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Chun MY, An H, Lee HA, Hwang S, Chung S, Kim NY, Lee HW. Clinical characteristics of seizure recurrence and epilepsy development in patients with alcohol-related seizures. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39333025 DOI: 10.1111/acer.15449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 09/05/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Alcohol withdrawal is widely recognized as a trigger for acute symptomatic seizures among individuals with chronic alcohol consumption. While most alcohol withdrawal seizures occur shortly after cessation, chronic alcohol consumption can be associated with the development of epilepsy, necessitating anti-epileptic drug (AED) therapy. This study aimed to investigate the clinical characteristics, seizure recurrence, and epilepsy development in patients with alcohol-related seizures and to identify prognostic factors for epilepsy. METHODS In a retrospective analysis at Ewha Womans University Mokdong Hospital, 206 patients with alcohol-related seizures were examined and 15 were excluded due to preexisting epilepsy. Demographic and clinical data, including alcohol withdrawal duration, seizure recurrence, types, and comorbidities, were investigated. Logistic regression models were used to analyze the risk factors for seizure recurrence and epilepsy development. The performance of the final models was evaluated based on the area under the receiver operating characteristic curve (AUC) and validated using calibration plots and leave-one-out cross-validation. RESULTS Of the 191 patients (146 males; mean age 48.3 ± 12.1 years) with alcohol-related seizures, 99 patients (51.8%) experienced seizure recurrence and 79 patients (41.4%) developed epilepsy. Factors associated with seizure recurrence included alcohol consumption levels, occurrence of focal impaired awareness seizure, anxiety, and headache. The number of recurrent seizures, semiology, status epilepticus, electroencephalogram findings, and brain imaging findings was associated with epilepsy development. The predictive models showed strong diagnostic performance, with AUCs of 0.833 for seizure recurrence and 0.939 for epilepsy development. CONCLUSION High alcohol consumption and specific clinical and diagnostic features are significant predictors of seizure recurrence and the development of epilepsy among patients with alcohol-related seizures. These findings underscore the importance of early identification and intervention to prevent seizure recurrence and the onset of epilepsy, emphasizing the importance of AED treatment in managing these conditions.
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Affiliation(s)
- Min Young Chun
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Hyungmi An
- Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Sungeun Hwang
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Seungwon Chung
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Na-Young Kim
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea
| | - Hyang Woon Lee
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea
- Neurology and Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, South Korea
- Computational Medicine, System Health Science & Engineering, Ewha Womans University, Seoul, South Korea
- Artificial Intelligence Convergence Graduate Programs, Ewha Womans University, Seoul, South Korea
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Yoo JJ, Lee DH, Kim SG, Jang JY, Kim YS, Kim LY. Impacts of smoking on alcoholic liver disease: a nationwide cohort study. Front Public Health 2024; 12:1427131. [PMID: 39171308 PMCID: PMC11335641 DOI: 10.3389/fpubh.2024.1427131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/15/2024] [Indexed: 08/23/2024] Open
Abstract
Objectives Smoking is a preventable risk factor for morbidity and mortality in patients with liver disease. This study aims to explore the additional risks of smoking in the development of alcoholic liver disease (ALD), cirrhosis, and hepatocellular carcinoma (HCC) in high-risk drinkers. Methods Data from the National Health Insurance Service, including claims and health check-up information spanning 2011 to 2017, were used. The overall alcohol consumption was calculated, and ALD was defined based on ICD-10 codes. High-risk drinking was defined as 7 or more drinks for men and 5 or more for women, twice weekly. Half of the high-risk drinkers were smokers, decreasing in men but stable at 20% for women. Results ALD prevalence was 0.97% in high-risk drinkers and 1.09% in high-risk drinkers who smoked, higher than 0.16% in social drinkers (p < 0.001). ALD incidence over 3-years was highest in high-risk drinkers who smoked (2.35%), followed by high-risk drinkers (2.03%) and social drinkers (0.35%) (p < 0.001). Cirrhosis and HCC followed similar patterns, with prevalence and incidence was highest in drinkers who smoked. 3-year mortality was 0.65% in high-risk drinkers who smoked, compared to 0.50% in high-risk drinkers and 0.24% in social drinkers (p < 0.001). Smoking increased the incidence of ALD, cirrhosis, and HCC by 1.32, 1.53, and 1.53 times, respectively (all p < 0.001). Gender-specific analysis revealed higher risk ratios (RR) for women in ALD, alcoholic cirrhosis, and HCC, particularly among high-risk drinkers who smoked. Women showed significantly increased RR in ALD (6.08 to 12.38) compared to men (4.18 to 4.40), and similar trends were observed for cirrhosis and HCC. Conclusion Smoking significantly heightens the risk of ALD, cirrhosis, and HCC, especially in women, among high-risk drinkers. This emphasizes the importance of smoking cessation, particularly for female patients with ALD.
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Affiliation(s)
- Jeong-Ju Yoo
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Dong Hyeon Lee
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sang Gyune Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jae Young Jang
- Department of Internal Medicine, Digestive Disease Center, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Log Young Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Republic of Korea
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Yoo JJ, Lee DH, Chang Y, Jo H, Cho YY, Lee S, Kim LY, Jang JY. Trends in alcohol use and alcoholic liver disease in South Korea: a nationwide cohort study. BMC Public Health 2024; 24:1841. [PMID: 38987717 PMCID: PMC11234741 DOI: 10.1186/s12889-024-19321-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND There is a lack of national-level research on alcohol consumption and the epidemiology of alcoholic liver disease (ALD) in South Korea. This study aims to address the critical public health issue of ALD by focusing on its trends, incidence, and outcomes, using nationwide claims data. METHODS Utilizing National Health Insurance Service data from 2011 to 2017, we calculated the population's overall drinking amount and the incidence of ALD based on ICD-10 diagnosis codes. RESULTS From 2011 to 2017 in South Korea, social drinking increased from 15.7% to 16.5%, notably rising among women. High-risk drinking remained around 16.4%, decreasing in men aged 20-39 but not decreased in men aged 40-59 and steadily increased in women aged 20-59. The prevalence of ALD in high-risk drinkers (0.97%) was significantly higher than in social drinkers (0.16%). A 3-year follow-up revealed ALD incidence of 1.90% for high-risk drinkers and 0.31% for social drinkers. Women high-risk drinkers had a higher ALD risk ratio (6.08) than men (4.18). The economic burden of ALD was substantial, leading to higher healthcare costs and increased hospitalization. Progression rates to liver cirrhosis and hepatocellular carcinoma (HCC) in ALD patients were 23.3% and 2.8%, respectively, with no gender difference in cirrhosis progression. CONCLUSIONS The study revealed a concerning rise in alcohol consumption among South Korean women and emphasizes the heightened health risks and economic burdens associated with high-risk drinking, especially concerning ALD and its complications.
