Korean Adult Population Research Articles

RETRACTED ARTICLE: Correlates, comorbidities, and suicidal tendencies of problematic game use in a national wide sample of Korean adults

BackgroundThis study aimed to investigate the prevalence, correlates, comorbidities, and suicidal tendencies of problematic game use in a nationally representative sample of Korean adults.MethodsOf the 6022 subjects who participated in the 2011 Korean Epidemiologic Catchment Area study and completed the Composite International Diagnostic Interview 2.1, 1397 game users were evaluated for problematic game use using 9-item DSM-5 proposed criteria for Internet gaming disorder. Respondents who responded “yes” to five or more of the nine DSM-5 criteria were considered as problematic game users and the reminders were considered as normal game users.Results4.0% (56/1397) of game users were classified as a problematic game user. Problematic game users were more likely to be in younger age group and live in urban area compared with normal game user. Problematic game use was positively associated with several psychiatric disorders including nicotine use disorder, depressive disorder, and anxiety disorder, but not associated with alcohol use disorder and obsessive-compulsive disorder, after adjusting for age, sex, and residential area. Problematic game use was significantly and positively associated with suicide plans, after controlling for psychiatric disorders as well as socio-demographic factors.ConclusionProblematic game use is relatively prevalent in Korean adult population and highly comorbid with other psychiatric disorders and suicidality. Therefore, preventive strategy for problematic game use is needed for game users who were more likely to be addicted such as young adults in urban area, and mental health screening and appropriate treatment are needed for individuals with problematic game use.

0741 PREVALENCE AND CHARACTERISTICS OF RESTLESS LEGS SYNDROME IN KOREAN ADULTS: THE STUDY ON TWO-INDEPENDENT POPULATIONS

Restless legs syndrome (RLS) is regarded as a common sleep disorder with a significant impact on quality of life and with a genetic background, more frequently occurring in Caucasian than Asian population. RLS prevalence in Korean adult population is 3.9 - 14.3%, higher than those reported in other Asian countries. A wide range of reported prevalence derives from the differences in the population characteristics and in the methods to define RLS. We aimed to provide the RLS prevalence estimate in Korean adults, compared with previous reports in Korea, Asian and western countries. In this study, we included two independent samples of Korean adult populations: group-1 was a nation-wide stratified random sample of adult population (n = 2,824; aged 19 - 79 years) and group-2 was a community based cohort (n = 2,685; aged 47 - 79 years). The presence of RLS was evaluated with the Cambridge-Hopkins diagnostic questionnaire for RLS (CH-RLSq). We compared sleep profiles, sleep-related symptoms, mood/anxiety, and comorbid medical conditions between RLS and non-RLS groups. RLS prevalence was 0.42% in the group-1 and 0.86% in the group-2. There were no significant differences of age, sex, and body mass index between RLS and non-RLS groups. In group-1, RLS subjects have depression and insomnia more frequently than those without RLS (p < 0.05). In group-2, RLS subjects were more sleepy and depressive with shorter sleep duration, worse sleep quality and more severe insomnia symptom (p < 0.05). Underlying comorbidities including smoking, alcohol, hypertension, diabetes, hyperlipidemia, anemia, neurological disorder, or kidney disease were not statistically different between RLS and non-RLS groups. RLS prevalence in Korean adult was less than 1%, which contrasts with previously reported ones in Korea. Considering the ethnic difference and genetic background of RLS, and the RLS prevalence depending on the diagnostic metrics, a high prevalence of RLS in Korea is questionable. None

Trends in the pervasiveness of type 2 diabetes, impaired fasting glucose and co-morbidities during an 8-year-follow-up of nationwide Korean population

The prevalence and incidence of type 2 diabetes, impaired fasting glucose, and co-morbidities from 2006 to 2013 in the population aged ≥30 years were estimated using the Korean NHIS database. The prevalence of type 2 diabetes increased 0.2–0.5% annually, from 5.6% in 2006 to 8% in 2013. The prevalence of type 2 diabetes was higher in men than in women and increased with age. The incidence of type 2 diabetes was 0.81% in 2013 and was 1.4 times higher in men than in women and increased with age. An overall decrease in the incidence rate occurred from 2006 to 2013(from 0.95 to 0.81%), which was mirrored in all age groups except the 30–39-year-old group. The prevalence of IFG was 25% in 2013. The prevalence of hypertension(62.5 vs 16.9%) and dyslipidemia(49.5 vs 9.7%) were more prevalent in patients with type 2 diabetes compared to non-diabetic cases. This study shows that type 2 diabetes is both common and increasing and that one-quarter of the Korean adult population has IFG. We also confirmed that the prevalence of hypertension and dyslipidemia are 3.7-fold and 5.1-fold higher, respectively, in diabetic patients than in non-diabetic adults.

