Epidemiology and Health

Most-read articles are from the articles published in 2023 during the last three month.

Special Article

Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis: Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park; Epidemiol Health. 2023;45:e2023092. Published online October 16, 2023; DOI: https://doi.org/10.4178/epih.e2023092

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780 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.

METHODS

Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.

RESULTS

Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males.

CONCLUSIONS

Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.

Summary

Korean summary
본 연구는 코호트 연구를 기반으로 하여 음주의 수준에 따른 암 위험 연관성에 대해 체계적 문헌고찰(139편)과 메타분석(106편)을 수행하였다. 연구 결과, 음주와 암 위험 사이에 용량-반응 관계가 나타났으며, 소량의 음주는 암 유형에 따라 차이가 있었으나, 식도암, 대장암, 전립선암(남성), 유방암(여성)에서 암 위험과의 연관성이 있음을 발견했다. 따라서, 암 위험 측면에서 음주에 안전한 수준이 없음을 시사하며, 음주와 관련된 잠재적 피해를 완화하기 위해서는 음주 지침 강화와 같은 공중보건개입이 필요하다.

Key Message
The aim of this study was to assess the relationship between different levels of alcohol consumption and the risk of various cancer types through a systematic review and meta-analysis, providing insights into the ongoing debate about alcohol consumption and cancer causality. The findings support a dose-response relationship between alcohol consumption levels and cancer risk and the light alcohol consumption was associated with risks of esophageal, colorectal, prostate (male), and breast (female) cancer. These results emphasize the absence of a safe threshold for alcohol consumption in terms of cancer risk.

Citations

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Liwei Ma, Edwin C. K. Tan, Benjamin Goudey, Liang Jin, Yijun Pan
Alzheimer's & Dementia.2025;[Epub] CrossRef
Associations of lifestyle factors with oral cancer risk: An umbrella review
Haobo Xu, Zhonglan Gao, Hairong Liu, Liya An, Ting Yang, Bojun Zhang, Guobin LIU, Dali Sun
Journal of Stomatology Oral and Maxillofacial Surgery.2025; 126(3): 102234. CrossRef
Estudio bibliométrico de las publicaciones sobre cirugía pancreática realizadas por cirujanos españoles
Juan Jesús Rubio-García, Celia Villodre Tudela, Cándido Alcázar López, Silvia Carbonell Morote, Mariano Franco Campello, Paola Melgar Requena, Adrián Paredes Segura, José Manuel Ramia Ángel
Cirugía Española.2025; 103(4): 201. CrossRef
Personalized Lifestyle Interventions for Prevention and Treatment of Obesity-Related Cancers: A Call to Action
Mohamad Motevalli, Fatima Cody Stanford
Cancers.2025; 17(8): 1255. CrossRef
Bibliometric study of publications on pancreatic surgery carried out by spanish surgeons
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Design and Optimization of Surface Plasmon Resonance-Based Non-Invasive Refractive Index Biosensor Using Ag-SiO2 Materials for Alcoholic Beverages Compound Detection
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Plasmonics.2025;[Epub] CrossRef
Invisible foes: how air pollution and lifestyle conspire in the rise of colorectal cancer
Di Zhao, Meng Zhu
QJM: An International Journal of Medicine.2025;[Epub] CrossRef
Wine Consumption and Lung Cancer Risk: A Systematic Review and Meta-Analysis
Carlotta Bertola, Camilla Gobbetti, Gaia Baccarini, Roberto Fabiani
Nutrients.2025; 17(8): 1322. CrossRef
A narrative review on alcohol and alimentary tract cancer with special emphasis on acetaldehyde and oxidative stress
Helmut Karl Seitz
Zeitschrift für Gastroenterologie.2025;[Epub] CrossRef
Association of Cigarette Smoking and Alcohol Drinking With Risk of 12 Common Cancers Among Low-Income American Adults in the Southeastern United States
Jiajun Shi, Wanqing Wen, Qiuyin Cai, Martha J. Shrubsole, Xiao-Ou Shu, Wei Zheng
Cancer Control.2025;[Epub] CrossRef
Identification of MMP14 and MKLN1 as colorectal cancer susceptibility genes and drug-repositioning candidates from a genome-wide association study
Dabin Yun, Jung-Ho Yang, Jin-ah Sim, Minjung Kim, Ji Won Park, Seung Yong Jeong, Aesun Shin, Sun-Seog Kweon, Nan Song
Journal of Translational Medicine.2025;[Epub] CrossRef
Research Progress on Risk Factors and Endoscopic Diagnosis of Gastric Mucosal Intestinal Metaplasia
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Advances in Clinical Medicine.2025; 15(05): 1135. CrossRef
Global Cancer Burden Forecast for 204 Countries and Territories, 2022–2050: A Predictive Analysis from the Global Burden of Disease Study 2021
Jinghao Liang, Yijian Lin, Wenxi Wang, Jingchun Ni, Hongmiao Lin, Zishan Huang, Jihao Qi, Zhaofeng Tan, Hengrui Liang, Jianxing He
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Global burden of breast cancer attributable to alcohol consumption: a multi-regional observational analysis (1990–2021)
Fangfang Cui, Yuntian Chu, Weiyi Wang, Meihao Ji, Sidong Zhang, Zhengyu Wu, Yadong Song
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Zuzanna Marczak, Bartosz Olkowski, Olga Maria Rostkowska, Dorota Miszewska-Szyszkowska, Olga Kozińska-Przybył, Tomasz Warężak, Magdalena Durlik
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Analysis of Novel DNA Adducts Derived from Acetaldehyde
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Biomolecules.2025; 15(6): 878. CrossRef
Granulocyte function in response to acute alcohol consumption: temporal shifts from proinflammatory activation to antiinflammatory modulation in healthy volunteers
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Journal of Leukocyte Biology.2025;[Epub] CrossRef
Exploring genetic associations of Crohn’s disease and ulcerative colitis with extraintestinal cancers in European and East Asian populations
Chengdong Yu, Jiawei Xu, Siyi Xu, Lei Tang, Qinyuan Han, Xiaoqiang Zeng, Yanxiao Huang, Tenghua Yu, Zhengkui Sun
Frontiers in Immunology.2024;[Epub] CrossRef
The Impact of Tobacco Smoking and Alcohol Consumption on the Development of Gastric Cancers
Waku Hatta, Tomoyuki Koike, Naoki Asano, Yutaka Hatayama, Yohei Ogata, Masahiro Saito, Xiaoyi Jin, Kaname Uno, Akira Imatani, Atsushi Masamune
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Genetic Heterogeneity Across Dimensions of Alcohol Use Behaviors
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To Drink or Not to Drink? Investigating Alcohol’s Impact on Prostate Cancer Risk
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Factors associated with acquiring exercise habits through health guidance for metabolic syndrome among middle-aged Japanese workers: A machine learning approach
Jiawei Wan, Kyohsuke Wakaba, Takeshi Onoue, Kazuyo Tsushita, Yoshio Nakata
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Carlos A. González Svatetz
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Global, regional, and national trends in gastric cancer burden: 1990-2021 and projections to 2040
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Systematic Reviews

