Middle-aged Korean Adults Research Articles

Effects of the Interaction Between Oxidative Balance Score and Polygenic Risk Scores on Incidence of Metabolic Syndrome in Middle-Aged Korean Adults

Oxidative stress is implicated in insulin resistance, obesity, and metabolic syndromes (MetSs). However, the interplay between oxidative stress and genetic predisposition during the development of MetS remains unclear. In this study, we aimed to investigate the effects of the interaction between oxidative balance score (OBS) and polygenic risk score (PRS) on the incidence of MetS in middle-aged Korean adults. We analyzed data from 25,879 participants aged ≥40 years from the Health Examinees Cohort of the Korean Genome and Epidemiology Study. The OBS was calculated using 11 antioxidant and five pro-oxidant factors. A genome-wide association study and clumping analysis identified 16 independent single-nucleotide polymorphisms associated with MetS that were used to calculate individual PRSs. Multivariable Cox proportional hazard models adjusted for confounding variables were used to assess the impact of OBS and PRS on the incidence of MetS. During a mean follow-up period of 4.3 years, we recorded 3153 cases of MetS. In both men and women, the group with the lowest OBS and a high PRS had a 1.50-fold (hazard ratio [HR] 1.50, 95% confidence interval [CI] 1.07–2.11) and 1.89-fold (HR 1.89, 95% CI 1.40–2.56) higher incidence, respectively, of MetS compared to those with the highest OBS and a low PRS. Among women with a high PRS, the HRs decreased significantly across OBS quintiles 1 through 5 (p for trend = 0.009). These findings suggest that managing the oxidative balance may be particularly crucial for individuals with a high genetic risk for MetS.

Perceived age estimation from facial image and demographic data in young and middle-aged South Korean adults

Biological age is an indicator of whether an individual is experiencing rapid, slowing, or normal aging. Perceived age is highly correlated with biological age, which reflects health appraisal and is often used as a clinical marker of aging. Perceived age has been reported as an important indicator of biological age and general health status, not only in older adult populations but also in young and middle-aged adults. However, there is a lack of objective methods for quantifying perceived age in these younger age groups. Thus, this study aimed to propose a novel perceived age estimation algorithm to meet the need for an objective method to predict perceived age. This cross-sectional study included 609 healthy men and 1388 healthy women (29.02–57.91 years, average 44.4 years) from 2017 to 2019 using data from the Korean Medicine Daejeon Citizen Cohort Study. The proposed algorithm comprised two steps. First, the initial predicted perceived age was estimated from facial images using a convolutional neural network (CNN) ensemble model. Then, the final perceived age was estimated using regression from the chronological age, sex, BMI, and initial predicted perceived age obtained in the first step. Better performance results were obtained by model averaging and model stacking generated from various basic regression models. The averaging models of Lasso, XGBoost, and CatBoost showed a mean absolute error of 2.2944, indicating that this algorithm can be used as a screening method for general health status in the population.

Longitudinal association between social participation and trajectories of life satisfaction in late middle-aged Korean adults with physical disabilities

Late middle-aged adults (50–64 years of age) who have physical disabilities often experience a decline in life satisfaction due to those bodily limitations. It is crucial to understand how their life satisfaction can be enhanced to support the social participation, health and wellbeing of this age group. This study examined the association between social participation and life satisfaction over time in Korean adults 50–64 years of age with physical disabilities. Data on 545 adults with physical disabilities aged 50–64 years from the 2016–2021 Korea Panel Survey of Employment for the Disabled (PSED) were extracted. The dependent variable was self-reported life satisfaction while social participation was the time-varying independent variable which was measured with a single question. The latent growth model (LGM) was used to examine the association between social participation and life satisfaction at each time point. The sample was composed of 313 (57.43 per cent) males and 232 (42.57 per cent) females from Korea having an average age of 57.42 years. A piecewise LGM demonstrated good model fit. Social participation was positively associated with life satisfaction at each time point for over the course of six years, with standardised coefficients ranging from 0.154 to 0.275 (p<0.001). Social participation contributed significantly to life satisfaction in Korean adults 50–64 years of age with physical disabilities. The findings indicate the need for social participation that could improve the life satisfaction of those with physical disabilities.

