한국인 뇌혈관질환의 위험요인에 관한 메타분석

박종구,강명근,김춘배,김기순,지선하,Park, Jong-Ku,Kang, Myung-Guen,Kim, Chun-Bae,Kim, Ki-Soon,Jee, Sun-Ha 대한예방의학회 1998 Journal of Preventive Medicine and Public Health Vol.31 No.1

This study was conducted to integrate the results of studies which evaluated or identified the risk factors of CVD(cerebrovascular disorders) for Koreans. We retrieved the literature published in Korean by manual search and the English literature by Medline database to identify studies on the relationship between reported risk factors and CVD conducted for the Korean from 1980 to August, 1997. Hypertension and total serum cholesterol were selected as subjects of quantitative meta-analysis on risk factors of CVD in Koreans. The overall effect sizes of the risk of CVD due to hypertension and total serum cholesterol were calculated by common odds ratio(OR) and average standardized mean difference, retrospectively. Before the integration of each effect sizes into common effect sizes, the heterogeneity tests were conducted. Also, sensitivity tests were conducted for the estimated common effect sizes. Regarding hypertension and CVD, a total of 9 epidemiologic studies were identified with a total of 2,271 cases of CVD. The overall OR of hypertension associated CVD was 4.10(95% confidence interval[CI] 3.56 to 4.71). The OR of hypertension associated with hemorrhagic CVD and ischemic CVD were 6.56(95% CI : 4.92 to 8.80) and 3.28 (95% CI : 2.77 to 3.90), retrospectively. The OR of hypertension in relation to hemorrhagic CVD was significantly higher than that of hypertension in relation to overall CVD or ischemic CVD. Regarding total serum cholesterol and ischemic CVD, total 9 epidemiologic studies were identified with a total of 843 cases of ischemic CVD. Average mean difference as an effect size was 0.76, which was judged an important value according to Cohen's criteria. Our data suggested that hypertension was an important risk factor of overall CVD and its subtypes, and that the total serum cholesterol was associated with ischemic CVD in Koreans. For the lack of reliable prospective studies, however, we concluded that further research designed longitudinally would be required in this area.

무증상 성인에서 심혈관질환 위험요소와 관상동맥 석회 수치와의 관계

문일봉(Il-Bong Moon),손석준(Seok-Joon Sohn) 한국콘텐츠학회 2010 한국콘텐츠학회논문지 Vol.10 No.7

관상동맥 석회수치(CACS)는 조직학적으로 동맥경화반의 총량과 높은 상관관계를 보이며, 관상동맥의 협착을 예측하는 지표와 향후 허혈성 심장질환 발생의 독립적인 위험인자가 된다. 본 연구는 2006년 1월부터 2008년 12월까지 화순전남대학교병원 건강증진센터에서 건강검진을 목적으로 CACS검사를 시행한 1042명을 대상자로 심혈관질환 위험요소 및 관상동맥 석회수치와 Framingham Risk Scores(FRS)와의 상관관계를 알아보고자 하였다. CACS와 FRS는 남성(OR, 2.38; 95% CI, 1.83-3.11), 여성(OR, 2.12; 95% CI, 1.03-4.35) 모두 관상동맥 석회수치가 없는 군과 비교하여 통계적으로 유의하게 높았으며, CACS와 심혈관질환 위험요인과의 관계에서는 연령과 성별을 통제한 다변량분석에서 여자는 연령(OR, 1.10; 95% CI, 1.06-1.15), 고밀도지단백콜레스테롤(OR, 2.38; 95% CI, 1.04-5.44), 공복혈당(OR, 2.89; 95% CI, 1.16-7.21)이 남자에서는 연령(OR, 1.11; 95% CI, 1.08-1.14), 저밀도지단백콜레스테롤(OR, 2.12; 95% CI, 1.28-3.50), 감마-글루타밀전이효소(OR, 1.73; 95% CI, 1.17-2.55), 당뇨병(OR, 3.92; 95% CI, 1.73-8.89)이 관상동맥 석회수치의 유의한 위험인자로 나타났다. Coronary artery calcium scores(CACS) has been used as surrogate marker for coronary atherosclerosis. We evaluated 1042 patients who visited the Department of Health Promotion Center in Chonnam National University Hospital and had a test of the CACS from January 2006, to December 2008. This study was performed to evaluate the relation of the CACS with Cadiovascular disease(CVD) risk factors and FRS. CACS and FRS was a significant difference between the group whose calcium score was 0 and the group whose calcium scores were 1 in case of men 2.38(95% CI, 1.83-3.11), women 2.12(95% CI, 1.03-4.35). The age-and sex-adjusted odds ratios for predictor of CVD risk factors to women with age was 1.10(95% CI, 1.06-1.15), HDL-cholesterol was 2.38(95% CI, 1.04-5.44), Fasting plasma glucose was 2.89(95% CI, 1.16-7.21), to men with age was 1.11(95% CI, 1.08-1.14), LDL-cholesterol was 2.12(95% CI, 1.28-3.50), gamma -GTP was 1.73(95% CI, 1.17-2.55), Diabetes mellitus medication was 3.92(95% CI, 1.73-8.89). The CACS seems to be a siginificant factor to evaluate the CVD risk factors.

