1.Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021
Sung-Bin HONG ; Ji-Eun KIM ; Seung Seok HAN ; Joseph J. SHEARER ; Jungnam JOO ; Ji-Yeob CHOI ; Véronique L. ROGER
Epidemiology and Health 2025;47(1):e2025005-
OBJECTIVES:
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).
METHODS:
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.
RESULTS:
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.
2.Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021
Sung-Bin HONG ; Ji-Eun KIM ; Seung Seok HAN ; Joseph J. SHEARER ; Jungnam JOO ; Ji-Yeob CHOI ; Véronique L. ROGER
Epidemiology and Health 2025;47(1):e2025005-
OBJECTIVES:
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).
METHODS:
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.
RESULTS:
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.
3.Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021
Sung-Bin HONG ; Ji-Eun KIM ; Seung Seok HAN ; Joseph J. SHEARER ; Jungnam JOO ; Ji-Yeob CHOI ; Véronique L. ROGER
Epidemiology and Health 2025;47(1):e2025005-
OBJECTIVES:
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).
METHODS:
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.
RESULTS:
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.
4.Prevalence of cardiovascular-kidney-metabolic syndrome in Korea: Korea National Health and Nutrition Examination Survey 2011-2021
Sung-Bin HONG ; Ji-Eun KIM ; Seung Seok HAN ; Joseph J. SHEARER ; Jungnam JOO ; Ji-Yeob CHOI ; Véronique L. ROGER
Epidemiology and Health 2025;47(1):e2025005-
OBJECTIVES:
The American Heart Association (AHA) recently defined cardiovascular-kidney-metabolic (CKM) syndrome to better characterize the associations among cardiovascular, kidney, and metabolic diseases. Although about 9 in 10 United States adults have at least 1 risk factor for CKM syndrome, its prevalence in other populations is less understood. To fill this gap, we examined the prevalence of CKM syndrome in Korea and its association with demographic and socioeconomic status (SES).
METHODS:
Using data from the Korean National Health and Nutrition Examination Survey between 2011 and 2021, we calculated the prevalence of CKM syndrome across the following stages: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stages 3-4 (subclinical/clinical cardiovascular diseases) among adults aged ≥20 years. Weighted analyses were used to estimate prevalence and 95% confidence intervals (CIs) for each CKM syndrome stage, stratified by age, gender, and SES factors.
RESULTS:
Among 54,994 Korean adults, the prevalence of CKM syndrome was as follows: stage 0 (25.2%; 95% CI, 24.7 to 25.8), stage 1 (19.3%; 95% CI, 18.9 to 19.7), stage 2 (51.6%; 95% CI, 51.1 to 52.2), and stages 3-4 (3.9%; 95% CI, 3.7 to 4.0). The prevalence of stages 2 and 3-4 was higher in men than in women. In addition, stages 3-4 were more prevalent among rural residents and those with lower education or income.
CONCLUSIONS
About 3 out of 4 Koreans are at risk for CKM syndrome. These findings highlight that CKM syndrome is a global health problem and that interventions are urgently needed to prevent further progression.
5.Clonal Distribution and Its Association With the Carbapenem Resistance Mechanisms of Carbapenem-Non-Susceptible Pseudomonas aeruginosa Isolates From Korean Hospitals
Nayeong KIM ; Seo Yeon KO ; Seong Yong PARK ; Seong Yeob KIM ; Da Eun LEE ; Ki Tae KWON ; Yu Kyung KIM ; Je Chul LEE
Annals of Laboratory Medicine 2024;44(5):410-417
Background:
Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals.
Methods:
A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase.
Results:
Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates.
Conclusions
Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.
6.Clonal Distribution and Its Association With the Carbapenem Resistance Mechanisms of Carbapenem-Non-Susceptible Pseudomonas aeruginosa Isolates From Korean Hospitals
Nayeong KIM ; Seo Yeon KO ; Seong Yong PARK ; Seong Yeob KIM ; Da Eun LEE ; Ki Tae KWON ; Yu Kyung KIM ; Je Chul LEE
Annals of Laboratory Medicine 2024;44(5):410-417
Background:
Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals.
Methods:
A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase.
Results:
Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates.
Conclusions
Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.
7.Clonal Distribution and Its Association With the Carbapenem Resistance Mechanisms of Carbapenem-Non-Susceptible Pseudomonas aeruginosa Isolates From Korean Hospitals
Nayeong KIM ; Seo Yeon KO ; Seong Yong PARK ; Seong Yeob KIM ; Da Eun LEE ; Ki Tae KWON ; Yu Kyung KIM ; Je Chul LEE
Annals of Laboratory Medicine 2024;44(5):410-417
Background:
Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals.
Methods:
A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase.
Results:
Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates.
Conclusions
Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.
