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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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  • 127 Download
AbstractAbstract AbstractSummary PDFSupplementary 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
  • 8,828 View
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  • 5 Citations
AbstractAbstract 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
Korean summary
Key Message

Citations

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  • Gestational diabetes mellitus in early pregnancy amongst Asian Indian women: Evidence for poor pregnancy outcomes despite treatment
    John Punnose, Rajeev Kumar Malhotra, Komal Sukhija, Rashika Rijhwani M, Naimaa Choudhary, Asha Sharma, Prassan Vij, Pinky Bahl
    Diabetic Medicine.2023;[Epub]     CrossRef
  • Socio-economic inequalities in diabetes and prediabetes among Bangladeshi adults
    Abdur Razzaque Sarker, Moriam Khanam
    Diabetology International.2022; 13(2): 421.     CrossRef
  • Regional estimates of noncommunicable diseases associated risk factors among adults in India: results from National Noncommunicable Disease Monitoring Survey
    Thilagavathi Ramamoorthy, Sravya Leburu, Vaitheeswaran Kulothungan, Prashant Mathur
    BMC Public Health.2022;[Epub]     CrossRef
  • Efficacy Analysis of Team-Based Nursing Compliance in Young and Middle-Aged Diabetes Mellitus Patients Based on Random Forest Algorithm and Logistic Regression
    Dongni Qian, Hong Gao, Yao Chen
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
  • Factors Influencing Optimal Glucose Control among Type II Diabetes Patients: From the Health Behaviour Models’ Perspective
    Eslavath Rajkumar, GT Kruthika, Padiri Angiel Ruth, R Lakshmi, Daniel Monica, John Romate, Abraham John
    The Open Public Health Journal.2022;[Epub]     CrossRef
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
  • 9,752 View
  • 238 Download
  • 11 Citations
AbstractAbstract 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
Korean summary
Key Message

Citations

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  • Exploring the Causes of Obesity Among Adults in the Kurdish Regions of Iran: A Qualitative Study
    Seyed Fahim Irandoost, Bahman Bayangani, Tahereh Dehdari, Javad Yousefi Lebni, Nafe Babasfari, Nafiul Mehedi, Mohammad Hosein Taghdisi
    Community Health Equity Research & Policy.2023; 43(2): 183.     CrossRef
  • Individual and contextual predictors of overweight or obesity among women in Uganda: a spatio-temporal perspective
    Prince M. Amegbor, Ortis Yankey, Megan Davies, Clive E. Sabel
    GeoJournal.2022; 87(5): 3793.     CrossRef
  • Then and Now: Investigating Anthropometrics and Child Mortality among Females in Malawi
    Sally Sonia Simmons, John Elvis Hagan, Thomas Schack
    International Journal of Environmental Research and Public Health.2022; 19(10): 6171.     CrossRef
  • Maternal overweight and obesity and its associated factors and outcomes in human immunodeficiency virus ( HIV) ‐infected and HIV ‐uninfected black South African pregnant women
    Christen R. Erasmus, Anil A. Chuturgoon, Niren R. Maharaj
    Journal of Obstetrics and Gynaecology Research.2022; 48(11): 2697.     CrossRef
  • Country-Level Variations in Overweight and Obesity among Reproductive-Aged Women in Sub-Saharan Countries
    Olah Owobi, Osaretin Okonji, Chimezie Nzoputam, Michael Ekholuenetale
    Women.2022; 2(4): 313.     CrossRef
  • Food purchasing decisions of Malawian mothers with young children in households experiencing the nutrition transition
    Valerie L. Flax, Chrissie Thakwalakwa, Courtney H. Schnefke, John C. Phuka, Lindsay M. Jaacks
    Appetite.2021; 156: 104855.     CrossRef
  • Time trends in socio-economic, urban-rural and regional disparities in prevalence of obesity among non-pregnant women in Lesotho: evidence from Lesotho demographic and health surveys (2004–2014)
    Betregiorgis Zegeye, Gebretsadik Shibre, Gashaw Garedew Woldeamanuel
    BMC Public Health.2021;[Epub]     CrossRef
  • Risk factors for overweight and obesity among women of reproductive age in Dar es Salaam, Tanzania
    Dominic Mosha, Heavenlight A. Paulo, Mary Mwanyika-Sando, Innocent B. Mboya, Isabel Madzorera, Germana H. Leyna, Sia E. Msuya, Till W. Bärnighausen, Japhet Killewo, Wafaie W. Fawzi
    BMC Nutrition.2021;[Epub]     CrossRef
  • Observed magnitude and trends in socioeconomic and geographic area inequalities in obesity prevalence among non-pregnant women in Chad: evidence from three waves of Chad demographic and health surveys
    Gebretsadik Shibre, Betregiorgis Zegeye, Gashaw Garedew Woldeamanuiel, Wassie Negash, Gorems Lemma, Mitku Mamo Taderegew
    Archives of Public Health.2021;[Epub]     CrossRef
  • Education and prevalence of overweight and obesity among reproductive age group women in Ethiopia: analysis of the 2016 Ethiopian demographic and health survey data
    Ayelign Mengesha Kassie, Biruk Beletew Abate, Mesfin Wudu Kassaw
    BMC Public Health.2020;[Epub]     CrossRef
  • Drivers of food consumption among overweight mother-child dyads in Malawi
    Chrissie Thakwalakwa, Valerie L. Flax, John C. Phuka, Harrison Garcia, Lindsay M. Jaacks, Mauro Lombardo
    PLOS ONE.2020; 15(12): e0243721.     CrossRef
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
  • 11,990 View
  • 269 Download
  • 5 Citations
AbstractAbstract AbstractSummary 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.
Key Message