The effectiveness of protein supplementation combined with resistance exercise programs among community-dwelling older adults with sarcopenia: a systematic review and meta-analysis: Phatcharaphon Whaikid, Noppawan Piaseu; Epidemiol Health. 2024;46:e2024030. Published online February 14, 2024; DOI: https://doi.org/10.4178/epih.e2024030

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455 Download
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Abstract Summary PDF

Abstract

OBJECTIVES
The combination of protein supplementation and resistance exercise shows promise for improving and maintaining muscle mass, strength, and performance in older adults with sarcopenia. This systematic review aimed to evaluate the effects of this combination on muscle mass, muscle strength, and physical performance in community-dwelling older adults with sarcopenia.

METHODS

We conducted a comprehensive search of 4 electronic databases: PubMed, Scopus, Embase, and the MEDLINE Library. The search covered literature from January 2013 to January 2023 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers assessed the methodological quality of each study using the standard critical appraisal tool from the Joanna Briggs Institute (JBI). Meta-analysis was performed with the JBI Sumari program.

RESULTS

The review included 7 randomized controlled trials and 1 quasi-experimental study, encompassing a total of 854 participants aged 60 years and above. The study durations ranged from 10 weeks to 24 weeks. An analysis of standardized mean differences (SMDs) showed that protein supplementation combined with resistance exercise significantly increased muscle mass (SMD, 0.95; 95% confidence interval [CI], 0.13 to 1.78; p<0.05) and muscle strength (SMD, 0.32; 95% CI, 0.08 to 0.56; p<0.05).

CONCLUSIONS

Although the limited number of randomized controlled trials restricts the robustness of our conclusions, the evidence suggests that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Summary

Key Message
Sarcopenia is a significant health concern. Given the contextual variations and the diverse factors that contribute to the prevalence of sarcopenia, delivering precision interventions to older adults diagnosed with sarcopenia who still reside in the community poses unique challenges. Therefore, precision interventions are vital for proper and feasible treatment planning, especially for early management actions, to reduce the impact of sarcopenia and its associated adverse effects in older adults. Our systematic review and meta-analysis showed that protein supplementation combined with resistance exercise is effective in enhancing muscle mass and strength in community-dwelling older adults with sarcopenia.

Citations

Citations to this article as recorded by

Protein supplementation alone or combined with exercise for sarcopenia and physical frailty: A systematic review and meta-analysis of randomized controlled trials
Yoshihiro Yoshimura, Ayaka Matsumoto, Tatsuro Inoue, Masatsugu Okamura, Masafumi Kuzuya
Archives of Gerontology and Geriatrics.2025; 131: 105783. CrossRef
The diagnosis and treatment of sarcopenia and sarcopenic obesity
Basel Habboub, Robert Speer, Markus Gosch, Katrin Singler
Deutsches Ärzteblatt international.2025;[Epub] CrossRef
Osteosarcopenia as a risk factor for depression: Longitudinal findings from the SHARE study
Nicola Veronese, Francesco Saverio Ragusa, Shaun Sabico, Ligia J. Dominguez, Mario Barbagallo, Gustavo Duque, Lee Smith, Nasser Al-Daghri
Bone Reports.2025; : 101848. CrossRef
The Impact of Protein in Post-Menopausal Women on Muscle Mass and Strength: A Narrative Review
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Effectiveness of community-based interventions for older adults living alone: a systematic review and meta-analysis: Inhye Kim, Hyunseo An, Sohyeon Yun, Hae Yean Park; Epidemiol Health. 2024;46:e2024013. Published online January 3, 2024; DOI: https://doi.org/10.4178/epih.e2024013

12,858 View
251 Download
3 Web of Science
3 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis.

METHODS

The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions.

RESULTS

Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.96 (95% confidence interval [CI], 0.66 to 1.25) and 0.43 (95% CI, 0.26 to 0.60), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.98 (95% CI, 0.73 to 1.22) for health behavior and 0.67 (95% CI, 0.19 to 1.16) for mental health.

CONCLUSIONS

This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.

Summary

Korean summary
본 연구는 독거 노인들 대상으로 한 지역사회 기반 중재의 효과에 대하여 탐색하고 그 효과 크기를 확인하기 위하여 체계적고찰 및 메타분석을 실시하였다. 영양 및 복합 중재가 특히 효과적이었으며, 이는 건강 행동과 정신건강에 있어 중요한 긍정적 효과를 나타내어 추후 개별적 맞춤 중재의 잠재적 효과성을 나타낸다. 이러한 발견은 독거노인 집단의 웰빙 향상을 위한 프로그램과 정책 입안에 근거로 활용될 수 있다.

Key Message
This systematic review and meta-analysis evaluated the impact of community-based interventions for older adults living alone, incorporating 9 studies to assess effectiveness in areas like nutrition and combined strategies. Results indicated significant benefits, particularly in health behavior and mental health, demonstrating the potential of tailored interventions. These findings support the development of targeted programs and policy decisions aimed at improving the well-being of this demographic.

