Showing papers in "Korean Journal of Family Medicine in 2018"
TL;DR: High social support could increase happiness among elders as the quality and quantity of social support can be taken into account as proper determinants and predictors of Happiness among elders.
Abstract: Background Elderly people's life is affected by multiple factors including social support, which is of the utmost importance. This study aimed to explore the association between social support and happiness as well as the impact of types of social support on happiness among elders. Methods This descriptive and analytical study was carried out on 411 elderly men and women referred to the retirement, cultural, and rehabilitation centers in Hamadan, west of Iran. Participants were selected by a multi-stage random sampling method. The research instrument included a questionnaire consisting of three parts: demographic information, the Oxford Argyle Happiness Inventory, and a Questionnaire derived from Social Support Theory. The questionnaire was completed through a self-report study. The collected data were analyzed using Pearson correlation coefficients, multiple linear regression, independent t-tests, and one-way analysis of variance in IBM SPSS Software ver. 22.0. Results The mean for happiness was reported as 41.17±15.2. The values given for social support were 29.40±11.95 and for its dimensions were 7.53±3.89 and 13.70±4.90 for informational support and emotional support, respectively. Moreover, the mean value for appraisal support was 3.48±2.37 and was 4.70±2.56 for instrumental support. Multiple linear regression analysis revealed that social support and demographic variables could account for approximately 25% (R2 =0.25) of changes in the variable of happiness. Conclusion High social support could increase happiness among elders. The quality and quantity of social support can be taken into account as proper determinants and predictors of happiness among elders.
45 citations
TL;DR: The evidence presented in this review supports the pressing need for long, outcome-oriented, randomized clinical trials to determine whether the identification and treatment of patients with these comorbid conditions will improve their medical outcomes and quality of life.
Abstract: Diabetes is a major public health problem worldwide. Depression is a serious mental condition that decreases mental and physical functioning and reduces the quality of life. Several lines of evidence suggest a bidirectional relationship between diabetes and depression: diabetes patients are twice as likely to experience depression than nondiabetic individuals. In contrast, depression increases the risk of diabetes and interferes with its daily self-management. Diabetes patients with depression have poor glycemic control, reduced quality of life, and an increased risk of diabetes complications, consequently having an increased mortality rate. Conflicting evidence exists on the potential role of factors that may account for or modulate the relationship between diabetes and depression. Therefore, this review aims to highlight the most notable body of literature that dissects the various facets of the bidirectional relationship between diabetes and depression. A focused discussion of the proposed mechanisms underlying this relationship is also provided. We systematically reviewed the relevant literature in the PubMed database, using the keywords "Diabetes AND Depression". After exclusion of duplicate and irrelevant material, literature eligible for inclusion in this review was based on meta-analysis studies, clinical trials with large sample sizes (n≥1,000), randomized clinical trials, and comprehensive national and cross-country clinical studies. The evidence we present in this review supports the pressing need for long, outcome-oriented, randomized clinical trials to determine whether the identification and treatment of patients with these comorbid conditions will improve their medical outcomes and quality of life.
42 citations
TL;DR: Age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence and patients who had a habit of high salt intake were less adherent to medication.
Abstract: Background Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.
39 citations
TL;DR: Considering the PSS as a factor influencing the reduction in depression and anxiety in thalassemia patients, social support from the social networks should be integrated with interventions that are designed to improve the mental and physical health of thalassesmia patients.
Abstract: Background Considering the high prevalence of depression and anxiety among thalassemia patients and the role of social support in preventing mental disorders, this study aimed to determine prevalence of depression, anxiety, and perceived social support (PSS) among adults with beta-thalassemia major. Methods This cross-sectional study was performed with 389 adults with beta-thalassemia major. Data were collected via a questionnaire consisting of three parts: demographic and medical information, the Persian version of the hospital anxiety and depression scale, and the Persian version of the Multidimensional Scale of Perceived Social Support. Data were analyzed using IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) through analytical statistics (independent-samples t-test, one-way analysis of variance, Pearson correlation coefficient, and multilevel linear regression), and the results less than 0.05 were considered to be significant. Results The mean scores of depression, anxiety, and PSS of patients were 7.42±3.17, 7.47±4.35, and 41.8±8.64, respectively. Of 389 patients, 19.8% had depression and 23.7% had an anxiety disorder. Relationships of depression and anxiety with age, the level of education, job, and family income were statistically significant, as were those of PSS with age, thalassemia center, family income, job, and the level of education. PSS from family, friends, and significant others were the significant predictive factors of depression and anxiety among adult patients with beta-thalassemia major. Conclusion Considering the PSS as a factor influencing the reduction in depression and anxiety in thalassemia patients, social support from the social networks (spouse, family members, friends, and healthcare workers) should be integrated with interventions that are designed to improve the mental and physical health of thalassemia patients.
27 citations
TL;DR: The quantity and quality of protein intake were inadequate in the elderly Korean population and only one-third of the protein intake came from animal sources.
