Epidemiology and Health

Original Articles

Non-linear relationship between body mass index and self-rated health in older Korean adults: body image and sex considerations: Seok-Joon Yoon, Jin-Gyu Jung, Soon-Ki Ahn, Jong-Sung Kim, Jang-Hee Hong; Epidemiol Health. 2023;45:e2023061. Published online June 20, 2023; DOI: https://doi.org/10.4178/epih.e2023061

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex.
METHODS
Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables.
RESULTS
Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not “exactly the right weight” had a higher risk of poor SRH than those who perceived their weight as “exactly the right weight” in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH.
CONCLUSIONS
The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.; Summary

Korean summary
자가 평가 건강 상태 (self-rated health, SRH)와 체질량지수는 각각 건강에 많은 관련이 있는 것으로 밝혀져 있다. 하지만 둘 사이의 관계는 연구마다 다양하게 나타나 있고, 노인들을 대상으로 한 연구도 많지 않다. 노인들은 본인들의 체중을 낮게 평가하는 경향이 있어 둘 사이 관계를 살펴볼 때 자기 인지 체형에 대한 고려가 필요하며, 성별에 따른 영향도 역시 고려해봐야 한다. 본 연구에서는 체질량지수로 파악한 비만의 정도에 관계없이 남성과 여성 모두에서 자기 인지 체형이 정상인 경우에 좋지 않은 SRH를 가질 위험성이 낮았다. 남성에서는 체질량지수와 SRH의 관계가 불분명하게 나타났고 자기 인지 체형이 더 중요한 요인으로 보인다. 한편 여성에서는 체질량지수가 증가함에 따라 SRH도 나빠지는 경향을 보였다. 이에 노인들의 비만과 관련된 교육에 있어서는 자가 인지 체형과 체질량지수를 이용한 비만의 기준에 대해 포함하는 것이 중요하다.

Key Message
Previous research has not fully explored the relationship between BMI, SBI, and SRH in older adults. Our study, using big data, found that the relationships differed between men and women. Those who perceived their weight as ‘exactly the right weight’ had the lowest risk of poor SRH. In men, BMI had a weak effect on SRH, while in women, the risk of poor SRH increased as BMI increased. We recommend that healthcare providers should educate older adults about BMI standards and help them identify their SBI for effective obesity counseling.

The association between obesity and glaucoma in older adults: evidence from the China Health and Retirement Longitudinal Study: Xiaohuan Zhao, Qiyu Bo, Junran Sun, Jieqiong Chen, Tong Li, Xiaoxu Huang, Minwen Zhou, Jing Wang, Wenjia Liu, Xiaodong Sun; Epidemiol Health. 2023;45:e2023034. Published online March 9, 2023; DOI: https://doi.org/10.4178/epih.e2023034

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Abstract Summary PDF: Abstract
OBJECTIVES
This study evaluated the association between obesity and glaucoma in middle-aged and older people. A population-based retrospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study.
METHODS
Glaucoma was assessed via self-reports. Multivariate logistic regression analysis and a Cox proportional hazards model were used to assess the relationship between obesity and glaucoma risk.
RESULTS
Older males living in urban areas who were single, smokers, and non-drinkers were found to have a significantly higher incidence of glaucoma (all p<0.05). Diabetes, hypertension, and kidney disease were also associated with higher glaucoma risk, while dyslipidemia was associated with lower risk (all p<0.05). After the model was adjusted for demographic, socioeconomic, and health-related variables, obesity was significantly associated with a 10.2% decrease in glaucoma risk according to the Cox proportional hazards model (hazard ratio, 0.90; 95% confidence interval [CI], 0.83 to 0.97) and an 11.8% risk reduction in the multivariate logistic regression analysis (odds ratio, 0.88; 95% CI, 0.80 to 0.97). A further subgroup analysis showed that obesity was associated with a reduced risk of glaucoma in people living in rural areas, in smokers, and in those with kidney disease (all p<0.05). Obesity also reduced glaucoma risk in people with diabetes, hypertension, or dyslipidemia more than in healthy controls (all p<0.05).
CONCLUSIONS
This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease. Obesity exerted a stronger protective effect in people with diabetes, hypertension, or dyslipidemia than in healthy people.; Summary

