• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1172-1178
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• 2005

Purpose : Childhood Obesity is increasing throughout the world, and it is known to incur many diseases especially in later life such as diabetes and cardiovascular disorders. The purpose of this study was to investigate the association between obesity and insulin, insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-3(IGFBP-3) and know if these factors are useful in predicting cardiovascular diseases. Methods : The study group consisted of 64 moderate and severe obese adolescents and the controls were normal adolescents of the same age. body mass index(BMI) was calculated by height and weight; systolic and diastolic blood pressure was measured at resting state. After 10-hour fasting period, blood cholesterol, triglyceride, high density lipoprotein(HDL) cholesterol, low density lipoprotein(LDL) cholesterol, glucose, insulin, free fatty acid, IGF-I and IGFBP-3 were measured. Results : Insulin was significantly higher in the obese adolescent group than the control group(obese group $15.6{\pm}7.0{\mu}IU/mL$, P<0.01). IGF-I was also significantly higher in the obese adolescent group than the control group(obese group $498.1{\pm}122.2ng/mL$, P<0.05). In addition, IGFBP-3 was significantly higher in the obese adolescent group than the control group(obese group $3,777{\pm}4,721ng/mL$, P<0.05). Insulin showed significantly positive correlation with BMI(r=0.3944) and obesity index(r=0.34). IGFBP-3 were significantly correlated with obesity index(r=0.419), diastolic blood pressure (r=0.264) and BMI(r=0.247). Insulin resistance index significantly positive correlation with BMI(r=0.595), blood triglycerid level(r=0.515) and obesity index(r=0.469). Conclusion : Serum insulin, insulin resistance index, IGF-I and IGFBP-3 levels may be useful to predict cardiovascular diseases in adolescent obesity.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1076-1081
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• 2005

Purpose : Insulin resistance is the most important risk factor linked to the development of impaired glucose tolerance(IGT), diabetes mellitus and cardiovascular diseases in childhood and adolescent obesity, The purpose of this study was to see whether insulin resistance of obese adolescent is higher than that of obese children. and to analyze gender difference and affecting factors of insulin resistance. Methods : Of the 9,837 school children from 5 to 16 tears old, 92 obese children and 187 adolescent, underwent a two-hour oral glucose tolerance test and plasma glucose, insulin, lipid profiles, leptin and high sensitive C-reactive protein(hs-CRP) were measure. Results : Plasma insulin levels of female were higher compared to those of males during oral glucose tolerance test(P<0.05). Four(4.3%) in obese children and twenty five(13.3%) in obese adolescents met the criteria of IGT. Female, leptin, adiponectin and triglyceride concentrations were strongly correlated with homeostatic model assessment insulin-resistance(HOMA-IR) by multiple linear regression analysis(P<0.05). Conclusion : Obese adolescents might have higher insulin concentrations compared to obese children and obese girls higher insulin concentrations than obese boys. Obese boys and children with impaired glucose tolerance have higher insulin concentrations than those with normal glucose tolerance. HOMA-IR was significantly correlated with female, plasma leptin, adiponectin and triglyceride concentrations.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.2
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• pp.112-119
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• 2011

Objectives : Obesity has been linked to various psychological problems as well as medical complications, especially among adolescents. Previous studies have suggested an association between body weight and depression or self-esteem ; however, there has been little evidence on self-perception of weight and mental health. The aim of this study was to examine the association of perceptional weight status with mental health in Korean adolescents. Methods : This study was based on data obtained from the third Korean National Health and Nutritional Examination Survey (2005). The study sample consisted of 583 adolescents (268 boys, 315 girls) aged 12-18 years, who had completed the health survey, the health examination, and the nutritional survey. Participants were divided into two groups based on the actual or perceptional weight status: non-obese and obese. Questionnaires for stress, depressive mood, and suicidal thoughts were utilized as mental health indicators. Results : The agreement between actual and perceptional weight status was moderate (k value, 0.585 ; p<0.01). The influencing factors for the discrepancy between actual and perceptional weight status were body mass index of subjects and their parents' education. The obese group was likely to have higher stress levels and more experience of depressive mood or suicidal ideation in regard to both actual and perceptional weight status. A multiple logistic regression analysis revealed that girls who had perceived themselves as obese were more likely to have an experience of depressive mood than other girls (unadjusted OR, 4.98 ; adjusted OR, 5.15). Conclusion : An experience of depressive mood was significantly associated with the perception of weight status and not actual weight status in Korean female adolescents.