Abstract: Background Protein intake in South Korea is generally considered to be adequate; however, there is concern that it may be inadequate among the elderly. This study evaluated the adequacy of protein intake, the source of protein, and the distribution of protein intake in daily meals in the Korean elderly population. Methods Data were obtained from 1,484 men and 2,028 women aged 60 years or older who had participated in the nutrition survey of the 2013-2014 Korea National Health and Nutrition Examination Survey. One-day (24-hour) recall data were used to estimate the daily protein intake. Results The mean protein intake was 65.3±1.0 g/d (13.1%±0.1% of energy) and 49.7±0.7 g/d (12.6%±0.1% of energy) for men and women, respectively. The protein intake was less than the estimated average requirement in 30.8%±1.4% of men and 42.6%±1.3% of women, and 47.9%±1.6% and 60.1%±1.4%, respectively, consumed less than the recommended daily allowance. The protein intake was relatively evenly distributed among meals; however, the absolute amount of protein consumption per meal was very low. Only one-third of the protein intake came from animal sources. Conclusion The quantity and quality of protein intake were inadequate in the elderly Korean population.
24 citations
TL;DR: A higher socioeconomic status was associated with a higher rate of participation in health check-ups in a Korean population aged 40 years or older, and men and women with a Higher income and education appeared to undergo more healthCheck-ups.
Abstract: Background We investigated the association between socioeconomic status and adherence to health check-ups in a Korean population aged 40 years or older. Methods This cross-sectional study included 12,311 participants who participated in the 2010-2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess each participant's socioeconomic status (household income, occupation, and education) and adherence to health check-ups. Results Men with a higher income (highest vs. lowest: odds ratio [OR], 1.799; 95% confidence interval [CI], 1.296-2.497) and men with a higher education level (≥12 vs. <6 years: OR, 1.488; 95% CI, 1.078-2.054) and office workers compared with manual workers (men: OR, 1.431; 95% CI, 1.077-1.902; women: OR, 1.783; 95% CI, 1.256-2.532) appeared to undergo more health check-ups. In particular, men and women with a higher income and education appeared more likely to undergo opportunistic health check-ups (men: highest vs. lowest income: OR, 2.380; 95% CI, 1.218-4.653; ≥12 vs. <6 years education: OR, 2.121; 95% CI, 1.142-3.936; women: highest vs. lowest income: OR, 4.042; 95% CI, 2.239-7.297; ≥12 vs. <6 years education: OR, 2.475; 95% CI, 1.283-4.775). Conclusion A higher socioeconomic status was associated with a higher rate of participation in health check-ups. More efforts are needed to identify the factors associated with disparity in adherence to health check-ups.
21 citations
TL;DR: PCOS is associated with lower serum adiponectin levels independent of age and body mass index, and the T allele of the rs1501299 (+276 G/T) SNP of the ADIPOQ gene protects against PCOS.
Abstract: Background Polycystic ovary syndrome (PCOS) is a common reproductive disorder. Obesity, which is linked with lower adiponectin levels, increases a woman's risk of developing PCOS; however, the association between adiponectin and PCOS is controversial. Adiponectin levels could be affected by single nucleotide polymorphisms (SNPs) in the ADIPOQ gene. This study aimed to test the relationship between serum adiponectin and PCOS in Jordan and the association between the rs2241766, rs1501299, and rs266729 SNPs in the ADIPOQ gene and PCOS. Methods One hundred and fifty-four women with PCOS and 149 age- and body mass index-matched normally menstruating controls were recruited. Serum adiponectin levels were measured using enzyme-linked immunosorbent assay. Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism analysis. Results Serum adiponectin levels were significantly lower (P=0.0064) in PCOS women and rs1501299 (+276 G/T) genotype distributions were significantly different (P=0.01) between them and normally menstruating women. Multivariate analysis revealed that adiponectin levels remained significantly lower in PCOS women (P=0.001; odds ratio [OR], 0.9; 95% confidence interval [CI], 0.84-0.96). The GT genotype of rs1501299 increased the risk of PCOS (P<0.001; OR, 5.46; 95% CI, 2.42-12.33) and increased the risk of PCOS by three-fold (P<0.001; OR, 3.00; 95% CI, 1.36-6.60) relative to the TT genotype. The GG genotype increased the risk of PCOS as well (P<0.001; OR, 3:00; 95% CI, 1.36-6.60). Conclusion PCOS is associated with lower serum adiponectin levels independent of age and body mass index. The T allele of the rs1501299 (+276 G/T) SNP of the ADIPOQ gene protects against PCOS.
19 citations
TL;DR: Total LM has a protective effect on BMD and FM can have a detrimental effect onBMD besides its skeletal loading effect, which is inversely associated with BMD after adjusting for weight.
Abstract: Background We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea. Methods A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008-2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed. Results In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11-18.01) and truncal FM (OR, 5.48; 95% CI, 1.75-17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women. Conclusion Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.
