Hashimoto Thyroiditis and Mortality in Patients with Differentiated Thyroid Cancer: The National Epidemiologic Survey of Thyroid Cancer in Korea and Meta-Analysis.

BACKGRUOUND: Many studies have shown that Hashimoto's thyroiditis (HT) acts as a protective factor in differentiated thyroid cancer (DTC), but little is known about its effects on mortality. Therefore, this study was performed to reveal the prognosis of HT on mortality in patients with DTC. METHODS: This study included two types of research. RESULTS: retrospective cohort study using the National Epidemiologic Survey of Thyroid cancer (NEST) in Korea and meta-analysis study with the NEST data and eight selected studies. RESULTS: Of the 4,398 patients with DTC in NEST, 341 patients (7.8%) died during the median follow-up period of 15 years (interquartile range, 12.3 to 15.6). Of these, 91 deaths (2.1%) were related to DTC. HT was associated with a smaller tumor size and less aggressive DTC. In Cox regression analysis after adjusting for age and sex, patients with HT showed a significantly lower risk of all-cause death (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52 to 0.96) and DTC-related death (HR, 0.33; 95% CI, 0.14 to 0.77). The analysis with inverse probability of treatment weight data adjusted for age, sex, and year of thyroid cancer registration showed similar association. The meta-analysis showed that patients with HT showed a lower risk of all-cause mortality (risk ratio [RR], 0.24; 95% CI, 0.13 to 0.47) and thyroid cancer-related mortality (RR, 0.23; 95% CI, 0.13 to 0.40) in comparison with patients without HT. CONCLUSION: This study showed that DTC co-presenting with HT is associated with a low risk of advanced DTC and presents a low risk for all-cause and DTC-related death.

Association between body composition and the risk of mortality in the obese population in the United States.

Background: Recent studies have presented the concept of the obesity paradox, suggesting that individuals with obesity have a lower risk of death than those without obesity. This paradox may arise because body mass index (BMI) alone is insufficient to understand body composition accurately. This study investigated the relationship between fat and muscle mass and the risk of mortality in individuals with overweight/obesity. Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006 and 2011 to 2018, which were linked to mortality information obtained from the National Death Index. Multiple Cox regression analyses were performed to estimate mortality risk. Subgroup analysis was conducted using propensity score-matched (PSM) data for age, sex, and race/ethnicity. Results: This study included 16,555 participants who were overweight/obese (BMI≥25 kg/m2). An increase in appendicular skeletal muscle mass index was associated with a lower mortality risk (hazard ratio [HR]: 0.856; 95% confidence interval [CI]: 0.802-0.915). This finding was consistent with the subgroup analysis of the PSM data. Contrastingly, a high fat mass index was associated with an increased risk of mortality. Sarcopenic overweight/obesity was significantly associated with high mortality compared to obesity without sarcopenia (HR: 1.612, 95%CI: 1.328-1.957). This elevated risk was significant in both age- and sex-based subgroups. This finding was consistent with the subgroup analysis using PSM data. Conclusion: In contrast to the obesity paradox, a simple increase in BMI does not protect against mortality. Instead, low body fat and high muscle mass reduce mortality risk.

Smoking and passive smoking increases mortality through mediation effect of cadmium exposure in the United States.

Cigarette smoking is one of the leading causes of preventable and premature death worldwide. Even worse, many people are generally exposed to passive smoking, which leads to several respiratory diseases and related mortalities. Considering, more than 7000 compounds are included in cigarettes, their combustion results intoxicants that have deleterious effects on health. However, there is a lack of research analyzing the effects of smoking and passive smoking on all-cause and disease-specific mortality through its chemical compounds including heavy metals. Thus, this study aimed to evaluate the effect of smoking and passive smoking on all-cause and disease-specific mortality mediated by cadmium, one of the representative smoking-related heavy metals using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 in the United States. We found that current smoking and passive smoking was related to increased risk of all-cause, CVD-related, and cancer-related mortality. Notably, passive smoking showed a synergistic effect with smoking status on the risk of mortality. In particular, current smokers with passive smoking had the highest risk of all-cause and disease-specific deaths. In addition, the accumulation of cadmium in the blood due to smoking and passive smoking mediates the increased risk of all-cause mortality. Further studies are needed to monitor and treat cadmium toxicity to improve smoking-related mortality rates.

