1
|
Kwon O, Myong JP, Lee Y, Choi YJ, Yi JE, Seo SM, Jang SW, Kim PJ, Lee JM. Sodium-glucose co-transporter-2 inhibitors after acute myocardial infarction in type 2 diabetes patients: a population-based investigation from South Korea. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Whether the early use of sodium-glucose co-transporter-2 (SGLT2) inhibitors has cardioprotective effects following acute myocardial infarction (AMI) is unknown.
Purpose
We aimed to evaluate the association between the early initiation of SGLT2 inhibitors and cardiac event rates in diabetes patients with AMI undergoing percutaneous coronary intervention (PCI).
Methods
Based on the National Health Insurance claims data in South Korea, patients aged 18 years or older who had undergone PCI for the diagnosis of AMI between 2014 and 2018 were analyzed. Patients treated with SGLT2 inhibitors or other glucose-lowering drugs were matched based on a propensity score. The primary endpoint was a composite of all-cause mortality and hospitalizations for heart failure (HF). Major adverse cardiac events (MACE; a composite of all-cause death, non-fatal MI, and ischemic stroke) were compared as the secondary endpoint.
Results
After 1:2 propensity score matching, a total of 26,814 patients were assigned to the SGLT2 inhibitors group (938 patients) and the no use of SGLT2 inhibitors group (1,876 patients), respectively. During a median follow-up of 2.1 years, compared to no use of SGLT2 inhibitors, the early use of SGLT2 inhibitors was associated with lower risks of both the primary endpoint (9.8% vs. 13.9%, adjusted hazard ratio [HR] = 0.68, 95% confidence interval [CI]: 0.54 to 0.87, p=0.002) and secondary endpoint (9.1% vs. 11.6%, adjusted HR = 0.77, 95% CI: 0.60 to 0.99, p=0.04) (Figure 1). All-cause mortality and hospitalizations for HF were significantly lower in the early use of SLGT2 inhibitors group (adjusted HR = 0.55; 95% CI: 0.37 to 0.80; p=0.002; and HR = 0.74; 95% CI: 0.56 to 0.98; p=0.03, respectively). The incidence of non-fatal MI and ischemic stroke were not statistically different (Figure 2).
Conclusions
The early use of SGLT2 inhibitors in diabetes patients treated with PCI for AMI was associated with a significantly lower risk of cardiovascular events including all-cause mortality, hospitalizations for HF, and MACE. Our results suggest that the use of SGLT2 inhibitors could expand to the acute phase of AMI survivors with diabetes to reduce mortality and the subsequent development of congestive HF and ischemic events.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): This work was partly supported by the Research Institute of Medical Science, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea.
Collapse
Affiliation(s)
- O Kwon
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - J P Myong
- The Catholic University of Korea Seoul St. Mary's Hospital, Department of Occupational & Environmental Medicine , Seoul , Korea (Republic of)
| | - Y Lee
- The Catholic University of Korea Seoul St. Mary's Hospital, Department of Urology , Seoul , Korea (Republic of)
| | - Y J Choi
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - J E Yi
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S M Seo
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - S W Jang
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - P J Kim
- Eunpyeoung St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - J M Lee
- Eunpyeoung St. Mary's Hospital, Division of Endocrinology, Department of Internal Medicine , Seoul , Korea (Republic of)
| |
Collapse
|
2
|
Koo JW, Myong JP, Yoon HK, Rhee CK, Kim Y, Kim JS, Jo BS, Cho Y, Byun J, Choi M, Kim HR, Kim EA. Occupational exposure and idiopathic pulmonary fibrosis: a multicentre case-control study in Korea. Int J Tuberc Lung Dis 2018; 21:107-112. [PMID: 28157473 DOI: 10.5588/ijtld.16.0167] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Multicentred hospital-based cases and control subjects in Korea. OBJECTIVE To evaluate the association between idiopathic pulmonary fibrosis (IPF) and hazardous materials to which people are occupationally exposed. DESIGN A multicentre, hospital-based, matched case-control study was performed. The ratio of IPF cases to controls was 1:1 (n = 78 in each group). IPF cases and controls were matched in terms of age group, sex and place of residence. Conditional logistic regression analysis was performed. RESULTS In simple logistic regression analysis, exposure to metal dust and any exposure for >1 year in an occupational setting were significantly associated with IPF (metal dust OR 4.00, 95%CI 1.34-11.97; any exposure OR 3.67, 95%CI 1.02-13.14). After adjustment for environmental and military exposures and smoking history, the OR for metal dust exposure was 4.97 (95%CI 1.36-18.17) in multiple logistic regression analysis. CONCLUSIONS Metal dust was associated with incident IPF in Seoul and Gyeonggi Provinces in Korea. This information will be used to support a tailored preventive strategy in specific industries or occupations.
