Epidemiology and Health

Original Article

Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020: Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim; Epidemiol Health. 2023;45:e2023033. Published online March 7, 2023; DOI: https://doi.org/10.4178/epih.e2023033

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Abstract

OBJECTIVES
This study investigated recent trends in the prevalence of obesity among Korean adolescents and explored socioeconomic disparities in obesity.

METHODS

This study used annual self-reported data on height, weight, and socioeconomic information from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2020. With a 95.8% response rate, the sample consisted of 818,210 adolescents. Obesity prevalence was calculated according to 4 socioeconomic indicators (household income, father’s educational attainment, mother’s educational attainment, and urbanicity). Socioeconomic inequality was quantified using the relative index of inequality (RII).

RESULTS

The overall prevalence of obesity increased, doubling from 5.9% in 2006 to 11.7% in 2020. Boys and high school students showed a higher prevalence. The RIIs in household income and parental educational attainments significantly increased with time, indicating a growing inequality in obesity. Socioeconomic disadvantages had a greater influence on obesity among girls. The most recent RII values for boys were 1.25 for income, 1.79 for the father’s education, and 1.45 for the mother’s education, whereas the corresponding values for girls were 2.49, 3.17, and 2.62, respectively.

CONCLUSIONS

These findings highlight growing inequalities in adolescent obesity according to household income and parental educational attainments, especially for girls and middle schoolers.

Summary

Korean summary
2006년부터 2020년까지 청소년 비만의 유병은 증가 추세에 있을 뿐 아니라, 가정의 경제상태, 부모의 학력수준에 따른 비만의 위험 격차도 점점 심해지는 추세를 보였다. 특히, 남학생과 고등학생의 비만 유병률이 높게 나타났으나, 사회경제적 지표에 따른 비만의 불평등 격차는 여학생과 중학생에서 높게 나타났다.

Key Message
Not only the prevalence but also socioeconomic inequality in adolescent obesity increased between 2006 and 2020. The potential impact of socioeconomic disparity on obesity was greater in girls and middle school students than their counterparts.

Citations

Citations to this article as recorded by

A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study
Mi-Sun Lee, Hooyeon Lee
Psychiatry Investigation.2023; 20(11): 1086. CrossRef

COVID-19: Special Article

Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey: Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh; Epidemiol Health. 2022;44:e2022041. Published online April 25, 2022; DOI: https://doi.org/10.4178/epih.e2022041

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Abstract

OBJECTIVES
We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population.

METHODS

Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment).

RESULTS

Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively).

CONCLUSIONS

An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.

Summary

Korean summary
한국인의 비만, 고혈압, 당뇨 및 고지혈증 유병률은 지난 10년간 전반적으로 증가하는 경향을 보였다. 특히, 코로나 19가 유행한 2020년에 남성의 주요 만성질환 유병률은 지난 3년 평균치와 비교하였을 때 모두 유의하게 증가하였다. 반면, 여성에서 만성질환 유병률의 뚜렷한 증가는 관찰되지 않았다.

Key Message
During COVID-19 pandemic, the overall increase in major chronic diseases was observed in Korean adults, and this trend was prominent in men. Accordingly, target-specific intervention strategies need to be developed to reduce the burden of cardiovascular and metabolic diseases in the future.

