Epidemiology and Health

Original Articles

Associations between usual source of care characteristics and health outcomes in diabetes mellitus: a focus on medication adherence and healthy behaviors in Korea: Seung Eun Lee, Chul-Woung Kim, Ji Eun Bae, Jee Hyun Choi; Epidemiol Health. 2025;47:e2025063. Published online December 2, 2025; DOI: https://doi.org/10.4178/epih.e2025063

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Abstract Summary PDF: Abstract
OBJECTIVES
This study investigated the associations between usual source of care (USC) characteristics, which incorporate primary care functions, and medication adherence and healthy behaviors in Korean adults with diabetes.
METHODS
We used data from 1,543 adults with diabetes in the 2020 Korea Health Panel Survey. USC was categorized into 5 types based on whether a regular doctor was identified and whether that provider fulfilled comprehensiveness and coordination functions. Multivariable logistic regression was used to assess associations with medication adherence and healthy behaviors.
RESULTS
A significant difference in medication adherence was observed by USC type, although no significant associations emerged for healthy behaviors (smoking, drinking, exercise). Compared to the group without a USC, patients whose regular doctor fulfilled either function were 2.38 times more likely to adhere (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.70 to 3.32), and those whose doctor fulfilled both functions were 1.84 times more likely to adhere (OR, 1.84; 95% CI, 1.31 to 2.59). This association was particularly strong for adherence to medication dosage, frequency, and timing.
CONCLUSIONS
The findings underscore that the functional quality of the USC, particularly the fulfillment of comprehensiveness and coordination, is crucial in improving medication adherence. Simply having a USC is insufficient. The lack of association with healthy behaviors suggests that physicians may focus more on pharmacological control, highlighting the need for multifaceted interventions.; Summary

Korean summary
본 연구는 단순히 주치의가 있는 것만으로는 당뇨병 환자의 복약 순응에 불충분하며, 일차 의료 기능을 충실히 수행하는 상용치료원만이 복약 순응과 유의한 관련이 있음을 입증했습니다. 하지만 상용치료원이 건강 행동 개선과는 관련이 없음을 확인하여, 의료진이 생활 습관 개선에는 영향을 주지 못하고 있음을 시사했습니다. 이러한 결과는 만성질환 관리를 개선하기 위해 상용치료원의 일차 의료 기능을 강화해야 한다는 정책적 근거를 제공합니다.

Key Message
This study shows that simply having a usual source of care (USC) is insufficient; only USCs that fully perform primary care functions are significantly associated with better medication adherence in diabetic patients. However, USC was not linked to improved health behaviors, suggesting providers fail to influence lifestyle changes. The findings provide policy evidence to reinforce the primary care functions of USCs to enhance chronic disease management.

Prospective associations between psychosocial stress and the risk of type 2 diabetes in middle-aged adults: findings from the KoGES_CAVAS: Ji Eun Kim, Hye Won Woo, Yu-Mi Kim, Min-Ho Shin, Sang Baek Koh, Mi Kyung Kim; Epidemiol Health. 2025;47:e2025061. Published online October 31, 2025; DOI: https://doi.org/10.4178/epih.e2025061

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Psychosocial stress is a potential risk factor for type 2 diabetes (T2D); however, the influence of the timing of stress exposure remains uncertain. We examined the prospective associations of baseline, cumulative average, and recent psychosocial stress with the risk of incident T2D in middle-aged adults.
METHODS
We analyzed data from 7,880 participants aged 40-64 years without T2D at baseline. Psychosocial stress was assessed repeatedly using the Psychosocial Well-Being Index-Short Form. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression models with robust error estimators.
RESULTS
A total of 437 T2D cases occurred over 47,621 person-years. While baseline stress showed a non-significant association, both cumulative and recent stress demonstrated positive associations with T2D risk. Recent stress exhibited the strongest association in both male (stress vs. healthy group: IRR, 2.23; 95% CI, 1.41 to 3.52; highest [T3] vs. lowest tertile [T1]: IRR, 1.50; 95% CI, 1.07 to 2.10) and female (stress vs. healthy group: IRR, 1.72; 95% CI, 1.11 to 2.66; T3 vs. T1: IRR, 1.73; 95% CI, 1.26 to 2.37). These associations were more pronounced among participants with abdominal obesity, showing a significant positive linear trend (Bonferroni-corrected threshold, p=0.003).
CONCLUSIONS
Recent psychosocial stress was associated with an increased incidence of T2D, underscoring the importance of integrating psychosocial factors into diabetes prevention strategies, particularly for individuals with abdominal obesity.; Summary

Korean summary
최근(진단 전 방문)의 심리사회적 스트레스는 T2D의 위험인자로 확인되었으며, 기저 스트레스와는 유의미하지 않은 관계를 보였고 누적 스트레스와는 보다 약한 연관성을 보였다. 특히, 복부 비만이 있는 대상자에서 이러한 양상이 두드러져, 이 고위험군을 중심으로 한 스트레스 관리의 필요성이 제기된다.

Key Message
Recent psychosocial stress was identified as the strongest risk factor for type 2 diabetes (T2D), showing non-significant relationship with baseline stress and weaker link for cumulative stress. Particularly, it was more pronounced among those with abdominal obesity, highlighting the importance of stress management in T2D prevention focusing on this high-risk subgroup.

Importance of younger age group and high inflammatory status in the association between periodontal disease and diabetes mellitus: results from the Korea National Health and Nutrition Examination Survey 2012-2018: Hyunmin Lee, Myung-Hee Shin; Epidemiol Health. 2024;46:e2024088. Published online November 15, 2024; DOI: https://doi.org/10.4178/epih.e2024088

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Abstract Summary PDF

Abstract

OBJECTIVES
Although previous studies have demonstrated an association between periodontal disease (PD) and diabetes mellitus (DM), the influence of age and the mediating role of inflammation have seldom been explored. This study investigated this association while considering the modifying effects of age and inflammatory status.

METHODS

This study included 29,491 participants from the 2012-2018 Korea National Health and Nutrition Examination Survey. The community periodontal index (CPI) was assessed by trained dentists using the World Health Organization CPI probe. PD was defined as a CPI score of 3 or 4. Pre-existing and incident DM were identified based on serum glucose levels, a history of DM diagnosis, medication use, and insulin injections. Serum high-sensitivity C-reactive protein (hs-CRP) levels were utilized as an indicator of chronic inflammation.

RESULTS

PD and DM exhibited a significant association, which was more pronounced with incident DM than with pre-existing DM, particularly in individuals younger than 65 years. Among those aged 20-44 years, the odds ratio of incident DM for CPI=4 versus CPI=0 was 2.61 (95% confidence interval, 1.16 to 6.09). High hs-CRP levels (>3 mg/L) were also associated with DM, especially in individuals with PD. This association was stronger with incident DM than with pre-existing DM. A notable joint effect was observed in younger individuals and those with PD.

CONCLUSIONS

The association between PD and DM was more pronounced in younger age groups and those with higher levels of inflammation. Therefore, early interventions for PD in younger patients may be crucial for preventing DM.

Summary

Korean summary
- 치주 질환과 당뇨병 사이의 연관성은 젊은 연령과 염증 수치가 높게 나타난 대상에서 더 두드러지게 나타남 - 치주 질환과 높은 염증 수치를 동시에 가지고 있을 경우의 당뇨 오즈비는 각각의 오즈비 합보다 더 크게 나타나 시너지 효과를 보였음 - 젊은 치주 질환 환자에 대한 조기 개입은 당뇨병 예방에 중요하게 작용할 수 있음

Key Message
• The association between PD and DM was more pronounced in younger age groups and those with higher levels of in- flammation. • The odds of DM increased synergistically for those with both PD and high inflammatory status. • Therefore, early interventions for PD in younger patients may be crucial for preventing DM.

