Journal of Preventive Medicine and Public Health

Hyeon Chang Kim

22 Articles

The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults: Eunji Kim, Kiho Sung, Chang Oh Kim, Yoosik Youm, Hyeon Chang Kim; J Prev Med Public Health. 2023;56(1):31-40. Published online November 22, 2022; DOI: https://doi.org/10.3961/jpmph.22.350

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Abstract Summary PDF Supplementary Material: Objectives
This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults.
Methods
This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults’ complete network maps across an entire village in 2011-2012. Participants’ deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment.
Results
In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively.
Conclusions
The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.; Summary

Korean summary
고령인구에서의 불충분한 사회연결망 특성은 높은 사망 위험과 연관이 있었으며, 이는 인지기능이 저하된 그룹에서 그렇지 않은 군에 비해 더 높게 관찰되었다. 특히, 인지기능이 저하된 노인에서 사회활동들에 참여하지 않는 것, 한정된 소집단에만 속하는 것, 주변으로부터 도움을 받지 못하는 것은 높은 사망 위험과 연관이 있기 때문에, 이들의 사회연결망을 강화하는 것이 사망 위험을 낮추는 데 도움이 될 수 있다.

Association Between Parity and Low Bone Density Among Postmenopausal Korean Women: Eunsun Seo, Yongrong Lee, Hyeon Chang Kim; J Prev Med Public Health. 2021;54(4):284-292. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.162

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Abstract Summary PDF Supplementary Material

Objectives
Low bone density (LBD) in the postmenopausal period has long been a pervasive public health concern; however, the association between parity and LBD has yet to be fully elucidated. Thus, we investigated the association between parity and LBD in postmenopausal Korean women.
Methods
This study used baseline data from 1287 Korean postmenopausal women aged 40 years or older enrolled in the Cardiovascular and Metabolic Diseases Etiology Research Center community-based cohort study conducted in Korea from 2013 to 2017. The main exposure was parity (nullipara, 1, 2, 3+). The main outcome was LBD, including osteopenia and osteoporosis, based on bone mineral density measured using quantitative computed tomography of the lumbar spine (L1-2).
Results
The mean age of participants was 57.1 years, and the median parity was 2. Of the 1287 participants, 594 (46.2%) had osteopenia and 147 (11.4%) had osteoporosis. No significant difference in the prevalence of LBD was found between nullipara and parous women, whereas higher parity was associated with a higher risk of LBD among parous women; the adjusted odds ratio (95% confidence interval) for the presence of LBD was 1.40 (0.97 to 2.02) for a parity of 2 and 1.95 (1.23 to 3.09) for a parity of 3 relative to a parity of 1.
Conclusions
Women who have given birth multiple times may be at greater risk of bone loss after menopause; therefore, they should be a major target population for osteoporosis prevention.

Summary

Korean summary
40-64세 폐경 여성 1287명을 대상으로 과거 출산 횟수와 골밀도의 관련성을 평가하였다. 정량적 전산화 단층촬영(QCT)으로 L1-L2의 평균 골무기질밀도(bone mineral density, BMD)를 측정하였으며, 그 값이 120mg/cm3 미만이면 골밀도 감소가 있는 것으로 정의하였다. 나이, 비만도, 폐경후기간, 직업, 소득, 교육, 결혼, 흡연, 음주, 신체활동, 질병력 등을 보정하여도, 출산횟수가 많을수록 평균 골밀도는 낮고 골밀도감소의 빈도는 높은 경향이 관찰되었다.

