As sociation of Non-alcoholic Fatty Liver Disease with Metabolic Syndrome over 65 Years Elderly

BACKGROUND: The prevalence of non alcoholic fatty liver disease(NAFL) was increased by common use of abdominal ultrasonography and non alcoholic fatty liver disease has been associated metabolic syndrome. The aim of the present study was to evaluate the association of non alcoholic fatty liver disease with metabolic syndrome over 65 years elderly. METHOD: The subject of this study included 262 elderly aged 65 years or older who visited the Health Promotion Center of one university hospital, and the 42 non alcoholic fatty liver disease and the 220 normal control diagnosed by abdominal ultrasonography. We estimated the diagnosis of metabolic syndrome according to ATPlll guideline except Asia-Pacific waist circumference guideline. we evaluated the prevalence of non alcoholic fatty liver disease and the association of non alcoholic fatty liver disease with metabolic syndrome risk factors. We used the multiple logistic regression method to estimate odds ratios for metabolic syndrome of non alcoholic fatty liver disease and other risk factors. RESULTS: The prevalence of non alcoholic fatty liver disease was 16.0%. The mean values of waist circumference, HDL cholesterol, triglyceride, and fasting glucose were significantly increased in non alcoholic fatty liver disease compared with control subjects. The prevalence of abdominal obesity, hypertriglycemia, low HDL cholesterolemia, impaired fasting glucose was significantly increased in non alcoholic fatty liver disease compared with control subjects. Odds ratios of hypertriglycemia, low HDLcholesterolemia, and impaired fasting glucose on non alcoholic fatty liver disease were 2.18, 2.35, and 2.46 and were significantly associated. Odds ratio of non alcoholic fatty liver disease on metabolic syndrome was 2.32 and was significantly associated. CONCLUSION: The non alcoholic fatty liver disease was accompanied often in metabolic syndrome. This study suggested that life style modifications such as regular physical activity, weight reduction and diet were needed for management and treatment of non alcoholic fatty liver disease and metabolic syndrome.

Changes of VO2max According to Sex, Age and Related Factors in Korean Adults

BACKGROUND: There is a lack of data on Korean average VO2max values. This study attempted to yield average values of VO2max corresponding to each age group of Koreans. This study was also designed to investigate the factors associated with VO2max. METHODS: From May 1st 1996 to January 30th 2000, we recruited 21,458 subjects who visited the health promotion center at one university hospital. We obtained the data related to age, exercise by self-administered questionnaire and weight, height and blood pressure by instrumental measurements and hemoglobin, cholesterol by overnight fasting blood sampling. VO2max was estimated by submaximal bicycle ergometer test. RESULTS: The number of research subjects was 21,458: males 12,646 (58.9%) and females 8,812 (41.1%) and the average age was 48.6 (SD: ?10.05) years with age span from 20 to 79 years. The average VO2max was 26.4 (SD; ?6.77) (ml/kg/min) for men and was 19.8 (SD; ?5.94) (ml/kg/min) for women. Relating to factors such as age, VO2max, SBP, DBP, cholesterole, Hb, and body mass index, there were significant statistical differences between sex (p<0.05). For both sexes, VO2max decreased as age, cholesterol, BP and BMI increased. Regular exercise group showed significantly a higher VO2max than non-exercise group for both sexes. CONCLUSION: The average VO2max values for Koreans, according to sex and age group are reported in this study. The decreasing VO2max may be attributed to increasing age, BP, cholesterol, BMI and non-exercise.

Diseases and Health Service Utilization Patterns of Geriatric Inpatients

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.

