Epidemiology and Health

Original Articles

The predictive value of resting heart rate in identifying undiagnosed diabetes in Korean adults: Korea National Health and Nutrition Examination Survey: Dong-Hyuk Park, Wonhee Cho, Yong-Ho Lee, Sun Ha Jee, Justin Y. Jeon; Epidemiol Health. 2022;44:e2022009. Published online January 3, 2022; DOI: https://doi.org/10.4178/epih.e2022009

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Abstract

OBJECTIVES
The purpose of this study was (1) to examine whether the addition of resting heart rate (RHR) to the existing undiagnosed diabetes mellitus (UnDM) prediction model would improve predictability, and (2) to develop and validate UnDM prediction models by using only easily assessable variables such as gender, RHR, age, and waist circumference (WC).

METHODS

Korea National Health and Nutrition Examination Survey (KNHANES) 2010, 2012, 2014, 2016 data were used to develop the model (model building set, n=19,675), while the data from 2011, 2013, 2015, 2017 were used to validate the model (validation set, n=19,917). UnDM was defined as a fasting glucose level ≥126 mg/dL or glycated hemoglobin ≥6.5%; however, doctors have not diagnosed it. Statistical package for the social sciences logistic regression analysis was used to determine the predictors of UnDM.

RESULTS

RHR, age, and WC were associated with UnDM. When RHR was added to the existing model, sensitivity was reduced (86 vs. 73%), specificity was increased (49 vs. 65%), and a higher Youden index (35 vs. 38) was expressed. When only gender, RHR, age, and WC were used in the model, a sensitivity, specificity, and Youden index of 70%, 67%, and 37, respectively, were observed.

CONCLUSIONS

Adding RHR to the existing UnDM prediction model improved specificity and the Youden index. Furthermore, when the prediction model only used gender, RHR, age, and WC, the outcomes were not inferior to those of the existing prediction model.

Summary

Korean summary
당뇨병 미인지 또는 미진단은 적절한 치료 시작 시기를 늦추고 당뇨병 합병증 발생의 위험을 높이기 때문에, 각국은 당뇨병 예측 모형을 개발하여 당뇨병을 조기에 예측하고, 치료 시기를 앞당기기 위해 노력하고 있다. 본 연구는 기존의 한국인 당뇨병 예측 모형에 안정시심박수를 추가 변수로 포함시켜, 예측 모형의 성능이 일부개선되는 것을 확인하였고, 더 나아가 나이, 허리 둘레, 그리고 안정시심박수를 포함하여 예측 모형을 개발하고, 그 성능을 확인하였다. 본 연구에서는 간단하게 측정이 가능한 허리 둘레와 안정시심박수 그리고 나이만 포함한 예측 모형이 기존의 예측 모형과 비교해 성능이 열등하지 않은 것을 확인하였다.

Key Message
Higher RHR is associated with increased risk of diabetes. When RHR is added to the Korean undiagnosed diabetes risk score model (Age, Family history of diabetes, Hypertension, Waist circumference, Smoking, Alcohol consumption), the model somewhat increased its predictability of undiagnosed diabetes. Furthermore, the prediction model developed only using age, waist circumference and RHR, which anyone can easily measure or access, had similar predictability to the previous undiagnosed diabetes risk prediction model. The results of this study may help develop future strategies or applications for predicting early undiagnosed diabetes.

Citations

Citations to this article as recorded by

Comparisons of the prediction models for undiagnosed diabetes between machine learning versus traditional statistical methods
Seong Gyu Choi, Minsuk Oh, Dong–Hyuk Park, Byeongchan Lee, Yong-ho Lee, Sun Ha Jee, Justin Y. Jeon
Scientific Reports.2023;[Epub] CrossRef
Factors related to undiagnosed diabetes in Korean adults: a secondary data analysis
Bohyun Kim
Journal of Korean Biological Nursing Science.2023; 25(4): 295. CrossRef

Changes of Hepatitis B Surface Antigen Seroprevalence in Korea, 1998-2005.: Seunghee Jeong, Hyeon Woo Yim, Si Hyun Bae, Won Chul Lee; Korean J Epidemiol. 2008;30(1):119-127. Published online June 30, 2008; DOI: https://doi.org/10.4178/kje.2008.30.1.119

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Abstract

PURPOSE
The purpose of this study was to investigate the prevalence rate of HBsAg and the epidemiological characteristics of hepatitis B virus (HBV) infection from 1998 to 2005. National Health and Nutrition Examination Survey (NHANES) data of 1998, 2001 and 2005 were analyzed.

