• Title/Summary/Keyword: Confounding

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A Habitat Characteristic of Population of Khingan Fir(Abies Nephrolepis) in Seoraksan National Park Using Landscape Indices (경관지수를 활용한 설악산국립공원 아고산대 분비나무개체군의 서식지 특성)

  • Lee, Ho-young;Park, Hong-chul;Lee, Na-yeon;Lee, Ho
    • Korean Journal of Environment and Ecology
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    • v.34 no.2
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    • pp.170-178
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    • 2020
  • There are few landscape ecological analyses of Khingan fir (Abies nephrolepis) and other habitats of the sub-alpine zone in South Korea. In this study, we tried to quantitatively interpret and assess the habitat characteristics by analyzing 15 landscape indices according to the differences in tree layer coverage, in the Khingan fir habitat growing naturally in the sub-alpine zone of Seoraksan National Park. It was difficult to identify the tendency of landscape ecology to increase and decrease the tree layer coverage in the study site, which was the entire Khingan fir habitat in Seoraksan National Park. However, the Khingan fir habitat was found to be generally low in coverage, and population density as the tree layer coverage of less than 50 percent accounts for 85 percent of the total habitat. Moreover, the Khingan fir habitat in the 10 to 50 percent range was fragmented into a total of 286 patches, making it relatively less connected to the habitat. The total edge length and edge density, which could determine the edge effect of the main part according to the physical form, were the highest in the habitat of 26 to 50 percent coverage, indicating a relatively high impact from outside than habitats of other coverages. The shape with the tree layer coverage of between 10 and 50 percent was more complex even with patches of the same size, and it is believed that these characteristics make it more susceptible to habitat fragmentation and external confounding. We expect that the results of this study can be useful for time series analysis of spatial expansion or reduction of the Khingan fir habitat in Seoraksan National Park and provide the reference data for the morphological change and movement of patches and the connectivity and break-off between forests.

Prevalence and Predictors of Nocturia in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성수면무호흡증 환자의 야간뇨 유병률 및 관련인자)

  • Kang, Hyeon Hui;Lee, Jongmin;Lee, Sang Haak;Moon, Hwa Sik
    • Sleep Medicine and Psychophysiology
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    • v.21 no.1
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    • pp.14-20
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    • 2014
  • Objectives: Several studies suggest that nocturia may be related to obstructive sleep apnea syndrome (OSAS). The mechanism by which OSAS develops nocturia has not been determined. The present study aimed to determine the prevalence of nocturia among adults with OSAS and to identify factors that may be predictive in this regard. Methods: Retrospective review of clinical and polysomnographic data obtained from patients evaluated at the sleep clinics of the St. Paul's Hospital between 2009 and 2012. The urinary symptoms were assessed on the basis of the International Prostate Symptom Score (IPSS). Pathologic nocturia was defined as two or more urination events per night. OSAS was defined as apnea-hypopnea index (AHI) ${\geq}5$. A multivariate analysis using logistic regression was performed to examine the relationship between polysomnographic variables and the presence of pathologic nocturia, while controlling for confounding factor. Results: A total of 161 men >18 years of age (mean age $46.7{\pm}14.1$), who had been referred to a sleep laboratory, were included in the present study. Among these, 27 patients with primary snoring and 134 patients with obstructive sleep apnea were confirmed by polysomnography. Nocturia was found in 53 patients with OSAS (39.6%) and 8 patients with primary snoring (29.6%). The AHI was higher in patients with nocturia than in those without nocturia (p=0.001). OSAS patients with nocturia had higher arousal index (p=0.044), and lower nadir oxyhemoglobin saturation (p=0.001). Multiple regression analysis showed that age (${\beta}$=0.227, p=0.003), and AHI (${\beta}$=0.258, p=0.001) were associated with nocturia, and that the presence of pathologic nocturia was predicted by age (OR 1.04 ; p=0.004) and AHI (OR 1.02 ; p=0.001). Conclusion: Nocturia is common among patients with OSAS. The strongest predictors of nocturia are age and AHI in patients with OSAS.