Citations

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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
    Nutrients.2022; 14(16): 3332.     CrossRef
  • Socioeconomic Disparities in Cardiovascular Health in South Korea
    Chi-Young Lee, Eun-Ok Im
    Journal of Cardiovascular Nursing.2021; 36(1): 8.     CrossRef
  • Incidence and risk of venous thromboembolism according to primary treatment in women with ovarian cancer: A retrospective cohort study
    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
    SuJin Song, Jae Eun Shim
    Korean Journal of Community Nutrition.2021; 26(6): 495.     CrossRef
  • Regional disparities in the associations of cardiometabolic risk factors and healthy dietary factors in Korean adults
    Kyungho Ha, YoonJu Song, Hye-Kyeong Kim
    Nutrition Research and Practice.2020; 14(5): 519.     CrossRef
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
  • 9,856 View
  • 195 Download
  • 11 Citations
AbstractAbstract AbstractSummary PDFSupplementary 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.
Key Message

Citations

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  • Contribution of low skeletal muscle mass in predicting cardiovascular events: A prospective cohort study
    Yiting Xu, Tingting Hu, Yun Shen, Yufei Wang, Yuqian Bao, Xiaojing Ma
    European Journal of Internal Medicine.2023;[Epub]     CrossRef
  • A new paradigm in sarcopenia: Cognitive impairment caused by imbalanced myokine secretion and vascular dysfunction
    Danbi Jo, Gwangho Yoon, Oh Yoen Kim, Juhyun Song
    Biomedicine & Pharmacotherapy.2022; 147: 112636.     CrossRef
  • Low serum creatinine to cystatin C ratio is independently associated with sarcopenia and high carotid plaque score in patients with type 2 diabetes
    Jang Yel Shin
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(6): 1454.     CrossRef
  • Association of High Muscle Mass with Carotid Atherosclerosis: A Community-Based Population Cohort Study
    Y. Xu, T. Hu, Y. Shen, Y. Wang, Xiaojing Ma, Yuqian Bao
    The journal of nutrition, health & aging.2022; 26(12): 1087.     CrossRef
  • Sarcopenia, sarcopenic overweight/obesity and risk of cardiovascular disease and cardiac arrhythmia: A cross-sectional study
    Ming-Feng Xia, Ling-Yan Chen, Li Wu, Hui Ma, Xiao-Ming Li, Qian Li, Qiqige Aleteng, Yu Hu, Wan-Yuan He, Jian Gao, Huan-Dong Lin, Xin Gao
    Clinical Nutrition.2021; 40(2): 571.     CrossRef
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    Jang Yel Shin, Jung Soo Lim
    Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(10): 2935.     CrossRef
  • Low muscle mass is associated with carotid atherosclerosis in patients with type 2 diabetes
    Da Hea Seo, Yong-ho Lee, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, Young Ju Choi, Byoung Wook Huh, Seok Won Park, Eunjig Lee, So Hun Kim
    Atherosclerosis.2020; 305: 19.     CrossRef
  • Associations of skeletal muscle mass with atherosclerosis and inflammatory markers in Korean adults
    Soon-Kyu Yoon, Ha-Na Kim, Sang-Wook Song
    Archives of Gerontology and Geriatrics.2020; 90: 104163.     CrossRef
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    Shuhei Nakanishi, Masahiro Iwamoto, Hisanori Shinohara, Hideyuki Iwamoto, Hideaki Kaneto
    Geriatrics & Gerontology International.2020; 20(12): 1196.     CrossRef
  • Quantification of Plasma Kynurenine Metabolites Following One Bout of Sprint Interval Exercise
    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
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  • 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
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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
  • 8,172 View
  • 198 Download
  • 2 Citations
AbstractAbstract PDF
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
Korean summary
Key Message

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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
  • 13,514 View
  • 234 Download
  • 4 Citations
AbstractAbstract 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
Korean summary
Key Message

