What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Obesity, hypertension, diabetes mellitus, and hypercholesterolemia (n=60098). Intervention: COVID-19 pandemic period (2020) vs. Pre-pandemic period (2017-2019). Primary outcome: Obesity prevalence in men (95% CI 3.2 to 8.8).

April 25, 2022Open Access

Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey

Key Result

The COVID-19 pandemic in 2020 was associated with a 6.0 percentage point increase in obesity prevalence among Korean men compared to the 2017-2019 pre-pandemic average.

Study Design

Type

Cross-Sectional (n=60,098)

Structured PICO

Did the COVID-19 pandemic increase the prevalence of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults?

Population

60,098 Korean adults aged ≥19 years from the Korea National Health and Nutritional Examination Survey (KNHANES) between 2011 and 2020.

Intervention

COVID-19 pandemic period (2020)

Comparator

Pre-pandemic period (2017-2019)

Outcome

Age-standardized prevalence and annual percent changes (APCs) of obesity, hypertension, diabetes, and hypercholesterolemia

The COVID-19 pandemic was associated with a significant increase in the prevalence of obesity, diabetes, and hypercholesterolemia among Korean men, highlighting the secondary public health impact of the pandemic on cardiometabolic health.

Main Result

Absolute Event Rate: 48% vs 42.1%

Limitations

Sample was limited to the non-institutionalized civilian population, excluding those admitted to hospitals or nursing homes.
Information on disease diagnosis and medication usage was obtained through self-reporting, leaving a possibility of measurement error.
Sample size was insufficient to determine the management status of chronic diseases by year.
Possibility that the increase was observed by chance due to random error or variation cannot be ruled out.

Abstract

OBJECTIVES: We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population.METHODS: Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment).RESULTS: Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively).CONCLUSIONS: An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.

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