Homocysteine has been known as a risk factor for cardiovascular disease. This study sought to evaluate the influence of homocysteine on the risk of subclinical coronary atherosclerosis in ...asymptomatic individuals.
We reviewed 3,186 asymptomatic individuals (mean age 53.8 ± 8.0 years, 2,202 men 69.1%) with no prior history of coronary artery disease who voluntarily underwent coronary computed tomographic angiography (CCTA) and laboratory tests as part of a general health examination. The subjects were stratified into tertiles according to their homocysteine levels. The degree and extent of subclinical coronary atherosclerosis were assessed by CCTA. Logistic regression analysis was used to determine the association between homocysteine levels and subclinical coronary atherosclerosis.
The prevalence of significant coronary artery stenosis, any atherosclerotic, calcified, mixed, and non-calcified plaques increased with homocysteine tertiles (all p < 0.05). However, after adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios (ORs) for any atherosclerotic plaque (OR 1.06; 95% CI confidence interval 0.85-1.32; p = 0.610), calcified plaques (OR 1.17; 95% CI 0.92-1.48; p = 0.199), non-calcified plaques (OR 0.80; 95% CI 0.61-1.04; p = 0.089), and mixed plaques (OR 1.42; 95% CI 0.96-2.11; p = 0.077) between the third and first homocysteine tertiles. In addition, the adjusted OR for significant coronary artery stenosis (OR 0.92; 95% CI 0.63-1.36; p = 0.687) did not differ between the first and third tertiles.
In asymptomatic individuals, homocysteine is not associated with an increased risk of subclinical coronary atherosclerosis.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
It is unclear whether high-intensity statin therapy provides incremental clinical benefits over moderate-intensity statin therapy in Asian patients with angina. This study sought to compare the ...clinical outcomes of moderate- and high-intensity statin therapies in patients undergoing percutaneous coronary intervention (PCI) for angina in Korean patients.
Based on the national health insurance claims data in South Korea, patients aged 18 years or older without a known history of coronary artery disease, who underwent PCI with drug-eluting stents due to angina between 2011 and 2015, were enrolled. According to the intensity of statin therapy, patients were categorized into moderate-intensity statin therapy (n = 23,863) and high-intensity statin therapy (n = 9,073) groups. The primary endpoint, defined as a composite of all-cause death and myocardial infarction, was compared between the two groups using a propensity-score matching analysis.
During the follow-up period (median, 2.0 years; interquartile range, 1.1-3.1), 1,572 patients had 1,367 deaths and 242 myocardial infarctions. After propensity-score matching, there were 8,939 matched pairs. There was no significant difference in the incidence of the primary endpoint between the two groups (adjusted hazard ratio of high-intensity statin therapy, 1.093; 95% confidence interval: 0.950-1.259; p = 0.212).
In Korean patients undergoing PCI with drug-eluting stents for angina, the high-intensity statin therapy did not provide additional clinical benefits over the moderate-intensity statin therapy.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Traditional lipid parameters-including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-HDL-C (calculated ...as TC minus HDL-C)-have long been used as indicators of cardiovascular disease (CVD) risk. The laboratory records of 9604 Korean adults who underwent traditional lipid panel tests (TC, TG, and HDL), as well as ApoB testing, were analyzed to evaluate the prevalence of dyslipidemia and high CVD risk (utilizing the NCEP ATP III criteria for traditional lipid panels and various ApoB test cutoffs recommended by international guidelines (145 mg/dL, 130 mg/dL, and 100 mg/dL)). The overall prevalence of dyslipidemia, as determined by traditional lipid panel criteria, was 27.4%. Utilizing the ApoB cutoffs of 145 mg/dL, 130 mg/dL, and 100 mg/dL resulted in prevalence figures of 5.3%, 11.0%, and 36.3%, respectively. The concordance in dyslipidemia classification between traditional lipid tests and ApoB at cutoffs of 145 mg/dL, 130 mg/dL, and 100 mg/dL was 78.4%, 81.3%, and 74.7%, respectively. Up to 17.5% of participants, based on an ApoB cutoff of ≥100 mg/dL, exhibited isolated high ApoB in the absence of traditional lipid test anomalies. Incorporating ApoB testing could enhance the identification of Koreans at high CVD risk.
