The Association between Thyroid Function and Metabolic Syndrome in Euthyroid Korean Male Adults: Korean National Health and Nutrition Examination Survey VI

BACKGROUND: Thyroid hormones are one of the key factors involved in energy, lipid, and glucose metabolisms. Many studies have been conducted to establish the association between thyroid function and metabolic syndrome. This study aimed to identify the association between thyroid hormone and metabolic syndrome in euthyroid Korean male adults.METHODS: Using data from the sixth Korea National Health and Nutrition Examination Survey from 2013 to 2015, this cross-sectional study of 2,285 male adults was conducted. Subjects who had thyroid diseases and were not euthyroid were excluded. The included subjects were divided into four groups according to free thyroxine (fT4) and thyroid-stimulating hormone levels. We analyzed the prevalence and adjusted odds ratio of metabolic syndrome according to thyroid hormone levels.RESULTS: The prevalence of metabolic syndrome and its components decreased constantly from the lowest fT4 quartile to the highest fT4 quartile. Compared with that in the lowest fT4 quartile, the adjusted odds ratio of hypertriglyceridemia in the highest fT4 quartile was 0.651.CONCLUSION: In euthyroid subjects, fT4 levels are associated with metabolic syndrome and all its components.

Factors Associated with Influenza Vaccination Location in Korean Adult Population

BACKGROUND: Increasing the influenza vaccination rate is important because influenza infection can cause serious illness or death. One way to increase vaccination rates is to expand the number of vaccination sites. This study examined the location of influenza vaccination in 2016 according to sex, age, socioeconomic status, and health behavior variables.METHODS: The study included 2,485 subjects from the Korean National Health and Nutrition Examination Survey aged 19 years or older who had received the vaccine. Variables that could affect health behaviors were examined by the chi-square test or t-test. The odds ratios (ORs) of public health center inoculations between different income and education groups, adjusted for age and sex, were analyzed using multivariate logistic regression.RESULTS: People aged 65 years or older, those living in rural areas, those with low incomes, those with up to elementary school education, and those with underlying diseases had the lowest vaccination rates at medical clinics and hospitals (P-value<0.05). The ORs for public health center inoculations were significantly higher in those with lower incomes and those with elementary school education than in those with higher incomes and those with more than university level education (OR 2.50, 95% confidence interval [CI]; 1.67–3.77 and OR 2.60, 95% CI; 1.72–3.95, respectively).CONCLUSION: To improve the influenza vaccination rates at medical clinics and hospitals among groups with low vaccination rates, we need to actively encourage high-risk patients to receive vaccinations.

Could the Doctors Have Their Own Language? : Doctoring through Doctor's Essay, Narrative Medicine / 의학교육논단

No abstract available.

Fast Eating Speed Increases the Risk of Endoscopic Erosive Gastritis in Korean Adults / 가정의학회지

BACKGROUND: Fast eating or overeating can induce gastrointestinal diseases such as gastritis. However, the association between gastritis and speed of eating is unclear. The aim of this study was to determine whether eating speed is associated with increased risk of endoscopic erosive gastritis (EEG). METHODS: We carried out a cross-sectional study involving 10,893 adults who underwent a general health checkup between 2007 and 2009. Two groups, EEG patients and EEG-free patients, were compared by using the t-test and the chi-square test. Multiple logistic regression analyses were performed to investigate the association between eating speed and EEG. RESULTS: The group with EEG had a higher proportion of males, average age, body mass index, and percentages of current smokers and risky drinkers than those without EEG. After adjusting for anthropometric, social, and endoscopic parameters, the group with the highest eating speed ( or =15 min/meal) (odds ratio, 1.71; 95% confidence interval, 1.20-2.45). CONCLUSION: High eating speed is an independent risk factor for EEG. Our results indicate the need for further studies to clarify the role of eating speed in gastritis.

The Relationship between Opioids Use, Cortisol and DHEAS / 한국호스피스완화의료학회지

PURPOSE: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. METHODS: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. RESULTS: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). CONCLUSION: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.

Opioids Use and Adrenal Insufficiency / 한국호스피스완화의료학회지

The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.