Ju Hee Kim
@khmc.or.kr
Clinical assistant professor in Pediatric department
Kyung Hee university Medical Center
RESEARCH, TEACHING, or OTHER INTERESTS
Immunology, Epidemiology
Scopus Publications
Scopus Publications
Yohwan Lim, Bo Chang Kim, Sung Soo Yoon, Hye Jun Kim, Sang Jun Lee, Myeong Hoon Lee, Ju Hee Kim, Sun Jae Park, Seogsong Jeong, and Hyun Wook Han
Elsevier BV
Ju Hee Kim, Hye Ryeong Cha, Eun Kyo Ha, Ji Hee Kwak, Hakjun Kim, Jeewon Shin, Hye Mi Jee, and Man Yong Han
MDPI AG
Cardiotoxicity from first-generation H1-antihistamines has been debated since the 1990s. However, large-scale studies on this topic in a general pediatric population are lacking. This study aimed to assess the association between first-generation H1-antihistamine use and cardiovascular events in a nationwide pediatric population. In this case-crossover study, the main cohort included children with cardiovascular events from the National Health Insurance Service database (2008–2012 births in Korea) until 2018. The second cohort excluded children with specific birth histories or underlying cardiovascular diseases from the main cohort. Cardiovascular events of interest included cardiac arrhythmia and ischemic heart disease. Odds ratios (ORs) of cardiovascular events were estimated using conditional logistic regression models, comparing first-generation H1-antihistamine use during 0–15 days before cardiovascular events (hazard period) with use during 45–60 and 75–90 days before events (control periods). Among the participants, 1194 (59.9%) were aged 24 months to 6 years, and 1010 (50.7%) were male. Cardiovascular event risk was increased among users of first-generation H1-antihistamines (adjusted OR [aOR], 1.201; 95% confidence interval, 1.13–1.27). Significant odds of cardiovascular events persisted within 10 and 5 days (aOR, 1.25 and 1.25). In the second cohort, the association was comparable with that in the main cohort. Our findings indicate that cardiovascular event risk is increased in children who are administered first-generation H1-antihistamines.
Eun Kyo Ha, Seung Won Lee, Ju Hee Kim, Eun Lee, Hye Ryeong Cha, Bo Eun Han, Jeewon Shin, and Man Yong Han
MDPI AG
The timing of complementary food (CF) introduction is closely related to childhood health, and it may vary depending on the region, culture, feeding type, or health condition. Despite numerous studies on the benefits of breastfeeding and the optimal timing of CF introduction, there have been limited investigations regarding delayed CF introduction in exclusively breastfed children. We compared an exposed group (CF introduction ≥7 months) with a reference group (CF introduction at 4 –< 7 months) regarding hospital admission, disease burden, and growth until age 10. Data from a nationwide population-based cohort study involving children born between 2008 and 2012 in the South Korea were analyzed. The final cohort comprised 206,248 children (165,925 in the exposed group and 40,323 in the reference group). Inverse probability of treatment weighting with propensity score matching was used to balance baseline health characteristics in the comparison groups. We estimated the incident risk ratios (IRR) for outcomes using modified Poisson regression and weighted odds ratios (weighted ORs) and their 95% confidence intervals (CIs) using multinomial logistic regression. The exposed group was associated with low height-for-age z-score (HAZ) (IRR (95% CI) for −1.64 < HAZ ≤ −1.03: 1.11 (1.08 to 1.14); HAZ ≤ −1.64: 1.21 (1.14 to 1.27)) and frequent (≥6 events) hospitalizations (weighted OR 1.18 (1.09 to 1.29). The rates of hospital admission, death, and specific medical conditions did not differ between groups. However, delaying the introduction of CF until seven months in exclusively breastfed infants was associated with frequent hospitalization events and lower heights.
Ji Eun Lim, Hye Min Kim, Ju Hee Kim, Hey Sung Baek, and Man Yong Han
Korean Pediatric Society
Background: The association between dyslipidemia and asthma in children remains unclear.Purpose: This study investigated the association between dyslipidemia and cholesterol levels in children.Methods: A systematic literature review was performed to identify studies investigating the association between dyslipidemia and asthma in children. The PubMed database was searched for articles published from January 2000–March 2022. Data from a cohort study using electronic health records from 5 hospitals, converted to the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM), were used to identify the association between total cholesterol (TC) levels and asthma in children. This cohort study used the Cox proportional hazards model to examine hazard ratio (HR) of asthma after propensity score matching, and included an aggregate meta-analysis of HR.Results: We examined 11 studies reporting an association between dyslipidemia and asthma in children. Most were cross-sectional; however, their results were inconsistent. In OMOP-CDM multicenter analysis, the high TC (>170 mg/dL) group included 29,038 children, while the normal TC (≤170 mg/dL) group included 88,823 children including all hospital datasets. In a meta-analysis of this multicenter cohort, a significant association was found between high TC levels and later development of asthma in children <15 years of age (pooled HR, 1.30; 95% confidence interval, 1.12–1.52).Conclusion: Elevated TC levels in children may be associated with asthma.
