1.Comparing the Status of Chronic Diseases between Immigrants and Korean
Seong-Woo CHOI ; Seong-Eun KIM ; Yu-Il KIM ; Kyung-Hak KIM ; Bong-Kyu SUN ; Jin-Hyeong KIM ; Jun-Hwi CHO ; Sun-Seog KWEON
Journal of Agricultural Medicine & Community Health 2024;49(2):93-101
Objective:
This study compared the status of chronic diseases among immigrants and the Korean population.
Methods:
This study was conducted on 153 immigrants living in Gwangju Metropolitan City in 2022.For comparison, 459 Koreans were selected using the 2021 Korea National Health and Nutrition Examination Survey (KNHANES). A survey was conducted on the management status of hypertension, diabetes, and hyperlipidemia using a questionnaire.
Results:
Immigrants were significantly more likely to have hypertension (50.3% vs. 24.2%, p<0.001) and diabetes (19.0% vs. 11.5%, p=0.002) than Koreans. In awareness, immigrants had significantly lower rates of hypertension (57.1% vs. 73.0%, p=0.031) and hyperlipidemia (immigrants 25.4% vs. 44.5%, p=0.006). In treatment rates, immigrants had significantly lower rates of hypertension (40.3% vs. 69.4%, <0.001) and hyperlipidemia (17.9% vs. 39.6%, p=0.003). In control rates, immigrants had significantly lower rates of hypertension (18.2% vs. 62.2%, <0.001) than Koreans.
Conclusions
Chronic diseases are common among immigrants, but awareness, treatment, and control rates are low, so education and prevention policies are critical to improving immigrants’ access to medical care and raising awareness.
2.Comparative analysis of body mass index and obesity-related anthropometric indices for mortality prediction: a study of the Namwon and Dong-gu cohort in Korea
Ye Rim KIM ; Min-Ho SHIN ; Young-Hoon LEE ; Seong-Woo CHOI ; Hae-Sung NAM ; Jeong-Ho YANG ; Sun-Seog KWEON
Epidemiology and Health 2024;46(1):e2024066-
OBJECTIVES:
This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI).
METHODS:
We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell concordance index (c-index).
RESULTS:
Adding anthropometric indices to the basic mortality model (c-index, 0.7723; 95% CI, 0.7647 to 0.7799) significantly increased the predictive power of BMI (c-index, 0.7735; 95% CI, 0.7659 to 0.7811), a body shape index (ABSI; c-index, 0.7735; 95% CI, 0.7659 to 0.7810), weight-adjusted waist index (WWI; c-index, 0.7731; 95% CI, 0.7656 to 0.7807), and waist to hip index (WHI; c-index, 0.7733; 95% CI, 0.7657 to 0.7809). The differences between the BMI model and the other 3 models were not statistically significant.
CONCLUSIONS
In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.
3.Comparative analysis of body mass index and obesity-related anthropometric indices for mortality prediction: a study of the Namwon and Dong-gu cohort in Korea
Ye Rim KIM ; Min-Ho SHIN ; Young-Hoon LEE ; Seong-Woo CHOI ; Hae-Sung NAM ; Jeong-Ho YANG ; Sun-Seog KWEON
Epidemiology and Health 2024;46(1):e2024066-
OBJECTIVES:
This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI).
METHODS:
We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell concordance index (c-index).
RESULTS:
Adding anthropometric indices to the basic mortality model (c-index, 0.7723; 95% CI, 0.7647 to 0.7799) significantly increased the predictive power of BMI (c-index, 0.7735; 95% CI, 0.7659 to 0.7811), a body shape index (ABSI; c-index, 0.7735; 95% CI, 0.7659 to 0.7810), weight-adjusted waist index (WWI; c-index, 0.7731; 95% CI, 0.7656 to 0.7807), and waist to hip index (WHI; c-index, 0.7733; 95% CI, 0.7657 to 0.7809). The differences between the BMI model and the other 3 models were not statistically significant.
CONCLUSIONS
In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.
4.Comparative analysis of body mass index and obesity-related anthropometric indices for mortality prediction: a study of the Namwon and Dong-gu cohort in Korea
Ye Rim KIM ; Min-Ho SHIN ; Young-Hoon LEE ; Seong-Woo CHOI ; Hae-Sung NAM ; Jeong-Ho YANG ; Sun-Seog KWEON
Epidemiology and Health 2024;46(1):e2024066-
OBJECTIVES:
This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI).
METHODS:
We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell concordance index (c-index).
RESULTS:
Adding anthropometric indices to the basic mortality model (c-index, 0.7723; 95% CI, 0.7647 to 0.7799) significantly increased the predictive power of BMI (c-index, 0.7735; 95% CI, 0.7659 to 0.7811), a body shape index (ABSI; c-index, 0.7735; 95% CI, 0.7659 to 0.7810), weight-adjusted waist index (WWI; c-index, 0.7731; 95% CI, 0.7656 to 0.7807), and waist to hip index (WHI; c-index, 0.7733; 95% CI, 0.7657 to 0.7809). The differences between the BMI model and the other 3 models were not statistically significant.
