Korean Journal of Family Medicine最新文献

Background: The liver plays an important role in gonadal steroid hormone metabolism, which can affect reproductive health, including the menstrual cycle. However, evidence from large population-based studies is limited. Therefore, this study aimed to investigate the association between liver function markers and menstrual cycle irregularities in premenopausal Korean women using nationwide data.

Methods: This study analyzed Data from the Korea National Health and Nutrition Examination Survey 2010-2011. We investigated 3,045 premenopausal women aged 19-59 years. Liver function markers including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase, and fatty liver index were analyzed. Multivariable logistic regression analysis was performed to investigate the association between liver function markers and menstrual cycle irregularity while adjusting for confounding factors. Values were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analysis was also performed.

Results: Baseline characteristic analysis showed that approximately 14.4% of the study population experienced menstrual cycle irregularity. The mean age was 34.5±0.7 years. The highest quartile of serum ALT and AST levels showed significantly higher ORs for menstrual cycle irregularity (adjusted OR, 1.83; 95% CI, 1.26-2.64 and adjusted OR, 1.67; 95% CI, 1.17-2.39, respectively). A similar result was observed in the subgroup analysis.

Conclusion: Liver function markers were positively associated with menstrual cycle irregularities. In clinical settings, women of reproductive age with relatively decreased liver function should be considered for regular followup of their reproductive health status.

Background: Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.

Methods: This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.

Results: E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=3.95; never: mean=9.18; P<0.001). The e-cigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03-1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03-2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14-12.30).

Conclusion: Our findings suggest that e-cigarette use is significantly associated with insulin resistance.

Background: The Korean Journal of Family Medicine (KJFM), which is an official journal of the Korean Academy of Family Medicine, is an English-text medical journal published since 2009. Although nearly 15 years have passed since the journal was launched, to the best of our knowledge, no study has reviewed articles published in the KJFM. Accordingly, we analyzed articles published in the KJFM for the first time.

Methods: Articles published in the KJFM between January 2018 and November 2023 were categorized according to article type. Information about author affiliations, study subjects, research methods, and modes of data collection was then scrutinized. Moreover, we compared the frequencies of subjects, research methods and modes of data collection before, during, and after the coronavirus disease 2019 pandemic.

Results: Original article was the most common article type. Approximately 52% of the articles were published by authors affiliated with departments other than family medicine, and 40% were published by family medicine. Approximately 60% and 38% of the articles were published by Korean authors and authors of international affiliations, respectively. Throughout the pandemic periods, research subjects focusing on "diseases & symptoms" have diminished, while "principles of family medicine" have progressively increased. Additionally, the use of cross-sectional study methods has declined. In terms of data collection, the use of "big data," "medical records," and "questionnaires" has decreased, whereas the use of "study results" has increased.

Conclusion: KJFM is journal with wide and international participation covering various research subjects and study methods. We believe that our study provides valuable data for the future direction and development of the KJFM.

Background: No disease-specific, reliable, and valid self-assessment tools exist for athletes with mild coronavirus disease (COVID-19) to self-return to sports. This study aimed to develop a self-assessment screening method for athletes with mild COVID-19.

Methods: Item generation, item reduction, and pretesting were used to develop a questionnaire that served as a screening tool to detect severe post-COVID-19 complications. The questionnaire was validated by both internal and external reviewers, and the final version consisted of 11 items. Face validity was assessed through direct interviews with 11 athletes. Severe COVID-19 complications were identified for criterion validity and correlation analysis. A total score of 11 indicates that there is no risk of severe COVID-19 complications and gradual return to play is recommended; results <11 indicate a need for further evaluation by trained medical personnel. For reliability test, 50 respondents were chosen and asked to answer the questionnaires 7 days after their first responses.

Results: Physical Activity Readiness Questionnaires for post-COVID-19 athletes (PAR-COVID-Q) demonstrated excellent internal consistency (r=1, P<0.05) and test-retest reliability (r=1, P<0.05). A total of 118 athletes scored 11, had normal health screening, normal electrocardiogram and chest X-ray, and successfully returned to sports without any reported complications (r=1, P<0.05). Two athletes scored <11 and underwent further medical evaluation.

Conclusion: The PAR-COVID-Q is a valid and reliable self-assessment tool with a low burden for athletes to return to sports following mild COVID-19.

Background: Circadian misalignment is associated with metabolic syndrome. This study aimed to examine the association between circadian rhythm-disturbing factors and metabolic syndrome.

Methods: We used data from the 7th and 8th Korea National Health and Nutrition Examination Survey conducted between 2016 and 2020, which surveyed 16,253 individuals. Circadian rhythm-disturbing factors were defined as follows: sleep duration outside the reference group (6-8 hours), irregular breakfast, shift work, and physical inactivity. The adjusted odds ratio (aOR) for metabolic syndrome was calculated based on the number of circadian rhythm-disturbing factors present in adults over the age of 19 years.

