Atopic dermatitis (AD) is characterized by pruritic and eczematous skin lesions, which often cause depressive symptoms, anxiety, stress, sleep disturbances, social withdrawal, and stigmatization.
In total, 23,442 subjects (434 AD patients and 23,008 control subjects) aged 19 years or older and without a history of major medical illness or depressive disorders were selected from The Fifth Korea National Health and Nutrition Examination Survey 2007-2012. Following the initial selection, 2,170 age- and sex-matched control subjects were selected using 1:5 propensity score matching. Multiple logistic regression analysis was performed to identify the presence of depressive symptoms of at least 2 weeks in duration.
The demographic, socioeconomic, and clinical characteristics of AD patients and control subjects were presented and compared, and some variables differed significantly between groups. Presence of depressive symptoms was set as dependent variable, and multiple logistic regression analysis was performed as follows: (1) unadjusted; (2) with alcohol use, exercise status, smoking status, and body mass index (BMI) adjusted for; and (3) with alcohol use, exercise status, smoking status, marital status, occupation, BMI, total caloric intake, history of hypertension, and history of diabetes mellitus adjusted for. Depressive symptoms were significantly higher (odds ratios, 1.46, 1.40, and 1.36; 95% confidence intervals, 1.09-1.95, 1.0.4-1.88, and 1.01-1.85, respectively) in AD patients relative to those of matched controls.
AD and clinical depression interact closely, and causal relationships between the two conditions have frequently been observed. Physicians should consider mental health interventions cautiously. It is particularly important that primary care physicians provide comprehensive, continuous long-term care.
Citations
Proper physical activities are known to be helpful in the prevention and management of chronic diseases. However, the physical activity level of patients with chronic diseases is low. Therefore, this study aimed to investigate the physical activity compliance of patients with hypertension, diabetes, and dyslipidemia in Korea.
This study analyzed the 2010-2012 Fifth Korean National Health and Nutrition Examination Survey data. We included 13,873 individuals in the analysis. The level of physical activity compliance was measured by performing multivariate logistic regression analyses.
In the univariate analysis, the subjects with hypertension or diabetes tended to comply with the physical activity guidelines less faithfully than their healthy counterparts. The proportion of subjects with hypertension who were insufficiently physically active was 65.4% among the men and 75.8% among the women. For diabetes, the proportions were 66.7% and 76.8%, respectively. No significant difference was found between the subjects with dyslipidemia and their healthy counterparts. In the multivariate logistic regression analysis, no significant difference in physical activity compliance was observed between the subjects with hypertension, diabetes, or dyslipidemia and their healthy counterparts for both sexes.
The patients with hypertension or diabetes tended to have lower physical activity prevlaence than their healthy counterparts. However, for dyslipidemia, no significant difference was found between the two groups. Given the significance of physical activities in the management of chronic diseases, the physical activities of these patients need to be improved.
Citations
The prevalence of metabolic syndrome is increasing worldwide, and previous studies have shown that inadequate sleep duration and skipping breakfast may be related to metabolic syndrome. Therefore, we investigated the effects of inadequate sleep and skipping breakfast on metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV & V reports (2007-2009 and 2010-2012, respectively).
The sample included 12,999 subjects who participated in the KNHANES IV & V. Sleep duration and breakfast eating were self-reported, and metabolic syndrome was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III guidelines. Subjects were divided into 12 groups according to breakfast eating and sleep duration patterns, and multiple logistic regression analyses adjusted for age, sex, household income, education level, smoking status, alcohol drinking, physical activity, and total daily energy intake were conducted.
In subjects under 50 years of age, sleeping less than 6 hours was significantly associated with increased metabolic syndrome except among those who ate breakfast on only 1 of the past 2 days. In subjects over 50 years of age, sleeping less than 6 hours was significantly associated with a decreased risk of metabolic syndrome among those who ate breakfast on both days.
In conclusion, significant associations between metabolic syndrome and sleep duration were identified, and these associations differed according to age group.
Citations
Previous randomized controlled trials (RCTs) have reported inconsistent findings regarding the association between vitamin C supplementation and the risk of cancer.
We performed a meta-analysis of RCTs to investigate the efficacy of vitamin C supplements for prevention of cancer. We searched the PubMed, EMBASE, and Cochrane Library databases in November 2014 using common keywords related to vitamin C supplements and cancer.
