Publications by authors named "Bumjo Oh"

44 Publications

ADL/ IADL dependencies and unmet healthcare needs in older persons: A nationwide survey.

Arch Gerontol Geriatr 2021 Jun 11;96:104458. Epub 2021 Jun 11.

Department of Family Medicine, Seoul National University Bundang Hospital, Republic of Korea; Department of Family Medicine, College of Medicine, Seoul National University, Republic of Korea. Electronic address:

Purpose: To determine the impact of overall and component-wise activities for daily living (ADL) as well as instrumental activities of daily living (IADL) dependencies on unmet healthcare needs in older adults.

Materials And Methods: Cross-sectional analyses were performed based on a National Survey of Older Koreans. A total of 10,082 participants aged ≥ 65 years were included. All data were collected through standardized, personal interviews with participants and their representatives. Logistic regression was used to analyse the risk of unmet healthcare needs, with or without adjustment.

Results: Amongst all participants, 734 (7.2%) had ADL dependency. Participants with ADL dependency had lower income, education level, and perceived health status (p<0.001). The adjusted odds ratio (aOR) for the risk of unmet healthcare needs was 1.52 (95%, confidence interval [CI] 1.19-1.95) for ADL and 1.54 (95%, CI 1.28-1.86) for IADL. When men have ADL dependency, aOR of unmet healthcare needs was higher than that of women (aOR 1.89, 95% CI 1.15 - 3.11; aOR 1.65, 95% CI 1.15 - 2.36, respectively) and IADL showed the same trend. Any dependency on ADL or IADL was associated with higher risk of unmet healthcare needs, whether adjusted or not (p<0.001).

Conclusions: Older adults with ADL or IADL dependency had higher risks of unmet healthcare needs than their independent counterparts. In addition to mobility problems, other components were related to unmet healthcare needs. Therefore, to reduce unmet healthcare needs, integration of health and social care that supports ADL or IADL dependency should be considered.
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http://dx.doi.org/10.1016/j.archger.2021.104458DOI Listing
June 2021

Spore-forming Bacillus coagulans SNZ 1969 improved intestinal motility and constipation perception mediated by microbial alterations in healthy adults with mild intermittent constipation: A randomized controlled trial.

Food Res Int 2021 08 19;146:110428. Epub 2021 May 19.

Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea; Department of Nutritional Science and Food Management, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Republic of Korea. Electronic address:

The spore-forming Bacillus coagulans has attracted attention for their therapeutic action in the colon. However, the mechanism of this action remains unclear. In this study, healthy subjects with mild intermittent constipation were supplemented with B. coagulans SNZ 1969 (BC) or the placebo for 8 weeks (n = 80). Then, we assessed colonic transit time (CTT), weekly complete spontaneous bowel movement (CSBM) scores, bowel discomfort symptom (BDS) scores, and 16S rRNA fecal microbiome profiles. The association between the critically altered gut microbiome and clinical outcomes was analyzed using redundancy analysis (RDA) and validated by receiver operating characteristic (ROC) curves. BC supplementation significantly improved CTT (p = 0.031), CSBM at weeks 2 (p = 0.045) and 9 (p = 0.038), and BDS at weeks 3 (p = 0.019) and 6 (p = 0.029) compared with the placebo, while altering the community composition of the gut microbiota. We also confirmed that BC was effectively delivered to the gut. Finally, the multivariate redundancy analysis concluded that BC-induced enrichment of Lactobacillales and diminishment of Synergistales were related to CTT improvements. This study provides important new data on how spore-forming B. coagulans SNZ 1969 contributes to improving gut motility and presents evidence supporting the use of B. coagulans SNZ 1969 in adults with mild intermittent constipation and habitual low intake of fruit and vegetables.
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http://dx.doi.org/10.1016/j.foodres.2021.110428DOI Listing
August 2021

Prediction Models for the Clinical Severity of Patients With COVID-19 in Korea: Retrospective Multicenter Cohort Study.

J Med Internet Res 2021 04 16;23(4):e25852. Epub 2021 Apr 16.

Department of Statistics, Seoul National University, Seoul, Republic of Korea.

Background: Limited information is available about the present characteristics and dynamic clinical changes that occur in patients with COVID-19 during the early phase of the illness.

Objective: This study aimed to develop and validate machine learning models based on clinical features to assess the risk of severe disease and triage for COVID-19 patients upon hospital admission.

Methods: This retrospective multicenter cohort study included patients with COVID-19 who were released from quarantine until April 30, 2020, in Korea. A total of 5628 patients were included in the training and testing cohorts to train and validate the models that predict clinical severity and the duration of hospitalization, and the clinical severity score was defined at four levels: mild, moderate, severe, and critical.

Results: Out of a total of 5601 patients, 4455 (79.5%), 330 (5.9%), 512 (9.1%), and 301 (5.4%) were included in the mild, moderate, severe, and critical levels, respectively. As risk factors for predicting critical patients, we selected older age, shortness of breath, a high white blood cell count, low hemoglobin levels, a low lymphocyte count, and a low platelet count. We developed 3 prediction models to classify clinical severity levels. For example, the prediction model with 6 variables yielded a predictive power of >0.93 for the area under the receiver operating characteristic curve. We developed a web-based nomogram, using these models.

Conclusions: Our prediction models, along with the web-based nomogram, are expected to be useful for the assessment of the onset of severe and critical illness among patients with COVID-19 and triage patients upon hospital admission.
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http://dx.doi.org/10.2196/25852DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054775PMC
April 2021

Possible aerosol transmission of COVID-19 associated with an outbreak in an apartment in Seoul, South Korea, 2020.

