Association between Sleep Duration and Presbycusis in Korean Adults: Korea National Health and Nutrition Examination Survey / 가정의학회지

Background@#Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years. @*Methods@#We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and 40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates. @*Results@#The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration. @*Conclusion@#Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Utilization of End-of-Life Care Rooms by Patients Who Died in a Single Hospice Unit at a National University Hospital in South Korea / 한국호스피스완화의료학회지

Purpose@#For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. @*Methods@#This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. @*Results@#During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P＜0.001). @*Conclusion@#To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

Association between Serum Folic Acid Levels and Asthma in the Korean Population: A Study Based on the 2016–2018 Korea National Health and Nutrition Examination Survey / 가정의학회지

Background@#Folic acid is involved in inflammatory reactions; however, the association between folic acid and allergic diseases, particularly asthma, remains unclear. Thus, this study aimed to evaluate the association between serum folic acid levels and asthma in Koreans. @*Methods@#This study analyzed the serum folic acid levels of 6,615 individuals included in the 2016–2018 Korea National Health and Nutrition Examination Survey. The prevalence of asthma was determined using a questionnaire that identified cases of physician-diagnosed asthma. The relationship between serum folic acid levels and asthma was analyzed using logistic regression analysis. @*Results@#Multiple logistic regression analysis showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of asthma after adjusting for confounding factors including sex, age, household income, current smoking, current alcohol use, and body mass index (odds ratio [OR], 0.930; 95% confidence interval [CI], 0.876– 0.987; P=0.017). The relationship between the adjusted odds of asthma and serum folic acid levels were consistently inverse (OR, 2.266; 95% CI, 1.126–4.420; P for trend=0.038). @*Conclusion@#Serum folic acid levels are inversely associated with physician-diagnosed asthma in the Korean population.

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.

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.

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.

Cytomegalovirus-Associated Severe Direct Antiglobulin Test Negative Hemolytic Anemia: A Case Report / 임상소아혈액종양

Cytomegalovirus is a common virus that is mostly asymptomatic when infected, but rarely causes life-threatening hemolysis especially in immunocompromised children. We report a case of antiglobulin test negative severe hemolytic anemia caused by cytomegalovirus infection developed in an immune competent 9-year-old girl. The patient's hemoglobin level was 4.8 g/dL on the day of admission. The diagnosis was achieved by exclusion of other causes of hemolytic anemia and serological evidence of recent CMV infection. The patient was successfully treated with anti-viral agents and steroids resulting in recovery from anemia. Clinicians should consider cytomegalovirus infection in the differential diagnosis of hemolytic anemia in pediatric patients.

Responses of Medical Students to Using Smartphone Video at Clinical Performance Examination / 의료커뮤니케이션

BACKGROUND: There are practical difficulties to show exact clinical symptoms such as seizure to medical students at Clinical Performance Examination (CPX). We developed a new CPX case of child's seizure on video using smartphone.METHODS: A total of 356 4th-year students of five universities in Daegue-Gyeongbuk and Gyeongnam area took the clinical skill examination from June 13th to 17th in 2016. Among them, 72 students took the new CPX case in June 15th and 71 students filled out the questionnaire on whether the new CPX with smartphone video is helpful, authentic, difficult, and necessary for other CPX. All the questions were measured on 5-Likert scale.RESULTS: Mean score of the new CPX was 57.1, lower than the mean scores of the other 11 CPX cases, 62.8. For the question “Smartphone videos helped to solve the problem”, 45 students (63.4%) answered ‘Very much’. For the question “Is it realistic compared to other questions?” 30 students (42.3%) and 25 students (35.2%) answered ‘Very much’ and ‘Much’. For the question “Is it difficult compared with other questions?” 18 students (25.4%) and 26 students (36.6%) answered ‘Very much’ and ‘Much’. As for the question “I would like to have more tests using smartphone video”, 26 students (36.6%) answered ‘So and so’.CONCLUSION: A majority of students responded that video presentation was helpful and authentic to figure out the CPX, whereas they assessed smartphone video was more difficult compared with other CPXs. Further, students were negative toward using smartphone video for the other CPXs.

Structured Assessment to Evaluate a Family Medicine Clerkship Program / 의학교육논단

This correction is being published to revise the acknowledgements of the above article.

