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Original Articles
Associations between adverse childhood experiences and diabetes among middle-aged and older Chinese: a social-ecological perspective
Siyu Zhu, Leying Hou, Jiaying Ma, Shuting Li, Weidi Sun, Wen Liu, Jiajun Hao, Wenhan Xiao, Siqing Cheng, Dexing Zhang, Dong Zhao, Peige Song
Epidemiol Health. 2023;45:e2023071.   Published online August 2, 2023
DOI: https://doi.org/10.4178/epih.e2023071
  • 3,122 View
  • 124 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined the associations between adverse childhood experiences (ACEs) and diabetes within a social-ecological framework, incorporating personal and environmental unfavorable conditions during childhood from family, school, and community contexts.
METHODS
Data were obtained from the China Health and Retirement Longitudinal Study (2014 life history survey and 2015 survey), including 9,179 participants aged ≥45 years. ACEs were collected through self-report questionnaires, and participants were categorized based on the number of distinct ACEs experienced (0, 1, 2, 3, or ≥4 ACEs). Diabetes was defined by biomarkers, self-reported diagnosis, and treatment status. Logistic regression was conducted to explore the associations between ACEs and diabetes. Subgroup analyses were conducted by gender, age, and obesity status.
RESULTS
Compared with participants without ACEs, those exposed to any ACE (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40), 3 ACEs (OR, 1.32; 95% CI, 1.07 to 1.62) and ≥4 ACEs (OR, 1.29; 95% CI, 1.07 to 1.56) had an increased risk of diabetes. For each additional ACE, the risk of diabetes increased by about 5%. Regarding the source of ACEs, those originating from the family (OR, 1.23; 95% CI, 1.08 to 1.41) were associated with diabetes. In terms of specific ACE types, family members with substance abuse (OR, 1.23; 95% CI, 1.01 to 1.52), emotional abuse (OR, 1.28; 95% CI, 1.12 to 1.46), and poor parental relationship (OR, 1.25; 95% CI, 1.09 to 1.43) were associated with diabetes.
CONCLUSIONS
ACEs, particularly those originating from the family, were associated with diabetes. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.
Summary
Key Message
From a social-ecological perspective, this study delineates an association between adverse childhood experiences (ACEs), particularly those originating from the family, and diabetes among middle-aged and older Chinese. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.
Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study
Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park
Epidemiol Health. 2023;45:e2023029.   Published online February 23, 2023
DOI: https://doi.org/10.4178/epih.e2023029
  • 5,043 View
  • 204 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of this study was to clarify the clinical trait of familial diabetes mellitus (DM) by analyzing participants’ risk of DM according to the age of DM onset in parents and siblings, and to evaluate individuals’ risk of DM-associated cardiometabolic diseases.
METHODS
Altogether, 211,173 participants aged ≥40 years from the Korean Genome and Epidemiology Study were included in this study. The participants were divided into groups based on the number (1 or 2 relatives) and age of onset (no DM and early, common, or late onset) of familial DM. Participants’ risk of DM was assessed using a Cox regression model with hazard ratios and 95% confidence intervals (CIs). A logistic regression model with odds ratios was used to evaluate associations among the participants’ likelihood of acquiring cardiometabolic diseases such as hypertension, chronic kidney disease (CKD), and cardiovascular disease.
RESULTS
The risk of developing DM was 2.02-fold (95% CI, 1.88 to 2.18) and 2.88-fold (95% CI, 2.50 to 3.33) higher, respectively, in participants with 1 and 2 family members diagnosed with familial DM. It was 2.72-fold (95% CI, 2.03 to 3.66) higher in those with early-onset familial DM. In the early-onset group, the respective risks of hypertension and CKD were 1.87-fold (95% CI, 1.37 to 2.55) and 4.31-fold (95% CI, 2.55 to 7.27) higher than in the control group.
CONCLUSIONS
The risk of DM and related cardiometabolic diseases was positively associated with the number of family members diagnosed with DM and an early diagnosis in family members with DM.
Summary
Korean summary
본 연구는 한국인유전체역학조사사업 역학자료를 이용하여, 당뇨병을 진단받은 가족 구성원 (부모 및 형제)의 수가 많고 당뇨병이 조기에 발생할수록 개인의 당뇨발생 위험도가 높아짐을 보고하였습니다. 또한 당뇨병이 조기에 발생한 가족구성원이 있을 경우 개인의 일부 심대사질환과의 연관성이 있을 수 있음을 설명하였습니다.
Key Message
This study demonstrated that the risk of diabetes in individuals was significantly associated with the quantity and the onset of family members diagnosed with diabetes. We also explained that having a family member with early-onset diabetes can be associated with some cardiometabolic diseases in individuals.

