• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.158-163
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• 1994

Slightly elevated urinary albumin excretion rate (microalhuminuria) is a marker of early diabectic nephropathy, but it is unclear if the established definition of microalbuminuria ($20-200{\mu}g/min$) is correct for children and adolescents. We investigated th.: albumin excretion rate, albumin/creatinine ratio and urinary albumin concentration in 150 healthy schoolchildren and adolescents to (a) obtain a reterence value for albumin excretion rate, (b) relate albumin excretion to pubertal stages and (c) evaluate albumin/creatinine ratio and morning albumin concentration as screening methods for elevated albumin excretion rate. Albumin concentration was measured by immunoturbidimetry in timed overnight urine samples. The albumin excretion showed a skewed distribution (geometric mean $3.2{\mu}g/min$, 95 percentile ($15.1{\mu}g/min$). In girls. a peak in the albumin excretion rate was found at the pubertal stage 4 (Tanner) and in boys at stage 5. Albumin/creatinine ratio of 2.5 mg/mmol as a screening level for elevated albumin excretion ($15{\mu}g/min$) showed a high positive (0.88) and negative (0.99) predictive value.

• Journal of Nutrition and Health
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• v.35 no.9
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• pp.970-981
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• 2002

To assess riboflavin status by dietary intake and urinary excretion of preschool children in Busan and to evaluate the relationship of intakes of food and nutrient with urinary riboflavin excretion, riboflavin food frequencies of 40 common foods affecting intakes of riboflavin by food fequency method, nutrient intake by 24hr recall and 24hr urinary riboflavin excretion were measured with 97 preschool children. The mean riboflavin intake was 0.90 mg and above RDA. Dairy group was the primary source of riboflavin intake and provided 44.8% of the total daily riboflavin intake. The mean urinary riboflavin excretion and riboflavin excretion per gram of creatinine were 395.21$\mu\textrm{g}$ and 2110.41$\mu\textrm{g}$ respectively, The mean riboflavin intake (p<0.01, p<0.01), riboflavin density (p <0.001, p<0.001) and urinary riboflavin excretion per gram of creatinine (p<0.05, p<0.05) were significantly low with the two patterns of food group intake where dairy group was omitted (GMVFDS = 111101, consuming no dairy group and GMVFDS=l11001, consuming no fruit and dairy groups). On the basis of urinary riboflavin excretion per gram of creatinine, 14.3% of subjects in the group aged 1 to 3 and 18.2% of subjects in the group aged 4 to 6 were at risk of deficiency respectively. The urinary riboflavin excretion per gram of creatinine showed positive significant correlations with usual intakes of riboflavin from food groups of dairy (p<0.05), meat (p<0.05) and animal (p<0.05). So nutritional education is needed in order to consume dairy food group daily and to increase usual intake of animal food group including meat.(Korean J Nutrition 35(9) : 970~981, 2002)

• Journal of Nutrition and Health
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• v.36 no.9
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• pp.950-959
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• 2003

To assess zinc status by dietary intake and urinary excretion of preschool children in Busan and to evaluate the relationship of intakes of food and nutrient with urinary zinc excretion, zinc food frequencies of 40 common foods affecting intakes of zinc by food fequency method, nutrient intake by 24hr recall and 24hr urinary zinc excretion were measured with 97 preschool children. The mean zinc intake was 4.29 mg and 43.0% of RDA. The mean zinc intake per 1,000 kcal was 3.09 mg.97.9％ of subjects had zinc intake less than 75％ of RDA. Grains food group was the primary source of zinc intake and supplied 38.9% of the total daily zinc intake. Altogether, plant food products supplied 49.7% of zinc intake. The mean urinary zinc excretion and zinc excretion per gram of creatinine were 0.19 mg and 1.00 mg respectively. The urinary zinc excretion showed positive significant correlations with height and weight (p < 0.05, p < 0.05) , urine volume and urinary creatinine excretion (p < 0.05, p < 0.001) , urinary zinc excretion per creatinine (p < 0.001) , urinary zinc excretion per weight (p < 0.001) , intakes of energy and carbohydrate (p < 0.05, p < 0.01) and usual intake of zinc from eggs food group (p < 0.05) . In conclusion, these results show that the zinc intake of preschool children is low and that sources of dietary zinc are mainly plant foods, suggesting low bioavailability. So nutritional education is needed in order to inc-rease usual intake of animal food group. Interpretation of urinary zinc excretion data is complicated by current uncertainty about "normal" zinc level at this age group. Further studies are needed to obtain extensive data on urinary zinc excretion for this age group.age group.

