Epidemiology and Health

Original Article

Evaluation of gestational age by pregnancy outcomes and distribution of pregnancy-related codes in Korean claims data: Woo-Jung Kim, Yunha Noh, Yongtai Cho, Eun-Young Choi, HyunJoo Lim, Hyesung Lee, Ju-Young Shin; Epidemiol Health. 2026;48:e2026007. Published online February 4, 2026; DOI: https://doi.org/10.4178/epih.e2026007

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to evaluate a fixed-duration algorithm for gestational age (GA) estimation according to pregnancy outcomes and to describe the GA distribution of pregnancy-related codes in Korea.
METHODS
We included 351,055 pregnancy episodes (2019–2022) from linked data between the National Health Insurance Service and the Korea Immunization Registry Information System (KIRIS). GA from claims data was estimated by subtracting fixed durations from the delivery date (algorithm-based GA), and GA derived from KIRIS was defined as the gold standard. Accuracy was evaluated as the proportion of episodes in which the difference between the estimated GA and the reference standard fell within ±2 weeks. We described the distributions of the GA at which each prenatal test, pregnancy complication, and diagnostic code was recorded.
RESULTS
Algorithm-based GA estimation showed high accuracy for live births (92.2% within ±2 weeks) but markedly lower accuracy for non-live birth outcomes, including stillbirth (3.3%), termination (7.2%), spontaneous abortion (45.2%), and ectopic pregnancy (20.0%). In additional analyses aimed at identifying potential indicators for improving GA estimation, most events occurred within clinically expected timeframes, although some individual codes exhibited poor temporal alignment.
CONCLUSIONS
Algorithm-based GA estimation using claims data performed well for live births but demonstrated limited accuracy for non-live birth outcomes. Incorporating information from prenatal tests and pregnancy complications may enhance GA estimation.; Summary

Korean summary
본 연구는 국내 전국민 단위 청구자료와 예방접종 등록자료를 연계하여 고정 임신기간 기반 알고리즘의 재태연령 추정 정확도를 임신 결과별로 체계적으로 검증하였다. 출생아에서는 ±2주 기준 92.2%의 높은 정확도를 보였으나, 사산·인공임신중절·자연유산·자궁외임신 등 비출생 결과에서는 현저히 낮은 정확도를 보여 결과 유형에 따른 성능 이질성이 확인되었다. 산전검사 및 임신 합병증과 같은 시간 민감적 임상지표를 통합한 계층적 접근이 청구자료 기반 재태연령 추정의 타당도 향상에 기여할 수 있다.

Key Message
Using nationwide linked claims and immunization registry data in Korea, this study systematically validated the performance of a fixed-duration algorithm for gestational age estimation across pregnancy outcomes. While high accuracy was observed for live births (92.2% within ±2 weeks), substantially poorer performance was identified for non–live-birth outcomes, indicating marked outcome-specific heterogeneity. Integration of time-sensitive clinical indicators, including prenatal tests and pregnancy complications, may enhance the validity of gestational age estimation in administrative data research.

Cohort Profile

Cohort profile: the KDCA-Tuberculosis-NHIS cohort linking tuberculosis surveillance and health insurance data in Korea: Dawoon Jeong, Jinsun Kim, Seung Won Lee, Hongjo Choi, Hojoon Sohn, Jieun Kim, Hyewon Lee, Hyeran Jeong, Seung Eun Lee, Young-joon Park, Jaiyong Kim, Eun Mi Kim, Minji Koo, Hoyeon Jang, Young Ae Kang; Epidemiol Health. 2025;47:e2025071. Published online December 13, 2025; DOI: https://doi.org/10.4178/epih.e2025071

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Abstract Summary PDF Supplementary Material: Abstract
Despite a steady decline in incidence, tuberculosis (TB) remains a substantial public health burden in Korea, particularly among older adults. Existing national TB surveillance systems lack sufficiently comprehensive data to assess long-term outcomes and health disparities. The K-TB-N cohort integrates data from 3 national sources: the Korean Tuberculosis Surveillance System (2011-2022), the National Health Insurance Database (2010-2022), and mortality data from Statistics Korea (2010-2022). After data cleaning and linkage, the final cohort included 373,812 patients (375,440 episodes) with either drug-susceptible TB or drug- resistant TB. TB notifications declined by approximately 60% over the study period, while the median patient age continued to rise. Treatment success improved over time, accompanied by reductions in lost to follow-up. However, mortality during treatment increased, with more than half of deaths attributed to non-TB causes such as pneumonia, cancer, and cardiovascular disease. Post-treatment mortality also remained high, particularly among patients with drug-resistant TB. The K-TB-N cohort provides a comprehensive, linked dataset for advancing research on TB epidemiology, treatment outcomes, comorbidities, and health disparities. It enables evaluations of public health interventions, long-term prognosis, and strategies for post-TB care. This cohort will remain a valuable resource for shaping data-driven TB control policies in aging and high-burden settings.; Summary

Korean summary
- K-TB-N 코호트는 결핵 신고자료, 건강보험청구자료, 통계청 사망자료를 연계한 국내 최초의 전국단위 결핵 통합자료 코호트이다. - 이 코호트를 결핵 치료 성과와 치료 종료 이후 사망을 포함한 장기예후 분석이 가능하다. - 코호트에 포함된 2011-2022년 사이, 결핵 발생은 60% 감소하였고, 결핵 환자의 평균 연령은 증가하였다. 결핵 치료 중 사망율은 증가하였는데, 사망원인의 50% 이상은 비결핵성 사망이었다.

Key Message
- The K-TB-N cohort is the first national-level integrated TB cohort in South Korea that combines three distinct datasets, overcoming the limitations of single-source TB registries. - The linkage of clinical data (KTB-Surv), health insurance claims (NHID), and mortality records (Statistics Korea) allows long-term tracking of treatment outcomes and post-treatment mortality. - TB notifications declined by ~60% during the study period, while the median patient age increased. - The mortality during TB treatment rose, with over half of deaths attributed to non-TB causes.

Original Articles

Dental implant removal rates and related factors in older adults in Korea: a cross-sectional study using National Health Insurance Sharing Service database: Hyang-Ah Park, A-Rang Lim, Jae-In Ryu; Epidemiol Health. 2025;47:e2025064. Published online December 3, 2025; DOI: https://doi.org/10.4178/epih.e2025064

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Abstract Summary PDF: Abstract
OBJECTIVES
Dental implants have been covered by the National Health Insurance for older adults in Korea since 2014. As the number of implant treatments has increased, the occurrence of related complications has also grown. While many clinical studies have examined mechanical and biological complications, few epidemiological studies using national data have identified population-level risk factors. This study aimed to determine the dental implant removal rate and related factors among older adults based on the Andersen Behavioral Model.
METHODS
A cross-sectional analysis was conducted using the National Health Insurance Service–National Sample Cohort. Logistic regression analyses were performed to identify factors associated with implant removal. Unadjusted and stepwise cumulative models were applied for predisposing, enabling, and need factors. All analyses were conducted using SPSS version 26.0, with statistical significance set at α=0.05.
RESULTS
The overall dental implant removal rate among older adults was approximately 0.4%. Higher removal rates were observed among males, those aged 65-69, current smokers, individuals with diabetes, and the self-employed group with higher income levels. Current smokers had 1.75 times higher odds of implant removal (95% confidence interval, 1.39 to 2.22) than non- smokers or former smokers.
CONCLUSIONS
Targeted education, management, and preventive interventions for high-risk groups, including smokers and patients with diabetes, are necessary to improve implant success and reduce complications. These findings provide population- based evidence to inform public health strategies that promote successful implant outcomes among older adults.; Summary

Korean summary
이 연구는 국가 단위의 빅데이터 코호트를 이용해 치과 임플란트 제거에 관해 시행한 선행 연구가 없었기 때문에 국가 빅데이터를 활용해 치과 임플란트 제거율과 관련 요인을 파악하기 위해 Anderson Model을 기반으로 다요인 분석을 실시하였다. 전체 치과 임플란트 제거율은 약 0.4%였으며, 남성, 젊은 연령, 건강보험 가입자, 상위 소득분위 자영업자, 당뇨병, 흡연, 유산소 신체 활동 실천자에서 더 높게 나타났다. 특히 현재 흡연자인 경우 치과 임플란트 제거율을 경험할 확률이 1.8배 높았다. 따라서, 치과 임플란트 시술의 성공률을 높이기 위해서는 위험요인에 대해 명시한 가이드라인 제작이 필수적이다.

Key Message
This study conducted a multifactorial analysis based on the Andersen model to identify factors associated with dental implant removal using national big data, addressing the lack of prior studies that examined these determinants sufficiently. The dental implant removal rate among all subjects was approximately 0.4%, and higher removal rates were observed among men, younger individuals, those receiving medical benefits, the self-employed group with higher income quintiles, and individuals with diabetes, smoking habits, or engagement in aerobic physical activity. Current smokers had a 1.8-fold higher probability of implant removal. These findings reinforce the importance of developing and implementing guidelines to increase the success rate of dental implants.

Age-period-cohort analysis of dietary sodium, potassium, and sodium-to-potassium ratio in Korea: Hee Ju Jun, Shieon Kim, Garam Jo; Epidemiol Health. 2025;47:e2025062. Published online November 4, 2025; DOI: https://doi.org/10.4178/epih.e2025062

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Excessive sodium and insufficient potassium consumption are major dietary contributors to hypertension (HTN) and cardiovascular diseases. The sodium-to-potassium ratio is a known predictor of blood pressure (BP) and HTN. This study evaluated 16-year-trends in dietary sodium, potassium, and the sodium-to-potassium ratio, and their associations with BP and HTN in Korea.
METHODS
Data from 76,484 participants aged 19-79 years were obtained from the Korea National Health and Nutrition Examination Survey conducted in 2007-2022. Sodium and potassium intake were assessed using 24-hour recalls, and the sodium- to-potassium ratio was calculated. All values were energy-adjusted using the residual method. Age-period-cohort (APC) models were used to analyze temporal trends. Associations with BP and HTN were examined using multivariate linear and logistic regression models, adjusting for confounders.
RESULTS
Energy-adjusted sodium intake decreased across all age groups, and potassium slightly increased in the recent 5 years, though both remained suboptimal relative to recommendations. APC analyses showed increasing potassium intake with age and a reversed U-shape cohort pattern. The sodium-to-potassium ratio decreased with age and calendar year but increased in recent cohorts. A higher sodium-to-potassium ratio was strongly associated with elevated systolic (β=0.028, p<0.001) and diastolic BP (β=0.036, p<0.001), and increased odds of HTN (odds ratio, 1.19; 95% confidence interval, 1.07 to 1.33). A linear association appeared when the sodium-to-potassium ratio exceeded 1.00 in the spline model.
CONCLUSIONS
Despite improvements, sodium intake remains excessive, and potassium insufficient, particularly in younger adults and recent cohorts. Public health interventions should prioritize reducing sodium and promoting potassium-rich foods to reduce cardiovascular risk.; Summary

Korean summary
한국 성인의 나트륨 섭취는 지난 16년간 감소했지만 여전히 과도한 수준이고, 칼륨 섭취는 최근 증가했으나 권장량에 미치지 못했습니다. 연령·기간·코호트(APC) 분석 결과, 나트륨-칼륨 비율이 최근 출생 코호트에서 높아지는 경향을 보였습니다. 나트륨-칼륨 비율이 높을수록 혈압 상승과 고혈압 위험 증가가 유의하게 연관되는 만큼, 공중보건적 관리가 필요합니다.

Key Message
Over the past 16 years, sodium intake among Korean adults has decreased but remains high, while potassium intake has recently increased yet still falls below recommended levels. Age-period-cohort (APC) analyses showed that the sodium-to-potassium ratio has tended to increase in more recent cohorts. Because a higher sodium-to-potassium ratio is significantly associated with elevated blood pressure and a higher risk of hypertension, targeted public health efforts are needed.

Behavioral and psychosocial factors associated with sugar-sweetened beverage consumption among Korean adolescents: a path analysis using the 2022 Korea Youth Risk Behavior Survey: Hye-Young Park, Soo Rack Ryu, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park; Epidemiol Health. 2025;47:e2025047. Published online August 21, 2025; DOI: https://doi.org/10.4178/epih.e2025047

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Rising obesity rates among adolescents are a major global health concern and are closely linked to the consumption of sugar-sweetened beverages (SSBs). This study aimed to identify key behavioral and psychosocial factors influencing SSB consumption among adolescents.

METHODS

This cross-sectional study analyzed data from the 2022 Korea Youth Risk Behavior Survey, which included 49,548 participants aged 12-18 years. Information on SSB consumption frequency, socio-demographic characteristics, eating habits, sedentary behaviors, and other health-related factors was collected through self-administered questionnaires. Path analysis was used to model SSB consumption and estimate the direct and indirect effects of modifiable factors.

RESULTS

Male students, current alcohol drinkers, those with higher frequencies of fast-food or late-night snack consumption, and heavy smartphone users were more likely to frequently consume SSBs. Fast-food intake had the strongest direct effect on SSB consumption (B=0.3884), while nighttime eating showed a substantial direct effect (B=0.1437) and mediated 21.7% of the relationship between fast-food intake and SSB consumption. Leisure sitting time exerted both direct (B=0.0741) and indirect effects on SSB intake, mediated through watching mukbang, smartphone use, fast-food consumption, and nighttime eating. Self-perceived health status was negatively associated with SSB consumption (B=-0.0619), with indirect effects mediated by fast-food intake and nighttime eating.

CONCLUSIONS

Among Korean adolescents, SSB consumption was strongly associated with unhealthy eating patterns and prolonged leisure sitting time. Increased fast-food consumption, nighttime eating, watching mukbang, smartphone use, and negative self-perceived health status not only directly influenced SSB intake, but also acted as mediating factors.

Summary

Korean summary
바람직하지 않은 식습관과 과도한 스마트폰 사용은 한국 청소년의 당음료 섭취와 밀접한 관련이 있습니다. 특히 패스트푸드와 야식은 주요한 매개 요인으로 작용하여, 이러한 행동을 줄이면 당음료 섭취를 효과적으로 낮출 수 있습니다. 본 연구는 청소년을 위한 맞춤형 공중보건 개입 전략 수립에 근거를 제공합니다.

Key Message
Unhealthy eating behaviors and excessive screen time are strongly linked to sugar-sweetened beverage (SSB) consumption among Korean adolescents. Fast-food intake and nighttime snacking act as major mediators, suggesting that reducing these behaviors could significantly decrease SSB intake. These findings provide evidence to guide targeted public health interventions for adolescents.

Citations

Citations to this article as recorded by

Sugar-sweetened beverage consumption, waist-to-height ratio and psychological symptoms among Chinese adolescents
Lu Li, Ting Wei, Feng Zhang, Tianyu Zhou
Scientific Reports.2026;[Epub] CrossRef

Sugar-sweetened beverage consumption and metabolic dysfunction-associated steatotic liver disease: a beverage type-specific analysis using Korea National Health and Nutrition Examination Survey: Hong Jae Jeon, Woo Sun Rou, Seok Hyun Kim, Byung Seok Lee, Ha Neul Kim, Hei-Gwon Choi, Jaehee Seo, Hyuk Soo Eun, Sukyoung Jung; Epidemiol Health. 2025;47:e2025038. Published online July 21, 2025; DOI: https://doi.org/10.4178/epih.e2025038

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver disease. Evidence indicates a relationship between sugar-sweetened beverage (SSB) consumption and MASLD development; however, the effects of specific SSB types on MASLD remain underexplored. This study investigated the association between consumption of 3 distinct types of SSBs and MASLD in Korean adults.
METHODS
We analyzed data from the Korea National Health and Nutrition Examination Survey 2012-2016, including 8,310 participants aged 40-64 years. SSB consumption (soft drinks, fruit drinks, and Korean traditional drinks) was assessed using a food frequency questionnaire. MASLD was defined as a hepatic steatosis index ≥36 in the presence of any cardiometabolic risk factor. Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for relevant covariates.
RESULTS
Compared to non-drinkers, consumption of soft drinks (≥3 serving/wk) was associated with higher odds of MASLD (OR, 1.36; 95% CI, 1.02 to 1.81; p for trend=0.03), while consumption of Korean traditional drinks (≥3 serving/wk) was associated with lower odds of MASLD (OR, 0.63; 95% CI, 0.45 to 0.89; p for trend=0.01). No association was found between fruit drink consumption and MASLD. In sex-stratified analysis (p-interaction=0.38), an inverse association between Korean traditional drinks and MASLD was observed in male (OR, 0.57; 95% CI, 0.34 to 0.95; p for trend=0.03), but not in female (OR, 0.72; 95% CI, 0.45 to 1.14; p for trend=0.17).
CONCLUSIONS
Consuming soft drinks at least 3 times per week was positively associated with MASLD, whereas an equivalent intake of Korean traditional drinks was inversely associated with MASLD.; Summary

Korean summary
-본 연구는 국민건강영양조사에 참여한 40-64세 한국 성인 8,310명을 대상으로 가당 음료와 새롭게 정의된 대사기능장애 연관 지방간질환(MASLD) 간 연관성을 음료 유형별로 비교 분석하였다. - 주 3회 이상의 탄산음료 섭취는 MASLD 유병 가능성이 증가한 반면, 동일한 빈도의 한국 전통음료 섭취는 유병 가능성을 낮췄다. - 음료 유형에 따른 MASLD 유병 차이는 향후 식이 지침 개발에 중요한 근거가 될 수 있으며, 향후 개인이 건강을 위해 보다 선택적인 음료 섭취를 위한 정책 수립에 기여할 수 있다.

Key Message
Among 8,310 Korean adults aged 40-64 years, soft drink consumption (≥3 servings/week) increased the odds of MASLD, while the same intake of Korean traditional drinks decreased the odds. These findings suggest that beverage type may be an important dietary factor associated with MASLD. Given the differential associations observed, our findings may help inform dietary recommendations that enable individuals to make more selective beverage choices for better liver health.