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The Heterogeneity of Post-Menopausal Disease Risk: Could the Basis for Why Only Subsets of Females Are Affected Be Due to a Reversible Epigenetic Modification System Associated with Puberty, Menstrual Cycles, Pregnancy and Lactation, and, Ultimately, Meno
David A. Hart
International Journal of Molecular Sciences.2024; 25(7): 3866. CrossRef
Genetic Prediction of Osteoporosis by Anti-Müllerian Hormone Levels and Reproductive Factors in Women: A Mendelian Randomization Study
Yuan Li, Jinquan Lai, Wenbo Wu, Shuyi Ling, Yuqing Dai, Zhisheng Zhong, Xiaodong Chen, Yuehui Zheng
Calcified Tissue International.2024; 115(1): 41. CrossRef
La densité minérale osseuse est-elle associée à la reproduction et l’allaitement chez les femmes ménopausées ?
I. Cherif, L. Kharrat, H. Ferjani, D. Ben Nessib, F. Majdoub, D. Kaffel, K. Maatallah, W. Hamdi
Revue du Rhumatisme.2024; 91: A341. CrossRef
Bridging the Gap: Pregnancy—And Lactation—Associated Osteoporosis
Mara Carsote, Maria Roxana Turturea, Ana Valea, Cristian Buescu, Claudiu Nistor, Ionut Florin Turturea
Diagnostics.2023; 13(9): 1615. CrossRef
Associations of breastfeeding duration and the total number of children breastfed with self-reported osteoarthritis in Korea women 50 years and older: a cross-sectional study
Dajeong Ham, Sanghyuk Bae
Epidemiology and Health.2023; 45: e2023044. CrossRef
Association between parity and bone mineral density in postmenopausal women
Yimei Yang, Shanshan Wang, Hui Cong
BMC Women's Health.2022;[Epub] CrossRef

Effects of Income Level on the Association Between Hypertension and Depression: 2010-2017 Korea National Health and Nutrition Examination Survey: San Kang, Hyeon Chang Kim; J Prev Med Public Health. 2020;53(6):439-446. Published online October 8, 2020; DOI: https://doi.org/10.3961/jpmph.20.337

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Abstract PDF Supplementary Material

Objectives
This study analyzed the associations of hypertension (HTN) with symptoms and diagnosis of depression by income level among Korean adults.
Methods
This study was based on the 2010-2017 Korea National Health and Nutrition Examination Survey data; a total of 29 425 adults (aged 20 years or older) were analyzed. HTN was defined as a systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of hypertensive medications. Depression symptoms were evaluated based on a questionnaire about depression-related symptoms. A depression diagnosis was defined based on questionnaire responses indicating that a participant had been diagnosed with depression. Household income was divided into higher or lower income ranges based on the median income of the participants. Multiple logistic regression analyses were performed to assess the associations between HTN and depression symptoms/diagnosis in the higher-income and lower-income groups.
Results
In the higher-income group, the odds ratio (OR) for the association between HTN and depression symptoms was 1.15 (95% confidence interval [CI], 0.97 to 1.37), and the OR for the association between HTN and depression diagnosis was 1.41 (95% CI, 1.13 to 1.76). In the lower-income group, the OR for the association between HTN and depression symptoms was 1.18 (95% CI, 1.04 to 1.34), whereas the OR for the association between HTN and depression diagnosis was 0.82 (95% CI, 0.70 to 0.97).
Conclusions
The associations of HTN with symptoms and diagnosis of depression differed by income level.

Summary

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Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults
Rohan M. Shah, Sahil Doshi, Sareena Shah, Shiv Patel, Angela Li, Joseph A. Diamond
High Blood Pressure & Cardiovascular Prevention.2023; 30(4): 337. CrossRef
Machine learning-based predictive modeling of depression in hypertensive populations
Chiyoung Lee, Heewon Kim, Gennady S. Cymbalyuk
PLOS ONE.2022; 17(7): e0272330. CrossRef
The Association between Plasma Concentration of Phytoestrogens and Hypertension within the Korean Multicenter Cancer Cohort
Juyeon Lee, Ju-Young Kang, Kwang-Pil Ko, Sue-Kyung Park
Nutrients.2021; 13(12): 4366. CrossRef

Comparison of Computed Tomography-based Abdominal Adiposity Indexes as Predictors of Non-alcoholic Fatty Liver Disease Among Middle-aged Korean Men and Women: Jongmin Baek, Sun Jae Jung, Jee-Seon Shim, Yong Woo Jeon, Eunsun Seo, Hyeon Chang Kim; J Prev Med Public Health. 2020;53(4):256-265. Published online June 18, 2020; DOI: https://doi.org/10.3961/jpmph.20.140

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Objectives
We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women.
Methods
The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes—visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)—were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC.
Results
VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women.
Conclusions
Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.

