Epidemiology and Health

Original Articles

Long working hours and the risk of hypothyroidism in healthy Korean workers: a cohort study: Yesung Lee, Woncheol Lee, Hyoung-Ryoul Kim; Epidemiol Health. 2022;44:e2022104. Published online November 8, 2022; DOI: https://doi.org/10.4178/epih.e2022104

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Abstract Summary PDF: Abstract
OBJECTIVES
Long working hours have been reported to cause various health problems, but are currently practiced in many countries. Building upon a previous cross-sectional study, the authors aimed to elucidate the causal relationship between long working hours and hypothyroidism through a longitudinal study.
METHODS
Data were collected at baseline from 45,259 participants without thyroid disease and with consistent weekly working hours (36-40, 41-52, 53-60, and >60 hours) during the follow-up period. Hypothyroidism was defined using the reference limits of serum thyroid-stimulating hormone and free thyroxine levels. By estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analysis, the risk of incident hypothyroidism was evaluated with 36-40 hours of work per week as the reference.
RESULTS
During 138,261.7 person-years of follow-up, 2,914 participants developed hypothyroidism (incidence density, 2.11/102 person-years). The multivariable-adjusted HRs of incident hypothyroidism for 41-52 hours, 53-60 hours, and >60 hours of work per week were 1.13 (95% CI, 1.03 to 1.24), 2.53 (95% CI, 2.17 to 2.95), and 2.57 (95% CI, 2.09 to 3.15), respectively. In dose-response analyses, long working hours had an approximately linear relationship with hypothyroidism incidence. The risk of incident hypothyroidism in those who worked 53-60 hours and >60 hours per week compared with the reference group was significantly higher among the older age group (≥36 years, stratified by median age), men, and daytime workers.
CONCLUSIONS
This large-scale cohort study demonstrated the association between long working hours and an increased risk of incident hypothyroidism with a dose-response relationship.; Summary

Korean summary
대규모 코호트연구를 통해 장시간노동을 수행한 노동자들에서 갑상선기능저하증의 위험이 높아지는 것을 확인할 수 있었다. 특히 연령, 성, 교대근무 유무에 따라 층화하여 분석한 결과에서 고연령, 남성, 교대근무를 하지 않는 노동자에서 관련성의 크기가 증가하였다.

Key Message
This large-scale cohort study (The Kangbuk Samsung Health Study), which used 45,259 participants without thyroid disease at baseline and estimated hazard ratios (HRs) using Cox proportional hazards regression analysis, demonstrated the association between long working hours and an increased risk of incident hypothyroidism with a dose-response relationship especially in older age group, men, and daytime workers.

Type 2 diabetes mellitus increases the severity of non-fatal injuries, but not the risk of fatal injuries, among driver victims of motor vehicle crashes in Taiwan: I-Lin Hsu, Wen-Hsuan Hou, Ya-Hui Chang, Chung-Yi Li; Epidemiol Health. 2022;44:e2022076. Published online September 16, 2022; DOI: https://doi.org/10.4178/epih.e2022076

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Abstract PDF Supplementary Material: Abstract
OBJECTIVES
Limited information is available on whether diabetes increases the severity of injuries from motor vehicle crashes (MVCs). This study aimed to investigate the association of type 2 diabetes with injury severity among driver victims of MVCs.
METHODS
This cohort study involved 75,737 adult driver victims with type 2 diabetes from Taiwan’s Police-Reported Traffic Accident Registry in 2015-2017, along with 150,911 sex-, age-, and calendar year-matched controls. The severity level of non- fatal injuries was derived from the International Classification of Diseases Programs for Injury Categorization based on the diagnostic codes of National Health Insurance claims within 3 days after an MVC. Information on fatal injuries within 3 days after an MVC was obtained from the Taiwan Death Registry. Logistic regression models were used to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of injury severity in association with type 2 diabetes.
RESULTS
After adjusting for potential confounders, driver victims with type 2 diabetes experienced significantly higher risks of mild and severe non-fatal injuries than their counterparts without diabetes, with covariate-adjusted ORs of 1.08 (95% CI, 1.05 to 1.11) and 1.28 (95% CI, 1.20 to 1.37), respectively. By contrast, the adjusted OR for fatal injuries was not significantly elevated, at 1.02 (95% CI, 0.89 to 1.18). Similar results were found when car and scooter driver victims were analyzed separately.
CONCLUSIONS
Type 2 diabetes was found to moderately increase the severity of non-fatal injuries from MVCs among car and scooter driver victims.; Summary

Korean summary

Key Message
With 75,737 driver victims with diabetes and 150,911 matched controls, this study showed an 8% and 28% increase in mild and severe non-fatal injury, respectively among driver victims with diabetes. Such increase in risk was equally applied to both car and scooter drivers. No increase in risk of 3-day mortality after crash was found.

