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Background: Insulin resistance (IR) is assessed using surrogate markers such as the triglyceride–glucose (TyG) index, the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and the metabolic score for IR (METS-IR). Limited studies investigated their association with colorectal cancer (CRC) incidence, and no research has been conducted on their association with the METS-IR. Method: This study used claims data from the Korean National Health Insurance Service, analyzing a cohort of 314,141 Koreans aged over 40 who participated in the National Health Screening Program from 2009 to 2010. The follow-up period was extended until 31 December 2019. Participants were divided into four groups based on quartiles (Q1–Q4) of the markers. Results: All surrogate markers of IR had sequentially statistically lower disease-free probabilities from Q1 to Q4. The Cox proportional hazard model demonstrated statistically significant positive associations between CRC incidence and Q3 and Q4 of the TyG index, as well as Q3 and Q4 of the TG/HDL-C ratio and Q4 of the METS-IR. The constrained cubic spline method revealed a nonlinear, positive dose–response relationship between the TyG index and the METS-IR in relation to CRC incidence. Conclusions: In conclusion, the TyG index, TG/HDL-C ratio, and METS-IR were positively correlated with CRC incidence in Koreans. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions We investigated the association between statin compliance and the risk of dementia among patients with chronic periodontitis.Chronic periodontitis patients were extracted from the National Health Insurance Service‐Health Screening Cohort Database, covering the period from 2002 to 2019. A total of 22,089 subjects were included in the study and divided into three groups based on their compliance with statin administration. The Cox proportional hazard model was utilized to calculate hazard ratios and 95% confidence intervals for analyzing the risk of dementia.In the restricted cubic spline of the multivariable‐adjusted model, the hazard ratio for dementia decreased prominently with a higher medication possession ratio. The hazard ratios and 95% confidence intervals in the multivariable‐adjusted model for dementia risk in the middle and high medication possession ratio groups, compared to the low medication possession ratio group, were confirmed as 0.70 (0.57–0.87) and 0.57 (0.45–0.72), respectively. In the subgroup analysis, a significant association between dementia and good statin medication possession ratio was found in both severe periodontitis and mild periodontitis cases.Our findings suggest that a group of patients with chronic periodontitis who maintain good statin compliance are associated with a reduced risk of dementia. [ABSTRACT FROM AUTHOR]

Phosphate-buffered saline (PBS) and Alsever's solution (AS) are frequently used as media in blood-related studies, while 0.9% normal saline (NS) is frequently used in transfusion medicine. Despite the frequent use, the effects of these solutions on the shape and volume of red blood cells (RBCs) have not been reported. We collected blood samples from five healthy adults and used three-dimensional refractive index tomography to investigate the changes in the morphology of RBCs caused by changes in osmolality and solutes at the single-cell level. After diluting 2 μL of RBCs 200-fold with each solution (PBS, AS, and 0.9% NS), 40 randomly selected RBCs were microscopically observed. RBC shape was measured considering sphericity, which is a dimensionless quantity ranging from 0 (flat) to 1 (spherical). RBCs in plasma or AS showed a biconcave shape with a small sphericity, whereas those in 0.9% NS or PBS showed a spherical shape with a large sphericity. Moreover, we confirmed that sodium chloride alone could not elicit the biconcave shape of RBCs, which could be maintained only in the presence of an osmotic pressure-maintaining substance, such as glucose or mannitol. Although 0.9% NS solution is one of the most commonly used fluids in hematology and transfusion medicine, RBCs in 0.9% NS or PBS are not biconcave. Therefore, as the debate on the use of NS continues, future clinical studies or applications should consider the effect of glucose or mannitol on the shape of RBCs. [ABSTRACT FROM AUTHOR]

