Objectives: Diabetes and obesity each increases mortality, but recent papers have shown that lean Asian persons were at greater risk for mortality than were obese persons. The objective of this study is to determine whether an interaction exists between body mass index (BMI) and diabetes, which can modify the risk of death by cardiovascular disease (CVD). Methods: Subjects who were over 20 years of age, and who had information regarding BMI, past history of diabetes, and fasting blood glucose levels (n=16 048), were selected from the Korea Multi-center Cancer Cohort study participants. By 2008, a total of 1290 participants had died; 251 and 155 had died of CVD and stroke, respectively. The hazard for deaths was calculated with hazard ratio (HR) and 95% confidence interval (95% CI) by Cox proportional hazard model. Results: Compared with the normal population, patients with diabetes were at higher risk for CVD and stroke deaths (HR, 1.84; 95% CI, 1.33 to 2.56; HR, 1.82; 95% CI, 1.20 to 2.76; respectively). Relative to subjects with no diabetes and normal BMI (21 to 22.9 $kg/m^2$), lean subjects with diabetes (BMI <21 $kg/m^2$) had a greater risk for CVD and stroke deaths (HR, 2.83; 95% CI, 1.57 to 5.09; HR, 3.27; 95% CI, 1.58 to 6.76; respectively), while obese subjects with diabetes (BMI ${\geq}25kg/m^2$) had no increased death risk (p-interaction <0.05). This pattern was consistent in sub-populations with no incidence of hypertension. Conclusions: This study suggests that diabetes in lean people is more critical to CVD deaths than it is in obese people.
Objectives: This study was conducted to determine the incidence and risk factors of myocardial infarction (MI) and stroke in farmers compared to the general population and to establish 5-year prediction models. Methods: The farmer cohort and the control cohort were generated using the customized database of the National Health Insurance Service of Korea database and the National Sample Cohort, respectively. The participants were followed from the day of the index general health examination until the events of MI, stroke, or death (up to 5 years). Results: In total, 734 744 participants from the farmer cohort and 238 311 from the control cohort aged between 40 and 70 were included. The age-adjusted incidence of MI was 0.766 and 0.585 per 1000 person-years in the farmer and control cohorts, respectively. That of stroke was 0.559 and 0.321 per 1000 person-years in both cohorts, respectively. In farmers, the risk factors for MI included male sex, age, personal history of hypertension, diabetes, current smoking, creatinine, metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). Those for stroke included male sex, age, personal history of hypertension, diabetes, current smoking, high γ-glutamyl transferase, and metabolic syndrome components (blood pressure, triglycerides, and high-density lipoprotein cholesterol). The prediction model showed an area under the receiver operating characteristic curve of 0.735 and 0.760 for MI and stroke, respectively, in the farmer cohort. Conclusions: Farmers had a higher age-adjusted incidence of MI and stroke. They also showed distinct patterns in cardiovascular risk factors compared to the general population.
The purpose of this study is to identify health problems and health behaviors of the middle-aged residing in urban areas and to plan and implement health promotion programs based on their health needs. The subjects' age ranged from 30-64 years in 1.040 middle-aged residing in an area of Kangbook-ku in Seoul. The data were collected from September 1998 to February 1999 with structured questionnaire using face-to-face or telephone interviews. The data were analyzed by SPSS-PC+ and identified by $X^2$ test and ANOVA. The results were as follows: 1. 35.4% of the males and 27.8% of the female responded that they were healthy regarding their perceived health status. In the order of chronic illness prevalence in the case of males was hypertension, diabetes, and digestive disorders and. in the case of females, was digestive disorders, hypertension, arthritis, anemia, and diabetes. 2. Male and female's smoking rates were 7.3% and 3.6% each and marked the highest rate of 30 to 40 years: drinking behavior was 66.9% in males and 32.2% in females. 3. The younger males had the worse dietary habits and had the lowest frequency of regular exercise. The older the females were, the more their weight increased. According to the results, health promotion programs by sex are recommended, especially in the target population of 30 to 40 years. and focused on the strategies for promoting self-care and actual health practice: it is strongly suggested that health promotion programs for adolescent and school-aged children before middle aged health behavior begins.
