Dietary Intake and Nutritional Status in Young and Middle-Aged Adults according to the Meal Frequency from the Korea National Health and Nutritional Survey / 가정의학회지

Background@#Previous studies have shown a close relationship between skipping breakfast and nutritional deficiency. However, the impact of regular eating, including lunch and dinner, has not been studied well. We explored the correlation between regularity and frequency of daily meals and nutritional status. @*Methods@#We analyzed Korea National Health and Nutrition Examination Surveys between 2016 and 2018. A total of 7,725 adults aged 19–49 years were classified into four groups according to the regularity of meal intake: three-meal regular diet (3MRD), two-meal regular diet, one-meal regular diet, and irregular diet (IRD). Food and nutrient intake was assessed using the 24-hour recall method and estimated by a generalized linear model in complex sample weight variables. @*Results@#In IRD, there were relatively more females who were not married, lived alone, or reported low levels of education. As subjects ate more meals, more people felt thinner and healthier by themselves. Dietary intake of cereal, vegetables, seaweed, and fiber was directly proportional to the number of regular meals as well as essential components such as water, carbohydrates, protein, fat, and micronutrients. Contrarily, alcohol and beverage consumption was inversely proportional to the number of regular meals. Intake level of legumes, fish, fruits, seasonings, milk, oils, sugars, and cholesterol was consistent regardless of meal frequency. @*Conclusion@#Our findings suggest that 3MRD showed nutrient adequacy and a healthier profile on body weight, body mass index, waist circumference, blood pressure, serum fasting glucose, total cholesterol, and triglyceride.

Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study / 가정의학회지

BACKGROUND: Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data. METHODS: This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiatric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted. RESULTS: The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P < 0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P < 0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P < 0.001), Clinical Dementia Rating Sum of Box (P < 0.001), Global Deterioration Scale score (P < 0.001), abnormality of free T4 level (P < 0.001), anemia (P < 0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers. CONCLUSION: Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.

Association between Multimorbidity and Suicidal Ideation in Korean Elderly

BACKGROUND: Recent studies have reported that multimorbidity is associated with suicidality. The objective of this study was to evaluate the association between physical multimorbidity and suicidal ideation (SI) among the elderly.METHODS: A total of 6,712 subjects aged over 65 years without depression were analyzed from the Korea National Health and Nutrition Examination Survey databases (2010–2013, 2015). In our study, multimorbidity was defined as being diagnosed with two or more chronic diseases. The association between multimorbidity and SI was evaluated through multiple logistic regression analysis.RESULTS: Through our analysis, 40.7% of participants had multimorbidity and the 14.6% had SI. Multimorbidity was associated with suicidal ideation when adjusting for sociodemographic and health behavior covariates (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.14–1.55). However, no association between multimorbidity and SI existed after adjusting for additional health status factors. In subgroup analyses performed according to education level and health status, the risk of SI was high in subjects with multimorbidity only in those with below elementary school education level (OR, 1.36; 95% CI, 1.14–1.63). Further subgroup analysis indicated that the group without stress and the group without depressiveness both showed association of multimorbidity with SI (OR, 1.27; 95% CI, 1.02–1.59; OR, 1.28; 95% CI, 1.05–1.56).CONCLUSION: The study findings suggest that elderly with multimorbidity must be identified, evaluated, and managed for SI with special attention to those with education levels below elementary school. Physicians should also focus on assessing mental health status in the case of multimorbidity in the elderly without depression.

