• Journal of the Korea Convergence Society
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• v.13 no.1
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• pp.399-408
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• 2022

The purpose of this study was to compare the usefulness of the lipid ratio indicators for the diagnosis of metabolic syndrome in the elderly aged 65 years or older. From January 2018 to December 2020, 1,464 people aged 65 years or older who underwent a health checkup at a general hospital in Seoul were included. Lipid ratio indicators were measured through blood tests. The prevalence of metabolic syndrome according to the quartiles of the lipid ratio index was confirmed by logistic regression analysis. In addition, the metabolic syndrome predictive ability and cutoff value of the lipid ratio indices were estimated with the receiver operating characteristic(ROC) curve. The correlation between atherogenic index of plasma(AIP) and waist circumference was the highest in both men and women(r=0.278, p<0.001 vs r=0.252, p<0.001). As for the lipid ratio indices, the incidence of metabolic syndrome was higher in the fourth quartile than in the first quartile. The area under the ROC curve(AUC) value of AIP was higher at 0.826(95% CI=0.799-0.850) and 0.852(95% CI=0.820-0.881) for men and women, respectively, compared to other lipid ratio indicators, and the optimal cutoff values for both men and women was 0.44(p<0.001). Therefore, the AIP among the lipid ratio indicators was found to be the most useful index for diagnosing metabolic syndrome in the elderly aged 65 years or older.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5101-5106
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• 2016

Purpose: We aimed to establish an inflammatory prognostic index (IPI) in early and advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze its predictive value for NSCLC survival. Materials and Methods: A retrospective review of 685 patients with early and advanced NSCLC diagnosed between 2009 and 2014 was conducted with collection of clinical, and laboratory data. The IPI was calculated as C-reactive protein ${\times}$ NLR (neutrophil/ lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. Results: The optimal cut-off value of IPI for overall survival (OS) stratification was determined to be 15. Totals of 334 (48.8%) and 351 (51.2%) patients were assigned to high and low IPI groups, respectively. Compared with low IPI, high IPI was associated with older age, greater tumor size, high lymph node involvement, distant metastases, advanced stage and poor performance status. Median OS was worse in the high IPI group (low vs high, 8.0 vs 34.0 months; HR, 3.5; p<0.001). Progression free survival values of the patients who had high vs low IPI were determined 6 months (95% CI:5.3-6.6) and 14 months (95% CI:12.1-15.8), respectively (HR; 2.4, P<0.001). On multivariate analysis, stage, performance status, lactate dehydrogenase and IPI were independent prognostic factors for OS. Subgroup analysis showed IPI was generally a significant prognostic factor in all clinical variables. Conclusion: The described IPI may be an inexpensive, easily accessible and independent prognostic index for NSCLC patients, useful for clinical practice.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.125-130
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• 2017

Purpose: To evaluate the clinical significance of T1 high signal intensity on the globus pallidus as a predictor of severe hepatic encephalopathy in patients with acute-on-chronic liver failure (ACLF), which is a distinct syndrome characterized by multi-organ dysfunction including cerebral failure. Materials and Methods: From January 2002 to April 2014, we retrospectively reviewed the magnetic resonance imaging (MRI) findings and clinical and magnetic resonance (MR) features of 74 consecutive patients (44 men and 30 women; mean age, 59.5 years) with liver cirrhosis. The chronic liver failure-sequential organ failure assessment score was used to diagnose ACLF. The pallidal index (PI), calculated by dividing the mean signal intensity of the globus pallidus by that of the subcortical frontal white matter were compared according to ACLF. The PI was compared with the Model for End-Stage Liver Disease (MELD) score in predicting the development of ACLF. Results: Fifteen patients who were diagnosed with ACLF had higher hepatic encephalopathy grades (initial, P = 0.024; follow-up, P = 0.002), MELD scores (P < 0.001), and PI (P = 0.048). In the ACLF group, the mean PI in patients with cerebral failure was significantly higher than that in the patients without cerebral failure (1.33 vs. 1.20, P = 0.039). In patients with ACLF, the area under the curve (AUC) for PI was 0.680 (95% confidence intervals [CI], 0.52-0.85), which was significantly lower than that for the MELD score (AUC, 0.88; 95% CI, 0.77-0.99) (P = 0.04). Conclusion: The PI can be an ancillary biomarker for predicting the development of ACLF and severe hepatic encephalopathy.

