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Brief Report
Safety monitoring of COVID-19 vaccination among adolescents aged 12 to 17 years old in the Republic of Korea
Seontae Kim, Insob Hwang, Mijeong Ko, Yunhyung Kwon, Yeon-Kyeng Lee
Osong Public Health Res Perspect. 2022;13(3):230-237.   Published online June 10, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0122
  • 728 View
  • 50 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
This study aimed to disseminate information on coronavirus disease 2019 (COVID-19) vaccine safety among adolescents aged 12 to 17 years in the Republic of Korea. Methods: Two databases were used to assess COVID-19 vaccine safety in adolescents aged 12 to 17 years who completed the primary Pfizer-BioNTech vaccination series. Adverse events reported to the web-based COVID-19 vaccination management system (CVMS) and collected in the text message-based system were analyzed. Results: From March 5, 2021 to February 13, 2022, 12,216 adverse events among 12- to 17-yearolds were reported to the CVMS, of which 97.1% were non-serious adverse events and 2.9% were serious adverse events, including 85 suspected cases of anaphylaxis, 74 suspected cases of myocarditis and/or pericarditis, and 2 deaths. From December 13, 2021 to January 26, 2022, 10,389 adolescents responded to a text message survey, and local/systemic adverse events were more common after dose 2 than after dose 1. The most commonly reported events following either vaccine dose were pain at the injection site, headache, fatigue/tiredness, and myalgia. Conclusion: The overall results are consistent with previous findings; the great majority of adverse events were non-serious, and serious adverse events were rare among adolescents aged 12 to 17 years following Pfizer-BioNTech COVID-19 vaccination.
Original Articles
Prevalence and correlates of highly caffeinated beverage consumption among Korean adolescents
Ho-Kyung Kwak, Jaesin Sa, Siyoung Choe, Jean-Philippe Chaput, Joon Chung, Gayle Cummings, Jounghee Lee
Osong Public Health Res Perspect. 2021;12(6):374-384.   Published online November 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0013
  • 7,314 View
  • 71 Download
AbstractAbstract PDF
Objectives
The purposes of this study were to (1) examine the multi-year prevalence of highly caffeinated beverage (HCB) consumption, (2) identify sex differences in the prevalence, and (3) investigate relationships between HCB consumption and behavioral characteristics in a nationally representative sample of Korean adolescents.
Methods
Data from the Korea Youth Risk Behavior Web-based Survey (2014–2017) were analyzed.
Results
HCB consumption was higher in 2017 than 2014 (23.9% vs. 12.0%), and higher among boys than girls (17.2% vs. 13.1%). HCB drinkers were more likely to (1) be boys, (2) be overweight or obese, (3) use alcohol and tobacco, (4) consume soda at least once per week, (5) consume sweetened beverages at least once per week, (6) have seriously considered suicide during the past 12 months, and (7) have attempted suicide during the past 12 months (p<0.05 for all).
Conclusion
Effective programs to curb HCB consumption among Korean adolescents need to be established.
The current status of sexually transmitted infections in South Korean children in the last 10 years
Yumi Jang, Eunjung Oh
Osong Public Health Res Perspect. 2021;12(4):230-235.   Published online August 4, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0046
  • 2,506 View
  • 83 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
This study aimed to determine the status of sexually transmitted infections (STIs) in children in South Korea between 2010 and 2019), as well as to establish preventive maintenance guidelines to reduce the incidence of STIs in children.
Methods
Data reports from 590 STI surveillance systems in community clinics, hospital-level medical institutions with urology or obstetrics/gynecology departments and public hospitals between 2010 and 2019 in the integrative disease management system of the Korea Disease Control and Prevention Agency as of December 2020 were analyzed.
Results
A total of 172,645 cases of STIs were reported over the 10-year period (2010–2019), of which 2,179 cases (1.26%) represented STIs in children below the age of 18 years. A higher incidence of infections was observed in girls (1,499 cases, 68.79%) than in boys (680 cases, 31.21%). The STIs that had the highest incidence were, in descending order, chlamydia (997 cases, 45.75%), gonorrhea (592 cases, 27.17%), genital warts (338 cases, 15.51%), genital herpes (250 cases, 11.47%), and chancroid (2 cases, 0.09%). In adolescents aged 14 to 17 years, chlamydia, genital herpes, and gonorrhea were most frequently reported. Genital warts, in particular, have been consistently reported in children below the age of 14 years.
Conclusion
Children must be protected legally and institutionally from sexual abuse. Specific management protocols for STIs in children must be established by local governments and associated organizations. National human papillomavirus vaccination programs should be expanded to include boys, and anti-STI educational efforts using modern media should be implemented.
Behavioral interventions for smoking cessation among adolescents: a rapid review and meta-analysis for the Korea Preventive Services Task Force
Younglee Choi, Cheol Min Lee, Belong Cho, Eon Sook Lee, Seung-Won Oh, Naae Lee, Jae Moon Yun
Osong Public Health Res Perspect. 2021;12(3):177-186.   Published online June 2, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0018
  • 6,009 View
  • 120 Download
  • 2 Citations
AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to evaluate the effectiveness of behavioral smoking cessation interventions among adolescents.
Methods
MEDLINE, CENTRAL, Embase, CINAHL, KoreaMed, and KMbase were searched from inception to June 2020. Systematic reviews (SRs) or meta-analyses of randomized controlled trials (RCTs) were initially searched to perform a rapid SR. After selecting the final SR, RCTs after the publication year of the selected SR were searched. The primary outcome was smoking status after at least 6 months of follow-up, and the secondary outcome was smoking status at 4 weeks. Two reviewers independently assessed the selected studies’ quality using the Cochrane risk of bias tool. The meta-analysis utilized a Mantel-Haenszel fixed-effect model reporting the relative risk (RR) and 95% confidence interval (CI). The subgroup analysis utilized Cochrane’s Q.
Results
Thirty-two RCTs (11,637 participants) from a single SR were meta-analyzed. After 6 months of follow-up, the intervention group had significantly higher abstinence rates (RR, 1.30; 95% CI, 1.20−1.41; I2=26.46%). At 4 weeks of follow-up, the intervention group also had significantly higher abstinence rates (RR, 1.92; 95% CI, 1.49–2.47; I2=0.00%). The subgroup analysis indicated a significant difference in the abstinence rate according to the study setting and the period between intervention completion and follow-up.
Conclusion
This review showed that adolescent behavioral smoking cessation intervention programs significantly increased abstinence rates compared to the usual care.
Noncommunicable Disease Risk Factors Among Adolescent Boys and Girls in Bangladesh: Evidence From a National Survey
Nushrat Jahan Urmy, Md. Mokbul Hossain, Abu Ahmed Shamim, Md. Showkat Ali Khan, Abu Abdullah Mohammad Hanif, Mehedi Hasan, Fahmida Akter, Dipak Kumar Mitra, Moyazzam Hossaine, Mohammad Aman Ullah, Samir Kanti Sarker, SM Mustafizur Rahman, Md. Mofijul Islam Bulbul, Malay Kanti Mridha
Osong Public Health Res Perspect. 2020;11(6):351-364.   Published online December 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.6.03
  • 4,870 View
  • 158 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh.