Single Mothers and Mental Health in South Korea: The Seventh Korea National Health and Nutrition Examination Survery, 2016

BACKGROUND: Recent studies indicate that single mothers are at a greater risk for mental illness as compared to married mothers. However, the relationship between single motherhood and mental health in South Korea has not been adequately studied. This study was aimed at comparing major depressive disorder (MDD) and other mental health problems in single and married mothers in South Korea.METHODS: We analyzed data from the 2016 Korea National Health and Nutrition Examination Survey. In this cross-sectional study, the data of 1,770 subjects were analyzed. MDD was assessed using the Patient Health Questionnaire. We used chi-square tests to evaluate subjects' general attributes and mental health (MDD, perceived stress, suicidal ideation, and counseling for psychological problems). Multiple logistic regression analyses were conducted to examine the relationship between single motherhood and MDD.RESULTS: The results demonstrated that single mothers were at an increased risk for MDD as compared to married mothers; single mothers had greater odds of MDD (odds ratio, 1.68; 95% confidence interval, 1.06–2.67) after adjusting for all covariates.CONCLUSION: According to the results, single South Korean mothers are at a higher risk for MDD than those who are married. With this study having identified single mothers as a vulnerable group, targeted interventions to improve their mental health must be developed.

Relationship between Secondhand Smoking with Depressive Symptom and Suicidal Ideation in Korean Non-Smoker Adults: The Korean National Health and Nutrition Examination Survey 2010-2012 / 가정의학회지

BACKGROUND: Research suggests that mental health is affected not only by smoking, but also by secondhand smoking. But the most researches have been conducted in North America and/or Europe. We examined whether this relationship remains evident within the South Korean population. Specifically, we investigated the effect of secondhand smoking on depressive symptoms and suicidal ideation. METHODS: We analyzed data from 6,043 non-smoking adults who participated in the 2010-2012 Korea National Health and Nutrition Examination Survey. We compared the presence of depressive symptoms and suicidal ideation in 3,006 participants who were exposed to secondhand smoking in the office or at home with 3,037 non-exposed participants. RESULTS: In unadjusted logistic regression analysis, secondhand smoking exposure group had more suicidal ideations than no secondhand smoking exposure (16.1% vs. 12.2%; odds ratio [OR], 1.50; 95% confidence interval [CI], 1.241-1.804), but risk of depressive symptoms was not significantly different between two groups (15.2% vs. 12.2%; OR, 1.21; 95% CI, 0.997-1.460). In multivariate logistic regression analysis, Among those exposed to secondhand smoking, the OR for depressive symptoms was 1.02 (95% CI, 0.866-1.299) and 1.43 (95% CI, 1.139-1.802) for suicidal ideation. Overall, secondhand smoking at home was significantly related to depressive symptoms and suicidal ideation. Among females, secondhand smoking exposure at home only (not in the office) was related to depressive symptoms and suicidal ideation. CONCLUSION: Exposure to secondhand smoking, especially at home, may be associated with an increase in especially in female depressive symptoms and suicidal ideation among adults in South Korea.

Occupational Stress and Physical Symptoms among Family Medicine Residents / 가정의학회지

BACKGROUND: The purpose of this study was to examine the levels of occupational stress and physical symptoms among family medicine residents and investigate the effect of subscales of occupational stress on physical symptoms. METHODS: A self-administered questionnaire survey of 1,152 family medicine residents was carried out via e-mail from April 2010 to July 2010. The response rate was 13.1% and the R (ver. 2.9.1) was used for the analysis of completed data obtained from 150 subjects. The questionnaire included demographic factors, resident training related factors, 24-items of the Korean Occupational Stress Scales and Korean Versions of the Wahler Physical Symptom Inventory. RESULTS: The total score of occupational stress of family medicine residents was relatively low compared to that of average workers. The scores of 'high job demand', 'inadequate social support', 'organizational injustice', and 'discomfort in occupational climate' were within the top 50%. Parameters associated with higher occupational stress included level of training, on-duty time, daily patient load, critical patient assigned, total working days, night duty day, sleep duration, and sleep quality. The six subscales of occupational stress, except for 'Job insecurity', had a significant positive correlation with physical symptom scores after adjustment had been made for potential confounders (total score, r = 0.325 and P < 0.001; high job demand, r = 0.439 and P < 0.001). CONCLUSION: After the adjustment had been made for potential confounders, the total score of occupational stress and six subscales in family medicine residents showed a significant positive correlation with physical symptom scores.

