Epidemiology and Health

Original articles

Association between the safety climate and occupational injury in the Korean working population: a cross-sectional study: Jeehee Min, Tae-Won Jang, Hye-Eun Lee, Mo-Yeol Kang, Seong-Sik Cho; Epidemiol Health. 2024;e2024082. Published online October 1, 2024; DOI: https://doi.org/10.4178/epih.e2024082 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Preventing occupational injuries remains a significant challenge in Korea. A positive safety climate can contribute to reducing workplace injuries. However, the impact of safety climate on preventing occupational injuries among the Korean workforce has not been adequately explored. Therefore, this study aimed to investigate the relationship between the perceived safety climate and occupational injuries within the Korean working population.
METHODS
This study used baseline data from the Korean Work, Sleep, and Health Study (KWSH). The safety climate was measured using the brief version of the Nordic Safety Climate Questionnaire. Occupational injury was determined by whether injuries or accidents had occurred at workplaces in the past year. Logistic regression analysis was performed to examine the association between the safety climate and occupational injury.
RESULTS
Participants who reported an unfavorable workplace safety climate were more likely to experience occupational injuries. Multiple logistic regression analysis revealed that the adjusted odds ratio (OR) for occupational injuries in an unfavorable safety climate was 2.20 (95% confidence interval [CI], 1.38–3.51) compared to a favorable safety climate. Specifically, factors such as “not encouraging employees to follow safety rules when on a tight schedule” (OR, 2.02; 95% CI, 1.25–3.24) and “not helping each other work safely” (OR, 1.98; 95% CI, 1.17–3.25) were significantly associated with occupational injuries.
CONCLUSIONS
An unfavorable safety climate was associated with increased occupational injuries among Korean workers. Improving the safety climate in the workplace may reduce occupational injuries in Korea.; Summary

Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul: a multifaceted time series approach: Kiook Baek, Chulyong Park; Epidemiol Health. 2024;e2024081. Published online October 1, 2024; DOI: https://doi.org/10.4178/epih.e2024081 [Accepted]

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Abstract: Abstract
OBJECTIVES
This study investigated the impact of the COVID-19 pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from South Korea's National Health Insurance.
METHODS
We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences.
RESULTS
The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.0% to -3.3%). It also showed a 17% decrease in uncomplicated cases (95% CrI, -22% to -12%) and increases of 13% (95% CrI, 4.9% to 22.0%) in complicated cases and 39% (95% CrI, 27.0% to 53.0%) in the ratio of complicated to uncomplicated appendicitis.
CONCLUSIONS
The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.; Summary

Systematic review

Adverse health effects of climate change and air pollution in people with disabilities: a systematic review: Nakyung Rhim, Seohyun Lee, Kyung-Hwa Choi; Epidemiol Health. 2024;e2024080. Published online September 27, 2024; DOI: https://doi.org/10.4178/epih.e2024080 [Accepted]

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Abstract PDF: Abstract
Global warming and air pollution adversely affect the health of the entire human population, particularly older adults, people with disabilities (PWDs), and children. In this systematic review, we investigated the adverse health effects of climate change and air pollution in PWDs. We conducted a comprehensive literature search of the PubMed database using the terms “disab*,” “air pollution,” and “climate change” on July 4, 2023, and August 8, 2023 and searched the Web of Science (WOS) database on December 28, 2023. We identified 425 and 1169 studies on climate change cited in PubMed and WOS, respectively, as well as 333 studies on air pollution in PubMed and 495 studies on air pollution in WOS. The studies were classified by type of exposure, and full-text screening was conducted to confirm that the population, intervention or exposure, comparator, outcome statement, and inclusion and exclusion criteria were met. The Newcastle-Ottawa Scale was used to assess the quality of the included cohort and case-control studies and for data analysis. In extreme temperatures, PWDs experienced higher rates of injury, heat-related illness, functional impairment, heart disease, mental disorders, and mortality than people who were nondisabled (ND). Exposure to air pollution resulted in higher rates of obesity, cardiovascular disease, poststroke neurological and functional disability, and mortality in PWDs than in people who were ND. Therefore, because PWDs were more affected by climate change and air pollution than people who were ND, sensitive policies and preparedness measures should be developed for PWDs.; Summary