Methods

Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018–2019, was used. Descriptive analysis and multivariable logistic regression were performed.

Results

The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls.

Conclusion

The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.

An Investigation into Chronic Conditions and Diseases in Minors to Determine the Socioeconomic Status, Medical Use and Expenditure According to Data from the Korea Health Panel, 2015
Jong-Hoon Moon
Osong Public Health Res Perspect. 2019;10(6):343-350.   Published online December 31, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.6.04
  • 2,759 View
  • 133 Download
AbstractAbstract PDF
Objectives

This study compared the socioeconomic status, medical use and expenditures for infants (1–5 years), juveniles (6–12 years), and adolescents (13–19 years) with a chronic condition or disease to determine factors affecting health spending.

Methods

Data from 3,677 minors (< 20 years old, without disabilities) were extracted from the Korea Health Panel (2015) database.

Results

Minors with chronic conditions or diseases were older (juveniles, and adolescents; p < 0.001), and included a higher proportion of Medicaid recipients (p = 0.004), a higher use of hospital outpatient care (p < 0.001), and higher medical expenditure (p < 0.001) compared to minors without chronic conditions or diseases. Boys were more likely to have a chronic condition or disease than girls (p = 0.036). Adolescents and juveniles were more likely than infants to have a chronic condition or disease (p = 0.001). Medicaid recipients were more likely to have a chronic condition or disease than those who were not Medicaid recipients (p = 0.008). Minors who had been hospital outpatients were more likely to have a chronic condition or disease, compared with minors who had not been an outpatient (p = 0.001). Having a chronic condition or disease, was a factor increasing medical expenditure (p = 0.001). Medical expenditure was higher in infants than in juveniles and adolescents (p = 0.001). Infants had higher rates of medical use when compared with juveniles and adolescents (p = 0.001).

Conclusion

These findings suggest that systematic health care management for minors with chronic conditions or diseases, is needed.