Association between body shape index and risk of mortality in the United States.

The body mass index (BMI) neither differentiates fat from lean mass nor does it consider adipose tissue distribution. In contrast, the recently introduced z-score of the log-transformed A Body Shape Index (LBSIZ) can be applied to measure obesity using waist circumference (WC), height, and weight. We aimed to investigate the association between LBSIZ and mortality. We used data from the National Health and Nutrition Examination Survey 1999-2014 and linked the primary dataset to death certificate data from the National Death Index with mortality follow-up through December 31, 2015. A multiple Cox regression analysis was performed to evaluate the hazard ratio (HR) of all-cause and cardiovascular disease (CVD) mortalities with adjustment for baseline characteristics. LBSIZ, WC, and BMI showed positive association with total fat percentage (P < 0.001); however, only WC and BMI were positively associated with appendicular skeletal mass index (ASMI) (P < 0.001). In the multiple Cox regression analysis, only LBSIZ showed a significant HR for all-cause and CVD mortalities. Under restricted cubic spline regression, mortality risk increased with LBSIZ. However, BMI and WC showed a U-shape association. In conclusion, LBSIZ is strongly associated with all-cause and CVD mortalities. Since LBSIZ is independent of BMI, LBSIZ complements BMI to identify high-risk groups for mortality even in individuals with low or normal BMI.

The Relationship Between Nocturia and Mortality: Data From the National Health and Nutrition Examination Survey.

PURPOSE: We investigated the relationship between nocturia and mortality risk in the United States. METHODS: Data were obtained from the National Health and Nutrition Examination Survey 2005-2010. Mortality data were obtained by linking the primary database to death certificate data found in the National Death Index with mortality follow-up up to December 31, 2015. Nocturia was defined based on symptoms reported in the symptom questionnaire. We categorized patients into 2 groups: mild nocturia (2-3 voids/night) and moderate-to severe nocturia (≥4 voids/night). Multiple Cox regression analyses were performed with adjustment for confounding variables at the baseline survey. RESULTS: This study included 9,892 adults (4,758 men, 5,134 women). Nocturia occurred in 3,314 individuals (33.5%). Nocturia was significantly associated with all-cause mortality (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.10-1.39) and cardiovascular disease (CVD) mortality (HR, 1.55; 95% CI, 1.19-2.01). Moreover, the mortality risk increased with increasing nocturia severity. Further analysis with propensity score matching showed that nocturia was still significantly associated with all-cause mortality and CVD mortality. In subgroup analysis according to sex, nocturia was significantly associated with allcause mortality and CVD mortality in men. In women, moderate-to-severe nocturia was significantly associated with allcause mortality and CVD mortality. In subgroup analysis according to cardio-metabolic diseases, nocturia was associated with CVD mortality in patients with diabetes mellitus, hypertension, dyslipidemia, or CVD at baseline. In subgroup analysis of patients without diabetes mellitus, hypertension or CVD, nocturia was significantly associated with all-cause mortality. CONCLUSION: Nocturia was significantly associated with mortality in men and women after adjusting for major confounding factors.

Implication of diet and exercise on the management of age-related sarcopenic obesity in Asians.

The incidence of sarcopenic obesity among adults aged ≥65 years is rising worldwide. Sarcopenic obesity is a high-risk geriatric syndrome defined as a gain in the amount of adipose tissue along with the age-related loss of muscle mass and strength or physical performance. Sarcopenic obesity is associated with increased risks of falls, physical limitations, cardiovascular diseases, metabolic diseases, and/or mortality. Thus, the identification of preventive and treatment strategies against sarcopenic obesity is important for healthy aging. Diet and exercise are the reasons for the development of sarcopenic obesity and are key targets in its prevention and treatment. Regarding weight reduction alone, it is most effective to maintain a negative energy balance with dietary calorie restriction and aerobic exercise. However, it is important to preserve skeletal muscle mass while reducing fat mass. Resistance exercise and appropriate protein supply are the main ways of preserving skeletal muscle mass, as well as muscle function. Therefore, in order to improve sarcopenic obesity, a complex treatment strategy is needed to limit energy ingestion with proper nutrition and to increase multimodal exercises. In this review, we focus on recently updated interventions for diet and exercise and potential future management strategies for Asian individuals with aging-related sarcopenic obesity. Geriatr Gerontol Int 2022; 22: 695-704.

