Evaluation of the Appropriateness of Platelet Transfusions at Two Tertiary Hospitals / 대한수혈학회지

Background@#Appropriate platelet transfusion is essential for patient blood management and allocating limited healthcare resources. Therefore, this study evaluated the appropriateness of platelet transfusion in two tertiary hospitals. @*Methods@#At Chonnam National University Hospital (Hospital A) and Chonnam National University Hwasun Hospital (Hospital B), 1,470 platelet transfusions (299 and 1,171 cases at Hospitals A and B, respectively) during a single month were reviewed retrospectively using the Korean Transfusion Guidelines (5th edition). @*Results@#The most common indications were therapeutic transfusion to ensure hemostasis (54.8%) at Hospital A and to prevent spontaneous bleeding in patients with hematologic/oncologic diseases (65.8%) at Hospital B. Overall, 87.3% and 76.3% of transfusions were appropriate at Hospitals A and B, respectively. According to the different transfusion indications, the therapeutic transfusions were appropriate in more than 80% of cases in both hospitals.The appropriateness of prophylactic transfusions against spontaneous bleeding was 80.7% and 69.3%, respectively, and those before surgery or invasive procedures were 72.0% and 66.2%, respectively. Of the 38 and 278 inappropriate transfusions in Hospitals A and B, respectively (as determined by pre-transfusion platelet counts), most cases had platelet counts between 50 and 100×109 /L in Hospital A (23 cases) and between 20 and 50×109 /L in Hospital B (198 cases). @*Conclusion@#The two hospitals differed in terms of transfusion indications, appropriateness, and cases of inappropriateness. The indications and appropriateness of platelet transfusion should be reviewed in real practice on a hospital-by-hospital basis to improve transfusion management.

Associated Factors with Changes of Metabolic Abnormalities among General Population in COVID-19 Pandemic

Background@#The coronavirus disease-2019 (COVID-19) pandemic has led to restrictions on daily living including social distancing. These restrictions had an impact on the individual's healthy lifestyle and health status. We investigated the associated factors with changes of metabolic abnormalities among general population in COVID-19. @*Methods@#The participants were 43,639 people who received health check-ups twice in 2019 and 2021 during COVID-19 pandemic, at 16 health promotion centers. Metabolic abnormalities were identified according to the third report of the cholesterol education program criteria. Multiple logistic regression analysis was performed to confirm the factors related to changes of metabolic abnormalities during COVID-19. @*Results@#Metabolic syndrome and metabolic abnormalities increased overall during the COVID-19 pandemic. This increase was mostly appeared in males. The occurrence of metabolic syndrome during COVID-19 was associated with 50s and older age (odds ratio [OR], 1.130; 95% confidence interval [CI], 1.019-1.254), attempt to quit smoking (OR, 1.467; 95% CI, 1.171-1.839), start smoking (OR, 1.251; 95% CI, 1.110-1.412), decrease in aerobic exercise (OR, 1.328; 95% CI, 1.162-1.517), and increase in strength exercise (OR, 0.704; 95% CI, 0.592-0.838). @*Conclusions@#The metabolic syndrome is closely related to smoking experience and lack of exercise during COVID-19.

The patterns of lifestyle, metabolic status, and obesity among hypertensive Korean patients: a latent class analysis / 한국역학회지

OBJECTIVES@#This study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex. @*METHODS@#This cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension. @*RESULTS@#A four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male. @*CONCLUSIONS@#Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.

