Risk Factor Analysis of Diabetic Retinopathy Diagnosed with Non-mydriatic Fundus Camera: KNHANES V

PURPOSE: To clarify the relationship between various factors (sociodemographic factors, health behavioral risk factors and health status, and diabetic factors) related to diabetic retinopathy and to suggest improvements regarding the associated medical examination. METHODS: The subjects were 1,444 diabetic patients diagnosed in the 5th Korean National Health and Nutrition Examination Survey (KNHANES), aged 19 years or older, who underwent non-mydriatic fundus photography. The criteria for diagnosing diabetes were a fasting glucose level ≥ 126 mg/dL and a previous diagnosis of diabetes or currently undergoing treatment. The diagnosis of diabetic retinopathy followed the modified Airlie House classification. Univariate and multivariate analyses of diabetic retinopathy were performed. RESULTS: Among the 1,444 patients who were diagnosed with diabetes, 277 had diabetic retinopathy; the prevalence rate was 19.18%. The higher the body mass index, the lower the risk of diabetic retinopathy by 0.924 times (p = 0.001; 95% confidence interval [CI], 0.883–0.966). The longer the duration of diabetes, the greater the risk of diabetic retinopathy; the prevalence period group of more than 11 years had a 26.025-fold higher risk than the newly diagnosed group (p < 0.001; 95% CI, 10.840–62.482). The risk of diabetic retinopathy increased with the hemoglobin A1c (HbA1c) level; the risk was 5.973-fold higher in the group with HbA1c above 11.0% (p < 0.001; 95% CI, 2.984–11.956) compared with the group with HbA1c < 6.0%. The risk of diabetic retinopathy was 2.050-fold greater with insulin injections (p = 0.003; 95% CI, 1.284–3.275). CONCLUSIONS: The risk of diabetic retinopathy was higher in patients with a longer duration of diabetes, a high HbA1c level, and in those using insulin. These findings highlight the need for early education and ophthalmologic examinations for at-risk patients.

Female Hormone Factors Associated with Age-related Macular Degeneration in Menopausal Korean Women: KNHANES V

PURPOSE: To investigate whether endogenous and exogenous female hormone exposures were associated with risks for age-related macular degeneration (AMD) in postmenopausal women. METHODS: This study included 4,479 postmenopausal females aged 45 years and older who completed the Korea National Health and Nutrition Examination Survey (KNHANES) V. The participants were divided into 4 groups: subjects with AMD, subjects without AMD, subjects with early AMD, and subjects with late AMD. Variables associated with endogenous and exogenous female hormone exposures were analyzed. RESULTS: Among the 4,479 participants, 516 were found to have AMD and 3,963 were normal. There was no significant difference between the AMD and normal groups execpt for age in the risk analysis. Of the total 516 AMD participants, 488 had early AMD and 28 had late AMD. Women with AMD who had used oral contraceptives longer in the past had significantly higher odds of late AMD than early AMD (odds ratio [OR] = 1.013, 95% confidence interval [CI]: 1.002–1.024). Increasing number of children was also associated with decreased odds of late AMD (OR = 0.672, 95% CI: 0.506-0.893). CONCLUSIONS: These findings suggest that exposure to endogenous and exogenous female hormones may influence the risk of AMD progression.

Quality of Life and Visual Efficiency: fifth Korea National Health and Nutrition Examination Survey

PURPOSE: To analyze the association of visual efficiency and quality of life using data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V). METHODS: The present study included 5,244 glaucoma or glaucoma suspect subjects who completed a visual acuity test, visual field test and health-related questionnaire from the KNHANES V. Visual efficiency was calculated using best corrected visual acuity and visual field test. Quality of life was assessed with EuroQoL 5D (EQ-5D). Visual efficiency was compared with best corrected vision of the better eye to evaluate the relationship with quality of life. One-way analysis of variance (ANOVA) and partial correlations analysis were used to analyze the associations between factors. RESULTS: Both visual efficiency and best corrected visual acuity of the better eye were significantly different with all EQ-5D parameters (p < 0.005). After controlling for age, gender, income, education, spouse and house ownership, visual efficiency showed a positive correlation coefficient of +0.040 (p = 0.006) with the quality of life and the best corrected visual acuity of the better eye showed negative correlation coefficient of -0.044 (p = 0.002) with the quality of life. CONCLUSIONS: Visual efficiency was associated with the quality of life. Not only visual acuity but also visual efficiency would be a valuable parameter when considering the quality of life. Further studies are needed to evaluate non-glaucomatous populations.

Correlation between vitamin C intake and periodontal disease: The Fifth Korea National Health and Nutrition Examination Survey, 2010 / 대한구강보건학회지

OBJECTIVES: Vitamin C is important for maintaining periodontal health. The purpose of this study was to examine the correlation between vitamin C intake and periodontal disease in adults. METHODS: The data collected from the 2010 Fifth Korea National Health and Nutrition Examination Survey was retrospectively reviewed. The final sample included 2,878 subjects, aged between 30 and 59 years. These patients had also undergone the required oral examinations and had taken health and nutrition surveys. RESULTS: The incidence of periodontal disease was 24.4%. The patients' gender, age, spouse, education level, smoking habits, brushing frequency, and vitamin C intake were considered to be significant risk factors for periodontal disease based on complex sampling analysis. The multivariate-adjusted odds ratio for occurrence of periodontal disease was 0.69 (95% confidence interval, 0.477-0.987) when the vitamin C intake of subjects in quartile 4 (Q4) and Q1 were compared (P=0.0421). CONCLUSIONS: The findings of this study suggest that vitamin C intake is significantly associated with periodontal disease, and also provide information that will aid in the prevention of periodontal disease.

