RESUMEN
The objective of this study was to identify the main risk factors for gastric cancer in Koreans through the development of a predictive model by multivariate logistic regression analysis that could aid the development of specific guidelines for early detection. We conducted a case control study to identify the risk factors for gastric cancer. The cohorts comprised 183 patients with gastric cancer and 199 adults without gastric cancer as controls. Risk factors were identified, and a predictive model was established by multivariate logistic regression analysis. Major risk factors included in the final predictive model were being older, having a family history of gastric cancer, a family history of gastric ulcer, a personal history of gastric ulcer, a poor perceived health status, a low perceived financial status, being exposed to jobs considered to cause stomach cancer, drinking tap water, and eating irregularly and rapidly. The accuracy of the final predictive model was confirmed by its high degrees of sensitivity and specificity. The predictive model developed in this study can be used for classifying high-risk groups and for guiding early-detection screening for gastric cancer.
Asunto(s)
Modelos Teóricos , Neoplasias Gástricas/epidemiología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Corea (Geográfico)/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Factores de Riesgo , Factores SocioeconómicosRESUMEN
BACKGROUND: Although the prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing, there have been few studies of long-term changes in NAFLD in large numbers of subjects. This study was performed to assess the long-term changes in severity of fatty liver and to analyze the association with changes in body weight and lifestyle factors. METHODS: We analyzed lifestyle factors, biochemical data, and abdominal ultrasonography in subjects who underwent voluntary medical checkups at a 5-year interval. Fatty liver on ultrasonography was graded as normal, mild, moderate, or severe by the degree of echogenicity. RESULTS: The analyzed population consisted of 2895 subjects of age 47+/-8.7 years (range, 20-79 years). Among the 1938 subjects who had normal livers at baseline, 374 subjects (19%) developed fatty liver 5 years later. Those who developed fatty liver showed more weight gain, increase of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (gamma-GT), and glucose levels during the 5-year period. Among the 930 subjects who had fatty liver at baseline, 263 (28%) subjects showed a decrease in grade and 209 (22%) progressed to a higher grade of fatty liver after 5 years. The group with a lower grade lost -2.2+/-4.3 kg of body weight from baseline, and reduction in hepatic steatosis grade was associated with decreased serum AST, ALT, triglycerides, gamma-GT, and fasting glucose levels. CONCLUSIONS: Even a small weight reduction was associated with improvements in NAFLD and related metabolic abnormalities such as dyslipidemia and hyperglycemia. Subjects with fatty liver should be advised to lose weight through lifestyle modifications.
Asunto(s)
Hígado Graso/etiología , Adulto , Anciano , Presión Sanguínea , Peso Corporal , Hígado Graso/dietoterapia , Hígado Graso/patología , Hígado Graso/fisiopatología , Femenino , Humanos , Corea (Geográfico) , Estilo de Vida , Pruebas de Función Hepática , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pérdida de Peso , Adulto JovenRESUMEN
Immunomodulatory effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) demonstrated using animals are thymic atrophy, downregulation of cytotoxic T or B lymphocyte differentiation or activation, whereas human immunotoxicities have not been investigated well. This study was undertaken to evaluate overall immunologic spectrum of the Vietnam War Korean veterans exposed to Agent Orange contaminated with TCDD. Quantity of red blood cells, hemoglobin and hematocrit in the veterans suffered from chronic diseases associated with Agent Orange exposure (Veterans-patient group) were decreased in comparison with those of the veterans without the diseases and the age-matched healthy controls, but no differences in leukocyte populations. Plasma IgG levels were lowered in the veterans than the controls, owing to significant decrease in the IgG1 levels. Increase in the IgE levels was observed in the plasma from the veterans. Alteration of T cell-mediated immunity was also resulted from activation of peripheral blood mononuclear cells with polyclonal T cell activators. Production of IFNgamma, a major cytokine mediating host resistance against infection or tumoregenesis, was lowered in the veterans-patient group. However, production of IL-4 and IL-10, representative cytokines involved with hypersensitivity induction, was enhanced in the patient group. Overall, this study suggests that military service in Vietnam and/or Agent Orange exposure disturbs immune-homeostasis resulting in dysregulation of B and T cell activities.