Korean Journal of Family Medicine

"Primary Prevention"

Original Article

Association of lipoprotein(a) with progression of coronary artery calcification: retrospective longitudinal study: Anna Lee, Hyun-Min Koh, Ji-Yong Jang, Hye-Rang Bak, Hye-Jin Jang, Jun-Young Huh, Nak-Gyeong Ko; Korean J Fam Med 2025;46(3):176-184. Published online May 22, 2024; DOI: https://doi.org/10.4082/kjfm.23.0108

Abstract
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Background
Atherosclerotic cardiovascular disease (ASCVD) is a major health concern, and lipoprotein(a) (Lp(a)) is an independent risk factor. However, there is limited evidence regarding Lp(a) and the risk of ASCVD in Asian populations. This study aimed to assess the predictive value of changes in coronary artery calcification (CAC) for ASCVD risk associated with Lp(a) level.
Methods
Participants (n=2,750) were grouped according to their Lp(a) levels, and the association between Lp(a) and CAC progression was examined. CAC progression was defined as the occurrence of incident CAC or a difference ≥2.5 between the square root (√) of baseline and follow-up coronary artery calcium scores (CACSs) (Δ√transformed CACS). To adjust for differences in follow-up periods, Δ√transformed CACS was divided by the follow- up period (in years).
Results
Over an average follow-up of 3.07 years, 18.98% of participants experienced CAC progression. Those with disease progression had notably higher Lp(a) levels. Higher Lp(a) tertiles correlated with increased baseline and follow-up CACS, CAC progression (%), and Δ√transformed CACS. Even after adjustment, higher Lp(a) levels were associated with CAC progression. However, annualized Δ√transformed CACS analysis yielded no significant results.
Conclusion
This study demonstrated an association between elevated Lp(a) levels and CAC progression in a general population without ASCVD. However, longer-term follow-up studies are needed to obtain meaningful results regarding CAC progression. Further research is necessary to utilize Lp(a) level as a predictor of cardiovascular disease and to establish clinically relevant thresholds specific to the Korean population.

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Review Article

Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians: Piero Portincasa, Agostino Di Ciaula, Ignazio Grattagliano; Korean J Fam Med 2016;37(4):205-213. Published online July 21, 2016; DOI: https://doi.org/10.4082/kjfm.2016.37.4.205

Abstract
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Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case–controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting.

Citations

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Different types and numbers metabolic abnormalities and risk of gallbladder stone disease in adults
Tingting Yang, Jianqin Zhong, Renhua Zhang, Fei Xiao, Yuan Wang, Huimin Tao, Feng Hong
Frontiers in Nutrition.2024;[Epub] CrossRef
Ten-Year Trends of Persistent Mortality With Gallstone Disease: A Retrospective Cohort Study in New Jersey
Gregory L. Peck, Yen-Hong Kuo, Edward Nonnenmacher, Vicente H. Gracias, Shawna V. Hudson, Jason A. Roy, Brian L. Strom
Gastro Hep Advances.2023; 2(6): 818. CrossRef
Incidence of symptomatic cholelithiasis after laparoscopic sleeve gastrectomy and its association with rapid weight loss
FaisalA Alsaif, FahadS Alabdullatif, MohammedK Aldegaither, KhalidA Alnaeem, AbdulrahmanF Alzamil, NoufH Alabdulkarim, AbdullahD Aldohayan
Saudi Journal of Gastroenterology.2020; 26(2): 94. CrossRef
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Binwu Sheng, Qingbin Zhao, Mao Ma, Jianqin Zhang
Lipids in Health and Disease.2020;[Epub] CrossRef
Cholesterol cholelithiasis: part of a systemic metabolic disease, prone to primary prevention
Agostino Di Ciaula, David Q-H Wang, Piero Portincasa
Expert Review of Gastroenterology & Hepatology.2019; 13(2): 157. CrossRef
An update on the pathogenesis of cholesterol gallstone disease
Agostino Di Ciaula, David Q.-H. Wang, Piero Portincasa
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Brief Communication

The Association Chronic Liver Diseases with Health Related Behaviors in South Korea.: Juwon Lim, Soyeun Kim, Soshin Ke, Belong Cho; Korean J Fam Med 2010;31(4):302-307. Published online April 20, 2010; DOI: https://doi.org/10.4082/kjfm.2010.31.4.302

Abstract
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Background
The chronic liver disease is a relatively common health problem in primary care in Korea. But there are few studies of the prevalence and management status of chronic liver disease in Korea. The aim of this study is to estimate the ratio of health relative behavior among the patients of chronic liver disease, and analyse the association of chronic liver disease with health related behaviors such as private insurance, liver cancer screening examination, smoking, drinking, and exercise.Methods: We analyzed data from the third Korea National Health and Nutrition Examination Survey (KNANES III) 2005. The subjects of this study included the persons over 40 years. We used data about demographics, chronic liver disease, and health behavior data. Results: The prevalence of chronic liver disease was 2.4%. The ratios of private insurance, liver cancer screening examination among the patients of chronic liver disease were 72.6%, 44.2% respectively. The ratios of no smoking, abstinence from drinking, and exercise were 70.0%, 52.6%, and 33.8% respectively. After adjusted with demographic data, the odds ratio of liver cancer screening among the patients of chronic liver disease was 8.4 (P < 0.001), that of abstinence from drinking was 1.2 (P = 0.434). Adjusted odds ratio of private insurance, no smoking and exercise were 1.3 (P = 0.425), 1.2 (P = 0.578), 0.6 (P < 0.05).Conclusion: The primary prevention is less satisfactory than secondary prevention among the patients with chronic liver disease in Korea. In primary care, it is necessary for them not only to check liver cancer screening examination but also encourage no smoking, abstinence from drinking, and exercise.

