Epidemiology and Health

Original Articles

Association of appendicular skeletal muscle mass with carotid intima-media thickness according to body mass index in Korean adults: Ji Eun Heo, Hyeon Chang Kim, Jee-Seon Shim, Bo Mi Song, Hye Yoon Bae, Ho Jae Lee, Il Suh; Epidemiol Health. 2018;40:e2018049. Published online October 7, 2018; DOI: https://doi.org/10.4178/epih.e2018049

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middleaged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults.

METHODS

Herein, 595 men and 1,274 women aged 30-64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2 .

RESULTS

Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI.

CONCLUSIONS

Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.

Summary

Korean summary
한국 중년 성인을 대상으로 사지근육양과 죽상경화증(경동맥 내중막 두께≥75 percentile)의 관련성을 체질량지수(≥25, <25 kg/m2)로 층화하여 평가하였다. 체질량지수 25 kg/m2 미만인 남자에서는, 사지근육양이 낮으면 죽상경화증의 위험이 유의하게 높았으나, 체질량지수 25 kg/m2 이상인 남자에서는 관련성이 없었다. 반면 여자에서는 체질량지수에 상관없이 사지근육양과 죽상경화증의 독립적인 관련성이 관찰되지 않았다.

Citations

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A multifaceted and inclusive methodology for the detection of sarcopenia in patients undergoing bariatric surgery: an in-depth analysis of current evidence
Eunhye Seo, Yeongkeun Kwon, Ahmad ALRomi, Mohannad Eledreesi, Sungsoo Park
Reviews in Endocrine and Metabolic Disorders.2024;[Epub] CrossRef
Contribution of low skeletal muscle mass in predicting cardiovascular events: A prospective cohort study
Yiting Xu, Tingting Hu, Yun Shen, Yufei Wang, Yuqian Bao, Xiaojing Ma
European Journal of Internal Medicine.2023; 114: 113. CrossRef
Low appendicular skeletal muscle index increases the risk of carotid artery plaque in postmenopausal women with and without hypertension/hyperglycemia: a retrospective study
Yayun Lu, Jianguang Tian, Liangyu Wu, Qing Xia, Qinzhong Zhu
BMC Geriatrics.2023;[Epub] CrossRef
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Y. Xu, T. Hu, Y. Shen, Y. Wang, Xiaojing Ma, Yuqian Bao
The Journal of nutrition, health and aging.2022; 26(12): 1087. CrossRef
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Ming-Feng Xia, Ling-Yan Chen, Li Wu, Hui Ma, Xiao-Ming Li, Qian Li, Qiqige Aleteng, Yu Hu, Wan-Yuan He, Jian Gao, Huan-Dong Lin, Xin Gao
Clinical Nutrition.2021; 40(2): 571. CrossRef
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Jang Yel Shin, Jung Soo Lim
Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(10): 2935. CrossRef
Low muscle mass is associated with carotid atherosclerosis in patients with type 2 diabetes
Da Hea Seo, Yong-ho Lee, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, Young Ju Choi, Byoung Wook Huh, Seok Won Park, Eunjig Lee, So Hun Kim
Atherosclerosis.2020; 305: 19. CrossRef
Associations of skeletal muscle mass with atherosclerosis and inflammatory markers in Korean adults
Soon-Kyu Yoon, Ha-Na Kim, Sang-Wook Song
Archives of Gerontology and Geriatrics.2020; 90: 104163. CrossRef
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Shuhei Nakanishi, Masahiro Iwamoto, Hisanori Shinohara, Hideyuki Iwamoto, Hideaki Kaneto
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Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea
Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Yoosik Youm, Eui-Cheol Shin, Hyeon Chang Kim
Yonsei Medical Journal.2019; 60(8): 804. CrossRef

Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey: Won Joon Lee, Hyeon Chang Kim, Sun Min Oh, Dong Phil Choi, Jaelim Cho, Il Suh; Epidemiol Health. 2013;35:e2013005. Published online June 20, 2013; DOI: https://doi.org/10.4178/epih/e2013005

