- Metabolic Risk/Epidemiology
- Differential Impact of Obesity on the Risk of Diabetes Development in Two Age Groups: Analysis from the National Health Screening Program
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Tae Kyung Yoo, Kyung-Do Han, Yang-Hyun Kim, Ga Eun Nam, Sang Hyun Park, Eun-Jung Rhee, Won-Young Lee
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Diabetes Metab J. 2023;47(6):846-858. Published online August 23, 2023
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DOI: https://doi.org/10.4093/dmj.2022.0242
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Abstract
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- Background
The effect of obesity on the development of type 2 diabetes mellitus (DM) in different age groups remains unclear. We assessed the impact of obesity on the development of DM for two age groups (40-year-old, middle age; 66-year-old, older adults) in the Korean population.
Methods We analyzed Korean National Health Insurance Service data of 4,145,321 Korean adults with 40- and 66-year-old age without DM, between 2009 and 2014. Participants were followed up until 2017 or until the diagnosis of DM. We assessed the risk of DM based on the body mass index and waist circumference of the participants. Multiple confounding factors were adjusted.
Results The median follow-up duration was 5.6 years. The association of general and abdominal obesity with the risk of DM development was stronger in the 40-year-old group (general obesity: hazard ratio [HR], 3.566, 95% confidence interval [CI], 3.512 to 3.622; abdominal obesity: HR, 3.231; 95% CI, 3.184 to 3.278) than in the 66-year-old group (general obesity: HR, 1.739; 95% CI, 1.719 to 1.759; abdominal obesity: HR, 1.799; 95% CI, 1.778 to 1.820). In the 66-year-old group, abdominal obesity had a stronger association with the development of DM as compared to general obesity. In the 40-year-old group, general obesity had a stronger association with the risk of DM development than abdominal obesity.
Conclusion The influence of general and abdominal obesity on the development of DM differed according to age. In older adults, abdominal obesity had a stronger association with DM development than general obesity.
- Metabolic Risk/Epidemiology
- Dose-Dependent Effect of Smoking on Risk of Diabetes Remains after Smoking Cessation: A Nationwide Population-Based Cohort Study in Korea
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Se Eun Park, Mi Hae Seo, Jung-Hwan Cho, Hyemi Kwon, Yang-Hyun Kim, Kyung-Do Han, Jin-Hyung Jung, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
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Diabetes Metab J. 2021;45(4):539-546. Published online March 4, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0061
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Abstract
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- Background
This study aimed to evaluate the dose-dependent effects of smoking on risk of diabetes among those quitting smoking.
Methods We analyzed clinical data from a total of 5,198,792 individuals age 20 years or older who received health care check-up arranged by the national insurance program of Korea between 2009 and 2016 using the Korean National Health Insurance Service database. Cumulative smoking was estimated by pack-years. Smokers were classified into four categories according to the amount of smoking: light smokers (0.025 to 5 smoking pack-years), medium smokers (5 to 14 smoking pack-years), heavy smokers (14 to 26 smoking pack-years), and extreme smokers (more than 26 smoking pack-years).
Results During the study period, 164,335 individuals (3.2% of the total population) developed diabetes. Compared to sustained smokers, the risk of diabetes was significantly reduced in both quitters (hazard ratio [HR], 0.858; 95% confidence interval [CI], 0.838 to 0.878) and nonsmokers (HR, 0.616; 95% CI, 0.606 to 0.625) after adjustment for multiple risk factors. The risk of diabetes gradually increased with amount of smoking in both quitters and current smokers. The risk of diabetes in heavy (HR, 1.119; 95% CI, 1.057 to 1.185) and extreme smokers (HR, 1.348; 95% CI, 1.275 to 1.425) among quitters was much higher compared to light smokers among current smokers.
Conclusion Smoking cessation was effective in reducing the risk of diabetes regardless of weight change. However, there was a potential dose-dependent association between smoking amount and the development of diabetes. Diabetes risk still remained in heavy and extreme smokers even after smoking cessation.
