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Original Articles

Tobacco use among older Korean men: a classification and regression tree analysis
Sung Seek Moon, Hyeouk Chris Hahm, Jinwon Lee
Received June 23, 2025  Accepted September 11, 2025  Published online January 8, 2026  
DOI: https://doi.org/10.4082/kjfm.25.0179    [Epub ahead of print]
Background
Tobacco use among older adults remains a pressing public health concern in South Korea, particularly among men. Despite the decline in tobacco use rates with age, a range of sociodemographic, psychological, and behavioral factors persist to influence tobacco use behaviors. However, prior studies have primarily relied on linear modeling approaches, which may overlook indirect associations. This study addressed this gap using classification and regression tree (CART) analysis to identify hierarchical and interactive patterns among factors associated with tobacco use.
Methods
We analyzed data from the 2023 Korea Community Health Survey, which included 34,924 Korean men aged ≥65 years. Using CART analysis, we identified distinct subgroups and patterns across multiple predictors of tobacco use behavior, including demographic factors, lifestyle characteristics, and chronic health conditions.
Results
CART analysis identified age as the strongest predictor of tobacco use. Men aged ≤72.5 years had higher tobacco use rates, especially those with low social engagement (24.8%). Younger men with higher social activity and aged ≤67.5 years had the lowest rate (12.9%). Among men ≥72.5 years, alcohol use was the key predictor. Non-drinkers had the lowest tobacco use rate (9.3%), whereas drinkers aged ≤78.5 years showed elevated rates (22.0%), suggesting persistent risk even in later life.
Conclusion
These findings underscore the importance of promoting social engagement and reducing alcohol use to decrease tobacco use among older men, particularly those under 73 years of age.
  • 199 View
  • 15 Download
Sociodemographic determinants and comorbidities associated with polypharmacy among the adult population in Korea: a nationwide claim analysis
Woo-young Shin, Tae-Hwa Go, Jung-ha Kim
Received December 20, 2024  Accepted March 31, 2025  Published online October 28, 2025  
DOI: https://doi.org/10.4082/kjfm.24.0328    [Epub ahead of print]
Background
Polypharmacy poses a growing challenge to healthcare systems because of its association with adverse effects and the misuse of medication. This study aimed to identify the sociodemographic factors and comorbidities associated with polypharmacy.
Methods
We selected patients aged ≥30 years registered in the National Health Information Database in 2018 who were prescribed at least one medication for ≥180 days. Multivariate logistic regression analyses were performed to evaluate the associations between polypharmacy, sociodemographic characteristics, and comorbidities.
Results
Polypharmacy was significantly associated with increasing age, with the strongest association observed in adults aged ≥65 years. Compared with medical aid recipients, higher-income groups had a weaker association with polypharmacy. After adjusting for covariates, significant associations with polypharmacy were found for specific comorbidities, such as Parkinson disease (odds ratio [OR], 3.804; 95% confidence interval [CI], 3.733–3.876; P<0.001) and chronic ischemic heart disease (OR, 3.199; 95% CI, 3.178–3.221; P<0.001).
Conclusion
These findings may help reduce the burden of polypharmacy by facilitating the development of targeted strategies tailored to patients.
  • 463 View
  • 19 Download
Association between sedentary time and anxiety in Korean adults: insights from the 2021 Korea National Health and Nutrition Examination Survey
So Hyeon Kim, Gyu Lee Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Young Jin Ra, Sang Yeop Lee, Eun Ju Park, Young Hye Cho, Young In Lee, Jung In Choi, Sae Rom Lee, Ryuk Jun Kwon, Soo Min Son
Received August 30, 2024  Accepted February 21, 2025  Published online September 17, 2025  
DOI: https://doi.org/10.4082/kjfm.24.0219    [Epub ahead of print]
Background
Physical inactivity and sedentary behavior influence the prevalence of anxiety disorders. However, there is a lack of research on how these factors affect Korean adults. Therefore, we conducted a large-scale cohort study to investigate the association of physical activity and sedentary behavior with the development of anxiety disorders.
Methods
This cross-sectional study included 5,615 Korean adults aged 19 years and over. This study analyzed data from the Korea National Health and Nutrition Examination Survey VIII (2021). Participants were divided into three groups based on sedentary time (minute per day), and anxiety levels were compared using the Generalized Anxiety Disorder Scale.
Results
The odds ratio (OR) for severe generalized anxiety disorder was higher in the longer sedentary time group (≥480 & <660 minutes and ≥660 minutes) than in the lowest sedentary time group (<480 minutes) (≥480 & <660 minutes: OR, 1.004; 95% confidence interval [CI], 0.463–2.178; ≥660 minutes: OR, 2.233; 95% CI, 1.385–3.599; P=0.001). After adjusting for confounding factors, these correlations remained consistent and statistically significant. Furthermore, subgroup analysis revealed that middle-aged adults, women, high school graduates, individuals living with housemates, and employed individuals had a stronger association with severe anxiety as sitting time increased.
Conclusion
Sitting for more than 11 hours a day is a significant risk factor for the development of severe anxiety. Incorporating regular walking into daily routines and reducing sedentary behaviors could alleviate anxiety in Korean adults.
  • 987 View
  • 17 Download
One-year mortality disparities between infants of unmarried and married families in South Korea: a large scale retrospective cohort study
Seonyoung Jeong, Yeani Choi, Hajin Kim, Sang Min Park
Korean J Fam Med 2026;47(1):46-58.   Published online April 16, 2025
DOI: https://doi.org/10.4082/kjfm.24.0226
Background
This study examined disparities in 1-year mortality rates between infants born to married and unmarried single-parent families, emphasizing the need for targeted health policies.
Methods
Data from 3,298,263 cases, obtained from the South Korea National Statistical Office (2010–2017), were analyzed. T-tests and chi-square tests were used to assess the demographic characteristics of the study group. The number of deaths per 1,000 live births was calculated, and logistic and multivariable logistic regressions were employed to compare infant mortality rates between family types. Additional stratified analyses, based on gestational age and birth weight, further elucidated the relationship between parental marital status and infant mortality.
Results
Infants from unmarried families exhibited a 3.34-fold higher crude odds ratio (OR) for 1-year mortality (95% confidence interval [CI], 2.56–4.36; P<0.001) than that from married families. After adjusting for confounders, the adjusted OR was 1.40 (95% CI, 1.03–1.92). Stratification by gestational age and birth weight revealed crude ORs of 4.62 (95% CI, 3.34– 6.39) in non-preterm infants (≥37 weeks) and 4.76 (95% CI, 3.46–6.56) in non-low-birth-weight infants (≥2.5 kg), highlighting a more pronounced disparity in infants born at or above normal weight and full term. No significant difference (P>0.05) was found in the crude OR for 1-year mortality rates among low-birth-weight (<2.5 kg) or preterm (<37 weeks) infants between the two-family types.
Conclusion
This study highlights the significant disparity in infant mortality rates based on parental marital status, underscoring the need for enhanced social support and tailored policies for unmarried single-parent families.
  • 2,745 View
  • 28 Download
Investigation of the prevalence and treatment of atopic dermatitis in South Korea using a large national dataset
Kyunguk Jeong, Sue Kyung Kim, Dukyong Yoon, Young Choi, Sooyoung Lee, Eun-So Lee
Korean J Fam Med 2025;46(6):426-434.   Published online November 14, 2024
DOI: https://doi.org/10.4082/kjfm.24.0124
Background
Updated reports on the population-based analysis of atopic dermatitis (AD) in Korea are rare. This study aimed to investigate the nationwide prevalence and systemic medication prescription trends of AD in Korea.
Methods
Based on the Korean National Health Insurance database, the prevalence of AD and systemic medication prescription trends in patients with AD were analyzed according to age groups and regional districts from 2010 to 2015.
Results
The prevalence of AD was the highest among patients aged 0–1 year (18.6%–24.5%), decreasing rapidly with increasing age (<2% in patients aged ≥20 years). From 2010 to 2015, the prevalence of AD decreased in children but increased slightly in adolescents and adults. In 2015, the proportion of systemic steroid prescriptions increased from 11.2% in the 0–9 years age group to 41.1% in the 50–59 years age group, while that of systemic antibiotic prescriptions gradually decreased from 6.2% in the 0–9 years age group to 1.8% in the 80–89 years age group. The proportion of systemic steroid prescriptions by region remained consistently high in Gyeongbuk (34.2%– 34.9%) and low in Daejeon (20.2%–22.5%). The annual proportion of systemic cyclosporine prescriptions increased significantly from 0.6% in 2010 to 1.2% in 2015, with the highest rates observed in patients in their 30s (1.5%–2.4%), followed by those in their 20s (1.3%–2.3%) and 40s (1.1%–2.0%).
Conclusion
From 2010 to 2015, the prevalence of AD decreased in children but increased slightly in adolescents and adults. Approximately one-fourth of the patients with AD were prescribed systemic steroids, and the percentage of cyclosporine prescriptions doubled during the study period.
  • 5,677 View
  • 86 Download
Association between water intake and abdominal obesity: the Korea National Health and Nutrition Examination Survey 2019–2021
Yun-Ji Kim, Si Nae Oh, Eun-Kyung Kong, Eun-Seong Seon
Korean J Fam Med 2025;46(4):270-277.   Published online June 10, 2024
DOI: https://doi.org/10.4082/kjfm.23.0277
Background
This study aimed to determine the link between water consumption and abdominal obesity in individuals aged 19 years and above, utilizing a sample from the 8th Korea National Health and Nutrition Examination Survey.
Methods
Participants were divided into two groups based on their water intake: those meeting adequate intake (≥5 cups for men and ≥4 cups for women) and those with inadequate intake (<5 cups for men and <4 cups for women). Multivariate logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders.
Results
Compared with the inadequate water intake group, the adequate water intake group showed a lower adjusted OR for abdominal obesity (adjusted OR, 0.874; 95% CI, 0.770–0.992). In the subgroup analysis, the adjusted OR for abdominal obesity in the 19–39 age group was 0.712 (95% CI, 0.520–0.974). However, no significant association was observed in the 40–64 and 65 or higher age groups.
Conclusion
Our findings indicate that sufficient water consumption may be negatively associated with abdominal obesity in adults, particularly among young adults; however, this association may not extend to older age groups.

Citations

Citations to this article as recorded by  
  • Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
    Joung Sik Son
    Korean Journal of Family Medicine.2025; 46(4): 215.     CrossRef
  • 7,267 View
  • 97 Download
  • 2 Web of Science
  • 1 Crossref
Background
Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents.
Methods
This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users.
Results
Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users.
Conclusion
This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.

Citations

Citations to this article as recorded by  
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Longitudinal Associations between Adolescent Electronic Cigarette Use and Eating Behaviors
    Saira Sarwar, W. Alex Mason, Jennifer Mize Nelson, Kimberly Andrews Espy, Timothy D. Nelson
    Substance Use & Misuse.2025; 60(14): 2144.     CrossRef
  • The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
    Joung Sik Son
    Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef
  • 4,276 View
  • 64 Download
  • 3 Web of Science
  • 3 Crossref
Background
This study aimed to examine the effects of different types of skipped meals on cardiometabolic risk factors (CMRF) in Korean adults.
Methods
We analyzed 14,062 adults from the Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018. The irregularity of breakfast, lunch, and dinner consumption was assessed using 24-hour recall data, and we categorized the habit of skipping regular meals into eight types. Multiple linear regression was used to estimate the association between each type of meal skipping and the CMRF. We also presented the estimated effects of individual types of meal skipping on the CMRF based on their predicted values and mean differences.
Results
Korean adults tended to have irregular meal consumption habits when they had one or more of the following characteristics: female sex, under the age of 50 years, middle-high to high household income, high school or college or higher education levels, alcohol consumption, and current smoking. Compared to regular eaters, we have observed significantly higher total cholesterol in the following types of meal skipping: irregular breakfast (IB) (P<0.001), irregular lunch (P=0.005), irregular breakfast and lunch (IBL) (P=0.001), irregular breakfast and dinner (P=0.001); higher low-density lipoprotein-cholesterol in IB (P=0.009); higher triglyceride in IB (P=0.005) and IBL (P=0.034); and higher fasting glucose in IB (P=0.046).
Conclusion
Different types of meal skipping were associated with CMRF. Regular breakfast and lunch consumption should be emphasized to prevent and manage cardiometabolic disorders. However, skipping dinner showed no significant association with CMRF.

Citations

Citations to this article as recorded by  
  • A Biochemical View on Intermittent Fasting’s Effects on Human Physiology—Not Always a Beneficial Strategy
    Willian F. Zambuzzi, Marcel Rodrigues Ferreira, Zifan Wang, Maikel P. Peppelenbosch
    Biology.2025; 14(6): 669.     CrossRef
  • Past Meal-Skipping Habits Associate With Physical Frailty in Later Life: A Retrospective Cohort Study
    Chiharu Nishijima, Kenji Harada, Satoshi Kurita, Masanori Morikawa, Kazuya Fujii, Daisuke Kakita, Hiroyuki Shimada
    Journal of the American Medical Directors Association.2025; 26(12): 105893.     CrossRef
  • Primary Care Physicians’ Important Role: Lifestyle Modification for Chronic Disease Management
    Su-Min Jeong
    Korean Journal of Family Medicine.2024; 45(5): 237.     CrossRef
  • 5,326 View
  • 97 Download
  • 3 Web of Science
  • 3 Crossref
Association between Combustible Cigarettes and Noncombustible Nicotine or Tobacco Products and Generalized Anxiety Disorder Based on Data from the 8th Korea National Health and Nutrition Examination Survey 2021
Sungkwon Cho, Joo-Hyun Park, Do-Hoon Kim, Hangseok Choi, Youngdoo Park, Hyun-Jin Kim, An-Na Lee, Junghwa Shin, Jaesun Ha
Korean J Fam Med 2024;45(6):317-323.   Published online March 25, 2024
DOI: https://doi.org/10.4082/kjfm.23.0172
Background
Despite the increasing prevalence of anxiety disorders in Korea, there have been no nationwide studies on the association between tobacco status and generalized anxiety disorder (GAD). Furthermore, despite the increasing number of people using noncombustible nicotine or tobacco products (NNTPs), the association between NNTP use and GAD remains unclear. Therefore, this study investigated the association between tobacco use and GAD.
Methods
This nationwide study used data from the 8th Korea National Health and Nutrition Examination Survey (2021) and included 5,454 adults aged ≥19 years who self-reported on the tobacco use and mental health sections. Multivariable logistic regression analysis was performed to investigate the odds ratios (ORs) of GAD (Generalized Anxiety Disorder-7 score ≥10) according to tobacco status among Korean adults. The severity of anxiety was assessed using the Generalized Anxiety Disorder-7 scale.
Results
Compared to never tobacco users, the ORs of GAD for combustible cigarette smokers and NNTP users were 2.74 (95% confidence interval [CI], 1.66–4.50) and 2.11 (95% CI, 1.16–3.83), respectively. The OR of GAD for former tobacco users was 1.63 (95% CI, 0.98–2.72).
Conclusion
Tobacco use (combustible cigarettes and NNTP) was positively associated with GAD. However, in former tobacco users, there was no significant association with GAD when compared with never tobacco users. Given the OR of GAD among tobacco users, it is crucial to pay attention to screening for GAD and implement appropriate early interventions.