Risk prediction of pulmonary tuberculosis using genetic and conventional risk factors in adult Korean population.

A complex interplay among host, pathogen, and environmental factors is believed to contribute to the risk of developing pulmonary tuberculosis (PTB). The lack of replication of published genome-wide association study (GWAS) findings limits the clinical utility of reported single nucleotide polymorphisms (SNPs). We conducted a GWAS using 467 PTB cases and 1,313 healthy controls obtained from two community-based cohorts in Korea. We evaluated the performance of PTB risk models based on different combinations of genetic and nongenetic factors and validated the results in an independent Korean population comprised of 179 PTB cases and 500 healthy controls. We demonstrated the polygenic nature of PTB and nongenetic factors such as age, sex, and body mass index (BMI) were strongly associated with PTB risk. None of the SNPs achieved genome-wide significance; instead, we were able to replicate the associations between PTB and ten SNPs near or in the genes, CDCA7, GBE1, GADL1, SPATA16, C6orf118, KIAA1432, DMRT2, CTR9, CCDC67, and CDH13, which may play roles in the immune and inflammatory pathways. Among the replicated SNPs, an intergenic SNP, rs9365798, located downstream of the C6orf118 gene showed the most significant association under the dominant model (OR = 1.59, 95% CI 1.32–1.92, P = 2.1×10−6). The performance of a risk model combining the effects of ten replicated SNPs and six nongenetic factors (i.e., age, sex, BMI, cigarette smoking, systolic blood pressure, and hemoglobin) were validated in the replication set (AUC = 0.80, 95% CI 0.76–0.84). The strategy of combining genetic and nongenetic risk factors ultimately resulted in better risk prediction for PTB in the adult Korean population.

Prevalence and associated factors of blepharoptosis in Korean adult population: The Korea National Health and Nutrition Examination Survey 2008-2011.

PurposeThis study aimed to evaluate the prevalence and associated factors of involutional blepharoptosis in a nationwide representative sample in Korea.MethodsCross-sectional study 20 941 Korean men and women 40 years of age and older who participated in last 2 years (2008 and 2009) of the 4th wave of the Korean National Health and Nutrition Examination Survey (KNHANES) IV and the first 2 years (2010 and 2011) of KNHANES V. Ocular examinations were performed by ophthalmologists trained in procedure and grading methods, and blepharoptosis was defined as a marginal reflex distance <2 mm on either eye.ResultsThe prevalence of involutional blepharoptosis in the Korean adult was 13.5% (95% CI: 12.1%, 14.9%). It was increasing along with aging (5.4% among 40's and 32.8% in people over 70 years old). A statistically significant negative association between levator function and blepharoptosis was found. With right eye, while only 5.4% (95% CI: 4.5%, 6.2%) had blepharoptosis among people whose levator function was excellent (≥12 mm), 71.4% (95% CI: 60.0%, 85.9%) of people whose levator function was poor (≤4 mm) had blepharoptosis. Hypertension, diabetes, higher body mass index (BMI), and lower education had statistically significant association with blepharoptosis adjusting all other confounders.ConclusionsThe distribution and proportional changes of levator function and marginal reflex distance 1 (MRD1) with aging implicate a contributory role of muscular degeneration. Strong association with hypertension, diabetes, BMI, and education level suggests that etiology of involutional blepharoptosis would be multifactorial and further investigation would be necessary to determine precise mechanism and contribution of factors.

Disease burden of 2013-2014 seasonal influenza in adults in Korea.

