Association between Near Work Time and Depression among Workers in South Korea / 가정의학회지

Background@#The aim of this study was to evaluate the association between near work time and depression. @*Methods@#Data of 1,551 workers aged 19–49 years from the sixth Korea National Health and Nutrition Examination Survey were examined. The Patient Health Questionaire-9 scores were used to screen for depression. Participants who scored a total of 10 or above, which is suggestive of the presence of depression, were classified as the depression group; the rest were classified as normal. The correlation between daily near work time and depression was analyzed using multivariate logistic analysis after adjusting for other sociodemographic and health behavior-related variables. @*Results@#Multivariate logistic analysis found that workers with 3 or more hours of near work were more likely to report depression compared to the reference group who had 2 or fewer hours per day of near work (adjusted odds ratio, 2.471; 95% confidence interval, 1.062–5.747). @*Conclusion@#Longer near work time was associated with depression among South Korea’s workers. Therefore, it is necessary to reduce near work time to prevent depression.

Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea / 가정의학회지

Background@#Although many studies have demonstrated that the first cigarette in the morning increases the prevalence of smoking-related morbidity, limited studies have examined the impact of time to first cigarette (TTFC) on the health-related quality of life (HRQoL). Thus, we assessed this relationship using nationally-representative data from the Korea National Health and Nutrition Examination Survey VII-1 (2016). @*Methods@#We conducted a cross-sectional study using data from 577 current male smokers aged 30–59 years, after excluding those with a certain disease. Participants were divided into four categories according to TTFC (≤5 min, 6–30 min, 31–60 min, >60 min). HRQoL was measured using self-reported EuroQol-5 (EQ-5D). The relationship between TTFC and EQ-5D index was analyzed using a multivariate-adjusted generalized linear model to assess how HRQoL varies according to TTFC. After adjusting for confounders, a multivariate-adjusted logistic regression analysis was performed to identify which of the five dimensions of the EQ-5D affected the HRQoL according to TTFC. @*Results@#The generalized linear analysis indicated that as TTFC decreased (6–30 min, 31–60 min vs. >60 min), the EQ-5D index score decreased significantly (P=0.037). Shorter TTFC (≤5 min vs. >60 min) was associated with higher pain/discomfort (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.39–10.48) and anxiety/depression (OR, 7.58; 95% CI, 1.75–32.88). @*Conclusion@#Higher nicotine dependence was associated with impaired HRQoL. These results may be used to improve smoking cessation treatment outcomes.

Association between Near Work Time and Depression among Workers in South Korea / 가정의학회지

Background@#The aim of this study was to evaluate the association between near work time and depression. @*Methods@#Data of 1,551 workers aged 19–49 years from the sixth Korea National Health and Nutrition Examination Survey were examined. The Patient Health Questionaire-9 scores were used to screen for depression. Participants who scored a total of 10 or above, which is suggestive of the presence of depression, were classified as the depression group; the rest were classified as normal. The correlation between daily near work time and depression was analyzed using multivariate logistic analysis after adjusting for other sociodemographic and health behavior-related variables. @*Results@#Multivariate logistic analysis found that workers with 3 or more hours of near work were more likely to report depression compared to the reference group who had 2 or fewer hours per day of near work (adjusted odds ratio, 2.471; 95% confidence interval, 1.062–5.747). @*Conclusion@#Longer near work time was associated with depression among South Korea’s workers. Therefore, it is necessary to reduce near work time to prevent depression.

Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea / 가정의학회지

Background@#Although many studies have demonstrated that the first cigarette in the morning increases the prevalence of smoking-related morbidity, limited studies have examined the impact of time to first cigarette (TTFC) on the health-related quality of life (HRQoL). Thus, we assessed this relationship using nationally-representative data from the Korea National Health and Nutrition Examination Survey VII-1 (2016). @*Methods@#We conducted a cross-sectional study using data from 577 current male smokers aged 30–59 years, after excluding those with a certain disease. Participants were divided into four categories according to TTFC (≤5 min, 6–30 min, 31–60 min, >60 min). HRQoL was measured using self-reported EuroQol-5 (EQ-5D). The relationship between TTFC and EQ-5D index was analyzed using a multivariate-adjusted generalized linear model to assess how HRQoL varies according to TTFC. After adjusting for confounders, a multivariate-adjusted logistic regression analysis was performed to identify which of the five dimensions of the EQ-5D affected the HRQoL according to TTFC. @*Results@#The generalized linear analysis indicated that as TTFC decreased (6–30 min, 31–60 min vs. >60 min), the EQ-5D index score decreased significantly (P=0.037). Shorter TTFC (≤5 min vs. >60 min) was associated with higher pain/discomfort (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.39–10.48) and anxiety/depression (OR, 7.58; 95% CI, 1.75–32.88). @*Conclusion@#Higher nicotine dependence was associated with impaired HRQoL. These results may be used to improve smoking cessation treatment outcomes.

Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014–2015 Korea National Health and Nutrition Examination Survey / 가정의학회지

Background@#Grip strength is a convenient method to measure muscle strength. Recently, relative handgrip strength (HGS) was recommended as a clinical predictor of metabolic health and disease, such as dyslipidemia, which is considered a risk factor for cardiovascular disease. The purpose of this study was to characterize the association between relative HGS and dyslipidemia. @*Methods@#We included 6,027 adults (2,934 men, 3,093 women) aged 30–69 years who participated in the Korea National Health and Nutrition Examination Survey in 2014 and 2015. Relative HGS was obtained by dividing the HGS by body mass index. Complex sampling analysis was conducted to compare the general characteristics of participants according to the quartiles of relative HGS. Logistic regression analysis was used to examine the association between quartiles of relative HGS and dyslipidemia. @*Results@#After adjustment for age, prevalence of diabetes mellitus, prevalence of hypertension, alcohol consumption, smoking status, exercise, income, and education level, relative HGS was inversely associated with dyslipidemia in both men and women. In multivariable logistic regression analysis, the odds ratios (95% confidence intervals) for dyslipidemia in quartiles 1, 2, and 3 relative to quartile 4 were 1.36 (1.00–1.83), 1.29 (0.98–1.70), 1.23 (0.95– 1.60) in men and 1.81 (1.30–2.50), 1.81 (1.32–2.47), 1.39 (1.07–1.81) in women, respectively. @*Conclusion@#Relative HGS was inversely associated with dyslipidemia risk in Korean adults. Muscle-strengthening exercise is recommended to enhance health outcomes.

Association between Serum-Ferritin Levels and Sleep Duration, Stress, Depression, and Suicidal Ideation in Older Koreans: Fifth Korea National Health and Nutrition Examination Survey 2010–2012 / 가정의학회지

BACKGROUND: Serum-ferritin levels may be associated with psychiatric symptoms among the elderly; however, this association has not been extensively studied. The aim of this study was to evaluate the association between serum-ferritin levels and mental health issues in older Koreans. METHODS: This cross-sectional study included large-scale national data from the Korea National Health and Nutrition Examination Survey 2010–2012. In total, 1,802 older Koreans (≥65 years old) were included. The assessed psychiatric symptoms included short sleep duration, stress, depressed mood, and suicidal ideation. Any association between serum-ferritin levels and mental health issues according to sex was examined using logistic regression analysis. RESULTS: The prevalence of short sleep duration, stress, depressed mood, and suicidal ideation was 50.9%, 21.7%, 18.2%, and 22.5%, respectively. In men, suicidal ideation decreased with increased serum-ferritin levels after multivariate adjustment for sociodemographic and lifestyle factors and comorbidities. The odds ratios (OR) and 95% confidence interval (CI) of suicidal ideation by quartiles of serum-ferritin level were 1 (reference), 1.132 (95% CI, 0.569–2.252), 0.453 (95% CI, 0.217–0.945), and 0.608 (95% CI, 0.295–1.253), respectively, (P for trend=0.039). In women, no trend was observed. However, compared to the lowest quartile, short sleep duration (<7 h) and stress perception were significantly decreased in the third quartile, with odds ratios of 0.601 (95% CI, 0.461–0.888), and 0.606 (95% CI, 0.386–0.952), respectively. CONCLUSION: Moderate serum-ferritin levels were associated with decreased risk for suicide ideation in men, and were associated with decreased short sleep duration and stress perception in women.

