• Title/Summary/Keyword: Cardiovascular Risk Index

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Caloric Restriction vs Testosterone Treatment ; The Effect on Body Fat Distribution and Serum Lipid Levels in Overweight Male Patients with Coronary Artery Disease (관상동맥경화증인 과체중 남성에서 열량제한과 Testosterone 투여가 체지방 분포 및 혈청 지질 농도에 미치는 영향)

  • 이종호;채지숙;고수정;강석민;최동훈;장양수
    • Journal of Nutrition and Health
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    • v.36 no.9
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    • pp.924-932
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    • 2003
  • In middle-aged men, abdominal obesity has been an important risk factor of coronary artery disease (CAD) as well as a predictor of hypertension, dyslipidemia, insulin resistance and glucose intolerance. Particularly, risks from abdominal obesity increase when adipose tissue accumulates in visceral compartment. Many studies showed that weight reduction by caloric restriction improves abdominal obesity and reduces lots of cardiovascular risk factors. Testosterone treatment also results in a significant decrease in visceral fat area and normalizes endocrine metabolism. However there is no study that compare the effect of caloric restriction with that of testosterone treatment. The purpose of this study is to investigate the effect of caloric restriction and that of testosterone treatment on body fat distribution, serum lipids and glucose metabolism in male patients with CAD. Forty five middle-aged overweight-obese men with CAD participated in 12 weeks' program. They were matched with age, body weight, body mass index (BMI) and divided into three groups : control group (n = 15) , caloric restriction group (-300 kcal/day, n = 15) and testosterone treatment group (testosterone undecanoate tablets, n = 15) . After 12 weeks, control group did not have any changes in anthropometries, lipid profile, body fat distribution, glucose metabolism and hormonal status. Expectedly, caloric restriction group showed decreases in body weight, BMI, waist to hip ratio, % body fat. Ten percentage of total cholesterol and 23% of triglyceride in serum were also decreased. In body fat distribution, total fat areas at both L1 and L4 levels were significantly reduced in this group without reduction in muscle of thigh and calf. However, testosterone treatment group did not have any significant changes in body weight, % body fat, serum lipid profile and abdominal fat distribution. In conclusion, weight reduction by caloric restriction is more beneficial in body fat distribution and serum lipid level than testosterone treatment in overweight male patients with CAD. This result suggests that modest weight reduction is possible to help decrease risk factors of CAD.

Evaluation of Waist Circumference Cut-off Values as a Marker for Fatty Liver among Japanese Workers

  • Abe, Naomi;Honda, Sumihisa;Jahng, Doosub
    • Safety and Health at Work
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    • v.3 no.4
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    • pp.287-293
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    • 2012
  • Objectives: Metabolic syndrome has received attention as a risk factor for cardiovascular disease, with particular importance attached to visceral fat accumulation, which is associated with lifestyle-related diseases and is strongly correlated with waist circumference. In this study, our aim is to propose waist circumference cut-off values that can be used as a marker for fatty liver based on a sample of workers receiving health checkups in Japan. Methods: This study was conducted in a total of 21,866 workers who underwent periodic health checkups between January 2007 and December 2007. The mean age of the subjects was 47.4 years for men (standard deviation [SD]: 8.0) and 44.7 years for women (SD: 6.9). Evaluation included abdominal ultrasound and measurement of waist circumference, body mass index, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure. Results: Based on receiver operating characteristic curve analysis, the optimal waist circumference cut-off values were shown as 85.0 cm (sensitivity 0.72, specificity 0.69) for men and 80.0 cm (sensitivity 0.75, specificity 0.78) for women. Conclusion: Abdominal ultrasound is the most efficient means of diagnosing fatty liver, but this examination seldom occurs because the test is not routinely performed at workers' health checkups. In people found to have a high risk of fatty liver, recommendations can be made for abdominal ultrasound based on the waist circumference cut-off values obtained in this study. That is, waist circumference can be used in high risk individuals as an effective marker for early detection of fatty liver.

Statistical Analysis of the Risk Factors for Single Toe Amputation Patients in Wound Healing (단일 족지 절단 환자의 상처 치유 위험인자에 대한 통계적 분석)

