Fam Med 2018;39(3):147-154.   Published online May 18, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.3.147
Background
The eating habits of Jeju Island natives are quite different from those of the mainland people because of geographic isolation. Diet is a main factor affecting gallstone disease. We investigated the prevalence of gallstone disease in both Jeju Island natives and migrants and studied the risk factors affecting gallstone disease in the Jeju Island people.
Methods
A total of 20,763 subjects who underwent medical checkups at the Health Promotion Center of Jeju National University Hospital in Korea from January 2003 to December 2015 were enrolled in the study. Ultrasonography was used to determine the presence of gallbladder stones. Body mass index and biochemical parameters, including liver function test results, lipid profiles, and fasting blood glucose levels, were verified, and data on age, birthplace, and sex were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors affecting gallstone disease.
Results
The prevalence of gallstone disease in the Jeju Island people was 4.0%: Jeju Island natives, 3.8% and migrants, 4.4% (P=0.047). After multivariate logistic regression analysis, the independent risk factors were older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower high-density lipoprotein cholesterol levels.
Conclusion
The prevalence of gallstone disease was significantly lower in natives than in migrants from Jeju Island. Older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower highdensity lipoprotein cholesterol levels contributed to gallstone disease prevalence in the Jeju Island people.

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  • Retrospective Study of the Prevalence and Associated Factors of Gallbladder Polyps among Residents of Two Korean Cities
    Oh-Sung Kwon, Young-Kyu Kim, Hyeon Ju Kim
    Journal of Clinical Medicine.2024; 13(8): 2290.     CrossRef
  • Liver Function‐Related Indicators and Risk of Gallstone Diseases—A Multicenter Study and a Systematic Review and Meta‐Analysis
    Shiyi Li, Pei Zhu, Fangyuan Chen, Wenqian Yu, Linjun Xie, Jing Xia, Peng Jiao, Ping Cui, Chi Zhang, Ye Bai, Guoheng Jiang, Hongyu Li, Yanmei Lou, Guangcan Li, Xuefeng Shan, Xin Wang, Fariborz Mansour-Ghanaei
    Gastroenterology Research and Practice.2024;[Epub]     CrossRef
  • Cholecystectomy reduces the risk of myocardial and cerebral infarction in patients with gallstone-related infection
    Seon Mee Park, Hyun Jung Kim, Tae Uk Kang, Heather Swan, Hyeong Sik Ahn
    Scientific Reports.2022;[Epub]     CrossRef
  • Epidemiological survey to determine the prevalence of cholecystolithiasis in Uyghur, Kazakh, and Han Ethnic Groups in the Xinjiang Uyghur Autonomous Region of China: cross-sectional studies
    Fujun Lv, Guangjun Wang, Dandan Ding, Caifu Shen, Jiangwei Liu, Feng Ji, Yan Kang
    BMC Gastroenterology.2021;[Epub]     CrossRef
  • Prevalence and risk factors for gallstone disease: A population‐based cross‐sectional study
    Sen Tao Song, Jian Shi, Xiao Hang Wang, Yi Bin Guo, Ping Fang Hu, Feng Zhu, Xin Zeng, Wei Fen Xie
    Journal of Digestive Diseases.2020; 21(4): 237.     CrossRef
  • Physical activity can reduce the prevalence of gallstone disease among males
    Oh-Sung Kwon, Young-Kyu Kim, Kyu Hee Her, Hyeon Ju Kim, Seung Duk Lee
    Medicine.2020; 99(26): e20763.     CrossRef
  • The grade of nonalcoholic fatty liver disease is an independent risk factor for gallstone disease
    Young-Kyu Kim, Oh-Sung Kwon, Kyu Hee Her
    Medicine.2019; 98(27): e16018.     CrossRef
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  • 121 Download
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Association between Sedentary Time and Cardiovascular Risk Factors in Korean Adults
Jae-Hong Park, Hee-Kyung Joh, Gyeong-Sil Lee, Sang-Jun Je, Soo-Hwan Cho, Soo-Jin Kim, Seung-Won Oh, Hyuk-Tae Kwon
Korean J Fam Med 2018;39(1):29-36.   Published online January 23, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.1.29
Background

Sedentary behavior has been shown to have deleterious effects on cardiovascular outcomes. This study aimed to examine the association between sedentary time and cardiovascular risk factors in Korean adults.

Methods

A cross-sectional study was performed using data from adults aged 19 years and above in the 2013 Korean National Health and Nutrition Examination Survey. Sedentary time was self-reported and categorized into quintiles. Cardiovascular risk factors, including blood pressure (BP), total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein cholesterol, and fasting glucose levels, were categorized into dichotomous variables according to the Adult Treatment Panel III criteria. Multivariate logistic regression was performed with adjustment for various demographic and lifestyle variables, body mass index (BMI), waist circumference (WC), and moderate-to-vigorous physical activity. Complex sampling design was used, and survey weights and sample design variables were applied in analyses.

Results

A total of 3,301 individuals were included in the analyses, and mean sedentary time was 6.1 h/d. Prolonged sedentary time was significantly associated with high diastolic BP (top vs. bottom quintile: adjusted odds ratio [OR], 1.71; 95% confidence interval [CI], 1.09–2.68; Ptrend=0.03) and low HDL cholesterol level (top vs. bottom quintile: adjusted OR, 1.42; 95% CI, 1.02–1.98; Ptrend=0.02) after adjustment for BMI, WC, moderate-to-vigorous physical activity, and other variables. No significant associations were found between sedentary time and other cardiovascular risk factors.

Conclusion

Prolonged sedentary time was significantly associated with high diastolic BP and low HDL cholesterol level in Korean adults. The associations were independent of general and abdominal obesity and moderate-to-vigorous physical activities.

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    Korean Journal of Family Medicine.2026; 47(2): 135.     CrossRef
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    Hira Iqrar, Maham Mohsin, Vaneeza Ahmad, Misbah Qayum, Wajida Perveen
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    Dominikus Raditya Atmaka, Shintia Yunita Arini, Bian Shabri Putri Irwanto, Asri Meidyah Agustin, Aliffah Nurria Nastiti, Muh. Agus Prianto, Andi Suci Rahman
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    Mi Kyoung Son, Nam-Kyoo Lim, Joong-Yeon Lim, Hyun-Young Park
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    Nestor Asiamah, Kyriakos Kouveliotis, Carl Petersen, Richard Eduafo, Richard Borkey
    Journal of Public Health.2023; 31(9): 1453.     CrossRef
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    Litao Du, Guangkai Li, Pengfei Ren, Qiang He, Yang Pan, Si Chen, Xianliang Zhang
    European Journal of Cardiovascular Nursing.2023; 22(4): 374.     CrossRef
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    Environment International.2023; 180: 108184.     CrossRef
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    Andrea T. Duran, Emily Romero, Keith M. Diaz
    Current Cardiology Reports.2022; 24(4): 393.     CrossRef
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    Brittany A. Matenchuk, Valerie Carson, Laurel A. Riske, Allison Carnio, Margie H. Davenport
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Association between Weight Changes after Smoking Cessation and Cardiovascular Disease among the Korean Population
Eun Ha Kim, Hyejin Lee, Dong Wook Shin, Jae Moon Yun, Jung-Hyun Shin, Yoo Kyoung Lim, Hye Yeon Koo, Miso Jang
Korean J Fam Med 2017;38(3):122-129.   Published online May 23, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.3.122
Background

Cigarette smoking is a risk factor for cardiovascular disease (CVD) and has both beneficial and harmful effects in CVD. We hypothesized that weight gain following smoking cessation does not attenuate the CVD mortality of smoking cessation in the general Korean population.

Methods

Study subjects comprised 2.2% randomly selected patients from the Korean National Health Insurance Corporation, between 2002 and 2013. We identified 61,055 subjects who were classified as current smokers in 2003–2004. After excluding 21,956 subjects for missing data, we studied 30,004 subjects. We divided the 9,095 ex-smokers into two groups: those who gained over 2 kg (2,714), and those who did not gain over 2 kg (6,381, including weight loss), after smoking cessation. Cox proportional hazards regression models were used to estimate the association between weight gain following smoking cessation and CVD mortality.

