Epidemiology and Health

Volume 28 (2); December 2006

Original Articles

Trend of the Anthropometric Indices Among Adolescents in a Urban and a Rural Area Over the Period 1996~2005.: SoHyun Park, Minjung Ko, Shin Ah Kim, Mi Kyung Kim, Soo Hun Cho, Bo Youl Choi; Korean J Epidemiol. 2006;28(2):189-198.

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Abstract PDF: Abstract
This study investigated the secular trend of anthropometric parameters of 2,153 high school students in one urban and one rural area in Korea. The cross-sectional data was collected in 1996 and 2005 in Seoul and Gyung-gi province. As a result, the height of boys has increased by 2cm, whereas the weight has increased by 6.3kg from 1996 to 2005. By contrast, those parameters, including height or weight, did not change in girls. The prevalence of obesity has been more than doubled from 9.3% in 1996 to 20.5% in 2005 in boys; while that of girls was almost same for the same period (1998, 11.1%; 2005, 11.4%). In particular, the greater increase of obesity among boys was found in urban, which implicates the importance of environmental factor in determining weight gains among adolescents. This result emphasizes that the tailored intervention is strongly warranted, in particular among boys residing in urban area.; Summary

Correlation Between Muscle Amounts and Grasp Power in the Elderly People, Jejudo.: Hojun Lee, Minsung Park, Yeoju Go, Yeong Ja Yang, Jong Myon Bae; Korean J Epidemiol. 2006;28(2):182-188.

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Abstract PDF: Abstract
OBJECTIVES
This study was conducted to examine the relationships between muscle mass and hand strength in elderly people.
METHODS
The study subjects were 659 volunteers aged older than 65 in Jejudo, south Korea. The anthropometric information such as weight, body mass index (BMI) and muscular mass was collected by the body composition analyzer. The hand strength was obtained by the digital grip dynamometer. The fasting blood sugar index called as potential diabetes mellitus (DM) was defined as the condition over 120 mg/dL of the blood sugar. The BMI was classified into under 23, 23-25 and over 25 to analyze the relationships of BMI and muscle mass, hand strength.
RESULTS
The factors affecting muscle mass were sex (p<0.001), age (p<0.001) and BMI (p<0.001). The factors affecting hand strength were sex (p<0.001), age (p<0.001) and BMI (p=0.003). And there was a weak association between muscle mass and hand strength after controlling with the affected factors (r2=0.15, p<0.001).
CONCLUSIONS
The hand strength is weekly correlated with the muscle mass. So we recommend to use digital grip dynamometer combining with other measurements for diagnosis the sarcopenia in epidemiologic study.; Summary

Infection of Methicillin-Resistant S. Aureus Nasal Carriage in the Community Pediatric Population.: Jiyoung Park, Soonduck Kim, Jesuk Lee; Korean J Epidemiol. 2006;28(2):171-181.

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Abstract PDF: Abstract
PURPOSE
Methcillin-resistant Staphylococcus aureus(MRSA) is known as a major cause of hospital acquired infection. The infection with MRSA bacteria is becoming frequent in the community because there are many people who have risk factors with low immunity. This study is intended to investigate the prevalence of MRSA in children and determine risk factors using genetic analysis.
METHODS
Children aged between 3 and 7 years were recruited from six preschool institutions from Nov. 2004 to Feb. 2005 based in Seoul, Gyeonggi Province and Gyeongsang Province. A questionnaires was distributed to 1,000 parent of these children along with the letter of consent. A total of 242 questionnaires were collected and used for this study. Nasal secretion samples were collected using sterilized specimen containers and incubated in culture medium using mannitol salt agar to separate S. aureus. MRSA samples were identified through coagulase test and MICRO SCAN. PCR was performed on MRSA isolates to detect genetic sequence specific of MRSA.
RESULTS
Of total 242 respondents, 16(6.6%) were found to be positive for MRSA. By residence area, 2(1.9%) out of 103 were positive in Seoul, 4(10.3%) out of 39 were positive in Gyeonggi Province and 10(10.0%) out of 100 were positive in Gyeongsang Province, showing a significant difference(p=0.037). A logistics regression was performed to evaluate the influences of variables that were significant. Gyeongsang Province had prevalence of MRSA(OR=5.520), and Gyeonggi Province(OR=5.710). Based on PCR, the distribution of genotypes of MRSA showed various patterns. But there was no difference between regions.
CONCLUSIONS
MRSA infection was high in children when one of their parents were working in hospital or when one of their family members have underlying disease. This study provided evidence that the prevalence of MRSA is largely influenced by individual element such as family and health condition.; Summary

Framingham Equation Model Overestimates Risk of Ischemic Heart Disease in Korean Men and Women.: Kyung A Ahn, Ji Eun Yun, Eo Rin Cho, Chung Mo Nam, Yangsu Jang, Sun Ha Jee; Korean J Epidemiol. 2006;28(2):162-170.