Eun Kyo Ha, Ju Hee Kim, Hye Ryeong Cha, Gi Chun Lee, Jeewon Shin, Youn Ho Shin, Hey-Sung Baek, Seung Won Lee, and Man Yong Han
American Medical Association (AMA)
ImportanceRotavirus infection is a common cause of gastroenteritis in children that can trigger autoimmune processes, but the nature of this interaction remains poorly understood.ObjectiveTo estimate the association of rotavirus infection with the risk of subsequent autoimmune disease.Design, Setting, and ParticipantsThis population-matched cohort study used data from children and adolescents (aged younger than 18 years) in South Korea (national registers from January 1, 2002, to December 31, 2017). The cohort consisted of 86 157 patients in the exposure group who had experienced rotavirus-associated hospitalization and the same number of matched patients in the unexposed group. Data analyses were from May 1, 2020, through October 20, 2022.ExposuresHospitalization for rotavirus infection.Main Outcomes and MeasuresThe main outcome was childhood autoimmune diseases during the study defined by diagnoses according to the National Health Insurance Database. Hazard ratios (HRs) with 95% CIs for autoimmune diseases were estimated using a Cox model, with multiple confounding factors controlled.ResultsThis cohort study consisted of 1 914 461 individuals born in South Korea from 2002 to 2005 who were potentially eligible. After exclusions, there were 86 517 individuals in the exposed group and 86 517 in the unexposed group after 1:1 incidence density sampling. The study included 49 072 (57.0%) male patients. The median (IQR) age at diagnosis of rotavirus-associated hospitalization was 1.5 (0.9-2.7) years, and the HR for autoimmune disease in the exposed group was 1.24 (95% CI, 1.19-1.28) for a mean (SD) follow-up time of 12.1 (3.2) years. The use of more stringent definitions for exposure and outcomes in a multivariable stratified analysis also indicated that rotavirus-associated hospitalization was associated with an increased risk of subsequent autoimmune disease (HR, 1.22 [95% CI, 1.16-1.28]). Sensitivity analysis showed that individuals with rotavirus-associated hospitalization was related to multiple autoimmune syndromes (2 or more: HR, 1. 51 [95% CI, 1. 31-1. 73]; 3 or more: HR, 1. 79 [95% CI, 1.18-2.72]) and that the number of rotavirus-associated hospitalization were associated with higher risks for autoimmune disease in a dose-dependent manner (single hospitalization event: HR, 1.20 [95% CI, 1.16-1.24]; multiple events HR, 1.60 [95% CI, 1.49-1.72]).Conclusions and RelevanceOur results indicate that rotavirus-associated hospitalization is significantly associated with subsequent autoimmune disease during childhood. Clinicians should be aware of the heightened susceptibility to autoimmune disease in individuals with prior rotavirus-associated hospitalization.
Eun Lee, Ju Hee Kim, Hye Ryeong Cha, Eun Kyo Ha, Jeewon Shin, Won Seok Lee, Seung Won Lee, and Man Yong Han
Wiley
AbstractBackgroundAlthough atopic dermatitis (AD) in children affects diverse stages of life, no studies have reported on the association between school readiness and AD.MethodsThis study used Korean National Health Insurance data and the Health Screening Program for Infants and Children. Among all children born between 2008 and 2012 in Korea, those who were assessed for school readiness through questionnaires in a health screening program performed at 54 and 60 months old were enrolled. AD was defined based on the International Classification of Diseases codes, with two or more prescriptions of topical corticosteroids during the first 54–60 months of life. The primary outcome was the association between school readiness and AD. The questionnaire relating to school readiness comprised six items – cognitive skills, social development, activeness, concentration, emotional development, and language skills. Logistic regression analysis was used to identify the associations between school readiness and AD.ResultsThis study included 239,673 children without AD and 38,229 children with AD. The average age at which school readiness was assessed was 4.8 years. AD was associated with vulnerability in activeness (adjusted odds ratio: 1.127; 95% confidence interval: 1.071–1.186) and concentrations (1.170; 1.093–1.254). The impact of AD on concentrations showed consistent results regardless of sex, exposure to systemic corticosteroids and antihistamines, and age at the diagnosis of AD.ConclusionsChildren with AD have vulnerability in school readiness in the aspects of activeness and concentration.
