The Relationship between Smoking and Pulmonary Function Test by Body Mass Index and Age: The Korean National Health and Nutrition Survey

Background@#Smoking is a known risk factor for decreasing pulmonary function. The objective of this study was to investigate the relationship between smoking and lung function considering obesity and age group. @*Methods@#This study was based on the data collected during the 2016 Korean National Health and Nutrition Examination Surveys (KNHANES VII). A total of 3,411 adults were retrieved from KNHANES VII. Among 3,411 adults, we studied 1,411 male subjects. Impaired lung function was measured by spirometry at least twice. Data were analyzed using one way analysis of variance. @*Results@#In this study, forced expiratory volume in the first second was associated with smoking status (P=0.024). The association was stronger in old subjects (P=0.008). Also, in the obese group, the association of lung function with smoking status was not significant, but the association was significant in the non-obese group (P=0.019). @*Conclusions@#In this study, Smoking was significantly associated with impaired lung function. The association was stronger in old men and obese men. In order to obtain an accurate assessment of the association between smoking and pulmonary function values, further prospective cohort study in the future is necessary.

The Relationship between Smoking and Pulmonary Function Test by Body Mass Index and Age: The Korean National Health and Nutrition Survey

Background@#Smoking is a known risk factor for decreasing pulmonary function. The objective of this study was to investigate the relationship between smoking and lung function considering obesity and age group. @*Methods@#This study was based on the data collected during the 2016 Korean National Health and Nutrition Examination Surveys (KNHANES VII). A total of 3,411 adults were retrieved from KNHANES VII. Among 3,411 adults, we studied 1,411 male subjects. Impaired lung function was measured by spirometry at least twice. Data were analyzed using one way analysis of variance. @*Results@#In this study, forced expiratory volume in the first second was associated with smoking status (P=0.024). The association was stronger in old subjects (P=0.008). Also, in the obese group, the association of lung function with smoking status was not significant, but the association was significant in the non-obese group (P=0.019). @*Conclusions@#In this study, Smoking was significantly associated with impaired lung function. The association was stronger in old men and obese men. In order to obtain an accurate assessment of the association between smoking and pulmonary function values, further prospective cohort study in the future is necessary.

The Relationship between Pulmonary Function and Serum Uric Acid Level in the Korean Population

BACKGROUND@#Forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and the ratio of FEV₁ to FVC (FEV₁/FVC) are considered as the major spirometry parameters. Serum uric acid is associated with increased risk of gout and cardiovascular disease. We analyzed the relationship between pulmonary function and serum uric acid level in the Korean men and women.@*METHODS@#This study was based on the data collected during the 2016 Korea National Health and Nutrition Examination Survey (KNHANES VII-1). A total of 3,411 adults were retrieved from KNHANES VII-1. Among 3,411 adults, 1,500 were men and 1,911 were women.@*RESULTS@#In this study, a significant negative correlation was observed between serum uric acid level and pulmonary function values only in females. Also, in the male non-smoker group, pulmonary function values were negatively associated with serum uric acid level (FVC %predicted, β=−0.014; FEV₁ %predicted, β=−0.015).@*CONCLUSIONS@#In this study, hyperuricemia was associated with the low lung function in males and females. In order to obtain an accurate assessment of the association between hyperuricemia and pulmonary function values, further prospective cohort study in the future is necessary.

Effects of Obesity and Family History of Diabetes on the Association of CETP rs6499861 with HDL-C Level in Korean Populations

OBJECTIVES: The aim of this study was to examine the associations of cholesterol ester transfer protein (CETP) rs6499861 and rs12708980 with high-density lipoprotein cholesterol (HDL-C) considering obesity and family history of diabetes (FHD) in Korean men and women. METHODS: We analyzed the association of CETP single nucleotide polymorphisms (SNPs) with HDL-C among individuals selected from a hospital (n=4 294) and the Bundang-gu area in Korea (n=2 304). RESULTS: We found that the CETP SNP rs6499861 was associated with a lower HDL-C level (effect per allele: −2.044 mg/dL, p<0.0001). Individuals with a rs6499861 CG/GG genotype had a 1.45-fold higher risk of an abnormal level of HDL-C (<40 mg/dL) than those with a CC genotype. This genotype-HDL-C association was stronger in women (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.39–2.85) compared with men (OR, 1.33; 95% CI, 1.10–1.61) and in women with a FHD (OR, 4.82; 95% CI, 1.86–12.5; p=0.0012) compared with women without a family history. Relative to individuals with a CC genotype and body mass index (BMI) <25.69 kg/m², individuals with a CG/GG genotype and BMI ≥25.69 kg/m² had an OR (95% CI) of 2.61 (1.97–3.47). CONCLUSIONS: These findings indicate that CETP variants are linked to HDL-C level in Koreans and that this link is stronger in obese men and in women who have a FHD.

