일개 사업장 남성 노동자들에서 심혈관질환 발병위험도평가(KOSHA 모형)와 한국인 허혈성심질환 발생예측모형(Jee's 모형)의 비교

이경진,허현택,김동원,김인아,김수영,노준래,문제혁 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

Objectives: This study was conducted to evaluate the relationship between KOSHA's cardiovascular disease risk assessment and the predicted lO-year risk of cardiovascular disease developed by Jee. Subjects and Methods: Data were obtained from a structured questionnaire survey and medical examination of 509 male workers aged 30-59 years employed at a wallpaper and floor covering workplace in May 2008. We calculated KOSHA's cardiovascular disease risk assessment and Jee's predicted l0-year risk of cardiovascular disease. A high risk of cardiovascular disease was defined as the upper 10th percentile of Jee's predicted 10-year risk of cardiovascular disease, Statistical analysis was conducted using the Wilcoxon rank sum test, Kruskal Wallis test and a logistic regression model. Results: Jee's predicted 10-year risk of cardiovascular disease significantly increased as KOSHA's cardiovascular disease risk increased. Logistic regression analysis indicated that the group with 3 or more cardiovascular disease risk factors according to KOSHA's model was more likely to experience Cardiovascular disease within 10 years(0R=34.4, 95% C.I.=4.4-267.2). Conclusions: KOSHA's cardiovascular disease risk assessment was fairly well associated with Jee's predicted lO-year risk of cardiovascular disease and was believed to be a practical and convenient method of preventing cardiovascular disease at the workplace. 목적: 이 연구는 한국산업안전보건공단의 KOSHA 모형과 Jee's 모형 사이의 관련성을 확인한 후 이를 통해 KOSHA 모형의 활용도를 평가하고자 하였다. 방법: 2008년 5월 일개 제조업 사업장에 종사하는 30-59세 남성 노동자를 대상으로 설문과 건강검진을 실시하여 총 509명을 분석하였다. KOSHA 모형과 Jee's 모형에 따라 대상자의 허혈성심질환 발생위험도를 평가하였으며, 허혈성심질환 발생위험도 점수의 상위 10%를 고위험군으로 정의하였다. 또한 K08HA 모형에 따라 정상군, 저·증등도위험군, 고위험군으로 나누었으며, 두 모형을 비교하기 위해 Wilcoxon rank sum test, Kruskal-Wallis test 및 multiple logistic regression 분석을 시행하였다. 결과: 연구 대상자들의 Jee s 모형에 따른 허혈성심질환 발생위험도는 30대는 0.67%, 40대는 2.23%, 50대는 3.78%이었다. Jee's 모형과 KOSHA 모형에 따른 위험인자의 logistic regression 분석 결과, 3개 이상의 위험인자를 갖고 있는 경우 Jee s 모형에서 10년 이내 허혈성심질환이 발생할 위험도가 크게 증가하였다 (OR=34.4, 95% C.I. =4.4-267.2). 또한 KOSHA 모형의 저·중등도위험군, 고위험군에서 Jee's 모형의 허혈정심질환 발생위험도가 정상군에 비해 통계적으로 유의하게 높게 나타났다. 결론: KOSHA 모형은 Jee's 모형과 상당한 관련성을 갖고 있었으며, 사업장에서 KOSHA 모형을 이용하여 신속하고 간편하게 심혈관질환 발병위험도를 평가하여 위험인자에 대한 적극적인 관리를 할 수 있을 것으로 판단된다.

Suboptimal Attainment of Cardiovascular Disease Prevention Guideline Goals in Korean Women