Occurrence rate and estimated economic burden of pulp and periapical disease treatment among Korean older adults: a national population-based retrospective study: Hyeonjeong Go, Masae Kuboniwa, Youn-Hee Choi; Epidemiol Health. 2025;47:e2025035. Published online July 3, 2025; DOI: https://doi.org/10.4178/epih.e2025035

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Abstract Summary PDF: Abstract
OBJECTIVES
Maintaining healthy dentition is essential for the overall health of older adults. Treatment of pulp and periapical disease (PPD) is crucial for preserving teeth. This study assessed the occurrence rate and economic burden of PPD treatment in an older Korean population.
METHODS
Data were obtained for adults aged ≥65 years from the Korean National Health Insurance Services from 2014 to 2018. The occurrence rate was defined as the proportion of individuals who received ≥1 PPD treatment. The economic burden was estimated using both direct and indirect expenditures, calculated from a societal perspective. Regression analysis was performed to evaluate yearly trends in occurrence rate and economic burden.
RESULTS
Direct costs, which included insured and non-insured medical expenses, ranged from US$13.79 million to US$10.47 million. Indirect costs, comprising transportation and time costs, ranged from US$0.89 million to US$0.80 million. Total costs declined from US$14.68 million to US$11.36 million. The occurrence rate of PPD treatment decreased significantly from 1.24% to 0.91% (p<0.05). The economic burden also demonstrated a statistically significant downward trend, with total PPD costs decreasing from 0.00099% to 0.00066% of Korea’s GDP, and from 0.63% to 0.30% of the annual total dental care benefit costs between 2014 and 2018 (p<0.05).
CONCLUSIONS
The occurrence rate and estimated economic burden of PPD treatment significantly decreased among older Korean adults from 2014 to 2018. Conservative approaches to tooth preservation contribute to more effective oral health policies and help reduce the economic burden of oral disease treatments in an aging society.; Summary

Korean summary
· 한국 노년층에서 치수 및 치근단 질환 치료의 발생률과 경제적 부담은 연구 기간 동안 통계적으로 유의미하게 감소했습니다. · 이러한 연구 결과는 보존적 치과 치료가 고령화 사회에서 구강 질환으로 인한 경제적 부담을 줄이는 효과적인 구강 보건 정책이 될 수 있음을 시사합니다.

Key Message
· The occurrence rate and economic burden of pulp and periapical disease (PPD) treatment among older Korean adults have shown a statistically significant decrease over the study period. · These findings suggest that conservative dental treatment can serve as an effective oral health policy for reducing the economic burden of oral diseases in an aging society.

Safety of combination therapy of azilsartan medoxomil and amlodipine: a population-based cohort study: Hyesung Lee, Bin Hong, Chris Tzu-Ting Su, Sungho Bea, Han Eol Jeong, Kyungyeon Jung, Michael Chun-Yuan Cheng, Zoe Chi-Jui Chang, Edward Chia-Cheng Lai, Jongyoung Lee; Epidemiol Health. 2025;47:e2025029. Published online May 28, 2025; DOI: https://doi.org/10.4178/epih.e2025029

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Abstract

OBJECTIVES
This study investigated the safety of azilsartan and amlodipine combination therapy versus other angiotensin receptor blockers (ARBs) and amlodipine in patients with hypertension.

METHODS

We conducted a cohort study utilizing healthcare databases from Korea and Taiwan. Patients aged between 18 years and 75 years who were newly prescribed both an ARB and amlodipine within 6 months of hypertension diagnosis were included. Safety outcomes assessed were hypotension, angioedema, acute pancreatitis, hyperkalemia, hypokalemia, toxic liver disease, hepatic failure, nausea and vomiting, and fall-related injury. Hazard ratios (HRs) with 95% confidence intervals (CIs) for each safety outcome associated with azilsartan medoxomil and amlodipine versus other ARBs combined with amlodipine were calculated within a 1:1 propensity score (PS)-matched cohort. Summary HRs across databases were computed using random-effects meta-analysis.

RESULTS

We identified 2,472 eligible patients (1,521 from Korea, 951 from Taiwan) initiating treatment with azilsartan medoxomil and amlodipine, and 671,468 patients (312,322 from Korea, 355,409 from Taiwan) initiating other ARBs with amlodipine. After PS matching, baseline characteristics were well-balanced between treatment groups. During the 180-day follow-up, most adverse outcomes did not occur even once in either group, thus precluding the calculation of HRs. The risk of acute pancreatitis was not significantly different between the azilsartan medoxomil and amlodipine group and the other ARB and amlodipine groups (summary HR, 0.86; 95% CI, 0.14 to 5.37).

CONCLUSIONS

In this population-based cohort study, azilsartan medoxomil combined with amlodipine was not associated with an increased risk of adverse outcomes compared to other ARBs combined with amlodipine.

Summary

Korean summary
Azilsartan medoxomil과 amlodipine 병용요법의 장기적인 안전성을 평가한 연구는 제한적임. 본 코호트 연구에서는 azilsartan과 amlodipine 병용요법이 다른 ARB-amlodipine 병용요법에 비해 중대한 이상반응 발생 위험을 증가시키지 않는 것으로 나타났음. 이러한 결과는 고혈압 환자에서 azilsartan-amlodipine 병용요법의 실제 진료 환경에서의 안전성을 뒷받침함.

Key Message
Limited studies have evaluated the long-term safety of combined azilsartan medoxomil and amlodipine therapy. This cohort study found the azilsartan and amlodipine combination therapy was not associated with increased risk of serious adverse events compared to other ARB-amlodipine combinations. These results support the real-world safety of azilsartan-amlodipine caombination therapy in patients with hypertension.

Citations

Citations to this article as recorded by

Letter to the Editor: Safety of combination therapy of azilsartan medoxomil and amlodipine: a population-based cohort study
Zhanyi Zhou
Epidemiology and Health.2025; 47: e2025053. CrossRef
Authors’ Reply: Safety of combination therapy of azilsartan medoxomil and amlodipine: a population-based cohort study
Hyesung Lee, Bin Hong, Chris Tzu-Ting Su, Sungho Bea, Han Eol Jeong, Kyungyeon Jung, Michael Chun-Yuan Cheng, Zoe Chi-Jui Chang, Edward Chia-Cheng Lai, Jongyoung Lee
Epidemiology and Health.2025; 47: e2025054. CrossRef

Mortality burden attributable to long-term exposure to fine particulate matter among older adults in Korea: Jongmin Oh, Jisun Myung, Changwoo Han, Hyun-Joo Bae, Soontae Kim, Yun-Chul Hong, Dong-Wook Lee, Youn-Hee Lim; Epidemiol Health. 2025;47:e2025028. Published online May 28, 2025; DOI: https://doi.org/10.4178/epih.e2025028

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to evaluate the association between long-term exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and cause-specific mortality among older adults in Korea, providing insights into the evolving public health burden in an aging society.

METHODS

We analyzed national insurance claims data spanning 2010-2019. Modeled PM2.5 concentrations were assigned to participants according to their residential districts. We employed time-varying Cox proportional hazard models, using age as the time scale, adjusted for potential confounders. Six cause-specific mortalities were considered: ischemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD), acute lower respiratory infection (ALRI), lung cancer (LC), and type 2 diabetes mellitus (T2DM). Annual excess deaths attributable to long-term PM2.5 exposure were calculated.

RESULTS

A total of 5,360,032 older adults were followed from 2010 to 2019. Hazard ratios (HRs) per 10 μg/m3 increase in 12-month PM2.5 concentration were as follows: IHD, 1.068 (95% CI, 1.040 to 1.097); stroke, 1.023 (95% CI, 1.003 to 1.043); ALRI, 1.050 (95% CI, 1.026 to 1.076); COPD, 1.114 (95% CI, 1.072 to 1.157); T2DM, 1.046 (95% CI, 1.007 to 1.086); and LC, 0.972 (95% CI, 0.948 to 0.996). Excess deaths attributable to long-term PM2.5 exposure were estimated at 4,888 (95% CI, 2,304 to 7,323) in 2010 and 5,179 (95% CI, 2,585 to 7,648) in 2019.

CONCLUSIONS

Although PM2.5 levels in Korea have shown a declining trend over the past decade, mortality among older adults associated with long-term PM2.5 exposure has not significantly decreased, likely due to the rapid aging of the population.

Summary

Korean summary
2010–2019년 동안 대한민국 노인 536만 명 대상의 후향적 코호트 연구를 수행하였다. 장기적인 초미세먼지(PM2.5) 노출은 허혈성 심질환, 뇌졸중, 하기도 감염, 만성폐쇄성폐질환, 제2형 당뇨병으로 인한 사망 위험 증가와 관련성이 있었다. 연간 PM2.5 농도는 감소했으나, 고령화로 인해 PM2.5에 기인한 초과 사망은 2010년 4,888명에서 2019년 5,179명으로 증가하였다. 대기질 개선에도 불구하고 고령화로 인해 PM2.5로 인한 사망 부담은 여전히 중요한 공중보건 문제이다.

Key Message
A retrospective cohort of 5.36 million older adults was followed from 2010 to 2019 in Korea. Long-term PM2.5 exposure was associated with increased mortality from IHD, stroke, ALRI, COPD, and T2DM. Although annual PM2.5 concentrations declined, excess deaths rose from 4,888 in 2010 to 5,179 in 2019, largely driven by population aging. Despite improvements in air quality, the PM2.5-related mortality burden remains a significant public health concern due to population aging.

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Exposure to particulate matters and risk of diabetes-related mortality: a systematic review and meta-analysis
Weifang Yang, Jing Li
Environmental Health and Preventive Medicine.2026; 31: 18. CrossRef

Social capital and regional influences: key predictors of unmet dental care needs among older adults in Korea: Ji-Yeon Lim, Ju-Mi Lee, Hae-Sung Nam; Epidemiol Health. 2025;47:e2025025. Published online May 7, 2025; DOI: https://doi.org/10.4178/epih.e2025025

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Abstract Summary PDF

Abstract

OBJECTIVES
Access to dental services is essential for improving quality of life, and social capital plays a key role in facilitating that access. This study aimed to identify individual-level and regional-level factors, including social capital, that predict unmet dental care needs among older adults.

METHODS

We analyzed data from 59,414 older adults obtained from the 2023 Korea Community Health Survey and the Korean Statistical Information Service, employing a 2-level multilevel model. The dependent variables comprised 3 types of unmet dental care needs: overall, due to lack of acceptability, and due to economic reasons. Twelve independent variables, including social capital and other individual and regional factors, were examined.

RESULTS

The prevalence of unmet needs was 14.15% overall, 8.70% for acceptability reasons, and 4.85% for economic reasons. Lower individual social capital was associated with higher odds of unmet dental care needs, whereas regional social capital factors demonstrated no significant association. Residing in regions with higher fiscal independence ratios was related to an increased likelihood of economic unmet needs (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.09 to 1.52). In contrast, a greater density of dentists per 10,000 population was inversely associated with overall and acceptability-related unmet needs (OR, 0.82 for both; 95% CI, 0.73 to 0.92 and 0.73 to 0.93, respectively).

CONCLUSIONS

Individual social capital and specific regional factors—namely, fiscal independence and density of dentists—may represent important determinants of unmet dental care needs among older adults. Policy interventions aimed at reducing unmet needs should consider these variables.

Summary

Korean summary
· 낮은 사회적 자본(이웃에 대한 낮은 신뢰, 적은 연락빈도, 배우자의 부재, 낮은 사회참여)은 노인의 미충족 치과의료경험을 증가시킨다. · 지역의 높은 재정자립도는 경제성 결여로 인한 미충족 치과의료경험을 증가시키며, 인구 1만명당 치과의사수가 높을수록 전체, 수용성 결여로 인한 미충족 치과의료경험을 감소시킨다.

Key Message
· Lower social capital (lower levels of trust in neighbors, less frequent contact, absence of a spouse, and lack of social participation) increases the risk of unmet dental care needs among older adults. · Higher regional fiscal independence increases unmet dental care needs due to economic reasons, while a greater density of dentists reduces overall unmet dental care needs and those due to lack of acceptability.

Citations

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Mobility Limitations and Self-Perceived Unmet Dental Needs Among Korean Adults: A Nationwide Multilevel Analysis for Integrated Care
Han-Nah Kim, Nam-Hee Kim
International Dental Journal.2026; 76(2): 109371. CrossRef
Age Differences in Oral Function and Unmet Dental Care Among Korean Adults
Eun Gyo Son
Gerodontology.2026;[Epub] CrossRef

Palivizumab coverage rates among moderate-to-late preterm infants in Korea: a nationwide cross-sectional study: Seungyeon Kim, Saram Lee, Young June Choe, Ju Sun Heo; Epidemiol Health. 2025;47:e2025015. Published online April 1, 2025; DOI: https://doi.org/10.4178/epih.e2025015

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Since October 2016, Korea has implemented a national reimbursement program for palivizumab aimed at moderate-to-late preterm (MLPT) infants born between 32 0/7 weels and 35 6/7 weeks of gestation during the respiratory syncytial virus (RSV) season (October–March). However, large-scale data on coverage rates and associated factors remain limited. This study evaluated palivizumab coverage rates and identified predictive factors influencing its administration in MLPT infants.
METHODS
This nationwide, population-based cross-sectional study utilized data from the Korean National Health Insurance Service collected between October 2016 and March 2019. MLPT infants eligible for palivizumab reimbursement were divided into administration and non-administration groups. Seasonal and overall coverage rates were assessed. A multivariate logistic regression analysis examined factors associated with palivizumab administration, with a focus on infant and maternal characteristics.
RESULTS
Among 2,843 eligible MLPT infants, 1,201 (42.2%) received palivizumab, while 1,642 (57.8%) did not. Although coverage rates increased annually, they remained suboptimal. Lower palivizumab prophylaxis coverage was observed in infants with higher gestational ages, female sex, absence of low birth weight, those born in March, residents of non-capital areas, infants not admitted to a neonatal intensive care unit at birth, and infants of mothers aged <35 years.
CONCLUSIONS
In the initial 3 RSV seasons following the introduction of palivizumab reimbursement for MLPT infants in Korea, the overall coverage rate was low (42.2%). National policies targeting infants with higher gestational ages, those born in March, and those residing in non-capital areas are necessary to improve coverage and ensure equitable RSV prophylaxis.; Summary

Korean summary
- 한국에서 중후기 미숙아를 대상으로 팔리비주맙 예방접종이 도입된 이후, 초기 3개 RSV 유행 시즌 동안 전체 예방접종률은 42.2%로 낮은 수준에 머물렀다. - 재태주수가 높은 영아, 3월 출생 영아, 그리고 비수도권 거주 영아에서 예방접종률이 유의하게 낮았다.

Key Message
- In Korea, following the introduction of palivizumab for MLPT infants, the overall coverage rate during the initial 3 RSV seasons was low (42.2%). - Infants with higher gestational ages, those born in March, and residents of non-capital areas exhibited significantly lower coverage rates.

Miscarriage, stillbirth, and mortality risk from stroke in women: findings from the PLCO study: Hui Tang, Zhou Li, Yuan Zhang, Mingjun Dai, Xiaoya Wang, Chuan Shao; Epidemiol Health. 2024;46:e2024093. Published online November 25, 2024; DOI: https://doi.org/10.4178/epih.e2024093

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Abstract PDF Supplementary Material: Abstract
OBJECTIVES
Existing evidence suggests that miscarriage and stillbirth are associated with an increased risk of stroke in women. However, the impact of these events on stroke mortality remains unclear. This study aimed to elucidate the potential association between miscarriage and stillbirth and stroke mortality in women.
METHODS
We employed a competing risk model using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial to assess the relationship between miscarriage/stillbirth and stroke death. Death from other causes was considered as a competing risk, and we conducted a subgroup analysis to explore the potential impact.
RESULTS
Our study included 68,629 women for miscarriage and 65,343 women for stillbirth. No significant association was observed between miscarriage and stroke mortality (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.84 to 1.10; p=0.58). While a single stillbirth did not show a significant association (HR, 0.81; 95% CI, 0.57 to 1.15; p=0.23), recurrent stillbirth (≥2) was associated with a significantly increased risk of stroke mortality compared to women with no stillbirths (HR, 2.24; 95% CI, 1.45 to 3.46; p<0.001).
CONCLUSIONS
Our findings suggest that recurrent stillbirth, but not single events, is associated with an elevated risk of stroke mortality in women. Further research is warranted to clarify the underlying mechanisms and potential long-term health implications of recurrent pregnancy loss.; Summary

Importance of younger age group and high inflammatory status in the association between periodontal disease and diabetes mellitus: results from the Korea National Health and Nutrition Examination Survey 2012-2018: Hyunmin Lee, Myung-Hee Shin; Epidemiol Health. 2024;46:e2024088. Published online November 15, 2024; DOI: https://doi.org/10.4178/epih.e2024088

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Abstract Summary PDF

Abstract

OBJECTIVES
Although previous studies have demonstrated an association between periodontal disease (PD) and diabetes mellitus (DM), the influence of age and the mediating role of inflammation have seldom been explored. This study investigated this association while considering the modifying effects of age and inflammatory status.

METHODS

This study included 29,491 participants from the 2012-2018 Korea National Health and Nutrition Examination Survey. The community periodontal index (CPI) was assessed by trained dentists using the World Health Organization CPI probe. PD was defined as a CPI score of 3 or 4. Pre-existing and incident DM were identified based on serum glucose levels, a history of DM diagnosis, medication use, and insulin injections. Serum high-sensitivity C-reactive protein (hs-CRP) levels were utilized as an indicator of chronic inflammation.

RESULTS

PD and DM exhibited a significant association, which was more pronounced with incident DM than with pre-existing DM, particularly in individuals younger than 65 years. Among those aged 20-44 years, the odds ratio of incident DM for CPI=4 versus CPI=0 was 2.61 (95% confidence interval, 1.16 to 6.09). High hs-CRP levels (>3 mg/L) were also associated with DM, especially in individuals with PD. This association was stronger with incident DM than with pre-existing DM. A notable joint effect was observed in younger individuals and those with PD.

CONCLUSIONS

The association between PD and DM was more pronounced in younger age groups and those with higher levels of inflammation. Therefore, early interventions for PD in younger patients may be crucial for preventing DM.

Summary

Korean summary
- 치주 질환과 당뇨병 사이의 연관성은 젊은 연령과 염증 수치가 높게 나타난 대상에서 더 두드러지게 나타남 - 치주 질환과 높은 염증 수치를 동시에 가지고 있을 경우의 당뇨 오즈비는 각각의 오즈비 합보다 더 크게 나타나 시너지 효과를 보였음 - 젊은 치주 질환 환자에 대한 조기 개입은 당뇨병 예방에 중요하게 작용할 수 있음

Key Message
• The association between PD and DM was more pronounced in younger age groups and those with higher levels of in- flammation. • The odds of DM increased synergistically for those with both PD and high inflammatory status. • Therefore, early interventions for PD in younger patients may be crucial for preventing DM.