  • Chung, Hyung-Jin;Bae, Su-Young;Shin, Woo-Jin;Lee, Jun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.18-23
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    • 2019
  • Purpose: This study compared and analyzed the risk factors that affect a wound healing group and healing failure group. Materials and Methods: From 2010 to 2018, 39 patients who had suffered a single toe amputation were evaluated retrospectively. The patients were divided into two groups (wound healing group and healing failure group - within at least 3 months following the amputation). Regarding the possible risk factors, age, gender, Wagner and Brodsky classifications, duration of diabetes mellitus, whether the patient had peripheral arterial occlusive disease (PAOD) or cardiovascular disease, body mass index, HbA1c, total cholesterol, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), smoking, and alcohol were investigated. Results: The mean duration of diabetes mellitus was 140 months in the healing group and 227 months in the healing failure group, and the duration of diabetes was significantly longer in the failure group (p=0.009). A significant difference in eGFR was observed between the two groups ($59.17mL/min/1.73m^2$ in the healing group and $31.1mL/min/1.73m^2$ in the failure group) (p=0.022). Sixteen patients with PAOD were found, all 10 patients in the healing failure group were PAOD patients. Conclusion: To reduce the additional complications in single toe amputation patients, the underlying disease and appropriate treatment are the most important factors. In addition, a more proximal level of amputation also should be considered in cases of patients with PAOD, high BUN and low eGFR, and patients with long-term diabetes.

Analysis of Association with Risk Factors of Cardiovascular Disease and Heart Rate Variability (심박동수 변이에 따른 심혈관질환 위험 인자와의 관련성에 미치는 영향 분석)

  • Lim, Bo-Hee;Seok, Jong-Min;Jeon, Woo-Jin;Ko, Eun-Ju;Lee, Jin
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.321-328
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    • 2018
  • The purpose of this study was to investigate factors affecting the heart rate, to analyze the relevance and to use it as a management index of factors of increase in heart rate. A total of 204 adults from November, 2016 to March, 2017 who responded to a personal questionnaire among the adults who underwent coronary computed tomography scans for health screening, were the target of the investigation. In the study, there was a statistically significant difference (p <.05) between the heart rate and the gender, CACS, Stenosis and the forces affecting cardiovascular disease. CACS, Stenosis had a statistically significant difference (p <.05) compared with the other groups in the group with a heart rate of 80 bpm or more, the ability to influence cardiovascular disease was different from that of other groups There was a meaning difference in the heart rate below 60 bpm group compared (p <.05). In conclusion, it is important and desirable to maintain heart rate below 60 bpm in order to prevent having cardiovascular disease history, and below 80 bpm to prevent CACS and stenosis.

Correlation between Arterial Stiffness and Physiological Parameters (동맥경화도와 생리학적 변수들 간의 상관관계)

  • Shin, Jae-Wook;Seok, Seong-Ja;Lee, Gil-Hyun;Choi, Seok-Cheol;Hyun, Kyung-Yae
    • The Korean Journal of Health Service Management
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    • v.7 no.3
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    • pp.71-82
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    • 2013
  • Arterial stiffness(AS) is an important pathologic state of vascular injury. This study was carried out to elucidate the effect of physiological variables on brachial-ankle pulse wave velocity(BAPWV), index of AS. Four hundred adults(volunteers) participated in this study. Body indices, biochemical, cardiac and inflammatory markers, and right(Rt)- and left(Lt)-BAPWV were measured. Body mass index(BMI), Rt- and Lt-BAPWV, glucose, triglyceride, alkaline phosphatase(ALP), gamma-glutamyl transferase(GGT), creatinine, uric acid, troponin-I(TNI), NT-proBNP and high sensitivity C-reactive protein(hs-CRP) levels were higher than the reference value of each variable. Rt- and Lt-BAPWV were directly correlated with age, body weight, BMI, glucose, ketone, aspartate aminotransferase, alanine aminotransferase, ALP, GGT, total cholesterol, low density lipoprotein, lipoprotein(a), apolipoprotein-B, blood urea nitrogen, heart rate, TNI, creatine kinase, CK-MB, lactic dehydrogenase, myoglobin, hs-CRP, lipase, reumatoid factor, fibrinogen and D-dimer (P<0.05, P<0.01, P<0.001 or P<0.000, respectively), but inversely associated with total bilirubin, uric acid, apolipoprotein-A1 and GFR (P<0.05). These observations suggest that a variety of physiological variables may influence BAPWV, resulting in increased risk or prevention of cardiovascular and/or cerebrovascular attacks. Therefore, physiological variables affecting BAPWV should be regularly controlled.

The Study of Relationship among Serum Leptin, Nutritional Status, Serum Glucose and Lipids of Middle-school Girls (일부 사춘기 여중생의 혈청 Leptin 함량과 영양소섭취상태 및 혈당, 혈청지질과의 상관관계 연구)