Summary

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Perceived Discrimination, Depression, and the Role of Perceived Social Support as an Effect Modifier in Korean Young Adults: Kwanghyun Kim, Sun Jae Jung, So Mi Jemma Cho, Ji Hye Park, Hyeon Chang Kim; J Prev Med Public Health. 2019;52(6):366-376. Published online October 24, 2019; DOI: https://doi.org/10.3961/jpmph.19.114

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Abstract Summary PDF Supplementary Material

Objectives
The relationships among discrimination, social support, and mental health have mostly been studied in minorities, and relevant studies in the general population are lacking. We aimed to investigate associations between discrimination and depressive symptoms in Korean non-minority young adults, considering the role of social support.
Methods
In total, 372 participants who completed the psychological examinations conducted in the third wave of the Jangseong High School Cohort study were included. We used the Everyday Discrimination Scale to evaluate perceived discrimination and the Beck Depression Inventory-II to measure depressive symptoms. Social support was measured by the Multidimensional Scale of Perceived Social Support. Multivariate linear regression was conducted to investigate associations between discrimination and depression, along with the effect modification of social support. We stratified the population by gender to investigate gender differences.
Results
Perceived discrimination was significantly associated with depressive symptoms (β=0.736, p<0.001), and social support was negatively associated with depression (β=-0.245, p<0.001). In men, support from friends was the most influential factor (β=-0.631, p=0.011), but no significant effect modification was found. In women, support from family was the most influential factor (β=-0.440, p=0.010), and women with higher familial support showed a significantly diminished association between discrimination and depression, unlike those with lower family support.
Conclusions
Discrimination perceived by individuals can lead to depressive symptoms in Korean young adults, and this relationship can may differ by gender and social support status.

Summary

Korean summary
본 연구에서는 한국인에서 차별이 우울 증상에 미치는 영향을 평가하고 사회적 지지가 차별의 건강영향을 조절하는지 확인하고자 하였다. 인지된 차별은 우울 증상과 양의 상관관계를 보였으며, 높은 사회적 지지는 차별의 부정적 건강 영향을 경감시키는 효과를 보였다. 남성에서는 친구로부터의 사회적 지지가 가장 강한 영향력을 나타냈으며, 여성에서는 가족으로부터의 사회적 지지가 가장 강한 효과를 보였다.

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Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease: Da-Hye Jeon, Hyungseon Yeom, Jaewon Yang, Jong Suk Song, Hyung Keun Lee, Hyeon Chang Kim; J Prev Med Public Health. 2017;50(6):369-376. Published online November 2, 2017; DOI: https://doi.org/10.3961/jpmph.17.089

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Abstract PDF

Objectives
Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI).
Methods
The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI.
Results
Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations.
Conclusions
The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

Summary

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C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population: Jung Hyun Lee, Hyungseon Yeom, Hyeon Chang Kim, Il Suh, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin, Sang-Baek Koh, Song Vogue Ahn, Tae-Yong Lee, So Yeon Ryu, Jae-Sok Song, Hong-Soon Choe, Young-Hoon Lee, Bo Youl Choi; J Prev Med Public Health. 2016;49(5):275-287. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.025

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Abstract PDF Supplementary Material

Objectives
C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
Methods
A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
Results
The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
Conclusions
Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.

