Gamma-Glutamyltransferase and Cancer Incidence: The Ohsaki Cohort Study

Tsuboya, Toru,Kuriyama, Shinichi,Nagai, Masato,Hozawa, Atsushi,Sugawara, Yumi,Tomata, Yasutake,Kakizaki, Masako,Nishino, Yoshikazu,Tsuji, Ichiro Japan Epidemiological Association 2012 Journal of epidemiology Vol.22 No.2

<P><B>Background</B></P><P>Although experimental studies have shown that gamma-glutamyltransferase (GGT) has a role in tumor progression, epidemiologic evidence for a relationship between GGT and cancer incidence is limited. The present study investigated the association between GGT and cancer incidence and assessed the role of alcohol consumption in this association.</P><P><B>Methods</B></P><P>We examined a cohort of 15 031 Japanese adults aged 40 to 79 years who attended a health checkup in 1995 and were free of cancer at that time. GGT was measured using the Szasz method. The participants were then followed from 1 January 1996 until 31 December 2005, and cancer incidence was recorded by using the Miyagi Regional Cancer Registry. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for each quartile of GGT and compared. The lowest quartile (GGT <13.0 IU/ml) was used as the reference category.</P><P><B>Results</B></P><P>We documented 1505 cancers. Among participants in the highest quartile (GGT ≥31.0 IU/ml), the multivariate HR for any cancer was 1.28 (95% CI, 1.08–1.53; <I>P</I> for trend, <0.001), the HR for colorectal cancer was significantly greater than unity, and the HRs for esophageal, pancreatic, and breast cancers were greater than unity but not significantly so. This positive trend was observed only in current drinkers.</P><P><B>Conclusions</B></P><P>Our findings suggest that there is a positive relationship between GGT and cancer incidence only for alcohol-related cancers in current drinkers and that the positive association of GGT with cancer incidence largely reflects alcohol consumption.</P>

Epicardial Fat Thickness and Bone Mineral Content: The Healthy Twin Study in Korea

Lee, Dong-won,Cho, Min Soo,Choe, Eun Yeong,Park, Seung Woo,Song, Yun-Mi,Lee, Sang-Chol,Sung, Joohon Japan Epidemiological Association 2018 Journal of epidemiology Vol.28 No.5

<P><B>Background</B></P><P>The conventional concept of positive association between general obesity and bone health was challenged in recent studies reporting the different effects of specific fat deposition on bone health. In the present study, we investigated the association between epicardial fat and bone health.</P><P><B>Methods</B></P><P>We measured echocardiographic epicardial fat thickness (EFT) and bone mineral content (BMC) in a twin-family cohort of Koreans (<I>n</I> = 1,198; 525 men, 460 pre- and 213 post-menopausal women). A total 121 pairs of monozygotic twin (MZ) and 404 pairs of dizygotic twin and sibling pairs (DZ/Sib) were included.</P><P><B>Results</B></P><P>EFT was positively associated with BMC in total, as well as in three subgroups (β = 0.107, 0.076, and 0.058 for men, pre-, and post-menopausal women, respectively). The positive association between EFT and BMC remained for DZ/Sib difference analysis, but was absent for MZ comparisons. The positive association between BMI and BMC was consistent for DZ/Sib and MZ difference analysis. After adjusting for the effect of general obesity via BMI, the association between BMC and EFT was statistically non-significant (β = 0.020, 0.000, and −0.009 for men, pre-, and post-menopausal women, respectively).</P><P><B>Conclusion</B></P><P>Our findings do not support epicardial fat’s beneficial effects on bone health, whereas general adiposity has an osteotropic effect. The association between EFT and BMC is through common genetic component factors.</P>

Modifying Effects of Resting Heart Rate on the Association of Binge Drinking With All-cause and Cardiovascular Mortality in Older Korean Men: the Kangwha Cohort Study

