Sleep is exceedingly important for our physical, physiological, psychological, and social health. Currently, few Koreans get the recommended daily amount of sleep. Stress can also have a major impact on our physiological, neurological, and mental health. In this study, we explored the correlation between sleep duration and perceived stress. The study used data from the Community Health Survey (CHS), 2017, which included 133,444 responses from Koreans. Sleeping time and stress were measured by self-diagnosis. The relationship between sleeping time and stress was analyzed using the chi-square test and multivariable regression. Both men and women felt the most stress when they slept for an average of 6 h a day. The results of the subgroup analysis showed that even when they sleep for the same time, younger people felt more stressed than older people. In the group that slept for an average of 6 h a day, women were the most stressed. We observed a correlation between sleeping time and stress in Korean adults. We found that about 16.7% of Koreans were sleeping for less than 5 h. This is less than the 7–9 h of sleep recommended by the National Sleep Foundation (NSF). In addition, stress was found to increase when sleep was insufficient. In particular, it was also observed that young people who slept for less than 8 h felt stressed more easily.
This study aimed to examine the association of smoking exposure at home with attempts to quit smoking and the success or failure of such attempts among South Korean adolescents. We utilized the data of 28,652 South Korean adolescents who smoked from the 2015–2017 Korea Youth Risk Behavior Web-based Survey, including demographic variables (age, sex, and family structure), socioeconomic variables (allowance per week, household income level, and grade), and health-related characteristics (alcohol consumption, intensity of physical activity, stress level, self-reported health status, attendance in smoking cessation programs, and smoking onset). A multiple logistic regression analysis revealed that attempting to quit smoking was less likely among those exposed to smoking at home every day compared to those without such exposure (boys exposed to smoking every day: OR = 0.52, CI = 0.45–0.60; girls exposed to smoking every day: OR = 0.48, CI = 0.38–0.61); cessation success showed similar results (boys exposed to smoking every day: OR = 0.51, CI = 0.46–0.58; girls exposed to smoking every day: OR = 0.56, CI = 0.47–0.66). These findings highlight the impacts of smoking exposure at home and the importance of considering this exposure when supporting adolescents to quit.
Importance: Despite the existing guideline’s recommendation of metformin therapy as the initial approach for managing diabetes mellitus (DM), there remains a scarcity of comprehensive documentation regarding metformin’s impact on outcomes that are important for patients. Objectives: The objective of this study was to assess the potential impact of metformin treatment on the risk of death in individuals diagnosed with both gastric cancer and pre-existing diabetes mellitus (DM); Design, Setting, and Participants: The study made use of a dataset encompassing nationwide health insurance claims, allowing for a retrospective analysis of all patients with a history of gastric cancer diagnosis (classified under International Classification of Diseases 10th Revision code: C16.X) spanning from 1 January 2002 to 31 December 2012. The primary objective was to observe death within a 5-year follow-up period. The study population comprised 63,664 individuals who fell into two categories: those treated with metformin (n = 29,548) and those who did not receive metformin treatment (n = 34,116). This classification was based on the initial treatment allocation following the diagnosis of gastric cancer. Exposures: Metformin treatment, comorbidities, concurrent medication, and procedural information. Outcomes: All-cause death, disease-specific death, cardiovascular death. Results: During the 5-year follow-up period, the metformin treatment group exhibited a lower cumulative incidence of all-cause death (27.5%) in comparison to the group not receiving metformin treatment (32.8%). Furthermore, the relative hazards for all-cause death were significantly reduced in the metformin treatment group (HR: 0.80, 95% CI 0.78–0.82), indicating a lower risk of death when compared to the non-metformin group. In addition, metformin treatment was associated with lower occurrences of disease-specific death (related to gastric cancer) and cardiovascular death when compared to the group not undergoing metformin treatment. Conclusions: The findings demonstrated that the use of metformin was effective at improving prognosis among gastric cancer patients documented with prior DM. In this population-based cohort study, metformin treatment was associated with reduced risk of mortality.
