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Original Articles
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
  • 4,209 View
  • 166 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
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.
The associations of obesity phenotypes with the risk of hypertension and its transitions among middle-aged and older Chinese adults
Ziyue Sheng, Shang Lou, Jin Cao, Weidi Sun, Yaojia Shen, Yunhan Xu, Ziyang Ren, Wen Liu, Qian Yi, Peige Song
Epidemiol Health. 2023;45:e2023043.   Published online April 10, 2023
DOI: https://doi.org/10.4178/epih.e2023043
  • 3,810 View
  • 89 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate the associations of obesity phenotypes with hypertension stages, phenotypes, and transitions among middle-aged and older Chinese.
METHODS
Using the 2011-2015 waves of the China Health and Retirement Longitudinal Study, we conducted a cross-sectional analysis included 9,015 subjects and a longitudinal analysis included 4,961 subjects, with 4,872 having full data on the hypertension stage and 4,784 having full data on the hypertension phenotype. Based on body mass index and waist circumstance, subjects were categorized into 4 mutually exclusive obesity phenotypes: normal weight with no central obesity (NWNCO), abnormal weight with no central obesity (AWNCO), normal weight with central obesity (NWCO), and abnormal weight with central obesity (AWCO). Hypertension stages were classified into normotension, pre-hypertension, stage 1 hypertension, and stage 2 hypertension. Hypertension phenotypes were categorized as normotension, pre-hypertension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). The association between obesity phenotypes and hypertension was estimated by logistic regression. A comparison between different sexes was conducted by testing the interaction effect of sex.
RESULTS
NWCO was associated with normal→stage 2 (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.11 to 3.42), maintained stage 1 (OR, 1.62; 95% CI, 1.14 to 2.29), and normal→ISH (OR, 1.39; 95% CI, 1.05 to 1.85). AWCO was associated with normal→stage 1 (OR, 1.75; 95% CI, 1.40 to 2.19), maintained stage 1 (OR, 2.77; 95% CI, 2.06 to 3.72), maintained stage 2 (OR, 2.80; 95% CI, 1.50 to 5.25), normal→ISH (OR, 1.56; 95% CI, 1.20 to 2.02), and normal→SDH (OR, 2.54; 95% CI, 1.72 to 3.75). An interaction effect of sex existed in the association between obesity phenotypes and hypertension stages.
CONCLUSIONS
This study highlights the importance of various obesity phenotypes and sex differences in hypertension progression. Tailored interventions for different obesity phenotypes may be warranted in hypertension management, taking into account sex-specific differences to improve outcomes.
Summary
Key Message
This study elucidates the distinct associations between obesity phenotypes and various hypertension stages and phenotypes. Furthermore, it reveals significant sex differences in the risk for hypertension stages, phenotypes, and transitions, providing essential insights for targeted interventions and personalized medicine.
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
  • 4,169 View
  • 224 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
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  
  • 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
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
  • 3,322 View
  • 66 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract 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

Citations to this article as recorded by  
  • 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
The relationship between poor sleep quality measured by the Pittsburgh Sleep Quality Index and smoking status according to sex and age: an analysis of the 2018 Korean Community Health Survey
Jun Hyun Hwang, Soon-Woo Park
Epidemiol Health. 2022;44:e2022022.   Published online February 14, 2022
DOI: https://doi.org/10.4178/epih.e2022022
  • 10,246 View
  • 451 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Multiple studies have found that cigarette smokers are more likely to experience sleep disturbances than non-smokers. This study aimed to examine various associations between smoking and sleep quality according to sex and age, which have yet to be sufficiently examined in prior studies.
METHODS
Data analysis was conducted using a nationally representative sample of 224,986 Korean adults who participated in the 2018 Korea Community Health Survey. Sleep quality, as the dependent variable, was measured using the Pittsburgh Sleep Quality Index (PSQI), with PSQI scores indicating either good (≤4 points) or poor (>5 points) sleep quality. Multiple logistic regression analysis was performed considering socio-demographic factors, health behaviors, comorbidities, and psychological factors as covariates.
RESULTS
The overall weighted prevalence of poor sleep quality was 39.4% (95% confidence interval, 39.1 to 39.7). In the multivariate model that excluded psychological factors, poor sleep quality positively correlated to smoking for both sexes and all age groups except for male aged ≥65 years. However, in the full model that included psychological factors, statistically significant odds ratios (approximately 1.5) for poor sleep quality according to smoking status were only observed for female under 65 years of age.
CONCLUSIONS
The relationship between poor sleep quality and smoking status differed according to sex and age. In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.
Summary
Korean summary
한국 성인의 39.4%는 수면의 질(피츠버그 수면의 질 지수(PSQI) 기준)이 낮았다. 성별 및 연령에 따라 흡연과 수면의 질 사이의 관련성은 다르게 나타났다. 구체적으로는 65세 이하의 여성에서 흡연은 수면의 질 악화와 관련성이 있었으나, 남성 또는 65세 이상 여성에서는 흡연과 수면의 질 간 유의한 관련성을 보이지 않았다.
Key Message
In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.