Key Message
Glaucoma is a neurodegenerative disease and the leading cause of irreversible vision loss worldwide. The diagnosis of glaucoma is frequently delayed, as it may be asymptomatic until a relatively late stage. Thus, there is a need to identify protective and risk factors for glaucoma. Glaucoma is a multifactorial disease, and the impact of obesity on glaucoma risk remains uncertain. This study evaluated the association between obesity and glaucoma in middle-aged and older people. This cohort study suggests that obesity was associated with a reduced risk of glaucoma, especially in rural residents, smokers, and people with kidney disease.

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 Summary PDF Supplementary Material: 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.

Diabetes and prediabetes prevalence among young and middle-aged adults in India, with an analysis of geographic differences: findings from the National Family Health Survey: Siddardha G. Chandrupatla, Isma Khalid, Tejdeep Muthuluri, Satyanarayana Dantala, Mary Tavares; Epidemiol Health. 2020;42:e2020065. Published online September 18, 2020; DOI: https://doi.org/10.4178/epih.e2020065

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6 Citations

Abstract PDF

Abstract

OBJECTIVES
This study aimed to approximate the prevalence of hyperglycemia in India.

METHODS

The study was conducted using the Demographic and Health Survey 2015-16 (also known as the National Family Health Survey-4), which surveyed 811,808 individuals using a stratified, multistage, cluster sampling design. This cross-sectional survey recorded socio-demographic and anthropometric data, including blood glucose levels, of adults aged 18 years to 54 years.

RESULTS

The final analysis included 718,597 individuals, of whom 49.90% (weighted) were males. The overall prevalence of diabetes was 6.65% and that of prediabetes was 5.57%. A positive association was seen with urban residence, geographic region, sex, age, body mass index, socioeconomic status, and hypertension. Approximately two-thirds of individuals with diabetes lived in urban areas, and about half of the urban population was considered overweight/obese. South India showed a higher prevalence of diabetes (prevalence ratio, 2.01; p<0.001) than northern India.

CONCLUSIONS

Hyperglycemia (diabetes and prediabetes) has a high prevalence in India and is a major public health issue. Diabetes is unevenly distributed based on geographic location and urbanization. Prevention, early detection, and treatment strategies should consider this uneven distribution of diabetes.

Summary

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John Punnose, Rajeev Kumar Malhotra, Komal Sukhija, Rashika Rijhwani M, Naimaa Choudhary, Asha Sharma, Prassan Vij, Pinky Bahl
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Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015-2016): Leonard Mndala, Abhay Kudale; Epidemiol Health. 2019;41:e2019039. Published online September 27, 2019; DOI: https://doi.org/10.4178/epih.e2019039

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Abstract PDF

Abstract

OBJECTIVES
Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi.

METHODS

A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2 , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds.

RESULTS

In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43).

CONCLUSIONS

Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.

Summary

Citations

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Community Health Equity Research & Policy.2023; 43(2): 183. CrossRef
Updating the association between socioeconomic status and obesity in low‐income and lower‐middle‐income sub‐Saharan African countries: A literature review
Bertille Daran, Pierre Levasseur, Matthieu Clément
Obesity Reviews.2023;[Epub] CrossRef
Analysis of Correlation between the Socioeconomic Environment and Level of Nutrition in the Population of Serbia: A Part of the National Survey
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Christen R. Erasmus, Anil A. Chuturgoon, Niren R. Maharaj
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Olah Owobi, Osaretin Okonji, Chimezie Nzoputam, Michael Ekholuenetale
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Betregiorgis Zegeye, Gebretsadik Shibre, Gashaw Garedew Woldeamanuel
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Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women’s Health-Related Issues: Eunji Choi, Ha Na Cho, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee; Epidemiol Health. 2019;41:e2019005. Published online February 13, 2019; DOI: https://doi.org/10.4178/epih.e2019005

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5 Citations

Abstract Summary PDF

Abstract

OBJECTIVES
While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.

