Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES: In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates. METHODS: Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error. RESULTS: With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES. CONCLUSIONS: When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.

Associations between socioeconomic status and blood cadmium levels in Korea / 한국역학회지

OBJECTIVES: Although smoking is associated with both low socioeconomic status and blood cadmium (Cd) levels, the association between socioeconomic status and Cd levels remains unclear. Therefore, our study aimed to examine this association and to clarify whether smoking is a confounding or mediating variable in this relationship. METHODS: Data (n=7,734) were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008- 2011), including years that contained data on blood Cd and urinary cotinine levels. We investigated the associations of income, education, and occupation with blood Cd levels. Smoking was investigated by categorizing participants by smoking status (never, former, and current) and pack-years into quartiles. The weekly frequency of rice and barley intake was analyzed to gain insights into participants’ dietary patterns. Additionally, urinary cotinine levels were used to ensure the validity of the smoking variables. RESULTS: Participants earning a low income and with less formal education had higher blood Cd levels. After controlling for smoking, the association between income and Cd levels substantially weakened. Further controlling for education, the association between income and Cd levels disappeared. However, there was a strong negative association between education and Cd levels, even after controlling for smoking history, pack-years, and urinary cotinine levels. CONCLUSIONS: In cross-sectional data from the KNHANES, blood Cd levels were significantly higher among those with a low income and less formal education. Smoking history contributed to, but did not fully explain, these associations.

Association between depression and cardiovascular disease risk in general population of Korea: results from the Korea National Health and Nutrition Examination Survey, 2016

BACKGROUND: Depression is considered as a risk factor for cardiovascular disease (CVD) and associated with changes in individuals' health status that might influence CVD risk. However, most studies have scrutinized this relationship on a rather narrower and specific study population. By focusing on general population of Korea, we sought to inspect the association of depression with CVD risk and cardiovascular risk factors. METHODS: The data from the first year (2016) of the 7th Korea National Health and Nutrition Examination Survey was used. Participants were classified by the Patient Health Questionnaire-9 (PHQ-9) score as such: normal group (PHQ-9 score 0–4), mild depression (MD) group (PHQ-9 score 5–9) and moderate and severe depression (MSD) group (PHQ-9 score 10–27). General linear model was used to analyze differences and the trend of mean CVD risk according to depression level. Adjusted odds ratios (AORs) were calculated by logistic regression to identify the association between depression and cardiovascular risk factors after adjusting for age. RESULTS: Mean CVD risk of MSD group was higher than that of normal group (p 125 mg/dL; AOR, 2.37; 95% CI, 1.25–4.50) and taking diabetes medications (AOR, 3.08; 95% CI, 1.65–5.72). MD group was associated with current smoking (AOR, 1.60; 95% CI, 1.18–2.17). Among women, MSD group was associated with high body mass index (≥ 25 kg/m2; AOR, 1.61; 95% CI, 1.11–2.32), large waist circumference (≥ 85 cm; AOR, 1.63; 95% CI, 1.12–2.37), current smoking (AOR, 5.11; 95% CI, 3.07–8.52) and taking diabetes medications (AOR, 2.62; 95% CI, 1.68–4.08). MD group was associated with current smoking (AOR, 1.86; 95% CI, 1.18–2.93). CONCLUSIONS: We suggest that depression is associated with increased risk for CVD occurrence in general population of Korea.

Associations of the eating alone behavior with nutrient intake, obesity and metabolic syndrome in middle-aged adults based on the 2013 ~ 2017 Korean National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined the changes in the nutrient intake and the prevalences of obesity and metabolic syndrome according to the eating alone behavior in middle-aged men and women. METHODS: The data from the 2013 ~ 2017 Korean National Health and Nutrition Examination Survey were analyzed. A total of 7,728 adults (3,404 male, 4,324 female) aged 40 ~ 64 years old were included. The subjects were classified into three groups according to the number of times eating alone per day (0, 1 ~ 2, and 3 times/day). Dietary data were collected by a 1-day 24-h recall. The nutrient intakes were compared among the three groups. Survey logistic regression analyses were conducted to examine the association of the eating alone behavior with obesity and metabolic syndrome, adjusting for the related confounding variables. RESULTS: In men, eating alone was associated significantly with a lower intake of potassium (p-for-trend = 0.048) and lower intake of calories from protein (p-for-trend = 0.04). In women, the proportion of subjects consuming energy less than 75% of the estimated energy requirement (p = 0.001) and less than the estimated adequate requirement of riboflavin (p < 0.001) differed significantly according to the eating alone behavior. The eating alone behavior was positively associated with an increased risk of developing metabolic syndrome (p-for-trend = 0.033), increased blood pressure (p-for-trend < 0.001), and increased waist circumference (p-for-trend = 0.004). On the other hand, in women, however, the eating alone behavior was associated with a decreased risks of developing obesity (p-for-trend = 0.02). No association was found between the eating alone behavior and the risk of metabolic syndrome in women. CONCLUSION: These results suggest that the eating alone behavior is a risk factor for the development of metabolic syndrome in middle-aged Korean men.

