Hyun-Young Shin

Chemerin levels are positively correlated with abdominal visceral fat accumulation

Objective  Chemerin, a recently discovered adipocytokine, may be linked to obesity and obesity‐associated metabolic complications. However, the relationship between visceral fat accumulation and chemerin is still unknown. Therefore, we investigated the relationship between serum chemerin levels and body composition as measured by computed tomography (CT).

Association between fasting serum glucose levels and incidence of colorectal cancer in Korean men: the Korean Cancer Prevention Study-II.

INTRODUCTION The incidence of colorectal cancer (CRC) is steadily increasing worldwide. Numerous studies have demonstrated that diabetes mellitus is related to an increased risk of CRC; however, the association between impaired fasting glucose and CRC is unclear. Therefore, we evaluated the correlation between fasting serum glucose (FSG) levels and the incidence of CRC, which can be used to develop novel methods for preventing CRC. METHODS A total of 175,677 individuals from the Korean Metabolic Syndrome Research Initiative study were enrolled between 2004 and 2011. The incidence of CRC was assessed during a mean follow-up of 4.7 years. Hazard ratios (HR) for CRC according to FSG levels were calculated with the Cox proportional hazard model adjusted for age, sex, body mass index, smoking status, alcohol consumption, and regular exercise. RESULTS The risk of developing CRC in subjects with high FSG was significant (HR, 1.45; 95% confidence interval [CI], 1.10-1.90), and the risk was higher in men (HR, 1.51; 95% CI, 1.12-2.05). The HR of rectal cancer, but not colon cancer, was significantly higher both in the total population and in men in the high FSG group. CONCLUSIONS The incidence of CRC positively correlated with FSG levels in men. Rectal cancer incidence was especially correlated with high FSG in the site-specific analysis. Therefore, serum glucose levels maybe a potential marker of colorectal cancer. Early detection and intervention for controlling elevated glucose levels may be indicated as a way to prevent carcinogenesis.

Recent trends in the prevalence of underweight, overweight, and obesity in Korean adults: The Korean National Health and Nutrition Examination Survey from 1998 to 2014

Background Recent obesity studies have reported that the rising trend in obesity has stabilized or leveled off. Our study aimed to update estimates of the recent prevalence trend in obesity based on the Korean National Health and Nutrition Examination Survey 1998–2014. Methods A total of 66,663 subjects were included and defined as being either underweight, overweight, or obese, in accordance with a BMI of 18.5 kg/m2 or lower, 23 kg/m2 or higher, and 25 kg/m2 or higher, respectively. Results The prevalence of underweight in KNHANES I through VI surveys was 5.4%, 6.1%, 5.8%, 6.5%, 7.6%, and 7.5%, respectively, in men (p for trend = 0.04, β = 0.003) and 4.7%, 3.3%, 3.4%, 3.3%, 2.7%, and 2.6%, respectively, in women (p for trend = 0.03, β = −0.002). Also for KNHANES I through VI, the respective prevalence of overweight/obesity was 50.3%, 57.2%, 62.5%, 62.3%, 61.4%, and 61.3% in men (p for trend<0.01, β = 0.009) and 48.3%, 50.3%, 50.0%, 47.8%, 47.0%, and 45.3% in women (p for trend<0.01, β = −0.01), respectively. Conclusions The obesity occurrence in men was trending upward with respect to overweight/obesity and for grade 1 and 2 obesity, but not for abdominal obesity. However, the obesity trends in women were leveling off from overweight/obesity, grade 1 obesity, and abdominal obesity measures. Further studies are required with data on muscle mass and adiposity for effective obesity control policies.

Association between Sarcopenic Obesity and Bone Mineral Density in Middle-Aged and Elderly Korean.

