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Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.
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Objective@#To evaluate the perspective of healthcare professionals towards the 2019 European Alliance of Associations for Rheumatology (EULAR) vaccination guideline in patients with autoimmune inflammatory rheumatic diseases (AIIRD). @*Methods@#Healthcare professionals who care for patients with AIIRD were invited to participate in an online survey regarding their perspective on the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD. Level of agreement and implementation of the 6 overarching principles and 9 recommendations were rated on a 5-point Likert scale (1~5). @*Results@#Survey responses of 371 healthcare professionals from Asia (42.2%) and North America (41.6%), Europe (13.8%), and other countries were analyzed. Only 16.3% of participants rated their familiarity with the 2019 EULAR guideline as 5/5 (“very well”). There was a high agreement (≥4/5 rating) with the overarching principles, except for the principles applying to liveattenuated vaccines. There was a high level of agreement with the recommendations regarding influenza and pneumococcal vaccinations; implementation of these recommendations was also high. Participants also reported a high level of agreement with the remaining recommendations but did not routinely implement these recommendations. @*Conclusion@#The 2019 update of EULAR recommendations for the vaccination of adult patients with AIIRD is generally thought to be important by healthcare professionals, although implementation of adequate vaccination is often lacking. Better education of healthcare providers may be important to optimize the vaccination coverage for patients with AIIRD.
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Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.
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Background@#The aim of this study is to assess the relationships between familial types and dietary quality measured by the Korean Healthy Eating Index (KHEI) in representative Korean elderly. @*Methods@#We used cross-sectional data from 4,260 Korean elderly, aged over 65 years, who had participated in the 2016-2018 Korea National Health and Nutrition Examination Survey. The 14-item KHEI scores were calculated from the Food Frequency Questionnaire and the Dietary Habit Survey from the Nutrition Survey.Familial type was categorized into three groups of Live alone (LA), Live with a partner with or without other(s) (LP), and Live with other(s) without a partner (LO) based on the Household Interview Survey. @*Results@#LP had better dietary quality than LO for both sexes (both P<0.05). LA (64.5; standard error [SE], 1.0) had worse dietary quality than LP (66.7; SE, 0.6]) in elderly male (P<0.05) while they were not significantly different in elderly female. The percentages of subjects having poor dietary quality (total KHEI score of ≤50) in LA, LP, and LO were 20.6% (SE, 2.7), 7.3% (SE, 0.8), 8.9% (SE, 3.6) in elderly male, and 9.6% (SE, 1.2), 5.7% (SE, 0.8), 12.9% (SE, 1.8) in elderly female, respectively. The multivariate-adjusted odds ratios of having poor dietary quality compared with LP was 2.45 (95% confidence interval [CI], 1.66-3.60) for LA male, and 1.98 (95% CI, 1.19-3.28) for LO female. @*Conclusions@#Familial type affects dietary quality in Korean elderly. However, differential associations were shown between elderly male and female.
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Background@#This study aimed to evaluate the adequacy of protein intake through meals and present the major protein sources of Korean adults. @*Methods@#Cross-sectional data of 15,639 adults aged 19 years or older from the 2016-2018 Korea National Health and Nutrition Examination Survey were obtained. The total, animal, plant protein intakes were assessed using 1-day 24-hour recall. The distinction between breakfast, lunch, and dinner was based on the subjective answers of the participants. @*Results@#The adequacy of protein intake based on the Recommended Nutrient Intake was 67.4±1.2% and 62.9±1.1% in young men and women, respectively; it was 51.9±1.4% and 35.7±1.3% in older men and women, respectively. For men, the proportions of proteins through meals were 17.4±0.3%, 32.6±0.3%, 38.4±0.3%, and 11.6±0.2% for breakfast, lunch, dinner, and snacks, respectively. The women showed a similar distribution. In both men and women, as the age group progressed from the young (10.9±0.4 g/day, 12.2±0.4%) to the old (16.9±0.3 g/day, 27.3±0.4%), their intake of proteins and their proportions in meals taken as breakfast also increased, while their dinner protein intake and proportion decreased. The highest-ranked and the 2nd highest-ranked protein sources among the young and middle-aged groups were meat and grains, respectively; the third sources were fish and shellfish. In the old-age group, grains were the highest-ranked protein sources across all three meals. @*Conclusions@#Despite the increase in protein intake, one out of three young people and two out of three older adults in Korea had inadequate protein intake and uneven meal distributions of protein intake.
