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Association between Physical Activity Types and Mental Health in Korean Adults: Korea National Health and Nutrition Examination Survey, 2014–2018
Korean J Sports Med 2021;39:181-187
Published online December 1, 2021;  https://doi.org/10.5763/kjsm.2021.39.4.181
© 2021 The Korean Society of Sports Medicine.

Hak Kyun Kim1, Yeon Soo Kim1,2, Hoyong Sung1, Jungjoon Lim1, Joonsik Kim1, Harim Choi1

1Department of Physical Education, College of Education, Seoul National University, Seoul, 2Institute of Sport Science, Seoul National University, Seoul, Korea
Correspondence to: Yeon Soo Kim
Institute of Sport Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
Tel: +82-2-880-7794, Fax: +82-2-872-2867, E-mail: kys0101@snu.ac.kr
Received July 26, 2021; Revised August 23, 2021; Accepted September 29, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: The purpose of this study was to examine the associations of aerobic physical activity and musclestrengthening exercise with mental health, respectively. Furthermore, the relationship between combined exercise with depression, stress, and suicidal thoughts was also examined.
Methods: The association between adherence to physical activity guidelines and mental health was analyzed among 27,268 adults who participated in the 2014– 2018 Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict the relationship between adherence to physical activity guidelines and mental health.
Results: The odds ratio for depression and suicidal thoughts in groups that met both aerobic physical activity and muscle-strengthening exercise guidelines decreased by 27% (95% confidence interval [CI], 0.56– 0.94) and 40% (95% CI, 0.39– 0.93), respectively, compared to those that did not meet both. Stress awareness decreased by 22% (95% CI, 0.67– 0.90) in those who met muscular exercise guidelines, but did not meet aerobic physical activity guidelines. For those who met only the aerobic physical activity guidelines, stress awareness decreased by 12% (95% CI, 0.82– 0.95). In addition, the odds ratio decreased by 29% (95% CI, 0.62– 0.80) in groups that met both guidelines.
Conclusion: The most positive relationships between adherence to physical activity guidelines and mental health were found when both aerobic and muscular exercise guidelines were met.
Keywords : Exercise, Resistance training, Mental health, Depression, Suicide ideation
꽌 濡

쟾 꽭怨꾩쟻쑝濡 떊泥댁쟻 嫄닿컯肉먮쭔 븘땲씪 젙떊쟻 嫄닿컯뿉 븳 愿떖룄 利앷븯怨 엳쑝硫 씠뿉 븳 愿由ъ쓽 以묒슂꽦씠 젏李 媛뺤“릺怨 엳떎. 듅엳 肄붾줈굹諛붿씠윭뒪 媛먯뿼利(coronavirus disease 2019, COVID-19)怨 媛숈 궗쉶쟻 샎씠 吏냽릺硫댁꽌 슦슱, 뒪듃젅뒪, 옄궡 깮媛곴낵 媛숈 젙떊嫄닿컯쓽 븯쐞 슂냼뱾쓽 臾몄젣젏뱾씠 뜑슧 떖솕븯怨 엳떎1. 꽭怨꾩쟻씤 異붿꽭肉먮쭔 븘땲씪 슦由щ굹씪뿉꽌룄 젙떊嫄닿컯뿉 븳 臾몄젣뒗 젏李 떖솕븯怨 엳뒗뜲, 떎젣濡 븳援씤쓽 옄궡瑜좎 2020뀈 湲곗 寃쎌젣삊젰媛쒕컻湲곌뎄(Organisation for Economic Cooperation and Development, OECD)援媛 以 1쐞씠怨, 씠뒗 OECD 룊洹 옄궡瑜좊낫떎 2諛 媛源뚯씠 넂 닔移섏씠떎2.

COVID-19 떆瑜 寃쏀뿕븯硫댁꽌 궗쉶쟻 嫄곕━몢湲, 硫댄솢룞쓽 理쒖냼, 寃⑸━ 벑쑝濡 떊泥댁쟻 솢룞 洹밸룄濡 媛먯냼릺怨 엳쑝硫, 씠濡 씤븳 젙떊쟻 뒪듃젅뒪 利앹긽룄 湲됯꺽엳 利앷븯怨 엳떎3. 蹂닿굔蹂듭遺뿉꽌 諛쒗몴븳 옄猷뚯뿉 쓽븯硫, 2020뀈 3썡 COVID-19媛 떆옉맂 씠썑 媛먯뿼蹂묒뿉 븳 怨듯룷媛, 遺덉븞怨 湲댁옣, 遺덉떊怨 遺꾨끂 벑쑝濡 슦由щ굹씪 꽦씤뱾쓽 뒪듃젅뒪 吏닔뒗 湲됱냽룄濡 넂븘吏怨 엳쑝硫, 寃쎄린뿰援ъ썝뿉꽌 諛쒗몴븳 옄猷뚯뿉 쓽븯硫 援誘쇰뱾씠 泥닿컧븯뒗 COVID-19쓽 뒪듃젅뒪 닔以 3.7젏쑝濡 怨쇨굅 떎瑜 옱궃怨 鍮꾧탳븯硫 ‘以묐룞 샇씉湲 利앺썑援(Middle East Respiratory Syndrome)’ (2.5젏)쓽 1.5諛, ‘룷빆 吏吏’(2.7젏)쓽 1.4諛곗怨, ‘꽭썡샇 移⑤ぐ’쓽 뒪듃젅뒪(3.3젏)蹂대떎룄 넂 닔以씠뿀떎4.

젙떊嫄닿컯쓣 媛쒖꽑븯湲 쐞븳 뿬윭 諛⑸쾿씠 젣떆릺怨 엳뒗 媛슫뜲, 떊泥댄솢룞뿉 愿븳 吏냽쟻씤 뿰援щ뱾 떊泥댄솢룞씠 떒닚엳 떊泥댁쟻 嫄닿컯肉먮쭔 븘땲씪 젙떊쟻 嫄닿컯뿉룄 룄씠 맂떎뒗 利앷굅뱾쓣 젣떆븯怨 엳떎. 슫룞 빟臾쇱뿉꽌 삱 닔 엳뒗 떎뼇븳 遺옉슜쓣 以꾩씠怨 떊泥댁쟻 嫄닿컯룄 利앹쭊븷 닔 엳떎뒗 遺媛쟻씤 옣젏룄 媛吏怨 엳뼱, 젙떊嫄닿컯 臾몄젣 빐寃곗쓣 쐞븳 以묒옱 以 븯굹濡 젣븞릺怨 엳뒗 寃껋씠떎5,6.