Citations

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Falls among older adults: An exploration of trends, clinical outcomes, predisposing risk factors, and intervention strategies
Sanjan Kumar, Francis Cruz, Zackary Yates, Quratulain Amin, Muhammad Usman Awan, Philip Lee, Sarthak Kumar, Adel Elkbuli
The American Journal of Surgery.2025; 245: 116385. CrossRef
A DESCRIPTIVE STUDY ON TRIGLYCERIDE AND BLOOD GLUCOSE LEVELS IN THE ELDERLY POPULATION
Ika Ainur Rofiah, Lasiyati Yuswo Yani
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Walaa Badawy Mohamed Badawy, Amal Hashem Mohamed, Mostafa Shaban
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Special Article

The Korea National Disability Registration System: Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin; Epidemiol Health. 2023;45:e2023053. Published online May 11, 2023; DOI: https://doi.org/10.4178/epih.e2023053

23,540 View
340 Download
40 Web of Science
41 Crossref

Abstract Summary PDF Supplementary Material

Abstract

The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number of disability types has gradually expanded, and 15 disability types have been legally defined. As of 2021, 2.645 million people were registered as disabled, accounting for approximately 5.1% of the total population. Among the 15 disability types, disabilities of the extremities account for the largest proportion (45.1%). Previous studies have investigated the epidemiology of disabilities using data from the KNDRS, combined predominantly with data from the National Health Insurance Research Database (NHIRD). Korea has a mandatory public health insurance system that covers the entire Korean population, and the National Health Insurance Services manages all eligibility information, including disability types and severity ratings. In short, the KNDRS-NHIRD is a significant data resource for research on the epidemiology of disabilities.

Summary

Korean summary
한국에서는 장애의 유형과 장애 유형별 장애정도를 장애인 복지법에서 규정하고 있다. 우리는 한국의 장애등록제도의 역사와 장애등록절차 그리고 장애유형별 통계 현황에 대해서 다루고자 한다.

Key Message
In Korea, the types and severity levels of disabilities are legally defined by the Korea National Disability Registration System (KNDRS). We address the history of the KNDRS, disability registration procedures, and current statistics.

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Journal of Alzheimer's Disease.2024; 97(2): 679. CrossRef
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Youn Huh, Kye-Yeung Park, Kyungdo Han, Jin-Hyung Jung, Yoon Jeong Cho, Hye Soon Park, Ga Eun Nam, Soo Lim
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Systematic Review

Tea consumption and risk of all-cause, cardiovascular disease, and cancer mortality: a meta-analysis of thirty-eight prospective cohort data sets: Youngyo Kim, Youjin Je; Epidemiol Health. 2024;46:e2024056. Published online June 21, 2024; DOI: https://doi.org/10.4178/epih.e2024056

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Tea consumption has been considered beneficial to human health because tea contains phytochemicals such as polyphenols and theaflavins. We conducted a systematic review and meta-analysis on the association between tea consumption and mortality from all causes, cardiovascular disease (CVD), and cancer to provide a quantitative assessment of current evidence.

METHODS

The PubMed, Web of Science, and Scopus databases were searched through April 2024 to identify eligible studies. Random effects models were used to combine study-specific effect estimates (ESs).

RESULTS

A total of 38 prospective cohort data sets (from 27 papers) with 1,956,549 participants were included in this meta-analysis. The pooled ESs of the highest versus lowest categories of tea consumption were 0.90 (95% confidence interval [CI], 0.86 to 0.95) for all-cause mortality, 0.86 (95% CI, 0.79 to 0.94) for CVD mortality, and 0.90 (95% CI, 0.78 to 1.03) for cancer mortality. In the dose-response analysis, a non-linear association was observed. The greatest risk reductions were observed for the consumption of 2.0 cup/day for all-cause mortality (ES, 0.91; 95% CI, 0.88 to 0.94) and 1.5 cup/day for cancer mortality (ES, 0.92; 95% CI, 0.89 to 0.96), whereas additional consumption did not show a further reduction in the risk of death. A plateau was observed for CVD mortality at moderate consumption levels (1.5-3.0 cup/day), but a sustained reduction in mortality risk was observed at higher intake levels.

CONCLUSIONS

Moderate tea consumption (e.g., 1.5-2.0 cup/day) was associated with lower all-cause, CVD, and cancer mortality compared to no tea consumption. Further well-designed prospective studies are needed for a definitive conclusion.

Summary

Korean summary
차는 전세계적으로 널리 소비되는 음료로 그 공중보건학적 영향력이 크다. 차의 섭취와 만성질환의 관련성은 아직 일관성 있게 결론이 나지 않았는데 최근에 이 주제에 대하여 대규모의 코호트 연구 결과들이 발표된 바 있었다. 38개의 코호트 데이터에 근거한 본 메타분석의 결과는 하루 한 잔 반에서 두 잔의 차를 마시는 것이 총사망위험과 심혈관계질환이나 암으로 인한 사망 위험을 낮추는 것과 관계가 있음을 나타내고 있다.

Key Message
Tea is a commonly consumed beverage worldwide and has a significant public health impact. The association between tea consumption and risk of mortality from chronic disease remains inconsistent, and extensive cohort studies have been published recently. In this meta-analysis, including thirty-eight cohort studies, people who drank one and a half to two cups of tea daily had a lower risk of mortality from all causes, cardiovascular disease, and cancer than those who drank less tea.

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Bioavailability of Tea Polyphenols: A Key Factor in Understanding Their Mechanisms of Action In Vivo and Health Effects
Mingchuan Yang, Xiangchun Zhang, Chung S. Yang
Journal of Agricultural and Food Chemistry.2025; 73(7): 3816. CrossRef
Molecular mechanisms of action of DIM and its clinical application
E. A. Nikitina, S. V. Orlova, T. T. Batysheva, N. V. Balashova, M. V. Alekseeva, A. N. Vodolazkaya, E. V. Prokopenko, Kh. A. Magomedova
Medical alphabet.2024; (19): 9. CrossRef

Original Articles

Associations of the magnesium depletion score and magnesium intake with diabetes among US adults: an analysis of the National Health and Nutrition Examination Survey 2011-2018: Zhong Tian, Shifang Qu, Yana Chen, Jiaxin Fang, Xingxu Song, Kai He, Kexin Jiang, Xiaoyue Sun, Jianyang Shi, Yuchun Tao, Lina Jin; Epidemiol Health. 2024;46:e2024020. Published online January 10, 2024; DOI: https://doi.org/10.4178/epih.e2024020

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The magnesium depletion score (MDS) is considered more reliable than traditional approaches for predicting magnesium deficiency in humans. We explored the associations of MDS and dietary magnesium intake with diabetes.