Citations

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  • Association between consumption of tryptophan with sleep quality in King Saud University students
    Nora Alafif
    Journal of King Saud University - Science.2024; 36(2): 103046.     CrossRef
  • The Microbiota–Gut–Brain Axis in Metabolic Syndrome and Sleep Disorders: A Systematic Review
    Adriano dos Santos, Serena Galiè
    Nutrients.2024; 16(3): 390.     CrossRef
  • The association between passive smoking and sleep quality in a Chinese hypertensive population: A cross-sectional study
    Niuniu Sun+, Yang Ni+, Yuqian Deng, Jiale Qi, Zhenjie Yu, Chang Wu, Juan He, Yibo Wu
    Tobacco Induced Diseases.2024; 22(February): 1.     CrossRef
  • Network analysis of smoking-related sleep characteristics in Chinese adults
    Yuting Xie, Peiyuan Sun, Huang Huang, Jianjun Wu, Yue Ba, Guoyu Zhou, Fangfang Yu, Daming Zhang, Yaqun Zhang, Ranran Qie, Zhuolun Hu, Kaiyong Zou, Yawei Zhang
    Annals of Medicine.2024;[Epub]     CrossRef
  • The associations between working conditions and subjective sleep quality among female migrant care workers
    I-Ming Chen, Tzu-Yun Lin, Yi-Ling Chien, Jennifer Yi-Ying Chen, Jen-Hui Chan, Shih-Cheng Liao, Po-Hsiu Kuo, Hsi-Chung Chen
    Frontiers in Public Health.2023;[Epub]     CrossRef
Prevalence of sexual experience among Korean adolescent: age-period-cohort analysis
Yongho Jee, Gyuyoung Lee
Epidemiol Health. 2020;42:e2020008.   Published online March 3, 2020
DOI: https://doi.org/10.4178/epih.e2020008
  • 13,022 View
  • 220 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents.
METHODS
We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed.
RESULTS
The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years.
CONCLUSIONS
In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.
Summary
Korean summary
성경험 유병률은 일반적으로 남녀 공히 모든 시기에서 연령대에 따라 증가했다. 공통적으로 최근 연도에서 12-13세 연령군의 성 경험 유병률이 증가한 반면 16-17세 연령군에서 성경험 유병률이 감소했다. 전반적으로 2006 년부터 2017 년까지 청소년들의 성경험률은 소폭 감소했지만, 조기 성경험의 빈도는 증가하고 있다. 따라서 피임이나 순결 교육뿐만 아니라 성적자기결정능력같은 보다 실질적인 성교육이 어릴 때부터 강화되어야 할 것으로 보인다.

