A Case of Wilson's Disease in Patient with Mildly Elevated Liver Enzymes

Wilson's disease is an autosomal recessive disorder affecting copper transport; it results in the accumulation of copper in the liver, brain, and other organs. Wilson's disease is the most common inherited liver disease with more than 500 cases reported in Korea. An impairment in biliary excretion process leads to copper accumulation in the liver, which progressively damages the liver, leading to cirrhosis. Since effective treatment is available for this disease, early and correct diagnosis is very important. Here, we report a case of Wilson's disease with mildly elevated liver enzyme levels in a 29-year-old breast-feeding woman with weight loss.

Effects of a new medical insurance payment system for hospice patients in palliative care programs in Korea

BACKGROUND

This study investigates the effects of a new medical insurance payment system for hospice patients in palliative care programs and analyzes length of survival (LoS) determinants.

METHOD

At the Pusan National University Hospital hospice center, between January 2015 and April 2016, 276 patients were hospitalized with several diagnosed types of terminal stage cancer. This study separated patients into two groups, "old" and "new," by admission date, considering the new system has been applied from July 15, 2015. The study subsequently compared LoS, total cost, and out-of-pocket expenses for the two groups.

RESULTS

Overall, 142 patients applied to the new medical insurance payment system group, while the old medical insurance payment system included 134 patients. The results do not show a significantly negative difference in LoS for the new system group (p = 0.054). Total cost is higher within the new group (p <  0.001); however, the new system registers lower patient out-of-pocket expenses (p <  0.001).

CONCLUSION

The novelty of this study is proving that the new medical insurance payment system is not inferior to the classic one in terms of LoS. The total cost of the new system increased due to a multidisciplinary approach toward palliative care. However, out-of-pocket expenses for patients overall decreased, easing their financial burden.

Correlations between obesity indices and cardiometabolic risk factors in obese subgroups in women with severe obesity: A multicenter, cross-sectional study

BACKGROUND

To investigate associations between degrees of obesity using correlations between obesity indices and cardiometabolic risk factors in women.

METHODS

BMI, waist circumference (WC), fasting insulin, fasting glucose, lipids, and visceral adipose tissue (VAT) area using computed tomographic images were measured in 113 women with obesity. Correlations between obesity indices and cardiometabolic risk factors were analyzed in subgroups defined using sequential obesity indices.

RESULTS

Mean BMI and WC were 29.6kg/m2 and 92.8cm. BMI showed significant correlations with all five cardiometabolic risk factors until the BMI cut-off point reached 29kg/m2, but when it exceeded 30kg/m2, correlations no longer existed. WC was significantly correlated with all five cardiometabolic risk factors up to a value of 85cm, but when WC exceeded 90cm, correlations no longer existed.

CONCLUSIONS

Our cross-sectional study suggest that significant correlations between obesity indices and cardiometabolic risk factors may disappear, when obesity cut-off points exceed certain limits in women.

The Role of the Teaching Hospital in the Effective Clerkship

A teaching hospital is a place where both patient care and learning occur together. To identify the role of the teaching hospital in an effective clerkship, we first determined the features of workplace learning and the factors that affect learning in the workplace, and then we proposed a role for the teaching hospital in the clinical clerkship. Features of learning in a clerkship include learning in context, and learning from patients, supervising doctors, others in the team, and colleagues. During the clerkship, medical students learn in three-way learner-patient-teacher relationships, and students’ participation in the tasks of patient care is crucial for learning. Factors that influence learning in the workplace are associated with tasks, context, and learner. Tying the three factors together, we proposed a role for the teaching hospital in the three categories: involvement in the tasks of patient care, engagement in the medical team, and engagement in the learning environment and system. Supervising doctors and team members in a teaching hospital support students’ deep participation in patient care, while improving the learning environment through organizational guidelines and systems. Gathering both qualitative and quantitative data for the evaluation of a teaching hospital is important.