18 citations
TL;DR: Prolonged sedentary time was significantly associated with high diastolic BP and low HDL cholesterol level in Korean adults, and the associations were independent of general and abdominal obesity and moderate-to-vigorous physical activities.
Abstract: Background Sedentary behavior has been shown to have deleterious effects on cardiovascular outcomes. This study aimed to examine the association between sedentary time and cardiovascular risk factors in Korean adults. Methods A cross-sectional study was performed using data from adults aged 19 years and above in the 2013 Korean National Health and Nutrition Examination Survey. Sedentary time was self-reported and categorized into quintiles. Cardiovascular risk factors, including blood pressure (BP), total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein cholesterol, and fasting glucose levels, were categorized into dichotomous variables according to the Adult Treatment Panel III criteria. Multivariate logistic regression was performed with adjustment for various demographic and lifestyle variables, body mass index (BMI), waist circumference (WC), and moderate-to-vigorous physical activity. Complex sampling design was used, and survey weights and sample design variables were applied in analyses. Results A total of 3,301 individuals were included in the analyses, and mean sedentary time was 6.1 h/d. Prolonged sedentary time was significantly associated with high diastolic BP (top vs. bottom quintile: adjusted odds ratio [OR], 1.71; 95% confidence interval [CI], 1.09-2.68; Ptrend=0.03) and low HDL cholesterol level (top vs. bottom quintile: adjusted OR, 1.42; 95% CI, 1.02-1.98; Ptrend=0.02) after adjustment for BMI, WC, moderate-to-vigorous physical activity, and other variables. No significant associations were found between sedentary time and other cardiovascular risk factors. Conclusion Prolonged sedentary time was significantly associated with high diastolic BP and low HDL cholesterol level in Korean adults. The associations were independent of general and abdominal obesity and moderate-to-vigorous physical activities.
18 citations
TL;DR: Boric acid is relatively effective in treating CSOM, especially at a high concentration, and distilled water was found safe in animal studies, but the ototoxicity of boric acid concentrations higher than 4% needs further evaluation.
Abstract: Chronic suppurative otitis media (CSOM) is one of the most common chronic infectious diseases worldwide, especially affecting children. The patients or the parents of the affected children are often worried about the cost of medical visits, prescription medicines, or inconsistently effective medication. The complications of CSOM have been greatly reduced because of the development of antibiotics; however, the irrational use of antibiotics has led to the emergence of organisms resistant to the commonly used drugs. Owing to the increase in antibiotic resistance, the development of new treatments that will efficiently eradicate infectious microorganisms has become imperative. Boric acid solutions are effective in the treatment of CSOM because of their acidic effect. Various databases, such as the PubMed, The Cochrane Library, and SciELO, were searched for references related to the efficacy of boric acid in the treatment of mucosal CSOM, as well as its ototoxicity. The search revealed that boric acid is relatively effective in treating CSOM, especially at a high concentration. Boric acid in distilled water was found safe in animal studies. However, the ototoxicity of boric acid concentrations higher than 4% needs further evaluation, considering the effectivity of boric acid at high concentrations.
17 citations
TL;DR: It is suggested that maintaining an appropriate sleep duration as found in the recent consensus recommendation is important for mental health, even in healthy subjects without any medical or psychiatric illnesses, in Korea.
Abstract: Background Recently, several institutions, including the American Academy of Sleep Medicine, the Sleep Research Society, and the National Sleep Foundation, have made consensus recommendations concerning appropriate sleep duration for adults. Although numerous studies conducted in Western populations have provided evidence of the harmful effects of short or long sleep duration on mental health, it is still unclear whether these consensus recommendations are appropriate in Korean culture. Methods Data from 1,892 subjects with no history of medical or psychiatric diagnoses were selected from the Korea National Health and Nutrition Examination Survey of 2014. Subjects were divided into seven groups based on their sleep duration (≤4, 5, 6, 7, 8, 9, and ≥10 hours). Depressive symptoms were measured using the Patient Health Questionnaire-9 and perceived stress severity was evaluated using a Likert-type scale. Group differences in depressive symptoms and severity of stress were analyzed using an analysis of covariance. Results Depressive symptoms in subjects with sleep duration of ≤4 hours (5.7±5.9) or 5 hours (3.4±3.9) were higher than in subjects with a sleep duration of 7 (2.2±2.9) or 8 hours (2.2±2.9) (corrected P<0.05). Furthermore, subjects with a short sleep duration (5 hours or below) had greater perceived stress severity than subjects with a sleep duration of 7 or 8 hours (corrected P<0.05). Conclusion Our results suggest that maintaining an appropriate sleep duration as found in the recent consensus recommendation is important for mental health, even in healthy subjects without any medical or psychiatric illnesses, in Korea.
TL;DR: VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI) and the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults were proposed.