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Abstract

<sec><title>OBJECTIVES</title>The low-sodium diet is a known preventive factor for hypertension and cardiovascular disease. Factors associated with low-sodium diets should be identified to reduce sodium intake effectively. This study was conducted to identify factors correlated with a low-sodium diet.</sec><sec><title>METHODS</title>This cross-sectional study analyzed data from a total of 14,539 Koreans aged 20 years or older, who participated in the Fourth (2007-2009) Korean National Health and Nutrition Examination Survey. A low-sodium diet was defined as having ≤2,000 mg/day based on 24-hour recalls. Multiple logistic regression models were used to assess sex, age, education, number of family members, household income, occupation, alcohol drinking, total energy intake, frequency of eating out, and hypertension management status for their associations with low-sodium diets.</sec><sec><title>RESULTS</title>Among all participants, only 13.9% (n=2,016) had low-sodium diets. In the multivariate analysis, 40-49 years of age, clerical work jobs, higher total energy intake, and frequent eating out were inversely associated with low-sodium diets. And female sex and living-alone were associated with low-sodium diets. Lower frequency of eating out was significantly associated with low-sodium diets, even after adjusting for total energy intake and other potential confounders. Adjusted odds ratios (95% confidence interval) for a low-sodium diet were 1.97 (1.49-2.61), 1.47 (1.13-1.91), 1.24 (0.96-1.61), and 1.00 (reference) in people who eat out <1 time/month, 1-3 times/month, 1-6 times/week, and ≥1 time/day, respectively.</sec><sec><title>CONCLUSIONS</title>Our study suggests that sex, age, number of family members, occupation, total energy intake, and lower frequency of eating out were associated with a low-sodium diet in Korean adults.</sec>

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Citations

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A study on statistics used to test the tracking phenomenon of bloodpressure in childhood.: Chung Mo Nam, Soon Young Lee, Il Suh, Chong Yon Park; Korean J Epidemiol. 1992;14(2):117-127.

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This study was conducted to investigate the behavior of statistics, correlation analysis and 2X2 contingency table analysis, which were used to test the tracking phenomenon of blood pressure in childhood. Data were randomly generated by Blomqvist's model. The results of this study were as follows； 1. The correlation coefficients and probabilities of remaining in the upper quartile increased by the degree of tracking index θ, and decreased by the degree of within individual variation σe2. 2. The estimates of test statistics at θ=0.1, and σe2=82 were lower than those at θ= 0.0, and σe2=62 The results indicate that within individual variation must be considered to study the tracking phenomenon of blood pressure.; Summary

Cholera in Korea, 1991: models of transmission.: Han Joong Kim, Il Suh, Hee Choul Oh, Kyoo Sang Kim, Sun Ha Jee, Soon Young Lee, Sun Hee Lee; Korean J Epidemiol. 1991;13(2):123-139.

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In August-September 1991，Korea had a cholera epidemic caused by Vibrio El Tor Ogawa with 92 bacteriologically confirmed cases and 8 deaths. Seochun-gun Choongnam, Kunsan-si and Okgu-gun Chunbuk area, which are located near the mid-west coast of the country, were mainly affected. Vibrio cholerae were isolated from sewage water, sea water, squid and shell-fish tested during the epidemic, and an epidemiologic study found that consumption of raw shellfish or fish was the most probable source of cholera infection. Vibrio cholerae were thought to have spread from foreign countries and there were some evidence that an environmental reservoir of cholera might play a role in the transmission of cholera in this epidemic.; Summary

An epidemiologic study on scrub typhus in Koje island: Il Suh, Il Soon Kim, Byung Yool Cheon, Young Joon Kim, Yun Sop Chong; Korean J Epidemiol. 1987;9(1):17-27.

