Objectives Decreased fertility and impaired health owing to early menopause are significant health issues. Smoking is a modifiable health-related behavior that influences menopausal age. We investigated the effects of smoking-associated characteristics on menopausal age in Korean women.
Methods This study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Menopausal age in relation to smoking was analyzed as a Kaplan-Meier survival curve for 11 510 women (aged 30 to 65 years). The risk of entering menopause and experiencing early menopause (before age 48) related to smoking were assessed using a Cox proportional hazards model.
Results The menopausal age among smokers was 0.75 years lower than that among non-smokers (p<0.001). The results of the Cox proportional hazards model showed pre-correction and post-correction risk ratios for entering menopause related to smoking of 1.26 (95% confidence interval [CI], 1.09 to 1.46) and 1.27 (95% CI, 1.10 to 1.47), respectively, and pre-correction and post-correction risk ratios for experiencing early menopause related to smoking of 1.36 (95% CI, 1.03 to 1.80) and 1.40 (95% CI, 1.05 to 1.85), respectively.
Conclusions Smokers reached menopause earlier than non-smokers, and their risk for experiencing early menopause was higher.
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BACKGROUND Many previous studies have shown that elevated homocysteine in the serum is a well known risk factor for cardiovascular disease and this is associated with other risk factors for cardiovascular disease, but any Korean data on this is limited. OBJECTIVES: This study aimed to calculate the prevalence of hyperhomocysteinemia and to analyze the relation between elevated homocysteine and the lifestyle factors of Korean adults. METHODS: We conducted a cross-sectional survey that included 650 men and 743 women (age range, 20 to 79 years) who were residents of Gwangju City in Gyeonggi-do. These subjects participated in the health interview and examination survey from November to December 2005. The total homocysteine, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride in the serum were measured. All the participants had their body composition measured such as height and weight, and we obtained health-related behavioral information through the self-entry questionnaire. RESULTS: Very right-handed skewed distributions of homocysteine were shown in men and women. The prevalence of hyperhomocysteinemia was 22.6% in men and 13.7% in women in Gwangju city. On the multiple logistic regression analysis, hyperhomocysteinemia was associated with age (OR=1.02, 95% CI=1.01-1.04), male gender (OR=1.60, 95% CI=1.02-2.52), severe general physical activity (OR=0.32, 95% CI=0.15-0.69) and nutrient consumption (OR=0.49, 95% CI=0.31-0.76). CONCLUSIONS: There is a great prevalence of hyperhomocysteinemia in adults of Gwangju City, Korea and it was associated with both genetic factors and lifestyle risk factors. This study can suggest that comprehensive lifestyle modification is needed in order to diminish the prevalence of hyperhomocysteinemia and to prevent CVD.
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OBJECTIVES The purpose of the present study was to explore a possible interaction effect of stress and social support on the smoking status and identify smoking related factors of high school students. METHODS: A cross-sectional design was used for this study. A total of 1, 251 high school students from Gyeonggi-do were selected using stratified-proportional random cluster sampling methods. The participants completed a set of questionnaires to measure their smoking status, stress, social support and sociodemographic information. The obtained data were analyzed using descriptive statistics, x2-tests and hierarchical logistic regressions. RESULTS: The interaction effect of stress and social support on smoking status was not supported. However, stress, sex, types of school, parent's smoking and friends' smoking were significantly predicted the smoking status of the high school students. CONCLUSIONS: In relation to the prevention of adolescents' smoking, it is recommended to decrease the stress levels of students, to make adolescents' parents cease smoking, and to educate adolescents on how to refuse the temptation to smoke or pressure from their smoking friend.
OBJECTIVES To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. METHODS: We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. RESULTS: 106 of 125 hospitals responding (84.8%) had more than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. CONCLUSION: Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.
