흡연, 비만 및 대사증후군

이상엽 ( Sang Yeoup Lee ) 대한비만학회 2014 The Korean journal of obesity Vol.23 No.3

일상적인 이동 전화의 사용과 혈압, 체질량지수 및 혈색소와의 관련성

이상엽(Sang-Yeoup Lee),김윤진(Yun-Jin Kim) 한국항공우주의학협회 2000 항공우주의학회지 Vol.10 No.1

학생들이 강의에 집중하고 싶도록 만드는 팁

이상엽(Sang Yeoup Lee) 한국의학교육학회 2008 Korean journal of medical education Vol.20 No.3

종설 : 한국인의 복부비만 기준을 위한 허리둘레 분별점

이상엽 ( Sang Yeoup Lee ),박혜순 ( Hye Soon Park ),김선미 ( Sun Mee Kim ),권혁상 ( Hyuk Sang Kwon ),김대영 ( Dae Young Kim ),김대중 ( Dae Joong Kim ),조금주 ( Guem Joo Cho ),한지혜 ( Jee Hye Han ),김성래 ( Sung Rae Kim ),박철영 ( 대한비만학회 2006 The Korean journal of obesity Vol.15 No.1

연구배경: 최근 국제당뇨병연맹 (International Diabetes Federation, 이하 IDF)에서는 민족적 특성을 고려한 복부비만을 대사증후군의 필수 진단항목으로 설정하였다. 이에 비만학회에서는 한국인에서 복부비만 기준을 위한 허리둘레 분별점 설정 사업을 시행하였다. 방법: 체계적인 문헌 고찰 및 전문가 토론 과정을 거쳐 가장 적절한 도구로 분석 방법을 선정하였다. 분석자료로는 한국인을 대표할 수 있는 1998년도 국민건강영양조사 자료 (총 6,562명)를 이용하였으며, 분별점의 기준 지표로는 가장 최근에 제시된 IDF의 대사증후군 진단기준을 택하였다. Receiver Operating Characteristics (이하 ROC) curve를 통해 가장 적절한 분별점을 살펴보았으며, 교차비를 통해 대사 항목 2개 이상의 존재를 가장 잘 예측할 수 있는 수치를 구하였고, 얻어진 수치별로 복부비만의 유병률을 구하여 현재 국내의 실정에 가장 타당하다고 여겨지는 분별점을 정하였다. 결과: ROC 분석 결과, 높은 중성지방, 낮은 HDL-콜레스테롤, 높은 혈압, 높은 혈당 및 이러한 4가지 대사 이상을 예측하는 적정 허리둘레의 분별점은 대사 항목에 따라 남자에서는 82~84㎝, 여자에서는 79~82㎝의 범위를 보였다. 허리둘레 70㎝ 미만을 기준으로 교차비를 구한 결과, 허리둘레가 5㎝ 단위로 증가함에 따라 각각의 대사 항목 및 2개 이상 집합체의 교차비가 증가하는 경향을 나타내었다. 특히 대사 항목 2개 이상 집합체의 교차비가 5일 때의 허리둘레가 남자는 약 90㎝, 여자는 약 85㎝이었으며, 80백분위수에 해당하는 허리둘레는 남, 녀 각각 90.0㎝, 86.5㎝로 나타났다. 결론: 현재의 시점에서 사용 가능한 자료를 이용하여 분석, 고찰한 결과 한국인에서 복부비만의 기준을 위한 허리둘레 분별점은 남자에서 90㎝, 여자에서 85㎝로 나타났다. 따라서 남자에서 90㎝ 이상, 여자에서 85㎝ 이상일 때 복부비만으로 정의하는 것이 가장 적절할 것으로 보인다. Background: Recently, the International Diabetes Federation (IDF) consensus proposed a new definition for diagnosing metabolic syndrome. Ethnic-specific waist circumference (WC) cut-off points have been incorporated into the definition. Therefore, the study of the WC cut-off points for defining abdominal obesity in Koreans was performed by the Korean Society of the Study of Obesity. Methods: The data used for analysis was from the Korean National Health and Nutritional Examination Survey (KNHANES) performed in 1998 (involved 6562 participants), which is representative of nutritional health research in Korea. The 2005 International Diabetes Federation definition of the metabolic syndrome was applied. The reasonable cut-off points of WC for abdominal obesity in Koreans were set based on Receiver Operating Characteristics (ROC) curve, odds ratio and prevalence of abdominal obesity in the study population. Results: Using ROC analysis, the optimal WC to predict the risk factors of metabolic syndrome, such as high triglyceride levels, low levels of HDL-cholesterol, hypertension, and high glucose levels in Koreans, was 82~84㎝ for men, and 79~82㎝ for women. The odds ratio of having more than 2 metabolic abnormalities was about 5 in men with WC>90㎝ and in women with WC>80㎝. WC in the 80th percentile in the Korean population is 90㎝ and 86.5㎝ for men and women, respectively. Conclusions: The cut-off points of WC for abdominal obesity in Koreans are 90㎝ for men and 85㎝ for women, respectively. The cut-off points of waist circumference for defining abdominal obesity should be followed up by future additional studies and updated when new data becomes available.