METHODS

We obtained data from 18,853 participants in the National Health and Nutrition Examination Survey 2011-2018. Using multivariate regression and stratified analysis, we investigated the relationships of both MDS and magnesium intake with diabetes. To compute prevalence ratios (PRs), we employed modified Poisson or log-binomial regression. We characterized the non-linear association between magnesium intake and diabetes using restricted cubic spline analysis.

RESULTS

Participants with MDS ≥2 exhibited a PR of 1.26 (95% confidence interval [CI], 1.19 to 1.34) for diabetes. Per-standard deviation (SD) increase in dietary magnesium intake was associated with a lower prevalence of diabetes (PR, 0.91; 95% CI, 0.87 to 0.96). Subgroup analyses revealed a positive association between MDS ≥2 and diabetes across all levels of dietary magnesium intake, including the lowest (PR, 1.35; 95% CI, 1.18 to 1.55), middle (PR, 1.23; 95% CI, 1.12 to 1.35), and highest tertiles (PR, 1.25; 95% CI, 1.13 to 1.37; pinteraction<0.001). Per-SD increase in magnesium intake was associated with lower diabetes prevalence in participants with MDS <2 (PR, 0.92; 95% CI, 0.87 to 0.98) and those with MDS ≥2 (PR, 0.91; 95% CI, 0.84 to 0.98; pinteraction=0.030).

CONCLUSIONS

MDS is associated with diabetes, particularly among individuals with low magnesium intake. Adequate dietary magnesium intake may reduce diabetes risk, especially in those with high MDS.

Summary

Key Message
The relationship between magnesium intake and risk is currently understudied in the field of diabetes prevention. The study found that magnesium deficiency is associated with diabetes risk, especially in people with low magnesium intake. Dietary magnesium supplementation may reduce risk and provide a new strategy for diabetes prevention. This study fills this knowledge gap and is important for scientific understanding of diabetes pathogenesis and epidemiological prevention and control.

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Magnesium Depletion Score and Mortality in Individuals with Metabolic Dysfunction Associated Steatotic Liver Disease over a Median Follow-Up of 26 Years
Lei Fan, Xiangzhu Zhu, Xinyuan Zhang, Shakirat Salvador, Xuehong Zhang, Martha J. Shrubsole, Manhal J. Izzy, Qi Dai
Nutrients.2025; 17(2): 244. CrossRef
Higher magnesium depletion score increases the risk of all‑cause and cardiovascular mortality in US adults with diabetes
Hao Zhang, Liping Kuang, Qiang Wan, Amirmohammad Khalaji
PLOS ONE.2025; 20(1): e0314298. CrossRef
Magnesium Matters: A Comprehensive Review of Its Vital Role in Health and Diseases
Ghizal Fatima, Andrej Dzupina, Hekmat B Alhmadi, Aminat Magomedova, Zainab Siddiqui, Ammar Mehdi, Najah Hadi
Cureus.2024;[Epub] CrossRef
Magnesium depletion score and depression: a positive correlation among US adults
Wei Zhao, Hai Jin
Frontiers in Public Health.2024;[Epub] CrossRef
Magnesium depletion score and gout: insights from NHANES data
Xu Cao, Haixia Feng, Huijie Wang
Frontiers in Nutrition.2024;[Epub] CrossRef
Association between magnesium depletion score and the prevalence of kidney stones in the low primary income ratio: a cross-sectional study of NHANES 2007–2018
Jiahao Wang, Yunfei Xiao, Yaqing Yang, Shan Yin, Jianwei Cui, Ke Huang, Jia Wang, Yunjin Bai
International Journal of Surgery.2024; 110(12): 7636. CrossRef

Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021: Sung-Bin Hong, Ji-Eun Kim, Seung Seok Han, Joseph J. Shearer, Jungnam Joo, Ji-Yeob Choi, Véronique L. Roger; Epidemiol Health. 2025;47:e2025005. Published online February 14, 2025; DOI: https://doi.org/10.4178/epih.e2025005

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).

METHODS

Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.

RESULTS

Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.

CONCLUSIONS

About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.

Summary

Korean summary
최근, 심장-신장-대사 증후군을 하나로 묶어 관리하는 것의 필요성이 대두되고 있다. 본 연구 결과 20세 이상의 한국 성인들의 74.8%가 심장-신장-대사 증후군의 위험군에 속해 있었다. 또한 그 정도가 증가하는 추세로 나타나 적절한 관리가 필요해 보인다.

Key Message
Recently, the need for an integrated approach to managing cardiovascular-kidney-metabolic (CKM) syndrome has been emphasized. This study found that 74.8% of Korean adults aged 20 and older had a risk for CKM syndrome. Moreover, the prevalence is increasing, highlighting the necessity of proper management.

Citations

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Relationship between estimated pulse wave velocity trajectories and cardiovascular disease risk in patients with cardiovascular-kidney-metabolic syndrome stages 0–3
Tingting Chen, Huangyi Yin, Yubo Zhou, Min Liang
Nutrition, Metabolism and Cardiovascular Diseases.2025; : 104192. CrossRef

Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea: Kyoung Hoon Kim, Sang Min Lee, Minha Hong, Kyu-Man Han, Jong-Woo Paik; Epidemiol Health. 2023;45:e2023022. Published online February 14, 2023; DOI: https://doi.org/10.4178/epih.e2023022

15,631 View
326 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic.

METHODS

Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators.

RESULTS

The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak.

CONCLUSIONS

Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.

Summary

Korean summary
이 연구는 COVID-19 전후 정신질환 의료서비스 이용 변화를 분석하였다. 팬데믹 기간 중에 정신질환 의료서비스는 전반적으로 감소하였고, 특히 중증 정신질환의 외래 방문이 감소하였다. 따라서, 정신질환자의 진료 연속성을 보장하기 위한 조치가 요구된다.

Key Message
This study examined the impact of the COVID-19 pandemic on mental health service utilization. The mental health service utilization decreased overall after the outbreak of COVID-19, especially outpatient visits for severe mental illness significantly decreased. Therefore, countermeasures are needed to maintain the continuity of care.