  • 김미현;승정자
    • Journal of Nutrition and Health
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    • v.33 no.1
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    • pp.49-58
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    • 2000
  • The purpose of this study was to investigate the relationship among urn leptin, nutritional status, and urn lipids, glucose of 99 middle school girls residing in Kyluggi-do, Korea. Subjects were assigned to one of three groups such as underweight(BMI < 20, n=38), normal(20$\leq$BMI<25, n=36) and over weight(BMI$\geq$25, n=25) groups. The nutritional status of the subjects was evaluated by anthropometric measurements, questionnaires, 24-hr dietary recalls and blood anal),sis. The results were as follows : The mean age, body weight, height and BMI were 13.93 years, 55.19kg, 158.40cm and 21.96kg/㎡ respectively. The mean menarche age of the subjects was 12.64 years and the mean daily energy intake was 94.22% off RDA for Koreans. The energy ratio from carbohydrate fat and protein was 63: 24: 13. Underweight group showed the lowest intakes of oils and fats among three groups(p<0.05). The mean serum levels of leptin, glucose, total cholesterol, HDL-cholesterol. LDL-cholesterol and triglyceride were 10.57ng/ml 78.80mg/dl, 12.29mg/dl, 48.07mg/dl, 93.50mg/dl and 78.61mg/d1, respectively. The mean atherogenic index was 2.37. There were significant increases in serum leptin, glucose, LDL-cholesterol, triglyceride and atherogenic index of subjects with increases in their BMIs. Serum leptin showed a significantly positive correlation with BMI(p<0.001), body fat percent(p<0.001). When BMI was adjused, serum leptin showed a significantly positive partial correlations with intakes of animal protein(p<0.05), milks and animal foods(p<0.05), Serum leptin showed a significantly positive correlation with serum glucose(p<0.05) total cholesterol(p<0.01), LDL-cholesterol(p<0.001), triglyceride(p<0.001) and atherogenic index(p<0.001), however, it had significantly negative correlations with HDL-cholesterol(p<0.05). Therefore, these results suggest that the increase of serum levels of leptin may elevate the risk of cardiovascular disease and lipids and some nutrient intakes may be related with serum leptin levels. (Korean J Nutrition 33(1) : 49-58, 2000)

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Lack of Replication of Genetic Association with Body Mass Index Detected by Genome-wide Association Study

  • Lee, Hae-In;Kim, Jae-Jung;Park, Tae-Sung;Kim, Kyung-A;Lee, Jong-Eun;Cho, Yoon-Shin;Lee, Jong-Young;Han, Bok-Ghee;Lee, Jong-Keuk
    • Genomics & Informatics
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    • v.9 no.2
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    • pp.59-63
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    • 2011
  • Obesity provokes many serious human diseases, including various cardiovascular diseases and diabetes. Body mass index (BMI) is a highly heritable trait that is broadly used to diagnose obesity. To identify genetic loci associated with obesity in Asians, we conducted a genome-wide association study (GWAS) of a population of Korean adults (n=6,742, age 40~60 years) and detected six BMI risk loci (TNR, FAM124B, RGS12, NFE2L3, MC4R and FTO) having p< $1{\times}10^{-5}$. However, in the replication study, only melanocortin 4 receptor gene (MC4R) (rs9946888, p=$4.58{\times}10^{-7}$) was replicated with marginal significance (p<0.05) in the second cohort (n=5,102, age 40~60 years). This study indicates that each locus associated with BMI has very weak genetic effect.

Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma

  • Urabe, Masayuki;Ohkura, Yu;Haruta, Shusuke;Ueno, Masaki;Udagawa, Harushi
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.466-472
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    • 2021
  • Background: Major intraoperative hemorrhage reportedly predicts unfavorable survival outcomes following surgical resection for esophageal carcinoma (EC). However, the factors predicting the amount of blood lost during thoracoscopic esophagectomy have yet to be sufficiently studied. We sought to identify risk factors for excessive blood loss during video-assisted thoracoscopic surgery (VATS) for EC. Methods: Using simple and multiple linear regression models, we performed retrospective analyses of the associations between clinicopathological/surgical factors and estimated hemorrhagic volume in 168 consecutive patients who underwent VATS-type esophagectomy for EC. Results: The median blood loss amount was 225 mL (interquartile range, 126-380 mL). Abdominal laparotomy (p<0.001), thoracic duct resection (p=0.014), and division of the azygos arch (p<0.001) were significantly related to high volumes of blood loss. Body mass index and operative duration, as continuous variables, were also correlated positively with blood loss volume in simple linear regression. The multiple linear regression analysis identified prolonged operative duration (p<0.001), open laparotomy approach (p=0.003), azygos arch division (p=0.005), and high body mass index (p=0.014) as independent predictors of higher hemorrhage amounts during VATS esophagectomy. Conclusion: As well as body mass index, operation-related factors such as operative duration, open laparotomy, and division of the azygos arch were independently predictive of estimated blood loss during VATS esophagectomy for EC. Laparoscopic abdominal procedures and azygos arch preservation might be minimally invasive options that would potentially reduce intraoperative hemorrhage, although oncological radicality remains an important consideration.