Collapse
Affiliation(s)
- J-W Koo
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - J-P Myong
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea<; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - H-K Yoon
- Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - C K Rhee
- Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Y Kim
- Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, Catholic University of Korea, Bucheon, South Korea
| | - J S Kim
- Department of Internal Medicine, Incheon St Mary's Hospital, College of Medicine, Catholic University of Korea, Incheon, South Korea
| | - B S Jo
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - Y Cho
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - J Byun
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - M Choi
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - H-R Kim
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - E-A Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea
| |
Collapse
|
3
|
Kim SW, Myong JP, Yoon HK, Koo JW, Kwon SS, Kim YH. Health care burden and medical resource utilisation of idiopathic pulmonary fibrosis in Korea. Int J Tuberc Lung Dis 2018; 21:230-235. [PMID: 28234090 DOI: 10.5588/ijtld.16.0402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Despite the clinical importance of idiopathic pulmonary fibrosis (IPF), its epidemiology has been rarely reported. The economic burden from IPF is therefore difficult to predict. OBJECTIVE To analyse the health care burden and current situation with respect to medical resource utilisation in patients with IPF in Korea. METHODS We analysed nationwide data collected between 2009 and 2013 from the Korean Health Insurance Review and Assessment (HIRA) database. Patients with IPF were defined by the K-J84.18 code of the Korean Classification of Disease, 6th revision. RESULTS The total direct health care costs increased from US$19 805 167 in 2009 to US$31 410 083 in 2013; the principal factor responsible for the highest proportion of costs was hospitalisation. The proportion of the total IPF patient population who were hospitalised at least once a year was 27.2%, and the average length of hospital stay was 12.7 days. From post-hoc analysis, hospital admission, emergency room visit and intensive care unit admission rates showed significant seasonal variations; the admission rates were highest in the spring and lowest in autumn. CONCLUSIONS Health care costs of IPF are increasing annually, with hospital admissions representing the major financial burden.
Collapse
Affiliation(s)
- S W Kim
- Division of Pulmonology, Department of Internal Medicine, Yeouido St Mary's Hospital, Seoul, Korea
| | - J-P Myong
- Department of Occupational & Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H K Yoon
- Division of Pulmonology, Department of Internal Medicine, Yeouido St Mary's Hospital, Seoul, Korea
| | - J-W Koo
- Department of Occupational & Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S S Kwon
- Division of Allergy and Pulmonology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Y H Kim
- Division of Allergy and Pulmonology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| |
Collapse
|
4
|
Lee HE, Myong JP, Kim HR, Rhee CK, Yoon HK, Koo JW. Incidence and prevalence of idiopathic interstitial pneumonia and idiopathic pulmonary fibrosis in Korea. Int J Tuberc Lung Dis 2018; 20:978-84. [PMID: 27287654 DOI: 10.5588/ijtld.16.0003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Although the incidence and prevalence of idiopathic interstitial pneumonia (IIP) and idiopathic pulmonary fibrosis (IPF) have been assessed in Western countries, their epidemiology has not been analysed in Asian countries, including the Republic of Korea. OBJECTIVE To estimate the prevalence and incidence of IIP, including IPF, in Korea, using a large, nationwide database. DESIGN The Health Insurance Review and Assessment Services claims database, which includes information on every patient with diagnostic codes for IPF and IIP from 2010 to 2013, was reviewed. Age- and sex-specific IPF and IIP prevalence and incidence rates were estimated. RESULTS Among Korean males and females, IPF prevalence from 2010 to 2013 was estimated at respectively 39.7 and 24.3 per 100 000 population, while IIP prevalence was estimated at respectively 97.1 and 66.5/100 000. The annual incidence rates among Korean males and females during 2011 and 2012 were respectively 16.4 and 9.7/100 000, for IPF, and respectively 42.3 and 27.5/100 000 for IIP. CONCLUSIONS IPF is more prevalent in Korea than previously reported; its prevalence may be similar to or higher than in the United States and in European countries.