Structured Assessment to Evaluate a Family Medicine Clerkship Program / 의학교육논단

This study was conducted to analyze the strengths and weaknesses of a 3-week family medicine clerkship program based on the results of an online survey taken by the students (N=127) and a structured interview with a focus group (n=10), aimed to improve the quality of the clerkship program. The online survey contained questions pertaining to goals, schedule, contents, arrangement, atmosphere, environment, evaluation, and satisfaction regarding the clerkship. The focus group interview addressed the schedule and achievements of the program. Scores were reported on a 5-point Likert scale. Most students were highly satisfied with the overall quality of the clerkship. The structured interview results showed that 97.6% of the clerkship program was executed according to the schedule. The focus group reported a perfect score of 5 points on several measures including: accomplishment of the educational goals of the family medicine clerkship, providing many chances to obtain medical histories and perform physical examinations on real patients, experience with various symptoms and diseases, positive attitudes of faculty members when teaching, notification of the guidelines for evaluation beforehand, well-constructed and effective clerkship schedule, and reflection of student feedback. However, the focus group gave low scores on: support for health accidents of students, access to patient information, enough opportunities to practice clinical skills, appropriate rest facilities for students, and fairness of clerkship evaluation process. In conclusion, the structured evaluation performed after the 3-week clerkship program motivated students and helped them ensure an efficient clerkship. This structured evaluation also suggested basic data to make the professor who is subject of the assessment. This study shows that structured assessment is an effective method which can be used to improve the quality of clerkships.

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.

Comparison of the Serum Cholesterol, Insulin Resistance and Markers of Metabolic Syndrome Based on Hepatitis C Virus RNA / 農村醫學 地域保健

OBJECTIVES: We compared the difference of lipid, insulin resistance and metabolic markers based on HCV RNA in Korean adults. METHODS: This was a cross-sectional study of 222 subjects visited the health promotion center of Pusan national university hospital from 2004 to 2007. Subjects were anti-HCV antibody positive and were performed RT-PCR for HCV RNA. The HCV RNA (+) group were 85 subjects, HCV RNA (−) control group were 115 subjects, and the HCV RNA (−) but past positive group were 22 subjects. We performed anthropometry, anti-HCV, RT-PCR, plasma concentrations of insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride. RESULTS: BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride, HDL cholesterol, insulin resistance such as HOMA-IR and QUICKI were not significantly different between HCV RNA positive and negative groups. The serum total cholesterol and LDL cholesterol level were significantly lower in the HCV RNA positive group than in the negative group (186.24±37.63 vs 197.22±37.23 mg/dl, p=0.041, 111.66±34.06 vs 121.38±35.50 mg/dl, p=0.042). After adjusting age and sex, high total cholesterol (≥ 200mg/dl) (adjusted OR=0.51, 95%CI 0.28-0.94, p=0.03) and high LDL cholesterol (≥ 130mg/dl) (adjusted OR=0.46, 95%CI 0.24~0.87, p=0.02) were inversely associated with being HCV RNA positive (p<0.05). CONCLUSIONS: The serum total cholesterol and LDL-cholesterol level were significantly lower in HCV RNA (+) group than in HCV RNA (−) group, but not in HCV RNA (−) but past positive group. Prospective cohort studies are needed to clarify the relationship between HCV RNA and metabolic markers.

Association Between Geriatric Nutritional Risk Index and Prolonged Length of Stay After Elective Hepatectomy in the Elderly Patients

BACKGROUND: Malnutrition is common in elderly patients with cancer and is associated with many adverse clinical outcomes, including longer length of hospital stay (LOS), muscle loss, and various postsurgical complications. In particular, elderly patients with hepatocellular carcinoma have a high risk for malnutrition, which is associated with mortality and reduced quality of life. Therefore, we evaluated the association between nutritional status and the LOS after hepatectomy for the treatment of hepatocellular carcinoma in elderly patients. METHODS: A retrospective study was conducted on 66 patients aged ≥65 years admitted consecutively from January 2010 to December 2014 for elective surgery to treat hepatocellular carcinoma. The Geriatric Nutritional Risk Index (GNRI) was applied for the assessment of nutritional risk in hospitalized elderly patients before surgery. RESULTS: The association between several factors that have been identified to influence outcomes and the LOS were evaluated by using multiple regression analysis. We found that only the GNRI was associated with the LOS. CONCLUSION: Our study shows that identifying nutritional risk using the GNRI before elective surgery is associated with increased risk of prolonged LOS. Therefore, prospective research based on GNRI can serve as a valuable resource for evaluating nutritional status of elderly patients under various clinical circumstances. Moreover, this particular research allows us to establish new ways of reducing the length of hospital stay for patients who underwent hepatic resection.

