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Journal of Korean medical science 12/2012; 27(12):1607. · 0.84 Impact Factor
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ABSTRACT: This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P < 0.001). The additional consultation led to improvements in the stage of health behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program.
Journal of Korean medical science 11/2012; 27(11):1285-91. · 0.84 Impact Factor
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ABSTRACT: BACKGROUND: Health risk appraisal (HRA) is an effective tool for lifestyle modification. We updated a national HRA using Robbins' method and tested its validity for predicting mortality. METHODS: We used various national statistical data (such as life tables and mortality rates) to construct a Geller-Gesner table and referred to well-designed cohort studies to calculate composite risks. We compiled an HRA age table from these data and calculated health age (HA). To test the validity of this HRA, we compared the difference in 8-year mortality among different chronological age and health age (CA-HA) categories and used age-adjusted, sex-specific Cox proportional hazard models to investigate the association between CA-HA and all-cause mortality. RESULTS: There was a significant difference in mortality according to CA-HA category, and the Cox proportional hazard model showed that as CA-HA decreased from ≥2 to ≤-6, the cumulative survival rate was significantly decreased. CONCLUSIONS: This HRA can be an effective tool for detecting people at risk and for motivating lifestyle modification in Korea.
Journal of Public Health 08/2012; · 2.06 Impact Factor
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ABSTRACT: Although obesity is shown to be less common among current smokers than never smokers, the association between visceral obesity and smoking remains uncertain.
For this cross-sectional analysis, we recruited 4656 Korean men of 19 to 79years who received a regular checkup at a health examination center between 2008 and 2010. Computed tomography was performed to measure the area of visceral and subcutaneous adipose tissue (VAT and SAT). We compared the mean VAT by multiple regression analysis across smoking status after adjusting for confounders.
Both current and former smokers had more mean VAT than never smokers. Current smokers who consumed more than 20cigarettes per day had 11% higher mean VAT than never smokers (P<0.01). Longer smoking duration, higher daily cigarette consumption before quitting, and shorter abstinence duration among ex-smokers were associated with increasing mean VAT (all P for trend<0.01). The mean VAT in former smokers was highest within 2years of abstinence. There was no significant difference of mean VAT between ex-smokers with >20years of abstinence duration and never smokers.
Both current and former smoking is associated with increased VAT. The risk of visceral obesity is proportional to the degree of exposure to cigarette smoking.
Preventive Medicine 06/2012; 55(3):183-7. · 3.22 Impact Factor
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ABSTRACT: The association between low serum testosterone levels, visceral adipose tissue (VAT), and metabolic syndrome is now well known. However, the relationship between hepatic steatosis and serum testosterone levels has not been extensively studied. Our aim was to investigate the association of serum total testosterone levels with nonalcoholic fatty liver disease (NAFLD), adjusting for the influence of VAT and insulin resistance.
This study is a retrospective observational cross-sectional one of healthy Korean men and was conducted at the Seoul National University Hospital Healthcare System Gangnam Center. We used data obtained from 495 men who were at least 20 years of age and who had undergone blood testing, abdominal computed tomography, and ultrasonography. Multiple logistic regression analysis was used to explore the association of serum total testosterone levels with NAFLD.
Men in the low serum testosterone quintile were at a higher risk for NAFLD than men in the highest serum testosterone quintile. After adjusting for age, smoking, diabetes, exercise, BMI, triglycerides, and high-density-lipoprotein cholesterol, subjects with serum testosterone levels in the lowest quintile had an odds ratio (OR) (95% confidence interval (CI)) of 5.12 (2.43-10.77) for NAFLD (p value, 0.0004). The inverse association between serum testosterone and NAFLD was attenuated by further adjustment for variables including VAT; however, it remained statistically significant (OR (95% CI): 4.52 (2.09-9.80) in the lowest quintile; p value=0.004).
A low serum total testosterone level was independently associated with NAFLD. This report is the first one suggesting the association remains unchanged even after controlling for VAT and insulin resistance.
BMC Gastroenterology 06/2012; 12:69. · 2.42 Impact Factor
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ABSTRACT: The purpose of the present study is to investigate the association of alcohol with visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) distribution and metabolic syndrome (MetS).
We conducted a cross-sectional study in 951 healthy male Korean participants who underwent health checkups. We measured the cross-sectional areas of VAT and SAT by computed tomography of the abdomen and performed a study of alcohol consumption based on questionnaire responses and a 24-hour dietary recall assessment. We analyzed the relationship of alcohol consumption with VAT, SAT, and MetS.
Alcohol consumption showed a negative association with SAT (β = -18.76, p = 0.047) but a positive association with VAT (β = 17.70, p = 0.037), independent of other factors. The adjusted odds ratios for MetS for those who consumed <7, 7 to <14, 14 to <28, and ≥28 standard drinks per week were 0.99 (0.59-1.68), 1.49 (0.84-2.63), 1.95 (1.10-3.45), and 1.99 (1.07-3.70), respectively (p for linear trend = 0.042).
Alcohol consumption is associated with decreased SAT and increased VAT accumulation. Further, alcohol consumption of ≥14 standard drinks is associated with an increased risk of MetS. Light-to-moderate drinking, which has been regarded to lower the risk of cardiovascular diseases, did not show a protective effect on adipose tissue accumulation.
Annals of Nutrition and Metabolism 01/2012; 60(1):52-61. · 2.26 Impact Factor