Implications of fasting plasma glucose variability on the risk of incident peripheral artery disease in a population without diabetes: a nationwide population-based cohort study.

BACKGROUND: Diabetes have been known as a traditional risk factor of developing peripheral artery disease (PAD). However, the study evaluating the impact of long-term glycemic variability on the risk of developing PAD is limited, especially in a general population without diabetes. METHODS: We included 152,931 individuals without diabetes from the Korean National Health Insurance Service-Health Screening Cohort. Fasting plasma glucose (FPG) variability was measured using coefficient variance (FPG-CV), standard deviation (FPG-SD), and variability independent of the mean (FPG-VIM). RESULTS: A total of 16,863 (11.0%) incident cases of PAD were identified during a median follow-up of 8.3 years. Kaplan-Meier curves showed a progressively increasing risk of PAD in the higher quartile group of FPG variability than in the lowest quartile group (log rank P < 0.001). Multivariable Cox proportional hazard analysis showed the hazard ratio for PAD prevalence as 1.11 (95% CI 1.07-1.16, P < 0.001) in the highest FPG-CV quartile than in the lowest FPG-CV quartile after adjusting for confounding variables, including mean FPG. Similar degree of association was shown in the FPG-SD and FPG-VIM. In sensitivity analysis, the association between FPG variability and the risk of developing PAD persisted even after the participants were excluded based on previously diagnosed diseases, including stroke, coronary artery disease, congestive heart failure, chronic kidney disease, or current smokers or drinkers. Subgroup analysis demonstrated that the effects of FPG variability on the risk of PAD were more powerful in subgroups of younger age, regular exercisers, and those with higher income. CONCLUSIONS: Increased long-term glycemic variability may have a significant prognostic effect for incident PAD in individuals without diabetes.

Efficacy and Safety of Insulin Degludec/Insulin Aspart Compared with a Conventional Premixed Insulin or Basal Insulin: A Meta-Analysis.

Insulin degludec/insulin aspart (IDegAsp) is a novel co-formulation of 70% insulin degludec and 30% insulin aspart. The present meta-analysis was conducted to assess the efficacy and safety of IDegAsp compared with a conventional premixed insulin or basal insulin. We extracted data from citation databases, including PubMed, EMBASE, and the Cochrane Library, since inception to 2021. We calculated the mean differences for hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), self-measured mean glucose, and postprandial glucose (PPG) and odds ratios for confirmed hypoglycemia events. Compared with twice-daily conventional premixed insulin, twice-daily IDegAsp showed a similar effect on changes in HbA1c, but it significantly reduced FPG and self-measured mean glucose levels. Furthermore, compared to once-daily basal insulin, once-daily IDegAsp had a similar effect on changes in HbA1c, but it significantly reduced self-measured mean glucose and PPG levels. The risk of overall confirmed hypoglycemia was similar between treatments; however, the risk of nocturnal hypoglycemia events was significantly lower with IDegAsp than with conventional premixed insulin and basal insulin. Thus, IDegAsp was more effective than conventional premixed insulin and basal insulin at reducing blood glucose with fewer nocturnal hypoglycemia events.

A self-amplifying loop of YAP and SHH drives formation and expansion of heterotopic ossification.

Heterotopic ossification (HO) occurs as a common complication after injury or in genetic disorders. The mechanisms underlying HO remain incompletely understood, and there are no approved prophylactic or secondary treatments available. Here, we identify a self-amplifying, self-propagating loop of Yes-associated protein (YAP)-Sonic hedgehog (SHH) as a core molecular mechanism underlying diverse forms of HO. In mouse models of progressive osseous heteroplasia (POH), a disease caused by null mutations in GNAS, we found that Gnas-/- mesenchymal cells secreted SHH, which induced osteoblast differentiation of the surrounding wild-type cells. We further showed that loss of Gnas led to activation of YAP transcription activity, which directly drove Shh expression. Secreted SHH further induced YAP activation, Shh expression, and osteoblast differentiation in surrounding wild-type cells. This self-propagating positive feedback loop was both necessary and sufficient for HO expansion and could act independently of Gnas in fibrodysplasia ossificans progressiva (FOP), another genetic HO, and nonhereditary HO mouse models. Genetic or pharmacological inhibition of YAP or SHH abolished HO in POH and FOP and acquired HO mouse models without affecting normal bone homeostasis, providing a previously unrecognized therapeutic rationale to prevent, reduce, and shrink HO.