Health Risk Assessment with Source Apportionment of Ambient Volatile Organic Compounds in Seoul by Positive Matrix Factorization (수용체 모델(PMF)를 이용한 서울시 대기 중 VOCs의 배출원에 따른 위해성평가)

  • Kwon, Seung-Mi;Choi, Yu-Ri;Park, Myoung-Kyu;Lee, Ho-Joon;Kim, Gwang-Rae;Yoo, Seung-Sung;Cho, Seog-Ju;Shin, Jin-Ho;Shin, Yong-Seung;Lee, Cheolmin
    • Journal of Environmental Health Sciences
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    • v.47 no.5
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    • pp.384-397
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    • 2021
  • Background: With volatile organic compounds (VOCs) containing aromatic and halogenated hydrocarbons such as benzene, toluene, and xylene that can adversely affect the respiratory and cardiovascular systems when a certain concentration is reached, it is important to accurately evaluate the source and the corresponding health risk effects. Objectives: The purpose of this study is to provide scientific evidence for the city of Seoul's VOC reduction measures by confirming the risk of each VOC emission source. Methods: In 2020, 56 VOCs were measured and analyzed at one-hour intervals using an online flame ionization detector system (GC-FID) at two measuring stations in Seoul (Gangseo: GS, Bukhansan: BHS). The dominant emission source was identified using the Positive Matrix Factorization (PMF) model, and health risk assessment was performed on the main components of VOCs related to the emission source. Results: Gasoline vapor and vehicle combustion gas are the main sources of emissions in GS, a residential area in the city center, and the main sources are solvent usage and aged VOCs in BHS, a greenbelt area. The risk index ranged from 0.01 to 0.02, which is lower than the standard of 1 for both GS and BHS, and was an acceptable level of 5.71×10-7 to 2.58×10-6 for carcinogenic risk. Conclusions: In order to reduce the level of carcinogenic risk to an acceptable safe level, it is necessary to improve and reduce the emission sources of vehicle combustion and solvent usage, and eco-car policies are judged to contribute to the reduction of combustion gas as well as providing a response to climate change.

The Effect of Isoflavone Supplement on Plasma Lipids & Antioxidant Status in Hypercholesterolemic Postmenopausal Women (고지혈증인 폐경 후 여성에서 이소플라본 보충이 혈청 지질 농도 및 항산화능에 미치는 영향)

  • Lee, Jong-Ho;Kim, Eun-Mi;Chae, Ji-Sook;Jang, Yang-Soo;Lee, Jin-Hee;Lee, Geun
    • Journal of Nutrition and Health
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    • v.36 no.6
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    • pp.603-612
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    • 2003
  • Postmenopausal women are at an increased risk of developing coronary artery disease. This is due to primarily dyslipidemia accompanying the loss of estrogen secretion. Soy isoflavones are known to have weak estrogenic effects. The purpose of this study is to investigate whether isoflavone supplement improves the risk of cardiovascular disease in hypercholesterolemic postmenopausal women. Subjects consisted of 39 Korean postmenopausal women with hypercholesterolemia (total cholesterol $\geq$ 200 mg/㎗ or LDL cholesterol $\geq$ 130 mg/㎗). Subjects were divided into 2 groups; placebo group (PG), isoflavone supplement group (IG). During 12 weeks, subjects were given placebo and 80mg isoflavone daily. Anthropometric measurement, blood sample analysis and dietary intake measurement were taken at baseline and after 12 weeks. After 12 weeks, systolic blood pressure was decreased significantly (p < 0.01) and plasma HDL cholesterol level was increased significantly (p < 0.05) in IG. But there were no significant changes in plasma total cholesterol, LDL cholesterol and triglyceride levels after isoflavone supplementation. There was a negative correlation between initial plasma HDL cholesterol level and the extent of plasma HDL cholesterol reduction in IG (r=-0.572, p=0.012). Atherogenic index (AI), total-/LDL- cholesterol ratio and LDL/HDL cholesterol ratio were improved significantly after isoflavone supplementation. In subjects whose initial plasma LDL cholesterol level were above 160 mg/㎗, plasma malondialdehyde (MDA) level were decreased and total antioxidant status (TAS) were increased significantly after isoflavone supplement (p < 0.05). However there were no significant changes in flow-mediated dilator (FMD), the marker of endothelium-dependent vasodilation and nitroglycerine-mediated dilator (NMD), the marker of endothelium-independent vasodilation and the extent of DNA damage after isoflavone supplement. In conclusion, these results indicate that isoflavone supplement may decrease the risk of cardiovascular disease via improving blood pressure, HDL cholesterol level and AI in hypercholesterolemic postmenopausal women. Futhermore, in case of subjects with elevated LDL cholesterol level, isoflavone supplementation may have more antiatherogenic effects via improving antioxidant status.