Effects of 4-Week Intervention with Ulmus macrocarpa Hance Extract on Immune Function Biomarkers in Healthy Adults: A Randomized Controlled Trial

Ulmus macrocarpa extract has been shown to have immune-related effects in animals, but no studies have yet been performed in humans. This randomized, double-blind, placebo-controlled trial was conducted to determine the effect of short-term administration of Ulmus macrocarpa Hance extract (UME) on immune function biomarkers and its safety in human subjects. Fifty-eight subjects were randomly assigned to a UME group or a placebo group. Subjects in the UME group were given 500 mg per day of UME orally for 4 weeks. Mean fluorescence intensity (MFI) of tumor necrotic factor-α increased only in the UME group at 1 week (P = 0.027). The MFI of interleukin-2 decreased less significantly in the UME group than in the placebo group at 1 week (P = 0.028). However, unfortunately, at 4 weeks, no intergroup differences were detected in MFIs of cytokine. In conclusion, administration of UME for 1 week increased serum TNF-α and sustains IL-2 in human, which suggests that UME increases Th1-related immune function in the short term in healthy people. However, additional studies are needed to confirm the results of this first-stage study and further trials are required to decide on optimal dosage and duration of administration. This trial is registered with ClinicalTrials.gov Identifier: NCT02414412.

Holistic rubric vs. analytic rubric for measuring clinical performance levels in medical students

BACKGROUND

Task-specific checklists, holistic rubrics, and analytic rubrics are often used for performance assessments. We examined what factors evaluators consider important in holistic scoring of clinical performance assessment, and compared the usefulness of applying holistic and analytic rubrics respectively, and analytic rubrics in addition to task-specific checklists based on traditional standards.

METHODS

We compared the usefulness of a holistic rubric versus an analytic rubric in effectively measuring the clinical skill performances of 126 third-year medical students who participated in a clinical performance assessment conducted by Pusan National University School of Medicine. We conducted a questionnaire survey of 37 evaluators who used all three evaluation methods-holistic rubric, analytic rubric, and task-specific checklist-for each student. The relationship between the scores on the three evaluation methods was analyzed using Pearson's correlation. Inter-rater agreement was analyzed by Kappa index. The effect of holistic and analytic rubric scores on the task-specific checklist score was analyzed using multiple regression analysis.

RESULTS

Evaluators perceived accuracy and proficiency to be major factors in objective structured clinical examinations evaluation, and history taking and physical examination to be major factors in clinical performance examinations evaluation. Holistic rubric scores were highly related to the scores of the task-specific checklist and analytic rubric. Relatively low agreement was found in clinical performance examinations compared to objective structured clinical examinations. Meanwhile, the holistic and analytic rubric scores explained 59.1% of the task-specific checklist score in objective structured clinical examinations and 51.6% in clinical performance examinations.

CONCLUSION

The results show the usefulness of holistic and analytic rubrics in clinical performance assessment, which can be used in conjunction with task-specific checklists for more efficient evaluation.

Association between gene polymorphisms and obesity and physical fitness in Korean children

Obesity is affected by genetic factors and environmental influences. This research was undertaken to identify single nucleotide polymorphisms (SNPs) related to obesity and physical fitness and then to analyse and compare interactions between physical fitness and obesity-associated genotypes. To investigate relationships between physical fitness and major SNPs previously reported to be related to obesity, 68 SNPs in 32 genes were genotyped in 71 Korean children. Tests were conducted to evaluate five elements of physical fitness (speed, aerobic endurance, muscular endurance, muscular strength, and flexibility). The results obtained showed significant (P<0.02) differences in physical fitness scores for the following genotypes: CNR1 (rs1049353; GG), LEP (rs7799039; AA+AG), HHEX (rs1111875; TT), GC (rs16847015; TG+GG), LRP5 (rs4988300; GG+GT), NPY2R (rs2880415; CT+CC), PPY (rs231472; GG), UCP2 (rs660339; CT+TT), CDKN2B (rs10811661; AA+AG), and ADIPOQ (rs266729; CG+GG). Ten physical fitness-related genotypes were newly identified during the present study. This study suggests that classification of genotypes by physical fitness level could be used as an index for predicting the risk of obesity and for selecting individuals for intervention programmes. Furthermore, the study shows that even children participating in the same physical fitness improvement programme can exhibit different genotype dependencies.

