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Original Articles
Causal association between serum bilirubin and ischemic stroke: multivariable Mendelian randomization
Jong Won Shin, Keum Ji Jung, Mikyung Ryu, Jungeun Kim, Heejin Kimm, Sun Ha Jee
Epidemiol Health. 2024;46:e2024070.   Published online August 19, 2024
DOI: https://doi.org/10.4178/epih.e2024070
  • 1,606 View
  • 93 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Previous research has predominantly focused on total bilirubin levels without clearly distinguishing between direct and indirect bilirubin. In this study, the differences between these forms were examined, and their potential causal relationships with ischemic stroke were investigated.
METHODS
Two-sample multivariable Mendelian randomization (MVMR) analysis was employed, extracting summary data on bilirubin from the Korean Cancer Prevention Study-II (n=159,844) and the Korean Genome and Epidemiology Study (n=72,299). Data on ischemic stroke were obtained from BioBank Japan (n=201,800). Colocalization analysis was performed, focusing on the <i>UGT1A1, SLCO1B1</i>, and <i>SLCO1B3</i> genes, which are the primary loci associated with serum bilirubin levels.
RESULTS
Crude 2-sample Mendelian randomization analysis revealed a significant negative association between total bilirubin levels and ischemic stroke. However, in MVMR analyses, only indirect bilirubin demonstrated a significant negative association with ischemic stroke (odds ratio, 0.76; 95% confidence interval, 0.59 to 0.98). Colocalization analysis did not identify a shared causal variant between the 3 genetic loci related to indirect bilirubin and the risk of ischemic stroke.
CONCLUSIONS
Our study establishes a causal association between higher genetically determined levels of serum indirect bilirubin and reduced risk of ischemic stroke in an Asian population. Future research should include more in-depth analysis of shared genetic variants between indirect bilirubin and ischemic stroke.
Summary
Korean summary
이 연구는 혈청 빌리루빈의 세 가지 형태(총, 직접, 간접 빌리루빈)와 허혈성 뇌졸중 간의 인과적 연관성을 다루었습니다. 다변수 멘델리안 무작위 분석(MVMR)을 통해 간접 빌리루빈이 허혈성 뇌졸중 위험을 유의미하게 감소시키는 것으로 나타났습니다. 이 결과는 빌리루빈의 항산화 역할과 허혈성 뇌졸중 간의 상관관계를 심화 이해하는 데 기여합니다.
Key Message
This study investigated the causal associations between three forms of serum bilirubin (total, direct, and indirect) and ischemic stroke. Multivariable Mendelian randomization (MVMR) analysis revealed a significant inverse association between indirect bilirubin and the risk of ischemic stroke. These findings contribute to a deeper understanding of the relationship between bilirubin's antioxidant role and ischemic stroke.
Hand-to-face contact behaviors during indoor activities in daily life among Korean adults: an observational pilot study using videotaping
Hyang Soon Oh, Mikyung Ryu, Youngran Yang
Epidemiol Health. 2021;43:e2021030.   Published online April 22, 2021
DOI: https://doi.org/10.4178/epih.e2021030
  • 13,057 View
  • 364 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Hand-to-face contact (HFC) is the major route for the self-inoculation of pathogens. This study aimed to describe the characteristics of HFC behaviors among Korean adults during indoor activities.
METHODS
Thirty participants were enrolled in the study, and 2 hours of videotaped data were collected from each participant. Contact data were recorded by examining the frequency and duration of HFC on the videos. Three training sessions were conducted for 2 readers to ensure the accuracy and reliability of videotape reading. Re-reading and verification of selected video data were performed to confirm intrapersonal and interpersonal validity. Contact exposure (CE) was determined by multiplying the contact frequency (CF) by the contact duration (CD) to quantify the intensity of contact during the observation time (2 hours).
RESULTS
A total of 3,007 HFCs (1,305 mucous membrane contacts and 1,702 non-mucous membrane contacts) were observed for 60 person-hours. The median CF (person/2 hr) of the mucous membranes (eye; 4.0, nose; 15.5, mouth; 16.5) was 39.5/person and the median total CD was 177.0 sec/person. The median CE (frequency-duration/sec/person) was 5,795.0 (mouth: 1,356.0, nose: 600.0, eye: 57.5).
CONCLUSIONS
This study showed that the mouth and nose were the most frequent exposure sites for HFC. Avoiding habitual HFC, awareness of self-inoculation by HFC, and vigorous hand hygiene should be strengthened to prevent the spread of infections.
Summary
Korean summary
· 얼굴의 가장 빈번한 직접 자가 손접촉 노출은 입과 코에서 발생했습니다. · 접촉 노출량 지표 (contact exposure)는 입과 코에 자가 손접촉을 보다 잘 구별할 수 있습니다. · 습관적인 손-얼굴 접촉을 피하고, 마스크 사용 및 철저한 손위생으로 감염성 질환의 전파를 예방해야 합니다.
Key Message
• Average contact frequency (no./person) and contact duration (sec/person) of hand-to-face contact to the mucous membranes were high on the mouth, nose and then nose. • Contact exposure could differentiate more distinguished the hand contacts to mouth and to nose than contact frequency. • Hand-to face contacts, especially to mouth and then to nose can be the most frequent route of self-inoculation among Korean adults. • Avoiding habitual hand-to-face contacts, mask use, and vigorous hand hygiene should be strengthened as we counter epidemics of transmitting infectious diseases.

