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Department of Foods and Nutrition, College of Science and Technology, Kookmin University, Seoul, Korea
© 2024, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of interest
The author has no conflicts of interest to declare for this study.
Funding
This work was supported by a National Research Foundation of Korea grant funded by the Korean government (RS-2024-00336637).
Author contributions
All work was done by IB.
Characteristics |
Quartiles of NC (median, cm) |
p for trend | |||
---|---|---|---|---|---|
1st (31.7) | 2nd (32.8) | 3rd (34.0) | 4th (39.0) | ||
No. of participants (% of total) | 671 (25.2) | 658 (24.7) | 682 (25.6) | 655 (24.6) | |
Age (yr) | 52.0±7.4 | 51.8±7.1 | 52.2±7.1 | 52.6±7.6 | 0.11 |
Men | 48.7 | 48.3 | 46.9 | 51.3 | 0.48 |
FTO rs9939609 minor alleles1 | 20.0 | 21.3 | 25.1 | 26.6 | <0.01 |
Waist circumference (cm) | 74.1±5.6 | 78.6±5.6 | 82.1±5.7 | 87.2±6.6 | <0.001 |
Low income2 | 33.8 | 32.8 | 31.4 | 32.2 | 0.43 |
Office worker | 24.9 | 27.1 | 31.5 | 30.5 | <0.01 |
Current smokers | 14.8 | 19.5 | 15.5 | 16.3 | 0.89 |
Current alcohol drinkers | 47.1 | 48.8 | 51.8 | 51.2 | 0.08 |
Having sleep apnea episodes | 8.8 | 10.6 | 17.0 | 19.5 | <0.001 |
Physical activity (MET-hr/day)3 | 45.5±7.8 | 44.9±8.1 | 44.9±7.3 | 44.7±7.4 | 0.07 |
Total energy intake (kcal/day) | 1,798±500 | 1,848±511 | 1,860±514 | 1,922±556 | <0.001 |
Variables | Quartiles of NC | No. of cases/PY |
Adjusted |
||
---|---|---|---|---|---|
Age | Age and WC | Multivariable1 | |||
All (n=2,666) | 1st | 159/7,110 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
2nd | 236/6,200 | 1.71 (1.40, 2.09) | 1.51 (1.23, 1.85) | 1.53 (1.24, 1.88) | |
3rd | 306/5,886 | 2.34 (1.94, 2.84) | 1.88 (1.53, 2.31) | 1.99 (1.61, 2.45) | |
4th | 376/5,390 | 3.09 (2.56, 3.72) | 2.16 (1.73, 2.69) | 2.50 (2.00, 3.14) | |
p for trend | <0.001 | <0.001 | <0.001 | ||
Men (n=1,301) | 1st | 90/3,137 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
2nd | 151/2,723 | 1.95 (1.50, 2.53) | 1.81 (1.38, 2.36) | 1.69 (1.29, 2.21) | |
3rd | 175/2,484 | 2.50 (1.94, 3.22) | 2.18 (1.64, 2.89) | 2.02 (1.51, 2.68) | |
4th | 197/2,461 | 2.84 (2.21, 3.64) | 2.33 (1.72, 3.17) | 2.37 (1.74, 3.22) | |
p for trend | <0.001 | <0.001 | <0.001 | ||
Women (n=1,365) | 1st | 69/3,973 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
2nd | 85/3,477 | 1.37 (0.99, 1.89) | 1.29 (0.93, 1.78) | 1.26 (0.91, 1.74) | |
3rd | 131/3,402 | 2.10 (1.57, 2.81) | 1.88 (1.38, 2.57) | 1.84 (1.34, 2.51) | |
4th | 179/2,929 | 3.15 (2.38, 4.16) | 2.61 (1.86, 3.65) | 2.65 (1.89, 3.72) | |
p for trend | <0.001 | <0.001 | <0.001 |
Values are presented as hazard ratio (95% confidence interval).
NC, neck circumference; WC, waist circumference; PY, person-years: MET, total metabolic equivalent.
1 Data are adjusted for age (continuous), gender, WC (continuous), FTO rs9939609 allele status (risk or non-risk alleles), income level (<2×106 or ≥2×106 Korean won monthly), occupational type (office worker or non-office worker and other status), smoking status (never, former, or current smoker; <10 and ≥10 cigarette/yr), alcohol consumption (abstainers, current consumers; <15.1, 15.1-30.0, >30.0 g/day), presence of sleep apnea episodes (yes or no), physical activity (quartiles of MET-hr/day), and total energy intake (quartiles).
