Women with Metabolic Syndrome and Unhealthy Lifestyle Factors Are at a Higher Risk for Hyperuricemia.

Hyperuricemia (HUA) has become a significant medical concern due to its complications and links to metabolic syndrome (MetS) and cardiovascular disease (CVD), which result in increased mortality. The pathogenic processes associated with unhealthy behaviors, MetS, and HUA can be cooperative and potentially synergistic in the activation of risk factors. Recent research has shown sex-based differences in the relationship between HUA and its associated risk factors. This study aimed to investigate these differences, particularly in the context of MetS and CVD risk factors and unhealthy lifestyles. We also aimed to evaluate the joint effects of these factors based on sex. We conducted a cross-sectional study using nationally representative survey data from the Korean National Health and Nutritional Examination Survey 2016-2018. We performed multivariable logistic regression analysis, calculating adjusted odds ratios (ORs) with their 95% confidence intervals (CIs). We also conducted subgroup analyses based on sex and the presence of MetS with or without unhealthy lifestyle factors (tobacco use, alcohol intake). We found sex-based differences in the relationships between HUA and MetS, CVD risk factors, and lifestyle behaviors. Our major finding was a significant association between MetS and HUA in both men and women, regardless of alcohol consumption and smoking status, and this association was stronger in women. We also observed a synergistic effect of MetS and lifestyle factors on the risk of HUA, particularly in women, in whom the risk of HUA increased up to four times compared to the reference group. A sex-based clinical strategy for HUA is necessary to reduce related complications and their socio-economic burden.

Lemon juice improved color acceptance of aronia (Aronia melanocarpa) pound cake by copigmentation.

Anthocyanins can be changed into dark purplish color during pound cake preparation due to high temperature and alkaline baking soda, which lowers color acceptance by consumers. To stabilize a red color of anthocyanins in pound cake enriched with aronia (Aronia melanocarpa) powder, lemon juice was added to contain final concentrations of 0, 1, 2, and 3% (w/w) in the pound cake, which were assigned as control, PL1%, PL2%, and PL3%, respectively. As lemon juice amount increased, redness (a*) and sensory color perception as well as overall acceptance were enhanced, whereas hardness, gumminess, and chewiness decreased in texture profile analysis. In a model system, the addition of lemon juice to aronia solution caused bathochromic shift and hyperchromic effect in UV-Vis absorption spectrum, which are typical phenomena of copigmentation derived from interactions between anthocyanins and copigments. The results indicate that lemon juice improved color acceptance for aronia pound cake by copigmentation. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-023-01286-1.

Characterisation and storage stability of aronia anthocyanins encapsulated with combinations of maltodextrin with carboxymethyl cellulose, gum Arabic, and xanthan gum.

Encapsulation was used to protect anthocyanins extracted from aronia (Aronia melanocarpa) fruit using the combinations of maltodextrin (MD) with anionic polysaccharides, including carboxymethyl cellulose (CMC), gum Arabic (GA), and xanthan gum (XG) as the coating agents. The encapsulation efficiencies were 98 % in MD, MD + CMC, and MD + GA and 94 % in MD + XG. In comparison, the loading efficiency, total anthocyanins, total phenolics, and antioxidant activity were higher in the combined coating agents than in MD alone. In storage for 100 days at 25℃, the retention of anthocyanins was much higher in encapsulated aronia (88-91 %) compared with nonencapsulated aronia (47 %). Cyanidin 3-galactoside and arabinoside showed higher stability (91-93 %) than cyanidin 3-glucoside and xyloside (60-65 %). New compounds, including cyanidin 3-(coumaroyl)-pentoside and 10-carboxy-pyranocyanidin-3-hexoside, were found after 20 days, indicating that anthocyanins formed new adducts with other components in aronia. The results show that MD + CMC and MD + XG are suitable coating agents for the encapsulation of anthocyanins in aronia.

Altered Risk of Incident Gout According to Changes in Metabolic Syndrome Status: A Nationwide, Population-Based Cohort Study of 1.29 Million Young Men.

