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The dielectric screening from the disordered media surrounding atomically thin transition metal dichalcogenides (TMDs) monolayers modifies the effective defect energy levels and thereby the transport and energy dynamics of excitons. In this work, we study this effect in WSe2 monolayers for different combinations of surrounding dielectric media. Specifically, we study the source of the anomalous diffusion of excitons in the WSe2 monolayer and attribute the anomaly to the modification of the energy distribution of defect states in different disordered dielectric environments. We use this insight to manipulate exciton transport by engineering the dielectric environment using a graphene/hexagonal boron nitride (h-BN) moiré superlattice. Finally, we observe that the effect of dielectric disorder is even more significant at high excitation fluences, contributing to the nonequilibrium phonon drag effect. These results provide an important step toward achieving control over the exciton energy transport for next-generation opto-excitonic devices.
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Grafite , Elementos de Transição , Difusão , Fônons , SemicondutoresRESUMO
Intelligent dynamic spectrum resource management, which is based on vast amounts of sensing data from industrial IoT in the space-time and frequency domains, uses optimization algorithm-based decisions to minimize levels of interference, such as energy consumption, power control, idle channel allocation, time slot allocation, and spectrum handoff. However, these techniques make it difficult to allocate resources quickly and waste valuable solution information that is optimized according to the evolution of spectrum states in the space-time and frequency domains. Therefore, in this paper, we propose the implementation of intelligent dynamic real-time spectrum resource management through the application of data mining and case-based reasoning, which reduces the complexity of existing intelligent dynamic spectrum resource management and enables efficient real-time resource allocation. In this case, data mining and case-based reasoning analyze the activity patterns of incumbent users using vast amounts of sensing data from industrial IoT and enable rapid resource allocation, making use of case DB classified by case. In this study, we confirmed a number of optimization engine operations and spectrum resource management capabilities (spectrum handoff, handoff latency, energy consumption, and link maintenance) to prove the effectiveness of the proposed intelligent dynamic real-time spectrum resource management. These indicators prove that it is possible to minimize the complexity of existing intelligent dynamic spectrum resource management and maintain efficient real-time resource allocation and reliable communication; also, the above findings confirm that our method can achieve a superior performance to that of existing spectrum resource management techniques.
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Edge computing offers a promising paradigm for implementing the industrial Internet of things (IIoT) by offloading intensive computing tasks from resource constrained machine type devices to powerful edge servers. However, efficient spectrum resource management is required to meet the quality of service requirements of various applications, taking into account the limited spectrum resources, batteries, and the characteristics of available spectrum fluctuations. Therefore, this study proposes intelligent dynamic spectrum resource management consisting of learning engines that select optimal backup channels based on history data, reasoning engines that infer idle channels based on backup channel lists, and transmission parameter optimization engines based genetic algorithm using interference analysis in time, space and frequency domains. The performance of the proposed intelligent dynamic spectrum resource management was evaluated in terms of the spectrum efficiency, number of spectrum handoff, latency, energy consumption, and link maintenance probability according to the backup channel selection technique and the number of IoT devices and the use of transmission parameters optimized for each traffic environment. The results demonstrate that the proposed method is superior to existing spectrum resource management functions.
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We present experimental results confirming extreme quantum confinement in GaN/AlxGa1-xN (x = 0.65 and 1.0) nanowire and planar heterostructures, where the GaN layer thickness is of the order of a monolayer. The results were obtained from temperature- and excitation-dependent and time-resolved photoluminescence measurements. In the GaN/AlN nanowire heterostructure array sample, the measured emission peak at 300 K is â¼5.18-5.28 eV. This is in excellent agreement with the calculated optical gap of 5.23 eV and 160-260 meV below the calculated electronic gap of 5.44 eV, suggesting that the observed emission is excitonic in nature with an exciton binding energy of â¼160-260 meV. Similarly, in the monolayer GaN/Al0.65Ga0.35N planar heterostructure, the measured emission peak at 300 K is 4.785 eV and in good agreement with the calculated optical gap of 4.68 eV and 95 meV below the calculated electronic gap of 4.88 eV. The estimated exciton binding energy is 95 meV and in close agreement with our theoretical calculations. Excitation-dependent and time-resolved photoluminescence data support the presence of excitonic transitions. Our results indicate that deep-ultraviolet excitonic light sources and microcavity devices can be realized with heterostructures incorporating monolayer-thick GaN.
