Epidemiology and Health

Original article

Association of decreased estimated glomerular filtration rate with lung cancer risk in the Korean population: Soonsu Shin, Min-Ho Kim, Chang-Mo Oh, Hyejin Chun, Eunhee Ha, Hyo Choon Lee, Seong Ho Moon, Dong-Young Lee, Dosang Cho, Sangho Lee, Min Hyung Jung, Jae-Hong Ryoo; Epidemiol Health. 2024;e2024041. Published online March 20, 2024; DOI: https://doi.org/10.4178/epih.e2024041 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Inconsistent results are available regarding the association between low estimated glomerular filtration rate (eGFR) and lung cancer risk. We aimed to explore the risk of lung cancer according to eGFR category in the Korean population.
METHODS
We included 358,293 adults who underwent health checkups between 2009 and 2010, utilizing data from the National Health Insurance Service-National Sample Cohort. Participants were categorized into 3 groups based on their baseline eGFR, as determined using the Chronic Kidney Disease Epidemiology Collaboration equation: group 1 (eGFR ≥90 mL/min/1.73m2), group 2 (eGFR ≥60 to <90mL/min/1.73m2), and group 3 (eGFR <60 mL/min/1.73m2). Incidences of lung cancer were identified using the corresponding codes from the International Classification of Diseases, 10th Revision. Multivariate Cox proportional hazard models were employed to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for lung cancer incidence up to 2019.
RESULTS
In multivariate analysis, group 2 exhibited a 26.5% higher risk of developing lung cancer than group 1 (HR, 1.265; 95% CI, 1.189 to 1.346). Furthermore, group 3 demonstrated a 72.5% elevated risk of lung cancer relative to group 1 (HR, 1.725; 95% CI, 1.577 to 1.887). Among participants with dipstick proteinuria of 2+ or greater, group 3 faced a significantly higher risk of lung cancer than group 1 (HR, 2.928; 95% CI, 1.375 to 6.237).
CONCLUSION
Low eGFR was significantly associated with increased lung cancer risk within the Korean population. A particularly robust association was observed in individuals with severe proteinuria, emphasizing the need for further investigation.; Summary

Original Articles

Identifying pregnancy episodes and estimating the last menstrual period using an administrative database in Korea: an application to patients with systemic lupus erythematosus: Yu-Seon Jung, Yeo-Jin Song, Jihyun Keum, Ju Won Lee, Eun Jin Jang, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung; Epidemiol Health. 2024;46:e2024012. Published online December 19, 2023; DOI: https://doi.org/10.4178/epih.e2024012

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study developed an algorithm for identifying pregnancy episodes and estimating the last menstrual period (LMP) in an administrative claims database and applied it to investigate the use of pregnancy-incompatible immunosuppressants among pregnant women with systemic lupus erythematosus (SLE).
METHODS
An algorithm was developed and applied to a nationwide claims database in Korea. Pregnancy episodes were identified using a hierarchy of pregnancy outcomes and clinically plausible periods for subsequent episodes. The LMP was estimated using preterm delivery, sonography, and abortion procedure codes. Otherwise, outcome-specific estimates were applied, assigning a fixed gestational age to the corresponding pregnancy outcome. The algorithm was used to examine the prevalence of pregnancies and utilization of pregnancy-incompatible immunosuppressants (cyclophosphamide [CYC]/mycophenolate mofetil [MMF]/methotrexate [MTX]) and non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy in SLE patients.
RESULTS
The pregnancy outcomes identified in SLE patients included live births (67%), stillbirths (2%), and abortions (31%). The LMP was mostly estimated with outcome-specific estimates for full-term births (92.3%) and using sonography procedure codes (54.7%) and preterm delivery diagnosis codes (37.9%) for preterm births. The use of CYC/MMF/MTX decreased from 7.6% during preconception to 0.2% at the end of pregnancy. CYC/MMF/MTX use was observed in 3.6% of women within 3 months preconception and 2.5% during 0-7 weeks of pregnancy.
CONCLUSIONS
This study presents the first pregnancy algorithm using a Korean administrative claims database. Although further validation is necessary, this study provides a foundation for evaluating the safety of medications during pregnancy using secondary databases in Korea, especially for rare diseases.; Summary

Korean summary
임산부의 약물 사용 안전성에 대한 근거 제공을 위해 실제 인구집단에서의 임신 중 약물 치료 안전성을 평가하는 청구자료 기반 연구가 중요하다. 본 연구에서는 국내 청구자료에 적용할 수 있는 임신 정의 및 임신 결과 조작적 정의 알고리즘을 개발하였다. 본 알고리즘은 임신 결과 간의 우선순위를 고려한 계층 구조를 활용하며, 조기 분만 및 초음파 검사 코드 등을 통해 최종 월경 기간을 추정하였다. 또한 알고리즘을 전신홍반루푸스 환자에 적용하여 유산, 사산 등의 유병률을 산출하고 임신 중 잠재적으로 부적절한 면역억제제 사용을 파악하여 국내 청구자료의 특성을 고려한 임신 중 약물 사용 연구의 기반을 마련하였다.

Key Message
Limited safety data for pregnant women prompted recent studies on medication during pregnancy using real-world databases. This study developed a tailored algorithm for Korean healthcare claims database, employing a hierarchy of pregnancy outcomes and incorporating pre-term delivery and sonography codes for last menstrual period estimation. Applied to systemic lupus erythematosus (SLE) patients, this study presented the prevalence and drug utilization pattern of pregnancy-incompatible immunosuppressants from preconception to pregnancy end, laying a foundation for further claims database studies on medication pregnancy safety.

Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults: Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han; Epidemiol Health. 2024;46:e2024008. Published online December 11, 2023; DOI: https://doi.org/10.4178/epih.e2024008

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to establish the validity—specifically, the sensitivity and specificity—of the screening questionnaire and diagnostic criteria for oral frailty proposed by the Korean Academy of Geriatric Dentistry (KAGD) among community-dwelling older adults.
METHODS
This study enrolled 100 participants. Among various definitions of oral frailty, this study used the criteria proposed by Tanaka as the reference test. The screening questionnaire consisted of 11 items for screening physical frailty, chewing ability, swallowing difficulties, oral dryness, and tongue and lip motor function. Each question had a different scoring weight, and if the total score was 1 or higher, an oral frailty diagnostic examination proposed by the KAGD would be recommended. The diagnostic test was the oral frailty diagnostic criteria proposed by the KAGD including 6 measures: chewing ability, occlusal force, tongue pressure, oral dryness, swallowing difficulty, and oral hygiene. If a participant exhibited 2 or more positive measures, this participant was classified as “oral frail.” The screening questionnaire was analyzed using a cut-off value of 1 or higher, while the diagnostic criteria utilized a cut-off of 2 or more positive measures. Sensitivity and specificity were calculated.
RESULTS
The screening questionnaire showed significant power for screening oral frailty (area under the receiver operating characteristic curve, 0.783; sensitivity, 87.8%; specificity, 52.5%). The diagnostic accuracy of the newly proposed diagnostic criteria was acceptable (sensitivity, 95.1%; specificity, 42.4%).
CONCLUSIONS
The newly proposed screening questionnaire and diagnostic criteria in Korea appear to be a useful tool to identify oral frailty in community-dwelling older adults.; Summary

Korean summary
본 연구는 지역사회에 거주하는 노인들의 구강 노쇠에 대한 선별검사 설문지와 진단 기준을 검증하는 것을 목표로 했습니다. 민감도와 특이도가 계산되었으며, 스크리닝 설문지는 구강 노쇠를 식별하는 데 상당한 힘을 보여주었고(민감도 87.8%, 특이도 52.5%), 진단 기준은 수용 가능한 정확도(민감도 95.1%, 특이도 42.4%)를 나타냈습니다. 연구 결과는 제안된 선별 설문지와 진단 기준이 한국 지역사회에 거주하는 노인들의 구강 노쇠를 식별하는 데 유용한 도구임을 시사합니다.

Key Message
This study aimed to validate a screening questionnaire and diagnostic criteria for oral frailty among older adults living in the community. Sensitivity and specificity were calculated, with the screening questionnaire demonstrating a significant power for identifying oral frailty (sensitivity 87.8%, specificity 52.5%) and the diagnostic criteria showing acceptable accuracy (sensitivity 95.1%, specificity 42.4%). The findings suggest that the proposed screening questionnaire and diagnostic criteria are valuable tools for identifying oral frailty in community-dwelling older adults in Korea.

Changes in proteinuria and the associated risks of ischemic heart disease, acute myocardial infarction, and angina pectoris in Korean population: Sung Keun Park, Ju Young Jung, Min-Ho Kim, Chang-Mo Oh, Eunhee Ha, Eun Hye Yang, Hyo Choon Lee, Soonsu Shin, Woo Yeon Hwang, Sangho Lee, So Youn Shin, Jae-Hong Ryoo; Epidemiol Health. 2023;45:e2023088. Published online September 30, 2023; DOI: https://doi.org/10.4178/epih.e2023088

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Proteinuria is widely used to predict cardiovascular risk. However, there is insufficient evidence to predict how changes in proteinuria may affect the incidence of cardiovascular disease.
METHODS
The study included 265,236 Korean adults who underwent health checkups in 2003-2004 and 2007-2008. They were categorized into 4 groups based on changes in proteinuria (negative: negative → negative; resolved: proteinuria ≥1+ → negative; incident: negative → proteinuria ≥1+; persistent: proteinuria ≥1+ → proteinuria ≥1+). We conducted 6 years of follow-up to identify the risks of developing ischemic heart disease (IHD), acute myocardial infarction (AMI), and angina pectoris according to changes in proteinuria. A multivariate Cox proportional-hazards model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident IHD, AMI, and angina pectoris.
RESULTS
The IHD risk (expressed as HR [95% CI]) was the highest for persistent proteinuria, followed in descending order by incident and resolved proteinuria, compared with negative proteinuria (negative: reference, resolved: 1.211 [95% CI, 1.104 to 1.329], incident: 1.288 [95% CI, 1.184 to 1.400], and persistent: 1.578 [95% CI, 1.324 to 1.881]). The same pattern was associated with AMI (negative: reference, resolved: 1.401 [95% CI, 1.048 to 1.872], incident: 1.606 [95% CI, 1.268 to 2.035], and persistent: 2.069 [95% CI, 1.281 to 3.342]) and angina pectoris (negative: reference, resolved: 1.184 [95% CI, 1.065 to 1.316], incident: 1.275 [95% CI, 1.160 to 1.401], and persistent: 1.554 [95% CI, 1.272 to 1.899]).
CONCLUSIONS
Experiencing proteinuria increased the risks of IHD, AMI, and angina pectoris even after proteinuria resolved.; Summary

Korean summary
- 본 연구의 목적은 요 시험지 검사를 통해 확인된 단백뇨의 3-5년간의 변화 수준에 따른 허혈성 심질환, 급성 심근 경색, 협심증의 발생 위험을 평가하는 것이다. - 지속적으로 단백뇨가 음성인 집단에 (negative proteinuria) 비해서, 단백뇨가 있었다 사라진 집단 (resolved proteinuria), 새로이 단백뇨가 생긴 집단 (incident proteinuria), 지속적으로 단백뇨가 존재하는 집단 (persistent proteinuria)은 유의하게 증가한 허혈성 심질환, 급성 심근 경색, 협심증의 발생 위험을 나타내었다. - 이러한 결과는 단백뇨가 일단 발생한 사람은, 나중에 사라지더라도, 관상 동맥 질환에 대한 위험이 높으며, 이에 대한 관리와 주의가 필요하다는 것을 시사한다.

Key Message
- The present study was to evaluate the risk of incident ischemic heart disease, acute myocardial infarction, and angina pectoris according to changes in urine dipstick proteinuria over 3-5 years. - Compared with persistently negative proteinuria (negative → negative), resolved proteinuria (positive → negative), incident proteinuria (negative → positive), and persistent proteinuria (positive → positive) had the increased risk of ischemic heart disease, acute myocardial infarction, and angina pectoris. - These results suggest that once manifested proteinuria lead to the increased risk of coronary artery disease, regardless of changes in proteinuria.

Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?: Rora Oh, Myoung-Hee Kim, Juyeon Lee, Rangkyoung Ha, Jungwook Kim; Epidemiol Health. 2023;45:e2023072. Published online August 3, 2023; DOI: https://doi.org/10.4178/epih.e2023072

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study examined changes in socioeconomic inequalities in mortality in Korea before and after the outbreak of coronavirus disease 2019 (COVID-19).
METHODS
From 2017 to 2020, age-standardized mortality rates were calculated for all-cause deaths, avoidable deaths (preventable deaths, treatable deaths), and unavoidable deaths using National Health Insurance claims data and Statistics Korea’s cause of death data. In addition, the slope index of inequality (SII) and the relative index of inequality (RII) by six income levels (Medical Aid beneficiary group and quintile of health insurance premiums) were computed to analyze the magnitude and change of mortality inequalities.
RESULTS
All-cause and avoidable mortality rates decreased steadily between 2017 and 2020, whereas unavoidable mortality remained relatively stable. In the case of mortality inequalities, the disparity in all-cause mortality between income classes was exacerbated in 2020 compared to 2019, with the SII increasing from 185.44 to 189.22 and the RII increasing from 3.99 to 4.29. In particular, the preventable and unavoidable mortality rates showed an apparent increase in inequality, as both the SII (preventable: 91.31 to 92.01, unavoidable: 69.99 to 75.38) and RII (preventable: 3.42 to 3.66, unavoidable: 5.02 to 5.89) increased.
CONCLUSIONS
In the first year of the COVID-19 pandemic, mortality inequality continued to increase, although there was no sign of exacerbation. It is necessary to continuously evaluate mortality inequalities, particularly for preventable and unavoidable deaths.; Summary

Korean summary
이 연구는 COVID-19 발생 전후 한국에서의 사망률 추이와 사망률 불평등 변화를 조사했다. 2017~2020년 사이에 총사망률과 회피가능사망률은 줄어들었지만, 사망률의 사회경제적 불평등은 더 커지는 경향을 보였다. 특히 예방가능사망과 회피불가능사망에서 불평등이 커져 지속적인 추적과 평가가 필요하다.

Key Message
This study examined the trends in mortality rates and changes in mortality inequality in Korea before and after the onset of COVID-19. Between 2017 and 2020, while the all-cause and avoidable mortality rates decreased, there was a growing trend of inequality in mortality rates based on income levels. Particularly, inequalities in preventable and unavoidable deaths have increased, emphasizing the need for ongoing evaluation.

Associations of cumulative average dietary total antioxidant capacity and intake of antioxidants with metabolic syndrome risk in Korean adults aged 40 years and older: a prospective cohort study (KoGES_CAVAS): Ji-Sook Kong, Jiseon Lee, Youngjun Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim; Epidemiol Health. 2023;45:e2023067. Published online July 28, 2023; DOI: https://doi.org/10.4178/epih.e2023067

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Limited and inconsistent prospective evidence exists regarding the relationship of dietary total antioxidant capacity (dTAC) and antioxidant intake with metabolic syndrome (MetS) risk. We evaluated the associations of the cumulative averages of dTAC and antioxidant intake (in 5 classes: retinol, vitamin C, vitamin E, carotenoids, and flavonoids, as well as 7 flavonoid subclasses) with the risk of MetS.

METHODS

This study included 11,379 participants without MetS, drawn from the Korean Genome and Epidemiology Study_CArdioVascular disease Association Study (KoGES_CAVAS). The cumulative average consumption was calculated using repeated food frequency questionnaires. Incidence rate ratios were estimated using a modified Poisson regression model with a robust error estimator.

RESULTS

The median follow-up period was 5.16 years, and 2,416 cases of MetS were recorded over 58,750 person-years. In men, significant inverse associations were observed in all 5 antioxidant classes, except for the highest quartile of dTAC. In women, dTAC and total flavonoids were not significantly associated with MetS; however, significant L-shaped associations were found for the remaining 4 antioxidant classes. Of the 7 flavonoid subclasses, only flavones in the highest quartile for men and flavan-3-ols in women lacked significant associations with MetS. The inverse associations were not sex-specific, but they were particularly pronounced among participants with a body mass index (BMI) of 23 kg/m<sup>2</sup> or higher.

CONCLUSIONS

The findings suggest that most antioxidant classes and flavonoid subclasses, unlike dTAC, exhibit a clear beneficial association with MetS in an L-shaped pattern in both men and women, particularly those with a high BMI.

Summary

Korean summary
농촌코호트 조사 참여자를 대상으로 식이 총항산화능, 총항산화능 하위분류, 플라보노이드 하위분류와 대사증후군 발생 위험의 전향적 연관성을 평가한 결과, 대부분의 항산화물(5개항산화물 분류:4개 항산화 비타민과 플라보노이드; 플라보노이드 7개 하부분류)에서 대사증후군과 음의 상관성을 확인할 수 있었으며 총항산화능(남자와 여자)과 플라보노이드(여자)에서 약한 연관성을 보였다. 남녀간 유의한 상호작용은 없었고 특히 BMI가 높은 집단에서 두드러졌다. 이 연구의 결과는 특히 식이 총항산화능을 구성하는 하위 유형을 적절히 섭취하는 것이 특히 비만한 성인에서 대사증후군 위험을 낮추는 예방전략으로 효과가 있을 수 있음을 시사한다.

Key Message
We observed that the cumulative average of dietary antioxidant vitamins and most flavonoids may be have pivotal roles in prevention of MetS, although there may be weak associations of dTAC and flavonoids in women. Moreover, these inverse associations were more pronounced in high BMI individuals. Our results suggest that the consumption of antioxidants and flavonoid may mitigate the MetS risk, particularly in overweight/obese individuals at high risk of developing chronic diseases.

