Does the Severity of Type 2 Diabetes Affect Yearly Diabetic Retinal Examination?: A Cross Sectional Analysis of the Korea National Health and Nutrition Examination Survey 2013-2015

Background: The purpose of this study was to analyze how the severity of type 2 diabetes impacts the prevalence of diabetic retinal examinations, to explore the prevention of microvascular complications and to clarify the factors associated with yearly eye examinations in diabetes patients. Methods: This was a cross-sectional study. We chose 11 factors related to type 2 diabetes patients, including hemoglobin A1c (HbA1c), age, education level, income level, and comorbidity with hypertension. We used the chi-square test and logistic regression to analyze these factors according to whether or not patients had undergone fundus examination. Results: After adjustment for covariates, we found no significant relationship between severity of type 2 diabetes and yearly diabetic retinal examinations. However, patients with severely uncontrolled type 2 diabetes (HbA1c≥10%) tended to undergo more diabetic retinal examinations than other groups. Additionally, individuals with lower levels of education were found to be significantly less likely to have a fundus examination, while patients with hypertension tend to more likely to undergo yearly diabetic retinal examinations. Conclusion: Patients with uncontrolled type 2 diabetes do not undergo more yearly diabetic retinal examinations than patients with controlled type 2 diabetes (HbA1c＜7%). Physicians should educate patients with severely uncontrolled type 2 diabetes on the importance of yearly retinal screening. Physicians and policy makers should also strongly recommend yearly eye examinations for diabetic patients who smoke, have lower levels of education, or have comorbidity with hypertension

Association of Coffee Consumption and Estimated Glomerular Filtration Rate in Middle-Aged Koreans without Renal Impairment: The Korea National Health and Nutrition Examination Surveys 2013-2014

Background: Previous studies have suggested that anti-inflammatory and anti-oxidative effect of caffeine has an influence on renal function. However, the effect of coffee consumption on estimated glomerular filtration rate (eGFR) without renal impairment has not been investigated. The aim of this study was to evaluate the association between coffee consumption and eGFR in middle-aged Koreans without renal impairment using data from a representative nationwide survey. Methods: This was a cross-sectional study conducted in Koreans aged 45 to 64 years, who enrolled for the sixth Korea National Health and Nutrition Examination Surveys 2013–2014. The participants were classified into three groups based on the amount of coffee consumption as reported on the food frequency questionnaire: (specify) category 1, 2, and 3. eGFR calculated using the Modification of Diet in Renal Disease equation was used for evaluation of kidney function. Results: In all the three categories of daily coffee consumption, eGFR showed a significant increase with the increase in coffee consumption in middle-aged Korean women (P=0.006). However, no such trend was observed in middle-aged Korean men. In middle-aged women, eGFR increased significantly in individuals consuming ≥2 cups per day, compared with those consuming <1 cup per day, after adjusting for other compounding factors (β=2.614, P=0.041). Conclusion: Coffee consumption and estimated glomerular filtration rate showed a significant positive relationship only in middle-aged Korean women consuming ≥2 cups coffee per day

The Association Between Esomeprazole And Pneumonia In The Elderly

Background: Proton pump inhibitors (PPIs) are widely and routinely used to treat gastric acid-related disorders, such as gastroesophageal reflux disease (GERD) and peptic ulcer disease, in both inpatient and outpatient settings. Moreover, due to the characteristics of the elderly, GERD is one of common geriatric diseases, and then PPIs could be prescribed more frequently and longer in the elderly. Thus, in this study, the association between esomeprazole use and the prevalence of pneumonia has been evaluated in the elderly. Methods: From the National Health Insurance Service-National Sample Cohort database of Korea from 2007 to 2010, the elderly were selected and separated into subgroups according to the gender (female vs. male) and GERD (GERD vs. non-GERD). Also, esomeprazole was divided into two groups according to the daily dose; ＜40 mg and ≥40 mg. Then, the subjects were subdivided according to the duration of esomeprazole treatment; 1 week, 2 weeks, 3 weeks, 30 days and ≥31 days. Logistic regression was also performed to identify the association between duration of esomeprazole administration and pneumonia. Results: The total of 4,091 elderly subjects were selected. However, the association between the use of esomeprazole and the prevalence of pneumonia had been failed to show a significant association (in ＜40 mg esomeprazole group P=0.698, 0.504, 0.961 and 0.682 respectively; in ≥40 mg esomeprazole group, P=0.348, 0.846, 0.01and 0.713 respectively) Conclusion: The esomeprazole use was not associated with the prevalence of pneumonia in the elderly.ope

