- What will be the Proper Criteria for Impaired Fasting Glucose for Korean Men?: Based on Medical Screening Data from a General Hospital.
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Seungho Ryu, Yoo Soo Chang, Dong Il Kim, Byung Seong Suh, Woon Sool Kim
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J Prev Med Public Health. 2005;38(2):203-207.
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Recently, the American Diabetes Association (ADA) redefined the criteria of prediabetes, which has lowered the diagnostic level of fasting plasma glucose (FPG) from 110 to 125 mg/dl, down to levels between 100 to 125mg/dl. The purpose of this study was to determine the predictive cutoff level of FPG as a risk for the development of diabetes mellitus in Korean men. METHODS: A retrospective cohort study was conducted on 11, 423 (64.5%) out of 17, 696 males < or =30 years of age, and who met the FPG of < or =125 mg/dl and hemoglobin A1c of < or = 6.4% criteria, without a history of diabetes, and who were enrolled at the screening center of a certain university hospital between January and December 1999. The subjects were followed from January 1999 to December 2002 (mean follow-up duration; 2.3 (+/-0.7) years). They were classified as normal (FPG < 100mg/dl), high glucose (FPG > or =100mg/dl and < 110mg/dl) and impaired fasting glucose (FPG > or =110mg/dl and < or =125mg/dl) on the basis of their fasting plasma glucose level measured in 1999. We compared the incidence of diabetes between the 3 groups by performing Cox proportional hazards model and used receiver operating characteristic analyses of the FPG level, in order to estimate the optimal cut-off values as predictors of incident diabetes. RESULTS: At the baseline, most of the study subjects were in age in their 30s to 40s (mean age, 41.8 (+/-7.1) year). The incidence of diabetes mellitus in this study was 1.19 per 1, 000 person-years (95% CI=0.68-1.79), which was much lower than the results of a community-based study that was 5.01 per 1, 000 person-years. The relative risks of incident diabetes in the high glucose and impaired fasting glucose groups, compared with the normal glucose group, were 10.3 (95% CI=2.58-41.2) and 95.2 (95% CI= 29.3-309.1), respectively. After adjustment for age, body mass index, and log triglyceride, a FPG greater than 100mg/dl remained significant predictors of incident diabetes. Using the receiver operating characteristic (ROC) curve, the optimal cutoff level of FPG as a predictor of incident diabetes was 97.5 mg/dl, with a sensitivity and a specificity of 81.0% and 86.0%, respectively. CONCLUSION: These results suggest that lowering the criteria of impaired fasting glucose is needed in Korean male adults. Future studies on community-based populations, including women, will be required to determine the optimal cutoff level of FPG as a predictor of incident diabetes.
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- Abdominal Obesity in Relation to the Incidence of Type 2 Diabetes Mellitus and Impaired Fasting Glucose among some Korean Adults: A Retrospective Cohort Study.
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Seung Ho Ryu, Sung Ho Beck, Yoo Soo Chang, Dong Il Kim, Byung Seong Suh, Woon Sool Kim, Ki Chul Sung
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J Prev Med Public Health. 2004;37(4):359-365. Published online November 30, 2004
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This study was performed to determine whether an increase in abdominal obesity is an independent risk factor for impaired fasting glucose and type 2 DM. METHODS: Among 24, 212 adults over 30 years who undertook comprehensive medical screening examinations from Jan to Dec 1999, in a university hospital in Seoul, a total of 11, 183 subjects were selected who had no DM at baseline and who were followed up more than once by Dec 2002. The average follow up period was 2.4 (+/-0.5) years. DM was defined as having a fasting glucose level > or = 126mg/dl, and impaired fasting glucose as showing a fasting glucose level between 110 and 125 mg/dl. Body weight, height and waist circumference (WC) were simultaneously measured with blood sampling. The relative risks (RRs) for DM and impaired fasting glucose by WC were calculated using Cox proportional hazard model. Ageadjusted rates were estimated by direct standardization using a reference population of 2000 from 30 to 80 years. RESULTS: The average age of the subjects was 41.7 (+/- 7.0) years; males 41.2 (+/-6.5) and females 45.6 (+/-9.2). RRs for type 2 DM by WC with the reference group of WC < 80cm were as follows: 2.66 (95%, CI 0.55~12.8) for WC of 80~89cm in men, 5.92 (95%, CI 1.08~32.3) for WC > or = 90 cm in men, and 2.64 (95%, CI 0.23~29.8) for WC of 80~89cm in females. RRs for impaired fasting glucose by WC were 3.03 (95%, CI 2.18~4.22) for WC 80~89cm in men, 6.10 (95%, CI 4.25~8.75) for WC > or = 90cm in men, and 1.56 (95%, CI 0.43~5.67) for WC 80~89cm in women, and 8.08 (95%, CI 2.22~29.4) for WC > or = 90cm in females. These results remained significant after adjustment for age, BMI and fasting glucose concentrations at baseline in both sexes. Annual increment of more than 1 cm in WC was associated with the development of DM and impaired fasting glucose independently of age, sex, BMI, or presence of abdominal obesity. CONCLUSION: In Korean adults, abdominal obesity increased the risk for the development of type 2 diabetes and impaired fasting glucose. This result supports many other prospective studies suggesting abdominal obesity as a risk factor for type 2 diabetes.
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- Incidence Density of Antibody against Hepatitis C Virus in Seoul and Gyeonggi Area; A Retrospective Cohort Study: Based on Medical Screening Data from a General Hospital.