METHOD

Study population was consisted of 24,093, aged 10 year or over who performed NHANES self reported surveys and blood tests. Statistical analysis was performed by age, sex, and the year of survey. Also the prevalence of HBsAg was compared by self reported family history of liver disease.

RESULTS

The prevalence rate of HBsAg was reduced from 4.5% in 1998 to 3.7% in 2005. Also age-specific prevalence rate of HBsAg was significantly decreased in persons born after introduction of the hepatitis B virus vaccination. HBsAg seropositivity was slightly higher in male than in female. Among the people with the family history of liver diseases, the risk of HBsAg seropositive was much higher than those without. Study subjects with mother's liver disease history showed much higher HBsAg serepositive rate. Although after the implementation of hepatitis B virus vaccination program prevalence of HBsAg decreased, but persons with history of liver disease showed still higher rate Of HBsAg seropositive rate.

CONCLUSION

Although the introduction of the HBV vaccination program has resulted in a decline of HBV infection, the family history of liver diseases was still an important factor for transmission of HBV in Korea. In addition to the mother-to-child transmission prevention program from 2002, it might be advisable to introduce a screening program for persons with family history of liver diseases for further reduction of HBV infection.

Summary

Citations

Citations to this article as recorded by

Are there differences in hepatitis-B immunization status between diabetes and non-diabetes subjects in Korea?
Ji Young Park, Su Kyoung Kwon
Kosin Medical Journal.2018; 33(1): 41. CrossRef
Study of the Associations Between TT Virus Single and Mixed Infections With Leukemia
Ramin Yaghobi, Marjan Shaheli, Abbasali Rezaeian, Mahdiyar Iravani Saadi, Mani Ramzi
Jundishapur Journal of Microbiology.2015;[Epub] CrossRef
Reactivation of hepatitis B (reverse seroconversion) after melphalan/dexamethasone therapy for primary amyloidosis: a case report
Woo-Ram Moon, Do-Sik Moon, JoA Kim, Young-min Yoon, Byung-Seok Choi, Choon-Hae Chung, Sang-Gon Park
Journal of Medical Case Reports.2015;[Epub] CrossRef
Hepatitis B virus infection, diabetes mellitus, and their synergism for cholangiocarcinoma development: A case-control study in Korea
Ban Seok Lee
World Journal of Gastroenterology.2015; 21(2): 502. CrossRef
Association between Hepatitis B Surface Antigen Seropositivity and Metabolic Syndrome
Tae-Heum Chung, Moon-Chan Kim, Chang-Sup Kim
Korean Journal of Family Medicine.2014; 35(2): 81. CrossRef
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Hyun Jung Lee, Dae Young Kim, Bhumsuk Keam, Jeong Hoon Lee, Sae-Won Han, Do-Youn Oh, Jung Hwan Yoon, Tae-You Kim, Yu Jung Kim, Keun Wook Lee, Jin-Wook Kim, Sook-Hyang Jeong, Jong Seok Lee, Jee Hyun Kim, Seock-Ah Im
Breast Cancer.2014; 21(4): 387. CrossRef
Factors Influencing on Perinatal Outcomes of Asian Marriage Immigrant Women: Ten-year Experience in a Single Center
Hye Young Lee, Gi Cheol Park, Mi Kyung Kim, Oh Kyung Lee
Korean Journal of Perinatology.2013; 24(3): 168. CrossRef
Changes in Birth Rate, Perinatal Risk Factors and Outcome in Newborns in Multi-cultural Family: Ten-year Experience in One Center
Hae In Jang, Joon Sik Choi, Eun Song Song, Young Youn Choi
Neonatal Medicine.2013; 20(1): 146. CrossRef
Treatment of Rheumatoid Arthritis Patients with Chronic Hepatitis B: Analysis of Korean National Health Insurance Claims Data
Kichul Shin, Hyeongap Jang, Won Mo Jang, Jin-Seok Lee, Yeong-Wook Song
Journal of Rheumatic Diseases.2013; 20(1): 24. CrossRef
