Salivary flow rate and the risk of cognitive impairment among Korean elders: a cross-sectional study

Background Salivary function has been suggested to be associated with cognitive impairment. However, the effect of salivary flow rate (SFR) on cognitive impairment remains unclear. This study aimed to investigate whether SFR is associated with cognitive impairment among Korean elders. Methods This cross-sectional study included 649 elders aged 65 and older in the Korean community-dwelling population. Cognitive impairment was assessed using the Mini-Mental Status Examination. Unstimulated SFR was measured and dichotomized. Denture status, age, sex, education level, smoking, drinking, diabetes, hypertension, and obesity were considered confounders. Multivariable logistic regression analysis was applied to assess the adjusted association. Stratified analysis by sex and denture status was performed to clarify the effect modification. Results Participants without cognitive impairment showed a higher SFR level than those with cognitive impairment (0.81 mL/min for non-cognitive impairment versus 0.52 mL/min for cognitive impairment, p < 0.001). After controlling for confounders, participants with low SFR (< 0.3 mL/min) were more likely to have cognitive impairment by 1.5 times than participants with normal SFR (odds ratio [OR] = 1.5, confidence interval [CI] = 1.05–2.10). The association of low SFR with cognitive impairment was higher in women and dentate participants: about 10% higher in women (OR = 1.63, CI = 1.07–2.50) and about 22% higher in dentate participants (OR = 1.82, CI = 1.41–2.90). Conclusions Salivary flow rate is independently associated with cognitive impairment among Korean elders. The association was modified in females and dentate elders. Physicians and dentists should consider low SFR and cognitive impairment as a risk factor between them in clinics.This study had financial support through HDK from the National Research Foundation (NRF) of the Ministry of Science and ICT, Korea (NRF2017M3A9B6062986) and the Korea Centers for Disease Control and Prevention (2018P330400) that did not do anything for the submitted wor

Association of smoking cessation after atrial fibrillation diagnosis on the risk of cardiovascular disease: a cohort study of South Korean men

While smoking elevates the risk for cardiovascular disease (CVD) among atrial fibrillation (AF) patients, whether smoking cessation after AF diagnosis actually leads to reduced CVD risk is unclear. We aimed to determine the association of smoking cessation after AF diagnosis with subsequent CVD Risk among South Korean men. This retrospective cohort study included 2372 newly diagnosed AF male patients during 2003–2012 from the Korean National Health Insurance Service database. Self-reported smoking status within 2 years before and after diagnosis date were determined, after which the participants were divided into continual smokers, quitters (smokers who quit after AF diagnosis), sustained-ex smokers (those who quit prior to AF diagnosis), and never smokers. Participants were followed up from 2 years after AF diagnosis until 31 December 2015 for CVD. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence interval (CIs) for CVD according to the change in smoking habits before and after AF diagnosis. The mean (standard deviation, minimum-maximum) age of the study subjects was 62.5 (8.6, 41–89) years. Among AF patients, quitters had 35% reduced risk (aHR 0.65, 95% CI 0.44–0.97) and never smokers had 32% reduced risk (aHR 0.68, 95% CI 0.52–0.90) for CVD compared to continual smokers (p for trend 0.020). Similarly, compared to continual smokers, quitters had 41% risk-reduction (aHR 0.59, 95% CI 0.35–0.99) and never smokers 34% risk-reduction (aHR 0.66, 95% CI 0.46–0.93) for total stroke (p for trend 0.047). Quitters had 50% reduction (aHR 0.50, 95% CI 0.27–0.94), sustained ex-smokers had 36% reduction (aHR 0.64, 95% CI 0.42–0.99), and never smokers had 39% reduction (aHR 0.61, 95% CI 0.41–0.91) in ischemic stroke risk (p for trend 0.047). The risk-reducing effect of quitting on CVD risk tended to be preserved regardless of aspirin or warfarin use. Smoking cessation after AF diagnosis was associated with reduced CVD, total stroke, and ischemic stroke risk

Morphometric Variation in Pine Wood Nematodes, Bursaphelenchus xylophilus and B. mucronatus, Isolated from Multiple Locations in South Korea

Intraspecific variation in morphometry of pine wood nematodes Bursaphelenchus xylophilus and B. mucronatus in relation to geographical locations in South Korea was investigated using morphometric characters (body length, a, b and c ratio, stylet length, and spicule length for a male nematode and V (%) value for a female nematode). B. xylophilus was isolated from Pinus thunbergii in Jinju (1998), Ulsan (2000), Yangsan (2000), Mokpo (2001) and Jeju (2004), and from P. densiflora in Gumi (2001). B. mucronatus was isolated from P. thunbergii in Jinju (1991) and from P. densiflora in Milyang (2001). The body length of male and female B. xylophilus had the highest coefficient of variability and showed significant differences among geographical locations. The V (%) value for female B. xylophilus showed the lowest coefficient of variability, changing little with geographical area and host plant. All morphometric characters in B. mucronatus except for stylet length and female body length showed no significant differences between locations or hosts, suggesting they may not be affected by geographical area or host plant