Relationship between Sleep Disturbances and Cognitive Impairments in Older Adults with Depression (노인성 우울증 환자에서 수면 장애와 인지기능 저하의 관련성)

  • Lee, Hyuk Joo;Lee, Jung Suk;Kim, Tae;Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.21 no.1
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    • pp.5-13
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    • 2014
  • Objectives: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. Methods: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). Results: The control group ($GDS{\leq}9$) when compared with mild ($10{\leq}GDS{\leq}16$) and severe ($17{\leq}GDS$) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted $R^2$=35.6%, p<0.001) and BVRT-A score (adjusted $R^2$=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted $R^2$=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. Conclusion: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.

Comparison of dietary habits, perception and consumption frequency of fast foods between youths working part-time at fast food restaurants and other food-related services (패스트푸드점 아르바이트생과 그 외 음식관련 서비스업 아르바이트생의 식습관, 패스트푸드에 대한 인식 및 섭취빈도 비교)

  • Jo, Mi Yang;Hyun, Taisun
    • Journal of Nutrition and Health
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    • v.47 no.3
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    • pp.206-213
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    • 2014
  • Purpose: The purpose of the study was to compare dietary habits, perception, and consumption frequency of fast foods between part-time working youths at fast food restaurants and those at other food-related services. Methods: The study subjects were part-time working youths in 13 fast food restaurants (n = 118) and in 25 other places including bakeries, cafes, convenience stores, and other restaurants (n = 115) in Cheongju. Demographic characteristics, dietary habits, perception regarding fast foods, and consumption frequencies of food groups and fast foods were assessed using a self-administered questionnaire. Results: Female youths working at fast food restaurants had unhealthier dietary habits, such as meal skipping and night snacking compared to those working at other places. Consumption frequencies of fruits in males and beans/bean products in females working at fast food restaurants were significantly lower than those working at other places. Perception score on fast foods was significantly lower in males working at fast food restaurants than in males working at other places. However, the consumption frequencies of hamburgers, pizzas, and a total of six fast foods among both males and females working at fast food restaurants were significantly higher than those working at other places after adjusting for confounding variables including age, status, type of residence, allowance, alcohol, smoking, working hours, and hourly pay. Conclusion: Part-time working youths at fast food restaurants had worse dietary habits, such as meal skipping and night snacking, and consumed fast foods more frequently than those working at other places. Interventions for part-time working youths at fast food restaurants may be needed in order to reduce fast food consumption and increase the intake of fruits and vegetables.

Relationship between health behaviors and high level of low density lipoprotein-cholesterol applying cardiovascular risk factors among Korean adults: based on the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013 ~ 2015 (성인의 심혈관계 위험인자를 적용한 고저밀도지단백-콜레스테롤혈증과 건강행태의 관련성 연구 : 국민건강영양조사 제6기 (2013 ~ 2015) 자료 이용)

  • Cha, Bo-Kyoung
    • Journal of Nutrition and Health
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    • v.51 no.6
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    • pp.556-566
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    • 2018
  • Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

Trends in metabolic risk factors among patients with diabetes mellitus according to income levels: the Korea National Health and Nutrition Examination Surveys 1998~2014 (성인 당뇨병 환자의 소득수준에 따른 혈당, 당화혈색소, 혈압, 및 혈중지질 지표의 변화 추이 : 국민건강영양조사 1998~2014 분석 결과)

  • Cho, Sukyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.206-216
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    • 2019
  • Purpose: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. Methods: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. Results: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. Conclusion: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.