Int J Infect Dis 2021 Mar 17;104:73-76. Epub 2020 Dec 17.

National Assembly Futures Institute, Seoul, Republic of Korea; JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Scientists have strongly implied that aerosols could be the plausible cause of coronavirus disease-2019 (COVID-19) transmission; however, aerosol transmission remains controversial.

The Study: We investigated the epidemiological relationship among infected cases on a recent cluster infection of COVID-19 in an apartment building in Seoul, South Korea. All infected cases were found along two vertical lines of the building, and each line was connected through a single air duct in the bathroom for natural ventilation. Our investigation found no other possible contact between the cases than the airborne infection through a single air duct in the bathroom. The virus from the first infected case can be spread to upstairs and downstairs through the air duct by the (reverse) stack effect, which explains the air movement in a vertical shaft.

Conclusions: This study suggests aerosol transmission, particularly indoors with insufficient ventilation, which is underappreciated.
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http://dx.doi.org/10.1016/j.ijid.2020.12.035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834623PMC
March 2021

Multidisciplinary Approach to Smoking Cessation in Late Adolescence: A Pilot Study.

Glob Pediatr Health 2020 3;7:2333794X20944656. Epub 2020 Oct 3.

SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.

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http://dx.doi.org/10.1177/2333794X20944656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536474PMC
October 2020

Comparative analysis of the tonsillar microbiota in IgA nephropathy and other glomerular diseases.

Sci Rep 2020 10 1;10(1):16206. Epub 2020 Oct 1.

Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.

Immunoglobulin A nephropathy (IgAN) involves repeated events of gross haematuria with concurrent upper airway infections. The mucosal immune system, especially the tonsil, is considered the initial site of inflammation, although the role of the tonsillar microbiota has not been established in IgAN. In this study, we compared the tonsillar microbiota of patients with IgAN (n = 21) and other glomerular diseases (n = 36) as well as, healthy controls (n = 23) from three medical centres in Korea. The microbiota was analysed from tonsil swabs using the Illumina MiSeq system based on 16S rRNA gene. Tonsillar bacterial diversity was higher in IgAN than in other glomerular diseases, although it did not differ from that of healthy controls. Principal coordinates analysis revealed differences between the tonsillar microbiota of IgAN and both healthy and disease controls. The proportions of Rahnella, Ruminococcus_g2, and Clostridium_g21 were significantly higher in patients with IgAN than in healthy controls (corrected p < 0.05). The relative abundances of several taxa were correlated with the estimated glomerular filtration rate, blood urea nitrogen, haemoglobin, and serum albumin levels. Based on our findings, tonsillar microbiota may be associated with clinical features and possible immunologic pathogenesis of IgAN.
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http://dx.doi.org/10.1038/s41598-020-73035-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530979PMC
October 2020

Erratum: Perceptions, Attitudes, Behaviors, and Barriers to Effective Obesity Care in South Korea: Results from the ACTION-IO Study.

J Obes Metab Syndr 2020 Sep;29(3):240

Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.7570/jomes20013eDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539337PMC
September 2020

Efficacy and safety of HX 110-A and HX 110-B in promoting respiratory health: protocol for an 8-week, randomized, double-blind, parallel group, placebo-controlled trial.

Ann Palliat Med 2020 Sep 3;9(5):3584-3592. Epub 2020 Sep 3.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Republic of Korea.

Background: HX110-A and HX110-B are compound extracts based on radix adenophorae and rhizoma dioscoreae, respectively, which have anti-inflammatory activity. There are limited data on whether they may help improve respiratory conditions including lung function. Therefore, in this trial, we will evaluate the effectiveness and safety of the use of HX110-A and HX110-B for the treatment of respiratory health in adults with mild respiratory symptoms.

Methods: This will be an 8-week, randomized, double-blind, parallel group, placebo-controlled trial with three arms. Adults more than 40 years old with persistent respiratory symptoms will be enrolled. Patients with definite respiratory disease or with a history of recent intake of antioxidants or anti-inflammatory agents will be excluded. Study subjects will be assigned at a 1:1:1 ratio into the following three arms: controls, experimental group 1 (HX110-A), and experimental group 2 (HX110-B). Control or experimental foods will be administered for 8 weeks, and follow-up will be up to 12 weeks. The primary outcome will be total antioxidant capacity. Secondary outcomes will be inflammatory indexes, respiratory symptoms, lung function, quality of life, and fatigue level. Safety outcomes will be assessed by monitoring adverse events and vital signs, and through clinical pathology tests.

Results: This trial will reveal the effectiveness and safety of HX110-A and/or HX110-B for medical purposes in adults with respiratory symptoms. The results should clarify if active intake of specific foods with these functional compounds may promote respiratory health in adults without definite respiratory disease.

Trial Registration: Clinical Research Information Service, KCT0003614. Registered 12 May 2019 (Respectively registered, https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=13364).
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http://dx.doi.org/10.21037/apm-20-1214DOI Listing
September 2020

Psychological well-being and gene expression in Korean adults: The role of age.

Psychoneuroendocrinology 2020 10 24;120:104785. Epub 2020 Jun 24.

Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, United States.

Background: Happiness has traditionally been thought to comprise two parts - pleasure (hedonia) and meaning (eudaimonia). Even though the two types of happiness are correlated, genomics studies have found distinct transcriptional correlates of hedonia and eudaimonia, particularly in the Conserved Transcriptional Response to Adversity (CTRA) marked by up-regulation of proinflammatory genes and down-regulation of interferon-related genes. Eudaimonia has been associated with reduced CTRA gene expression in several studies, whereas hedonia shows no consistent association with the CTRA. However, most of these social genomics studies have been conducted in Western cultures with Caucasian samples, so it is unclear if these findings extended to non-Western cultures with other ethnic groups. Moreover, it is unknown whether age might modify the association between CTRA gene expression and eudaimonia. To this end, we examined in a sample of Koreans the relationship between CTRA profiles and measures of hedonia and eudaimonia, as well as the role of age in modulating the strength of those relationships.

