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Noh Y, Jeong HE, Kim HJ, Ko H, Nah EH, Shin JY. The Multi-Institutional Health Screening Records Database of South Korea: Description and Evaluation of Its Characteristics. Yonsei Med J 2019; 60:1216-1222. [PMID: 31769254 PMCID: PMC6881703 DOI: 10.3349/ymj.2019.60.12.1216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/18/2019] [Accepted: 10/04/2019] [Indexed: 11/27/2022] Open
Abstract
This study sought to describe and to evaluate the characteristics of the Health Screening Records Database (HSRD) of the Korea Association of Health Promotion as a data source for epidemiologic studies. The HSRD was compared to a National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) database for 2015. Common variables between the databases were selected, and sex-based analyses were conducted. The HSRD showed statistical concordance when NHIS-HEALS estimates fell within the HSRD estimate's 95% confidence interval. The HSRD and NHIS-HEALS included 946461 and 111690 participants in health screening programs, respectively. Compared to the NHIS-HEALS, the HSRD had more female (55.2% vs. 42.6%) but fewer older adult participants (34.4% vs. 51.2%). Virtually all variables had clinical concordance, with some having statistical concordance as well, among both general and life-transition program participants. The HSRD comprised more clinical information over a wider age range in contrast to the NHIS-HEALS, while showing clinical concordance. Providing more comprehensive clinical data, the HSRD may serve as an alternative resource for epidemiologic studies.
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Affiliation(s)
- Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Hye Jun Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Hanju Ko
- IT Development & Support Office, Seoul, Korea
| | - Eun Hee Nah
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
| | - Ju Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea.
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Nah EH, Kim S, Cho S, Cho HI. Complete Blood Count Reference Intervals and Patterns of Changes Across Pediatric, Adult, and Geriatric Ages in Korea. Ann Lab Med 2018; 38:503-511. [PMID: 30027692 PMCID: PMC6056383 DOI: 10.3343/alm.2018.38.6.503] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 04/05/2018] [Accepted: 06/27/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. METHODS The reference population comprised 804,623 health examinees (66,611 aged 3-17 years; 564,280 aged 18-59 years; 173,732 aged 60-99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. RESULTS RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P<0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P<0.001). CONCLUSIONS We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.
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Affiliation(s)
- Eun Hee Nah
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
| | - Suyoung Kim
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Seon Cho
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Han Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea
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Nah EH, Cho S, Kim S, Cho HI, Chai JY. Comparison of Traditional and Reverse Syphilis Screening Algorithms in Medical Health Checkups. Ann Lab Med 2018; 37:511-515. [PMID: 28840989 PMCID: PMC5587824 DOI: 10.3343/alm.2017.37.6.511] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/02/2017] [Accepted: 07/03/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The syphilis diagnostic algorithms applied in different countries vary significantly depending on the local syphilis epidemiology and other considerations, including the expected workload, the need for automation in the laboratory and budget factors. This study was performed to investigate the efficacy of traditional and reverse syphilis diagnostic algorithms during general health checkups. METHODS In total, 1,000 blood specimens were obtained from 908 men and 92 women during their regular health checkups. Traditional screening and reverse screening were applied to the same specimens using automatic rapid plasma regain (RPR) and Treponema pallidum latex agglutination (TPLA) tests, respectively. Specimens that were reverse algorithm (TPLA) reactive, were subjected to a second treponemal test performed by using the chemiluminescent microparticle immunoassay (CMIA). RESULTS Of the 1,000 specimens tested, 68 (6.8%) were reactive by reverse screening (TPLA) compared with 11 (1.1%) by traditional screening (RPR). The traditional algorithm failed to detect 48 specimens [TPLA(+)/RPR(-)/CMIA(+)]. The median TPLA cutoff index (COI) was higher in CMIA-reactive cases than in CMIA-nonreactive cases (90.5 vs 12.5 U). CONCLUSIONS The reverse screening algorithm could detect the subjects with possible latent syphilis who were not detected by the traditional algorithm. Those individuals could be provided with opportunities for evaluating syphilis during their health checkups. The COI values of the initial TPLA test may be helpful in excluding false-positive TPLA test results in the reverse algorithm.
