Eun-Jung Oh

Non-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older

Background Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share common pathogenic mechanisms and many risk factors, and both are linked to an increased risk of cardiovascular diseases. The aim of this study was to assess the association between NAFLD and CKD according to the presence of hypertension and diabetes mellitus in Koreans aged 50 years or older. Methods A cross-sectional study of 1,706 subjects who received their routine health examination was conducted between May 2008 and April 2010 at Konkuk University medical center. Biochemical tests for liver and abdominal ultrasonography were performed. CKD was defined as either proteinuria or glomerular filtration rate ≤60 mL/min per 1.73 m2. Results Among the 1,706 subjects, There were 545 (31.9%) with non-alcoholic fatty liver disease and 424 (24.9%) with chronic kidney disease. In univariate logistic regression analysis, NAFLD was significantly associated with CKD (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.34 to 2.12). In multivariate logistic regression analysis adjusted for age, sex, current smoking, abdominal obesity, aspartate aminotransferases, alanine aminotransferases, γ-glutamyltransferase, hypertension, diabetes mellitus, hypertriglyceridemia, and low high-density lipoprotein cholesterol, NAFLD was associated with CKD (adjusted OR, 1.68; 95% CI, 1.27 to 2.24). This relationship remained significant after classification according to the presence of hypertension or diabetes mellitus. Conclusion NAFLD diagnosed by ultrasonography was significantly associated with CKD in Koreans aged 50 years or older.

Predictors of Successful Smoking Cessation after Inpatient Intervention for Stroke Patients

Background Smoking is a well-known risk factor of cancer, chronic disease, and cerebrovascular disease. Hospital admission is a good time to quit smoking but patients have little opportunity to take part in an intensive smoking cessation intervention. The purpose of this study was to identify the factors of successful smoking cessation among stroke patients who undergo an intensive cessation intervention during the hospitalization period. Methods Thirty-nine male smokers who were admitted with stroke were enrolled in the study. They participated in a smoking cessation intervention during hospitalization. Smoking status was followed up by telephone 3 months later. Nicotine dependence, sociodemographic factors, and other clinical characteristics were assessed. Results After 3 months post-intervention, the number of patients who stopped smoking was 27 (69.2%). In addition, there was no significant difference in nicotine dependence, sociodemographic factors, and clinical characteristics. Only the stages of readiness for smoking cessation were a significant predictor (odds ratio, 18.86; 95% confidence interval, 1.59–223.22). Conclusion This study shows that a patients willingness to quit is the most significant predictor of stopping smoking after Inpatient cessation Intervention for stroke Patients.

Association of High-Risk Drinking with Metabolic Syndrome and Its Components in Elderly Korean Men: The Korean National Health and Nutrition Examination Survey 2010–2012

Background Previous studies have examined the association between alcohol consumption and metabolic syndrome (MetS) in adults, but studies in the elderly are lacking. We examined the relationship between high-risk alcohol consumption and MetS in elderly Korean men using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire from the 2010–2012 Korean National Health and Nutrition Examination Survey. Methods Among 25,534 subjects, 2,807 were men >60 years of age; after exclusions, we included 2,088 men in the final analysis. We categorized the study participants into three groups according to AUDIT score: low risk (0–7), intermediate risk (8–14), and high risk (≥15 points). Results Among the study population, 17.0% of the men were high-risk drinkers, who had the highest mean waist circumference, systolic and diastolic blood pressure (BP), fasting plasma glucose (FPG), and triglyceride (TG) levels. The overall prevalence of MetS was 41.9% in the elderly men, and it was significantly higher in the group with high (48.3%) versus low (31.9%) AUDIT scores. The prevalence of MetS components (elevated BP, high FPG, high TG, and low high-density lipoprotein cholesterol) was associated with a high AUDIT score. The odds ratios (95%confidence interval) of the high-risk group for MetS, elevated BP, and high TG were 1.40 (1.03–1.89), 1.82 (1.28– 2.60), and 1.77 (1.30–2.41) after adjustment for confounding variables. Conclusion AUDIT score was correlated with most MetS components in elderly Korean men.