Prevention of Viral Hepatitis and Vaccination
Yoo-Kyung Cho, Byung-Cheol Song
Korean Journal of Medicine.2012; 82(2): 123. CrossRef
Prevalence and clinical significance of occult hepatitis B virus infection among renal transplant recipients in Korea
Eunsin Bae, Chang-Hun Park, Chang-Seok Ki, Sung-Joo Kim, Wooseong Huh, Ha-Young Oh, Eun-Suk Kang
Scandinavian Journal of Infectious Diseases.2012; 44(10): 788. CrossRef
Occupational Infections of Health Care Personnel in Korea
Jung Oak Kang
Hanyang Medical Reviews.2011; 31(3): 200. CrossRef
Predictors of HBsAg Seroclearance in HBeAg-Negative Chronic Hepatitis B Patients
Min-Sun Kwak, Eun-Ju Cho, Eun-Sun Jang, Jeong-Hoon Lee, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Hyo-Suk Lee
Digestion.2011; 84(s1): 23. CrossRef
New Insight for HBV DNA and HBsAg Quantitation during Antiviral Therapy in Patients with Chronic Hepatitis B
Yoo-Kyung Cho, Byung-Cheol Song
The Korean Journal of Gastroenterology.2011; 57(3): 144. CrossRef
High prevalence of hepatitis B and hepatitis C virus infections in Korean patients with hematopoietic malignancies
Jun Kang, Jeong Hyun Cho, Cheol Won Suh, Dae Ho Lee, Heung Bum Oh, Yong Hak Sohn, Hyun Sook Chi, Chan Jeong Park, Sung Soo Jang, Kyoo Hyung Lee, Je-Hwan Lee, Jung Hee Lee, Sang Wook Lee, Young Hwa Chung, Tae Hyup Kim, Hai-Rim Shin, Jooryung Huh
Annals of Hematology.2011; 90(2): 159. CrossRef
Shifting in Seroprevalence of HBsAg and Anti-HCV during Recent 10 Years in Adults Resident in Daegu and Gyeongbuk Province
Kyung In Lee, Kyung Sik Park, Hye Jin Seo, Tae Yul Kim, Eun Soo Kim, Byoung Kuk Jang, Woo Jin Chung, Kwang Bum Cho, Jae Seok Hwang
The Korean Journal of Gastroenterology.2011; 58(2): 82. CrossRef
Development of the Guideline for HIV Testing in South Korea with Low Prevalence of HIV-1 Infection Based on the Expert Consensus
Hee Jung Choi, Kyoung Ae Kong, Jung Won Min, Hun-Jae Lee, Hae-Sook Park
World Journal of AIDS.2011; 01(04): 155. CrossRef

The Current Status and the Perspectives of Nutrition Survey.: Mi Kyung Kim, Kirang Kim, Cho Il Kim, Kyungwon Oh, Yoo Jin Oh, Bo Youl Choi; Korean J Epidemiol. 2007;29(2):111-128.

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Abstract PDF: Abstract
The Korea National Health and Nutrition Examination Survey is a nationwide health survey in Korea. This survey is composed of three parts: the Health Interview Survey, the Health Examination Survey, and the Nutrition Survey. The aim of this study was to refine the nutrition survey system in the Korean National Health and Nutrition Examination Survey (KNHANES). Based on the literature review, we summarized international survey systems and the limitations of the current system in Korea and proposed an improved system. We suggested the following: 1) A government agency which will be exclusively responsible for KNHANES overall is needed. 2) The current short-term nutrition survey should be a year-round survey. 3) The objectives of this survey should be written with more clarity and detail. 4) Biochemical measures in relation to nutritional status should be added. 5) The budget to set up various databases in the nutrition survey should be increased. 6) Various other issues should be addressed, including the definition of raw data (i.e., whether nutrient intake data per day is raw data), ethical issues in survey techniques, and strategies to produce evidence for the public using this survey data. Not all suggestions could be adopted in the short-term, but should be integrated into long-term goals for survey system improvement.; Summary

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