Citations

Citations to this article as recorded by  
  • Comprehensive Health Strategies for the Post-pandemic Era: Integrating Physical Health, Psychological Resilience, Lifestyle Choices, and Occupational Well-being
    Su Hwan Cho
    Korean Journal of Family Medicine.2024; 45(6): 303.     CrossRef
  • 4,931 View
  • 141 Download
  • 1 Web of Science
  • 1 Crossref
Association of Primary Care Physician Supply with Population Mortality in South Korea: A Pooled Cross-Sectional Analysis
Hyeonseok Koh, Soonman Kwon, Belong Cho
Korean J Fam Med 2024;45(2):105-115.   Published online January 30, 2024
DOI: https://doi.org/10.4082/kjfm.23.0156
Background
Primary care physicians perform a comprehensive role by providing continuous, patient-centered, and accessible healthcare and establishing connections with specialized care. However, the association between the supply of primary care physicians and mortality rates in South Korea has not been thoroughly investigated.
Methods
This study utilized data from 229 si-gun-gu in South Korea from 2016 to 2020. The densities of primary care physicians, physicians in functional primary clinics, specialists in primary care facilities, and active physicians per 100,000 people were independent variables. Age-adjusted all-cause mortality and cause-specific mortality rates per 100,000 individuals were the dependent variables. Negative binomial regression, negative binomial regression with a pseudo-panel approach, and geographically weighted regression were used to analyze the data.
Results
Our study revealed a significant negative association between the density of primary care physicians and all-cause mortality. An increase in a primary care physician per 100,000 population was significantly linked to a 0.11% reduction in all-cause mortality (incidence rate ratio, 0.9989; 95% confidence interval, 0.9983–0.9995). Similar associations have been observed between mortality rates owing to cardiovascular diseases, respiratory tract diseases, and traffic accidents.
Conclusion
This study provides evidence that having a higher number of primary care physicians in South Korea is associated with lower mortality rates. Future research should consider better indicators that reflect the quality of primary care to better understand its impact on population health outcomes. These findings emphasize the significance of strengthening primary care in the South Korean healthcare system to improve the overall health and wellbeing.

Citations

Citations to this article as recorded by  
  • What is the optimal number of physicians for a sustainable healthcare system?
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(1): 1.     CrossRef
  • Reinforcing Primary Care in Korea: Policy Implications, Data Sources, and Research Methods
    Chung-Nyun Kim, Seok-Jun Yoon
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Obesity management in primary care: A joint clinical perspective and expert review from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) - 2025
    Nicholas Pennings, Catherine Varney, Shaun Hines, Bernadette Riley, Patricia Happel, Samir Patel, Harold Edward Bays
    Obesity Pillars.2025; 14: 100172.     CrossRef
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Current Status and Future Directions of Primary Care in the World: Insights from Japan
    Sinyoung Cho, Belong Cho, Seo Eun Hwang
    Korean Journal of Family Practice.2025; 15(1): 22.     CrossRef
  • Impact of general practitioners and specialists on mortality: a longitudinal study
    Akin Dayan, Erdinc Unal, Egemen Tural
    BMC Health Services Research.2025;[Epub]     CrossRef
  • Assessing the impact of physician supply inequality on mortality in China: implications for global health
    Maomao Cao, Wei Jiang, Run Dong, Yan Chen, Rong Liufu, Li Weng, Bin Du
    International Journal for Equity in Health.2025;[Epub]     CrossRef
  • Supply of Primary Care Physicians: A Key Strategy to Reduce Population Mortality
    Young Gyu Cho
    Korean Journal of Family Medicine.2024; 45(2): 59.     CrossRef
  • Primary Care Physicians’ Important Role: Lifestyle Modification for Chronic Disease Management
    Su-Min Jeong
    Korean Journal of Family Medicine.2024; 45(5): 237.     CrossRef
  • 7,729 View
  • 121 Download
  • 9 Web of Science
  • 9 Crossref
Correlation between Usual Source of Care and Medication Adherence in Patients with Hypertension
Han-Kil Kang, Nak-Jin Sung
Korean J Fam Med 2024;45(2):82-88.   Published online November 27, 2023
DOI: https://doi.org/10.4082/kjfm.23.0125
Background
Maintaining a usual source of care (USC), which is crucial for primary healthcare, encompasses initial contact, comprehensive services, coordinated care, and ongoing support. However, limited research exists on the relationship between USC and medication adherence in patients with hypertension. This study aimed to investigate the association between USC and medication adherence among patients with hypertension.
Methods
Data from the 2nd Korea Health Panel Survey 2020 were analyzed. The final sample consisted of 3,318 participants aged 19 years or older diagnosed with hypertension. USC was categorized into three groups: no USC, place only (without a regular doctor), and regular doctor. Medication adherence was assessed using detailed items (dose, frequency, time, no stop) and a 4-point Likert scale. A logistic regression analysis was conducted with control for relevant variables.
Results
Compared to the no USC group, the regular doctor group had significantly higher odds ratios (ORs) for overall perfect/high medication adherence rates: 1.70 (95% confidence interval [CI], 1.42–2.03) and 1.59 (95% CI, 1.14–2.20). Similar results were observed for each adherence item, including prefect dose (OR, 2.14; 95% CI, 1.73– 2.63), frequency (OR, 1.87; 95% CI, 1.53–2.28), time (OR, 1.72; 95% CI, 1.43–2.07), and no stop (OR, 1.56; 95% CI, 1.09–2.23)/high frequency (OR, 2.47; 95% CI, 1.21–5.01), time (OR, 2.30; 95% CI, 1.19–4.44). However, the place only group showed no significant differences in medication adherence except for perfect adherence to dose (OR, 1.35; 95% CI, 1.06–1.71).
Conclusion
These findings provide evidence supporting the need for healthcare policies that encourage having a regular doctor in South Korea, which has a healthcare system with limited primary care.

Citations

Citations to this article as recorded by  
  • Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
    Yoon-Eui Choi, Nak-Jin Sung
    Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
  • Medication adherence and associated factors among hypertensive older adults: A study focusing on health literacy
    Ji Young Kim, Ju Young Yoon
    Korean Journal of Health Education and Promotion.2025; 42(2): 33.     CrossRef
  • Lifestyle prescriptions for obesity treatment in primary care: a narrative review
    Ji-Hye Jung, YangIm Hur
    Ewha Medical Journal.2025; 48(4): e54.     CrossRef
  • Supply of Primary Care Physicians: A Key Strategy to Reduce Population Mortality
    Young Gyu Cho
    Korean Journal of Family Medicine.2024; 45(2): 59.     CrossRef
  • 30,151 View
  • 103 Download
  • 1 Web of Science
  • 4 Crossref
Fruits and the Risk of Type 2 Diabetes: The Korean Genome and Epidemiology Study Cohort
Hojun Yu, Cheol Min Lee, Seung-Won Oh
Korean J Fam Med 2024;45(1):44-50.   Published online November 23, 2023
DOI: https://doi.org/10.4082/kjfm.23.0201
Background
To determine the association between type 2 diabetes mellitus and the consumption of various fruits.
Methods
The Korean Genome And Epidemiology Study is an ongoing prospective longitudinal cohort study of community dwellers and participants (men and women, aged 40–69 years) recruited from the national health examinee registry of Korea. Their individual consumption habits for 12 different fruit types were recorded using food frequency questionnaires. The fruits were then divided into three groups according to their glycemic indexes and glycemic loads. Participants with extreme caloric intakes, pre-existing type 2 diabetes mellitus, chronic kidney diseases, chronic liver diseases, and ongoing cancer treatments were excluded. The incidence of type 2 diabetes in the cohort was identified through self-reporting and supplemented by glycated hemoglobin and fasting blood glucose levels.
Results
A total of 2,549 cases of type 2 diabetes were documented during 283,033.8 person-years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors for diabetes, the pooled hazard ratio of type 2 diabetes for every serving per week of total whole fruit consumption was 1.02 (95% confidence interval [CI], 0.99–1.06; P=0.2). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every serving per week were 0.94 (95% CI, 0.88–1.00; P=0.039) for bananas, and 0.90 (95% CI, 0.84–0.96; P<0.001) for grapes.
Conclusion
Our findings suggest associations between the consumption of certain fruits and the risk of developing type 2 diabetes. A greater consumption of grapes was significantly associated with a lower risk of type 2 diabetes in our cohort, but the total amount of fruit consumption was not associated with a reduced risk.

Citations

Citations to this article as recorded by  
  • Lifestyle prescriptions for diabetes management in primary care: a narrative review
    Hye Jun Lee, Jung-Ha Kim
    Ewha Medical Journal.2025; 48(4): e55.     CrossRef
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • 6,682 View
  • 119 Download
  • 1 Web of Science
  • 2 Crossref
Background
This study aimed to identify the clinical content of patients registered with the Lifetime Health Maintenance Program (LHMP) under the care of a single family physician who introduced and operated the program in Korea at a tertiary hospital for over 30 years.
Methods
We analyzed the electronic medical records of 745 patients who had registered for more than 3 times with the LHMP under the care of a single family physician between January 1, 2010 and December 31, 2019. We reviewed medical records from June 1989, when the hospital was established, to February 2022. The participants’ age at the time of LHMP enrollment, sex, initial consultation date, final consultation date, and consultation content were evaluated.
Results
Patients visited the LHMP for various reasons, including acute symptom management, chronic disease management, psychiatric consultation, counseling on health behaviors, health checkups, and vaccination. The top five diagnoses for acute symptom management were upper respiratory infection, abdominal pain, dizziness/vertigo, headache, and lower back pain, whereas those for chronic disease management were dyslipidemia, hypertension, osteoarthritis, osteoporosis/osteopenia, and diabetes. More than one in five patients received psychiatric consultation and counseling on health behaviors. As the duration of the program enrollment increased, the proportion of patients visiting the LHMP for acute symptoms, vaccinations, and health checkups also increased. Furthermore, the number of categories of consultation content increased for each patient.
Conclusion
The LHMP emphasized the need to systematize regular primary care physicians in Korea. Policy changes are necessary to strengthen primary care, and the LHMP serves as an intermediate step in organizing regular primary care physicians in Korea.

Citations

Citations to this article as recorded by  
  • Pharmacotherapy guidelines for smoking cessation in primary healthcare clinics
    Cheol Min Lee, Yu Jin Paek, Yoo Bin Seo, Eon Sook Lee
    Journal of the Korean Medical Association.2024; 67(4): 230.     CrossRef
  • 4,181 View
  • 83 Download
  • 1 Web of Science
  • 1 Crossref

Review Article

Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans’ alcohol metabolism capabilities that can be predicted by presence of facial flushing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups according to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.

