Isotype and IgG Subclass Distribution of Autoantibody Response to Alpha-enolase Protein in Adult Patients with Severe Asthma

이혜아,권별,허규영,최성진,박해심,남동호 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.6

Purpose: A possible involvement of autoimmune mechanism in the pathogenesis of bronchial asthma has been proposed. Recently, alpha-enolase protein was identified as a major autoantigen recognized by circulating IgG autoantibodies in patients with severe asthma. To evaluate a possible pathogenetic significance of these autoantibodies in severe asthma, isotype (IgG, IgA, IgM, and IgE) and IgG subclass (IgG1, IgG2, IgG3, and IgG4) distributions of autoantibodies to recombinant human alpha-enolase protein were analyzed. Patients and Methods: We examined serum samples from 10 patients with severe asthma and 7 patients with mild-to-moderate asthma, and 5 healthy controls by immunoblot analysis. Severe asthma was defined as patients having at least 1 severe asthmatic exacerbation requiring an emergency department visit or admission in the last year despite continuous typical therapies. Results: IgG1 was the predominant IgG subclass antibody response to alpha-enolase protein in patients with severe asthma. IgG1 autoantibody to alpha-enolase protein was detected in 7 of 10 patients with severe asthma (70%), 1 of 7 patients with mild-to-moderate asthma (14.3%), and none of 5 healthy controls (0%) (chi-square test; p<0.05). IgA, IgM, and IgE autoantibodies to alpha-enolase protein could not be detected in patients with severe asthma. Conclusion: IgG1 subclass was the predominant type of autoantibody response to alpha-enolase protein in patients with severe asthma, suggests a possibility of IgG1 autoantibody-mediated complement activation in the pathogenesis of severe asthma.

Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome

이혜아,박혜숙 대한예방의학회 2013 Journal of Preventive Medicine and Public Health Vol.46 No.4

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity,which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis

이혜아,박혜숙 대한예방의학회 2012 Journal of Preventive Medicine and Public Health Vol.45 No.5

Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an ageperiod-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60’s. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence

이혜아,이원경,공경애,장남수,하은희,홍영선,박혜숙 대한예방의학회 2011 Journal of Preventive Medicine and Public Health Vol.44 No.5

Objectives: Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined. Methods: The subjects consisted of 261 children aged 7- 9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests. Results: A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR],3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2?3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82). Conclusions: This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome Objectives: Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined. Methods: The subjects consisted of 261 children aged 7- 9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests. Results: A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR],3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2?3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82). Conclusions: This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.

임신 전 체질량지수와 임신 중 체중증가량이 자녀의 과체중에 미치는 상호작용 영향 -출생 코호트 자료 기반 분석-

이혜아,박은애,김영주,이화영,홍영선,장남수,오세영,하은희,박혜숙 한국모자보건학회 2012 한국모자보건학회 학술대회 연제집 Vol.2012 No.1

Risks of Lung Cancer due to Radon Exposure among the Regions of Korea

이혜아,이원경,임도희,박수현,Sun Jung Baik,공경애,정최경희,박혜숙 대한의학회 2015 Journal of Korean medical science Vol.30 No.5

Radon is likely the second most common cause of lung cancer after smoking. We estimated the lung cancer risk due to radon using common risk models. Based on national radon survey data, we estimated the population-attributable fraction (PAF) and the number of lung cancer deaths attributable to radon. The exposure-age duration (EAD) and exposure-age concentration (EAC) models were used. The regional average indoor radon concentration was 37.5 95 Bq/m3. The PAF for lung cancer was 8.3% (European Pooling Study model), 13.5% in males and 20.4% in females by EAD model, and 19.5% in males and 28.2% in females by EAC model. Due to differences in smoking by gender, the PAF of radon-induced lung cancer deaths was higher in females. In the Republic of Korea, the risk of radon is not widely recognized. Thus, information about radon health risks is important and efforts are needed to decrease the associated health problems.

Sex Differences in the Effects of CDKAL1 Variants on Glycemic Control in Diabetic Patients: Findings from the Korean Genome and Epidemiology Study

이혜아,박혜숙,홍영선 대한당뇨병학회 2022 Diabetes and Metabolism Journal Vol.46 No.6

Background: Using long-term data from the Korean Genome and Epidemiology Study, we defined poor glycemic control and investigated possible risk factors, including variants related to type 2 diabetes mellitus (T2DM). In addition, we evaluated interaction effects among risk factors for poor glycemic control.Methods: Among 436 subjects with newly diagnosed diabetes, poor glycemic control was defined based on glycosylated hemoglobin trajectory patterns by group-based trajectory modeling. For the variants related to T2DM, genetic risk scores (GRSs) were calculated and divided into quartiles. Risk factors for poor glycemic control were assessed using a logistic regression model.Results: Of the subjects, 43% were in the poor-glycemic-control group. Body mass index (BMI) and triglyceride (TG) were associated with poor glycemic control. The risk for poor glycemic control increased by 11.0% per 1 kg/m² increase in BMI and by 3.0% per 10 mg/dL increase in TG. The risk for GRS with poor glycemic control was sex-dependent (P_interaction=0.07), and a relationship by GRS quartiles was found in females but not in males. Moreover, the interaction effect was found to be significant on both additive and multiplicative scales. The interaction effect was evident in the variants of cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like (<i>CDKAL1</i>).Conclusion: Females with risk alleles of variants in <i>CDKAL1</i> associated with T2DM had a higher risk for poor glycemic control than males.