A Multivariable Prediction Model for Mild Cognitive Impairment and Dementia: Algorithm Development and Validation.

Mild cognitive impairment (MCI) poses significant challenges in early diagnosis and timely intervention. Underdiagnosis, coupled with the economic and social burden of dementia, necessitates more precise detection methods. Machine learning (ML) algorithms show promise in managing complex data for MCI and dementia prediction. This study assessed the predictive accuracy of ML models in identifying the onset of MCI and dementia using the Korean Longitudinal Study of Aging (KLoSA) dataset. This study used data from the KLoSA, a comprehensive biennial survey that tracks the demographic, health, and socioeconomic aspects of middle-aged and older Korean adults from 2018 to 2020. Among the 6171 initial households, 4975 eligible older adult participants aged 60 years or older were selected after excluding individuals based on age and missing data. The identification of MCI and dementia relied on self-reported diagnoses, with sociodemographic and health-related variables serving as key covariates. The dataset was categorized into training and test sets to predict MCI and dementia by using multiple models, including logistic regression, light gradient-boosting machine, XGBoost (extreme gradient boosting), CatBoost, random forest, gradient boosting, AdaBoost, support vector classifier, and k-nearest neighbors, and the training and test sets were used to evaluate predictive performance. The performance was assessed using the area under the receiver operating characteristic curve (AUC). Class imbalances were addressed via weights. Shapley additive explanation values were used to determine the contribution of each feature to the prediction rate. Among the 4975 participants, the best model for predicting MCI onset was random forest, with a median AUC of 0.6729 (IQR 0.3883-0.8152), followed by k-nearest neighbors with a median AUC of 0.5576 (IQR 0.4555-0.6761) and support vector classifier with a median AUC of 0.5067 (IQR 0.3755-0.6389). For dementia onset prediction, the best model was XGBoost, achieving a median AUC of 0.8185 (IQR 0.8085-0.8285), closely followed by light gradient-boosting machine with a median AUC of 0.8069 (IQR 0.7969-0.8169) and AdaBoost with a median AUC of 0.8007 (IQR 0.7907-0.8107). The Shapley values highlighted pain in everyday life, being widowed, living alone, exercising, and living with a partner as the strongest predictors of MCI. For dementia, the most predictive features were other contributing factors, education at the high school level, education at the middle school level, exercising, and monthly social engagement. ML algorithms, especially XGBoost, exhibited the potential for predicting MCI onset using KLoSA data. However, no model has demonstrated robust accuracy in predicting MCI and dementia. Sociodemographic and health-related factors are crucial for initiating cognitive conditions, emphasizing the need for multifaceted predictive models for early identification and intervention. These findings underscore the potential and limitations of ML in predicting cognitive impairment in community-dwelling older adults.

Mediating effects of eHealth literacy and social connection on the association between smartphone use and mental health among Korean adults

ABSTRACT This study investigated the complex associations among smartphone use, eHealth literacy, social connection and mental health and how eHealth literacy and social connection mediate these associations between older and middle-aged Korean adults in 2020. We recruited 1,400 Korean adults and conducted a multigroup path analysis. Findings revealed significant pathways among major variables and the mediating effects of eHealth literacy and social connection on the association between smartphone use and mental health only for older adults. Future research should investigate the longitudinal effects of various digital devices and eHealth literacy on mental health in Koreans after COVID-19.

Predictors of preparedness for well-dying among middle-aged and older adults.