Associations of the eating alone behavior with nutrient intake, obesity and metabolic syndrome in middle-aged adults based on the 2013~2017 Korean National Health and Nutrition Examination Survey (중년 성인에서 혼자 식사하는 행동과 영양소 섭취, 비만 및 대사증후군 연관성 연구 : 2013~2017년 국민건강영양조사 자료를 이용하여)

  • Kim, Hyun Kyung;Chung, Jayong
    • Journal of Nutrition and Health
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    • v.52 no.5
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    • pp.435-448
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    • 2019
  • Purpose: This study examined the changes in the nutrient intake and the prevalences of obesity and metabolic syndrome according to the eating alone behavior in middle-aged men and women. Methods: The data from the 2013 ~ 2017 Korean National Health and Nutrition Examination Survey were analyzed. A total of 7,728 adults (3,404 male, 4,324 female) aged 40 ~ 64 years old were included. The subjects were classified into three groups according to the number of times eating alone per day (0, 1 ~ 2, and 3 times/day). Dietary data were collected by a 1-day 24-h recall. The nutrient intakes were compared among the three groups. Survey logistic regression analyses were conducted to examine the association of the eating alone behavior with obesity and metabolic syndrome, adjusting for the related confounding variables. Results: In men, eating alone was associated significantly with a lower intake of potassium (p-for-trend = 0.048) and lower intake of calories from protein (p-for-trend = 0.04). In women, the proportion of subjects consuming energy less than 75% of the estimated energy requirement (p = 0.001) and less than the estimated adequate requirement of riboflavin (p < 0.001) differed significantly according to the eating alone behavior. The eating alone behavior was positively associated with an increased risk of developing metabolic syndrome (p-for-trend = 0.033), increased blood pressure (p-for-trend < 0.001), and increased waist circumference (p-for-trend = 0.004). On the other hand, in women, however, the eating alone behavior was associated with a decreased risks of developing obesity (p-for-trend = 0.02). No association was found between the eating alone behavior and the risk of metabolic syndrome in women. Conclusion: These results suggest that the eating alone behavior is a risk factor for the development of metabolic syndrome in middle-aged Korean men.

Correlation between fish consumption and the risk of mild cognitive impairment in the elderly living in rural areas (농촌지역에 거주하는 노인의 생선 섭취량과 인지기능저하 위험도 간의 상관성)

  • Yu, Areum;Kim, Jihye;Choi, Bo Youl;Kim, Mi Kyung;Yang, Yoonkyoung;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.54 no.2
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    • pp.139-151
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    • 2021
  • Purpose: This study examines the correlation between fish consumption and the risk of mild cognitive impairment in the elderly living in rural areas. Methods: The Yangpyeong cohort data collected from Yangpyeong in July 2009 and August 2010 was used as the data set. Adults greater than or equal to 60 years who have completed the Korean version of the Mini-Mental State Examination (MMSE-KC) were selected for the study. After excluding participants with less than 500 kcal of energy intake (n = 2), a total of 806 adults were enrolled as the final subjects. Cognitive function was assessed using the MMSE-KC, and dietary intake was collected using the quantitative food frequency questionnaire comprising 106 foods or food groups. Results: The educational level, proportion of people who exercise, fruits and vegetable intake, and energy intake, tended to increase with fish intake among men, while increasing age resulted in decreased fish consumption. Among women, the educational level, proportion of subjects who exercise, proportion of subjects currently taking dietary supplements, fruits and vegetable intake, and energy intake, tended to increase with fish consumption, whereas increasing age showed decreasing fish consumption. Increased fish intake resulted in a higher MMSE-KC score after adjusting for the confounding variables in women (p for trend = 0.016), but no significant trend was observed between fish intake and MMSE-KC score in men. Fish intake was inversely related to the risk of mild cognitive impairment after adjusting for covariates in women (Q1 vs. Q4; odds ratio, 0.46 [0.23-0.90]; p for trend = 0.009). Conclusion: This study determined that increased fish consumption is correlated with reduced risk of mild cognitive impairment in the female elderly. Further longitudinal studies with larger samples are required to determine a causal relationship between fish intake and cognitive function.

