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    ๊ฑด์กฐํ™˜๊ฒฝ๊ณผ ๋„์‹œ๊ฑฐ์ฃผ์ž์˜ ๊ฑด๊ฐ•

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ๋ณด๊ฑด๋Œ€ํ•™์› ๋ณด๊ฑดํ•™๊ณผ, 2018. 2. ์กฐ์„ฑ์ผ.and the odds of atopic dermatitis increased by 1.08 (1.01 โ€“ 1.15) times if the road density increased by 13,120m2 within 300m of place of residence. For the children living on the tenth floor and higher, the prevalence of asthma and allergic rhinitis was higher for those living closer to major roads, but its effect was not consistent. Discussions In this study, the effect of urban BE measure regarding accessibility, density, and distance on walking practice and health results such as obesity and atopic eczema were analyzed by applying spatial analysis on public health monitoring data. Based on the results of analyses, the following implications were drawn: (1) the recently diminishing amount of physical activities exercised by urban residents could be significantly improved through increased neighborhood walkability, and one of the methods for improvement may increase adjusting accessibility to public transport from the place of residence(2) because obesity of urban residents is affected by neighborhood diet environment, additional intervention from the public health discipline must be considered simultaneouslyand (3) higher proximity to roads indicate higher air pollution in the neighborhood and it may trigger other health issues such as allergic reaction and atopic eczema especially for those with restricted activity perimeter, e.g., children. To sum up, adjusting access in BE will increase physical activity level, and thereby, effectively reduce noninfectious disorders such as obesity, but it may also increase the prevalence of noninfectious disorders in a certain population with vulnerability. Therefore, to improve the health issues in our cities, we must first adequately test various urban planning concepts formulated in Western urban environments and need better awareness and proactive intervention from the public health perspective.Background A neighborhood environment is comprised of a physical environment and a socioeconomic environment and influences human health in a range of ways. Within a physical environment, all the human-made surroundings are referred to as built environment (BE), and it substantially influences the health of people living in an urban setting, more so in cities with higher population density. Interests and intervention from the public health perspective on health and wellness in the BE as a remedy against communicable diseases diminished after the 19th century but began to resurface in recent years to get to the bottom of noninfectious disorders relating to physical activities. Unfortunately, most studies conducted in this area focused on increasing quantity of physical activities of the general population and the scope of dialogue needs to be much expanded to deal with various health issues and effect on a vulnerable population. In South Korea, the demographic convergence in the Seoul Metropolitan Area is on the extremely high side, making it one of the most densely populated regions in the world. Accordingly, a multilateral evaluation in public health on its BE is very important. Especially, to overcome the numerous problems materialized due to the rapid expansion of cities in the past few decades, it is imperative to deliberate urban renewal programs regarding public health. However, the previous studies verified individual environmental factors, that was evaluated in Western cities, in connection with physical activities, and most of them were in the field of urban planning. A continuous health surveillance system is indispensable to determine and evaluate health effects of BE, and it is important to first determine whether the regional data from public health surveillance system are compatible with this study. Furthermore, applying spatial analysis and geographic information system will facilitate determining the relationship between urban planning components and its public health impact in a more extensive geographical region. Objectives The purpose of this study is to explore the urban built environmental factors that affect public health through spatial analysis using regional public health surveillance data, determine correlation among those factors and present basis stemming from the public health perspective for healthy urban renewal. This study aimed to evaluate the effect of urban BE on healthy activities and health results. Applying three aspects, density, distance, and accessibility, for measuring BE out of the available 5, the following analyses were performed: Analysis 1: Correlation between accessibility to public transport and walking practices in adults Analysis 2: Correlation between fast food outlet density and prevalence of obesity in adults Analysis 3: Correlation between distance to a major roads and allergic diseases in children Methods Information on individual health behaviors and diseases prevalence was collected from public health surveillance data, more specifically, the Community Health Survey data (2011-2014, 92,357 subjects) for adults of 19 years of age or higher and the Seoul Atopy-Friendly School Survey data (2010, 24,040 subjects) for children. The built environmental factors influencing them were analyzed using a geographic information system, which required very precise location information. To achieve this, the participants of the Seoul Atopy-Friendly School Survey were geocoded on their home addresses. Those of the Community Health Survey were geocoded on regional representative location based on their type of residence (detached house, apartment) and geographically censored information of their home address at the community level (424 dongs in 2014). Of the many elements to the BE, accessibility to public transport by a community, density of top 5 fast food outlets (McDonald's, Lotteria, Burger King, KFC, Popeyes) by county, distance to major roads from residential address were used in analyses 1, 2 and 3. As for the impact of BE, walking duration (minutes) per week, obesity as defined by BMI of 25kg/m2, and prevalence of allergic and atopic diseases (atopic eczema, asthma, allergic rhinitis) were determined in each analysis. Results Accessibility to public transport and weekly walking duration had a nonlinear relationship, where the walking duration for those who lived between 1.0 to 1.5km from a subway station increased by 28.5 minutes (95% CI=16.7 - 40.2) but for those who lived 1.5km or farther away from a subway station decreased by 1.9 minutes (-19.9 โ€“ 16.1). The density of fast food outlets, when adjusted with personal and regional factors, had an insignificant correlation with obesity in a county-level (male: Odds ratio=1.01, 95% CI=0.97 โ€“ 1.05female: 1.04, 0.99 โ€“ 1.09). Because the density of fast food restaurants closely correlated with regional socioeconomic level, when the effect was determined after adjusting the financial independence of the region, there was some discrepancy between the regional socioeconomic level and gender, but overall it had an insignificant correlation with obesity. The odds of atopic eczema were higher for children living on less than 4 floors and 150m, 150-300m, and 300-500m away from a major street than those living over 500m away, respectively by 1.15 (1.01 โ€“ 1.32), 1.17 (1.03 โ€“ 1.34) and 1.16 (1.01 โ€“ 1.34) timesChapter 1. Introduction 1 Chapter 2. Built Environment and Walking Behavior 19 2-1. Introduction 20 2-2. Methods 23 2-3. Results 33 2-4. Discussion 44 References 49 Chapter 3. Built Environment and Obesity 53 3-1. Introduction 54 3-2. Methods 57 3-3. Results 62 3-4. Discussion 70 3-5. References 74 Chapter 4. Built Environment and Allergic Diseases 83 4-1. Introduction 84 4-2. Methods 87 4-3. Results 96 4-4. Discussion 105 References 112 Chapter 5. Discussions 123 Appendices 129 Abstract in Korean 133Docto

    ์‹ ์—ฌ์„ฑ์˜ ๋ฌธํ•™์  ์žฌํ˜„: ใ€Ž์—ฌ์ธ์˜ ์ดˆ์ƒใ€, ใ€Ž๊ฐ์„ฑใ€, ใ€Ž๋‚˜์˜ ์•ˆํ† ๋‹ˆ์•„ใ€๋ฅผ ์ค‘์‹ฌ์œผ๋กœ

