Background : As recent studies show that pulse pressure (PP) is the most potent predictor of cardiovascular diseases, many studies focus on the non-invasive methods to evaluate arterial stiffness influencing on pulse pressure. This study attempted to show the relationship between cardiovascular risk factors and aortic pulse wave velocity (PWV) as a classical factor of arterial stiffness in Korean adults.
Methods : The subjects were 305 adults who had visited a health care center of a university medical center in Suwon from December, 2003 to April, 2004. We had measured the aortic pulse wave velocity through auto PWV analyzer (PP-1000, Hanbyul Meditech, Korea) and had compared the relationships with smoking, total cholesterol, high density lipoprotein, low density lipoprotein, body mass index, sex, age, systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and fasting glucose.
Results : There were positive correlation between aortic pulse wave velocity and age (P=0.001), fasting blood sugar (P=0.013), systolic blood pressure (P=0.007), diastolic blood pressure (P=0.038), mean blood pressure (P=0.012), pulse pressure (P=0.035), total cholesterol (P=0.009), low density lipoprotein (P=0.023). There were significant differences of the groups by sex (P=0.029).
Conclusion : The estimation of the aortic pulse wave velocity (PWV) using the auto PWV analyzer (PP-1000, Hanbyul Meditech, Korea) seems to be a useful diagnostic method of early detection of atherosclerosis for management and prevention of cardiovascular diseases. In future more data about correlations between cardiovascular risk factors and pulse wave velocity and methods managing these factors, and more studies for determining the meaningful values of pulse wave velocity, in larger cases are needed.
Background : This study aimed at finding out how much the rate of the JNC-7 guideline was carried out, and assessed the degree of evidence based clinical practice patterns and the validity of the new guideline by comparatively analyzing primary care practice patterns in hypertensive patients.
Methods : A questionnaire regarding the management of hypertension was conducted by mail between May 15 and July 15, 2005, to 1,008 of the Korean Association of Family Medicine listed in the address book. There were 195 respondents with a response rate of 19.4%.
Results : Among the total respondents, 91.1% were aware of the new guideline and had received information mainly through training lectures and seminars. They said that the biggest difference between the new guideline from the previous one was the inclusion of prehypertension (62.3%), and 61.1% were using the new term prehypertension in their practice. The most frequency advice given to patients related to lifestyle modification were in the order of smoking cessation (44.8%), exercise (41.7%) and weight reduction (38.0%). Calcium channel blocker was the most commonly used (60.9%) as the first-line agent. When physicians failed to control blood pressure with the first medication in cases of stage 1 hypertension, 67.7% added other agents. In treating stage 2 hypertension, 59.9% started with a single agent and gradually added other agents.
Conclusion : Family physicians in primary care clinics had a good understanding of the JNC-7 guideline. However, the rate at which they applied it in treatment was low. To effectively apply the guideline in actual treatments, aggressive education of practitioners and improvement on medical system and treatment guidelines are needed.
Background : As the metabolic syndrome represents a constellation of cardiovascular risk factors,its prevention is very important. Especially, child and adolescent obesity and metabolic abnormalities track into adulthood and it may promote the development of the metabolic syndrome in adults. however, in Korea there are only few studies about the metabolic syndrome of children and adolescents. Therefore, the objective of this study was to determine the prevalence and distribution of the metabolic syndrome in Korean children and adolescents.
Methods : The Korean National Health and Nutrition Survey (KNHNS) 2001 was a nation representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood sample were obtained from 1,090 Korean children and adolescents (567 boys, 523 girls), aged 10 to 19 years. The metabolic syndrome was determined by using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition modified for age.
Results : The prevalence of the metabolic syndrome in Korean children and adolescents was 7.1% (9.2% in boys, 4.8% in girls). The syndrome was present in 36.6% of overweight children and adolescents (body mass index [BMI] ≥ 95th percentile) compared with 11.2% of at-risk children and adolescents (BMI 85th to ＜95th percentile) and 2.5% of those with a BMI below the 85th percentile (P＜0.001). A multivariate logistic regression model showed a significant increase in risk of the metabolic syndrome in association with gender and BMI.
Conclusion : Overall, 7.1% of children and adolescents and 36.6% of overweight children and adolescents in Korea met the criteria for the metabolic syndrome. These findings emphasize the need for both public health and clinical interventions to improve the detection, prevention, and treatment of the metabolic syndrome, especially in obese children and adolescents.
Background : Currently, several definitions for metabolic syndrome are in use. For epidemiological and clinical purposes, universally accepted definition would be needed. International Diabetes Federation (IDF) has introduced a new diagnostic criteria for the metabolic syndrome (MS). We analyzed the association between insulin resistance and MS using both the National Cholesterol Education Program Adult Treatment Panel III (NCEP- ATP III) definition and new IDF definition, in order to compare the clinical utility of these two different definitions.
