Triglyceride-Glucose Index, Modifiable Lifestyle, and Risk of Colorectal Cancer: A Prospective Analysis of the Korean Genome and Epidemiology Study.

BACKGROUND: Insulin-mediated pathways plausibly explain the pathogenesis of colorectal cancer (CRC). The triglyceride-glucose index (TyG) is a surrogate of insulin resistance (IR), but its association with CRC in the Korean population has not been evaluated. METHODS: From the 2004-2013 Korean Genome and Epidemiology Study, 98,800 participants aged 40-69 years were followed through 2020. Data on CRC incidence were obtained from the Korean National Cancer Center registry. Cox regression models and restricted cubic splines were fitted to examine the association between the TyG; In [(triglycerides) × (fasting glucose)/2] and CRC incidence. Joint effects of modifiable lifestyle factors and TyG on CRC risk were also investigated. RESULTS: Median follow-up time was 10.6 years, and 699 CRC cases were observed. A unit-increment in TyG was associated with increased risk of CRC combined (hazard ratio, HR: 1.28, and 95% confidence interval, CI: 1.12-1.46), colon (1.29, 1.10-1.54), and rectal cancer (1.24, 1.01-1.52). Associations were dose-dependent, with linear associations observed for CRC and colon, but non-linear associations were observed for rectal cancer. A high TyG index (above 8.4) combined with overweight/obesity was linked to an increased risk of CRC (1.31, 1.07-1.61) and colon cancer (1.33, 1.03-1.72). When combined with low fruit and vegetable intake, the risks were higher for CRC (1.40, 1.12-1.74) and colon cancer (1.57, 1.18-2.09). Combined with high red meat consumption, the risks were elevated for CRC (1.32, 1.05-1.65) and colon cancer (1.52, 1.15-2.02). CONCLUSIONS: A high TyG index was associated with a higher risk of colorectal cancer, and the risk was highest among participants with a high BMI, low fruit and vegetable intake, and high intake of red meat, suggesting a role of both insulin resistance and modifiable lifestyle in colorectal cancer development.

Effects of abdominal aortic aneurysm on long-term survival in lung cancer patients.

The major causes of death in patients with abdominal aortic aneurysm (AAA) are cardiovascular disease and cancer. The purpose of this study was to evaluate the effect of AAA on long-term survival in lung cancer patients. All patient data with degenerative type AAA and lung cancer over 50 years of age during the period 2009 to 2018 was collected retrospectively from a National Health Insurance Service (NHIS) administrative database and matched to lung cancer patients without AAA by age, sex, metastasis, and other comorbidities. Mortality rate was compared between the groups. A total of 956 AAA patients who could be matched with patients without AAA were included, and 3824 patients in the matched group were used for comparison. Patients with AAA showed higher risk of death compared with the matched cohort (adjusted hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.06-1.23, p < 0.001). When compared to a matched group of untreated AAA patients, patients with of history of AAA exhibited a significantly increased risk of overall mortality [HR (95%CI) 1.219 (1.113-1.335), p < .001, adjusted HR (95% CI) 1.177 (1.073-1.291), p = .001]. By contrast, mortality risk of AAA patients treated either by endovascular abdominal aortic repair or open surgical repair was not significantly different from that of the matched group (p = 0.079 and p = 0.625, respectively). The mortality risk was significantly higher when AAA was present in lung cancer patients, especially in patients with unrepaired AAA, suggesting the need for continuous cardiovascular risk management.

Acute Stress Enhances Memory and Preference for Smoking-Related Associations in Smokers.