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  • Human Papillomavirus (HPV) Vaccination Intent among Mothers of Adolescent Sons: A National Survey on HPV Knowledge, Attitudes and Beliefs in South Korea
    Jihye Choi, Seyoung Kim, Seung-Ju Lee, Sangrak Bae, Sooyoun Kim
    The World Journal of Men's Health.2023; 41(2): 413.     CrossRef
  • Association Between School Bullying Victimization and Sexual Risk-Taking among South Korean Adolescents: The Role of Teacher and Parental Relationships
    Jihoon Kim, Yeungjeom Lee, Lindsay Leban, Wesley G. Jennings
    Archives of Sexual Behavior.2023; 52(7): 2811.     CrossRef
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    Zhengyue Jing, Jie Li, Yi Wang, Chengchao Zhou
    JMIR Public Health and Surveillance.2023; 9: e45236.     CrossRef
  • Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women
    Jhosuny Perez-Fernandez, Diego O. Arroyo-Velasco, Mariella R. Huaman, Sarai G. Chavez-Bustamante, Anita P. Llamo-Vilcherrez, Carolina J. Delgado-Flores, Carlos J. Toro-Huamanchumo
    Frontiers in Public Health.2023;[Epub]     CrossRef
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    Yuhang Fang, Yujia Zheng, Yan Jin, Chunyan Yu, Xiayun Zuo, Qiguo Lian, Chaohua Lou, Lihe Li, Ping Hong, Xiaowen Tu
    Children.2022; 9(8): 1206.     CrossRef
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    Ka Young Kim, Hye Young Shin
    BMJ Open.2022; 12(11): e066307.     CrossRef
Cohort Profile
Korea HIV/AIDS Cohort Study: study design and baseline characteristics
Bo Youl Choi, Jun Yong Choi, Sang Hoon Han, Sang Il Kim, Mee-Kyung Kee, Min Ja Kim, Shin-Woo Kim, Sung Soon Kim, Yu-Mi Kim, Nam Su Ku, Jin-Soo Lee, Joo-Shil Lee, Yunsu Choi, Kyong Sil Park, Joon Young Song, Jun Hee Woo, Moon Won Kang, June Kim
Epidemiol Health. 2018;40:e2018023.   Published online June 6, 2018
DOI: https://doi.org/10.4178/epih.e2018023
  • 16,266 View
  • 368 Download
  • 15 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.
Summary
Korean summary
세계적으로 HIV 감염인은 감소하고 있으나, 한국의 HIV 감염은 증가하여 2013년 이후 매년 1,000명이 넘는 신규 감염인이 보고되고 있다. HIV/AIDS 코호트 연구진은 2006년부터 HIV 감염인과 AIDS 환자를 대상으로 6개월 간격의 반복 조사를 시행하여 역학과 임상 자료를 수집하여 데이터베이스를 구축하고, 생물검체를 채취하여 인체자원은행에 보관하여, HIV/AIDS의 발생 기전을 구명하고, 자연사를 파악하며, 예방과 진단, 치료, 관리 방법을 개발하기 위한 기초와 임상, 역학 연구에 활용하고 있다.

Citations

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  • Smoothed quantile residual life regression analysis with application to the Korea HIV/AIDS cohort study
    Soo Min Kim, Yunsu Choi, Sangwook Kang, Korea HIV/AIDS cohort study
    BMC Medical Research Methodology.2024;[Epub]     CrossRef
  • Rate of and Risk Factors for Loss to Follow Up in HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study
    Hye Seong, Yunsu Choi, Minjeong Kim, Jung Ho Kim, Joon Young Song, Shin-Woo Kim, Sang Il Kim, Youn Jeong Kim, Dae Won Park, Boyoung Park, Bo Youl Choi, Jun-Yong Choi
    Infection & Chemotherapy.2023; 55(1): 69.     CrossRef
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    Yunsu Choi, Bo Youl Choi, Sang Il Kim, Jungsoon Choi, Jieun Kim, Bo Young Park, Soo Min Kim, Shin-Woo Kim, Jun Yong Choi, Joon Young Song, Youn Jeong Kim, Hyo Youl Kim, Jin-Soo Lee, Jung Ho Kim, Yoon Hee Jun, Myungsun Lee, Jaehyun Seong
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    Kyungmin Kim, Seoyoung Jang, Hyo-Deog Rim, Shin-Woo Kim, Hyun-ha Chang, Jungmin Woo
    Psychiatry Investigation.2023; 20(5): 418.     CrossRef
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    Hye Seong, Yunsu Choi, Kyoung Hwan Ahn, Jun Yong Choi, Shin-Woo Kim, Sang Il Kim, Mee-Kyung Kee, Bo Youl Choi, Boyoung Park, Hak Jun Hyun, Jin Gu Yoon, Ji Yun Noh, Hee Jin Cheong, Woo Joo Kim, Joon Young Song
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    Kyung Sun Oh, Jin-soo Lee, Euna Han
    Korean Journal of Clinical Pharmacy.2023; 33(4): 254.     CrossRef
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    Kyung Sun Oh, Gi Hyeon Seo, Hee Kyoung Choi, Euna Han
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Original Articles
Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery
Hyemin Lee, Jooyoung Park, Bokyoung Choi, Horim Yi, Seung-Sup Kim
Epidemiol Health. 2018;40:e2018005.   Published online February 27, 2018
DOI: https://doi.org/10.4178/epih.e2018005
  • 29,879 View
  • 441 Download
  • 30 Web of Science
  • 31 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Transgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.
METHODS
In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.
RESULTS
Of transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.
CONCLUSIONS
Our findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.
Summary
Korean summary
- 본 연구는 한국 성인 트랜스젠더의 정신과진단, 호르몬요법, 성전환수술의 경험과 그 과정에서 마주하는 장벽에 대해 파악하고자 했다. 전체 트랜스젠더 중 성주체성장애 진단을 받은 참여자는 91.0%(N=253/278), 호르몬요법을 현재 받고 있거나 과거에 받은 경험이 있는 참여자는 88.0%(N=243/276), 한 가지 종류 이상 성전환수술을 받은 참여자는 42.4%(N=115/271)였다. 트랜스젠더가 의료적 트랜지션 과정에서 경험하는 가장 큰 장벽으로는 의료적 조치에 소요되는 비용인 것으로 밝혀졌다.

