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Ryu HE, Jung DH, Heo SJ, Park B, Lee YJ. METS-IR and all-cause mortality in Korean over 60 years old: Korean genome and epidemiology study-health examinees (KoGES-HEXA) cohorts. Front Endocrinol (Lausanne) 2024; 15:1346158. [PMID: 38572476 PMCID: PMC10987815 DOI: 10.3389/fendo.2024.1346158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Background The metabolic score for insulin resistance index (METS-IR) is a novel non insulin-based marker that indicates the risk for metabolic syndrome and type 2 diabetes mellitus (T2DM). However, METS-IR has not been investigated in relation to all-cause mortality. We investigated the longitudinal effect of METS-IR on all-cause mortality in a significantly large cohort of Korean adults over 60 years old. Methods Data were assessed from 30,164 Korean participants over 60 years of age from the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort data, linked with the death certificate database of the National Statistical Office. The participants were grouped into three according to METS-IR tertiles. We used multivariate Cox proportional-hazard regression models to prospectively assess hazard ratios (HRs) for all-cause mortality with 95% confidence intervals (CIs) over an 11-year postbaseline period. Results During the mean 11.7 years of follow-up, 2,821 individuals expired. The HRs of mortality for METS-IR tertiles were 1.16 (95% CI, 1.01-1.34) in T3 after adjustment for metabolic parameters, but the T2 did not show statistical significance towards increases for incident mortality respectively. In subgroup analysis depending on the cause of mortality, higher METS-IR was associated with cancer mortality (HR, 1.23, 95% CI, 1.01-1.51) but not with cardiovascular mortality (HR, 1.14, 95% CI, 0.83-1.57) after adjustment for the same confounding variables. Conclusion The METS-IR may be a useful predictive marker for all-cause mortality and cancer mortality, but not for cardiovascular mortality in subjects over 60 years of age. This implies that early detection and intervention strategies for metabolic syndrome could potentially benefit this identified group.
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Affiliation(s)
- Ha Eun Ryu
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Hyuk Jung
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
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Kityo A, Lee SA. Association of cardiometabolic factors and insulin resistance surrogates with mortality in participants from the Korean Genome and Epidemiology Study. Lipids Health Dis 2023; 22:210. [PMID: 38041195 PMCID: PMC10691157 DOI: 10.1186/s12944-023-01981-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Simple biochemical and anthropometric measurements such as fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), waist circumference (WC), and body mass index (BMI) are used to formulate insulin resistance (IR) indices. Whether these indices provide new predictive information for mortality remains unknown. This study examined the relationships of biochemical, anthropometric, and IR indices with mortality risk, as well as their predictive performance. METHODS The data source was the Korean Genome and Epidemiology Study (2004-2020) involving 114,957 participants whose data were linked to death records. The IR indices- triglyceride-glucose index (TyG), TyG-BMI, TyG-WC, visceral adiposity index (VAI), lipid accumulation product (LAP), and metabolic score for insulin resistance (METS-IR) were computed using standard formulae. The associations were examined using restricted cubic splines. The predictive performance was compared using the log-likelihood ratio chi-square test. RESULTS Body mass index was U-shaped, HDL-C was reverse J-shaped, and FBG and TG levels were J-shaped associated with all-cause mortality. Results showed U-shaped (TyG), J-shaped (TyG-BMI, VAI, LAP, and METS-IR), and reverse J-shaped (TyG-WC) associations with all-cause mortality. The percentages of new predictive information for all-cause mortality explained by the FBG level, BMI, TyG-BMI, and METIR were 3.34%, 2.33%, 1.47%, and 1.37%, respectively. Other IR indices and biochemical and anthropometric measurements provided < 1.0% of new predictive information. For cardiovascular disease mortality, the FBG, BMI, METIR, TyG-BMI, and HDL-C levels explained 2.57%, 2.12%, 1.59%, 1.30%, and 1.27% of new predictive information respectively. Moreover, the risks of cancer mortality explained by FBG level, VAI, and HDL-C level were 2.05%, 1.49%, and 1.28%, respectively. CONCLUSIONS Fasting blood glucose level is a superior predictor of mortality risk and may be used as a simple predictive and preventative factor.
