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"Sang Hyun Lee"

Original Articles

Association of Hand Grip Strength and Cardiometabolic Markers in Korean Adult Population: The Korea National Health and Nutrition Examination Survey 2015-2016
Hanul Chong, Young Eun Choi, Jin Young Kong, Joo Hyun Park, Hyun Jeong Yoo, Jeong Ho Byeon, Hye Jun Lee, Sang Hyun Lee
Korean J Fam Med 2020;41(5):291-298.   Published online May 8, 2020
DOI: https://doi.org/10.4082/kjfm.18.0129
Background
Muscle strength has been suggested as a cardiovascular marker. The aim of this study was to examine the associations between hand grip strength and biomarkers of cardiovascular disease in the Korean population.
Methods
A total of 9,083 participants aged 20–80 years from Korea National Health and Nutrition Examination Survey 2015–2016 were investigated.
Results
Among men, both relative and dominant hand grip strength showed a positive association with diastolic blood pressure in those aged 65–80 years (95% confidence interval, P-value of dominant and relative hand grip strength: β=0.06, 0.01; P<0.05). Among women, relative and dominant hand grip strength showed a positive relationship to diastolic blood pressure in those aged 20–64 years (β=0.06, 0.01; P<0.001). Body mass index was positively associated with dominant hand grip strength in younger women (β=0.18, P<0.05), whereas it was positively associated with relative hand grip strength in all sex and age groups. High-sensitivity C-reactive protein showed a negative association with relative and dominant hand grip strength in all women, although the same association was observed only in younger men. Diabetes was inversely related to hand grip strength in younger women and men.
Conclusion
Increased hand grip strength may be associated with lower C-reactive protein in women and with less risk of diabetes in the Korean adult population. Further prospective studies are needed for the determination of causality between cardiometabolic markers and hand grip strength.

