Background : Osteoporosis has been a rising problem as growth of older age population increased caused by elongation of life. The purpose of this research was to find out about the mean values and differences of BMD by age, relationships between body weight and bone mineral density (BMD) and differences of BMD between pre-and post-menopausal status based on data of lumbar spines and left hip joint performed by dual energy X-ray absorptiometry(DEXA).
Methods : We evaluated 502 female patients who visited Namwon Medical Center from Jan. 1998 to Dec. 1999. The bone mineral density (gm/cm2) of lumbar spines (L2-L4) and left hip joint were evaluated by DEXA machine.
Results : The BMD of lumbar spines was highest at fourth decades, rapidly declined at fifth to sixth decades ad slowly declined at eighth decades. The density of left hip joint was highest at fourth decades, but progressively declined to eighth decades. The relationship between body weight and BMD showed positive correlation (p<0.05). The BMD of pre- & postmenauposal women showed significant difference (p<0.001).
Conclusion : The BMD of Korean women is rapidly declining after menopause. Thus enthusiastic treatment of osteoporosis is needed at this period.
Background : Atrial fibrillation is the commonest arrhythmia seen in clincial practice. However, there have been no epidemiologic data on its prevalence in general populaton of Korea. We performed this study to investigate the prevalene of atrial fibrillaton in Korea.
Methods : From March 1, 1999 to July 31, 2000, Kangwon Branch, Korea Association of Health(KAH) performed electrocardiograms to investigate the health status in the general public in Kangwon Province. We analqzed these data by chi-square(χ²) test.
Results : A total of 45,133 persons participated in the health screening performed by KAH. The number of persons above 40 years old was 13,768, with men and women 6,367(46.2%) and 7,401(53.8%) respectively. Prevalence among those above 40 years old was 0.72% and the prevalence among men, 0.96% (61 persons) was significantly higher than that of women, 0.51% (38 persons)(p<0.01). In the group above 60 years old with the prevalence of 1.24%, a similar phenomenon was observed with 1.57% (40 persons) in men and 0.97% (29 persons) in women (p<0.05).
Conclusion : Prevalence of atrial fibrillation became higher as age increased, specifically in persons older than 40 years.
Background : Fatty liver, the most possible cause for an elevated hepatic aminotransferase level once hepaitis B, hepatitis C, and the drug induced hepatitis were excluded, is supposed to have association with obesity as well as ingestion of alcohol. This study was performed to find an epidemiologic evidence for the association between obesity and fatty liver.
Methods : A case-control study was carried out on 160 cases matched for age and sex with 160 controls in a tertiary care hospital family practice clinic. Patients who had either an elevated aminotransferase level (> 45 IU/L) at two separate times of at one time with ultrasonic evidence compatible to fatty liver without any evidence of other causes that might affect the liver were included into case group. Information on the height, weight, cholesterol level, alcohol consumption, smoking, physical exericise, and past medical history were obtained through a review of medical records and self administered questionnaire. Multiple logistic regression analysis were used to evaluate the independent association.
Results : With the increase of body mass index (BMI), the association between BMI and an elevated aminotransferase level suspected of fatty liver increased. Significantly increased associations were observed in BMI levels 25-29 kg/m² (Odds ratio[OR], 5.02; 95% confdence interval[CI], 1,49-16.93) and more than 30 kg/m² (OR, 14.87; 95% CI, 2.58-85.62). Consuming large amount of alcohol (> 60g/day) and increasing cholesterol level were also significantly associated with eleveted aminotransferase level suspected of fatty liver.
Conclusion : Factors associated with elevated aminotransferase level suspected of fatty liver were heavy drinking, cholesterol level, and BMI. Large OR observed in high BMI levels(over 25 kg/m²) and dose-response relationship with BMI seem to suggest a causal relationship between obesity and fatty liver.
Background : Obesity is a protecitive factor of osteoporosis, which is one of the important health proplems in the elderly. The purpose of this study was to determine the association between indicators of central obesity and bone mineral density (BMD) in women.