Analysis of the Difference in Nutrients Intake, Dietary Behaviors and Food Intake Frequency of Single- and Non Single-Person Households: The Korea National Health and Nutrition Examination Survey (KNHANES), 2014–2016 / 대한지역사회영양학회지

OBJECTIVES: This study was performed to compare the dietary life of single- and non single-person households in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A nationally representative sample of 20,421 19-64-year-olds who had 24-hour recall data was taken from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES). Single- and non single-persons were compared for nutrient intake, dietary behaviors, food consumption patterns, nutrition education and confirm nutrition label. RESULTS: The dietary intakes of dietary fiber and iron were lower in single-person households than in non single-person households. The lower the level of education and income, the lower the nutrient intake of single-person households. In the case of those aged 19 to 29, the breakfast skipping rate was higher in single-person households than in non single-person households. The higher the education level, the higher the breakfast skipping rate and the eating out frequency in the single-person households. In the food intake survey, the frequency of healthy food intake in single-person households was much lower than that of non single-person households. The confirmation rate of nutrition labeling was lower in single-person households than in non single-person households. CONCLUSIONS: This study shows that single-person households have poorer health-nutritional behaviors than multi-person households. Therefore, a nutrition education program based on the data of this study needs to be developed for health promotion of single-person households.

Analysis of the Difference in Nutrients Intake, Dietary Behaviors and Food Intake Frequency of Single- and Non Single-Person Households: The Korea National Health and Nutrition Examination Survey (KNHANES), 2014–2016 / 대한지역사회영양학회지

OBJECTIVES: This study was performed to compare the dietary life of single- and non single-person households in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A nationally representative sample of 20,421 19-64-year-olds who had 24-hour recall data was taken from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES). Single- and non single-persons were compared for nutrient intake, dietary behaviors, food consumption patterns, nutrition education and confirm nutrition label. RESULTS: The dietary intakes of dietary fiber and iron were lower in single-person households than in non single-person households. The lower the level of education and income, the lower the nutrient intake of single-person households. In the case of those aged 19 to 29, the breakfast skipping rate was higher in single-person households than in non single-person households. The higher the education level, the higher the breakfast skipping rate and the eating out frequency in the single-person households. In the food intake survey, the frequency of healthy food intake in single-person households was much lower than that of non single-person households. The confirmation rate of nutrition labeling was lower in single-person households than in non single-person households. CONCLUSIONS: This study shows that single-person households have poorer health-nutritional behaviors than multi-person households. Therefore, a nutrition education program based on the data of this study needs to be developed for health promotion of single-person households.

Location of Retinal Nerve Fiber Layer Defects in Open-angle Glaucoma and Associated Factors

PURPOSE: To investigate the location of retinal nerve fiber layer defects (RNFLDs) in open-angle glaucoma and the differences in systemic and ocular factors between superotemporal and inferotemporal RNFLDs. METHODS: We performed a retrospective review of the 2008 to 2012 data from the Korea National Health and Nutrition Examination Survey. Subjects aged ≥19 years with an evaluable fundus photograph of at least one eye were enrolled, and open-angle glaucoma was diagnosed according to modified International Society of Geographical and Epidemiological Ophthalmology criteria. In subjects with open-angle glaucoma, locations of RNFLDs were evaluated, and systemic and ocular factors were compared between the bilateral superotemporal RNFLD group and bilateral inferotemporal RNFLD group. RESULTS: A total of 534 subjects had open-angle glaucoma with RNFLDs. The unilateral inferotemporal region (25.8%) was the most common location for RNFLDs, followed by the unilateral superotemporal region (24.4%). Multivariate analysis revealed that hypertension was more significantly associated (p = 0.048) with the bilateral superotemporal RNFLD group than with the bilateral inferotemporal RNFLD group. CONCLUSIONS: Superotemporal RNFLDs are more related to hypertension than are inferotemporal RNFLDs.

