Association between Skipping Breakfast and Overweight in Korean Adolescents: Analysis of the 13th Korea Youth Risk Behavior Web-based Survey / 계명의대학술지

In Korea, skipping breakfast is of concern as an unhealthy dietary habit. While the relationship between skipping breakfast and overweight and obesity has been established in children and adolescents in Europe, studies on this topic in Korean adolescents are scarce. Therefore, we investigated the relationship between body mass index (BMI) and skipping breakfast in Korean adolescents. Data from the 13th Korea Youth Risk Behavior Web-based Survey (2017) were analyzed. This anonymous, self-administered online questionnaire examined health behaviors including smoking, drinking, obesity, eating habits, sleep duration, and physical activity in Korean youth. Questions included those on general characteristics, such as economic status, parental education level, etc. This study included data from 56,933 adolescents aged 12–18 years. Skipping breakfast was defined as consuming breakfast fewer than five times per week. BMI, health behaviors, and general characteristics were compared between the breakfast-skipping and control groups. The skipping-breakfast and control groups comprised 25,836 (45.4%) and 31,097 (54.6%) subjects, respectively. BMI was significantly higher in the breakfast-skipping group than that in the control group (21.6 ± 3.24 kg/m2 vs. 21.4 ± 3.26 kg/m2, p < 0.001). Among the normal-weight and overweight groups, 44.9% and 47.3% skipped breakfast, respectively (p < 0.001). After adjusting for health behaviors and general characteristics, the risk of overweight was higher in those who skipped breakfast than that in the control group (odds ratio; 1.125, 95% confidence interval; 1.077–1.176).Skipping breakfast was related to overweight in Korean adolescents. Therefore, longitudinal research is needed to determine whether skipping breakfast is associated with overweight.

Waist-to-Height Ratio as an Index for Screening Lifestyle-Related Diseases in Overweight Adults / 계명의대학술지

Central obesity carries more metabolic risks compared with total obesity assessed by Body mass index (BMI). Also, there’s paradoxical relationship between BMI and all-cause mortality in overweight group (23 kg/㎡ ≤ BMI < 25 kg/㎡). The aim of this study is to assess relationship between waist-to-height ratio (WHtR) and lifestyle-related diseases such as metabolic syndrome, hypertension, and type 2 diabetes in overweight group, and to find the most predictable and useful obesity index for screening lifestyle-related diseases.A total of 3,994 overweight (23 kg/㎡ ≤ BMI < 25 kg/㎡) adults from the Korea National Health and Nutrition Examination Survey, 2013-2015 (KNHANES VI) were included. We assessed the relationship between WHtR and metabolic syndrome components using multiple regression analysis, and assessed the relationship between abdominal obesity (WHtR ≥ 0.5) and lifestyle-related diseases using complex samples logistic regression analysis. Also, to find the most useful index to predict lifestyle-related diseases, we calculated the areas under the Receiver operating characteristic (ROC) curves.WHtR was significantly related to metabolic syndrome components. Odds ratios of metabolic syndrome, hypertension and type 2 diabetes were 2.187, 1.445, 2.463 in abdominal obese group (WHtR ≥ 0.5), respectively. Area under the curve of WHtR was the most significantly highest among those of obesity indices.WHtR is a simple and useful obesity index to predict lifestyle-related diseases in overweight Korean adults. Further investigations for other obesity indices are needed to predict lifestyle-related diseases better.

Waist-to-Height Ratio as an Index for Screening Lifestyle-Related Diseases in Overweight Adults / 계명의대학술지

Central obesity carries more metabolic risks compared with total obesity assessed by Body mass index (BMI). Also, there’s paradoxical relationship between BMI and all-cause mortality in overweight group (23 kg/㎡ ≤ BMI < 25 kg/㎡). The aim of this study is to assess relationship between waist-to-height ratio (WHtR) and lifestyle-related diseases such as metabolic syndrome, hypertension, and type 2 diabetes in overweight group, and to find the most predictable and useful obesity index for screening lifestyle-related diseases.A total of 3,994 overweight (23 kg/㎡ ≤ BMI < 25 kg/㎡) adults from the Korea National Health and Nutrition Examination Survey, 2013-2015 (KNHANES VI) were included. We assessed the relationship between WHtR and metabolic syndrome components using multiple regression analysis, and assessed the relationship between abdominal obesity (WHtR ≥ 0.5) and lifestyle-related diseases using complex samples logistic regression analysis. Also, to find the most useful index to predict lifestyle-related diseases, we calculated the areas under the Receiver operating characteristic (ROC) curves.WHtR was significantly related to metabolic syndrome components. Odds ratios of metabolic syndrome, hypertension and type 2 diabetes were 2.187, 1.445, 2.463 in abdominal obese group (WHtR ≥ 0.5), respectively. Area under the curve of WHtR was the most significantly highest among those of obesity indices.WHtR is a simple and useful obesity index to predict lifestyle-related diseases in overweight Korean adults. Further investigations for other obesity indices are needed to predict lifestyle-related diseases better.