Variables | Selected variables | Unit or reference | p-value | Multivariable1 |
---|---|---|---|---|
All (n=2,666) | Neck circumference | 1 cm | <0.001 | 1.08 (1.05, 1.10) |
Age | 1 yr | <0.001 | 1.03 (1.02, 1.04) | |
Waist circumference | 1 cm | <0.001 | 1.03 (1.02, 1.04) | |
Smoking | Non-smoking | <0.001 | 1.37 (1.17, 1.62) | |
Heavy alcohol consumption | Non-drinking and light to moderate alcohol consumption | <0.010 | 1.31 (1.08, 1.58) | |
Men (n=1,301) | Neck circumference | 1cm | <0.001 | 1.08 (1.03, 1.12) |
Waist circumference | 1cm | <0.001 | 1.03 (1.01, 1.04) | |
Smoking | Non-smoking | <0.001 | 1.37 (1.15, 1.63) | |
Age | 1 yr | <0.010 | 1.02 (1.01, 1.03) | |
Office worker | Non-office worker and other status | <0.050 | 1.23 (1.04, 1.47) | |
Heavy alcohol consumption | Non-drinking and light to moderate alcohol consumption | <0.050 | 1.23 (1.01, 1.51) | |
FTO rs9939609 risk alleles | Non-risk allele | <0.050 | 1.21 (1.00, 1.45) | |
Women (n=1,365) | Age | 1 yr | <0.001 | 1.06 (1.04, 1.07) |
Neck circumference | 1 cm | <0.001 | 1.09 (1.05, 1.13) | |
Waist circumference | 1 cm | <0.001 | 1.03 (1.02, 1.04) | |
Total energy intake | 500 kcal | <0.050 | 1.12 (1.01, 1.23) |
Values are presented as hazard ratio (95% confidence interval).
MET, total metabolic equivalent.
1 Data are adjusted for age (continuous), gender, waist circumference (continuous), FTO rs9939609 allele status (risk or non-risk alleles), income level (<2×106 or ≥2×106 Korean won monthly), occupational type (office worker or non-office worker and other status), smoking status (never, former, or current smoker; <10 and ≥10 cigarette/yr), alcohol consumption (abstainers, current consumers; <15.1, 15.1-30.0, >30 g/day), presence of sleep apnea episodes (yes or no), physical activity (quartiles of MET-hr/day), and total energy intake (quartiles).
Variables | Groups of NC (quartile) | FTO rs9939609 alleles1 |
aHR (95% CI) |
p for interaction | ||
---|---|---|---|---|---|---|
Age | Age and WC | Multivariable2 | ||||
All (n=2,666) | 1st and 2nd | Non-risk allele | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 0.23 |
1st and 2nd | Risk alleles | 1.14 (0.90, 1.44) | 1.11 (0.88, 1.39) | 1.11 (0.88, 1.40) | ||
3rd and 4th | Non-risk allele | 2.04 (1.77, 2.35) | 1.54 (1.31, 1.81) | 1.65 (1.40, 1.94) | ||
3rd and 4th | Risk alleles | 2.25 (1.87, 2.71) | 1.70 (1.39, 2.07) | 1.89 (1.54, 2.31) | ||
Men (n=1,301) | 1st and 2nd | Non-risk allele | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 0.57 |
1st and 2nd | Risk alleles | 1.20 (0.90, 1.60) | 1.20 (0.90, 1.60) | 1.24 (0.93, 1.66) | ||
3rd and 4th | Non-risk allele | 1.88 (1.55, 2.27) | 1.52 (1.23, 1.90) | 1.53 (1.23, 1.91) | ||
3rd and 4th | Risk alleles | 2.14 (1.66, 2.75) | 1.78 (1.36, 2.33) | 1.82 (1.39, 2.39) | ||
Women (n=1,365) | 1st and 2nd | Non-risk allele | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 0.22 |
1st and 2nd | Risk alleles | 0.92 (0.62, 1.37) | 0.90 (0.60, 1.33) | 0.87 (0.58, 1.29) | ||
3rd and 4th | Non-risk allele | 2.11 (1.69, 2.63) | 1.76 (1.38, 2.25) | 1.75 (1.37, 2.25) | ||
3rd and 4th | Risk alleles | 2.32 (1.76, 3.07) | 1.88 (1.38, 2.55) | 1.87 (1.37, 2.56) |
NC, neck circumference; aHR, adjusted hazard ratio; CI, confidence interval; WC, waist circumference; MET, total metabolic equivalent.
