Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea

Seong, Sang Cheol; Kim, Yeon Yong; Park, Sung Sup; Khang, Young-Ho; Kim, Hyeon Chang; Park, Jong Heon; Kang, Hee Jin; Ho, Cheol; Song, Jong Sun; Lee, Eun Joo; Ha, Seongjun; Shin, Soon Ae; Jeong, Seung lyeal

doi:10.1136/bmjopen-2017-016640

Cited by 580 publications

(499 citation statements)

References 16 publications

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“…Records from inpatient and outpatient department visits including diagnosis, drug prescriptions, treatment, and surgical procedures are collected. Furthermore, the NHIS provides biannual mandatory health screening examinations for all enrollees 40 years or older . The health screening examination consists of a self‐reported questionnaire on health behavior, body measurements including height, weight, and blood pressure, and blood and urine tests.…”

Section: Methodsmentioning

confidence: 99%

“…From this claims database, the NHIS provides a part of its data for research purposes that include information on inpatient and outpatient hospital use, drug prescriptions, death dates, and results from health screening examinations. The NHIS database was previously used for multiple epidemiological studies, and its validity is described in detail elsewhere …”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the NHIS provides biannual mandatory health screening examinations for all enrollees 40 years or older. 14 The health screening examination consists of a self-reported questionnaire on health behavior, body measurements including height, weight, and blood pressure, and blood and urine tests. From this claims database, the NHIS provides a part of its data for research purposes that include information on inpatient and outpatient hospital use, drug prescriptions, death dates, and results from health screening examinations.…”

Section: Study Populationmentioning

confidence: 99%

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Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Choi

Kim

Chang

et al. 2019

J American Geriatrics Society

116

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OBJECTIVES Although chronic periodontitis has been associated with Alzheimer's disease, the effect of chronic periodontitis on vascular dementia as well as the role of lifestyle behaviors such as smoking, alcohol consumption, and physical activity in this association are still unclear. DESIGN Retrospective cohort study. SETTING Population based. PARTICIPANTS The study population was derived from the Korean National Health Insurance Service‐Health Screening Cohort. Among 262 349 participants, diagnosis of chronic periodontitis was determined during 2003‐2004. MEASUREMENTS Starting from 2005, participants were followed up for overall dementia, Alzheimer's disease, and vascular dementia until 2015. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementia according to chronic periodontitis. RESULTS Compared with nonchronic periodontitis participants, chronic periodontitis patients had elevated risk for overall dementia (aHR = 1.06; 95% CI = 1.01‐1.11) and Alzheimer's disease (aHR = 1.05; 95% CI = 1.00‐1.11). There was a tendency toward increased vascular dementia risk among chronic periodontitis patients (aHR = 1.10; 95% CI = 0.98‐1.22). The risk‐increasing effect of chronic periodontitis on dementia tended to be stronger among participants with healthy lifestyle behaviors including never‐smokers and those who exercised and did not consume alcohol. CONCLUSION Chronic periodontitis may be associated with a higher risk of developing dementia. Future studies that investigate whether preventing chronic periodontitis may lead to reduced risk of dementia are needed.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

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Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Choi

Kim

Chang

et al. 2019

J American Geriatrics Society

116

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“…Information on medical utilization includes diagnoses with the International Classification of Diseases, 10th revision (ICD‐10) codes and drug prescription information on days and dosages with the anatomical therapeutic chemical code for each prescribed drug for each outpatient visit or hospitalization. In addition, NHI provides a biennial national health screening program (NHSP) to all members aged older than 40 years, in which the participation rate is 74.8% . The NHSP includes a self‐questionnaire on health behavior, anthropometric measurements, and a laboratory test (eg, fasting glucose and lipid levels).…”

Section: Methodsmentioning

confidence: 99%

Association of statin use with Parkinson's disease: Dose–response relationship

2019

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Background There have been conflicting results on the association between statin use and Parkinson's disease (PD) incidence. Objectives This study investigated the association between time‐varying status of statin use and incidence of PD while considering the dose–response relationship and total cholesterol level. Methods Using the database of the Korean National Health Insurance Service from 2002 to 2015, we examined 76,043 subjects (≥60 years old) free of PD, dementia, and stroke at baseline. The dose of statin use was classified into the following four 6‐month categories (<180, 180‐365, 365‐540, and ≥540 days) for each 2‐year interval. The incidence of PD was identified by the prescription records for any anti‐PD medication with a diagnosis of PD. Results During 10 years of follow‐up, 1,427 PD cases occurred. Statin “ever use” was significantly associated with a high risk of PD incidence (adjusted hazard ratio = 1.28; 95% confidence interval = 1.12‐1.46) when compared with statin nonuse. In terms of a dose–response relationship, although a duration of statin use <365 days was associated with a higher risk of PD, the duration of statin use ≥365 days was not significantly associated with an increased risk of PD. Conclusions Statin use was associated with an elevated PD risk of PD, but long‐term and adherent statin use was not significantly associated with elevated PD risk. However, there was no evidence of benefit with any statin treatment related to PD risk. Our study suggests that there is a complex relationship among cholesterol level, statin use, and PD risk that warrants further studies. © 2019 International Parkinson and Movement Disorder Society

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“…The study cohort (n=514 795) was a 10% random sample of 5.15 million NHIS health screening participants during 2002–2003 who were aged 40–79 years in 2002 15. We excluded 85 575 individuals due to missing information (n=1595) on body mass index (BMI), serum fasting glucose, total cholesterol and SBP; known heart disease or stroke (n=9695); or known prevalent hypertension (n=74 285) at baseline as assessed by the NHIS claim database.…”

Section: Methodsmentioning

confidence: 99%

Age-specific associations between systolic blood pressure and cardiovascular mortality

Jung

et al. 2019

Heart

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ObjectiveWe aimed to identify the following in all age groups among individuals without known hypertension and CVD: (1) Whether a systolic blood pressure (SBP) of 130–139 mm Hg elevates cardiovascular disease (CVD) mortality. (2) Whether SBP shows a linear association with cause-specific CVD mortality.MethodsWe used the Korean National Health Insurance sample data (n=429 220). Participants were categorised into three groups by age (40–59 years, 60–69 years and 70–80 years).ResultsDuring 10.4 years of follow-up, 4319 cardiovascular deaths occurred. A positive and graded association was generally observed between SBP and overall and cause-specific CVD mortality regardless of age, except for ischaemic heart disease (IHD) mortality in those aged 70–80 years. Among those aged 70–80 years, the HRs (95% CIs) for overall CVD mortality were 1.08 (0.92–1.28), 1.14 (0.97–1.34) and 1.34 (1.14–1.58) for SBP values of 120–129 mm Hg, 130–139 mm Hg and 140–149 mm Hg, respectively, compared with SBP <120 mm Hg. For total stroke mortality, the corresponding HRs were 1.29 (1.02–1.64), 1.37 (1.09–1.72) and 1.52 (1.20–1.93), while for IHD mortality, the corresponding HRs were 0.90 (0.64–1.26), 0.86 (0.62–1.19) and 1.29 (0.93–1.78), respectively. Non-linear associations were significant for IHD.ConclusionsIn the elderly Korean population, SBPs of 130–139 mm Hg elevated total stroke mortality, but not IHD mortality, compared with normal blood pressure, and a linear association was not observed for IHD mortality in the range <140 mm Hg.

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Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea

Cited by 580 publications

References 16 publications

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

Association of statin use with Parkinson's disease: Dose–response relationship

Age-specific associations between systolic blood pressure and cardiovascular mortality

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