Migration and Attacking Ability of Bursaphelenchus mucronatus in Pinus thunbergii Stem Cuttings

To understand how Bursaphelenchus xylophilus kills pine trees, the differences between the effects of B. xylophilus and B. mucronatus on pine trees are usually compared. In this study, the migration and attacking ability of a non-pathogenic B. mucronatus in Pinus thunbergii were investigated. The distribution of B. mucronatus and the number of dead epithelial cells resulting from inoculation were compared with those of the pathogenic B. xylophilus. Although B. mucronatus is non-pathogenic in pines, its distribution pattern in P. thunbergii was the same as that of B. xylophilus. We therefore concluded that the non-pathogenicity of B. mucronatus could not be attributed to its migration ability. The sparse and sporadic attacking pattern of B. mucronatus was also the same as that of B. xylophilus. However, the number and area of the dead epithelial cells in pine cuttings inoculated with B. mucronatus were smaller than in those cuttings inoculated with B. xylophilus, meaning that the attacking ability of B. mucronatus is weaker than that of B. xylophilus. Therefore, we concluded that the weaker attacking ability of B. mucronatus might be the factor responsible for the non-pathogenicity

Association of pre-existing depression with all-cause, cancer-related, and noncancer-related mortality among 5-year cancer survivors: a population-based cohort study

Previous studies on the association between mental health and mortality in patients with cancer have reported contradictory results. We conducted a population-based cohort study to determine whether pre-existing depression is associated with all-cause and cause-specific mortality after cancer diagnosis. We included 5-year cancer survivors, identified from the National Health Insurance Scheme Health Screening Cohort between January 1, 2004 and December 31, 2009. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals (CI) to assess the association between pre-existing depression and all-cause, cancer-related, and noncancer-related mortality among 5-year cancer survivors. After adjustment for sociodemographics, lifestyle, and clinical status, the multivariable adjusted hazard ratios (95%CIs) for all-cause, cancer-related, and noncancer-related mortality among 5-year cancer survivors with pre-existing depression were 1.52 (1.13-2.05), 1.17 (0.75-1.81), and 2.07 (1.38-3.10) compared with those without pre-existing depression, respectively. Significant associations between pre-existing depression and mortalities (all-cause and noncancer-related mortality) were only observed among male cancer survivors. Our findings suggest that depression is associated with all-cause mortality after cancer diagnosis and that greater efforts should be focused on the long-term survival of patients with cancer with pre-existing depression, especially in male cancer survivors.Y

Changes in Body Composition Are Associated with Metabolic Changes and the Risk of Metabolic Syndrome

In a cohort of 190,599 participants from The National Health Insurance Service-National Health Screening (NHIS-HEALS) study, we investigated the association of changes in the predicted body composition and metabolic profiles with the risk of metabolic syndrome (MetS) in the general population, which was hitherto incompletely elucidated. At baseline and follow-up examinations, the body composition, including lean body mass (LBM), body fat mass (BFM), and appendicular skeletal mass (ASM), were estimated using a prediction equation, and the risk of MetS was analyzed according to relative body composition changes. An increase in relative LBM and ASM decreased the risk of MetS in men and women (adjusted odds ratio (aOR), 0.78 and 0.80; 95% confidence interval (CI), 0.77–0.79 and 0.79–0.81, respectively; all p p-trend < 0.001). In men, when the relative LBM increased (aOR, 0.68; 95% CI, 0.63–0.73), the risk of MetS was low despite increased BMI. Thus, our findings suggested that an increase in the relative LBM and ASM reduced the risk of MetS, whereas an increase in the relative BFMI increased the risk of MetS; this result was consistent in men despite an increase in BMI

Association of Air Pollutants with Incident Chronic Kidney Disease in a Nationally Representative Cohort of Korean Adults

(1) Background: There is limited information regarding association between long-term exposure to air pollutants and risk of chronic kidney disease (CKD) (2). Methods: This study acquired data of 164,093 adults aged at least 40 years who were residing in 7 metropolitan cities between 2002 and 2005 from the Korean National Health Insurance Service National Sample Cohort database. CKD risk was evaluated using the multivariate Cox hazards proportional regression. All participants were followed up with until CKD, death, or 31 December 2013, whichever occurred earliest. (3) Results: Among 1,259,461 person-years of follow-up investigation, CKD cases occurred in 1494 participants. Air pollutant exposures including PM10, SO2, NO2, CO, and O3 showed no significant association with incident CKD after adjustments for age, sex, household income, area of residence, and the Charlson comorbidity index. The results were consistent in the sensitivity analyses including first and last year annual exposure analyses as well as latent periods-washed-out analyses. (4) Conclusions: Long-term exposure to air pollution is not likely to increase the risk of CKD

Blood Pressure Change from Normal to 2017 ACC/AHA Defined Stage 1 Hypertension and Cardiovascular Risk

