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Factors Associated With Long-term Retention in Antiretroviral Therapy Among People Living With HIV: Evidence From a Tertiary Hospital in Jakarta, Indonesia
Ifael Yerosias Mauleti, Krishna Adi Wibisana, Djati Prasetio Syamsuridzal, Sri Mulyati, Vivi Lisdawati, Ika Saptarini, Nurhayati , Armedy Ronny Hasugian, Harimat Hendarwan
J Prev Med Public Health. 2024;57(3):252-259.   Published online April 30, 2024
DOI: https://doi.org/10.3961/jpmph.23.512
  • 6,666 View
  • 407 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment.
Methods
A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years.
Results
In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72).
Conclusions
Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.
Summary
Key Message
The administration of antiretroviral therapy to HIV patients has resulted in increased rates of survival, enhanced quality of life, and less transmission of the virus. Nevertheless, a negative correlation exists between the length of antiretroviral therapy and patient retention in care. Our study used data from a tertiary hospital and indicated a decrease in the retention rate of antiretroviral therapy over the third year. Retention was associated with the CD4 count, year of enrollment, and the use of an efavirenz-based treatment. Emphasizing patient engagement has been a longstanding focus in HIV programs, with initiatives being implemented to tackle this matter.

Citations

Citations to this article as recorded by  
  • Functional status as a predictor of loss to follow-up among people living with HIV on antiretroviral therapy in Tangerang District, Indonesia
    Nata Pratama Hardjo Lugito, Maria Irawati Simanjuntak, Stevent Sumantri, Yohan Kho, Sherina Kosayuz, Raenen Liauw
    BMC Infectious Diseases.2025;[Epub]     CrossRef
  • Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
    Boyoung Park, Yoonyoung Jang, Taehwa Kim, Yunsu Choi, Kyoung Hwan Ahn, Jung Ho Kim, Hye Seong, Jun Yong Choi, Hyo Youl Kim, Joon Young Song, Shin-Woo Kim, Hee Jung Choi, Dae Won Park, Young Kyung Yoon, Sang Il Kim
    Epidemiology and Health.2024; 46: e2024097.     CrossRef
Clinical Features and Risk Factors of Post-COVID-19 Condition in Korea
Myungwon Jang, Dongkwon Choi, Jonghyuk Choi, Ho-Jang Kwon
J Prev Med Public Health. 2023;56(5):431-439.   Published online September 8, 2023
DOI: https://doi.org/10.3961/jpmph.23.124
  • 5,968 View
  • 117 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Numerous studies have explored the causes and spread of outbreaks, yet there is a lack of research on post-coronavirus disease 2019 condition (PCC) in Korea. The goal of this study was to identify the various types of PCC and associated factors in discharged patients and to provide directions for the ongoing health management of confirmed patients.
Methods
A telephone survey was conducted among 680 coronavirus disease 2019 (COVID-19) patients diagnosed between July 7, 2021 and August 26, 2021, in Dangjin, Chungnam, Korea. A descriptive analysis of characteristics, univariate analysis, and regression were performed using data from basic epidemiological surveys conducted at the time of diagnosis and post-discharge questionnaires.
Results
Of the 585 patients who responded, 159 (27.2%) developed PCC. Of the 211 patients with no initial symptoms, 27 (12.8%) developed PCC, versus 132 (35.3%) of the 374 patients with initial symptoms. Among the initial symptoms, fever or chills, cough or sputum, loss of smell, and sore throat were associated with PCC. Compared to patients with less than 10 days of hospitalization, those with a hospitalization period of 21 days to 30 days (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 5.2) and 31 days or more (OR, 5.8; 95% CI, 1.9 to 18.1) had a higher risk of PCC.
Conclusions
More than a quarter of COVID-19 patients, including those who had no initial symptoms, experienced PCC in Korea. People with the initial symptoms of fever, chills, and respiratory symptoms and those who had prolonged hospital stays had a high risk of PCC.
Summary
Korean summary
코로나19 후유증은 진단 시 초기증상과 연관되며, 입원기간이 길어질수록 후유증 발병 위험이 높았다. 코로나19 후유증의 위험인자에 대한 추가적인 연구가 필요하며, 이러한 특징을 갖는 확진환자를 대상으로 퇴원 후 지속직인 환자관리가 필요하다.
Key Message
Post-coronavirus disease 2019 condition (PCC) are associated with initial symptoms at diagnosis, and the risk of this increases with longer hospital stays. Further research on the risk factors for PCC is needed, and continued patient care is necessary for confirmed patients with these characteristics after discharge.

Citations

Citations to this article as recorded by  
  • Prevalence, Symptoms, and Associated Factors of Long COVID-19: A Cross-Sectional Survey Study
    Rapeephan R Maude, Siriwan Tangjitgamol, Kasem Sirithanakul, Yanisa Duangduen, Natapon Ativanichayapong
    Vajira Medical Journal : Journal of Urban Medicine.2025; 69(4): e273464.     CrossRef
A Peer-support Mini-counseling Model to Improve Treatment in HIV-positive Pregnant Women in Kupang City, East Nusa Tenggara, Indonesia
Artha Camellia, Plamularsih Swandari, Gusni Rahma, Tuti Parwati Merati, I Made Bakta, Dyah Pradnyaparamita Duarsa
J Prev Med Public Health. 2023;56(3):238-247.   Published online April 11, 2023
DOI: https://doi.org/10.3961/jpmph.22.516
  • 6,416 View
  • 205 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Objectives
Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.
Methods
This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.
Results
Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.
Conclusions
There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.
Summary

Citations

Citations to this article as recorded by  
  • The Childbirth Experience of Pregnant Women Living with HIV Virus
    Andréa Paula de Azevedo, Luisa Castro, Cristina Barroso Hofer, Francisca Rego
    Journal of Clinical Medicine.2025; 14(6): 1975.     CrossRef
  • Manifestation and Markings of HIV Stigma in Indonesia: A Scoping Review
    Ni Kadek Sudastri, Luh Putu Lila Wulandari, Pande Putu Januraga
    International Journal of Environmental Research and Public Health.2025; 22(6): 840.     CrossRef
  • Letter to the Editor: Supporting the Sick and the Vulnerable
    Fides A. del Castillo
    Journal of Preventive Medicine and Public Health.2023; 56(4): 392.     CrossRef
  • Author Response: Supporting the Sick and the Vulnerable
    Artha Camellia, Gusni Rahma
    Journal of Preventive Medicine and Public Health.2023; 56(4): 394.     CrossRef
Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran
Moslem Soofi, Farid Najafi, Shahin Soltani, Behzad Karamimatin
J Prev Med Public Health. 2023;56(1):50-58.   Published online January 6, 2023
DOI: https://doi.org/10.3961/jpmph.22.373
  • 7,496 View
  • 144 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Objectives
Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran.
Methods
This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CIn) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants.
Results
The proportion of MetS in the sample was 41.1%. The CIn of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%).
Conclusions
Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.
Summary

Citations

Citations to this article as recorded by  
  • Prevalence of metabolic syndrome and its components in Iran: an updated meta-analysis
    Asra Moradkhani, Pardis Mohammadzadeh, Srwa Assadi, Lotfolah Saed, Hamid Reza Baradaran, Yousef Moradi
    BMC Endocrine Disorders.2025;[Epub]     CrossRef
  • The prevalence of metabolic syndrome and its economic inequality in an elderly population
    Farid Fotouhi, Hassan Hashemi, Abbasali Yekta, Mahtab Niroomand, Mehrdad Esmaeili, Reza Norouzirad, Nasim Vaghefi, Mehdi Khabazkhoob
    Scientific Reports.2025;[Epub]     CrossRef
  • Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study
    Guadalupe Gutiérrez-Esparza, Mireya Martinez-Garcia, Tania Ramírez-delReal, Lucero Elizabeth Groves-Miralrio, Manlio F. Marquez, Tomás Pulido, Luis M. Amezcua-Guerra, Enrique Hernández-Lemus
    Nutrients.2024; 16(5): 612.     CrossRef
  • Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
    Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
    Epidemiology and Health.2023; 45: e2023083.     CrossRef
The Association Between Metabolic Syndrome and Colorectal Cancer Risk by Obesity Status in Korean Women: A Nationwide Cohort Study
Seong-geun Moon, Boyoung Park
J Prev Med Public Health. 2022;55(5):475-484.   Published online September 21, 2022
DOI: https://doi.org/10.3961/jpmph.22.286
  • 6,912 View
  • 141 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to determine the association between metabolic syndrome (MetS) and the incidence of colorectal cancer (CRC) in Korean women with obesity.
Methods
Cancer-free women (n=6 142 486) aged 40-79 years, who underwent National Health Insurance Service health examinations in 2009 and 2010 were included. The incidence of CRC was followed until 2018. The hazard ratio (HR) of MetS for the incidence of colon and rectal cancer was analyzed according to body mass index (BMI) categories, adjusting for confounders such as women’s reproductive factors. In addition, the heterogeneity of associations across BMI categories was assessed.
Results
Women with MetS were at increased risk of colon and rectal cancer compared to women without MetS (HR, 1.20; 95% confidence interval [CI], 1.16 to 1.23 and HR,1.15; 95% CI, 1.11 to 1.20), respectively. The HR of MetS for colon cancer across BMI categories was 1.12 (95% CI, 1.06 to 1.19), 1.14 (95% CI, 1.08 to 1.20), and 1.16 (95% CI, 1.12 to 1.21) in women with BMIs <23.0 kg/m2, 23.0-24.9 kg/m2, and ≥25.0 kg/m2, respectively. The HR of MetS for rectal cancer across corresponding BMI categories was 1.16 (95% CI, 1.06 to 1.26), 1.14 (95% CI, 1.05 to 1.23), and 1.13 (95% CI, 1.06 to 1.20). The heterogeneity of associations across BMI categories was not significant in either colon or rectal cancer (p=0.587 for colon cancer and p=0.927 for rectal cancer).
Conclusions
Women with MetS were at increased risk of colon and rectal cancer. Clinical and public health strategies should be considered for primary CRC prevention with an emphasis on improving women’s metabolic health across all BMI groups.
Summary
Korean summary
한국 여성에서 대사증후군은 대장암 발생과 직장암 발생에 유의한 위험요인으로 보인다. 이는 체질량지수를 층화하고 여성력과 관련된 요인들을 보정하더라도 유의했다. 한국 여성의 대장암 및 직장암 예방을 위해 비만도에 관계 없이 대사증후군 요소를 관리하는 것이 필요하다.