Abstract: Background Cut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individuals at risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly for large populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare the ability of VFA and WC to predict the presence of ≥2 metabolic risk factors. Methods We included 36,783 subjects aged 19-79 years undergoing abdominal fat CT during regular health checkups between January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the International Diabetes Federation criteria. Receiver operating characteristic curve analyses were used to determine the appropriate VFA and WC cut-off values for MetS. Results VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). The optimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age, particularly among women. Conclusion This large population study proposed the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WC may be considered.
TL;DR: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies and some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.
Abstract: Background A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. Methods Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. Results The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. Conclusion Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.
TL;DR: Longer sleep duration is associated with a significantly higher incidence of sarcopenia in Korean women aged ≥40 years, and this association was stronger for individuals who slept ≥9 h/d than for those who slept 6–8 h/D.
Abstract: Background The association between sleep duration and body composition measures in Korean adults remains unclear. Methods This cross-sectional study included 3,532 subjects aged ≥40 years (1,542 men and 1,990 women) who participated in the 2010 Korea National Health and Nutrition Examination Survey V-1. Self-reported sleep duration and anthropometric data were collected. Appendicular skeletal muscle mass (ASM) was quantified via dual-energy X-ray absorptiometry. Obesity was defined according to the body mass index and waist circumference. Sarcopenia was defined as the muscle mass percentage (ASM/weight) below the lowest quintile computed for the study population. Multivariate logistic regressions with or without adjustment for sociodemographic and lifestyle factors were used to evaluate the association of sleep duration with obesity and sarcopenia for participants who slept ≤5, 6-8, and ≥9 h/d. The results were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). Results In women, the association between sleep duration and sarcopenia was stronger for individuals who slept ≥9 h/d than for those who slept 6-8 h/d (unadjusted OR, 1.99; 95% CI, 1.19-3.34; adjusted OR, 1.77; 95% CI, 1.06- 2.96). Conclusion Longer sleep duration is associated with a significantly higher incidence of sarcopenia in Korean women aged ≥40 years.
TL;DR: Family mealtimes were closely associated with depressive symptoms in elderly Koreans, which suggests that maintaining intrafamilial bonding is important for mental health in an older population.
Abstract: Background Several studies have revealed the frequency of family mealtimes to be inversely associated with depressive symptoms in adolescents. However, there have been few studies in older populations. This cross-sectional study investigated the association between family mealtime frequency and depressive symptoms in elderly Koreans. Methods This study analyzed 4,959 elderly men and women (aged 65 years or older) who participated in the Korea National Health and Nutrition Examination Survey. Self-administered questionnaires were used to assess depressive status, family mealtime frequency, and covariates. Multiple logistic regression analysis was performed to evaluate the association using the eating alone group as a reference. Results After adjusting for all covariates, participants who had family meals 3 times a day had fewer depressive symptoms than the eating alone group; adjusted odds ratios (ORs) (95% confidence intervals [CIs]) were 0.72 (0.58- 0.89) for point depressiveness/anxiety and 0.73 (0.56-0.94) for depressiveness lasting for at least 2 weeks. In suicidal ideation, the OR (95% CI) of eating with family twice a day was significant after full adjusting for covariates at 0.67 (0.50-0.88). Conclusion Family mealtimes were closely associated with depressive symptoms in elderly Koreans, which suggests that maintaining intrafamilial bonding is important for mental health in an older population.
TL;DR: The widowed middle-aged group tended to have a higher risk of metabolic syndrome, which is speculated to be related to socioeconomic factors and health behavior.
Abstract: BACKGROUND This study aimed to investigate the relationship between marital status and the incidence of metabolic syndrome in Korean middle-aged women. METHODS Based on data from the sixth Korea National Health and Nutrition Examination Survey (2013-2014), 3,225 women aged 40-69 years were subjected to the analysis. Marital status was categorized as married, unmarried, separated, widowed, or divorced. The odds ratios (ORs) for metabolic syndrome were calculated based on marital status. After adjustment for age, income level, education level, alcohol intake, smoking status, leisure physical activity, menopause status, daily calories, and fat intake, changes in the OR for metabolic syndrome based on marital status were examined by multivariate logistic regression analysis. RESULTS The OR for metabolic syndrome in the widowed group to the married group was 4.818 (95% confidence interval [CI], 3.861-6.002; P<0.001) and that after adjustment of age, economic level, education level, alcohol intake, smoking status, physical activity, menopause status, total daily calories, and fat intake was 2.141 (CI, 1.432-3.199; P<0.001), both of which were statistically significant. The OR for metabolic syndrome in the unmarried group to the married group was 0.246 (CI, 0.141-0.431; P<0.001) after adjustment of all components. On the contrary, the ORs of the separated group and the divorced group to the married group were not significant. CONCLUSION In comparison with the married middle-aged group, the widowed middle-aged group tended to have a higher risk of metabolic syndrome, which is speculated to be related to socioeconomic factors and health behavior.
