Chang-Ho Youn

Effects of laughter therapy on depression, cognition and sleep among the community-dwelling elderly.

Aim:  To investigate the effects of laughter therapy on depression, cognitive function, quality of life, and sleep of the elderly in a community.

Determination of the beginning age for colonoscopic screening among colonoscopy-naïve individuals

OBJECTIVE This study purported to analyze the results of colonoscopy for different age groups and to identify the optimal beginning age for colonoscopic screening. METHODS A total of 3102 cases of asymptomatic, average-risk, colonoscopy-naïve individuals who underwent colonoscopy at the Health Promotion Center at the Kyungpook National University Hospital during the period from January 2005 to December 2010 and colonoscopy results were analyzed. RESULTS The prevalence of any colorectal neoplasia in 30s, 40s, 50s and over 60 group was 14.9%, 28.9%, 43.1% and 45.1% respectively. Compared with the 30s age group, the adjusted odd ratios (aOR) for any colorectal neoplasia in 40s, 50s and over 60 group was 2.38, 4.73 and 5.42 respectively (P<0.001), and the aOR for advanced neoplasia in 40s, 50s and over 60 group was 4.34, 9.68 and 14.71 respectively (P<0.001). Based on the results of the ROC curve analysis, the optimal beginning age for CRC screening was found to be below age 46 for any neoplasia and below age 47 for advanced neoplasia. CONCLUSION The prevalence of colorectal neoplasms significantly increased from age 40s in asymptomatic, average-risk, colonoscopy-naïve individuals and the beginning age for colonoscopic screening was approximately age 46.

Obesity Markers as Predictors for Colorectal Neoplasia

Background The goal of this study was to determine the relations between the risk of colorectal neoplasia and obesity markers: body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). Methods The subjects who underwent screening colonoscopies at a Kyungpook National University Hospital in Daegu from July to December 2010 were enrolled. We defined colorectal neoplasia as tubular adenoma, advanced adenoma, or cancer. We performed a logistic regression analysis to investigate the correlations between obesity and colorectal neoplasia and a receiver operating characteristic (ROC) curve analysis to determine the cut-off obesity marker values for detecting colorectal neoplasia. Results Among the total of 268 subjects, 83 (31.0%) subjects had colorectal neoplasia. Subjects with neoplasia had higher BMI, WC, and WHtR than the subjects without any neoplasia. The adjusted odds ratio (aOR) of WHtR ≥0.5 with the association of neoplasia was 1.927 (95% confidence interval [CI], 1.041–3.569) in the total subjects. In women, the obesity markers of WC ≥85 cm (aOR 4.611; 95% CI, 10.166–18.240) and WHtR ≥0.5 (aOR 1.747; 95% CI, 1.149–19.617) were significantly related to neoplasia; however, there was no significant result in men. The ROC analysis showed the optimal cut-off values of BMI as >23.14 kg/m2 (P=0.002), WHtR as >0.50 (P<0.001), and WC as>82.5 cm (P=0.650) in men and >77 cm in women (P<0.001). Conclusion Obesity is significantly associated with the increased risk of colorectal neoplasia. WC and WHtR have more significant correlations with neoplasia; thus, obese people should undergo regular colonoscopy screenings to detect colorectal neoplasia.

Associations between Body Mass Index and Chronic Atrophic Gastritis and Intestinal Metaplasia

Background/Aims Chronic atrophic gastritis (AG) and intestinal metaplasia (IM) of the stomach are premalignant lesions. The present study aimed to examine the associations between obesity and these lesions. Methods A total of 2,997 patients, who underwent gastroscopy, participated in this study, excluding those who had been diagnosed with gastric cancer. Participants were divided into four groups based on their body mass index (BMI). The risk of AG and IM with increasing BMI was analyzed in men and women, separately. Results The association between BMI and AG was not significant. After adjusting for age, smoking, alcohol, and AG, the odds ratios for IM in the overweight, obesity, and severe obesity groups were 2.25 (95% confidence interval [CI], 1.50-3.37), 2.32 (95% CI, 1.58-3.42), and 4.86 (95% CI, 2.04-11.5) in men, and 2.66 (95% CI, 1.29-5.47), 4.46 (95% CI, 2.28-8.75), and 9.57 (95% CI, 3.26-28.12) in women, compared with the normal BMI group. Conclusions Gastric IM was significantly associated with increased BMI.

Obesity Markers as Predictors for Colorectal Neoplasia (J Obes Metab Syndr 2017;26:28-35)

Obesity is known to be an important risk factor that increases the prevalence of malignancies including colorectal cancer.1,2 Considering that colorectal cancers are mostly developed from adenomatous polyps through an adeno-carcinoma sequence, it is important to determine the association of colorectal neoplasia, including adenomatous polyps, with obesity in order to prevent colorectal cancer. However, there is a lack of studies investigating which obesity parameter would be the best index to predict colorectal neoplasia; hence, we studied the relationships among colorectal neoplasia, obesity, and obesity markers. Our study revealed that obesity was significantly associated with colorectal neoplasia including tubular adenoma, advanced adenoma, or cancer; waist-to-height ratio was a better indicator of colorectal neoplasia than the other obesity markers. Among women, waist circumference was also a more useful marker than body mass index. This result might indicate that abdominal obesity is associated with an increased risk of colorectal cancer by the mechanisms of insulin resistance, hyperinsulinemia, chronic inflammation, and altered levels of growth factors.3 Our study adjusted for possible confounding variables that can influence the development of colorectal neoplasia, such as sex, smoking, drinking, and exercise. However, this study has a limitation in that we did not adjust for menopausal status in women, which is also an important variable related to colorectal neoplasia. Estrogen, especially estradiol, has revealed a protective effect against colorectal carcinogenesis through several mechanisms: reducing secondary bile acid production and circulating insulin like growth factor-1, stimulating humoral and cell-mediated immune responses, and inhibiting cell proliferation of colorectal tumors by binding to estrogen receptors like ER-β. Menopausal status is related to increased risk of colorectal cancer, although menopausal hormone therapy might reduce the risk of colorectal cancer.7 In our study, the mean age of the female subjects was 46.27 years, and the majority (69.5%) of the women were younger than 50. Although we did not adjust for the use of hormone replacement, the influence of menopausal status was considered to be trivial. Among the types of abdominal obesity, visceral adipose tissue (VAT) is plays a main role in hyperinsulinemia and preneoplastic colonic mucosal changes.8 Recently, new procedures to measure visceral adiposity have been developed. Among those, Nagata et al.9 revealed that VAT measured by computed tomography (CT) had a strong relationship with colorectal adenoma. Furthermore, a meta-analysis of the association of colorectal adenoma with VAT measured by abdominal CT showed that the amount of VAT was significantly associated with an increased risk of colorectal adenoma in both men and women.10 Since abdominal visceral obesity