Korean Journal of Family Medicine最新文献

Background: Although breakfast provides essential nutrients and energy, skipping this meal has become increasingly common among young adults in Korea. In this study, we examine the relationship between breakfast consumption and body composition.

Methods: We analyzed data from 17,763 students aged 18-39 at Seoul National University (2018-2022). Participants were categorized based on their breakfast frequency: non-skippers, 1 to 3-day skippers, and 4 to 7-day skippers. Measurements included body mass index, waist circumference, body fat percentage, fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI). Multivariable logistic and linear regression models adjusted for age, sex, alcohol use, smoking, physical activity, sleep, and food consumption frequencies were used.

Results: Obesity (17.4% vs. 14.8%) and abdominal obesity (10.0% vs. 7.8%) were higher in those skipping breakfast 4 to 7 d/wk compared with non-skippers. Skipping breakfast was not significantly associated with abdominal obesity in either sex. In women, the odds of obesity were higher (odds ratio, 1.57; 95% confidence interval, 1.14-2.15; P=0.006), whereas no significant difference was observed in men. Men who skipped breakfast had increased body fat percentage (coefficient, 0.87; P<0.001) and FMI (coefficient, 0.18; P=0.009) and decreased FFMI and SMI. Women showed increased body fat percentage (coefficient, 0.92; P<0.001) and FMI but no significant differences in FFMI or SMI.

Conclusion: Skipping breakfast adversely affects body composition by increasing body fat percentage and FMI. Further research is needed to confirm these findings and explore the underlying mechanisms.

Background: The association between sleep duration and obesity risk among risky drinkers remains controversial. This study aims to investigate the relationship between adequate sleep duration and both central and overall obesity among risky drinkers in Korea, with a focus on identifying potential interventions to reduce obesity rates.

Methods: We analyzed data from 978 individuals, selected from 1,356 risky drinkers-as defined by the World Health Organization criteria-who participated in the 2019-2020 Korea National Health and Nutrition Examination Survey. Participants had no missing values and were engaged in economic activities. Demographic characteristics and key variables by obesity status were examined using frequency analysis and chi-square tests. Multivariable logistic regression analysis was performed to explore the association between sleep duration and obesity. To account for the stratified sampling design, we utilized complex sample analysis with weighted values.

Results: Risky drinkers with adequate sleep duration (7-9 hours) were less likely to be obese based on waist circumference (≥90 cm in males; ≥85 cm in females) (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.48-0.86) and body mass index (≥25 kg/m2) (OR, 0.56; 95% CI, 0.41-0.76). Trend analysis revealed a significant inverse relationship between sleep duration and obesity likelihood (P for trend <0.05). Gender-stratified analysis demonstrated that the association was significant among males and more pronounced in risky drinkers compared to the general population.

Conclusion: This study suggests that adequate sleep duration may play a key role in reducing obesity rates among Korean male risky drinkers. Further longitudinal studies are recommended to strengthen this finding.

Background: This study examined disparities in 1-year mortality rates between infants born to married and unmarried single-parent families, emphasizing the need for targeted health policies.

Methods: Data from 3,298,263 cases, obtained from the South Korea National Statistical Office (2010-2017), were analyzed. T-tests and chi-square tests were used to assess the demographic characteristics of the study group. The number of deaths per 1,000 live births was calculated, and logistic and multivariable logistic regressions were employed to compare infant mortality rates between family types. Additional stratified analyses, based on gestational age and birth weight, further elucidated the relationship between parental marital status and infant mortality.

Results: Infants from unmarried families exhibited a 3.34-fold higher crude odds ratio (OR) for 1-year mortality (95% confidence interval [CI], 2.56-4.36; P<0.001) than that from married families. After adjusting for confounders, the adjusted OR was 1.40 (95% CI, 1.03-1.92). Stratification by gestational age and birth weight revealed crude ORs of 4.62 (95% CI, 3.34- 6.39) in non-preterm infants (≥37 weeks) and 4.76 (95% CI, 3.46-6.56) in non-low-birth-weight infants (≥2.5 kg), highlighting a more pronounced disparity in infants born at or above normal weight and full term. No significant difference (P>0.05) was found in the crude OR for 1-year mortality rates among low-birth-weight (<2.5 kg) or preterm (<37 weeks) infants between the two-family types.

Conclusion: This study highlights the significant disparity in infant mortality rates based on parental marital status, underscoring the need for enhanced social support and tailored policies for unmarried single-parent families.