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Affiliation(s)
- Jeong-Ju Yoo
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Dong Hyeon Lee
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Young Chang
- Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Republic of Korea
| | - Hoongil Jo
- Department of Internal Medicine, Wonkwang University School of Medicine & Hospital, Iksan, South Korea
| | - Young Youn Cho
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea
| | - Sangheun Lee
- Department of Internal Medicine, Catholic Kwandong University College of Medicine, Gangneung, South Korea
| | - Log Young Kim
- Department of Big DATA Strategy, National Health Insurance Service, 32, Geongang-Ro, Wonju-si, 26464, Republic of Korea.
| | - Jae Young Jang
- Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Republic of Korea.
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Cho SY, Jeong J, Shin S. Effect of alcohol consumption on risk of hypertension based on alcohol-related facial flushing response: From the health examinees study. Alcohol 2024; 121:133-139. [PMID: 38432421 DOI: 10.1016/j.alcohol.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/13/2023] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Alcohol consumption is a significant public health concern in Korea, with many individuals engaging in risky drinking behaviors. This study aims to analyze the association between facial flushing responses and the progression of hypertension in Korean adults, stratified by gender, using a large-scale prospective cohort study. METHODS This study included 39,868 participants (10,868 males and 29,000 females) from the health examinees cohort. Participants were divided into two groups according to their weekly drinking patterns (moderate and heavy) and facial flushing responses (non-flusher and flusher) for statistical analysis. A multivariate Cox proportional hazards regression model was used to calculate hazard ratios and 95% confidence intervals between flushing response after alcohol consumption and hypertension risk. RESULTS In males, the flusher group with a moderate alcohol intake pattern had a decreased risk of incident hypertension compared with non-flushers. In females, the flusher group had relatively higher risk of pre-hypertension and hypertension compared to the non-flusher group. CONCLUSION The association between facial flushing and hypertension varies depending on the level of alcohol consumption and should be considered in relation to gender differences. Further research is needed to understand the relationship between facial flushing response and the risk of hypertension based on alcohol consumption levels.
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Affiliation(s)
- Seung Yeon Cho
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, Republic of Korea
| | - Jiwon Jeong
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, Republic of Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, Republic of Korea.
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Lee J, Jeong Y, Kim J, Kwon S, Seo E, Jeong J, Lee W. The impact of alcohol consumption on hearing loss in male workers with a focus on alcohol flushing reaction: the Kangbuk Samsung Cohort Study. Ann Occup Environ Med 2024; 36:e1. [PMID: 38379640 PMCID: PMC10874948 DOI: 10.35371/aoem.2024.36.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/10/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024] Open
Abstract
Background Despite hearing loss being a prevalent chronic condition, estimated to nearly 20% of the global population by the World Health Organization, the specific association with individual lifestyle factors, particularly alcohol consumption, remains unclear. In South Korea, approximately 80% of the population engages in alcohol consumption, with a notably high prevalence among males, indicating a high-risk drinking pattern. Therefore, this study aimed to assess the correlation between alcohol consumption and hearing loss in male workers, as well as to analyze additional variables such as alcohol flushing reaction, with the intention of improving worker health. Methods The study was conducted from January 2012 to December 2019, targeting 114,114 participants who visited Kangbuk Samsung Hospital Total Healthcare Centers. Data were collected through pure-tone audiometry tests and alcohol-related questionnaire, and statistical analysis was performed using Cox regression analysis. Based on previous studies indicating a potential protective effect of light drinking on hearing loss, this group was designated as the reference. Additionally, stratified analyses were conducted based on the presence of alcohol flushing reaction and different working hours. Results The hazard ratio (95% confidence interval) for hearing loss was higher in the heavy drinking group (1.23 [1.11-1.37]) compared to the moderate drinking group (1.09 [0.98-1.20]). Stratified analyses revealed a significantly elevated the hazard ratio of hearing loss in groups with alcohol flushing reaction compared to those without this factor. Conclusions Our study demonstrated that moderate or heavy alcohol consumption in male workers can increase the risk of hearing loss, particularly in those with alcohol flushing reaction. These findings underscore the importance of addressing alcohol-related factors concerning hearing health among male workers.
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Affiliation(s)
- Jaehong Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youshik Jeong
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihoon Kim
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seonghyeon Kwon
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eunhye Seo
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsook Jeong
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woncheol Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Aung TNN, Thaikla K, Wiwatkunupakarn N, Aramrat C, Pinyopornpanish K, Jiraporncharoen W, Quansri O, Papachristou Nadal I, Kinra S, Angkurawaranon C. Development of a tool to estimate sugar and caloric contents in alcoholic beverages for a diabetes self-management program in Thailand. Heliyon 2023; 9:e21162. [PMID: 37954307 PMCID: PMC10637927 DOI: 10.1016/j.heliyon.2023.e21162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Diabetes self-management education and support (DSMES) is recommended as a standard of care for patients with diabetes worldwide. Alcohol consumption is one aspect mentioned within the DSMES program in Thailand where alcohol consumption is the highest among Southeast Asian countries. Many diabetes guidelines suggest limiting alcohol intake to not more than one standard drink per day for adult women and two for adult men if they cannot abstain from drinking. In practice, however, the conversion of alcohol consumption into standard drinks, and nutritional information about the calorie and sugar contents of alcoholic beverages, especially domestically produced spirits, are not commonly available in Thailand. By reviewing the diabetes guidelines internationally and the Thailand alcoholic beverage industry, a visual health education tool to help convert different alcoholic beverages into standard drinks and to provide the calorie and sugar content of alcoholic beverages was developed as a part of the DSMES program. It was finalized following pilot testing and focus group discussions with policymakers, healthcare providers, and type 2 diabetes patients. The personalized counseling tool, integrated with guidelines and culturally tailored to the Thai setting is distributed to counselors/educators. It is a potentially useful tool for patients to make informed choices for their self-management of diabetes.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Kanittha Thaikla
- Research Institute for Health Sciences, Chiang Mai University, Thailand
| | - Nutchar Wiwatkunupakarn
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Chanchanok Aramrat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
| | - Orawan Quansri
- ASEAN Health Institute for Health Development, Mahidol University, Nakhorn Pathom, Thailand
| | - Iliatha Papachristou Nadal
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, United Kingdom
- King's College London, United Kingdom
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand
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Kim HW, Min J, Ko Y, Oh JY, Jeong YJ, Lee EH, Yang B, Koo HK, Lee SS, Park JS, Park KJ, Chang JH, Joh J, Lee MK, Kim JS. Risk of loss to follow-up among tuberculosis patients in South Korea: whom should we focus on? Front Public Health 2023; 11:1247772. [PMID: 37927864 PMCID: PMC10622659 DOI: 10.3389/fpubh.2023.1247772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/15/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction In South Korea, public-private mix (PPM) has been a key strategy in national tuberculosis (TB) control program. This study aimed to identify rate of loss to follow-up (LTFU) among TB patients in nationwide PPM institutions and their risk factors. Methods A nationwide prospective observational study including drug susceptible TB patients diagnosed from the 1st day to the 10th day of every month between July 2018 and December 2020 in PPM institutions was designed. Multivariable survival models in which death and failure were designated as events with competing risk were used to investigate risk factors for LTFU. Results A total of 14,942 patients were included. Of them, 356 (2.4%) had an LTFU. Risk factors for LTFU were: underweight patients (adjusted hazard ratio (aHR): 1.47, 95% CI: 1.12-1.92), patients living alone (aHR: 1.43, 95% CI: 1.16-1.76), heavy drinkers (aHR: 1.67, 95% CI: 1.16-2.39), those with malignancy (aHR: 1.49, 95% CI: 1.07-2.05), foreigners (aHR: 5.96, 95% CI: 4.51-7.89), and those with previous TB history reported as an unfavorable outcome (aHR: 4.43, 95% CI: 2.77-7.08). Effect of age on LTFU was not significant. Brief interruption of anti-TB treatment (less than two months) in current session was associated with subsequent LTFU [adjusted odds ratio: 13.09 (10.29-16.66)]. Conclusion Identifying vulnerability of patients such as living alone, being heavy alcoholics, being foreigners or having previous TB history reported as an unfavorable outcome is required. Thorough case management for these vulnerable groups could be feasible with collaboration between public and private sectors.