Citations

Citations to this article as recorded by  
  • Unhealthy alcohol use: screening and behavioral counseling interventions
    Wonyoung Jung, Seung-Won Oh, Se-Hong Kim, Soo Young Kim
    Korean Journal of Family Medicine.2025; 46(1): 20.     CrossRef
  • Associations of Body Mass Index and Lifestyle Factors with Suicidal Ideation, Planning, and Attempts Among Korean Adolescents: A Cross-Sectional Study
    Haitao Wang, Kyung-O Kim
    Healthcare.2025; 13(12): 1470.     CrossRef
  • Association of Insulin Resistance with Dysglycemia in Elder Koreans: Age- and Sex-Specific Cutoff Values
    Sang Min Yoon, Boyoung Park
    Journal of Personalized Medicine.2025; 15(9): 438.     CrossRef
  • The preventative effects of statin on lung cancer development in patients with idiopathic pulmonary fibrosis using the National Health Insurance Service Database in Korea
    Yoo Jung Lee, Nayoon Kang, Junghyun Nam, Eung Gu Lee, Jiwon Ryoo, Soon Seog Kwon, Yong Hyun Kim, Hye Seon Kang, Tsai-Ching Hsu
    PLOS ONE.2024; 19(3): e0299484.     CrossRef
  • Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
    Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
    Epidemiology and Health.2023; 45: e2023092.     CrossRef
  • 17,920 View
  • 251 Download
  • 4 Web of Science
  • 5 Crossref

Original Articles

Characteristics of Critically Ill COVID-19 Patients in Busan, Republic of Korea
Jungmin Lee, Hyunjin Son
Korean J Fam Med 2023;44(3):158-167.   Published online May 20, 2023
DOI: https://doi.org/10.4082/kjfm.22.0179
Background
This study aimed to improve the clinical course of patients through rapid response by analyzing the characteristics of critically ill patients with confirmed coronavirus disease 2019 (COVID-19) in Busan between December 1, 2020, and December 31, 2021.
Methods
We divided patients diagnosed with COVID-19 into mild-to-moderate and critical groups based on their clinical severity. The critically ill patients were further sub-divided into delta and delta variant non-epidemic group.
Results
The following factors were significantly more frequent in critically ill patients than in patients with mild-tomoderate symptoms: male sex, age ≥60 years, symptoms at the time of diagnosis, and those with underlying diseases. The following factors were significantly more common in the non-delta variant epidemic group than in the delta variant epidemic group in critically ill patients: male sex, age ≥60 years, underlying diseases, and not being vaccinated. In the delta variant epidemic group, the duration between confirmation of disease and its progression to critically ill status was significantly shorter than that in the non-delta variant epidemic group.
Conclusion
COVID-19 is characterized by the emergence of new variants and repeated epidemics. Therefore, it is necessary to analyze the characteristics of critically ill patients to efficiently distribute and manage medical resources.
  • 3,491 View
  • 114 Download
Relationship between Serum Testosterone Level and Carotid Intima-Media Thickness among Korean Men and Postmenopausal Women
Miso Kim, Yohwan Yeo, Yun-Mi Song
Korean J Fam Med 2022;43(6):374-380.   Published online November 20, 2022
DOI: https://doi.org/10.4082/kjfm.21.0204
Background
Given that the role of serum testosterone on incident cardiovascular disease has been uncertain, it is necessary to find out the relationship between serum testosterone and carotid atherosclerosis.
Methods
The study participants included 1,302 Korean adults (873 men and 429 postmenopausal women) who participated in the Healthy Twin Study and were not receiving androgen deprivation therapy. The participants were classified into three groups: men aged <40 and ≥40 years and postmenopausal women. Total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations were measured using electrochemiluminescence immunoassays, and free testosterone (cFT) levels were calculated using Vermeulen’s method. Carotid intima-media thickness (IMT) was measured at three levels using a high-resolution B-mode ultrasound equipped with a 7-MHz linear transducer. The associations between sex hormone concentrations and carotid IMT were evaluated using a mixed linear regression analysis.
Results
After adjusting for cardiovascular risk factors, TT was found to be inversely associated with common carotid IMT in men aged ≥40 years, with a 4.5% decrease in common carotid IMT for every one-standard deviation increase in TT concentration (P=0.0063). In contrast, TT was not significantly associated with carotid IMT in all segments in men aged <40 years and postmenopausal women. Additionally, SHBG and cFT were not associated with carotid IMT in any segment.
Conclusion
The significant association between TT level and common carotid IMT in men aged ≥40 years suggests that decreased testosterone levels are involved in the development of atherosclerosis in men.

Citations

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  • Serum norethisterone (NET) levels in NET-enanthate (NET-EN) injectable contraception users substantially interfere with testosterone immunoassay measurements and confound interpretation of biological outcomes
    Chanel Avenant, Johnson Mosoko Moliki, Alexis J. Bick, Sigcinile Dlamini, Mandisa Singata-Madliki, G. Justus Hofmeyr, Pai-Lien Chen, Karl-Heinz Storbeck, Donita J. Africander, David W. Erikson, Janet P. Hapgood
    Contraception and Reproductive Medicine.2025;[Epub]     CrossRef
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    Hu Sigan, Li Min, Cheng Zengwei, Gao Shiyi, Kang Pinfang, Gao Dasheng
    Atherosclerosis Plus.2024; 55: 63.     CrossRef
  • 5,053 View
  • 60 Download
  • 2 Web of Science
  • 2 Crossref
Types of Usual Source of Care and Patient-Centered Communications
Daye Kim, Nak-Jin Sung
Korean J Fam Med 2022;43(6):353-360.   Published online November 20, 2022
DOI: https://doi.org/10.4082/kjfm.21.0183
Background
A usual source of care (USC) is related to longitudinal and personalized services, which are attributes of primary care. Patient-centered communication, an important element of patient-centered care, helps physicians understand health problems from a patient’s point of view. We analyzed the association between USC and patient-centered communication.
Methods
Data from the Korea Health Panel 2018 were used in the analysis. Patient-centered communication scores were obtained by combining the four communication-related questionnaire items. Usual source of care types were categorized based on responses to two questionnaire items: no USC, a place without a regular doctor and with a regular doctor. Multiple logistic regression analysis was used to adjust for confounders.
Results
Good communication rate was higher for those with a regular doctor (71.8%) than for those with no USC (61.8%) or a place only (61.5%). Those with a regular doctor had better communication (odds ratio, 1.49 for individuals with poor/moderate health, and 2.08 for those with good health) than those without a USC after adjusting for confounders. In terms of communication, no difference was observed between individuals with no USC and those with a place only.
Conclusion
Having a regular doctor promotes communication between patients and doctors. Good communication may be a mediator between having a regular doctor and related beneficial outcomes. Better communication by having a regular doctor, along with several other benefits identified in previous studies suggests the need for a health policy that encourages individuals to have regular doctors.

Citations

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  • Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
    Yoon-Eui Choi, Nak-Jin Sung
    Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
  • Patterns of health literacy and influencing factors differ by age: a cross-sectional study
    Da Hae Kwon, Young Dae Kwon
    BMC Public Health.2025;[Epub]     CrossRef
  • Correlation between Usual Source of Care and Medication Adherence in Patients with Hypertension
    Han-Kil Kang, Nak-Jin Sung
    Korean Journal of Family Medicine.2024; 45(2): 82.     CrossRef
  • Determinants of Patient-Centered Communication, Its Impact On Quality of Services, Overall Health Status And Trust In The Healthcare System In The United States
    Cuma Çakmak, İsmail Biçer
    Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi.2024; 11(4): 630.     CrossRef
  • 4,744 View
  • 87 Download
  • 2 Web of Science
  • 4 Crossref
Comparison between the International Classification of Primary Care and the International Classification of Diseases Classifications in Primary Care in Korea
Mi-Ra Cho, Yu-Jin Kwon, Shin-Hye Kim, Jinseub Hwang, Jimin Kim, Jangmi Yang, Jeonghoon Ahn, Jae-Yong Shim
Korean J Fam Med 2022;43(5):305-311.   Published online September 20, 2022
DOI: https://doi.org/10.4082/kjfm.22.0119
Background
The International Classification of Primary Care-2 (ICPC-2) is a classification method designed for primary care. Although previous studies have found that ICPC-2 is a useful tool for demonstrating the relationship between patients’ expectations and health providers’ diagnoses, its utility of ICPC-2 has yet to be fully studied in Korea. This study aimed to evaluate the practicality of ICPC-2 in Korean primary care.
Methods
The study was conducted at primary care clinics in Seoul and Gyeonggi areas from October to November 2015. Third-year family medicine residents examined and analyzed the medical records of patients who visited primary care physicians using ICPC-2, and the results were compared with those obtained using the International Classification of Diseases-10 (ICD-10) (Korean version: Korean Standard Classification of Diseases-7).
Results
A total of 26 primary care physicians from 23 primary care clinics participated in the study. Furthermore, 2,458 ICD-10 codes and 6,091 ICPC-2 codes were recorded from the data of 1,099 patients. The common disease codes were vasomotor and allergic rhinitis (J30), according to ICD-10, and acute upper respiratory infection (R74) in ICPC-2. Comparing disease status by body systems, the proportion of gastrointestinal disease with ICD-10 codes was significantly higher than that with ICPC-2 codes (P<0.001). Furthermore, patients with >4 diagnoses accounted for 36% of the ICD-10 classifications, whereas those with >4 diagnoses accounted for 4% of the ICPC-2 classifications.
Conclusion
Introducing ICPC as a complementary means for diagnosing common diseases could be a practical approach in Korean primary care.

Citations

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  • Evaluation of Diagnoses According to ICD‐10 and ICPC‐2 in Family Medicine Practice: A Retrospective Study
    Olgun Göktaş, Marta Laranjo
    International Journal of Clinical Practice.2025;[Epub]     CrossRef
  • 7,517 View
  • 83 Download
  • 1 Web of Science
  • 1 Crossref
Background
Previous studies have shown a close relationship between skipping breakfast and nutritional deficiency. However, the impact of regular eating, including lunch and dinner, has not been studied well. We explored the correlation between regularity and frequency of daily meals and nutritional status.
Methods
We analyzed Korea National Health and Nutrition Examination Surveys between 2016 and 2018. A total of 7,725 adults aged 19–49 years were classified into four groups according to the regularity of meal intake: three-meal regular diet (3MRD), two-meal regular diet, one-meal regular diet, and irregular diet (IRD). Food and nutrient intake was assessed using the 24-hour recall method and estimated by a generalized linear model in complex sample weight variables.
Results
In IRD, there were relatively more females who were not married, lived alone, or reported low levels of education. As subjects ate more meals, more people felt thinner and healthier by themselves. Dietary intake of cereal, vegetables, seaweed, and fiber was directly proportional to the number of regular meals as well as essential components such as water, carbohydrates, protein, fat, and micronutrients. Contrarily, alcohol and beverage consumption was inversely proportional to the number of regular meals. Intake level of legumes, fish, fruits, seasonings, milk, oils, sugars, and cholesterol was consistent regardless of meal frequency.
Conclusion
Our findings suggest that 3MRD showed nutrient adequacy and a healthier profile on body weight, body mass index, waist circumference, blood pressure, serum fasting glucose, total cholesterol, and triglyceride.

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  • Eating patterns in Korean adults, 1998–2018: increased energy contribution of ultra-processed foods in main meals and snacks
    Sukyoung Jung, Jee Young Kim, Sohyun Park
    European Journal of Nutrition.2024; 63(1): 279.     CrossRef
  • Analysis of dietary behavior and intake related to glycemic control in patients with type 2 diabetes aged 30 years or older in Korea: Utilizing the 8th Korea National Health and Nutrition Examination Survey (2019–2021)
    Jin-Ah Seok, Yeon-Kyung Lee
    Nutrition Research and Practice.2024; 18(2): 239.     CrossRef
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • A national cross-sectional study on breakfast skipping-related factors and comparison of nutritional status according to breakfast skipping in older adults based on the 8th Korea National Health and Nutrition Examination Survey (KNHANES, 2020)
    Anna Han, Yean Jung Choi
    The Journal of nutrition, health and aging.2024; 28(9): 100335.     CrossRef
  • The Association between Personality Factors and Metabolic Parameters among Patients with Non-Alcoholic-Fatty Liver Disease and Type 2 Diabetes Mellitus—A Cross-Sectional Study
    Marcin Kosmalski, Rafał Frankowski, Monika Różycka-Kosmalska, Kasper Sipowicz, Tadeusz Pietras, Łukasz Mokros
    Journal of Clinical Medicine.2023; 12(13): 4468.     CrossRef
  • Nutrition fact label (NFL) use is related to meeting the requirements for vitamins and minerals not listed on NFLs: Data from the Korea National Health and Nutritional Examination Survey VIII (2019–2021) for the prepandemic and pandemic periods
    Jung Min Cho, Niravkumar Joshi
    PLOS ONE.2023; 18(12): e0296268.     CrossRef
  • Association between Prediabetes and Meal Patterns Related to Meal Sharing among Korean Young Adults: Eighth Korean National Health and Nutrition Examination Survey, 2019–2020
    Saebom Kim, Sehee Kim, Youngmin Kim, Seonmi Seo, Yu Jin Chung, Sam Cheol Kim
    Korean Journal of Family Practice.2023; 13(3): 179.     CrossRef
  • Meal Frequency, Metabolic Health, and Social Norms
    Young Gyu Cho
    Korean Journal of Family Medicine.2022; 43(5): 275.     CrossRef
  • 7,745 View
  • 123 Download
  • 7 Web of Science
  • 8 Crossref
Analysis of Continuity of Care and Its Related Factors in Diabetic Patients: A Cross-Sectional Study
Ji Yeh Shin, Ha Jin Kim, BeLong Cho, Yun Jun Yang, Jae Moon Yun
Korean J Fam Med 2022;43(4):246-253.   Published online July 19, 2022
DOI: https://doi.org/10.4082/kjfm.21.0145
Background
Continuity of care in primary care settings is crucial for managing diabetes. We aimed to statistically define and analyze continuity factors associated with demographics, clinical workforce, and geographical relationships.
Methods
We used 2014–2015 National Health Insurance Service claims data from the Korean registry, with 39,096 eligible outpatient attendance. We applied multivariable logistic regression to analyze factors that may affect the continuity of care indices for each patient: the most frequent provider continuity index (MFPCI), modified-modified continuity index (MMCI), and continuity of care index (COCI).
Results
The mean continuity of care indices were 0.90, 0.96, and 0.85 for MFPCI, MMCI and COCI, respectively. Among patient factors, old age >80 years (MFPCI: odds ratio [OR], 0.81; 95% confidence interval [CI], 0.74–0.89; MMCI: OR, 0.84; 95% CI, 0.76–0.92; and COCI: OR, 0.81; 95% CI, 0.74–0.89) and mild disability were strongly associated with lower continuity of care. Another significant factor was the residential area: the farther the patients lived from their primary care clinic, the lower the continuity of diabetes care (MFPCI: OR, 0.74; 95% CI, 0.70–0.78; MMCI: OR, 0.70; 95% CI, 0.66–0.73; and COCI: OR, 0.74; 95% CI, 0.70–0.78).
Conclusion
The geographical proximity of patients’ residential areas and clinic locations showed the strongest correlation as a continuity factor. Further efforts are needed to improve continuity of care to address the geographical imbalance in diabetic care.

