Journal of Preventive Medicine and Public Health

Original Articles

Association Between Cadmium Exposure and Liver Function in Adults in the United States: A Cross-sectional Study: Dongui Hong, Jin-Young Min, Kyoung-Bok Min; J Prev Med Public Health. 2021;54(6):471-480. Published online November 30, 2021; DOI: https://doi.org/10.3961/jpmph.21.435

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Abstract Summary PDF Supplementary Material

Objectives
Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population.
Methods
In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index.
Results
The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively.
Conclusions
Chronic exposure to cadmium showed positive associations with liver damage.

Summary

Korean summary
카드뮴은 사회 전반에서 널리 쓰이고 있어 직업적인 노출은 물론 환경적인 노출이 빈번히 일어나고 있다. 본 연구는 미국 국민건강영양조사 데이터를 이용하였으며 소변 내 카드뮴의 증가는 알라닌 아미노전이효소 (ALT), 아스파테이트 아미노전이효소 (AST), 감마 글루타밀전이효소 (GGT), 총 빌리루빈, 알칼리 인산분해효소 (ALP)의 상승과 관련이 있었다. 따라서 만성적인 카드뮴 노출은 간 손상과 연관이 있다고 할 수 있다.

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Cadmium-associated protein changes in residents of contaminated areas: Abandoned mine and smelter
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Toxicity Tolerance in the Carcinogenesis of Environmental Cadmium
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International Journal of Molecular Sciences.2024; 25(3): 1851. CrossRef
Cross-talk between Vimentin and autophagy regulates blood-testis barrier disruption induced by cadmium
Na Chen, Xiaoyan Wan, Mei Wang, Yamin Li, Xiaofei Wang, Ling Zeng, Jinzhao Zhou, Yanwei Zhang, Shun Cheng, Yi Shen
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Xingxi Luo, Liling Wei, Shun Liu, Kaili Wu, Dongping Huang, Suyang Xiao, Erna Guo, Lei Lei, Xiaoqiang Qiu, Xiaoyun Zeng
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Wenjie Li, Xinyan Li, Jing Su, Han Chen, Ping Zhao, Haisheng Qian, Xin Gao, Qiang Ye, Guoxin Zhang, Xuan Li
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MCU Upregulation Overactivates Mitophagy by Promoting VDAC1 Dimerization and Ubiquitination in the Hepatotoxicity of Cadmium
Cong Liu, Hui‐Juan Li, Wei‐Xia Duan, Yu Duan, Qin Yu, Tian Zhang, Ya‐Pei Sun, Yuan‐Yuan Li, Yong‐Sheng Liu, Shang‐Cheng Xu
Advanced Science.2023;[Epub] CrossRef
Effects of Environmental Cadmium Exposure on the Liver in Korean Adults: Cross-Sectional and Longitudinal Studies
Mi-Na Seo, Sang-Yong Eom, Ji-Ae Lim, Jung-Eum Lee, Byung-Sun Choi, Ho-Jang Kwon, Young-Seoub Hong, Heon Kim, Jung-Duck Park
Archives of Environmental Contamination and Toxicology.2023; 84(2): 237. CrossRef
Estimation of health risks associated with dietary cadmium exposure
Soisungwan Satarug, David A. Vesey, Glenda C. Gobe, Kenneth R. Phelps
Archives of Toxicology.2023; 97(2): 329. CrossRef
Sex, Nutrition, and NAFLD: Relevance of Environmental Pollution
Arianna Dolce, Sara Della Torre
Nutrients.2023; 15(10): 2335. CrossRef
ROS‐mediated PERK‐CHOP pathway plays an important role in cadmium‐induced HepG2 cells apoptosis
Cao Zhaohui, Tang Cifei, Huang Di, Zeng Weijia, Han Cairui, Li Zecong, Hu Xiaobo
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Zhi Chen, Qinyue Lu, Jiacheng Wang, Xiang Cao, Kun Wang, Yuhao Wang, Yanni Wu, Zhangping Yang
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Soisungwan Satarug, David A. Vesey, Glenda C. Gobe
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Association Between Low Muscle Mass and Non-alcoholic Fatty Liver Disease Diagnosed Using Ultrasonography, Magnetic Resonance Imaging Derived Proton Density Fat Fraction, and Comprehensive NAFLD Score in Korea: Hun Ju Lee, Jae Seung Chang, Jhii Hyun Ahn, Moon Young Kim, Kyu-Sang Park, Yeon-Soon Ahn, Sang Baek Koh; J Prev Med Public Health. 2021;54(6):412-421. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.387

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Abstract Summary PDF Supplementary Material

Objectives
Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF).
Methods
This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations.
Results
According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD.
Conclusions
Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.

