Na Hyun Kim

Spatial epidemiology of dry eye disease: findings from South Korea

BackgroundDED rate maps from diverse regions may allow us to understand world-wide spreading pattern of the disease. Only few studies compared the prevalence of DED between geographical regions in non-spatial context. Therefore, we examined the spatial epidemiological pattern of DED prevalence in South Korea using a nationally representative sample.MethodsWe analyzed 16,431 Korean adults aged 30xa0years or older of the 5th Korea National Health and Nutrition Examination Survey. DED was defined as previously diagnosed by an ophthalmologist as well as symptoms experienced. Multiple logistic regression analysis was used to assess the spatial pattern in the prevalence of DED, and effects of environmental factors.ResultsAmong seven metropolitan cities and nine provinces, three metropolitan cities located in the southeast of Korea revealed the highest prevalence of DED. After adjusting for sex, age and survey year, people living in urban areas had higher risk of having DED. Adjusted odds ratio for having previously diagnosed DED was 1.677 (95% CI 1.299-2.166) for metropolitan cities and 1.580 (95% CI 1.215-2.055) for other cities compared to rural areas. Corresponding odds ratio for presenting DED symptoms was 1.388 (95% CI 1.090-1.766) for metropolitan cities and 1.271 (95% CI 0.999-1.617) for other cities. Lower humidity and longer sunshine duration were significantly associated with DED. Among air pollutants, SO2 was associated with DED, while NO2, O3, CO, and PM10 were not.ConclusionOur findings suggest that prevalence of DED can be affected by the degree of urbanization and environmental factors such as humidity and sunshine duration.

Association between environmental tobacco smoke and depression among Korean women

Objective To evaluate the association between environmental tobacco smoke (ETS) exposure and depression among Korean women. Methods Between 2008 and 2011, we examined 731 men and 1249 women (aged 39–85u2005years) for the Korean Genome and Epidemiology Study (KoGES)-Kangwha. Among 1208 never-smoking women, we excluded two women taking antidepressants and five women who did not complete the Beck Depression Inventory (BDI). Therefore, we performed a cross-sectional analysis on 1201 women. ETS exposure was assessed using a self-reported questionnaire, and was classified into three groups: no exposure, occasional exposure and regular exposure. Depression was assessed using the BDI score, which ranged from 0 to 63, and the presence of depression was defined as a BDI score ≥10. Results Women exposed to ETS were more likely to have depression than those without ETS exposure (p=0.019). When BDI was analysed as a continuous variable, women exposed to ETS had significantly higher BDI scores after full adjustment (overall exposure: β=1.36, p=0.013; occasional exposure: β=1.15, p=0.063; regular exposure: β=1.90, p=0.039). ETS exposure was significantly associated with depression in a dose–response manner even after adjusting for age, body mass index, menopause, socioeconomic status, lifestyle and prevalent chronic diseases. The adjusted OR for depression (95% CI) was 1.72 (1.25 to 2.37) for overall ETS exposure, 1.56 (1.09 to 2.24) for occasional exposure and 2.19 (1.30 to 3.69) for regular exposure, when compared to no exposure. Conclusions Exposure to ETS was associated with depression among middle aged and elderly Korean women.

Secondhand Smoke Exposure and Depressive Symptoms among Korean Adolescents: JS High School Study

Introduction Increasing evidence suggests that secondhand smoke exposure (SHSE) may affect not only physical health, but also mental health. Therefore, we evaluated the association between SHSE and depressive symptoms among Korean adolescents. Methods The JS High School Study enrolled 1071 high school freshmen from a rural community of South Korea. The current analysis was limited to 989 adolescents (495 male and 494 female adolescents), after excluding 48 ever-smokers, 3 students with physician-diagnosed depression, and 31 students who did not complete the depression questionnaire. SHSE was assessed using a self-reported questionnaire and was classified into three groups: none, occasional exposure, and regular exposure. Depressive symptoms were assessed according to the Beck Depression Inventory (BDI) score, ranging from 0 to 63, and the presence of depressive symptoms was defined as a BDI score ≥10. Results Overall, adolescents with SHSE were more likely to have depressive symptoms than those without SHSE (p = 0.042).In a sex-specific analysis treating the BDI score as a continuous variable, regular SHSE was independently associated with higher BDI scores in male adolescents (β = 2.25, p = 0.026), but not in female adolescents (β = 1.11, p = 0.253). Compared to no SHSE, the odds ratio for having depressive symptoms among male adolescents with regular SHSE was 2.17 (95% confidence interval, 1.11 to 4.25) after adjusting for age, body mass index, and study year, and 3.65 (95% confidence interval, 1.52 to 8.73) after adjusting for age, body mass index, study year, exercise, and household income. Conclusion Regular exposure to secondhand smoke was associated with having depressive symptoms among Korean male adolescents.

Active and Passive Smoking and Serum Total Bilirubin in a Rural Korean Population.