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์‚ฌ๋ฒ”๋Œ€ํ•™ ์™ธ๊ตญ์–ด๊ต์œก๊ณผ, 2018. 2. ์‹ ๋ฌธ์ˆ˜.๋ณธ ๋…ผ๋ฌธ์€ 19์„ธ๊ธฐ ๋ง์—์„œ 20์„ธ๊ธฐ ์ดˆ๋ผ๋Š” ๋ฏธ๊ตญ์‚ฌํšŒ์˜ ๊ฒฉ๋ณ€๊ธฐ์— ์ƒˆ๋กœ์ด ๋“ฑ์žฅํ•œ ์ด๋ฅธ๋ฐ” ์‹ ์—ฌ์„ฑ์ด ๋‹น๋Œ€์˜ ๋ฏธ๊ตญ์†Œ์„ค ์†์— ์–ด๋–ป๊ฒŒ ์žฌํ˜„๋˜๊ณ  ์žˆ๋Š”์ง€๋ฅผ ์ž์•„์‹คํ˜„์„ ์ถ”๊ตฌํ•˜๋Š” ์‹ ์—ฌ์„ฑ๋“ค์˜ ๋‘๋“œ๋Ÿฌ์ง„ ๋‘ ๊ฐ€์ง€ ์ž์งˆ, ์ฆ‰ ์ž๊ธฐ์• ์— ๋ฐ”ํƒ•์„ ๋‘” ์ž๋ฆฝ์  ์ฃผ์ฒด์„ฑ๊ณผ ๋‚จ๋‹ค๋ฅธ ์ฑ…์ž„์˜์‹์— ์ดˆ์ ์„ ๋‘๊ณ  ์‚ดํŽด๋ณด๊ณ ์ž ํ•˜๋Š” ์‹œ๋„์ด๋‹ค. ์šฐ์„ , ๊ธ‰๊ฒฉํ•œ ๋ณ€ํ™”์˜ ์‹œ๊ธฐ์— ๋…๋ฆฝ์ ์ธ ์ž์•„๋ฅผ ์ถ”๊ตฌํ•˜๋ฉฐ ๊ณ ๋“ฑ๊ต์œก์„ ๋ฐ›๊ณ  ์Šคํฌ์ธ ๋ฅผ ์ฆ๊ธฐ๊ณ  ์ „๋ฌธ์ง์— ์ง„์ถœํ•ด์„œ ๊ฒฝ์ œ์  ์ž๋ฆฝ์„ ์ถ”๊ตฌํ•˜๋ฉฐ ๊ถ๊ทน์ ์œผ๋กœ ์‚ฌํšŒ๊ฐœํ˜์„ ๋„๋ชจํ•˜๋Š” ์—ฌ์„ฑ๋“ค์„ ํ”ํžˆ ์‹ ์—ฌ์„ฑ์ด๋ผ ์ง€์นญํ•  ๋•Œ, ใ€Ž์—ฌ์ธ์˜ ์ดˆ์ƒใ€์˜ ์ด์‚ฌ๋ฒจ ์•„์ฒ˜, ใ€Ž๊ฐ์„ฑใ€์˜ ์—๋“œ๋‚˜ ํฐํ…”๋ฆฌ์—, ใ€Ž๋‚˜์˜ ์•ˆํ† ๋‹ˆ์•„ใ€์˜ ์•ˆํ† ๋‹ˆ์•„์™€ ๋ ˆ๋‚˜ ๋“ฑ๊ณผ ๊ฐ™์€ ์—ฌ์„ฑ์ธ๋ฌผ๋“ค์ด ๊ณผ์—ฐ ์—„๋ฐ€ํ•œ ์˜๋ฏธ์—์„œ ์‹ ์—ฌ์„ฑ์ด๋ผ ๊ทœ์ •๋  ์ˆ˜ ์žˆ๋Š”์ง€ ๋ช…ํ™•์น˜ ์•Š์„ ์ˆ˜ ์žˆ๋‹ค. ์‚ฌ์‹ค ์ด๋Ÿฌํ•œ ๋ฌธ์ œ ์ œ๊ธฐ๊ฐ€ ๋ฐ”๋กœ ์ด ๋…ผ๋ฌธ์˜ ํ•œ๊ณ„์™€ ์˜์˜๋ฅผ ์—ญ์„ค์ ์œผ๋กœ ๋™์‹œ์— ๋…ธ์ •ํ•œ ๊ฒƒ์ด๋ผ ๋ณผ ์ˆ˜ ์žˆ๋‹ค. ์ด๋ฅธ๋ฐ” ์‹ ์—ฌ์„ฑ์ด๋ž€ ์ƒ์ง•์ ์ธ ์œ ํ˜•์œผ๋กœ ํฌ๊ด„์ ์ธ ์˜๋ฏธ์—์„œ ์Šค์Šค๋กœ๋ฅผ ๊ฐœ์กฐํ•ด๋‚˜๊ฐ€๋Š” ์˜์ง€๋ฅผ ๋ณด์ด๋Š” ํ˜„๋Œ€์ ์ธ ์ด์ƒํ˜•์„ ํ†ต์นญํ•œ๋‹ค๋Š” ๋งˆ์‚ฌ ํŒจํ„ฐ์Šจ์˜ ์ด์•ผ๊ธฐ์ฒ˜๋Ÿผ, ๋ณธ ๋…ผ๋ฌธ์ด ๋‹น์‹œ์˜ ์‹ ์—ฌ์„ฑ๋“ค์—๊ฒŒ์„œ ๊ฐ€์žฅ ์ฃผ๋ชฉํ•˜๊ณ  ์ฒœ์ฐฉํ•˜๊ณ  ์žˆ๋Š” ๊ฒƒ์€ ํŒŒ์ƒ์ ์ธ ์‚ฌํšŒํ™œ๋™๋ณด๋‹ค๋Š” ๊ทธ๊ฒƒ์˜ ๊ฐ•๋ ฅํ•œ ์œ ์ธ์ด ๋˜์—ˆ๋˜ ์‹ ์—ฌ์„ฑ์œผ๋กœ์„œ์˜ ๋ณธ๋ น, ์ฆ‰ ๋ฐ”๋กœ ์ด์ „ ์„ธ๋Œ€์˜ ์—ฌ์„ฑ๋“ค๊ณผ๋Š” ํ™•์—ฐํžˆ ๊ตฌ๋ถ„๋˜๋Š” ์ž์•„๋ฐœ์ „์„ ์œ„ํ•œ ์„ฑ์ฐฐ, ์ฃผ์ฒด๋กœ์„œ์˜ ์ž์กด๊ฐ๊ณผ ์ž๋ฆฝ์˜์ง€ ๊ทธ๋ฆฌ๊ณ  ์ฑ…์ž„์˜์‹์ด๋ผ๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋ฐ”๋กœ ์ด๋Ÿฌํ•œ ์ด์œ ๋กœ ์ด์‚ฌ๋ฒจ, ์—๋“œ๋‚˜ ๊ทธ๋ฆฌ๊ณ  ์•ˆํ† ๋‹ˆ์•„๋Š” ๋ฌธํ•™์ ์œผ๋กœ ์žฌํ˜„๋œ ์‹ ์—ฌ์„ฑ๋“ค๋กœ ๊ฐ„์ฃผ๋  ์ˆ˜ ์žˆ๊ณ  ์ดํ›„ ํ™œ๋ฐœํ•œ ์‚ฌํšŒ๊ฐœํ˜์„ ๊ฐ€์ ธ์˜ค๋Š” ํ›„๋ฐฐ๋“ค์˜ ๊ด„๋ชฉํ• ๋งŒํ•œ ์ „์œ„๋ผ ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋˜ํ•œ ์ด์‚ฌ๋ฒจ๊ณผ ์—๋“œ๋‚˜๋Š” ์™ธ์–‘์ด๋‚˜ ๋ฒ ๋ธ”๋Ÿฐ์ด ์ด์•ผ๊ธฐํ•˜๋Š” ๊ณผ์‹œ์  ์†Œ๋น„๋ผ๋Š” ์‚ถ์˜ ๋ฐฉ์‹์—์„œ ๋‹น์‹œ ์ƒˆ๋กญ๊ฒŒ ๋“ฑ์žฅํ•œ ๊น์Šจ๊ฑธ๊ณผ ์ƒ๋‹นํ•œ ์ ‘์ ์„ ๋ณด์ด๊ธฐ๋„ ํ•œ๋‹ค. ๊น์Šจ๊ฑธ์ด ๋ณด๋‹ค ๋” ์ ๊ทน์ ์ด๊ณ  ํŒŒ๊ฒฉ์ ์ธ ์ƒˆ๋กœ์šด ์œ ํ˜•์˜ ์—ฌ์„ฑ๋“ค์˜ ๋“ฑ์žฅ์„ ์œ„ํ•œ ๊ธธ์„ ๋‹ฆ์•„๋†“์€ ๊ฒƒ์ฒ˜๋Ÿผ, ์ž์•„์„ฑ์ฐฐ์— ๋Œ€ํ•œ ์ด์‚ฌ๋ฒจ๊ณผ ์—๋“œ๋‚˜์˜ ๋…ธ๋ ฅ์€ ๋…ธ๋™์„ ํ†ตํ•ด ๋ณด๋‹ค ์ ๊ทน์ ์œผ๋กœ ์‚ฌํšŒํ™œ๋™์— ์ฐธ์—ฌํ•˜๋Š” ์—ฌ์„ฑ์ธ๋ฌผ ์•ˆํ† ๋‹ˆ์•„์—๊ฒŒ๋กœ ์ด์–ด์ง„๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋จผ์ €ใ€Ž์—ฌ์ธ์˜ ์ดˆ์ƒใ€์„ ์‚ดํŽด๋ณด๋ฉด, ์ด์‚ฌ๋ฒจ ์•„์ฒ˜๋Š” ๋‚˜๋ฅด์‹œ์ŠคํŠธ์ ์ธ ํ™˜์ƒ๊ณผ ์ง€๋‚˜์นœ ์ž์‹ ๊ฐ์„ ๊ฐ€์ง„ ์‹ ์—ฌ์„ฑ์˜ ํ•œ ์œ ํ˜•์ด๋ผ ํ•  ์ˆ˜ ์žˆ๋‹ค. ์œ ๋Ÿฝ๋Œ€๋ฅ™์„ ์ž์•„ํ˜•์„ฑ์„ ์œ„ํ•œ ์ผ์ข…์˜ ์‹คํ—˜์‹ค๋กœ ์„ ํƒํ–ˆ๋˜ ์ด์‚ฌ๋ฒจ์€ ๋ง‰๋Œ€ํ•œ ์œ ์‚ฐ์ด ๊ฐ€ํ•˜๋Š” ์••๋ฐ•๊ณผ ๋ณธ์—ฐ์˜ ์ž์•„๋ฅผ ์ง€ํ‚จ๋‹ค๋Š” ๋ช…๋ถ„์œผ๋กœ ์ธํ•ด, ์„ธ์ƒ์„ ์ง์ ‘ ์ฒดํ—˜ํ•ด๋ณด๊ณ ์ž ํ–ˆ๋˜ ํ™œ๊ธฐ๋ฅผ ์‰ฝ๊ฒŒ ํฌ๊ธฐํ•˜๊ณ  ์˜ค์ฆˆ๋จผ๋“œ๋ฅผ ๊ฒฐํ˜ผ์ƒ๋Œ€๋กœ ์„ ํƒํ•˜๋Š” ์น˜๋ช…์  ์˜คํŒ์„ ๋ฒ”ํ•œ๋‹ค. ์—ฐ๋ฏผ์œผ๋กœ ์™œ๊ณก๋œ ๋ชจ์„ฑ์• , ๋งน๋ชฉ์ ์ธ ์ž๊ธฐ์ค‘์‹ฌ์ฃผ์˜ ๊ทธ๋ฆฌ๊ณ  ๋‚˜์ด๋ธŒํ•œ ์ƒ์ƒ๋ ฅ์€ ์Šค์Šค๋กœ๋ฅผ ๊ฐ€๋ถ€์žฅ์ ์ธ ๊ฒฐํ˜ผ์ด๋ผ๋Š” ๋ซ์— ๋น ์ง€๊ฒŒ ๋งŒ๋“  ๊ทธ๋…€์˜ ๋˜ ๋‹ค๋ฅธ ํ•œ๊ณ„์ด๋‹ค. ๋‹ค๋งŒ ์‹คํŒจํ•œ ๊ฒฐํ˜ผ์ด๋ผ๋Š” ์‹œ์ ์—์„œ, ๋งˆ๊ฐ€๋ › ํ’€๋Ÿฌ์™€ ๋งˆ์ฐฌ๊ฐ€์ง€๋กœ ๋ฏธ๊ตญ์˜ ์ฝ”๋ฆฐ๊ณผ ๊ฐ™์€ ์œ ํ˜•์˜ ์—ฌ์„ฑ์ด๋ผ ํ•  ์ˆ˜ ์žˆ๋Š” ์ด์‚ฌ๋ฒจ์€ ์™œ ์–ด๋ฆฌ์„์€ ๊ฒฐํ˜ผ์„ ์„ ํƒํ–ˆ๋Š”๊ฐ€?๋ผ๋Š” ๋ฌธ์ œ๊ฐ€ ์•„๋‹ˆ๋ผ ๊ณผ์—ฐ ๋ฌด์—‡์„ ํ•  ๊ฒƒ์ธ๊ฐ€?