METHODS

Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.

RESULTS

Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.

CONCLUSIONS

Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.

Summary

Korean summary
한국 성인 여성의 과체중 및 비만유병률은 서구여성에 비해 낮으며 2005년 이후 큰 변화 없이 약40%대로 일정하게 유지되어왔으나, 사회경제적불평등에 대한 연구는 체계적으로 이루어지지 않음. 경사불평등(Slope index of inequality)과 상대불평등(Relative index of inequality) 지표를 사용하여 비만유병률에서 발견되는 사회경제적불평등을 조사한 결과, 교육수준별 불평등이 유의하게 나타남. 19-44세의 젊은 여성층에서는 소득수준이 낮은 집단에, 65-79세의 노년기 여성층에서는 도시화된 지역에 사는 집단에 비만유병률이 치중되어있음.

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Disparities in Obesity Rates among Adults: Analysis of 514 Districts in Indonesia
Dumilah Ayuningtyas, Dian Kusuma, Vilda Amir, Dwi Hapsari Tjandrarini, Pramita Andarwati
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Socioeconomic Disparities in Cardiovascular Health in South Korea
Chi-Young Lee, Eun-Ok Im
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Jin-Sung Yuk, Banghyun Lee, Kidong Kim, Myoung Hwan Kim, Yong-Soo Seo, Sung Ook Hwang, Sang-Hee Yoon, Yong Beom Kim, Wen-Chi Chou
PLOS ONE.2021; 16(4): e0250723. CrossRef
Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys
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Association of appendicular skeletal muscle mass with carotid intima-media thickness according to body mass index in Korean adults: Ji Eun Heo, Hyeon Chang Kim, Jee-Seon Shim, Bo Mi Song, Hye Yoon Bae, Ho Jae Lee, Il Suh; Epidemiol Health. 2018;40:e2018049. Published online October 7, 2018; DOI: https://doi.org/10.4178/epih.e2018049

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12 Citations

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middleaged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults.

METHODS

Herein, 595 men and 1,274 women aged 30-64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2 .

RESULTS

Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI.

CONCLUSIONS

Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.

Summary

Korean summary
한국 중년 성인을 대상으로 사지근육양과 죽상경화증(경동맥 내중막 두께≥75 percentile)의 관련성을 체질량지수(≥25, <25 kg/m2)로 층화하여 평가하였다. 체질량지수 25 kg/m2 미만인 남자에서는, 사지근육양이 낮으면 죽상경화증의 위험이 유의하게 높았으나, 체질량지수 25 kg/m2 이상인 남자에서는 관련성이 없었다. 반면 여자에서는 체질량지수에 상관없이 사지근육양과 죽상경화증의 독립적인 관련성이 관찰되지 않았다.

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Ada Trepci, Sophie Imbeault, Victoria L Wyckelsma, Håkan Westerblad, Sigurd Hermansson, Daniel C Andersson, Fredrik Piehl, Tomas Venckunas, Marius Brazaitis, Sigitas Kamandulis, Lena Brundin, Sophie Erhardt, Lilly Schwieler
International Journal of Tryptophan Research.2020; 13: 117864692097824. CrossRef
Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea
Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Yoosik Youm, Eui-Cheol Shin, Hyeon Chang Kim
Yonsei Medical Journal.2019; 60(8): 804. CrossRef

Application of a non-parametric non-mixture cure rate model for analyzing the survival of patients with colorectal cancer in Iran: Mehdi Azizmohammad Looha, Mohamad Amin Pourhoseingholi, Maryam Nasserinejad, Hadis Najafimehr, Mohammad Reza Zali; Epidemiol Health. 2018;40:e2018045. Published online September 17, 2018; DOI: https://doi.org/10.4178/epih.e2018045

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Abstract

OBJECTIVES
Colorectal cancer (CRC) patients are considered to have been cured when the mortality rate of individuals with the disease returns to the same level as expected in the general population. This study aimed to assess the impact of various risk factors on the cure fraction of CRC patients using a real dataset of Iranian CRC patients with a non-mixture non-parametric cure model.