Results

In the primary analysis, the hazard ratios of all-cause deaths and CVD deaths were assessed in the three groups. The CVD risk factors and Charlson comorbidity index adjusted hazard ratios (aHRs) for CVD deaths were 0.80 (95% confidence interval [CI], 0.37 to 1.75) for ex-smokers with weight gain and 0.80 (95% CI, 0.50 to 1.27) for ex-smokers with no weight gain, compared to one for sustained smokers. The associations were stronger for events other than mortality. The aHRs for CVD events were 0.69 (95% CI, 0.54 to 0.88) and 0.81 (95% CI, 0.70 to 0.94) for the ex-smokers with and without weight gain, respectively.

Conclusion

Although smoking cessation leads to weight gain, it does not increase the risk of CVD death.

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  • Association between waist circumference or weight change after smoking cessation and incidence of cardiovascular disease or all-cause death in Korean adults with type 2 diabetes
    Heajung Lee, Jaeyong Shin, Jae Woo Choi
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Lifelong smoking status, weight gain, and subsequent risk of major adverse cardiovascular events: Long‐term follow‐up of a middle‐aged Chinese population
    Lirong Liang, Changwei Li, Xiaoqing Liu, Long Zhou, Shuilian Chu, Ruiyuan Zhang, Jinzhuang Mai, Adrianna Westbrook, Jiachen Li, Di Zhang, Liancheng Zhao, Yangfeng Wu
    Obesity.2022; 30(3): 762.     CrossRef
  • Smoking Cessation May Reduce Risk of Visual Field Progression in Heavy Smokers
    Golnoush Mahmoudinezhad, Takashi Nishida, Robert N. Weinreb, Sally L. Baxter, Evan Walker, Medi Eslani, Jeffrey M. Liebmann, Christopher A. Girkin, Sasan Moghimi
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  • Thirty-six Year Trends in Mortality from Diseases of Circulatory System in Korea
    Jongmin Baek, Hokyou Lee, Hyeok-Hee Lee, Ji Eun Heo, So Mi Jemma Cho, Hyeon Chang Kim
    Korean Circulation Journal.2021; 51(4): 320.     CrossRef
  • Weight Gain After Smoking Cessation and Risk of Major Chronic Diseases and Mortality
    Berhe W. Sahle, Wen Chen, Lal B. Rawal, Andre M. N. Renzaho
    JAMA Network Open.2021; 4(4): e217044.     CrossRef
  • Smoking Cessation, Weight Gain, Cardiovascular Risk, and All-Cause Mortality: A Meta-analysis
    Xiaowen Wang, Li-Qiang Qin, Ahmed Arafa, Ehab S Eshak, Yonghua Hu, Jia-Yi Dong
    Nicotine & Tobacco Research.2021; 23(12): 1987.     CrossRef
  • Dose-Dependent Effect of Smoking on Risk of Diabetes Remains after Smoking Cessation: A Nationwide Population-Based Cohort Study in Korea
    Se Eun Park, Mi Hae Seo, Jung-Hwan Cho, Hyemi Kwon, Yang-Hyun Kim, Kyung-Do Han, Jin-Hyung Jung, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
    Diabetes & Metabolism Journal.2021; 45(4): 539.     CrossRef
  • Cancer risk among young men with weight gain after smoking cessation: A population-based cohort study
    Kyuwoong Kim, Seulggie Choi, Gyeongsil Lee, Su-Min Jeong, Sung Min Kim, Joung Sik Son, Jae-Moon Yun, Yeon-Yong Kim, Seong Yong Park, Sang Min Park
    Cancer Epidemiology.2019; 60: 86.     CrossRef
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    Carol Mitchell, Megan E Piper, Stevens S Smith, Claudia E Korcarz, Michael C Fiore, Timothy B Baker, James H Stein
    Vascular Medicine.2019; 24(6): 493.     CrossRef
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    Nancy A Rigotti, Carole Clair
    European Heart Journal.2018; 39(17): 1532.     CrossRef
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Relationship Between Alcohol Consumption and Prostatic Hyperplasia According to Facial Flushing After Drinking in Korean Men
Hak Sun Jang, Jong Sung Kim, Sung Soo Kim, Jin-Gyu Jung, Seok-Joon Yoon, HyunJu Yang, Hyun Chul Joung
Korean J Fam Med 2017;38(2):93-98.   Published online March 22, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.2.93
Background

The purpose of this study was to examine whether facial flushing after drinking influences the relationship between alcohol consumption and prostatic hyperplasia among Korean men.

Methods

The subjects were 957 Korean men (180 non-drinkers, 389 with drinking-related facial flushing, 388 without facial flushing) in the 40–69 age group, who underwent prostate ultrasound at the health promotion center of Chungnam National University Hospital between 2008 and 2014. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. In terms of the amount consumed, 14 g of alcohol was considered a standard drink. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and prostatic hyperplasia in the flushing and non-flushing groups, with adjustment for confounding factors such as age, body mass index, smoking, and exercise patterns.

Results

Individuals aged 50–59 years who experienced drinking-related facial flushing had a significantly lower risk of prostatic hyperplasia than the non-drinker group, depending on alcohol consumption: ≤4 standard drinks (adjusted odds ratio [OR], 0.38; 95% confidence interval [CI], 0.16 to 0.86); >4 ≤8 standard drinks (OR, 0.35; 95% CI, 0.13 to 0.95); >8 standard drinks (OR, 0.33; 95% CI, 0.13 to 0.84). However, no significant relationship was observed between the number of drinks consumed and the risk of prostate hyperplasia in the non-flushing group.

Conclusion

The risk of prostatic hyperplasia appears to be reduced by alcohol consumption among Korean men aged 50–59 years who exhibit drinking-related facial flushing.

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    Amanda J. Macke, Armen Petrosyan
    Biomolecules.2022; 12(3): 375.     CrossRef
  • The prevalence and associated factors of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in aging males
    Yang Xiong, Yangchang Zhang, Xiaoyu Li, Feng Qin, Jiuhong Yuan
    The Aging Male.2020; 23(5): 1432.     CrossRef
  • Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing
    Sami Lee, Jong-Sung Kim, Jin-Gyu Jung, Mi-Kyeong Oh, Tae-Heum Chung, Jihan Kim
    Korean Journal of Family Medicine.2019; 40(4): 204.     CrossRef
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  • 31 Download
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Prevalence and Predictive Factors of Sexual Dysfunction in Iranian Women: Univariate and Multivariate Logistic Regression Analyses
Ashraf Direkvand-Moghadam, Zainab Suhrabi, Malihe Akbari, Azadeh Direkvand-Moghadam
Korean J Fam Med 2016;37(5):293-298.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.293
Background

Female sexual dysfunction, which can occur during any stage of a normal sexual activity, is a serious condition for individuals and couples. The present study aimed to determine the prevalence and predictive factors of female sexual dysfunction in women referred to health centers in Ilam, the Western Iran, in 2014.

Methods

In the present cross-sectional study, 444 women who attended health centers in Ilam were enrolled from May to September 2014. Participants were selected according to the simple random sampling method. Univariate and multivariate logistic regression analyses were used to predict the risk factors of female sexual dysfunction. Diffe rences with an alpha error of 0.05 were regarded as statistically significant.

Results

Overall, 75.9% of the study population exhibited sexual dysfunction. Univariate logistic regression analysis demonstrated that there was a significant association between female sexual dysfunction and age, menarche age, gravidity, parity, and education (P<0.05). Multivariate logistic regression analysis indicated that, menarche age (odds ratio, 1.26), education level (odds ratio, 1.71), and gravida (odds ratio, 1.59) were independent predictive variables for female sexual dysfunction.

Conclusion

The majority of Iranian women suffer from sexual dysfunction. A lack of awareness of Iranian women's sexual pleasure and formal training on sexual function and its influencing factors, such as menarche age, gravida, and level of education, may lead to a high prevalence of female sexual dysfunction.

