Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial

This study examined the effects of resistance training on muscle quality, muscle growth factors, and functional fitness in older adult women with sarcopenia. Twenty-two older adult women aged over 65 with sarcopenia were randomly assigned to either resistance training (RT, n = 12) or non-exercise co...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:International journal of environmental research and public health 2021-06, Vol.18 (13), p.6762
Hauptverfasser: Seo, Myong-Won, Jung, Sung-Woo, Kim, Sung-Woo, Lee, Jung-Min, Jung, Hyun Chul, Song, Jong-Kook
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 13
container_start_page 6762
container_title International journal of environmental research and public health
container_volume 18
creator Seo, Myong-Won
Jung, Sung-Woo
Kim, Sung-Woo
Lee, Jung-Min
Jung, Hyun Chul
Song, Jong-Kook
description This study examined the effects of resistance training on muscle quality, muscle growth factors, and functional fitness in older adult women with sarcopenia. Twenty-two older adult women aged over 65 with sarcopenia were randomly assigned to either resistance training (RT, n = 12) or non-exercise control group (CG, n = 10). The body weight-based and elastic band RT were performed three times a week, 60 min per session, for 16 weeks. Body composition and thigh muscle quality were estimated by dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT), respectively. The muscle growth factors, including growth differentiation factor-8 (GDF-8), growth differentiation factor-15 (GDF-15), activin A, and follistatin, were analyzed via blood samples. Statistical analyses were performed using repeated measures multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and effect size (i.e., cohen’s d, partial eta square), and the significance level was set at 0.05. The RT group improved their functional fitness, grip strength, gait speed, and isometric muscle strength (p < 0.01, d > 0.99; large), while these variables did not change in the CG. An increase in intramuscular fat was only observed in the CG (p < 0.01, 1.06; large). Muscle growth factors such as follistatin were significantly increased in the RT (p < 0.05, 0.81; large), but other variables did not change following resistance training. Sixteen weeks of resistance training improved functional fitness and prevented age-related increases in intramuscular fat in the thigh area. However, there were only some changes in muscle growth factors, such as follistatin, suggesting that the effectiveness of resistance training on muscle growth factors is limited. Body weight-based and elastic band resistance training is an alternative training method for sarcopenia to minimize the age-related adverse effects on muscle function and quality.
doi_str_mv 10.3390/ijerph18136762
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8267934</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2548405465</sourcerecordid><originalsourceid>FETCH-LOGICAL-c395t-862e2106335d2fa14bf70a6d6784f81453978b387a7815771fa64a04a0e8a07c3</originalsourceid><addsrcrecordid>eNpdkVFrFDEQxxdRbG376nPAF1-uJptskvVBOI62CpVie6WPYS4728uZTc5k11I_ip_WnK1ihcD8yfzyY8JU1WtGjzlv6Tu3wbRdM824VLJ-Vu0zKelMSMqe_5P3qlc5byjlWsj2ZbXHRU3LG7pf_Tzpe7RjJrEnTJIbxK-_8yVml0cIFskygQsu3JIYyOcpW4_kywTejfcEQvfn6izFu3FNTsGOMWXiArnwHSYy7yY_kps4YCB3rhBXkGzcYnDwnszJZVHEwf3AjixiGFP0vsRlcuAPqxc9-IxHj_Wguj49WS4-zs4vzj4t5uczy9tmnGlZY82o5Lzp6h6YWPWKguyk0qLXTDS8VXrFtQKlWaMU60EKoOWgBqosP6g-PHi302rAzmIZA7zZJjdAujcRnHnaCW5tbuN3o2upWi6K4O2jIMVvE-bRDC5b9B4CximbuhFa0EbIpqBv_kM3cUqhfG9HFdnOWajjB8qmmHPC_u8wjJrd2s3TtfNf-7CgYQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2549348267</pqid></control><display><type>article</type><title>Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Seo, Myong-Won ; Jung, Sung-Woo ; Kim, Sung-Woo ; Lee, Jung-Min ; Jung, Hyun Chul ; Song, Jong-Kook</creator><creatorcontrib>Seo, Myong-Won ; Jung, Sung-Woo ; Kim, Sung-Woo ; Lee, Jung-Min ; Jung, Hyun Chul ; Song, Jong-Kook</creatorcontrib><description>This study examined the effects of resistance training on muscle quality, muscle growth factors, and functional fitness in older adult women with sarcopenia. Twenty-two older adult women aged over 65 with sarcopenia were randomly assigned to either resistance training (RT, n = 12) or non-exercise control group (CG, n = 10). The body weight-based and elastic band RT were performed three times a week, 60 min per session, for 16 