Citations

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Synergic Elevation of Systemic Inflammation by the Coexistence of Periodontitis and Diabetes Mellitus: A Nationwide Analysis of Korean Adults
Hye-Sun Shin
Biomedicines.2025; 13(10): 2441. CrossRef
Resveratrol supplementation as a non-surgical treatment in periodontitis and related systemic conditions
Caterina Vinciguerra, Loredana Bellia, Graziamaria Corbi, Sandro Rengo, Alessandro Cannavo
Journal of Traditional and Complementary Medicine.2024;[Epub] CrossRef

Association between the safety climate and occupational injury in the Korean working population: a cross-sectional study: Jeehee Min, Tae-Won Jang, Hye-Eun Lee, Mo-Yeol Kang, Seong-Sik Cho; Epidemiol Health. 2024;46:e2024082. Published online October 1, 2024; DOI: https://doi.org/10.4178/epih.e2024082

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Preventing occupational injuries remains a significant challenge in Korea. A positive safety climate can contribute to reducing workplace injuries. However, the impact of safety climate on preventing occupational injuries among the Korean workforce has not been adequately explored. Therefore, this study aimed to investigate the relationship between the perceived safety climate and occupational injuries within the Korean working population.

METHODS

This study used baseline data from the Korean Work, Sleep, and Health Study (KWSH). The safety climate was measured using the brief version of the Nordic Safety Climate Questionnaire. Occupational injury was determined by whether injuries or accidents had occurred at workplaces in the past year. Logistic regression analysis was performed to examine the association between the safety climate and occupational injury.

RESULTS

Participants who reported an unfavorable workplace safety climate were more likely to experience occupational injuries. Multiple logistic regression analysis revealed that the adjusted odds ratio (OR) for occupational injuries in an unfavorable safety climate was 2.20 (95% confidence interval [CI], 1.38 to 3.51) compared to a favorable safety climate. Specifically, factors such as “not encouraging employees to follow safety rules when on a tight schedule” (OR, 2.02; 95% CI, 1.25 to 3.24) and “not helping each other work safely” (OR, 1.98; 95% CI, 1.17 to 3.25) were significantly associated with occupational injuries.

CONCLUSIONS

An unfavorable safety climate was associated with increased occupational injuries among Korean workers. Improving the safety climate in the workplace may reduce occupational injuries in Korea.

Summary

Korean summary
한국 노동인구집단에서도 안전풍토는 직업성 손상과 관련성이 관찰되었다. 이 같은 결과는 작업장의 안전풍토를 개선함으로써 직업성 손상을 예방할 수 있음을 시사한다.

Key Message
Safety climate was related to occupational injuries in the Korean working population. This result may indicate that occupational injuries can be prevented by improving the workplace safety climate. Workplace safety should be a high priority goal for management, and workers need to help each other for workplace safety.

Citations

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Data profile: Korean Work, Sleep, and Health Study (KWSHS)
Seong-Sik Cho, Jeehee Min, Heejoo Ko, Mo-Yeol Kang
Ann Occup Environ Med.2025; 37: e3. CrossRef
Safety Climate and Occupational Injuries in the Iron and Steel Industries in Tanzania
Saumu Shabani, Bente Elisabeth Moen, Teferi Abegaz, Simon Henry Mamuya
International Journal of Environmental Research and Public Health.2025; 22(9): 1372. CrossRef
Association between safety climate, safety participation, safety compliance, and occupational injuries among workers in large-scale building construction projects in Ethiopia
Teferi Abegaz, Wakgari Deressa, Bente E. Moen
International Archives of Occupational and Environmental Health.2025; 98(7): 685. CrossRef

Homelessness and mortality: gender, age, and housing status inequity in Korea: Gum-Ryeong Park, Dawoon Jeong, Seung Won Lee, Hojoon Sohn, Young Ae Kang, Hongjo Choi; Epidemiol Health. 2024;46:e2024076. Published online September 12, 2024; DOI: https://doi.org/10.4178/epih.e2024076

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Abstract

OBJECTIVES
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.

METHODS

Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.

RESULTS

The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.

CONCLUSIONS

The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.

Summary

Korean summary
전체 인구의 사망률은 큰 폭으로 줄어들면서 홈리스와 전체 인구 간의 사망 불평등이 1.3배에서 1.8배로 증가했다. 특히 쪽방주민이나 거리 홈리스보다 시설 거주 홈리스의 사망 위험이 더 높았으며, 동일 조건하에서 거리 홈리스 대비 약 1.7배 높은 사망 위험을 보였다. 본 연구는 홈리스의 탈시설화를 촉진하는 정책 전환의 필요성을 시사한다.

Key Message
The mortality rate of the general population has significantly declined, leading to an increase in mortality inequality between the homeless and the general population from 1.3 to 1.8 times. In particular, the mortality risk for homeless individuals in facilities was higher than that of those living in jjokbang or on the streets. This study highlights the need for a policy shift to promote deinstitutionalization for the homeless population.

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Bezdomność w Polsce. Epidemiologiczne spojrzenie na przyczyny zgonów i implikacje zdrowotne (2015–2022)
Jadwiga Duda, Igor Popiela, Karolina Dudzik, Aleksandra Adamus, Maciej Przygoda, Andrzej Kościsz, Tomasz Konopka
Zdrowie Publiczne i Zarządzanie.2025; 23(1): 29. CrossRef

Cohort Profiles

Cohort profile: the Taiwan Initiative for Geriatric Epidemiological Research - a prospective cohort study on cognition: Pei-Iun Hsieh, Te-Hsuan Huang, Jeng-Min Chiou, Jen-Hau Chen, Yen-Ching Chen; Epidemiol Health. 2024;46:e2024057. Published online June 25, 2024; DOI: https://doi.org/10.4178/epih.e2024057

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Abstract

The Taiwan Initiative for Geriatric Epidemiological Research (TIGER) was founded in 2011 to elucidate the interrelationships among various predictors of global and domain-specific cognitive impairment, with the aim of identifying older adults with an increased risk of dementia in the preclinical phase. TIGER, a population-based prospective cohort, recruited 605 and 629 (total of 1,234) older adults (aged 65 and above) at baseline (2011-2013 and 2019-2022) of phase I and II, respectively. Participants have undergone structured questionnaires, global and domain-specific cognitive assessments, physical exams, and biological specimen collections at baseline and biennial follow-ups to date. By 2022, TIGER I has included 4 biennial follow-ups, with the participants comprising 53.9% female and having a mean age of 73.2 years at baseline. After an 8-year follow-up, the annual attrition rate was 6.1%, reflecting a combination of 9.9% of participants who passed away and 36.2% who dropped out. TIGER has published novel and multidisciplinary research on cognitive-related outcomes in older adults, including environmental exposures (indoor and ambient air pollution), multimorbidity, sarcopenia, frailty, biomarkers (brain and retinal images, renal and inflammatory markers), and diet. TIGER’s meticulous design, multidisciplinary data, and novel findings elucidate the complex etiology of cognitive impairment and frailty, offering valuable insights into factors that can be used to predict and prevent dementia in the preclinical phase.

Summary

Key Message
1. The Taiwan Initiative for Geriatric Epidemiological Research (TIGER), established in 2001, aims to fill the knowledge gap regarding the longitudinal associations between environmental exposure, clinical factors, and performance in global and cognitive domains. 2. TIGER has made significant findings in various aspects, including the effects of exposure to low-level air pollutants, indoor air quality, clinical factors (brain and retinal images, dental health), nutrition, and biomarkers on cognition over time. 3. TIGER's multidisciplinary data and advanced analysis elucidate the predictors of cognitive impairment, identifying older adults at increased risk of dementia in the preclinical phase for early prevention and intervention.

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Disturbing dreams and dementia incidence across diverse cohort studies: A COSMIC collaboration study
Darren M. Lipnicki, Ashleigh S. Vella, Erico Castro‐Costa, Sergio Luis Blay, Maria Fernanda Lima‐Costa, Karen Ritchie, Elena Rolandi, Annalisa Davin, Michele Rossi, Ki Woong Kim, Ji Won Han, Dae Jong Oh, Ding Ding, Qianhua Zhao, Xiaowen Zhou, Yen‐Ching Ch
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Tzuyuan Stessa Chao, Yi Sun, Hung Lin, Yuhsuan Lin
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Ting-Wen Chu, Yi-Ting Hsieh, Jeng-Min Chiou, Yao-Lin Liu, Yen-Ching Chen, Jen-Hau Chen
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Cohort profile: understanding health service system needs for people with intellectual disability using linked data in New South Wales, Australia: Simone Reppermund, Preeyaporn Srasuebkul, Claire M. Vajdic, Sallie-Anne Pearson, Rachael E. Moorin, Julian N. Trollor; Epidemiol Health. 2024;46:e2024054. Published online June 12, 2024; DOI: https://doi.org/10.4178/epih.e2024054

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Abstract

This cohort profile describes one of the largest linked datasets in the world concerning the health of people with intellectual disability. The cohort comprises a retrospective group of 100,089 individuals with intellectual disability who received disability and/or health services in New South Wales, Australia. Of these participants, 34% were female, with a median age at cohort entry of 3 years (interquartile range, 0-19). A separate comparator cohort included 455,677 individuals, matched by 5-year age group, sex, and residential postcode at a 5:1 ratio. Initial results indicate that between 2001 and 2018, people with intellectual disability experienced more than double the rate of hospitalisations (538 vs. 235 per 1,000 person-years), as well as markedly higher rates of emergency department presentations (707 vs. 379 per 1,000 person-years) and use of ambulatory mental health services (1,012 vs. 157 per 1,000 person-years), relative to the comparator cohort. The largest disparities in hospital admissions were for mental disorders, dialysis, and diseases of the nervous system and sense organs. Furthermore, individuals with intellectual disability had more than double the rate of dispensed medications found in the comparator cohort. Of these medications, 46.6% were for the treatment of nervous system conditions, as opposed to 24.7% for the comparator cohort. The mean±standard deviation age at death was 52±19 years for people with intellectual disability and 64±22 years for the comparator participants.

Summary

Key Message
This cohort study of individuals with intellectual disability is one of the largest internationally looking at health profiles and health service use. The goal is to improve the health and well-being of individuals with intellectual disability by informing the development of services, variations in prescribing practices, and access to preventative health services.

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Addressing the challenges of intellectual disability identification for health policy and research in Australia
Helen Leonard, Kingsley Wong, Peiwen Liao, Manzoor Khan, Zoe Aitken, Jenny Bourke, Julian N. Trollor, Jenny Downs, Mary-Ann O’Donovan, Anne M. Kavanagh, Preeyaporn Srasuebkul
Frontiers in Psychiatry.2026;[Epub] CrossRef
Life expectancy of people with intellectual disability: a retrospective cohort study from New South Wales, Australia
Preeyaporn Srasuebkul, Julian Trofimovs, Julian Trollor
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Prevalence of psychiatric conditions in people with intellectual disability: A record linkage study in New South Wales, Australia
Samuel RC Arnold, Yunhe Huang, Preeyaporn Srasuebkul, Rachael C Cvejic, Stefan C Michalski, Julian N Trollor
Australian & New Zealand Journal of Psychiatry.2025; 59(5): 433. CrossRef
Predictors of mental illness onset in adolescents and adults with intellectual disability: A retrospective cohort study in New South Wales, Australia
Stefan C Michalski, Yunhe Huang, Preeyaporn Srasuebkul, Rachael C Cvejic, Samuel RC Arnold, Julian N Trollor
Australian & New Zealand Journal of Psychiatry.2025; 59(12): 1095. CrossRef
Contraception use in women with intellectual disability: a retrospective cohort study
Yunhe Huang, Peiwen Liao, Preeyaporn Srasuebkul, Pramudie Gunaratne, Julian Trollor
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Original Articles

Seasonal impact of diurnal temperature range on intracerebral hemorrhage in middle-aged and elderly people in central China: Shiwen Wang, Jinyu Yin, Hao Zhou, Jingmin Lai, Guizhen Xiao, Zhuoya Tong, Jing Deng, Fang Yang, Qianshan Shi, jingcheng shi; Epidemiol Health. 2024;46:e2024053. Published online June 11, 2024; DOI: https://doi.org/10.4178/epih.e2024053

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults.
METHODS
We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model.
RESULTS
Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period.
CONCLUSIONS
The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.; Summary

Key Message
In a large-scale, study of 54,690 hospitalizations for intracerebral hemorrhage (ICH) from China, we identified the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle aged and elderly adults. Specifically, the impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. The findings of this study could be instrumental in the prevention and control of ICH.

Profiling the socioeconomic characteristics, dietary intake, and health status of Korean older adults for nutrition plan customization: a comparison of principal component, factor, and cluster analyses: Kyungsook Woo, Kirang Kim; Epidemiol Health. 2024;46:e2024043. Published online April 12, 2024; DOI: https://doi.org/10.4178/epih.e2024043

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study was conducted to establish profiles of socioeconomic characteristics, dietary intake, and health status among Korean older adults by employing 3 multivariate analysis techniques.
METHODS
Data were obtained from 1,352 adults aged 65 years and older who participated in the 2019 Korea National Health and Nutrition Examination Survey. Principal component analysis (PCA), factor analysis (FA), and cluster analysis (CA) were utilized for profiling, with data preprocessing undertaken to facilitate these approaches.
RESULTS
PCA, FA, and CA yielded similar results, reflecting the high common variance among the variables. PCA identified 4 components, accounting for 71.6% of the accumulated variance. FA revealed 5 factors, displaying a Kaiser-Meyer-Olkin value of 0.51 and explaining 74.3% of the total variance. Finally, CA grouped the participants into 4 clusters (R2=0.465). Both PCA and FA identified dietary intake (energy, protein, carbohydrate, etc.), social support from family (incorporating family structure, number of family numbers, and engagement in social eating), and health status (encompassing oral, physical, and subjective health) as key factors. CA classified Korean older adults into 4 distinct typologies, with significant differences observed in dietary intake, health status, and household income (p<0.01).
CONCLUSIONS
The study utilized PCA, FA, and CA to analyze profiling domains and derive characteristics of older adults in Korea, followed by a comparison of the results. The variables defining the clusters in CA were consistent with those identified by PCA and FA.; Summary

Korean summary
동일한 데이터셋을 사용하여 PCA, FA, CA를 이용한 프로파일링 분석이 한국의 노인들을 특성화하고 분류하기 위해 수행되었습니다. 분석 결과, 세 가지 기법은 한국 노인들의 특성에서 유사한 패턴을 보였습니다.

Key Message
Profiling analysis using PCA, FA, and CA was performed to characterize and classify older adults in Korea on the same dataset. As a result of the analysis, the three techniques showed similar patterns in the characteristics of Korean older adults.

Association between dietary and behavioral-based oxidative balance score and phenotypic age acceleration: a cross-sectional study of Americans: Dongzhe Wu, Yulin Shen, Chaoyi Qu, Peng Huang, Xue Geng, Jianhong Zhang, Zhijian Rao, Qiangman Wei, Shijie Liu, Jiexiu Zhao; Epidemiol Health. 2024;46:e2024023. Published online January 18, 2024; DOI: https://doi.org/10.4178/epih.e2024023

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Abstract

OBJECTIVES
In light of the rise in the global aging population, this study investigated the potential of the oxidative balance score (OBS) as an indicator of phenotypic age acceleration (PhenoAgeAccel) to better understand and potentially slow down aging.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey collected between 2001 and 2010, including 13,142 United States adults (48.7% female and 51.2% male) aged 20 and above, OBS and PhenoAgeAccel were calculated. Weighted generalized linear regression models were employed to explore the associations between OBS and PhenoAgeAccel, including a sex-specific analysis.

RESULTS

The OBS demonstrated significant variability across various demographic and health-related factors. There was a clear negative correlation observed between the higher OBS quartiles and PhenoAgeAccel, which presented sex-specific results: the negative association between OBS and PhenoAgeAccel was more pronounced in male than in female. An analysis using restricted cubic splines revealed no significant non-linear relationships. Interaction effects were noted solely in the context of sex and hyperlipidemia.

CONCLUSIONS

A higher OBS was significantly associated with a slower aging process, as measured by lower PhenoAgeAccel. These findings underscore the importance of OBS as a biomarker in the study of aging and point to sex and hyperlipidemia as variables that may affect this association. Additional research is required to confirm these results and to investigate the biological underpinnings of this relationship.

Summary

Key Message
• The study found a significant negative correlation between the oxidative balance score (OBS) and phenotypic age acceleration (PhenoAgeAccel), with higher OBS associated with slower biological aging. This association was more pronounced in males, and significant in individuals with high cholesterol.
• OBS can serve as an effective biomarker for studying the aging process and its association with lifestyle and dietary factors.

Citations

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Association between methyl donor nutrients’ dietary intake with phenotypic aging among US adults: a cross-sectional study from NHANES 2005–2018
Yong Li, Da Peng, Zhenyuan Yu, Jiaqi Deng, Lijuan Zhao, Ruoyan Cao
Scientific Reports.2025;[Epub] CrossRef
Dose-response relationship between sleep duration and mediation of phenotypic age acceleration: A cross-sectional study
Yujia Liu, Kai Qiao
Medicine.2025; 104(40): e44786. CrossRef
Association of oxidative balance score with chronic kidney disease: NHANES 1999-2018
Haibin Wen, Xianhua Li, Jiangming Chen, Yi Li, Nailong Yang, Ning Tan
Frontiers in Endocrinology.2024;[Epub] CrossRef
Association between oxidative balance score and diabetic kidney disease, low estimated glomerular filtration rate and albuminuria in type 2 diabetes mellitus patients: a cross-sectional study
Cong Liu, Jiju Yang, Hongdian Li, Yuanyuan Deng, Pengfei He, Jiao Zhang, Mianzhi Zhang
Frontiers in Endocrinology.2024;[Epub] CrossRef
Dose–response relationship of dietary Omega-3 fatty acids on slowing phenotypic age acceleration: a cross-sectional study
Dongzhe Wu, Yishuai Jia, Yujia Liu, Mingyu Shang
Frontiers in Nutrition.2024;[Epub] CrossRef
Dose-response relationship between leisure-time physical activity patterns and phenotypic age acceleration in American adults: A cross-sectional analysis
Dongzhe Wu, Peng Huang, Xue Geng, Chaoyi Qu, Zhijian Rao, Jianhong Zhang, Yulin Shen, Qiangman Wei, Shijie Liu, Jiexiu Zhao
Journal of Exercise Science & Fitness.2024; 22(4): 445. CrossRef

Associations of depressive symptoms with lower extremity function and balance in Korean older adults: Bong Jo Kim, Kyupin Ha, Hyun Soo Kim, Hye Ran Bae, Minkook Son; Epidemiol Health. 2024;46:e2024021. Published online January 15, 2024; DOI: https://doi.org/10.4178/epih.e2024021

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Abstract Summary PDF

Abstract

OBJECTIVES
The relationship of depressive symptoms to lower extremity function and balance, especially in older adults without a depression diagnosis, remains unclear. Therefore, our study analyzed this relationship using a large sample of Korean older adults.