誘멸뎅뒪룷痢좎쓽븰쉶(American College of Sports Medicine)뿉꽌뒗 18꽭 씠긽 65꽭 씠븯 꽦씤뿉寃 씪二쇱씪뿉 理쒖냼 빀怨 150遺꾩쓽 以묐벑룄 쑀궛냼 솢룞, 삉뒗 씪二쇱씪뿉 쟻뼱룄 75遺 씠긽쓽 寃⑸젹븳 쑀궛냼 솢룞쓣 沅뚯옣븯怨 엳쑝硫, 嫄닿컯쓽 쑀씡쓣 쐞빐꽌뒗 쑀궛냼 솢룞쓣 씪二쇱씪뿉 300遺, 삉뒗 寃⑸젹븳 솢룞쓣 씪二쇱씪뿉 150遺꾩쑝濡 뒛由щ뒗 寃껋쓣 沅뚯옣븯怨 엳떎7. 삉븳 洹쇰젰 슫룞 二쇱슂 洹쇱쑁쓣 룷븿븯뿬 씪二쇱씪뿉 2쉶 씠긽 떎떆븯뒗 寃껋쓣 沅뚯옣븯怨 엳떎. 湲곕낯쟻쑝濡 二쇱뼱吏 媛씠뱶씪씤뿉꽌룄 蹂 닔 엳벏씠 떊泥댄솢룞, 利 슫룞 쑀궛냼꽦쓽 슫룞怨 洹쇰젰 슫룞쓽 몢 媛吏쓽 떊泥댄솢룞쓽 삎깭瑜 룞떆뿉 沅뚯옣븯怨 엳쑝誘濡, 쑀궛냼 슫룞怨 洹쇰젰 슫룞 몢 삎깭쓽 떊泥댄솢룞씠 蹂듯빀쟻쑝濡 젙떊嫄닿컯뿉 쁺뼢쓣 誘몄튂뒗吏瑜 븣븘蹂대뒗 寃껋씠 留ㅼ슦 以묒슂븳 遺遺꾩씠씪 븷 닔 엳떎.

슫룞씠 슦슱利앹씠굹 뒪듃젅뒪 씤吏 媛숈 젙떊嫄닿컯怨 媛뽯뒗 愿怨꾨 븯굹쓽 湲곗쟾쑝濡 꽕紐낇븷 닔 엳뒗 紐낅갚븳 利앷굅뒗 뾾吏留, 쑀궛냼꽦 슫룞怨 臾댁궛냼꽦 슫룞 紐⑤몢 젙떊嫄닿컯쓣 媛쒖꽑븯뒗 뜲 以묒슂븳 슂냼씤 寃껋 遺꾨챸븯떎8. 슦슱利앹긽쓣 媛吏怨 엳뒗 156紐낆쓽 꽦씤쓣 긽쑝濡 븳 뿰援ъ뿉꽌뒗 4媛쒖썡 룞븞쓽 궗씠겢 슫룞 諛 嫄룰린, 議곌퉭쓣 蹂듯빀쟻쑝濡 떎떆븳 쑀궛냼 슫룞 李몄뿬媛 슦슱利 媛쒖꽑뿉 룄씠 릺뿀怨, 6媛쒖썡씠 吏궃 썑뿉룄 슦슱利 諛쒖깮瑜좎씠 궙寃 쑀吏릺뒗 寃껋쑝濡 굹궗떎9.

2017뀈 援誘쇨굔媛뺤쁺뼇議곗궗 옄猷뚮 넗濡 븳 뿰援ъ뿉 뵲瑜대㈃ 洹쇰젰 슫룞쓣 씪二쇱씪뿉 3씪 씠긽 븯뒗 궗엺씠 洹몃젃吏 븡 궗엺蹂대떎 뒪듃젅뒪媛 궙븯怨, 洹쇰젰 슫룞씠 遺덉븞뿉 誘몄튂뒗 쁺뼢쓣 븣븘蹂닿린 쐞빐 吏꾪뻾맂 7媛쒖쓽 臾댁옉쐞 諛곗젙 엫긽떆뿕뿰援 寃곌낵瑜 醫낇빀빐 蹂대㈃ 쟾諛섏쟻씤 遺덉븞쓽 媛먯냼뿉 슚怨쇨 굹궗떎怨 蹂닿퀬븯떎10. 굹씠媛 鍮꾧탳쟻 젇 븰깮뱾쓽 寃쎌슦뿉룄 以묎컯룄 씠긽쓽 洹쇰젰 슫룞 遺덉븞, 슦슱, 옄궡 깮媛 벑쓣 以꾩뿬二쇰뒗 뜲 湲띿젙쟻씤 뿭븷쓣 븯怨 嫄닿컯뿉 븳 씤떇씠 醫뗭븘吏뒗 寃껋쑝濡 議곗궗릺뿀떎11.

쑀궛냼 슫룞怨 洹쇰젰 슫룞쓣 蹂듯빀쟻쑝濡 異⑹”떆궓 洹몃9씠 슦슱利앹긽쓣 媛먯냼떆궎뒗 뜲 湲띿젙쟻씠씪뒗 援쇅 끉臾몄 굹엳吏留12, 슦由щ굹씪뿉꽌쓽 쑀궛냼 슫룞怨 洹쇰젰 슫룞쓽 蹂듯빀쟻씤 떊泥댄솢룞 異⑹” 젙룄媛 젙떊쟻 嫄닿컯뿉 誘몄튂뒗 쁺뼢뿉 븳 뿰援щ뒗 븘吏 留롮씠 吏꾪뻾릺吏뒗 븡 긽깭씠떎. 遺遺꾩쓽 떊泥댄솢룞怨 젙떊嫄닿컯뿉 愿젴맂 뿰援щ뱾 떒씪쟻씤 떊泥댄솢룞 삎깭瑜 湲곗쑝濡 뿰援ш 吏꾪뻾릺뿀쑝硫, 쑀궛냼 슫룞씠굹 洹쇰젰 슫룞쓽 諛⑸쾿쟻씤 痢〓㈃뿉꽌쓽 援щ텇怨 蹂듯빀쟻씤 슚怨쇱뿉 븳 뿰援щ뒗 遺議깊븳 떎젙씠떎. 꽭怨꾨낫嫄닿린援(World Health Organization, WHO)뿉꽌룄 슫룞 삎깭쓽 蹂듯빀쟻 떎泥쒖씠 以묒슂븯떎怨 媛뺤“븯怨 엳쑝굹, 쑀궛냼 슫룞씠굹 洹쇰젰 슫룞쓽 떒씪 삎깭쓽 슫룞蹂대떎뒗 蹂듯빀쟻 슫룞씠 젙떊嫄닿컯뿉 뼹留덈굹 뜑 겙 湲띿젙쟻씤 뿭븷쓣 븯뒗吏뿉 沅뚭퀬뒗 븘吏 遺議깊븳 긽깭씠떎.