Systematic Review

The relationship between metabolic syndrome and its components with bladder cancer: a systematic review and meta-analysis of cohort studies: Mozhgan Ahmadinezhad, Maedeh Arshadi, Elahe Hesari, Maedeh Sharafoddin, Hosein Azizi, Farzad Khodamoradi; Epidemiol Health. 2022;44:e2022050. Published online May 30, 2022; DOI: https://doi.org/10.4178/epih.e2022050

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Abstract PDF Supplementary Material: Abstract
A previous meta-analysis, entitled “The association between metabolic syndrome and bladder cancer susceptibility and prognosis: an updated comprehensive evidence synthesis of 95 observational studies involving 97,795,299 subjects,” focused on all observational studies, whereas in the present meta-analysis, we focused on cohort studies to obtain more accurate and stronger evidence to evaluate the association between metabolic syndrome and its components with bladder cancer. PubMed, Embase, Scopus, and Web of Science were searched to identify studies on the association between metabolic syndrome and its components with bladder cancer from January 1, 2000 through May 23, 2021. The pooled relative risk (RR) and 95% confidence intervals (CI) were used to measure this relationship using a random-effects meta-analytic model. Quality appraisal was undertaken using the Newcastle-Ottawa Scale. In total, 56 studies were included. A statistically significant relationship was found between metabolic syndrome and bladder cancer 1.09 (95% CI, 1.02 to 1.17), and there was evidence of moderate heterogeneity among these studies. Our findings also indicated statistically significant relationships between diabetes (RR, 1.23; 95% CI, 1.16 to 1.31) and hypertension (RR, 1.07; 95% CI, 1.01 to 1.13) with bladder cancer, but obesity and overweight did not present a statistically significant relationship with bladder cancer. We found no evidence of publication bias. Our analysis demonstrated statistically significant relationships between metabolic syndrome and the risk of bladder cancer. Furthermore, diabetes and hypertension were associated with the risk of bladder cancer.; Summary

Korean summary

Key Message
In this meta-analysis study, an attempt was made to investigate the relationship between metabolic syndrome and its components with bladder cancer, and as a result of this study, the relationship between metabolic syndrome and its components such as diabetes, high blood pressure, and bladder cancer was observed. Metabolic syndrome is more common among middle-aged and elderly people, and the elderly population is increasing worldwide, so the prevalence of this disease shortly may affect the healthcare system. Therefore, with correct health policies in all societies, the exorbitant costs that this disease brings can be avoided.

Original Articles

The association between fruit and vegetable consumption and metabolic syndrome in Korean adults: does multivitamin use matter?: Jihae Kim, Li-Juan Tan, Hyein Jung, Yumi Roh, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022039. Published online April 19, 2022; DOI: https://doi.org/10.4178/epih.e2022039

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Metabolic syndrome (MetS) is closely associated with dietary intake; however, few studies have investigated whether the consumption of fruits and vegetables and multivitamin use affect MetS in the Korean population. This study aimed to examine these effects in Korean adults.
METHODS
This was a cross-sectional study of 89,548 participants aged between 40 years and 69 years selected from the baseline data of the Health Examinees study conducted in Korea. Fresh vegetable and fruit consumption was assessed using a validated 106-item food frequency questionnaire. MetS and its components were defined using the National Cholesterol Education Program, Adult Treatment Panel III criteria. Multivariate logistic regression analyses were conducted to identify associations of fresh vegetable, fruit, and fresh vegetable+fruit consumption and multivitamin use with the prevalence of MetS.
RESULTS
Female in the highest quartile of fresh vegetable, fruit, and fresh vegetable + fruit consumption exhibited a lower prevalence of MetS than those in the lowest quartile. An inverse association with the prevalence of MetS was observed among male with only fresh vegetable consumption. The interaction between the 3 categories and multivitamin intake on the prevalence of MetS was not significant (all p_interaction>0.05), regardless of sex.
CONCLUSIONS
Multivitamin use and consumption of fresh vegetables and fruits had no significant synergistic effects. Although fresh vegetable and fruit consumption showed an inverse association with the prevalence of MetS, this relationship was not altered by multivitamin use.; Summary

Korean summary
본 연구는 한국인 유전체역학조사사업의 도시코호트 조사에 참여한 40-69세 한국 성인 89 548명의 과일과 채소의 섭취와 종합비타민 섭취가 대사증후군에 미치는 영향을 분석하였다. 본 연구에서는 매일 다양한 과일과 채소를 섭취하면, 종합비타민의 섭취와 상관없이 대사증후군 유병 위험도를 낮추는 것을 확인하였다. 따라서, 대사증후군 예방을 위해서는 일상적인 식사에서 충분한 과일과 채소를 섭취하는 것이 권장된다.