The purpose of this study was to investigate the clinical significance of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) defined stage 1 hypertension (systolic blood pressure (SBP) 130&ndash;139 mmHg or diastolic blood pressure (DBP) 80&ndash;89 mmHg), and increase in BP from previously normal BP in Korean adults. We conducted a retrospective analysis of 60,866 participants from a nationally representative claims database. Study subjects had normal BP (SBP &lt; 120 mmHg and DBP &lt; 80 mmHg), no history of anti-hypertensive medication, and cardiovascular disease (CVD) in the first period (2002&ndash;2003). The BP change was defined according to the BP difference between the first and second period (2004&ndash;2005). We used time-dependent Cox proportional hazards models in order to evaluate the effect of BP elevation on mortality and CVD with a mean follow-up of 7.8 years. Compared to those who maintained normal BP during the second period, participants with BP elevation from normal BP to stage 1 hypertension had a higher risk for CVD (adjusted hazard ratio (aHR) 1.23; 95% confidence interval (CI), 1.08&ndash;1.40), and ischemic stroke (aHR 1.32; 95% CI, 1.06&ndash;1.64). BP elevation to 2017 ACC/AHA defined elevated BP (SBP 120&ndash;129 mmHg and DBP &lt; 80 mmHg) was associated with an increased risk of CVD (aHR 1.26; 95% CI, 1.06&ndash;1.50), but stage 1 isolated diastolic hypertension (SBP &lt; 130 and DBP 80&ndash;89 mmHg) was not significantly related with CVD risk (aHR 1.12; 95% CI, 0.95&ndash;1.31)

The effect of change in fasting glucose on the risk of myocardial infarction, stroke, and all-cause mortality: a nationwide cohort study

Abstract Background The effect of change in blood glucose levels on the risk of cardiovascular disease among individuals without diabetes is currently unclear. We aimed to examine the association of change in fasting serum glucose with incident cardiovascular disease and all-cause mortality among representative large population. Methods We analyzed the data from retrospective cohort of Korean National Health Insurance Service. In total, 260,487 Korean adults aged over 40 years, without diabetes mellitus and cardiovascular disease at baseline measured change in fasting serum glucose according to the criteria of impaired and diabetic fasting glucose status: normal fasting glucose (NFG, fasting glucose: < 100 mg/dL), impaired fasting glucose (IFG, fasting glucose: 100.0–125.9 mg/dL), and diabetic fasting glucose (DFG, fasting glucose: ≥ 126.0 mg/dL). Compared to the persistently unchanged group (i.e. NFG to NFG or IFG to IFG), Cox proportional hazards regression analyses were performed in the changed group to obtain the hazards ratio (HR) with 95% confidence interval (CI) for the subsequent median 8-year myocardial infarction, stroke, and all-cause mortality. Results Compared to individuals with persistent NFG (i.e., NFG to NFG), individuals who shifted from NFG to DFG had an increased risk of stroke (HR [95% CI]: 1.19 [1.02–1.38]) and individuals who shifted from NFG to IFG or DFG had increased risks of all-cause mortality (HR [95% CI]: 1.08 [1.02–1.14] for NFG to IFG and 1.56 [1.39–1.75] for NFG to DFG). Compared to individuals with persistent IFG, individuals who shifted from IFG to DFG had an increased risk of MI and all-cause mortality (HR [95% CI]: 1.65 [1.20–2.27] and 1.16 [1.02–1.33], respectively). Conclusions Increasing fasting glucose in non-diabetic population is associated with risks of the MI, stroke, and all-cause mortality, which is more rapid, more severe

Association between Proton Pump Inhibitor Use and Risk of Hepatocellular Carcinoma: A Korean Nationally Representative Cohort Study

(1) Background: The association between proton pump inhibitor (PPI) use and hepatocellular carcinoma (HCC) has been controversial, especially in the general population. We aimed to determine the impact of PPI on HCC risk in participants without liver cirrhosis or chronic hepatitis virus infection. (2) Methods: We assessed 406,057 participants from the Korean National Health Insurance Service database who underwent health screening from 2003 to 2006. We evaluated exposure to PPI before the index date using a standardized daily defined dose (DDD) system. The association of proton pump inhibitor use with the risk of HCC was evaluated using multivariable-adjusted Cox proportional hazards regression. (3) Results: Compared with non-users, PPI use was not associated with the HCC risk in low (<30 DDDs; aHR, 1.07; 95% CI, 0.91–1.27), intermediate (30 ≤ PPI < 60 DDDs; aHR, 0.96; 95% CI, 0.73–1.26), and high (≥60 DDDs; aHR, 0.86; 95% CI, 0.63–1.17) PPI groups in the final adjustment model. In addition, risks of cirrhosis-associated HCC and non-cirrhosis-associated HCC were not significantly associated with PPI use. The results remained consistent after excluding events that occurred within 1, 2, and 3 years to exclude pre-existing conditions that may be associated with the development of HCC. We also found no PPI-associated increase in HCC risk among the selected population, such as those with obesity, older age, and chronic liver diseases. (4) Conclusions: PPI use may not be associated with HCC risk regardless of the amount. We call for future studies conducted in other regions to generalize our findings