Citations

Citations to this article as recorded by  
  • Metabolic Syndrome Components and Cancer Risk in Normal-Weight Subjects: Systematic Review and Meta-Analysis in over 18 Million Individuals
    Yasmin Ezzatvar, Jorge Olivares-Arancibia, Jacqueline Páez-Herrera, Rodrigo Yáñez-Sepúlveda, Óscar Caballero
    Journal of Clinical Medicine.2026; 15(2): 538.     CrossRef
  • The Association of Urinary Zinc with Metabolic Syndrome and the Mediating Role of Liver Enzymes in the Bouyei Ethnic Group in China
    Fei Xiao, Yuxin Hu, Yuan Wang, Yuxin Zhang, Enhui Zhou, Tingting Yang, Feng Hong
    Cardiovascular Toxicology.2025; 25(8): 1139.     CrossRef
  • Age-Related Differences in Anthropometric and Lifestyle Factors Linked to Metabolic Syndrome in Women with Overweight and Obesity: A Cross-Sectional Study
    Edyta Łuszczki, Magdalena Zielińska, Łukasz Oleksy, Artur Stolarczyk, Katarzyna Dereń
    Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1765.     CrossRef
  • Association of metabolic obesity phenotypes with risk of overall and site-specific cancers: a systematic review and meta-analysis of cohort studies
    Yahya Mahamat-saleh, Dagfinn Aune, Heinz Freisling, Sheetal Hardikar, Rola Jaafar, Sabina Rinaldi, Marc J. Gunter, Laure Dossus
    British Journal of Cancer.2024; 131(9): 1480.     CrossRef
  • Overweight and obesity significantly increase colorectal cancer risk: a meta-analysis of 66 studies revealing a 25–57% elevation in risk
    Zoltan Ungvari, Mónika Fekete, Peter Varga, Andrea Lehoczki, János Tibor Fekete, Anna Ungvari, Balázs Győrffy
    GeroScience.2024; 47(3): 3343.     CrossRef
  • Increased risk of cancer and cancer-related mortality in middle-aged Korean women with prediabetes and diabetes: a population-based study
    Thi Xuan Mai Tran, Soyeoun Kim, Huiyeon Song, Boyoung Park
    Epidemiology and Health.2023; 45: e2023080.     CrossRef
COVID-19: Original Articles
Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type
Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung
J Prev Med Public Health. 2021;54(2):86-95.   Published online January 19, 2021
DOI: https://doi.org/10.3961/jpmph.20.540
  • 8,890 View
  • 224 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.
Summary
Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

Citations

Citations to this article as recorded by  
  • Prevalence of post-traumatic stress disorder in healthcare workers before and during COVID-19: a systematic review and meta-analysis
    Claire Frodsham, Samuel B. Harvey, Daniel Collins, Karen Krakue, Vita Ligaya Dalgaard, Rosie Lipscomb, Matthew Hotopf, Mark Deady, Richard Bryant, Aimee Gayed
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • Prevalence of post-traumatic stress disorder in Peruvian military: a cross-sectional study
    Mario J. Valladares-Garrido, Cinthia Karina Picón-Reátegui, J. Pierre Zila-Velasque, Virgilio E. Failoc-Rojas, César Johan Pereira Victorio, Danai Valladares-Garrido, Víctor J. Vera-Ponce
    Frontiers in Psychiatry.2025;[Epub]     CrossRef
  • Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
    Ji Su Yang, Yu Jin Lee, Hyeon Chang Kim, Chul-Hyun Cho, Alexander C. Tsai, Sun Jae Jung
    Comprehensive Psychiatry.2023; 127: 152432.     CrossRef
  • Development and Validation of COVID-19 Stress Scale (CSS) in an Iranian Non-clinical Population
    Roghieh Nooripour, Nikzad Ghanbari, Laurel E. Radwin, Simin Hosseinian, Peyman Hassani-Abharian, Mohsen Hosseinbor, Keyvan Kakabraee, Mojtaba Amiri Majd, Serge Brand, Esmaeil Soleimani, Hossein Ilanloo
    Zahedan Journal of Research in Medical Sciences.2022;[Epub]     CrossRef
Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study
Akram Hernández-Vásquez, Diego Azañedo, Rodrigo Vargas-Fernández, Guido Bendezu-Quispe
J Prev Med Public Health. 2020;53(4):211-219.   Published online May 28, 2020
DOI: https://doi.org/10.3961/jpmph.20.186
  • 13,161 View
  • 2,351 Download
  • 29 Crossref
AbstractAbstract PDF
Objectives
The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death.
Methods
This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age.
Results
Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions.
Conclusions
Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.
Summary

Citations

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  • REGEN-COV as the First Line of Defense—A Single-Centre Experience
    Milica Popović, Vladimir Đurović, Bojana Ljubičić, Nadica Kovačević, Slobodan Šajinović, Lada Petrović, Tatjana Ilić, Sonja Golubović
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    Gilberto González-Parra, Giulia Luebben, Rafael J. Villanueva, F.J. Navarro-González, Bhumika Bhakta
    Mathematics and Computers in Simulation.2026; 241: 293.     CrossRef
  • Clinical, Demographic, and Virological Predictors of Hospital Admission in Patients with Acute Viral Respiratory Infections: A Retrospective Observational Study
    Karolina Akinosoglou, Nikolaos Theofanis, Konstantinos Asimos, Michail Michailidis, Despoina Papageorgiou, Eleni Polyzou, Charalambos Gogos
    Viruses.2026; 18(1): 135.     CrossRef
  • A network-based model to assess vaccination strategies for the COVID-19 pandemic by using Bayesian optimization
    Gilberto González-Parra, Javier Villanueva-Oller, F.J. Navarro-González, Josu Ceberio, Giulia Luebben
    Chaos, Solitons & Fractals.2024; 181: 114695.     CrossRef
  • Impact of COVID-19 on ‘Start Smart, Then Focus’ Antimicrobial Stewardship at One NHS Foundation Trust in England Prior to and during the Pandemic
    Rasha Abdelsalam Elshenawy, Nkiruka Umaru, Zoe Aslanpour
    COVID.2024; 4(1): 102.     CrossRef
  • Multimorbidity and frailty are associated with poorer SARS-CoV-2-related outcomes: systematic review of population-based studies
    Tatjana T. Makovski, Jinane Ghattas, Stéphanie Monnier-Besnard, Lisa Cavillot, Monika Ambrožová, Barbora Vašinová, Rodrigo Feteira-Santos, Peter Bezzegh, Felipe Ponce Bollmann, James Cottam, Romana Haneef, Brecht Devleesschauwer, Niko Speybroeck, Paulo Jo
    Aging Clinical and Experimental Research.2024;[Epub]     CrossRef
  • Multimorbidity raises the odds of decease in COVID-19 patients: An Iranian prospective study
    Masood Faghih Dinevari, Mohammad Hossein Somi, Leila Mokhtari, Elham Sadeghi Majd, Zeinab Nikniaz
    Journal of Research in Clinical Medicine.2024; 12: 28.     CrossRef
  • Mortalidad en adultos mexicanos de 50 a 80 años de edad con multimorbilidad en un período de observación de 18 años
    Beatriz Novak, Daniel Lozano Keymolen
    Estudios Demográficos y Urbanos.2023; 38(1): 9.     CrossRef
  • Age and Comorbidities as Risk Factors for Severe COVID-19 in Mexico, before, during and after Massive Vaccination
    Lenin Domínguez-Ramírez, Francisca Sosa-Jurado, Guadalupe Díaz-Sampayo, Itzel Solis-Tejeda, Francisco Rodríguez-Pérez, Rosana Pelayo, Gerardo Santos-López, Paulina Cortes-Hernandez
    Vaccines.2023; 11(11): 1676.     CrossRef
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    Giulia Luebben, Gilberto González-Parra, Bishop Cervantes
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Special Article
Introduction of Vaccinomics to Develop Personalized Vaccines in Light of Changes in the Usage of Hantaan Virus Vaccine (Hantavax®) in Korea
Jong-Myon Bae
J Prev Med Public Health. 2019;52(5):277-280.   Published online August 7, 2019
DOI: https://doi.org/10.3961/jpmph.19.018
  • 9,250 View
  • 211 Download
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
The Ministry of Food and Drug Safety of Korea made an official announcement in March 2018 that the total number of inoculations of Hantaan virus vaccine (Hantavax®) would change from 3 to 4. Some aspects of this decision remain controversial. Based on the characteristics of Hantaan virus (HTNV) and its role in the pathogenesis of hemorrhagic fever with renal syndrome, it might be difficult to develop an effective and safe HTNV vaccine through the isolate-inactivate-inject paradigm. With the development of high-throughput ‘omics’ technologies in the 21st century, vaccinomics has been introduced. While the goal of vaccinomics is to develop equations to describe and predict the immune response, it could also serve as a tool for developing new vaccine candidates and individualized approaches to vaccinology. Thus, the possibility of applying the innovative field of vaccinomics to develop a more effective and safer HTNV vaccine should be considered.
Summary
Korean summary
신증후출혈열 (Hemorrhagic fever with renal syndrome, HFRS)를 예방하기 위한 백신들이 여러 가지로 개발 중에 있지만, 한탄 바이러스 (Hantaan virus) 의 병원체 특성과 HFRS의 임상적 특성으로 효과적이고 안전한 백신 개발을 어렵게 하고 있다. 투여할 백신에 대한 ‘면역과정을 이해하고 백신효능을 예측하여’ 백신개발에 활용하는 백신체학의 적용을 적극 강구할 필요가 있다.