Summary

Korean summary
비알콜성 간질환은 대사질환 중 하나로 적은 근육양과의 연관성이 지속적으로 제시되었으나, 기존 연구들에서 일관되지 않은 결과를 보여주었다. KoGES-ARIRANG 코호트의 320명을 대상으로 초음파·MRI-PDFF·CNS 진단기준을 사용하여 단면연구를 수행한 결과, 세 진단기준에서 모두 적은 근육량과 비알콜성 간질환 사이에 연관성이 나타났다.

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COVID-19: Perspective

Unconventional Answers to Unprecedented Challenges: The Swedish Experience During the COVID-19 Outbreak: Giuseppe Valeriani, Iris Sarajlic Vukovic, Richard Mollica; J Prev Med Public Health. 2020;53(4):233-235. Published online July 22, 2020; DOI: https://doi.org/10.3961/jpmph.20.235

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Abstract PDF

Since its early stages, the coronavirus disease 2019 (COVID-19) pandemic has posed immense challenges in meeting the public health and healthcare and social care needs of migrants. In line with other reports from United Kingdom and United States, data from Sweden’s health authority show that migrants have been disproportionately affected by COVID-19. Following the World Health Organization’s statements, as well as the European Public Health Association’s call for action, several centres in Sweden’s most populated areas have activated tools to implement national plans for community outreach through initiatives targeting migrants and ethnic minority groups. Unconventional means should be promoted to mitigate the impact of COVID-19 on migrants and the health of the public at large.

Summary

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Kevin Morisod, Marie-Anne Durand, Kevin Selby, Marie-Annick Le Pogam, Véronique S. Grazioli, Javier Sanchis Zozaya, Patrick Bodenmann, Christian von Plessen
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Prevalence of SARS-CoV-2 infection and associated risk factors among asylum seekers living in asylum centres: A cross-sectional serologic study in Canton of Vaud, Switzerland
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Original Articles

Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea: Jisun Sung, Seungho Ryu, Yun-Mi Song, Hae-Kwan Cheong; J Prev Med Public Health. 2020;53(5):342-352. Published online July 17, 2020; DOI: https://doi.org/10.3961/jpmph.20.089

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Abstract PDF

Objectives
The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease.
Methods
This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient’s age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors.
Results
Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant.
Conclusions
NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

Summary

Citations

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Association between body fat and bone mineral density in Korean adults: a cohort study
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Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease
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Oxana M. Drapkina, Anastasia Yu. Elkina, Anna F. Sheptulina, Anton R. Kiselev
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Hepatic fibrosis is associated with an increased rate of decline in bone mineral density in men with nonalcoholic fatty liver disease
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Comparison of Computed Tomography-based Abdominal Adiposity Indexes as Predictors of Non-alcoholic Fatty Liver Disease Among Middle-aged Korean Men and Women: Jongmin Baek, Sun Jae Jung, Jee-Seon Shim, Yong Woo Jeon, Eunsun Seo, Hyeon Chang Kim; J Prev Med Public Health. 2020;53(4):256-265. Published online June 18, 2020; DOI: https://doi.org/10.3961/jpmph.20.140

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Abstract PDF Supplementary Material

Objectives
We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women.
Methods
The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC.
Results
VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women.
Conclusions
Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.

