[Show abstract][Hide abstract]ABSTRACT: Background:
A previous large-scale cohort study investigated the relationship between coffee intake and the progression of diabetes mellitus in the United States. However, studies on the effects of coffee on diabetes are rare in South Korea. Therefore, this study assessed the amount and method of coffee intake in Koreans in order to determine if coffee intake has a prophylactic effect on diabetes progression.
This study included 3,497 prediabetic patients from a single medical institution, with glycated hemoglobin levels ranging from 5.7% to 6.4%. Cross-tabulation and Kaplan-Meier survival analyses were performed to compare patients with and without diabetes progression based on the frequency and method of coffee intake. Cox proportional hazard analysis was performed to correct for confounding variables.
The observation period (mean±standard deviation) was 3.7±2.3 years. Kaplan-Meier survival analysis revealed that the risk of diabetes progression was lowest in patients who drank black coffee three or more times per day (P=0.036). However, correction for confounding variables in Cox proportional hazard analysis revealed that, while the risk was lower for the patients who typically consumed black coffee than for those who mixed creamer and sugar into their coffees, the difference was not significant.
The results of this study suggest that drinking coffee without sugar and creamer at least three times daily has the greatest preventive effect on diabetes onset.
[Show abstract][Hide abstract]ABSTRACT: Background
Alcohol is traditionally known to have a relaxing effect. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia. In this study, we aimed to evaluate the effects of alcohol use on sleep quality.
A questionnaire-based cross-sectional survey was conducted with 234 men and 159 women who had visited a general hospital. We used structured questionnaires, including Alcohol Use Disorder Identification Test-Korean revised version (AUDIT-KR) and the Pittsburgh Sleep Quality Index-Korean version (PSQI-K). We analyzed the association between scores for all subcategories of the PSQI-K and the AUDIT-KR and then analyzed the correlation between AUDIT-KR and global PSQI-K scores.
The global PSQI-K score for men was positively correlated with the AUDIT-KR score (P=0.008) after adjusting for age, chronic disease, tobacco use, exercise, depression, and anxiety. The AUDIT-KR score was significantly associated with subjective sleep quality (P=0.005), sleep duration (P=0.047), and sleep disturbance (P=0.048); it was not associated with sleep latency, sleep efficiency, or daytime dysfunction. Sleep disturbances due to snoring were significantly associated with total AUDIT-KR score (P=0.008). There was no correlation between the global PSQI-K and AUDIT-KR scores for women (P=0.333). However, daytime dysfunction showed a significant association with total AUDIT-KR score (P=0.048).
Men with higher AUDIT-KR scores tended to suffer from poor sleep quality. AUDIT-KR scores showed significant correlations with subjective sleep quality, sleep duration, and sleep disturbances in men.
[Show abstract][Hide abstract]ABSTRACT: Alcohol is a risk factor for hypertension. Facial flushing after drinking is a typical symptom of high alcohol sensitivity. This study assessed the role of the facial flushing response in the relationship between alcohol consumption and hypertension.
The subjects were 1,763 men (288 nondrinkers, 527 flushing drinkers, 948 nonflushing drinkers) who had received a health checkup. Data were collected from the subjects' medical records. The risk of hypertension related to weekly drinking amount in nonflushers and flushers was analyzed and compared with that in nondrinkers.
After adjusting for age, body mass index, exercise status, and smoking status, the risk of hypertension was significantly increased when flushers consumed more than 4 drinks per week (more than 4 and up to 8 drinks: odds ratio [OR] = 2.23; above 8 drinks: OR = 2.35). In contrast, in nonflushers, the risk was increased with alcohol consumption of more than 8 drinks (OR = 1.61) per week. The OR (flushers/nonflushers) for hypertension was also increased: more than 4 and up to 8 drinks, 2.27 and above 8 drinks, 1.52.
These findings suggest that hypertension associated with alcohol consumption has a lower threshold value and higher risk in flushers than in nonflushers. Clinicians should consider evaluating patients' flushing response as well as drinking amount in a daily practice for health promotion.
Article · Nov 2013 · Alcoholism Clinical and Experimental Research
[Show abstract][Hide abstract]ABSTRACT: It is believed that alcohol has an intimate connection with metabolic syndrome (MS). However, the role of facial flushing after alcohol consumption in this relationship has not yet been well known. We explored the relationship between weekly alcohol consumption, risk of MS, and the flushing response.
The subjects were 1823 Korean adult males (305 nondrinkers, 540 flushers, 978 nonflushers) who had undergone a comprehensive medical check-up at Chungnam National University Hospital. We excluded the cases with the history of hypertension, diabetes, dyslipidemia, or who had taken medication in the previous month. After controlling for age, body mass index, exercise status, and smoking history, we used a logistic regression analysis to calculate the risk of MS with drinks per week in flushers and nonflushers as compared with nondrinkers.
The risk of MS in flushers was significantly increased with alcohol consumption >4 drinks (4-16 drinks: odds ratio [OR] 1.93; >16 drinks: OR 2.20). However, in nonflushers, the risk of MS was increased in those consuming >16 drinks (OR 2.02).
Our results suggest that the threshold for MS from alcohol consumption is lower in flushers than in nonflushers.
[Show abstract][Hide abstract]ABSTRACT: An ischemic foot can be developed by acute arterial occlusion. Given proper treatment within critical time, the patient can avoid foot amputation and death. Early proper diagnosis and treatment by family physician at the initial clinical interviewing is important in saving the affected leg and the life. Thrombosis and embolism are the common causes of acute arterial occlusion. Thrombosis mostly arises from underlying cardiac disease such as arrhythmia, coronary artery disease and valvular heart disease while arterial occlusion by embolism can be shown on a narrowed artery related with systemic atherosclerosis. Because the treatment options depend on the underlying cause of the acute ischemic foot, it is important to identify the cause of acute ischemic foot. At this paper, we reported a case that the cause of acute ischemic foot of the patient proved paroxysmal atrial fibrillation after some diagnostic tests.
