Relationship between Decreased Estimated Glomerular Filtration Rate and Sarcopenic Obesity among Postmenopausal Women: Korea National Health and Nutrition Examination Survey (2008–2011)

홍창빈,백재용,이지원,이지훈,Kayoung Lee,Tae-jin Park,김진승 대한가정의학회 2020 Korean Journal of Family Medicine Vol.41 No.5

Background: Previous studies have shown that body composition is associated with chronic kidney disease (CKD), and perimenopause is associated with increased fat mass and decreased lean body mass. Muscle wasting is common among patients with CKD. Sarcopenic obesity (SO) refers to excess adiposity with decreased muscle mass. However, little is known about the relationship between SO and renal function decline. Here, we identified the relationship between SO and decreased estimated glomerular filtration rate (eGFR) in postmenopausal women. Methods: We conducted a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Survey (2008–2011). We analyzed 4,560 postmenopausal women who underwent dual energy X-ray absorptiometry. Sarcopenia was defined based on weight-adjusted appendicular skeletal muscle mass. Obesity was defined based on body mass index. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were classified into four groups: normal, obese, sarcopenic, and sarcopenic obese. Logistic regression analysis was performed to examine the association between SO and decreased eGFR. The results were adjusted for variable confounders. Results: In the unadjusted model, the odds ratio (OR) of decreased eGFR for SO was 1.67 (95% confidence interval [CI], 1.23–2.26). The obese and sarcopenic groups had ORs of 0.67 (95% CI, 0.44–1.03) and 0.70 (95% CI, 0.44–1.10), respectively. After controlling for confounding variables, there was also a significant association between SO and decreased eGFR (adjusted OR, 1.48; 95% Cl, 1.05–2.07). Conclusion: SO was independently associated with decreased eGFR in postmenopausal Korean women.

두경부 암의 고식적 방사선치료

홍창빈,김원택 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

금연을 목적으로 전자담배 사용하는 청소년에 영향을 미치는 요인: 제13차(2017년) 청소년건강행태 온라인 조사

백재용,홍창빈,이지원,이지훈,박태진,김진승,이가영 대한임상건강증진학회 2019 Korean Journal of Health Promotion Vol.19 No.2

Background: This study used the data of Korea Youth Risk Behavior Web-based Survey (KYRBS) to confirm the relationship between electronic cigarette use for smoking cessation among Korean adolescents and demographic, health behavior, and school-life factors. Methods: Data were taken from the 13th KYRBS in 2017. In this study on 62,276 adolescents, characteristics of 1,244 electronic cigarette users were compared with those of non-electronic cigarette users. The 1,244 adolescent electronic cigarette users were evaluated for characteristics related to smoking cessation. Among the related characteristics, demographic factors comprised sex, grade, economic status, weekly allowance, and residence type. Health status-related factors comprised physical activity, lifetime drinking experience, smoking amount, subjective health perception, and stress perception. School characteristics included school type, academic performance, and smoking cessation education. Chi-square test and logistic regression analysis were performed using complex sample analysis. Results: The proportion of current electronic cigarette users was 2.2% (boys, 3.3%; girls, 0.9%). Of the 41.5% of cigarette users willing to quit smoking, 11% used electronic cigarettes for this purpose. Among the electronic cigarette users, characteristics related to smoking cessation were grade, weekly allowance, and residence type, but logistic regression analysis revealed that increases in grade (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.21-3.35) and living with family (OR, 4.17; 95% CI, 1.89-9.18) were associated with smoking cessation. Conclusions: According to the 13th KYRBS in 2017, adolescents were likely to use electronic cigarette for smoking cessation when they are older and live with their families. 연구배경: 흡연의 초기 단계에 있는 청소년들의 전자담배이용에 관한 행태 조사는 중요하다. 본 연구는 청소년건강행태 온라인 조사 자료를 활용하여, 전자담배를 금연 목적으로 사용하는 청소년과 관련된 인구사회학적 요인과 건강행태 요인, 학교특성 요인들과의 연관성을 확인하는 데에그 목적이 있다. 방법: 제13차 청소년건강행태 온라인 조사를 이용하여62,276명의 청소년에서 현재 전자담배 사용자인 1,244명과현재 전자담배를 사용하지 않는 청소년들 간에 특성 비교및 1,244명의 현재 전자담배를 사용하는 청소년들에서 금연목적 사용 유무와 관련된 특성을 분석하였다. 결과: 현재 전자담배 사용자 중 금연 목적 사용과 관련된특성은 ‘학년’, ‘일주일용돈’, ‘거주형태’였으며, 로지스틱회귀분석에서 학년 증가(오즈비, 2.01; 95% 신뢰구간, 1.21-3.35), 가족과 함께 거주하는 경우(오즈비, 4.17; 95% 신뢰구간, 1.89-9.18)에 금연 목적으로 전자담배 사용과 관련성을 보였다. 결론: 2017년 제13차 청소년건강행태 온라인 조사 자료를통하여 현재 전자담배를 사용하는 청소년 중에서 고학년일수록, 가족과 함께 거주할 때 금연을 목적으로 전자담배를사용함을 알 수 있었다.