Citations

Citations to this article as recorded by  
  • The impact of reduced muscular fitness on cardiometabolic risk factors in children aged 9–11 years
    Eva Rodríguez‐Gutiérrez, Ana Torres‐Costoso, Lidia Lucas‐de la Cruz, Arthur E. Mesas, Vicente Martínez‐Vizcaíno, Ana Díez‐Fernández
    Acta Paediatrica.2024; 113(6): 1364.     CrossRef
  • Association between handgrip strength and metabolic syndrome in relation to gender and adiposity among middle aged and older Saudi populations
    Shaea A. Alkahtani, Ghedeir M. Alshammari, Aishah Alzuwaydi, Abdulaziz Alfuhaid, Abeer A. Al-Masri, Rizwan Qaisar, Syed Shahid Habib
    The Aging Male.2024;[Epub]     CrossRef
  • Higher dietary methyl donor micronutrient consumption is associated with higher muscle strength in adults: a cross-sectional study
    Amin Mirrafiei, Parisa Radkhah, Mahla Chambari, Samira Davarzani, Nadia Babaee, Kurosh Djafarian, Sakineh Shab-Bidar
    British Journal of Nutrition.2024; 131(11): 1926.     CrossRef
  • The combined effect of handgrip strength and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly: A cohort study
    Kai-jie Qi, Qiang Li, Gao-lei Lu, Min-jie Zhang, Min-zhe Zhang, Jia-min Yan, Qi-qiang He
    Archives of Gerontology and Geriatrics.2024; 124: 105481.     CrossRef
  • The Relationship Between Health Parameters, Body Size, Elements of Lifestyle, and Hand Grip Strength in a Group of Patients with Type 2 Diabetes, Aged 40–98, from Ulaanbaatar, Mongolia
    Myadagmaa Jaalkhorol, Agata Cieślik, Myagmartseren Dashtseren, Anya Khairat, Otgonbayar Damdinbazar, Gerelmaa Ochirdorj, Tsetsegsuren Khurelbaatar, Ganbayar Batmunkh, Ulemjjargal Ganzorig, Sławomir Kozieł
    Journal of Clinical Medicine.2024; 14(1): 102.     CrossRef
  • Relación entre adiposidad corporal y fuerza de prensión manual con la preocupación por la alimentación en deportistas universitarios
    Jorge Mendez-Cornejo, Ruben Vidal-Espinoza, Fernando Alvear-Vasquez, Ana Belen-Guzman, Rossana Gomez-Campos, Marco Cossio Bolaños
    Nutrición Clínica y Dietética Hospitalaria.2024;[Epub]     CrossRef
  • C-reactive protein and muscle-related measures over 14 years in Chinese community-dwelling older adults
    Suey S.Y. Yeung, Timothy Kwok, Jean Woo
    Archives of Gerontology and Geriatrics.2023; 106: 104878.     CrossRef
  • Increasing muscular strength to improve cardiometabolic risk factors
    Patricio Lopez-Jaramillo, Jose P. Lopez-Lopez, Maria Camila Tole, Daniel D. Cohen
    Clínica e Investigación en Arteriosclerosis.2023; 35(3): 144.     CrossRef
  • Handgrip strength is associated with risks of new-onset stroke and heart disease: results from 3 prospective cohorts
    Guochen Li, Yanqiang Lu, Liping Shao, Luying Wu, Yanan Qiao, Yi Ding, Chaofu Ke
    BMC Geriatrics.2023;[Epub]     CrossRef
  • Increasing muscular strength to improve cardiometabolic risk factors
    Patricio Lopez-Jaramillo, Jose P. Lopez-Lopez, Maria Camila Tole, Daniel D. Cohen
    Clínica e Investigación en Arteriosclerosis (English Edition).2023; 35(3): 144.     CrossRef
  • Lower handgrip strength levels probably precede triglyceride glucose index and associated with diabetes in men not in women
    Jia Zheng, Lu Zhang, Min Jiang
    Journal of Diabetes Investigation.2022; 13(1): 148.     CrossRef
  • Changes in high-sensitivity C-reactive protein levels and metabolic indices according to grip strength in Korean postmenopausal women
    Y. N. Kim, J.-h. Jung, S. B. Park
    Climacteric.2022; 25(3): 306.     CrossRef
  • Factors Associated with Handgrip Strength Among Older Adults in Malaysia
    Shamsul Azhar Shah, Nazarudin Safian, Zulkefley Mohammad, Siti Rohani Nurumal, Wan Abdul Hannan Wan Ibadullah, Juliana Mansor, Saharuddin Ahmad, Mohd Rohaizat Hassan, Yugo Shobugawa
    Journal of Multidisciplinary Healthcare.2022; Volume 15: 1023.     CrossRef
  • Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity
    Yanqiang Lu, Guochen Li, Pietro Ferrari, Heinz Freisling, Yanan Qiao, Luying Wu, Liping Shao, Chaofu Ke
    BMC Medicine.2022;[Epub]     CrossRef
  • Association between Grip Strength, Obesity, and Cardiometabolic Risk Factors among the Community-Dwelling Elderly Population in Taiwan
    Chun-Yung Chang, Nain-Feng Chu, Ming-Hsun Lin, Shu-Chuan Wang, Der-Min Wu, Ming-Kai Tsai, Chieh-Hua Lu
    International Journal of Environmental Research and Public Health.2022; 19(18): 11359.     CrossRef
  • Association of Absolute and Relative Handgrip Strength with Prevalent Metabolic Syndrome in Adults: Korea National Health and Nutrition Examination Survey 2014–2018
    Sunghyun Hong, Minsuk Oh, Youngwon Kim, Justin Y. Jeon
    International Journal of Environmental Research and Public Health.2022; 19(19): 12585.     CrossRef
  • Factors Influencing the Muscle Strength of the Elderly Without Activity Restrictions By Gender
    Myoungjin Kwon, Moonkyoung Park, Hyun Joo Kim, Jong Im Kim, Sun Ae Kim
    Journal of Korean Gerontological Nursing.2021; 23(1): 43.     CrossRef
  • Relationship Between Handgrip Strength and the Prevalence of Diabetes Mellitus Among Korean Adults: Korean National Health and Nutrition Examination Survey, 2014-2018
    Sung-hyun Hong, Ji-yong Byeon, Ji-hee Min, Dong-hyuk Park, Won-hee Cho, Justin Y. Jeon
    Exercise Science.2021; 30(1): 110.     CrossRef
  • Role of handgrip strength in predicting new-onset diabetes: findings from the survey of health, ageing and retirement in Europe
    Guochen Li, Yanan Qiao, Yanqiang Lu, Siyuan Liu, Yi Ding, Xing Chen, Chaofu Ke
    BMC Geriatrics.2021;[Epub]     CrossRef
  • Association between Adjusted Handgrip Strength and Metabolic Syndrome in Arab Men
    Shaea Alkahtani
    International Journal of Environmental Research and Public Health.2021; 18(20): 10898.     CrossRef
  • Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population
    Iris Paola Guzmán-Guzmán, Pedro Delgado-Floody, Ilse Adriana Gutiérrez-Pérez, Felipe Caamaño-Navarrete, Daniel Jerez-Mayorga, Óscar Zaragoza-García, Isela Parra-Rojas
    Nutrición Hospitalaria.2021;[Epub]     CrossRef
  • Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength
    Ana Torres-Costoso, Vicente Martínez-Vizcaíno, Rubén Fernández-Rodríguez, Irene Sequí-Dominguez, Sara Reina-Gutiérrez, Sergio Núñez de Arenas-Arroyo, Miriam Garrido-Miguel
    Nutrients.2021; 13(12): 4498.     CrossRef
  • Grip Strength as a Cardiometabolic Marker
    Jungun Lee
    Korean Journal of Family Medicine.2020; 41(5): 271.     CrossRef
  • 6,212 View
  • 129 Download
  • 21 Web of Science
  • 23 Crossref
Association between Sarcopenia and Dipstick Proteinuria in the Elderly Population: The Korea National Health and Nutrition Examination Surveys 2009–2011
Duna Hwang, Mi-Ryung Cho, Minyong Choi, Sang Hyun Lee, Youngmin Park
Korean J Fam Med 2017;38(6):372-379.   Published online November 14, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.6.372
Background

Sarcopenia and proteinuria are significant health difficulties in the elderly; however, few studies have investigated their relationship. In this study, we investigated the association between sarcopenia and proteinuria in Korean subjects over 60 years old.

Methods

We included data from the Korean National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey conducted from 2009 to 2011 (n=4,008). Sarcopenia was defined using appendicular skeletal muscle mass as a percentage of body weight. Proteinuria was defined by a urine dipstick test result above trace levels.

Results

The overall proteinuria prevalence was 7.2%. The incidence of sarcopenia was significantly higher in subjects with proteinuria. The prevalence of proteinuria was significantly higher in the sarcopenic group (5.5% vs. 14.5% in the non-chronic kidney disease (CKD) group; 17.2% vs. 23.2% in the CKD group) than in the non-sarcopenic group. Furthermore, sarcopenic participants had worse metabolic parameters, such as higher body mass indexes, waist circumferences, and fasting glucose levels, and lower high-density lipoprotein cholesterol levels than those in the non-CKD group. After adjustment for confounders, the odds ratios (95% confidence interval) for proteinuria were 2.84 (1.92–4.18) in the sarcopenic non-CKD group, 3.70 (2.59–5.30) in the non-sarcopenic CKD group, and 5.19 (2.64–10.18) in the sarcopenic CKD group, compared to the non-sarcopenic, non-CKD group. Sarcopenia increased the proteinuria risk in elderly participants without CKD, even after adjustment for obesity, hypertension, diabetes, and metabolic syndrome.