The patterns of lifestyle, metabolic status, and obesity among hypertensive Korean patients: a latent class analysis / 한국역학회지

OBJECTIVES@#This study aimed to identify latent classes in hypertensive patients based on the clustering of factors including lifestyle risk factors, metabolic risk factors, and obesity in each sex. @*METHODS@#This cross-sectional study included 102,780 male and 103,710 female hypertensive patients who underwent health check-ups at 16 centers in Korea, in 2018. A latent class analysis approach was used to identify subgroups of hypertensive patients. Multinomial logistic regression was performed to examine the association between latent classes and comorbidities of hypertension. @*RESULTS@#A four-class model provided the best fit for each sex. The following latent classes were identified: Class I (male: 16.9%, female: 1.7%; high risk of lifestyle behaviors [HB] with metabolic disorders and obesity [MO]), Class II (male: 32.4%, female: 47.1%; low risk of lifestyle behaviors [LB] with MO), Class III (male: 15.3%, female: 1.8%; HB with metabolic disorders and normal weight [MNW]), Class IV (male: 35.5%, female: 49.4%; LB with MNW). Lifestyle patterns in the latent classes were classified as high-risk or low-risk according to smoking and high-risk drinking among male, and presented complex patterns including physical inactivity alone or in combination with other factors, among female. Stage 2 hypertensive or diabetic individuals were likely to belong to classes including obesity (HB-MO, LB-MO) in both sexes, and additionally belonged to the HB-MNW class in male. @*CONCLUSIONS@#Metabolic disorders were included in all latent classes, with or without lifestyle risk factors and obesity. Hypertensive females need to manage obesity, and hypertensive males need to manage lifestyle risk factors and obesity. Sex-specific lifestyle behaviors are important for controlling hypertension.

Experience and Current Use of Heated Tobacco Products in Korean Military Personnel

BACKGROUND@#Heat tobacco products (HTPs) are emerging in Korea. There are few studies that investigated the rates of HTPs use among military personnel in Korea. This study was performed to identify the prevalence of HTPs experience and use. Also this study aimed to evaluate the related factors of HTPs experience and use among military personnel in Korea.@*METHODS@#The study subjects were 3,878 military personnel participated health survey for Korean soldiers from November to December in 2018. Binominal logistic regression analysis was performed to confirm the related factors of HTPs experience and use among military personnel in Korea.@*RESULTS@#The HTPs experience and current use rates of study subjects were 17.4% and 8.7%, respectively. And the HTPs experience and current use among military personnel was associated with college/university degree (adjusted odds ratio [aOR] 1.441, 1.377), lance-corporal (aOR 2.049, 5.636), superiors' smoking in military camp (aOR 1.516, 1.567), interest in health (aOR 1.637, 1.571), ever used smoking (aOR 2.817, 3.575), and ever used electronic cigarette (E-cigarette) (aOR 3.129, 1.587).@*CONCLUSIONS@#The HTPs experience and current use among military personnel are closely related to educational level, military level, smoking status of the superiors, interests in health, conventional cigarette smoking, and E-cigarette use.

Relationship between Hypertension and Mircroalbuminuria according to Obesity Status in Prediabetes

BACKGROUND@#Microalbuminuria (MA) is a predictor for diabetic nephropathy and mortality of cardiovascular disease. Diabetic nephropathy can be prevented by blood glucose and blood pressure control. Koreans have been found to have a significantly higher risk of type 2 diabetes than Caucasians, despite having normal weights. It is necessary to consider obesity status in the prevention of type 2 diabetes. This study aimed to determine the relationship between MA and hypertension according to obesity status in prediabetes.@*METHODS@#This study was retrospectively conducted in 1,183 prediabetes, aged 30-70 years with fasting blood glucose levels of 100-125 mg/dL or hemoglobin A1c levels of 5.7–6.4% who health examinees at 16 health promotion centers from 2015 to 2016. Study subjects were classified according to obesity and hypertension. Obesity is defined as body mass index of ≥25 kg/m². Blood pressure was categorized as follows: normal blood pressure, <120/80 mmHg; prehypertension, 120–139/80–89 mmHg; and hypertension, ≥140/90 mmHg. We analyzed the relationship between MA and hypertension according to obesity using multivariable logistic regression analysis.@*RESULTS@#While both prehypertensive and hypertensive subgroups were significantly associated with MA in the nonobese, the hypertensive subgroup was only associated with MA in the obese. In the combined effects of obesity and hypertension, prediabetes with normal weight and hypertension had the highest risk of MA (adjusted odds ratio, 6.39; 95% confidence interval, 2.90–14.10) compared to those with nonobese and normal blood pressure.@*CONCLUSIONS@#Our findings suggest that nonobese prediabetes with hypertension would need to be more concerned about MA than do obese prediabetes with hypertension.