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Affiliation(s)
- Hyung Woo Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yousang Ko
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jee Youn Oh
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yun-Jeong Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Eun Hye Lee
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Sung-Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Jae Seuk Park
- Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Kwang Joo Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jung Hyun Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Joonsung Joh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ju Sang Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Jeong JE, Park HK, Hwang HS, Park KY, Lee MH, Shin SH, Choi N. Body mass index and prevalence of metabolic syndrome among Korean adults before and after the COVID-19 outbreak: a retrospective longitudinal study. Epidemiol Health 2023; 45:e2023081. [PMID: 37654163 PMCID: PMC10728615 DOI: 10.4178/epih.e2023081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in Korea. METHODS This retrospective study included 1,118 male and female (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016 and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance. RESULTS Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021. CONCLUSIONS Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post- pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.
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Affiliation(s)
- Joo-Eun Jeong
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea, Seongdong-gu, Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea, Seongdong-gu, Korea
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea, Seongdong-gu, Korea
| | - Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea, Seongdong-gu, Korea
| | - Myoung-Hye Lee
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea, Seongdong-gu, Korea
| | - Seon-Hi Shin
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea
| | - Nayeon Choi
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea
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Lee S, Kim J, Kim JS. Current Status of Korean Alcohol Drinking in Accordance with the Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing. Korean J Fam Med 2023; 44:129-142. [PMID: 37225438 DOI: 10.4082/kjfm.23.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023] Open
Abstract
Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans' alcohol metabolism capabilities that can be predicted by presence of facial flushing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups according to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.
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Affiliation(s)
- Sami Lee
- Department of Family Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Jihan Kim
- Department of Family Medicine, Sejong Trinium Woman's Hospital, Sejong, Korea
- Department of Family Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jong Sung Kim
- Department of Family Medicine, Chungnam National University School of Medicine, Daejeon, Korea
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Chung JW, Lee SR, Choi EK, Park SH, Lee H, Choi J, Han M, Ahn HJ, Kwon S, Lee S, Han K, Kim S, Oh S, Lip GYH. Cumulative Alcohol Consumption Burden and the Risk of Stroke in Young Adults: A Nationwide Population-Based Study. Neurology 2023; 100:e505-e515. [PMID: 36323515 PMCID: PMC9931082 DOI: 10.1212/wnl.0000000000201473] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/12/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Alcohol consumption is one of the important modifiable risk factors for stroke in young adults. The association between the cumulative burden of alcohol consumption and its impact on incident stroke in young adults is unknown. We aimed to investigate the association between cumulative alcohol burden and the risk for stroke among young adults. METHODS Using data from the Korean National Health Insurance Service database, patients age between 20 and 39 years, who underwent 4 consecutive annual health examinations between 2009 and 2012, were included. The cumulative alcohol burden score of moderate-to-heavy drinking was evaluated by assigning a score of 1 for alcohol consumption ≥105 g/wk at the health examination each year and calculating the sum of 4 years (0-4). The main outcome was incident stroke and its subtypes, ischemic stroke, and hemorrhagic stroke during the follow-up period. RESULTS Of 1 536 668 patients (mean age of 29.5 years, 71.5% male, and median follow-up of 6-year), 3 153 experienced an incident stroke (incidence rate, 0.37 per 1,000 person-years). After multivariable adjustment, patients with alcohol burden scores of 2, 3, and 4, who consumed more than 105 g/wk of alcohol for 2, 3, and 4 years, demonstrated significantly higher risks for stroke (hazard ratio [HR] 1.19, 95% CI 1.05-1.34 for 2; HR 1.22, 95% CI 1.09-1.38 for 3; HR 1.23, 95% CI 1.10-1.38 for 4) compared with those with a burden score of 0. This positive dose-response relationship was primarily driven by hemorrhagic rather than ischemic stroke. High alcohol burden scores (i.e., 2, 3, and 4) were significantly associated with higher risks for hemorrhagic stroke (HR 1.30, 95% CI 1.10-1.54 for 2; HR 1.42, 95% CI 1.21-1.67 for 3; HR 1.36, 95% CI 1.16-1.59 for 4) compared with a burden score of 0. DISCUSSION Young adults who engaged in moderate-to-heavy drinking demonstrated a higher risk for incident stroke, especially hemorrhagic stroke. Reducing alcohol consumption should be emphasized in young adults with heavy drinking habits as part of any stroke prevention strategy.
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Affiliation(s)
- Jae-Wook Chung
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - So-Ryoung Lee
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Eue-Keun Choi
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark.
| | - Sang-Hyeon Park
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - HuiJin Lee
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - JungMin Choi
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark.
| | - Minju Han
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Hyo-Jeong Ahn
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Soonil Kwon
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - SeungWoo Lee
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Kyungdo Han
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Sunhwa Kim
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Seil Oh
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
| | - Gregory Y H Lip
- From the Departments of Internal Medicine (J.-w.C., S.-R.L., E.-K.C., S.-H.P., H.L., J.C., M.H., H.-J.A., Soonil Kwon, Sunhwa Kim, S.O.) and Internal Medicine (E.-K.C., S.O., G.Y.H.L.), Seoul National University College of Medicine; Department of Medical Statistics (S.L.), College of Medicine, Catholic University of Korea, Seoul; Statistics and Actuarial Science (K.H.), Soongsil University, Seoul, Republic of Korea; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom; and Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark
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11
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Mauro PM, Kane JC, Askari MS, Iwamoto D, Martins SS. Mind The Gap: Differences in Alcohol Use Screening And Discussions Among Adults Comparing Asian American And Other Racial And Ethnic Subgroups in the United States, 2015-2019. Alcohol Alcohol 2023; 58:31-39. [PMID: 36309849 PMCID: PMC9830473 DOI: 10.1093/alcalc/agac050] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 08/29/2022] [Accepted: 09/16/2022] [Indexed: 01/13/2023] Open
Abstract
AIMS Asian Americans are the fastest growing racial and ethnic subgroup in the USA but are underrepresented in the alcohol literature, partially due to misconceptions and racial stereotypes. We estimated any alcohol screening/discussions with providers among Asian Americans and other racial and ethnic subgroups and tested associations with alcohol treatment. METHODS Weighted prevalences of any alcohol screening or discussions with providers included US adults reporting past-year alcohol use and > =1 healthcare visit in the 2015-2019 National Survey on Drug Use and Health (n = 123,002). Multinomial logistic regressions estimated adjusted associations between alcohol use screening/discussions (ref: no screening/discussion) comparing Asian Americans to other racial and ethnic adult subgroups. Among adults with alcohol use disorder (AUD), we estimated adjusted odds of alcohol treatment and perceived treatment need by screening/discussions and racial and ethnic subgroup. RESULTS Among Asian American adults who reported past-year alcohol use and a healthcare visit, 24.7% reported any screening only and 51.4% discussed alcohol with providers. All racial and ethnic subgroups were more likely than Asian Americans to report alcohol screening/discussions (e.g. white adults, screening adjusted relative risk ratio [aRRR] = 1.48, 95% CI: 1.28-1.72; discussions aRRR = 1.92, 95% CI: 1.74-2.10). AUD treatment use and perceived need were about two times higher among people reporting alcohol discussions. CONCLUSIONS Asian Americans were less likely to report discussing alcohol with providers than all other racial and ethnic subgroups. Alcohol discussions were associated with treatment use and perceived need. Efforts to increase equitable alcohol screening and discussions with clinicians are needed.