Evaluation of the Nutrition Status and Metabolic Syndrome Prevalence of the Members according to the Number of Household Members based on the Korea National Health and Nutrition Examination Survey (2013–2014) / 대한지역사회영양학회지

OBJECTIVES: This study evaluated the nutritional status and prevalence of metabolic syndrome of the people who participated in the KNHANES according to the number of household members. They were assessed by using information from the 2013~2014 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 6,088 persons aged 19 years and over participated in 2013~2014 KNHANES, and they were classified into three groups according to the number of household members (single-person, two-person, three-person & over). The dietary behavior, nutritional status, health-related factors and the prevalence of metabolic syndrome of the subjects were investigated with using information from the survey questionnaires of KNHANES. The nutrient intake data of the subjects were obtained by the 24-hour recall method and this was analyzed for evaluating the nutrition adequacy ratio and the index of nutritional quality. The prevalence of metabolic syndrome among the subjects, and according to the study groups, was estimated using the blood and physical measurement data of the subjects. RESULTS: As for EQ-5D index available for all the health states generated by the EQ-5D descriptive system, the single-person household member was the lowest among all the household types. The index of nutrition quality for protein, crude fiber, calcium, phosphorus, potassium, riboflavin and vitamin C in the single-person household was lower than that of the two-person or the three-person and over households (p<0.001). The mean adequacy ratio of single-person households was significantly decreased compared with that of the other types of households (p<0.001). The prevalence of metabolic syndrome was higher in the single-person households than that in the multiple-person households (p<0.001). CONCLUSIONS: These results showed that dietary behaviors, nutrition status and health status might be influenced by the number of household members. The results from this study would be useful for improving Korean people's dietary life and health status by implementing evidence-based, specialized intervention for the members of diverse types of households.

Factors Associated with Dry Eye Symptoms in Elderly Koreans: The Fifth Korea National Health and Nutrition Examination Survey 2010–2012 / 가정의학회지

BACKGROUND: Dry eye disease is an aging-related ophthalmic disease that not only affects the daily activities but also causes deterioration in the quality of life. This study aimed to evaluate the factors associated with dry eye symptoms in elderly Koreans. METHODS: We investigated 4,185 subjects (men=1,787 and women=2,398) aged ≥65 years from the fifth Korea National Health and Nutrition Examination Survey 2010–2012. Data were analyzed using multiple logistic regressions to identify the relationships between dry eye symptoms and other factors. RESULTS: The prevalence of dry eye symptoms was 17.9%. After adjustment for confounding factors, dry eye symptoms were significantly associated with female sex (adjusted odds ratio [aOR], 1.806; 95% confidence interval [CI], 1.410–2.313), a history of cataract (aOR, 1.683; 95% CI, 1.255–2.255), suicidal ideation (aOR, 1.414; 95% CI, 1.070–1.870), hypercholesterolemia (aOR, 1.289; 95% CI, 1.025–1.621), age ≥80 years (aOR, 0.538; 95% CI, 0.337–0.859), and sleep duration ≥9 h/d (aOR, 0.524; 95% CI, 0.330–0.834). CONCLUSION: Among elderly Koreans, female sex, a history of cataract, suicidal ideation, and hypercholesterolemia may be the risk factors for dry eye symptoms, whereas sleep duration ≥9 h/d can be a protective factor against dry eye symptoms.

Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES: In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates.METHODS: Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error.RESULTS: With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES.CONCLUSIONS: When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.

Associations between socioeconomic status and blood cadmium levels in Korea / 한국역학회지

OBJECTIVES: Although smoking is associated with both low socioeconomic status and blood cadmium (Cd) levels, the association between socioeconomic status and Cd levels remains unclear. Therefore, our study aimed to examine this association and to clarify whether smoking is a confounding or mediating variable in this relationship.METHODS: Data (n=7,734) were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008- 2011), including years that contained data on blood Cd and urinary cotinine levels. We investigated the associations of income, education, and occupation with blood Cd levels. Smoking was investigated by categorizing participants by smoking status (never, former, and current) and pack-years into quartiles. The weekly frequency of rice and barley intake was analyzed to gain insights into participants' dietary patterns. Additionally, urinary cotinine levels were used to ensure the validity of the smoking variables.RESULTS: Participants earning a low income and with less formal education had higher blood Cd levels. After controlling for smoking, the association between income and Cd levels substantially weakened. Further controlling for education, the association between income and Cd levels disappeared. However, there was a strong negative association between education and Cd levels, even after controlling for smoking history, pack-years, and urinary cotinine levels.CONCLUSIONS: In cross-sectional data from the KNHANES, blood Cd levels were significantly higher among those with a low income and less formal education. Smoking history contributed to, but did not fully explain, these associations.

