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Original article
Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study Prospective, Retrospective, and National Reporting System
Yunsu Choi, Jun Yong Choi, Bo Youl Choi, Bo Young Park, Shin-Woo Kim, Joon Young Song, Jung Ho Kim, Sang Il Kim
Epidemiol Health. 2024;e2024055.   Published online June 18, 2024
DOI: https://doi.org/10.4178/epih.e2024055    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with HIV in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets.
METHODS
We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403).
RESULTS
The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher percentage of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The percentage of patients with CD4 T-cell counts below 200/mm3 at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3.
CONCLUSIONS
The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed.
Summary
Cohort profile
Cohort profile: understanding health service system needs for people with intellectual disability using linked data in New South Wales, Australia
Simone Reppermund, Preeyaporn Srasuebkul, Claire M Vajdic, Sallie Pearson, Rachael E Moorin, Julian N Trollor
Epidemiol Health. 2024;e2024054.   Published online June 12, 2024
DOI: https://doi.org/10.4178/epih.e2024054    [Accepted]
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Abstract
This cohort profile describes one of the largest linked datasets in the world concerning the health of people with intellectual disability. The cohort comprises a retrospective group of 100,089 individuals with intellectual disability who received disability and/or health services in New South Wales, Australia. Of these participants, 34% were female, with a median age at cohort entry of 3 years (interquartile range, 0 to 19 years). A separate comparator cohort included 455,677 individuals, matched by 5-year age group, sex, and residential postcode at a 5:1 ratio. Initial results indicate that between 2001 and 2018, people with intellectual disability experienced more than double the rate of hospitalisations (538 versus 235 per 1000 person-years), as well as markedly higher rates of emergency department presentations (707 versus 379 per 1000 person-years) and use of ambulatory mental health services (1012 versus 157 per 1000 person-years), relative to the comparator cohort. The largest disparities in hospital admissions were for mental disorders, dialysis, and diseases of the nervous system and sense organs. Furthermore, individuals with intellectual disability had more than double the rate of dispensed medications found in the comparator cohort. Of these medications, 46.6% were for the treatment of nervous system conditions, as opposed to 24.7% for the comparator cohort. The mean age at death was 52 years (standard deviation [SD], 19 years) for people with intellectual disability and 64 years (SD, 22 years) for the comparator participants.
Summary
Original articles
Seasonal impact of diurnal temperature range on intracerebral hemorrhage in middle-aged and elderly people in central China
Shiwen Wang, Jinyu Yin, Hao Zhou, Jingmin Lai, Guizheng Xiao, Zhuoya Tong, Jing Deng, Fang Yang, Qianshan Shi, jingcheng shi
Epidemiol Health. 2024;e2024053.   Published online June 11, 2024
DOI: https://doi.org/10.4178/epih.e2024053    [Accepted]
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AbstractAbstract
Abstract
OBJECTIVES
This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults.
METHODS
We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag nonlinear model.
RESULTS
Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a nonlinear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period.
CONCLUSIONS
The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.
Summary
Inequality in dental flossing behavior among Korean adults based on household income levels
Zi-Lan Wang, Eun-Jae Choi, Seung-Hee Ryu, Seon-Jip Kim, Hyun-Jae Cho
Epidemiol Health. 2024;e2024052.   Published online May 24, 2024
DOI: https://doi.org/10.4178/epih.e2024052    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to estimate the association between household income and dental flossing.
METHODS
This cross-sectional study investigated the impact of household income on flossing among 9,391 adults aged 30+ with ≥20 natural teeth, utilizing data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018). Outcome measures included flossing (yes/no), with income categorized into 4 levels: lowest, medium to low, medium to high, and highest. Logistic regression, adjusted for age, gender, brushing frequency, recent dental exams, periodontitis, smoking, and alcohol use, was employed to evaluate the influence of socioeconomic status on oral hygiene practices.