Methods : The subjects of this study included 206 men, aged 29∼65 years, who visited a health promotion center located in Seoul. Among the subjects, we excluded hypertensive or diabetic patients. We measured their waist circumference, blood pressure, fasting glucose, insulin and lipid profiles. The metabolic syndrome was diagnosed using both ATP III and IDF definitions. We used the multiple logistic regression method to estimate odds ratio for MS according to the level insulin resistance measured by HOMA-IR.
Results : The prevalence of metabolic syndrome was 14.1% according to the NCEP-ATP III defintion, and 12.6% according to the IDF definition. After adjusting for age, alcohol, smoking and exercise, the odds ratios for insulin resistance of metabolic syndrome group defined by NCEP-ATP III criteria and IDF criteria were 3.04 (95%CI 1.28∼7.22) and 2.33 (0.95∼5.76) respectively.
Conclusion : New IDF definition does not seem to be as sensitive as ATP III definition with respect to insulin resistance. Studies using the new IDF definition for metabolic syndrome are still scarce and therefore further investigations will be required.
Background : Increased abdominal obesity is clearly associated with metabolic diseases and associated with increased risk for atherosclerosis and cardiovascular diseases. But the mechanisms underlying these associations are not completely understood. The aim of this study was to correlate the regional body composition with pulse wave velocity in the overweight and obese women.
Methods : We investigated 104 overweight and obese participants. Regional body composition was distinguished by anthropometry, dual-energy X-ray absorptiometry, and computed tomography (CT). For estimates of arterial stiffness, we measured brachial ankle pulse wave velocity (baPWV). Fasting blood glucose, lipid parameters, CRP, and free fatty acid were measured. Pearson's correlation analysis and multiple regression analysis were conducted to identify the relationship between baPWV and regional body composition.
Results : Average age, fasting blood sugar, HDL-cholesterol, triglyceride, HOMA-IR, abdominal visceral fat area measured by CT, visceral fat area/ subcutaneous fat area (VSR), and visceral fat area/midthigh muscle area (VMR) were all significantly higher in the visceral obesity group than the subcutaneous obesity group. BaPWV was positively correlated with age, blood pressure, triglyceride, waist circumference, waist hip ratio, abdominal visceral fat area measured by CT, and VSR and inversely correlated with thigh subcutaneous fat area. In multiple regression models, after adjustment for confounding factors, baPWV was independently correlated with abdominal visceral fat area measured by CT (R2=0.560, P=0.006).
Conclusion : Abdominal visceral fat area measured by CT was the only measurement positively associated with baPWV which explains the relationship of regional body composition and arterial stiffness.
Background : Underreporting in self-reported dietary survey is a potential source of bias in nutritional epidemiology. We assessed if dietary underreporting existed in the 2001 Korean National Health and Nutrition Survey (KNHANS) and evaluated the health related factors and nutrients associated with dietary underreporting.
Methods : The subjects were 2,552 men and 3,335 women, 18 years of age or older, with a complete 24 hour recall and physical examination data including height and weight. Basal metabolic rate (BMR) was calculated from weight and height using WHO equations. Questionnaire to assess daily physical activity and regular exercise was done. EI/BMR ratio was used to evaluate dietary underreporting.
Results : The mean EI/BMR ratio of Korean men and women were 1.43±0.56 and 1.41±0.57, respectively. Among the total, 20.6% of men and 22.8% of women reported their energy intake lower than their BMR. Age was negatively related with EI/BMR ratio only in women (P＜0.001). Body mass index, education level, and household income were negatively and daily physical activity was positively associated with the EI/BMR ratio in both sexes. Lower EI/BMR ratio was significantly associated with lower reported fat energy density (% of energy intake) and higher reported carbohydrate and protein energy densities. The EI/BMR ratio was related negatively with nutrient energy densities of Vitamin C, Calcium, and Iron.
Conclusion : We could confirm selective dietary underreporting in the 2001 KNHNS. Caution should be paid on the interpretation of the nutrition survey data and efforts should be exercised to reduce dietary underreporting at data collection stages.
The 68-year-old man who have no particular symptom except 10 kg weight loss was received the gastroscopy as a part of diagnostic tests. On his gastroscopic examination, it was ascertained as high grade B-cell type mucosa- associated lymphoid tissue (MALT) lymphoma from the biopsy of the erosive lesion on the angle of stomach. This lesion, after pharmacotherapy for Helicobacter pylori, was visible the normal mucosal pattern at the gastroscopic follow-up. Hereupon the writer tried to review the clinical aspect, the diagnosis, the treatment, and the prognosis, along with the literature investigation regarding MA LT lymphoma.
First
Prev