Ryu, Mikyung,Gombojav, Bayasgalan,Nam, Chung Mo,Lee, Yunhwan,Han, Kimyoung Japan Epidemiological Association 2014 Journal of epidemiology Vol.24 No.4

<P><B>Background</B></P><P>Although binge drinking and high resting heart rate independently affect cardiovascular and all-cause mortality risk, the combined effect of these two risk factors and their interaction has rarely been studied. This study examined the association between binge drinking and cardiovascular and all-cause mortality and evaluated the potential modifying effect on this association of resting heart rate in Korean men.</P><P><B>Methods</B></P><P>Men aged 55 years or older in 1985 (<I>n</I> = 2600) were followed for cardiovascular and all-cause mortality for 20.8 years, until 2005. We estimated hazard ratios (HRs) for cardiovascular and all-cause mortality by binge drinking and resting heart rate using the Cox proportional hazard model.</P><P><B>Results</B></P><P>Heavy binge drinkers (≥12 drinks on one occasion) with elevated resting heart rate (≥80 bpm) had a HR of 2.25 (95% confidence interval [CI], 1.47–3.45) for death from cardiovascular disease and 1.37 (95% CI, 0.87–2.14) for all-cause mortality compared to the reference group (non-drinking and resting heart rate 61–79 bpm). The HRs of dying from cardiovascular disease increased linearly from 1.36 to 1.52, 1.71, and 2.25 among individuals with resting heart rate greater than or equal to 80 bpm within the four alcohol consumption categories (non-drinking, non-binge, moderate binge, and heavy binge), respectively.</P><P><B>Conclusions</B></P><P>Our findings suggest that, among older Korean men, heavy binge drinkers with an elevated resting heart rate are at high risk for cardiovascular and all-cause mortality.</P>

Mendelian Randomization Analysis of the Effect of Maternal Homocysteine During Pregnancy, as Represented by Maternal <i>MTHFR C677T</i> Genotype, on Birth Weight

Lee, Hye Ah,Park, Eun Ae,Cho, Su Jin,Kim, Hae Soon,Kim, Young Ju,Lee, Hwayoung,Gwak, Hye Sun,Kim, Ki Nam,Chang, Namsoo,Ha, Eun Hee,Park, Hyesook Japan Epidemiological Association 2013 Journal of epidemiology Vol.23 No.5

<P><B>Background</B></P><P>We used Mendelian randomization analysis to investigate the causal relationship between maternal homocysteine level, as represented by maternal methylenetetrahydrofolate reductase (<I>MTHFR</I>) <I>C677T</I> genotype, with the birth weight of offspring.</P><P><B>Methods</B></P><P>We recruited women at 24 to 28 weeks’ gestation who visited Ewha Womans University Hospital for prenatal care during the period from August 2001 to December 2003. A total of 473 newborns with a gestational age of at least 37 weeks were analyzed in this study. We excluded twin births and children of women with a history of gestational diabetes, gestational hypertension, or chronic renal disease. The association of maternal homocysteine concentration with the birth weight of infants was analyzed using 2-stage regression.</P><P><B>Results</B></P><P><I>MTHFR C677T</I> genotype showed a dose–response association with homocysteine concentration for each additional <I>T</I> allele (<I>P</I><SUB>trend</SUB> < 0.01). Birth weight decreased from 120 to 130 grams as maternal homocysteine level increased, while controlling for confounding factors; however, the association was of marginal significance (<I>P</I> = 0.06).</P><P><B>Conclusions</B></P><P>Our results suggest an adverse relationship between maternal homocysteine level and birth weight. A reduction in homocysteine levels might positively affect birth outcomes.</P>

Sociodemographic and Lifestyle Factors are Associated with the Use of Dietary Supplements in a Korean Population

Kim, Jeongseon,Lee, Jung-Sug,Shin, Aesun,Kang, Myung-Hee,Shin, Dong-Soon,Chung, Hae-Rang,Kim, Woo-Kyoung Japan Epidemiological Association 2010 Journal of epidemiology Vol.20 No.3