Conclusion

These findings showed that sarcopenia was associated with dipstick proteinuria, especially in elderly participants without CKD, regardless of comorbidities.

Citations

Citations to this article as recorded by  
  • Association between grip strength and albuminuria in the general United States population: NHANES 2011–2014
    Laisha Yan, Xiaoyan Hu, Shanshan Wu, Lina Chen, Shunying Zhao
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • The Relationship Between Sarcopenia And Proteinuria, What Do We Know?
    Ozkan Gungor, Sena Ulu, Ayca Inci, Kenan Topal, Kamyar Kalantar-Zadeh
    Current Aging Science.2024; 17(2): 93.     CrossRef
  • Campanha de prevenção de doença renal crônica: relação entre proteinúria e idosos
    Júlio César Chaves Nunes Filho, David Silva Camurça, Gabriel Alves Rocha, Ana Beatriz Timbó de Oliveira, Gabriela Correia Pequeno Marinho, Sérgio Gabriel Monteiro Santos, Dyego Castelo Branco Holanda Gadelha Pereira, Gdayllon Cavalcante Meneses, Elizabeth
    Brazilian Journal of Nephrology.2023; 45(2): 162.     CrossRef
  • Chronic kidney disease prevention campaign: relationship between proteinuria and elderly people
    Júlio César Chaves Nunes Filho, David Silva Camurça, Gabriel Alves Rocha, Ana Beatriz Timbó de Oliveira, Gabriela Correia Pequeno Marinho, Sérgio Gabriel Monteiro Santos, Dyego Castelo Branco Holanda Gadelha Pereira, Gdayllon Cavalcante Meneses, Elizabeth
    Brazilian Journal of Nephrology.2023; 45(2): 162.     CrossRef
  • Association of Hand Grip Strength and Albuminuria in Adults Aged over 40 Years: The 2019 Korea National Health and Nutrition Examination Survey (KNHANES VIII-1)
    Hae Hyeong Kang, Yohwan Yeo, Jung Jin Cho, Jong Lull Yoon, Mee Young Kim, Bo Mi Chun, Su Jin Lee
    Korean Journal of Family Practice.2023; 13(2): 80.     CrossRef
  • The risk of Parkinson's disease according to diabetic kidney disease status in a Korean population
    Seung Eun Lee, Juhwan Yoo, Han Seok Choi, Kyungdo Han, Kyoung-Ah Kim
    Parkinsonism & Related Disorders.2022; 100: 13.     CrossRef
  • Low urine pH associated with sarcopenia in the elderly
    Akihiro Saitsu, Yoshitaka Iwazu, Haruka Matsushita, Hirotaka Hayashi, Yumiko Mizuhashi, Kazuhiko Kotani
    Medicine.2021; 100(21): e26114.     CrossRef
  • Mock Urinalysis Demonstration: Making Connections among Acid–Base Chemistry, Redox Reactions, and Healthcare in an Undergraduate Nursing Course
    Angela L. Mahaffey
    Journal of Chemical Education.2020; 97(7): 1976.     CrossRef
  • Relationship between Decreased Estimated Glomerular Filtration Rate and Sarcopenic Obesity among Postmenopausal Women: Korea National Health and Nutrition Examination Survey (2008–2011)
    Changbin Hong, Jae Yong Baek, Ji Won Lee, Ji Hoon Lee, Kayoung Lee, Tae-jin Park, Jinseung Kim
    Korean Journal of Family Medicine.2020; 41(5): 332.     CrossRef
  • Breastfeeding and Sarcopenia in Later Life
    Jungun Lee
    Korean Journal of Family Medicine.2019; 40(3): 133.     CrossRef
  • Association between Sarcopenia and Renal Function in Patients with Diabetes: A Systematic Review and Meta-Analysis
    Satoshi Ida, Ryutaro Kaneko, Kanako Imataka, Kazuya Murata
    Journal of Diabetes Research.2019; 2019: 1.     CrossRef
  • 9,162 View
  • 68 Download
  • 8 Web of Science
  • 11 Crossref
Relationship between Changes in Fatigue and Exercise by Follow-Up Period
Seung Min Oh, Woo Kyung Bae, Se Ryung Choo, Hee Tae Kim, Hyun Ho Kim, Sang Hyun Lee, Han Sol Jeong
Korean J Fam Med 2016;37(2):78-84.   Published online March 25, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.2.78
Background

Fatigue is one of the most common presenting symptoms in primary care in Korea. In this study, we aimed to determine the effect of exercise intervention on the severity of fatigue of unknown medical cause during a period of follow-up.

Methods

We used the data collected from an outpatient fatigue clinic in Seoul National University Bundang Hospital. The study was conducted from March 3, 2010 to May 31, 2014. We measured the body mass index of each patient and evaluated variables including lifestyle factors (smoking, alcohol consumption, and regular exercise), quality of sleep, anxiety, depression, stress severity, and fatigue severity using questionnaires. A total of 152 participants who completed questionnaires to determine changes in fatigue severity and the effect of exercise for each period were evaluated. We used univariate analysis to verify possible factors related to fatigue and then conducted multivariate analysis using these factors and the literature.

Results

Of 130 patients with the complaint of chronic fatigue for over 6 months, over 90 percent reported moderate or severe fatigue on the Fatigue Severity Scale and Brief Fatigue Inventory questionnaires. The fatigue severity scores decreased and fatigue improved over time. The amount of exercise was increased in the first month, but decreased afterwards.

