Korea National Health And Nutrition Examination Survey Research Articles

Distinct characteristics of MetALD (metabolic dysfunction-associated steatotic liver disease with greater alcohol consumption) in the general population.

The term MetALD has been introduced to describe individuals who have metabolic dysfunction-associated steatotic liver disease (MASLD) with greater alcohol consumption, according to the new nomenclature for steatotic liver disease (SLD). This study aims to evaluate the prevalence and clinical characteristics of MetALD in the general population. This study is a retrospective, cross-sectional analysis that utilizes the population-based data from the Korea National Health and Nutrition Examination Survey (KNHANES) undertaken between 2019 and 2021. A total of 16521 participants aged over 18years were included in the analysis. The presence of hepatic steatosis was determined based on a hepatic steatosis index of 36 or higher. The prevalence of MetALD was 2.8% (95% confidence interval, 2.5-3.2). Individuals with MetALD were predominantly men (85.4%) and tended to be younger compared to those with MASLD. They showed a higher prevalence of hypertension and had significantly higher levels of fasting glucose, triglycerides, high-density lipoprotein cholesterol, and creatinine compared to individuals with MASLD. The average daily total energy intake was higher in the MetALD group. In addition, the MetALD group had a lower proportion of unemployment with higher income compared to the MASLD group. Patients with MetALD showed distinct clinical characteristics from those with MASLD. The characteristics of MetALD were similar to those with alcohol-related liver disease. Further analysis of MetALD across various regions and ethnic groups would be needed.

Development of a Predictive Model for Chewing Difficulty Using EuroQol-5 Dimension Among Korean Older Adults.

We aimed to develop a predictive model for chewing difficulty using the EuroQol-5 dimension measure (EQ-5D). We included 6643 individuals aged ≥ 65 years (mean age: 72.6 ± 4.96 years; women: 3761 [56.6%]) who had completed the sixth (2013-2015) and seventh (2016-2018) Korea National Health and Nutrition Examination Survey (KNHANES). The participants were further divided into young-old (65-74 years) and old-old (≥ 75 years) adults. Data from the sixth KNHANES were used to establish an internal validation model (overall, young-old and old-old adult populations were 3472, 2271 and 1201, respectively). Data from the seventh KNHANES were used to establish an external validation model (overall, young-old and old-old adult populations were 3171, 1879 and 1292 participants, respectively). We evaluated chewing difficulty using the EQ-5D (Model 1) and comparative models, subjective oral health status indicators (SOHSI) and objective oral health status indicators (OOHSI). Compared with SOHSI and OOHSI, EQ-5D showed similar predictive utility for chewing difficulty in both the internal and external validation models. Effect sizes, quantified using Cohen's d, indicated that EQ-5D parameters had a moderate impact on the prediction accuracy for chewing difficulties.

Relationship between perception of body image on obesity and smoking status by age group in women: Findings of a seven-year Korean National Survey.

This descriptive study examined the relationship between body image perception and smoking status among women aged 19-64 years in Korea, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study is a secondary analysis of data gathered from the KNHANES between 2014 and 2020, encompassing 12515 women aged 19-64 years. The final study group consisted of 742 current smokers (CS), 132 hidden smokers (HS), and 11641 non-smokers (NS). Hidden smokers were defined as participants who reported being non-smokers but had urine cotinine levels >50 ng/mL. The participants were divided into three age categories: 19-29, 30-49, and 50-64 years. A multiple logistic regression analysis was used to assess the relationship between body image perception and smoking status, by age group. Baseline statistics indicated that smokers (both CS and HS) generally had a lower socioeconomic status across all age groups. The highest rate of obesity perception was observed in the CS group, followed by the HS group, in both groups of women aged 19-29 and 30-49 years. However, only women aged 19-29 years in the CS group were more likely to perceive themselves as obese than those in the NS group (AOR=2.60; 95% CI: 1.49-4.52; p=0.001). Furthermore, factors such as current smoking status (AOR=2.32; 95% CI: 1.28-4.23; p=0.006), higher body mass index (AOR=2.95; 95% CI: 2.59-3.37; p<0.001), and perceived health status as poor (AOR=3.82; 95% CI: 2.11-6.92; p<0.001), significantly influenced the perception of obesity in this age group. This study identified a notable relationship between obesity perception and smoking among women aged 19-29 years only. These findings suggest that interventions aimed at weight reduction or modifying the perception of obesity, could potentially aid smoking cessation efforts in young women.