The Association between Obesity Phenotypes and Early Renal Function Decline in Adults without Hypertension, Dyslipidemia, and Diabetes / 가정의학회지

BACKGROUND: The prevalence of chronic kidney disease is increasing worldwide. Several studies have suggested that obesity is associated with early renal dysfunction. However, little is known about the relationship between obesity phenotypes and early renal function decline. Therefore, this study aimed to identify the relationship between obesity phenotypes and early renal function decline in adults without hypertension, dyslipidemia, and diabetes. METHODS: We conducted a cross-sectional analysis of clinical and anthropometric data from 1,219 patients who underwent a routine health checkup in 2014. We excluded adults with cardiovascular disease, renal disease, diabetes, hypertension, dyslipidemia, or low glomerular filtration rate (<60 mL/min/1.73 m2). Renal function was determined according to the estimated glomerular filtration rate calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation. RESULTS: Age, sex, body mass index, waist circumference, triglyceride, low-density lipoprotein, and fasting glucose had an association with the estimated glomerular filtration rate. After adjusting for age, sex, smoking status, and alcohol intake, the odds ratios of the metabolically abnormal normal weight and metabolically abnormal obese phenotypes for the presence of low estimated glomerular filtration rates were 1.807 (95% confidence interval, 1.009–3.236) and 1.834 (95% confidence interval, 1.162–2.895), compared with the metabolically healthy normal weight phenotype. However, the metabolically healthy obese phenotype did not show a significant association with early renal function decline. CONCLUSION: In this cross-sectional study, we confirmed the association between the metabolically abnormal normal weight and metabolically abnormal obese phenotypes and early kidney function decline in adults without hypertension, dyslipidemia, and diabetes.

Genome Sequencing of Human Cytomegalovirus Strain LCW and Identification of Asia-specific Cluster

Human cytomegalovirus (HCMV) is a ubiquitous human pathogen and contains double stranded DNA genome with approximately 230 kbp. Molecular genomic studies of HCMV have been attempted in order to understand the pathogenesis and evolution of HCMV. However, studies on HCMV strains of Asian origin are limited. In this study, it was attempted to understand the genomics of HCMV isolated from Korea. Clinical strain LCW isolated from Korean patient was passaged in vitro cell culture, and subjected to next-generation sequencing. Complete genome sequence was obtained and compared with other HCMV strains. The LCW genome was found to contain 170 open reading frames (ORFs) and two ORF (RL5A and RL13) of the strain LCW were found to be truncated due to early stop codon. Phylogenetic analysis suggested that the strain LCW was closely related with Asian strains such as HCMV strains JHC and HAN. Common nucleotide sequences among the 3 Asian strains distinguishable from other strains were detected at 197 sites including 104 sites in ORFs.

The Association of Body Fat and Arterial Stiffness Using the Brachial-Ankle Pulse Wave Velocity / 가정의학회지

BACKGROUND: BMI alone may not serve as an index of obesity because it does not reflect body composition. The present study aimed to compare arterial stiffness as assessed by the brachial-ankle pulse wave velocity (ba-PWV) among groups defined by body fat percentage (pBF) and BMI. METHODS: This cross-sectional study was based on 1,700 participants (1,044 men and 656 women) who completed a health screening examination at a national hospital between January 2011 and February 2016. Participants were divided into four groups according to BMI and pBF: normal fat and normal weight (NFNW); excessive fat and normal weight (EFNW); normal fat and obese (NFO); and excessive fat and obese (EFO). The ba-PWV and other cardiometabolic factors were compared among the four groups in men and women separately. RESULTS: For both sexes, the NFNW group had a lower metabolic risk compared to that in the other groups (EFNW, NFO, and EFO). After adjusting for multiple variables, the NFO males had a significantly lower ba-PWV compared to those in the other groups, including NFNW males. The NFO group had significantly more skeletal muscle mass and muscle mass compared the other groups (P < 0.05). Among women, the NFNW group had a significantly lower ba-PWV compared the other groups, even after adjusting for multiple variables. CONCLUSION: Lower pBF in obese men may be associated with improved cardiovascular risk.

Prediction of Patient Discharge Status Based on Indicators on Admission / 한국호스피스완화의료학회지

PURPOSE: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. METHODS: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. RESULTS: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). CONCLUSION: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.