Citations

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    Grant C Paulsen, Robert Frenck, Kay M Tomashek, Rodolfo M Alarcon, Elizabeth Hensel, Ashley Lowe, Rebecca L Brocato, Steve A Kwilas, Matthew D Josleyn, Jay W Hooper
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    Rui-Xu Chen, Huan-Yu Gong, Xiu Wang, Ming-Hui Sun, Yu-Fei Ji, Su-Mei Tan, Ji-Ming Chen, Jian-Wei Shao, Ming Liao
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Perspective
Introduction of Phylodynamics for Controlling the HIV/AIDS Epidemic in Korea
Jong-Myon Bae
J Prev Med Public Health. 2018;51(6):326-328.   Published online October 22, 2018
DOI: https://doi.org/10.3961/jpmph.18.150
  • 6,520 View
  • 80 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
As over 1000 new cases of HIV/AIDS occur in Korea annually, preventive health programs against HIV/AIDS are urgently needed. Since phylodynamic studies have been suggested as a way to understand how infectious diseases are transmitted and evolve, phylodynamic inferences can be a useful tool for HIV/AIDS research. In particular, phylodynamic models are helpful for dating the origins of an epidemic and estimating its basic reproduction number. Thus, the introduction of phylodynamics would be a highly valuable step towards controlling the HIV/AIDS epidemic in Korea.
Summary
Korean summary
국내 HIV/AIDS 신환자가 지속적으로 발생하고 있는 상황에서, 다른 나라에서는 HIV 감염관리에 계통역동학을 적용하고 있다. 이는 감염원과 감염경로를 알아내고, 기본재생산지수를 산출하도록 해주기 때문이다. 따라서 국내 HIV/AIDS 관리를 위해 계통역동학 적용을 적극 제안한다.”
Original Articles
Areca Nut Chewing and the Risk of Re-hospitalization and Mortality Among Patients With Acute Coronary Syndrome in Pakistan
Muhammad Tariq Karim, Sumera Inam, Tariq Ashraf, Nadia Shah, Syed Omair Adil, Kashif Shafique
J Prev Med Public Health. 2018;51(2):71-82.   Published online February 19, 2018
DOI: https://doi.org/10.3961/jpmph.17.189
  • 12,988 View
  • 202 Download
  • 2 Crossref
AbstractAbstract PDF
Objectives
Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.
Summary

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  • Association between habitual betel quid chewing and risk of adverse cardiovascular outcomes: A systematic review
    Rodney Itaki, Shalon Taufa
    Tropical Medicine & International Health.2024; 29(6): 447.     CrossRef
  • Systemic Health Effects of Areca Nuts with Particular Emphasis on Carcinogenesis – A Review

    International Journal of Biosciences (IJB).2021; : 113.     CrossRef
Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease
Da-Hye Jeon, Hyungseon Yeom, Jaewon Yang, Jong Suk Song, Hyung Keun Lee, Hyeon Chang Kim
J Prev Med Public Health. 2017;50(6):369-376.   Published online November 2, 2017
DOI: https://doi.org/10.3961/jpmph.17.089
  • 10,199 View
  • 191 Download
  • 17 Crossref
AbstractAbstract PDF
Objectives
Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI).
Methods
The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI.
Results
Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations.
Conclusions
The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.
Summary

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    R. Selimoğlu, A. Mete, S.A. Seyyar, S. Kimyon
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    Maurizio Rolando, Stefano Barabino
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    Bhavya Gorimanipalli, Rohit Shetty, Swaminathan Sethu, Pooja Khamar
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    Diksha Malik, Renu Garg, Sumita Sethi, Rajiv Mahendru, Sanjeet Singh
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    Miłosz Caban, Urszula Lewandowska
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    Busayanut Puangsricharoen, Kavin Vanikieti, Panitha Jindahra, Tanyatuth Padungkiatsagul
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    Lei Shi, Ting-Yu Li, Liang-Yu Li, Bao-Ke Hou
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    Shireen M. Shousha, Nehal EL-Ghobashy, Maha Alhelf, Dalia Abd El-kareem, Pavly Moawad
    Delta Journal of Ophthalmology.2022; 23(2): 75.     CrossRef
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    Trailokyanath Panigrahi, Sharon D’Souza, Rohit Shetty, Archana Padmanabhan Nair, Anuprita Ghosh, Everette Jacob Remington Nelson, Arkasubhra Ghosh, Swaminathan Sethu
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Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013
Ram Bajpai, Himanshu Chaturvedi, Lakshmanan Jayaseelan, Pauline Harvey, Nicole Seguy, Laxmikant Chavan, Pinnamaneni Raj, Arvind Pandey
J Prev Med Public Health. 2016;49(6):394-405.   Published online October 28, 2016
DOI: https://doi.org/10.3961/jpmph.16.073
  • 11,439 View
  • 168 Download
  • 9 Crossref
AbstractAbstract PDF
Objectives
The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India.
Methods
The present study used data from 139 679 HIV patients aged ≥15 years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival.
Results
The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for <100 cells/mm3 vs. >350 cells/mm3), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients.
Conclusions
The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.
Summary

Citations

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  • Highly active antiretroviral therapy is necessary but not sufficient. A systematic review and meta-analysis of mortality incidence rates and predictors among HIV-infected adults receiving treatment in Ethiopia, a surrogate study for resource-poor settings
    Beshada Zerfu Woldegeorgis, Yordanos Sisay Asgedom, Aklilu Habte, Gizachew Ambaw Kassie, Abebe Sorsa Badacho
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    Animut Alebel, David Sibbritt, Pammla Petrucka, Daniel Demant
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    Ramón E. R. González, Pedro Hugo de Figueirêdo, Sergio Galvao Coutinho
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    Haddis Birhanu, Atsede Alle, Molla Yigzaw Birhanu
    HIV/AIDS - Research and Palliative Care.2021; Volume 13: 251.     CrossRef
  • Predictors of Mortality Among Adult HIV-Infected Patients Taking Antiretroviral Therapy (ART) in Harari Hospitals, Ethiopia
    Abdi Birhanu, Tariku Dingeta, Moti Tolera
    HIV/AIDS - Research and Palliative Care.2021; Volume 13: 727.     CrossRef
  • Cost-effectiveness of a novel strategy of HIV/AIDS care in Armed Forces: A stochastic model with Monte Carlo simulation
    S. Shankar, Santosh Karade, Rajul K. Gupta, M.V. Singh
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    Ram Bajpai, Himanshu K Chaturvedi, Josip Car
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  • Survival after Long-Term ART Exposure: Findings from an Asian Patient Population Retained in Care beyond 5 Years on ART
    Rimke Bijker, Sasisopin Kiertiburanakul, Nagalingeswaran Kumarasamy, Sanjay Pujari, Ly P Sun, Oon T Ng, Man P Lee, Jun Y Choi, Kinh V Nguyen, Yu J Chan, Tuti P Merati, Do D Cuong, Jeremy Ross, Awachana Jiamsakul
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  • Survival rate and mortality risk factors among TB–HIV co-infected patients at an HIV-specialist hospital in Myanmar: A 12-year retrospective follow-up study
    Zaw Zaw Aung, Yu Mon Saw, Thu Nandar Saw, Nwe Oo, Hnin Nwe Ni Aye, Sithu Aung, Htun Nyunt Oo, Su Myat Cho, Moe Khaing, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima
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The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study
Venetia Notara, Demosthenes B. Panagiotakos, Yannis Kogias, Petros Stravopodis, Antonis Antonoulas, Spyros Zombolos, Yannis Mantas, Christos Pitsavos
J Prev Med Public Health. 2016;49(4):220-229.   Published online June 24, 2016
DOI: https://doi.org/10.3961/jpmph.16.005
  • 12,883 View
  • 133 Download
  • 22 Crossref
AbstractAbstract PDF
Objectives
The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated.
Methods
From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years).
Results
Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed.
Conclusions
A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.
Summary

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Metabolic Risk Profile and Cancer in Korean Men and Women
Seulki Ko, Seok-Jun Yoon, Dongwoo Kim, A-Rim Kim, Eun-Jung Kim, Hye-Young Seo
J Prev Med Public Health. 2016;49(3):143-152.   Published online May 18, 2016
DOI: https://doi.org/10.3961/jpmph.16.021
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AbstractAbstract PDF
Objectives
Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented.
Methods
We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise.
Results
A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer.
Conclusions
The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.
Summary

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Special Articles
Ethical Perspectives on the Middle East Respiratory Syndrome Coronavirus Epidemic in Korea
Ock-Joo Kim
J Prev Med Public Health. 2016;49(1):18-22.   Published online January 29, 2016
DOI: https://doi.org/10.3961/jpmph.16.013
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AbstractAbstract PDF
Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.
Summary

