Cohort profile: The National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea
TL;DR: A cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker.
Abstract: Purpose The National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea The NHIS constructed the NHIS-HEALS cohort database in 2015 The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker Participants To construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013 This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003 Findings to date The age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 98%, 82%, 356%, 27%, 142% and 20%, respectively The age-standardised mortality rate for the first 2 years (through 2004) was 4420 per 100 000 person-years, while the rate for 10 years (through 2012) was 8659 per 100 000 person-years The most common cause of death was malignant neoplasm in both sexes (3641 per 100 000 person-years for men, 1283 per 100 000 person-years for women) Future plans This database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated The cohort will be maintained and continuously updated by the NHIS
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TL;DR: Seong, Sang Cheol; Kim, Yeon-Yong; Khang, Young-ho; Park, Jong Heon; Kang, Hee-Jin; Lee, Heeyoung; Do, Cheol-Ho; Song, Jong-Sun; Bang, Ji Hyon; Ha, Seongjun;Lee, Eun-Joo; Shin, Soon Ae.
Abstract: Seong, Sang Cheol; Kim, Yeon-Yong; Khang, Young-Ho; Park, Jong Heon; Kang, Hee-Jin; Lee, Heeyoung; Do, Cheol-Ho; Song, Jong-Sun; Bang, Ji Hyon; Ha, Seongjun; Lee, Eun-Joo; Shin, Soon AeOctober, 2016Data resource profile,Articles,[Wentworthville, Australia]International Epidemiological Association,6
742 citations
TL;DR: The change from NAFLD to MAFLD criteria may identify a greater number of individuals with metabolically complicated fatty liver and increased risk for CVD.
195 citations
TL;DR: Individuals with CVD may benefit from physical activity to a greater extent than do healthy subjects without CVD.
Abstract: AIMS Physical activity has been shown to reduce mortality in a dose-response fashion. Current guidelines recommend 500-1000 metabolic equivalent task (MET)-min per week of regular physical activity. This study aimed to compare the impact of leisure-time physical activity on mortality in primary versus secondary cardiovascular prevention. METHODS AND RESULTS This study included a total of 131 558 and 310 240 subjects with and without cardiovascular disease (CVD), respectively, from a population-based cohort. Leisure-time physical activity was measured by self-report questionnaires. The study subjects were followed-up for a median of 5.9 years, and the main study outcome was all-cause mortality. There was an inverse relationship between the physical activity level and the mortality risk in both groups. The benefit in the secondary prevention group was shown to be greater than that in the primary prevention group: every 500 MET-min/week increase in physical activity resulted in a 14% and 7% risk reduction in mortality in the secondary and primary prevention groups, respectively (interaction P < 0.001). In addition, while individuals without CVD benefited the most between 1 and 500 MET-min/week of physical activity, the benefit in those with CVD continued above 500 - 1000 MET-min/week. The adjusted mortality risk of individuals with CVD who performed a high level of physical activity (≥1000 MET-min/week) was shown to be comparable to or lower than that of their counterparts without CVD. CONCLUSION Individuals with CVD may benefit from physical activity to a greater extent than do healthy subjects without CVD.
136 citations
Cites methods from "Cohort profile: The National Health..."
...Details about the cohort have been described previously.(22) Enrolees in the insurance system aged 40 years or older are entitled to undergo a general health screening programme every 2 years....
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TL;DR: The structure of the Korean NHID and the recent researches conducted in the field of cardiovascular science are summarized and the operational definition of covariates and clinical outcomes is important for researchers interested in using the NHID data as new tools to prove their hypothesis.
Abstract: The Korean National Health Information Database (NHID) contains nationwide claims data, including sociodemographic data, health care utilization, health screening data, and healthcare provider information. To compensate for the limitations of randomized clinical trials, real-world observational studies using claims data have emerged as a novel research tool. We summarized the structure of the Korean NHID and the recent researches conducted in the field of cardiovascular science. Epidemiological studies, prescription patterns, temporal trends, comparison of effectiveness and safety of treatments, variability index using laboratory data, and rare intractable disease constitute interesting topics of research in cardiovascular science using the NHID. The operational definition of covariates and clinical outcomes is important for researchers interested in using the NHID data as new tools to prove their hypothesis. A step-by-step approach adopted by a team of data scientists, epidemiologists, statisticians, and clinical researchers may be most effective while designing research studies. The ultimate direction of research using the NHID should aim to improve the welfare of the public by promoting public health, reducing medical costs, and guiding healthcare policies.