TL;DR: Serum UA is related to oxidative status, especially antioxidant capacity, in Korean adults; UA may play a role in antioxidant defense systems in humans.
Abstract: BACKGROUND Oxidative stress is implicated in the pathogenesis and development of lifestyle-related diseases In the present study, we evaluated the correlation between the serum uric acid (UA) levels and oxidative status in Korean adults METHODS The subjects were 5,093 individuals (2,041 women and 3,052 men) who underwent a health checkup between June 2012 and December 2016 Oxidative stress levels (derivatives of reactive oxygen metabolites [d-ROMs]) and antioxidant potential (biological antioxidant potential [BAP]) were measured Metabolic markers, including UA, were also examined RESULTS Higher serum UA levels were associated with decreased levels of d-ROMs (P<005) The UA levels were positively associated with BAP levels (P<0001) CONCLUSION Serum UA is related to oxidative status, especially antioxidant capacity, in Korean adults; UA may play a role in antioxidant defense systems in humans
TL;DR: QoL of patients with unexplained fatigue could largely diminish than those with explained fatigue, and the primary clinician should be aware of poor QoL in patients with inexplicable fatigue to identify who is in need of more attention and intervention.
Abstract: Background Recently, despite the high prevalence of fatigue in patients, there is a lack of research on the quality of life (QoL) in unexplained fatigue patients, indicating that they are not properly diagnosed and treated. The aim of this study was to compare fatigue severity and QoL between patients with explained and unexplained fatigue. Methods The study consisted of 200 Korean adults who complained of fatigue without underlying disease. Fatigue Severity Scale, Short Form Health Survey-36 version 2 (SF-36v2), and Beck Depression Inventory-II (BDI-II) self-questionnaires were administered. Participants were dichotomized to two groups, namely, patients with unexplained or explained fatigue, sorted according to laboratory examination results. The chi-square test, t-test, and Wilcoxon rank-sum test were used, and analysis of covariance was calculated after adjusting for age, sex, body mass index, smoking status, and physical component summary (PCS) of SF-36v2 or BDI-II. Results PCS of SF-36v2 between the two groups showed significant difference. Compared to patients with explained fatigue, those with unexplained fatigue showed lower physical component scores of QoL. Conclusion QoL of patients with unexplained fatigue could largely diminish than those with explained fatigue. The primary clinician should be aware of poor QoL in patients with unexplained fatigue to identify who is in need of more attention and intervention.
TL;DR: It is suggested that workshops promoting iron supplementation should be conducted in health centers with the aim of preventing widespread iron deficiency anemia among pregnant women visiting Neyshabur healthcare centers.
Abstract: Background Iron is an essential element for women of reproductive age, especially in the period before and during the pregnancy This study investigates the consumption of iron to prevent iron deficiency anemia among pregnant women visiting Neyshabur healthcare centers based on the theory of planned behavior Methods In this experimental study, data were collected through a questionnaire survey It included 160 pregnant women who were receiving maternity services at twelve healthcare centers in the city of Neyshabur in Iran between 2015 and 2017 The participants' demographic and anthropometric characteristics, Using the theory of planned behavior, and blood lab examination results, including ferritin levels were measured and the data were analyzed using IBM SPSS ver 220 (IBM Corp, Armonk, NY, USA) Results The average scores of knowledge, attitude, perceived behavioral control, subjective norms, and intention categories for the intervention group were meaningfully increased after the participants received education on iron supplementation (P 005) No statistically significant difference was obtained in the subjective norms category between the two groups after the education intervention (P=092) Conclusion Based on the experimental effects of education encouraging iron supplementation in pregnant women, it is suggested that workshops promoting iron supplementation should be conducted in health centers with the aim of preventing widespread iron deficiency anemia
TL;DR: This case is of an elderly woman with long standing uncontrolled diabetes who presented with abnormal movement in her left upper limb for 2 months, which resolved slowly with good control of her glucose levels.
Abstract: Hemiballismus, a subtype of chorea, is a rare movement disorder, and is most commonly found secondary to stroke. Movements are involuntary, violent, coarse, and have a wide amplitude. There is increasing report of hemiballismus occurring in non-ketotic hyperglycemia. Spontaneous improvements or remissions were observed in many patients, and treatment should be directed towards the cause of hemiballismus. There is no randomized control trial to guide clinicians in deciding the best treatment option when managing hemiballismus. Symptomatic treatment includes the use of drugs such as dopamine receptor blocker and tetrabenazine. Surgical treatment is reserved for severe, persistent, and disabling hemiballismus. This case is of an elderly woman with long standing uncontrolled diabetes who presented with abnormal movement in her left upper limb for 2 months, which resolved slowly with good control of her glucose levels. Treating physicians need to have a high index of suspicion to prevent mismanagement of the condition.