Obesity Education in Medical School Curricula in Korea

Obesity is one of the three most common diseases, affecting about one-third of adults. Obesity also increases vulnerability to metabolic disorders, psychological disorders, and various cancers and decreases quality of life. Therefore, obesity must be adequately addressed in medical school. Here, I will review how obesity education is implemented in medical school curricula in Korea. Many studies have shown that students who are well educated about obesity through various educational methods reduce their prejudice toward obese patients. The Korean Society for the Study of Obesity is an interdisciplinary academy, including experts from fields such as general research, clinical practice, nutrition, nursing, exercise, and rehabilitation. They aim to identify the core competencies of obesity education necessary for medical students, develop curricula of obesity education, and present examples of lectures and discussions. In the future, health professionals who receive such education will be able to take better care of obese patients without bias.

Short-term effect of gastric resection on circulating levels of ghrelin, peptide YY3-36 and obestatin in patients with early gastric cancer

The short-term responses of gut hormones and the compensative interaction during a one-week period after subtotal gastrectomy in early gastric cancer (EGC) patients were assessed. Previous studies have reported gut hormonal changes after Roux-en-Y gastric bypass surgery. Blood samples were collected from 40 patients with EGC preoperatively, at 1 h after gastric resection, and on postoperative day (POD) 1, 3, and 7. Levels of active ghrelin, total ghrelin, obestatin, and PYY3-36 were measured. Total ghrelin level rapidly reached a nadir of 69.1%, while active ghrelin level had increased to 135.5% at 1 h after resection. Then, both returned to preoperative level. On the contrary, active/total ghrelin reached its nadir quickly at 1 h after resection and had returned to the preoperative level by POD 3. The nadir PYY3-36 level was 71.4% on POD 1, followed by a gradual recovery, and had increased to 116.5% by POD 7. The same pattern was observed for obestatin. Active ghrelin/obestatin showed an increase on POD 1 while total ghrelin/obestatin showed a decrease on POD 3. Then, both returned to preoperative level. These results suggest that a rapid interactive compensatory mechanism of gut hormones does exist in the remnant gastrointestinal tract after abrupt changes in the production reservoir in nonobese people.

Health behaviors of Korean adults with hepatitis B: Findings of the 2016 Korean National Health and Nutrition Examination Survey

AIM

To assess the frequencies of five health-related behaviors (smoking, alcohol consumption, body weight, sleep duration, and physical activity) in Korean adults with chronic hepatitis B.

METHODS

Data were obtained from the 2016 Korean National Health and Nutrition Examination Survey. In total, 5887 subjects (2568 males, 3319 females) over 19 years old were enrolled in this study. Interviews were performed to obtain information on demographic characteristics and medical conditions. A selfadministered questionnaire and medical examination were used to assess the smoking history, alcohol use, physical activity, sleep duration, and body weight of the subjects. Chronic hepatitis B was diagnosed based on detection of hepatitis B surface antigen (HBsAg). The subjects were categorized into HBsAg positive and negative groups, and a complex sampling analysis was conducted to compare the health behaviors between these groups.

RESULTS

Among males, the current smoking rate in the HBsAg positive group was higher than that in the negative group (45.5% vs 38.5%). In the positive group, the rates of monthly and high-risk alcohol use were 70.4% and 17.6% in males and 45.9% and 3.8% in females, respectively. The rate of alcohol use was similar between the two groups [P = 0.455 (males) and P = 0.476 (females)]. In the HBsAg positive group, 32.3% and 49.9% of males and 26.5% and 49.6% of females were overweight and physically inactive, respectively. High-risk alcohol consumption and physical inactivity were significantly associated with self-perceived health status.