BackgroundThis study was performed to investigate the disease burden of seasonal influenza in adults ≥20 years of age in Korea, based on surveillance data from the Hospital-based Influenza Morbidity & Mortality Surveillance (HIMM) network.Materials and methodsThe HIMM network is composed of two surveillance systems: emergency room-based and inpatients-based surveillance. A total of ten university hospitals all over the country are included in the surveillance network. The adult catchment population of the HIMM network was calculated by using the data of each hospital and the database of the Health Insurance Review and Assessment Service (HIRA) of Korea. The incidence rates of laboratory-confirmed medically-attended influenza, laboratory-confirmed influenza-related admission and laboratory-confirmed influenza-related death were calculated based on the catchment population. The socioeconomic burden of influenza was estimated using the human capital approach.ResultsDuring the 2013–2014 influenza season, the calculated adult catchment population of the HIMM network was 1,380,000. The incidence of medically-attended laboratory-confirmed influenza infection was 242.8 per 100,000 adults. The incidence of laboratory-confirmed influenza-related admission was 57.9 per 100,000 adults. The incidence of laboratory-confirmed influenza-related death was 3.1 per 100,000 adults. The total socioeconomic cost of 2013–2014 seasonal influenza in Korean adult population was estimated as 125 million USD (1 USD = 1,100 KRW).ConclusionThe disease burden of 2013–2014 seasonal influenza in Korean adult population is very high and indicates that more active prevention and control policies will be needed to decrease the burden. Additional researches will be needed to assess the burden of seasonal influenza in the Korean child population.

A Nation-Wide Epidemiological Study of Newly Diagnosed Primary Spine Tumor in the Adult Korean Population, 2009-2011.

ObjectiveThis 2009–2011 nation-wide study of adult Koreans was aimed to provide characteristics, medical utilization states, and survival rates for newly diagnosed patients with primary nonmalignant and malignant spine tumors.MethodsData for patients with primary spine tumors were selected from the Korean Health Insurance Review and Assessment Service database. The data included their age, sex, health insurance type, co-morbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person occurring in one calendar year were used. In addition, survival rates of patients with primary malignant spine tumors were evaluated.ResultsThe incidence rate of a primary spine tumor increased with age, and the year of diagnosis (p≤0.0001). Average annual medical costs ranged from 1627 USD (pelvis & sacrum & coccyx tumors) to 6601 USD (spinal cord tumor) for primary nonmalignant spine tumor and from 12137 USD (spinal meningomas) to 20825 USD (pelvis & sacrum & coccyx tumors) for a primary malignant spine tumor. Overall survival rates for those with a primary malignant spine tumor were 87.0%, 75.3%, and 70.6% at 3, 12, and 24 months, respectively. The Cox regression model results showed that male sex, medicare insurance were significantly positive factors affecting survival after a diagnosis of primary malignant spine tumor.ConclusionOur study provides a detailed view of the characteristics, medical utilization states, and survival rates of patients newly diagnosed with primary spine tumors in Korea.

Testing the Representativeness of a Multimode Survey in South Korea: Results from KAMOS

The Korean Academic Multimode Open Survey (KAMOS) is a national survey first conducted in 2016. Stratified cluster random sampling was used in an initial face-to-face survey during which panel members were recruited. The second survey allowed invited panel members to answer online or by phone. KAMOS includes both longitudinal items and omnibus items, i.e., researchers can propose questions to include on KAMOS. This paper seeks to establish that KAMOS is representative of the South Korean adult population. The demographic variables from the first survey were comparable to demographic variables from two well-respected surveys in South Korea: the KOSTAT Social Survey and the Gallup Korea Omnibus Survey. To ensure that there was no substantial difference between those who answered the first survey and those who answered the second survey, we compared the results of 22 items from the first survey. The 2,000 panel members who were invited to participate in the second survey had similar responses to the 1,008 of those who responded to the second survey. Based on our findings, KAMOS can be considered a representative sample.

Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population

BackgroundData on the epidemiology of atrial fibrillation (AF) and temporal trends are not well established in the Korean population. We aimed to estimate the incidence and prevalence of AF in Korea between 2008 and 2015. MethodsUsing the National Health Insurance Service database, we analyzed as a nationwide cohort the entire Korean adult population from 2008 to 2015 (n=41,505,679 in 2015). AF was identified by using diagnostic codes. ResultsDuring an 8-year period representing 314,311,360 person-years of follow-up, 496,341 individuals were newly diagnosed with AF. The incidence of AF increased to >1.12-fold as follows: from 15.34 to 17.14 per 10,000 person-years (p<0.001). We also found a 1.68-fold increase in the prevalence of AF, from 0.46% in 2008 to 0.67% in 2015 (p<0.001). The incidence and prevalence of AF increased with advancing age. The median age of the AF patients increased from 68 to 71years (p<0.001). The prevalence of diabetes and heart failure in AF subjects increased (p<0.001). The percentage of patients with a CHA2DS2-VASc score of ≥2, who were strongly recommended for anticoagulation treatment, increased from 80.2% to 86.8% (p<0.001). ConclusionThe incidence and prevalence of AF gradually increased from 2008 to 2015. The proportion of AF patients who were candidates for anticoagulation therapy also significantly increased owing to population aging and increasing comorbidities (i.e., heart failure and diabetes). These findings may provide a framework to understand the actual disease burden and establish the optimal management strategy for AF.