Citations

Citations to this article as recorded by

Synergic Elevation of Systemic Inflammation by the Coexistence of Periodontitis and Diabetes Mellitus: A Nationwide Analysis of Korean Adults
Hye-Sun Shin
Biomedicines.2025; 13(10): 2441. CrossRef
Resveratrol supplementation as a non-surgical treatment in periodontitis and related systemic conditions
Caterina Vinciguerra, Loredana Bellia, Graziamaria Corbi, Sandro Rengo, Alessandro Cannavo
Journal of Traditional and Complementary Medicine.2024;[Epub] CrossRef

Sex-specific associations between dietary legume subtypes and type 2 diabetes in a prospective cohort study: Hye Won Woo, Sangmo Hong, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024083. Published online October 17, 2024; DOI: https://doi.org/10.4178/epih.e2024083

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Abstract

OBJECTIVES
Dietary soy, known for its high phytoestrogen content, has been suggested to exhibit a sex-specific association with type 2 diabetes. However, evidence regarding the sex-specific associations of different legume subtypes with type 2 diabetes remains scarce. We aimed to evaluate whether habitual consumption of soy and non-soy legumes (beans and peanuts) was prospectively and sex-specifically associated with the risk of type 2 diabetes incidence, taking into considering significant sex-specific genetic factors beyond legume consumption.

METHODS

A total of 16,666 participants (96,945 person-years) were followed and 945 incident cases were observed. Cumulative intake of legume subtypes was calculated using a food frequency questionnaire administered at baseline and during the revisit surveys.

RESULTS

Non-soy legumes are inversely associated with type 2 diabetes in both men and women. Dietary soy intake, however, demonstrated a unilaterally interacting sex-specific association with type 2 diabetes risk (pinteraction for sex=0.017). Specifically, there was a significant inverse association with type 2 diabetes risk in women (incidence rate ratio, 0.66; 95% confidence interval, 0.48 to 0.80; ptrend=0.007), but no such association was observed in men. This sex-specific association persisted and even appeared antagonistic in minor allele carriers of 2 novel single nucleotide polymorphisms, rs10196939 (LRRTM4) and rs11750158 (near GFPT2) (pinteraction for sex=0.001 and 0.011, respectively).

CONCLUSIONS

Habitual consumption of legumes shows protective impacts against type 2 diabetes, although these benefits vary by sex. Non-soy legumes provide health advantages for both men and women, whereas soy consumption seems to be beneficial exclusively for women.

Summary

Korean summary
콩류 섭취는 제2형 당뇨병 예방에 도움이 되는데, 대두를 제외한 콩류와 땅콩은 남녀 모두에게 건강상의 이점이 있는 반면, 대두는 여성에게만 보호적 이점이 있는 것으로 관찰되었다. 대두 섭취는 남성과 여성에서 서로 다른 영향을 미치는 것으로 관찰되었으며, 이는 대두 섭취의 건강상의 영향이 성별에 따라 다르게 나타날 수 있음을 시사하였다.

Key Message
Our findings showed that while legume consumption was protective against type 2 diabetes, beans and peanuts demonstrated health benefits in both sexes, whereas soy's protective benefits were observed only in women. Soy consumption was observed to have different effects between men and women, suggesting that the health impact of soy intake may differ by sex.

Citations

Citations to this article as recorded by

Differential Network-Based Dietary Structure and Type 2 Diabetes Risk: A Prospective Cohort Study Using Food Co-Consumption Networks
Hye Won Woo, Yu-Mi Kim, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Mi Kyung Kim
Nutrients.2026; 18(3): 506. CrossRef

Influence of practice location on prescribing, diabetes care, and colorectal cancer screening among Czech general practitioners during the COVID-19 pandemic: Jan Bělobrádek, Luděk Šídlo, Tom Philipp; Epidemiol Health. 2024;46:e2024033. Published online February 23, 2024; DOI: https://doi.org/10.4178/epih.e2024033

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices.

METHODS

We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology.

RESULTS

We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs).

CONCLUSIONS

Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.

Summary

Key Message
Primary care in Czechia has effectively adapted to the changes brought about by the COVID-19 pandemic. Minimal impact was observed in prescribtions and diabetic patient care. There was a significant decline in colorectal cancer screening, with a slow restitution after the pandemic subsided. Rural GPs consistently provided in-house treatment and have higher shares of both prescribing and diabetes care, as well as performing more COVID-19 specific procedures.

Citations

Citations to this article as recorded by

Geographical Disparities in Faecal Immunochemical Test‐Based Colorectal Cancer Screening Participation and Positivity Rates: A Systematic Review and Meta‐Analysis
Melkalem Mamuye Azanaw, Erin L. Symonds, Geraldine Laven‐Law, Wudneh Simegn Belay, Syme Aftab, Muktar B. Ahmed, Molla M. Wassie
Health Promotion Journal of Australia.2026;[Epub] CrossRef
Effect of Age, Practice Location and Covid-19 on the Use of POCT Methods by General Practitioners in Czechia in 2017–2021
Jan Bělobrádek, Luděk Šídlo, Tom Philipp
Acta Medica (Hradec Kralove, Czech Republic).2025; 68(3): 87. CrossRef

A prospective association between dietary mushroom intake and the risk of type 2 diabetes: the Korean Genome and Epidemiology Study–Cardiovascular Disease Association Study: Yu-Mi Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Mi Kyung Kim; Epidemiol Health. 2024;46:e2024017. Published online January 8, 2024; DOI: https://doi.org/10.4178/epih.e2024017

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Abstract

OBJECTIVES
Mushrooms, known for their nutritious and functional components, are considered healthy and medicinal. This study investigated the prospective association between dietary mushroom consumption and the incidence of type 2 diabetes among Korean adults aged ≥40 years.

METHODS

In total, 16,666 participants who were not taking anti-diabetic medication or insulin and had normal fasting blood glucose (FBG; <126 mg/dL) were included. We used the cumulative average dietary consumption of mushrooms as an exposure metric, calculated from food frequency questionnaires at every follow-up, along with covariates collected during a baseline survey. To estimate incidence rate ratios (IRRs) for type 2 diabetes, a modified Poisson regression model with a robust error estimator was applied.

RESULTS

In multivariable models, dietary mushroom consumption was inversely associated with type 2 diabetes incidence in both genders (men: IRR, 0.65; 95% confidence interval [CI], 0.47 to 0.90; plinearity=0.043 in the highest quartile (Q4) vs. the lowest quartile (Q1); women: IRR, 0.70; 95% CI, 0.54 to 0.93; plinearity=0.114 in Q4 vs. Q1). The inverse association remained after adjustment for dietary factors instead of dietary quality index, the baseline FBG, and the exclusion of incidence within the first year. Additionally, no significant interaction was found regarding the risk of type 2 diabetes between dietary mushroom consumption and participants’ gender or other factors.

CONCLUSIONS

Dietary mushroom consumption was inversely linked with the risk of type 2 diabetes incidence in both genders, indicating the beneficial role of mushrooms in preventing the disease.

Summary

Korean summary
- 흔히 사용하는 버섯의 식이 섭취량이 증가함에 따라 한국 40세 이상 성인에서 제2형 당뇨병 발생 위험이 낮았다. - 이러한 역관계는 성별과 다양한 식이 배경에서도 일관성을 유지하였고, 이는 버섯이 제2형 당뇨병 예방에 있어 잠재적인 식이요소로서의 가능성을 보여주는성을 보여주는 보여주는 결과이다.

Key Message
• Increased dietary consumption of commonly used mushrooms is associated with a lower risk of type 2 diabetes incidence among adults aged 40 years or older in Korea. • This inverse relationship remains consistent across genders and various dietary backgrounds, underscoring the potential of mushrooms as a preventive dietary component against.

