금오도 특집(金鰲島 特輯) : 금오도 지역주민의 골밀도 실태

조남한 ( Nam Han Cho ) 한국도서(섬)학회 1998 韓國島嶼硏究 Vol.9 No.1

우리나라 당뇨병의 유병률과 관리 상태

조남한 ( Nam Han Cho ) 대한내과학회 2005 대한내과학회지 Vol.68 No.1

지역사회에서 손 골관절염과 무릎 골관절염의 유병률 및 위험인자

조남한 ( Nam Han Cho ),김수호 ( Su Ho Kim ),김현아 ( Hyun Ah Kim ),서영일 ( Young Il Seo ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.4

Objective: To estimate the prevalence of radiographic and symptomatic knee osteoarthritis (OA) and hand OA among community dwellers in a Korean rural area and to elucidate its risk factors. Methods: This cross-sectional population based study was conducted on residents over 40 years of age in Ansung, Gyeonggi Province. Subjects completed an interview based on a standardized questionnaire and clinical evaluation including knee and hand radiographs. We defined a subject with the Kellgren and Lawrence grade ≥2 as having radiographic OA (ROA). Symptomatic OA (SOA) was defined by the presence of both radiographic OA and self-reported pain. Results: We obtained both symptom information and radiographs from 3,876 subjects. The prevalence of radiographic and symptomatic knee OA was 14.9% and 5.4%, respectively. The prevalence of radiographic and symptomatic hand OA was 13.4% and 8.0%, respectively. The prevalence of knee and hand OA (ROA & SOA) was higher among women than men. Multiple logistic regression analysis showed a significant association of age and female sex with both knee and hand OA (ROA & SOA), of body mass index (BMI) with knee OA (ROA & SOA) and hand ROA. Conclusion: Both symptomatic and radiographic knee OA and hand OA is common in the general adult population of Korea, with preponderance for women. Age and female sex are common risk factors for knee and hand OA. Weight control is necessary for prevention of knee OA. Other factors might also contribute to the development of OA, but further study is needed to elucidate the role of these factors.

신질환 환아에서 초음파 골량측정법을 이용한 골상태 평가

강주형,신윤혜,조남한,배기수,Kang Ju-Hyung,Shin Yun-Hye,Cho Nam-Han,Pai Ki-Soo 대한소아신장학회 2005 Childhood kidney diseases Vol.9 No.1

목 적 : 소아 신질환 환자들의 골상태 평가 및 골다공증의 유병률을 산출하고 스테로이드 치료 기간 및 용량과의 연관성을 알아본 후 예방과 치료를 위한 진료에 지침을 마련하고자 시행하였다. 방 법 1994년 이후 아주대병원 소아과에서 신장질환을 진단 받은 환자들을 대상으로 초음파 골량측정법으로 골밀도를 측정한 후 한국 소아표준골밀도치를 참조하여 골상태를 평가하였고 환자의 임상소견 및 생화학적 지표들의 평균값간에 차이가 있는 지를 알아보았다. 결 과 : 골밀도를 측정 받은 환자는 총44명이었다. 진단시 나이는 6.7$\pm$4.2세였고, 골밀도 측정시 역연령은 9.3$\pm$4.2세, 골연령은 8.2$\pm$4.6세로 골연령이 저하되어 있었다. 질환별로는 특발성 신증후군 24명(54.5%), Henoch Shonlein 신염 7명(15.9%), IgA 신병증 5명(13.6%), 역류성 신병증 2명(4.5%), 기타 5명(11.4%)이었다. 환아 13명(29%)의 골밀도가 감소되어 있었고 이중 5명(11%)은 골다공증 범주에 속하였다 질환별로는 특발성 신증후군 1명(4%), Henoch Shonlein 신염 2명(29%), 역류성 신병증 1명(50%), 기타 1명(23%)이었다. 정상, 골감소증, 골다공증 세 군으로 나누었을 때 골밀도 측정시점까지 스테로이드 투여기간은 각각 26.5$\pm$27.3개월, 32.1$\pm$39.6개월, 8.9$\pm$12.9개월이었고, 투여한 축적 용량은 221.7 $\pm$248.6 mg/kg, 177.1 $\pm$302.9 mg/kg, 49.9$\pm$45.5 mg/kg이었으며 세 군간에 유의한 차이는 없었다. 스테로이드의 투여기간을 장기간(6개월이상)과 단기간(6개월 미만)으로 나누어 비교했을 때 골밀도 측정값 및 골관련 생화학적 수치들은 차이가 없었다.결 론 : 초음파 골량측정법이 보편화되지 않았지만 정상 참고치와 비교가 가능하였으며 측정결과 골감소증은 29%, 골다공증은 11%로 상당수에서 골상태가 비정상임을 알 수 있었다. 본 연구에서는 스테로이드 사용기간 및 축적용량이 골상내의 변화에 특별한 영향을 미치지 않는 것으로 나타났다. 동일 환자들의 골상태의 변화관찰과 신질환 관련 골감소의 요인을 밝혀내기 위한 추가적인 연구가 필요할 것으로 사료된다. Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.