METHODS

This study was conducted on the medical records of 512 patients who were definitively diagnosed with CRC at Taleghani Hospital, Tehran, Iran from 2001 to 2007. A non-mixture non-parametric cure rate model was applied to the data after using stepwise selection to identify the risk factors of CRC.

RESULTS

For non-cured cases, the mean survival time was 1,243.83 days (95% confidence interval [CI], 1,174.65 to 1,313.00) and the median survival time was 1,493.00 days (95% CI, 1,398.67 to 1,587.33). The 1- and 3-year survival rates were 92.9% (95% CI, 91.0 to 95.0) and 73.4% (95% CI, 68.0 to 79.0), respectively. Pathologic stage T1 of the primary tumor (estimate=0.58; p=0.013), a poorly differentiated tumor (estimate=1.17; p<0.001), a body mass index (BMI) between 18.6 and 24.9 kg/m2 (estimate=−0.60; p=0.04), and a BMI between 25.0 and 29.9 kg/m2 (estimate=−1.43; p<0.001) had significant impacts on the cure fraction of CRC in the multivariate analysis. The proportion of cured patients was 64.1% (95% CI, 56.7 to 72.4).

CONCLUSIONS

This study found that the pathologic stage of the primary tumor, tumor grade, and BMI were potential risk factors that had an impact on the cure fraction. A non-mixture non-parametric cure rate model provides a flexible framework for accurately determining the impact of risk factors on the long-term survival of patients with CRC.

Summary

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Assessment of prognostic factors in long-term survival of male and female patients with colorectal cancer using non-mixture cure model based on the Weibull distribution
Mehdi Azizmohammad Looha, Elaheh Zarean, Fatemeh Masaebi, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali
Surgical Oncology.2021; 38: 101562. CrossRef
Actual survival after resection of primary colorectal cancer: results from a prospective multicenter study
Inge van den Berg, Robert R. J. Coebergh van den Braak, Jeroen L. A. van Vugt, Jan N. M. Ijzermans, Stefan Buettner
World Journal of Surgical Oncology.2021;[Epub] CrossRef

Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study: Maryam Shakiba, Hamid Soori, Mohammad Ali Mansournia, Seyed Saeed Hashemi Nazari, Yahya Salimi; Epidemiol Health. 2016;38:e2016025. Published online June 4, 2016; DOI: https://doi.org/10.4178/epih.e2016025

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Abstract PDF

Abstract

OBJECTIVES
The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality.

METHODS

Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model.

RESULTS

Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality.

CONCLUSIONS

This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF.

Summary

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Klara Komici, Leonardo Bencivenga, Stefania Paolillo, Paola Gargiulo, Roberto Formisano, Roberta Assante, Carmela Nappi, Fabio Marsico, Adriana D’Antonio, Giovanni De Simini, Antonio Cittadini, Dino Franco Vitale, Alberto Cuocolo, Pasquale Perrone Filardi
European Journal of Nuclear Medicine and Molecular Imaging.2020; 47(7): 1713. CrossRef
Impact of prior bariatric surgery on outcomes of hospitalized patients with heart failure: a population-based study
Hedong Han, Tiantian Zhu, Yibin Guo, Yiming Ruan, Eyal Herzog, Jia He
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Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study
Lu Wang, Xin Du, Jian-Zeng Dong, Wen-Na Liu, Ying-Chun Zhou, Song-Nan Li, Xue-Yuan Guo, Chen-Xi Jiang, Rong-Hui Yu, Cai-Hua Sang, Ri-Bo Tang, De-Yong Long, Nian Liu, Rong Bai, Laurent Macle, Chang-Sheng Ma
Clinical Research in Cardiology.2019; 108(12): 1371. CrossRef
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Hailey R Banack, Jennifer W Bea, Jay S Kaufman, Andrew Stokes, Candyce H Kroenke, Marcia L Stefanick, Shirley A Beresford, Chloe E Bird, Lorena Garcia, Robert Wallace, Robert A Wild, Bette Caan, Jean Wactawski-Wende
American Journal of Epidemiology.2019; 188(10): 1838. CrossRef