Citations

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  • Impact of body mass index on cardiac adrenergic derangement in heart failure patients: a 123I-mIBG imaging study
    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
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    Hedong Han, Tiantian Zhu, Yibin Guo, Yiming Ruan, Eyal Herzog, Jia He
    Surgery for Obesity and Related Diseases.2019; 15(3): 469.     CrossRef
  • 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
  • The Effects of Reverse Causality and Selective Attrition on the Relationship Between Body Mass Index and Mortality in Postmenopausal Women
    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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AbstractAbstract AbstractSummary PDF
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.
Key Message

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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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    F1000Research.2018; 7: 565.     CrossRef
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  • Relationship between smoking characteristics and obesity among military personnel in Korea : Data from smoking cessation clinics, 2009∼2017
    Eunjoo Kwon, Suyoung Kim, Jieun Chu, Seon Cho, Eunhee Nah
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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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  • 2 Citations
AbstractAbstract 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
Korean summary
Key Message

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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
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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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  • 17 Citations
AbstractAbstract 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
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    M.N. Ammar, L. Lipovich, R.M. Ali, M.A. Amelina, T.P. Shkurat
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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
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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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AbstractAbstract 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
Korean summary
Key Message
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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AbstractAbstract 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
Korean summary
Key Message
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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AbstractAbstract PDF
Abstract
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
Korean summary
Key Message
The Analysis of the Correlation of Diabetes Mellitus Incidence and Prevalence with Body Mass Index among Adults Registered in a Health Promotion Center of a University Hospital.
Sang Hoon Ahn, Jung Soon Kim
Korean J Epidemiol. 2000;22(2):159-170.
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AbstractAbstract PDF
Abstract
BACKGROUND
The prevalence and incidence of diabetes mellitus in Korea are higher than western countries. Despite the fact that obesity is an important risk factor of DM, western obesity criteria by BMI level has been used in Korea, which was based on the data derived from the western people having higher average body mass index(BMI) and lower DM incidence than Koreans. Therefore, this study was performed to find out the BMI level, at which point the risk of developing DM increases and its incidence per year.
METHODS
13,301 men and women who visited the Health Promotion Center at Seoul National University Hospital between March 1, 1995 and February 28, 1999 were studied. Factors attributable to DM including BMI were investigated. BMI was categorized in detail to find out the critical point of BMI with increased DM. The incidence of DM per year was investigated by analysing the cohort consisting of people who have visited the center more than once.
RESULTS
The risk factors of DM revealing significant statistical association were age, systolic blood pressure, total cholesterol, triglyceride and BMI. The age-sex adjusted odds ratio at BMI 24.0 was 1.950(95% CI 1.089~3.492) compared to the reference BMI(<21.0) when applying the current diagnostic criteria of DM(140mg/dl), and it was 1.635(95% CI 1.018~2.627) at BMI 22.0 by the new criteria of DM(126mg/dl). Crude incidence rate of DM was 0.9% by the current criteria and 2.1% by the new criteria.
CONCLUSIONS
Current WHO obesity criteria by BMI that we use in Korea should be readjusted(the criteria of overweight lowered from BMI 25.0 to 24.0, and obesity from 30.0 to 27.0 for Koreans), particularly in the aspect of prevention of DM for Korean people. Crude incidence rate of DM was 0.9%, much higher than that of western people, which calls for national concern on prevention and management of DM.
Summary
Korean summary
Key Message
Usefulness of Somatotype Drawing as an Instrument of Recalling Obesity in High School Girls.
Jong Myon Bae
Korean J Epidemiol. 1997;19(2):147-151.
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AbstractAbstract PDF
Abstract
INTRODUCTION: The obesity is related to the chronic diseases of adults. The measurement of obesity level in adolescence is recommended by using Body Mass Index (BMI), but there is a possiblity of recall bias. S@rensen et al(1983) suggested the usefulness of somatotype drawing in measuring the past weight. The aim is to evaluate the usefulness of somatotype drawing as a instrument of recalling obesity in girls.
METHODS
Study population were second-grade girl students in a high school. The questionnaire survey was done. The somatotype drawing used to assess body build in now, 2-year-ago, 4-year-ago, and 5-year-ago. The BMIs in each period were obtained from 'Annual Health Profile Records'(AHPR).
RESULTS
The means of height now and of weight now were 160.48cm and 54.66kg respectively in the 651 subjects so that the median of BMI now was 20.82. The scores of somatotype drawing increased according to higher BMI in all 4 periods. Spearman's correlation coefficients between score of somatotype drawing and BMI in now, 2-year-ago, 4-year-ago, and 5-year-ago were 0.71, 0.67, 0.65 and 0.63 respectively.
CONCLUSION
The instrument of somatotype drawing might be useful to measure the level of past obesity in girls.
Summary
Korean summary
Key Message
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.