Methods: Blood samples were collected from 152 healthy Korean adults (mean age = 44.64; 50 % female). Well-being was measured using the Mental Health Continuum short form (MHC-SF), Ryff Scales of Psychological Well-being (PWB), and subjective well-being (SWB) scales. RNA transcriptome profiles were obtained by RNA sequencing. Mixed effect linear model analyses examined the association between CTRA gene expression and measures of MHC-SF, SWB, PWB (total scores and six subscales) and additional analyses examined a possible moderating role of age.

Results: CTRA gene expression was significantly downregulated in association with the MHC-SF eudaimonic scores as well as the PWB total scores. Among the six domains of PWB, autonomy showed the strongest inverse correlation with CTRA profiles. Moreover, the inverse association between CTRA and PWB was stronger for older participants.

Conclusion: Eudaimonia is associated with reduced CTRA gene expression in a Korean population, with particularly marked relationships for autonomy. Findings also suggest that aging with meaning may bring biological advantage in later life.
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http://dx.doi.org/10.1016/j.psyneuen.2020.104785DOI Listing
October 2020

Perceptions, Attitudes, Behaviors, and Barriers to Effective Obesity Care in South Korea: Results from the ACTION-IO Study.

J Obes Metab Syndr 2020 Jun;29(2):133-142

Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: The prevalence of obesity is increasing in South Korea. We aimed to identify the perceptions, attitudes, behaviors, and barriers to effective obesity care in South Korea.

Methods: The Awareness, Care, and Treatment In Obesity maNagement-an International Observation (ACTION-IO) study was a cross-sectional survey conducted in 11 countries. Respondents were people with obesity (PwO; body mass index ≥25 kg/m in South Korea from self-reported height/weight) and healthcare professionals (HCPs) primarily involved in direct care with PwO.

Results: The survey was completed by 1,500 PwO and 200 HCPs in South Korea. PwO (78%) and HCPs (81%) agreed that obesity is a chronic disease, but more PwO (84%) believed that obesity has an extreme impact on their overall health compared with HCPs (65%). Most PwO felt completely responsible for their own weight loss (81%), and 78% reported at least one serious weight loss attempt in the past. In contrast, HCPs reported that, on average, only 35% of their patients with obesity had made a serious attempt at losing weight. Only 31% of PwO had discussed weight with their HCP in the past 5 years; of those, 78% appreciated that HCPs initiated these conversations. Short appointment times restricted weight loss discussions for 70% of HCPs, and 29% of HCPs expressed complete comfort with such conversations.

Conclusion: South Korean PwO are motivated to lose weight and have expressed interest in HCPs being more active in their weight management. Further nationwide efforts may be required to lower the barriers to education about obesity and effective weight loss discussion and management.
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http://dx.doi.org/10.7570/jomes20013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338493PMC
June 2020

The association between mastication and mild cognitive impairment in Korean adults.

Medicine (Baltimore) 2020 Jun;99(23):e20653

Department of Preventive and Social Dentistry, Seoul National University, Seoul, South Korea.

Currently, a few of studies revealed that there is an association between mastication and cognitive impairment. There is no study of Korean adult representative samples in relation to mastication and cognitive decline. This study was to investigate the relationship between mastication and mild cognitive impairment in Korean adults.A population-based cross-sectional study was conducted in which a total of 7029 subjects (2987 men and 4042 women) over 45 years old were surveyed from the Korea Longitudinal Study on Aging (KLoSA), Round 5th survey. Logistic regression analysis was performed for the study data controlling for confounding factors such as age, gender, education, income, smoking, drinking, exercise, wearing denture, and the number of chronic diseases.Decreased chewing function is associated with mild cognitive impairment (odds ratio [OR] = 3.24, 95% confidence interval [CI] = 2.67-3.93) after controlling for confounding variables. In the participants who did not wear dentures, the reduction of chewing function was strongly correlated with mild cognitive impairment (OR = 3.97, 95% CI = 3.11-5.08).Mastication was associated with mild cognitive impairment. To prevent cognitive decline, health specialists should pay more attention to the decline of the mastication in people without dentures.
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http://dx.doi.org/10.1097/MD.0000000000020653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306381PMC
June 2020

The association between mastication and mild cognitive impairment in Korean adults.

Medicine (Baltimore) 2020 Jun;99(23):e20653

Department of Preventive and Social Dentistry, Seoul National University, Seoul, South Korea.

Currently, a few of studies revealed that there is an association between mastication and cognitive impairment. There is no study of Korean adult representative samples in relation to mastication and cognitive decline. This study was to investigate the relationship between mastication and mild cognitive impairment in Korean adults.A population-based cross-sectional study was conducted in which a total of 7029 subjects (2987 men and 4042 women) over 45 years old were surveyed from the Korea Longitudinal Study on Aging (KLoSA), Round 5th survey. Logistic regression analysis was performed for the study data controlling for confounding factors such as age, gender, education, income, smoking, drinking, exercise, wearing denture, and the number of chronic diseases.Decreased chewing function is associated with mild cognitive impairment (odds ratio [OR] = 3.24, 95% confidence interval [CI] = 2.67-3.93) after controlling for confounding variables. In the participants who did not wear dentures, the reduction of chewing function was strongly correlated with mild cognitive impairment (OR = 3.97, 95% CI = 3.11-5.08).Mastication was associated with mild cognitive impairment. To prevent cognitive decline, health specialists should pay more attention to the decline of the mastication in people without dentures.
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http://dx.doi.org/10.1097/MD.0000000000020653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306381PMC
June 2020

Effect of mHealth With Offline Antiobesity Treatment in a Community-Based Weight Management Program: Cross-Sectional Study.