METHODS

We used data from the Korean National Health Insurance Service’s Health Screening Program database. Individuals aged 66 years who had undergone the National Screening Program for Transitional Ages in Korea and were without a diagnosis of depressive disorder were included. The lower extremity function and balance were evaluated using 2 physical tests, while depressive symptoms were assessed using a 3-question survey. Multivariable-adjusted logistic regression analysis was used to examine the association between depressive symptoms and lower extremity function and balance.

RESULTS

Among 66,041 individuals, those with depressive symptoms showed significantly higher rates of abnormal lower extremity function and abnormal balance. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association of depressive symptoms to abnormal lower extremity function and abnormal balance were (aOR, 1.34; 95% CI, 1.25 to 1.44) and (aOR, 1.38; 95% CI, 1.29 to 1.48), respectively. Assessment of the relationship based on depressive symptom scores revealed that higher scores were associated with higher aORs (p for trend <0.001). Subgroup analyses further confirmed this relationship, especially among patients with cerebrovascular disease or dementia.

CONCLUSIONS

This study revealed an association between depressive symptoms and the abnormal lower extremity function and balance of 66-year-old individuals without a diagnosis of depressive disorder.

Summary

Key Message
• This study investigated the associations of depressive symptoms with lower extremity function and balance in 66-year-old individuals without a diagnosis of major depressive disorder.
• Older adults with depressive symptoms showed significantly higher levels of abnormal lower extremity function and balance than those without.
• Higher depressive symptom scores were associated with higher odds ratios for abnormal lower extremity function and balance.

Citations

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Association of kidney function and proteinuria with lower-extremity dysfunction in older Korean adults: a cross-sectional study
Bongjo Kim, Eun-Bin Lim, Young Sang Lyu, Minkook Son, Youngmin Yoon
The Korean Journal of Internal Medicine.2025; 40(5): 823. CrossRef

Systematic Review

Effectiveness of community-based interventions for older adults living alone: a systematic review and meta-analysis: Inhye Kim, Hyunseo An, Sohyeon Yun, Hae Yean Park; Epidemiol Health. 2024;46:e2024013. Published online January 3, 2024; DOI: https://doi.org/10.4178/epih.e2024013

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Abstract

OBJECTIVES
This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis.

METHODS

The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions.

RESULTS

Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.96 (95% confidence interval [CI], 0.66 to 1.25) and 0.43 (95% CI, 0.26 to 0.60), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.98 (95% CI, 0.73 to 1.22) for health behavior and 0.67 (95% CI, 0.19 to 1.16) for mental health.

CONCLUSIONS

This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.

Summary

Korean summary
본 연구는 독거 노인들 대상으로 한 지역사회 기반 중재의 효과에 대하여 탐색하고 그 효과 크기를 확인하기 위하여 체계적고찰 및 메타분석을 실시하였다. 영양 및 복합 중재가 특히 효과적이었으며, 이는 건강 행동과 정신건강에 있어 중요한 긍정적 효과를 나타내어 추후 개별적 맞춤 중재의 잠재적 효과성을 나타낸다. 이러한 발견은 독거노인 집단의 웰빙 향상을 위한 프로그램과 정책 입안에 근거로 활용될 수 있다.

Key Message
This systematic review and meta-analysis evaluated the impact of community-based interventions for older adults living alone, incorporating 9 studies to assess effectiveness in areas like nutrition and combined strategies. Results indicated significant benefits, particularly in health behavior and mental health, demonstrating the potential of tailored interventions. These findings support the development of targeted programs and policy decisions aimed at improving the well-being of this demographic.

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Journal of Geriatric Oncology.2026; 17(3): 102907. CrossRef
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Giovanna Apicella, Luca Grosset, Rosario Maggistro, Elena Sartori
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Original Articles

Identifying pregnancy episodes and estimating the last menstrual period using an administrative database in Korea: an application to patients with systemic lupus erythematosus: Yu-Seon Jung, Yeo-Jin Song, Jihyun Keum, Ju Won Lee, Eun Jin Jang, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung; Epidemiol Health. 2024;46:e2024012. Published online December 19, 2023; DOI: https://doi.org/10.4178/epih.e2024012

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Abstract

OBJECTIVES
This study developed an algorithm for identifying pregnancy episodes and estimating the last menstrual period (LMP) in an administrative claims database and applied it to investigate the use of pregnancy-incompatible immunosuppressants among pregnant women with systemic lupus erythematosus (SLE).

METHODS

An algorithm was developed and applied to a nationwide claims database in Korea. Pregnancy episodes were identified using a hierarchy of pregnancy outcomes and clinically plausible periods for subsequent episodes. The LMP was estimated using preterm delivery, sonography, and abortion procedure codes. Otherwise, outcome-specific estimates were applied, assigning a fixed gestational age to the corresponding pregnancy outcome. The algorithm was used to examine the prevalence of pregnancies and utilization of pregnancy-incompatible immunosuppressants (cyclophosphamide [CYC]/mycophenolate mofetil [MMF]/methotrexate [MTX]) and non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy in SLE patients.

RESULTS

The pregnancy outcomes identified in SLE patients included live births (67%), stillbirths (2%), and abortions (31%). The LMP was mostly estimated with outcome-specific estimates for full-term births (92.3%) and using sonography procedure codes (54.7%) and preterm delivery diagnosis codes (37.9%) for preterm births. The use of CYC/MMF/MTX decreased from 7.6% during preconception to 0.2% at the end of pregnancy. CYC/MMF/MTX use was observed in 3.6% of women within 3 months preconception and 2.5% during 0-7 weeks of pregnancy.

CONCLUSIONS

This study presents the first pregnancy algorithm using a Korean administrative claims database. Although further validation is necessary, this study provides a foundation for evaluating the safety of medications during pregnancy using secondary databases in Korea, especially for rare diseases.

Summary

Korean summary
임산부의 약물 사용 안전성에 대한 근거 제공을 위해 실제 인구집단에서의 임신 중 약물 치료 안전성을 평가하는 청구자료 기반 연구가 중요하다. 본 연구에서는 국내 청구자료에 적용할 수 있는 임신 정의 및 임신 결과 조작적 정의 알고리즘을 개발하였다. 본 알고리즘은 임신 결과 간의 우선순위를 고려한 계층 구조를 활용하며, 조기 분만 및 초음파 검사 코드 등을 통해 최종 월경 기간을 추정하였다. 또한 알고리즘을 전신홍반루푸스 환자에 적용하여 유산, 사산 등의 유병률을 산출하고 임신 중 잠재적으로 부적절한 면역억제제 사용을 파악하여 국내 청구자료의 특성을 고려한 임신 중 약물 사용 연구의 기반을 마련하였다.

Key Message
Limited safety data for pregnant women prompted recent studies on medication during pregnancy using real-world databases. This study developed a tailored algorithm for Korean healthcare claims database, employing a hierarchy of pregnancy outcomes and incorporating pre-term delivery and sonography codes for last menstrual period estimation. Applied to systemic lupus erythematosus (SLE) patients, this study presented the prevalence and drug utilization pattern of pregnancy-incompatible immunosuppressants from preconception to pregnancy end, laying a foundation for further claims database studies on medication pregnancy safety.

Citations

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Immunosuppressant use and adverse pregnancy outcomes in women with systemic lupus erythematosus: a retrospective cohort study in Korea
Yu-Seon Jung, Yeo-Jin Song, Eun Jin Jang, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung
Rheumatology.2026;[Epub] CrossRef
Evaluation of gestational age by pregnancy outcomes and distribution of pregnancy-related codes in Korean claims data
Woo-Jung Kim, Yunha Noh, Yongtai Cho, Eun-Young Choi, HyunJoo Lim, Hyesung Lee, Ju-Young Shin
Epidemiology and Health.2026; 48: e2026007. CrossRef
Evaluating and Refining Claims-Based Algorithms for Pregnancy Outcomes and Gestational Age Estimation in Korea
Hee-Jin Kim, Haerin Cho, Sun-Young Jung, Ju-Young Shin, Seung-Ah Choe, Nam-Kyong Choi
Journal of Korean Medical Science.2026;[Epub] CrossRef
Development and Validation of Gestational Age Estimation Algorithms for Nonlive Births in Administrative Healthcare Databases
Yongtai Cho, Eun-Young Choi, Hyesung Lee, Yunha Noh, Jung Yeol Han, Seung-Ah Choe, Hoon Kim, Ju-Young Shin
Epidemiology.2026; 37(3): 336. CrossRef
Utilisation patterns of immunomodulators and pregnancy outcomes in systemic lupus erythematosus: Insights from Korean national data
Yu-Seon Jung, Yeo-Jin Song, Hyeon Ji Lee, Eunji Kim, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung
Lupus.2025; 34(2): 140. CrossRef
Narrative Review of National Health Insurance Claims Data for Gestational Age Calculation and Vaccine Safety Evaluation in Pregnancy
Taemi Kim, Seung-Ah Choe
Health Insurance Review & Assessment Service Research.2025; 5(2): 98. CrossRef
Neurodevelopmental delays in children born after medically assisted reproduction: a national population cohort study
Seung-Ah Choe, Eunseon Gwak, Juyoung Lee, Jung Hye Byeon, Ju-Young Shin, Seungbong Han, Jee Hyun Kim
Journal of Neurodevelopmental Disorders.2025;[Epub] CrossRef

Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses: Hana Kim, Heewon Kang, Sung-il Cho; Epidemiol Health. 2024;46:e2024009. Published online December 13, 2023; DOI: https://doi.org/10.4178/epih.e2024009

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011.

METHODS

Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign.

RESULTS

For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively).

CONCLUSIONS

A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.

Summary

Korean summary
지난 15년 동안 한국 청소년의 가정 내 간접흡연 노출은 감소했다. 가정 내 간접흡연 노출에 대하여 중학교 입학 코호트 효과가 존재하였다. 또한, 청소년의 가정 내 간접흡연 노출 감소는 2011년 12월 공공장소에서의 금연구역 규제와 2008년 시행된 캠페인과 연관되어 있었다.

Key Message
Household secondhand smoke (SHS) exposure among Korean adolescents has decreased over the past 15 years. There was a school admission cohort effect on household SHS exposure. A complete smoking ban in public space with increased penalties in December 2011 and a campaign in 2008 to avoid SHS exposure were associated with reduced household SHS exposure among adolescents.

Citations

Citations to this article as recorded by

Effectiveness of tobacco control policy interventions on tobacco use behaviours and health outcomes based on ITS research methodology: a scoping review
Ying Shi, Dan Qin, Haiyin Wang, Lihang Sun, Kaicheng Gu
BMJ Open.2025; 15(11): e094148. CrossRef

Folate, vitamin B12, and homocysteine status in the Korean population: data from the 2013-2015 Korea National Health and Nutrition Examination Survey: Sihan Song, Bo Mi Song, Hyun-Young Park; Epidemiol Health. 2024;46:e2024007. Published online December 11, 2023; DOI: https://doi.org/10.4178/epih.e2024007

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Abstract

OBJECTIVES
We aimed to assess the serum folate, vitamin B12, and homocysteine status in Korean adolescents and adults using national data.

METHODS

Blood samples were collected from participants aged ≥10 years in the Korea National Health and Nutrition Examination Survey 2013-2015. The stored serum samples were used to measure folate, vitamin B12, and homocysteine concentrations. A total of 8,016 participants were included in this analysis. Unweighted descriptive statistics and adjusted geometric means of the B vitamins and homocysteine concentrations were estimated.

RESULTS

Females had higher serum folate and vitamin B12 concentrations and lower serum homocysteine concentrations than males. Folate deficiency (<6.8 nmol/L) and hyperhomocysteinemia (>15 μmol/L) were found in 8.6% and 11.8% of males, respectively. Approximately 3% of males had low or marginally low vitamin B12 status (≤221 pmol/L). Folate and vitamin B12 deficiencies and hyperhomocysteinemia were found in <2% of females. Suboptimal folate status was prevalent among adolescents and young adults, while suboptimal vitamin B12 status and hyperhomocysteinemia were relatively higher in older adults. Adjusted mean homocysteine concentrations were sharply decreased from the first to second decile of serum folate in males.

CONCLUSIONS

In the Korean population, the proportion of males who achieved desirable folate and homocysteine concentrations were lower than those of females. Although most Koreans have adequate vitamin B12, a suboptimal folate status is common, particularly among adolescents and young adults. These findings could establish a foundation for public health initiatives aimed at improving folate levels in the Korean population.

Summary

Korean summary
엽산과 비타민B12는 전 생애에 걸쳐 건강에 영향을 미치는 필수 비타민이다. 그러나 해당 비타민 상태에 대한 국내 자료는 부족한 실정이다. 본 연구는 국민건강영양조사 참여자로부터 수집된 혈청으로부터 엽산, 비타민B12, 그리고 이들의 기능성 지표인 호모시스테인 농도를 측정하였고 성별과 연령별 분포와 적합 상태를 평가하였다. 엽산 결핍과 고호모시스테인혈증은 남성에서 높은 유병률을 가졌다. 적정 엽산 상태를 충족하지 못하는 비율은 청소년과 젊은 성인에서 흔하게 관찰되었다. 대부분의 한국인은 충분한 비타민B12 수준을 가졌으나, 노인의 경우 정기적인 평가가 필요하다. 본 연구는 한국인이 최적의 엽산과 비타민B12 상태를 유지하기 위한 기반적 근거를 제공한다.

Key Message
Folate and vitamin B12 have significant health impacts throughout the life cycle. However, national-level data on B vitamins in Korea are limited. Serum folate, vitamin B12, and homocysteine concentrations were measured from samples stored during the national survey. In our study, the proportions of folate deficiency and hyperhomocysteinemia were higher in men than in women.Suboptimal folate status was common among adolescents and young adults. Most Koreans had adequate levels of vitamin B12; however, regular monitoring is warranted, especially in the older population. The current data provide a future direction for achieving optimal B vitamin status in the Korean population.

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Essential micronutrients in children and adolescents with a focus on growth and development: a narrative review
Sukjin Hong
Journal of Yeungnam Medical Science.2025; 42: 25. CrossRef

Food literacy and its relationship with food intake: a comparison between adults and older adults using 2021 Seoul Food Survey data: Seulgi Lee, Sohyun Park, Kirang Kim; Epidemiol Health. 2023;45:e2023062. Published online July 3, 2023; DOI: https://doi.org/10.4178/epih.e2023062

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Abstract Summary PDF

Abstract

OBJECTIVES
This study was conducted to examine the differences in food literacy between adults and older adults and the association of food literacy with food group intake.

METHODS

In total, 4,039 participants from the 2021 Survey for Food Consumption in Seoul were included in this study. The intake of whole grains, high-protein foods, total vegetables, vegetables excluding kimchi and pickles, fresh fruits, and milk and dairy products was assessed using a simple food frequency questionnaire. Food literacy was measured using a food literacy measurement questionnaire.

RESULTS

With the exception of milk and dairy, adults had a significantly higher proportion of insufficient food intake than older adults (p<0.001). Both adults and older adults with sufficient food group consumption had higher food literacy scores. Notably, the difference in food literacy scores by level of food intake was highest for fresh fruits (p<0.001). After adjusting for confounding factors affecting food literacy scores, a higher score was associated with a lower probability of having insufficient food intake in all food groups for both adults and older adults. Specifically, those in the highest food literacy score quartile were less likely to have insufficient intake of vegetables (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.28 to 0.43) and fresh fruits (OR, 0.32; 95% CI, 0.24 to 0.43), compared to the lowest quartile.

CONCLUSIONS

Improving food literacy is an important factor for promoting healthy food intake in older adults as well as adults. Therefore, it is necessary to develop intervention programs to work toward this goal.

Summary

Korean summary
건강정보 이해능력(health literacy)은 노인에서 만성질환이나 인지능력과의 관련성이 보고되고 있으나 영양정보 이해능력(food literacy)에 대한 연구는 미비하다. 급변하는 식이 환경에서 식사 및 영양과 관련된 정보를 올바르게 이해하고 판단할 수 있는 영양정보 이해능력은 노인성 질환 예방에 중요하다. 본 연구에서 영양정보 이해능력과 식품군 섭취와의 상관성을 분석한 결과 영양정보 이해능력이 높은 노인이 건강한 식품 섭취 부족 위험이 낮았다. 특히 과일 섭취 부족 위험은 영양정보 이해능력이 높은 노인에서 뚜렷하게 낮았다. 국내 영양정보 이해능력 연구는 초기 단계로 주로 성인 대상으로 연구가 이루어져서 본 연구에서의 결과는 그 의의가 크며, 영양정보 이해능력 향상은 성인과 마찬가지로 노인에서도 건강한 식품 섭취를 위한 중요한 요인으로서 이를 위한 프로그램 개발이 필요할 것으로 사료된다.

Key Message
The study on food literacy among older adults in Korea is significant as previous research has mostly focused on adults. The results showed that older adults with higher food literacy score had lower risk of insufficient food intake as compared with those with lower food literacy score. Specifically, the risk of insufficient fresh fruits intake was the lowest among older adults with higher food literacy score. Therefore, improving food literacy is an important factor for promoting healthy food consumption among older adults.

Citations

Citations to this article as recorded by

Nutritional vulnerability and its associated characteristics among the elderly in Seoul: analysis of data from the Seoul food survey 2024
Misung Lee, Youngmin Nam, Hye-Jong Yoo, Jihyun Yoon
Frontiers in Nutrition.2026;[Epub] CrossRef
Does Health Literacy Mediate Sociodemographic and Economic Inequalities in Fruit and Vegetable Intake? An Analysis of Slovenian National HLS19 Survey Data
Andrej Kirbiš, Stefani Branilović, Maruša Lubej
Foods.2025; 14(3): 378. CrossRef
Current status of nutrition education media and its utilization in providing customized nutrition information for older adults in Korea: a scoping review based on the transtheoretical model and food literacy
Seojin Yun, Jiwon An, Kirang Kim
Korean Journal of Community Nutrition.2025; 30(3): 175. CrossRef
Examining the Association Between Food Insecurity, Food Literacy, and Food Intake Among Low-Income Adults in Jeddah, Saudi Arabia: A Cross-Sectional Study
Mahitab Hanbazaza, Lama Alaklabi
Foods.2025; 14(17): 3078. CrossRef
남성의 조리문해력이 식생활만족도에 미치는 영향: 조리관심도의 매개효과를 중심으로
진영 장, 지영 윤
Korean Journal of Food and Cookery Science.2025; 41(6): 430. CrossRef
Self-perceived food literacy in relation to the quality of overall diet and main meals: A cross-sectional study in Japanese adults
Kentaro Murakami, Nana Shinozaki, Tsuyoshi Okuhara, Tracy A. McCaffrey, M. Barbara E. Livingstone
Appetite.2024; 196: 107281. CrossRef
Status of Food Literacy and Association with the Nutrition Quotient among Korean Adults
Geum-Bi Ryu, Young-Ran Heo
Human Ecology Research.2024; 62(3): 399. CrossRef

Non-linear relationship between body mass index and self-rated health in older Korean adults: body image and sex considerations: Seok-Joon Yoon, Jin-Gyu Jung, Soon-Ki Ahn, Jong-Sung Kim, Jang-Hee Hong; Epidemiol Health. 2023;45:e2023061. Published online June 20, 2023; DOI: https://doi.org/10.4178/epih.e2023061

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The purpose of this study was to investigate the association between body mass index (BMI) and self-rated health (SRH) in older adults aged over 65 years while examining the influence of self-perceived body image (SBI) and sex.