OBJECTIVE: Few data are available on whether changes in metabolic syndrome affect incident gout. This study was undertaken to assess associations between metabolic syndrome status and incident gout, as well as changes in the clinical characteristics of metabolic syndrome and incident gout, in a cohort of young men. METHODS: This nationwide, population-based cohort study included 20-39-year-old men who participated in serial health check-ups. The outcome, incident gout, was defined according to the claims database diagnostic code for gout. Associations among changes in metabolic syndrome status and incident gout were analyzed using Cox proportional hazards models. RESULTS: Among 1,293,166 individuals, 18,473 were diagnosed as having gout (incidence rate 3.36 per 1,000 person-years). Subjects who had chronic metabolic syndrome (defined as metabolic syndrome at all 3 health check-ups) had a nearly 4-fold higher risk of incident gout compared to subjects who did not have metabolic syndrome at any of the 3 health check-ups (adjusted hazard ratio [HRadj ] 3.82 [95% confidence interval (95% CI) 3.67-3.98]). Development of metabolic syndrome more than doubled the risk of incident gout (HRadj 2.31 [95% CI 2.20-2.43]). Conversely, recovery from metabolic syndrome reduced the risk of incident gout by nearly half (HRadj 0.52 [95% CI 0.49-0.56]). Among metabolic syndrome components, changes in elevated triglycerides (development of elevated triglycerides, HRadj 1.74 [95% CI 1.66-1.81]; recovery from elevated triglycerides, HRadj 0.56 [95% CI 0.54-0.59]) and abdominal obesity (development of abdominal obesity, HRadj 1.94 [95% CI 1.85-2.03]; recovery from abdominal obesity, HRadj 0.69 [95% CI 0.64-0.74]) showed the greatest association with altered risk of incident gout. Associations between changes in the status and clinical characteristics of metabolic syndrome and incident gout were more pronounced in subjects ages 20-29 years compared to those ages 30-39 years, and in subjects who were underweight or who had a normal weight. CONCLUSION: Changes in the status and clinical characteristics of metabolic syndrome were associated with altered risk of incident gout. These results suggest that metabolic syndrome is a modifiable risk factor for gout.

Increased risk of incident gout in young men with metabolic syndrome: A nationwide population-based cohort study of 3.5 million men.

Background: To date, few studies have focused on risk factors for gout in young people, and large-scale studies on the relationship between metabolic syndrome (MetS) and gout are lacking. We aimed to investigate the association between gout and MetS in a large nationwide population-based cohort of young men who participated in national health examination. Materials and methods: Cohort included men aged 20-39 years who participated in a health check-up in 2009-2012. A total of 3,569,104 subjects was included in the study, excluding those who had a previous diagnosis of gout or had renal impairment. The outcome was the occurrence of gout, which was defined using the diagnosis code of gout in the claims database. Cox proportional hazard model was used to evaluate the association between MetS and incident gout. Results: Mean follow-up duration was 7.35 ± 1.24 years and the incidence rate of gout was 3.36 per 1,000 person-years. The risk of gout in subjects with MetS was 2.4-fold higher than subjects without MetS. Among the components of MetS, hypertriglyceridemia and abdominal obesity showed the greatest association with gout. As the number of MetS components increased, the risk of gout increased. The association between gout and MetS was more pronounced in relatively young subjects and in low- or normal-weight subjects. Conclusion: Metabolic syndrome is an important risk factor for the gout in young men. In particular, the association between MetS and gout was greater in young and non-obese men. Management of MetS in young men will be important for future gout prevention.

Increased risk of malignancy in patients with Takayasu's arteritis: a population-based cohort study in Korea.