Garlic powder intake and cardiovascular risk factors

Jin Sook Kwak,Ji Yeon Kim,Ju Eun Paek,You Jin Lee,Haeng-Ran Kim,Dong-Sik Park,Oran Kwon 한국영양학회 2014 Nutrition Research and Practice Vol.8 No.6

BACKGROUND/OBJECTIVES: Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. MATERIALS/METHODS: We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). RESULTS: The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. CONCLUSIONS: This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.

Geographic Variation in Morbidity and Mortality of Cerebrovascular Diseases in Korea during 2011-2015

Lee, Juyeon,Bahk, Jinwook,Kim, Ikhan,Kim, Yeon-Yong,Yun, Sung-Cheol,Kang, Hee-Yeon,Lee, Jeehye,Park, Jong Heon,Shin, Soon-Ae,Khang, Young-Ho Elsevier 2018 Journal of stroke and cerebrovascular diseases Vol.27 No.3

<P><B>Background</B></P> <P>Little is known about within-country variation in morbidity and mortality of cerebrovascular diseases (CVDs). Geographic differences in CVD morbidity and mortality have yet to be properly examined. This study examined geographic variation in morbidity and mortality of CVD, neighborhood factors for CVD morbidity and mortality, and the association between CVD morbidity and mortality across the 245 local districts in Korea during 2011-2015.</P> <P><B>Methods</B></P> <P>District-level health care utilization and mortality data were obtained to estimate age-standardized CVD morbidity and mortality. The bivariate Pearson correlation was used to examine the linear relationship between district-level CVD morbidity and mortality Z-scores. Simple linear regression and multivariate analyses were conducted to investigate the associations of area characteristics with CVD morbidity, mortality, and discrepancies between morbidity and mortality.</P> <P><B>Results</B></P> <P>Substantial variation was found in CVD morbidity and mortality across the country, with 1074.9 excess CVD inpatients and 73.8 excess CVD deaths per 100,000 between the districts with the lowest and highest CVD morbidity and mortality, respectively. Higher rates of CVD admissions and deaths were clustered in the noncapital regions. A moderate geographic correlation between CVD morbidity and mortality was found (Pearson correlation coefficient = .62 for both genders). Neighborhood level indicators for socioeconomic disadvantages, undersupply of health care resources, and unhealthy behaviors were positively associated with CVD morbidity and mortality and the relative standing of CVD mortality vis-à-vis morbidity.</P> <P><B>Conclusions</B></P> <P>Policy actions targeting life-course socioeconomic conditions, equitable distribution of health care resources, and behavioral risk factors may help reduce geographic differences in CVD morbidity and mortality in Korea.</P>