RESULTS
In the highest income group, flossing was 62.6% more prevalent than in the lowest income group (adjusted odds ratio [aOR], 1.63; 95% CI, 1.27-2.08). The strongest association between income levels and flossing was observed in individuals aged ≥70 years (aOR, 3.64; 95% CI, 1.86-7.11), with a decreasing strength of association in the 60s (aOR, 1.72; 95% CI, 1.05-2.84) and 50s age groups (aOR, 1.69; 95% CI, 1.07-2.68). Higher-income women demonstrated a higher frequency of flossing than their lower-income counterparts (aOR, 1.67; 95% CI, 1.24-2.23). Higher-income individuals without periodontitis were more likely to floss (aOR, 1.64; 95% CI, 1.23-2.18), and among those with periodontitis, flossing was significantly associated only with the highest income category (aOR, 1.64; 95% CI, 1.10-2.44).
CONCLUSIONS
The findings of this study indicate a significant correlation between higher household income levels and an increased prevalence of flossing.
Summary
Dietary mercury intake, the IL23R rs10889677 polymorphism, and the risk of gastric cancer: a hospital-based case-control study
Ji Hyun Kim, Madhawa Gunathilake, Jeonghee Lee, Il Ju Choi, Young-Il Kim, Jeongseon Kim
Epidemiol Health. 2024;e2024051.   Published online May 21, 2024
DOI: https://doi.org/10.4178/epih.e2024051    [Accepted]
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AbstractAbstract
Abstract
OBJECTIVES
Mercury can stimulate immune responses through T helper 17 (Th17). The gene IL23R is a key factor in Th17 function, which may also contribute to digestive tract diseases. The aim of this study was to observe the associations between dietary mercury and gastric cancer (GC) and to investigate whether the IL23R rs10889677 polymorphism modifies those associations.
METHODS
This case-control study included 377 patients with GC and 756 healthy controls. Dietary mercury intake (total mercury and methylmercury) was assessed using a dietary heavy metal database incorporated into the food frequency questionnaire. IL23R genetic polymorphism rs10889677 (A>C) was genotyped. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression models with adjustments for potential confounders.
RESULTS
A higher dietary methylmercury intake was associated with an elevated risk of GC (OR for the highest versus lowest tertile [T3 vs. T1]=2.02; 95% CI, 1.41–2.91; p for trend <0.001). The IL23R rs10889677 reduced the risk of GC in individuals who carried at least 1 minor allele (OR=0.62; 95% CI, 0.46–0.83; p=0.001; AC/CC vs. AA). Individuals with a C allele exhibited a lower susceptibility to GC through methylmercury intake than those with the AA genotype (OR for the T3 of methylmercury and AA carriers=2.93; 95% CI, 1.77–4.87; and OR for the T3 of methylmercury and AC/CC genotype=1.30; 95% CI, 0.76–2.21; p-interaction=0.013).
CONCLUSIONS
Our findings suggest that a genetic polymorphism, rs10889677 in IL23R, plays a role in modifying the association between dietary methylmercury intake and the risk of GC.
Summary
Methods
Expansion of a food composition database for the food frequency questionnaire in the Korean Genome and Epidemiology Study (KoGES): a comprehensive database of dietary antioxidants and total antioxidant capacity
Jiseon Lee, Ji-Sook Kong, Hye Won Woo, Mi Kyung Kim
Epidemiol Health. 2024;e2024050.   Published online May 10, 2024
DOI: https://doi.org/10.4178/epih.e2024050    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study constructed a comprehensive database of dietary antioxidants and total antioxidant capacity (TAC) to facilitate the estimation of daily antioxidant intake using a food frequency questionnaire (FFQ). This database was applied to 3 general population-based cohorts (n=195,961) within the Korean Genome and Epidemiology Study (KoGES).
