Health Screening and Promotion Center

Songpa Gu, South Korea

Health Screening and Promotion Center

Songpa Gu, South Korea

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Kim Y.-J.,University of Ulsan | Min S.-Y.,Health Screening and Promotion Center | Lee D.H.,Chonnam National University | Lee B.K.,Chonnam National University | And 8 more authors.
JACC: Cardiovascular Interventions | Year: 2017

Objectives The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography. Background The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial. Methods Between January 2010 and December 2014, 1,088 consecutive adult nontraumatic patients with return of spontaneous circulation who visited the emergency department of 3 tertiary care hospitals were enrolled. After excluding 245 patients with obvious extracardiac causes, 200 patients were finally included. Results The patients were categorized into 2 groups: those with ST-segment changes with spontaneous subarachnoid hemorrhage (SAH) (n = 50) and those with OHCA of suspected cardiac origin group (n = 150). The combination of 4 ECG characteristics including narrow QRS (<120 ms), atrial fibrillation, prolonged QTc interval (≥460 ms), and ≥4 ST-segment depressions had a 66.0% sensitivity, 80.0% specificity, 52.4% positive predictive value, and 87.6% negative predictive value for predicting SAH. The area under the receiver-operating characteristic curves in the post-resuscitation ECG findings was 0.816 for SAH. Conclusions SAH was observed in a substantial number of OHCA survivors (25.0%) with significant ST-segment changes on post-resuscitation ECG. Resuscitated patients with narrow QRS complex and any 2 ECG findings of atrial fibrillation, QTc interval prolongation, or ≥4 ST-segment depressions may help identify patients who need brain CT as the next diagnostic work-up. © 2017 American College of Cardiology Foundation


Kim C.-H.,Soonchunhyang University | Kim H.-K.,Health Screening and Promotion Center | Kim E.-H.,Health Screening and Promotion Center | Bae S.-J.,Health Screening and Promotion Center | Park J.-Y.,University of Ulsan
Diabetic Medicine | Year: 2012

Aims The optimal anthropometric measure of obesity or body fat distribution that best predicts the risk of Type 2 diabetes in Asians is unclear. Moreover, it has not been determined whether BMI modifies the effect of body fat distribution on diabetes risk in Asians. Methods We analysed the anthropometric and laboratory data of 7658 non-diabetic Korean adults (5061 men and 2597 women, aged 20-79years) who underwent routine medical check-ups at 5-year intervals. BMI, waist circumference, waist-to-height ratio, and bioelectrical impedance (to calculate fat mass and per cent body fat) were measured at baseline. Results Of the 7658 participants, 278 subjects (3.6%) developed diabetes over 5years. Each of the anthropometric measures of general obesity (BMI, fat mass, per cent body fat) and central body fat distribution (waist circumference and waist-to-height ratio) was a good predictor of Type 2 diabetes. However, when the areas under the receiver-operating characteristic curves were compared, BMI (0.697; 95% CI, 0.669-0.725), waist circumference (0.709, 0.682-0.736) and waist-to-height ratio (0.718, 0.692-0.743) were better predictors of diabetes risk than fat mass (0.672, 0.643-0.700) or per cent body fat (0.657, 0.628-0.686). In the low- (<23kg/m2) and mid- (23-27kg/m2) BMI groups, the addition of waist-to-height ratio or waist circumference to BMI could improve the prediction of diabetes risk. Conclusions BMI, waist circumference and waist-to-height ratio were good predictors of Type 2 diabetes risk in Koreans. In non-obese or less obese subjects, measures of central body fat distribution can help improve the prediction of Type 2 diabetes risk when added to measures of general obesity. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.


Kim C.-H.,Soonchunhyang University | Kim H.-K.,Health Screening and Promotion Center | Bae S.-J.,Health Screening and Promotion Center | Kim E.-H.,Health Screening and Promotion Center | Park J.-Y.,University of Ulsan
Metabolic Syndrome and Related Disorders | Year: 2012