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Affiliation(s)
- Anthony Kityo
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Gangwon, Republic of Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Gangwon, Republic of Korea.
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Gangwon, Republic of Korea.
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Jeerakathil TJ, Yu AYX, Choi PMC, Fang S, Shuaib A, Majumdar SR, Demchuk AM, Butcher K, Watson TJ, Dean N, Gordon D, Hill MD, Edmond C, Coutts SB. Effects of a Province-wide Triaging System for TIA: The ASPIRE Intervention. Neurology 2023; 100:e2093-e2102. [PMID: 36977597 PMCID: PMC10186240 DOI: 10.1212/wnl.0000000000207201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 02/03/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Urgent transient ischemic attack (TIA) management to reduce stroke recurrence is challenging, particularly in rural and remote areas. In Alberta, Canada, despite an organized stroke system, data from 1999 to 2000 suggested that stroke recurrence after TIA was as high as 9.5% at 90 days. Our objective was to determine whether a multifaceted population-based intervention resulted in a reduction in recurrent stroke after TIA. METHODS In this quasi-experimental health services research intervention study, we implemented a TIA management algorithm across the entire province, centered around a 24-hour physician's TIA hotline and public and health provider education on TIA. From administrative databases, we linked emergency department discharge abstracts to hospital discharge abstracts to identify incident TIAs and recurrent strokes at 90 days across a single payer system with validation of recurrent stroke events. The primary outcome was recurrent stroke; with a secondary composite outcome of recurrent stroke, acute coronary syndrome, and all-cause death. We used an interrupted time series regression analysis of age-adjusted and sex-adjusted stroke recurrence rates after TIA, incorporating a 2-year preimplementation period (2007-2009), a 15-month implementation period, and a 2-year postimplementation period (2010-2012). Logistic regression was used to examine outcomes that did not fit the time series model. RESULTS We assessed 6,715 patients preimplementation and 6,956 patients postimplementation. The 90-day stroke recurrence rate in the pre-Alberta Stroke Prevention in TIA and mild Strokes (ASPIRE) period was 4.5% compared with 5.3% during the post-ASPIRE period. There was neither a step change (estimate 0.38; p = 0.65) nor slope change (parameter estimate 0.30; p = 0.12) in recurrent stroke rates associated with the ASPIRE intervention implementation period. Adjusted all-cause mortality (odds ratio 0.71, 95% CI 0.56-0.89) was significantly lower after the ASPIRE intervention. DISCUSSION The ASPIRE TIA triaging and management interventions did not further reduce stroke recurrence in the context of an organized stroke system. The apparent lower mortality postintervention may be related to improved surveillance after events identified as TIAs, but secular trends cannot be excluded. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that a standardized population-wide algorithmic triage system for patients with TIA did not reduce recurrent stroke rate.