INTRODUCTION: Nicotine dependence follows a chronic course that is characterized by repeated relapse, often driven by acute stress and rewarding memories of smoking retrieved from related contexts. These two triggers can also interact, with stress influencing retrieval of contextual memories. However, the roles of these processes in nicotine dependence remain unknown. AIMS AND METHODS: We investigated how acute stress biases memory for smoking-associated contexts among smokers (N = 65) using a novel laboratory paradigm. On day 1, participants formed associations between visual stimuli of items (either neutral or related to smoking) and places (background scenes). On day 2 (24 hours later), participants were exposed to an acute laboratory-based stressor (socially evaluated cold pressor test; N = 32) or a matched control condition (N = 33) prior to being tested on their memory recognition and preferences for each item and place. We distinguished the accuracy of memory into specific (ie, precisely correct) or gist (ie, lure items with similar content) categories. RESULTS: Results demonstrated that the stressor significantly induced physiological and subjective perceived stress responses, and that stressed smokers exhibited a memory bias in favor of smoking-related items. In addition, the stressed group displayed greater preference for both smoking-related items and places that had been paired with the smoking-related items. We also found suggestive evidence that stronger smoking-related memory biases were associated with more severe nicotine dependence (ie, years of smoking). CONCLUSIONS: These results highlight the role of stress in biasing smokers toward remembering contexts associated with smoking, and amplifying their preference for these contexts. IMPLICATIONS: The current study elucidates the role of acute stress in promoting memory biases favoring smoking-related associations among smokers. The results suggest that the retrieval of smoking-biased associative memory could be a crucial factor in stress-related nicotine seeking. This may lead to a potential intervention targeting the extinction of smoking-related context memories as a preventive strategy for stress-induced relapse.

Association of cardiometabolic factors and insulin resistance surrogates with mortality in participants from the Korean Genome and Epidemiology Study.

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.

Novosphingobium cyanobacteriorum sp. nov., isolated from a eutrophic reservoir during the Microcystis bloom period.

A novel Gram-stain-negative, aerobic and rod-shaped bacterial strain, HBC54T, was isolated from periphyton during a Microcystis bloom. Based on the results of the 16S rRNA gene sequence analysis, strain HBC54T was closely related to Novosphingobium aerophilum 4Y4T (98.36 %), Novosphingobium aromaticivorans DSM 12444T (98.08 %), Novosphingobium huizhouense c7T (97.94 %), Novosphingobium percolationis c1T (97.65 %), Novosphingobium subterraneum DSM 12447T (97.58 %), Novosphingobium olei TW-4T (97.58 %) and Novosphingobium flavum UCT-28T (97.37 %). The average nucleotide identity and digital DNA-DNA hybridization values between HBC54T and its related type stains were below 78.97 and 23.7 %, which are lower than the threshold values for species delineation. The major fatty acids (>10.0 %) were identified as C14 : 0 2-OH, summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c) and summed feature 8 (C18 : 1 ω7c and/or C18 : 1 ω6c) and the respiratory quinone was ubiquinone Q-10. The main polar lipids detected in the strain were phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, diphosphatidylglycerol and three unidentified phospholipids. The genomic DNA G+C content was 64.8 mol%. Strain HBC54T is considered to represent a novel species within the genus Novosphingobium, for which the name Novosphingobium cyanobacteriorum sp. nov. is proposed. The type strain is HBC54T (=KCTC 92033T=LMG 32427T).

2-Deoxy-d-ribose induces ferroptosis in renal tubular epithelial cells via ubiquitin-proteasome system-mediated xCT protein degradation.

Ferroptosis is a novel form of cell death triggered by iron-dependent lipid peroxidation. Recent findings suggest that inhibiting system χc-induces ferroptosis by reducing intracellular cystine levels, and that ferroptosis in renal tubular epithelial cells (RTECs) contributes to acute kidney injury (AKI) and diabetic nephropathy. Moreover, 2-deoxy-d-ribose (dRib) has been shown to inhibit cystine uptake through xCT, the functional unit of system χc-, in ß-cells. This study aimed to investigate if dRib induces ferroptosis in RTECs and identify the underlying mechanisms. dRib treatment reduced cystine uptake and glutathione (GSH) content, and increased intracellular levels of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), lipid reactive oxygen species (ROS), and cell death in both NRK-52E cells and primary cultured RTECs. However, treatment with inhibitors of ferroptosis, such as deferoxamine (DFO), ferrostatin-1 (Fer-1), and liproxstatin-1 (Lip-1), counteracted the effects of dRib on GSH, MDA, 4-HNE, and lipid ROS levels, as well as cell death. Additionally, 2-mercaptoethanol (2-ME) treatment or xCT gene overexpression protected against dRib-induced changes. Moreover, transmission electron microscopy revealed dRib-induced mitochondrial shrinkage, decrease in cristae number, and outer membrane rupture. Furthermore, dRib treatment upregulated the expression of genes associated with ferroptosis, and downregulated xCT protein expression. The decrease in xCT protein caused by dRib was consistently observed even when treated with the protein synthesis inhibitor cycloheximide. However, treatment with the proteasome inhibitor MG132 reversed the dRib-induced decrease in xCT protein expression. Additionally, dRib increased xCT protein ubiquitination. Overall, dRib induces ferroptosis in RTECs by degrading xCT protein through ubiquitin-proteasome system (UPS), resulting in reduced intracellular cystine uptake. Therefore, targeting the regulation of system χc-through UPS could be a potential therapeutic approach for AKI and diabetic nephropathy.