Citations

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A population-based cohort to investigate the impact of COVID-19 on socioeconomic inequalities in mental health care in Italy (CoMeH): study protocol
Alessio Petrelli, Massimiliano Aragona, Roberta Ciampichini, Anteo Di Napoli, Valeria Fano, Sara Leone, Martina Pacifici, Claudio Rosini, Caterina Silvestri, Alberto Zucchi, Martina Ventura
Social Psychiatry and Psychiatric Epidemiology.2025; 60(4): 967. CrossRef
Factors Associated with Leaving Ambulatory Psychiatric Treatment in a Large, Academic Health System During the COVID-19 Pandemic
Nathaniel A. Sowa, Xiaoming Zeng
Psychiatric Quarterly.2025;[Epub] CrossRef
Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions
Jackson Newberry-Dupé, Wanyu Chu, Simon Craig, Rohan Borschmann, Gerard O’Reilly, Paul Yates, Glenn Melvin, Kylie King, Harriet Hiscock
Psychiatric Quarterly.2024; 95(1): 33. CrossRef
Incidence of Panic Disorder Diagnoses After Celebrity Disclosures of Panic Disorder in South Korea
Ga Eun Kim, Min-Woo Jo, Young Eun Kim, Seok-Jun Yoon, Yong-Wook Shin
JAMA Network Open.2024; 7(7): e2420934. CrossRef
Stigma Experience and Mental Health of Vulnerable Groups: Focusing on the COVID-19 Period
Sung Moon Choi, Jong-Woo Paik, Myung Jae Paik, Jin Hee Hyun, Sung Eun You, Ah Rah Lee, Sang Min Lee
Journal of Korean Neuropsychiatric Association.2024; 63(4): 225. CrossRef
Changes in psychiatric disorder incidence patterns during the COVID-19 pandemic in Korea: a study using the nationwide universal health insurance data
Changwoo Han, Juho Choi, Hoyeon Jang, Hwa-Young Lee, Tarik Benmarhnia, Juhwan Oh
BMC Psychiatry.2024;[Epub] CrossRef
The impact of the COVID-19 pandemic on access to mental health services and socioeconomic inequalities in Italy
Alessio Petrelli, Martina Ventura, Roberta Ciampichini, Anteo Di Napoli, Valeria Fano, Christian Napoli, Martina Pacifici, Claudio Rosini, Caterina Silvestri, Fabio Voller, Alberto Zucchi, Massimiliano Aragona
Frontiers in Psychiatry.2024;[Epub] CrossRef
Trends in telemedicine utilization for mental illness during the COVID-19 pandemic: an analysis of a nationwide database in Korea
Kyoung Hoon Kim, Sang Min Lee, Minha Hong, Kyu-Man Han, Jong-Woo Paik
BMC Psychiatry.2023;[Epub] CrossRef
Admissions to psychiatric inpatient services and use of coercive measures in 2020 in a Swiss psychiatric department: An interrupted time-series analysis
Alexandre Wullschleger, Leonel Gonçalves, Maya Royston, Othman Sentissi, Julia Ambrosetti, Stefan Kaiser, Stéphanie Baggio, Jahida Gulshan
PLOS ONE.2023; 18(7): e0289310. CrossRef

Association of blood pressure measurements in sitting, supine, and standing positions with the 10-year risk of mortality in Korean adults: Inkyung Baik, Nan Hee Kim, Seong Hwan Kim, Chol Shin; Epidemiol Health. 2023;45:e2023055. Published online June 8, 2023; DOI: https://doi.org/10.4178/epih.e2023055

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This prospective cohort study investigated the association between blood pressure (BP) as measured in different body postures and all-cause and cardiovascular (CV) mortality risk.

METHODS

This population-based investigation included 8,901 Korean adults in 2001 and 2002. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured sequentially in the sitting, supine, and standing positions and classified into 4 categories: (1) normal, SBP <120 mmHg and DBP <80 mmHg; (2) high normal/prehypertension, SBP 120-129 mmHg and DBP <80 mmHg/SBP 130-139 mmHg or DBP 80-89 mmHg; (3) grade 1 hypertension (HTN), with SBP 140-159 mmHg or DBP 90-99 mmHg; and (4) grade 2 HTN, SBP ≥160 mmHg or DBP ≥100 mmHg. The date and cause of individual deaths were confirmed in the death record data compiled until 2013. Data were analyzed using Cox proportional hazard regression.

RESULTS

Significant associations were found between the BP categories and all-cause mortality, but only when BPs were measured in the supine position. The multivariate hazard ratios (95% confidence intervals, [CIs]) were 1.36 (95% CI, 1.06 to 1.75) and 1.59 (95% CI, 1.06 to 2.39) for grade 1 HTN and grade 2 HTN, respectively, compared with the normal category. The associations between the BP categories and CV mortality were significant regardless of body posture among participants ≥65 years, whereas they were significant for supine BP measurements only in those <65 years.

CONCLUSIONS

BP measured in the supine position predicted all-cause mortality and CV mortality better than BP measured in other postures.

Summary

Korean summary
본 역학 연구는 한국 성인 8,901명을 연구대상자로 하여 기초조사에서 세가지 자세, 즉 앉은 자세, 누운 자세, 일어선 자세에서 혈압을 측정하고, 이후 10년 동안의 사망 여부를 추적조사하여, 측정 자세에 따른 혈압과 사망 위험과의 관련성을 분석하였다. 그 결과, 누운 자세에서 측정된 고혈압(기준: 수축기 혈압이 140 mmHg 이상 혹은 이완기 혈압이 90 mmHg 이상)인 사람은 정상 혈압(기준: 수축기 혈압이 120 mmHg 미만이고 이완기 혈압이 80 mmHg 미만)인 사람에 비해 36%(1단계 고혈압) 혹은 59%(2단계 고혈압) 가량 총 사망 위험이 유의적으로 증가하는 것으로 나타났다. 이에 비해, 앉은 자세 및 일어선 자세에서 측정, 정의된 고혈압은 총 사망 위험을 증가시켰지만 유의적인 결과를 나타내지 못했다. 추후 연구에서 재확인이 필요하지만, 본 연구 결과가 시사하는 바는 앉은 자세나 일어선 자세보다 누운 자세에서 측정하는 혈압이 총 사망 위험을 더 잘 예측하므로, 고혈압 진단 외의 추가적인 활용 가능성이 있는 것으로 평가된다.

