Korean Journal of Family Medicine

Association between weight changes over a 4-year period and health-related quality of life in middle-aged and older adults in Korea: the Korean Genome and Epidemiology Study Cohort: Sinyoung Cho, Mun Young Yoo, Na Hyun Kim, Sooah Paik, Doyeon Won, Jong Soo Han, Hyejin Lee, Woo Kyung Bae; Korean J Fam Med 2025;46(4):262-269. Published online June 14, 2024; DOI: https://doi.org/10.4082/kjfm.23.0152

Abstract
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Background
The relationship between weight change and quality of life remains controversial. This study aimed to investigate whether changes in body weight among participants in different baseline body mass index categories are associated with physical and mental health functioning.
Methods
We conducted an analysis involving 5,106 adults who participated in the Korean Genome and Epidemiology Study, a cohort comprising Korean adults aged 40 to 69 years. We categorized participants into three groups based on body weight change, and physical and mental health were assessed using the 12-Item Short-Form Health Survey in year 4. We employed logistic regression analysis to assess the association between body weight change and poor functioning at year 4. We also utilized a generalized estimating equation to determine the relationship between weight changes and mental component summary (MCS) scores over the study period for each weight group.
Results
Weight gain in both the normal weight (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.13–3.11; P=0.01) and overweight groups (OR, 1.75; 95% CI, 1.05–2.91; P=0.03) was associated with poor MCS. Normal weight weight-losers were associated with a greater increase (2.69 points; 95% CI, 0.50–4.88) in MCS compared to weightmaintainers. Significant differences in mean MCS were observed for overweight weight-losers, obese weight-gainers, and underweight weight-gainers when compared to weight maintainers in each respective weight group.
Conclusion
Different patterns of relationships between weight change and mental health-related quality of life were observed. Hence, it is crucial to focus on the mental health of middle-aged and older adults when assessing body weight changes.

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Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
Joung Sik Son
Korean Journal of Family Medicine.2025; 46(4): 215. CrossRef

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Impact of Sleep Duration on Decline in Kidney Function in Adult Patients with Hypertension: A Community-Based Prospective Cohort Study: Yoon Jun Cha, Ju Young Kim, Eunbyul Cho, Keehyuck Lee, Kiheon Lee, Woo Kyung Bae, Hyejin Lee, Jong Soo Han, Se Young Jung, Sumi Lee; Korean J Fam Med 2022;43(5):312-318. Published online September 20, 2022; DOI: https://doi.org/10.4082/kjfm.21.0164

Abstract
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Background
Sleep duration is associated with various health conditions, including chronic kidney disease. However, the association between sleep duration and decline in kidney function in the South Korean population remains unclear. We aimed to investigate the impact of sleep duration on kidney function decline in adult patients with hypertension.
Methods
This cohort study was performed using data obtained from the Korean Genome and Epidemiology Study; 2,837 patients with hypertension who initially had normal kidney function were included. Glomerular filtration rates (GFRs) were estimated at baseline and throughout the 16 years of follow-up. A person was considered to have a decline in kidney function if they had a GFR <60 mL/min/1.73 m². Sleep duration data were obtained through interviewer-assisted questionnaires. Sleep durations were classified as short (<6 hours), normal (≥6 hours but <9 hours), and long (≥9 hours). The Cox proportional hazards model was applied, with adjustments for covariates.
Results
After adjusting for covariates, sleep duration was not associated with a decline in kidney function. However, among men with poorly controlled hypertension at baseline, compared to men with normal sleep durations, men with sleep durations <6 hours had a significantly higher risk of kidney function decline (hazard ratio, 1.56; 95% confidence interval, 1.02–2.36).
Conclusion
Short sleep duration did not seem to be associated with an increased risk of decline in kidney function; however, it may be a risk factor for the decline in kidney function in men with poorly controlled hypertension.

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The risk of chronic kidney disease or proteinuria with long or short sleep duration: a systematic review and meta-analysis of cohort studies
Meng Hu, Yongchong Wang, Wen Zhu, Xiaozhen Chen
Clinical and Experimental Nephrology.2025; 29(3): 301. CrossRef
Short or long sleep duration was associated with chronic kidney disease in the general population
Gang Wang, Ning Zhuo, Zhichun Liu
International Urology and Nephrology.2024; 56(7): 2441. CrossRef
The association of sleep duration with the risk of chronic kidney disease: a systematic review and meta-analysis
Jin Hean Koh, Brian Sheng Yep Yeo, Timothy Wei En Tan, Mark Yong Siang See, Adele Chin Wei Ng, Shaun Ray Han Loh, Joshua Gooley, Chieh Suai Tan, Song Tar Toh
Clinical Kidney Journal.2024;[Epub] CrossRef
Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study
Saber Jafari Maskouni, Hossein Bavi Behbahani, Meysam Alipour, Ahmad Zare Javid, Fatemeh Fayazfar, Pardis Tofighzadeh, Shiva Shokri, Sara Keramatzadeh, Haleh Soltaniyan Dehkordi, Morteza Sharifat, Siavash Babajafari Esfandabad, Shokouh Shayanpour
Frontiers in Nutrition.2024;[Epub] CrossRef