CONCLUSION

Our data demonstrate that a large proportion of Korean adults with chronic hepatitis B have poor health behaviors. Further studies are needed to confirm our results.

Group counseling for medical students with drop-out experiences

PURPOSE

The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences.

METHODS

Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed.

RESULTS

Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships.

CONCLUSION

A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.

The Risk of Osteoporosis and Osteoporotic Fracture Following the Use of Irritable Bowel Syndrome Medical Treatment: An Analysis Using the OMOP CDM Database

Patients with irritable bowel syndrome (IBS) are at increased risk of osteoporosis and osteoporotic fracture. This study investigated whether IBS medication attenuated the rate of osteoporosis and osteoporotic fracture risk. We conducted a retrospective large-scale multicenter study across eight hospital databases encoded in the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). The primary outcome was the incidence of osteoporosis, whereas secondary outcomes were osteoporotic fractures. After 1:4 matching, 24,723 IBS patients, 78,318 non-IBS patients, 427,640 non-IBS patients with IBS medication, and 827,954 non-IBS patients without IBS medication were selected. The risk of osteoporosis was significantly increased in the IBS group compared to the non-IBS group (hazard ratio (HR) 1.33; confidence interval (CI) 1.17~1.51). Even in patients who were not diagnosed with IBS, the risk of osteoporosis was significantly increased in those with IBS medication compared to those without (HR 1.77, CI 1.62~1.93). The risk of osteoporotic fracture was significantly increased in the IBS medication group (HR 1.69, CI 1.55~1.84). Patients exposed to IBS treatment even without IBS diagnosis were at increased risk of osteoporosis and osteoporotic fracture. Early diagnosis and treatment of osteoporosis should be considered in patients who have received medication for IBS symptoms.

Instructional analysis of lecture video recordings and its application for quality improvement of medical lectures

PURPOSE

The lecture is a technique for delivering knowledge and information cost-effectively to large medical classes in medical education. The aim of this study was to analyze teaching quality, based on triangle analysis of video recordings of medical lectures, to strengthen teaching competency in medical school.

METHODS

The subjects of this study were 13 medical professors who taught 1st- and 2nd-year medical students and agreed to a triangle analysis of video recordings of their lectures. We first performed triangle analysis, which consisted of a professional analysis of video recordings, self-assessment by teaching professors, and feedback from students, and the data were crosschecked by five school consultants for reliability and consistency.

RESULTS

Most of the distress that teachers experienced during the lecture occurred in uniform teaching environments, such as larger lecture classes. Larger lectures that primarily used PowerPoint as a medium to deliver information effected poor interaction with students. Other distressing factors in the lecture were personal characteristics and lack of strategic faculty development.

CONCLUSION

Triangle analysis of video recordings of medical lectures gives teachers an opportunity and motive to improve teaching quality. Faculty development and various improvement strategies, based on this analysis, are expected to help teachers succeed as effective, efficient, and attractive lecturers while improving the quality of larger lecture classes.

Adjustment of gut hormones release pattern following a fixed mealtime change in human

BACKGROUND

Gut hormones secretion is related to habitual mealtimes. However, how fast gut hormones adjust to that change when people change their fixed mealtime remains unknown.

METHODS

Seven healthy male volunteers were asked to eat a test breakfast at 0700 am for 2 weeks before the start of the study. Then, their fixed mealtime was intentionally changed from 0700 am to 0900 am for next 2 weeks. Blood samples were drawn every half hour from 0500 am until next 3h after breakfast for determining gut hormone levels every week.