Original articles

The role of supervisor support in the association between night work and depressive symptoms: a gender-stratified analysis of 22,422 full-time wage workers in South Korea: Hee Won Kim, Ji-Hwan Kim, Garin Lee, Hye-Lin Lee, Hayoung Lee, Seung-Sup Kim; Epidemiol Health. 2024;e2024079. Published online September 25, 2024; DOI: https://doi.org/10.4178/epih.e2024079 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
This study investigated the relationship between night work, supervisor support, and depressive symptoms among full-time wage workers, with a focus on gender differences.
METHODS
A nationwide sample of 22,422 full-time wage workers from the Sixth Korean Working Conditions Survey (2020-2021) was analyzed. Experiences of night work were categorized into 5 groups based on the number of night work days per month: 0, 1-5, 6-10, 11-15, and 16-31. Depressive symptoms were evaluated using the 5-item World Health Organization Well-Being Index. Supervisor support was assessed with 5 items.
RESULTS
Workers who engaged in 1-5 days (prevalence ratio [PR], 1.23; 95% CI, 1.12-1.36) and 6-10 days (PR, 1.17; 95% CI, 1.06-1.30) of night work per month exhibited a higher prevalence of depressive symptoms than those without night work. After stratifying by supervisor support levels, workers with 1-5, 6-10 and 11-15 days of night work per month were more likely to experience depressive symptoms compared to those without night work in the low supervisor support group. In contrast, no association was found between night work (≥ 6 days) and depressive symptoms in the high supervisor support group. Furthermore, gender differences were notable: female workers with 6-10 days (PR, 1.45; 95% CI, 1.23-1.70), and 11-15 days (PR, 1.43; 95% CI, 1.08-1.90) of night work per month exhibited a higher prevalence of depressive symptoms, whereas their male counterparts did not. This pattern of gender difference was also found among those with low supervisor support.
CONCLUSIONS
Supervisor support may mitigate the adverse effects of night work on depressive symptoms among full-time wage workers, with differences manifested across genders.; Summary

Temporal trends in the prevalence, incidence, and mortality of cardiac amyloidosis in South Korea over 12 years: You-Jung Choi, Yun Jin Choi, Ji Eun Lee, Jah Yeon Choi, Geum Joon Cho, Jin Oh Na; Epidemiol Health. 2024;e2024078. Published online September 15, 2024; DOI: https://doi.org/10.4178/epih.e2024078 [Accepted]

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Abstract PDF: Abstract
Objectives
This study investigated the prevalence, incidence, and prognosis of cardiac amyloidosis (CA) in South Korea.
Methods
This retrospective nationwide population-based study used the Health Insurance Review and Assessment Service databases between 2008 and 2020. All patients diagnosed with amyloidosis were included, and those with a diagnosis of heart failure or cardiomyopathy were classified as having CA. Both the special code for amyloidosis (V121), which enables coverage of medical expenses, and the corresponding International Classification of Diseases, 10th Revision codes for amyloidosis (E850–E854, E858, E859) were used to improve the reliability of amyloidosis diagnosis.
Results
Among 2,239 patients with amyloidosis, 758 met the criteria for CA (mean age, 64.4±11.9 years; 59.1% male). The mean age of patients with CA increased from 59.5±14.7 years in 2009 to 68.1±13.9 years in 2020. The incidence and prevalence increased from 0.09 (95% confidence interval [CI], 0.06–0.12) to 0.22 (95% CI, 0.18–0.27) per 100,000 person-years and 0.20 (95% CI, 0.16–0.25) to 1.30 (95% CI, 0.12–0.42) per 100,000 persons, respectively (all p<0.001). Patients with light-chain CA showed similar trends. In-hospital mortality decreased from 17.3% (95% CI, 9.23%–29.6%) to 6.1% (95% CI, 4.21%–8.48%) between 2009 and 2020. While age-specific in-hospital mortality was significantly higher in patients aged ≥70 years (p=0.004), no significant age-specific difference in in-hospital mortality was observed in patients with CA aged <70 years (p=0.981).
Conclusions
The prevalence and incidence of CA have increased in South Korea, predominantly affecting older individuals, particularly males. Notably, in-hospital mortality decreased significantly.; Summary