This study investigated psychosocial factors related to preparedness for well-dying among middle-aged and older adults and verified a model that can predict it along with psychosocial factors and demographic profiles to provide useful information for intervention. The participants were 340 middle-aged and older Korean adults aged 40-79 years. The predictive models were verified using stepwise regression and decision tree analyses. The results revealed that personality, meaning of life, hardiness, intrinsic religiosity, death anxiety, family support, subjective well-being, and expectations for future life were significantly correlated with preparedness for well-dying among middle-aged and older adults. A stepwise regression analysis revealed that meaning of life accounted for the greatest variance in preparedness for well-dying. A decision tree model predicting preparedness for well-dying included search for meaning, the presence of a spouse, family support, having a job, tenacity, conscientiousness, and positive emotions. These findings suggest that search for meaning and tenacity in middle-aged and older adults as well as the presence of a spouse or occupation and family support may play important roles in preparing for well-dying.

Sex-specific association between carbohydrate antigen 19–9 and incident type 2 diabetes

Carbohydrate antigen 19–9 (CA19-9) levels are associated with glycemic control, insulin resistance, and chronic complications in patients with type 2 diabetes (T2D). Women generally show higher CA19-9 levels despite a greater T2D prevalence in men. We evaluated the sex-specific longitudinal associations between CA19-9 levels and T2D incidence. Korean adults (n = 329,380) without previous cancer or T2D were categorized into four groups based on their CA19-9 levels. The study end point was the development of incident T2D during follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) according to CA19-9 levels. During a median follow-up of 6.1 years (3.3–9.3 years), the incidence rates of T2D were 9.9 per 1,000 person-years in men and 3.6 per 1,000 person-years in women. In the time-dependent analysis, adjusted HRs (95% confidence intervals) for incident T2D comparing CA19-9 levels of 10.0–19.9, 20.0–29.9, and ≥ 30 U/mL to the reference (< 10 U/mL) were 1.08 (1.04–1.13), 1.18 (1.07–1.30), and 1.64 (1.35–1.99), respectively, among men. However, this association was not observed in women. The association between CA19-9 category and incident T2D significantly differed by sex (Pinteraction = 0.006). Among young and middle-aged Korean adults, elevated CA19-9 levels were significantly associated with increased risk of type 2 diabetes in men but not in women. Elevated CA19-9 levels in men could be a useful marker for identifying individuals at high risk of developing T2D. Evaluation approaches for individuals with elevated CA19-9 levels should be sex-specific.

Influence of dietary cholesterol on metabolic syndrome risk in middle-aged Korean adults: using the Korean Genome and Epidemiology Study (KoGES)

BackgroundThe association between dietary cholesterol and metabolic diseases remains controversial. However, the majority of studies focus on egg intake, and there is a limitation in the availability of prospective cohort studies. Our study examined the association between dietary cholesterol and the incidence risk of metabolic syndrome (MetS) in middle aged adults using large prospective cohort study in Republic of Korea.MethodsThe Health Examinees cohort from the Korean Genome and Epidemiology Study was used from baseline to follow-up. Dietary cholesterol intake was assessed by the validated semi-quantitative food frequency questionnaire. Participants were classified as quintile groups according to adjusted dietary cholesterol for total energy intake. MetS was defined as more than 3 of the 5 components of MetS. Hazard ratio (HR) and 95% confidence intervals (CI) for MetS were evaluated by multivariable cox regression analyses.ResultsOf the total 40,578 participants, metabolic syndrome developed in 4,172 (10.28%) individuals during an average follow-up period of approximately 4.76 years. Dietary cholesterol did not exhibit a significant association with the risk of MetS after adjusting for potential confounding factors, but a trend was observed indicating an increased risk with higher intake (p for trend = 0.044). Among the components of MetS, the incidence risk of high waist circumference (HR: 1.164, 95% CI: 1.049–1.290), high blood pressure (HR: 1.188, 95% CI: 1.075–1.313), high serum triglyceride (HR: 1.132, 95% CI: 1.044–1.227) and high fasting blood glucose (HR: 1.217, 95% CI: 1.132–1.308) in the group that consumed the highest dietary cholesterol intake was increased compared with the group that consumed the lowest dietary cholesterol intake. Dose-response relationship suggested a positive linear association between dietary cholesterol intake and the risk of high waist circumference (p-linearity = 0.004), blood pressure (p-linearity = 0.012), and triglycerides (p-linearity = 0.005).ConclusionThis study suggests a positive association between dietary cholesterol intake and the risk of MetS and its components (abdominal obesity, hypertension, hypertriglyceridemia, and hyperglycemia) in middle-aged Korean adults.

