Hyungseon Yeom

Metabolic outcomes of workers according to the International Standard Classification of Occupations in Korea

BACKGROUND Occupation influences the risk for developing chronic metabolic diseases. METHODS We compared the prevalence of MetS by International Standard Classification of Occupations using the nationally representative data in Korea (KNHANES). We enrolled 16,763 workers (9,175 males; 7,588 females) who had measurements for the National Cholesterol Education Program criteria III and other variables. OR and 95%CIs for MetS and its components were estimated according to occupation using the multiple logistic regression models. RESULTS The occupational groups with the highest age-standardized prevalence of MetS were lower skilled white-collar men (31.1 ± 2.4%) and green-collar women (24.2 ± 2.9%). Compared with the unskilled male blue-collar group, which had the lowest prevalence of MetS, the OR (95%CIs) of MetS in men were 1.77 (1.45-2.15) in higher skilled white-collar, 1.82 (1.47-2.26) in lower-skilled white-collar, 1.63 (1.32-2.01) in pink-collar and 1.37 (1.13-1.66) in skilled blue-collar workers in final logistic regression model. CONCLUSIONS MetS and its components vary by occupational category and gender in ways that may guide health interventions. Am. J. Ind. Med. 59:685-694, 2016.

Prevalence of Comorbidity among People with Hypertension: The Korea National Health and Nutrition Examination Survey 2007-2013.

Background and Objectives Joint National Committee guidelines attempt to vary treatment recommendations for patients based on considerations of their comorbidities. The aim of the present study is to estimate the age-standardized prevalence of common comorbidities among Korean hypertension patients. Subjects and Methods We analyzed the Korea National Health and Nutrition Examination Survey from 2007 to 2013. Among the 58423 participants, 30092 adults, aged ≥30 yrs who completed a health examination and interview survey, were selected. The survey procedures were used to estimate weighted prevalence and odds ratios for 8 comorbidities, including obesity, diabetes mellitus, dyslipidemia, cardiovascular disease, chronic kidney disease, and thyroid disease. Results Most chronic conditions were more prevalent in adults with hypertension than in those without hypertension. Common comorbidities were obesity (60.1%), dyslipidemia (57.6%), and impaired fasting glucose (45.1%). Hypertensive patients with two or more comorbid diseases were 42.2% and those with three or more diseases were 17.7%. The age- and sex-specific prevalence of three or more comorbid diseases among male hypertension patients was significantly higher than those patients in the 30-59 (p<0.05) age group. Conclusion Comorbidity is highly prevalent in Korean patients with hypertension.

Association between vitamin D status and asymmetric dimethylarginine (ADMA) concentration in the Korean elderly population

OBJECTIVES Vitamin D deficiency has been reported to be associated with the risk of cardiovascular disease. We investigated the relationship between vitamin D status and asymmetric dimethylarginine (ADMA) concentration, a marker of endothelial dysfunction, in the Korean elderly population. STUDY DESIGN A cross-sectional study was conducted on 269 men and 382 women (mean age, 71.6 years) enrolled in the Korean Social Life, Health, and Aging Project (KSHAP), a population-based longitudinal study of health determinants in elderly Koreans. We stratified patients by vitamin D status into three groups according to serum 25-hydroxyvitamin D [25(OH)D] level: sufficient (≥30ng/mL, n=25), insufficient (10-<30ng/mL, n=516), and deficient (<10ng/mL, n=110). To measure endothelial dysfunction, ADMA concentration was assayed by high-performance liquid chromatography. The association between 25(OH)D status and ADMA concentration was analyzed by multiple linear regression models. RESULTS The mean ADMA concentration was significantly higher in the insufficient 25(OH)D group (0.665μmol/L, p=0.001) and the deficient 25(OH)D group (0.734μmol/L, p<0.001) compared with the sufficient 25(OH)D group (0.589μmol/L). Even after adjusting for sex, age, body mass index, blood pressure, diabetes mellitus, total and HDL cholesterol, estimated glomerular filtration rate (eGFR), smoking status, and drinking status, ADMA concentrations were higher in the insufficient group (β=0.0742μmol/L, p=0.001) and the deficient group (β=0.1417μmol/L, p<0.001) compared than in the sufficient group. In a sex-stratified analysis, 25(OH)D deficiency was associated with higher ADMA levels in both women (p<0.001) and men (p=0.007), while 25(OH)D deficiency was associated with higher ADMA levels in women (p<0.001) but not in men (p=0.631). CONCLUSION Our findings suggest that low serum 25(OH)D level may be associated with endothelial dysfunction in elderly Korean people.

The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population

Objectives: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. Methods: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. Results: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). Conclusions: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database

OBJECTIVES The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea. METHODS The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database. RESULTS Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%). CONCLUSIONS The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.