The associations of cardiovascular and lifestyle factors with mortality from chronic kidney disease as the underlying cause: the JACC study: Shuai Guo, Tomoko Sankai, Kazumasa Yamagishi, Tomomi Kihara, Akiko Tamakoshi, Hiroyasu Iso; Epidemiol Health. 2024;e2024077. Published online September 13, 2024; DOI: https://doi.org/10.4178/epih.e2024077 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
This study investigated conventional cardiovascular and lifestyle risk factors affecting mortality from chronic kidney disease as the underlying cause in the general Japanese population.
METHODS
We conducted an 18.8-year follow-up study of 44,792 men and 61,522 women aged 40-79 from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk between 1986 and 1990. Cox proportional hazard models were used to analyze the association between risk factors and mortality from chronic kidney disease.
RESULTS
During the follow-up period, 373 participants (185 men and 188 women) died from chronic kidney disease. A body mass index of ≥27 kg/m2 (hazard ratio [95% confidence interval] = 2.00 [1.19-3.36] for men and 1.91 [1.19-3.07] for women, compared with 23.0-24.9 kg/m2), a history of hypertension (2.32 [1.67-3.22] for men and 2.01 [1.44-2.81] for women) and a history of diabetes mellitus (5.21 [3.68-7.37] for men and 7.10 [4.93-10.24] for women) were associated with an increased risk of mortality from chronic kidney disease in both sexes. In men, smoking was also associated with an increased risk (1.91 [1.25-2.90]), while current drinking (0.58 [0.34-0.98] for <23 g/day, 0.48 [0.29-0.80] for 23-45 g/day and 0.53 [0.32-0.86] for ≥46 g/day) and exercising ≥5 hours/week (0.42 [0.18-0.96]) were associated with a lower risk. Similar but non-significant associations for smoking and drinking were observed in women.
CONCLUSIONS
In addition to a history of hypertension and a history of diabetes mellitus, body mass index, smoking status, drinking status, and exercise habits were associated with the risk of mortality from chronic kidney disease.; Summary

Homelessness and mortality: gender, age, and housing status inequity in South Korea: Gum-Ryeong Park, Dawoon Jeong, Seung-Won Lee, Hojoon Sohn, Young Ae Kang, Hongjo Choi; Epidemiol Health. 2024;e2024076. Published online September 12, 2024; DOI: https://doi.org/10.4178/epih.e2024076 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis (TB) Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS
The mortality rate among the homeless population was twice as high as that of the general population, at 1159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.702 (95% CI, 1.369-2.115). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.; Summary

Epidemic characteristics of measles and efforts to control measles infections in Zhejiang Province, China: Rui Yan, Mengya Yang, He Hanqing, Feng Yan, Zhou Yang, Tang Xuewen, Deng Xuan, Zhu Yao, Yuxia Du, Can Chen, Cao Kexin, Shigui Yang; Epidemiol Health. 2024;e2024075. Published online September 11, 2024; DOI: https://doi.org/10.4178/epih.e2024075 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies.
METHODS
We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan software (version 9.5) to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort.
RESULTS
The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system.
CONCLUSIONS
The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.; Summary

Contrasting income-based inequalities in incidence and mortality of breast cancer in South Korea, 2006–2015: Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi; Epidemiol Health. 2024;e2024074. Published online September 11, 2024; DOI: https://doi.org/10.4178/epih.e2024074 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Breast cancer incidence and mortality rates in Korea are increasing. This study analyzed income-based inequalities in the incidence and mortality of female breast cancer from 2006 to 2015, using national data that covered all Korean women.
METHODS
We used the National Health Information Database from 2006 to 2015. For women aged 20 and older, the age-standardized incidence and mortality rates of breast cancer per 100,000 by income quintile per year were calculated using the direct method. The rate ratio and rate difference (RD) of the age-standardized incidence and mortality rates of breast cancer per 100,000 between the top and bottom income quintiles were calculated as relative and absolute measures for inequalities.
RESULTS
When comparing 2006 and 2015, both the incidence and mortality rates of breast cancer increased. The lowest income quintile experienced higher mortality rates despite having lower incidence rates. In 2015, the income-based relative difference (RD) in incidence and mortality rates between the highest and lowest income quintiles (Q1-Q5) was -19.9 (95% CI, -24.3 to -15.5) and 4.4 (95% CI, 2.9 to 5.8), respectively. Throughout this period, there was no statistically significant trend in income-based disparities in breast cancer incidence and mortality. The age-specific contributions to the absolute magnitude of inequality (RD) in incidence and mortality were more pronounced among middle-aged women than among older women.
CONCLUSIONS
This study found that breast cancer in Korea exhibited pro-rich inequalities in mortality despite pro-poor inequalities in incidence. More equitable policies for screening and treatment of breast cancer are needed.; Summary