Key Message
This study aimed to examine whether the consumption of fruits and vegetables and multivitamin use affect MetS among Korean middle-aged adults. Data was from the Health Examinees Study among 89 548 subjects. Results suggested that fruits and vegetables consumption was related with a decreased prevalence of MetS. However, there was no significant synergistic effect between the consumption of fruits and vegetables and multivitamin use in further reducing MetS prevalence.

Dairy product consumption and type 2 diabetes among Korean adults: a prospective cohort study based on the Health Examinees (HEXA) study: Jiaqi Zhang, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022019. Published online February 4, 2022; DOI: https://doi.org/10.4178/epih.e2022019

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
It has been suggested that the consumption of dairy products helps lower the prevalence of type 2 diabetes (T2D). We investigated the association between the consumption of dairy products and T2D events in middle-aged Korean adults.

METHODS

We followed up 53,288 participants (16,895 male and 36,393 female) in the Health Examinees (HEXA) study. The consumption of dairy products was assessed using the self-administered food frequency questionnaire, and T2D was defined according to the 2015 treatment guidelines of the Korean Diabetes Association. Hazard ratios (HRs) and 95% confidence intervals (CIs) between the consumption of dairy products and the risk of T2D were calculated using Cox proportional hazards models after adjusting for potential confounders. Spline regression was used to better represent the association between the consumption of dairy products and the risk of T2D.

RESULTS

Among male, those with higher consumption of dairy products had a significantly lower risk of T2D than those who consumed essentially no dairy products (HR, 0.73; 95% CI, 0.58 to 0.91). In particular, consumption of yogurt (HR, 0.75; 95% CI, 0.60 to 0.93; p_trend=0.035) and cheese (HR, 0.66; 95% CI, 0.49 to 0.89; p_trend=0.005) was negatively associated with the incidence of T2D in male. In female, daily consumption of 1 serving of yogurt decreased the risk of T2D by 11%.

CONCLUSIONS

The association between the consumption of dairy products and the risk of T2D differed by sex and dairy product type. Further prospective studies are needed to confirm these associations.

Summary

Korean summary
본 연구는 한국인유전체역학조사사업의 도시코호트 기반조사와 추적조사에 참여한 40-69세 한국 성인 53 288명의 유제품 섭취와 제2형 당뇨병 발생 위험도를 분석하였다. 요거트와 치즈를 포함한 유제품 섭취가 많을수록 남성의 제2형 당뇨병 위험도가 낮아졌다. 요거트 섭취량을 하루에 한번 증가하면 여성의 제2형 당뇨병 위험도가 감소하다. 유제품 소비와 제2형 당뇨병의 위험도의 연관성은 성별과 유제품에 따라 다르다. 이를 확인하기 위해서는 추가 연구가 필요하다.

Key Message
The study aimed to assess the association between the consumption of dairy products and type 2 diabetes events in Korean adults. Data was from the Health Examinees Study among 53 288 participants. Higher consumption of dairy products including yogurt and cheese was associated with a lower risk of developing type 2 diabetes in men. Increasing yogurt intake by one serving/day reduces the risk of type 2 diabetes in women. The association between the consumption of dairy products and the risk of type 2 diabetes differed by gender and dairy product type. Further studies are needed to confirm this.

Citations

Citations to this article as recorded by

Association of milk consumption with management and incidence of hypertension among South Korean adults: A prospective analysis of the health examinees study cohort
Hyein Jung, Geongu Lee, Kyungjoon Lim, Sangah Shin
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(11): 2515. CrossRef
Association between dairy consumption and the risk of diabetes: A prospective cohort study from the China Health and Nutrition Survey
Yucheng Yang, Xiaona Na, Yuandi Xi, Menglu Xi, Haibing Yang, Zhihui Li, Ai Zhao
Frontiers in Nutrition.2022;[Epub] CrossRef
Association of dairy consumption patterns with the incidence of type 2 diabetes: Findings from Alberta's Tomorrow Project
Emad Yuzbashian, Mohammadreza Pakseresht, Jennifer Vena, Catherine B. Chan
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(12): 2760. CrossRef

Independent predictors of depressive symptoms and social isolation on 2-year all-cause mortality among the Korean elderly in a population-based cohort study: gender differences: Hyunsuk Jeong, Hyeon Woo Yim, Beom-Woo Nam; Epidemiol Health. 2022;44:e2022012. Published online January 8, 2022; DOI: https://doi.org/10.4178/epih.e2022012

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study examined whether depressive symptoms and social isolation were independent predictors of 2-year all-cause mortality among the elderly using data from a population-based cohort study.