OBJECTIVES To investigate the association between BMI and Mortality. METHODS: This study was based on the analysis and assembly of the 'Kangwha Cohort Study', previously conducted by the Department of Preventive Medicine, Yonsei University. A total of 2,696 males and 3,595 females were followed for almost ten years and ten months from March 1985 to January 1996, a total of whom 2,420 died during this period. The Cox's proportional hazards regression model was used to analyze this data. RESULTS: We found a U-shaped relationship between BMI and mortality among the aged men in the Kangwha cohort. The hazard ratio of dying was adjusted for age, marital status, occupation, self cognitive health level, chronic disease, smoking, and alcohol frequency, then sorted by body mass index into the following groups; less than 18.5, 18.5 to less than 21.0, 21.0 to less than 23.5, 23.5 to less than 26.0 and greater than or equal to 26. The corresponding ratios for men were 1.81(1.50-2.19, 95%CI), 1.31(1.14-1.51, 95%CI), 1.0(referent), 1.05(0.87-1.26, 95%CI) and 1.39(1.09-1.76, 95%CI), respectively. And for women, 1.46(1.19-1.78), 1.12(0.95-1.31, 95%CI), 1.0(referent), 1.00(0.84-1.20, 95%CI) and 1.09(0.89-1.34, 95%CI), respectively. CONCLUSIONS: The risk of death among aged men in Kangwha increased in the under and overweight groups. The relationship between BMI and mortality has been well studied in Western populations, but little is known about the association between BMI and mortality in our country. So, on the basis of this study, it is apparent that more studies of the relationship between BMI and mortality will be needed for future work.
OBJECTIVES The health examination survey was conducted in order to estimate the prevalence of major chronic diseases in a community. METHODS: A multi-stage stratified probability sample of 1,656 persons, aged from 20 to 69 years, was drawn out from Kuri City. All sampled persons were personally informed of the purpose, content and procedures of the survey and mobile examination center was run between 6 AM and 9 PM for the convenience of the participants. RESULTS: 854 persons (339 males and 515 females) completed this survey with a response rate of 53.4%. Prevalent diseases in male were hypertension(19.0%), HBs Ag carrier(9.8%), impaired glucose tolerance(8.7%), diabetes mellitus(6.3%), hypercholesterolemia(3.4%), anemia(2.7%) and degenerative arthritis(2.6%) in order of prevalence rate. Prevalent diseases in female were osteoporosis(22.5%), impaired glucose tolerance(17.3%), anemia(12.8%), hypertension(12.4%), degenerative arthritis (6.6%), HBs Ag carrier(5.8%), diabetes mellitus(5.4%) and hypercholesterolemia(3.5%) in order of prevalence rate. CONCLUSIONS: This results suggest that hypertension was most prevalent in adult male whereas diabetes mellitus including IGT, osteoporosis were most prevalent in adult female, in Kuri City.
This study was conducted in order to clarify the factors affecting the number of utilization to health center for the shipyard workers who have been work in exposed environment to solvent. At first the tendencies of the number of utilization to health center in accordance with cumulative exposure(CE), lifetime weighted average exposure(LWAE), one's place of duty, work contents, states of using safety apparatus, the degree of the knowledge on handling solvents, exposure year. 1) The increase in the cumulative exposure(CE) was significantly higher in the number of utilization to health center. The group with longer exposure year showed significantly higher number of utilization to health center(p<0.01). Considering the work contents such as power blasting, spray, mixing and touch-up, the group of touch-up showed higher number of utilization to health center and this difference was statistically significant(p<0.001). Those who were not using the safety apparatus, showed higher number of utilization to health center, which was statistically significant(p<0.05). The degree of the knowledge on handling the solvent had no relation with using health center. 2) The results conducted from this study by multiple regression analysis in clarifying the factors affecting the number of utilization to health center, CE, exposure year and using safety apparatus was significant factor in utilization of health center.
The purpose of this study was to identify the major health components and measurements to be conducted in National Health Examination Survey(KNHES). The prevalence and severity of disease, acceptability of population and the possibility, of standardization of measurement were considered as guideline for selecting the components. On the base of magnitude and severity of disease, chronic liver disease, hepatic cancer, gastric ulcer, stomach cancer, essential hypertension, cerebrovascular disease, ischemic heart disease, pulmonary tuberculosis, lung cancer, DM, breast cancer, cervical cancer, arthritis and intervertebral disc disorder were selected as the preliminary target diseases. Questionnaire survey for 648 persons in 'K' city and medical specialists in five clinical societies were conducted for evaluating the acceptability of general population for the measurements and the possibility of standardization for the procedures. In conclusion, the major target diseases were chronic liver disease, hypertension and DM and the total cholesterol, high density lipoprotein, triglyceride, total protein, albumin, hemoglobulin, hematocrit, platlet count, anti-HBs, HBsAg, height and weight were selected for basic physical components.