Association of pain with falls and fractures among middle-aged Korean community-dwelling adults.

The relationship between pain and falls remains controversial. Therefore, this study explored the associations between pain and fall-related outcomes in 5,340 middle-aged (45-65 years) adults residing in the communities in Korea. Pain was defined as pain at any location, pain-related activity restriction (PAR), and persistent pain. The outcome measures included fall injuries, recurrent falls, injurious falls, and fall-related hip fractures. A multivariate logistic regression model was used to examine the relationship between pain and fall outcome. Among the study participants, 54.0% reported having experienced pain. During a follow-up period of up to 14 years, those who reported pain and PAR at baseline exhibited a positive association with the occurrence of fall injury (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.27-2.53) and injurious falls (OR 1.72, 95% CI 1.20-2.48) but not with recurrent falls (OR 1.90, 95% CI 0.80-4.54). We also observed a positive association between persistent pain and the risk of fall injury (OR 1.41, 95% CI 1.13-1.91), whereas no consistent conclusions were drawn regarding the risk of recurrent falls and injurious falls. We also did not identify any correlation between pain and hip fractures resulting from falls. In conclusion, our findings of the positive correlations of pain and PAR at baseline with fall injuries and injurious falls but not recurrent falls during follow-up suggest that public health initiatives should prioritize pain screening, especially for participants reporting ankle and toe pain, and implement suitable interventions to mitigate the risk of falls and the associated adverse outcomes among middle-aged adults.

Effects of a nutrition education program on metabolic syndrome risk factors in middleaged Korean adults: an intervention study

Objectives: This study was conducted to evaluate the effects of a nutrition education program on metabolic syndrome in middle-aged Korean adults. Methods: A total of 411 Korean adults 30–59 years of age were allocated randomly into three groups: the nutrition education group for promoting Han-sik consumption (HG), the nutrition education group for eating balanced diet (EG), and the control group (CG). The HG and EG received four face-to-face nutrition education sessions over 16 weeks to improve nutritional problems based on the individual’ usual diet. Effectiveness of the program was evaluated with the differences of self-reported dietary behaviors, dietary intakes, anthropometric measurements and biochemical indices between the baseline and the end of the nutrition education program. The changes within groups were analyzed using paired t-test and McNemar test and effectiveness among three groups was analyzed by repeated analysis of variance. Results: After the nutrition education, the percentages of participants who achieved the recommended food group consumption in the Korean Food Guidance Systems significantly increased in HG (P = 0.022). Body weight (P = 0.007), body mass index (P = 0.002), and triglycerides (P = 0.002) significantly decreased in HG. Waist circumference and diastolic blood pressure decreased in all three groups (P &lt; 0.05). Conclusions: This study found that tailored nutrition education program for middle aged Korean adults showed beneficial effects on improving dietary behaviors and metabolic syndrome risk factors. Further studies are needed to assess the long-term effects of the nutrition education programs on metabolic syndrome risks.

Preferences for Features of Current and Future Residential Environments Among Korean Middle-Aged Adults.