The Relationship between Pulmonary Function and Serum Uric Acid Level in the Korean Population

BACKGROUND: Forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and the ratio of FEV₁ to FVC (FEV₁/FVC) are considered as the major spirometry parameters. Serum uric acid is associated with increased risk of gout and cardiovascular disease. We analyzed the relationship between pulmonary function and serum uric acid level in the Korean men and women.METHODS: This study was based on the data collected during the 2016 Korea National Health and Nutrition Examination Survey (KNHANES VII-1). A total of 3,411 adults were retrieved from KNHANES VII-1. Among 3,411 adults, 1,500 were men and 1,911 were women.RESULTS: In this study, a significant negative correlation was observed between serum uric acid level and pulmonary function values only in females. Also, in the male non-smoker group, pulmonary function values were negatively associated with serum uric acid level (FVC %predicted, β=−0.014; FEV₁ %predicted, β=−0.015).CONCLUSIONS: In this study, hyperuricemia was associated with the low lung function in males and females. In order to obtain an accurate assessment of the association between hyperuricemia and pulmonary function values, further prospective cohort study in the future is necessary.

The ABCG2 Polymorphism rs2725220 Is Associated with Hyperuricemia in the Korean Population

Elevated serum uric acid levels are associated with a variety of adverse health outcomes, including gout, hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular diseases. Several genome-wide association studies on uric acid levels have implicated the ATP-binding cassette, subfamily G, member 2 (ABCG2) gene as being possibly causal. We investigated an association between the single-nucleotide polymorphism (SNP) rs2725220 in the ABCG2 gene and uric acid levels in the Korean population. A total of 991 subjects in Seoul City were used for a replication study with ABCG2 SNP rs2725220. The rs2725220 SNP in the ABCG2 gene was associated with mean uric acid levels (effect per allele 0.25 mg/dL, p or =7.0 mg/dL) than subjects with the GG genotype. When analyzed by gender, the association with ABCG2 was stronger in men than in women. The association with ABCG2 was much stronger in male subjects with body mass index (BMI) > or = 26.4 (odds ratio, 5.09; 95% confidence interval, 2.41 to 10.8) than in male subjects with BMI < 26.4. This study clearly demonstrates that genetic variations in ABCG2 influence uric acid levels in Korean adults.

The Associations between Alcohol Intake and HDL Cholesterol Subclasses in Korean Population

OBJECTIVE: Alcohol intake has been found to be associated with high-density lipoprotein (HDL) cholesterol. However, the association of alcohol intake with HDL cholesterol subclasses is unclear. Therefore, this study was conducted to determine the association between alcohol intake and HDL cholesterol subclasses among Koreans. METHODS: This study included in 1,101 healthy Koreans (men: 765, women: 336) who underwent health check-up at two hospitals in the Korean Cancer Prevention Study 2 (KCPS2). The amounts of alcohol intake were classified into 4 groups: non-, light, moderate, and heavy drinkers (0, or =50.0 g/day, respectively). The proportions of HDL cholesterol subclasses were measured after subclasses were identified by 4-30% gradient gel electrophoresis. Multiple regression models were used to estimate regression coefficients after multivariate adjustments. RESULTS: The concentration of HDL, HDL2 and HDL3 significantly increased with increasing amount of alcohol intake. After adjusted for age, body mass index (BMI), waist and smoking status, alcohol consumers of <12.5 g/day, 12.5-49.9 g/day and more than 50.0g/day showed significant positive associations with HDL, HDL2 and HDL3 concentration when compared to non-alcohol drinkers in men. In particular, The strongest positive associations were obtained with HDL2b and HDL3c. CONCLUSION: HDL2 and HDL3 were significantly associated with increasing amount of alcohol intake in Koreans. In particular, HDL2b among HDL2 and HDL3c among HDL3 showed the strongest positive association with increasing amount of alcohol intake.