JMIR Mhealth Uhealth 2020 01 21;8(1):e13273. Epub 2020 Jan 21.

Department of Family Medicine, Myongji Hospital, College of Medicine, Hanyang University, Goyang-Si, Republic of Korea.

Background: Weight loss interventions using mobile phone apps have recently shown promising results.

Objective: This study aimed to analyze the short-term weight loss effect of a mobile coaching intervention when it is integrated with a local public health care center and a regional hospital's antiobesity clinic as a multidisciplinary model.

Methods: A total of 150 overweight or obese adults signed up to complete an 8-week antiobesity intervention program with human coaching through a mobile platform. Paired t tests and multiple linear regression analysis were used to identify the intervention factors related to weight change.

Results: Among the 150 participants enrolled in this study, 112 completed the 8-week weight loss intervention. Weight (baseline: mean 77.5 kg, SD 12.9; after intervention: mean 74.8 kg, SD 12.6; mean difference -2.73 kg), body mass index, waist circumference, fat mass (baseline: mean 28.3 kg, SD 6.6; after intervention: mean 25.7 kg, SD 6.3; mean difference -2.65 kg), and fat percentage all showed a statistically significant decrease, and metabolic equivalent of task (MET) showed a statistically significant increase after intervention. In multiple linear regression analysis, age (beta=.07; P=.06), △MET (beta=-.0009; P=.10), number of articles read (beta=-.01; P=.04), and frequency of weight records (beta=-.05; P=.10; R=0.4843) were identified as significant factors of weight change. Moreover, age (beta=.06; P=.03), sex (female; beta=1.16; P=.08), △MET (beta=-.0009; P<.001), and number of articles read (beta=-.02; P<.001; R=0.3728) were identified as significant variables of fat mass change.

Conclusions: The multidisciplinary approach, combining a mobile health (mHealth) care app by health care providers, was effective for short-term weight loss. Additional studies are needed to evaluate the efficacy of mHealth care apps in obesity treatment.
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http://dx.doi.org/10.2196/13273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001049PMC
January 2020

Potentially modifiable blood triglyceride levels by the control of conventional risk factors.

Lipids Health Dis 2019 Dec 13;18(1):222. Epub 2019 Dec 13.

International Healthcare Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

Backgrounds: Triglyceride (TG) is known to be regulated by multiple lifestyle factors rather than genetic factors. This cross-sectional and community-based study (Healthy Twin study in Korea) aimed to estimate the "modifiable TG level" by identifying non-genetic risk factors of TG.

Methods: Participants were recruited between 2006 and 2011 who fulfilled health examinations and detail surveys: 3079 Korean adults including 949 monozygotic twins and 222 dizygotic twins. In order to investigate conventional risk factors, a mixed model accounting for family as a random effect was performed. In addition, we conducted a co-twin control analysis for 452 monozygotic twin (MZ) pairs, to examine non-genetic risk factors and potentially modifiable serum triglyceride levels.

Results: After excluding patients on dyslipidemia or diabetes medication, 2672 individuals (1029 men, with mean age of 43.9; and 1643 women with mean age of 43.3; 949 MZ pairs, 222 dizygotic twin pairs, and 1501sibling pairs) were analyzed. Fasting blood sugar (FBS), lipid panel, height, weight, waist (WC) and hip circumference, body mass index (BMI), amount of dietary intake and amount of physical activity was examined after adjusting for age and sex. For conventional analysis, WC, fat %, and BMI were identified as significant factors influencing serum triglyceride levels. Examination of non-genetic factors from the Co-twin control study revealed BMI (beta coefficient 9.94 with C.I. 3.42 to 16.46) and amount of alcohol intake (beta coefficient 0.08 with C.I. 0.02 to 0.14) as significant factors.

Conclusion: Our findings suggest that controlling body weight and alcohol intake might be effective to control TG; moderate weight control (BMI 1 reduction) and reducing alcohol consumption by 50 g/week (about two glassed of beer) might reduce TG level by 9.94 and 4.0 mg/dL.
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http://dx.doi.org/10.1186/s12944-019-1134-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911291PMC
December 2019

Impact of number of medications and age on adherence to antihypertensive medications: A nationwide population-based study.

Medicine (Baltimore) 2019 Dec;98(49):e17825

Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital.

This study tried to investigate the effects of number of medications and age on antihypertensive medication adherence in a real-world setting using a nationwide representative cohort.We obtained data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) of Korea, which is a sample of 2.2% (N = 1,048,061) of total population (N = 46,605,433). Patients aged 20 years or older (N = 150,550) who took antihypertensive medications for at least 1 year were selected. Medication possession ratio (MPR) was used for measuring adherence. The subjects were divided into 5 subgroups according to total number of medications: 1-2, 3-4, 5-6, 7-8, and 9 or more. The mean age and the mean number of medications were 60.3 ± 12.6 years and 4.1 ± 2.2, respectively. The mean MPR was 80.4 ± 23.9%, and 66.9% (N = 100,645) of total subjects were adherent (MPR ≥ 80%). The overall tendency of antihypertensive medication adherence according to the total number of medications displayed an inverted U-shape with a peak at 3-4 drugs. Adherence consistently increased as the age increased until age 69 and started to decrease from age 70. The proportion of adherent patients (MPR ≥ 80%) according to the total number of medications also showed an inverted U-shape with a peak at 3-4 drugs. When the same number of drugs was taken, the proportion of adherent patients according to age featured an inverted U- shape with a peak at 60 to 69 years. Patients taking 9 or more total drugs had the overall odds ratio (95% CI) of non-adherence (MPR < 80%) with 1.17 (1.11-1.24) compared with those taking 1 to 8 total drugs and the odds ratios in the age subgroups of 40 to 49, 50 to 59, 60 to 69 years were 1.57 (1.31-1.87), 1.21 (1.08-1.36), and 1.14 (1.04-1.25), respectively (P < .05).Association between age, total number of medications, and antihypertensive adherence displayed an inverted U-shape with a peak at 3 to 4 total medications and at age 60 to 69 years. When the total number of drugs was 9 or more, adherence decreased prominently, regardless of age.
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http://dx.doi.org/10.1097/MD.0000000000017825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6919523PMC
December 2019