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Background@#The ultrasonic stadiometer was originally developed as a device to measure and monitor children’s height. However, an ultrasonic stadiometer (InLab S50; InBody Co., Seoul, Korea) was used to measure adults’ height in the 2018 Korea Community Health Survey (KCHS). This study was conducted to assess the reliability and validity of the InLab S50 in adults. @*Methods@#The study subjects were 120 adults (reliability test, n=20; validity test, n=100) who had visited a health screening center. The intra- and inter-rater reliabilities of InLab S50 were assessed using the intraclass correlation coefficient (ICC). The agreement between InLab S50 and an automatic stadiometer (HM-201; Fanics, Busan, Korea) was assessed using Pearson’s correlation coefficient and Bland-Altman analysis. @*Results@#The intra- and inter-rater reliabilities of the InLab S50 were excellent (ICC=0.9999 and 0.9998, respectively). The correlation coefficient of the height measured by the two measurement devices was very high (r=0.996). The difference (Δheight [HM-201-InLab S50]) was -0.15±0.78 cm (95% limit of agreement [LOA], -1.69 to 1.38). After excluding the values outside 95% LOA, the difference was further reduced to -0.05±0.59 cm (95% LOA, -1.20 to 1.10). @*Conclusion@#This study showed that the InLab S50 is a reliable and valid device for the measurement of adults’ height. Therefore, we think that InLab S50 could be used to measure adults’ height in household health surveys such as the KCHS.
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Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.
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Background@#This study aimed to evaluate the adequacy of protein intake through meals and present the major protein sources of Korean adults. @*Methods@#Cross-sectional data of 15,639 adults aged 19 years or older from the 2016-2018 Korea National Health and Nutrition Examination Survey were obtained. The total, animal, plant protein intakes were assessed using 1-day 24-hour recall. The distinction between breakfast, lunch, and dinner was based on the subjective answers of the participants. @*Results@#The adequacy of protein intake based on the Recommended Nutrient Intake was 67.4±1.2% and 62.9±1.1% in young men and women, respectively; it was 51.9±1.4% and 35.7±1.3% in older men and women, respectively. For men, the proportions of proteins through meals were 17.4±0.3%, 32.6±0.3%, 38.4±0.3%, and 11.6±0.2% for breakfast, lunch, dinner, and snacks, respectively. The women showed a similar distribution. In both men and women, as the age group progressed from the young (10.9±0.4 g/day, 12.2±0.4%) to the old (16.9±0.3 g/day, 27.3±0.4%), their intake of proteins and their proportions in meals taken as breakfast also increased, while their dinner protein intake and proportion decreased. The highest-ranked and the 2nd highest-ranked protein sources among the young and middle-aged groups were meat and grains, respectively; the third sources were fish and shellfish. In the old-age group, grains were the highest-ranked protein sources across all three meals. @*Conclusions@#Despite the increase in protein intake, one out of three young people and two out of three older adults in Korea had inadequate protein intake and uneven meal distributions of protein intake.
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Background@#The ultrasonic stadiometer was originally developed as a device to measure and monitor children’s height. However, an ultrasonic stadiometer (InLab S50; InBody Co., Seoul, Korea) was used to measure adults’ height in the 2018 Korea Community Health Survey (KCHS). This study was conducted to assess the reliability and validity of the InLab S50 in adults. @*Methods@#The study subjects were 120 adults (reliability test, n=20; validity test, n=100) who had visited a health screening center. The intra- and inter-rater reliabilities of InLab S50 were assessed using the intraclass correlation coefficient (ICC). The agreement between InLab S50 and an automatic stadiometer (HM-201; Fanics, Busan, Korea) was assessed using Pearson’s correlation coefficient and Bland-Altman analysis. @*Results@#The intra- and inter-rater reliabilities of the InLab S50 were excellent (ICC=0.9999 and 0.9998, respectively). The correlation coefficient of the height measured by the two measurement devices was very high (r=0.996). The difference (Δheight [HM-201-InLab S50]) was -0.15±0.78 cm (95% limit of agreement [LOA], -1.69 to 1.38). After excluding the values outside 95% LOA, the difference was further reduced to -0.05±0.59 cm (95% LOA, -1.20 to 1.10). @*Conclusion@#This study showed that the InLab S50 is a reliable and valid device for the measurement of adults’ height. Therefore, we think that InLab S50 could be used to measure adults’ height in household health surveys such as the KCHS.
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Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.