8.Clonal Distribution and Its Association With the Carbapenem Resistance Mechanisms of Carbapenem-Non-Susceptible Pseudomonas aeruginosa Isolates From Korean Hospitals
Nayeong KIM ; Seo Yeon KO ; Seong Yong PARK ; Seong Yeob KIM ; Da Eun LEE ; Ki Tae KWON ; Yu Kyung KIM ; Je Chul LEE
Annals of Laboratory Medicine 2024;44(5):410-417
Background:
Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals.
Methods:
A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase.
Results:
Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates.
Conclusions
Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.
9.Tobacco Use in Korea: Current Epidemiology and Public Health Issues
Jong Eun PARK ; Woo Min JEONG ; Ye Jin CHOI ; So Young KIM ; Kyoung Eun YEOB ; Jong Hyock PARK
Journal of Korean Medical Science 2024;39(45):e328-
Tobacco control efforts in Korea began nearly three decades ago with the enactment of the National Health Promotion Act in 1995. Monitoring smoking prevalence is crucial for evaluating the effectiveness of tobacco control measures, as reductions in smoking rates reflect the impact of anti-smoking policies. This review aims to provide an updated overview of the epidemiology of tobacco use in Korea, outline the nation’s advancements in tobacco control, and emphasize emerging challenges in tobacco use. The data sources included statistics and reports from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD), the Korea National Health and Nutrition Examination Survey, as well as various national statistics and reports on tobacco use and control in Korea.Over the past quarter-century, there was a notable 49.6% reduction in the prevalence of cigarette smoking among Korean adults, with a particularly pronounced decline among men (1998: 66.3% vs. 2022: 30.0%; a 54.8% decrease). However, the reduction among women was more modest, with only a 1.5 percentage point decrease (1998: 6.5% vs. 2022: 5.0%; a 23.1% decrease), and an increase in smoking prevalence was observed among women in their 20s and 30s. Overall use of any tobacco product, including cigarettes, heated tobacco products, electronic nicotine delivery systems, and others, was 6.6 percentage points higher among males and 2.2 percentage points higher among females compared to cigarette smoking alone.In 2019, there were 58,036 deaths attributed to direct smoking in Korea, with an estimated socioeconomic cost of smoking amounting to 12,191.3 billion Korean won. Furthermore, critical issues in tobacco use persist in Korea, including significant disparities in tobacco use related to age, gender, and disability, the growing use of novel tobacco and nicotine products among adolescents and younger adults, and regulatory blind spots. The reduction in smoking rates in Korea reflects the impact of expanded tobacco control policies and public health initiatives. However, for Korea to advance to the next level in tobacco control policies, it is essential to implement the WHO Framework Convention on Tobacco Control’s MPOWER measures more thoroughly.
10.Tobacco Use in Korea: Current Epidemiology and Public Health Issues
Jong Eun PARK ; Woo Min JEONG ; Ye Jin CHOI ; So Young KIM ; Kyoung Eun YEOB ; Jong Hyock PARK
Journal of Korean Medical Science 2024;39(45):e328-
Tobacco control efforts in Korea began nearly three decades ago with the enactment of the National Health Promotion Act in 1995. Monitoring smoking prevalence is crucial for evaluating the effectiveness of tobacco control measures, as reductions in smoking rates reflect the impact of anti-smoking policies. This review aims to provide an updated overview of the epidemiology of tobacco use in Korea, outline the nation’s advancements in tobacco control, and emphasize emerging challenges in tobacco use. The data sources included statistics and reports from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD), the Korea National Health and Nutrition Examination Survey, as well as various national statistics and reports on tobacco use and control in Korea.Over the past quarter-century, there was a notable 49.6% reduction in the prevalence of cigarette smoking among Korean adults, with a particularly pronounced decline among men (1998: 66.3% vs. 2022: 30.0%; a 54.8% decrease). However, the reduction among women was more modest, with only a 1.5 percentage point decrease (1998: 6.5% vs. 2022: 5.0%; a 23.1% decrease), and an increase in smoking prevalence was observed among women in their 20s and 30s. Overall use of any tobacco product, including cigarettes, heated tobacco products, electronic nicotine delivery systems, and others, was 6.6 percentage points higher among males and 2.2 percentage points higher among females compared to cigarette smoking alone.In 2019, there were 58,036 deaths attributed to direct smoking in Korea, with an estimated socioeconomic cost of smoking amounting to 12,191.3 billion Korean won. Furthermore, critical issues in tobacco use persist in Korea, including significant disparities in tobacco use related to age, gender, and disability, the growing use of novel tobacco and nicotine products among adolescents and younger adults, and regulatory blind spots. The reduction in smoking rates in Korea reflects the impact of expanded tobacco control policies and public health initiatives. However, for Korea to advance to the next level in tobacco control policies, it is essential to implement the WHO Framework Convention on Tobacco Control’s MPOWER measures more thoroughly.

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