신체활동수준이 암 발생과 사망에 미치는 영향

목예진,김희진,남정모,지선하 대한보건협회 2013 대한보건협회 보건종합학술대회 Vol.2013 No.-

연구배경 규칙적인 신체활동은 심혈관질환의 발생과 사망 또는 전체사망을 감소시킨다고 알려져 있다. 또한 규칙적인 신체활동은 암 발생과 암으로 인한 사망에 예방적인 효과가 있다고 알려져 있다. 하지만 이러한 연구들은 대부분 서양인을 대상으로 한 연구이고 아시아인에 대한 대규모 코호트 연구는 미흡한 실정이다. 그러므로 이 연구는 대규모의 한국인을 대상으로 자기기입식 설문을 통해 얻어진 신체활동량이 암 발생, 암으로 인한 사망, 암을 제외한 사망, 그리고 전체사망에 미치는 영향을 알아보고자 하였다. 대상 및 방법 연구대상은 1994년부터 2003년까지 최소 한 번 이상 세브란스 건강증진센터에 내원한 자를 대상으로 하였다. 1994년에서 2003년까지 내원한 30세 이상 성인 남녀 중에서 암을 진단받은 자와 신체 계측치, 혈액검사 결과, 흡연력, 음주력 등의 문진에서 결측이 있는 자를 제외하여 총 65,320명을 연구대상자로 선정하였다. 신체활동수준 별로 대상자들의 특성을 비교하기 위하여 신체활동을 전혀 하지 않는 자와 신체활동을 하는 자로 분류하였고 신체활동을 하는 자 중에서 MET-min/week로 나타낸 신체활동량을 4분위수로 나누어 총 5개의 군으로 분류하여 분석하였다. 또한 신체활동 수준이 암 발생 및 사망에 미치는 영향을 알아보기 위하여 콕스비례위험모형(Cox proportional hazard model)을 사용하여 분석하였다. 연구결과 신체활동을 전혀 하지 않는 군과 비교하였을 때, 신체활동을 하는 군 남성에서는 암발생, 암으로 인한 사망, 암을 제외한 사망, 전체사망의 위험이 남자에게서 통계적으로 유의하게 감소하였다. 여자에서는 암을 제외한 사망과 전체사망의 위험만 통계적으로 유의하게 감소하였다. MET-min/week로 나타낸 신체활동량을 4분위수로 나눈 후, 신체활동을 전혀 하지 않는 군과 비교하였을 때, 신체활동 수준이 증가할수록 남녀 모두 암을 제외한 사망과 전체사망의 위험이 감소하였다. 연구시작시점으로부터 3년 이내에 암 발생 또는 사망했을 경우를 제외한 후에도 결과에는 차이가 없었다. 결론 신체활동을 전혀 하지 않은 군과 비교하였을 때, 신체활동을 하는 군이 암 발생, 암으로 인한 사망, 암을 제외한 사망, 전체사망의 위험이 낮았고, 신체활동의 수준이 증가할 수록 암을 제외한 사망과 전체사망의 위험이 줄어들었다.

직장 내 휘트니스 센터 이용횟수와 심혈관질환 위험요인의 변화

목예진 ( Ye Jin Mok ),윤지은 ( Ji Eun Yun ),옥창원 ( Chang Won Ok ),김정호 ( Joung Ho Kim ),김관호 ( Gwan Ho Kim ),김정화 ( Jeong Wha Kim ),지선하 ( Sun Ha Jee ) 한국보건정보통계학회 (구 한국보건통계학회) 2011 보건정보통계학회지 Vol.36 No.2

Objectives: It has been proven that doing exercise regularly is effective in lowering the risk of cardiovascular disease. The purpose of this study is to evaluate the relationship between physical activity and the cardiovascular risk factors. Methods: The study samples were 404 men and women who went to Yonsei Fitness Center from May of 2009 to April of 2010. We tried to assess the relationship between physical activity and cardiovascular risk factors. We used paired t-test and multiple regression, Results: The result showed that the significant relationship between the mean value of body weight and the frequency of gym visit in men (mean of 75.9±8.3 in 2009 vs. 74.1±8.6 in 2010 (p=0.0067). Men who used 90 times in gym showed a significantly lower risk (GOT: p=-7.76978, p=0.0 629 GPT: 13=-12.45055, p=0.0003 GGT: p=-9.94185, p=0.0 194) of liver function vs. those who used 1-29 times. Women who used 60 times in gym showed a significantly lower risk (total cholesterol: 13=-28.265l3, p=0.0066; LDL cholesterol: 13=-23.69l64, p=0.0071) of lipid profile vs. those who used 1-29 times. Conclusions: Increased physical activity influences in lowering body weight, lipid profile and improving liver function. We need to conduct follow up research about physical activity program in the work place.

