한국인 성인 남녀의 흡연관련 사망에 관한 연구

정금지 ( Keum Ji Jung ),윤영덕 ( Young Duk Yun ),백수진 ( Soo Jin Baek ),지선하 ( Sun Ha Jee ),김일순 ( Il Soon Kim ) 한국보건정보통계학회(구 한국보건통계학회) 2013 보건정보통계학회지 Vol.38 No.2

Objectives: Cigarette smoking has been widely recognized as a major risk factor for lung cancer and other diseases in Western countries. In Korea, male cigarette smoking prevalence was among the world`s highest between 1980 and 1990 and smoking has also become a strong risk factor for lung cancer and cardiovascular diseases. The objective of the study was to calculate the smoking-attributable mortality in 2012 in Korea. Methods: Number of smoking-attributable deaths were calculated by applying the percentages of population attributable risks (PARs) to the estimated number of deaths by diseases in 2012. In this study, PARs were obtained by using relative risks from the Korean Cancer Prevention Study and the Metabolic Syndrome Mortality Study, and population smoking prevalence surveyed in 1985 conducted by Korean Institute of Tuberculosis. Results: The smoking-attributable mortality was 58,155 death in 2012. Among adult male, the smokingattributable mortality (49,704) represents 34.7% of total 2012 mortality, whereas the smoking-attributable mortality (8,451) for adult females was 7.2%. Smoking was supposed to be responsible for 41.1% of all male cancer and 33.4% of all male cardiovascular diseases, whereas smoking for 5.1% of all female cancer and 5.4% of all female cardiovascular diseases in Korea. Conclusions: Smoking actually represents a remarkable burden of avoidable deaths in Korea. Smokingattributable mortality appears to continue increasing by the next 10 to 20 years.

암 발생예측 모형과 유전위험점수에 관한 고찰

정금지 ( Keum Ji Jung ),김소리울 ( Soriul Kim ),윤미욱 ( Miwuk Yun ),전티나 ( Christina Jeon ),지선하 ( Sun Ha Jee ) 한국보건정보통계학회(구 한국보건통계학회) 2014 보건정보통계학회지 Vol.39 No.1

Objectives: In genome-wide association studies (GWASs), single-nucleotide polymorphisms (SNPs) that have been identified as cancer-associated loci are common, but they confer only small increases in risk. The question was whether combining multiple disease-related SNPs and the modest effects within Genetic Risk Score (GRS) may be useful in identifying subgroups that are at high risk of cancer. Methods: In this paper, we first reviewed articles that examined the predictability of GRS on cancer prediction models. Our data sources included a PubMed search of the literature published until February 2014. Secondly, we have calculated the GRS using the data example data with five SNPs related colorectal cancer (CRC) obtained from the Korean cancer prevention study II. Two approaches were used to calculate the GRS: a simple risk alleles count method (counted GRS) and a weighted method based on the genotype frequencies for each SNP and the effect sizes (allelic odds ratio or beta coefficient) from our study (weighted GRS). Results: Of 31 studies initially identified, 16 (135,110 participants) met the inclusion criteria. Among 16 articles, 7 studies were related to prostate cancer, 6 studies to breast cancer, and 3 studies to colon cancer and lung cancer. Fifteen studies except for one study concluded that in general, a genetic score may be helpful or useful in identifying the high risk group and particularly to determining the high risk individual among patients within a ‘‘gray zone’’ of cancer risk. The weighted GRS with age and sex (AUC=0.9333) had higher predictability on the CRC risk than the model with GRS alone (AUC=0.816). Conclusions: Although adding GRS improves prediction model performance, the clinical utility of these genetic risk models is limited. Nonetheless, the modelling suggests public health potential since it is possible to stratify the population into cancer risk categories, thereby informing targeted prevention and management.

2012년 흡연으로 인한 건강보험 진료비 추정 연구

지선하 ( Sun Ha Jee ),정금지 ( Keum Ji Jung ),전티나 ( Christina Jeon ),김희진 ( Hee Jin Kim ),윤영덕 ( Young Duk Yun ),김일순 ( Il Soon Kim ) 한국보건정보통계학회(구 한국보건통계학회) 2014 보건정보통계학회지 Vol.39 No.1

Objectives: The purpose of the study was to estimate relative risk and attributable risk of 35 tobacco-related diseases and to compute total medical expenses on smoking by providing a cohort study with 20 years follow-up period. Methods: Smoking-attributable medical costs were calculated by applying the percentages of population attributable risks (PARs) to the estimated medical costs by the tobacco related diseases in 2012. In this study, PARs were obtained by using relative risks from the Korean Cancer Prevention Study and the previous studies, and population smoking prevalence surveyed in 1990 conducted by Korean Institute of Tuberculosis. Results: As a result, the medical expenses from tobacco use were 1,846,562,350,000 won (about 3.86% of total medical expenses). The top 5 medical expenses on tobacco-related diseases were ischemic heart diseases, cerebrovascular diseases, lung cancer, diabetes, and chronic obstructive pulmonary disease, respectively. More than a half percent of total medical expenses (about one billion dollars) were spent from these five, tobacco-related diseases. Conclusions: While the harmful effect of smoking is expected to have a steady increase for a while, antismoking policy should be reinforced to reduce the risk of disease incidence, and the medical expenses for treating the tobacco-related diseases.