Methods : Among the healthy people who visited a tertiary hospital in Pusan for health exam from January to May 1999, we selected 303 women. We measured body mass index(BMI), waist, waist-to-hip ratio(WHR), menopausal period, and BMD. The SPSS statistical program was used for statistical analysis and the following test used: correlation and partial correlation adjusted for age and menopausal period.
Results : The total subjects consisted of 162 premenopausal and 141 postmenopausal women. In all subjects, BMI and WHR were positively correlated with spinal BMDs, but after controlling for age and menopausal period, BMI (r=0.322, P<0.01) and waist (r=0.220, P<0.01) were related to spinal BMDs. In the premenopausal group, spinal BMDs were correlated with BMI, waist, but after controlling for age, they were related to BMI (r=0.270, P<0.01) and waist(r=0.193, p<0.05). In the postmenopausal group, BMI, waist and menopausal period were correlated with spinal BMDs, and after controlling for age and menopausal period, BMI(r=0.365, p<0.01) and waist(r=0.251, p<0.01) remained related to spinal BMDs. In women of BMI below 25kg/m², spinal BMDs were correlated with waist(r=0.163, P=0.02)and not WHR.
Conclusion : These results suggest that waist, not WHR was associated with spinal BMDs in women.
Background : Upper respiratory infection account for many of the visits in primary care. As most URIs are caused by viruses, antibiotic therapy is not desirable. However, for URI treatment antibiotic therapy is commonly used, which causes many public health proplems such as drug-resistant becteria and high medical cost. This paper examines patient knowledge of the normal presentation of a URI, beliefs in the effectiveness of antibiotics and health care utilzation.
Methods : A survey of 200 outpatients or their families was conducted in one university hospital from March to April, 1998. Two URI conditions were given for the survey:(1) a condition of 5 days' duration with cough, sore throat, and clear nasal discharge (question 1), (2) a condition of the same symptom as (1) except discolored nasal discharge (question 2). For various questions in each of these conditions they were to answer in 5 point Likert-type scale. Statistical softwares of SAS 8.0 and GAUSS 3.21 were used for analyzing the survey data.
Results : For question 1, 61% of the sample reported that they would seek care from a physician while for question 2, 75% of the sample reported that they would do so (p<0.1). the health service suppliers, in the order of visiting frequencies, were pharmacy (58%), hospital (38%), no visit (2.5%), public health center (0.5%), and Chinese medicine clinic (0.5%) for question 1 and pharmacy (54%), hospital (42%), no visit(2%), Chinese medicine clinic(0.5%) and public health center (0.0%) for question 2. For question 1, 54% of the sample and for question 2, 63% reported that they believe antibiotics were effective (p=.068). For question 1, 79.5% and for question 2, 89.5% of the subjects reported that they had complied to prescriptions of doctors or pharmacists (p<0.05). Out of those subjects, only 19.5% for question 1 and 21.2% for question 2 reported that they checked the presence of antibiotics in the prescriptions. A multivariate analysis shows that older people, normally used antibiotics and current smokers had higher tendency of seeking care and stronger beliefs in the effectiveness of antibiotics.
Conclusion : There is a lack in patient understanding of normal presentation of a URI and the effectiveness of antibiotics as a treatment. A confusion about the meaning of discolored nasal discharge is particularly evident. The patients visited pharmacies more often than hospitals, and majority of them (80%) did not know the details of their prescriptions.
Background : Obesity is a risk factor of hyperlipidemia, DM, hypertension and cardiovascular deseases. In clinical practice the evaluation of obesity has been done indirectly by anthropometric indices such as BMI, waist to hip ratio, waist and hip circumference. This study was attempted to show whetjer waist circumference is better simple anthropometric index of abdominal obesity and has better correlation of metabolic profile than waist to hip ratio which has been commonly used.
Methods : We gathered 286 cases who have taken medical examination from May 1997 to July 1997 at Dankook University Hospital and measured BMI, relative ideal body weight by Modified Broca method, waist circumference, waist to hip ratio, metabolic profiles, fasting blood sugar, systolic and diastolic blood pressure.