Conclusion

There was no significant relationship between changes in the amount of exercise and fatigue severity in each follow-up period. Randomized controlled trials and a cohort study with a more detailed exercise protocol in an outpatient setting are needed in the future.

Citations

Citations to this article as recorded by  
  • Effectiveness and safety of subthreshold vibration over suprathreshold vibration in treatment of muscle fatigue in elderly people
    Ayman A Mohamed, Esra Khaled, Asma Hesham, Ahmed Khalf
    World Journal of Clinical Cases.2023; 11(15): 3434.     CrossRef
  • New trends in treatment of muscle fatigue throughout rehabilitation of elderlies with motor neuron diseases
    Ayman Mohamed
    World Journal of Clinical Cases.2022; 10(2): 397.     CrossRef
  • Reflux Esophagitis and Fatigue: Are They Related?
    Sung-Goo Kang, Hyun jee Hwang, Youngwoo Kim, Junseak Lee, Jung Hwan Oh, Jinsu Kim, Chul-Hyun Lim, Seung Bae Youn, Sung Hoon Jung
    Journal of Clinical Medicine.2021; 10(8): 1588.     CrossRef
  • Can Proprioceptive Training Enhance Fatigability and Decrease Progression Rate of Sarcopenia in Seniors? A Novel Approach
    Ayman A. Mohamed
    Current Rheumatology Reviews.2021; 17(1): 58.     CrossRef
  • Can Proprioceptive Training Reduce Muscle Fatigue in Patients With Motor Neuron Diseases? A New Direction of Treatment
    Ayman A. Mohamed
    Frontiers in Physiology.2019;[Epub]     CrossRef
  • 4,822 View
  • 21 Download
  • 6 Web of Science
  • 5 Crossref
Effect of Video-Education on Pre-Procedure Anxiety.
Min Young Kim, Serng Bai Park, Su Yong Park, Young Eun Choi, Young Sung Kim, Sang Hyun Lee, Seung Su Kim, Kyung Hee Cho
Korean J Fam Med 2011;32(1):37-45.   Published online January 20, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.1.37
Background
The value of endoscopy is more increasing as a tool of the cancer screening, and many studies are now progressed for decreasing the inconvenience of patients who undergo the endoscopy. There are some overseas studies that the video-education before procedures like colonoscopy or coronary angiography increases the satisfaction and decreases the anxiety of the patients. But in Korea, there is lack of studies about the methods of decreasing the anxiety of the patients before procedures especially endoscopy.Methods: We carried out the survey with 95 patients underwent the endoscopy in the medical health checkup center of National Health Insurance Medical Center during 19 July 2008 to 8 September 2008. The patients who had the medical history of gastrectomy, had pains due to another diseases and had a prescription about psychiatric medicine including hypnotics were excluded.Results: Statistically there are no differences between two groups of the video-education and the paper-education according to age, sex, height, weight, body mass index, numbers of former endoscopy, smoking history and educational standard. The video-education is more effective than the paper-education in decreasing the anxiety index between before and after the education.Conclusion: The prior video-education for the patients awaiting endoscopy can decrease the anxiety about procedure. Moreover, it can decrease the suffi cation of the patients and increase the satisfaction of physicians. If the patients feeling the prior anxiety are educated with the video before undergoing endoscopy, the video-education is very effective to decrease the prior anxiety of the patients.
  • 2,006 View
  • 35 Download
Predictors Related to the Non-alcoholic Fatty Liver Disease.
Ha Young Na, Deok Ju Baek, Sang Hyun Lee, Young Eun Choi, Kyung Hee Cho, Sung Bae Park, Young Sung Kim, Seung Soo Kim
Korean J Fam Med 2010;31(2):94-100.   Published online February 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.2.94
Background
As the metabolic syndrome is increased, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increased. In recent studies, metabolic syndrome is related to serum uric acid. And some authors reported the association of uric acid and NAFLD. We have studied the association of serum uric acid and NAFLD. Methods: The authors conducted a cross-sectional survey of 3,430 subjects out of 6,731 individuals who had visited the Health Promotion Center at the National Insurance Corporation Ilsan Hospital for the purpose of a regular check-up from January 2005 to April 2008. We excluded who showed evidence of more than moderate alcohol consumption, hepatitis B or C, or severe hepatic dysfunction. Results: Among 3,430 participants, 1,775 subjects (51.7%) were diagnosed with NAFLD and 1,655 subjects (48.3%) were control. Age, BMI, triglyceride, fasting glucose, uric acid were greater in the patients with NAFLD than in the controls. The severity of NAFLD is related to uric acid. When uric acid is divided in 4 groups, elevation of uric acid is associated with risk for NAFLD. This relationship is showed in similar pattern when adjusting for age, sex, BMI, triglyceride, fasting glucose. The uric acid elevation of 1mg/dL is associated with the increase of 1.11 fold in risk for NAFLD. Conclusion: The risk for non-alcoholic fatty liver disease is related to uric acid. And the severity of non-alcoholic fatty liver disease is associated with uric acid.