Collapse
Affiliation(s)
- H-E Lee
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - J-P Myong
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - H-R Kim
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - C K Rhee
- Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - H-K Yoon
- Department of Internal Medicine, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - J-W Koo
- Department of Occupational and Environmental Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
5
|
Koh JH, Myong JP, Yoo J, Lim YW, Lee J, Kwok SK, Park SH, Ju JH. Predisposing factors associated with atypical femur fracture among postmenopausal Korean women receiving bisphosphonate therapy: 8 years' experience in a single center. Osteoporos Int 2017; 28:3251-3259. [PMID: 28748389 DOI: 10.1007/s00198-017-4169-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 07/18/2017] [Indexed: 01/27/2023]
Abstract
UNLABELLED The risk factors for atypical femur fracture in patients exposed to bisphosphonates for at least 1 year were examined. Prolonged and continuous use of bisphosphonates, long-term use of glucocorticoids, and a higher body mass index were associated with increased risk of atypical femur fracture. INTRODUCTION The purpose of the present study is to determine whether rheumatoid arthritis (RA) and other clinical factors are associated with an increased risk of bisphosphonate (BP)-related atypical femur fracture (AFF). METHODS A retrospective nested case-control study of patients who had taken BPs for at least 1 year was conducted. Patients with AFF were identified by reviewing surgical and radiographic records. Three controls with no history of AFFs were randomly selected and age- and sex-matched to each patient with AFFs. Cox proportional hazard models were used to analyze the independent contribution of risk factors to BP-related AFF. RESULTS Among the 35,104 patients prescribed BPs for at least 1 year, 43 females (mean age, 68 years) suffered AFFs (0.12%). Patients with AFFs were exposed to BPs for a mean of 7.3 years. Patients with AFFs were exposed to BPs for longer than those without AFFs and continued treatment without a drug holiday. More patients with AFF than controls had taken glucocorticoids and disease-modifying anti-rheumatic drugs. Multivariate Cox regression analyses estimated that long-term use of glucocorticoids, prolonged exposure to BP without cessation, and every 1 kg/m2 increase in the body mass index (BMI) increased the hazard ratio for AFFs by 3.0, 5.2, and 1.2, respectively. CONCLUSIONS Prolonged and continuous use of BPs, long-term use of glucocorticoids, and a higher BMI increase the risk of AFFs. Switching long-term BP and glucocorticoid users to other bone-protective agents should be considered.
Collapse
Affiliation(s)
- J H Koh
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-040, South Korea
| | - J P Myong
- Department of Occupational & Environmental Medicine, Center for Occupational & Environmental Medicine (WHO Collaboratory Center), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - J Yoo
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-040, South Korea
| | - Y-W Lim
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - J Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-040, South Korea
| | - S-K Kwok
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-040, South Korea
| | - S-H Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-040, South Korea
| | - J H Ju
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-040, South Korea.