반정량식품섭취빈도조사지의 타당성 검증 및 보정 - 지역사회 유전체 코호트 참여자를 대상으로 -

안윤진,이지은,조남한,신철,박찬,오범석,김규찬,Ahn, Youn-Jhin,Lee, Ji-Eun,Cho, Nam-Han,Shin, Chol,Park, Chan,Oh, Berm-Seok,Kimm, Ku-Chan 대한지역사회영양학회 2004 대한지역사회영양학회지 Vol.9 No.2

We carried out a validation-calibration study of the food frequency questionnaire (FFQ) that we had previously developed for a community-based cohort of the Korean Genome and Health Study of the Korea National Genome Research Institute. We have collected a total of 254 3-day diet records (DRs) from 400 subjects, 200 each randomly selected from the two study cohorts of Ansung and Ansan. FFQ was administered at the time of cohort recruitment in 2001, and DRs were collected during a two month period from January through February of 2002. The mean age was 52.2 years. Farming for men and housewife for women were the most common occupations. The majority of the subjects had undergone 6∼12 years of education. The general characteristics including demographic and other data were not different from the total cohort subjects. Absolute levels of consumed nutrients including total energy (energy), protein, fat, carbohydrate, calcium, phosphorus, sodium, potassium, iron, retinol, carotene, vitamin A, thiamin, riboflavin, niacin and vitamin C were compared. The average of energy intake was not significantly different between the data collected by the 2 methods. However, consumptions of protein and fat were higher in data of DRs, whereas that of carbohydrate was higher in FFQ data. Significant correlation of each nutrient consumption between the data sets was observed (p < 0.05) except in the case of iron, while the average correlation coefficient between them was 0.22 ranging from 0.33 for energy to 0.11 for iron. The results of cross classification by quantile for exact classification ranged from 25.2% (carotene) to 35.0% (phosphorus), and from 64.6% (vitamin A) to 76.4% (retinol) for adjacent classification. The proportion of completely opposite classification was 8.1% in average. Calibration slope was estimated by regression and calibration parameters ranged from 0.025 for carotene to 0.423 for niacin. We conclude that the FFQ we have developed is an appropriate tool for assessing the nutrient intakes as ranking exposures in epidemiology studies in view that amounts of consumed nutrients obtained by FFQ were similar to those collected by DRs, that correlations between consumed nutrients collected by these methods were significant, and that classification results were relatively fair. The correlation coefficients, however, were lower than expected, which may be mainly due to the survey season. In fact, any short-term dietary survey cannot accurately reflect the overall dietary intakes that change heavily depending on seasons. Further studies including the analysis of chemical indices would be helpful for the studies of causal relationship between the diet and disease.

지역사회 코호트 연구를 통한 한국인에서 무증상 갑상선 기능저하증의 유병률 분석

최훈성 ( Hoon Sung Choi ),박영주 ( Young Joo Park ),김현규 ( Hyun Kyu Kim ),최성희 ( Sung Hee Choi ),임수 ( Soo Lim ),박도준 ( Do Joon Park ),장학철 ( Hak Chul Jang ),조남한 ( Nam Han Cho ),조보연 ( Bo Youn Cho ) 대한갑상선학회 2010 International Journal of Thyroidology Vol.3 No.1

Background and Objectives: We examined the prevalence of subclinical hypothyroidism (SCH) in Korean population. Materials and Methods: Using data from two cohorts, Ansung cohort consist of adults between 40 and 70 years old and Korean Longitudinal Study on Health and Aging (KLoSHA) study consist of elderly subjects over 65 years old, we examined the prevalence of SCH and the association of age with SCH, free T4 and thyrotropin (TSH). Results: The prevalence of SCH was 11.7% in Ansung cohort and 17.3% in KoSHA study. The prevalence of SCH increased with advanced age in Ansung cohort, especially in the male subjects. In the male subjects of Ansung cohort, serum free T4 decreased and TSH increased with advanced age, whereas age was not associated with free T4 and TSH concentration in the female subjects. In KLoSHA study, age did not show significant association with prevalence of SCH and concentrations of free T4 and TSH. Antithyroidperoxidase (TPO) antibody was associated with SCH, however, it did not show significant association with advanced age in both cohorts. Conclusion: In Korean population, the prevalence of SCH was 11.7% in adults and 17.3% in elderly subjects. The prevalence of SCH increased with advanced age, however, it did not increase any more in elderly subjects.

