SCI 발표논문

2026년 74편

442026

제1저자 이희선, 강응재 · 교신저자 최수연

, , , , , , ,
Age- and sex-specific attributable impact of modifiable risk factors on atherosclerotic cardiovascular disease in Korea: a nationwide population-based cohort study.
Lancet Reg Health West Pac. 2026;69:101844.

Abstract
BACKGROUND While modifiable risk factors are central to the development of atherosclerotic cardiovascular disease (ASCVD), their relative contributions differ by age, sex, region, and period. However, contemporary evidence on these patterns in the large-scale Korean population remains scarce. We aimed to quantify the age- and sex-specific burden of major modifiable risk factors for ASCVD in a large nationwide cohort.
METHODS This retrospective cohort study included 6,249,852 Korean adults without prior ASCVD who underwent the National Health Screening between 2009 and 2010. The primary outcome was incident ASCVD, defined as cardiovascular death, myocardial infarction, or ischemic stroke. Participants were followed for these outcomes through linkage to the Korean National Health Insurance Service claims database and Statistics Korea mortality data. Population-attributable fractions (PAFs) for risk factors-body mass index, systolic blood pressure (SBP), smoking, diabetes, and non-HDL-cholesterol-were estimated from multivariable-adjusted Cox proportional hazards models and stratified by age and sex.
FINDINGS In this cohort (mean age 46.9 ± 13.7 years; 52.2% men), 279,093 ASCVD events occurred (incidence rate, 3.58/1000 person-years) during a median follow-up of 13.0 years. The five risk factors collectively explained 46.2% of the ASCVD burden, with the greatest contribution from SBP, followed by smoking, non-HDL-cholesterol, diabetes, and obesity. PAFs were higher in men (52.8%) than women (30.4%), and highest in men aged <50 years (71.5%), where SBP (48.6%) and smoking (29.4%) predominated. In women, SBP remained the leading contributor with less variation by age, whereas diabetes and atherogenic lipids contributed more prominently at older ages.
INTERPRETATION These findings reveal distinct age- and sex-specific patterns in the burden of modifiable risk factors in contemporary Koreans. Tailored prevention strategies that reflect national epidemiological profiles and demographic risk patterns are needed to effectively reduce the ASCVD burden.
FUNDING None.
PubMed IF 9.4 순환기내과
432026

제1저자 이가은, 신철민 · 교신저자 원성호, 김나영

, , , , , , , , , , , ,
Discrepancy between Genetically Predicted and Observed Alcohol Intake and Its Impact on Gastric Cancer Susceptibility.
Cancer Res Treat. 2026;58(2):563-572.

Abstract
PURPOSE We aimed to investigate how genetic predisposition to drinking and gastric cancer (GC) modifies the association between alcohol consumption and GC risk in the Korean population.
MATERIALS AND METHODS Polygenic risk scores for GC (PRS-GC) and alcohol consumption (PRS-Alcohol) were formulated using genome-wide association results from BioBank Japan. Validation was performed using Korean cohorts (SNUBH-GENIE cohort), incorporating 8,846 controls and 531 patients with GC. Subsequently, these PRSs were applied to an independent Korean cohort of 67,771 participants, including 313 patients with GC during the follow-up for 14 years (KoGES cohort).
RESULTS In KoGES cohort, the influence of alcohol consumption on GC risk was significantly altered by the PRS-GC and exhibited a synergistic interaction effect. PRS-Alcohol itself shows a negative correlation with GC risk. However, when actual alcohol consumption significantly exceeded genetically predicted levels, the risk of alcohol-related GC was notably increased (adjusted hazard ratio, 1.32; 95% confidence interval, 1.01 to 1.72). Heavy drinkers in the high-PRS-GC/low-PRS-Alcohol group had a 2.16 times higher risk of GC than non-to-light drinkers, which was prominent in males.
CONCLUSION Korean drinkers with higher PRS-GC who consume alcohol more than genetically predicted levels are susceptible to GC. PRS-GC and PRS-Alcohol may be beneficial for assessing the impact of alcohol consumption on GC risk in Koreans.
PubMed IF 4.2 소화기내과
422026

제1저자 곽순구, 박찬순 · 교신저자 한경도, 박준빈

, , , , , , , ,
Hypertensive Disorders of Pregnancy Subtypes and Long-Term Cardiovascular Risk.
JAMA Intern Med. 2026;186(4):469-478.

