Hong-Kyu Kim

Ulsan University Hospital, Urusan, Ulsan, South Korea

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Publications (39)115.18 Total impact

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    ABSTRACT: Many lines of evidence indicate that dehydroepiandrosterone (DHEA) plays a distinct role in bone metabolism, and that its sulfated form (DHEA-S), which is easily measured in blood, may be a potential biomarker of osteoporosis-related phenotypes. However, most previous epidemiologic studies focused on postmenopausal women and reported conflicting results. We aimed to investigate the association between the serum DHEA-S level and bone mass in men. This large cross-sectional study included 1,089 healthy Korean men who participated in a routine health screening examination. Bone mineral density (BMD) at the lumbar spine, total femur, femur neck, and trochanter and serum DHEA-S level were obtained in all subjects. After adjustment for age, body mass index, lifestyle factors, and serum levels of calcium, phosphorus, testosterone, 25-OH-vitamin D3, and cortisol, higher serum DHEA-S concentrations were associated with higher BMD values at all skeletal sites. Consistently, compared to the subjects in the highest DHEA-S quartile (Q4), those in the lowest DHEA-S quartile (Q1) showed significantly lower BMD values. Multiple logistic regression analyses revealed that the odds ratios for the risk of lower BMD (T-score <-1) increased in a dose-dependent manner across decreasing DHEA-S quartiles, and the odds for the risk of lower BMD was 2.59-fold higher in Q1 than in Q4. These findings support previous evidences that DHEA-S has favorable effects on bone mass in men and suggest that a low serum DHEA-S level may be a potential risk factor for male osteoporosis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 02/2015; · 3.35 Impact Factor
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    ABSTRACT: We sought to estimate the prevalence of coronary atherosclerosis by coronary computed tomographic angiography (CCTA) and to identify risk factors attributable to the development of coronary atherosclerosis in an asymptomatic Asian population. We analyzed 6,311 consecutive asymptomatic individuals aged 40 and older with no prior history of coronary artery disease (CAD) who voluntarily underwent CCTA evaluation as part of a general health examination. The mean age of study participants was 54.7 ± 7.4 years, and 4,594 (72.8 %) were male. After age and gender adjustment using the population census of the National Statistical Office, the prevalence of plaque was 40.5 % [95 % confidence interval (CI) 38.1-42.9], and significant CAD (diameter stenosis ≥50 %) was observed in 9.0 % (95 % CI 7.7-10.2). Individuals with significant CAD were significantly older than those without (59.2 ± 8.8 vs. 54.0 ± 7.1 years, p < 0.001). Compared with individuals with no cardiovascular risk factors, there was a higher prevalence of significant CAD in individuals with diabetes mellitus [standardized rate ratio (SRR) 2.66; 95 % CI 1.93-3.68; p < 0.001], hypertension (SRR 2.24; 95 % CI 1.69-2.97; p < 0.001), or hyperlipidemia (SRR 1.65; 95 % CI 1.25-2.17; p < 0.001). There was also a greater prevalence of significant CAD in individuals with an intermediate or high Framingham risk score (SRR 5.91; 95 % CI 2.34-14.95; p < 0.001) or a high atherosclerotic cardiovascular disease risk score (SRR 8.04; 95 % CI 3.04-21.23; p < 0.001). The prevalence of coronary atherosclerosis in this Asian population was not negligible and was associated with known cardiovascular risk factors and high-risk individuals.