<P><B>Objective</B></P><P>The use of dietary supplements has been increasing rapidly in Korea over the last decade. The aim of this study was to investigate associations between the pattern of dietary supplement use and the sociodemographic/lifestyle characteristics of Korean consumers.</P><P><B>Methods</B></P><P>Participants were asked to complete a self-administered questionnaire on their sociodemographic and lifestyle characteristics, perceived health status, and regular dietary supplement use.</P><P><B>Results</B></P><P>A total of 697 men and 832 women completed the questionnaire. Of the respondents, 44.3% of the men and 53.2% of the women used some kind of dietary supplement regularly. Dietary supplement users were more likely to be women (<I>P</I> < 0.001), to be older than 50 years (<I>P</I> < 0.001), to have a higher household income (<I>P</I> = 0.003), to engage in moderate or vigorous physical activity (<I>P</I> < 0.032), to perceive themselves as healthy (<I>P</I> = 0.026), and to have received a diagnosis of a chronic disease (<I>P</I> < 0.001). In addition, the type of dietary supplements used varied with respect to sociodemographic and lifestyle factors. Among dietary supplement users, men preferred ginseng, and older respondents were more likely to use carbohydrate supplements and less likely to use lipid supplements. Those who had a lower BMI, were ex-smokers, or were nondrinkers preferred either vitamins or minerals. Those who were highly physical active or were nondrinkers tended to prefer either vitamin/mineral complexes or carbohydrate supplements.</P><P><B>Conclusions</B></P><P>The use of dietary supplements was related to sociodemographic and lifestyle factors in a Korean population.</P>

Trends and Correlates of High-Risk Alcohol Consumption and Types of Alcoholic Beverages in Middle-Aged Korean Adults: Results From the HEXA-G Study

Choi, Jaesung,Choi, Ji-Yeob,Shin, Aesun,Lee, Sang-Ah,Lee, Kyoung-Mu,Oh, Juhwan,Park, Joo Yong,Lee, Jong-koo,Kang, Daehee Japan Epidemiological Association 2019 Journal of epidemiology Vol.29 No.4

<P><B>Background</B></P><P>We aimed to report the prevalence and correlates of high-risk alcohol consumption and types of alcoholic beverages.</P><P><B>Methods</B></P><P>The baseline data of the Health Examinees-Gem (HEXA-G) study participants, including 43,927 men and 85,897 women enrolled from 2005 through 2013, were used for analysis. Joinpoint regression was performed to estimate trends in the age-standardized prevalence of alcohol consumption. Associations of demographic and behavioral factors, perceived health-related effects, social relationships, and the diagnostic history of diseases with alcohol consumption were assessed using multinomial logistic regression.</P><P><B>Results</B></P><P>The prevalence of alcohol consumption remained higher in men during the study period and increased in women. The amount of alcohol consumed has increased in women, especially that from beer and makgeolli, a traditional Korean fermented rice wine. Older participants were less likely to be high-risk drinkers (men and women who drink more than 40 or 20 g/day of alcohol, respectively) and drink Soju, a distilled liquor, and beer, and more likely to drink makgeolli. Educational level was negatively associated with high-risk drinking. However, it was positively associated with the consumption of strong spirits and wine. Smoking was associated with high-risk drinking and the consumption of soju and strong spirits. Engaging in regular exercise and having stress were associated with drinking all types of beverages except for soju.</P><P><B>Conclusions</B></P><P>Sex-specific trends in alcohol consumption were influenced by demographic, behavioral, and perceived health-related factors. The findings will help improve the understanding of alcohol-related problems and provide evidence for establishing country-specific policies and campaigns in Korea.</P>

Subsequent Risk of Metabolic Syndrome in Women With a History of Preeclampsia: Data From the Health Examinees Study