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Affiliation(s)
- Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Jeremy C Kane
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Melanie S Askari
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Derek Iwamoto
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
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12
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Correlation between shift work and non-alcoholic fatty liver disease among male workers in the steel manufacturing company of Korea: a cross-sectional study. Ann Occup Environ Med 2022; 34:e33. [PMID: 36544884 PMCID: PMC9748156 DOI: 10.35371/aoem.2022.34.e33] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022] Open
Abstract
Background Circadian rhythm disturbance caused by shift work has adverse effects on the metabolic homeostasis of the liver. Disruption of the metabolic homeostasis of the liver causes fat accumulation in the liver. The aim of this study was to investigate the correlation between shift work and non-alcoholic fatty liver disease (NAFLD) among male workers in the steel manufacturing industry of Korea. Methods Based on medical examination data collected in June 2020, 2,511 male subjects from one steel manufacturing company in Korea were selected in total. NAFLD was evaluated using abdominal ultrasound, which was performed by two experienced radiologists. The multinomial logistic regression analysis was performed by adjusting for age, physical activity, smoking history, alcohol consumption, body mass index, waist circumference, blood pressure, blood glucose, lipidemia, liver function test, employment duration, and hepatotoxic materials exposure status. Results Compared to daytime workers, the odds ratio (OR) of moderate-severe NAFLD in shift workers was 1.449 (95% confidence interval [CI], 1.028-2.043). Compared to daytime workers, the ORs of moderate-severe NAFLD were significantly higher for the group that engaged in total shift work for more than 20 years (OR, 2.285; 95% CI, 1.051-4.970), the group that was not allowed to sleep during night shift work (OR, 1.463; 95% CI, 1.030-2.078), and the group that consumed food during night shift work (OR, 1.580; 95% CI, 1.093-2.284). Conclusions There was a correlation between shift work and moderate-severe NAFLD in male steel manufacturing workers. There will be a need for more research related to the correlation of shift work with steatohepatitis and cirrhosis in the future.
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13
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Lee J. Alcohol and Testosterone Deficiency in People Who Experience Facial Flushes. Korean J Fam Med 2022; 43:345-346. [PMID: 36444117 PMCID: PMC9708851 DOI: 10.4082/kjfm.43.6e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jungun Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
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14
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Koh K, Kim SS, Kim JS, Jung JG, Yoon SJ, Suh WY, Kim HG, Kim N. Relationship between Alcohol Consumption and Testosterone Deficiency according to Facial Flushes among Middle-Aged and Older Korean Men. Korean J Fam Med 2022; 43:381-387. [PMID: 36444123 PMCID: PMC9708857 DOI: 10.4082/kjfm.21.0173] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study examined the relationship between alcohol consumption and total testosterone deficiency based on facial flushing among Korean men. METHODS A total of 314 men were included in this study and divided into non-drinkers (n=78) and drinkers (n=236). Drinkers were also divided into flushers (n=96) and non-flushers (n=140). Flushers and non-flushers were separated into two groups based on the amount of alcohol consumed: moderate drinkers (≤8 standard drinks per week) and heavy drinkers (>8 standard drinks per week). Total testosterone <3.5 ng/mL was defined as testosterone deficiency. RESULTS The risk of testosterone deficiency was significantly higher in heavy drinkers who flushed than in nondrinkers (odds ratio, 4.37; 95% confidence interval, 1.20-15.88; P=0.025). However, no significant difference was observed in the risk of testosterone deficiency in non-flushers, regardless of the amount of alcohol consumed. CONCLUSION This study suggests that the risk of testosterone deficiency increases in heavy drinkers (>8 drinks per week) who flush compared to that in non-drinkers.
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Affiliation(s)
- Kyungmi Koh
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sung Soo Kim
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea,Department of Family Medicine, Chungnam National University College of Medicine, Daejeon, Korea,Corresponding Author: Sung Soo Kim https://orcid.org/0000-0001-9417-7728 Tel: +82-42-280-8111, Fax: +82-42-280-8373, E-mail:
| | - Jong-Sung Kim
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea,Department of Family Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jin-Gyu Jung
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea,Department of Family Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Seok-Joon Yoon
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea,Department of Family Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Won Yoon Suh
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea,Department of Family Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hyun Gu Kim
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Namhee Kim
- Department of Family Medicine, Chungnam National University Hospital, Daejeon, Korea
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15
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Wang TD, Chiang CE, Chao TH, Cheng HM, Wu YW, Wu YJ, Lin YH, Chen MYC, Ueng KC, Chang WT, Lee YH, Wang YC, Chu PH, Chao TF, Kao HL, Hou CJY, Lin TH. 2022 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension. ACTA CARDIOLOGICA SINICA 2022; 38:225-325. [PMID: 35673334 PMCID: PMC9121756 DOI: 10.6515/acs.202205_38(3).20220321a] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 11/23/2022]
Abstract
Hypertension is the most important modifiable cause of cardiovascular (CV) disease and all-cause mortality worldwide. Despite the positive correlations between blood pressure (BP) levels and later CV events since BP levels as low as 100/60 mmHg have been reported in numerous epidemiological studies, the diagnostic criteria of hypertension and BP thresholds and targets of antihypertensive therapy have largely remained at the level of 140/90 mmHg in the past 30 years. The publication of both the SPRINT and STEP trials (comprising > 8,500 Caucasian/African and Chinese participants, respectively) provided evidence to shake this 140/90 mmHg dogma. Another dogma regarding hypertension management is the dependence on office (or clinic) BP measurements. Although standardized office BP measurements have been widely recommended and adopted in large-scale CV outcome trials, the practice of office BP measurements has never been ideal in real-world practice. Home BP monitoring (HBPM) is easy to perform, more likely to be free of environmental and/or emotional stress, feasible to document long-term BP variations, of good reproducibility and reliability, and more correlated with hypertension-mediated organ damage (HMOD) and CV events, compared to routine office BP measurements. In the 2022 Taiwan Hypertension Guidelines of the Taiwan Society of Cardiology (TSOC) and the Taiwan Hypertension Society (THS), we break these two dogmas by recommending the definition of hypertension as ≥ 130/80 mmHg and a universal BP target of < 130/80 mmHg, based on standardized HBPM obtained according to the 722 protocol. The 722 protocol refers to duplicate BP readings taken per occasion ("2"), twice daily ("2"), over seven consecutive days ("7"). To facilitate implementation of the guidelines, a series of flowcharts encompassing assessment, adjustment, and HBPM-guided hypertension management are provided. Other key messages include that: 1) lifestyle modification, summarized as the mnemonic S-ABCDE, should be applied to people with elevated BP and hypertensive patients to reduce life-time BP burden; 2) all 5 major antihypertensive drugs (angiotensin-converting enzyme inhibitors [A], angiotensin receptor blockers [A], β-blockers [B], calcium-channel blockers [C], and thiazide diuretics [D]) are recommended as first-line antihypertensive drugs; 3) initial combination therapy, preferably in a single-pill combination, is recommended for patients with BP ≥ 20/10 mmHg above targets; 4) a target hierarchy (HBPM-HMOD- ambulatory BP monitoring [ABPM]) should be considered to optimize hypertension management, which indicates reaching the HBPM target first and then keeping HMOD stable or regressed, otherwise ABPM can be arranged to guide treatment adjustment; and 5) renal denervation can be considered as an alternative BP-lowering strategy after careful clinical and imaging evaluation.
