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Prevalence and risk factors for gallstone and renal stone formation in patients with intestinal Behçet's disease. 肠道白塞氏病患者胆石和肾结石形成的发病率和风险因素。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.3904/kjim.2024.006
Jaewon Song, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jihye Park, Jae Hee Cheon

Background/aims: The association between inflammatory bowel disease (IBD) and gallstone and renal stone formation has been established. However, few studies have investigated this association in patients with intestinal Behçet's disease (BD). We aimed to examine the prevalence of gallstones and renal stones in patients with intestinal BD and identify potential risk factors.

Methods: We analyzed gallstone and renal stone occurrences in 553 patients diagnosed with intestinal BD who had undergone cross-sectional imaging examinations between March 2005 and April 2021 at the IBD Center, Severance Hospital, Seoul, South Korea. Logistic regression models were used to identify risk factors for gallstone and renal stone formation.

Results: Of 553 patients over a mean 12.1-year duration, 141 (25.4%) patients had gallstones and 35 (6.3%) had renal stones. In multivariate logistic regression analysis, disease duration > 19 years (OR 2.91, 95% CI 1.56-5.44, 0.002). No significant correlation 0.001), prior intestinal BD-related surgery (OR 2.29, 95% CI 1.42-3.68, p < 0.001), and disease activity index for intestinal BD scores ≥ 75 (OR 2.23, 95% CI 1.12-4.45, p = 0.022) were associated with increased gallstone occurrence. A positive correlation was observed between renal stones, disease duration > 19 years (OR 5.61, 95% CI 1.98-15.90, p = 0.001) and frequent hospitalization (> 3 times) (OR 3.29, 95% CI 1.52-7.13, p = 0.002). No significant correlation was observed between gallstone and renal stone occurrence.

Conclusion: These findings contribute to greater understanding concerning gallstone and renal stone prevalence and associated risk factors in patients with intestinal BD.

背景/目的:炎症性肠病(IBD)与胆结石和肾结石形成之间的关联已被证实。然而,很少有研究调查肠道白塞氏病(BD)患者的这种关联。我们旨在研究肠道白塞氏病患者中胆结石和肾结石的发病率,并确定潜在的风险因素:我们分析了 2005 年 3 月至 2021 年 4 月期间在韩国首尔 Severance 医院 IBD 中心接受横断面成像检查的 553 名确诊为肠 BD 患者的胆结石和肾结石发生率。采用逻辑回归模型确定胆石和肾结石形成的风险因素:在平均病程为 12.1 年的 553 名患者中,141 人(25.4%)患有胆结石,35 人(6.3%)患有肾结石。在多变量逻辑回归分析中,病程大于 19 年(OR 2.91,95% CI 1.56-5.44,0.002)。无明显相关性,0.001)、既往肠道 BD 相关手术(OR 2.29,95% CI 1.42-3.68,p <0.001)和肠道 BD 疾病活动指数评分≥75(OR 2.23,95% CI 1.12-4.45,p = 0.022)与胆结石发生率增加相关。肾结石、病程大于 19 年(OR 5.61,95% CI 1.98-15.90,p = 0.001)和频繁住院(大于 3 次)(OR 3.29,95% CI 1.52-7.13,p = 0.002)之间呈正相关。胆结石与肾结石的发生无明显相关性:这些发现有助于进一步了解肠道 BD 患者中胆结石和肾结石的发病率及相关风险因素。
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引用次数: 0
High vegetable consumption and regular exercise are associated with better quality of life in patients with gout. 多吃蔬菜和经常锻炼与痛风患者生活质量的提高有关。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.3904/kjim.2023.476
Hyunsue Do, Hyo Jin Choi, Byoongyong Choi, Chang-Nam Son, Sang-Hyon Kim, You-Jung Ha, Ji Hyoun Kim, Min Jung Kim, Kichul Shin, Hyun-Ok Kim, Ran Song, Sung Won Lee, Joong Kyong Ahn, Seung-Geun Lee, Chang Hoon Lee, Kyeong Min Son, Ki Won Moon

Background/aims: The Gout Impact Scale (GIS), a part of the Gout Assessment Questionnaire 2.0, is used to measure gout-specific health-related quality of life (HRQOL). Although several studies have been conducted on the factors affecting the HRQOL of patients with gout, few have focused on lifestyle factors. This study aimed to investigate the correlation between lifestyle habits and HRQOL using the GIS in patients with gout.