    The international journal of cardiovascular imaging. 01/2015;
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    ABSTRACT: Pro-inflammatory cytokines play important roles in bone metabolism and several studies have shown that carcinoembryonic antigen (CEA) may promote inflammation. We investigated the association of serum CEA levels with risk of osteoporosis and incident fracture. We performed a small cross-sectional study with 302 Korean women and a large, longitudinal study with 7,192 Korean women in an average 3-years follow-up period. For the cross-sectional study, bone mineral density (BMD) and bone turnover markers (BTMs) were measured. For the longitudinal study, incident fractures in the follow-up period were identified by using the selected International Classification of Diseases, 10th revision (ICD-10) codes and the nationwide claims database of the Health Insurance Review and Assessment Service of Korea. In the cross-sectional study, serum CEA levels correlated negatively with BMD at the lumbar spine (γ=-0.023; P=0.029) and positively with BTMs (γ=0.122 to 0.138, P=0.002 to P<0.001) after adjustment for confounding variables. In the longitudinal study, 254 (3.5%) women developed incident fractures in the follow-up period (2.8±1.3years). After adjustment for potential confounders, the hazard ratio (HR) per 1ng/mL increment of the baseline CEA level for the development of incident fracture was 1.22 [95% confidence interval (CI): 1.05-1.42]. The HR was markedly higher in subjects in the highest CEA quartile category compared with those in the lowest CEA quartile category (HR=1.54, 95% CI: 1.04-2.28). Therefore, serum CEA may be a biomarker of the risk of incident fracture in postmenopausal Korean women. Copyright © 2014. Published by Elsevier Inc.
    Bone 12/2014; 73. · 4.46 Impact Factor
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    ABSTRACT: Objective: To investigate whether the metabolically healthy obese (MHO) phenotype is associated with an increased risk of incident type 2 diabetes in a Korean population and, if so, whether systemic inflammation affects this risk in MHO individuals. Design and methods: The study population comprised 36,135 Koreans without type 2 diabetes. Participants were stratified by BMI (cutoff value, 25.0 kg/m(2)) and metabolic health state (assessed using Adult Treatment Panel-III criteria). High-sensitive C-reactive protein (hsCRP) was used as a surrogate marker of systemic inflammation. Subjects were classified into low (i.e., hsCRP< 0.5 mg/L) and high (i.e., hsCRP ≥ 0.5 mg/L) systemic inflammation groups. Results: During a median follow-up of 36.5 months (range 4.8-81.7 months), 635 of the 36,135 individuals (1.8%) developed type 2 diabetes. The MHO group had a significantly higher risk of incident type 2 diabetes (multivariate-adjusted hazard ratio [HR], 1.57 [95% CI 1.16-2.11]) than the metabolically healthy nonobese (MHNO) group. However, the risk of the MHO group varied according to the degree of systemic inflammation. Compared with the MHNO/low systemic inflammation group, the risk of type 2 diabetes in the MHO/low systemic inflammation group was not significantly elevated (multivariate-adjusted HR, 1.61 [95% CI 0.77-3.34]). However, the MHO/high systemic inflammation group had an elevated risk of incident type 2 diabetes (multivariate-adjusted HR, 3.73 [95% CI 2.36-5.88]). Conclusions: MHO subjects show a substantially higher risk of incident type 2 diabetes than MHNO subjects. The level of systemic inflammation partially explains this increased risk.
    Journal of Clinical Endocrinology &amp Metabolism 12/2014; · 6.31 Impact Factor
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    ABSTRACT: A model for predicting cardiovascular disease in Asian populations is limited.
    Circulation Cardiovascular Quality and Outcomes 10/2014; · 5.66 Impact Factor
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    ABSTRACT: This study was performed to investigate whether ventilatory dysfunction is a predictor for the development of prediabetes and type 2 diabetes in Koreans.
    Acta Diabetologica 10/2014; · 3.68 Impact Factor
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    ABSTRACT: We investigated the association between microalbuminuria and prediabetes in Korean population using data from the KNHANES 2011-2012. Prevalence of microalbuminuria was significantly increased in prediabetes group. However, the odds ratio became insignificant after adjustment for blood pressure, and the prevalence of microalbuminuria was not increased in prediabetic subjects without hypertension.
