• Physical Therapy Korea
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• v.6 no.3
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• pp.82-93
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• 1999

Stroke is a serious disease despite recent improvement in medical and surgical treatment. Hence, identification of modifiable risk factors for stroke is important. This case-control study was done to demonstrate that relationship between smoking, alcohol consumption, obesity, perception of saltness and the incidence of stroke and to identify that smoking, alcohol consumption, obesity and perception of saltness, after adjusting for age, hypertension. A structured interview was carried out from April 15, 1996 to May 3, 1996 in Yonsei Medical Center. The study group consisted of 59 neurologically confirmed stroke patients as the study group and 59 non-stroke patients as controls. Analysis of the data was done by means of ${\chi}^2$-test and logistic regression analysis. The results were as follows. In the study group: 1) Hypertension in males had a 10.2 odds ratio (p<0.05), cardiovascular disease in females had a 11.3 odds ratio (p<0.05) and a farnily history of stroke in males had a 3.1 odds ratio (p<0.05). 2) Females smoking one or more cigarettes had a 8.3 odds ratio (p<0.1), but males had no direct relationship with odds ratio of 1.5 (non-significant). 3) Alcohol consumption in males had a 0.4 odds ratio, and in females had a 0.8 odds ratio. The odds ratio was decreased in alcohol consumption group (non-significant). 4) Males with more than 20 cigarettes pack-years history had a 2.5 odds ratio (p<0.05), more than 25 Body Mass Index had a 3.1 odds ratio (p<0.05) and more than 220 ml ethanol weekly consumption had a 1.5 odds ratio (non-significant). 5) Female smokers had a 8.3 odds ratio (p<0.1), drinkers a 0.8 odds ratio and more than 25 Body Mass Iidex, a 43.1 odds ratio (p<0.05). 6) Females without saltness perception from a 0.5% salt solution had a 6.8 odds ratio (non-significant). 7) By logistic regression analysis independent risk factors for stroke in males were found to be hypertention, age, and obesity. The study was limited because number of subjects was too small for practical implications. However, like as other results, this study suggest that people should be advised to control hypertension, and obesity since these carry a risk of stroke.

• The Korean Journal of Food And Nutrition
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• v.31 no.3
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• pp.425-434
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• 2018

Metabolic syndrome is a risk factor for cardiovascular and type 2 diabetes. This study was conducted to examine the relevance between nutrition intake, meal quality, and high-sensitivity C-reactive protein in Koreans with metabolic syndrome. The 2,536 subjects, aged 19~64, who participated in 2015 National Nutrition Survey were included in this study. The 24-hour recall method was employed to analyze nutrition intake and dietary quality. Subjects were grouped into either the non-metabolic syndrome group (n=1,938) or the metabolic syndrome group (n=598). Total males and females were divided into 3 groups according to the high-sensitivity C-reactive protein (hs-CRP) level to study its relationship to metabolic syndrome and its components, including odds ratio (OR) and confidence interval (CI). Results showed the homeostasis model assessment of insulin resistance (HOMA-IR) value was higher in the metabolic syndrome group (3.37) than non-metabolic syndrome group (1.57) (p<0.001). In the Index of Nutrition Quality, males in the non-metabolic syndrome group showed higher niacin (p<0.05) than males in metabolic syndrome group. Females in the non-metabolic syndrome group had higher vitamin $B_1$ (p<0.01), vitamin $B_2$ (p<0.001), niacin (p<0.05), calcium (p<0.001), and phosphate (p<0.01). Female in the high hs-CRP group showed high OR in blood glucose component (OR 2.488, 95% CI: 1.269~4.879) and metabolic syndrome risk (OR 2.856, 95% CI: 1.292~6.314). Females in the middle hs-CRP group had high triglycerides component (OR 2.956, 95% CI: 1.920~4.551), compared to the low hs-CRP group. The study showed females with higher hs-CRP had a higher risk of metabolic syndrome.

• The Journal of the Korea Contents Association
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• v.19 no.12
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• pp.279-288
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• 2019

The purpose of this study was to compare the health behaviors and health indices according to whether a percutaneous coronary intervention(PCI) was performed due to chest pain. This is a secondary data analysis study of nursing information questionnaires and electronic medical records of 247 chest pain patients in a hospital from January 2010 to December 2017. The participants were divided into non-PCI and PCI groups, and the health behaviors, blood pressure, and blood lipid levels were collected at the first hospital admission and re-admission. Collected data were analyzed using SPSS 24.0. As a result of the study, smoking and lipid levels were significantly healthier than the participants in PCI group during re-hospitalization. Non-PCI group had a high risk of smoking despite the high risk of coronary artery stenosis. It was found that continuous integrated management to promote health behavior is needed. The significance of this study was to identify the importance of health behavior in patients with the risk of cardiovascular disease.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.579-587
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• 2006