Summary

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The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population: Hyungseon Yeom, Jung Hyun Lee, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2016;49(2):108-117. Published online March 23, 2016; DOI: https://doi.org/10.3961/jpmph.15.062

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Abstract PDF Supplementary Material

Objectives
Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy.
Methods
We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m²). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked.
Results
Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29).
Conclusions
Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Summary

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Lifestyle factors associated with a rapid decline in the estimated glomerular filtration rate over two years in older adults with type 2 diabetes–Evidence from a large national database in Japan
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Gender Differences in Hypertension Control Among Older Korean Adults: Korean Social Life, Health, and Aging Project: Sang Hui Chu, Ji Won Baek, Eun Sook Kim, Katherine M. Stefani, Won Joon Lee, Yeong-Ran Park, Yoosik Youm, Hyeon Chang Kim; J Prev Med Public Health. 2015;48(1):38-47. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.043

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Abstract PDF

Objectives
Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients’ attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults.
Methods
This cross-sectional study analyzed data from 653 Koreans aged ≥60 years who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension.
Results
Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one’s blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013).
Conclusions
This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

Summary

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Predictive Performance of Pender’s Health Promotion Model for Hypertension Control in Iranian Patients

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Social Network Characteristics and Body Mass Index in an Elderly Korean Population: Won Joon Lee, Yoosik Youm, Yumie Rhee, Yeong-Ran Park, Sang Hui Chu, Hyeon Chang Kim; J Prev Med Public Health. 2013;46(6):336-345. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.336

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Abstract PDF

Objectives

Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m²) in an elderly Korean population.

Methods

This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis.

Results

After adjusting for potential confounders, the men with lower density (<0.71) and higher network size (4-6) had the higher BMI (β=1.089, p=0.037) compared to the men with higher density (>0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (β=0.885, p=0.049), but not in the men (p=0.140).

Conclusions

Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association.

Summary

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Noncommunicable Diseases: Current Status of Major Modifiable Risk Factors in Korea: Hyeon Chang Kim, Sun Min Oh; J Prev Med Public Health. 2013;46(4):165-172. Published online July 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.4.165

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Abstract PDF

A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.

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Association Between Serum Uric Acid Level and Metabolic Syndrome: Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh; J Prev Med Public Health. 2012;45(3):181-187. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.181

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Abstract PDF

Objectives

Serum uric acid levels have been reported to be associated with a variety of cardiovascular conditions. However, the direct association between uric acid levels and metabolic syndrome remains controversial. Thus, we evaluated the association of serum uric acid levels and metabolic syndrome in a community-based cohort study in Korea.

Methods

We performed cross-sectional analysis of baseline data of 889 males and 1491 females (aged 38 to 87) who participated in baseline examinations of the Korean Genome and Epidemiology Study: Kanghwa study. Blood samples were collected after at least an 8 hour fast. Uric acid quartiles were defined as follows: <4.8, 4.8-<5.6, 5.6-<6.5, ≥6.5 mg/dL in males; and <3.8, 3.8-<4.3, 4.3-<5.1, ≥5.1 mg/dL in females. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III Criteria with adjusted waist circumference cutoffs (90 cm for males; 80 cm for females). The association between serum uric acid quartiles and metabolic syndrome was assessed using multivariate logistic regression.

Results

The odds ratio for having metabolic syndrome in the highest versus lowest quartiles of serum uric acid levels was 2.67 (95% confidence interval [CI], 1.60 to 4.46) in males and 2.14 (95% CI, 1.50 to 3.05) in females after adjusting for age, smoking, alcohol intake, body mass index, total cholesterol, HbA1c, albumin, γ-glutamyltransferase, blood urea nitrogen, and log C-reactive protein. The number of metabolic abnormalities also increased gradually with increasing serum uric acid levels (adjusted p for trend < 0.001 in both sexes).

Conclusions

Higher serum uric acid levels are positively associated with the presence of metabolic syndrome in Korean males and females.