Citations

Citations to this article as recorded by

The association of dietary total flavonoids and their subclasses with the risk of type 2 diabetes: a prospective cohort study
Hye Won Woo, Mi Kyung Kim, Kong Ji-Sook, Jiseon Lee, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim
European Journal of Nutrition.2024;[Epub] CrossRef
A Systematized Review of the Relationship Between Obesity and Vitamin C Requirements
Julia K. Bird, Edith J.M. Feskens, Alida Melse-Boonstra
Current Developments in Nutrition.2024; : 102152. CrossRef

Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data: Hong Ki Min, Hyeongsu Kim, Ho Jin Jeong, Se Hee Kim, Hae-Rim Kim, Sang-Heon Lee, KunSei Lee, Soon-Ae Shin, Jong Heon Park; Epidemiol Health. 2023;45:e2023045. Published online April 15, 2023; DOI: https://doi.org/10.4178/epih.e2023045

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4 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA).

METHODS

We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups.

RESULTS

Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups.

CONCLUSIONS

In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.

Summary

Korean summary
1. 한국인 류마티스관절염 환자를 대상으로 한 실제임상자료 결과, JAK 억제제가 종양괴사인자 억제제에 비해 심혈관질환, 혈전증, 암 등의 심각한 부작용을 증가시키지는 않았다. 2. 본 연구를 토대로 한국인 대상자에서 JAK 억제제가 심혈관질환 등의 심각한 부작용을 증가시키는지에 대한 재평가가 필요하다.

Key Message
1. The real word-data based results showed that risks of MACE, thromboembolism, and cancers were not increased in Korean RA patients with JAK inhibitor when compared to Korean RA patients with TNF inhibitors. 2. Therefore, the risk of serious adverse events of JAK inhibitors in Korean population should be reconsidered and reassessed before adding black box warning of JAK inhibitors.

Citations

Citations to this article as recorded by

Multicenter evaluation of tofacitinib retention and safety in rheumatoid arthritis – why cardiovascular risk factors do not equate to overt risk
Anna Felis-Giemza, Mateusz Moskal, Krzysztof Proc, Zbigniew Guzera, Marcin Stajszczyk, Karolina Palej, Kornelia Chmurzyńska, Piotr Wiland, Krzysztof Batko, Bogdan Batko
Rheumatology.2024; 61(6): 414. CrossRef
Safety and Effectiveness of Baricitinib in Chinese Patients with Moderate-to-Severe Rheumatoid Arthritis: 24-Week Results from a Post-Marketing Safety Study
Chan-yuan Wu, Qian Wang, Jian Shi, Xiu-ying Zhang, Rong Du, Jie-ruo Gu, Qi-huan Liu, Jiao Yu, Jia-wei Xu, Yan-jie Zhang, Hao Zhu, Meng-tao Li, Xiao-feng Zeng
Rheumatology and Therapy.2023; 10(6): 1609. CrossRef
Comparative cardiovascular safety with janus kinase inhibitors and biological disease-modifying antirheumatic drugs as used in clinical practice: an observational cohort study from Sweden in patients with rheumatoid arthritis
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Johan Askling
RMD Open.2023; 9(4): e003630. CrossRef
Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk? A comparative effectiveness study of b/tsDMARDs in Sweden
Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Ulf Lindström, Carl Turesson, Katerina Chatzidionysiou, Elisabet Lindqvist, Ann Knight, Helena Forsblad-d'Elia, Johan Askling
RMD Open.2023; 9(4): e003648. CrossRef

The association between occupational stress level and health-related productivity loss among Korean employees: Jonghee Chung, Jin-Hyo Kim, Jae Yoon Lee, Hee Seok Kang, Dong-wook Lee, Yun-Chul Hong, Mo-Yeol Kang; Epidemiol Health. 2023;45:e2023009. Published online December 28, 2022; DOI: https://doi.org/10.4178/epih.e2023009

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Abstract Summary PDF: Abstract
OBJECTIVES
Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers’ health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers.
METHODS
In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions.
RESULTS
Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress.
CONCLUSIONS
Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.; Summary

Korean summary
직무스트레스가 건강에 미치는 영향은 잘 알려져 있으나, 노동생산성에 대해 분석한 결과는 그동안 부족하였다. 한국 노동자 1078명을 분석한 결과, 직무스트레스가 낮은 군에 비해서 중등도이거나 높은 경우, 결근이나 프리젠티즘과 같은 건강관련 노동생산성 손실이 약 20%p 정도 높은 것으로 분석되었다.

Key Message
As a result of analyzing 1078 Korean workers, it was revealed that health-related labor productivity losses such as absenteeism and presenteeism were about 20%p higher when occupational stress was moderate or high compared to the low occupational stress group.

Long-term association of pericardial adipose tissue with incident diabetes and prediabetes: the Coronary Artery Risk Development in Young Adults Study: Minsuk Oh, Wonhee Cho, Dong Hoon Lee, Kara M. Whitaker, Pamela J. Schreiner, James G. Terry, Joon Young Kim; Epidemiol Health. 2023;45:e2023001. Published online December 3, 2022; DOI: https://doi.org/10.4178/epih.e2023001

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
We examined whether pericardial adipose tissue (PAT) is predictive of prediabetes and type 2 diabetes over time.
METHODS
In total, 2,570 adults without prediabetes/diabetes from the Coronary Artery Risk Development in Young Adults Study were followed up over 15 years. PAT volume was measured by computed tomography scans, and the new onset of prediabetes/diabetes was examined 5 years, 10 years, and 15 years after the PAT measurements. Multivariable Cox regression models were used to examine the association between the tertile of PAT and incident prediabetes/diabetes up to 15 years later. The predictive ability of PAT (vs. waist circumference [WC], body mass index [BMI], waist-to-height ratio [WHtR]) for prediabetes/diabetes was examined by comparing the area under the receiver operating characteristic curve (AUC).
RESULTS
The highest tertile of PAT was associated with a 1.56 times (95% confidence interval [CI], 1.03 to 2.34) higher rate of diabetes than the lowest tertile; however, no association was found between the highest tertile of PAT and prediabetes in the fully adjusted models, including additional adjustment for BMI or WC. In the fully adjusted models, the AUCs of WC, BMI, WHtR, and PAT for predicting diabetes were not significantly different, whereas the AUC of WC for predicting prediabetes was higher than that of PAT.
CONCLUSIONS
PAT may be a significant predictor of hyperglycemia, but this association might depend on the effect of BMI or WC. Additional work is warranted to examine whether novel adiposity indicators can suggest advanced and optimal information to supplement the established diagnosis for prediabetes/diabetes.; Summary

Korean summary
본 연구는 심장 내 축적되는 내장지방과 5년에서 15년 뒤의 당뇨병 전조 단계 및 당뇨병의 발생률과 연관성이 있음을 제안한다. 또한, 본 연구는 심장 내 내장지방과 당뇨병 발생률의 관계는 체질량 지수 또는 허리둘레의 영향에 따라 상이할 수 있음을 제안한다.