Citations

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  • Association of rurality and decreased continuity of care prior to a diagnosis of prediabetes
    Bobbie L. Johannes, Arch G. Mainous, Alex R. Chang, H. Lester Kirchner, G. Craig Wood, Christopher D. Still, Lisa Bailey‐Davis
    The Journal of Rural Health.2025;[Epub]     CrossRef
  • A Systematic Review of Continuity of Care Strategies for Enhancing Diabetes Self-Management in Older Adults in Asian Countries
    Citra Sari, Hartiah Haroen, Neti Juniarti, Lisda Amalia, Jerico Pardosi
    Journal of Multidisciplinary Healthcare.2025; Volume 18: 5441.     CrossRef
  • Evidence of Overlapping Roles Between Clinics and Hospitals in Primary Care
    Boram Sim, Jihye Shin, Hyun Woo Kim, Jin Yong Lee, Min-Woo Jo
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Disease prevention measures applicable to primary healthcare clinics
    Jae-Heon Kang
    Journal of the Korean Medical Association.2024; 67(4): 226.     CrossRef
  • Association between continuity of care and inappropriate prescribing in outpatient care in Germany: a cross-sectional analysis conducted as part of the LoChro trial
    Aline Pfefferle, Nadine Binder, Julia Sauer, Mario Sofroniou, Gloria Metzner, Erik Farin, Sebastian Voigt-Radloff, Andy Maun, Claudia Salm
    BMJ Open.2024; 14(7): e082245.     CrossRef
  • COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country
    Abbasali Dehghani Tafti, Azadeh Fatehpanah, Ibrahim Salmani, Mohammad Amin Bahrami, Hossien Tavangar, Hossien Fallahzadeh, Ali Ahmadi Tehrani, Sajjad Bahariniya, Gholamreza Ahmadi Tehrani
    BMC Primary Care.2023;[Epub]     CrossRef
  • Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis
    Boram Sim, Sunmi Kim, Eun Woo Nam
    BMC Public Health.2023;[Epub]     CrossRef
  • The Impact of Continuity of Care on Health Indicators in Patients With Type 2 Diabetes Mellitus in Family Medicine Clinics in Riyadh
    Ghada Hussein, Aljoharah A Al Saud, Ahmad M Siddiqi, Abdallah Khasawinah, Ahmad Alenezi, Riham A Mohammed, Yaser A Alendijani
    Cureus.2023;[Epub]     CrossRef
  • The Role of Continuity of Care in the Management of Chronic Disease
    Seung-Won Oh
    Korean Journal of Family Medicine.2022; 43(4): 207.     CrossRef
  • 5,251 View
  • 118 Download
  • 9 Web of Science
  • 9 Crossref
Association between Serum Folic Acid Levels and Asthma in the Korean Population: A Study Based on the 2016–2018 Korea National Health and Nutrition Examination Survey
So Ra Kim, Eun Ju Park, Young Hye Cho, Sang Yeoup Lee, Jung-In Choi, Young-In Lee, Sae Rom Lee, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra
Korean J Fam Med 2022;43(4):241-245.   Published online July 19, 2022
DOI: https://doi.org/10.4082/kjfm.21.0143
Background
Folic acid is involved in inflammatory reactions; however, the association between folic acid and allergic diseases, particularly asthma, remains unclear. Thus, this study aimed to evaluate the association between serum folic acid levels and asthma in Koreans.
Methods
This study analyzed the serum folic acid levels of 6,615 individuals included in the 2016–2018 Korea National Health and Nutrition Examination Survey. The prevalence of asthma was determined using a questionnaire that identified cases of physician-diagnosed asthma. The relationship between serum folic acid levels and asthma was analyzed using logistic regression analysis.
Results
Multiple logistic regression analysis showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of asthma after adjusting for confounding factors including sex, age, household income, current smoking, current alcohol use, and body mass index (odds ratio [OR], 0.930; 95% confidence interval [CI], 0.876– 0.987; P=0.017). The relationship between the adjusted odds of asthma and serum folic acid levels were consistently inverse (OR, 2.266; 95% CI, 1.126–4.420; P for trend=0.038).
Conclusion
Serum folic acid levels are inversely associated with physician-diagnosed asthma in the Korean population.

Citations

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  • The anti-inflammatory effects of folic acid
    Mengmeng Song, Benjamin P. Xu
    Precision Nutrition.2024; 3(2): e00070.     CrossRef
  • Association between serum folate levels and blood eosinophil counts in American adults with asthma: Results from NHANES 2011–2018
    Jun Wen, Changfen Wang, Mohan Giri, Shuliang Guo
    Frontiers in Immunology.2023;[Epub]     CrossRef
  • 5,775 View
  • 100 Download
  • 1 Web of Science
  • 2 Crossref
Association between Near Work Time and Depression among Workers in South Korea
Na Rae Jeong, Seung Hun Lee, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Yougn Jin Tak, Hye Rim Hwang, Gyu Lee Kim, Sang Yeoub Lee, Young Hye Cho, Eun Ju Park, Young In Lee, Jung In Choi
Korean J Fam Med 2021;42(5):390-394.   Published online September 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0217
Background
The aim of this study was to evaluate the association between near work time and depression.
Methods
Data of 1,551 workers aged 19–49 years from the sixth Korea National Health and Nutrition Examination Survey were examined. The Patient Health Questionaire-9 scores were used to screen for depression. Participants who scored a total of 10 or above, which is suggestive of the presence of depression, were classified as the depression group; the rest were classified as normal. The correlation between daily near work time and depression was analyzed using multivariate logistic analysis after adjusting for other sociodemographic and health behavior-related variables.
Results
Multivariate logistic analysis found that workers with 3 or more hours of near work were more likely to report depression compared to the reference group who had 2 or fewer hours per day of near work (adjusted odds ratio, 2.471; 95% confidence interval, 1.062–5.747).
Conclusion
Longer near work time was associated with depression among South Korea’s workers. Therefore, it is necessary to reduce near work time to prevent depression.

Citations

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  • Low Vision Rehabilitation and Eye Exercises: A Comprehensive Guide to Tertiary Prevention of Diabetic Retinopathy
    Tibor Rák, Andrea Kovács-Valasek, Etelka Pöstyéni, Róbert Gábriel, Adrienne Csutak
    Life.2025; 15(6): 857.     CrossRef
  • 5,875 View
  • 95 Download
  • 1 Web of Science
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Factors that Predict Smoking Cessation among Older Koreans: Based on the Korea National Health and Nutrition Examination Survey 2016–2018
Han Kyul Lim, Yong Soon Park, Jeong Hyeon Kim, Jeong Hyun Kim
Korean J Fam Med 2021;42(5):363-368.   Published online September 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0203
Background
Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans.
Methods
We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans.
Results
Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70).
Conclusion
Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.

Citations

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  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • 5,482 View
  • 93 Download
  • 1 Web of Science
  • 1 Crossref
Background
This study aimed to evaluate the association between the high risk of cardiovascular disease (CVD) and the consumption of sugar-sweetened beverages (SSBs) in Korean men.
Methods
This cross-sectional study analyzed the data of 3,705 men (age 30–64 years) who participated in the 2014–2016 Korea National Health and Nutrition Examination Survey (KNHANES). SSB intake was defined as the sum of the intakes of carbonated beverages and fruit juices. Participants were categorized into study groups depending on their intake of SSBs: ≤2, 3–4, or ≥5 times per week. High CVD risk was defined as a 10-year risk of more than 10%, based on the Framingham Heart Study 10-year CVD Risk Calculator. The association between high CVD risk and SSB intake was evaluated using a multivariable-adjusted logistic regression model.
Results
Korean men who consumed SSBs 3–4 and ≥5 times a week showed a multivariate-adjusted odds ratio of 1.49 (95% confidence interval [CI], 1.05–2.11) and 1.61 (95% CI, 0.97–2.67) for high CVD risk, respectively, compared with those who consumed SSBs ≤2 times per week. Additionally, the risk of CVD increased with the increase in the intake of SSBs (P-trend=0.01). In subgroup analysis, no association was observed between SSB intake and high CVD risk in the group with regular physical activity (P for interaction=0.01).
Conclusion
In Korean men, except those with regular physical activity, SSB intake ≥3 times a week is associated with a high risk for CVD (10-year CVD risk ≥10%).

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    Markos Makiso Urugo, Banchiywsen Kidane, Samrawit Firew, Wesena Hunde, Senay Demeke Endere, Aelaf Semu, Selam Getachew, Yohannis Yirga
    BMC Public Health.2026;[Epub]     CrossRef
  • Sugar-sweetened beverage consumption and metabolic dysfunction-associated steatotic liver disease: a beverage type-specific analysis using Korea National Health and Nutrition Examination Survey
    Hong Jae Jeon, Woo Sun Rou, Seok Hyun Kim, Byung Seok Lee, Ha Neul Kim, Hei-Gwon Choi, Jaehee Seo, Hyuk Soo Eun, Sukyoung Jung
    Epidemiology and Health.2025; 47: e2025038.     CrossRef
  • Coffee Consumption Patterns According to Health Behavior and Dietary Factors among Young Adults : From the Korea National Health and Nutrition Examination Survey 2021
    Hyun-Ju Jo, Hyun-Kyoung Bang
    Journal of the East Asian Society of Dietary Life.2025; 35(4): 369.     CrossRef
  • The Burden of Cardiovascular Diseases Attributed to Diet High in Sugar-Sweetened Beverages in 204 Countries and Territories From 1990 to 2019
    Donglei Shi, Yujia Tao, Li Wei, Dongqing Yan, Hongsen Liang, Junhang Zhang, Zhaojun Wang
    Current Problems in Cardiology.2024; 49(1): 102043.     CrossRef
  • Factors affecting sugar intake in adults based on the social cognitive theory
    Kilye Kim, Yeon-Kyung Lee
    Journal of Nutrition and Health.2024; 57(1): 120.     CrossRef
  • Association of Urine (pH < 5.5) with Community Periodontal Index (CPI) and the Number of Remaining Teeth in Korean Adults: A Cross-Sectional Study Using Data from Korea National Health and Nutrition Examination Survey 2016–2018
    Su-Yeon Hwang, Jung-Eun Park
    Healthcare.2024; 12(7): 740.     CrossRef
  • Health-Related Behaviors and Perceived Health Status According to Water and Sugar-Sweetened Beverage Intake in Korean Adolescents
    Yoon Sun Kim, Hyun Ja Kim
    Nutrients.2024; 16(17): 3038.     CrossRef
  • A Study on the Relationship between Food Security and the Number of Remaining Teeth in Korean Adults: The Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016–2018
    Su-Yeon Hwang, Jung-Eun Park
    International Journal of Environmental Research and Public Health.2023; 20(4): 2964.     CrossRef
  • A machine learning based decision tree analysis of influential factor for the number of remaining teeth in Korean adults
    Su-Yeon Hwang, Jung-Eun Park
    Journal of Korean Academy of Oral Health.2023; 47(1): 26.     CrossRef
  • High intake of sweet foods and low life satisfaction can act as risk factors for acute coronary syndrome through synergistic interaction
    Jisun So, Kyong-Mee Chung, Jihyeon Seo, Byungmi Kim, Hyejin Chun, Sung Nim Han, Ick-Mo Chung
    Frontiers in Nutrition.2023;[Epub]     CrossRef
  • A study on the relationship between food insecurity and periodontitis in Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES VII) from 2016-2018
    Soo-Jin Kang, Jung-Eun Park, Jong-Hwa Jang
    Journal of Korean Academy of Oral Health.2023; 47(3): 106.     CrossRef
  • Association between Healthy Lifestyle (Diet Quality, Physical Activity, Normal Body Weight) and Periodontal Diseases in Korean Adults
    Su-Yeon Hwang, Jong-Hwa Jang, Jung-Eun Park
    International Journal of Environmental Research and Public Health.2022; 19(7): 3871.     CrossRef
  • Association between Stroke and Abdominal Obesity in the Middle-Aged and Elderly Korean Population: KNHANES Data from 2011–2019
    Jong Yeon Kim, Sung Min Cho, Youngmin Yoo, Taesic Lee, Jong Koo Kim
    International Journal of Environmental Research and Public Health.2022; 19(10): 6140.     CrossRef
  • Association of Sugar-Sweetened Beverages and Cardiovascular Diseases Mortality in a Large Young Cohort of Nearly 300,000 Adults (Age 20–39)
    Chien-Hua Chen, Min-Kuang Tsai, June-Han Lee, Christopher Wen, Chi-Pang Wen
    Nutrients.2022; 14(13): 2720.     CrossRef
  • The Perception of Overweight and Obesity among South African Adults: Implications for Intervention Strategies
    Mashudu Manafe, Paul Kiprono Chelule, Sphiwe Madiba
    International Journal of Environmental Research and Public Health.2022; 19(19): 12335.     CrossRef
  • Current status of nutrient intake in Korea: focused on macronutrients
    Seung-Won Oh
    Journal of the Korean Medical Association.2022; 65(12): 801.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Association between Sugar-Sweetened Beverage Intake and Dietary Quality using Nutritional Quotient among Adults in Daegu, Korea
    Kilye Kim, Yeon-Kyung Lee
    Korean Journal of Community Nutrition.2021; 26(5): 350.     CrossRef
  • 7,683 View
  • 148 Download
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Trajectories of Handgrip Strength and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging
Kyung Hyun Bae, Yong Ho Jo, Dong Ryul Lee, Jungun Lee
Korean J Fam Med 2021;42(1):38-46.   Published online May 27, 2020
DOI: https://doi.org/10.4082/kjfm.19.0140
Background
Handgrip strength (HGS) is a good predictor of adverse health outcomes in later life. This prospective study aimed to investigate whether HGS trajectory patterns were associated with all-cause mortality among older adults in Korea.
Methods
This study used the database of the 2006–2016 Korean Longitudinal Study of Aging. Study participants included 3,069 adults aged ≥65 years without a previous history of cancer. The trajectory model was developed to identify different homogeneous trajectory patterns of HGS according to study period. Cox proportional hazards models were then applied to investigate the association between HGS and all-cause mortality.
Results
The survival probability according to HGS during the follow-up period decreased as base HGS weakened. We identified four distinct trajectory groups of HGS among men and three among women. The risk of mortality increased as the HGS of both males and females decreased. Compared with the highest HGS group, the adjusted hazard ratios for all-cause mortality of the lowest, lower-mid, and upper-mid HGS groups among males were 3.46 (95% confidence interval [CI], 2.17–6.69), 2.26 (95% CI, 1.47–3.48), and 1.58 (95% CI, 1.07–2.32). Those of the low and mid HGS groups among females were 2.69 (95% CI, 1.39–5.21) and 1.97 (95% CI, 1.05–3.69).
Conclusion
The faster HGS declined over time, the greater the all-cause mortality risk increased compared with the slowly decreasing or maintained HGS groups among men and women. HGS measurement among older adults will be helpful in assessing their health statuses and pre-assessing disease-associated morbidity.