Citations

Citations to this article as recorded by

Integrative Roles of Functional Foods, Microbiotics, Nutrigenetics, and Nutrigenomics in Managing Type 2 Diabetes and Obesity
Hong Nhung Lam, Shih-Ping Lin, Dang Hien Ngan Nguyen, Chiao-Ming Chen, Chien-Tien Su, Te-Chao Fang, Sing-Chung Li
Nutrients.2025; 17(4): 608. CrossRef
Protective Properties of the White Button Mushroom, Agaricus bisporus, in a Mouse Model of Colitis
Elaine Dempsey, Aaron M. Walsh, Supriya Yadav, Jude Wilson, Frederick J. Sheedy, Sinead C. Corr
Molecular Nutrition & Food Research.2025;[Epub] CrossRef
Underappreciated Health Benefits of Edible Mushrooms in the Dietary Management of Chronic Kidney Disease
Mona S. Calvo, Jaime Uribarri
Journal of Renal Nutrition.2025;[Epub] CrossRef

Increased risk of cancer and cancer-related mortality in middle-aged Korean women with prediabetes and diabetes: a population-based study: Thi Xuan Mai Tran, Soyeoun Kim, Huiyeon Song, Boyoung Park; Epidemiol Health. 2023;45:e2023080. Published online August 28, 2023; DOI: https://doi.org/10.4178/epih.e2023080

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Abstract

OBJECTIVES
This study investigated the risk of developing and dying from all types of cancer, as well as cancer-specific mortality, in women diagnosed with prediabetes and diabetes.

METHODS

We included women aged ≥40 years who underwent cancer screening from 2009 to 2014 with follow-up until 2020. Diabetes status was determined based on fasting plasma glucose levels, self-reported history of diabetes, and the use of antidiabetic medication. We quantified the risk of cancer and mortality in the prediabetes and diabetes groups, relative to the normoglycemia group, by calculating adjusted hazard ratios (aHRs).

RESULTS

The study included 8,309,393 participants with a mean age of 52.7±9.7 years. Among these participants, 522,894 cases of cancer and 193,283 deaths were detected. An increased risk of cancer was observed in both the prediabetes group (aHR, 1.03; 95% confidence interval [CI], 1.02 to 1.04) and the diabetes group (aHR, 1.13; 95% CI, 1.12 to 1.14). The highest risk was identified in those with diabetes who developed liver (aHR, 1.72; 95% CI, 1.66 to 1.79), pancreatic (aHR, 1.68; 95% CI, 1.60 to 1.76), and gallbladder cancer (aHR, 1.43; 95% CI, 1.36 to 1.51). Women with prediabetes and diabetes exhibited a 1.07-fold (95% CI, 1.05 to 1.08) and 1.38-fold (95% CI, 1.36 to 1.41) increased risk of death from cancer, respectively.

CONCLUSIONS

Both prediabetes and diabetes were associated with an elevated risk of cancer, as well as an increased risk of death from cancer, in middle-aged Korean women. However, the degree of risk varied depending on the specific site of the cancer.

Summary

Korean summary
40세 이상의 중년 여성에서 당뇨 또는 당뇨 전 단계는 암 발생 위험과 암으로 인한 사망위험을 증가시킴. 암 종별로는 위암, 대장암, 직장암, 간암, 담낭암, 췌장암, 유방암, 자궁경부암, 자궁암, 신장암, 방광암의 발생 위험이 증가한 반면, 갑상선암의 발생 위험은 감소하였음. 거의 대부분의 암종에서 당뇨는 암으로 인한 사망위험을 증가시킴

Key Message
Both prediabetes and diabetes were independently associated with an overall increased risk of cancer, with a stronger association with malignancies in the liver and pancreas in women. Additionally, both prediabetes and diabetes status are associated with an elevated risk of death from cancer. These findings support the need for prevention and management to reduce cancer-related burden and premature deaths due to cancer, not only in individuals with diabetes but also in those with prediabetes.

Citations

Citations to this article as recorded by

Overview of the prevalence and features of oncological diseases in type 2 diabetes and possible immunological mechanisms
Ya. V. Dvoryanchikov, S. M. Deunezhewa, I. A. Yatskov, V. A. Beloglazov
Problems of Endocrinology.2025; 71(2): 75. CrossRef
Prognostic value of preoperative serum tumor markers in gallbladder cancer
Qianhui Duan, Jie Zhong, Yinghui Song, Sicheng Zhang, Weimin Yi, Chuang Peng, Sulai Liu, Jianping Wu, Lianhong Zou
BMC Gastroenterology.2025;[Epub] CrossRef
A burden of proof study of the effects of exposure to high fasting plasma glucose on the risk of seven types of cancer
Paula Portal Teixeira, Yvonne Yiru Xu, Aleksandr Aravkin, Peng Zheng, Lisa M. Force, Jonathan Kocarnik, Susan McLaughlin, Theo Vos, Hailey Lenox, Simon Hay, Bruce Bartholow Duncan, Verônica Colpani, Chris Murray, Fernando Gerchman, Kanyin Liane Ong
Scientific Reports.2025;[Epub] CrossRef
Prediabetes persistence or remission and subsequent risk of gallbladder cancer: A nationwide cohort study
Joo-Hyun Park, Jung Yong Hong, Kyungdo Han, Young Suk Park, Joon Oh Park, Ho Yeong Lim, Jay J. Shen
European Journal of Cancer.2024; 213: 114312. CrossRef

Associations between adverse childhood experiences and diabetes among middle-aged and older Chinese: a social-ecological perspective: Siyu Zhu, Leying Hou, Jiaying Ma, Shuting Li, Weidi Sun, Wen Liu, Jiajun Hao, Wenhan Xiao, Siqing Cheng, Dexing Zhang, Dong Zhao, Peige Song; Epidemiol Health. 2023;45:e2023071. Published online August 2, 2023; DOI: https://doi.org/10.4178/epih.e2023071

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Abstract

OBJECTIVES
This study examined the associations between adverse childhood experiences (ACEs) and diabetes within a social-ecological framework, incorporating personal and environmental unfavorable conditions during childhood from family, school, and community contexts.

METHODS

Data were obtained from the China Health and Retirement Longitudinal Study (2014 life history survey and 2015 survey), including 9,179 participants aged ≥45 years. ACEs were collected through self-report questionnaires, and participants were categorized based on the number of distinct ACEs experienced (0, 1, 2, 3, or ≥4 ACEs). Diabetes was defined by biomarkers, self-reported diagnosis, and treatment status. Logistic regression was conducted to explore the associations between ACEs and diabetes. Subgroup analyses were conducted by gender, age, and obesity status.

RESULTS

Compared with participants without ACEs, those exposed to any ACE (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40), 3 ACEs (OR, 1.32; 95% CI, 1.07 to 1.62) and ≥4 ACEs (OR, 1.29; 95% CI, 1.07 to 1.56) had an increased risk of diabetes. For each additional ACE, the risk of diabetes increased by about 5%. Regarding the source of ACEs, those originating from the family (OR, 1.23; 95% CI, 1.08 to 1.41) were associated with diabetes. In terms of specific ACE types, family members with substance abuse (OR, 1.23; 95% CI, 1.01 to 1.52), emotional abuse (OR, 1.28; 95% CI, 1.12 to 1.46), and poor parental relationship (OR, 1.25; 95% CI, 1.09 to 1.43) were associated with diabetes.

CONCLUSIONS

ACEs, particularly those originating from the family, were associated with diabetes. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.

Summary

Key Message
From a social-ecological perspective, this study delineates an association between adverse childhood experiences (ACEs), particularly those originating from the family, and diabetes among middle-aged and older Chinese. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.