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    Kevan Richard Wylie, Michael G Kirby, Filippo Maria Nimbi, Michael Krychman, Jennifer Barsky Reese, Deborah C Marshall
    Sexual Medicine Reviews.2026;[Epub]     CrossRef
  • Prevalence and Sociodemographic Determinants of Persistent Female Sexual Dysfunction Among Breast Cancer Survivors: A Prospective Cohort Study
    Amirhossein Hessami, Erfan Ghadirzadeh, Afshin Zarei, Farima Taghavi, Forouzan Elyasi, Mobina Gheibi, Ehsan Zaboli, Reza Alizadeh-Navaei, Fatemeh Akbari Gelvardi, Akbar Hedayatizadeh-Omran, Mahmood Moosazadeh
    International Journal of Sexual Health.2026; 38(3): 1190.     CrossRef
  • Translation and investigation of the psychometric properties of the revised female sexual distress scale among Iranian couples
    Roghieh Bayrami, Hamid Sharif-Nia, Roksana Janghorban, Daniz Montakhabi Oskuii, Esmaeil Hoseinzadeh
    Scientific Reports.2025;[Epub]     CrossRef
  • Machine learning driven biomarker selection for medical diagnosis
    Divyagna Bavikadi, Ayushi Agarwal, Shashank Ganta, Yunro Chung, Lusheng Song, Ji Qiu, Paulo Shakarian, John Adeoye
    PLOS One.2025; 20(6): e0322620.     CrossRef
  • Função sexual durante o período gestacional: um estudo transversal
    Jamile Monteiro De Andrade, Elisa Helena Borges Filgueira, Amannda Gabrielle da Cruz Silva, Bárbara Gabrielle Morais Maciel, Hayandra Ferreira Dias Mota, Mariana Cecchi Salata
    Health Residencies Journal.2025;[Epub]     CrossRef
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    Jingxiang Zhang, Siyu Qian, Guoxin Su, Chao Deng, David Reid, Barbara Sinclair, Ping Yu
    Alcohol and Alcoholism.2025;[Epub]     CrossRef
  • Sexual dysfunction, marital relationship, and subjective quality of life among women with schizophrenia: Analytical case-control study
    Puja Kumari, Rajesh Kumar, Jitendra Rohilla
    Indian Journal of Psychiatry.2024; 66(3): 280.     CrossRef
  • The effect of rose damascene extract on anxiety and sexual function of breastfeeding women: a randomized controlled trial
    Gohar Akbarzadeh, Parvin Abedi, Shayesteh Jahanfar, Hossein Sadeghi Mansurkhani, Ahmad Fakhri, Elham Maraghi
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Sexual myths during pregnancy: a comparative study
    Hüsniye Dinç Kaya, Tülay Yılmaz, Sevil Günaydın, Emine Nur Çalımlı, Elham Sadeghi
    Journal of Obstetrics and Gynaecology.2022; 42(4): 587.     CrossRef
  • Impact of pelvic floor muscle strength on female sexual function: retrospective multicentric cross-sectional study
    Luísa Pasqualotto, Cássio Riccetto, Ana Flávia Biella, Joseane Marques, Larissa Carvalho Pereira, Fabíola Kênia Alves, Anna Lygia Barbosa Lunardi, Délcia Barbosa de Vasconcelos Adami, Anita Nagib, Natalia Martinho, Adriana Piccini, Tirza Sathler, Valeria
    International Urogynecology Journal.2022; 33(6): 1591.     CrossRef
  • The Effect of the PLISSIT Model on Sexual Functions: A Systematic Review
    Serap KIRICI, Emel EGE
    Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi.2021; 3(3): 199.     CrossRef
  • Sexual functions in pregnancy: different situations in near geography:a case study on Turkey, Iran and Greece
    Mahide Demireloz Akyuz, Esin Ceber Turfan, Serap Cetintas Oner, Tugce Sakar, Dilek Mamik Aktay
    The Journal of Maternal-Fetal & Neonatal Medicine.2020; 33(2): 222.     CrossRef
  • Effects ofWithania somniferaon Reproductive System: A Systematic Review of the Available Evidence
    Ramin Nasimi Doost Azgomi, Afshar Zomorrodi, Hossein Nazemyieh, Seyed Mohammad Bagher Fazljou, Homayoun Sadeghi Bazargani, Fatemeh Nejatbakhsh, Arezoo Moini Jazani, Yadollah Ahmadi AsrBadr
    BioMed Research International.2018; 2018: 1.     CrossRef
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Brief Communication

Prevalence and Risk Factors of Domestic Violence against Iranian Women: A Cross-Sectional Study
Fathola Mohamadian, Ataollah Hashemian, Maryam Bagheri, Ashraf Direkvand-Moghadam
Korean J Fam Med 2016;37(4):253-258.   Published online July 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.4.253
Background

Violence against women in families is the most common form of violence against them. The purpose of this study was to determine the prevalence of domestic violence and its effects on married women of Ilam.

Methods

In this descriptive-sectional research, 334 married women referred to medical health centers in Ilam were selected to participate using a random sampling method. After obtaining their consent to participate in the study, participants responded to a 46 items questionnaire and responses were analyzed using IBM SPSS for Windows ver. 20.0 (IBM Co., Armonk, NY, USA).

Results

The majority of the participants reported experiencing domestic violence and emotional violence was more prevalent than other kinds of violence. Logistic regression analysis showed that lower education level, marriage at a younger age, shorter duration of marriage, fewer children, being a housewife, and husband's unemployment had a significant relationship with domestic violence against women.

Conclusion

The high prevalence of wife abuse in Ilam especially emotional violence due to lower education levels and marriage at younger age could be a serious threat for women's health as well as for other members of the family. This could be a grounding factor for other social harms such as suicide and this issue must be studied from legal, religious, and cultural standpoints.

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Original Article

Risk of Cardiovascular Disease Using Framingham Risk Score in Korean Cancer Survivors
Ji-Hyun So, Jung-Kwon Lee, Jin-Young Shin, Wan Park
Korean J Fam Med 2016;37(4):235-241.   Published online July 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.4.235
Background

Cardiovascular disease is an important cause of morbidity and mortality in cancer survivors. The aim of this study was to investigate the modifiable cardiovascular disease risk factors and 10-year probability of the disease based on the Framingham risk score in cancer survivors, compared with the general population.

Methods

A total of 1,225 cancer survivors and 5,196 non-cancer controls who participated in the 2007–2013 Korea National Health and Nutrition Examination Surveys were enrolled. We assessed modifiable cardiovascular disease risk factors including smoking, body mass index, physical inactivity, high blood pressure, high cholesterol, and elevated blood glucose level. The 10-year probability of cardiovascular disease was determined by applying the Framingham cardiovascular disease risk equation among cancer survivors and non-cancer controls, ranging from 30 to 74 years old who had no overt cardiovascular diseases.

Results

The proportion of subjects who had higher fasting glucose levels, hemoglobin A1c levels, systolic blood pressure, and low density lipoprotein cholesterol levels, and those who had lower high density lipoprotein cholesterol levels was significantly higher in the cancer survivors than in the non-cancer controls. The average 10-year probability of cardiovascular disease among the cancer survivors was higher than that in the non-cancer controls in both men and women. The average 10-year probability of cardiovascular disease in relation to the cancer type was significantly higher in patients with hepatic, colon, lung, breast, and gastric cancer.

Conclusion

Cancer survivors have a higher cardiovascular disease risk and 10-year probability of cardiovascular disease than non-cancer controls. Control of cardiovascular disease risk factors and implementation of a well-defined cardiovascular disease prevention program are needed for treating cancer survivors.

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Review Article

Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
Piero Portincasa, Agostino Di Ciaula, Ignazio Grattagliano
Korean J Fam Med 2016;37(4):205-213.   Published online July 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.4.205

Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case–controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting.

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Original Articles
Health-Related Quality of Life and Cardiovascular Disease Risk in Korean Adults
Hyeon-Young Ko, Jung-Kwon Lee, Jin-Young Shin, Euni Jo
Korean J Fam Med 2015;36(6):349-356.   Published online November 20, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.6.349
Background

Health-related quality of life (HRQoL) is considered an important outcome measure in chronic diseases, in particular cardiovascular disease (CVD), which is known to be associated with impaired HRQoL. However, few studies have examined HRQoL in individuals at high risk of CVD.

Methods

Using the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, we analyzed data from 10,307 adults aged ≥30 years. The study subjects were stratified into 3 groups on the basis of their Framingham risk score-a 10-year estimate of CVD risk: <10.0% (low risk), 10.0%-19.9% (moderate risk), and ≥20.0% (high risk). The EuroQol-5D (EQ-5D) was used to evaluate HRQoL.

