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Associations of fasting glucose and glycated hemoglobin with vitamin D levels according to diabetes mellitus status in Korean adults
Yerin Hwang, Jiyoung Jang, Myung-Hee Shin
Epidemiol Health. 2022;44:e2022025.   Published online February 21, 2022
DOI: https://doi.org/10.4178/epih.e2022025
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
According to previous studies, vitamin D deficiency might increase the risk of type 2 diabetes mellitus (DM). However, few studies have examined whether vitamin D continues to affect glucose control after DM diagnosis. Therefore, we examined the association between vitamin D and glucose levels in individuals with and without DM.
METHODS
We analyzed data for 32,943 adults aged 19 years and older from the 2008 to 2014 Korea National Health and Nutrition Examination Survey. Patients were classified into 3 groups according to the 25-hydroxyvitamin D concentration. DM was defined as a fasting glucose level ≥126 mg/dL, current use of DM medications or insulin injections, or a self-reported diagnosis of DM by a doctor.
RESULTS
In male DM patients, the hemoglobin A1c (HbA1c) level increased significantly as vitamin D levels became severely deficient. In male and postmenopausal female with abnormal HbA1c, those with severe vitamin D deficiency had significantly higher HbA1c levels (p for trend=0.004 and 0.022 for male and postmenopausal female, respectively). Significant differences were found between participants with normal and abnormal HbA1c levels in both male and female. However, regardless of sex or menopausal status, there was no significant association between vitamin D and fasting glucose in any of the fasting glucose subgroups.
CONCLUSIONS
Male and female with abnormal HbA1c levels showed markedly elevated blood glucose when they also had vitamin D deficiency. A more distinct difference was observed in the HbA1c subgroups than in the fasting glucose subgroups.
Summary
Korean summary
당화혈색소 비정상군에서 비타민 D가 부족할수록 혈당의 상승을 보였다. 현재까지 비타민 D와 혈당 조절과 관련하여 한국인을 대상으로 한 연구는 매우 미비한 상황이며, 한국인을 대상으로 한 연구 결과를 반영한 당뇨병 환자들의 혈당 조절 관리 지침 마련이 필요하다.
Key Message
Guidelines are needed for managing glucose control in DM patients that reflect the results of this research performed among Koreans. Additional large-scale longitudinal studies should be conducted to clarify the causal relationships underlying this association.
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
  • 9,034 View
  • 169 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary 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

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    Julio Ernesto Pérez-Parra, Claudia Patricia Henao-Lema, Anyi Vanesa Arcos-Rodríguez, Natalia López-Ocampo, Carolina Castaño-García, Olga Patricia Pérez-Gamboa
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    BMC Medicine.2022;[Epub]     CrossRef
Trends in the prevalence and management of diabetes in Korea: 2007-2017
Ji-Yeon Shin
Epidemiol Health. 2019;41:e2019029.   Published online July 4, 2019
DOI: https://doi.org/10.4178/epih.e2019029
  • 15,842 View
  • 309 Download
  • 40 Web of Science
  • 39 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study analyzed Korea National Health and Nutrition Examination Survey data from 2007 to 2017 to assess trends in the prevalence, treatment, and control of diabetes in Korean adults ≥30 years of age.
METHODS
Prevalent diabetes was defined as a fasting plasma glucose level ≥126 mg/dL, self-reported use of anti-diabetic treatment (insulin or oral anti-diabetic drugs), or diabetes diagnosis by a physician. Target levels were defined as glycosylated hemoglobin <6.5% or <7.0%, blood pressure <130/80 mmHg, and total cholesterol <200 mg/dL. All survey waves were age-standardized to the 2005 Korean census population.
RESULTS
Diabetes prevalence increased from 9.6% in 2007-2009 to 10.8% in 2016-2017 (p<0.001). Impaired fasting glucose prevalence significantly increased in both genders and almost every age group. Diabetes awareness and glycemic control did not show an increasing trend; however, the treatment rate and proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved from 57.2% to 63.5% (p=0.008), from 41.1% to 53.2% (p<0.001), and from 65.0% to 78.0% (p<0.001), respectively.
CONCLUSIONS
From 2007 to 2017, the prevalence of diabetes increased moderately in Korea, whereas the diabetes treatment rate and the proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved. However, awareness of diabetes and glycemic control require significant improvements. A national-level action plan is required to raise awareness about diabetes and prediabetes, with the goal of improving glycemic control and minimizing the occurrence of adverse health outcomes.
Summary
Korean summary
지난 2007년-2017년 동안 우리나라 30세 이상 성인의 당뇨병 유병률은 소폭 증가하였으며, 당뇨환자의 치료율, 혈압 조절율, 총콜레스테롤 조절율은 증가 추세를 보였다. 그러나 당뇨병 인지율과 당뇨 환자의 혈당 조절율은 현재의 추세대로라면 Health Plan 2020의 목표치를 달성하기 어려울 것으로 보이며, 개선이 필요하다.

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Application of an artificial neural network model for diagnosing type 2 diabetes mellitus and determining the relative importance of risk factors
Shiva Borzouei, Ali Reza Soltanian
Epidemiol Health. 2018;40:e2018007.   Published online March 10, 2018
DOI: https://doi.org/10.4178/epih.e2018007
  • 13,356 View
  • 286 Download
  • 13 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To identify the most important demographic risk factors for a diagnosis of type 2 diabetes mellitus (T2DM) using a neural network model.
METHODS
This study was conducted on a sample of 234 individuals, in whom T2DM was diagnosed using hemoglobin A1c levels. A multilayer perceptron artificial neural network was used to identify demographic risk factors for T2DM and their importance. The DeLong method was used to compare the models by fitting in sequential steps.
RESULTS
Variables found to be significant at a level of p<0.2 in a univariate logistic regression analysis (age, hypertension, waist circumference, body mass index [BMI], sedentary lifestyle, smoking, vegetable consumption, family history of T2DM, stress, walking, fruit consumption, and sex) were entered into the model. After 7 stages of neural network modeling, only waist circumference (100.0%), age (78.5%), BMI (78.2%), hypertension (69.4%), stress (54.2%), smoking (49.3%), and a family history of T2DM (37.2%) were identified as predictors of the diagnosis of T2DM.
CONCLUSIONS
In this study, waist circumference and age were the most important predictors of T2DM. Due to the sensitivity, specificity, and accuracy of the final model, it is suggested that these variables should be used for T2DM risk assessment in screening tests.
Summary

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