씠뿉 蹂 뿰援ъ쓽 紐⑹쟻 븳援 꽦씤쓽 쑀궛냼꽦 슫룞怨 洹쇰젰 슫룞쓽 슫룞 삎깭 쑀궛냼 슫룞怨 洹쇰젰 슫룞쓣 蹂듯빀쟻쑝濡 異⑹”븳 洹몃9뿉꽌 슦슱, 뒪듃젅뒪 씤吏, 옄궡 깮媛곴낵 媛숈 젙떊嫄닿컯쟻 痢〓㈃뿉 뼱뼚븳 쁺뼢쓣 誘몄튂뒗吏 洹 李⑥씠젏쓣 洹쒕챸븯뒗 뜲 洹 紐⑹쟻씠 엳떎.

뿰援 諛⑸쾿

援誘쇨굔媛뺤쁺뼇議곗궗뒗 援誘쇨굔媛뺤쬆吏꾨쾿 젣16議곗뿉 洹쇨굅븯뿬 援誘쇱쓽 嫄닿컯뻾깭 留뚯꽦吏덊솚쓽 쑀蹂묓쁽솴, 洹몃━怨 떇뭹 諛 쁺뼇꽠痍⑥떎깭뿉 愿빐 留ㅻ뀈 吏덈퀝愿由ъ껌뿉꽌 떆뻾븯뒗 踰뺤젙議곗궗씠硫, 씤援ъ<깮珥앹“궗 옄猷뚮 몴蹂 異붿텧濡 븯뿬 吏꾪뻾맂 2떒怨 痢듯솕吏묐떒몴蹂몄텛異 솗瑜좏몴蹂몄“궗씠떎. 뿰援щ긽옄뒗 씠룞寃吏꾩꽱꽣뿉꽌 嫄닿컯꽕臾몄“궗 寃吏꾩“궗瑜 떎떆븯쑝硫, 빆紐⑹뿉 뵲씪 硫댁젒諛⑸쾿怨 옄湲곌린엯떇 諛⑸쾿쑝濡 議곗궗븯떎. 蹂 뿰援щ뒗 븳援 꽦씤쓽 떊泥댄솢룞怨 젙떊嫄닿컯 媛꾩쓽 뿰愿꽦쓣 솗씤븯湲 쐞빐 援誘쇨굔媛뺤쁺뼇議곗궗쓽 2014뀈(젣6湲 2李 뀈룄)遺꽣 2018뀈(젣7湲)쓽 썝떆옄猷뚮 궗슜븯뿬 留 19꽭 씠긽 꽦씤쓣 긽쑝濡 닔뻾븯떎. 蹂 뿰援ъ뿉꽌 遺꾩꽍맂 옄猷뚮뒗 吏덈퀝愿由ъ껌 뿰援ъ쑄由ъ떖쓽쐞썝쉶쓽 듅씤쓣 넻빐 議곗궗릺뿀쑝硫, 2李 옄猷 遺꾩꽍쓣 쐞빐 꽌슱븰援 깮紐낆쑄由ъ쐞썝쉶쓽 떖쓽硫댁젣 듅씤쓣 諛쏆븯떎(No. E2108/003-001).

1. 뿰援щ긽

븳援 꽦씤쓽 슫룞 삎깭뿉 뵲瑜 젙떊嫄닿컯怨쇱쓽 뿰愿꽦쓣 遺꾩꽍븯湲 쐞븳 理쒖쥌 뿰援щ긽옄 꽑젙 怨쇱젙 Fig. 1뿉 룄떇솕븯떎. 2014–2018뀈룄 援誘쇨굔媛뺤쁺뼇議곗궗쓽 珥 議곗궗긽옄 31,310紐낆뿉꽌 떊泥댄솢룞 떆媛꾩씠 쑀슚븯吏 븡 씤썝 3,668紐낆쓣 젣쇅븯怨(n=27,642), 洹쇰젰 슫룞 蹂닔媛 寃곗륫씤 씤썝 39紐낆쓣 젣쇅븯떎(n=27,603). 怨듬씤(covariates)쑝濡 援먯쑁닔以, 냼뱷닔以, 씉뿰, 쓬二 닚꽌濡 寃곗륫 씤썝쓣 솗씤븯뿬 珥 335紐낆쓣 젣쇅븯떎(n=27,268). 뵲씪꽌 뿰援щ긽 꽑젙 怨쇱젙쓣 嫄곗튇 27,268紐낆쓣 긽쑝濡 떊泥댄솢룞 삎깭 젙떊嫄닿컯怨쇱쓽 뿰愿꽦쓣 遺꾩꽍븯떎.

Fig. 1. Flow diagram of participants excluded.