Short Communication
Percentage Body Fat is As a Good Indicator for Determining Adolescents Who Are Overweight or Obese: A Cross-Sectional Study in Vietnam
Le Thu Trang, Nguyen Nam Trung, Dinh-Toi Chu, Nguyen Thi Hong Hanh
Osong Public Health Res Perspect. 2019;10(2):108-114.   Published online April 30, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.2.10
  • 3,263 View
  • 49 Download
  • 9 Citations
AbstractAbstract PDF
Objectives

To identify trends in percentage body fat (PBF) in adolescents to determine gender-specific classification thresholds for being overweight and obese.

Methods

A cross-sectional study of 899 adolescents (11 to 14.5 years) from Hanoi and Nam Dinh was conducted in Vietnam. PBF, subcutaneous fat and percentage of lean mass were measured directly using OMRON HBF 375 scales to measure bioelectrical impedance.

Results

PBF decreased in boys with increasing age (p < 0.001). The difference in PBF between boys and girls, significantly increased with age after 12.5 years (p < 0.001). There was a stronger correlation between PBF and fat content (Pearson’s r = 0.860, p < 0.0001) than that between (BMI) and fat content (Pearson’s r = 0.521, p < 0.0001). The prevalence of being overweight or obese in girls was similar when determined by PBF or BMI. Hanoi had higher rates of adolescents being overweight or obese compared with Nam Dinh.

Conclusion

PBF provides a more accurate body assessment for being overweight or obese in adolescents compared with BMI.

Original Articles
Health Related Nutritional Knowledge and Dietary Behavior Regarding Caffeine Intake among High School Students in Yongin Region
Seong Yeong Kim
Osong Public Health Res Perspect. 2018;9(6):299-308.   Published online December 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.6.03
  • 2,860 View
  • 30 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

We aimed to examine health-related nutritional knowledge and dietary behavior related to caffeine intake among high school students (n = 310) in the Yongin region of Korea.

Methods

Data were collected using a face-to-face survey, and analyzed using chi-square test, t- test, and logistic regression analysis.

Results

The level of caffeine intake in respondents was divided into low (< 30 mg/d; n = 208) and high caffeine intake groups (> 30 mg/d; n = 102). Total nutritional knowledge related to bone disease was higher in the low intake group (score 2.75) than the high intake group (score 2.39; p < 0.05). The high intake group had lower scores for nutritional knowledge (score 0.70; p < 0.05) related to how caffeinated beverages affect sleep and for dietary behavior (score 3.25; p < 0.001), based on “I avoid caffeinated foods before sleep,” than the low intake group (nutritional knowledge score, 0.80; dietary behavior score, 3.76).

Conclusion

In the overall analysis, the low caffeine intake group had better nutritional knowledge related to bone and sleep health, and healthier dietary behavior related to sleep health compared with the high intake group.

Multilevel Analysis of the Risk Factors in High-Risk Health Behavior among Korean Adolescents
Eun Gyeong Kim
Osong Public Health Res Perspect. 2018;9(1):3-8.   Published online December 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2018.9.1.02
  • 3,089 View
  • 72 Download
  • 3 Citations
AbstractAbstract PDF
Objectives

To examine health behaviors among Korean adolescents with a focus on both individual and school-based factors, specifically in relation to predictors of high-risk groups.

Methods

Secondary data analysis was conducted with data from the 8th Korea Youth Risk Behavior Web-Based Survey, using descriptive statistics, t tests, χ2 test, and multilevel logistic regression analysis. Health Practice Index was calculated and a range of 0 to 2 was classified as a high-risk group.

Results

The results revealed that the individual-level variables of sex, age, stress, depression, subjective health status, school performance, health education, father’s level of education, and living situation were significant predictors of high-risk behaviors. The risk was greater in girls, greater with higher age and higher stress scores, greater in adolescents with depression, greater with lower paternal educational level, and greater in adolescents who did not live with both parents, as were the school-level variables of school grade and school affluence score. The possibility of being in the high-risk group in health behavior was greater if a student attended a school where the Family Affluence Score (FAS) was lower.

Conclusion

School health education should be expanded to manage students’ high-risk health behaviors, especially in schools that have many students from families with a low affluence status.

Korean Adolescents’ Health Behavior and Psychological Status according to Their Mother’s Nationality
Yunjeong Yi, Ji-Soo Kim
Osong Public Health Res Perspect. 2017;8(6):377-383.   Published online December 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.6.04
  • 2,421 View
  • 23 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

This study was conducted to compare adolescents’ health behaviors and psychological status according to whether or not their mother was born in Korea.