• Korean Journal of Human Ecology
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• v.21 no.6
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• pp.1223-1234
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• 2012

The purpose of this study was to investigate the effects of body weight, perception of body shape and satisfaction with body shape on obesity stress and self-esteem among middle school students. The participants in this study were 446 middle school students in K-city. The major results of this study are as follows. First, male students demonstrated higher obesity rates than female students, and female students considered themselves to be fatter and less satisfied with their body shape than male students. Female students had significantly more obesity-related stress than male students. Second, there were significant differences in physical obesity stress according to body weight status among male and female students, and there was statistically significant difference in psychological obesity stress according to body weight status among male students. Male and female students who considered themselves to be fatter and less satisfied with their body shape suffered from high obesity stress. Third, there was no significant difference in self-esteem according to body weight status, but self-esteem was affected by perception and satisfaction of body shape; male and female students who considered themselves to be fatter and less satisfied with their body shape showed low levels of self-esteem. As the result of regression analysis, psychological obesity stress was the strongest factor in explaining self-esteem among all students, and satisfaction of body shape was also found to be a significant variable among female students.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.115-120
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• 2015

Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent cholecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by comparing a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group. Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was $21.7kg/m^2$, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of overweight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy. Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.

• Nutrition Research and Practice
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• v.7 no.5
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• pp.385-392
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• 2013

Although several studies have assessed the influence of the glycemic index on body weight and blood pressure among adults, limited evidence exists for the pediatric age population. In the current study, we compared the effects of low glycemic index (LGI) diet to the healthy nutritional recommendation (HNR)-based diet on obesity and blood pressure among adolescent girls in pubertal ages. This 10-week parallel randomized clinical trial comprised of 50 overweight or obese and sexually mature girls less than 18 years of age years, who were randomly assigned to LGI or HNR-based diet. Macronutrient distribution was equivalently prescribed in both groups. Blood pressure, weight and waist circumference were measured at baseline and after intervention. Of the 50 participants, 41 subjects (include 82%) completed the study. The GI of the diet in the LGI group was $42.67{\pm}0.067$. A within-group analysis illustrated that in comparison to the baseline values, the body weight and body mass index (not waist circumference and blood pressure) decreased significantly after the intervention in both groups (P = 0.0001). The percent changes of the body weight status, waist circumference and blood pressure were compared between the two groups and the findings did not show any difference between the LGI diet consumers and those in the HNR group. In comparison to the HNR, LGI diet could not change the weight and blood pressure following a 10-week intervention. Further longitudinal studies with a long-term follow up should be conducted in this regard.

• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.390-399
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• 2016

Purpose: The purpose of this study was to determine the effects of smartphone apps applying BodyThink program on BMI, percentage of body fat, skeletal muscle rate, body image, and self-esteem of adolescent girls. Methods: Sixty-eight high school girls with a BMI of over $25kg/m^2$ were recruited to participate in this study. Girls from four schools were divided into two groups: the experimental group, which used the smartphone apps applying BodyThink program, and the control group, which used smartphone apps and small group counseling. The experimental group received the BodyThink program 6 times, scheduled once a week, with each session lasting 40~50 minutes. Test measures were completed before and after the 6 week intervention period for all participants. Collected data was analyzed using Shapiro-Wilk test, descriptive statistics, ${\chi}^2$ test, independent t-test, Mann-Whitney U test with the SPSS/WIN 18.0 program. Results: The girls in the experimental group significantly improved their results in BMI(Z=-1.67, p=.042), percentage of body fat (Z=-3.01, p=.001), skeletal muscle rate (t=-3.50, p<.001), and self-esteem (t=2.66, p=.005) after the program, compared to the girls in the control group. Conclusion: Mobile applications applying psychological and emotional intervention programs have the potential to be effective alternative methods to improve the body composition and self-esteem of obese adolescent girls.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.320.1-320.8
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• 2018