Citations

Citations to this article as recorded by

Association of Adverse Childhood Experiences and Metabolic Syndrome: A Systematic Review and Meta‐Analysis
Joohan Kim, Luyu Xie, Alejandra Fernandez, Jaime P. Almandoz, Sarah E. Messiah
Obesity Reviews.2026;[Epub] CrossRef
Health effects associated with exposure of children to physical violence, psychological violence and neglect: a Burden of Proof study
Luisa S. Flor, Caroline Stein, Gabriela F. Gil, Mariam Khalil, Molly Herbert, Aleksandr Y. Aravkin, Alejandra Arrieta, María Jose Baeza de Robba, Flavia Bustreo, Jack Cagney, Renzo J. C. Calderon-Anyosa, Sinclair Carr, Jaidev Kaur Chandan, Joht Singh Chan
Nature Human Behaviour.2025; 9(6): 1217. CrossRef

Effects of multigrain rice and white rice on periodontitis: an analysis using data from the Korea National Health and Nutrition Examination Survey 2012-2015: Seung-Hee Ryu, Zi-lan Wang, Seon-Jip Kim, Hyun-Jae Cho; Epidemiol Health. 2023;45:e2023063. Published online July 3, 2023; DOI: https://doi.org/10.4178/epih.e2023063

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Abstract

OBJECTIVES
Numerous studies have investigated the efficacy of whole grains; however, research on multigrain remains limited. Grains exhibit combined positive effects against various diseases. The purpose of this study was to examine the impact of multigrain and white rice consumption on periodontitis.

METHODS

We analyzed data from the Korea National Health and Nutrition Examination Survey V-3 and VI, collected between 2012 and 2015, which included 12,450 patients (4,859 male and 7,591 female) aged 19-64 years. The World Health Organization’s Community Periodontal Index (CPI) was utilized to assess the presence of periodontitis, with periodontitis defined as a CPI index score of ≥3. Multivariable logistic regression analysis was performed after adjusting for potential confounding variables.

RESULTS

The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.69 to 0.93). When stratified by sex, the risk of periodontitis demonstrated a 24% decrease in female who consumed only multigrain rice (OR, 0.76; 95% CI, 0.62 to 0.93). A similar result was observed in the age group of 40-64 years (OR, 0.84; 95% CI, 0.71 to 0.99). In the diabetes stratification model, the normal group that consumed only multigrain rice exhibited a 25% decrease in the odds of periodontitis (OR, 0.75; 95% CI, 0.62 to 0.91).

CONCLUSIONS

Our findings suggest that the prevalence of periodontitis may vary depending on the type of rice consumed.

Summary

Korean summary
본 연구에서는 우리나라의 대규모 자료를 이용하여 쌀 섭취 종류가 치주염 위험에 미치는 영향을 살펴보았다. 우리의 연구 결과는 잡곡밥을 매일 2회 이상 섭취하는 것이 흰쌀밥을 먹는 것보다 치주염 예방에 더 효과적이라는 것을 보여준다. 이러한 결과는 당뇨병이 있는 사람에 비해 건강한 사람, 남성보다는 여성, 40~64세에서 더 큰 예방 효과를 시사한다.

Key Message
In this study, we examined the impact of different types of rice consumption on the risk of periodontitis using large-scale data from Korea. The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR]=0.80; 95% confidence interval [CI], 0.69–0.93). The risk of periodontitis was reduced by 24% in female who consumed only multigrain rice, 16% decrease in the 40–64 age group, and in the diabetic stratification model, the normal group who consumed only multigrain rice had a 25% decrease in periodontitis risk.

Citations

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Is Starch Intake Associated With Periodontal Status? An 11‐Year Longitudinal Analysis Among Finnish Adults
F. H. Jangda, A. L. Suominen, A. Lundqvist, S. Männistö, A. Golkari, E. Bernabé
Journal of Clinical Periodontology.2025; 52(3): 353. CrossRef
The need and strategies for increasing whole-grain intake: a narrative review focused on the UK and Ireland
Neil Bernard Boyle, Louise Dye, Chris J. Seal
British Journal of Nutrition.2025; 134(7): 600. CrossRef
Trends and Characteristics of Brown Rice Consumption among Adults in Japan: An Analysis of the National Health and Nutrition Surveys, 2012–2019
Nayu Ikeda, Miwa Yamaguchi, Nobuo Nishi
Nutrients.2024; 16(10): 1473. CrossRef

Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study: Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park; Epidemiol Health. 2023;45:e2023029. Published online February 23, 2023; DOI: https://doi.org/10.4178/epih.e2023029

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The aim of this study was to clarify the clinical trait of familial diabetes mellitus (DM) by analyzing participants’ risk of DM according to the age of DM onset in parents and siblings, and to evaluate individuals’ risk of DM-associated cardiometabolic diseases.

METHODS

Altogether, 211,173 participants aged ≥40 years from the Korean Genome and Epidemiology Study were included in this study. The participants were divided into groups based on the number (1 or 2 relatives) and age of onset (no DM and early, common, or late onset) of familial DM. Participants’ risk of DM was assessed using a Cox regression model with hazard ratios and 95% confidence intervals (CIs). A logistic regression model with odds ratios was used to evaluate associations among the participants’ likelihood of acquiring cardiometabolic diseases such as hypertension, chronic kidney disease (CKD), and cardiovascular disease.

RESULTS

The risk of developing DM was 2.02-fold (95% CI, 1.88 to 2.18) and 2.88-fold (95% CI, 2.50 to 3.33) higher, respectively, in participants with 1 and 2 family members diagnosed with familial DM. It was 2.72-fold (95% CI, 2.03 to 3.66) higher in those with early-onset familial DM. In the early-onset group, the respective risks of hypertension and CKD were 1.87-fold (95% CI, 1.37 to 2.55) and 4.31-fold (95% CI, 2.55 to 7.27) higher than in the control group.

CONCLUSIONS

The risk of DM and related cardiometabolic diseases was positively associated with the number of family members diagnosed with DM and an early diagnosis in family members with DM.

Summary

Korean summary
본 연구는 한국인유전체역학조사사업 역학자료를 이용하여, 당뇨병을 진단받은 가족 구성원 (부모 및 형제)의 수가 많고 당뇨병이 조기에 발생할수록 개인의 당뇨발생 위험도가 높아짐을 보고하였습니다. 또한 당뇨병이 조기에 발생한 가족구성원이 있을 경우 개인의 일부 심대사질환과의 연관성이 있을 수 있음을 설명하였습니다.

Key Message
This study demonstrated that the risk of diabetes in individuals was significantly associated with the quantity and the onset of family members diagnosed with diabetes. We also explained that having a family member with early-onset diabetes can be associated with some cardiometabolic diseases in individuals.

Citations

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Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults
Jung-Hwan Kim, Yaeji Lee, Chung-Mo Nam, Yu-Jin Kwon, Ji-Won Lee
Endocrine.2024; 86(2): 528. CrossRef

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

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Abstract Summary PDF Supplementary 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.