2. 蹂닔 꽕紐

1) 떊泥댄솢룞

蹂 뿰援щ뒗 援誘쇨굔媛뺤쁺뼇議곗궗 솃럹씠吏뿉꽌 2014뀈遺꽣 2018뀈룄쓽 썝떆옄猷뚮 궡젮諛쏆븘 遺꾩꽍븯떎. 꽕臾몄뒗 떊猶곕룄 諛 떦룄媛 寃利앸맂 Global Physical Activity Questionnaire (GPAQ) 븳湲뙋씠 궗슜릺뿀떎. GPAQ 룊냼 1二쇱씪媛 떎떆븯뒗 쑀궛냼 떊泥댄솢룞뿉 븳 吏덈Ц쑝濡 援ъ꽦릺뼱 엳떎. 쑀궛냼 떊泥댄솢룞뿉 븳 踰붿<뒗 씪(work), 옣냼 씠룞(transportation), 뿬媛(leisure)쓽 踰붿<濡 릺뼱 엳怨, 以묎컯룄 怨좉컯룄 솢룞 媛곴컖뿉 븳 씪닔 諛 룊洹 솢룞떆媛(遺)쓣 씪怨 뿬媛쓽 踰붿< 궡뿉꽌 떟빐빞 븳떎. 삉븳 옣냼 씠룞怨 愿젴맂 以묎컯룄 쑀궛냼 떊泥댄솢룞뿉 븳 씪닔 諛 룊洹 솢룞떆媛(遺)룄 룷븿릺뼱 엳떎. 꽕臾몄뒗 WHO쓽 ‘GPAQ Analysis Guideline’뿉꽌 젣怨듯븯뒗 젅李⑤ 넻빐 뜲씠꽣瑜 寃利앺븯怨, 씠긽移섎뒗 뾾뿀떎. 쑀궛냼 떊泥댄솢룞 誘멸뎅蹂닿굔蹂듭遺쓽 ‘Physical Activity Guidelines for Americans, 2nd edition’뿉꽌 沅뚯옣븯뒗 吏移⑥뿉 뵲씪 二쇰떦 150遺꾩쓣 湲곗쑝濡 “異⑹”븿”, “異⑹”븯吏 紐삵븿”쑝濡 援щ텇븯떎. 삉븳 洹쇰젰 슫룞뿉 愿븳 꽕臾몄 1二쇱씪 룞븞 뙏援쏀렣湲, 쐵紐몄씪쑝궎湲곗 媛숈 洹쇰젰 슫룞쓣 븳 씪닔濡 援ъ꽦릺뼱 엳쑝硫, 吏移⑥꽌뿉 뵲씪 二쇰떦 2씪 씠긽쓣 湲곗쑝濡 “異⑹”븿”, “異⑹”븯吏 紐삵븿”쑝濡 援щ텇븯떎.

2) 젙떊嫄닿컯 蹂씤

蹂 뿰援ъ뿉꽌뒗 WHO쓽 2018뀈 옄猷13瑜 湲곕컲쑝濡 슦슱, 뒪듃젅뒪 씤吏, 옄궡 깮媛곸쓣 蹂닔濡 궗슜븯떎. 슦슱 利앹긽 슦슱利 꽑蹂꾨룄援(Patient Health Questionnaire-9, PHQ-9)瑜 씠슜븯뿬 議곗궗븯뒗뜲, PHQ-9 珥 9媛吏쓽 슦슱 愿젴 吏덈Ц쑝濡 援ъ꽦릺뼱 吏궃 2二 룞븞쓽 利앹긽뿉 빐 떟빐빞 븳떎. 珥앺빀씠 5젏 씠긽씪 寃쎌슦 寃쎈명븳 슦슱 利앹긽씠 엳뒗 寃껋쓣 쓽誘명븯誘濡, 蹂 뿰援ъ뿉꽌뒗 5젏쓣 湲곗쑝濡 “삁” “븘땲삤” 吏묐떒쑝濡 젙쓽븯떎14. 援誘쇨굔媛뺤쁺뼇議곗궗뿉꽌 뒪듃젅뒪 씤吏 젙룄뒗 룊긽떆 뼱뒓 젙룄쓽 뒪듃젅뒪瑜 뒓겮怨 엳뒗吏瑜 꽕臾몄쓣 넻빐 議곗궗븯怨 엳怨, 蹂 뿰援ъ뿉꽌뒗 꽕臾몄쓽 떟쓣 湲곗쑝濡 “떒엳 留롮씠 뒓떎” 삉뒗 “留롮씠 뒓겮뒗 렪씠떎”씪怨 떟뻽쓣 寃쎌슦 뒪듃젅뒪瑜 留롮씠 씤吏븯뒗 吏묐떒, “議곌툑 뒓겮뒗 렪씠떎” 삉뒗 “嫄곗쓽 뒓겮吏 븡뒗떎”씪怨 떟븳 寃쎌슦 뒪듃젅뒪瑜 쟻寃 씤吏븯뒗 吏묐떒쑝濡 援щ텇븯떎. 삉븳 援誘쇨굔媛뺤쁺뼇議곗궗뿉꽌뒗 옄궡怨 愿젴맂 꽕臾몄쓣 닔뻾븯怨 엳뒗뜲, 蹂 뿰援ъ뿉꽌뒗 理쒓렐 1뀈 룞븞 옄궡쓣 깮媛곹븳 쟻씠 엳뒗吏뿉 븳 꽕臾몄쓽 떟蹂쓣 湲곗쑝濡 “삁” “븘땲삤” 吏묐떒쑝濡 遺꾨쪟븯떎.

3) 怨듬씤(covariates)

젙떊嫄닿컯 愿젴 슂씤怨 떊泥댄솢룞 궗씠쓽 룆由쎌쟻씤 愿怨꾨 鍮꾧탳븯湲 쐞빐 뿰졊, 꽦蹂, 援먯쑁 닔以, 냼뱷 닔以, 쓬二, 씉뿰, 泥댁쭏웾吏닔(body mass index, BMI), 以묎퀬媛뺣룄 떊泥댄솢룞 떆媛, 룞諛 吏덊솚 닔瑜 怨듬씤쑝濡 꽑젙븯떎. 뿰졊 留 19꽭遺꽣 10꽭 떒쐞濡 뿰졊瑜 援щ텇븯떎. 援먯쑁 닔以 珥덈벑븰援 議몄뾽 씠븯, 以묓븰援 議몄뾽 씠븯, 怨좊벑븰援 議몄뾽 씠븯, 븰援 議몄뾽 씠긽쑝濡 援щ텇븯怨, 냼뱷 닔以 꽦蹂꾧낵 뿰졊쓣 怨좊젮븯뿬 4遺꾩쐞닔濡 援щ텇븯떎. 쓬二쇰뒗 룊깮 鍮꾩쓬二, 理쒓렐 1뀈媛 썡 1옍 誘몃쭔 쓬二쇳븳 寃쎌슦, 理쒓렐 1뀈媛 썡 1옍 씠긽 쓬二쇳븳 寃쎌슦濡 援щ텇븯떎. 씉뿰 鍮꾪씉뿰, 怨쇨굅 씉뿰, 쁽옱 씉뿰쑝濡 援щ텇븯떎. BMI뒗 <18.5 kg/m2씪 寃쎌슦 泥댁쨷(underweight), ≥18.5 kg/m2뿉꽌 <24.9 kg/m2씪 寃쎌슦 젙긽(normal), ≥25 kg/m2뿉꽌 <29.9 kg/m2뒗 怨쇱껜以(overweight), 30 kg/m2 씠긽 鍮꾨쭔(obesity)쑝濡 援щ텇븯떎. 以묎퀬媛뺣룄 떊泥댄솢룞 떆媛꾩 뿰냽 蹂씤쑝濡 궗슜븯떎. 룞諛 吏덊솚 怨좏삁븬, 씠긽吏吏덊삁利, 뇤議몄쨷, 떖洹쇨꼍깋利, 삊떖利, 愿젅뿼, 怨⑤떎怨듭쬆, 룓寃고빑, 泥쒖떇, 떦눊, 媛묒긽꽑, 媛꾧꼍蹂利, 븫쓽 쁽옱 쑀蹂 뿬遺瑜 솗씤븯뿬 뾾쓬, 1媛, 2媛, 3媛, 4媛 씠긽쓽 5洹몃9쑝濡 援щ텇븯떎.

