Investigation of the Association between Smoking Behavior and Metabolic Syndrome Using Lipid Accumulation Product Index among South Korean Adults

The prevalence and clustering of metabolic syndrome risk components in Chinese population: a cross-sectional study

Objective

The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components. The present study evaluated the epidemiological characteristics of the MetS components and their clustering condition among Chinese adults.

Methods

68383 participants aged 18-80 years from TIDE were scored on a six-point (0-5) MetS severity score (MSSS), which quantified their cumulative amount of MetS risk components. We evaluated the epidemiological characteristics of these components and their clustering conditions. Additionally, we examined the relation of age with the prevalence of different MSSSs or specific MetS components using restricted cubic splines.

Results

Among 68383 participants, 26113 men and 24582 women had abnormal MetS components. There were significant differences in most epidemiological characteristics between the 6 MSSS groups. The top three prevalence of abnormal metabolic components were high systolic blood pressure (SBP) (9.41%, n=6568), high waist circumference (WC) (8.13%, n=6120), and the cooccurrence of high SBP and high WC (6.33%, n=4622). Participants were more likely to have all five MetS components when HDL-C was low. Restricted cubic splines showed that when the MSSS ≥3, the MetS prevalence of male peaked and that of the female population increased most rapidly at 40-60 age group.

Conclusion

The 40-60 age group can be regarded as the high-risk period of MetS, and elderly women have a higher risk of multiple metabolic disorders than men. The top three clustering of abnormal metabolic components were high SBP, high WC, and their combination. Multiple components aggregation was more likely to occur when HDL-C decreased.

Association between smoking and obstructive sleep apnea based on the STOP-Bang index

Smoking is a risk factor for respiratory diseases, and it worsens sleep quality due to nicotine stimulation and sudden nicotine withdrawal during sleep. This can increase the severity of OSA through alterations upper airway inflammation and neuromuscular function, arousal mechanisms, and sleep architecture. Therefore, it may lead to sleep-disrupted breathing, particularly obstructive sleep apnea (OSA). Herein, this study aims to research the association between smoking and OSA through the STOP-Bang index. In this study, total sample of 3442 participants (1465 men and 1977 women) were analyzed. We used data from the Korea National Health and Nutrition Examination Survey in 2020 by classifying adults into current, ex-, and non-smokers. A multiple logistic regression analysis was used to investigate the association between smoking and OSA. Furthermore, multinomial regression analysis was used to investigate the effect of smoking cessation. For males, compared to the non-smokers, the odds ratios (OR) for the OSA were significantly higher in the ex-smokers (OR: 1.53, 95% confidence interval(CI) 1.01-2.32) and current smokers (OR: 1.79, 95% CI 1.10-2.89). In females, higher ORs were observed for OSA risk, similar to the non-smokers, smoking cessation, and pack-years. Among men, OSA was significantly associated with a moderate risk for ex-smokers (OR: 1.61, 95% CI 1.05-2.48) and a severe risk for current smokers (OR: 1.88, 95% CI 1.07-3.29). This study observed that smoking might contribute to OSA risk among adults. Smoking cessation can help to manage sleep quality properly.

Role of breast cancer screening in the overdiagnosis of thyroid cancer: results from a cross-sectional nationwide survey

BACKGROUND

South Korea has the highest incidence of thyroid cancer worldwide, raising questions regarding the possibility of overdiagnosis. Examining the factors affecting thyroid cancer screening is crucial in elucidating the reasons for this unusually high incidence of thyroid cancer. Therefore, in the present study, we investigated the association between breast cancer screening and thyroid cancer screening to determine the potential role of breast cancer screening in the overdiagnosis of thyroid cancer in South Korea.

METHODS

We analyzed the data of women aged > 30 years who were enrolled in the 2014 Korean National Cancer Screening Survey. Self-reported breast cancer screening behavior was categorized as follows: no screening, mammography only, ultrasonography only, and both ultrasonography and mammography. Thyroid cancer screening behavior was categorized as follows: those who had or had not undergone ultrasonography screening. Logistic regression analysis was used to examine the associations between breast and thyroid cancer screening behaviors.

RESULTS

Of the 2270 participants, a total of 569 (25.1%) were screened for thyroid cancer. Those who underwent only mammography, only ultrasonography, or both mammography and ultrasonography were more likely to be screened for thyroid cancer than those who did not undergo breast cancer screening (odds ratio [OR]: 1.47, 95% confidence interval [CI] 1.06-2.04; OR 2.71, 95% CI 1.83-4.02; OR 2.75, 95% CI 1.99-3.80, respectively).

CONCLUSIONS

Our findings indicate that thyroid cancer screening in Korea is likely to be performed on an opportunistic basis. Therefore, a nationwide public health and medical initiative is needed to curb the unnecessary use of thyroid screening in the asymptomatic general population.

