• Title/Summary/Keyword: multivariable

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Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study

  • Jihoon Kim;Yesung Lee;Eunhye Seo;Daehoon Kim;Jaehong Lee;Youshik Jeong;Seonghyun Kwon;Jinsook Jeong;Woncheol Lee
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.38.1-38.10
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    • 2023
  • Background: Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs. Methods: We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age. Results: In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02-1.34); the OR was 0.99 (95% CI: 0.80-1.22) in those under 40 and 1.28 (1.08-1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92-1.19); the OR was 1.10 (95% CI: 0.90-1.35) in those under 40 and 1.20 (1.01-1.43) in those over 40. Conclusions: This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.

Relationship Between Dairy Intake and Hospitalization Risk and Disease Severity in Patients With COVID-19

  • Seyed Ali Abbas-Hashemi;Zahra Yari;Samira Soltanieh;Marieh Salavatizadeh;Sara Karimi;Sussan K. Ardestani;Mohammadreza Salehi;Soodeh Razeghi Jahromi;Tooba Ghazanfari;Azita Hekmatdoost
    • Clinical Nutrition Research
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    • v.12 no.4
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    • pp.283-292
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    • 2023
  • The aim of this study was to investigate whether dairy intake was associated with the severity of coronavirus disease 2019 (COVID-19) disease and the probability of hospitalization of patients. This cross-sectional study was conducted on 141 patients with COVID-19 with an average age of 46.23 ± 15.88 years. The number of men (52.5%) participating in this study was higher than that of women. The association between dairy intake and COVID-19 was evaluated by multivariable logistic regression analysis. The risk of hospitalization in the highest tertile of dairy intake was 31% lower than in the lowest tertile (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.37-1.25, p trend = 0.023). Higher milk and yogurt intake was associated with a reduced risk of hospitalization due to COVID-19. Patients in the third tertiles were about 65% (p for trend = 0.014) and 12% (p for trend = 0.050) less likely to be hospitalized than those in the first tertile, respectively. Dairy consumption, especially low-fat ones, was associated with a lower risk of hospitalization due to COVID-19 and lower severity of COVID-19.

Use of vitamin and mineral supplements and related variables among university students in Seoul (서울 일부지역 대학생의 비타민·무기질 보충제 섭취 실태 및 관련요인에 관한 연구)

  • Choi, Jung-Hwa;Je, Youjin
    • Journal of Nutrition and Health
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    • v.48 no.4
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    • pp.352-363
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    • 2015
  • Purpose: Despite the popularity of dietary supplements, little data are available on their use by university students. The purpose of this study was to examine the use of vitamin mineral supplements and to identify factors related to supplement use among university students. Methods: University students (N = 345) in Seoul were surveyed. Survey questions included descriptive demographics, types of vitamin and mineral supplements used, health related lifestyle factors, mini dietary assessment, and knowledge and behaviors related to supplement use. Results: Of university students surveyed, 41% consumed vitamin and mineral supplements. Among the supplement users, multivitamins were the most commonly used dietary supplements (68.6%), followed by vitamin C (31.4%) and calcium (17.1%). In particular, the use of vitamin C and iron supplements was more common in females than males (p < 0.05). For the number of supplements taken daily, 32.1% of supplement users consumed 2 or more supplements; 20% of supplement users had almost no knowledge of the supplements being taken. Based on the results of multivariable logistic regression analysis, supplement use was associated with higher interest in their own health, non-smoker, and supplement use by family (p < 0.05). In addition, supplement use was slightly associated with healthy dietary behavior such as consuming a variety of foods (p = 0.05) and current disease status (p = 0.05). Conclusion: University students with relatively healthy lifestyles appear to take vitamin and mineral supplements, but they had little knowledge of the supplements. Given high prevalence of dietary supplement use among university students, nutrition education regarding supplement use is needed.

The Association of Life Event Stress, Family Function and Cancer (암과 생활사건스트레스 및 가족기능의 연관성)

  • Choi, Youn-Seon;Lee, Young-Mee;Hong, Myung-Ho;Chun, Byung-Chul
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.114-124
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    • 1999
  • Purpose : To clarify the relation between psychosocial variables and cancer in Korea. Methods : Case-control study. Participants: 239 subjects in 2 university hospitals in Seoul completed a series of psychometric instruments(the Olson's FACES III and the Lee's 98-items life event scale). Results : In bivariable analysis, there were statistically significant difference in age and economic status(income): marginal significance in education status and marital status between the cases and controls. The family function type and stress score were not significantly different. The result of multivariable logistic regression, analysis showed that the risk of cancer was associated with economic status and marital status, but neither the family function nor the life event stress. Conclusion : In this study, we cannot prove the statistical association between the family function, life event stress and cancer. It is necessary to persevere in our efforts to clarify the relation between stress and disease and to develop the useful tools to measure the Korean family function and life event stress.