Ju Hee Kim, Eun Lee, Eun Kyo Ha, Gi Chun Lee, Jeewon Shin, Hey-Sung Baek, Sun-Hee Choi, Youn Ho Shin, and Man Yong Han
MDPI AG
(1) Background: Feeding behavior habits have a pattern with a certain tendency during infancy. We aimed to identify the associations between feeding patterns in infancy and the subsequent 10-year childhood disease burden. (2) Methods: Data from 236,372 infants were obtained from the national health insurance and screening program records in South Korea. Parent-administered questionnaires during infancy provided details on the feeding type and types/frequency of complementary food for analyzing feeding patterns. The outcomes were all-cause hospitalization and the development of 15 representative childhood diseases until the age of 10 years. Anthropometric measurements obtained at 6 years of age were analyzed. To estimate outcome risks while considering multiple risk factors, we employed a Cox proportional hazard and modified Poisson regression. (3) Results: Three clusters were identified: high prevalence of breastfeeding with regular exposure to a variety of solid foods (n = 116,372, cluster 1), similar prevalence of breastfeeding and formula feeding with less exposure to solid foods (n = 108,189, cluster 2), and similar prevalence of breastfeeding and formula feeding with the least exposure to solid foods in infancy (n = 11,811, cluster 3). Compared with cluster 1, children in clusters 2 and 3 had increased risks of all-cause hospitalization (hazard ratio (HR), (95% confidence interval (CI)), 1.04 (1.03–1.06) and 1.08 (1.05–1.11), respectively). Children in clusters 2 and 3 had an increased risk of upper respiratory infection, pneumonia, and gastroenteritis, as well as neurobehavioral diseases. Overweight/obesity at the age of 6 years was associated with clusters 2 and 3. (4) Conclusions: Feeding patterns in infancy were associated with an increased risk of childhood disease burden.
Eun Kyo Ha, Ju Hee Kim, Hey‐Sung Baek, Eun Lee, Ji Hyeon Baek, Somin Shim, Young Hyeon Kim, Luis A. Moreno, Seung Won Lee, and Man Yong Han
Wiley
AbstractBackgroundThe optimal time of starting complementary foods (CFs) in infants remains a subject of debate. This population‐based longitudinal cohort study evaluated the association between early CF introduction and body mass index (BMI) in children aged 5–7 years.MethodsThe present study included 917,707 children born in Korea during 2008–2009. Initial timing of CF introduction was obtained by questionnaires administered between 4 and 6 months and 9 and 12 months of age. The cohort consisted of 154,565 eligible individuals who properly completed the screening programme, including structured questionnaires, anthropometric measurements and physical examinations. To balance baseline characteristics, children were subjected to propensity score matching based on 95 covariates, including indicators of baseline health such as perinatal condition, birth weight, economic status, clinical disease and drug exposure. Exposure was defined as introduction to CF at age < 4 months, and outcomes were overweight (BMI z‐score > 85th percentile) and obesity (BMI z‐score > 95th percentile) at ages 5–7 years.ResultsOf the 154,565 eligible children in the observed cohort, 10,499 (6.8%) were introduced to CF at age < 4 months and 144,066 (93.2%) at age ≥ 4 months. Propensity score matching yielded 9680 children introduced to CF at age < 4 months and 35,396 at age ≥ 4 months. The risk for being overweight or obese at age 5–7 years was slightly higher among those who started CF at age < 4 months than at age ≥4 months (adjusted relative risk = 1.06; 95% confidence interval = 1.02–1.09). A similar but stronger association was observed for being obese at age 5–7 years (adjusted relative risk = 1.12; 95% confidence interval = 1.05–1.19).ConclusionsEarly CF introduction before age 4 months was associated with increased BMI at age 5–7 years.
Eun Kyo Ha, Ju Hee Kim, Hye Ryeong Cha, Won Seok Lee, Seung Won Lee, and Man Yong Han
Elsevier BV
Hyun Joo Lee, Seung Won Lee, Hye Ryeong Cha, Eun Kyo Ha, Ju Hee Kim, Seung Yong Shin, Ki Cheon Lee, Patrick S.C. Leung, Man Yong Han, Jin Jung Choi,et al.