Association between Sleep Duration and Prevalence of Dyslipidemia in Korean Adults: The Sixth Korean National Health and Nutrition Examination Survey

BACKGROUND: This study was performed to evaluate the correlation between sleep duration and the prevalence of dyslipidemia in Korean adults.METHODS: Among the 18,034 adults who participated in the 6th Korean National Health and Nutrition Examination Survey, 3,020 adults with missing values were excluded, and 15,014 adults were enrolled in our study. The association between sleep duration and the prevalence of dyslipidemia was analyzed by multiple logistic regression. We controlled for factors including sex, age, body mass index, smoking, drinking, diabetes mellitus, hypertension, walking exercise, muscular exercise, and stress.RESULTS: After adjusting for sex, age, body mass index, smoking, drinking, diabetes mellitus, hypertension, walking, muscular exercise, and stress in a multiple logistic regression analysis, sleep duration was associated with the prevalence of dyslipidemia. The group who slept for less than 7 hours per night had a higher prevalence of dyslipidemia than the group who slept for between 7 and 9 hours per night.CONCLUSION: In this study, a shorter sleep duration was associated with a higher prevalence of dyslipidemia.

Association between Metabolic Syndrome and Severity of Depression Scored with Patient Health Questionnaire-9 in Men Older Than 50 Years

BACKGROUND: This study aimed to evaluate the association between metabolic syndrome and depression severity based on the Patient Health Questionnaire 9 (PHQ-9) score in men aged >50 years.METHODS: In this study, we used data of 1,230 individuals from the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VII-1) 2016 conducted by the Korea Centers for Disease Control and Prevention. We diagnosed metabolic syndrome in accordance with National Cholesterol Education Program-Adult Treatment Panel III guidelines using waist circumference, blood pressure, fasting serum triglyceride level, high-density lipoprotein cholesterol level, and fasting glucose level in men aged >50 years (mean±standard deviation: 64.6±8.8 years), and their PHQ-9 scores were classified as mild and severe (cutoff, 10).RESULTS: The mean waist circumference, fasting glucose level, triglyceride level, and high-density lipoprotein cholesterol level were 87.1±8.2 cm, 109.8±28.3 mg/dL, 155.9±123.9 mg/dL, and 46.5±12.2 mg/dL, respectively. The mean systolic and diastolic blood pressures were 124.7±15.9 mmHg and 76.2±10.7 mmHg, respectively. The mean body mass index, was 24.2±2.9 kg/m². The prevalence of metabolic syndrome was 43.7%. The mean PHQ-9 score was 2.0±3.3. The prevalence of severe depression with a score of >10 was 4.2%. Metabolic syndrome and depression were related (P<0.05). The adjusted odds ratio for metabolic syndrome was 0.5 (95% confidence interval [CI], 0.3–0.9). However, age (95% CI, 0.9–1.0), sleep duration during weekdays (95% CI, 0.9–1.0), and sleep duration during weekends (95% CI, 0.9–1.0) were not related.CONCLUSION: Metabolic syndrome was associated with depression in men aged >50 years in this study.

Factors Associated with Screening for Diabetic Retinopathy in Elderly Diabetic Patients: The Sixth Korea National Health and Nutrition Examination Survey