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Considerable evidence suggests breast cancer metastasis arises from cells undergoing epithelial-to-mesenchymal-transition (EMT) and cancer stem-like cells (CSCs). Using a microfluidic device that enriches migratory breast cancer cells with enhanced capacity for tumor formation and metastasis, we identified genes differentially expressed in migratory cells by high-throughput single-cell RNA-sequencing. Migratory cells exhibited overall signatures of EMT and CSCs with variable expression of marker genes, and they retained expression profiles of EMT over time. With single-cell resolution, we discovered intermediate EMT states and distinct epithelial and mesenchymal sub-populations of migratory cells, indicating breast cancer cells can migrate rapidly while retaining an epithelial state. Migratory cells showed differential profiles for regulators of oxidative stress, mitochondrial morphology, and the proteasome, revealing potential vulnerabilities and unexpected consequences of drugs. We also identified novel genes correlated with cell migration and outcomes in breast cancer as potential prognostic biomarkers and therapeutic targets to block migratory cells in metastasis.
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Neoplasias da Mama/genética , Movimento Celular/genética , Genes Neoplásicos , Metástase Neoplásica/genética , RNA/análise , Linhagem Celular Tumoral , Transição Epitelial-Mesenquimal/genética , Perfilação da Expressão Gênica/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Dispositivos Lab-On-A-Chip , Técnicas Analíticas Microfluídicas/instrumentação , Técnicas Analíticas Microfluídicas/métodos , Células-Tronco Neoplásicas/química , Análise de Célula Única/métodos , TranscriptomaRESUMO
Non-alcoholic fatty liver disease (NAFLD) is a relatively common disease, and preventing its occurrence is important for both individual health and reducing social costs. Shift work is reported to have several negative effects on health. An association has been observed between NAFLD and both sleep time and quality; however, this association remains unclear in night shift workers. We aimed to evaluate the relationship between shift work and the incidence of NAFLD. Overall, 45,149 Korean workers without NAFLD were included at baseline. NAFLD was defined as the presence of a fatty liver observed on ultrasonography without excessive alcohol use. incidence rate ratios for incident NAFLD were estimated using negative binomial regression according to age groups (20s, 30s, 40s, and 50s). In the 20s age group, shift work showed a significant incidence rate ratio (IRR) for NAFLD in all models. After adjusting for all variables, the IRR (95% confidence interval) was 1.24 (1.08-1.43) in the 20s age group. In their 20s, a significant association between shift work and incident NAFLD was consistently observed among women and workers with poor sleep quality. In this large-scale cohort study, shift work was significantly associated with the development of NAFLD among young workers in their 20s.
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Hepatopatia Gordurosa não Alcoólica , Jornada de Trabalho em Turnos , Humanos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Feminino , Masculino , Adulto , Jornada de Trabalho em Turnos/efeitos adversos , Incidência , Pessoa de Meia-Idade , Adulto Jovem , República da Coreia/epidemiologia , Tolerância ao Trabalho Programado/fisiologia , Fatores de Risco , Estudos de CoortesRESUMO
Background: Despite hearing loss being a prevalent chronic condition, estimated to nearly 20% of the global population by the World Health Organization, the specific association with individual lifestyle factors, particularly alcohol consumption, remains unclear. In South Korea, approximately 80% of the population engages in alcohol consumption, with a notably high prevalence among males, indicating a high-risk drinking pattern. Therefore, this study aimed to assess the correlation between alcohol consumption and hearing loss in male workers, as well as to analyze additional variables such as alcohol flushing reaction, with the intention of improving worker health. Methods: The study was conducted from January 2012 to December 2019, targeting 114,114 participants who visited Kangbuk Samsung Hospital Total Healthcare Centers. Data were collected through pure-tone audiometry tests and alcohol-related questionnaire, and statistical analysis was performed using Cox regression analysis. Based on previous studies indicating a potential protective effect of light drinking on hearing loss, this group was designated as the reference. Additionally, stratified analyses were conducted based on the presence of alcohol flushing reaction and different working hours. Results: The hazard ratio (95% confidence interval) for hearing loss was higher in the heavy drinking group (1.23 [1.11-1.37]) compared to the moderate drinking group (1.09 [0.98-1.20]). Stratified analyses revealed a significantly elevated the hazard ratio of hearing loss in groups with alcohol flushing reaction compared to those without this factor. Conclusions: Our study demonstrated that moderate or heavy alcohol consumption in male workers can increase the risk of hearing loss, particularly in those with alcohol flushing reaction. These findings underscore the importance of addressing alcohol-related factors concerning hearing health among male workers.