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Affiliation(s)
- Thomas J Jeerakathil
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
| | - Amy Ying Xin Yu
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Philip M C Choi
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Shoufan Fang
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Ashfaq Shuaib
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Sumit R Majumdar
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Andrew M Demchuk
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Kenneth Butcher
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Tim J Watson
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Naeem Dean
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Deb Gordon
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Michael D Hill
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Cathy Edmond
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Shelagh B Coutts
- From the Department of Medicine (Neurology) (T.J.J., A.S.), and Division of General Internal Medicine (S.R.M., N.D.), University of Alberta (S.F), Edmonton; Alberta Health Services, Edmonton (T.J.J., A.S., D.G.) and Alberta Health Services, Calgary (C.E.); Department of Medicine (Neurology) (A.Y.X.Y.), University of Toronto, Ontario, Canada; Department of Neurosciences (P.M.C.C.), Monash University, Melbourne, Australia; Department of Clinical Neurosciences (A.M.D., T.J.W., M.D.H., S.B.C.), University of Calgary, Alberta, Canada; Neurology (K.B.), Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
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Griffin BR, Vaughan-Sarrazin M, Perencevich E, Yamada M, Swee M, Sambharia M, Girotra S, Reisinger HS, Jalal D. Risk Factors for Death Among Veterans Following Acute Kidney Injury. Am J Med 2023; 136:449-457. [PMID: 36708794 PMCID: PMC10765959 DOI: 10.1016/j.amjmed.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/08/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Acute kidney injury is prevalent among hospitalized veterans, and associated with increased risk of death following discharge. However, risk factors for death following acute kidney injury have not been well defined. We developed a mortality prediction model using Veterans Health Administration data. METHODS This retrospective cohort study included inpatients from 2013 through 2018 with a creatinine increase of ≥0.3 mg/dL. We evaluated 45 variables for inclusion in our final model, with a primary outcome of 1-year mortality. Bootstrap sampling with replacement was used to identify variables selected in >60% of models using stepwise selection. Best sub-sets regression using Akaike information criteria was used to identify the best-fitting parsimonious model. RESULTS A total of 182,683 patients were included, and 38,940 (21.3%) died within 1 year of discharge. The 10-variable model to predict mortality included age, chronic lung disease, cancer within 5 years, unexplained weight loss, dementia, congestive heart failure, hematocrit, blood urea nitrogen, bilirubin, and albumin. Notably, acute kidney injury stage, chronic kidney disease, discharge creatinine, and proteinuria were not selected for inclusion. C-statistics in the primary validation cohorts were 0.77 for the final parsimonious model, compared with 0.52 for acute kidney injury stage alone. CONCLUSION We identified risk factors for long-term mortality following acute kidney injury. Our 10-variable model did not include traditional renal variables, suggesting that non-kidney factors contribute to the risk of death more than measures of kidney disease in this population, a finding that may have implications for post-acute kidney injury care.
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Affiliation(s)
- Benjamin R Griffin
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City.
| | - Mary Vaughan-Sarrazin
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Eli Perencevich
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Masaaki Yamada
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Melissa Swee
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Meenakshi Sambharia
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Saket Girotra
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Heather S Reisinger
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
| | - Diana Jalal
- Center for Access Delivery & Research and Evaluation (CADRE) Center, Iowa VA Health Care System, Iowa City; Department of Medicine, University of Iowa Carver College of Medicine, Iowa City
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Kityo A, Lee SA. The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort. PLoS One 2023; 18:e0285314. [PMID: 37141249 PMCID: PMC10159145 DOI: 10.1371/journal.pone.0285314] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
The relationship between ultra-processed food (UPF) intake and mortality is unknown in Asian countries, yet the intake of UPF is on the rise in these countries. This study examined the association of UPF intake with all-cause, cancer and cardiovascular disease (CVD) mortality. Participants were 113,576 adults who responded to a 106-item food frequency questionnaire during recruitment of the 2004-2013 Health Examinees (HEXA) study, a prospective cohort study in Korea. UPF were defined using the NOVA classification and evaluated as quartiles of the proportion of UPF in the diet (% total food weight). Multivariable Cox regression and restricted cubic spline models were used to examine the association of UPF intake with all-cause and cause specific mortality. A total of 3456 deaths were recorded during a median follow-up of 10.6 (interquartile range, 9.5-11.9) years. There was no evidence of an association of UPF intake with all-cause, cancer or CVD mortality comparing the highest with the lowest quartiles of UPF intake (all-cause mortality, men: hazard ratio [HR] 1.08, 95% confidence interval [CI] 0.95-1.22; women: HR 0.95, 95% CI 0.81-1.11; cancer mortality, men: HR 1.02, 95% confidence interval [CI] 0.84-1.22; women: HR 1.02, 95% CI 0.83-1.26; CVD mortality, men: HR 0.88, 95% CI 0.64-1.22; women: HR 0.80, 95% CI 0.53-1.19). However, the risk of all-cause mortality increased in both men and women with high consumption of ultra-processed red meat and fish (men, HR 1.26, 95% CI 1.11-1.43); women, HR 1.22 95% CI 1.05-1.43); and in men with high consumption of ultra-processed milk (HR 1.13, 95% CI 1.01-1.26); and soymilk drink (HR 1.12, 95% CI 1.00-1.25). We found no evidence of an association between total UPF intake and all-cause, cancer or CVD mortality, but ultra-processed red meat and fish in both sexes, and milk and soymilk drinks in men were positively associated with all-cause mortality.