The Effect of Changes in Family Developmental Stage According to Child Independence on the Incidence of Depression in South Korean Middle-Aged Adults

Background@#The incidence of depression in middle-aged adults is increasing and has been affected by physiological changes and various sociodemographic factors. The present study aimed to examine the longitudinal relationship between depression and changes in the family developmental stage based on child independence in South Korean middle-aged adults living with children. @*Methods@#This study included 1,593 people in the age group of 45-64 years who participated in the first survey of the Korean longitudinal study of aging in 2006. Participants did not have depression, lived with unmarried children, and responded to Center for Epidemiologic Studies Depression 10 scale and child-related questions in the 7th survey (2018). The chi-squared test, t-test, and Mann-Whitney U test were used to compare differences in depression according to general characteristics and family developmental stage. The generalized estimating equation model was used to longitudinally examine the effect of changes in the family developmental stage on the incidence of depression from the 1st to the 7th survey. @*Results@#Changes in the family developmental stage based on child independence have a significant effect on the incidence of depression in middle-aged adults (P=0.000). In addition, in the generalized estimating equation model, the longitudinal association between changes in the family developmental stage and the incidence of depression was confirmed. @*Conclusions@#Therefore, confirming the independence of children as an important factor is essential in the management of depression in middle-aged adults.

The Effect of Housing Unaffordability on the Incidence of Depression in Korean Adults: Focusingon Korean Longitudinal Study of Aging

Background@#This study examined the effect of housing affordability on the incidence of depression in Korean adults aged 45 years and above usingthe Korean Longitudinal Study of Aging (KLoSA). @*Methods@#Five-year data from wave two to wave six of the KLoSA provided by the Ministry of Labor were used. In the first year of KLoSA in 2006, amongthose who did not suffer from depression, ones who had one or more of the survey data from the second to the sixth were analyzed. generalizedestimating equation (GEE) regression analysis and chi-square test were used as data processing methods. @*Results@#According to the 2010 data, out of 4,606 people, 3,558 (77.3%) were in the affordable group, and 1,048 (22.8%) in the experienced overburdengroup. The result of regression analysis with controlling general characteristics as covariates showed that the experienced overburden group had ahigher incidence of depression than the affordable group. A longitudinal analysis of housing affordability and incidence of depression for five yearsrevealed no significant difference in the incidence of depression. However, the overall share of overburden experience increased steadily. Acomparison of the incidence of depression between the affordable and experienced overburden groups in each year showed that the incidence ofdepression was statistically higher each year. @*Conclusion@#Housing affordability increases the incidence of depression, and eight years of data indicated depression in the experienced overburdengroup to be higher than the affordable group.

Clinical Characteristics of Mild Coronavirus Disease 2019 Inpatients / 계명의대학술지

About 30~50% COVID-19 hospital inpatients is reported to have mild clinical presentation, and the clinical course is known to be good even in the older population. In order to compare the clinical symptoms of mild patients with COVID-19 infection by age, the clinical symptoms and laboratory results were analyzed by dividing mild patients admitted to a dedicated hospital into three groups: under the age of 64, 65-84, and above 85 years of age.There was no difference in gender ratio by age among 555 mild cases. Concomitant diseases with significant differences by age were hypertension, diabetes, stroke, and coronary artery disease.Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age. Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age.The white blood cell count (WBC), neutrophil count, monocyte, blood sugar, procalcitonin, and creatinine were significantly higher in the 85 years old or older group, and the hemoglobin, albumin, and glomerular filtration rate (GFR) were significantly lower in the 85 years old or older group.

