Journal of Preventive Medicine and Public Health

Original Articles

The Korea Cohort Consortium: The Future of Pooling Cohort Studies: Sangjun Lee, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Sun Ha Jee, Aesun Shin, Sun-Seog Kweon, Min-Ho Shin, Sangmin Park, Seungho Ryu, Sun Young Yang, Seung Ho Choi, Jeongseon Kim, Sang-Wook Yi, Daehee Kang, Keun-Young Yoo, Sue K. Park; J Prev Med Public Health. 2022;55(5):464-474. Published online September 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.299

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Abstract Summary PDF Supplementary Material

Objectives
We introduced the cohort studies included in the Korea Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies.
Methods
We mainly focused on the characteristics of individual cohort studies from the KCC. We developed “PROFAN”, a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated.
Results
The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102.
Conclusions
We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.

Summary

Korean summary
한국 코호트 컨소시엄(KCC)은 “2015년 한국의 생활 습관 및 환경 요인에 따른 암 기여분율” 프로젝트의 3단계 과업으로써, 본 프로젝트에 참여한 기존의 구축된 개인 코호트 연구의 연구자들을 주도로 다수의 대규모 한국 코호트 연구를 기반으로 구성되었다. 따라서 본 연구는 KCC에 포함된 한국 코호트 연구를 소개하는 것을 목표로 하였다. 또한 여러 기 확립된 국제 컨소시엄을 기반으로 빅데이터 기반 코호트 풀링 연구의 중요성을 제시하였다.

Citations

Citations to this article as recorded by

The relationship between regional inequalities in the provision of emergency health services and other health services
Erkan Boğa
Medicine.2023; 102(45): e35930. CrossRef

Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea: Jisun Sung, Seungho Ryu, Yun-Mi Song, Hae-Kwan Cheong; J Prev Med Public Health. 2020;53(5):342-352. Published online July 17, 2020; DOI: https://doi.org/10.3961/jpmph.20.089

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Abstract PDF

Objectives
The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease.
Methods
This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient’s age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors.
Results
Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant.
Conclusions
NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

Summary

Citations

Citations to this article as recorded by

Anti-osteoporotic treatments in the era of non-alcoholic fatty liver disease: friend or foe
Maria Eleni Chondrogianni, Ioannis Kyrou, Theodoros Androutsakos, Christina-Maria Flessa, Evangelos Menenakos, Kamaljit Kaur Chatha, Yekaterina Aranan, Athanasios G. Papavassiliou, Eva Kassi, Harpal S. Randeva
Frontiers in Endocrinology.2024;[Epub] CrossRef
Association between body fat and bone mineral density in Korean adults: a cohort study
Hyunjung Yoon, Eunju Sung, Jae-Heon Kang, Cheol-Hwan Kim, Hocheol Shin, Eunsol Yoo, Minyoung Kim, Mi Yeon Lee, Sujeong Shin
Scientific Reports.2023;[Epub] CrossRef
Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease
Ilaria Barchetta, Carla Lubrano, Flavia Agata Cimini, Sara Dule, Giulia Passarella, Arianna Dellanno, Alberto Di Biasio, Frida Leonetti, Gianfranco Silecchia, Andrea Lenzi, Maria Gisella Cavallo
Hepatology International.2023; 17(2): 357. CrossRef
Non-Alcoholic Fatty Liver Disease and Bone Tissue Metabolism: Current Findings and Future Perspectives
Oxana M. Drapkina, Anastasia Yu. Elkina, Anna F. Sheptulina, Anton R. Kiselev
International Journal of Molecular Sciences.2023; 24(9): 8445. CrossRef
Nonalcoholic Fatty Liver Disease Is Associated With Decreased Bone Mineral Density in Adults: A Systematic Review and Meta‐Analysis
Ying‐Hao Su, Kuo‐Liong Chien, Shu‐Hua Yang, Wei‐Tso Chia, Jen‐Hau Chen, Yen‐Ching Chen
Journal of Bone and Mineral Research.2023; 38(8): 1092. CrossRef
The National Consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities
Marina V. Maevskaya, Yulia V. Kotovskaya, Vladimir T. Ivashkin, Olga N. Tkacheva, Ekaterina A. Troshina, Marina V. Shestakova, Valeriy V. Breder, Natalia I. Geyvandova, Vladimir L. Doshchitsin, Ekaterina N. Dudinskaya, Ekaterina V. Ershova, Khava B. Kodzo
Terapevticheskii arkhiv.2022; 94(2): 216. CrossRef
Nonalcoholic fatty liver disease and osteoporosis: A potential association with therapeutic implications
Ilias D. Vachliotis, Athanasios D. Anastasilakis, Antonis Goulas, Dimitrios G. Goulis, Stergios A. Polyzos
Diabetes, Obesity and Metabolism.2022; 24(9): 1702. CrossRef
Hepatic fibrosis is associated with an increased rate of decline in bone mineral density in men with nonalcoholic fatty liver disease
Ji Won Yoon, Min Joo Kim, Goh-Eun Chung, Jong In Yang, Jeong Yoon Yim, Jin Ju Kim, Sun Mie Kim, Min-Sun Kwak
Hepatology International.2021; 15(6): 1347. CrossRef
NAFLD Associated Comorbidity
L. B. Lazebnik, S. V. Turkina
Experimental and Clinical Gastroenterology.2021; (10): 5. CrossRef

