Incidence of Primary Liver Cancer in Subjects with Chronic Hepatitis B in Korean National Liver Cancer Screening Program

BACKGROUND/AIMS: To optimize efficacy of National Liver Cancer Screening Program (NLCSP) for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer and its predisposing factors in the program. METHODS: From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg) positive participants who received at least two or more abdominal ultrasonography under NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary liver cancer was calculated and related clinical factors were investigated. RESULTS: During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292 subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%). Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8 per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%, respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI] 1.97–38.71, P=0.024), age (HR 1.08, 95% CI 1.01–1.15, P=0.024) were significantly associated with cancer development. CONCLUSIONS: Despite of high rate of oral antiviral therapy, incidence of primary liver cancer is not low in CHB patients in Korea. Old age and presence of LC are independently associated with higher risk of cancer development during surveillance. This study could be used as baseline data for quality control of NLCSP.

Comparison of 'Serial 7's Subtraction' and "Sam-Chun-Ri-Gang-San" Backward for Evaluation of in Primary Medicine

BACKGROUND: There are two variations in the attention subitem of the Mini-Mental State Exam (MMSE): 'serial 7's subtraction and "sam-chun-ri-gang-san" backward. At a scale of one to five, they can be used interchangeably, which inevitably brings a considerable difference in results. Thus, we compared the scores of the 'serial 7's subtraction' and the "sam-chun-ri-gang-san" backward and analyzed the influence of sociodemographic factors on the differences. METHODS: We administered the Korean MMSE including the two types of attention item: serial 7's and "sam-chun-rigang-san" backward to 239 community-dwelling elderly people aged 65 or older in Kyung Hee University Medical Center and four Seoul senior centers and analyzed the difference from June 2012 to July 2012. RESULTS: The score for "sam-chun-ri-gang-san" backward (2.5+/-2.1) was lower than that of the serial 7's (3.4+/-1.7) by a mean point of 0.9+/-1.9. The score of "sam-chun-ri-gang-san" backward was zero in 31.4% of the subjects. However, only 9.6% scored zero on the serial 7's. The ratio of the same scores between two tasks was 36.0%. Education was the primary source of variance on difference score, followed by the number of family. There was no significant effect of age or gender when the score of difference was analyzed by multiple regression. CONCLUSION: In this study, subjects tended to outperform the serial 7's in general. Upon administering "sam-chun-rigang-san" backward instead of serial 7's due to the preference of the patient, we should take into account that the score of "sam-chun-ri-gang-san" backward was 0.9 point (mean value) lower than serial 7's to ensure appropriate interpretation of MMSE score.

Association between Bone Mineral Density and Sleep Duration in the Korean Elderly Population / 가정의학회지

BACKGROUND: An association between sleep duration and a wide spectrum of diseases has been reported, but little is known about its relationship with bone mineral density (BMD). Previously conducted studies in Korea and abroad have reported results that are controversial. The present study sought to assess whether sleep duration can be considered an independent risk factor of osteoporosis. METHODS: We included participants over the age of 60 years with data on self-reported habitual sleep duration and BMD measured with dual X-ray absorptiometry. Comprehensive data on the study sample was obtained from the Korea National Health and Nutritional Survey performed from 2008 to 2010. Sex-stratified multiple regression analyses were conducted with adjustments for possible confounding factors. RESULTS: There was a significant inverse dose-dependent association between sleep duration and BMD measured at total hip, femur neck, and lumbar spine for women and total hip and femur neck for men. Sex-stratified regression analyses adjusted for age and body mass index revealed that sleep duration had a negative correlation with BMD at total hip and femoral neck for both women (beta = -0.0048; P = 0.0172 for total hip, beta = -0.0037; P = 0.0303 for femur neck) and men (beta = -0.0057; P = 0.0218 for total hip, beta = -0.0057; P = 0.0143 for femur neck). For women, the significance remained after further adjustment of confounding variables. CONCLUSION: Prolonged sleep duration appears to have a significant association with lower total hip and femur neck BMD in elderly women but not in elderly men.