Developing Risk Factor-Related Injury Indicators Based on Injury Surveillance Data in Korea

이혜아,이선화,임도희,박보현,한혜진,손혜리,안선희,최용주,김보애,임도상,홍성옥,김영택,박주옥,박혜숙 사단법인 대한보건협회 2017 대한보건연구 Vol.43 No.4

Objective : In Korea, the Emergency Department-based In-depth Injury Surveillance System was designed to provide information necessary to establish injury prevention and management policies. To optimize the effectiveness and strategic utility of the injury surveillance system requires risk factor-related injury indicators. Thus, this study aimed to suggest indicators with description of a process to develop indicators that adhere to the goals of a surveillance system using data from hospital-based injury surveillance systems. Methods : Stepwise methodology using a Haddon matrix-based approach was used to develop risk factor- related injury indicators. Expert evaluation of the appropriateness, importance, clarity, sensitivity and applicability of candidate indicators was conducted in two rounds by referencing results for descriptive analysis using injury surveillance data. Results : Through the expert evaluation, 33 indicators were selected including those that measured the scale of injury. When classified according to the injury categories, indicators involving transport accidents were the most common with nine indicators, followed by those related to fall injuries with six indicators. Indicators also included poisoning, drowning, self-injury/suicide and violence. As a risk factor-related indicator, distribution of poisonous substances among injury patients admitted to an emergency department for intentional poisoning was selected. Conclusions : Appropriate indicators are needed that allow the effective operation of an injury surveillance system and policy-based use of such a system. It is also necessary to improve indicators that are cyclic in nature and can reflect changes in social interests and policies.

Blood Pressure Curve for Children Less than 10 Years of Age: Findings from the Ewha Birth and Growth Cohort Study

이혜아,박보현,박은애,Su Jin Cho,Hae Soon Kim,Eunjeong Choi,김남은,박혜숙 대한의학회 2020 Journal of Korean medical science Vol.35 No.12

Background: Routine blood pressure (BP) measurement is recommended to begin at 3 years of age, but there are no national BP reference values for Korean children less than 7 years of age. Therefore, we developed sex-, age-, and height-specific BP reference values for non- overweight children aged 3–9 years. Methods: We analyzed the data of 416, 340, 321, 323, and 332 subjects aged 3, 5, 7, 8, and 9 years, respectively, who participated in the Ewha Birth and Growth Cohort Study. BP percentile curves were generated using generalized additive models for location, scale, and shape. Reference values for the 50th, 90th, and 95th percentiles of BP were determined according to sex, age, and height percentiles. Results: In both boys and girls, a gradual increase in systolic blood pressure (SBP) with age was more pronounced than that in diastolic blood pressure (DBP). In boys, the reference values for 90th percentile of SBP/DBP at median height for children aged 3 and 9 years were 105/69 and 118/70, respectively. In girls, the reference values corresponding to the above conditions were 105/69 and 116/70, respectively. Among children aged 7–9 years of median height, the 90th percentile of SBP in the current study was lower and that of DBP was similar to the national reference values of Korea. For children aged < 7 years of median height, the reference value for SBP, but not that for DBP, was similar to that developed in the European study. Conclusion: Although further research is needed, our findings could be used to help identify high BP in children less than 10 years of age.

Changes in eating behaviors according to household income in adolescents during the COVID-19 pandemic: Findings from the Korea National Health and Nutrition Examination Survey

이혜아,Ho Jung Lee,Park Bomi,Shin Yoonhee,Park Hyun Jin,박혜숙 한국역학회 2022 Epidemiology and Health Vol.44 No.-

OBJECTIVES: To assess the social inequalities in changes of dietary behaviors among adolescents during the COVID-19 pandemic, we compared changes in dietary behavior indicators by household income. METHODS: Using cross-sectional data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, the prevalence of dietary behaviors in adolescents (12-18 years old) was estimated and changes in dietary behaviors before and after the COVID-19 pandemic were evaluated. We assessed changes in dietary behaviors with a household income (as a measure of socioeconomic status [SES]) disparity. RESULTS: During the COVID-19 pandemic, average consumption of vegetables has decreased and food insecurity has worsened. Adolescents were more likely to skip breakfast than before COVID-19 (33.1 % and 37.4 %). Soft drink consumption also increased in 2020 than in 2019 (7.6 % and 14.8 %), especially among boys. Average sugar intake and sodium intake showed a tendency to decrease only in girls, but there was no difference according to SES level. Skip breakfast was particularly evident in the low SES group, and the difference according to household income level (high vs. low) was greater after COVID-19 than before. The prevalence of soft drink consumption increased significantly in low SES group, but the rate of increase did not differ by SES level. CONCLUSIONS: We found that the social disparity in skipping breakfast was further aggravated. For a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.