Background: Although obesity and metabolic syndrome have been associated with the risk of type 2 diabetes mellitus (T2DM), it is unclear whether obese or overweight people without metabolic syndrome are at increased risk for T2DM. Methods: Clinical and laboratory data were assessed in 8,748 subjects without diabetes (5,707 men, 3,041 women; age 20-79 years) who underwent voluntary medical check-ups at a 5-year interval. The subjects were categorized by body mass index (BMI) and metabolic syndrome status at baseline, and the incidence of diabetes over 5 years was assessed. Results: Of the 8,748 subjects, 308 (3.5%) developed T2DM over 5 years. Compared with normal weight (BMI <25.0 kg/m 2) individuals without metabolic syndrome, the adjusted odds ratios (ORs) were 1.61 (1.13-2.29) and 4.93 (1.90-12.79) for overweight (BMI 25.0-29.9 kg/m2) and obese (BMI ≥30.0 kg/m2) individuals without metabolic syndrome, respectively, and 6.94 (5.08-9.47) and 10.61 (5.59-20.14) for overweight and obese individuals with metabolic syndrome, respectively. Using the lower BMI cutoff points for Asian populations, compared with subjects with BMI <23 kg/m2 without metabolic syndrome, the adjusted ORs for subjects with BMI 23-27.4 kg/m2 and BMI ≥27.5 kg/m2 without metabolic syndrome were 2.64 (1.74-4.00) and 4.31 (2.36-7.86), respectively, and 10.11 (6.53-15.67) and 16.69 (10.40-26.77), respectively, for those with metabolic syndrome. Conclusions: Overweight/obesity and metabolic syndrome both are significant risk factors for development of T2DM in Koreans, and overweight or obesity without metabolic syndrome should not be considered a harmless condition. The lower BMI cutoffs for Asian populations can be useful in predicting risk of T2DM in Koreans. © 2012, Mary Ann Liebert, Inc.


Kim C.-H.,Soonchunhyang University | Kim H.-K.,Health Screening and Promotion Center | Kim B.-Y.,Soonchunhyang University | Jung C.-H.,Soonchunhyang University | And 2 more authors.
Journal of Diabetes Investigation | Year: 2015

To examine the impact of hemoglobin A1c (HbA1c) criterion on the diagnosis of prediabetes in Koreans, we analyzed nationally representative cross-sectional data of 5,845 Korean adults aged ≥20 years from the Fifth Korea National Health and Nutrition Examination Survey 2011. Standardized prevalence rates of prediabetes in Korean adults by fasting plasma glucose (FPG; 5.6-6.9 mmol/L), HbA1c (5.7-6.4% [39-46 mmol/mol]), and combined criteria were 16.9, 28.4 and 33.8%, respectively. Among the subjects with prediabetes, 16% met FPG criteria only, 55% met HbA1c criteria only and 29% met both criteria. Prediabetic subjects who met HbA1c criteria only were significantly older, more likely to be women, and had lower hemoglobin and serum iron concentrations, whereas those who met FPG criteria only had higher body mass index, waist circumference, systolic and diastolic blood pressure. In conclusion, introduction of HbA1c criterion markedly increased the prevalence of prediabetes in Koreans, and the two criteria identified people with different characteristics. © 2014 The Authors. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and Wiley Publishing Asia Pty Ltd.


Kim H.-K.,Health Screening and Promotion Center | Bae S.-J.,Health Screening and Promotion Center | Choe J.,Health Screening and Promotion Center
Diabetes and Metabolism Journal | Year: 2012

Background: We performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea. Methods: We retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women) which were measured during regular health check-ups. After excluding subjects with previously diagnosed diabetes mellitus (n=1,812) and with overt anemia (n=318), 35,624 subjects (21,201 men and 14,423 women) were included in the analysis. Results: Among the 35,624 subjects, 11,316 (31.8%) subjects were categorized as increased risk for diabetes (IRD) by fasting plasma glucose (FPG) criteria, 6,531 (18.1%) subjects by HbA1c criteria, and 13,556 (38.1%) subjects by combined criteria. Therefore, although HbA1c criteria alone identifies 42% [(11,316-6,531)/11,316] fewer subjects with IRD than does FPG criteria, about 20% [(13,556-11,316)/11,316] more subjects could be detected by including new HbA1c criteria in addition to FPG criteria. Among the 13,556 subjects with IRD, 7,025 (51.8%) met FPG criteria only, 2,240 (16.5%) met HbA1c criteria only, and 4,291 (31.7%) met both criteria. Among subjects with impaired fasting glucose, 65% were normal, 32% were IRD, and 3% were diabetes by HbA1c criterion. In receiver operating characteristic curve analysis, cutoff point of HbA1c with optimal sensitivity and specificity for identifying IRD was 5.4%. Conclusion: Although HbA1c criteria alone identifies fewer subjects with IRD than does FPG criteria, about 20% more could be detected by addition of HbA1c criteria. Further studies are needed to define optimal cutoff point of HbA1c and to establish screening and management guidelines for IRD. © 2012 Korean Diabetes Association.