INTRODUCTIONnSerum bilirubin is an endogenous antioxidant biomarker and its low level is a potential risk factor for smoking related health disorders. This study investigated the association of cigarette smoke with serum total bilirubin among Koreans.nnnMETHODSnBetween 2006 and 2011, we examined 4899 Korean adults living in a rural community. After excluding 38 participants with serum bilirubin more than 2mg/dL, 75 participants who did not report their smoking status or who had liver or bile duct disorders, and 711 participants with liver enzymes exceeding the upper reference values, we performed a cross-sectional analysis on 4075 participants. Participants were classified into four groups: never-smokers without secondhand smoke exposure (SHSE), never-smokers with SHSE, former smokers, and active smokers. Serum total bilirubin concentration was measured using the enzyme method.nnnRESULTSnCompared to never-smokers without SHSE, never-smokers with SHSE (β = -0.025 mg/dL), former smokers (β = -0.049 mg/dL), and active smokers (β = -0.149 mg/dL) had significantly lower serum bilirubin even after adjusting for demographic factors, study year, alanine aminotransferase, gamma-glutamyl transferase, hemoglobin, lifestyle factors, and chronic diseases. A sex-stratified analysis indicated that for men, former smokers and active smokers were significantly associated with having lower bilirubin when compared to never-smokers without SHSE. However, for women, never-smokers with SHSE and active smokers were significantly associated with having lower bilirubin when compared to never-smokers without SHSE.nnnCONCLUSIONnOur findings suggest that both active and passive cigarette smoking are associated with low serum bilirubin among Korean adults.nnnIMPLICATIONSnOur results suggest that not only active smoking but also passive smoking including SHSE can have an influence on decreasing serum bilirubin levels. With this different point of view, our study supports efforts to create smoke-free environments in order to foster more favorable serum bilirubin profiles, which may improve endothelial function and reduce the risk of cardiovascular disease.

Secondhand smoke exposure and mental health problems in Korean adults

OBJECTIVES: To evaluate the association between secondhand smoke exposure (SHSE) and mental health problems among Korean adults. METHODS: We analyzed data from the 2011 Korean Community Health Survey. From the total of 229,226 participants aged 19 years or above, we excluded 48,679 current smokers, 36,612 former smokers, 3,036 participants with a history of stroke, 2,264 participants with a history of myocardial infarction, 14,115 participants who experienced at least one day in bed per month due to disability, and 855 participants for whom information regarding SHSE or mental health problems was not available. The final analysis was performed with 22,818 men and 100,847 women. Participants were classified into four groups according to the duration of SHSE: none, <1 hr/d, 1-<3 hr/d, and ≥3 hr/d. The presence of depressive symptoms, diagnosed depression, and high stress were measured by questionnaire. RESULTS: After adjusting for demographic factors, lifestyle, and chronic disease, the odds ratio (OR) and 95% confidence interval (CI) of depressive symptoms with 1-<3 hr/d and ≥3 hr/d SHSE were 1.44 (95% CI, 1.14 to 1.82) and 1.59 (95% CI, 1.46 to 1.74), respectively. However, SHSE ≥3 hr/d had a higher OR of 1.37 (95% CI, 1.20 to 1.58) for diagnosed depression. SHSE was also associated with high stress (1-<3 hr/d: OR, 1.56; 95% CI, 1.38 to 1.76; ≥3 hr/d: OR, 1.33 95% CI, 1.28 to 1.40). However, the association between SHSE and symptoms of depression and stress did not differ significantly by region. CONCLUSIONS: SHSE may be associated with mental health problems such as depression and stress in Korean adults.

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: <13.3u200ag/dL; women: <11.6u200ag/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 ≥140u200amm Hg, diastolic blood pressure ≥90u200amm 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 (1.2u200ag/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.

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.

PS 06-15 HEMOGLOBIN CONCENTRATIONS AND HYPERTENSION INCIDENCE: A POPULATION-BASED COHORT STUDY

Objective: To investigate cross-sectional and longitudinal associations between serum hemoglobin concentration and hypertension in a Korea population. Design and Method: Between 2006 and 2013, we examined 4899 participants with mean age 56.6 (27–88 years) from a rural community. We excluded 298 participants with a history of myocardial infarction or stroke and 390 participants with very low hemoglobin levels (men <13.3u200ag/dl and women <11.6u200ag/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/or those who did not participate in follow-up examinations. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or use of antihypertensive treatment. Results: Mean hemoglobin level was significantly higher in people with hypertension than in those without hypertension (pu200a=u200a0.002 for men, pu200a=u200a0.006 for women). In cross-sectional analysis, the odds ratio (95% CI) for hypertension per one standard deviation (SD) increase in hemoglobin concentration (1.2u200ag/dl) was 1.11 (1.05–1.18) before adjustment and 1.22 (1.11–1.34) after adjusting for age, sex, body mass index, lifestyle factors, and comorbidities. In longitudinal analysis, the relative risk (95% CI) for incident hypertension per one SD increase in hemoglobin concentration was 1.09 (0.96–1.23) before adjustment and 0.92 (0.79–1.09) after adjusting for age, sex, body mass index, lifestyle factors, baseline blood pressure, and baseline comorbidities. Conclusions: This study suggests that hemoglobin level is positively associated with high blood pressure, but not with incident hypertension Figure. No caption available.