CONCLUSIONS
In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.
5.Comparing the Status of Chronic Diseases between Immigrants and Korean
Seong-Woo CHOI ; Seong-Eun KIM ; Yu-Il KIM ; Kyung-Hak KIM ; Bong-Kyu SUN ; Jin-Hyeong KIM ; Jun-Hwi CHO ; Sun-Seog KWEON
Journal of Agricultural Medicine & Community Health 2024;49(2):93-101
Objective:
This study compared the status of chronic diseases among immigrants and the Korean population.
Methods:
This study was conducted on 153 immigrants living in Gwangju Metropolitan City in 2022.For comparison, 459 Koreans were selected using the 2021 Korea National Health and Nutrition Examination Survey (KNHANES). A survey was conducted on the management status of hypertension, diabetes, and hyperlipidemia using a questionnaire.
Results:
Immigrants were significantly more likely to have hypertension (50.3% vs. 24.2%, p<0.001) and diabetes (19.0% vs. 11.5%, p=0.002) than Koreans. In awareness, immigrants had significantly lower rates of hypertension (57.1% vs. 73.0%, p=0.031) and hyperlipidemia (immigrants 25.4% vs. 44.5%, p=0.006). In treatment rates, immigrants had significantly lower rates of hypertension (40.3% vs. 69.4%, <0.001) and hyperlipidemia (17.9% vs. 39.6%, p=0.003). In control rates, immigrants had significantly lower rates of hypertension (18.2% vs. 62.2%, <0.001) than Koreans.
Conclusions
Chronic diseases are common among immigrants, but awareness, treatment, and control rates are low, so education and prevention policies are critical to improving immigrants’ access to medical care and raising awareness.
6.Comparative analysis of body mass index and obesity-related anthropometric indices for mortality prediction: a study of the Namwon and Dong-gu cohort in Korea
Ye Rim KIM ; Min-Ho SHIN ; Young-Hoon LEE ; Seong-Woo CHOI ; Hae-Sung NAM ; Jeong-Ho YANG ; Sun-Seog KWEON
Epidemiology and Health 2024;46(1):e2024066-
OBJECTIVES:
This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI).
METHODS:
We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell concordance index (c-index).
RESULTS:
Adding anthropometric indices to the basic mortality model (c-index, 0.7723; 95% CI, 0.7647 to 0.7799) significantly increased the predictive power of BMI (c-index, 0.7735; 95% CI, 0.7659 to 0.7811), a body shape index (ABSI; c-index, 0.7735; 95% CI, 0.7659 to 0.7810), weight-adjusted waist index (WWI; c-index, 0.7731; 95% CI, 0.7656 to 0.7807), and waist to hip index (WHI; c-index, 0.7733; 95% CI, 0.7657 to 0.7809). The differences between the BMI model and the other 3 models were not statistically significant.
CONCLUSIONS
In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.
7.Comparing the Status of Chronic Diseases between Immigrants and Korean
Seong-Woo CHOI ; Seong-Eun KIM ; Yu-Il KIM ; Kyung-Hak KIM ; Bong-Kyu SUN ; Jin-Hyeong KIM ; Jun-Hwi CHO ; Sun-Seog KWEON
Journal of Agricultural Medicine & Community Health 2024;49(2):93-101
Objective:
This study compared the status of chronic diseases among immigrants and the Korean population.
Methods:
This study was conducted on 153 immigrants living in Gwangju Metropolitan City in 2022.For comparison, 459 Koreans were selected using the 2021 Korea National Health and Nutrition Examination Survey (KNHANES). A survey was conducted on the management status of hypertension, diabetes, and hyperlipidemia using a questionnaire.
Results:
Immigrants were significantly more likely to have hypertension (50.3% vs. 24.2%, p<0.001) and diabetes (19.0% vs. 11.5%, p=0.002) than Koreans. In awareness, immigrants had significantly lower rates of hypertension (57.1% vs. 73.0%, p=0.031) and hyperlipidemia (immigrants 25.4% vs. 44.5%, p=0.006). In treatment rates, immigrants had significantly lower rates of hypertension (40.3% vs. 69.4%, <0.001) and hyperlipidemia (17.9% vs. 39.6%, p=0.003). In control rates, immigrants had significantly lower rates of hypertension (18.2% vs. 62.2%, <0.001) than Koreans.
Conclusions
Chronic diseases are common among immigrants, but awareness, treatment, and control rates are low, so education and prevention policies are critical to improving immigrants’ access to medical care and raising awareness.
8.Effect Modification of Kidney Function on the Non-linear Association Between Serum Calcium Levels and Cardiovascular Mortality in Korean Adults
Jung-Ho YANG ; Sun-Seog KWEON ; Young-Hoon LEE ; Seong-Woo CHOI ; So-Yeon RYU ; Hae-Sung NAM ; Hye-Yeon KIM ; Min-Ho SHIN
Journal of Preventive Medicine and Public Health 2023;56(3):282-290
Objectives:
This study aimed to evaluate the potential interaction between kidney function and the non-linear association between serum calcium levels and cardiovascular disease (CVD) mortality.