Kim C.-H.,Soonchunhyang University | Kim H.-K.,Health Screening and Promotion Center | Kim E.H.,Health Screening and Promotion Center | Bae S.J.,Health Screening and Promotion Center | Park J.-Y.,University of Ulsan
Diabetic Medicine | Year: 2013

Aims: Controversies still exist regarding the relative contributions of insulin resistance and β-cell dysfunction to the pathogenesis of Type 2 diabetes in different populations. We examined the associations of baseline insulin resistance and β-cell function indices with the development of Type 2 diabetes in Koreans. Methods: We analysed the clinical and laboratory data of 17 878 Korean adults (age 20-79 years) who underwent routine medical examinations with a median interval of 3.5 years (range 2.5-4.7 years). Using the homeostasis model assessment, insulin resistance (HOMA-IR) and β-cell function (HOMA-%B) indices at baseline were assessed. Results: Those who developed diabetes (n = 732, 4.1%) had significantly higher fasting serum insulin level (53.4 ± 31.2 vs. 41.4 ± 23.4 pmol/l) and HOMA-IR (2.38 ± 1.45 vs. 1.65 ± 1.02) and lower HOMA-%B (74 ± 47 vs. 85 ± 48) at baseline (P < 0.001 for all). Both high HOMA-IR and low HOMA-%B were independently associated with an increased odds ratio of incident Type 2 diabetes. Among the participants who developed diabetes, 29% demonstrated predominant β-cell dysfunction (HOMA-%B < 25th percentile) and 51% had predominant insulin resistance (HOMA-IR > 75th percentile). When we divided the participants according to the median BMI of the whole population (23.7 kg/m2), 49% of participants in the low BMI group demonstrated predominant β-cell dysfunction and 26% had predominant insulin resistance, whilst 21% in the high BMI group demonstrated mainly β-cell dysfunction and 60% had mainly insulin resistance. Conclusions: In individuals with low BMI, β-cell dysfunction is the predominant defect, whereas insulin resistance is the predominant pathogenetic factor in individuals with high BMI in the development of Type 2 diabetes in Koreans. © 2013 Diabetes UK.


Kim T.H.,Health Screening and Promotion Center | Jo M.-W.,University of Ulsan | Lee S.-I.,University of Ulsan | Kim S.H.,University of Ulsan | Chung S.M.,Samsung
Quality of Life Research | Year: 2013

Purpose: The EQ-5D-5L was developed to compensate for a high ceiling effect and lack of descriptive richness of the EQ-5D-3L. We evaluated psychometric properties of EQ-5D-5L in the general population. Methods: Six hundred of adults were sampled from the general population in South Korea using a multistage stratified quota sampling method. Participants completed the EQ-5D-5L, EQ-5D-3L, and SF-36v2. One hundred participants were resurveyed for reliability evaluation. The ceiling effect, known-groups construct validity, convergent and discriminant validity, and reliability of EQ-5D-5L were evaluated. Results: A smaller proportion of participants answered 'no problem' to all dimensions of EQ-5D-5L (61.2 %) than EQ-5D-3L (65.7 %, p < 0.01), indicating a reduced ceiling effect. Female, elderly, low-educated, and low-income participants reported health problems more frequently, indicating known-groups construct validity. The mobility dimension of EQ-5D-5L was better correlated with the physical component score (|r| = 0.48) than the mental component score (|r| = 0.25) of the SF-36v2, and the anxiety/depression dimension was better correlated with mental component score (|r| = 0.45) than physical component score (|r| = 0.34), indicating convergent and discriminant validity. The intraclass correlation coefficient of EQ-5D-5L index was 0.75. Conclusions: The EQ-5D-5L has a smaller ceiling effect than the EQ-5D-3L and is a valid and reliable instrument to measure health-related quality of life in the general population. © 2012 Springer Science+Business Media Dordrecht.


Chang J.H.,Health Screening and Promotion Center | Lee H.S.,Health Screening and Promotion Center | Kang E.H.,Health Screening and Promotion Center
Journal of Nutrition and Health | Year: 2014