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Affiliation(s)
- Anthony Kityo
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
- Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
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6
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Kim J, Park SH, Kim JM. Effect of Comorbidities on the Infection Rate and Severity of COVID-19: Nationwide Cohort Study With Propensity Score Matching. JMIR Public Health Surveill 2022; 8:e35025. [PMID: 36265125 PMCID: PMC9678330 DOI: 10.2196/35025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A vaccine against COVID-19 has been developed; however, COVID-19 transmission continues. Although there have been many studies of comorbidities that have important roles in COVID-19, some studies have reported contradictory results. OBJECTIVE This study was conducted using real-world data from COVID-19 patients in South Korea and aimed to investigate the impact of patient demographics and comorbidities on the infection rate and severity of COVID-19. METHODS Data were derived from a nationwide South Korean COVID-19 cohort study with propensity score (PS) matching. We included infected individuals who were COVID-19-positive between January 1, 2020, and May 30, 2020, and PS-matched uninfected controls. PS matching was performed to balance the baseline characteristics of each comorbidity and to adjust for potential confounders, such as age, sex, Charlson Comorbidity Index, medication, and other comorbidities, that were matched with binary variables. The outcomes were the confirmed comorbidities affecting the infection rate and severity of COVID-19. The endpoints were COVID-19 positivity and severe clinical outcomes of COVID-19 (such as tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, and death). RESULTS The COVID-19 cohort with PS matching included 8070 individuals with positive COVID-19 test results and 8070 matched controls. The proportions of patients in the severe group were higher for individuals 60 years or older (severe clinical outcomes for those 60 years or older, 16.52%; severe clinical outcomes for those of other ages, 2.12%), those insured with Medicaid (Medicaid, 10.81%; other insurance, 5.61%), and those with disabilities (with disabilities, 18.26%; without disabilities, 5.07%). The COVID-19 infection rate was high for patients with pulmonary disease (odds ratio [OR] 1.88; 95% CI 1.70-2.03), dementia (OR 1.75; 95% CI 1.40-2.20), gastrointestinal disease (OR 1.74; 95% CI 1.62-1.88), stroke (OR 1.67; 95% CI 1.23-2.27), hepatobiliary disease (OR 1.31; 95% CI 1.19-1.44), diabetes mellitus (OR 1.28; 95% CI 1.16-1.43), and cardiovascular disease (OR 1.20; 95% CI 1.07-1.35). In contrast, it was lower for individuals with hyperlipidemia (OR 0.73; 95% CI 0.67-0.80), autoimmune disease (OR 0.73; 95% CI 0.60-0.89), and cancer (OR 0.73; 95% CI 0.62-0.86). The severity of COVID-19 was high for individuals with kidney disease (OR 5.59; 95% CI 2.48-12.63), hypertension (OR 2.92; 95% CI 1.91-4.47), dementia (OR 2.92; 95% CI 1.91-4.47), cancer (OR 1.84; 95% CI 1.15-2.94), pulmonary disease (OR 1.72; 95% CI 1.35-2.19), cardiovascular disease (OR 1.54; 95% CI 1.17-2.04), diabetes mellitus (OR 1.43; 95% CI 1.09-1.87), and psychotic disorders (OR 1.29; 95% CI 1.01-6.52). However, it was low for those with hyperlipidemia (OR 0.78; 95% CI 0.60-1.00). CONCLUSIONS Upon PS matching considering the use of statins, it was concluded that people with hyperlipidemia could have lower infection rates and disease severity of COVID-19.