Clinical Characteristics of Mild Coronavirus Disease 2019 Inpatients / 계명의대학술지

About 30~50% COVID-19 hospital inpatients is reported to have mild clinical presentation, and the clinical course is known to be good even in the older population. In order to compare the clinical symptoms of mild patients with COVID-19 infection by age, the clinical symptoms and laboratory results were analyzed by dividing mild patients admitted to a dedicated hospital into three groups: under the age of 64, 65-84, and above 85 years of age.There was no difference in gender ratio by age among 555 mild cases. Concomitant diseases with significant differences by age were hypertension, diabetes, stroke, and coronary artery disease.Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age. Among the symptoms, cough and sore throat were different by age, and cough was significantly higher in the group under 64 years of age.The white blood cell count (WBC), neutrophil count, monocyte, blood sugar, procalcitonin, and creatinine were significantly higher in the 85 years old or older group, and the hemoglobin, albumin, and glomerular filtration rate (GFR) were significantly lower in the 85 years old or older group.

Association between Raising Grandchildren and Depression in Korean Adults

BACKGROUND: Several contradictory studies exist on the relationship between raising grandchildren and the grandparent's health. The present study identified the association between raising grandchildren and depression among Korean grandparents.METHODS: The wave 1 (2006) and wave 2 (2008) databases of the Korean longitudinal study on aging (KLoSA) were analyzed. T-test and chi-square test were used to compare the demographics and health condition variable between the two groups based on the presence or absence of raising grandchildren. Logistic regression analysis, including demographics and health conditions, was conducted to identify the relationship between depression and raising grandchildren. Depression was assessed using the Center for Epidemiologic Studies Depression scale (CES-D-10).RESULTS: In all, 4,784 participants (4,636: not raising grandchildren; 148: raising grandchildren) were examined. Significantly lower CES-D-10 scores (3.34 vs. 4.35, P<0.001), and therefore, lower depression (25% vs. 39.9%, P<0.001) was found among grandparents raising grandchildren than those who did not raise grandchildren. After adjusting the confounding variables through logistic regression analysis, the odds ratio of depression when raising grandchildren was 0.57 (95% confidence interval=0.37–0.89), which indicates significant relevance.CONCLUSION: The results show lower depressive symptoms among grandparents raising grandchildren. Even after adjusting the variables, the results presented a lower risk of depression among them.

The Association between the Body Mass Index and the Incidence of Depression in Korean Adults: Result from the Korean Longitudinal Study

BACKGROUND: Several conflicting studies exist on the relationship between body mass index (BMI) and depression. We investigated the effect of BMI on the development of depression in adults aged 45 years and older using the Korean Longitudinal Study of Aging Study (KLoSA).METHODS: The data from the wave 1 (2006), wave 2 (2008), wave 3 (2010), wave 4 (2012), and wave 5 (2014) database of the Korean Longitudinal Study on Aging (KLoSA) were analyzed. Depression was assessed using the Center for Epidemiologic Studies Depression Scale-10. To investigate the relationship between BMI and depression, ANOVA and chi-square test was used. Kaplan-Meier survival curves were generated, and Cox proportional hazard regression modeling was used to estimate the risk of depression according to obesity status, by controlling for age, sex, and health-related, lifestyle, and socioeconomic variables.RESULTS: This study included 6,811 individuals who were not found to have depression in the first survey. The incidence of depression was the highest in the underweight group (underweight, 74.3%; normal, 63.1%; overweight, 59.5%; obese, 63.0%; severe obese, 59.9%, P < 0.001). The risk of depression was significantly lower in the overweight and severe obese groups than in the underweight group after adjusting for age, sex, and demographic, social, and physical factors (overweight: hazard ratio [HR]=0.872, 95% confidence interval [CI]=0.775–0.981; severe obese: HR=0.791, 95% CI=0.648–0.966).CONCLUSION: The incidence of depression was the highest in the underweight group. The risk of depression was higher in the underweight group than in the overweight and severe obese groups.

Medical Students' Perception of Family Medicine and Career Choice

BACKGROUND: The role of family medicine specializing in primary care is important. This study examined medical students' perception of family medicine and their career choice, and provides policy and educational implications for family medicine.METHODS: The study used data collected from the 111 medical students from Keimyung University. The questionnaire comprised items pertaining to respondents' demographic information, career plan, and perceptions about family medicine.RESULTS: The most common mode of learning about family medicine was class or clinical practice (68.5%). Further, 73 students (65.8%) reported an intention to select family medicine as their major. These students were most likely to be employed (34 persons). Among the 111 students, 3 (2.8%) choose family medicine as their preferred major. Before receiving clinical practice experience, the most common reason for not choosing family medicine was “does not fit into the reality in Korea” (32.1%). After clinical practice, “lack of professionalism” (44.6%) was the most commonly cited reason.CONCLUSION: Medical students' perception about family medicine was strongly influenced by their experiences during class and clinical practice. Students also reported the need to improve professionalism in family medicine. Building public relations could help improve medical students' awareness about family medicine, and it is also necessary to improve social awareness of family medicine through the support of government such as th family doctor system.

