• Journal of Nutrition and Health
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• v.50 no.2
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• pp.158-170
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• 2017

Purpose: The purpose of this study was to explore the relationship between milk intake and prevalence rates of chronic diseases using KNHANES data, and the significance of the relationship was tested based on meditators, socioeconomic status (income, education), dietary behaviors (smoking, alcohol drinking, breakfast, and eating out), and physical activity (walking, medium, and high). Methods: Using the 5th and 6th survey data of KNHANES, milk intake rates and presence of seven chronic diseases were summarized and analyzed by ANOVA for two groups of adult men and women as follows: hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, abdominal obesity, obesity, and metabolic syndrome. The dependent variables for the presence of seven chronic diseases regressed with socioeconomic, dietary behavior, and physical activity variables according to Logistic models. The dependent variables for milk intake using predictor variables of socioeconomic, dietary behaviors and physical activity were analyzed according to Logistic models. Finally, the significant socioeconomic, dietary behavior, and physical activity variables in the above model along with milk intake as a control variable or mediator variable regressed with significant chronic diseases according to Logistic models. Results: Milk intake, socioeconomic status, dietary behaviors, and physical activity were significantly different among the two groups of adult men and women, which were also critical factors to the prevalence of chronic diseases. The dependent variable for prevalence of chronic diseases regressed with significant factors of socioeconomic status, dietary behavior, and physical activity variables according to chronic diseases using the control or mediator variable of milk intake and summarized as follows: For adult men, milk intake controlled the education effect on diabetes partly, alcohol on hypertension and hypertriglyceridemia, low HDL-cholesterol, metabolic syndrome, breakfast on metabolic syndrome, eating out on obesity, and medium physical activity on hypertriglyceridemia. For adult women, household income on hypertriglyceridemia, diabetes, abdominal obesity, education level on hypertension, alcohol drinking, eating out, and walking activity on abdominal obesity, alcohol, breakfast, eating out, walking activity on low HDL-cholesterol, and medium physical activity on hypertriglyceridemia and low HDL-cholesterol were partly controlled by milk intake. Other significant socioeconomic status, dietary behavior, and physical activity variables related to prevalence of chronic diseases were fully controlled or mediated by milk intake. Conclusion: This study shows that milk intake (daily more than 200 g) prevents chronic diseases such as hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, obesity, abdominal obesity, and metabolic syndrome.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.38-47
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• 2023

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

• Journal of agricultural medicine and community health
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• v.35 no.3
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• pp.249-259
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• 2010

Objectives: The purpose of this study was to analyze the influence of four lifestyle-related diseases, diabetes, hypertension, obesity and hypercholesterolemia, on oral health in the rural elderly in Korea. Methods: We enrolled 399 subjects over 60 years of age over a six year period, year 2000-2006/ year 2001-2007. All subjects received a routine health examination as part of a program conducted by the National Health Insurance Corporation at Seongju-gun Public Health Center in Gyeongsangbuk-do Province, South Korea. All subjects were surveyed and examined to determine their general and oral health statuses. Results: Our results suggest that the duration of lifestyle-related diseases has a significant influence on oral health. The following factors were all significant in the results of analyses: duration of diabetes, tooth decay, which teeth had decayed, missing and filled teeth(DMFT), duration of hypertension, and duration of obesity and hypercholesterolemia(p<0.05). Our results also suggest that the number of lifestyle related diseases has a significant influence on oral health. Subjects with more than two diseases had significantly greater numbers of missing teeth and greater numbers of DMFT(p<0.01). The results of simple regression analysis indicate that patients exhibiting longer durations of diabetes also exhibit more tooth decay, and that patients exhibiting longer durations of hypertension and obesity are characterized by greater numbers of missing teeth. The longer the duration of any of the four lifestyle-related diseases we considered, the more DMFT we observed. Multiple regression analyses also demonstrated that longer duration of lifestyle-related disease was associated with greater numbers of missing teeth. As the number of lifestyle-related diseases increased, DMFT also increased. Conclusions: In summary, lifestyle-related diseases such as diabetes, hypertension, obesity and hypercholesterolemia have significant influences on oral health in the elderly. In this context, the prevention and management of lifestyle-related disease is critical for the maintenance and promotion of oral health.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.209-220
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• 1996

This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.190-195
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• 2023

Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.189-230
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• 2020

The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1963-1969
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• 2012