Associations of smoking with overall obesity, and central obesity: a cross-sectional study from the Korea National Health and Nutrition Examination Survey (2010-2013): Yeonjung Kim, Seong Min Jeong, Bora Yoo, Bitna Oh, Hee-Cheol Kang; Epidemiol Health. 2016;38:e2016020. Published online May 19, 2016; DOI: https://doi.org/10.4178/epih.e2016020

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Abstract

OBJECTIVES
The association between smoking and obesity is a significant public health concern. Both are preventable risk factors of cardiovascular disease and a range of other conditions. However, despite numerous previous studies, no consensus has emerged regarding the effect of smoking on obesity. We therefore carried out a novel study evaluating the relationship between smoking and obesity.

METHODS

A total of 5,254 subjects aged 19 years or older drawn from the 2010-2013 Korea National Health and Nutrition Examination Survey were included in this cross-sectional study. Smoking was examined both in terms of smoking status and the quantity of cigarettes smoked by current smokers. Multiple logistic regression analysis was used to assess the association between smoking and obesity. Overall obesity was defined as a body mass index (BMI) ≥25 kg/m2, and central obesity was defined as a waist circumference ≥90 cm for males and ≥85 cm for females. We adjusted for the possible confounding effects of age, sex, physical activity, alcohol consumption, and the presence of hypertension or diabetes.

RESULTS

A statistically significant difference in central obesity according to smoking status was identified. Current smokers were more likely to be centrally obese than never-smokers (adjusted odds ratio,1.30; 95% confidence interval, 1.02 to 1.67). However, no significant association was found between smoking and obesity defined by BMI. Moreover, among current smokers, no statistically significant association was found between the daily amount of smoking and obesity or central obesity.

CONCLUSIONS

Smoking was positively associated with central obesity. Current smokers should be acquainted that they may be more prone to central obesity.

Summary

Korean summary
이 연구는 국민건강영양조사(2010-2013) 자료를 이용하여 한국 성인에서 흡연과 비만의 연관성을 분석하였다. 현재 흡연자는 비흡연자와 비교하여 비만의 위험도는 유의한 차이를 보이지 않았지만 복부비만의 위험도는 유의하게 증가하였다. 흡연이 복부 비만의 위험증가와 연관성이 있음을 확인하였으며 향후 인과관계 및 기전 규명을 위한 연구가 필요할 것으로 생각된다.

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Ji Hye Kim, Byung Jin Kim, Young Youl Hyun, Jin Ho Kang
Endocrinology and Metabolism.2020; 35(4): 892. CrossRef
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Influence of behavioral determinants on deviation of body mass index among 12-15 years old school children of Panchkula: Amandeep Chopra, Nanak Chand Rao, Nidhi Gupta, Shelja Vashisth, Manav Lakhanpal; Epidemiol Health. 2014;36:e2014021. Published online September 29, 2014; DOI: https://doi.org/10.4178/epih/e2014021

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Abstract PDF

Abstract

OBJECTIVES
To evaluate the body mass index (BMI) and factors related to BMI in 12-15 years old adolescents attending school in the Panchkula district of Haryana, India.