Relationship between Serum Uric Acid Level and Hypertension: A Retrospective Cohort Study / 가정의학회지

BACKGROUND: Many epidemiological studies suggest the pathogenic role of serum uric acid level in development of hypertension. Several cross-sectional studies have shown the relationship between uric acid and development of hypertension in Korea. We investigated whether uric acid associates with the development of hypertension in a retrospective cohort study. METHODS: We included 2,353 people who did not have hypertension initially and underwent general medical examination between 1997 and 1998 and were re-examined after 10 years later. Study people divided into three groups according to serum uric acid level tertiles. RESULTS: The incidences of hypertension in tertile groups were 14.1% (108/764), 22.0% (175/769), and 24.3% (193/793) and they showed statistically significant difference. We performed multivariable logistic regression with serum uric acid and other risk factors of hypertension. The incidence of hypertension in second and third tertile group were significantly higher than first tertile group (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.11 to 2.10; P = 0.009 in second tertile group and OR, 1.66; 95% CI, 1.17 to 2.37; P = 0.005 in third tertile group). CONCLUSION: Serum uric acid level is associated with the development of hypertension.

Association between Smoking Status and Insulin Resistance in Apparently Healthy Korean Men / 가정의학회지

BACKGROUND: Several studies have suggested that smoking may cause insulin resistance. However, the association between smoking and insulin resistance is still controversial. The purpose of this study was to investigate the association between smoking status and insulin resistance in Korean nondiabetic male population. METHODS: A total of 5,969 men, aged > 20 years were recruited from those who visited the Health Promotion Center, Samsung Medical Center between 2005 and 2006. All subjects were divided into three categories: on-smokers (n = 2,594), ex-smokers (n = 1,580), and current-smokers (n = 1,795). Fasting values for glucose and insulin were used to estimate insulin resistance by HOMA (homeostasis model assessment). An independent association between smoking status and HOMA-IR (homeostasis model assessment of insulin resistance) was assessed after adjustment for factors influencing insulin sensitivity such as age, exercise, alcohol, body mass index, abdominal circumference, and blood pressure. RESULTS: HOMA-IR was signifi cantly higher in ex-smokers and current-smokers than in non-smokers (2.09 +/- 0.94 vs. 2.04 +/- 0.90, 1.96 +/- 0.86, P or = 40 pack-years smokers than in non-smokers CONCLUSION: Based on HOMA-IR, previous-smoking and chronic smoking were significantly associated with insulin resistance in apparently healthy Korean nondiabetic men.

Association between Smoking Status, C-reactive Protein and the Metabolic Syndrome in Long-term Smokers among Middle-aged Korean Men

BACKGROUND: There are few studies about association between the metabolic syndrome and smoking status (onset of smoking, duration, number of cigarettes per day, pack-years) in long-term smokers. And CRP level, a risk factor of the metabolic syndrome, is known to be higher in smokers than in non-smokers. This study was done to assess the association of smoking status and CRP level with the metabolic syndrome in long-term smokers. METHODS: Healthy men aged 40 years old or more who visited the Samsung Medical Health Promotion Center were selected. We examined the participants' clinical characteristics by using self-reporting questionnaires, laboratory data, and Bruce treadmill test. We estimated the prevalence of the metabolic syndrome and identified the association between smoking status, CRP, and the metabolic syndrome by multiple logistic regression method. RESULTS: The prevalence of the metabolic syndrome was higher in the long-term smokers (21.4%) than in the non-smokers (17.5%). The odds ratios of developing the metabolic syndrome were 2.46 (95% CI 1.31~4.62) and 2.57 (95% CI 1.20~5.50) in men who smoked 20~29 and 30 or more cigarettes, respectively, compared with those who smoked 1~9 cigarettes. And the odd ratio was 1.41 (95% CI 1.01~1.97) in men who had high CRP level (> or =0.3 mg/dl) compared with the normal CRP group. The number of cigarettes had statistically positive association with the CRP level (coefficient beta=0.059; P<0.05). CONCLUSION: The prevalence of the metabolic syndrome was higher in the long-term smokers than in the non-smokers, and proportional to the number of cigarettes in the long-term smokers. The number of cigarettes smoked per day was correlated positively to the CRP level in the middle-aged Korean men.