Citations

Citations to this article as recorded by  
  • Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Korean Patients Undergoing Bariatric Surgery
    Ki Hyun Kim, Yoonhong Kim, Kwang Il Seo, Kyung Won Seo
    Journal of Metabolic and Bariatric Surgery.2022; 11(2): 63.     CrossRef
  • Systematic review on the prevalence of nonalcoholic fatty liver disease in South Korea
    Hwi Jin Im, Yo Chan Ahn, Jing-Hua Wang, Myung Min Lee, Chang Gue Son
    Clinics and Research in Hepatology and Gastroenterology.2021; 45(4): 101526.     CrossRef
  • Subclinical steatohepatitis and advanced liver fibrosis in health examinees with nonalcoholic fatty liver disease (NAFLD) in 10 South Korean cities: A retrospective cross-sectional study
    Eun-Hee Nah, Seon Cho, Hyeran Park, Dongwon Noh, Eunjoo Kwon, Han-Ik Cho, Daisuke Tokuhara
    PLOS ONE.2021; 16(11): e0260477.     CrossRef
  • 2,005 View
  • 24 Download
  • 3 Crossref
Factors Related to Increase of Blood Pressure in Obese Children and Adolescents.
Sang Hyun Lee, Eunju Sung, Ho Cheol Shin, Yong Woo Park, Cheol Hwan Kim, Kyung Seop Soh
J Korean Acad Fam Med 2007;28(7):515-522.   Published online July 10, 2007
Background
As obese population is increasing nowadays, research on blood pressure of obese children is being performed more frequently. However, there are only few research related to factors about blood pressure among obese children in Korea. The purpose of this study was to analyze the factors affecting blood pressure of obese children and adolescents. Methods: The subjects were elementary and middle school students diagnosed with obesity (n=1716). Height, weight, waist circumstance, body fat percent, blood pressure were measured. Family history and sexual maturity were investigated through the questionnaire. The relationship between the factors and the increase of blood pressure was analyzed. Results: Body weight was the most powerful factor among to factors related to increase of blood pressure (male r=0.45, P<0.05, female r=0.37, P<0.05). Also, height, percentage weight for height (PWH), body mass index (BMI) and waist circumference was correlated with the blood pressure. In multiple regression analysis, family history of hypertension and the sexual maturity were significant determinants of blood pressure in males after adjusting for weight. However, body fat percent was a significant determinant in females. Conclusion: Body weight was the most important factor which increased the blood pressure in obese children and adolescents in both sexes. But males and females had different factors related to the increase of blood pressure with the exception of body weight. (J Korean Acad Fam Med 2007;28:515-522)
  • 1,620 View
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Readability of Patient Information on Hypertension in Korea.
Soo Yun Kim, Young Woo Park, Ho Chul Shin, Chul Hwan Kim, Eun Joo Sung, Sang Hyun Lee
J Korean Acad Fam Med 2007;28(5):346-351.   Published online May 10, 2007
Backginformaround: Patient education is an important component of family practice. Pamphlets and the websites have been one of the most common resources for patient education. Patient information has been assessed using criteria with marks allocated for its content, design, readability. Up to present there have been studies on content, design but not readability. The WHO identifies readability as an essential tool for people to increase control over their health. Therefore, patient information should be assessed readability. The objective of our study was to assess patient information leaflets and the websites on hypertension to determine the readability of information currently available to patients. Methods: Ten leaflets were reviewed, five form the internet and five from other sources. A total of ten subjects were assessed for readability using 'grading system of vocabulary' presented by the Academy of Korea Education in 2002. Results: In five leaflets, about 41.3% vocabularies were comprised of 1st and 2nd grade. The portion of vocabularies in higher grade than 4th was 35%. In the five websites, 41.3% vocabularies in 1st and 2nd grade were used. The mean reading level (calculated with weight) was 2.057 for the five leaflets and 2.050 for the five websites. These results indicated that the leaflets were easier to read than websites. But, both of them were not comprehensible to the majority of patients. Conclusion: All 10 patient information materials for hypertension were at higher readability level than high school level. As recommended levels of readability were lower than 2nd grade, educational materials need to be modified to meet the information needs for the people with low reading skills. (J Korean Acad Fam Med 2007;28:346-351)
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Relationship between total testosterone and serum lipid in middle aged men.
In Suk Park, Young Ah Choi, Moon Jong Kim, Sang Hyun Lee, Young Gon Kang, Ho Taek Lee, Young Jin Lee, Chul Young Bae
J Korean Acad Fam Med 2001;22(7):1126-1136.   Published online July 1, 2001
Background
: The prevalance of coronary heat disease is significantly higher in men than in premenopausal women of the same age. Impact that endogenous androgens have on serum lipid has many arguments and few researches were made in Korea. So this study was made to investigate correlation between total testosterone and serum lipid known as effect on cardiovascular disease.

Methods : This was a cross-sectional study on 560 middle aged men undertaken health screening program in Pundang General Hospital. Korea for June 1999 to June 2000. We surveyed informations concerning exercise, consumption of alcohol and smoking by means of self questionnaire records and total testosterone and serum lipid were measured at fasting state.

Results : Body mass index was positively correlated with total cholesterol and triglycerides(r=2.023;P<0.01, r=0.229;P<0.01) but negatively correlated with HDL-cholesterol (r=-0.284;P<0.001). Total testosterone concentrations were negatively correlated with total cholesterol and triglyceride(r=-0.096; P<0.05, r=-0.145; P<0.01) but positively correlated with HDL-cholesterol(r=0.155; P<0.001). Total testosterone concentrations were independently correlated with HDL-cholesterol after age and body mass index were adjusted(B=0.734; P<0.05). And after statistical adjustment for age, body mass index, exercise, smoking and alcohol, total, testosterone concentrations were significantly correlated with triglyceride(B=-10.467; P<0.05).

Conclusion : The result indicate that total testosterone can be a independent determinant of HDL-cholesterol and we expect that appropriate maintenance of total tetosterone concentrations will have a protective effect for cardiovascular disease.
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Psychogenic symptoms in patients with noncardiac chest pain.
Young Ho Chang, Ji Ho Choi, Sang Hyun Lee, In Ho Kwak, Sun Duk Lee
J Korean Acad Fam Med 1999;20(12):1784-1793.   Published online December 1, 1999
Background
: Patients with chest pain are common among outpatients. Several researches shows that chest pain patients can suffer from psychiatric illnesses such as hypochondriasis, depression, anxiety, somatization, panic disorder and so on. This study aims to examine the psychogenic symptoms in patients with noncardiac chest pain.