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  • Longitudinal trajectories of handgrip strength and their association with motoric cognitive risk syndrome in older adults
    Hui Chang, Yu Zhao
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  • Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people
    Wonjeong Jeong, Jong Youn Moon, Jae-Hyun Kim
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Associations between Living Alone and Smoking and Alcohol Consumption in Korean Adults
Sang-Woo Lee, Byoungduck Han, Sung Jung Cho, Seung Jin Jung, Youn Huh, Junghun Kim, Do Hyun Eum, Taeryoon Kim, Soon-Hong Min, Woohyun Lee, Jinhee Cho, Min Hee Kwon, Ga Eun Nam
Korean J Fam Med 2020;41(5):306-311.   Published online May 26, 2020
DOI: https://doi.org/10.4082/kjfm.18.0148
Background
Recently, single-person households have increased in Korea and this trend may have potential public health implications and affect various health behaviors. This study investigated the associations between living alone and health behaviors such as smoking and alcohol consumption among Korean adults.
Methods
We used data from the 6th Korea National Health and Nutrition Examination Survey between 2013 and 2015 and a total of 17,088 adults were included. We performed a multivariable logistic regression analysis and calculated odds ratios (ORs) with 95% confidence intervals (CIs).
Results
Single-person households accounted for about 10% of the total participants. The proportions of currently smoking and heavy alcohol consumption were higher among individuals living alone than those living together among younger women and middle-aged and elderly men and women. In the multivariable logistic regression analysis, living alone was associated with increased odds of currently smoking compared to living together among middle-aged men and women (OR, 7.37; 95% CI, 2.33–23.32 in men and OR, 2.36; 95% CI, 1.04–5.36 in women) after adjusting for confounding variables.
Conclusion
From this nationwide, population-based study, we found that living alone is associated with increased odds of currently smoking, especially in middle-aged people. Public health concerns may be warranted for middle-aged single-person households to reduce health risks related to smoking.

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    Nan-He Yoon, Dong Ha Kim, Seunghyun Yoo
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  • Community Health Perspectives on Middle-aged Adults Living Alone: A Scoping Review
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    Yu Jiang, Jin-Gang Yang, Hai-Yan Qian, Yue-Jin Yang
    BMC Public Health.2024;[Epub]     CrossRef
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    Masuma Novak, Margda Waern, Lena Johansson, Anna Zettergren, Lina Ryden, Hanna Wetterberg, Therese Rydberg Sterner, Madeleine Mellqvist Fässberg, Pia Gudmundsson, Ingmar Skoog
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    International Journal of Environmental Research and Public Health.2022; 19(8): 4472.     CrossRef
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    Zhaowei Zhu, Zhenyu Peng, Zhenhua Xing
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Repeated Dry Sauna Therapy Improves Quality of Life in Obese Korean People
Hoon Sung Choi, Hyuki Kwon, Keun-Hyok Cho, Le Cong Thuc, So Young Park, Nam-Hun Kim, Wae-Jung Kim, Yun-Ki Kim, Woo-Seok Jeon, Ju-Ah Lee, Hyoung-Chun Kim, Eun-Hee Cho
Korean J Fam Med 2020;41(5):312-317.   Published online May 21, 2020
DOI: https://doi.org/10.4082/kjfm.18.0160
Background
Dry sauna treatments improve the quality of life for chronic pain, congestive heart failure, and type 2 diabetes patients. This study aimed to determine whether dry sauna therapy improved the quality of life of obese people.
Methods
A total of 38 consecutive participants aged over 20 years with a body mass index of ≥25 kg/m2 were recruited for the study. The participants were treated with a 90°C dry sauna for 15 minutes, twice daily for 4 consecutive days. To assess the quality of life, all participants completed the 5 level EQ-5D questionnaires and the EQ-Visual Analog Scale. Study parameters were measured on the same day prior to commencing the sauna sessions in a fasted state and 2 days after the last sauna session.
Results
The average age was 62.3±9.5 years; 84.2% of the participants were female. The mean body mass index was 28.5±2.4 kg/m2. Dry sauna significantly improved the mean 5 level EQ-5D index scores from 0.83±0.12 to 0.89±0.11 and increased the mean EQ-Visual Analog Scale from 79.0±15.2 to 91.1±9.7. However, there were no significant changes in body mass index, blood pressure, heart rate, or body composition before and after the 8-session sauna therapy.
Conclusion
Dry sauna improved the health-related quality of life of obese patients without adverse events. Further clinical studies in larger study populations are needed to verify these findings and provide concrete evidence for obesity treatment.

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  • Clinical Implication of Korean Dry Sauna Therapy
    Teruhiko Imamura
    Korean Journal of Family Medicine.2021; 42(3): 257.     CrossRef
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  • 88 Download
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The Impact of Depression on Cardiovascular Disease: A Nationwide Population-Based Cohort Study in Korean Elderly
Dong Han Park, Jung Jin Cho, Jong Lull Yoon, Mee Young Kim, Young Soo Ju
Korean J Fam Med 2020;41(5):299-305.   Published online May 8, 2020
DOI: https://doi.org/10.4082/kjfm.18.0134
Background
Depression is suggested to be associated with cardiovascular disease, including ischemic heart disease and cerebrovascular disease. This study investigated the impact of depression on cardiovascular disease in the elderly population in Korea.
Methods
This retrospective cohort study was performed using the Senior Cohort database released by the Korean National Health Insurance Services from January 1, 2008 to December 31, 2012, or January 1, 2009 to December 31, 2013. The study group constituted participants newly diagnosed with depression, but not cardiovascular disease. The control group constituted participants with no past history of depression or cardiovascular disease, and were not diagnosed with depression during the follow-up period. During the 5-year follow-up period, development of ischemic heart disease or cerebrovascular disease was assessed. Depression and cardiovascular disease were identified using the International Classification of Diseases, 10th revision, Clinical Modification codes. The data was analyzed using Cox proportional hazards model.
Results
The hazard ratio (HR) between depression and ischemic heart disease was 1.38 (95% confidence interval [CI], 1.23 to 1.55) and the HR between depression and cerebrovascular disease was 1.46 (95% CI, 1.32 to 1.62), after adjusting all confounding variables.
Conclusion
Independent of other cardiovascular risk factors, depression increased the risk of ischemic heart disease by 38% and cerebrovascular disease by 46% among older adults in Korea. Since depression may increase the risk of cardiovascular disease, future research should focus on the diagnosis and prevention of cardiovascular disease in people with depression.

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    Shushu You, Xiang Gu, Jing Sui, Ziyu Xiang, Fan Gao, Noah Hammarlund
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    Namra Aziz, Tanya Tripathi, Anurag Rawat, Uttam Prasad Panigrahy, Darshan Jogi Chandrashekhar, Mukesh Chandra Sharma, Pranay Wal
    Current Cardiology Reviews.2025;[Epub]     CrossRef
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    Frontiers in Pharmacology.2024;[Epub]     CrossRef
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Factors Associated with the Intention to Quit Smoking in Elderly Korean Men: The Korea National Health and Nutrition Examination Survey 2010-2015
Inho Lee, Yong Soon Park, Jeong Hyeon Kim, Seung Hyeok Han
Korean J Fam Med 2020;41(4):237-242.   Published online April 24, 2020
DOI: https://doi.org/10.4082/kjfm.18.0124
Background
Tobacco smoking is the most preventable cause of diseases and death in older adults. This study aimed to evaluate the factors associated with the intention to quit smoking in elderly Korean men.
Methods
We investigated 813 male smokers aged 65 years or more from the 5th and 6th Korea National Health and Nutrition Examination Survey 2010–2015. Multiple logistic regression analysis was performed to identify factors related with smoking cessation intention.
Results
Of the respondents, 26.3% had the intention to quit smoking. After adjustment for confounding factors, the intention to quit smoking was significantly associated with a history of ischemic heart disease (adjusted odds ratio, 1.88; 95% confidence interval, 1.02–3.48).
Conclusion
Identifying the factors related to the intention to quit smoking among older adults can help in developing effective smoking cessation strategies for this section of the population.

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  • Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey
    Minjung Han, Donghee Seo, Yeol Kim, Hong Gwan Seo, Sung-il Cho, Sungkyu Lee, Sujin Lim, Susan C. Kaai, Anne C. K. Quah, Mi Yan, Steve S. Xu, Geoffrey T. Fong
    International Journal of Environmental Research and Public Health.2022; 19(17): 10839.     CrossRef
  • Factors that Predict Smoking Cessation among Older Koreans: Based on the Korea National Health and Nutrition Examination Survey 2016–2018
    Han Kyul Lim, Yong Soon Park, Jeong Hyeon Kim, Jeong Hyun Kim
    Korean Journal of Family Medicine.2021; 42(5): 363.     CrossRef
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  • 99 Download
  • 2 Web of Science
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Association between Smartphone Usage and Mental Health in South Korean Adolescents: The 2017 Korea Youth Risk Behavior Web-Based Survey
Hyunjeong Kim, Min-Kyoung Cho, Hyeonyoung Ko, Jung Eun Yoo, Yun-Mi Song
Korean J Fam Med 2020;41(2):98-104.   Published online March 19, 2020
DOI: https://doi.org/10.4082/kjfm.18.0108
Background
Smartphone usage is indispensably beneficial to people’s everyday lives. However, excessive smartphone usage has been associated with physical and mental health problems. This study aimed to evaluate the association of smartphone usage with depressive symptoms, suicidal thoughts, and suicide attempts in Korean adolescents.
Methods
This cross-sectional study was conducted in 54,603 Korean adolescent participants (26,930 male and 27,673 female) in the Korea Youth Risk Behavior Survey in 2017 who reported their smartphone use. We performed multiple logistic regression analysis to evaluate the association of smartphone use with mental health after adjusting for relevant covariates.
Results
Among the participants, 25.6% of male students and 38.4% of female students reported using their smartphone for at least 30 hours per week. As time duration of smartphone usage increased, the risk of experiencing depressive symptoms, suicidal thoughts, and suicide attempt tended to increase, with odds ratios (95% confidence interval) of 1.18 (1.10–1.26), 1.18 (1.08–1.29), and 1.34 (1.11–1.60), respectively, for high smartphone usage compared with low smartphone usage. These associations remained significant with only slight change in odds ratios after consideration of problems that may be caused by smartphone usage, such as conflicts with family members or peers, or disturbance in school work.
Conclusion
Smartphone overuse was independently associated with an increased risk of mental health problems, which did not seem to be mediated by the problems caused by smartphone usage.

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    Young Gyu Cho
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  • Fatores relacionados à dependência do smartphone em adolescentes de uma região do Nordeste brasileiro
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  • Excessive and Problematic Smartphone Use and Poor Mental Health in Adolescents
    Young Gyu Cho
    Korean Journal of Family Medicine.2020; 41(2): 73.     CrossRef
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Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea
Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
Korean J Fam Med 2020;41(2):119-125.   Published online December 19, 2019
DOI: https://doi.org/10.4082/kjfm.18.0130
Background
This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population.
Methods
Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups.
Results
For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population.
Conclusion
Primary care underserved area residents were underdiagnosed and under-controlled for hypertension and reported poorer subjective health and HRQoL compared to the general population. Primary care is the attributable factor to awareness and control of chronic diseases and subjective health and QoL in communities.

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    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
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Association between Hand Grip Strength and Self-Rated Health in Middle- and Old-Aged Korean Citizens
Sae-Kyun Jang, Jae-Hyun Kim
Korean J Fam Med 2020;41(1):53-60.   Published online December 17, 2019
DOI: https://doi.org/10.4082/kjfm.18.0200
Background
To investigate the relationship between hand grip strength (HGS) and self-rated health in middleand old-aged Korean subjects.
Methods
The data used for this study were derived from the Korean Longitudinal Study of Aging. A total of 9,132 participants were enrolled using the year 2006 as the baseline, with additional data collected throughout the followup period until 2016. Chi-square test and generalized estimating equation regression models were used for data analysis. HGS was measured in a sitting position with the elbow fixed at 90° on both sides using a dynamometer, and calculated using the values measured from both sides. Relative HGS was measured by dividing HGS by the subject’s body mass index. Self-rated health was assessed with the question “How would you rate your current health in general?” and answers were categorized as “excellent,” “moderate,” or “poor.”
Results
HGS was shown to be inversely associated with self-rated health (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.93–0.94; P<0.0001). Patients aged 65 years or older with lower scores were more likely to report poor self-rated health. Similar results were obtained with relative HGS (OR, 0.40; 95% CI, 0.36–0.45; P<0.0001), but standard HGS had better model fitting (quasi-likelihood under independence model criteria=33,890).
Conclusion
HGS may be considered an index for the diagnosis of sarcopenia and may also affect self-rated health, which is a multidimensional indicator of an individual’s health status and can identify patients who may require special attention.