Methods:
This study included 8927 participants enrolled in the Dong-gu Study. Albumin-corrected calcium levels were used and categorized into 6 percentile categories: <2.5th, 2.5-25.0th, 25.0-50.0th, 50.0-75.0th, 75.0-97.5th, and >97.5th. Restricted cubic spline analysis was used to examine the non-linear association between calcium levels and CVD mortality. Cox proportional hazard regression was used to estimate hazard ratios (HRs) for CVD mortality according to serum calcium categories. All survival analyses were stratified by the estimated glomerular filtration rate.
Results:
Over a follow-up period of 11.9±2.8 years, 1757 participants died, of whom 219 died from CVD. A U-shaped association between serum calcium and CVD mortality was found, and the association was more evident in the low kidney function group. Compared to the 25.0-50.0th percentile group for serum calcium levels, both low and high serum calcium tended to be associated with CVD mortality (<2.5th: HR, 6.23; 95% confidence interval [CI], 1.16 to 33.56; >97.5th: HR, 2.56; 95% CI, 0.76 to 8.66) in the low kidney function group. In the normal kidney function group, a similar association was found between serum calcium levels and CVD mortality (<2.5th: HR, 1.37; 95% CI, 0.58 to 3.27; >97.5th: HR, 1.65; 95% CI, 0.70 to 3.93).
Conclusions
We found a non-linear association between serum calcium levels and CVD mortality, suggesting that calcium dyshomeostasis may contribute to CVD mortality, and kidney function may modify the association.
9.Association Between Serum Bilirubin and Atrial Fibrillation: A Mendelian Randomization Study
Si-Woo KIM ; Jung-Ho YANG ; Sun-Seog KWEON ; Young-Hoon LEE ; Seong-Woo CHOI ; So-Yeon RYU ; Hae-Sung NAM ; Hye-Yeon KIM ; Min-Ho SHIN
Korean Circulation Journal 2023;53(7):472-479
Background and Objectives:
The association between bilirubin and atrial fibrillation (AF) has been evaluated previously in observational studies but with contradictory results. This study evaluated the causal association between serum bilirubin level and AF using Mendelian randomization (MR) analysis.
Methods:
This cross-sectional study includes 8,977 participants from the Dong-gu Study.In the observational analysis, multivariate logistic regression was performed to evaluate the association between bilirubin and prevalent AF. To evaluate the causal association between bilirubin and AF, MR analysis was conducted by using the UGT1A1 rs11891311 and rs4148323 polymorphisms as instrumental variables.
Results:
Elevated serum bilirubin levels were associated with an increased risk for AF in observational analysis (total bilirubin: odds ratio [OR], 1.31; 95% confidence interval [95% CI], 1.15–1.48 per 1 standard deviation [SD]; direct bilirubin: OR, 1.31; 95% CI, 1.18–1.46 per 1 SD), whereas the genetically predicted serum bilirubin levels in MR analysis did not show this association (total bilirubin: OR, 1.02; 95% CI, 0.67–1.53 per 1 SD; direct bilirubin: OR, 1.03; 95% CI, 0.61–1.73 per 1 SD).
Conclusions
Genetically predicted bilirubin levels were not associated with prevalent AF.Thus, the observational association between serum bilirubin levels and AF may be noncausal and affected by reverse causality or unmeasured confounding.
10.Association Between Plasma Homocysteine Level and Mortality:A Mendelian Randomization Study
Chang Kyun CHOI ; Sun-Seog KWEON ; Young-Hoon LEE ; Hae-Sung NAM ; Seong-Woo CHOI ; Hye-Yeon KIM ; Min-Ho SHIN
Korean Circulation Journal 2023;53(10):710-719
Background and Objectives:
In previous studies, high homocysteine levels were associated with high cardiovascular mortality. However, these results were inconsistent with those of randomized controlled trials. We aimed to evaluate the causal role of homocysteine on allcause and cardiovascular mortality using Mendelian randomization (MR) analysis.
Methods:
This study included the 10,005 participants in the Namwon Study. In conventional observational analysis, age, sex, survey years, lifestyles, body mass index, comorbidities, and serum folate level were adjusted using multivariate Cox proportional regression. MR using 2-stage least squares regression was used to evaluate the association between genetically predicted plasma homocysteine levels and mortality. Age, sex, and survey years were adjusted for each stage. The methylenetetrahydrofolate reductase (MTHFR) polymorphism was used as an instrumental variable for predicting plasma homocysteine levels.
Results:
Observed homocysteine levels were positively associated with all-cause (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.26–1.54) and cardiovascular (HR, 1.62; 95% CI, 1.28–2.06) mortality when plasma homocysteine levels doubled. However, these associations were not significant in MR analysis. The HRs of doubling genetically predicted plasma homocysteine levels for all-cause and cardiovascular mortality were 0.99 (95% CI, 0.62–1.57) and 1.76 (95% CI, 0.54–5.77), respectively.
Conclusions
This MR analysis did not support a causal role for elevated plasma homocysteine concentrations in premature deaths.

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