Citations

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Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations
Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Dasom Son, Minsung Cho, Sojung Shin, Yeeun Seo, Eun-Jin kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Jong Ku Park, Il Suh, Tae-Yong Lee
Clinical Hypertension.2024;[Epub] CrossRef
Factors associated with gastric and duodenal neuroendocrine tumors: A multicenter case-control study
Kwangwoo Nam, Su Youn Nam, Jun Chul Park, Young Sin Cho, Hyuk Soon Choi, Kyoungwon Jung, Seon-Young Park, Joon Hyun Cho, Hyonho Chun
Digestive and Liver Disease.2024;[Epub] CrossRef
Association between Weight Change and Incidence of Dyslipidemia in Young Adults: A Retrospective Cohort Study of Korean Male Soldiers
Joon-Young Yoon, Won Ju Park, Hee Kyung Kim, Ho-Cheol Kang, Cheol-Kyu Park, Wonsuk Choi
Journal of Obesity & Metabolic Syndrome.2024; 33(1): 36. CrossRef
Sleep Deficit as a Risk Factor for Hypertension in Korean Adults
Mi-Joon Lee, Bum-Jeun Seo, Inmyung Song
Sustainability.2023; 15(3): 2586. CrossRef
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Junkyung Kwak, Dayeon Shin
International Journal of Molecular Sciences.2023; 24(4): 3758. CrossRef
Identifying the Associations of Nightly Fasting Duration and Meal Timing with Type 2 Diabetes Mellitus Using Data from the 2016–2020 Korea National Health and Nutrition Survey
Junkyung Kwak, Kyeong-A Jang, Haeng-Ran Kim, Min-Sook Kang, Kyung Won Lee, Dayeon Shin
Nutrients.2023; 15(6): 1385. CrossRef
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Kyungchul Song, Juyeon Yang, Hye Sun Lee, Su Jin Kim, Myeongseob Lee, Junghwan Suh, Ahreum Kwon, Ho-Seong Kim, Hyun Wook Chae
Yonsei Medical Journal.2023; 64(4): 269. CrossRef
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The Journal of Korean Diabetes.2023; 24(1): 1. CrossRef
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Surim Park, Eun-hee Jang, Seungmin Lee
Korean Journal of Community Nutrition.2023; 28(2): 124. CrossRef
Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020
Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim
Epidemiology and Health.2023; 45: e2023033. CrossRef
Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey
Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
Epidemiology and Health.2023; 45: e2023015. CrossRef
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Soyeon Jung, Haeeun Shin, Hee Seung Chin
Journal of the Korean Ophthalmological Society.2023; 64(6): 490. CrossRef
Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly
Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Gabin Lee, Eunji Kim, Moses Song, Jenny Moon, Yeeun Seo
Clinical Hypertension.2023;[Epub] CrossRef
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Cardiovascular Therapy and Prevention.2023; 22(8S): 3785. CrossRef
Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
Epidemiology and Health.2023; 45: e2023014. CrossRef
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Hyeon Chang Kim
Journal of the Korean Medical Association.2022; 65(10): 633. CrossRef
Association between Mental Health and Hand Hygiene Practices in Adults with Hypertension and Diabetes during the COVID-19 Pandemic: The 2020 Korea Community Health Survey
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Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
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COVID-19: Original Article

Socioeconomic inequality in compliance with precautions and health behavior changes during the COVID-19 outbreak: an analysis of the Korean Community Health Survey 2020: Ga Bin Lee, Sun Jae Jung, Yang Yiyi, Jea Won Yang, Hoang Manh Thang, Hyeon Chang Kim; Epidemiol Health. 2022;44:e2022013. Published online January 9, 2022; DOI: https://doi.org/10.4178/epih.e2022013

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examined socioeconomic inequalities in compliance with precautions and health behavior changes during the coronavirus disease 2019 (COVID-19) outbreak using a representative Korean sample.

METHODS

This exploratory study utilized around 210,000 participants aged ≥25 years in the Korean Community Health Survey 2020. Socioeconomic status was measured with educational attainment and household income. Outcomes included non-compliance with 8 precaution measures and deterioration in 6 health behaviors. The relative inequality index (RII) was calculated to quantify the degree of inequality by education and income level. RII values >1.0 indicate that deprived people have a higher frequency of health problems, and RII values <1.0 conversely indicate a higher frequency of health problems in more advantaged groups.

RESULTS

People with lower education or income levels tended to have higher rates of non-compliance with COVID-19 safety precautions (RII range, 1.20 to 3.05). Lower education and income levels were associated with an increased smoking amount (RII=2.10 and 1.67, respectively) and sleep duration changes (RII=1.21 and 1.36, respectively). On the contrary, higher education and income levels were associated with decreased physical activity (RII=0.59 and 0.77, respectively) and increased delivery food consumption (RII=0.27 and 0.37, respectively). However, increased alcohol drinking was associated with lower education and income levels in younger men (RII=1.73 and 1.31, respectively), but with higher levels in younger women (RII=0.73 and 0.68, respectively).

CONCLUSIONS

Our findings suggest the need to develop customized strategies, considering the characteristics of the target population, to decrease the burden and impact of the COVID-19 outbreak.

Summary

Korean summary
코로나19 유행기간 동안 예방지침 준수율과 건강관련 생활습관이 나빠지는 정도는 사회경제적 수준에 따라 차이가 있다. 전반적으로 코로나19 예방지침 준수율은 높았지만, 사회경제수준이 낮을수록 예방지침 준수율도 낮아지는 경향을 보였다. 하지만, 사회경제수준과 생활습관 악화의 관계는 성, 연령, 생활습관의 종류에 따라 달랐다.