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Epidemiology and Health.2026; 48: e2026001. CrossRef
Korea Hypertension Fact Sheet 2024: nationwide population-based analysis with a focus on young adults
Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Song Vogue Ahn, Ju-Mi Lee, Dae Young Cheon, Jong Hyun Jhee, Minjae Yoon, Min-Ho Shin, JoonNyung Heo, Eunji Kim, Seung Won Lee, Jaeyong Lee, Yeon Woo Oh, Jooeun Jeon, Minsung Cho, Dasom Son, Na Yeon Ahn
Clinical Hypertension.2025;[Epub] CrossRef
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Scientific Reports.2025;[Epub] CrossRef
Predictive Model of Medication Adherence among Hypertension and Diabetes Patients Using the Korea Health Panel Data
Seonhye Jeong, Yuyoung Lee, Moonhyang Kim, Yeoungsuk Song
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Eunbyul Cho, Sujeong Han, Jae-ryun Lee, Hyejin Lee, Bumjo Oh
Korean Journal of Family Medicine.2024; 45(5): 283. CrossRef
Socioeconomic inequalities in the prevalence, non-awareness, non-treatment, and non-control of diabetes among South Korean adults in 2021
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Topic Modeling-Based Analysis of News Keywords Related to Patients with Diabetes during the COVID-19 Pandemic
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International Journal of Molecular Sciences.2023; 24(14): 11576. CrossRef

Original Articles

Type 2 diabetes mellitus increases the severity of non-fatal injuries, but not the risk of fatal injuries, among driver victims of motor vehicle crashes in Taiwan: I-Lin Hsu, Wen-Hsuan Hou, Ya-Hui Chang, Chung-Yi Li; Epidemiol Health. 2022;44:e2022076. Published online September 16, 2022; DOI: https://doi.org/10.4178/epih.e2022076

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Limited information is available on whether diabetes increases the severity of injuries from motor vehicle crashes (MVCs). This study aimed to investigate the association of type 2 diabetes with injury severity among driver victims of MVCs.

METHODS

This cohort study involved 75,737 adult driver victims with type 2 diabetes from Taiwan’s Police-Reported Traffic Accident Registry in 2015-2017, along with 150,911 sex-, age-, and calendar year-matched controls. The severity level of non- fatal injuries was derived from the International Classification of Diseases Programs for Injury Categorization based on the diagnostic codes of National Health Insurance claims within 3 days after an MVC. Information on fatal injuries within 3 days after an MVC was obtained from the Taiwan Death Registry. Logistic regression models were used to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of injury severity in association with type 2 diabetes.

RESULTS

After adjusting for potential confounders, driver victims with type 2 diabetes experienced significantly higher risks of mild and severe non-fatal injuries than their counterparts without diabetes, with covariate-adjusted ORs of 1.08 (95% CI, 1.05 to 1.11) and 1.28 (95% CI, 1.20 to 1.37), respectively. By contrast, the adjusted OR for fatal injuries was not significantly elevated, at 1.02 (95% CI, 0.89 to 1.18). Similar results were found when car and scooter driver victims were analyzed separately.

CONCLUSIONS

Type 2 diabetes was found to moderately increase the severity of non-fatal injuries from MVCs among car and scooter driver victims.

Summary

Key Message
With 75,737 driver victims with diabetes and 150,911 matched controls, this study showed an 8% and 28% increase in mild and severe non-fatal injury, respectively among driver victims with diabetes. Such increase in risk was equally applied to both car and scooter drivers. No increase in risk of 3-day mortality after crash was found.

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Prevalence of diabetes mellitus among traumatic patients admitted to Aseer Central Hospital, Aseer Region, Abha, Saudi Arabia: cross-sectional study
Majed Mohammed Al Saleh, Bandar A. Alasmari, Ali Mohammed AlAmri, Mohammed Mabkhoot Mogbel, Ali Saeed Alasmary, Alhussein Ali Almonawar, Saeed Doos S. Almontashri, Hassan Mussa Al Mojamad, Turki Abdullah Al Qahtani, Abdulrahman Mohammed Alshehri, Ibrahim
BMC Endocrine Disorders.2025;[Epub] CrossRef
A population-based study on meteorological conditions in association with motor vehicle collisions among people with type 2 diabetes
Chung-Yi Li, Ya-Hui Chang, Hon-Ping Ma, Ping-Ling Chen, Chang-Ta Chiu, I-Lin Hsu
Environmental Health and Preventive Medicine.2025; 30: 91. CrossRef

Associations of fasting glucose and glycated hemoglobin with vitamin D levels according to diabetes mellitus status in Korean adults: Yerin Hwang, Jiyoung Jang, Myung-Hee Shin; Epidemiol Health. 2022;44:e2022025. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022025

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
According to previous studies, vitamin D deficiency might increase the risk of type 2 diabetes mellitus (DM). However, few studies have examined whether vitamin D continues to affect glucose control after DM diagnosis. Therefore, we examined the association between vitamin D and glucose levels in individuals with and without DM.
METHODS
We analyzed data for 32,943 adults aged 19 years and older from the 2008 to 2014 Korea National Health and Nutrition Examination Survey. Patients were classified into 3 groups according to the 25-hydroxyvitamin D concentration. DM was defined as a fasting glucose level ≥126 mg/dL, current use of DM medications or insulin injections, or a self-reported diagnosis of DM by a doctor.
RESULTS
In male DM patients, the hemoglobin A1c (HbA1c) level increased significantly as vitamin D levels became severely deficient. In male and postmenopausal female with abnormal HbA1c, those with severe vitamin D deficiency had significantly higher HbA1c levels (p for trend=0.004 and 0.022 for male and postmenopausal female, respectively). Significant differences were found between participants with normal and abnormal HbA1c levels in both male and female. However, regardless of sex or menopausal status, there was no significant association between vitamin D and fasting glucose in any of the fasting glucose subgroups.
CONCLUSIONS
Male and female with abnormal HbA1c levels showed markedly elevated blood glucose when they also had vitamin D deficiency. A more distinct difference was observed in the HbA1c subgroups than in the fasting glucose subgroups.; Summary

Korean summary
당화혈색소 비정상군에서 비타민 D가 부족할수록 혈당의 상승을 보였다. 현재까지 비타민 D와 혈당 조절과 관련하여 한국인을 대상으로 한 연구는 매우 미비한 상황이며, 한국인을 대상으로 한 연구 결과를 반영한 당뇨병 환자들의 혈당 조절 관리 지침 마련이 필요하다.

Key Message
Guidelines are needed for managing glucose control in DM patients that reflect the results of this research performed among Koreans. Additional large-scale longitudinal studies should be conducted to clarify the causal relationships underlying this association.

Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis: Hwa Jeong Seo, Hyun Sook Oh; Epidemiol Health. 2021;43:e2021103. Published online December 17, 2021; DOI: https://doi.org/10.4178/epih.e2021103

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients.

METHODS

Population-based cohort data were used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013. Patient-specific medication prescription status was defined by the landmark time (LMT; a fixed time after cohort entry), considering both pre- and post-LMT prescriptions to control methodological biases in observational research. The LMT was set to 2 years. Logistic regression analysis with multivariable adjustment was conducted to analyze cancer incidence by patient-specific medication prescription status.

RESULTS

Only 33.4% of the subjects were prescribed medication early (before the LMT) with compliance. Cancer incidence in individuals with early prescription and compliance was 25% lower (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.67 to 0.84) than in those without. As early-prescribed medications, metformin monotherapy and metformin combination therapy were associated with 34% (OR, 0.66; 95% CI, 0.51 to 0.83) and 25% (OR, 0.75; 95% CI, 0.64 to 0.88) lower cancer risk than non-use, respectively. Patients who were prescribed late (post-LMT) but did not comply with the prescription had a 24% (OR, 1.24; 95% CI, 0.97 to 1.58) higher cancer incidence than non-users. Among patients who started monotherapy early without changes throughout the entire follow-up period, those who started on metformin had a 37% (OR, 0.63; 95% CI, 0.41 to 0.99) lower risk of cancer than non-metformin users.

CONCLUSIONS

Doctors must prescribe antidiabetic medication early, and patient compliance is required, regardless of the prescription time, to prevent cancer. Metformin monotherapy or combination therapy is recommended as an early prescription.