Key Message
The current epidemiological study revealed that blood pressure measured in a supine position could predict all-cause mortality and cardiovascular mortality better than blood pressure measured in a sitting or standing position. As a result, blood pressure measurements in a supine position may be useful in assessing mortality risk.

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Supine Blood Pressure and Risk of Cardiovascular Disease and Mortality
Duc M. Giao, Hannah Col, Fredrick Larbi Kwapong, Ruth-Alma Turkson-Ocran, Long H. Ngo, Jennifer L. Cluett, Lynne Wagenknecht, B. Gwen Windham, Elizabeth Selvin, Pamela L. Lutsey, Stephen P. Juraschek
JAMA Cardiology.2025; 10(3): 265. CrossRef
Central vs. Brachial Blood Pressure and Pulse Pressure Amplification for Mortality Risk Prediction in Patients Undergoing Coronary Angiography
Clara Daschner, Marcus E Kleber, Niklas Ayasse, Ksenija Stach, Gökhan Yücel, Faeq Husain-Syed, Alexander Niessner, Bernd Krüger, Winfried März, Bernhard K Krämer, Babak Yazdani
American Journal of Hypertension.2025; 38(5): 272. CrossRef
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Yoshitsugu Sunagawa, Akio Ishida, Masanobu Yamazato, Yusuke Ohya, Kenya Kusunose
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Homelessness and mortality: gender, age, and housing status inequity in Korea: Gum-Ryeong Park, Dawoon Jeong, Seung Won Lee, Hojoon Sohn, Young Ae Kang, Hongjo Choi; Epidemiol Health. 2024;46:e2024076. Published online September 12, 2024; DOI: https://doi.org/10.4178/epih.e2024076

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS
The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.; Summary

Korean summary
전체 인구의 사망률은 큰 폭으로 줄어들면서 홈리스와 전체 인구 간의 사망 불평등이 1.3배에서 1.8배로 증가했다. 특히 쪽방주민이나 거리 홈리스보다 시설 거주 홈리스의 사망 위험이 더 높았으며, 동일 조건하에서 거리 홈리스 대비 약 1.7배 높은 사망 위험을 보였다. 본 연구는 홈리스의 탈시설화를 촉진하는 정책 전환의 필요성을 시사한다.

Key Message
The mortality rate of the general population has significantly declined, leading to an increase in mortality inequality between the homeless and the general population from 1.3 to 1.8 times. In particular, the mortality risk for homeless individuals in facilities was higher than that of those living in jjokbang or on the streets. This study highlights the need for a policy shift to promote deinstitutionalization for the homeless population.

Special Article

Incidence and case fatality of stroke in Korea, 2011-2020: Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim; Epidemiol Health. 2024;46:e2024003. Published online December 26, 2023; DOI: https://doi.org/10.4178/epih.e2024003

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Stroke remains the second leading cause of death in Korea. This study was designed to estimate the crude, age-adjusted and age-specific incidence rates, as well as the case fatality rate of stroke, in Korea from 2011 to 2020.

METHODS

We utilized data from the National Health Insurance Services from January 1, 2002 to December 31, 2020, to calculate incidence rates and 30-day and 1-year case fatality rates of stroke. Additionally, we determined sex and age-specific incidence rates and computed age-standardized incidence rates by direct standardization to the 2005 population.

RESULTS

The crude incidence rate of stroke hovered around 200 (per 100,000 person-years) from 2011 to 2015, then surged to 218.4 in 2019, before marginally declining to 208.0 in 2020. Conversely, the age-standardized incidence rate consistently decreased by 25% between 2011 and 2020. When stratified by sex, the crude incidence rate increased between 2011 and 2019 for both sexes, followed by a decrease in 2020. Age-standardized incidence rates displayed a downward trend throughout the study period for both sexes. Across all age groups, the 30-day and 1-year case fatality rates of stroke consistently decreased from 2011 to 2019, only to increase in 2020.

CONCLUSIONS

Despite a decrease in the age-standardized incidence rate, the total number of stroke events in Korea continues to rise due to the rapidly aging population. Moreover, 2020 witnessed a decrease in incidence but an increase in case fatality rates.

Summary

Key Message
This nationwide study using Korean National Health Insurance System data reveals a decade-long downward trend in overall stroke incidence rates. While the crude incidence rate showed a temporary increase from 2016 to 2019 before a slight decline in 2020, the age-standardized incidence rate consistently decreased over the study period. The study emphasizes the significance of continuous monitoring and preventive strategies to address stroke as a public health concern in Korea

Citations

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Effect of regular exercise on stroke prevention: an instrumental variables approach
Wonseok Jeong
BMC Public Health.2025;[Epub] CrossRef
A Study on the Healthcare Workforce and Care for Acute Stroke: Results From the Survey of Hospitals Included in the National Acute Stroke Quality Assessment Program
Jong Young Lee, Jun Kyeong Ko, Hak Cheol Ko, Hae-Won Koo, Hyon-Jo Kwon, Dae-Won Kim, Kangmin Kim, Myeong Jin Kim, Hoon Kim, Keun Young Park, Kuhyun Yang, Jae Sang Oh, Won Ki Yoon, Dong Hoon Lee, Ho Jun Yi, Heui Seung Lee, Jong-Kook Rhim, Dong-Kyu Jang, Yo
Journal of Korean Medical Science.2025;[Epub] CrossRef
Confidence-linked and uncertainty-based staged framework for phenotype validation using large language models
Sumin Lee, Hyeok-Hee Lee, Hokyou Lee, Kyu Sun Yum, Jang-Hyun Baek, Jaewon Khil, Jaeyong Lee, Sojung Shin, Minsung Cho, Na Yeon Ahn, Seng Chan You, Hyeon Chang Kim
Journal of the American Medical Informatics Association.2025;[Epub] CrossRef

Original Articles

Associations between digital media use and lack of physical exercise among middle-school adolescents in Korea: Gyeongmin Kim, Hyunsuk Jeong, Hyeon Woo Yim; Epidemiol Health. 2023;45:e2023012. Published online January 10, 2023; DOI: https://doi.org/10.4178/epih.e2023012

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Abstract

OBJECTIVES
The reported effects of digital media overuse on physical activity among adolescents are inconsistent. This study examined the association between hours of digital media use and lack of moderate-intensity physical exercise (mPE) according to the type of digital media.