Background: Insulin resistance (IR) influences lipid metabolism, particularly small dense low-density lipoprotein cholesterol (sdLDL-C), a key feature of diabetic dyslipidemia and a predictor of cardiovascular disease. The single-point insulin sensitivity estimator (SPISE) index is an effective tool for assessing IR. This study explored the relationship between the SPISE index and average low-density lipoprotein cholesterol (LDL-C) particle size in obese Korean adults.

Methods: Cardiovascular risk was assessed in 161 obese individuals. The participants were divided into three groups based on SPISE index tertiles. Steiger's Z test was used to assess the differences in correlation coefficients among various IR indices and average LDL-C particle size. Multivariate linear regression models were used to determine the independent association between the SPISE index and average LDL-C particle size. Receiver operating characteristic (ROC) curves established the SPISE index cut-off for sdLDL-C particle dominance.

Results: The SPISE index was positively correlated with mean LDL-C particle size after adjusting for confounders. It demonstrated a stronger independent association with average LDL-C particle size (r=0.679, P<0.001) than with fasting insulin, the homeostatic model assessment for IR, and the quantitative insulin sensitivity check index (P<0.001 for all). ROC analysis identified an optimal SPISE index cutoff for sdLDL-C predominance of 4.955, with an area under the curve of 0.745.

Conclusion: Our findings indicate a direct correlation between the SPISE index and average LDL-C particle size, suggesting that the SPISE index may complement labor-intensive IR indices and sdLDL-C measurement techniques for estimating IR-induced sdLDL-C predominance.

Background: The coronavirus disease 2019 (COVID-19) pandemic in Indonesia has led to an increase in mental health problems, especially among those with comorbid hypertension. Uncontrolled hypertension is the primary comorbidity of COVID-19. Thus, this study aimed to determine the pattern of uncontrolled hypertension at two time points during the pandemic and to confirm its relationship with common mental disorders (CMDs).

Methods: This longitudinal study was conducted at two time points (2019 and 2021), and the data of individuals with hypertension was sourced from the Bogor of Noncommunicable Diseases Risk Factors Cohort Study. Data of 1,231 respondents who met the inclusion and exclusion criteria were included in the analyses. The Self-Reported Questionnaire-20 was used to measure CMDs (score of >6). This study used a generalized estimating equation to analyze the data.

Results: The percentage of those with uncontrolled hypertension increased from 57.6% to 66.4%, whereas those with CMDs increased from 6.1% to 11.5%, from 2019 to 2021. The risk of uncontrolled hypertension was higher in patients with CMDs than in those without CMDs. The risk of uncontrolled hypertension increased from twice (adjusted odds ratio [aOR], 1.57; 95% confidence interval [CI], 1.071-2.069) in 2019 to 3 times (aOR, 2.765; 95% CI, 2.243-3.287) in 2021.

Conclusion: Since stress increases the risk of developing uncontrolled hypertension, individuals with hypertension must be able to manage their stress. Apropos this, the governments should provide mental health consultation services in treating patients with hypertension, especially during adverse events such as pandemics.

Background: Premenstrual syndrome (PMS) and dysmenorrhea are common symptoms in women. In this study, we investigated the effects of saffron on PMS and dysmenorrhea in women.

Methods: In this systematic review and meta-analysis, we comprehensively screened a range of databases, including PubMed, Web of Science, and Science Direct. We included randomized clinical trials investigating the effects of saffron on PMS or dysmenorrhea. Quality assessment of the identified studies was conducted using the Cochrane risk-of-bias assessment tool. Meta-analysis was performed using Comprehensive Meta-Analysis software ver. 2 based on the random effects model.

Results: Meta-analysis revealed that saffron had a significant positive effect on the symptoms of PMS in women (standardized mean difference [SMD], -0.64; 95% confidence interval [CI], -0.84 to -0.44). Furthermore, saffron was effective in reducing dysmenorrhea (SMD, -0.51; 95% CI, -1.01 to -0.01).

Conclusion: The findings of our meta-analysis indicate that saffron exerts beneficial effects on the symptoms of both PMS and dysmenorrhea in women.

Background: This study aimed to compare the effects of two home-based exercises, the self-Epley maneuver (SEM) and Brandt-Daroff exercise (BDE), in patients with posterior canal benign paroxysmal positional vertigo (BPPV).

Methods: A total of 50 outpatients with unilateral posterior canal BPPV, a documented positive Dix-Hallpike test, and symptoms of vertigo for a duration of at least 1 week were randomized into the SEM and BDE groups. Patients in both groups performed home-based exercises for a total duration of 2 weeks. The primary outcome was vertigo resolution at 1 and 6 months. Secondary outcomes included conversion of a positive to a negative Dix-Hallpike test at 1 month and reduction in vertigo intensity and Dizziness Handicap Inventory (DHI) scores at 1 month and 6 months.