Citations

Citations to this article as recorded by  
  • Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults
    Jung-Hwan Kim, Yaeji Lee, Chung-Mo Nam, Yu-Jin Kwon, Ji-Won Lee
    Endocrine.2024;[Epub]     CrossRef
Factors associated with indoor smoking at home by adults across Korea: a focus on socioeconomic status
Bomgyeol Kim, Yejin Lee, Young Dae Kwon, Tae Hyun Kim, Jin Won Noh
Epidemiol Health. 2020;42:e2020067.   Published online October 28, 2020
DOI: https://doi.org/10.4178/epih.e2020067
  • 9,077 View
  • 185 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Secondhand smoke is an issue that cannot be ignored due to its various negative effects. Especially, secondhand smoke inside the household is an area where health policy must pay attention as it can affect all age groups. This study aims to identify the factors associated with smoking inside the household focusing on socioeconomic status in Korea.
METHODS
We used data from the Community Health Survey of 2017 and a total of 33,462 participated in the study. Data were analyzed through IBM SPSS version 25.0 to conduct binary logistic regression analysis.
RESULTS
Results indicated that indoor smoking had a significant association with socioeconomic status. This association was more marked in those participants who had low household income or those with elementary school education level or less. Furthermore, the study indicates that when the smoker is a woman, older, has higher stress, and is a heavier smoker, the probability of her smoking inside the house is higher.
CONCLUSIONS
Based on the results, it is meaningful that this study has found the factors of smoking inside household. The result identify the factors associated with indoor smoking at home, and it can be used as baseline data for developing new smoking cessation policies.
Summary
Korean summary
이 연구는 가정 실내 흡연과 관련된 다양한 요인들을 파악하였으며, 소득, 교육수준과 같은 사회경제적 요인과 가정 실내 흡연의 연관성을 확인하였다. 이를 통해 가정 실내 흡연 감소를 위한 금연 정책의 근거자료로 활용될 수 있을 것으로 기대된다.

Citations

Citations to this article as recorded by  
  • Tobacco usage in the home: a cross-sectional analysis of heated tobacco product (HTP) use and combustible tobacco smoking in Japan, 2023
    Satomi Odani, Takahiro Tabuchi
    Environmental Health and Preventive Medicine.2024; 29: 11.     CrossRef
  • Impacts of smoking ban policies on billiard halls sales in South Korea using objective sales information of a credit card company: A quasi-experimental study (Preprint)
    Jin-Won Noh, Jooyoung Cheon, Hohyun Seong,, Young Dae Kwon, Ki-Bong Yoo
    JMIR Public Health and Surveillance.2023;[Epub]     CrossRef
Characteristics of depressive symptoms in middle-aged family members of dementia patients: 2017 Korea Community Health Survey
Jinbeom Park, Won-Chul Lee, Hyunsuk Jeong, Nayoung Hong, BoYoung Bae, Hyeon Woo Yim
Epidemiol Health. 2020;42:e2020031.   Published online May 15, 2020
DOI: https://doi.org/10.4178/epih.e2020031
  • 13,413 View
  • 246 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The characteristics of depressive symptoms in the family members of home-dwelling patients with dementia have not been clearly reported. This study aimed to investigate the characteristics of depressive symptoms in middle-aged family members living with a patient with dementia.
METHODS
This study used the data from the nationwide 2017 Korea Community Health Survey. Among the 228,381 survey participants, 77,276 participants in their 40s and 50s were finally selected for this study. The participants consisted of 760 family members of home-dwelling dementia patients and 76,516 general family members comprising a control group.
RESULTS
The positive rate of Patient Health Questionnaire-9 (PHQ-9)-measured depressive symptoms was significantly higher in the family members of home-dwelling dementia patients (4.4%; control group: 1.9%). After adjusting for potential confounders, the prevalence of PHQ-measured depressive symptoms was 1.72 times (95% confidence interval [CI], 1.03 to 2.85) higher in the family members of home-dwelling dementia patients compared to the control group. The positive rate of depressive symptoms was 2.26 times higher (95% CI, 1.26 to 4.05) in the female middle-aged family members of home-dwelling dementia patients compared to the control group. In addition, those who reported having symptoms almost every day in the PHQ-9 questions had significantly higher positive rates on questions about loss of interest, depression, sleep disturbance, fatigue, poor appetite, and suicidal ideation, and not on questions regarding feelings of worthlessness and psychomotor agitation, compared to the control group.
CONCLUSIONS
Active interventions are needed to relieve depression in the family members of home-dwelling dementia patients.
Summary

