• Journal of Korean Biological Nursing Science
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• 제5권1호
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• pp.5-12
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• 2003

The purpose of this study to compare of clinical profile between obese and nonobese type 2 diabetic patients. The subjects were consist of 111 obese (50 male, 61 female) and 159 non obese (79 male, 80 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, fasting C-peptide and 2-hour postprandial C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association (ADA) criteria. Obesity was defined as body mass index (BMI, kilograms per meters squared) ${\geq}23$. Data analyses were t-test, chisquare test in SAS program. The results were as follows : 1) Triglycerides and 2-hour postprandial C-peptide were significant higher in obese than non-obese patients. 2) Systolic blood pressure, Diastolic blood pressure, fasting blood sugar, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high-density lipoprotein, microalbuminuria and fasting C-peptide were no difference between obese and non-obese groups. These data indicate that obesity is a risk factor for the development of coronary heart disease (CHD) in diabetic patients. Therefore, weight reductions have beneficial effects on insulin action and glycemic control in obese type 2 diabetic patients.

• Preventive Nutrition and Food Science
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• 제5권1호
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• pp.58-64
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• 2000

Obesity is a global pandemic that is increasing throughout most of the world. Increases in obesity are not restricted to highly industrialized countries, but have been observed in newly developed and developing countries as well. Obesity is associated with increased risk for non-insulin dependent diabetes mellitus, coronary artery disease, and some types of cancer. Tragically, eliminating food shortages in developing countries may result in substituting heart disease, diabetes, and cancer for malnutrition. There are many approaches to reducing obesity, including dietary modification, surgical interventions, and drug therapies. However, only dietary modification has the potential to be effective on a global scale. Public health measures in the United States have sought to reduce obesity by reducing the intake of dietary fat. While these efforts have succeeded in reducing dietary fat, obesity has continued to increase, suggesting that moderate fat reduction may not be effective. Other proposed diets include low-carbohydrate diets, low glycemic index diets, and very low fat diets. While all of these diets may be effective for some people, they are not satisfactory for public health policy. In fact, the ratio of fat to carbohydrate may not be as important as previously believed. Humans may be well suited to adapt to diets as varied as a high carbohydrate tropical diet consisting mostly of fruits to the high fat Eskimo diet consisting largely of animal foods. Either extreme may be healthful if providing adequate, but not excessive, energy and adequate amounts of micronutrients. Public health measures may need to focuss on reducing the overconsumption of inexpensive and convenient foods.

• 대한임상검사과학회지
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• 제38권2호
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• pp.105-110
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• 2006

This study was carried out to establish the normal values of serum lipids by age and sex for healthy adults and the frequency of dyslipidemia as a risk factor of coronary atherosclerosis. Total cholesterol, triglyceride, and HDL-cholesterol were measured for 14,485 average adults (8,712 males and 5,773 females) aged 20 to 69 years and analyzed using the auto-analyzer Hitach 7600 in enzyme method. Mean values of total cholesterol, LDL-cholesterol and atherogenic index were higher in men than in women at the ages of 20-40 years but significantly higher in women than in men in the age group of 60 years. Theses findings suggest that the mean concentrations of total cholesterol, triglyceride and LDL-cholesterol in men and women vary with age. The frequency of hypercholesterolemia ($${\geq_-}200mg/dL$$) in men and women was about 31.4% and increased with age.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.109-116
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• 1997