METHODS
To establish a database of 412 foods derived from recipes of a 106-item FFQ, we followed a pre-established standardized protocol. This included the selection of source databases, matching of foods, substitution of unmatched items with identical foods and input of values, and assessment of coverage. For each food, the TAC was estimated by summing the individual antioxidant capacities, calculated by multiplying the amount of each antioxidant by its vitamin C equivalent antioxidant capacity.
RESULTS
We identified 48 antioxidants across 5 classes: retinol, carotenoids, vitamins C and E, and flavonoids, with flavonoids divided into 7 subclasses. TAC values were then established. Coverage exceeded 90.0% for retinol, carotenoids, vitamin C, and vitamin E, while coverage for flavonoids was 60.9%. The daily intakes of 4 antioxidant classes—all but vitamin E—were higher in women than in men. The Ansan-Ansung cohort exhibited the highest levels of dietary TAC, vitamin E, and flavonoids, while the Health Examinees Study cohort displayed the highest values for retinol, carotenoids, and vitamin C.
CONCLUSIONS
We customized a comprehensive antioxidant database for the KoGES FFQ, achieving relatively high coverage. This expansion could support research investigating the impact of dietary antioxidants on the development of chronic diseases targeted by the KoGES.
Summary
Original article
Association of healthy lifestyle factors with the risk of hypertension, dyslipidemia, and their comorbidity in Korea: results from the Korea National Health and Nutrition Examination Survey 2019–2021
Ji-Sook Kong, Mi Kyung Kim
Epidemiol Health. 2024;e2024049.   Published online May 1, 2024
DOI: https://doi.org/10.4178/epih.e2024049    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
We investigated the association of individual healthy lifestyle factors (HLFs) and their combined healthy lifestyle score (HLS) with hypertension and/or dyslipidemia.
METHODS
We analyzed data from 10,693 adults aged ≥19 from the 2019 to 2021 Korea National Health and Nutrition Examination Survey. HLS was evaluated based on smoking status, alcohol consumption, body mass index (BMI), diet, and physical activity. Using logistic regression models, we estimated odds ratios (ORs) with 95% confidence intervals (CIs) to evaluate the associations of HLFs and HLS with hypertension, dyslipidemia, and their comorbidity.
RESULTS
The prevalence of hypertension alone, dyslipidemia alone, and their comorbidity was 8.69%, 24.6%, and 15.0%, respectively. Multivariable models showed an inverse association of hypertension (OR, 0.37; 95% CI; 0.30–0.46) and dyslipidemia (OR, 0.36; 95% CI, 0.32–0.41) with healthy BMI. Hypertension was inversely associated with healthy alcohol consumption (OR, 0.46; 95% CI, 0.35–0.61) and diet (OR, 0.79; 95% CI, 0.63–0.99), whereas dyslipidemia was inversely associated with non-smoking (OR, 0.51; 95% CI, 0.43–0.60). Physical activity was inversely associated with their comorbidity (OR, 0.69; 95% CI, 0.56–0.85). Adherence to HLS was associated with significantly lower odds of hypertension (81%), dyslipidemia (66%), and their conditions (89%) (all ptrend<0.001). Stratified analyses consistently showed inverse associations between HLS and hypertension and/or dyslipidemia independently of demographic factors (pinteractions>0.05).
CONCLUSIONS
HLFs were associated with lower risk for hypertension and/or dyslipidemia. Obesity may contribute significantly to the risk of these conditions, while relevant HLFs for individual chronic diseases may vary significantly.
