Trends and Barriers in Diabetic Retinopathy Screening: Korea National Health and Nutritional Examination Survey 2016–2021
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ABSTRACT:
SUBMITTER: Kim M
PROVIDER: S-EPMC11249577 | biostudies-literature | 2024 Jun
REPOSITORIES: biostudies-literature
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Project description:PurposeTo explore the relationship between chronic kidney disease and diabetic retinopathy in a representative population of Korean diabetic adults.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Surveys (2008-2010). A total of 15,409 individuals (weighted frequency, 32,168,636) aged 19 and over who completed ophthalmologic and renal functional examinations were evaluated. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate of < 60 ml/min/1.73 m2 or proteinuria greater than 1+. Seven standard photographs from the Early Treatment for Diabetic Retinopathy Study were obtained from each eye after pharmacological pupil dilatation. Diabetic retinopathy (DR) was defined as the presence of 1 or more retinal microaneurysms or retinal blot hemorrhages with or without more severe lesions. Vision-threatening diabetic retinopathy (VTDR) was defined as the presence of a clinically significant macular edema (CSME) or proliferative diabetic retinopathy.ResultsCKD was significantly associated with DR and VTDR (odds ratio (OR), 95% confidence interval (CI); 2.49(1.43-4.35) and 3.74(1.56-8.95), respectively) in the diabetic population. After controlling for confounders, however, CKD was significantly associated only with DR [adjusted OR (aOR), 95% CI; 2.34(1.04-5.28)]. In the subgroup analysis for CKD, only proteinuria was significantly associated with DR and VTDR (aOR, 95% CI; 4.56(1.51-13.77) and 5.61(1.06-29.87), respectively) in this population.ConclusionsOur results show that CKD appears to be associated with DR and VTDR in a Korean diabetic population. In particular, proteinuria, not decreased eGFR, is more significantly associated with DR or VTDR.
| S-EPMC4388494 | biostudies-literature
Project description:ObjectivesThe present study evaluated the association of electronic cigarette (EC) exposure with serum uric acid (UA) level and hyperuricemia (HUA) using a nationally representative sample of South Korea.MethodsThis study included 10,692 participants (9,905, 609, and 178, never, ever, and current EC users, respectively). Urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels were used to determine conventional smoking exposure among EC users. The association between EC use and UA level was evaluated by linear regression analysis. Multivariable logistic regression analysis was used to assess the association between EC and HUA. Subgroup analysis confined to cotinine-verified active smokers was performed to address the association between the dual use of EC and combustible cigarettes and serum UA levels.ResultsThe serum UA level was highest among current EC users, followed by ever and never EC users. The prevalence of HUA was 26.2%, 19.3%, and 10.8% in current, ever, and never EC users, respectively. Although EC exposure was positively associated with HUA in a dose-dependent manner only in men (Ptrend = 0.04), a similar tendency was also observed in women with marginal significance (Ptrend = 0.102). The positive association of HUA with EC exposure was more apparent among dual users (odds ratio [OR] = 1.96, 95% confidence interval [CI]: 1.29-2.99) than among those who only smoked combustible cigarettes.ConclusionsEC exposure was associated with higher serum UA level and higher OR of HUA. The positive association between EC exposure and HUA was more prominent in dual users who concurrently consumed EC and combustible cigarettes.
| S-EPMC7920355 | biostudies-literature
Project description:Studies on the trends in the prevalence of rheumatoid arthritis (RA) and osteoarthritis (OA) are limited, particularly during the COVID-19 pandemic. This study aimed to analyze the temporal trend of RA and OA in South Korean adults from 1998 to 2021, including the COVID-19 pandemic period. The Korea National Health and Nutrition Examination Survey (KNHANES) data on adults aged ≥ 19 years were analyzed to investigate the prevalence of RA and OA from 1998 to 2021. The prevalence trends were compared by the years, and βdiff (β difference) was calculated. Odds ratios (ORs) were computed for each disease to examine changes in disease prevalence before and during the pandemic in order to determine the impact of the pandemic on disease prevalence. Among 163,221 Korean adults, the prevalence of RA and OA showed a steady decrease from 2005 (RA: from 1.91% in 2005-2007 to 1.55% in 2016-2019 and OA: from 9.75% in 2005-2007 to 8.27% in 2016-2019), but there was a slight increased after the onset of the COVID-19 pandemic (RA: from 1.23% in 2020 to 1.36% in 2021 and OA: from 8.04% in 2020 to 8.27% in 2021). Vulnerable groups, including participants aged ≥ 60 years (versus 19-60 years, ratio of ORs: 1.222; 95% CI 1.011-1.477), urban residents (ratio of ORs: 1.289; 95% CI 1.007-1.650), and participants with higher education level (ratio of ORs: 1.360; 95% CI 1.119-1.653) showed higher ORs of OA, whereas no particularly vulnerable population was observed for RA. Our findings provide an insight into the long-term trends of RA and OA among adult population and highlight a novel perspective on the impact of COVID-19 on disease prevalence.
