Background : Obesity in adolescents has been shown to be significantly associated with long-term mortality and morbidity. Leptin serceted by adipose tissue regulates body weight, and obese people show high leptin levels as well as as leptinresistance. The objective of this study was to ex-amine the relationships of leptin concentration with various indices of obesity, cardiovascular risk factors, and diet in adolescents.
Methods : We conducted cross sectional study with sixty-eight obese (28 male and 40 female)and 80 normal weight adolescents (40 male and 40 female), aged 12-18y, from and urban area in South Korea. Weight, height, body fat, waist and hip circumference, blood pressure, and fasting serum glucose, total, LDL, and HDL-cholesterol, triglyceride, and leptin were measured, and a 24 dietary recall obtained.
Results : Females had, on average, two-times higher leptin concentrations per fat mass than males. Circulating leptin was strongly associated with body fat (male:r=0.69, p<0.01; female:r=0.67, p<0.01), and waist circumference (male:r=0.65, p<0.01; female:r=0.64, p<0.01). The correlations between log.leptin and some cardiovascular risk factors were weakly positive. None of the association between log.leptin and nutrient intakes were significant. In a multiple regression model, body fat, gender, and waist circumference were found to be significant independent determinants of leptin concentration.
Conclusion : These results show that female adolescents have higher leptin levels compared to male adolescents, independent of the concomitant variation in total body fat mass. Although leptin concentration did not have direct association with intakes, there was significant correlations with obesity and several cardiovascualr risk factors in Korean adolescents.
Background : A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation.
Methods : To quantify the relationship between anthropometric indices of abdominal obesity (waist circumference, waist-to-hip ratio, waist-to-height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted.
Results : No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist-to-hip ratio is larger in women, but waist-to-height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat-to-subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69), women: 0.76) with abdominal visceral fat area in both genders. stepwise analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist-to-height ratio. In women, abdominal diameter is the only significant index.
Conclusion : Abdominal sagittal diameter, in comparison with the waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.
Background : Ischemic heart diseases have increased by more than 80% in the past 10 years among Korean and the global risk assessment of coronary heart disease(CHD) based on the relative risk factors to the probability of developing CHD became widely used for western populations. In this study we hope to provide information on the distribution and characteristics of the relative risks of CHD using the Framingham risk score.
Methods : This study involved the subjects who visited a university hospital for health promotion from 1995 to 2000 without CHD. We surveyed medical history of the subjects, and measured their blood pressure, serum glucose, total cholesterol(total-C) and HDL-cholesterol(HDL-C). Risk points from the Framingham chart were given to age, systolic BP, total-C, HDL-C, smoking, diabetes, and the global risk score was calculated from their sum. We analyzed the global risk scores and each risk points of the high risk groups.
Results : For younger and older men in the high risk group, the factors smoking and high blood pressure had the highest score assigned respectively. With younger women total-C had the highest score assigned, and with older women diabetes took over but HDL-C and high blood pressure still had a higher score.
Conclusion : For primary prevention of CHD, younger men need active education to quit smoking and for older aggressive blood pressure control is desperately needed. For women, concern about low HDL-C is highly needed and after menopause aggressive treatment for diabetes, high blood pressure, low HDL-C is needed.
Background : The elderly is known to have many different clinical laboratory data compared with the young adults. There have been rare studies comparing tumor markers and rheumatoid factors between young adults and the elderly in Korea. This study was conducted to evaluate the differences in tumor markers and rheumatoid factor between elderly and young adults.
Methods : We gathered 94 healthy elderly cases and 91 healthy young adults who have taken periodic health examination from November 1996 to February 1997 at one hospital. We compared the mean of rheumatoid factor and tumor markers between two groups and took multiple regression analysis.
Results : In the elderly, the mean of CEA and AFP are significantly higher than young adults. The number of abnormally elevated rheumatoid factor is significantly higher in elderly group, but in case of CEA the number of abnormal data is not significantly different. The CEA level is significantly high in smoker group than non-smoker group. The factors that increase the CEA level are old age, smoking amount, albumin level. The factors that increase the AFP level are old age, hemoglobin level. The factor that increase the rheumatoid factor is old age only. Conciusions: When we interpret the level of tumor markers and rheumatoid factor, we must consider the patient's age. Aging is a factor that is associated with CEA, AFP, rheumatoid factor.
Background : There are no agreement for abnormalities in serum lipid concentrations and lipoprotein(a) (Lp(a)) in patients with subclinical hypothyroidism. But there are no reports for consideration of postmenopausal state and hormone replacement therapy(HRT). Therefore, we anayzed serum Lp(a) and lipid concentrations in patients with subclinical hypothyroidism considering menopause and HRT and the correlation between serum Lp(a) level and thyroid-stimulating hormone (TSH) concentration.
Methods : We undertook this study in 99 patients with subclinical hypothyroidism (TSH>5uIU/mL) and 297 age- and sex-matched normal control. They and no abnormalities in liver and renal function, fasting blood glucose and medical and drug histories. We excluded who were receiving HRT. Serum free thyroxine, triiodothyronine, TSH were measured by radioimmune assay using commercial kits, and Lp(a), total cholesterol, TG and HDL by Latex and enzyme method, respectively.
Results : There were no significant differences of serum Lp(a), total cholesterol, LDL, TG, HDL concentrations in patients with subclinical hypothyroidism and control subjects, analyzing after dividing into men, premenopausal and postmenopausal women. In patients with subclinical hypothyroidism, there was no correlation between serum Lp(a) and TSH concentraions(r=0.06, P>0.05).
Conclusion : Considering menopause and HRT, there were no increase in serum Lp(a) and lipid concentrations in subclinical hypothyroidism. There was no correlation between serum Lp(a) and TSH concentration in patients with subclinical hypothyroidism.