    Diabetes Research and Clinical Practice 09/2014; · 2.54 Impact Factor
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    ABSTRACT: Background. The presence of common risk factors suggests that there is a relationship between osteoporosis and cardiovascular disease, possibly via dyslipidemia and inflammation. We investigated the relationships among the lipid profile, the inflammation marker high-sensitivity C-reactive protein (hsCRP), bone turnover markers, and bone mineral density (BMD) to assess the correlation between osteoporosis and cardiovascular disease and identify factors predicting osteoporosis. Methods. The study included 759 Korean women older than 20 years of age. The BMD, serum lipid profile, and levels of hsCRP, cross-linked C-terminal peptide (CTX), and osteocalcin were measured. We compared the serum biomarkers between groups with normal and low BMD and assessed the correlations between the levels of bone turnover markers and the lipid profile and hsCRP level. Results. The concentrations of CTX, osteocalcin, and total cholesterol were significantly higher in the low BMD group than in the normal BMD group in premenopausal women group. However, hsCRP was not correlated with these parameters. Multivariate logistic regression analysis revealed that TC (OR, 1.647; 95% CI, 1.190-2.279) and osteocalcin (OR, 1.044; 95% CI, 1.002-1.088) had an increased risk of low BMD in premenopausal women. Conclusions. These results indicate that total cholesterol concentration is correlated with the levels of bone turnover markers, suggesting that it might predict osteoporosis in premenopausal women.
    BioMed Research International 05/2014; 2014:398397. · 2.71 Impact Factor
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    ABSTRACT: Purpose To determine whether C-reactive protein is associated with the type of coronary plaque seen at computed tomographic (CT) angiography. Materials and Methods The institutional review board approved this retrospective study, and the need for informed consent was waived. C-reactive protein levels were measured in 2653 asymptomatic subjects (mean age ± standard deviation, 54.7 years ± 9.2; 1811 men) who underwent self-referred coronary CT angiography as part of a general health checkup. The presence of coronary plaque, plaque type (calcified, mixed calcified, or noncalcified), stenosis degree, and number of involved segments were evaluated. Subjects with one type of plaque (calcified plaque, mixed plaque, and noncalcified plaque groups) and two or more types of plaque (multiple lesions group) were analyzed separately. Multivariate logistic regression analysis was used to evaluate the association between increasing C-reactive protein levels and plaque type. Results Coronary plaque was found in 1150 of the 2653 subjects (43.3%): calcified plaque (n = 604, 22.8%), mixed plaque (n = 67, 2.5%), noncalcified plaque (n = 208, 7.8%), and multiple lesions (n = 271, 10.2%). The C-reactive protein cutoff value of the fourth quartile was 1.2 mg/L (11.4 nmol/L), and all types of coronary plaque were increased in the higher quartile of the C-reactive protein levels. Multivariate logistic regression analysis showed that a higher C-reactive protein level was an independent predictor for the presence of noncalcified plaque (fourth vs first quartile group, odds ratio = 1.70, P = .025) and significant (50% and higher) coronary stenosis (odds ratio = 1.76, P = .020) after adjustment for traditional risk factors for coronary artery disease. Conclusion C-reactive protein is associated with noncalcified coronary arterial plaque, as seen at coronary CT angiography in asymptomatic patients after adjustment for traditional risk factors. © RSNA, 2014 Online supplemental material is available for this article.
    Radiology 04/2014; · 6.21 Impact Factor
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    ABSTRACT: Context: Although the prevalence of both metabolic syndrome (MetS) and fractures increases with advancing age, studies on possible associations between these conditions in men are limited and the results are inconsistent. Objective: To clarify the impact of MetS on male risk of incident fractures. Design and Setting: A large, longitudinal study with an average 3-year follow-up period. Participants: Korean men (n=16,078) aged 50 years or older who had undergone comprehensive routine health examinations. Main Outcome Measures: Incident fractures found after baseline examinations were identified using selected ICD-10 codes in the nationwide claims database of the Health Insurance Review and Assessment Service of Korea. Results: In total, 158 (1.0%) men developed incident fractures. The fracture event rates for subjects with and without MetS were 26.2 and 35.7 per 10,000 person-years, respectively. After adjustment for potential confounders, subjects with MetS had a much lower risk of incident fractures than subjects without MetS (HR = 0.662, 95% CI = 0.445-0.986). Furthermore, subjects with 3 and 4 or more MetS components had a 49.4% and 50.4% lower risk, respectively, of incident fractures compared to subjects without any MetS components. Importantly, additional adjustment for body mass index eliminated the statistical significance of these associations. Conclusion: Our current results indicate that the beneficial effects of MetS in reducing fracture risk could be explained by the general obesity that accompanies MetS, although other related factors, such as greater padding effect, peripheral aromatization or adipokine changes, may also contribute.