만성 질환과 적극적 환자 참여의 연관성

김양근,김혜원,박재용,홍창빈,이가영,박태진,김진승 대한임상건강증진학회 2017 Korean Journal of Health Promotion Vol.17 No.3

Background:Active patient participation in health care decision-making can results in better medical outcomes. This study's purpose is to investigate the association between the patient participation and the diseases often encountered in primary care. Methods:We used the data from the Korean National Health and Nutrition Examination Survey conducted in 2015 which included 4,158 adults aged older than 19 and who had no missing data. The association between the presence of disease or the number of accompanying diseases and the active patient participation in the treatment decision was studied. Logistic regression analysis was conducted using complex sampling design in each sex. Results:After adjusting for confounding variables, the relationship between active patient participation and the diagnosis of hypertension, odds ratio (OR) was 1.95 (95% confidence interval [CI], 1.25-3.04) for men and 1.83 (95% CI, 1.27-2.65) for women. In women diagnosed with diabetes, OR was 0.58 (95% CI, 0.35-0.97). Between active patient participation and increasing number of accompanying diseases have positive tendency but not statistically significant. Conclusions:This study suggests that active patient participation is related to the diagnosis of hypertension, and the number of accompanying diseases and active patient participation were not significantly associated. This is a rare study related to the active patient participation in the Korean population, that it may be helpful in establishing further relevant research and strategies to increase the patient participation rate 연구배경: 치료 결정 과정에서 적극적인 환자 참여는 더나은 진료 성과를 나타낼 수 있다. 이에 적극적 환자 참여 경험과 일차진료에서 흔히 접할 수 있는 질환과의 연관성을 살펴보고자 한다. 방법:2015년도에 시행된 국민건강영양조사 자료를 사용하였으며, 변수 자료에 결측치가 없는 19세 이상 성인4,158명을 대상으로 하였다. 질병의 유무 또는 동반된 질환의 개수에 따른 치료 결정시 적극적 환자 참여와의 연관성을 연구하였다. 성별에 따른 복합표본분석을 감안하여 로지스틱회귀분석을 실시하였다. 결과: 교란변수를 보정한 후, 고혈압 진단을 받은 경우에적극적 치료 참여와의 연관성에서 대조군에 비해 남성은OR 1.95 (95% CI, 1.25-3.04), 여성은 OR 1.83 (95% CI, 1.27-2.65)으로 나타났다. 당뇨병을 진단받은 여성에서는OR 0.58 (95% CI, 0.35-0.97)로 나타났다. 동반된 질환의개수 증가와 적극적 환자 참여는 양의 경향성을 보였으나통계적으로 유의하지는 않았다. 결론: 본 연구를 통해서 고혈압을 진단받은 경우에서 적극적인 환자 참여와의 연관성이 있는 것을 알 수 있었으며, 동반된 질환의 개수와 치료 참여는 유의한 연관성이 없었다. 국내 인구를 대상으로 시행한 적극적 환자 참여 요인과관련된 드문 연구로써, 치료 참여율을 높이기 위한 관련 연구 및 전략 수립에 도움이 될 것으로 보인다

