한국 성인 남녀에서 헬리코박터 파이로리감염과 대사증후군과의 관련성

정태흠,김문찬,최정헌,김창섭 대한가정의학회 2010 Korean Journal of Family Medicine Vol.31 No.2

Background: Metabolic syndrome is a cluster of metabolic abnormalities leading diabetes and cardiovascular diseases. Helicobacter pylori (H. pylori) infection is suggested to be a risk factor of cardiovascular diseases. We aimed to investigate the association between H. pylori infection and metabolic syndrome. Methods: This study was designed with Korean adults having a health check-up in a university hospital in Ulsan from March 2008 to February 2009. The subjects were 17,448 over 20 years old. The analysis was undertaken according to sex separately. The association of H. pylori seropositivity (IgG) with metabolic syndrome components was investigated by multiple linear regression analysis. The association of H. pylori seropositivity with metabolic syndrome was investigated by multiple logistic regression analysis. Results: H. pylori seropositivity was significantly inversely associated with high density lipoprotein cholesterol in men (Coefficient, -0.02; 95% confidence interval [CI], -0.03 to -0.004; P = 0.01). However, H. pylori seropositivity was not significantly associated with metabolic syndrome in both men and women (OR, 1.01; 95% CI, 0.90 to 1.14; P = 0.81 for men; OR, 0.75; 95% CI, 0.55 to 1.02; P = 0.06 for women). Conclusion: H. pylori infection was significantly negatively associated with high density lipoprotein cholesterol in men, but not significantly associated with metabolic syndrome in both men and women. 연구배경: 대사증후군은 심혈관질환과 당뇨병의 위험성을 증가시키는 대사이상의 조합이며 헬리코박터 감염이 대사증후군의 발생과 관련될 가능성이 있어서 이를 규명하기 위해 연구를 시행하였다. 방법: 2008년 3월부터 2009년 2월 사이에 울산광역시의 한 대학병원의 건강증진센터에서 건강검진을 받은 성인 17,448명의 검진결과를 분석하였다. 대상자들을 남녀로 나누어 헬리코박터 파이로리 IgG항체 유무를 독립변수로 하고 대사증후군의 구성요소들을 각각 종속변수로 하여 선형 회귀분석을 이용하여 분석하였고 대사증후군유무를 종속변수로 하여 로지스틱 회귀분석을 이용하여 분석하였다. 결과: 남자에서 헬리코박터 감염이 있을 때 고밀도 지단백콜레스테롤이 유의하게 감소되었으나(회귀계수, -0.02; 95% 신뢰구간, -0.03--0.004; P=0.01) 헬리코박터 감염과 대사증후군유무 사이에는 남녀모두에서 유의한 관련성이 없었다(남 교차비, 1.01; 95% 신뢰구간, 0.90-1.14; P=0.81; 여 교차비, 0.75; 95% 신뢰구간, 0.55-1.02; P=0.06). 결론: 헬리코박터 파이로리 감염은 남자에서 고밀도 지단백콜레스테롤의 감소와 유의한 관련성이 있었으나 대사증후군의 존재와는 남녀모두에서 유의한 관련성이 없었다.

대구지역 일부 인문계 고교생들의 흡연에 관련된 요인

정태흠,박성민,배무경,이근미,정승필,백승호 대한가정의학회 1998 Korean Journal of Family Medicine Vol.19 No.1

Real Asymptomatic SARS-CoV-2 Infection Might be Rare: the Importance of Careful Interviews and Follow-up

정태흠,Pak Chuiyong,Ock Minsu,Lee Seock-Hwan,Son Joung Sik,Jeon Young-Jee 대한의학회 2020 Journal of Korean medical science Vol.35 No.37

Background: There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms. Methods: We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement. Results: Forty patients were included (median age, 30 years; interquartile range [IQR], 25–57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse- transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4–6 days), and the duration of viral shedding was 21 days (IQR, 14–28 days; maximum, 51 days). Conclusion: The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.

