Main Article Content
Metabolic syndrome, health management behavior, socioeconomic status
Metabolic syndrome (MetS) is a highly prevalent condition that cannot be cured but can be controlled by health management. Health management not only includes regulation of drinking, smoking, and physical activity but also health medical examinations. However, health medical examinations at private medical facilities involve high cost, limiting continuous and regular examination. The aim of this study was to analyze the prevalence of MetS and health management behavior according to the number of health medical examinations conducted in 14 years. According to the number of health medical examinations undertaken each year from 1999 to 2012, in 2012, 21,803 visitors (14,511 men and 7,292 women) from a health medical examination center at a private medical facility were assigned to low- (3–5 health examinations in 14 years), middle- (6–10 health examinations in 14 years), and high-frequency groups (11–14 health examinations during 14 years). MetS was evaluated according to the criteria of the National Cholesterol Education Program and Adult Treatment Panel III and waist circumference was measured according to the standard for Asians by the World Health Organization. Odds ratio (OR) was calculated by logistic regression analysis. Blood pressure tended to decrease to 124.5 vs. 123.9 vs. 123.5 in the low-, middle-, and high-frequency groups in men, respectively. In addition, middle- and high-frequency groups demonstrated better total cholesterol, high-density lipoprotein, low-density lipoprotein, and systolic blood pressure compared with the low-frequency group. The prevalence of MetS demonstrated no significance before adjusting for variables in men, and high-frequency examinees demonstrated 18% low OR values (0.823, p<0.001) after adjusting for age. OR was 0.868 (p=0.015) when adjusted for age, other socioeconomic factors, and health behavior. In women, the prevalence of MetS demonstrated significantly high OR of 1.205 (p=0.007) and 1.300 (p=0.008) in the middle- and high-frequency groups, respectively, but OR value decreased by 21% (0.791, p=0.026) after adjusting for age. However, OR remained significant when adjusting for socioeconomic variables, physical activity, drinking, and smoking. For income and education, high-frequency examinees belonged to high socioeconomic status group among men and women, but there were significant differences in only walking among men with regard to physical activity (p<0.001). Smoking was well managed in the high-frequency group among men and women, and drinking showed a significant difference only in women (p<0.001). High-frequency of health medical examination showed low prevalence of MetS in men and women, and higher socioeconomic status involved good management of health.
2. Lim S, Shin H, Song JH, et al. Increasing prevalence of metabolic syndrome in Korea the Korean national health and nutrition examination survey for 1998–2007. Diabetes Care 2011;34(6):1323-1328.
3. Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis. J Am Coll Cardiol 2010;56(14):1113–32.
4. Kohro T, Furui Y, Mitsutake N, et al. The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome. Int Heart J 2008;49(2):193–203.
5. Kim Y, Jun JK, Choi KS, et al. Overview of the National Cancer screening programme and the cancer screening status in Korea. Asian Pac J Cancer Prev 2011;12(3):725–30.
6. Kang S, You CH, Kwon YD. The determinants of the use of opportunistic screening programs in Korea. J Prev Med Public Health 2009;42(3):177–82.
7. Lee K, Lim HT, Hwang SS, et al. Socio-economic disparities in behavioural risk factors for cancer and use of cancer screening services in Korean adults aged 30 years and older: the Third Korean National Health and Nutrition Examination Survey, 2005 (KNHANES III). Public Health 2010;124(12):698–704.
8. World Health Organization. International association for the study of obesity, international obesity task force. The Asia-Pacific perspective: redefining obesity and its treatment. Geneva: Author; 2000.
9. Alberti KG1, Zimmet P, Shaw J. Metabolic syndrome—a new world‐wide definition. A consensus statement from the international diabetes federation. Diabet Med 2006;23(5):469–80.
10. IPAQ Research Committee. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)–short and long forms. 2005.
11. Thompson PD, Arena R, Riebe D, et al. ACSM’s new preparticipation health screening recommendations from ACSM’s guidelines for exercise testing and prescription. Curr Sports Med Rep 2013;12(4):215–17.
12. Egger G, Swinburn B, Islam FM. Islam, Economic growth and obesity: An interesting relationship with world-wide implications. Econ Hum Biol 2012;10(2):147–53.
13. Park J, Hilmers DC, Mendoza JA. Prevalence of metabolic syndrome and obesity in adolescents aged 12 to 19 years: comparison between the United States and Korea. J Korean Med Sci 2010;25(1):75–82.
14. National Center for Health Statistics (US). Health, United States, 2011: With special feature on socioeconomic status and health. 2012.
15. Khang YH, Lynch JW, Yun S, et al. Trends in socioeconomic health inequalities in Korea: use of mortality and morbidity measures. J Epidemiol Community Health 2004;58(4):308–14.
16. Yoo S, Cho HJ, Khang YH. General and abdominal obesity in South Korea, 1998–2007: gender and socioeconomic differences. Prev Med 2010.51(6):460–65.
17. Jee SH. The mortality rate and medical cost by the national health examination analysis. National Evidence-based Health Collaborating Agency: Seoul, Korea, 2014.
18. Statistics Korea. Cause of death in 2016, Statistics Korea; 2017.
19. Heron M. Deaths: Leading Causes for 2012. Natl Vital Stat Rep; 2015.
20. Gupta R, Deedwania PC, Sharma K, et al. Association of educational, occupational and socioeconomic status with cardiovascular risk factors in Asian Indians: a cross-sectional study. PLoS One 2012;7(8):e44098.
21. Back JH, Lee Y. Gender differences in the association between socioeconomic status (SES) and depressive symptoms in older adults. Arch Gerontol Geriatr 2011;52(3):e140–e144.
22. McNeill LH, Kreuter MW, Subramanian SV. Social environment and physical activity: a review of concepts and evidence. Soc Sci Med 2006;63(4):1011–22.
23. Stringhini S, Sabia S, Shipley M. Association of socioeconomic position with health behaviors and mortality. JAMA 2010;303(12):1159–66.
24. Park MJ, Yun KE, Lee GE, et al. A cross-sectional study of socioeconomic status and the metabolic syndrome in Korean adults. Ann Epidemiol 2007;17(4):320–26.
25. Santos AC, Ebrahim S, Barros H. Gender, socio-economic status and metabolic syndrome in middle-aged and old adults. BMC Public Health 2008;8:62.
26. Marmot MG. Status syndrome: a challenge to medicine. JAMA 2006;295(11):1304–307.