부선주,Erika Sivarajan Froelicher 한국간호과학회 2012 Asian Nursing Research Vol.6 No.2

Purpose: The purposes of this study were to estimate the distribution of three levels of risk for developing coronary heart disease (CHD; low, moderate, and high risk) and to evaluate the attainment of cardiovascular disease prevention guideline goals by the American Heart Association in a nationally representative sample of Korean women. Methods: This is a secondary data analysis study using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 3,301 Korean women (representing 15,600,514women) older than 20 years without cardiovascular disease. Distribution of CHD risk and level of goal attainment were calculated using sampling weights and presented in percentages. Results: Among Korean women without established cardiovascular disease, 7.9% were at high risk for CHD, 20.5% were at moderate risk, and 71.6% were at low risk. The proportion of Korean women who did not meet their goals was substantial, and most women at high risk remained unmanaged for their high blood lipids. Conclusion: Korean women at risk for developing CHD need to be managed as soon as possible to attain the guideline goals and to lower their risk for future CHD. Aggressive risk reduction efforts are urgently needed to reduce the public burden of CHD in Korean women. Purpose: The purposes of this study were to estimate the distribution of three levels of risk for developing coronary heart disease (CHD; low, moderate, and high risk) and to evaluate the attainment of cardiovascular disease prevention guideline goals by the American Heart Association in a nationally representative sample of Korean women. Methods: This is a secondary data analysis study using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 3,301 Korean women (representing 15,600,514women) older than 20 years without cardiovascular disease. Distribution of CHD risk and level of goal attainment were calculated using sampling weights and presented in percentages. Results: Among Korean women without established cardiovascular disease, 7.9% were at high risk for CHD, 20.5% were at moderate risk, and 71.6% were at low risk. The proportion of Korean women who did not meet their goals was substantial, and most women at high risk remained unmanaged for their high blood lipids. Conclusion: Korean women at risk for developing CHD need to be managed as soon as possible to attain the guideline goals and to lower their risk for future CHD. Aggressive risk reduction efforts are urgently needed to reduce the public burden of CHD in Korean women.

Framingham risk score and risk of incident chronic kidney disease: A community-based prospective cohort study

( Changhyun Lee ),( Hae-ryong Yun ),( Young Su Joo ),( Sangmi Lee ),( Joohwan Kim ),( Ki Heon Nam ),( Jong Hyun Jhee ),( Jung Tak Park ),( Tae-hyun Yoo ),( Shin-wook Kang ),( Seung Hyeok Han ) 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.1

Background: Cardiovascular disease and chronic kidney disease share several common risk factors. The Framingham risk score is hypothesized to predict chronic kidney disease development. We determined if the Framingham risk scoring system can correctly predict incident chronic kidney disease in the general population. Methods: This study included 9,080 subjects who participated in the Korean Genome and Epidemiology Study between 2001 and 2014 and had normal renal function. The subjects were classified into low- (< 10%), intermediate- (10-20%), and high- ( > 20%) risk groups based on baseline Framingham risk scores. The primary endpoint was de novo chronic kidney disease development (estimated glomerular filtration rate [eGFR], < 60 mL/min/1.73 m2). Results: During a mean follow-up duration of 8.9 ± 4.3 years, 312 (5.3%), 217 (10.8%), and 205 (16.9%) subjects developed chronic kidney disease in the low, intermediate, and high risk groups, respectively (P < 0.001). Multivariable analysis after adjustment for confounding factors showed the hazard ratios for the high- and intermediate risk groups were 2.674 (95% confidence interval [CI], 2.197-3.255) and 1.734 (95% CI, 1.447-2.078), respectively. This association was consistently observed irrespective of proteinuria, age, sex, obesity, or hypertension. The predictive power of this scoring system was lower than that of renal parameters, such as eGFR and proteinuria, but increased when both were included in the prediction model. Conclusion: The Framingham risk score predicted incident chronic kidney disease and enhanced risk stratification in conjunction with traditional renal parameters in the general population with normal renal function.

사상체질병증 임상진료지침: 예방 및 위험인자

배나영,이의주,Bae, Na-Young,Lee, Eui-Ju 사상체질의학회 2015 사상체질의학회지 Vol.27 No.1

Objectives This research was proposed to present Clinical Practice Guideline (CPG) for Prevention of Sasangin disease pattern of Sasang Constitutional Medicine (SCM) and diseases closely related with Sasang constitution. Each CPG was developed by the national-wide experts committee consisting of SCM professors. Methods At first, we searched the literatures related to SCM such as "Dongeuisusebowon", Textbook of SCM and Clinical Guidebook of SCM. Also we searched the articles related to the studies about risk factors for Sasangin disease pattern of both at home and abroad. Finally, we selected leading risk factors of Sasangin disease pattern and developed CPG for prevention of Sasangin disease pattern of SCM. And then, we searched the literatures related SCM such as "Dongeuisusebowon" and the articles on the correlation between disease and Sasang constitution using case-control studies, observational studies or cross sectional studies of both at home and abroad. Next, we selected diseases closely related with Sasang constitution on the basis of articles including prevalence rate and odds ratio between disease and Sasang constitution and finally developed CPG for these diseases. Results and Conclusions We categorized risk factors of Sasang disease pattern into 2 types: non-modifiable and potentially modifiable. 3 items (age, sex and genetic factors) were classified as non-modifiable risk factors of Sasang disease pattern. 6 items (original symptom, stress, diet and nutrition, physical activity, alcohol and drug misuse) were classified as less well-documented or potentially modifiable risk factors of Sasangin disease pattern. We found out Sasang constitution is more likely to develop some diseases. It was proven that Sasang constitution increase the risk of hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. And there is high probability of Sasang constitution being potential risk factor for obesity, hyperlipidemia, allergy and cancer. Also, we found out Taeeumin is independent risk factor for hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. Therefore we recommend that Taeeumin need to prevent these disease by regular checkups and aggressive management.

