• 운동영양학회지
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• 제25권1호
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• pp.30-34
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• 2021

[Purpose] Many studies have observed a high prevalence of erectile dysfunction among individuals performing physical activity in less leisure-time. However, this relationship in patients with type 2 diabetic patients is not well studied. In exposure outcome studies with ordinal outcome variables, investigators often try to make the outcome variable dichotomous and lose information by collapsing categories. Several statistical models have been developed to make full use of all information in ordinal response data, but they have not been widely used in public health research. In this paper, we discuss the application of two statistical models to determine the association of physical inactivity with erectile dysfunction among patients with type 2 diabetes. [Methods] A total of 204 married men aged 20-60 years with a diagnosis of type 2 diabetes at the outpatient unit of the Department of Endocrinology at PSG hospitals during the months of May and June 2019 were studied. We examined the association between physical inactivity and erectile dysfunction using proportional odds ordinal logistic regression models and continuation ratio models. [Results] The proportional odds model revealed that patients with diabetes who perform leisure time physical activity for over 40 minutes per day have reduced odds of erectile dysfunction (odds ratio=0.38) across the severity categories of erectile dysfunction after adjusting for age and duration of diabetes. [Conclusion] The present study suggests that physical inactivity has a negative impact on erectile function. We observed that the simple logistic regression model had only 75% efficiency compared to the proportional odds model used here; hence, more valid estimates were obtained here.

• 대한조현병학회지
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• 제22권1호
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• pp.8-13
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• 2019

Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

• 한국식품영양과학회지
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• 제27권1호
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• pp.182-190
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• 1998

This study was conducted to compare food intakes between newly diagnosed diabetics and non-diabetics by food frequency questionnarie in adults in rural area. Food frequency questionnaire containing 65 food items was executed to 2,406 subjects over 30 years of age living inYeonchon-gun, Kyungki province. Frequency of consumption of each food items were divided into 9 categories ranging from 'over 3 tiemes a day' to 'never'. Fasting blood glucose levels were measured and 2-hour glucose tolerance test was administered for each subject. Newly diagnosed diabetics were identified as those with fasting blood glucose level ≥ 140mg/dl or 2-hour postprandial glucose level ≥200mg/dl and without previous diagnosis of diabetes. Intake frequencies of food items were compared between newly diagnosed diabetics and nondiabetics. For each food item examined, odds ratios for developing diabetes were calculated for people consuming more frequently, after adjusting for age, BMI and sex. Food intake frequencies were compared according to the occurrence of diabetes. Twenty four items were more frequently consumed by nonidabetics and 12 items were more frequently consumed by newly diagnosed diabetics. Odds ratios for diabetes were significantly lower for breads, biscuit, beef loin, beef tender loin, pork belly, fish paste, coffee, cola/cider, candy, beer, chongak kimchi, carrot, mushrooms and other white vegetables, banana, melon and juice. On the other hand, odds ratios for diabetes were higher for zucchini and garlic. Although this was a cross over prevalence study, the results indicate that consumption frequencies of several food items were related with the occurrence of diabetes in the study subjects.

• Biomolecules & Therapeutics
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• 제28권1호
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• pp.110-118
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• 2020

Migration presents a substantial social and public health issue. However, it is unclear whether diabetes is worse among Asian migrants than natives of South Korea over time. This longitudinal study investigated the nationwide population, including 2,680,495 adults aged 20 years and older (987,214 Asian migrants and 1,693,281 natives), who received health check-ups, using the Korean National Health Insurance Service data (2009-2015). Joinpoint regression was used to estimate the annual percentage change of diabetes, and multivariable logistic regression was used to examine differences in incident type 2 diabetes between Asian migrants and natives adjusting for age, sex, economic status, body mass index, smoking status, any alcohol use, and physical activity. The age-adjusted prevalence of diabetes increased among native men (from 8.8% in 2009 to 9.7% in 2015, APC=1.64, p<0.05) compared to Asian migrant men, and the age-adjusted prevalence of diabetes increased among native women (from 6.0% in 2009 to 6.7% in 2015, APC=1.88, p<0.05) compared to Asian migrant women. In the multivariate analyses, Asian migrants were less likely to get type 2 diabetes than natives (odds ratio, 0.82; 95% CI, 0.78 to 0.86) between the first and last health check-ups. However, the odds ratio for developing type 2 diabetes was 1.15 (95% CI, 1.10 to 1.20) among low-income levels compared to high-income levels, regardless of whether they were Asian migrants or natives. The results could help to establish a new strategy for prevention, treatment, and management of diabetes among the Asian population.