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Affiliation(s)
- Tzung-Dau Wang
- Cardiovascular Center and Divisions of Cardiology and Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital
- Department of Internal Medicine, School of Medicine, National Taiwan University College of Medicine
| | - Chern-En Chiang
- General Clinical Research Center and Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Ting-Hsing Chao
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Hao-Min Cheng
- School of Medicine, Institute of Public Health and Community Medicine Research Center, and Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University
- Center for Evidence-based Medicine, Department of Medical Education, Taipei Veterans General Hospital, Taipei
| | - Yen-Wen Wu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Cardiology, Cardiovascular Medical Center, and Department of Nuclear Medicine, Far Eastern Memorial Hospital
| | - Yih-Jer Wu
- Department of Medicine, Mackay Medical College, New Taipei City
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital
| | - Yen-Hung Lin
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei
| | - Michael Yu-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien
| | - Kwo-Chang Ueng
- Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung
| | - Wei-Ting Chang
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan
| | - Ying-Hsiang Lee
- Department of Medicine, Mackay Medical College, New Taipei City
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital
| | - Yu-Chen Wang
- Division of Cardiology, Department of Medicine, Asia University Hospital
- Department of Medical Laboratory Science and Biotechnology, Asia University
- Division of Cardiology, Department of Internal Medicine, China Medical University College of Medicine and Hospital, Taichung
| | - Pao-Hsien Chu
- Department of Cardiology, Chang Gung Memorial Hospital
- School of Medicine, Chang Gung University, Taoyuan
| | - Tzu-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
- Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei
| | - Hsien-Li Kao
- Department of Internal Medicine, School of Medicine, National Taiwan University College of Medicine
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei
| | - Charles Jia-Yin Hou
- Department of Medicine, Mackay Medical College, New Taipei City
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine Kaohsiung Medical University Hospital
- Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Park EJ, Shin HJ, Kim SS, Kim KE, Kim SH, Kim YR, Chung KM, Han KD. The Effect of Alcohol Drinking on Metabolic Syndrome and Obesity in Koreans: Big Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094949. [PMID: 35564344 PMCID: PMC9105397 DOI: 10.3390/ijerph19094949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to assess the effect of alcohol consumption on metabolic syndrome (MetS) and obesity in Koreans by analysis of big data from the National Health Insurance Service health checkup database. A total of 26,991,429 subjects aged 20 years or older were included. Alcohol consumption was divided into five groups: nondrinkers, ≤7.0 g/d, 7.1–14.0 g/d, 14.1–28.0 g/d, ≥28.1 g/d. Logistic regression analyses were performed after adjusting for age, exercise, smoking, and income. The odds ratios (ORs) of MetS and obesity in men and women were lowest at ≤7.0 g/d, similar to that of the nondrinkers at 7.1–14.0 g/d, and increased with the alcohol consumption. At 7.1–14.0 g/d in older men, the ORs of metabolic syndrome and obesity were similar to those in the nondrinkers, but the OR of obesity was slightly increased in older women. This study suggests that the risk of MetS and obesity may be higher in Korean men, women, and the elderly who drink more than 14 g/d than the nondrinkers. In people with obesity or abdominal obesity, or those who need to manage their blood pressure, glucose, or triglyceride, drinking more than 7 g/d may increase the risk of MetS.
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Affiliation(s)
| | - Hye Jung Shin
- Department of Pediatrics, National Medical Center, Seoul 04564, Korea;
| | - Sung Soo Kim
- Department of Family Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon 35015, Korea
- Correspondence: ; Tel.: +82-42-280-8111
| | - Ki Eun Kim
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul 06135, Korea;
| | - Sun Hyun Kim
- Department of Family Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon 22711, Korea;
| | - Youl Ri Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul 04551, Korea;
| | - Kyong Mee Chung
- Department of Psychology, Yonsei University, Seoul 03722, Korea;
| | - Kyung Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea;
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c-Met and EPHA7 Receptor Tyrosine Kinases Are Related to Prognosis in Clear Cell Renal Cell Carcinoma: Focusing on the Association with Myoferlin Expression. Cancers (Basel) 2022; 14:cancers14041095. [PMID: 35205843 PMCID: PMC8870418 DOI: 10.3390/cancers14041095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 01/01/2023] Open
Abstract
Receptor tyrosine kinases (RTKs) are important targets for clear cell renal cell carcinoma (ccRCC) treatment. Myoferlin is a strong regulator of RTKs. To identify myoferlin-associated RTKs and their prognostic implications in ccRCC, we investigated the expression of RTKs and myoferlin using proteome-based evaluation and immunohistochemical staining in tissue microarray. Multivariate Cox analysis adjusted for TNM stage and WHO grade was performed (n = 410 and 506). Proteomic analysis suggested c-Met and EPHA7 as novel candidates for myoferlin-associated RTKs. We immunohistochemically validated the positive association between c-Met and myoferlin expression. High c-Met expression was independently associated with overall (hazard ratio (HR) = 1.153-2.919) and cancer-specific survival (HR = 1.150-3.389). The prognostic effect of high c-Met expression was also determined in an independent cohort (overall survival, HR = 1.503-3.771). Although expression of EPHA7 and myoferlin was not correlated, EPHA7 expression was independently associated with progression-free (HR = 1.237-4.319) and cancer-specific survival (HR = 1.214-4.558). In addition, network-based prioritization showed co-functional enrichment of c-Met and myoferlin, suggesting a novel regulatory function of myoferlin in c-Met signaling. This study indicates that c-Met and EPHA7 might be useful prognostic biomarkers, and the presumed myoferlin/c-Met pathway could be a novel therapeutic target in ccRCC.