지역사회 폐경 초기 여성에서 골밀도에 미치는 호르몬대체요법의 효과와 관련 요인

정태흠,사공준,김문찬,김창섭,김창윤 대한가정의학회 2004 Korean Journal of Family Medicine Vol.25 No.3

Background: Hormone replacement therapy (HRT) has been used as a effective therapeutic strategy of postmenopausal osteoporosis. However, the studies on HRT are insufficient, particularly in early postmenopausal women in Korea. This study was designed as a community based clinical trial and was conducted for 1 year. Methods: One hundred and forty early postmenopausal women aged 49 to 54 years who resided in Ulsan in Korea were enrolled in this study. The osteoporosis prone life style and general characteristics of the participants and their measured BMD were investigated. The therapy groups included 45 women who were assigned to one of the following regimens in 28 day cycles for 1 year: (1) conjugate equine estrogen (CEE), 0.625 mg/d daily, medroxyprogesterone acetate (MPA) 2.5 mg/d daily and calcium 500 mg/d daily (2) CEE 0.625 mg/d daily, MPA 10 mg/d for days 1 through 12 and calcium 500 mg/d daily. Results: The women in the therapy groups had an average gain of 5.4%, 4.2%, 2.1%, 4.9% in BMD in the lumbar spine, femur total, femur neck and ward’s area, respectively. HRT has significantly influenced the BMD after controlling age, month since menopause, alcohol intake, smoking, calcium intake, exercise, body mass index and baseline BMD. The baseline BMD and the BMI were factors that influenced the effect of HRT in BMD. Conclusion: HRT had positively influenced the BMD in Korean women. The baseline BMD and the BMI were predictors of the effect of HRT in BMD change. 연구배경: 폐경 여성들에 있어서 골다공증은 난소기능의 소실로 인한 에스트로겐의 부족이 주 원인으로 이를 보충하는 호르몬대체요법은 골다공증을 예방하고 치료하는 데 있어서 도움이 되는 것으로 알려져 있다. 호르몬대체요법이 골밀도에 미치는 효과와 특히 골소실이 급격한 초기 폐경기 여성들에 대한 국내의 연구는 부족한 실정이다. 이에 저자는 지역사회 주민을 대상으로 호르몬대체요법을 시행하고 그 효과를 평가하고 호르몬대체요법의 효과에 미치는 요인을 규명하기 위하여 연구를 시작하였다. 방법: 1개 광역시에 거주하고 있는 49세부터 54세까지의 폐경기 여성 140명을 대상으로 치료군 45명에게는 1년간 호르몬대체요법을 시행하였고 비치료군 95명은 추적 관찰만 하고 1년 전후의 골밀도의 변화를 분석하였다. 골밀도는 이중에너지 X-선 흡수 계측법(Dual energy X-ray Absorptiometry; DXA)을 이용하였다. 요추골은 L1- L4를 측정하여 평균치를 이용하였고 대퇴골은 전체, 경부, 워즈지역을 측정하였다. 결과: 치료군에서는 요추골, 대퇴골 전체, 대퇴골 경부, 워즈지역의 골밀도가 1년 전과 비교해 각각 5.4%, 4.2%, 2.1%, 4.9%로 유의하게 증가하였다. 비치료군에서는 요추골과 대퇴골 경부에서 -1.37%, -1.0%로 1년 전과 비교해 유의하게 감소하였다. 다변량분석에서 호르몬대체요법은 다른 모든 변수를 통제한 후에도 요추골과 대퇴골 경부의 골밀도를 유의하게 증가시켰다. 치료군에서 호르몬대체요법의 효과에 유의하게 영향을 미치는 요인은 기저 골밀도치와 체질량지수였고 기저골밀도치가 낮을수록 골밀도는 많이 증가하였고 체질량지수가 낮을수록 많이 증가하였다. 비치료군에서는 1년간의 시간경과만이 골밀도의 변화에 영향을 주었다. 결론: 지역사회의 폐경 여성에 있어서 호르몬대체요법은 요추골과 대퇴골 경부의 골밀도를 유의하게 증가시켰고 호르몬대체요법의 효과는 골밀도치가 낮고 체질량지수가 낮은 여성에서 크게 나타났다.

울산지역 성인에서의 C형간염 바이러스 PCR 양성률과 위험요인

정태흠,전태희 대한가정의학회 1998 Korean Journal of Family Medicine Vol.19 No.4

지하주차장 근무자의 혈중 연 및 Zine Protoporphyrin 농도

정태흠,전만중,황태윤,김창윤,정종학 영남대학교 기초/임상의학연구소 1998 Yeungnam University Journal of Medicine Vol.15 No.2

Effect of Weight Changes on the Development of Erosive Esophagitis

정태흠,이지호,정인두,이근철 대한가정의학회 2020 Korean Journal of Family Medicine Vol.41 No.1

Background: Gastroesophageal reflux disease is highly prevalent among overweight and obese individuals. This study aimed to investigate the effect of weight change on the development of erosive esophagitis (EE). Methods: A retrospective review of medical records from a university hospital in South Korea identified 7,123 subjects who underwent routine health checkups in 2012 and 2014. We excluded participants with EE in 2012. Body mass index (BMI) changes were classified as loss, stable, mild gain, or moderate gain. Results: Mild and moderate weight gain increased the odds of EE development (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06–1.84 and OR, 2.80; 95% CI, 1.87–4.21, respectively) relative to weight stability. Weight loss decreased the odds of EE development (OR, 0.58; 95% CI, 0.38–0.90) relative to weight stability. After stratifying subjects into three groups by baseline BMI, those with mild and moderate weight gain in the obese group and moderate gain in the overweight group showed increased odds of EE development relative to members of those groups whose weights remained stable (OR, 2.08; 95% CI, 1.29–3.36; OR, 3.92; 95% CI, 1.99–7.73 in obese group, and OR, 3.30; 95% CI, 1.64–6.64 in overweight group, respectively). In comparison, weight loss in the normal weight group decreased the odds of EE development relative to weight stability (OR, 0.38; 95% CI, 0.15–0.97). Conclusion: Weight gain was positively associated with EE development in overweight or obese individuals. Weight loss was negatively associated with EE development in normal-weight individuals.