Summary

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Correlation between CT Abdominal Anthropometric Measurements and Liver Density in Individuals with Non-Alcoholic Fatty Liver Disease
Dragoș Constantin Cucoranu, Marian Pop, Raluca Niculescu, Vlad Vunvulea, Irina-Bianca Kosovski, Radu-Ovidiu Togănel, Eliza Russu, Adrian Vasile Mureșan, Răzvan-Andrei Licu, Anca Bacârea
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Impact of Regional Cardiocerebrovascular Centers on Myocardial Infarction Patients in Korea: A Fixed-effects Model: Sang Guen Cho, Youngsoo Kim, Youngeun Choi, Wankyo Chung; J Prev Med Public Health. 2019;52(1):21-29. Published online November 28, 2018; DOI: https://doi.org/10.3961/jpmph.18.154

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Abstract Summary PDF Supplementary Material

Objectives
The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality.
Methods
We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes.
Results
We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality.
Conclusions
The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

Summary

Korean summary
권역심뇌혈관질환센터 설립 사업은 지역별로 심뇌혈관센터를 지정/육성하여, 심뇌혈관질환 발생시 3시간 이내 진료체계를 구축함으로써 급성심근경색과 뇌졸중의 급성기 응급상황에 대한 대응을 강화하고자 시행되었다. 본 연구는 권역심뇌혈관질환센터 설립 정책으로 인해 시술 건수와 30일 내 사망 등과 같은 치료 성과가 지역 수준에서 향상되었는지 살펴보기 위해 건강보험 청구자료로 지역 수준 패널자료를 구축하여 권역심뇌혈관질환센터 설립의 효과를 추정하였다. 분석 결과, 시계열적 효과와 관련 변수를 통제하였을 때 권역심뇌혈관질환센터 설립 이후 설립 지역에서 여성의 치료 사례 수가 통계적으로 유의하게 증가하였고, 사망률은 유의미한 변화가 관찰되지 않았다. 따라서 권역심뇌혈관질환센터 설립은 대비성 향상과 치료 사례 수 증가를 통해 추가적인 치료를 받은 급성심근경색 환자의 잠재적인 원외 사망을 방지하는 효과가 있는 것으로 판단된다.

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The Effect of Geographic Units of Analysis on Measuring Geographic Variation in Medical Services Utilization: Agnus M. Kim, Jong Heon Park, Sungchan Kang, Kyosang Hwang, Taesik Lee, Yoon Kim; J Prev Med Public Health. 2016;49(4):230-239. Published online July 14, 2016; DOI: https://doi.org/10.3961/jpmph.16.034

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Abstract PDF Supplementary Material

Objectives
We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea.
Methods
To compare geographic variation in geographic units of analysis, we calculated the age–sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units.
Results
Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures.
Conclusions
Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.

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Perspective

Implementation of Quaternary Prevention in the Korean Healthcare System: Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea: Jong-Myon Bae; J Prev Med Public Health. 2015;48(6):271-273. Published online November 24, 2015; DOI: https://doi.org/10.3961/jpmph.15.059

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Abstract PDF

Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.

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Contribuições técnicas e socioculturais da prevenção quaternária para a atenção primária à saúde
Fernanda Beatriz Melo Maciel, Hebert Luan Pereira Campos dos Santos, Nilia Maria de Brito Lima Prado
Revista Brasileira de Medicina de Família e Comunidade.2020; 15(42): 2571. CrossRef
The Author Reply: A Comment on “Quaternary Prevention in Public Health”
Jong-Myon Bae
Journal of Preventive Medicine and Public Health.2016; 49(2): 141. CrossRef
A Comment on “Quaternary Prevention in Public Health” by Dr. Jong-Myon Bae
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Original Articles

Physical Activity- and Alcohol-dependent Association Between Air Pollution Exposure and Elevated Liver Enzyme Levels: An Elderly Panel Study: Kyoung-Nam Kim, Hyemi Lee, Jin Hee Kim, Kweon Jung, Youn-Hee Lim, Yun-Chul Hong; J Prev Med Public Health. 2015;48(3):151-169. Published online May 15, 2015; DOI: https://doi.org/10.3961/jpmph.15.014

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Abstract PDF Supplementary Material