The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort.

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.

Investigating Endocrine Disrupting Impacts of Nine Disinfection Byproducts on Human and Zebrafish Estrogen Receptor Alpha.

BACKGROUND: Disinfection byproducts (DBPs) cause endocrine disruption via estrogenic or anti-estrogenic effects on estrogen receptors. However, most studies have focused on human systems, with little experimental data being presented on aquatic biota. This study aimed to compare the effects of nine DBPs on zebrafish and human estrogen receptor alpha (zERα and hERα). METHODS: In vitro enzyme response-based tests, including cytotoxicity and reporter gene assays, were performed. Additionally, statistical analysis and molecular docking studies were employed to compare ERα responses. RESULTS: Iodoacetic acid (IAA), chloroacetonitrile (CAN), and bromoacetonitrile (BAN) showed robust estrogenic activity on hERα(maximal induction ratios of 108.7%, 50.3%, and 54.7%, respectively), while IAA strongly inhibited the estrogenic activity induced by 17ß-estradiol (E2) in zERα (59.8% induction at the maximum concentration). Chloroacetamide (CAM) and bromoacetamide (BAM) also showed robust anti-estrogen effects in zERα (48.1% and 50.8% induction at the maximum concentration, respectively). These dissimilar endocrine disruption patterns were thoroughly assessed using Pearson correlation and distance-based analyses. Clear differences between the estrogenic responses of the two ERαs were observed, whereas no pattern of anti-estrogenic activities could be established. Some DBPs strongly induced estrogenic endocrine disruption as agonists of hERα, while others inhibited estrogenic activity as antagonists of zERα. Principal coordinate analysis (PCoA) showed similar correlation coefficients for estrogenic and anti-estrogenic responses. Reproducible results were obtained from computational analysis and the reporter gene assay. CONCLUSIONS: Overall, the effects of DBPs on both human and zebrafish highlight the importance of controlling their differences in responsiveness for estrogenic activities including the water quality monitoring and endocrine disruption, as DBPs have species-specific ligand-receptor interactions.

Changes in cervical dysplasia, carcinoma in situ, and cervical cancer after expanding the National Cancer Screening Program to younger women in Korea.

The National Cancer Screening Program of South Korea for cervical cancer was expanded from women aged ≥30 years to women aged ≥20 years in 2016. This study investigated the effect of this policy on occurrence rates of cervical dysplasia, carcinoma in situ, and cervical cancer in women in their twenties. The National Health Information Database for the years 2012-19 was used. The outcome measures were monthly occurrence rates of cervical dysplasia, cervical carcinoma in situ, and cervical cancer. An interrupted time series analysis was performed to investigate whether the number of occurrences changed after policy implementation. For cervical dysplasia, a pre-intervention decreasing trend of 0.3243 per month (P-value < .0001) was found. The post-intervention trend did not differ significantly, although the slope increased at a rate of 0.4622 per month (P-value < .0001). For carcinoma in situ, a trend of increase at 0.0128 per month (P-value = .0099) was seen before policy implementation. The post-intervention trend did not escalate, but the slope showed an increasing trend of 0.0217 per month (P-value < .0001). For cervical cancer, no significant trend was present before intervention. Occurrences of cervical cancer escalated at a rate of 0.0406 per month (P-value < .0001) after policy implementation, and the slope also showed an increasing trend at a rate of 0.0394 per month (P-value < .0001). Expanding the target population for cervical cancer screening increased detection rates for cervical cancer in women aged between 20 and 29 years.