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Abstract PDF: Abstract
BACKGROUND
The prediction of the absolute risk of ischemic heart disease (IHD) is commonly based on the risk prediction equations, originated from the Framingham Heart Study.
METHOD
Framingham equation model was applied to participants from 2001 Korean National Health and Nutrition Examination Survey (KNHNES) to estimate the 5 year risk of IHD among Koreans ranging from 30 to 74 year-olds. The estimated risks were compared to the incidence and admission rates from two statistical reports among Koreans. Five year admission rate was estimated by the annual report from National Health Insurance Corporation (NHIC).
RESULTS
The average ages (standard deviation) were 34.31(27.23) year-old for KNHNES and 48.26(12.87) year-old for Framingham population used in this study. The risk of IHD predicted by the Framingham equation model substantially exceeded the risks actually reported in Korea. Five-year predicted risks by Framingham equation model were 4.86% for men and 1.93% for women; whereas from incidence data in Korea, five-year risks for acute myocardial infarction (AMI) were for 0.47% for men and 0.18% for women. These AMI incidence was similar to the admission rate (0.34 for men and 0.15 for women) estimated by NHIC. Also, 5-year admission rate of IHD were 1.16 for men and 0.78 for women. The magnitude of risk overestimation by Framingham mode is approximately at least 150 to 320%.
CONCLUSION
Korean guidelines for the management for high risk group of IHD need to develop and correct for overestimation to avoid inflation of costs in primary prevention.; Summary

Regional Variation in Accessing Regional Hospitals for Cancer Patients.: Yeon Ok Moon, Eun Cheol Park, Hai Rim Shin, Young Joo Won, Kyu Won Jung, Jin Hee Lee, Soon Young Hwang, Hyun Joo Kong, Seung Sik Hwang, Jong Koo Lee, In Sik Kong, Myung Il Hahm; Korean J Epidemiol. 2006;28(2):152-161.

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Abstract PDF: Abstract
OBJECTIVES
To investigate the differences in accessing regional hospitals and the utilization rate of hospitals located in other regions for cancer patients by regions.
METHODS
Data for the utilization of regional hospitals for cancer patients were obtained from the Korean National Cancer Incidence Databases in 1999 and 2002. We divided the regions into 16 provinces by administrative districts. We using the SAS 9.1.3 to analyze difference of regional self-sufficiency and the Arcview 3.2 to show in a schematize for regional variation of the regional self-sufficiency.
RESULTS
There were regional variations in the regional self-sufficiency of cancer patients. Especially, Jeollanam-do(1999 13.6%, 2002 12.8%), Gyeongsangbuk-do(1999 22.0%, 2002 20.7%), and Chungcheongnam-do(1999 27.8%, 2002 27.1%) had low regional self-sufficiency. The regional self-sufficiency in Gyeonggi-do and utilization rate of cancer patients who lived in other regions were increased between 1999 and 2002(regional self-sufficiency: 1999 37.2%, 2002 48.2%).
CONCLUSION
The results of this study showed that there were regional variation in utilization of regional hospitals for cancer patients. Accessibility of cancer patients in metropolitan areas was higher than in small size cities, medium size cities, and rural county areas. These results suggested that it should be considered support medical facilities for cancer patients in rural areas where have lower relevance rate.; Summary

Risk Factors of Impaired Fasting Glucose and Type 2 Diabetes Mellitus: Using Datamining.: Jongseon Ryu, Soonduck Kim, Jongsoon Park, Jesuk Lee; Korean J Epidemiol. 2006;28(2):138-151.

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Abstract PDF: Abstract
PURPOSE
This study aimed to contribute to overall public health by examining the prevalence rates of impaired fasting blood glucose and type 2 diabetes mellitus and developing a model to predict high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus.
METHODS
The 1998 Public Health Nutrition Survey data was used for this study. Subjects were 7,702 adult at the age of 20 or over. The frequency analysis, chisquared test was performed. A decision tree was utilized to define a model designed to predict high risk factors for impaired fasting glucose and type 2 diabetes mellitus.
RESULTS
The prevalence rates of impaired fasting blood glucose was 10.8% and prevalence rates of type 2 diabetes mellitus was 9.4%. The decision tree analysis exhibited that age was strong factors for impaired fasting blood glucose. HDL cholesterol and kind of economic activities were high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus on those in 20s. BMI, total cholesterol level, marriage status, sex for impaired fasting blood glucose and type 2 diabetes mellitus on those in 30s. The total cholesterol level, drinking and waist size were identified as risk factors on those in 40s. BMI, education level and hypertension seemed to have an impact on those in 50s. The waist size, sex and income had an impact on those in 60s.
CONCLUSIONS
This study underscores the need for the public health infrastructure to improve various health promotion programs for those who have risk factors for impaired fasting blood glucose and type 2 diabetes mellius. The implementation of effective nutrition, workout and anti-drinking programs will boost public health.; Summary

Review

Bioethics and Protection of Personal Information in Observational Studies.: Ock Joo Kim, Eun Kyung Choi; Korean J Epidemiol. 2006;28(2):129-137.

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Abstract PDF: Abstract
Observational studies constitute an important part of epidemiologic research. Researchers need to recognize that some of the observational studies may result in serious damage to the participants, and it is very important to understand that which aspect of such studies may pose a risk to the participant. The key element of an observational study that may raise an important ethical issue is specific information itself. Researchers need to make sure who has the right to make decision on the information, and by what pathways the information flows. Informed consent is an essential component involved in handling the information associated with participants' interest. Institutional review board (IRB) should oversee the study design and procedures to ensure the study procedures respect the rights of the participants and communities they belong to and protect them from any harm. Modern technologies add new dimensions to observational studies because of genetic information and large scale database systems that are linked with the study. Data security need to be assured by various procedures and legal protections. As the value of information becomes greater in the modern society, the importance of bioethics and personal information protection also becomes greater in the observational studies.; Summary

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