weeks. Body composition and thigh muscle quality were estimated by dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT), respectively. The muscle growth factors, including growth differentiation factor-8 (GDF-8), growth differentiation factor-15 (GDF-15), activin A, and follistatin, were analyzed via blood samples. Statistical analyses were performed using repeated measures multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and effect size (i.e., cohen’s d, partial eta square), and the significance level was set at 0.05. The RT group improved their functional fitness, grip strength, gait speed, and isometric muscle strength (p &lt; 0.01, d &gt; 0.99; large), while these variables did not change in the CG. An increase in intramuscular fat was only observed in the CG (p &lt; 0.01, 1.06; large). Muscle growth factors such as follistatin were significantly increased in the RT (p &lt; 0.05, 0.81; large), but other variables did not change following resistance training. Sixteen weeks of resistance training improved functional fitness and prevented age-related increases in intramuscular fat in the thigh area. However, there were only some changes in muscle growth factors, such as follistatin, suggesting that the effectiveness of resistance training on muscle growth factors is limited. Body weight-based and elastic band resistance training is an alternative training method for sarcopenia to minimize the age-related adverse effects on muscle function and quality.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph18136762</identifier><identifier>PMID: 34201810</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Activin ; Angina pectoris ; Biopsy ; Body composition ; Body fat ; Body weight ; Bone density ; Computed tomography ; Differentiation ; Dual energy X-ray absorptiometry ; Elastic limit ; Follistatin ; Gait ; Grip strength ; Growth factors ; Medical imaging ; Mortality ; Multivariate analysis ; Muscle contraction ; Muscle function ; Muscle strength ; Musculoskeletal system ; Older people ; Physical fitness ; Physical training ; Questionnaires ; Resistance training ; Sarcopenia ; Statistical analysis ; Statistical methods ; Strength training ; Thigh ; Variance analysis ; Womens health ; Working groups</subject><ispartof>International journal of environmental research and public health, 2021-06, Vol.18 (13), p.6762</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c395t-862e2106335d2fa14bf70a6d6784f81453978b387a7815771fa64a04a0e8a07c3</citedby><cites>FETCH-LOGICAL-c395t-862e2106335d2fa14bf70a6d6784f81453978b387a7815771fa64a04a0e8a07c3</cites><orcidid>0000-0001-8545-4711 ; 0000-0001-5976-277X ; 0000-0002-3465-8965 ; 0000-0002-8033-0725</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267934/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267934/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Seo, Myong-Won</creatorcontrib><creatorcontrib>Jung, Sung-Woo</creatorcontrib><creatorcontrib>Kim, Sung-Woo</creatorcontrib><creatorcontrib>Lee, Jung-Min</creatorcontrib><creatorcontrib>Jung, Hyun Chul</creatorcontrib><creatorcontrib>Song, Jong-Kook</creatorcontrib><title>Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial</title><title>International journal of environmental research and public health</title><description>This study examined the effects of resistance training on muscle quality, muscle growth factors, and functional fitness in older adult women with sarcopenia. Twenty-two older adult women aged over 65 with sarcopenia were randomly assigned to either resistance training (RT, n = 12) or non-exercise control group (CG, n = 10). The body weight-based and elastic band RT were performed three times a week, 60 min per session, for 16 weeks. Body composition and thigh muscle quality were estimated by dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT), respectively. The muscle growth factors, including growth differentiation factor-8 (GDF-8), growth differentiation factor-15 (GDF-15), activin A, and follistatin, were analyzed via blood samples. Statistical analyses were performed using repeated measures multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and effect size (i.e., cohen’s d, partial eta square), and the significance level was set at 0.05. The RT group improved their functional fitness, grip strength, gait speed, and isometric muscle strength (p &lt; 0.01, d &gt; 0.99; large), while these variables did not change in the CG. An increase in intramuscular fat was only