Associations between urinary phthalate metabolites and bisphenol A levels, and serum thyroid hormones among the Korean adult population - Korean National Environmental Health Survey (KoNEHS) 2012-2014.

Phthalates and bisphenol A (BPA) have been used extensively in many consumer products, resulting in widespread exposure in the general population. Studies have suggested associations between exposure to phthalates and BPA, and serum thyroid hormone levels, but confirmation on larger human populations is warranted. Data obtained from nationally representative Korean adults (n=6003) recruited for the second round of the Korean National Environmental Health Survey (KoNEHS), 2012-2014, were employed. Three di-(2-ethylhexyl) phthalate (DEHP) metabolites, along with benzyl-butyl phthalate (BBzP) and di-butyl phthalate (DBP) metabolites, and BPA were measured in subjects' urine. Thyroxine (T4), total triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were measured in serum. The associations between urinary phthalates or BPA and thyroid hormone levels were determined. Urinary phthalate metabolites were generally associated with lowered total T4 or T3, or increased TSH levels in serum. Interquartile range (IQR) increases of mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) were associated with a 3.7% increase of TSH, and a 1.7% decrease of total T4 levels, respectively. When grouped by sex, urinary MEHHP levels were inversely associated with T4 only among males. Among females, mono-benzyl phthalate (MBzP) and mono-n-butyl phthalate (MnBP) levels were inversely associated with TSH and T3, respectively. In addition, negative association between BPA and TSH was observed. Several phthalates and BPA exposures were associated with altered circulatory thyroid hormone levels among general Korean adult population. Considering the importance of thyroid hormones, public health implications of such alteration warrant further studies.

A new landmark for measuring the Ischium-Pubis index for sex determination by using three-dimensional models of South Korean population

The Ischium-pubis index (IPI) is one of the parameters of sex determination using the hip bone. IPI is defined as the percentage of the pubis length to the ischium length. On dry bones, the combined starting point of the lengths of the pubis and ischium is in the acetabulum. In this study, we evaluated the accuracy of IPI determination by using three-dimensional computational models. We compared the accuracy of three acetabular landmarks: the traditional acetabulum notch, the deepest point of the acetabulum and the point on the superior acetabulum border. The deepest point of the acetabulum was newly defined to facilitate the computational measurement. One-hundred models reconstructed from computed tomography scans of Korean adult cadavers were measured for the pubic and ischium length. After computer-assisted landmark indication procedure on software that enables three-dimensional model handling, measurements were automatically calculated. In the Korean adult population, measurements involving the deepest point of the acetabulum have shown the highest accuracy, 91%. We compared our results with those of the former reports on pubis length, ischium length, and IPI.

Association between unmet needs for dental treatment and the DMFT index among Korean adults

Objectives: Unmet needs for dental treatment are one of the potential contributing factors to poor oral health because oral health problems worsen if left untreated. This study aimed to demonstrate the prevalence of and the causes for unmet dental needs, and to evaluate the association between unmet needs for dental treatment and oral health status. Methods: Data on 3,883 subjects aged ≥18 years from the Korean National Oral Health Survey 2006 were analyzed. Information regarding unmet needs for dental treatment was obtained using standard ized questionnaires. Eight trained dentists examined decayed, missing, or filled teeth (DMFT). Multiple regression models were built to assess the association between unmet needs for dental treatment and the DMFT scores. Results: The prevalence of perceived unmet needs for dental treatment was 34.7% among the adult Korean population. Economic constraints were the main cause (38.6%) for unmet dental needs. The average DMFT scores were higher in the subjects with unmet needs for dental treatment than in those without. In individuals with unmet needs for dental treatment within the past 1 year, the number of de cayed teeth after adjusting for confounders was likely to be greater by 0.58 and that of missing teeth by 0.27 compared to that in their counterparts with no unmet dental needs in the past 1 year. Conclusions: Perceived unmet needs for dental treatment were significantly associated with poor oral health status among the adult Korean population. Further studies are needed to clarify the direct and indirect effects of unmet needs for dental treatment on an individual’s oral health status by investigating critical variables of the causal pathways among perceived dental needs, dental care utilization, and oral health status.