Summary

Korean summary
당뇨 환자는 암 발병 위험이 높으며 암은 주요 사망 원인이다. 당뇨환자의 암발생 예방을 위한 관리로서, 당뇨병 진단 후 약물 치료 시기에 대한 연구는 부족하다. 또한, 전 세계적으로 가장 흔히 처방되는 당뇨병 치료제인 메트포민은 암 예방 효과가 있다고 알려져 왔으나 관측연구에서 발생하는 선택 편향의 문제가 제기되었고, 최근 일부 연구에서 기존의 암 예방 효과와 상충되는 결과가 나오고 있어 논쟁이 이어지고 있다. 본 연구는 선택 편향을 통제한 코호트 연구에서 조기 약물 치료와 메트포민 사용이 당뇨환자의 암 예방에 효과적임을 밝혔다. 따라서 의사들은 처음 당뇨 진단을 받은 환자에게 조기에 약물 처방을 하고, 환자들은 처방에 잘 따라야 한다. 조기 처방 약물로서 메트포민이 권장된다.

Key Message
Diabetic patients have a high risk of developing cancer, and cancer is the leading cause of death. There are few studies on the timing of medication treatment after diagnosis of diabetes. In addition, metformin, the most commonly prescribed diabetes treatment worldwide, is known to have cancer-preventive effects, but the problem of selection bias that occurs in observational studies has been raised, and some studies have recently been contradicting the existing cancer-preventing effects of metformin. This study, in a cohort study controlled for selection bias, demonstrated that early medication treatment and metformin use were effective in preventing cancer in diabetic patients.

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Hong Kyu Kim, Wanhyung Lee, Ik Hee Ryu, Jin Kuk Kim, Hyungsu Kim, Tae Keun Yoo
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Sara S Bashraheel, Hadeel Kheraldine, Sarah Khalaf, Ala-Eddin Al Moustafa
Biomedicine & Pharmacotherapy.2023; 162: 114676. CrossRef
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Editorial

Spatiotemporal analyses of the epidemiological characteristics of diabetes mellitus: Sang Youl Rhee; Epidemiol Health. 2021;43:e2021102. Published online December 16, 2021; DOI: https://doi.org/10.4178/epih.e2021102

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Abstract Summary PDF

Abstract

Research based on spatiotemporal analysis has been conducted to identify various factors that can affect an individual’s or community’s degree of health and disease. These spatiotemporal studies can effectively illustrate patterns in disease frequency, features, and temporal flow in different parts of a country. Furthermore, identifying these regional characteristics can aid in the development of disease prevention or intervention strategies.

Summary

Korean summary
1. 시공간 분석은 국가 혹은 지역의 질병 빈도, 특징 및 시간 흐름의 패턴을 효과적으로 설명할 수 있다. 2. 시공간 분석은 질병의 예방 또는 중재 전략 개발에 도움이 될 수 있다.

Key Message
1. Spatiotemporal analyses can effectively illustrate patterns in disease frequency, features, and temporal flow in different parts of a country. 2. Spatiotemporal analysis can aid in disease prevention or development of intervention strategies.

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Epidemiological characteristics and spatiotemporal analysis of mumps at township level in Wuhan, China, 2005–2019
Ying Peng, Peng Wang, De-guang Kong, Wen-zhen Li, Dong-ming Wang, Li Cai, Sha Lu, Bin Yu, Bang-hua Chen, Pu-Lin Liu
Epidemiology and Infection.2023;[Epub] CrossRef

Original Articles

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

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Abstract Summary PDF Supplementary Material

Abstract

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Summary

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

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

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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

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Abstract Summary PDF Supplementary 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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Trends in prediabetes and diabetes prevalence and associated risk factors in Vietnamese adults: That Thanh Ton, Anh Thi Ngoc Tran, Ich Thanh Do, Hoa Nguyen, Thi Thanh Binh Nguyen, Minh Tu Nguyen, Van Anh Bao Ha, Anh Quoc Tran, Huu Khoi Hoang, Binh Thang Tran; Epidemiol Health. 2020;42:e2020029. Published online May 11, 2020; DOI: https://doi.org/10.4178/epih.e2020029

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385 Download
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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
The prevalence of diabetes mellitus is rapidly increasing in Vietnam, particularly among adults aged over 45 years. This study estimated trends in diabetes and prediabetes prevalence and determined risk factors in Vietnamese adults (over 45 years).

METHODS

A cross-sectional study was conducted based on data from an annual diabetes screening program among people aged 45-69 years in an urban city in central Vietnam (Da Nang). Joinpoint regression analyses were performed to calculate the annual percentage change and ptrend-values. Multinomial logistic regression analysis was used to determine risk factors.

RESULTS

In total, 3,765 men and 9,149 women were included in this analysis. The age-adjusted prevalence of diabetes and prediabetes in 2017 was 11.4% and 52.9%, respectively. The prevalence of diabetes was higher in men (15.1%) than in women (10.3%), but that of prediabetes was similar in both genders (53.4% vs. 52.8%). The prevalence of prediabetes significantly increased during the study period, whereas no upward or downward trend for diabetes was observed. The prevalence of obesity, abdominal obesity, hypertension, and dyslipidemia showed no obvious trend. Obesity, a high waist-to-hip ratio, hypertension, more severe abdominal obesity, and dyslipidemia were significantly associated with a higher risk of diabetes and prediabetes.

CONCLUSIONS

Diabetes and prediabetes were more prevalent among people aged over 45 years than in the general population. Da Nang has experienced a marked increase in the prevalence of prediabetes. These findings have significant implications regarding the need for nationwide public health interventions and management aiming at diabetes prevention and control.

Summary

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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

33,347 View
344 Download
49 Web of Science
50 Crossref

Abstract Summary PDF Supplementary 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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Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study: Ahmad Khosravi, Mohammad Hassan Emamian, Hassan Hashemi, Akbar Fotouhi; Epidemiol Health. 2018;40:e2018026. Published online June 23, 2018; DOI: https://doi.org/10.4178/epih.e2018026

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Abstract PDF

Abstract

OBJECTIVES
The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.

METHODS

In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.

RESULTS

The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.

CONCLUSIONS

Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

Summary

Citations

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The difference between cystatin C- and creatinine-based estimated glomerular filtration rate and risk of hypertension: a population-based study in middle-aged and elderly Chinese
Junxi Liu, Yanjia Li, Xuwen Yi, Xue Wang, Boda Zhou
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The association of ALT to HDL-C ratio with type 2 diabetes in 50–74 years old adults: a population-based study
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Prevalence of prediabetes, diabetes, diabetes awareness, treatment, and its socioeconomic inequality in west of Iran
Farhad Moradpour, Satar Rezaei, Bakhtiar Piroozi, Ghobad Moradi, Yousef Moradi, Negar Piri, Azad Shokri
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Association between cardiovascular risk factors and stage 1 hypertension defined by the 2017 ACC/AHA guidelines
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Obesity is the Most Important Factor for Gender Inequality in Type 2 Diabetes Incidence in an Iranian Population
Ahamd Khosravi, Mohammad Hassan Hashemian, Hassan Hashemi, Akbar Fotouhi
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Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009: Kumban Walter Chuck, Minji Hwang, Kui Son Choi, Mina Suh, Jae Kwan Jun, Boyoung Park; Epidemiol Health. 2017;39:e2017036. Published online August 10, 2017; DOI: https://doi.org/10.4178/epih.e2017036

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Abstract Summary PDF

Abstract

OBJECTIVES
To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes.

METHODS

Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes.

RESULTS

Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9).

CONCLUSIONS

The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

Summary

Korean summary
기존의 여러 연구에서 당뇨병이 있는 사람에서 당뇨병이 없는 경우에 비해 암 발생의 위험이 증가하는 것이 확인되었다. 본 연구에서 당뇨병이 있는 사람과 없는 사람에서 암 수검률을 비교했을 때, 당뇨병이 있는 사람의 위암, 유방암, 자궁경부암의 평생 수검률과 권고안 이행 수검률은 모두 낮았다. 당뇨병 환자가 암 발생의 고위험군임을 고려하였을 때 이들을 대상으로 암 검진 수검률을 높이려는 노력이 필요하다.