Summary
Cohort profile
Korea Nurses’ Health Study and the health of reproductive-aged women: a cohort profile
Chiyoung Cha, Heeja Jung, Sue Kim, Jung Eun Lee, Kwang-Pil Ko, Eunyoung Cho, Hyun-Young Park, Joong-Yeon Lim, Bo Mi Song, Sihan Song, Soojin Park, Aram Cho
Epidemiol Health. 2024;e2024048.   Published online April 30, 2024
DOI: https://doi.org/10.4178/epih.e2024048    [Accepted]
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AbstractAbstract PDF
Abstract
The Korea Nurses’ Health Study (KNHS) is an ongoing, large-scale, prospective cohort study of female nurses, focusing on the effects of occupational, environmental, and lifestyle factors on the health of women. The first KNHS survey was performed in 2013–2014 (n=20,613). As of December 2023, 11 follow-up surveys have been conducted. Participants who were pregnant were asked to participate in the early pregnancy survey (n=2,179) and postpartum survey after giving birth (n=2,790). The main variables included sociodemographic, work-related, lifestyle, physical, mental, and women’s health factors. Blood, urine, and toenail samples were collected from a participant subgroup of the first survey (n=1,983). The subgroups of the second survey completed a food frequency questionnaire in 2019 (n=300) and 2021 (n=871). In 2020, a subgroup of the first survey answered a coronavirus disease 2019 (COVID-19)-related survey (n=975). To examine various health-related factors in young adults, new participants were added to the KNHS cohort in the 11th (n=1,000) and 12th (n=1,002) surveys. The KNHS cohort will help identify health and illness determinants in Korean women. Data can be accessed at https://coda.nih.go.kr/frt/index.do.
Summary
Systematic review
Handgrip strength thresholds associated with metabolic syndrome risk in children and adolescents: a systematic review and meta-analysis
Hye Ah Lee, Seunghee Jun, Hyesook Park
Epidemiol Health. 2024;e2024047.   Published online April 24, 2024
DOI: https://doi.org/10.4178/epih.e2024047    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
Certain studies have reported that handgrip strength (HGS) is associated with metabolic health risks in children and adolescents, and some studies have suggested HGS thresholds for identifying poor metabolic health. Therefore, we aimed to determine the HGS thresholds associated with metabolic syndrome (MetS) in children and adolescents through a systematic review.
METHODS
We searched 3 electronic databases from their inception until October 2023 to identify original papers that focused on children and adolescents and assessed their risks of MetS according to specific HGS values. Studies were selected for inclusion through a planned screening process based on specific criteria. The Quality Assessment Tool for Diagnostic Accuracy Studies v2 (QUADAS-2) was used to evaluate quality, and a meta-analysis was performed using the diagmeta R package to suggest the optimal thresholds.
RESULTS
From the search, 8 studies were selected for this systematic review. For detecting MetS risk, the optimal threshold for HGS (defined as relative HGS by adjusting for body mass) was found to be 0.422, with a sensitivity of 76.7% (95% confidence interval [CI], 64.0% to 85.8%) and a specificity of 62.9% (95% CI, 56.9% to 68.5%). The stratification analysis by sex resulted in optimal thresholds of 0.416 for boys and 0.376 for girls. Additionally, when the data were stratified by age, the thresholds were 0.356 for children and 0.416 for adolescents.
CONCLUSIONS
Our results provide practical information for detecting high-risk groups and encouraging strength-related activities that may reduce the risk of MetS in children and adolescents.
Summary
Original articles
Changes in food sufficiency among Korean adults in urban and rural areas during the COVID-19 pandemic: an analysis of the 7th and 8th Korea National Health and Nutrition Examination Survey
Sarang Jeong, Jin-Young Jeong, Sohyun Park
Epidemiol Health. 2024;e2024045.   Published online April 16, 2024
DOI: https://doi.org/10.4178/epih.e2024045    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
Understanding changes in food sufficiency within various demographic groups during emergency situations, such as the global coronavirus disease 2019 (COVID-19) pandemic, is crucial in formulating public health policies for future preparedness. This study investigated potential differences between urban and rural residents in food sufficiency trends during the COVID-19 pandemic and examined how these changes varied according to sociodemographic factors.
METHODS
This cross-sectional study analyzed data from 19,724 adults aged 20 years and older, utilizing information from the 7th–8th Korea National Health and Nutrition Examination Survey (2018–2021).