Key Message
This study of a representative Korean sample found that socioeconomic inequalities existed in compliance with COVID-19 precautions and in health behavior deterioration. There is a need to develop target group-specific strategies to reduce health inequalities and the long-term health burden of the COVID-19 outbreak.

Citations

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Ruixue Ye, Yuju Wu, Chang Sun, Qingzhi Wang, Yue Ma, Yunwei Chen, Lucy Pappas, Cindy Feng, Scott Rozelle, Huan Zhou
Preventive Medicine Reports.2024; 39: 102617. CrossRef
Aftermath on COVID-19 technological and socioeconomic changes: A meta-analytic review
Xuan Yao, Zeshui Xu, Marinko Škare, Xindi Wang
Technological Forecasting and Social Change.2024; 202: 123322. CrossRef
Association of Depression With Precautionary Behavior Compliance, COVID-19 Fear, and Health Behaviors in South Korea: National Cross-sectional Study
Hyerine Shin, Ji-Su Kim, HyunHae Lee
JMIR Public Health and Surveillance.2023; 9: e42677. CrossRef
Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020
Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim
Epidemiology and Health.2023; 45: e2023033. CrossRef
Communication inequalities in the COVID-19 pandemic: socioeconomic differences and preventive behaviors in the United States and South Korea
Woohyun Yoo, Yangsun Hong, Sang-Hwa Oh
BMC Public Health.2023;[Epub] CrossRef
Compliance Trajectory and Patterns of COVID-19 Preventive Measures, Japan, 2020–2022
Taro Kusama, Kenji Takeuchi, Yudai Tamada, Sakura Kiuchi, Ken Osaka, Takahiro Tabuchi
Emerging Infectious Diseases.2023;[Epub] CrossRef
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Riyadh Lafta, Sahar Al-Shatari, Meighan Mary, Gilbert Burnham
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Journal of Health Communication.2023; 28(sup2): 32. CrossRef
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Tim Schröder, Anne Speer, Patrick Sachweh, Olaf Groh-Samberg
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Epidemiology and Health.2022; 44: e2022107. CrossRef

Original Articles

Association between a family history of diabetes and carotid artery atherosclerosis in Korean adults: Sun Young Shim, Ga Bin Lee, Jee-Seon Shim, Sun Jae Jung, Hyeon Chang Kim; Epidemiol Health. 2021;43:e2021049. Published online August 3, 2021; DOI: https://doi.org/10.4178/epih.e2021049

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Diabetes is a well-known risk factor for atherosclerosis, but the association between a family history of diabetes and atherosclerosis remains unknown. In this study, we assessed the association between a family history of diabetes and increased carotid intima-media thickness (IMT), a marker of subclinical atherosclerosis, in a middle-aged Korean population.

METHODS

This cross-sectional study included 3,974 community-dwelling adults (1,404 male and 2,570 female) aged 30-64 years from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. The presence of a family history of diabetes was assessed through face-to-face interviews using a standardized questionnaire. Carotid IMT was assessed using B-mode ultrasonography, and increased IMT was defined as a value in the top quartile of the IMT values of all participants. Multivariate logistic regression was used to evaluate independent associations between a family history of diabetes and increased IMT.

RESULTS

A family history of diabetes was significantly associated with increased carotid IMT (odds ratio, 1.23; 95% confidence interval, 1.03 to 1.48) after adjusting for sex; age; body mass index; systolic blood pressure; total cholesterol, triglyceride, and hemoglobin A1c levels; smoking; alcohol consumption; exercise; use of antidiabetic, antihypertensive, and antilipidemic drugs; and a family history of hypertension. The positive association remained significant after excluding participants with diabetes (odds ratio, 1.21; 95% confidence interval, 1.00 to 1.47).

CONCLUSIONS

A family history of diabetes was positively associated with increased carotid IMT, even in participants without diabetes. Therefore, information on a family history of diabetes may help identify individuals at high risk of atherosclerotic cardiovascular disease.

Summary

Korean summary
한국의 30–64세 성인에게서 당뇨병 가족력이 있는 경우, 본인의 당뇨병 여부와 무관하게 경동맥 내중막 두께가 증가된 경향을 보였다. 이 결과는 당뇨병 가족력에 대한 정보를 파악하는 것은 죽상경화성 심혈관 질환의 위험이 높은 개인을 식별하는 데 도움이 될 수 있음을 시사한다.

