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COVID-19: Health Statistics
Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
Epidemiol Health. 2023;45:e2023014.   Published online February 1, 2023
DOI: https://doi.org/10.4178/epih.e2023014
  • 4,633 View
  • 164 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to analyze the changes in chronic disease management indicators, including hypertension, diabetes mellitus, and hypercholesteremia, from 2010-2020 and before (2019) and during (2020) the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This study included 58,504 individuals aged ≥30 years who participated in the Korea National Health and Nutrition Examination Survey 2010-2020. Trends in the prevalence, awareness, treatment, and control of chronic diseases and the difference in those between before and during the COVID-19 pandemic were analyzed using the SAS program PROC SURVEYREG.
RESULTS
From 2010-2020, the awareness, treatment, and control in adults aged ≥30 years for hypertension and hypercholesterolemia continuously improved, whereas no significant change in the management indicators of diabetes mellitus was observed. The prevalence of hypertension, diabetes mellitus, and hypercholesterolemia in men increased from before to during the COVID- 19 pandemic. However, there was no significant change in the management indicators of hypertension and diabetes mellitus in men and women, and the awareness, treatment, and control rates for hypercholesterolemia increased by 5.5%p, 6.9%p, and 4.1%p respectively.
CONCLUSIONS
In 2020, the first year of the COVID-19 pandemic, the prevalence of hypertension, diabetes mellitus, and hypercholesterolemia increased, but the management indicators of the chronic diseases did not significantly deteriorate. Considering the ongoing COVID-19 pandemic, it is necessary to monitor changes in chronic disease management indicators and to develop efficient and accessible chronic disease prevention and management programs.
Summary
Korean summary
국민건강영양조사 자료를 분석한 결과 11년간(2010-2020년) 성인의 고혈압, 고콜레스테롤혈증 인지율, 치료율, 치료자 중 조절률은 개선된 반면 당뇨병은 변화가 없었다. 코로나19 유행 전(2019년)·후(2020년) 비교시 남자에서 고혈압, 당뇨병, 고콜레스테롤혈증 유병률이 증가했다. 그러나 고혈압, 당뇨병 관리지표는 변화가 없었고, 고콜레스테롤혈증 관리지표만 개선되었다.
Key Message
The rates of awareness, treatment, and control in adults aged ≥30 years for hypertension and hypercholesterolemia continuously improved, whereas no significant change in the management indicators of diabetes mellitus was observed over the past 11 years (2010-2020). The prevalence of hypertension, diabetes mellitus, and hypercholesterolemia in men increased from before (2019) to during (2020) the COVID-19 pandemic. However, there was no significant change in the management indicators of hypertension and diabetes mellitus in men and women, and that of hypercholesterolemia improved.

Citations

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  • Topic Modeling-Based Analysis of News Keywords Related to Patients with Diabetes during the COVID-19 Pandemic
    Jeong-Won Han, Jung Min Kim, Hanna Lee
    Healthcare.2023; 11(7): 957.     CrossRef
Original Articles
Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
Taiyue Jin, Eun Young Park, Byungmi Kim, Jin-Kyoung Oh
Epidemiol Health. 2022;44:e2022046.   Published online May 15, 2022
DOI: https://doi.org/10.4178/epih.e2022046
  • 8,728 View
  • 324 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.
METHODS
A total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
Elevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.
CONCLUSIONS
Non-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
Summary
Korean summary
본 연구는 국민건강영양조사 자료를 활용하여 한국 성인에서 혈청 엽산 농도와 고콜레스테롤혈증 및 저밀도지단백 (LDL) 콜레스테롤혈증 유병률 간의 비선형 연관성을 확인하였다. 이 결과는 적정 혈청 엽산 농도와 정확한 엽산 권장섭취량을 추정하는데 근거로 활용될수 있을 것이다.
Key Message
1. The prevalence of hypercholesterolemia and hyper-LDL cholesterolemia were non-linearly associated with serum concentrations of folate in the Korean population. 2. An inverse association with a significant linear trend between serum folate concentrations and prevalence of hypo-HDL cholesterolemia was observed. 3. In relation to folate intake and folic acid fortification and supplementation, more accurate recommendations should be provided.