Efficacy and Safety of the New Appetite Suppressant, Liraglutide: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Obesity is a chronic disease associated with metabolic diseases such as diabetes and cardiovascular disease. Since the U.S. Food and Drug Administration approved liraglutide as an anti-obesity drug for nondiabetic patients in 2014, it has been widely used for weight control in overweight and obese people. This study aimed to systematically analyze the effects of liraglutide on body weight and other cardiometabolic parameters. METHODS: We investigated articles from PubMed, EMBASE, and the Cochrane Library to search randomized clinical trials that examined body weight changes with liraglutide treatment. RESULTS: We included 31 studies with 8,060 participants for this meta-analysis. The mean difference (MD) between the liraglutide group and the placebo group was -4.19 kg (95% confidence interval [CI], -4.84 to -3.55), with a -4.16% change from the baseline (95% CI, -4.90 to -3.43). Liraglutide treatment correlated with a significantly reduced body mass index (MD: -1.55; 95% CI, -1.76 to -1.34) and waist circumference (MD: -3.11 cm; 95% CI, -3.59 to -2.62) and significantly decreased blood pressure (systolic blood pressure, MD: -2.85 mm Hg; 95% CI, -3.36 to -2.35; diastolic blood pressure, MD: -0.66 mm Hg; 95% CI, -1.02 to -0.30), glycated hemoglobin (MD: -0.40%; 95% CI, -0.49 to -0.31), and low-density lipoprotein cholesterol (MD: -2.91 mg/dL; 95% CI, -5.28 to -0.53; MD: -0.87% change from baseline; 95% CI, -1.17 to -0.56). CONCLUSION: Liraglutide is effective for weight control and can be a promising drug for cardiovascular protection in overweight and obese people.

The impact of urinary incontinence on falls: A systematic review and meta-analysis.

OBJECTIVE: Previous studies on the association between urinary incontinence (UI) and falls have reported conflicting results. We, therefore, aimed to evaluate and clarify this association through a systematic review and meta-analysis of relevant studies. METHODS: We performed a literature search for relevant studies in databases including PubMed and EMBASE from inception up to December 13, 2020, using several search terms related to UI and falls. Based on the data reported in these studies, we calculated the pooled odds ratios (ORs) for falls and the corresponding 95% confidence intervals (CIs) using the Mantel-Haenszel method. RESULTS: This meta-analysis included 38 articles and a total of 230,129 participants. UI was significantly associated with falls (OR, 1.62; 95% CI, 1.45-1.83). Subgroup analyses based on the age and sex of the participants revealed a significant association between UI and falls in older (≥65 years) participants (OR, 1.59; 95% CI, 1.31-1.93), and in both men (OR, 1.88; 95% CI, 1.57-2.25) and women (OR, 1.41; 95% CI, 1.29-1.54). Subgroup analysis based on the definition of falls revealed a significant association between UI and falls (≥1 fall event) (OR, 1.61; 95% CI, 1.42-1.82) and recurrent falls (≥2 fall events) (OR, 1.63; 95% CI, 1.49-1.78). According to the UI type, a significant association between UI and falls was observed in patients with urgency UI (OR, 1.76; 95% CI, 1.15-1.70) and those with stress UI (OR, 1.73; 95% CI, 1.39-2.15). CONCLUSIONS: This meta-analysis, which was based on evidence from a review of the published literature, clearly demonstrated that UI is an important risk factor for falls in both general and older populations.

Association of nocturia and cardiovascular disease: Data from the National Health and Nutrition Examination Survey.