Disease risk map of anthracnose-twister of onion based on previous disease locations as a future predictors

R. T. Alberto,M. F. Isip,A. R. Biagtan,R. C. Tagaca 대한공간정보학회 2019 Spatial Information Research Vol.27 No.3

Understanding the disease epidemiology of anthracnose-twister disease provide us with information about the spread of disease in different areas with different climates which necessitates site specific disease predictions, management and spread of infection to other areas. Anthracnose-twister disease is caused by Colletotrichum gloeosporioides and Gibberella moniliformis and is considered to be the most destructive disease of onion in the Philippines. The disease had spread in Nueva Ecija and neighboring onion growing provinces in Luzon. To prevent the same situation in the future, disease risk maps could be of great value among decision makers and farmers to minimize damage and losses due to the disease. A geographic information system is an essential tool in analyzing disease data associated with geographic locations which can generate spatial distribution, spread and occurrence of plant diseases in the form of maps. These can provide meaningful information that can be easily interpreted. In this study, the data of previous disease location was utilized to generate prediction and disease risk maps through interpolation using Kriging model. Based on the results, the prediction map suggests anthracnose-twister disease of onion will become an epidemic and the disease outbreak will most likely to occur in the southern part of Bongabon (Philippines). It shows that the southeastern part of Bongabon has a very high risk due to the high incidence rate (50.01% to 75.00%) on this area during the previous cropping seasons. To mitigate the situation in these areas it is recommended to avoid using white onion varieties which is very susceptible to anthracnose-twister, and spray potential fungicides 1 week after transplanting.

중소규모 사업장에서 근골격계 증상의 고 위험군 선정과 운동프로그램의 효과

김보경,박정일,임현우,구정완,이강숙 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.1

목적: 중소규모사업장 근로자들의 근골격계증상을 실제적이며 효과적으로 관리하는 방안을 제시하기 위하여 중점관리대상자를 선별하고 근골격계 운동프로그램의 효과를 평가하고자 하였다. 방법: 문헌검색과 Delphi법에 의한 전문가의견을 종합하여 근골격계질환과 관련된 요인을 선정하고 785명을 대상으로 이들 요인들에 관한 설문조사(5점척도)를 실시하였으며, 증상이 있는 군(3점척도 이상)을 위험군으로, 위험군 중에서 작업특성관련요인과 일반특성관련요인이 함께 있는 군(평균이 3점척도이상)을 고 위험군으로 분류하여 중점관리대상자를 선별하였다. 저 위험군과 고 위험군을 대상으로 12주간 근골격계 운동프로그램을 실시 한후 증상 호소율의 변화를 비교, 분석하여 운동프로그램의 효과를 평가하였다. 결과: 근골격계질환 위험군은 전체대상자 785명 중, 454명(57.8%)이었으며 고 위험군은 121명 (15.4%)이었다. 저 위험군의 근골격계증상에 대한 위험요인의 다중로지스틱회귀분석 결과 유의한 위험용인은 성, 근골격계질환과 관현된 개인질병이었고, 고 위험군에서의 위험요인은 연령, 성, 근골격계질환과 관련된 개인질병 등이었다. 저 위험군을 대상을 12주간의 운동프로그램 실시한 후 대조군에서의 근골격계증상호소율은 유의한 변화가 없었으나 중재군에서는 근골격계증상 호소율이 신체부위 모두에서 유의하게 감소하였고, 고위험군을 대상으로 12주간의 운동프로그램을 실시한 결과 대조군에서 근골격계 증상호소율이 팔과 팔꿈치 부위에서 유의하게 증가한 반면 중재군에서는 허리부위에서 증상호소율이 유의하게 감소하였다. 결론: 이상의 결과를 종합하면 저 위험군에서는 운동프로그램이 근골격계증상 관리에 유의하게 기여하였으나 고 위험군에서 운동프로그램의 효과는 확인할 수 없었기 때문에 고 위험군에서의 근골격계 증상을 효과적으로 관리하기 위하여는 운동프로그램외의 다른 조치가 필요할 것으로 판단된다. Objectives: This study was conducted to provide data for the establishment of a practical and the effective exercise program for managing the musculoskeletal symptoms of workers who are employed in small and medium sized enterprises. Methods: The risk factors related to musculoskeletal disease management were chosen according to the relevant literatures, and were based on advise from experts on the Delphi method. Questionnaires on selected risk factors (with a 5-point Likert scale) were given to 785 subjects who worked in small and medium sized enterprises. The subjects were then classified in the risk group when they had the symptoms and recorded at least 3 points. From those subjects in the risk group, those who had both work-related factors and general characteristics factors (with an average of at least 3 points) were further classified as the high risk group. We performed a 12-week musculoskeletal exercise program for the low and high risk groups to analyze their changes in symptoms and complaints in order to estimate the effectiveness of the exercise program. Results: Out of 785 subjects, 454(57.8%) were in the risk group of musculoskeletal diseases and 121(15.4%) were in the high risk group. According to multiple logistic regression analysis of the factors for the musculoskeletal symptoms in the low risk group, the significant risk factors were sex and personal disease related with musculoskeletal disease, while the risk factors in the high risk group were age, sex, and personal disease related with musculoskeletal disease. After the I2-week exercise program was performed by the low risk group, the number of musculoskeletal symptom complaints in the control group did not significantly changed, whereas for the intervention group, the number of musculoskeletal symptom complaints significantly declined for all parts of the body. After the 12-week exercise program performed by the high risk group, the number of musculoskeletal symptom complaints in the control group was significantly enhanced for the arm and elbow parts. In the intervention group, the complaint rate for musculoskeletal symptoms significantly declined only for the low back. Conclusion: The musculoskeletal symptoms were significantly improved by the exercise program in the low risk group, but not in the high risk group. It is suggested that control measures on administrative and/or work related factors, in addition to the exercise program should be considered simultancously for the control of musculoskeletal symptoms in groups at high risk of musculoskeletal disease.