Purpose: The purpose of this study was to evaluate dietary habits, food intakes, nutrient intakes, and diet quality of nonalcoholic fatty liver disease in a health screening and promotion center. Methods: The total number of study subjects was 10,111 adults, where 3087 subjects (30.5%) were diagnosed as NAFLD. The dietary intakes were obtained using a food frequency questionnaire. They were then compared with the dietary reference intakes could be used in the future for development of diet and nutrition guidelines s (KDRIs). Results: Mean age of subjects in the normal group was 52.9±10.3 yrs and body mass index (BMI) was 22.4 ± 2.6 kg/m2, and those of the NAFLD group were 55.1 ± 9.2 yrs and 25.4 ± 2.9 kg/m2. BMI, blood pressure of the NAFLD group were significantly higher than those of the normal group. The rates of skipping breakfast, overeating, and eating out were significantly could be used in the future for development of diet and nutrition guidelines er in the NAFLD group (p < 0.05, p < 0.000, p < 0.000 respectively). The speed of eating was fast in the NAFLD group (p < 0.000). The NAFLD group consumed significantly higher amounts of grains, meats, fish, seaweeds, kimchies, sugars, sweets, coffee, teas, and oils compared to the normal group (p < 0.05). Meanwhile, intakes of starch products, fruits, milk, and milk products were significantly lower in the NAFLD group compared with those of the normal group (p < 0.05). Riboflavin, calcium, and dietary fiber nutrient adequacy ratio (NAR) of the NAFLD group were significantly lower than those of the normal group. The Korean's dietary diversity score (KDDS) of the NAFLD group was lower than that of the normal group. Conclusion: In conclusion, we suggest that diet guidelines, such as increasing the intake of calcium and dietary fiber, reducing the intake of energy, fat, and simple carbohydrates, are necessary to improvement of NAFLD. The results could be used in the future for development of diet and nutrition guidelines for NAFLD. © 2014 The Korean Nutrition Society


Kim H.-K.,Health Screening and Promotion Center | Kim C.-H.,Soonchunhyang University | Kim E.H.,Health Screening and Promotion Center | Bae S.J.,Health Screening and Promotion Center | And 7 more authors.
Diabetes Care | Year: 2013

OBJECTIVE-The relationship between impaired fasting glucose (IFG) and risk of cardiovascular disease (CVD) or ischemic heart disease (IHD) varies widely according to sex and ethnicity. We evaluated the relationship between IFG and CVD or IHD among Korean men and women. RESEARCH DESIGN AND METHODS-Atotal of 408,022 individuals who underwent voluntary private health examinations in 17 centers in South Korea were followed for 10 years. Data regarding CVD or IHD events were obtained from the Korean National Health Insurance database. IFG was categorized as grade 1 (fasting glucose 100-109 mg/dL) or grade 2 (110-125 mg/dL). RESULTS-Incidence rates of CVD (per 100,000 person-years) were 2,203 for diabetes. Age-adjustedhazard ratios (HRs)for CVD were 1.17(95%CI 1.13-1.20)for grade 1IFG, 1.30(1.24- 1.35) for grade 2 IFG, and 1.81 (1.75-1.86) for diabetes. The increased risk for women was similar to that of men. Age-adjusted HRs for IHD and ischemic stroke were also significantly increased for men and women with IFG and diabetes. After multivariate adjustment of conventional risk factors (hypertension, dyslipidemia, smoking, obesity, and family history of CVD), the overall risk of CVD was greatly attenuated in all categories. However, the HRs for IHD and ischemic stroke remained significantly increased in men for grade 2 IFG but not in women. CONCLUSIONS-In Korea, grade 2 IFG is associated with increased risk of IHD and ische-mic stroke, independent of other conventional risk factors, in men but not in women.© 2013 by the American Diabetes Association.


Hong S.,University of Ulsan | Lim J.H.,University of Ulsan | Jeong I.G.,University of Ulsan | Choe J.,University of Ulsan | And 2 more authors.
Journal of Human Hypertension | Year: 2013

To assess the impact of simple renal cyst (SRC) on hypertension, we evaluated the prevalence of SRC as well as the relationship between SRC and hypertension. Data were obtained from 29 666 participants who underwent general health screening tests in 2006. Only participants who underwent contrast-enhanced computed tomography or abdominal ultrasonography were included in our study population. We then correlated the clinical characteristics and parameters of hypertension with the presence or absence of renal cysts. Of all the enrolled participants, 5674 (19.2%) had radiologic evidence of SRC, and hypertension was diagnosed in 9865 participants (33.4%). The SRC had a multivariable-adjusted odds ratio (OR) of 1.28 (95% confidence interval (CI), 1.20-1.36) for the presence of hypertension. In study participants with multiple cysts (>1), a large cyst (≥4 cm in diameter) or a peripheral cyst location, the ORs for the presence of hypertension were 1.31 (95% CI, 1.19-1.44), 1.29 (95% CI, 1.06-1.56) and 1.33 (95% CI, 1.11-1.64), respectively, compared with those for study participants without cyst after adjusting for other variables. We found the presence of SRC to be associated with a significantly increased incidence of hypertension. In addition, the cyst number, size and location are important characteristics of SRC related to hypertension.© 2013 Macmillan Publishers Limited All rights reserved.

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