Association between electronic cigarette smoking and allergic rhinitis – The Korea National Health and Nutrition Examination Survey (2015)

Purpose: Allergic rhinitis (AR) is one of the common chronic diseases. Although it is not a life-threatening disease, its persistent symptoms may cause fatigue, mood change, discomfort at work, and academic disability as well as the decrease of quality of life. The prevalence of AR has been increasing steadily due to the Westernized lifestyle and environmental change. In previous studies, it has been found that AR has a clear relationship with smoking. However, there is no relationship study between AR and electronic cigarettes smoking (ECS). Methods: The study was conducted on >19 -year-old adults who participated in the 2015 Korea National Health and Nutrition Ex amination Survey. Sex, age, residence status, tobacco smoking, alcohol drinking, stress level, economic status, and diagnosis of AR were analyzed by using univariate and multivariate logistic regression analyses. Results: AR tended to be associated with ECS in the Korean adult population in univariate analysis, but ECS was not statistically sig nificant in multivariate analysis. By multivariate analysis, AR was significantly related with younger age, male sex, alcohol consump tion, and stress. Moreover, the prevalence of AR was linearly decreased as age increased from 19 to 69 years. Conclusion: A diagnosis of AR was not significantly associated with ECS. Instead, AR showed an increased prevalence in adults at younger age, of male sex, and with alcohol consumption and high stress. To derive statistically significant results of relationship be tween AR and ECS, more well-designed studies focusing on the temporal causal are needed. (Allergy Asthma Respir Dis 2017;5:344-350)

Trends in energy intake among Korean adults, 1998-2015: Results from the Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVESAssessing changes in energy intake and dietary sources is important to understand trends in the prevalence of obesity. Thus, we examined trends in energy intake and its nutrient and food sources in Korean adults from 1998 through 2015.SUBJECTS/METHODSThis study included 70,769 subjects aged ≥ 19 years who completed a nutrition survey. Subject data were obtained from the 1998, 2001, 2005, 2007-2009, 2010-2012, and 2013-2015 Korea National Health and Nutrition Examination Surveys. Dietary intake was assessed by a 1-day 24-hour recall method.RESULTSIn men, the daily energy intake significantly increased from 2,196 kcal in 1998 to 2,489 kcal in 2013-2015 (P for trend < 0.0001). However, the daily energy intake among women did not change significantly over the same period (P for trend = 0.5772). The percentages of energy intake from animal foods (e.g., meat and milk) and beverages increased during the study period in both men and women. However, the percentage of energy intake from plant foods decreased due to a marked decrease in the intake of white rice. Changes in food sources of energy intake led to changes in the nutrient sources of energy intake; for example, the increase of energy intake from fat and decrease of energy intake from carbohydrate.CONCLUSIONSThis study suggests that since 1998, energy intake has increased among Korean adult men, but not among women. However, the composition of food and nutrient sources of energy intake has changed in both men and women. Energy intake and its nutrient and food sources should continue to be monitored regularly in the Korean adult population.

Examining the Social Capital Measures Associated with Mental Health among the Korean Adult Population

Examining the Social Capital Measures Associated with Mental Health among the Korean Adult Population

The Association of Resting Heart Rate with the Presence of Diabetes in Korean Adults: The 2010-2013 Korea National Health and Nutrition Examination Survey.