Objectives
The deleterious effects of air pollution on various health outcomes have been demonstrated. However, few studies have examined the effects of air pollution on liver enzyme levels.
Methods
Blood samples were drawn up to three times between 2008 and 2010 from 545 elderly individuals who regularly visited a community welfare center in Seoul, Korea. Data regarding ambient air pollutants (particulate matter ≤2.5 μm [PM_2.5], nitrogen dioxide [NO₂], ozone [O₃], carbon monoxide, and sulfur dioxide) from monitoring stations were used to estimate air pollution exposure. The effects of the air pollutants on the concentrations of three liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and γ-glutamyltranspeptidase [γ-GTP)]) were evaluated using generalized additive and linear mixed models.
Results
Interquartile range increases in the concentrations of the pollutants showed significant associations of PM_2.5 with AST (3.0% increase, p=0.0052), ALT (3.2% increase, p=0.0313), and γ-GTP (5.0% increase, p=0.0051) levels; NO₂ with AST (3.5% increase, p=0.0060) and ALT (3.8% increase, p=0.0179) levels; and O₃ with γ-GTP (5.3% increase, p=0.0324) levels. Significant modification of these effects by exercise and alcohol consumption was found (p for interaction <0.05). The effects of air pollutants were greater in non-exercisers and heavy drinkers.
Conclusions
Short-term exposure to air pollutants such as PM_2.5, NO₂, and O₃ is associated with increased liver enzyme levels in the elderly. These adverse effects can be reduced by exercising regularly and abstinence from alcohol.

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Has Income-related Inequity in Health Care Utilization and Expenditures Been Improved? Evidence From the Korean National Health and Nutrition Examination Survey of 2005 and 2010: Eunkyoung Kim, Soonman Kwon, Ke Xu; J Prev Med Public Health. 2013;46(5):237-248. Published online September 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.5.237

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Abstract PDF

Objectives

The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea.

Methods

We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners.

Results

The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010.

Conclusions

We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

Summary

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Special Articles

A Strategy Toward Reconstructing the Healthcare System of a Unified Korea: Yo Han Lee, Seok-Jun Yoon, Seok Hyang Kim, Hyun-Woung Shin, Jin Yong Lee, Beomsoo Kim, Young Ae Kim, Jangho Yoon, Young Seok Shin; J Prev Med Public Health. 2013;46(3):134-138. Published online May 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.3.134

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Abstract PDF

This road map aims to establish a stable and integrated healthcare system for the Korean Peninsula by improving health conditions and building a foundation for healthcare in North Korea through a series of effective healthcare programs. With a basic time frame extending from the present in stages towards unification, the roadmap is composed of four successive phases. The first and second phases, each expected to last five years, respectively, focus on disease treatment and nutritional treatment. These phases would thereby safeguard the health of the most vulnerable populations in North Korea, while fulfilling the basic health needs of other groups by modernizing existing medical facilities. Based on the gains of the first two phases, the third phase, for ten years, would prepare for unification of the Koreas by promoting the health of all the North Korean people and improving basic infrastructural elements such as health workforce capacity and medical institutions. The fourth phase, assuming that unification will take place, provides fundamental principles and directions for establishing an integrated healthcare system across the Korean Peninsula. We are hoping to increase the consistency of the program and overcome several existing concerns of the current program with this roadmap.

Summary

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Public Health Challenges of Electronic Cigarettes in South Korea: Sungkyu Lee, Heejin Kimm, Ji Eun Yun, Sun Ha Jee; J Prev Med Public Health. 2011;44(6):235-241. Published online November 14, 2011; DOI: https://doi.org/10.3961/jpmph.2011.44.6.235

44,752 View
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Abstract PDF

Electronic cigarettes (e-cigarrettes) were recently introduced and advertised as a smoking cession device in South Korea. As the social norm to quit smoking has gained hold in the country, the number of e-cigarette users is growing rapidly. This phenomenon should be urgently considered, because of the lack of research that has been conducted to examine the safety of e-cigarettes and its efficacy as a smoking cessation aid.

This paper raises several public health concerns on e-cigarettes in South Korea. Uncertain regulations of the government on e-cigarettes are contributing to an increase of e-cigarette users and allowing the e-cigarette industry to circumvent existing regulations. The aggressive marketing activity of this industry is also a core factor that is responsible for the rapid increase of e-cigarette use, in particular among the youth. Following the enforcement of tobacco control, some cigarette smokers may be encouraged to purchase e-cigarettes in order to circumvent the regulations, even though the dual use of e-cigarette and cigarette may be more harmful.

Until there is clear evidence of the e-cigarette's safety, it is recommended that the industry's marketing and promotional activities be banned and closely monitored, and public campaigns be initiated to educate the public regarding e-cigarettes.

