Association Between Atopic Dermatitis and Suicidal Behaviors in North Korean Adolescent Defectors From 2011 to 2019.

OBJECTIVE: To evaluate the association between atopic dermatitis (AD) and suicidal behaviors in adolescent defectors among residents who escaped from North Korean (adolescent defectors, n=423) and adolescents with South Korean parents (Korean adolescents, n=540,265). METHODS: The study used data from the Korea Youth Risk Behavior Survey conducted from 2011 to 2019. Differences in general characteristics, health behaviors, suicidal ideation, suicide plans, suicide attempts, and AD between adolescent defectors and Korean adolescents were examined. Multiple logistic regression analysis was used to determine the association between AD and suicidal behaviors. RESULTS: The adolescent defectors group had lower AD (16.3% vs. 24.2%), poorer subjective health (10% vs. 6%), smoked more (47% vs. 18%), drank more (60% vs. 43%), lived with family less frequently (56% vs. 96%), and were more than twice as likely to have depression (42% vs. 27%), suicidal ideation (30% vs. 14%), a suicide plan (23% vs. 5%), or have made a prior suicide attempt (19% vs. 3%) compared with the Korean adolescent group (p<0.001). The adjusted odds ratio for the adolescent defectors group compared to the Korean adolescent group was 1.66 for suicidal ideation, 3.59 for suicide plans, and 4.34 for suicide attempts (p<0.001). AD was found to be associated with suicide plans and attempts in adolescent defectors and associated with suicidal ideation in Korean adolescents. CONCLUSION: AD was significantly associated with suicide plans and suicidal attempts among adolescent defectors and suicidal ideation in Korean adolescents, based on a random sample of middle- and high-school students.

Trends in Incidence and Case Fatality Rates of Heart Disease and Its Subtypes in Korea, 2006-2015.

Heart disease (HD) is the second leading cause of death in Korea. Several studies in Korea have analyzed the trends of incidence and mortality of myocardial infarction (MI) and ischemic heart disease (IHD), but few have investigated incidence and mortality trends of HD and its subtypes. The aim of this study was to assess the national trends in incidence and case fatality rates of overall HD and its subtypes (including IHD, heart failure (HF), arrhythmia, hypertensive HD (HHD), valvular HD, pulmonary HD, and others) in Korea between 2006 and 2015. Using records from the National Health Insurance Service (NHIS) claims database (2003-2015) and by obtaining the causes of death (Korean Statistical Information Service, 2006-2017), we analyzed the crude and age-standardized incidence rates from 2006 to 2015 and the case fatality rates from 2006 to 2017 of HD and its subtypes. Between 2006 and 2015, the incidence of overall HD changed minimally, but the age-standardized incidence of HD decreased from 210.0 persons per 100,000 populations in 2006 to 161.3 persons in 2015. However, incidence rates have increased in arrhythmia, HD other, pulmonary HD, and the case fatality rates have increased in HF, valvular HD, and HD other. Therefore, it is essential to continuously monitor the incidence and case fatality rates of HD and its subtypes and expand the focus onto prevention and treatment strategies from MI or IHD to various HD subtypes. Active prevention and management are needed to alleviate the burden of HD due to an aging population in Korea.

Prevalence and mortality of congenital heart disease in Korean adults.

The aim of this study was to assess the age-standardized prevalence (prevalence) and age-standardized mortality (mortality) of congenital heart disease (CHD) by sex in Korean adults. Data were collected from the National Health Insurance Service in Korea from 2006 through 2016. The data consisted of main and secondary diagnoses related to CHD. We calculated the prevalence and mortality of CHD in adults with the direct method using the estimated Korean population in 2015 as the reference. The prevalence of CHD in Korean adults increased from 35.8 cases per 100,000 persons in 2006 to 65.6 cases in 2015. In 2015, the prevalence in the 20- to 44-year-old group, 45- to 64-year-old group, and the older than 65 years group was 54.6, 69.6, and 95.1 cases, respectively. Among women, the prevalence was 34.3 and 31.3 cases in men. The mortality of CHD in adults decreased from 3.061 persons per 100,000 persons in 2007 to 0.551 persons in 2015. The 5-year survival rate (SR) for people with CHD was 0.92 (95% confidence interval [CI] 0.91-0.93). The 5-year SR for the 20- to 44- and 45- to 64-year-old groups was more than 0.95; however, the 5-year SR of the older than 65 years group was only 0.73 (95% CI 0.72-0.74). The prevalence of CHD in Korean adults increased and the related mortality decreased during a decade. The 5-year SR of CHD for those over 65 years was lower than that for younger age groups.

Prevalence of Amyloidosis in Korea.

BACKGROUND: The aim of this study was to assess in amyloidosis prevalence in Korea between 2006 and 2015. METHODS: Primary diagnoses related to amyloidosis, regardless of subtype, were collected from the Korean National Health Insurance Service from 2006 through 2015. RESULTS: Overall, the age-standardized prevalence of amyloidosis was 0.93 (95% confidence interval (CI) 0.81, 1.04) persons per 100,000 persons in 2006 and 1.91 (95% CI 1.78, 2.05) persons per 100,000 persons in 2015. This included an increase from 0.43 (95% CI 0.35, 0.51) to 1.04 (95% CI 0.94, 1.14) persons per 100,000 persons in men and from 0.49 (95% CI 0.40, 0.57) to 0.87 (95% CI 0.77, 0.96) persons per 100,000 persons in women. In particular, the age-standardized prevalence of amyloidosis showed a greater increase in patients aged 65 years or older and in patients aged 45-64 years than in patients aged 20-44 years, for both men and women. CONCLUSIONS: The overall age-standardized prevalence of amyloidosis was approximately 2 persons per 100,000 persons in 2015. The overall age-standardized prevalence of amyloidosis increased between 2006 and 2015, especially in individuals aged 45-64 and older than 65 years.

The Prevalence of Marfan Syndrome in Korea.

The aim of this study was to assess the prevalence of Marfan syndrome (MFS) in Korean adults. Data were collected from the National Health Insurance Service in Korea from 2006 through 2013. The data consisted of primary diagnoses related to MFS (Q87.4) diagnosed according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems. The age-standardized prevalence of MFS in adults was calculated using the estimated Korean population in 2010 as a reference. Overall, the prevalence of MFS was 0.90 per 100,000 persons in 2006 and 2.27 in 2013. For males in 2013, the prevalence per 100,000 persons was 2.61 in overall and 4.32 in 15-19 years-old. For females in 2013, the prevalence per 100,000 persons was 1.92 in overall and 3.02 in 10-14 years-old. In conclusion, currently, the age-standardized overall prevalence of MFS was 2.27 persons per 100,000 persons. And the overall age-standardized prevalence of MFS increased between 2006 and 2013 especially in 15-19 years-old males and 10-14 years-old females.

Changes in the etiology of valvular heart disease in the rapidly aging Korean population.

BACKGROUND: The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. METHODS: Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. RESULTS: Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65 years or older compared with groups aged 20-44 years or 45-64 years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. CONCLUSIONS: The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65 years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population.

The incidence of stroke by socioeconomic status, age, sex, and stroke subtype: a nationwide study in Korea.

OBJECTIVES: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. METHODS: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. RESULTS: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. CONCLUSIONS: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.