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  • Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp
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  • Mediation of Grip Strength on the Association Between Self-Rated Health and Estimated Cardiovascular Disease Risk
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Association between Serum-Ferritin Levels and Sleep Duration, Stress, Depression, and Suicidal Ideation in Older Koreans: Fifth Korea National Health and Nutrition Examination Survey 2010–2012
Kyung Mi Kim, Hye Rim Hwang, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Sung In Chung
Korean J Fam Med 2019;40(6):380-387.   Published online November 20, 2019
DOI: https://doi.org/10.4082/kjfm.18.0097
Background
Serum-ferritin levels may be associated with psychiatric symptoms among the elderly; however, this association has not been extensively studied. The aim of this study was to evaluate the association between serumferritin levels and mental health issues in older Koreans.
Methods
This cross-sectional study included large-scale national data from the Korea National Health and Nutrition Examination Survey 2010–2012. In total, 1,802 older Koreans (≥65 years old) were included. The assessed psychiatric symptoms included short sleep duration, stress, depressed mood, and suicidal ideation. Any association between serum-ferritin levels and mental health issues according to sex was examined using logistic regression analysis.
Results
The prevalence of short sleep duration, stress, depressed mood, and suicidal ideation was 50.9%, 21.7%, 18.2%, and 22.5%, respectively. In men, suicidal ideation decreased with increased serum-ferritin levels after multivariate adjustment for sociodemographic and lifestyle factors and comorbidities. The odds ratios (OR) and 95% confidence interval (CI) of suicidal ideation by quartiles of serum-ferritin level were 1 (reference), 1.132 (95% CI, 0.569–2.252), 0.453 (95% CI, 0.217–0.945), and 0.608 (95% CI, 0.295–1.253), respectively, (P for trend=0.039). In women, no trend was observed. However, compared to the lowest quartile, short sleep duration (<7 h) and stress perception were significantly decreased in the third quartile, with odds ratios of 0.601 (95% CI, 0.461–0.888), and 0.606 (95% CI, 0.386–0.952), respectively.
Conclusion
Moderate serum-ferritin levels were associated with decreased risk for suicide ideation in men, and were associated with decreased short sleep duration and stress perception in women.

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Prevalence of and Risk Factors for Diseases in Korean Americans and Native Koreans Undergoing Health Checkup
So Young Jo, Hyojin Park, Byoung Kwon Lee, Su Jung Baik, Hyun Ju Lee, Yoo Mi Park
Korean J Fam Med 2019;40(6):388-394.   Published online October 23, 2019
DOI: https://doi.org/10.4082/kjfm.18.0093
Background
Korean Americans constitute the fifth largest subgroup in the Asian American population. Despite their increasing population, research and guidelines regarding their health status assessment and disease screening are lacking. This study aimed to compare the prevalence of diseases in Korean Americans and native Koreans to determine the risk factors and guidelines for disease screening.
Methods
Patients who visited the Gangnam Severance Hospital from February 2010 to May 2015 for a health checkup were enrolled in this study. Baseline characteristics, laboratory data, and the organs (stomach, colon, thyroid, brain, prostate, lung, liver, kidney, pancreas, adrenal gland, and heart) of patients were examined. Data regarding patients’ dietary patterns were also obtained. Overall, 1,514 Korean Americans (group 1) and 1,514 native Koreans (group 2) were enrolled.
Results
The following diseases were more prevalent in group 1 than in group 2: reflux esophagitis (12.9% vs. 10%), gastric ulcer (3.0% vs. 5.5%), colorectal polyp (37.7% vs. 28.7%), hemorrhoids (32.2% vs. 29.9%), and benign prostatic hyperplasia (30.2% vs. 14.3%). Although not statistically significant, coronary artery disease has a high prevalence rate of >20% in both groups. Dietary patterns were not significant between the two groups.
Conclusion
This study showed that the prevalence of several diseases in Korean Americans differed from that observed in native Koreans. Therefore, a foundation for setting up new guidelines for disease screening among Korean Americans is established.

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Review Articles

Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing
Sami Lee, Jong-Sung Kim, Jin-Gyu Jung, Mi-Kyeong Oh, Tae-Heum Chung, Jihan Kim
Korean J Fam Med 2019;40(4):204-211.   Published online July 15, 2019
DOI: https://doi.org/10.4082/kjfm.19.0059
This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.

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Cigarette Smoking in South Korea: A Narrative Review
Rebekah Gunter, Edwin Szeto, Se-Hoon Jeong, Sooyeon (Aly) Suh, Andrew J. Waters
Korean J Fam Med 2020;41(1):3-13.   Published online June 13, 2019
DOI: https://doi.org/10.4082/kjfm.18.0015
Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

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Original Articles
Association of Lung Function with Serum 25-Hydroxyvitamin D Level according to the Presence of Past Pulmonary Tuberculosis in Korean Adults
Min Sung Kim, Chang-Jin Choi, Kyung Min Kwon, Kyung-Soo Kim, Whan-Seok Choi, Yoon Jee Oh
Korean J Fam Med 2019;40(2):93-99.   Published online December 4, 2018
DOI: https://doi.org/10.4082/kjfm.17.0083
Background
Vitamin D deficiency is associated with an increased risk of pulmonary tuberculosis (PTB) infection and the treatment outcome. The aim of this study was to examine the relationship between the serum 25-hydroxyvitamin D (25[OH]D) level and lung function in Korean adults according to whether or not there is a history of PTB.
Methods
The data for subjects aged 19 years or older from the Korea National Health and Nutrition Examination Survey 2008–2012 who underwent spirometry, chest radiography, and serum 25(OH)D level measurement were analyzed.
Results
Evidence of past PTB infection was found in 1,482 (9.6%) of 15,516 subjects. The serum 25(OH)D level was lower in the group with past PTB than in the non-PTB group (P=0.013). Respiratory dysfunction was more common in the past PTB group than in the non-PTB group (restrictive pattern, 14.0% vs. 9.6%; obstructive pattern, 29.6% vs. 8.2%; both P<0.001). After adjusting for age, sex, height, and season, the mean difference in forced expiratory volume in 1 second (FEV1) between the highest and lowest quartiles of 25(OH)D was 100.2 mL (standard error=49.3 mL, P for trend=0.049) in the past PTB group and 34.7 mL (standard error=13.6 mL, P=0.009) in the nonPTB group.
Conclusion
FEV1 tended to increase as the vitamin D quartile increased in both study groups. This relationship was more pronounced in subjects with a history of PTB. A higher serum 25(OH)D level might be beneficial in preserving lung function after PTB infection.

Citations

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  • Post-pulmonary tuberculosis lung function: a systematic review and meta-analysis
    Sharenja Ratnakumar, Sally E Hayward, Emma K Denneny, Lucy P Goldsmith, Rebecca Evans, William Checkley, Delia Goletti, Catherine W M Ong, Mateusz Gotowiec, Junkai Zhu, Jon S Friedland, Joanna C Porter
    The Lancet Global Health.2025; 13(6): e1020.     CrossRef
  • Post-tuberculosis lung impairment: systematic review and meta-analysis of spirometry data from 14 621 people
    Olena Ivanova, Verena Sophia Hoffmann, Christoph Lange, Michael Hoelscher, Andrea Rachow
    European Respiratory Review.2023; 32(168): 220221.     CrossRef
  • Associating the blood vitamin A, C, D and E status with tuberculosis: a systematic review and meta-analysis of observational studies
    Fei Xu, Baolan Ma, Dandan Wang, Jialin Lu, Ke Xiong, Jinyu Wang
    Food & Function.2022; 13(9): 4825.     CrossRef
  • Effectiveness of Maternal Vitamin D Supplementation in Preventing Respiratory Tract Infections in Children
    Soo Young Kim
    Korean Journal of Family Medicine.2022; 43(3): 155.     CrossRef
  • Decreased lung function is associated with vitamin D deficiency in apparently health, middle aged Koreans: the Kangbuk Samsung Health Study
    Jonghoo Lee, Hye Kyeong Park, Min-Jung Kwon, Soo-Youn Ham, Si-Young Lim, Jae-Uk Song
    European Journal of Clinical Nutrition.2021; 75(3): 501.     CrossRef
  • 7,048 View
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  • 5 Web of Science
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Association between Types of Usual Source of Care and User Perception of Overall Health Care Service Quality in Korea
Nak-Jin Sung, Jae-Ho Lee
Korean J Fam Med 2019;40(3):143-150.   Published online November 13, 2018
DOI: https://doi.org/10.4082/kjfm.17.0093
Background
Patients’ perceptions of care tend to correlate with the quality of care provided. Different health care systems and service environments may show different associations between types of usual source of care (USC) and overall service quality assessment. We attempted to analyze this association as a benefit of having a USC.
Methods
This study used the 2012 Korea Health Panel data version 1.1 as representative national household survey data. The total number of subjects aged 18 years or more was 12,708. The number of subjects in the final analysis was 10,665. Multiple logistic regression analysis was used to assess the association between types of USC and overall health care service quality. The main outcome variable was users’ ratings of the quality of health care service.
Results
People having a usual doctor (n=1,796) were more likely to positively assess the quality of health care they received than those not having a USC (n=7,920; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.20–1.60) or with those having only a place as a USC without a usual doctor (n=949; OR, 1.29; 95% CI, 1.05–1.58) after adjustment for demographic characteristics and health-related variables.
Conclusion
People having a usual doctor rated overall health care service quality as high, which might be due to benefits of primary care attributes related to usual doctors. Further studies are needed to elucidate the causal relationship. This finding implies that health policies encouraging people to have a usual doctor are needed in Korea.

Citations

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  • Utilization of usual source of care and health literacy among older adults with hypertension: a retrospective study
    Dahye Hong, Jennifer Ivy Kim, Min Kyung Park, Seolah Yoon, Bada Kang, Michelle Putnam, PhD, MGS, FGSA
    Innovation in Aging.2025;[Epub]     CrossRef
  • Patient perceived service quality profiles of primary health care associated with usual source of care: a latent profile analysis
    Li Zhang, Baokai Wang, Qi Xu
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Fatores determinantes no reconhecimento de uma fonte usual de cuidado por adolescentes brasileiros
    Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
    Ciência & Saúde Coletiva.2024;[Epub]     CrossRef
  • Determinants factors in the recognition of a usual source of care by Brazilian adolescents
    Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
    Ciência & Saúde Coletiva.2024;[Epub]     CrossRef
  • Ações intersetoriais e o reconhecimento de uma fonte de cuidado da atenção primária por adolescentes brasileiros
    Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Leila Denise Alves Ferreira Amorim, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
    Cadernos de Saúde Pública.2024;[Epub]     CrossRef
  • Types of usual sources of care and their association with healthcare outcomes among cancer survivors: a Medical Expenditure Panel Survey (MEPS) study
    Ambrish A. Pandit, Chenghui Li
    Journal of Cancer Survivorship.2023; 17(3): 748.     CrossRef
  • How do perceptions of public health measures affect experience of unmet healthcare needs among older Korean adults during COVID-19 pandemic?
    Jongnam Hwang, Sujin Kim
    Preventive Medicine Reports.2022; 26: 101735.     CrossRef
  • Public Perspectives on Decisions About Emergency Care Seeking for Care Unrelated to COVID-19 During the COVID-19 Pandemic
    Rebecca Gale, Samuel Eberlein, Garth Fuller, Carine Khalil, Christopher V. Almario, Brennan M.R. Spiegel
    JAMA Network Open.2021; 4(8): e2120940.     CrossRef
  • 10,155 View
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  • 7 Web of Science
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The Association between Family Mealtime and Depression in Elderly Koreans
Yunhwa Kang, Soyeon Kang, Kyung Jung Kim, Hyunyoung Ko, Jinyoung Shin, Yun-Mi Song
Korean J Fam Med 2018;39(6):340-346.   Published online October 31, 2018
DOI: https://doi.org/10.4082/kjfm.17.0060
Background
Several studies have revealed the frequency of family mealtimes to be inversely associated with depressive symptoms in adolescents. However, there have been few studies in older populations. This cross-sectional study investigated the association between family mealtime frequency and depressive symptoms in elderly Koreans.
Methods
This study analyzed 4,959 elderly men and women (aged 65 years or older) who participated in the Korea National Health and Nutrition Examination Survey. Self-administered questionnaires were used to assess depressive status, family mealtime frequency, and covariates. Multiple logistic regression analysis was performed to evaluate the association using the eating alone group as a reference.
Results
After adjusting for all covariates, participants who had family meals 3 times a day had fewer depressive symptoms than the eating alone group; adjusted odds ratios (ORs) (95% confidence intervals [CIs]) were 0.72 (0.58– 0.89) for point depressiveness/anxiety and 0.73 (0.56–0.94) for depressiveness lasting for at least 2 weeks. In suicidal ideation, the OR (95% CI) of eating with family twice a day was significant after full adjusting for covariates at 0.67 (0.50–0.88).
Conclusion
Family mealtimes were closely associated with depressive symptoms in elderly Koreans, which suggests that maintaining intrafamilial bonding is important for mental health in an older population.

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Background
Acute alcoholic intoxication patients (AAIP) are a common public health problem. The aim of this study was to perform a comprehensive laboratory analysis for these patients to investigate the co-morbid medical problem.
Methods
We retrospectively reviewed laboratory findings of AAIP who were transferred to the emergency department (ED) from January 2017 to June 2017.
Results
A total of 160 male patients were enrolled. Sixteen patients (16/160, 10.0%) and three patients (3/160, 1.9%) had macrocytic anemia and microcytic anemia, respectively. A total of 33 patients (33/160, 20.6%) showed thrombocytopenia (<150×109 /L). Twelve patients (12/159, 7.5%) showed low serum albumin level (<3.5 g/dL). Three patients (3/160, 1.9%) had chronic kidney disease stages 3–4 based on estimated glomerular filtration rate. Six patients (6/27, 22.2%) had high hemoglobin A1c (HbA1c) level (>7.0%). Positive rates of hepatitis B surface antigen and antiHBs antibody (anti-HBs Ab) were 3.5% (5/141) and 49.0% (68/141), respectively.
Conclusion
Patients with AAIP who were transferred to ED had various laboratory abnormalities (anemia, thrombocytopenia, high HbA1c). They had low positive rate of anti-HBs Ab. This might be a public health problem, suggesting the need of hepatitis B virus vaccination program for AAIP. Our data suggest the need of further nationwide studies.