Association of Premenstrual Syndrome with Quality of Life in Young Korean Women

BACKGROUND: Menstruation is often regarded as a privilege for women allowing reproductive activity. However, abrupt hormonal fluctuations in menstrual cycle may cause distressing physical and psychological symptoms such as premenstrual syndrome (PMS). PMS is known to have a great impact on daily life activities and social functions, and might result in significantly decreased quality of life (QOL). In this study, we aimed to evaluate a relation between PMS and QOL in young adult Korean women. METHODS: Self-administered questionnaires were distributed to a total of 514 women who were aged 16~35 years and who were employed in an industrial complex located in Gyeonggi-do, Korea. PMS was assessed using diagnostic criteria recommended by the American Psychiatric Association. QOL was assessed using Korean health related Quality of Life Scale. The association between PMS and QOL was examined in 440 women using the two-sample t-test after excluding 74 women who were missing for variables essential for the assessment of PMS and QOL. RESULTS: The prevalence of PMS was 7.3% (32 out of 440 women). Women with PMS had the worse QOL score in almost all domains of QOL except for spiritual health (physical function, psychological health, social function, pain, vitality, role limitation, health status perception, and health status change). CONCLUSION: There was a significant relation between PMS and QOL. The finding of significantly lower QOL in women with PMS suggests that PMS should be evaluated and treated actively in primary care.

Caffeine Consumption and Its Related Symptoms in University Students

BACKGROUND: Although caffeine is commonly consumed substance and not seriously harmful as compared to alcohol and nicotine, Korea is planning to mark on the products which contain caffeine above a definite level with "containing large amounts caffeine". At this point in time, the study concerning caffeine related symptoms is in need. METHODS: After surveying university students by using self-administered questionnaires based on DSM-IV substance related disorder, healthy 810 subjects were assessed for socio-demographic characteristics and features of caffeine intake and its dependence, withdrawal, and intoxication. RESULTS: The mean amount of caffeine consumption in 810 subjects was 120.49 mg (median=93.0) per day. The major features of caffeine dependence were as follows: tolerance (61.1%), withdrawal (46.3%), using more or longer than intended (46.0%), and unsuccessful attempt to cut down or control use (12.6%). The prevalence was increased by daily caffeine consumption. Among 711 subjects who had experienced no caffeine consumption over 24 hours {amount of daily caffeine consumption was 116.0 mg (median=86.5)}, 6.19% showed significant distress in usual activity, and 22.1% used caffeine contents to avoid withdrawal symptoms. The prevalence of caffeine withdrawal based on DSM-IV research criteria was 2.67% and the frequency for symptoms were as follows: fatigue (37.7%), drowsiness (17.6%), headache (14.5%), an anxiety (8.3%). In addition, the prevalence of caffeine intoxication was 2.1% and the frequency for symptoms were as follows: insomnia (41.9%), diuresis (35.8%), tachycardia (26.7%), and gastrointestinal disturbance (23.3%). CONCLUSION: The unwanted symptoms related to caffeine withdrawal or intoxication were common in students using caffeine. Therefore, major features of caffeine-related symptoms should be considered in primary care practice.