노화방지를 위한 성장 호르몬 치료 (허와 실 그리고 향후 방향)

ope

Smoking and its Relationship with Sarcopenia: Result from the 2008-2011 Korean National Health and Nutrition Examination Survey

Background: This study investigated whether smoking defined as smoking status and smoking level is associated with sarcopenia after the age of 50 years by sex using data from the Korea National Health and Nutrition Examination Survey. Methods: The total number of subjects in this analysis was 8,622. Participants were queried on smoking status (current, past, never) and smoking level (light, ≤11.3 pack-years; medium, ＞11.3–24.5 pack-years; heavy, ＞24.5 pack-years). Sarcopenia was evaluated by dividing the body weight by the appendicular skeletal muscle mass (ASM/Wt). Logistic regression analysis was performed to examine the association between sarcopenia and smoking, after adjusting for potential confounders. Results: Smoking status was not associated with sarcopenia in men and women, but smoking level and sarcopenia were significantly related in women. After adjusting for confounding factors, the multivariate-adjusted odds ratio (95% confidence interval) of sarcopenia in smokers was 0.383 (0.153–0.964) in the medium smoking group of women, and 3.456 (1.542–7.742) and 3.052 (1.292–7.207) in the heavy smoking group of women. Conclusion: Therefore, our study identified smoking as a reversible and independent risk factor for sarcopenia and smoking defined by smoking level such as pack-years might be an appropriate definition from a sarcopenia perspective

Association between Carotid Intima-Media Thickness, Brachial-Ankle Pulse Wave Velocity and Carcinoembryonic Antigen in Female Non-smokers

ope

Do Benign Pancreatic Cysts Increase the Incidence Risk of Pancreatic Cancer?: For Korean Aged over 40 Years

Background: Whether pancreatic cysts such as mucinous cystic neoplasm and intraductal papillary mucinous neoplasm have malignant potential is known. However, whether patients with benign pancreatic cysts have a higher risk of pancreatic cancer (PaCa) has not been established yet. Methods: We evaluated data from the National Health Insurance Service-National Sample Cohort (2002–2006) of the Korean National Health Insurance Service. Patients with pancreatic cysts detected on computed tomography/magnetic resonance imaging were identified using the Korean Classification of Diseases, 6th Edition. Patients aged >40 years with and those without pancreatic cystic lesions were followed up until 2010 (389,777 patients). Results: During the study period, PaCa was diagnosed in 2 of 71 patients with pancreatic cysts and in 1,605 of 389,706 patients without pancreatic cyst. The incidence rates of PaCa were 2.82% and 0.41%, respectively. The hazard ratio of PaCa in all the patients with cysts was 9.839 (95% confidence interval, 2.461–39.332; P=0.0012) when compared with the rest of the patients without cysts. Conclusion: Patients aged >40 years with pancreatic cysts have a significantly higher risk of PaCa

Association between daily sunlight exposure duration and diabetic retinopathy in Korean adults with diabetes: A nationwide population-based cross-sectional study

Purpose: To investigate the association between daily sunlight exposure duration and diabetic retinopathy in Korean adults with diabetes. Methods: This study used data from the 2008-2011 Korea National Health and Nutrition Examination Survey. Overall, 1,089 patients with diabetes aged >40 years were included. The duration of daily sunlight exposure was assessed via health interviews. Comprehensive ophthalmic evaluations, including standard retinal fundus photography after pupil dilation, were conducted. Diabetic retinopathy was graded using the modified Airlie House Classification. Multivariate logistic regression analysis was performed to analyze the association between daily sunlight exposure duration and the diagnosis of diabetic retinopathy and non-proliferative diabetic retinopathy. Results: The risk of diabetic retinopathy was 2.66 times higher in the group with ≥5 h of daily sunlight exposure than in the group with less exposure after adjusting for risk factors such as duration of diabetes, serum hemoglobin A1c level, hypertension, and dyslipidemia (P = 0.023). Furthermore, the risk of non-proliferative diabetic retinopathy was 3.13 times higher in the group with ≥5 h of daily sunlight exposure than in the group with less exposure (P = 0.009). In patients with diabetes for <10 years, the risks of diabetic retinopathy and non-proliferative diabetic retinopathy were 4.26 and 4.82 times higher in the group with ≥5 h of daily sunlight exposure than the group with less exposure, respectively (P < 0.05). Conclusions: This study revealed that sunlight exposure for ≥5 h a day was significantly associated with an increased risk of diabetic retinopathy and non-proliferative diabetic retinopathy in Korean patients with diabetes. The risks were significantly higher in patients with diabetes for <10 years. Therefore, reducing daily sunlight exposure could be an early preventive strategy against diabetic retinopathy in people with diabetes.ope