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  • Efficiency of Flossing Technique Application among Dental Students at Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
    Rakan S Shaheen, Mohammed M Aldosari, Humod A Altuwaijri, Faris T Arnous, Abdullah A Alamro, Rayan A Almarshedi
    Journal of Oral Health and Community Dentistry.2019; 13(3): 63.     CrossRef
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Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study
Sunyoung Park, Doh Kwan Kim, Woojae Myung, Jun Hyun Yoo, Su Jeong Shin, Duk L. Na, Sang Yun Kim, Jae-Hong Lee, Seong Yoon Kim, Seol-Heui Han, Seong Hye Choi, Jinyoung Shin
Korean J Fam Med 2019;40(1):16-21.   Published online October 29, 2018
DOI: https://doi.org/10.4082/kjfm.17.0061
Background
Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data.
Methods
This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiatric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted.
Results
The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P<0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P<0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P<0.001), Clinical Dementia Rating Sum of Box (P<0.001), Global Deterioration Scale score (P<0.001), abnormality of free T4 level (P<0.001), anemia (P<0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers.
Conclusion
Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.

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Factors Associated with Dry Eye Symptoms in Elderly Koreans: the Fifth Korea National Health and Nutrition Examination Survey 2010–2012
Kyong In Kim, Yong Soon Park, Ryoung Hee Kim, Jeong Hyeon Kim
Korean J Fam Med 2019;40(1):22-30.   Published online October 29, 2018
DOI: https://doi.org/10.4082/kjfm.17.0058
Background
Dry eye disease is an aging-related ophthalmic disease that not only affects the daily activities but also causes deterioration in the quality of life. This study aimed to evaluate the factors associated with dry eye symptoms in elderly Koreans.
Methods
We investigated 4,185 subjects (men=1,787 and women=2,398) aged ≥65 years from the fifth Korea National Health and Nutrition Examination Survey 2010−2012. Data were analyzed using multiple logistic regressions to identify the relationships between dry eye symptoms and other factors.
Results
The prevalence of dry eye symptoms was 17.9%. After adjustment for confounding factors, dry eye symptoms were significantly associated with female sex (adjusted odds ratio [aOR], 1.806; 95% confidence interval [CI], 1.410−2.313), a history of cataract (aOR, 1.683; 95% CI, 1.255−2.255), suicidal ideation (aOR, 1.414; 95% CI, 1.070−1.870), hypercholesterolemia (aOR, 1.289; 95% CI, 1.025−1.621), age ≥80 years (aOR, 0.538; 95% CI, 0.337−0.859), and sleep duration ≥9 h/d (aOR, 0.524; 95% CI, 0.330−0.834).
Conclusion
Among elderly Koreans, female sex, a history of cataract, suicidal ideation, and hypercholesterolemia may be the risk factors for dry eye symptoms, whereas sleep duration ≥9 h/d can be a protective factor against dry eye symptoms.

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    Muhammad Ali Tariq, Hamza Amin, Bilal Ahmed, Uzair Ali, Ashar Mohiuddin
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Association between Sleep Duration and Body Composition Measures in Korean Adults: The Korea National Health and Nutrition Examination Survey 2010
Ryoung Hee Kim, Kyong In Kim, Jeong Hyeon Kim, Yong Soon Park
Korean J Fam Med 2018;39(4):219-224.   Published online July 4, 2018
DOI: https://doi.org/10.4082/kjfm.17.0030
Background
The association between sleep duration and body composition measures in Korean adults remains unclear.
Methods
This cross-sectional study included 3,532 subjects aged ≥40 years (1,542 men and 1,990 women) who participated in the 2010 Korea National Health and Nutrition Examination Survey V-1. Self-reported sleep duration and anthropometric data were collected. Appendicular skeletal muscle mass (ASM) was quantified via dual-energy X-ray absorptiometry. Obesity was defined according to the body mass index and waist circumference. Sarcopenia was defined as the muscle mass percentage (ASM/weight) below the lowest quintile computed for the study population. Multivariate logistic regressions with or without adjustment for sociodemographic and lifestyle factors were used to evaluate the association of sleep duration with obesity and sarcopenia for participants who slept ≤5, 6–8, and ≥9 h/d. The results were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results
In women, the association between sleep duration and sarcopenia was stronger for individuals who slept ≥9 h/d than for those who slept 6–8 h/d (unadjusted OR, 1.99; 95% CI, 1.19–3.34; adjusted OR, 1.77; 95% CI, 1.06– 2.96).
Conclusion
Longer sleep duration is associated with a significantly higher incidence of sarcopenia in Korean women aged ≥40 years.

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Association between Physical Activity and Depressive Mood among Korean Adults with Chronic Diseases
Seon-Young Park, Kiheon Lee, Yoo Jin Um, Suekyoung Paek, In Sun Ryou
Korean J Fam Med 2018;39(3):185-190.   Published online May 18, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.3.185
Background
This study aimed to investigate the association between physical activity and depressive mood among Korean adults with chronic diseases.
Methods
This study analyzed the 2014 Korean National Health and Nutrition Examination Survey data. The study was restricted to participants aged ≥20 years who had completed the survey and were not diagnosed as having depression. After exclusion, 4,676 participants were included in the final analysis. Subjects were categorized according to their level of physical activity. Physical activity was assessed using the International Physical Activity Questionnaire. Patients were categorized into two groups according to depressive traits (normal and depressed) based on the 9-item Patient Health Questionnaire scores.
Results
In univariate analysis, significant associations were observed between the level of physical activity and depressive mood in both chronic and healthy groups. Participants with higher levels of physical activity had lower risks of depressive mood than those with lower levels of physical activity, especially patients with chronic diseases (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.31–0.73). Similar trends were observed in multivariate logistic regression analysis (OR, 0.54; 95% CI, 0.34–0.88).
Conclusion
Physical activity significantly decreased the development of depressive mood among Korean adults with chronic diseases compared with their healthy counterparts. Physical activity must be emphasized in patients with chronic diseases.

Citations

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  • Outdoor Exercise for People with Rheumatic Disease–Study Protocol and Baseline Characteristics of the OUTdoor Physical ACtivity Cohort (OUTPAC)
    Jonas R. Ahler, Lars H. Tang, Dorthe V. Poulsen, Søren T. Skou, Pætur M. Holm
    International Journal of Environmental Research and Public Health.2025; 22(1): 92.     CrossRef
  • The Mediating Effect of Physical Activity on the Relationship between Depression and Health-related Quality of Life among Patients with Hypertension and Diabetes in Seoul
    In-Young Yoo
    Journal of The Korean Society of Living Environmental System.2025; 32(2): 179.     CrossRef
  • Benefits and harms of structured outdoor physical activity for people with somatic or mental diseases: A systematic review and meta-analysis
    Jonas R. Ahler, Henriette Busk, Pætur M. Holm, Alessio Bricca, Dorthe V. Poulsen, Søren T. Skou, Lars H. Tang
    Preventive Medicine.2024; 183: 107966.     CrossRef
  • Is COVID-19 induced reductions in the level of physical activity associated with increased depressive symptoms in patients with hypertension?
    Yeong Jun Ju, Woorim Kim, Soon Young Lee
    Journal of Psychosomatic Research.2023; 166: 111160.     CrossRef
  • Gender Difference of the Association between Energy Intake Expenditure Balance and Depression among Korean Adults: A Cross-Sectional Study from the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey
    Eunho Lee, Ha Jin Kim, Jusam Hwang, Minseon Park
    Korean Journal of Family Medicine.2023; 44(6): 319.     CrossRef
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Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea
Young-Soo Song, Seong-Woo Choi
Korean J Fam Med 2018;39(3):161-167.   Published online May 18, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.3.161
Background
The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans.
Methods
Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database.
Results
The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m2) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02–7.89).
Conclusion
The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea.

Citations

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  • Health and Integration of North Korean Refugees in South Korea
    Hye-Seung Wee, Daehwan Kim
    SSRN Electronic Journal.2023;[Epub]     CrossRef
  • Health and Labour Market Outcomes of North Korean Refugees in South Korea
    Hyeseung Wee, Daehwan Kim
    Global Economic Review.2023; 52(4): 251.     CrossRef
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The Association between Smoking Status and Influenza Vaccination Coverage Rate in Korean Adults: Analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey
Jung Keun Park, Soo Lee, Ji Eun Lee, Kyung-Do Han, Ji Hyun Kim, Jin Hee Yoon, Suk Won Park, Yang-Hyun Kim, Kyung-Hwan Cho
Korean J Fam Med 2018;39(2):90-95.   Published online March 22, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.2.90
Background

Globally, smoking is one of the biggest challenges in public health and is a known cause of several important diseases. Influenza is preventable via annual vaccination, which is the most effective and cost-beneficial method of prevention. However, subjects who smoke have some unhealthy behaviours such as alcohol, low physical activity, and low vaccination rate. In this study, we analyzed the relationship between smoking status and factors potentially related to the influenza vaccination coverage rate in the South Korean adult population.

Methods

The study included 13,565 participants aged >19 years, from 2010 to 2012 from the Korea National Health and Nutrition Examination Survey data. Univariate analyses were conducted to examine the association between influenza coverage rate and related factors. Multivariate analysis was obtained after adjusting for variables that were statistically significant.

Results

The overall vaccination rate was 27.3% (n=3,703). Older individuals (P<0.0001), women (P<0.0001), non-smokers (P<0.0001), light alcohol drinkers (P<0.0001), the unemployed (P<0.0001), and subjects with diabetes mellitus (P<0.0001), hypercholesterolemia (P<0.0001), and metabolic syndrome (P<0.0001) had higher influenza vaccination coverage than the others. In multivariate analyses, current smokers and heavy smokers showed lower vaccination rates (odds ratio, 0.734; 95% confidence interval, 0.63–0.854).

Conclusion

In the current study, smokers and individuals with inadequate health-promoting behaviors had lower vaccination rates than the others did.

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  • The Impact of COVID‐19 Vaccine Myths and Conspiracy Theories on Vaccine Hesitancy and Vaccine Refusal in Turkey: Future Implications
    Ayşe Gül Parlak, Gönül Gökçay, Yasemin Karacan
    Public Health Nursing.2025;[Epub]     CrossRef
  • Smoking and serological response to influenza vaccine
    Won Suk Choi, Mary Patricia Nowalk, Krissy Moehling Geffel, Michael Susick, Sean Saul, Chyongchiou Jeng Lin, Ted M. Ross, Richard K. Zimmerman
    Human Vaccines & Immunotherapeutics.2024;[Epub]     CrossRef
  • Determining the intention of receiving the influenza vaccine: a cross-sectional survey among international and domestic college students in the USA
    ChengChing Liu, Angela Chia-Chen Chen, Jiying Ling, Charles Liu, Nagwan Zahry, Ravichandran Ammigan, Loveleen Kaur
    BMJ Open.2024; 14(12): e085377.     CrossRef
  • Factors Associated With Influenza Vaccination During the COVID-19 Pandemic in Older Adults Residing in Brazil
    Bruna Moretti Luchesi, Nathalia de Oliveira Andrade, Mariana Ferreira Carrijo, Humberta Correia Silva Azambuja, Tatiana Carvalho Reis Martins, Rosimeire Aparecida Manoel Seixas
    Journal of Gerontological Nursing.2023; 49(5): 31.     CrossRef
  • Influenza Vaccination Uptake and Associated Factors Among Adults With and Without Human Immunodeficiency Virus in a Large, Integrated Healthcare System
    Brandon M Imp, Tory Levine, Derek D Satre, Jacek Skarbinski, Mitchell N Luu, Stacy A Sterling, Michael J Silverberg
    Clinical Infectious Diseases.2023; 77(1): 56.     CrossRef
  • Understanding Factors Contributing to Vaccine Hesitancy in a Large Metropolitan Area
    Paolo Montuori, Immanuela Gentile, Claudio Fiorilla, Michele Sorrentino, Benedetto Schiavone, Valerio Fattore, Fabio Coscetta, Alessandra Riccardi, Antonio Villani, Ugo Trama, Francesca Pennino, Maria Triassi, Antonio Nardone
    Vaccines.2023; 11(10): 1558.     CrossRef
  • Secular trends and determinants of influenza vaccination uptake among patients with cardiovascular disease in Korea: Analysis using a nationwide database
    Min Kim, Bumhee Yang, Seonhye Gu, Eung-Gook Kim, So Rae Kim, Kyeong Seok Oh, Woong-Su Yoon, Dae-Hwan Bae, Ju Hee Lee, Sang Min Kim, Woong Gil Choi, Jang-Whan Bae, Kyung-Kuk Hwang, Dong-Woon Kim, Myeong-Chan Cho, Hyun Lee, Dae-In Lee
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Factors Associated with Annual Influenza Vaccination Uptake in U.S. Older Adults from 2019 to 2020
    Margaret Anne Lovier, Roger Wong
    Journal of Ageing and Longevity.2022; 2(4): 340.     CrossRef
  • An Assessment on Impact of COVID-19 Infection in a Gender Specific Manner
    Himanshu Agrawal, Neeladrisingha Das, Sandip Nathani, Sarama Saha, Surendra Saini, Sham S. Kakar, Partha Roy
    Stem Cell Reviews and Reports.2021; 17(1): 94.     CrossRef
  • Smoking increases the risk of infectious diseases: A narrative review
    Chen Jiang, Qiong Chen, Mingxuan Xie
    Tobacco Induced Diseases.2020;[Epub]     CrossRef
  • Health Behavior, Health Service Use, and Health Related Quality of Life of Adult Women in One-person and Multi-person Households
    Hyun Ju Chae, MiJong Kim
    Korean Journal of Women Health Nursing.2019; 25(3): 299.     CrossRef
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Association of Fasting Glucose Level with Neutrophil-Lymphocyte Ratio Compared to Leukocyte Count and Serum C-Reactive Protein
Jin-Kyu Kim, Ah-Young Lee, Jee-Hyun Kang, Byung-Yeon Yu, Seong-Ju Kim
Korean J Fam Med 2018;39(1):42-50.   Published online January 23, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.1.42
Background

The neutrophil-lymphocyte ratio (NLR) is often used as an inflammatory marker in chronic diseases such as cancer or cardiovascular diseases. However, there are few studies about the association between the NLR and diabetes mellitus (DM) or impaired fasting glucose (IFG) patients in Korea. This study investigated the association between the fasting plasma glucose (FPG) level and NLR in Koreans.