The Association between the Low Muscle Mass and Osteoporosis in Elderly Korean People

The purpose of this study was to predict osteoporosis risk as decreasing muscle mass and to declare the cut-off value of low muscle mass in an elderly Korean population. This study was based on data from the 2008-2010 Korea National Health and Nutritional Examination Surveys (KNHANES). The subjects included 1,308 men and 1,171 women over 65 yr. Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured by dual energy X-ray absorptiometry (DXA), and appendicular skeletal muscle was adjusted by height as a marker of sarcopenia. After confirming the correlation between low muscle mass and BMD, the best cut-off value of muscle mass to estimate osteoporosis was suggested through the receiver operating characteristic (ROC) curve. For both men and women, BMD correlated positively with low muscle mass when ASM/Ht2 was used as a marker for sarcopenia. The ROC curve showed that ASM/Ht2 was the best marker for osteoporosis at a cut-off value of 6.85 kg/m2 for men and 5.96 kg/m2 for women. When these cut-off values were used to determine sarcopenia, the risk of osteoporosis increased 4.14 times in men and 1.88 times in women. In particular, men (OR 2.12) with sarcopenia were more greatly affected than women (OR 1.15), even after adjusting for osteoporosis risk factors. In elderly Korean people, sarcopenia is positively correlated with BMD and there is a strong correlation between sarcopenia and osteoporosis with risk of bone fracture.

Relationship between Physical Activity Level, Amount of Alcohol Consumption and Metabolic Syndrome in Korean Male Drinkers / 대한스포츠의학회지

Studies on the effect of drinking and exercise on metabolic syndrome (MetS) are lacking despite the high prevalence of the disease and the high drinking rate among Korean men. This study sought to elucidate the association of MetS with alcohol consumption and physical activity. Data on male drinkers aged 19 to 65 years were obtained from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2009. Participants were divided into mild to moderate and heavy drinkers according to daily alcohol consumption. By the intensity of physical activity expressed as metabolic equivalents (METs), participants were categorized into inactive, moderate active, and health enhancing groups. Logistic regression models were used for analyses. Prevalence of MetS was significantly higher in heavy drinkers compared to mild to moderate drinkers. In heavy drinkers, low high density lipoprotein (HDL) was significantly less frequent while the remaining four components were more frequent. Compared to inactive group, health promoting group showed a 35% decrease in MetS after adjusting for confounding factors. Higher physical activity level was associated with less low HDL and high triglyceride (TG) in mild to moderate drinkers and smaller waist in heavy drinkers. In Korean men, higher level of physical activity was associated with less low HDL and high TG, and physical activity achieving more than 3,000 MET.min/wk decreased the risk for MetS. Higher physical activity level was also associated with less large waist circumference in heavy drinkers, while there was no significant association with development of MetS.

Comprehensive Geriatric Assessment for Elderly Orthopedic Inpatients Consulted by Geriatric Medicine in a Hospital

BACKGROUND: With a rapidly aging population, more elderly patients are being hospitalized than before. Thus, a comprehensive geriatric assessment medium is needed to carefully evaluate geriatric patients. The author's university hospital has a geriatric medicine team to where patients are referred for comprehensive evaluations. Their services will be introduced here. METHODS: From December 2010 to January 2012, the team performed comprehensive geriatric assessments comprising of a thorough review of systems, physical examination, and surveys, and reviewed past medical records of the elderly hospitalized patients aged 65 or over, referred from the Department of Orthopedics. RESULTS: Of total 58 patients, 4 patients (6.9%) had severe dysfunction in the activities of daily living with the score of 16 or higher. Twenty-two patients (73.3%) had cognitive impairment or dementia upon assessing cognitive function after excluding those previously diagnosed with dementia or those within 5 days after surgery, thus predisposed to delirium who had tested mini mental state examination for cognitive function level test. Fifteen patients (31.3%) had mild depression, while four (8.3%) had moderate depression; and 37 patients (67.3%) were at moderate risk and five (9.1%) were at high risk for developing delirium. CONCLUSION: A comprehensive evaluation of the functional status of elderly hospitalized patients was helpful in detecting medical problems other than the initial diagnosis. A significant proportion of the elderly patients we assessed were suspected to have cognitive impairment.