This study aimed to evaluate the relative risk of malignancy in patients with Takayasu's arteritis compared to that in the general population. This retrospective nationwide cohort study used data from the Korean Health Insurance Review and Assessment Service database. All newly diagnosed patients with Takayasu's arteritis were identified between January 2009 and December 2019. They were observed until the diagnosis of malignancy, death, or end of the observational period, December 2020. The standardized incidence ratios (SIRs) of the overall and site-specific malignancies were estimated and compared with the incidence of cancer in the general population retrieved from the National Cancer Registry. We identified 1449 newly diagnosed patients with Takayasu's arteritis during the observational period (9196 person-years). A total of 74, 66, and 8 patients had overall, solid, and hematologic malignancies, respectively. The risks of overall [SIR, 1.62; 95% confidence interval (CI) 1.27-2.03], solid (SIR, 1.51; 95% CI 1.17-1.92), and hematologic (SIR, 4.05; 95% CI 1.75-7.98) malignancies were increased compared to those in the general population. In solid malignancies, breast (SIR, 2.07; 95% CI 1.16-3.42) and ovarian (SIR, 4.45; 95% CI 1.21-11.39) cancers had an increased risk. In hematologic malignancies, the risk of myelodysplasia increased (SIR, 18.02; 95% CI 3.72-52.66). Immunosuppressive agent use was not associated with malignancy. There was no specific period when cancer more frequently occurred. An increased risk of malignancy was observed in patients with Takayasu's arteritis compared to that in the general population in this large-scale nationwide population study of Korean health insurance data.

Associations between Cardiovascular Outcomes and Rheumatoid Arthritis: A Nationwide Population-Based Cohort Study.

Despite a growing burden posed by cardiovascular disease (CVD) in rheumatoid arthritis (RA) patients, large-scale studies on the association between the characteristics of RA patients and CVD risks and studies adjusted for various confounding factors are lacking. In this large-scale nationwide cohort study, we aimed to investigate the association between CVD risk and RA and factors that may increase CVD risk using a dataset provided by the Korean National Health Insurance Service (NHIS). We enrolled 136,469 patients with RA who participated in national health examinations within two years of RA diagnosis between 2010 and 2017 and non-RA controls matched by age and sex (n = 682,345). The outcome was the occurrence of myocardial infarction (MI) or stroke. MI was defined as one hospitalization or two outpatient visits with ICD-10-CM codes I21 or I22. Stroke was defined as one hospitalization with ICD-10-CM codes I63 or I64 and a claim for brain imaging (CT or MRI). The Cox proportional hazard model and Kaplan-Meier curve were used for analysis. The mean follow-up duration was 4.7 years, and the incidence rate of CVD was higher in the RA group than the control group (MI: 3.20 vs. 2.08; stroke: 2.84 vs. 2.33 per 1000 person-years). The risk of MI and stroke was about 50% and 20% higher, respectively, in RA patients. The association between RA and CVD was prominent in females after adjusting for confounding variables. The association between RA and risk of MI was significant in individuals without DM. Therefore, appropriate screening for CVD is important in all RA patients including females and younger patients.

Cardiovascular risk associated with allopurinol or benzbromarone treatment in patients with gout.

Background: In previous studies, cardiovascular (CV) risk was increased in patients with gout. The effects of uric acid-lowering therapy on CV risk in gout patients have been investigated in numerous studies; however, allopurinol and benzbromarone have rarely been compared. Objectives: To compare CV risk based on allopurinol and benzbromarone treatment in Korean gout patients. Design: A nationwide population-based retrospective cohort study. Methods: We used South Korea database of the Health Insurance Review and Assessment (HIRA) service to identify gout patients ⩾18 years of age who newly started allopurinol or benzbromarone between 2009 and 2015. The primary outcome of the study was the occurrence of a composite CV endpoint, which included coronary revascularization, hospitalization due to myocardial infarction, ischemic stroke, and transient ischemic attack. Cox proportional hazard regression analysis and Kaplan-Meier curves were used for analysis. Results: The study included 257,097 allopurinol initiators and 7868 benzbromarone initiators. Compared with allopurinol initiators, the adjusted hazard ratio (aHR) of the composite CV endpoint of benzbromarone initiators was 1.01 [95% confidence interval (CI): 0.83-1.21], which was not significantly different. The results did not change even when 1:3 propensity score matching was performed for baseline characteristics. In subgroup analysis of high-risk patients with CV disease, significant difference was not observed between allopurinol and benzbromarone initiators. Conclusion: In this study, significant difference was not found in CV risk between allopurinol and benzbromarone initiators. In the high-CV-risk group, the incidence of CV events did not differ between allopurinol and benzbromarone initiators.

Stability assessment of anthocyanins from black soybean, grape, and purple sweet potato under in vitro gastrointestinal digestion.