AIMS: To investigate the association of nocturia with the prevalence of cardiovascular disease (CVD) using the National Health and Nutrition Examination Survey (NHANES) data. METHODS: Among the 40 790 individuals who participated in NHANES from 2005 to 2012, 14 114 adults were analyzed in this study. A participant was considered to have nocturia if they have two or more voiding episodes nightly. In addition, participants with nocturia more than four times in a day were considered to have severe nocturia. A multivariate logistic regression analysis with adjustment for confounding variables, including age, sex, race, body mass index (BMI), smoking status, alcohol consumption, sleeping time, dyslipidemia, hypertension, and diabetes mellitus was performed with 1:1 propensity score matching (PSM). RESULTS: Nocturia occurred in 4610 individuals (32.7%). The prevalence of CVD was significantly higher in men, older individuals, those with higher BMI, smokers, and those with diabetes, hypertension, and hyperlipidemia. There was also a significantly higher prevalence of nocturia in the participants with CVD. Multivariate analysis showed that odds ratios (ORs) of mild and severe nocturia for CVD were 1.23 (95% confidence interval [CI]: 1.08-1.39) and 1.74 (95% CI: 1.39-2.17), respectively. After 1:1 PSM, the ORs of mild and severe nocturia were 1.27 (95% CI: 1.10-1.48) and 1.73 (95% CI: 1.33-2.26), respectively, showing statistical significance. CONCLUSION: Data from the NHANES indicate that CVD was significantly associated with the prevalence of nocturia, after taking major confounding factors into account. Furthermore, the risk for CVD increases with increasing nocturia severity.

Effect of Metabolic Health and Obesity Phenotype on the Risk of Pancreatic Cancer: A Nationwide Population-Based Cohort Study.

BACKGROUND: Recently, a few studies have reported different results regarding the relationship between metabolic health and obesity phenotype and several cancers. We examined the effects of metabolic health and obesity phenotype on pancreatic cancer using a nationwide population-based cohort database. METHODS: Using the Korean National Health Insurance Service-Health Screening Cohort, we enrolled 347,434 Korean adults who underwent a health examination between 2009 and 2010 and were followed until 2015. This population was divided into four groups based on metabolically healthy status and body mass index (BMI): metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). RESULTS: Over a median follow-up of 6.1 (5.5-6.5) years, 886 individuals were diagnosed with pancreatic cancer. The adjusted HRs for incident pancreatic cancer were 1.52 [95% confidence interval (CI) 1.27-1.81] and 1.34 (95% CI, 1.12-1.61) for the MUNW and MUO phenotypes (compared with the MHNW phenotype) after adjusting for various confounding factors. However, compared with the MHNW phenotype, the MHO phenotype did not show an elevated risk of pancreatic cancer. Moreover, the HR for pancreatic cancer gradually increased with an increase in number of metabolically unhealthy components, even after adjusting for BMI (P trend < 0.001). CONCLUSIONS: Regardless of BMI, metabolically unhealthy phenotype demonstrated significantly increased risk of pancreatic cancer, whereas obese individuals with metabolically healthy phenotype did not. IMPACT: These findings suggest that metabolically unhealthy phenotype might represent a potential risk factor for pancreatic cancer occurrence independent of obesity.

Z-score of the log-transformed A Body Shape Index predicts low muscle mass in population with abdominal obesity: The U.S. and Korea National Health and Nutrition Examination Survey.

BACKGROUND AND OBJECTIVE: Sarcopenic obesity is associated with a higher risk of cardiometabolic disease and mortality than either sarcopenia or obesity alone. However, no study has investigated body shape indices for the assessment of sarcopenia in obese populations. Thus, this study aimed to evaluate the accuracy of body shape indices to assess sarcopenia in nationally representative populations with abdominal obesity. METHODS: Data from the U.S. National Health and Nutrition Examination Survey (U.S. NHANES) 1999-2006 and Korea NHANES (KNHANES) 2008-2011 were assessed. The association between Body Shape Index and sarcopenia was analyzed using a receiver operating characteristic curve. The Z-score of the log-transformed A Body Shape Index (LBSIZ) cut-off value was defined as that with the highest score of the Youden's index. Changes in odds ratios (OR) for sarcopenia were investigated using restricted cubic spline (RCS) plots. RESULTS: This study included 8,013 American and 4,859 Korean adults with abdominal obesity. The overall area under the curve (AUC) of LBSIZ for sarcopenia was 0.816 (95% CI: 0.794-0.838) in U.S. NHANES and 0.822 (95% CI: 0.799-0.844) in KNHANES, which was higher than that of the body roundness index, conicity index, and waist to height ratio (p with DeLong's test <0.001). The cut-off values for the LBSIZ were 1.05 (sensitivity, 88.0%; specificity, 81.5%) for American men, 0.45 (sensitivity, 77.1%; specificity, 70.6%) for American women, 1.15 (sensitivity, 77.5%; specificity, 77.1%) for Korean men and 0.95 (sensitivity, 74.3%; specificity, 69.3%) for Korean women in the development groups. Comparable results were verified in validation groups. The RCS plot indicated that ORs for sarcopenia rapidly increased with an increase in the LBSIZ cut-off value. CONCLUSION: The increased LBSIZ could function as a reliable and cost-effective screening tool for assessing low muscle mass in populations with abdominal obesity.