METHODS

In total, 1,033 participants (320 men and 713 women) older than 60 years of age participated in this study. Depressive symptoms, social isolation status, and socio-demographic and health-related covariates were assessed at baseline. The primary outcome measure was 2-year all-cause mortality. Data were collected through in-person interviews by trained interviewers. The GENMOD procedure was used to calculate relative risks (RRs).

RESULTS

Of the 1,033 participants, 102 (40 men and 62 women) died within the follow-up period of 2 years. During the 2-year follow-up period, 17.8% of depressed men and 12.3% of depressed women died, and 29.8% of socially isolated men and 14.9% of socially isolated women died. Social isolation was an independent predictor of mortality in elderly men (adjusted relative risk [aRR], 4.6, 95% confidence interval [CI], 2.0 to 10.2), while depressive symptoms were an independent predictor of mortality in elderly women (aRR, 2.0; 95% CI, 1.2 to 3.6) when controlling for potential confounding factors. However, the depressive symptoms detected using the geriatric depression scale were not associated with mortality in men, and social isolation was not associated with mortality in women.

CONCLUSIONS

The effects of depressive symptoms and social isolation on 2-year all-cause mortality within an elderly population differed according to gender. Gender-specific community-based interventions must be developed to potentially reduce 2-year all-cause mortality among the elderly.

Summary

Korean summary
본 연구는 지역사회 거주하는 저소득층 노인을 대상으로 한 코호트 연구로 2년 추적조사를 수행하여 사망 원인의 예측인자를 분석하였다. 남성노인에서는 사회적 고립이, 여성노인에서는 우울증상이 2년 모든 사망원인의 독립적인 예측인자였다. 노인의 사망율을 줄이기 위한 지역사회 개입 프로그램은 남성에게는 사회적 고립을 해소를, 여성에게는 우울증상 개선을 위한 프로그램이 요구된다.

Key Message
The effects of depressive symptoms and so¬cial isolation on 2-year all-cause mortality among the elderly dif¬fered according to gender. For elderly men, social isolation increased the risk of 2-year all-cause mortality by 4.6 times compared to those who were not socially isolated. However, the depressive symptoms identified by the GDS-15 were not associated with 2-year all-cause mortality in men. From a public health perspective, these findings suggest that gender-specific community-based interventions are needed to mitigate all-cause mortality among the elderly.

Citations

Citations to this article as recorded by

Relationship between Cognition, Depression, and Oral health status in Older adults: A longitudinal cross-lagged analysis
Bo Zhao, Xiaoxu Jiang, Fanlei Kong, Eun Woo Nam
Journal of Affective Disorders.2023; 330: 158. CrossRef

Cohort Profiles

Cohort profile: the Environmental-Pollution-Induced Neurological EFfects (EPINEF) study: a multicenter cohort study of Korean adults: Heeseon Jang, Woojin Kim, Jaelim Cho, Jungwoo Sohn, Juhwan Noh, Gayoung Seo, Seung-Koo Lee, Young Noh, Sung Soo Oh, Sang-Baek Koh, Hee Jin Kim, Sang Won Seo, Ho Hyun Kim, Jung Il Lee, Sun-Young Kim, Changsoo Kim; Epidemiol Health. 2021;43:e2021067. Published online September 16, 2021; DOI: https://doi.org/10.4178/epih.e2021067