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Surgical Results and Risk Facor Analysis of the Patients with Single Ventricle Associated with Total Anomalous Pulmonary Venous Connection (총폐정맥연결이상증을 동반한 단심증 환아의 수술결과 및 위험인자 분석)

  • 이정렬;김창영;김홍관;이정상;김용진;노준량
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.862-870
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    • 2002
  • The surgical results of the patients with single ventricle(SV) associated with total anomalous pulmonary venous connection(TAPVC) has been reported with high mortality and morbidity due to their morphologic and hemodynamic complexity. A retrospective review was undertaken to report the outcome of the first-stage palliative surgery in our institution and to determine the factors influencing early death. Material and Method: Between January 1987 and June 2002, 39 patients with SV and TAPVC underwent surgical intervention with or without TAPVC repair. Age at operation ranged from 1day to 10.7months (median age, 2.4month), and 29 patients were male. Preoperative diagnosis included 20 right-dominant SV, 15 SV with endocardial cushion defect, 3 left-dominant SV, and 1 tricuspid atresia. The pulmonary venous connection was supracardiac in 22, cardiac in 5, infracardiac in 11, and mixed in 1, Obstructed TAPVC was present in 11. First-stage palliative surgery was performed in 37. Repair of TAPVC, either alone or in association with other procedures, was performed during the initial operation in 31. Univariate and multivariate analyses were performed to analyze the risk factors influencing the operative death. Result: A mean follow-up period of survivors was 34.3 $\pm$ 43.0(0.53 ~ 146.2)months. Overall early operative mortality was 43.6%(17/39). The causes were low cardiac output in 8, failure of weaning from cardiopulmonary bypass in 3, sepsis in 2, pulmonary hypertensive crisis in 1, pulmonary edema in 1, pneumonia in 1, and postoperative arrhythmia in 1. Risk factors influencing early death in univariate analysis were body weight, surgical intervention in neonate, obstructive TAPVC, preoperative conditions including metabolic acidosis, and need for inotropic support, TAPVC repair in initial operation, operative time, and cardiopulmonary bypass(CPB) time. In multivariable analysis, body weight, age at initial operation, surgical intervention in neonate, preoperative conditions including metabolic acidosis, need for inotropic support and CPB time were the risk factors. Conclusion: In this study, we demonstrated that the patients with SV and TAPVC had high perioperative mortality. Preoperative poor condition, young age, the length of operative and CPB time, the presence of obstructive TAPVC had been proven to be the risk factors. This fact suggests that the avoidance of unnecessarily additional procedures may improve the surgical outcomes of the first-stage palliative surgery. However further observation and collection of the data is mandatory to determine the ideal surgical strategy.

Dietary assessment according to intake of Korean soup and stew in Korean adults: Based on the 2011~2014 Korea National Health and Nutrition Examination Survey (한국 성인의 국물 음식류 섭취에 따른 식생활 평가 : 2011~2014 국민건강영양조사 자료를 이용하여)

  • Kwon, Yong-Suk;Han, Gyusang
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.335-346
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    • 2016
  • Purpose: This study was conducted to conduct dietary assessment of Korean adults according to intake of Korean soup and stew. Methods: To accomplish this study, 20,926 adults aged 19 yr or higher who participated in the dietary intake survey (24 h recall method) were analyzed from the data of the 2011~2014 Korea National Health and Nutrition Examination Survey (KNHANES). The items included in the soup and stew were guk, tang, jjigae, jijimi, and jeongol. Results: Intakes of soup and stew of subjects were divided into quartiles; intake range by quartile was Q1: < 22.96 g, Q2: 22.96~98.75 g, Q3: 98.75~212.23 g, and Q4: $${\geq_-}212.24g$$. In the case of the Q4 group, male, married, employed, higher educated, and high income subjects showed increased intakes of soup and stew. In addition, sodium intake among nutrient intakes increased from 3,849.04 mg in Q1 group to 5,363.57 mg in Q4 group. Intakes of cereals/grains, potatoes/starches, legumes, seeds/nuts, vegetables, mushrooms, fruits, meat, fishes/shell fishes, milks/dairy products, oils/fats, and seasonings among all foods significantly increased from Q1 group to Q4 group. Lastly, in the multivariable regression analysis, male, higher age, married, eating breakfast, consumption of snacks, prepared meals from home/institution, average eating-out frequency per week, energy consumption, and sodium intake related parameters increased intake of Korean soup and stew. Conclusion: Excessive intake of sodium was related to high blood pressure and metabolic syndrome. Thus, there are needs to improve dietary guidelines and nutrition education for balanced intake of soup and stew.