The Relationship of Water Intake and Health Status in Korean Adult: 5th Korea National Health and Nutrition Examination Survey / 계명의대학술지

BACKGROUND: Water is essential to body homeostasis. But there are little attention to basic impact or attribute of response to drinking water. We investigated the factors related to drinking water through the ‘5th Korea National Health and Nutrition Examination Survey’ (KNHANESV). METHODS: From the database of the 5th KNHANESV conducted in 2010 to 2012, data of 15,716 adults who aged 19 or above, and responded to all the questionnaires of health interview, nutrition survey and had health examination were included in this analysis. SPSS 21.0 was used for statistical analysis with complex sample survey modules. RESULTS: The study subjects drink 5.2 ± 0.48 cups of water for a day. The elderly (>65 yrs) drink less water (p < 0.000), and male drink more than female (p < 0.000). And obesity is significantly associated with higher water intake (p < 0.000). Calorie and sodium intake, HbA1c, low-density lipoprotein, triglyceride, feritin, Fe, creatinine are significantly associated with higher water intake. Physical activity and serum vitamin D level are also associated with higher water intake (p < 0.000). CONCLUSION: Older people drink less water and several disease is related with water intake amount. Further studies need to be done about the value of water intake in healthy life style, and measuring the effect of water intake.

Beneficial Effect of Diet Intervention on School Children with Atopic Dermatitis

BACKGROUND: Atopic dermatitis (AD) is one of the most common skin disorders affecting infants and children. Food allergy is a strong risk factor for the development of AD. This study was designed to evaluate the improvement of symptoms among AD patients in the late childhood while they take the customized (organic, balanced, non-allergic, diverse vegetable, little saturated fat and trans fat free) diet. METHODS: Nineteen children with AD who agreed to the written consent were enrolled in the study from October to December, 2014. We supplied them with the customized diet for 8 weeks. Clinical evaluations, blood tests and nutritional status were conducted at baseline, at 4th and at 8th week. Eczema area and severity index (EASI) and Scoring atopic dermatitis (SCORAD) were used to determine the severity of AD. RESULTS: The mean age of 19 patients was 8.5±1.54 years. EASI and SCORD index were decreased after diet intervention (2.6±3.06 [standard deviation] vs. 2.0±2.93 P=0.026, 24.9±10.76 vs. 20.0±12.65 P=0.009). Pruritus scores using visual analogue scale, rated by patients and hemoglobin revealed statistically significant improvement after diet intervention. CONCLUSIONS: The customized diet helps to improve the symptoms of atopic dermatitis and the nutritional indicators. Additional long-term and large-scale studies are required as well as the development of various diets.

Thoracolumbar Junction Syndrome Causing Pain around Posterior Iliac Crest: A Case Report / 가정의학회지

Thoracolumbar junction syndrome is characterized by referred pain which may originate at the thoracolumbar junction, which extends from 12th thoracic vertebra to 2nd lumbar vertebra, due to functional abnormalities. Clinical manifestations include back pain, pseudo-visceral pain and pseudo-pain on the posterior iliac crest, as well as irritable bowel symptoms. During clinical examination, pain can be demonstrated by applying pressure on the facet joints or to the sides of the spinous processes. Radiological studies show only mild and insignificant degenerative changes in most cases. We report a 42-year-old female patient with osteogenesis imperfecta who suffered from chronic low back pain. Under the diagnosis of thoracolumbar junction syndrome, she was treated with an epidural block and a sympathetic nerve block, which improved her symptoms.