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OBJECTIVE: This study aimed to investigate the effect of vitamin D deficiency on metabolic syndrome among shift workers. METHODS: This study included 207 756 workers who underwent a comprehensive health examination at a large South Korean university hospital between 2012 and 2018. We performed multivariate-adjusted logistic regression analysis and analyzed mediation and exposure-mediator interaction. RESULTS: Overall, 5.5% of the participants had metabolic syndrome. Compared to day work, the odds ratios (OR) of metabolic syndrome and vitamin D deficiency (<12 ng/mL) for shift work were 1.14 [95% confidence interval (CI) 1.06-1.22] and 1.63 (95% CI 1.57-1.70), respectively. Among shift workers, the OR of metabolic syndrome for vitamin D levels of 12-20 and <12 ng/mL, compared with a level of ≥20 ng/mL, were 1.36 (95% CI 1.15-1.61) and 1.51 (95% CI 1.26-1.81), respectively. Shift work and vitamin D deficiency showed an additive interaction; the relative excess risks due to interaction, attributable proportion, and synergy index were 0.26 (95% CI 0.08-0.44), 0.17 (95% CI 0.07-0.28), and 2.09 (95% CI 1.23-3.55), respectively. When vitamin D deficiency was treated as a mediator, the direct and total effects of shift work on metabolic syndrome were 1.12 (95% CI 1.04-1.22) and 1.15 (95% CI 1.07-1.25), respectively. The indirect effect was 1.03 (95% CI 1.02-1.04) and accounted for 18% of the total effect. CONCLUSION: Vitamin D is a potential mediator of the impact of shift work on metabolic risk factors.
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Síndrome Metabólica , Deficiência de Vitamina D , Humanos , Síndrome Metabólica/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D , Fatores de Risco , República da Coreia/epidemiologiaRESUMO
Shift work has adverse health effects such as diabetes, cardiovascular disease, sleep disturbance, depression, and breast cancer. Gastro-esophageal reflux disease (GERD) results in lesions such as reflux esophagitis (RE) and Barrett's esophagus. This study investigated the association between shift work and RE. A cohort study was conducted with 140,553 participants who were followed up at least once from 2012 to 2018. Type of working and shift types were collected using standardized questionnaires. Esophagogastroduodenoscopy (EGD) was performed by experienced endoscopists who were blinded to the aims of this study. According to the Los Angeles classification, RE was categorized based on the extent of esophageal mucosal breaks. During the 469,217.2 person-years of follow-up, 35,185 participants developed incident cases of RE. The multivariable adjusted hazard ratio (95% confidence intervals) for incident cases comparing shift work to fixed day work was 1.09 (1.04-1.13). This association was more strongly observed in the younger age group (18-39 years old) and the female group. In conclusion, shift work was significantly associated with the incidence of RE. Particularly, the results were more significant in the younger and female groups.
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Esôfago de Barrett , Esofagite Péptica , Jornada de Trabalho em Turnos , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Esofagite Péptica/etiologia , Esofagite Péptica/complicações , Estudos de Coortes , Incidência , Esôfago de Barrett/etiologia , Esôfago de Barrett/complicações , República da Coreia/epidemiologiaRESUMO
INTRODUCTION: Occupational health nurses (OHNs) in South Korea who visit the workplace periodically could play a key role in smoking cessation. It would be helpful to assess their understanding of smoking hazards and smoking cessation methods to encourage them to provide smoking intervention services at the workplace. This study aimed to investigate the knowledge of smoking hazards and perceptions of smoking cessation methods among OHNs. METHODS: We conducted an anonymous self-administered cross-sectional questionnaire survey of 108 OHN nurses employed in an occupational health service outsourcing specialized agency with 19 regional branches in Korea from July to August 2019. We assessed the perceptions of the OHNs about smoking interventions, hazards of smoking, and perceived competence to counsel smokers according to training experience, using chi-squared tests and Fisher's exact tests. RESULTS: The majority of the nurses underestimated the smoking-attributable fraction for lung cancer (78.7%), chronic obstructive pulmonary disease (64.8%), and mortality (49.0%), regardless of training experience on smoking cessation, while more than half perceived their skill and knowledge to counsel patients concerning smoking as inadequate (56.5%). However, those trained in smoking cessation interventions felt more competent in smoking cessation counselling, with 52.2% and 29.3% in the trained and non-trained groups, respectively (p=0.019). CONCLUSIONS: The OHNs in this study underestimated smoking hazards and perceived themselves as lacking counselling skills regarding smoking cessation interventions. It is necessary to encourage OHNs to promote smoking cessation by increasing their knowledge, skills and competence in smoking cessation interventions.