Association Between Serum 25-Hydroxyvitamin D Levels and Dry Eye in Korean Adults: A Study Based on Korean National Health and Nutrition Examination Survey, 2010–2011 / 가정의학회지

BACKGROUND: Dry eye is a common disease. Many patients continue to experience residual symptoms despite optimal treatment. Thus, new treatment options are required. The purpose of this study was to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and dry eye. METHODS: This study was performed using data from the fifth Korean National Health and Nutrition Examination Survey, which is a cross-sectional study of the Korean population that was conducted from 2010 to 2011. We included adults aged >19 years who underwent ophthalmologic interviews and examinations. We excluded subjects who had comorbid conditions (rheumatoid arthritis, thyroid disease, chronic kidney disease, or depression) that are associated with dry eye. The subjects were divided into normal and dry eye groups. The dry eye group consisted of those who had clinically diagnosed dry eye syndrome or symptoms. Multiple logistic regression analysis was conducted to determine the association between serum 25(OH)D levels and dry eye. RESULTS: In the univariate model, the 25(OH)D levels were lower in the dry eye group than in the normal group (P=0.01). A significant association was found between severe vitamin D deficiency (<10 ng/mL) and dry eye (P=0.04). However, after multivariate adjustment, the statistical significance of the association disappeared (P-values= 0.49, vitamin D insufficiency; P=0.33, vitamin D deficiency; P=0.18, severe vitamin D deficiency). CONCLUSION: Severe vitamin D deficiency was associated with dry eye in an unadjusted model, but the association was not statistically significant after adjustment.

The Health Behavior and Status according to Household Income Level in Korean Women Aged 35 Years or Older: the 2013 National Health and Nutrition Examination Survey

BACKGROUND: Income is a major socioeconomic index, and low household income is known to negatively affect health. Nevertheless, there is a lack of research on the health status and health behavior of middle-aged and older women with low-income. This study aims to provide basic information on the health status and health behavior of low-income women, using data representative of South Koreans. METHODS: This cross-sectional study used data from the 6th Korea National Health and Nutrition Examination Survey. Among the total of 8,018 respondents, 2,713 women aged 35 years or older were enrolled in the study. The subjects were classified by income status based on standard household income quartiles. RESULTS: The low-income group showed the lowest education levels and the highest unemployment rate (P<0.001). The percentage of smokers was the highest, while the frequency of exercise was the lowest in this group (P<0.001). The incidence of hyperlipidemia was highest (P=0.028), and they showed the highest body mass index, waist circumference (P<0.001), blood pressure, fasting blood glucose (P=0.018), and triglyceride level (P=0.03), as well as the lowest high density lipoprotein level (P=0.039), and the highest risk of cardiovascular diseases (P=0.002). Additionally, perceived health status was negative and quality of life was lowest among the groups (P<0.001). Although the enrollment rate for free health check-up services was highest (P=0.007), subscription to private health insurance, adult health check-ups, cancer screening rate were all lowest of the groups. CONCLUSIONS: This study confirmed a health gap among middle-aged and elderly women of low income, compared to higher income groups.

Vitamin-Mineral Supplement Use Patterns in Elderly Koreans: Data from the 2007-2008 Korean National Health and Nutrition Examination Survey / 가정의학회지

BACKGROUND: Vitamin-mineral supplements are the most popular dietary supplements in Korea. However, few studies have assessed the relationship between vitamin-mineral supplementation and associated factors among the Korean elderly. The purpose of this study was to assess the use of vitamin-mineral supplements among elderly in Korea as well as its association with sociodemographic factors, health-related behaviors, medical conditions, and nutrient intake. METHODS: This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008 to 2009. Data from 3,294 elderly men and women (65 years of age and older) were analyzed. Multivariable-weighted logistic regression model analysis was used to evaluate the association between vitamin-mineral supplement use and sociodemographic factors, health-related habits, and medical conditions. RESULTS: Vitamin-mineral supplementation was reported by 16.3% of the participants. The most common reason for using dietary supplements was recommendations from friends and acquaintances. Highly educated person, female participants had a greater likelihood of taking vitamin-mineral supplements. In addition, analysis of nutrient intake from food sources alone revealed a lower proportion of vitamin-mineral supplement users with nutrient intakes below the estimated average requirements for vitamin A, vitamin C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus, compared to nonusers. However, vitamin-mineral supplementation was not associated with health-related behaviors or medical conditions. CONCLUSION: Highly educated person, elderly Korean women had a greater likelihood of using vitamin-mineral supplements. In addition, nutrient intakes from food sources alone were significantly higher among vitamin-mineral supplement users. Finally, vitamin-mineral supplementation may be an indicator of healthier diet in elderly Koreans.