Relationship between Family Meals and Depressive Symptoms in Children / 가정의학회지

BACKGROUND: Recently, importance of family meals has been emphasized at home and abroad, and several journals reported that family meals had a big impact on children's development. In this paper, we would like to report the relationship between family meals and depressive symptoms in children. METHODS: This study was based on questionnaires distributed to 162 5th and 6th graders of one elementary school in the area of Daegu, Korea, in July, 2010. The questionnaire was about general characteristics, family characteristics, and quantity/quality of family meals. Family functions and depressive symptoms in children were evaluated with Smilkstein's family APGAR (adaptability, partnership, growth, affection, and resolve) score (FAS) and Kovac's Children's Depression Inventory (CDI). RESULTS: In one-way analyses of variance, there was no significant difference in FAS and CDI according to general and family characteristics (P > 0.05). CDI was significantly lower in the group having more frequent family meals (P 0.05). CONCLUSION: The frequency of family meals, having more conversation and better atmosphere during family meals predicted less depressive symptoms in children.

Perception and Performance of Preventive Behaviors for the Pandemic Influenza in Hospital Employees and Outpatients

PURPOSE: A new strain of the H1N1 subtype of influenza A virus resulted in a pandemic outbreak. In South Korea, cases of pandemic influenza have increased. Therefore, we explored perception or preventive behaviors for this virus in hospital employees and outpatients. MATERIALS AND METHODS: Data was collected from hospital employees and outpatients at three university hospitals located in Daegu, Gyeongju in South Korea between the 21st and 30th of September, 2009 using a self-administrated questionnaire. We estimated perception by components of The Health Belief Model (HBM), preventive behaviors consisted of avoidance behaviors, and the recommended behaviors by the Korea Center of Disease Control and Prevention (KCDC). Desire for vaccination was identified. RESULTS: The 1,837 participants comprised hospital employees (n = 880, 47.9%) and outpatients (n = 957, 52.1%). Of all hospital employees, 491 (55.8%) and 708 (80.5%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Among all outpatients, 490 (51.2%) and 651 (68.0%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Recommended preventative behaviors were adopted by 674 (76.6%) of hospital employees and 631 (65.9%) of outpatients. Vaccination was desired by 479 (54.4%) of hospital employees and 484 (50.6%) of outpatients. Factors influencing preventative behaviors included gender, economic status (for hospital employees) and educational level (for outpatients). All HBM components except perception of barriers were associated with the preventive behaviors in both groups. CONCLUSION: The majority of the surveyed hospital employees and outpatients perceived the benefits of preventive behaviors for pandemic influenza and performed them.

Perception and Performance of Preventive Behaviors for the Pandemic Influenza in Hospital Employees and Outpatients

PURPOSE: A new strain of the H1N1 subtype of influenza A virus resulted in a pandemic outbreak. In South Korea, cases of pandemic influenza have increased. Therefore, we explored perception or preventive behaviors for this virus in hospital employees and outpatients. MATERIALS AND METHODS: Data was collected from hospital employees and outpatients at three university hospitals located in Daegu, Gyeongju in South Korea between the 21st and 30th of September, 2009 using a self-administrated questionnaire. We estimated perception by components of The Health Belief Model (HBM), preventive behaviors consisted of avoidance behaviors, and the recommended behaviors by the Korea Center of Disease Control and Prevention (KCDC). Desire for vaccination was identified. RESULTS: The 1,837 participants comprised hospital employees (n = 880, 47.9%) and outpatients (n = 957, 52.1%). Of all hospital employees, 491 (55.8%) and 708 (80.5%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Among all outpatients, 490 (51.2%) and 651 (68.0%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Recommended preventative behaviors were adopted by 674 (76.6%) of hospital employees and 631 (65.9%) of outpatients. Vaccination was desired by 479 (54.4%) of hospital employees and 484 (50.6%) of outpatients. Factors influencing preventative behaviors included gender, economic status (for hospital employees) and educational level (for outpatients). All HBM components except perception of barriers were associated with the preventive behaviors in both groups. CONCLUSION: The majority of the surveyed hospital employees and outpatients perceived the benefits of preventive behaviors for pandemic influenza and performed them.

Iron Deficiency Anemia due to Long-time Bloodletting Using Cupping / 가정의학회지

We report three cases of iron deficiency anemia due to long-time bloodletting using cupping. Case 1 was a 52-year-old man who sought evaluation at the Health Promotion Center in our hospital due to fatigue and dyspnea on exertion (DOE). There were no abnormal findings on his general health examination, except anemia. He has performed self-bloodletting for a long time with cupping on his back and extremities for fatigue, myalgias, or polyarthralgias. Case 2 was a 52-year-old woman with fatigue and DOE. The physical examination revealed a systolic murmur at her left lower anterior chest and pale conjunctiva. The initial hematocrit was 22.4% and the hemoglobin was 6.4 g/dL. She has self-bloodletted using cupping 2 to 3 times a week when she felt tired or had myalgias. Case 3 was a 35-year-old man with sudden onset fatigue and DOE. He had severe DOE during a challenging physical test. He frequently received bloodletting using cuppings on his back and extremities by a doctor of Oriental medicine. There were no abnormal findings on the general health examination, except anemia. All three patients were diagnosed with iron deficiency anemia due to chronic blood loss. We recommended stopping bloodletting using cupping and prescribed oral iron supplements.