Summary

Citations

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The Association Between Serum Albumin Levels and Metabolic Syndrome in a Rural Population of Korea: Hye Min Cho, Hyeon Chang Kim, Ju-Mi Lee, Sun Min Oh, Dong Phil Choi, Il Suh; J Prev Med Public Health. 2012;45(2):98-104. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.98

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Abstract PDF

Objectives

A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults.

Methods

This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value (≥90 cm for men and ≥85 cm for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis.

Results

Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men.

Conclusions

These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.

Summary

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Association Between Meat Consumption and Carotid Intima-Media Thickness in Korean Adults with Metabolic Syndrome.: Sun Min Oh, Hyeon Chang Kim, Song Vogue Ahn, Hye Jin Chi, Il Suh; J Prev Med Public Health. 2010;43(6):486-495.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.486

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Abstract PDF

OBJECTIVES
The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. METHODS: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. RESULTS: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (> or =5 servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. CONCLUSIONS: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (> or =5 servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.

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Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults
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Korean Journal of Community Nutrition.2020; 25(1): 61. CrossRef
Association between Total Diet Quality and Metabolic Syndrome Incidence Risk in a Prospective Cohort of Korean Adults
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Clinical Nutrition Research.2019; 8(1): 46. CrossRef
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Bernhard Haring, Wenyu Wang, Amanda Fretts, Daichi Shimbo, Elisa T. Lee, Barbara V. Howard, Mary J. Roman, Richard B. Devereux
Journal of Hypertension.2017; 35(9): 1794. CrossRef
The Strong Heart Study
José R. Banegas, Fernando Rodríguez-Artalejo
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Song Vogue Ahn, Sang-Baek Koh, Kwang-Sik Lee, Yeon-Sik Bong, Jong-Ku Park
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Jong-Ku Park, Song Vogue Ahn, Mi Kyung Kim, Kwang-Sik Lee, Sang-Baek Koh, Yeon-Sik Bong
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Hannah Gardener, Clinton B. Wright, Digna Cabral, Nikolaos Scarmeas, Yian Gu, Ken Cheung, Mitchell S.V. Elkind, Ralph L. Sacco, Tatjana Rundek
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C-reactive Protein and Carotid Intima-media Thickness in a Population of Middle-aged Koreans.: Mina Suh, Joo Young Lee, Song Vogue Ahn, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2009;42(1):29-34.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.29

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OBJECTIVES
This study was performed to evaluate the relationship between C-reactive protein (CRP) and carotid intima-media thickness (carotid IMT) in a population of middle-aged Koreans. METHODS: A total of 1,054 men and 1,595 women (aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause (women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. RESULTS: Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women (p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men (p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women (p for trend=0.017), but not in men (p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55 (95% CI=1.06-2.26) in women, but only 1.05 (95% CI=0.69-1.62) in men. CONCLUSIONS: CRP and carotid IMT levels appear to be directly related in women, but not in men.

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Hematocrit Values Predict Carotid Intimal-Media Thickness in Obese Patients With Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study
Giovanni Tarantino, Luigi Barrea, Domenico Capone, Vincenzo Citro, Teresa Mosca, Silvia Savastano
Frontiers in Endocrinology.2018;[Epub] CrossRef
Association Between Serum Uric Acid Level and Metabolic Syndrome
Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Il Suh
Journal of Preventive Medicine and Public Health.2012; 45(3): 181. CrossRef
Relationships between high-sensitive C-reactive protein and markers of arterial stiffness in hypertensive patients. Differences by sex
Manuel A Gomez-Marcos, Jose I Recio-Rodríguez, Maria C Patino-Alonso, Cristina Agudo-Conde, Leticia Gomez-Sanchez, Emiliano Rodriguez-Sanchez, Marta Gomez-Sanchez, Vicente Martinez-Vizcaino, Luis Garcia-Ortiz
BMC Cardiovascular Disorders.2012;[Epub] CrossRef