Methods: We used data from the Urate-Lowering TheRApy in Gout (ULTRA) registry, a prospective cohort of Korean patients with gout treated at multiple centers nationwide. The patients were aged ≥18 years and met the 2015 American College of Rheumatology/European League Against Rheumatism gout classification criteria. They were asked to complete a GIS and questions regarding their lifestyle habits at enrollment.

Results: The study included 232 patients. 'Gout concern overall' scores in the GIS were significantly lower in patients who exercised more frequently and consumed soft drinks and meat less, and 'well-being during attack' scores were significantly lower in patients who consumed vegetables and exercised more frequently. The frequency of vegetable consumption had a negative linear relationship with the 'well-being during attack' and 'gout concern during attack' scores (p = 0.01, p = 0.001, respectively). The frequency of exercise had a negative linear relationship with the 'gout concern overall' and 'gout concern during attack' scores (p = 0.04 and p = 0.002, respectively).

Conclusion: Patients with gout who frequently consumed vegetables and exercised regularly experienced less impact of gout, exhibiting a better GIS that represented HRQOL.

背景/目的:痛风影响量表(GIS)是痛风评估问卷 2.0 的一部分,用于测量痛风特定的健康相关生活质量(HRQOL)。虽然已有多项研究探讨了影响痛风患者 HRQOL 的因素,但很少有研究关注生活方式因素。本研究旨在利用 GIS 调查痛风患者的生活习惯与 HRQOL 之间的相关性:我们使用的数据来自痛风中的尿酸盐降低疗法(ULTRA)登记,这是一个在全国多个中心接受治疗的韩国痛风患者的前瞻性队列。患者年龄≥18岁,符合2015年美国风湿病学会/欧洲抗风湿联盟痛风分类标准。他们在入组时被要求填写一份地理信息系统和有关其生活习惯的问题:研究共纳入 232 名患者。GIS中的 "痛风总体关注度 "得分在运动频率高、软饮料和肉类摄入量少的患者中明显较低,而 "发作时的舒适度 "得分在食用蔬菜和运动频率高的患者中明显较低。食用蔬菜的频率与 "痛风发作时的幸福感 "和 "痛风发作时的担忧 "得分呈负线性关系(分别为 p = 0.01 和 p = 0.001)。运动频率与 "对痛风的总体担忧 "和 "发作时对痛风的担忧 "得分呈负线性关系(分别为 p = 0.04 和 p = 0.002):结论:经常食用蔬菜并定期锻炼的痛风患者受痛风的影响较小,在代表 HRQOL 的 GIS 中表现较好。
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引用次数: 0
Patterns of hormonal changes in hypophysitis by immune checkpoint inhibitor. 免疫检查点抑制剂对肾上腺皮质功能减退症的荷尔蒙变化模式。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.3904/kjim.2023.523
Hyunji Sang, Yun Kyung Cho, Sang-Hyeok Go, Hwa Jung Kim, Eun Hee Koh

Background/aims: Immune checkpoint inhibitors (ICIs) can induce immune-related adverse events, including endocrine dysfunctions, which can have serious consequences on patient health and quality of life. The clinical course and characteristics of immune-related hypophysitis (irH) are not well established. This study aimed to analyze the clinical course and characteristics of irH.

Methods: This single-center, retrospective study analyzed data from electronic medical records of Asan Medical Center, spanning January 2017 through June 2021. It included adult patients with solid tumors who underwent thyroid and adrenal function tests, along with gonadotropin and/or growth hormone evaluations, following the initiation of ICI treatment within the same period. The study explored the clinical characteristics of ICI-treated patients with and without irH, the incidence of irH, the time to irH onset, and the associated hormonal changes.

