Background
Serum gamma-glutamyltransferase (GGT) was reported to be associated with type 2 diabetes, many cardiovascular disease risk factors, and individual components of metabolic syndrome. We performed a cross-sectional study to elucidate the relations between GGT and impaired fasting glucose (IFG). Methods: The subject of this study included 693 adults (males 272, females 421) aged 45 years or over who have lived in Chuncheon, suburban small-sized city. IFG was defined by an elevated fasting plasma glucose (FPG) concentration (≥100 and < 126 mg/dl). Results: The risk of IFG appeared to increase with increasing levels of serum GGT even after adjusting for other covariates, such as body mass index and inflammatory markers among men only: Adjusted odds ratios of IFG across GGT categories (<25th, <50th, <75th and ≥75th) were 1.0, 0.56, 1.57, 2.79. (p-value for trend 0.022). In women, the association between the risk of IFG and GGT was not statistically significant. Conclusion: This study suggests that elevated level of GGT within the normal range is a independent predictor of impaired fasting glucose in middle-ages or older men but not in women.

Background
: To estimate the prevalence of the metabolic syndrome in Chuncheon city in those ages 45 and over and to evaluate the association between risk factors and the risk of the metabolic syndrome.

Methods : The subject of this study included 662 adults (males 276, females 386) aged 45 years or over who lived in Chuncheon city. The metabolic syndrome was defined as having 3 or more conditions including abdominal obesity, high blood pressure, low HDL cholesterol, high triglyceride, and high fasting glucose. The association between the metabolic syndrome and its life-style related factors, such as smoking, exercise, and drinking, was examined, using multiple logistic regression.

Results : The prevalence of the metabolic syndrome from ATP III criteria was 30.1% in men, and 37.9% in women. The prevalence increased with age in women. In men, however, the prevalence increased to 55∼64 age group and then it gradually decreased. The prevalence of the metabolic syndrome from Asia-Pacific criteria was 48.2% in men, and 46.6% in women. The prevalence increased with age in men and decreased in women. The highest prevalence among the individual components of diagnostic criteria of the metabolic syndrome in men was hypertension, followed by abdominal obesity, hypertriglyceridemia, low HDL-cholesterolemia, and high fasting blood glucose. And in women, it was abdominal obesity, followed by hypertension, low HDL cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. After adjusting for potential covariates, current smoker was 1.93 times at a greater risk for the metabolic syndrome than non-smokers (95% confidence interval 1.06∼3.51).

Conclusion : The prevalence of the metabolic syndrome was higher than previously reported in Korea. Further studies are strongly needed to elucidate the factors which are related to the syndrome and to develop effective prevention guidelines, especially among the elderly.

Background
: To understand why primary physicians prescribe antibiotics for some cases of acute upper respiratory infections and to explore the factors that influence their prescribing.

Methods : Qualitative analysis of semi-structured interviews. Participants were 12 primary physicians in the maximum variety sample.

Results : Interviewees were identified the problems of antibiotics abuse and misuse in Korea. Primary physicians were certain that patients will benefit from antibiotics and prescribe for the patients' expectation of fast relief. Doctors are mostly comfortable with their prescribing decisions by their clinical experiences. They are also more likely to prescribe antibiotics in pressures of time and in competitive clinical environment.

Conclusion : Multiple factors are involved in primary physicians' decision of their prescribing for acute upper respiratory infections. Further interventions to reduces prescribing would need to improve identification of patients at risk of complications and be workable in busy clinical situations. Repeating evidence for lack of effectiveness and lack of efficiency in general might be helpful.