3. 넻怨 遺꾩꽍 諛⑸쾿

븳援 꽦씤쓽 꽦蹂꾩뿉 뵲瑜 듅꽦쓣 굹궡湲 쐞빐 뿰냽 蹂씤씤 以묎퀬媛뺣룄 떊泥댄솢룞 떆媛꾩 룊洹좉낵 몴以삤李⑥쓽 삎깭濡 젣떆븯쑝硫, 鍮꾩뿰냽 蹂씤씤 뿰졊, 援먯쑁 닔以, 냼뱷 닔以, 쓬二, 씉뿰, BMI, 떊泥댄솢룞 異⑹” 뿬遺 諛 젙떊嫄닿컯 옄猷뚮뒗 鍮덈룄닔 洹몃9 궡 鍮꾩쑉(%)쓽 삎깭濡 젣떆븯떎. 以묎퀬媛뺣룄 떊泥댄솢룞 諛 洹쇰젰 슫룞怨 젙떊嫄닿컯 媛꾩쓽 뿰愿꽦쓣 遺꾩꽍븯湲 쐞빐 濡쒖뒪떛 쉶洹遺꾩꽍(logistic regression)쓣 궗슜븯뿬 紐⑤뱺 怨듬씤씠 蹂댁젙맂(adjusted) 紐⑤뜽쓣 遺꾩꽍븯떎. 遺꾩꽍 떆 쑀궛냼 떊泥댄솢룞怨 洹쇰젰 슫룞 吏移⑥쓣 紐⑤몢 異⑹”븯吏 븡 洹몃9쓣 李몄“(reference) 洹몃9쑝濡 븯떎. 濡쒖뒪떛 쉶洹遺꾩꽍 寃곌낵뒗 援먯감鍮(odds ratio, OR) 95% 떊猶곌뎄媛(confidence interval, CI)쓣 젣떆븯뿬 愿怨꾩쓽 쑀쓽꽦쓣 鍮꾧탳븯떎. 紐⑤뱺 썝옄猷뚯쓽 泥섎━뒗 SAS version 9.4 (SAS Institute, Cary, NC, USA), 넻怨꾨텇꽍 STATA (SE) version 16.0 (StataCorp., College Station, TX, USA)쓣 씠슜븯쑝硫, 紐⑤뱺 遺꾩꽍뿉꽌 쑀쓽닔以 p<0.05濡 꽕젙븯떎.

寃 怨

蹂 뿰援щ긽옄쓽 떊泥댄솢룞 媛씠뱶씪씤 異⑹” 뿬遺뿉 뵲瑜 듅꽦뿉 븳 鍮덈룄닔 鍮꾩쑉 Table 1뿉 젣떆븯떎. 쑀궛냼 슫룞留 異⑹”븯뒗 씤썝怨 洹쇰젰 슫룞留 異⑹”븯뒗 씤썝 媛꾩쓽 李⑥씠媛 겕寃 굹궗쑝硫, 떊泥댄솢룞 媛씠뱶씪씤쓣 紐⑤몢 異⑹”븯뒗 鍮꾩쑉 긽쟻쑝濡 젇 뿰졊 궓꽦뿉寃뚯꽌 넂븯떎. 삉븳, 鍮꾨쭔씤 씤썝쓽 鍮꾩쑉 媛씠뱶씪씤쓣 紐⑤몢 異⑹”븯吏 븡뒗 吏묐떒뿉꽌 넂寃 굹궃 諛섎㈃, 怨쇰룄븳 쓬二쇱 쁽옱 씉뿰쓣 븯怨 엳뒗 씤썝쓽 鍮꾩쑉 긽쟻쑝濡 媛씠뱶씪씤쓣 紐⑤몢 異⑹”븯뒗 吏묐떒뿉꽌 넂寃 굹궗떎.

Table 1 . Descriptive of covariates

VariableGuideline adherence

Meet neitherAerobic MVPA onlyMuscle strengthening onlyMeet both
Age (yr)
19−291,016 (12.2)1,365 (21.8)147 (13.2)778 (31.3)
30−391,940 (18.4)1,633 (20.2)216 (13.6)524 (16.7)
40−492,217 (20.2)1,753 (21.5)300 (18.6)660 (19.5)
50−592,518 (20.6)1,698 (18.8)416 (24.7)664 (17.7)
60−692,368 (13.6)1,453 (10.9)440 (17.6)571 (10.3)
>692,901 (15.0)1,027 (6.8)363 (12.3)300 (4.6)
Sex
Male4,858 (43.0)3,618 (46.5)1,112 (64.4)2,175 (67.7)
Female8,102 (57.0)5,311 (53.5)770 (35.6)1,322 (32.3)
Education status
<Middle school5,278 (32.2)2,320 (19.0)579 (23.7)529 (10.4)
High school graduate3,760 (32.5)3,128 (38.8)630 (36.1)1,355 (41.4)
>Undergraduate3,922 (35.3)3,481 (42.2)673 (40.2)1,613 (48.2)
Alcohol*
No1,845 (11.6)921 (8.0)184 (7.7)199 (4.5)
Moderate9,770 (75.6)7,013 (79.0)1,472 (78.6)2,838 (81.3)
Heavy1,345 (12.8)995 (13.0)226 (13.7)460 (14.3)
Smoking
No8,170 (59.2)5,666 (59.7)959 (48.1)1,790 (50.0)
Past2,435 (18.7)1,701 (19.4)609 (32.0)1,035 (27.5)
Current2,355 (22.1)1,562 (21.0)314 (19.9)672 (22.5)
Income
Low3,062 (19.0)1,392 (13.1)310 (13.7)379 (9.4)
Mid-low3,283 (24.7)2,149 (23.5)471 (23.1)773 (21.7)
Mid-high3,414 (29.3)2,593 (30.3)533 (30.1)1,027 (30.7)
High3,201 (27.0)2,795 (33.1)568 (33.1)1,318 (38.2)
Body mass index
Underweight553 (4.8)346 (4.1)51 (2.7)119 (3.6)
Normal7,785 (59.8)5,552 (61.4)1,234 (66.5)2,265 (64.4)
Overweight3,836 (29.3)2,550 (28.7)523 (27.2)975 (27.8)
Obesity786 (6.1)481 (5.8)74 (3.6)138 (4.2)