Methods : In this study, the 98 people who have undergone treadmill test for chest pain during the three months from June 1st to September 30 of 1998 were selected, and the 98 patients were asked to respond to the prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) before they underwent treadmill test. And then, they were classified into two groups. One group consisted of patients with noncardiac chest pain, and the other group of patients with cardiac chest pain. These two groups were compared in 19 measures, and the compared results were analyzed by t-test.

Results : Among the 25 patients with cardiac chest pain, 15 patients were males and 10 patients (33%) were females, and among the 44 patients with noncardiac chest pain, 31 patients(70%) were males, 13 patients (30%) were females. The average age was 47 years old. The average age in patients with noncardiac chest pain was 48, and the 46 for those patients with cardiac chest pain. In the statistical analysis between the patients with cardiac chest pain and those with noncardiac chest pain, significant difference(p<0.005) was shown in the measures such as somatization, depression, phobic anxiety, obsessive-compulsive, neurasthenic, hypochodrial, anxiety, anger-hostility, interpersonal sensitivity.

Conclusion : As in the analysis the patients with noncardiac chest pain showed significant difference in the symptom check list minor psychiatric disorder compared to those with cardiac chest pain. We conclude that primary care physician should take more interest in evaluating psychiatric symptoms in patients with noncardiac chest pain.( J Korean Acad Fam Med 1999;20:1784-1793)
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Recognition status of early at-risk alcohol intake.
Hey Kyung Kim, Ji Ho Choi, Sang Hyun Lee, In Ho Kwak
J Korean Acad Fam Med 1999;20(12):1732-1740.   Published online December 1, 1999
Background
: Alcohol has much effect on our lives as a taste food that people in almost all of the world generally have had. The effects of alcohol cause social problems as well as physical and psychological problems. Recently, interest about drinking increasingly rises as the rate of drinking accident increases in Korea. For this, our study examined the amount of alcohol consumption and early at-risk alcohol intake.

Methods : The prepared questionnaire was presented to subjects who were employees in Inchon. The anonymous, self-administered questionnaire was composed of questionnaire concerning alcohol consumption, early at-risk alcohol intake and doctor’s role in drinking behaviour.

Results : Among 305 subjects, there were 189(62%) men, 116(38%) women whose mean age was 37 9 years. 87(28.5%) subjects were classified as high alcohol group and 218(71.5%) low alcohol group. High alcohol group was defined as early at-risk alcohol intake for men who were consuming 135g of alcohol per day, 630 per week and for women 90g per day, 270g per week. Low alcohol group was defined as early at-risk alcohol intake for men whose consumption was 90g per day, 450 per week and for women 45g per day, 270g per week. Mea alcohol consumption of drinker was 158.9g per week. 3 days per week people should not drink in order to avoid risk. Although 54% of respondents thought doctors should ask about their drinking habits, only 16.4% of respondents reported ever being asked about alcohol intake on the subject.

Conclusion : Early at-risk drinking subject in the study was much more than those suggested by NIH(National Institutes of Health). We conclude that primary care physicians should take more inter-est in screening, treating and preventing alcohol related problems and advise and educate patients to cut down or quit drinking. ( J Korean Acad Fam Med 1999;20:1732-1740)
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The relationship between depression and school related adjustment.
Jai Been Choi, In Ho Kwak, Sang Hyun Lee, Ji Ho Choi, Sung Min Cho
J Korean Acad Fam Med 1999;20(9):1144-1151.   Published online September 1, 1999
Background
: It is known tat patients with depression can have physical and social dysfunction Even though adolescents spend most of their time in school, researches on the researches on the relationship between adolescent depression and school adjustment are lacking. Therefore, this research surveys depression of adolescents and deals with the relationship between depression and school adjustment or school achievement.
Method : Questionnaires were distributed to 572 students in one coed high school located in Incheon. Depression tendency was based upon B야 as cut off point 21. School adjustment was based on school related adjustment scale and the class standing following the first semester.

Results : 25%(143) of 572 responses belonged to the depression tendency group. The school related adjustment scale of the depression tendency group averaged 80.06 14.78, while that of the non-depression tendency and school group averaged 91.78 14.98. The relationship between depression tendency and school adjustment was statistically significant(P<0.001). The relationship between depression tendency and school life related adjustment, school environment-related adjustment, school friend-related adjustment, school teacher-related adjustment or school instruction-related adjustment was statistically significant(P<0.001). In addition, the relationship between depression tendency and class standing was statistically significant(P<0.001).

Conclusion : there was a significant relationship between depression tendency and school adjustment or school achievement. As a result, family physicians as primary care physicians need to consider examination of psychiatric symptoms such as depression tendency as well as physical symptoms, when consulting with adolescent who have trouble adjusting to school of those who have low school achievements.
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Review

Dementia in the primary care.
Sang Hyun Lee
J Korean Acad Fam Med 1999;20(4):295-308.   Published online April 1, 1999
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Original Articles

Comparison of the clock drawing test with the Mini-Mental State Examination as a cognitive screening tool for dlderly patients..
Sang Hyun Lee, Moon Jong Kim
J Korean Acad Fam Med 1999;20(3):269-278.   Published online March 1, 1999
Background
: Cognitive impairment often goes unrecognized by physicians because the many previous tools to evaluate cognitive function in the clinical setting are difficult and time-consuming. The purpose of this study was to compare the Clock Drawing Test(CDT) with the Mini-Mental State Examination(MMSE) as a cognitive screening tool for elderly patients.