Key Message
The family history of diabetes was positively associated with an increase in intima-media thickness of the carotid artery, even among people with normal fasting glucose levels. This suggests that asking for a family history of diabetes can help identify people at high risk of arteriosclerotic cardiovascular disease.

Citations

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Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study
Ge Meng, Tongfeng Liu, Sabina Rayamajhi, Amrish Thapa, Shunming Zhang, Xuena Wang, Hongmei Wu, Yeqing Gu, Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Zhongze Fang, Kaijun Niu
Nutrition, Metabolism and Cardiovascular Diseases.2023; 33(11): 2209. CrossRef
The association between grip strength and incident carotid atherosclerosis in middle-aged and older adults: The TCLSIH cohort study
Bei Zhang, Xuena Wang, Yeqing Gu, Qing Zhang, Li Liu, Ge Meng, Hongmei Wu, Shunming Zhang, Tingjing Zhang, Huiping Li, Juanjuan Zhang, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Jian Huang, Junsheng Huo, Bing Zhang, Gangqiang Ding, Kaijun Niu
Maturitas.2023; 167: 53. CrossRef
Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study
Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park
Epidemiology and Health.2023; 45: e2023029. CrossRef
The Relationship between Family History of Diabetes and Diabetes by BMI and Age in Korean Men and Women
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Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea: Naharin Sultana Anni, Sun Jae Jung, Jee-Seon Shim, Yong Woo Jeon, Ga Bin Lee, Hyeon Chang Kim; Epidemiol Health. 2021;43:e2021042. Published online June 9, 2021; DOI: https://doi.org/10.4178/epih.e2021042

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population.

METHODS

We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positive/negative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL.

RESULTS

Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men.

CONCLUSIONS

Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.

Summary

Korean summary
30-64세 중년 남성에서 스트레스성 생활 사건(stressful life events)를 많이 경험한 경우 혈청 중성지방 농도가 높은 경향이 관찰되었다. 스트레스성 질환의 적절한 관리가 이상지질혈증같은 만성대사질환 예방에 도움이 될 수 있음을 시사하는 결과이다.

Key Message
Stressful life events can be linked to hypertriglyceridemia among middle-aged men. This suggests that proper management of stressful events can help prevention of metabolic disorders such as abnormal blood lipids.

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Comparison of self-reported and accelerometer-assessed measurements of physical activity according to socio-demographic characteristics in Korean adults: Seung Won Lee, Jee-Seon Shim, Bo Mi Song, Ho Jae Lee, Hye Yoon Bae, Ji Hye Park, Hye Rin Choi, Jae Won Yang, Ji Eun Heo, So Mi Jemma Cho, Ga Bin Lee, Diana Huanan Hidalgo, Tae-Hoon Kim, Kyung Soo Chung, Hyeon Chang Kim; Epidemiol Health. 2018;40:e2018060. Published online November 29, 2018; DOI: https://doi.org/10.4178/epih.e2018060

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Abstract Summary PDF

Abstract

OBJECTIVES
Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population.

METHODS

This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors.

RESULTS

The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p<0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend <0.001) and depression scores (p for trend <0.001).

CONCLUSIONS

We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.

Summary

Korean summary
역학연구에서 신체활동량 측정에 가장 많이 사용되는 설문조사와 가속도계 착용법인데, 두 가지 방법으로 측정한 신체활동량은 상관성이 그리 높지 않으며, 대상자 특성에 따라서도 일치도가 다른 것으로 보고되고 있다. 따라서, 비교적 건강한 중년의 한국 성인을 대상으로 자가설문과 가속도계 조사를 사용해 측정한 신체활동량의 관련성을 조사해보았다. 이 연구는 전향적 코호트 연구의 기반조사 결과를 이용한 단면연구로, 지역사회 거주하는 30-64세 성인 623명(남성203명, 여성 420명)을 대상으로 하였으며, 신체활동을 자가보고 설문조사와 3축 가속도계를 7일간 손목에 연속착용하여 측정하고 두 방법으로 측정한 신체활동량을 비교하였다. 전체 대상자에서 두 방법으로 측정한 신체활동량 삼분위(tertile) 값의 일치도를 조사했을 때 Kappa 통계량은 0.16 이었으며 Spearman 상관계수는 0.26 (p<0.001)이었다. 나이가 많을수록 우울증상이 많을수록 두 방법 간 일치도와 상관성이 낮아지는 경향을 보였다.

Citations

Citations to this article as recorded by

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