Factors Associated with Cognitive Function in Breast Cancer Patients Complaining Cognitive Decline (인지 저하를 호소하는 유방암 환자들의 인지 기능 관련 요인)

  • Lee, Sun Ah;Park, Kyung Mee;Kim, Tae Ho;Lee, Eun
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.136-144
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    • 2017
  • Objectives : Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. Methods : We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. Results : There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p<0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(${\beta}=-0.336$, p=0.001) and anxiety(${\beta}=-0.273$, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(${\beta}=-0.375$, p=0.023) and anxiety (${\beta}=-0.404$, p=0.013). Conclusions : The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.

Associations between Sleep Quality, Daytime Sleepiness, with Perceived Errors during Nursing Work among Hospital Nurses (간호사의 수면의 질, 주간졸음 및 간호업무 중 인지한 오류 경험과의 관련성)

  • Kim, Mi Sung;Kim, Jang-Rak;Park, Ki-Soo;Kang, Young Sil;Choe, Sung Pil Michael
    • Journal of agricultural medicine and community health
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    • v.38 no.4
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    • pp.229-242
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    • 2013
  • Objectives: The objective of this study was to identify the influence of shift work on sleep quality, daytime sleepiness, and perceived errors during nursing work among hospital nurses. Methods: The study subjects were 209 hospital nurses working in two general hospitals in South Korea. The data were collected through self-administered questionnaires in May 2013. Sleep quality was measured using Korea Pittsburgh Sleep Quality Index (PSQI-K), daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and perceived errors in past 6 months during nursing duty hours with the tool developed in this study. Results: The sleep quality was significantly worse among rotating shift nurses when compared to fixed day duty nurses. However, the odds ratio (OR) of 1.92 [95% confidence interval(CI): 0.58-6.37] adjusted for sociodemographic variables, health behaviors, and working environment in logistic regression was not significant. There was no significant difference in the daytime sleepiness between rotating shift nurses and fixed day duty nurses in both simple and multivariable analyses. There were significantly more perceived errors in rotating shift nurses than fixed day duty nurses. However, the OR of 1.26 (95% CI: 0.38-4.21) adjusted for sociodemographic variables, health behaviors, working environment, sleep quality, and daytime sleepiness in logistic regression was not significant. Depression (OR=3.31, 95% CI: 1.11-9.84) and daytime sleepiness(OR=1.18, 95% CI: 1.07-1.30) were significantly associated with perceived errors in logistic regression. Conclusion: This study suggested shift work among hospital nurses had no independent influence of sleep quality, daytime sleepiness, and perceived errors. However, daytime sleepiness had independent influence of perceived errors. More studies are warranted to achieve more reliable conclusion.

The Clinical Value of Intima-media Thickness in Patients with Stable Coronary Artery Disease and C-reactive Protein within Normal Limits (경동맥 내중막 두께가 정상 C-반응성 단백질 농도를 가진 안정형 협심증 환자에서 가지는 임상적 의의)

  • Kwon, Jong-Bum;Park, Kuhn;Choi, Si-Young;Park, Chan-Beom;Kim, Yong-Hwan;Her, Sung-Ho;Park, Mahn-Won;Lee, Jong-Ho
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.482-489
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    • 2010
  • Background: The purpose of this study was to determine whether hand-measured carotid intima-media thickness (IMT) was a reliable and simple tool that could be used to evaluate the severity of stable coronary artery disease (CAD) with normal high-sensitivity C-reactive protein (CRP). Material and Method: We examined left carotid IMTs in 688 patients with stable CAD and excluded 121 patients with abnormally elevated hs-CRP ($\geq$0.5 mg/dL). We sought to determine the association between risk factors and the severity of stable CAD and carotid IMT in 567 patients who were divided into lower and higher groups based on the median value. Patients underwent a coronary artery angiogram and had at least significant stenosis (>50% of the original luminal diameter involving one or more major coronary artery). Result: Of the 567 patients, 300 (52.9%) were in the lower IMT group and 267 (47.1%) were in the higher IMT group; the median value was 0.76 mm. By multivariable logistic regression analysis, the following groups were different: older age (~49 vs. 70~ years, respectively; OR=6.552), high FBS (~99 vs. 120~ mg/dL; OR=1.713) and severity of CAD (1 vessel vs. 2 vessel disease; OR=1.711, 1 vessel vs. 3 vessel disease; OR=1.714). Conclusion: We conclude that there are correlations between increased carotid IMT and severity of CAD in stable angina patients with normal CRP levels.

A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU (중환자실 섬망 환자와 비섬망 환자 구분에 기여하는 임상 지표에 관한 연구)

  • Ko, Chanyoung;Kim, Jae-Jin;Cho, Dongrae;Oh, Jooyoung;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.101-110
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    • 2019
  • Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.