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This study aimed to identify the major industries and jobs with the highest proportion of workers' compensation (WC) claims for COVID-19, characterize COVID-19 WC claims in terms of their demographic properties and disease severity, and identify factors influencing the approval of COVID-19 WC claims as occupational disease. A total of 488 workers who submitted COVID-19-related claims to the Korea Workers' Compensation and Welfare Service (KWCWS) from January 2020 to July 2021 were analyzed. A Fisher's exact test was employed to associate the severity of COVID-19 infection with demographic properties. The highest proportion of all COVID-19 WC claims compensated as occupational disease (N=462) were submitted by healthcare workers (HCW=233, 50%), while only 9% (N=41) of the total originated from manufacturing industries. The 5% (N=26) of the COVID-19 WC claims accepted were evaluated as severe (N=15) and acute respiratory distress syndrome (N=9). A total of 71% (N=329) of the COVID-19 patients compensated (N=462) were from workplaces with infection clusters. A total of 26 WC cases were rejected for various reasons, including unclear infection routes, infection at private gatherings (including within families), no diagnosis, and more. Given our findings, we suggest an official system should be established to detect and compensate more job-associated infectious diseases like COVID-19.
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COVID-19 , Doenças Profissionais , Indenização aos Trabalhadores , Humanos , COVID-19/epidemiologia , Indústrias/estatística & dados numéricos , Doenças Profissionais/epidemiologia , República da Coreia/epidemiologia , Indenização aos Trabalhadores/estatística & dados numéricosRESUMO
Background: Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs. Methods: We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age. Results: In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02-1.34); the OR was 0.99 (95% CI: 0.80-1.22) in those under 40 and 1.28 (1.08-1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92-1.19); the OR was 1.10 (95% CI: 0.90-1.35) in those under 40 and 1.20 (1.01-1.43) in those over 40. Conclusions: This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.
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Background: Shift work has been reported to have several harmful effects on the human body. However, a small number of studies have evaluated the association between shift work and adverse effects on the thyroid. In our longitudinal study, we examined the causal association between shift work and the risk of hypothyroidism. Methods: A Kangbuk Samsung Cohort Study was conducted on 112,648 men without thyroid disease at baseline who were followed up at least once between 2012 and 2019. Shift work status and shift schedule types were categorized using standardized questionnaires. Hypothyroidism was defined using the reference ranges of serum thyroid-stimulating hormones and free thyroxine levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypothyroidism were estimated using Cox proportional hazards regression analyses with the daytime work group as the reference. Results: During the 501,237 person-years of follow-up, there were 6,306 incident cases of hypothyroidism (incidence density, 1.26 per 100 person-years). The multivariable-adjusted HR of incident hypothyroidism for the shift work total group that included all shifts compared with the daytime work group was 1.27 (95% CI: 1.15-1.40). For the fixed evening, fixed night, rotating shift, and other shift workers, the multivariable-adjusted HRs (95% CI) were 1.11 (0.76-1.61), 2.18 (1.20-3.93), 1.39 (1.23-1.56), and 1.00 (0.82-1.22), respectively. In subgroup analyses by age, the association between shift work and hypothyroidism was more pronounced in younger participants (< 40 years; HR: 1.31; 95% CI: 1.16-1.47). Conclusions: Our large-scale cohort study showed an association between shift work and the incidence of hypothyroidism, especially in younger workers with night shifts.