RESULTS
In urban areas, across all subpopulations, food sufficiency improved significantly during the COVID-19 period relative to pre-pandemic levels (p<0.001). However, in rural regions, a significant increase in food sufficiency during the COVID-19 era was observed only among women, with an odds ratio of 1.42 (confidence interval, 1.06 to 1.89). Nevertheless, no significant interaction terms were found between region and various sociodemographic factors regarding changes in food sufficiency during the COVID-19 period.
CONCLUSIONS
During the COVID-19 pandemic, food sufficiency among urban residents improved compared to the pre-pandemic era, whereas their rural counterparts saw no such improvement. Additionally, no significant interaction was detected between urban versus rural areas and changes in food sufficiency during the COVID-19 period. These findings indicate the need for targeted food policies to prepare for potential future pandemics, particularly in rural areas, where food sufficiency did not improve.
Summary
Predicting over-the-counter antibiotic use in rural Pune, India, using machine learning methods
Pravin Arun Sawant, Sakshi Shantanu Hiralkar, Yogita Purushottam Hulsurkar, Mugdha Sharad Phutane, Uma Satish Mahajan, Abhay Machindra Kudale
Epidemiol Health. 2024;e2024044.   Published online April 13, 2024
DOI: https://doi.org/10.4178/epih.e2024044    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
Over-the-counter (OTC) antibiotic use can cause antibiotic resistance, threatening global public health gains. To counter OTC use, this study used machine learning (ML) methods to identify predictors of OTC antibiotic use in rural Pune, India.
METHODS
The features of OTC antibiotic use were selected using stepwise logistic, lasso, random forest, XGBoost, and Boruta algorithms. Regression and tree-based models with all confirmed and tentatively important features were built to predict the use of OTC antibiotics. Five-fold cross-validation was used to tune the models’ hyperparameters. The final model was selected based on the highest area under the curve (AUROC) with a 95% confidence interval and the lowest log-loss.
RESULTS
In rural Pune, the prevalence of OTC antibiotic use was 35.9% (95% CI, 31.56%-40.46%). The perception that buying medicines directly from a medicine shop/pharmacy is useful, using antibiotics for eye-related complaints, more household members consuming antibiotics, and longer duration and higher doses of antibiotic consumption in rural blocks and other social groups were confirmed as important features by the Boruta algorithm. The final model was the XGBoost+Boruta model with 7 predictors (AUROC=0.934; 95% CI, 0.8906-0.9782; log-loss=0.2793) log-loss.
CONCLUSIONS
XGBoost+Boruta, with 7 predictors, was the most accurate model for predicting OTC antibiotic use in rural Pune. Using OTC antibiotics for eye-related complaints, higher consumption of antibiotics and the perception that buying antibiotics directly from a medicine shop/pharmacy is useful were identified as key factors for planning interventions to improve awareness about proper antibiotic use.
Summary
Profiling the socioeconomic characteristics, dietary intake, and health status of Korean older adults for nutrition plan customization: a comparison of principal component, factor, and cluster analyses
Kyungsook Woo, Kirang Kim
Epidemiol Health. 2024;e2024043.   Published online April 12, 2024
DOI: https://doi.org/10.4178/epih.e2024043    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to establish profiles of socioeconomic characteristics, dietary intake, and health status among Korean older adults by employing 3 multivariate analysis techniques.
METHODs
Data were obtained from 1,352 adults aged 65 years and older who participated in the 2019 Korea National Health and Nutrition Examination Survey. Principal component analysis (PCA), factor analysis (FA), and cluster analysis (CA) were utilized for profiling, with data preprocessing undertaken to facilitate these approaches.