Results: Vertigo resolution was achieved in 40% of the patients at 1 month and in 48% at 6 months in both groups. The conversion rates from positive to negative Dix-Hallpike test at 1 month were 92% and 84% in the SEM and BDE groups, respectively. There was a significant reduction in the vertigo intensity and an improvement in the mean DHI score. Both SEM and BDE were well tolerated, with a few minor complications, such as transient dizziness and nausea.

Conclusion: Both SEM and BDE are effective for treating posterior canal BPPV. Although there was no significant resolution of the vertigo, there was a reduction in its intensity and a perceived decrease in its negative impact on daily life.

Prolonged or irregular menstrual bleeding is common in women, particularly in the early years after menarche. Over time, menstrual cycles often become regular; however, persistently irregular menstruation warrants further investigation. Serious conditions, such as endometrial cancer, which is often linked to prolonged unopposed estrogen exposure, can be prevented with timely detection. We report a case involving a 27-year-old obese, nulliparous woman with a history of prolonged irregular menstrual bleeding since menarche. She had not undergone regular health checkups and had never been properly evaluated until multiple admissions for severe anemia prompted further investigation, which confirmed the diagnosis of endometrial carcinoma. Delays in seeking care for abnormal menstrual bleeding resulted in serious outcomes. Endometrial carcinoma may significantly reduce future fertility potential. Therefore, primary healthcare providers play a pivotal role in educating and raising public awareness about this frequently under-recognized issue, as timely investigation for early recognition is paramount.

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon acquired hematological disease resulting from somatic PIGA gene mutations. These mutations cause a deficiency in glycosylphosphatidylinositol-anchored-anchored proteins such as CD55 and CD59 on blood cell surfaces, leading to uncontrolled complement-mediated hemolysis. Although this condition is typically identified in individuals in their third or fourth decades of life, diagnosis during late adolescence is rare. Renal complications are a known feature of PNH; however, they present more frequently as a gradual decline in function rather than as a severe acute insult. This report describes the unusual case of an 18-year-old male who presented with a 6-month history of intermittent dark urine followed by an acute illness. Laboratory evaluation revealed severe Coombsnegative hemolytic anemia, significantly elevated lactate dehydrogenase levels, and acute kidney injury requiring immediate hemodialysis. Renal biopsy-confirmed pigment nephropathy, and high-sensitivity flow cytometry detected a large PNH clone, establishing the diagnosis of classical PNH. The patient's renal function improved with supportive care, but hemolysis persisted. This case highlights the fact that PNH can manifest in young adults with acute kidney injury as the primary presenting symptom. Including PNH in the differential diagnosis of patients with unexplained hemolytic anemia and renal impairment is crucial, even in atypical age groups. Prompt diagnosis is vital for initiating appropriate management, including supportive measures and the consideration of complementary inhibitor therapy, to improve outcomes.

Background: Sexual and reproductive health remains a significant public health issue, especially in low- and middle-income countries where access to contraception and sexuality education is often limited. This study examined factors associated with the use of condoms and other birth control methods among school-going adolescents in Brunei Darussalam, Indonesia, and Thailand.

Methods: This study utilized cross-sectional data from the Global School-based Student Health Survey conducted in Brunei Darussalam (2019), Thailand (2021), and Indonesia (2023), involving 868 sexually active school-going adolescents. Multivariate logistic regression was applied to assess the association between demographic, psychosocial, and behavioral risk factors with use of condoms and other birth control methods among adolescents who reported being sexually active.

Results: Condom use was significantly higher among adolescents in Thailand than those in Indonesia (adjusted odds ratio [AOR], 8.035); no significant difference was observed in Brunei Darussalam. High parental support was positively associated with condom use (AOR, 1.883). Regarding other birth control methods, adolescents aged 17 years and older were more likely to use contraception than their younger peers (AOR, 1.557). Adolescents in Thailand also demonstrated a higher use of other birth control methods (AOR, 2.132). Additionally, experiencing a single symptom of psychological distress was positively associated with using other birth control methods.

Conclusion: Age, number of sexual partners, psychological distress, parental support, and national context significantly influenced contraceptive use among adolescents in Southeast Asia. Enhancing parental involvement, expanding access to adolescent-friendly health services, and strengthening comprehensive sexuality education are crucial strategies for reducing the risk of unintended pregnancy and sexually transmitted infections among adolescents.