• Nutrition Research and Practice
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• v.15 no.5
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• pp.604-612
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• 2021

BACKGROUND/OBJECTIVES: We aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently. SUBJECTS/METHODS: We analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates. RESULTS: We observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5-18.3), 21.0 (20.6-21.5), 22.1 (21.5-22.8), and 25.1 (24.2-26.1) in men and 29.7 (29.4-30.0), 32.0 (31.6-32.3), 32.9 (32.4-33.4), and 34.7 (33.2-36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m²) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51-7.59), 7.62 (7.56-7.68), 7.65 (7.56-7.74), and 7.22 (7.04-7.41) in men and 5.83 (5.80-5.85), 5.96 (5.92-6.00), 6.03 (5.96-6.10), and 5.88 (5.73-6.03). CONCLUSIONS: There was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1231-1244
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• 2020

Objective: This study was conducted to report the glucose-lowering effect and safety of herbal extracts in patients with type 2 diabetes mellitus. Methods: We investigated 21 patients with type 2 diabetes mellitus who were administered Daeshiho-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san at Kyung-Hee University Korean Medical Hospital from 2014 to 2019. The hypoglycemic effect of the herbal extracts was assessed by comparing blood glucose levels, including fasting blood sugar (FBS) and 2-hour postprandial glucose (PP2) levels. For safety assessment, the effects of herbal extracts on liver and kidney function were analyzed by liver function tests, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT), and kidney function tests, including blood urea nitrogen (BUN) and creatinine (Cr). Patients were stratified according to their glycated hemoglobin (<6.5 or >6.5) levels and the kind of herbal extract used for treatment. Results: After administration of herbal extracts, FBS and PP2 significantly decreased to 20.24 mg/dL and 35.0 mg/dL respectively. Subgroup analysis revealed that, regardless of the glycated hemoglobin level, FBS and PP2 were significantly reduced in both groups. The safety profile showed no significant difference before and after taking herbal extracts. Conclusions: Daeshigo-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san may show the further glucose-lowering effects on patients with type 2 diabetes mellitus who have already treated with anti-hyperglycemic agents.

• 한국사회정책
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• v.23 no.2
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• pp.173-200
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• 2016

This study has two objectives. First, this study examines subjective well-being among elders that operationalize life satisfaction and aging anxiety, guided by life-course perspective. Second, it examines the relationship between subjective well-being and age-friendly environment factor structure among age-cohort groups. This study employs the stratified sampling method from 4,000 Seoul citizens. Main findings from the multivariate regression analyses include: (1) as age increases, aging anxiety levels appeared to be higher, while decreasing the life satisfaction. (2) a substantially larger variance of life satisfaction and aging anxiety was accounted for by demographic variables and age-friendly environments across age-cohort groups. (3) the influence of age-friendly environment factors such as neighborhood problems, accessibility to social activities, social services and parks on subjective well-being was different across age-cohort groups. This study discusses the policy and practical implications of the results.

• Health Policy and Management
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• v.31 no.1
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• pp.74-90
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• 2021

Background: It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex. Methods: Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016-2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex. Results: The proportion of people having 'not good' self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having 'not good' self-rated health was high in people having 'poor' (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34-12.03) self-rated oral health status and in those having 'fair' (OR, 4.03; 95% CI, 1.68-9.70) in comparison with those having 'good' self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having 'no discomfort' speaking difficulty, the risk of having 'not good' self-rated health was high in people having 'not bad' (OR, 1.60; 95% CI, 1.14-2.24) and 'discomfort' (OR, 1.79; 95% CI, 1.30-2.47) speaking difficulty. The covariates significantly associated with the risk of having 'not good' self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women. Conclusion: Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way.