METHODS

Raw data were obtained from the Korea Community Health Survey, which included BMI measurements of Koreans aged over 65 years (n=59,628). Non-linear relationships between BMI and SRH were analyzed separately for each sex using restricted cubic splines while controlling for SBI and other confounding variables.

RESULTS

Men showed a reverse J-shaped association, while women showed a J-shaped association between BMI and poor SRH. However, including SBI in the model changed this association for men to an inverted U-shape showing a negative direction, with the highest risk of poor SRH observed in the underweight to overweight range. For women, a nearly linear positive relationship was observed. Regardless of BMI, those who perceived their weight as not “exactly the right weight” had a higher risk of poor SRH than those who perceived their weight as “exactly the right weight” in both men and women. Older men who thought they were much too fat or too thin had similar highest risks of poor SRH, whereas older women who thought they were too thin had the highest risk of poor SRH.

CONCLUSIONS

The findings of this study emphasize the importance of considering sex and body image perceptions when assessing the relationship between BMI and SRH in older adults, especially in men.

Summary

Korean summary
자가 평가 건강 상태 (self-rated health, SRH)와 체질량지수는 각각 건강에 많은 관련이 있는 것으로 밝혀져 있다. 하지만 둘 사이의 관계는 연구마다 다양하게 나타나 있고, 노인들을 대상으로 한 연구도 많지 않다. 노인들은 본인들의 체중을 낮게 평가하는 경향이 있어 둘 사이 관계를 살펴볼 때 자기 인지 체형에 대한 고려가 필요하며, 성별에 따른 영향도 역시 고려해봐야 한다. 본 연구에서는 체질량지수로 파악한 비만의 정도에 관계없이 남성과 여성 모두에서 자기 인지 체형이 정상인 경우에 좋지 않은 SRH를 가질 위험성이 낮았다. 남성에서는 체질량지수와 SRH의 관계가 불분명하게 나타났고 자기 인지 체형이 더 중요한 요인으로 보인다. 한편 여성에서는 체질량지수가 증가함에 따라 SRH도 나빠지는 경향을 보였다. 이에 노인들의 비만과 관련된 교육에 있어서는 자가 인지 체형과 체질량지수를 이용한 비만의 기준에 대해 포함하는 것이 중요하다.

Key Message
Previous research has not fully explored the relationship between BMI, SBI, and SRH in older adults. Our study, using big data, found that the relationships differed between men and women. Those who perceived their weight as ‘exactly the right weight’ had the lowest risk of poor SRH. In men, BMI had a weak effect on SRH, while in women, the risk of poor SRH increased as BMI increased. We recommend that healthcare providers should educate older adults about BMI standards and help them identify their SBI for effective obesity counseling.

Citations

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Obesity and self-rated health in middle-aged Danes
Frederik Pagh Bredahl Kristensen, Morten Madsen, Lars Pedersen, Reimar Wernich Thomsen, Henrik Toft Sørensen
International Journal of Obesity.2026; 50(3): 536. CrossRef
Nutritional Risk Factors Model of Community-Dwelling Older People in Poland–Pilot Study
Robert Gajda, Marzena Jeżewska-Zychowicz, Karolina Rak, Monika Maćków
Nutrients.2025; 17(13): 2150. CrossRef
Sex Based Comparison of Health Self-Perception, Sleep, Anxiety, and Body Composition Among University Students
Sondos Basheer, Hadia Radwan, Veena Raigangar, Falak Zeb, Ayat Zamrik, Raghda Adi, Tala Faraj, Woroud Chaker, Tareq Osaili, Hayder Hasan
International Journal of Public Health.2025;[Epub] CrossRef
Healthy Behaviors and Self-Rated Health Among Community-Dwelling Older Adults: A Cross-National Comparison Between US and Korea
Seungah H. Lee, Jiyoung Lyu, Kimberly J. Johnson
Asian Women.2025; 41(3): 117. CrossRef
The Associations Between Physical Activity, Body Perception, and Self-Rated Health in Korean Adults: An Analysis of the 2023 Korean Community Health Survey
Geun-Kook Kim, Su-Yeon Roh, Sung-Ho Hwang
Medicina.2025; 61(11): 1898. CrossRef
The Association between Self-Rated Health and Body Weight Image among Korean Adolescents
Yoonsoo SUNG, Jung Ah LEE, Sung SUNWOO
Korean Journal of Health Promotion.2025; 25(4): 138. CrossRef

A comparison of methods for the measurement of adherence to antihypertensive multidrug therapy and the clinical consequences: a retrospective cohort study using the Korean nationwide claims database: Minji Jung, Eunjung Choo, Sukhyang Lee; Epidemiol Health. 2023;45:e2023050. Published online May 1, 2023; DOI: https://doi.org/10.4178/epih.e2023050

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
In observational studies, the methods used to measure medication adherence may affect assessments of the clinical outcomes of drug therapy. This study estimated medication adherence to multidrug therapy in patients with hypertension using different measurement methods and compared their impacts on clinical outcomes.

METHODS

This was a retrospective cohort study using the Korean National Health Insurance Service–National Sample Cohort database (2006-2015). Adults diagnosed with hypertension who initiated multidrug antihypertensive therapy in the index year 2007 were included. Adherence was defined as over 80% compliance. Adherence to multidrug antihypertensive therapy was measured in 3 ways using the proportion of days covered (PDC) with 2 approaches to the end-date of the study observations: PDC with at least one drug (PDCwith≥1), PDC with a duration weighted mean (PDCwm), and the daily polypharmacy possession ratio (DPPR). The primary clinical outcome was a composite of cardiovascular and cerebrovascular disease-specific hospitalizations or all-cause mortality.

RESULTS

In total, 4,226 patients who initiated multidrug therapy for hypertension were identified. The mean adherence according to the predefined measurements varied from 72.7% to 79.8%. Non-adherence was associated with an increased risk of a primary outcome. The hazard ratios (95% confidence intervals, CIs) primary outcomes varied from 1.38 (95% CI, 1.19 to 1.59) to 1.44 (95% CI, 1.25 to 1.67).

CONCLUSIONS

Non-adherence to multidrug antihypertensive therapy was significantly associated with an increased risk of a primary clinical outcome. Across the varying estimates based on different methods, medication adherence levels were similar. These findings may provide evidence to support decision-making when assessing medication adherence.

Summary

Korean summary
- 여섯 가지 다중약물 순응도 평가 방법을 적용했을 때, 고혈압제 병용 요법 순응도는 70~80%으로 유사한 결과값을 보였다. - 순응군 대비 비순응군에서 심혈관질환 관련 입원 및 전체 사망 위험 증가가 1.4배 높았다.

Key Message
-In Korea, adherence to multidrug antihypertensive therapy was approximately 70~80% across the six measurements. -Similar impacts of adherence to multidrug antihypertensive therapy upon the clinical consequences with a 4-folds increased risk across the six measurements. -We provide evidence for decision-making of applying adherence measurement in observational analysis.

Citations

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The link between adherence to antihypertensive medications and mortality rates in patients with hypertension: a systematic review and meta-analysis of cohort studies
Xuemei Peng, Lihong Wan, Benkai Yu, Jianhui Zhang
BMC Cardiovascular Disorders.2025;[Epub] CrossRef
Calcium Channel Blocker Versus Renin–Angiotensin System Inhibitor in Risk of Kidney Cancer Among Patients With Hypertension: A Propensity Score‐Matched Cohort Study
Minji Jung, Shufeng Li, Zhengyi Deng, Jinhui Li, Mingyi Li, Satvir Basran, Marvin E. Langston, Benjamin I. Chung
Cancer Medicine.2024;[Epub] CrossRef

Impaired pulmonary function mediates the impact of preterm birth on later-life stroke: a 2-step, multivariable Mendelian randomization study: Xingzhi Guo, Peng Tang, Chen Hou, Yue Liu, Rui Li; Epidemiol Health. 2023;45:e2023031. Published online March 3, 2023; DOI: https://doi.org/10.4178/epih.e2023031

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Observational studies have suggested an association between preterm birth and stroke in late adulthood, but it remains unclear whether the association is causal. The purpose of this study was to evaluate the causal effects of gestational age on stroke and to determine the pathophysiological mechanisms underlying the causal associations.

METHODS

Two-sample Mendelian randomization (MR) was performed to assess the causal effects of fetal gestational duration, early preterm birth (EPB), preterm birth, or postterm birth on stroke and its subtypes. Two-step Mendelian randomization (TSMR) and multivariable Mendelian randomization (MVMR) were additionally used to determine the role of common stroke risk factors, including cardiovascular diseases, hypertension, pulmonary impairment, inflammation, and metabolic diseases, in mediating the causal associations between gestational age and stroke and its subtypes.

RESULTS

Genetically predicted EPB increased the risk of cardioembolic stroke (CES; odds ratio [OR], 1.115; 95% confidence interval [CI], 1.036 to 1.200; p=0.004) and large artery stroke (LAS; OR, 1.131; 95% CI, 1.031 to 1.241; p=0.009). The TSMR results showed that EPB was associated with a lower forced expiratory volume in the first second and forced vital capacity ratio (FEV1/FVC) (β=-0.020; 95% CI, -0.035 to -0.005; p=0.009), which increased the risk of CES and LAS. Further MVMR analysis showed that the associations between EPB and stroke disappeared after adjustment for FEV1/FVC.

CONCLUSIONS

Our data demonstrate that EPB is causally associated with an elevated risk of CES and LAS, and that pulmonary dysfunction mediates the causal impact of EPB on CES and LAS.

Summary

Key Message
Genetically predicted early preterm birth (EPB) is significantly associated with an increased risk of cardioembolic stroke (CES) and large artery stroke (LAS). Further multivariable Mendelian randomization analysis demonstrates that pulmonary impairment mediates the causal impact of EPB on CES and LAS in adulthood.

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Association between triglyceride glucose-waist-adjusted waist index and incident stroke in Chinese adults: a prospective cohort study
Yaqin Ye, Zhenyi He, Jingguo Wu, Junlin Wu, Yanbing Liang
Frontiers in Nutrition.2025;[Epub] CrossRef
Causal associations of mood swings with preterm birth: a Mendelian randomization analysis
Yuting Xia, Jianan Zhang, Yun Shang
The Journal of Maternal-Fetal & Neonatal Medicine.2025;[Epub] CrossRef
Methodological approaches, challenges, and opportunities in the application of Mendelian randomisation to lifecourse epidemiology: A systematic literature review
Grace M. Power, Eleanor Sanderson, Panagiota Pagoni, Abigail Fraser, Tim Morris, Claire Prince, Timothy M. Frayling, Jon Heron, Tom G. Richardson, Rebecca Richmond, Jessica Tyrrell, Nicole Warrington, George Davey Smith, Laura D. Howe, Kate M. Tilling
European Journal of Epidemiology.2024; 39(5): 501. CrossRef
Tumor necrosis factor mediates the impact of PM2.5 on bone mineral density: Inflammatory proteome Mendelian randomization and colocalization analyses
Mingzheng Li, Peng Shi, Huajie Yang, Suyuan Tong, Nianfeng Qiu, Fan Yao, Yuan Du, Shuhua Xi, Fei Wang
Ecotoxicology and Environmental Safety.2024; 270: 115896. CrossRef
Causal associations of circulating Helicobacter pylori antibodies with stroke and the mediating role of inflammation
Xingzhi Guo, Peng Tang, Xin Zhang, Rui Li
Inflammation Research.2023; 72(6): 1193. CrossRef
Causal relationship between Helicobacter pylori antibodies and gastroesophageal reflux disease (GERD): A mendelian study
Jiaqin Chen, Junning Zhang, Xiaolu Ma, Yuehan Ren, Yi Tang, Zhongmian Zhang, Wangyu Ye, Xiyan Zhang, Zili Lin, Lan Wang, Zhihong Li, Yasin Sahin
PLOS ONE.2023; 18(12): e0294771. CrossRef

Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study: Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park; Epidemiol Health. 2023;45:e2023029. Published online February 23, 2023; DOI: https://doi.org/10.4178/epih.e2023029

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The aim of this study was to clarify the clinical trait of familial diabetes mellitus (DM) by analyzing participants’ risk of DM according to the age of DM onset in parents and siblings, and to evaluate individuals’ risk of DM-associated cardiometabolic diseases.

METHODS

Altogether, 211,173 participants aged ≥40 years from the Korean Genome and Epidemiology Study were included in this study. The participants were divided into groups based on the number (1 or 2 relatives) and age of onset (no DM and early, common, or late onset) of familial DM. Participants’ risk of DM was assessed using a Cox regression model with hazard ratios and 95% confidence intervals (CIs). A logistic regression model with odds ratios was used to evaluate associations among the participants’ likelihood of acquiring cardiometabolic diseases such as hypertension, chronic kidney disease (CKD), and cardiovascular disease.

RESULTS

The risk of developing DM was 2.02-fold (95% CI, 1.88 to 2.18) and 2.88-fold (95% CI, 2.50 to 3.33) higher, respectively, in participants with 1 and 2 family members diagnosed with familial DM. It was 2.72-fold (95% CI, 2.03 to 3.66) higher in those with early-onset familial DM. In the early-onset group, the respective risks of hypertension and CKD were 1.87-fold (95% CI, 1.37 to 2.55) and 4.31-fold (95% CI, 2.55 to 7.27) higher than in the control group.

CONCLUSIONS

The risk of DM and related cardiometabolic diseases was positively associated with the number of family members diagnosed with DM and an early diagnosis in family members with DM.

Summary

Korean summary
본 연구는 한국인유전체역학조사사업 역학자료를 이용하여, 당뇨병을 진단받은 가족 구성원 (부모 및 형제)의 수가 많고 당뇨병이 조기에 발생할수록 개인의 당뇨발생 위험도가 높아짐을 보고하였습니다. 또한 당뇨병이 조기에 발생한 가족구성원이 있을 경우 개인의 일부 심대사질환과의 연관성이 있을 수 있음을 설명하였습니다.

Key Message
This study demonstrated that the risk of diabetes in individuals was significantly associated with the quantity and the onset of family members diagnosed with diabetes. We also explained that having a family member with early-onset diabetes can be associated with some cardiometabolic diseases in individuals.

Citations

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Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults
Jung-Hwan Kim, Yaeji Lee, Chung-Mo Nam, Yu-Jin Kwon, Ji-Won Lee
Endocrine.2024; 86(2): 528. CrossRef

COVID-19: Brief Communication

Prevalence of SARS-CoV-2 infection among urban cleaning and solid waste management workers during transmission of the Omicron variant in Brazil: Paulo Ricardo Martins-Filho, Joyce Thayane da Conceição dos Santos, Márcia Santos Rezende, Fernanda Oliveira de Carvalho, Érica Santos dos Reis, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Cliomar Alves dos Santos, Lucindo José Quintans-Júnior, Renata Grespan, Cristiane Bani Corrêa, Tatiana Rodrigues de Moura, Dulce Marta Schimieguel, Jullyana de Souza Siqueira Quintans, Adriano Antunes de Souza Araújo; Epidemiol Health. 2023;45:e2023025. Published online February 16, 2023; DOI: https://doi.org/10.4178/epih.e2023025

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Abstract Summary PDF

Abstract

This study estimated the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in urban cleaning and solid waste management workers during the transmission of the Omicron variant in one of the poorest regions of Brazil (the state of Sergipe). Nasopharyngeal swabs were collected from 494 workers, and the presence of SARS-CoV-2 RNA was tested by quantitative reverse-transcriptase polymerase chain reaction. Data on socio-demographic characteristics, comorbidities, vaccination status, mask use, and use of public transport to commute to the workplace were collected. The prevalence with a 95% confidence interval (CI) was calculated from the proportion of SARS-CoV-2 positive cases among the total number of individuals tested. The prevalence ratio (PR) with a 95% CI was the measure of association used to evaluate the relationship between SARS-CoV-2 infection and the exposure variables. The prevalence of SARS-CoV-2 infection was 22.5% (95% CI, 19.0 to 26.4). Individuals under the age of 40 had a higher prevalence of infection (PR, 1.53; 95% CI, 1.03 to 2.30) as well as those who did not believe in the protective effect of vaccines (PR, 1.78; 95% CI, 1.05 to 2.89). Our results indicate the need for better guidance on preventive measures against coronavirus disease 2019 among urban cleaning and solid waste management workers.

Summary

Key Message
Urban cleaning and waste management workers in Brazil faced a significant risk of SARSCoV-2 infection during the Omicron variant transmission, with higher rates observed among younger individuals and those skeptical about vaccine protection.