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Xiaomin Sun, Dong Keon Yon, Tuan Thanh Nguyen, Kumpei Tanisawa, Kumhee Son, Ling Zhang, Jing Shu, Wen Peng, Yuexin Yang, Francesco Branca, Mark L. Wahlqvist, Hyunjung Lim, Youfa Wang The Lancet Regional Health - Western Pacific.2024; 43: 100842. CrossRef - The Concentrations of Interleukin-6, Insulin, and Glucagon in the Context of Obesity and Type 2 Diabetes and Single Nucleotide Polymorphisms in IL6 and INS Genes
Magdalena Król-Kulikowska, Iwona Urbanowicz, Marta Kepinska, Mayank Choubey Journal of Obesity.2024; 2024: 1. CrossRef - Prevalence, cessation, and geographical variation of smoking
among middle-aged and elderly adults in China:
A population-based study
Qingjia Zeng, Chongyang Zhang, Feiyu Su, Yanli Wan, Wen-jun Tu, Hongpu Hu Tobacco Induced Diseases.2024; 22(July): 1. CrossRef - Chronic cigarette smoking is associated with increased arterial stiffness in men and women: evidence from a large population-based cohort
Omar Hahad, Volker H. Schmitt, Natalie Arnold, Karsten Keller, Jürgen H. Prochaska, Philipp S. Wild, Andreas Schulz, Karl J. Lackner, Norbert Pfeiffer, Irene Schmidtmann, Matthias Michal, Jörn M. Schattenberg, Oliver Tüscher, Andreas Daiber, Thomas Münzel Clinical Research in Cardiology.2023; 112(2): 270. CrossRef - Association between Meal Frequency and Type 2 Diabetes Mellitus in Rural Adults: A Large-Scale Cross-Sectional Study
Bota Baheti, Xiaotian Liu, Mu Wang, Caiyun Zhang, Xiaokang Dong, Ning Kang, Linlin Li, Xing Li, Songcheng Yu, Jian Hou, Zhenxing Mao, Chongjian Wang Nutrients.2023; 15(6): 1348. CrossRef - Impaired Lung Function and Lung Cancer Incidence: A Nationwide Population-Based Cohort Study
Hye Seon Kang, Yong-Moon Park, Seung-Hyun Ko, Seung Hoon Kim, Shin Young Kim, Chi Hong Kim, Kyungdo Han, Sung Kyoung Kim Journal of Clinical Medicine.2022; 11(4): 1077. CrossRef - Smoking cessation and risk of type 2 diabetes
Jana Malinovská, Jana Urbanová, Veronika Vejtasová, Alexandra Romanová, Sabina Pálová, Syed Taha Naeem, Jan Brož Vnitřní lékařství.2022; 68(1): E04. CrossRef - Association between lung function and the risk of atrial fibrillation in a nationwide population cohort study
Su Nam Lee, Seung-Hyun Ko, Sung-Ho Her, Kyungdo Han, Donggyu Moon, Sung Kyoung Kim, Ki-Dong Yoo, Yu-Bae Ahn Scientific Reports.2022;[Epub] CrossRef - Sex differences in factors associated with prediabetes in Korean adults
Jin Suk Ra Osong Public Health and Research Perspectives.2022; 13(2): 142. CrossRef - Smoking and diabetes interplay: A comprehensive review and joint statement
Vincent Durlach, Bruno Vergès, Abdallah Al-Salameh, Thibault Bahougne, Farid Benzerouk, Ivan Berlin, Carole Clair, Jacques Mansourati, Alexia Rouland, Daniel Thomas, Philippe Thuillier, Blandine Tramunt, Anne-Laurence Le Faou Diabetes & Metabolism.2022; 48(6): 101370. CrossRef - Impact of healthy lifestyle on the risk of type 2 diabetes mellitus in southwest China: A prospective cohort study
Yanli Wu, Xi He, Jie Zhou, Yiying Wang, Lisha Yu, Xuejiao Li, Tao Liu, Jianhua Luo Journal of Diabetes Investigation.2022; 13(12): 2091. CrossRef - Current status of health promotion in Korea
Soo Young Kim Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef - Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death
So-Ryoung Lee, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip Journal of Clinical Medicine.2021; 10(11): 2238. CrossRef
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- Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study
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Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Eun-Jung Rhee, Won-Young Lee
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Diabetes Metab J. 2021;45(3):379-389. Published online December 11, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0008
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- Background
Previous studies have suggested that depression in patients with diabetes is associated with worse health outcomes. The aim of this study was to evaluate the risk of cardiovascular disease (CVD) and mortality in patients with diabetes with comorbid depression.
Methods We examined the general health check-up data and claim database of the Korean National Health Insurance Service (NHIS) of 2,668,615 participants with type 2 diabetes mellitus who had examinations between 2009 and 2012. As NHIS database has been established since 2002, those who had been diagnosed with depression or CVD since 2002 were excluded. The 2,228,443 participants were classified into three groups according to the claim history of depression; normal group (n=2,166,979), transient depression group (one episode of depression, n=42,124) and persistent depression group (at least two episodes of depression, n=19,340). The development of CVD and mortality were analyzed from 2009 to 2017.