IgA 신병증에서 혈청 면역글로불린 A 의 유용성

김명성(Myeong Sung Kim),신규태(Gyu Tae Shin),임현이(Hyun Ee Yim),김승정(Seung Jung Kim),신승수(Seung Soo Sheen),마경애(Kyoung Ai Ma),조남한(Nam Han Cho),최영일(Young Il Choi),김흥수(Heung Soo Kim),김도헌(Do Hun Kim) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1

배 경 : 면역글로불린 A (Immunoglobulin A, 이하 IgA) 신병증은 가장 흔한 사구체신염으로 알려져 있다. IgA 환자의 30- 50%에서 혈청 IgA 농도가 증가하지만 혈청 IgA 측정이 갖는 IgA 신병증 진단의 유용성에 대해서는 잘 밝혀져 있지 않다. 방 법 : 1994년 6월부터 1998년 12월까지 아주대학교병원에 내원하여 신조직 검사를 시행한 전체환자 333명 중 혈청 IgA 농도를 측정한 270명을 후향적으로 조사하였다. 결 과 : 혈청 IgA 농도의 정상치의 상한 값인 365 ㎎/dL를 초과하는 환자 수는 IgA 신병증 환자들에서는 80명 중에 32.5%인 26명이었으며, 나머지 환자들에서는 190명 중에 8.9%인 17명이 혈청 IgA치가 365 ㎎/dL를 초과하였다(p<0.001). 혈청 IgA 농도 증가에 따라 IgA 신병증 진단에 대한 민감도는 감소하며, 특이도는 증가하는 관계를 나타내었다. 혈청 IgA농도 1 ㎎/dL에 대해 IgA 신병증으로 진단 받을 위험도(Risk ratio)는 1.0025였다(p- value 0.0043). 또한 혈청 보체치가 저하되지 않은 환자만을 대상으로 하였을 경우 이러한 위험도는 1.0079로 더욱 상승하였다. 그러나 혈청 IgA 농도와 신조직 면역형광 소견과는 상관관계가 없는 것으로 나타났다. 결 론 : 혈청 IgA 농도 측정이 IgA 신병증 진단 추정에 유용함을 보여 주었고, 이러한 결과는 특히 신 조직 검사가 적합하지 않은 환자에서, 혈청 IgA 농도, 보체 등을 이용하여 IgA 신병증 진단을 추정하는데 임상적으로 도움을 줄 수 있다. Background : Immunoglogulin A (IgA) nephropathy is the most common primary glomerular disease throughout the world. 30-50% of patients with IgA nephropathy (IgAN) have high serum IgA concentrations. However, we do not know if the degree of elevation in IgA level increases the likelihood of having IgAN. Neither do we know if the IgA level has any association with pathological findings of IgAN. Methods : We analyzed the relationships between IgAN and the levels of serum IgA which has been a routine part of the study in all patients with glomerulonephritis in our institution for the last 4 years. We reviewed 270 patients in whom the pathological diagnosis and the results of their IgA levels were both available. Results : Of 80 patients who were IgA nephropathy, 26 patients (32.5%) had higher than normal cutoff value of serum IgA (385 ㎎/dL). In contrast, 8.9% of patients with other types of glomerulonephropathies showed the values above normal(p<0.0001). The risk ratio for an increase of one unit of the IgA level was 1.0025(logistic regression, p=0.0043), which was increased to 1.0079 when patients with low complement levels were excluded from the analysis. The data were also analyzed according to the immunofluorescence microscopic findings of IgAN, which were found to have no significant correlation with IgA concentrations. Conclusion : The IgA level is a risk factor for IgAN throughout the whole range. However, it does not correlate with the IgA deposition in the renal tissue. We believe that this study will help understanding the interpretation of IgA levels in patients with IgAN.

인슐린비의존형 당뇨병의 위험인자 분석을 위한 역학 연구

조남한 대한당뇨병학회 1996 Diabetes and Metabolism Journal Vol.20 No.1

당뇨병과 역학

조남한 대한당뇨병학회 1995 Diabetes and Metabolism Journal Vol.19 No.4

임신성 당뇨병이 태아에 미치는 영향

조남한 대한당뇨병학회 1999 Diabetes and Metabolism Journal Vol.23 No.4