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Risk factors for amputation in patients with diabetic foot ulcer in southwest Iran: a matched case-control study: Mohammad Kogani, Mohammad Ali Mansournia, Amin Doosti-Irani, Kourosh Holakouie-Naieni; Epidemiol Health. 2015;37:e2015044. Published online October 5, 2015; DOI: https://doi.org/10.4178/epih/e2015044

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Abstract PDF

Abstract

OBJECTIVES
Amputation is a multifactorial complication in diabetic patients. The aim of this study was to determine the risk factors associated with amputation in patients with diabetic foot ulcers.

METHODS

This matched case-control study was conducted based on new cases of amputation from March 2012 to November 2014. We selected new cases who had undergone amputation, and the control group was chosen from the cities or areas where the cases resided. Each case was matched with two controls based on the duration of diabetes and location. Conditional logistic regression was used to evaluate the associations between potential risk factors and amputation.

RESULTS

A total of 131 cases were compared with 262 controls. The results of the adjusted model showed that sex (odds ratio [OR], 8.66; 95% confidence interval [CI], 2.68 to 27.91), fewer than two hemoglobin A1c (HbA1c) tests per year (OR, 13.97; 95% CI, 4.97 to 39.26), unsuitable shoes (OR, 5.50; 95% CI, 2.20 to 13.77), smoking (OR, 3.44; 95% CI, 1.45 to 8.13), and body mass index (OR, 1.20; 95% CI, 1.03 to 1.41) were associated with amputation in diabetic patients.

CONCLUSIONS

The most important factors associated with amputation were females, irregular monitoring of HbA1c levels, improper footwear, and smoking. Developing educational programs and working to ensure a higher quality of care for diabetic patients are necessary steps to address these issues.

Summary

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Effect change of obesity on diabetes depending on measurement: self-reported body mass index from 2012 Community Health Survey vs. directly measured from the Korea National Health and Nutrition Examination Survey: Kyuhyun Yoon, Kyungduk Min, Heeran Chun, Soong-Nang Jang, Sung-il Cho; Epidemiol Health. 2015;37:e2015001. Published online January 6, 2015; DOI: https://doi.org/10.4178/epih/e2015001

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Abstract Summary PDF

Abstract

OBJECTIVES
Obesity is a well-recognized risk factor for type 2 diabetes mellitus (DM) among young and middle-aged adults in South Korea. To elaborate on the association between obesity and DM, subjective data from self-reporting survey or objective data from health examination is generally used. This study was conducted to validate the change of association from using these different measurements.

METHODS

Community Health Survey data and Korea National Health and Nutrition Examination Survey data, as subjective and objective data respectively, were used. Population, resident in Seoul and over 45 aged, were selected for the study and the association between obesity and DM were defined by using multivariate logistic regression model.

RESULTS

In subjective data, DM prevalence was 12.4% (male, 14.7; female, 10.6) and obesity prevalence was 26.0% (male, 29.2; female, 23.4). Whereas, in objective data, DM prevalence was 15.0% (male, 17.8; female, 12.9), and obese population was 32.4% (male, 34.4; female, 30.8). Based on the effect of obesity on DM prevalence from each data, using objective data increased the impact of obesity. Difference of relative risk of obesity between from subjective data and from objective was bigger in female than male and statistically significant.

CONCLUSIONS

The differences of association pattern between subjective and objective data were found, due to higher obesity prevalence in objective data, and discrepancies of socio-economic status. These discrepancies could be inevitable Therefore we have to face them proactively, and understand the different aspect of various variables from different measurement.

Summary

Korean summary
지역사회건강조사는 각 지역의 건강관련 지표들을 제시하기 위한 기본 목적을 가지고 있으나, 자가보고를 통한 자료수집에 의존하고 있다는 면에서 연구결과의 신뢰성에 한계를 가지고 있다고 인식되어왔다. 본 연구는 실측자료와 자가보고자료에서의 분석결과차이를 파악함으로써, 이러한 인식에 대한 직접적 평가와 더불어, 자가보고자료에 대한 활용도 증진에 기여하고자 하였다. 연구 결과, 비만의 당뇨병에 대한 영향은 실측자료보다 자가보고자료에서 더 작아졌고, 이러한 차이는 남성에서보다 여성에서 더 크게 나타났다.

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Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey
Ji Son Ki, Ho Kim
Epidemiology and Health.2019; 41: e2019012. CrossRef

Effect of Medicine Adherence on the Occurrence of Cerebrovascular Disorders in Diabetes Mellitus Patients: Il-Su Park, Hae-Sook Sohn; Epidemiol Health. 2011;33:e2011001. Published online January 28, 2011; DOI: https://doi.org/10.4178/epih/e2011001

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Abstract

<sec><title>OBJECTIVES</title>To assess the association between the occurrence of cerebrovascular disorders and a medication adherence in diabetes mellitus patients.</sec><sec><title>METHODS</title>Medical records from 1,114 new patients with diabetes mellitus were collected and the occurrence of cerebrovascular disorders was observed. Data was gathered from the health examination records of diabetes mellitus patients registered at the Korean Metabolic Syndrome Research from 1996 to 2005, medication records from the National Health Insurance Corporation and death data from the National Statistics Office from 1997 to 2007. Hazard ratios were analyzed using the Cox proportional hazard model to test the association between the occurrence of cerebrovascular disorders and the level of medication adherence. Medication adherence was calculated using Continuous measure of Medication Acquisition (CMA).</sec><sec><title>RESULTS</title>Of 1,114 diabetes mellitus patients, cerebrovascular disorders occurred in 67 cases (6.1%). The mean duration for the development of a cerebrovascular disorder was 3.82 yr. Medication adherence (≥0.8 vs. <0.5: HR, 3.26; 95% CI, 1.47-7.21, ≥0.8 vs. 0.5-0.7 HR, 0.99; 95% CI, 0.33-2.95) was an independent factor associated with the occurrence of cerebrovascular disorders in diabetes mellitus.</sec><sec><title>CONCLUSION</title>Increased medication adherence is necessary to prevent the occurrence of cerebrovascular disorders in diabetes mellitus patients. Furthermore we propose that CMA be considered as a method for monitoring medication adherence in clinics.</sec>

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Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis
Hwa Jeong Seo, Hyun Sook Oh
Epidemiology and Health.2021; 43: e2021103. CrossRef
Clinical inertia, reverse clinical inertia, and medication non-adherence in type 2 diabetes
D. Giugliano, M. I. Maiorino, G. Bellastella, K. Esposito
Journal of Endocrinological Investigation.2019; 42(5): 495. CrossRef
El incumplimiento en el tratamiento de la diabetes mellitus tipo 2 en España
Emilio Márquez Contreras
Hipertensión y Riesgo Vascular.2012; 29: 8. CrossRef

Comparison of Prevalence of Metabolic Syndrome Between Korean Emigrants and Host Country Residents in Japan and China-The Korean Emigrant Study: Myung-Hee Shin, Mi Kyung Kim, Zhong Min Li, Hyun-Kyung Oh, Soo Ryang Kim, Miyuki Taniguchi, Jinnv Fang; Epidemiol Health. 2010;32:e2010005. Published online May 7, 2010; DOI: https://doi.org/10.4178/epih/e2010005