Elsevier BV
Jeewon Shin, Yoowon Kwon, Ju Hee Kim, and Su Jin Jeong
Korean Pediatric Society
Background: Recent studies reported that prepregnancy body mass index (BMI) and weight gain during pregnancy affect birth weight and contribute to childhood obesity. However, no such data are available in Korea.Purpose: This study gathered data on weight gain during pregnancy and its impact on birth weight and childhood obesity in Korea.Methods: We reviewed 1,753 singleton full-term babies born at CHA Bundang Medical Center in 2014–2016. We first review each maternal and baby factor based on prepregnancy BMI (underweight, normal, overweight/obese) and then divided them into low, normal, and excess gestational weight gain (GWG) groups based on the American Institute of Medicine (IOM) guidelines. We reviewed the characteristics of each group and analyzed the association between maternal GWG based on IOM guidelines and child BMI after 6 years.Results: The maternal prepregnancy BMI group showed a significant difference in birth weight and child BMI at 6 years. As the prepregnancy BMI increased, the birth weight and BMI at 6 years also increased (P<0.001). Mean birth weight and child BMI at 6 years differed significantly among the GWG groups. Furthermore, excess postpartum weight gain increased the risk of childhood overweight and obesity (odds ratio, 2.21; 95% confidence interval, 1.40–3.49).Conclusion: Excess weight gain during pregnancy should be avoided due to its short- and long-term association with childhood obesity. Owing to the high prevalence of excess GWG and childhood obesity, excess weight gain during pregnancy can have significant public health implications.
Ju Hee Kim, Eun Lee, Eun Kyo Ha, Jeewon Shin, Gi Chun Lee, Yeong Ho Rha, and Man Yong Han
Wiley
AbstractBackgroundIndividuals with atopic dermatitis often develop other conditions.ObjectiveThis study aimed to determine how atopic dermatitis comorbidities develop in children over time.MethodsThis population‐based administrative cohort study used national health insurance data. We traced individuals born in Korea between 2002 and 2003 to 2018. The date of initial atopic dermatitis diagnosis was set as the index date. Fifty‐three childhood comorbidities of atopic dermatitis were identified as outcomes of interest by performing a comprehensive literature search and comparing the prevalence of diagnostic codes in children with and without atopic dermatitis. Four control children per individual in the atopic dermatitis group were randomly matched based on sex and index date. The association between atopic dermatitis and the development of each specified disease was assessed using proportional hazard assumption, followed by mapping of the temporal sequences of interconnected comorbidities.ResultsThe atopic dermatitis and control groups contained 67,632 and 270,528 individuals, respectively. The median age at the index date was 10 months, whereas the median follow‐up period was 15 years. Twenty diseases that were associated with a higher risk of atopic dermatitis were identified and a chain of interconnected conditions created. The progression began in childhood with febrile seizures, constipation, and asthma, and was later associated with the emergence of food allergy, allergic rhinitis, psychiatric disorders, and autoimmune diseases.ConclusionOur study highlights the temporal nature of atopic dermatitis comorbidities in children, and indicates that an understanding of the comorbidities may inform its clinical management and treatment.
M. Sung, D. Kim, H. Jee, J. Kim, HA E.K., Y. Shin and M. Han
OBJECTIVE
Phthalates can cause immunological disorders and aggravate allergic diseases. Thus, we investigated the relationship between urinary phthalate, skin barrier function, and atopic sensitization in children.
PATIENTS AND METHODS
In total, 448 school children [334 with severe allergic disease; and 123 with severe atopic dermatitis (AD)] aged 10-12 years were enrolled in this study between June and July 2017. Four high-molecular-weight phthalates (HMWP) [Σ4HMWP] and three low-molecular-weight phthalates (LMWP) [Σ3LMWP] metabolites in urine samples, specific immunoglobulin E (IgE), and total eosinophil count were measured. Four-part trans epidermal water loss (TEWL) (cheek, leg, and upper/lower arm; Σ4TEWL) was measured to evaluate the skin barrier function.