This study examined differences in middle-aged adults' preferred features of their current versus future residential environments and how these differences varied by health and social characteristics. A sample of 1,651 Korean middle-aged adults (aged 49-64) rated their preferences for each of 12 features (e.g., proximity to family/relatives, house price) regarding current and future residential environments, separately. Respondents considered "accessibility to health services" and "opportunity for leisure activities" more important for future residential environments than for current ones. Respondents with poorer health considered features that help them compensate for health decline more important, while those who contacted friends/neighbors more frequently and participated in more cultural activities considered features that help them maintain their social interactions more important for future residential environments than the past. Our findings identified middle-aged adults' various demands for residential features after retirement, which reflect their strategic reactions to future needs for successful adaptation in later years.

Estimated pulse wave velocity as a forefront indicator of developing metabolic syndrome in Korean adults.

The predictive value of the estimated pulse wave velocity (ePWV) for the development of metabolic syndrome has not yet been extensively explored. This study aimed to fill this gap by evaluating ePWV as a potential predictor of metabolic syndrome development in middle-aged Korean adults. Using prospective data obtained from the Ansan-Ansung cohort database, participants without metabolic syndrome at baseline were studied. ePWV was calculated using specific equations based on age and blood pressure. The primary outcome was the incidence of metabolic syndrome during a median follow-up period of 187 months. Among the 6,186 participants, 2,726 (44.1%) developed metabolic syndrome during the follow-up period. ePWV methvalues were categorized into tertiles to assess their predictive value for the development of metabolic syndrome. An ePWV cut-off of 7.407 m/s was identified as a predictor of metabolic syndrome development, with a sensitivity of 0.743 and a specificity of 0.464. Participants exceeding this cut-off, especially those in the third tertile (8.77-14.63 m/s), had a notably higher risk of developing metabolic syndrome. Specifically, the third tertile exhibited a 52.8% cumulative incidence compared with 30.8% in the first tertile. After adjustments, those in the third tertile faced a 1.530-fold increased risk of metabolic syndrome (95% confidence interval, 1.330-1.761). ePWV is a significant predictor of the development of metabolic syndrome. This finding underscores the potential of ePWV as a cardiometabolic risk assessment tool and can thus provide useful information for primary prevention strategies.

Difference in association of carbohydrate intake with all-cause mortality between middle-aged and older Korean adults with and without diabetes mellitus: A prospective study

The relationship between diet and health, particularly the role of carbohydrates, has been extensively studied. However, carbohydrate intake based on individual health conditions remains unclear. Here, we aimed to investigate whether the association between carbohydrate intake and all-cause mortality varied between individuals with and without diabetes mellitus (DM). This prospective cohort study used data from the Korean Genome and Epidemiology Study (KoGES). Overall, 143,050 participants were included, with 10.1% having DM. Dietary intake was assessed using a semiquantitative food frequency questionnaire. Cox proportional hazards regression models were used to assess the association between carbohydrate intake and mortality after adjusting for confounders. The study showed that 5436 deaths occurred during the median follow-up period of 10.1 years. A significant interaction between carbohydrate intake and DM was observed in the study population (interaction p=0.061). Higher carbohydrate intake proportion was associated with an increased risk of all-cause mortality among individuals with DM (adjusted hazard ratio [HR], p-value=1.10 [1.01-1.20], p=0.032). Conversely, no association was observed between the proportion of carbohydrate intake and all-cause mortality in participants without DM. Additionally, both total sugar and added sugar intakes were associated with an increased risk of all-cause mortality in participants with DM (adjusted HR, p-value=1.02 [1.01-1.04], p<0.001 and 1.18 [1.13-1.24], p<0.001). High carbohydrate (%) and added sugar intake were associated with an increased mortality risk in individuals with DM. Reducing carbohydrate intake and opting for healthy carbohydrates to mitigate mortality risk may be beneficial for individuals with DM, particularly when compared with the general population.

Metabolic Obesity Phenotypes and Incident Cardiovascular Outcomes in Middle-Aged and Older Korean Adults: A Longitudinal 10-Year Analysis of the Korean Genome and Epidemiology Study.