BACKGROUND: The purpose of this study was to analyze factors related to screening for diabetic retinopathy in elderly diabetic patients.METHODS: This study included 682 elderly diabetic patients aged older than 65 years who answered the question “Have you undergone an eye examination in the last year?” from the Sixth Korea National Health and Nutrition Examination Survey 2013–2015. Data were analyzed using multiple logistic regression to identify the relationship between screening for diabetic retinopathy in elderly diabetic patients and related factors.RESULTS: Among the study population, 493 patients (73.3%) did not undergo eye examinations in the last year. Age ≥80 years (odds ratio [OR], 2.250; 95% confidence interval [CI], 1.014–4.992), current smoking (OR, 2.006; 95% CI, 1.018–3.953), poor subjective health status (OR, 0.457; 95% CI, 0.242–0.863), history of stroke (OR, 0.479; 95% CI, 0.246–0.933), and history of hypertension (OR, 1.674; 95% CI, 1.114–2.516) were significantly associated with not undergoing eye examinations for diabetic retinopathy in elderly diabetic patients aged older than 65 years.CONCLUSION: In elderly diabetic patients aged older than 65 years living in Korea, those aged older than 80 years, who are current smokers, and with a history of hypertension showed low rates of undergoing eye examinations for diabetic retinopathy, while those with poor subjective health status and a history of stroke had high rates of undergoing eye examinations.

The Relationship between Hyperuricemia and Triglyceride Glucose Index: Based on 2016 Korean National Health and Nutrition Examination Survey

BACKGROUND: Hyperuricemia refers to an excess of uric acid in the blood and is associated with gouty arthritis, hypertension, metabolic syndrome, atrial fibrillation, kidney stones, insulin resistance (IR), and type 2 diabetes mellitus. Previous studies have used the homeostatic model assessment of IR (HOMA-IR), a well-known index of IR, to investigation the correlation between serum uric acid levels and IR. However, difficulty with measuring insulin levels limits the clinical applicability of the HOMA-IR index. This study investigated the correlation between hyperuricemia and the triglyceride glucose (TyG) index.METHODS: We used data from the Seventh Korea National Health and Nutrition Examination Survey, 2016. The study population included adults without diabetes aged >19 years. The TyG index, which serves as an indicator of IR, was calculated using fasting serum glucose and triglyceride levels to investigate the correlation between the TyG index and hyperuricemia. Pearson's correlation coefficient and analysis of covariance were used for statistical analysis, which was performed using IBM SPSS software.RESULTS: A statistically significant correlation was observed between serum uric acid levels and the TyG index. After adjustment for factors that may affect IR (age, body mass index, waist circumference, and systolic and diastolic blood pressures), we observed that the TyG index was significantly higher in the hyperuricemia than in the non-hyperuricemia group (8.96 vs. 8.54, P < 0.001).CONCLUSION: Serum uric acid levels were significantly correlated with IR assessed using the TyG index in adults without diabetes aged >19 years.

Association between Body Mass Index and Dental Caries: Based on the Korea National Health and Nutrition Examination Survey 2013 – 2015 / 대한소아치과학회지

The purpose of this study was to evaluate the relationship between Body Mass Index (BMI) and dental caries by considering related factors in Korean children and adolescents. A total of 2,874 children, aged from 2 to 18, who participated in the Korea National Health and Nutrition Examination Survey 2013 – 2015 were included. BMI (kg/m²) was calculated, and participants were categorized into 4 groups using age and gender specific criteria. Decayed and filled teeth index were obtained. There were statistically significant differences in DMFT index between overweight group and other groups (p < 0.01). Underweight group showed the highest mean DMFT index compared to other groups. These findings suggest that children in obesity and underweight group tend to have more caries than normal group in this study.

Association between Sleep Duration and Body Composition Measures in Korean Adults: The Korea National Health and Nutrition Examination Survey 2010 / 가정의학회지

BACKGROUND: The association between sleep duration and body composition measures in Korean adults remains unclear. METHODS: This cross-sectional study included 3,532 subjects aged ≥40 years (1,542 men and 1,990 women) who participated in the 2010 Korea National Health and Nutrition Examination Survey V-1. Self-reported sleep duration and anthropometric data were collected. Appendicular skeletal muscle mass (ASM) was quantified via dual-energy X-ray absorptiometry. Obesity was defined according to the body mass index and waist circumference. Sarcopenia was defined as the muscle mass percentage (ASM/weight) below the lowest quintile computed for the study population. Multivariate logistic regressions with or without adjustment for sociodemographic and lifestyle factors were used to evaluate the association of sleep duration with obesity and sarcopenia for participants who slept ≤5, 6–8, and ≥9 h/d. The results were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). RESULTS: In women, the association between sleep duration and sarcopenia was stronger for individuals who slept ≥9 h/d than for those who slept 6–8 h/d (unadjusted OR, 1.99; 95% CI, 1.19–3.34; adjusted OR, 1.77; 95% CI, 1.06–2.96). CONCLUSION: Longer sleep duration is associated with a significantly higher incidence of sarcopenia in Korean women aged ≥40 years.