The Korean National Liver Cancer Surveillance Program: Experience of a Single Healthcare Center in 2011 / 대한내과학회지

BACKGROUND/AIMS: The aim of this study was to investigate outcomes and current status of the National Liver Cancer Screening Program in a single healthcare center. METHODS: Subjects received abdominal ultrasonography (US) and/or serum alpha-fetoprotein (AFP) testing from January 2011 to December 2012. The clinical characteristics of the subjects, detection rate of liver cancer, and direct medical costs were investigated. RESULTS: Among 621 subjects, five (0.8%) were newly detected with hepatocellular carcinoma. Four underwent curative treatment, and all were detected by US (two surgical resections and two radiofrequency ablations). The remaining patient, whose disease was detected by an elevated AFP level, was infiltrative type with a poor prognosis. Of 492 subjects whose medical history was revealed, 45% had hepatitis B, 5% had hepatitis C, 1% had both, and 3% had other liver cirrhosis including alcoholic cirrhosis. The remaining 46% of subjects had no risk factors for liver cancer. Direct medical costs were estimated at 8,420,000 Won for detecting a single case of liver cancer, which was much lower than that of stomach cancer at 45,060,000 Won. If the non-high risk subjects were excluded, the cost for a single case of liver cancer decreased to 5,560,000 Won. CONCLUSIONS: The high-risk group should be more accurately defined by appropriate screening tests to optimize liver cancer surveillance. The detection rate by the liver cancer surveillance program was about 1%, and most tumors could be detected at the early stage by US. The role of AFP seemed to be small for early defection of liver cancer.

Predictability of Various Serial Subtractions on Global Deterioration Scale According to Education Level / 가정의학회지

BACKGROUND: The serial 100-7s subtraction, an item on the Mini-Mental State Examination (MMSE), is well known for being difficult for uneducated people. Therefore, we investigated into alternative serial subtractions for serial 100-7s subtraction in uneducated people. METHODS: One hundred sixty-nine subjects were enrolled by neurologic or neuropsychiatric out-patient clinics in 4 university medical centers. The subjects were divided into two groups: an uneducated group and an educated group (at least primary schooling) by questionnaire. We investigated the correlation between incorrect number of serial subtractions and Global Deterioration Scale (GDS) score in both groups and undertook receiver operating characteristic (ROC) curve analysis. MMSE including serial 40-4s subtraction, serial 20-2s subtraction, and serial 10-1s subtraction instead of serial 100-7s subtraction were arbitrally named MMSE4, MMSE2, and MMSE1. RESULTS: In the educated group, serial 100-7s subtraction showed the highest correlation with GDS score (correlation coefficient, 0.465; P or = 3) in uneducated subjects, the area under the curve (AUC) was 0.648, 0.770, 0.758, and 0.711, respectively, and in educated subjects, AUC for MMSE, MMSE4, MMSE2, and MMSE1 was 0.729, 0.719, 0.716, and 0.714, respectively. CONCLUSION: Out of MMSE items, serial 100-7s is adequate in the educated elderly, but may be less adequate in the uneducated elderly. Serial 40-4s seems to be more appropriate for MMSE in the uneducated elderly.