| |
Collapse
|
6
|
Chang HK, Chang DG, Myong JP, Kim JH, Lee SJ, Lee YS, Lee HN, Lee KH, Park DC, Kim CJ, Hur SY, Park JS, Park TC. Bone mineral density among Korean females aged 20-50 years: influence of age at menarche (The Korea National Health and Nutrition Examination Survey 2008-2011). Osteoporos Int 2017; 28:2129-2136. [PMID: 28293690 DOI: 10.1007/s00198-017-3997-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 03/01/2017] [Indexed: 11/28/2022]
Abstract
UNLABELLED To evaluate a possible correlation between bone mineral density (BMD) and age at menarche, the present study used the BMD dataset of the Korea National Health and Nutrition Examination Survey IV-V (KNHANES IV-V). Age at menarche had a small but significant association with BMD of the lumbar spine in premenopausal Korean females, aged 20-50 years. INTRODUCTION To investigate any correlation between bone mineral density (BMD) and age at menarche in Korean females using data from the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-V; 2008-2011). METHODS In total, 37,753 individuals participated in health examination surveys between 2008 and 2011. A total of 5032 premenopausal females aged 20-50 years were eligible. Age, height, weight, and age at menarche were assessed. RESULTS Results from the univariate linear regression and analysis of covariance (ANCOVA) indicated that age (per 1 year), height (per 1 cm), weight (per 1 kg), exercise (per 1 day/week), familial osteoporosis history (yes), parity (n = 0 to ≥4), and menarche age distribution were associated with BMD of the total femur, femur neck, and lumbar spine. After stratifying the bone area and adjusting for age, parity, alcohol intake, smoking, exercise, and familial osteoporosis history, no effect was seen for the total femur or femur neck. Age at menarche 16~17 and ≥18 years groups were associated with BMD of the lumbar spine only. CONCLUSIONS Age at menarche had a small but significant association with BMD of the lumbar spine in premenopausal Korean females, aged 20-50 years. Females with late menarche may achieve lower peak bone mass at some skeletal sites, which may put them at greater risk for osteoporosis in later life.
Collapse
Affiliation(s)
- H K Chang
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - D-G Chang
- Department of Orthopaedic Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea
| | - J-P Myong
- Department of Occupational & Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| | - J-H Kim
- Department of Orthopaedic Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea
| | - S-J Lee
- Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y S Lee
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-N Lee
- Department of Obstetrics and Gynecology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K H Lee
- Department of Obstetrics and Gynecology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - D C Park
- Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C J Kim
- Department of Obstetrics and Gynecology, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S Y Hur
- Department of Obstetrics and Gynecology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J S Park
- Department of Obstetrics and Gynecology, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - T C Park
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
7
|
Myong JP, Yoon HK, Rhee CK, Kim HR, Koo JW. Risk factors for lung function impairment among the general non-smoking Korean population. Int J Tuberc Lung Dis 2016; 19:1019-26, i-iii. [PMID: 26260818 DOI: 10.5588/ijtld.14.0929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Nationwide general population in South Korea. OBJECTIVE Except for tobacco smoking, risk factors for the impairment of lung function have not been widely evaluated. We evaluated the risk factors for lung function impairment among the general non-smoking Korean population. DESIGN A total of 8164 non-smokers from the spirometry data set of the Korean National Health and Nutrition Examination Surveys IV and V (2008-2010) were included in the study. After sex stratification, multiple survey logistic regression analyses were performed to estimate the association between potential risk factors and impaired lung function in this nationwide cross-sectional study. RESULTS The proportion of non-smokers among the general Korean population with forced expiratory volume in 1 s (FEV1) < 80% of predicted, forced vital capacity (FVC) < 80% of predicted and FEV1/FVC ratio < 0.7 were respectively 46.2%, 50.3% and 30.2%. In multiple survey logistic regression analyses, lung function impairment was associated with tuberculosis (TB) and asthma in female non-smokers and asthma in male non-smokers. CONCLUSIONS TB and asthma are risk factors for lung function impairment among Korean non-smokers. To prevent further lung function impairment, a careful control system for these factors should be considered when setting health policy priorities.