Results: Among a total of 16,253 participants (mean age 48.2±15 years), metabolic syndrome was found in 5,237 participants (29.3 %). The participants were classified into three categories based on the number of circadian rhythm-disturbing factors as follows: 2,627 (15.6%) did not have any factors, 6,406 (38.13%) had one factor, and 7,220 (46.3%) had two or more factors. Participants with a single circadian rhythm-disturbing factor were 21% more likely to have metabolic syndrome (aOR, 1.21; 95% confidence interval [CI], 1.08-1.36), and participants with two or more factors were 27% more likely to have metabolic syndrome (aOR, 1.27; 95% CI, 1.12-1.43).

Conclusion: Circadian rhythm-disturbing factors were significantly associated with the prevalence of metabolic syndrome in Korean adults. This finding has potential clinical implications for maintaining circadian rhythms by avoiding certain factors to prevent metabolic syndrome. Further studies are required to confirm these findings.

Background: Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker.

Methods: A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016-2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely "0-2 breakfasts per week" and "3-7 breakfasts per week"; hs-CRP concentrations were measured through blood tests.

Results: Comparing between the "infrequent breakfast consumption (0-2 breakfasts per week)" and "frequent breakfast consumption (3-7 breakfasts per week)" groups, the mean hs-CRP was found to be significantly higher in the "infrequent breakfast consumption" group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036).

Conclusion: Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Background: Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents.

Methods: This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users.

Results: Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users.

Conclusion: This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.

The coronavirus disease 2019 (COVID-19) pandemic is notable among infectious diseases for its distinctive impact, which has halted millions of livelihoods owing to strict social distancing rules and lockdowns. Consequently, millions of individuals have turned to online sources, particularly social media, to remain informed about the virus. The transition to digital sources has resulted in an abundance of information, including both accurate and misleading or false content being shared and consumed on online platforms, contributing to what is commonly referred to as an "infodemic." Although these platforms have been valuable tools for healthcare professionals and public health authorities in disseminating crucial public health messages, they have also aided in the spread of misleading and false information. The widespread dissemination of false information has been instrumental in propagating harmful beliefs and behaviors such as vaccine hesitancy, promoting discriminatory attitudes, and endorsing false beliefs about the efficacy of certain therapeutic products for treating COVID-19. False information has undoubtedly become a challenge and burden for governments, health professionals, and the general population. This review has three main objectives: (1) to assess the scope of the "infodemic" issue, including investigating the factors contributing to the spread of false information online; (2) to examine the multifaceted consequences resulting from false information; and (3) to argue that an interdisciplinary, multi-layered approach, encompassing a focus on prevention, deterrence, and education, should be adopted to prevent the conception and dissemination of false information in this modern digital age.

Background: Chronic atrophic gastritis causes hypochlorhydria, hypergastrinemia, and malabsorption of nutrients, leading to lower bone mineral density. The few studies that investigated the association between chronic atrophic gastritis and bone mineral density have reported inconsistent findings. As such, the present study assessed the association between chronic atrophic gastritis and bone mineral density among a large sample of women >40 years of age in Korea.

Methods: Data from 8,748 women >40 years of age who underwent esophagogastroduodenoscopy and bone densitometry were analyzed. Chronic atrophic gastritis was diagnosed using esophagogastroduodenoscopy. Bone mineral density of the lumbar vertebrae (L), femur neck, and femur total, measured using dual-energy X-ray absorptiometry, were the primary outcome variables. Low bone mineral density, which could be diagnosed as osteoporosis or osteopenia, was defined and analyzed as a secondary outcome. Linear regression was used to calculate adjusted mean values of bone mineral density. The association between low bone mineral density and chronic atrophic gastritis was analyzed using multiple logistic regression.

Results: The adjusted mean bone mineral density for L1-L4 was 1.063±0.003, femur neck (0.826±0.002), and femur total (0.890±0.002) were significantly lower in patients with chronic atrophic gastritis than others (1.073±0.002, 0.836±0.001, 0.898±0.002, respectively; all P<0.01). Women with chronic atrophic gastritis exhibited an increased likelihood for osteopenia or osteoporosis, even after adjusting for age and other confounding factors (odds ratio, 1.25; 95% confidence interval, 1.13-1.40; P<0.01). However, subgroup analysis revealed statistical significance only in postmenopausal women (odds ratio, 1.27; P<0.001).

Conclusion: Chronic atrophic gastritis was associated with lower bone mineral density and a higher risk for osteopenia or osteoporosis among postmenopausal women.