RESULTS
PCA, FA, and CA yielded similar results, reflecting the high common variance among the variables. PCA identified 4 components, accounting for 71.6% of the accumulated variance. FA revealed 5 factors, displaying a Kaiser-Meyer-Olkin value of 0.51 and explaining 74.3% of the total variance. Finally, CA grouped the participants into 4 clusters (R2=0.465). Both PCA and FA identified dietary intake (energy, protein, carbohydrate, etc.), social support from family (incorporating family structure, number of family numbers, and engagement in social eating), and health status (encompassing oral, physical, and subjective health) as key factors. CA classified Korean older adults into 4 distinct typologies, with significant differences observed in dietary intake, health status, and household income (p<0.01).
CONCLUSIONS
The study utilized PCA, FA, and CA to analyze profiling domains and derive characteristics of older adults in Korea, followed by a comparison of the results. The variables defining the clusters in CA were consistent with those identified by PCA and FA.
Summary
Special article
Nutrition survey methods and food composition database update of the Korean Genome and Epidemiology Study
Seon-Joo Park, Jieun Lyu, Kyoungho Lee, Hae-Jeung Lee, Hyun-Young Park
Epidemiol Health. 2024;e2024042.   Published online April 2, 2024
DOI: https://doi.org/10.4178/epih.e2024042    [Accepted]
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AbstractAbstract AbstractSummary PDF
Abstract
This study presents the nutrition survey methods and the updated food composition database for the Korean Genome and Epidemiology Study (KoGES). The KoGES, which is the largest and longest cohort study in Korea, aims to identify genetic and environmental factors associated with chronic diseases. This study has collected dietary data using a validated semi-quantitative food frequency questionnaire and/or the 24-hour recall method. However, these dietary survey methods use different food composition databases, and their nutritional values are out of date. Therefore, it became necessary to update the food composition database by correcting errors in nutrient analysis values to reflect improvements in the performance of food ingredient analysis equipment, revising international values ​​to analysis values ​​of Korean agricultural products, adjusting nutrient units, and adding newly reported nutrients related to chronic diseases. For this purpose, we integrated the different food composition databases used in each nutrition survey, updated 23 nutrients, and expanded 48 new nutrients for 3,648 food items using the latest reliable food composition databases published by national and international institutions. This revised food composition database may help to clarify the relationship between various nutrients and chronic diseases. It could serve as a valuable resource for nutritional, epidemiological, and genomic research and provide a basis for determining public health policies.
Summary
Korean summary
한국인유전체역학조사사업은 우리나라에서 가장 크고 오래된 코호트로 만성질환과 영양과의 관련성을 밝히기 위하여 사용되고 있다. 이 논문에서는 영양조사에 대한 자세한 방법론과 현재 공개하고 있는 23개 영양소의 업데이트 및 48개 새로운 영양소의 확대에 대한 내용을 소개하였다. 이러한 개선을 통해 KoGES 영양 데이터의 활용도가 더욱 높아질 것으로 기대된다.
Key Message
The Korean Genome and Epidemiology Study (KoGES) is the largest and longest-running cohort study in South Korea aimed at identifying the relationship between chronic diseases and nutrient intake. This paper provides a detailed methods of the nutritional surveys and introduces updates to the existing 23 nutrients and the addition of 48 new nutrients. These enhancements are expected to significantly increase the utility of the KoGES nutritional data.
Original articles
Association of decreased estimated glomerular filtration rate with lung cancer risk in the Korean population
Soonsu Shin, Min-Ho Kim, Chang-Mo Oh, Hyejin Chun, Eunhee Ha, Hyo Choon Lee, Seong Ho Moon, Dong-Young Lee, Dosang Cho, Sangho Lee, Min Hyung Jung, Jae-Hong Ryoo
Epidemiol Health. 2024;e2024041.   Published online March 20, 2024
DOI: https://doi.org/10.4178/epih.e2024041    [Accepted]
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Inconsistent results are available regarding the association between low estimated glomerular filtration rate (eGFR) and lung cancer risk. We aimed to explore the risk of lung cancer according to eGFR category in the Korean population.