Results

A significantly higher proportion of high-risk subjects than low-risk participants had impaired HRQoL (defined as the lowest quartile of the EQ-5D index); this held true even after adjustment for confounding factors in multivariable logistic regression analysis (men: odds ratio [OR], 1.62; 95% confidence interval [CI], 1.24-2.11; women: OR, 1.46; 95% CI, 1.02-2.08). In terms of the 5 EQ-5D dimensions, a 10-year CVD risk ≥20.0% was significantly associated with self-reported problems of mobility in men (OR, 3.15; 95% CI, 2.02-4.90), and of mobility (OR, 1.56; 95% CI, 1.09-2.24), self-care (OR, 2.14; 95% CI, 1.09-4.22), and usual activity problems (OR, 1.80; 95% CI, 1.17-2.78) in women.

Conclusion

A high CVD risk is associated with impaired HRQoL. After adjustment for demographic and clinical factors, a 10-year CVD risk ≥20.0% is an independent predictor of impaired HRQoL in the general population; in particular, of mobility problems in men, and of mobility, self-care, and usual activity problems in women.

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Relationship between Neck Length, Sleep, and Cardiovascular Risk Factors
Tae Seung Han, Mi Kyeong Oh, Su Min Kim, Hyun Ju Yang, Bum Soon Lee, Soon Yeob Park, Won Joon Lee
Korean J Fam Med 2015;36(1):10-21.   Published online January 31, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.1.10
Background

Neck circumference, as a predicator of obesity, is a well-known risk factor for obstructive sleep apnea and cardiovascular diseases. However, little research exists on neck length associated with these factors. This study explored the association of neck length with sleep and cardiovascular risk factors by measuring midline neck length (MNL) and lateral neck length (LNL).

Methods

We examined 240 patients aged 30 to 75 years who visited a health check-up center between January 2012 and July 2012. Patients with depressive disorder or sleep disturbance were excluded from this study. MNL from the upper margin of the hyoid bone to the jugular notch and LNL from the mandibular angle to the mid-portion of the ipsilateral clavicle were measured twice and were adjusted by height to determine their relationship with sleep and cardiovascular disease risk factors.

Results

Habitual snorers had shorter LNL height ratios (P = 0.011), MNL height ratios in men (P = 0.062), and MNL height ratios in women (P = 0.052). Those snoring bad enough to annoy others had shorter MNL height ratios in men (P = 0.083) and women (P = 0.035). Men with objective sleep apnea had longer distances from the mandible to the hyoid bone to the mandible (P = 0.057). Men with metabolic syndrome had significantly shorter LNL height ratios (P = 0.021), and women with diabetes, hyperlipidemia, and metabolic syndrome had shorter MNL height ratios (P < 0.05).

Conclusion

This study shows that a short neck by measuring the MNL is probably associated with snoring. In addition, MNL is related to cardiovascular disease risk factors in women.

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  • The accuracy of neck circumference for assessing overweight and obesity: a systematic review and meta-analysis
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    Annals of Human Biology.2017; 44(8): 667.     CrossRef
  • Predictive value of craniofacial and anthropometric measures in obstructive sleep apnea (OSA)
    Krishnan Jyothi Remya, Krishnakumar Mathangi, Damal Chandrasekhar Mathangi, Yerlagadda Sriteja, Ramamoorthy Srihari, Soundararajan Govindaraju, David R. Hillman, Peter R. Eastwood
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    Sleep Medicine.2016; 19: 116.     CrossRef
  • Relationship between Neck Length, Sleep, and Psychiatric Disorders: A Psychiatric Aspect
    Cemil Celik, Barbaros Ozdemir, Taner Oznur
    Korean Journal of Family Medicine.2015; 36(3): 156.     CrossRef
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Dehydroepiandrosterone Sulfate as a Risk Factor for Premature Myocardial Infarction: A Comparative Study
Mohammad Shojaie, Mohammad Yaghoub Rajpout, Armin Abtahian, Azadeh Esmail Pour, Mohamed Amin Ghobadifar, Armin Akbarzadeh
Korean J Fam Med 2015;36(1):1-9.   Published online January 31, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.1.1
Background

This study aimed to evaluate some of the major risk factors of myocardial infarction including dehydroepiandrosterone sulfate in patients with premature myocardial infarction (age <50 years old) and myocardial infarction (age ≥50 years).

Methods

This is a parallel case-control study on 50 premature myocardial infarction patients and 50 myocardial infarction patients. We also recruited 50 matched participants for each of the two groups. Patients and their control groups were assessed for dehydroepiandrosterone sulfate serum level, diabetes mellitus, hyperlipidemia, hypertriglyceridemia, and hypertension. In addition, family history of cardiovascular disease and current smoking was recorded. Univariate and multivariate logistic regression analyses were performed to evaluate predictors of premature myocardial infarction and myocardial infarction.

Results

No significant differences were observed between the demographic data of patients and their controls. The dehydroepiandrosterone sulfate serum level was significantly higher in patients with premature myocardial infarction compared with controls. Multivariate logistic regression analysis revealed only serum dehydroepiandrosterone sulfate dehydroepiandrosterone sulfate level to be significantly associated with premature myocardial infarction (odds ratio, 2.65; 95% confidence interval, 1.44 to 4.877; P = 0.002). Additionally, hypertension was found to be associated with myocardial infarction.

Conclusion

Higher levels of serum dehydroepiandrosterone sulfate level are associated with premature myocardial infarction but not with myocardial infarction, and this association is independent of the effects of other risk factors.

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    Xidong Li, Shouwen Zhang, Mingguang Wa, Zhonghua Liu, Shunpeng Hu
    Journal of the American Heart Association.2019;[Epub]     CrossRef
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Influence of the Flushing Response in the Relationship between Alcohol Consumption and Cardiovascular Disease Risk
Hae Sun Suh, Jong Sung Kim, Sung Soo Kim, Jin Gyu Jung, Seok Jun Yoon, Jae Bum Ahn
Korean J Fam Med 2014;35(6):295-302.   Published online November 21, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.6.295
Background

The purpose of this study was to examine the relationship between cardiovascular disease risk and alcohol consumption according to facial flushing after drinking among Korean men.

Methods

The subjects were 1,817 Korean men (non-drinker group, 283 men; drinking-related facial flushing group, 662 men; non-flushing group, 872 men) >30 years who had undergone comprehensive health examinations at the health promotion center of a Chungnam National University Hospital between 2007 and 2009. Alcohol consumption and alcohol-related facial flushing were assessed through a questionnaire. Cardiovascular disease risk was investigated based on the 2008 Framingham Heart Study. With the non-drinker group as reference, logistic regression was used to analyze the relationship between weekly alcohol intake and cardiovascular disease risk within 10 years for the flushing and non-flushing groups, with adjustment for confounding factors such as body mass index, diastolic blood pressure, low density lipoprotein cholesterol, triglycerides, and exercise patterns.

Results

Individuals in the non-flushing group with alcohol consumption of ≤4 standard drinks (1 standard drink = 14 g of alcohol) per week had significantly lower moderate or high cardiovascular disease risk than individuals in the nondrinker group (adjusted odds ratio, 0.51; 95% confidence interval, 0.37 to 0.71). However, no significant relationship between the drinking amount and cardiovascular disease risk was observed in the flushing group.

Conclusion

Cardiovascular disease risk is likely lowered by alcohol consumption among non-flushers, and the relationship between the drinking amount and cardiovascular disease risk may differ according to facial flushing after drinking, representing an individual's vulnerability.

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  • Does the Risk for Diabetes Related with Alcohol Drinking Depend on Facial Flushing?
    Soo Young Kim
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  • Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing
    Sami Lee, Jong-Sung Kim, Jin-Gyu Jung, Mi-Kyeong Oh, Tae-Heum Chung, Jihan Kim
    Korean Journal of Family Medicine.2019; 40(4): 204.     CrossRef
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    Seong Gu Kim, Jong Sung Kim, Han Ju Pack, Han Na Sung
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    Eo Chin Kim, Jong Sung Kim, Won Chul Uh, Soo Young Choi, Sun Kyung Lee, Bog Seon Jeong
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Factors Associated with Hemorrhoids in Korean Adults: Korean National Health and Nutrition Examination Survey
Jong-Hyun Lee, Hyo-Eun Kim, Ji-Hun Kang, Jin-Young Shin, Yun-Mi Song
Korean J Fam Med 2014;35(5):227-236.   Published online September 24, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.5.227
Background

Although hemorrhoids are one of the most common anal diseases among Koreans, risk factors for hemorrhoids have not been well identified.