| S-EPMC10636038 | biostudies-literature
Project description:ObjectivesThis study aimed to investigate trends in obesity by dividing it based on body mass index (BMI) and waist circumference indicators, sedentary behavior, and leisure-time physical activity (LTPA) in Korean adults from 2014 to 2021. This study also aimed to determine the adherence rate of people with obesity to physical activity.MethodsData from the Korea National Health and Nutritional Examination Survey (KNHANES) from 2014 to 2021 were used. A total of 42,676 participants 19 years or older were included in the final analysis. Sociodemographic characteristics, anthropometric measurements, and physical activity levels were recorded. Physical activity levels were assessed using the Global Physical Activity Questionnaire, a self-reported questionnaire. Multivariable logistic regression analysis adjusted for covariates was used to investigate the prevalence of obesity and sitting time or adherence to meeting the physical activity guidelines for each survey year.ResultsThis study included 42,676 adults. The weighted prevalence of obesity in all ages significantly increased from 30.8% (29.1%-32.5%) in 2014 to 34.5% (32.9%-36.2%) in 2017 and 37.3% (35.5%-39.1%) in 2021 (p for trend < 0.004). The weighted adherence rate to LTPA ranged from 25.5% (95% confidence interval [CI], 23.7%-27.2%) in 2014 to 20.5% (95% CI, 18.7%-22.2%) in 2021(p for trend < 0.001). The weighted prevalence of sitting time for 8 h/day or more significantly increased from 46.7% (44.4%-49.0%) in 2014 to 56.2% (54.4%-58.0%) in 2017 and 63% (60.7%-65.3%) in 2021 (p for trend < 0.001). According to this study, the LTPA level among women with obesity was significantly low.ConclusionFrom 2014 to 2021, obesity and sedentary behavior significantly increased and adherence to LTPA decreased among Korean adults. Given these concerning trends, comprehensive interventions are needed at the national level to encourage healthy lifestyle behaviors.
| S-EPMC10763961 | biostudies-literature
Project description:BackgroundAmbient humidity has a significant impact on respiratory health and influences disease and symptoms. However, large-scale studies are required to clarify its specific effects on lung function and respiratory symptoms. We examined the relationship between relative humidity (RH), lung function, and respiratory symptoms using data from the Korea National Health and Nutrition Examination Survey (KNHANES).MethodsIn this cross-sectional study, we analyzed data from KNHANES participants aged ≥ 40 years, collected between 2016 and 2018. Pulmonary function tests (PFTs) and health questionnaires were used to assess lung function and respiratory symptoms. Individual environmental data, including RH, were obtained from the Community Multiscale Air Quality model and linked to the participants' addresses. Short-term (0-14 days), mid-term (30-180 days), and long-term (1-5 years) RH exposures were examined. Linear regression models were used to evaluate the associations between RH and PFTs. Univariate and multivariable logistic regression models were applied to assess the risk of lung function abnormalities and respiratory symptoms.ResultsIn total, 10,396 participants were included (mean age: 58.3 years, male: 43.6%). In multiple regression analysis, higher RH was negatively associated with the forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio across various time lags, while FVC was positively correlated with long-term RH exposure. In multiple logistic analysis adjusted for clinical and environmental covariates, long-term higher RH exposure was associated with a lower risk of restrictive lung disease (odds ratio [OR] at 4-year moving average [MA]: 0.978, 95% confidence interval [CI]: 0.959-0.997), while mid-term RH exposure decreased the risk of chronic cough (OR at 90-day MA: 0.968, 95% CI: 0.948-0.987) and sputum production (OR at 90-day MA: 0.985, 95% CI: 0.969-1.001).ConclusionsHigher RH was negatively associated with lung function and increased the risk of obstructive lung disease, whereas mid-term RH exposure reduced the risk of chronic cough and sputum production.
| S-EPMC11613709 | biostudies-literature
Project description:The global surge in obesity rates is closely linked to the rise in sleep deprivation and prevalence of sleep disorders. This study aimed to investigate the association between weekend catch-up sleep (CUS) and obesity among Korean adults. Using multiple logistic regression analysis, we analyzed the data of 6790 adults aged >19 years obtained from the Korea National Health and Nutrition Examination Survey 2016-2021. In the subgroup analysis, we conducted multiple logistic regression analysis to determine the association between weekend CUS and obesity, stratified by sex. Women were significantly more likely to be obese than men (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.46-0.61). Obesity was associated with 1 ≤ weekend CUS < 2 (OR = 0.86, 95% CI = 0.75-0.99) but not with weekend CUS ≤ 0. Compared to men, women had a lower obesity risk when engaging in weekend supplementary sleep that was 1 ≤ weekend CUS < 2 (OR = 0.78, 95% CI = 0.63-0.97). Our findings revealed that weekend CUS was associated with obesity. Our findings suggest that weekend CUS may offer a form of biological protection against obesity, and they contribute to a better understanding of this association and may serve as a basis for better obesity management.
