The association of visual impairment and depression has been investigated in several studies based on a cross-sectional design, which cannot delineate temporal relationships. In the present study, we ...evaluated the influence of visual impairment on depression in all age groups using a longitudinal database of a national sample cohort from 2002 to 2013 provided by the Korean National Health Insurance Service. Of a total of 1,025,340 subjects, 5,846 participants who were registered as visually impaired persons without a previous diagnosis of depression were enrolled at a 1:4 ratio with 23,384 control participants matched for age, sex, income, and region of residence. The crude and adjusted (age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia) hazard ratios (HRs) for the development of depression between the visually impaired and control groups were analyzed using a Cox proportional hazards model. Visual impairment increased the risk of depression after adjusting for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia (adjusted HR = 1.19, P = 0.002). The risk of depression increased significantly in both the non-blindness visual impairment (adjusted HR = 1.15, P = 0.036) and blindness subgroups (adjusted HR = 1.31, P = 0.016), with a higher HR in the blindness subgroup.
The purpose of this study is to evaluate the associations between gastroesophageal reflux disease (GERD) and depression using a national sample cohort of the Korean population. Data were collected ...from individuals ≥20 years old in the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2013. We designed two different nested case-control studies. In study I, 60,957 participants with depression were matched at a 1:4 ratio with 243,828 controls, and their previous histories of GERD were analyzed. In study II, 133,089 participants with GERD were matched at a 1:2 ratio with 266,178 controls, and their previous histories of depression were analyzed. Crude and adjusted odds ratios (ORs) were analyzed using unconditional logistic regression analyses, and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed according to age and sex. The adjusted OR for GERD was 2.01 (95% CI = 1.96-2.07) in the patients with depression (study I). The adjusted OR for depression was 1.48 (95% CI = 1.43-1.52) in the patients with GERD (study II). The results of the subgroup analyses were consistent. GERD and depression displayed bidirectional associations.
This study aimed to explore the risk of dementia in a middle- and older-aged population with severe or profound hearing impairments. Data were collected for the Korean National Health Insurance ...Service-National Sample Cohort from 2002 to 2013. Participants aged 40 or older were selected. The 4,432 severely hearing-impaired participants were matched 1:4 with 17,728 controls, and the 958 profoundly hearing-impaired participants were matched 1:4 with 3,832 controls who had not reported any hearing impairment. Age, sex, income, region of residence, hypertension, diabetes mellitus, and dyslipidemia histories were matched between hearing-impaired and control groups. The crude (simple) and adjusted (age, sex, income, region of residence, dementia, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, cerebrovascular disease, and depression) hazard ratios (HRs) of hearing impairment on dementia were analyzed using Cox-proportional hazard models. The severe hearing impairment group showed an increased risk of dementia (adjusted HR = 1.17, 95% confidence interval CI = 1.04-1.31, P = 0.010). The profound hearing impairment group also showed an increased risk of dementia (adjusted HR = 1.51, 95% CI = 1.14-2.00, P = 0.004). Both severe and profound hearing impairments were associated with elevated the risk of dementia in middle- and older-aged individuals.
The present study investigated the associations of active, passive, and electronic cigarette (E-cigarette) smoking with asthma in Korean adolescents. We used the cross-sectional study of Korea Youth ...Risk Behavior Web-based Survey conducted in 2011, 2012 and 2013. Active smoking was classified into 4 groups (0 days, 1-5 days, 6-19 days, and ≥20 days a month). Passive smoking was also categorized into 4 groups (0 days, 1-2 days, 3-4 days, and ≥5 days a week). E-cigarette was defined as yes or no in the last 30 days. Age, sex, obesity, region of residence, economic level, and parental educational level were adjusted for as confounders. Smoking variables were adjusted for one another. Adjusted odd ratios (AORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression analysis with complex sampling. In total, 2.3% (4,890/216,056) of participants reported asthma in the past 12 months. Active smoking was significantly associated with asthma (AOR 95% CI of smoking ≥20 days/month = 1.57 1.38-1.77, P < 0.001). Passive smoking was also related with asthma (AOR 95% CI of smoking ≥5 days/week = 1.40 1.28-1.53, P < 0.001). E-cigarette showed positive relation with asthma, although the effects of past smoking history could not be excluded (AOR 95% CI = 1.12 1.01-1.26, P = 0.027).
The aim of this study was to investigate the association of body mass index (BMI), alcohol consumption, and smoking status with the occurrence of Bell's palsy. The Korean National Health Insurance ...Service-Health Screening Cohort of a ≥ 40-year-old population from 2000-2003 was used. A total of 5,632 Bell's palsy participants were matched with 22,528 control participants in terms of age, sex, income, region of residence, and past medical histories of hypertension, diabetes, and dyslipidemia. Bell's palsy was classified by a history of ≥2 diagnoses with ICD-10 code (G510) and steroid treatment. BMI (kg/m
) was classified as <18.5 (underweight), ≥18.5 to <23 (normal), ≥23 to <25 (overweight), ≥25 to <30 (obese I), and ≥30 (obese II). Alcohol consumption was divided into non-drinkers and those who drank 2-3 times a month, 1-2 times a week, and ≥3 times a week. Smoking status was categorized as current smokers, past smokers, and non-smokers. The odds of obesity, alcohol consumption, and smoking with Bell's palsy were analyzed using logistic regression analysis. BMI showed proportionally positive associations with Bell's palsy (adjusted OR 95% CI = 0.61 0.47-0.79 for underweight, 1.16 1.08-1.26 for normal, 1.24 1.15-1.33 for obese I, and 1.61 1.38-1.88 for obese II, P < 0.001). The odds of alcohol consumption with Bell's palsy were 0.90 (95% confidence interval CI = 0.82-0.99) for 2-3 times a month, 0.77 (95% CI = 0.69-0.85) for 1-2 times a week, and 0.79 (95% CI = 0.71-0.88) for ≥3 times a week compared to nondrinkers (P < 0.001). Smoking did not show a relationship with the occurrence of Bell's palsy. Obesity was related to the risk of Bell's palsy in the population over 40 years old. On the other hand, alcohol consumption was negatively associated with the occurrence of Bell's palsy.