Background: This study investigated the association of four metabolic obesity phenotypes with incident coronary artery disease and stroke in a large-scale, community population-based, prospective Korean cohort observed for over 10 years. Methods: The study participants included 7374 adults aged 40-69 years, drawn from the Korean Genome and Epidemiology Study. Participants with different metabolic obesity phenotypes were categorized according to body weight and metabolic health status into four groups: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUHNO), and metabolically unhealthy obese (MUHO). Combined cardiovascular events were defined as coronary artery disease and stroke. We used multivariate Cox proportional hazards regression models to prospectively assess hazard ratios (HRs) with 95% confidence intervals (CIs) for incident coronary artery disease or stroke over 10 years after the baseline survey. Results: During the follow-up period, newly developed coronary artery disease, stroke, and combined cardiovascular events were diagnosed in 151 (2.0%), 137 (1.9%), and 283 (3.8%) participants, respectively. After adjusting for confounding variables, the HRs (95% CIs) for incident combined cardiovascular events were 1.81 (1.34-2.46) in the MUHO group, 1.29 (0.92-1.81) in the MUHNO group, and 1.21 (0.81-1.79) in the MHO group compared with those in the MHNO group. Conclusions: This study revealed distinct risks associated with four metabolic obesity phenotypes concerning incident coronary artery disease and stroke. After adjusting for potential confounding variables, the results indicated that MUHO, but not MUHNO or MHO, showed a higher risk of developing coronary artery disease and stroke than MHNO.

The Fatty Liver Index's Association with Incident Chronic Kidney Disease in Korean Middle-Aged Adults: A Community-Based Cohort Study.

(1) Background: The relationship between nonalcoholic fatty liver disease (NAFLD) and incident chronic kidney disease (CKD) is unclear, and long-term follow-up data are limited. Therefore, this study aimed to evaluate whether NAFLD, as assessed by the fatty liver index (FLI), could predict the development of CKD in a community-based Korean cohort over 16 years. (2) Methods: Among the 10,030 total participants, 7778 patients without CKD were selected from the Korean Genome and Epidemiology Study (KoGES). The FLI grade ranged from 0 to 100 and was divided into three groups: low (FLI, <30), intermediate (FLI, 30-59), and high (FLI, ≥60). An estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 or the development of proteinuria was considered to indicate incident CKD. (3) Results: During the 16-year follow-up period, 919 individuals (11.8%) developed CKD. The HRs of incident CKD in the intermediate FLI group (30-59) and high FLI group (≥60) increased compared with the reference low FLI group (<30) after adjusting for potentially confounding variables. NAFLD, as assessed by the FLI, was an independent risk factor for CKD. (4) Conclusions: Our findings suggest that the FLI, a simple surrogate biomarker of fatty liver disease, may be used to identify people at high risk of incident CKD in clinical practice.

Smartphone usage and overdependence risk among middle-aged and older adults: a cross-sectional study