TL;DR: Body weight perception is an important factor that influences the practice to reduce weight especially among young adult group and college students and those who had correct body weight perception were less likely to engage in weight loss practice.
Abstract: BACKGROUND Body image is associated with the perception of people on themselves. Influencing factors are generated internally and/or externally. The most common issue pertaining to body image is body weight and weight loss. This study aimed to determine the association between body weight perception and weight loss practices among college students. METHODS A cross-sectional study was conducted involving 297 college students from private nursing colleges in the state of Kelantan, Malaysia. A self-administered questionnaire was used to assess sociodemographic characteristics, body weight perception, and weight loss methods. Weight and height were measured, and body mass index (BMI) was calculated based on weight and height measurement. The World Health Organization BMI cutoffs were applied in the study. RESULTS More than half (54.2%) of college students perceived their weight correctly as per actual measured BMI. A total of 51.5% of participants had tried various methods to reduce their weight. Body weight perception is associated with weight loss practices (odds ratio, 0.31; 95% confidence interval, 0.19-0.50; P<0.001) adjusted for sex, marital status, and status of having obese family members. Those who had correct body weight perception were less likely to engage in weight loss practice. Food intake restriction (42.4%) is the most popular weight reduction method among students in nursing colleges. Over a quarter of the participants chose physical exercise (25.3%) to reduce their weight, and a small number engaged in unhealthy weight loss practices. CONCLUSION Body weight perception is an important factor that influences the practice to reduce weight especially among young adult group and college students.
TL;DR: Cerebrovascular disease, arthritis, and especially fear of falls were significantly associated with UI in elderly Korean women, while chronic lung disease, psychiatric disease, difficulty in daily living due to visual and hearing problems, and experiencing a fall in the last 2 years were not associated withUI.
Abstract: Background Urinary incontinence (UI) is highly prevalent in the aging population. UI is one of the most common geriatric syndromes and affects overall health, quality of life, and economical burden in patients. The aims of this study were to investigate the characteristics of patients with UI and to assess its association with other geriatric health problems. Methods We used data from the Korean Longitudinal Study of Ageing obtained in 2006. Among the 10,254 individuals aged 45 years and older, we analyzed data from 2,418 women aged 65 years and older. Data were obtained using questionnaires for UI, comorbidities, and lifestyle factors. Results Among the 2,418 women aged 65 years and older, 506 (20.9%) had UI. Cerebrovascular disease (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.26 to 3.23), arthritis (OR, 1.44; 95% CI, 1.18 to 1.77), and fear of falling (OR, 1.62; 95% CI, 1.18 to 2.22) were significantly associated with UI, while chronic lung disease, psychiatric disease, difficulty in daily living due to visual and hearing problems, and experiencing a fall in the last 2 years were not associated with UI. Conclusion Cerebrovascular disease, arthritis, and especially fear of falls were significantly associated with UI in elderly Korean women.
TL;DR: Early or late menarche was not associated with an increased risk of MetS in premenopausal Korean women, suggesting that even before menopause, current age has a major influence on the development of metS.
Abstract: Background Early menarche may be associated with increased risk of cardiovascular disease. The aim of this study was to evaluate the relationship between age at menarche and metabolic syndrome (MetS) in Korean premenopausal women. Methods We used nationally representative data from the Korea National Health and Nutrition Examination Survey from 2013 to 2014, and 3,023 premenopausal women aged 20-55 years were our subjects. We defined early menarche as age at first menstrual period less than 12 years. Multivariable logistic regression analysis was used to evaluate the relationship between age at menarche and MetS after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables. Results MetS was much more common in women aged 40-55 years than in women aged 20-39 years (4.1% vs. 15.1%). Compared with women who experienced menarche at age 12-15 years, the risk of MetS in the early menarche group was not higher in either age group, after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables (odds ratio [OR], 1.767; 95% confidence interval [CI], 0.718-4.351 in those aged 20-39 years; OR, 1.780; 95% CI, 0.775-4.085 in those aged 40-55 years). The risk of MetS in women with menarche at age ≥16 years was not higher than in women with menarche at age 12-15 years. Conclusion Early or late menarche was not associated with an increased risk of MetS in premenopausal Korean women. Even before menopause, current age has a major influence on the development of MetS.
TL;DR: Type 2 diabetes mellitus is associated with higher branched chain amino acid levels in Jordan independent of age, sex, body mass index, waist circumference, and total serum cholesterol and serum triglyceride levels.
