| Yu-Jin Kwon | 7 Articles |
Background
In patients with breast cancer, a healthy diet can help reduce breast cancer-specific recurrence, mortality, and comorbid chronic disease rates. There have been few studies on dietary habits immediately after breast cancer diagnosis, especially those involving the Asian population. Therefore, this study aimed to compare the nutritional habits of newly diagnosed patients with breast cancer and the general population without cancer in Korea using propensity score (PS) matching. Methods We conducted a case-controlled study of 157 patients with breast cancer and 2,363 cancer-free control participants from the Korea National Health and Nutrition Examination Survey. The PS values for the predicted probability of patients with breast cancer and the general population were estimated using logistic regression analysis, including age and body mass index. The dietary patterns were assessed using a 24-hour recall of 1 day and the Food Frequency Questionnaire. Results PS matching showed that patients with breast cancer consumed fewer calories and carbohydrates; however, they consumed more protein and fat compared to the general population. Compared to the general population, patients with breast cancer consumed more healthy foods such as fish, seaweed, vegetables, fruit, mixed-grain rice, and nuts; however, they also consumed more soup, stew, and red meat. Conclusion Newly diagnosed patients with breast cancer have some healthy dietary habits compared to the general population. However, there is considerable room for improvement in their diet quality. Our results support the need to develop tailored dietary recommendations for patients with breast cancer during the diagnostic and posttreatment periods to improve their diet quality.
Background
The International Classification of Primary Care-2 (ICPC-2) is a classification method designed for primary care. Although previous studies have found that ICPC-2 is a useful tool for demonstrating the relationship between patients’ expectations and health providers’ diagnoses, its utility of ICPC-2 has yet to be fully studied in Korea. This study aimed to evaluate the practicality of ICPC-2 in Korean primary care. Methods The study was conducted at primary care clinics in Seoul and Gyeonggi areas from October to November 2015. Third-year family medicine residents examined and analyzed the medical records of patients who visited primary care physicians using ICPC-2, and the results were compared with those obtained using the International Classification of Diseases-10 (ICD-10) (Korean version: Korean Standard Classification of Diseases-7). Results A total of 26 primary care physicians from 23 primary care clinics participated in the study. Furthermore, 2,458 ICD-10 codes and 6,091 ICPC-2 codes were recorded from the data of 1,099 patients. The common disease codes were vasomotor and allergic rhinitis (J30), according to ICD-10, and acute upper respiratory infection (R74) in ICPC-2. Comparing disease status by body systems, the proportion of gastrointestinal disease with ICD-10 codes was significantly higher than that with ICPC-2 codes (P<0.001). Furthermore, patients with >4 diagnoses accounted for 36% of the ICD-10 classifications, whereas those with >4 diagnoses accounted for 4% of the ICPC-2 classifications. Conclusion Introducing ICPC as a complementary means for diagnosing common diseases could be a practical approach in Korean primary care. Citations Citations to this article as recorded by
Background
The association between serum cholesterol levels and depression has been studied extensively; however, results are inconsistent. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and depressive symptoms among Korean adults. Methods This cross-sectional study used data obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey. In total, 40,904 adults were included in the final analysis. Participants were categorized into five groups according to their LDL-C levels, using the Korean guidelines for dyslipidemia. Symptoms of depression were evaluated using a self-reported questionnaire. Weighted logistic regression was used to examine the relationship between LDL-C levels and self-reported depressive symptoms. Results Compared with the intermediate category, the lowest (<70 mg/dL) and highest (≥160 mg/dL) LDL-C categories were associated with depressive symptoms, after adjusting for potential confounding factors (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.008–1.409; OR, 1.241; 95% CI, 1.073–1.435, respectively). The highest LDL-C category was positively associated with depressive symptoms in those who were middle-aged, female, had a low body mass index, and taking or not taking dyslipidemia medications. Conclusion A U-shaped association was identified between LDL-C categories and self-reported depressive symptoms. Our findings suggest that LDL-C levels that are too low or too high are associated with self-reported depressive symptoms. Further prospective studies are needed to determine the causal relationship of this association. Citations Citations to this article as recorded by
Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.