Age-Related Increase in Type C Tympanogram.

Background: This study evaluated the relationship between aging and tympanometric changes, specifically the incidence of type C tympanograms, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: We analyzed data from the 2019-2022 KNHANES, including 26,738 ears from individuals aged 40 and older. Tympanometry at 226 Hz identified type C tympanograms based on peak pressure below -100 daPa. Multiple logistic regression evaluated the association between age and type C tympanograms, adjusting for confounders such as sex, smoking status, allergic rhinitis, chronic sinusitis, and lifestyle disease markers. Results: The incidence of type C tympanograms increased significantly with age (R2 = 0.953, p < 0.001). Age was the most significant factor associated with type C tympanograms (p < 0.001, odds ratio 1.052), while other factors were not statistically significant. Ears with type C tympanograms had significantly poorer hearing thresholds compared to those with type A tympanograms (p < 0.001). Conclusions: Aging is significantly associated with an increased incidence of type C tympanograms, indicating possible middle ear dysfunction in older adults. The correlation between type C tympanograms and poorer hearing thresholds suggests that age-related changes in middle ear function may contribute to hearing impairment. Tympanometric screening in older adults may facilitate early detection and management of middle ear dysfunction, potentially improving hearing outcomes and quality of life.

Suicide risk in juvenile open angle glaucoma patients.

To investigate the association between juvenile open angle glaucoma (JOAG) and mental health among Koreans. This study used nationally representative data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES) 2021. Glaucoma diagnosis followed the International Society of Geographical and Epidemiological Ophthalmology criteria based on glaucomatous structural defects, visual field defects, corrected vision, and intraocular pressure. As outcomes, suicidal behaviors, psychiatric counseling, and depression were evaluated through mental health questionnaires. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression models, adjusting for covariates. Among 7090 participants, 3446 met the inclusion criteria for analysis, and 88 (2.6%) were diagnosed with open angle glaucoma (OAG). After adjusting for age, sex, and best-corrected visual acuity (VA), participants with OAG were revealed to have significantly higher odds of suicidal behaviors (i.e., ideation, planning, or attempts) compared with those without OAG (OR: 2.70; 95%CI: 1.12-6.54; P=0.028). This association remained significant after further adjustments for socioeconomic status, lifestyle factors, and presence of chronic conditions (P=0.031 and 0.035, respectively). However, there was no significant difference for the other two outcomes, psychiatric counseling and depression. An age-stratified analysis revealed a stronger association between OAG and suicidal behaviors in younger JOAG participants (<40y) than in older OAG participants (≥40y; OR: 3.80 vs 2.22; 95%CI: 0.79-18.22 vs 0.56-8.80, respectively). OAG patients show a higher risk of suicidal behaviors than those without glaucoma particularly in JOAG patients.

7551 Association of Remnant Cholesterol with Sarcopenia in Korean Adults: A Nationwide Population-Based Study using Data from the KNHANES