METHODS

Our multistage sampling method enrolled 810 adolescents. Demographic data and dietary history data over 5 days were recorded. Height and weight were measured to calculate BMI, which was further categorized according to the World Health Organization classification system. Diet was analysed using the Nizel criteria and socioeconomic status (SES) was assessed using Prasad’s socioeconomic classification. The chi-squared test and analysis of variance test were performed, and a multinomial regression analysis was performed to find significant correlates with BMI.

RESULTS

The prevalences of underweight, normal weight, overweight, and obesity were 13.6, 58.4, 22.7, and 5.3%, respectively. The prevalence of both overweight and obesity was higher among males than that among females. The overall food group, nutrient, sweet, and oral health diet scores were higher among overweight and obese adolescents. Adolescents attending public school were 2.62 times more likely than private school adolescents were to be underweight. Private school adolescents were 2.08 times more likely than public school adolescents were to be overweight. Those with a high SES, vegetarians, and those aged 15 years were highly likely to be obese.

CONCLUSIONS

We found 41.6% of these adolescents to have a BMI that deviated from the norm. Important factors related with BMI were age, gender, socioeconomic score, mean daily diet score, and the type of school.

Summary

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Heavy menstrual bleeding among women aged 18–50 years living in Beijing, China: prevalence, risk factors, and impact on daily life
Chengyi Ding, Jing Wang, Yu Cao, Yuting Pan, Xueqin Lu, Weiwei Wang, Lin Zhuo, Qinjie Tian, Siyan Zhan
BMC Women's Health.2019;[Epub] CrossRef
Association between underweight and tooth loss among Korean adults
In-Seok Song, Kyungdo Han, Jae-Jun Ryu, Jun-Beom Park
Scientific Reports.2017;[Epub] CrossRef

ADIPOQ Gene Variants Associated with Susceptibility to Obesity and Low Serum Adiponectin Levels in Healthy Koreans: Ji Wan Park, Jungyong Park, Sun Ha Jee; Epidemiol Health. 2011;33:e2011003. Published online April 25, 2011; DOI: https://doi.org/10.4178/epih/e2011003

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Abstract PDF

Abstract

OBJECTIVES

This study aimed to measure the association between the adiponectin, C1Q and collagen domain-containing (ADIPOQ) gene variants and obesity in Koreans.

METHODS

Three single nucleotide polymorphisms located in the ADIPOQ gene were genotyped in a population-based cross-sectional study of 986 healthy Koreans. Three different case-control groups (i.e. G1, G2, and G3) were defined according to body mass index (BMI) and serum adiponectin levels. Allelic and genotypic associations of this gene with obesity were measured using multivariate logistic regression analyses in each group.

RESULTS

The G allele of -11377C>G, a polymorphism located in the promoter region of the ADIPOQ gene (odds ratio (OR), 1.48; 95% confidence interval, 1.13-1.94) and most haplotypes including this allele significantly increased the risk for obesity. However, the OR decreased from 3.98 (G1 group) to 2.90 (G2 group) and 2.30 (G3 group) when a less strict definition of obesity was used. Most haplotypes, including this allele, significantly increased the risk of obesity. The statistical evidence from the GG genotype of -11377C>G (OR, 3.98) and the GT/GT diplotype composed of -11377G>C and +45T>G (OR, 5.20) confirmed the contribution of the G allele toward a predisposition for obesity.

CONCLUSION

These results suggest the contribution of the ADIPOQ gene toward susceptibility to obesity in healthy Koreans. The high-risk genotypes and haplotypes identified here may provide more information for identifying individuals who are at risk of obesity.