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Affiliation(s)
- Jiyong Kim
- Department of Rehabilitation, Inje University Ilsanpaik Hospital, Goyang, Republic of Korea
| | - Seong Hun Park
- Statistical analysis company, HYMS, Gwangju, Republic of Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
- Department of Medical Informatics Big Data Center, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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7
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An S, Ahn C, Moon S, Sim EJ, Park SK. Individualized Biological Age as a Predictor of Disease: Korean Genome and Epidemiology Study (KoGES) Cohort. J Pers Med 2022; 12:505. [PMID: 35330504 PMCID: PMC8955355 DOI: 10.3390/jpm12030505] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/13/2022] [Accepted: 03/17/2022] [Indexed: 12/25/2022] Open
Abstract
Chronological age (CA) predicts health status but its impact on health varies with anthropometry, socioeconomic status (SES), and lifestyle behaviors. Biological age (BA) is, therefore, considered a more precise predictor of health status. We aimed to develop a BA prediction model from self-assessed risk factors and validate it as an indicator for predicting the risk of chronic disease. A total of 101,980 healthy participants from the Korean Genome and Epidemiology Study were included in this study. BA was computed based on body measurements, SES, lifestyle behaviors, and presence of comorbidities using elastic net regression analysis. The effects of BA on diabetes mellitus (DM), hypertension (HT), combination of DM and HT, and chronic kidney disease were analyzed using Cox proportional hazards regression. A younger BA was associated with a lower risk of DM (HR = 0.63, 95% CI: 0.55-0.72), hypertension (HR = 0.74, 95% CI: 0.68-0.81), and combination of DM and HT (HR = 0.65, 95% CI: 0.47-0.91). The largest risk of disease was seen in those with a BA higher than their CA. A consistent association was also observed within the 5-year follow-up. BA, therefore, is an effective tool for detecting high-risk groups and preventing further risk of chronic diseases through individual and population-level interventions.
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Affiliation(s)
- Seokyung An
- Department of Biomedical Science, Graduate School, Seoul National University, Seoul 03080, Korea; (S.A.); (C.A.)
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.M.); (E.J.S.)
- Cancer Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Choonghyun Ahn
- Department of Biomedical Science, Graduate School, Seoul National University, Seoul 03080, Korea; (S.A.); (C.A.)
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.M.); (E.J.S.)
- Cancer Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Sungji Moon
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.M.); (E.J.S.)
- Cancer Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
- Interdisciplinary Program in Cancer Biology, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Eun Ji Sim
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.M.); (E.J.S.)
- Cancer Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Sue-Kyung Park
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Korea; (S.M.); (E.J.S.)
- Cancer Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
- Interdisciplinary Program in Cancer Biology, College of Medicine, Seoul National University, Seoul 03080, Korea
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8
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Huh K, Lee R, Ji W, Kang M, Hwang IC, Lee DH, Jung J. Impact of obesity, fasting plasma glucose level, blood pressure, and renal function on the severity of COVID-19: A matter of sexual dimorphism? Diabetes Res Clin Pract 2020; 170:108515. [PMID: 33096185 PMCID: PMC7575440 DOI: 10.1016/j.diabres.2020.108515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 12/24/2022]
Abstract
AIMS This study aimed to assess whether body mass index (BMI), fasting plasma glucose (FPG) levels, blood pressure (BP), and kidney function were associated with the risk of severe disease or death in patients with COVID-19. METHODS Data on candidate risk factors were extracted from patients' last checkup records. Propensity score-matched cohorts were constructed, and logistic regression models were used to adjust for age, sex, and comorbidities. The primary outcome was death or severe COVID-19, defined as requiring supplementary oxygen or higher ventilatory support. RESULTS Among 7,649 patients with confirmed COVID-19, 2,231 (29.2%) received checkups and severe COVID-19 occurred in 307 patients (13.8%). A BMI of 25.0-29.9 was associated with the outcome among women (aOR, 2.29; 95% CI, 1.41-3.73) and patients aged 50-69 years (aOR, 1.64; 95% CI, 1.06-2.54). An FPG ≥ 126 mg/dL was associated with poor outcomes in women (aOR, 2.06; 95% CI, 1.13-3.77) but not in men. Similarly, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 was a risk factor in women (aOR, 3.46; 95% CI, 1.71-7.01) and patients aged < 70 years. CONCLUSIONS The effects of BMI, FPG, and eGFR on outcomes associated with COVID-19 were prominent in women but not in men.