RESULTS

After a change in fixed mealtime, the release pattern of acylated ghrelin was first adjusted identically according to the change and then total ghrelin was made. The meal-related fluctuations of acylated ghrelin were delayed by 120 min from week 1 after the change, while those of total ghrelin were delayed by 60 min at week 1, by 120 min at week 2. Two weeks was not enough time to adjust completely for PYY(3-36) to the change.

CONCLUSION

Two weeks is enough time until the pattern release of ghrelin, but not PYY(3-36) , is adjusted fully after a fixed mealtime change in human.

Effect of once-weekly subcutaneous semaglutide 2.4 mg on weight- and health-related quality of life in an East Asian population: Patient-reported outcomes from the STEP 6 trial

We assessed the effect of semaglutide 2.4 and 1.7 mg versus placebo on weight-related quality of life (WRQOL) and health-related quality of life (HRQOL) in the STEP 6 trial. Adults from East Asia (body mass index [BMI] ≥27.0 kg/m2 with ≥2 weight-related comorbidities, or ≥35.0 kg/m2 with ≥1 weight-related comorbidity) were randomized 4:1:2:1 to once-weekly subcutaneous semaglutide 2.4 mg or placebo, or semaglutide 1.7 mg or placebo, plus lifestyle intervention for 68 weeks. WRQOL and HRQOL were assessed from baseline to Week 68 using the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT) and the 36-Item-Short-Form-Survey-version-2.0 acute (SF-36v2), with changes in scores by categories of baseline BMI ( Collapse

Key Words

• East Asian
• IWQOL-Lite-CT
• SF-36v2
• obesity
• patient-reported outcomes
• semaglutide

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MESH Headings

• Adult
• Humans
• Quality of Life
• East Asian People
• Obesity/psychology
• Patient Reported Outcome Measures
• Diabetes Mellitus, Type 2

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Grants

• Novo Nordisk A/S

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Collaborators Collapse

[Two-and-a-half year follow-up study of strategy factors in successful learning to predict academic achievements in medical education]

PURPOSE

We performed a two-and-a-half year follow-up study of strategy factors in successful learning to predict academic achievements in medical education.

METHODS

Strategy factors in successful learning were identified using a content analysis of open-ended responses from 30 medical students who were ranked in the top 10 of their class. Core words were selected among their responses in each category and the frequency of the words were counted. Then, a factors survey was conducted among year 2 students, before the second semester. Finally, we performed an analysis to assess the association between the factors score and academic achievement for the same students 2.5 years later.

RESULTS

The core words were "planning and execution," "daily reviews" in the study schedule category; "focusing in class" and "taking notes" among class-related category; and "lecture notes," "previous exams or papers," and "textbooks" in the primary self-learning resources category. There were associations between the factors scores for study planning and execution, focusing in class, and taking notes and academic achievement, representing the second year second semester credit score, third year written exam scores and fourth year written and skill exam scores. Study planning was only one independent variable to predict fourth year summative written exam scores.

CONCLUSION

In a two-and-a-half year follow-up study, associations were founded between academic achievement and the factors scores for study planning and execution, focusing in class, and taking notes. Study planning as only one independent variable is useful for predicting fourth year summative written exam score.

Effects of Electrical Muscle Stimulation on Waist Circumstance in Adults with Adbominal Obesity: A Randomized, Double-blind, Sham-Controlled Trial

INTRODUCTION

We investigated the effects of electrical muscle stimulationon waist circumference as compared with an identical device providing transcutaneous electrical nerve stimulation as control in adults with abdominal obesity.

METHODS

This was a randomized, double-blind, sham-controlled trial. Sixty patients with abdominal obesity received electrical muscle stimulation or transcutaneous electrical nerve stimulation randomly five times a week for 12 weeks.