    The Journal of Clinical Endocrinology and Metabolism 02/2014; · 6.31 Impact Factor
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    ABSTRACT: The objectives of this study were to develop a coronary heart disease (CHD) risk model among the Korean Heart Study (KHS) population and compare it with the Framingham CHD risk score.
    BMJ Open 01/2014; 4(5):e005025. · 2.06 Impact Factor
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    ABSTRACT: Oxidative stress has detrimental effects on bone metabolism, and gamma-glutamyl transferase (GGT) is known to play an important role in the generation of free radical species through the extra-cellular hydrolysis of glutathione, the main cellular antioxidant. We performed a large longitudinal study with an average follow-up period of 3 years to investigate the association between baseline serum GGT levels and the development of future osteoporotic fractures (OFs) in men. A total of 16,036 Korean men aged 50 years or older who had undergone comprehensive routine health examinations were enrolled. Incident fractures at osteoporosis-related sites (e.g., hip, spine, distal radius, and proximal humerus) that occurred after baseline examinations were identified from the nationwide claims database of the Health Insurance Review and Assessment Service of Korea using selected ICD-10 codes. Among the study subjects, 156 cases (1.0%) developed incident OFs during the study period. The event rate was 32.7 (95% CI = 28.0-38.3) per 10,000 person-years. Multivariable adjusted Cox proportional hazard analyses adjusted for age, body mass index, lifestyle factors, and medical and drug histories revealed that the hazard ratio per standard deviation increase of the baseline GGT levels for the development of incident fractures was 1.115 (95% CI = 1.011-1.230). These data provide the first epidemiological evidence, in support of previous in vitro and animal studies, of the harmful effects of GGT on bone metabolism, and indicate that the serum GGT level may be a useful biomarker of poor bone health outcomes in men.
    Endocrine Journal 12/2013; · 2.02 Impact Factor
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    ABSTRACT: Backgroud: Low serum vitamin D level has been associated with several autoimmune diseases, but its association with thyroid autoimmunity is unclear. We evaluated the association of serum vitamin D level with the prevalence of autoimmune thyroid disease (AITD). Methods: Our cross-sectional study included subjects who underwent routine health check-ups, which included assays of serum 25-hydroxy vitamin D3 (25(OH)D3) and anti-thyroid peroxidase antibody (TPO-Ab), as well as thyroid ultrasonography (US) between 2008 and 2012 at Asan Medical Center. We defined AITD according to the level of TPO-Ab and US findings. Results: Total 6,685 subjects (Male, 58%; Female, 42%) were enrolled for this study. Overall prevalence of TPO-Ab positivity and both TPO-Ab/US positivity were 10.1% (Male, 6.3%; Female, 15.3%) and 5.4% (Male, 2.3%; Female, 9.7%), respectively. In female subjects, mean serum 25(OH)D3 levels were significantly lower in TPO-Ab(+) (22.0 vs. 23.5 ng/mL, P=0.030), and TPO-Ab(+)/US(+) group (21.6 vs. 23.4 ng/mL, P=0.027) as compared with corresponding control group, respectively. According to the level of serum 25(OH)D3, the prevalence of TPO-Ab positivity (21.2%, 15.5% and 12.6% in deficient, insufficient, and sufficient group, respectively, P=0.001) and both TPO-Ab/US positivity (14.7%, 9.9% and 7.1% in deficient, insufficient, and sufficient group, respectively, P<0.001) was decreased in female subjects. Interestingly, this pattern was significant only in pre-menopausal women (P=0.003 and P<0.001, respectively), but not in post-menopausal women. Multivariate analysis indicated that the adjusted odds ratios (OR) for AITD among those in the 25(OH)D3-deficient (TPO-Ab(+); OR=1.95, P=0.001 and TPO-Ab(+)/US(+); OR=2.36, P<0.001), and -insufficient group (TPO-Ab(+); OR=1.31, P=0.043 and TPO-Ab(+)/US(+); OR=1.50, P=0.017) were significantly increased when compared with -sufficient group. Conclusions: The level of serum vitamin D was significantly lower in pre-menopausal women with AITD. Vitamin D deficiency and insufficiency were significantly associated with AITD in pre-menopausal women.