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Abstract

The general population is exposed to numerous environmental pollutants, and it remains unclear which pollutants affect the brain, accelerating brain aging and increasing the risk of dementia. The Environmental-Pollution-Induced Neurological Effects study is a multi-city prospective cohort study aiming to comprehensively investigate the effect of different environmental pollutants on brain structures, neuropsychological function, and the development of dementia in adults. The baseline data of 3,775 healthy elderly people were collected from August 2014 to March 2018. The eligibility criteria were age ≥50 years and no self-reported history of dementia, movement disorders, or stroke. The assessment included demographics and anthropometrics, laboratory test results, and individual levels of exposure to air pollution. A neuroimaging sub-cohort was also recruited with 1,022 participants during the same period, and brain magnetic resonance imaging and neuropsychological tests were conducted. The first follow-up environmental pollutant measurements will start in 2022 and the follow-up for the sub-cohort will be conducted every 3-4 years. We have found that subtle structural changes in the brain may be induced by exposure to airborne pollutants such as particulate matter 10 μm or less in diameter (PM₁₀), particulate matter 2.5 μm or less in diameter (PM_2.5) and Mn₁₀, manganese in PM₁₀; Mn_2.5, manganese in PM_2.5. PM₁₀, PM_2.5, and nitrogen dioxide in healthy adults. This study provides a basis for research involving large-scale, long-term neuroimaging assessments in community-based populations.

Summary

Korean summary
EPINEF 코호트는 환경유해인자에 의한 신경계 질환의 위해성을 평가하고, 환경유해인자로 유발되는 신경심리학적 기능 저하 또는 뇌 노화에 대한 근거를 제공하기 위해 2014년부터 50세 이상의 건강한 성인을 대상으로 시작되었습니다. 본 코호트는 뇌 영상학적 표지자와 인지 기능과 관련된 환경유해인자를 광범위하게 조사한 한국 최초의 장기 추적관찰 연구로, 대기 오염 물질 또는 다환방향족탄화수소 노출이 대뇌 영상표지자 및 신경심리학적 기능, 노인의 우울 증상에 대한 악화 요인으로서의 대기오염물질 노출과 결혼 상태의 교호작용 등의 연구결과들을 발표하였습니다. 또한, 추후에도 코호트의 지속적인 추적을 통해 환경유해인자 노출에 따른 신경학적 건강영향을 연구하여, 신경계 질환 관리를 위한 보건 정책 개선에 기여할 수 있을 것으로 기대됩니다.

Key Message
The EPINEF cohort was started in 2014 to assess the risk of neurological diseases caused by environmental harmful factors and to provide evidence for neuropsychological dysfunction or brain aging induced by these factors. This cohort is the first long-term follow-up study in Korea to extensively investigate brain imaging markers and environmental harmful factors related to cognitive function, and several related research results have been published. In addition, the follow-up survey will be continued in the future, and we expect that the results of the study will contribute to improving health policies for the management of neurological diseases.

Citations

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Surveillance of long-term environmental elements and PM2.5 health risk assessment in Yangtze River Delta, China, from 2016 to 2020
Keqin Wu, Yuanhua Meng, Yan Gong, Xuhui Zhang, Linlin Wu, Xinliang Ding, Xiaofeng Chen
Environmental Science and Pollution Research.2022; 29(54): 81993. CrossRef
Reduced brain subcortical volumes in patients with glaucoma: a pilot neuroimaging study using the region-of-interest-based approach
Yae Won Ha, Heeseon Jang, Sang-Baek Koh, Young Noh, Seung-Koo Lee, Sang Won Seo, Jaelim Cho, Changsoo Kim
BMC Neurology.2022;[Epub] CrossRef

Cohort profile: the Ewha Birth and Growth Study: Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Jeong Choi, Ui Jeong Kim, Hyun Jin Park, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eui-Jung Kim, Eun Hee Ha, Hyesook Park; Epidemiol Health. 2021;43:e2021016. Published online February 22, 2021; DOI: https://doi.org/10.4178/epih.e2021016

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Abstract

With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.

Summary

Korean summary
이화영아성장코호트는 만성질환 예방을 위한 생애초기 위험인자에 대한 근거를 제공하기 위해 2001년에 시작되었습니다. 이화영아성장코호트는 국내에서 선도적인 장기 추적관찰 연구로, 소아기 건강과 관련된 산전 및 출생 시 특징, 소아기 대사와 관련된 유전적 혹은 후성학적 특성, 내분비 장애물질 노출에 따른 영향, 소아기의 식이패턴과 같은 다양한 연구결과들을 발표하였습니다. 추후 청년기의 자료 수집을 계획하고 있으며, 우리의 연구결과는 만성질환 예방을 위한 중재 개발에 기여할 것으로 기대됩니다.

Key Message
To provide evidence of early life risk factors for the prevention of chronic diseases, the Ewha Birth and Growth Study was started in 2001. The Ewha Birth and Growth cohort is a leading long-term follow-up study in Korea, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. We are planning to collect data for early adulthood, and our findings will contribute to the development of interventions to prevent chronic diseases.