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Affiliation(s)
- Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Rugyeom Lee
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Minsun Kang
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Dae Ho Lee
- Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea; Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea.
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9
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Circulating cell-free DNA level predicts all-cause mortality independent of other predictors in the Health 2000 survey. Sci Rep 2020; 10:13809. [PMID: 32796872 PMCID: PMC7427793 DOI: 10.1038/s41598-020-70526-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/10/2020] [Indexed: 12/22/2022] Open
Abstract
Increased levels of circulating cell-free DNA (cf-DNA) are associated with and predict poor health outcomes. However, its predictive ability for mortality in population-based samples remains understudied. We analysed the capability of cf-DNA to predict all-cause mortality and assessed whether it adds predictive value on top of the other risk factors in the Health 2000 survey (n = 1,257, 46–76 years of age, 15-years-follow-up, 18% deceased). When analysed in a multivariate model with the other factors that independently predicted mortality in the sample (age, gender, self-rated health, smoking and plasma levels of glucose and adiponectin), increases in cf-DNA levels were associated with increased risk of mortality (hazard ratio [HR] for 0.1 µg increase in cf-DNA: 1.017, 95% confidence interval [CI] 1.008–1.026, p = 0.0003). Inclusion of cf-DNA in the model improved the model fit and discrimination. Stratifying the analysis by cardiovascular disease (CVD) status indicated that cf-DNA predicted mortality equally well in individuals with (HR 1.018, 95% CI 1.008–1.026, p = 0.002) and without (HR 1.018, 95% CI 1.001–1.035, p = 0.033) CVD. In conclusion, our study indicates that cf-DNA level predicts mortality in middle-aged and older individuals, also among those with established CVD, and adds significant value to mortality prediction. Our results thus underscore the role of cf-DNA as a viable marker of health.
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10
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Ahn SS, Yoo J, Jung SM, Song JJ, Park YB, Lee SW. Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis. BMC Nephrol 2020; 21:258. [PMID: 32635898 PMCID: PMC7341643 DOI: 10.1186/s12882-020-01915-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/28/2020] [Indexed: 11/17/2022] Open
Abstract
Background Lupus nephritis is associated with increased risk of end-stage renal disease (ESRD) and all-cause mortality. We evaluated the clinical features and outcomes of patients with early and delayed lupus nephritis. Methods The medical records of 171 patients who met the 1997 revised classification criteria for systemic lupus erythematosus (SLE) with pathologic confirmation of lupus nephritis were reviewed. Early lupus nephritis was defined when lupus nephritis was histopathologically confirmed as the first clinical manifestation of SLE, whereas delayed lupus nephritis was defined as lupus nephritis that was identified after the diagnosis of SLE. Clinical and laboratory data, as well as kidney histopathology and medication usage were investigated. Kaplan-Meier and Cox-proportional hazard analysis was performed to compare the outcomes of early and delayed lupus nephritis and evaluate factors associated with ESRD and all-cause mortality. Results Patients with early lupus nephritis had higher disease activity (median non-renal SLE disease activity index-2000, 6.0 vs. 4.0; p < 0.001) and more frequent skin rash, oral ulcer and serositis; however, the proportion of patients with higher renal chronicity index was greater in the delayed lupus nephritis group (p = 0.007). Nevertheless, no difference was found regarding ESRD and all-cause mortality between the groups. In Cox-proportional hazard analysis, C-reactive protein level, creatinine level and chronicity index were factors associated with ESRD, while age and haemoglobin level were associated with all-cause mortality. Conclusions In conclusion, clinical outcomes of early and delayed lupus nephritis are not significantly different. Rigorous adherence to current treatment recommendations is essential for the treatment of lupus nephritis.