목적 : 말기 신부전 환자에서 심혈관계 질환은 유병율 및 사망율의 중요한 원인중 하나이다. 이들 환자에서 흔히 동반되는 고지질단백 혈증은 심혈관계 질환의 위험인자로 작용하며, 특히 lipoprotein(a)[Lp(a)]는 관상동맥 질환과 혈전증의 위험 인자로 알려져 있다. 소아에서도 만성 신부전시 고지질 혈증이 보고되어 있다. 저자들은 투석 치료중인 만성 신부전 소아를 대상으로 혈중 지질, 지질단백 및 Lp(a)의 농도 변화를 분석하였다. 방법 : 서울대학교 어린이병원 소아과에서 유지 혈액 투석을 받고 있는 환아 10명과 지속성 외래 복막 투석을 받고 있는 환아 14명을 대상으로 정맥 혈청중 지질, 지질단백 및 Lp(a)농도를 측정하여 건강 대조군과 비교하였으며, Lp(a)의 혈중 농도에 따른 다른 지질단백의 혈중 농도를 비교하였다. 혈액투석(hemodialysis, HD)환아군의 평균 연령이 $162{\pm}59$ 개월, 남녀비는 7:3 이었으며 복막투석(peritoneal dialysis, PD)환아군의 평균 연령은 $123{\pm}69$개월, 남녀비는 6:8 이었다. 결과 : 1) 연령, 성별, 비만지수, 투석기간은 HD군과 PD군 간의 차이가 없었으나 혈중 단백과 알부민치는 PD군에서 유의하게 낮았다. 2) HD군과 PD군 모두에서 혈중 콜레스테롤, 중성지방, 저비중 지질단백 콜레스테롤(low density lipoprotein-cholesterol, LDL-콜레스테롤)과 고비중 지질단백 콜레스테롤(high density lipoprotein-cholesterol, HDL-콜레스테롤)의 비는 대조군에 비해 증가되어 있었으며, HDL-콜레스테롤과 콜레스테롤의 비는 대조군에 비해 유의하게 낮았다. 3) 혈중 아포단백 B치는 대조군에 비해 상승되어 있었지만 아포단백 Al과 아포단백 B의 비는 차이가 없었고, 혈중 Lp(a)치는 PD군에서만 대조군보다 상승되어 있었다. 4) 혈중 Lp(a)치가 30 mg/dl 미만인 환아는 13명, 30 mg/dl 이상인 환아는 11명으로 이들 간에 연령, 비만지수, 투석방법, 투석기간은 차이가 없었으나 혈중 알부민은 Lp(a)가 상승된 환아들에서 감소되어 있었다. 5) 혈중 Lp(a)농도와 다른 지질 단백과의 비교에서 아포 단백 B만이 유의한 차이를 보였다. 결론 : 투석 치료중인 만성 신부전 소아에서 혈중 지질단백 이상이 관찰되었으며 특히 PD군에서는 혈중 Lp(a)치가 증가되어 있었다. 따라서 만성 신부전 소아에서 관상 동맥 질환의 위험도가 높을 것으로 사료되며 이에 대한 장기적이고 지속적인 관찰이 필요하다.

• Archives of Plastic Surgery
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• 제41권2호
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• pp.116-121
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• 2014

Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12- 3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ${\geq}30$) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

• 한국건강관리협회지
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• 제4권1호
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• pp.12-27
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• 2006

"본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• Radiation Oncology Journal
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• 제33권3호
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• pp.242-249
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• 2015

Purpose: The purpose of this study is to compare the dosimetry of electron beam (EB) plans and three-dimensional helical tomotherapy (3DHT) plans for the patients with left-sided breast cancer, who underwent breast conserving surgery. Materials and Methods: We selected total of 15 patients based on the location of tumor, as following subsite: subareolar, upper outer, upper inner, lower lateral, and lower medial quadrants. The clinical target volume (CTV) was defined as the area of architectural distortion surrounded by surgical clip plus 1 cm margin. The conformity index (CI), homogeneity index (HI), quality of coverage (QC) and dose-volume parameters for the CTV, and organ at risk (OAR) were calculated. The following treatment techniques were assessed: single conformal EB plans; 3DHT plans with directional block of left anterior descending artery (LAD); and 3DHT plans with complete block of LAD. Results: 3DHT plans, regardless of type of LAD block, showed significantly better CI, HI, and QC for the CTVs, compared with the EB plans. However, 3DHT plans showed increase in the $V_{1Gy}$ at skin, left lung, and left breast. In terms of LAD, 3DHT plans with complete block of LAD showed extremely low dose, while dose increase in other OARs were observed, when compared with other plans. EB plans showed the worst conformity at upper outer quadrants of tumor bed site. Conclusion: 3DHT plans offer more favorable dose distributions to LAD, as well as improved target coverage in comparison with EB plans.