Abstract Disclosure: S. Jang: None. S. Hwang: None. A. Jang: None. K. Kim: None. J. Yu: None. N. Kim: None. H. Yoo: None. J. Seo: None. S. Kim: None. N. Kim: None. S. Baik: None. K. Choi: None. Objectives: Mounting evidences indicate the importance of interplay between skeletal muscle and lipid metabolism. Remnant cholesterol (remnant-C) is considered as one of the principal residual risk factors for atherosclerotic cardiovascular disease (ASCVD) as well as metabolic disorders, but there is limited study about the impact of remnant-C on sarcopenia. Research design and Methods: Data from the Korea National Health and Nutrition Examination Surveys (KNHANES) between 2008 and 2011 was used in this nationwide population-based study. A total of 17,408 participants were enrolled. Subjects were categorized into 4 groups according to the quartile of remnant-C values. We conducted multivariable logistic regression analysis to evaluate the association between remnant-C and muscle mass measured using dual-energy X-ray absorptiometry (DXA). Results: 1,989 participants (11.4%) presented low muscle mass, and there was a sequential increase in the percentage of low muscle mass across remnant-C quartiles (Q1, 5.8%; Q2, 9.9%; Q3, 12.9%; Q4, 17.1%). In the full adjusted model, those in the highest remnant-C quartile group showed the highest odds ratio for low muscle mass after adjusting for various confounding factors (Q2, 1.18 [0.95-1.47]; Q3, 1.12 [0.9-1.39]; Q4, 1.37 [1.1-1.71], P &amp;lt;0.05). A wide range of subgroup and sensitivity analyses showed consistent results, which may support the robustness of the present findings. Conclusions: Increased remnant-C value is related to high risk of low muscle mass in Korean population. Remnant-C may be a novel marker to predict and manage sarcopenia in the aging society. There should be future research to verify its clinical usefulness. Presentation: 6/2/2024

Physical activity and nutrient intake levels according to grip strength among single-household elderly in Korea: data from 2014 and 2019 Korea National Health and Nutrition Examination Survey (KNHANES).

We analyzed the differences in physical activity (PA) levels and nutrient intake based on grip strength among elderly men and women in single-person households (ESH) in Korea. Data were obtained from 1,581 ESH individuals (aged ≥65 years) from the Korean National Health and Nutrition Examination Survey (2014-2019). PA levels (occupational and recreational moderate-intensity activities, travel to and from places, walking, and strength training) and nutrient intake (including, total energy, carbohydrates, protein, and fat) were analyzed. Men exhibited no differences in PA related to grip strength, except for the number of strength training days (p=0.000). Women with higher grip strength engaged more in recreational activities, travel, and strength training (all, p=0.000). Men with higher grip strength consumed more protein, while women consumed greater amounts of total fat (p=0.030), monounsaturated fatty acids (MUFA) (p=0.024), and polyunsaturated fatty acids (PUFA) (p=0.011). Both sexes had increased Vitamin C intake (men: p=0.023, women: p=0.020). Sex-related differences in PA levels and nutrient intake based on grip strength were observed among older individuals in ESH. Women require programs to enhance diverse PA and balance fat intake, while men need interventions focused on strength training and protein intake.

Association between the duration of oral contraceptive use and the prevalence of type 2 diabetes mellitus: Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2021

Association between the duration of oral contraceptive use and the prevalence of type 2 diabetes mellitus: Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2021

Correlation between Hearing Impairment and the Triglyceride Glucose Index in Middle-Aged Female Based on a Korean National Health and Nutrition Examination Survey

Background and Objectives: This study aimed to investigate the association between insulin resistance, as measured by the triglyceride–glucose index (TyG index), and hearing impairment in middle-aged women in Korea. Materials and Methods: This cross-sectional survey utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2007–2009), specifically from the period after July 21, 2009, when hearing test results became available, and from the KNHANES V (2010–2012). This study was conducted on 5416 women aged 40 to 69 who had completed both the health examination survey and audiometric tests, excluding those with missing data on menopausal status and the use of hormone replacement therapy. Results: In the study group, the prevalence of high-frequency hearing loss according to the TyG index was significantly higher in the mild hearing loss group (OR = 1.29; 95% CI: 1.12, 1.49, p &lt; 0.001) and the moderate hearing loss group (OR = 1.27; 95% CI: 1.09, 1.48, p = 0.002). Conversely, the prevalence of low-frequency hearing loss did not show a significant difference in either the mild hearing loss group (OR = 1.17; 95% CI: 0.99, 1.37, p = 0.065) and the moderate hearing loss group (OR = 1.13; 95% CI: 0.94, 1.35, p = 0.199) Conclusions: Since diabetes can induce hearing impairment in women, it is recommended that women with a high TyG index undergo early hearing tests

Association and interaction effect of shift work and the risk for obstructive sleep apnea on diabetes mellitus in middle-aged Korean workers.