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Scrub typhus was reported in 1986 for the first time among Korean. Koje island was suspected of an endemic area because many patients with symptoms like scrub typhus were reported. To identify endemicity and epidemiologic characteristics of the disease an epidemiologic survey was conducted from Oct. 1 to Nov. 30 in Koje island. Patients with similar symptoms and signs suspected of scrub typhus were reported from 7 clinics in Koje island during the survey period. Bloods were drawn from those suspected patients and interviews were followed. Final diagnosis of scrub typhus was made by Indirect immunoperoxidase test in addition to clinical signs and symptoms. The endemicity of scrub typhus was identified. Incidence rate of scrub typhus in Koje island in 1986 was estimated to be exceeding 14.4 per 100,000 population. The rate was slightly higher in woman than that of man and majority of patients were aged between 20 and 60. Any special findings in relation with occupation of patients were unable to identify with present study. The major clinical symptoms were high fever, rash, loss of appetite, fatigue, headache and lymphnode enlargement. Eschar which is a pathognomonic finding of the disease was observed in 7 patients out of 15 serologically confirmed cases. The duration of illness was about 6 to 20 days.; Summary

Physical characteristics of workers and industrial accidents: Yong Joon Kim, Il Soon Kim, Il Suh, Kee Hong Chun; Korean J Epidemiol. 1987;9(2):205-216.

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To investigate the relationship between physical characteristics of workers and industrial accidents, a case-control study was carried out using matched samples of 281 injured workers and 843 non-injured workers. Age, types of work and duration of employment were matched, and their physical characteristics at the time of employment were analzed.
Results
were summarized below; 1) Physical characteristics such as hearing ability, body weight, and visual acuity in the injured group were significantly lower than those in control group whereas measurements of blood pressure, hemoglobin, and urinalysis and color blindness showed no differences in two groups. 2) The relative risks of physical characteristics for industrial accidents, expressed in terms of odds ratios, were 13.2 for hearing loss, 1.8 for impairment of visual acuity and 1.6 for underweight. 3) Hearing ability, body weight, and visual acuity were selected as significant factors influencing industrial accidents based on log-linear model. Odds ratio from logistic regression analysis were 3.6 for hearing loss. 1.3 for underweight, 1.2 for the impairment of visual acuity. Since physical characteristics such as hearing impairement. underweight, and impairement of visual acuity were shown to increases industrial accident risk, the workers with these problems revealed at employment or periodic health examination should be assigned to the job which is more suitable for their physical fitness. Especially, those of who have hearing impairment should be closely supervised in order to prevent industrial accident since it was identified as the most significant risk factor among the three.; Summary

Special editions

Cancer registered in Korea: Il Suh, Il Soon Kim; Korean J Epidemiol. 1988;10(1):40-43.

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Epidemiologic characteristics of smoking in Korea: Il Suh; Korean J Epidemiol. 1988;10(2):131-137.

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PDF: Abstract; Summary

Original Articles

A seroepidemiologic study on scrub typhus in Koje island: Il Suh, Sang Nae Cho, Il Soon Kim, Young Joon Kim, Joon Yong Bang, Eun Cheol Park, Kyung Jong Lee, Ki Hong Jeun, Moon Shik Kim, Dae Kyu Oh; Korean J Epidemiol. 1988;10(2):230-238.

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In order to examine the past infection rate an incidence of Scrub typhus a seroepidemiologi study was performed in Koje County. Paired serums were collected from 518 residents in Sadeung and Koje myun. Serum were analyzed by ELISA for detection o IgG to R. tsutsugamushi, and were also analyzed by Microscopic Agglutination test for Leptospirosis. First serum were collected from Aug. 25 to Aug. 31, 1987 and second serum were collected from Jan. 13 to Jan 31, 1988. The result summarized as follows: 1. One hunderd seventy people(33.9%) had a experience of infection by R. tsutsugamushi： among 501 subjects. The past infection rate was significantly higher in female than that in male and it was increased according to age. By occupation farmers showed the highest infection rate. 2. The incidence rate of Scrub typhus was estimated 4.7%(19 people among 405 subjects) during the study period. The incidence rate was also significantly higher in female than that in male and 40-49 age group showed the highest incidence rate. 3. Two people(0.4%) were reacted to Microscopic Agglutnation test for Leptospirosis. Among 501 sujects and these two people were also reacted to ELISA for Scrub typhus.; Summary

A study on cigarette smoking of male students in middle and high school in Korea: Il Suh, Hae Sook Lee, Myongsei Sohn, Il Soon Kim, Dong Choun Shin, Young Yee Choi; Korean J Epidemiol. 1988;10(2):219-229.

