Purpose: This study aimed to assess the feasibility of operational definitions of cancer patients in conducting cancer-related studies using the claims data from the National Health Insurance Service (NHIS). Materials and Methods: Cancer incidence data were obtained from the Korean Central Cancer Registry, the NHIS primary diagnosis, and from the rare and intractable disease (RID) registration program. Results: The operational definition with higher sensitivity for cancer patient verification was different by cancer type. Using primary diagnosis, the lowest sensitivity was found in colorectal cancer (91.5%; 95% confidence interval [CI], 91.7 to 92.0) and the highest sensitivity was found in breast cancer (97.9%; 95% CI, 97.8 to 98.0). With RID, sensitivity was the lowest in liver cancer (91.9%; 95% CI, 91.7 to 92.0) and highest in breast cancer (98.1%; 95% CI, 98.0 to 98.2). In terms of the difference in the date of diagnosis in the cancer registration data, > 80% of the patients showed a < 31-day difference from the RID definition. Conclusion Based on the NHIS data, the operational definition of cancer incidence is more accurate when using the RID registration program claims compared to using the primary diagnosis despite the relatively lower concordance by cancer type requires additional definitions such as treatment.

BACKGROUND AND OBJECTIVES: The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. METHODS: We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. RESULTS: A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP < 60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. CONCLUSION: A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg.
Aged ; Blood Pressure ; Cohort Studies ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Male ; Mortality ; Myocardial Ischemia ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Vascular Diseases

BACKGROUND AND OBJECTIVES: The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. METHODS: We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30–95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. RESULTS: A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP < 60 mmHg compared to 70–79 mmHg were 1.23 (95% confidence interval [CI], 1.16–1.30) and 1.37 (95% CI, 1.20–1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30–59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60–69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30–59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. CONCLUSION A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg.

BACKGROUND: Elevated serum levels of growth differentiation factor-15 (GDF-15) are associated with type 2 diabetes. Therefore, the effects of atorvastatin on metabolic parameters and GDF-15 levels in patients with type 2 diabetes and dyslipidemia were evaluated. METHODS: In this prospective randomized trial from February 2013 to March 2014, 50 consecutive type 2 diabetic patients with a low density lipoprotein cholesterol (LDL-C) levels > or =100 mg/dL were enrolled. The patients were divided into two groups based on the amount of atorvastatin prescribed, 10 mg/day (n=23) or 40 mg/day (n=27). The effect of atorvastatin on metabolic parameters, including lipid profiles and GDF-15 levels, at baseline and after 8 weeks of treatment were compared. RESULTS: The baseline metabolic parameters and GDF-15 levels were not significantly different between the two groups. After 8 weeks of treatment, the total cholesterol (TC) and LDL-C levels were significantly decreased in both groups. The mean changes in TC and LDL-C levels were more significant in the 40 mg atorvastatin group. The GDF-15 level was decreased in the 10 mg atorvastatin group, from 1,460.6+/-874.8 to 1,451.0+/-770.8 pg/mL, and was increased in the 40 mg atorvastatin group, from 1,271.6+/-801.0 to 1,341.4+/-855.2 pg/mL. However, the change in the GDF-15 level was not statistically significant in the 10 or 40 mg atorvastatin group (P=0.665 and P=0.745, respectively). CONCLUSION: The GDF-15 levels were not significantly changed after an 8-week treatment with atorvastatin in type 2 diabetic patients.
Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus, Type 2* ; Dyslipidemias* ; Growth Differentiation Factor 15 ; Humans ; Prospective Studies ; Atorvastatin Calcium

OBJECTIVES: This study was aimed to identify the socioeconomic factors, health behavior factors and dietary patterns that have an influence on the periodontal disease in adults. METHODS: This study used data collected from the fifth Korea National Health and Nutrition Examination Survey (NHANES V-1). The final sample included 2,386 subjects who were 30-59 years old and who had completed the necessary health examinations, the health behaviors survey and nutrition survey. RESULTS: Eleven dietary patterns emerged from the factor analysis with different factor loading. After controlling for potential confounders, multiple logistic regression analysis of the dietary patterns showed that 'legumes/mixed grains' and 'instant foods' affected the periodontal disease. Lower consumption of 'legumes/mixed grains' and higher consumption of 'instant foods' were significantly associated only with an increased risk of periodontal disease. CONCLUSIONS: In the light of the results of this study, it appears pretty likely that the risk of developing periodontal disease can be reduced by changing a person's dietary patterns.
Adult* ; Health Behavior ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys* ; Periodontal Diseases* ; Socioeconomic Factors

BACKGROUND: Metabolic syndrome is associated with type 2 diabetes and cardiovascular disease in patients with prediabetes. The aim of this study was to investigate and compare WHtR (Waist-to-Height Ratio) as a predictor of metabolic syndrome with other anthropometric indices as in Body Mass Index (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) in prediabetes. METHODS: A total of 816 subjects with prediabetes were recruited from a community based Cohort Study. Receiver operating characteristic (ROC) curve was performed to find the optimal cutoff value of WHtR. Area under the curve (AUC) was calculated for each anthropometric index and correlation coefficient between WHtR and various dermographic and clinical factors was calculated. RESULTS: WHtR had a significant correlation with metabolic parameters except for fasting glucose and increased with increasing number of risk factors for metabolic syndrome. AUC of WHtR was significantly higher than that of other anthropometric indices. The optimal cutoff value of WHtR was 0.53 for metabolic syndrome in prediabetes. CONCLUSION: WHtR may be the simple and effective anthropometric index for predicting metabolic syndrome in prediabetic patients.
Area Under Curve ; Body Mass Index ; Cardiovascular Diseases ; Cohort Studies ; Fasting ; Glucose ; Humans ; Prediabetic State ; Risk Factors ; ROC Curve ; Waist Circumference ; Waist-Hip Ratio