가정의학과 임상실습학생들의 논문작성법 교육에 적용한 간이 조사 시행 경험

이상엽(Sang-Yeoup Lee),김영주(Young-Joo Kim),최상한(Sang-Han Choi),이해균(Hae-Gyun Lee),안성률(Seong-Yul Ahn),김윤진(Yun-Jin Kim) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.1

Purpose: This study was to report our experience of the brief survey for teaching journal writing by medical students in a clinical curriculum of family medicine. Methods: Brief surveys performed by medical students in clinical clerkship of department of family medicine from 1998 to 2000. Medical students determined theme without rein for brief surveys. Lecture about meaning and process of survey was given for sufficient understanding of students, and then surveys were conducted. The subjects of survey were outpatients, nursing person, medical students, nursing students, and other general persons. The subjects of theme were classified to 17 chapters 7 components by international classification of primary care (ICPC). Results: In analysis of brief surveys according to ICPC, the reasons for surveys by components were diagnostic, screening prevention (89.0%), treatment, procedures, medication (5.7%), symptoms, complaints (5.3%). By chapters, there were social (64.6%), psychological (12.6%), metabolic and endocrine (6.5%). Among social problems, there were other social problem (35.4%), health care system/access (20.9%), problem with education (13.9%), relation problems partner (12.7%). Majority of medical students had affirmative response for survey conduction. In conclusion, our finding suggest that teaching journal writing as brief survey seems to be useful in understanding of journal writing of medical students.

STOP-Bang 설문으로 평가한 폐쇄성수면무호흡증 고위험 노인의 성별, 연령 특성 및 임상 특성

김규리(Gyu Lee Kim),김윤진(Yun Jin Kim),이정규(Jeong Gyu Lee),이유현(Yu Hyeon Yi),탁영진(Young Jin Tak),이승훈(Seung Hun Lee),라영진(Young Jin Ra),이상엽(Sang Yeoup Lee),조영혜(Young Hye Cho),박은주(Eun Ju Park),이영인(Youngin Lee),최 대한임상노인의학회 2023 대한임상노인의학회지 Vol.24 No.2

Background: Obstructive sleep apnea (OSA) is considered to be associated with neurocognitive dysfunction, depression, quality of life and cardiovascular diseases. OSA is likely to have a significant impact on the health of older adults. This study was to identify characteristics of older adults with high risk for OSA according to age and gender. Methods: This study was conducted on adults aged 65 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey (KNHANES) 2020. Characteristics of the high-risk group for OSA were investigated using the STOP-Bang questionnaire of the KNHANES data and were compared according to gender and age. The health status, metabolic variables, concurrent disease of the high risk group were compared with the control group. Results: In older adults aged 65 or older, snoring rates significantly decreased as their ages increased in both sex. The high risk group had a higher rate for performing strength exercise than control group. Depression showed a higher rate in the high risk group, but there was no difference in stress and quality of life in the two groups. The waist circumference and the prevalence of hypertension, stroke, dyslipidemia, diabetes, and metabolic syndrome was higher in the high-risk OSA group. Conclusion: It is unclear whether OSA-related symptoms increase with age in older adults over 65 years of age. Waist circumference was higher in the OSA high risk group, and this study showed that the OSA high risk group may be more likely to have metabolic syndrome and cardiovascular disease.

의료정보이해능력(Health Literacy)

김성수(Sung-Soo Kim),김상현(Sang-Hyun Kim),이상엽(Sang-Yeoup Lee) 한국보건교육건강증진학회 2005 보건교육건강증진학회지 Vol.22 No.4

Corrigendum: Correction of Acknowledgments

박은주,이상엽,임선주,윤소정,감비성,백선용,김윤진,우재석,이정규,정동욱,조영혜,이유현,탁영진,Park, Eun Ju,Lee, Sang Yeoup,Im, Sun Ju,Yune, So Jung,Kam, Beesung,Baek, Sun Yong,Kim, Yun-Jin,Woo, Jae Seok,Lee, Jeong-Gyu,Jeong, Dong-Wook,Cho, Yo 연세대학교 의과대학 2017 의학교육논단 Vol.19 No.2

3학년 학생의 역량수준과 관련 요소

감비성,이상엽,임선주,Kam, Beesung,Lee, Sang Yeoup,Im, Sun Ju 연세대학교 의과대학 2013 의학교육논단 Vol.15 No.2