Prevalence of Osteoporosis, Related Factors in 66-Year-Old Women in Korea

BACKGROUND: With the rapid increase in the elderly population and the ensuing increase in osteoporosis and subsequent fractures, there has been a rise in socioeconomic costs. This study evaluated the relationship between osteoporosis and physical function in 66-year-old Korean women. METHODS: All of the 193 Korean women aged 66 years were recruited from life-transition health examinations from May to December, 2007. Background information was collected through a self-administered questionnaire; and height, weight, and waist circumference were measured. Bone mineral density of the lumbar spine was measured with the Dual Energy X-ray Absorptiometry and the 'timed up and go (TUG)' and 'one-leg balance (OLB)' tests were administered. Risk factors for osteoporosis were analyzed by correlation coefficients and binary logistic regression analysis. RESULTS: The prevalence of osteoporosis for 66-year-old women was 25.9%. A short stature and lower body mass index (BMI) were associated with osteoporosis of the lumbar spine. A longer time to complete the TUG test (>10 second) was associated with a 4-time higher prevalence of lumbar osteoporosis, which was not observed with the OLB test. CONCLUSIONS: One out of four 66-year-old Korean women had osteoporosis. A longer TUG time, short stature, and lower BMI were associated with osteoporosis.

The Validity and Reliability of the Kaigo-Yobo Checklist in Korean Elderly

BACKGROUND: This study was done to evaluate the validity and reliability of the Kaigo-Yobo (K-Y) checklist in the Korean elderly population. METHODS: The study population included 283 men and women over 65 years who visited the three community senior's welfare centers located in Seoul and Gyeonggi province from March 29, 2011 to May 26, 2011. The Korean frailty index (FI), Japanese K-Y checklist, Cardiovascular Health Study frailty index (CHSFI), activities of daily living, and Korean Mini-Mental Status Examination were completed for each participant. Reliability was tested by internal consistency (Cronbach's alpha), as was the test-retest reliability, at a 2-week interval. Validity was tested by the area under the curve (AUC) from the receiver operating characteristics curve as a predictor of frailty according to the CHS criteria and the validity index estimated by the reliability index. RESULTS: The correlation coefficients between Korean FI and K-Y checklist, Korean FI and CHSFI, and K-Y checklist and CHSFI were 0.61, 0.43, and 0.44 respectively. The range of Kappa value for each item on the Korean FI was 0.28 to 0.60 and 0.19 to 0.65 for the K-Y checklist. Cronbach's alpha for the Korean FI was 0.58 and 0.64 for the K-Y checklist. The AUC for the Korean FI was 0.79, and 0.64 for the K-Y checklist. The validity index for the items on the Korean FI ranged from 0.28-0.53 to 0.60-0.78 and 0.19-0.44 to 0.65-0.81 for the K-Y checklist. CONCLUSION: The K-Y checklist is a valid and reliable instrument to measure frailty in the Korean elderly population. Follow-up studies are needed.

Trends of the New Outpatients in a University-based Family Practice / 가정의학회지

BACKGROUND: Analysis of outpatient visits to primary care offers essential data for residency training by understanding 'reasons for encounter (RFE).' This study was designed to recognize the effect of population aging on demographic characteristics and RFEs. METHODS: We included all patients who had visited family practice clinic in Kyung Hee University Hospital in Seoul during each first 5 working days of September, October, and November in 2001 and 2008. New patients included those who hadn't visited within the last 6 months or more. Information on each patient's age, sex, and reason for encounter was obtained from the electronic medical record. The RFEs were compared using International Classification of Primary Care (ICPC)-2-E. RESULTS: Mean age of overall outpatients was 50.5 and 52.4 years in 2001 and 2008 respectively. The number of new outpatient visits increased from 215 (21.3%) to 326 (29.7%) between 2001 and 2008 (P < 0.001) along with the number of patients aged 65 or more from 7.4% to 12.0% (P = 0.08). Mean age of established patients was 52.5 and 56.9 years (P < 0.001), and the patients aged 65 or more was 14.1% and 35.8% (P < 0.001) in 2001 and 2008 respectively. Analysis by ICPC-2-E revealed a decrease in chapter A in 2008 (P = 0.03) and an increase in chapter F, L, and X (P = 0.01, 0.003, <0.001). Component 1 had increased (P = 0.01), and component 2 had decreased (P = 0.04) in proportion. CONCLUSION: Changes in population composition have brought a shift of the distribution of age in outpatients, more significantly in follow-up patients. Comparison by ICPC-2-E showed changes in RFEs of new patients between 2001 and 2008.