Nutritional status and metabolic syndrome risk according to the dietary pattern of adult single-person household, based on the Korea National Health and Nutrition Examination Survey (국민건강영양조사 자료에 의한 식이 패턴별 1인 가구의 영양 상태와 대사증후군 위험도)

  • Keum, Yu Been;Yu, Qi Ming;Seo, Jung-Sook
    • Journal of Nutrition and Health
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    • v.54 no.1
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    • pp.23-38
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    • 2021
  • Purpose: This study was undertaken to evaluate the health, nutritional status and metabolic syndrome risk according to the dietary pattern of adult single-person households, using information obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data were collected from the 2013-2016 KNHANES, of adults aged 19-64 years, belonging to single-person households. Based on cluster analysis, the dietary patterns of subjects were classified into three groups. The dietary behavior factors, health-related factors, nutritional status, and prevalence of metabolic syndrome obtained from KNHANES questionnaires were compared according to the individual dietary pattern. The nutrient intake data of the subjects were calculated using the semi-food frequency questionnaire. Moreover, blood and physical measurement data of the subjects were analyzed to obtain the prevalence of metabolic syndromes. Results: The major dietary intakes of subjects were classified as 'Rice and kimchi', 'Mixed', and 'Milk·dairy products and fruits' patterns. Characteristics of subjects based on their dietary pattern, gender, age, and education level were significantly different. The 'Milk and fruits' pattern showed low frequency of skipping breakfast and eating out, and had higher intake of dietary supplements. Frequency of alcohol intake and smoking rates were highest in the 'Mixed' pattern. Maximum nutrient intake of fat, vitamin A, riboflavin, vitamin C, niacin, calcium, phosphorus, and potassium was obtained in the 'Milk·dairy products and fruits' pattern. According to dietary patterns adjusted for age and gender, the risk of metabolic syndrome was 0.380 times lower in the 'Milk·dairy products and fruit' pattern than in the 'Rice and kimchi' pattern. However, when adjusted for other confounding factors, no significant difference was obtained between dietary patterns for metabolic syndrome risk. Conclusion: These results indicate that the health and nutritional status of a single-person household is possibly affected by the dietary intake of subjects.

Relationship of Carbohydrate and Fat Intake with Metabolic Syndrome in Korean Women: The Korea National Health and Nutrition Examination Survey (2007-2016) (한국 여성의 탄수화물/지질 섭취가 대사증후군에 미치는 영향: 국민건강영양조사(2007-2016)를 중심으로)

  • Lee, Jaesang;Kim, Yookyung;Shin, Woo-Kyoung
    • Journal of Korean Home Economics Education Association
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    • v.35 no.1
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    • pp.1-14
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    • 2023
  • The objective of the study was to examine the associations of dietary carbohydrate and fat intake with the prevalence of metabolic syndrome in Korean women. A cross-sectional study was employed based on data from the Korea National Health and Nutrition Examination (2007-2016). A total of 22,850 women aged 19 to 69 years were studied after excluding responses from pregnant or lactating women and those with missing metabolic values. Dietary intake data were collected with a 24-hour recall method. Dietary carbohydrate and fat intakes were divided into quintiles. After controlling for confounding variables, a multivariable logistic regression and general linear model were used. The findings indicated that HDL cholesterol levels were lower (p for trend<0.01), while triglyceride levels (p for trend=0.04), waist circumference (p for trend<0.01), and systolic blood pressure (p for trend<0.01) were higher among participants in the highest quintile of carbohydrate intake compared to those in the lowest quintile. Participants in the highest quintile of fat intake had lower waist circumference (p for trend=0.02), triglyceride level (p for trend<0.01), and systolic blood pressure (p for trend<0.01), while higher HDL cholesterol level (p for trend<0.01) compared to those in the lowest fat intake quintile. Metabolic syndrome was more likely to be present in the highest quintile of carbohydrates intake than in the lowest quintile (5th quintile vs. 1st quintile, OR: 1.32; 95% CI: 1.11 to 1.57). However, metabolic syndrome was less likely to be present in the highest quintile of fat intake than in the lowest quintile (5th quintile vs. 1st quintile, OR: 0.73; 95% CI: 0.61 to 0.86). This study revealed that high dietary carbohydrate intake and low dietary fat intake were associated with metabolic syndrome in Korean women.