Author's summary Previous observational studies presented a positive association between alcohol and atrial fibrillation (AF). However, previous studies using genetic polymorphisms on the causal relationship between alcohol consumption and AF have reported conflicting results. This study evaluated the causality between alcohol consumption and AF using the aldehyde dehydrogenase 2 ( ALDH2 ) rs671 polymorphism. In 8,964 cohort participants, genetic analysis and Mendelian randomization analysis using the ALDH2 genotypes showed a significant causal association between alcohol consumption and AF in men.

This study aimed to examine the association between body mass index (BMI) and self-rated health (SRH) in Korean adults. Methods The study included 214,997 adults who participated in the 2016 Korean Community Health Survey. Participants were categorized into four groups according to WHO Asian classification based on their BMI: underweight (<18.5 kg/m 2), normal-weight (18.5-22.9 kg/m 2), overweight (23.0-24.9 kg/m 2), obese (25.0-29.9 kg/m 2), and severely obese (�30.0 kg/m 2). Multivariate Poisson regression analysis with sampling weights and robust variance estimators was performed to evaluate the relationship between BMI categories and poor SRH. Results A J-shaped association was observed between BMI and poor SRH in both sexes. Compared to normal-weight subjects, the age, lifestyle, and comorbidities adjusted prevalence rate ratios (PRRs) in men for poor SRH were 1.73 (95% confidence interval [CI], 1.60-1.88) for underweight, 0.87 (95% CI, 0.83-0.92) for overweight, 0.98 (95% CI, 0.93-1.03) for obese, and 1.79 (95% CI, 1.63-1.97) for severely obese. In women, compared to normalweight subjects, the age, lifestyle, and comorbidities adjusted PRRs for poor SRH were 1.33

This study aimed to investigate the prevalence of depression among Koreans living in urban and rural areas, stratified by socioeconomic status. The study included 216,765 participants from the 2017 Korean Community Health Survey. Depressive symptoms were assessed using the PHQ-9, with a score of 10 or higher indicating depressive symptoms. Residences with the words Eup and Myeon in their addresses were categorized as rural areas, and residences with Dong in their addresses as urban areas. Socioeconomic status was evaluated by household income and education level. A Poisson regression analysis with sampling weights was conducted and adjusted for demographic, lifestyle, socioeconomic status, and comorbidity. The adjusted prevalence rate of depressive symptoms was 3.33% (95% CI, 3.21-3.45) in urban areas and 2.59% (95% CI, 2.43-2.74) in rural areas. The prevalence of depressive symptoms in urban areas was 1.29 times (95% CI, 1.20-1.38) higher than in rural areas. The prevalence rate ratio for depressive symptoms in urban areas compared to rural areas sorted by monthly incomes was 1.39 (95% CI, 1.28-1.51) for less than 2 million won, 1.22 (95% CI, 1.06-1.41) for 2 to 3.99 million won, and 1.09 (95% CI, 0.90-1.32) for more than 4 million won, and the urban-rural difference was more evident in lower household income subjects (p for interaction=0.033). However, urban-rural differences did not differ according to sex, age, or education level. In conclusion, we found urban-rural differences in depressive symptoms in a representative sample of Koreans, and revealed that these differences may vary according to income level. These results suggest that mental health policy must consider the health disparities according to residence and income.

Objective: Several previous studies have evaluated associations between body mass index (BMI) and self-rated health (SRH); however, the results were inconsistent. This study aimed to examine the association between BMI and SRH in Korean adults. Methods:The study was conducted in 214,997 adults who participated in the 2016 Korean Community Health Survey. Participants were categorized into four groups based on BMI: underweight (<18.5 kg/m 2 ), normal weight (18.5-24.9 kg/m 2 ), overweight (25.0-29.9 kg/m 2 ), or obese (≥30.0 kg/m 2 ). Multivariate Poisson regression analysis with sampling weights and robust variance estimators was performed to evaluate the relationship between BMI categories and poor SRH. Results:There was a J-shaped association between BMI and poor SRH in both sexes, with the lowest risk observed in the normal weight group in both sexes. Compared with normal weight subjects, the age and lifestyle adjusted prevalence rate ratios for poor SRH were 1.61 (95% CI, 1.50-1.74) for underweight, 1.16 (95% CI, 1.11-1.21) for overweight, and 2.35 (95% CI, 2.13-2.58) for obese men; and 1.24 (95% CI, 1.17-1.32) for underweight, 1.26 (95% CI, 1.22-1.31) for overweight, and 1.77 (95% CI, 1.64-1.91) for obese women. Conclusions:In a cross-sectional study using a nationally representative survey, there was a nonlinear relationship between BMI and poor SRH. This relationship was more prominent in men than in women. Prospective studies are needed to further clarify the relationship between BMI and SRH.

Improved diabetes management in primary care is essential for reducing the public health burden of diabetes, and various programs are being implemented in Korea for this purpose. Although the Health Insurance Review and Assessment (HIRA) evaluates the quality of type 2 diabetes management in primary care clinics and hospitals, it is unclear whether the implementation of these evaluations is related to the adequate management of complications in diabetic patients. We evaluated the association between the proportion of clinics managing diabetes well and lifestyles and uptake of screening for complications in 24,620 diabetic participants of the 2019 Korean Community Health Survey (KCHS). Multivariate multilevel logistic regression was performed to evaluate the fixed effect of the district-level variable and the heterogeneity among districts. The proportion of clinics with good diabetes management per 10,000 inhabitants was positively related to screening for diabetes complications. Furthermore, this district variable was significantly related to engaging in walking activity (Odds ratio: 1.39, 95% CI: 1.10–1.76) and sufficiently explained the heterogeneity among districts. However, current smoking and weight control were not associated with the proportion of clinics with good diabetes management. The financial incentives to primary care clinics would improve the primary prevention of diabetic complications.