Association between Grip Strength as Diagnostic Criteria of Sarcopenia and Health-Related Quality of Life in Korean Elderly / 대한스포츠의학회지

PURPOSE: This study aimed to investigate the association between grip strength as diagnostic criteria of sarcopenia and health-related quality of life (HRQL) in Korean elderly. METHODS: Data were obtained through the 2014–2015 Korea National Health and Nutrition Examination Survey (6th KNHANES), targeting a total of 3,096 elderlies (over 60 years old). Grip strength was measured and divided into four quartiles, and the lower quartile was used as the muscle strength criterion for sarcopenia. The EuroQol-5 Dimension (EQ-5D) questionnaire was used to measure HRQL and classified as poor HRQL when the EQ-5D index was less than 1. Complex sample design logistic regression was used to evaluate the odds ratio (OR) and 95% confidence interval (CI) of prevalence of poor HRQL associated with sarcopenia. RESULTS: When confounding factors are adjusted, the OR (95% CI) of prevalence of poor HRQL for male and female elderlies in the group with the highest strength, as compared to the group with the lowest strength were 0.605 (0.413–0.893), and 0.406 (0.297–0.590), respectively. CONCLUSION: Muscle strength can be considered to be more effective in assessing the health status of the elderly compared to muscle mass. In particular, this is acceptable given the cost of measurement and the clarity as a health goal.

The Relationship between Oral Health and Stroke in Adults Based on the 6th (2015) Korea National Health and Nutrition Examination Survey / 치위생과학회지

Stroke is the second cause of death worldwide, although the survival period is increasing after the occurrence of stroke, severe physical disability is caused with aftereffect. Oral inflammation is not limited to the oral cavity, it can cause malignant changes in other tissues and organs. In previous studies, we confirmed the relationship between tooth loss and stroke due to periodontal inflammation. The purpose of this study was to investigate the relationship between oral health and stroke such as oral hygiene behavior, tooth loss and periodontal disease among Korean adults over 40 years of age. This study was analyzed using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3,389 adults over 40 years of age were analyzed as final subjects. Socioeconomic statuses and oral health status was analyzed using a complex sample analysis technique. Logistic regression was used to analyze the relationship of oral health and stroke, and 95% confidence intervals were computed using SPSS. When the prevalence of stroke according to oral hygiene behavior was checked, the prevalence of strokes was lower in subjects who had a lot of brushings per day and subjects who used oral hygiene products (p 0.05). Loss of teeth was found to be associated with the risk factor of stroke. Therefore, loss of teeth due to periodontal disease is an additional issue that should be considered as a risk factor for stroke.

Association between Stroke Status and Depression in a Community Setting: The 2014 Korea National Health and Nutrition Examination Survey

BACKGROUND AND PURPOSE: Previous studies have examined the risk factors for depression in stroke patients, but little information is available on the relationship between stroke status and depression in the community-dwelling general population. We evaluated the association between stroke status and depression using representative nationwide data. METHODS: In total, 3,487 subjects (aged ≥40 years) who participated in version VI-2 of the sixth Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 were included. We compared the prevalence of depression in 120 community-dwelling stroke patients and 3,367 nonstroke controls using the nine-item Patient Health Questionnaire (PHQ-9). RESULTS: The prevalence of depression (PHQ-9 score ≥10) was 16.7% in stroke patients and 6.4% in controls. In the unadjusted model, depression was more common in stroke patients than in nonstroke controls [odds ratio (OR), 2.95; 95% confidence interval (CI), 1.79–4.86]. After adjusting for demographic characteristics, socioeconomic status, health-related behaviors, and comorbidities, stroke diagnosis was a significant risk factor for depression (OR, 1.85; 95% CI, 1.06–3.24). Specifically, a diagnosis of stroke in patients aged <60 years (OR, 3.82; 95% CI, 1.81–8.09) and the presence of stroke complications (OR, 2.77; 95% CI, 1.25–6.13) remained significant risk factors for depression even after adjusting for potential confounders. CONCLUSIONS: In a community setting, poststroke survivors had a higher prevalence of depression, and stroke was an independent risk factor for depression. Public psychosocial interventions are needed to improve the mental health care of community-dwelling stroke survivors.