BackgroundPrevious studies have predominantly focused on smartphone overdependence among adolescents and young adults. However, as smartphone usage has recently surged among South Korean middle-aged and older adults, the risk of smartphone overdependence cannot be overlooked among this population. Therefore, this study was conducted to examine the smartphone usage pattern and the associated risk of overdependence in this specific age group.MethodsThe data for individuals who aged 50 or older were extracted from the dataset of a nationwide survey, “The Survey on Smartphone Overdependence, 2021,” and the usage of each type of smartphone content and risk of smartphone overdependence among individuals in their 50 s and 60 s were investigated. Age-group-based differences in demographic characteristics, Smartphone Overdependence Scale scores, self-awareness of smartphone overdependence, digital literacy, and psychosocial factors were analyzed. Additionally, a multivariable logistic regression analysis was conducted to explore the factors associated with the potential-to-high risk of smartphone overdependence in both age groups.ResultsIndividuals in their 50s had significantly higher digital literacy, social relations, life satisfaction, and smartphone overdependence scores than those in their 60s, and the percentage of individuals in the high-risk group was also higher in the 50s age group. For both age groups, the most used content was “messenger,” “news,” and “movies/TV/videos,” whereas the least used content was e-learning, gambling, and adult content. The multivariable analysis indicated that, for individuals in their 50s, having a lower educational level was associated with significantly higher odds, whereas having a job and utilizing e-commerce-related contents on smartphone were associated with significantly lower odds of potential-to-high risk for smartphone overdependence. Concerning individuals in their 60s, having a lower educational level and using adult content or gambling were significantly associated with higher odds of potential-to-high risk for smartphone overdependence.ConclusionThis study reveals the risk of smartphone overdependence among middle-aged and older adults in South Korea as well as the associated risk factors. This will assist policymakers in developing policies for the appropriate use of smartphones by these age groups.

Harnessing Metabolic Indices as a Predictive Tool for Cardiovascular Disease in a Korean Population without Known Major Cardiovascular Event.

This study evaluated the usefulness of indices for metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR), as predictive tools for cardiovascular disease in middle-aged Korean adults. The prospective data obtained from the Ansan-Ansung cohort database, excluding patients with major adverse cardiac and cerebrovascular events (MACCE). The primary outcome was the incidence of MACCE during the follow-up period. A total of 9,337 patients were included in the analysis, of whom 1,130 (12.1%) experienced MACCE during a median follow-up period of 15.5 years. The metabolic syndrome severity Z-score, metabolic syndrome severity score, hepatic steatosis index, and NAFLD liver fat score were found to significantly predict MACCE at values above the cut-off point and in the second and third tertiles. Among these indices, the hazard ratios of the metabolic syndrome severity score and metabolic syndrome severity Z-score were the highest after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) of the 10-year atherosclerotic cardiovascular disease (ASCVD) score for predicting MACCE was 0.716, and the metabolic syndrome severity Z-score had an AUC of 0.619. The metabolic syndrome severity score is a highly reliable indicator and was closely associated with the 10-year ASCVD risk score in predicting MACCE in the general population. Given the specific characteristics and limitations of metabolic syndrome severity scores as well as the indices of NAFLD and IR, a more practical scoring system that considers these factors is essential to achieve greater accuracy in forecasting cardiovascular outcomes.

Machine-learning model predicting quality of life using multifaceted lifestyles in middle-aged South Korean adults: a cross-sectional study

BackgroundIn the context of population aging, advances in healthcare technology, and growing interest in healthy aging and higher quality of life (QOL), have gained central focus in public health, particularly among middle-aged adults.MethodsThis study presented an optimal prediction model for QOL among middle-aged South Korean adults (N = 4,048; aged 30–55 years) using a machine-learning technique. Community-based South Korean population data were sampled through multistage stratified cluster sampling. Twenty-one variables related to individual factors and various lifestyle patterns were surveyed. QOL was assessed using the Short Form Health Survey (SF-12) and categorized into total QOL, physical component score (PCS), and mental component score (MCS). Seven machine-learning algorithms were used to predict QOL: decision tree, Gaussian Naïve Bayes, k-nearest neighbor, logistic regression, extreme gradient boosting, random forest, and support vector machine. Data imbalance was resolved with the synthetic minority oversampling technique (SMOTE). Random forest was used to compare feature importance and visualize the importance of each variable.ResultsFor predicting QOL deterioration, the random forest method showed the highest performance. The random forest algorithm using SMOTE showed the highest area under the receiver operating characteristic (AUC) for total QOL (0.822), PCS (0.770), and MCS (0.786). Applying the data, SMOTE enhanced model performance by up to 0.111 AUC. Although feature importance differed across the three QOL indices, stress and sleep quality were identified as the most potent predictors of QOL. Random forest generated the most accurate prediction of QOL among middle-aged adults; the model showed that stress and sleep quality management were essential for improving QOL.ConclusionThe results highlighted the need to develop a health management program for middle-aged adults that enables multidisciplinary management of QOL.