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Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies
Dong-Hyun Kim
J Prev Med Public Health. 2015;48(6):265-270.   Published online November 30, 2015
DOI: https://doi.org/10.3961/jpmph.15.066
  • 41,237 View
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AbstractAbstract PDF
The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system’s weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of “control tower” in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.
Summary

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Perspective
Costly Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in Korea
Sang-il Lee
J Prev Med Public Health. 2015;48(6):274-276.   Published online November 25, 2015
DOI: https://doi.org/10.3961/jpmph.15.064
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AbstractAbstract PDF
Since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (hereafter Korea) began on May 11, 2015, a total of 186 persons have been infected by the MERS coronavirus, 38 of whom have died. With this number, Korea becomes second only to the Kingdom of Saudi Arabia in the ranking of cumulative MERS cases. In this paper Korea’s unique experience of an outbreak of MERS will be summarized and discussed briefly.
Summary

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Original Articles
Associations of Sarcopenia and Sarcopenic Obesity With Metabolic Syndrome Considering Both Muscle Mass and Muscle Strength
Jihye Lee, Yeon-pyo Hong, Hyun Ju Shin, Weonyoung Lee
J Prev Med Public Health. 2016;49(1):35-44.   Published online November 23, 2015
DOI: https://doi.org/10.3961/jpmph.15.055
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AbstractAbstract PDF
Objectives
We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome.
Methods
Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were <26 kg for men and <18 kg for women, and the second criteria were the lowest quintile of handgrip strength among the study subjects. Sarcopenic obesity was defined as the combination of class II sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models.
Results
The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, p<0.001) in women, which were found to be statistically significant relationships. The RRs of metabolic syndrome being compared in people with or without sarcopenic obesity were 1.31 in men (95% CI, 1.10 to 1.56, p=0.003) and 1.17 in women (95% CI, 1.10 to 1.25, p<0.001), which were likewise found to be statistically significant relationships.
Conclusions
The associations of sarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be considered as part of the community-based management of non-communicable diseases.
Summary

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The Economic Burden of Cancers Attributable to Metabolic Syndrome in Korea
Dongwoo Kim, Seok-Jun Yoon, Young-Hoon Gong, Young Ae Kim, Hye-Young Seo, Jihyun Yoon, A-Rim Kim
J Prev Med Public Health. 2015;48(4):180-187.   Published online July 20, 2015
DOI: https://doi.org/10.3961/jpmph.15.022
  • 12,635 View
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  • 15 Crossref
AbstractAbstract PDF
Objectives
Metabolic syndrome is an important etiologic factor in the development of certain types of cancers. The economic cost of the treatment of cancer has been steadily increasing. We therefore estimated the economic burden of cancers attributable to metabolic syndrome in Korea.
Methods
We reviewed metabolic syndrome-related cancers and relative risk and then calculated population attributable fractions. We analyzed insurance claims data for metabolic syndrome-related cancers in 2012 in order to estimate the direct costs associated with these cancers, including hospitalization, outpatient visits, transportation costs, and caregivers’ costs as well as indirect costs such as loss of productivity due to cancer treatment and premature death.
Results
In 2012, 18 070 patients in Korea had cancers attributable to metabolic syndrome. The economic burden was USD 199.8 million and the direct and indirect costs were USD 124.5 million and USD 75.3 million, respectively.
Conclusions
We estimated the economic burden of cancers attributable to metabolic syndrome in Korea and the efforts are necessary to reduce this burden.
Summary

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Serum Uric Acid Level and the Incidence of Metabolic Syndrome in Middle-aged Korean Men: A 5-Year Follow-up Study
Jong-Keun Lee, Jae-Hong Ryoo, Joong-Myung Choi, Sung Keun Park
J Prev Med Public Health. 2014;47(6):317-326.   Published online November 4, 2014
DOI: https://doi.org/10.3961/jpmph.14.028
  • 13,297 View
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  • 5 Crossref
AbstractAbstract PDF
Objectives
Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS.
Methods
A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed.
Results
During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses.
Conclusions
Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.
Summary

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Special Article
Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome
Hye Ah Lee, Hyesook Park
J Prev Med Public Health. 2013;46(4):173-182.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.173
  • 16,086 View
  • 108 Download
  • 7 Crossref
AbstractAbstract PDF

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

Summary

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Original Articles
Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
J Prev Med Public Health. 2012;45(3):181-187.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.181
  • 20,849 View
  • 181 Download
  • 59 Crossref
AbstractAbstract PDF
Objectives

Serum uric acid levels have been reported to be associated with a variety of cardiovascular conditions. However, the direct association between uric acid levels and metabolic syndrome remains controversial. Thus, we evaluated the association of serum uric acid levels and metabolic syndrome in a community-based cohort study in Korea.

Methods

We performed cross-sectional analysis of baseline data of 889 males and 1491 females (aged 38 to 87) who participated in baseline examinations of the Korean Genome and Epidemiology Study: Kanghwa study. Blood samples were collected after at least an 8 hour fast. Uric acid quartiles were defined as follows: <4.8, 4.8-<5.6, 5.6-<6.5, ≥6.5 mg/dL in males; and <3.8, 3.8-<4.3, 4.3-<5.1, ≥5.1 mg/dL in females. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III Criteria with adjusted waist circumference cutoffs (90 cm for males; 80 cm for females). The association between serum uric acid quartiles and metabolic syndrome was assessed using multivariate logistic regression.

Results

The odds ratio for having metabolic syndrome in the highest versus lowest quartiles of serum uric acid levels was 2.67 (95% confidence interval [CI], 1.60 to 4.46) in males and 2.14 (95% CI, 1.50 to 3.05) in females after adjusting for age, smoking, alcohol intake, body mass index, total cholesterol, HbA1c, albumin, γ-glutamyltransferase, blood urea nitrogen, and log C-reactive protein. The number of metabolic abnormalities also increased gradually with increasing serum uric acid levels (adjusted p for trend < 0.001 in both sexes).

Conclusions

Higher serum uric acid levels are positively associated with the presence of metabolic syndrome in Korean males and females.

Summary

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The Association Between Serum Albumin Levels and Metabolic Syndrome in a Rural Population of Korea
Hye Min Cho, Hyeon Chang Kim, Ju-Mi Lee, Sun Min Oh, Dong Phil Choi, Il Suh
J Prev Med Public Health. 2012;45(2):98-104.   Published online March 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.2.98
  • 15,071 View
  • 117 Download
  • 31 Crossref
AbstractAbstract PDF
Objectives

A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults.

Methods

This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value (≥90 cm for men and ≥85 cm for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis.

Results

Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men.

Conclusions

These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.

Summary

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The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence
Hye Ah Lee, Won Kyung Lee, Kyoung-Ae Kong, Namsoo Chang, Eun-Hee Ha, Young Sun Hong, Hyesook Park
J Prev Med Public Health. 2011;44(5):226-233.   Published online September 28, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.5.226
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AbstractAbstract PDF
Objectives

Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined.

Methods

The subjects consisted of 261 children aged 7-9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests.

Results

A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2-3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82).

Conclusions

This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.

Summary

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Research Support, Non-U.S. Gov'ts
Association Between Meat Consumption and Carotid Intima-Media Thickness in Korean Adults with Metabolic Syndrome.
Sun Min Oh, Hyeon Chang Kim, Song Vogue Ahn, Hye Jin Chi, Il Suh
J Prev Med Public Health. 2010;43(6):486-495.
DOI: https://doi.org/10.3961/jpmph.2010.43.6.486
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AbstractAbstract PDF
OBJECTIVES
The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. METHODS: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. RESULTS: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (> or =5 servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. CONCLUSIONS: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (> or =5 servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.
Summary

Citations

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The Distribution of Intraocular Pressure and Its Association With Metabolic Syndrome in a Community.
Sang shin Park, Eun Hee Lee, Ganchimeg Jargal, Domyung Paek, Sung Il Cho
J Prev Med Public Health. 2010;43(2):125-130.
DOI: https://doi.org/10.3961/jpmph.2010.43.2.125
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AbstractAbstract PDF
OBJECTIVES
The current study was performed to assess the distribution of intraocular pressure (IOP) and its association with metabolic syndrome (MS) in a community. METHODS: We measured IOP and MS components from 446 adults, age 20 or more years old, who reside in a community in Kyunggi Province, South Korea. We compared the level of IOP according to the number of metabolic abnormalities and between normal and abnormal metabolic components. Linear regression analyses were used to determine the relationship between IOP and metabolic components. RESULTS: No significant difference in IOP (mean +/- SE) was found between men (12.24 +/- 2.42) and women (12.55 +/- 2.41 mmHg, p > 0.1), while IOP of men tended to decrease as age increased (p for trend < 0.01). After adjusting for age, IOP of subjects with abdominal obesity in men and high blood pressure in women were significantly higher than those without abdominal obesity or high blood pressure (p < 0.05). Female subjects with MS showed significantly higher IOP than those without MS. Participants with more metabolic disturbances tended to have a greater IOP elevation with a linear trend after adjusting for age and sex. In the univariate regression analysis, age and waist circumference were significantly associated with IOP in men, but systolic and diastolic blood pressure were associated with IOP in women. In final multiple regression model, age, systolic blood pressure, and triglyceride were associated with IOP in women, and age in men. CONCLUSIONS: These findings suggest that MS and its components may be important determinants of elevated IOP.
Summary