RESULTS
After adjusting for confounding variables, Σ4TEWL was significantly associated with the quartiles of urinary Σ4HMWP [adjusted β=7.897, 95% confidence interval (CI): 0.636-15.158, p=0.033] and Σ3LMWP (adjusted β=9.670, 95% CI: 2.422-16.919, p=0.009). The adjusted analyses revealed that the quartiles of urinary Σ4HMWP and Σ3LMWP were not significantly associated with total eosinophil count, atopic sensitization, and severe AD (p>0.05). According to the quartiles of urinary Σ4HMWP and Σ3LMWP, there were significant differences in the TEWL of the lower arm and leg (p<0.05) but not in cheek and upper arm.
CONCLUSIONS
Exposure to HMWPs and LMWPs was significantly associated with skin barrier dysfunction but not with atopic sensitization. These results suggest that children exposed to phthalates may be more susceptible to fragile skin barrier function.
Hye Jun Kim, Sang Jun Lee, Soonok Sa, Jung Ho Bae, Gyuseon Song, Chae Won Lee, Ju Hee Kim, Sung Ryul Shim, Myunghee Hong, and Hyun Wook Han
Korean Diabetes Association
Background: Little is known about the adverse events (AEs) associated with coronavirus disease 2019 (COVID-19) vaccination in patients with type 2 diabetes mellitus (T2DM).Methods: This study used vaccine AE reporting system data to investigate severe AEs among vaccinated patients with T2DM. A natural language processing algorithm was applied to identify people with and without diabetes. After 1:3 matching, we collected data for 6,829 patients with T2DM and 20,487 healthy controls. Multiple logistic regression analysis was used to calculate the odds ratio for severe AEs.Results: After COVID-19 vaccination, patients with T2DM were more likely to experience eight severe AEs than controls: cerebral venous sinus thrombosis, encephalitis myelitis encephalomyelitis, Bell’s palsy, lymphadenopathy, ischemic stroke, deep vein thrombosis (DVT), thrombocytopenia (TP), and pulmonary embolism (PE). Moreover, patients with T2DM vaccinated with BNT162b2 and mRNA-1273 were more vulnerable to DVT and TP than those vaccinated with JNJ-78436735. Among patients with T2DM administered mRNA vaccines, mRNA-1273 was safer than BNT162b2 in terms of the risk of DVT and PE.Conclusion: Careful monitoring of severe AEs in patients with T2DM may be necessary, especially for those related to thrombotic events and neurological dysfunctions after COVID-19 vaccination.
Joo Young Song, Hye Ryeong Cha, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, and Man Yong Han
XMLink
Background There are inconsistent reports regarding the association between general anesthesia and adverse neurodevelopmental and behavioral disorders in children. Methods This nationwide administrative cohort study included children born in Korea between 2008 and 2009, and followed until December 31, 2017. The cohort included 93,717 participants who received general anesthesia with endotracheal intubation (ETI) who were matched to unexposed subjects in a 1:1 ratio. General anesthesia was defined by National Health Insurance Service treatment codes with intratracheal anesthesia, and the index date was the first event of general anesthesia. The primary outcome was attention deficit hyperactive disorder (ADHD), which was defined as at least a principal diagnosis of 10th revision of the International Classification of Diseases code F90.X after the age of 72 months. Neurodevelopment, which was assessed using a developmental screening test (Korean-Ages and Stages Questionnaire [K-ASQ]), was a secondary outcome. The K-ASQ is performed annually from 1 to 6 years of age and consists of 5 domains. The association between general anesthesia and ADHD was estimated using a Cox hazard model, and its association with neurodevelopment was estimated using a generalized estimation equation, with control for multiple risk factors beyond 1 year after the index date. Results The median age at the index date was 3.8 (95% confidence interval [CI], 1.7–5.8) years, and there were 57,625 (61.5%) men. During a mean follow-up period of 5 years, the incidence rate of ADHD was 42.6 and 27.7 per 10,000 person-years (PY) in the exposed and unexposed groups, respectively (absolute rate difference 14.9 [95% CI, 12.5–17.3] per 10,000 PY). Compared to the unexposed group, the exposed group had an increased risk of ADHD (adjusted hazard ratio, 1.41 [95% CI, 1.30–1.52]). In addition, a longer duration of anesthesia with ETI and more general anesthesia procedures with ETI were associated with greater risk of ADHD. General anesthesia with ETI was also associated with poorer results in the K-ASQ. Conclusion Administration of general anesthesia with ETI to children is associated with an increased risk of ADHD and poor results in a neurodevelopmental screening test.