Comparison of Patient-Physician Interaction (PPI) Evaluation between Different Grade Medical Students / 한국의학교육

PURPOSE: A proper patient-physician interaction (PPI) creates rapport between doctors and patients and improves medical outcomes. The importance of PPI evaluation items was evaluated in each medical student in grades 3 and 4, before and after their clinical clerkship. METHODS: Six PPI evaluation guidelines (SEGUE, Kalamazoo Consensus, Calgary-Cambridge Guide, Macy guideline, 2 Korean Consortium guidelines) were selected and importance of each guideline was evaluated through the structured questionnaire in 73 pre-clinical clerkship (3rd-grade) and 78 post-clinical clerkship (4th-grade) medical students. RESULTS: The importance of medical communication items among total clinical performance, students-rated PPI portion was 21+/-9.7%. In SEGUE recommendations, 'Elicit information' was evaluated to be most important items before (58.3%) and after (65.8%) clinical clerkship. In Kalamazoo Consensus, 'Gathering information' was evaluated to be most important (49.3%/42.3%), same as in Calgary-Cambridge Guide (52.1%/56.4%) and Daegu Gyeongbuk Consortium (47.9%/43.6%). In the Macy guideline, 'Listening' was evaluated to be most important (28.8%/33.3%). In the Seoul Gyeonggi Consortium, 'Buidling relationships' was evaluated to be most important (23.3%/28.2%). CONCLUSION: In the 4th-grade post-clerkship medical students after clinical clerkship, importance of 'Gathering information' was evaluated to be less important, however, 'Giving information' and 'Understanding the patient perspective' was evaluated to be more important, compared to pre-clerkship students 3rd-grade students.

The Association Study of Kir6.2 E23K Polymorphism and Fat Distribution in Koreans / 체질인류학회지

Obesity is caused by interactions of energy consumption, amount of food intake, physical activity and etc, and these elements are influenced by genetic factors. Obesity related genes which have been known by now are over 200. One of these is Kir6.2 which forms the pore region of K(ATP) channel, and genetic variation of which may result in altered beta-cell electrical activity, insulin secretion, glucose homeostasis, and increased susceptibility to type 2 diabetes. Therefore, the purpose of this study was to examine the relationship between Kir6.2 E23K polymorphism and fat distribution or metabolic profiles in Korean. A total of 164 patients who visited Dongsan Medical Center Obesity Clinic from February 2004 to December 2005, were enrolled in this study. Screening for Kir6.2 polymorphism carried out by PCR-RFLP analyses. We divided this group into three groups E/E, E/K, K/K. Serum lipid and blood glucose were measured by autoanalyzer. Visceral fat amount and subcutaneous fat by abdominal CT, total fat mass by DEXA were measured. The subjects of E/E, E/K, K/K genotypes were 24, 79, and 61, respectively. The results of ANOVA analysis was that subjects with the K/K genotypes had more visceral fat amount (P<0.05) and higher total cholesterol levels (P<0.05) than E/E subjects group. Visceral fat amount and serum total cholesterol were significantly different according to Kir6.2 E23K polymorphism. Therefore, Kir6.2 polymorphism may act on fat distribution in Koreans.

Smoking as a Disease / 가정의학회지

Smoking is known as one of the major cause of disability and premature death. It should be framed as an individual-level disease requiring medical treatment. Smoking is addictive disease characterized by compulsive drug seeking, and smokers needs therapeutic interventions such as nicotine replacement therapy and nicotine agonist. In terms of addiction, nicotine facilitating neurotransmitter release results in the development of nicotine dependence, and corticotropin-releasing factor related nicotine withdrawal. Smoking will be regarded as disease, for smoking cessation is more effective intervention to prevent mortality than hypertension and dyslipidemia treatment. We will review some aspects of framing tobacco as a disease, and move on to the recent American and Japanese guideline which encourage the social reimbursement system of cessation practice.