[Show abstract][Hide abstract]ABSTRACT: Patients' insight has a critical role in the recovery from problematic behavior. The aim of this study was to evaluate the effects of a brief intervention to promote insight among alcohol-dependent patients. A total of 41 alcohol-dependent patients (30 males, 11 females) in an insight-deficient state who had been admitted to a community-based alcohol treatment center, were randomized into two groups based on their admission order: an intervention group (IG) (n = 20) and a control group (CG) (n = 21). Patients in both the IG and CG participated in an identical treatment program with one exception: patients in the IG were required to undergo five sessions of brief individual intervention focusing on insight enhancement. Changes in insight state were assessed after the intervention. The IG exhibited significant (P < 0.05) changes in the distribution of insight level, while the CG did not exhibit any significant changes in the distribution of insight level. The insight score after intervention was significantly (P < 0.05) greater for the IG than the CG with adjustment for the baseline characteristics. The results suggest that a brief individual intervention focused on insight enhancement may be an effective tool to improve insight among alcohol-dependent patients.
Full-text available · Article · Jan 2011 · Journal of Korean medical science
[Show abstract][Hide abstract]ABSTRACT: Facial flushing responses to drinking, because of intolerance to alcohol, are observed in some people, especially Asians. This study examined the role of flushing responses in the relationship between alcohol consumption and insulin resistance (IR).
Participants in this cross-sectional analysis included 624 Korean men (80 nondrinkers, 306 nonflushing drinkers, and 238 flushing drinkers) who were free of cardiovascular disease and diabetes. Data on the flushing response to drinking and alcohol consumption were collected from medical records. IR was estimated using the Homeostasis Model Assessment (HOMA(IR) ). On the basis of comparisons with nondrinkers, the risk of IR according to the quantity of alcohol consumed per week was analyzed among nonflushers and flushers.
After adjusting for age, exercise status, smoking status, BMI, waist circumference, blood pressure, high-density lipoprotein cholesterol, and triglycerides using a logistic regression model, we found a low risk of IR among nonflushers who consumed ≤4 drinks (1 drink = 14 g of alcohol) per week (OR = 0.3). In contrast, a higher risk of IR was associated with nonflushers who consumed >20 drinks per week (OR = 3.5). On the other hand, only a higher risk of IR was associated with flushers who consumed >12 drinks per week (>12 to 20 drinks: OR = 4.7; >20 drinks: OR = 3.5).
The amount of drinking associated with the development of IR in flushers was lower than in nonflushers. Additionally, no positive effect of moderate drinking on IR was observed in flushers. The findings support acetaldehyde-derived mechanisms in the development of alcohol-related IR.
Article · Oct 2010 · Alcoholism Clinical and Experimental Research
[Show abstract][Hide abstract]ABSTRACT: Hypertension is a major risk factor for the development of cardiovascular disease. The prevalence of secondary hypertension, 10% is known as a common cause of resistant hypertension. Development of diagnostic technology and the aging is likely to be increased of the prevalence. Secondary hypertension, if it is not appropriate etiologic treatment may sometimes be fatal, as well as to the proper treatment be treatable or curable hypertension. Secondary causes of hypertension include a greater prevalence of obstructive sleep apnea, renal parenchymal disease, renovascular disease and primary aldosteronism. Uncommon secondary causes include pheochromocytoma, Cushing's syndrome, hyperparathyroidism and thyroid disease. Clinical clues for secondary hypertension is onset of hypertension in persons younger than age 20 or older than age 50 without family history of hypertension, poor response to therapy, worsening of control in previously stable hypertensive patient, markedly elevated blood pressure or hypertension with severe end-organ damage, presence of abdominal bruit (renal artery stenosis), moon face and abdominal striae (Cushing's syndrome), paroxysmal headaches and palpitations (pheochromocytoma), pronounced hypokalemia due to low dose diuretic therapy (primary aldosteronism), acute renal failure or hypokalemia after initiation of angiotensin converting enzyme inhibitors or angiotensin II receptor blocker (renal artery stenosis), hypercalcemia (hyperparathyroidism), snoring and daytime somnolence (obstructive sleep apnea). A combination of a good history and physical examination, astute observation, and accurate interpretation of available data usually are helpful in the diagnosis of a specific causation. This article provides an overview of the range of secondary hypertension, including key clinical features, appropriate diagnostic approach and treatment for primary physician.
Article · Jun 2010 · Korean Journal of Family Medicine
[Show abstract][Hide abstract]ABSTRACT: A case of successful correction of subclavian steal syndrome by percutaneous transluminal angioplasty with stenting in a male patient who found incidentally significant interarm blood pressure difference. Small difference in blood pressure (BP) between two arms is a relatively common. Significant interarm BP difference is a potential marker of peripheral vascular disease such as subclavian artery stenosis and a predictor of cardiovascular disease. The subclavian steal syndrome is a condition that results from stenosis of subclavian artery proximal to the vertebral artery. The resulting symptoms are vertebrobasilar insufficiency symptoms due to reversal of blood flow from the contralateral vertebral and basilar artery into the ipsilateral upper extremity vessels and arm ischemic symptoms. Stenotic lesion of subclavian artery has traditionally been treated surgically. However recent trends are undergoing a paradigm shift from open surgery to endovascular approach. We report a patient with subclavian steal syndrome who found incidentally 35 mmHg interarm systolic BP difference. It was successfully treated by percutaneus transradial angioplasty with stenting on stenotic lesion of the subclavian artery.
Article · Dec 2009 · Korean Journal of Family Medicine