Background
: Since 1998, mass urinary screening tests have been conducted in Korean school children. We analyzed the urinary screening test data gathered from the metropolitan city, Seoul, to identify the prevalence of persistent urine abnormalities.

Methods : The students were tested for hematuria and/or proteinuria using dipstick urinalysis. If the results were positive, the students were asked to visit a medical clinic to recheck urinalysis and in report their results.

Results : Among 1,337,210 students, who were screened with initial urinalysis, 10,871 students (proteinuria, 3,626 (0.27%); hematuria, 7,634 (0.57%); both, 389) were recommended to undergo second urinalysis in which 8,819 students (81.1%) did. Among them, 851 had persistent proteinuria and 2,618 had persistent hematuria. The results of the first urinalysis were scored based on the severity of hematuria and proteinuria from +1 to +4. Among all students 24.7% of the students who scored +1 and 40.4% who scored +3 proteinuria on the first test had persistent proteinuria, and 56.4% with both proteinuria and hematuria had persistent proteinuria on the second test. For hematuria, the more positive in the first test showed more prevalence of persistent hematuria. And 61.6% of students with both proteinuria and hematuria had persistent hematuria on the second test.

Conclusion : The presence of both hematuria and proteinuria seemed to be a powerful predictor for persistent abnormal urine finding. And the more positive response in the first test was related to persistent abnormal finding. Therefore we should follow up closely for those students with positive findings.

Background
: Obesity in adolescence is a serious health problem because it may proceed to adulthood, cause metabolic complications, and thereby increase mortality. The main purpose of this study was to investigate the prevalence of obesity and other metabolic complications related to obesity among Korean adolescents.

Methods : The subjects of the study were 3,615 adolescents recruited from 12 middle schools nationwide. We measured their height, weight, obesity indices, fasting blood glucose, serum total cholesterol, triglyceride, HDL- cholesterol, ALT, AST, and uric acid levels. The risk factors of obesity were assessed by self-administered questionnaires.

Results : Obesity was evident in 16.2% of the subjects (20.7% in boys, 11.0% in girls). Adolescent obesity was closely related to parental obesity (Odds Ratio 2.9, 95% CI (Confidence Interval) 1.7∼2.5). Obese adolescents were at higher risk of elevated AST (OR 10.2, 95% CI, 5.2 ∼19.9), elevated ALT (OR 12.9, 95% CI, 6.9∼24.2), hypercholesterolemia (OR 1.5 95% CI, 1.2∼1.8, P＜0.05), hypertriglyceridemia (OR 4.0, 95% CI, 3.1∼5.3), and hyperuricemia (OR 2.2, 95% CI, 1.7∼3.0). More than 70% of obese adolescents had one or more metabolic complications related to obesity.

Conclusion : Adolescent obesity was closely related to parental obesity and metabolic complications related to the obesity were common among both obese boys and girls.

Background
: The metabolic syndrome is a cluster of related cardiovascular risk factors and it is the cause of morbidity and mortality in cardiovascular diseases. Recently, new diagnostic criteria of glucose metabolism impairment has been recommended. The purpose of this study was to estimate the difference of cardiovascular risk by investigating the prevalence of metabolic syndrome according to the degree of glucose metabolism impairment.

Methods : A population of 757 subjects was selected from a database of individuals who visited a health promotion center. We classified these subjects into 5 groups [Normal, Isolated impaired glucose tolerance (I-IGT), Isolated impaired fasting glucose (I-IFG), combined IGT with IFG (IGT/IFG) and Diabetes]. We compared the general characteristics, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the prevalence of metabolic syndrome in these groups.

Results : HOMA-IR and the prevalence of metabolic syndrome in the IGT/IFG and the Diabetes group were significantly greater than the Normal group. HOMA-IR and the prevalence of metabolic syndrome of the I-IGT and the I-IFG group were not significantly different with the Normal group.

Conclusion : The insulin resistance and the prevalence of metabolic syndrome in the IGT/IFG group was significantly greater than the Normal group, and its presence may increase the risk of cardiovascular diseases. Therefore, it is important to control other combined metabolic disorders to prevent cardiovascular events after effective selection for IGT/ IFG.

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
: Pulse pressure, a clinical marker of arterial stiffness, is an independent and strong predictor of cardiovascular disease, and reflects aging of arterial system. It is a well known fact that serum IGF-1 level is a parameter of growth hormone (GH) secretion and decreased GH secretion is related to aging. The aim of this study was to find out if there was any correlation between pulse pressure and IGF-1 concentration.

