국민건강영양조사를 이용한 한국인 관절염의 유병률 현황과 연도별 변화

허남욱 ( Nam Wook Hur ),최찬범 ( Chan Bum Choi ),엄완식 ( Wan Sik Uhm ),배상철 ( Sang Cheol Bae ) 대한류마티스학회 2008 대한류마티스학회지 Vol.15 No.1

Objective: To estimate the prevalence of musculoskeletal diseases, especially osteoarthritis, rheumatoid arthritis, osteoporosis and lumbar disc herniation, in Korean adults. For arthritis and total musculoskeletal diseases, trend of the age-standardized prevalence rates were evaluated. Methods: This study was based on the data obtained from the Korea National Health and Nutrition Examination Surveys (KNHANES) I, II and III, conducted in 1998, 2001 and 2005, respectively. KNHANES is a nationwide cross-sectional study using a stratified, multistage probability sampling design for the selection of household units. Annual self-reported prevalence and its confidence interval were estimated in adults aged over 19, using Health Interview Survey in KNHANES. All analyses were done using SAS 9.1 with survey procedure except for age-standardized prevalence rates for comparison prevalence rates of each survey. Age-standardized prevalence rates were calculated using a direct-method. Results: The prevalence of musculoskeletal diseases was 144.6, 140.0 and 197.2 and the annual self-reported prevalence of arthritis was 117.9, 109.2 and 146.4 per 1,000 population in 1998, 2001 and 2005, respectively. In KNHANES III, osteoarthritis was the most prevalent disease of the musculoskeletal diseases for both sex. Fifty-eight percent of the over 65 year-old population had at least one musculoskeletal disease and it was higher in women with 73%. Conclusion: The prevalence of musculoskeletal diseases was high in Koreans with arthritis being the most prevalent. The prevalence of musculoskeletal disease correlated with low sociodemographic status.

유방암 조기진단을 위한 검진주기 결정에 대한 연구

정성화,강대룡,허남욱,김진흠,이순영,정상혁,남정모,Jeong, Seong-Hwa,Kang, Dae-Ryong,Hur, Nam-Wook,Kim, Jin-Heum,Lee, Soon-Young,Jung, Sang-Hyuk,Nam, Chung-Mo 대한예방의학회 2006 예방의학회지 Vol.39 No.4

Objectives: The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. Methods: The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. Results: For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. Conclusions: The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.

젊은 성인에서 교정 QT간격과 심혈관질환 위험요인의 관련성: 강화연구

안성복,김현창,허남욱,하경수,장후선,김진배,서일,Ahn, Song-Vogue,Kim, Hyeon-Chang,Hur, Nam-Wook,Ha, Kyoung-Soo,Jang, Hoo-Sun,Kim, Jin-Bae,Suh, Il 대한예방의학회 2006 예방의학회지 Vol.39 No.6

Objectives : Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people, The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. Methods : This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. Results : The mean QTc interval was significantly longer in women $(419{\pm}17ms)$ than in men $(405{\pm}17ms)$ (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. Conclusions : In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.

청소년기 비만지표와 초기 성인기 경동맥 내중막 두께와의 관련성: Kangwha Study

이유정,남정모,김현창,허남욱,서일,Lee, Yoo-Jung,Nam, Chung-Mo,Kim, Hyeon-Chang,Hur, Nam-Wook,Suh, Il 대한예방의학회 2008 예방의학회지 Vol.41 No.2

Objectives : The aim of this study is to investigate the association between obesity indices(body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. Methods : This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescence") and 25 years-old in 2005 (defined as "early adulthood"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. Results : In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. Conclusions : This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.

노인의 일상생활수행능력(ADL/IADL) 결정요인에 관한 연구: 도시와 농촌 비교를 중심으로

이상붕(Sang-Boong Lee),허남욱(Nam-Wook Hur) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.4