혈청 대사체와 뇌졸중 발생위험의 용량반응 분석

지연호 ( Yon Ho Jee ),정금지 ( Keum Ji Jung ),임연희 ( Youn-hee Lim ),이예승 ( Yeseung Lee ),박영자 ( Youngja Park ),지선하 ( Sun Ha Jee ) 한국보건정보통계학회(구 한국보건통계학회) 2016 한국보건정보통계학회지 Vol.41 No.3

Objectives: Except the known risk factors for stroke, few studies have identified novel metabolic markers that could effectively detect stroke at an early stage. In this study, we explored the dose-response relationship between serum metabolites and the incidence of stroke. Methods: We studied 213 adults in the Korean Cancer Prevention Study-II (KCPS-II) biobank and estimated dose-response relationship between serum metabolites and stroke (42 cases and 171 controls). Three serum metabolites (Acetylcholine, HexadecylAcetylGlycerol, and 1-acetyl-2-formyl-sn-glycero-3-phosphocholine) were used in this study. The analysis included (1) exploratory nonlinear analysis, (2) estimation of flexion points and slopes at below and above the points. In the model to estimate risk of incidence of stroke, we controlled for conventional risk factors such as age, sex, systolic blood pressure, type 2 diabetes, tri-glyceride, and smoking status. Results: The relationship between incidence of stroke and log-transformed 1-acetyl-2-formyl-sn-glycero-3-phosphocho-line was non-linear with flexion point around intensity score of 8.8, whereas other metabolites, log-transformed Acetylcholine and HexadecylAcetylGlyc-erol, showed negative linear patterns. Conclusions: The study suggests that metabolic markers are associated with incidence of stroke, particularly, at or above the flexion point. The study result may contribute to developing a novel system for precise stroke prediction.

공복혈당 궤적에 따른 심장병 발생 위험: 국민건강보험공단 표본 코호트 연구

전주은 ( Jooeun Jeon ),조어린 ( Eo Rin Cho ),정금지 ( Keum Ji Jung ),지선하 ( Sun Ha Jee ) 한국보건정보통계학회(구 한국보건통계학회) 2016 보건정보통계학회지 Vol.41 No.4

Objectives: To classify trajectories of fasting blood glucose (FBS) levels and examine each trajectory`s associations with risk of cardiovascular disease (CVD). Methods: The National Health Insurance Service-National Sample Cohort (NHIS-NSC) sampled in the 2002 NHIS database was followed until 2010, and 13,829 participants aged 20 years and above had conducted nationwide health examinations annually. We used Cox proportional hazards models to examine the association of trajectories to risk of CVD. Four distinct trajectory groups were identified for FBS: low-stable, moderate-stable, elevated-upward, and High-upward. Results: During 88947.9 person-years of follow-up (mean follow-up, 6.4 years), we documented 2,778 incident case of CVD. Age-standardized incidence rate were increased with FBS levels (5,296.2 in low-stable group, 6,292.6 in moderate-stable group, and 8047.9 in elevated-upward group), but not in High-upward group. In multivariate models adjusted for age and sex, FBS was a significant predictor of CVD in elevated-upward group (hazard ratio (HR)=1.6, 95% confidence interval (CI):1.4-1.8) and High-upward group (HR=1.6, 95% CI:1.3-2.1). However, further adjustment for clinical covariates, only elevated-upward group was significantly associated with CVD (HR=1.2, 95% CI:1.1-1.4). Conclusions: Using the trajectory approach, we found that elevated-upward and High-upward FBS trajectories were associated with greater risk of CVD. These findings indicate the importance of FBS management across the lifespan, prognostic assessments and the targeting of prevention strategies to high-risk individuals.

우리나라 성인의 고감도 C-반응성 단백과 대사증후군의 관련성: 성별 분석

신은영 ( Eunyoung Shin ),이용재 ( Yongjae Lee ),김태현 ( Taehyun Kim ),정금지 ( Keum Ji Jung ),정우진 ( Woojin Chung ) 한국보건행정학회 2021 보건행정학회지 Vol.31 No.2

Background: Metabolic syndrome has been known as a risk of cardiovascular disease. Meanwhile, high sensitivity C-reactive protein (hs-CRP) is used as a predictor of cardiovascular disease. In this paper, we aimed to investigate the association between hs-CRP and metabolic syndrome. Method: A total of 7,633 were chosen as the study population from the 7th Korea National Health and Nutrition Examination Survey dataset (2016-2017). Our dependent variable was whether an individual had metabolic syndrome or not, and the independent variable of interest was hs-CRP which was categorized into three groups. The chi-square tests and hierarchical logistic regression analyses reflecting survey characteristics were conducted. All analyses were stratified by gender. Results: According to the adjusted model with all covariates, compared to individuals having the low risk of hs-CRP, those having its average risk were more likely to have metabolic syndrome in men (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.12-1.76) and women (OR, 1.69; 95% CI, 1.33-2.16). Individuals having the high risk was not significantly different in men; however, they were more likely to have metabolic syndrome in women (OR, 2.03; 95% CI, 1.28-3.23). Conclusion: In an upcoming aging society, it is important to reduce the risk of metabolic syndrome to improve population health. This study suggests that hs-CRP may be used as a marker of the risk of metabolic syndrome in a gender-specific way, thereby contributing to enhancing awareness of the risk of metabolic syndrome among the general public.