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Decomposing economic disparities in risky sexual behaviors among people who inject drugs in Tehran: Blinder-Oaxaca decomposition analysis
Mehdi Noroozi, Hamid Sharifi, Alireza Noroozi, Fatemah Rezaei, Mohammad Rafi Bazrafshan, Bahram Armoon
Epidemiol Health. 2017;39:e2017049.   Published online November 5, 2017
DOI: https://doi.org/10.4178/epih.e2017049
  • 11,858 View
  • 241 Download
  • 1 Web of Science
AbstractAbstract PDF
Abstract
OBJECTIVES
To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.
METHODS
Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.
RESULTS
Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.
CONCLUSIONS
Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Summary
Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I
Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim
Epidemiol Health. 2017;39:e2017046.   Published online October 19, 2017
DOI: https://doi.org/10.4178/epih.e2017046
  • 52,063 View
  • 365 Download
  • 19 Web of Science
  • 18 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities.
METHODS
The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women).
RESULTS
Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men.
CONCLUSIONS
The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Summary
Korean summary
본 연구는 만 19세 이상의 한국 성인 동성애자와 양성애자를 대상으로 이들의 건강상태에 대한 설문조사를 시행하고, 수집한 자료를 분석하여 동성애자·양성애자의 건강불평등 실태를 파악하고자 하였다. 본 연구의 목적은 자가평가건강, 정신건강(우울, 자살생각 및 자살시도), 신체적 건강(근골격계 통증) 및 건강관련행동(흡연율, 위험음주율)을 포함하여 다양한 측면에서 한국 성인 동성애자·양성애자와 일반인구집단의 건강수준을 비교하는 것이다.

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Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study
Fatemeh Khosravi Shadmani, Erfan Ayubi, Salman Khazaei, Mohadeseh Sani, Shiva Mansouri Hanis, Somayeh Khazaei, Mokhtar Soheylizad, Kamyar Mansori
Epidemiol Health. 2017;39:e2017020.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017020
  • 15,866 View
  • 280 Download
  • 27 Web of Science
  • 25 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran.
METHODS
This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province.
RESULTS
We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC.
CONCLUSIONS
Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.
Summary

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Brief Communication
Incidence and mortality rates of colorectal cancer in Malaysia
Muhammad Radzi Abu Hassan, Ibtisam Ismail, Mohd Azri Mohd Suan, Faizah Ahmad, Wan Khamizar Wan Khazim, Zabedah Othman, Rosaida Mat Said, Wei Leong Tan, Siti Rahmah @ Noor Syahireen Mohammed, Shahrul Aiman Soelar, Nik Raihan Nik Mustapha
Epidemiol Health. 2016;38:e2016007.   Published online March 9, 2016
DOI: https://doi.org/10.4178/epih.e2016007
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AbstractAbstract PDF
Abstract
OBJECTIVES
This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity.
METHODS
The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution.
RESULTS
The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05).
CONCLUSIONS
CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.
Summary

