• Journal of Preventive Medicine and Public Health
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• 제43권4호
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• pp.309-318
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• 2010

Objective: This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. Methods: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. Results: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). Conclusions: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2031-2037
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• 2012

Background: Analysis of gene-gene and gene-environment interactions for complex multifactorial human disease faces challenges regarding statistical methodology. One major difficulty is partly due to the limitations of parametric-statistical methods for detection of gene effects that are dependent solely or partially on interactions with other genes or environmental exposures. Based on our previous case-control study in Chongqing of China, we have found increased risk of colorectal cancer exists in individuals carrying a novel homozygous TT at locus rs1329149 and known homozygous AA at locus rs671. Methods: In this study, we proposed statistical method-crossover analysis in combination with logistic regression model, to further analyze our data and focus on assessing gene-environmental interactions for colorectal cancer. Results: The results of the crossover analysis showed that there are possible multiplicative interactions between loci rs671 and rs1329149 with alcohol consumption. Multifactorial logistic regression analysis also validated that loci rs671 and rs1329149 both exhibited a multiplicative interaction with alcohol consumption. Moreover, we also found additive interactions between any pair of two factors (among the four risk factors: gene loci rs671, rs1329149, age and alcohol consumption) through the crossover analysis, which was not evident on logistic regression. Conclusions: In conclusion, the method based on crossover analysis-logistic regression is successful in assessing additive and multiplicative gene-environment interactions, and in revealing synergistic effects of gene loci rs671 and rs1329149 with alcohol consumption in the pathogenesis and development of colorectal cancer.

• Clinical and Experimental Pediatrics
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• 제60권11호
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• pp.359-364
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• 2017

Purpose: The risk of cardiovascular disease (CVD) has been shown to be associated with systemic inflammation in obese adults with metabolic syndrome (MetS). The aims of this study were to evaluate the prevalence of MetS and its relation to inflammatory markers in obese Thai children. Methods: A cross-sectional study was conducted. Children with history of endogenous obesity, chronic diseases, drug ingestion, and any acute illness within 2 weeks prior to enrollment were excluded. Their fasting blood glucose (FBG) levels, oral glucose tolerance tests, insulin, lipid profiles, and selected inflammatory markers, including interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein (hs-CRP) levels, were tested. Results: In this study, 58 obese Thai children (female, 20; male, 38) with a mean body mass index z score of $5.1{\pm}2.2$ were enrolled. The prevalence of MetS and prediabetes was 31% and 17.2%, respectively. None of the children had diabetes. FBG levels, 2-hour glucose levels, and lipid profiles were not statistically different between those with and without MetS. However, obese children with MetS had higher insulin levels and homeostasis model assessment of insulin resistance values. Elevated hs-CRP levels were found in 69% of the cases, although it was not statistically different between the 2 groups. Conclusion: We described a substantial prevalence of MetS in Thai obese children. Regardless of MetS status, two-thirds of the obese children had elevated hs-CRP level, indicating subtle ongoing inflammatory process. This chronic inflammation feasibly predisposes them to CVD in the future, even in children without MetS.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권3호
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• pp.276-285
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• 2020

Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

• Journal of Preventive Medicine and Public Health
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• 제46권1호
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• pp.10-18
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• 2013

Objectives: We investigated the association between particulate matter less than $10{\mu}m$ in aerodynamic diameter ($PM_{10}$) exposure and non-accidental mortality in Asian populations by meta-analysis, using both time-series and case-crossover analysis. Methods: Among the 819 published studies searched from PubMed and EMBASE using key words related to $PM_{10}$ exposure and non-accidental mortality in Asian countries, 8 time-series and 4 case-crossover studies were selected for meta-analysis after exclusion by selection criteria. We obtained the relative risk (RR) and 95% confidence intervals (CI) of non-accidental mortality per $10{\mu}g/m^3$ increase of daily $PM_{10}$ from each study. We used Q statistics to test the heterogeneity of the results among the different studies and evaluated for publication bias using Begg funnel plot and Egger test. Results: Testing for heterogeneity showed significance (p<0.001); thus, we applied a random-effects model. RR (95% CI) per $10{\mu}g/m^3$ increase of daily $PM_{10}$ for both the time-series and case-crossover studies combined, time-series studies relative risk only, and case-crossover studies only, were 1.0047 (1.0033 to 1.0062), 1.0057 (1.0029 to 1.0086), and 1.0027 (1.0010 to 1.0043), respectively. The non-significant Egger test suggested that this analysis was not likely to have a publication bias. Conclusions: We found a significant positive association between $PM_{10}$ exposure and non-accidental mortality among Asian populations. Continued investigations are encouraged to contribute to the health impact assessment and public health management of air pollution in Asian countries.

