Recent obesity studies have reported that the rising trend in obesity has stabilized or leveled off. Our study aimed to update estimates of the recent prevalence trend in obesity based on the Korean ...National Health and Nutrition Examination Survey 1998–2014.
A total of 66,663 subjects were included and defined as being either underweight, overweight, or obese, in accordance with a BMI of 18.5 kg/m2 or lower, 23 kg/m2 or higher, and 25 kg/m2 or higher, respectively.
The prevalence of underweight in KNHANES I through VI surveys was 5.4%, 6.1%, 5.8%, 6.5%, 7.6%, and 7.5%, respectively, in men (p for trend = 0.04, β = 0.003) and 4.7%, 3.3%, 3.4%, 3.3%, 2.7%, and 2.6%, respectively, in women (p for trend = 0.03, β = −0.002). Also for KNHANES I through VI, the respective prevalence of overweight/obesity was 50.3%, 57.2%, 62.5%, 62.3%, 61.4%, and 61.3% in men (p for trend<0.01, β = 0.009) and 48.3%, 50.3%, 50.0%, 47.8%, 47.0%, and 45.3% in women (p for trend<0.01, β = −0.01), respectively.
The obesity occurrence in men was trending upward with respect to overweight/obesity and for grade 1 and 2 obesity, but not for abdominal obesity. However, the obesity trends in women were leveling off from overweight/obesity, grade 1 obesity, and abdominal obesity measures. Further studies are required with data on muscle mass and adiposity for effective obesity control policies.
•We conducted this study using the KNHANES from 1998 to 2014.•Male obesity showed upward trends in overweight/obesity and grade 1 and 2 obesity.•Overweight/obesity, grade 1, and abdominal obesity were leveling off in females.•The prevalence of underweight decreased in men but increased in women.
A health check-up is one of the best ways to prevent diseases and maintain health by screening for risk factors and diagnosing diseases early. As the burden of illness shifts from infectious to ...chronic diseases, the importance of health check-ups is emphasized. Korean health authorities began the National Health Screening Programs (NHSPs) for public servants and private school staff in 1980. The NHSP is composed of the National Cancer Screening Programs (NCSPs) and general health checkups. NCSPs, started in 1999, included screenings for stomach, liver, colorectal, breast, and uterine cervical cancers, and they may have contributed to the improved cancer survival rate from 42.9% in 1993-1995 to 77.5% in 2013-2017 in Korea. General health check-ups included lifestyle questionnaires, anthropometric measurements; blood pressure measurement; visual acuity test; hearing test; laboratory tests including fasting glucose, lipid profile, liver function tests, creatinine, and urinalysis; and, chest radiography. Additionally, bone density, cognitive function, and depression were assessed. Testing for non-communicable diseases has improved the control rates of chronic diseases such as hypertension and diabetes mellitus. Favorable changes in the risk factors for cardio-cerebrovascular diseases may lead to a decline in age-standardized mortality and heart disease over several decades. However, many areas of the programs need to be improved. NHSPs should be designed on the basis of individual health conditions, medical needs, and scientific evidence. Greater opportunities to receive NHSPs should be provided to socioeconomically vulnerable individuals. In addition, stricter quality control of NHSPs is required. Follow-up management after the NHSPs should be systematized. In conclusion, NHSPs have contributed to the improvement of public health; however, several aspects of these programs must be addressed.
Background
Diabetes mellitus (DM) increases atherosclerotic cardiovascular complications and cancer risks. Stomach cancer is the most common cancer in Korea. Although the survival rate of stomach ...cancer has improved, the disease burden is still high.
Methods
This retrospective study investigated the association between metformin use and stomach cancer incidence in a Korean population using the National Health Insurance Service-National Health Screening Cohort database. Participants aged 40–80 years old at the baseline period (2002–2003) were enrolled. The study population was categorized into three groups of metformin non-users with DM, metformin users with DM, and individuals without DM (No DM group).
Results
A total of 347,895 participants (14,922 metformin non-users, 9891 metformin users, and 323,082 individuals without DM) were included in the final analysis. The median follow-up duration was 12.70 years. The estimated cumulative incidence of stomach cancer was highest in metformin non-users and lowest in the No DM group (men vs. women: 3.75 vs. 1.97% in metformin non-users, 2.91 vs. 1.53% in metformin users, and 2.54 vs. 0.95% in the No DM group). Compared with metformin non-users, the hazard ratios (95% confidence intervals) for stomach cancer incidence of metformin users and the No DM group were 0.710 (0.579–0.870) and 0.879 (0.767–1.006) in men and 0.700 (0.499–0.981) and 0.701 (0.544–0.903) in women, respectively, after full adjustment.