Association between Hypertension and Pulmonary Function in Rural Adults in Korea.: Joo Young Lee, Song Vogue Ahn, Dong Phil Choi, Mina Suh, Hyeon Chang Kim, Young Sam Kim, Il Suh; J Prev Med Public Health. 2009;42(1):21-28.; DOI: https://doi.org/10.3961/jpmph.2009.42.1.21

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OBJECTIVES
Whilst hypertension exerts a negative effect on several organs there have been few studies regarding its effect on pulmonary function. The objective of this study was to examine the relationship between hypertension and pulmonary function in rural Korean adults. METHODS: In 2006, 2534 people were recruited, aged 40 to 70, in Kangwha County. We selected 1454 (male: 624, female: 830) participants whose pulmonary function results were repeatable. Blood pressure (BP) was measured twice and the average calculated. Participants were divided into two groups (hypertensive group and non-hypertensive group) in accordance with The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Pulmonary function was measured by dry rolling seal spirometry. Forced expiratory volume in the one second and forced vital capacity were converted into percent-predicted values based on average pulmonary function amongst Koreans. RESULTS: The number of hypertensive participants in the present study was 460 (male: 205, female: 255) and the number of non-hypertensive participants was 994 (male: 419, female: 575). Our findings have shown that the mean values for expiratory volume in the one second and forced vital capacity were significantly lower for hypertensive people than for non-hypertensive people, among women (P=0.002 for forced expiratory volume in the one second, P<0.001 for forced vital capacity volume). Odds ratio analysis revealed that hypertensive participants were more likely to have lower pulmonary function than non-hypertensive participants, again significantly among women. CONCLUSIONS: The pulmonary function of hypertensive women was significantly lower than that of non-hypertensive women aged 40-70.

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Seung Won Lee, Hyeon Chang Kim, Ju-mi Lee, Young Mi Yun, Joo Young Lee, Il Suh
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The Association between Obesity Indices in Adolescence and Carotid Intima-media Thickness in Young Adults: Kangwha Study.: Yoo Jung Lee, Chung Mo Nam, Hyeon Chang Kim, Nam Wook Hur, Il Suh; J Prev Med Public Health. 2008;41(2):107-114.; DOI: https://doi.org/10.3961/jpmph.2008.41.2.107

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OBJECTIVES
The aim of this study is to investigate the association between obesity indices (body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. METHODS: This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescencec") and 25 years-old in 2005 (defined as "early adulthoodc"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. RESULTS: In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. CONCLUSIONS: This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.

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Association between Blood Pressure and Carotid Intima-Media Thickness
Sun Min Lim, Hyeon Chang Kim, Hoon Sang Lee, Joo Young Lee, Mina Suh, Song Vogue Ahn
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Impact of Multiple Cardiovascular Risk Factors on the Carotid Intima-media Thickness in Young Adults: The Kangwha Study.: Hoo Sun Chang, Hyeon Chang Kim, Song Vogue Ahn, Nam Wook Hur, Il Suh; J Prev Med Public Health. 2007;40(5):411-417.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.411

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OBJECTIVES
Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. METHODS: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. RESULTS: The mean carotid IMT+/-standard deviation observed was 0.683+/-0.079 mm in men and 0.678+/-0.067 mm in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). CONCLUSIONS: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.

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Sun Min Lim, Hyeon Chang Kim, Hoon Sang Lee, Joo Young Lee, Mina Suh, Song Vogue Ahn
The Journal of Pediatrics.2009; 154(5): 667. CrossRef

Relationship between Corrected QT Interval and Cardiovascular Risk Factors in Young Healthy Adults: The Kangwha Study.: Song Vogue Ahn, Hyeon Chang Kim, Nam Wook Hur, Kyoung Soo Ha, Hoo Sun Jang, Jin Bae Kim, Il Suh; J Prev Med Public Health. 2006;39(6):455-461.