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Original Articles

Health-adjusted life expectancy according to lifestyle classified by the Yonsei Lifestyle Profile-BREF: Sanghun Nam, Kang-Hyun Park, Ji-Hyuk Park, Ickpyo Hong; Epidemiol Health. 2022;44:e2022095. Published online October 28, 2022; DOI: https://doi.org/10.4178/epih.e2022095

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to investigate health-adjusted life expectancy (HALE) by demographic characteristics (sex, educational achievement, and residential area) according to the lifestyle classifications of the Yonsei Lifestyle Profile-BREF (YLP-BREF).
METHODS
This study included 569 participants aged 55 years or older living in Korea. The YLP-BREF domains were physical activity, activity participation, and nutrition.
RESULTS
Females had a longer HALE (mean±standard deviation, 8.90±5.06 years) in the physical activity domain, while males had a longer HALE in the nutrition domain (9.44±5.91 years). People living in rural areas had longer HALE in physical activity (12.02±5.60 years), activity participation (8.58±4.21 years), and nutrition (11.33±6.43 years). There were no significant differences according to sex or residential area. High school graduates showed the longest HALE (physical activity: 10.38± 6.89; activity participation: 7.64±4.29; nutrition: 9.59±6.40 years). There was a significant difference in educational achievement.
CONCLUSIONS
As people age, the demand for a healthy lifestyle increases. This study attempted to calculate HALE by demographic characteristics according to lifestyle. The results of this study will help inform future research directions for providing a healthy lifestyle.; Summary

Korean summary
본 연구는 Yonsei Lifestyle Profile-BREF(YLP-BREF)의 라이프스타일 분류에 따른 인구통계학적 특성(성별, 주거지역, 학력)에 따른 건강조정수명(Health-Adjusted Life Expectancy; HALE)을 알아보고자 하였다. 본 연구에서 사용한 자료는 한국에 거주하는 55세 이상의 569명이 포함되었으며, YLP-BREF는 신체활동, 활동참여, 영양으로 총 세 영역으로 구성되어 있다. 본 연구 결과, 성별에 따른 건강조정수명은 영양에서 9.44세로 남성이 가장 높았으며, 거주지역은 따른 건강조정수명은 신체활동 영역에서 농촌이 12.02세로 가장높았고, 학력에 따른 건강조정수명은 신체활동 영역에서 고등학교 졸업자가 10.38세로 가장 높았다. 본 연구 결과는 건강한 라이프스타일을 인구통계학적 특성에 따라 제공하기 위한 향후 연구 방향을 제시하는 데 도움이 될 것으로 사료된다.

Key Message
This study investigated Health-Adjusted Life Expectancy (HALE) according to demographic characteristics (sex, residence, educational achievement) according to lifestyle classification of Yonsei Lifestyle Profile-BREF. As a result of this study, the HALE by gender was the highest in nutrition at 9.44 years, and the HALE by residential area was the highest in physical activity at 12.02 years in rural areas, and the HALE by education was in physical activity. , high school graduates had the highest age at 10.38. The results of this study are considered to be helpful in suggesting future research directions for providing a healthy lifestyle.

The associations of the national health and productivity management program with corporate profits in Japan: Yuichiro Yano, Hiroshi Kanegae, Koichi Node, Atsushi Mizuno, Akira Nishiyama, Hiromi Rakugi, Hiroshi Itoh, Kaori Kitaoka, Naoki Kashihara, Fumiaki Ikeno, Ichiro Tsuji, Kunio Okada; Epidemiol Health. 2022;44:e2022080. Published online September 23, 2022; DOI: https://doi.org/10.4178/epih.e2022080

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Abstract

OBJECTIVES
Using a dataset from a survey on national health and productivity management, we identified health and productivity factors associated with organizational profitability.

METHODS

The Ministry of Economy, Trade and Industry conducted an annual survey on Health and Productivity Management between 2014 and 2021. We assessed the associations of organizational health and productivity management using survey questions collected in 2017 and 2018, with the rate of change in profits from 2017 and 2018 to 2020. We identified factors associated with organizational profitability using eXtreme Gradient Boosting, and calculated SHapley Additive exPlanation (SHAP) values for each factor.

RESULTS

Among 1,593 companies (n= 4,359,834 employees), the mean age of employees at baseline was 40.3 years and the proportion of women was 25.8%. A confusion matrix for evaluating model performance had an accuracy of 0.997, precision of 0.993, recall of 0.997, and area under the precision-recall curve of 0.999. The most important factors related to an increase in corporate profits were the percentage of current smokers (SHAP value, 0.121), per-employee cost of health services (0.084) and medical services (0.050); the percentage of full-time employees working in sales departments (0.074) and distribution or customer service departments (0.054); the percentage of employees who slept well (0.055); and the percentage of employees within a company who regularly exercised (0.043).

CONCLUSIONS

Employees’ lifestyle-related health risk factors and organizations’ management systems were associated with organizational profitability. Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce.

Summary

Key Message
Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce

Citations

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Systematic Review

The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis: Phei Nie Yau, Clairen Jia Ern Foo, Nicholas Li Jie Cheah, Kar Foong Tang, Shaun Wen Huey Lee; Epidemiol Health. 2022;44:e2022058. Published online July 12, 2022; DOI: https://doi.org/10.4178/epih.e2022058

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region.

METHODS

A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis.

RESULTS

Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life.

CONCLUSIONS

Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.

Summary

Key Message
Highly common and disabling among older adults in ASEAN region, functional disability limits the ability to carry out activities of daily living, and markedly reduces life quality.

Citations

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Original Articles

The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database: Seon-Rye Kim, Minkook Son, Yu-Rin Kim; Epidemiol Health. 2022;44:e2022055. Published online July 5, 2022; DOI: https://doi.org/10.4178/epih.e2022055

20,355 View
338 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis.

METHODS

Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index.

RESULTS

In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities.

CONCLUSIONS

Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.

Summary

Korean summary
만성치주질환을 가진 노인에서 스타틴 복용순응도가 낮은 그룹에 비해 높은 그룹이 뇌졸증 발생위험이 낮았다. 특히 여성과 후기 노인 (85세 이상), 동반 질환을 가진 그룹에서 유의한 차이가 있었다. 따라서 스타틴 복용 순응도를 증대시키기 위한 의료진의 노력이 필요할 것이다.

Key Message
The stroke risk of chronic periodontal disease patients was related to statin medication compliance, and the effect of stroke risk was different in women, the elderly, and comorbidities.

Citations

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Joonsang Yoo, Joo Youn Shin, Jimin Jeon, Jinkwon Kim
Epidemiology and Health.2023; 45: e2023035. CrossRef

The vaccination coverage rate in under-5 children in Nasiriyah, Iraq before and during the COVID-19 pandemic: Ali Rifaat Alhaddad, Elham Ahmadnezhad, Akbar Fotouhi; Epidemiol Health. 2022;44:e2022035. Published online March 14, 2022; DOI: https://doi.org/10.4178/epih.e2022035

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Abstract

providOBJECTIVES: This study compared the vaccination coverage rate (VCR) in children under 5 years old in Nasiriyah, Iraq before and during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants’ parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors.

RESULTS

The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p<0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively).

CONCLUSIONS

The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.

Summary

Key Message
Vaccination is one of the most important essential health services. COVID-19 pandemic has reduced the coverage of vaccination among under five.

Citations

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Impact of measles vaccination on clinical characteristics and outcomes in children in Ramadi, Iraq
Sou’dad Khaled Mawlood, Mohammed Maher Al-Ani, Raid M Al-Ani, Asfar Alshibib
World Journal of Clinical Pediatrics.2025;[Epub] CrossRef
Achieving immunization milestones: Insights from Oman’s national coverage survey
Bader Al-Rawahi, Prakash K. P., Noura Al-Farsi, Mariyam Al-Shaibi, Athari Al-Jahwari, Bader Al-Abri, Seif Al-Abri, Mohamed Samy Abousenna
PLOS One.2025; 20(7): e0327788. CrossRef
The influence of the COVID-19 pandemic on measles vaccination coverage
Gustavo de Almeida Santos, Expedito José de Albuquerque Luna
Cadernos de Saúde Pública.2025;[Epub] CrossRef
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Narjes Sargolzaei, Saeedeh Sarhadi, Gamy Hashemzehi, Sahar Lakzaee
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COVID-19 infections among Iraqi school students: Severity, types, and symptoms
Saad Hantoosh
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Current Impact and Long-Term Influence of the COVID-19 Pandemic on Iraqi Healthcare Systems: A Case Study
Taysir Al Janabi, Sunny Chung
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Model-based cost-effectiveness analysis of oral antivirals against SARS-CoV-2 in Korea: Youngji Jo, Sun Bean Kim, Munkhzul Radnaabaatar, Kyungmin Huh, Jin-Hong Yoo, Kyong Ran Peck, Hojun Park, Jaehun Jung; Epidemiol Health. 2022;44:e2022034. Published online March 12, 2022; DOI: https://doi.org/10.4178/epih.e2022034

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Many countries have authorized the emergency use of oral antiviral agents for patients with mild-to-moderate cases of coronavirus disease 2019 (COVID-19). We assessed the cost-effectiveness of these agents for reducing the number of severe COVID-19 cases and the burden on Korea’s medical system.

METHODS

Using an existing model, we estimated the number of people who would require hospital/intensive care unit (ICU) admission in Korea in 2022. The treatment scenarios included (1) all adult patients, (2) elderly patients only, and (3) adult patients with underlying diseases only, compared to standard care. Based on the current health system capacity, we calculated the incremental costs per severe case averted and hospital admission for each scenario.

RESULTS

We estimated that 236,510 COVID-19 patients would require hospital/ICU admission in 2022 with standard care only. Nirmatrelvir/ritonavir (87% efficacy) was predicted to reduce this number by 80%, 24%, and 17% when targeting all adults, adults with underlying diseases, and elderly patients (25, 8, and 4%, respectively, for molnupiravir, with 30% efficacy). Nirmatrelvir/ritonavir use is likely to be cost-effective, with predicted costs of US$8,878, US$8,964, and US$1,454, per severe patient averted for the target groups listed above, respectively, while molnupiravir is likely to be less cost-effective, with costs of US$28,492, US$29,575, and US$7,915, respectively.

CONCLUSIONS

In Korea, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients targeting elderly patients would be highly cost-effective and would substantially reduce the demand for hospital admission to below the capacity of the health system if targeted to all adult patients instead of standard care.

Summary

Korean summary
본 연구는 감염병 수리모형을 바탕으로 두가지 항바이러스제의 (nirmatrelvir/ritonavir와 molnupiravir) 비용 효익을 평가하였다. 본 모델에 따르면, 2022년 한국에서, 현재 의료시스템의 수용한계를 넘는 코로나 19 대유행이 발생할 때, nirmatrelvir/ritonavir 를 코로나 감염 및 증상 있는 고령층 환자들을 대상으로 투여할 경우 높은 비용 효익이 기대되고 (중증환자 1명 감소효과에$1,454 비용소요), 성인 환자 대상으로 투여할 경우, (molnupiravir이나 nirmatrelvir/ritonavir를 투여하지 않는) 일반 치료에 비해서 전체 입원 수요를 80% 줄일 것으로 기대된다.

Key Message
Given an expected high epidemic resurgence in 2022 that could exceed South Korea’s current health system capacity, oral treatment using nirmatrelvir/ritonavir for symptomatic COVID-19 patients may be a highly cost-effective solution if targeted to elderly patients ($1,454 per severe case averted) and substantially reduce the demand for hospital admission (80%, 188,478 patients) below the capacity of the health system if targeted to all adult patients compared to standard care.

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Akira Yuasa, Hiroyuki Matsuda, Yosuke Fujii, Tendai Mugwagwa, Yuki Kado, Mizuki Yoshida, Koichi Murata, Yoshiaki Gu
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Cost-effectiveness Analysis of Nirmatrelvir/Ritonavir Compared with Molnupiravir in Patients at High Risk for Progression to Severe COVID-19 in Japan
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Yi Zhang, Yuezhen Zhu, Hui Yang, Chunguo Jiang, Wanying Chen, Hui Zhang, Xintong Zhang, Han Wu, Jia Li, Zhuoling An
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The medium-term consequences of a COVID-19 lockdown on lifestyle among Spanish older people with hypertension, pulmonary disease, cardiovascular disease, musculoskeletal disease, depression, and cancer: Irene Rodríguez-Gómez, Coral Sánchez-Martín, Francisco J. García-García, Esther García-Esquinas, Marta Miret, Germán Vicente-Rodriguez, Narcís Gusi, Asier Mañas, José A. Carnicero, Marcela Gonzalez-Gross, José L. Ayuso-Mateos, Fernando Rodríguez-Artalejo, Leocadio Rodríguez-Mañas, Ignacio Ara; Epidemiol Health. 2022;44:e2022026. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022026

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated the associations of chronic diseases with changes in lifestyle and health behaviours in older people following the coronavirus disease 2019 (COVID-19) lockdown in Spain and compared the differences in changes over time.

METHODS

1,092 participants (80.3±5.6 years; 66.5% female) from 2 Spanish cohorts were included. Telephone-based questionnaires were conducted to evaluate lifestyle and health risk behaviours at the end of lockdown and 7 months post-lockdown. Participants were classified as having physician-diagnosed chronic diseases based on self-reported data. Cox proportional models adjusted for major confounders were used.

RESULTS

Compared to those without the corresponding chronic diseases, older people with hypertension were less likely to report increased alcohol consumption (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55 to 0.99). Pulmonary diseases were associated with lower risks of increased sedentary time (HR, 0.58; 95% CI, 0.39 to 0.86) and worsened sleep quality (HR, 0.56; 95% CI, 0.36 to 0.87), while cardiovascular diseases were associated with a lower risk of decreased sedentary time (HR, 0.58; 95% CI, 0.38 to 0.88). Depression was linked to a higher likelihood of improved diet quality (HR, 1.53; 95% CI, 1.00 to 2.36). Cancer pacients were less likely to have worsened sleep quality (HR, 0.44; 95% CI, 0.22 to 0.89) but more likely to have reduced their frequency of social contact (HR, 2.05; 95% CI, 1.05 to 3.99).

CONCLUSIONS

Older people with chronic diseases showed beneficial changes in lifestyle and health risk behaviours after the COVID-19 lockdown. In particular, older people with hypertension, pulmonary disease, and cancer tended to make beneficial lifestyle and health behaviour changes. However, older people with cardiovascular disease and depression engaged in more health risk behaviours.

Summary

Key Message
Although the majority of older people with chronic diseases showed beneficial changes in lifestyle and health risk behaviors after the COVID-19 lockdown, public health interventions should be developed to prevent the dangerous long-term effects that COVID-19 pandemic-type situations may have on the health of older people, with a particular focus on older people with CVD and depression that seem to have experienced more health risk behaviors during the COVID-19 pandemic than older people with other chronic diseases.

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Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods
Min Du, Min Liu, Yaping Wang, Chenyuan Qin, Jue Liu
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The relationship between poor sleep quality measured by the Pittsburgh Sleep Quality Index and smoking status according to sex and age: an analysis of the 2018 Korean Community Health Survey: Jun Hyun Hwang, Soon-Woo Park; Epidemiol Health. 2022;44:e2022022. Published online February 14, 2022; DOI: https://doi.org/10.4178/epih.e2022022

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Multiple studies have found that cigarette smokers are more likely to experience sleep disturbances than non-smokers. This study aimed to examine various associations between smoking and sleep quality according to sex and age, which have yet to be sufficiently examined in prior studies.

METHODS

Data analysis was conducted using a nationally representative sample of 224,986 Korean adults who participated in the 2018 Korea Community Health Survey. Sleep quality, as the dependent variable, was measured using the Pittsburgh Sleep Quality Index (PSQI), with PSQI scores indicating either good (≤4 points) or poor (>5 points) sleep quality. Multiple logistic regression analysis was performed considering socio-demographic factors, health behaviors, comorbidities, and psychological factors as covariates.

RESULTS

The overall weighted prevalence of poor sleep quality was 39.4% (95% confidence interval, 39.1 to 39.7). In the multivariate model that excluded psychological factors, poor sleep quality positively correlated to smoking for both sexes and all age groups except for male aged ≥65 years. However, in the full model that included psychological factors, statistically significant odds ratios (approximately 1.5) for poor sleep quality according to smoking status were only observed for female under 65 years of age.

CONCLUSIONS

The relationship between poor sleep quality and smoking status differed according to sex and age. In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.

Summary

Korean summary
한국 성인의 39.4%는 수면의 질(피츠버그 수면의 질 지수(PSQI) 기준)이 낮았다. 성별 및 연령에 따라 흡연과 수면의 질 사이의 관련성은 다르게 나타났다. 구체적으로는 65세 이하의 여성에서 흡연은 수면의 질 악화와 관련성이 있었으나, 남성 또는 65세 이상 여성에서는 흡연과 수면의 질 간 유의한 관련성을 보이지 않았다.

Key Message
In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.

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Data Profile

The Korea National Health and Nutrition Examination Survey data linked Cause of Death data: Sungha Yun, Kyungwon Oh; Epidemiol Health. 2022;44:e2022021. Published online February 9, 2022; DOI: https://doi.org/10.4178/epih.e2022021

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Abstract

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.

Summary

Korean summary
1. 국민건강영양조사 자료가 사망 위험요인 규명 연구에 활용되도록 통계청의 사망원인통계와 연계자료 구축함 2. 2007~2015년 국민건강영양조사와 2007~2019년 사망원인통계의 연계율은 97.1%이었음 3. 국민건강영양조사-사망원인통계 연계자료는 2020년부터 연구자에게 질병관리청 내 학술연구자료처리실를 통해 제공되고 있음

Key Message
1. To utilize the Korea National Health and Nutrition Examination Survey (KNHANES) data to studies of mortality risk factors, the data were linked to the Cause of Death Statistics in the Statistics Korea. 2. The linkage rate between the 2007-2015 KNHANES and the 2007-2019 Cause of Death Statistics was 97.1%. 3. The Korea National Health and Nutrition Examination Survey data linked Cause of Death data have been provided to researchers through the Research Data Center in the Korea Disease Control and Prevention Agency (KDCA) since 2020.

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Original Articles

Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis: Hwa Jeong Seo, Hyun Sook Oh; Epidemiol Health. 2021;43:e2021103. Published online December 17, 2021; DOI: https://doi.org/10.4178/epih.e2021103

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated the effectiveness of early medication treatment and metformin use for cancer prevention in type 2 diabetes patients.

METHODS

Population-based cohort data were used from the Korean National Health Insurance Service-National Sample Cohort database (KNHIS-NSC) for 2002-2013. Patient-specific medication prescription status was defined by the landmark time (LMT; a fixed time after cohort entry), considering both pre- and post-LMT prescriptions to control methodological biases in observational research. The LMT was set to 2 years. Logistic regression analysis with multivariable adjustment was conducted to analyze cancer incidence by patient-specific medication prescription status.

RESULTS

Only 33.4% of the subjects were prescribed medication early (before the LMT) with compliance. Cancer incidence in individuals with early prescription and compliance was 25% lower (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.67 to 0.84) than in those without. As early-prescribed medications, metformin monotherapy and metformin combination therapy were associated with 34% (OR, 0.66; 95% CI, 0.51 to 0.83) and 25% (OR, 0.75; 95% CI, 0.64 to 0.88) lower cancer risk than non-use, respectively. Patients who were prescribed late (post-LMT) but did not comply with the prescription had a 24% (OR, 1.24; 95% CI, 0.97 to 1.58) higher cancer incidence than non-users. Among patients who started monotherapy early without changes throughout the entire follow-up period, those who started on metformin had a 37% (OR, 0.63; 95% CI, 0.41 to 0.99) lower risk of cancer than non-metformin users.