• Journal of Korean Academy of Nursing
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• v.44 no.4
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• pp.391-397
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• 2014

Purpose: This study was done to examine the association between body mass index (BMI) and any type of clinical dementia. Methods: Participants were 60,321 people over 60 years of age enrolled in the Seoul Dementia Management Project in 2011. K-MMSE was used to classify participants as having a cognitive impairment and the Clinical Dementia Rating or DSM-IV by psychiatrists or neurologists to determine whether participants were in the dementia group or the non-dementia group. Descriptive statistics, chi-square test, and binary logistic regression analysis were performed. Results: In the univariate analysis, age, education level, living with spouse, BMI, alcohol consumption, and exercise were significantly associated with dementia. In multivariable analysis, increasing age was positively associated with dementia, and educational level was negatively associated with dementia. The exercise group had a lower prevalence of dementia than the non-exercise group. The odds ratio of dementia in the over-weight and obese groups compared to the normal group was 0.85 (95% CI 0.60, 0.98) and 0.64 (95%CI 0.46, 0.75), respectively. Conclusion: Results indicate that dementia is negatively associated with increasing BMI in people aged 60 years or older, but a prospective cohort study is needed to elucidate the causal effect relationship between BMI and dementia.

• Tuberculosis and Respiratory Diseases
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• v.73 no.3
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• pp.162-168
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• 2012

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease. Effective treatment is not currently available and the prognosis is poor. The aim of our study was to identify clinical predictors of survival in patients with IPF. Methods: By using medical record database of a university hospital, we reviewed the records of patients who had been diagnosed as having IPF from January 1996 through December 2007. Results: Among 89 patients considered as having interstitial lung disease (ILD) on computed tomography (CT) of the chest, 22 were excluded because of the diagnosis of other ILDs or connective tissue disease, and finally, 67 met the criteria of IPF. The mean age at the diagnosis of IPF was 70 years (range, 41~87 years) and 43 (64%) were male. The mean survival time following the diagnosis of IPF was 40 months (range, 0~179 months). Among them, 28 cases were diagnosed as the progressive state of IPF on the follow-up CT examination, and the mean duration between diagnosis of IPF and progression was 31 months. Multivariate analysis using Cox regression model revealed that body mass index (BMI) less than 18.5 $kg/m^2$ (p=0.030; hazard ratio [HR], 12.085; 95% confidence interval [CI], 1.277~114.331) and CT progression before 36 months from the diagnosis of IPF (p=0.042; HR, 13.564; 95% CI, 1.101~167.166) were independently associated with mortality. Conclusion: Since low BMI at the diagnosis of IPF and progression on follow-up CT were associated with poor prognosis, IPF patients with low BMI and/or progression before 36 months following the diagnosis should be closely monitored.

• Clinical Nutrition Research
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• v.12 no.1
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• pp.7-20
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• 2023

Creating a complex balance between dietary composition, circadian rhythm, and the hemostasis control of energy is important for managing diseases. Therefore, we aimed to determine the interaction between cryptochrome circadian clocks 1 polymorphism and energy-adjusted dietary inflammatory index (E-DII) on high-sensitivity C-reactive protein in women with central obesity. This cross-sectional study recruited 220 Iranian women aged 18-45 with central obesity. The 147-item semi-quantitative food frequency questionnaire was used to assess the dietary intakes, and the E-DII score was calculated. Anthropometric and biochemical measurements were determined. By polymerase chain response-restricted length polymorphism method, cryptochrome circadian clocks 1 polymorphism was assigned. Participants were categorized into three groups based on the E-DII score, then categorized according to cryptochrome circadian clocks 1 genotypes. The mean and standard deviation of age, BMI, and high-sensitivity C-reactive protein (hs-CRP) were 35.61 ± 9.57 years, 30.97 ± 4.16 kg/m², and 4.82 ± 5.16 mg/dL, respectively. The interaction of the CG genotype and E-DII score had a significant association with higher hs-CRP level compared to GG genotype as the reference group (β, 1.19; 95% CI, 0.11-2.27; p value, 0.03). There was a marginally significant association between the interaction of the CC genotype and the E-DII score with higher hs-CRP level compared to the GG genotype as the reference group (β, 0.85; 95% CI, -0.15 to 1.86; p value, 0.05). There is probably positive interaction between CG, CC genotypes of cryptochrome circadian clocks 1, and E-DII score on the high-sensitivity C-reactive protein level in women with central obesity.