Key Message
Pericardial adipose tissue may be a significant predictor of future hyperglycemia in adults, but this association might depend on the effect of body mass index or waist circumference.

The association between metabolic syndrome and heart failure in middle-aged male and female: Korean population-based study of 2 million individuals: Tae-Eun Kim, Hyeongsu Kim, JiDong Sung, Duk-Kyung Kim, Myoung-Soon Lee, Seong Woo Han, Hyun-Joong Kim, Sung Hea Kim, Kyu-Hyung Ryu; Epidemiol Health. 2022;44:e2022078. Published online September 21, 2022; DOI: https://doi.org/10.4178/epih.e2022078

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Abstract PDF

Abstract

OBJECTIVES
Although an association is known to exist between metabolic syndrome (MetS) and heart failure (HF) risk, large longitudinal studies are limited. We investigated metabolic status as a risk factor for HF in middle-aged male and female and considered sex differences in various risk factors for HF using nationwide real-world data.

METHODS

Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. A total of 2,151,597 middle-aged subjects (between 50 and 59 years old) were enrolled. Subjects were divided into 3 groups (normal, pre‐ MetS, and MetS). Cox proportional hazard models were used to estimate the association between MetS and incident HF after adjusting for clinical risk factors.

RESULTS

At baseline, MetS existed in 23.77% of male and 10.58% of female. Pre-MetS and MetS increased the risk of HF: the hazard ratios of pre-MetS for incident HF were 1.508 (95% confidence interval [CI], 1.287 to 1.767) in male and 1.395 (95% CI, 1.158 to 1.681) in female, and those of MetS were 1.711 (95% CI, 1.433 to 2.044) in male and 2.144 (95% CI, 1.674 to 2.747) in female. Current smoking, a low hemoglobin level, underweight (body mass index < 18.5 kg/m2), a high creatinine level, and acute myocardial infarction were also predictors of HF in both sexes.

CONCLUSIONS

Pre-MetS and MetS were identified as risk factors for HF in middle-aged male and female. The effect of MetS on the occurrence of HF was stronger in female than in male. Pre-MetS was also a predictor of HF, but was associated with a lower risk than MetS.

Summary

Citations

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Integrating machine learning and nontargeted plasma lipidomics to explore lipid characteristics of premetabolic syndrome and metabolic syndrome
Xinfeng Huang, Qing He, Haiping Hu, Huanhuan Shi, Xiaoyang Zhang, Youqiong Xu
Frontiers in Endocrinology.2024;[Epub] CrossRef
17-year follow-up of association between telomere length and all-cause mortality, cardiovascular mortality in individuals with metabolic syndrome: results from the NHANES database prospective cohort study
Lijiao Xiong, Guangyan Yang, Tianting Guo, Zhaohao Zeng, Tingfeng Liao, Yanchun Li, Ying Li, Fujuan Chen, Shu Yang, Lin Kang, Zhen Liang
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
Modifications of long-term heart rate variability produced in an experimental model of diet-induced metabolic syndrome
W. M. Lozano, J. E. Ortiz-Guzmán, O. Arias-Mutis, A. Bizy, P. Genovés, L. Such-Miquel, A. Alberola, F. J. Chorro, M. Zarzoso, C. J. Calvo
Interface Focus.2023;[Epub] CrossRef

Predictors of COVID-19 booster vaccine hesitancy among fully vaccinated adults in Korea: a nationwide cross-sectional survey: Yunha Noh, Ju Hwan Kim, Dongwon Yoon, Young June Choe, Seung-Ah Choe, Jaehun Jung, Sang-Won Lee, Ju-Young Shin; Epidemiol Health. 2022;44:e2022061. Published online July 22, 2022; DOI: https://doi.org/10.4178/epih.e2022061

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study explored predictors of coronavirus disease 2019 (COVID-19) booster hesitancy among fully vaccinated young adults and parental COVID-19 vaccine hesitancy for their children.

METHODS

This cross-sectional study administered an online survey from December 2 to December 20, 2021. We enrolled participants aged 18-49 years, for whom ≥2 weeks had passed after their initial COVID-19 vaccination. We estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multivariate logistic regression to evaluate factors associated with booster/vaccine hesitancy.

RESULTS

Among the 2,993 participants, 48.8% showed hesitancy (wait and see: 40.2%; definitely not: 8.7%). Booster hesitancy was more common among women (OR, 1.25; 95% CI, 1.05 to 1.50), younger people (OR, 1.44; 95% CI, 1.17 to 1.77), those with a lower education level (OR, 2.05; 95% CI, 1.10 to 3.82), those who received the mRNA-1273 vaccine type (OR, 2.01; 95% CI, 1.65 to 2.45), and those who experienced serious adverse events following previous COVID-19 vaccination (OR, 2.03; 95% CI, 1.47 to 2.80). The main reasons for booster hesitancy were concerns about safety (54.1%) and doubts about efficacy (29.8%). Among the 1,020 respondents with children aged <18 years, 65.8% were hesitant to vaccinate their children against COVID-19; hesitancy was associated with younger parental age, education level, the type of vaccine the parent received, and a history of COVID-19 infection.

CONCLUSIONS

Concerns about the efficacy and safety of COVID-19 vaccines were the major barrier to booster acceptance. The initial COVID-19 vaccine type (mRNA-1273), young age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.

