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Wonhee Cho 2 Articles
The predictive value of resting heart rate in identifying undiagnosed diabetes in Korean adults: Korea National Health and Nutrition Examination Survey
Dong-Hyuk Park, Wonhee Cho, Yong-Ho Lee, Sun Ha Jee, Justin Y. Jeon
Epidemiol Health. 2022;44:e2022009.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022009
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The purpose of this study was (1) to examine whether the addition of resting heart rate (RHR) to the existing undiagnosed diabetes mellitus (UnDM) prediction model would improve predictability, and (2) to develop and validate UnDM prediction models by using only easily assessable variables such as gender, RHR, age, and waist circumference (WC).
METHODS
Korea National Health and Nutrition Examination Survey (KNHANES) 2010, 2012, 2014, 2016 data were used to develop the model (model building set, n=19,675), while the data from 2011, 2013, 2015, 2017 were used to validate the model (validation set, n=19,917). UnDM was defined as a fasting glucose level ≥126 mg/dL or glycated hemoglobin ≥6.5%; however, doctors have not diagnosed it. Statistical package for the social sciences logistic regression analysis was used to determine the predictors of UnDM.
RESULTS
RHR, age, and WC were associated with UnDM. When RHR was added to the existing model, sensitivity was reduced (86 vs. 73%), specificity was increased (49 vs. 65%), and a higher Youden index (35 vs. 38) was expressed. When only gender, RHR, age, and WC were used in the model, a sensitivity, specificity, and Youden index of 70%, 67%, and 37, respectively, were observed.
CONCLUSIONS
Adding RHR to the existing UnDM prediction model improved specificity and the Youden index. Furthermore, when the prediction model only used gender, RHR, age, and WC, the outcomes were not inferior to those of the existing prediction model.
Summary
Korean summary
당뇨병 미인지 또는 미진단은 적절한 치료 시작 시기를 늦추고 당뇨병 합병증 발생의 위험을 높이기 때문에, 각국은 당뇨병 예측 모형을 개발하여 당뇨병을 조기에 예측하고, 치료 시기를 앞당기기 위해 노력하고 있다. 본 연구는 기존의 한국인 당뇨병 예측 모형에 안정시심박수를 추가 변수로 포함시켜, 예측 모형의 성능이 일부개선되는 것을 확인하였고, 더 나아가 나이, 허리 둘레, 그리고 안정시심박수를 포함하여 예측 모형을 개발하고, 그 성능을 확인하였다. 본 연구에서는 간단하게 측정이 가능한 허리 둘레와 안정시심박수 그리고 나이만 포함한 예측 모형이 기존의 예측 모형과 비교해 성능이 열등하지 않은 것을 확인하였다.
Key Message
Higher RHR is associated with increased risk of diabetes. When RHR is added to the Korean undiagnosed diabetes risk score model (Age, Family history of diabetes, Hypertension, Waist circumference, Smoking, Alcohol consumption), the model somewhat increased its predictability of undiagnosed diabetes. Furthermore, the prediction model developed only using age, waist circumference and RHR, which anyone can easily measure or access, had similar predictability to the previous undiagnosed diabetes risk prediction model. The results of this study may help develop future strategies or applications for predicting early undiagnosed diabetes.
Long-term Association of Pericardial Adipose Tissue with Incident Diabetes and Prediabetes: the Coronary Artery Risk Development in Young Adults Study
Minsuk Oh, Wonhee Cho, Dong Hoon Lee, Kara M. Whitaker, Pamela J. Schreiner, James G. Terry, Joon Young Kim
Epidemiol Health. 2022;e2023001.   Published online December 3, 2022
DOI: https://doi.org/10.4178/epih.e2023001    [Accepted]
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AbstractAbstract PDF
Abstract
OBJECTIVES
We examined if pericardial adipose tissue (PAT) is predictive of prediabetes and type 2 diabetes over time.
METHODS
A total of 2,570 adults without prediabetes/diabetes from the Coronary Artery Risk Development in Young Adults Study were followed up over 15 years. PAT volume was measured by computed-tomography scans and new onset of prediabetes/diabetes was examined 5, 10, and 15 years after the PAT measurement. Multivariable Cox regression models were used to examine the association between tertile of PAT and up to 15 years later incident prediabetes/diabetes. The predictive ability of PAT (vs. waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR)) for prediabetes/diabetes was examined by comparing the receiver operating characteristics curve (ROC)-area under the curve (AUC).
RESULTS
The highest tertile of PAT was associated with 1.56 (95% CI 1.03, 2.34) times higher rate of diabetes than the lowest tertile; however, no association was found between the highest tertile of PAT and prediabetes in the fully adjusted models, including additional adjustment for BMI or WC. In the fully adjusted models, the ROC-AUC of WC, BMI, WHtR, and PAT in predicting diabetes were not significantly different, whereas the ROC-AUC of WC in predicting prediabetes were higher than that of PAT.
CONCLUSIONS
PAT may be a significant predictor of hyperglycemia, but this association may be dependent on the effect of BMI or WC. Additional work is warranted to examine if novel adiposity indicators can suggest advanced and optimal information to the established diagnosis for prediabetes/diabetes.
Summary
Korean summary
Key Message

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