Values are presented as unweighted number (weighted %).

*No: never drunk, heavy: at least twice a week and more than 6 times for male or 4 for female glasses at once, moderate: less than the ‘heavy’ criteria.



떊泥댄솢룞 媛씠뱶씪씤 異⑹” 뿬遺뿉 뵲瑜 젙떊嫄닿컯 吏몴뿉 븳 鍮덈룄닔 鍮꾩쑉 Table 2뿉 젣떆븯떎. 쟾諛섏쟻쑝濡 떊泥댄솢룞 媛씠뱶씪씤쓣 紐⑤몢 異⑹”븳 吏묐떒뿉 鍮꾪빐 紐⑤몢 異⑹”븯吏 븡뒗 吏묐떒뿉꽌 슦슱利앹긽, 뒪듃젅뒪 씤吏 諛 옄궡 깮媛곸쓣 븯뒗 씤썝씠 留롮 寃껋쑝濡 굹궗떎.

Table 2 . Descriptive of mental health outcomes

VariableGuideline adherence

Meet neitherAerobic MVPA onlyMuscle strengthening onlyMeet both
PHQ-9
Normal (<5)6,046 (78.7)4,353 (79.3)956 (85.8)1,788 (84.1)
Depressive disorder (≥5)1,673 (21.3)1,126 (20.7)155 (14.2)318 (15.9)
Stress
Less*9,402 (70.8)6,474 (71.1)1,503 (78.1)2,721 (75.9)
More3,548 (29.2)2,453 (28.9)379 (21.9)776 (24.1)
Suicide ideation
No4,821 (94.0)3,263 (95.3)737 (96.2)1,349 (97.2)
Yes328 (6.0)164 (4.7)31 (3.8)38 (2.8)

Values are presented as number (%).

*Those who answered ‘feeling low or no stress’; those who answered ‘feeling excessive or intense stress’; those who answered ‘thinking suicide ideation in recent 1-year’.

MVPA: moderate-to-vigorous physical activity, PHQ-9: Patient Health Questionnaire-9.



떊泥댄솢룞 媛씠뱶씪씤 異⑹” 뿬遺 젙떊嫄닿컯 媛꾩쓽 뿰愿꽦쓣 遺꾩꽍븳 寃곌낵뒗 Table 3뿉 젣떆븯떎. 떊泥댄솢룞 媛씠뱶씪씤쓣 紐⑤몢 異⑹”븯吏 븡 吏묐떒뿉 鍮꾪빐 紐⑤몢 異⑹”븳 吏묐떒쓽 슦슱利앹긽怨 옄궡 깮媛곸뿉 븳 OR 媛곴컖 23% (OR, 0.77; 95% CI, 0.65–0.92), 40% (OR, 0.60; 95% CI, 0.39–0.93) 媛먯냼븯쑝硫, 몢 媛吏 以 븳 媛吏留 異⑹”븳 吏묐떒쓽 OR 紐⑤몢 넻怨꾩쟻쑝濡 쑀쓽븯寃 굹굹吏 븡븯떎. 뒪듃젅뒪 씤吏쓽 寃쎌슦 떊泥댄솢룞 媛씠뱶씪씤쓣 紐⑤몢 異⑹”븯吏 븡 吏묐떒뿉 鍮꾪빐 쑀궛냼 슫룞留 異⑹”븳 吏묐떒뿉꽌 22% (OR, 0.78; 95% CI, 0.67–0.90), 洹쇰젰 슫룞留 異⑹”븳 吏묐떒뿉꽌 11% (OR, 0.89; 95% CI, 0.82–0.96) 媛먯냼븯쑝硫, 紐⑤몢 異⑹”븳 吏묐떒뿉꽌뒗 29% (OR, 0.71; 95% CI, 0.63–0.80) 媛먯냼븯떎.

Table 3 . Logistic regression of guideline adherence on mental health outcomes

VariablePHQ-9StressSuicide ideation
Meet neitherReferenceReferenceReference
Aerobic MVPA only0.80 (0.64−1.00)0.78 (0.67−0.90)0.78 (0.49−1.25)
Muscle strengthening only0.92 (0.81−1.04)0.89 (0.82−0.96)0.85 (0.66−1.10)
Meet both0.77 (0.65−0.92)0.71 (0.63−0.80)0.60 (0.39−0.93)

Values are presented as odds ratio (95% confidence interval).

MVPA: moderate-to-vigorous physical activity, PHQ-9: Patient Health Questionnaire-9.

Covariates: age, sex, education status, socioeconomic status, alcohol, smoking, body mass index, MVPA, number of comorbidities.