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Affiliation(s)
- Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Juyoung Yoo
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Seung Min Jung
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jason Jungsik Song
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea.
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11
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Bahk J, Kang HY, Khang YH. Inequality in Life Expectancy in Korea according to Various Categorizations of the National Health Insurance Premiums as a Marker of Income. Yonsei Med J 2020; 61:640-643. [PMID: 32608209 PMCID: PMC7329743 DOI: 10.3349/ymj.2020.61.7.640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to examine the degree to which the magnitude of income inequality in life expectancy according to different categorization across beneficiary types under the National Health Insurance Service (NHIS) in Korea. We used population and death data in 2017 from the National Health Information Database of the NHIS. Income quintile groups were classified in four ways according to beneficiary type (employee insured, self-employed insured, and Medical Aid beneficiaries). Standard life table procedures were used to calculate life expectancy. The life expectancy gap between the lowest and highest income quintiles was the largest when the entire population was divided into quintiles without distinguishing among types of beneficiaries. In conclusion, we suggest that income quintile indicators in NHIS data, measured without distinguishing among types of beneficiaries, may best represent the magnitude of health inequalities in Korean society. This indicator could be used for future research on health inequalities, as well as for monitoring health inequalities in Korea.
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Affiliation(s)
- Jinwook Bahk
- Department of Public Health, Keimyung University, Daegu, Korea
| | - Hee Yeon Kang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
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12
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Computational Drug Screening Identifies Compounds Targeting Renal Age-associated Molecular Profiles. Comput Struct Biotechnol J 2019; 17:843-853. [PMID: 31316728 PMCID: PMC6611921 DOI: 10.1016/j.csbj.2019.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/27/2019] [Accepted: 06/18/2019] [Indexed: 01/06/2023] Open
Abstract
Aging is a major driver for chronic kidney disease (CKD) and the counterbalancing of aging processes holds promise to positively impact disease development and progression. In this study we generated a signature of renal age-associated genes (RAAGs) based on six different data sources including transcriptomics data as well as data extracted from scientific literature and dedicated databases. Protein abundance in renal tissue of the 634 identified RAAGs was studied next to the analysis of affected molecular pathways. RAAG expression profiles were furthermore analysed in a cohort of 63 CKD patients with available follow-up data to determine association with CKD progression. 23 RAAGs were identified showing concordant regulation in renal aging and CKD progression. This set was used as input to computationally screen for compounds with the potential of reversing the RAAG/CKD signature on the transcriptional level. Among the top-ranked drugs we identified atorvastatin, captopril, valsartan, and rosiglitazone, which are widely used in clinical practice for the treatment of patients with renal and cardiovascular diseases. Their positive impact on the RAAG/CKD signature could be validated in an in-vitro model of renal aging. In summary, we have (i) consolidated a set of RAAGs, (ii) determined a subset of RAAGs with concordant regulation in CKD progression, and (iii) identified a set of compounds capable of reversing the proposed RAAG/CKD signature.
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13
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Min JK, Cha JM, Cho YK, Kim JH, Yoon SM, Im JP, Jung Y, Moon JS, Kim JO, Jeen YT. Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea. Clin Endosc 2018; 51:239-252. [PMID: 29874905 PMCID: PMC5997069 DOI: 10.5946/ce.2018.075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/14/2018] [Indexed: 12/12/2022] Open
Abstract
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.
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Affiliation(s)
- Jun Ki Min
- Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yu Kyung Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Yonsei University School of Medicine, Seoul, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yunho Jung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Jin-Oh Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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14
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Min JK, Cha JM, Cho YK, Kim JH, Yoon SM, Im JP, Jung Y, Moon JS, Kim JO, Jeen YT. [Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2018; 71:269-281. [PMID: 29791986 DOI: 10.4166/kjg.2018.71.5.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.
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Affiliation(s)
- Jun Ki Min
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yu Kyung Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jie Hyun Kim
- Department of Internal Medicine, Yonsei University School of Medicine, Seoul, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yunho Jung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Jin Oh Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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