Background: Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have poor surgical outcome; prolonged pleural drainage, protein losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for prolonged pleural effusion drainage after the Fontan operation. Material and Method: A retrospective review of 96 consecutive patients who underwent the Extracardiac Fontan procedures (median age: 3.9 years) was performed. Fontan risk score (FRS) was calculated from 12 categorized preoperative anatomic and physiologic variables. PVC $(mm^2/m^2{\cdot}mmHg)$ was defined as pulmonary artery index $(mm^2/m^2)$ divided by total pulmonary resistance $(W.U{\cdot}/m^2)$ and pulmonary blood flow $(L/min/m^2)$ based on the electrical circuit analogue of the pulmonary circulation. Chest tube indwelling time was log-transformed (log indwelling time, LIT) to fit normal distribution, and the relationship between preoperative predictors and LIT was analyzed by multiple linear regression. Result: Preoperative PVC, chest tube indwelling time and LIT ranged from 6 to 94.8 $mm^2/mmHg/m^2$ (median: 24.8), 3 to 268 days (median: 20 days), and 1.1 to 5.6 (mean: 2.9, standard deviation: 0.8), respectively. FRS, PVC, cardiopulmonary bypass time (CPB) and central venous pressure at postoperative 12 hours were correlated with LIT by univariable analyses. By multiple linear regression, PVC (p=0.0018) and CPB (p=0.0024) independently predicted LIT, explaining 21.7% of the variation. The regression equation was LIT=2.74-0.0158 PVC+0.00658 CPB. Conclusion: Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.368-374
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• 2006

Purpose : The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. Methods : Thirty-eight obese children(14-16 years old of age, male, body mass index $29.40{\pm}3.18kg/m^2$) and forty-five age and sex-matched healthy control children(body mass index $18.43{\pm}1.01kg/m^2$) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flowmediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. Results : The obese children had significantly increased IMT($0.52{\pm}0.09mm$ vs $0.40{\pm}0.07mm$, P< 0.001) and markedly impaired FMD($7.35{\pm}7.78$ percent vs $20.34{\pm}16.81$ percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P<0.001) and reduced FMD(r=-0.414, P<0.001). Conclusion : We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.109-116
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• 1997

Purpose : Chronic renal failure is often accompanied by severe dyslipidemia, a known risk factor for cardiovascular disease. Lipoprotein(a) [Lp(a)] has recently been characterized as a risk factor for atherosclerosis and thrombosis. Cardiovascular disease is the leading cause of death in adult patients on dialysis. However, there are only limited data available concerning risk factors for atherosclerosis in uremic children. We have measured serum levels of lipids, lipoproteins, apolipoproteins and Lp(a) in uremic children with maintenance dialysis. Methods : Ten uremic children with hemodialysis (HD) and 14 with peritoneal dialysis (PD) in our dialysis unit were included in this study. The mean age of HD patients was $162{\pm}59$ months and the male to female ratio was 7:3. The mean age and sex ratio of PD patients were $123{\pm}63$ months and 6:8, respectively. The levels of cholesterol, triglyceride, lipoproteins, apolipoproteins and Lp(a) were measured from serum sampled after 14 hours of fasting. The normal control levels were cited from 2 articles presenting the normal blood lipid and lipoprotein levels of primary school and middle school children in Korea. Results : There was no difference in age, sex ratio, body mass index and duration of dialysis between the HD and the PD group. The serum concentration of the cholesterol, triglyceride and apolipoprotein B were significantly elevated in dialysis patients compared with normal subjects. The serum level of Lp(a) was significantly elevated in only PD group. The serum Lp(a) level was below 30 mg/dl in 13 and above 30 mg/dl in 11 patients. The serum albumin level was significantly decreased in high Lp(a) group than in low Lp(a) group. Conclusion : The uremic children receiving dialysis reveal abnormal serum lipid and lipoprotein profiles. These results suggest that they have a higher risk for coronary heart disease, although there has been no clinical evidence of coronary heart disease at present. A long-term follow-up study of these children to clarify the suggestion should be started now.

• Nutrition Research and Practice
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• v.5 no.4
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• pp.329-336
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• 2011

Obesity contributes to an increased risk for chronic diseases, including diabetes, cardiovascular diseases, and certain types of cancer. The prevalence of obesity has increased in Korea. We compared the clinical and dietary characteristics of obese adults (n = 30, 17 men and 13 women, mean age 29.9) to those with a normal weight (n = 15, 8 men and 7 women, mean age 26.5). We determined lipid profiles, fasting blood sugar (FBS), blood pressure, and serum free fatty acid (FFA). Dietary intake was estimated using a food frequency questionnaire (FFQ) and a 3-day dietary record. Exercise patterns and average alcohol intake were determined. The average body mass index was 28.3 kg/$m^2$ in the obese and 21.2 kg/$m^2$ in the normal weight groups. The obese group had significantly higher levels of total cholesterol, LDL cholesterol, and triglycerides, lower levels of HDL cholesterol, and higher blood pressures compared to the normal weight group. FBS was not significantly different between the two groups. The obese group had significantly more subjects with metabolic syndrome (26.7%) compared to the normal weight group (0%). Serum FFA levels tended to be higher in the obese (P = 0.087). No significant difference in caloric intake was observed between the two groups. No differences in carbohydrate, protein, or fat intake between two groups were observed from the FFQ. However, results from the 3-day dietary record showed that the percentage of energy from fat was significantly higher in the obese group. The frequency and amount of exercise did not differ between the two groups. Alcohol consumed per drinking episode was significantly higher in the obese group. These results confirm that excessive weight is associated with disturbances in lipid metabolism in these fairly young and otherwise healthy adults. Dietary factors, including higher fat intake and alcohol consumption, seem to be contributing to the obesity of these subjects.