๋ผ๋Š” ๋ฌธ์ œ๋กœ ๋‹ค์‹œ ์‹œ์„ ์„ ๋Œ๋ฆฌ๊ณ  ์ž์‹ ์˜ ์‚ถ์„ ์กฐ์ข…ํ•˜๋ ค๋Š” ์ฃผ์œ„์ธ๋ฌผ๋“ค์„ ์ดˆ์›”ํ•ด ์ž์•„๋ฅผ ์žฌ์ •๋ฆฝํ•˜๋Š” ๋‚จ๋‹ค๋ฅธ ์ฑ…์ž„์˜์‹๊ณผ ์ž์กด๊ฐ์„ ๋‹ค์‹œ ํ•œ๋ฒˆ ๋ณต์›ํ•˜๊ฒŒ ๋œ๋‹ค. ์ƒˆ๋กœ์šด ์ž์•„๋ฅผ ํ˜•์„ฑํ•˜๋Š” ํ•˜๋‚˜์˜ ์‹คํ—˜์‹ค๋กœ์„œ ์œ ๋Ÿฝ์„ ์„ ํƒํ–ˆ๋˜ ๋ฏธ๊ตญ ์—ฌ์„ฑ์œผ๋กœ์„œ ๋งˆ์น˜ ์‹ ๋Œ€๋ฅ™์„ ๊ฐœ์ฒ™ํ•œ ์ฒญ๊ต๋„๋“ค์ด ๊ทธ๋Ÿฌํ–ˆ๋“ฏ์ด ๊ทธ ๊ณณ์—์„œ ์ž์‹ ์ด ๊ฒช๋Š” ๋ชจ๋“  ๊ฒฝํ—˜๋“ค์„ ๊ด€์ฐฐํ•˜๊ณ  ์Šค์Šค๋กœ๋ฅผ ์„ฑ์ฐฐํ•˜๋Š” ๊ณผ์ •์„ ํ†ตํ•ด ๋งˆ์นจ๋‚ด ๋ฏธ์ˆ™ํ–ˆ๋˜ ๋ชจ์Šต์„ ์กฐ๊ธˆ์”ฉ ํƒˆํ”ผํ•˜๊ณ  ์ „๋ณด๋‹ค ๋” ์„ฑ์žฅํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋œ ๊ฒƒ์ด๋‹ค. ์ด ๋•Œ ํŒฌ์ง€๋‚˜ ๋ž ํ”„์™€ ๋งบ๊ฒŒ ๋˜๋Š” ๋‚จ๋งค์• ์— ๊ฐ€๊นŒ์šด ๋ชจ์„ฑ๋„ ๊ฐ€๋ถ€์žฅ์ œ์— ์ข…์†๋œ ๋ชจ์„ฑ์ด ์•„๋‹ˆ๋ผ ๊ทธ๊ฒƒ์„ ๋Œ€์ฒดํ•˜๋Š” ์„ฑ๊ฒฉ์˜ ๋ชจ์„ฑ์ด๋ผ ๊ฐ„์ฃผ๋  ์ˆ˜ ์žˆ๋‹ค. ใ€Ž์—ฌ์ธ์˜ ์ดˆ์ƒใ€์ด 1870๋…„๋Œ€ ๋ฏธ๊ตญ์—์„œ ์œ ๋Ÿฝ์œผ๋กœ ๊ฑด๋„ˆ์™€ ์ž์‹ ์˜ ์šด๋ช…์„ ๋Œ€๋ณ€ํ•˜๊ณ ์ž ํ•œ ์ด์‚ฌ๋ฒจ์˜ ์ด์•ผ๊ธฐ๋ผ๋ฉด ใ€Ž๊ฐ์„ฑใ€์€ ๊ทธ๋ณด๋‹ค 20๋…„ ์ฏค ํ›„์ธ 1890๋…„๋Œ€ ๋ฏธ๊ตญ ๋‰ด ์˜ฌ๋ฆฌ์–ธ์ฆˆ ํฌ๋ ˆ์˜ฌ ์‚ฌํšŒ์—์„œ ํ•œ ๋‚จ์ž์˜ ์•„๋‚ด์ด์ž ๋‘ ์•„์ด์˜ ์–ด๋จธ๋‹ˆ๋กœ ์‚ด์•„์•ผ๋งŒ ํ–ˆ๋˜ ์‹ ์—ฌ์„ฑ์ธ ์—๋“œ๋‚˜์˜ ์ด์•ผ๊ธฐ์ด๋‹ค. ์ด์‚ฌ๋ฒจ์ด ๊ต์–‘์ด ํ’๋ถ€ํ•˜๊ณ  ๋‚ญ๋งŒ์  ์ƒ์ƒ๋ ฅ์œผ๋กœ ๊ฐ€๋“ํ•œ ๋ฏธํ˜ผ์—ฌ์„ฑ์ด๋ผ๋Š” ์‹ ์—ฌ์„ฑ์˜ ์™ธํ˜•์  ์กฐ๊ฑด์„ ๊ฐ–์ถ˜๋ฐ ๋น„ํ•ด์„œ ์—๋“œ๋‚˜๋Š” ๋ชจ์„ฑ์• ์— ๋Œ€ํ•œ ์ธ์œ„์  ์ฐฌ์–‘์„ ๋ฏธ๋ผ๋กœ ์—ฌ์„ฑ์„ ์˜์›ํžˆ ๊ฐ€์ •์ด๋ผ๋Š” ์˜์—ญ์— ํ•œ์ •ํ•ด ๊ฐ€๋‘๋ ค ํ•˜๋Š” ํ•จ์ •์— ๋Œ€ํ•ด ๋ˆ„๊ตฌ๋ณด๋‹ค ์ฒ˜์ ˆํ•˜๊ฒŒ ๋ฐ˜์‘ํ•ด์•ผ ํ•˜๋Š” ๊ธฐํ˜ผ์—ฌ์„ฑ์˜ ์ž…์žฅ์— ์„œ์žˆ๋‹ค๊ณ  ๋ณผ ์ˆ˜ ์žˆ๋‹ค. ๊ฒฐ๊ตญ ๊ทธ๋…€๋Š” ๊ฒฐํ˜ผ๊ณผ ๋ชจ์„ฑ์œผ๋กœ ํ™˜์›๋˜๋Š” ์ž์‹ ์˜ ์ •์ฒด์„ฑ์— ๊ฐ€ํ•ด์ง„ ์†๋ฐ•์„ ๋ฒ—์–ด๋‚˜๊ธฐ ์œ„ํ•ด ๊ทธ ์ ˆ๋ง์ ์ธ ๋ถ„๋…ธ๋ฅผ ์ž์‚ด์ด๋ผ๋Š” ๊ทน๋‹จ์  ์„ ํƒ์œผ๋กœ ํ•ด์†Œํ•˜๊ณ ์ž ํ•œ๋‹ค. ์–ด๋จธ๋‹ˆ๊ฐ€ ๋˜๊ธฐ ์ด์ „์ด๋ผ๋ฉด ์–ด์ฉŒ๋ฉด ์ด์‚ฌ๋ฒจ์ฒ˜๋Ÿผ ์ž์‹ ๋งŒ์˜ ๋‚ญ๋งŒ์  ์‚ถ์˜ ๋ฐฉ์‹์„ ์œก์ฒด์  ์ƒ๋ช…๊ณผ ๊ณต์กด์‹œํ‚ค๋ฉฐ ํƒ์ƒ‰ํ•ด ๋‚˜๊ฐˆ ์ˆ˜ ์žˆ์—ˆ๊ฒ ์ง€๋งŒ ์—๋“œ๋‚˜์—๊ฒŒ๋Š” ์ด๋ฏธ ๋„ˆ๋ฌด ๋Šฆ์–ด๋ฒ„๋ ธ๊ณ  ์ฃฝ์Œ๋งŒ์ด ์œ ์ผํ•œ ํ•ด๊ฒฐ์ฑ…์ด์—ˆ๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋ณธ์งˆ์ ์ธ ์ž์•„๋ฅผ ์ง€ํ‚ค๊ณ ์ž ํ•˜๋Š” ๊ฐ•ํ•œ ์ž๊ธฐ์• ๋กœ ์ธํ•ด ๋น„๋ก ์œก์ฒด์  ์ฃฝ์Œ์„ ์„ ํƒํ–ˆ์„์ง€์–ธ์ • ๋งˆ์ง€๋ง‰ ์ž์กด์‹ฌ๋งŒ์€ ๊ฟ‹๊ฟ‹์ด ์ง€์ผœ๋‚ด ์ •์‹ ์ ์ธ ์ฃฝ์Œ๋งŒ์€ ๋ชจ๋ฉดํ•  ์ˆ˜ ์žˆ์—ˆ๋˜ ๊ฒƒ์ด๋‹ค. ์—๋“œ๋‚˜๋Š” ์ž์‹ ์ด ๋Š๊ปด์˜จ ๋ง‰์—ฐํ•œ ๋ถ„๋…ธ๊ฐ€ ๊ฐ์„ฑ์„ ๊ณ„๊ธฐ๋กœ ์Šค์Šค๋กœ์˜ ๋‚ด๋ฉด์„ ํŒŒ๊ณ ๋“ค๋„๋ก ํ—ˆ๋ฝํ•จ์œผ๋กœ์จ ์ž๊ธฐ ํŒŒ๊ดด์  ํ˜•ํƒœ์ธ ์ฃฝ์Œ์„ ์ถ”๊ตฌํ•˜๊ฒŒ ๋œ๋‹ค. ๊ฒฐ๊ตญ ์—๋“œ๋‚˜์˜ ํƒ€๋‚˜ํ† ์Šค์ ์ธ ์š•๋ง์€ ์šฐํšŒ์ ์ธ ๋ถ„๋…ธ์˜ ํ‘œํ˜„์ด์ž ์‹ ์—ฌ์„ฑ๋“ค์˜ ์ฃผ์ฒด์  ์‚ถ์— ๋Œ€ํ•œ ์ ˆ์ ˆํ•œ ๊ฐˆ๋ง์„ ๋น„๊ปด ๋งํ•œ ๊ฒƒ์ด๋ผ๋Š” ๋ช…์ œ๊ฐ€ ์œ ํšจํ•ด์งˆ ์ˆ˜ ์žˆ๋‹ค. ใ€Ž๋‚˜์˜ ์•ˆํ† ๋‹ˆ์•„ใ€๋Š” ์ด์ „ ์„ธ๋Œ€์˜ ์‹ ์—ฌ์„ฑ๋“ค์ธ ์ด์‚ฌ๋ฒจ์ด๋‚˜ ์—๋“œ๋‚˜์™€๋Š” ๋˜ ๋‹ค๋ฅธ ์œ ํ˜•์˜ ์‹ ์—ฌ์„ฑ์˜ ๋ชจ์Šต์„ ์„ ๋ณด์ด๊ณ  ์žˆ๋‹ค. 1910๋…„๋Œ€ ๋ฏธ๊ตญ ์ค‘์„œ๋ถ€์˜ ๋„ค๋ธŒ๋ผ์Šค์นด์—์„œ ๊ฐ•ํ•œ ๊ฐœ์ฒ™์ง€์—ฌ์ธ์œผ๋กœ ์‚ด์•„๊ฐ€๊ฒŒ ๋˜๋Š” ์•ˆํ† ๋‹ˆ์•„๋Š” ํ† ์ฐฉ๋ฏผ๊ณผ ๋Œ€๋น„๋˜๋Š” ๋‚ฏ์„  ์ด๋ฏผ์ž ์‚ฌํšŒ์˜ ์ผ์›์ด๋ฉฐ ๋™์‹œ์— ๊ฐ€๋ถ€์žฅ์  ๊ถŒ์œ„ ํ•˜์˜ ์—ฌ์„ฑ์ด๋ผ๋Š” ์ด์ค‘์˜ ํ•จ์ •์œผ๋กœ ๊ณ ๋‚œ์„ ๊ฒช๊ฒŒ ๋˜๋Š” ์ธ๋ฌผ์ด๋‹ค. ์ด์‚ฌ๋ฒจ์ด๋‚˜ ์—๋“œ๋‚˜๊ฐ€ ์ค‘์‚ฐ์ธต์˜ ์‚ถ์„ ํ–ฅ์œ ํ•˜๋ฉฐ ๊ฒฝ์ œ์  ์–ด๋ ค์›€์€ ๊ทธ ๊ณ ๋ ค์˜ ๋Œ€์ƒ์ด ๋˜์ง€ ์•Š์•˜๋˜ ๋ฐ˜๋ฉด์— ์•ˆํ† ๋‹ˆ์•„๋Š” ๋‹น์žฅ ํ† ๊ตด ์†์—์„œ ๊ฒจ์šธ์„ ๋‚˜์•ผ ํ•˜๋Š” ์ƒ์กด์ด๋ผ๋Š” ์ ˆ์ฒด์ ˆ๋ช…์˜ ๊ณผ์ œ์— ์ง๋ฉดํ•ด ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋น„์ถ”์–ด์ง„๋‹ค. ๋”ฐ๋ผ์„œ ์–ด๋ฆฐ ์‹œ์ ˆ๋ถ€ํ„ฐ ์–ธ์–ด๋ฅผ ๋น„๋กฏํ•œ ๊ต์œก์— ๋Œ€ํ•œ ์—ด๋ง์ด ์ง€๋Œ€ํ–ˆ์Œ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ์—ฌํ–‰์ด๋‚˜ ํ† ๋ก , ๋…์„œ, ์˜ˆ์ˆ  ํ™œ๋™๊ณผ ๊ฐ™์€ ์‹ ์—ฌ์„ฑ๋“ค์˜ ํŠน๊ถŒ์œผ๋กœ๋ถ€ํ„ฐ๋Š” ์•„์˜ˆ ๋ฐฐ์ œ๋˜์–ด์ง„ ์—ฌ์„ฑ์ธ๋ฌผ์ด๋ผ๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด์™€ ๊ฐ™์ด ์•ˆํ† ๋‹ˆ์•„๊ฐ€ ์ด์ „ ์„ธ๋Œ€์˜ ์„ ๋ฐฐ๋“ค๊ณผ๋Š” ๋‹ค๋ฅธ ์–‘์ƒ์„ ๋ ๋Š” ์—ฌ์„ฑ์ธ๋ฌผ์ž„์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ์‹ ์—ฌ์„ฑ์˜ ๋ฒ”์ฃผ์— ํฌํ•จ๋  ์ˆ˜ ์žˆ๋Š” ์ด์œ ๋Š” ๋ˆ„๊ตฌ๋ณด๋‹ค๋„ ๊ฐ•ํ•œ ์ž๋ฆฝ์˜์ง€์™€ ์ž์‹ ์˜ ์‚ถ์— ๋Œ€ํ•œ ์—ด์ •, ์ฑ…์ž„์˜์‹์„ ๊ตฌํ˜„ํ•ด๋ƒˆ๊ธฐ ๋•Œ๋ฌธ์ด๋‹ค. ํŠนํžˆ ๋…ธ๋™์— ๋Œ€ํ•œ ์•ˆํ† ๋‹ˆ์•„์˜ ์‹œ๊ฐ์€ ์ด์‚ฌ๋ฒจ์ด๋‚˜ ์—๋“œ๋‚˜์˜ ๋‹ค์†Œ ์†Œ๊ทน์ ์ธ ์ž…์žฅ๊ณผ๋Š” ๋น„๊ตํ•˜๊ธฐ๊ฐ€ ์–ด๋ ค์šธ ์ •๋„๋กœ ๊ฐ•๋ ฌํ•œ ์ธ์ƒ์„ ์ฃผ๊ณ  ์žˆ๋‹ค. ๊ฐœ์ฒ™์ง€์˜ ์ฃผ์ธ๊ณต์€ ๋‚จ์„ฑ์ด ๋˜์–ด์•ผ ํ•œ๋‹ค๋Š” ํ†ต๋…์„ ์ „๋ณต์‹œํ‚ค๊ณ  ์ ๊ทน์ ์ธ ๋…ธ๋™์„ ํ†ตํ•ด ๊ฐ€์กฑ๊ณผ ๋Œ€์ง€์˜ ์šด๋ช…์„ ๊ฐœ์ฒ™ํ•ด ๋‚˜๊ฐ€๋Š” ์•ˆํ† ๋‹ˆ์•„๋Š” ์„ธ ์—ฌ์„ฑ์ธ๋ฌผ ์ค‘ ๋ˆ„๊ตฌ๋ณด๋‹ค๋„ ์ฑ…์ž„๊ฐ ์žˆ๋Š” ๋ชจ์Šต์„ ๊ตฌํ˜„ํ•˜๋ฉฐ ๋Œ€์ง€๋ชจ๋กœ์„œ ์ฒดํ™”ํ•˜๋Š” ์–‘์ƒ์„ ๋ณด์ด๊ฒŒ ๋œ๋‹ค. ๊ฐ•ํ•œ ์ƒ๋ช…๋ ฅ์œผ๋กœ๋ถ€ํ„ฐ ๋‚˜์˜ค๋Š” ์ž๋ฆฝ์˜์ง€๋Š” ์•ˆํ† ๋‹ˆ์•„์™€ ๊ฐ™์€ ๊ฐœ์ฒ™์ง€์˜ ์ด๋ฏผ ์—ฌ์„ฑ๋“ค์—๊ฒŒ ์‚ถ์„ ๋ณต์›์‹œํ‚ค๋Š” ๊ธฐ์ œ๋กœ ์ž‘์šฉํ–ˆ๊ณ  ๋งˆ์น˜ ์ƒ๋Ÿฌ๋“œ ๋ณผ๊ณผ ๊ฐ™์€, ์•ˆํ† ๋‹ˆ์•„๊ฐ€ ๋งŒ๋“œ๋Š” ๋ณดํ—ค๋ฏธ์•„์‹ ์ฝœ๋ผ์‰ฌ์™€ ๊ฐ™์€ ๋‹ค์›์ ์ธ ๋ฏธ๊ตญ์‚ฌํšŒ์˜ ์ •์ฒด์„ฑ์„ ์„ฑ๊ณต์ ์œผ๋กœ ๊ตฌ์ถ•ํ•ด๋ƒˆ๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด์‚ฌ๋ฒจ์ด ๋‚ญ๋งŒ์  ์ƒ์ƒ๋ ฅ๊ณผ ์†”์งํ•จ, ์ž์œ ์™€ ๋…๋ฆฝ์— ๋Œ€ํ•œ ๋“œ๋†’์€ ์ด์ƒ๊ณผ ์ž์‹ ๊ฐ์œผ๋กœ ์ฃผ์ฒด์  ์‹ ์—ฌ์„ฑ์œผ๋กœ์„œ์˜ ์ž์‹ ์˜ ์ดˆ์ƒ์„ ์™„์„ฑํ•˜๊ณ  ์—๋“œ๋‚˜๊ฐ€ ์ž์‚ด์ด๋ผ๋Š” ๊ทน๋‹จ์ ์ธ ๋ฐฉ๋ฒ•์œผ๋กœ ๋ณธ์—ฐ์˜ ์ž์•„๋ฅผ ์ง€ํ‚ค๋Š” ์„ ํƒ์„ ํ•  ์ˆ˜๋ฐ–์— ์—†์—ˆ๋‹ค๋ฉด ์•ˆํ† ๋‹ˆ์•„๋Š” ๋ถˆ๋ชจ์ง€๋ฅผ ๊ฐœ์ฒ™ํ•˜๊ณ  ๊ฐ€์กฑ์˜ ์‚ถ์„ ์ฑ…์ž„์ง€๊ณ ์ž ํ•˜๋Š” ์ž๋ฆฝ์˜์ง€๋กœ ๋ณด๋‹ค ๊ฐ•์ธํ•œ ์‹ ์—ฌ์„ฑ์˜ ๋ชจ์Šต์„ ๊ตฌํ˜„ํ•ด๋ƒˆ๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด์ƒ๊ณผ ๊ฐ™์€ ์—ฌ์„ฑ์ธ๋ฌผ๋“ค์€ ๋ชจ๋‘ ์‚ฌํšŒ์  ํ†ต๋…์— ์ €ํ•ญํ•˜๊ณ  ๋ˆ„๊ตฌ๋ณด๋‹ค๋„ ์ž๊ธฐ ์ž์‹ ์„ ์‚ฌ๋ž‘ํ•œ ์ž์˜์‹๊ณผ ์ฑ…์ž„๊ฐ์„ ์ง€๋‹Œ ์ƒˆ๋กœ์šด ์œ ํ˜•์˜ ์—ฌ์„ฑ ์ฆ‰ ์‹ ์—ฌ์„ฑ๋“ค์ด๋ผ ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด๋“ค์ด ๊ณตํ†ต์ ์œผ๋กœ ์ด์•ผ๊ธฐํ•˜๋Š” ์ฐธ๋‹ค์šด ์‚ถ์˜ ๊ฐ€์น˜๋Š” ๋ฌด์—‡๋ณด๋‹ค๋„, ์ž๊ธฐ ์ž์‹ ์˜ ๋‚ด๋ฉด์—์„œ ์šธ๋ ค๋‚˜์˜ค๋Š” ๋ณธ์—ฐ์˜ ๋ชฉ์†Œ๋ฆฌ์— ๋”ฐ๋ฅด๋Š” ์ถฉ์‹คํ•œ ์‚ถ์ด๋‹ค. ๋ณธ ๋…ผ๋ฌธ์˜ ๊ฐ€์žฅ ํฐ ์˜์˜๋Š” ์‚ฐ์—…ํ™”์™€ ์ž๋ณธ์ฃผ์˜๋กœ์˜ ๊ธ‰๊ฒฉํ•œ ์ „ํ™˜ ์†์— ์ •์ฒด์„ฑ์˜ ํ˜ผ๋ž€์„ ๊ฒช์–ด์•ผ๋งŒ ํ–ˆ๋˜ ์ด๋Ÿฌํ•œ ์‹ ์—ฌ์„ฑ๋“ค์˜ ์ด์•ผ๊ธฐ๋ฅผ ๊ณ ์ฐฐํ•ด ๋ด„์œผ๋กœ์จ ์˜ค๋Š˜๋‚ ์˜ ์—ฌ์„ฑ๋“ค ์—ญ์‹œ ๊ฐ„์ ‘์ ์ธ ์‹œ์‚ฌ์ ์„ ๋ฐœ๊ฒฌํ•  ์ˆ˜ ์žˆ๋‹ค๋Š” ์ ์ผ ๊ฒƒ์ด๋‹ค. ์ด๋“ค์˜ ์ด์•ผ๊ธฐ๋ฅผ ํ†ตํ•ด ๊ฒฐํ˜ผ๊ณผ ๋ชจ์„ฑ์ด ์—ฌ์„ฑ์—๊ฒŒ ์–ด๋–ค ๋ณ€ํ™”๋ฅผ ๊ฐ€์ ธ์˜ค๋Š”์ง€ ๋ฐ˜์ถ”ํ•ด ๋ณด๊ณ  ์‚ฌํšŒ๋ฅผ ๋ฐ”๋ผ๋ณด๋Š” ์„ฑ์ˆ™ํ•œ ์‹œ์„ ์„ ํ‚ค์šฐ๋ฉฐ ์ž์•„์„ฑ์žฅ์„ ์œ„ํ•ด ๊ฐ€์žฅ ๊ธด์š”ํ•œ ์กฐ๊ฑด๋“ค์„ ์„ฑ์ฐฐํ•˜๋Š” ๊ณผ์ •์— ์ฐธ์—ฌํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋ฉฐ ์‚ถ์˜ ์ง€ํ‘œ๋ฅผ ์Šค์Šค๋กœ ํ™•์ธํ•ด๋ณด๊ฒŒ ๋  ๊ฒƒ์ด๋‹ค.์ œ 1์žฅ ์„œ๋ก  1 1. ์—ฐ๊ตฌ์˜ ๋ชฉ์  1 2. ์‹ ์—ฌ์„ฑ์˜ ๋“ฑ์žฅ๊ณผ ์˜์˜ 5 ์ œ 2์žฅ ์—ฌ์ธ์˜ ์ดˆ์ƒ: ์ด์‚ฌ๋ฒจ ์•„์ฒ˜์˜ ๋งˆ์ง€๋ง‰ ์„ ํƒ 26 1. ์ด์‚ฌ๋ฒจ์˜ ์ž๊ธฐ์• ์™€ ์ž์•„์„ฑ์ฐฐ 28 2. ์™œ๊ณก๋˜๊ณ  ๋ณ€์ฃผ๋œ ๊ฒฐํ˜ผ๊ณผ ๋ชจ์„ฑ 49 3. ์ด์‚ฌ๋ฒจ์˜ ๋งˆ์ง€๋ง‰ ์„ ํƒ 69 ์ œ 3์žฅ ๊ฐ์„ฑ: ํ•ด๋ฐฉ๋œ ์—ฌ์„ฑ์„ฑ์˜ ๊ณต๊ฐ„, ๋ฐ”๋‹ค 74 1. 19์„ธ๊ธฐ ํฌ๋ ˆ์˜ฌ ์‚ฌํšŒ์ฒด์ œ์—์„œ์˜ ์—๋“œ๋‚˜์˜ ์—๋กœ์Šค์™€ ํƒ€๋‚˜ํ† ์Šค 77 2. ํŒ์˜ตํ‹ฐ์ฝ˜ ์†์— ๊ฐ‡ํžŒ ์—๋“œ๋‚˜์˜ ๋”œ๋ ˆ๋งˆ 92 3. ์—๋“œ๋‚˜์˜ ์ฃฝ์Œ์— ๋Œ€ํ•œ ์‹œ๊ฐ 104 ์ œ 4์žฅ ๋‚˜์˜ ์•ˆํ† ๋‹ˆ์•„: ๋„ค๋ธŒ๋ผ์Šค์นด ํ‰์›์œผ๋กœ์˜ ๊ท€ํ–ฅ 110 1. ์‹ ์—ฌ์„ฑ์œผ๋กœ์„œ์˜ ์•ˆํ† ๋‹ˆ์•„์˜ ์ž๋ฆฝ์˜์ง€ 113 2. ์„œ๋ถ€ ์ด๋ฏผ์ž ์‚ฌํšŒ์™€ ๊ฐœ์ฒ™์ง€ ์—ฌ์„ฑ 129 3. ๋„ค๋ธŒ๋ผ์Šค์นด ํ‰์›์œผ๋กœ์˜ ๊ท€ํ–ฅ 148 ์ œ 5์žฅ ๊ฒฐ๋ก  160 ์ฐธ๊ณ ๋ฌธํ—Œ 167 Abstract 179Docto