Citations

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  • A Review of Major Secondary Data Resources Used for Research in Traditional Korean Medicine
    Chunhoo Cheon, Bo-Hyoung Jang, Seong-Gyu Ko
    Perspectives on Integrative Medicine.2023; 2(2): 77.     CrossRef
  • The Utilization of Serum Folate and Homocysteine Tests and the Prevalence of Folate Deficiency in Reproductive-Age Korean Women during the COVID-19 Pandemic
    Rihwa Choi, Wonseo Park, Gayoung Chun, Sang Gon Lee, Eun Hee Lee
    Nutrients.2023; 15(14): 3236.     CrossRef
Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
Yoonjung Kim, Sun Jin Nho, Gyeongji Woo, Hyejin Kim, Suyeon Park, Youngtaek Kim, Ok Park, Kyungwon Oh
Epidemiol Health. 2021;43:e2021028.   Published online April 19, 2021
DOI: https://doi.org/10.4178/epih.e2021028
  • 12,487 View
  • 373 Download
  • 13 Web of Science
  • 16 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
The study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program.
RESULTS
The prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC= 1.9, p< 0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC= -0.5, p< 0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC= -0.9, p< 0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC= 1.6, p< 0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC = 8.2, p < 0.001] and 21.4% in women [APC= 7.1, p< 0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change.
CONCLUSIONS
Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.
Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 우리나라 성인의 비만, 고혈압, 당뇨병, 고콜레스테롤혈증 유병률 및 관리수준을 분석한 결과, 20년 동안 비만(남자), 당뇨병, 고콜레스테롤혈증 만성질환의 유병 수준은 악화되고 있는 반면, 만성질환의 인지율, 치료율, 치료자 중 조절률 등 관리지표는 지속적으로 개선되고 있었다.
Key Message
We examined trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from the 1998-2018 Korea National Health and Nutrition Examination Survey. Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.

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    Jihyun Kim, Seunghee Kye
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    Jee-Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
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    Epidemiology and Health.2023; 45: e2023049.     CrossRef
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    Obesity.2023; 31(9): 2430.     CrossRef
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    Jin-Ju Baek, Soo-In Ryu, Jean Kyung Paik
    Journal of the Korean Society of Food Science and Nutrition.2023; 52(10): 983.     CrossRef
  • Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
    Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023014.     CrossRef
  • Korea hypertension fact sheet 2021: analysis of nationwide population-based data with special focus on hypertension in women
    Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Eunsun Seo, Eunji Kim, Jiyen Han, Ja-Young Kwon, Hyeon Chang Kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Hokyou Lee, Jong Ku Park, Il Suh, Tae-Yong Lee
    Clinical Hypertension.2022;[Epub]     CrossRef
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    Eunsun Seo, Sunjae Jung, Hokyou Lee, Hyeon Chang Kim
    Korean Circulation Journal.2022; 52(5): 382.     CrossRef
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    Sun A Choi, Sung Suk Chung, Jeong Ok Rho
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  • Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
    Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh
    Epidemiology and Health.2022; 44: e2022041.     CrossRef
  • Current Status of the National Health Screening Programs in South Korea
    Hee-Taik Kang
    Korean Journal of Family Medicine.2022; 43(3): 168.     CrossRef
  • Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
    Taiyue Jin, Eun Young Park, Byungmi Kim, Jin-Kyoung Oh
    Epidemiology and Health.2022; 44: e2022046.     CrossRef
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    Hyeon Chang Kim
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Trends in the prevalence and management of diabetes in Korea: 2007-2017
Ji-Yeon Shin
Epidemiol Health. 2019;41:e2019029.   Published online July 4, 2019
DOI: https://doi.org/10.4178/epih.e2019029
  • 15,767 View
  • 307 Download
  • 40 Web of Science
  • 39 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study analyzed Korea National Health and Nutrition Examination Survey data from 2007 to 2017 to assess trends in the prevalence, treatment, and control of diabetes in Korean adults ≥30 years of age.
METHODS
Prevalent diabetes was defined as a fasting plasma glucose level ≥126 mg/dL, self-reported use of anti-diabetic treatment (insulin or oral anti-diabetic drugs), or diabetes diagnosis by a physician. Target levels were defined as glycosylated hemoglobin <6.5% or <7.0%, blood pressure <130/80 mmHg, and total cholesterol <200 mg/dL. All survey waves were age-standardized to the 2005 Korean census population.
RESULTS
Diabetes prevalence increased from 9.6% in 2007-2009 to 10.8% in 2016-2017 (p<0.001). Impaired fasting glucose prevalence significantly increased in both genders and almost every age group. Diabetes awareness and glycemic control did not show an increasing trend; however, the treatment rate and proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved from 57.2% to 63.5% (p=0.008), from 41.1% to 53.2% (p<0.001), and from 65.0% to 78.0% (p<0.001), respectively.
CONCLUSIONS
From 2007 to 2017, the prevalence of diabetes increased moderately in Korea, whereas the diabetes treatment rate and the proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved. However, awareness of diabetes and glycemic control require significant improvements. A national-level action plan is required to raise awareness about diabetes and prediabetes, with the goal of improving glycemic control and minimizing the occurrence of adverse health outcomes.
Summary
Korean summary
지난 2007년-2017년 동안 우리나라 30세 이상 성인의 당뇨병 유병률은 소폭 증가하였으며, 당뇨환자의 치료율, 혈압 조절율, 총콜레스테롤 조절율은 증가 추세를 보였다. 그러나 당뇨병 인지율과 당뇨 환자의 혈당 조절율은 현재의 추세대로라면 Health Plan 2020의 목표치를 달성하기 어려울 것으로 보이며, 개선이 필요하다.