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Relationship Between Serum Concentrations of Organochlorine Pesticides and Metabolic Syndrome Among Non-Diabetic Adults.
Sun Kyun Park, Hyo Kyung Son, Sung Kook Lee, Jung Ho Kang, Yoon Seok Chang, David R Jacobs, Duk Hee Lee
J Prev Med Public Health. 2010;43(1):1-8.
DOI: https://doi.org/10.3961/jpmph.2010.43.1.1
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AbstractAbstract PDF
OBJECTIVES
This study was performed to investigate if organochlorine pesticides (OCPs) were associated with metabolic syndrome and insulin resistance among non-diabetes. METHODS: Among subjects who participated in a community-based health survey, 50 non-diabetic subjects with metabolic syndrome and 50 normal controls were selected. Insulin resistance was measured by the homeostasis model assessment (HOMA-IR). Eight OCPs were selected. RESULTS: After adjusting for confounders except for body mass index (BMI), beta-hexachlorocyclohexane (beta-HCH) and heptachlor epoxide were positively associated with metabolic syndrome. Odds ratios across tertiles of beta-HCH and heptachlor epoxide were 1.0, 3.2 and 4.4, and 1.0, 4.0 and 6.0, respectively (p for trend = 0.01 and <0.01). After additional adjustment for body mass index (BMI), heptachlor epoxide still showed an increasing trend with adjusted odds ratios of 1.0, 4.1, and 4.6 (p for trend = 0.10). When the five components of metabolic syndrome (with the definition of high fasting glucose (> or =100 mg/dL)) were separately analyzed, all components were positively, but not significantly, associated with heptachlor epoxide. As the serum concentration of heptachlor epoxide increased, HOMA-IR increased significantly in subjects with metabolic syndrome even after adjusting for BMI (p value <0.05 and <0.01). CONCLUSIONS: Despite the small sample size, this study suggests that the background exposure to some OCPs may be associated with metabolic syndrome.
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English Abstracts
Lifestyle and Metabolic Syndrome among Male Workers in an Electronics Research and Development Company.
Jun Pyo Myong, Hyoung Ryoul Kim, Yong Kyu Kim, Jung Wan Koo, Chung Yill Park
J Prev Med Public Health. 2009;42(5):331-336.
DOI: https://doi.org/10.3961/jpmph.2009.42.5.331
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AbstractAbstract PDF
OBJECTIVES
The objectives of this study were to determine the relationship between lifestyle-implementation and metabolic syndrome in an electronics research and development company, and to provide a foundation for health providers of health management programs for setting priorities. METHODS: From July 1 to July 16, 2008 we carried out a descriptive cross-sectional survey. Consecutive workers of one R & D company in Seoul, Korea (N=2,079) were enrolled in study. A checklist for lifestyle (from the National Health Insurance Corporation) consisted of questions regarding diet, drinking, smoking and exercise. After the survey, researchers obtained data from health profiles for metabolic syndrome(waist-circumference, triglycerides, HDL cholesterol, blood pressure and fasting blood sugar level). Lifestyle was recorded as good or not good. Statistical analysis of metabolic syndrome and the lifestyle of subjects was done using multiple logistic regression analysis. RESULTS: The prevalence of metabolic syndrome in our study gropu was 13.3% (N=277). After adjustment for age, the adjusted odds ratios (odds ratio, 95% confidence intervals) for metabolic syndrome increased in proportion to the number of bad habits: two (1.72, 1.23-2.44), three (2.47, 1.73-3.56), and four (3.63, 2.03-6.34). Relative to subjects eating both vegetables and meat', the OR for 'meat' eaters was 1.66 (1.18-2.31). Compared with 'non-smokers and ever-smoker', the OR for 'current-smoker' was 1.62 (1.25-2.10). Compared with 'Healthy drinker', the OR for 'unhealthy drinker' was 1.38 (1.05-1.83). CONCLUSIONS: Poor lifestyle was associated with an increased likelihood of metabolic syndrome. These findings suggest that lifestyle-based occupational health interventions for young employees should include a specific diet, smoking cessation, and healthy-drinking programs.
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Association of Current and Past Smoking with Metabolic Syndrome in Men.
A Rum Hong, Kang Sook Lee, Seon Young Lee, Jae Hee Yu
J Prev Med Public Health. 2009;42(3):160-164.
DOI: https://doi.org/10.3961/jpmph.2009.42.3.160
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AbstractAbstract PDF
OBJECTIVES
The objective of this study was to determine the relationship between past smoking and the risk factors for metabolic syndrome. METHODS: From January 2007 to December 2007, a total of 3,916 over thirty years old male health screen examinees were divided into the nonsmoking, smoking, ex-smoking groups. The diagnosis of metabolic syndrome was based on the criteria of the NCEP ATP (Executive Summary of The Third Report of The National Cholesterol Education Program). Metabolic syndrome was defined as the presence of three or more of the following: a blood pressure > or = 130/85 mmHg, a fasting glucose level > or = 110 mg/dL, a HDL-C (High Density Lipoprotein Cholesterol) level < 40 mg/dL, a triglyceride level > or = 150 mg/dL and, a waist circumference men > or = 102 cm, but a waist to hip ratio > 0.90 was used as a surrogate for the waist circumference. RESULTS: After adjustment for age, alcohol consumption and, exercise in the smokers, for the ex-smokers compared with the nonsmokers, the odds ratio (OR) of a lower HDL cholesterol level (< 40 mg/dL) was 1.29 (95% CI=1.03-1.61) in the smokers, the ORs of a higher triglyceride level were 1.35 (95% CI=1.09-1.66) in the ex-smokers and, 2.12 (95% CI=1.75-2.57) in the smokers, and the OR of a waist to hip ratio was 1.25 (95% CI=1.03-1.52) in the ex-smokers. When there were over three components of metabolic syndrome in the ex-smokers and smokers as compared with the nonsmokers, the odds ratio against the risk of metabolic syndrome were 2.39 (95% CI=1.00-6.63) and 2.37 (95% CI=1.02-6.46), respectively. CONCLUSIONS: The present study suggested that there is an association of smoking with metabolic syndrome in men.
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The Relationship between Physical Activity and Clustering of Metabolic Abnormalities in Children.
Hyun Jin Son, Mi Kyung Kim, Hyun Ja Kim, Ho Kim, Bo Youl Choi
J Prev Med Public Health. 2008;41(6):427-433.
DOI: https://doi.org/10.3961/jpmph.2008.41.6.427
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AbstractAbstract PDF
OBJECTIVES
This study was performed to assess the association between physical activity and the clustering of metabolic abnormalities among Korean children. The effect of substituting moderate to vigorous physical activity for the time spent in inactivity was examined as well. METHODS: The study subjects were comprised of 692 (354 boys, 338 girls) 4th grade elementary school students. We used a modified form of the physical activity questionnaire that was developed in the Five-City Project. The subjects with clustering of metabolic abnormalities were defined as having two or more of the following five characteristics: waist circumference > or =90 %, systolic or diastolic blood pressure > or =90 %, fasting glucose > or =110 mg/dl, triglycerides > or =110 mg/dl and HDL cholesterol < or =40 mg/dl. We calculated the odds ratios to assess the effect of substituting moderate to vigorous physical activity for time spent in inactivity. RESULTS: The risk of clustered metabolic abnormalities was inversely correlated with the increased time spent on moderate to vigorous physical activity, but the correlation was not significant. The odds ratio for clustering of metabolic abnormalities that represented the effect of substituting moderate to vigorous physical activity for 30minutes of sedentary activity was 0.87 (95% CI=0.76-1.01). CONCLUSIONS: These findings suggest that substituting moderate to vigorous physical activity for sedentary activity could decrease the risk of clustered metabolic abnormalities.
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  • Association between sedentary behavior, screen time and metabolic syndrome among Chinese children and adolescents
    Xue Cheng, Qiya Guo, Lahong Ju, Weiyi Gong, Xiaoqi Wei, Xiaoli Xu, Liyun Zhao, Hongyun Fang
    BMC Public Health.2024;[Epub]     CrossRef
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    Mi-Ae You, Youn-Jung Son
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Research Support, Non-U.S. Gov't
The Association Between Circulating Inflammatory Markers and Metabolic Syndrome in Korean Rural Adults.
So Yeon Ryu, Ki Soon Kim, Jong Park, Myeng Guen Kang, Mi Ah Han
J Prev Med Public Health. 2008;41(6):413-418.
DOI: https://doi.org/10.3961/jpmph.2008.41.6.413
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AbstractAbstract PDF
OBJECTIVES
This study was performed to investigate the associations between the metabolic syndrome (MetS) and inflammatory markers. METHODS: This cross-sectional analysis was performed using data from 1578 Koreans aged 40-69 years residing in a rural area. We investigated associations between MetS and circulating high sensitivity C-reactive protein (hs-CRP), white blood cells (WBC) and adiponectin. MetS was defined using the criteria proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). RESULTS: Increased WBC counts and hs-CRP levels and decreased adiponectin levels were observed in subjects with MetS. WBC, hs-CRP and adiponectin levels linearly deteriorated with an increase in the number of MetS components (all ptrend <0.005). Finally, adjusted odds ratios (ORs) for the risk of MetS by increase/decrease in 3 inflammatory markers were calculated by multivariate logistic regression analyses. In terms of changes in inflammation markers, in men, the adjusted ORs (95% confidence interval) were 1.15 (1.01-1.31) for WBC, 1.64 (1.02-2.64) for hs-CRP, and 0.19 (0.08-0.45) for adiponectin, whereas corresponding adjusted ORs (95% CIs) in women were 1.27 (1.15-1.40), 0.98 (0.67-1.42), 0.09 (0.04-0.18), respectively. CONCLUSIONS: Serum adiponectin levels and WBC counts were found to be strongly associated with MetS in both sexes. However, hs-CRP lost its significance after adjusting for BMI and other inflammatory markers in women. This study shows that inflammatory response is associated with MetS in the Korean population. Further prospective studies are necessary to confirm the contribution made by inflammatory markers to the development of MetS.
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English Abstracts
Syndromic Surveillances based on the Emergency Department.
Joon Pil Cho, Young Gi Min, Sang Cheon Choi
J Prev Med Public Health. 2008;41(4):219-224.
DOI: https://doi.org/10.3961/jpmph.2008.41.4.219
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AbstractAbstract PDF
Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only for the early detection of bioterrorism but also for more effective public health responses to disease.
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  • ISS-An Electronic Syndromic Surveillance System for Infectious Disease in Rural China
    Weirong Yan, Lars Palm, Xin Lu, Shaofa Nie, Biao Xu, Qi Zhao, Tao Tao, Liwei Cheng, Li Tan, Hengjin Dong, Vinod K. Diwan, Alessandro Vespignani
    PLoS ONE.2013; 8(4): e62749.     CrossRef
  • Analysis of the Korean Emergency Department Syndromic Surveillance System: Mass Type Acute Diarrheal Syndrome
    Shin Ahn, Jae Ho Lee, Won Kim, Kyung Soo Lim
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Serum Ferritin and Risk of the Metabolic Syndrome in Some Korean Rural Residents.
So Yeon Ryu, Ki Soon Kim, Jong Park, Myeng Guen Kang, Mi Ah Han
J Prev Med Public Health. 2008;41(2):115-120.
DOI: https://doi.org/10.3961/jpmph.2008.41.2.115
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AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). METHODS: We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings: elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. RESULTS: The MS was more common in those persons with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval ; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. CONCLUSIONS: Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.
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    Eli Mohapatra, Ritu Priya, Rachita Nanda, Suprava Patel
    Journal of Family Medicine and Primary Care.2020; 9(7): 3458.     CrossRef
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    Hea Shoon Lee, Eunmi Park
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  • Ferritin, metabolic syndrome and its components: A systematic review and meta-analysis
    Milton Fabian Suárez-Ortegón, Eduardo Ensaldo-Carrasco, Ting Shi, Stela McLachlan, José Manuel Fernández-Real, Sarah H. Wild
    Atherosclerosis.2018; 275: 97.     CrossRef
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    Chizumi YAMADA, Noriaki KISHIMOTO, Nobushige YUKUMATSU, Asami TAKEDA, Tamae OGATA, Emiko KIKUCHI, Emiko KURODA, Shigeyuki MOTEGI, Naoaki ISHII, Yasuhiro NISHIZAKI
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  • The Association of Serum Ferritin and Metabolic Syndrome and Metabolic Syndrome Score in Korean Adults
    Hyun Yoon, Jae Seong Go, Kang Uk Kim, Keon Woo Lee
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    Sachin Bongale, Yeshwanth G, Nagaraja V T
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  • Ferritin levels and risk of metabolic syndrome: meta-analysis of observational studies
    Victoria Abril-Ulloa, Gemma Flores-Mateo, Rosa Solà-Alberich, Begoña Manuel-y-Keenoy, Victoria Arija
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    Won-Hoon Jeong, Bok-Hee Jin, Eun-Hee Hwang
    Journal of the Korean Society of Food Science and Nutrition.2012; 41(2): 205.     CrossRef
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    Soo Hyun Cho
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    So Yeon Ryu, Ki Soon Kim, Jong Park, Myeng Guen Kang, Mi Ah Han
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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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AbstractAbstract 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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  • Associations of serum carotenoids with cardiovascular disease mortality among patients with metabolic dysfunction‐associated steatotic liver disease
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    Manash Pratim Pathak, Kalyani Pathak, Riya Saikia, Urvashee Gogoi, Pompy Patowary, Pronobesh Chattopadhyay, Aparoop Das
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The Relationship between Metabolic Syndrome and Korean Cardiocerebrovascular Risk Assessment: for Male Researchers in a Workplace.
Jongwan Yoon, Kyungjin Yi, Janggyun Oh, Sangyun Lee
J Prev Med Public Health. 2007;40(5):397-403.
DOI: https://doi.org/10.3961/jpmph.2007.40.5.397
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AbstractAbstract PDF
OBJECTIVES
The prevalence of metabolic syndrome has recently increased. Payments from the Korea Labor Welfare Corporation for compensation for mortality in workers caused by cardiovascular and cerebrovascular diseases have also increased in Korea in recent years. The association of metabolic syndrome and cardiocere brovascular disease has been investigated by several researchers in recent studies. This study was conducted in an attempt to characterize the relationship between metabolic syndrome and Korean cardiocerebrovascular disease risk assessment, and to provide basic data to group health practices for the prevention of cardiocere brovascular disease. METHODS: Health examinations were previously conducted for 1526 male researchers at a private laboratory. The prevalence by age and the odds ratio of metabolic syndrome scores into the "cardiocerebrovascular risk group" (sum of low, intermediate, and high risk groups) of the Korean cardiocerebrovascular disease risk assessment were assessed, in an effort to elucidate the associations between metabolic syndrome and cardiocere brovascular disease risk assessment. RESULTS: The prevalence of metabolic syndrome and inclusion in the cardiocerebrovascular risk group was 11.7% and 22.1% respectively. The severity of metabolic syndrome and cardiocerebrovascular risk assessment showed that individuals in their 40's and 50's were at higher risk than those in their 30's (p<0.001). The age-adjusted odds ratio of metabolic syndrome to cardiocere brovascular risk group inclusion was 5.6. CONCLUSIONS: An active prevention program for cardiocerebrovascular disease needs to begin in the 40's, as the prevalence of metabolic syndrome and the risk group of cardiocerebrovascular risk assessment peak in the 40's age group. The odds ratio between metabolic syndrome and the cardiocerebrovascular risk group was high, which indicates that metabolic syndrome scores should be utilized as guidelines during the consultation and behavioral modification program for the workplace prevention of cardiocerebrovascular diseases in group health practices.
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Original Articles
Prevalence of Metabolic Syndrome and Waist Circumference Estimation in Some Korean Adults.
Young Seoub Hong, Byoung Gwon Kim, Baek Geun Jeong, Yong Woo Park, Jong Tae Park, Kap Yeol Jung, Joon Youn Kim
J Prev Med Public Health. 2004;37(1):51-58.
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AbstractAbstract PDF
OBJECTIVE
The purpose of this study was to estimate the prevalence of metabolic syndrome, as defined by the ATP III report, in some Korean adults and use the Asian-Pacific proposed waist circumference to investigate waist circumference in some Korean adults using ROC curves. METHODS: Study subjects were seventy-five thousands and ninety one persons (47, 979 men and 27, 111 women) who were selected among the patients who visited hospital for health evaluation from January 2000 to December 2001. All subjects were measured by height, weight, waist and hip circumferences, blood pressure and blood chemistry (lipid profile). RESULTS: The mean age was 41.6+/-8.5 years in men, 41.1+/-10.4 years in women (p< 0.05). Body mass index was in the normal range in 35.3% of men, and 55.9% of women. In both men and women, blood pressure, blood sugar, total cholesterol and triglyceride were positively correlated with BMI. waist circumference, and Broca's index (p< 0.01). However HDL. choloesterol was correlated negatively (p< 0.01). Using ROC curve, the calculated waist circumferences were 84 cm in men (sensitivity 61.4% and specificity 64.1%) and 74 cm in women (sensitivity 65.0% and specificity 73.2%). The age adjusted prevalences of the metabolic syndrome as defined by NCEP ATP III were different for men (6.4%) and women (14.6%). The prevalence increased from 1.2% among participants aged 20 through 29years to 15.0% among participants aged over 60years in men (p< 0.05) and from 1.6% to 27.4% respectively, in women. The age adjusted prevalences, as defined by using the waist circumference that was recommended by WHO's regional office for the western Pacific, were 10.6% in men and 18.5% in women. The age adjusted prevalences, as defined by using the waist circumference that was calculated by the ROC curves, were 17.1% in men and 22.4% in women. And All prevalences were increased following increased BMI and Broca's index. CONCLUSIONS: The prevalence of metabolic syndrome in some Korean adults was lower than that in western adults. Nevertheless because waist circumference was differed among race and region, application of the same criteria was not proper. Morcover, a higher awareness was required in women, because the prevalence of metabolic syndrome was rapidly increased with increment of age.
Summary
Cause of Enterohemorrhagic Escherichia coli Infection in Ulju County, Korea.
Geun Ryang Bae, Sang Won Lee, Byung Guk Yang, Bok Kwon Lee, Jae Gu Park, Byeong Hun Hwang, Hyun Sul Lim
Korean J Prev Med. 2003;36(1):77-84.
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OBJECTIVES
Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
Summary
A Survey of the Prevalence of Rubella Antibodies in Teachers of Child Bearing Age on Cheju Island .
Jong Myon Bae, Hyun Jong Yang, Seong Chul Hong
Korean J Prev Med. 2000;33(3):280-284.
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AbstractAbstract PDF
BACKGROUND
Congenital rubella syndrome (CRS) can be controlled by vaccination. Because rubella is typically a childhood disease, occurring predominantly in the 5 to 14 year age group, female school teachers may be a high-risk population for CRS. CONCLUSIONS: To determine the prevalence rate of rubella antibodies in school teachers of child bearing age. METHODS: The study population consisted of primary, middle and high school teachers of child bearing age. The subjects were aged 35 years and younger, and consented to immunoglobulin (Ig) level testing using the ELISA method. RESULTS: The positive rate of IgG was 77.9% in the study subjects (n=314). Sixty-three teachers (21.4%) were susceptible to rubella infection. Thirty-seven teachers (11.8%) had a history of rubella vaccination. Among the female teachers with no vaccination history, the proportion of negative IgM and IgG was 21.7%, and the proportion of positive IgM was 2.9%. Seventy-nine percent of the study subjects did not know that they should not become pregnant for three months after receiving the rubella vaccine. CONCLUSION: School teachers of child bearing age should be considered a high risk group for CRS, and should be vaccinated if they are found to be seronegative.
Summary
Prevalence and Risk Factors of Myofascial Pain Syndrome on School Boys.
Duck Soo Kim, Hyun Sul Lim, Jong Min Lee