Objectives: Recent data show that the metabolic syndrome may play a role in several cancers, but the etiology for biliary tract cancer is incompletely defined. The present aim was to evaluate risk factors for biliary tract cancer in China. Methods: A case-control study in which cases were biliary tract cancer patients referred to Peking Union Medical College Hospital (PUMCH). Controls were randomly selected from an existing database of healthy individuals at the Health Screening Center of PUMCH. Data on the metabolic syndrome, liver diseases, family history, and history of diabetes and hypertension were collected by retrospective review of the patients' records and health examination reports or by interview. Results: A total of 281 patients (102 intrahepatic cholangiocarcinoma (ICC), 86 extrahepatic cholangiocarcinoma (ECC) and 93 gallbladder carcinoma (GC)) and 835 age- and sex-matched controls were enrolled. $HBsAg^+/anti-HBc^+$ (P=0.002), history of diabetes (P=0.000), cholelithiasis (P=0.000), TC (P=0.003), and HDL (P=0.000) were significantly related to ICC. Cholelithiasis (P=0.000), Tri (P=0.001), LDL (P=0.000), diabetes (P=0.000), Apo A (P=0.000) and Apo B (P=0.012) were significantly associated with ECC. Diabetes (P=0.017), cholelithiasis (P=0.000) and Apo A (P=0.000) were strongly inversely correlated with GC. Conclusion: Cholelithiasis, HBV infection and metabolic symptoms may be potential risk factors for the development of biliary tract cancer.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.850-862
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• 2007

Background : Cerebrovascular disease is a major cause of death and disability in adults. Silent cerebral infarction (SCI) portends more severe cerebral infarction or may lead to insidious progressive brain damage resulting in vascular dementia. Known cardiovascular risk factors, such as arterial hypertension, diabetes mellitus, smoking, hyperlipidemia and ischemic heart disease may increase the risk of SCI. This study was designed to evaluate the risk factors of SCI in an apparently normal adult population. Methods : We divided 340 neurologically normal adults (mean age=59.90$\pm$8.30, men:women = 146:194) who underwent brain computed tomography (CT) or magnetic resonance imaging (MRI) at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital in two groups, Silent inf. and Controls,and analyzed risk factors of SCI by interview, physical examination and blood test. Risk factors of SCI were assessed by interview, physical examination and blood test. We performed Pearson's chi-square test and two-sample t-test for univariate analysis and multiple logistic regressions for multivariate analysis to evaluate risk factors of SCI. Results : Old age, diabetes mellitus, and high lactate dehydrogenase (LDH) levels were associated with SCI on univariate analysis. Diabetes mellitus was demonstrated to be an independent risk factor for SCI on multivariate analysis. Conclusions : Advanced age, diabetes mellitus, and LDH levels are associated with SCI.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.89-100
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• 2024

Purpose : The objective of this study was to determine the major factors influencing the onset of diabetes and prediabetes and for collection of the basic data required to reduce the prevalence of diabetes and plan for administration of an effective health care system. By classifying the level of blood sugar management according to three categories: normal, prediabetes, and diabetes diagnosis, and determining the causes of diabetes in consideration of various variables, we will conduct an analysis of the main factors to be addressed for effective management of blood sugar and for preparation of basic data for use in early management. Methods : In this study, an analysis of raw data from the 8th National Health and Nutrition Examination Survey collected over a period of three years from 2019 to 2021, including 8,110 subjects in 2019, 7,359 subjects in 2020, and 7,090 subjects in 2021 was performed. A total of 22,559 subjects were aged 19 years or older, and 15,821 subjects were classified as subjects for inclusion in the final analysis. In the analysis, categorical variables were tested for difference, analysis of continuous variables using regression was performed, and analysis of influencing factors was performed using multinomial logistic analysis. Result : Significant factors related to the onset of diabetes and prediabetes included age (p<.001), marital status (p<.001), occupation (p<.001), hypertension (p<.001), dyslipidemia (p<.001), cardiovascular disease (p=.008), alcohol (p=.030) smoking (p=.005), systolic blood pressure (p<.001), diastolic blood pressure (p<.001), body mass index (p<.001) and waist circumference (p=.037), blood triglycerides (p<.001), and blood cholesterol (p<.001). Conclusion : Diabetes, a complex disease affected by a variety of diseases, requires active management from the prediabetes stage, and providing an appropriate level of medical information and services to elderly individuals without family support is considered a long-term health care system requirement in Korean society where the demographic structure is changing. In particular, determining the causes of prediabetes and development of a preventive approach to administering the health care system will be important for efficient management of diabetic patients.