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Cost-effectiveness analysis of low density lipoprotein cholesterol-lowering therapy in hypertensive patients with type 2 diabetes in Korea: single-pill regimen (amlodipine/atorvastatin) versus double-pill regimen (amlodipine+atorvastatin)
Ji-Hyun Park, Yong-Ho Lee, Su-Kyoung Ko, Bong-Soo Cha
Epidemiol Health. 2015;37:e2015010.   Published online February 22, 2015
DOI: https://doi.org/10.4178/epih/e2015010
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Single-pill combination therapy (amlodipine/atorvastatin) might be more effective than double-pill therapy (amlodipine+atorvastatin) in patients with diabetes and concomitant hypertension requiring statin therapy. We compared the cost-effectiveness of a single-pill with that of double-pill for control of low density lipoprotein cholesterol (LDL-C) levels, with the ultimate goal of cardiovascular disease prevention, in these patients using a cost-effectiveness analysis model that considered medication adherence.
METHODS
Effectiveness was defined as the percentage (%) attainment of target LDL-C levels (<100 mg/dL) based on adherence for each therapy. Adherence was defined as compliance to medication (≥80% proportion of days covered). A systematic review of the literature was conducted to determine the proportion of patients who were adherent and target goal attainment based on adherence level. The annual medication costs were based on the adherence levels for each regimen. The average cost-effectiveness ratio (ACER) was calculated as the cost per % attainment of the target LDL-C level.
RESULTS
The ACER for the single-pill regimen was lower than for the double-pill regimen (4,123 vs. 6,062 Korean won per 1% achievement of target goal). Compared with the double-pill, the medication costs were approximately 32% lower with the single-pill.
CONCLUSION
A single-pill for reductions in LDL-C is cost-effective compared with double-pill in hypertensive patients with type 2 diabetes.
Summary
Korean summary
본 연구는 고혈압을 동반한 당뇨환자에게 혈중지질의 추가적인 관리가 필요한 경우 단일복합제제(Amlodipine/Atorvastatin) 투여와 단일제제 병용 (Amlodipine + Atorvastatin) 투여의 두 대안에서 복약 순응도를 고려한 비용-효과성을 비교 분석하였다. 복약순응도의 차이는 치료결과에도 영향을 미치게 되어 복약순응군에서의 치료효과가 비순응군의 효과보다 더 우수하므로 비용-효과 분석 결과 단일복합제 투여군이 단일제제 병용투여군과 비교하였을때 더 효율적인 대안임을 확인할 수 있다.