Summary

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English Abstracts

The Association of Cardiovascular Risk Factors with Nonalcoholic Fatty Liver Disease in Health Checkup Examinees.: Jae Hee Yu, Kang Sook Lee, Seon Young Lee, A Rum Hong, Yong Sang Park; J Prev Med Public Health. 2008;41(6):407-412.; DOI: https://doi.org/10.3961/jpmph.2008.41.6.407

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Abstract PDF

OBJECTIVES
The purpose of this study was to evaluate the relationship of nonalcoholic fatty liver and cardiovascular risk factors. METHODS: This study was conducted to investigate the association of nonalcoholic fatty liver and cardiovascular risk factors for adult men (n=2976) and women (n=2442) who were over 19 years old, after excluding the HBsAg(+) or anti-HCV(+) patients and the men and women with increased alcohol intake (men: 40 g/week, women: 20 g/week). RESULTS: Compared with the normal liver subjects, the nonalcoholic fatty liver subjects showed a significantly increased frequency of abnormal systolic blood pressure (> or =120 mmHg), fasting blood sugar (> or =100 mg/dL), total cholesterol (> or =200 mg/dL), triglyceride (> or =150 mg/dL), high density lipoprotein cholesterol (<40 mg/dL), low density lipoprotein cholesterol (> or =130g m/dL) and abdominal obesity in men, and all these measures were significantly increased in the women except for abnormal HDL cholesterol. After adjusting for the body mass index, age, smoking, exercise and a nonalcoholic liver, the odds ratios of an abnormal waist hip ratio were 1.35(95% Confidence Interval=1.05-4.72) in the mild fatty liver, 1.61(1.19-2.18) in the moderate fatty liver, 2.77(1.57-4.92) in the severe fatty liver compared with a normal liver. The adjusted odds ratios for abnormal fasting blood sugar were 1.26(1.03-1.53) in the mild fatty liver, 1.62(1.27-2.06) in the moderate fatty lliver and 1.77(1.12-2.78) in the severe fatty liver. The adjusted odds ratios for abnormal triglyceride were 1.38(1.11-1.72) in the mild fatty liver, 1.73(0.33-2.24) in the moderate fatty liver and 1.91(1.17-3.10) in the severe fatty liver of men. Adjusted odds ratios for abnormal triglyceride were 1.50(1.04-2.15) in mild, 1.71(1.07-2.68) in moderate, 1.81(0.69-4.38) in severe fatty liver of women. CONCLUSIONS: The nonalcoholic fatty liver subjects had more cardiovascular risk factors compared with the normal liver subjects. Thus, prevention and treatment of the nonalcoholic fatty liver is necessary by lifestyle modifications such as restriction of alcohol intake, no smoking, exercise and adequate eating habits.

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Insulin sensitizers for the treatment of non-alcoholic fatty liver disease
Zeynel Abidin Ozturk
World Journal of Hepatology.2014; 6(4): 199. CrossRef
Leitura A Influência da Composição Corporal e Idade no Perfil Hepático e Prostático de Homens do Município de Flores da Cunha/RS
F. Nascimento, E. Borba, A. Philipi, A.C. Guimarães, R. Boff, P. Spada, A. Coitinho, C. Funchal, C. Dani
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Recent advances in nonalcoholic fatty liver disease
Onpan Cheung, Arun J Sanyal
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Recent advances in nonalcoholic fatty liver disease
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Associations of Non Alcoholic Fatty Liver with the Metabolic Syndrome and Serum Carotenoids.: Sun kyun Park, Hyun Jung Lee, Duk Hee Lee, Sung Kook Lee, Byung Yeol Chun, Sung Ae Kim, Hye Sung Lee, Hyo Kyung Son, Sung Hi Kim; J Prev Med Public Health. 2008;41(1):39-44.; DOI: https://doi.org/10.3961/jpmph.2008.41.1.39