Chronic kidney disease–mineral bone disorder (CKD-MBD) is the most common complication in CKD patients. Although there is a consensus on treatment guidelines for CKD-MBD, it remains uncertain whether these treatment recommendations reflect actual practice. Therefore, the aim of this study was to investigate the CKD-MBD medication trend in real-world practice. This was a retrospective and observational study using a 12-year period database transformed into a common data model from three tertiary university hospitals. Study populations were subjects initially diagnosed as CKD. The date of diagnosis was designated as the index date. New patients were categorized year to year from 2008 to 2019 with a fixed observation period of 365 days to check the prescription of CKD-MBD medications including calcium-containing phosphate binder, noncalcium-containing phosphate binder, aluminium hydroxide, vitamin D receptor activator (VDRA), and cinacalcet. The numbers of CKD patients in the three hospitals were 7555, 2424, and 5351, respectively. The proportion for patients with CKD-MBD medication prescription decreased yearly regardless of hospital and CKD stage (p for trend < 0.05). The use of aluminium hydroxide disappeared steadily while the use of VDRA increased annually in all settings. Despite these changes in prescription patterns, the mean value for CKD-MBD-related serologic markers was almost within target range. The proportion of the population within the target value was not significantly changed. Irrespective of hospital and CKD stage, similar trends of prescription for CKD-MBD medications were observed in real-world practice. Further research with a distributed network study may be helpful to understand medication trends in CKD-MBD treatment. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions To study the use of a quasi‐experimental design to assess the effects of scaling reimbursement policies on the incidence of chronic‐periodontitis procedures.Interrupted time series analysis was used to compare the effects before and after policy implementation using data on the number of periodontitis‐related procedures from the Korean National Health Insurance Service‐National Sample Cohort (n = 740,467) and the Health Screening Cohort (n = 337,904). Periodontitis‐related procedures with diagnosis codes were categorized into basic (scaling or root planing), intermediate (subgingival curettage) and advanced (tooth extraction, periodontal flap surgery, bone grafting for alveolar bone defects or guided tissue regeneration). Subjects' demographics and comorbidities were considered. The incidence rate of immediate changes and gradual effects before and after policy implementation was assessed.Following the policy implementation from July 2013, an immediate increase was observed in total and basic procedures. No significant changes were noted in intermediate and advanced procedures initially. A decrease in the slope of intermediate procedures was observed in both databases. Advanced procedures showed varied trends, with no change in the National Sample Cohort but an increase in the Health Screening Cohort, particularly among subjects with comorbidities.Following the new policy implementation, the number of intermediate procedures decreased while the number of advanced procedures increased, especially among patients with comorbidities. These findings offer valuable insights on policy evaluation. [ABSTRACT FROM AUTHOR]

Hemoglobin level determines blood viscosity and as hemoglobin level rises, blood pressure rises. However, hemoglobin level in individuals is not fixed and change in hemoglobin is affected by various clinical conditions. The purpose of this study is to investigate whether the hemoglobin variability affects the development of hypertension using Korean cohort database. This study was conducted with 94,798 adults (age ≥ 40 years) who visited the health screening in 2006 or 2007 (index year) and had at least 3 health screenings from 2002 to 2007. Hemoglobin variability was assessed by 3 indices of coefficient of variation (CV), standard deviation, and variability independent of the mean. Cox proportional hazard regression analysis was performed for each index of quartile groups (Q1–Q4). A total of 29,145 participants (30.7%) had the incidence of hypertension during a median follow-up of 7.4 ± 2.5 years. In the multivariable adjusted model, the hazard ratio and 95% confidence interval for incidence of hypertension of Q2, Q3, and Q4 compared with Q1 of hemoglobin variability CV were 1.014 [0.981–1.047], 1.064 [1.030–1.099] and 1.094 [1.059–1.131] respectively. The results were consistent in various sensitivity and subgroup analyses. This study showed that hemoglobin variability could be associated with hypertension development. [ABSTRACT FROM AUTHOR]

