Association between Timed Up and Go Test and Subsequent Functional Dependency

BACKGROUND@#This study aimed to evaluate the association between baseline results of the Timed Up and Go (TUG) test and subsequent functional dependency occurrence.@*METHODS@#From the National Health Insurance Service-Senior Cohort database, we identified 39,519 people who participated in the National Screening Program for Transitional Ages at the age of 66 during 2007–2008. Impaired mobility was defined as taking 10 seconds or longer to perform the TUG test. Functional dependency occurrence was defined as the initiation of receiving national Long-Term Care Insurance services—home care or admission to long-term care facilities. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) for dependency occurrence according to baseline TUG test results.@*RESULTS@#The mean follow-up period was 5.7 years. Occurrence rates of dependency were 2.0 and 3.4 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. Impaired mobility was associated with a higher risk of functional dependency occurrence (adjusted HR [aHR], 1.65; 95% confidence interval [CI], 1.40–1.95; P < 0.001). Additionally, in the subgroup analysis for the participants with intact baseline activities of daily living, impaired mobility was associated with a higher risk of dependency occurrence (aHR, 1.65; 95% CI, 1.33–2.04; P < 0.001).@*CONCLUSION@#The TUG test might be a useful predictive marker of subsequent functional dependency occurrence. Intervention to prevent functional dependency may be helpful for older adults with impairment on the TUG test.

Association between Timed Up and Go Test and Subsequent Functional Dependency

Association between Timed Up and Go Test and Subsequent Functional Dependency

BACKGROUND@#This study aimed to evaluate the association between baseline results of the Timed Up and Go (TUG) test and subsequent functional dependency occurrence.@*METHODS@#From the National Health Insurance Service-Senior Cohort database, we identified 39,519 people who participated in the National Screening Program for Transitional Ages at the age of 66 during 2007–2008. Impaired mobility was defined as taking 10 seconds or longer to perform the TUG test. Functional dependency occurrence was defined as the initiation of receiving national Long-Term Care Insurance services—home care or admission to long-term care facilities. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) for dependency occurrence according to baseline TUG test results.@*RESULTS@#The mean follow-up period was 5.7 years. Occurrence rates of dependency were 2.0 and 3.4 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. Impaired mobility was associated with a higher risk of functional dependency occurrence (adjusted HR [aHR], 1.65; 95% confidence interval [CI], 1.40–1.95; P < 0.001). Additionally, in the subgroup analysis for the participants with intact baseline activities of daily living, impaired mobility was associated with a higher risk of dependency occurrence (aHR, 1.65; 95% CI, 1.33–2.04; P < 0.001).@*CONCLUSION@#The TUG test might be a useful predictive marker of subsequent functional dependency occurrence. Intervention to prevent functional dependency may be helpful for older adults with impairment on the TUG test.

Relationship between the Change in Body Weight or Body Mass Index and Pulmonary Function

BACKGROUND: Obesity and deterioration of pulmonary function are known to increase all-cause mortality and morbidity associated with chronic diseases. Obesity is a known risk factor for decreasing pulmonary function; however, studies on the effect of changes in body weight or body mass index (BMI) on pulmonary function are rare. This study aimed to investigate the relationship between the change in body weight or BMI and the pulmonary function test (PFT) in Koreans who underwent consecutive screening at a health promotion center. METHODS: We enrolled 5,032 patients who underwent consecutive screening health check-ups at a health promotion center in 2015 and 2017. The BMI was calculated as the body weight (kg) divided by the square of the height (m²) in 2015 and 2017. We analyzed the association between the change in body weight or BMI and PFT. RESULTS: In males, PFT and changes in body weight were associated with forced expiratory volume in 1 second (FEV₁) but not with changes in BMI. In females, FEV₁/forced vital capacity and forced expiratory flow between 25–75% of vital capacity (FEF(25−75%)) were significantly associated with the changes in body weight and BMI. A correlation analysis between body weight and BMI showed a negative correlation with FEF(25−75%) in males. In females, FEV₁/FVC and FEF(25−75%) were negatively correlated. CONCLUSIONS: We observed that the increase in body weight and BMI was significantly associated with pulmonary function. This finding suggests that careful monitoring of body weight and BMI may aid in maintaining proper pulmonary function, thereby, reducing mortality and morbidity.