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Abstract PDF

OBJECTIVES
This study was conducted to investigate the associations of non alcoholic fatty liver with metabolic syndrome and the serum carotenoids. METHODS: This study was conducted in a general hospital in South Korea from November, 2004 to August, 2005. The study subjects were 350 sampled persons who were aged from 40 years and older (males: 180, females: 170). They were grouped into the normal, mild and severe groups according to fat accumulation in their livers, as determined by ultrasonography. We analyzed the association between non alcoholic fatty liver and metabolic syndrome by multiple logistic regression analysis and we analyzed the association between non alcoholic fatty liver and the serum carotenoids by a general linear model(ANCOVA). RESULTS: After adjustment for the effect of potential covariates, the prevalence of metabolic syndrome was associated with fat accumulation in the liver (p trend <0.001). If the odds ratio of normal group is 1.00, then that of the mild group is 2.80 (95% C.I=1.17-6.71) and that of the severe group is 7.29 (95% C.I=2.76-19.30). The prevalence of metabolic alterations fitting the criteria of metabolic syndrome, according to the class of fat accumulation in the liver, was significantly increased, except for criteria of high blood pressure, a large waist circumference and low HDL (high density lipoprotein) cholesterol level (p trend <0.001). The level of serum beta-carotene was decreased according to the class of fat accumulation in the liver (p trend=0.036), but the levels of serum alpha-carotene, lycopene, bata-cryptoxanthin and lutein were not decreased. CONCLSIONS: This study shows that non alcoholic fatty liver was associated with metabolic syndrome and with the serum beta-carotene level.

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Therapeutic potential of bioactive phytoconstituents found in fruits in the treatment of non-alcoholic fatty liver disease: A comprehensive review
Manash Pratim Pathak, Kalyani Pathak, Riya Saikia, Urvashee Gogoi, Pompy Patowary, Pronobesh Chattopadhyay, Aparoop Das
Heliyon.2023; 9(4): e15347. CrossRef
The Protection Conferred by HSD17B13 rs72613567 Polymorphism on Risk of Steatohepatitis and Fibrosis May Be Limited to Selected Subgroups of Patients With NAFLD
Eduardo Vilar-Gomez, Carlos J. Pirola, Silvia Sookoian, Laura A. Wilson, Tiebing Liang, Naga Chalasani
Clinical and Translational Gastroenterology.2021; 12(9): e00400. CrossRef
Trends and Patterns of Burden of Disease and Injuries in Korea Using Disability-Adjusted Life Years
Young-Eun Kim, Hyesook Park, Min-Woo Jo, In-Hwan Oh, Dun-Sol Go, Jaehun Jung, Seok-Jun Yoon
Journal of Korean Medical Science.2019;[Epub] CrossRef
Dietary Carotenoids and Non-Alcoholic Fatty Liver Disease among US Adults, NHANES 2003–2014
Krista Christensen, Thomas Lawler, Julie Mares
Nutrients.2019; 11(5): 1101. CrossRef
Central obesity and nonalcoholic fatty liver disease risk after adjusting for body mass index
Qing Pang
World Journal of Gastroenterology.2015; 21(5): 1650. CrossRef
Association Between Liver Vitamin A Reserves and Severity of Nonalcoholic Fatty Liver Disease in the Class III Obese Following Bariatric Surgery
Gabriela Villaça Chaves, Sílvia Elaine Pereira, Carlos José Saboya, Daiane Spitz, Camila Santos Rodrigues, Andréa Ramalho
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Se Jin Park, Ki Dong Ko, Seung-Il Shin, Yu Jeong Ha, Gy Young Kim, Hyoung Ah Kim
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The Association of Cardiovascular Risk Factors with Nonalcoholic Fatty Liver Disease in Health Checkup Examinees
Jae-Hee Yu, Kang-Sook Lee, Seon-Young Lee, A-Rum Hong, Yong-Sang Park
Journal of Preventive Medicine and Public Health.2008; 41(6): 407. CrossRef

Fasting Serum Glucose and Subsequent Liver Cancer Risk in a Korean Prospective Cohort.: Jin Gwack, Seung Sik Hwang, Kwang Pil Ko, Jae Kwan Jun, Sue Kyung Park, Soung Hoon Chang, Hai Rim Shin, Keun Young Yoo; J Prev Med Public Health. 2007;40(1):23-28.; DOI: https://doi.org/10.3961/jpmph.2007.40.1.23

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Abstract PDF

OBJECTIVES
Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. METHODS: Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. RESULTS: The RRs of serum glucose for liver caner were 1.20 (95% CI=0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI=1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI=1.09-18.28) for those with glucose levels >100 mg/dL. CONCLUSIONS: The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.

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