본 연구의 목적은 도시와 농촌에 거주하는 노인을 대상으로 일상생활수행능력에 영향을 주는 사회인구학적 요인의 차별성과 영향력을 비교 분석하는 것이다. 연구자료는 패널 자료인 「한국인의 사회적 삶, 건강과 노화에 대한 조사」이며, 분석 대상은 도시 노인 400명(서울시 K구: 2017년 4월부터 2017년 6월까지 조사), 농촌 노인 524명(경기도 B면: 2015년 12월부터 2016년 2월까지 조사)이다. 연구방법은 기술 통계 분석, 교차 분석을 통한 카이제곱검정, 상관 분석, 로짓 분석을 실시한다. 연구결과를 요약하면 다음과 같다. 첫째, ADL/IADL의 ‘완전 자립’의 비율은 ‘ADL(도시) > ADL(농촌) > IADL(도시) > IADL(농촌)’의 모습을 보인다. 둘째, 농촌에 거주하는 노인이 도시 노인에 비교하여 낮은 ADL 수준을 경험할 확률은 7.1배, 낮은 IADL 수준을 경험할 확률은 3.25배 높다. 마지막으로, 도시 노인의 ADL 수준에 영향을 통계적 유의미한 변수는 우울감이고, IADL 수준은 성별, 연령, 경제활동유무, 배우자 유무, 우울감이다. 농촌 노인의 ADL 수준은 연령과 경제활동유무가 통계적으로 유의미한 변수이며, IADL 수준은 성별, 연령, 경제활동유무이다. This study examined the differentiation and influence of socio-demographic factors that affect the daily living ability of the elderly living in urban and rural areas. The research data is 「Korean Social Life, Health and Aging Project」. The analysis target was 400 urban elderly people (K-gu, Seoul: surveyed Apr. ~ Jun. 2017) and 524 rural elderly people (B-myeon, Gyeonggi-do: surveyed Dec. 2015 ~ Feb. 2016). The research methods included descriptive statistical analysis, chi-square test through cross-analysis, correlation analysis, and logit analysis. The summary of the research results is as follows. First, the ratio of ‘complete independence’ in ADL/IADL was ‘ADL(city)> ADL(rural)> IADL(city)> IADL(rural)’. Second, the probability that the elderly living in rural areas will experience a lower ADL level and lower IADL level was 7.1 times and 3.25 times higher than that of the urban elderly. Lastly, the statistically significant variable affecting the ADL level of urban elderly was depression, and the IADL level was gender, age, economic activity, spouse presence, and depression. Age and economic activity were statistically significant variables for the ADL level of the rural elderly, and the IADL level was gender, age, and economic activity.

청소년 고혈압 관련 유전자의 연관성 분석: Kangwha Study

서일,남정모,김성주,신동직,허남욱,강대룡,Suh, Il,Nam, Chung-Mo,Kim, Sung-Joo,Shin, Dong-Jik,Hur, Nam-Wook,Kang, Dae-Ryong 대한예방의학회 2006 예방의학회지 Vol.39 No.2

Objectives : In this study we examined the association between the genetic markers ACE (A-240T, C-93T, I/D, A2350G), AGT (M235T), AT1R (A1166C), CYP11B2 (T344C, V386A), REN (G2646A), ADRB2 (G46A, C79G, T47C, T1641), GNB3 (C825T) and ADD1 (G460W) and the presence of essential hypertension in adolescents. Methods : The Kangwha Study is an 18-year prospective study that is aimed at elucidating the determinants of the blood pressure level from childhood to early adulthood. For this study, we constructed a case-control dataset of size of 277 and 40 family trios data from the Kangwha Study. For this purpose, we perform a single locus-based case-control association study and a single locus-based TDT (transmission/disequilibrium test) study. Results : In the case-control study, the single locus-based association study indicated that the ADD1 (G460W) (p=0.0403), AGT (M235T) (p=0.0002), and REN (G2646A) (p=0.0101) markers were significantly associated with the risk of hypertension. These results were not confirmed on the TDT study. This study showed that genetic polymorphisms of the ADD1, AGT and REN genes might be related to the hypertension in Korean adolescents. Conclusions : This study provided useful information on genetics markers related to blood pressure. Further study will be needed to confirm the effect of the alpha adducin gene, the angiotensinogen gene and the renin gene on essential hypertension.

체질량지수와 유방암발생의 관련성

임선미 ( Sun Mi Lim ),허남욱 ( Nam Wook Hur ),김현창 ( Hyun Chang Kim ),강대용 ( Dae Ryong Kang ),서일 ( Il Suh ) 한국보건정보통계학회 (구 한국보건통계학회) 2011 보건정보통계학회지 Vol.36 No.1

Objectives: This study investigated the association between body mass index (BMI) (and its change) and risk of breast cancer in Korea women by age. Methods: Participants were 64,149 women aged 35~59 years at the baseline (1990~1992) of the Korea Medical Insurance Corporation study. They were stratified as 44,923 women aged 37~47 years and 19,226 women aged 48~61 years by age at year 1992. BMI change was defined as BMI at 1994 minus baseline BMI. Baseline BMI was categorized quartile and first quartile used as reference group for the analysis. BMI change was categorized quartile and second quartile used as reference group for the analysis. Hazard ratio (HR) calculated using Cox`s proportional hazard model. Results: Baseline BMI and breast cancer risk were not associated in women aged < 48 (HR = 0.83, p for trend = 0.182 for Q4 vs Q1), but associated in women aged ≥ 48 (HR = 2.08, p for trend = 0.002 for Q4 vs Q1). However, BMI change was not associated with breast cancer risk in either age group. Conclusions: These results suggest that obesity may be a risk factor breast cancer in premenopausal women but not in post menopausal women.

수학적 모델을 이용한 신종인플루엔자 환자 예측 및 대응 전략 평가

서민아,이지현,지혜진,김영근,강대용,허남욱,하경화,이동한,김창수,Suh, Min-A,Lee, Jee-Hyun,Chi, Hye-Jin,Kim, Young-Keun,Kang, Dae-Yong,Hur, Nam-Wook,Ha, Kyung-Hwa,Lee, Dong-Han,Kim, Chang-Soo 대한예방의학회 2010 예방의학회지 Vol.43 No.2

Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.