BackgroundPrevious epidemiologic studies have shown that elevated resting heart rate (HR) is associated with higher cardiovascular disease (CVD) morbidity and mortality. Although the relationship between elevated HR and CVD is well established, the association between resting HR and diabetes has been relatively understudied, particularly in non-Western populations.ObjectivesWe confirmed the association between the presence of type 2 diabetes and resting HR in the Korean adult population using data from the 2010–2013 Korea National Health and Nutrition Examination Survey (KNHANES).MethodsAmong 25,712 adults (≥ 19 years of age) who participated in the 2010–2013 KNHANES, a total of 22,512 subjects completed laboratory examinations and were included in this analysis. The fasting plasma glucose (FPG) level was categorized into the following five groups: normal fasting glucose (NFG) 1 (<90 mg/dL), NFG 2 (90–99 mg/dL), impaired fasting glucose (IFG) 1 (100–110 mg/dL), IFG 2 (111–125 mg/dL), and diabetes (≥ 126 mg/dL).ResultsThe unadjusted weighted resting HRs were 69.6, 69.4, 69.8, 70.1, and 72.0 beats per minute (bpm) in the NFG 1, NFG 2, IFG 1, IFG 2, and diabetes groups, respectively (P<0.001). We assessed the adjusted weighted resting HR according to the FPG level after adjusting for age, sex, smoking history, high risk alcohol drinking, daily energy intake, waist circumference, serum total cholesterol level, serum triglyceride (TG) level, serum white blood cell (WBC) count, serum hemoglobin (Hb), and the presence of hypertension. The adjusted weighted resting HR significantly increased across the FPG groups (P<0.001). The weighted prevalence rates of diabetes were 6.8% (6.2–7.5%), 7.6% (6.7–8.5%), 8.0% (7.0–9.1%), and 11.8% (10.8–12.7%) in subjects with HR ≤ 64, 65–69, 70–75, and ≥ 76 bpm, respectively (P<0.001), after adjusting for the confounding factors mentioned above. Using resting HR ≤ 64 bpm as the control, resting HR ≥ 76 bpm was correlated with the presence of diabetes (adjusted OR 1.83, 95% CI 1.55–2.16, P<0.001). Each 10 bpm increment of HR increased the risk of the presence of diabetes by 35% (P<0.001). This association of high resting HR with the presence of diabetes was not influenced by the status of blood pressure (BP) medication.ConclusionWe demonstrated that higher HR was associated with diabetes in a representative sample of Korean adults. These positive associations were independent of age, sex, current smoking, high risk alcohol drinking, daily energy intake, waist circumference, and the presence of hypertension and other potential confounders. This study suggests that individuals with higher resting HR are at risk of diabetes and that HR might provide an easy and simple surrogate marker for the risk of diabetes.

Elevated leukocyte count is associated with periodontitis in Korean adults: the 2012-2014 KNHANES.

Both an elevated leukocyte count and periodontitis share well-recognized associations with cardiometabolic diseases. This cross-sectional study aimed to identify whether the leukocyte count is associated with periodontitis in a nationally representative Korean adult population. Data from 9391 participants (3659 males and 5732 females) enrolled in 2012-2014 Korean National Health and Nutrition Examination Survey were analyzed. Leukocyte quartiles were categorized as follows: 3000≤Q1≤4870, 4880≤Q2≤5790, 5800≤Q3≤6840, and 6850≤Q4≤10000cells/μl. Periodontitis was defined as scoring greater than or equal to 'code 3' in at least one site according to the WHO's Community Periodontal Index. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for periodontitis in each leukocyte count quartile were calculated using multiple logistic regression analyses. The prevalence of periodontitis was directly correlated with increasing leukocyte quartiles: 19%, 20.4%, 24.3%, and 30.3%. Compared with the lowest leukocyte quartile group, the OR (95% CI) for periodontitis of the highest leukocyte quartile was 1.558 (1.285-1.891) after controlling for confounding factors. An elevated leukocyte count was positively associated with the presence of periodontitis.

Dry Eye Disease and Allergic Conditions: A Korean Nationwide Population-Based Study

Dry eye disease (DED) is a multifactorial disease of the tears and ocular surface. No epidemiologic reports have yet been published about the relationship between DED and allergic rhinitis or sensitization to allergens. To investigate the association between DED and allergic conditions in the general adult Korean population. This population-based cross-sectional study included 17,542 individuals (ages ≥ 19 years) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2010 to 2012. Data for total serum immunoglobulin E (IgE) and allergen-specific IgE levels were available for 1857 subjects. Data were analyzed by using logistic regression to determine the association of DED with allergy or allergic conditions, including allergic rhinitis, atopic dermatitis, asthma, increased total serum IgE, and sensitization to house-dust mite (Dermatophagoides farinae), dog, and cockroach allergens. The prevalence of DED, allergic rhinitis, atopic dermatitis, and asthma was 10.4, 13.1, 2.2, and 3.3%, respectively. The prevalence of the increased total serum IgE level and sensitization to D. farinae, dog, and cockroach allergens was 34.6, 15.7, 1.0, and 2.8%, respectively. After adjusting for general characteristics, DED was significantly associated with allergic rhinitis (odds ratio 1.58 [95% confidence interval, 1.38-1.81]) and D. farinae sensitization (odds ratio 1.80 [95% confidence interval, 1.17-2.79]). This study demonstrated a close association between DED and both allergic rhinitis and D. farinae sensitization in Korean adults. Further studies are warranted to establish temporal relationships between DED and allergic rhinitis.

