• Korean Journal of Community Nutrition
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• v.26 no.3
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• pp.211-227
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• 2021

Objectives: We aimed to examine the association between the relative preference for vegetables and meat and cancer incidence, in a population-based retrospective cohort in Korea. Methods: We included 10,148,131 participants (5,794,124 men; 4,354,007 women) who underwent national health screening between 2004 and 2005 from the National Health Information Database of the National Health Insurance Service (NHIS-NHID). Participants were asked whether they preferred consuming 1) vegetables more often, 2) both vegetables and meat or 3) meat more often. Participants were followed up to Dec. 31, 2017. All cancer and eighteen common cancer cases were identified through the code from the International Classification of Diseases, 10th revision. We estimated sex-specific relative risks and 95% confidence intervals, adjusting for age, body mass index, alcohol consumption, smoking, physical activity, and income level. Results: During an average follow-up of 12.4 years, 714,170 cancer cases were documented. In men, consuming meat more often was associated with lower risk of esophageal, liver, and stomach cancers, but higher risk of lung and kidney cancers. Consuming both vegetables and meat was associated with higher risk of prostate cancer, but with lower risk of esophageal, liver, and stomach cancers in men. In women, consuming meat more often was associated with a higher risk of colorectal cancer and breast, endometrial, and cervical cancers diagnosed before the age of 50. Consuming both vegetables and meat was associated with lower risk of liver cancer in women. Conclusions: Our study suggests a potential link between vegetable and meat intake and cancer incidence in the Korean population. Further investigation on the association between the intake of specific types of vegetables and meat and cancer risk in Korean prospective cohort studies is needed.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.194-203
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• 2018

Background: Bone fractures are high in elderly patients with type 2 diabetes mellitus (T2DM). Hyperglycemia and chronic kidney disease may increase the risk of fracture prevalence via altered bone metabolism, but whether glycemic control and kidney function are associated with the risk of fracture prevalence remains unclear. This study evaluated the relationship between glycemic control and baseline estimated glomerular filtration rate (eGFR) and risk of fracture prevalence in older and middle-aged patients with T2DM. Methods: Patients who underwent a general medical check-up between 2009 and 2013 were selected from the Korean National Health Insurance Sharing Service records. Chi-square test and multiple logistic regression analysis were used to assess the relationship between glycemic control and eGFR and risk of fracture prevalence. Results: Cumulative fracture prevalence were higher in patients with T2DM, irrespective of whether they had tight or less stringent glycemic control (fasting blood glucose [FBG] ${\geq}110mg/dL$). After adjustment for baseline age and FBG, tight and less stringent glycemic control was significantly associated with increased adjusted risk of fracture prevalence in middle-aged patients with T2DM (OR=1.13, 95% CI, 1.05-1.21, p=0.0005 vs OR=1.13, 95% CI, 1.06-1.20, p=0.0001), but not in older patients. Baseline eGFR was not significantly related to fracture prevalence in either older or middle-aged patients. Conclusion: Less stringent glycemic control significantly increased the adjusted risk of fracture prevalence in middle-aged patients with T2DM. Further studies are needed to confirm the effect of tight glycemic control on fracture prevalence.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.1
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• pp.49-57
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• 2020

Objectives: This study aimed to understand the nationwide patterns of antibiotic prescription after tooth extraction in adult patients. Materials and Methods: This study analyzed dental records from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database on 503,725 tooth extractions performed in adults (≥19 years) during 2011-2015. Patient sex, age, household income, systemic disease (diabetes mellitus and hypertension), type of dental institution, region of dental institution, year of prescription, and type of tooth extraction procedure were considered. The antibiotic prescription rate and broad-spectrum antibiotic prescription frequency were analyzed using chi-squared tests. Factors affecting the prescription of broad-spectrum antibiotics were evaluated using multivariate logistic regression analysis. Results: The rate of antibiotic prescription after tooth extraction was 81.85%. Penicillin was most commonly prescribed (45.25%), followed by penicillin with beta-lactamase inhibitors (18.76%), metronidazole (12.29%), and second- to fourth-generation cephalosporins (11.52%). The proportion of broad-spectrum antibiotics used among all prescribed antibiotics was 45.88%. Conclusion: The findings of this study demonstrate that the rate of antibiotic prescription after tooth extraction is higher in Korea than in other countries. Furthermore, broad-spectrum antibiotics are used more frequently, which may indicate unnecessary drug prescription, an important contributor to antibiotic resistance.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2783-2787
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• 2013