• Journal of Nutrition and Health
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• v.34 no.7
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• pp.786-796
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• 2001

To assess calcium and sodium and urinary excretion of preschool children in Busan and to evaluate the relationship of intakes of food and nutrient with urinary calcium excretion, calcium and sodium food frequencies of 25 common foods affecting intakes of calcium and sodium per week, nutrient intake by 24hr recall and 24hr urinary calcium and sodium excretion were measured with 97 preschool children. The mean calcium intake was 436.11mg and below RDA. The mean sodium intake was 1890.11mg. The mean urinary calcium and sodium excretion were 42.88mg and 735.25mg respectivery. The mean urinary calcium/creatinine ratio was 0.20. The urinary calcium excretion showed positive significant correlations with weight, intake frequency of pizza consumed per week and urinary sodium excretion (p<0.05, p<0.05, p<0.001). The urinary calcium excretion per milligram of creatinine showed positive significant correlations with intake frequencies of pizza and common squid consumed per week(p<0.01, p<0.05) and negative correlation with intake frequencies of pizza and common squid consumed per week(p<0.01, p<0.05) and negative correlation with age(p<0.05). No significant relations were found between urinary calcium and intakes of calcium, protein and phosphorus. Urinary sodium was found to be the most important determinant of urinary calcium excretion. Intake frequency of pizza consumed per week was found to be the most important determinant of urinary calcium excretion per milligram of creatinine. Based on the results, urinary calcium excretion was related to intake frequency of pizza consumed per week and urinary sodium excretion. Low calcium intake and increase of calcium loss in the urine potentiated by sodium intake during growth may reduce peak bone mass. So nutritional education is needed in order to increase calcium intake and decrease sodium intake, especially from food like pizza.

• Journal of Nutrition and Health
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• v.5 no.4
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• pp.151-159
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• 1972

Protein malnutrition of children is one of the most serious nutritional deficiencies in developing country. Urea nitrogen excretion in ureotelic animals is the function most sensitive to dietary protein. The 24 hours excretion of creatinine in the urine of a given subject is remarkably constant from day to day. The creatinine excretion of different individuals of the same age and sex is also quite constant. Low ratios of urinary urea to creatinine are found children low protein intake. The foregiving world-wide investigations indicate that the urea nitrogen/creatinine ratios seems to be a good biochemical indicator to distinguish among group with different levels of protein intake. The purpose of this study is to evluate an indicator of protein intake on the elementary school children ranged from 6 to 8 years of age living in rural and urban areas. Each child measured for height and weight of body. weight measured by means of a plate from scale and height by a vertical measuring rod. Biochemical test were taken from a finger-tip and urine. Hemoglobin level in the blood was measured by cyanomethemoglobin method. From the urine samples, urea nitrogen and urea creatinie were determined by Folin-Wu method and: calculate the ratio. The following result were obtained: 1) Mean of the body weight and height in urban children(Seoul) was higher and heavier than rural children(Kyunggi, Kangwon). And 12% of boys, 18% of girls in Kyunggi and 25% of boys, 22% of girls in Kangwon area weight less than 80% of Korean Physical Standard weight level. 2) The mean hemoglobin values of boys and girls in Seoul are children were 13. 3g/100ml, 13.1g/100ml and the mean of hemoglobin values in Kyunggi 12.9g/100ml of boys, 12.4g/100ml of girls, and 12.4g/100ml of boys, 12.9g/100ml of girls in Kangwon children. It is found that 22% to 24% children inrural area (Kyunggi, Kangwon) had hemoglobin level less than 12g/100ml which means anemia. 3) The mean of hematocrit level of Seoul, boys and girls children were 33.5%, 34.1% and 33.4%, 33.1%, in Kyunggi area and 33.1%, 32.9% in Kangwon area. 4) Urea nitrogen/creatinine ratios in Seoul children were 9. 0, 10. 0 of boys and girls, the ratio were 8.2, 8.0 in Kyunggi boys and girls children, and 7.5 and 7.4 in Kangwon boys, girls children. Low-income rural and upper-income urban background large differences between two groups in the urea nitrogen/creatinine ratio(Seoul: Kangwon in male, female children. p<0.05, p<0.001). The urea nitrogen/creatinine ratio definetly seems to be a good indicator of the quantity of the protein intake. However, whether or not it is an indicator of the quality of the ingested protein ramains to be seen.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.1-5
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• 2000

Purpose: The plcr of spot urine has been uised to predict the timed urine protein excretion. Although this method reduces errors caused by variations in urine volume, it is relatively thconvenient and expensive. Recently, a more rapid and less expensive screening method with specific gravity(SG) has been reported, and we have examined whether estimated-creatinine(Cr-est) with urine 5G could be used in place of urine creatinine to predict 24-hour collected urine protein excretion in children. Methods: We had retrospectively analyzed protein, creatinine and urine SG in randomized spot urine samples of 147 patients from March 1998 till June 1998 in Korea university Guro hospital and compared the urinary protein creatinine ratio(P/Cr) with the protein estimated-creatinine ratio(P/Cr-est). We compared the correlation of urinary creatinine vs-urine 5G with the timed urine pretein excretion. Results: 1) urine SG accurately estimated urine creatinine concentration (r=0.407, P<0.001, Cr=SG x 4485.82-4482.87). 2) P/Cr correlated with urine protein excretion measured in a 24-hour urine collection (r=0.771, P<0.001, 24-hour collected urine protein : 0.338 x (P/Cr) 4+667.885). 3) P/Cr-est correlated with a 24-hour collected urine protein (r=0.723, P<0.001, 24-hour collected urine protein =0.354 x (P/Cr-est)+726.044), Conclusions: These results suggest that P/Cr-est with urine SG could be useful method for screening proteinuria in children.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.150-156
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• 2008