The Multi-Institutional Health Screening Records Database of South Korea: Description and Evaluation of Its Characteristics

This study sought to describe and to evaluate the characteristics of the Health Screening Records Database (HSRD) of the Korea Association of Health Promotion as a data source for epidemiologic studies. The HSRD was compared to a National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) database for 2015. Common variables between the databases were selected, and sex-based analyses were conducted. The HSRD showed statistical concordance when NHIS-HEALS estimates fell within the HSRD estimate's 95% confidence interval. The HSRD and NHIS-HEALS included 946461 and 111690 participants in health screening programs, respectively. Compared to the NHIS-HEALS, the HSRD had more female (55.2% vs. 42.6%) but fewer older adult participants (34.4% vs. 51.2%). Virtually all variables had clinical concordance, with some having statistical concordance as well, among both general and life-transition program participants. The HSRD comprised more clinical information over a wider age range in contrast to the NHIS-HEALS, while showing clinical concordance. Providing more comprehensive clinical data, the HSRD may serve as an alternative resource for epidemiologic studies.

Experience and Current Use of Heated Tobacco Products in Korean Military Personnel

BACKGROUND: Heat tobacco products (HTPs) are emerging in Korea. There are few studies that investigated the rates of HTPs use among military personnel in Korea. This study was performed to identify the prevalence of HTPs experience and use. Also this study aimed to evaluate the related factors of HTPs experience and use among military personnel in Korea.METHODS: The study subjects were 3,878 military personnel participated health survey for Korean soldiers from November to December in 2018. Binominal logistic regression analysis was performed to confirm the related factors of HTPs experience and use among military personnel in Korea.RESULTS: The HTPs experience and current use rates of study subjects were 17.4% and 8.7%, respectively. And the HTPs experience and current use among military personnel was associated with college/university degree (adjusted odds ratio [aOR] 1.441, 1.377), lance-corporal (aOR 2.049, 5.636), superiors' smoking in military camp (aOR 1.516, 1.567), interest in health (aOR 1.637, 1.571), ever used smoking (aOR 2.817, 3.575), and ever used electronic cigarette (E-cigarette) (aOR 3.129, 1.587).CONCLUSIONS: The HTPs experience and current use among military personnel are closely related to educational level, military level, smoking status of the superiors, interests in health, conventional cigarette smoking, and E-cigarette use.

Relationship between Hypertension and Mircroalbuminuria according to Obesity Status in Prediabetes

BACKGROUND: Microalbuminuria (MA) is a predictor for diabetic nephropathy and mortality of cardiovascular disease. Diabetic nephropathy can be prevented by blood glucose and blood pressure control. Koreans have been found to have a significantly higher risk of type 2 diabetes than Caucasians, despite having normal weights. It is necessary to consider obesity status in the prevention of type 2 diabetes. This study aimed to determine the relationship between MA and hypertension according to obesity status in prediabetes.METHODS: This study was retrospectively conducted in 1,183 prediabetes, aged 30-70 years with fasting blood glucose levels of 100-125 mg/dL or hemoglobin A1c levels of 5.7–6.4% who health examinees at 16 health promotion centers from 2015 to 2016. Study subjects were classified according to obesity and hypertension. Obesity is defined as body mass index of ≥25 kg/m². Blood pressure was categorized as follows: normal blood pressure, <120/80 mmHg; prehypertension, 120–139/80–89 mmHg; and hypertension, ≥140/90 mmHg. We analyzed the relationship between MA and hypertension according to obesity using multivariable logistic regression analysis.RESULTS: While both prehypertensive and hypertensive subgroups were significantly associated with MA in the nonobese, the hypertensive subgroup was only associated with MA in the obese. In the combined effects of obesity and hypertension, prediabetes with normal weight and hypertension had the highest risk of MA (adjusted odds ratio, 6.39; 95% confidence interval, 2.90–14.10) compared to those with nonobese and normal blood pressure.CONCLUSIONS: Our findings suggest that nonobese prediabetes with hypertension would need to be more concerned about MA than do obese prediabetes with hypertension.

