Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans.Methods: Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database.Results: The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m2) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02–7.89).Conclusion: The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea.
Abstract
Background: The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans.Methods: Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database.Results: The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m2) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02–7.89).Conclusion: The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea.
참고문헌 (31)
- Chimonas T, "Diverging trends in cardiovascular morbidity and mortality in a low risk population", Eur J Epidemiol, 24, pp.415~423 (2009)[DOI]
- National Kidney Foundation, "K", DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification, 2002, pp.39(2 Suppl 1), S1~S266
- Muntner P, "Renal insufficiency and subsequent death resulting from cardiovascular disease in the United States", J Am Soc Nephrol, 13, pp.745~753 (2002)
- Shlipak MG, "Renal insufficiency and cardiovascular events in postmenopausal women with coronary heart disease", J Am Coll Cardiol, 38, pp.705~711 (2001)[DOI]
- McDonald JT, "Is migration to Canada associated with unhealthy weight gain?: overweight and obesity among Canada's immigrants", Soc Sci Med, 61, pp.2469~2481 (2005)[DOI]
- Goel MS, "Obesity among US immigrant subgroups by duration of residence", JAMA, 292, pp.2860~2867 (2004)[DOI]
- Haggard S, "Famine in North Korea: markets, aid, and reform" (2009), Columbia University Press
- [URL]
- 이인숙, "북한 이탈 아동의 신체 및 심리적 건강상태 평가", Child Health Nursing Research, 17(4), pp.256~263 (2011), 한국아동간호학회
- Schwekendiek D, "Recent growth of children in the two Koreas: a meta-analysis", Econ Hum Biol, 7, pp.109~112 (2009)[DOI]
- Dorman K, "Health status of North Korean refugees in Toronto: a community based participatory research study", J Immigr Minor Health, 19, pp.15~23 (2017)[DOI]
- Lee YH, "North Korean refugee health in South Korea (NORNS) study: study design and methods", BMC Public Health, 12, pp.172~ (2012)[DOI]
- Levey AS, "A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group", Ann Intern Med, 130, pp.461~470 (1999)[DOI]
- Levey AS, "Chronic kidney disease", Lancet, 379, pp.165~180 (2012)[DOI]
- Bo A, "Coronary heart disease incidence among non-Western immigrants compared to Danish-born people: effect of country of birth, migrant status, and income", Eur J Prev Cardiol, 22, pp.1281~1289 (2015)[DOI]
- Gadd M, "Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease?", Eur J Cardiovasc Prev Rehabil, 12, pp.535~541 (2005)[DOI]
- Lara-Esqueda A, "The body mass index is a less-sensitive tool for detecting cases with obesity-associated co-morbidities in short stature subjects", Int J Obes Relat Metab Disord, 28, pp.1443~1450 (2004)[DOI]
- Shiwaku K, "Appropriate BMI for Asian populations", Lancet, 363, pp.1077~ (2004)
- Lofgren I, "Waist circumference is a better predictor than body mass index of coronary heart disease risk in overweight premenopausal women", J Nutr, 134, pp.1071~1076 (2004)[DOI]
- McDonald JT, "Insights into the ‘healthy immigrant effect': health status and health service use of immigrants to Canada", Soc Sci Med, 59, pp.1613~1627 (2004)[DOI]
- Norredam M, "Inequalities in mortality among refugees and immigrants compared to native Danes: a historical prospective cohort study", BMC Public Health, 12, pp.757~ (2012)[DOI]
- 최슬기, "Still life with less: North Korean young adult defectors in South Korea show continued poor nutrition and physique", Nutrition Research and Practice, 4(2), pp.136~141 (2010), 한국영양학회
- Wang BR, "Factors associated with the frequency of physician visits among North Korean defectors residing in South Korea: a cross-sectional study", BMC Health Serv Res, 15, pp.90~ (2015)[DOI]
- Spallek J, "What do we have to know from migrants' past exposures to understand their health status?: a life course approach", Emerg Themes Epidemiol, 8, pp.6~ (2011)[DOI]
- 김정은, "Nutritional State of Children in the Democratic People’s Republic of Korea (DPRK): Based on the DPRK Final Report ofthe National Nutrition Survey 2012", Pediatric Gastroenterology, Hepatology & Nutrition, 17(3), pp.135~139 (2014), 대한소아소화기영양학회
- Chang N, "Anthropometric measurements and dietary patterns of North Korean migrant children in China", Korean J Nutr, 33, pp.324~331 (2000)
- Klahr S, "Effects of chronic protein-calorie malnutrition on the kidney", Kidney Int, 3, pp.129~141 (1973)[DOI]
- Bruce MA, "Social environmental stressors, psychological factors, and kidney disease", J Investig Med, 57, pp.583~589 (2009)[DOI]
- Day EC, "Associations of acculturation and kidney dysfunction among Hispanics and Chinese from the Multi-Ethnic Study of Atherosclerosis (MESA)", Nephrol Dial Transplant, 26, pp.1909~1916 (2011)[DOI]
- 연미영, "한국인의 나트륨 섭취 급원 음식 및 섭취 양상 - 2008-2009 국민건강영양조사 자료에 근거 -", 대한지역사회영양학회지, 16(4), pp.473~487 (2011), 대한지역사회영양학회
- Lin J, "Associations of diet with albuminuria and kidney function decline", Clin J Am Soc Nephrol, 5, pp.836~843 (2010)[DOI]