Summary

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Muhammad Saqlain, Madiha Khalid, Muhammad Fiaz, Sadia Saeed, Asad Mehmood Raja, Muhammad Mobeen Zafar, Tahzeeb Fatima, João Bosco Pesquero, Cristina Maglio, Hadi Valadi, Muhammad Nawaz, Ghazala Kaukab Raja, Nidaa Ababneh
PLOS ONE.2022; 17(9): e0274904. CrossRef
Association of the ADIPOQ-AS LncRNA polymorphism rs2241766 with obesity: A Meta-analysis
M.N. Ammar, L. Lipovich, R.M. Ali, M.A. Amelina, T.P. Shkurat
Human Gene.2022; 34: 201114. CrossRef
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Shatha S Hammad, Peter Eck, Jyoti Sihag, Xiang Chen, Philip W Connelly, Benoît Lamarche, Patrick Couture, Valérie Guay, Julie Maltais-Giguère, Sheila G West, Penny M Kris-Etherton, Kate J Bowen, David J A Jenkins, Carla G Taylor, Danielle Perera, Angela W
The Journal of Nutrition.2019; 149(10): 1749. CrossRef
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Weina Fan, Xiaowei Qu, Jing Li, Xingning Wang, Yanping Bai, Qingmei Cao, Liqun Ma, Xiaoyao Zhou, Wei Zhu, Wei Liu, Qiang Ma
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An Updated Systematic Review and Meta-analysis of Association Between Adiponectin Gene Polymorphisms and Coronary Artery Disease
Haifeng Hou, Siqi Ge, Linlin Zhao, Chenglin Wang, Wei Wang, Xuezhen Zhao, Zheng Sun
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Pia Riestra, Samson Y. Gebreab, Ruihua Xu, Rumana J. Khan, Aurelian Bidulescu, Adolfo Correa, Fasil Tekola-Ayele, Sharon K. Davis
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Jie-fu Lu, You Zhou, Gui-hua Huang, Hai-xing Jiang, Bang-li Hu, Shan-yu Qin
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J S R Machado, A C T Palei, L M Amaral, A C Bueno, S R Antonini, G Duarte, J E Tanus-Santos, V C Sandrim, R C Cavalli
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Ivana Karmelić, Jasna Lovrić, Tamara Božina, Hana Ljubić, Željka Vogrinc, Nada Božina, Jadranka Sertić
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Nabil Mtiraoui, Intissar Ezzidi, Amira Turki, Arbi Chaieb, Touhami Mahjoub, Wassim Y. Almawi
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The Association Between Adiponectin and Diabetes in the Korean Population.: Sun Ha Jee, Hee Yeon Lee, Sun Ju Lee, Ji Eun Yun, Eun Jung Jee, Hye Yun Song, Sang Yeun Kim, Jungyong Park, Hyon Suk Kim; Korean J Epidemiol. 2007;29(2):176-186.

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Abstract PDF: Abstract
BACKGROUND
As indicators of obesity, waist circumference (WC), body mass index (BMI), and adiponectin are well known risk factor for diabetes mellitus. The objectives of this study were to measure the independent association between these obesity indicators and diabetes and to examine the combined effect of these indicators on diabetes in a Korean population.
METHODS
The WC, BMI, and serum adiponectin were measured in 6,505 healthy Koreans and were classified into tertile groups for men and women. The independent and combined associations of the obesity indicators with diabetes were measured using logistic regression analyses. Diabetes was defined as fasting serum glucose greater than 126 mg/dL or taking medication.
RESULTS
Levels of adiponectin were inversely associated with BMI and WC and directly associated with age and high density lipoprotein cholesterol (HDL) cholesterol (P <0.001). After adjusting for age, WC, and other lifestyle factors, low levels of adiponectin were associated with an increased prevalence of diabetes. Further adjustment for HDL cholesterol and triglyceride attenuated this association in both men and women. The best cut-off value of adiponectin in terms of identifying the presence of diabetes was 5.5 /ml with a sensitivity and specificity of 46.7% and 63.9% for men and 9.5 /ml with a sensitivity and specificity of 68.2% and 55.2 for women.
CONCLUSIONS
These results suggest that adiponectin was associated with diabetes. The association was independent of WC and was partly modified by HDL and triglyceride. There were no effect modifications of adiponectin with WC on diabetes.; Summary

Distribution and Correlates of Obesity in a Korean Rural People.: Jong Ku Park, Sang Baek Koh, Myung Gun Kang, Jin Baek Kim, Sook Jung Hyun, Ju Hee Hong, Jun Ho Park, Sei Jin Chang; Korean J Epidemiol. 2004;26(2):8-19.