Citations

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    Kanila Perera, Ning Kam, Zanfina Ademi, Danny Liew, Ella Zomer
    Journal of Clinical Lipidology.2020; 14(6): 772.     CrossRef
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    Clinical Therapeutics.2019; 41(4): 728.     CrossRef
  • Formulations of Amlodipine: A Review
    Muhammad Ali Sheraz, Syed Furqan Ahsan, Marium Fatima Khan, Sofia Ahmed, Iqbal Ahmad
    Journal of Pharmaceutics.2016; 2016: 1.     CrossRef
Heritability and segregation analysis of the level of HDL-cholesterol.
Ji Eun Yun, Chung Mo Nam, Il Suh, Sun Ha Jee
Korean J Epidemiol. 2004;26(2):43-53.
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AbstractAbstract PDF
Abstract
OBJECTIVES
The purpose of this study was to investigate the familial correlation and heritability in HDL cholesterol through segregation analysis.
METHODS
This study, based on data from 11,117 Korean individuals ascertained pedigrees who had participated in 1998 and 2001 Korean National Health & Nutrition Examination Survey. The subjects of segregation analysis were 4,688 Korean who had more than five members in their family.
RESULTS
Serum lipid levels revealed strong familial correlation among spouses, parent-offspring and siblings with low correlation of spouse. The heritability of HDL cholesterol was 54.8% after controlling for age, age2, gender, agexgender, waist circumference, smoking, alcohol drinking, exercise and education. Two models of inheritance, the Mendelian dominant model and the Mendelian codominant model were found in HDL cholesterol. In the codominant model, the predicted HDL-cholesterol for genotype AA, AB, and BB were 44.96, 49.13, and 69.67 mg/dl, respectively. However the Mendelian codominant model only was found in high risk families.
CONCLUSIONS
In conclusion, randomly ascertained Korean families of this study showed strong familial aggregation in HDL cholesterol. The results suggested that the variations in HDL cholesterol may be influencing by major effect of gene.
Summary
The Relationship Between Cholesterol Level and Mortality in Korean Women.
Yun Mi Song, Joo Hon Sung, Jai Jun Byeon, Joung Soon Kim, Oh Young Park
Korean J Epidemiol. 1997;19(2):131-146.
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AbstractAbstract PDF
Abstract
BACKGROUND
There were many efforts to evaluate the relationship between cholesterol and mortality. But almost all of them have been performed on male western people who have higher mean cholesterol concentration than oriental people and have different disease pattern from women's. So, upto now, the relationship of cholesterol to mortality in women with low cholesterol concentration was not well known. We carried out this study to investigate the relationship in Korea women whose mean cholesterol level was lower than that of western people and men.
METHOD
Study subjects included in were 100,363 Korean women aged 30-65 years. They undertook multiphasic health examination provided by Korea Medical Insurance Corporation between March 1990 and July 1990, and had no history of cancer and no significant medical illnesses which could change blood cholesterol level. Study subjects were followed for 5.5 years until December 1995 and it was determined whether each subject was dead or alive using the mortality data from the Korea National Statistical office and the Korea Medical Insurance Corporation. Nonlinear ralationship between serum total cholesterol and mortality was investigated with the use of quadratic regression and with dummy variables using the 158-180mg/dl group as the comparison group. To analyzing the relationship between cholesterol concentra-tion and mortality with controlling for age, smoking, alcohol drinking, exercise, diastolic blood pressure, body mass index, pay level, Cox propor-tional hazard model was used.
RESULT
During the follow-up period, there were 369 deaths. Mean cholesterol concentration of study subjects was 182.8mg/dl There was no significant association between serum cholesterol and total mortality, but women with cholesterol concentrations below 130mg/dl showed slightly increased risk of death(RR=1.20). Cholesterol had an inverse relationship with mortality from stroke, and women with cholesterol concentrations below 130mg/dl had higher risk of death from stroke(RR=3.28). Although there was no statistical significance,risk of mortality from hemorrhagic stroke in women with very low cholesterol concentration was markedly higher than in women with cholesterol concentrations above 130mg/dl. Mortality relationship with cholesterol. And women with cholesterol concentrations higher than 203mg/dl had abruply increased risk for death from ischemic heart disease.
CONCLUSION
Through this study, we could observe an inverse J shaped relationship between cholesterol concentration and mortality in Korean women. The increased risk of mortality from hemorrhagic stroke in people with very low cholesterol concentration supports the previous report which proposed low cholesterol level as a significant risk factor of hemorrhagic stroke. In spite of the lack of statistical signi-ficance, greately increased risk of mortality from ischemic heart disease in people with cholesterol higher than 203mg/dl suggests that cholesterol concentration at the upper end of distribution can be a significant risk factor of ischemic heart disease in women.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.