RESULTS

The electrical muscle stimulationgroup achieved a mean 5.2±2.8 cm decrease in waist circumference while the transcutaneous electrical nerve stimulation group showed only a 2.9±3.3 cm decrease (P=0.005). About 20 (70.0%) of the electrical muscle stimulation group lost more than 4 cm of waist circumference but that only 8 (33.3%) of the transcutaneous electrical nerve stimulation group did so (P=0.008). Furthermore, fasting free fasting acid levels were significantly higher in the electrical muscle stimulation than in the transcutaneous electrical nerve stimulationgroup at week 12 (P=0.006). In the electrical muscle stimulation group, slight decreases in visceral abdominal fat and total abdominal fat areas by computer tomography were observed at 12 weeks, but these decreases were not significant. In addition, patients' self-rated satisfaction scores with this program were significantly higher in the electrical muscle stimulation group.

CONCLUSIONS

The 12-week electrical muscle stimulation program modestly reduced waist circumference in abdominally obese adults without side effects.

Correction: The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients

[This corrects the article on p. 173 in vol. 38, PMID: 28775806.].

Metabolic Syndrome is Associated with Lower Plasma Levels of Desacyl Ghrelin and Total Ghrelin in Asymptomatic Middle-aged Korean Men

BACKGROUND

Desacyl ghrelin is acylated by ghrelin O-acyltransferase (GOAT) and converted to acyl ghrelin. To date, little is known about the relationship among the levels of these two forms of ghrelin, GOAT level, and insulin resistance in Asian individuals. The purpose of this study was to determine the relationship between insulin resistance and the levels of plasma acyl ghrelin, desacyl ghrelin, and GOAT in asymptomatic middle-aged Korean men.

METHODS

This cross-sectional study evaluated 78 asymptomatic middle-aged Korean men with metabolic syndrome (MS). We examined the correlation between the plasma levels of acyl ghrelin, desacyl ghrelin, and GOAT and sociodemographic, dietary, anthropometric, and metabolic parameters, as well as the association between insulin resistance and plasma levels of acyl ghrelin, desacyl ghrelin, and GOAT.

RESULTS

The levels of desacyl ghrelin and total ghrelin were significantly lower in the MS group than in the non-MS group (P<0.017, P=0.01, respectively). HOMA-IR values showed a significant negative correlation with desacyl ghrelin (r=-0.271, P=0.017) and total ghrelin (r=-0.271, P=0.016) levels. Acyl ghrelin and GOAT were not significantly correlated with HOMA-IR, and no correlation was found between the plasma levels of the two ghrelin types and GOAT.

CONCLUSION

The plasma levels of desacyl ghrelin and total ghrelin in middle-aged Korean men with MS were lower than in those without MS. A significant negative correlation was observed between desacyl ghrelin level and HOMA-IR; however, no correlation was found between plasma levels of acyl ghrelin and GOAT and HOMA-IR.

Elevated C-reactive protein level, obesity, and quality of life

OBJECTIVE

To investigate the association between serum C-reactive protein level and health-related quality of life, and to assess the relationship between the two in terms of controlling for obesity and other covariates.

METHODS

The cross-sectional study was conducted retrospectively at university hospital in Yangsan from January to December 2017 using the nationally representative 2015 Korea National Health and Nutrition Examination Survey (KNHANES). High C-reactive protein was defined as level ≥1.0mg/L. Health-related quality of life was assessed using the Euro-Quality of Life-5 dimensions tool. The association between high C-reactive protein and health-related quality of life was analysed using logistic regression analysis and was adjusted for variables. The subjects were categorised into four groups according to the level of C-reactive protein, and the presence of obesity was analysed.

RESULTS

Of the 3376 subjects, 1,413(42%) were men and 1,963(58%) were women. C-reactive protein level was <1.0 in 2490(73.7%) subjects and ≥1.0 in 886(26.2%). High CRP level was associated with low health-related quality of life for mobility and usual activities (p<0.05). However, in multivariable logistic model, the associations ceased to be statistically significant (p>0.05) after adjusting for the presence of obesity.

