Background The disease burden of metabolic syndrome (MetS) is increasing with increasing prevalence. Economic deprivation is a risk factor for MetS and contributes to the overall mortality. Therefore, this study aimed to investigate the association between economic status and mortality in patients with MetS.
Methods Overall, 83,786 patients with MetS were included from the Korean National Health Insurance Service-Health Screening Database. They were divided into three economic levels (low, medium, and high) based on the health insurance premiums charged according to the annual household income. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality were calculated using Cox proportional hazards regression models.
Results The median follow-up duration was 10.0 years. Kaplan-Meier plots showed that the mortality rate was highest in males with a low economic status (P<0.001, log-rank test). Compared with that of the high economic status group, unadjusted HRs (95% CIs) of the middle and low economic status groups for all-cause mortality were 1.44 (1.32–1.57) and 1.88 (1.72–2.06), respectively, in males, and 0.84 (0.76–0.93) and 0.99 (0.89–1.10), respectively, in females. However, in the fully adjusted model, the corresponding HRs (95% CIs) were 1.23 (1.13–1.48) and 1.35 (1.23–1.48), respectively, in males and 1.17 (1.06–1.30) and 1.25 (1.12–1.39), respectively, in females.
Conclusion Among South Korean adults with MetS, the economically deprived population was significantly associated with higher mortality rates than those of wealthier groups.
Background As the global prevalence of diabetes mellitus continues to increase, it is important to identify its risk factors and implement preventive approaches. This study aimed to investigate the association between changes in systolic blood pressure (SBP) and the incidence of diabetes.
Methods Data from 152,547 participants, who underwent two consecutive health checkups between 2002 and 2003, and 2004 and 2005, and included in the Korean National Health Insurance Service Health Screening Database, were reviewed. Participants were divided into three groups according to change in SBP: decrease (≥10 mm Hg); no change (<10 mm Hg); and increase (≥10 mm Hg). Cox proportional hazard regression models for diabetes incidence were constructed to evaluate adjusted hazard ratio (HR) with corresponding 95% confidence interval (CI).
Results The median follow-up was 14.3 years, and 26,352 patients with diabetes were identified. Compared to those with no change in SBP, the adjusted HRs for decrease and increase among males were 1.06 (95% CI, 1.02–1.10) and 1.10 (95% CI, 1.06–1.14), and 1.06 (95% CI, 1.00–1.12) and 1.08 (95% CI, 1.02–1.13) for females, respectively. After stratifying data according to SBP at baseline, the HRs for decrease in males and females were as follows: normotensive group, 1.16 (95% CI, 1.08–1.24) and 1.11 (95% CI, 1.02–1.21); and prehypertensive group, 1.14 (95% CI, 1.09–1.20) and 1.19 (95% CI, 1.10–1.29), respectively.
Conclusion Changes in SBP were associated with a risk for diabetes.
Hyo-Sun You, Yu-Jin Kwon, Sunyoung Kim, Yang-Hyun Kim, Ye-seul Kim, Yonghwan Kim, Yong-kyun Roh, Byoungjin Park, Young Kyu Park, Chang-Hae Park, Joung Sik Son, Jinyoung Shin, Hyun-Young Shin, Bumjo Oh, Jae-woo Lee, Jae Yong Shim, Chang Won Won, Ji Won Yoo, Sang-Hyun Lee, Hee-Taik Kang, Duk Chul Lee
Korean J Fam Med 2021;42(6):413-424. Published online November 20, 2021
Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.
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Background Few studies have reported on the trends in influenza vaccination rates among cancer survivors in Korea. We investigated these trends over a recent 11-year period (2005–2015).
Methods Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) III– VI (2005–2015). After excluding individuals younger than 40 years of age, the participants included 2,210 cancer survivors (861 men and 1,349 women). We categorized these study participants into four groups according to age and sex.
Results The influenza vaccination rate decreased significantly among male cancer survivors, with rates of 74.8, 64.7, 56.2, and 55.2% (β coefficient=-0.257, P for trend <0.001) in KNHANES III, VI, V, and VI, respectively. While influenza vaccination rates decreased significantly among older male cancer survivors (≥65 years) (β coefficient=-0.359, P for trend=0.017), they increased among older female cancer survivors (β coefficient=0.375, P for trend=0.011) from 2005 to 2015.
Conclusion Influenza vaccination rates in older cancer survivors significantly decreased in men but increased in women in successive KNHANES phases. Efforts are needed to improve immunization education and awareness, especially in older male cancer survivors.
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