    Thyroid: official journal of the American Thyroid Association 12/2013; · 2.60 Impact Factor
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    ABSTRACT: Aims/IntroductionInsulin has been associated with the risk of colorectal cancer (CRC). However, few studies have evaluated the association between insulin and colorectal adenoma. We investigated the relationship between fasting serum insulin levels or homeostasis model assessment of insulin resistance (HOMA-IR) and colorectal adenoma. Materials and Methods We retrospectively enrolled 15,427 participants who underwent both fasting serum insulin measurement and colonoscopy for a routine health examination at Asan Medical Center from January 2007 to December 2008. Participants with a history of any cancer, previous colectomy or polypectomy, those taking antidiabetic medications, and inflammatory bowel disease, non-specific colitis, non-adenomatous polyps only or CRC on colonoscopic findings were excluded. Finally, 3,606 participants with histologically confirmed colorectal adenoma and 6,019 controls with no abnormal findings on colonoscopy were included. Participants were categorized into quartiles (Q) based on fasting serum insulin levels and HOMA-IR. ResultsFasting serum insulin and HOMA-IR were significantly higher in participants with colorectal adenomas compared with controls. Multivariate regression analysis adjusting for age, sex, smoking habits, drinking habits and family history of CRC showed that participants with higher quartiles of fasting serum insulin levels (odd ratio [OR] 1.17 for 2nd Q, 1.19 for 3rd Q, and 1.42 for 4th Q, P < 0.05) or HOMA-IR (OR 1.18 for 2nd Q and 1.45 for 4th Q, P < 0.05) showed significantly increased ORs of colorectal adenoma compared with the lowest quartiles. Conclusions These findings showed that increased serum insulin levels and insulin resistance were significantly associated with the presence of colorectal adenoma.
    Journal of Diabetes Investigation. 12/2013; 5(3).
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    ABSTRACT: Bilirubin, a natural product of heme catabolism by heme oxygenase, one of key antioxidant enzymes, has been recognized as a substance with potent antioxidant and cytoprotective properties. Several studies have shown a significant negative relationship between serum bilirubin levels and the risk of metabolic disorders, including type 2 diabetes. However, longitudinal studies investigating the association of elevated serum bilirubin levels and type 2 diabetes are lacking. In the present study, we aimed to investigate the longitudinal effects of baseline serum bilirubin concentrations on the development of type 2 diabetes in healthy Korean men. This 4year retrospective longitudinal observational study was conducted at the Asan Medical Center, Seoul, Republic of Korea. The study population consisted of 5960 men without type 2 diabetes who underwent routine health examinations in 2007 (baseline) and 2011 (follow-up). Baseline serum bilirubin concentrations were determined by the vanadate oxidation method. During a 4year period, 409 incident cases of diabetes (6.9 %) were identified. Incident type 2 diabetes decreased across the baseline bilirubin quartile categories (P for trend <0.001). In multivariable-adjusted model, the relative risk (RR) for the development of type 2 diabetes was significantly lower in the highest (i.e., 1.30-2.00mg/dl) than in the lowest bilirubin quartile category (i.e., ≤0.90mg/dl), even after adjustment for confounding variables (RR=0.69, 95% confidence interval 0.48-0.99, P for trend=0.041). The results indicate that serum total bilirubin level may provide additional information for predicting future development of type 2 diabetes in healthy subjects.