Results: Twenty-one patients were included in this analysis. Clinical characteristics did not differ significantly between the irH (n = 13) and non-irH (n = 8) groups. Deficiency rates in the irH group were 23.1% for thyroid-stimulating hormone (n = 3), 76.9% for adrenocorticotropic hormone (n = 10), 61.5% for gonadotropin (n = 8), and 15.4% for growth hormone (n = 2). The overall incidence was 0.9 per person-year, with 6-month and 1-year cumulative incidences of 38.8% and 57.1%, respectively. The median time from ICI initiation to irH diagnosis was 7.7 months. Time to levothyroxine replacement was shorter in the irH group.

Conclusion: The findings provide evidence that could facilitate the prediction of ICI-induced irH based on clinical course and characteristics.

背景/目的:免疫检查点抑制剂(ICIs)可诱发免疫相关不良事件,包括内分泌功能障碍,从而对患者的健康和生活质量造成严重影响。免疫相关性肾上腺皮质功能减退症(irH)的临床过程和特征尚未明确。本研究旨在分析免疫相关性肾上腺皮质功能减退症的临床过程和特征:这项单中心回顾性研究分析了牙山医疗中心电子病历中的数据,时间跨度为 2017 年 1 月至 2021 年 6 月。研究对象包括同期开始接受 ICI 治疗并接受甲状腺和肾上腺功能检测以及促性腺激素和/或生长激素评估的实体瘤成人患者。研究探讨了接受 ICI 治疗的虹膜睫状体异常患者和未接受 ICI 治疗的虹膜睫状体异常患者的临床特征、虹膜睫状体异常的发生率、虹膜睫状体异常发生的时间以及相关的激素变化:本次分析共纳入 21 名患者。irH组(13人)和非irH组(8人)的临床特征无明显差异。irH组促甲状腺激素缺乏率为23.1%(3例),促肾上腺皮质激素缺乏率为76.9%(10例),促性腺激素缺乏率为61.5%(8例),生长激素缺乏率为15.4%(2例)。总发病率为 0.9 人/年,6 个月和 1 年的累计发病率分别为 38.8% 和 57.1%。从开始使用 ICI 到确诊虹膜性贫血的中位时间为 7.7 个月。虹膜性心脏病组患者更换左甲状腺素的时间更短:研究结果提供了证据,有助于根据临床病程和特征预测 ICI 诱导的虹膜性心脏病。
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引用次数: 0
Clinical effects of non-pharmaceutical interventions for COVID-19 on other nationally notifiable infectious diseases in South Korea. 针对 COVID-19 的非药物干预措施对韩国其他国家通报传染病的临床影响。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.3904/kjim.2023.501
Hyun-Jin Lee, Beom Seuk Hwang, Seong Ho Im, Seog-Kyun Mun, Munyoung Chang

Background/aims: This study aimed to assess the impact of non-pharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic on nationally notifiable infectious diseases (NNIDs) in South Korea.

Methods: Long-term data on seven NNIDs from 2018 to 2021 were analyzed to identify trends and change points using a change point detection technique. The timings of the NPI implementations were compared to the identified change points to determine their association.

Results: Varicella, mumps, and scarlet fever showed a significant decrease in incidence following the implementation of NPIs during the COVID-19 pandemic. These diseases, which are primarily transmitted through respiratory droplets, demonstrated a clear response to NPIs. However, carbapenem-resistant Enterobacterales (CRE) showed an increasing trend unrelated to the timing of NPI implementation, suggesting the complex nature of controlling healthcare-associated infections. Hepatitis A, hepatitis C, and scrub typhus did not show significant changes associated with NPIs, likely due to their non-respiratory route of transmission.

Conclusion: NPIs effectively controlled NNIDs, particularly those transmitted through respiratory infections. However, the impact varied depending on the disease. Understanding the effectiveness and limitations of NPIs is crucial for developing comprehensive public health strategies during infectious disease outbreaks.