• Journal of Gastric Cancer
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• v.22 no.2
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• pp.120-134
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• 2022

Purpose: This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods: This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as any-cause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results: The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions: Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.134-146
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• 2022

BACKGROUND/OBJECTIVES: Accumulating evidence has shown the beneficial effects of isoflavone on health. There is limited information on the usual isoflavone intake for Koreans. This study examined the usual intake of total isoflavone and its major food sources in Koreans according to age and gender. SUBJECTS/METHODS: The dietary intake data of 21,271 participants aged 1 yrs and older from the Korea National Health and Nutrition Examination Survey (KNHANES) VII 2016-2018 were analyzed. The average isoflavone intake was estimated based on the 24-h dietary recall data in KNHANES and the isoflavone database from the Korea Rural Development Administration (RDA) and literatures. The usual isoflavone intake was estimated by applying the ratio of within- and between-participant variance estimated from the 2009 KNHANES data to the 7th KNHANES (2016-2018) data. The variance of the isoflavone intake was calculated using MIXTRAN macro with intake data for two days in the 2009 KNHANES. Complex sample analysis with stratified variables and integrated weights was conducted. RESULTS: The mean total isoflavone intake in the Korean population aged 1 yrs and older (n = 21,271) was 139.27 mg/d, which was higher than the usual intake of 47.44mg/d. Legumes were a major contributing food group (91%), with arrowroot being a major individual contributor to the isoflavone intake (67.2%), followed by 21.3% of soybean, 5.4% of bean sprouts, and 2.1% of tofu. The usual isoflavone intake was highest in the participants aged 50 to 64 yrs old and increased with age until 50 to 64 yrs and then decreased with further increases in age. The usual isoflavone intake of participants aged 65 yrs and older was higher for men than for women, showing gender differences. CONCLUSIONS: The usual dietary intake of isoflavone varied according to age and gender in the Korean population. This study showed that the usual isoflavone intake was lower than the average isoflavone intake. The difference between percentiles of the usual isoflavone intake was similarly smaller than the average intake. An estimation of average intake can be hindered by the occasional consumption of foods high in isoflavones, suggesting that the usual intake estimation method can be more appropriate. Further research will be needed to establish isoflavone dietary guidelines regarding the effects of isoflavone intake on health outcomes.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.120-134
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• 2023

Purpose: We investigated whether repeated irradiation with light-emitting diodes (LEDs) at a combination of 470 nm and 525 nm could suppress the progression of experimental periodontitis. Methods: A experimental periodontitis model was established in the second, third, and fourth premolars of the mandible in beagle dogs for 2 months. The spontaneous progression of periodontitis was monitored under the specified treatment regimen for 3 months. During this period, the animals were subjected to treatments of either plaque control only (control) or plaque control with LED application (test) at 2-week intervals. The clinical parameters included the probing pocket depth (PPD), gingival recession (GR), and the clinical attachment level (CAL). Histomorphometric analysis was performed using measurements of the length of the junctional epithelium, connective tissue (CT) zone, and total soft tissue (ST). Results: There were significant differences in PPD between the control and test groups at baseline and 12 weeks. When the change in PPD was stratified based on time intervals, it was shown that greater differences occurred in the test group, with statistical significance for baseline to 12 weeks, 6 to 12 weeks, and baseline to 6 weeks. There was no significant difference in GR between the control and test groups at any time points. Likewise, no statistically significant differences were found in GR at any time intervals. CAL showed a statistically significant difference between the control and test groups at baseline only, although significant differences in CAL were observed between baseline and 12 weeks and between 6 and 12 weeks. The proportion of CT to ST was smaller for both buccal and lingual areas in the control group than in the test group. Conclusions: Repeated LED irradiation with a combination of 470-nm and 525-nm wavelengths may help suppress the progression of periodontal disease.

• Journal of Preventive Medicine and Public Health
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• v.56 no.3
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• pp.282-290
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• 2023