• Journal of Nutrition and Health
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• 제42권6호
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• pp.547-558
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• 2009

This study was carried out to compare the effect of smoking on dietary habits, nutrient intakes and blood lipid profiles in 173 adult male drinkers. Subjects were classified by two groups, alcohol-only and alcohol-smoking, based on their alcohol or smoking habits. The BMI of the alcohol-smoking group was significantly lower than those of alcohol-only group. In dietary habits, the alcohol-smoking group had higher irregular breakfast and dinner intakes than alcoholonly group (p < 0.05). Plant lipid intake of the alcohol-smoking group was higher than those of alcohol-only group (p < 0.05) and the vitamin C intake of the alcohol-smoking group was lower than those of alcohol-only group (p < 0.05). With regard to the diet quality evaluation of subjects, the alcohol-smoking group showed significantly lower values than alcohol-only group in the nutrient density of carbohydrate, dietary fiber, sodium, potassium, vitamin $B_6$, and vitamin C. Also, with regard to the index of nutrition quality (INQ) and the nutrient adequacy ratio (NAR), the alcohol-smoking group showed significantly lower value than alcohol-only group in vitamin C. With these results, we found that the alcohol-smoking group had lower diet quality evaluation. The results of blood analysis showed that HDL-cholesterol in the alcohol-smoking group was significantly lower than that in the alcohol-only group. In conclusion, the alcohol-smoking group had greater health risk than the alcohol-only group. Particularly, alcohol-smoking caused irregular eating patterns and unbalanced nutrition intakes compared to alcohol-only and also changed blood composition as shown in the decrease of HDL-cholesterol. Besides, the index of coronary heart disease such as AI was higher in both groups suggesting that alcohol-only or alcohol-smoking cause health problems. Since there is the limiting point in which the comparative analysis of non-drinkers and non-smokers is unable to be performed in this study, further wide research is needed on that matter.

• 한국임상약학회지
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• 제28권3호
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• pp.204-215
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• 2018

Background: In this systematic review and meta-analysis, the effect of metformin on weight loss was assessed to determine whether metformin should be recommended for the prevention or treatment of weight gain in patients receiving antipsychotic medication for the treatment of schizophrenia or schizoaffective disorder. Methods: The PubMed, Embase, and Cochrane Library databases were searched for all published randomized controlled trials (RCTs) from inception to June 2018. In addition, the references of relevant articles were also examined. Using Review Manager 5, the pooled estimates of the weighted mean difference (WMD) of the changes in body weight and body mass index (BMI) and the corresponding 95 % confidence intervals (CIs) were calculated. Results: The meta-analysis included 15 RCTs. The pooled analysis showed that compared with placebo, metformin led to significant reductions in body weight (WMD: -2.09, 95% CI: -2.59, -1.60; p<0.00001) and BMI (WMD: -0.90, 95% CI: -1.08, -0.72; p<0.00001). The effect of metformin on weight loss was greater in patients receiving olanzapine than in patients receiving clozapine (body weight, WMD: -2.39, 95% CI: -3.76, -1.02; p=0.0006 for olanzapine; -1.99, 95% C: -3.47, -0.51; p=0.009 for clozapine; BMI, WMD: -1.15, 95% CI: -1.74, -0.57, p=0.0001 for olanzapine; WMD: 0.76, 95% CI: -1.23, -0.28; p=0.002 for clozapine). Conclusion: Metformin can be recommended to manage olanzapine-induced weight gain in patients with schizophrenia or schizoaffective disorder. The magnitude of the reductionss in body weight and BMI implieds that the use of metformin to attenuate olanzapine-induced weight gain can minimize the risk of coronary heart disease.