怨 李

蹂 뿰援щ뒗 援誘쇨굔媛뺤쁺뼇議곗궗옄猷뚮 넗濡 援궡 꽦씤쓽 떊泥댄솢룞 삎깭瑜 뙆븙븯怨 떊泥댄솢룞 삎깭 異⑹” 뿬遺뿉 뵲瑜 젙떊嫄닿컯怨쇱쓽 뿰愿꽦쓣 遺꾩꽍븯떎. 떊泥댄솢룞 媛씠뱶씪씤쓣 異⑹”븯뒗 닔以뿉꽌 쑀궛냼 슫룞怨 洹쇰젰 슫룞留뚯쓣 異⑹”븳 洹몃9뿉꽌뒗 PHQ-9 옄궡 깮媛곸쓽 OR 쑀쓽븯吏 븡 닔以쑝濡 굹궗怨, 뒪듃젅뒪 씤吏쓽 OR 궙寃 굹궗떎. 濡쒖뒪떛 쉶洹遺꾩꽍쓣 넻븯뿬 쑀궛냼꽦 슫룞怨 洹쇰젰 슫룞 媛곴컖씠 젙떊嫄닿컯뿉 誘몄튂뒗 쁺뼢蹂대떎뒗 쑀궛냼 슫룞怨 洹쇰젰 슫룞쓣 蹂듯빀쟻쑝濡 異⑹”븯쓣 븣 슦슱利앹긽怨 옄궡 깮媛곸뿉 븳 OR씠 媛먯냼븯뒗 寃껋쓣 솗씤븯떎. 쑀궛냼꽦 슫룞씠 뒪듃젅뒪 씤吏뿉 誘몄튂뒗 쁺뼢 쑀궛냼꽦 슫룞뿉 李몄뿬븯뒗 떆媛꾩씠 利앷븿뿉 뵲씪 뒪듃젅뒪 씤吏쓽 OR 궙븘吏怨, 洹쇰젰 슫룞씠 뒪듃젅뒪 씤吏뿉 誘몄튂뒗 쁺뼢룄 李몄뿬븯뒗 떆媛꾩씠 利앷맖뿉 뵲씪 OR씠 궙븘議뚮떎. 媛옣 以묒슂븳 寃곌낵뒗 쑀궛냼 슫룞怨 洹쇰젰 슫룞쓣 蹂듯빀쟻쑝濡 異⑹”븳 궗엺뱾뿉꽌 뒪듃젅뒪 씤吏 닔以쓽 OR씠 媛옣 궙寃 굹궃 寃껋씠씪 븷 닔 엳떎.

씠 寃곌낵뒗 젙떊嫄닿컯 吏몴뿉 븳 슫룞 諛⑹떇쓣 洹몃9蹂꾨줈 鍮꾧탳븳 臾댁옉쐞 엫긽떎뿕怨 遺遺꾩쟻쑝濡 씪移섑븯뒗 寃껋쑝濡, 249紐낆쓽 꽦씤쓣 긽쑝濡 臾댁옉쐞濡 쑀궛냼 슫룞怨 洹쇰젰 슫룞留 떎떆븯뒗 洹몃9怨 몮 떎 떎떆븯뒗 洹몃9쓣 議곌뎔쑝濡 諛곗젙븯怨, 21二 썑뿉 떎瑜 洹몃9怨 쑀궛냼 슫룞 諛 洹쇰젰 슫룞쓣 몮 떎 떎떆븯뒗 洹몃9쓣 鍮꾧탳빐蹂 寃곌낵 몮 떎 떎떆븯뒗 洹몃9뿉꽌 옄媛 뒫젰怨 젙떊쟻 吏몴媛 겕寃 뼢긽븳 寃껋쑝濡 굹궗떎15. 씠 뿰援ъ뿉꽌 젣떆븷 닔 엳뒗 二쇱슂 寃곌낵뒗 뼢썑 뿰援ъ뿉꽌 떊泥댄솢룞怨 젙떊嫄닿컯쓽 뿰愿꽦쓣 븣븘蹂닿퀬옄 븷 븣뿉뒗 쑀궛냼꽦 삎깭쓽 슫룞怨 洹쇰젰 슫룞쓽 슚怨쇰 븿猿 議곗궗빐 遊먯빞 븳떎뒗 寃껋쓣 떆궗븳떎.

꽑뻾 뿰援щ뱾쓣 醫낇빀빐 蹂대㈃ 嫄룰린, 議곌퉭, 궗씠겢 벑 쑀궛냼꽦 삎깭쓽 슫룞씠 슦슱利, 遺덉븞, 뒪듃젅뒪 씤吏, 닔硫댁쓽 吏, 옄궡 깮媛 벑뿉 湲띿젙쟻씤 쁺뼢쓣 誘몄튂뒗 寃껋쑝濡 뙆븙릺뿀쑝굹, 洹쇰젰 슫룞씠 젙떊嫄닿컯뿉 誘몄튂뒗 쁺뼢뿉 븳 援궡 뿰援щ뒗 긽쟻쑝濡 遺議깊븯떎. 씠 뿰援ъ뿉꽌뒗 쑀궛냼꽦 슫룞怨 洹쇰젰 슫룞 삎깭 몮 떎 異⑹”븳 洹몃9뿉꽌 슦슱, 뒪듃젅뒪 씤吏, 옄궡 깮媛곸뿉 湲띿젙쟻씤 媛쒖꽑씠 엳떎뒗 寃껋쓣 솗씤븿쑝濡쒖뜥 씠썑 뿰援ъ뿉 李멸퀬븷 닔 엳떎怨 깮媛곹븳떎. 삉븳 蹂 뿰援ъ뿉꽌 뒪듃젅뒪 씤吏 떊泥댄솢룞 異⑹”怨쇱쓽 愿怨꾧 쑀쓽븯寃 굹삩 諛섎㈃, 슦슱 諛 옄궡 깮媛곴낵 愿젴븯뿬 븳 媛吏 삎깭쓽 슫룞留 異⑹”븯뒗 寃쎌슦뿉뒗 쑀쓽븯寃 굹굹吏 븡븯떎. 씠윭븳 寃곌낵뒗 꽑뻾 由щ럭 뿰援10쓽 寃ы빐 떖由, 媛 뿰援ъ뿉꽌 紐⑥쭛맂 吏묐떒 듅꽦쓽 씠吏덉꽦怨 뵾뿕옄 닔뿉 뵲瑜 넻怨꾩쟻 李⑥씠뿉꽌 삤뒗 寃껋쑝濡 깮媛곷맂떎.