Pneumonia is related to oral health of the elderly and intensive care unit patients. However, studies on the relationship between overall oral health and pneumonia in the general population have been limited. The purpose of this study was to investigate the association between oral health and pneumonia using a nationwide population-based Korean cohort database. Data from 122,251 participants who underwent health screening and oral examinations in 2004 or 2005 were analyzed. Cox proportional hazard regression analysis was performed to evaluate the association between oral health and pneumonia. The risk of pneumonia increased significantly in groups with a higher number of dental caries and missing teeth, with respective adjusted hazard ratios (HRs) and 95% confidence interval (CI) of 1.265 (1.086–1.473; p = 0.0025) and 1.218 (1.113–1.332; p < 0.0001), and decreased significantly in frequent tooth brushing and regular professional dental cleaning groups, with respective adjusted HRs and 95% CI of 0.853 (0.786–0.926; p = 0.0001) and 0.920 (0.855–0.990; p = 0.0255). In addition, regardless of age and comorbidities, oral health status and oral hygiene behaviors were associated with pneumonia. The results indicate that improved oral health may reduce the risk of pneumonia in the general population. [ABSTRACT FROM AUTHOR]

Objectives: Despite the growing pieces of evidence linking hyperuricemia with metabolic syndrome and cardiovascular disease, the relationship between dyslipidemia and serum uric acid has not yet been established. This study aimed to investigate the association between individual components of dyslipidemia and serum uric acid by using the nationally representative Korea National Health and Nutrition Examination Survey 2016–2017. Methods: A total of 8,722 participants (age ≥ 19 years) without missing values were analyzed for this study. Serum uric acid levels according to the presence of individual dyslipidemia components were calculated using multivariable-adjusted general linear models (GLM). Odds ratios of individual dyslipidemia components to hyperuricemia were calculated using unadjusted and multivariable-adjusted logistic regression analysis. Results: A total of 1,061 participants were identified as having hyperuricemia, with a prevalence of 12.2%. Multivariable-adjusted GLM demonstrated a significant trend between individual dyslipidemia components and serum uric acid levels (P < 0.05). A positive association between the numbers of dyslipidemia components and the increments of serum uric acid levels was also observed (P < 0.001). In multivariable-adjusted logistic regression analysis, odds ratios (OR) and 95% confidence interval (CI) of all dyslipidemia components to hyperuricemia were shown to be statistically significant (P < 0.05). When further adjusted for the combined components themselves, each 10 mg/dL increments of total cholesterol (OR 1.053; 95% CI 1.028–1.079), triglycerides (OR 1.017; 95% CI 1.009–1.026) and HDL-C (OR 0.804; 95% CI 0.729–0.887), retained significant correlation with hyperuricemia. Conclusion: Our study demonstrated that the dyslipidemia components of serum total cholesterol, triglycerides and LDL-C levels are positively associated with serum uric acid levels, whereas serum HDL-C levels are inversely related. Further complementary studies regarding other lipid parameters are needed to confirm the accurate association between dyslipidemia and serum uric acid levels. [ABSTRACT FROM AUTHOR]

Background: Joint replacement is an important surgery for replacing a damaged joint with prosthesis. Implants used for joint replacement are made of metal, plastic, and ceramic. Skin reactions, such as dermatitis, can occur due to a hypersensitivity to these external substances. Aims: The aim of this study was to find the relationship between joint replacement and dermatitis. Methods: A nationwide population-based retrospective cohort study was performed using the National Health Insurance Service Database of the Republic of Korea. A total of 40,218 patients who underwent joint replacement were enrolled as the operation group and 40,218 controls were also enrolled. A cox proportional hazard regression model, and Fine and Gray regression model were used to compare the risk of dermatitis between the two groups. Results: Dermatitis occurred in 9.2% of the operation group and 9.1% of the control group, and no statistical difference was observed between the two groups. According to the Cox proportional hazard regression model, and Fine and Gray regression model, the risk of dermatitis did not increase in the operation group compared to that in the control group. However, the risk of dermatitis increased 1.20-fold in the operation group compared to that in the control group aged <60 years according to the Fine and Gray regression model (95% confidence index (CI) = 1.05–1.37, P = 0.0008). Conversely, no difference in dermatitis risk was observed between the two groups aged ≥60 years. Conclusions: We found that the risk of dermatitis increased after joint replacement in those aged <60 years. [ABSTRACT FROM AUTHOR]