Methods

We analyzed the data from the 4th Korean National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2009. Study subjects were 17,228 participants of KNHANES who were aged 19 years or older. Logistic regression analysis was conducted to evaluate associations between hemorrhoids and probable risk factors.

Results

Overall prevalence of hemorrhoids among study subjects was 14.4%, being more prevalent among women (15.7%) than among men (13.0%). Obesity and abdominal obesity were associated with a higher risk of hemorrhoids with odds ratio (OR) (95% confidence intervals, 95% CI) of 1.13 (1.01 to 1.26) and 1.16 (1.04 to 1.30), respectively. Both self-reported depression (OR, 1.83; 95% CI, 1.62 to 2.08) and physician diagnosed depression (OR, 1.71; 95% CI, 1.35 to 2.17) were associated with significantly higher risk of hemorrhoids. No regular walking (OR, 1.11; 95% CI, 1.00 to 1.23) and experience of pregnancy (OR, 1.62; 95% CI, 1.17 to 2.25) for women were also associated with higher risk of hemorrhoids. However, educational level, alcohol consumption, physical activities, diabetes mellitus, hypertension, fiber, fat intake, and energy intake were not associated with a risk of hemorrhoids. Low quality of life assessed with EuroQol-5 Dimension and EuroQol-Visual Analogue Scale was significantly associated with hemorrhoids.

Conclusion

This nationwide cross-sectional study of Korean adults suggests that obesity, abdominal obesity, depression, and past pregnancy may be risk factors for hemorrhoids and hemorrhoids affect quality of life negatively.

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  • THE CHOICE OF TREATMENT IN PATIENTS WITH HEMORRHOIDAL DISEASE (THE RESULTS OF THE OBSERVATIONAL PROGRAM RE-VISION)
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Factors Associated with Persistent Smoking after the Diagnosis of Cardiovascular Disease
Hyo-Eun Kim, Yun-Mi Song, Bo-Kyoung Kim, Yong-Soon Park, Mi-Hyun Kim
Korean J Fam Med 2013;34(3):160-168.   Published online May 24, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.3.160
Background

Although cigarette smoking is a major modifiable risk factor for the occurrence of primary and secondary cardiovascular disease (CVD), not all survivors from CVD attacks can successfully stop smoking. However, little is known about the factors associated with the change in smoking behavior after CVD attack.

Methods

Study subjects included 16,807 participants (≥19 years) in the fourth Korean National Health and Nutrition Examination Surveys. From them, we selected 180 persons who had previous CVD diagnosis (angina pectoris, myocardial infarction, or stroke) and were smoking at the time of CVD diagnosis. Then, we categorized the 180 persons into two groups according to change in smoking status after the CVD: quitter and non-quitter. Logistic regression analysis was done to evaluate multivariable-adjusted association.

Results

Even after CVD diagnosis, 63.60% continued to smoke. Fully-adjusted analysis revealed that regular drinking (odds ratio [OR], 4.44) and presence of smokers among family members (OR, 5.86) were significantly (P < 0.05) associated with greater risk of persistent smoking, whereas lower education level (OR, 0.20), larger amount of smoking (OR, 0.95), longer time since diagnosis (OR, 0.88), and diabetes (OR, 0.36) were significantly (P < 0.05) associated with decreased risk of persistent smoking after CVD.

Conclusion

A great proportion of CVD patients tended to continue smoking in the Korean population. In order to reduce smoking rates among CVD patients further, more aggressive efforts towards smoking cessation should be continuously made with consideration of individual socioeconomic, behavioral, and clinical characteristics of CVD patients.

Citations

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  • Chronic disease and smoking cessation intention: associations with oral health status, behaviors, and care in Korea
    Hye-Lim Hong, Nam-Hee Kim
    Frontiers in Public Health.2026;[Epub]     CrossRef
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    Shafeel Umam, Rubaiya Binte Razzak
    BioSocial Health journal.2026; 3(1): 37.     CrossRef
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    Lucrecia Maria Burgos, Juan Pablo Costabel, Paola Ramos Cano, Gabriel Rubén Micali, Paola Teresa Koslowski, José Luis Zamorano
    Current Problems in Cardiology.2026; 51(11): 103428.     CrossRef
  • Relating Onset of Health Conditions to Changes in Tobacco/Nicotine Use — Analyses based on the U.S. PATH Study *
    Peter N. Lee, John S. Fry
    Contributions to Tobacco & Nicotine Research.2023; 32(1): 1.     CrossRef
  • Patterns of smoked and smokeless tobacco use among multimorbid and non-multimorbid middle-aged and older-aged adults in Karachi, Pakistan: a cross-sectional survey
    Salima Khowaja, Shahkamal Hashmi, Sidra Zaheer, Kashif Shafique
    BMJ Open.2022; 12(12): e060090.     CrossRef
  • Predictors of Smoking Resumption After Acute Coronary Syndrome: A Prospective Study in Western Iran
    Reza Heidari Moghadam, Nahid Salehi, Mohamadreza Moatazedian, Parisa Janjani, Alireza Rai, Javad Azimivghar, Arsalan Naderipour, Etrat Javadi Rad, Mohammed Rouzbahani
    International Journal of High Risk Behaviors and Addiction.2021;[Epub]     CrossRef
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    Youn-Jung Son, Hyeon-Ju Lee
    Tobacco Induced Diseases.2020;[Epub]     CrossRef
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    In Ae Uhm, Seon Young Hwang
    Korean Journal of Adult Nursing.2020; 32(2): 156.     CrossRef
  • Factors Associated with the Intention to Quit Smoking in Elderly Korean Men: The Korea National Health and Nutrition Examination Survey 2010-2015
    Inho Lee, Yong Soon Park, Jeong Hyeon Kim, Seung Hyeok Han
    Korean Journal of Family Medicine.2020; 41(4): 237.     CrossRef
  • Development and Psychometric Evaluation of Coronary Artery Disease Treatment Adherence Scale
    Nahid Dehghan Nayeri, Mohammad Ali Yadegary, Khatereh Seylani, Elham Navab
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  • Factors associated with continued smoking after the diagnosis of type 2 diabetes: a retrospective study in the Korean cohort
    Mi Hee Cho, Sung Min Kim, Kiheon Lee, Sang Min Park, Jooyoung Chang, Seulggie Choi, Kyuwoong Kim, Hye-Yeon Koo, Ji-Hye Jun
    BMJ Open.2018; 8(6): e020160.     CrossRef
  • Persistent smoking after a cardiovascular event: A nationwide retrospective study in Korea
    Yoo Kyoung Lim, Dong Wook Shin, Hyeon Suk Kim, Jae Moon Yun, Jung-Hyun Shin, Hyejin Lee, Hye Yeon Koo, Min Jung Kim, Jeong Yeon Yoon, Mi Hee Cho, Katriina Aalto-Setala
    PLOS ONE.2017; 12(10): e0186872.     CrossRef
  • Smoking Cessation in the Middle East after Percutaneous Coronary Intervention. Results from the First Jordanian Percutaneous Coronary Intervention Registry (JoPCR1)
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  • Continuous Abstinence Rates from Smoking Over 12 Months according to the Frequency of Participation in a Hospital-based Smoking Cessation Program among Patients Discharged after Acute Myocardial Infarction
    Young-Hoon Lee, Mi-Hee Han, Mi Rim Lee, Jin-Won Jeong, Nam-Ho Kim, Seok Kyu Oh, Kyeong Ho Yun, Sang Jae Rhee, Jum Suk Ko, Gyung-Jae Oh
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  • Tabagismo, consumo de álcool e atividade física: associações na síndrome coronariana aguda
    Evelise Helena Fadini Reis Brunori, Agueda Maria Ruiz Zimmer Cavalcante, Camila Takao Lopes, Juliana de Lima Lopes, Alba Lucia Bottura Leite de Barros
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Inter-arm Differences in Simultaneous Blood Pressure Measurements in Ambulatory Patients without Cardiovascular Diseases
Kyoung Bog Kim, Mi Kyeong Oh, Haa Gyoung Kim, Ji Hoon Ki, Soo Hee Lee, Su Min Kim
Korean J Fam Med 2013;34(2):98-106.   Published online March 20, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.2.98
Background

It has traditionally been known that there is normally a difference in blood pressure (BP) between the two arms; there is at least 20 mm Hg difference in the systolic blood pressure (SBP) and 10 mm Hg difference in the diastolic blood pressure (DBP). However, recent epidemiologic studies have shown that there are between-arm differences of < 5 mm Hg in simultaneous BP measurements. The purposes of this study is to examine whether there are between-arm differences in simultaneous BP measurements obtained from ambulatory patients without cardiovascular diseases and to identify the factors associated these differences.