Anthocyanins are glycosylated derivatives of anthocyanidins, whose hydroxyl groups are occasionally acylated with organic acids. The effect of anthocyanin composition on their stability under in vitro gastrointestinal digestion was investigated. Black soybean had all glycosylated anthocyanins with monosaccharide, grape contained glycosylated anthocyanins with disaccharide (23%) and acylated anthocyanins bound with two sugars (77%), and purple sweet potato had all acylated anthocyanins bound with three sugars. The order of total anthocyanins content was purple sweet potato, grape, and black soybean. Gastric digestion did not significantly decrease anthocyanins content in three samples, while intestinal digestion resulted in the significant decrease of total anthocyanins content in black soybean (40%), grape (45%), and purple sweet potato (25%). This indicates that the degree of glycosylation and acylation of anthocyanins affects their stability under the gastrointestinal conditions. Phenolic acids derived from anthocyanin degradation increased total phenolic content as well as ABTS radical scavenging activity. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-022-01071-6.

Clinical characteristics and radiographic outcomes of vascular Behçet's disease involving the aorta or its major branches.

OBJECTIVE: To describe the clinical characteristics and radiographic outcomes of vascular Behçet's disease (BD) involving the aorta or its major branches. METHODS: This retrospective cohort study was performed in patients with vascular BD involving the aorta or its major branches. All included patients underwent computed tomography angiography (CTA) at least two times with a 2- to 5-year interval. Radiographic progression was defined as newly developed and/or aggravated (> 20%) characteristic features on CTA. RESULTS: The cohort included 22 patients with BD with a median interval of 3.65 years between the initial and follow-up CTA. Five patients (22.7%) showed radiographic progression. Patients with radiographic progression had a longer disease duration at baseline than those without (6.67 vs. 0.26 years, p = 0.028). Of all patients, 21 (95.5%) had vascular aneurysms/pseudoaneurysms and 11 (50.0%) had thrombosis. The most frequently involved artery with aneurysmal change was the abdominal aorta (8/21, 38.1%), followed by the iliac arteries (5/21, 23.8%). In the case of thrombosis, the most frequently involved arteries were the femoral (4/11, 36.4%) and iliac (4/11, 36.4%) arteries. The characteristics and locations of vascular involvement did not significantly differ according to the radiographic outcome. CONCLUSIONS: A considerable proportion of patients with BD with arterial involvement showed radiographic progression within 2-5 years. Patients with radiographic progression had a longer disease duration at baseline. The most common form of arterial involvement of BD was aneurysmal change, followed by thrombus formation. KEY POINTS: • This study evaluated for the first time the radiographic outcomes of 22 patients with Behçet's disease involving the aorta or its major branches. • A considerable proportion of patients (5/22, 22.7%) showed radiographic progression. • Patients with radiographic progression had a longer disease duration at baseline than their counterparts; however, no other clinical factors were significantly different. • The most frequent form of vascular involvement was pseudoaneurysm followed by thrombosis.

Association between female reproductive factors and gout: a nationwide population-based cohort study of 1 million postmenopausal women.

BACKGROUND: Previous studies have shown that the incidence and risk factors of gout differs according to sex. However, little research has been done on the association between reproductive factors and gout. We conducted an analysis of a large nationwide population-based cohort of postmenopausal women to determine whether there is an association between reproductive factors and the incidence of gout. METHODS: A total of 1,076,378 postmenopausal women aged 40-69 years who participated in national health screenings in 2009 were included in the study. The outcome was the occurrence of incident gout, which was defined using the ICD-10 code of gout (M10) in the claim database. Cox proportional hazard models were used for the analyses and stratified analyses according to body mass index (BMI) and the presence/absence of chronic kidney disease (CKD) were performed. RESULTS: The mean follow-up duration was 8.1 years, and incident cases of gout were 64,052 (incidence rate 7.31 per 1000 person-years). Later menarche, earlier menopause, and a shorter reproductive span were associated with a high risk of gout. No association between parity and gout incidence was observed. Use of oral contraceptives (OC) and hormone replacement therapy (HRT) were associated with an increased risk of gout. The association between reproductive factors and gout was not statistical significant in the high BMI group. The effects of OC and HRT usage on gout were not significant in the CKD group. CONCLUSION: Shorter exposure to endogenous estrogen was associated with a high risk of gout. Conversely, exposure to exogenous estrogen such as OC and HRT was associated with an increased risk of gout.