Collapse
Affiliation(s)
- J-P Myong
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - H-K Yoon
- Department of Internal Medicine, Yeouido St Mary's Hospital College of Medicine, Catholic University of Korea, Seoul, Korea
| | - C K Rhee
- Department of Internal Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - H-R Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - J-W Koo
- Department of Occupational and Environmental Medicine, College of Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea; Center for Occupational and Environmental Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, Korea
| |
Collapse
|
8
|
Kim KY, Myong JP, Kim HR, Lee HE, Jang TW, Koo JW, Park CY. Dose-related effect of urinary cotinine levels on pulmonary function among Korean women. Int J Tuberc Lung Dis 2015; 18:622-7. [PMID: 24903802 DOI: 10.5588/ijtld.13.0677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Country-wide general population in South Korea. BACKGROUND The dose-response relationship between smoking and pulmonary function in women may have been significantly over-estimated by studies that employed a self-reporting questionnaire. OBJECTIVE To evaluate whether this relationship was still observed among Korean women when smoking levels were determined by urinary cotinine measurements. DESIGN A total of 4584 Korean women from the spirometry data set of the Korean National Health and Nutrition Examination Surveys IV and V (2008-2010) were included. Analysis of covariance was performed to estimate the dose-related effect of urinary cotinine levels on pulmonary function after adjusting for covariates in this country-wide cross-sectional study. RESULTS Compared to urinary cotinine levels (cut-off 50 ng/ml), the false-positive rate of self-reported smoking was 53.2%. After the smokers were divided into deciles, the regression coefficients for percentage forced expiratory volume in 1 second (FEV₁%) and percentage forced expiratory volume/forced volume capacity (FEV₁/FVC) ratio (FEV1/FVC%) were -0.2903 and -0.2680 (%/decile), respectively (both P < 0.001). CONCLUSION It is necessary to use objective methods when determining the smoking status of Korean women. Even after reducing information bias, smoking affected pulmonary function in a dose-dependent manner.
Collapse
Affiliation(s)
- K Y Kim
- Department of Occupational & Environmental Medicine, Korea Medical Institute, Seoul, Republic of Korea
| | - J-P Myong
- Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-R Kim
- Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H E Lee
- Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - T-W Jang
- Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J-W Koo
- Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C Y Park
- Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
9
|
Myong JP, Kim HR, Choi SE, Koo JW. Dose-related effect of urinary cotinine levels on bone mineral density among Korean females. Osteoporos Int 2013; 24:1339-46. [PMID: 22890363 DOI: 10.1007/s00198-012-2107-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 07/05/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED To evaluate the dose-dependent relationship between smoking and bone mineral density (BMD), the present study used the BMD dataset of the Korean National Health and Nutrition Examination Survey IV (KNHANES IV). The linearity of BMD for urinary cotinine levels was demonstrated with statistical significance in postmenopausal females. INTRODUCTION It is well established that smoking is an important lifestyle risk factor for bone health (bone loss, osteoporosis, and fracture). However, several studies demonstrated conflicting evidence for a dose-dependent relationship between smoking and bone health. To evaluate the dose-dependent relationship between smoking and BMD, the present study estimated dose-related effects of smoking (urinary cotinine level) on BMD at various sites (femur neck, total femur, and lumbar spine) in females with controlling menopausal status. METHODS The present study used the BMD dataset of the KNHANES IV, which was performed in 2008 and 2009. A total of 4,260 pre- and postmenopausal females were included in the present study. Dose-response relationships between BMD and urinary cotinine levels were estimated using analysis of covariance in pre-menopausal females and postmenopausal females, respectively. RESULTS In postmenopausal females, the regression coefficients for BMD with urinary cotinine levels were -0.006, -0.006, and -0.008 (g/cm2 per ng/ml) at femur neck, total femur, and lumbar spine, respectively (p value<0.05). Thus, the linearity of BMD for urinary cotinine levels was demonstrated with statistical significance in postmenopausal females. CONCLUSION Our findings suggested a significant dose-related effect of urinary cotinine level with BMD at femur neck, total femur, and lumbar spine among postmenopausal females.
Collapse
Affiliation(s)
- J-P Myong
- Department of Preventive Medicine, Center for Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701, Republic of Korea
| | | | | | | |
Collapse
|