Methods

This secondary analysis used nationally representative data from the 2015 Korean Youth Risk Behavior Web-based Survey. The self-administered questionnaire included computer measured socio-demographic variables, 15 health behaviors, and psychological status. Data from 65,426 middle school and high school students were analyzed. Multiple logistic regression, adjusting for socio-demographic variables, was used to analyze differences in health behaviors and psychological status between adolescents with a foreign-born mother and those with a Korean mother.

Results

Adolescents who have foreign-born mothers had a lower level of current drinking and subjective happiness, but a higher stress level.

Conclusion

The stress levels of the adolescents with foreign-born mothers could be affected by their multicultural background. It is necessary to analyze stress-influencing factors of multicultural adolescents by comparing them to adolescents from Korean parents. Additionally, our society should pay more attention to the mental health of multicultural adolescents. Schools should also make various efforts to protect multicultural adolescents by adopting mental health management programs led by school nurses and counselors.

Development of a Food Safety and Nutrition Education Program for Adolescents by Applying Social Cognitive Theory
Jounghee Lee, Soyeon Jeong, Gyeongah Ko, Hyunshin Park, Youngsook Ko
Osong Public Health Res Perspect. 2016;7(4):248-260.   Published online August 31, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.05.005
  • 1,730 View
  • 17 Download
  • 7 Citations
AbstractAbstract PDF
Objectives
The purpose of this study was to develop an educational model regarding food safety and nutrition. In particular, we aimed to develop educational materials, such as middle- and high-school textbooks, a teacher’s guidebook, and school posters, by applying social cognitive theory.
Methods
To develop a food safety and nutrition education program, we took into account diverse factors influencing an individual’s behavior, such as personal, behavioral, and environmental factors, based on social cognitive theory. We also conducted a pilot study of the educational materials targeting middle-school students (n = 26), high-school students (n = 24), and dietitians (n = 13) regarding comprehension level, content, design, and quality by employing the 5-point Likert scale in May 2016.
Results
The food safety and nutrition education program covered six themes: (1) caffeine; (2) food additives; (3) foodborne illness; (4) nutrition and meal planning; (5) obesity and eating disorders; and (6) nutrition labeling. Each class activity was created to improve self-efficacy by setting one’s own goal and to increase self-control by monitoring one’s dietary intake. We also considered environmental factors by creating school posters and leaflets to educate teachers and parents. The overall evaluation score for the textbook was 4.0 points among middle- and high-school students, and 4.5 points among dietitians.
Conclusion
This study provides a useful program model that could serve as a guide to develop educational materials for nutrition-related subjects in the curriculum. This program model was created to increase awareness of nutrition problems and self-efficacy. This program also helped to improve nutrition management skills and to promote a healthy eating environment in middle- and high-school students.
Does Skipping Breakfast and Being Overweight Influence Academic Achievement Among Korean Adolescents?
Yang Wha Kang, Jong-Hyock Park
Osong Public Health Res Perspect. 2016;7(4):220-227.   Published online August 31, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.05.004
  • 1,596 View
  • 22 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
Health status and health behaviors are associated with academic achievement in children and adolescents. The purpose of this study was to investigate whether skipping breakfast and being overweight are related to academic achievement of Korean adolescents.
Methods
Cross-sectional data on a sample of 1,652 high-school seniors (942 males and 710 females) drawn from the 2004 Korea Education Employment Panel were analyzed.
Results
A higher proportion of males (15.3%) than females (6.1%) was overweight (p < 0.001); 37% of males and 41% of females reported skipping breakfast. Overall test scores were significantly higher for females than males (p < 0.05), and in language and foreign language subjects. However, both males and females who reported skipping breakfast had significantly lower scores in language, mathematics, and foreign language than those who did not report skipping breakfast. Overweight males had a lower probability than normal-weight males of having the highest language scores (OR = 0.52, p < 0.05), but there was no difference among females. Females who skipped breakfast had a lower probability of having the highest scores in language (OR = 0.41, p < 0.05), mathematics (OR = 0.24, p < 0.01), or foreign language (OR = 0.18, p < 0.01), while males had a lower probability of having the highest scores in language only (OR = 0.46, p < 0.05).
Conclusion
Skipping breakfast and being overweight are associated with poor academic achievement in Korean adolescents. Eating breakfast and weight control is being discussed as the overlooked factors that may influence better academic achievement.