1 TT is the non-risk allele, while TA and AA are risk alleles.
2 Data are adjusted for age (continuous), gender, waist circumference (continuous), income level (<2×106 or ≥2×106 Korean won monthly), occupational type (office worker or non-office worker and other status), smoking status (never, former, or current smoker; <10 and ≥10 cigarette/yr), alcohol consumption (abstainers, current consumers; <15.1, 15.1-30.0, >30.0 g/day), presence of sleep apnea episodes (yes or no), physical activity (quartiles of MET-hr/day), and total energy intake (quartiles).
Characteristics | Quartiles of NC (median, cm) |
p for trend | |||
---|---|---|---|---|---|
1st (31.7) | 2nd (32.8) | 3rd (34.0) | 4th (39.0) | ||
No. of participants (% of total) | 671 (25.2) | 658 (24.7) | 682 (25.6) | 655 (24.6) | |
Age (yr) | 52.0±7.4 | 51.8±7.1 | 52.2±7.1 | 52.6±7.6 | 0.11 |
Men | 48.7 | 48.3 | 46.9 | 51.3 | 0.48 |
FTO rs9939609 minor alleles |
20.0 | 21.3 | 25.1 | 26.6 | <0.01 |
Waist circumference (cm) | 74.1±5.6 | 78.6±5.6 | 82.1±5.7 | 87.2±6.6 | <0.001 |
Low income |
33.8 | 32.8 | 31.4 | 32.2 | 0.43 |
Office worker | 24.9 | 27.1 | 31.5 | 30.5 | <0.01 |
Current smokers | 14.8 | 19.5 | 15.5 | 16.3 | 0.89 |
Current alcohol drinkers | 47.1 | 48.8 | 51.8 | 51.2 | 0.08 |
Having sleep apnea episodes | 8.8 | 10.6 | 17.0 | 19.5 | <0.001 |
Physical activity (MET-hr/day) |
45.5±7.8 | 44.9±8.1 | 44.9±7.3 | 44.7±7.4 | 0.07 |
Total energy intake (kcal/day) | 1,798±500 | 1,848±511 | 1,860±514 | 1,922±556 | <0.001 |
Variables | Quartiles of NC | No. of cases/PY | Adjusted |
||
---|---|---|---|---|---|
Age | Age and WC | Multivariable |
|||
All (n=2,666) | 1st | 159/7,110 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
2nd | 236/6,200 | 1.71 (1.40, 2.09) | 1.51 (1.23, 1.85) | 1.53 (1.24, 1.88) | |
3rd | 306/5,886 | 2.34 (1.94, 2.84) | 1.88 (1.53, 2.31) | 1.99 (1.61, 2.45) | |
4th | 376/5,390 | 3.09 (2.56, 3.72) | 2.16 (1.73, 2.69) | 2.50 (2.00, 3.14) | |
p for trend | <0.001 | <0.001 | <0.001 | ||
Men (n=1,301) | 1st | 90/3,137 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
2nd | 151/2,723 | 1.95 (1.50, 2.53) | 1.81 (1.38, 2.36) | 1.69 (1.29, 2.21) | |
3rd | 175/2,484 | 2.50 (1.94, 3.22) | 2.18 (1.64, 2.89) | 2.02 (1.51, 2.68) | |
4th | 197/2,461 | 2.84 (2.21, 3.64) | 2.33 (1.72, 3.17) | 2.37 (1.74, 3.22) | |
p for trend | <0.001 | <0.001 | <0.001 | ||
Women (n=1,365) | 1st | 69/3,973 | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
2nd | 85/3,477 | 1.37 (0.99, 1.89) | 1.29 (0.93, 1.78) | 1.26 (0.91, 1.74) | |
3rd | 131/3,402 | 2.10 (1.57, 2.81) | 1.88 (1.38, 2.57) | 1.84 (1.34, 2.51) | |
4th | 179/2,929 | 3.15 (2.38, 4.16) | 2.61 (1.86, 3.65) | 2.65 (1.89, 3.72) | |
p for trend | <0.001 | <0.001 | <0.001 |
Variables | Selected variables | Unit or reference | p-value | Multivariable |
---|---|---|---|---|
All (n=2,666) | Neck circumference | 1 cm | <0.001 | 1.08 (1.05, 1.10) |
Age | 1 yr | <0.001 | 1.03 (1.02, 1.04) | |
Waist circumference | 1 cm | <0.001 | 1.03 (1.02, 1.04) | |
Smoking | Non-smoking | <0.001 | 1.37 (1.17, 1.62) | |
Heavy alcohol consumption | Non-drinking and light to moderate alcohol consumption | <0.010 | 1.31 (1.08, 1.58) | |
Men (n=1,301) | Neck circumference | 1cm | <0.001 | 1.08 (1.03, 1.12) |
Waist circumference | 1cm | <0.001 | 1.03 (1.01, 1.04) | |