METHODS

This study included 1,837 middle school students from the iCURE (Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence) study conducted in Korea. Hours spent using digital media were measured by self-reported daily usage time for Internet games, messengers, social media, and watching game streaming on weekdays. Lack of mPE was defined as performing a minimum of 30 minutes at a time less than twice weekly. Multivariable logistic regression analysis stratified by sex was performed.

RESULTS

Among male students, the group with the highest hours of using either Internet games or watching game streaming was more likely to lack mPE than each non-user group. In contrast, among male students, the group using either messengers or social media had a higher rate of mPE compared to each non-user group. Female students showed no association between hours spent using Internet games, messengers, social media, or watching game streaming and a lack of mPE.

CONCLUSIONS

Among male middle school students in Korea, the excessive use of Internet games or watching game streaming was associated with a lack of mPE. Thus, guidelines should be established regarding adolescent use of internet games and watching game streaming.

Summary

Korean summary
한국에서 남, 여 중학생을 대상으로 4개 인터넷 매체(인터넷 게임, 메신저, 소셜미디어, 게임 스트리밍 시청) 과다사용과 신체 운동 부재와의 연관성을 알아보기 위한 단면조사 연구를 시행하였다. 남자 중학생에서 인터넷 게임 사용 또는 게임 스트리밍 시청 시간이 가장 높은 사분위 그룹은 비이용 그룹보다 중간 강도의 신체운동 부재율이 유의하게 높았다.

Key Message
A cross-sectional study was conducted to find out the relationship between excessive use of four Internet media (internet games, messengers, social media, and game streaming) and lack of physical exercise targeting male and female middle school students in Korea. Among male middle school students, the upper quartile group with the highest Internet game use or game streaming viewing time had a significantly higher moderate-intensity physical exercise absence rate than the non-use group.

Citations

Citations to this article as recorded by

Social Media Addiction and Cognitive Behavioral Physical Activity Among Adolescent Girls: A Cross‐Sectional Study
Ebru Sönmez Sari, Handan Terzi, Didem Şahin
Public Health Nursing.2025; 42(1): 61. CrossRef
Delineating temporal dynamics for the linkage between anxiety symptoms and problematic media use among Chinese adolescents
Hongjian Cao, Shaofan Wang, Nan Zhou, Ming-Chen Zhang
Journal of Applied Developmental Psychology.2025; 97: 101761. CrossRef
‘We wanted to spend more time with each other than with our phones’. Relationship between digital disconnection and physical activity of family members
Katarzyna Kopecka-Piech
Cogent Arts & Humanities.2024;[Epub] CrossRef
Cyber Sex Crimes Targeting Children and Adolescents in South Korea: Incidents and Legal Challenges
Yujin Jang, Youngmeen Suh
Social Sciences.2024; 13(11): 596. CrossRef
Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents
Hunju Lee, Hyowon Choi, Sang Baek Koh, Hyeon Chang Kim
Epidemiology and Health.2023; 45: e2023085. CrossRef

Risk of non-cancer respiratory diseases attributed to humidifier disinfectant exposure in Koreans: age-period-cohort and differences-in-difference analyses: Jaiyong Kim, Kyoung Sook Jeong, Seungyeon Heo, Younghee Kim, Jungyun Lim, Sol Yu, Suejin Kim, Sun-Kyoung Shin, Hae-Kwan Cheong, Mina Ha, Epidemiology Expert Committee for Reviewing the Epidemiological Correlations between Humidifier Disinfectant Exposure and Health Effects; Epidemiol Health. 2025;47:e2025006. Published online February 22, 2025; DOI: https://doi.org/10.4178/epih.e2025006

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Humidifier disinfectants (HDs) were sold in Korea from 1994 until their recall in 2011. We examined the incidence patterns of 8 respiratory diseases before and after the HD recall and estimated the attributable risk in the Korean population.
METHODS
Using National Health Insurance data from 2002 to 2019, we performed age–cohort–period and differences-in-diffference analyses (comparing periods before vs. after the recall) to estimate the population-attributable fraction and the excess number of episodes. The database comprised 51 million individuals (99% of the Korean population). The incidence of 8 diseases—acute upper respiratory infection (AURI), acute lower respiratory infection (ALRI), asthma, pneumonia, chronic sinusitis (CS), interstitial lung disease (ILD), bronchiectasis, and chronic obstructive pulmonary disease (COPD)—was defined by constructing episodes of care based on patterns of medical care and the clinical characteristics of each disease.
RESULTS
The relative risks (RRs) for AURI, ALRI, asthma, pneumonia, CS, and ILD were elevated among younger individuals (with an RR as high as 82.18 for AURI in males), whereas chronic conditions such as bronchiectasis, COPD, and ILD showed higher RRs in older individuals. During the HD exposure period, the population-attributable risk percentage ranged from 4.6% for bronchiectasis to 25.1% for pneumonia, with the excess number of episodes ranging from 6,218 for ILD to 3,058,861 for CS. Notably, females of reproductive age (19-44 years) experienced 1.1-9.2 times more excess episodes than males.
CONCLUSIONS
This study provides epidemiological evidence that inhalation exposure to HDs affects the entire respiratory tract and identifies vulnerable groups.; Summary

Korean summary
- 2002년부터 2012년까지 가습기살균제 흡입 노출은 한국 인구의 호흡기 질환 중 4~25%에 기여했으며, 특히 천식, 폐렴, 간질성폐질환이 젊은 연령층에서 더 큰 영향을 보였다. - 기관지확장증과 간질성폐질환 같은 만성질환에서는 고령층에서 초과 발생 사례 수가 더 많았다. - 어린이, 노인, 가임기 여성이 취약집단으로 확인되었다.

Key Message
- From 2002 to 2012, humidifier disinfectant inhalation exposure contributed to 4–25% of respiratory diseases in Korea, with greater effects among younger people, especially for asthma, pneumonia, and interstitial lung disease. - Older individuals showed more excess episodes for chronic conditions like bronchiectasis and interstitial lung disease. - The young, the elderly, and reproductive-age women were identified as vulnerable groups in association with humidifier disinfectant exposure.