The purpose of this study was to assess third-year medical students' competency for development or revision of the undergraduate curriculum and assessments. One hundred and twenty-seven third-year medical students at the Pusan National University were included in the study. After third- and fourth-year students took a common written examination, clinical performance examination (CPX), and objective structured clinical examination (OSCE) with common items as a summative assessment, the third-year students' competency was compared with 132 forth-year students' results. The correlation of the written examination and CPX/OSCE was analysed, and the summative results were compared with the grade point average (GPA) through the second year, CPX/ OSCE in the second year, and GPA in the clerkship. On the written examination, the third-year students' mean score was lower than the fourth-year students' by over 11 points, whereas the gap in the CPX/OSCE was 4 points and there was no difference in the OSCE. There was a moderate correlation between the written examination and the CPX/OSCE scores (R=0.371, p<0.01). The written examination was highly correlated with GPA through the second year, which mainly evaluated medical knowledge (R=0.771, p<0.01). A relatively high correlation was observed between CPX/OSCE scores and GPA in the clerkship (R=0.641, p<0.01). The summative CPX/ OSCE scores showed a moderate correlation with formative CPX/OSCE scores in the second year (R=0.464, p< 0.01). The third-year students' score was quite low on the written examination and slightly low on the CPX/OSCE compared to that of the fourth-year students. The written examination and CPX/OSCE cannot replace each other and should be combined with other methods of evaluation to measure competency. Early OSCE and workplacebased assessment should be useful in the early assessment of clinical skills competency.

식사시간에 따른 Ghrelin과 PYY3-36 농도 변화

최상한 ( Sang Han Choi ),이상엽 ( Sang Yeoup Lee ),김형회 ( Hyoung Hoi Kim ),전태용 ( Tae Yong Jeon ),김현준 ( Hyun Jun Kim ) 대한비만학회 2007 The Korean journal of obesity Vol.16 No.1

연구배경: 그렐린과 펩티드 YYJ3-36은 에너지 항상성과 연관된 위장관 호르몬이다. 저자 등은 식후 그렐린과 펩티드 YY3-36의 시간별 변화를 동시에 조사하였다. 방법: 연구를 시작하기 2주 전부터 아침식사시간을 엄격히 고정한 9명의 건강한 자원자를 대상으로 하였다. 채혈은 식전 1시간부터 11시 30분까지 매 시간 실시되었다. 혈장 그렐란, 펩티드 YY3-36, 렙틴 및 인슐린을 방사선면 역법으로 측정하였다. 결과: 혈장 그렐린 농도는 식전에는 588.0±204.4 pg/mL이었고 식후 1시간째는 394.22±145.25 pg/mL으로 감소하였다. 반면에 펩티드 YY3-36는 식전에는 29.9±13.7 pmol/L이었고 식후 1시간째에는 44.2±12.1 pmol/L로 증가하였다. 렙틴은 식전에는7.4±2.7 ng/mL이었고, 식후 1시간째에는 7.1±2.9ng/mL이었다. 반면에 인슐린은 식전에는 129.8±50.0 pmol/mL이었고, 식후 1시간째에는 658.8±332.3 pmol/L로 증가하였다. 혈장 그렐린은 식후 1시간째 최저 농도이었고, 펩티드 YY3-36는 식후 1시간째 최고 농도이었다. 결론 혈장 그렐린은 식후 1시간째 최저인 반면에 펩티드 YY3-36는 식후 l시간째 최고 농도이었다. 이는 혈장 그렐린과 펩티드 YY3-36가 식사에 띠라 같은 속도로 반대방향으로 반응한다는 것을 시사하는 소견이다. Background: Ghrelin and Peptide YY3-36 are gastrointestinal hormones related energy homeostasis. We investigated the changes in post-meal plasma ghrelin and PYY3-36 levels in people after meal, simultaneously. Methods: Nine healthy volunteers adhered to strict meal rimes starting two weeks before the study. Blood was drawn hourly for 4 hours. Plasma ghrelin, PYY3-36, leptin, and insulin levels were measured by radioimmunoassay. (RIA). Results: The mean plasma ghrelin level in subjects consuming the meal was 588.0±204.4 pg/mL just before breakfast and 394.22±145.25 pg/mL 1 h after meal, with the mean plasma PYY3-36 levels of 29.9±13.7 pmol/L and 44.2±12.1 pmol/L, respectively. The mean plasma leptin level in subjects consuming the meal was 7.4±2.7 ng/mL before the meal and 7.1±2.9 ng/mL 1 h after meal, with insulin levels of 129.8±50.0 pmol/L and 658.8±332.3 pmol/L, respectively. Plasma ghrelin levels were lowest 1 h after the meal. although PYY 3-36 levels were highest 1 h after the meal. Conclusion: While plasma ghrelin levels were lowest 1 h, PYY 3-36 levels were highest 1 h after the meal. These findings suggest that Plasma ghrelin and peptide YY3-36 levels change in opposite ways at the same speed.