PAP Smear-screening in Primary Care Women Physicians and Its Influence on Patients

BACKGROUND: PAP smear has been highly appraised for screening cervical cancer. Generally regarded is that women physicians regularly screen for PAP would promote patients' early detection and treatment rate by their strong recommendation. Hereby we investigated PAP-screening in primary care women physicians, recommending proportion and associated factors. METHODS: Questionnaires were sent to 981 members of the Korean Academy of Family Medicine, Korean Association of Family Practitioners, Korean Medical Women's Association, and Songpa-gu and Kangdong-gu family practitioners. a total of 193 respondents was analyzed. RESULTS: Among the total 55.4% of the respondents screened for PAP smear regularly, either annually (23.9%), or from their treating gynecologists (61.6%) or through routine check-up (81.1%). Common reasons for not screening were lack of time (40.7%) and forgetfulness (38.4%). Recommending proportion for PAP to patients was 49.2%. Reasons for not recommending were lack of equipment, forgetfulness (18.8% each). Confidence of PAP as a screening test was very high (71.5%); significantly related to PAP-screening and to recommending proportion (P=0.033, P=0.005, respectively). Many of the respondents thought physician's own PAP-screening affected its recommendation (45.3%), whereas significant relation to their actual PAP-screening was not found (P=0.845). PAP-screening in physicians showed no significant relationship with recommending proportion (P=0.053). Internal disease history had meaningful relation only with recommending proportion (P=0.001). CONCLUSION: Though physicians show strong confidence in PAP and undergo more than the general public, most do not screen for it regularly and the recommending proportion was low. To improve physician's PAP-screening and recommending proportion, re-education of physicians and provision of proper clinical equipment are required.

Family Physician's Knowledge of and Attitude towards Spouse Abuse in Korea

BACKGROUND: The primary physician may be the first or the only professional who may come in contact with victims of spouse abuse. But little is known about family physician's knowledge of and attitude towards spouse abuse in Korea. Therefore, this study was conducted. METHODS: We selected 191 doctors from the participants of the 2003 annual meeting of the Korean Academy of Family Medicine (KAFM). We distributed a 5 paged questionnaire them to fillout and analyzed 125 cases among them. The questionnaire included social demographic characteristics, individual knowledge of and attitudes toword spouse abuse, individual practice experience, education and training experience, and others. RESULTS: We found a significant relationship between doctor's knowledge of spouse abuse and intervention after coming in contact with the victim. Also, this study showed that 31.8% of doctors intervened and traced the spouse abuse cases actively after physical treatment of victims, but none of the cases were reported to the police. Among the total 64.7% of the doctors explained that they did not want to intervene because they were afraid of getting involved in a legal situation. Some of the doctors who had prior educational experience concerning spouse abuse showed very significant high rate of actual intervention (P=0.0112). CONCLUSION: The more educational experience on spouse violence the doctors had, the more active intervention they showed. Therefore, we need to intensify the practical educational program along with the training medical program targeting medical practitioners. Of course we need to reguest sacrifice from doctors based on moral principles, but we also need systemic aid and reform to legal system to minimize burden to doctors.

Angiotensin-converting Enzyme Deletion Polymorphism is Associated with Essential Hypertension in Men with Higher Salt Intake

Background: Hypertension is etiologically associated with lifestyles and genetic factors. A number of investigations in various populations have shown discordant evidence on the association of the insertion-deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE) gene with hypertension. However, there is no population study on hypertension, ACE gene and salt. This study explored whether the ACE I/D polymorphism is associated with essential hypertension in relation to dietary salt intake. Methods: A cross-sectional study was conducted on a total of 4,588 healthy male subjects aged 20 to 79 years. ACE genotypes were determined using polymerase chain reaction. Semi-quantitative questionnaire using weekly recall method was used to assess dietary salt intake. With regard to level of salt intake, subjects were divided into tertile groups. Results: The overall OR of ACE DD genotype for hypertension showed 29% increased risk (OR=1.29, 95% CI, 1.08 - 1.56) (p=0.003), with adjustment for age, body mass index, and impaired fasting glucose. According to salt intake, only a group consuming higher salt (more than 17 gram/day) showed that DD genotype was at increased risk for hypertension, having 48% increased risk in DD genotype than ID/II genotype (OR 1.48, 95% CI 1.06-2.05). Conclusions: Among Korean men studied, ACE DD genotype was at increased risk of hypertension in men consuming higher dietary salt. Finding suggests that ACE polymorphism may be one of the factors involved in the predisposition of hypertension, in men consuming high salt.