Effects of student human rights ordinances on mental health among middle and high school students in South Korea: a difference-in-differences analysis: Sang Jun Eun; Epidemiol Health. 2025;47:e2025011. Published online March 1, 2025; DOI: https://doi.org/10.4178/epih.e2025011

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
To actively protect and enhance students’ human rights, student human rights ordinances (SHROs) have been enforced in seven provinces in South Korea at different times since 2010. Although human rights are closely linked to mental health, there has been no research on the effectiveness of human rights legislation on adolescent mental health. This study evaluated the effects of SHROs on the mental health of middle and high school students.
METHODS
Repeated cross-sectional data were used, including 1,148,257 respondents from the Korea Youth Risk Behavior Web-based Survey between 2006 and 2023. Probabilities of perceived stress, sleep insufficiency, depressive mood, suicide ideation, and suicide attempt in treated provinces were estimated through a difference-in-differences approach that accounts for treatment effect heterogeneity across groups over time.
RESULTS
SHROs had no consistently significant effects on any mental health outcomes, except for slightly increased suicide ideation in total students (0.7%, 95% confidence interval 0.3% to 1.1%). Suicide attempts in total and male students and perceived stress and sleep insufficiency in female students tended to decrease, while other mental health outcomes tended to increase. Uncertainty in the effect estimates of SHROs increased for all mental health outcomes with possible violations of parallel trends, rendering originally significant effects insignificant.
CONCLUSIONS
SHROs failed to improve mental health of middle and high school students in treated provinces, possibly due to the absence of enforcement mechanisms. Further research is needed on the effectiveness of and effect mechanisms for legal measures to improve human rights on adolescent mental health.; Summary

Korean summary
학생의 인권을 포괄적으로 보장하기 위해 학생인권조례가 시행되었지만 학생인권조례 시행 지역에서 중고등학생의 정신건강은 향상되지 않았는데, 이는 조례에 벌칙 조항 같은 강제성 기전이 없었기 때문이었을 수 있다. 학생인권조례는 중고등학생의 정신건강에 대해 효과가 없었지만 이 연구는 인권 법제의 청소년 정신건강에 대한 효과를 처음으로 평가했다. 인권증진을 위한 법적 수단의 청소년 정신건강에 대한 효과성과 효과 기전에 관하여 추가 연구가 필요하다.

Key Message
Although student human rights ordinances have been enforced in South Korea to comprehensively guarantee human rights for students, they failed to improve the mental health of middle and high school students in treated provinces, possibly due to the absence of enforcement mechanisms such as penalty provisions. Despite the ineffectiveness of student human rights ordinances, this study first estimated the effects of human rights legislation on adolescent mental health. Further research is needed on the effectiveness of and effect mechanisms for legal measures to improve human rights on adolescent mental health.

Folate, vitamin B12, and homocysteine status in the Korean population: data from the 2013-2015 Korea National Health and Nutrition Examination Survey: Sihan Song, Bo Mi Song, Hyun-Young Park; Epidemiol Health. 2024;46:e2024007. Published online December 11, 2023; DOI: https://doi.org/10.4178/epih.e2024007

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Abstract

OBJECTIVES
We aimed to assess the serum folate, vitamin B12, and homocysteine status in Korean adolescents and adults using national data.

METHODS

Blood samples were collected from participants aged ≥10 years in the Korea National Health and Nutrition Examination Survey 2013-2015. The stored serum samples were used to measure folate, vitamin B12, and homocysteine concentrations. A total of 8,016 participants were included in this analysis. Unweighted descriptive statistics and adjusted geometric means of the B vitamins and homocysteine concentrations were estimated.

RESULTS

Females had higher serum folate and vitamin B12 concentrations and lower serum homocysteine concentrations than males. Folate deficiency (<6.8 nmol/L) and hyperhomocysteinemia (>15 μmol/L) were found in 8.6% and 11.8% of males, respectively. Approximately 3% of males had low or marginally low vitamin B12 status (≤221 pmol/L). Folate and vitamin B12 deficiencies and hyperhomocysteinemia were found in <2% of females. Suboptimal folate status was prevalent among adolescents and young adults, while suboptimal vitamin B12 status and hyperhomocysteinemia were relatively higher in older adults. Adjusted mean homocysteine concentrations were sharply decreased from the first to second decile of serum folate in males.

CONCLUSIONS

In the Korean population, the proportion of males who achieved desirable folate and homocysteine concentrations were lower than those of females. Although most Koreans have adequate vitamin B12, a suboptimal folate status is common, particularly among adolescents and young adults. These findings could establish a foundation for public health initiatives aimed at improving folate levels in the Korean population.

Summary

Korean summary
엽산과 비타민B12는 전 생애에 걸쳐 건강에 영향을 미치는 필수 비타민이다. 그러나 해당 비타민 상태에 대한 국내 자료는 부족한 실정이다. 본 연구는 국민건강영양조사 참여자로부터 수집된 혈청으로부터 엽산, 비타민B12, 그리고 이들의 기능성 지표인 호모시스테인 농도를 측정하였고 성별과 연령별 분포와 적합 상태를 평가하였다. 엽산 결핍과 고호모시스테인혈증은 남성에서 높은 유병률을 가졌다. 적정 엽산 상태를 충족하지 못하는 비율은 청소년과 젊은 성인에서 흔하게 관찰되었다. 대부분의 한국인은 충분한 비타민B12 수준을 가졌으나, 노인의 경우 정기적인 평가가 필요하다. 본 연구는 한국인이 최적의 엽산과 비타민B12 상태를 유지하기 위한 기반적 근거를 제공한다.

Key Message
Folate and vitamin B12 have significant health impacts throughout the life cycle. However, national-level data on B vitamins in Korea are limited. Serum folate, vitamin B12, and homocysteine concentrations were measured from samples stored during the national survey. In our study, the proportions of folate deficiency and hyperhomocysteinemia were higher in men than in women.Suboptimal folate status was common among adolescents and young adults. Most Koreans had adequate levels of vitamin B12; however, regular monitoring is warranted, especially in the older population. The current data provide a future direction for achieving optimal B vitamin status in the Korean population.

Citations

Citations to this article as recorded by

Essential micronutrients in children and adolescents with a focus on growth and development: a narrative review
Sukjin Hong
Journal of Yeungnam Medical Science.2025; 42: 25. CrossRef

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