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Uric acid has been reported to function both as an oxidant or antioxidant depending on the context. A previous study in the Korean population reported a positive linear association between serum uric acid level and arterial stiffness in men, but little is known about how serum uric acid level is related to the risk of increased arterial stiffness in Korean postmenopausal women. We performed a cross-sectional study of 293 subjects who participated in a health examination program run by the health promotion center of Gangnam Severance Hospital between October 2007 and July 2010. High brachial-ankle pulse wave velocity was defined as a brachial-ankle pulse wave velocity of more than 1,450 cm/s. The odds ratios (ORs) for high brachial-ankle pulse wave velocity were calculated using multivariate logistic regression analysis across uric acid quartiles after adjusting for other indicators of cardiovascular risk. The 293 postmenopausal women were divided into quartiles according to uric acid level. The mean brachial-ankle pulse wave velocity values of each quartile were as follows: Q1, 1,474 cm/s; Q2, 1,375 cm/s; Q3, 1,422 cm/s; Q4, 1,528 cm/s. The second quartile was designated as the control group based on mean brachial-ankle pulse wave velocity value. Multivariate adjusted ORs (95% confidence intervals) for brachial-ankle pulse wave velocity across the uric acid quartiles were 2.642 (Q1, 1.095–6.3373), 1.00, 4.305 (Q3, 1.798–10.307), and 4.375 (Q4, 1.923–9.949), after adjusting for confounding variables. Serum uric acid level has a J-shaped association with arterial stiffness in Korean postmenopausal women. Citations Citations to this article as recorded by
Several studies have shown that family meals promote a well-balanced and healthier diet and weight status. Metabolic syndrome is related to eating behavior. This study investigated the association between eating family meals and the prevalence of metabolic syndrome. This cross-sectional study included 4,529 subjects who participated in the Korea National Health and Nutrition Examination Survey IV and V (2007–2012). A self-reported questionnaire was used to assess dietary status. Metabolic syndrome was defined according to the guidelines of the modified version of the National Cholesterol Education Program Adult Treatment Panel III. We compared the overall quality of dietary intake in family meal. Nutritional adequacy ratios for energy, protein, calcium, vitamin A, vitamin B1, vitamin B2, vitamin C, niacin, and potassium, and the mean adequacy ratio were significantly higher in the family meal group (P<0.05). The prevalence of metabolic syndrome was lower in the family meal group (P<0.05). However, we observed no significant association between eating family meals and the prevalence of metabolic syndrome. This study demonstrated that eating family meals appeared to be associated with nutrient adequacy. However, we observed no significant differences in prevalence of metabolic syndrome between the 2 groups. Citations Citations to this article as recorded by
Background
Insulin resistance (IR) influences lipid metabolism, particularly small dense low-density lipoprotein cholesterol (sdLDL-C), a key feature of diabetic dyslipidemia and a predictor of cardiovascular disease. The single-point insulin sensitivity estimator (SPISE) index is an effective tool for assessing IR. This study explored the relationship between the SPISE index and average low-density lipoprotein cholesterol (LDL-C) particle size in obese Korean adults. Methods Cardiovascular risk was assessed in 161 obese individuals. The participants were divided into three groups based on SPISE index tertiles. Steiger’s Z test was used to assess the differences in correlation coefficients among various IR indices and average LDL-C particle size. Multivariate linear regression models were used to determine the independent association between the SPISE index and average LDL-C particle size. Receiver operating characteristic (ROC) curves established the SPISE index cut-off for sdLDL-C particle dominance. Results The SPISE index was positively correlated with mean LDL-C particle size after adjusting for confounders. It demonstrated a stronger independent association with average LDL-C particle size (r=0.679, P<0.001) than with fasting insulin, the homeostatic model assessment for IR, and the quantitative insulin sensitivity check index (P<0.001 for all). ROC analysis identified an optimal SPISE index cutoff for sdLDL-C predominance of 4.955, with an area under the curve of 0.745. Conclusion Our findings indicate a direct correlation between the SPISE index and average LDL-C particle size, suggesting that the SPISE index may complement labor-intensive IR indices and sdLDL-C measurement techniques for estimating IR-induced sdLDL-C predominance.
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