Citations

Citations to this article as recorded by  
  • Burden and preparedness of care partners of people living with amyotrophic lateral sclerosis at home in Korea: A care partner survey
    Sun Young Lee, Shin Hye Yoo, Belong Cho, Kye Hyung Kim, Min Seoul Jang, Jeongmi Shin, Inyoung Hwang, Seok‐Jin Choi, Jung‐Joon Sung, Min Sun Kim
    Muscle & Nerve.2024;[Epub]     CrossRef
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    Rayhanah R. Almutairi, Jaclene A. Zauszniewski
    Issues in Mental Health Nursing.2023; 44(6): 538.     CrossRef
  • Depression before and during-COVID-19 by Gender in the Korean Population
    Won-Tae Cha, Hye-Jin Joo, Yu-Shin Park, Eun-Cheol Park, Soo-Young Kim
    International Journal of Environmental Research and Public Health.2022; 19(6): 3477.     CrossRef
  • A Study on Complementary Policy to Enhance the Effectiveness of National Dementia Policy in Terms of Medical Services
    Su Jeong Seong, Kang Joon Lee, Woo Jung Kim, Kiwon Kim, Dong Woo Lee
    Journal of Korean Neuropsychiatric Association.2021; 60(4): 396.     CrossRef
Data Profile
Family tree database of the National Health Information Database in Korea
Yeon-Yong Kim, Hae-young Hong, Kyu-Dong Cho, Jong Heon Park
Epidemiol Health. 2019;41:e2019040.   Published online October 1, 2019
DOI: https://doi.org/10.4178/epih.e2019040
  • 13,532 View
  • 167 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
We constructed the family tree database (DB) by using a new family code system that can logically express interpersonal family relationships and by comparing and complementing health insurance eligibility data and resident register data of the National Health Information Database (NHID). In the family tree DB, Parents and grandparents are matched for more than 95% of those who were born between 2010 and 2017. Codes for inverse relationships and extended relationships are generated using sequences of the three-digit basic family codes. The family tree DB contains variables such as sex, birth year, family relations, and degree of kinship (maximum of 4) between subjects and family members. Using the family tree DB, we find that prevalence rates of hypertension, diabetes, ischemic heart disease, cerebrovascular disease, and cancer are higher for those with family history. The family tree DB may omit some relationships due to incomplete past data, and some family relations cannot be uniquely determined because the source data only contain relationships between head and members of the household. The family tree DB is a part of the NHID, and researchers can submit requests for data on the website at http://nhiss.nhis.or.kr. Requested data will be provided after approval from the data service review board. However, the family tree DB can be limitedly provided for studies with high public value in order to maximize personal information protection.
Summary
Korean summary
가족관계도(family tree) DB는 건강보험공단이 보유하는 건강보험 가입자정보와 행정전산망 정보를 바탕으로 가공·구축된 자료다. 4촌까지의 가족 관계를 파악할 수 있으며, 세대주 중심의 관계코드가 아닌 개인 단위의 논리적 기호로 구성된 관계코드를 통해 촌수, 계통, 성별을 구분하도록 하였다. 이를 바탕으로 의학적, 사회정책적으로 다양한 연구가 가능하다.