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In order to examine the smoking rate, knowlege and attitude on smoking of male students attending middle and high school in Korea a study was performed at the period between July 11 and July 23, 1988. In each grade 10 classes were sampled and surveyed and the total number of respondents was 3,437. The results were as follows; 1. Proportion of current smoker among middle school students was less than 3%, but it was increased very rapidly among high school students. So proportion of smoker was 9.5%, 19.1% and 40.4% among first second and third grade students respectively. Proportion of ex-smoker was 16.9% among middle school students and 28.1% among high school students. Proportion of current smoker and ex-smoker were significantly higher among students in city than students in rural area. 2. Proportion of smoker and ex-smoker among students who had smoker in their family were significantly higher than those who had no smoker in their family. 3. Most frequent motivation to smoking was “from curiosity(40.0%)” among smokers in middle school and “to release stress(31.0%)” among smokers in high schools. 4. The proportion of smokers who smoke a cigarette regularly was 31.3% among smokers in middle school and 51.7% among smokers in high school. Sixty percent of smokers in middle school smoked less than 5 cigarettes per day and 76.0% of smokers in high school smoked less than 10 cigarettes per day. 5. Almost all respondents(99.1% in middle school, 98.8% in high school) knew about the harmful effect of cigarette smoking on health and cigarette smoking was regarded as undesirable behavior to 79.5% of middle school students and 49.3% of high school students. 6. Most smokers(63.3% in middle school, 73.8% in high school) wanted to quit smoking due to the harmful effect of cigarette smoking on health. So family factors were found to be significantly correlated with smoking students. A effective method to release stress and to quit smoking should to be suggested for students.; Summary

A study of the seroconversion rates of anti-HBs and the duration of anti-HBs persistence after hepatitis B vaccination: Bok Soon Han, Il Soon Kim, Il Suh; Korean J Epidemiol. 1989;11(2):215-231.

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When the patients were contracted with acute type B hepatitis, most of them recover completely. But approximately 15-20% of them may have chronic hepatitis, liver cirrhosis or hepatoma. For the prevention of serious type B hepatitis, many different products of vaccine were developed. And there were many researches on the effectiveness, security, and immunity of these products. The purpose of this study is to assess the seroconversion rates of Anti HBs with PHA method and the duration of Anti HBs persistence after hepatitis B vaccination. The factors relevant to the rates and duration were analyzed using x2 test and survival analysis based on the data from self-written questionares, blood test and chart Reviews from Oct 1988 to May 1989. The results were as follows; 1. The seroconversion rates of Anti HBs was 67.2%. 2. The statistically significant variables influencing seroconversion rates of Anti HBs after HBV vaccination were sex, age, type of vaccines, blood types, smoking. 3. The seroconversion rates for male and female were 62.1%, and 75.5%, respectively. These rates were statistically significant(p<0.05). For male, the age specific rates for 19-29, 30-39, 40-49, 50 over were 73.6%, 57.3%, 74.6%, 52.0%, respectively. These rates were also statistically significant(p<0.05). 4. Of the 661 cases of completely HBV vaccinated persons, 444 cases(67.2%) were responders with vaccination. Their 5 year survival rate of Ant HBs was 57.3%. 5. The statistically significant variables influencing survival time of Anti HBs were Q index, and past history of liver diseases. The lower the Q index, the more mean survival time of Anti HBs. The mean survival time of Anti HBs for the persons with no history of liver disease was longer than that of the persons with history of liver disease. 6. The mean survival time of Anti HBs of Q index group for the average weight, overweight and obesity were 55.82 months，51.37 months and 35.57 months, respectively. 7. The mean survival time of Anti HBs for the persons with no history of liver disease, the persons with history of liver disease were 57.31 months and 40.01 months, respectively.; Summary