Estimating quality of life with biomarkers among older Korean adults: A machine-learning approach.

Arch Gerontol Geriatr 2020 Mar - Apr;87:103966. Epub 2019 Nov 9.

Department of Family Medicine, SMG- SNU Boramae Medical Center 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Republic of Korea. Electronic address:

Background: While health-related quality of life (HRQoL) has clinical value, its determinants, particularly objective health-related measurements, have not been fully explored. This study seeks to identify the biological indicators that relate to HRQoL among a group of older Korean adults using a machine-learning approach.

Methods: We used physical and mental scores from the 36-item Short Form Health Survey (SF-36) to measure HRQoL among older Korean adults who participated in the Korean Longitudinal Study of Aging (KLoSA) biomarker pilot study (N = 385). The variables for the multivariate penalized regression analysis included demographic factors, medical measurements, physical performance, and health-related behaviors.

Results: The multivariate profiles identified several significant biomarkers that relate to quality of life. Among the 20 variables, handgrip strength was the most powerful indicator in both men and women for the SF-36 physical scores, followed by walking speed. Age and total sleep duration exclusively were significantly associated with the SF-36 physical scores only in women, whereas body mass index, blood pressure, and sit-to-stand times were unique elements in men.

Conclusions: The present study suggests significant physical indicators that explain quality of life in elderly populations, using a data-driven approach. Based on these findings, maintaining a good level of physical performance is considered a key element of successful aging.
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http://dx.doi.org/10.1016/j.archger.2019.103966DOI Listing
September 2020

Influence of Microbiota on Diabetic Foot Wound in Comparison with Adjacent Normal Skin Based on the Clinical Features.

Biomed Res Int 2019 19;2019:7459236. Epub 2019 Aug 19.

Department of Life Science, Hallym University, Chuncheon, Gangwon-do 24252, Republic of Korea.

Diabetic foot ulcer (DFU) is a complication experienced by diabetic patients and does not heal well in an altered wound environment. Although diverse microbes in DFU were detected, little is known about their influences on diabetic foot wound (DFW) and the association with the skin microbiota in normal tissue from the same patients according to clinical features. We aimed to analyze the microbiota in normal skin and DFW tissue from the same subject and predict their roles based on clinical features. We analyzed the microbiota in normal skin and DFW tissue from the same subject and compared the associated members of microbiota with clinical parameters. The diversity of skin microbiota was higher than that of DFW tissues, along with compositional differences. In addition, different microbes were associated with clinical features. The proportions of Bacteroidetes, , , , and were higher in the severe groups than of the mild groups, whereas that of Firmicutes was lower in the severe groups. According to wound severity, the microbiota could be related to inflammation, damaging host cell membrane, and pathogenicity through lipopolysaccharide biosynthesis, cellular antigens, and protein digestion metabolism. The predicted DFW microbiota functions according to systemic diabetic status defined by ESRD and HbA1c, differed from those presented by wound severity. Results indicate that the microbiota in normal skin is related to the colonizing microbes in DFW tissue according to clinical features and the different microbes can play important roles in DFW prognosis. This information can be applied to prevent and manage DFW by modulating the microbiota.
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http://dx.doi.org/10.1155/2019/7459236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720033PMC
February 2020

Association between weekend catch-up sleep and health-related quality of life of Korean adults.

Medicine (Baltimore) 2019 Mar;98(13):e14966

Department of Family Medicine, Jeju National University Hospital, Jeju-si.

Sleep debt is known to have harmful effects on health. Weekend catch-up sleep (CUS) is a behavior to cope with weekday sleep debt. However, it is unclear whether weekend CUS has advantageous effects on health because sleep hygiene guidelines recommend regularizing bed time and arousal time. The aim of this study was to identify whether weekend CUS behavior has an association with better health-related quality of life (HRQoL)According to the inclusion criteria, 4871 participants were selected from the 2016 Korea National Health and Nutrition Examination Survey. Sleep questionnaires and European quality of life scale-5 dimensions (EQ-5D) questionnaire were used to collect data about the participants' sleep patterns and HRQoL. Odds ratios (ORs) with 95% confidence intervals (95% CIs) for each dimensional problem of EQ-5D were derived by logistic regression. Mean EQ-5D index scores were compared between weekend CUS and non-CUS groups based on their weekday sleep durations and quintile of chronotype.The ORs of dimensional problems of HRQoL of non-CUS group versus weekend CUS group were 1.63 (95% CI 1.07, 2.47) for usual activities, and 1.45 (95% CI 1.11, 1.90) for anxiety/depression. Mean EQ-5D scores of the weekend CUS group were significantly higher than those of the non-CUS group for sleeping less than 6 hours (0.953 ± 0.004 vs 0.936 ± 0.007, P = .036) and sleeping 6 to 7 hours (0.965 ± 0.003 vs 0.955 ± .0.004, P = .045). These findings were similar in the fourth quintile (Q4) of chronotype (0.965 ± 0.007 vs 0.951 ± 0.008, P = .008) and fifth quintile (Q5) (0.952 ± 0.006 vs 0.941 ± 0.007, P = .022).Weekend CUS behavior was associated with better HRQoL than non-CUS among Korean adults. Especially, it was significant in participants who slept for less than 7 hours or participants whose chronotype was the fourth or fifth quintile. Attention may be needed for subjects with sleep short time and later chronotype who do not have weekend-CUS behaviors, because there is a risk that their HRQoL might be compromised.
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http://dx.doi.org/10.1097/MD.0000000000014966DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455713PMC
March 2019