To assess the risk of cancer incidence after medical radiation exposure for coronary artery disease (CAD), a retrospective cohort study was conducted based on Taiwan's National Health Insurance Research Database (NHIRD). Patients with CAD were identified according to the International Classification of Diseases code, 9th Revision, Clinical Modification (ICD-9-CM), and their records of medical radiation procedures were collected from 1997 to 2010. A total of 18,697 subjects with radiation exposure from cardiac imaging or therapeutic procedures for CAD were enrolled, and 19,109 subjects receiving cardiac diagnostic procedures without radiation were adopted as the control group. The distributions of age and gender were similar between the two populations. Cancer risks were evaluated by age-adjusted incidence rate ratio (aIRR) and association with cumulative exposure were further evaluated with relative risks by Poisson regression analysis. A total of 954 and 885 subjects with various types of cancers in both cohorts after following up for over 10 years were found, with incidences of 409.8 and 388.0 per 100,000 person-years, respectively. The risk of breast cancer (aIRR=1.85, 95% confidence interval: 1.14-3.00) was significantly elevated in the exposed female subjects, but no significant cancer risk was found in the exposed males. In addition, cancer risks of the breast and lung were increased with the exposure level. The study suggests that radiation exposure from cardiac imaging or therapeutic procedures for CAD may be associated with the increased risk of breast and lung cancers in CAD patients.

• Journal of dental hygiene science
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• v.24 no.1
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• pp.22-28
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• 2024

Background: Particulate matter (PM) has been extensively observed due to its negative association with human health. Previous research revealed the possible negative effect of air pollutant exposure on oral health. However, the predictive model between air pollutant exposure and the prevalence of periodontitis has not been observed yet. Therefore, this study aims to propose a predictive model for the number of patients with periodontitis exposed to PM and atmospheric factors in South Korea using deep learning. Methods: This study is a retrospective cohort study utilizing secondary data from the Korean Statistical Information Service and the Health Insurance Review and Assessment database for air pollution and the number of patients with periodontitis, respectively. Data from 2015 to 2022 were collected and consolidated every month, organized by region. Following data matching and management, the deep neural networks (DNN) model was applied, and the mean absolute percentage error (MAPE) value was calculated to ensure the accuracy of the model. Results: As we evaluated the DNN model with MAPE, the multivariate model of air pollution including exposure to PM_2.5, PM₁₀, and other atmospheric factors predict approximately 85% of the number of patients with periodontitis. The MAPE value ranged from 12.85 to 17.10 (mean±standard deviation=14.12±1.30), indicating a commendable level of accuracy. Conclusion: In this study, the predictive model for the number of patients with periodontitis is developed based on air pollution, including exposure to PM_2.5, PM₁₀, and other atmospheric factors. Additionally, various relevant factors are incorporated into the developed predictive model to elucidate specific causal relationships. It is anticipated that future research will lead to the development of a more accurate model for predicting the number of patients with periodontitis.

• Korean Journal of Clinical Pharmacy
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• v.29 no.4
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• pp.278-285
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• 2019