Citations

Citations to this article as recorded by

Prospective association between phthalate exposure in childhood and liver function in adolescence: the Ewha Birth and Growth Cohort Study
Seonhwa Lee, Hye Ah Lee, Bohyun Park, Hyejin Han, Young Sun Hong, Eun Hee Ha, Hyesook Park
Environmental Health.2023;[Epub] CrossRef
BMI trajectory and inflammatory effects on metabolic syndrome in adolescents
Ui-Jeong Kim, Eun Jeong Choi, Hyunjin Park, Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eun Hee Ha, Seungyoun Jung, Hyesook Park
Pediatric Research.2023;[Epub] CrossRef
The Effect of Childhood Obesity or Sarcopenic Obesity on Metabolic Syndrome Risk in Adolescence: The Ewha Birth and Growth Study
Hyunjin Park, Seunghee Jun, Hye-Ah Lee, Hae Soon Kim, Young Sun Hong, Hyesook Park
Metabolites.2023; 13(1): 133. CrossRef
The Mediating Effect of Inflammation between the Dietary and Health-Related Behaviors and Metabolic Syndrome in Adolescence
Ui-Jeong Kim, Eun-Jeong Choi, Hyunjin Park, Hye-Ah Lee, Bomi Park, Haesoon Kim, Youngsun Hong, Seungyoun Jung, Hyesook Park
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Precision medicine via the integration of phenotype-genotype information in neonatal genome project
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Brief Communication

Prospective cohort data quality assurance and quality control strategy and method: Korea HIV/AIDS Cohort Study: Soo Min Kim, Yunsu Choi, Bo Youl Choi, Minjeong Kim, Sang Il Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Mee-Kyung Kee, Myeongsu Yoo, Jeong Gyu Lee, Bo Young Park; Epidemiol Health. 2020;42:e2020063. Published online September 4, 2020; DOI: https://doi.org/10.4178/epih.e2020063

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Abstract

OBJECTIVES
The aim of effective data quality control and management is to minimize the impact of errors on study results by identifying and correcting them. This study presents the results of a data quality control system for the Korea HIV/AIDS Cohort Study that took into account the characteristics of the data.

METHODS

The HIV/AIDS Cohort Study in Korea conducts repeated measurements every 6 months using an electronic survey administered to voluntarily consenting participants and collects data from 21 hospitals. In total, 5,795 sets of data from 1,442 participants were collected from the first investigation in 2006 to 2016. The data refining results of 2015 and 2019 were converted into the data refining rate and compared.

RESULTS

The quality control system involved 3 steps at different points in the process, and each step contributed to data quality management and results. By improving data quality control in the pre-phase and the data collection phase, the estimated error value in 2019 was 1,803, reflecting a 53.9% reduction from 2015. Due to improvements in the stage after data collection, the data refining rate was 92.7% in 2019, a 24.21%p increase from 2015.

CONCLUSIONS

Despite this quality management strategy, errors may still exist at each stage. Logically possible errors for the post-review refining of downloaded data should be actively identified with appropriate consideration of the purpose and epidemiological characteristics of the study data. To improve data quality and reliability, data management strategies should be systematically implemented.

Summary

Korean summary
이 연구는 한국 에이즈 코호트 자료의 연구 목적과 역학적 특성을 고려한 체계적인 질 관리 방법과 결과를 제시한다. 시간적 선후 관계를 고려한 로직을 활용한 자료정제 과정을 비롯한 3단계의 체계적인 질 관리 방법은 이제껏 없었던 국내 코호트 자료 질 관리에 도움이 될 것으로 사료된다.

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Jaqueline Driemeyer Correia Horvath, Marina Bessel, Natália Luiza Kops, Flávia Moreno Alves Souza, Gerson Mendes Pereira, Eliana Marcia Wendland
JMIR Research Protocols.2022; 11(1): e31365. CrossRef

Cohort Profile

Cohort profile: congenital Zika virus infection and child neurodevelopmental outcomes in the ZEN cohort study in Colombia: Maritza Gonzalez, Van T. Tong, Helena Rodriguez, Diana Valencia, Jacqueline Acosta, Margaret A. Honein, Martha L. Ospina; Epidemiol Health. 2020;42:e2020060. Published online August 31, 2020; DOI: https://doi.org/10.4178/epih.e2020060