To investigate the association of shift work and the risk for obstructive sleep apnea (OSA) with diabetes mellitus (DM), and the interaction effect of shift work and the risk for OSA on DM. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2019-2021 were used. The participants were 3012 employees aged 40 to 59 years. Shift work was assessed using self-reporting questionnaires. The risk for OSA was assessed by STOP-BANG score. The distribution of demographic factors was calculated using the chi-square test. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression. An interaction effect between shift work and the risk for OSA on DM was evaluated using relative excess risk owing to interaction (RERI) and attributable proportion (AP) with 95% CIs. The synergic index (SI) was also calculated. Shift work and the risk for OSA were each significantly associated with DM. There was also a significant interaction effect between shift work and the risk for OSA on DM. The RERI was 0.543 (95% CI 0.205-1.361) and the AP was 0.230 (95% CI 0.145-0.342). The SI was 1.662 (95% CI 1.481-1.843). There was an association and a significant interaction effect of shift work and the risk for OSA on DM. The management of OSA in shift workers should be implemented to prevent DM.

Impact of COVID-19 pandemic on ocular disease: KNHANES 2015–2021

The aim of this study was to evaluate the impact of COVID-19 on ocular diseases and changes in risk factors before and after the COVID-19 pandemic. This study was conducted using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2015–2021, a national cross-sectional health examination and survey. Associations between ocular diseases and risk factors were determined using the chi-squared test and logistic regression analysis. Bivariable adjusted logistic regression analysis was performed to examine the odds ratio (OR) and 95% confidence interval (CI) to evaluate of the impact of COVID-19 on ocular diseases. Individuals were divided into two age groups (< 60 and ≥ 60 years). A total of 50,158 people were diagnosed, of whom 7270 were diagnosed with cataract, 921 with glaucoma, and 439 with age-related macular degeneration (AMD). Risk factors for cataract were COVID-19 pandemic (OR 1.161), hypertension (OR 1.608), diabetes (OR 1.573), dyslipidemia (OR 1.167), stroke (OR 1.272), and depression (OR 1.567). Risk factors for AMD were COVID-19 pandemic (OR 1.600), dyslipidemia (OR 1.610), and depression (OR 1.466). Risk factors for glaucoma were hypertension (OR 1.234), dyslipidemia (OR 1.529), diabetes (OR 1.323), and depression (OR 1.830). The COVID-19 pandemic was a risk factor for cataracts and AMD, but not for glaucoma. Cataracts and AMD may be more influenced by the acquired health conditions or the environment.

Accelerometer-Based Physical Activity and Health-Related Quality of Life in Korean Adults: Observational Study Using the Korea National Health and Nutrition Examination Survey.

Health-related quality of life (HRQoL) reflects an individual's perception of their physical and mental health over time. Despite numerous studies linking physical activity to improved HRQoL, most rely on self-reported data, limiting the accuracy and generalizability of findings. This study leverages objective accelerometer data to explore the association between physical activity and HRQoL in Korean adults. The objective of this study is to analyze the relationship between objectively measured physical activity using accelerometers and HRQoL among Korean adults, aiming to inform targeted interventions for enhancing HRQoL through physical activity. This observational study included 1298 participants aged 19-64 years from the Korea National Health and Nutrition Examination Survey (KNHANES) VI, who wore an accelerometer for 7 consecutive days. HRQoL was assessed using the EQ-5D questionnaire, and physical activity was quantified as moderate-to-vigorous physical activity accelerometer-total (MVPA-AT) and accelerometer-bout (MVPA-AB). Data were analyzed using logistic regression to determine the odds ratio (ORs) for low HRQoL, adjusting for socioeconomic variables and mental health factors. Participants with higher HRQoL were younger, more likely to be male, single, highly educated, employed in white-collar jobs, and had higher household incomes. They also reported less stress and better subjective health status. The high HRQoL group had significantly more participants meeting MVPA-AB ≥600 metabolic equivalents (P<.01). Logistic regression showed that participants meeting MVPA-AB ≥600 metabolic equivalents had higher odds of high HRQoL (OR 1.55, 95% CI 1.11-2.17). Adjusted models showed consistent results, although the association weakened when adjusting for mental health factors (OR 1.45, 95% CI 1.01-2.09). The study demonstrates a significant association between HRQoL and moderate to vigorous physical activity sustained for at least 10 minutes, as measured by accelerometer. These findings support promoting physical activity, particularly sustained moderate to vigorous activity, to enhance HRQoL. Further interventional studies focusing on specific physical activity domains such as occupational, leisure-time, and commuting activities are warranted.