Evaluation of Audiometric Test Results to Determine Hearing Impairment in Patients with Rheumatoid Arthritis: Analysis of Data from the Korean National Health and Nutrition Examination Survey.

This study aimed to evaluate the association between rheumatoid arthritis (RA) and hearing impairment in the Korean adult population. Audiometric and laboratory test data from the 2010–2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used for analysis. The relationship between RA and hearing impairment was analyzed, adjusting for various known risk factors associated with hearing impairment. RA was defined in the questionnaire as “RA diagnosed by a physician (yes/no) through a standardized interview.” We defined hearing impairment according to 2 categories of frequency (low/mid and high) as follows (average values in kHz): low/mid frequency, 0.5, 1.0, and 2.0, and high frequency, 3.0, 4.0, and 6.0. Of the subjects, 15,158 (weighted n = 32,035,996) completed the audiometric tests. The overall weighted prevalence of RA was 1.5%. The prevalence of hearing impairment was higher in the subjects with RA than in those without RA, in both, the low/mid- and high-frequency categories (21.1% vs 7.5%, p < 0.001 and 43.3% vs. 26.2%, p < 0.001, respectively). In the multivariable logistic analysis, RA (odds ratios [OR] 1.47, 95% confidence interval [CI] 1.05–2.06, p = 0.025) was an independent risk factor of low/mid-frequency hearing impairment along with age (OR 1.12, 95% CI 1.12–1.13, p < 0.001), current smoking (OR 1.27, 95% CI 1.03–1.56, p = 0.026), and college graduation (OR 0.53, 95% CI 0.39–0.72, p < 0.001). In the multivariable analysis of high-frequency hearing impairment, RA did not show any association with hearing impairment. This study suggests that RA is associated with low/mid-frequency hearing impairment after adjustment for various known risk factors. Further study is needed to verify the hearing impairment in RA.

Lifecourse socioeconomic position indicators and tooth loss in Korean adults.

The aim of this study was to assess the association between lifecourse socioeconomic position (SEP) indicators and tooth loss in a large representative sample of the Korean adult population. Data from the Fourth and Fifth Korea National Health and Nutritional Examination Survey on 17,549 Korean adults aged 50 years or older were analyzed. The study design was cross-sectional. Tooth loss was defined as either edentulism (0 teeth) or severe tooth loss (<20 teeth). Parental education, own education, and income were used as indicators of early childhood SEP, adolescent SEP, and adulthood SEP, respectively. The association between the lifecourse SEPs and tooth loss was estimated with three different lifecourse models: the independent impact model for three different lifecourse SEPs, the cumulative impact model using the sum of the three SEP scores, and the social mobility model using the pathway information of the three SEPs. The covariates were demographic factors and health behaviors. The prevalence ratios (PRs), slope index of inequality (SII), and relative index of inequality (RII) for tooth loss were estimated with log-binomial regression analyses. In the independent impact model, significant associations of each SEP with edentulism (SII=3.61%, 4.76%, 2.17% and RII=1.67, 1.52, 1.41 for parental education, own education, and income, respectively) and severe tooth loss (SII=8.03%, 17.73%, 12.73% and RII=1.26, 1.72, 1.42 for parental education, own education, and income, respectively) were found after adjusting for all covariates. For the cumulative impact model, stepwise patterns of PRs according to the summed SEP scores were found. In addition, in the social mobility model, the PR of tooth loss was greatest in the persistently low SEP group over the life course (PR=2.10 for edentulism and 2.33 for severe tooth loss). The other mobile groups in lifecourse SEPs also presented higher PRs of tooth loss than the persistently high SEP group. Parental education was independently associated with edentulism in later life, and own education showed the strongest associations with tooth loss. The cumulative and social mobility models for the social impacts of life course on oral health should be considered in oral epidemiological studies.