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Abstract

<sec><title>OBJECTIVES</title>This study aims to compare the prevalence of metabolic syndrome between Korean emigrants (KEs) and their host country residents in Japan and China.</sec><sec><title>METHODS</title>The Korean Emigrant Study (KES) is a cohort study initiated in 2005 to elucidate the effect of genetic susceptibility and environmental change on hypertension, diabetes, and metabolic syndrome. Equal numbers of KEs and host country residents, aged 30 or over, were recruited from three regions; Kobe-Osaka in Japan (total number=965), Yanbian in China (n=1,019), and Changchun in China (n=949).</sec><sec><title>RESULTS</title>The age-adjusted prevalences of metabolic syndrome among KEs in Kobe-Osaka were significantly higher than those among Japanese (in men 24.0% vs. 15.6%, p=0.04, in women 8.4% vs. 2.7%, p=0.01), while the age-adjusted prevalences among KEs in Changchun were similar to those among Chinese (in men 11.7% vs. 16.1%, p=0.37, in women 28.3% vs. 30.1%, p=0.91). The age-adjusted prevalences were generally higher in Yanbian than other regions, and KEs had higher prevalence than Chinese in men but not in women (in men 37.9% vs. 28.3%, p=0.03, women 46.0% vs. 50.6%, p=0.44). The components with significant ethnic differences in prevalence were high blood pressure and abdominal obesity in Japan, and triglyceride in China. The most influential component in diagnosing metabolic syndrome was abdominal obesity in men and triglyceride in women.</sec><sec><title>CONCLUSION</title>The prevalence of metabolic syndrome was higher in KEs than in host country residents in Japan but not in China. Abdominal obesity and triglyceride are both discriminating and influential components in metabolic syndrome.</sec>

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New Common and Rare Variants Influencing Metabolic Syndrome and Its Individual Components in a Korean Population
Ho-Sun Lee, Yongkang Kim, Taesung Park
Scientific Reports.2018;[Epub] CrossRef
Cohort Profile: The Korean Genome and Epidemiology Study (KoGES) Consortium
Yeonjung Kim, Bok-Ghee Han
International Journal of Epidemiology.2017; 46(2): e20. CrossRef
Is There Disparity in Cardiovascular Health Between Migrant Workers and Native Workers?
Hyeonkyeong Lee, Sunghye Cho, Yune Kyong Kim, Jung Hee Kim
Workplace Health & Safety.2016; 64(8): 350. CrossRef
Coffee Intake and Liver Enzyme Association in Korean Immigrants and Japanese: A Comprehensive Cross-Sectional Study
Soo Ki Kim, Myung-Hee Shin, Kayo Sugimoto, Soo Ryang Kim, Susumu Imoto, Ke Ih Kim, Miyuki Taniguchi, Hyun-Kyung Oh, Yoshihiko Yano, Yoshitake Hayashi, Masatoshi Kudo
Digestive Diseases.2016; 34(6): 665. CrossRef

Relationship between serum gamma-glutamyltransferase and metabolic syndrome among Korean non-diabetic adults.: Wee Hyun Park, Shung Chull Chae, Byung Yeol Chun, Kyung Eun Lee, Bo Wan Kim, Jung Guk Kim, Ji Seun Lim, Sun Kyun Park; Korean J Epidemiol. 2008;30(2):206-215. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.206

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Abstract

PURPOSE
This study was conducted to investigate the association of gamma-glutamyltransferase (GGT) with metabolic syndrome among non-diabetic adults.

METHODS

This study was conducted in a rural area, South Korea from August, 2003 to November, 2003. The study subjects were 1,023 sampled persons aged from 40 years and older (male 377, female 646). We analyzed the association between GGT with metabolic syndrome by multiple logistic regression analysis using SAS 9.1 version.

RESULTS

The prevalence of metabolic syndrome in this study was 28.8%. The prevalence of metabolic syndrome was increased by quartiles of serum GGT level (P for trend <0.05). The prevalence of metabolic alterations fitting the criteria of the metabolic syndrome by quartiles of serum GGT level were almost significantly increased except for the criterion of low high density lipoprotein (HDL) cholesterol with adjustment for age and alcohol intake. Among 5 components of metabolic syndrome, the criterion of high serum triglyceride was most powerfully associated with serum GGT level in both gender.

CONCLUSIONS

This study shows that serum GGT level was significantly associated with metabolic syndrome even after excluding diabetic adults.

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Relations between Normal Serum Gamma-glutamyltransferase and Risk Factors of Coronary Heart Diseases according to Age and Gender
Se Young Kwon, Young Ak Na
Korean Journal of Clinical Laboratory Science.2016; 48(1): 22. CrossRef
The Association between Serum Gamma-glutamyltransferase within Normal Range and Risk Factors of Cardiovascular Diseases: Based on the Framingham Risk Score
Hae-Jin Ko, Chang-Su Choi, Chang-Ho Youn, Duk-Hee Lee, Sung-Guk Lee
The Korean Journal of Obesity.2013; 22(1): 21. CrossRef
Letter: The Association between Serum Gamma-glutamyltransferase within Normal Range and Risk Factors of Cardiovascular Diseases: Based on the Framingham Risk Score (Korean J Obes Vol.22 No.1 2013)
Hye Jin Yoo
The Korean Journal of Obesity.2013; 22(4): 259. CrossRef

Risk Factors of Impaired Fasting Glucose and Type 2 Diabetes Mellitus: Using Datamining.: Jongseon Ryu, Soonduck Kim, Jongsoon Park, Jesuk Lee; Korean J Epidemiol. 2006;28(2):138-151.

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Abstract PDF: Abstract
PURPOSE
This study aimed to contribute to overall public health by examining the prevalence rates of impaired fasting blood glucose and type 2 diabetes mellitus and developing a model to predict high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus.
METHODS
The 1998 Public Health Nutrition Survey data was used for this study. Subjects were 7,702 adult at the age of 20 or over. The frequency analysis, chisquared test was performed. A decision tree was utilized to define a model designed to predict high risk factors for impaired fasting glucose and type 2 diabetes mellitus.
RESULTS
The prevalence rates of impaired fasting blood glucose was 10.8% and prevalence rates of type 2 diabetes mellitus was 9.4%. The decision tree analysis exhibited that age was strong factors for impaired fasting blood glucose. HDL cholesterol and kind of economic activities were high risk factors for impaired fasting blood glucose and type 2 diabetes mellitus on those in 20s. BMI, total cholesterol level, marriage status, sex for impaired fasting blood glucose and type 2 diabetes mellitus on those in 30s. The total cholesterol level, drinking and waist size were identified as risk factors on those in 40s. BMI, education level and hypertension seemed to have an impact on those in 50s. The waist size, sex and income had an impact on those in 60s.
CONCLUSIONS
This study underscores the need for the public health infrastructure to improve various health promotion programs for those who have risk factors for impaired fasting blood glucose and type 2 diabetes mellius. The implementation of effective nutrition, workout and anti-drinking programs will boost public health.; Summary

Insulin resistance and cancer.: Hee Jin Kim, Sun Ha Jee; Korean J Epidemiol. 2005;27(2):38-50.

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Abstract PDF: Abstract
Both obesity and diabetes have been proposed as risk factors of cancer. Obesity may be a more significant health problem, which can increase the risk of cancer and cardiovascular disease, which is the most common cause of death. Insulin resistance and metabolic syndrome are suspected of being correlated with cancer risk. Most studies are carried out on the assumption that obesity, diabetes, cardiovascular disease, and cancer are different conditions. However, they have common risk factors-smoking, obesity, and physical inactivity. Although the pathways leading to these diseases are unknown, we brought a focus into the multi-dimensional pathways instead of single pathogenesis. The interaction between pathogenesis can be thought to start from risk factors, and through pathogenesis, diseases can also lead to a severe cause of death. Epidemic of obesity and diabetes is a significant and growing public health problem. This paper reviewed the evidences of the correlation between insulin resistances and cancer and we explored whether insulin resistance may contribute to carcinogenesis.; Summary

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