Objectives Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene , which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults.
Methods A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling.
Results The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model (pint<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model (pint<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05).
Conclusions These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.
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Objectives Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population.
Methods From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores.
Results A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42).
Conclusions Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.
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Objectives C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
Methods A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
Results The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
Conclusions Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.
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Objectives Diagnostic medical radiation workers in Korea have been officially monitored for their occupational radiation doses since 1996. The purpose of this study was to design models for reconstructing unknown individual radiation doses to which diagnostic radiation technologists were exposed before 1996.
Methods Radiation dose reconstruction models were developed by using cross-sectional survey data and the personal badge doses of 8167 radiologic technologists. The models included calendar year and age as predictors, and the participants were grouped into six categories according to their sex and facility type. The annual doses between 1971 and 1995 for those who were employed before 1996 were estimated using these models.
Results The calendar year and age were inversely related to the estimated radiation doses in the models of all six groups. The annual median estimated doses decreased from 9.45 mSv in 1971 to 1.26 mSv in 1995, and the associated dose variation also decreased with time. The estimated median badge doses from 1996 (1.22 mSv) to 2011 (0.30 mSv) were similar to the measured doses (1.68 mSv to 0.21 mSv) for the same years. Similar results were observed for all six groups.
Conclusions The reconstruction models developed in this study may be useful for estimating historical occupational radiation doses received by medical radiologic technologists in Korea.
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Objectives This study investigated the association between perceived ethnic discrimination and depressive symptoms among biethnic adolescents in South Korea.
Methods We performed a cross-sectional study of 4141 biethnic adolescents using data from the 2012 National Survey of Multicultural Families. Perceived ethnic discrimination was measured using the question “Have you ever been discriminated against or ignored because either of your parents is not a Korean?” with an assessment of depressive symptoms over the past 12 months. Logistic regression was applied to examine potential associations between perceived ethnic discrimination and depressive symptoms.
Results Among 4141 biethnic adolescents, 558 (13.5%) reported having experienced ethnic discrimination. The most common discriminatory perpetrators were friends (n=241, 5.8%), followed by strangers (n=67, 1.6%). Depressive symptoms were related to experience of ethnic discrimination (odds ratio [OR], 3.80; 95% confidence interval [CI], 2.89 to 4.98) after adjusting for potential confounders. In an analysis focusing on the perpetrators of discrimination, depressive symptoms were found to be associated with perceived ethnic discrimination from friends (OR, 3.95; 95% CI, 2.75 to 5.68), teachers (OR, 4.53; 95% CI, 2.16 to 9.51), family members and relatives (OR, 3.89; 95% CI, 1.59 to 9.48), neighbors (OR, 2.48; 95% CI, 1.14 to 5.38), and strangers (OR, 2.49; 95% CI, 1.30 to 4.79). Furthermore, the OR for depressive symptoms among those exposed to 1, 2, or 3 or more discriminatory perpetrators were 3.61 (95% CI, 2.49 to 5.24), 3.61 (95% CI, 1.68 to 7.74), and 6.69 (95% CI, 2.94 to 15.22), respectively.
Conclusions According to our findings, friends were the most common perpetrators of discrimination and the experience of ethnic discrimination was associated with depressive symptoms among biethnic adolescents in South Korea.
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Objectives The objective of this study is to investigate associations between contextual characteristics and unmet healthcare needs in South Korea after accounting for individual factors.
Methods The present study used data from the 2012 Korean Community Health Survey (KCHS) of 228 902 adults residing within 253 municipal districts in South Korea. A multilevel analysis was conducted to investigate how contextual characteristics, defined by variables that describe the regional deprivation, degree of urbanity, and healthcare supply, are associated with unmet needs after controlling for individual-level variables.
Results Of the surveyed Korean adults, 12.1% reported experiencing unmet healthcare needs in the past. This figure varied with the 253 districts surveyed, ranging from 2.6% to 26.2%. A multilevel analysis found that the association between contextual characteristics and unmet needs varied according to the factors that caused the unmet needs. The degree of urbanity was associated with unmet need due to “financial burden” (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.42 to 0.66 for rural vs. metropolitan), but not unmet need due to “service not available when needed.” There were no significant associations between these unmet need measures and regional deprivation. Among individual-level variables, income level showed the highest association with unmet need due to “financial burden” (OR, 5.63; 95% CI, 4.76 to 6.66), while employment status showed a strong association with unmet need due to “service not available when needed.”
Conclusions Our finding suggests that different policy interventions should be considered for each at-risk population group to address the root cause of unmet healthcare needs.
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Methods Data collection was done using an interview method among the mothers of 502 under-5 children, following a pre-designed, semi-structured schedule during house-to-house visits in a set of villages in the Hooghly district of West Bengal.
Results The prevalence of unsafe disposal of child faeces was 72.4%, and maternal education, per capita income, and water source were found to be significantly associated with unsafe child faeces disposal.
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Objectives The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients’ prior history of allergic diseases.
Methods Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [NO2], ozone [O3], sulfur dioxide [SO2], and particulate matter with an aerodynamic diameter <10 μm [PM10]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season.
Results A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in O3 concentration. IQR changes in NO2 and PM10 concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in PM10 concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history.
Conclusions Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.
Summary
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