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Changes in Diagnostic Performance of Thyroid Cancer Screening before and after the Korean Thyroid Imaging Reporting and Data System Revision: Na Hyun Kim, Jong Soo Han, Woo Kyung Bae, Joo Young Kim, Kiheon Lee, Hyejin Lee, Kee Hyuck Lee, Se Young Jung, HanKyung Lee, Hee-Yeong Jeong, Young A Kim, Suyoun Sim, Ji-Won Kang; Korean J Fam Med 2022;43(4):225-230. Published online July 19, 2022; DOI: https://doi.org/10.4082/kjfm.21.0168

Abstract
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Background
Since the era of “thyroid cancer epidemic,” many Korean academic societies discouraged the use of ultrasonography in healthy individuals and revised the Korean Thyroid Imaging Reporting and Data System to address the overscreening and overdiagnosis issues. This study aimed to evaluate the change in the diagnostic effectiveness of thyroid cancer screening over the last decade.
Methods
This single-center, retrospective observational study analyzed the data of 125,962 thyroid nodules obtained during cancer screening at the health promotion center of Seoul National University Bundang Hospital from 2010 to 2019. Only 327 thyroid cancer cases pathologically confirmed by fine-needle aspiration (FNA) were included in the study. The strength of the association between the number of FNA and (1) the number of thyroid cancer diagnoses, (2) the positive predictive values (PPVs), and (3) the difference in PPV from the previous year were evaluated using Pearson’s correlation analysis.
Results
The number of thyroid FNA biopsies as well as the thyroid cancer diagnoses decreased from 2010 to 2019 (166 to 48 [-71.1%] vs. 43 to 22 [-48.8%]). The PPV of FNA biopsies increased from 25.9% to 45.8% (+76.8%) and was negatively correlated with the number of FNA biopsies performed (R=-0.87, P<0.001). The difference in PPV from the previous year increased similarly but without statistical significance (R=-0.59, P=0.09).
Conclusion
The diagnostic efficiency of thyroid cancer screening has increased over the last decade, as evidenced by the increasing PPV of FNA biopsies.

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Impact of Incretin Mimetics on Thyroid Cancer Among Patients with Type 2 Diabetes: A Retrospective Cohort Time-to-Event Analysis
Michael W. Strand, Daniel Chow, Weining Shen, Jonathan H. Watanabe
Pharmacoepidemiology.2025; 4(2): 9. CrossRef

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Fruit Intake and Changes of Cardio-Metabolic Risk Factors in People with Obesity: Shiao Shih Liu, Ju Young Kim, Jung Ha Park, Sohye Kim, Kiheon Lee, Woo Kyung Bae, Kee Hyuck Lee, Jong Soo Han, Hyejin Lee, Se Young Jung; Korean J Fam Med 2021;42(5):382-389. Published online September 20, 2021; DOI: https://doi.org/10.4082/kjfm.20.0205

Abstract
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Background
This study aimed to explore the relationship between fruit intake, changes in fruit intake, and changes in cardiometabolic factors in people with obesity.
Methods
A total of 21,270 subjects (8,718 men, 12,552 women) aged 40 years and over, from the Korean-based Genome and Epidemiology Study, were followed up for an average of 4.4 years. Fruit intake was assessed using a food frequency questionnaire at baseline and the second follow-up. The beta coefficient and confidence intervals for changes in cardiometabolic risk factors according to fruit consumption were calculated using a linear regression model.
Results
In men, the abdominal circumference decreased with changes in fruit intake (P=0.029). Fruit intake and increased fruit intake in men were associated with a lower systolic blood pressure (P=0.012 and P=0.02, respectively) and lower triglyceride levels (P=0.002 and P<0.001, respectively). In women, abdominal circumference decreased with both fruit intake and increased fruit intake (P<0.001 and P=0.013, respectively). Systolic blood pressure and triglycerides tended to decrease only with fruit intake (P=0.048 and P<0.001, respectively). Unlike in men, fasting blood glucose tended to decrease in women with both fruit intake and increased fruit intake (P=0.011 and P=0.005, respectively).
Conclusion
Fruit intake and increased fruit intake may have beneficial effects on cardiometabolic risk factors among individuals who are obese.