Insulin Resistance and Impaired Insulin Secretion Predict Incident Diabetes: A Statistical Matching Application to the Two Korean Nationwide, Population-Representative Cohorts.

To evaluate whether insulin resistance and impaired insulin secretion are useful predictors of incident diabetes in Koreans using nationwide population-representative data to enhance data privacy. This study analyzed the data of individuals without diabetes aged >40 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010 and 2015 and the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). Owing to privacy concerns, these databases cannot be linked using direct identifiers. Therefore, we generated 10 synthetic datasets, followed by statistical matching with the NHIS-HEALS. Homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were used as indicators of insulin resistance and insulin secretory function, respectively, and diabetes onset was captured in NHIS-HEALS. A median of 4,580 (range, 4,463 to 4,761) adults were included in the analyses after statistical matching of 10 synthetic KNHANES and NHIS-HEALS datasets. During a mean follow-up duration of 5.8 years, a median of 4.7% (range, 4.3% to 5.0%) of the participants developed diabetes. Compared to the reference low-HOMA-IR/high-HOMA-β group, the high-HOMA-IR/low- HOMA-β group had the highest risk of diabetes, followed by high-HOMA-IR/high-HOMA-β group and low-HOMA-IR/low- HOMA-β group (median adjusted hazard ratio [ranges]: 3.36 [1.86 to 6.05], 1.81 [1.01 to 3.22], and 1.68 [0.93 to 3.04], respectively). Insulin resistance and impaired insulin secretion are robust predictors of diabetes in the Korean population. A retrospective cohort constructed by combining cross-sectional synthetic and longitudinal claims-based cohort data through statistical matching may be a reliable resource for studying the natural history of diabetes.

머신러닝을 통한 관절염 환자의 삶의 질 영향 분석

This study aimed to analyze the health-related quality of life(HRQoL) of osteoarthritis patients and develop a predictive model using machine learning. Data from the 2019 Korea National Health and Nutrition Examination Survey(KNHANES) were used. Hierarchical regression analysis examined the impact of osteoarthritis on quality of life. Multiple linear regression, lasso regression, random forest and XGBoost were used. Of 8,110 participants, 5,837 were selected, excluding those under 19 with missing EQ-5D data; of these, 602 had osteoarthritis. Their average EQ-5D score was lower than the normal group's. Analysis showed osteoarthritis significantly affects quality of life. Compared to the XGBoost(default), the predictive performance of multiple linear regression, lasso regression, random forest and XGBoost(tuned) models was significantly better, with no significant differences among these. Random forest and XGBoost confirmed osteoarthritis as a key factor. Regression equations to predict quality of life were derived. This study is the first to use machine learning for this purpose and aims to support new clinical assessments and interventions.

Temporal trends in adherence to lifestyle recommendations of patients with hypertension in Korea, 2007-2021.

Adherence to lifestyle recommendations is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of adherence to lifestyle recommendations and analyze the trends in adherence to lifestyle recommendations among patients with hypertension in Korea from 2007 to 2021 using the Korea National Health and Nutrition Examination Survey (KNHANES). The study included adults aged ≥20 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed. In 2021, A doublefold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared to 2007. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. The body mass index (BMI) and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles. Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. A multidisciplinary approach is necessary for improving the lifestyle habits of hypertensive patients.