Post-operative recurrence of focal segmental glomerulosclerosis according to pre-transplant treatment after kidney transplantation.

BACKGROUND: Recurrent focal segmental glomerulosclerosis (FSGS) after kidney transplantation (KT) is a serious complication and a significant risk factor for graft failure. However, there is no clear evidence of the effectiveness of pre-transplant treatment using plasmapheresis (PP) or rituximab in preventing post-operative FSGS recurrence after KT. METHODS: This single-center retrospective study included 99 adult patients with biopsy-proven primary FSGS who underwent KT between 2007 and 2018. The patients were divided into the pre-treatment group (N = 53, 53.5%) and no pre-treatment group (N = 46, 46.5%). In the pre-transplant group, prophylactic PP was administered before KT in patients undergoing living donor transplantation and the day after KT in those undergoing deceased donor transplantation. RESULTS: The rate of immediate post-operative recurrence was significantly higher in the no pre-treatment group (16 [34.8%]) than in the pre-treatment group (5 [9.4%]; P = 0.002). There were three cases of graft failure due to recurrent FSGS, all of which were in the no pre-treatment group. After adjusting for possible confounding factors, age (per 10-year increase; OR = 0.61, CI, 0.42-0.90; P = 0.012) and pre-transplant treatment (vs. no pre-transplant treatment; OR = 0.17, CI, 0.05-0.54; P = 0.003) were identified as significant factors associated with FSGS recurrence. The rate of death-censored graft survival was significantly superior in the pretransplant treatment group (P = 0.042). CONCLUSION: Pre-transplant treatment with PP was associated with beneficial effects on preventing FSGS recurrence after KT.

Total and cause-specific mortality associated with meat intake in a large cohort study in Korea.

Background: Asia has experienced a large increase in meat intake in the past decade, yet the health impact of meat intake is not well studied. Objective: We examined the association of meat intake with all-cause, cancer and cardiovascular disease (CVD) mortality in an Asian country. Methods: Participants were 113,568 adults with dietary data at recruitment (2004-2013) of the Health Examinees-Gem (HEXA-G) study, a prospective cohort study conducted in 8 regions of Korea. Participants were followed until 31 December 2020. Total, red, white, and organ meat intake were computed based on a 106-item questionnaire. Multivariable Cox proportional hazard models were implemented using the lowest quintile of meat intake as the reference category. Findings: For 1,205,236 person-years, 3,454 deaths were recorded. High intake of processed red meat was positively associated with all-cause mortality [men: hazard ratio (HR) 1.21, 95% confidence interval (95% CI) 1.07-1.37; women: HR 1.32, 95% CI 1.12-1.56]. Increased risk of all-cause mortality (HR 1.21, 95% CI 1.05-1.39) and cancer mortality (HR 1.24, 95% CI 1.03-1.50) was observed in women with high intake of organ meat. Moderate intake of pork belly was associated with reduced risk of all-cause mortality in men (HR 0.76, 95% CI 0.62-0.93) and women (HR 0.83, 95% 0.69-0.98) but high intake was associated with increased risk of CVD mortality in women (HR 1.84, 95% CI 1.20-2.82). Low beef intake decreased the risk of CVD mortality in men (HR 0.58, 95% CI 0.40-0.84), but roasted pork increased cancer mortality in women (HR 1.26, 95% CI 1.05-1.52). Conclusion: There was increased risk of all-cause mortality associated with intake of processed red meat in men and women, increased risk of all-cause and cancer mortality with intake of organ meat in women, and increased risk of cancer mortality with intake of roasted pork intake in women. High intake of pork belly increased the risk of CVD mortality in women, but moderate intake was inversely associated with mortality from all-causes in both men and women.

Associations Between Modifiable Risk Factors and Changes in Glycemic Status Among Individuals With Prediabetes.

