Smoking as a risk for CAD : The KMIC Study

지선하 한국지질학회 1999 韓國脂質學會誌 Vol.9 No.3

Serum Adiponectin and Type 2 Diabetes: A 6-Year Follow-Up Cohort Study

지선하,안철우,박종숙,박창규,김현숙,이상학,박성하,이명숙,이창범,박혜순,김희진,최성희,성지동,오승준,정효지,김성래,윤호정,김선미,이홍수,목예진,최은미,윤영덕,백수진,주재성,허갑범 대한당뇨병학회 2013 Diabetes and Metabolism Journal Vol.37 No.4

Background: Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women. Methods: A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used. Results: Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders. Conclusion: A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.

Linkage of Epidemiologic Evidence With the Clinical Aspects of Metabolic Syndrome

지선하,조재성 대한심장학회 2012 Korean Circulation Journal Vol.42 No.6

Metabolic syndrome (MetS) is characterized by a cluster of cardiovascular risk factors, such as hypertension, glucose intolerance, high tri-glycerides, and a low high density lipoprotein-cholesterol level. MetS is known to be associated with cardiovascular diseases. In order to diagnose MetS, definitions such as National Cholesterol Education Program Adult Treatment Panel III, American Heart Association/Na -tional Heart Lung and Blood Institute, International Diabetes Federation, World Health Organization, European Group for the Study of Insu-lin Resistance and American College of Endocrinology are widely used. However, using different criteria may lead to confusion regarding the diagnosis and treatment of patients with MetS in the primary care setting. Our objected was to review 3 aspects concerning MetS us-ing the Metabolic Syndrome Research Initiatives study of 123892 healthy Koreans (1994-2001) that had a maximum follow-up of 12 years. The 3 aspects were reviewed by determination of the association of MetS with the development of atherosclerotic cardiovascular disease (ASCVD) and ischemic heart disease (IHD). Based on our findings, each metabolic factor associated with MetS was not weighted equally. The hazard ratio (HR) was higher in individuals with higher glucose compared with the HR in individuals with higher body mass index. In-dividuals with pre-MetS (having 1 or 2 metabolic factors) had 1.5-2.3 fold higher risk of developing ASCVD and IHD in both genders. In the pres-ence of MetS, both singly and in combination, precede the development of ASCVD and IHD and individuals with pre-MetS must not be ig-nored as there is no apparent threshold in defining MetS. Furthermore, MetS may complement the Framingham Risk Score and can be used as the first line approach to treat the ASCVD or IHD. Metabolic syndrome (MetS) is characterized by a cluster of cardiovascular risk factors, such as hypertension, glucose intolerance, high tri-glycerides, and a low high density lipoprotein-cholesterol level. MetS is known to be associated with cardiovascular diseases. In order to diagnose MetS, definitions such as National Cholesterol Education Program Adult Treatment Panel III, American Heart Association/Na -tional Heart Lung and Blood Institute, International Diabetes Federation, World Health Organization, European Group for the Study of Insu-lin Resistance and American College of Endocrinology are widely used. However, using different criteria may lead to confusion regarding the diagnosis and treatment of patients with MetS in the primary care setting. Our objected was to review 3 aspects concerning MetS us-ing the Metabolic Syndrome Research Initiatives study of 123892 healthy Koreans (1994-2001) that had a maximum follow-up of 12 years. The 3 aspects were reviewed by determination of the association of MetS with the development of atherosclerotic cardiovascular disease (ASCVD) and ischemic heart disease (IHD). Based on our findings, each metabolic factor associated with MetS was not weighted equally. The hazard ratio (HR) was higher in individuals with higher glucose compared with the HR in individuals with higher body mass index. In-dividuals with pre-MetS (having 1 or 2 metabolic factors) had 1.5-2.3 fold higher risk of developing ASCVD and IHD in both genders. In the pres-ence of MetS, both singly and in combination, precede the development of ASCVD and IHD and individuals with pre-MetS must not be ig-nored as there is no apparent threshold in defining MetS. Furthermore, MetS may complement the Framingham Risk Score and can be used as the first line approach to treat the ASCVD or IHD.

우리나라 흡연율 변화추이와 흡연의 사회적비용

지선하 한국보건사회연구원 2003 보건복지포럼 Vol.81 No.-

한국인의 금연 실태

지선하 대한결핵협회 1999 보건세계 Vol.46 No.6

한국 정상 성인의 혈청 지질치에 관한 연구

지선하,김혜련,송경순 대한임상검사정도관리학회 1990 臨床檢査와 精度管理 Vol.12 No.2

전산 모의실험을 통한 자동혈구분석기의 적정한 정도관리 방식

지선하,송경순,이삼열,채영문 대한임상검사정도관리학회 1989 臨床檢査와 精度管理 Vol.11 No.2

임상 혈액검사실의 업무량 분석에 관한 연구

지선하,양용석,송경순 대한임상검사정도관리학회 1988 臨床檢査와 精度管理 Vol.10 No.2

흡연과 건강: 새해에는 끊읍시다

지선하 한국산업간호협회 1998 한국산업간호협회지 Vol.5 No.1

이중구간중도절단된 생존자료의 생존함수 비교를 위한 검정: 한국인 암 예방연구 중 당뇨병에의 응용

지선하,남정모,김진흠,Jee, Sun-Ha,Nam, Chung-Mo,Kim, Jin-Heum 한국통계학회 2009 응용통계연구 Vol.22 No.3

이중구간중도절단된 자료의 생존함수를 비교하기 위한 두 검정법을 소개하고 한국인 암 예방연구 (Jee 등, 2005) 자료에 적용하여 당뇨병 잠복시간의 분포를 성별과 연령에 따라 비교하였다. Kim 등 (2006)의 검정법을 이중구간중도절단된 자료로 확장한 검정법은 위험집합의 크기에만 의존하는 가중값을 사용하기 때문에 대용량 자료의 분석에서 Sun (2006)의 검정법보다 계산 시간을 대폭 줄일 수 있으며, 이산형 생존자료뿐만 아니라 연속형 생존자료에도 적용가능한 장점이 있다. 당뇨병의 잠복시간이 성별에 따라 매우 유의하게 달랐으며 여자의 잠복시간이 남자보다 긴 것으로 나타났다. 4개 연령그룹 간 당뇨병의 잠복시간도 성별에 관계 없이 매우 유의하게 달랐으며 여자의 경우가 남자의 경우보다 그 차이가 훨씬 더 유의했다. 한편, 소표본 모의실험을 통해 제안한 검정법과 Sun (2006)의 검정법의 검정력을 비교하였으며 제안한 검정법의 검정력이 Sun (2006)의 검정법보다 더 좋은 것으로 나타났다. Two tests were introduced for comparing several survival functions with doubly interval-censored data and illustrated with data surveyed by Korean Cancer Prevention Study (Jee et al., 2005). The test which extended Kim et al. (2006)'s test to the doubly interval-censored data has an advantage over Sun (2006)'s test in terms of saving computation time because the proposed test only depends on the size of risk set, and also the proposed test is applicable to continuous failure time data as well as discrete failure time data unlike Sun's test. Comparing male with female groups on the incubation time of diabetes was highly different and the survival of female group was longer than that of male one. Regardless of gender, the difference in survival functions of four age groups was highly significant with p-value of less than 0.001. This trend was more remarkable for female group than for male one. Simulation results showed that the significance level of both tests was well controlled and the proposed test was better than Sun's test in terms of power.