Synergistic effects of COVID-19 pandemic and sedentary lifestyles on obesity rates among South Korean adults

Since March 2020, South Korea has implemented social distancing measures to reduce the spread of the coronavirus disease (COVID-19). These policies resulted in significant changes in the lifestyle of Korean adults, including spending more time indoors and experiencing increased sedentary time during the pandemic. This study aimed to investigate the combined influence of sedentary lifestyle and the COVID-19 pandemic on obesity rates among adults residing in South Korea. Data were obtained from the 2018–2020 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple logistic regression was used to analyze the synergistic effects of a sedentary lifestyle and COVID-19 on obesity. The prevalence of sedentary lifestyles among the participants increased from 30.4% pre-COVID-19 to 36.6% during the pandemic. Furthermore, the obesity rates were raised independently by COVID-19 (OR: 1.16, 95% CI 1.04–1.30) and by a sedentary lifestyle (OR = 1.17, 95% CI 1.04–1.31). A synergistic effect of a sedentary lifestyle and COVID-19 on obesity was identified (OR: 1.57, 95% CI 1.30–1.85). COVID-19 and a sedentary lifestyle significantly increased the risk of obesity in South Korean adults. Moreover, the combined synergistic effects of these risk factors were too substantial to be disregarded by merely summing their individual effects on obesity.

Impact of Alcohol-Induced Facial Flushing Phenotype on Alcohol Consumption Among Korean Adults: 2-Year Cross-Sectional Study.

The alcohol-induced facial flushing phenotype (flushing) is common among East Asians. Despite a small intake of alcohol, they experience heightened levels of acetaldehyde, a group-1 carcinogen, which, in turn, causes unpleasant symptoms such as redness, acting as a robust protective mechanism against consuming alcohol. However, some individuals with this genetic trait exhibit weakened alcohol restraint, which increases the risk of developing alcohol-related cancers, such as esophageal and head or neck cancer, by several times. Although this flushing phenomenon is crucial for public health, there is a paucity of studies that have comprehensively investigated the effect of flushing or its genotype on alcohol consumption in a large group of East Asians while controlling for various sociodemographic and health-related variables at a country level. This 2-year cross-sectional study aims to explore the effect of flushing on drinking behavior in Koreans and to examine whether the effect varies across sociodemographic and health-related factors. We used data from the Korea National Health and Nutrition Examination Survey (KNHANES) for 2019 and 2020 conducted by the Korea Disease Control and Prevention Agency. Our sample comprised 10,660 Korean adults. The study investigated the association of 26 variables, including flushing, with drinking frequency and amount. The effect of flushing was examined with and without adjusting for the other 25 variables using multinomial logistic regression analysis. In addition, we tested the interaction effect with flushing and conducted a simple effect analysis. We used complex sample design elements, including strata, clusters, and weights, to obtain unbiased results for the Rao-Scott χ2 test, 2-tailed t test, and multinomial logistic regression analysis. The suppressive effect of flushing was significant (P<.001) across all pronounced categories of alcohol consumption in 2019. The ranges of standardized regression slopes and odds ratios (ORs) were -6.70≥β≥-11.25 and 0.78≥OR≥0.50 for frequency and -5.37≥β≥-17.64 and 0.73≥OR≥0.36 for amount, respectively. The effect became somewhat stronger when adjusted for confounders. The effect also exhibited an overall stronger trend as the severity of alcohol consumption increased. The β values and ORs were consistently smaller in 2020 compared to the previous year. A simple effect analysis revealed a diminished alcohol-suppressive effect of flushing on alcohol consumption for specific groups (eg, those with low levels of education, limited family support, physical labor, or health-related issues). Our findings suggest that flushing suppresses drinking in Koreans overall but has little or no effect in certain susceptible populations. Therefore, health authorities should conduct targeted epidemiological studies to assess drinking patterns and disease profiles, particularly regarding alcohol-related cancers, and establish effective preventive measures tailored to this population.

Prevalence of and factors associated with likely obstructive sleep apnea in individuals with airflow limitation.