    Bilirubin and risk of ischemic heart disease in Korea: a two-sample Mendelian randomization study

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    OBJECTIVES: Bilirubin is an endogenous antioxidant that protects cells against oxidative stress. Increased plasma levels of bilirubin have been associated with a reduced risk of ischemic heart disease (IHD) in previous studies. Nonetheless, whether those associations reflect a true protective effect of bilirubin on IHD, rather than confounding or reverse causation, remains unknown. Therefore, we applied two-sample Mendelian randomization to evaluate the causal association between bilirubin levels and IHD risk in a Korean population. METHODS: A total of 5 genetic variants-TRPM8 (rs10490012), USP40 (rs12993249), ATG16L1 (rs2119503), SLCO1B1 (rs4149014), and SLCO1B3 (rs73233620)-were selected as genetic instruments for serum bilirubin levels using a communitybased cohort, the Korean Genome and Epidemiology Study, comprising 33,598 subjects. We then evaluated their impact on IHD using the Korean Cancer Prevention Study-II cohort. RESULTS: Among the 5 instrumental variables that showed significant associations with serum bilirubin levels, rs12993249 (USP40) showed the most significant association (p<2.36ร—10-105). However, we found no significant association between serum bilirubin levels and IHD. Sensitivity analyses demonstrated a consistent association, suggesting that our observations were robust. CONCLUSIONS: Using two-sample Mendelian randomization, we found no association between serum bilirubin levels and IHD. Further studies that confirm the observed interactions among other ethnicities are warranted.ope

