농약사용과 암발생과의 관계

설재웅,이상욱,손태용,지선하,남정모,오희철,Sull, Jae-Woong,Yi, Sang-Wook,Sohn, Tae-Yong,Jee, Sun-Ha,Nam, Chung-Mo,Ohrr, Hee-Chul 대한예방의학회 2002 예방의학회지 Vol.35 No.1

Objective : Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. Methods : We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks(RR). Results : At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 140 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95%. CI=1.0-1.9), p for trend=0.041, for digestive organ cancer Incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer, incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0(95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.5-27.9)). Conclusions : This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.

가족기반 코호트 연구의 사례와 전망

설재웅(Jae Woong Sull),박수경(Sue Kyung Park),오희철(Heechoul Ohrr),지선하(Sun Ha Jee) 한국역학회 2008 Epidemiology and Health Vol.30 No.1

  가족기반 코호트 연구를 하는 것은 단면연구나 일반인을 대상으로 하는 코호트 연구에 비하여 비용과 시간이 많이 걸리는 단점이 있으나 만성질환의 환경요인과 유전요인을 동시에 연구함에 있어서 많은 장점을 가지므로 연구계획 시 고려할 가치가 있겠다. 그 주된 장점으로는 population structure의 영향을 적게 받는 다는 것, Imprinting의 효과를 볼 수 있다는 것과 연관성(association) 분석 이외에 linkage 분석도 동시에 할 수 있다는 것이다. 따라서 실제로 미국의 프램험 연구와 유럽의 IMAGE project 등에서 가족기반 코호트 연구를 활발히 진행 중이며 genome-wide association 연구를 포함한 성공적인 여러 관련 결과들을 발표하고 있다.   가족 기반 코호트에서 주로 사용되는 연구방법은 linkage 분석과 TDT 분석, 그리고 imprinting effect 분석이다. 이와 관련된 내용은 본 연구에서 간단히 기술하였다. 최근 가족기반 코호트 연구의 방향은 다른 환자-대조군 연구나 일반인구 코호트 유전 연구와 마찬가지로 genome-wide association 연구를 하는 것이다. 미국과 영국을 포함한 여러 나라에서 경쟁적으로 가족기반코호트를 이용한 genome-wide association 연구를 진행하고 있으나 생활습관요인과 유전요인이 상이한 자국민에 대한 연구는 필수적이다. 또한 genome-wide association 연구를 통한 genome-wide imprinting 연구는 국제적으로 초기단계라 할 수 있다. 따라서 국내에서도 국가적인 지원 하에 가족기반 코호트 연구를 시작한다면 국제적으로 경쟁력 있는 연구를 하는 것이 가능하겠다.   Family-based designs are commonly used in genetic association studies to identify and to locate genes that underlie complex diseases. In this paper, we review two examples of genome-wide association studies using family-based cohort studies, including the Framingham Heart Study and International Multi-Center ADHD Genetics Project. We also review statistical methods of family-based designs, including the transmission disequilibrium test (TOT), linkage analysis, and imprinting effect analysis.   In addition, we evaluate the strengths and limitations of the family-based cohort design. Despite the costs and difficulties in carrying out this type of study, a family-based cohort study can play avery important role in genome wide studies. First, the design will be free from biases clue to population heterogeneity or stratification. Moreover, family-based designs provide the opportunity to conduct joint tests of linkage and association. Finally, family-based designs also allow access to epigenetic phenomena like imprinting. The family-based cohort design should be given careful consideration in planning new studies for genome-wide strategies.

타액 중 코티닌 검출을 이용한 청소년 흡연 자가 보고의 타당도

설재웅 ( Jae Woong Sull ),지선하 ( Sun Ha Jee ),목예진 ( Ye Jin Mok ),최문영 ( Moon Young Choi ),바이사,오희철 ( Hee Choul Ohrr ),( Bayasgalan Gombojav ) 한국보건정보통계학회 2010 한국보건정보통계학회지 Vol.35 No.1

Relationship of Metabolic Diseases with Physical Activity Depending on Age

임효경,설재웅,박범석,문지영,홍민화,이유리,황민지,이미나,이지영,김인식,Lim, Hyo Kyung,Sull, Jae Woong,Park, Beom Seok,Mun, Ji Young,Hong, Min Hwa,Lee, Yoori,Hwang, Min Ji,Lee, Mi Na,Lee, Ji Young,Kim, In Sik Korean Society for Clinical Laboratory Science 2018 대한임상검사과학회지(KJCLS) Vol.50 No.2

