Korean Journal of Family Medicine最新文献

Background: This study aimed to examine the relationship between genetically predicted metabolite levels and gastric cancer (GC) risk using Mendelian randomization (MR), and to identify the metabolic pathways potentially involved.

Methods: We selected genetic instruments for metabolites from 64 genome-wide association studies covering 362,750 participants. A two-sample MR design was applied to evaluate the associations with GC using summary-level data from a combined analysis of the UK Biobank and FinnGen. The primary analysis relied on the inverse-variance weighted method, while the median-weighted and MR-Egger methods were used to account for potential violations of instrumental variable assumptions and provide the estimate even when a subset of instruments was invalid. The MR-Egger intercept test was performed to detect directional pleiotropy. Metabolites showing significant associations with GC were further examined using pathway enrichment analysis to identify relevant metabolic and lipid processes.

Results: MR analyses identified 25 and 17 metabolites that were positively and inversely associated with GC risk, respectively. Notably, hexanoylcarnitine and cis-4-decenoylcarnitine were strongly associated with increased risk, whereas pregnanediol disulfate, acetylcarnitine, prolyl-hydroxyproline, and X-18914 were associated with reduced risk, with no evidence of heterogeneity or directional pleiotropy. Enrichment analyses highlighted key metabolic pathways, including cysteine and methionine catabolism, beta-oxidation of pristanoyl-CoA (coenzyme A), oxidation of branched-chain fatty acids, and peroxisomal lipid metabolism.

Conclusion: This study identified a set of genetically predicted metabolites associated with GC risk, highlighting the potential utility of metabolite panels and lipid-based biomarkers for risk stratification and early detection. However, further standardization and extensive validation are necessary prior to clinical application.

Background: Pre-elderly families experience a significant impact on their quality of life as they transition to old age. This study aimed to identify and analyze the preparatory measures taken by families as they enter aging and develop an index to measure their readiness for aging based on physical, economic, and social aspects.

Methods: This study employed a quantitative approach, drawing secondary data from the 2019 Performance Accountability Survey of the Family Planning and Family Development Program. Binary logistic regression was used to examine the bivariate relationships between demographic characteristics and family readiness.

Results: Physical readiness was the most prevalent among pre-elderly families (88.1%), followed by economic (74.0%) and social (50.2%) readiness. Higher readiness was significantly associated with higher education (adjusted odds ratio [AOR], 3.39), urban residence (AOR, 1.39), health insurance ownership (AOR, 1.95), unemployment (AOR, 1.22), and awareness of aging programs (AOR, 1.62), whereas sex, family structure, and number of children were not significantly associated.

Conclusion: To increase physical readiness, families should be encouraged to use health services such as community health centers and perform regular medical check-ups. Additionally, this study suggests government intervention through outreach and guidance on all dimensions of old-age preparation.

Background: Tobacco use among older adults remains a pressing public health concern in South Korea, particularly among men. Despite the decline in tobacco use rates with age, a range of sociodemographic, psychological, and behavioral factors persist to influence tobacco use behaviors. However, prior studies have primarily relied on linear modeling approaches, which may overlook indirect associations. This study addressed this gap using classification and regression tree (CART) analysis to identify hierarchical and interactive patterns among factors associated with tobacco use.

Methods: We analyzed data from the 2023 Korea Community Health Survey, which included 34,924 Korean men aged ≥65 years. Using CART analysis, we identified distinct subgroups and patterns across multiple predictors of tobacco use behavior, including demographic factors, lifestyle characteristics, and chronic health conditions.

Results: CART analysis identified age as the strongest predictor of tobacco use. Men aged ≤72.5 years had higher tobacco use rates, especially those with low social engagement (24.8%). Younger men with higher social activity and aged ≤67.5 years had the lowest rate (12.9%). Among men ≥72.5 years, alcohol use was the key predictor. Non-drinkers had the lowest tobacco use rate (9.3%), whereas drinkers aged ≤78.5 years showed elevated rates (22.0%), suggesting persistent risk even in later life.

Conclusion: These findings underscore the importance of promoting social engagement and reducing alcohol use to decrease tobacco use among older men, particularly those under 73 years of age.

Background: Exclusive breastfeeding (EBF) is critical during the early stages of life. Babies require only breast milk from birth until 6 months of age. This study analyzed the correct target for increasing EBF in Indonesia.

Methods: This cross-sectional study included 12,534 infants and examined EBF practices as outcome variables. Seven maternal characteristics were included as exposure variables (residence, age, marital status, education, employment, prenatal class, and wealth) and four infant characteristics as control variables (age, sex, birth weight, and early initiation of breastfeeding). Finally, binary logistic regression analysis was performed.

Results: Result showed that the proportion of EBF in Indonesia is 52.90% (95% confidence interval [CI], 52.37%-53.43%). Mothers in rural areas were 1.134 times more likely to perform EBF than were those in urban areas (95% CI, 1.126-1.141). All maternal age groups were more likely to achieve EBF than the youngest group (<20 years), except for those aged >44 years, for which there was no significant difference compared with those aged <20 years. Married mothers were 1.361 times more likely to achieve EBF than were divorced/widowed mothers (95% CI, 1.311-1.412). Maternal education and employment were associated with EBF achievement. There was no significant relationship between the prenatal class and EBF performance in Indonesia. Furthermore, results indicate that all wealth statuses are less likely to achieve EBF than the poorest in Indonesia.