• Journal of Acupuncture Research
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• v.19 no.3
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• pp.126-137
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• 2002

Objective : There is accumulating data that cardiovascular diseases, including hypertension, cerebro-vascular accident, coronary heart disease, relate to atherosclerotic changes. Increased serum levels of lipids could play a role in these circumstances. the SDPTG(the second derivative of photoplethysmogram waveform) is noninvasive methods for evaluating the pulse wave and is correlated with age and other risk factors for atherosclerosis. Methods : To study the effects of serum lipid levels on the SDPTG in the middle-age adults, data on serum lipid levels and the SDPTG were collected in 80 healthy middle age with varying serum lipid concentrations. Biological vascular age was assessed using the SDPTG. the SDPTG consists of an a, b, c, and d wave in systole and an e wave in diastole; an SDPTG aging index(Al) was calculated as (b-c-d-e)/a. Results : Serum triglyceride, total cholesterol, total lipid, phospholipid, HDL cholesterol levels were respectively and significantly correlated with SDPTG Al. Serum lipid levels and blood pressure are age-dependent and the SDPTG is blood pressure-dependent. Restricting analysis to age and blood pressure yield strong positive correlations between serum triglyceride, total lipid levels and SDPTG Al, but no correlations between serum total cholesterol, phospholipid levels and SDPTG Al. Conclusion : The results of this study suggest that preventive acupuncture programs or herbal medications for reducing serum lipid, especially triglyceride, levels in middle-age should include a evaluation of biological vascular aging with the second derivative of photoplethysmogram waveform.

• Journal of Nutrition and Health
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• v.34 no.4
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• pp.417-425
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• 2001

The purpose of this study was to confirm that regular physical exercise habit and calcium intake play a role in reducing the risk of cardiovascular disease, particularly to confirm that regular exercise is important in reducing serum lipid levels in postmenopausal women. Subjects were classified into regular exercise group(more than 3 times/wk, more than 30 min per exercise) and non-regular exercise group. A convenient frequency method was used to assess the nutritional intake of subjects. Anthropometric measurement such as body weight and height, and blood pressure were measured. There was no significant difference between non-regular exercise group and regular exercise group in energy intake and calcium intake. The total cholesterol and LDL-cholesterol concentrations in non-regular exercise group were significantly higher than those in regular exercise group. There were no significant correlations between age or weight with blood lipids and blood pressure in regular exercise group, while there were significant positive correlations between age or weight with blood lipids and blood pressure in non-regular exercise group. The levels of serum cholesterol, triglyceride, blood pressure and atherogenic index increased with age in non-regular exercise women. The blood pressure in low total Ca intake/plant Ca intake ratio group was significantly higher than that in high total Ca intake/plant Ca intake ratio group. There was a highly significant positive correlation between Ca intake and HDL-cholesterol in non-regular exercise women. And, there was a highly significant negative correlation between Ca intake and blood pressure in regular exercise women. The results suggest that increased habitual physical activity and calcium intake should be recommended by way of decreasing blood lipids and blood pressure in postmenopausal women. (Korean J Nutrition 34(4) : 417∼425, 2001)

• Journal of Nutrition and Health
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• v.42 no.8
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• pp.759-769
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• 2009

This study investigated the effects of the nutrition education and exercise program on body composition, dietary intakes and physical fitness in obese women. The subjects were 44 obese women (BMI${\geq}$ 25 kg/$m^2$) who had been participating in nutrition education (1 time/week) and exercise program (3 time/week) for 12 weeks. Nutrition education was focused on low energy, high protein and low carbohydrate diet to reduce the body weight and improve the diet quality. To evaluate the effectiveness of the program, daily nutrient intakes were assessed by 24-hour recall method. Body composition, blood lipid profiles and physical fitness test were assessed before and after the intervention. After the intervention, body weight, BMI, percent body fat, soft lean mass and waist/hip ratio were significantly decreased (p < 0.001). Fasting blood sucrose, total cholesterol, LDL-cholesterol and atherogenic index (AI) were significantly decreased (p < 0.001), while HDLcholesterol was significantly increased (p < 0.001). Energy adjusted protein, fiber, vitamin A, vitamin $B_2$, vitamin $B_6$, vitamin C, vitamin E, niacin and folate were significantly increased. After the intervention, the muscle endurance, muscle strength, agility, balance were significantly increased. The changes in obesity indices (body weight, BMI, percent body fat, waist-hip ratio) were correlated with the changes of the nutrient intakes, serum lipid profiles, physical fitness. These results show that nutrition education and exercise program was effective not only for weight reduction but also for the improvement of physical strength and cardiovascular disease risk factors in obese women.