Original Article : Alcoholic fatty liver disease elevates estimated coronary heart disease risk to levels comparable with those of nonalcoholic fatty liver disease in the Korean population: a cross-sectional study

( Hai Jin Kim ),( Jeong Han Kim ),( Won Hyeok Choe ),( So Young Kwon ),( Chang Hong Lee ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.2

Background/Aims: A close relationship has been established between nonalcoholic fatty liver disease (NAFLD) and an elevated risk of coronary heart disease (CHD), but little is known about the association between alcoholic fatty liver disease (AFLD) and CHD risk. The aim of this study was to determine whether AFLD is associated with elevated CHD risk. Methods: We retrospectively enrolled 10,710 subjects out of 11,469 individuals who visited the Konkuk University Health Care Center for a routine health checkup in 2010. AFLD was diagnosed made when the usual amount of alcohol consumption exceeded 210 g/week in males and 140 g/week in females for the previous 2 years and when hepatic steatosis was detected by liver ultrasonography. The 10-year risk for CHD was estimated using the Framingham Risk Score. Results: Hepatic steatosis was diagnosed in 4,142 of the 10,710 individuals (38.7%); the remainder (i.e., n=6,568) became the control group. The 4,142 individuals with hepatic steatosis were divided into two groups: NAFLD (n=2,953) and AFLD (n=1,189). The risk of CHD was higher in AFLD (6.72±0.12) than in the control group (5.50±0.04, P<0.001), and comparable to that in NAFLD (7.32±0.07, P=0.02). Conclusions: Individuals with AFLD have an elevated 10-year risk of CHD that is comparable to those with NAFLD. Therefore, AFLD should be considered a significant risk for future CHD, and preventive measures should be considered earlier. (Clin Mol Hepatol 2014;20:154-161)