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Affiliation(s)
- Eun Hee Nah
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
| | - Seon Cho
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Suyoung Kim
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Han Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea
| | - Jong Yil Chai
- Institute of Parasitic Diseases, Korea Association of Health Promotion, Seoul, Korea
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Abstract
BACKGROUND The prevalence and genotype distribution of Human papillomavirus (HPV) infection vary depending on geographical region and the immunity provided by vaccines. This study aimed to clarify the recent prevalence and genotype distribution of HPV according to age and cervical cytology findings in Korea. METHODS This study included 18,815 health examinees that underwent cervical cytology and HPV genotyping tests at 16 centers of Korean Association of Health Promotion in 13 cities in Korea, between January 2014 and October 2015. HPV was genotyped by using multiplex PCR (Anyplex II HPV 28, Seegene, Korea), which detects 19 high-risk HPVs (HR-HPV) and nine low-risk HPVs (LR-HPV). RESULTS Overall HPV prevalence was 27.8%, with 22.2% HR-HPV and 11.4% LR-HPV. The five most common carcinogens were HPV 52 (3.2%), 58 (2.7%), 16 (2.0%), 56 (1.9%), and 51 (1.8%). The five most common HR-HPVs in normal cytology samples were HPV 53, 68, 70, 52, and 58, while HPV 16, 52, 58, 33, and 31 were prevalent in high grade squamous intraepithelial lesions (HSIL). In atypical squamous cells of undetermined significance (ASCUS), the prevalence of HR-HPV varied with age; it was highest in those aged <30 yr, declining to a minimum at age 50-59 yr, and then increasing in older women (P<0.05). CONCLUSIONS The prevalence and distribution of HR-HPV varied with age and cervical cytology findings. This information would be helpful in the development of cervical cancer prevention policies.
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Affiliation(s)
- Eun Hee Nah
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
| | - Seon Cho
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Suyoung Kim
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Han Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea
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Nah EH, Cho S, Kim S, Cho HI. Comparison of Urine Albumin-to-Creatinine Ratio (ACR) Between ACR Strip Test and Quantitative Test in Prediabetes and Diabetes. Ann Lab Med 2017; 37:28-33. [PMID: 27834062 PMCID: PMC5107614 DOI: 10.3343/alm.2017.37.1.28] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/19/2016] [Accepted: 10/05/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. METHODS Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. RESULTS The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of <30, 30-300, and >300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. CONCLUSIONS The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.
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Affiliation(s)
- Eun Hee Nah
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.
| | - Seon Cho
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Suyoung Kim
- Department of Laboratory Medicine and Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Han Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Cheongju, Korea
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Nah EH, Kim S, Cho HI. Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans. ACTA ACUST UNITED AC 2015. [DOI: 10.3343/lmo.2015.5.2.84] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Eun Hee Nah
- Department of Laboratory Medicine, Korea Association of Health Promotion, Seoul, Korea
| | - Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea
| | - Han-Ik Cho
- Korea Association of Health Promotion, Seoul, Korea
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Nah EH, Lee JK. [The Relationship between High Sensitivity C-Reactive Protein and Metabolic Syndrome according to the Fasting Glucose Level at Medical Checkups.]. Korean J Lab Med 2012; 26:454-9. [PMID: 18156767 DOI: 10.3343/kjlm.2006.26.6.454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study was performed to investigate the difference in high sensitivity C-reactive protein (hsCRP) and metabolic syndrome according to the fasting glucose level, especially between the groups of less than 100 mg/dL and 100-109 mg/dL, which were conventionally categorized into normal levels. METHODS Those who underwent routine medical checkups aged above 20 (male, 3,221; female, 3,334) at a Health Promotion Center (Seoul, Korea) were divided into normal fasting glucose group I (glucose <100 mg/dL), normal fasting glucose group II (glucose, 100-109 mg/dL), impaired fasting glucose group, and diabetes mellitus group. The hsCRP, obesity index, blood pressure, total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and lipoprotein(a) [Lp(a)] were compared among the groups. The hsCRP and the components of metabolic syndrome were compared. RESULTS The hsCRP level, age, obesity index, blood pressure, total cholesterol and triglyceride significantly increased along with the increment in fasting glucose level in the 4 groups. The hsCRP had a positive correlation with the fasting glucose level, age, and systolic blood pressure, while it had a negative correlation with HDL-C. The metabolic syndrome was more common in the group with a higher level of glucose. CONCLUSIONS The group with glucose level of less than 110 mg/dL, conventionally categorized into normal range, needs to be subdivided into a group of 100-109 mg/dL and a group of less than 100 mg/dL. The former group seems to require more efforts to have the glucose level to be maintained under the level of 100 mg/dL.
