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Original Articles
Associations of fasting glucose and glycated hemoglobin with vitamin D levels according to diabetes mellitus status in Korean adults
Yerin Hwang, Jiyoung Jang, Myung-Hee Shin
Epidemiol Health. 2022;44:e2022025.   Published online February 21, 2022
DOI: https://doi.org/10.4178/epih.e2022025
  • 12,463 View
  • 374 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
According to previous studies, vitamin D deficiency might increase the risk of type 2 diabetes mellitus (DM). However, few studies have examined whether vitamin D continues to affect glucose control after DM diagnosis. Therefore, we examined the association between vitamin D and glucose levels in individuals with and without DM.
METHODS
We analyzed data for 32,943 adults aged 19 years and older from the 2008 to 2014 Korea National Health and Nutrition Examination Survey. Patients were classified into 3 groups according to the 25-hydroxyvitamin D concentration. DM was defined as a fasting glucose level ≥126 mg/dL, current use of DM medications or insulin injections, or a self-reported diagnosis of DM by a doctor.
RESULTS
In male DM patients, the hemoglobin A1c (HbA1c) level increased significantly as vitamin D levels became severely deficient. In male and postmenopausal female with abnormal HbA1c, those with severe vitamin D deficiency had significantly higher HbA1c levels (p for trend=0.004 and 0.022 for male and postmenopausal female, respectively). Significant differences were found between participants with normal and abnormal HbA1c levels in both male and female. However, regardless of sex or menopausal status, there was no significant association between vitamin D and fasting glucose in any of the fasting glucose subgroups.
CONCLUSIONS
Male and female with abnormal HbA1c levels showed markedly elevated blood glucose when they also had vitamin D deficiency. A more distinct difference was observed in the HbA1c subgroups than in the fasting glucose subgroups.
Summary
Korean summary
당화혈색소 비정상군에서 비타민 D가 부족할수록 혈당의 상승을 보였다. 현재까지 비타민 D와 혈당 조절과 관련하여 한국인을 대상으로 한 연구는 매우 미비한 상황이며, 한국인을 대상으로 한 연구 결과를 반영한 당뇨병 환자들의 혈당 조절 관리 지침 마련이 필요하다.
Key Message
Guidelines are needed for managing glucose control in DM patients that reflect the results of this research performed among Koreans. Additional large-scale longitudinal studies should be conducted to clarify the causal relationships underlying this association.
The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies
Mehmet Onur Kaya, Esra Pamukçu, Burkay Yakar
Epidemiol Health. 2021;43:e2021074.   Published online September 23, 2021
DOI: https://doi.org/10.4178/epih.e2021074
  • 24,896 View
  • 659 Download
  • 53 Web of Science
  • 56 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.
METHODS
We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.
RESULTS
Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).
CONCLUSIONS
According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.
Summary
Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.

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  • Integrated bioinformatics and in silico approaches reveal the biological targets and molecular mechanisms of 1,25-dihydroxyvitamin D against COVID-19 and diabetes mellitus
    Fanqiang Zeng, Yongli Xu, Chaoling Tang, Zhigang Yan, Chaohe Wei
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    Endrit Shahini, Francesco Pesce, Antonella Argentiero, Antonio Giovanni Solimando
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • Cholecalciferol as part of complex therapy for acute COVID-19
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Seasonality of tuberculosis in the Republic of Korea, 2006-2016
Eun Hee Kim, Jong-Myon Bae
Epidemiol Health. 2018;40:e2018051.   Published online October 20, 2018
DOI: https://doi.org/10.4178/epih.e2018051
  • 17,573 View
  • 205 Download
  • 13 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016.
METHODS
Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages.
RESULTS
While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016.
CONCLUSIONS
Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.
Summary
Korean summary
2006-2016년 신고된 신환자의 연보를 근거로 결핵발생의 계절성 여부를 분석한 결과, 2006-2012년까지는 여름, 2013년이후는 봄에 발생 신고율이 높은 계절성을 확인하였다. 계절성을 야기하는 이유들을 찾아서 향후 결핵 예방에 활용할 필요가 있다.