Among 785 articles, a total of seven trials were identified, which included 62,619 participants; 31,326 and 31,293 were randomized to vitamin C supplementation and control or placebo groups, respectively, which were included in the final analysis. A fixed-effects meta-analysis of all seven RCTs revealed no significant association between vitamin C supplementation and cancer (relative risk, 1.00; 95% confidence intervals, 0.95-1.05). Similarly, subgroup meta-analysis by dose of vitamin C administered singly or in combination with other supplements, follow-up period, methodological quality, cancer mortality, gender, smoking status, country, and type of cancer also showed no efficacy of vitamin C supplementation for cancer prevention.
This meta-analysis shows that there is no evidence to support the use of vitamin C supplements for prevention of cancer.
Citations
Given emerging evidence of the association between stress and disease, practitioners need a tool for measuring stress. Several instruments exist to measure perceived stress; however, none of them are applicable for population surveys because stress conceptualization can differ by population. The aim of this study was to develop and validate the Perceived Stress Inventory (PSI) and its short version for use in population surveys and clinical practice in Korea.
From a pool of perceived stress items collected from three widely used instruments, 20 items were selected for the new measurement tool. Nine of these items were selected for the short version. We evaluated the validity of the items using exploratory factor analysis of the preliminary data. To evaluate the convergent validity of the PSI, 387 healthy people were recruited and stratified on the basis of age and sex. Confirmatory analyses and examination of structural stability were also carried out. To evaluate discriminatory validity, the PSI score of a group with depressive symptoms was compared with that of a healthy group. A similar comparison was also done for persons with anxious mood.
Exploratory factor analysis supported a three-factor construct (tension, depression, and anger) for the PSI. Reliability values were satisfactory, ranging from 0.67 to 0.87. Convergent validity was confirmed through correlation with the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. People with depressive or anxious mood had higher scores than the healthy group on the total PSI, all three dimensions, and the short version.
The long and short versions of the PSI are valid and reliable tools for measuring perceived stress. These instruments offer benefits for stress research using population-based surveys.
Citations
Alcohol is traditionally known to have a relaxing effect. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia. In this study, we aimed to evaluate the effects of alcohol use on sleep quality.
A questionnaire-based cross-sectional survey was conducted with 234 men and 159 women who had visited a general hospital. We used structured questionnaires, including Alcohol Use Disorder Identification Test-Korean revised version (AUDIT-KR) and the Pittsburgh Sleep Quality Index-Korean version (PSQI-K). We analyzed the association between scores for all subcategories of the PSQI-K and the AUDIT-KR and then analyzed the correlation between AUDIT-KR and global PSQI-K scores.
The global PSQI-K score for men was positively correlated with the AUDIT-KR score (P=0.008) after adjusting for age, chronic disease, tobacco use, exercise, depression, and anxiety. The AUDIT-KR score was significantly associated with subjective sleep quality (P=0.005), sleep duration (P=0.047), and sleep disturbance (P=0.048); it was not associated with sleep latency, sleep efficiency, or daytime dysfunction. Sleep disturbances due to snoring were significantly associated with total AUDIT-KR score (P=0.008). There was no correlation between the global PSQI-K and AUDIT-KR scores for women (P=0.333). However, daytime dysfunction showed a significant association with total AUDIT-KR score (P=0.048).
Men with higher AUDIT-KR scores tended to suffer from poor sleep quality. AUDIT-KR scores showed significant correlations with subjective sleep quality, sleep duration, and sleep disturbances in men.
Citations
Fast eating or overeating can induce gastrointestinal diseases such as gastritis. However, the association between gastritis and speed of eating is unclear. The aim of this study was to determine whether eating speed is associated with increased risk of endoscopic erosive gastritis (EEG).
We carried out a cross-sectional study involving 10,893 adults who underwent a general health checkup between 2007 and 2009. Two groups, EEG patients and EEG-free patients, were compared by using the t-test and the chi-square test. Multiple logistic regression analyses were performed to investigate the association between eating speed and EEG.
The group with EEG had a higher proportion of males, average age, body mass index, and percentages of current smokers and risky drinkers than those without EEG. After adjusting for anthropometric, social, and endoscopic parameters, the group with the highest eating speed (<5 min/meal) had 1.7 times higher risk for EEG than the group with the lowest eating speed (≥15 min/meal) (odds ratio, 1.71; 95% confidence interval, 1.20-2.45).
High eating speed is an independent risk factor for EEG. Our results indicate the need for further studies to clarify the role of eating speed in gastritis.
Citations
Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women.
Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (β) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM.
Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17±3.7 and 50.58±3.5 years, respectively), with a statistically significant correlation (P<0.05). This correlation was still observed after adjusting for age, body mass index, menstrual regularity, and personal income (P<0.05 for variables).