Abstract: BACKGROUND Diabetes mellitus is a global public health problem that is caused by the lack of insulin secretion (type 1) or resistance to its action (type 2). A low insulin-to-glucagon ratio predicts an increase in the serum levels of branched chain amino acids, a feature confirmed in several populations. This relationship has not been assessed in Jordan. The objective of this study was to investigate the association between serum branched chain amino acids and type 2 diabetes mellitus in patients in Jordan. METHODS Two hundred type 2 diabetes mellitus patients and an additional 200 non-diabetic controls were recruited. Age, body mass index, and waist circumference of the subjects were recorded. Branched chain amino acid, total cholesterol, and triglyceride levels were measured from the collected serum samples. RESULTS Serum branched chain amino acid levels were significantly higher in type 2 diabetes mellitus patients than in non-diabetes individuals (P<0.0001). In binomial regression analysis, serum branched chain amino acid levels remained significantly associated with diabetes mellitus and increased its risk (odds ratio, 1.004; 95% confidence interval, 1.001-1.006; P=0.003). CONCLUSION Type 2 diabetes mellitus is associated with higher branched chain amino acid levels in Jordan independent of age, sex, body mass index, waist circumference, and total serum cholesterol and serum triglyceride levels.
TL;DR: Smokers and individuals with inadequate health-promoting behaviors had lower vaccination rates than the others did in the current study.
Abstract: Background Globally, smoking is one of the biggest challenges in public health and is a known cause of several important diseases. Influenza is preventable via annual vaccination, which is the most effective and cost-beneficial method of prevention. However, subjects who smoke have some unhealthy behaviours such as alcohol, low physical activity, and low vaccination rate. In this study, we analyzed the relationship between smoking status and factors potentially related to the influenza vaccination coverage rate in the South Korean adult population. Methods The study included 13,565 participants aged >19 years, from 2010 to 2012 from the Korea National Health and Nutrition Examination Survey data. Univariate analyses were conducted to examine the association between influenza coverage rate and related factors. Multivariate analysis was obtained after adjusting for variables that were statistically significant. Results The overall vaccination rate was 27.3% (n=3,703). Older individuals (P<0.0001), women (P<0.0001), non-smokers (P<0.0001), light alcohol drinkers (P<0.0001), the unemployed (P<0.0001), and subjects with diabetes mellitus (P<0.0001), hypercholesterolemia (P<0.0001), and metabolic syndrome (P<0.0001) had higher influenza vaccination coverage than the others. In multivariate analyses, current smokers and heavy smokers showed lower vaccination rates (odds ratio, 0.734; 95% confidence interval, 0.63-0.854). Conclusion In the current study, smokers and individuals with inadequate health-promoting behaviors had lower vaccination rates than the others did.
TL;DR: It is suggested that AUDIT-KR can be used as a screening tool for alcohol use disorder in groups of college students when DSM-5 diagnosis criteria are applied.
Abstract: BACKGROUND There is a distinction in alcohol consumption behavior between adults and college students. This study aims to verify the usability and the optimal cutoff point of Alcohol Use Disorders Identification Test-Korean revised version (AUDIT-KR) for screening alcohol use disorder in college students when the diagnostic and statistical manual of mental disorders (DSM), 5th edition diagnostic criteria is applied. METHODS A total of 922 college students living in Daejeon were enrolled and divided into two groups based on how many items they corresponded to among DSM-5 alcohol use disorder diagnostic criteria: those who corresponded to ≥2 of the 11 items were classified into the patient group (107 males, 89 females) while the others into the control group (311 males, 415 females). The participants were evaluated using AUDIT-KR to find the optimal cutoff point for screening alcohol use disorder, sensitivity, and specificity. RESULTS The mean±standard deviation scores in the AUDIT-KR were 12.76±7.27, 10.72±4.62 for males and females, respectively, in the patient group. In contrast, in the control group the scores were 6.26±5.23 and 3.95±3.59 in males and females, respectively. The area under the receiver operating characteristic curve (95% confidence interval) regarding alcohol use disorder screening by AUDIT-KR was 0.768 (0.715-0.821) and 0.883 (0.848-0.919) for males and females, respectively. The optimal cutoff point of alcohol use disorder for males was >9, sensitivity 64.49%, and specificity 76.85%. The optimal cutoff point for females was >6, sensitivity 82.02%, and specificity 80.48%. CONCLUSION This study suggested that AUDIT-KR can be used as a screening tool for alcohol use disorder in groups of college students when DSM-5 diagnosis criteria are applied.
TL;DR: A significantly positive association between 25-hydroxyvitamin D and ASCVD score was indicated and further detailed studies to evaluate this correlation are needed.
Abstract: BACKGROUND We examined the relationship between 10-year predicted atherosclerosis cardiovascular disease (ASCVD) risk score and 25-hydroxyvitamin D in Koreans aged 40-79 years. METHODS A population-based, cross-sectional design was used from data based on the Korea National Health and Nutrition Examination Survey 2014. RESULTS A total of 1,134 healthy Koreans aged 40-79 years were included. A positive relationship between serum 25-hydroxyvitamin D level and ASCVD score was shown in women (β=0.015) after adjusting for central obesity, physical activity, and supplement intake. The chances of being in the moderate to high risk (risk group, ASCVD score ≥5%) with vitamin D sufficiency (serum 25-hydroxyvitamin D ≥20 ng/mL) was 1.267-fold (95% confidence interval, 1.039-1.595) greater than the chance of being included in the group with vitamin D deficiency (serum 25-hydroxyvitamin D <20 ng/mL) after adjustments in women. CONCLUSION Our research indicated a significantly positive association between 25-hydroxyvitamin D and ASCVD score. Further detailed studies to evaluate this correlation are needed.