Prediction of Colorectal Cancer Risk Using a Genetic Risk Score: The Korean Cancer Prevention Study-II (KCPS-II)

Colorectal cancer (CRC) is among the leading causes of cancer deaths and can be caused by environmental factors as well as genetic factors. Therefore, we developed a prediction model of CRC using genetic risk scores (GRS) and evaluated the effects of conventional risk factors, including family history of CRC, in combination with GRS on the risk of CRC in Koreans. This study included 187 cases (men, 133; women, 54) and 976 controls (men, 554; women, 422). GRS were calculated with most significantly associated single-nucleotide polymorphism with CRC through a genomewide association study. The area under the curve (AUC) increased by 0.5% to 5.2% when either counted or weighted GRS was added to a prediction model consisting of age alone (AUC 0.687 for men, 0.598 for women) or age and family history of CRC (AUC 0.692 for men, 0.603 for women) for both men and women. Furthermore, the risk of CRC significantly increased for individuals with a family history of CRC in the highest quartile of GRS when compared to subjects without a family history of CRC in the lowest quartile of GRS (counted GRS odds ratio [OR], 47.9; 95% confidence interval [CI], 4.9 to 471.8 for men; OR, 22.3; 95% CI, 1.4 to 344.2 for women) (weighted GRS OR, 35.9; 95% CI, 5.9 to 218.2 for men; OR, 18.1, 95% CI, 3.7 to 88.1 for women). Our findings suggest that in Koreans, especially in Korean men, GRS improve the prediction of CRC when considered in conjunction with age and family history of CRC.

Differential Parental Transmission of Markers in BCL3 among Korean Cleft Case-parent Trios / 예방의학회지

OBJECTIVES: Isolated cleft lip with or without cleft palate (CL/P) is among the most common human birth defects, with a prevalence of approximately 1 in 700 live births. The B-Cell Leukemia/lymphoma 3 (BCL3) gene has been suggested as a candidate gene for CL/P based on association and linkage studies in some populations. This study tests for an association between markers in BCL3 and isolated, non-syndromic CL/P using a case-parent trio design, while considering parent-of-origin effects. METHODS: Forty case-parent trios were genotyped for two single nucleotide polymorphisms (SNPs) in the BCL3 gene. We performed a transmission disequilibrium test (TDT) on individual SNPs, and the FAMHAP package was used to estimate haplotype frequencies and to test for excess transmission of multi-SNP haplotypes. RESULTS: The odds ratio for transmission of the minor allele, OR (transmission), was significant for SNP rs8100239 (OR=3.50, p=0.004) and rs2965169 (OR=2.08, p=0.027) when parent-of-origin was not considered. Parent-specific TDT revealed that SNP rs8100239 showed excess maternal transmission. Analysis of haplotypes of rs2965169 and rs8100239 also suggested excess maternal transmission. CONCLUSIONS: BCL3 appears to influence risk of CL/P through a parent-of-origin effect with excess maternal transmission.

Examples and outlook of family-based cohort study / 한국역학회지

Family-based designs are commonly used in genetic association studies to identify and to locate genes that underlie complex diseases. In this paper, we review two examples of genome-wide association studies using family-based cohort studies, including the Framingham Heart Study and International Multi-Center ADHD Genetics Project. We also review statistical methods of family-based designs, including the transmission disequilibrium test (TDT), linkage analysis, and imprinting effect analysis. In addition, we evaluate the strengths and limitations of the family-based cohort design. Despite the costs and difficulties in carrying out this type of study, a family-based cohort study can play avery important role in genome wide studies. First, the design will be free from biases due to population heterogeneity or stratification. Moreover, family-based designs provide the opportunity to conduct joint tests of linkage and association. Finally, family-based designs also allow access to epigenetic phenomena like imprinting. The family-based cohort design should be given careful consideration in planning new studies for genome-wide strategies.

Ras association domain family 1A (RASSF1A) Ala133Ser polymorphism is associated with cervical cancer in Korean women / 부인종양