背景/目的本研究旨在评估 COVID-19 大流行期间实施的非药物干预措施(NPIs)对韩国全国应报传染病(NNIDs)的影响:对 2018 年至 2021 年七种 NNID 的长期数据进行分析,利用变化点检测技术确定趋势和变化点。将 NPI 的实施时间与确定的变化点进行比较,以确定其关联性:结果:在 COVID-19 大流行期间实施 NPI 后,水痘、腮腺炎和猩红热的发病率显著下降。这些疾病主要通过呼吸道飞沫传播,对 NPIs 有明显的反应。然而,耐碳青霉烯类肠杆菌(CRE)的发病率呈上升趋势,与实施 NPI 的时间无关,这表明控制医疗相关感染的复杂性。甲型肝炎、丙型肝炎和恙虫病未显示出与 NPI 相关的显著变化,这可能是由于它们的传播途径与呼吸道无关:NPIs 有效控制了非传染性疾病,尤其是通过呼吸道感染传播的非传染性疾病。结论:非传染性疾病药物能有效控制非传染性疾病,尤其是通过呼吸道感染传播的非传染性疾病。了解非呼吸道感染药物的有效性和局限性对于在传染病爆发期间制定全面的公共卫生策略至关重要。
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引用次数: 0
Gut microbiota dysbiosis and its impact on asthma and other lung diseases: potential therapeutic approaches. 肠道微生物群失调及其对哮喘和其他肺部疾病的影响:潜在的治疗方法。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.3904/kjim.2023.451
Young-Chan Kim, Kyoung-Hee Sohn, Hye-Ryun Kang

The emerging field of gut-lung axis research has revealed a complex interplay between the gut microbiota and respiratory health, particularly in asthma. This review comprehensively explored the intricate relationship between these two systems, focusing on their influence on immune responses, inflammation, and the pathogenesis of respiratory diseases. Recent studies have demonstrated that gut microbiota dysbiosis can contribute to asthma onset and exacerbation, prompting investigations into therapeutic strategies to correct this imbalance. Probiotics and prebiotics, known for their ability to modulate gut microbial compositions, were discussed as potential interventions to restore immune homeostasis. The impact of antibiotics and metabolites, including short-chain fatty acids produced by the gut microbiota, on immune regulation was examined. Fecal microbiota transplantation has shown promise in various diseases, but its role in respiratory disorders is not established. Innovative approaches, including mucus transplants, inhaled probiotics, and microencapsulation strategies, have been proposed as novel therapeutic avenues. Despite challenges, including the sophisticated adaptability of microbial communities and the need for mechanistic clarity, the potential for microbiota-based interventions is considerable. Collaboration between researchers, clinicians, and other experts is essential to unravel the complexities of the gut-lung axis, paving a way for innovative strategies that could transform the management of respiratory diseases.

新兴的肠肺轴研究领域揭示了肠道微生物群与呼吸系统健康之间复杂的相互作用,尤其是在哮喘病中。本综述全面探讨了这两个系统之间错综复杂的关系,重点关注它们对免疫反应、炎症和呼吸系统疾病发病机制的影响。最近的研究表明,肠道微生物群失调可导致哮喘发病和加重,这促使人们研究纠正这种失衡的治疗策略。益生菌和益生元以其调节肠道微生物组成的能力而闻名,被认为是恢复免疫平衡的潜在干预措施。研究还探讨了抗生素和代谢物(包括肠道微生物群产生的短链脂肪酸)对免疫调节的影响。粪便微生物群移植已在多种疾病中显示出前景,但其在呼吸系统疾病中的作用尚未确定。创新方法,包括粘液移植、吸入益生菌和微胶囊策略,已被提出作为新的治疗途径。尽管微生物群落具有复杂的适应性,而且需要从机理上加以明确,但基于微生物群的干预措施潜力巨大。研究人员、临床医生和其他专家之间的合作对于揭示肠肺轴的复杂性至关重要,这将为改变呼吸系统疾病管理的创新策略铺平道路。
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引用次数: 0
A case of esophagogastric junctional outlet obstruction caused by thoracic aortic aneurysm. 一例由胸主动脉瘤引起的食管胃交界出口梗阻。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-05-22 DOI: 10.3904/kjim.2024.084
Jin Ook Jang, Tae Un Kim, Hwaseong Ryu, Byung-Soo Park, Su Jin Kim
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引用次数: 0
Efficacy of single-dose evolocumab injection in early-phase acute myocardial infarction: a retrospective single-center study. 单剂量伊夫洛单抗注射液对早期急性心肌梗死的疗效:一项回顾性单中心研究。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.3904/kjim.2024.080
Yongcheol Kim, Ji Woong Roh, Oh-Hyun Lee, Seok-Jae Heo, Eui Im, Deok-Kyu Cho, Byeong-Keuk Kim