규칙적인 운동이 sarcopenic 비만여성고령자의 심혈관질환 위험인자에 미치는 영향

정주하(Jung, Joo-Ha),양승재(Yang, Seung-Jai) 한국산학기술학회 2012 한국산학기술학회논문지 Vol.13 No.9

고령기의 생활을 위협하는 obesity 여성고령자를 대상으로 sarcopenia 동반에 따른 CVD 위험의 가중성과 16 주간의 운동중재가 CVD 위험인자에 미치는 변화를 알아보고자 한다. 또한, 이러한 운동효과를 검증하여 obesity 여성 고령자에게 obesity와 sarcopenia에 대한 운동의 중요성을 부각시켜 삶의 질 향상에 도움을 주기 위한 연구이다. 비만 여성고령자를 sarcopenia 동반유무에 따라 sarcopenic obesity group(SOG)과 non-sarcopenic obesity group(NOG)으로 나 누어 16주간, 주 3회, 50-60분간 복합운동 실시 후 심혈관질환 위험인자에 미치는 영향을 분석하여 다음과 같은 결론 을 얻었다. 운동 전 두 그룹간 CVD 위험인자 비교에서는 비만 여성고령자에게 sarcopenia가 동반될 경우 CVD 위험 이 가중되지 않았으며, sarcopenic obesity 여성고령자가 non-sarcopenic obesity 여성고령자보다 HDL-C는 높게, TG는 더 낮게 나타났다. 운동중재 후에는 혈청지질에서 sarcopenic obesity 여성고령자의 경우 TC, TG는 감소하였고, HDL-C, LDL-C은 차이가 없었다. non-sarcopenic obesity 여성고령자의 경우 TC, TG, LDL-C는 감소하였으며, HDL-C 증가하였다. 따라서, sarcopenia와 CVD 위험인자와의 낮은 관련성을 확인할 수 있었으며, sarcopenic obesity 여성고령 자가 non-sarcopenic obesity 여성고령자에 비해 HDL-C, LDL-C, BP, right baPWV에서 운동효과가 더디다는 것을 발견할 수 있었다. The purpose of this study was to analyze the effects of combined exercise on body composition and cardiovascular disease risk factors in sarcopenic obesity elderly women. The subjects for the study were 21 obesity elderly women over 65 years old . They were divided into two groups, the sarcopenic obesity group(n=9) and non-sarcopenic obesity group(n=12). The variables of body composition and CVD risk factors were measured in all the subjects before and after 16-week combined exercise. The findings of this study were as follows; In the sarcopenic obesity elderly women significantly decreased total cholesterol(TC), triglyceride(TG), and left baPWV. The non-sarcopenic obesity elderly women significantly decreased total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol (LDL-C), and left baPWV, but significantly increased high density lipoprotein-cholesterol(HDL-C). The most important finding in this study was that sarcopenic obesity elderly women showed delayed effects of a 16-week combined exercise on HDL, LDL-C, BP, and right baPWV compared to the non-sarcopenic obesity elderly women.

Associations Between Screen-Based Sedentary Behavior and Cardiovascular Disease Risk Factors in Korean Youth

변원우,Marsha Dowda,Russell R. Pate 대한의학회 2012 Journal of Korean medical science Vol.27 No.4

The purposes of this study were to: 1) describe the patterns of screen-based sedentary behaviors, and 2) examine the association between screen-based sedentary behavior and cardiovascular disease (CVD) risk factors in representative Korean children and adolescents,aged 12 to 18 yr, in the Korean National Health and Nutrition Examination Survey. Screenbased sedentary behavior was measured using self-report questionnaires that included items for time spent watching TV and playing PC/video games. Physical activity was measured using items for frequency and duration of moderate-to-vigorous physical activity (MVPA). CVD risk factors such as body mass index (BMI), waist circumference, LDL cholesterol, HDL cholesterol, total cholesterol, triglycerides, glucose, systolic blood pressure, and diastolic blood pressure were measured. Boys spent more time playing PC/video games, and girls spent more time watching TV. After adjusting for age, gender,annual household income, and MVPA, an additional hour of watching TV was significantly associated with the risk of overweight (OR 1.17 [95% CI 1.03-1.33]), high abdominal adiposity (OR 1.27 [1.06-1.51]), and low HDL cholesterol (OR 1.27 [1.10-1.47]). An additional hour spent playing PC/video games also increased the risk of high abdominal adiposity (OR 1.20 [1.03-1.40]). Prospective observations and interventions are needed to determine causal relationships between screen-based sedentary behavior and CVD risk profiles in Korean youth.