observed in the CG (p &lt; 0.01, 1.06; large). Muscle growth factors such as follistatin were significantly increased in the RT (p &lt; 0.05, 0.81; large), but other variables did not change following resistance training. Sixteen weeks of resistance training improved functional fitness and prevented age-related increases in intramuscular fat in the thigh area. However, there were only some changes in muscle growth factors, such as follistatin, suggesting that the effectiveness of resistance training on muscle growth factors is limited. Body weight-based and elastic band resistance training is an alternative training method for sarcopenia to minimize the age-related adverse effects on muscle function and quality.</description><subject>Activin</subject><subject>Angina pectoris</subject><subject>Biopsy</subject><subject>Body composition</subject><subject>Body fat</subject><subject>Body weight</subject><subject>Bone density</subject><subject>Computed tomography</subject><subject>Differentiation</subject><subject>Dual energy X-ray absorptiometry</subject><subject>Elastic limit</subject><subject>Follistatin</subject><subject>Gait</subject><subject>Grip strength</subject><subject>Growth factors</subject><subject>Medical imaging</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Muscle contraction</subject><subject>Muscle function</subject><subject>Muscle strength</subject><subject>Musculoskeletal system</subject><subject>Older people</subject><subject>Physical fitness</subject><subject>Physical training</subject><subject>Questionnaires</subject><subject>Resistance training</subject><subject>Sarcopenia</subject><subject>Statistical analysis</subject><subject>Statistical methods</subject><subject>Strength training</subject><subject>Thigh</subject><subject>Variance analysis</subject><subject>Womens health</subject><subject>Working groups</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkVFrFDEQxxdRbG376nPAF1-uJptskvVBOI62CpVie6WPYS4728uZTc5k11I_ip_WnK1ihcD8yfzyY8JU1WtGjzlv6Tu3wbRdM824VLJ-Vu0zKelMSMqe_5P3qlc5byjlWsj2ZbXHRU3LG7pf_Tzpe7RjJrEnTJIbxK-_8yVml0cIFskygQsu3JIYyOcpW4_kywTejfcEQvfn6izFu3FNTsGOMWXiArnwHSYy7yY_kps4YCB3rhBXkGzcYnDwnszJZVHEwf3AjixiGFP0vsRlcuAPqxc9-IxHj_Wguj49WS4-zs4vzj4t5uczy9tmnGlZY82o5Lzp6h6YWPWKguyk0qLXTDS8VXrFtQKlWaMU60EKoOWgBqosP6g-PHi302rAzmIZA7zZJjdAujcRnHnaCW5tbuN3o2upWi6K4O2jIMVvE-bRDC5b9B4CximbuhFa0EbIpqBv_kM3cUqhfG9HFdnOWajjB8qmmHPC_u8wjJrd2s3TtfNf-7CgYQ</recordid><startdate>20210623</startdate><enddate>20210623</enddate><creator>Seo, Myong-Won</creator><creator>Jung, Sung-Woo</creator><creator>Kim, Sung-Woo</creator><creator>Lee, Jung-Min</creator><creator>Jung, Hyun Chul</creator><creator>Song, Jong-Kook</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8545-4711</orcidid><orcidid>https://orcid.org/0000-0001-5976-277X</orcidid><orcidid>https://orcid.org/0000-0002-3465-8965</orcidid><orcidid>https://orcid.org/0000-0002-8033-0725</orcidid></search><sort><creationdate>20210623</creationdate><title>Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial</title><author>Seo, Myong-Won ; Jung, Sung-Woo ; Kim, Sung-Woo ; Lee, Jung-Min ; Jung, Hyun Chul ; Song, Jong-Kook</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c395t-862e2106335d2fa14bf70a6d6784f81453978b387a7815771fa64a04a0e8a07c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Activin</topic><topic>Angina pectoris</topic><topic>Biopsy</topic><topic>Body composition</topic><topic>Body fat</topic><topic>Body weight</topic><topic>Bone density</topic><topic>Computed tomography</topic><topic>Differentiation</topic><topic>Dual energy X-ray absorptiometry</topic><topic>Elastic limit</topic><topic>Follistatin</topic><topic>Gait</topic><topic>Grip strength</topic><topic>Growth factors</topic><topic>Medical imaging</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Muscle contraction</topic><topic>Muscle function</topic><topic>Muscle strength</topic><topic>Musculoskeletal system</topic><topic>Older people</topic><topic>Physical fitness</topic><topic>Physical training</topic><topic>Questionnaires</topic><topic>Resistance training</topic><topic>Sarcopenia</topic><topic>Statistical analysis</topic><topic>Statistical methods</topic><topic>Strength training</topic><topic>Thigh</topic><topic>Variance analysis</topic><topic>Womens health</topic><topic>Working groups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seo, Myong-Won</creatorcontrib><creatorcontrib>Jung, Sung-Woo</creatorcontrib><creatorcontrib>Kim, Sung-Woo</creatorcontrib><creatorcontrib>Lee, Jung-Min</creatorcontrib><creatorcontrib>Jung, Hyun