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Eum YH, Kim HJ, Bak S, Lee SH, Kim J, Park SH, Hwang SE, Oh B. Factors related to the success of smoking cessation:
A retrospective cohort study in Korea. Tob Induc Dis 2022; 20:15. [PMID: 35221858 PMCID: PMC8822910 DOI: 10.18332/tid/144272] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yoon Hee Eum
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ho Jun Kim
- Department of Family Medicine, Hongseong Medical Center, Chungcheongnam-do, Republic of Korea
| | - Seolah Bak
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sung-Ha Lee
- Center for Happiness Studies, Seoul National University, Seoul, Republic of Korea
| | - Jinri Kim
- Department of Family Medicine, H+ Yangji Hospital, Seoul, Republic of Korea
| | - Su Hyeon Park
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Seo Eun Hwang
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Bumjo Oh
- Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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Hyun MK, Park JH, Kim KH, Ahn SK, Ji SM. Incidence and Risk Factors for Progression to Diabetes Mellitus: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010123. [PMID: 35010384 PMCID: PMC8750431 DOI: 10.3390/ijerph19010123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 05/25/2023]
Abstract
(1) Objective: This study examined the incidence and risk factors contributing to the progression to diabetes mellitus (DM) in a seven-year follow-up study of non-diabetic National Health Examinees. (2) Methods: For this retrospective observational cohort study, we used two national representative databases: the National Health Screening (HEALS) database 2009 and the National Health Insurance Service (NHIS) database 2009-2015. The eligible subjects without DM with blood sugar levels of <126 mg/dL were selected using the HEALS database. The subsequent follow-up and clinical outcomes were evaluated using the NHIS database. Cox proportional hazard regression was applied to examine the effects of the covariates on progression to diabetes. (3) Results: Among those who took part in the national health screening in 2009, 4,205,006 subjects who met the eligibility criteria were selected. Of these, 587,015 were diagnosed with DM during the follow-up by 2015. The incidence of progression from non-diabetes to DM was 14.0%, whereas that from impaired fasting glucose (IFG) to DM was 21.9%. Compared to the normal group, the newly diagnosed DM group was more likely to comprise older, female, currently smoking, and high-risk drinking participants and participants with IFG, hypertension, dyslipidemia, and metabolic syndrome. (4) Conclusions: This epidemiological study in the Republic of Korea found risk factors similar to those of other studies, but the incidence of progression to DM was 22.8 per 1000 person-years, which is higher than that previously reported. Hence, more care is needed to prevent DM.
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Affiliation(s)
- Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju 38066, Korea;
| | | | - Kyoung Hoon Kim
- Health Insurance Review & Assessment Service, Wonju 26465, Korea;
| | - Soon-Ki Ahn
- Public Health and Medical Services Office, Chungnam National University Hospital, Daejeon 35015, Korea;
| | - Seon Mi Ji
- National Health Insurance Service, Wonju 26464, Korea;
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20
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Kim IS, Choi YJ, Choi EY, Min PK, Yoon YW, Lee BK, Hong BK, Rim SJ, Kwon HM, Kim JY. Comparison of risk profiles for new-onset atrial fibrillation between patients aged <60 and ≥60 years. PLoS One 2021; 16:e0258770. [PMID: 34793457 PMCID: PMC8601466 DOI: 10.1371/journal.pone.0258770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/06/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) has a heterogeneous pathophysiology according to individual patient characteristics. This study aimed to identify the effects of widely known risk factors on AF incidence according to age and to elucidate the clinical implications of these effects. METHODS AND RESULTS We analyzed data from 501,668 subjects (≥18years old) without AF and valvular heart disease from the Korean National Health Insurance Service-National Sample Cohort. The total population was divided into two groups according to age, <60years and ≥60years. AF occurred in 0.7% of the overall population (3,416 of 501,668) during the follow-up period (mean 47.6 months). In Cox regression analysis, age, male sex, previous ischemic stroke, heart failure, and hypertension were related to increased risk of new-onset AF in both age groups. Especially in the <60years age group, risk of new-onset AF was increased by relatively modifiable risk factors: obesity (body mass index ≥25kg/m2; hazard ratio[HR] 1.37 [1.22-1.55], p<0.001, interaction p<0.001), and hypertension (HR 1.93[1.69-2.22], p<0.001, interaction p<0.001). Although interactions were not significant, chronic obstructive pulmonary disease (HR 1.41[1.24-1.60], p<0.001) and chronic kidney disease (HR 1.28[1.15-1.41], p<0.001) showed increased trends of the risk of new-onset AF in the ≥60years age group. CONCLUSION The risk profile for new-onset AF was somewhat different between the <60years and the ≥60years age groups. Compared to the ≥60years group, relatively modifiable risk factors (such as obesity and hypertension) had a greater impact on AF incidence in the <60years age group. Different management strategies to prevent AF development according to age may be needed.
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Affiliation(s)
- In-Soo Kim
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yeon-Jik Choi
- Division of Cardiology, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Eui-Young Choi
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Pil-Ki Min
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Won Yoon
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoung Kwon Lee
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bum-Kee Hong
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se-Joong Rim
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyuck Moon Kwon
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Youn Kim
- Cardiology, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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21
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Golder S, McCambridge J. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews. Soc Sci Med 2021; 289:114450. [PMID: 34607052 PMCID: PMC8586735 DOI: 10.1016/j.socscimed.2021.114450] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Alcohol's effects on heart health is the site of a major scientific controversy. We conducted a co-authorship network analysis of systematic reviews on the impacts on alcohol on cardiovascular disease (CVD) in order to investigate patterns of co-authorship in the literature, with particular attention given to industry funding. METHODS We used Epistemonikos to identify systematic reviews. Review characteristics, influential authors, co-authorship subnetworks, prior histories of alcohol industry funding, study outcomes and citations were investigated. RESULTS 60 systematic reviews with 231 unique authors met our inclusion criteria. 14 systematic reviews were undertaken by authors with histories of alcohol industry funding, including 5 that were funded directly by the alcohol industry itself. All 14 such reviews identified a cardioprotective effect of alcohol. These formed distinct co-authorship subnetworks within the literature. Of reviews by authors with no prior histories of alcohol industry funding, the findings were mixed, with 54% (25/46) concluding there was evidence of health protective effects. These two groups of reviews differed in other respects. Those with industry funding were more likely to study broader outcomes such as 'cardiovascular disease' or 'coronary heart disease' as opposed to specific CVD issues such as hypertension or stroke (93% [13/14] versus 41% [19/46]) (chi-squared 12.4, p < 0.001) and have more included studies (mean of 29 versus 20). They were also more widely cited by others. Over time the proportions of systematic reviews on CVD and alcohol undertaken by authors with no prior histories of alcohol industry funding has increased. CONCLUSIONS Systematic reviews undertaken by authors with histories of alcohol industry funding were more likely to study broader outcomes, and be cited more widely, and exclusively reported favorable conclusions.
