• 지질동맥경화학회지
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• 제7권2호
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• pp.110-121
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• 2018

Objective: We developed a new equation for predicting coronary heart disease (CHD) risk in Korean diabetic patients using a hospital-based cohort and compared it with a UK Prospective Diabetes Study (UKPDS) risk engine. Methods: By considering patients with type 2 diabetes aged ${\geq}30years$ visiting the diabetic center in Boramae hospital in 2006, we developed a multivariable equation for predicting CHD events using the Cox proportional hazard model. Those with CHD were excluded. The predictability of CHD events over 6 years was evaluated using area under the receiver operating characteristic (AUROC) curves, which were compared using the DeLong test. Results: A total of 732 participants (304 males and 428 females; mean age, $60{\pm}10years$; mean duration of diabetes, $10{\pm}7years$) were followed up for 76 months (range, 1-99 month). During the study period, 48 patients (6.6%) experienced CHD events. The AUROC of the proposed equation for predicting 6-year CHD events was 0.721 (95% confidence interval [CI], 0.641-0.800), which is significantly larger than that of the UKPDS risk engine (0.578; 95% CI, 0.482-0.675; p from DeLong test=0.001). Among the subjects with <5% of risk based on the proposed equation, 30.6% (121 out of 396) were classified as ${\geq}10%$ of risk based on the UKPDS risk engine, and their event rate was only 3.3% over 6 years. Conclusion: The UKPDS risk engine overestimated CHD risk in type 2 diabetic patients in this cohort, and the proposed equation has superior predictability for CHD risk compared to the UKPDS risk engine.

• Journal of Preventive Medicine and Public Health
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• 제51권6호
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• pp.298-309
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• 2018

Objectives: The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases. Methods: We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model. Results: Compared to normal levels (SBP <120 or DBP <90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85-89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ${\geq}160mmHg$) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ${\geq}160mmHg$) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively). Conclusions: An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.

• 한국학교보건학회지
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• 제14권2호
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• pp.269-277
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• 2001

This study examined the health conditions of schoolteachers in terms of the prevalence rate and risk factors for liver disease. A cohort design was conducted for 21,319 teachers who were born from 1953 to 1957. The cohort was constructed for teachers who had no disease history such as liver disease, hypertension, cerebral vascular disease, heart disease, diabetes mellitus and cancer, and had 'normal' results from liver disease examinations in 1998. They were followed up from 1998 to 2000. SAS 6.12 was used for the data analysis. The results were as follows; (1) Prevalence rates of liver disease per 1,000 people in 1998 were 43.0. (2) The 2-year cumulative incidence of liver disease was 433/16,103(26.9/1000 persons). (3) Factors such as sex, age, school type(private or public), drinking, smoking, exercise, BMI, weight gain, fasting-blood sugar levels and total cholesterol levels were statistically significant. The significant risk factors of liver disease be identified from the multiple logistic regression analysis were age, sex(male), drinking, smoking, BMI, weight gain, fasting-blood sugar levels, and total cholesterol levels.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.526-537
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• 1999

Objectives : It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. Methods : Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years' follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. Results : In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of $\geq$ 110 mg/dl compared with $\leq$ 80 mg/dl, Hazard Ratio[HR]:15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI $\geq$ 25.3 compared with $\leq$ 21.3) was 7.19(95% CI=3,75-13.8); of weight change during middle life(>10kg compared with $\leq$ 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper fertile compared with lower fertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). Conclusion : The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.

• Childhood Kidney Diseases
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• 제27권1호
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• pp.34-39
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• 2023

Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.256-257
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• 2002

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.313-314
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• 1998

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.65-66
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• 1995

• 대한지리학회지
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• 제47권1호
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• pp.98-120
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• 2012

본 연구의 주된 목적은 다지역 코호트-요인법을 적용하여 우리나라의 시도별 장래 인구 추계를 실행하는 것이다. 마르코프 연쇄 모델과 Rogers의 다지역 인구 추계 모델에 대한 검토를 바탕으로 실행 가능한 다지역 코호트-요인법의 프레임워크를 설정하였다. 이 프레임워크를 우리나라 데이터에 적용하여 2005~2030년에 대한 5년 단위의 시도별 인구 추계를 실행하였으며, 그 결과에 대한 타당성을 검토하였다. 중요한 연구 결과는 다음과 같다. 첫째, 본 연구의 추계치를 기존 통계청의 추계치 및 경험 데이터와 비교해 본 결과 제안된 추계 기법의 방법론적 타당성이 매우 높은 것으로 드러났다. 둘째, 본 연구의 방법론은 미래의 지역간 인구이동 매트릭스를 산출한다는 측면에서 추계 결과의 유용성이 매우 높은 것으로 판단되었다. 미래의 지역간 인구이동에 대한 정보는 지역별 인구변동을 이해하고 실질적인 정책 대안을 제시하는데 핵심적인 역할을 할 수 있다. 본 연구는 국가 전체의 인구변동 보다는 인구 이동을 통해 상호 연결되어 있는 하위 지역 인구들의 진화 과정을 더욱 강조하는 다지역 관점의 중요성을 예증하고 있다.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.507-513
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• 2022

Objective : The goal of the following statewide age and gender-coordinated cohort study in Korea is to find out if there is a link between acute myocardial infarction (AMI) and Parkinson's disease (PD). Methods : Utilizing the National Health Insurance Sharing Service cohort, patient data were collected. Six thousand four hundred seventy-five individuals with PD were distinguished by utilizing the International Classification of Diseases 10 code G20 and have enrolled in the PD group. The number of participants decreased to 5259 after excluding 1039 patients who were hospitalized less than one time or who visited an outpatient clinic less than twice. Then, 26295 individuals were selected as part of the control group after case control matching was conducted through 1 : 5 age- and gender-coordinated matching. The Cox proportional hazard regression analysis and Kaplan-Meier method were utilized to analyze the likelihood of AMI in PD. Results : After controlling for age and gender, the hazard ratio of AMI in the PD group was 3.603 (95% confidence interval [CI], 2.837-4.577). After that, the following hazard ratio of AMI in the PD group was modified against for co-morbid medical disorders, resulting in 3.551 (95% CI, 2.795-4.511). According to a subgroup analysis, in males and females aged <65 and aged ≥65 and in the non-diabetes and diabetes, hypertension and non-hypertension, dyslipidemia and non-dyslipidemia subgroups, the AMI incidence rates were dramatically higher in the PD group compared to that of the control. Conclusion : Individuals with PD have a greater chance of AMI, according to this cross-national study.