Citations

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  • Association between familial aggregation of chronic kidney disease and its incidence and progression
    Jae Young Kim, Sung-youn Chun, Hyunsun Lim, Tae Ik Chang
    Scientific Reports.2023;[Epub]     CrossRef
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    Seon‐Mi Kim, Yujin Jeong, Yae Lim Kim, Minjung Kang, Eunjeong Kang, Hyunjin Ryu, Yunmi Kim, Seung Seok Han, Curie Ahn, Kook‐Hwan Oh
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    Jin-Su Park, Chan Hee Lee
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  • Comparison between calcium channel blocker with angiotensin converting enzyme inhibitor or angiotensin II type 1 receptor blocker combination on the development of new-onset diabetes in hypertensive Korean patients
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Original Articles
Sleep quality and associated factors among the elderly living in rural Chiang Rai, northern Thailand
Weerakorn Thichumpa, Nopporn Howteerakul, Nawarat Suwannapong, Visasiri Tantrakul
Epidemiol Health. 2018;40:e2018018.   Published online May 14, 2018
DOI: https://doi.org/10.4178/epih.e2018018
  • 18,340 View
  • 407 Download
  • 36 Web of Science
  • 48 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study aimed to characterize the prevalence of poor sleep quality and to identify associated factors among community-dwelling elderly individuals in northern Thailand.
METHODS
A cross-sectional study was conducted among 266 randomly selected elderly people in a sub-district in rural Chiang Rai Province, northern Thailand. The participants were interviewed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI).
RESULTS
Roughly 44.0% of the participants had poor sleep quality (PSQI score, >5), 9.4% used sleep medication, 27.1% had poor family relationships, and 12.0% had mild depression. Multiple logistic regression analysis indicated that being female (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.10 to 3.02), a higher education level (OR, 3.03; 95% CI, 1.34 to 6.86 for primary school; OR, 2.48; 95% CI, 1.31 to 5.44 for higher than primary school), mild depression (OR, 2.65; 95% CI, 1.11 to 6.36), and poor family relationships (OR, 3.65; 95% CI, 1.98 to 6.75) were significantly associated with poor sleep quality.
CONCLUSIONS
The prevalence of poor sleep quality among the elderly was moderately high. Healthcare providers should regularly conduct screenings for sleep quality and depression; provide sleep health education; and conduct interventions to encourage participating in family activities, resolving conflicts, sharing ideas, and making compromises within the family.
Summary

Citations

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Effects of living alone versus with others and of housemate type on smoking, drinking, dietary habits, and physical activity among elderly people
Seungmin Jeong, Sung il Cho
Epidemiol Health. 2017;39:e2017034.   Published online August 6, 2017
DOI: https://doi.org/10.4178/epih.e2017034
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined differences in health behaviors between elderly people living alone and with others; it also investigated whether the effect of living with others differs according to housemate type, namely a spouse and/or younger generations.
METHODS
Gender-stratified data from the 2013 Korea Community Health Survey for individuals aged 60 to 74 living in Seoul were analyzed. Logistic regression modeling was conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of the outcome variables (smoking, drinking, eating salty foods, inactive lifestyle) for the variables of interest (living alone/with others, housemate type). Models were adjusted for confounding variables including history of medical conditions, employment type, and adjusted household income.
RESULTS
Analysis involved 1,814 men and 2,199 women. Risk of smoking was 1.80 times (95% CI, 1.21 to 2.67) higher for men living alone than living with others. Risk of eating salty foods was 0.78 times lower (95% CI, 0.62 to 0.98) for men living with a spouse than a spouse and younger generations. Risk of inactive lifestyle was 1.47 times higher (95% CI, 1.13 to 1.92) for women living alone. Risk of smoking was higher for women living alone (OR, 1.41; 95% CI, 1.03 to 1.92) or with younger generations (OR, 9.12; 95% CI, 2.04 to 40.80) than with a spouse and younger generations.
CONCLUSIONS
Living alone was associated with smoking in men and physical activity in women; housemate type was associated with dietary habits in men and smoking in women. These gender-specific findings can help identify groups of individuals vulnerable to risky health behaviors and to develop policies.
Summary
Korean summary
서울시의 60-74세 노인 남성 1,814명, 여성 2,199명을 대상으로, 노인의 독거 여부와 동거인의 유형이 흡연, 음주, 짜게 먹는 습관, 신체 활동 등 건강 행태에 미치는지 분석한 결과, 독거가 남성의 흡연 및 여성의 신체활동과 연관이 있는 것으로 나타났으며, 동거인의 유형이 남성의 짜게 먹는 습관 및 여성의 흡연과 연관이 있는 것으로 나타났다. 이 결과를 바탕으로 성특이적으로 나타난 노인의 건강 행태를 개선하기 위해 적극적으로 생활 행태를 교정할 수 있도록 영향을 주려는 정책을 만들어야 할 것이다.