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OBJECTIVES: Long working hours have been reported to cause various health problems, but are currently practiced in many countries. Building upon a previous cross-sectional study, the authors aimed to elucidate the causal relationship between long working hours and hypothyroidism through a longitudinal study. METHODS: Data were collected at baseline from 45,259 participants without thyroid disease and with consistent weekly working hours (36-40, 41-52, 53-60, and >60 hours) during the follow-up period. Hypothyroidism was defined using the reference limits of serum thyroid-stimulating hormone and free thyroxine levels. By estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analysis, the risk of incident hypothyroidism was evaluated with 36-40 hours of work per week as the reference. RESULTS: During 138,261.7 person-years of follow-up, 2,914 participants developed hypothyroidism (incidence density, 2.11/102 person-years). The multivariable-adjusted HRs of incident hypothyroidism for 41-52 hours, 53-60 hours, and >60 hours of work per week were 1.13 (95% CI, 1.03 to 1.24), 2.53 (95% CI, 2.17 to 2.95), and 2.57 (95% CI, 2.09 to 3.15), respectively. In dose-response analyses, long working hours had an approximately linear relationship with hypothyroidism incidence. The risk of incident hypothyroidism in those who worked 53-60 hours and >60 hours per week compared with the reference group was significantly higher among the older age group (≥36 years, stratified by median age), men, and daytime workers. CONCLUSIONS: This large-scale cohort study demonstrated the association between long working hours and an increased risk of incident hypothyroidism with a dose-response relationship.
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OBJECTIVES: We aimed to find evidence of the inflammation-mediated mechanism by which long working hours contribute to cardiovascular disease (CVD). METHODS: This cohort study was performed in 56 953 Korean adults free of CVD who underwent a comprehensive screening examination and were followed for up to 7 years. An increase in blood high-sensitivity C-reactive protein (hsCRP) of 1 mg/L or more at the follow-up visit was defined as an incidence. The average weekly working hours in the past year were categorized as ≤40, 41-52, 53-60, and ≥60 h per week. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using generalized estimating equations to calculate the risk of an incidental increase of hsCRP. RESULTS: Participants with longer working hours had a higher incidence of hsCRP. Multivariable-adjusted ORs (95% CIs) of incident cases for ≥61 h compared with ≤40 h was 1.69 (1.04-2.75). In subgroup analyses according to sex and the presence of hypertension and diabetes, the risk of hsCRP incidence were highest in the group working more than 61 h in all subgroups, but none of them were statistically significant. CONCLUSIONS: Working hours are independently associated with increased risk of elevated hsCRP in a dose-response relationship. Excessive long-time work is a risk factor for CVD, and it was found that an increase in hsCRP was associated with the pathogenesis.
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Proteína C-Reativa , Doenças Cardiovasculares , Adulto , Humanos , Proteína C-Reativa/análise , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Coortes , Eletrólitos , Fatores de RiscoRESUMO
This study investigated the association between parental long working hours and the depression of children living with their parents even after becoming adults in South Korea. Data from two years of the Korean National Health and Nutrition Examination Survey (KNHANES) in 2014 and 2016 were analyzed using a cross-sectional study. Logistic regression analyses were performed to determine the association between parental long working hours and their adult children's depression. Adult children of mothers who worked more than 60 hours per week were more likely to have depression than 40 hours or less per week. Comprehending aging mothers' weekly working hours is an important factor for understanding the reason of adult children's depression.
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Filhos Adultos , Mães , Adulto , Feminino , Humanos , Estudos Transversais , Inquéritos Nutricionais , República da Coreia/epidemiologiaRESUMO
OBJECTIVE: This study aimed to evaluate the relationship between working hours and glycemic control. METHODS: Study was performed among Korean participants who underwent at least two health screening examinations between 2012 and 2018. The study included 2169 participants who were older than 40 years and undergoing treatment for diabetes at baseline. A hemoglobin A1c level >9% at the follow-up visit was defined as poor glycemic control. The weekly working hours were divided into three groups for analysis. RESULTS: Compared with participants with 45-54 weekly working hours, multivariate-adjusted hazard ratios (95% confidence intervals) for incident poor glycemic control among participants with ≥55 and 35-44 working hours were 1.40 (1.01-1.96) and 1.51 (1.09-2.09), respectively. CONCLUSIONS: Standard working hours and long working hours were independent risk factors for poor diabetes control in patients with diabetes.
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Diabetes Mellitus Tipo 2 , Diabetes Mellitus , Diabetes Mellitus/epidemiologia , Hemoglobinas Glicadas/análise , Controle Glicêmico , Humanos , Modelos de Riscos Proporcionais , Fatores de RiscoRESUMO
Long working hours have negative effects on the health of workers. Several studies have reported the association between long working hours and both diabetes and prediabetes. Therefore, we aimed to examine the temporal relationship between long working hours and glucose intolerance. Our cohort study collected data from 25,803 healthy male participants at baseline. To evaluate the risk of incident glucose intolerance, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox proportional hazards regression analyses. During 77,605.0 person-years of follow-up, 6741 participants developed glucose intolerance. Multivariable-adjusted HRs (95% CI) for weekly working 41-52 and >52 h compared with working 35-40 h, were 1.28 (1.17-1.40) and 2.80 (2.54-3.09), respectively. In the dose-response analyses, long working hours had a nearly linear relationship with the development of glucose intolerance across most working hours per week. The association between long working hours and incident glucose intolerance was stronger in the younger-age subgroups than in the older-age subgroups (p for interaction <0.001). Our large-scale cohort study demonstrated that long working hours were associated with incident glucose intolerance, with a dose-response relationship.
