Diabetes Mellitus Inequality in South Korean Adults by Region: The Influence of Obesity and Depression
Abstract
Background: Diabetes mellitus (DM) has different prevalence by region. This study aimed to identify the differences in the effects of obesity and depression on DM in South Korean adults by region.
Methods: The participants were 14,343 adults (≥30 yr) from Ulsan (regions with the lowest prevalence of DM) and Jeonbuk (regions with the highest prevalence of DM), and data were extracted from the Community Health Survey 2019. We applied a complex sampling design analysis to reflect the stratified, clustering and weights. The data were analyzed using the unweighted frequencies, weighted percentage, mean, standard error, Chi-Square test and multiple logistic regression analysis (SPSS 25.0).
Results: Regarding the main result for Ulsan, the odds ratio of DM increased by 1.94, 2.52,1.57, and 4.87 times for obesity(25-29.9kg/m²), high obesity(≥30kg/m²), depression, and receipt of psychological counseling for depression, respectively. In Jeonbuk, the odds ratio of DM increased by 1.79, 2.84, and 3.59 times for obesity, high obesity, and unmet medical experience, respectively. On the other hand, depression-related variables were found to not influence DM
Conclusion: We provided the rationale for conducting a health project that interventions for obesity and depression should be included in DM management programs differently in Ulsan and Jeonbuk regions.
1. International Diabetes Federation (2021). IDF Diabetes Atlas (10th ed). Brussels: In-ternational Diabetes Federation.
2. Korean Community Health Survey (2019). 2019 Korea Centers for Disease Control and Prevention. Korea, Osong: Korea Cen-ters for Disease Control and Prevention.
3. Assmann G, Nofer JR, Schulte H (2004). Cardiovascular risk assessment in the metabolic syndrome: view from PRO-CAM. Endocrinol Metab Clin North Am, 33(2):377-392.
4. Dabelea D, DeGroat J, Sorrelman C, et al (2009). Diabetes in Navajo youth: preva-lence, incidence, and clinical character-istics: the search for diabetes in youth study. Diabetes Care, 32 Suppl 2(Suppl 2):S141-7.
5. World Health Organization. Regional Of-fice for the Western Pacific (2017). Overweight and Obesity in the Western Pacific Region: an equity perspective. Philippines, Manila: WHO Regional Of-fice for the Western Pacific.
6. Korea Centers for Disease Control and Prevention (2016). The Sixth Korea Na-tional Health and Nutrition Examina-tion Survey (KNHANES Ⅶ-1). Korea, Osong: Korea Centers for Disease Con-trol and Prevention.
7. Shulman GI (2000). Cellular mechanisms of insulin resistance. J Clin Invest, 106(2):171-176.
8. Akter R, Nessa A, Husain MF, et al (2017). Effect of obesity on fasting blood sugar. Mymensingh Med J, 26(1):7-11.
9. Rubin RR, Ma Y, Marrero DG, et al (2008). Elevated depression symptoms, antide-pressant medicine use, and risk of de-veloping diabetes during the diabetes prevention program. Diabetes Care, 31(3):420-426.
10. Kammer JR, Hosler AS, LeckmanWestin E, et al (2016). The association between an-tidepressant use and glycemic control in the Southern Community Cohort Study. J Diabetes Complications, 30(2):242-247.
11. Black SA, Markides KS, Ray LA (2003). De-pression predicts increased incidence of adverse health outcomes in older Mexi-can Americans with type 2 diabetes. Di-abetes Care, 26(10):2822-8.
12. Roy T, Lloyd CE (2012). Epidemiology of depression and diabetes: a systematic review. J Affect Disord, 142 Suppl:S8-21.
13. Gonzalez JS, Peyrot M, McCarl LA, et al (2008). Depression and diabetes treat-ment nonadherence: a meta-analysis. Diabetes Care, 31(12):2398-2403.
14. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders DSM-5 (5th ed). Arlington: Amer-ican Psychiatric Association.
15. Kroenke K, Spitzer RL, Williams JBW, Lowe B (2010). The Patient Health Ques-tionnaire Somatic, Anxiety, and Depres-sive Symptom Scales: a systematic re-view. Gen Hosp Psychiatry, 32(4):345-359.