Ju Hee Kim, Eun Kyo Ha, Seung Won Lee, Hye Ryeong Cha, Hey‐Sung Baek, and Man Yong Han
Wiley
AbstractBackgroundThere is a lack of longitudinal studies of associations between growth from infancy to childhood and asthma development.ObjectiveThe objective of the study was to investigate the effects of weight change during infancy, body mass index (BMI) and the interaction of these factors on the risk of childhood asthma.MethodsWe enrolled children born in 2008 and 2009 at full‐term and with normal birth weight. The weight change in infancy was grouped into slow, on‐track and rapid. BMI status in childhood was stratified into low, normal and high groups and used as a time‐varying variable. The outcome was asthma, defined as two or more diagnoses of asthma separated by at least 1 year after 2 years of age. The risk of asthma was assessed using Cox proportional hazard regression, with adjustment for sex, residence area at birth, economic status and feeding types in infancy.ResultsOf 917,707 children born in Korea in 2008 and 2009, 271,871 were eligible for analysis. The risk of asthma was greater in groups with low birth weight (aHR 1.06, 95% CI 1.04 to 1.08), rapid body weight change during early infancy (aHR 1.08, 95% CI 1.07 to 1.10) and high BMI during childhood (aHR 1.06, 95% CI 1.04–1.08). The interaction of weight change during early infancy with BMI during childhood was significant for asthma (p < .01). Rapid weight gain in infancy was associated with lower risk of asthma in those with low BMI during childhood; had no association with asthma in those with normal BMI during childhood; and was associated increased asthma risk in those with high BMI during childhood—aHR 1.26 (95% CI 1.19 to 1.33) and aHR 1.33 (95% CI 1.12 to 1.56) compared with on‐track and slow infant weight gain, respectively.ConclusionLow birth weight, high BMI during childhood and, in those with high childhood BMI, rapid weight gain during early infancy are associated with increased risk of childhood asthma.
Ju Hee Kim, Yoon Young Yi, Eun Kyo Ha, Hey Ryung Cha, Man Yong Han, and Hey-Sung Baek
Elsevier BV
Won Seok Lee, Kyung Suk Lee, Eun Kyo Ha, Ju Hee Kim, So Min Shim, Seung Won Lee, and Man Yong Han
Springer Science and Business Media LLC
AbstractThis study analyzed the effect of parental supervision of infants at age 4 to 6 months on injuries at age 4 to 12 months. Among all Korean children born during 2008–2009, 464,326 (50.6%) infant had parents who responded to a questionnaire that surveyed their safety and supervision when infant were 4 to 6 months-old. Based on questionnaire score, infant were divided into “safe” or “unsafe” group. 1:1 propensity score matching was used to balance the groups, and injury diagnosis and treatments were analyzed. After matching, we examined the records of 405,862 infant. The unsafe group had significantly increased risk ratios (RRs) for injury of head/neck (RR: 1.06), trunk/abdominopelvic region (RR: 1.12), upper extremities (RR: 1.04), and from burn and frostbite (RR: 1.10). The risks of a wound and fracture and foreign body injury were significantly greater in infant whose parents sometimes left them alone (RR: 1.15 and 1.06, respectively), and whose parents did not always keep their eyes on them (RR: 1.04 and 1.13, respectively). Infant whose parents had a hot drink when carrying them had an increased risk of burn injuries (RR: 1.21). Injuries were less common in infant whose parents provided more supervision.
Myungjin Kim, Seungwon Lee, Jung Eun Lee, Ju Hee Kim, Eun Kyo Ha, Manyong Han, and Helen Lew
Springer Science and Business Media LLC
AbstractThis national administrative investigation of Republic of Korea compared the risk of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders(ASD) in preschool amblyopic children and identified factors that possibly mediate this association. After propensity score (PS) matching, 7762 amblyopic children and 31,030 non-amblyopic children were included. Amblyopia was associated with ADHD (aOR:1.687; 95% CI 1.444, 1.970) but not with ASD (aOR: 0.591; 95% CI 0.341, 1.026). Fine motor skill impairment was a mediating factor in association of amblyopia with ADHD, accounting for 4.2% (95% CI 1.7, 8.0). In conclusion, amblyopic children have a greater risk of ADHD, and deficits in fine motor skills mediate this association. We suggest increased attention given to fine motor skill underdevelopment in amblyopic children to prevent the development of ADHD.