Methods : By reviewing the medical records of a hospital in Korea, healthy 194 men and 180 women were studied. We measured serum IGF-1, triglyceride, total cholesterol, HDL cholesterol concentrations and fasting blood sugar (FBS). Also, anthropometric and blood pressure measurements were performed.

Results : In men, the pulse pressure was positively correlated with age (r=0.29, P＜0.001), systolic blood pressure (SBP) (r=0.70, P＜0.001), diastolic blood pressure (DBP) (r=0.22, P=0.003), and body mass index (BMI) (r= 0.28, P＜0.001) and inversely with IGF-1 levels (r=-0.27, P＜0.001). In women, pulse pressure was positively levels with SBP (r=0.28, P＜0.001), BMI (r=0.27, P＜0.001), triglyceride (r=0.19, p=0.011), total cholesterol (r=0.15, P=0.049) levels, and FBS (r=0.17, P=0.027) and was not correlated with age, DBP, and serum IGF-1 levels. After adjustment for age, BMI, triglyceride, total cholesterol, and FBS, the pulse pressure was independently negatively correlated with serum IGF-1 levels (β=-6.052, P=0.007) in men. The multiple regression analysis showed that serum IGF-1 levels (R²=0.04) was the third most powerful factor influencing the pulse pressure.

Conclusion : There was as independent negative correlation between the pulse pressure and serum IGF-1 levels in healthy men.

Background
: Recently, obesity has become an important health problem in Korea. In 2000, the WHO Western Pacific Region recommended an obesity diagnostic criteria for Asian population. But among Asians, each ethnic group had their own anthrometric characteristics and so it was difficult to apply the same criteria to different ethnic groups. Thus, the aim of this study was to study the appropriate cut-off value of visceral fat area (VFA) and waist circumference (WC) which increases the risk of obesity-related disorders and to validate the diagnostic criteria of abdominal obesity and metabolic syndrome in Korean adult population.

Methods : A total of 278 of subjects (101 men and 177 women) were included for this study. The subjects were selected among Korean adults who visited the Department of Family Medicine, St. Mary's Hospital from January 1999 to August 2005. Three obesity-related disorders were defined to hypertension, hyperglycemia, and dyslipidemia.

Results : The cut-off value of visceral fat area which increased the risk of obesity-related disorders by ROC curve was 114.3 cm² (sensitivity 76.3%, specificity 65.9%, P＜0.005), and the waist circumference corresponding to a VFA of 114.3 cm² by simple regression analysis was 74.2 cm in men and 87.37 cm in women (P＜0.05).

Conclusion : Based on the results of this study, the visceral fat area which increased the risk of obesity-related disorders was 114.3 cm² and the WC corresponding to this VFA was 74.2 cm in men and 87.37 cm in women. For appropriate diagnostic criteria of abdominal obesity and metabolic syndrome in Korean adult population, further studies are required.

Background
: This study was done to estimate the size of long-term care in-patients in one Veterans Hospital. Using KADL and KIADL (developed in 2002, verified validity & reliability), we evaluated the activities of daily living among in-patients in Daegu Veterans Hospital.

Methods : During the two months in June and July 2003, interviews were conducted by two interviewers. Daegu Veterans Hospital is 300-bed hospital and 257 in-patients were interviewed. Information from patients, care-givers, nurses and others were obtained. We classified a patient as severely disabled requiring long-term care if one's total-KADL score over 16.

Results : The patients studied were representative of in-patients of Daegu Veterans Hospital. Their characteristics were males, old aged, slightly lower education but with high income compared to community based people. Among the total, 34% were classified as severe disabled (total-KALD score over 16) needing long-term care. The distribution of total-KADL was bi-modal (both the independent group and the dependent group occupied a high percentage). But the distribution of total-KIADL was more skewed to the independent group and we were able to estimate that the real long-term care need might be over 34%. Average admission period during the recent six months was 83.3 days in all-covered patients and 55.3 days in partial-covered patients. There was no significant correlation between the total-KADL/KIADL score and the admission period. It was suggested that Daegu Veterans Hospital was utilized as a long-term care hospital.

Conclusion : Among the total, 34% of admitted patients was classified as a long-term care group. Considering KIADL, the percentage of patients needing long-term care may be greater than those studied.