Background : Though many adolescents are suffering from depression in Korea, there have been few studies about the prevalence of it and depressive adolescents are not managed appropriately yet because of ignorance of the society and family. This study was intended to find out college freshmen's prevalence of depression, and the relationship between family function and depression.
Methods : The subjects were college freshmen of one university both in Seoul and Suwon and the study period was from January to February, 1999. Family APGAR was used as a family function index Beck's Depression Inventory (BDI) was used to measure the degree of depres-sion. Chi square tests and logistic regression were done for analysis using SPSS 8.0/PC program.
Results : The prevalence of depression among college freshmen was 1.5% (37 out of 2465) as of BDI score 21 or more. Depression was more common in the families with low Family APGAR score and those in Suwon campus. No significant differences were found in gender, age, blood pressuere, blood type, BMI, present illness, number of families, marital status of parents or siblings. Relative risks of depression were 4.5 times for family dysfunction group and 2.6 times for Suwon campus group.
Conclusion : Depression is not a rare disease among college freshmen. Therefore, family physician as a primary care physician should consider the possibility of depression among adolescence and screen depression using BDI for adolescents in dysfunctional family particularly.
Background : As the mean life span is prolonged, the concern about health care in postmenopausal women is now promoted. Especially, osteoporosis is the serious health problem in postmenopausal women. Bone mineral density in postmenopause is controlled by that in premenopause. Therefore, we searched for the factors which contribute to bone mineral density in premenopause.
Methods : The study subjects who visited the Health Screening and Diagnosis Center in Yeungnam University Hospital from March 1998 to July 1999 was measured BMD at the lumbar spine using dual Energy X-ray Absorptiometry. Subjects were checked past medical history, life style (smoking, drinking, physical activity, exercise etc.), birth history, breast feeding, oral pill intake. The subjects who had disorders known to interfere with bone metabolism and premature menopausal and surgical menopausal women were excluded from the study. And we reviewed the results of the laboratory and radiologic findings which had done in Health Screening and Diagnosis Center.
Results : 352 women were included in this study. The number of normal BMD was 228 and the number of osteopenia was 124. Weight, height, BMI, exercise was significant positively correlated with bone mineral density(P<0.05). Previous operation history was significant negatively correlation with bone mineral density (P<0.05). Multiple logistic regression result showed that weight was the most significant factor affecting to BMD and the history of operation and exercise were significant factors affecting BMD(P<0.05).
Conclusion : In postmenopaual women, who has low weight, past operation history and lack of exercise, evaluation of BMD and education for prevention of osteoporosis are needed.
Background : Use of Complementary and Alternative Medicine(CAM) is common among patients with chronic conditions such as rheumatic disorder. This study was conducted to know rate and behavior of using CAM and to improve doctor-patient relationship in rheumatic patients.
Methods : Among patients visiting a tertiary hospital rheumatology clinic, 867 persons (15.8% of total) were selected conveniently and interviewed by a trained nurse according to structured questionnaire from July 1st through July 31st 1999. Three hundred and sixty two CAM users completed the interview.
Results : Among 867 persons interviewed, 372 persons had used CAM (use rate 44%). Use rate of Chinese medicine was 26%, CAM except Chinese medicine 21%. Herb medicine(49.4%) was the commonest single category of all CAM. Twenty four percents of users had used two or more types of CAM, 6.8% had experienced adverse effects. The average yearly cost for CAM was 704,000 won/person, 64% of the one for hospital use, 1,100,000 won/person. The subjectively rated degree of effectiveness was 6.3 points which was significantly higher when compared with 5.9 points for hospital services. The degree of satisfaction with CAM was 5.6 points which was higher than that of hospital services, 4.8 points. The most frequently reported reason for using CAM was the hope for synergistic treatment effect(32%). The proportion of experiencing adverse effects from CAM was 7% of all users. Only one fourth of the users had discussed on the CAM use with the western doctors. The commonest reason for not discussing CAM was that the respondents had no need to discuss about it (40%). Among doctor's attitudes when discussing CAM with patient, limited aproval was most common(40%).
Conclusion : Among patients with rheumatic conditions, 44% use CAM. Herb medicine was most commonly used CAM. Comparing with hospital services, cost for CAM is 2/3 but its subjective effectiveness and satisfaction are higher. Western doctors must consider appropriately the need from users of alternative medicine.
Background : Although sexuality in old women is important for the quality of life, that has been overlooked due to social indifference. Because the studies for sexuality in old women were lack in Korea, we surveyed sexuality and its influential factors in old women.
Methods : From March to July 2000, we surveyed 115 old women over 60 years with 22 items of questionnaire. Data were gathered through written responses to the questionnaire and one to one interview between doctor and subject. Statistical analysis was done with SPSS ver10.0/PC+ and its significance was tested by chi-square(P<0.05).
Results : Mean age of 115 women is 64.84±4.54 years. There are 80 cases (69.6%) that thought sexuality is important in old women. Sexuality and sexual interest get gradually decreased by aging. Marital state, age of husband, family structure, economic state, sexual interest are statistically significant as the influential factors of sexuality (P<0.05). Sexual satisfaction comes out 35.7%. Age, marital state, family structure, job, economic state, subjective health state, current medication, sexual interest are statistically significant as the influential factors of sexual satisfaction(P<0.05). The reasons of decreased sexuality is due to aging process(47.8%), no partner(17.4%), partner problem(14.8%), physical illness(10.4%) and decreased libido.
Conclusion : We conclude that sexuality in old women is important. Its influential factors are marital state, age of husband, family structure, economic state, sexual interest. Age, marital state, family structure, job, economic state, subjective health state, current medication, sexual interest are statistically significant as the influential factors of sexual satisfaction.
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