This study aimed to evaluate the relations of smoking with asthma and asthma-related symptoms, considering quantitative and temporal influences. The 820,710 Korean adults in the Korean Community ...Health Survey in 2009, 2010, 2011, and 2013 were included and classified as non-smoker, past smoker or current smoker. Total smoking years, total pack-years, and age at smoking onset were assessed. Information on wheezing, exercise wheezing, and aggravation of asthma in the past 12 months and asthma diagnosis history and current treatment was collected. Multiple logistic regression analysis with complex sampling was used. Current and former smokers showed significant positive relations with wheezing, exercise wheezing, asthma ever, current asthma, and asthma aggravation. Current smokers demonstrated higher adjusted odd ratios (AORs) for wheezing, exercise wheezing, and asthma aggravation than former smokers. Former smokers showed higher AORs than current smokers for current asthma treatment. Longer passive smoking was related to wheezing and exercise wheezing. Greater age at smoking onset and duration since cessation were negatively related to wheezing, exercise wheezing, and current asthma; total pack-years demonstrated proportional associations with these symptoms. Former, current, and passive smoking was positively correlated with wheezing and exercise wheezing. Total pack-years and early initiation were increasingly related to asthma.
A relation between gastroesophageal reflux disease (GERD) and asthma has been suggested; however, causality has not been investigated.
This study aimed to delineate the causal relation between GERD ...and asthma.
Participants of the Korean National Health Insurance Service-National Sample Cohort 2002-2013 who were ≥20 years old were selected for this study. In study I, 116,502 patients with GERD were matched in a 1:2 ratio to 233,004 control I participants, and the hazard ratio (HR) of asthma in patients with GERD was analyzed. In study II, 104,146 patients with asthma were matched in a 1:1 ratio to 104,146 control II participants, and the HR for GERD in patients with asthma was analyzed. A stratified Cox-proportional hazards model was used. Subgroup analyses were performed according to age and sex.
In study I, 12.5% (14,595 of 116,502) of the GERD group and 7.8% (18,135 of 233,004) of the control I group presented asthma (P < .001). The GERD group demonstrated a 1.46-fold higher HR for asthma than the control I group (95% confidence interval CI = 1.42-1.49, P < .001). In study II, 16.9% (17,582 of 104,146) of the asthma group and 11.9% (12,393 of 104,146) of the control II group presented GERD (P < .001). The asthma group showed a 1.36-fold higher HR for GERD than the control II group (95% CI = 1.33-1.39, P < .001). All age and sex subgroups presented consistent results.
GERD and asthma had a bidirectional relation in the study population.
Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study ...was to analyze the prevalence and associated risk factors of tinnitus.
We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling.
The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR) of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h), those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss.
Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history.
Although an association between energy drinks and suicide has been suggested, few prior studies have considered the role of emotional factors including stress, sleep, and school performance in ...adolescents. This study aimed to evaluate the association of energy drinks with suicide, independent of possible confounders including stress, sleep, and school performance.
In total, 121,106 adolescents with 13-18 years olds from the 2014 and 2015 Korea Youth Risk Behavior Web-based Survey were surveyed for age, sex, region of residence, economic level, paternal and maternal education level, sleep time, stress level, school performance, frequency of energy drink intake, and suicide attempts. Subjective stress levels were classified into severe, moderate, mild, a little, and no stress. Sleep time was divided into 6 groups: < 6 h; 6 ≤ h < 7; 7 ≤ h < 8; 8 ≤ h < 9; and ≥ 9 h. School performance was classified into 5 levels: A (highest), B (middle, high), C (middle), D (middle, low), and E (lowest). Frequency of energy drink consumption was divided into 3 groups: ≥ 3, 1-2, and 0 times a week. The associations of sleep time, stress level, and school performance with suicide attempts and the frequency of energy drink intake were analyzed using multiple and ordinal logistic regression analysis, respectively, with complex sampling. The relationship between frequency of energy drink intake and suicide attempts was analyzed using multiple logistic regression analysis with complex sampling.
Higher stress levels, lack of sleep, and low school performance were significantly associated with suicide attempts (each P < 0.001). These variables of high stress level, abnormal sleep time, and low school performance were also proportionally related with higher energy drink intake (P < 0.001). Frequent energy drink intake was significantly associated with suicide attempts in multiple logistic regression analyses (AOR for frequency of energy intake ≥ 3 times a week = 3.03, 95% CI = 2.64-3.49, P < 0.001).
Severe stress, inadequate sleep, and low school performance were related with more energy drink intake and suicide attempts in Korean adolescents. Frequent energy drink intake was positively related with suicide attempts, even after adjusting for stress, sleep time, and school performance.
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