16. Kroenke K, Spitzer RL, Williams JBW (2001). The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med,16(9):606-613.
17. Al-Goblan AS, Al-Alfi MA, Khan MZ (2014). Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes, 7: 587–591.
18. Lee HS (2019). Sex difference in the effect of body mass index and stress on high-risk diabetes mellitus in Korean adults. Journal of Korean Biological Nursing Science, 21(3):224-230.
19. Ma Q, Liu H, Xiang G, Shan W, Xing A (2016). Association between glycated hemoglobin A1c levels with age and gender in Chinese adults with no prior diagnosis of diabetes mellitus. Biomed Rep, 4(6):737-740.
20. Mommersteeg PM, Herr R. Pouwer F, et al (2013). The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231797 individuals from 47 countries. Diabet Med, 30(6):e208-214.
21. Rubin RR, Ma Y, Peyrot M, et al (2010). An-tidepressant medicine use and risk of developing diabetes during the diabetes prevention program and diabetes pre-vention program outcomes study. Diabe-tes Care, 33(12): 2549-2551.
22. Bădescu SV, Tătaru C, Kobylinska L, et al (2016). The association between Diabe-tes mellitus and Depression. J Med Life, 9(2): 120-125.
23. Meurs M, Roest AM, Wolffenbuttel BHR, et al (2016). Association of Depressive and Anxiety Disorders with Diagnosed Ver-sus Undiagnosed Diabetes: An Epide-miological Study of 90,686 Participants. Psychosom Med, 78(2):233-241.
24. Berge LI, Riise T (2015). Comorbidity be-tween Type 2 Diabetes and Depression in the Adult Population: Directions of the Association and Its Possible Patho-physiological Mechanisms. Int J Endo-crinol, 2015: 164760
25. Kautzky-Willer A, Jürgen Harreiter J, Pacini G (2016). Sex and Gender Differences in Risk, Pathophysiology and Complica-tions of Type 2 Diabetes Mellitus. Endocr Rev, 37(3): 278–316.
26. Tang M, Chen Y, Krewski D (2003). Gen-der-related differences in the associa-tion between socioeconomic status and self-reported diabetes. Int J Epidemiol, 32(3):381-385.
27. Jang. EH (2020). Gender difference in qual-ity of life among workers with diabetes mellitus. Journal of Digital Convergence, 18(8):281-291.
28. Lee KI (2019). The Relationship with Geological Proximity of Medical Institution and Cure Rates of Chronic Diseases: Diabetes and High Blood Pressure [master's thesis]. Seoul Na-tional University, Korea.
29. Yun KO (2016). Diabetes Management through Care Communities. J Korea Dia-bete,17(4): 271-276.
2. Korean Community Health Survey (2019). 2019 Korea Centers for Disease Control and Prevention. Korea, Osong: Korea Cen-ters for Disease Control and Prevention.
3. Assmann G, Nofer JR, Schulte H (2004). Cardiovascular risk assessment in the metabolic syndrome: view from PRO-CAM. Endocrinol Metab Clin North Am, 33(2):377-392.
4. Dabelea D, DeGroat J, Sorrelman C, et al (2009). Diabetes in Navajo youth: preva-lence, incidence, and clinical character-istics: the search for diabetes in youth study. Diabetes Care, 32 Suppl 2(Suppl 2):S141-7.
5. World Health Organization. Regional Of-fice for the Western Pacific (2017). Overweight and Obesity in the Western Pacific Region: an equity perspective. Philippines, Manila: WHO Regional Of-fice for the Western Pacific.
6. Korea Centers for Disease Control and Prevention (2016). The Sixth Korea Na-tional Health and Nutrition Examina-tion Survey (KNHANES Ⅶ-1). Korea, Osong: Korea Centers for Disease Con-trol and Prevention.
7. Shulman GI (2000). Cellular mechanisms of insulin resistance. J Clin Invest, 106(2):171-176.
8. Akter R, Nessa A, Husain MF, et al (2017). Effect of obesity on fasting blood sugar. Mymensingh Med J, 26(1):7-11.
9. Rubin RR, Ma Y, Marrero DG, et al (2008). Elevated depression symptoms, antide-pressant medicine use, and risk of de-veloping diabetes during the diabetes prevention program. Diabetes Care, 31(3):420-426.