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Affiliation(s)
- Eun Hee Nah
- Korea Association of Health Promotion, Seoul, Korea.
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Abstract
BACKGROUND The individuals with prehypertension are known to progress to hypertension, one of the risk factors of cardiovascular disease, more readily than the group of normal blood pressure. This study was performed to investigate the differences in the risk factors of cardiovascular disease between normotensive and prehypertensive groups, and to identify the determinants of prehypertension. METHODS Normotensive (N=3,732) and prehypertensive individuals (N=676) were selected from the people who underwent routine medical checkups at the Health Promotion Center (Seoul, Korea). The age, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, LDL-cholesterol (C), HDL-C, high sensitivity C-reactive protein (hsCRP), lipoprotein(a) [Lp(a)], and the number of white blood cell were compared between the normotensive and prehypertensive groups. RESULTS The age, BMI, fasting blood glucose, triglyceride, and total cholesterol were higher in the males and females in the prehypertensive group than in the normotensive group. LDL-C, however, was higher and HDL-C was lower in the females in the prehypertensive group than in the normotensive group. The determinants of prehypertension were found to be age, BMI, and triglyceride. CONCLUSIONS There were differences in the risk factors of cardiovascular disease between the prehypertensive and normotensive groups.
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Affiliation(s)
- Eun Hee Nah
- Korea Association of Health Promotion, Seoul, Korea.
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Nah EH, Park JY. Metabolic Characteristics and Associated Factors of Nonalcoholic Fatty Liver Disease Diagnosed at Medical Checkups. Ann Lab Med 2008; 28:244-50. [DOI: 10.3343/kjlm.2008.28.3.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Eun Hee Nah
- Korea Association of Health Promotion, Seoul, Korea
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Nah EH, King DE, Craig FE. CD4 and CD8 antigen coexpression: a flow cytometric study of peripheral blood, bone marrow, body fluid, and solid lymphoreticular specimens. Arch Pathol Lab Med 1997; 121:381-4. [PMID: 9140307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE CD4 and CD8 antigen coexpression occurs not only on blastic T-cell malignancies, but also on a small subset of mature lymphocytes. The aim of this study was to determine the prevalence of this population of cells and to identify features that can be used to differentiate them from T lymphoblasts. DESIGN All specimens submitted to the clinical flow cytometry laboratory from August 1, 1994, through July 31, 1995, were analyzed for CD4 and CD8 coexpression. MAIN OUTCOME MEASURE Percentage of lymphocytes coexpressing the CD4 and CD8 antigens. RESULTS Four percent (22/526) of all specimens contained a population of CD4/CD8 coexpressing cells. Five cases represented CD4 and CD8 antigen expression on neoplastic cells. In 17 cases, the CD4/CD8 coexpressing cells appeared to represent a population of mature lymphocytes with a normal phenotype. The immature cells of T-cell acute lymphocytic leukemia and lymphoblastic lymphoma represented a dominant uniform population of cells demonstrating strong staining with both the CD4 and CD8 antigens. Cases containing a mature population of CD4/CD8 coexpressing cells were characterized by fewer coexpressing cells and variable expression of CD8. There were cases where distinction of this population of mature CD4/CD8 coexpressing lymphoid cells from a blastic malignancy was not possible using immunophenotyping alone. CONCLUSION Correlation of clinical, morphologic, and immunophenotypic data is recommended to prevent the misdiagnosis of subtle involvement by a blastic T-cell malignancy.
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Affiliation(s)
- E H Nah
- Department of Clinical Pathology, Chonnam University Hospital, Kwangju, Korea
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