한국남자에서 결혼상태와 대사증후군과의 관련성

정태흠,김문찬,최정헌,김창섭 대한가정의학회 2010 Korean Journal of Family Medicine Vol.31 No.3

Background: We aimed to investigate the association between marital status and metabolic syndrome, and observed how their lifestyle may influence within their relationship. Methods: We analyzed the data from 12,288 Korean men over 20 years old taking a health checkup in a university hospital in Ulsan from March 2008 to February 2009. The subjects were classified as married, unmarried, separated, widowed,and divorced. The odds ratios for metabolic syndrome in each marital status were calculated after adjusting for age,educational level, and family income. In only married men and divorced men, odds ratios were calculated again after adjusting for alcohol intake, smoking, or exercise added to age, educational level, and family income. Results: After adjustment for age, educational level, and family income, the odds ratio for metabolic syndrome in divorced men was 1.48 (95% confidence internal [CI], 1.03 to 2.12; P = 0.03) compared to married men. However, the odds ratios in divorced men decreased to 1.47 (95% CI, 0.97 to 2.24; P = 0.07) after adjusting for alcohol intake added to age, educational level, and family income, 1.42 (95% CI, 0.99 to 2.04; P = 0.06) after adjusting for smoking added, 1.35 (95% CI, 0.93 to 1.96; P = 0.12) after adjusting for exercise added, and 1.37 (95% CI, 0.89 to 2.12; P = 0.15) after adjusting for alcohol intake,smoking, and exercise added. Conclusion: Divorced men were likely to have metabolic syndrome compared to married men and this finding may be mediated by their bad lifestyle. 연구배경: 높은 이혼율을 보이고 있는 우리나라에서 결혼상태와 대사증후군과의 관련성을 조사하고 여기에 생활습관의차이가 어떻게 관여하는가를 알아보기 위하여 연구를 시행하였다. 방법: 2008년 3월부터 2009년 2월 사이에 울산광역시의 한 대학병원의 건강증진센터에서 건강검진을 받은 20세 이상 남자12,288명의 건강검진 자료를 분석하였다. 대상자를 결혼군, 미혼군, 별거군, 사별군, 이혼군으로 나누고 결혼군에 대한 나머지 결혼상태의 대사증후군에 대한 교차비를 구하였고 결혼한남자와 이혼한 남자 만을 대상으로 음주횟수, 흡연, 운동횟수를 추가로 보정한 후 다시 교차비를 구하였다. 결과: 나이, 교육수준, 가구수입을 보정한 상태에서 이혼군의결혼군에 대한 대사증후군의 교차비가 1.48 (95% 신뢰구간,1.03-2.12; P=0.03)로 통계적으로 유의하였다. 이혼상태이거나 결혼상태인 남자들 만을 대상으로 한 경우에 대사증후군의 교차비는 음주횟수를 추가로 보정했을 때 1.47 (95% 신뢰구간, 0.97-2.24; P=0.07), 흡연을 추가로 보정했을 때 1.42 (95%신뢰구간, 0.99-2.04; P=0.06), 운동횟수를 추가로 보정했을때 1.35 (95% 신뢰구간, 0.93-1.96; P=0.12), 음주횟수, 흡연, 운동횟수를 모두 추가로 보정했을 때 1.37 (95% 신뢰구간, 0.89-2.12; P=0.15)로 낮아져 모두 통계적인 의의가 소실되었다. 결론: 인구사회학적 인자만을 보정하였을 때 이혼한 남자의대사증후군에 대한 위험도가 유의하게 높았으나 생활습관을추가로 보정하였을 때에는 이혼여부와 대사증후군의 관련성에 있어서의 유의성이 소실되었다. 이는 이혼한 남자의 나쁜생활습관이 이혼여부와 대사증후군의 관련성을 매개할 가능성을 시사한다.

폐경기여성에서 시청각 교육이 호르몬대체요법의 시행과 골다공증관련 생활습관의 변화에 미치는 효과

정태흠,전태희,김문찬,김영일,전대준,양승오,함수연,고병균,김성률 大韓家庭醫學會 2000 Korean Journal of Family Medicine Vol.21 No.11

남성근로자에서 8년 동안의 체중변화가 대사증후군의 발생에 미치는 영향

정태흠(Tae-Heum Chung),김문찬(Moon-Chan Kim),이지호(Ji-Ho Lee),최정헌(Chung-Hun Choi),김창섭(Chang-Sup Kim) 대한직업환경의학회 2010 대한직업환경의학회지 Vol.22 No.1