In Korean women between 40 and 70 years of age who are in natural menopause, there is a statistically significant correlation between stress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
Citations
The aim of this study was to determine the association between carotid intima-media thickness (IMT) and newly developed 10-year atherosclerotic cardiovascular disease (ASCVD) risk score.
Participants were 201 Korean adults who underwent carotid ultrasonography at the Health Promotion Center of the Eulji General Hospital. We obtained information about medical history and lifestyle, and conducted laboratory tests. Carotid IMT by B-mode ultrasonography was measured. Carotid injury was considered present when the maximum carotid IMT was ≥0.9 mm or when arteriosclerotic plaques were detected. The 10-year ASCVD risk score was calculated using the 2013 American College of Cardiology/American Heart Association guidelines.
Men had higher 10-year ASCVD risk score than did women (mean±standard deviation: 7.15±6.04 vs. 2.53±3.67, respectively; P<0.001). Ten-year ASCVD risk was significantly correlated with right maximum carotid IMT (r=0.307), left maximum carotid IMT (r=0.230), right mean carotid IMT (r=0.322), and left mean carotid IMT (r=0.264). The group with high 10-year ASCVD risk were at even higher risk of carotid injury than were the group with low 10-year ASCVD risk (odds ratio, 2.201; 95% confidence interval, 1.162-4.1706; P=0.019). Only 10-year ASCVD risk score was significantly associated with carotid injury (odds ratio, 4.104; 95% confidence interval, 1.570-10.729). Variables that were not included in the 10-year ASCVD risk score were not significantly associated with carotid injury.
The findings of this study suggest that 10-year ASCVD risk score is associated with carotid injury.
Citations
This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM).
We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables.
The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR.
The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.
Citations
An association between arterial stiffness and osteoporosis has previously been reported. Therefore, we investigated the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and bone mineral density in a sample of healthy women undergoing routine medical checkup.
We retrospectively reviewed the medical charts of 135 women who had visited the Health Promotion Center (between May 2009 and December 2012). Brachial-ankle pulse wave velocity was measured using an automatic wave analyzer. Bone mineral density of the lumbar spine (L1-L4) and femur was measured by dual-energy X-ray absorptiometry. Metabolic syndrome was defined according to National Cholesterol Education Program-Adult Treatment Panel III criteria, using body mass index >25 kg/m2 instead of waist circumference >88.9 cm.
Pearson's correlation analysis revealed significant inverse relationships between pulse wave velocity and bone mineral density of the lumbar spine (r=-0.335, P<0.001), femur neck (r=-0.335, P<0.001), and total femur (r=-0.181, P=0.04). Pulse wave velocity showed the strongest association with age (r=0.586, P<0.001). Multiple regression analysis identified an independent relationship between pulse wave velocity and lumbar spine bone mineral density in women after adjusting for age, metabolic syndrome, body mass index, smoking status, alcohol intake, and exercise (r=-0.229, P=0.01).
This study confirmed an association between arterial stiffness and bone mineral density in women.
Citations
Gastric cancer is the second most common cancer in Korea. Fatigue is a common symptom among cancer survivors. The aim of this study was to identify factors associated with fatigue in gastric cancer survivors.
Data were analyzed from 199 gastric cancer survivors who visited a cancer survivor outpatient clinic from July 2013 to June 2014. Patients were surveyed using a questionnaire containing a fatigue severity scale (FSS) and questions regarding associated symptoms. Participants were divided into fatigue (FSS) and non-fatigue groups based on FSS scores (≥4 and <4, respectively). Age, sex, weight, body mass index, cancer stage, pathology, surgery type, chemotherapy, radiotherapy, comorbid disease, family history of cancer, smoking, alcohol consumption, exercise, and laboratory results were investigated.
The fatigue and non-fatigue groups contained 42 and 157 survivors, respectively. Their mean age was 58 years, and the mean post-operative period was 6.58 years. Arthralgia (odds ratio [OR], 12.95; 95% confidence interval [CI], 3.21-52.34), dyspnea (OR, 10.54; 95% CI, 2.94-37.80), dyspepsia (OR, 8.26; 95% CI, 2.63-25.96), changed bowel habits (OR, 4.56; 95% CI, 1.09-19.11), anemia (OR, 3.18; 95% CI, 1.26-8.05), and regular exercise (OR, 0.31; 95% CI, 0.12-0.77) were significantly associated with fatigue in gastric cancer survivors, while weight, treatment, and depressive mood were not.