A comparative study on cigarette smoking of male students in middle and high school in Korea (1988-1989): Hae Sook Lee, Il Soon Kim, Il Suh; Korean J Epidemiol. 1989;11(2):198-208.

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In order to examine the actual condition of smoking, the change of knowledge and attitude on smoking of the male students attending middle and high school in Korea, the surveys were performed twice ranging from 1988 to 1989. The male students in middle and high school were selected by a random sampling method and surveyed by mail. In this survey, the number of classes of middle and high schools in Korea was a sampling unit, and the classes were selected in proportion to each city and each county. The total number of respondents was 3,055 in 1989(1,602 of middle school students, 1,453 of high school students). The results obtained from the data analysis are as follows; 1. The ratio of smoker in 1989 was 1.5% among middle school students and 32.0% among high school students. The ratio of current smokers and experienced among middle school students has increased from 18.7% to 24.5% and among high school students the ratio has increased by 58.0%. The ratio of smoking among high school students was on the increase significantly as the grade becomes higher. Especially, in the case of third grade high school students, the ratio of smokers who have ever experienced smoking was 72.4%. This result showed that there was little change in the case of middle school students in comparision the first survey(1.8%), while in the case of high school students the ratio has increased by 8.1% in comparision with the first survey(23.9%). 2. With respect to the area, the number of current smokers and experienced among middle and high school students was higher in county then in city. This result showed difference from the first survey in which the number of current smokers and experienced among middle school students was higher in city than in county. 3. In the respect of whether or not there is a smoker among the number of a family, the ratio was 72.3% in middle school students and 75.1% in high school students. This result showed that the ratio of current smoking and the past experience of smoking were significantly higher among the students who had a smoker in their family. 4. In the first survey, the strongest motivation of smoking among middle school students was “from curiosity” and the next was “to join with the friends”while in the second survey the strongest motivation was “from curiosity"(36.4%) and the next was “to release stress”. In the case of high school students strongest motivation in the first survey was “to release stress”(31.0%)，while in the second survey the ratio of “from curiosity”(31.4%) was the highest. 5. The average number of cigarette per day among middle school students was less than 5(60.0%), and this result was same as the first survey. In the case of high school students the average number of cigarettes per day was 6-10 in the first survey, but in the second survey it changed to less than 5(45.9%). 6. The most preferred cigarette among the current smokers was “Eighty-eight”(40.9%) in middle school students, which is same as the first survey. But in the case of high school students the preference tendency has changed from “Sol”(52.2%) to “Eighty-eight(76.0%). The tendency to prefer a foreign cigarette of high school students was significantly higher in cities than in counties. 7. Almost all of the middle and high school students knew about the harmful effect of smoking on health and only 1.2% of middle school students and 2.5% of high school students answered that smoking did not affect our health. In their attitudes on smoking, 79.2% of middle school students and 46.6% of high school students regarded smoking as undesirable behavior, because it can do harm to themselves and other people. This result is almost same as the first survey. 8. Most of current smokers wanted to give up smoking(77.3% of middle school students and 79.1% of high school students) in the same manner as the first survey because of the harmful effect of cigarette smoking on health.; Summary

Special Article

Mortality of Koreans in the fourth decade of age: Il Soon Kim, Sun Ha Jee, Hee Choul Oh, Il Suh; Korean J Epidemiol. 1990;12(2):191-210.