Summary

Korean summary
본 연구는 국내 19-49세 성인을 대상으로, 코로나19 3차접종 의향과 그들의 18세 미만 자녀에 대한 코로나19 기초접종 의향을 조사하고, 코로나19 백신접종 기피와 관련된 요인을 파악하고자 하였다. 2021년 12월 2일부터 20일까지 온라인 설문조사를 통하여 자료를 수집하였으며, 연구대상자는 코로나19 기초접종을 완료한 후 2주 경과한 19-49세 성인으로, 전국 대표성을 확보하기 위해 성별, 연령, 지역별로 층화하여 모집하였다. 코로나19 3차접종 기피율은 약 48.8%로 나타났으며, 접종 기피 관련 영향요인으로는 젊은 연령층, 여성, 낮은 교육수준, 기초접종 백신 종류, 기초접종 후 중증 이상반응 경험이 포함되었으며, 18세 미만 자녀에 대한 코로나19 기초접종 기피율은 65.8%로, 관련 영향요인으로는 젊은 부모 연령, 교육수준, 부모의 기초접종 백신 종류, 코로나19 감염 과거력이 포함되었다.

Key Message
Concerns about the safety and efficacy of COVID-19 vaccines were the major barrier to booster acceptance; the initial COVID-19 vaccine type (mRNA-1273), younger age, gender (women), a low education level, and adverse events after the first COVID-19 vaccine were key predictors of booster hesitancy.

Citations

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Why Some People Are Hesitant to Receive COVID-19 Boosters: A Systematic Review
Yam B. Limbu, Bruce A. Huhmann
Tropical Medicine and Infectious Disease.2023; 8(3): 159. CrossRef
COVID-19 Vaccine Booster Hesitancy in Malaysia: A Web-Based Cross-Sectional Study
Kai Wei Lee, Sook Fan Yap, Hooi Tin Ong, Myo Oo, Kye Mon Min Swe
Vaccines.2023; 11(3): 638. CrossRef
Factors associated with parental intention to vaccinate their preschool children against COVID-19: a cross-sectional survey in urban area of Jakarta, Indonesia
Theresia Santi, Badriul Hegar, Zakiudin Munasir, Ari Prayitno, Retno Asti Werdhani, Ivo Novita Sah Bandar, Juandy Jo, Ruswati Uswa, Ratna Widia, Yvan Vandenplas
Clinical and Experimental Vaccine Research.2023; 12(3): 240. CrossRef
Factors associated with COVID-19 booster vaccine hesitancy: a nationwide, cross-sectional survey in Japan
A. Takamatsu, H. Honda, T. Miwa, T. Tabuchi, K. Taniguchi, K. Shibuya, Y. Tokuda
Public Health.2023; 223: 72. CrossRef
Predictors of COVID-19 Vaccine Hesitancy Among Parents of Children Aged 5–11 Years in Korea
Ju Hwan Kim, Dongwon Yoon, Yunha Noh, Jaehun Jung, Young June Choe, Ju-Young Shin
Journal of Korean Medical Science.2023;[Epub] CrossRef
Effective Vaccination and Education Strategies for Emerging Infectious Diseases Such as COVID-19
Seong-Heon Wie, Jaehun Jung, Woo Joo Kim
Journal of Korean Medical Science.2023;[Epub] CrossRef
COVID-19 vaccination acceptance, safety and side-effects in European patients with severe asthma
Apostolos Bossios, Alison M. Bacon, Katrien Eger, Dóra Paróczai, Florence Schleich, Shane Hanon, Svetlana Sergejeva, Eleftherios Zervas, Konstantinos Katsoulis, Christina Aggelopoulou, Konstantinos Kostikas, Eleni Gaki, Nikoletta Rovina, Zsuzsanna Csoma,
ERJ Open Research.2023; 9(6): 00590-2023. CrossRef
Parental concerns about COVID-19 vaccine safety and hesitancy in Korea: implications for vaccine communication
Hye-Kyung Cho, Hyunju Lee, Young June Choe, Shinkyeong Kim, Sujin Seo, Jiwon Moon, Eun Hwa Choi, Geun-Yong Kwon, Jee Yeon Shin, Sang-Yoon Choi, Mi Jin Jeong, Myoungsoon You
Epidemiology and Health.2022; 45: e2023004. CrossRef

The association of pancreatic cancer incidence with smoking status and smoking amount in Korean men: Do Jin Nam, Chang-Mo Oh, Eunhee Ha, Min-Ho Kim, Eun Hye Yang, Hyo Choon Lee, Soon Su Shin, Woo Yeon Hwang, Ann Hee You, Jae-Hong Ryoo; Epidemiol Health. 2022;44:e2022040. Published online April 21, 2022; DOI: https://doi.org/10.4178/epih.e2022040

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Our study examined the dose-response relationship between smoking amounts (pack-years) and the risk of developing pancreatic cancer in Korean men.

METHODS

Of 125,743 participants who underwent medical health checkups in 2009, 121,408 were included in the final analysis and observed for the development of pancreatic cancer. We evaluated the associations between smoking amounts and incident pancreatic cancer in 4 groups classified by pack-year amounts. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident pancreatic cancer by comparing groups 2 (<20 pack-year smokers), 3 (20-≤40 pack-year smokers), and 4 (>40 pack-year smokers) with group 1 (never smokers).

RESULTS

During 527,974.5 person-years of follow-up, 245 incident cases of pancreatic cancer developed between 2009 and 2013. The multivariate-adjusted HRs (95% CIs) for incident pancreatic cancer in groups 2, 3, and 4 were 1.05 (0.76 to 1.45), 1.28 (0.91 to 1.80), and 1.57 (1.00 to 2.46), respectively (p for trend=0.025). The HR (95% CI) of former smokers showed a dose-response relationship in the unadjusted model, but did not show a statistically significant association in the multivariate-adjusted model. The HR (95% CI) of current smokers showed a dose-response relationship in both the unadjusted (p for trend=0.020) and multivariate-adjusted models (p for trend=0.050).

CONCLUSIONS

The risk of developing pancreatic cancer was higher in current smokers status than in former smokers among Korean men, indicating that smoking cessation may have a protective effect.

Summary

Korean summary
본 연구에서는 대한민국 남성을 대상으로 흡연양 및 흡연상태에 따른 췌장암 발병을 분석하였다. 흡연양이 많을수록, 현재 흡연상태일수록 췌장암 발병이 높았고, 금연한 경우 췌장암의 발병이 낮은 것을 확인할 수 있었다.