| S-EPMC10648526 | biostudies-literature
Project description:Cardiovascular disease (CVD) is the leading cause of death globally, although the mortality rate has declined with improved technology and risk factor control. The incidence rate of stroke, one of the CVDs, is increasing in young adults, whereas it is decreasing in the elderly. The risk factors for CVD may differ between young adults and the elderly. Previous studies have suggested that cadmium was a potential CVD risk factor in the overall and middle-aged to elderly populations. We assessed the associations between cadmium and CVD events in the Korean population aged 20-59 years using the 2008-2013 and 2016 Korea National Health and Nutrition Examination Survey (KNHANES), a population-based cross-sectional study. Among 10,626 participants aged 20-59 years, those with high blood cadmium (BCd) level (>1.874 µg/L, 90th percentile) were higher associated with stroke and hypertension (stroke: odds ratio (OR), 2.39; 95% confidence interval (CI), 1.03-5.56; hypertension: OR, 1.46; 95% CI, 1.20-1.76). The strongest association between high blood cadmium concentrations and hypertension was among current smokers. Ischemic heart disease (IHD) was not associated with high blood cadmium level. These findings suggest that high blood cadmium levels may be associated with prevalent stroke and hypertension in the Korean population under 60 years of age.
| S-EPMC7503499 | biostudies-literature
Project description:To explore gender differences and associations between metabolic syndrome (MetS) and its components, and diabetic retinopathy (DR) in Korean adults aged 40 years and older with diabetes.We analyzed data from the Korean National Health and Nutrition Examination Surveys (2008-2012). In total, 2,576 type 2 diabetic participants, aged 40 and older, were evaluated. Seven standard retinal fundus photographs were obtained after pupil dilation in both eyes. DR was graded using the modified Airlie House classification system. Vision-threatening diabetic retinopathy (VTDR) included proliferative diabetic retinopathy and clinically significant macular edema. MetS was defined according to the Joint Interim Statement, proposed in 2009, by the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Multivariate logistic regression analysis was used to assess the relationship between MetS and its individual components with DR and VTDR.After controlling for confounders, MetS was not associated with DR in men or women. Moreover, the risk for DR or VTDR did not increase with increasing MetS components. However, high waist circumference was significantly inversely associated with VTDR (adjusted odds ratio = 0.36; 95% confidence interval = 0.14-0.93) only in men.MetS was not associated with DR or VTDR in a Korean diabetic population. However, among MetS components, it seems that abdominal obesity was inversely associated with VTDR in Korean diabetic men.
| S-EPMC4898740 | biostudies-other
Project description:Gender differences in alcohol use have narrowed over the decades. This study aimed to explore changes in alcohol consumption patterns between 2007 and 2016 to identify gender convergence in alcohol use in Korea. Data from the Korea National Health and Nutrition Examination Survey were used. For all respondents (41,662 girls/women and 32,041 boys/men) aged ≥12 years, lifetime drinking, current drinking, age of drinking onset, heavy alcohol use, and binge drinking were analyzed. Gender differences in heavy alcohol use and binge drinking decreased from 2007 to 2016 (p = 0.001 and p < 0.001, respectively). The prevalence of heavy alcohol use and binge drinking decreased in boys/men (67.5% to 63.9%, p = 0.001; 63.4% to 60.9%, p = 0.001, respectively), but not in girls/women (50.2% to 50.4%, p = 0.279; 30.6% to 32.0%, p = 0.994, respectively). The proportion of lifetime abstainers decreased among both girls/women (24.3% to 19.1%, p < 0.001) and boys/men (12.1% to 9.7%, p = 0.01). In girls/women, the mean age of drinking onset decreased (from 24.1 to 23.6 years, p = 0.017); however, in boys/men, significant changes were not observed (from 18.9 to 18.7 years, p = 0.307). Healthcare providers should be aware of the growing health risks resulting from increased unhealthy alcohol use in women and develop gender-specific preventive interventions.
| S-EPMC7764704 | biostudies-literature
Project description:ObjectivesWe aimed to evaluate the association between serum folate concentrations and the prevalence of dyslipidemia.MethodsA total of 4,477 adults (2,019 male and 2,458 female) enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 were included. Serum samples were used to assess folate concentrations and total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol levels. Multivariate logistic regression with sampling weights was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsElevated TC, TG, LDL-cholesterol and HDL-cholesterol levels were observed in 506 (11.3%), 646 (14.4%), 434 (9.7%), and 767 (17.1%) participants, respectively. We found non-linear trends between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia from the restricted cubic smoothing spline. A higher prevalence of hypercholesterolemia was observed among participants in the first tertile of serum folate concentrations (OR,1.38; 95% CI, 1.05 to 1.79) than among those in the second tertile. However, a higher prevalence of hyper-LDL cholesterolemia was identified for both the first and third serum folate concentration tertiles (OR, 1.49; 95% CI, 1.08 to 2.05 and OR, 1.63; 95% CI, 1.20 to 2.20, respectively); furthermore, in these tertiles, the prevalence of hyper-LDL cholesterolemia was more pronounced among obese participants.ConclusionsNon-linear associations may exist between serum folate concentrations and the prevalence of hypercholesterolemia and hyper-LDL cholesterolemia in adults. The findings suggest that more accurate recommendations about folate intake and folic acid fortification and supplementation should be provided.
| S-EPMC9684009 | biostudies-literature