Impact of body mass index and waist-to-hip ratio on mortality in middle-aged Koreans: A prospective cohort study based on a Health Examinees study: Sooyoung Cho, Aesun Shin, Ji-Yeob Choi, Jong-Koo Lee, Daehee Kang; Epidemiol Health. 2024;e2024073. Published online September 2, 2024; DOI: https://doi.org/10.4178/epih.e2024073 [Accepted]

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OBJECTIVES
We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study.
METHODS
We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality.
RESULTS
A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both men and women with BMIs of less than 21 kg/m2 and greater than or equal to 30 kg/m2 are at increased risk. The results showed that men with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted HR: 2.24 [95% CI: 1.73–2.91]) and cardiovascular mortality (2.27 [1.23–4.20]). Similarly, men with a WHR of less than 0.80 (1.38 [1.08–1.77]), 0.90 to less than 0.95 (1.15 [1.02–1.29]), and greater than or equal to 0.95 (1.28 [1.11–1.47]) showed an increased risk of all-cause mortality. In women, a BMI of less than 18 kg/m² was linked to a higher risk of cardiovascular mortality (2.67 [1.13–6.33]).
CONCLUSIONS
Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in men who were slightly overweight with a BMI of 23-25 kg/m2.; Summary

Sex-specific associations among neck circumference, the rs9939609 FTO gene polymorphism, and the 14-year risk of metabolic syndrome: Inkyung Baik; Epidemiol Health. 2024;e2024072. Published online August 23, 2024; DOI: https://doi.org/10.4178/epih.e2024072 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Limited data exist on the relation between neck circumference (NC) and the risk of developing metabolic syndrome (MS). This study investigated sex-specific associations between NC and the 14-year risk of MS and explored the impact of the FTO rs9939609 polymorphism on these associations.
METHODS
This population-based prospective cohort study involved 2,666 participants (1,301 men and 1,365 women), who were free of MS at baseline (2005–2006). Incident MS cases, defined by the presence of 3 or more criteria regarding blood pressure and blood levels of glucose, triglycerides, and high-density lipoprotein cholesterol, were identified through biennial examinations until 2020. NC measurements taken at baseline and between 2013 and 2014 were analyzed using Cox proportional hazard regression to determine sex-specific associations with MS risk.
RESULTS
Controlling for potential confounders such as waist circumference (WC), significant associations were observed in both sexes. Individuals in the highest NC quartile exhibited more than a 2-fold higher MS risk than those in the lowest quartile; with hazard ratios of 2.37 (95% CI, 1.74 to 3.22) for men and 2.65 (95% CI, 1.89 to 3.72) for women (p-value for trend <0.001). No significant interaction was found between the FTO polymorphism and NC. In diagnostic test analyses, NC and WC demonstrated comparable area under the curve values in both sexes.
CONCLUSIONS
The findings suggest that NC is as effective as WC for predicting the incidence of MS.; Summary

Data profile

Data resource profile: the Korean Workers’ Compensation-National Health Insurance Service (KoWorC-NHIS) cohort: Jeehee Min, Eun Mi Kim, Jaiyong Kim, Jungwon Jang, Youngjin Choi, Inah Kim; Epidemiol Health. 2024;e2024071. Published online August 19, 2024; DOI: https://doi.org/10.4178/epih.e2024071 [Accepted]

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The KoWorC-NHIS cohort was established to investigate the longitudinal health outcomes of Korean workers who have been compensated for occupational injuries or diseases. This cohort study, which utilized data spanning from 2004 to 2015, merged workers' compensation insurance claim data with the National Health Insurance Database (NHID), encompassing 858,793 participants. The data included sociodemographic factors such as age, sex, income, address, insurance type, and disability grade. It also covered the types of occupational accidents, International Classification of Diseases, 10th revision codes for diseases or accidents, work tenure, industry, occupation code, and company size. Additional details such as the occupational hire date, date of claim, date of recognition, and affected body parts were recorded. The cohort predominantly consisted of male workers (80%), with the majority experiencing their first occupational accident in their 40s (27.6%) or 50s (25.3%). Notably, 93.1% of the cases were classified as occupational injuries. By integrating this data with that from the NHID, updates on health utilization, employment status, and income changes were made annually. The follow-up period for this study is set to conclude in 2045.; Summary

