{"title":"利用分层年龄-时期-队列分析和交叉分类随机效应模型探索韩国肥胖症的差异。","authors":"Chang Kyun Choi, Jung-Ho Yang, Sun-Seog Kweon, Min-Ho Shin","doi":"10.3346/jkms.2024.39.e169","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This research article investigates the age, period, and birth cohort effects on prevalence of obesity in the Korean population, with the goal of identifying key factors to inform effective public health strategies.</p><p><strong>Methods: </strong>We analyzed data from the Korea National Health and Nutrition Examination Survey, spanning 2007-2021, including 35,736 men and 46,756 women. Using the hierarchical age-period-cohort (APC) analysis with cross-classified random effects modeling, we applied multivariable mixed logistic regression to estimate the marginal prevalence of obesity across age, period, and birth cohort, while assessing the interaction between APC and lifestyle and socioeconomic factors.</p><p><strong>Results: </strong>Our findings reveal an inverted U-shaped age effect on obesity, influenced by smoking history (<i>P</i> for interaction = 0.020) and physical activity (I for interaction < 0.001). The period effect was positive in 2020 and 2021, while negative in 2014 (<i>P</i> for period effect < 0.001). A declining trend in obesity prevalence was observed in birth cohorts from 1980s onward. Notably, disparities in obesity rates among recent birth cohorts have increased in relation to smoking history (<i>P</i> for interaction = 0.020), physical activity (<i>P</i> for interaction < 0.001), and residence (<i>P</i> for interaction = 0.005). Particularly, those born after 1960 were more likely to be obese if they were ex-smokers, physical inactive, or lived in rural areas.</p><p><strong>Conclusion: </strong>These findings highlight growing disparities in obesity within birth cohorts, underscoring the need for targeted health policies that promote smoking cessation and physical activity, especially in rural areas.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136680/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exploring Disparities for Obesity in Korea Using Hierarchical Age-Period-Cohort Analysis With Cross-Classified Random Effect Models.\",\"authors\":\"Chang Kyun Choi, Jung-Ho Yang, Sun-Seog Kweon, Min-Ho Shin\",\"doi\":\"10.3346/jkms.2024.39.e169\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This research article investigates the age, period, and birth cohort effects on prevalence of obesity in the Korean population, with the goal of identifying key factors to inform effective public health strategies.</p><p><strong>Methods: </strong>We analyzed data from the Korea National Health and Nutrition Examination Survey, spanning 2007-2021, including 35,736 men and 46,756 women. Using the hierarchical age-period-cohort (APC) analysis with cross-classified random effects modeling, we applied multivariable mixed logistic regression to estimate the marginal prevalence of obesity across age, period, and birth cohort, while assessing the interaction between APC and lifestyle and socioeconomic factors.</p><p><strong>Results: </strong>Our findings reveal an inverted U-shaped age effect on obesity, influenced by smoking history (<i>P</i> for interaction = 0.020) and physical activity (I for interaction < 0.001). The period effect was positive in 2020 and 2021, while negative in 2014 (<i>P</i> for period effect < 0.001). A declining trend in obesity prevalence was observed in birth cohorts from 1980s onward. Notably, disparities in obesity rates among recent birth cohorts have increased in relation to smoking history (<i>P</i> for interaction = 0.020), physical activity (<i>P</i> for interaction < 0.001), and residence (<i>P</i> for interaction = 0.005). Particularly, those born after 1960 were more likely to be obese if they were ex-smokers, physical inactive, or lived in rural areas.</p><p><strong>Conclusion: </strong>These findings highlight growing disparities in obesity within birth cohorts, underscoring the need for targeted health policies that promote smoking cessation and physical activity, especially in rural areas.</p>\",\"PeriodicalId\":16249,\"journal\":{\"name\":\"Journal of Korean Medical Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136680/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Korean Medical Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3346/jkms.2024.39.e169\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Korean Medical Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3346/jkms.2024.39.e169","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:这篇研究文章调查了年龄、时期和出生队列对韩国人口肥胖率的影响,目的是找出关键因素,为有效的公共卫生策略提供依据:这篇研究文章调查了年龄、时期和出生队列对韩国人口肥胖患病率的影响,目的是找出关键因素,为有效的公共卫生策略提供依据:我们分析了韩国全国健康与营养调查(2007-2021 年)的数据,其中包括 35736 名男性和 46756 名女性。我们采用分层年龄-时期-队列(APC)分析和交叉分类随机效应模型,运用多变量混合逻辑回归估算了不同年龄、时期和出生队列的边际肥胖患病率,同时评估了APC与生活方式和社会经济因素之间的相互作用:我们的研究结果显示,肥胖的年龄效应呈倒 U 型,受吸烟史(交互作用 P = 0.020)和体育锻炼(交互作用 I < 0.001)的影响。2020 年和 2021 年的时期效应为正,而 2014 年为负(时期效应的 P <0.001)。从 20 世纪 80 年代开始,出生队列中的肥胖患病率呈下降趋势。值得注意的是,与吸烟史(交互作用的 P = 0.020)、体育锻炼(交互作用的 P < 0.001)和居住地(交互作用的 P = 0.005)有关的近期出生队列中肥胖率的差异有所增加。尤其是 1960 年后出生的人,如果曾经吸烟、不爱运动或居住在农村地区,则更有可能肥胖:这些发现凸显了出生队列中肥胖差异的日益扩大,强调了有必要制定有针对性的健康政策,促进戒烟和体育锻炼,尤其是在农村地区。
Exploring Disparities for Obesity in Korea Using Hierarchical Age-Period-Cohort Analysis With Cross-Classified Random Effect Models.
Background: This research article investigates the age, period, and birth cohort effects on prevalence of obesity in the Korean population, with the goal of identifying key factors to inform effective public health strategies.
Methods: We analyzed data from the Korea National Health and Nutrition Examination Survey, spanning 2007-2021, including 35,736 men and 46,756 women. Using the hierarchical age-period-cohort (APC) analysis with cross-classified random effects modeling, we applied multivariable mixed logistic regression to estimate the marginal prevalence of obesity across age, period, and birth cohort, while assessing the interaction between APC and lifestyle and socioeconomic factors.
Results: Our findings reveal an inverted U-shaped age effect on obesity, influenced by smoking history (P for interaction = 0.020) and physical activity (I for interaction < 0.001). The period effect was positive in 2020 and 2021, while negative in 2014 (P for period effect < 0.001). A declining trend in obesity prevalence was observed in birth cohorts from 1980s onward. Notably, disparities in obesity rates among recent birth cohorts have increased in relation to smoking history (P for interaction = 0.020), physical activity (P for interaction < 0.001), and residence (P for interaction = 0.005). Particularly, those born after 1960 were more likely to be obese if they were ex-smokers, physical inactive, or lived in rural areas.
Conclusion: These findings highlight growing disparities in obesity within birth cohorts, underscoring the need for targeted health policies that promote smoking cessation and physical activity, especially in rural areas.
期刊介绍:
The Journal of Korean Medical Science (JKMS) is an international, peer-reviewed Open Access journal of medicine published weekly in English. The Journal’s publisher is the Korean Academy of Medical Sciences (KAMS), Korean Medical Association (KMA). JKMS aims to publish evidence-based, scientific research articles from various disciplines of the medical sciences. The Journal welcomes articles of general interest to medical researchers especially when they contain original information. Articles on the clinical evaluation of drugs and other therapies, epidemiologic studies of the general population, studies on pathogenic organisms and toxic materials, and the toxicities and adverse effects of therapeutics are welcome.