Performance of a Community-based Noncommunicable Disease Control Program in Korea: Patients 65 Years of Age or Older.

BACKGROUND: In Korea, the Korean Community-based Noncommunicable Disease Prevention and Control Program (KCNPC) was implemented in 2012 for the management of patients with chronic diseases. Nineteen primary care clinics, public health centers, and education and consulting centers (ECCs) participated in the implementation of this program. This study assessed the effectiveness of this chronic disease control model by comparing mortality rate and the incidence of complications between patients participating in the KCNPC program and a control group. METHODS: Using data from the National Health Insurance Service and data from hypertension and diabetes patients registered with 19 ECCs between January 1, 2010 and December 31, 2012, hypertension and diabetes patients who had been treated at a clinic were selected. The final analysis included 252,900 patients, with the intervention group and control group having 126,450 patients each. Survival for the two groups was analyzed using the Kaplan-Meier method. Complications were analyzed using the Cox proportional hazards model. RESULTS: The 5-year survival rate in the intervention group (0.88) was higher than that in the control group (0.86). Cox proportional hazards analysis showed that the intervention group had lower risk for mortality (0.84; 95% confidence interval [CI], 0.82-0.86) compared to the control group. Hospitalization due to complications and the proportional risk of hospitalization were also lower in the intervention group. CONCLUSION: The KCNPC model for prevention and control of chronic disease in Korea was found to be effective for hypertension and diabetes patients. Therefore, the KCNPC will be necessary to strengthen the capabilities of local communities, primary medical institutions, and individuals for prevention and control of chronic disease. Expanding the efficient prevention and control policies of the KCNPC to a nationwide scale may be effective as has been demonstrated through limited implementation in some regions.

Sex differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population.

AIMS: Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, for which various risk engines have been developed. The important keys to CVD risk engines are high reliability and accuracy, which show differences in predictability depending on disease status or race. Framingham risk score (FRS) and the atherosclerotic cardiovascular disease risk equations (ASCVD) were applied to the Korean population to assess their suitability. METHODS: A retrospective cohort study was conducted using National Health Insurance Corporation sample cohort from 2003 to 2015. The enrolled participants over 30 years of age and without CVD followed-up for 10 years. We compared the prediction performance of FRS and ASCVD and calculated the relative importance of each covariate. RESULTS: The AUCs of FRS (men: 0.750; women: 0.748) were higher than those of ASCVD (men: 0.718; women: 0.727) for both sexes (Delong test P <0.01). Goodness of fits (GOF) were poor for all models (Chi-square P < 0.001), especially, underestimation of the risk was pronounced in women. When the men's coefficients were applied to women's data, AUC (0.748; Delong test P<0.01) and the GOF (chi-square P = 0.746) were notably improved in FRS. Hypertension was found to be the most influential variable for CVD, and this is one of the reasons why FRS, having the highest relative weight to blood pressure, showed better performance. CONCLUSION: When applying existing tools to Korean women, there was a noticeable underestimation. To accurately predict the risk of CVD, it was more appropriate to use FRS with men's coefficient in women. Moreover, hypertension was found to be a main risk factor for CVD.

Relationship between Bone Density, Eating Habit, and Nutritional Intake in College Students.

BACKGROUND: The importance of bone health is emphasized throughout the life cycle. Young adults have problems with bone health due to irregular lifestyle and unbalanced diet, but studies related to them are insufficient. The purpose of this study was to measure the bone mineral density (BMD) of college students and to analyze the differences in BMD according to lifestyle. METHODS: BMD was measured by bone ultrasound in 161 male and female college students. The questionnaire was surveyed about lifestyle, eating habits, and nutrient intake status. RESULTS: Osteopenia was 8.8% in male and 10.8% in female. The body fat percentage of female was significantly higher than male. Male college students, smoking, fast food consumption, and overeating rate were significantly higher than female. Nutrient intake was not significantly different between male and female students. But energy and vitamin A and C levels were inadequate, and protein and sodium intake was excessive compared with the recommended nutrient intake for Koreans. BMD was significantly lowest in male who often intake fast food than male who did not intake at all or intake sometimes. Female who often intake fast food had significantly lower BMD than female who did not eat at all. CONCLUSIONS: College students have different BMDs according to lifestyle. There was a difference in BMD according to smoking and fast food consumption.