Citations

Citations to this article as recorded by  
  • Impact of a Serious Game (#RedPingüiNO) to Reduce Facial Self-Touches and Prevent Exposure to Pathogens Transmitted via Hands: Quasi-Experimental Intervention
    Marta Arévalo-Baeza, Alejandro Viuda-Serrano, Carmen Juan-Llamas, Pablo Sotoca-Orgaz, Iván Asín-Izquierdo
    JMIR Serious Games.2023; 11: e45600.     CrossRef
  • Hemşirelik Öğrencilerine Eğitimleri Sırasında Öğretilen Asepsi Uygulamalarının Covid -19 Pandemi Dönemindeki Bireysel Uygulamalarına Etkisi
    Ayşe SERPİCİ, Neriman AKANSEL, Nursel VATANSEVER, Vahit DALKIZAN
    Uludağ Üniversitesi Tıp Fakültesi Dergisi.2023; 49(2): 245.     CrossRef
  • Hand-to-Face Contact of Preschoolers during Indoor Activities in Childcare Facilities in the Republic of Korea
    Hyang Soon Oh, Mikyung Ryu
    International Journal of Environmental Research and Public Health.2022; 19(20): 13282.     CrossRef
Association between Alcohol Intake and Abdominal Obesity among the Korean Population
Mikyung Ryu, Heejin Kimm, Jaeseong Jo, Sun Ju Lee, Sun Ha Jee
Epidemiol Health. 2010;32:e2010007.   Published online May 19, 2010
DOI: https://doi.org/10.4178/epih/e2010007
  • 20,215 View
  • 116 Download
  • 14 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Although abdominal obesity has been reported to be highly related with alcohol intake, the results are still inconclusive. Therefore, this study was conducted to explore the association between alcohol and abdominal obesity among the Korean population.</p></sec><sec><title>METHODS</title><p>This study included 8,603 participants (men: 5,195, women: 3,408) aged 30 to 87 who visited the health promotion centers in Seoul for routine health examinations from April, 2006 to June, 2007. Abdominal obesity was defined as WC ≥90 cm for men and ≥85 cm for women in accordance with the Korean Society for the Study of Obesity. For ever drinkers, total alcohol consumption in grams was classified into four groups (group 1, non-drinkers; group 2, 1-10 g of alcohol per day; group 3, 11-20 g of alcohol per day; and group 4, over 20 g of alcohol per day).</p></sec><sec><title>RESULTS</title><p>The mean age of the study population was 45.4 yr old (men) and 45.3 yr (women). The average waist circumference was 85.3 cm in men and 75.3 cm in women. A high alcohol intake was associated with high waist circumference in both genders. In multivariate analysis, the group of men and women drinkers consuming >20 g in a day had a large waist circumference compared with men and women non-drinkers.</p></sec><sec><title>CONCLUSION</title><p>This study showed that a high alcohol intake was related to high waist circumference. Such association remained independently even after adjustment for smoking, which is strongly related to abdominal obesity.</p></sec>
Summary

Citations

Citations to this article as recorded by  
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    US Ophthalmic Review.2022; 16(1): 22.     CrossRef
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