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Diabetes Mellitus , Intolerância à Glucose , Estado Pré-Diabético , Estudos de Coortes , Intolerância à Glucose/epidemiologia , Humanos , Masculino , Estado Pré-Diabético/epidemiologia , Modelos de Riscos Proporcionais , Fatores de RiscoRESUMO
Coronary artery calcium score (CACS) is a useful method for predicting coronary artery disease in asymptomatic adults. In this study, we investigated the association between prolonged sedentary time and CACS. A cohort study was conducted in 14949 men with negative CACS (CACS = 0) at baseline who were followed up at least once. Sedentary time was categorized into < 7, 7-8, and ≥ 9 h/day. CACS was calculated by cardiac tomography. During 60,112.1 person-years of follow-up, 569 participants developed positive CACS. The multivariable adjusted hazard ratios (95% confidence intervals) for incident positive CACS comparing sedentary times of 7-8 h/day and ≥ 9 h/day to sedentary time of < 7 h/day were 1.25 (0.97-1.62) and 1.28 (1.03-1.59), respectively. This association was more strongly observed in the non-obese group (BMI < 25 kg/m2). In contrast, in the obese group (BMI ≥ 25 kg/m2), there was no significant association between sedentary time and incidence of positive CACS. Prolonged sedentary time was significantly associated with incidence of positive CACS in the study. CACS is also an effective screening tool for predicting future cardiovascular events in asymptomatic patients. Therefore, CACS can be an effective screening method for predicting coronary artery diseases in people with prolonged sedentary time, especially in metabolically healthy people.
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Vasos Coronários/metabolismo , Comportamento Sedentário , Calcificação Vascular/epidemiologia , Adulto , Estudos de Coortes , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Correlação de Dados , Voluntários Saudáveis , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , República da Coreia/epidemiologia , Tempo , Calcificação Vascular/complicaçõesRESUMO
Background: According to the occupational accident status analysis in 2020, of 1,180 occupational deaths, 463 were caused by cardiovascular disease (CVD). Workers should be assessed for CVD risk at regular intervals to prevent work-related CVD in accordance with the rules on occupational safety and health standards. However, no previous study has addressed risk and mortality. Therefore, this longitudinal study was conducted to evaluate the relationship between 10-year cardiovascular risk of the general health checkup and mortality. Methods: The study included 545,859 participants who visited Kangbuk Samsung Total Healthcare Centers from January 1, 2002, to December 31, 2017. We performed 10-year cardiovascular risk assessment for the participants and the risk was divided into 4 groups (low, moderate, high, and very high). The study used death data from the Korea National Statistical Office for survival status as an outcome variable by December 31, 2019, and the cause of death based on the International Classification of Diseases, 10th Revision (ICD-10) was identified. Statistical analysis was performed using Cox proportional hazards regression analysis, and the sum of the periods from the first visit to the date of death or December 31, 2019, was used as a time scale. We also performed a stratified analysis for age at baseline and sex. Results: During 5,253,627.9 person-years, 4,738 overall deaths and 654 cardiovascular deaths occurred. When the low-risk group was set as a reference, in the multivariable-adjusted model, the hazard ratios (HRs) (95% confidence interval [CI]) for overall mortality were 3.36 (2.87-3.95) in the moderate-risk group, 11.08 (9.27-13.25) in the high-risk group, and 21.20 (17.42-25.79) in the very-high-risk group, all of which were statistically significant. In cardiovascular deaths, the difference according to the risk classification was more pronounced. The HRs (95% CI) were 8.57 (4.95-14.83), 38.95 (21.77-69.69), and 78.81 (42.62-145.71) in each group. As a result of a subgroup analysis by age and sex, the HRs of all-cause mortality and cardiovascular mortality tended to be higher in the high-risk group. Conclusions: This large-scale longitudinal study confirmed that the risk of death increases with the 10-year cardiovascular risk of general health checkup.