Ju Hee Kim, Jin Ah Kim, Eun Kyo Ha, Hye Mi Jee, Seung Won Lee, Mo Kyung Jung, Sanghoo Lee, Yoon Ho Shin, Eun-Gyong Yoo, and Man Yong Han
Springer Science and Business Media LLC
Abstract Background During puberty, changes in body composition due to sex hormones are associated with lung mechanics. However, little is known about the mediation effect of sex differences in body composition during puberty with total airway resistance. Methods We prospectively recruited 620 children (10–12 years old) from the general population and conducted a cross-sectional study. This study assessed pubertal status according to the five Tanner stages using a questionnaire, line drawings, and each subject’s blood sex hormone profile. Both the impulse oscillation system for total lung mechanics and multifrequency bioelectrical impedance for body composition analyses were conducted. The effects of puberty on body composition and subsequent total lung resistance were evaluated using mediation analysis. Results Among the 503 children enrolled, there were 261 males (51.9%) and 242 females (48.1%). In males, higher testosterone levels corresponded with reduced total lung resistance (β = –0.13, 95% CI = –0.21 to –0.05, p < 0.001), and the proportion of the mediating effect through the muscle-fat ratio was 19% (95% CI = 4 to 59, p = 0.02). In contrast, in females, pubertal status reduced total lung resistance (β = –0.27, 95% CI = –0.58 to –0.05, p = 0.04), however, the proportion of the mediating effect through the body mass index was –51% (95% CI = –244 to –4%, p = 0.04). Conclusion The muscle-fat ratio in adolescent males had a synergistic effect with testosterone on improving total airway resistance, whereas improvements in lung resistance by pubertal status were partially masked by body mass index in adolescent females. In conclusion, body composition changes during puberty between males and females have differing effects on total airway resistance.
Juhee Kim, Kyu-sang Yun, Ajin Cho, Do Hyoung Kim, Young-Ki Lee, Myung-Jin Choi, Seok-hyung Kim, Hyunsuk Kim, Jong-Woo Yoon, and Hayne C. Park
Springer Science and Business Media LLC
Abstract Background Chronic stimulation of the mineralocorticoid receptor has been suggested as one of the potential causes of cardiovascular events and death in patients with end-stage renal disease. This observational cohort study was performed to demonstrate that serum cortisol might be a predictive marker for patient mortality and to evaluate its association with oxidized low-density lipoprotein (oxLDL) in hemodialysis (HD) patients. Methods Patients receiving HD three times a week were screened for enrollment at two institutions. Baseline cortisol levels were measured before each HD session, and the patients were divided into two groups according to the median value of serum cortisol before analysis. The baseline characteristics and laboratory values of the high and low cortisol groups were compared. Serum cortisol, adrenocorticotropic hormone, renin, aldosterone, and oxLDL were measured in 52 patients to evaluate the effect of oxidative stress on serum cortisol levels. Results A total of 133 HD patients were enrolled in this cohort study. Compared to the patients with low serum cortisol levels, the patients with high serum cortisol levels (baseline cortisol ≥ 10 μg/dL) showed higher rates of cardiovascular disease (59.7% vs. 39.4%, P=0.019) and left ventricular systolic dysfunction (LVSD) (25.9% vs. 8.0%, P=0.016). The patients in the high cortisol group demonstrated higher all-cause mortality than those in the low cortisol group. The serum cortisol level was an independent risk factor for patient mortality (hazard ratio 1.234, 95% confidence interval 1.022-1.49, P=0.029). Among the 52 patients with oxLDL measurements, oxLDL was an independent risk factor for elevated serum cortisol levels (Exp(B) 1.114, P=0.013) and LVSD (Exp(B) 12.308, P=0.045). However, plasma aldosterone levels did not affect serum cortisol levels. Conclusions Serum cortisol is a useful predictive marker for all-cause death among patients receiving HD. OxLDL is an independent marker for elevated serum cortisol among HD patients.
Ji Yun Baek, Joo Ok Jin, Ju Hee Kim, Hye Mi Jee, Youn Ho Shin, Hey Sung Baek, Man Yong Han, and Eun Kyo Ha
Wiley
AbstractAimWe investigated the association of food allergy, food sensitisation, and food restriction with growth and micronutrients levels in schoolchildren.MethodsA total of 195 schoolchildren (6–12 years old) from six elementary schools in Korea were enrolled, and questionnaires were administered to their parents during June and July 2015. Food allergy was defined by the presence of urticaria, skin rash, pruritus, throat tightness, gastrointestinal complaints, or respiratory difficulty after consumption of a food to which allergy was plausible during the past 12 months. Skin prick tests were performed and serum levels of haemoglobin and micronutrients were measured.ResultsAmong 195 participants (51.3% males) enrolled, 35 (17.9%) were reported to have food allergies, 17 (8.7%) were on food restriction, and 27 (14.0%) were sensitised to at least one food allergen. Food allergy and food restriction were associated with a lower height‐for‐age z‐score (p for trend = 0.018, p = 0.048; p for trend = 0.076, p = 0.008). Food restriction was related to reduced serum calcium level (aOR: −0.094, 95% CI: −0.156 to −0.032).ConclusionSigns and symptoms of food allergy and consequent food restrictions in children were related to lower height‐for‐age z‐score and lower serum calcium levels.