Angiotensin-converting Enzyme Gene Polymorphism and Risk of Glucose Intolerance in Korean Men

Background: Prenatal exposure to Dutch famine was associated with glucose intolerance in adults. There is a line of evidence implicating the involvement of renin-angiotensin system in fetal development, but it is not known whether a genetic variant of reninangiotensin system may modify the long-term outcome in offspring born to mothers exposed to famine. Method: To examine whether an Insertion/Deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene is associated with glucose intolerance in subjects born during the famine in the Pacific War, 8,657 healthy men were studied. ACE genotypes were determined using polymerase chain reaction. Subjects with fasting glucose more than 6.1 mmol/l or those diagnosed as diabetes mellitus or current user of oral hypoglycemic agents or insulin were considered as glucose intolerance. Result: Among overall subjects, logistic regression analysis did not show a significant risk of ACE DD genotype for glucose intolerance (men OR 1.03; 95% CI, 0.88-1.21), but showed 42% increased risk in men (adjusted OR: 1.42; 95% CI, 1.04-1.93, p=0.019), born during the war period, between 1941 and 1944. Conclusion: A genetic variant of renin-angiotensin system may modify the glucose intolerance as the long-term outcome in offspring born during the war-induced famine. Finding provides an evidence for the interaction of fetal ACE genotype and intrauterine environmental factor in predisposition to type 2 diabetes mellitus.

Relation of Regular Exercise Habit to Bone Mineral Density in Korean Climacteric Women

BACKGROUND: Even if the effect of regular exercise on the prevention against osteoporosis has been confirmed by many researchers, the research which evaluates the effect of regular exercises by adjusting the differences between climacteric women with respect to the status of menopause, and other health behaviors, has been few. The main purpose of this study was to evaluate the risk of osteoporosis and its relation to regular exercise. METHODS: We studied 222 climacteric women aged 40~59 years who visited the health care centers run by Chunchon branch of Korean Association of Health for preventive health examination at 2002/3~2002/11. The study subjects were asked to self-administer to the questionnaire including the items for the evaluation of the status of regular exercise and other characteristics of health behaviors and nutritional intakes. Bone mineral density was measured in L1-4 using dual-energy X ray absorption device. RESULTS: Among the total 222 subjects, 52 women (23%) have been exercising regularly, among whom 22 subjects (42%) were in the phase of menopause. Exercise group had higher levels of intake of protein, calcium, iron, vitamin B1, niacin, and vitamin C than non-exercise group. In multiple logistic regression analysis, aged 50 years (OR: 5.87, 95% CI: 2.26~15.23), menopause (OR: 2.65, 95%CI: 1.03~6.82), body mass index over 25 (OR: 0.24, 95%CI: 0.10~0.59) were significant. There was no significant difference for the bone mineral density between exercise and non-exercise groups. T score seemed to be slightly higher in the regular exercise group (-1.88 vs -1.79) compared with non-exercise group, but the difference was not significant (p>0.05). CONCLUSION: Age, menopause, low body mass index are risk factor of osteoporosis. Postmenopausal women who do not exercise showed a tendency of decreased bone mass density and increased frequency of osteoporosis. Further study is needed to prove the relation of regular exercise to bone mass density in Korean climacteric women.