The Factors Influencing Health-Related Quality of Life in the Elderly: Focused on the General Characteristics, Health Habits, Mental Health, Chronic Diseases, and Nutrient Intake Status: Data from the Fifth Korea National Health and Nutrition Examination / 대한지역사회영양학회지

OBJECTIVES: This study intended to determine significant factors that influence the health-related quality of life ("HRQoL"; EuroQol 5 Dimension health-related quality of life (EQ_5D) & EuroQol visual analogue scale (EQ_VAS)) of the elderly in Korea. METHODS: This study was based on 3,903 subjects aged 65 years or more who participated in the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012. The HRQoL was analyzed by various factors (general characteristics, health habits, mental health, chronic diseases, nutrient intakes). SPSS statistics for complex samples (Windows ver. 21.0) was used. RESULTS: The HRQoL was higher in the males, those with higher educational level or higher income level while it was lower in those belong to single households. In particular, the EQ_5D was significantly higher in the group who reported walking practice, moderate physical activity (male), and the group who reported no vigorous physical activity (female). The EQ_VAS was significantly higher in the group who reported walking practice. Both EQ_5D and EQ_VAS were significantly lower in the group with stress, melancholy, suicidal thinking, and osteoarthritis. EQ_5D was significantly lower in the group with < 75% Estimated Energy Requirements (EER) in energy intake, and with < Estimated Average Requirements (EAR) in iron or niacin intake. A stepwise regression analysis revealed that i) higher educational level (male), and good self-rated health status significantly increased the EQ_5D, ii) age, alcohol intake (male), melancholy (female), suicidal thinking, osteoarthritis, and niacin intake deficiency (male) significantly decreased the EQ_5D, iii) higher income level (male) and good self-rated health status significantly increased the EQ_VAS, and iv) age (male), stress, suicidal thinking (female) and osteoarthritis significantly decreased the EQ_VAS. CONCLUSIONS: This study suggested that general characteristics, mental health, osteoarthritis, and niacin intake were associated with the HRQoL. Prospective research of long-term control is needed to establish the causal relationship between factors and the HRQoL.

Prevalence of Osteoarthritis and Related Risk Factors in the Elderly: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012

The purpose of this study was to estimate the prevalence of osteoarthritis as well as assess the risk factors associated with osteoarthritis in Koreans over 65 years using data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012. Of the participants from KNHANES V, a total of 3,479 subjects were analyzed using SPSS statistics complex samples (Windows ver. 21.0). Osteoarthritis was more frequently found in female (32.5%) or rural (26.8%) groups than male (9.3%) or urban (20.3%) groups. Mean age of the osteoarthritis group was significantly higher than that of the normal group. Mean values of BMI and waist circumference were significantly higher in the osteoarthritis group than in the normal group, whereas height, fasting blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, hemoglobin, and hematocrit levels were not. Health-related quality of life (EQ-5D) was significantly higher in the normal group than in the osteoarthritis group. The results of multiple logistic regression showed that obesity and vitamin A/riboflavin intakes were significantly related to the prevalence of osteoarthritis, whereas smoking, alcohol intake, physical activity, hypertension, hypercholesterolemia, hypertriglyceridemia, anemia, and diabetes were not. This study suggests that obesity and nutrient intakes were associated with osteoarthritis, whereas chronic diseases such as hyper-lipidemia, anemia, and diabetes as well as health habits were not. Prospective research of long-term control is needed to establish the effects of those factors on the osteoarthritis.

Various Factors Affecting the Bone Mineral Density in Korean Young Adult Women: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011

This study investigated factors affecting the bone mineral density (BMD) of Korean young adult women (20~30 yrs) living in Seoul, according to the state of employment. Data on BMD and anthropometric and biochemical measurements were obtained from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) (2010~2011). BMD of the working group (WG) was generally higher than that of the non-working group (NWG). The prevalence of osteopenia, and osteoporosis between the groups was 29.0/31.5%, and 12.9/18.5% from 20~29 yrs as well as 25.5/24.1%, and 20.2/20.5% from 30~39 yrs, respectively. From 20~29 yrs, prevalence of osteopenia and osteoporosis in the WG was lower than that of the NWG. Alkaline phosphatase activity of the WG was lower than that of the NWG. In the WG, from 20~29 yrs, total femur BMD showed significant positive correlations with waist circumstance and BMI. In the NWG, from 20~29 yrs, total femur, femoral neck, and lumbar spine BMDs showed significant positive correlations with weight and fat mass, whereas they showed significant negative correlations with vitamin D. In the WG, from 30~39 yrs, total femur and femoral neck BMDs showed significant positive correlations with weight and free fat mass. The results of this study show that BMD of young adult women is insufficient regardless of their employment status. Therefore, practical and systematic programs are required to improve the BMD of young adult women as well as to maintain healthy bone levels.