Prevalence and Risk Factors of the Metabolic Syndrome as Defined by NCEP-ATP III

BACKGROUNDS: The Third Report of the Adult Treatment Panel (NCEP-ATP III) has newly introduced the clinical diagnosis guideline of the metabolic syndrome which is characterized by clustering of the CHD risk factors. The purpose of this study was to estimate the prevalence of the metabolic syndrome in Korean adults by the newly introduced guideline and to evaluate possible risk factors with the syndrome. METHODS: The subject of this study included 3,873 adults (males 2,144, females 1,729) aged 20 years or older who visited the Health Promotion Center of SNUH. Among the subjects, we excluded those who did not have records of physical parameters, blood test results and who were on current medications except antihypertensives and oral hypoglycemic agents. We estimated the prevalence of the metabolic syndrome in Korean adults according to the ATP III waist-circumference guideline, Asia-Pacific waist- circumference, and Body Mass Index (BMI), respectively, and calculated the age-adjusted prevalence of the metabolic syndrome using the direct standardized method. While applying the Asia-Pacific waist circumference, we estimated the prevalence of the metabolic syndrome by age group and the prevalence of the individual abnormalities of the metabolic syndrome. To identify variables associated with the metabolic syndrome, we used the multiple logistic regression method to estimate the prevalence odds ratios for the metabolic syndrome vs. the non-metabolic syndrome. RESULTS: The age-adjusted prevalence of the metabolic syndrome in Korean adults was 9.3% when ATP III waist-circumference was applied, 15.4% for Asia-Pacific waist-circumference, and 18.6% for body mass index (BMI). The highest prevalence of the individual criteria among the metabolic syndrome diagnostic criteria in men was hypertension, followed by hypertriglyceridemia, abdominal obesity, high fasting blood glucose, and low HDL-cholesterolemia. And in women, it was also hypertension, followed by abdominal obesity, low HDL- cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. The prevalence increased from 3.8% among participants aged 20 through 29 years to 27.1% for ages 60 through 69 years and 31.6% for ages above 70 years. Females, increasing age, increased BMI, current smoking, physical inactivity were higher risk factors for the metabolic syndrome, but mild drinking was a lower risk factor for the metabolic syndrome. CONCLUSION: These results show that the metabolic syndrome is highly prevalent although less prevalent than in American adults. The family physician should focus on the screening and comprehensive management of the metabolic syndrome.

Prevalence of Depression and Correlates of Depressive Symptoms among Residents in Rural Areas of Jeju Island

BACKGROUND: Recently, various effective and rapid acting treatment modality for depression have been massively developed. Thus, early detection and treatment of depression is vitally important to improve community mental health. Using BDI, primary practitioner can easily find depressive symptoms that can complicate other physical diseases. Finding and treating depression early can improve general prognosis of physical diseases. The purpose of this study was to find out the prevalence of depression and depressive symptoms and their correlates among residents in Jeju and to provide baseline data. METHODS: The study subjects were 1,086 residents consisting of 531 males and 555 females of 10-Li in rural Jeju island and the data was gathered from trained interviewer using BDI and questionnaire about sociodemographic factors and health behavior. Depression was defined as BDI total score over 23 in males and over 24 in females. Depressive symptom was defined as BDI STEN score over 7. RESULTS: The prevalence of depression in rural Jeju island was 5.8% in total, 4.9% among males, 6.5% among females. The prevalence of depressive symptoms was 16.7% in total, 14.9% among males, 18.4% among females. The risk factors of depressive symptoms were self-assessed living standard, education years, perceived health status, self-assessed level of stress, perceived social support, body image, breakfast intake, and sleep. Sex, marital status and drinking habit were not statistically significant risk factors. CONCLUSION: The prevalence of depression and depressive symptoms in rural Jeju island was very low, especially among females. With intensive mental health service for those who are in low socioeconomic class and low education level and those who have poor health behavior, early detection of depressive symptoms from community will be important to improve general health status.

Subclinical hypothyroidism and coronary risk factors in women above 55 years

BACKGROUND: There are several reports on the association between hypothyroidism and coronary heart disease. But, it is not convincing whether the subclinical hypothyroidism is associated with the coronary heart disease or not. We have attempted to investigate the association between subclinical hypothyroidism and the difference of Framingham risk score between subclinical hypothyroidism and normal control subjects in women above 55 years old, who have higher prevalence in subclinical hypothyroidism. METHODS: This study involved the subjects above age 55, who visited the health promotion center in a university hospital from 1995 to 2000. Subclinical hypothyroidism was defined as a TSH level greater than 4.1 mu1U/7L in the presence of a normal T3 (87-184 mug/dL) and T4 (6.6-13.1 mug/dL) level. We measured thyroid function test (TSH, T3, T4) and the coronary risk factors (systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, fasting glucose, uric acid, C-reactive protein, and body mass index) . Also, we calculated the Framingham risk score from their sum. RESULTS: There were no significant differences of systolic/diastolic blood pressure, fasting g1ucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, uric acid, C -reactive protein body mass index and Framingham risk score in subclinical hypothyroidism patients and normal control subjects. CONCLUSIONS: There were no significant differences between the subclinical hypothyroidism patients and normal control subjects with coronary risk assessment in women above 56-years -old.

