• Journal of Preventive Medicine and Public Health
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• 제45권6호
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• pp.394-401
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• 2012

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.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.139-146
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• 2012

Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

• Journal of Gastric Cancer
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• 제17권2호
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• pp.145-153
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• 2017

Purpose: Identification of the infrapyloric artery (IPA) type is a key component of pylorus-preserving gastrectomy. As the indocyanine green (ICG) fluorescence technique is known to help visualize blood vessels and flow during reconstruction, we speculated that this emerging technique would be helpful in identifying the IPA type. Materials and Methods: From August 2015 to February 2016, 20 patients who underwent robotic or laparoscopic gastrectomy were prospectively enrolled. After intravenous injection of approximately 3 mL of ICG (2.5 mg/mL), a near-infrared fluorescence apparatus was applied. The identified shape of the IPA was confirmed by examining the actual anatomy following infrapyloric dissection. Results: The mean interval time between ICG injection and visualization of the artery was 22.2 seconds (range, 14-30 seconds), and the mean duration of the arterial phase was 16.1 seconds (range, 9-30 seconds). The overall positive predictive value (PPV) of ICG fluorescence in identifying the IPA type was 80% (16/20). The IPA type was incorrectly predicted in four patients, all of whom were obese with a body mass index (BMI) of more than $25kg/m^2$. Conclusions: Our preliminary results indicate that intraoperative vascular imaging using the ICG fluorescence technique may be helpful for robotic or laparoscopic pylorus-preserving gastrectomy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2225-2229
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• 2013

Background: As data on the relation between obesity and lymph node ratio are missing in the literature, we here aimed to assess the impact of obesity on this parameter and other clinicopathological features of breast cancer cases and patient survival. Materials and Methods: Medical data of 646 patients, all referred to two centers in Tehran, Iran, were reviewed. Factors that showed significant association on univariate analysis were entered in a regression model. Kaplan-Meier and Cox-regression were employed for survival analysis. Results: Obesity was correlated with the expression of estrogen and progesterone receptor (p=0.004 and p=0.039, respectively), metastasis to axillary lymph nodes (p=0.017), higher lymph node rate (p<0.001) and larger tumor size (p<0.001). The effect of obesity was stronger in premenopausal women. There was no association between obesity and expression of human epidermal growth factor receptor. Three factors showed independent association with BMI on multivariate analysis; tumor size, estrogen receptor and lymph node ratio. Obesity was predictive of shorter disease-free survival with a hazard ratio of 3.324 (95%CI: 1.225-9.017) after controlling for the above-mentioned variables. Conclusions: The findings of this study support the idea that obese women experience more advanced disease with higher axillary lymph node ratio, and therefore higher stage at the time of diagnosis. Furthermore, obesity was associated with poorer survival independent of lymph node rate.

• 생명과학회지
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• 제19권4호
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• pp.543-548
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• 2009

Treatment for breast cancer produces side effects that diminish functional capacity and quality of life (QOL) among survivors. Tai Chi is a moderate form of exercise that may improve functional capacity, physical activity and oxidative stress. The purpose of this study was to evaluate the effects of regular Tai Chi exercise on malondialdehyde (MDA), SOD and physical fitness (muscle strength, flexibility, flexion, extension, adduction, and abduction). Forty obese women were recruited from a public health center and divided into control (CON: n=20) and trained (EXP: n=20) groups. The Tai Chi exercise group participated in a 12-week (4 times/week) training program. Data were analyzed with T-test. MDA, SOD and physical fitness (muscle strength, flexibility, flexion, extension, adduction, and abduction) were evaluated before and after the Tai Chi program in both groups. There were significant improvements in shoulder flexibility, flexion, extension, abduction, and adduction. However, there was no improvement in muscle strength. There were also significant improvements in MDA and SOD. Based on these results, Tai Chi exercise has been shown to stimulate endogenous antioxidant enzymes and reduce oxidative damage markers. and also be effective in improving physical fitness and QOL. Further study is needed in this area.

• 비만대사연구학술지
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• 제1권1호
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• pp.43-45
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• 2022

Intensive lifestyle modifications and anti-obesity medications are essential for obesity treatment. Antiobesity medications should be selected according to the patient's comorbidities, symptoms, and preferences. This case report describes the treatment of a morbidly obese patient with a history of depression, who complained of tingling and numbness after total thyroidectomy for papillary thyroid cancer. Very low-dose controlled-release phentermine/topiramate was prescribed and intensive lifestyle modifications were encouraged. As a result, the patient effectively lost weight and reached a near-normal weight without adverse drug effects. This implies that even an off-label anti-obesity medication low dose may be better for some patients, and the most important factor in obesity treatment is patient-tailored treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6805-6810
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• 2014