Geriatrics in Family Medicine Residency Program: Training Conditions and Suggestions

BACKGROUND: With the number of geriatric population on a steep increase, the roles of family physicians broaden to give comprehensive medical care to the elderly. Therefore, geriatrics is becoming increasingly more important for the residents of family medicine. The authors have surveyed and researched on resident's current attention, actual training conditions, and future needs on geriatrics. METHODS: Family medicine residents in 79 hospitals registered to Korean Family Medicine Resident Union were enrolled. By means of electronic and postage mail surveys, informations were gathered; including demographics, the order of importance of nine training curricula, the necessity of training itself, the facility and academic conference of geriatrics training. RESULTS: A total of 173 residents in 45 hospitals replied with return rates of 51.9%. Among the total, 169 (97.7%) of the answered agreed on the necessity of geriatrics training. Of the nine curricula, geriatrics was considered the most important. And residents considered family medicine outpatient department and inpatient ward to be the most important place for geriatrics training. Furthermore, the residents considered elderly's diseases or symptoms as more important conference title, but the parameters such as the quality of life, physiology of aging, care in nursing home were considered less important. CONCLUSION: The geriatrics training program is not up to the standards of residents' satisfaction. This is considered to be due to the absence of a formal training program. To provide a better care for the elderly, it is compulsory to gain broad knowledge of geriatrics and actual experience out in the field.

Influence of Loneliness on Cognitive Decline among Elderly Living Alone in Korea: One Year Prospective Study

BACKGROUND: Dementia is the most important factor affecting everyday life of the elderly and there have been studies on the relationship between dementia and social withdrawal or loneliness. However, there is a lack of investigations on the relationship between loneliness and cognitive function in the elderly living alone. METHODS: Ninety five community-dwelling elderly people registered to Sungbook elderly welfare center in Seoul, who were living alone, were enrolled in the study. Personal visits by three pre-trained researchers were made during April 2006. One year later, 11 elderly dropped out, and 84 elderly were interviewed in the same way. They were interviewed based on loneliness scale, social support, Hasegawa dementia scale, instrumental activities of daily living, and depression. RESULTS: The mean age of the subjects was 78.3 years. Most of them were women (90.5%) and education level was low (no schooling in 69%). The loneliness scale did not change much during one year (P=0.63), but the instrumental activities of daily living (IADL) score had worsened from 10.5 to 11.2 (P=0.002) The mean Hasegawa dementia scale score decreased from 23.2 to 21.0 during one year (P<0.001). Multivariate regression analysis for the one-year difference in Hasegawa Dementia Scale revealed loneliness was a significant factor after adjusting for age, the level of education, social support, IADL score, and depression (regression coefficient=-0.712, P=0.02). CONCLUSION: Loneliness was associated with a decline in cognitive function in the elderly people living alone. In contrast, social withdrawal and depression had no effect on changes of cognitive function during one year.

An Analysis of Original Articles Targeting the Elderly Published by Korean Medical Doctors in 2007

BACKGROUND: Few analyses of the original articles targeting the elderly submitted by Korean medical doctors have been published. METHODS: We reviewed the articles on the elderly which were submitted in 2007 by Korean medical doctors and detected through KoreaMed, KMbase, PubMed. RESULTS: Total 169 articles were detected in foreign journals; case report, articles not targeting elderly, not by medical doctors, published in Korean journal, and review article were excluded. Finally, 10 articles were found to have been submitted in foreign journals by Korean doctors, 2007. In a similar way, 126 articles were found to have been submitted in Korean journals by Korean doctors, 2007. The most common articles were about dementia and/or cognitive function, and function change, endocrine disease, geriatric surgery were followed in order. Neuropsychiatrists were publishing the most articles, and neurosurgeons were the next. CONCLUSION: Out of articles on the elderly published in 2007, case reports were much more common than original articles. Articles on the health promotion and disease prevention, medical ethics, long term care need to be published much more.