Index of Waist-to- Height Ratio (W/HtR) related abdominal fat and CVD risk factors

Lee Dong-Jun(이동준),Nho Ho-Sung(노호성),Kim Jung-Ju(김정주) 한국체육과학회 2006 한국체육과학회지 Vol.15 No.1

The purpose of this study was to determine whether waist-to-height ratio (W/HtR) is an effective index for assessing abdominal fat and cardiovascular disease risk factors in middle aged women. The participants included in this study were ninety-eight middle aged women. The age, height, weight and body mass index of the subjects were 49.2±7.2years, 155.6±4.8㎝, 66.6±8.3㎏ and 27.5±3.0(㎏/㎡). All subjects were included in the study after informed consent was obtained. There was significant correlations between W/HtR and weight (r=0.580, P<.0001). The W/HtR is positively correlated with BMI (r=0.734, P<.0001). The fat mass (r=0.692, P<.0001), %fat (r=0.600, P<.0001) and WHR (r=0.882, P<.0001) were significantly correlated with the W/HtH. The total fat area (r=0.830, P<.0001), subcutaneous fat area (r=0.758, P<.0001), visceral fat area (r=0.676, P<.0001), and ViS ratio (r=0.270, P<.0001) in abdominal fat area were also significantly correlated with the W/HtH. There were significant correlations between W/HtR and HDLC (r=-0.349, P<.001), AI (r=0.199, P<.001), TG (r=0.270, P<.001). The slopes of regression equation showed that WHR, TFA were two best indicators to predict waist/height ratio (W/HtR). We propose to use W/HtR for detecting abdominal fat and cardiovascular disease risk factors in middle-aged women, because the W/HtR is the effective index of anthropometric variables, abdominal fat and CVD risk factors in middle-aged women. As a simple and non-invasive method for a assessing abdominal fat and obesity, anthropometric measurements could be efficiently used in epidemiologic study and clinical screening.

The association between measurement sites of visceral adipose tissue and cardiovascular risk factors after caloric restriction in obese Korean women

Hye-Ok Lee,Jung-Eun Yim,Jeong-Sook Lee,Young-Seol Kim,Ryowon Choue 한국영양학회 2013 Nutrition Research and Practice Vol.7 No.1

Quantities as well as distributions of adipose tissue (AT) are significantly related to cardiovascular disease (CVD) risk factors and can be altered with caloric restriction. This study investigated which cross-sectional slice location of AT is most strongly correlated with changes in CVD risk factors after caloric restriction in obese Korean women. Thirty-three obese pre-menopausal Korean women (32.4 ± 8.5 yrs, BMI 27.1 ± 2.3 kg/m2) participated in a 12 weeks caloric restriction program. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were measured using computed tomography (CT) scans at the sites of L2-L3, L3-L4, and L4-L5. Fasting serum levels of glucose, insulin, triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), leptin and homeostasis model assessment-insulin resistance (HOMA-IR) were observed. Pearson’s partial correlation coefficients were used to assess the relationship between AT measurement sites and changes in CVD risk factors after calorie restriction. When calories were reduced by 350 kcal/day for 12 weeks, body weight (-2.7%), body fat mass (-8.2%), and waist circumference (-5.8%) all decreased (P < 0.05). In addition, following caloric restriction, serum levels of glucose (-4.6%), TC (-6.2%), LDL-C (-5.3%), leptin (-17.6%) and HOMA-IR (-18.2%) decreased significantly (P < 0.05) as well. Changes in VAT at the level of L3-L4 were significantly greater than those at other abdominal sites, and these changes were correlated with changes in TC (P < 0.05), LDL-C (P < 0.001), SBP (P < 0.001) and HOMA-IR (P < 0.01). These results show that VAT at L3-L4 had a stronger correlation with CVD risk factors than with other AT measurement sites after caloric restriction.

과체중, 비만아동의 체질량지수, 근지구력과 심혈관질환 위험요인의 관계

이미경(MiKyungLee),제갈윤석(YoonSukJekal),김은성(EunSungKim),이승환(SeungHwanLee),전용관(JustinY.Jeon) 한국체육학회 2009 한국체육학회지 Vol.48 No.4