Background/aims: Achieving rapid reduction of low-density lipoprotein cholesterol (LDL-C) levels below 55 mg/dL in patients with acute myocardial infarction (AMI) can be challenging with statins alone. This single-center, retrospective study aimed to assess the impact of single-dose injection of evolocumab 140 mg on LDL-C levels during the peri-percutaneous coronary intervention (PCI) period in patients with AMI.

Methods: A total of 95 patients with AMI who underwent PCI were divided into the evolocumab (n = 50) and non-evolocumab (n = 45) groups.

Results: The percentage change of LDL-C level at 1-3 weeks from baseline was 78.4 ± 13.4% reduction in the evolocumab group versus 45.6 ± 22.6% in the non-evolocumab group, with a mean difference of -33.5% between the groups (95% CI: -42.6 to -24.5%; p < 0.001). The achievement rate of LDL-C levels below 55 mg/dL at 1-3 weeks was significantly higher in the evolocumab group than in the non-evolocumab group (97.7% vs. 60.0%, p < 0.001).

Conclusion: Patients with AMI who received single-dose injection of evolocumab 140 mg during the peri-PCI period had a significantly greater LDL-C reduction and higher proportion of patients achieved the target LDL-C level in the early phase AMI than those who did not receive evolocumab.

背景/目的:急性心肌梗死(AMI)患者的低密度脂蛋白胆固醇(LDL-C)水平要迅速降至55 mg/dL以下,仅靠他汀类药物很难实现。这项单中心回顾性研究旨在评估单剂量注射 evolocumab 140 毫克对急性心肌梗死(AMI)患者围经皮冠状动脉介入治疗(PCI)期间 LDL-C 水平的影响:方法:将95名接受PCI的AMI患者分为evolocumab组(n=50)和非evolocumab组(n=45):1-3周时,evolocumab组患者的LDL-C水平较基线下降了78.4 ± 13.4%,而非evolocumab组为45.6 ± 22.6%,组间平均差异为-33.5% (95% CI: -42.6 to -24.5%; p < 0.001)。在1-3周时,evolocumab组的LDL-C水平低于55 mg/dL的比率显著高于非evolocumab组(97.7% vs. 60.0%,p < 0.001):结论:与未接受 evolocumab 治疗的急性心肌梗死患者相比,在急性心肌梗死围手术期接受单剂量注射 evolocumab 140 毫克治疗的急性心肌梗死患者的低密度脂蛋白胆固醇降低幅度明显更大,在急性心肌梗死早期达到目标低密度脂蛋白胆固醇水平的患者比例更高。
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引用次数: 0
Drug retention of biologic and targeted synthetic disease-modifying antirheumatic drugs in Korean patients with seropositive rheumatoid arthritis. 韩国血清反应阳性类风湿关节炎患者服用生物制剂和靶向合成改善病情抗风湿药物的药物保留率。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.3904/kjim.2023.297
Bong-Woo Lee, Jennifer Jooha Lee, Wan-Uk Kim

Background/aims: The aim of this study was to compare the short- and long-term retention rates of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in Korean patients with seropositive rheumatoid arthritis.

Methods: This study was conducted with 1,538 treatment courses of 1,063 patients, including adalimumab (n = 332), etanercept (n = 369), infliximab (n = 146), abatacept (n = 152), tocilizumab (n = 299), tofacitinib (n = 136), and baricitinib (n = 104), in patients with seropositive rheumatoid arthritis who started b/tsDMARD treatment between 2008 and 2020 at Seoul St. Mary's Hospital. Discontinuation 1 and 3 years after the first prescription of each drug was investigated. Kaplan- Meier estimates of time to discontinuation were calculated to compare the difference in drug retention rate for each drug. Patient-level predictors of drug discontinuation were evaluated using a Cox proportional hazards model.