The purpose of this study was to investigate the relation between health behavior patterns and demographic, socio-economic characteristics, health status, health information in Korea. The quantification method through canonical correlation analysis was conducted to the data from Korea National Health Survey in 1995, which consisted of 5,805 persons. The health lifestyle patterns were quantified as good diet lifestyle, passive lifestyle to the negative direction and drinker lifestyle, smoker lifestyle, hedonic lifestyle and fitness lifestyle to the positive direction. The covariate were related to health lifestyle patterns in the order of sex, age, marital status, occupation, health information, economic status, level of physical labour, health status. Characteristics of male, age below 50, married, blue colored worker, no health information, low in economic status, heavy level of physical labour, and poor in health status were positively related to drinker lifestyle, smoker lifestyle, hedonic lifestyle, fitness lifestyle sequentially.
Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examine the hypothessis that "bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea", subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10, 1997, the survey was conducted. Among the total number of selected sample population(1,656 people), response rate was 52.4 percent(348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analysis results are as follows. 1. General characteristics : Mean BMD was 0.493 g/cm2, mean age was 43.0, mean BMI was 23.9 kg/m(3). The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results : Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4296 vs. 0.5057 g/cm2). But, there were to few cases of osteoarthritis of hip and hand, so comparative studies of BMD in ostearthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance wer significantly related with BMD. 3. Multivariate analysis results : To examine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. Further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.
The purpose of this study was to identify population subgroups with similar patterns of diet quality, physical activity, alcohol consumption and cigarette smoking of Korean. The cluster analysis was conducted using the data from Korea National Health Survey(KNHS) in 1995, which consisted of 5,805 persons. We identified six health behavior typologies: 32.9% of the sample had a good diet but sedentary activity level(good diet lifestyle), 7.2% had high activity level but less diet quality(fitness lifestyle). Individuals in the passive lifestyle cluster(39.1%) had no active health promoting activities but tended to avoid risk taking health behavior such as cigarette smoking and alcohol drinking. 1.1% of the sample were in a drinking cluster, 17.2% in a smoking cluster and 2.5% had a hedonic lifestyle characterized by heavy drinking and smoking. The other characteristics of these lifestyle clusters could be presented by demographic and socioeconomic factors.
Exploring the epidemiological trend of HIV/AIDS is required for making the national AIDS policy. In this study, the trend of HIV/AIDS incidence, rout of transmission and some characteristics of AIDS for the past 11 years in Korea using the reported cases from the national STD screening scheme were reviewed. Based on the results, the trend of main route of transmission according to the year was established by stage and the HIV/AIDS cases in this year was estimated and that to the year 2000 was projected by 'Epimodel' programme. The results were as follows. 1. Of the total infected persons, 76% were in their twenties and thirties, socioeconomically and sexually active age groups while the transmission by sexual contact overseas was decreasing, the infection through domestic heterosexual and homosexual contact was increasing. 2. In the middle of the 1980's, the infected persons were mainly prostitutes infected through heterosexual contact with the HIV positive foreigner in this county(stage l). And in the late of the 1980's the main source of infection was the sexual contact overseas and the domestic heterosexual contact(stage 2). Since the early of the 1990's, the infection through the heterosexual contact with non-regular sexual partner in this country has increased rapidly(stage 3), which was the evidence of the possibility of HIV epidemics. After that, it was expected that the infection through the homosexual contacts, the heterosexual contacts with commercial sex workers outside and the non-regular sexual contact inside of this county would increase continuously. In the result, the occurrence of neonatal infection by vertical transmission was expected(stage 4). 3. The number of HIV/AIDS was estimated at 572 to 2,313 and the projected number of HIV/AlDS to the year 2000 was around 5,800 including 627 AlDS patients. For the further study on the estimation and projection of HIV/AIDS, it was suggested that the sampling survey on the HIV infection rate in the high risk groups and the sentinel hospital surveillance system should be conducted.