This study was performed to assess the nutritional status, frequency of visiting and necessity of nutrition programs for 157 elderly(male:49, female:108) visiting public health centers in Puchon. The purpose of the study was to provide the basic data for developing a nutrition service model. The subject were investigated by interviews with a questionnaire to obtain dietary data and other information related to public health center. Blood tests for analyzing biochemical status were also carried out. The elderly showed low income status. Ninety two percent of them showed their monthly income was less than 400,000 won and 72.6% was observed as having 30,000 won/month as their pocket money. The most frequent disease reported as having or being treated were hypertension(32.6%), rheumatic arthritis(28.5%), diabetes(10.2%), and stomach disease(8.2%) for males and hypertension(33.1%), diabetes(19.4%), rheumatic arthritis(16.7%), anemia(11.1%) for females. The nutrients whose daily intakes were less than 2/3 of RDA were calcium(37.5% RDA),vitamin A(49.9% RDA), iron(60.0% of RDA) and protein(62.0% RDA) for males and vitamin A(27.7% RDA), vitamin B$_2$(33.3% RDA), calcium(44.1% RDA), iron(53.3% RDA), and niacin(60.0% RDA) for females, respectively. Prevalence of anemia, assessed by hemogloben using WHO definition, were 4.1% for males and 18.5% for females. The percentage of males with hypercholesterolemia( 220 mg/dl) was 2.1% and 19.4% fir females, Two percent of males and 12.0% of females were observed as having a LDL-C higher than 165 mg/dl. The mean fasting blood glucose(FBG) level of males and female was 84.2 mg/dl and 101.7 mg/dl respectively. Two percent of males and 8.3% of females were found with a FBG higher than 140 mg/dl. Seventy one percent of elderly reported they were visiting public health centers at least once per week or more frequently. They were satisfied most with the low medical bills but showed the lowest satisfaction for the facilities of the public health centers. What the nutrition service programs wanted most was nutrition counseling and guidance.
Kim, Tae Hyun;Lee, Min-Jee;Yoo, Ki-Bong;Han, Euna;Choi, Jae-Woo
Journal of Preventive Medicine and Public Health
/
제48권3호
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pp.170-177
/
2015
Objectives: The goal of this study was to examine the association of various demographic and socioeconomic factors with risk factors for chronic kidney disease (CKD). Methods: We used nationally representative pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007-2013. We estimated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation. We defined CKD as a GFR <60 mL/min/$1.73m^2$, and 1304 of the 45 208 individuals included in the KNHANES were found to have CKD by this definition. The outcome variable was whether individual subjects adhered to the CKD prevention and management guidelines recommended by the Korea Centers for Disease Control and Prevention. The guidelines suggest that individuals maintain a normal weight, abstain from alcohol consumption and smoking, manage diabetes and hypertension, and engage in regular exercise in order to prevent and manage CKD. Results: This study found that individuals with CKD were more likely to be obese and have hypertension or diabetes than individuals without CKD. In particular, male and less-educated CKD patients were less likely to adhere to the guidelines. Conclusions: Although the prevalence of CKD, as indicated by the KNHANES data, decreased from 2007 to 2013, the prevalence of most risk factors associated with CKD fluctuated over the same time period. Since a variety of demographic and socioeconomic factors are related to the successful implementation of guidelines for preventing and managing CKD, individually tailored prevention activities should be developed.
Lee, Moo-Sik;Flammer, Andreas J.;Kim, Hyun-Soo;Hong, Jee-Young;Li, Jing;Lennon, Ryan J.;Lerman, Amir
Journal of Preventive Medicine and Public Health
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제47권4호
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pp.216-229
/
2014
Objectives: This study aims to investigate trends of cardiovascular disease (CVD) risk factor profiles over 17 years in percutaneous coronary intervention (PCI) patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS) and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for ${\beta}$-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.
This study was designed to investigate dietary life related to sodium of participants in hypertension and diabetes preventive education at the public health center located in Incheon Metropolitan City. Subjects were comprised of 301 adults (males: 102, female: 199) of age 50 years and above. The questionnaire for dietary life and salty taste assessment were performed on the subjects. Data were analyzed using SPSS package (ver. 18.0). According to the result of questionnaire for dietary behavior, 70% of the subjects were in the low salt intake group (p<0.001). In the result of questionnaire for dietary frequency, all ages groups were in the low salt intake group (p<0.01). The data of questionnaire for dietary behavior showed that the subjects of age above 75 years preferred salted seafood, soup, and kimchi (p<0.01). The data of questionnaire for dietary frequency showed that the subjects of age between 65 and 74, least chose fried kimchi, noodle, and soybean paste soup with clams (p<0.05), and the healthy adult groups chose kimchi stew, ssam and ssamjang (p<0.05). The score for dietary behavior in male subjects was higher than female subjects (p<0.01). In particular, the score for dietary frequency was the lowest in the subjects of age between 65 and 74 (p<0.01). The mean value of salty taste assessment in the subjects was 0.41% which is higher than the ideal value of 0.3% (p<0.01). Offering more nutrition education and continuous feedback of healthcare center may be needed to improve the health status of the adults.