Methods : In a hospital-based outpatient clinic, 99 patients aged 65 or older were administered with the MMSE and were asked to mark the digits in the pre-drawn clock. They are also evaluated with the Geriatric depression scale, the Activities of Daily Living, and the Instrumental Activities of Daily Living.

Results : Correlation between CDT and MMSE was high(r=-0.606; p<0.001). With respect to CDT, there were significant correlations with all subscales of MMSE except registration of memory(p<0.01).
CDT with scores of 2 had a sensitivity of 68.2% and a specificity of 70.9% for mild cognitive impairment. CDT with scores of 4 had a sensitivity of 80.8% and a specificity of 84.8% for severe cognitive impairment.

Conclusion : CDT can be an effective and simple cognitive screening tool for the elderly patients in the primary care outpatient clinic, if compensated for registration of memory among the cognitive function.
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Risk Factors of Orthostatic Hypotension among the Long-term Hospitalized Elderly Patients.
Sang Hyun Lee
J Korean Acad Fam Med 1997;18(2):169-183.   Published online February 1, 1997
Background
: The purpose of this studdy was to assess the prevalence of orthostatic hypotension(OH) and its associations with demographic characteristics, body mass index, medications, disease and activities of daily living.

Methods : Orthostatic hypotension was assessed at 1 minutes after the patient arose from a supine position among the 183 elderly patients aged 60 year or older in a mental hospital.

Results : The prevalence of orthostatic hypotension defined by changes in systolic or diastolic blood pressure was 41.0% and the prevalence of systolicorthostatic hypotension was 13.1%.
Body mass index and serum sodium concentration were lower in women with orthostatic hypotension than those without orthostatic hypotension, but there were no differences among men. Orthostatic hypotension was significantly associated with the level of supine systolic and diastolic blood pressure.
Through multiple logistic regression analysis, orthostatic hypotension seemed to be associated with factors such as body mass index, supine diastolic blood pressure and serum sodium concentration. There was no association between orthostatic hypotension and factors such as sex, age and medications.

Conclusion : Orthostatic hypotension was common in the long-term hospitalized elderly patients. It was associated with hypertension, hyponatremia and low body weight.
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(RELATIONSHIP BETWEEN PASSIVE SMOKING , RESIDING LOCALITY , RESIDENTIAL MODES AND LEVELS OF IMMUNOGLOBULIN WITH TEC IN ASTHMATIC CHILDREN)
In Mok Yoo, Myung Kee Rah, Dong Wook Kim, Sang Hyun Lee, Bang Bu Youn
J Korean Acad Fam Med 1995;16(11):264-264.   Published online November 1, 1995
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Original Articles

Quality of life in the diabetic patients.
Bang Boo Yoon, Sang Hyun Lee, Jin Seog Gong, In Mog Yoo
J Korean Acad Fam Med 1995;16(9):617-629.   Published online September 1, 1995
Background
: DM is a chronic disease which self-management has been required for a long timee. Besides blood sugar control, the Quality-of-Life which the patients themselves have been satisfied with is important in diabetic management. But the studies for the diabetic QOL have been rare until now. The purpose of this study is to help that family physician take care of diabetic patient with evaluation and understanding of diabetic quality of life.

Methods : This study has been made of 108 NIDDM patients that have been visited to Incheon Segiwang and Seoul Seoboo hospitals during 7 months(1994.3-1994.9). The diabetic patients were evaluated by Duke-UNC general health profile as the Diabetic Quality-of-Life(DQOL) scale in this evaluated by Duke-UNC general health profile as the Diabetic Quality-of-Life(DQOL) scale in this study. The prupose of this study is to evaluate DQOL was scaled and compared with age, weight, economics, education, job, fasting blood sugar, treatment modality, and duration of the D.M..

Results : 1. The difference between males and females was not found on the total DQOL, but females were significantly more distressed than males in emotional function(P<0.05) and physical function(P<0.01).
2. The differences in non-diabetic factors(weights, economics, educations, jobs) were not found on the DQOL.
3. There was no significant difference in fasting glucose levels. The difference in durations of D.M. was not found on the DQOL.
4. The difference in treatment modality group such as diet&exercise group, oral hypoglycemic agent group and insulin therapy group was found on the total DQOL(P<0.01), especially with insulin therapy group being significantly more distressed than diet&exercise therapy group in emotional function(P<0.01), symptom status and social function(P<0.05).

Conclusion : The difference in treatment modality group such as diet&exercise group, oral hypoglycemic agent group and insulin therapy group was found on the total DQOL. The DQOL in treatment modality was depressed in order of insulin therapy group, oral hypoglycemic agent group and diet&exercise group. Finally, besides biochemical controls such as blood glucose level and prevention of the diabetic complications, the various factors in diabetic management which depress diabetic QOL should be detected and repaired, and the diabetic treatments and educations which improve diabetic QOL should be investigated further.
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The assessment of insight in alcoholics and associated factors ; a preliminary insight scale for alcoholics.
Sung Bae Seo, Jong Min Lee, Sang Hyun Lee, Jong Seong Kim, Bang Bu Youn
J Korean Acad Fam Med 1995;16(8):514-522.   Published online August 1, 1995
Background
: The screening tests for alcoholics have been made and use, however, there were few tools to assess the psychopathologic condition of alcoholics objectively for treatment. In this situation, as we can say that treatment of alcoholics begins from the recognition of disease by the patient, we tried to evaluate insight of alcoholics objectively and to investigate the associated factors.

Methods : Among the patients admitted to Alcohol Clinic due to problem of drinking between April and September in 1994, 41 patients who were admitted longer than one month diagnosed as alcoholism by DSM-Ⅲ-R, from whom we get information can be related to insight through data sheet inquiring demographic characteristics. A new insight scale, preliminary Insight Scale for Alcoholics(ISA) was made by this study as tools to measure insight of alcoholics based on insight scale which is used to other psychiatric diseases.