Key Message
As a result of analyzing the incidence of pancreatic cancer according to the amount of smoking and smoking status among Korean men, it was confirmed that the more smoked and the current smoking status, the higher the incidence of pancreatic cancer, and the lower the incidence of pancreatic cancer when quitting smoking.

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Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18-45 years
Sijie He, Li Wan
Frontiers in Endocrinology.2023;[Epub] CrossRef
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Natalia Michalak, Ewa Małecka-Wojciesko
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Childhood and adulthood passive and active smoking, and the ABO group as risk factors for pancreatic cancer in women
Anne‐Laure Vedie, Nasser Laouali, Amandine Gelot, Gianluca Severi, Marie‐Christine Boutron‐Ruault, Vinciane Rebours
United European Gastroenterology Journal.2023;[Epub] CrossRef

Depression, anxiety, and stress in Korean general population during the COVID-19 pandemic: Hooyeon Lee, Dongwoo Choi, Jung Jae Lee; Epidemiol Health. 2022;44:e2022018. Published online January 18, 2022; DOI: https://doi.org/10.4178/epih.e2022018

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Abstract Summary PDF

Abstract

OBJECTIVES
The aim of this study was to investigate the prevalence and risk factors of poor mental health in the general Korean population during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This cross-sectional, population-based, online survey-based study was conducted from November 5 to 20, 2020 and included adults aged 20-49 years in Chungnam Province, Korea. A total of 549 adults were included.

RESULTS

In total, 18.8% of the participants had symptoms of depression, 10.6% had symptoms of anxiety, and 5.1% had a high level of perceived stress during the COVID-19 pandemic. Higher levels of stress (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.13 to 8.67), anxiety (OR, 2.33; 95% CI, 1.09 to 4.49), and depression (OR, 3.00; 95% CI, 1.64 to 5.50) were found among never married, widowed, divorced, and separated people than among married/cohabiting/partnered participants. Participants who felt increased stress at home during the COVID-19 outbreak reported more depression (OR, 2.45; 95% CI, 1.49 to 4.05) and anxiety (OR, 2.42; 95% CI, 1.31 to 4.50). Women had higher risks of anxiety (OR, 1.97; 95% CI, 1.09 to 3.58) and stress (OR, 6.40; 95% CI, 2.30 to 17.85) than men. Participants with the highest household income were less likely to report symptoms of stress than those with the lowest household income (OR, 0.24; 95% CI, 0.06 to 0.96).

CONCLUSIONS

The participants in this study exhibited poor mental health index scores, suggesting that some people are at risk for mental health problems during the COVID-19 pandemic. Being married was independently and significantly associated with a lower likelihood of depression, anxiety, and stress.

Summary

Korean summary
이 연구는 코로나-19 유행 기간 동안 정신건강 현황과 위험 요인을 알아보기 위한 단면연구이다. 코로나 19 유행 이후 가정내 스트레스가 증가했다고 응답한 경우 우울증과 불안감의 유병률이 높았다. 반면, 남성인 경우, 결혼했거나 동거인과 같이 살고 있는 경우에는 우울증, 불안 또는 스트레스의 유병률이 통계적으로 유의하게 낮았다. 마스크 착용하기, 비대면 활동 증가, 또는 사회적 거리두기 등 코로나 19의 유행을 통제하기 위한 많은 정책은 개인의 일상생활과 정신건강에 많은 영향을 미쳤다. 이 연구는 취약 집단을 발굴하고, 정신건강 회복을 위한 전략을 개발하는데 기초자료를 제공할 수 있다.

Key Message
This study revealed high prevalence rates of depression, anxiety, and stress in the general population of Korea aged 20-49 years during the COVID-19 pandemic. Participants who felt increased stress at home reported more depression and anxiety. Men and being married were significantly associated with a lower likelihood of depression, anxiety, or stress. The COVID-19 pandemic has been a traumatic event. In addition, the policies created to prevent its spread have disrupted daily living for the general population. Implementing strategies to promote resilience and support psychologically vulnerable individuals during the COVID-19 crisis is of fundamental importance.

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Salma M Abdalla, Shaffi Fazaludeen Koya, Samuel B. Rosenberg, Isaac B. Stovall, Olivia Biermann, Zahra Zeinali, Gregory H. Cohen, Catherine K. Ettman, Sandro Galea
Social Psychiatry and Psychiatric Epidemiology.2024; 59(4): 585. CrossRef
Protective Behaviors Against COVID-19 and Related Factors in Korean Adults With Depressive Symptoms: Results From an Analysis of the 2020 Korean Community Health Survey
Ho-Jun Cho, Kyeong-Sook Choi, Jin-Young Lee, Ji-Ae Yun, Je-Chun Yu
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Alejo Ramiro Barbuzza, Fabricio Ballarini, Celina Goyeneche, Victoria Reppucci, Pedro Benedetti, Franco Moscato, Jorge H Medina, Cynthia Katche, Diego Moncada, Haydeé Viola
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Soo Jung Rim, Bong-Jin Hahm, Su Jeong Seong, Jee Eun Park, Sung Man Chang, Byung-Soo Kim, Hyonggin An, Hong Jin Jeon, Jin Pyo Hong, Subin Park
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Mythily Subramaniam, Edimansyah Abdin, Saleha Shafie, Peizhi Wang, Shazana Shahwan, Pratika Satghare, Boon Yiang Chua, Michael Y Ni, Phyllis Lun, Wen Lin Teh, Janhavi Ajit Vaingankar, Siow Ann Chong
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Long COVID in Pakistan: a cross-sectional analysis of health and psychosocial outcomes
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Associations between grip strength and glycemic control in type 2 diabetes mellitus: an analysis of data from the 2014-2019 Korea National Health and Nutrition Examination Survey: Harim Choe, Hoyong Sung, Geon Hui Kim, On Lee, Hyo Youl Moon, Yeon Soo Kim; Epidemiol Health. 2021;43:e2021080. Published online October 8, 2021; DOI: https://doi.org/10.4178/epih.e2021080

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Glycemic control is essential for preventing severe complications in patients with diabetes mellitus. This study investigated the association between grip strength and glycemic control in Korean adults with type 2 diabetes mellitus.