The J-curve between Diastolic Blood Pressure and Risk of All-cause and Cardiovascular Death

김희진,목예진,이선주,이선미,백정환,지선하 대한심장학회 2018 Korean Circulation Journal Vol.48 No.1

Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cas Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg. es). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cas Background and Objectives The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. Methods We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. Results A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg. es). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. Conclusion A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg

Association between Idiopathic Pulmonary Fibrosis and Coronary Artery Disease: a Case-control Study and Cohort Analysis

김원영,목예진,백수진,윤영덕,지선하,김동순 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

Background: Although the increased risk of coronary artery disease (CAD) in the patients with idiopathic pulmonary fibrosis (IPF) has been reported, there was no detailed information on the risk factors for CAD in IPF. The aim of this study was to investigate the prevalence of CAD in IPF with analysis of other risk factors. Methods: The subjects were 460 patients (mean age at diagnosis, 65 years; 79% male; 74% current or ex-smoker) diagnosed as IPF at Asan Medical Center and 1,925 controls matched with age, sex, smoking habits, and date of IPF diagnosis obtained from Korea Heart Study. Cardiovascular risk factors and prevalence of CAD in both groups were compared and the incidence of newly developed CAD during follow-up was also analyzed. Results: The IPF group was more diabetic, and the control group had a higher proportion of hypertension and hypercholesterolemia. The prevalence of CAD in IPF group (7.2%) was two times higher than that of control group (3.4%). Multivariate analysis revealed that age (OR, 1.04; 95% CI, 1.01-1.07), hypertension (OR, 1.94; 95% CI, 1.23-3.05), hypercholesterolemia (OR, 5.11; 95% CI, 3.15-8.29), and IPF (OR, 3.94; 95% CI, 2.44-6.37) were significant risk factors for CAD. During the follow-up period (median: 2.5 years for IPF and 4.4 years for controls), the incidence of newly diagnosed CAD was higher in the patients with IPF (4%) compared to controls (2.7%) (RR, 3.08; 95% CI, 1.70-5.58). Conclusions: IPF itself seems to be an independent risk factor for CAD after the adjustment of age, hypertension, diabetes and hypercholesterolemia.

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

Serum Adiponectin and Type 2 Diabetes: A 6-Year Follow-Up Cohort Study

지선하,안철우,박종숙,박창규,김현숙,이상학,박성하,이명숙,이창범,박혜순,김희진,최성희,성지동,오승준,정효지,김성래,윤호정,김선미,이홍수,목예진,최은미,윤영덕,백수진,주재성,허갑범 대한당뇨병학회 2013 Diabetes and Metabolism Journal Vol.37 No.4

Background: Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women. Methods: A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used. Results: Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders. Conclusion: A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.

한강 상수원 미세플라스틱 분포와 항생제 내성 유전자의 상관관계 연구

조홍목(Hongmok Jo),박선구(Sun Ku Park),이효영(Hyoyoung Lee),최예진(Yejin Choi),조시경(Si-Kyung Cho) 대한환경공학회 2022 대한환경공학회 학술발표논문집 Vol.2022 No.11

한강 상수원 미세플라스틱 분포와 항생제 내성 유전자의 상관관계 연구

조홍목 ( Hongmok Jo ),박선구 ( Sun Ku Park ),이효영 ( Hyoyoung Lee ),최예진 ( Yejin Choi ),조시경 ( Si-kyung Cho ) 한국물환경학회 2023 공동춘계 학술발표회 논문집 Vol.2023 No.0

NaOCl 처리에 따른 하수처리장 방류수 미세플라스틱 바이오필름 내 항생제 내성 유전자 제거율 조사

박영미,조홍목,김민상,한의정,박선구,이효영,최예진,조시경 환경독성보건학회 2022 한국독성학회 심포지움 및 학술발표회 Vol.2022 No.5