    Metabolism: clinical and experimental 10/2013; · 3.61 Impact Factor
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    ABSTRACT: Elevated ferritin concentration has been implicated in the etiology of type 2 diabetes. Accumulating evidence, mostly from studies conducted on western populations, has demonstrated a strong association between the elevated ferritin concentrations and incident type 2 diabetes. In Asian populations, however, the longitudinal studies investigating the association of elevated serum ferritin levels and type 2 diabetes are lacking. In present study, we aimed to determine whether elevated serum ferritin levels are related to the incident type 2 diabetes in healthy Korean men. This 4 year longitudinal observational study was conducted at the Asan Medical Center, Seoul, Republic of Korea. The study population consisted of 2,029 men without type 2 diabetes who underwent routine health examination in 2007 (baseline) and 2011 (follow-up). Baseline serum ferritin concentrations were measured by chemiluminescent two-site sandwich immunoassay. In multiple-adjusted model, the relative risk (RR) for incident type 2 diabetes was significantly higher in highest compared with the lowest ferritin quartile category, even after adjusting for confounding variables including homeostasis model assessment of insulin resistance (RR = 2.17, 95% confidence interval 1.27-3.72, P for trend = 0.013). These results demonstrated that elevated level of serum ferritin at baseline was associated with incident type 2 diabetes in an Asian population.
    PLoS ONE 09/2013; 8(9):e75250. · 3.53 Impact Factor
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    ABSTRACT: To describe the rationale, objectives, protocol, and preliminary results for a new prospective cohort study of cardiovascular disease (CVD) risk factors in South Korea. Study members were recruited from participants in routine health assessments at health promotion centres across South Korea. Established and emerging CVD risk factors were measured. Eighteen centres holding electronic health records agreed to linkage of participants' records to future health insurance claims for monitoring of disease events. The recruitment of 430,920 participants (266,782 men, 164,138 women), aged 30-74 years, provides broad geographical reach across South Korea. Risk factor prevalence was more favourable in women than men, and, in general, in the younger rather than older study members. There was also close similarity between the characteristics of the present sample and the Korean National Health and Nutrition Examination Survey. The expected associations between risk factors and both CVD and death were also apparent. Data from the present sample, based on data linkage, show close agreement with South Korea-wide surveys (for risk factor prevalence) and the extant literature (for risk factor associations). These findings gives confidence in future results anticipated from this cohort study of east Asians - a group that has been traditionally under-researched.
    European journal of preventive cardiology. 07/2013;
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    ABSTRACT: Despite the noninvasiveness and accuracy of multidetector computed tomography (MDCT), its use as a routine screening tool for occult coronary atherosclerosis is unclear. We investigated whether the ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1), an indicator of the balance between atherogenic and atheroprotective cholesterol transport could predict occult coronary atherosclerosis detected by MDCT. We collected the data of 1,401 subjects (877 men and 524 women) who participated in a routine health screening examination of Asan Medical Center. Significant coronary artery stenosis defined as > 50% stenosis was detected in 114 subjects (8.1%). An increase in apoB/A1 quartiles was associated with increased percentages of subjects with significant coronary stenosis and noncalcified plaques (NCAP). After adjustment for confounding variables, each 0.1 increase in serum apoB/A1 was significantly associated with increased odds ratios (ORs) for coronary stenosis and NCAP of 1.23 and 1.18, respectively. The optimal apoB/A1 ratio cut off value for MDCT detection of significant coronary stenosis was 0.58, which had a sensitivity of 70.2% and a specificity of 48.2% (area under the curve, 0.61; 95% CI, 0.58-0.63, P < 0.001). Our results indicate that apoB/A1 ratio is a good indicator of occult coronary atherosclerosis detected by coronary MDCT.