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Abstract PDF: Abstract
OBJECTIVE: The aim of present study was to assess the distribution and correlates of obesity in a Korean rural people using both body mass index(BMI) and body fat percent.
METHODS
A total of 1,243 participants were recruited using a two-staged stratified sampling. A structured questionnaire was used to ask their sociodemographics (gender, age, marital status, educational background, and etc.) and health-related behaviors (smoking, drinking, and regular exercise etc.). The data of weight-for height, and body fat percent were also collected by physical examination. For the estimation and analysis of correlates of obesity, we used BMI(>or=25kg/m2) and body fat percent(male>or=25%, female>or=30) as a cut-point of obesity. All analyses were stratified to three age groups(>20, 20-39, 40>or=).
RESULTS
The prevalence of obesity in this study was higher than that in previous studies. This study showed that 32.6% (male: 33.7%, female: 31.7%) of participants according to BMI, and 45.6% (male: 43.8%, female: 47.4%) of them according to body fat percent were obese group. Logistic regression analysis showed that, in the criteria of BMI, while obesity was associated with female and low educational background under the age of 40, prevalence of obesity was higher in non smokers over the age of 40. In case of body fat percent crteria, single(unmarried, divorced, separated, widowed) were more likely to be obese in male aged 20 to 39 years. In the group aged 40 years and over, risk of obesity was higher in female than in male.
CONCLUSION
This result suggests that obesity is common in Korean rural areas, especially among adolescents and female aged 40 years or over, and the risk factors for obesity were different by age. It is required that health management program focusing on obesity and its adverse outcomes should be developed in a community setting.; Summary

The Effect of Anthropometric Change on Blood Lipids in Adolescents in Rural Area of Korea.: Kyeong Soo Cheon, Myoung Hee Kim, Kirang Kim, Mi Kyung Kim, Young Jeon Shin, Bo Youl Choi; Korean J Epidemiol. 2002;24(1):17-28.

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Primary prevention of atherosclerosis is important for reducing morbidity and mortality from cardiovascular disease. As modifiable risk factors for atherosclerosis which appears and progresses in early life, obesity and hyperlipidemia are related with each other. Especially hyperlipidemia during adolescent period is closely related to cardiovascular morbidity and mortality in later life, but the association between anthropometric changes in growth period and lipids level in adolescence is not known yet. Therefore we investigated the effect of anthropometric changes in growth period on adolescent lipids level among 615 high school students in rural area of Korea. The study results were as the followings; In childhood, the weight and the height of boys didn't differ from those of girls, however, began to exceed them at 14 and 15 years old respectively. The body mass index(BMI) of both genders was appeared to increase with age. The BMI increase of girls was greater than that of boys from twelve years of age. The BMI slope (annual average increment of BMI; coefficient of regression line) of girls was greater than that of boys(t-test, p<0.01). The proportion of high obesity tracking group was 13.1%(82 persons). In multivariate analysis, total cholesterol and LDL-cholesterol were positively correlated with obesity tracking in boys; BMI slope and BMI at 7 years old in girls. The HDL-cholesterol didn't show any significant association with those factors. The triglyceride was related to BMI slope and obesity tracking in boy, but nothing in girls. In this study, the obesity at 7 years old, the BMI slope, and the obesity tracking are associated with adolescent serum lipid level. For primary prevention of cardiovascular disease, it is needed to develop more active prevention or health promotion program for children and adolesecents in Korea.; Summary

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