    The Associations between Alcohol Intake and HDL Cholesterol Subclasses in Korean Population

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    Objective: Alcohol intake has been found to be associated with high-density lipoprotein (HDL) cholesterol. However, the association of alcohol intake with HDL cholesterol subclasses is unclear. Therefore, this study was conducted to determine the association between alcohol intake and HDL cholesterol subclasses among Koreans. Methods: This study included in 1,101 healthy Koreans (men: 765, women: 336) who underwent health check-up at two hospitals in the Korean Cancer Prevention Study 2 (KCPS2). The amounts of alcohol intake were classified into 4 groups: non-, light, moderate, and heavy drinkers (0, <12.5, 12.5-49.9, and โ‰ฅ50.0 g/day, respectively). The proportions of HDL cholesterol subclasses were measured after subclasses were identified by 4โ€“30% gradient gel electrophoresis. Multiple regression models were used to estimate regression coefficients after multivariate adjustments. Results: The concentration of HDL, HDL2 and HDL3 significantly increased with increasing amount of alcohol intake. After adjusted for age, body mass index (BMI), waist and smoking status, alcohol consumers of <12.5 g/day, 12.5-49.9 g/day and more than 50.0g/day showed significant positive associations with HDL, HDL2 and HDL3 concentration when compared to non-alcohol drinkers in men. In particular, The strongest positive associations were obtained with HDL2b and HDL3c. Conclusion: HDL2 and HDL3 were significantly associated with increasing amount of alcohol intake in Koreans. In particular, HDL2b among HDL2 and HDL3c among HDL3 showed the strongest positive association with increasing amount of alcohol intake.ope

    In vitro Expansion of Mesenchymal Stem Cells using 3D Matrix Derived from Cardiac Fibroblast

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    Mesenchymal stem cells (MSC), nonhematopoietic progenitor cells are capable of differentiating into multiple lineage of the mesenchyme such as bone, cartilage, tendon, fat, heart, muscle, and brain, in vitro and in vivo. Although autologous MSC have some advantageous factors, MSC have very poor replicative capacity. Previous studies indicated that growth factors but also cell seeding density made an effect on expansion of MSCs. In this study, we examined the growth rate and adhesion of MSC in tissue culture coated with a basement membrane-like extracellular matrix. When self-renewal of MSC were compared between 2-D and 3-D, the growth rate of MSCs on 3-D matrix was highest among plastic, Fibronectin- and 3-D matrix plate but also attachment of MSCs on 3-D matrix was 6-fold greater than that on plastic. MSCs plated into 3-D matrix showed colocalization of ฮฑ5 integrin and ฮฑV integrin. This study may reflect that the extracellular matrix had greater effect on the expansion of MSCs because this distinctive in 3-D matrix adhesion differ in localization and function from classically described in vitro adhesion.ope

    Enhanced calreticulin expression promotes calcium-dependent apoptosis in postnatal cardiomyocytes

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    Calreticulin (CRT) is one of the major Ca2+ binding chaperone proteins of the endoplasmic reticulum (ER) and an unusual luminal ER protein. Postnatally elevated expression of CRT leads to impaired development of the cardiac conductive system and may be responsible for the pathology of complete heart block. In this study, the molecular mechanisms that affect Ca2+-dependent signal cascades were investigated using CRT-overexpressing cardiomyocytes. In particular, we asked whether calreticulin plays a critical role in the activation of Ca2+-dependent apoptosis. In the cells overexpressing CRT, the intracellular calcium concentration was significantly increased and the activity of PKC and level of SECAR2a mRNA were reduced. Phosphorylation of Akt and ERKs decreased compared to control. In addition the activity of the anti-apoptotic factor, Bcl-2, was decreased and the activities of pro-apoptotic factor, Bax, p53 and caspase 8 were increased, leading to a dramatic augmentation of caspase 3 activity. Our results suggest that enhanced CRT expression in mature cardiomyocytes disrupts intracellular calcium regulation, leading to calcium-dependent apoptosis.ope

    Hydrophilicity of non-fatty acid moiety: significant determinant affecting antibacterial activity of lauric acid esters

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ๋†์ƒ๋ช…๊ณตํ•™๋ถ€ ์‹ํ’ˆ์ƒ๋ช…๊ณตํ•™์ „๊ณต, 2016. 2. ์žฅํŒ์‹.What affects to the antibacterial activities of lauric acid esters was investigated. Based on the results of antibacterial activity test evaluating minimum inhibitory concentration and minimum bactericidal concentration, sesamol laurate was found to have no effect on either Gram positive bacteria or Gram negative bacteria. On the other hand, erythorbyl laurate had antibacterial activity to Gram positive bacteria. To investigate why the antibacterial activities are shown differently between sesamol laurate and erythorbyl laurate, monolaurin, sucrose monolaurate, isoamyl laurate, and methyl laurate, erythorbyl laurate, and sesamol laurate were chosen based on hydrophilicity of non-fatty acid moiety. Minimum inhibitory concentration was assessed by broth micro-dilution method against Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium. Monolaurin, erythorbyl laurate, and sucrose monolaurate showed antibacterial activities against Gram positive bacteria. On the other hand, isoamyl laurate, methyl laurate, and sesamol laurate had no inhibitory effect on both Gram positive and Gram negative bacteria even treated up to 1.0 mM. The mechanism of monolaurin, erythorbyl laurate, and sucrose monolaurate was investigated by measuring the released cell constituents at 260 nm using spectrophotometer and the lipid compositional changes using gas chromatography (GC). 260 nm absorbing materials of Staphylococcus aureus treated with monolaurin, erythorbyl laurate, and sucrose monolaurate were increased for 2 h, and membrane lipid composition was also changed. Octanol/water partition coefficient was calculated by atom/fragment contribution method. The partition coefficients indicating lipophilicity were 7.175, 5.284, and 5.717 for isoamyl laurate, methyl laurate, and sesamol laurate, respectively, whereas monolaurin, erythorbyl laurate, and sucrose monolaurate showed 3.670, -0.6858, and -4.122, respectively. The hydrophilic-lipophilic balance values of isoamyl laurate, methyl laurate, and sesamol laurate were 1.800, 3.700, and 4.835, respectively, while monolaurin, erythorbyl laurate, and sucrose monolaurate had the higher HLB value of 7.025, 15.25, and 16.09, respectively. These results suggested that lauric acid esters should retain proper hydrophilicity based on the log P value of lower than 4, and the HLB value of higher than 7 to incorporate into bacterial cell membrane as antibacterial agents.1. Introduction 1 2. Materials and methods 3 2.1. Materials 3 2.1.1. Sample preparation 3 2.1.2. Chemicals 3 2.2. Procedure for lipase-catalyzed esterification between sesamol and lauric acid 4 2.2.1. Quantitative analysis of esterification product 4 2.2.2. Purification and identification of sesamol laurate 5 2.3. Cell culture 6 2.4. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) 6 2.5. Release of cellular constituents 7 2.6. Fluorescence microscopy 9 2.7. Membrane lipid composition 10 2.8. Octanol-water partition coefficient (log P) 11 2.9. Hydrophilic-lipophilic balance (HLB) 16 2.10. Statistical analysis 18 3. Results and discussion 19 3.1. Progression of enzymatic synthesis of sesamol laurate in acetonitrile 19 3.2. Structural analysis of sesamol laurate produced 21 3.3. Susceptibility screening of sesamol laurate 22 3.4. Selection of lauric acid esters 23 3.5. Antibacterial activities of lauric acid esters 26 3.5.1. Minimum inhibitory concentration (MIC) 26 3.5.2. Minimum bactericidal concentration (MBC) 32 3.6. Release of cellular constituents 37 3.7. Fluorescence microscopy 39 3.8. Membrane lipid composition 41 3.9. Octanol-water partition coefficient (log P) 44 3.10. Hydrophilic-lipophilic balance (HLB) value 45 4. Conclusion 47 5. References 48 ๊ตญ๋ฌธ์ดˆ๋ก 55Maste

    Prevalence of a metabolic syndrome and analysis on its' related factors in Korea : Seoul City metabolic syndrome research initiatives