Objectives: This study aimed to evaluate the potential interaction between kidney function and the non-linear association between serum calcium levels and cardiovascular disease (CVD) mortality. Methods: This study included 8927 participants enrolled in the Dong-gu Study. Albumin-corrected calcium levels were used and categorized into 6 percentile categories: <2.5th, 2.5-25.0th, 25.0-50.0th, 50.0-75.0th, 75.0-97.5th, and >97.5th. Restricted cubic spline analysis was used to examine the non-linear association between calcium levels and CVD mortality. Cox proportional hazard regression was used to estimate hazard ratios (HRs) for CVD mortality according to serum calcium categories. All survival analyses were stratified by the estimated glomerular filtration rate. Results: Over a follow-up period of 11.9±2.8 years, 1757 participants died, of whom 219 died from CVD. A U-shaped association between serum calcium and CVD mortality was found, and the association was more evident in the low kidney function group. Compared to the 25.0-50.0th percentile group for serum calcium levels, both low and high serum calcium tended to be associated with CVD mortality (<2.5th: HR, 6.23; 95% confidence interval [CI], 1.16 to 33.56; >97.5th: HR, 2.56; 95% CI, 0.76 to 8.66) in the low kidney function group. In the normal kidney function group, a similar association was found between serum calcium levels and CVD mortality (<2.5th: HR, 1.37; 95% CI, 0.58 to 3.27; >97.5th: HR, 1.65; 95% CI, 0.70 to 3.93). Conclusions: We found a non-linear association between serum calcium levels and CVD mortality, suggesting that calcium dyshomeostasis may contribute to CVD mortality, and kidney function may modify the association.

• 한국노년학
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• v.30 no.4
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• pp.1077-1093
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• 2010

This study aims to examine the effects of health status on life satisfaction and depression and to examine the effect of spirituality and religious involvement on this relationship among Korean older persons. On the basis of the previous literature, we hypothesize that health status will have a direct effect on life satisfaction and depression, but that spirituality and religious involvement will moderate this effect in addition to having direct effects on life satisfaction and depression. In light of the different gender effects on all five variables (health status, spirituality, religious involvement, life satisfaction, and depression), we also examine the effects of gender on these variables. The data for this study came from the Hallym Aging Study conducted by the Hallym University Institute of Aging from February to March in 2005. Through stratified multi-stage random sampling, 1409 individuals aged 65 and over, who lived in Seoul and Chuncheon in Korea. Multiple regression analysis was used to investigate whether health status, gender, spirituality and religious involvement could predict life satisfaction and depression, and whether the direct relationships were moderated by interactions among these variables. We took three ordered regression steps to examine the hypothesis; the first step contained the covariates of age, education, living with spouse, monthly expense, living with adult children, and household income. We also entered gender into this step, so it would be adjusted for in relation to the other covariates. The second step then looked for any direct effects that gender, health status, spirituality, and religious involvement might have on life satisfaction and depression above and beyond the effects of the covariates. The third step contained interaction terms to look for further variance accounted for by indirect, moderating effects on life satisfaction and depression. The results showed that health status had a significant effect on both life satisfaction and depression, and religious involvement had a significant effect on depression. Spirituality and religious involvement were found overall to be a moderator, reducing the negative effect of health status on life satisfaction and depression. The direct effect of religious involvement and the moderating effects of spirituality and religious involvement on life satisfaction and depression are consistent with the view that spirituality and religion are resources and benefit the well-being of older adults.

• Korean Journal of Culture and Social Issue
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• v.8 no.2
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• pp.137-170
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• 2002

The present paper reviews the development of democracy in the West and Korea. The first part of the paper provide a cultural framework for understanding the development of democracy in West and Korea. In the second part of the paper, an empirical study conducted in Korea will be presented. A survey questionnaire was developed to assess respondents' conception of political participation, political efficacy, trust, leadership, and social relations and it has been administered to national stratified sample in Korea (n=1,000). The results indicate that Korean respondents support the basic ideas of liberal democracy, such as the right to vote, participate in political organization, freedom of speech, and criticize government. At the same time, Korean respondents supported collective values, such as harmonious family life, harmonious social relations, and governmental welfare programs. Although Koreans trusted close ingroup members, such as family members and friends, they were less likely to trust their colleagues and outgroup members and were not likely to trust political and governmental institutions. Moreover, Korean respondents showed a low degree of political participation and efficacy and a high degree of political alienation. As for leadership, Koreans preferred moral and strong leaders. The overall results indicate that in Korea, although the basic ideals of democracy are valued, the method of implementing these ideals is different from the West. Detailed analysis of the results and implications of the study will be presented.