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Abstract

Zika en Embarazadas y Niños (ZEN) is a prospective cohort study designed to identify risk factors and modifiers for Zika virus (ZIKV) infection in pregnant women, partners, and infants, as well as to assess the risk for adverse maternal, fetal, infant, and childhood outcomes of ZIKV and other congenital infections. ZIKV infection during pregnancy may be associated with longterm sequelae. In the ZEN cohort, 1,519 pregnant women and 287 partners were enrolled from 3 departments within Colombia between February 2017 and January 2018, as well as 1,108 infants born to the pregnant women who were followed to 6 months. The data include baseline questionnaires at enrollment; repeated symptoms and study follow-up questionnaires; the results of lab tests to detect ZIKV and other congenital infections; medical record abstractions; infant physical, eye, and hearing exams; and developmental screening tests. Follow-up of 850 mother-child dyads occurred at 9 months, 12 months, and 18 months with developmental screenings, physical exams, and parent questionnaires. The data will be pooled with those from other prospective cohort studies for an individual participant data meta-analysis of ZIKV infection during pregnancy to characterize pregnancy outcomes and sequelae in children.

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Angelica Rico, Sheila C. Dollard, Diana Valencia, Sheryll Corchuelo, Van T. Tong, Katherine Laiton‐Donato, Minal M. Amin, Monica Benavides, Phili Wong, Suzanne Newton, Marcela Daza, Jordan Cates, Maritza Gonzalez, Laura D. Zambrano, Marcela M. Mercado, El
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Youssef A. Kousa, Reafa A. Hossain
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Original Article

Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study: Masoumeh Sadeghi, Maryam S. Daneshpour, Soheila Khodakarim, Amir Abbas Momenan, Mahdi Akbarzadeh, Hamid Soori; Epidemiol Health. 2020;42:e2020009. Published online March 8, 2020; DOI: https://doi.org/10.4178/epih.e2020009

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Abstract

OBJECTIVES
Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers).

METHODS

In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders.

RESULTS

The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern.

CONCLUSIONS

The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.

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Cohort Profiles

Health Effects of Underground Workspaces cohort: study design and baseline characteristics: Gerard Dunleavy, Thirunavukkarasu Sathish, Nuraini Nazeha, Michael Soljak, Nanthini Visvalingam, Ram Bajpai, Hui Shan Yap, Adam C. Roberts, Thuan Quoc Thach, André Comiran Tonon, Chee Kiong Soh, Georgios Christopoulos, Kei Long Cheung, Hein de Vries, Josip Car; Epidemiol Health. 2019;41:e2019025. Published online August 16, 2019; DOI: https://doi.org/10.4178/epih.e2019025

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The development of underground workspaces is a strategic effort towards healthy urban growth in cities with ever-increasing land scarcity. Despite the growth in underground workspaces, there is limited information regarding the impact of this environment on workers’ health. The Health Effects of Underground Workspaces (HEUW) study is a cohort study that was set up to examine the health effects of working in underground workspaces. In this paper, we describe the rationale for the study, study design, data collection, and baseline characteristics of participants. The HEUW study recruited 464 participants at baseline, of whom 424 (91.4%) were followed-up at 3 months and 334 (72.0%) at 12 months from baseline. We used standardized and validated questionnaires to collect information on socio-demographic and lifestyle characteristics, medical history, family history of chronic diseases, sleep quality, health-related quality of life, chronotype, psychological distress, occupational factors, and comfort levels with indoor environmental quality parameters. Clinical and anthropometric parameters including blood pressure, spirometry, height, weight, and waist and hip circumference were also measured. Biochemical tests of participants’ blood and urine samples were conducted to measure levels of glucose, lipids, and melatonin. We also conducted objective measurements of individuals’ workplace environment, assessing air quality, light intensity, temperature, thermal comfort, and bacterial and fungal counts. The findings this study will help to identify modifiable lifestyle and environmental parameters that are negatively affecting workers’ health. The findings may be used to guide the development of more health-promoting workspaces that attempt to negate any potential deleterious health effects from working in underground workspaces.

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Korea HIV/AIDS Cohort Study: study design and baseline characteristics: Bo Youl Choi, Jun Yong Choi, Sang Hoon Han, Sang Il Kim, Mee-Kyung Kee, Min Ja Kim, Shin-Woo Kim, Sung Soon Kim, Yu-Mi Kim, Nam Su Ku, Jin-Soo Lee, Joo-Shil Lee, Yunsu Choi, Kyong Sil Park, Joon Young Song, Jun Hee Woo, Moon Won Kang, June Kim; Epidemiol Health. 2018;40:e2018023. Published online June 6, 2018; DOI: https://doi.org/10.4178/epih.e2018023