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    ๊ฑด๊ฐ•์ฆ์ง„๊ต์œกํ•™๊ณผ/์„์‚ฌ[ํ•œ๊ธ€] ์—ฐ๊ตฌ ๋ฐฐ๊ฒฝ ๋ฐ ๋ชฉ์ ์‹ฌํ˜ˆ๊ด€์งˆํ™˜์€ ์ „ ์„ธ๊ณ„์ ์œผ๋กœ 15์„ธ ์ด์ƒ ์„ฑ์ธ ์งˆ๋ณ‘๋ถ€๋‹ด์˜ 13%๋ฅผ ์ฐจ์ง€ํ•˜๊ณ  ์žˆ๋‹ค. ์šฐ๋ฆฌ๋‚˜๋ผ 2005๋…„ ์‚ฌ๋ง๋ฅ  ํ†ต๊ณ„๋ฅผ ๋ณด๋ฉด, ์‹ฌํ˜ˆ๊ด€์งˆํ™˜ ์‚ฌ๋ง๋ฅ ์€ ์ด ์‚ฌ๋ง์›์ธ์˜ 20.6%๋ฅผ ์ฐจ์ง€ํ•  ์ •๋„๋กœ ์ฃผ์š”ํ•œ ์‚ฌ๋ง์›์ธ ์ค‘ ํ•˜๋‚˜์ด๋‹ค. ๋Œ€์‚ฌ์ฆํ›„๊ตฐ(Metabolic Syndrome)์€ ๋น„๋งŒ, ๊ณ ํ˜ˆ์••, ์ด์ƒ ์ง€ํ˜ˆ์ฆ, ๋‹น๋‡จ ๋“ฑ์ด ํ˜ผํ•ฉํ•˜์—ฌ ๋‚˜ํƒ€๋‚˜๋Š” ๊ฒƒ์„ ๋งํ•˜๋ฉฐ, ์ด๋Š” ์‹ฌํ˜ˆ๊ด€์งˆํ™˜์˜ ์œ„ํ—˜์š”์ธ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ์ฐธ์—ฌ๋Œ€์ƒ์ž์˜ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์œ ๋ณ‘๋ฅ ์„ ๊ตฌํ•˜๊ณ  ๊ด€๋ จ์š”์ธ์„ ๋ถ„์„ํ•˜์—ฌ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ๊ณผ ์‹ฌํ˜ˆ๊ด€์งˆํ™˜ ๋ฐœ์ƒ์„ ์˜ˆ๋ฐฉํ•˜๊ณ ์ž ํ•œ๋‹ค.์—ฐ๊ตฌ ๋ฐฉ๋ฒ•2006๋…„ 4์›”๋ถ€ํ„ฐ 2006๋…„ 12์›”๊นŒ์ง€ ์‹ ์ดŒ์„ธ๋ธŒ๋ž€์Šค๋ณ‘์›, ์˜๋™์„ธ๋ธŒ๋ž€์Šค๋ณ‘์›, ์ด๋Œ€๋ชฉ๋™๋ณ‘์›, ๋ถ„๋‹น์„œ์šธ๋Œ€๋ณ‘์›, ๊ณ ๋Œ€๊ตฌ๋กœ๋ณ‘์›์˜ 5๊ฐœ ๊ฒ€์ง„์„ผํ„ฐ๋ฅผ ๋ฐฉ๋ฌธํ•œ ์ˆ˜์ง„์ž 13,756๋ช… ์ค‘ ์‹ ์ฒด๊ณ„์ธก(์‹ ์žฅ, ์ฒด์ค‘, ๋น„๋งŒ๋„, ํ—ˆ๋ฆฌ๋‘˜๋ ˆ, ํ˜ˆ์••)๊ณผ ํ˜ˆ์•ก๊ฒ€์‚ฌ(์ค‘์„ฑ์ง€๋ฐฉ, HDL-์ฝœ๋ ˆ์Šคํ…Œ๋กค, ๊ณต๋ณตํ˜ˆ๋‹น), ๋ฌธ์ง„(ํก์—ฐ๋ ฅ)์ด ๋ˆ„๋ฝ๋œ ์ˆ˜์ง„์ž์™€ 30์„ธ ๋ฏธ๋งŒ ์„ฑ์ธ 1,011๋ช…์„ ์ œ์™ธํ•œ 12,745๋ช…(๋‚จ์ž 7,466๋ช…, ์—ฌ์ž 5,279๋ช…)์„ ์—ฐ๊ตฌ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค.์—ฐ๊ตฌ๋Œ€์ƒ์ž์˜ ์ผ๋ฐ˜์ ์ธ ํŠน์„ฑ๊ณผ ์—ฐ๋ น๊ตฐ/๋ณ‘์›๋ณ„ ํŠน์„ฑ์„ ๋‚˜ํƒ€๋‚ด๊ณ  30์„ธ ์ด์ƒ์—์„œ NCEP-ATPโ…ข(National Cholesterol Education Program Adult Treatment Panel โ…ข)์™€ APC(Asia Pacific Criteria: ์•„์‹œ์•„-ํƒœํ‰์–‘๋น„๋งŒ์ง€์นจ) ๊ธฐ์ค€์˜ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์—ฐ๋ น ๊ต์ • ์œ ๋ณ‘๋ฅ (2005๋…„ ์„œ์šธ์‹œ ํ‘œ์ค€์ธ๊ตฌ)์„ ๊ตฌํ•˜์˜€๋‹ค. ์ด ๋•Œ ๋น„๋งŒ๊ธฐ์ค€์„ ์ฒด์งˆ๋Ÿ‰์ง€์ˆ˜(Body Mass Index)์™€ ํ—ˆ๋ฆฌ๋‘˜๋ ˆ๋กœ ๊ตฌ๋ถ„ํ•˜์—ฌ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์œ ๋ณ‘๋ฅ ์„ ๋น„๊ตํ•˜์˜€๋‹ค.๋Œ€์‚ฌ์ฆํ›„๊ตฐ๊ณผ ๊ด€๋ จ์š”์ธ๋ถ„์„(๋‹จ๋ณ€๋Ÿ‰ ๋กœ์ง€์Šคํ‹ฑ)์„ ํ•˜์˜€์œผ๋ฉฐ ์ด ๋•Œ ๊ฐ ํ•ญ๋ชฉ์„ ์—ฐ๋ นํ†ต์ œํ•œ ํ›„ ๋น„์ฐจ๋น„(odds ratio)๋ฅผ ๊ตฌํ•˜์˜€๋‹ค. ๊ด€๋ จ์š”์ธ์œผ๋กœ AST(Aspartate aminotransferase), ALT(Alanine aminotransferase), GGT(Gamma Glutamyl Transferase), WBC(White Blood Cells)์˜ ๊ฒฝ์šฐ ๊ฒฐ๊ณผ์ˆ˜์น˜๋ฅผ ์‚ฌ๋ถ„์œ„์ˆ˜(Q1-Q4)๋กœ ๋‚˜๋ˆ„์—ˆ์œผ๋ฉฐ CRP(C-reactive protein)๋Š” ๋ฏธ๊ตญ์‹ฌ์žฅํ˜‘ํšŒ์™€ ์งˆ๋ณ‘ํ†ต์ œ์„ผํ„ฐ์—์„œ ๋งˆ๋ จํ•œ ๊ฒ€์‚ฌ์ง€์นจ์— ๋”ฐ๋ผ 0.1mg/dL ์ดํ•˜(์ €์œ„ํ—˜), 0.1๏ฝž0.3mg/dL(ํ‰๊ท ์œ„ํ—˜), 0.3mg/dL ์ด์ƒ(๊ณ ์œ„ํ—˜)์œผ๋กœ ๊ตฌ๋ถ„ํ•˜์˜€๋‹ค. ๊ฐ ๊ด€๋ จ์š”์ธ๋ณ„๋กœ ๊ฐ€์žฅ ๋‚ฎ์€ ์ง‘๋‹จ์„ ๋น„๊ต๊ตฐ์œผ๋กœ ํ•˜์—ฌ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ๊ณผ์˜ ๋น„์ฐจ๋น„(odds ratio)๋ฅผ ๊ตฌํ•˜์—ฌ ๊ด€๋ จ์„ฑ์„ ๋ณด์•˜๋‹ค.์—ฐ๊ตฌ ๊ฒฐ๊ณผ์—ฐ๊ตฌ๋Œ€์ƒ์ž์˜ ํ‰๊ท ์—ฐ๋ น์€ ๋‚จ์ž 45.9์„ธ, ์—ฌ์ž 46.2์„ธ์ด๋ฉฐ ๋‚จ๋…€ ๊ตฌ์„ฑ์€ ๋‚จ์ž 58.6%, ์—ฌ์ž 41.4%๋กœ ๋‚จ์ž๊ฐ€ ๋งŽ์•˜๋‹ค. ๋น„๋งŒ๊ธฐ์ค€์„ ํ—ˆ๋ฆฌ๋‘˜๋ ˆ๋กœ ํ•œ ๊ฒฝ์šฐ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์—ฐ๋ น ๊ต์ • ์œ ๋ณ‘๋ฅ ์€ ์ „์ฒด 17.2%์ด๋ฉฐ ๋‚จ์ž 19.1%, ์—ฌ์ž 14.9%๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด์™€ ๋น„๊ตํ•˜์—ฌ ๋น„๋งŒ๊ธฐ์ค€์„ ์ฒด์งˆ๋Ÿ‰์ง€์ˆ˜๋กœ ํ•œ ์—ฐ๋ น ๊ต์ • ์œ ๋ณ‘๋ฅ ์€ ์ „์ฒด 18.5%์ด๋ฉฐ ๋‚จ์ž 22.8%, ์—ฌ์ž 13.2%๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค.๋Œ€์‚ฌ์ฆํ›„๊ตฐ ๊ด€๋ จ์š”์ธ๋ถ„์„์—์„œ๋Š” ์—ฐ๋ น์ด ์ฆ๊ฐ€ํ• ์ˆ˜๋ก ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ๋น„์ฐจ๋น„(odds ratio)๋Š” ์ฆ๊ฐ€ํ•˜์˜€์œผ๋ฉฐ ํŠนํžˆ ์—ฌ์ž์˜ ๊ฒฝ์šฐ 30~39์„ธ์— ๋น„ํ•˜์—ฌ 60์„ธ ์ด์ƒ์—์„œ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์œ„ํ—˜์ด 17.7๋ฐฐ ๋†’์•˜๋‹ค. ์—ฐ๋ น์„ ํ†ต์ œํ•œ ํ›„ WBC๋Š” ๊ฐ€์žฅ ๋‚ฎ์€ ์ง‘๋‹จ(Q1)์— ๋น„ํ•ด ๋†’์€ ์ง‘๋‹จ(Q2๏ฝžQ4)์ผ์ˆ˜๋ก ๋Œ€์‚ฌ์ฆํ›„๊ตฐ์˜ ์œ„ํ—˜์ด ๋‚จ์ž์˜ ๊ฒฝ์šฐ 1.6๋ฐฐ(Q2), 2.2๋ฐฐ(Q3), 3.7๋ฐฐ(Q4)๋กœ ์—ฌ์ž์˜ ๊ฒฝ์šฐ 1.6๋ฐฐ(Q1), 2.6๋ฐฐ(Q2), 4.8๋ฐฐ(Q3)๋กœ ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜๊ฒŒ ์ฆ๊ฐ€ํ•˜์˜€๋‹ค. ๋˜ํ•œ AST, ALT, GGT๋Š” ๊ฐ€์žฅ ๋‚ฎ์€ ์ง‘๋‹จ(Q1)์— ๋น„ํ•ด ๋†’์€ ์ง‘๋‹จ (Q2๏ฝžQ4)์ผ์ˆ˜๋ก ๋น„์ฐจ๋น„(odds ratio)๊ฐ€ ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜๊ฒŒ ์ฆ๊ฐ€ํ•˜์˜€๋‹ค. ๊ทธ ์ค‘ GGT์˜ ๊ฒฝ์šฐ ๊ฐ€์žฅ ๋‚ฎ์€ ์ง‘๋‹จ(Q1)์— ๋น„ํ•˜์—ฌ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์œ„ํ—˜์ด ๋‚จ์ž์˜ ๊ฒฝ์šฐ 2.8๋ฐฐ(Q2), 5.9๋ฐฐ(Q3), 15.0๋ฐฐ(Q4)๋กœ ์ฆ๊ฐ€ํ•˜์˜€์œผ๋ฉฐ ์—ฌ์ž์˜ ๊ฒฝ์šฐ 2.4๋ฐฐ(Q2), 4.5๋ฐฐ(Q3), 6.5๋ฐฐ(Q4)๋กœ ์ฆ๊ฐ€ํ•˜์˜€๋‹ค. CRP๋Š” ์ €์œ„ํ—˜์ง‘๋‹จ๋ณด๋‹ค ํ‰๊ท ์œ„ํ—˜, ๊ณ ์œ„ํ—˜์ง‘๋‹จ์ผ์ˆ˜๋ก ๋Œ€์‚ฌ์ฆํ›„๊ตฐ์˜ ๋น„์ฐจ๋น„(odds ratio)๊ฐ€ ๋‚จ๋…€ ๋ชจ๋‘ ์ฆ๊ฐ€ํ•˜์˜€๋‹ค.WBC์™€ GGT๋Š” ์ฆ๊ฐ€ํ• ์ˆ˜๋ก ๊ณ ์ค‘์„ฑ์ง€๋ฐฉํ˜ˆ์ฆ์˜ ์œ„ํ—˜์„ ๊ฐ€์žฅ ๋†’์˜€์œผ๋ฉฐ AST, ALT, CRP๋Š” ์ˆ˜์น˜๊ฐ€ ์ฆ๊ฐ€ํ• ์ˆ˜๋ก ๋น„๋งŒ์˜ ์œ„ํ—˜์„ ๊ฐ€์žฅ ๋†’์˜€๋‹ค.๊ฑด๊ฐ•๊ฒ€์ง„์„ผํ„ฐ ์ค‘์‹ฌ์˜ ๋Œ€์‚ฌ์ฆํ›„๊ตฐ ์—ฐ๊ตฌ๋Š” ์ ˆ๋Œ€์น˜์˜ ์ถ”์ •๋ณด๋‹ค๋Š” ์ƒ๋Œ€์ ์ธ ๊ด€๋ จ์„ฑ์„ ๋ณด๋Š” ์—ฐ๊ตฌ์— ์ง‘์ค‘ํ•˜๋Š” ๊ฒƒ์ด ๋ฐ”๋žŒ์งํ•œ ๊ฒƒ์œผ๋กœ ๋ณด์ด๋ฉฐ ๋ณ‘์›๋ณ„๋กœ ๊ฒ€์‚ฌ์ˆ˜์น˜์˜ ์ฐจ์ด์ ์„ ๋ณด์˜€์œผ๋ฉฐ ์ด๋Š” ํ–ฅํ›„ ๋งŽ์€ ์—ฐ๊ตฌ๋ฅผ ์œ„ํ•˜์—ฌ ๋ฌธ์ง„๊ณผ ๊ฒ€์‚ฌ๋ฐฉ๋ฒ•์˜ ํ†ต์ผ ๋˜๋Š” ์ •๋„๊ด€๋ฆฌ๋ฅผ ํ†ตํ•œ ๊ฒ€์ง„์ˆ˜์น˜์˜ ๋ณด์ •์ด ํ•„์š”ํ•  ๊ฒƒ์œผ๋กœ ๋ณด์ธ๋‹ค. [์˜๋ฌธ]Purposes: The purposes of this study were to examine prevalence of a metabolic syndrome in healthy subjects aged 30 years old and more, and to analyze influencing factors. The present study might contribute to prevent metabolic syndrome and cardiovascular disease incidence.Methods: The data for the study were collected from a sample of 13,756 subjects who had a routine examination at 5 health centers from April, 2006 till December, 2006. We excluded 1,011 subjects who were under 30 years old and did not submit questionnaires, physical exam data and blood test results. The final sample used for the study was 12,745 (7,466 men, 5,279 women). To estimate the prevalence of the metabolic syndrome among the subjects, the reference values applied to the data were based on the Asia-Pacific waist-circumference (WC), and body mass index (BMI). The age-adjusted prevalence of the metabolic syndrome was estimated by using the direct standardized method. Factors related with metabolic syndrome were analyzed through logistic regression analysis.Results: The mean age for the study subjects was 45.9 years old for men and 46.2 years old for women. Forty one point four percent among subjects were women. The prevalence of the metabolic syndrome was increased with increasing age group. The age-adjusted prevalence of the metabolic syndrome was 17.2% (19.1% for men, 14.9% for women) based on the Asia-Pacific criteria for WC. The age-adjusted prevalence was 18.5% (22.8% for men, 13.2% for women) based on BMI.Associated factors for metabolic syndrome were age, ex-smoker, WBC, AST, ALT, GGT and CRP. Among these factors, women aged 60 years old or higher and/or men with highest quartile of GGT were significantly associated with metabolic syndrome. Also, WBC and GGT were highly associated with high level of triglycerides. In addition, AST, ALT and CRP were significantly associated with obesity.Conclusions: Based on multi-center approach in urban area, the prevalence of metabolic syndrome was relatively lower than that from nationwide survey. However, metabolic syndrome related factors were similar including: age, WBC, AST, ALT, GGT and CRP.ope

