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4 "Ji-Yeob Choi"
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Original article
Impact of body mass index and waist-to-hip ratio on mortality in middle-aged Koreans: A prospective cohort study based on a Health Examinees study
Sooyoung Cho, Aesun Shin, Ji-Yeob Choi, Jong-Koo Lee, Daehee Kang
Epidemiol Health. 2024;e2024073.   Published online September 2, 2024
DOI: https://doi.org/10.4178/epih.e2024073    [Accepted]
  • 690 View
  • 45 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study.
METHODS
We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality.
RESULTS
A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both men and women with BMIs of less than 21 kg/m2 and greater than or equal to 30 kg/m2 are at increased risk. The results showed that men with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted HR: 2.24 [95% CI: 1.73–2.91]) and cardiovascular mortality (2.27 [1.23–4.20]). Similarly, men with a WHR of less than 0.80 (1.38 [1.08–1.77]), 0.90 to less than 0.95 (1.15 [1.02–1.29]), and greater than or equal to 0.95 (1.28 [1.11–1.47]) showed an increased risk of all-cause mortality. In women, a BMI of less than 18 kg/m² was linked to a higher risk of cardiovascular mortality (2.67 [1.13–6.33]).
CONCLUSIONS
Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in men who were slightly overweight with a BMI of 23-25 kg/m2.
Summary
Korean summary
중년 한국인으로 구성된 코호트 연구에서 BMI와 WHR이 원인별 사망에 미치는 영향을 평가함. BMI와 WHR이 사망 원인별 사망률과 U자형 연관성을 보였고, 특히 심혈관 질환에서 이러한 경향을 관찰함.
Key Message
This study examined the association between BMI, WHR, and cause-specific mortality in middle-aged Koreans. Both BMI and WHR showed U-shaped associations with mortality, particularly for cardiovascular outcomes. These findings may indicate a need to carefully consider the optimal BMI cut-off values for Asians to better capture mortality risks.
Original Articles
Adherence to the World Cancer Research Fund/American Institute for Cancer Research and Korean Cancer Prevention Guidelines and cancer risk: a prospective cohort study from the Health Examinees-Gem study
Jeeyoo Lee, Aesun Shin, Woo-Kyoung Shin, Ji-Yeob Choi, Daehee Kang, Jong-Koo Lee
Epidemiol Health. 2023;45:e2023070.   Published online August 1, 2023
DOI: https://doi.org/10.4178/epih.e2023070
  • 6,859 View
  • 210 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The purpose of this study was to explore the association between adherence to 2 cancer prevention recommendations and cancer risk.
METHODS
In total, 104,386 individuals aged 40-69 years old who were recruited between 2004 and 2013 in the Health Examinees-Gem study were included. Adherence scores were constructed based on 8 items from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, including body weight, physical activity, diet, alcohol consumption and breastfeeding, and on 6 items from the Korean cancer prevention guidelines (smoking status, eating vegetables and fruits, salty foods, alcohol intake, physical activity, and body weight). A Cox proportional hazards model was used to estimate the associations between adherence scores and the risk of total and 5 major cancers.
RESULTS
The multivariable hazard ratio (HR) for total cancer with the high adherence score versus the lowest score (4.25-7.00 vs. 0.00-3.25) for the WCRF/AICR guidelines was 0.91 (95% confidence interval [CI], 0.82 to 1.00) in men. A reduced breast cancer risk was observed among women with the highest score. Men within the highest category of the Korean cancer prevention guideline score (3.25-6.00) had an HR of 0.80 (95% CI, 0.73 to 0.88) for developing total cancer compared to men within the lowest score (0.00-2.50). The higher adherence group among men showed lower risks of developing stomach, colorectal, and lung cancers.
CONCLUSIONS
Adhering to guidelines for cancer prevention can help to reduce the risk of developing cancer in Korean men. The association might differ by cancer type and gender.
Summary
Korean summary
- 암예방 가이드라인 준수가 실제로 암 발생을 예방하는지에 대한 해외 연구들이 다수 있으나 한국을 포함한 아시아 국가에서 수행된 연구는 없다. - 국제암연구재단 암예방수칙과 한국 암예방수칙을 준수하는 한국인 남성에서 암 발생 감소가 관찰되었다. 이러한 관련성은 암종에 따라 다르게 나타났다.
Key Message
- The adherence to the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) guidelines on cancer prevention has been addressed in several studies in Western countries. -Among the Korean population, adherence to WCRF/AICR cancer prevention guidelines as well as the Korean cancer prevention guidelines helps prevent cancer in men. Association varies by gender and type of cancer.