Results Those with depression showed a significantly increased risk for stroke (transient depression group: hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.15 to 1.26) (persistent depression group: HR, 1.54; 95% CI, 1.46 to 1.63). Those with depression had an increased risk for myocardial infarction (transient depression group: HR, 1.25; 95% CI, 1.18 to 1.31) (persistent depression group: HR, 1.38; 95% CI, 1.29 to 1.49). The persistent depression group had an increased risk for all-cause mortality (HR, 1.66; 95% CI, 1.60 to 1.72).
Conclusion Coexisting depression in patients with diabetes has a deleterious effect on the development of CVD and mortality. We suggest that more attention should be given to patients with diabetes who present with depressive symptoms.
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Ajele Kenni Wojujutari, Erhabor Sunday Idemudia, Lawrence Ejike Ugwu Scientific Reports.2024;[Epub] CrossRef - CVD incidence and mortality among people with diabetes and/or hypertension: Results from the English longitudinal study of ageing
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Gege Jiang, Yaoling Wang, Liping Wang, Minfang Chen, Wei Li Journal of Affective Disorders.2023; 321: 208. CrossRef - Frailty and outcomes in lacunar stroke
Sima Vazquez, Zehavya Stadlan, Justin M Lapow, Eric Feldstein, Smit Shah, Ankita Das, Alexandria F Naftchi, Eris Spirollari, Akash Thaker, Syed Faraz Kazim, Jose F Dominguez, Neisha Patel, Christeena Kurian, Ji Chong, Stephan A Mayer, Gurmeen Kaur, Chirag Journal of Stroke and Cerebrovascular Diseases.2023; 32(2): 106942. CrossRef - Comparison of Operational Definition of Type 2 Diabetes Mellitus Based on Data from Korean National Health Insurance Service and Korea National Health and Nutrition Examination Survey
Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko Diabetes & Metabolism Journal.2023; 47(2): 201. CrossRef - The Association between Dietary Carotenoid Intake and Risk of Depression among Patients with Cardiometabolic Disease
Jie Liang, Yuhao Wang, Min Chen International Heart Journal.2023; 64(2): 223. CrossRef - Associations of concomitant retinopathy and depression with mortality in a nationally representative population
Zheng Lyu, Yilin Chen, Zhuoting Zhu, Xiaoyang Luo, Ying Cui, Jie Xie, Zhifan Chen, Junbin Liu, Xiyu Wu, Gabrella Bulloch, Qianli Meng Journal of Affective Disorders.2023; 336: 15. CrossRef - Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses
Chiara Possidente, Giuseppe Fanelli, Alessandro Serretti, Chiara Fabbri Neuroscience & Biobehavioral Reviews.2023; 152: 105298. CrossRef - Prevalence of depression and association with all-cause and cardiovascular mortality among individuals with type 2 diabetes: a cohort study based on NHANES 2005–2018 data
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Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park European Journal of Endocrinology.2023; 189(3): 363. CrossRef - The association between cardiovascular drugs and depression/anxiety in patients with cardiovascular disease: A meta-analysis
Lijun Zhang, Yanping Bao, Shuhui Tao, Yimiao Zhao, Meiyan Liu Pharmacological Research.2022; 175: 106024. CrossRef - Association of mental health with the risk of coronary artery disease in patients with diabetes: A mendelian randomization study
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Christopher Rohde, Jens Steen Nielsen, Jakob Schöllhammer Knudsen, Reimar Wernich Thomsen, Søren Dinesen Østergaard European Journal of Endocrinology.2022; 187(4): 567. CrossRef - Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
Jin Hwa Kim Diabetes & Metabolism Journal.2021; 45(5): 789. CrossRef - Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
Inha Jung, Eun-Jung Rhee, Won-Young Lee Diabetes & Metabolism Journal.2021; 45(5): 793. CrossRef - Affective Temperament and Glycemic Control – The Psychological Aspect of Obesity and Diabetes Mellitus
Natalia Lesiewska, Anna Kamińska, Roman Junik, Magdalena Michalewicz, Bartłomiej Myszkowski, Alina Borkowska, Maciej Bieliński Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 4981. CrossRef
- Cardiovascular Risk/Epidemiology
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- Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults
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Eun-Jung Rhee, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
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Diabetes Metab J. 2020;44(4):592-601. Published online April 20, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0104
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Correction in: Diabetes Metab J 2020;44(5):783
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Abstract
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- Background
Recent studies suggest an association between diabetes and increased risk of heart failure (HF). However, the associations among obesity status, glycemic status, and risk of HF are not known. In this study, we analyzed whether the risk of HF increases in participants according to baseline glycemic status and whether this increased risk is associated with obesity status. MethodsWe analyzed the risk of HF according to baseline glycemic status (normoglycemia, impaired fasting glucose [IFG], and diabetes) in 9,720,220 Koreans who underwent Korean National Health Screening in 2009 without HF at baseline with a median follow-up period of 6.3 years. The participants were divided into five and six groups according to baseline body mass index (BMI) and waist circumference, respectively. ResultsParticipants with IFG and those with diabetes showed a 1.08- and 1.86-fold increased risk of HF, respectively, compared to normoglycemic participants. Compared to the normal weight group (BMI, 18.5 to 22.9 kg/m2), the underweight group (BMI <18.5 kg/m2) showed a 1.7-fold increased risk of HF, and those with BMI ≥30 kg/m2 showed a 1.1-fold increased risk of HF, suggesting a J-shaped association with BMI. When similar analyses were performed for different glycemic statuses, the J-shaped association between BMI and HF risk was consistently observed in both groups with and without diabetes. ConclusionParticipants with IFG and diabetes showed a significantly increased HF risk compared to normoglycemic participants. This increased risk of HF was mostly prominent in underweight and class II obese participants than in participants with normal weight.