    Thomas Hardy ์†Œ์„ค์— ๋‚˜ํƒ€๋‚œ ํƒ€์ž๋กœ์„œ์˜ ์—ฌ์„ฑ

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์™ธ๊ตญ์–ด๊ต์œก๊ณผ ์˜์–ด์ „๊ณต,2002.Maste

    Eros and Thanatos in Chopin's The Awakening

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    This paper is to investigate how the dynamics of Eros (sexual instinct, the instinct of self-preservation) and Thanatos (death instinct) work with each other in Chopins The Awakening. In truth, Eros is not incompatible with Thanatos. Instead the highest self-love inevitably goes with the self-destruction (physical death) as we can see in Tristan and Isolde. At the end of the 19th century, American society witnessed a very intense conflict between the traditional Victorian moral values and the new awakening for women that mainly stemmed from both the philosophy of enlightenment and American transcendentalism. As for Edna, the heroine of The Awakening, everything which surrounds her, especially the 19th century Creole society in Louisiana rigorously prohibits her from realizing her real identity, her so-called essentials. The role assigned for her by society is nothing but that of a wife or a mother. At first, Edna repeatedly tries to overcome these social barriers through the salvation of the surrogate mothers (Adele Ratignolle, Mlle. Reisz) or the perfect lover (Robert Lebrun) which is destined to fail. Gradually the home, the counterpart of Foucaults prison, is suffocating her to the extent that she cannot sustain herself as an integrated individual any more. Motherhood is one of the most unwilling duties imposed on her by society. She neither wants to be a woman-angel nor a woman-monster. Like the great thunderstorm that hit all of Louisiana in 1893, the Thanatos in Edna finally induces her to take her own life. Her suicide should be regarded as not a defeat to her fate but a victory to achieve her true self which is the only worthwhile object of her highest Eros
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