Association of Z-Score of the Log-Transformed A Body Shape Index with Cardiovascular Disease in People Who Are Obese but Metabolically Healthy: The Korea National Health and Nutrition Examination Survey 2007–2010

정완교,박정환,류옥현,유재명,유형준,문신제 대한비만학회 2018 The Korean journal of obesity Vol.27 No.3

Background: We aimed at evaluating the effect of the z-score of the log-transformed A Body Shape Index (LBSIZ) on cardiovascular disease (CVD) outcomes according to obesity phenotype. Methods: Data were collected from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2010. Obesity was defined as a body mass index above 25 kg/m2 and metabolic abnormality was defined as the presence of two or more metabolic risk factors of the Adult Treatment Panel III definition. The participants were classified by obesity and metabolic healthy status: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). Each group was further classified into three groups based on the tertile of LBSIZ. A multivariate logistic regression analysis with adjustment for age, sex, smoking status, income, education level, physical activities, alcohol, and energy intake was conducted to evaluate the odds ratio (OR) for CVD events. Results: In the multivariate logistic regression model, MHO participants who are within the third tertile of LBSIZ had a significantly higher OR for CVD events, whereas those who are within the first and second tertile of LBSIZ were not at high risk of developing CVDs compared to MHNO participants who are within the first tertile of LBSIZ. In addition, a similar increase in the OR was observed in MUNO or MUO participants. Conclusion: LBSIZ had the lowest risk for CVDs in the first tertile of LBSIZ and a linear relationship with all its tertiles in MHO, MUNO, and MUO participants.

The Association between Z-Score of Log-Transformed A Body Shape Index and Cardiovascular Disease in Korea

정완교,박정환,정혜수,유재명,문신제,김동선 대한당뇨병학회 2019 Diabetes and Metabolism Journal Vol.43 No.5

Background: In order to overcome the limitations of body mass index (BMI) and waist circumference (WC), the z-score of thelog-transformed A Body Shape Index (LBSIZ) has recently been introduced. In this study, we analyzed the relationship betweenthe LBSIZ and cardiovascular disease (CVD) in a Korean representative sample. Methods: Data were collected from the Korea National Health and Nutrition Examination VI to V. The association between CVDand obesity indices was analyzed using a receiver operating characteristic curve. The cut-off value for the LBSIZ was estimated usingthe Youden index, and the odds ratio (OR) for CVD was determined via multivariate logistic regression analysis. ORs accordingto the LBSIZ value were analyzed using restricted cubic spline regression plots. Results: A total of 31,227 Korean healthy adults were analyzed. Area under the curve (AUC) of LBSIZ against CVD was 0.686(95% confidence interval [CI], 0.671 to 0.702), which was significantly higher than the AUC of BMI (0.583; 95% CI, 0.567 to0.599) or WC (0.646; 95% CI, 0.631 to 0.661) (P<0.001). Similar results were observed for stroke and coronary artery diseases. The cut-off value for the LBSIZ was 0.35 (sensitivity, 64.5%; specificity, 64%; OR, 1.29, 95% CI, 1.12 to 1.49). Under restricted cubicspline regression, LBSIZ demonstrated that OR started to increase past the median value. Conclusion: The findings of this study suggest that the LBSIZ might be more strongly associated with CVD risks compared toBMI or WC. These outcomes would be helpful for CVD risk assessment in clinical settings, especially the cut-off value of the LBSIZsuggested in this study.

장기요양서비스 수요의 결정요인

정완교 한국개발연구원 2009 KDI Journal of Economic Policy (KDI JEP) Vol.31 No.1

A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration. 본 논문은 65세 이상 고령인구의 수와 노인들의 건강상태 등만을 중심으로 한 기존의 연구에 더하여, 노인장기요양보험제도 제2차 시범사업의 자료를 이용한 계량분석을 통해 장기요양서비스 수요의 결정요인을 분석하였다. 분석 결과에 따르면, 우선 노인장기요양보험제도상 장기요양서비스 이용에 대한 보험 적용 대상자를 정하는 등급판정에 일상생활활동에서의 장애가 노인들이 많이 앓고 있는 고혈압, 관절염, 치매 등의 질환을 통제하고서도 통계적으로 유의한 영향을 미쳤다. 또한 노인들의 건강상태, 여성, 기초생활수급자 여부, 노인가구 형태, 노인가구의 월평균 소득 등이 장기요양서비스 이용 및 이용 양태에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 특히, 노인가구의 월평균 소득을 통제하고서도 장기요양서비스를 무료로 이용할 수 있는 기초생활수급 대상 노인들의 재가서비스 이용확률이 높게 나타나는데, 이는 소득과 더불어 장기요양서비스의 가격도 장기요양서비스 이용을 결정하는 중요한 요인임을 의미한다.