Effect of body shape on the development of cardiovascular disease in individuals with metabolically healthy obesity.

Studies about the effects of metabolically healthy obesity on cardiovascular disease (CVD) have yielded conflicting results. These heterogeneous results could be due to the limited usefulness of BMI in measuring general adiposity, as body mass index (BMI) does not accurately reflect body composition. This study aimed to evaluate the effect of body shape on CVD outcomes across different obesity phenotypes, and to provide an explanation for the heterogeneous effects of metabolically healthy obese (MHO) phenotype on CVD.We analyzed data from the Korean Genome and Epidemiology Study, a population-based cohort study conducted between 2001 and 2012. We divided the participants into 4 groups: metabolically healthy non-obese (MHNO), MHO, metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). To assess body shape, we calculated the z-score of the log-transformed a body shape index (LBSIZ). We computed Pearson correlation coefficients to examine the association of LBSIZ with muscle mass index, percentage of total fat mass (%Total FM), and percentage of abdominal fat mass (%Abdominal FM). We also used Cox proportional hazards regression to evaluate the effect of LBSIZ on CVD events according to the obesity phenotypes.A total of 9460 participants were assessed in this study. The incidence of CVD was 8.53 cases per 1000 person-year. LBSIZ showed strong positive correlation with %Total FM and %Abdominal FM, but negative correlation with muscle mass index. In Cox regression, MHO individuals did not show increased risk of CVD compared with MHNO individuals (hazard ratio [HR], 1.29; 95% confidence interval [CI], 0.96-1.73). However, MHO individuals in the 3rd (HR, 2.40; 95% CI, 1.28-4.51) and 4th (HR, 3.67; 95% CI, 1.99-6.74) quarters of LBSIZ showed significantly higher risk of CVD compared with MHNO individuals in the 1st quarter of LBSIZ. Moreover, LBSIZ showed a linear relationship with CVD among MHO individuals.While the MHO individuals showed similar CVD risk to the MHNO individuals, CVD risk increases with LBSIZ among the MHO individuals. LBSIZ appears to be a useful measure for CVD risk assessment in clinical practice and epidemiologic studies, especially for MHO patients.

Impact of fashion braces on oral health related quality of life: a web-based cross-sectional study.

BACKGROUND: Orthodontic braces have become symbols of wealth and fashion accessories in some parts of the world. However, there is a scarcity of information about the effects of fashion braces on various aspects of quality of life. Therefore, our aim was to investigate the effects of fashion braces on oral health related quality of life (OHRQoL). METHODS: A cross-sectional study was carried out with data collection from a Google form questionnaire distributed in Saudi Arabia via various forms of social media over a period of 4 months. OHRQoL was assessed using the validated Arabic version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The fashion braces group included respondents who had braces installed for fashion purposes only. Therapeutic braces group included subjects who were wearing braces to treat any malocclusion problems. Control group included subjects who did not have any kind of braces. People who had previously completed orthodontic treatments were excluded from the study. The negative impacts were divided into seven domains and a total OHIP score was calculated. Statistical analyses and data illustration were performed with SPSS v25 (IBM, NY). RESULTS: A total of 1141 people voluntarily participated in the study. More than 60% of the participants were in the control group while 33.7% had conventional braces for therapeutic reasons and 3.4% had fashion braces. Sociodemographic distributions varied among the groups, with the majority of the fashion braces group having education below the university level and family incomes less than average. There were significant group differences in OHIP domains. Physical pain was the most frequently reported complaint by all subjects and was the highest in the therapeutic braces group. People with therapeutic braces reported significantly higher functional limitation and physical disability than the controls. Fashion braces group reported significantly lower psychological discomfort and disability, social disability and handicap compared to control groups. CONCLUSIONS: The illustrated effects of fashion braces on OHRQoL suggest the need to study the role of social media and educate the public on the use of braces to minimize the negative effects experienced by individuals.