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Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, United Kingdom.
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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22
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Chung Y, Kim H, Koh DH, Park JH, Yoon S. Relationship Between Shift Intensity and Insomnia Among Hospital Nurses in Korea: A Cross-sectional Study. J Prev Med Public Health 2021; 54:46-54. [PMID: 33618499 PMCID: PMC7939760 DOI: 10.3961/jpmph.20.555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives This study explored the relationship between shift intensity and insomnia among hospital nurses. Methods The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8. Results The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p<0.001), to have experienced a greater number of short recovery periods after the previous shift (p=0.021), and to have worked for more hours (p=0.006) than the nurses without insomnia. Among the other variables, no statistically significant differences between groups were observed. Experiences of 3 or more consecutive night shifts (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.29 to 4.20) and 3 or more short recovery periods (OR, 2.01; 95% CI, 1.08 to 3.73) were associated with increased odds of insomnia. Conclusions The results suggest that decreasing the shift intensity may reduce insomnia among hospital nurses working rotating shifts.
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Affiliation(s)
- Yuhjin Chung
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Hyunjoo Kim
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Dong-Hee Koh
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Ju-Hyun Park
- Department of Statistics, Dongguk University, Seoul, Korea
| | - Seohyun Yoon
- Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
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23
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Ahn SK, Lee JM, Ji SM, Kim KH, Park JH, Hyun MK. Incidence Hypertension and Fasting Blood Glucose from Real-World Data: Retrospective Cohort for 7-Years Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042085. [PMID: 33669927 PMCID: PMC7924835 DOI: 10.3390/ijerph18042085] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 12/14/2022]
Abstract
This retrospective cohort study was done to investigate the incidence of hypertension and its relation to the fasting blood glucose level in Korea. The eligible non-hypertensive subjects (n = 3,396,187) among the National Health Insurance Service-National Health Screening (NHIS-HEALS) examinees (n = 10,644,911) in 2009 were followed up until 2015. A Cox proportional hazards regression was used to estimate the risk of the high blood glucose level for the incident hypertension while controlling for covariates' confounding effect. The cumulative incidence rate was 10.6% for seven years (11.6% in men and 8.3% in women). The incidence density was 1474.8 per 100,000 person-years. High fasting blood glucose (adjusted Hazard Ratio (aHR), 1.836; 95% confidence interval (CI), 1.810 to 1.862), prediabetes (aHR, 1.249; 95% CI, 1.237 to 1.260), a history of diabetes mellitus (aHR, 1.635; 95% CI, 1.605 to 1.666), high triglyceride (aHR, 1.292; 95% CI, 1.280 to 1.303), a history of dyslipidemia (aHR, 1.279; 95% CI, 1.253 to 1.305) and prehypertension group (aHR, 1.964; 95% CI, 1.948 to 1.979) were significantly related to the incident hypertension after adjusting for covariates. Among real-world data in Korea, high blood glucose level was the independent risk factor for developing hypertension.
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Affiliation(s)
- Soon-Ki Ahn
- Public Health and Medical Services Office, Chungnam National University Hospital, Jung-gu, Daejeon 35015, Korea;
| | - Ju-Mi Lee
- Department of Preventive Medicine, Eulji College of Medicine, Daejeon 34824, Korea;
| | - Seon Mi Ji
- National Health Insurance Service, Wonju 26464, Korea;
- Correspondence:
| | - Kyoung Hoon Kim
- Health Insurance Review & Assessment Service, Wonju 26465, Korea;
| | | | - Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju-si 38066, Korea;
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Trends in Alcohol Consumption for Korean Adults from 1998 to 2018: Korea National Health and Nutritional Examination Survey. Nutrients 2021; 13:nu13020609. [PMID: 33668462 PMCID: PMC7918354 DOI: 10.3390/nu13020609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 12/13/2022] Open
Abstract
Drinking culture has been well developed in Korea. This research assessed trends in daily pure alcohol consumption over time and examined its trends regarding socio-demographic variables and alcoholic beverage types. We used data from the 1998–2018 Korea National Health and Nutrition Examination Survey. A total of 87,623 adults aged ≥ 19 years were included. Alcohol intake was assessed via 24-h dietary recall, and pure alcohol content was calculated according to alcoholic beverage type. Daily alcohol consumption increased from 8.37 g in 1998 to 14.98 g in 2016–2018 (p for trend < 0.001). The degree of the increasing trend was higher for women (2.09 g to 5.79 g) than men (14.78 g to 23.94 g) from 1998 to 2016–2018. Alcohol intake was highest in men aged 30–49 years and women aged 19–29 years. Moreover, the change of the rising trend in alcohol consumption according to high socioeconomic factors was more pronounced than the other variables. Lastly, the alcohol intake from soju and beer was dominant in alcohol consumption and escalated over time. The total daily alcohol intake increased about two times during 21 years in Korea, and the trends varied according to socio-demographic status.
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25
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Kim J, Lee S, Kim SS, Lee JP, Kim JS, Jung JG, Yoon SJ, Kim KP, Park CK, Kim YH. Association between body mass index and fragility fracture in postmenopausal women: a cross-sectional study using Korean National Health and Nutrition Examination Survey 2008-2009 (KNHANES IV). BMC WOMENS HEALTH 2021; 21:60. [PMID: 33563259 PMCID: PMC7871625 DOI: 10.1186/s12905-021-01209-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/03/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women. METHODS Among subjects who participated in the 4th Korea National Health and Nutrition Examination Survey (2008-2009), 2114 women ≥ 40 years of age were included. BMI was based on standards set by the Korean Society for the Study of Obesity, as follows: < 18.5 kg/m2, underweight; 18.5 ≤ to < 25 kg/m2, normal weight; and ≥ 25 kg/m2, obese. Subjects were also divided into three groups according to the location of fragility fracture: spine, hip, or wrist. RESULTS The mean (± SD) rate of fragility fracture was significantly different among the three groups: 5.9 ± 2.9% (underweight), 1.1 ± 0.3% (normal weight), and 3.0 ± 0.7% (obese) (p = 0.001). After correcting for age, family history, and treatment history of osteoporosis and rheumatoid arthritis, smoking and drinking status, and level of exercise, multivariable regression analysis revealed that the odds ratio for fragility fracture in the underweight group was 5.48 [95% confidence interval (CI) 1.80-16.73] and 3.33 (95% CI 1.61-6.87) in the obese group. After subdividing fragility fractures into vertebral and non-vertebral, the odds ratio for vertebral fracture in the underweight group was 5.49 (95% CI 1.31-23.09) times higher than that in the normal weight group; in the obese group, the non-vertebral fracture odds ratio was 3.87 (95% CI 1.45-10.33) times higher. Analysis of non-vertebral fractures in the obese group revealed an odds ratio for fracture 22.05 (95% CI 1.33-365.31) times higher for hip fracture and 3.85 (95% CI 1.35-10.93) times higher for wrist fracture. CONCLUSIONS Obesity and underweight increased the risk for fragility fractures in postmenopausal Korean women.