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Background@#Dietary intake is affected by socioeconomic status (SES). The aim of this study is to assess adequacy of protein intake, and to investigate the association between SES, in terms of household income and educational attainment, and protein intake according to the protein source i.e., plant or animal protein, in a nationally representative sample of young and middle-aged Korean adults. @*Methods@#We used cross-sectional data from 1,404 Koreans, aged between 19 and 64, who had participated in the 2016-2018 Korea National Health and Nutrition Examination Survey. One day (24-hour) recall data was used to estimate the daily total of animal and plant protein intake. Household income quartiles and educational attainment were assessed by trained interviewers. @*Results@#The proportion of protein intake adequacy, based on the Korean recommended nutrient intake (RNI; 0.91 g/kg/day), was 66.5% (0.8) for males and 58.2% (0.8) for females. After adjustment, household income quartiles were positively associated with animal protein intake with a marginal significance both in males (P=0.051) and females (P=0.080) and showed a marginal negative association with plant protein intake in males (P=0.050) and a marginal positive association in females (P=0.074). Educational attainment was positively associated with total protein (P=0.001), animal protein (P=0.003), and plant protein intake (P=0.002), only in females. @*Conclusions@#One out of three young and middle-aged Korean adults showed protein intake inadequacy. Socioeconomic status, measured by household income and educational attainment, was associated with protein intake in young and middle-aged Korean adults and the associations were more marked in females.
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BACKGROUND@#The consumption of dietary supplements is increasing in Korea. The aim of this study is to assess the prevalence, types, and trends of dietary supplement (DS) use in Korean adults.@*METHODS@#We analyzed the Nutrition Survey data of Korean aged 19 years old or older from the 2015 Korea National Health and Nutrition Examination Survey. Two thousand and six hundred twenty one men and 3,324 women totaling 5,945 adults were included. The prevalence of DS use was calculated by two methods, i.e., consumption experience of more than two weeks during previous one year and current consumption. Each reported DS in the one day 24 hour recall was coded based on ingredients according to the 2016 Korean Food and Drug Administration Notification.@*RESULTS@#The prevalence (standard error) of current DS use was 18.4% (1.2) for men, 27.4% (1.1) for women. Those with DS use for longer than two weeks during previous one year were 35.2% (1.5), and 50.4% (1.2), for men and women respectively. Multi-vitamin mineral supplement (89.6/103 persons) was the most frequently consumed DS in Korean adults followed by vitamin C (66.2/103 persons), omega 3 fatty acid (49.5/103 persons), Panax ginseng (27.3/103 persons), and probiotics (22.2/103 persons) in listing.@*CONCLUSIONS@#The trend for DS use in Korean adults is changing as well as increasing. These factors should be considered in patient care.
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BACKGROUND@#The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents.@*METHODS@#This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level.@*RESULTS@#In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04).@*CONCLUSIONS@#This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.
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BACKGROUND@#Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother.@*METHODS@#This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires.@*RESULTS@#In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09–1.40) and overweight (OR 1.17, 95% CI 1.03–1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23–1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13–1.91) and overweight (OR 1.31, 95% CI 1.00–1.70).@*CONCLUSIONS@#This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.
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BACKGROUND: Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother. METHODS: This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires. RESULTS: In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09–1.40) and overweight (OR 1.17, 95% CI 1.03–1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23–1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13–1.91) and overweight (OR 1.31, 95% CI 1.00–1.70). CONCLUSIONS: This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.
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Adolescente , Humanos , Estudios Transversales , Padre , Corea (Geográfico) , Madres , Obesidad , Sobrepeso , Padres , Asunción de Riesgos , Padres Solteros , Familia MonoparentalRESUMEN
BACKGROUND: The consumption of dietary supplements is increasing in Korea. The aim of this study is to assess the prevalence, types, and trends of dietary supplement (DS) use in Korean adults. METHODS: We analyzed the Nutrition Survey data of Korean aged 19 years old or older from the 2015 Korea National Health and Nutrition Examination Survey. Two thousand and six hundred twenty one men and 3,324 women totaling 5,945 adults were included. The prevalence of DS use was calculated by two methods, i.e., consumption experience of more than two weeks during previous one year and current consumption. Each reported DS in the one day 24 hour recall was coded based on ingredients according to the 2016 Korean Food and Drug Administration Notification. RESULTS: The prevalence (standard error) of current DS use was 18.4% (1.2) for men, 27.4% (1.1) for women. Those with DS use for longer than two weeks during previous one year were 35.2% (1.5), and 50.4% (1.2), for men and women respectively. Multi-vitamin mineral supplement (89.6/103 persons) was the most frequently consumed DS in Korean adults followed by vitamin C (66.2/103 persons), omega 3 fatty acid (49.5/103 persons), Panax ginseng (27.3/103 persons), and probiotics (22.2/103 persons) in listing. CONCLUSIONS: The trend for DS use in Korean adults is changing as well as increasing. These factors should be considered in patient care.