쑀궛냼 슫룞쓽 寃쎌슦 슫룞쓣 떎泥쒗븷 닔 엳뒗 諛⑸쾿쟻씤 痢〓㈃뿉꽌 洹쇰젰 슫룞怨 鍮꾧탳빐 遊ㅼ쓣 븣 뜑 젒洹쇳븯湲 돺떎怨 뙋떒릺吏留, 洹쇰젰 슫룞쓽 寃쎌슦뿉뒗 洹쇰젰 슫룞쓽 紐⑹쟻, 떎뼇븳 슫룞 醫낅ぉ, 슫룞쓽 鍮덈룄 諛 媛뺣룄 꽕젙, 湲곗닠 뒿뱷 벑 떎뼇븳 痢〓㈃뿉꽌 怨좊젮븷 궗빆뱾씠 留롮븘 긽쟻쑝濡 젒洹쇱꽦씠 뼥뼱吏꾨떎怨 蹂 닔 엳떎怨 蹂닿퀬븯怨 엳떎16. 삉븳 媛쒓컻씤쓽 湲곗큹泥대젰 닔以怨 뒿뱷 뒫젰씠 떎瑜닿린 븣臾몄뿉 씠瑜 怨좊젮븯吏 紐삵븷 寃쎌슦 쟻젅븯吏 紐삵븳 洹쇰젰 슫룞쓽 닔뻾씠 삤엳젮 뒪듃젅뒪瑜 利앷떆궎嫄곕굹 遺긽쓽 쐞뿕쓣 珥덈옒븷 닔 엳떎17. 洹몃윭誘濡 洹쇰젰 슫룞쓽 媛씠뱶씪씤쓣 젣떆븷 븣뿉뒗 슫룞 紐⑹쟻 꽕젙怨 鍮덈룄, 媛뺣룄, 슫룞 떆媛 벑뿉 뵲瑜 슚怨쇱 嫄닿컯 긽쓽 씠젏쓣 蹂대떎 硫대븳 옄猷 닔吏묎낵 遺꾩꽍쓣 넻븯뿬 紐낇솗엳 굹궪 븘슂꽦씠 엳떎18.

씠 媛숈씠 떊泥댄솢룞쓽 삎깭뿉 뵲瑜 媛쒕퀎쟻씤 異⑹”씠 媛뺤“릺誘濡 떊泥댄솢룞쓽 삎깭뿉꽌 뜑 꽭遺쟻씤 젒洹쇱씠 븘슂븯硫, 씠뿉 븳 뿰援щ뱾쓣 넻빐 理쒖쟻쓽 媛씠뱶씪씤쓣 젣떆븷 븘슂媛 엳떎. 듅엳 洹쇰젰 슫룞쓽 寃쎌슦 슫룞쓽 鍮덈룄, 媛뺣룄, 醫낅쪟 꽑깮 벑씠 留ㅼ슦 以묒슂븯湲 븣臾몄뿉 媛쒖씤쓽 洹쇰젰 닔以뿉 留욌뒗 슫룞 닔以쓣 꽕젙븷 닔 엳뒗 諛⑸쾿룄 젣떆빐빞 븷 寃껋씠떎19.

씠윭븳 寃곌낵뱾쓣 醫낇빀빐 遊ㅼ쓣 븣 떊泥댄솢룞씠 젙떊嫄닿컯쓽 痢〓㈃뿉꽌 湲띿젙쟻씤 뿭븷쓣 븯湲 쐞빐꽌뒗 쑀궛냼꽦 슫룞 삎깭굹 洹쇰젰 슫룞 삎깭쓽 떒닚솕맂 媛씠뱶씪씤 젣떆蹂대떎뒗 쑀궛냼 삎깭쓽 슫룞怨 洹쇰젰 슫룞 삎깭쓽 蹂듯빀쟻 떎泥쒕갑踰뺤쓣 젣떆븯怨 젙梨낆쓣 떆뻾븯뒗 寃껋씠 븵쑝濡쒖쓽 븳援 꽦씤쓽 젙떊嫄닿컯뿉 蹂대떎 湲띿젙쟻씤 옉슜쓣 븷 닔 엳떎뒗 寃껋쓣 쓽誘명븳떎.

씠 뿰援щ뒗 援誘쇨굔媛뺤쁺뼇議곗궗 옄猷뚮 넗濡 슒떒뿰援ъ쓽 寃곌낵瑜 遺꾩꽍븳 寃껋쑝濡 蹂닔 媛꾩쓽 吏곸젒쟻씤 씤怨쇨怨꾨 紐낇솗븯寃 꽕紐낇븷 닔 뾾怨 꽑삎쟻 뿰愿꽦쓣 寃利앺븯吏 紐삵뻽떎뒗 젣븳젏씠 엳떎. 삉븳, 꽕臾몄뿉 궗슜맂 떊泥댄솢룞뿉 엳뼱 젙솗븳 洹쇰젰 슫룞쓽 떆媛꾩씠굹 媛뺣룄뒗 솗씤븷 닔 뾾뿀떎. 洹몃윭굹 援誘쇨굔媛뺤쁺뼇議곗궗뒗 援誘쇱쓣 몴븷 닔 엳뒗 洹쒕え쓽 옄猷뚯씠誘濡, 떊泥댄솢룞쓽 삎깭뿉 뵲瑜 異⑹”씠 젙떊嫄닿컯怨 쑀쓽븳 뿰愿꽦씠 엳떎뒗 寃껋쓣 솗씤븯怨 異뷀썑 뿰援ъ뿉 엳뼱 湲곗큹옄猷뚮줈 솢슜븷 닔 엳쓣 寃껋씠떎.

븵쑝濡 뿰졊蹂, 紐⑹쟻蹂꾨줈 蹂대떎 꽭遺꾪솕맂 洹쇰젰 슫룞쓽 봽濡쒓렇옩怨 젏吏꾩쟻 삎깭쓽 沅뚭퀬궗빆 벑뿉 븳 뿰援ш 吏냽쟻쑝濡 씠猷⑥뼱졇빞 븯硫, 떊泥닿굔媛뺣퓧留 븘땲씪 젙떊嫄닿컯 痢〓㈃뿉꽌룄 뜑 꽭遺꾪솕맂 뿰援ъ쟻 젒洹쇱씠 씠猷⑥뼱졇빞 븷 寃껋씠떎. 듅엳 COVID-19 媛숈 듅닔븳 긽솴씠 吏냽맖뿉 뵲씪, 쑀궛냼 슫룞 諛 洹쇰젰 슫룞쓣 洹쒖튃쟻쑝濡 쑀吏븯뒗 泥 諛⑸쾿怨 봽濡쒓렇옩 媛쒕컻뿉 븳 뿰援щ룄 븿猿 씠猷⑥뼱졇빞 븷 寃껋씠떎.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Author Contributions

Conceptualization: YSK. Formal analysis: HS, JL, JK. Methodology: HC. Writing–original draft: HKK. Writing–review & editing: HKK, HC.

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