CONCLUSIONS

Doctors must prescribe antidiabetic medication early, and patient compliance is required, regardless of the prescription time, to prevent cancer. Metformin monotherapy or combination therapy is recommended as an early prescription.

Summary

Korean summary
당뇨 환자는 암 발병 위험이 높으며 암은 주요 사망 원인이다. 당뇨환자의 암발생 예방을 위한 관리로서, 당뇨병 진단 후 약물 치료 시기에 대한 연구는 부족하다. 또한, 전 세계적으로 가장 흔히 처방되는 당뇨병 치료제인 메트포민은 암 예방 효과가 있다고 알려져 왔으나 관측연구에서 발생하는 선택 편향의 문제가 제기되었고, 최근 일부 연구에서 기존의 암 예방 효과와 상충되는 결과가 나오고 있어 논쟁이 이어지고 있다. 본 연구는 선택 편향을 통제한 코호트 연구에서 조기 약물 치료와 메트포민 사용이 당뇨환자의 암 예방에 효과적임을 밝혔다. 따라서 의사들은 처음 당뇨 진단을 받은 환자에게 조기에 약물 처방을 하고, 환자들은 처방에 잘 따라야 한다. 조기 처방 약물로서 메트포민이 권장된다.

Key Message
Diabetic patients have a high risk of developing cancer, and cancer is the leading cause of death. There are few studies on the timing of medication treatment after diagnosis of diabetes. In addition, metformin, the most commonly prescribed diabetes treatment worldwide, is known to have cancer-preventive effects, but the problem of selection bias that occurs in observational studies has been raised, and some studies have recently been contradicting the existing cancer-preventing effects of metformin. This study, in a cohort study controlled for selection bias, demonstrated that early medication treatment and metformin use were effective in preventing cancer in diabetic patients.

Citations

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Association between metformin use and the risk of developing open-angle glaucoma among patients with diabetes: a retrospective cohort study and meta-analysis
Hong Kyu Kim, Wanhyung Lee, Ik Hee Ryu, Jin Kuk Kim, Hyungsu Kim, Tae Keun Yoo
International Ophthalmology.2024;[Epub] CrossRef
Metformin and HER2-positive breast cancer: Mechanisms and therapeutic implications
Sara S Bashraheel, Hadeel Kheraldine, Sarah Khalaf, Ala-Eddin Al Moustafa
Biomedicine & Pharmacotherapy.2023; 162: 114676. CrossRef
Effects of millimeter-wave for preventing joint stiffness in the immobilized knee rat model
Xiao-ping Shui, Feng Ye, Chun-ying Li, Xin Zhang, Min-jia Wang, Bin Li, Ke Chen, Ying-ying Liao
The Knee.2023; 42: 236. CrossRef

Words are not just words: how the use of media language in the COVID-19 era affects public health: Georgios P. Georgiou; Epidemiol Health. 2021;43:e2021072. Published online September 23, 2021; DOI: https://doi.org/10.4178/epih.e2021072

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Abstract Summary PDF

Abstract

OBJECTIVES
Language can shape the way we perceive the world. In this paper, we investigated how exposure to media texts containing alarming and militaristic language affects peoples’ notions regarding coronavirus disease 2019 (COVID-19) and the consequences of this effect for public health.

METHODS

After reading a passage including either alarming and militaristic or neutral terminology on COVID-19, participants completed a questionnaire in which they answered 4 questions on a 7-point Likert scale. The questions assessed participants’ notions on the end of the pandemic, vaccine effectiveness, and the consequences of COVID-19 for economies and mental health. Ordinal regression models in R were used for the analysis.

RESULTS

Individuals who were exposed to alarming and militaristic language expressed more pessimistic notions regarding COVID-19 than those who were exposed to more neutral language. However, both groups of individuals had similar notions regarding vaccine effectiveness.

CONCLUSIONS

The media should redefine the language they use for the description of the pandemic, considering that the extensive use of alarming and militaristic terminology may have a negative impact on public health.

Summary

Key Message
This study shows that exposure to alarming and militaristic terminology creates pessimistic notions about COVID-19. The media should avoid the extensive use of such terminology for the description of the pandemic, as this can negatively affect public health.

Citations

Citations to this article as recorded by

Reporting maternal deaths in Anglophone West Africa: A media content analysis of articles published online between 2015 and 2025
Kiran Roy, Noimot Balogun, Aduragbemi Banke-Thomas, Emmanuel Olamijuwon
PLOS Global Public Health.2026; 6(4): e0006254. CrossRef
Examining the association between the COVID-19 pandemic and self-harm death counts in four Canadian provinces
Shelly Isnar, Mark Oremus
Psychiatry Research.2022; 310: 114433. CrossRef
How Has COVID-19 Impacted Our Language Use?
Francesca Pisano, Alessio Manfredini, Daniela Brachi, Luana Landi, Lucia Sorrentino, Marianna Bottone, Chiara Incoccia, Paola Marangolo
International Journal of Environmental Research and Public Health.2022; 19(21): 13836. CrossRef

The age-standardized incidence, mortality, and case fatality rates of COVID-19 in 79 countries: a cross-sectional comparison and their correlations with associated factors: Dongui Hong, Sohyae Lee, Yoon-Jung Choi, Sungji Moon, Yoonyoung Jang, Yoon-Min Cho, Hyojung Lee, Sukhong Min, Hyeree Park, Seokyung Hahn, Ji-Yeob Choi, Aesun Shin, Daehee Kang; Epidemiol Health. 2021;43:e2021061. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021061

39,814 View
413 Download
15 Web of Science
13 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, crude incidence and mortality rates have been widely reported; however, age-standardized rates are more suitable for comparisons. In this study, we estimated and compared the age-standardized incidence, mortality, and case fatality rates (CFRs) among countries and investigated the relationship between these rates and factors associated with healthcare resources: gross domestic product per capita, number of hospital beds per population, and number of doctors per population.

METHODS

The incidence, mortality, and CFRs of 79 countries were age-standardized using the World Health Organization standard population. The rates for persons 60 years or older were also calculated. The relationships among the rates were analysed using trend lines and coefficients of determination (R2). Pearson correlation coefficients between the rates and the healthcare resource-related factors were calculated.

RESULTS

The countries with the highest age-standardized incidence, mortality, and CFRs were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively. The R2 between the incidence and mortality rates was 0.852 for all ages and 0.945 for those 60 years or older. The healthcare resources-related factors were associated positively with incidence rates and negatively with CFRs, with weaker correlations among the elderly.

CONCLUSIONS

Compared to age-standardized rates, crude rates showed greater variation among countries. Medical resources may be important in preventing COVID-19-related deaths; however, considering the small variation in fatality among the elderly, preventive measures such as vaccination are more important, especially for the elderly population, to minimize the mortality rates.

Summary

Korean summary
국가별 발생률, 사망률, 치명률을 WHO 표준 인구로 연령표준화하였고, 의료자원과 관계된 지표와의 상관관계를 파악하였다. 2021년 4월 6일 기준, 연령표준화 발생률, 사망률, 치명률이 가장 높은 나라는 각각 체코 (10만명당 14,253명), 멕시코 (10만명당 182명), 멕시코 (6.7%)이며, 60세 이상 노인은 사망률과 치명률이 더 높은 것으로 나타났다. 1인당GDP, 인구당 의사 수, 인구당 병상 수는 발생률과 양의 상관관계가, 치명률과는 음의 상관관계가 있었고 노인에게서는 상관관계가 약하게 나타났다. 코로나바이러스감염증-19로 인한 피해를 최소화하기 위해서 의료자원의 투입과 더불어 노인의 감염예방이 중요할 것이다.

Key Message
The incidence, mortality, and case fatality rates of 79 countries were age-standardized using the WHO standard population. The correlations between the rates and the healthcare resource-related factors were investigated. As of April 6, 2021, the countries with the highest age-standardized incidence, mortality, and case fatality rates were Czechia (14,253 cases/100,000), Mexico (182 deaths/100,000), and Mexico (6.7%), respectively; the mortality and case fatality rates were higher among the elderly. GDP per capita, number of hospital beds per population, and number of doctors per population were associated positively with incidence rate, and negatively with case fatality rates: the correlations were weaker among the elderly. To minimize the burden caused by COVID-19, preventing the elderly from infection is important as well as supply of medical resources.

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Evolving burden of metabolic dysfunction–associated steatotic liver disease and its complications in a US nationwide healthcare system
Basim Ali, Ronald Samuel, Jennifer R. Kramer, Liang Li, Xian Yu, Yumei Cao, Roxanne Desiderio, George Cholankeril, Steven M. Asch, Hashem B. El-Serag, Fasiha Kanwal
Hepatology Communications.2026;[Epub] CrossRef
COVID-19 case fatality rate and infection fatality rate from 2020 to 2023: Nationwide analysis in Austria
Uwe Riedmann, Alena Chalupka, Lukas Richter, Martin Sprenger, Wolfgang Rauch, Robert Krause, Peter Willeit, Harald Schennach, Bernhard Benka, Dirk Werber, Tracy Beth Høeg, John PA Ioannidis, Stefan Pilz
Journal of Infection and Public Health.2025; 18(4): 102698. CrossRef
Occurrence of COVID-19 and serum per- and polyfluoroalkyl substances: A case-control study among workers with a wide range of exposures
Anna K. Porter, Sarah E. Kleinschmidt, Kara L. Andres, Courtney N. Reusch, Ryan M. Krisko, Oyebode A. Taiwo, Geary W. Olsen, Matthew P. Longnecker
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Age-standardization and Standard Population
Dongui Hong, Sohyae Lee, Kyu-Won Jung, Aesun Shin
Journal of Health Informatics and Statistics.2023; 48(Suppl 1): S15. CrossRef
Topic and Trend Analysis of Weibo Discussions About COVID-19 Medications Before and After China’s Exit from the Zero-COVID Policy: Retrospective Infoveillance Study
Duo Lan, Wujiong Ren, Ke Ni, Yicheng Zhu
Journal of Medical Internet Research.2023; 25: e48789. CrossRef
Rapid establishment of a dedicated COVID-19 hospital in Mexico city during a public health crisis
Roberto Tapia-Conyer, Rafael Ricardo Valdez-Vázquez, Julieta Lomelín-Gascón, Rodrigo Saucedo-Martínez, Luis Alberto Martinez-Juarez, Héctor Gallardo-Rincón
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Iván de Jesús Ascencio-Montiel, Oscar David Ovalle-Luna, Ramón Alberto Rascón-Pacheco, Victor Hugo Borja-Aburto, Gerardo Chowell
BMC Infectious Diseases.2022;[Epub] CrossRef
Global burden of calcific aortic valve disease and attributable risk factors from 1990 to 2019
Jiaye Yu, Zhuo Wang, Qinyi Bao, Shuxin Lei, Yayu You, Zhehui Yin, Xiaojie Xie
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Is it possible to prepare for a pandemic?
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Time-series comparison of COVID-19 case fatality rates across 21 countries with adjustment for multiple covariates
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Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
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Epidemiology and Health.2022; 44: e2022110. CrossRef

Recent increase in pertussis incidence in Korea: an age-period-cohort analysis: Chanhee Kim, Seonju Yi, Sung-il Cho; Epidemiol Health. 2021;43:e2021053. Published online August 18, 2021; DOI: https://doi.org/10.4178/epih.e2021053

25,987 View
248 Download
10 Web of Science
12 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Pertussis or whooping cough—one of the most contagious diseases—is caused by the Gram-negative bacterium Bordetella pertussis. Despite a high vaccination rate, Korea recently experienced a resurgence of pertussis. This study explores patterns and possible explanations for this resurgence through an age-period-cohort analysis.

METHODS

Using secondary data from the infectious disease portal of the Korea Disease Control and Prevention Agency and the Korea Statistical Information Service of Statistics Korea, this study analyzed the incidence of pertussis in Korea to determine which factors contributed to the recent increase using an age-period-cohort model.

RESULTS

Analysis of the age effect indicated that the age group most vulnerable to pertussis was 0-year to 2-year-olds. Analysis of the period effect showed a sharp increase in the incidence rate after 2016. Analysis of the cohort effect showed a significant decrease in incidence beginning with the 1955 birth cohort, with the risk increasing again with the 2000s birth cohort.

CONCLUSIONS

Previous studies have suggested 3 main possible explanations for our results. First, the increased incidence rate can be attributed to contact rates. Second, the rate of immunity through natural exposure has decreased due to the low number of circulating pathogens, in turn affecting the trend of infection. Lastly, variations in pathogens may have also contributed to the increase in incidence. Given that the most significant increase in incidence was observed among infants younger than 1 year old, sufficient maternal immunity must be prioritized to provide passive immunity to newborns via the placenta.

Summary

Korean summary
본 연구는 연령-기간-코호트 모델을 활용하여 예방접종률이 높은 국가들의 백일해 재출현에 기여하는 요인에 무엇이 있는지 살펴보았다. 연령에 따른 사회적 접촉률(contact rate)의 변화, 자연노출에 의한 면역 강화(natural boosting) 기회의 감소, 그리고 백일해 병원체의 변이가 백일해 재출현의 원인일 수 있다. 분석 결과 영아 집단에서 백일해 발병률이 가장 급격한 증가가 관찰되었으며, 이는 모성면역의 확보가 중요하다는 점을 시사한다.

Key Message
This study examined factors contribute to the re-emergence of pertussis in countries with high vaccination rates using the age-period-cohort model. Changes in social contact rates according to age, reduction in immune boosting opportunities by natural exposure, and variations in pertussis pathogens may be the cause of re-emergence. As a result of the analysis, the sharpest increase in the incidence of pertussis in the infant group was observed, suggesting that securing maternal immunity is important.

Citations

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Pertussis in the Post-COVID-19 Era: Resurgence, Diagnosis, and Management
Hyun Mi Kang, Taek-Jin Lee, Su Eun Park, Soo-Han Choi
Infection & Chemotherapy.2025; 57(1): 13. CrossRef
Pertussis epidemic in Korea and implications for epidemic control
Joowon Lee
Infectious Diseases.2025; 57(2): 207. CrossRef
Epidemiological features of the 2024 pertussis outbreak in Gyeonggi Province, Korea
Yeon Hwa Chang, Kyujin Chang, Yeong Jun Ju
Epidemiology and Health.2025; 47: e2025072. CrossRef
2023–2024절기 경상남도 백일해 유행조사 보고
유진 조, 아라 김, 혜림 박, 다혜 안, 슬기 양, 연정 김
Public Health Weekly Report.2024; 17(26): 1143. CrossRef
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Lele Deng, Yajun Han, Jinlong Wang, Haican Liu, Guilian Li, Dayan Wang, Guangxue He
International Journal of Environmental Research and Public Health.2023; 20(5): 3946. CrossRef
Incidence and Healthcare Burden of Pertussis among Older Adults with and without Pre-Existing Chronic Obstructive Pulmonary Disease or Asthma in South Korea
Jing Chen, Ju-Young Shin, Hyungwoo Kim, Ju Hwan Kim, Ahhyung Choi, Hee Jin Cheong, Yeon-Mok Oh, Adrienne Guignard, Sumitra Shantakumar
COPD: Journal of Chronic Obstructive Pulmonary Disease.2023; 20(1): 126. CrossRef
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Allergy, Asthma & Immunology Research.2023; 15(5): 673. CrossRef
Post-Marketing Surveillance of Tetravalent Diphtheria-Tetanus-Acellular Pertussis and Inactivated Poliovirus (DTaP-IPV) Vaccine in South Korea, 2009 to 2015
Young June Choe, Emmanuel Vidor, Christine Manson
Infectious Diseases and Therapy.2022; 11(4): 1479. CrossRef
ARIMA and ARIMA-ERNN models for prediction of pertussis incidence in mainland China from 2004 to 2021
Meng Wang, Jinhua Pan, Xinghui Li, Mengying Li, Zhixi Liu, Qi Zhao, Linyun Luo, Haiping Chen, Sirui Chen, Feng Jiang, Liping Zhang, Weibing Wang, Ying Wang
BMC Public Health.2022;[Epub] CrossRef
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Ewa Szwejser-Zawislak, Mieszko M. Wilk, Piotr Piszczek, Justyna Krawczyk, Daria Wilczyńska, Daniela Hozbor
Vaccines.2022; 11(1): 1. CrossRef

Health Statistics

A comparison of breast cancer survival across different age groups: a multicentric database study in Penang, Malaysia: King Fang Tan, Farzaana Adam, Hasmah Hussin, Noor Mastura Mohd Mujar; Epidemiol Health. 2021;43:e2021038. Published online May 25, 2021; DOI: https://doi.org/10.4178/epih.e2021038

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Abstract

This study compared breast cancer survival and the prognostic factors across different age groups of women in Penang, Malaysia. Data on 2,166 women with breast cancer who had been diagnosed between 2010 and 2014 were extracted from the Penang Breast Cancer Registry and stratified into 3 age groups: young (< 40 years old), middle-aged (40-59 years old), and elderly (≥ 60 years). The overall and relative survival rates were calculated using the life table method, median survival time was calculated using the Kaplan-Meier method, and comparisons between groups were conducted using the log-rank test. Prognostic factors were analyzed using a Cox proportional hazards model. The 5-year overall and breast cancer-specific survival rates for women with breast cancer in Penang were 72.9% and 75.2%, with a mean survival time of 92.5 months and 95.1 months, respectively. The 5-year breast cancer-specific survival rates for young, middle-aged, and elderly women were 74.9%, 77.8%, and 71.4%, respectively, with a mean survival time of 95.7 months, 97.5 months, and 91.2 months. There was a significant difference in breast cancer survival between age groups, with elderly women showing the lowest survival rate, followed by young and middle-aged women. Disease stage was the most prominent prognostic factor for all age groups. Survival rates and prognostic factors differed according to age group. Treatment planning for breast cancer patients should be age-specific to promote better cancer care and survival.

Summary

Key Message
The relationship between breast cancer survival and age at diagnosis has been explored, but information between survival at different age groups remains unclear, in addition to conflicting study results. This multicentre study was conducted to compare breast cancer survival across different age groups in an Asian setting.