Impact of urinary incontinence on falls in the older population: 2017 national survey of older Koreans.

OBJECTIVES: To investigate the association and influence of urinary incontinence (UI) on falls in older adults using the 2017 National Survey of Older Koreans data. METHODS: We retrospectively analyzed the 2017 National Survey of Older Koreans, which was conducted on 10,299 adults aged 65 and older in 2017 by the Korea Institute for Health and Social Affairs. RESULTS: This study included a total of 6,134 women aged 65-106, with a mean age of 74.8. In total, 1,152 women experienced at least 1 fall in the past 1 year and 382 experienced 2 or more recurrent falls; 281 women were diagnosed with UI. UI and falls (odds ratio, 1.329; 95 % confidence interval, 1.003-1.762) and recurrent falls (odds ratio=,1.703; 95% confidence interval=,1.145-2.534) were significantly associated. Older individuals with UI were more likely to fall at least once per year (odds ratio=,1.52; 95 % confidence interval=,1.15-2.20, odds ratio=,1.49; 95 % confidence interval=,1.09-2.04) than those without and were also linked to higher odds of recurrent falls (odds ratio=,2.16; 95 % confidence interval=,1.47-3.16, odds ratio=,2.13; 95 % confidence interval=,1.41-3.22) in those with at least 1 cognitive impairment, body functional impairment, or activity limitation. CONCLUSION: Our findings showed a possible increased risk of falls and recurrent falls in older individuals with UI compared to those without, especially in people with cognitive and functional impairment.

Beneficial Effects of Time-Restricted Eating on Metabolic Diseases: A Systemic Review and Meta-Analysis.

Various behavioral and physiological pathways follow a pre-determined, 24 hour cycle known as the circadian rhythm. Metabolic homeostasis is regulated by the circadian rhythm. Time-restricted eating (TRE) is a type of intermittent fasting based on the circadian rhythm. In this study, we aim to analyze systemically the effects of TRE on body weight, body composition, and other metabolic parameters. We reviewed articles from PubMed, EMBASE, and the Cochrane Library to identify clinical trials that compared TRE to a regular diet. We included 19 studies for meta-analysis. Participants following TRE showed significantly reduced body weight (mean difference (MD), -0.90; 95% confidence interval (CI): -1.71 to -0.10) and fat mass (MD: -1.58, 95% CI: -2.64 to -0.51), while preserving fat-free mass (MD, -0.24; 95% CI: -1.15 to 0.67). TRE also showed beneficial effects on cardiometabolic parameters such as blood pressure (systolic BP, MD, -3.07; 95% CI: -5.76 to -0.37), fasting glucose concentration (MD, -2.96; 95% CI, -5.60 to -0.33), and cholesterol profiles (triglycerides, MD: -11.60, 95% CI: -23.30 to -0.27). In conclusion, TRE is a promising therapeutic strategy for controlling weight and improving metabolic dysfunctions in those who are overweight or obese. Further large-scale clinical trials are needed to confirm these findings and the usefulness of TRE.

Organokines in disease.

Studies have linked obesity, metabolic syndrome, type 2 diabetes, cardiovascular disease (CVD), nonalcoholic fatty liver disease (NAFLD) and dementia. Their relationship to the incidence and progression of these disease states suggests an interconnected pathogenesis involving chronic low-grade inflammation and oxidative stress. Metabolic syndrome represents comorbidities of central obesity, insulin resistance, dyslipidemia, hypertension and hyperglycemia associated with increased risk of type 2 diabetes, NAFLD, atherosclerotic CVD and neurodegenerative disease. As the socioeconomic burden for these diseases has grown signficantly with an increasing elderly population, new and alternative pharmacologic solutions for these cardiometabolic diseases are required. Adipose tissue, skeletal muscle and liver are central endocrine organs that regulate inflammation, energy and metabolic homeostasis, and the neuroendocrine axis through synthesis and secretion of adipokines, myokines, and hepatokines, respectively. These organokines affect each other and communicate through various endocrine, paracrine and autocrine pathways. The ultimate goal of this review is to provide a comprehensive understanding of organ crosstalk. This will include the roles of novel organokines in normal physiologic regulation and their pathophysiological effect in obesity, metabolic syndrome, type 2 diabetes, CVD, NAFLD and neurodegenerative disorders.