English Abstract

What will be the Proper Criteria for Impaired Fasting Glucose for Korean Men?: Based on Medical Screening Data from a General Hospital.: Seungho Ryu, Yoo Soo Chang, Dong Il Kim, Byung Seong Suh, Woon Sool Kim; J Prev Med Public Health. 2005;38(2):203-207.

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Abstract PDF: OBJECTIVES
Recently, the American Diabetes Association (ADA) redefined the criteria of prediabetes, which has lowered the diagnostic level of fasting plasma glucose (FPG) from 110 to 125 mg/dl, down to levels between 100 to 125mg/dl. The purpose of this study was to determine the predictive cutoff level of FPG as a risk for the development of diabetes mellitus in Korean men. METHODS: A retrospective cohort study was conducted on 11, 423 (64.5%) out of 17, 696 males < or =30 years of age, and who met the FPG of < or =125 mg/dl and hemoglobin A1c of < or = 6.4% criteria, without a history of diabetes, and who were enrolled at the screening center of a certain university hospital between January and December 1999. The subjects were followed from January 1999 to December 2002 (mean follow-up duration; 2.3 (+/-0.7) years). They were classified as normal (FPG < 100mg/dl), high glucose (FPG > or =100mg/dl and < 110mg/dl) and impaired fasting glucose (FPG > or =110mg/dl and < or =125mg/dl) on the basis of their fasting plasma glucose level measured in 1999. We compared the incidence of diabetes between the 3 groups by performing Cox proportional hazards model and used receiver operating characteristic analyses of the FPG level, in order to estimate the optimal cut-off values as predictors of incident diabetes. RESULTS: At the baseline, most of the study subjects were in age in their 30s to 40s (mean age, 41.8 (+/-7.1) year). The incidence of diabetes mellitus in this study was 1.19 per 1, 000 person-years (95% CI=0.68-1.79), which was much lower than the results of a community-based study that was 5.01 per 1, 000 person-years. The relative risks of incident diabetes in the high glucose and impaired fasting glucose groups, compared with the normal glucose group, were 10.3 (95% CI=2.58-41.2) and 95.2 (95% CI= 29.3-309.1), respectively. After adjustment for age, body mass index, and log triglyceride, a FPG greater than 100mg/dl remained significant predictors of incident diabetes. Using the receiver operating characteristic (ROC) curve, the optimal cutoff level of FPG as a predictor of incident diabetes was 97.5 mg/dl, with a sensitivity and a specificity of 81.0% and 86.0%, respectively. CONCLUSION: These results suggest that lowering the criteria of impaired fasting glucose is needed in Korean male adults. Future studies on community-based populations, including women, will be required to determine the optimal cutoff level of FPG as a predictor of incident diabetes.; Summary

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