The diagnosis distribution in health examination and associated sociodemographic factors

BACKGROUND: According as people have an increased interest in early detection of disease and health promotion, people who take health examinations are increased. So this study is aimed to survey common problems about health in community and their frequency by way of investigation on diagnosis in health examination data and to evaluate the effects of health risk factors on each disease patterns. METHODS: The medical records of the clients who have taken health examinations for the first time from March 1995 to February 2000 at a health examination center of a university hospital in Seoul were reviewed. The category and number of judged diagnosis, sociodemographic factors are compared and analyzed. RESULTS: The selected medical records accounted to 22,393. The study subjects consist of 11,544(51.6%) male. Mean age is 52.0+/-10.5 years(range 16~90). Mean number of judged diagnosis is 4.04+/-2.13(range 0~9) per one person and female took more diagnosis than male on an average(4.09+/-2.17 Vs 3.99+/-2.09). The organic diagnosis(56.4%) is most in total and other diagnosis is 35.7%, functional diagnosis is 7.9%. The common diagnoses are liver disease(7.07%), decreased physical strength(6.68%), hyperlipidemia(6.53%), obesity(5.90%), osteoporosis or postmenopausal syndrome(4.72%), need for immunization against viral hepatitis(4.69%), hypertension(4.20 %), functional gastrointestinal disease(3.93%). The number of total diagnosis and organic diagnosis is larger in older age, no exercise, female, smoker, no spouse, lower education(p<0.05). The number of functional diagnosis is larger in female, younger age, non smoker, lower education(p<0.05). The number of other diagnosis is larger in no exercise, smoker, female, younger age(p<0.05). CONCLUSION: According to health examination, total diagnosis and organic diagnosis are influenced by age, exercise, sex, smoking, spouse, education, functional diagnosis is influenced by sex, age, smoking, education and other diagnosis is influenced by exercise, smoking, sex, age.

Associated factor of prevalence of asymptomatic gallstone

BACKGROUND: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone. METHODS: We screened adults over 20 years who were visited the health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression. RESULTS: Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose. CONCLUSION: Associated factors of prevalence of asymptomatic gallstone were increased by age(>40 years old) and were associated with BMI(>25 kg/m2), fasting blood glucose, and were not different from those in West countries. further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to asymptomatic gallstone.

Cardiovascular risk factors in men with normal and overweight according to waist-to-height ratio

BACKGROUND: Abdominal obesity is a risk factor for morbidity and mortality associated with cardiovascular disease. It has been reported that metabolically obese is common even in normal weight individuals. In this study, we analysed characteristics of cardiovascular risk factors in normal and overweight men using waist- to -height ratio to find out whether it reflects such risks. METHOD: Study subjects were 510 men. (18.5or=0.5, Group 3; 25.0or=0.5. The prevalence, Odds ratio for cardiovascular risk factors were compared. RESULTS: In normal weight group, the prevalence of hypertension(P<0.01), high blood glucose(P<0.01), hypercholesterolemia (P<0.05), hypertrigtceridemia (P<0.01) was significantly higher in group 1 than group 2. In overweight group, the prevalence of hypercholesterolemia (P<0.01), low HDL(P<0.01) was significantly higher in group 4 than group 3. When compared odds ratio for each groups with reference to group 1, adjusted for age, smoking status and regular exercise, high blood glucose(4.48), hvpertrigtceridemia(5.91) in group 2,hyertension(3.54) ,hypertriglyceridemia (3.44) in group 3, hypertension(2.90), hypertriglyceridemia (3.81), low HDL(2.60) in group 4 were significantly higher. CONCLUSION: Waist-to-height ratio may be a useful method for early detection of abdominal obesity and it's related risk factors in normal and overweight individuals.

Comparative consistency between obesity determination standards using Body Mass Index and Ideal body weight

BACKGROUND: Ideal Body Weight(IBW) is commonly used to determine obesity levels because of its usefulness as target weight. This study was attempted to evaluate the comparative consistency between standards of determining obesity levels using the BMI and IBW. And the authors here provide a definition of IBW and attempt to suggest a new classification of obesity by IBW. METHODS: The test subjects for the research were 24,816 patients who received treatment at the SNUH Health Promotion Center between May 1, 1996 and December 31, 1999. The comparative consistency between standards of determining obesity levels using the BMI and IBW were analyzed calculating the kappa value. RESULTS: The IBW from the Broca method produced a kappa value of 0.668(p<0.001), while the calculation method for IBW recommended by the Japan Obesity Institute produced a kappa value of 0.664(p<0.001). On the other hand, an IBW calculated as 21(kg/m2)X[height(m)]2 (kg) produced the highest value of consistency at a kappa value of 0.911(p<0.001). After calculating IBW as 21(kg/m2)X[height(m)]2 (kg) and comparing the kappa values while adjusting the boundary zone standards, it was found that defining underweight as below 88% of IBW and obesity as above 145% produced the highest value of concurrence at a kappa value of 0.935(p<0.001). CONCLUSION: The validity and confidence with respect to the definition of IBW and the determination method for obesity as proposed by the authors may be confirmed through the methods high level of consistency [kappa value=0.935(p<0.001)] with determination methods using the BMI.