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Abstract

The number of persons infected by HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection in 1985 and reached 15,208 by 2016. About 1,100 new patients with HIV/ AIDS infections have emerged every year since 2013. In Korea, the Korea HIV/AIDS Cohort Study was established for the evidenced-based prevention, treatment, and effective management of patients infected with human immunodeficiency virus (HIV) in December 2006. This study monitored 1,438 patients, who accounted for about 10% of all patients with HIV/AIDS in Korea, for 10 years with the following aims: (1) to develop an administrative system for the establishment of a HIV/AIDS cohort-based study; (2) to standardize methodologies and the case report forms; and (3) to standardize multi-cohort data and develop a data cleaning method. This study aims to monitor at least 1,000 patients (excluding those for whom investigation had been completed) per year (estimated number of patients who can be monitored by January 2018: 939). By December 2016, the sex distribution was 93.3% for men, and 6.7% for women (gender ratio, 13.9:1.0), and 98.9% of all participants were Korean. More than 50.0% of the participants were confirmed as HIV positive after 2006. This study reports competitive, long-term research that aimed to develop policies for the prevention of chronic infectious diseases for patients with HIV. The data collected over the last decade will be used to develop indices for HIV treatment and health promotion.

Summary

Korean summary
세계적으로 HIV 감염인은 감소하고 있으나, 한국의 HIV 감염은 증가하여 2013년 이후 매년 1,000명이 넘는 신규 감염인이 보고되고 있다. HIV/AIDS 코호트 연구진은 2006년부터 HIV 감염인과 AIDS 환자를 대상으로 6개월 간격의 반복 조사를 시행하여 역학과 임상 자료를 수집하여 데이터베이스를 구축하고, 생물검체를 채취하여 인체자원은행에 보관하여, HIV/AIDS의 발생 기전을 구명하고, 자연사를 파악하며, 예방과 진단, 치료, 관리 방법을 개발하기 위한 기초와 임상, 역학 연구에 활용하고 있다.

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Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment: Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Hyeon Chang Kim; Epidemiol Health. 2017;39:e2017016. Published online April 1, 2017; DOI: https://doi.org/10.4178/epih.e2017016

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Abstract

Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.

Summary

Korean summary
심뇌혈관 및 대사질환 원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center)에서는 심뇌혈관질환 및 대사질환의 새로운 발병 원인을 찾고 효율적인 예방 전략을 개발하고자 코호트(CMERC cohort와 CMERC-HI cohort)를 구축하였다. 지역사회에 거주하는 만 30-64세 건강한 성인을 대상으로 하는 CMERC cohort는 2013년부터 2018년 까지 총 5년 동안 8000명 등록을 목표로 기반조사를 진행 중이며(2016년 12월 현재 6000여명 등록), 이미 알려진 다양한 위험요인 이외에 사회연결망 정보와 면역노화 관련 바이오마커 등 새로운 위험 요인에 관한 광범위한 정보가 수집되고 있다. CMERC cohort는 심뇌혈관 및 대사질환 예방연구의 기초자료로 활용되어 과학적 데이터에 근거한 예방 전략 수립에 기여하게 될 것이다.

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The Korean social life, health and aging project-health examination cohort: Ju-Mi Lee, Won Joon Lee, Hyeon Chang Kim, Wungrak Choi, Jina Lee, Kiho Sung, Sang Hui Chu, Yeong-Ran Park, Yoosik Youm; Epidemiol Health. 2014;36:e2014003. Published online May 13, 2014; DOI: https://doi.org/10.4178/epih/e2014003

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Abstract

The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr).

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Korean summary
한국인의 사회적 삶, 건강과 노화에 대한 조사(Korean Social Life, Health, and Aging Project, KSHAP) 연구는 노인 건강의 사회적 결정요인과 그 상호작용을 평가하는 것을 목적으로 한다. 이를 위하여 사회연결망분석(social network analysis) 기법을 도입하였다. 사회연결망분석은 개인간의 관계를 네트워크로 파악하는 개념으로, 본 연구에서는 지역사회 전체의 사회연결망 안에서 개인의 특성 및 개인간 상호작용의 특성이 신체적 정신적 건강에 미치는 영향을 연구하고자 한다. 대상인구집단은 인천광역시 강화군 일개 면 지역의 60세 이상 인구 및 그 배우자이며, 전체 860명의 모집단에서 814명(94.7%)의 건강면접조사 및 사회연결망 분석을 완료하였으며, 이 가운데 보건지소(533명) 또는 가정(165명)에서 추가 건강검진을 수행한 698명을 대상으로 KSHAP-Health Examination (KSHAP-HE) 코호트를 구축하였다.

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