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Esther Bastiaannet, Sophie Pilleron
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Ang Woan Yean, Elvynna Leong, Ong Sok King, Zulkhairi Mohamad
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Duc Tran Quang, Thanh Luong Thi, Khanh Nguyen Di, Chi Vu Thi Quynh, Huyen Nguyen Thi Hoa, Quang Phan Ngoc
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Han Lei, Baojie Hua, Yingying Mao, Wei Cui, Caiping Mao, Shaoxue Yang, Jiayu Li
Frontiers in Oncology.2024;[Epub] CrossRef
Five-year survival prognosis of young, middle-aged, and elderly adult female invasive breast cancer patients by clinical and lifestyle characteristics
Yu-Tung Teng, Yong Alison Wang, Yaa-Hui Dong, Jason J. Liu
Breast Cancer Research and Treatment.2024; 205(3): 619. CrossRef
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Mohd Najman Abd Wahid, Rosediani Muhamad, Noraini Mohamad, Nani Draman
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Tingting Cai, Tingting Zhou, Qingmei Huang, Fulei Wu, Feixia Ni, Changrong Yuan
European Journal of Oncology Nursing.2023; 63: 102287. CrossRef
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Lijun Ma, Ailan Liu, Jinnan Gao, Haoliang Zhao
Open Life Sciences.2023;[Epub] CrossRef
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Jun Lu, Pinbo Liu, Ran Zhang
Frontiers in Molecular Biosciences.2022;[Epub] CrossRef
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International Journal of Environmental Research and Public Health.2022; 19(22): 15335. CrossRef

Original Article

Association between weekly fruit and vegetable consumption and depressive symptoms: results from the Korean Elderly Environmental Panel study: Youjeong Yuk, Chae-Rin Han, Yoonyoung Jang, Yun-Chul Hong, Yoon-Jung Choi; Epidemiol Health. 2021;43:e2021029. Published online April 20, 2021; DOI: https://doi.org/10.4178/epih.e2021029

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Although previous studies have investigated the correlation between fruit and vegetable consumption and depression, the results remain inconclusive. The present study aimed to investigate the association between weekly fruit and vegetable consumption and depressive symptoms in elderly Koreans.

METHODS

A multiple covariate linear regression analysis was performed using the data of 1,226 elderly individuals ≥ 60 years of age who participated in the Korean Elderly Environmental Panel II study from 2012 to 2014. Depressive symptoms were evaluated using the Korean version of the Short form Geriatric Depression Scale (SGDS-K). Generalized linear mixed-effects models were constructed to analyze the repeated measurements of 305 people who participated in the survey every year.

RESULTS

After adjusting for confounders, SGDS-K scores were negatively associated with the frequency of weekly fruit consumption as follows (β [95% confidence interval; CI]: -0.17 [-0.28 to -0.05], -0.17 [-0.27 to -0.07], -0.42 [-0.54 to 0.29], and -0.33 [-0.44 to -0.21]) for less than 1 time/wk, 1-3 times/wk, 4-6 times/wk, and daily, respectively, compared to no consumption. The SGDS-K scores were also negatively associated with the frequency of vegetable consumption (β [95% CI]: -0.86 [-1.18 to -0.55], -0.18 [-0.35 to -0.01], -0.36 [-0.53 to -0.18], and -0.15 [-0.29 to 0.00]) in the above order, respectively.

CONCLUSIONS

Fruit consumption was inversely associated with depression levels in a dose-dependent manner. Although there was no dose-response relationship between vegetable consumption and the level of depression, it was negatively associated with SGDS-K scores.

Summary

Korean summary
KEEP-II 데이터를 활용하여 한국 노년층의 주간 과일 및 채소 섭취 빈도와 우울증상 간의 상관관계를 알아보았다. 주중 과일을 섭취하는 빈도와 우울증상의 정도 및 우울증 이환 간에서 음의 상관관계가 있었으며 양반응관계가 나타났다. 채소 섭취 빈도의 경우에는 양반응관계가 나타나지 않았으나 채소 섭취 빈도와 우울증상의 정도 간에 음의 상관관계가 있었다.

Key Message
Weekly fruit consumption frequency was inversely associated with the level of depression in a dose-dependent manner in Korean elderly population who participated in KEEP-II study. Although there was no dose-response relationship between vegetable consumption and the level of depression, vegetable consumption frequency was negatively associated with the level of depression.

Citations

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Digital village construction and depressive symptoms in rural middle-aged and older adults: Evidence from China
Shenwei Wan, Pengfei Zhang, Song Chen, Yue Yang
Journal of Affective Disorders.2025; 372: 200. CrossRef
Regular consumption of fruits, vegetables, and whole grain foods is associated with fewer depressive symptoms in older adults: a cross-sectional analysis of EpiFloripa Aging cohort study, Brazil
Karine Kahl, Gilciane Ceolin, Eleonora d’Orsi, Julia Dubois Moreira
Aging & Mental Health.2025; 29(12): 2273. CrossRef
Bidirectional associations between dietary diversity and depressive symptoms in Chinese adult women: A retrospective cohort study
Xiaoqian Dong, Ying Li, Xingxing Wang, Yinglong Duan, Min Liu, Sha Wang, Xue He, Pingting Yang, Yaqin Wang, Jianfei Xie, Andy S.K. Cheng
Journal of Affective Disorders.2024; 351: 683. CrossRef
Regional differences in the effects of healthy aging on depressive symptoms: a Korean longitudinal study of aging (2006–2020)
Soo Jin Kang, Jinseub Hwang, Dohyang Kim, Bongjeong Kim
Frontiers in Public Health.2024;[Epub] CrossRef
Anti-Inflammatory, Antioxidant, and Neuroprotective Effects of Polyphenols—Polyphenols as an Element of Diet Therapy in Depressive Disorders
Anna Winiarska-Mieczan, Małgorzata Kwiecień, Karolina Jachimowicz-Rogowska, Janine Donaldson, Ewa Tomaszewska, Ewa Baranowska-Wójcik
International Journal of Molecular Sciences.2023; 24(3): 2258. CrossRef
Genetic and environmental influences on fruit and vegetable consumption and depression in older adults
Annabel P. Matison, Anbupalam Thalamuthu, Victoria M. Flood, Julian N. Trollor, Vibeke S. Catts, Margaret J. Wright, David Ames, Henry Brodaty, Perminder S. Sachdev, Simone Reppermund, Karen A. Mather
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Longitudinal correlates of fruit and vegetable consumption with depressive symptoms among middle-aged and older adults in South Africa
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Brief Communication

Analysis of the difference in the perinatal mortality rate between white-collar and blue-collar workers in Japan, 1995-2015: Tasuku Okui; Epidemiol Health. 2020;42:e2020069. Published online November 24, 2020; DOI: https://doi.org/10.4178/epih.e2020069

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Abstract PDF

Abstract

OBJECTIVES
This study investigated differences in the perinatal mortality rate between white-collar and blue-collar workers.

METHODS

Data from the “Report of Vital Statistics: Occupational and Industrial Aspects” in Japan covering the period from 1995 to 2015 were used. Five-year maternal age groups from 15-19 years to 45-49 years were analyzed according to work type, and the perinatal mortality rate for each age group and the age-standardized perinatal mortality rate according to maternal age were calculated in each analyzed year. A Bayesian age-period-cohort analysis was used to estimate age, period, and cohort effects for the perinatal mortality rate according to work type. Moreover, the perinatal mortality rate ratios between types of workers were estimated for each age group, period, and cohort.

RESULTS

The estimated perinatal mortality rate ratios of blue-collar to white-collar workers were above 1 in most of the age groups and cohorts. The age effect for the perinatal mortality rate among white-collar workers was the largest in the 15-year to 19-year age group, whereas that among blue-collar workers was the largest in the 45-year to 49-year age group. Furthermore, the estimated perinatal rate ratio between white-collar and blue-collar workers tended to increase with maternal age. The magnitude of the decrease of the cohort effects on the perinatal mortality rate was rather larger in blue-collar workers in the cohorts born between 1946-1950 and 1996-2000.

CONCLUSIONS

The magnitude of the disparity markedly increased with maternal age. Thus, middle-aged blue-collar workers need more prenatal care and preventive measures for perinatal mortality than white-collar workers.

Summary

Citations

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Low blood glucose and fatigue accumulation at peak hours of occupational trauma in secondary industry workers
Ryunosuke Ishikawa, Rikiya Shirato, Asuka Watanabe, Shinji Matsuoka, Ryousaku Sugihara, Kazushi Kimura
International Journal of Occupational Safety and Ergonomics.2024; 30(3): 782. CrossRef
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BMC Pregnancy and Childbirth.2024;[Epub] CrossRef

Original Articles

Comparison between walking and moderate-to-vigorous physical activity: associations with metabolic syndrome components in Korean older adults: Ki-Yong An; Epidemiol Health. 2020;42:e2020066. Published online October 28, 2020; DOI: https://doi.org/10.4178/epih.e2020066

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Abstract

OBJECTIVES
The purpose of this study was to compare moderate-to-vigorous physical activity (MVPA) with walking in terms of associations with metabolic syndrome components in Korean older adults.

METHODS

Data on 1,388 older adults (age ≥65 years) from the Korea National Health and Nutrition Examination Survey 2018 were analyzed in this study. MVPA time and walking time per week were used as physical activity variables and blood pressure, waist circumference, glucose, high-density lipoprotein cholesterol, and triglyceride levels were analyzed as metabolic syndrome components. Partial correlations, analysis of covariance, and multinomial logistic regression were used for statistical analysis after adjusting for age, sex, smoking, and alcohol consumption.

RESULTS

High-density lipoprotein cholesterol levels were significantly higher in the low MVPA/high walking and high MVPA/ high walking groups than in the low MVPA/low walking group. Triglyceride levels were significantly lower in the high MVPA/ high walking group than in the low MVPA/low walking and low MVPA/high walking groups. Engaging in <150 min/wk of MVPA increased the likelihood of abnormal blood pressure and metabolic syndrome by 1.81 times and 1.89 times, respectively, compared to ≥150 min/wk of MVPA. Engaging in <180 min/wk of walking raised the likelihood of having abnormal highdensity lipoprotein levels by 1.32 times compared to ≥180 min/wk of walking.

CONCLUSIONS

Not only MVPA but also walking was significantly associated with metabolic syndrome components in Korean older adults. Considering older adults’ preferences and exercise barriers, walking should be considered as an essential component of physical activity guidelines to prevent chronic diseases in older adults.

Summary

Korean summary
현재까지 저강도 신체활동 (걷기)은 중고강도 신체활동에 비해 상대적으로 그 중요성이 간과되어 왔다. 하지만 본 연구는 저강도 신체활동도 중고강도 신체활동 못지 않게 노인들에게서 대사증후군을 예방할 수 있는 중요한 역할을 할 수 있음을 보여준다. 게다가 노인들의 신체적 제약, 부상의 위험, 운동 선호도 등을 감안하면 걷기와 같은 저강도 신체활동은 노인들의 건강유지를 위한 신체활동 권고사항의 필수요소로 고려되어야 함을 제안한다.

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Ki-Yong An, Fernanda Z. Arthuso, Spencer J. Allen, Stephanie M. Ntoukas, Kerry S. Courneya
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Nikoletta Barka, Feifei Wang, Robert Jarai, Szilvia Boros
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Yeon Soo Kim, Geonhui Kim, Hoyong Sung, Byung-Cheol Kim, Jeh-Kwang Ryu, Sowon Hahn
The Korean Journal of Sports Medicine.2024; 42(2): 126. CrossRef
Interactive associations of smoking and physical activity with metabolic syndrome in adult men in Korea
Minjun Kim, Joonwoong Kim, Inhwan Lee
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Differences in the Correlation between the Built Environment and Walking, Moderate, and Vigorous Physical Activity among the Elderly in Low- and High-Income Areas
Peng Zang, Fei Xian, Hualong Qiu, Shifa Ma, Hongxu Guo, Mengrui Wang, Linchuan Yang
International Journal of Environmental Research and Public Health.2022; 19(3): 1894. CrossRef
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Sunyoung Kim, Hyoung Kyu Yoon, Chin Kook Rhee, Hee-Won Jung, Hyun Lee, Yong Suk Jo
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Gender difference in socioeconomic factors affecting suicidal ideation and suicidal attempts among community-dwelling elderly: based on the Korea Community Health Survey: Jin-Young Jeong; Epidemiol Health. 2020;42:e2020052. Published online July 13, 2020; DOI: https://doi.org/10.4178/epih.e2020052

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study was performed to explore socioeconomic factors associated with suicidal ideation and suicidal attempts among the local community’s resident elderly.

METHODS

The subjects included 129,277 participants aged 65 years or above of the Korea Community Health Survey conducted in 2013 and 2017. Based on the questions for suicidal ideation and suicidal attempts, the subjects were divided into a no suicidal ideation group (n=111,344), a suicidal ideation group (n=17,487), and a suicidal attempt group (n=446). All analyses were stratified by gender, and a complex sample logistic regression analysis was performed to analyze associated factors. SAS version 9.4 was used for all analyses with a significance level of 0.05.

RESULTS

Common factors associated with suicidal ideation in both genders included marital status, frequency of contact with friends, social activity, and average monthly household income. Economic activity was demonstrated as relevant only to the elderly men subjects. According to the analysis, factors associated with suicidal attempts were the recipients of the National Basic Living Security Act for the elderly men compared to age, frequency of contact with family, frequency of contact with friends, and average monthly household income for the elderly women.

CONCLUSIONS

The study revealed that socioeconomic factors leading to suicidal ideation were similar in the elderly of both genders, while a difference was demonstrated for factors associated with suicidal attempts between the elderly of both genders. It is expected that the results of this study may be used as the basis for screening the local community’s elderly with a high suicidal risk, and in the development of suicide prevention services.

Summary

Korean summary
2013년과 2017년 지역사회건강조사에 참여한 129,277명의 노인을 대상으로 자살시도에 관련된 사회-경제적 요인을 탐색하였다. 분석결과, 남성 노인의 자살시도 관련요인은 국민기초생활수급자, 여성 노인의 자살시도 관련요인은 연령, 가족접촉빈도, 친구접촉빈도, 그리고 월평균가구소득으로 나타났다. 본 결과가 지역사회 거주 노인의 자살 고위험군 선별 및 자살 예방서비스 개발에 기초자료로 활용되기를 기대한다.

Citations

Citations to this article as recorded by

Sex differences in lifetime suicide attempts in retired older adults between 2000 and 2021 in France: results from six national surveys
Helen-Maria Vasiliadis, Christophe Léon, Mathilde Husky
Social Psychiatry and Psychiatric Epidemiology.2026; 61(3): 497. CrossRef
Depression subtypes, suicidality, and healthcare costs in older adults: results from a naturalistic study
Ismael Conejero, Alejandro Porras-Segovia, Lucía Albarracín-García, María Luisa Barrigón, Jorge Lopez-Castroman, Philippe Courtet, Enrique Baca-Garcia
Frontiers in Psychiatry.2025;[Epub] CrossRef
A systematic review of psychosocial protective factors against suicide and suicidality among older adults
Myung Ki, Sylvie Lapierre, Boeun Gim, Minji Hwang, Minku Kang, Luc Dargis, Myoungjee Jung, Emily Jiali Koh, Brian Mishara
International Psychogeriatrics.2024; 36(5): 346. CrossRef
Body mass index, subjective body shape, and suicidal ideation among community-dwelling Korean adults
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Intervention effects in the transmission of COVID-19 depending on the detection rate and extent of isolation: Okyu Kwon, Woo-Sik Son, Jin Yong Kim, Jong-Hun Kim; Epidemiol Health. 2020;42:e2020045. Published online June 23, 2020; DOI: https://doi.org/10.4178/epih.e2020045

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Abstract Summary PDF Supplementary Material

Abstract

Objectives
In 2020, the coronavirus disease 2019 (COVID-19) respiratory infection is spreading in Korea. In order to prevent the spread of an infectious disease, infected people must be quickly identified and isolated, and contact with the infected must be blocked early. This study attempted to verify the intervention effects on the spread of an infectious disease by using these measures in a mathematical model.

Methods

We used the susceptible-infectious-recovery (SIR) model for a virtual population group connected by a special structured network. In the model, the infected state (I) was divided into I in which the infection is undetected and Ix in which the infection is detected. The probability of transitioning from an I state to Ix can be viewed as the rate at which an infected person is found. We assumed that only those connected to each other in the network can cause infection. In addition, this study attempted to evaluate the effects of isolation by temporarily removing the connection among these people.

Results

In Scenario 1, only the infected are isolated; in Scenario 2, those who are connected to an infected person and are also found to be infected are isolated as well. In Scenario 3, everyone connected to an infected person are isolated. In Scenario 3, it was possible to effectively suppress the infectious disease even with a relatively slow rate of diagnosis and relatively high infection rate.

Conclusions

During the epidemic, quick identification of the infected is helpful. In addition, it was possible to quantitatively show through a simulation evaluation that the management of infected individuals as well as those who are connected greatly helped to suppress the spread of infectious diseases.

Summary

Korean summary
본 연구는 행위자 기반 모형의 시뮬레이션 평가를 통해 COVID-19 유행 상황에서 비약물적 중재 효과를 정량적으로 제시하였다. 비약물적 중재에 관한 세 가지 시나리오를 통해 제시한 결과에서, COVID-19 감염자를 신속하게 진단하고, 감염자 본인과 접촉자들을 가능한 한 빨리 모두 격리하여 관리하는 것이 감염병 확산을 억제하는데 있어서 보다 효과적이었다.

Citations

Citations to this article as recorded by

The effects of risk perception based on local or global information in suppressing the spread of infectious diseases
Okyu Kwon, Changeun Baek, Jae-Suk Yang
International Journal of Modern Physics C.2025;[Epub] CrossRef
Limitations in creating artificial populations in agent-based epidemic modeling: a systematic review
Irina I. Maslova, Aleksandr I. Manolov, Oksana E. Glushchenko, Ivan E. Kozlov, Vera I. Tsurkis, Nikolay S. Popov, Andrey E. Samoilov, Alexandr N. Lukashev, Elena N. Ilina
Journal of microbiology, epidemiology and immunobiology.2024; 101(4): 530. CrossRef
Mathematical Modeling of COVID-19 Transmission and Intervention in South Korea: A Review of Literature
Hyojung Lee, Sol Kim, Minyoung Jeong, Eunseo Choi, Hyeonjeong Ahn, Jeehyun Lee
Yonsei Medical Journal.2023; 64(1): 1. CrossRef
Non-pharmaceutical interventions during the COVID-19 pandemic: A review
Nicola Perra
Physics Reports.2021; 913: 1. CrossRef
Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic
Mohammad Keykhaei, Sogol Koolaji, Esmaeil Mohammadi, Reyhaneh Kalantar, Sahar Saeedi Moghaddam, Arya Aminorroaya, Shaghayegh Zokaei, Sina Azadnajafabad, Negar Rezaei, Erfan Ghasemi, Nazila Rezaei, Rosa Haghshenas, Yosef Farzi, Sina Rashedi, Bagher Larijan
Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1919. CrossRef

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