Smoking | Non-smoking | <0.001 | 1.37 (1.15, 1.63) | |
Age | 1 yr | <0.010 | 1.02 (1.01, 1.03) | |
Office worker | Non-office worker and other status | <0.050 | 1.23 (1.04, 1.47) | |
Heavy alcohol consumption | Non-drinking and light to moderate alcohol consumption | <0.050 | 1.23 (1.01, 1.51) | |
FTO rs9939609 risk alleles | Non-risk allele | <0.050 | 1.21 (1.00, 1.45) | |
Women (n=1,365) | Age | 1 yr | <0.001 | 1.06 (1.04, 1.07) |
Neck circumference | 1 cm | <0.001 | 1.09 (1.05, 1.13) | |
Waist circumference | 1 cm | <0.001 | 1.03 (1.02, 1.04) | |
Total energy intake | 500 kcal | <0.050 | 1.12 (1.01, 1.23) |
Variables | Groups of NC (quartile) | FTO rs9939609 alleles |
aHR (95% CI) |
p for interaction | ||
---|---|---|---|---|---|---|
Age | Age and WC | Multivariable |
||||
All (n=2,666) | 1st and 2nd | Non-risk allele | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 0.23 |
1st and 2nd | Risk alleles | 1.14 (0.90, 1.44) | 1.11 (0.88, 1.39) | 1.11 (0.88, 1.40) | ||
3rd and 4th | Non-risk allele | 2.04 (1.77, 2.35) | 1.54 (1.31, 1.81) | 1.65 (1.40, 1.94) | ||
3rd and 4th | Risk alleles | 2.25 (1.87, 2.71) | 1.70 (1.39, 2.07) | 1.89 (1.54, 2.31) | ||
Men (n=1,301) | 1st and 2nd | Non-risk allele | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 0.57 |
1st and 2nd | Risk alleles | 1.20 (0.90, 1.60) | 1.20 (0.90, 1.60) | 1.24 (0.93, 1.66) | ||
3rd and 4th | Non-risk allele | 1.88 (1.55, 2.27) | 1.52 (1.23, 1.90) | 1.53 (1.23, 1.91) | ||
3rd and 4th | Risk alleles | 2.14 (1.66, 2.75) | 1.78 (1.36, 2.33) | 1.82 (1.39, 2.39) | ||
Women (n=1,365) | 1st and 2nd | Non-risk allele | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 0.22 |
1st and 2nd | Risk alleles | 0.92 (0.62, 1.37) | 0.90 (0.60, 1.33) | 0.87 (0.58, 1.29) | ||
3rd and 4th | Non-risk allele | 2.11 (1.69, 2.63) | 1.76 (1.38, 2.25) | 1.75 (1.37, 2.25) | ||
3rd and 4th | Risk alleles | 2.32 (1.76, 3.07) | 1.88 (1.38, 2.55) | 1.87 (1.37, 2.56) |
Values are presented as mean±standard deviation or %. NC, neck circumference; MET, total metabolic equivalent. Genotypes TA and AA. Average monthly wage <2×106 Korean won. MET was calculated for daily physical activity.
Values are presented as hazard ratio (95% confidence interval). NC, neck circumference; WC, waist circumference; PY, person-years: MET, total metabolic equivalent. Data are adjusted for age (continuous), gender, WC (continuous),
Values are presented as hazard ratio (95% confidence interval). MET, total metabolic equivalent. Data are adjusted for age (continuous), gender, waist circumference (continuous),
NC, neck circumference; aHR, adjusted hazard ratio; CI, confidence interval; WC, waist circumference; MET, total metabolic equivalent. TT is the non-risk allele, while TA and AA are risk alleles. Data are adjusted for age (continuous), gender, waist circumference (continuous), income level (<2×106 or ≥2×106 Korean won monthly), occupational type (office worker or non-office worker and other status), smoking status (never, former, or current smoker; <10 and ≥10 cigarette/yr), alcohol consumption (abstainers, current consumers; <15.1, 15.1-30.0, >30.0 g/day), presence of sleep apnea episodes (yes or no), physical activity (quartiles of MET-hr/day), and total energy intake (quartiles).