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Tae Kyung Yoo, Kyung‐Do Han, Eun‐Jung Rhee, Won‐Young Lee Journal of Cachexia, Sarcopenia and Muscle.2024; 15(2): 671. CrossRef - Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
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Eun-Jung Rhee Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35. CrossRef - Impact of mental disorders on the risk of heart failure among Korean patients with diabetes: a cohort study
Tae Kyung Yoo, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee Cardiovascular Diabetology.2023;[Epub] CrossRef - Differential Impact of Obesity on the Risk of Diabetes Development in Two Age Groups: Analysis from the National Health Screening Program
Tae Kyung Yoo, Kyung-Do Han, Yang-Hyun Kim, Ga Eun Nam, Sang Hyun Park, Eun-Jung Rhee, Won-Young Lee Diabetes & Metabolism Journal.2023; 47(6): 846. CrossRef - Characterization of the oxidative stress and inflammatory markers in metabolically healthy obese individuals
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Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee Diabetes & Metabolism Journal.2022; 46(2): 327. CrossRef - Evaluating Triglyceride and Glucose Index as a Simple and Easy-to-Calculate Marker for All-Cause and Cardiovascular Mortality
Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park Journal of General Internal Medicine.2022; 37(16): 4153. CrossRef - Impact of hypoglycemia at the time of hospitalization for heart failure from emergency department on major adverse cardiovascular events in patients with and without type 2 diabetes
Seon-Ah Cha, Jae-Seung Yun, Gee-Hee Kim, Yu-Bae Ahn Cardiovascular Diabetology.2022;[Epub] CrossRef - Insulin resistance and heart failure with preserved ejection fraction. Pathogenetic and therapeutic crossroads
O. V. Tsygankova, N. E. Evdokimova, V. V. Veretyuk, L. D. Latyntseva, A. S. Ametov Diabetes mellitus.2022; 25(6): 535. CrossRef - The association between metabolic syndrome and heart failure in middle-aged male and female: Korean population-based study of 2 million individuals
Tae-Eun Kim, Hyeongsu Kim, JiDong Sung, Duk-Kyung Kim, Myoung-Soon Lee, Seong Woo Han, Hyun-Joong Kim, Sung Hea Kim, Kyu-Hyung Ryu Epidemiology and Health.2022; 44: e2022078. CrossRef - Diabetes and Heart Failure
Eun-Jung Rhee The Journal of Korean Diabetes.2021; 22(1): 12. CrossRef - Prediabetes and the risk of heart failure: A meta‐analysis
Xiaoyan Cai, Xiong Liu, Lichang Sun, Yiting He, Sulin Zheng, Yang Zhang, Yuli Huang Diabetes, Obesity and Metabolism.2021; 23(8): 1746. CrossRef - Diabetes and Heart Failure
Eun-Jung Rhee Cardiovascular Prevention and Pharmacotherapy.2021; 3(2): 21. CrossRef - Effects of Lipid Overload on Heart in Metabolic
Diseases
An Yan, Guinan Xie, Xinya Ding, Yi Wang, Liping Guo Hormone and Metabolic Research.2021; 53(12): 771. CrossRef - Obesity Degree and Glycemic Status: Factors That Should Be Considered in Heart Failure
Hye Soon Kim Diabetes & Metabolism Journal.2020; 44(4): 529. CrossRef - Letter: Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults (Diabetes Metab J 2020;44:592-601)
Darae Kim Diabetes & Metabolism Journal.2020; 44(5): 777. CrossRef - Response: Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults (Diabetes Metab J 2020;44:592-601)
Eun-Jung Rhee, Won-Young Lee Diabetes & Metabolism Journal.2020; 44(5): 781. CrossRef
- Epidemiology
- Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study
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Eun-Jung Rhee, Jung-Hwan Cho, Hyemi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
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Diabetes Metab J. 2019;43(6):794-803. Published online March 22, 2019
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DOI: https://doi.org/10.4093/dmj.2018.0184
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- Background