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Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people. The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. METHODS: This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. RESULTS: The mean QTc interval was significantly longer in women (419+/-17ms) than in men (405+/-17ms) (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. CONCLUSIONS: In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.; Summary

Dipstick Urine Protein, as a Predictor of Cardiovascular Mortality in Korean Men: Korea Medical Insurance Corporation Study.: Kyoungsoo Ha, Hyeon Chang Kim, Dae Ryong Kang, Chung Mo Nam, Song Vogue Ahn, Il Suh; J Prev Med Public Health. 2006;39(5):427-432.

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This study was to investigate if the dipstick proteinuria can predict cardiovascular mortality in a population of Korean men. METHODS: We measured urine protein and other cardiovascular risk factors in 100059 Korean men, aged between 35-59 years in 1990 and 1992. Levels of proteinuria measured by dipstick method were trace or less, 1+, 2+, and 3+ or greater. The primary outcomes were deaths from all causes, cardiovascular disease, cancer, and others in a 12 year follow-up from 1993 to 2004. RESULTS: The multivariate-adjusted relative risks (95% CI) for cardiovascular death according to the level of proteinuria (1+, 2+, 3+ and more) in 1990 examination were 2.18 (1.36-3.48), 2.55 (1.37-4.78), and 4.57 (2.16-9.66) respectively. The corresponding relative risks according to the level of proteinuria in 1992 examination were 2.49 (1.71-3.64), 2.64 (1.53-4.58), and 2.78 (1.15-6.73). The relative risks for cardiovascular death of men with proteinuria (1+ or greater) once and twice among the examinations were 2.18 (1.63-2.92) and 3.75 (2.27-6.18), compared with men without proteinuria in 1990 and 1992 examinations. CONCLUSIONS: Our results showed that dipstick proteinuria is associated with cardiovascular mortality in Korean men. Dipstick proteinuria could be a predictor for cardiovascular mortality.; Summary

Awareness, Treatment, Control, and Related Factors of Hypertension in Gwacheon.: Youn Hee Choi, Chung Mo Nam, Mi Hyun Joo, Ki Tae Moon, Jee Seon Shim, Hyeon Chang Kim, Il Suh; Korean J Prev Med. 2003;36(3):263-270.

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To identify the factors related to awareness, treatment, and control of hypertension in a Gwacheon population. METHODS: This study surveyed 1, 176 Gwacheon residents older than 40 years, and measured blood pressure using a standardized guideline in 1999. The study subjects were 473 adults (175 males, 298 females) with hypertension defined as a systolic blood pressure > or= 140 mmHg, diastolic blood pressure > or= 90 mmHg or reported treatment with antihypertensive medications. Information on awareness, treatment, and control of hypertension, and sociodemographic and health-related factors was collected through person-to-person interviews with a structured questionnaire. RESULTS: Overall, 252 (53.3%) of hypertensive subjects were aware of their condition, of whom as many as 193 (76.6%) were being treated, and 81 (42.0%) had their blood pressure controlled at the recommended level (< 140/90 mmHg). However, of the 473 subjects found to have hypertension, only 40.8% were being treated, and 17.1% were under control. There were no significant differences in the proportions of awareness, treatment, and control of hypertension. In multiple logistic regression models, awareness of hypertension was positively associated with age and family history of hypertension in females. Control of hypertension was also positively associated with having a partner and marital status in females. CONCLUSION: These findings demonstrate that much greater efforts on improving awareness, treatment, and control of hypertension are needed, even in urban community settings, considering related factors such as age, family history, and marital status. However, these factors should be further investigated for their causal relationship.; Summary

Twelve-year Incidence of Hypertension and Its Risk Factors in a Lean Population: the Kangwha Study.: Hyeon Chang Kim, Il Suh, Kang Hee Lee, Sun Ha Jee, Chang Soo Kim, Chung Mo Nam; Korean J Prev Med. 1999;32(4):435-442.

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The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. METHODS: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study. Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. RESULTS: During the 12-year period, 68 of 164 males and 53 of 214 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hypertension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67)in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). CONCLUSIONS: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.; Summary

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