Yang, Jae Jeong,Lee, Sang-Ah,Choi, Ji-Yeob,Song, Minkyo,Han, Sohee,Yoon, Hyung-Suk,Lee, Yunhee,Oh, Juhwan,Lee, Jong-Koo,Kang, Daehee Japan Epidemiological Association 2015 Journal of epidemiology Vol.25 No.4

<P><B>Background</B></P><P>To investigate whether preeclampsia is independently associated with risk of future metabolic syndrome and whether any such primary associations are modified by different ages at first pregnancy.</P><P><B>Methods</B></P><P>Based on the Health Examinees Study, a cross-sectional analysis was conducted. Data of women (<I>n</I> = 49 780) who had experienced at least 1 pregnancy during their lifetime and had never been diagnosed with any metabolic disorder before their pregnancy were analyzed using multiple logistic regression models. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated after adjusting for age, lifestyle characteristics, and reproductive factors. A stratified analysis was also conducted to estimate the extent of the primary association between preeclampsia and future metabolic syndrome by age at first pregnancy.</P><P><B>Results</B></P><P>Women with a history of preeclampsia had significantly increased odds of developing metabolic syndrome (adjusted OR 1.23; 95% CI, 1.12–1.35), central obesity (adjusted OR 1.36; 95% CI, 1.25–1.47), elevated blood pressure (adjusted OR 1.53; 95% CI, 1.41–1.67), or elevated fasting glucose (adjusted OR 1.13; 95% CI, 1.03–1.25) in later life. In the stratified analysis, women who first became pregnant at ages >35 years and had preeclampsia were found to be at significantly increased likelihood of metabolic syndrome later in life (adjusted OR 4.38; 95% CI, 1.62–11.9).</P><P><B>Conclusions</B></P><P>Our findings suggest that preeclampsia increases the risk of metabolic syndrome in later life, and late age at first pregnancy can further exacerbate this risk.</P>

Prevalence of Systemic Lupus Erythematosus in South Korea: An Administrative Database Study

Ju, Ji Hyeon,Yoon, Sang-Heon,Kang, Kwi Young,Kim, In Je,Kwok, Seung-Ki,Park, Sung-Hwan,Kim, Ho-Youn,Lee, Won-Chul,Cho, Chul-Soo Japan Epidemiological Association 2014 Journal of epidemiology Vol.24 No.4

<P><B>Background</B></P><P>Systemic lupus erythematosus (SLE) is a rare autoimmune disease for which a population-based survey on the prevalence of the disease in South Korea has not yet been conducted. Our goal was to estimate the nationwide prevalence of SLE.</P><P><B>Methods</B></P><P>The International Classification of Diseases, Tenth Revision (ICD-10) code for SLE diagnosis—M32—was tentatively given when patients were suspected to have SLE before 2009. As such, the positive predictive value (PPV) of the M32 code shown in medical bills reflecting true SLE was uncertain. We attempted to estimate the prevalence of SLE in South Korea using national administrative database data from 2004–2006. We approximated the actual number of SLE patients by analyzing a list of SLE-coded patients provided by the National Health Insurance (NHI) and Health Insurance Review and Assessment Service. Prevalence was estimated by multiplying the PPV of the M32 diagnostic code by the number of patients receiving the code. The PPV was determined by three methods: direct investigation of the medical records of patients randomly selected from the SLE-coded patients list; assessment of all SLE patients treated at 56 selected hospitals in South Korea; and extrapolation from sub-groups at a single institute to the sub-groups of the national NHI data.</P><P><B>Results</B></P><P>The estimated number of national SLE cases was between 9000 and 11 000, depending on the method of ascertainment, corresponding to a prevalence of 18.8–21.7 per 100 000 people.</P><P><B>Conclusions</B></P><P>This is the first report of a nationwide prevalence survey of SLE in South Korea. National databases may serve as a resource for epidemiologic studies of rare autoimmune diseases like SLE.</P>

The General Public’s Awareness of Early Symptoms of and Emergency Responses to Acute Myocardial Infarction and Related Factors in South Korea: A National Public Telephone Survey