OBJECTIVE: To examine the associations between modifiable risk factors and glycemic status changes in individuals with prediabetes. RESEARCH DESIGN AND METHODS: A total of 10,358 individuals with prediabetes defined by their fasting blood glucose and HbA1c levels from the Health Examinees-Gem study were included in the present study. Modifiable factors, including BMI, abdominal obesity, smoking status, physical activity, alcohol consumption, diet quality, hypertension, and dyslipidemia, were examined to determine their associations with changes in glycemic status during follow-up. In addition, modifiable-factor scores were calculated, and their association with changes in glycemic status was also analyzed. RESULTS: The median follow-up time for this study was 4 years (range, 1-7 years). BMI ≥25 kg/m2 (adjusted odds ratio [OR] 0.71 [95% CI 0.63-0.79]), abdominal obesity (OR 0.76 [95% CI 0.68-0.86]), heavy drinking (OR 0.74 [95% CI 0.60-0.91]), hypertension (OR 0.71 [95% CI 0.64-0.79]), and dyslipidemia (OR 0.78 [95% CI 0.70-0.85]) were associated with a lower possibility of normoglycemia reversion. BMI ≥25 kg/m2 (OR 1.58 [95% CI 1.29-1.94]), abdominal obesity (OR 1.31 [95% CI 1.11-1.55]), current smoking (OR 1.43 [95% CI 1.07-1.91]), and hypertension (OR 1.26 [95% CI 1.07-1.49]) were associated with a higher probability of type 2 diabetes progression. Having more favorable modifiable factors was also associated with normoglycemia reversion (OR 1.46 [95% CI 1.30-1.64]) and type 2 diabetes progression (OR 0.62 [95% CI 0.49-0.77]). CONCLUSIONS: More favorable modifiable factors were related to a higher probability of returning to normoglycemia and a lower probability of progression to type 2 diabetes.

Lifestyle Behaviors According to the Duration of Hypertension: Korea National Health and Nutrition Examination Survey 2016-2018.

BACKGROUND: The aim of this study was to examine the lifestyle characteristics of hypertensive patients and to investigate the association between the duration of hypertension and lifestyle characteristics. METHODS: A total 16,508 adults (including 5,933 hypertensive patients) aged 20 years and older who participated in the 7th Korea National Health and Nutrition Examination Survey 2016-2018 were analyzed. Multiple logistic regression analysis was performed to examine the association between the duration of hypertension and lifestyle factors. RESULTS: The longer duration of hypertension was associated with lower risk of drinking in men (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.66-0.93), and this observation remained when participants with hypertension for ≥ 13 years were compared to those with hypertension for < 1 year (OR, 0.57; 95% CI, 0.37-0.88). On the other hand, increased duration of hypertension increased the odds of engaging in high physical activity (PA) in women (OR, 1.72; 95% CI, 1.15-2.56), particularly in men with hypertension for 6-12 years (OR, 1.66; 95% CI, 1.03-2.69) and women with hypertension for ≥ 13 years (OR, 3.64; 95% CI, 1.38-9.62). CONCLUSION: In conclusion, adoption and maintenance of healthy lifestyle habits, particularly drinking cessation in men, and PA in both men and women was observed, and differences were observed depending on the duration of hypertension.

The Association of Serum High-Sensitivity C-Reactive Protein Level With the Risk of Site-Specific Cancer Mortality: The Health Examinees (HEXA) Study Cohort.

Few studies have investigated the association between high-sensitivity C-reactive protein (hsCRP) level and site-specific cancer mortality. In this study, we aimed to examine the associations of hsCRP with overall and site-specific cancer mortality among South Koreans using data on the Health Examinees (HEXA) Study cohort (41,070 men and 81,011 women aged ≥40 years). We obtained mortality information from the National Statistical Office of Korea, which provided the dates and causes of all deaths occurring through December 31, 2015, by linking mortality data with each participant's unique national identifier. Cox proportional hazards and restricted cubic spline models were used to assess the association between hsCRP and cancer mortality with adjustment for covariates. An analysis of site-specific cancer mortality was focused on 5 major cancers (lung, liver, gastric, colorectal, and breast/prostate). Median hsCRP levels were 0.77 mg/L and 0.59 mg/L for men and women, respectively. A dose-response association between hsCRP and overall cancer mortality was observed in men but disappeared in women after exclusion of deaths occurring in the first 1 or 2 years of follow-up. Elevated hsCRP levels increased the risks of lung, liver, and gastric cancer mortality in men, but the risks of colorectal and breast cancer mortality were not increased. The dose-response association between hsCRP and cancer mortality was observed differently depending on site-specific cancer mortality by sex.