Ju Hee Kim, Seung Won Lee, Yoowon Kwon, Eun Kyo Ha, Jaewoo An, Hye Ryeong Cha, Su Jin Jeong, and Man Yong Han
The Korean Society of Neurogastroenterology and Motility
Background/Aims Little is known about the association between infantile colic and the later onset of irritable bowel syndrome (IBS). Methods This study examined all 917 707 children who were born in Korea between 2007 and 2008. Infantile colic was defined with 1 or more diagnoses of ICD-10 code R10.4 or R68.1 at the age of 5 weeks to 4 months, and infants with a diagnosis of infantile colic and without were allocated into the infantile colic group and the control group. IBS was defined as 2 or more diagnoses of ICD-10 code K58.X after 4 years of age. Each child was traced until 2017. The risk of IBS with infantile colic was evaluated using a Cox proportional hazards model with propensity score inverse probability of treatment weighting (IPTW). Results After IPTW, 363 528 and 359 842 children were allocated to the control group and the infantile colic group, respectively. The infantile colic group had a higher risk of developing IBS in childhood (hazard ratio [95% CI], 1.12 [1.10 to 1.13]) than the control group. Moreover, the subgroup analyses according to the feeding status, birth weight, sex, or economic status, showed that the risk of IBS with former infantile colic remained statistically significant. Conclusions Children with a diagnosis of infantile colic during the infant period had a significant risk of developing IBS after 4 years of age. Understanding the pathogenesis of infantile colic in the neonatal period may reduce the prevalence and severity of functional gastrointestinal disorders from childhood to adolescence to adulthood.
Sung Ryul Shim, Hye Jun Kim, Myunghee Hong, Sun Kyu Kwon, Ju Hee Kim, Sang Jun Lee, Seung Won Lee, and Hyun Wook Han
Elsevier BV
Ji Hee Kwak, Eun Kyo Ha, Ju Hee Kim, Hye Ryung Cha, Seung Won Lee, and Man Yong Han
Ovid Technologies (Wolters Kluwer Health)
Background There are few studies on the association with Kawasaki disease in children and the family’s history of cardiovascular disease (CVD). The aim of this study was to identify the association of increased risks for Kawasaki disease in children with a family history of CVD. Methods and Results Clinical data of children born in 2008 and 2009 (n=917 707) were obtained from the National Health Insurance Service and the National Health Screening Program for Infants and Children for this study. The cohort consisted of 495 215 participants (53.8%) who completed the family history questionnaire for children 54 to 60 months old. Family history of CVD included 5 medical conditions: hypertension, dyslipidemia, myocardial infarction, stroke, and diabetes. Kawasaki disease was defined using the disease code, intravenous immunoglobulin prescription, and use of antipyretics for more than 25 days. Severe Kawasaki disease was defined as diagnosis of accompanied cardiac/coronary artery complications or intravenous immunoglobulin use ≥2 times. The incidence rate of Kawasaki disease was 124/100 000 person‐years (95% CI, 117.5–131.5) for children <2 years old, 95/100 000 person‐years (95% CI, 90.5–100.4) in children 2 to 5 years old, and 14/100 000 person‐years (95% CI, 12.6–15.6) in children >5 years old. After propensity‐score matching, 829 participants with a family history of CVD were diagnosed as having Kawasaki disease (0.68% [95% CI, 0.63–0.72]), and 690 patients with Kawasaki disease (0.56% [95% CI, 0.52–0.61]) had no family history of CVD. The family history of CVD was associated with increased risk for Kawasaki disease (risk ratio, 1.20 [95% CI, 1.08–1.32]) but not for severe Kawasaki disease (risk ratio, 1.23 [95% CI, 0.92–1.65]). Conclusions In this nationwide propensity‐score matched study, those with a family history of CVD had a significantly greater risk of Kawasaki disease compared with those who had no family history of CVD.