Electrical methods are among the primarily studied non-invasive glucose measurement techniques; however, various factors affect the accuracy of the sensors used. Of these, the temperature is a critical factor; hence, the effects of temperature on the electrical properties of blood components are investigated in this study. Furthermore, the changes in the electrical properties of blood according to the glucose level are corrected by considering the effects of temperature on the electrical properties. An impedance sensor is developed and used to measure whole blood impedance in 10 healthy participants at various temperatures and glucose levels. Subsequently, the conductivities of the plasma and cytoplasm were extracted. Changes in the electrical properties of the blood components are then analyzed using linear regression and repeated measures ANOVA. The electrical conductivities of plasma and cytoplasm increased with increasing temperatures (plasma: 0.0397 (slope), 0.7814 (R2), cytoplasm: 0.014 (slope), 0.694 (R2)). At three values of increasing glucose levels (85.4, 158.1, and 271.8 mg/dL), the electrical conductivities of the plasma and cytoplasm decreased. These tendencies are more significant upon temperature corrections (p-values; plasma: 0.001, 0.001, cytoplasm: 0.003, 0.002). The relationships between temperature and electrical conductivity changes can thus be used for temperature corrections in blood glucose measurement. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the relationship between the anion gap, including the corrected anion gap, and patient mortality in intensive care units (ICUs) without restricting the analysis to specific diseases or medical specialties. Our primary objective was to investigate the association between the anion gap and ICU mortality using multiple open-access databases. Methods: We identified 4229 subjects from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, whose entries were from between 2008 and 2019. For each patient, the anion gap and corrected anion gap were calculated, and the study sample was divided into tertile groups (T) according to these levels. The association between the anion gap and in-hospital mortality was assessed using hazard ratios (HRs) and 95% confidence intervals (CIs) derived from a multivariable-adjusted Cox proportional hazards model. Besides MIMIC-IV, we also incorporated study samples from two other databases (MIMIC-III and electronic ICU) to calculate summary HRs using a random-effects meta-analysis. Results: Within MIMIC-IV, 1015 patients (24%) died during an average follow-up period of 15.5 days. The fully adjusted HRs and 95% CIs for T2 and T3, relative to T1, were 1.31 (95% CI 1.08–1.58) and 1.54 (95% CI 1.24–1.90), respectively. When grouped by corrected anion gap, the results remained statistically significant. In the meta-analysis, the summary HRs and 95% CIs for T2 and T3 were 1.24 (95% CI 1.08–1.43) and 1.55 (95% CI 1.33–1.82), respectively. Conclusions: Both the anion gap and corrected anion gap were associated with in-hospital mortality regardless of specific diseases or medical specialties. [ABSTRACT FROM AUTHOR]

• The erythrocyte cytoplasm is a colloid of hydrated hemoglobin molecules. • Hemoglobin hydration significantly affects the dielectric properties of whole blood. • A numerical method for analyzing impedance data is developed. • The hemoglobin molecule in the cytoplasm has primary and secondary hydration shells. • The primary and secondary shells' thicknesses are 0.39 and 0.20 nm, respectively. Electrochemical impedance spectroscopy of whole blood and blood cells has great potential for assessing the health of patients. This potential has not been fully exploited for a detailed examination of the erythrocyte interior. The erythrocyte interior (cytoplasm) is often considered as continuous media. However, cytoplasm is a colloidal suspension of hydrated hemoglobin molecules. This study mainly focuses on the effect of hemoglobin hydration on the dielectric properties of erythrocyte cytoplasm and whole blood. The impedance spectra of separated cytoplasm and whole blood were measured at frequencies from 1 kHz to 110 MHz. The effective medium theory was used to analyze the experimental data. The cytoplasm was found to be best described as a colloid of hemoglobin cores surrounded by double hydration shells. The dielectric properties of the hemoglobin core, hydration shells and free intracellular fluid, as well as the thickness of the shells, were numerically determined from the impedance spectrum. An approach was developed to determine the intracellular fluid's viscosity and the density of bound water in the hydration shells. It shows that the hemoglobin hydration has a significant effect on the physical properties of blood. The detailed electrical properties of the cytoplasm can be detected from the impedance spectrum of whole blood. [Display omitted] [ABSTRACT FROM AUTHOR]