Citations

Citations to this article as recorded by  
  • Compliance with the WCRF/AICR Recommendations in Qualitative Adaptation and the Occurrence of Breast Cancer: A Case-Control Study
    Beata Stasiewicz, Lidia Wadolowska, Maciej Biernacki, Malgorzata Anna Slowinska, Ewa Stachowska
    Cancers.2024; 16(2): 468.     CrossRef
  • Transforming public health and economic outcomes by reducing risky behaviors: the potential for South Korea
    Joan E. Madia, Ji Yoon Baek, Aesun Shin
    Discover Social Science and Health.2024;[Epub]     CrossRef
Dynamic changes in clinical biomarkers of cardiometabolic diseases by changes in exercise behavior, and network comparisons: a community-based prospective cohort study in Korea
JooYong Park, Jaesung Choi, Ji-Eun Kim, Sang-Min Park, Joo-Youn Cho, Daehee Kang, Miyoung Lee, Ji-Yeob Choi
Epidemiol Health. 2023;45:e2023026.   Published online February 16, 2023
DOI: https://doi.org/10.4178/epih.e2023026
  • 4,692 View
  • 82 Download
  • 1 Web of Science
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Lifestyles, including exercise behaviors, change continually over time. This study examined whether the clinical biomarkers (CBs) related to cardiometabolic diseases (CMDs) and their relationships differed with changes in exercise behavior.
METHODS
The Ansan-Ansung cohort study (third to fifth phases; n=2,668) was used in the current study. Regular exercise behavior was investigated using a yes/no questionnaire. Changes in exercise behavior were classified into 4 groups: Y-N, N-Y, Y-Y, and N-N, with “Y” indicating that a participant regularly engaged in exercise at a given time point and “N” indicating that he or she did not. Fourteen CBs related to CMDs were used, and the associations between changes in exercise behavior and relative changes in CBs were examined. CB networks were constructed and topological comparisons were conducted.
RESULTS
Y-N was associated with increases in fasting blood sugar and insulin levels in men, and increased total cholesterol and low-density lipoprotein cholesterol levels in women. Meanwhile, N-Y was inversely associated with body fat percentage, visceral fat percentage, fasting insulin, and triglyceride level. Waist circumference played a central role in most networks. In men, more edges were found in the N-Y and Y-Y groups than in the N-N and Y-N groups, whereas women in the N-Y and Y-Y groups had more edges than those in the N-N and Y-N groups.
CONCLUSIONS
Consistent exercise or starting to engage in regular exercise had favorable effects on CBs related to CMDs, although their network patterns differed between the sexes.
Summary
Korean summary
한국 지역사회기반 코호트 자료를 이용하여, 운동 행태 변화에 따른 심혈관대사질환 관련 임상 생체 지표들의 변화가 남녀에 따라, 변화 행태에 따라 다르게 나타남을 확인하였다. 이런 변화와 차이는 네트워크 분석을 통한 구조적인 차이로도 확인되었다.
Key Message
This study examined that changes in the clinical biomarkers related to cardiometabolic diseases differed with changes in exercise behavior using a community-based prospective cohort study in Korea. Consistent exercise or change into exercise behavior had favorable effects on CB related to CMD, although their network patterns differed between the sexes.
The age-standardized incidence, mortality, and case fatality rates of COVID-19 in 79 countries: a cross-sectional comparison and their correlations with associated factors
Dongui Hong, Sohyae Lee, Yoon-Jung Choi, Sungji Moon, Yoonyoung Jang, Yoon-Min Cho, Hyojung Lee, Sukhong Min, Hyeree Park, Seokyung Hahn, Ji-Yeob Choi, Aesun Shin, Daehee Kang
Epidemiol Health. 2021;43:e2021061.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021061
  • 24,155 View
  • 389 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population.
METHODS
The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R<sup>2</sup>). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated.
RESULTS
The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R<sup>2</sup> between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly.
CONCLUSIONS
Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.
Summary
Korean summary
국가별 발생률, 사망률, 치명률을 WHO 표준 인구로 연령표준화하였고, 의료자원과 관계된 지표와의 상관관계를 파악하였다. 2021년 4월 6일 기준, 연령표준화 발생률, 사망률, 치명률이 가장 높은 나라는 각각 체코 (10만명당 14,253명), 멕시코 (10만명당 182명), 멕시코 (6.7%)이며, 60세 이상 노인은 사망률과 치명률이 더 높은 것으로 나타났다. 1인당GDP, 인구당 의사 수, 인구당 병상 수는 발생률과 양의 상관관계가, 치명률과는 음의 상관관계가 있었고 노인에게서는 상관관계가 약하게 나타났다. 코로나바이러스감염증-19로 인한 피해를 최소화하기 위해서 의료자원의 투입과 더불어 노인의 감염예방이 중요할 것이다.
Key Message
The incidence, mortality, and case fatality rates of 79 countries were age-standardized using the WHO standard population. The correlations between the rates and the healthcare resource-related factors were investigated. As of April 6, 2021, the countries with the highest age-standardized incidence, mortality, and case fatality rates were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively; the mortality and case fatality rates were higher among the elderly. GDP per capita, number of hospital beds per population, and number of doctors per population were associated positively with incidence rate, and negatively with case fatality rates: the correlations were weaker among the elderly. To minimize the burden caused by COVID-19, preventing the elderly from infection is important as well as supply of medical resources.

Citations

Citations to this article as recorded by  
  • Occurrence of COVID-19 and serum per- and polyfluoroalkyl substances: A case-control study among workers with a wide range of exposures
    Anna K. Porter, Sarah E. Kleinschmidt, Kara L. Andres, Courtney N. Reusch, Ryan M. Krisko, Oyebode A. Taiwo, Geary W. Olsen, Matthew P. Longnecker
    Global Epidemiology.2024; 7: 100137.     CrossRef
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    Victims & Offenders.2023; 18(5): 799.     CrossRef
  • Age-standardization and Standard Population
    Dongui Hong, Sohyae Lee, Kyu-Won Jung, Aesun Shin
    Journal of Health Informatics and Statistics.2023; 48(Suppl 1): S15.     CrossRef
  • Topic and Trend Analysis of Weibo Discussions About COVID-19 Medications Before and After China’s Exit from the Zero-COVID Policy: Retrospective Infoveillance Study
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    Journal of Medical Internet Research.2023; 25: e48789.     CrossRef
  • Rapid establishment of a dedicated COVID-19 hospital in Mexico city during a public health crisis
    Roberto Tapia-Conyer, Rafael Ricardo Valdez-Vázquez, Julieta Lomelín-Gascón, Rodrigo Saucedo-Martínez, Luis Alberto Martinez-Juarez, Héctor Gallardo-Rincón
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