Short stature and leg length are associated with risk of diabetes and obesity. However, it remains unclear whether this association is observed in Asians. We evaluated the association between short stature and increased risk for diabetes using the Korean National Health Screening (KNHS) dataset. MethodsWe assessed diabetes development in 2015 in 21,122,422 non-diabetic Koreans (mean age 43 years) enrolled in KNHS from 2009 to 2012 using International Classification of Diseases 10th (ICD-10) code and anti-diabetic medication prescription. Risk was measured in age- and sex-dependent quintile groups of baseline height (20 to 39, 40 to 59, ≥60 years). ResultsDuring median 5.6-year follow-up, 532,918 cases (2.5%) of diabetes occurred. The hazard ratio (HR) for diabetes development gradually increased from the 5th (reference) to 1st quintile group of baseline height after adjustment for confounding factors (1.000, 1.076 [1.067 to 1.085], 1.097 [1.088 to 1.107], 1.141 [1.132 to 1.151], 1.234 [1.224 to 1.244]), with similar results in analysis by sex. The HR per 5 cm height increase was lower than 1.00 only in those with fasting blood glucose (FBG) below 100 mg/dL (0.979 [0.975 to 0.983]), and in lean individuals (body mass index [BMI] 18.5 to 23 kg/m2: 0.993 [0.988 to 0.998]; BMI <18.5 kg/m2: 0.918 [0.9 to 0.935]). ConclusionHeight was inversely associated with diabetes risk in this nationwide study of Korean adults. This association did not differ by sex, and was significant in lean individuals and those with normal FBG levels.
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Tae Kyung Yoo, Kyung‐Do Han, Eun‐Jung Rhee, Won‐Young Lee Journal of Cachexia, Sarcopenia and Muscle.2024; 15(2): 671. CrossRef - Upper arm length and knee height are associated with diabetes in the middle-aged and elderly: evidence from the China Health and Retirement Longitudinal Study
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Shuwu Zhao, Yiming Li, Chen Su Frontiers in Endocrinology.2023;[Epub] CrossRef - Inverse association between adult height and diabetes risk in a cohort study of Chinese population
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Wei Song, Yaqin Hu, Jiao Yuan, Ying Wei, Zongyou Cheng, Jingdong Liu, Jixiong Xu, Xiaoyu Wang Frontiers in Endocrinology.2022;[Epub] CrossRef - No association between body height and metabolic risk factors in historically short height Asian Indian tribes
Binu Dorjee, Jaydip Sen, Mithun Das, Kaushik Bose, Christiane Scheffler, Gautam Kumar Kshatriya Human Biology and Public Health.2022;[Epub] CrossRef - Newly diagnosed diabetes has high risk for cardiovascular outcome in ischemic stroke patients
Kyung-Hee Cho, Sun U. Kwon, Ji Sung Lee, Sungwook Yu, A-Hyun Cho Scientific Reports.2021;[Epub] CrossRef - Risk of Diabetes in Subjects with Positive Fecal Immunochemical Test: A Nationwide Population-Based Study
Kwang Woo Kim, Hyun Jung Lee, Kyungdo Han, Jung Min Moon, Seung Wook Hong, Eun Ae Kang, Jooyoung Lee, Hosim Soh, Seong-Joon Koh, Jong Pil Im, Joo Sung Kim Endocrinology and Metabolism.2021; 36(5): 1069. CrossRef - The use of Broca index to assess cut- off points for overweight in adults: A short review
Irakoze Laurent, Manirakiza Astère, Banderembako Paul, Nkengurutse Liliane, Yue Li, Qingfeng Cheng, Qifu Li, Xiaoqiu Xiao Reviews in Endocrine and Metabolic Disorders.2020; 21(4): 521. CrossRef
- Obesity and Metabolic Syndrome
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- The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
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Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
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Diabetes Metab J. 2019;43(2):206-221. Published online December 27, 2018
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DOI: https://doi.org/10.4093/dmj.2018.0039
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- Background
Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI). MethodsOur study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data. ResultsA total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS. ConclusionWC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.
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