Results : Waist to hip ratio and waist circumference showed high correlation with BMI and Modified Broca index. In men, correlation coefficient of waist circumference and waist to hip ratio with BMI was r=0.761, r=0.467, and correlation coefficient of waist circumference and waist to hip ratio with Modified Broca index was r=0.726, r=0.458. In women, correlation coefficient of waist circumference and waist to hip ratio with BMI was r=0.791, r=0.628, and correlation coefficient of waist circumference and waist to hip ratio with Modified Broca index was r=0.769 r=0.660. This finding shows waist to hip ratio and waist circumference are more closely related to BMI and Modified Broca index in women than men and showed higher correlation with waist circumference than waist to hip ratio. There were significant differences of correlation coefficient of obesity indices between waist circumference and waist to hip ratio(p<0.00001). Waist circumference showed relatively significant correlation with metalbolic profiles but we could not notice high correlation coeffience. But there was sighificant difference of distribution between normal group and obese group defined as BMI>25, modified Broca index>120%.
Conclusion : Waist circumference, index of abdominal obesity has better correlation with obesity indices than waist to hip ratio and is more simple method.
Background : Falls in the elderly can lead to disability, hospitalizations, and premature death. Even if the fall does not cause significant injury, it may lead to fear of falling, loss of self-confidence and restriction of ambulation. Thus, we conducted this study to examine the risk factors of falls in the elderly.
Methods : The study population consisted of 70 persons, older than 65 years. Subjects were subdivided into 3 groups according to their experience of falls, during the past 2 year period. Among them, 30 persons had no previous experience, 20 had one fall, and 20 more than one fall. Age, past history, situations surrounding falls, MMSE-K, GDS-short form, ADL, IADL, Mini Nutritional assessment (MNA) were reviewed, and the Get up and go test, evaluation of orthostatic hypotension and hearing were done. T-test, chi-square, ANOVA, logistic regression test using the SAS program was performed.
Results : The mean age of the participants was 75.4 years with 62.9% males. The factors associated with falling were age (P=0.01), scores of MNA (P=0.04), Get up and go test (P=0.004), past history (P=0.01), MMSE-K (P=0.02), GDS-short from(P=0.001), ADL (P=0.003) and IADL (P=0.002). Those in the group who fell once occured mostly while doing a riskful task, while those who fell more than once happened mostly during positional change (P<0.0001). Independent predictors of falls were get up and go test results and GDS-short from scores.
Conclusion : The independent predictors of falls were Get up and go test results and Geriatric Depression Scale scores.
Background : Family physicians are interested in health promotion for maintaining one's sound health. But there is little information on what patients think about the practice of health promotion by family physicians. Therefore, we found out whether patiens think that it is appropriate for family physicians to be concerned about problems relating to four health risk factors, and the patients' perception both of their own health problems and of the concern actually shown by their family physicians.
Methods : Patients who had visited our two family medicine offices from March to August 1998 was asked to complete a self-administered questionnaire. Questions on attitudes towards and perceptions of family physicians' interest in weight, smoking, drinking, and fitness problems were included. 586 questionnaires with adequare response were analyzed using chi-square test and Mantel-Haenszel's linear trend test.
Results : A total of 586 respondents consisted of 230 men and 356 women. Of the respondents, the proportion of people who thought that family physicians should be concerned about the health risk factors ranged from 83.6% in the case of smoking to 86.5% of fitness, but 76.6% thought their family physicians had in fact been interested in smoking and 72.2% thought so about fitness. There was a significant age-group trend in the case of attitudes towards family physician concern for smoking with larger proportions of older patients (P<0.01). Significantly more women than men thought that their family physicians seemed interested in health risk factor with 62.2% to 70.0% in men and 78.6% to 80.9% in women (P<0.001). There were significant age-group differences in proportions who thought that their family physiciants seemed interested in weight(P<0.001), smoking(P<0.001), and drinking (P<0.05) problems except for fitness problem. 31.6% of the respondents thought that they had a weight problem, 20.5% smoking problem, 14.0% drinking problem, and 28.2% fitness problem.
Conclusion : These results suggest that many patients thought that most of their family physicians seemed interested in health promotion, but felt the need that should be come more interested.
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