Association of serum high-sensitivity C reactive protein with risk of mortality in an Asian population: the Health Examinees cohort.

OBJECTIVES: This study aimed to examine the association of high-sensitivity C reactive protein (hsCRP) with mortality risk and the attenuated effect of non-communicable disease history (NCD history ) on the association. DESIGN: Prospective cohort study. SETTING: Health Examinees cohort. PARTICIPANTS: A total of 41 070 men and 81 011 women aged ≥40 years were involved (follow-up: 6.8 years). OUTCOME MEASURES: Data and cause of death occurring until 31 December 2015 were confirmed by death statistics from the National Statistical Office. We conducted advanced analysis after stratification by NCD history and sensitivity analysis after excluding death before 1 or 2 years from recruitment. Cox proportional hazard and restricted cubic spline models were used to assess the association. RESULTS: The association between serum hsCRP and risk of all-cause mortality was observed with strong linearity in both genders and was not influenced by NCD history . The association of serum hsCRP with risk of cancer mortality was not observed in women with NCD history , but the association with risk of cardiovascular disease (CVD) mortality was predominantly observed in men with NCD history . CONCLUSIONS: This study suggests a dose-response association of hsCRP with mortality risk, including cancer and CVD mortality, in Koreans with low serum hsCRP, although the association with cancer and CVD mortality risk could be influenced by gender and NCD history .

Long-Term Exposure to Air Pollution and Incidence of Venous Thromboembolism in the General Population: A Population-Based Retrospective Cohort Study.

To date, the relationship between air pollutants and venous thromboembolism (VTE) has not been well established. Our aim is to investigate the association between ambient air pollutants and the incidence of VTE using the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) database. From 2003 to 2015, 338,616 subjects from the general population not previously diagnosed with VTE were included. The long-term average concentration of air pollutants before diagnosis for each subject was calculated. During the study period, there were 3196 incident cases of VTE. After adjusting for age, gender, economic status, body mass index, physical activity, smoking, alcohol consumption, comorbid diseases, and meteorological variables, the risk of VTE was observed to increase significantly with the long-term average concentration of particulate matter < 10 µm in diameter: PM10 (hazard ratio (HR) = 1.064 (95% confidence interval [CI] 1.053−1.074) for 1 µg/m3), SO2 (HR = 1.118 (95% CI 1.079−1.158) 1 ppb), and O3 (HR = 1.039 (95% CI 1.026−1.053) for 1 ppb), respectively. A difference between the date of the health screening and the date of diagnosis of the disease was observed. Long-term exposure to air pollutants including PM10, SO2, and O3 may be an independent risk factor for the development of VTE.

Seasonal variations in the occurrence of preeclampsia and potential implication of upper respiratory infections in South Korea.

The aim of this study was to examine the effect of seasonal changes on the incidence of preeclampsia (PE) in South Korea and East Asian populations, and to evaluate the relationship between upper respiratory infection (URI) during pregnancy and the development of PE. This cohort study included women who had singleton births between 2012 and 2018 in South Korea. A total of 548,080 first singleton births were analyzed, and 9311 patients (1.70%) were diagnosed with PE. Multivariate analysis showed that older age (≥ 30 years old), low income, residing in the southern part of South Korea, history of cigarette smoking, heavy drinking, higher body mass index, hypertension, or diabetes mellitus were risk factors for PE. Univariate analysis showed that URI was associated with the incidence of PE (P = 0.0294). However, this association was not statistically significant in the multivariate analysis (aOR 1.01; 95% CI 0.95-1.07). After adjusting for confounding variables, the occurrence of PE was the highest in December (aOR 1.21; 95% CI 1.10-1.34) and lowest in July and August. This study demonstrated that there are seasonal variations in the occurrence of PE in South Korea. Moreover, URI may be associated with the development of PE.

Panacibacter microcysteis sp. nov., isolated from a eutrophic reservoir during the Microcystis bloom period.