123 citations
TL;DR: Oral hygiene care such as frequent tooth brushing and regular dental visits for professional cleaning reduced the risk of future cardiovascular events in healthy adults, and improved oral hygiene behaviour may modify the association between oral health and cardiovascular diseases.
Abstract: Aims Oral health problems such as periodontal disease, dental caries, and tooth loss have been suggested to have associations with cardiovascular disease. This study aimed to evaluate whether oral hygiene behaviour can alleviate cardiovascular risk associated with oral health status using a nationwide population-based cohort. Methods and results The data of 247 696 healthy adults aged 40 years or older who underwent an oral health screening programme and had no history of major cardiovascular events were extracted from the National Health Insurance System-National Health Screening Cohort. After a median follow-up of 9.5 years, 14 893 major cardiovascular events occurred including cardiac death, myocardial infarction, stroke, and heart failure. The risk of cardiovascular events was higher when a subject had periodontal disease, a higher number of dental caries, or more tooth loss. Performing one more tooth brushing a day was associated with a 9% significantly lower risk of cardiovascular events after multivariable adjustment. Regular dental visits (once a year or more) for professional cleaning were also shown to reduce cardiovascular risk by 14%. Improved oral hygiene behaviours were shown to attenuate the cardiovascular risk originating from periodontal disease, dental caries, and tooth loss. Conclusion Oral hygiene care such as frequent tooth brushing and regular dental visits for professional cleaning reduced the risk of future cardiovascular events in healthy adults. This study also suggests that improved oral hygiene behaviour may modify the association between oral health and cardiovascular diseases.
120 citations
References
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01 Jan 2000
TL;DR: The World Health Organization (WHO) adopted a standard based on the average age-structure of those populations to be compared (the world) over the likely period of time that a new standard will be used (some 25-30 years), using the latest UN assessment for 1998 (UN Population Division, 1998) from these estimates, an average world population agestructure was constructed for the period 2000-2025 as discussed by the authors.
Abstract: Summary A recent WHO analysis has revealed the need for a new world standard population (see attached table). This has become particularly pertinent given the rapid and continued declines in age-specific mortality rates among the oldest old, and the increasing availability of epidemiological data for higher age groups. There is clearly no conceptual justification for choosing one standard over another, hence the choice is arbitrary. However, choosing a standard population with higher proportions in the younger age groups tends to weight events at these ages disproportionately. Similarly, choosing an older standard does the opposite. Hence, rather than selecting a standard to match the current age-structure of some population(s), the WHO adopted a standard based on the average age-structure of those populations to be compared (the world) over the likely period of time that a new standard will be used (some 25-30 years), using the latest UN assessment for 1998 (UN Population Division, 1998). From these estimates, an average world population age-structure was constructed for the period 2000-2025. The use of an average world population, as well as a time series of observations, removes the effects of historical events such as wars and famine on population age composition. The terminal age group in the new WHO standard population has been extended out to 100 years and over, rather than the 85 and over as is the current practice. The WHO World Standard population has fewer children and notably more adults aged 70 and above than the world standard. It is also notably younger than the European standard. It is important to note, however, that the age standardized death rates based on the new standard are not comparable to previous estimates that are based on some earlier standard(s). However, to facilitate comparative analyses, WHO will disseminate trend analyses of the “complete” historical mortality data using on the new WHO World Standard Population in future editions of the World Health Statistics Annual.
2,065 citations
"Cohort profile: The National Health..." refers methods in this paper
...The rates were age-standardised using the census population of Statistics Korea in 2005 and the world standard population.(18) The rates that were standardised using the world standard are presented below....
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TL;DR: Cohort Profile: The National Health Insurance Service–National Sample Cohort (NHIS-NSC), South Korea
Abstract: Cohort Profile: The National Health Insurance Service–National Sample Cohort (NHIS-NSC), South Korea Juneyoung Lee, Ji Sung Lee, Sook-Hee Park, Soon Ae Shin and KeeWhan Kim* Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea, Clinical Research Center, Asian Medical Center, Seoul, Korea, Big Data Steering Department, National Health Insurance Service, Seoul, Korea and Department of Applied Statistics, Korea University Sejong Campus, Sejong City, Korea
1,040 citations
TL;DR: In Korea, elevated fasting serum glucose levels and a diagnosis of diabetes are independent risk factors for several major cancers, and the risk tends to increase with an increased level offasting serum glucose.