Serum γ-glutamyltransferase level and metabolic syndrome in children and adolescents: Korean National Health and Nutrition Examination Survey

AIMS/INTRODUCTION: Serum γ-glutamyltransferase (GGT) is positively related to cardiometabolic diseases, such as type 2 diabetes mellitus, hypertension and metabolic syndrome (MetS), in adult populations. Our aim was to investigate whether serum GGT is independently associated with MetS and its components in a nationally representative sample of Korean children and adolescents. MATERIALS AND METHODS: The study included data from 1,618 participants (867 boys, 751 girls) aged 10-18 years from the 2010-2011 Korean National Health and Nutrition Examination Survey. MetS was diagnosed by the 2007 International Diabetes Federation criteria for children and adolescents. Participants were stratified using a cut-off value of the 75th percentile of serum GGT levels (19 IU/L for boys, 15 IU/L for girls). The odds ratios and 95% confidence intervals for MetS and its components were determined with multiple logistic regression analyses. RESULTS: The mean values of most cardiometabolic variables were significantly higher in the upper stratum. Except for low high-density lipoprotein cholesterol in boys and elevated blood pressure in girls, participants in the upper GGT stratum had significantly higher odds of MetS and its components than those in the lower stratum. The multivariate-adjusted odds ratios for MetS for the upper stratum were 5.79 (95% confidence interval 1.21-27.02) in boys and 6.20 (95% confidence interval 1.71-22.47) in girls, after adjusting for age, household income and residential area. CONCLUSIONS: Serum GGT was positively associated with MetS and its components in Korean children and adolescents. Serum GGT could be a useful measure for identifying children and adolescents with MetS.ope

Influence of Metabolic Syndrome on Brachial-Ankle Pulse Wave Velocity

Background: Metabolic syndrome (MetS) is characterized by a core set of disorders, including abdominal obesity, dyslipidemia, glucose intolerance and hypertension. Many studies have shown that MetS is associated with increased risk of developing cardiovascular diseases and related mortality. However, the relationship of MetS with early stage of cardiovascular diseases, which is even more important from a prevention prespective, has not been examined extensively. Brachial-ankle pulse wave velocity (baPWV) is known to predict future cardiovascular events. Thus, we examined the relationship of MetS, defined using the NCEP-ATP III criteria, with baPWV. Methods: We examined a total of 400 participants who did not have a past history of either coronary heart disease or peripheral vascular disease. All subjects underwent physical examination, blood chemistry, and baPWV. Results: Compared with subjects without MetS, subjects with MetS had increased age, body mass index (BMI), and ALT. Mean value of baPWV (adjusted for age, BMI, and blood pressure) was significantly higher in subjects with MetS (P=0.002). The baPWV was positively correlated with age, BMI, systolic and diastolic blood pressure in subjects with MetS. In group without MetS, the baPWV was associated with age, waist circumference, blood pressure, total cholesterol, LDL cholesterol, triglyceride, fasting blood sugar, AST, ALT, homocysteine, CRP, and ferritin. The mean values of baPWV with 0, 1, 2, 3, 4, 5 components of MetS were 1,362.3⁑182.2 cm/s, 1,531.3⁑267.0 cm/s, 1,694.1⁑315.8 cm/s, 1,777.0⁑334.0 cm/s, 2,087.7⁑192.3 cm/s, respectively. Conclusion: In this study, the MetS was associated with the risk for increased baPWV.ope