Combination of Diet Quality Score, Plasma Carotenoids, and Lipid Peroxidation to Monitor Oxidative Stress.

Oxid Med Cell Longev 2018 31;2018:8601028. Epub 2018 Dec 31.

Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea.

It is important to understand the association between oxidative stress-related parameters and to evaluate their status in advance of chronic disease development. Further development towards disease can then be prevented by dietary antioxidants. The present study was aimed at assessing the relationship between diet quality, blood antioxidants, and oxidative damage to determine whether the association between these markers differs by oxidative stress status. For a cross-sectional analysis, we used data and samples of baseline information from a prospective cohort study. A total of 1229 eligible adults were classified into apparently healthy subjects (66.5%) and those with oxidative stress conditions (35.5%). Diet quality was assessed using the recommended food score (RFS). Plasma carotenoids (blood antioxidants) and blood/urinary malondialdehyde (MDA; oxidative damage) were determined by high-performance liquid chromatography. We found that the healthy group was younger, and they had a lower RFS and plasma MDA level and higher plasma carotenoids compared to the oxidative stress condition group. This result is probably due to the quenching of the oxidative response in the tissues of those people. A positive association of RFS with plasma carotenoids (total and -carotene) was found in both groups, suggesting that carotenoids are a robust reflection of diet quality. Negative associations were observed between plasma MDA and RFS in the oxidative stress condition group and between urinary MDA and plasma zeaxanthin in the healthy group. Erythrocyte MDA was positively associated with plasma carotenoids (total, lutein, zeaxanthin, -cryptoxanthin, and - and -carotene), regardless of health condition, probably also as a result of the use of carotenoids as antioxidants. In conclusion, these results indicate that the above three factors may be associated with the oxidative stress response and depend on the oxidative status. Furthermore, it was also suggested that erythrocytes are important in the oxidative stress response and the quenching of this response is represented in plasma carotenoids.
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http://dx.doi.org/10.1155/2018/8601028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6332925PMC
February 2019

Results from South Korea's 2018 Report Card on physical activity for children and youth.

J Exerc Sci Fit 2019 Jan 26;17(1):26-33. Epub 2018 Nov 26.

Department of Physical Education, Seoul National University, Seoul, South Korea.

Background/objective: is the second comprehensive evaluation of physical activity and the sources of influence based on the 10 core indicators provided by the Active Healthy Kids Global Alliance. It will serve as an advocacy tool to promote physical activity among children and youth.

Methods: Three national surveillance data (i.e., 2017 Korea Youth Risk Behavior Web-based Survey, 2016 Korea National Health and Nutrition Examination Survey, 2016 Physical Activity Promotion System) were used as main sources to evaluate the indicators. Descriptive statistics were performed to obtain prevalence estimates of physical activity-related indicators. In addition, expert opinions as well as the most recently available published or unpublished relevant sources were synthesized.

Results: South Korea's 2018 Report Card, compared to the 2016 Report Card, showed favourable changes in the Active Transportation (B+), Organized Sports Participation (C), Sedentary Behaviours (D), and School (D+) indicators, while unfavourable changes were shown in Overall Physical Activity (F) and Government (D). Physical Fitness was graded as D+. In parallel with the 2016 Report Card, Active Play, Family and Peers, and Community and Environment remain ungraded due to insufficient data.

Conclusions: Successes as well as gaps and research needs were identified in the 2018 Report Card. Though some indicators have shown improvement, most children and youth continue to be insufficiently physically active with overall poor grades (Average of D+). To achieve substantial improvement in all grades in future Report Cards, more institutional and governmental support and investment is needed to promote physical activity. Furthermore, effort should be made to generate data pertaining to the indicators that were ungraded.
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http://dx.doi.org/10.1016/j.jesf.2018.10.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323304PMC
January 2019

The Relationship between Electronic Cigarette Use with or without Cigarette Smoking and Alcohol Use among Adolescents: Finding from the 11th Korea Youth Risk Behavior Web-based Survey.

Korean J Fam Med 2019 Jul 14;40(4):241-247. Epub 2019 Jan 14.

Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.

Background: Electronic cigarette (EC) consumption ('vaping') is rapidly increasing, not only in adults but also in adolescents. Little is known about the association between vaping and problem behaviors such as drinking.

Methods: We used data from the 11th Korea Youth Risk Behavior Web-based Survey, which was conducted in 2015 and included 68,043 participants who were Korean middle and high school students. The survey assessed EC, cigarette, and alcohol use. Multiple regression analysis was used to examine risk of current drinking and problem drinking across the following categories of users: never user (never used either product), former user (use of EC or cigarettes in the past, but not currently), vaping only, smoking only, and dual user (current use of both products).

Results: EC only users were 1.2% in males, and 0.3% in females. Dual user of both conventional cigarettes and ECs were 5.1% in males, and 1.2% in females. Drinking frequency, drinking quantity per once, and problem drinking were higher among vapers than non-vapers and former-vapers, moreover, were higher among daily vapers than intermittent vapers. Compared to never users, EC only users were higher on risk of current drink and problem drink. The dual users were highest on risk of current drink.