Conclusions
Metformin users with DM in the Korean population were at lower risk of stomach cancer incidence after controlling for potential confounding factors.
This study aimed to investigate the risk of all-cause mortality and incidence of CVD according to metabolic health and body mass index (BMI) in Korean adults. This study was retrospectively designed ...using the National Health Insurance Service-National Health Screening Cohort data. Participants were divided into six groups according to two category of metabolic syndrome and three categories of BMI. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the composite outcome (all-cause mortality and incidence of CVDs) were estimated using multivariable Cox proportional hazards regression models. 151,706 participants aged ≥ 40 years were enrolled; median follow-up period was 9.7 years in the study. Compared to metabolically healthy normal weight, the fully adjusted HRs (95% CIs) of metabolically healthy overweight, metabolically healthy obese, metabolically unhealthy normal weight, metabolically unhealthy overweight, and metabolically unhealthy obese for composite outcome were 1.07 (1.03-1.12), 1.12 (1.07-1.17), 1.33 (1.25-1.41), 1.28 (1.22-1.34), and 1.31 (1.26-1.37), respectively, in men, and 1.10 (1.05-1.16), 1.22 (1.16-1.29), 1.34 (1.26-1.43), 1.27 (1.19-1.34), and, 1.40 (1.34-1.47), respectively, in women. High BMI and metabolic unhealthiness were associated with an increased risk on the composite of all-cause mortality and incidence of CVD in both sexes.
Insulin resistance is associated with the incidence of diabetes and cardiovascular diseases such as myocardial infarction. The ratio of triglycerides (TG) to high-density lipoprotein cholesterol ...(HDL-C) (TG/HDL-C ratio) is positively correlated with insulin resistance. This study aimed to investigate the relationship between the TG/HDL-C ratio and the incidence of diabetes in Korean adults.
This retrospective study used data from the National Health Insurance Service-National Health Screening Cohort. The TG/HDL-C ratio was divided into three tertiles, the T
, T
, and T
groups, based on sex. We estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for diabetes using multivariate Cox proportional hazards regression analyses.
A total of 80,693 subjects aged between 40 and 79 years were enrolled. The median follow-up period was 5.9 years. The estimated cumulative incidence of diabetes in the T
, T
, and T
groups was 5.94%, 8.23%, and 13.50%, respectively, in men and 4.12%, 4.72%, and 6.85%, respectively, in women. Compared to T
, the fully adjusted HRs (95% CIs) of the T
and T
groups for new-onset diabetes were 1.17 (1.06-1.30) and 1.47 (1.34-1.62), respectively, in men and 1.20 (1.02-1.42) and 1.52 (1.30-1.78), respectively, in women.
Increased TG/HDL-C ratio was significantly associated with a higher risk of new-onset diabetes in both sexes.
Purpose
This study aimed to investigate the association between metformin usage and the risk of colorectal cancer (CRC) using data from the Korean National Health Insurance Service–National Health ...Screening Cohort database.
Methods
Data from the NHIS-HEALS cohort between 2002 and 2015 were longitudinally analyzed. Subjects were divided into three groups: metformin non-users with diabetes mellitus (DM), metformin users with DM, and no DM group. CRC was defined using the ICD-10 code (C18.0-C20.0) at the time of admission. Cox proportional hazard regression models were adopted after stepwise adjustment for confounders to investigate the association between metformin usage and colorectal cancer risk.
Results
During the follow-up period, of the total 323,430 participants, 2341 (1.33%) of the 175,495 males and 1204 (0.81%) of the 147,935 females were newly diagnosed with CRC. The estimated cumulative incidence of CRC was significantly different among the three groups based on Kaplan-Meier’s survival curve (
p
values < 0.05 in both sexes). Compared with metformin non-users, hazard ratios (95% CIs) of metformin users and the no DM group were 0.66 (0.51–0.85) and 0.72 (0.61–0.85) in males and 0.59 (0.37–0.92) and 0.93 (0.66–1.29) in females, respectively, after being fully adjusted.
Conclusions
Metformin users with diabetes appear to have a significantly lower risk of CRC compared with metformin non-users.
Telehealth has been adopted as an alternative to in-person primary care visits. With multiple participants able to join remotely, telehealth can facilitate the discussion and documentation of advance ...care planning (ACP) for those with Alzheimer's disease-related disorders (ADRDs). We measured hospitalization-associated utilization outcomes, instances of hospitalization and 90-day re-hospitalizations from payors' administrative databases and verified the data via electronic health records. We estimated the hospitalization-associated costs using the Nevada State Inpatient Dataset and compared the estimated costs between ADRD patients with and without ACP documentation in the year 2021. Compared to the ADRD patients without ACP documentation, those with ACP documentation were less likely to be hospitalized (mean: 0.74; standard deviation: 0.31;
< 0.01) and were less likely to be readmitted within 90 days of discharge (mean: 0.16; standard deviation: 0.06;
< 0.01). The hospitalization-associated cost estimate for ADRD patients with ACP documentation (mean: USD 149,722; standard deviation: USD 80,850) was less than that of the patients without ACP documentation (mean: USD 200,148; standard deviation: USD 82,061;
< 0.01). Further geriatrics workforce training is called for to enhance ACP competencies for ADRD patients, especially in areas with provider shortages where telehealth plays a comparatively more important role.