거짓비늘증후군에서 혈청 호모시스테인 농도와 관상동맥심질환의 위험도 분석

구병영(Byoung Young Gu),추지희(Ji Hee Chu),임수호(Su Ho Lim),차순철(Soon Cheol Cha) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 거짓비늘증후군 환자에서 혈청 호모시스테인 농도를 조사하여 관상동맥심질환의 위험도와 연관성을 알아보고자 하였다. 대상과 방법: 2013년 3월부터 2013년 9월까지 영남대학교병원 안과 외래를 방문한 거짓비늘증후군 환자 37명과 비슷한 연령대의 거짓비늘증후군이 없는 환자(대조군) 59명을 대상으로 전향적 연구를 시행하였다. 거짓비늘증후군 환자와 대조군에서 정맥혈을 채취하여 측정한 혈청 호모시스테인 농도를 비교 분석하였다. 프래밍햄 위험점수(Framingham risk score)를 이용하여 산출한 관상동맥심질환 10년 위험도를 두 군 간에 비교하였다. 아울러 혈청 호모시스테인 농도와 관상동맥심질환 10년 위험도 사이의 상관관계를 조사하였다. 결과: 거짓비늘증후군 환자의 평균 혈청 호모시스테인 농도는 13.3 ± 6.8 μmol/L였으며 대조군(10.0 ± 5.2 μmol/L)에 비하여 통계적으로 유의하게 높았다(p=0.009). 관상동맥심질환 10년 위험도가 20% 초과인 고위험군의 비율은 거짓비늘증후군 환자에서 21.4%로, 대조군의 4.4%에 비하여 통계적으로 유의하게 높았다(p=0.048). 거짓비늘증후군 환자와 대조군 전체에서, 혈청 호모시스테인 농도와 산출된 관상동맥심질환 10년 위험도 사이에는 양의 상관관계를 보였다(r=0.578, p<0.001). 결론: 거짓비늘증후군 환자에서 혈청 호모시스테인 농도가 높고, 관상동맥심질환 위험도가 큰 것으로 나타났다. 따라서 고호모시스테 인혈증을 보이는 거짓비늘증후군 환자에서 관상동맥심질환의 발생을 예방하기 위한 노력이 필요할 것으로 생각된다. Purpose: To investigate levels of serum homocysteine in patients with pseudoexfoliation syndrome and the association between serum homocysteine levels and risk of coronary heart disease. Methods: From March 2013 to September 2013, 37 patients with pseudoexfoliation syndrome and 59 age-matched patients(control group) were enrolled in this prospective study. Serum homocysteine levels were compared between the 2 groups. We compared the estimated 10-year risk of coronary heart disease based on Framingham risk score between the 2 groups. Additionally, we analyzed correlations between risk of coronary heart disease and serum homocysteine levels. Results: The mean homocysteine level of patients with pseudoexfoliation syndrome was significantly higher than the control group (13.3 ± 6.8 μmol/L vs. 10.0 ± 5.2 μmol/L, p = 0.009). The rate of high risk defined as a 10-year coronary heart disease risk >20% in the patients with pseudoexfoliation syndrome was significantly higher than in the control group (21.4% vs. 4.4%, p = 0.048). Correlation between serum homocysteine levels and estimated 10-year risk of coronary heart disease was statistically significant (r = 0.578, p < 0.001). Conclusions: Hyperhomocysteinemia and high risk of coronary heart disease were observed in patients with pseudoexfoliation syndrome. Therefore, we suggest efforts to prevent coronary heart disease in pseudoexfoliation syndrome patients with hyperhomocysteinemia are necessary.

허혈성심질환 예측모형을 이용한 사회경제적 위치와 허혈성심질환 위험도의 연관성

고동희,한순실,지선하,김형렬,Koh, Dong-Hee,Han, Sun-Shil,Jee, Sun-Ha,Kim, Hyoung-Ryoul 대한예방의학회 2006 예방의학회지 Vol.39 No.4

Objectives: The object of this study is to assess the relationship between socioeconomic factors and the predicted 10-year risk of cardiovascular disease by using health risk appraisal of ischemic heart disease. Methods: The study population was taken from The 2001 Korea National Health and Nutrition Survey, and it consisted of 1,566 men and 1,984 women aged 30-59. We calculated 10-year risk using the risk function of ischemic heart disease as developed by Jee. The educational level and equivalized household income were dichotomized by a 12 years education period and the median income level. Occupation was dichotomized into manual/non-manual work. We stratified the population by age(10 years) and sex, and then we rated the risk differences according to socioeconomic factors by performing t-tests for each strata. Results: There were gradients of the predicted 10-year risk of ischemic heart disease with the educational level and the equivalized household income, and thet was an increasing tendency of risk differences with age. Manual workers didn't show significant risk difference from non-manual workers. Conclusions: There was definite relationship between low socioeconomic position and the predicted risk of ischemic heart disease in the future.

65세 이상 노인에서의 대혈관질환과 Lipoprotein(a) 농도와의 연관성

박이병,조경환,백세현 대한노인병학회 1999 Annals of geriatric medicine and research Vol.3 No.4