Factors Related to Smoking Relapse among Military Personnel in Korea: Data from Smoking Cessation Clinics, 2015–2017

BACKGROUND@#Relapse is the common situation of smoking cessation attempts. There are few studies that analyzed the related factors of smoking relapse among military personnel. Thus, This study was performed to investigate factors related to smoking relapse among military personnel who participated smoking cessation clinics in Korea.@*METHODS@#The study subjects were 19,874 military personnel who enrolled smoking cessation clinic from January in 2015 to December in 2017. Smoking cessation applied to criteria exhaled carbon monoxide and urine cotinine levels. Binominal logistic regression analysis was performed to confirm related factors of smoking relapse among military personnel who succeed to quit smoking.@*RESULTS@#The smoking relapse rate of study subjects who succeeded in quitting smoking for 1-month was 15.3% after 3-months and 60.8% after 6-months follow-up. The factors associated with relapse smoking included implementing year, past year quit attempts, number or cigarettes smoked per day, regular exercise, blood pressure. Levels of nicotine dependence affected smoking relapse at 3-months follow-up.@*CONCLUSIONS@#Tailored approaches are necessary to reduce the rates of smoking relapse for military personnel who succeeded to quit smoking shortly but relapse back to smoking.

Factors Related to Smoking Relapse among Military Personnel in Korea: Data from Smoking Cessation Clinics, 2015–2017

BACKGROUND: Relapse is the common situation of smoking cessation attempts. There are few studies that analyzed the related factors of smoking relapse among military personnel. Thus, This study was performed to investigate factors related to smoking relapse among military personnel who participated smoking cessation clinics in Korea. METHODS: The study subjects were 19,874 military personnel who enrolled smoking cessation clinic from January in 2015 to December in 2017. Smoking cessation applied to criteria exhaled carbon monoxide and urine cotinine levels. Binominal logistic regression analysis was performed to confirm related factors of smoking relapse among military personnel who succeed to quit smoking. RESULTS: The smoking relapse rate of study subjects who succeeded in quitting smoking for 1-month was 15.3% after 3-months and 60.8% after 6-months follow-up. The factors associated with relapse smoking included implementing year, past year quit attempts, number or cigarettes smoked per day, regular exercise, blood pressure. Levels of nicotine dependence affected smoking relapse at 3-months follow-up. CONCLUSIONS: Tailored approaches are necessary to reduce the rates of smoking relapse for military personnel who succeeded to quit smoking shortly but relapse back to smoking.

Comparison of Auto RPR Plus and Auto TPIM Plus with Mediace RPR and Abbott Syphilis TP for Serologic Diagnosis of Syphilis