Relationship of Helicobacter pylori Infection with Appetite

BACKGROUND: It has been reported that H.pylori causes changes in fundic leptin levels and plasma levels of ghrelin, and that eradication of H.pylori infection can increase appetite. There is also a report that showed changes of appetite between before and after eradication of H.pylori in peritoneal dialysis patients. Our study investigated the degree of appetite between H.pylori negative group and H.pylori positive group in adults. METHODS: The subjects included those without appetite- related diseases. We carried out gastroscopy and then performed CLO test in subjects who had no gastric lesions. We interviewed the study subjects about appetite related behavior (three items: desire to eat, hunger before meal, deliciousness) using visual analogue scale. We examined the appetite related behavior between CLO (??) group and CLO (+) group. RESULTS: The difference of age, sex, height, weight, body mass index, alcohol con sumption, blood pressure, hemoglobin, fasting blood sugar, AST, ALT, GGT between CLO (??) group and CLO (+) group were not statistically significant. The difference of appetite related behavior (three items) between CLO (??) group and CLO (+) group was not statistically significant. CONCLUSION: The degree of appetite between CLO (??) group and CLO (+) group was not different.

Loneliness and Cognitive Function in the Elderly Living Alone: Cross-sectional Study

BACKGROUND: Many foreign researchs show that physical illness and loneliness are causes of cognitive decline in old men. Especially, living alone group feels more depressive mood and loneliness than married group. Neverthe- less, there is no domestic research whether loneliness is associated with cognitive decline. METHOD: We have interviewed 95 elderly, living alone, who are supported by an elderly wellfare office of Seoul city. Educated three interviewers investigated sociodemographic characteristics, loneliness scale, dementia scale, instru- mental activity of daily living, and depression scale. RESULTS: The subjects were almost women(90.5%), low educated(no schooling; 67.4%), low economic status(income < 600,000 won/month; 97%) and had moderate-high degree loneliness(UCLA lonliness scale 49.8), mild depression (GDSSF-K score; 7.8). In a multiple regression analysis, there was no correlation between the loneliness and cognitive function(p=.878), no association between social disengagement index and cognitive function(p=.817). However, age (p=0.005), education(p=0.000), smoking(p=0.045) had statistical correlation with cognitive function. CONCLUSION: In living alone elderly, the cognitive function is not associated with loneliness and social support, but associated with age, education, smoking.

Body Mass Index and C-Reactive Protein in the Healthy Korean Aged Men

The purpose of this study was to determine the relationship between plasma C-reactive protein (CRP) and body mass index (BMI) in elderly Korean men. A review of routine health examination records were done. Out of 671 eligible elderly men, who had their routine health examination in 2001 at a Health Promotion Center of a university hospital, 367 subjects were included after excluding inflammatory conditions. Subgroup analyses were performed on those who did not smoke and exercised regularly. Body composition, blood pressure, blood samples and radiologic examinations including chest radiography and abdominal ultrasound were obtained from each subject. Age, BMI, current smoking, regular exercise, WBC count, HDL-cholesterol, gamma glutamyl transferase were independently associated with logCRP. BMI subgroups according to the Asia-Pacific guideline did not show any difference in CRP level from each other by ANCOVA (p>0.05). However, BMI groups subdivided according to our criteria showed an association with CRP; the CRP level was lowest in the group of BMI between 18.5-19.4 and showed significant difference from BMI group of the highest BMI group (> or =29.0). Since elevated CRP levels are associated with higher risk for cardiovascular disease, lower BMI (18.5-19.4) levels may be advised for healthy elderly men in Korea.