Effect of fruit thermal processing on ethyl carbamate content in maesil (Prunus mume) liqueur.

The thermal effect of maesil on the content of ethyl carbamate and its precursors during one-year ripening of maesil liqueur was investigated. Fresh maesil (control), fruit blanched for 2 min (blanched), and fruit blanched and dried for 15 h at 50 °C (blanched/dried) were soaked in the liquor containing 25% alcohol at a ratio of 1:2 (w/w) for 100 days at 25 °C and the liquid was further ripened for 260 days. Ethyl carbamate ranged from 13.1 to 204.4 µg/kg with the highest value at 210 day. Thermally treated samples had higher ethyl carbamate concentration than the control, suggesting that thermal treatment increased the formation of ethyl carbamate. A positive correlation between ethyl carbamate content and ß-glucosidase activity in all samples indicated that enzymatic hydrolysis of amygdalin by ß-glucosidase determined ethyl carbamate concentration during the fermentation of maesil liqueur.

A cluster analysis of patients with axial spondyloarthritis using tumour necrosis factor alpha inhibitors based on clinical characteristics.

BACKGROUND: This study aimed to classify the distinct group of patients with axial spondyloarthritis (SpA) on tumour necrosis factor alpha inhibitors (TNFi) according to the baseline characteristics using a clustering algorithm. METHODS: The clinical characteristics and demographic data of patients with axial SpA included in the Korean College of Rheumatology Biologics and Targeted Therapy registry were investigated. The patterns of disease manifestations were examined using divisive hierarchical cluster analysis. After clustering, we compared the clinical characteristics of patients and the drug survival of TNFi between the classified groups. RESULTS: A total of 1042 patients were analysed. The cluster analysis classified patients into two groups: axial group predominantly showing isolated axial manifestations (n = 828) and extra-axial group more frequently showing extra-axial symptoms (n = 214). Almost all extra-axial symptoms (peripheral arthritis, enthesitis, uveitis, and psoriasis) were more frequently observed in the extra-axial group than in the axial group. Moreover, patients in the extra-axial group had shorter disease duration, later disease onset, and higher disease activity than those in the axial group. The disease activity was comparable between the two groups after 1 year of treatment with TNFi. Interestingly, the extra-axial group had a lower drug survival with TNFi than the axial group (p = 0.001). CONCLUSIONS: Cluster analysis of patients with axial SpA using TNFi classified two distinct clinical phenotypes. These clusters had different TNFi drug survival, clinical characteristics, and disease activity.

Cellular uptake of anthocyanins extracted from black soybean, grape, and purple sweet potato using INT-407 cells.

This study combined in vitro digestion and INT-407 cells to evaluate the bioaccessibility of anthocyanins in the small intestinal epithelial cells. Black soybean, grape, and purple sweet potato were chosen as they have a different anthocyanin composition. After the aqueous extract was digested under in vitro gastric and intestinal conditions, the digested mixture was incubated in the media of INT-407 for 2 h at 37 °C. Low proportion (< 0.3%) of anthocyanins in black soybean and grape passed through cell membranes. Cyanidin-3-O-glucoside and pelargonidin-3-O-glucoside in black soybean and cyanidin-3-O-(6-O-p-coumaroyl)-5-O-diglucoside and delphinidin-3-O-(6-O-p-coumaroyl)-5-O-diglucoside in grape were found inside the cell. However, acylated anthocyanins containing three sugar moieties in purple sweet potato were not detected inside the cell. p-Coumaric acid was detected in the cells incubated with grape, but not in the media. These indicate that chemical structure of anthocyanins affected their cellular uptake and antioxidant activity in INT-407 cells. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10068-021-00976-y.

Machine learning-based prediction model for responses of bDMARDs in patients with rheumatoid arthritis and ankylosing spondylitis.