METHODS
We included 358,293 adults who underwent health checkups between 2009 and 2010, utilizing data from the National Health Insurance Service-National Sample Cohort. Participants were categorized into 3 groups based on their baseline eGFR, as determined using the Chronic Kidney Disease Epidemiology Collaboration equation: group 1 (eGFR ≥90 mL/min/1.73m2), group 2 (eGFR ≥60 to <90mL/min/1.73m2), and group 3 (eGFR <60 mL/min/1.73m2). Incidences of lung cancer were identified using the corresponding codes from the International Classification of Diseases, 10th Revision. Multivariate Cox proportional hazard models were employed to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for lung cancer incidence up to 2019.
RESULTS
In multivariate analysis, group 2 exhibited a 26.5% higher risk of developing lung cancer than group 1 (HR, 1.265; 95% CI, 1.189 to 1.346). Furthermore, group 3 demonstrated a 72.5% elevated risk of lung cancer relative to group 1 (HR, 1.725; 95% CI, 1.577 to 1.887). Among participants with dipstick proteinuria of 2+ or greater, group 3 faced a significantly higher risk of lung cancer than group 1 (HR, 2.928; 95% CI, 1.375 to 6.237).
CONCLUSION
Low eGFR was significantly associated with increased lung cancer risk within the Korean population. A particularly robust association was observed in individuals with severe proteinuria, emphasizing the need for further investigation.
Summary
Korean summary
이번 연구에서는 한국인 인구집단에서 단백뇨와 동반된 낮은 사구체 여과율이 페암의 발생 위험을 증가시켰다. 이는 신장기능의 저하가 폐암의 위험을 증가시킬 수 있음을 시사한다. 신장기능이 저하된 환자들의 면밀한 추적관찰이 필요할 수 있다.
Key Message
Our research found that lower estimated glomerular filtration rate with proteinuria increased the risk of lung cancer in a Korean population. These findings suggest that decreased kidney function may increase the risk of lung cancer, indicating the need for careful observation of patients with impaired kidney function.
Effect of the human papillomavirus vaccine on the risk of genital warts: a nationwide cohort study of South Korean adolescent girls
Jaeyoung Cho, Eun Mi Kim, Jihye Kim, Ju-Young Shin, Eui Hyeok Kim, Jong Heon Park, Seunghyun Lewis Kwon, Geun-Yong Kwon, Soon-Ae Shin, Jaiyong Kim
Epidemiol Health. 2024;e2024040.   Published online March 18, 2024
DOI: https://doi.org/10.4178/epih.e2024040    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
The purpose of this study was to assess the effectiveness of human papillomavirus (HPV) vaccination administered to adolescent girls through South Korea’s National Immunization Program.
METHODS
This retrospective cohort study included individuals who were 12 to 13 years old, whether vaccinated or unvaccinated, between July 2016 and December 2017. The incidence of genital warts (GWs) was monitored through 2021. Time-stratified hazard ratios (HRs) were estimated, adjusting for birth year, socioeconomic status, and the level of urbanization of the region, and were presented with 95% confidence intervals (CIs). Data were sourced from the Immunization Registry Integration System, linked with the National Health Information Database.
RESULTS
The study included 332,062 adolescent girls, with an average follow-up period of approximately 4.6 years. Except for the first year, the HRs for the vaccinated group were lower than those for the unvaccinated group. The HRs for specific cutoff years were as follows: year 2, 0.62 (95% CI, 0.31 to 1.13); year 3, 0.58 (95% CI, 0.35 to 0.96); and year 4 and beyond, 0.39 (95% CI, 0.28 to 0.52).
CONCLUSIONS
Our findings indicate that HPV vaccination was associated with a reduction in the risk of GWs among adolescent girls. Notably, this reduction became significant as the incidence of GWs increased with age.
Summary

Epidemiol Health : Epidemiology and Health