Prevalence and Risk Factors of Functional Constipation in the Elderly

BACKGROUND: Gastrointestinal (GI) symptoms are believed to be common in the general population, and constipation is one of the most representative GI symptoms. However, the prevalence and risk factors of functional constipation are not well known in Korea. We aimed to study the prevalence of, and risk factors for, constipation in the elderly. METHODS: We randomly selected 852 among 854 (excluded by cancer and dementia) subjects, ages 65 yr and older, in three different geriatric welfare facilities in December, 2003. The prevalence of functional constipation was based on the Rome II criteria and the survey on risk factors for constipation was performed. RESULTS: Functional constipation had a prevalence of 26.6% and there was no difference between men and women. Exercise, fluid, fruit, vegetable intake, anal diseases and age related risk factors were associated with constipation. CONCLUSION: In the elderly, constipation is a common complaint. Further studies are now required for risk factors of constipation.

Insulin Resistance in Adolescence and the Related Factors: in 10th Grade High School Students in Seoul

BACKGROUND: There are some studies concerning fasting insulin and insulin resistance in normal healthy Korean adults, but none exists especially for adolescence. Therefore, we investigateck insulin resistance and its related factors in adolescence. METHODS: We analyzed 582 10th grade high school students. Height, weight, abdominal circumference, systolic and diastolic blood pressure, fasting glucose, total cholesterol, hemoglobin were measured. Fasting state and parent's and student's previous medical history were guestioned. We used Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) as an indicator of insulin resistance. RESULTS: By HOMA-IR 2.15, the subjects were divided into the insulin sensitive and the resistant groups. Two groups showed significant differences in body mass index, systolic diastolic blood pressure, fasting glucose, fasting insulin, total cholesterol and abdominal circumference (P <0.05). HOMA-IR was strongly related to the body mass index (r=0.53) and abdominal circumference (r=0.52), but weakly related to the total cholesterol (r= 0.20). According to logistic regression analysis of HOMA-IR, the odds ratio of the body mass index was 1.17 and that of abdominal circumference was 1.06 (P <0.05). CONCLUSION: HOMA-IR showed strong relationship with body mass index, abdominal circumference, but showed weak relationship with total cholesterol. There was no significant correlation with the parent's diabetic medical history. Therefore we conclude that in adolescence the body mass index or the abdominal circumference is far more important factor than the parent's diabetic history.

Estimation of Body Height in Korean Elderly

BACKGROUND: Height is essential variable for assessing nutritional status, estimating glomerular filtration rate, and drug dosage besides in epidemiologic study. In old age, spinal deformity and thinning of the intervertebral discs may produce a spurious decrease in height. In the nonambulants, standard methods of height measurement may be impractical. The present study has been designed to predict the height using regression analysis by long bone measurement. METHODS: One hundred twelve persons in one elderly welfare facility were studied. Standing height was measured. Total arm length, upper arm length, forearm length, tibial length in erect and supine position were measured. A nomogram has been prepared from these data to predict height. RESULTS: Multiple regression analysis was used to measure relationship between measured height, age, sex, and each of the measured parameters. Among the parameters in the erect position, height was best predicted by erect tibial length(ETL)(p<0.01). Among the parameters in the supine position, height was best predicted by supine total arm length(STAL)(p<0.05). Estimation of height was calculated by linear regression analysis. Estimation of height(cm)=93.036+2.383 x ETL(cm)-0.233 x age-5.747 x sex(R2=.815). Estimation of height(cm)=87.985 + 1.775 x STAL(cm)-0.151 age-6.787 x sex(R2=.803). CONCLUSION: In the present study it has been shown that erect tibial length and supine total arm length may be a good predictor of total height. The nomogram may provide the prediction of height in the nonambulant elderly.