Obstructive sleep apnea (OSA) is frequently associated with airflow limitation (AFL). However, information on the prevalence of and factors associated with likely OSA in individuals with AFL in Korea is limited. Data from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used, and 3,280 individuals (2,826 individuals without AFL and 454 individuals with AFL) were included. AFL was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < 0.7. A score ≥ 5 on the STOP-BANG questionnaire was used to identify individuals with likely OSA. The prevalence of likely OSA was compared between individuals with and without AFL. In addition, factors associated with likely OSA in individuals with AFL were evaluated using multivariable logistic regression analysis. Of 3,280 individuals, 13.8% had an AFL. The prevalence of likely OSA was significantly higher in individuals with AFL than in individuals without AFL (9.2% vs. 5.0%, p = 0.014). Among 454 individuals with AFL, obesity (adjusted odds ratio [aOR] = 14.78, 95% confidence interval [CI] = 4.20-52.02) was most strongly associated with likely OSA, followed by heavy alcohol consumption (aOR = 4.93, 95% CI = 1.91-12.70), hypertension (aOR = 4.92, 95% CI = 1.57-15.46), overweight (aOR = 4.71, 95% CI = 1.76-12.64), college graduate (aOR = 4.47, 95% CI = 1.10-18.22), and history of pulmonary tuberculosis (aOR = 3.40, 95% CI = 1.06-10.96). In Korea, approximately 1 in 10 individuals with AFL had likely OSA. Overweight and obesity, heavy alcohol consumption, high educational level, hypertension, and history of pulmonary tuberculosis were associated with likely OSA in individuals with AFL.

Epidemiologic relationship between alcohol flushing and smoking in the Korean population: the Korea National Health and Nutrition Examination Survey

Although facial flushing after drinking alcohol (alcohol flushing response) is common in Asian populations, the epidemiological features in a large sample have been investigated in only a few studies. This study assessed the epidemiologic characteristics and associated factors for alcohol flushing in a Korean population. This study was based on data collected during the 2019 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 5572 Korean adults was included in the general population group, and the alcohol flushing group consisted of 2257 participants. Smoking and physical activity were evaluated as possible associated factors for alcohol flushing. The overall prevalence of alcohol flushing was estimated at 40.56% of the general population (43.74% in males and 37.4% in females), and the prevalence was highest at 60–69 years of age and lowest in individuals older than 80 years. Occasional, frequent, and persistent alcohol flushing was reported by 11.9%, 3.7% and 15.0% of current flushers, among whom persistent flushers consumed the least amount of alcohol. Subjects who currently smoke had a higher propensity of alcohol flushing (adjusted OR 1.525, 95% CI 1.2–1.938), and subjects with smoking history of 20–29 pack-years (PYs) showed the highest association (adjusted OR 1.725, 95% CI 1.266–2.349) with alcohol flushing after adjustment for confounders. In contrast, significant association was not found between physical activity and alcohol flushing. The results demonstrated that current smoking status is shown to be significantly associated with alcohol flushing, and that current smokers with a history of smoking ≥ 20 PYs had a higher likelihood of alcohol flushing than non-smokers or ex-smokers.

Gastric and colorectal cancer incidence attributable to dietary factors in Korea.

Dietary factors play a role in the etiology of gastrointestinal cancer. We aimed to estimate the burden of gastric and colorectal cancer that can be attributable to dietary factors in adults aged 20 years and older in Korea in 2018. Dietary intakes in 2000 were estimated using data from the 2001, 2005, and 2007-2018 Korea National Health and Nutrition Examination Survey (KNHANES). For counterfactual scenarios, the optimal level of intake suggested by the Global Burden of Disease (GBD) study was used if it was available. Otherwise, the average intake values of reference groups among published studies globally were used. Relative risks (RRs) were pooled through dose-response meta-analyses of Korean studies. In Korea in 2018, an estimated 18.6% of gastric cancer cases and 34.9% of colorectal cancer cases were attributed to the combined effect of evaluated dietary factors. High intake of salted vegetables accounted for 16.0% of gastric cancer cases, followed by salted fish at 2.4%. Low intakes of whole grains (16.6%) and milk (13.7%) were leading contributors to colorectal cancer cases, followed by high intakes of processed meat (3.1%) and red meat (5.9%), and a low intake of dietary fiber (0.5%). These results suggest that a considerable proportion of gastric and colorectal cancer incidence might be preventable by healthy dietary habits in Korea. However, further research is needed to confirm the associations between dietary factors and gastric and colorectal cancers in Korea and to formulate and apply effective cancer prevention strategies to Koreans.