Purpose : Many results have reported a correlation between the spot urine protein/creatinine ratio(P/C ratio) and 24-hour urinary protein(24UP) amount. This study was designed to evaluated correlation between 24UP amounts and P/C ratio in children and to find the factors that affect this correlation. Methods : 210 patients who visited the Department of Pediatrics in Busan Paik Hospital from september 2003 to december 2007 were included in this study. All the patients were divided into I, II, III/A, B, C group[I:24UP(mg/$m^2$/day)]<100, II: 100$\leq$24UP<1,000, III: 24UP$\geq$1,000, A: Cr excretion(mg/kg)<15, B: 15$\leq$Cr excretion<25, C: Cr excretion$\geq$25)]. Pearson correlation analysis was performed between 24UP and P/C ratio to evaluate the relationship. We defined fractional difference between 24UP and P/C ratio, and then performed multiple regression analysis. Results : There was a strong positive linear correlation between 24UP and P/C ratio in all patients, and the correlation was also good in each group. The factors affecting accurate quantitation of proteinuria using spot urine P/C ratio was creatinine excretion. Conclusion : Spot urine P/C ratio is a useful test to predict proteinuria roughly. Therefore, we expect that urine P/C ratio can be used as parameter instead of 24UP, if we set cutoff value of P/C ratio considered to creatinine excretion according to age and sex in large pediatric population.

• Childhood Kidney Diseases
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• v.26 no.2
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• pp.69-73
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• 2022

Proteinuria is an early hallmark of kidney disease and a major risk factor for systemic cardiovascular diseases. There are several methods to measure proteinuria, such as the urine dipstick test, 24-hour urinary protein excretion method, and spot urine for the protein-to-creatinine ratio. The urine dipstick test is simple but inaccurate. The 24-hour urinary protein excretion method is the gold standard; however, it is cumbersome, especially in children. Spot urine for the protein-to-creatinine ratio is simple and accurate, but has limitations. Specific urinary protein such as albumin can be measured instead of the total protein content. Tests should be avoided in situations that cause transient proteinuria or false-positive results. It should be performed correctly, and its limitations should be recognized and interpreted accurately.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.6-10
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• 2000

Purpose: To evaluate whether the urinary creatinine concentration is a reliable reference value to standardize urinary solute excretion in a spot urine sample during the first week of life. Methods: Spontaneously voided urine specimens were obtained in 49 healthy full term neonates, and in 33 healthy older children with the median ages of $5.7{\pm}4.3$ years, two urine samples were available with an interval of 2 to 3 days. Urine creatinine concentration was determined by the Jaffe test(CoBAS, Integra, Roche, Swiss). Uurine osmolality was determined by the freezing point depression test(Multi-osmette, Precision, USA). Results: Mean urinary creatinine and osmolality values of the first urine samples were not significantly different with the second urine samples in each group. Mean urinary creatinine and osmolality values in neonates were significantly different from the older children of the each urine sample(P<0.01). In neonates, the mean of the urinary oreatinine/osmolality ratios was higher than that of the older children(P<0.01). The urinary creatinine and the creatinine/osmolality values of the first urine samples were closely correlated with those of the second samples in both two groups(P<0.001). Conclusion: The urinary creatinine concentration during the first day of life is relatively stable, even when corrected for urinary osmolality The urinary creatinine and the urinary creatinine/osmolality ratio, therefore, can be used to standardize the urinary excretion of solutes in the neonate.

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.286-288
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• 2005

This study was conducted to compare the fluoride concentrations in urine of preschool children aged 3${\sim}$6 years between residing in community water fluoridation area(Kwangju City) and non-fluoridation area(Sungnam City). The acid-diffusible fluoride in the urine and drinking water was isolated by the acid-diffusion technique and measured with a fluoride electrode. The mean daily fluoride excretion to urine of children residing in Kwangju and Sungnam were $1.27{\pm}0.75mgF^-$/g creatinine and $0.87{\pm}47 mgF^-$/g creatinine, respectively. It is concluded from this investigation that the $F^-$concentration in urine sample of kindergarten and drinking water of children living in Kwanju(fluoridated areas) were significantly higher than that of children living in Sungnam(non-fluoridated areas).