Korean J Prev Med. 2000;33(2):184-192.
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AbstractAbstract PDF
OBJECTIVES
To inquire the prevalence and the risk factors for myofascial pain syndrome (MPS) on young boys in order to use these results as the fundamental data for the prevention of their MPS. METHODS: For 7 days in May 1999, this research was taken on 489 male students ranging from 6th to 12th grade. We randomly selected a class for every group and from these classes we operated physical examinations, self-reported questionnaires and from a rehabilitation doctor, MPS test was taken. Thoracic kyphosis and lumbar lordosis were also taken by using the inclinometer. We defined MPS as a regional pain complaint, palpable taut band that is painful on compression. RESULTS: The shoulder MPS prevalence of the subjects were 29.7 persons/100 persons. The statistics revealed that as grades went up, the percentage significantly increased in the MPS prevalence. As of case-control study, 145 students who were tested postive in all aspects were placed as cases, and 176 students who were perfectly normal as controls on risk factors. As a result of comparing the student groups who were satisfied with their chairs to the student groups were not satisfied, the latter showed a significantly higher odds ratio (p<0.01). By the multiple logistic regression test, we concluded that the MPS disease was prevailed far more in the students in the higher grades (Odds ratio: 1.16, 95% C.I.: 1.03-1.31), and also those who were dissatisfied with their chairs than in the ones who were satisfied (Odds ratio: 1.92, 95% C.I.: 1.17-3.17). CONCLUSIONS: Significant correlations showed between the MPS diagnosed group and the students who are dissatisfied with their chairs. As a result, more research and observation has to be made concerning this disease, and the desks and chairs should be adjusted to suit the student? physical standards.
Summary
Relationship between Life Style, the Level of Stress and Irritable Bowel Syndrome on 1498 Male White Collars.
Jong Ryul Kim, Sang Hwa Urm, Jin Ho Chun, Soo Jin Jeong, Chang Hee Lee, Kui Won Jeong, Soon Seok Choi, Ki Taek Pee
Korean J Prev Med. 1997;30(4):791-804.
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AbstractAbstract PDF
Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group(41.8+/-14.2) than symptom-free group(34.6+/-12.6). As the result of comparison between the two groups, heavier smoking (adjusted OR=2.48, 95% CI 1.81-3.41), longer daily working time (adjusted OR=5.19, 95% CI 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted OR=1.87, 95% CI 1.44-2.45), higher body mass index (adjusted OR=1.80, 95% CI 1.27-2.57), and higher level of stress (adjusted OR=2.81, 95% CI 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted OR=0.38 95% CI 0.21-0.70), 3-4 times exercise per week (adjusted OR=0.57 95% CI 0.39-0.83), and tenure more than 20 years (adjusted OR=0.25 95% CI 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.
Summary
Association between Myofascial Pain Syndrome and the Assessment of Pain and the related Function tests in female telephone directory assistance operators using BDT.
Sang Chul Roh, Soo Jin Lee, Jae Cheol Song, Hung Bae Park
Korean J Prev Med. 1997;30(4):779-790.
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AbstractAbstract PDF
The Association between myofascial pain syndrome and some tests was assessed in a cross-sectional study of 904 female telephone operators using video display terminals(VDTs). 105 cases were diagnosed as Myofascial pain syndrome with symptom questionnaire, laboratory examination and physician's physical examination and 550 controls were defined to show only musculoskeletal symptoms using NIOSH symptom criteria. Data on demographics, musculoskeletal symptom and visual analogue scale(VAS) were obtained by questionnaire. Anthropometric measurements, pressure pain threshold, Grip and Pinch strength and laboratory test were conducted. No significant difference between case and control at comparing of demographics, occupational history and body measurements were observed. But, Grip strength, pressure pain threshold and VAS showed the statistical difference between case and control. Age, pressure pain threshold of Rt. Upper trapezius and VAS were associated with myofascial pain syndrome in multivariate logistic regression analysis. This results suggest that, to diagnose of myofascial pain syndrome, the consideration of the objective aspects among patients' subjective symptom complaints through the VAS and pressure pain threshold is required.
Summary
A Seroepidemiologic Study on Rubella Antibody in Pregnant Women in Kyonggi Do.
Moran Ki, Boyoul Choi, Young Jeon Shin, Hung Bae Park, Bae Joong Youn, Joong Surk Hahn
Korean J Prev Med. 1997;30(2):279-292.
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AbstractAbstract PDF
The vaccinations of susceptible children and postpubertal females are the major means to prevent congenital rubella syndrome(CRS). Another means for reducing the CRS is therapeutic abortion or fetal monitoring for women who are infected in the first four months of pregnancy. We couldnt estimate the incidence of CRS in Korea, because there was no surveillance system for rubella and CRS. Nationwide vaccination program for 15months infant had been started early 1980s. So, most women at childbearing age during study period were not received rubella vaccination. We set forth CRS management system for pregnant women in two rural county of Kyonggi province, Korea. In this system, the presence of rubella IgG and IgM antibodies for early pregnant women were examined with MEIA(Microparticle Enzyme Immunoassay) method by IMx automated analyzer Abbott. The infected pregnant women followed up in order to confirm their children CRS. This study was carried out from Mar.1993 to Jun.1994, and pregnant women examined were 874 persons. The results were summarized as follows. The overall positive rate of rubella IgG antibody was 94.5%(826/874). The positive rate was significantly increase as the age increased, and reached 100% in pregnant women who were over 35 years old. This results suggest that a meaningful number of women are infected during childbearing years. The geometric mean titer of IgG of sero-positive subjects was significantly declined as the age increased. On the question about history of URI symptoms and rash in pregnancy, 20.7% of respondents checked on URI symptoms with rash, 13.5% only URI symptoms without rash, and 65.8% no symptoms. However there was no demonstrable association between the rubella like infection history in pregnancy and the rubella IgG and IgM antibody status. Rubella infection rate in pregnant women was 0.9%(95% CI 0.4-1.8%). Two of these 8 infected pregnancies were terminated by therapeutic abortion. One of them was not followed. Five babies had no gross anomalies at birth. In Dec.1996, three of five babies were normal appeared infants. Two of them were not followed. Throughout this study results, we confirmed the need of CRS management system for pregnant women, in Korea.
Summary
Sick Building Syndrome and the Related Factors in Office Workers.
Jae Joong Bak, Soo Hun Cho, Byung Ju Park, Dae Hee Kang
Korean J Prev Med. 1997;30(1):157-170.
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AbstractAbstract PDF
A cross-sectional study was conducted to investigate the prevalence and risk factors for symptoms associated with sick building syndrome in four office buildings located in Seoul. Information on personal factors, job-related factors, and medical history were collected using self-administered questionnaires modified from the National Institute for Occupational Safety and Health Indoor Air Quality questionnaire in 321 office workers in these buildings. The prevalence of general and irritant symptom groups was higher than the prevalence of dermatologic and respiratory symptom groups. Daily total work time, work time in the office, and work time with video display terminals(VDT) were identified as the risk factors for symptom groups associated with sick building syndrome by multiple linear logistic regression analysis. In conclusion, these results indicated that the symptom prevalence in this study is similar with the results reported from previous studies conducted in other countries and work time and work with VDT are related to sick building syndrome in Korea.
Summary
Carpal Tunnel Syndrome among workers in a condom industry.
Joong Koo Kang, Do Myung Paek, Young Jung Lee, Hyeo Il Ma, Mi A Song, Hong Ki Lee, Jung Keun Choi
Korean J Prev Med. 1996;29(3):507-520.
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AbstractAbstract PDF
The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Summary
Combined Effect of Vibration Intensity, Grip Temperature, Noise and Pushing Power on Grip Forces and Skin Temperatures of Fingers.
Kyungsim Koh, B Griefahn, M Fritz, P Brode
Korean J Prev Med. 1994;27(4):763-776.
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AbstractAbstract PDF
Recent studies reveal that grip forces during the hand-arm vibration are most significant for the genesis of vibration-induced white finger syndrome. Therefore, exerted grip forces and skin temperatures or fingers were regarded as dependent variables in experiments and the effects of grip temperature, noise, pushing force, vibration and the combined effect of vibration and pushing force were studied. The objectives or the present study were, first, to varify and compare the changes of grip force affected by grip temperature, noise, pushing force, vibration and the combined effect of vibration and pushing force and, second, to observe the reaction of finger skin temperature affected by above factors. Forty-six healthy male students(25.07+/-2.85) participated in five systematically permuted trials, which endured 4 minutes each other. Experiments were executed in a special chamber with an air temperature of 21 C. In each experiments, the subjects were exposed to five experiment types: (l) grip force of 25 N only, (2) pushing force of 50 N, (3) acceleration of vibration 7.1m/sec2(z-direction), (4) pink noise or 95 dB(A) and (5) combination of pushing force 50 N and acceleration of vibration 7.1m/sec2. A repeated-measures analysis of variance(ANOVA) was performed on the grip force to test whether it was affected by noise, pushing force, vibration and pushing force. The present results show that vibration was significantly related to the increase of grip force, but the other factors, such as pushing force, noise and grip temperature had no significant influence on the increase of grip force and that the reaction of finger skin temperature were significantly affected by the skin temperature at start of experiment and grip temperature, not grip force and other experimental conditions. Therefore, we suggest that the management for decreasing the grip force is meaningful to prevent the occurrence of Hand-arm vibration syndrome (HAVS).