Association of Inter-arm Blood Pressure Difference with Atherosclerosis in Patients without Cardiovascular Diseases

BACKGROUND: Previous studies showed that great difference of inter-arm blood pressure (IABP) was associated with adverse cardiovascular outcomes. However, these studies had measurement bias because blood pressure (BP) was measured sequentially for each arm. Then, the aim of present study, using simultaneous BP measurement, is to investigate the association between ankle brachial index (ABI), brachial ankle pulse wave velocity (baPWV) and IABP difference in patients without cardiovascular disease. METHODS: We conducted cross sectional study from medical data and selected 153 (116 men, 37 women) patients aged 18 years or older. Simultaneous BP measurements were recorded using automatic oscillometric monitor equipped with dual arm cuffs in both arms. At the same day, ABI, baPWV, and physical parameters were evaluated. RESULTS: The mean age of the subjects was 52.8 +/- 9.9 and the difference of inter-arm systolic BP (SBP) and diastolic BP (DBP) were 5.6 +/- 4.3 and 4.5 +/- 3.7 mm Hg. Compared with group with an inter-arm SBP difference less than 5 mm Hg, group with an inter-arm SBP difference more than 5 mm Hg was more older (p = 0.012), more higher proportion of patient whose left arm SBP was higher than right (p = 0.004), higher left arm SBP (p = 0.044) and higher baPWV (p = 0.025). However, the difference of IABP in SBP and DBP had no significant correlation with the age (r = 0.152, p = 0.06 and r = 0.03, p = 0.715), ABI (r = 0.021, p = 0.801 and r = 0.131, p = 0.105) and baPWV (r = 0.115, p = 0.158 and r = 0.068, p = 0.403). CONCLUSIONS: There were no significant correlation between the differences of IABP in simultaneous BP measurements and ABI, baPWV.

Neurocognitive Function Impairment in Alcohol Dependent Patients with Diabetes Mellitus / 신경정신의학

OBJECTIVES: Diabetes and alcohol dependence are considered as independent risk factors for cognitive impairment. This research was to investigate whether cognitive functions in diabetic alcohol dependent patients were more impaired than non-diabetic alcohol dependent patients. METHODS: A cross-sectional study was conducted in alcohol dependence patients (n=138). Patients with alcohol dependence diagnosed by Diagnostic and Statistical Manual of Mental Disorder, 4th edition, Text Revision underwent a 75 g oral glucose tolerance test, to classify to diabetics group and non-diabetics group. In addition to demographic and clinical characteristics, cognitive functions assessed using the Korean-Mini Mental Status Examination (K-MMSE), word list memory test, and word fluency test, word list recall test from Korean version of the consortium to establish a registry for Alzheimer's disease, and block design test, digit span test, and digit symbol test from Korean-Wechsler Adult Intellogence Scale were compared between the two groups. RESULTS: There was no significant difference in demographic and other clinical characteristics between the non-diabetic and diabetic alcoholic patients. Compared to non-diabetic alcoholic patients, diabetic alcoholic patients were more impaired on language of K-MMSE (p=0.028) and digit symbol test (p=0.044). CONCLUSION: These findings suggest the more severe impairment of selective cognitive functions in diabetic alcoholic patients than non-diabetic alcoholic patients. Future replication of these findings in a large population is necessary.

Treatment of Psychiatric Symptoms in a Patient with Neuroacanthocytosis: A Case Report / 대한정신약물학회지

Neuroacanthocytosis is a rare hereditary disorder characterized by various neurological symptoms and the presence of abnormal red blood cell called acanthocytosis. Degeneration of striatum, which accounts for characteristic motor and psychiatric symptoms, mainly attributes to the pathology of neuroacanthocytosis. We experienced a case of chorea-acanthocytosis. He was a 50 year-old-man who presented with orofacial dyskinesia, dysarthria, uncontrolled lip biting, generalized choreic movements and sensorymotor polyneuropathy. He was also suffered from obsessive eating behavior, disinhibition, impulsivity and sleep disturbance. After antipsychotic medication, his psychiatric problems were improved. Clinicians must consider psychiatric managements of progressive neurological disorder for patients' quality of life and reducing their caregiver's burden.