본 연구의 목적은 과체중 및 비만아동의 체질량지수, 체력과 심혈관 질환 위험요인의 관계를 알아보는데 있다. 80명(나이:11.96±0.85세, BMI:25.54±2.70kg/㎡)의 과체중 및 비만아동이 연구에 참여하였고, 아동의 신체구성과 비만도를 측정하고 체력요인(멀리뛰기, 윗몸일으키기, 좌전굴, 50m달리기, 1000m 달리기), 심혈관질환 위험요인(혈압, 공복시 혈당, 인슐린, HOMA-IR, 총콜레스테롤, 중성지방, 고밀도 지단백 콜레스테롤, AST, ALT, GGT) 및 염증지표(hs-CRP, 아디포넥틴)를 측정하였다. 연구결과 비만아동의 체질량지수가 높은 그룹이 낮은 그룹보다 수축기 혈압, 중성지방, 공복시 인슐린, HOMA-IR, hs-CRP, 심혈관질환 위험 지수가 높게 나타났고 고밀도 지단백 콜레스테롤은 낮게 나타났다(p<.05). 또한 비만아동의 근지구력이 높은 그룹에서 낮은 그룹보다 체질량지수, 체지방률 과 심혈관 질환 위험지수가 낮게 나타났고 아디포넥틴 수치가 높게 나타났다. 이는 아동의 체질량지수가 높고 근지구력이 낮을수록 심혈관 질환 위험도가 높아진다는 것을 알 수 있다. The purposes of this study was to examine the relationship of obesity, physical fitness and cardiovascular disease(CVD) risk factors in grade 4-6 overweight and obese children. A total of 80 children (age: 11.96±0.85, BMI:25.54±2.70kg/㎡) participated in the cross-sectional study. We measured physical fitness, CVD risk factors, aspartate amiontransferase(AST), alanine aminotransferase (ALT), gamma glutamyl transferase(GGT), high sensitivity C-reactive protein(hs-CRP) and adiponectin. The result showed that subjects with higher BMI had significantly increased systolic blood pressure(SBP), triglyceride(TG), insulin, homeostasis of insulin resistance(HOMA-IR), hs-CRP and CVD risk score(p<.05). Subjects with better muscular endurance showed significantly better SBP, TG, insulin HOMA-IR, hs-CRP, CVD risk score and adiponectin levels(p<.05).

Alcoholic and Nonalcoholic Fatty Liver Disease and Incident Hospitalization for Liver and Cardiovascular Diseases

Chang, Yoosoo,Cho, Juhee,Cho, Yong Kyun,Cho, Ara,Hong, Yun Soo,Zhao, Di,Ahn, Jiin,Sohn, Chong Il,Shin, Hocheol,Guallar, Eliseo,Ryu, Seungho Elsevier 2020 Clinical gastroenterology and hepatology Vol.18 No.1

<P><B>Background & Aims</B></P> <P>We compared the associations of nonalcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (AFLD) with risk of incident hospitalization for liver and cardiovascular diseases.</P> <P><B>Methods</B></P> <P>We collected data from the Kangbuk Samsung Health Study on 218,030 men and women in Korea who underwent a health examination from 2011 through 2016. Fatty liver disease (FLD) was detected by ultrasound during the initial examination. The Fibrosis-4 index was used to identify individuals with liver fibrosis. Participants were followed up for as long as 5.9 years and data on hospitalizations for liver and cardiovascular diseases were collected.</P> <P><B>Results</B></P> <P>The prevalence of NAFLD was 22.0% and the prevalence of AFLD was 6.4%. Over a median follow-up period of 4.2 years, we observed 51 and 1097 incident cases of liver disease– or cardiovascular disease–related hospitalizations, respectively. After adjustment for potential confounders, the multivariable-adjusted hazard ratios for liver disease–related hospitalization, comparing NAFLD and AFLD with the reference category (no excessive alcohol intake and no FLD), were 1.73 (95% CI, 0.76–3.96) and 5.00 (95% CI, 2.12–11.83), respectively. The corresponding hazard ratios for cardiovascular disease hospitalization were 1.20 (95% CI, 1.02–1.40) and 1.08 (95% CI, 0.86–1.34), respectively. Among participants with FLD, the risk of liver disease–related hospitalization increased with high Fibrosis-4 index scores, whereas the risk of incident cardiovascular disease did not.</P> <P><B>Conclusions</B></P> <P>In a large cohort study, we found an increased risk of liver disease–related hospitalizations for patients with NAFLD or AFLD, especially among those with Fibrosis-4 index scores. An increased risk of cardiovascular disease–associated hospitalization was observed in patients with NAFLD but not AFLD.</P>