A comparison of cardiovascular risk factors among Asian migrants and the native population in Korea

Abstract

Migration presents a substantial social and public health issue. This study investigated the nationwide population, including 2,680,495 adults aged 20 years and older (987,214 Asian migrants and 1,693,281 Koreans), who received health check-ups, using the Korean National Health Information Database (2009-2015). With regard to the age-adjusted prevalence of lifestyle factors, socioeconomic status, and health status among Chinese, Japanese, Filipino, Vietnamese, and other Asian migrants, compared with Koreans, direct age standardisation was conducted separately by sex using 10-year age bands, in which the world standard population was used as the standard population. In 2015, among participants aged 20 years and older, the age-adjusted prevalence of obesity in Chinese migrant women (25.6%) was higher than that in Korean women (23.2%) (P < 0.0001). The age-adjusted prevalence of obesity in Filipino migrant women (30.9%) was higher than that in Korean women (23.2%) (P = 0.0023). The age-adjusted prevalence of obesity in other Asian migrant women (35.5%) was higher than that in Korean women (23.2%) (P < 0.0001). In addition, among participants aged 20–49 years, the age-adjusted prevalence of diabetes in Filipino migrant women (2.6%) was higher than that in Korean women (1.8%) (P = 0.0090). The age-adjusted prevalence of hypertension in Filipino migrant women (7.7%) was higher than that in Korean women (4.2%) (P < 0.0001). In the multivariate analyses, compared with Koreans, the odds ratios of developing type 2 diabetes and hypertension were 0.82 (95% CI, 0.78 to 0.86) and 0.77 (95% CI, 0.75 to 0.79) among Asian migrants between 2009-2015, respectively. However, the odds ratio of developing type 2 diabetes was 1.32 (95% CI, 1.11 to 1.57) among Vietnamese migrant men aged 20–39 years compared with Korean men. Compared with Korean women, the odds ratios of developing hypertension were 1.49 (95% CI, 1.05 to 2.11) and 2.22 (95% CI, 1.17 to 4.19) among Filipino migrant women aged 20–39 years and more than 40 years, respectively. Joinpoint regression was used to estimate the annual percentage change (APC) of cardiovascular risk factors. In the Joinpoint regression, the age-adjusted prevalence was calculated separately by sex using direct age standardisation, while the age groups consisted of those 20–44, 45–64, and ≥ 65 years; and the Korean mid-year population in 2005 was used as the standard population. Increasing prevalence trends of obesity were shown among Asian migrant men (from 27.9% in 2009 to 28.9% in 2013, APC = 0.89, P < 0.05; from 28.9% in 2013 to 31.7% in 2015, APC = 4.70, P < 0.05) compared with Korean men; increasing prevalence trends of obesity were shown among Asian migrant women (from 22.5% in 2009 to 25.2% in 2015, APC = 1.92, P < 0.05), compared with Korean women. Moreover, the age-adjusted prevalence of obesity (41.4%) in Filipino migrant men was higher than that (30.4%) in men from the general population in the Philippines in 2015. Furthermore, in 2014, the age-adjusted prevalence of diabetes (12.5%) among Filipino migrant men was higher than that (7.1%) in men from the general population in the Philippines. The results could help establish a new strategy for prevention, treatment, and management of obesity, diabetes, and hypertension among Asian migrants and the native population in Korea.

국제 이주 문제는 사회적 및 공중 보건 영역에서 여러가지 이슈가 되고 있다. 본 연구는 국민 건강보험공단자료를 (2009-2015년) 이용, 건강검진 수검자 20세 이상의 성인 2,680,495명 (아시아 이주민 987,214명, 내국인 1,693,281명)을 분석하였다. 세계표준인구를 표준 인구로 연령표준화 유병율을 산출하였다. 2015년도 연령표준화 비만 유병률은 중국 이주민 여성이 (25.6%) 한국인 여성보다 (23.2%) 높았고 (P < 0.0001), 필리핀 이주민 여성이 (30.9%) 한국인 여성보다 높았고 (P = 0.0023), 기타 아시아 이주민 여성이 (35.5%) 한국인 여성보다 높았다 (P < 0.0001). 20-49세 연령그룹에서 필리핀 이주민 여성의 (2.6%) 연령표준화 당뇨병 유병률은 한국인 여성보다 (1.8%) 높았고 (P = 0.0090), 필리핀 이주민 여성의 (7.7%) 연령표준화 고혈압 유병률은 한국인 여성보다 (4.2%) 높았다 (P < 0.0001). 다중회귀분석에서 한국인에 비하여 아시아 이주민의 당뇨병 (aOR, 0.82; 95% CI, 0.78 - 0.86) 고혈압 (aOR, 0.77; 95% CI, 0.75 - 0.79) 오즈비가 낮게 나타났다. 하지만 20-39세 연령그룹에서 한국인 남성에 비하여 베트남 이주민 남성의 당뇨병 (aOR, 1.32; 95% CI, 1.11 - 1.57) 오즈비는 높게 나타났고, 20-39세와 40세 이상 두 연령그룹에서 한국인 여성에 비하여 필리핀 이주민 여성의 고혈압 (aOR, 1.49; 95% CI, 1.05 - 2.11), (aOR, 2.22; 95% CI, 1.17 - 4.19) 오즈비가 각각 더 높게 나타났다. 심혈관질환 위험요인들의 annual percentage change (APC)를 추정하기 위해 Joinpoint 회귀분석을 시행하였다. Joinpoint 회귀분석에서도 연령표준화를 실시하였고, 연령그룹은 20-44, 45-64, ≥ 65세로 구성되었다. 2005년도 한국 연앙인구를 표준 인구로 사용하였다. 내국인 남성에 비하여 아시아 이주민 남성의 연령표준화 비만 유병률은 증가하는 추세로 나타났고 (2009년 27.9%에서 2013년 28.9%, APC = 0.89, P < 0.05; 2013년 28.9%에서 2015년 31.7%, APC = 4.70, P < 0.05); 내국인 여성에 비하여 아시아 이주민 여성의 연령표준화 비만 유병률은 증가하는 추세로 나타났다 (2009년 22.5%에서 2015년 25.2%, APC = 1.92, P < 0.05). 마지막으로 2015년도 필리핀 이주민 남성의 (41.4%) 연령표준화 비만 유병률은 필리핀 남성 일반인구보다 (30.4%) 높았고, 2014년도 필리핀 이주민 남성의 (12.5%) 연령표준화 당뇨병 유병률은 필리핀 남성 일반인구보다 (7.1%) 높았다. 본 연구의 결과들은 아시아 이주민과 한국인 인구의 비만, 당뇨병, 고혈압 예방, 치료 및 관리를 위한 새로운 전략을 수립하는데 도움이 될 수 있다.