CONCLUSIONS

Obesity was found to play an important role in the association between C-reactive protein and healthrelated quality of life in Korean population.

Effects of personality traits on collaborative performance in problem-based learning tutorials

[No Abstract Available].

Biomarkers and their relative contributions to identifying coronary artery stenosis based on coronary computed tomography angiography in asymptomatic adults

BACKGROUND

Coronary computed tomography angiography (CCTA) has emerged as an important, non-invasive imaging modality for the assessment of coronary vascular disease. However, CCTA as a screening tool still has issues with radiation exposure and cost in asymptomatic adults. In this study, we investigated the relationship between cardio-metabolic biomarkers and coronary artery stenosis on CCTA in asymptomatic, apparently healthy adults.

METHODS

Data for this cross-sectional study were obtained from 306 subjects who underwent a comprehensive medical check-up including CCTA. A 128-slice CT device was used to detect earlier stages of coronary stenosis, which was defined as > 25% luminal reduction in the most severe stenosis in the calcified segments of the coronary arteries.

RESULTS

On multivariate analysis, after adjustment for age, only γ-glutamyl transferase (GGT) was significantly and independently associated with CCTA stenosis (OR 1.006, 95% CI 1.001-1.011, P = .026). In a subgroup analysis of 103 subjects with brachial-ankle pulse wave velocity (baPWV) data, baPWV was significantly associated with CCTA stenosis (OR 1.005; 95% CI 1.003-1.008, P < .001).

CONCLUSIONS

GGT and baPWV were associated independently with the presence of CCTA stenosis in apparently healthy adults. Further research is needed to re-confirm on these findings.

Weight loss maintenance after bariatric surgery

Metabolic and bariatric surgery (MBS) is an effective treatment for patients with morbid obesity and its comorbidities. However, many patients experience weight regain (WR) after achieving their nadir weight. Establishing the definition of WR is challenging as postoperative WR has various definitions. Risk factors for WR after MBS include anatomical, racial, hormonal, metabolic, behavioral, and psychological factors, and evaluating such factors preoperatively is necessary. Long-term regular follow-up and timely treatment by a multidisciplinary team are important because WR after surgery is multi-factorial. Although lifestyle interventions that focus on appropriate dietary education, physical activity education or interventions, and behavioral psychological interventions are suggested, more well-designed studies are needed because studies evaluating intervention methods and the effectiveness of WR prevention are lacking. Anti-obesity drugs can be used to prevent and manage patients with WR after MBS; however, more research is needed to determine the timing, duration, and type of anti-obesity drugs used to prevent WR.

Association between pulse pressure and low muscle mass in Korean adults: A nationwide cross-sectional study

Sarcopenia is characterized by a loss of muscle mass and strength and is associated with a high risk of cardiovascular events and increased mortality. Pulse pressure (PP) serves as a marker for changes in heart structure and function, as well as arterial stiffness. A high PP also increases the risk of cardiovascular disease and all-cause mortality. However, the relationship between PP and sarcopenia is poorly understood. We used the data of participants of the Korea National Health and Nutrition Examination Survey (KNHANES) of 2008 to 2011. Participants were divided into a control group (PP < 40 mm Hg) and a high-PP group (PP ≥ 40 mm Hg). PP was calculated by subtracting the diastolic blood pressure (DBP) from the systolic blood pressure (SBP), and the low muscle index was assessed using appendicular skeletal muscle mass (ASM) normalized by body mass index (BMI). Multiple logistic regression analyses were performed to examine the association between PP and the prevalence of low muscle mass, adjusting for potential confounders. The high-PP group had a higher age, SBP, DBP, and prevalence of hypertension, diabetes and hyperlipidemia than the control group. The high-PP group had a higher prevalence of low muscle mass than the control group in all models. A high PP is significantly associated with a higher prevalence of low muscle mass. Therefore, PP monitoring may help identify individuals at risk of sarcopenia and guide interventions to improve health outcomes.