Results : Cronbach's alpha coefficient analysed internal consistency of the preliminary Insight Scale for Alcoholics(ISA) was 0.8371 by SPSS and the correlation between each item score and global score was used for another evaluation of reliability, and then correlation coefficient were from 0.3488 to 0.6851 in both scale done twice(P<0.05). This scale was analysed by factor analysis, and then yielded 8 factors, the factors accounted for more than 65% of items in the scale. These results show that this scale approximates to some of the aspects of insight in the definition of this stydy. The insight scale for alcoholics were enforced twice after earlier detoxification treatment and the education for abstinence from alcohol for 4 weeks, there were significatn changes statistically in scores of the insight scale for alcoholics(P<0.001). Although correlation analysis between MAST scores and scores of these insight scales was proportional(r=0.49), if the history of education for abstinence from alcohol was mediated, it was not significant statistically. The history of admission due to drinking was no significantly for those who has the history of education for abstinence from alcohol than those who has not(P<0.01) and for those who had the withdrawal symptoms(P<0.05). There were no significant between duration of drinking, APGAR score, psycho-social stress and scores of the insight scales.

Conclusion : Although it is necessary to refine the insight scale for alcoholics of this article, is was clinically possible to assess the insight and to evaluate the change of the insight. There was no close relation between MAST scores and the scores of the insight scale for alcoholics, and regardless of the times of admission the education for abstinence from alcohol is important factor associated with insight.
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Cerebral Venous Thrombosis.
Bong Bu Youn, Sang Hyun Lee, John A Linton, Lae Soon Jeong, Yung Hwan Yu
J Korean Acad Fam Med 1995;16(8):593-598.   Published online August 1, 1995
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Original Articles
The relation of serum magnesium with withdrawal symptoms in alcoholics.
Jong Min Lee, Jang Il Kim, Sang Hyun Lee, Jong Seong Kim, Bang Bu Youn
J Korean Acad Fam Med 1995;16(5):320-327.   Published online May 1, 1995
Background
: Alcoholics have been increased realistically, but the cause of withdrawal symptoms is not established. The role of magnesium has been claimed, therefore, we intends to see the relation of serum magnesium with alcohol withdrawal symptoms in this study.

Methods : The one hundred fifteen patients were cohsen, who were diagnosed as alcohol dependence in Alcohol clinic department of Dae Jeon Hani I1 Hospital from 1993. 10. 1 to 1994. 9. 30. The symptoms of selected patients were classified by DSM Ⅳ classification of alcohol withdrawal, and then compared with serum magnesium concentration at admission.

Results : The mean serum magnesium concentration of total 115 patients was 1.99±0.39 eEq/L. Among them, 61(53%) patients show sweating, 6(55.7%) tremor, 25(21.7%) delirium tremens, 26(22.6%) hallucination, 64(55.7%) agitation, and 24 patients(20.9%) have no withdrawal symptom. According as existence and/or nonexistence of withdrawal symptom, the difference of serum magnesium concentration was noted. The mean magnesium concentration of withdrawal symptom group is 1.90±0.31mEq/L, on the other hand, nonwithdrawal symptom group is 2.34±0.32eEq/L. As to magnesium concentration of each withdrawal symptom, sweating group is 1.79±0.27mEq/L, tremor group 1.84±0.36mEq/L, delirium tremens group 1.74±022mEq/L, hallucination group 1.83±0.39mEq/L. agitation group 1.89±0.38mEq/L, and so, the significant difference between symptom and nonsymptom group was seen.

Conclusion : The relation of serum magnesium concentration with alcohol withdrawal symptoms was observed, therefore, we guess the role of magnesium for alcohol withdrawal. Our study suggests that the active study and application of magnesium for the treatment of alcohol withdrawal may be required.
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Family and marital satisfaction according to the family life cycle.
Sang Hyun Lee, In Joo Kim, Do Won Kim, Ki Woo Kwak, Hye Ree Lee, Bang Bu Youn, Yun Jin Kim
J Korean Acad Fam Med 1991;12(8):1-9.   Published online August 1, 1991
Family physician should understand the various changes by family life cycle, and know the risk factors which can be expected from each stage. So he can help a family to cope with a change in a new stage. This study was designed to understand the changes of family and marital satisfaction according to the family life cycle.
For this purpose, we surveyed 341 men and women who had visited 3 general hospitals OPD in Seoul and Seochun from May to August in 1990. The family satisfaction(adaptability;6 items, cohesion 8 items) and the marital satisfaction(10 items) was evaluated according to the family life cycle(5 stages).

The results were as follows;
1. The family satisfaction score was higher in stage 5(launched; 52.5) and stage 1(beginning family; 52.4) than in other stages, but there was no significant difference.
2. The family adaptability score was the highest in stage 5(launched; 23.5), and was the lowest in stage 3(school age; 22.0).
The family cohesion score was the highest in stage 1(beginning family; 29.8), and the lowest in stage 4(launching; 28.3)
3. The marital satisfaction score was the highest in stage 1(beginning family; 37.6), and decreased gradually according to the family life cycle, and was the lowest in stage 4 (launched; 31.7), and increased in stage 5(launched; 33.8). There was a significant difference(P<0.01).
4. The marital satisfaction had a significant difference in the items (P<0.01) of personality, role, communication, sexual relationship, family & friends, and the item(P<0.01) of conflict resolution, but had no significant difference in the items of financial management, leisure activities, children, religious orientation.
5. The family satisfaction and the marital satisfaction had a significant correlation in each family life cycle stage (r=0.69, P<0.01).
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