    Journal of Korean medical science 05/2013; 28(5):709-16. · 0.84 Impact Factor
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    ABSTRACT: OBJECTIVE: Obesity is a well known risk factor for many cancers, including those of the esophagus, colon, kidney, breast, and skin. However, there are few reports on the relationship between obesity and thyroid cancer. We conducted this study to determine whether obesity is a risk factor for thyroid cancer by systematically screening a selected population by ultrasonography. DESIGN AND METHODS: We obtained data from 15,068 subjects that underwent a routine health checkup from 2007 to 2008 at the Health Screening and Promotion Center of Asan Medical Center. Thyroid ultrasonography was included in the checkup, and suspicious nodules were examined by ultrasonography-guided aspiration. Those with a prior history of thyroid disease or family history of thyroid cancer were excluded from this study. RESULTS: In total 15,068 subjects, 8,491 men and 6,577 women were screened by thyroid ultrasonography. Fine needle aspiration (FNA) cytology was performed in 1,427 of these patients based on predefined criteria and thyroid cancer was diagnosed in 267 patients. The prevalence of thyroid cancer in women associated with a high body mass index (BMI, per 5kg/m2 increase) (odds ratios [OR]= 1.63, 95% CI 1.24-2.10, p<0.001), after adjustment of age, smoking status, and thyroid-stimulation hormone (TSH) levels. There was no positive correlation between the prevalence of thyroid cancer in men and a high BMI (OR=1.16, 95% CI 0.85-1.57, p=0.336). There was no association between age, fasting serum insulin, or basal TSH levels and thyroid cancer in both genders. CONCLUSIONS: Obesity was associated with a higher prevalence of thyroid cancer in women when evaluated in routine health checkup setting. This association between risk factor and disease was unrelated to serum insulin and TSH levels. Additional studies are needed to understand the mechanism(s) behind the association of obesity with thyroid cancer risk.
    European Journal of Endocrinology 03/2013; · 3.69 Impact Factor
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    ABSTRACT: Bilirubin is known to have a physiologic role as an antioxidant that efficiently scavenges peroxyl radicals and suppresses oxidation, and oxidative stress has detrimental effects on bone metabolism. In the present study, we performed a 3-year longitudinal study of healthy middle-aged men, investigating the association between serum total bilirubin concentrations and annualized changes in bone mineral density (BMD). The study enrolled a total of 917 Korean men aged 40 years or older who had undergone comprehensive routine health examinations with an average follow-up interval of 3 years. BMD at proximal femur sites was measured with dual-energy X-ray absorptiometry using the same equipment at baseline and follow-up. The overall mean annualized rates of bone loss at the total femur, femoral neck, and trochanter were -0.25 %/year, -0.34 %/year, and -0.44 %/year, respectively. After adjustment for potential confounders, the rates of bone loss at all proximal femur sites were significantly attenuated in a dose-response fashion across increasing bilirubin concentrations (P = 0.006-0.046). Moreover, compared to subjects in the lowest bilirubin quartile category, those in the highest bilirubin quartile category showed significantly less bone loss at all proximal femur sites after adjustment for confounding factors (P = 0.010-0.048). This study provides the first clinical evidence that serum total bilirubin could be a protective marker against future bone loss, especially in subjects without liver diseases.
    Calcified Tissue International 02/2013; · 2.75 Impact Factor

Publication Stats

252 Citations
115.18 Total Impact Points

Institutions

  • 2009–2014
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea
    • Asan Medical Center
      • • Sports and Health Medicine Center
      • • Health Promotion Center
      Sŏul, Seoul, South Korea
  • 2012
    • Soonchunhyang University
      Onyang, South Chungcheong, South Korea
  • 2008
    • University of Ulsan
      • Asan Medical Center
      Ulsan, Ulsan, South Korea