METHODS

From the Korea National Health and Nutrition Examination Survey, 2,498 participants aged over 19 years that patients with diabetes mellitus who did not have a history of cardiovascular disease or cancer were selected for analysis. Grip strength was assessed using a handheld dynamometer and was represented as age-specific and sex-specific tertiles. Multivariable logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) of glycemic control according to the grip strength tertiles.

RESULTS

A significantly lower probability (OR, 0.67; 95% CI, 0.47 to 0.97) for glycemic control was found in the lowest tertile of grip strength compared to the highest tertile. Furthermore, a subgroup analysis by sex only found significant associations between grip strength and glycemic control in males.

CONCLUSIONS

Lower grip strength was associated with poor glycemic control in patients with diabetes mellitus, especially in males. However, further studies are needed to confirm the causal relationship between grip strength and glycemic control.

Summary

Korean summary
본 연구는 2014-2019년도 국민건강영양조사의 자료를 활용하여 당뇨병 유병자의 악력과 혈당 조절률 간의 연관성을 확인하였다. 당뇨병 유병자의 악력이 낮을수록 혈당 조절과의 연관성이 낮아졌으며, 이러한 연관성은 특히 남성에게 유의하게 나타났다.

Key Message
Grip strength is an inexpensive and straightforward method for measuring upper extremities strength and could represent the overall strength. After adjusting for confounders, lower grip strength with diabetic patients was associated with poor glycemic control. Specifically, this association was more prominent in Korean male.

Citations

Citations to this article as recorded by

Handgrip strength and upper limb functional performance measures in people over 18 years old: Analysis of relationships and influencing factors
Julio Ernesto Pérez-Parra, Claudia Patricia Henao-Lema, Anyi Vanesa Arcos-Rodríguez, Natalia López-Ocampo, Carolina Castaño-García, Olga Patricia Pérez-Gamboa
Journal of Hand Therapy.2024; 37(1): 101. CrossRef
Physio-cognitive decline syndrome among middle-aged diabetes patients: Handgrip strength significantly correlates with glycaemic control and cognitive score
Purwita Wijaya Laksmi, Dyah Purnamasari, Naldo Sofian, Nina Kemala Sari, Mohammad Kurniawan, Lugyanti Sukrisman, Dicky Levenus Tahapary, Noto Dwimartutie, Ikhwan Rinaldi
Heliyon.2024; 10(2): e24018. CrossRef
Low relative hand grip strength is associated with a higher risk for diabetes and impaired fasting glucose among the Korean population
Min Jin Lee, Ah Reum Khang, Dongwon Yi, Yang Ho Kang, Giacomo Pucci
PLOS ONE.2022; 17(10): e0275746. CrossRef
Frailty and risk of microvascular complications in patients with type 2 diabetes: a population-based cohort study
Yuanjue Wu, Ting Xiong, Xiao Tan, Liangkai Chen
BMC Medicine.2022;[Epub] CrossRef

Exploring the associations between cardiovascular health measured with the CANHEART model and early cognitive impairment in a middle-aged population in Korea: Ye Jin Jeon, Ji Heon Lee, Hyeon Chang Kim, Sun Jae Jung; Epidemiol Health. 2021;43:e2021044. Published online July 13, 2021; DOI: https://doi.org/10.4178/epih.e2021044

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Both cardiovascular health (CVH) and inflammation are associated with cognition, and inflammation is also associated with CVH. However, limited information has been reported on these factors in the Korean population. The objective of our study was to investigate the influence of inflammation on the association between CVH and cognition using a cross-sectional design.

METHODS

Data were obtained from the Cardiovascular and Metabolic Diseases Etiology Research Center baseline study. Participants who completed fasting serum analysis, questionnaires, and cognitive function tests were included in the analysis, whereas those with a history of autoimmune disease were excluded. The CVH in Ambulatory Care Research Team health index metrics, including smoking, physical activity, healthy diet, obesity, history of hypertension, and diabetes, were used to assess CVH. Cognitive function was evaluated with the Korean version of the Mini-Mental State Estimation for Dementia Screening. Inflammatory status was assessed based on a high-sensitivity C-reactive protein (hs-CRP) test.

RESULTS

Among 2,622 total participants (mean age, 57.2 years; 1,792 women), 13%, 58%, and 29% had poor, intermediate, and ideal CVH, respectively. Logistic regression analysis demonstrated that CVH was significantly associated with cognitive function only in women. A stratified analysis showed that cognitive impairment due to CVH was not associated with hs-CRP levels. When the same analyses were conducted for each CVH component, the only component affecting the association was hypertension history in men.

CONCLUSIONS

CVH is not significantly associated with cognitive decline in the middle-aged Korean population. Inflammation did not play a significant modifying role in this relationship.

Summary

Korean summary
• 본 연구는 심뇌혈관 및 대상질환원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center, CMERC) 코호트의 기반조사 데이터를 활용하여, 심혈관계건강과 인지기능 사이의 연관성을 한국 도시거주 중년인구에서 확인하고, 염증 지표인 고감도C반응단백 (high-sensitivity C-reactive protein, hs-CRP) 수준에 따른 차이를 탐색하였다. • 남성과 여성 모두에서 CANHEART health index가 낮은 집단에서 인지기능이 평균적으로 더 낮았으나, 통계적으로 유의하지는 않았다. • 염증 수준에 따른 심혈관계건강과 인지기능 사이의 연관성은 해당 연구에서는 확인할 수 없었다.

Key Message
In the Korean middle-aged population, poor cardiovascular health (CVH) assessed by CANHEART health index was associated with low cognitive function, but not statistically significant. Further investigation is suggested to develop CVH index specified in Korean populations and to estimate the association between CVH and cognitive function in larger population.

Citations

Citations to this article as recorded by

Cardiovascular disease risk models and dementia or cognitive decline: a systematic review
Ruirui Jia, Qing Wang, Hengyi Huang, Yanli Yang, Yuet Foon Chung, Tao Liang
Frontiers in Aging Neuroscience.2023;[Epub] CrossRef

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