Relationship between the Change in Body Weight or Body Mass Index and Pulmonary Function

BACKGROUND@#Obesity and deterioration of pulmonary function are known to increase all-cause mortality and morbidity associated with chronic diseases. Obesity is a known risk factor for decreasing pulmonary function; however, studies on the effect of changes in body weight or body mass index (BMI) on pulmonary function are rare. This study aimed to investigate the relationship between the change in body weight or BMI and the pulmonary function test (PFT) in Koreans who underwent consecutive screening at a health promotion center.@*METHODS@#We enrolled 5,032 patients who underwent consecutive screening health check-ups at a health promotion center in 2015 and 2017. The BMI was calculated as the body weight (kg) divided by the square of the height (m²) in 2015 and 2017. We analyzed the association between the change in body weight or BMI and PFT.@*RESULTS@#In males, PFT and changes in body weight were associated with forced expiratory volume in 1 second (FEV₁) but not with changes in BMI. In females, FEV₁/forced vital capacity and forced expiratory flow between 25–75% of vital capacity (FEF(25−75%)) were significantly associated with the changes in body weight and BMI. A correlation analysis between body weight and BMI showed a negative correlation with FEF(25−75%) in males. In females, FEV₁/FVC and FEF(25−75%) were negatively correlated.@*CONCLUSIONS@#We observed that the increase in body weight and BMI was significantly associated with pulmonary function. This finding suggests that careful monitoring of body weight and BMI may aid in maintaining proper pulmonary function, thereby, reducing mortality and morbidity.

The Association between Urinary Sodium Excretion and Metabolic Syndrome in Korean Adults from the 2010–2011 Korean National Health and Nutrition Examination Survey / 가정의학회지

BACKGROUND: The sodium intake of Koreans was higher than that recommended by the World Health Organization. Urinary sodium, which is correlated with sodium intake, can be easily calculated by the Tanaka's equation. This study aimed to evaluate the association between urinary sodium and metabolic syndrome in Korean adults using the 2010–2011 Korean National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 5,870 participants from the 2010–2011 KNHANES were included in this study. Twenty-four hour urinary sodium was calculated by the Tanaka's equation using spot urine. Participants were divided into tertiles based on urinary sodium levels. The association between urinary sodium and metabolic syndrome was analyzed using multivariate logistic regression analysis. RESULTS: The odds ratios (ORs) and 95% confidence intervals (CIs) of metabolic syndrome for the 2nd and 3rd tertile of urinary sodium levels was 1.51 (1.16–1.97) and 1.56 (1.23–1.97) compared to the lowest tertile of urinary sodium in men. The ORs and 95% CIs of metabolic syndrome in women were 1.20 (0.95–1.51) for the 2nd tertile and 2.16 (1.68–2.78) for the 3rd tertile. These associations remained statistically significant, even after adjusting for multiple covariates such as age, education, regular exercise, smoking, and alcohol consumption. CONCLUSION: These findings indicate that urinary sodium is significantly associated with metabolic syndrome in Korean adults.

Cancer Prevalence among Physicians in Korea: A Single Center Study / 가정의학회지

BACKGROUND: There is little research regarding whether working as a physician affects cancer risk. Moreover, there is no research on cancer prevalence among physicians in Korea. This study utilized the Korea National Cancer Incidence Database to determine whether the prevalence of cancer among physicians differs from the prevalence of cancer within the general population. METHODS: We analyzed the medical records of a representative sample of 382 doctors who underwent a health examination between 2010 and 2013 at a health examination center in a Ewha Womans University Medical Center.Cancer incidence was measured as cases that were eventually diagnosed as cancer according to a biopsy. RESULTS: We collected medical records from 382 physicians (mean age, 51.9±8.1 years) and calculated the standardized prevalence ratios compared to the general population. Thirty physicians (9 male and 21 female) were identified as having cancer. Physicians had a significantly higher prevalence of cancer compared to the general population.Cancer prevalence in male physicians was found to be 2.47 times higher than the prevalence expected within the general population (P=0.006). Among female physicians, cancer prevalence was 3.94 times higher than that in the general population (P<0.001). CONCLUSION: This study revealed that physicians had a higher prevalence of cancer compared to the general population in Korea, which suggests that there may be a problem present in the health care of physicians. Changes to the working environment of physicians will be needed to reduce the high prevalence of cancer among physicians.