We retrospectively reviewed serum 25-hydroxy vitamin D (25(OH)D) test results from an adult Korean population visiting local clinics and hospitals between July 2017 and December 2021 to gather recent ...information on the prevalence of vitamin D deficiency. The prevalence of vitamin D deficiency status was investigated according to criteria offered by various clinical guidelines. During the study period, 180,289 subjects (29,658 men and 150,631 women) were tested for 25(OH)D. The overall prevalence rates of vitamin D deficiency status based on 25(OH)D level were as follows: 0.4% for <5 ng/mL, 12.5% for <10 ng/mL, 20.6% for <12 ng/mL, 49.4% for <20 ng/mL, and <75.3% for <30 ng/mL. Women tested their 25(OH)D level more frequently than men, and the overall prevalence of 25(OH)D < 10 ng/mL was higher among women than men, while that of 25(OH)D <30 ng/mL was lower among women than men. Among age groups, the prevalence of 25(OH)D <30 ng/mL was higher in younger patients (20s−40s, 79.6−85.5%) than older ones (≥50 years, 62.6−69.2%). The overall prevalence of vitamin D deficiency decreased over time from 2018 to 2021. Future studies are needed to clarify the clinical impact of this change.
In this study, a porosity-graded micro porous layer (MPL) was prepared using the double coating method to enhance the water removal ability of the gas diffusion layer (GDL). In the double MPL, the ...porosity of each layer was controlled using thermal expandable graphite (TEG), which could produce pores in MPL through thermal expansibility. The porosity of the inner layer of the porosity-graded MPL was smaller than the outer layer, so the gradient direction in porosity was from the MPL/catalyst layer interface to the gas diffusion backing layer (GDBL)/MPL interface. In addition, the pore forming ability of TEG and the water removal ability of porosity-graded MPL were characterized. The performance of the porosity-graded MPL was evaluated and compared to the single layer conventional MPL. The porosity-gradient structure in MPL increased the water permeability of GDL and the performance of the single cell in the high current density region. Since the porosity-graded MPL increased the water removal ability of GDL, concentration loss due to water flooding in the high current density region was decreased. These results demonstrate that porosity-graded MPL was beneficial to PEMFC, which has to operate in the high current density region.
► We developed a porosity-graded MPL using the thermal expandable graphite. ► The thermal expandable graphite produced several pores in MPL during heat treatment. ► The porosity-graded MPL improved the water removal ability of the GDL. ► The single cell performance was fairly improved in high current density region.
Accurate estimation of the glomerular filtration rate (eGFR) is essential for the early detection of chronic kidney disease (CKD), targeted interventions, and ongoing monitoring. Although various ...equations for calculating eGFR exist, comparative studies on eGFR levels and the impact of these equations on CKD prevalence are limited in the Korean population.
We compared eGFR levels calculated using seven equations and investigated the prevalence of CKD through a retrospective analysis of the data from Korean adult patients who visited local clinics and hospitals and underwent simultaneous serum creatinine (Cr) and cystatin C (Cys-C) measurements. The equations analyzed were: 2006 MDRD, 2009 CKD-EPI Cr, 2012 CKD-EPI Cys-C, 2012 CKD-EPI Cr & Cys-C, 2021 CKD-EPI Cr, 2021 CKD-EPI Cr & Cys-C, and 2021 EKFC.
This study included 6688 Korean patients (3736 men and 2952 women; median age: 61.4; IQR: 47.2-73.4). Among the equations, the median eGFR levels were the highest when using the 2021 CKD-EPI Cr & Cys-C equation (85.1 mL/min/1.73 m
) and the lowest when using the 2006 MDRD equation (73.4 mL/min/1.73 m
). The highest prevalence of decreased eGFR < 60 mL/min/1.73 m
(equivalent to or worse than G3a CKD) was noted with the 2012 CKD-EPI Cys-C equation (32.4%), while the lowest was with the 2021 CKD-EPI Cr equation (22.9%), resulting in a maximum prevalence difference of 9.5%.
The prevalence of CKD varies based on the eGFR equation used and the patient's age. Equations that include Cys-C may identify a larger number of patients with decreased kidney function.
We investigated the prevalence of folate deficiency and associated factors in a large population of Korean women of reproductive age during the COVID-19 pandemic. We utilized different cut-offs and ...evaluated age, year of testing, geographical region, and the utilization of serum homocysteine levels. Out of the 27,758 women evaluated, the overall prevalence of folate deficiency was 12.5% (<4 ng/mL, metabolic indicator) and 5.4% (<3 ng/mL, hematologic indicator). Homocysteine testing was observed in 8.4% of women, with 2.7% having elevated homocysteine levels (>15.4 µmol/L). According to our multiple logistic regression analysis, younger women, particularly those aged 20 to 24 years, tested in 2020, and from Jeolla province, Gyeongsang province, and Jeju Island, were identified as being more prone to folate deficiency. Receiver operating characteristic curve analysis demonstrated that a cut-off of >8.4 µmol/L provided the most accurate definition of folate deficiency with serum folate levels <4 ng/mL, while a cut-off of >8.8 µmol/L best defined folate deficiency with serum folate levels <3 ng/mL, with both cut-offs being lower than 15.4 µmol/L. Our study emphasizes the prevalence of folate deficiency, associated factors, and the role of homocysteine in planning nutritional support programs in Korea.