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Adulto , Femenino , Humanos , Masculino , Ácido Ascórbico , Suplementos Dietéticos , Ácidos Grasos , Corea (Geográfico) , Minerales , Mineros , Encuestas Nutricionales , Panax , Atención al Paciente , Prevalencia , Probióticos , United States Food and Drug Administration , VitaminasRESUMEN
BACKGROUND: The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents. METHODS: This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level. RESULTS: In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04). CONCLUSIONS: This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.
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Adolescente , Femenino , Humanos , Desayuno , Estudios Transversales , Desarrollo Económico , Educación , Composición Familiar , Corea (Geográfico) , Actividad Motora , Obesidad , Sobrepeso , Padres , Obesidad Infantil , Asunción de Riesgos , Humo , Fumar , Clase Social , DelgadezRESUMEN
BACKGROUND: Protein intake in South Korea is generally considered to be adequate; however, there is concern that it may be inadequate among the elderly. This study evaluated the adequacy of protein intake, the source of protein, and the distribution of protein intake in daily meals in the Korean elderly population. METHODS: Data were obtained from 1,484 men and 2,028 women aged 60 years or older who had participated in the nutrition survey of the 2013–2014 Korea National Health and Nutrition Examination Survey. One-day (24-hour) recall data were used to estimate the daily protein intake. RESULTS: The mean protein intake was 65.3±1.0 g/d (13.1%±0.1% of energy) and 49.7±0.7 g/d (12.6%±0.1% of energy) for men and women, respectively. The protein intake was less than the estimated average requirement in 30.8%±1.4% of men and 42.6%±1.3% of women, and 47.9%±1.6% and 60.1%±1.4%, respectively, consumed less than the recommended daily allowance. The protein intake was relatively evenly distributed among meals; however, the absolute amount of protein consumption per meal was very low. Only one-third of the protein intake came from animal sources. CONCLUSION: The quantity and quality of protein intake were inadequate in the elderly Korean population.
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Anciano , Animales , Femenino , Humanos , Masculino , Corea (Geográfico) , Comidas , Encuestas Nutricionales , Ingesta Diaria RecomendadaRESUMEN
BACKGROUND AND OBJECTIVES: The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratified by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). MATERIALS AND METHODS: NT-proBNP, glomerular filtration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defined as EF<50%, and renal dysfunction as GFR<60 mL/min/1.73 m² (mild renal dysfunction: 30≤GFR<60 mL/min/1.73 m²; severe renal dysfunction: GFR<30 mL/min/1.73 m²). The primary outcome was 12-month all-cause death. RESULTS: There was an inverse correlation between GFR and log NT-proBNP level (r=−0.298, p<0.001), and between EF and log NT-proBNP (r=−0.238, p<0.001), but no correlation between EF and GFR (r=0.017, p=0.458). Interestingly, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank p<0.001). Multivariate analysis showed severe renal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.40–3.11). When stratified according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66–3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52–3.89). CONCLUSION: In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.
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Humanos , Tasa de Filtración Glomerular , Insuficiencia Cardíaca , Corazón , Mortalidad , Análisis Multivariante , Prevalencia , PronósticoRESUMEN
BACKGROUND: Youth suicide is increasingly being recognized as a major social problem in South Korea. In this study, we aimed to explore the effects of parental support on the relationship between life stress and suicidal ideation among middle-school students. METHODS: This study analyzed data from a cross-sectional study on mental health conducted by the South Korea National Youth Policy Institute between May and July of 2013. Questionnaire responses from 3,007 middle-school students regarding stress factors, thoughts of suicide during the past year, and parental support were analyzed in terms of 3 subscale elements: emotional, academic, and financial support. RESULTS: Among the participants, 234 male students (7.8%) and 476 female students (15.8%) reported experiencing suicidal ideation in the past year. Life stress significantly influenced suicidal ideation (P<0.001), and parental support and all of the subscale elements had a significant influence on decreasing suicidal ideation. As shown in model 1, life stress increased suicidal ideation (adjusted odds ratio [aOR], 1.318; P<0.001), and, in model 2, the effect of life stress on suicidal ideation decreased with parental support (aOR, 1.238; P<0.001). CONCLUSION: Parental support was independently related to a decrease in suicidal ideation, and life stress was independently related to an increase in suicidal ideation. Parental support buffered the relationship between life stress and suicidal ideation.