Background: As the world has become a 24 h society, people’s demands have generated various work schedules, leading to an increase in workers’ health problems. The study aimed to investigate the association between nighttime work and HbA1c levels among South Korean adults over the age of 30. Methods: Participants were selected from the 2016–2019 Korea National Health and Nutrition Survey; those diagnosed with diabetes were excluded. The dependent variable was the HbA1c level reported in the KNHANES health examination report. The main independent variable was the participant’s work schedule. Work schedules were classified into three categories based on the participant’s report: (1) day; (2) night and overnight, and (3) other. Generalized multiple linear regression was used, and the significance level was defined as p < 0.05. Results: The participants comprised 4773 men and 4818 women. Those engaged in the “day” schedule served as the reference group. Among the male participants, the “night and overnight” group had significantly larger HbA1c (%) levels than the “day” group (β = 0.061, p = 0.0085). Among these nighttime male workers, HbA1c (%) levels were particularly higher in the people who were physically inactive (β = 0.094, p = 0.0031), slept less than 7 h (β = 0.108, p = 0.0009), and skipped meals (β = 0.064, p = 0.0401). Conclusion: Our results revealed an association of nighttime work with increased HbA1c levels in male participants. High-risk groups for HbA1c levels require careful observation of physical activity, sleeping time, and eating habits.
30 March 2023 in JMIR Public Health and Surveillance
Background: There are regional gaps in the access to medical services for patients with chronic kidney disease (CKD), and it is necessary to reduce those gaps, including the gaps involving medical costs. Objective: This study aimed to analyze regional differences in the medical costs associated with CKD in the South Korean population. Methods: This longitudinal cohort study included participants randomly sampled from the National Health Insurance Service-National Sample Cohort of South Korea. To select those who were newly diagnosed with CKD, we excluded those who were diagnosed in 2002-2003 and 2018-2019. A total of 5903 patients with CKD were finally included. We used a marginalized two-part longitudinal model to assess total medical costs. Results: Our cohort included 4775 (59.9%) men and 3191 (40.1%) women. Of these, 971 (12.2%) and 6995 (87.8%) lived in medically vulnerable and nonvulnerable regions, respectively. The postdiagnosis costs showed a significant difference between the regions (estimate: –0.0152, 95% confidence limit: –0.0171 to –0.0133). The difference in medical expenses between the vulnerable and nonvulnerable regions showed an increase each year after the diagnosis. Conclusions: Patients with CKD living in medically vulnerable regions are likely to have higher postdiagnostic medical expenses compared to those living in regions that are not medically vulnerable. Efforts to improve early diagnosis of CKD are needed. Relevant policies should be drafted to decrease the medical costs of patients with CKD disease living in medically deprived areas.
Objectives: To examine sex differences in the association between food label unawareness and loss of renal function among South Korean diabetic patients aged ≥30 year and determine whether reading food labels when choosing which food products to consume plays a potential role in slowing the progression of renal disease. Methods: Data from the 2016–2017 Korea National Health and Nutrition Examination Survey were used for the analysis. Renal function was determined by the Modification of Diet in Renal Disease estimated glomerular filtration rate, and food label unawareness was defined as being unaware of the food label when choosing a food product for consumption. Multiple regression analysis was used to investigate the association between food label unawareness and loss of renal function among South Korean diabetic patients. Results: Four hundred and eighty-seven diabetic patients (men: 274; women: 213) were enrolled. Loss of renal function was associated with food label unawareness in only male diabetic patients (men: β = –10.01, standard error (SE) = 5.08, p = 0.0506; women: β = –0.30, SE = 5.14, p = 0.9528). A strong association was found between loss of renal function and food label unawareness among socially isolated male diabetic patients who lived in a one-generational household, did not have a spouse, and ate alone. Conclusion: Cultivating habits of reading food labels and inducing social facilitation may play a potential role in managing loss of renal function among male diabetic patients.