• 보건교육건강증진학회지
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• 제32권4호
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• pp.37-46
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• 2015

Objectives: This study was conducted to expand evidence-base for the effectiveness of lifestyle intervention programs to prevent the onset of diabetes and cardiovascular diseases. Methods: Seven intervention studies between 2006 and 2014 at Korea Association of Health Promotion were analyzed. All the studies were randomized controlled trials(RCTs) and included multi-component behavioral interventions. The participants of the programs were 2,172 adults with risk factors regarding metabolic syndrome criteria. The proportions of normalized participants were compared within and across the studies using odds ratio effect sizes. Results: The reductions in the prevalence of metabolic syndrome were from 49.6% to 65.1% in intervention groups, and from 38.7% to 52.3% in comparison groups. Significant differences in effectiveness between groups were found in two studies, one in 2006 with odds ratio of 1.69(p<0.01) and another in 2009 with odds ratio of 2.36(p<0.001). Proportions of normalized participants were higher in blood pressure(31.9% to 52.5% in the intervention groups and 23.0% to 43.3% in comparison groups) than other risk factors. Abdominal obesity showed weakest improvement after the intervention in both groups. Conclusions: Lifestyle modification program is an effective method to reduce diabetes and cardiovascular risks in adults by decreasing the prevalence of metabolic syndrome and its components.

• Nutrition Research and Practice
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• 제18권2호
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• pp.239-256
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• 2024

BACKGROUND/OBJECTIVES: Over the past 10 yrs, the prevalence of diabetes in Korea has continued to incline, and the importance of lifestyle modification to manage diabetes has been highlighted. For patients with diabetes, carbohydrate intake reduction is effective in improving glycemic control; thus, we aimed to analyze the effect of carbohydrate intake ratio and suggest an appropriate carbohydrate intake ratio. SUBJECTS/METHODS: Using the 8th Korea National Health and Nutrition Examination Survey (2019-2021), we analyzed the data including participants aged 30 yrs or older with diabetes, and they were stratified into good and poor glycemic control groups. To analyze the correlation between the dietary behavior characteristics of participants with diabetes and the carbohydrate intake ratio, sociodemographic characteristics, dietary behavior, and health behavior were adjusted, and multivariate logistic regression analysis was conducted to present the adjusted odds ratio and 95% confidence interval (CI). RESULTS: In the unadjusted crude model, when carbohydrate intake ratio in total energy intake increased by 1%, the likelihood of poor glycemic control increased by 1.007-fold (95% CI, 0.998-1.016; P = 0.121). In model 1, which uses age and sex as adjustment variables, an increase of up to 1.011-fold was possible (95% CI, 1.001-1.021; P = 0.008). In model 2, which added variables such as diabetes duration, frequency of fruit consumption, frequency of lunch and, frequency of dinner, the risk of poor glycemic control increased by 1.010-fold as the carbohydrate intake ratio increased (95% CI, 0.998-1.022; P < 0.001). CONCLUSION: This study confirmed that as the ratio of carbohydrate intake to total energy intake increases the likelihood of poor glycemic control also increases in patients with diabetes. Therefore, to improve glycemic control in patients with diabetes, controlling the carbohydrate intake may be helpful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권5호
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• pp.271-277
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• 2016

Objectives: The objective of this study was to retrospectively investigate the association of diseases having an influence on inhibition of angiogenesis such as hypertension, diabetes mellitus type II, hypercholesterolemia, and rheumatoid arthritis (RA) with the development of osteonecrosis of the jaws. Materials and Methods: The 135 patients were allocated into 4 groups of bisphosphonate-related osteonecrosis of the jaw (BRONJ) group (1A); non-BRONJ group (1B); osteonecrosis of the jaw (ONJ) group (2A); and control group (2B), according to histologic results and use of bisphosphonate. This retrospective study was conducted with patients who were treated in one institute from 2012 to 2013. Fisher's exact test and logistic regression analysis were used to analyze the odds ratios of diseases having an influence on inhibition of angiogenesis for development of ONJ. Results: The effects of diabetes and hypertension were not statistically significant on development of ONJ. When not considering bisphosphonate use, RA exhibited a high odds ratio of 3.23 (P=0.094), while hyperlipidemia showed an odds ratio of 2.10 (P=0.144) for development of ONJ. More than one disease that had an influence on inhibition of angiogenesis showed a statistically significant odds ratio of 2.54 (P=0.012) for development of ONJ. Conclusion: Patients without diseases having an influence on inhibition of angiogenesis were at less risk for developing ONJ.