• Korean Circulation Journal
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• v.53 no.12
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• pp.843-854
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• 2023

Background and Objectives: We evaluated the effect of diabetes on the relationship between body mass index (BMI) and clinical outcomes in patients following percutaneous coronary intervention (PCI) with drug-eluting stent implantation. Methods: A total of 6,688 patients who underwent PCI were selected from five different registries led by Korean Multicenter Angioplasty Team. They were categorized according to their BMI into the following groups: underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight to obese (≥25.0 kg/m²). Major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of death, nonfatal myocardial infarction, stroke, and target-vessel revascularization, were compared according to the BMI categories (underweight, normal and overweight to obese group) and diabetic status. All subjects completed 1-year follow-up. Results: Among the 6,688 patients, 2,561 (38%) had diabetes. The underweight group compared to normal weight group had higher 1-year MACCE rate in both non-diabetic (adjusted hazard ratio [HR], 2.24; 95% confidence interval [CI], 1.04-4.84; p=0.039) and diabetic patients (adjusted HR, 2.86; 95% CI, 1.61-5.07; p<0.001). The overweight to obese group had a lower MACCE rate than the normal weight group in diabetic patients (adjusted HR, 0.67 [0.49-0.93]) but not in non-diabetic patients (adjusted HR, 1.06 [0.77-1.46]), with a significant interaction (p-interaction=0.025). Conclusions: Between the underweight and normal weight groups, the association between the BMI and clinical outcomes was consistent regardless of the presence of diabetes. However, better outcomes in overweight to obese over normal weight were observed only in diabetic patients. These results suggest that the association between BMI and clinical outcomes may differ according to the diabetic status.

• Clinical and Experimental Pediatrics
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• v.65 no.2
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• pp.98-107
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• 2022

Background: Various interventions have been tested to prevent or treat childhood obesity in South Korea. However, the overall effect of those interventions is unclear, as very few reviews and meta-analyses were specific to Korean children and adolescents. Purpose: We aimed to examine the overall effect of obesity interventions among Korean children and adolescents, while also examining differences by sex, age group, baseline weight category, intervention duration, number of intervention components, and type of intervention components. Methods: A meta-analysis was conducted for all intervention studies sampling Korean children and adolescents, with at least one control group and one month of follow-up, published between January 2000 and August 2020. Cohen d was calculated as an effect size for treatment effect, using the standardized difference between intervention group's body mass index (BMI) change and control group's BMI change. Results: The final sample included 19 intervention studies with 2,140 Korean children (mean age, 12.2 years). Overall, interventions were strongly favored over their controls (d=1.61; 95% confidence interval [CI], 1.12-2.09). The subgroup analysis showed that interventions with at least one physical activity component (d=2.43; 95% CI, 1.63-3.24) were significantly better than those that did not include physical activity (d=0.02; 95% CI, -0.26 to 0.31). Conclusion: Type of intervention component appeared important, though no differential association was observed by sex, age, baseline weight category, intervention duration, and number of intervention components. Korean and non-Korean interventions may be substantively different. Additional studies are needed to understand why and how Korean interventions differ from non-Korean interventions.

• Tuberculosis and Respiratory Diseases
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• v.87 no.3
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• pp.349-356
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• 2024

Background: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand. Methods: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded. Results: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84). Conclusion: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.

• Journal of the Korean Society of Food Culture
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• v.37 no.4
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• pp.376-384
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• 2022

This study was performed to develop a K_diet-index based on the definitions and characteristics of traditional Korean food. The Korean Food Pattern Index (K_diet-index) for diseases was applied using dietary data from the 2017 National Health and Nutrition Examination Survey (KNHANES) and the association between K_diet-index and metabolic disease was confirmed. The study subjects were 1,971 Korean adults aged >40, and the components were classified according to 14 criteria used to establish the K_diet-index. Main ingredients up to the top 3 were designated using dish names, ingredients, and contents using KNHANES dietary data. K_diet-index was classified using scores of ≤3 points, 4-7 points, and ≥8 points and total K_diet-index were calculated by summing dietary scores. Correlations between K_diet-index and obesity, hypertension, hyperlipidemia, and diabetes were analyzed. The odds ratio (OR) and 95% confidence interval (CI) for obesity were 0.531, 0.385~0.732 and for elevated cholesterol (≥240 mg/dL) indices were 0.471, 0.282~0.788, respectively, which showed a significant decreased in the risk for each disease for K_diet-index of ≥8 points. This study confirms that metabolically related clinical results improved significantly as K_diet-index increased and that higher Korean food pattern indices are associated with lower risks of metabolic disease