Cross-sectional and longitudinal association between hemoglobin concentration and hypertension: A population-based cohort study

Abstract We investigated the cross-sectional and longitudinal associations between hemoglobin concentration and hypertension in a Korean population. Between 2006 and 2013, we examined 4899 participants with mean age of 56.6 years (range 35–88 years) from a rural community. We excluded 298 participants with a history of myocardial infarction or stroke and 264 participants with very low hemoglobin levels (men: <13.3 g/dL; women: <11.6 g/dL). Finally, we performed a cross-sectional analysis on 1629 men and 2708 women. Longitudinal associations were evaluated in 654 men and 1099 women, after excluding 2584 people with hypertension at baseline and those who did not participate in follow-up examinations. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive treatment. The mean hemoglobin level was significantly higher in people with hypertension than in those without hypertension (P = 0.002 for men, P = 0.006 for women). On cross-sectional analysis, the odds ratio (95% confidence interval) for hypertension per 1 standard deviation increase in hemoglobin concentration (1.2 g/dL) was 1.11 (1.05–1.18) before adjustment and 1.20 (1.09–1.32) after adjusting for age, sex, body mass index, kidney markers, lifestyle factors, and comorbidities. On longitudinal analysis, the relative risk (95% confidence interval) for incident hypertension per 1 standard deviation increase in hemoglobin concentration was 1.09 (0.96–1.23) before adjustment and 0.91 (0.78–1.08) after adjusting for age, sex, body mass index, lifestyle factors, baseline blood pressure, baseline comorbidities, and baseline kidney markers. This study suggests that hemoglobin per se does not cause hypertension development.

Effects of Offspring-Related Characteristics on Depressive Disorder among Cancer Patients and Survivors.

OBJECTIVE To investigate the influence of offspring-related characteristics on the prevalence of depressive disorders among cancer patients and those who survived cancer for at least 45 years. MATERIALS AND METHODS Data were obtained from the Korean Longitudinal Study of Aging (KLoSA). To investigate the association between offspring and depressive disorder among cancer patients and survivors, we analyzed data from 292 cancer patients and survivors drawn from a total subject pool of 16,613 individuals at baseline. RESULTS According to our results, the odds ratio (OR) for subjects with five or more offspring developing depressive disorder was -0.794 (p-value: 0.039, SE: 0.329) compared with that of those with two offspring. In addition, the adjusted effect of the number of male and female offspring on the presence of depressive disorder showed that the OR for those with three or more female offspring for developing depressive disorder was -0.958 lower (SE: 0.305, p-value: 0.012) than it was for those with no female offspring. CONCLUSIONS This article provides evidence for an association between offspring-related characteristics and depressive disorders among cancer patients and survivors. Therefore, offspring may be important contributors to the emotional status of cancer patients and survivors. Further study should precisely need to measure depressive disorders because of self-reported data.

Association between dry eye symptoms and suicidal ideation in a Korean adult population

Purpose This study assessed the association of dry eyes with depression and suicidal ideation in a Korean adult population. Methods Data from 16408 participants (6972 men and 9436 women) aged ≥ 19 years included in the fifth Korea National Health and Nutrition Examination Survey, conducted from 2010–2012, were analyzed. For dry eyes, surveys of previous diagnosis of dry eye disease (DED) by an ophthalmologist and experience of subjective dry eye symptoms were separately used. Diagnosis of depression and suicidal ideation were obtained via responses to an interviewer-assisted questionnaire, and questions were asked in a closed-ended response format. Logistic regression was used to examine the associations between dry eyes, depression, and suicidal ideation. Results DED diagnosis exhibited an odds ratio (OR) of 1.32 (95% confidence interval [CI] 1.11–1.57) for depression and 1.24 (95% CI 1.05–1.48) for suicidal ideation compared to those without DED, after adjusting for sex, age, education, occupation, household income, body mass index, smoking behavior, alcohol consumption, physical activity, hypertension, diabetes, dyslipidemia, thyroid diseases, major cardiovascular disease, and cancer. Similarly, the adjusted OR (95% CI) of dry eye symptoms was 1.50 (95% CI 1.30–1.73) for depression and 1.47 (95% CI 1.27–1.70) for suicidal ideation. Conclusion Our findings suggest that dry eyes (either DED diagnosis or dry eye symptoms) may be associated with the prevalence of depression and suicidal ideation in the Korean adult population.

Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease

Objectives Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI). Methods The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI. Results Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations. Conclusions The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

MPS 08-04 The association between ST interval and blood pressure in a general population of Korea

Objective: To evaluate the association of PR interval, QRS duration, and ST interval with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a general population of Korea. Design and Method: We conducted a cross-sectional analysis from the data of Cardiovascular and Metabolic diseases Etiology Research Center, an ongoing cohort of general population. Total 587 men and 1065 women were separately analyzed. PR interval, QRS duration and QT interval was obtained from electrocardiogram; ST interval was calculated by subtracting QRS duration from QT interval. Resting blood pressure was measured using an automatic sphygmomanometer. Linear regression analysis was used to obtain the estimates of each SBP and DBP with each PR interval, QRS duration, and ST interval, adjusting for age, body mass index, heart rate, triglyceride, high density lipoprotein cholesterol, smoking behavior, insulin, and diagnosis of hypertension or diabetes. Results: One beat per minute increase of resting heart rate was significantly associated with high DBP in both sexes, and low SBP in women. In men, the estimates (p value) for SBP (mmHg) with 10 millisecond increase of each PR interval, QRS duration, and ST interval was −0.013 (0.86), 0.467 (0.10), and 0.303 (0.01), respectively. The corresponding estimates (p value) was −0.045 (0.41), −0.255 (0.20), and −0.356 (<.001) for DBP (mmHg). In women, the estimates (p value) was 0.020 (0.61), 0.073 (0.37), and 0.053 (0.01) for SBP, and −0.017 (0.53), −0.053 (0.34), and −0.041 (0.004) for DBP. Conclusions: Beyond the three components of a heart rhythm, ST interval was significantly associated with high SBP and low DBP. This finding suggests that period of ventricle depolarization is associated with blood pressure. Figure. No caption available.