Conclusion: Six maternal characteristics were specifically targeted to increase EBF in Indonesia: living in urban areas, being young, having a divorced/widowed status, having poor education, being employed, and being wealthy.

Obesity is a chronic systemic disease with multifactorial causes that poses a substantial health and economic burden worldwide. In Korea, obesity is a significant public health concern owing to the increasing prevalence of obesity-related comorbidities and mortality. Obesity is defined as excess adiposity that poses health risks. Adiposity can be assessed using direct and indirect methods, among which body mass index (BMI) is the most widely used anthropometric measurement in epidemiological studies and clinical practice. However, limitations of BMI-centric obesity assessments have been noted in previous studies. Simple adiposity measures cannot capture obesity-related medical conditions, daily functional status, or mental health. Therefore, medical associations worldwide have increasingly emphasized the need for comprehensive obesity assessments, including the 2020 Canadian Adult Obesity Clinical Practice Guidelines, American Association of Clinical Endocrinologists/American College of Endocrinology 2023 Guidelines, 2024 European Association for the Study of Obesity diagnostic framework, and 2025 Lancet Commission's Clinical Obesity Diagnostic Criteria. Recent perspectives have emphasized multidimensional approaches to obesity assessment to capture individuals' overall health status. This review aims to evaluate the limitations of BMI-centric obesity diagnosis, summarize emerging recommendations from recent international guidelines, and highlight potential alternative approaches for improving the assessment of obesity and related health outcomes.

Tuberculous synovitis (TS) is an infrequent yet significant manifestation of tuberculosis (TB), particularly in regions where TB is endemic. The clinical presentation of TS is often nonspecific yet distinctive, and diagnosis is confirmed by histopathological examination. Anti-TB therapy is the cornerstone of treatment, although the necessity of surgical intervention remains debated. A case was reported of a 73-year-old female patient who complained of left wrist pain and swelling for the past 3 years. The left wrist was swollen from the metacarpophalangeal joints to the mid-forearm. Radiography on the left forearm revealed extensive, mixed predominant osteolytic and sclerotic bony lesions affecting all the carpal bones. These findings were associated with increased size of a hyperdense soft tissue swelling. Magnetic resonance imaging revealed rim-enhancing multiple encapsulated cystic fluid collections at the distal radioulnar and carpal regions. A biopsy of the left wrist was performed, revealing TS. The patient was subsequently started with anti-TB therapy.

Background: Depression is a prevalent mental health disorder that presents substantial public health challenges. Emerging evidence underscores the role of dietary patterns in mitigating depressive symptoms. This study investigated the association between diet quality, assessed using the Recommended Food Score (RFS), and depressive symptoms, evaluated with the Patient Health Questionnaire-9 (PHQ-9), in a sample of Korean adults.

Methods: This cross-sectional study analyzed data from 19,786 participants recruited from a general hospital in Korea, all of whom completed the RFS and PHQ-9 assessments. General characteristics and anthropometric indices were recorded. Statistical analyses included chi-square tests and binary logistic regression to calculate odds ratios (ORs) and 95% confidence intervals for depressive symptoms according to RFS scores, adjusting for potential confounders.

Results: Higher RFS scores were associated with reduced odds of depression in univariate (OR, 0.59; P<0.001) and multivariate (OR, 0.72; P<0.001) analyses. Sociodemographic factors, including older age, higher education, marital status, higher income, professional occupation, and regular exercise, were linked to decreased odds of depression. Conversely, female sex, current smoking, and alcohol consumption were associated with increased odds.

Conclusion: The findings reveal an inverse relationship between diet quality and depressive symptoms among Korean adults, emphasizing the potential of dietary improvements in mental health promotion. Sociodemographic factors significantly influence depression risk. Future studies should adopt longitudinal designs incorporating a wider range of variables to elucidate these complex interactions.

Background: The Physical Activity Readiness Questionnaire (PAR-Q)+ 2020 has been utilized to measure readiness for physical activity (PA). However, it is unavailable in the Indonesian language. We aimed to adapt and evaluate the validity and reliability of the PAR-Q+ 2020 culturally for the Indonesian population and its application in general and family medicine.

Methods: We conducted a cross-sectional study to adapt the PAR-Q+ 2020 to the Indonesian language. A face validity interview with 20 participants followed the translation and back-translation processes. Subsequently, an online questionnaire was distributed between June and October 2022, with 378 participants responding and a 72.2% response rate for the second test. Cohen's kappa was calculated to determine the intra-rater reliability of each item. Intra-class correlation (ICC) and Cronbach's alpha analyses were conducted to examine the first and second parts of the questionnaire and the overall intra-rater reliability and internal consistency of the questionnaire.

Results: The median age of the participants was 27 years (range, 18-61 years), and 63% (n=172) were female. The Cohen's kappa value of each item ranged from to 0.801-1.000 (almost perfect to perfect agreement). The ICC values for the first and second parts and the overall questionnaire were 0.957, 0.993, and 0.987, respectively. Cronbach's alpha was adequate for the first part (α=0.958), second part (α=0.993), and overall questionnaire (α=0.987).

Conclusion: The Indonesian version of the PAR-Q+ 2020 demonstrated reliability and preliminary evidence of its validity in measuring individual readiness for PA. Further studies involving a broader population and employing more comprehensive validation methods are necessary to establish its validity and applicability fully.