BACKGROUND: Serologic testing is considered a standard method for syphilis diagnosis. We compared Auto RPR Plus and Auto TPIM Plus with previously developed assays. METHODS: The precision around the cut-off, linearity, and recovery rate of Auto RPR Plus and Auto TPIM Plus was evaluated using their positive/negative control materials. The results of these two tests were compared with those of Mediace RPR and Abbott Syphilis TP using 431 remnant serum samples collected from people who underwent medical examinations. RESULTS: The within-run precisions (coefficient of variation, CV values) of negative/positive control materials of Auto RPR Plus, Mediace RPR, Auto TPIM Plus and Abbott Syphilis TP were 15.7/2.3%, 20.4/2.3%, -/2.7%, and 8.5/2.3%, respectively; between-run precisions were 67.7/3.3%, 39.1/3.4%, -/4.0%, and 7.0/1.5%, respectively. Auto RPR Plus showed better precision around the cutoff level (1.0 U) compared to Mediace RPR (7.2–7.3% vs. 12.2–14.3%). The CVs of Auto TPIM Plus around the cutoff (10.0 U) were 13.5% at 10.5 U and 6.6% at 12.5 U. Agreement rates between Auto RPR Plus and Mediace RPR and between Auto TPIM Plus and Abbott Syphilis TP were 97.2% and 98.4%, respectively. However, twelve samples showed discrepant results for Auto RPR Plus (−)/Mediace RPR (+) and false-positive Mediace RPR results could not be excluded around the cutoff of 1.0 U. CONCLUSIONS: Auto RPR Plus showing good precision near the cutoff can be used for syphilis screening in health checkups. However, Auto TPIM Plus needs improvement in precision and adjusting the cutoff to be used for syphilis screening.

Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea

BACKGROUND: Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. METHODS: The reference population comprised 804,623 health examinees (66,611 aged 3–17 years; 564,280 aged 18–59 years; 173,732 aged 60–99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. RESULTS: RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P < 0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P < 0.001). CONCLUSIONS: We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.

Comparison of Traditional and Reverse Syphilis Screening Algorithms in Medical Health Checkups

BACKGROUND: The syphilis diagnostic algorithms applied in different countries vary significantly depending on the local syphilis epidemiology and other considerations, including the expected workload, the need for automation in the laboratory and budget factors. This study was performed to investigate the efficacy of traditional and reverse syphilis diagnostic algorithms during general health checkups. METHODS: In total, 1,000 blood specimens were obtained from 908 men and 92 women during their regular health checkups. Traditional screening and reverse screening were applied to the same specimens using automatic rapid plasma regain (RPR) and Treponema pallidum latex agglutination (TPLA) tests, respectively. Specimens that were reverse algorithm (TPLA) reactive, were subjected to a second treponemal test performed by using the chemiluminescent microparticle immunoassay (CMIA). RESULTS: Of the 1,000 specimens tested, 68 (6.8%) were reactive by reverse screening (TPLA) compared with 11 (1.1%) by traditional screening (RPR). The traditional algorithm failed to detect 48 specimens [TPLA(+)/RPR(−)/CMIA(+)]. The median TPLA cutoff index (COI) was higher in CMIA-reactive cases than in CMIA-nonreactive cases (90.5 vs 12.5 U). CONCLUSIONS: The reverse screening algorithm could detect the subjects with possible latent syphilis who were not detected by the traditional algorithm. Those individuals could be provided with opportunities for evaluating syphilis during their health checkups. The COI values of the initial TPLA test may be helpful in excluding false-positive TPLA test results in the reverse algorithm.

Comparison of Urine Albumin-to-Creatinine Ratio (ACR) Between ACR Strip Test and Quantitative Test in Prediabetes and Diabetes

BACKGROUND: Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. METHODS: Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. RESULTS: The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of 300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. CONCLUSIONS: The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.

Human Papillomavirus Genotype Distribution Among 18,815 Women in 13 Korean Cities and Relationship With Cervical Cytology Findings