Methods

We examined 464 patients who visited the outpatient clinic of Gangneung Asan Hospital clinical department. For the current analysis, we excluded patients with ischemic heart disease, stroke, arrhythmia, congestive heart failure, or hyperthyroidism. Simultaneous BP measurements were obtained using the Omron MX3 BP monitor in both arms. The inter-arm difference (IAD) in BP was expressed as the relative difference (right-arm BP [R] minus left-arm BP [L]: R - L) and the absolute difference (|R - L|).

Results

The mean absolute IAD in SBP and DBP were 3.19 ± 2.38 and 2.41 ± 1.59 mm Hg, respectively, in men and 2.61 ± 2.18 and 2.25 ± 2.01 mm Hg, respectively, in women. In men, there were 83.8% of patients with the IAD in SBP of ≤ 6 mm Hg, 98.1% with the IAD in SBP of ≤ 10 mm Hg, 96.5% with the IAD in DBP of ≤ 6 mm Hg and 0% with the IAD in DBP of > 10 mm Hg. In women, 89.6% of patients had IAD in SBP of ≤ 6 mm Hg, 92.1% with IAD in DBP of ≤ 6 mm Hg, and 0% with IAD in SBP of > 10 mm Hg or IAD in DBP of > 10 mm Hg. Gangneung Asan Hospital clinical series of patients showed that the absolute IAD in SBP had a significant correlation with cardiovascular risk factors such as the 10-year Framingham cardiac risk scores and higher BP in men and higher BP in women. However, the absolute IAD in SBP and DBP had no significant correlation with the age, obesity, smoking, drinking, hyperlipidemia, diabetes, metabolic syndrome, and renal function.

Conclusion

Our results showed that there were no significant between-arm differences in simultaneous BP measurements. It was also shown that most of the ambulatory patients without cardiovascular diseases had an IAD in SBP of < 10 mm Hg and an IAD in DBP of < 6 mm Hg.

Citations

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  • Unilateral Exercise and Bilateral Vascular Health in Female Tennis Players and Active Controls
    Chanhtel E. Thongphok, Abena O. Gyampo, Elisa Fioraso, Anneli O. Ramolins, Elianna G. Hills, Claire E. Coates, Stephen J. Ives
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    Jiayu He, Jianlin Ou, An He, Lin Shu, Tao Liu, Ruowen Qu, Xiangmin Xu, Zhuoming Chen, Yifeng Yan
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    Rawand Abdulrahman Essa, Sirwan Khalid Ahmed
    Annals of Medicine & Surgery.2022;[Epub]     CrossRef
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    Nozomi Sasamoto, Koichi Akutsu, Takeshi Yamamoto, Toshiaki Otsuka, Hideto Sangen, Hiroshi Hayashi, Hiroshige Murata, Hideki Miyachi, Yusuke Hosokawa, Shuhei Tara, Yukichi Tokita, Satoshi Miyata, Tetsuro Morota, Takashi Nitta, Wataru Shimizu
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  • The Future Alert of Inter-Arm Blood Pressure Difference Among Young Healthy Population: A Cross-Sectional Study. (Preprint)
    Rawand Essa, Sirwan K. Ahmed, Sanaa Hassan Abdul-Sahib, Rozhgar Mohammed Qadir, Zhala Khdir Miire
    Journal of Medical Internet Research.2020;[Epub]     CrossRef
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    Harvey N. Mayrovitz
    Clinical Physiology and Functional Imaging.2019; 39(1): 35.     CrossRef
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    Daniel Neunhäuserer, Andrea Gasperetti, Sara Ortolan, Francesca Battista, Pietro Pettenella, Marco Zaccaria, Marco Bergamin, Andrea Ermolao
    High Blood Pressure & Cardiovascular Prevention.2018; 25(3): 303.     CrossRef
  • The interarm blood pressure difference: Do we know enough yet?
    Christopher E. Clark
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  • Monitorización de la presión arterial en esfuerzo. ¿Brazo dominante, no dominante o ambos? / Monitoring of the Arterial Pressure in Effort. Dominant, not Dominant Arm or Both?
    C.E. Polo-Portes, M.J. Del Castillo-Campos, J.J. Ramos-Álvarez, M.T. Lara-Hernández
    Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte.2017;[Epub]     CrossRef
  • Interarm Difference in Systolic Blood Pressure in Different Ethnic Groups and Relationship to the “White Coat Effect”: A Cross-Sectional Study
    Claire Lorraine Schwartz, Christopher Clark, Constantinos Koshiaris, Paramjit S Gill, Shelia M Greenfield, Sayeed M Haque, Gurdip Heer, Amanpreet Johal, Ramandeep Kaur, Jonathan Mant, Una Martin, Mohamed A Mohammed, Sally Wood, Richard J McManus
    American Journal of Hypertension.2017; 30(9): 884.     CrossRef
  • Interarm blood pressure difference in a post-stroke population
    Eva Gaynor, Linda Brewer, Lisa Mellon, Patricia Hall, Frances Horgan, Emer Shelley, Eamonn Dolan, Anne Hickey, Kathleen Bennett, David J. Williams
    Journal of the American Society of Hypertension.2017; 11(9): 565.     CrossRef
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    Christopher E Clark, Rod S Taylor, Angela C Shore, John L Campbell
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    Gwang-Seok Kim
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  • The Relationship Between the Metabolic Syndrome and Systolic Inter-Arm Systolic Blood Pressure Difference in Korean Adults
    Hyun Yoon, Seong Woo Choi, Jong Park, So Yeon Ryu, Mi Ah Han, Gwang Seok Kim, Sung Gil Kim, Hye Jong Oh, Cheol Won Choi
    Metabolic Syndrome and Related Disorders.2015; 13(8): 329.     CrossRef
  • Association of Inter-arm Blood Pressure Difference with Atherosclerosis in Patients without Cardiovascular Diseases
    Young-Jin Tak, Yun-Jin Kim, Sang-Yeoup Lee, Jeong-Gyu Lee, Dong-Wook Jeong, Yu-Hyeon Yi, Young-Hye Cho, Eun-Jung Choi, Kyung-Jee Nam, Hye-Rim Hwang
    Journal of the Korean Society of Hypertension.2013; 19(3): 71.     CrossRef
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Socioeconomic Status in Association with Metabolic Syndrome and Coronary Heart Disease Risk
Ji Young Kim, Sung Hi Kim, Yoon Jeong Cho
Korean J Fam Med 2013;34(2):131-138.   Published online March 20, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.2.131
Background

The purpose of this study was to examine the association of metabolic syndrome (MS) coronary heart disease (CHD) with socioeconomic status (SES).

Methods

The participants were 2,170 (631 men and 1,539 women), aged over 40 years who had visited for health screening from April to December in 2009. We classified them into three SES levels according to their education and income levels. MS was defined using the criteria of modified National Cholesterol Education Program Adult Treatment Panel III and CHD risk was defined using Framingham risk score (FRS) ≥ 10%.

Results

High, middle, and low SES were 12.0%, 73.7%, and 14.3%, respectively. The prevalence of MS was 18.1%. For high, middle, and low SES, after adjusted covariates (age, drinking, smoking, and exercise), odds ratios for MS in men were 1.0, 1.41 (confidence interval [CI], 0.83 to 2.38; P > 0.05), and 1.50 (CI, 0.69 to 3.27; P > 0.05), respectively and in women were 1.0, 1.74 (CI, 1.05 to 3.18; P < 0.05), and 2.81 (CI, 1.46 to 2.43; P < 0.05), respectively. The prevalence of FRS ≥ 10% was 33.5% (adjusted covariates were drinking, smoking, and exercise) and odds ratios for FRS ≥ 10% in men were 1.0, 2.86 (CI, 1.35 to 6.08; P < 0.001), and 3.12 (CI, 1.94 to 5.00; P < 0.001), respectively and in women were 1.0, 3.24 (CI, 1.71 to 6.12; P < 0.001), and 8.80 (CI, 4.50 to 17.23; P < 0.001), respectively.