Correlation between Overactive Bladder Syndrome and Obsessive Compulsive Disorder in Women

Background Overactive bladder syndrome is characterized by urinary urgency, usually accompanied by Frequent urination and nocturia, with or without urgent urinary incontinence. There must be the absence of causative infection or pathological conditions. Overactive bladder syndrome is related to mental disorders, particularly depression and anxiety. However, obsessive-compulsive symptoms are investigated much less frequently. The purpose of the present study was thus to assess obsessive-compulsive symptoms in overactive bladder syndrome patients. Methods Fifty-seven women patients with overactive bladder syndrome and fifty-seven women without it (age matched control group) were prospectively enrolled. They completed the overactive bladder syndrome-validated 8-question screener and the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire at the same time they visited the clinic. Patients were compared with controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire and its checking, tidiness, doubting, and fear of contamination components. Results Patients showed more obsessive traits than controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score (P=0.006) and on the checking subscale (P=0.001). Odds ratio for the overactive bladder syndrome groups obsessive-compulsive symptoms traits (score≥14) was 5.47 (P=0.001). The Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score was associated with the overactive bladder syndrome-validated 8-question screener score in patients (P=0.03). Conclusion Obsessive-compulsive symptoms may constitute an important aspect of the psychiatric profile of overactive bladder syndrome patients. The severity of obsessive-compulsive symptoms seems to be related to the degree of the overactive bladder syndrome severity. Clinicians may consider screening women with overactive bladder syndrome for obsessive-compulsive symptoms.

Acceptable macronutrient distribution ranges and hypertension.

Abstract Acceptable macronutrient distribution ranges (AMDRs) for carbohydrate, fat, and protein have been set by considering epidemiological evidences that suggest consumption within these ranges plays a role in reducing risk of chronic diseases. Little evidence has been presented on the relationship between the intake outside the AMDR for macronutrient and hypertension. Therefore, this study was performed to examine the association between the intake outside the AMDR and hypertension in Korean adults. This study was based on data obtained from the fifth Korean National Health and Nutrition Examination Survey. The AMDR for carbohydrate is 55–70%, for fat is 15–25%, and for protein is 7–20% of the energy intake for adults. The subjects who did not meet the AMDRs for carbohydrate, fat and protein were considered to be the non-AMDR group. The odds ratio of the non-AMDR group was 1.25 (95% CI, 1.02–1.53) in the hypertensive subjects without anti-hypertensive medication and 1.25 (95% CI, 1.06–1.48) in the hypertensive subjects with anti-hypertensive medication after adjustment for age, sex, current smoking, heavy drinking, physical inactivity, obesity, diabetes mellitus, dyslipidemia, total energy intake, high sodium intake, and vitamin D deficiency. The intake outside the AMDR was significantly associated with hypertension in Korean adults. The AMDR might be useful nutritional requirement for dietary management of hypertension. In the future, these findings need to be verified through prospective population-based studies.

Exertional Rhabdomyolysis after Spinning

Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24–48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.

Validation of the Korean version of the thyroid cancer-specific quality of life questionnaire

Purpose The increasing incidence of thyroid cancer worldwide has drawn attention to the needs for assessing and managing health-related quality of life (HRQoL) of thyroid cancer survivors. We conducted this study to validate the Korean version of the thyroid cancer-specific quality of life (THYCA-QoL) questionnaire. Methods Data obtained from 227 thyroid cancer survivors were analyzed using standard validity and reliability analysis techniques. Reliability was assessed by measuring internal consistency via Cronbach α coefficient, and validity was assessed by determining the Pearson correlation coefficient between the THYCA-QoL questionnaire and the following relevant assessment tools: the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30), the Korean version of Brief Fatigue Inventory (BFI-K), the Korean version of Brief Encounter Psychosocial Instrument (BEPSI-K), Goldberg Short Screening Scale for Anxiety and Depression, and a nine-item Patient Health Questionnaire (PHQ-9). A multitrait scaling analysis was performed to assess each items convergent and discriminant validity. Results The reliability of the THYCA-QoL questionnaire was confirmed by Cronbach α coefficients for multiple-item scales which ranged from 0.54 (sensory) to 0.82 (psychological). Except for a single item (sexual interest), the questionnaires validity was established by significant correlation observed between scales in the THYCA-QoL questionnaire and scales used in other assessment tools. A multitrait scaling analysis confirmed that all scales met the recommended psychometric standards. Conclusion The Korean version of the THYCA-QoL questionnaire is a reliable and valid assessment tool that can be used in combination with the EORTC QLQ-C30 to assess the HRQoL of thyroid cancer survivors in Korea.