Association between food consumption and serum aryl hydrocarbon receptor ligand activity among middle-aged Korean adults.

The diet is an important route of exposure to endocrine-disrupting chemicals (EDCs). However, few studies have investigated the association between dietary intake and EDC exposure levels among Koreans. In an earlier study, we showed that the bioactivity of serum aryl hydrocarbon receptor ligands (AhRLs) could be a surrogate biomarker to indicate exposure to EDCs and that they inhibit mitochondrial function. We also found that the mitochondria-inhibiting substances (MIS) in serum ascertained by intracellular adenosine triphosphate (MIS-ATP) and reactive oxygen species (MIS-ROS) levels could be biomarkers of exposure to EDCs, as they showed a strong correlation with AhRL and the levels of EDCs in the blood. Here, we investigated the association between the consumption of specific foods and surrogate serum biomarkers for EDCs, namely AhRL, MIS-ATP, and MIS-ROS, among middle-aged Korean adults. A total of 1,466 participants aged 45-76 yrs from the Ansung cohort of the Korean Genome and Epidemiology Study were included. Food consumption, including that of meat, fish, vegetables, and fruits, was measured using a semiquantitative food frequency questionnaire. Fish intake was positively associated with AhRL (β = 0.0035, P = 0.0166), whereas cruciferous vegetable intake was negatively associated with AhRL (β = -0.0007, P = 0.0488). Cruciferous vegetable intake was positively associated with the MIS-ATP levels (β = 0.0051, P = 0.0420). A higher intake of fish was significantly associated with an increased risk of high AhRL (tertile: odds ratio [OR], 1.49; 95% confidence intervals (CIs), 1.08-2.06; P for trend = 0.0305). In addition, the second-highest tertile of cruciferous vegetable intake had lower odds of high AhRL than the lowest tertile (OR, 0.73; 95% CIs, 0.54-0.97), although no significant linear trend was observed. Consumption of different types of foods may be differentially associated with EDC exposure in middle-aged Korean adults.

A combination of red and processed meat intake and polygenic risk score influences the incidence of hyperuricemia in middle-aged Korean adults.

The high consumption of purine-rich meat is associated with hyperuricemia. However, there is limited evidence linking the consumption of red and processed meat to the genetic risk of hyperuricemia. We investigated the relationship between various combinations of red and processed meat consumption and the polygenic risk scores (PRSs) and the incidence of hyperuricemia in middle-aged Koreans. We analyzed the data from 44,053 participants aged ≥40 years sourced from the Health Examinees (HEXA) cohort of the Korean Genome and Epidemiology Study (KoGES). Information regarding red and processed meat intake was obtained using a semiquantitative food frequency questionnaire (SQ-FFQ). We identified 69 independent single-nucleotide polymorphisms (SNPs) at uric acid-related loci using genome-wide association studies (GWASs) and clumping analyses. The individual PRS, which is the weighted sum of the effect size of each allele at the SNP, was calculated. We used multivariable Cox proportional hazards models adjusted for covariates to determine the relationship between red and processed meat intake and the PRS in the incidence of hyperuricemia. During an average follow-up period of 5 years, 2,556 patients with hyperuricemia were identified. For both men and women, the group with the highest red and processed meat intake and the highest PRS was positively associated with the development of hyperuricemia when compared with the group with the lowest red and processed meat intake and the lowest PRS (hazard ratio [HR], 2.72; 95% confidence interval [CI], 2.10-3.53; P < 0.0001; HR, 3.28; 95% CI, 2.45-4.40; P < 0.0001). Individuals at a high genetic risk for uric acid levels should moderate their consumption of red and processed meat to prevent hyperuricemia.