개별요소법을 이용한 불연속 암반내 지하공동의 변형 거동 해석

정완교,임한욱 강원대학교 산업기술연구소 2003 産業技術硏究 Vol.23 No.A

Numerical analysis is important for the design, construction and maintenance of large caverns. The rock mass contains generally discontinuities such as faults, joints and fissures The mechanical behavior and geometric Characteristics of these discontinuities would have a significant impact on the stability of the caverns. In this research the Distinct Element Method(DEM) was used to analyze the structural stability of the large cavern The Barton-Bandis Joint Model (B-B J.M) was used as a constitutive model for the joint In addition. two different cases . 1) analysis with a support system and 2) analysis with no support system, were analyzed to optimize a support system and to investigate reinforcing effects of a support system. The most significant parameters of in-situ stress, JRC of in-situ natural joints. and spatial distribution characteristics of discontinuities were acquired through field investigation. Displacement (horizontal. joint shear), maximum joint opening, maximum and minimum principal stresses, range of relaxed zone, rockbolt axial forces and shotcrete stresses were calculated at each excavation stage. As a result of analysis the calculated values proved to be under the allowable value Rockbolts also proved to be an efficient support measure to control joint shear displacement which had significant effects on extending the relaxed zone. As a consequence. the structural stability of the cavern was assured with an appropriate support system.

장기요양서비스 수요의 결정요인

정완교,Chung, Wankyo 한국개발연구원 2009 韓國 開發 硏究 Vol.31 No.1

본 논문은 65세 이상 고령인구의 수와 노인들의 건강상태 등만을 중심으로 한 기존의 연구에 더하여, 노인장기요양보험제도 제2차 시범사업의 자료를 이용한 계량분석을 통해 장기요양서비스 수요의 결정요인을 분석하였다. 분석 결과에 따르면, 우선 노인장기요양보험제도상 장기요양서비스 이용에 대한 보험 적용 대상자를 정하는 등급판정에 일상생활활동에서의 장애가 노인들이 많이 앓고 있는 고혈압, 관절염, 치매 등의 질환을 통제하고서도 통계적으로 유의한 영향을 미쳤다. 또한 노인들의 건강상태, 여성, 기초생활수급자 여부, 노인가구 형태, 노인가구의 월평균 소득 등이 장기요양서비스이용 및 이용 양태에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 특히, 노인가구의 월평균 소득을 통제하고서도 장기요양서비스를 무료로 이용할 수 있는 기초생활수급 대상 노인들의 재가서비스 이용확률이 높게 나타나는데, 이는 소득과 더불어 장기요양서비스의 가격도 장기요양서비스 이용을 결정하는 중요한 요인임을 의미한다. A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

Economic Resources and Child Health: An Assessment of Certain Mechanisms

정완교 한국개발연구원 2010 KDI Journal of Economic Policy (KDI JEP) Vol.32 No.1

We use data from the Indonesian Family Life Survey (IFLS) to examine the relationship between child health and household economic resources, and find that economic resources as measured by equivalized expenditure have a statistically significant positive effect on child health and protect children from acute health conditions. We make additional use of the data (where extensive data on children’s nutrition, household sanitation, the utilization of medical care, and family health status are available) to assess the mechanisms through which economic resources may affect child health. We find evidence that economic resources have a sizable and significant effect on these potential intermediary factors, and that they, particularly household sanitation, partly explain the protective role of economic resources in child health.

