1
|
Do HJ, Shin JS, Lee J, Lee YJ, Kim MR, Nam D, Kim EJ, Park Y, Suhr K, Ha IH. Association between liver enzymes and bone mineral density in Koreans: a cross-sectional study. BMC Musculoskelet Disord 2018; 19:410. [PMID: 30474546 PMCID: PMC6260874 DOI: 10.1186/s12891-018-2322-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/25/2018] [Indexed: 01/03/2023] Open
Abstract
Background Osteoporosis is a major health concern for both men and women, and associated fractures incur substantial economic burden. While there are a multitude of studies on bone mineral density (BMD) and liver diseases, not many studies have assessed the association between liver enzyme levels and BMD in homogeneous populations. Methods The current study investigated the association between serum liver enzyme levels and BMD at various sites in Koreans. Out of 21,517 surveyees of the 5th Korean National Health and Nutrition Examination Survey (2010–2012), 7160 participants’ data on BMD, serum liver enzymes, and full covariate data were included for cross-sectional analysis. BMD at the femoral neck, lumbar spine, entire femur, and whole body was assessed using dual energy X-ray absorptiometry (DEXA), and liver enzymes included aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma(γ)-glutamyl transferase (GGT) levels. Differences in participant characteristics by BMD and liver enzyme levels were analyzed, and complex sample design regression analysis adjusted for multiple covariates was performed to assess the relationship between liver enzymes and BMD. Results Negative associations were seen with GGT and BMD at all sites (P ≤ 0.02), ALT with lumbar spine (P = 0.0013), and AST with lumbar BMD (P = 0.0009). In particular, GGT presented strong negative associations with BMD in postmenopausal women and elder men. Conclusions This study demonstrates a negative relationship between liver enzyme levels and BMD, and suggests that a significant association exists between osteoporosis/decreased BMD and liver disorders. Electronic supplementary material The online version of this article (10.1186/s12891-018-2322-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ho Jeong Do
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 538 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Me-Riong Kim
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Dongguk University, 123 Dongdae-ro, Gyeongju, Gyeongsangbuk-do, Republic of Korea
| | - Yeoncheol Park
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, Republic of Korea
| | - Kristin Suhr
- Prevention Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 538 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Suh CY, Lee YJ, Shin JS, Lee J, Kim MR, Koh W, Cha YY, Shin BC, Hwang EH, Suhr K, Kim M, Ha IH. Analysis of medical service use of knee osteoarthritis and knee meniscal and ligament injuries in Korea: a cross-sectional study of national patient sample data. BMC Musculoskelet Disord 2017; 18:438. [PMID: 29126382 PMCID: PMC5681826 DOI: 10.1186/s12891-017-1795-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/31/2017] [Indexed: 01/09/2023] Open
Abstract
Background Osteoarthritis (OA) and meniscal and ligament injuries of the knee are the two most common knee disorders in Korea. The aim of this study was to analyze the demographic characteristics, medical service use and related costs for these disorders, and the results are expected to help inform practitioners, researchers, and policy-makers. Methods The present study aimed to evaluate incidence and patient characteristics, and to assess current medical service use, usual care, and medical expenses of knee disorders by analyzing 2014 national patient sample data from the Korean Health Insurance Review and Assessment Service. Data was extracted using 3% stratified sampling from all Korea national health insurance claims submitted in 2014, and analyzed. Usual care for M17 knee osteoarthritis and S83 knee meniscal and ligament injury codes of the International Classification of Diseases, 10th revision (ICD-10) were determined by investigating total number of patients, sociodemographic characteristics, days in care, number of visits, and expenses. Results Knee OA showed the highest incidence in females aged ≥60 years, whereas meniscal and ligament injuries of the knee were most prevalent among patients aged <20 years and young adults. Total inpatient care expenses exceeded the cost of ambulatory care for both disorders. Ambulatory care was mainly provided at primary care clinics, with 90% of these visits made to orthopedic specialists. Medical expenses for knee OA and meniscal and ligament injuries were largely due to procedures/surgeries and injections, and procedures/surgeries and hospitalizations, respectively. Total replacement arthroplasty was the most commonly performed surgery for knee OA, while meniscectomy and cruciate ligament reconstruction were the most often performed surgeries for meniscal and ligament injuries. Intra-articular injection rates were 55% in knee OA patients and 3% in meniscal and ligament injury patients. Aceclofenac, diclofenac, and tramadol were the most frequently prescribed analgesics. Conclusions The current findings may be used as basic data for establishing medical policies and can benefit researchers and clinicians in recognizing trends and patterns of treatment for knee disorders. Electronic supplementary material The online version of this article (10.1186/s12891-017-1795-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Chang Yong Suh
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Me-Riong Kim
- Department of Applied Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Wonil Koh
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Yun-Yeop Cha
- Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Sangji University, Wonju-si, Gangwon-do, Republic of Korea
| | - Byung-Cheul Shin
- Spine & Joint Center, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do, Republic of Korea.,Department of Korean Rehabilitation Medicine, School of Korean Medicine, Pusan National University, Yangsan-si, Gyeongsangnam-do, Republic of Korea
| | - Eui-Hyoung Hwang
- Spine & Joint Center, Pusan National University Korean Medicine Hospital, Yangsan-si, Gyeongsangnam-do, Republic of Korea.,Department of Korean Rehabilitation Medicine, School of Korean Medicine, Pusan National University, Yangsan-si, Gyeongsangnam-do, Republic of Korea
| | - Kristin Suhr
- Prevention Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mia Kim
- Department of Cardiovascular and Neurological Diseases (Stroke Center), College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Schultz KL, Vajaranant TS, Suhr K, Wilensky JT, Tu EY. Surgical technique for excisional bleb revision using a rotational conjunctival flap for a large conjunctival defect. Middle East Afr J Ophthalmol 2013; 20:98-101. [PMID: 23580864 PMCID: PMC3617541 DOI: 10.4103/0974-9233.106409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Bleb dysesthesia is a common but under recognized late complication of trabeculectomy, sometimes requiring surgical revision if conservative measures fail. We describe in detail a surgical technique for closure of a large conjunctival defect following bleb excision for refractory dysesthesia. Two subconjunctival 5-fluorouracil injections were given to improve bleb function. Eight months post-operatively, the intraocular pressure is well controlled on two agents, and the patient has had resolution of dysesthesia.
Collapse
Affiliation(s)
- Kara L Schultz
- Department of Ophthalmology and Visual Sciences, University of Illinois-Chicago, Chicago, IL 60612, USA
| | | | | | | | | |
Collapse
|