PURPOSE: This study aimed to examine the relationship between parent's history of allergic disease and children's atopic dermatitis. METHODS: Data from the 2011 Research on the Current Status of Atopic Disease with Elementary Schools and Kindergartens in Suwon were used for analysis. Among 20,052 persons consenting to the survey, 18,943 who had answered parent's history were included in the study. RESULTS: The prevalence of father, mother, and parent's allergic disease history were 8.5%, 9.5%, and 2.3%, respective. The children with atopic dermatitis comprised 15.1% of the study population. In multivariate analysis, gender, weight at birth, the practice of breast-feeding, father's educational level, the presence of chemical products in the inside, and the presence of mold were significant risk factors for children's atopic dermatitis. The multivariate-adjusted odds ratio for the occurrence of children's atopic dermatitis was 3.19 (95% confidence interval, 2.57-3.95) when subjects with and without parent's history were compared. CONCLUSION: When fathers have a history of allergic disease, children tend to have atopic dermatitis.
Child* ; Dermatitis, Atopic* ; Fathers ; Fungi ; Gyeonggi-do ; Humans ; Hypersensitivity ; Mothers ; Multivariate Analysis ; Odds Ratio ; Parents* ; Parturition ; Prevalence ; Risk Factors

OBJECTIVES: Among non-pharmaceutical measures for preventing cognitive impairment, involving in social activities is known to be very effective. We tried to examine the correlation between social activity and cognitive function. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire which included demographic characteristics, current and past history of illnesses, drug history, Korean version of Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale, and Beck Anxiety Inventory. We checked the time consumed in each 9 social activities through the checklist. RESULTS: On multiple logistic regression analysis, the total time spent in social activities wasinversely associated with the K-MMSE score after adjusting confounding variables like age, sex, education level, depression, anxiety and vascular risk factor (beta=-0.041, p=0.024). On the other hand, correlation was found between K-MMSE score and time spent in participating in religious party (beta=0.053, p=0.003) as well as time spent in elder's university (beta=0.040, p=0.025) after adjustingage, sex, education, depression, anxiety and vascular risk factor. CONCLUSION: Our results suggest that involving in quality social activities might be more effective in improving cognitive function than spending longer total time in any social activity.
Aged ; Anxiety ; Cognition ; Cohort Studies ; Confounding Factors (Epidemiology) ; Depression ; Hand ; Humans ; Logistic Models ; Surveys and Questionnaires ; Risk Factors

OBJECTIVES: The purpose of this study was to describe the status of mental activity participation in community-dwelling elderly and to evaluate the association between mental activity and cognitive function after adjustment for depression and anxiety. METHODS: This study was based on the Suwon Project, which was a cohort comprising of nonrandom convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire including their demographic characteristics, current and past illnesses history, drug history, Korean version-Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale (SGDS-K), Beck Anxiety Inventory (BAI). We checked how many hours per day are used for each items of 11 mental activities through the checklist. RESULTS: Total time spent in 11 mental activities was 237.4+/-152.4 minutes per day. On multiple regression analysis, total time spent in 11 mental activities (MA-total), and time spent by watching television and reading book/newspaper showed statistically significant association with K-MMSE score after adjustment with age, sex, education, chronic medical illness, depression and anxiety. CONCLUSION: Our result suggested that mental activity may be associated with cognitive function in the elderly without cognitive impairment in the community after adjusting age, sex, education, chronic medical illness, depression and anxiety.
Aged ; Anxiety ; Cognition ; Cohort Studies ; Depression ; Humans ; Surveys and Questionnaires ; Television ; Periodicals

OBJECTIVES: We aimed to investigate the relationship between anxiety and stroke warning signs in the elderly. METHODS: Data obtained from 1,078 subjects (256 men and 822 women) aged above 65 years was analyzed from Suwon Project, which was a cohort comprising of nonrandom convenience samples. All the subjects completed the study questionnaire including their demographic characteristics, history of current and past illnesses, drug history, Korean version-Mini Mental State Examination (K-MMSE), SGDS-K (Korean version of the Geriatric Depression Scale-Short Form), BAI (Beck Anxiety Inventory). Stroke warning signs were defined as 5 stroke warning signs consistent with the American heart association public health message. RESULTS: There was significant relationship of anxiety and the number of stroke warning signs after adjusting age, sex, educational level and depression (beta=2.145, p<0.0001). On analysis of covariance, the interaction of the number of experienced stroke warning signs with sex on anxiety was observed after adjusting for the age, educational level, K-MMSE, and SGDS-K (p=0.011). CONCLUSION: These results suggest that there was significant relationship of anxiety and stroke the elderly.
Aged ; American Heart Association ; Anxiety ; Cohort Studies ; Depression ; Humans ; Male ; Public Health ; Surveys and Questionnaires ; Stroke