Kim, Hee-Sook,Lee, HeyJean,Kim, KeonYeop,Park, Hyeung-Keun,Park, Ki-Soo,Kang, Gil Won,Shin, Hee-Young,Kim, Rock Bum,Oh, Gyung-Jae,Seo, Jae Hee,Lee, Young-Hoon Japan Epidemiological Association 2016 Journal of epidemiology Vol.26 No.5

<P><B>Background</B></P><P>Prompt treatment affects prognosis and survival after acute myocardial infarction (AMI) onset. This study evaluated the awareness of early symptoms of AMI and knowledge of appropriate responses on symptom occurrence, along with related factors.</P><P><B>Methods</B></P><P>Participants’ knowledge of the early symptoms of and responses to AMI onset were investigated using a random digit dialing survey. We included 9600 residents of 16 metropolitan cities and provinces in Korea.</P><P><B>Results</B></P><P>The proportions of respondents who were aware of early symptoms of AMI ranged from 32.9% (arm or shoulder pain) to 79.1% (chest pain and discomfort). Of the respondents, 67.0% would call an ambulance if someone showed signs of AMI, 88.7% knew ≥1 symptom, 10.9% knew all five symptoms, and 3.1% had excellent knowledge (correct identification of all five AMI symptoms, not answering “Yes” to the trap question, and correctly identifying calling an ambulance as the appropriate response when someone is exhibiting AMI symptoms). The odds ratio (OR) for having excellent knowledge was significantly higher for those who graduated college or higher (OR 3.42; 95% confidence interval [CI], 1.09–10.76) than for those with less than a primary school education, as well as for subjects with AMI advertisement exposure (OR 1.49; 95% CI, 1.10–2.02) and with knowledge of AMI (OR 1.63; 95% CI, 1.16–2.27). The 60- to 79-year-old group had significantly lower OR for excellent knowledge than the 20- to 39-year-old group (OR 0.53; 95% CI, 0.28–0.99).</P><P><B>Conclusions</B></P><P>Awareness of AMI symptoms and the appropriate action to take after symptom onset in South Korea was poor. Therefore, educational and promotional strategies to increase the overall awareness in the general public, especially in the elderly and those with low education levels, are needed.</P>

Self-reported Snoring and Carotid Atherosclerosis in Middle-aged and Older Adults: The Korean Multi-Rural Communities Cohort Study

Lee, Young-Hoon,Kweon, Sun-Seog,Choi, Bo Youl,Kim, Mi Kyung,Chun, Byung-Yeol,Shin, Dong Hoon,Shin, Min-Ho Japan Epidemiological Association 2014 Journal of epidemiology Vol.24 No.4

<P><B>Background</B></P><P>We investigated the relation of self-reported snoring with carotid intima-media thickness (IMT) and plaque in community-dwelling middle-aged and older adults.</P><P><B>Methods</B></P><P>In total, 7330 community-dwelling subjects in the Korean Multi-Rural Communities Cohort Study were included in the analysis. Common carotid artery IMT (CCA-IMT) and plaque were evaluated by high-resolution B-mode ultrasonography. Snoring status was evaluated using a structured interview.</P><P><B>Results</B></P><P>Snorers had a significantly greater average CCA-IMT than non-snorers (0.726 vs 0.713 mm; <I>P</I> < 0.001), after adjusting for age and gender. The odds ratios (OR) for high CCA-IMT (fifth quintile) were significantly higher for snorers than for non-snorers in multivariate-adjusted analysis (OR 1.25, 95% confidence interval [CI] 1.10–1.42). However, there was no significant relationship between snoring and carotid plaques.</P><P><B>Conclusions</B></P><P>Our data suggest that self-reported snoring is significantly associated with increased IMT, but not with the presence of plaques. These findings suggest that early screening and intervention for snoring in the general population are needed to prevent adverse cardiovascular events.</P>