Background: Sleep disorder is a precursor to depression, which is one of the psychological factors associated with periodontal disease that, in turn, affects general and periodontal health. This study aimed to investigate the relationship between sleep duration, depression, and periodontitis in older people aged over 65 years. Methods: A total of 2,002 older adults aged 65 years or older were included in the study. Their general and health aspects, including smoking, drinking, diabetes, hypertension, and depression, were investigated. Periodontitis was examined using the Community Periodontal Index (CPI). Data were analyzed through a complex sampling design method. Frequency and crossover analyses were conducted to investigate the relationship between depression and periodontitis. To investigate the effect of depression on periodontitis, a logistic regression analysis was performed. Results: Regarding depression and participants' general characteristics, statistically significant differences were found in sex, economic activity, smoking habit, and CPI (p<0.05). In the presence of depression, the odds ratio for periodontitis was 1.84, and the adjusted odds ratio for age, sex, economic activity, residence type, household income, education level, smoking habit, drinking, hypertension, and diabetes was 1.72, representing a significant difference (p<0.05). Conclusion: This study examined the relationship between depression and periodontitis in older persons and confirmed a significant correlation. As the population of older adults increases, we should pay attention to their mental and oral health as well as systemic diseases. Various programs for the health promotion of older persons need to be implemented to improve the quality of life of older people.
Assessing the health of international migrants is crucial in the Republic of Korea, Asia, and even worldwide. We compared the risk factors for non-communicable diseases among Asian migrants in Korea and the Korean population. This cross-sectional (2015) and longitudinal (2009-2015) observational study comprised a population-wide analysis spanning 2009 to 2015. Asian migrants (n=987,214) in Korea and Korean nationals (n=1,693,281) aged ≥20 were included. The Asian migrants were classified as Chinese, Japanese, Filipino, Vietnamese, and other. The prevalence of risk factors for non-communicable diseases (current smoking, obesity, diabetes mellitus, and hypertension) were analyzed. Regarding the age-adjusted prevalence, direct age standardization was conducted separately by sex using 10-year age bands; the World Standard Population was used as the standard population. Among the participants aged ≥20, the age-adjusted prevalence of current smoking was higher among Chinese and other Asian migrant men than among Korean men and women (p<0.001 and p<0.001, respectively). The age-adjusted prevalence of obesity was higher among Chinese, Filipino, and other Asian migrant women than in Korean women (p<0.001, p=0.002, and p<0.001, respectively). Among the participants aged 20-49, the age-adjusted prevalence of diabetes mellitus and hypertension was higher in Filipino migrant women than in Korean women (p=0.009 and p<0.001, respectively). Current rates of smoking and obesity were worse among Asian migrants of specific nationalities than among native Koreans. The health inequalities among Filipino migrant women in Korea, especially those aged 20-49, should be addressed.
Objectives : In order to apply useful data to clinical practice, we undertook this study and tried to find factors related with sequelae of facial palsy in relation with patients' age and gender distribution, past history with the disease, condition before onset, duration of recovery time, existence of remaining sequelae, types of the sequelae, and duration for sequelae to disappear. Methods : We evaluated patients' condition (fatigue, stress, chills, cold and so on), past history (diabetes mellitus, hypertension, stroke, herpes zoster, cancer and so on), duration of recovery time, types of the sequelae, age and sequelae distribution as to when the treatments were started as we examined 473 patients who were diagnosed with facial palsy, and visited the Out-patient Department of Acupuncture and Moxibustion of Bundang Oriental Medicine Hospital of Dongguk University through 2003 and 2004. Results : The sequelae of facial palsy were not significantly relevant to the signs found before facial palsy occurred(fatigue, stress, chills, and cold), or to patients' past history (hypertension, diabetes mellitus, facial palsy, herpes zoster). The duration of recovery time was within 30 days for 45.3% of the patients examined in this study, and within 90 days for 72.6%. Evaluating the existence of sequelae in relation to age, we found more in the group comprised of patients aged 50 and over than under 50. We found more sequelae in the group which is consisted of patients who had not been treated until 6 days after than within 5 days from the onset. Conclusion: Attention to sequelae will be needed for patients aged 50 and over and who were not treated until 6 days after the onset, as they had more sequelae.
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