This study aimed to investigate the association of pulse pressure (PP) with the cardio-cerebrovascular disease (CCVD) risk and all-cause mortality according to blood pressure level using Korean ...national cohort data.
This study was retrospectively designed and based on the Korean National Health Insurance Service-National Health Screening Cohort. Participants aged 40-69 years at baseline were categorized into normal, elevated, stage 1, and stage 2 groups according to blood pressure. Each group was further classified into 5 groups separated by 10-mm Hg increments in PP. The primary composite outcome was defined as CCVDs and all-cause mortality. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate the composite outcome.
During the follow-up period (median follow-up period, 12.0 years), the primary composite outcome occurred in 18,444 (15.0%) of 122,783 men and 10,096 (11.4%) of 88,550 women. After complete adjustment for confounders, in the stage 1 hypertensive men, the hazard ratio (95% confidence intervals CIs) of the 31-40, 41-50, 51-60, and >60 mm Hg PP groups was 1.112 (1.013-1.221), 1.035 (0.942-1.137), 1.009 (0.907-1.123), and 1.324 (1.130-1.551) in comparison with the ≤30 mm Hg PP group. In the stage 2 hypertensive men, the HRs (95% CIs) were 1.069 (0.949-1.204), 1.059 (0.940-1.192), 1.123 (0.999-1.263), and 1.202 (1.061-1.358) compared to the ≤30 mm Hg PP group. However, these associations were not significant in women.
Hypertensive men with an increased PP have an increased risk of CCVDs and all-cause mortality.
Dyslipidemia is a primary, critical risk factor for cardiovascular disease. Therefore, evaluating the trends in lipid profiles is crucial for the development of health policies and programs. We ...studied trends in lipid profiles in Korean adults over an 11-year period according to the use of lipid-lowering medications through age-specific analysis. A total of 73,890 participants were included in the Korean National Health and Nutrition Examination Survey III (2005)-VI (2013-2015). The proportion of participants on lipid-lowering medications has increased. This trend was apparent in age groups of over 40 years in both men and women. Lipid-lowering medications successfully reduced mean total cholesterol (TC), but there was no favorable trend in TC in participants not taking lipid-lowering medication in both men and women. Unlike men, triglyceride and non-high-density lipoprotein cholesterol (HDL) decreased in women without lipid-lowering medications. In age-specific hypercholesterolemia, the prevalence of hypercholesterolemia significantly increased in the age groups of 30-59 and 30-49 years in men and women without lipid-lowering medications, respectively. Meanwhile, mean HDL-C levels increased over the 11-year period regardless of lipid-lowering drug use in both men and women. These analyses identified an upward trend in TC and HDL-C over the 11-year period.
The burden of malignant neoplasms is increasing worldwide. Healthy lifestyles such as maintaining a healthy body weight are important to improve survival rate in cancer patients. This study was aimed ...to test the hypothesis that weight change affects mortality in patients newly diagnosed with cancer. This study was retrospectively designed based on the National Health Insurance Service-National Health Screening Cohort. A total of 1856 subjects aged at least 40 years who received a national health checkup within 6 months before cancer diagnosis was included. Study subjects were classified into 3 categories based on weight change before and after cancer diagnosis: weight loss, maintenance, and gain. Cox proportional hazards regression models were adopted to examine the association between weight change and mortality after adjusting for confounders. Compared to those experiencing weight loss, the adjusted hazards ratios (HRs) (95% confidence intervals CIs) for those experiencing weight maintenance were 0.327 (0.189−0.568) for all-cause mortality and 0.431 (0.215−0.867) for cancer-related mortality. The adjusted HRs (95% CIs) for those experiencing weight gain were 0.149 (0.044−0.505) for all-cause mortality and 0.289 (0.080−1.045) for cancer-related mortality. After stratifying according to baseline body mass index (BMI), weight maintenance and gain were negatively associated with all-cause mortality (0.286 0.138−0.592 for weight maintenance and 0.119 0.027−0.533 for weight gain) among those with a BMI < 25 kg/m
2
. Weight maintenance and gain reduced the risk of all-cause mortality in patients newly diagnosed with any cancer. In addition, weight maintenance was significantly related to cancer-related mortality.
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