BACKGROUND: The prevalence and genotype distribution of Human papillomavirus (HPV) infection vary depending on geographical region and the immunity provided by vaccines. This study aimed to clarify the recent prevalence and genotype distribution of HPV according to age and cervical cytology findings in Korea. METHODS: This study included 18,815 health examinees that underwent cervical cytology and HPV genotyping tests at 16 centers of Korean Association of Health Promotion in 13 cities in Korea, between January 2014 and October 2015. HPV was genotyped by using multiplex PCR (Anyplex II HPV 28, Seegene, Korea), which detects 19 high-risk HPVs (HR-HPV) and nine low-risk HPVs (LR-HPV). RESULTS: Overall HPV prevalence was 27.8%, with 22.2% HR-HPV and 11.4% LR-HPV. The five most common carcinogens were HPV 52 (3.2%), 58 (2.7%), 16 (2.0%), 56 (1.9%), and 51 (1.8%). The five most common HR-HPVs in normal cytology samples were HPV 53, 68, 70, 52, and 58, while HPV 16, 52, 58, 33, and 31 were prevalent in high grade squamous intraepithelial lesions (HSIL). In atypical squamous cells of undetermined significance (ASCUS), the prevalence of HR-HPV varied with age; it was highest in those aged <30 yr, declining to a minimum at age 50–59 yr, and then increasing in older women (P<0.05). CONCLUSIONS: The prevalence and distribution of HR-HPV varied with age and cervical cytology findings. This information would be helpful in the development of cervical cancer prevention policies.

Association between Metabolic Syndrome and Psychological Characteristics in Korean Postmenopausal Women

BACKGROUND: Metabolic syndrome is a major health problem in postmenopausal women, along with psychological issues. Hence, this study was conducted to investigate the relationship between metabolic syndrome and mental health properties targeting middle-aged menopausal women, and analyzed the psychological factors affecting the prevalence of metabolic syndrome. METHODS: The study subjects were 479 postmenopausal women aged 45-64 years, who had taken their routine health screenings from August to October in 2012. The presence of 3 or more of 5 risk factors constitutes diagnosis of metabolic syndrome. Depression, trait anxiety, and stress level were measured by Beck Depression Inventory, State-Trait Inventory, and Brief Encounter Psychological Instrument, respectively. Multiple logistic regression analysis was performed to confirm the relationship between the metabolic syndrome and psychological characteristics. RESULTS: The prevalence of metabolic syndrome in postmenopausal women was 16.5%. Metabolic syndrome was significantly related with trait anxiety (odds ratio [OR]=16.53, P=0.007) and depression (OR=0.16, P=0.012), after adjusting for age, marital status, educational level, monthly income, body mass index, eating habits and exercise. CONCLUSIONS: Trait anxiety and depression were found to be related with the prevalence of metabolic syndrome in postmenopausal women.

Association of Homocysteine Levels with Subclinical Coronary Atherosclerosis in Asymptomatic Subjects

BACKGROUND: Progression of atherosclerotic plaques is known to be correlated with elevated circulating homocysteine (Hcy). However, whether the level of Hcy is related with coronary atherosclerosis in the subclinical state is unclear. Therefore, we performed this study to investigate the relationship between blood Hcy levels and subclinical atherosclerosis in asymptomatic self-referred subjects. METHODS: We retrospectively enrolled 2,968 self-referred asymptomatic subjects (1,374 men, 1,594 women) who had undergone both coronary CT angiography (CCTA) and coronary artery calcium scoring. The relationships between atherosclerosis, Hcy, and other clinical factors were assessed. RESULTS: Higher levels of Hcy were related with age, male gender, body mass index (BMI), waist circumference, blood pressure, high density lipoprotein (HDL), triglyceride, blood glucose, HbA1c, hsCRP, and coronary artery calcium score (CACS). Coronary plaque was more frequently found in higher Hcy quartile groups (21.3%, 28.8%, 34.4%, and 34.3%, P50%) was also more frequent in higher Hcy quartile groups (1.8%, 5.4%, 5.0%, and 6.6%, P400) than the first quartile group. CONCLUSIONS: Blood Hcy levels were associated with an increased risk of the presence and extent of subclinical atherosclerosis in asymptomatic subjects.

Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

BACKGROUND: Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement. METHODS: A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D2 and 25(OH)D3 were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit. RESULTS: The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions. CONCLUSIONS: Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.

Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

BACKGROUND: Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement. METHODS: A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D2 and 25(OH)D3 were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit. RESULTS: The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions. CONCLUSIONS: Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.