• 한국화재소방학회논문지
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• 제23권5호
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• pp.110-116
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• 2009

본 연구는 Double Skin System의 화재 전파 위험성을 전산유체역학모델인 FDS를 이용하여 평가하였다. 화재모델링을 구현하기 위해 오피스 용도의 단위 구획공간을 화재지역으로 선정하였으며, 화재시나리오는 외창으로의 연소확대 위험 분석을 위하여 일반적으로 많이 설치되는 시스템조건들을 Case로 선정하여 분석하였다. 본 연구의 목적은 일반적으로 많이 사용되는 Double Skin System의 설치 간격에 따른 건물상층부로의 화재확대 위험성을 평가하고, 이에 따른 방화대책 등을 수립하는데 있다. 해석 결과, 더블스킨 중간층 간격이 넓을수록 상부층으로 연소확대 영향이 작은 것을 확인할 수 있었으며, 중간층 간격이 1m 미만인 경우는 발화층 상부 2개층으로 연소확대가 예상되므로 층간연소 확대 방지 시스템이 요구됨을 알 수 있다.

• 한국지진공학회논문집
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• 제11권3호
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• pp.11-21
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• 2007

지진하중에 의한 구조물의 손상 및 피해는 지진에 의한 동적 하중을 고려한 구조물의 내진설계의 도입을 통하여 저감시킬 수 있으며, 이 때 내진설계 도입으로 인한 구조물의 내진성능 향상 및 그에 필요한 비용을 동시에 고려하여 내진설계 도입의 적합성을 검증해야한다. 본 연구에서는 내진성능의 확률적 평가를 위해서 지진하중과 구조물 자체에 내재되어 있는 불확실성을 고려하여 빌딩구조물의 지진취약도를 작성하였으며 시뮬레이션의 효율성을 높이기 위한 Latin Hypercube 샘플링 기법을 도입하여 해석을 수행하였다. 내진 설계 도입의 필요성 검증을 위해서는 구조물의 물리적 내진성능 이외에도 구조물의 사회적, 경제적 기능 및 가치에 대한 고려가 필요하며 이러한 요소를 고려한 의사결정해석 절차를 등가비용모델의 예를 들어 제시하였다.

• Clinical and Experimental Pediatrics
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• 제62권2호
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• pp.48-54
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• 2019

Purpose: Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. Methods: A population of 120 apparently healthy adolescents aged 12-13 years was included in the cross-sectional design study; 58 were overweight or obese and 62 were of normal weight. We estimated anthropometric and laboratory measurements, including waist-to-height ratio, blood pressure, insulin sensitivity, aspartate aminotransferases (AST), ALT, and lipid profiles. Results: The mean ages of the overweight or obese and normal weight participants were $12.9{\pm}0.3$ and $13.0{\pm}0.3years$, respectively. Height, weight, body mass index, waist circumference, waist-to-height ratio, systolic and diastolic blood pressure, AST, ALT, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) score were significantly higher and the high-density lipoprotein-cholesterol and quantitative insulin-sensitivity check index were significantly lower in the overweight/obese participants in comparison to the normal-weight participants (all P<0.05). In multivariate linear regression analysis, waist-to-height ratio, systolic blood pressure, and HOMA-IR score were independently and positively associated with serum ALT levels. Conclusion: Screening for ALT levels in adolescents may help to differentiate those at risk of metabolic abnormalities and thus prevent disease progression at an early age.

• 대한통합의학회지
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• 제8권4호
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• pp.1-11
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• 2020

Purpose : The purpose of this meta-analysis was to examine the effects of microcurrent on inflammatory musculoskeletal diseases. Methods : Domestic databases (RISS, NDSL, KISS, DBpia, and Kmbase) were searched for studies that conducted clinical trials associated with microcurrent and its impact on inflammatory musculoskeletal diseases. A total of 606 studies published between 2002 and 2019 were identified, with 8 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with blood component, pain, and function. The 8 studies that were included in the study were evaluated using R meta-analysis (version 4.0). The quality of 7 randomized control trials was evaluated using Cochrane risk of bias (ROB). The quality of 1 non-randomized control trial was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression test was carried out to analyze the publishing bias. Results : The following factors had a large effect size involving microcurrent on inflammatory musculoskeletal diseases: blood component (Hedges's g=-2.46, 95 % CI=-4.20~-0.73), pain (Hedges's g=3.51, 95 % CI=2.44~4.77), and function (Hedges's g=3.06, 95 % CI: 1.53~4.58). Except for function (t=1.572, p=.191), Egger's regression test showed that the publishing bias had statistically significant differences. Conclusion : This study provides evidence for the effectiveness of microcurrent on inflammatory musculoskeletal diseases in terms of blood component, pain, and function. However, due to the small sample sizes used in the included studies, the results of our study should be interpreted cautiously, especially considering the publishing bias.

• 보건행정학회지
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• 제30권4호
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.