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Associations of cMIND Diet with depressive and anxiety symptoms among old people in China: a nationwide study
Tengfei Niu, Yu Zhang, Xilin Zhou, Kun Shen, Xinyan Ji, Juan Zhu, Ouxiang Wu, Xiaobing Xian
European Journal of Nutrition.2025;[Epub] CrossRef
Fruits and the Risk of Type 2 Diabetes: The Korean Genome and Epidemiology Study Cohort
Hojun Yu, Cheol Min Lee, Seung-Won Oh
Korean Journal of Family Medicine.2024; 45(1): 44. CrossRef
Association between cMIND diet and hypertension among older adults in China: a nationwide survey
Yazhu Wang, Yu Zhang, Xinrong Zeng, Xiaobing Xian, Jingyu Chen, Tengfei Niu
Aging Clinical and Experimental Research.2024;[Epub] CrossRef
Impact of fruits and vegetables consumption on metabolic health: a case–control study
Azza Abd El-Shaheed, Nermine N. Mahfouz, May M. Abdel Hamid
Bulletin of the National Research Centre.2024;[Epub] CrossRef
Effects of Semaglutide on Cardiac Protein Expression and Cardiac Function of Obese Mice
Xiaoyu Pan, Lin Yue, Jiangli Ban, Lin Ren, Shuchun Chen
Journal of Inflammation Research.2022; Volume 15: 6409. CrossRef
Current status of nutrient intake in Korea: focused on macronutrients
Seung-Won Oh
Journal of the Korean Medical Association.2022; 65(12): 801. CrossRef
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Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef

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Risk Factors of Cardiovascular Disease according to Alcohol Behavioral Change after Cancer Diagnosis: Eun Mi Bae, In Young Cho, Ji-Hye Jun, Kiheon Lee, Ju Young Kim, Woo Kyung Bae, Hyejin Lee, Jong Soo Han, Se Young Jung, Kee Hyuck Lee, Sarah Kim, Hye Yeon Koo, Sang Jin Cho, Houbuem Lee, Chuelmin Paek; Korean J Fam Med 2020;41(4):222-228. Published online April 22, 2020; DOI: https://doi.org/10.4082/kjfm.18.0119

Background
Problem drinking increases the incidence of all-cause mortality and specific cancers, and persistent drinking is associated with cardiovascular disease in certain cancer survivors. This study analyzed the cardiovascular risk factors before and after diagnosis in Korean cancer survivors.
Methods
Data for the period between 2002 and 2013 were collected from the National Health Insurance Service Health-Examinee Cohort Database. Among the 27,835 patients included, those with moderate alcohol consumption before and after cancer diagnosis were excluded. Problem drinking was defined as males under 65 years consuming over 14 glasses a week, and males over 65 years or females consuming over seven glasses a week. A t-test, chi-square test, and linear regression analysis were performed for differences in cardiovascular risk factors and differences according to cancer types.
Results
There was a difference in the body mass index, systolic and diastolic blood pressure, and total cholesterol among patients who became moderate drinkers after diagnosis, but fasting blood glucose did not show any significant changes. Risk factors for cardiovascular disease were analyzed in patients with liver, stomach, rectal, and breast cancer with improved drinking behavior, and there were significant differences in body mass index, systolic and diastolic blood pressure, fasting blood glucose, and total cholesterol in stomach cancer patients.
Conclusion
Moderate drinking can lower cardiovascular risk in cancer survivors, and among the many drinking-related cancers, stomach cancer patients demonstrated significantly reduced cardiovascular risk factors.

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Problem Drinking in Cancer Survivors
Seung-Won Oh
Korean Journal of Family Medicine.2020; 41(4): 205. CrossRef

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115 Download
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Association Between the Awareness of Dyslipidemia and Health Behavior for Control of Lipid Levels Among Korean Adults with Dyslipidemia: In Young Cho, Hwa Yeon Park, Kiheon Lee, Woo Kyung Bae, Se Young Jung, Hye Jin Ju, Jae Kyeong Song, Jong Soo Han; Korean J Fam Med 2017;38(2):64-74. Published online March 22, 2017; DOI: https://doi.org/10.4082/kjfm.2017.38.2.64

Abstract
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Background

Dyslipidemia is a major risk factor contributing to cardiovascular disease and its prevalence is steadily rising. Although screening tests are readily accessible, dyslipidemia remains undertreated. Evaluating health behavior patterns after diagnosis may help improve lifestyle interventions for the management of dyslipidemia.

Methods

Data from the fifth Korean National Health and Nutrition Examination Survey 2010–2012 were used. A total of 6,624 dyslipidemia patients over 20 years old were included according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Logistic regression analysis was completed using a weighted method to determine whether awareness of dyslipidemia was associated with health behavior. Health behavior was divided into two categories: behavioral factors (smoking, alcohol consumption, exercise) and nutritional factors (adequate intake of fiber, carbohydrate, fat, protein).

Results

There were no significant differences in health behavior among dyslipidemia patients according to awareness after adjustment for covariates, diabetes and hypertension. Awareness in women was associated with decreased smoking (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.32 to 0.94), but when adjusted for diabetes and hypertension the result was not significant (OR, 0.61; 95% CI, 0.35 to 1.06). The same pattern applied to intake of carbohydrate in men (OR, 1.28; 95% CI, 0.99 to 1.67) and protein in women (OR, 1.22; 95% CI, 0.98 to 1.50). In subgroup analysis, awareness of dyslipidemia in men without hypertension or diabetes was associated with adequate intake of carbohydrate (OR, 1.70; 95% CI, 1.06 to 2.72).

Conclusion

Increasing awareness alone may not be enough to improve healthy behavior in patients with dyslipidemia. Efforts including patient education and counseling through a multi-team approach may be required.

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