TL;DR: The prevalence of gallstone disease was significantly lower in natives than in migrants from Jeju Island, and the independent risk factors were older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower high-density lipoprotein cholesterol levels.
Abstract: BACKGROUND The eating habits of Jeju Island natives are quite different from those of the mainland people because of geographic isolation. Diet is a main factor affecting gallstone disease. We investigated the prevalence of gallstone disease in both Jeju Island natives and migrants and studied the risk factors affecting gallstone disease in the Jeju Island people. METHODS A total of 20,763 subjects who underwent medical checkups at the Health Promotion Center of Jeju National University Hospital in Korea from January 2003 to December 2015 were enrolled in the study. Ultrasonography was used to determine the presence of gallbladder stones. Body mass index and biochemical parameters, including liver function test results, lipid profiles, and fasting blood glucose levels, were verified, and data on age, birthplace, and sex were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors affecting gallstone disease. RESULTS The prevalence of gallstone disease in the Jeju Island people was 4.0%: Jeju Island natives, 3.8% and migrants, 4.4% (P=0.047). After multivariate logistic regression analysis, the independent risk factors were older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower high-density lipoprotein cholesterol levels. CONCLUSION The prevalence of gallstone disease was significantly lower in natives than in migrants from Jeju Island. Older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower highdensity lipoprotein cholesterol levels contributed to gallstone disease prevalence in the Jeju Island people.
TL;DR: The present study found a reduced prevalence of diabetes in women who had breastfed compared to those who had not, however, no association between the duration of breastfeeding and the prevalence of Diabetes could be found.
Abstract: Background It is well known that breastfeeding has a significant impact on the health of mothers and children. With the growing importance of breastfeeding, the present study aimed to investigate the relationship between breastfeeding and the prevalence of diabetes in Korean parous women. Methods The data of 5,448 premenopausal parous women aged 20-49 years who agreed to participate in the 5th- 6th Korea National Health and Nutrition Examination Survey were analyzed in this study. Control group included women who had not breastfed. The subjects who had breastfed were classified into three groups based on the duration of breastfeeding: 0-6 months, 6-12 months, and >12 months. The variables included age, body mass index, education level, income, alcohol drinking, smoking, family history of diabetes, use of oral contraceptives, the number of pregnancies, and regular exercise. Results Among the subjects, the prevalence of diabetes was significantly lower in women who had breastfed compared to those who had not, with an odds ratio of 0.534 (95% confidence interval [CI], 0.289-0.976) in women who breastfed for 0-6 months and 0.575 (95% CI, 0.321-0.990) in women who breastfed for 6-12 months (both P Conclusion The present study found a reduced prevalence of diabetes in women who had breastfed compared to those who had not. However, no association between the duration of breastfeeding and the prevalence of diabetes could be found.
TL;DR: Although the blood AST, CK, and LDH levels were markedly high, the erythrocyte sedimentation rate and C-reactive protein levels were normal, and the duration of IBAM symptoms correlated with theduration of fever, the IBAM-associated clinical and laboratory findings are highly characteristic and may allow its rapid diagnosis during the influenza season.
Abstract: Background Influenza-associated myositis (IAM) is a rare and poorly recognized complication of influenza infection in children, and is characterized by acute onset of severe pain in the lower extremities and a refusal to ambulate walk. We sought to understand the association between IAM and influenza B infection and to investigate its clinical and laboratory characteristics in affected children. Methods Influenza B-associated myositis (IBAM) cases diagnosed in the pediatrics department of Wonkwang University Hospital from January 2010 and March 2016 were analyzed retrospectively. Results Medical records of affected children were examined, and clinical characteristics and laboratory findings were recorded. Of the 536 children diagnosed with influenza B infection, 47 children complained of bilateral calf pain with or without gait disturbance. All children exhibited elevated serum aspartate aminotransferase (AST) level. The median serum creatine kinase (CK) and lactate dehydrogenase (LDH) levels, reportedly elevated in myositis, were 2,597 IU/L and 678 IU/L, respectively. While the immunofluorescence test results were negative for some patients, the polymerase chain reaction test results indicated influenza B infection in all 47 children. At the time of hospital discharge, the patients' symptoms had resolved, and their CK levels had improved. Conclusion IBAM was generally benign and short, and although the blood AST, CK, and LDH levels were markedly high, the erythrocyte sedimentation rate and C-reactive protein levels were normal. Further, the duration of IBAM symptoms correlated with the duration of fever. The IBAM-associated clinical and laboratory findings are highly characteristic and may allow its rapid diagnosis during the influenza season.