Original articles

Causal association between serum bilirubin and ischemic stroke: multivariable Mendelian randomization: Jong Won Shin, Keum Ji Jung, Mikyung Ryu, Jungeun Kim, Heejin Kimm, Sun Ha Jee; Epidemiol Health. 2024;e2024070. Published online August 19, 2024; DOI: https://doi.org/10.4178/epih.e2024070 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
Previous research has predominantly focused on total bilirubin levels without clearly distinguishing between direct and indirect bilirubin. In this study, the differences between these forms were examined, and their potential causal relationships with ischemic stroke were investigated.
METHODS
Two-sample multivariable Mendelian randomization (MVMR) analysis was employed, extracting summary data on bilirubin from the Korean Cancer Prevention Study-II (KCPS-II; n=159,844) and the Korean Genome and Epidemiology Study (KoGES; n=72,299). Data on ischemic stroke were obtained from BioBank Japan (BBJ; n=201,800). Colocalization analysis was performed, focusing on the UGT1A1, SLCO1B1, and SLCO1B3 genes, which are the primary loci associated with serum bilirubin levels.
RESULTS
Crude 2-sample Mendelian randomization analysis revealed a significant negative association between total bilirubin levels and ischemic stroke. However, in MVMR analyses, only indirect bilirubin demonstrated a significant negative association with ischemic stroke (odds ratio, 0.76; 95% confidence interval, 0.59 to 0.98). Colocalization analysis did not identify a shared causal variant between the 3 genetic loci related to indirect bilirubin and the risk of ischemic stroke.
CONCLUSIONS
Our study establishes a causal association between higher genetically determined levels of serum indirect bilirubin and reduced risk of ischemic stroke in an Asian population. Future research should include more in-depth analysis of shared genetic variants between indirect bilirubin and ischemic stroke.; Summary

Association of the Korean-specific food-based index of dietary inflammatory potential with the risk of mild cognitive impairment in Korean older adults: Se Yeon Hwang, Chong-Su Kim, Mi Kyung Kim, Yoonkyoung Yang, Yoon Jung Yang; Epidemiol Health. 2024;e2024067. Published online July 25, 2024; DOI: https://doi.org/10.4178/epih.e2024067 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
This study aimed to examine the association between the food-based index of dietary inflammatory potential (FBDI) and the risk of mild cognitive impairment (MCI) in Korean older adults.
METHODS
The subjects were 798 Korean adults aged 60 years and older. The FBDI was calculated based on the intake of 7 anti-inflammatory and 3 inflammatory food groups. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE-KC). A general linear model and multiple logistic regression were applied to assess the association between FBDI and the risk of MCI.
RESULTS
As the FBDI increased, the intake of white rice, cookies/candies, and sweetened drinks tended to increase, but the intake of niacin, β-carotene, calcium, and potassium tended to decrease (p for trend < 0.05). The highest FBDI group had a higher MCI risk (odds ratio [OR], 1.60; 95% CI, 1.01 - 2.52) than the lowest FBDI group, adjusted for sex, age, and education level; and this trend was significant in a fully adjusted model (p for trend = 0.039). No significant associations were found in men after adjusting for confounding factors. Among women, MCI risk increased as the FBDI increased (p for trend = 0.007); and the highest FBDI group had a higher MCI risk (OR, 2.22; 95% CI, 1.04 - 4.74) than the lowest FBDI group in a fully adjusted model.
CONCLUSIONS
These results suggest that the appropriate intake of anti-inflammatory foods and nutrients may be associated with a reduced risk of MCI among older adults.; Summary

Comparative analysis of body mass index and obesity-related anthropometric indices for mortality prediction: a study of the Namwon and Dong-gu cohorts: Ye-Rim Kim, Min-Ho Shin, Young-Hoon Lee, Seong-Woo Choi, Hae-Sung Nam, Jeong-Ho Yang, Sun-Seog Kweon; Epidemiol Health. 2024;e2024066. Published online July 17, 2024; DOI: https://doi.org/10.4178/epih.e2024066 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI).
METHODS
We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell c-index.
RESULTS
Adding anthropometric indices to the basic mortality model (c-index 0.7723; 95% CI, 0.7647-0.7799) significantly increased the predictive power of BMI (c-index 0.7735; 95% CI, 0.7659-0.7811), a body shape index (ABSI, c-index 0.7735; 95% CI, 0.7659-0.7810), weight-adjusted waist index (WWI, c-index 0.7731; 95% CI, 0.7656-0.7807), and waist to hip index (WHI, c-index 0.7733; 95% CI, 0.7657-0.7809). The differences between the BMI model and the other 3 models were not statistically significant.
CONCLUSIONS
In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.; Summary

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Accepted articles