Results: The overall 1-year drug retention rate was from 60.1% for adalimumab to 90.0% for tofacitinib in the b/tsDMARD-naïve group, and from 55.2% for infliximab to 84.8% for tofacitinib in the b/tsDMARD-experienced group. The 3-year drug retention rate was from 36.9% for infliximab to 86.5% for tofacitinib in the b/tsDMARD-naïve group, and from 31.0% for infliximab to 65.4% for tocilizumab in the b/tsDMARD-experienced group. Drug discontinuation appeared to be affected by specific types of b/tsDMARDs.

Conclusion: Tocilizumab and tofacitinib are less commonly discontinued compared to tumor necrosis factor-α inhibitors at 1 and 3 years. Specifically, tofacitinib in the b/tsDMARD-naïve group and tocilizumab in the b/tsDMARD-experienced group showed the highest 3-year retention rates.

背景/目的:本研究旨在比较韩国血清反应阳性类风湿关节炎患者使用生物制剂和靶向合成改善病情抗风湿药物(b/tsDMARDs)的短期和长期保留率:本研究对2008年至2020年期间在首尔圣玛丽医院开始使用b/tsDMARD治疗的血清反应阳性类风湿关节炎患者进行了研究,共对1063名患者的1538个疗程进行了研究,其中包括阿达木单抗(n = 332)、依那西普(etanercept)(n = 369)、英夫利昔单抗(n = 146)、阿帕替塞(abatacept)(n = 152)、妥西珠单抗(tocilizumab)(n = 299)、托法替尼(tofacitinib)(n = 136)和巴利替尼(baricitinib)(n = 104)。玛丽医院接受治疗的血清阳性类风湿关节炎患者。调查了首次处方每种药物1年和3年后的停药情况。计算了停药时间的 Kaplan- Meier 估计值,以比较每种药物的药物保留率差异。使用 Cox 比例危险度模型评估了患者层面的停药预测因素:在b/tsDMARD-naïve组中,阿达木单抗的1年总体药物保留率为60.1%,而托法替尼为90.0%;在b/tsDMARD-experienced组中,英夫利西单抗的1年总体药物保留率为55.2%,而托法替尼为84.8%。在b/tsDMARD-naïve组中,英夫利昔单抗的3年药物保留率为36.9%,托法替尼为86.5%;在b/tsDMARD-experienced组中,英夫利昔单抗的3年药物保留率为31.0%,托西珠单抗为65.4%。停药似乎受特定b/tsDMARDs类型的影响:结论:与肿瘤坏死因子-α抑制剂相比,托西珠单抗和托法替尼在1年和3年内的停药率较低。结论:与肿瘤坏死因子-α抑制剂相比,托西珠单抗和法替尼的1年和3年停药率较低,尤其是b/tsDMARD新药组的托法替尼和有b/tsDMARD经验组的托西珠单抗的3年保留率最高。
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引用次数: 0
Obesity and chronic kidney disease, an important piece in the puzzle of Cardiovascular-Kidney- Metabolic syndrome. 肥胖症和慢性肾脏病是心血管-儿童-代谢综合征的重要组成部分。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.3904/kjim.2024.273
Young Yul Hyun
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引用次数: 0
Obesity is associated with incident chronic kidney disease in individuals with normal renal function. 对于肾功能正常的人来说,肥胖与慢性肾病的发生有关。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.3904/kjim.2023.491
Su Hyun Song, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Seong Kwon Ma, Soo Wan Kim, Eun Hui Bae

Background/aims: Obesity has known to be a modifiable risk factor associated with worse outcomes in chronic kidney disease (CKD), but few studies have examined the impact of obesity on CKD incidence in the general population. The purpose of this study was to investigate the role of body mass index (BMI) and waist-to-hip ratio (WHR) as predictors of incident CKD and to evaluate the impact of weight reduction on CKD prevention.