Objectives: To identify the prevalence of osteosarcopenic obesity and to evaluate the association between sarcopenic obesity and bone mineral density in middle-aged and elderly Korean. Methods: This study included 3,385 males and 4,064 females (age ≥50 years and in the stage of menopause) who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011. The cutoff value for sarcopenia was 7.26 kg/m2 for men and 5.45 kg/m2 for female. The fat mass was >30% for men and 40% for female; these values were used to define obesity. Based on the combination of sarcopenia and obesity status, all subjects were classified as sarcopenic obese (SO), sarcopenic nonobese (SNO), nonsarcopenic obese (NSO), or nonsarcopenic nonobese. Results: The incidence rates of sarcopenia, sarcopenic obesity, and osteosarcopenic obesity were 31.5, 5.1, and 4.1%, respectively. Following adjustment, the ORs for osteoporosis were 8.67 in the SO group (95% CI 4.19-17.94), 3.85 in the SNO group (95% CI 2.61-5.67), and 1.88 in the NSO group (95% CI 0.72-4.91) in men and 2.93 in the SO group (95% CI 1.99-4.32), 1.71 in the SNO group (95% CI 1.31-2.23), and 0.58 in the NSO group (95% CI 0.43-0.78) in women. Conclusions: Sarcopenic obesity is associated with the development of osteoporosis among the middle-aged and elderly Korean population.

Adiponectin in Women with Polycystic Ovary Syndrome

Background Though adiponectin has been associated with insulin resistance and cardiovascular risk factors, the relationship between adiponectin and polycystic ovary syndrome (PCOS) remains controversial. The aim of this study was to compare adiponectin level in women with PCOS and without PCOS, and to investigate the relationship between adiponectin level and metabolic variables including insulin resistance. Methods 60 women with PCOS were enrolled along with a control group of 80 healthy women, matched for age and body mass index (BMI). We measured hormonal and metabolic parameters, as well as the plasma adiponectin concentration of each participant. We estimated the insulin sensitivity according to the quantitative insulin sensitivity check index (QUICKI). Results The PCOS group displayed significantly lower level of adiponectin (P < 0.001) after adjustment for age, BMI, mean blood pressure, fasting glucose, fasting insulin, and several metabolic parameters. Adiponectin levels were positively correlated with QUICKI in the PCOS group (P < 0.001) and the control group (P = 0.03). Following step-wise multiple regression analysis, however, adiponectin level was positively correlated with QUICKI in the control group only (P = 0.03). In addition, adiponectin level was found to be independently associated with HDL-cholesterol level (P < 0.001) and BMI (P = 0.02) in the PCOS group and independently associated with HDL-cholesterol (P = 0.02) in the control group. Conclusion We report decreased adiponectin level in PCOS patients in relation to controls independently of insulin resistance or other metabolic factors. And adiponectin is associated with both lipid metabolism and obesity, which, in turn, is related to insulin resistance in PCOS. Further studies are needed to clarify the mechanism of adiponectin in PCOS.

Mental Health of the People with Hearing Impairment in Korea: A Population-Based Cross-Sectional Study

Background The prevalence of hearing impairment is increasing and an association between hearing impairment and mental health has been reported. Our study aimed to determine the association between hearing impairment and mental health in Korea. Methods This was a cross-sectional study of data from the Korean National Health and Nutrition Examination Survey 2010–2013, with a sample size of 18,563 individuals (6,395 with hearing impairment and 12,168 without hearing impairment), aged ≥20 years. Results The female group with hearing impairment tended to have a higher rate of stress (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.11 to 1.56). The association between hearing impairment and depressive symptoms was higher in elderly males (OR, 1.60; 95% CI, 1.10 to 2.32), while the association of hearing impairment with suicide ideation was higher in elderly females (OR, 1.32; 95% CI, 1.00 to 1.75). Conclusion Elderly individuals with hearing impairment are easily susceptible to poor mental health status. Early targeted intervention to address mental health problems is recommended for people with hearing impairment.

Mental Health and Its Associated Factors Among North Korean Defectors Living in South Korea A Case-Control Study

This study aimed to compare current mental health status between North Korean defectors and South Korean natives. The proportions of depression/anxiety and the experience of suicidal ideation from 593 North Korean defectors were compared with South Koreans (n = 2372). Logistic regression analyses were conducted to determine the associated variables. As a result, the rates of depression/anxiety and suicidal ideation were significantly higher among North Korean defectors. North Koreans also had more than twice the number of escape attempts associated with high rates of depression/anxiety, and being female and single, longer durations of stay abroad, more than twice the number of escape attempts, and longer durations after entrance to South Korea were related to high rates of suicidal ideation. From these results, additional efforts are needed to identify the North Korean defectors who are at high risk for poor mental health and to provide appropriate medical services and social support.

