Current Status of Korean Alcohol Drinking in Accordance with the Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing / 가정의학회지

Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans’ alcohol metabolism capabilities that can be predicted by presence of facial flushing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups according to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.

Impact of a Doctor's Verbal Recommendation on Pneumococcal 13-Valent Conjugate Vaccine among High-Risk Patients for Pneumonia in a Primary Care Setting

Background@#Streptococcus pneumoniae is the main bacterial pathogen of community-acquired pneumonia in Korea. This study aimed to enhance the vaccination rate by evaluating the effectiveness of current methods of recommendation. @*Methods@#A retrospective analysis of the medical records of 143 patients with high risk of pneumonia among first-visit outpatients was conducted. High-risk patients for pneumonia are defined by the U.S. Advisory Committee on Immunization Practices. One hundred and twenty-seven patients, excluding 16 with pneumococcal 13-valent conjugate vaccination (PCV13) history prior to the first visit, were divided into three groups according to the method of vaccination recommendation: banner (B) group; banner+brochure (B+Br) group; banner+brochure+doctor's recommendation (B+Br+DR) group. The vaccination rates among patients in each group were compared. @*Results@#Patients with high risk of pneumonia showed 11.2% rate for PCV13 vaccination upon their first visit;however, this rate increased to 39.2% following counseling (P<0.001). Variation among the three groups was as follows: 9.0% in the B group, 20.0% in the B+Br group, and 75.0% in the B+Br+DR group (P<0.001). After adjusting for age, sex, high-risk group, occupation, and residence, a regression analysis was carried out. The odds ratio for the PCV13 vaccination rate compared to the B group was 2.49 (95% confidence interval [CI], 0.55-11.34) for the B+Br group and 43.72 (95% CI, 11.52-165.96) for the B+Br+DR group. @*Conclusions@#Among the available methods, we are thought to be more effective to add doctor's verbal recommendation in a clinical setting.

Influence of Facial Flushing on Pre- or Type 2 Diabetes Risk according to Alcohol Consumption in Korean Male / 가정의학회지

Background@#This study aims to examine the association between alcohol consumption and the risk of pre- or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI). @*Methods@#This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre- or T2DM. @*Results@#In both the normal-weight group (BMI 4 and ≤8 drinks: 2.64, 1.10–6.36; >8 drinks: 2.42, 1.11–5.27). However, obese non-flushers had only a significant higher risk of pre- or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39–5.30) @*Conclusion@#These results suggest that obese flushers have an increased risk of developing pre- or T2DM even with less alcohol consumption.

Relationship between Alcohol Consumption and Ocular Pressure according to Facial Flushing in Korean Men with Obesity / 가정의학회지

BACKGROUND: This study aimed to examine the relationship between alcohol consumption and intraocular pressure (IOP) according to facial flushing in Korean men with obesity. METHODS: The study included 479 Korean men with a body mass index of ≥25 kg/m² (75 non-drinkers, 174 with drinking-related facial flushing, and 230 without facial flushing) who underwent health check-ups between October 1, 2016 and March 31, 2017. Multivariate logistic regression was used to assess the relationship between alcohol consumption and high IOP (≥21 mm Hg). RESULTS: Flushers consuming ≤16 drinks per week had a significantly higher risk of high IOP than non-drinkers, depending on alcohol consumption (≤8 standard drinks: odds ratio [OR], 4.49; 95% confidence interval [CI], 1.05–19.25; >8 but ≤16 standard drinks: OR, 8.14; 95% CI, 1.37–48.45). However, when the consumption was >16 drinks per week, the high IOP risk did not significantly increase (OR, 0.71; 95% CI, 0.05–10.69). In addition, there was no significant relationship between alcohol consumption and high IOP among non-flushers consuming ≤8 drinks per week (OR, 2.07; 95% CI, 0.52–8.19). However, a significantly increased risk of high IOP was observed among non-flushers consuming >8 drinks per week, depending on alcohol consumption (>8 but ≤16 standard drinks: OR, 4.84; 95% CI, 1.14–20.61; >16 standard drinks: OR, 4.08; 95% CI, 1.02–16.26). CONCLUSION: This study suggests that obese men with alcohol flush reactions may have an increased risk of high IOP with the consumption of smaller amounts of alcohol than non-flushers.

Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing / 가정의학회지

This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.

Survey on the Causes of Blindness Among the Hospital Patient in 3 Districts

We surveyed the causes of blindness among the 6692 eye patients of 3 hospitals(Seoul, Chunan, Kumi) in 1984. Blindness is defined as visual acuity of 0.1(20/200) or less in better eye with best correction. The representation of the diagnosis of the ocular diseases is based on the examination of the ophthalmologists. The estimated number of blindness is 259(6.74%)in Seoul, 106(8.92%) in Chunan, 70(4.21%) in Kumi with total of 435(6.5%) among the 6692 eye patients. The leading causes of blindness for individual districts are cataract(28.19%), retinal and vitreous diseases(20.46%), trauma (15.06%), diseases of optic nerve(10.81%), corneal diseases(8.10%) in Seoul; cataract(35.81%), corneal diseases(18.87%), global diseases(13.21%), trauma(10.38%), retinal and vitreous diseases(6.60%) in Chunan; and cataract(34.29%), corneal diseases(14.21%), trauma (12.86%), global diseases(8.57%), retinal and vitreous diseases(8.50%) in Kumi. Rates of the blind eyes for the age groups are; 1.2%(under the age of 5), 4.1%(6~9), 10.3%(10~19), 30.8%(20~39), 23.5%(40~59), and 30.1%(above 60). Important causes of blindness in each age group are trauma(43.48%), optic nerve diseases(13.04%), and global diseases(13.04%) for below the age of 10, trauma(28.89%), retinal diseases(17.78%), and optic nerve diseases(13.33%) in 10~19 age group, corneal diseases(19.40%). cataract(18.66%), and retinal diseases(16.42%) in 20~39 age group, cataract(28.43%), retinal diseases(18.63%), and corneal diseases(10.78%) in 40~59 age group and cataract(59.54%), retinal diseases(9.92%), and glaucoma(8.40%) for above 60. There are no significant differences between male and female, right eyes and left eyes in the causes of the blind eyes, and also we make some comparisons with different statistics of domestic and foreign countries.