Background: Rheumatoid arthritis is highly prevalent in overweight patients with type 2 diabetes mellitus and can be reduced by physical activity via altered proinflammatory parameters. However, the association between the frequency of physical activity and the prevalence of rheumatoid arthritis in prediabetic patients remains unclear and was evaluated in this study. Methods: Utilizing the Korean National Health Insurance Sharing Service database, 58,391 adults, who met the research criteria and underwent a general medical check-up between 2009 and 2013, were selected for this study. To analyze the data, a logistic regression with a proc survey logistic procedure was used. Results: The study revealed that the cumulative rheumatoid arthritis prevalence was lower in prediabetic patients compared to that in the control group (OR, 0.64; 95% CI, 0.483-0.840; p=0.001). More frequent physical activity (≥3 days/week) was significantly associated with a reduced rheumatoid arthritis prevalence in both groups (OR, 0.28; 95% CI, 0.039-0.521; p=0.044 vs. OR, 0.15; 95% CI, 0.063-0.237; p=0.007). Additionally, a 3.8-fold higher risk of rheumatoid arthritis development was observed in prediabetic adults with less frequent baseline physical activity (≤2 days/week). Overall, in prediabetes, the prevalence of rheumatoid arthritis was associated with the frequency of physical activity and not with the fasting plasma glucose levels. Conclusion: More frequent physical activity is associated with a low risk of developing rheumatoid arthritis in prediabetic patients. Thus, further studies are needed to confirm the clinical outcomes of frequent physical activity in rheumatoid arthritis prevention and control.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.261-271
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• 2024

Background/Aims: Mucoprotective agents, such as eupatilin, are often prescribed to prevent gastrointestinal (GI) bleeding in addition to an acid suppressant despite the absence of a large-scale study. We evaluated the additional effect of eupatilin on the prevention of GI bleeding in both the upper and lower GI tract in concomitant aspirin and acid suppressant users using the nationwide database of national claims data from the Korean National Health Insurance Service (NHIS). Methods: An aspirin cohort was constructed using the NHIS claims data from 2013 to 2020. Patients who manifested with hematemesis, melena, or hematochezia were considered to have GI bleeding. A Cox proportional hazards regression model was used to determine the risk factors for GI bleeding associated with the concomitant use of GI drugs and other covariates among aspirin users. Results: Overall, a total of 432,208 aspirin users were included. The concurrent use of an acid suppressant and eupatilin (hazard ratio [HR] = 0.85, p = 0.016, vs. acid suppressant only) was a statistically significant preventive factor for GI bleeding. Moreover, a more than 3-month duration (HR = 0.88, p = 0.030) of acid suppressant and eupatilin prescription (vs. acid suppressant only) was a statistically significant preventive factor for GI bleeding. Conclusions: Eupatilin administration for ≥ 3 months showed additional preventive effect on GI bleeding in concomitant aspirin and acid suppressant users. Thus, cotreatment with eupatilin with a duration of 3 months or longer is recommended for reducing GI bleeding among aspirin plus acid suppressant users.

• Korean Circulation Journal
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• v.54 no.5
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• pp.256-267
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• 2024

Background and Objectives: Accumulating evidence shows that sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce adverse cardiovascular outcomes. However, whether SGLT2i, compared with other antidiabetic drugs, reduce the new development of atrial fibrillation (AF) is unclear. In this study, we compared SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4is) in terms of reduction in the risk of AF in individuals with type 2 diabetes. Methods: We included 42,786 propensity score-matched pairs of SGLT2i and DPP-4i users without previous AF diagnosis using the Korean National Health Insurance Service database between May 1, 2016, and December 31, 2018. Results: During a median follow-up of 1.3 years, SGLT2i users had a lower incidence of AF than DPP-4i users (1.95 vs. 2.65 per 1,000 person-years; hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.97; p=0.028]). In individuals without heart failure, SGLT2i users was associated with a decreased risk of AF incidence (HR, 0.70; 95% CI, 0.52-0.94; p=0.019) compared to DPP-4i users. However, individuals with heart failure, SGLT2i users was not significantly associated with a change in risk (HR, 1.04; 95% CI, 0.44-2.44; p=0.936). Conclusions: In this nationwide cohort study of individuals with type 2 diabetes, treatment with SGLT2i was associated with a lower risk of AF compared with treatment with DPP-4i.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.295-305
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• 2024

Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time. Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran-Armitage trend test. Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (p = 0.028). Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.

• Journal of Korean Neurosurgical Society
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• v.62 no.2
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• pp.217-224
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• 2019

Objective : We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death. Methods : We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities. Results : During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p<0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p<0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups. Conclusion : The incidence rates of congestive heart failure and death were increased in AS patients.