Jaekyung Choi

Efficacy of low‐calorie, partial meal replacement diet plans on weight and abdominal fat in obese subjects with metabolic syndrome: a double‐blind, randomised controlled trial of two diet plans – one high in protein and one nutritionally balanced

Background:  Little is known about the relative efficacy of high‐protein vs. conventional diet plans that include partial meal replacements on body fat loss in obese subjects with metabolic syndrome.

Global Prevalence of Physical Frailty by Fried's Criteria in Community-Dwelling Elderly With National Population-Based Surveys

This study presents a brief review of 6 articles published between 2001 and 2014 that examined the prevalence of frailty as defined by the Fried scale in community-dwelling adults representative of the national population, age 65 years and older.

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.

Chronic Kidney Disease, Early Age-related Macular Degeneration, and Peripheral Retinal Drusen

Purpose: To evaluate the association between chronic kidney disease (CKD) and early age-related macular degeneration (AMD) and peripheral retinal drusen in Korean adults 50 years and older. Methods: This study included 3008 participants aged 50–87 years. Early AMD was assessed from retinal photographs based on modified Wisconsin AMD grading system and peripheral retinal drusen were assessed with a standardized examination. We defined CKD as estimated glomerular filtration rate of 60mL/min/1.73m2 and below according to the Modification of Diet in Renal Disease equation. Logistic regression was used to examine the association between early AMD, peripheral retinal drusen, and CKD. Results: There were 88 subjects with early AMD and 42 subjects with peripheral retinal drusen. After adjusting for age, gender, body mass index, smoking status, hypertension, and diabetes mellitus, a significant association was found between CKD and peripheral retinal drusen as well as early AMD. Subjects with CKD were more likely to have early AMD (OR, 1.68; 95% CI, 1.04–2.72) and peripheral retinal drusen (OR, 2.01; 95% CI, 1.02–3.99) than those without CKD. Conclusions: CKD was associated with peripheral retinal drusen as well as early AMD in Korean adults 50 years and older.

Preference and awareness of telemedicine in primary care patients.

Background The telemedicine services in Korea are expected to rapidly expand its use to the general population due to the development of digital networking, and its recent revision of related law and regulations. The purpose of this study was to investigate the knowledge and attitude of telemedicine in primary care patients. Methods We enrolled a total 243 participants, visited Family Medicine clinics and health promotion centers of university hospital in Seoul metrocity and Chungju city from April 1, 2010 to May 31, 2010. Data was collected by questionnaire, including demographic variables, knowledge and attitude of telemedicine. Results Among the total of 243 participants, 117 (49.8%) respondents were aware of telemedicine, and 178 (73.3%) respondents preferred telemedicine. The awareness showed differences according to the residence (P = 0.007), education (P = 0.03), and occupation (P = 0.02) of the respondents. The patient preference showed the differences at 50 years of age (P = 0.01) and in income of the participants (P = 0.005). Conclusion Awareness of telemedicine in primary care patients was low. As for the patients more than 50 years of age who will be having difficulty manipulating the instruments, more education is crucial. Establishment of appropriate plans to increase patient preference is needed, especially for patients with low-incomes.

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.

Potentially Inappropriate Medications by Beers Criteria in Older Outpatients: Prevalence and Risk Factors

Background Prescription of inappropriate medicine to elderly patients is a major public health care concern. The Beers criteria have been commonly employed as a screening tool to identify the use of potentially inappropriate medications (PIMs). The present study investigated the prevalence of PIM use according to the Beers criteria as well as factors related to PIM use. Methods Data obtained from a retrospective survey included 25,810 outpatients aged ≥65 years from a university medical center in Seoul, Korea. PIMs were defined using the Beers criteria. Factors associated with PIM use were evaluated using multiple regression analysis. Results Of all participants, 7,132 (27.6%) were prescribed at least one PIM. The most commonly prescribed PIMs were alprazolam (11.2%), clonazepam (10.8%), zolpidem (8.7%), quetiapine (8.4%), and hydroxyzine (5.4%). In multivariate logistic regression analysis, having five or more prescription medicines (odds ratio [OR], 11.32; 95% confidence interval [CI], 9.38 to 13.66) and five or more prescribing doctors (OR, 4.40; 95% CI, 3.59 to 5.39) were strongly associated with PIM. In a likelihood ratio test for trend, an increasing number of medications and prescribing doctors were both significantly associated with PIM. Conclusion At a university medical center, the number of medications and the number of prescribing doctors was associated with PIM in older outpatients.

Long-term exposure to ambient air pollutants and mental health status: A nationwide population-based cross-sectional study

There is a suspected but unproven association between long-term exposure to ambient air pollution and mental health. The aim of this study is to investigate the association between long-term exposure to ambient air pollution and subjective stress, depressive disorders, health-related quality of life (QoL) and suicide. We selected 124,205 adults from the Korean Community Health Survey in 2013 who were at least 19 years old and who had lived in their current domiciles for > five years. Based on the computer-assisted personal interviews to measure subjective stress in daily life, EuroQoL-5 dimensions, depression diagnosis by a doctor, suicidal ideation, and suicidal attempts, we evaluated the risk of mental disorders using multiple logistic regression analysis according to the quartiles of air pollutants, such as particulate matter <10μm (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide, using yearly average concentration between August 2012 and July 2013. The prevalence of high stress, poor QoL, depressiveness, diagnosis of depression, and suicide ideation was positively associated with high concentrations of PM10, NO2, and CO after adjusting for confounding factors. Men were at increased risk of stress, poor QoL, and depressiveness from air pollution exposure than were women. The risk of higher stress or poor QoL in subjects < age 65 increased with air pollution more than did that in subjects ≥ age 65. Long-term exposure to ambient air pollution may be an independent risk factor for mental health disorders ranging from subjective stress to suicide ideation.

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.

Body volume, body fatness, and metabolic syndrome.

ABSTRACT Body volume by three-dimensional body scanning (3DBS) may be an alternative index for evaluating body fatness. The aim of this study was to evaluate the association of body volume with body fatness and metabolic syndrome. This study included 38 Korean women whose body volume was measured using 3DBS. We measured body fatness using dual-energy X-ray absorptiometry and computed tomography. Participants with metabolic syndrome were defined as having three or more of the following components: high blood pressure (≥130/85 mmHg), elevated fasting glucose (≥100 mg/dl), hypertriglyceridemia (≥150 mg/dl), low high-density lipoprotein-cholesterol (<50 mg/dl), and abdominal obesity measured by waist circumference ≥80 cm. Total body, trunk, lower trunk, and limb volumes were significantly correlated with body mass index, waist circumference, total fat mass, percentage body fat, and abdominal fat areas. After adjustment for age, current smoking, at-risk drinking, and physical inactivity, the odds ratios (95% confidence intervals) for metabolic syndrome associated with total body, trunk, lower trunk, and limb volume were 1.08 (1.01–1.16), 1.11 (1.01–1.22), 1.20 (1.01–1.43), and 1.31 (1.04–1.66), respectively. Body volume by 3DBS was significantly associated with body fatness and metabolic syndrome. 3DBS may be a useful tool for detecting and monitoring body fatness and metabolic syndrome.