Association between smoking behavior and serum uric acid among the adults: Findings from a national cross-sectional study

BACKGROUND

Gout incidence is increasing worldwide; appropriate management of serum uric acid levels and a healthy lifestyle may help its prevention. The popularity of electronic cigarettes and the resultant emergence of dual smokers is increasing. Despite many studies on the effects of various health behaviors on serum uric acid levels, the association between smoking and serum uric acid levels remains controversial. This study aimed to investigate the association between smoking and serum uric acid levels.

METHODS

In this study, total sample of 27,013 participants (11,924 men and 15,089 women) were analyzed. This study used data from the Korea National Health and Nutrition Examination Survey (2016-2020) and grouped adults into dual smokers, single smokers, ex-smokers, and non-smokers. Multiple logistic regression analyses were performed to investigate the association between smoking behavior and serum uric acid levels.

RESULTS

Compared to male non-smokers, male dual smokers had significantly higher serum uric acid level (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.08-1.88). In female, serum uric acid level was higher among single smokers than non-smokers (OR, 1.68; 95% CI, 1.25-2.25). Higher serum uric acid levels were more likely to be present in male dual smokers with a > 20 pack-year smoking habit (OR, 1.84; 95% CI, 1.06-3.18).

CONCLUSION

Dual smoking may contribute to high serum uric acid levels in adults. Thus, serum uric acid levels should be properly managed through smoking cessation.

High prevalence of hypertension among smokers of conventional and e-cigarette: Using the nationally representative community dwelling survey

This study aimed to clarify the association between hypertension and conventional cigarette and electronic cigarette (e-cigarette) use, together or individually. A total of 275,762 participants were included, of which 120,766 were men and 154,996 were women. The data were drawn from the Korea Community Health Survey conducted in 2019. A multiple logistic regression model was used to examine the association between hypertension and types of smoking. Hypertension was defined as systolic blood pressure higher than 140 mmHg or diastolic blood pressure higher than 90 mmHg. Based on the types of smoking, participants were grouped as dual smokers of conventional and e-cigarettes, e-cigarette only smokers, conventional cigarette only smokers, past-smokers, and non-smokers. Compared to non-smokers, dual smokers presented the highest odds ratio for hypertension in the male [odds ratio (OR): 1.24, confidence interval (CI): 1.10 to 1.39] and female groups (OR: 1.44 CI: 0.96 to 2.15). According to the Cochran-Mantel-Haenszel test, the two-sided p-value of < 0.001 indicated an overall statistically significant association between types of smoking and hypertension. Use of both cigarette types was statistically significant in the male group, but only the use of conventional cigarettes and past smoking were statistically significant in the female group. Among smokers of the two cigarette types, those who were dual smokers of e-cigarettes and conventional cigarettes were the most likely to have the highest prevalence of hypertension.

Association between dual smoking and dyslipidemia in South Korean adults

Objectives

Dyslipidemia increases the risk of serious cardiovascular disease; and conventional cigarette smoking is widely recognized as a risk factor. Thus, as electronic cigarettes were introduced, many smokers utilized them for smoking cessation. However, due to the lack of researches scrutinized the relationship between dual smoking and dyslipidemia, a lot of those who failed in cessation end up utilizing both types of cigarettes (dual smoking). Therefore, this study aimed to examine the effect of dual smoking on dyslipidemia in South Korean adults.

Methods

Data were included from the 2013, 2014, 2015, 2016, and 2019 Korean National Health and Nutrition Examination Survey of 8,398 Korean men. The KNHANES is conducted by a national institution based on random cluster sampling, and therefore, the data gained from it is statistically reliable and representative in comparison to surveys performed by private institutions. Cigarette use status was the main independent variable. Cigarette use status was categorized as one of the four status: dual smoker, single smoker, non-smoker, and ex-smoker. The dependent variable, presence of dyslipidemia, was defined according to the National Cholesterol Education Program as displaying one or more of the following criteria: total cholesterol: ≥240 ㎎/dL, LDL cholesterol: ≥160 ㎎/dL, triglyceride: ≥200 ㎎/dL, or HDL cholesterol: ≤40 ㎎/dL. Multiple logistic regression analysis was performed to examine target association.

Results

Current and former users of either electronic or conventional cigarettes presented with a higher odd ratio of dyslipidemia compared to non-smokers. (ex-smoker: OR = 1.60, 95% CI = 1.41–1.83; single smoker: OR = 1.21, 95% CI = 1.06–1.38). More importantly, those who smoke both conventional and electronic cigarettes were also, at high risk of dyslipidemia (dual smoker: OR = 1.66, 95% CI = 1.26–2.20). Along with smoking status, those who did not exercise had a higher risk of dyslipidemia than those who exercised regularly and higher self-reported health status was also related to a lower risk of dyslipidemia.

Conclusion

This study suggests that along with conventional cigarettes, dual smoking negatively impacts dyslipidemia, and smoking cessation of evert types is necessary for a healthy life.