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The impact of free vaccination policies under the Korean Influenza National Immunization Program: Trends in influenza vaccination rates in South Korea from 2010 to 2019
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PLOS ONE.2022; 17(1): e0262594. CrossRef
Relationship between Morbidity and Health Behavior in Chronic Diseases
Munjae Lee, Sewon Park, Kyu-Sung Lee
Journal of Clinical Medicine.2020; 9(1): 121. CrossRef
Life-Sustaining Treatment in End-Stage Liver Disease Patients: Patients’ Decisions and Results
Hyun Jung Jung, Jeong Yun Park
The Korean Journal of Hospice and Palliative Care.2020; 23(2): 85. CrossRef
A Structural Model of Alcohol Abstinence Behavior among Patients with Chronic Liver Diseases
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Korean Journal of Adult Nursing.2018; 30(1): 30. CrossRef
A study on the impacts of infection control education on dental hygienists' perceptions for hepatitis type B and their practices to prevent infection
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The Journal of Korean Academy of Prosthodontics.2014; 52(4): 287. CrossRef

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Original Articles

Level of Understanding of Importance of Preventing and Treating Dermatophytoses in Diabetic Patients.: Bong Wu Wu, Sung Kyung Je, Kyoung Kon Kim, Hee Cheol Kang, Bang Bu Youn; J Korean Acad Fam Med 2007;28(5):359-366. Published online May 10, 2007

Abstract
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Background
Dermatophytoses tend to have a poorer outcome in diabetic patients than in non-diabetic patients. Therefore, diabetic patients need to pay a closer attention to the prevention and treatment of dermatophytoses. The aim of this study was to determine the level of understanding of the dermatophytoses in diabetic patients and to clarify the factors associated with the level of understanding. Methods: A questionnaire survey was carried out from June to July, 2005, targeting 200 patients who had visited two hospitals in Seoul for the management of diabetes. There were 163 respondents (response rate 50.9%). The degree of understanding was calculated by giving 1 point to each question, with a maximum of 12 points. Results: The average degree of understanding of dermatophytoses was 6.68 points (SD 1.79). Younger age (P= 0.0002), high education level (P=0.0035), and high income (P=0.0013) were the factors related to a better understanding of dermatophytoses. The patients who had obtained the information on dermatophytoses from the websites, broadcasts, newspapers, or magazines showed higher recognition points than others (P=0.0377). The body mass index, the duration of diabetes, the complications associated with diabetes did not affect the understanding of dermatophytoses. Conclusion: There are many diabetes patients who do not know enough about dermatophytoses. Diabetes itself is not related to the level of understanding of dermatophytoses. However, diabetic patients who are older, have a lower level of education, and a low income will need to be informed about prevention and treatment of dermatophytoses. (J Korean Acad Fam Med 2007;28: 359-366)

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Assessment of risk factors of coronary heart disease in a university hospital using the Framingham risk score.: Young Hee Choi, Jung Hee Yang, Hyuk joon Choi, Kyung Hee Lee, Belong Cho, Bong Yul Huh; J Korean Acad Fam Med 2001;22(3):324-335. Published online March 1, 2001

Abstract
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Background
: Ischemic heart diseases have increased by more than 80% in the past 10 years among Korean and the global risk assessment of coronary heart disease(CHD) based on the relative risk factors to the probability of developing CHD became widely used for western populations. In this study we hope to provide information on the distribution and characteristics of the relative risks of CHD using the Framingham risk score.

Methods : This study involved the subjects who visited a university hospital for health promotion from 1995 to 2000 without CHD. We surveyed medical history of the subjects, and measured their blood pressure, serum glucose, total cholesterol(total-C) and HDL-cholesterol(HDL-C). Risk points from the Framingham chart were given to age, systolic BP, total-C, HDL-C, smoking, diabetes, and the global risk score was calculated from their sum. We analyzed the global risk scores and each risk points of the high risk groups.

Results : For younger and older men in the high risk group, the factors smoking and high blood pressure had the highest score assigned respectively. With younger women total-C had the highest score assigned, and with older women diabetes took over but HDL-C and high blood pressure still had a higher score.

Conclusion : For primary prevention of CHD, younger men need active education to quit smoking and for older aggressive blood pressure control is desperately needed. For women, concern about low HDL-C is highly needed and after menopause aggressive treatment for diabetes, high blood pressure, low HDL-C is needed.