The Association between Socioeconomic Status and Adherence to Health Check-up in Korean Adults, Based on the 2010–2012 Korean National Health and Nutrition Examination Survey

Background We investigated the association between socioeconomic status and adherence to health check-ups in a Korean population aged 40 years or older. Methods This cross-sectional study included 12,311 participants who participated in the 2010–2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess each participants socioeconomic status (household income, occupation, and education) and adherence to health check-ups. Results Men with a higher income (highest vs. lowest: odds ratio [OR], 1.799; 95% confidence interval [CI], 1.296–2.497) and men with a higher education level (≥12 vs. <6 years: OR, 1.488; 95% CI, 1.078–2.054) and office workers compared with manual workers (men: OR, 1.431; 95% CI, 1.077–1.902; women: OR, 1.783; 95% CI, 1.256–2.532) appeared to undergo more health check-ups. In particular, men and women with a higher income and education appeared more likely to undergo opportunistic health check-ups (men: highest vs. lowest income: OR, 2.380; 95% CI, 1.218–4.653; ≥12 vs. <6 years education: OR, 2.121; 95% CI, 1.142–3.936; women: highest vs. lowest income: OR, 4.042; 95% CI, 2.239–7.297; ≥12 vs. <6 years education: OR, 2.475; 95% CI, 1.283–4.775). Conclusion A higher socioeconomic status was associated with a higher rate of participation in health check-ups. More efforts are needed to identify the factors associated with disparity in adherence to health check-ups.

How to write a death certificate: from a statistical point of view

사망신고 시 사망진단서 또는 시체검안서를 첨부한 비율 은 우리나라의 경우 2016년 기준 99.5%로 2000년 69.1% 에 비해 많이 개선되었지만[1], 세계보건기구의 질병부담연 구(Global Burden of Disease)에 따르면 우리나라의 사망원 인이 잘 진단된 비율은 80.9%로 경제협력개발기구 35개 회 원국 중 29위이다(Figure 1) [2]. 이렇듯 국제사회에서 우리 나라의 사망원인통계와 암통계 등 의무기록에 대한 부분이 저평가되고 있는 실정에서, 이를 보완하기 위해 통계청에서 는 건강보험수진기록, 국가 암등록 자료 등 22가지 행정자료 를 연계하여 최종 원사인을 선정하고 있다. 그럼에도 불구하 고 19.1%가 불명확한 사망원인으로 집계되고 있는 것은 올 바른 사망진단서의 작성을 위해 지속적인 노력이 필요하다 는 것을 의미한다. 우리나라에서 사망진단서는 사망신고, 사체의 화장처리, 보험 증빙, 각종 사망 증빙용으로 사용되며, 사용목적에 따 라 사망한 사실의 증빙과 사망원인을 증빙하는 문서의 성격 사망진단서 작성요령: 통계학적 관점에서

Recent Trends in Blood Pressure According to Economic Status: Korean National Health and Nutrition Examination Survey From 2005 to 2015

Our study assessed recent blood pressure (BP) trends according to economic status based on data from 2005 to 2015. In total, 56 873 participants were included and were defined as low, middle-low, middle-high, and high according to their house income quartile. In men, the mean systolic BP (P < .001, β = −1.95; P = .01, β = −0.61; P = .35, β = −0.19; and P = .04, β = −0.47, from the low to the high group, respectively) and diastolic BP were decreased significantly in all groups (P < .001, β = −2.18; P < .001, β = −0.77; P = .02, β = −0.40; and P < .001, β = −0.69, from the low to the high group, respectively). In women, the decreasing trends in systolic BP and diastolic BP were statistically significant except in the high-income group. In addition, the percentages of less-than-normotensive and less-than-hypertensive BP in both sexes and the control rate of hypertension on antihypertensive medications increased in all groups. Decreasing BP trends were observed in the recent decade and the gap in health inequities has been decreased, particularly in men in Korea.