Poor Health-Related Quality of Life and Proactive Primary Control Strategy May Act as Risk Factors for Acute Coronary Syndrome

BACKGROUND AND OBJECTIVES: Increasing evidence supports that psychological factors may be related to development of coronary artery disease (CAD). Although psychological well-being, ill-being, and control strategy factors may play a significant role in CAD, rarely have these factors been simultaneously examined previously. We assessed comprehensive psychological factors in patients with acute coronary syndrome (ACS). SUBJECTS AND METHODS: A total of 85 ACS patients (56 unstable angina, 29 acute myocardial infarction; 52.6+/-10.2 years; M/F=68/17) and 63 healthy controls (48.7+/-6.7 years, M/F=43/20) were included. Socio-demographic information, levels of psychological maladjustment, such as anxiety, hostility, and job stress, health-related quality of life (HRQoL), and primary and secondary control strategy use were collected through self-report questionnaires. RESULTS: There was no significant difference between the ACS group and control group in levels of anxiety, hostility, and job stress. However, ACS patients had significantly lower scores on the general health perception and bodily pain subscales of HRQoL than the control group. The ACS group, as compared with the controls, tended to use primary control strategies more, although not reaching statistical significance by univariate analysis. Multivariate logistic regression analysis after adjusting age and gender identified the physical domain of HRQoL {odds ratio (OR)=0.40}, primary control strategy (OR=1.92), and secondary control strategy (OR=0.53) as independent predictors of ACS. CONCLUSION: Poor HRQoL and primary control strategy, proactive behaviors in achieving ones' goal, may act as risk factors for ACS, while secondary control strategy to conform to current situation may act as a protective factor for ACS.

The Association of Lung Age with Smoking Status in Korean Men / 가정의학회지

BACKGROUND: Lung age, calculated from sex, forced expiratory volume in one second (FEV1), and height, was developed to illustrate premature changes to the lungs and could be used to motivate smoking cessation. However, this method has not been tested in association with smoking in Korea. The purpose of this study was to investigate the association of lung age with smoking and other factors in Korean males. METHODS: We reviewed the records of 1,100 healthy men who visited a health promotion center at Ewha Womans University Medical Center from January 2008 to June 2009. Lung age was calculated from FEV1 and normal predictive values of spirometry according to age in the Korean population. The difference between lung age and chronological age was evaluated in relation to smoking status, weight, body mass index, waist, muscle mass, fat mass, and exercise. RESULTS: The age difference was significantly higher in current smokers than in non-smokers (12.47 +/- 19.90 vs. 7.30 +/- 19.52, P < 0.001). Additionally, the age difference was positively correlated with life time pack-year (beta = 0.223; P < 0.001) and fat mass (beta = 0.462; P < 0.001). Lung age increased 1 year for 4.48 pack-year increase or for 2.16% increase in fat mass. CONCLUSION: We found a significant relationship between lung age and both smoking status and fat mass in healthy Korean males. Lung age may be a useful tool for motivating cessation of cigarette smoking and management of risk factors related to obesity.

