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Vitamin D status and associated metabolic risk factors among North Korean refugees in South Korea: a cross-sectional study
  1. Kyeong Jin Kim1,
  2. Yoon Jung Kim2,
  3. Sun Hwa Kim1,
  4. Jee Hyun An1,
  5. Hye Jin Yoo1,
  6. Hee Young Kim1,
  7. Ji A Seo1,
  8. Sin Gon Kim1,
  9. Nan Hee Kim1,
  10. Kyung Mook Choi1,
  11. Sei Hyun Baik1,
  12. Dong Seop Choi1,
  13. Nam Hoon Kim1
  1. 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
  2. 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
  1. Correspondence to Dr Nam Hoon Kim; pourlife{at}


Objective Vitamin D deficiency is now recognised as a common health problem associated with various chronic diseases; however, it has not been fully elucidated among the minority groups. Here, we aimed to investigate the prevalence of vitamin D deficiency and its associated metabolic risk factors among North Korean refugees living in South Korea.

Design Cross-sectional analysis from the longitudinal cohort, the North Korean refugee health in South Korea (NORNS) study.

Participants A total of 386 North Korean refugees aged ≥30 years, who measured serum 25-hydroxy vitamin D (25(OH)D) level.

Results The prevalence of vitamin D deficiency (25(OH)D <20 ng/mL) was 87% and no participants had an adequate vitamin D level (25(OH)D ≥30 ng/mL). Underweight participants (body mass index (BMI) <18 kg/m2) had significantly lower 25(OH)D levels than individuals with normal BMI (≥18.5 and<23 kg/m2). In the multivariate logistic regression analysis, the lowest 25(OH)D level (<10 ng/mL) was significantly associated with metabolic syndrome (OR, 6.37, 95% CI 1.34 to 30.3), high triglyceride (OR, 6.71, 95% CI 1.75 to 25.7), and low high-density lipoprotein (OR, 5.98, 95% CI 1.54 to 23.2) compared with 25(OH)D levels ≥20 ng/mL after adjusting for age, sex, season, length of residence in South Korea, physical activity and BMI.

Conclusions Vitamin D deficiency is very common among North Korean refugees in South Korea. Despite their lower BMI, vitamin D deficiency was associated with metabolic syndrome in this population.

  • Vitamin D deficiency
  • North Korean refugees
  • Metabolic syndrome
  • vitamin D
  • Obesity

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