10. Kammer JR, Hosler AS, LeckmanWestin E, et al (2016). The association between an-tidepressant use and glycemic control in the Southern Community Cohort Study. J Diabetes Complications, 30(2):242-247.
11. Black SA, Markides KS, Ray LA (2003). De-pression predicts increased incidence of adverse health outcomes in older Mexi-can Americans with type 2 diabetes. Di-abetes Care, 26(10):2822-8.
12. Roy T, Lloyd CE (2012). Epidemiology of depression and diabetes: a systematic review. J Affect Disord, 142 Suppl:S8-21.
13. Gonzalez JS, Peyrot M, McCarl LA, et al (2008). Depression and diabetes treat-ment nonadherence: a meta-analysis. Diabetes Care, 31(12):2398-2403.
14. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders DSM-5 (5th ed). Arlington: Amer-ican Psychiatric Association.
15. Kroenke K, Spitzer RL, Williams JBW, Lowe B (2010). The Patient Health Ques-tionnaire Somatic, Anxiety, and Depres-sive Symptom Scales: a systematic re-view. Gen Hosp Psychiatry, 32(4):345-359.
16. Kroenke K, Spitzer RL, Williams JBW (2001). The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med,16(9):606-613.
17. Al-Goblan AS, Al-Alfi MA, Khan MZ (2014). Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes, 7: 587–591.
18. Lee HS (2019). Sex difference in the effect of body mass index and stress on high-risk diabetes mellitus in Korean adults. Journal of Korean Biological Nursing Science, 21(3):224-230.
19. Ma Q, Liu H, Xiang G, Shan W, Xing A (2016). Association between glycated hemoglobin A1c levels with age and gender in Chinese adults with no prior diagnosis of diabetes mellitus. Biomed Rep, 4(6):737-740.
20. Mommersteeg PM, Herr R. Pouwer F, et al (2013). The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231797 individuals from 47 countries. Diabet Med, 30(6):e208-214.
21. Rubin RR, Ma Y, Peyrot M, et al (2010). An-tidepressant medicine use and risk of developing diabetes during the diabetes prevention program and diabetes pre-vention program outcomes study. Diabe-tes Care, 33(12): 2549-2551.
22. Bădescu SV, Tătaru C, Kobylinska L, et al (2016). The association between Diabe-tes mellitus and Depression. J Med Life, 9(2): 120-125.
23. Meurs M, Roest AM, Wolffenbuttel BHR, et al (2016). Association of Depressive and Anxiety Disorders with Diagnosed Ver-sus Undiagnosed Diabetes: An Epide-miological Study of 90,686 Participants. Psychosom Med, 78(2):233-241.
24. Berge LI, Riise T (2015). Comorbidity be-tween Type 2 Diabetes and Depression in the Adult Population: Directions of the Association and Its Possible Patho-physiological Mechanisms. Int J Endo-crinol, 2015: 164760
25. Kautzky-Willer A, Jürgen Harreiter J, Pacini G (2016). Sex and Gender Differences in Risk, Pathophysiology and Complica-tions of Type 2 Diabetes Mellitus. Endocr Rev, 37(3): 278–316.
26. Tang M, Chen Y, Krewski D (2003). Gen-der-related differences in the associa-tion between socioeconomic status and self-reported diabetes. Int J Epidemiol, 32(3):381-385.
27. Jang. EH (2020). Gender difference in qual-ity of life among workers with diabetes mellitus. Journal of Digital Convergence, 18(8):281-291.
28. Lee KI (2019). The Relationship with Geological Proximity of Medical Institution and Cure Rates of Chronic Diseases: Diabetes and High Blood Pressure [master's thesis]. Seoul Na-tional University, Korea.
29. Yun KO (2016). Diabetes Management through Care Communities. J Korea Dia-bete,17(4): 271-276.
| Files | ||
| Issue | Vol 53 No 7 (2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Adults Depression Diabetes mellitus Obesity | ||
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How to Cite
1.
Park S-H, Lee H. Diabetes Mellitus Inequality in South Korean Adults by Region: The Influence of Obesity and Depression. Iran J Public Health. 2024;53(7):1508-1516.