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Affiliation(s)
- Jihan Kim
- Department of Family Medicine, Sejong Trinium Woman's Hospital, Sejong, Korea.,Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea
| | - Sami Lee
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea.
| | - Sung Soo Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea
| | - Jong-Pyo Lee
- Department of Obstetrics and Gynecology, Sejong Trinium Woman's Hospital, Sejong, Korea
| | - Jong Sung Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea
| | - Jin Gyu Jung
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea
| | - Seok Jun Yoon
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-Gu, Daejeon, 35015, Korea
| | - Kyu Pil Kim
- Department of Family Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Chan-Keol Park
- Division of Rheumatology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Yong-Hwan Kim
- Department of Orthopedic Surgery, Chungnam National University Hospital, Daejeon, Korea
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Kim SY. Does the Risk for Diabetes Related with Alcohol Drinking Depend on Facial Flushing? Korean J Fam Med 2020; 41:137-138. [PMID: 32456381 PMCID: PMC7272361 DOI: 10.4082/kjfm.41.3e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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27
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Kim J, Park CK, Kim JS, Lee S. Relationship between alcohol consumption and rheumatoid factor (RF) with alcohol-induced facial flushing response. Alcohol 2020; 84:43-48. [PMID: 31628981 DOI: 10.1016/j.alcohol.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 11/29/2022]
Abstract
This study investigated the relationship between alcohol consumption with alcohol-induced facial flushing response and rheumatoid factor (RF) in adult men. The cohort comprised 1675 men who underwent a general medical check-up between July 2016 and June 2017, including 355 non-drinkers, 498 flushers, and 822 non-flushers. One drink was defined as 14 g of alcohol. RF was considered negative if the level was less than 18 IU/mL and positive if the level was greater than 18 IU/mL. Logistic regression analyses were used. Compared to non-drinkers, the odds ratio for a positive RF among non-flushers was 0.92 (95% confidence interval [CI], 0.37-2.29) for those with an average alcohol consumption of ≤4 drinks per week, 1.64 (95% CI, 0.67-3.98) for those consuming more than 4 drinks per week but fewer than or equal to 8 drinks per week, and 1.17 (95% CI, 0.55-2.50) for those consuming more than 8 drinks per week; the differences were not statistically significant. Compared to non-drinkers, flushers also had a non-significant odds ratio for positive RF of 1.26 (95% CI, 0.54-2.90) among those with an average alcohol consumption of ≤4 drinks per week. However, flushers showed a significantly higher odds ratio for a positive RF of 3.12 (95% CI, 1.18-8.24) among those consuming more than 4 but fewer than or equal to 8 drinks per week, and 3.27 (95% CI, 1.42-7.52) among those consuming more than 8 drinks per week. Additionally, flushers consuming more than 8 drinks per week were associated with significantly higher rates of positive RF than non-flushers (odds ratio, 2.38; 95% CI, 1.05-5.17). Our study revealed that flushers consuming more than 4 drinks per week showed a higher probability of positive RF than non-drinkers. Furthermore, flushers consuming more than 8 drinks per week had a higher probability of positive RF than non-flushers. Our results strongly indicate that the average weekly alcohol consumption level and the presence or absence of flushing should be considered when interpreting the results of RF examinations in healthy men.
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Affiliation(s)
- Jihan Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Chan Keol Park
- Division of Rheumatology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Jong Sung Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, South Korea.
| | - Sami Lee
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, South Korea
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Seo YR, Kim JS, Kim SS, Jung JG, Yoon SJ. Association between Alcohol Consumption and Metabolic Syndrome Determined by Facial Flushing in Korean Women. Korean J Fam Med 2020; 42:24-30. [PMID: 32053860 PMCID: PMC7884890 DOI: 10.4082/kjfm.19.0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/29/2019] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to examine the relationship between alcohol consumption and metabolic syndrome in Korean women as determined by facial flushing. Methods Of the female patients aged <65 years who visited the health promotion center at Chungnam National University Hospital from January 2016 to March 2017, 1,344 women were included. After adjusting for confounding factors such as age, body mass index, smoking, exercise, and menopausal status, multiple logistic regression analysis was performed to assess the association between alcohol consumption and the risk of metabolic syndrome in the facial flushing and non-facial flushing groups compared with the non-drinkers. Results Even after adjusting for confounding factors, the risk of metabolic syndrome was significantly high in all drinking subgroups (≤2 standard drinks: odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10–2.68; 2<, ≤4 standard drinks: OR, 2.48; 95% CI, 1.29–4.74; and >4 standard drinks: OR, 4.16; 95% CI, 2.03–8.30) of the facial flushing group. The risk of metabolic syndrome was significantly high only in the subgroup of weekly alcohol consumption >4 standard drinks (OR, 2.20; 95% CI, 1.07–4.52) in the non-facial flushing group. Conclusion This study suggests that Korean women experiencing facial flushing when drinking have a higher risk of developing metabolic syndrome even with a low weekly drinking amount than those who do not experience face flushing.
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Affiliation(s)
- Yu Ri Seo
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jong Sung Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sung Soo Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin Gyu Jung
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Seok Jun Yoon
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
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Shin J, Kim H, Kim HS, Kim C, Choi WS. Increasing Individual Target Glucose Levels to Prevent Hypoglycemia in Patients with Diabetes. Korean J Fam Med 2020; 42:269-273. [PMID: 31995965 PMCID: PMC8321904 DOI: 10.4082/kjfm.19.0161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 12/13/2022] Open
Abstract
Hypoglycemia is one of the severe complications of diabetes. To prevent hypoglycemia, an emphasis is placed on maintaining an appropriate balance between nutrition, activity, and treatment, which can be achieved by the repetition of self-trials based on self-monitoring. Clinicians routinely focus on patients’ contribution, including timely intake of an adequate amount of carbohydrates, physical activity, antidiabetic medication, and abstinence from alcohol. Recently, many guidelines have highlighted the importance of clinicians’ factors and recommend individualized treatments according to lifestyle patterns and specific needs following the de-intensification of treatment. The optimal value of hemoglobin A1c (HbA1c) levels for blood glucose level regulation remains controversial among countries, but it generally does not exceed 8.0%. In populations that are at a risk of hypoglycemia, such as the older adults, it is advisable to adjust the target blood glucose level to less than 8.0%. Meanwhile, a blood glucose level of 7.0%–7.5% is generally recommended for healthy older adults. If the expected lifetime is shorter than 10 years or in patients with chronic kidney disease and severe cardiovascular disease, the HbA1c level target can be increased to 7.5%–8.0%. For even shorter lifetime expectancy, the target can be adjusted up to 8.0%–9.0%. To prevent hypoglycemia, the target blood glucose level needs to be adjusted, particularly in older adult patients. Ultimately, it is important to identify the maximum blood glucose levels that do not cause hypoglycemia and the minimum blood glucose levels that do not cause hyperglycemia-associated complications.
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Affiliation(s)
- Juyoung Shin
- Health Promotion Center, Seoul St. Mary's Hospital, Seoul, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyunah Kim
- College of Pharmacy, Sookmyung Women's University, Seoul, Korea
| | - Hun-Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Churlmin Kim
- Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Whan-Seok Choi
- Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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