Timing of Spermarche and Menarche are Associated with Physical Activity and Sedentary Behavior Among Korean Adolescents
Eun-Young Lee, Roman Pabayo, Ichiro Kawachi
Osong Public Health Res Perspect. 2016;7(4):266-272.   Published online August 31, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.04.010
  • 1,687 View
  • 16 Download
  • 14 Citations
AbstractAbstract PDF
Objectives
This study examined the timing of menarche and spermarche and their associations with physical activity (PA) and sedentary behavior (SB) after controlling for body mass index (BMI).
Methods
Multiple logistic regression analyses were conducted to determine whether the timing of menarche in girls and spermarche in boys is associated with PA and SB independent of BMI in a nationally representative sample of Korean adolescents (13–18 years; N = 74,186).
Results
After controlling for age, family economic status, and BMI, early timing of spermarche among boys was associated with a higher likelihood of engaging in PA and a lower likelihood of engaging in SB for < 2 hours during weekdays. By contrast, boys with late timing of spermarche were less likely to engage in PA and more likely to engage in SB for < 2 hours. Among girls, early or late timing of menarche was associated with a higher likelihood of engaging in PA and a lower likelihood of engaging in SB.
Conclusion
Timing of menarche in girls and spermarche in boys could be a marker for PA and SB among Korean adolescents. To promote PA and discourage SB among Korean adolescents, school-based, grade-specific interventions can be tailored by the absence or presence of menarche/spermarche.
Suicidal Ideation and its Correlates among Juvenile Delinquents in South Korea
Suyoung Kim, Hyekyeong Kim, Dong-Chul Seo, Dong Hwan Lee, Han-Ik Cho
Osong Public Health Res Perspect. 2014;5(5):258-265.   Published online October 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.08.007
  • 1,627 View
  • 20 Download
  • 5 Citations
AbstractAbstract PDF
Objectives
This study investigated suicidal ideation and its correlates among juvenile delinquents in South Korea.
Methods
Suicidal ideation, psychological health status, and health-related behaviors were assessed using a self-administered questionnaire in 1682 juvenile offenders aged between 15 and 18 years in 2012.
Results
The prevalence of suicidal ideation in juvenile delinquents was 15.2%. Girls were more likely to report suicidal thoughts than boys (30.3% vs. 12.7%). Suicidal ideation was more common among adolescents who were not living with their family prior to entering detention centers (22.6% vs. 13.2%) than their counterparts. The likelihood of suicidal ideation was significantly associated with problem drinking [odds ratio (OR) = 1.84], psychedelic drug use (OR = 2.04), feeling unhappy (OR = 3.05), feeling sad or depressed (OR = 13.37) after controlling for sociodemographic factors, other health behaviors and perceptions.
Conclusion
The present study provides evidence for an association between suicidal ideation and psychological health and health risk behaviors among juvenile delinquents. It also highlights the importance of mental health and behavioral interventions for this population to prevent suicidality.
Association Between Serum Vitamin D and Metabolic Risk Factors in Korean Schoolgirls
Han Byul Jang, Hye-Ja Lee, Ju Yeon Park, Jae-Heon Kang, Jihyun Song
Osong Public Health Res Perspect. 2013;4(4):179-186.   Published online August 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.06.004
  • 1,506 View
  • 17 Download
  • 14 Citations
AbstractAbstract PDF
Objectives
Vitamin D, a key regulator of bone metabolism, has been recently been linked with energy homeostasis and metabolic disorders in western countries. However, few studies have focused on the association of vitamin D with metabolic risk factors among Asian children. We studied the prevalence of vitamin D insufficiency and the association of 25-hydroxyvitamin D [25(OH)D] with metabolic risk factors in Korean schoolgirls.
Methods
The sample consisted of 320 13-year-old girls recruited from two middle schools in the city of Gwacheon, Korea (latitude 37°N), in July 2011. Anthropometric and blood biochemistry data were obtained for this cross-sectional observational study. We also obtained lifestyle data from questionnaires and dietary data from 3-day food diaries.
Results
Vitamin D deficiency [25(OH)D < 20 ng/mL] was noted in 63.8% of participants. The mean 25(OH)D level was not significantly lower in the overweight group. Level of physical activity and vitamin D intake did not significantly affect 25(OH)D. However, 25(OH)D levels were positively correlated with milk intake and negatively correlated with soft drink intake. Serum 25(OH)D had a negative relationship with fasting glucose and insulin resistance index (homeostasis model assessment-insulin resistance; HOMA-IR) after adjustment for physical activity and body mass index z score (r = −0.144, p = 0.015), and with metabolic risk score similarly (r = −0.141, p = 0.012). Levels of insulin, HOMA-IR, and systolic blood pressure were higher in girls with deficient 25(OH)D levels than in those with sufficient levels.
Conclusion
We found that low 25(OH)D levels were associated with higher blood glucose and insulin resistance. Korean girls with low 25(OH)D levels could be at increased risk for metabolic disorders.

PHRP : Osong Public Health and Research Perspectives