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The Mortality experience among Koreans in their forties during the past eight yeasrs was compared to the countries, of Singapore, Czechoslovakia, Hungary, Poland, U.S.A.，U.K., Japan, and Germany in order to determine the mortality status and structure of Koreans in the fifth decade of age. The major findings are as follows ； 1. The age — specific and sex — specific death rates of Koreans showed a continuous decrease during the past eight years. When compared to other countries, the death rate among males in Korea was similar to or lower than the rate in the developing countries but higher than the rate in the developed countries. On the other hand, there was no significant difference in death rates among females compared with the developed countries. 2. When comparing the causes of death among Koreans with the Japanese, infections disease was 3.4 — 4.5 times greater and chronic non—infectious desease was 1.5 — 2.1 times greater, for both sexes. Pulmonary tuberculosis was 30 times higher for males in their twenties to fities, and hepatic carcinoma and gastric carcinoma were 4 一 7 times and 1.5 — 2 times higher, respectively, for males in their thirties to forties. The higher death rates among Koreans compared with the developed countries are attributed to infectious disease, hepatic carcinoma, and gastric carcinoma, which have decreased in recent years. In conclusion, the death rates of Koreans in their forties are higher compared with the developed countries but lower compared to the developing countries, along the lines of socioeconomic achievement.; Summary

Special edition

Study of risk factors for hypertension in a rural adult population: Il Soon Kim, Il Suh, Hee Chul Oh, Yong Ho Lee, Dae Kyu Oh; Korean J Epidemiol. 1981;3(1):37-43.

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Arterial blood pressures, height, weight, skinfold thickness, blood pressure, 2 lead ECG, serum cholesterol of 1169 voluntary participants whose age were between 40-64 were examined in a rural community Korea in order to identify risk factors in developing CVD. The influences of 19 enables on the blood pressure were examined and their independent association with blood pressure was analyzed by means of multiple regression analysis. The most important factors influencing both systolic and diastolic blood pressure were: age, weight, height and cholesterol. The following factors were identified significantly correlated with blood pressure： pulse rate, hemoglobin and triglyceride. All 19 variables including modified variable from weight, height and age (Ponderal index, Quetelet index, age2, age3, weight2, weight3) could explain 14.4% of total variation of systolic blood pressure and 20.5% of total variation of diastolic blood pressure. Among 25 variables the most important factors influencing systolic blood pressure were: Ponderai index, age, Quetelet index, cholesterol and pulse rate. With these 5 variables 13% of total variation of systolic blood pressure could be explained. The most important factors influencing diastolic blood pressure were: weight, cholesterol, ponderal index, hemoglobin and triglyceride. With these 5 variables 16% of total variation of diastolic blood pressure could be explained.; Summary

Original Article

Heritability and segregation analysis of the level of HDL-cholesterol.: Ji Eun Yun, Chung Mo Nam, Il Suh, Sun Ha Jee; Korean J Epidemiol. 2004;26(2):43-53.

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OBJECTIVES
The purpose of this study was to investigate the familial correlation and heritability in HDL cholesterol through segregation analysis.
METHODS
This study, based on data from 11,117 Korean individuals ascertained pedigrees who had participated in 1998 and 2001 Korean National Health & Nutrition Examination Survey. The subjects of segregation analysis were 4,688 Korean who had more than five members in their family.
RESULTS
Serum lipid levels revealed strong familial correlation among spouses, parent-offspring and siblings with low correlation of spouse. The heritability of HDL cholesterol was 54.8% after controlling for age, age2, gender, agexgender, waist circumference, smoking, alcohol drinking, exercise and education. Two models of inheritance, the Mendelian dominant model and the Mendelian codominant model were found in HDL cholesterol. In the codominant model, the predicted HDL-cholesterol for genotype AA, AB, and BB were 44.96, 49.13, and 69.67 mg/dl, respectively. However the Mendelian codominant model only was found in high risk families.
CONCLUSIONS
In conclusion, randomly ascertained Korean families of this study showed strong familial aggregation in HDL cholesterol. The results suggested that the variations in HDL cholesterol may be influencing by major effect of gene.; Summary

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