• Journal of Preventive Medicine and Public Health
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• 제56권6호
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• pp.504-514
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• 2023

Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients' first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intra-class correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. Conclusions: This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

• 한국학교보건학회지
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• 제8권1호
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• pp.143-154
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• 1995

Korea has been recently reducing the quality of life as well as rising medical cost because of the increase of chronic diseases. But we can prevent those chronic diseases through the improvement of environment or life style. We evaluated the educational effectiveness of chronic diseases(hypertention, diabetes, cancer, stroke and other chronic diseases) designed to increase the knowledge, attitude and practice of chronic diseases among university students. Between August 1994 and November 1994, we implemented chronic diseases prevention instruction in intervention students; unmatched control students were selected in same university. We conducted pre- and post-intervention surveys both intervention and control students with self-reported questionnaires(50 items). We assigned score(0-4 points) to items and conducted a analysis of covariance(ANCOVA) with sex, grade and economic status as the covariate, using the SAS PC computer statistical package. And we culculated odds ratio with safety scores between intervention and control students. The results of this study were followed. 1. In demographic characteristics of subjects both pre- and post intervention, we found no significant differences in intervention and control students at religion, father's education, mother's education, mother's occupation and type of residence(p>0.05), but we found significant differences at sex(p<0.001), grade(p<0.001) and economic status(p<0.05). 2. The sex, grade and economic status-adjusted mean prevention knowledge scores for diabetes and stroke increased from the pre- to post-survey in the intervention students(p<0.001), but control students did not increased(p>0.05). As odds ratios in knowledge were below 1, the knowledge of intervention students were higher than control students. 3. The attitudes for general adult health increased from the pre- to post-survey in the intervention students(p<0.05), but control students did not increased(p>0.05). As odds ratios in attitudes were approximately 1, we can not say effectiveness in intervention students 4. The pratices for cancer and stroke increased from the pre- to post-survey in both the intervention and control students(p<0.001). Also odds ratio of hypertention was 0.91, and that of stroke was 1.14. 5. Health related behaviors did not increased from the pre- to post- survey in both the intervention and control students(p>0.05). But odds ratio of drinking was 0.76 and that of body weight was 1.21. 6. Health status did not increased from the pre- to post- survey in both the intervention and control students(p>0.05). As odds ratio of health status was 1.09, prevention education was not effect in intervention students We would like to recommend as follows; 1. University students must learn about prevention of chronic diseases. Because the knowledge of invetervention students was higher than that of control students. 2. The prevention education of chronic diseases should be taught from primary school. 3. Adult health education for university students must be practiced continuously. Education period(l5 weeks) in this study was not complete. 4. The evaluation of chronic diseases was conducted real measurement(such as BP check) as well as self reported-survey. 5. Educational materials(video tape, pamphlet) related the prevention of chronic diseases should be developed at national level. And we must easely use those materials. 6. The prevention education of chronic diseases should be made through mass media as well as school education.

• 한국학교ㆍ지역보건교육학회지
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• 제16권2호
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• pp.17-31
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• 2015

Objectives: This study aimed to analyze the relationship between metabolic syndrome and cataract in a middle-aged men over the age of 40's by using the data from the 5th Korean National Health and Nutrition Examination Survey(2010~2012). Methods: The subjects for the analysis were comprised of 5,808 patients who were at least 40 years or more with metabolic syndrome and cataract. The comparison between the metabolic syndrome and ophthalmic diseases according to the health demographic characteristics, health behavior and health conditions was analyzed with ${\chi}^2-test$. The complex samples logistic regression analysis was used to calculate the odds ratio of cataract according to the health demographic characteristics, health behavior and health conditions and the combination of the comprising factors of the metabolic syndrome. Results: After controlling the confounding factors, the odds ratio of cataract in the metabolic syndrome group was OR 1.30, which was significantly high (p<0.01). Furthermore, the odds ratio of cataract was significantly high in the case of males, as the age increased, educational level decreased, with exercising habits of less than 3 days a week, sun exposure of at least 5 hours, with hypertension and diabetes (p<0.01). The results of analyzing the odds ratio for the occurrence of cataract with the components of metabolic syndrome were OR 1.36 (concurrent high fasting blood glucose, high triglycerides, low HDL cholesterol), OR 1.63 (concurrent high fasting blood glucose, high triglycerides, high waist circumference) and OR 1.33 (high triglycerides, low HDL cholesterol, high waist circumference), which showed significantly high odds ratio for cataract occurrence (p<0.05). Conclusions: We come to know that the relation between metabolic syndrome and components are associate with cataract. Therefore the thorough management of metabolic syndrome and components is needed to prevent cataract.