본 연구의 목적은 2014년 조사되어진 제 6기 2차 국민건강영양조사 자료를 바탕으로 연령별 신체활동에 따른 대사성질환과의 관계를 파악하여 연령별 신체활동에 따른 대사성질환과의 관련성을 규명하여 예방적 기초자료를 제공하기 위한 연구이다. 본 연구는 제 6기 2차(2014) 국민건강영양조사의 자료를 이용하여 수행되었다. 정상군의 382명과 대사질환군의 1,525명을 총 9,701명의 설문 응답자 중 관련 자료가 없는 2,506명을 제외하고 총 7,295명을 분석했다. 본 연구에서 신체활동은 국제신체활동 설문지 (IPAQ)를 기반으로 재분류 되었다. 대사증후군의 정의는 2004년 개정 된 NCEP-ATP III에 근거하여 다음과 같은 결론을 얻었다. 연령에 따른 대사성질환과 신체활동과의 관계에서 10~29세 정상군과 50~69세의 대사질환군에서 혈색소, 적혈구용적, 크리아티닌의 수치는 고강도 신체활동이 수행되었을 때 증가했고 저강도 신체활동을 수행되었을 때 감소했다. 30~49세의 정상군과 대사질환군에서 고밀도 지단백 콜레스테롤 수치는 고강도 신체활동이 수행되었을 때 증가했지만, 저강도 신체활동이 수행되었을 때 감소하였다. 따라서 연령과 운동강도가 고밀도 지단백 콜레스테롤 수치에 미치는 영향을 조사하였다. 결과는 정상군에서 연령과 운동강도에 따라 고밀도 지단백 콜레스테롤 수치에 차이는 없었지만 대사질환군에서는 연령에 따라 고밀도 지단백 콜레스테롤 수치가 감소하였고 운동강도에 따라 증가하였다. 종합하면, 본 연구의 결과는 대사질환군에서 고밀도 지단백 콜레스테롤 수치는 고강도 신체활동에서 긍정적인 효과를 나타내고 연령은 부정적인 효과를 나타냈다. 이러한 결과는 우리가 신체활동과 연령에 따라 대사성질환을 더 잘 이해하는데 도움이 될 수 있다. Metabolic disease is associated with abdominal obesity, high blood pressure, and dyslipidemia. Physical activity has beneficial effects on a variety of diseases. This study examined the relationship between metabolic diseases and physical activity according to age. Among a total of 7,295 subjects, the data from 382 individuals in the normal group and 1,525 persons in the metabolic disease group were analyzed. The data were analyzed statistically by one-way ANOVA, the Pearson's correlation coefficient, and multiple regression analysis. The levels of hemoglobin (HB), hematocrit (HCT), and creatinine (CR), were elevated when a high-intensity physical activity was performed, but they were reduced when a low-intensity physical activity was performed in the normal group aged 10~29 years and the metabolic disease group aged 50~69 years. In the normal group and metabolic disease group aged 30~49 years, the level of high density lipoprotein cholesterol (HDL-C) was elevated when high-intensity physical activity was conducted, whereas it was reduced when low-intensity physical activity was performed. No difference in the level of HDL-C depending on age and exercise intensity was observed in the normal group; the level of HDL-C decreased with age and increased with exercise intensity in the metabolic disease group. Physical activity has different effects in metabolic disease depending on age.

CDH1 유전자 다형성 -160C〉A와 대장결장암 발생에 관한 정량적 메타분석

조재승 ( Jae Seong Jo ),유미경 ( Mi Kyung Lyu ),박은정 ( Eun Jung Park ),설재웅 ( Jae Woong Sull ),지선하 ( Sun Ha Jee ) 한국보건정보통계학회 2010 보건정보통계학회지 Vol.35 No.1

음주와 순환기계질환 사망 및 전체사망과의 관련성

이상욱,유상현,설재웅,오희철,Yi, Sang-Wook,Yoo, Sang-Hyun,Sull, Jae-Woong,Ohrr, Hee-Choul 대한예방의학회 2004 예방의학회지 Vol.37 No.2

Objectives : This study sought to examine relationships between alcohol drinking and cardiovascular disease mortality and all-cause mortality. Methods : From March 1985 through December 1999, 2,696 males and 3,595 females aged 55 or over as of 1985 were followed up for their mortality until 31 December 1999. We calculated the mortality risk ratios by level of alcohol consumption. Among the drinker, the level of alcohol consumption was calculated by the frequency of alcohol comsumption and the type of alcohol. Cox proportional hazard model was used to adjust for confounding factors. Results : Among males, compared to abstainer, heavy drinker had significantly higher mortality in all cause(Risk ratio=1.35), cardiovascular disease(Risk ratio=1.52) and cerebrovascular disease(Risk ratio =1.66). Although not significant, moderate drinker had lower ischemic heart disease mortality(Risk ratio =0.38). Among females, there was no statistically significant association between alcohol comsumption and mortality. Conclusion : The results of this study suggest that alcohol drinking has harmful effect on all-cause mortality, cardiovascular disease mortality and cerebrovascular disease mortality among males, especially in heavy drinker among males. Minimal evidence on protective effect for cardiovascular disease mortality in low or moderate drinker is observed.

한국인 흡연과 사망위험에 대한 11년 추적연구

지선하(Sun-Ha Jee),조인호(In-Ho Jo),윤지은(Ji-Eun Yun),박정용(Jung-Yong Park),설재웅(Jae-Woong Sull),오희철(Hee-Choul Ohrr),이상이(Sang-Vi Lee),윤유식(Yoo-Sik Yoon),Jonathan M Samet, 김일순(II-Soon Kim) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

Objective : In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking. Method : A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers. Results : In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36). Conclusion : In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.