Background: Muscle mass and muscle function are related to depressed mood in studies of adults. Like adults, Korean students are highly likely to suffer from decreased muscle mass due to social conditions. In this study, we evaluated the muscle mass status of Korean adolescents and assess the effect of muscle on depressive mood. Methods: A total of 1,233 adolescent boys and girls participants from the Korea National Health and Nutrition Examination Survey were enrolled in our study. Participants underwent dual-energy X-ray absorptiometry for assessment of appendicular muscle mass and completed questionnaires regarding depressed mood, stress, suicidal ideations, and attempts. Results: There was no difference in depressive mood according to muscle mass among boys (P = 0.634); girls with decreased muscle mass had a greater tendency for depressed mood compared to girls with optimal muscle mass (P = 0.023). After adjusting for age, waist circumference-to-height ratio, smoking status, alcohol consumption, frequency of physical activity, self-reported obesity, weight-loss efforts, and monthly household income, girls with low muscle mass (LMM) were 2.60 times more at risk of developing depression than girls with normal muscle mass (95% confidence interval [CI], 1.05-6.49; P = 0.040). This trend was similar for girls with LMM with obesity (95% CI, 1.00-11.97; P = 0.049). Conclusion: Adolescent girls who have insufficient muscle mass are more likely to report depressed mood than girls who have ideal muscle mass. Interventions for maintaining proper muscle mass are required.

• Clinical and Experimental Pediatrics
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• v.61 no.4
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• pp.121-128
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• 2018

Purpose: Obesity has been associated with higher total blood mercury levels, based on animal studies; however, studies that focus on children and adolescents are lacking. We aimed to assess the association between total blood mercury levels and the incidence of overweight and abdominal obesity in Korean adolescents. Methods: The study population comprised 1,567 adolescents (793 boys and 774 girls; aged 10-19 years), who participated in the Korea National Health and Nutrition Examination Survey 2010-2013. We analyzed total blood mercury levels according to obesity status in all participants. Results: The geometric mean of total blood mercury levels was $1.93{\mu}g/L$. Participants with overweight ($2.20{\mu}g/L$) and obesity ($2.17{\mu}g/L$) had higher levels than those with normal weight ($1.86{\mu}g/L$, P<0.0001). The prevalence of overweight significantly increased with elevation of the total blood mercury quartile in both sexes. Increased incidence of abdominal obesity corresponding to increased total blood mercury level was observed in boys. After adjusting for covariates, those in the highest total blood mercury quartile were found to be at higher risk of overweight/obesity than those in the lowest quartile in both sexes (odds ratio [95% confidence interval]: boys, 3.27 [1.66-6.41]; girls, 1.90 [1.03-3.49]). The association between total blood mercury quartile and abdominal obesity was significant after controlling for covariates in boys (2.35 [1.05-5.24]). Conclusion: Our results suggest an association between total blood mercury levels and overweight in Korean adolescents.

• The Journal of the Korea Contents Association
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• v.18 no.3
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• pp.626-635
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• 2018

To develop prevention messages for increasingly severe adolescent obesity in China. this study tested interaction effects between obesity involvement and message framing, and between obesity involvement and evidence types on obesity prevention attitudes and behavioral intentions. Message framing types are categorized with a gain frame and a loss frame. Evidence types are classified into narratives based on personal experiences and statistics based on objective numerical proofs. Three hundred sixty eight Chinese adolescents participated in the study. Results found that involvement, framing, and evidence types had significant effects on attitudes and behavioral intentions to obesity prevention. Adolescents highly involved in obesity were more likely to show positive attitudes and behavioral intentions when exposed to loss framing and statistical evidence. Those with low involvement showed positive attitudes and behavioral intentions after exposed to gain framing and narratives. Thus, we suggest that loss frames with numerical data should be developed to persuade adolescents with high involvement, and gain frames with narratives should be developed for those with low involvement.