Conclusion: Vaping is independently associated with alcohol use problems in Korean students, even those not currently smoking. Moreover, dual use of cigarettes and ECs is strongly associated with alcohol use problems. Therefore, vaping students should be concerned about their hidden alcohol use problems.
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http://dx.doi.org/10.4082/kjfm.17.0094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669390PMC
July 2019

Association between sleep duration and musculoskeletal pain: The Korea National Health and Nutrition Examination Survey 2010-2015.

Medicine (Baltimore) 2018 Dec;97(50):e13656

College of Medicine, American University of Antigua, Antigua and Barbuda, USA.

Both extremely long and short sleep durations have been associated with increased risk of numerous health problems. This study examined the association between self-reported sleep duration and reporting of musculoskeletal pain in the adult Korean population.This study included data from 17,108 adults aged ≥50 years, obtained from the Korea National Health and Nutrition Examination Survey 2010-2012 and 2013-2015. Self-reported daily hours slept and the presence of musculoskeletal pain in knee joint, hip joint, or low back were examined. Patients were stratified into 5 groups by their sleep duration: ≤5, 6, 7, 8, or ≥9 h. Multivariate logistic regression analysis was performed, adjusting for covariates including age, sex, marital status, smoking, alcohol use, family income level, education, physical exercise, body mass index (BMI), and stress level.A U-shaped relationship was observed between the length of sleep duration and the presence of musculoskeletal pain. After adjusting for covariates, sleep duration of ≤5 h or ≥9 h was significantly associated with musculoskeletal pain experienced for more than 30 days over a 3-month period. We also found that the presence of multi-site musculoskeletal pain was significantly higher among those who slept for ≤5 h or ≥9 h than in those who slept for 7 h.These findings suggest that either short or long sleep duration is associated with musculoskeletal pain among Korean adults.
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http://dx.doi.org/10.1097/MD.0000000000013656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320184PMC
December 2018

Prognostic Influence of Preoperative Mammographic Breast Density in Operable Invasive Female Breast Cancer.

Sci Rep 2018 10 30;8(1):16075. Epub 2018 Oct 30.

Department of Family Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.

We aimed to investigate the potential of preoperative mammographic breast density (MBD) as a prognostic factor in breast cancer. Data of 969 patients with primary breast cancer were analyzed. We defined low MBD as fatty or fibroglandular breast, and high MBD as heterogeneously dense or extremely dense breast, respectively. The high MBD group demonstrated a superior overall survival rate compared to the low MBD group (p < 0.001). Favorable prognostic effects of high MBD were observed in subgroups aged >50 years (p < 0.001) and with positive hormone receptor (HRc) and negative human epidermal growth factor receptor 2 (HER2) (p < 0.001). The high MBD group had a higher proportion of patients aged ≤50 years (p < 0.001) and patients with body mass index (BMI) ≤25 kg/m (p < 0.001), and a higher proportion of patients who received chemotherapy (p < 0.001). MBD was a significant independent prognostic factor by multivariable analysis (hazard ratio, 0.382; 95% confidence interval, 0.206-0.708). The high MBD group was associated with superior overall survival rates. Preoperative MBD was a strong independent prognostic factor in operable primary invasive female breast cancer, especially in patients with age >50 years and the HRc(+)/HER2(-) subtype. Favorable clinicopathologic features, active treatments, and other factors could contribute to this causality.
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http://dx.doi.org/10.1038/s41598-018-34297-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207781PMC
October 2018

Mobile health, physical activity, and obesity: Subanalysis of a randomized controlled trial.

Medicine (Baltimore) 2018 Sep;97(38):e12309

Future IT R&D Lab, LG Electronics, Woomyun R&D Campus Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul Department of Family Medicine, Jeju Nation University Hospital, Jeju Department of Family Medicine, Mediplex Sejong Hospital, Incheon, Korea.

Background: Recent studies on physical activity were analyzed by randomizing participants into either the intervention or control group. It is necessary to classify each intervention and control groups according to physical activity using the International Physical Activity Questionnaire (IPAQ).

Methods: This was a pilot project for SmartCare Services. The intervention group received obesity management services using a smartphone for 24 weeks, while the control group did not receive the interventions. Six anthropometric indices were analyzed: weight, body mass index (BMI), waist circumference, body fat, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Five laboratory tests, including fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TGs), were also assessed. The final 324 participants were categorized using the IPAQ questionnaire, and anthropometric indices and laboratory tests were analyzed for within-group and between-group changes from baseline to final visit.

Results: Statistically significant decreases in the intervention group compared with the control group were observed in terms of insufficient activity (IA) (-1.6 ± 3.03 vs -0.1 ± 1.94 kg) and moderate activity (MA) (-2.5 ± 3.81 vs -0.3 ± 2.24 kg) for weight, IA (-0.7 ± 1.14 vs -0.2 ± 0.93 kg/m) and MA (-0.9 ± 1.30 vs -0.2 ± 0.86 kg/m) for BMI, and health-enhancing physical activity (HEPA) (-1.6 ± 3.69% vs -0.1 ± 3.15%) for body fat. For HbA1c, HEPA in the intervention group showed significant decreases (-0.2 ± 0.67 vs 0.0 ± 0.34 mg/dL) compared with the control group.

Conclusion: Anthropometric indices and laboratory test results were improved in the smartphone-based intervention group. Especially, improvement of metabolic components in the group with more active physical activity was remarkable.
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http://dx.doi.org/10.1097/MD.0000000000012309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160111PMC
September 2018

Effect of duration of diabetes on bone mineral density: a population study on East Asian males.