Chul</creatorcontrib><creatorcontrib>Song, Jong-Kook</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seo, Myong-Won</au><au>Jung, Sung-Woo</au><au>Kim, Sung-Woo</au><au>Lee, Jung-Min</au><au>Jung, Hyun Chul</au><au>Song, Jong-Kook</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial</atitle><jtitle>International journal of environmental research and public health</jtitle><date>2021-06-23</date><risdate>2021</risdate><volume>18</volume><issue>13</issue><spage>6762</spage><pages>6762-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>This study examined the effects of resistance training on muscle quality, muscle growth factors, and functional fitness in older adult women with sarcopenia. Twenty-two older adult women aged over 65 with sarcopenia were randomly assigned to either resistance training (RT, n = 12) or non-exercise control group (CG, n = 10). The body weight-based and elastic band RT were performed three times a week, 60 min per session, for 16 weeks. Body composition and thigh muscle quality were estimated by dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT), respectively. The muscle growth factors, including growth differentiation factor-8 (GDF-8), growth differentiation factor-15 (GDF-15), activin A, and follistatin, were analyzed via blood samples. Statistical analyses were performed using repeated measures multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), and effect size (i.e., cohen’s d, partial eta square), and the significance level was set at 0.05. The RT group improved their functional fitness, grip strength, gait speed, and isometric muscle strength (p &lt; 0.01, d &gt; 0.99; large), while these variables did not change in the CG. An increase in intramuscular fat was only observed in the CG (p &lt; 0.01, 1.06; large). Muscle growth factors such as follistatin were significantly increased in the RT (p &lt; 0.05, 0.81; large), but other variables did not change following resistance training. Sixteen weeks of resistance training improved functional fitness and prevented age-related increases in intramuscular fat in the thigh area. However, there were only some changes in muscle growth factors, such as follistatin, suggesting that the effectiveness of resistance training on muscle growth factors is limited. Body weight-based and elastic band resistance training is an alternative training method for sarcopenia to minimize the age-related adverse effects on muscle function and quality.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34201810</pmid><doi>10.3390/ijerph18136762</doi><orcidid>https://orcid.org/0000-0001-8545-4711</orcidid><orcidid>https://orcid.org/0000-0001-5976-277X</orcidid><orcidid>https://orcid.org/0000-0002-3465-8965</orcidid><orcidid>https://orcid.org/0000-0002-8033-0725</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1660-4601
ispartof International journal of environmental research and public health, 2021-06, Vol.18 (13), p.6762
issn 1660-4601
1661-7827
1660-4601
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8267934
source Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central; Free Full-Text Journals in Chemistry
subjects Activin
Angina pectoris
Biopsy
Body composition
Body fat
Body weight
Bone density
Computed tomography
Differentiation
Dual energy X-ray absorptiometry
Elastic limit
Follistatin
Gait
Grip strength
Growth factors
Medical imaging
Mortality
Multivariate analysis
Muscle contraction
Muscle function
Muscle strength
Musculoskeletal system
Older people
Physical fitness
Physical training
Questionnaires
Resistance training
Sarcopenia
Statistical analysis
Statistical methods
Strength training
Thigh
Variance analysis
Womens health
Working groups
title Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T03%3A36%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%2016%20Weeks%20of%20Resistance%20Training%20on%20Muscle%20Quality%20and%20Muscle%20Growth%20Factors%20in%20Older%20Adult%20Women%20with%20Sarcopenia:%20A%20Randomized%20Controlled%20Trial&rft.jtitle=International%20journal%20of%20environmental%20research%20and%20public%20health&rft.au=Seo,%20Myong-Won&rft.date=2021-06-23&rft.volume=18&rft.issue=13&rft.spage=6762&rft.pages=6762-&rft.issn=1660-4601&rft.eissn=1660-4601&rft_id=info:doi/10.3390/ijerph18136762&rft_dat=%3Cproquest_pubme%3E2548405465%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2549348267&rft_id=info:pmid/34201810&rfr_iscdi=true