We investigated the reference intervals for Apolipoprotein B (ApoB), a valuable biomarker for cardiovascular diseases, in Korean adults who had undergone health check-ups and showed normal lipid ...levels under traditional lipid tests, including total cholesterol, triglyceride, and high-density lipoprotein cholesterol, along with ApoB. We compared the findings with different cutoffs for ApoB from international clinical guidelines. Among a total of 264,105 traditional lipid test sets, only 464 (0.2%) included ApoB tests, indicating underutilization of this test in health check-up clinics in Korea. From these 464 samples, 334 ApoB results (164 men and 170 women) with normal traditional lipid test results were used to establish reference intervals. Using the parametric method (mean ± 2 SD), the reference intervals ranged from 46 to 134 mg/dL for men and 49 to 129 mg/dL for women. Employing the non-parametric method (central 95th percentile value), the reference intervals ranged from 50 to 131 mg/dL for men and 51 to 127 mg/dL for women. The prevalence of high ApoB did not significantly differ by sex when considering the established reference intervals for each sex and the cutoffs recommended by international clinical guidelines. This study enhances knowledge on ApoB reference intervals in the Korean population, and it will in aid test result interpretation for clinicians and laboratories.
Background/Aim: Colorectal cancer (CRC) is one of the most common in the world and its prevalence is rapidly increasing. Jagged-1-activated Notch signaling by apurinic/apyrimidinic ...endodeoxyribonuclease 1 (APEX1) promotes CRC, and high expression of Jagged-1 is associated with poor prognosis. However, its clinical implication is unknown. The aim of this study was to investigate the clinical role of Jagged-1-activated Notch signaling by APEX1. Materials and Methods: The 5-dimethylthiazol-2-yl) 2, 5-diphenyltetrazolium bromide (MTT) assay was used to evaluate the anti-cancer efficacy of 5-fluorouracil (5-FU), oxaliplatin, and irinotecan. Tissue from CRC patients was analyzed to assess the clinical specificity of Jagged-1 activated by APEX1. Results: The half-maximal inhibitory concentration (IC50) in cells co-expressing APEX1 and Jagged-1 cells was higher than that in cells expressing only APEX1. These results indicated that the simultaneous expression of APEX1 and Jagged-1 might be associated with chemoresistance toward 5-FU, oxaliplatin, and irinotecan. Analysis of tissue from CRC patients revealed that high expression of Jagged-1 was associated with a statistically significantly low response to chemotherapy. Conclusion: Overexpression of Jagged-1 by APEX1 might serve as a predictor of response to chemotherapy and of poor prognosis, and moreover may be a therapeutic target for chemotherapy of advanced CRC.
As the usage growth rate of Internet of Things (IoT) devices is increasing, various issues related to these devices need attention. One of them is the distribution of the IoT firmware update. The IoT ...devices’ software development does not end when the manufacturer sells the devices to the market. It still needs to be kept updated to prevent cyber-attacks. The commonly used firmware update process, over-the-air (OTA), mostly happens in a centralized way, in which the IoT devices directly download the firmware update from the manufacturer’s server. This central architecture makes the manufacturer’s server vulnerable to single-point-of-failure and latency issues that can delay critical patches from being applied to vulnerable devices. The Open Connectivity Foundation (OCF) is one organization contributing to providing interoperability services for IoT devices. In one of their subject areas, they provide a firmware update protocol for IoT devices. However, their firmware update process does not ensure the integrity and security of the patches. In this paper, we propose a blockchain-based OCF firmware update for IoT devices. Specifically, we introduce two types of firmware update protocol, direct and peer-to-peer updates, integrated into OCF firmware update specifications. In the direct scenario, the device, through the IoT gateway, can download the new firmware update from the manufacturer’s server. Meanwhile, in the peer-to-peer scheme, the device can query the update from the nearby gateways. We implemented our protocol using Raspberry Pi hardware and Ethereum-based blockchain with the smart contracts to record metadata of the manufacturer’s firmware updates. We evaluated the proposed system’s performance by measuring the average throughput, the latency, and the firmware update distribution’s duration. The analysis results indicate that our proposal can deliver firmware updates in a reasonable duration, with the peer-to-peer version having a faster completion time than the direct one.
PDF