Conclusion

There was an inverse relationship between SES and FRS ≥ 10% risk in men, and an inverse relationship between SES and both risk of MS and FRS ≥ 10% in women.

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Educational Disparities in Distribution of Cardiovascular Risk Factors and Quality of Care in Korean Adults: Korean National Health and Nutrition Survey IV
Jae-Moon Yoon, Ji-Hye Kim, Beom-Seok Suh, Sang Min Park
Korean J Fam Med 2013;34(1):27-35.   Published online January 28, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.1.27
Background

The purpose of this study was to investigate how educational status influences cardiovascular risk factors and care of diabetes mellitus and hypertension.

Methods

From Korean National Health and Nutrition Survey IV, we obtained survey results of 6,835 men and 9,067 women more than 30 years old. We performed multivariate logistic regression to compare cardiovascular risk factors and care of hypertension and diabetes respective to educational status.

Results

There were disparities in cardiovascular risk factors by educational status. In men, impaired fasting glucose, high triglyceride, and smoking were less frequently found in the highest educated group than in the middle educated group. In women, the prevalence of abdominal obesity, impaired fasting glucose, high blood pressure, high triglyceride, and metabolic syndrome among the highest educated group were significantly lower. The proportion of those with proper physical activity in the highest educated group was found to be less than that of the middle educated group, regardless of gender. For care of diabetes mellitus and hypertension, disease recognition and treatment were lower among the lowest educated group in men, while these disparities were not shown in women. Instead, the lowest educated group in diabetic women received screening exams for eye and kidney complications less than the middle education group. In both genders, the high education group had a higher chance of receiving education about diabetes mellitus.

Conclusion

There were educational disparities in cardiovascular risk factors and care of hypertension and diabetes mellitus. The disparities were found to be different by gender.

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  • Educational Disparities in Risk for Metabolic Syndrome
    Insub Kim, Yun-Mi Song, Hyeonyoung Ko, Joohon Sung, Kayoung Lee, Jinyoung Shin, Sujeong Shin
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  • Social inequalities in abdominal obesity in Brazilian women: a nationwide study
    Diego Augusto Santos Silva
    Journal of Public Health.2014; 22(6): 535.     CrossRef
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Association between Metabolic Components and Subclinical Atherosclerosis in Korean Adults
In Cheol Hwang, Sang-Yeon Suh, Ah-Ram Seo, Hong Yup Ahn, Eunji Yim
Korean J Fam Med 2012;33(4):229-236.   Published online July 25, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.4.229
Background

Many studies have attempted to develop relatively simple and easy noninvasive measurements of atherosclerosis (NIMA), and each NIMA assesses different atherosclerotic properties. We, therefore, investigated the association between metabolic syndrome (MetS) components and different NIMAs.

Methods

This study included 1,132 Korean subjects over 20 years of age who had visited a Health Promotion Center in Korea. Carotid injury (increased carotid intima-media thickness or plaques) was evaluated by ultrasonography and arterial stiffness by brachial-ankle pulse wave velocity. The MetS components were assessed according to the Asian criteria of the American Heart Association/National Heart, Lung, and Blood Institute.

Results

Both arterial stiffness and carotid injury gradually deteriorated with increase in the number of MetS components. Arterial stiffness and carotid injury were associated with different MetS components, each of which had varying impact. After adjustment for all possible confounders such as age, sex, and lifestyle, elevated blood pressure (BP) was found to have the strongest association with arterial stiffness, whereas central obesity, impaired fasting plasma glucose, and elevated BP had comparable connection with carotid atherosclerosis.

Conclusion

Individual MetS components were related with subclinical atherosclerosis in different ways. Elevated BP showed the strongest association with arterial stiffness, while central obesity, impaired fasting plasma glucose, and elevated BP showed good correlation with carotid atherosclerosis.

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    Aldona Pietrzak, Jakub Kęsik, Radosław Mlak, Katarzyna Wertheim-Tysarowska, Dariusz Matosiuk, Bartłomiej Wawrzycki
    Journal of Clinical Medicine.2026; 15(13): 5179.     CrossRef
  • Is Obesity a Risk Factor for Carotid Atherosclerotic Disease?—Opportunistic Review
    Joana Ferreira, Pedro Cunha, Alexandre Carneiro, Isabel Vila, Cristina Cunha, Cristina Silva, Adhemar Longatto-Filho, Amílcar Mesquita, Jorge Cotter, Margarida Correia-Neves, Armando Mansilha
    Journal of Cardiovascular Development and Disease.2022; 9(5): 162.     CrossRef
  • Cardiac, Macro-, and Micro-Circulatory Abnormalities in Association With Individual Metabolic Syndrome Component: The Northern Shanghai Study
    Fang Zhao, Rong Yang, Rusitanmujiang Maimaitiaili, Jiamin Tang, Song Zhao, Jing Xiong, Jiadela Teliewubai, Chen Chi, Jacques Blacher, Jue Li, Yawei Xu, Yan Jiang, Yi Zhang, Weiming Li
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    Ali Reza Khoshdel, Radina Eshtiaghi
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    PLoS ONE.2014; 9(4): e93538.     CrossRef
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Misinterpreting Odds Ratio in the Articles Published in Korean Journal of Family Medicine
Ju Heon Kim, Min Young Kim, Soo Young Kim, In Hong Hwang, En Jin Kang
Korean J Fam Med 2012;33(2):89-93.   Published online March 30, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.2.89
Background

In reporting results of case-control studies, odds ratios are useful methods of reporting findings. However, odds ratios are often misinterpreted in the literature and by general readers.

Methods

We searched all original articles which were published in the Korean Journal of Family Medicine from 1980 to May 2011 and identified those that report "odds ratios." Misinterpretation of odds ratios as relative risks has been identified. Estimated risk ratios were calculated when possible and compared with odds ratios.

Results

One hundred and twenty-eight articles using odds ratios were identified. Among those, 122 articles were analyzed for the frequency of misinterpretation of odds ratios as relative risks. Twenty-two reports out of these 122 articles misinterpreted odds ratios as relative risks. The percentage of misinterpreting reports decreased over years. Seventy-seven reports were analyzed to compare the estimated risk ratios with odds ratios. In most of these articles, odds ratios were greater than estimated risk ratios, 60% of which had larger than 20% standardized differences.

Conclusion

In reports published in the Korean Journal of Family Medicine, odds ratios are frequently used. They were misinterpreted in part of the reports, although decreasing trends over years were observed.

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  • Comments on Statistical Errors for May Issue 2012
    Yong Gyu Park
    Korean Journal of Family Medicine.2012; 33(3): 186.     CrossRef
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Association of Heart Rate Variability with the Framingham Risk Score in Healthy Adults
Cheol Seung Yoo, Kayoung Lee, Sang Hoon Yi, Jun-Su Kim, Hee-Cheol Kim
Korean J Fam Med 2011;32(6):334-340.   Published online September 28, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.6.334
Background

The aim of this study was to investigate the relationship between heart rate variability (HRV), the Framingham risk score (FRS), and the 10-year risk of coronary heart disease (CHD) development among Korean adults.

Methods

The subjects were 85 healthy Korean adults recruited from a health check-up center. The FRS and 10-year risk of CHD development were calculated.

Results

The FRS in men was inversely correlated with the standard deviation of all normal to normal RR-intervals (SDNN); the root mean square successive difference (RMSSD); the percentage of successive normal cardiac inter-beat intervals greater than 20 ms, 30 ms, and 50 ms (pNN20, pNN30, pNN50); the low frequency (LF); and the high frequency (HF) (P < 0.05). There was no significant relationship between the FRS and HRV in women. Overall, in the receiver operating characteristic (ROC) analysis, the RMSSD, HF, SDNN, LF, LF/HF ratio, and pNN30 predicted an increased 10-year CHD risk. After adjusting for sex and body mass index, those with greater than one standard deviation in the RMSSD, HF, and LF had a 52-59% reduction in their 10-year risk of CHD development ≥ 10%.

Conclusion

This study therefore indicates that the HRV indices, particularly SDNN, RMSSD, pNN30, LF, and HF may be useful parameters for the assessment of CHD risk. Most notably, the usefulness of these HRV measures as indicators for CHD risk evaluation may be greater among men than among women.