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Seung Ho Ryu, Dong Il Kim, Byung Seong Suh, Woon Sool Kim, Yoo Soo Chang, Sung Ho Beck, Soo Jin Lee, Jaechul Song, Yong Kyu Kim
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J Prev Med Public Health. 2004;37(4):337-344. Published online November 30, 2004
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This study was performed to determine the incidence density and the prevalence of sero-positive hepatitis C from 1999 to 2002 among adults aged 20 and over residing in Seoul and the Gyeonggi province. METHOD: The data for period was obtained from 114, 635 adults, residing in Seoul or the Gyeonggi province, who had undertaken comprehensive health screening tests from Jan 1999 to Dec 2002 in a University hospital in Seoul. Among them, subjects with sero-negative status against hepatitis C were selected (21, 408 in 1999, 28, 830 in 2000) and then followed up until Dec 2002 to determine the incidence of hepatitis C during this period. The serum was tested with the immunoradiometric assay (IRMA) which uses third generation HCV antibody. Age adjusted rates were estimated by direct standardization using a reference population of 2000 aged from 20 to 80 years. RESULTS: The prevalence of anti-HCV from 1999 to 2002 was 2.1 per 1000 persons (95% CI 1.8~2.4). Male showed 1.7 per 1000 persons (95% CI 1.4~2.1), while female showed 2.7 per 1000 persons (95% CI 2.2~3.2). Age?sex adjusted rate showed 2.8 per 1000 persons (95% CI 2.64~2.96), which is lower than the results of some previous study. The prevalence showed a significantly increasing pattern with age both in males and females (p< 0.05). The incidence density of anti-HCV among the population aged 20 and over was 1.1 per 104 person-years at risk (95% CI 0.6~2.4) ; 1.2 (95% CI 0.6~2.7) for males and 0.8 (95% CI 0.6~4.2) for females. Age adjusted incidence density was 2.91 per 104 person-years at risk (95% CI 2.43~3.38) for those aged 20 and over. It showed an increasing pattern with age (p< 0.05), especially for those age over 50 years. CONCLUSION: The study subjects for this study were supposedly healthier than the general population so the prevalence and incidence for the general population are thought to be higher than the results of the present study.
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- Study on the Indoor-Outdoor NO2 Levels and Related Factors in Urban Aprtments.
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Byung Seong Suh, Sung Hwan Kim, In Shik Kim, Yum Young Hur, Sou Young Do, Jung Man Kim, Joon Youn Kim
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Korean J Prev Med. 1997;30(3):609-622.
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- Nitrogen dioxide (NO2) has been regarded as one of the main elements among air pollutants, and we measured NO2levels of near gas range, kitchen, living room and outdoor on 489 apartments in Pusan area. NO2were sampled by using Palmes tubes (diffusion tube sampler) during August 16-25, 1995 (summer) and January 15-29, 1996 (winter), respectively. Authors wanted to know comparison of NO2levels in summer and winter, NO2 levels categorized by variables, and variables affected to NO2levels. According to this study, we conducted to establish the degree of indoor-outdoor air pollution of urban apartments in Korea and methods to reduce indoor air pollution. The results of this study were summarized as follows: 1) Mean NO2levels of near gas range, kitchen, living room, and outdoor were 25.9+/-10.0 ppb, 23.3+/-8.0 ppb, 19.9+/-6.1 ppb, and 19.0+/-6.0 ppb in summer, and 34.5+/-16.8 ppb, 28.2+/-13.4 ppb, 25.3+/-12.5 ppb, 21.8+/-9.8 ppb in winter, respectively. 2) Mean NO2levels according to the floor levels were not significantly different in summer, and in winter, NO2levels were decreased as the floor levels were increasing, but those were increased above 16th floor. 3) Variables showing significant correlation (p<0.05) with NO2levels were as follows; Summer: floor level, family size, number of family during a meal, number using gas range during rice cooking per day, and natural ventilation. Winter: floor level, family size, number of person who have been respiratory disease in a house, number of family during a meal, total number of meals, and number using gas range during rice or side-dish cooking per day. 4) We suggest that the methods of reducing indoor NO2levels are ventilation during cooking, complete combustion, decreasing number and time of cooking, and substitution of fuels.
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- Seroepidemiologic Study of Hepatitis B Virus(HBV) and Hepatitis C Virus(HCV) Infection among Koreans in Rural Area, Korea.
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Hai Rim Shin, Joon Youn Kim, Jue Bok Song, Byung Seong Suh, Jung Man Kim, Bu Ok Lee, Su Ryang Kim, Mu Guan Yang, Chae Un Lee, Jin Ho Chun, Keun Young Yoo, Yoon Ok Ahn
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Korean J Prev Med. 1997;30(1):17-30.
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- To estimate the prevalence of hepatitis B virus(HBV) and hepatitis C virus(HCV) infection and to determine associated risk factors, a population-based seroepidemiologic study was carried out. In 1993, a health examination survey of the population was carried out in rural area known to have a high incidence of liver cancer. The study population were those who volunteered to participate in a health survey over 10 years of age. Examinees were interviewed by specially trained staffs. Sera from 1,033 study subjects were tested for hepatitis B surface antigen (HBsAg) by reverse passive hemagglutinin (RPHA) estimation and for hepatitis C virus antibody (anti-HCV) by 2nd generation passive hemagglutinin (PHA) estimation, The age and sex standardized prevalence of HBsAg was 6.3% which was similar to national average, but that of anti-HCV was 5.1% which was 4 to 5 times higher than that of blood or other health examinees in Korea. In a multivariate analysis, transfusion history, surgical operative history, and acupuncture history were not associated with HBsAg positivity. In contrast, acupuncture history (adjusted odds ratio[OR]=2.2 : 95% Confidence interval[CI] 1.0-4.7) and surgical operative history(adjusted OR=2.0 : 95% CI 1.0-4.1) were associated with anti-HCV positivity. The present study suggest that there is an highly endemic area of HCV infection in Korea and probably this endemicity is associated with a parenteral source of HCV infection other than blood transfusion.
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