The purpose of this study was to determine the relationships among the health concern, health practice and health status of Koreans. This study utilized the data from Korean individuals(1,304 male and 1,495 females), whose ages were between 20 and 59. The data were analyzed using SAS version 6.04 and LISREL version 7.13. The analytic methods for the study were chi-square analysis and covariance structural analysis. The results of the study were as follows. (1) There were significant positive relationships between health concern level and health practice index, and between health practice index and self-perceived health status. (2)There were negative relationships between practice index and chronic illness, and between health practice index and acute illness only in female. (3) Based on the findings, the structural model of the health concern, health practice, health status and socioeconomic variables was established and then the covariance structural analysis was used. The higher educational level and economic status were, the higher the health concern was. And urban residents were much more concerned with their health than rural residents. The more persons were concerned with health, the more they did health practices. And the more the health practice was, the higher the health status was. The younger the persons were and the higher the health status of one's family was, the higher the health status was. In female, the higher the economic status was, the higher the health status was.
The purpose of this study is to analyze the relationship between the blood pressure level and their sexual maturity and physical growth in the children at puberty. For this purpose, we estimated the blood pressure, physical growth and sexual maturity of the boys of 335 and girls of 373 who are in the middle schools which are located in Kang-wha County, KyungKi-Do. Both systolic and diastolic pressure were measured twice. Such physical growth as height, body weight, skin fold thickness, waist circumference, hip circumference and arm circumference were measured. The sexual maturity was estimated according to the classification of Tanner's 5-phase-sexual-maturity; in boys, their pubic hair development phase; in girls, their pubic hair and breast development phase and the menstrual experience. In the phase of the pubic hair development, the boy's sexual maturity was distributed into this; the 1 st 56.4%, the 2nd 29.3%, the 3rd 9.9%, the 4th 4.1% and the 5th 0.3%. While the girls sexual maturity was distributed into this : the 1 st 20.5%, the 2nd 34.9%, the 3rd 30.6% the 4th 12.6% and the 5th 1.3% in the phase of the pubic hair development, and the 1 st 0.8%, the 2nd 13.7%, the 3rd 36.2%, the 4th 18.8% and the 5th 30.5% in the phase of the breast development. This indicated that the girls sexual maturity was higher than those of the boys. The girls menstrual experience rate accounted to the 58.2%. In order to see the relationship between the children's sexual maturity and blood pressure level, we regress blood pressure level on physical growth(i.e., height, BMI) and sexual maturity. Sexual maturity in treats as dummy variables. As the result of this analysis, the boys' sexual maturity has nothing to do with the blood pressure either systolic or diastolic. But the girl's systolic pressure was statistically significant; the 9% of the physical growth, the 5% of the pubic hair development and the 4% of the breast development in sexual maturity was explained. In the girls' diastolic pressure, only their pubic hair development was statistically significant; the 7% of the physical growth and the 7% of the pubic hair development in the diastolic was explained and the 5% of the physical growth in the diastolic Korotokoff phase was explained, especially, the girls experienced menstruation, their systolic and diastolic pressure were significantly high(P<0.01). Conclusively, in the first grade children attending middle schools who are in the early process of the sexual development, the sexual maturity was not related to blood pressure level, on the other hand, the blood pressure level of the girls who are more sexual development than those of the boys' have something to do with sexual maturity and physical growth.
For the purposes of analyzing the distribution and the change in blood pressure according to age and determining the factors affecting the change in blood pressure, a follow-up study had been conducted for 6 years from 1986 to 1991 for 430 primary school children age 6 years old in 1986 in Kangwha County, Korea. The mean blood pressure increased according to age. Specifically mean systolic blood pressure increased from 97.3 mmHg for male and 96.4mmHg for female(at 6 years of age) to 108.8mmHg for male and 112.1mmHg for female(at 11 years of age). Mean diastolic blood pressure increased from 60.0mmHg for male and 61.8mmHg for female(at 6 years of age) to 72.9mmHg for male 73.8mmHg for female(at 11 years of age). The average annual increase in blood pressure was 2.3mmHg(in systolic blood pressure) and 2.4mmHg(in diastolic blood pressure) for female, respectively. To determine the factors affecting the change in blood pressure, the stepwise regression analysis was conducted. Children were divided into the three groups(low, middle, and upper) according to the level of systolic and diastolic blood pressure at the age of 6, and the regression analysis was performed in each group. For the change in systolic blood pressure, the changes in weight and skinfold thickness or initial skinfold thickness for male, and the change in weight for female were selected as significant factors for children in middle and upper group. For the change of blood pressure in diastolic blood pressure, no variables was significant.