Association of Hyperhomocysteinemia and MTHFR Genotype in Parkinson's Disease

BACKGROUND: Methylenetetrahydrofolate reductase (MTHFR) deficiency is rare in severe cases but common in mild cases. TT genotype of C677T of MTHFR shows reduced enzyme activity and hyperhomocysteinemia. It has been shown that homocysteine is very toxic to dopaminergic neuronal cell in vitro and animal experiment, which suggests some role of homocysteine in the pathogenesis of Parkinson's disease (PD). This study examined the association of MTHFR genotype, hyperhomocysteinemia, and Parkinson's disease. METHODS: Serum homocysteine concentration and the C677T genotypes of MTHFR were assessed in 80 patients with Parkinson's disease, and 80 healthy subjects matched for age and gender, in a hospital-based setting. RESULTS: Proportion of moderate hyperhomocysteinemia (plasma homocyst(e)ine > or =15 micromol/L) was higher in patients with Parkinson's disease than in normal controls (53.7% vs 30.0%, p=0.01). TT genotype of MTHFR was highly frequent in Parkinson's disease patients compared to controls (18.7% vs 11.3%, p=0.01). The combination of hyperhomocysteinemia and TT genotype of MTHFR augmented risk for Parkinson's disease (odds ratio 2.53 [95% confidence interval, 1.48-4.31, p=0.01]). CONCLUSIONS: Hyperhomocysteinemia is a common finding in the patients with Parkinson's disease. TT genotype of MTHFR is at increased risk for Parkinson's disease, and in conjunction with hyperhomocyeteinemia, augments the association.

The Effects of Depressive Symptoms to Metabolic and Glycemic Control among Type 2 Diabetes Patients

BACKGROUND: Depression is common among type 2 diabetic patients. To determine the relationship between depressive symptoms and metabolic control, we evaluated the risk factors that are related to metabolic control in diabetic patients. METHODS: This study was performed among 356 type 2 diabetic outpatients, who visited the Department of Family Medicine and Endocrinology, Samsung Medical Center, from November 2003 to January 2004. The data were collected through questionnaire about sociodemographic features diabetes-related factors and health behaviors. Beck Depression Inventory (BDI) was administered to measure depressive symptoms. The medical records were reviewed to confirm metabolic controls including HbA1c, lipids, blood pressure, body mass index (BMI), past medical history, and prescriptions. RESULTS: The prevalence of depressive symptoms (BDI> or =11) was 35.4%, including severe symptoms (BDI> or =21) 6.8%. There were significant graded relationships between greater depressive symptoms and higher serum level of HbA1c (P=0.000) and LDL-cholesterol (P=0.046). In binary logistic regression analysis, low level of exercise (OR=1.97; 95% CI=1.18~3.28), lack of exercise (OR= 2.94; 95% CI=1.28~6.77), poor LDL-cholesterol control (OR=1.94; 95% CI=1.19~3.18), and depressed group (OR=2.20; 95% CI=1.35~3.60) were significantly associated with poor glycemic control. CONCLUSION: There is a significant association between depressive symptoms and glycemic control of type 2 diabetes. Therefore, family physicians who provide continuous and comprehensive primary care should be more concerned for depressive symptoms in type 2 diabetes patients.

Diabetes mellius and serum ferrtin concentration

BACKGROUND: A prospective study about the association between serum ferritin concentration and diabetes mellitus showed that higher risk of diabetes was found in men in higher concentration of serum ferritin. The aims of this study is to examine the association between serum ferritin concentration and the risk of diabetes mellitus in healthy Korean in hospital-based samples. METHODS: In a volunterred healthy population(n=14,782), who underwent health examination in Samsung Medical Center, from January to December 1997, serum ferritin and glucose were determined. RESULTS: After adjusting for age, BMI, serum triglyceride concentration, and multiple logistic regression analysis showed that those in the highest quartile had increased risk of diabetes mellitus (OR: men 2.26(95% CI 2.41-2.95, p=0.0001), women 3.03(95% CI 2.51-3.67, p=0.0001), compared with those in the lowest quartile. CONCLUSION: In studied population, elevated serum ferrtin concentration was associated with an increaed risk of diabetes.

A Thermolabile Methylenetetrahydrofolate Reductaes (MTHFR) Gene Polymorphism is a Determinant of Hyperhomocysteinemia in the Elderly

No abstract available.