A Gram-stain-negative, rod-shaped bacterial strain DH6T was isolated from fresh water of the Daechung Reservoir during the Microcystis bloom period. The strain grew at pH 6.0-8.5, at temperature 17-40 °C, and at 0-1% (w/v) NaCl concentration. Comparison of 16S rRNA gene sequence indicated that strain DH6T exhibits the highest similarity with Panacibacter ginsenosidivorans Gsoil 1550T (96.6%). The average nucleotide identity (ANI), digital DNA-DNA hybridization (dDDH), and average amino acid identity (AAI) values of strain DH6T compared to its related type strains were below 74.2%, 22.3%, and 74.8%, respectively. The predominant fatty acids (> 5.0%) were identified as iso-C17:0 3-OH, iso-C13:0, iso-C15:0, C17:0 2-OH, iso-C11:0, anteiso-C13:0, and iso-C15:1 G. The polar lipid profile contained phosphatidylethanolamine, four unidentified aminolipids, and three unidentified lipids. The respiratory quinone was menaquinone 7 (MK-7). The genomic DNA G + C content was 42.6%. Collectively, strain DH6T should be classified as a novel species within the genus Panacibacter, for which the name Panacibacter microcysteis sp. nov. is proposed. The type strain is DH6T (= KCTC 82471T = LMG 32426T).

Risk factors for undergoing surgery in patients with newly diagnosed open-angle glaucoma.

Despite the clinical importance of glaucoma surgery, studies on its prevalence and risk factors are limited. We analyzed a database comprising approximately 1,000,000 Korean residents to investigate the prevalence and risk factors for undergoing glaucoma surgery within 5 years of diagnosis with open-angle glaucoma. Of the 4,303 patients evaluated, 226 (5.3%) underwent glaucoma surgery. Factors associated with the likelihood of glaucoma surgery included the use of two or more eye drops (odds ratio [OR], 30.30; 95% confidence interval [CI], 10.95-83.84), intake of oral carbonic anhydrase inhibitor (OR, 1.79; 95% CI, 1.23-2.61), age > 55 years (55-65 years: OR, 1.71; 95% CI, 1.06-2.76; > 65 years: OR 1.72; 95% CI, 1.10-2.70), female sex (OR, 1.46; 95% CI, 1.10-1.94), middle- and high-income (OR, 2.36; 95% CI, 1.30-4.28, OR, 1.86; 95% CI, 1.03-3.35, respectively), and metropolitan residence (OR, 1.61; 95% CI, 1.14-2.26). Our nomogram for predicting the likelihood of glaucoma surgery showed an acceptable result. In conclusion, older age, female sex, and the intensity of intraocular pressure lowering treatment increased the likelihood of undergoing glaucoma surgery. Our findings indicated that a lower socioeconomic status may forestall receiving this necessary surgery, which requires further attention.

Caenimonas aquaedulcis sp. nov., Isolated from Freshwater of Daechung Reservoir during Microcystis Bloom.

A Gram-stain-negative, white-coloured, and rod-shaped bacterium, strain DR4-4T, was isolated from Daechung Reservoir, Republic of Korea, during Microcystis bloom. Strain DR4-4T was most closely related to Caenimonas terrae SGM1-15T and Caenimonas koreensis EMB320T with 98.1% 16S rRNA gene sequence similarities. The average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) values between strain DR4-4T and closely related type strains were below 79.46% and 22.30%, respectively. The genomic DNA G+C content was 67.5%. The major cellular fatty acids (≥10% of the total) were identified as C16:0, cyclo C17:0, summed feature 3 (C16:1ω7c and/or C16:1ω6c), and summed feature 8 (C18:1ω7c and/or C18:1ω6c). Strain DR4-4T possessed phosphatidylethanolamine, diphosphatidylglycerol, and phosphatidylglycerol as the main polar lipids and Q-8 as the respiratory quinone. The polyamine profile was composed of putrescine, cadaverine, and spermidine. The results of polyphasic characterization indicated that the isolated strain DR4-4T represents a novel species within the genus Caenimonas, for which the name Caenimonas aquaedulcis sp. nov. is proposed. The type strain is DR4-4T (=KCTC 82470T =JCM 34453T).