Methods

This cross-sectional retrospective study included 3,219 healthy subjects who visited Konyang University Hospital in South Korea for regular health examinations. Participants with a history of insulin administration, anti-diabetic drugs, anti-inflammatory drugs, or underlying diseases related to inflammation were excluded.

Results

All statistical evaluation was performed by dividing participants into males and females. Based on FPG levels, the subjects were classified into three groups, with normal fasting glucose (n=1,969), IFG (n=1,138), and DM (n=122). The NLR had no significant mean differences among these groups for both sexes. Multiple linear regression analysis between FPG level and NLR showed an independent and significantly negative association (β±standard error, −0.67±0.24; P=0.006) in normal subjects after adjustment. Log(serum C-reactive protein [S-CRP]) showed an independently and significantly positive association with FPG in male IFG/DM patients. Total leukocyte (white blood cell [WBC]) showed an independently and significantly positive association with FPG in female IFG/DM patients.

Conclusion

In normal subjects, NLR shows an independently and significantly negative association with FPG. In IFG/DM patients, NLR was not significantly related to FPG. WBC count in female patients and S-CRP level in male patients were significantly positively associated with FPG only in IFG/DM.

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  • The association of Neutrophil-to-Lymphocyte ratio with metabolic syndrome in U.S. Adults: Findings from the 1999–2018 National Health and Nutrition Examination survey
    Zahra Sarrafan-Chaharsoughi, Ninet Sinaii, Andrew P Demidowich, Jack A Yanovski
    Journal of Clinical & Translational Endocrinology.2025; 39: 100382.     CrossRef
  • Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications
    Mircea Cătălin Coșarcă, Raluca Maria Tilinca, Nicolae Alexandru Lazăr, Suzana Vasilica Șincaru, Bogdan Corneliu Bandici, Cosmin Carașca, Ráduly Gergő, Adrian Vasile Mureșan, Mariana Cornelia Tilinca
    Medicina.2025; 61(5): 898.     CrossRef
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    Murat Arı, Hakan Cengiz, Ayça Tuzcu
    Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi.2025; 12(2): 135.     CrossRef
  • Follow-up study to explore the relationship between Neutrophil to lymphocyte ratio and impaired fasting glucose—using the group-based trajectory modeling
    Xuekui Liu, Gangshan Peng, Ran Liu, Xiu Zang, Caiyan Zou, Haojie Sun, Qian Zhu, Houfa Geng, Jun Liang
    Scientific Reports.2024;[Epub]     CrossRef
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    Xiu Zang, Xiangyu Meng, Xuekui Liu, Houfa Geng, Jun Liang
    Preventive Medicine Reports.2023; 36: 102441.     CrossRef
  • Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein levels and metabolic status in patients with a bipolar disorder
    Monica Sanchez-Autet, Belén Arranz, Pilar Sierra, Gemma Safont, Ana Garcia-Blanco, Lorena de la Fuente, Marina Garriga, Lorena Marín, Maria Paz García-Portilla
    The World Journal of Biological Psychiatry.2022; 23(6): 464.     CrossRef
  • Dietary patterns in association with the risk of elevated blood pressure, lipid profile and fasting plasma glucose among adults in Jiangsu Province of China
    Yuan-Yuan Wang, Jing-Xian Zhang, Ting Tian, Min-Yue Gao, Qian-Rang Zhu, Wei Xie, Ling-Meng Fu, Shao-Kang Wang, Yue Dai
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(1): 69.     CrossRef
  • Postoperative Fasting Blood Glucose Predicts Prognosis in Stage I-III Colorectal Cancer Patients Undergoing Resection
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  • Investigation of Neutrophil Lymphocyte Ratio and Blood Glucose Regulation in Patients with Type 2 Diabetes Mellitus
    Jithendra Chaitanya Gubbala, Thanuj Reddy K. V., Prabhakar K.
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Relationship between Coffee Consumption and Metabolic Syndrome in Korean Adults: Data from the 2013–2014 Korea National Health and Nutrition Examination Survey
Hyekyung Shin, John A. Linton, Yujin Kwon, Yohan Jung, Bitna Oh, Sinae Oh
Korean J Fam Med 2017;38(6):346-351.   Published online November 14, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.6.346
Background

The gradually increasing demand for coffee worldwide has prompted increased interest in the relationship between coffee and health issues as well as a need for research on metabolic syndrome in adults.

Methods

Data from 3,321 subjects (1,268 men and 2,053 women) enrolled in the 2013–2014 Korean National Health and Nutrition Examination Survey were analyzed. The subjects were divided into three groups according to their daily coffee consumption. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome in the coffee-drinking groups were calculated using multiple logistic regression analysis by adjusting for confounding variables.

Results

The prevalence of metabolic syndrome was 15.5%, 10.7%, and 9.7% in men and 3.0%, 7.1%, and 6.5% in women according to their coffee consumption (less than one, one or two, or more than three cups of coffee per day), respectively. Compared with the non-coffee consumption group, the ORs (95% CIs) for metabolic syndrome in the group that consumed more than three cups of coffee was 0.638 (0.328–1.244) for men and 1.344 (0.627–2.881) for women after adjusting for age, body mass index, household income, education, smoking, alcohol, regular exercise, and daily caloric intake.

Conclusion

The OR of metabolic syndrome was not statistically significant in both men and women.

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  • Association Between Coffee Consumption and Metabolic Syndrome Components Among Saudi Adults
    Wala I. Alzahrani, Sarah N. Alsharif, Maryam S. Hafiz, Doaa A. Alyoubi, Amal M. Alrizqi, Raneem A. Younes, Alaa M. Jahlan, Khaled A. Yaghmour
    Metabolites.2025; 15(3): 163.     CrossRef
  • Association between coffee consumption and metabolic syndrome in Korean adults
    Sooyeun Choi, Youjin Je
    European Journal of Clinical Nutrition.2024; 78(10): 905.     CrossRef
  • Coffee Consumption, General Obesity and Abdominal Obesity in Adults: A Systematic Review and Meta-Analysis of Cross-Sectional Studies
    Mohammad Nemati, Sanaz Soltani, Fatemeh Almasi, Asma Salari-Moghaddam, Bagher Larijani, Armin Ebrahimzadeh, Alireza Milajerdi, Ahmad Esmaillzadeh
    Advanced Biomedical Research.2024;[Epub]     CrossRef
  • The Relationship between Habitual Coffee Drinking and the Prevalence of Metabolic Syndrome in Taiwanese Adults: Evidence from the Taiwan Biobank Database
    Meng-Ying Lu, Hsiao-Yang Cheng, Jerry Cheng-Yen Lai, Shaw-Ji Chen
    Nutrients.2022; 14(9): 1867.     CrossRef
  • Association of Coffee Consumption and Its Types According to Addition of Sugar and Creamer with Metabolic Syndrome Incidence in a Korean Population from the Health Examinees (HEXA) Study
    Li-Juan Tan, Hye Joo Jeon, SoHyun Park, Seong-Ah Kim, Kyungjoon Lim, Sangwon Chung, Pahn-Shick Chang, Jong-koo Lee, Daehee Kang, Sangah Shin
    Nutrients.2021; 13(3): 920.     CrossRef
  • Beverages and Non-alcoholic fatty liver disease (NAFLD): Think before you drink
    Jyoti Chhimwal, Vikram Patial, Yogendra Padwad
    Clinical Nutrition.2021; 40(5): 2508.     CrossRef
  • The Association Between Coffee Consumption and Nonalcoholic Fatty Liver Disease in the South Korean General Population
    Li‐Juan Tan, Hyein Jung, Seong‐Ah Kim, Sangah Shin
    Molecular Nutrition & Food Research.2021;[Epub]     CrossRef
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    Jung-Sug Lee, Hyoung-Seop Park, Sanghoon Han, Gegen Tana, Moon-Jeong Chang
    Journal of Nutrition and Health.2019; 52(2): 227.     CrossRef
  • Coffee Intake and Obesity: A Meta-Analysis
    Ariel Lee, Woobin Lim, Seoyeon Kim, Hayeong Khil, Eugene Cheon, Soobin An, SungEun Hong, Dong Hoon Lee, Seok-Seong Kang, Hannah Oh, NaNa Keum, Chung-Cheng Hsieh
    Nutrients.2019; 11(6): 1274.     CrossRef
  • Association with obesity and abdominal obesity according to the kind and amount of coffee intake in Korean adults: 2013 ~ 2016 Korea National Health and Nutrition Examination Survey
    Hyoung-seop Park, Jung-Sug Lee
    Journal of Nutrition and Health.2019; 52(4): 369.     CrossRef
  • Moderate coffee consumption is inversely associated with the metabolic syndrome in the Korean adult population
    Youngyo Kim, Youjin Je
    British Journal of Nutrition.2018; 120(11): 1279.     CrossRef
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The Effect of Having a Regular Doctor as a Primary Care Provider on Emergency Room Utilization in South Korea
Su-Young Lee, Hyeong-Seok Lim
Korean J Fam Med 2017;38(6):322-326.   Published online November 14, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.6.322
Background

Because primary care is the cornerstone of an effective health care system, many developed countries have striven to establish and strengthen their primary care systems. However, the primary care system in South Korea is not well established, and primary care research is still in its infancy. This study aimed to show the benefits of regular doctors as primary care providers in South Korea by analyzing the effect of regular doctor visits on emergency room (ER) visits.

Methods

We analyzed cross-sectional data on 11,293 adults aged 18 years and over collected from the 2013 Korea Health Panel Survey (beta version 1.0). We classified those participants with and without regular doctors into the treatment and control groups, respectively, and estimated the average treatment effect (ATE) of having a regular doctor on ER visits. We used counterfactual framework and propensity score analysis to adjust for unevenly distributed confounding covariates between treatments and control groups.

Results

The estimated conditional ATE of a regular doctor on ER visits was statistically insignificant in the general population (-0.4%; 95% confidence interval [CI], -2.0 to 1.2) and in the subgroup of patients with hypertension (-1.8%; 95% CI, -4.5 to 0.9). However, in patients with diabetes mellitus (DM), the estimated ATE was statistically significant (-5.0; 95% CI, -9.2 to -0.7).

Conclusion

In the total study population, having a regular doctor did not result in a significant difference in ER visits. However, there was a decrease in ER visits in patients with DM in South Korea.

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    Safa Elkefi, Avishek Choudhury
    Journal of Cancer Education.2025; 40(5): 752.     CrossRef
  • Prevalence and Associated Factors of Having a Family Physician or Regular Doctor among Community-Dwelling Adults in South Korea: A Cross-Sectional Study
    Yookyeong Sim, Su-Min Jeong, Hee-Kyung Joh
    Korean Journal of Family Practice.2024; 14(1): 40.     CrossRef
  • The impact of primary health care reform on hospital emergency department overcrowding: Evidence from the Portuguese reform
    Alvaro Almeida, Joana Vales
    The International Journal of Health Planning and Management.2020; 35(1): 368.     CrossRef
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Seasonal Variations and Correlations between Vitamin D and Total Testosterone Levels
Moo-Yeol Sim, Soo-Hyun Kim, Kwang-Min Kim
Korean J Fam Med 2017;38(5):270-275.   Published online September 22, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.5.270
Background

Some studies have provided evidence for a possible association between vitamin D and testosterone levels; however, the evidence from studies in Koreans is inconsistent. In addition, insufficient evidence is available to support an association between seasonal variations in vitamin D and testosterone levels in Koreans. Therefore, we aimed to investigate the association between vitamin D and testosterone levels, and between seasonal variations in these levels in Korean men.

Methods

This cross-sectional study included 1,559 men, aged 25–86 years, who underwent a medical examination. We measured serum 25-hydroxyvitamin D (25[OH]D) and total testosterone levels, and compared other laboratory test results and patient lifestyle characteristics. On the basis of sample collection time, we categorized patients into four seasons, and analyzed seasonal variability in 25(OH)D and total testosterone levels.

Results

The average participant age (±standard deviation) was 53.3±8.8 years, and the average serum 25(OH)D and total testosterone levels were 15.9±7.0 ng/mL and 5.1±1.6 ng/mL, respectively. In the analysis of variance (ANOVA) model, no significant association was found between 25(OH)D and testosterone levels (P=0.51). ANOVA of the average 25(OH)D levels in season-based groups revealed significant seasonal variations in 25(OH)D levels (P-value for trend <0.001). No significant association was found between seasonal variations in total testosterone levels (P=0.06). However, after adjustment for confounding variables, total testosterone and 25(OH)D showed significant seasonal variability (P=0.007 and P<0.001, respectively).

Conclusion

We found no significant correlation between serum 25(OH)D and total testosterone levels in Korean men. Moreover, serum 25(OH)D and total testosterone levels showed significant seasonal variations.

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    Radvilė Matukaitienė, Augustė Pikelytė, Birutė Žilaitienė, Robertas Lažauskas, Rasa Verkauskienė, Jonas Čeponis
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    Neetha R Monson, Nimra Klair, Utkarsh Patel, Ayushi Saxena, Dhara Patel, Ismat E Ayesha, Tuheen Sankar Nath
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    T. Yoon, S. S. Ahn, J. Y. Pyo, J. J. Song, Y.-B. Park, S.-W. Lee
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