BMC Endocr Disord 2018 Sep 5;18(1):61. Epub 2018 Sep 5.

Department of Family Medicine, SMG-SNU Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea.

Background: The aim of the present study is to evaluate the association between BMD and type 2 DM status in middle-aged and elderly men. To investigate a possible correlation, the present study used the BMD dataset of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011.

Methods: In total, 37,753 individuals participated in health examination surveys between 2008 and 2011. A total of 3383 males aged ≥50 years were eligible. They underwent BMD measurement through dual-energy X-ray absorptiometry (DXA). The fasting plasma glucose and insulin levels of participants were also measured.

Results: Men with prediabetes and diabetes had significantly higher mean BMD at all measured sites than control men did, irrespective of DM status. This was confirmed by multivariable linear regression analyses. DM duration was an important factor affecting BMD. Patients with DM for > 5 years had lower mean BMD in the total hip and femoral neck than those with DM for ≤5 years. Per multivariable linear regression analyses, patients with DM for > 5 years had significantly lower mean BMD at the femoral neck than those with DM ≤5 years.

Conclusions: DM duration was significantly associated with reduced femoral neck BMD.
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http://dx.doi.org/10.1186/s12902-018-0290-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126021PMC
September 2018

A randomized, double-blind, placebo-controlled trial investigating cholesterol-lowering effects and safety of yellow yeast rice in adults with mild to moderate hypercholesterolemia: A study protocol.

Medicine (Baltimore) 2018 Jul;97(30):e11634

BiofoodCRO Co, Ltd, Seodaemun-gu Department of Internal Medicine, SMG-SNU Boramae Medical Centre, Dongjak-gu Department of Nutritional Science and Food Management, Ewha Womans University Biofood Network, Seodaemun-gu Department of Family Medicine, SMG-SNU Boramae Medical Center, Dongjak-gu, Seoul, Korea.

Background: Elevated levels of blood lipids are well-documented risk factors for cardiovascular disease. For cardiovascular risk reduction, preventive strategies to lower blood cholesterol levels are essential, and these strategies include lifestyle modification and cholesterol-lowering agents. We aim to investigate the cholesterol-lowering effects and safety of yellow yeast rice in a randomized, controlled, double-blind, and parallel group study.

Methods: Participants for this study will be selected based on the following inclusion criteria:Participants are randomly allocated to the placebo or yellow-yeast-rice-treated group. Participants with mild to moderately elevated LDL-C levels will consume 1 pouch of yellow yeast rice powder (containing monacolin K) or placebo twice daily for 8 weeks. Next, the lipid profiles will be evaluated.

Results: The number of participants required for this study is 68, and is currently recruiting participants. Participants are randomly assigned to control group and intervention group.

Conclusion: This is the first human intervention study to investigate the cholesterol-lowering effects and safety of yellow yeast rice in adults with mild to moderate hypercholesterolemia. Also, this is a randomized, double-blind, placebo-controlled trial that considers confounders, such as dietary habits, lifestyle factors, and genetic factors.
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http://dx.doi.org/10.1097/MD.0000000000011634DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078669PMC
July 2018

Cut-Off Values for Visceral Fat Area Identifying Korean Adults at Risk for Metabolic Syndrome.

Korean J Fam Med 2018 Jul 4;39(4):239-246. Epub 2018 Jul 4.

Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.

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.
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http://dx.doi.org/10.4082/kjfm.17.0099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056408PMC
July 2018

Risk Factors for High Myopia in Koreans: The Korea National Health and Nutrition Examination Survey.

Curr Eye Res 2018 08 10;43(8):1052-1060. Epub 2018 May 10.

a Department of Ophthalmology , Hallym University College of Medicine, Chuncheon Sacred Heart Hospital , Chuncheon , Korea.

Purpose: To investigate risk factors for high myopia in the general Korean population.

Methods: In this nationwide population study, the dataset of the Korea National Health and Nutrition Examination Survey 2008-2012 was analyzed. The study cohort included 11 703 participants, aged 25-49 years, who underwent neither refractive nor cataract surgery. The association between demographic, socioeconomic, behavioral, and systemic variables and high myopia was investigated.

Results: The mean participant age was 37.9 ± 6.8 years, and the prevalence of high myopia ≤-6.0D was 7.0 ± 0.3% in the study population. The right eyes (-1.76 ± 0.03 D) were more myopic than the left eyes (-1.70 ± 0.03 D; P < 0.001). In multivariate logistic regression analysis, high myopia was associated with age (odds ratio [OR], 0.97 per 1 year-increase) and female sex (OR, 1.24). Other identified risk factors included education level ≥ university graduation (OR, 1.91), the presence of hypertension (OR, 1.69), and serum glucose level (OR, 1.01 per 1 mg/dL). Sunlight exposure of ≥5 h/day (OR, 0.67) and serum 25-hydroxyvitamin D level (OR, 0.97 per 1 ng/mL) showed protective effect against high myopia.

Conclusion: High myopia is associated with younger age, female sex, high education level, longer sunlight exposure, and some other systemic conditions.
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http://dx.doi.org/10.1080/02713683.2018.1472286DOI Listing
August 2018

Erratum: Instant noodle consumption is associated with cardiometabolic risk factors among college students in Seoul.

Nutr Res Pract 2018 04 27;12(2):173. Epub 2018 Mar 27.

Department of Nutritional Science and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea.

[This corrects the article on p. 232 in vol. 11, PMID: 28584580.].
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http://dx.doi.org/10.4162/nrp.2018.12.2.173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886970PMC
April 2018