한국 청소년의 흡연과 자살관련행동과의 관계: 제12차(2016년) 청소년건강행태온라인조사

김혜원,김양근,백재용,홍창빈,이가영,박태진,김진승 대한임상건강증진학회 2017 Korean Journal of Health Promotion Vol.17 No.4

Background:Suicide is the first leading cause of death among teenagers in Korea, and smoking is reported to be one of the risk factors for suicide. The purpose of this study is to investigate the relationship between smoking and smoking amount and suicidal behavior using data from the Korea Youth Risk Behavior Web-based Survey (KYRBS). Methods:Using the 12th KYRBS 2016, we surveyed smoking, smoking amount, suicidal ideation, suicidal planning, and suicidal attempt of adolescents. And a total of 65,528 respondents were divided into current smoker, former smokers, and non-smoker, and 4,012 smokers were classified into ≤9 cigarettes/day group, 10-19 cigarettes/day group, and ≥20 cigarettes/day group according to the amount of smokers. We analyzed the relationship between smoking and smoking amount and suicidal ideation, suicidal planning, and suicidal attempt using multivariate logistic regression analysis. Results:As a result of adjusting for all confounding variables, the current smoker has an odds ratio of 1.143 (confidence interval 1.020-1.281) with suicidal ideation compared to non-smoker and the odds ratio of suicidal planning and suicidal attempt is also statistically significant, respectively. And the odds ratio of all suicidal behaviors was significantly higher in ≥20 cigarettes/day group than in ≤9 cigarettes/day group, respectively. Conclusions:We found that smoking and smoking amount was related to suicidal ideation, suicidal planning, and suicidal attempts in adolescents. Therefore, suicidal prevention strategies considering this relationship should be established. 연구배경: 자살은 우리나라 10대 인구 사망원인 중 1위로알려져 있으며, 흡연은 청소년 자살의 위험요인 중 하나로보고되고 있다. 본 연구는 청소년건강행태온라인조사를 이용하여 흡연 및 흡연량과 자살 관련 행동과의 연관성을 알아보고자 한다. 방법:2016년 제12차 청소년건강행태온라인조사를 이용하여, 청소년의 흡연 여부 및 흡연량과 자살생각, 자살계획, 자살시도 여부를 알아보았다. 조사 참여자인 65,528명을 대상으로 현재 흡연자, 과거 흡연자, 비흡연자로 나누고, 현재 흡연자 4,012명을 흡연량에 따라 9개비 이하군, 10-19개비군, 20개비 이상군으로 분류하였고, 자살생각, 자살계획, 자살시도와의 연관성을 다변량 로지스틱회귀분석을 사용하여 알아보았다. 결과: 모든 혼란변수들을 통제하여 분석한 결과, 현재 흡연자는 비흡연자, 과거 흡연자에 비해 자살생각과의 교차비가 1.143 (CI 1.020-1.281)으로 나타났으며, 자살계획, 자살시도의 교차비도 통계적으로 유의하게 높게 나타났다. 또한 9개비 이하군보다 20개비 이상군에서 자살 관련 행동의 교차비는 모두 각각 유의하게 높게 나타났다. 결론: 본 연구를 통해 청소년의 흡연과 흡연량은 자살생각, 자살계획, 자살시도에 영향을 주는 요인임을 알 수 있었고, 이 결과를 고려한 자살 예방 전략 수립이 필요할 것이다.