BACKGROUND: Few studies on rheumatoid arthritis (RA) have generated machine learning models to predict biologic disease-modifying antirheumatic drugs (bDMARDs) responses; however, these studies included insufficient analysis on important features. Moreover, machine learning is yet to be used to predict bDMARD responses in ankylosing spondylitis (AS). Thus, in this study, machine learning was used to predict such responses in RA and AS patients. METHODS: Data were retrieved from the Korean College of Rheumatology Biologics therapy (KOBIO) registry. The number of RA and AS patients in the training dataset were 625 and 611, respectively. We prepared independent test datasets that did not participate in any process of generating machine learning models. Baseline clinical characteristics were used as input features. Responders were defined as those who met the ACR 20% improvement response criteria (ACR20) and ASAS 20% improvement response criteria (ASAS20) in RA and AS, respectively, at the first follow-up. Multiple machine learning methods, including random forest (RF-method), were used to generate models to predict bDMARD responses, and we compared them with the logistic regression model. RESULTS: The RF-method model had superior prediction performance to logistic regression model (accuracy: 0.726 [95% confidence interval (CI): 0.725-0.730] vs. 0.689 [0.606-0.717], area under curve (AUC) of the receiver operating characteristic curve (ROC) 0.638 [0.576-0.658] vs. 0.565 [0.493-0.605], F1 score 0.841 [0.837-0.843] vs. 0.803 [0.732-0.828], AUC of the precision-recall curve 0.808 [0.763-0.829] vs. 0.754 [0.714-0.789]) with independent test datasets in patients with RA. However, machine learning and logistic regression exhibited similar prediction performance in AS patients. Furthermore, the patient self-reporting scales, which are patient global assessment of disease activity (PtGA) in RA and Bath Ankylosing Spondylitis Functional Index (BASFI) in AS, were revealed as the most important features in both diseases. CONCLUSIONS: RF-method exhibited superior prediction performance for responses of bDMARDs to a conventional statistical method, i.e., logistic regression, in RA patients. In contrast, despite the comparable size of the dataset, machine learning did not outperform in AS patients. The most important features of both diseases, according to feature importance analysis were patient self-reporting scales.

How much does fat mass change affect serum uric acid levels among apparently clinically healthy Korean men?

OBJECTIVE: The aim of this study was to examine the impact of fat mass alteration on serum uric acid (SUA) levels in apparently clinically healthy men. METHODS: We evaluated 27,387 men who consecutively underwent health check ups between 2015 and 2017. We assessed the likelihood of achieving a SUA level of <0.41 mmol/L and compared the SUA levels according to fat mass changes. RESULTS: Compared with those without fat mass change (the reference group), the odds ratios (95% confidence interval) of achieving a SUA level of <0.41 mmol/L for fat mass decreases of ⩾2.5, 1.5-2.5, and 0.5-1.5 kg were 1.63 (1.45-1.82), 1.19 (1.06-1.34), and 1.07 (0.97-1.18), respectively, while those for a fat mass increase of ⩾2.5, 1.5-2.5, and 0.5-1.5 kg were 0.71 (0.64-0.78), 0.87 (0.79-0.97), and 0.95 (0.86-1.04), respectively. The corresponding beta-coefficients of SUA levels (mmol/L) were -0.26 [-0.29-(-0.23)], -0.12 [-0.16-(-0.09)], and -0.09 [-0.12-(-0.06)] for fat mass decreases of ⩾2.5, 1.5-2.5, and 0.5-1.5 kg, respectively. Every 1-kg fat mass reduction was associated with 9% increased odds of achieving the target SUA level. The multivariate SUA level difference per 1-kg fat mass gain was 2.97 µmol/L. Similar levels of association persisted among the prespecified subgroups. CONCLUSION: We quantitatively demonstrated that fat mass reduction contributes to a clinically relevant decrease in SUA levels and a significant increase in the likelihood of achieving target SUA levels. Our findings may help to provide clear clinical guidance on fat mass alteration to reduce SUA levels in patients with hyperuricemia.

Factors associated with radiographic progression in patients with Takayasu's arteritis.