Abstract: ContextDiabetes is a serious and costly disease that is becoming increasingly
common in many countries. The role of diabetes as a cancer risk factor remains
unclear.ObjectiveTo examine the relationship between fasting serum glucose and diabetes
and risk of all cancers and specific cancers in men and women in Korea.Design, Setting, and ParticipantsTen-year prospective cohort study of 1 298 385 Koreans (829 770
men and 468 615 women) aged 30 to 95 years who received health insurance
from the National Health Insurance Corp and had a biennial medical evaluation
in 1992-1995 (with follow-up for up to 10 years).Main Outcome MeasuresDeath from cancer and registry-documented incident cancer or hospital
admission for cancer.ResultsDuring the 10 years of follow-up, there were 20 566 cancer deaths
in men and 5907 cancer deaths in women. Using Cox proportional hazards models
and controlling for smoking and alcohol use, the stratum with the highest
fasting serum glucose (≥140 mg/dL [≥7.8 mmol/L]) had higher death rates
from all cancers combined (hazard ratio [HR], 1.29; 95% confidence interval
[CI], 1.22-1.37 in men and HR, 1.23; 95% CI, 1.09-1.39 in women) compared
with the stratum with the lowest level (<90 mg/dL [<5.0 mmol/L]). By
cancer site, the association was strongest for pancreatic cancer, comparing
the highest and lowest strata in men (HR, 1.91; 95% CI, 1.52-2.41) and in
women (HR, 2.05; 95% CI, 1.43-2.93). Significant associations were also found
for cancers of the esophagus, liver, and colon/rectum in men and of the liver
and cervix in women, and there were significant trends with glucose level
for cancers of the esophagus, colon/rectum, liver, pancreas, and bile duct
in men and of the liver and pancreas in women. Of the 26 473 total cancer
deaths in men and women, 848 were estimated as attributable to having a fasting
serum glucose level of less than 90 mg/dL. For cancer incidence, the general
patterns reflected those found for mortality. For persons with a diagnosis
of diabetes or a fasting serum glucose level greater than 125 mg/dL (6.9 mmol/L),
risks for cancer incidence and mortality were generally elevated compared
with those without diabetes.ConclusionIn Korea, elevated fasting serum glucose levels and a diagnosis of diabetes
are independent risk factors for several major cancers, and the risk tends
to increase with an increased level of fasting serum glucose.
888 citations
TL;DR: Seong, Sang Cheol; Kim, Yeon-Yong; Khang, Young-ho; Park, Jong Heon; Kang, Hee-Jin; Lee, Heeyoung; Do, Cheol-Ho; Song, Jong-Sun; Bang, Ji Hyon; Ha, Seongjun;Lee, Eun-Joo; Shin, Soon Ae.
Abstract: Seong, Sang Cheol; Kim, Yeon-Yong; Khang, Young-Ho; Park, Jong Heon; Kang, Hee-Jin; Lee, Heeyoung; Do, Cheol-Ho; Song, Jong-Sun; Bang, Ji Hyon; Ha, Seongjun; Lee, Eun-Joo; Shin, Soon AeOctober, 2016Data resource profile,Articles,[Wentworthville, Australia]International Epidemiological Association,6
742 citations
TL;DR: The long-term reduction of acute cardiovascular events associated with high adherence to antihypertensive treatment underscores its importance in assessments of the beneficial effects of evidence-based therapies in the population.
Abstract: Background— Nonadherence to antihypertensive treatment is a common problem in cardiovascular prevention and may influence prognosis. We explored predictors of adherence to antihypertensive treatment and the association of adherence with acute cardiovascular events. Methods and Results— Using data obtained from 400 Italian primary care physicians providing information to the Health Search/Thales Database, we selected 18 806 newly diagnosed hypertensive patients ≥35 years of age during the years 2000 to 2001. Subjects included were newly treated for hypertension and initially free of cardiovascular diseases. Patient adherence was subdivided a priori into 3 categories—high (proportion of days covered, ≥80%), intermediate (proportion of days covered, 40% to 79%), and low (proportion of days covered, ≤40%)—and compared with the long-term occurrence of acute cardiovascular events through the use of multivariable models adjusted for demographic factors, comorbidities, and concomitant drug use. At baseline (ie, 6...
557 citations