Arthralgia, dyspnea, dyspepsia, bowel habit change, anemia, and regular exercise are associated with fatigue in gastric cancer survivors.
Citations
We studied the association between the triglyceride to high-density lipoprotein cholesterol ratio and computed tomography-measured visceral fat as well as cardiovascular risk factors among Korean male adults.
We measured triglycerides, high density lipoprotein cholesterol, body mass, waist circumference, fasting plasma glucose, hemoglobin A1c, systolic blood pressure, diastolic blood pressure, visceral fat, and subcutaneous fat among 372 Korean men. The visceral fat and subcutaneous fat areas were measured by computed tomography using a single computed tomography slice at the L4-5 lumbar level. We analyzed the association between the triglyceride to high density lipoprotein cholesterol ratio and visceral fat as well as cardiovascular risk factors.
A positive correlation was found between the triglyceride to high density lipoprotein cholesterol ratio and variables such as body mass index, waist circumference, fasting plasma glucose, hemoglobin A1c, visceral fat, and the visceral-subcutaneous fat ratio. However, there was no significant correlation between the triglyceride to high density lipoprotein cholesterol ratio and subcutaneous fat or blood pressure. Multiple logistic regression analyses revealed significant associations between a triglyceride to high density lipoprotein cholesterol ratio ≥3 and diabetes, a body mass index ≥25 kg/m2, a waist circumference ≥90 cm, and a visceral fat area ≥100 cm2. The triglyceride to high density lipoprotein cholesterol ratio was not significantly associated with hypertension.
There were significant associations between the triglyceride to high density lipoprotein cholesterol ratio and body mass, waist circumference, diabetes, and visceral fat among a clinical sample of Korean men. In the clinical setting, the triglyceride to high density lipoprotein cholesterol ratio may be a simple and useful indicator for visceral obesity and cardiovascular disease.
Citations
Pregnancy considerably alters cardiovascular dynamics, and thereby affects the transition of blood pressure after delivery in women. We aimed to analyze the association between parity and blood pressure in Korean adult women.
We included 8,890 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We divided the population according to the menopause status and analyzed the association between parity and blood pressure by using multiple regression analysis, and on hypertension, by using logistic regression analysis.
Systolic and diastolic blood pressures were significantly associated with parity in premenopausal women (β=-0.091 [P<0.001] and β=-0.069 [P<0.001], respectively). In the analysis that excluded women receiving antihypertensive medication, the systolic and diastolic blood pressure of postmenopausal women were significantly associated with parity (β=-0.059 [P=0.022] and β=-0.054 [P=0.044], respectively). Parity was found to prevent hypertension after adjustment for confounders in postmenopausal women (odds ratio, 0.55; 95% confidence interval, 0.310-0.985).
We found that parity prevented hypertension in Korean women.
Citations
Health-related quality of life (HRQoL) is considered an important outcome measure in chronic diseases, in particular cardiovascular disease (CVD), which is known to be associated with impaired HRQoL. However, few studies have examined HRQoL in individuals at high risk of CVD.
Using the Fifth Korea National Health and Nutrition Examination Survey 2010-2012, we analyzed data from 10,307 adults aged ≥30 years. The study subjects were stratified into 3 groups on the basis of their Framingham risk score-a 10-year estimate of CVD risk: <10.0% (low risk), 10.0%-19.9% (moderate risk), and ≥20.0% (high risk). The EuroQol-5D (EQ-5D) was used to evaluate HRQoL.
A significantly higher proportion of high-risk subjects than low-risk participants had impaired HRQoL (defined as the lowest quartile of the EQ-5D index); this held true even after adjustment for confounding factors in multivariable logistic regression analysis (men: odds ratio [OR], 1.62; 95% confidence interval [CI], 1.24-2.11; women: OR, 1.46; 95% CI, 1.02-2.08). In terms of the 5 EQ-5D dimensions, a 10-year CVD risk ≥20.0% was significantly associated with self-reported problems of mobility in men (OR, 3.15; 95% CI, 2.02-4.90), and of mobility (OR, 1.56; 95% CI, 1.09-2.24), self-care (OR, 2.14; 95% CI, 1.09-4.22), and usual activity problems (OR, 1.80; 95% CI, 1.17-2.78) in women.
A high CVD risk is associated with impaired HRQoL. After adjustment for demographic and clinical factors, a 10-year CVD risk ≥20.0% is an independent predictor of impaired HRQoL in the general population; in particular, of mobility problems in men, and of mobility, self-care, and usual activity problems in women.
Citations
First
Prev