OBJECTIVES: To identify the factors related to radiographic progression in patients with Takayasu's arteritis (TAK). METHODS: A retrospective cohort study was conducted among patients with TAK who underwent computed tomography angiography (CTA) at least twice in a 2-5-year interval. Radiographic progression was defined as newly developed and/or aggravated (more than 20%) characteristic CTA findings. Correlation analysis was performed using a multivariate Cox regression model. RESULTS: The cohort included 153 TAK patients with a mean CTA interval of 3.53 years, and 24 (15.7%) showed radiographic progression. Those with progression showed higher acute-phase reactant levels (erythrocyte sedimentation rate [ESR], 26.06 vs. 35.72 mm/h, p=0.040; C-reactive protein [CRP], 0.45 vs. 1.13 mg/dL, p<0.001), were younger at the initial CTA (43.70 vs. 31.81 years, p<0.001), and were more likely to be receiving immunosuppressants (14 [10.9%] vs. 7 [29.2%] patients, p=0.038). Multivariate Cox regression analysis revealed age at the initial CTA (hazard ratio [HR]=0.945, confidence interval [CI]=0.898-0.995, p=0.030) and area under the curve (AUC) of CRP levels (HR=2.126, CI=1.046-4.319, p=0.037) as significant factors for radiographic progression. In a subgroup of patients with high CRP levels, 30.4% (14/24) showed progression; only age at the initial CTA was significantly different (37.03 vs. 27.10 years, p=0.012) between those with and without progression. CONCLUSIONS: Higher CRP levels and younger age were risk factors of radiographic progression in patients with TAK. In the high CRP group, younger patients are more prone to progression and may need aggressive anti-inflammatory treatment.

The Effects of Sex and Estrogen on Radiographic Progression of Ankylosing Spondylitis in Korean Patients.

Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease with obvious male preponderance Males show more severe radiographic manifestations compared with females This study aimed to evaluate the effects of sex and estrogen on the radiographic progression of AS. Methods: A total of 101 patients with AS were included in this study All of the radiographs were scored using the modified Stoke AS Spine Score (mSASSS) Serum levels of 17ß-estradiol (E2), dickkopf-1 (Dkk1), and leptin were detected by enzyme-linked immunosorbent assay The generalized estimating equations model was used to evaluate factors associated with spinal radiographic progression. Results: The mean age at disease onset was 273±107 years, and 16 patients (158%) were female In the multivariable analysis, body mass index (ß-coefficient=012; p=0047) and levels of Dkk1 (ß-coefficient=-011; p<0001), and female (ß-coefficient=-140; p=0001) were associated with radiographic progression Among male patients with AS, baseline C-reactive protein (ß=011; p=0005) and mSASSS (ß=021; p=0030) were also associated with radiographic progression E2 and leptin levels were not significantly related to the radiographic progression. Conclusion: Although female patients were associated with less radiographic progression in AS, there was no significant relationship between serum estrogen level and radiographic progression Results of current study suggests that genetic factors or other environmental factors associated with female may influence radiographic progression in patients with AS.

KOBIO, the First Web-based Korean Biologics Registry Operated With a Unified Platform Among Distinct Disease Entities.

The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.

Assessment of estimated daily intake of 3-monochloropropane-1,2-diol from soy sauce in Korea.

Soy sauces collected from the Korean market were determined for 3-monochloropropane-1,2-diol (3-MCPD) and daily intake of 3-MCPD through the consumption of soy sauce was estimated. Thirty-one samples were chosen based on a market share in 2017. The amount of 3-MCPD varied from not detected to 54.97 µg/kg with a mean value of 11.62 µg/kg. Seven soy sauces, which corresponded to 23% of the analysed samples, exceeded 20 µg/kg that is a maximum limit established by the Ministry of Food and Drug Safety in Korea. Daily intake of 3-MCPD was estimated as 1.22 ng/kg body weight (bw) for average consumers and 4.47 ng/kg bw for 95th high consumers, respectively. The exposure for average consumers amounted to 0.03-0.11% of the provisional maximum tolerable daily intake (PMTDI, 4 µg/kg bw). This indicates that the exposure to 3-MCPD from soy sauce is of low concern in the Korean population.