예방과 일반 의료서비스 이용간의 관계

정완교 ( Wan Kyo Chung ) 한국보건경제정책학회(구 한국보건경제학회) 2013 보건경제와 정책연구 Vol.19 No.1

우리나라 건강보험의 재정안정화 방안으로 예방과 예방적 의료서비스의 이용증대가 강조 되고 있다. 본 연구는 예방의 현황과 수요를 분석하고 예방과 일반 의료서비스의 이용간의 관계를 분석한다. 예방의 현황과 그 변화를 통계청 『사회조사』를 이용하여 살펴본 결과 1999년 이 후 음주하는 사람들의 비율은 증가하였지만, 흡연하는 사람들의 비율은 감소하였다. 규칙적으로 운동하는 사람들의 비율도 증가하였으며 정기건강검진을 받는 사람들의 비율도 2003년 이 후 크게 증가하였다. 또한 개인의 예방과 예방적 의료서비스의 수요를 『국민건강영양조사』를 통하여 살펴본 결과, 나이가 들수록 통계적으로 유의하게 건강검진, 암검진, 예방접종을 많이 받으며, 남성 고령층은 흡연을 줄이고 여성 고령층은 음주를 줄이는 경향을 보였다. 민간의료 보험은 여성의 경우 사전적 도덕적 해이로 인해 예방을 낮추기 보다는 건강검진과 암 검진 등 의 예방적 의료서비스를 증진시키는 결과를 보였다. 한편, 개인의 예방과 예방적 의료서비스의 수요는 연령, 학력, 소득, 보험, 경제활동상태 등뿐만 아니라 ‘건강에 대한 선호’ 혹은 ‘질병에 걸렸을 경우 의료비 지출에 따른 재정위험을 회피하려는 선호’ 등의 공통요인(common factor) 에 의해서도 영향을 받는데 이는 서로 다른 예방과 예방적 의료서비스 이용간의 상관관계를 통해 확인할 수 있었다. 또한, 예방과 예방적 의료서비스 이용간의 상관관계 행렬을 통계적 기 법인 요인분석(factor analysis)을 통하여 공통요인을 추정하고 추정된 공통요인이 외래서비스 의 이용과 약국 이용을 통계적으로 유의하게 높이나 입원 서비스의 이용에는 통계적으로 유의 한 영향이 없음을 발견하였다. Presently, there is a growing emphasis on prevention and preventive medical care as a financial stability measure for National Health Insurance. This paper studies the status of Korean prevention and preventive medical care, and estimates the determinants of them. Moreover, it examines the relationship between prevention and other medical care use. The results show that the proportion of alcohol drinkers has risen since 1999 while that of smokers has fallen. Simultaneously, the proportion of regular exercisers has risen and that of the people who undergo regular health check-up has significantly risen since 2003. In addition, the analysis on the demand for prevention and preventive medical care shows that as people grow older, they increasingly tend to undergo health check-up, cancer screening, and vaccinations. Also, the more they age, the less men smoke and women drink. It turns out also that the private medical insurance contributes to more use of preventive medical care for women, such as health check-up and cancer screening. In the meantime, people with less education and income undergo less health check-up and cancer screening This paper also estimates a common factor through factor analysis using correlation matrix between prevention and preventive medical care, and then examines the impact of the estimated common factor on the use of curative medical services. The results show that the common factor increases the use of outpatient service and pharmacy, but has no statistically significant effect on the use of inpatient service. Therefore, it is not desirable to blindly emphasize the use of prevention and preventive medical care to reduce medical expense. Only after measuring the cost and benefit of each prevention and preventive medical care service, the ones with more cost effectiveness should be introduced with priority.

소득격차와 건강 : 인도네시아 사례

정완교 ( Wan Kyo Chung ) 한국사회보장학회 2008 사회보장연구 Vol.24 No.2

Electro-Mechanical Brake 제어 시스템을 위한 BLDC 모터의 벡터 제어

정완교(Wankyo Jung),이형철(Hyeongcheol Lee),전재한(Jaehan Jun),여훈(Hoon Yeo) 한국자동차공학회 2007 한국자동차공학회 춘 추계 학술대회 논문집 Vol.- No.-

This paper describes the implementation of the vector control schemes for an Electro-Mechanical Brake(EMB) with RCP device. X-by-wire implementations can lower manufacturing costs by reducing packaging problems and assembly costs. It also can provide a advantage to reduce weight of vehicle. One of these technologies is brake-by-wire system that can replace conventional hydraulic brake system An Electro-Mechanical Brake(EMB) system that is one of brake-by-wire is controlled by Vector Control Algorithm to reduce torque ripple and to improve accuracy. This paper presents experimental results that applied Vector Control Algorithm to an EMB system.

저출산 추세하에서의 출생아 건강수준 고찰

정완교(Wankyo CHUNG),이윤경 고려대학교 미래성장연구원 2022 미래성장연구 Vol.8 No.1

우리나라의 출산 수준은 정부의 지속적인 노력에도 불구하고 빠른 속도로 감소하고 있다. 본 연구는 출산과 관련된 여러 요인들을 먼저 살펴보고, 출생아의 몸무게를 출생아 건강수준에 대한 대리변수로 활용하여 출생아 건강수준과 관련된 주요 요인들을 살펴보았다. 분석 결과, 우리나라의 출산아 수는 빠른 속도로 감소하고 있는데 둘째 이상의 출산에서 그 경향이 두드러지게 나타나 “둘째아 단념 현상”이 확인되었다. 저체중 출산의 위험을 높이는 요인으로는 혼인 외 출산, 출산순서, 산모의 교육수준, 산모의 연령이 유의하였다. 따라서 출산률을 높이기 위한 정책과 더불어 건강한 출생 환경 조성과 같이 출생아 건강수준을 높이기 위한 정책도 함께 고려하여야 한다.