Association of Serum gamma-Glutamyltransferase Level and Incident Prehypertension in Korean Men

Several lines of evidence indicate that prehypertension is more atherogenic than normal blood pressure. Serum gamma-glutamyltransferase (GGT) is known to be positively associated with prehypertensive status and the progression of hypertension. However, there have been no prospective studies of serum GGT level as a predictor of prehypertension. Apparently 13,435 healthy men (mean age 42.0 +/- 6.6 yr) with normal blood pressure were included in a prospective cohort study in 2005 and were followed up to 2010 with the endpoint being incident of prehypertension. During the follow up period (median 2.80 +/- 1.44 yr; actual follow-up 37,679.1 person-year), prehypertension was developed in 7,867 (58.6%) participants. Risk estimations for incident prehypertension were analyzed based on quartiles of serum GGT levels using multivariate adjusted Cox proportional hazards model. In unadjusted model, the hazard ratio for incident prehypertension for the highest 3 quartiles of baseline serum GGT level was 1.21 (1.13-1.29), 1.29 (1.21-1.38), and 1.57 (1.47-1.67) compared the lowest quartile of serum GGT level, respectively (P for trend < 0.001). These associations still remained statistically significant, even after adjusting for multiple covariates. These findings indicate that increased serum GGT level is independently associated with incident prehypertension in Korean men.

The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men

BACKGROUND: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently, there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. METHODS: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol. RESULTS: The mean age of the participants was 44.9+/-8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2: 0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). CONCLUSIONS: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.

The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men

BACKGROUND: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently, there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. METHODS: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol. RESULTS: The mean age of the participants was 44.9+/-8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2: 0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). CONCLUSIONS: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.

The Relationship Between Serum Total Bilirubin and Framingham Risk Score in Healthy Korean Men

BACKGROUND: Serum total bilirubin has been considered a harmful substance inducing oxidative reaction; but recently, there have been reports of it possessing antioxidative, anti-inflammatory and protective features against cardiovascular diseases. The purpose of this study was to investigate the relationship between total bilirubin and the Framingham risk score. METHODS: This study involved 3,414 healthy Korean men who underwent a medical check-up in a health promotion center in 2008. We calculated the Framingham risk score using age, smoking status, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol. RESULTS: The mean age of the participants was 44.9+/-8.8 years. The log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship in a simple linear regression analysis (R2: 0.018, P<0.001). In a multivariable analysis model, as well, the log transformed serum total bilirubin level and the Framingham risk score had a negative linear relationship (R2: 0.384, P<0.001). CONCLUSIONS: Our study showed a statistically significant negative relationship between total bilirubin and the Framingham risk score. Total bilirubin had a stronger relationship with the Framingham risk score than other standard cardiovascular risk factors except smoking, and thus may be useful in predicting cardiovascular risk in the outpatient clinic.

The improvement of quality of life in patients treated with bariatric surgery in Korea / 대한외과학회지

PURPOSE: Bariatric surgery is considered an efficient treatment for severe obesity, but postoperative complications and psychosocial problems may impact quality of life (QoL). Although QoL is an important aspect of bariatric surgery, few studies have evaluated the changes in QoL. We examined whether severely obese patients who had undergone bariatric surgery had better QoL compared with severely obese adults who had not undergone bariatric surgery in Korea. METHODS: Data were obtained from 78 participants in two groups; bariatric surgery group (n = 53) and nonsurgery group (n = 25). EuroQoL-5D (EQ-5D), the impact of weight on quality of life-lite (IWQoL-lite) and the obesity-related psychosocial problem scale (OP-scale) were used to assess the improvement of QoL. RESULTS: A total of 78 patients completed the QoL forms as part of their surgical consultation. In the EQ-5D, the changes of EQ-5D 3 level and EQ-5D visual analogue scale in the surgery group was 0.174 and 24.6 versus 0.017 and 17.8 in the nonsurgery group (P = 0.197 and P = 0.179). The changes of IWQoL-lite and OP-scale were significantly improved after bariatric surgery. In the IWQoL-lite, the mean changes in the surgery group was 33.4 versus 14.3 points in the nonsurgery group (P = 0.000). In the OP-scale, the mean changes in the surgery group patients scored 39.3 versus 9.0 points in the nonsurgery group (P = 0.000). CONCLUSION: We demonstrated significant improvement of QoL observed after bariatric surgery compared to nonsurgical procedure. The results of this comparative study favor bariatric surgery for the treatment of severe obesity.