Summary
Cost-Benefit Analysis on Rubella Vaccination Policy.
Young Jeon Shin, Bo Youl Choi, Hung Bae Park, Ok Ryun Moon, Bae Joong Yoon
Korean J Prev Med. 1994;27(2):337-365.
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AbstractAbstract PDF
Rubella is a viral disease with mild constitutional symptoms and generalized rashes ln childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K's and Sweden's. In this study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births): The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infection amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won(American style). The cost for vaccination of female children at fifteen was about 339 million won (British style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9billion won (Swedish style). 3. The benefit to cost ratios of vaccination or female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80 % population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen(British style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program or revaccination, the benefit to cost ratios were 3.6(80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient 6. In sensitively analysis with different discount rates (4% or 7%) and different incidence rates of congenital rubella syndrome (l0 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.
Summary
A Survey on Physical Complaints Related with Farmers' Syndrome of Vinylhouse and Non-vinylhouse Farmers.
Ju Young Lee, Jung Han Park, Doohie Kim
Korean J Prev Med. 1994;27(2):258-273.
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AbstractAbstract PDF
To compare the physical complaints of vinylhouse farmers with those of non-vinylhouse farmers, a personal interviews on 250 and 142 vinylhouse farmers were conducted in Sungjoo county in Kyungpook province selected by a random sampling from July 5 to July 10, 1993. Blood pressure of the subjects was also measured. Vinylhouse farmers had a higher average age, larger family size, shorter experience of farming, more working hours per day and working days per year and higher annual income than non-vinylhouse farmers. The frequency of preticide spray of the vinylhouse farmer was 3.4times on the average in June 1993 as compared with 2.0 times of non-vinylhouse farmers, and 16.7 times for the vinylhouse farmers during the last one year while it was 8.3 times for the non-vinylhouse farmers in the same period. While 39.6% of vinylhouse farmers experienced pesticide intoxication symptoms such as headache, nausea, vomiting, dizziness, itching, and skin irritation, etc. during the month of June, 25.4% of non-vinylhouse farmers experienced such symptoms. The most frequent symptoms among eight symptoms that constitute the farmers' syndrome were lumbago, numbness of hand or foot shoulder pain and dizziness regardless of sex and type of farming. Prevalence of the farmers' syndrome in male and female among vinylhouse farmers were 22.1%, 43.4%, respectively, and the prevalence in non-vinylhouse farmers was 23.2% for male and 50.7%for female. There was no statistically significant difference in the prevalence of farmers' syndrome between vinylhouse and non-vinylhouse farmers. However, The prevalence on female was about 2 times higher than that of male When the effects of other factors were adjusted by multiple logistic regression for farmers' syndrome, the prevalence in female was 3.0 times higher than that of male. The prevalence of farmers' syndrome was increased as the age of farmers increased on both vinylhouse and non-vinylhouse farmers, and adjusted odds ratio of farmers' syndrome increased by 3% as the age increased by 1 year Adjusted odds ratio of Farmers' syndrome in farmers who experienced pesticide intoxication during the month of June was 3.7times higher than that of farmers who did not have such experience. While the prevalence of hypertension in male and female non-vinylhouse farmers were 22.4%, 13.7%, respectively, the prevalence in vinylhouse farmers were 13.5% for male and 12.0% for female. However, there was no association between farmers' syndrome and hypertension. It was found in this study that the vinylhouse farmers are at a high risk of pesticide intoxication, which is associated with the common physical complaints. To reduce such risk it is necessary to develop farming methods which do not require the pesticide of may use less pesticide, a safer method of pesticide spraying, and the protective equipments which can be worn at a high temperature and have a better protective effect. Also education of farmers for the correct methods of ventilation after pesticide spraying in the vinylhouse and wearing the protective equipments may be considered as a supportive method. Since inappropriate posture at work and intensive labor may cause farmers' syndrome, it is recommended to develop farming tools which reduce physical burden and take a rest and exercise periodically during work. It is necessary to strengthen the hypertension management program of the Kyungpook province, because the prevalence of hypertension was as high as about 15%.
Summary
The epidemiologic study of farmers' syndrome in Chonnam province.
Gang Moon, Jin Su Choi, Seok Joon Sohn, Byong Woo Kim
Korean J Prev Med. 1993;26(3):321-331.
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AbstractAbstract PDF
This survey was conducted to investigate Farmers' Syndrome and its related factors in Chonnam province. 5,920(men 6,148, women 6,722) persons in urban area and 12,870(men 6148, women 6,722) persons in rural area were selected in stratified cluster sampling manner, and interviewed individually with structured questionnaire in April, 1992. The results were summarized as follows: 1. In rural area of Chonnam province, the prevalence of Farmers' syndrome positive was 283 per 1,000 persons(203 in male, 355 in female). In urban area of Chonnam province, control area, the prevalence of Farmers' syndrome positive was 113(72 in male, 145 in female). The prevalence of Farmers' syndrome positive in rural area was 2.5 times higher that of urban area, and the prevalence in female was 1.7 times higher than that of male. The prevalence in total respondents was 256. 2. In rural area of Chonnam province, the age standardized prevalence of Farmers' syndrome positive was 209 per 1,000 persons(140 in male, 267 in female). In urban area of Chonnam province, control area, the age standardized prevalence of Farmers' syndrome positive was 122(79 in male, 158 in female). The age standardized prevalence in total respondents was 194. 3. The associated factors with Farmers' syndrome in univariate analysis were having illness during recent 15 days ,age, sex, occupation, area, monthly income, education, medical security status, family size and duration of farming. 4. When applying multiple logistic regression for Farmers' syndrome, the significant variables were having illness during recent 15 days, area, sex, age, education, medical security status, family size and duration of farming.
Summary
Carpal Tunnel Syndrome among Packing Workers in A Rayon Manufacturing Factory.
Won Jin Lee, Eun Il Lee, Chul Whan Cha
Korean J Prev Med. 1992;25(1):26-33.
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AbstractAbstract PDF
The carpal tunnel syndromes is one of the most common peripheral nerve entrapment syndromes. The typical symptoms are pain, numbness and paresthesia in the median nerve territory of the hand. Recently, it is widely recognized that occupational factor is regarded as the important cause of the carpal tunnel syndrome. Clinical study is performed in the 42 female workers who is repetitively working at packing department in a rayon manufacturing factory from November 1991 till March 1992. The study included a questionnaire, physical examinations, and the neurophysiological test. The summary of the results obtained was as follows: 1. Among 42 packing workers, 9 workers(21.4%) were diagnosed as carpal tunnel syndrome by electromyography. The affected side was bilateral in 4 workers(9.5%), right in 4 workers(9.5%), and left in one worker(2.4%). 2. Among 42 subjects, 28 workers(66.7%) complained the clinical symptoms related to carpal tunnel syndrome, 11 workers(26.2%) showed positive Phalen sign, and 7 workers(16.7%) showed positive Tinel sign. 3. Researchers regard electromyographic finding as the gold standard for diagnosis of carpal tunnel syndrome. The sensitivity and specificity of the clinical symptoms to diagnose the carpal tunnel syndrome were 0.89, 0.39 respectively. If the carpal tunnel syndrome is diagnosed by the combination of the positive findings of the symptoms and the physical examinations, either Tinel of Phalen sign, the sensitivity and specificity were 0.67 and 0.76 respectively. Considering above results, though this small number of worker is not adequate for epidemiologic conclusions, carpal tunnel syndrome seems to be an important occupational disorder among packing workers in a rayon manufacturing factory.
Summary
A study on the factors afecting the subjective symptoms of VDT syndrome.
Jai Dong Moon, Min Chul Lee, Byong Woo Kim
Korean J Prev Med. 1991;24(3):373-389.
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AbstractAbstract PDF
In order to develop the measuring tool of VDT syndrome and investigate the variables affecting the development of VDT syndrome, a questionnaire study accompanied with the evaluation of working environment was performed with 138 VDT users from six public organs in Kwangju area. The result were summarized as follows: 1. As a result of analysis with data collected by newly developed questionnaire, VDT syndrome included five factors named as eye-related component, psychological component, general body component, musculoskeletal component, and skin-related component and the estimates of the internal consistency of five factors were 0.877, 0.820, 0.796, 0.791, 0.593 respectively. 2. Variables affecting the level of eye-related symptoms were the type of main job using VDT, the total time of VDT operation per day, and the use of external filter on CRT. 3. The level of eye-related symptoms in the group using external filter was higher significantly than that in the group not using filter. 4. The past history of severe illness affected the level of psychological symptoms significantly. 5. Variables affecting the level of general body symptoms were job satisfaction and income satisfaction. 6. Variables affecting the level of musculoskeletal symptoms were the type of main job using VDT, whether majored in EDPS, the level of typewriting, job satisfaction, and the total time of VDT, operation per day. 7. Age and the use of external filter were significantly related to the level of skin-related symptoms. 7. Age and the use of external filter were significantly related to the level of skin-related symptoms.
Summary

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