Methods: A total of 2,711 participants from a community-based cohort with normal renal function were prospectively analyzed. Among participants with obesity, we analyzed the change in WHR to evaluate the association of obesity reduction with CKD development.

Results: During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 190 (7.0%) participants. In the fully adjusted multivariable Cox proportional hazard models, the risk of incident CKD increased with higher BMI (hazard ratio, 1.06; 95% confidence interval, 1.00-1.11; p = 0.033) and higher WHR (hazard ratio, 1.33; 95% confidence interval, 1.07-1.66; p = 0.009). In the Kaplan-Meier analysis, cumulative adverse renal events were significantly more common in the maintained obesity group than in the reduced obesity group (p = 0.001).

Conclusion: Both higher BMI and WHR were associated with development of CKD, but the magnitude of the effect of WHR was higher than that of BMI. Moreover, reducing obesity would be beneficial for renal prognosis.

背景/目的:众所周知,肥胖是与慢性肾脏病(CKD)不良预后相关的一个可改变的风险因素,但很少有研究探讨肥胖对普通人群中 CKD 发病率的影响。本研究旨在调查体重指数(BMI)和腰臀比(WHR)作为慢性肾脏病发病率预测因素的作用,并评估减轻体重对预防慢性肾脏病的影响:我们对社区队列中肾功能正常的 2711 名参与者进行了前瞻性分析。在肥胖的参与者中,我们分析了WHR的变化,以评估减少肥胖与CKD发展的关系:结果:在平均 11.03 ± 4.22 年的随访期间,有 190 人(7.0%)发生了慢性肾功能衰竭。在完全调整的多变量 Cox 比例危险模型中,发生 CKD 的风险随着体重指数(BMI)的升高(危险比为 1.06;95% 置信区间为 1.00-1.11;p = 0.033)和 WHR 的升高(危险比为 1.33;95% 置信区间为 1.07-1.66;p = 0.009)而升高。在卡普兰-梅耶分析中,持续肥胖组的累积肾脏不良事件发生率明显高于减少肥胖组(p = 0.001):结论:较高的体重指数和 WHR 都与慢性肾脏病的发生有关,但 WHR 的影响程度高于体重指数。此外,减少肥胖将有利于肾脏预后。
{"title":"Obesity is associated with incident chronic kidney disease in individuals with normal renal function.","authors":"Su Hyun Song, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Seong Kwon Ma, Soo Wan Kim, Eun Hui Bae","doi":"10.3904/kjim.2023.491","DOIUrl":"10.3904/kjim.2023.491","url":null,"abstract":"<p><strong>Background/aims: </strong>Obesity has known to be a modifiable risk factor associated with worse outcomes in chronic kidney disease (CKD), but few studies have examined the impact of obesity on CKD incidence in the general population. The purpose of this study was to investigate the role of body mass index (BMI) and waist-to-hip ratio (WHR) as predictors of incident CKD and to evaluate the impact of weight reduction on CKD prevention.</p><p><strong>Methods: </strong>A total of 2,711 participants from a community-based cohort with normal renal function were prospectively analyzed. Among participants with obesity, we analyzed the change in WHR to evaluate the association of obesity reduction with CKD development.</p><p><strong>Results: </strong>During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 190 (7.0%) participants. In the fully adjusted multivariable Cox proportional hazard models, the risk of incident CKD increased with higher BMI (hazard ratio, 1.06; 95% confidence interval, 1.00-1.11; p = 0.033) and higher WHR (hazard ratio, 1.33; 95% confidence interval, 1.07-1.66; p = 0.009). In the Kaplan-Meier analysis, cumulative adverse renal events were significantly more common in the maintained obesity group than in the reduced obesity group (p = 0.001).</p><p><strong>Conclusion: </strong>Both higher BMI and WHR were associated with development of CKD, but the magnitude of the effect of WHR was higher than that of BMI. Moreover, reducing obesity would be beneficial for renal prognosis.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Korean Journal of Internal Medicine
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