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Multicenter Study
Characteristics of major depressive disorder according to family history of depression : A CRESCEND-K (Clinical Research Center for Depression in Korea) study.
Seunghee Jeong, Hyeon Woo Yim, Youngeun Jung, Sunjin Jo, Taeyoun Jun, Sung Won Jung, Minsoo Lee, Jaemin Kim
Korean J Epidemiol. 2008;30(2):272-280.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.272
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AbstractAbstract PDF
Abstract
PURPOSE
People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression.
METHOD
Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report.
RESULTS
Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history.
CONCLUSION
Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Summary

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Original Articles
Examples and outlook of family-based cohort study.
Jae Woong Sull, Sue Kyung Park, Heechoul Ohrr, Sun Ha Jee
Korean J Epidemiol. 2008;30(1):49-59.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.49
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AbstractAbstract PDF
Abstract
Family-based designs are commonly used in genetic association studies to identify and to locate genes that underlie complex diseases. In this paper, we review two examples of genome-wide association studies using family-based cohort studies, including the Framingham Heart Study and International Multi-Center ADHD Genetics Project. We also review statistical methods of family-based designs, including the transmission disequilibrium test (TDT), linkage analysis, and imprinting effect analysis. In addition, we evaluate the strengths and limitations of the family-based cohort design. Despite the costs and difficulties in carrying out this type of study, a family-based cohort study can play avery important role in genome wide studies. First, the design will be free from biases due to population heterogeneity or stratification. Moreover, family-based designs provide the opportunity to conduct joint tests of linkage and association. Finally, family-based designs also allow access to epigenetic phenomena like imprinting. The family-based cohort design should be given careful consideration in planning new studies for genome-wide strategies.
Summary
Changes of Hepatitis B Surface Antigen Seroprevalence in Korea, 1998-2005.
Seunghee Jeong, Hyeon Woo Yim, Si Hyun Bae, Won Chul Lee
Korean J Epidemiol. 2008;30(1):119-127.   Published online June 30, 2008
DOI: https://doi.org/10.4178/kje.2008.30.1.119
  • 65,535 View
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  • 17 Crossref
AbstractAbstract PDF
Abstract
PURPOSE
The purpose of this study was to investigate the prevalence rate of HBsAg and the epidemiological characteristics of hepatitis B virus (HBV) infection from 1998 to 2005. National Health and Nutrition Examination Survey (NHANES) data of 1998, 2001 and 2005 were analyzed.
METHOD
Study population was consisted of 24,093, aged 10 year or over who performed NHANES self reported surveys and blood tests. Statistical analysis was performed by age, sex, and the year of survey. Also the prevalence of HBsAg was compared by self reported family history of liver disease.
RESULTS
The prevalence rate of HBsAg was reduced from 4.5% in 1998 to 3.7% in 2005. Also age-specific prevalence rate of HBsAg was significantly decreased in persons born after introduction of the hepatitis B virus vaccination. HBsAg seropositivity was slightly higher in male than in female. Among the people with the family history of liver diseases, the risk of HBsAg seropositive was much higher than those without. Study subjects with mother's liver disease history showed much higher HBsAg serepositive rate. Although after the implementation of hepatitis B virus vaccination program prevalence of HBsAg decreased, but persons with history of liver disease showed still higher rate Of HBsAg seropositive rate.
CONCLUSION
Although the introduction of the HBV vaccination program has resulted in a decline of HBV infection, the family history of liver diseases was still an important factor for transmission of HBV in Korea. In addition to the mother-to-child transmission prevention program from 2002, it might be advisable to introduce a screening program for persons with family history of liver diseases for further reduction of HBV infection.
Summary

