This study aimed to assess whether night shift work is associated with the risk of depression by using a meta-analysis of observational studies. We searched PubMed and EMBASE in August, 2016 to locate eligible studies and investigated the association between night shift work and the risk of depression, reporting outcome measures with adjusted odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs). In the meta-analysis of a total of 11 observational studies with 9 cross-sectional study, 1 longitudinal study, and 1 cohort study, night shift work was significantly associated with an increased risk of depression (OR/RR, 1.43; 95% CI, 1.24–1.64; I2 = 78.0%). Also, subgroup meta-analyses by gender, night shift work duration, type of occupation, continent, and type of publication showed that night shift work was consistently associated with the increased risk of depression. The current meta-analysis suggests that night shift work is associated with the increased risk of depression. However, further large prospective cohort studies are needed to confirm this association.

The finding that inadequate social support and discomfort in occupational climate is a better predictor of depressive symptoms than organizational injustice in Korea, indicates that the newly developed KOSS has cultural relevance for assessing occupational stress in Korea. Future studies need to understand factors such as "emotional labor" within certain industries where increased risk for depression is observed.

This study was conducted to assess the association between sarcopenic obesity and cardiovascular disease (CVD) risk in Korean adults (n=3,320; ≥40 yr) who participated in the 5th Korean National Health and Nutrition Examination Survey in 2010. The appendicular skeletal muscle mass divided by body weight was calculated for each participant; participants with values <1 standard deviation below the mean reference value (i.e., aged 20-39 yr) were considered sarcopenic. Subjects were further classified into 4 groups according to their obesity (i.e., body mass index ≥25 kg/m2) and sarcopenic status. Individuals' 10-yr CVD risk was determined using the Framingham risk model. The sarcopenic obese group had more participants (43.8% men, 14.6% women) with a high risk of CVD (≥20%). The sarcopenic obese group was associated with an increased 10-yr CVD risk than the non-sarcopenic, non-obese group (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.53-4.06, P<0.001 in men; OR, 1.87; 95% CI, 1.02-3.41, P=0.041 in women). Sarcopenic non-obese and non-sarcopenic obese subjects were not associated with an increased 10-yr CVD risk. Sarcopenic obesity, but not non-sarcopenic obesity, was closely associated with an increased CVD risk in Korean adults.Graphical Abstract

Atopic dermatitis is a common skin disease in adolescents, which may have a negative effect on the mental and emotional health. We investigated the relationship between atopic dermatitis and suicidal behaviors in Korean adolescents. Participants included 74,186 adolescents (38,221 boys and 35,965 girls) in middle and high school who completed the Eighth Korea Youth Risk Behavior Web-Based Survey. There were significant associations between atopic dermatitis and suicidal behaviors for girls. The overestimation of weight perception might have an additive impact on suicidal risk among girls. However, there were no significant associations between atopic dermatitis and suicidal behaviors in boys.

Background: Atypical symptoms often occur in elderly patients due to impaired homeostasis associated with age-related physiological changes and multiple pathologies. These atypical symptoms make diagnosis difficult and may partially increase morbidity and mortality. This study aimed to determine the incidence of atypical clinical presentation and to identify the effects of age and comorbidities on illness presentation in the elderly. Methods: Medical charts of 6,057 elderly patients (≥60 years) with pneumonia or coronary artery disease (CAD) admitted to 4 university hospitals were retrospectively reviewed. Determinants of atypical symptom presentation was evaluated using logistic regression analysis. The definition of atypical presentation was adapted from a previous study on atypical symptoms of pneumonia and CAD. Results: Among the 6,057 participants, 4,773 (78.8%) and 1,284 (21.2%) presented with typical and atypical symptoms, respectively. Among the participants, 24.8% CAD and 18.8% pneumonia patients had atypical presentations. Logistic regression analysis showed that factors associated with atypical presentation in CAD patients were age (≥85 years; odds ratio [OR], 2.7; 95% confidence interval [CI], 1.81-4.03), higher pulse rate (OR, 1.01; 95% CI, 1.00-1.01), and number of comorbidities ≥4 (OR, 1.62; 95% CI, 1.13-2.32). In pneumonia patients, age (≥85 years; OR, 2.22; 95% CI, 1.49-3.31), body mass index (OR, 0.97; 95% CI, 0.94-0.99), and 1 comorbidity (OR, 1.53; 95% CI, 1.01-2.36) were statistically significant factors that increased atypical presentation. Conclusion: This study suggested that older patients frequently present atypical geriatric syndrome with acute illness, and age and comorbidity are statistically significant factors associated with atypical symptoms in CAD or pneumonia patients.

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Associations between body mass index (BMI), body fat percentage (BF%), and health risks differ between Asian and European populations. BMI is commonly used to diagnose obesity; however, its accuracy in detecting adiposity in Koreans is unknown. The present cross-sectional study aimed at assessing the accuracy of BMI in determining BF%-defined obesity in 6,017 subjects (age 20-69 yr, 43.6% men) from the 2009 Korean National Health and Nutrition Examination Survey. We assessed the diagnostic performance of BMI using the Western Pacific Regional Office of World Health Organization reference standard for BF%-defined obesity by sex and age and identified the optimal BMI cut-off for BF%-defined obesity using receiver operating characteristic curve analysis. BMI-defined obesity (≥25 kg/m2) was observed in 38.7% of men and 28.1% of women, with a high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72% women) for BF%-defined obesity (25.2%, men; 31.1%, women). The optimal BMI cut-off (24.2 kg/m2) had 78% sensitivity and 71% specificity. BMI demonstrated limited diagnostic accuracy for adiposity in Korea. There was a -1.3 kg/m2 difference in optimal BMI cut-offs between Korea and America, smaller than the 5-unit difference between the Western Pacific Regional Office and global World Health Organization obesity criteria.Graphical Abstract

Background: The purpose of this study is to evaluate the influence of job characteristics and occupational stress on health related behavior. Methods: Eight thousand five hundred twenty two workers (21-65 years of age) who recruited from a nationwide sample in Korea completed a self-administered questionnaire regarding socio-demographic factors, job characteristics, healthrelated behaviors such as alcohol consumption, current smoking status & exercise, and occupational stress assessed by Korean Occupational Stress Scale. Multivariate analyses were conducted to analyze the association of occupational stress and job characteristics with health behavior according to gender separately. Results: In male, the problem drinking was positively associated with older age, lower educational level, some industries such as 'transport,' 'wholesale and retail trade' industries, difficult physical environment, insufficient job control, inadequate social support, job insecurity, and organizational injustice. Current smoking was positively associated with younger age, lower educational level, single marital status, lower incomes,'transport' industry and high job demand. The rate of regular exercise was negatively associated with lower incomes, shift works, and the 'electricity, gas and water supply' industies, high job demand, insufficient job control, inadequate social support, job insecurity, and lack of reward. 'Financial institutions and insurance' industry. Conclusion: Occupational stress and certain industrial classification have impact on health related lifestyles in Korean male employees.