OBJECTIVE: The ras association domain family 1A (RASSF1A) gene plays an important part in carcinogenesis by inactivation via promoter hypermethylation in several cancers. We aimed to examine the effect of the RASSF1A Ala133Ser polymorphism on cervical carcinogenesis in reference to environmental factors, such as smoking and age at first sexual intercourse. METHODS: Seven hundred five patients who were diagnosed with cervical neoplasia and who had a positive results for human papillomavirus were enrolled to experimental group, and 641 of normal healthy women were enrolled as controls. All of the subjects were genotyped using the SNaPshot single base primer extension assay. RESULTS: Compared with RASSF1A TT/GT, the odds ratio (95% confidence interval) for RASSF1A GG was 1.4 (0.9-2.1) for invasive cervical cancer and 1.1 (0.7-1.7) for cervical intraepithelial neoplasia (CIN) II or III. The risks for cervical cancer were higher in patients under 40 years old at diagnosis (1.6, 1.0-2.6), than in patients over 40 years old at diagnosis (1.0, 0.7-1.5). Women with RASSF1A GG who currently smoke had a 2.7 (1.3-5.9) times higher risk of cervical cancer. Women with RASSF1A GG who had an early age of first intercourse, as compared with RASSF1A TT/GT, were also at increased risk. CONCLUSION: The RASSF1A Ala133Ser polymorphism is associated with a higher risk of cervical cancer and particularly with an early onset of cervical carcinogenesis.

White Blood Cell Count and the Risk of Hyperglycemia according to Smoking Status

BACKGRUOND: Recently, inflammation has been associated with insulin resistance and the development of type 2 diabetes mellitus. We investigated the relationship between white blood cell (WBC) count and the incidence of hyperglycemia and the interactive effects of smoking and elevated WBC count on hyperglycemia. METHODS: We prospectively examined 6,734 Korean males without IFG (fasting plasma glucose concentration of > or = 110 mg/dL) or type 2 diabetes mellitus from 1994 to 2002. We divided WBC counts into 4 groups: 2.9~5.9 (reference quartile), 6.0~6.9, 7.0~8.1, 8.2~16.5 (x10(3) cells/microliter), respectively. The odds ratios were calculated by multiple logistic regression according to WBC quartiles after adjusting for predictive risk factors of type 2 diabetes mellitus. Also the odds ratios were calculated after stratification according to smoking status. RESULTS: Compaired to reference quartile, the odds ratio for hyperglycemia was 1.09 (95% CI, 0.91~1.30), 1.17 (95% CI, 0.99~1.40), 1.34 (95% CI, 1.12~1.60) (P value for trend=0.0009), respectively. And the odds ratio for IFG or type 2 diabetes mellitus was 1.08 (95% CI, 0.83~1.42), 1.16 (95% CI, 0.89~1.50), 1.28 (95% CI, 1.00~1.65) (P value for trend=0.0395) among the current smoking group, respectively. CONSLUSION: Our findings demonstrate that an elevated WBC count is associated with an increased risk of hyperglycemia, particularly in current and former smokers. These results support our hypothesis that inflammation increases the risk of hyperglycemia.

Smoking and cause of death in Korea: 11 years follow-up prospective study / 한국역학회지

OBJECTIVE: In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking. METHOD: A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers. RESULTS: In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36). CONCLUSION: In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.

Glutathione S-Transferase M1 Status and Breast Cancer Risk: A Meta-Analysis

It is not yet clear whether Glutathione S-transferase M1 (GSTM1) polymorphisms affect the risk of breast cancer. The aim of this study is to provide a comprehensive meta-analysis of all the available, published case-control studies on the extent of the possible association between GSTM1 polymorphisms and susceptibility to breast cancer. Twenty case-control studies on GSTM1 and breast cancer were identified using both PUBMED and a manual search. Meta-analysis was conducted by the Peto method. Subgroup analyses were undertaken, in order to explore the relationship between effect sizes and the study characteristics. The overall odds ratio (OR) was found to be 1.06 (95% CI, 0.99-1.14). The OR for post-menopausal women with GSTM1 deficiency was determined to be 1.19 (95% CI, 1.05-1.34). In populations with a low frequency of GSTM1 deficiency, a greater increase was observed (OR, 1.20; 95% CI, 1.08-1.34). Furthermore, the highest associations were found in post-menopausal women with a low frequency of GSTM1 deficiency (OR, 1.44; 95% CI, 1.20-1.73). The fact that GSTM1 deficiency is not rare in the general population implies that the attributable risk for breast cancer could be sizable. Further studies focusing on the structure of haplotype blocks of GSTM1 are required in order to find a specific haplotype with a predisposing breast cancer susceptibility allele.

Pesticides and Cancer Incidence: The Kangwha Cohort Study / 예방의학회지

OBJECTIVE: Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. METHODS: We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks (RR). RESULTS: At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 146 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95% CI=1.0-1.9), p for trend=0.041, for digestive organ cancer incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0 (95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.8-27.9)). CONCLUSIONS: This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.