The Correlation of Meal Frequency and Nutrition with Mental Health Status in Women Aged 20-39 Years: The 5th Korea National Health and Nutrition Examination Survey, 2010-2012

BACKGROUND: We analyzed the relationship between meal frequency and nutrition with mental health status, and provide basic data on health promotion for breakfast and dinner skippers compared to non-skippers. METHODS: This is a cross-sectional study of 2,114 women aged 20-39 years who participated in the KNHANES in 2010-2012. We compared differences such as marital status, weight change, obesity, and under-weightness, smoking, high-risk alcohol consumption, exercise, suicide ideation, stress perception, depression, blood pressure, lipid profile, 25-Hydroxyvitamin-D, and ferritin levels among meal-skipping groups by cross tabulation analysis and general linear model analysis. RESULTS: The proportion of respondent undergoing weight loss efforts was over 50%, and of those roughly 75% were using a specific diet (e.g., fasting, skipping meals, single food diet). The breakfast and dinner skippers tended to be young, unmarried, and, had higher stress perception and suicide ideation than the non-skipping meal group. There were significantly higher incidents of obesity (body mass index > or =25 kg/m2, P=0.004), weight loss efforts, smoking, high-risk alcohol consumption, suicide ideation, and irregular menstruation in dinner skippers. In addition, there were significantly higher levels of under-weightness (P=0.004) and frequent eating out (over 5-6/week, P=0.005) in breakfast skippers. CONCLUSION: There were more physical and mental problems in dinner skippers in regards to high-risk alcohol consumption, suicide ideation, stress perception, and irregular menstruation. In the future, long-term studies are needed to reveal the correlation of meal frequency and nutrition with mental health status in patients who skip meals.

Association between Secondhand Smoke and Health-related Quality of Life in Middle-aged Korean Adults

BACKGROUND: The relationship between secondhand smoke and health-related quality of life is still unclear. The aim of this study was to investigate the association between secondhand smoke and health-related quality of life (HRQoL) in middle-aged Korean adults. METHODS: Data from 583 men and 3,869 women aged 40 to 64 years who participated in the fifth Korea National Health and Nutrition Examination Survey in 2010 to 2012 were evaluated. All of them are non-smokers or have smoked less than 5 packs of cigarettes for their whole life. Secondhand smoke exposed at home and workplace was assessed by using a questionnaire and HRQoL was assessed by EuroQoL five dimensions (EQ-5D). The association of secondhand smoke and HRQoL was analyzed by logistic regression analysis. RESULTS: Low HRQoL was associated with sex, age, body mass index, education level, family income level, occupation status, underlying diseases and secondhand smoke exposure. After adjustment for variables, secondhand smoke exposure at home was positively associated with the anxiety/depression dimension of EQ-5D (Odds ratio: 1.49, 95% Confidence interval: 1.02-2.18). CONCLUSIONS: Secondhand smoke exposure at home is associated with anxiety and depression dimensions of EQ-5D in middle-aged Korean adults.

Excessive Sodium Intake and Related Factors According to Energy Intakes Among Korean Elderly: A Nationwide Cross-Sectional Study

BACKGROUND: Few large-scale studies have investigated sodium intake in Korean elderly. We examined excessive sodium intake and related factors according to energy intake in this population. METHODS: We conducted a cross-sectional study using data from the fifth Korea National Health and Nutrition Examination Survey 2012. We analyzed the 24-hour dietary recall data from 1,496 elderly individuals (635 men, 861 women), who were then categorized into three groups according to energy intake-insufficient, appropriate, and excessive. The association between sociodemographic factors and 4 g or more of sodium intake were examined by the multivariable logistic regression model. RESULTS: Mean sodium intake was 4.7 g/day for men and 3.3 g/day for women. Subjects who consumed excessive energy had a higher risk of consuming 4 g or more of sodium in men (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.24-5.08) and women (OR, 3.89; 95% CI, 2.21-6.85) compared with subjects who consumed an appropriate amount of energy. In men, low house income (OR, 2.36; 95% CI, 1.07-5.19) in the group with insufficient energy intake and living alone (OR, 6.30; 95% CI, 2.26-17.54) in the group with excessive energy intake were significantly associated with excessive sodium intake. In women, alcohol use (OR, 4.46; 95% CI, 1.29-15.44) and regular walking (OR, 3.22; 95% CI, 1.15-9.03) in the group with excessive energy intake were significantly associated with excessive sodium intake. CONCLUSION: We observed a significant association between excessive sodium intake with low income and living alone in men. Our findings suggest that dietary support to reduce sodium intake is needed in the elderly.