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Comparison of the Framingham Risk Score, UKPDS Risk Engine, and SCORE for Predicting Carotid Atherosclerosis and Peripheral Arterial Disease in Korean Type 2 Diabetic Patients
Hye-Ran Ahn, Min-Ho Shin, Woo-Jun Yun, Hye-Yeon Kim, Young-Hoon Lee, Sun-Seog Kweon, Jung-Ae Rhee, Jin-Su Choi, Seong-Woo Choi
Korean J Fam Med 2011;32(3):189-196.   Published online March 31, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.3.189
Background

To compare the predictability of the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study (UKPDS) risk engine, and the Systematic Coronary Risk Evaluation (SCORE) for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.

Methods

Among 1,275 registered type 2 diabetes patients in the health center, 621 subjects with type 2 diabetes participated in the study. Well-trained examiners measured the carotid intima-media thickness (IMT), carotid plaque, and ankle brachial index (ABI). The subject's 10-year risk of coronary heart disease was calculated according to the FRS, UKPDS, and SCORE risk scores. These three risk scores were compared to the areas under the curve (AUC).

Results

The odds ratios (ORs) of all risk scores increased as the quartiles increased for plaque, IMT, and ABI. For plaque and IMT, the UKPDS risk score provided the highest OR (95% confidence interval) at 3.82 (2.36, 6.17) and at 6.21 (3.37, 11.45). For ABI, the SCORE risk estimation provided the highest OR at 7.41 (3.20, 17.18). However, no significant difference was detected for plaque, IMT, or ABI (P = 0.839, 0.313, and 0.113, respectively) when the AUCs of the three risk scores were compared. When we graphed the Kernel density distribution of these three risk scores, UKPDS had a higher distribution than FRS and SCORE.

Conclusion

No significant difference was observed when comparing the predictability of the FRS, UKPDS risk engine, and SCORE risk estimation for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.

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The Association of Childhood Obesity with Attention Deficit/Hyperactivity Disorder.
Joo Hong Chun, Dong Ryul Lee, Jung Un Lee, Sae Ron Shin, Kyung Hee Park
Korean J Fam Med 2010;31(11):852-861.   Published online November 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.11.852
Background
Attention deficit hyperactivity disorder (ADHD) is caused by multiple risk factors and accompany many problems. This study aimed to analyze the association of childhood obesity with ADHD and to know the related factors of ADHD.Methods: In 2006, 427 students in fourth grade were recruited from two elementary schools in Gwangmyeong city. Height and weight were measured and children's weight status was classified as normal weight, overweight and obese using the age and gender-specific BMI established by Korean Academy of Pediatrics. The Korean abbreviated Conners' parent rating scale (ACRS) was used to measure the ADHD state.Results: The obesity rate was higher in ADHD group than in non-ADHD group (P = 0.005). The Kovacs' children's depression inventory score (CDI score) of ADHD group was higher than that of non-ADHD group (P = 0.003). In ADHD group, there were many cases where students were looked after by members of the family other than the parents after school (P = 0.01). ADHD group had a tendency to have breakfast heavily (P = 0.01). The average monthly income of the parents of ADHD group was relatively higher than that of the non-ADHD group (P = 0.03), and the fathers of ADHD group tend to have night eating syndrome (P = 0.003).Conclusion: The ADHD was significantly associated with childhood obesity, and was likely to be more depressive and had different life styles than non-ADHD group.

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  • Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention‐deficit hyperactivity disorder: A systematic review and meta‐analysis
    Yong‐Jiang Li, Xue‐Ni Xie, Xue Lei, Ya‐Min Li, Xianyang Lei
    Obesity Reviews.2020;[Epub]     CrossRef
  • Attention deficit/hyperactivity-disorder and obesity: A review and model of current hypotheses explaining their comorbidity
    Tomasz Hanć, Samuele Cortese
    Neuroscience & Biobehavioral Reviews.2018; 92: 16.     CrossRef
  • Nutritional Status and Hair Mineral Content of Elementary School Children with Behavioral Problems
    Seung-Wan Kang, Jin-Young Kim, Sang-Woon Cho, Yoo Kyoung Park
    Journal of the Korean Dietetic Association.2012; 18(2): 97.     CrossRef
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  • 3 Crossref
The Diagnostic Criteria of Metabolic Syndrome and the Risk of Coronary Heart Disease according to Definitions in Men.
Hyouk Soo Seo, Sung Hi Kim, Soon Woo Park, Jong Yeon Kim, Geon Ho Lee, Hye Mi Lee
Korean J Fam Med 2010;31(3):198-207.   Published online March 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.3.198
Background
Early detection of metabolic syndrome (MS) is important to prevent complications. Yet, there is no internationally agreed definition for MS. This study was performed to compare the diagnostic criteria of MS using various definitions and agreements, and to find better definition for screening high risk group of coronary heart disease. Methods: The participants were 426 men above forty years old who had visited to have health screening in a general hospital in Daegu from March to December in 2007. The diagnostic criteria of MS and Kappa statistic were calculated according to the following five diagnostic definitions; modified World Health Organization (WHO), National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) and NCEP-ATP III modified waist circumference ≥ 90 cm (modified NCEP-ATP III). The sensitivity and specificity of each definition of MS were calculated with respect to high risk group by Framingham risk score (FRS). Results: The diagnostic criteria of MS were 6.6% by IDF, 7.7% by WHO, 10.6% by NCEP-ATP III, 18.1% by modified NCEP-ATP III and 22.3% by AHA/NHLBI. The kappa satistic ranged from 0.30 to 0.87. The sensitivity of each definition with respect to FRS was 8.3% in IDF, 13.4% in WHO, 15.3% in NCEP-ATP III, 27.4% in modified NCEP-ATP III and 32.5% in AHA/NHLBI. Conclusion: There was great difference in the diagnostic criteria of MS according to diagnostic definitions. The author suggests that AHA/NHLBI or modified NCEP-ATP III definition may be better for screening high risk group of coronary heart disease than others.

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  • Prevalence of metabolic syndrome and cardiovascular risk level in a vulnerable population
    Chun‐Ja Kim, JeeWon Park, Se‐Won Kang
    International Journal of Nursing Practice.2015; 21(2): 175.     CrossRef
  • 2,893 View
  • 18 Download
  • 1 Crossref
Factors Related to Human Papilloma Virus Infection Rate in Women.
Sung Hee Kim, Ka Young Lee, Tae Jin Park, Jun Su Kim, Yeun Mi Kim, Hea Sook O
Korean J Fam Med 2009;30(12):972-978.   Published online December 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.12.972
Background
It is not clear which demographic factors would be considered for human papillomavirus (HPV) infection in Korean women and how women understand the HPV infection. This study was conducted to fi nd the factors related to HIV infection and the realities of follow-up tests and perception among women infected with HPV. Methods: The subjects were 2,113 women (median 41 years old) who received a Papanicolaou smear and a HPV DNA test at a health promotion center from March 2006 to October 2007. The follow-up rate and perception for HPV infection among women infected by HPV were surveyed using telephone. Results: Overall prevalence of HPV infection was 17.3% (N = 365). However, the prevalence of HPV infection among women younger than 30 years old reached 30.7% (17.6% for low-risk group of HPV, 13.1% for high-risk group of HPV). The odds for being infected with HPV was 3.2 (95% confi dence interval, 2.0 to 5.2) among unmarried women younger than 30 years old compared to those at the ages of 30 years or older. Married women younger than 30 years were also 2.1-4.3 times more likely to be infected with low-risk group of HPV compared to those aged 30 years or older. Among those infected with HPV and answered to the survey (N = 282), 51.4% took irregular gynecologic follow-up and 66.2% did not have information for the need or importance of follow-up examination. Conclusion: The risk of being infected with HPV seems to be higher for unmarried women younger than 30 years old. Additionally, a standardized guideline should be provided to improve follow-up examination and knowledge about HPV infection.

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  • Recommended Managements for the Male Human Papillomavirus Infection
    Jun Hyun Han
    The Korean Journal of Urogenital Tract Infection and Inflammation.2014; 9(2): 79.     CrossRef
  • Factors Associated with Human Papillomavirus related Stigma, Shame, and Intent of HPV Test
    Hae Won Kim
    Journal of Korean Academy of Nursing.2012; 42(2): 217.     CrossRef
  • 3,284 View
  • 22 Download
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