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Original Articles
Condom Use and Prevalence of Genital Chlamydia trachomatis Among the Korean Female Sex Workers
Joongyub Lee, Sun-Young Jung, Dong Seok Kwon, Minsoo Jung, Byung-Joo Park
Epidemiol Health. 2010;32:e2010008.   Published online August 13, 2010
DOI: https://doi.org/10.4178/epih/e2010008
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Since 2004, availability of resources for preventing sexually transmitted diseases in Korean female sex workers (FSWs) has decreased because of strict application of a law against prostitution. This study is to evaluate the condom use and prevalence of <italic>Chlamydia trachomatis</italic> among FSWs in Korea.</p></sec><sec><title>METHODS</title><p>We performed a cross-sectional study of FSWs from 15 major sex work sites in Korea from June to November 2008, using convenience sampling. Self-administered questionnaires and urine samples were collected after all participants' written informed consent. Urine samples were analyzed with PCR at a single central laboratory.</p></sec><sec><title>RESULTS</title><p>Among 1,086 FSWs who consented to study participation, data from 999 FSWs were appropriate for analysis. <italic>C. trachomatis</italic> prevalence was 12.8% (95% CI: 10.7-14.9%). Younger age increased risk for <italic>C. trachomatis</italic>. Whereas majority of FSWs (71.0%) answered high self confidence in condom negotiation, the proportion of FSWs who always used condoms last month was only 23.7%. However, practicing regular condom use showed significant protection against chlamydia infection, not self confidence in condom negotiation.</p></sec><sec><title>CONCLUSION</title><p>In Korea, FSWs were not practicing enough self-protection at work with a high prevalence of <italic>C. trachomatis</italic>. Education for constant practice of protection against sexually transmitted diseases is needed, especially for younger FSWs.</p></sec>
Summary

Citations

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Relationship among risk factors related to Human Papillomavirus infection among youth.
Jin Kyoung Oh, Young Hee Ju, Dong Young Yoon, Kap Yeol Jung, Se Il Jung, Hai Rim Shin
Korean J Epidemiol. 2005;27(1):118-128.
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AbstractAbstract PDF
Abstract
PURPOSE
To investigate the prevalence and related risk factors of infection with human papillomavirus(HPV) in young adults, and the interrelationships among the risk factors, school-based survey was conducted in Busan.
METHODS
A total of 1,430 male and female students(aged 16~25) participated in the survey that included self-administered questionnaire and, for males, physician-performed collection of exfoliated genital cells, for females, self-collection of vaginal cells. The prevalences of 25 HPV types were evaluated by a polymerase chain reaction-based assay.
RESULTS
HPV DNA detected more frequently in female students(15.2%) than in male students(8.7%). In female students, currently smoking cigarettes(OR=3.8, 95% CI=1.7~8.3) and having had penetrative sexual intercourse(OR=12.7, 95% CI=7.2~22.2) were the significant risk factors for HPV infection; in male students, there was nothing to show statistical significance. Smoking rate was 53.8% in males and 17.7% in females, and 55.6% of male students and 25.9% of female students reported having had a sexual intercourse. Smokers were more likely to have had a sexual intercourse than nonsmokers(OR=4.0, 95% CI=2.5~6.2, males; OR=9.1, 95% CI=5.6~14.7, females).
CONCLUSIONS
According to the strong interrelationship between sexual intercourse and smoking, multilateral behavioral intervention is needed to prevent infection with HPV.
Summary
Review
Is Breast Cancer Incidence Rate Further Increasing in Korea?.
Keun Young Yoo, Hai Rin Shin, Sue Kyung Park, Ha Chung Yoon, Ae Sun Shin, Dae Hee Kang, Dong Young Noh, Kuk Jin Choe
Korean J Epidemiol. 2001;23(2):1-7.
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AbstractAbstract
Abstract
Breast cancer ranks second to stomach cancer as a primary cancer site. An increasing trend in mortality and morbidity of breast cancet has been shown since 1980s. Studies on migrant populations, in which higher incidences were shown than population in their motherlands, indicated the importance of environmental factors on breast cancer development. Older age, family history of breast cancer, early menarche, late menopause, late full-term pregnancy, never-having had a breast-fed child, and postmenopausal obesity were idenrified as risk factors in Korea. These are not different from risk factors detected in western countries. Nevertheless, a ^-shape age-specific incidences surve is shown in Korea shose incidence is relatively low. In western countries, where incidence rates are high, the incidences increase with age in a straight line. This difference may be explained by the "Estrogen-Augmented-:rogesterone Hypothesis" that is relevant to sex hormones. In fact, a nuch lower estradiol levels was reported in Korean women compared to those in American. On the other hand, genetic polymorphism is expected for future research on breast cancer etiology. Only preventive strategies based on epidemiology of breast cancer in Korea may effective to counter this malignancy in Korean women.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.