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Development and validation of a sunlight exposure questionnaire for urban adult Filipinos
Marc Gregory Yu, Nina Castillo-Carandang, Maria Elinor Grace Sison, Angelique Bea Uy, Katrina Lenora Villarante, Patricia Maningat, Elizabeth Paz-Pacheco, Eileen Abesamis-Cubillan
Epidemiol Health. 2018;40:e2018050.   Published online October 11, 2018
DOI: https://doi.org/10.4178/epih.e2018050
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AbstractAbstract PDF
Abstract
OBJECTIVES
To develop and validate a self-reported sunlight exposure questionnaire (SEQ) for urban adult Filipinos.
METHODS
The study included adults (19-76 years old) in Metro Manila, Philippines, well-versed in the Filipino (Tagalog) language and had resided in Metro Manila for at least 1 year. Exclusion criteria included pregnancy, active skin disorders, and immunocompromised states. An expert panel created a questionnaire in Likert-scale format based on a conceptual framework and 4 existing instruments. The study proceeded in 4 phases: questionnaire item development, translation and back-translation, pretesting, and construct validity and reliability testing using factor analysis, the Cronbach alpha coefficient, and the paired t-test.
RESULTS
A 25-item, self-administered, Filipino (Tagalog) SEQ answerable using a 4-point Likert scale was created. The questionnaire was administered to 260 adult participants twice at a 2-week interval, with all participants completing both the first and second rounds of testing. All questionnaire items possessed adequate content validity indices of at least 0.86. After factor analysis, 3 questionnaire domains were identified: intensity of sunlight exposure, factors affecting sunlight exposure, and sun protection practices. Internal consistency was satisfactory for both the overall questionnaire (Cronbach alpha, 0.80) and for each of the domains (Cronbach alpha, 0.74, 0.71, and 0.72, respectively). No statistically significant differences were observed in the responses between the first and second rounds of testing, indicating good test-retest reliability.
CONCLUSIONS
We developed a culturally-appropriate SEQ with sufficient content validity, construct validity, and reliability to assess sunlight exposure among urban adult Filipinos in Metro Manila, Philippines.
Summary

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  • Reliability and validity of the Chinese version of the sunlight exposure questionnaire
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    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Development and Validation of Vitamin D- Food Frequency Questionnaire for Moroccan Women of Reproductive Age: Use of the Sun Exposure Score and the Method of Triad’s Model
    Noura Zouine, Ilham Lhilali, Aziza Menouni, Lode Godderis, Adil El Midaoui, Samir El Jaafari, Younes Zegzouti Filali
    Nutrients.2023; 15(4): 796.     CrossRef
  • Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age
    Ilham Lhilali, Noura Zouine, Aziza Menouni, Lode Godderis, Marie-Paule Kestemont, Adil El Midaoui, Samir El Jaafari, Younes Filali-Zegzouti
    Nutrients.2023; 15(3): 688.     CrossRef
  • Vitamin D Deficiency and Diseases
    Yasir Mahmood, Nazish Waris, Asher Fawwad, Abdul Basit
    Journal of Diabetology.2021; 12(4): 391.     CrossRef
  • Association of sunlight exposure with 25-hydroxyvitamin D levels among working urban adult Filipinos
    Noemie Marie M. Mansibang, Marc Gregory Y. Yu, Cecilia A. Jimeno, Frances Lina Lantion-Ang
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Perspective
Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students
Eun Hee Kim, Jong-Myon Bae
Epidemiol Health. 2018;40:e2018035.   Published online July 27, 2018
DOI: https://doi.org/10.4178/epih.e2018035
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.
Summary
Korean summary
잠복결핵검진 검사 양성자이면서 항결핵제 복용을 거부하는 고1학생에 대한 사후 조치가 필요하다. 그동안의 연구결과들에 근거할 때, 잠복결핵이 활동성결핵으로의 전환을 억제하기 위해서 비타민 D 보충제의 투여를 검토해 볼 수 있다.

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  • Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
    Yan Cao, Xinjing Wang, Ping Liu, Yue Su, Haotian Yu, Jingli Du
    BMC Pulmonary Medicine.2022;[Epub]     CrossRef
  • Association of vitamin D levels and risk of latent tuberculosis in the hemodialysis population
    Shang-Yi Lin, Yi-Wen Chiu, Hui-Ru Yang, Tun-Chieh Chen, Min-Han Hsieh, Wen-Hung Wang, Yen-Hsu Chen
    Journal of Microbiology, Immunology and Infection.2021; 54(4): 680.     CrossRef
  • A scoping review on climate change and tuberculosis
    Bijay Maharjan, Ram Sharan Gopali, Ying Zhang
    International Journal of Biometeorology.2021; 65(10): 1579.     CrossRef
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Review
Food, Nutrient, and the Risk of Breast Cancer.
Myung Hee Shin
Korean J Epidemiol. 2002;24(2):164-170.
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AbstractAbstract PDF
Abstract
Nutrients are the primary dietary component that are of interest in studying the diet-disease relationships because they give us more direct biological mechanisms. However, exploring the associations of the foods or food groups with disease occurrence could also give us an important information in the causal relationships between diet and diseases. When there are no specific nutrient that was shown to be related to a disease, a relationship between a certain food and the disease could provide a new hypothesis for the responsible components. If an association exists with both the overall intake of a nutrient and more than one food source of that nutrient, it is more likely that the association is causal. On the other hand, foods with similar nutrient components could have different effects on our body due to a complex interaction between the nutrients within the food. Epidemiologists should employ both approach (nutrient and food) in order to have an unbiased assessment for the association between diet and diseases. We will take an example of a cohort study which looked at the association between dairy products, calcium, and vitamin D and the risk of breast cancer.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
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