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A Study of Major Gene Dominant Family for Factor VII Concentration: Segregation Analysis.
Sun Ha Jee, Kyung Sooon Song, Won Heum Shim, Il Suh, Hyun Kyung Kim, Young Sup Yoon, Eunna Go, Jung Yong Park, Miyang Kim, Sujeong Kim
Korean J Epidemiol. 1999;21(2):176-184.
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AbstractAbstract PDF
Abstract
Elevated plasma level of factor VII is a risk factor for coronary artery disease. We investigated environmental, familial, and genetic influences on factor VII levels. We used maximum likelihood segregation analysis to fit several genetic and nongenetic modes of inheritance to the data to determine whether Mendelian inheritance of a major gene could best explain the familial distribution of factor VII. The study population included 414 family members of 67 subjects who had undergone elective coronary arteriography. The factor VII level was adjusted for age, gender, body mass index, smoking and alcohol drinking (R2=20.6%). Factor VII levels revealed strong familial aggregation with estimated correlation spouse of 0.12, parent-offspring of 0.31, and siblings of 0.40. Regressive models were used to examine inter-individual variation in adjusted factor VII levels in these 67 families. This analysis strongly favored a major gene model with codominant transmission. Genotypic means were 111.6, 123.2, and 184.3% with relative frequencies of 59.4%, 35.4%, and 5.2%. This putative major gene explains 39.9% of the total variance of factor VII. Likelihood was used to search for etiologic heterogeneity by sorting pedigrees into groups that favor one model over another. Compared to pedigrees less favoring Mendelian models, pedigrees favoring Mendelian codominant models have almost 8 times earlier onset of coronary heart disease. These family data suggest that there are strong familial and genetic effects on the factor VII activity in these high risk families. Therefore, linkage studies in these families may be worthwhile to clarify the molecular basis of factor VII levels.
Summary
The Changing Pattern of Cigarette Smoking of Students in Junior and Senior High Schools in Korea: 1988-1997.
Il Suh, Sun Ha Jee, Soh Yoon Kim, Dong Choun Shin, Soh Yeon Ryu, Il Soon Kim
Korean J Epidemiol. 1998;20(2):257-266.
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AbstractAbstract PDF
Abstract
In order to examine the actual condition of smoking, the change of knowledge and the attitude on smoking of the students attending junior and senior high schools in Korea, the survey was performed six times ranging from 1988 to 1997. The first two years, the survey was performed only for male students. Since 1991, both male and female students were surveyed. The students in junior and senior high school were selected by a random sampling method and surveyed by mail. In this survey, the number of classes of Junior and senior high schools in Korea was a sampling unit, and the classes were selected in proportion to the number of classes of each city and each county. The total number of respondents was 3,437 in 1988, 3,055 in 1989, 6,087 in 1991(2,923 of male, 3,164 of female), 7,067 in 1993(3,162 of male, 3,905 of female), 5,412 in 1995(2,598 of male, 2,814 of female), 4,754 in 1997(2,281 of male, 2,473 of female). The results obtained from the data analysis are as follows; 1.The ratio of smokers among male junior high school students has increased from 1.8% in 1988 to 3.9% in 1997. The ratio of smokers among female junior high school students has increased from 1.2% in 1991 to 3.9% in 1997. The ratio of smokers among male senior high school students has increased from 23.9% in 1988 to 35.3% in 1997. The ratio of smokers among male senior high school students has increased from 23.9% in 1988 to 35.3% 1997. And the ratio of smokers among female senior high school students has increased from 3.0% in 1991 to 8.7% in 1997. Especially the ratio of smokers among female junior high school students is same as that of male in 1997. 2. With respect to areas, the number of current smokers and the experienced ones was higher in the county than in the city in 1988. But in 1997, the number of current smokers and the experienced one is higher in the city than in the county. 3. In respect of whether or not there is a smoker among the member of a family, the odds ratio of smoking among the male senior high school students was 1.70 in 1988 and 1.94 in 1997. the odds ratio of smoking among female senior high school students was 1.43 in 1991 and 1.98 in 1997. This result showed that the effect of family smoking on adolescent smoking has not decreased.
Summary

Epidemiol Health : Epidemiology and Health