Background: Previous studies have suggested a link between obesity and breast cancer (BC). However, there is no universal consensus, especially in population based studies. Because only few studies have been conducted on African women, we aimed here to assess the relationship between BMI at time of diagnosis and the BC histopathological features among Tunisian patients according to menopausal status using a hospital-based prospective cohort study. Materials and Methods: Clinical and pathological data were collected from 262 patients stratified on four groups according to their BMI. The relationship between BMI and histopathological features at diagnosis was analysed using univariate and multivariate analysis. Receiver-operating characteristic (ROC) curves were used to evaluate the performance of BMI in predicting of high tumor grade, in comparison to ki-67 index of proliferation. Results: Obesity was correlated with larger tumors, advanced grade and with ER-PR-Her2+ BC subtype. An association of BMI with tumor size and tumor grade was observed in both premenopausal and postmenopausal women. Additionally, a significant association between BMI and ER+, ER+PR+Her2+ and ER-PR-Her2+ status was revealed for premenopausal patients, while only ER+PR+Her2+ was associated with BMI for postmenopausal women. Finally, our results showed that compared to Ki67 proliferation index, BMI is a useful prognostic marker of high grade BC tumors. Conclusions: These data are the first to show that in Tunisia obese women suffering from BC have significantly larger tumors and advanced tumor grade and that higher BMI might influence tumor characteristics and behavior.

• Clinical and Experimental Pediatrics
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• 제54권6호
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• pp.253-259
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• 2011

Purpose: Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods: We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results: A total of 19 (19.4%) patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P<0.001 and r=0.44, P<0.00, respectively). Sixty-one (62.2%) patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03). The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03). Conclusion: Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.

• 한국방사선학회논문지
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• 제11권4호
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• pp.289-295
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• 2017

일반적으로 유방암 발생에 영향을 미치는 요소는 여러 연구가 진행되었으나 위험인자에 관한 체계적인 조사는 드물다. 따라서 본 연구에서는 유방초음파 검사 전 실시하는 건강문진표 작성내용과 실제 초음파 검사에서 유방암 판정을 받은 환자를 바탕으로 관련인자를 파악하고자 하였다. 유방초음파를 실시한 417명을 대상으로 자기기입식 문진표를 작성하였고 양성, 악성으로 분류하여 후향적 연구를 시행하였다. 유방암 발생 관련인자로 나이, 체질량지수, 투약 종류에서 관련성을 보였으며(p<0.05), 다변량분석 결과 교차비(Odds ratio)는 나이에서 50대 이하를 기준으로 50대에서 4.93배, 체질량지수 정상군보다 비만군에서 2.43배 증가하였고 타목시펜과 여성호르몬제 투약 시에는 0.14배, 0.16배 감소하였다(p<0.05). 따라서 나이가 증가함에 따라 정기적인 검사를 실시하고 적절한 체중관리가 필요하다. 따라서 본 연구는 유방암 발생에 영향을 미치는 위험인자 규명의 기초자료로 제공될 것으로 기대한다.

• Journal of Gastric Cancer
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• 제7권4호
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• pp.242-247
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• 2007

목적: 아직까지 국내에서는 단지 비만 환자에 있어 수술 후 창상 합병증이 높을 것이라는 추측만 있을 뿐 정확히 체 질량 지수 값과 수술 후 창상 합병증과의 관계에 대해 조사된 바가 없다. 이에 대해 본원에서 위암으로 수술 받은 환자들을 대상으로 한국에서의 체 질량 지수 값과 수술 후 창상 합병증과의 관계에 대해 알아보고자 하였다. 대상 및 방법: 수술 후 창상 합병증은 2005년 9월부터 2006년 2월까지 서울아산병원에서 위암으로 수술 받은 772명의 환자들을 대상으로 하여 수술 전 과거력, 이학적 검사, 경과기록 등 의무 기록 등을 통해 후향적인 방법으로 조사하였다. 결과: 총 대상 환자는 772명이었으며 평균 나이는 $57.3{\pm}11.2$세였고, 성비는 남 : 여=1.82 : 1이었다. 수술 후 창상 합병증의 비율은 세 BMI 군간에 다르게 나타났다. BMI>$25\;kg/m^2$인 과 체중 환자 군에서 4.6%로, BMI<$20\;kg/m^2$인 저체중 환자 군과 $20M{\leq}BMI{\leq}25\;kg/m^2$인 정상 체중 환자 군의 0.9%, 1.6%보다 더 높게 나타났으며 통계학적으로 유의한 차이가 있었다(P=0.038). 결론: 과체중인 환자(BMI>$25\;kg/m^2$)는 저 체중 및 정상 체중인 환자($BMI{\leq}25\;kg/m^2$) 보다 수술 후 창상 합병증의 비율은 높았고 이는 BMI와 수술 후 창상 합병증은 유의하게 관계가 있는 것을 알 수 있었다.