Abstract
IMPORTANCE Hypertensive disorders of pregnancy (HDPs) are associated with an increased long-term risk of cardiovascular disease, but the risks across different HDP subtypes, particularly those other than preeclampsia, remain unclear.
OBJECTIVE To examine whether the risk and distribution of specific cardiovascular outcomes differ across HDP subtypes.
DESIGN, SETTING, AND PARTICIPANTS This nationwide cohort study retrospectively analyzed women with deliveries in South Korea from 2010 to 2018 using the National Health Insurance Service database. HDPs were classified into 5 subtypes: chronic hypertension, gestational hypertension, superimposed preeclampsia, preeclampsia/eclampsia, and unspecified hypertension. Events were verified through December 2022. Data were analyzed from June 1 to October 31, 2025.
EXPOSURES HDPs and their subtypes.
MAIN OUTCOMES AND MEASURES The primary outcome was a composite of cardiovascular events, including cardiovascular death, heart failure, myocardial infarction, stroke, and atrial fibrillation. Adjusted hazard ratios (AHRs) were estimated using Cox models accounting for age, cardiovascular comorbidities, demographic, lifestyle, and pregnancy-related factors.
RESULTS Among 570 843 women (mean [SD] age, 32.7 [4.0] years), 22 876 (4.0%) had HDPs. HDPs were associated with a higher incidence of cardiovascular events compared with women without HDPs (AHR, 1.62; 95% CI, 1.49-1.76; P < .001). The absolute risk increase was approximately 2.10 additional cardiovascular events per 1000 person-years over a median follow-up of 6.5 years (IQR, 4.7-8.7 years; incidence rate, 4.39 vs 2.29 per 1000 person-years). Among those with HDPs, 34.8% had gestational hypertension, 32.4% had preeclampsia or eclampsia, 17.7% had unspecified hypertension, 12.3% had chronic hypertension, and 2.8% had superimposed preeclampsia. All subtypes were independently associated with higher cardiovascular risk, with the highest risk observed in superimposed preeclampsia compared with women without HDPs (AHR, 2.93; 95% CI, 2.15-3.99; P < .001). All subtypes were associated with increased risks of heart failure and stroke, and most subtypes were associated with higher cardiovascular mortality. Unspecified hypertension was associated with myocardial infarction, and chronic hypertension and unspecified hypertension were associated with atrial fibrillation.
CONCLUSIONS AND RELEVANCE In this cohort study, all HDP subtypes were associated with modest increases in long-term cardiovascular risk, except superimposed preeclampsia, which was associated with a markedly higher risk. These findings suggest that women with superimposed preeclampsia may benefit from closer postpartum cardiovascular surveillance.
PubMed IF 26.3 순환기내과
412026

제1저자 장희준, 김연진 · 교신저자 이우주, 스테파노 로메오, 김원

, , , , , , , , , ,
Outcomes of oral antidiabetic drugs in metabolic dysfunction-associated steatotic liver disease: a nationwide target trial emulation study.
Clin Mol Hepatol. 2026;32(2):737-750.

Abstract
BACKGROUND/AIMS Patients with concurrent type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD) face elevated cardiovascular risks. However, optimal oral antidiabetic drug (OAD) selection for this population remains unclear.
METHODS Using the Korean National Health Information Database, we conducted a target trial emulation comparing cardiovascular outcomes among patients with T2DM and MASLD (defined by fatty liver index ≥30) who initiated sodium-glucose cotransporter 2 (SGLT2) inhibitors, thiazolidinediones, dipeptidyl peptidase-4 (DPP-4) inhibitors, or sulfonylureas with metformin. The primary outcome was major adverse cardiovascular events (MACE), including cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke.
RESULTS Among 71,071 patients (331,726 person-years), SGLT2 inhibitor users experienced a significantly lower MACE risk compared to sulfonylurea users (adjusted subdistribution hazard ratio [aSHR], 0.44; 95% confidence interval [CI], 0.31-0.62). SGLT2 inhibitors also demonstrated a lower MACE risk compared to thiazolidinediones (aSHR, 0.61; 95% CI, 0.39-0.96) and DPP-4 inhibitors (aSHR, 0.59; 95% CI, 0.42-0.83). Cardiovascular mortality risk was notably reduced with SGLT2 inhibitors compared to sulfonylureas (aSHR, 0.13; 95% CI, 0.03-0.50), thiazolidinediones (aSHR, 0.19; 95% CI, 0.04-0.86), and DPP-4 inhibitors (aSHR, 0.22; 95% CI, 0.06-0.84). Mediation analysis revealed that MASLD regression accounted for 8.7% of the total cardiovascular benefit when comparing SGLT2 inhibitors to sulfonylureas.
CONCLUSIONS In patients with concurrent T2DM and MASLD, SGLT2 inhibitors demonstrated better cardiovascular outcomes compared to other OADs. These findings suggest that SGLT2 inhibitors may be the preferred OAD choice for cardiovascular risk reduction in this high-risk population.
PubMed IF 21.7 소화기내과
402026

제1저자 송진희, 최용훈 · 교신저자 김나영

, , , , , , , ,
Differential NRF2 Methylation and PD-1 Expression in Normal Tissues of Colorectal Adenoma and Carcinoma across Sexes.
World J Mens Health. 2026;44(2):322-333.

Abstract
PURPOSE Metachronous cancer following the cure of the primary cancer could be related with the tumor microenvironment. Recently it has been known that nuclear factor erythroid 2-related factor 2 (NRF2), a key transcription factor regulates immune checkpoint expression, including programmed cell death-ligand 1 (PD-L1), a well-known checkpoint molecule. The aim of this study was to investigate the roles of NRF2 and PD-1 in the tumor microenvironment using the normal colon tissue, with a focus on sex-specific differences.
MATERIALS AND METHODS A total of 280 participants were enrolled including 66 healthy controls (HC), 109 patients with colorectal adenoma (AD), and 105 patients with colorectal cancer (CRC). Quantitative real-time polymerase chain reaction (PCR) for NRF2 and PD-1 and methylation-specific PCR for NRF2 were performed with normal mucosal tissue above the 20 cm from anal verge.
RESULTS NRF2 methylation levels were significantly lower in the AD and CRC groups compared to the HC in both sexes. PD-1 mRNA expression was significantly reduced in the AD and CRC groups compared to the HC group. In terms of sex males showed significantly lower PD-1 mRNA levels in the AD and CRC groups, whereas females displayed significantly higher PD-1 expression in the AD group but significantly lower levels in the CRC group. In conclusion there were significant differences in NRF2 methylation and PD-1 expression in the normal mucosal tissue among CRC, AD, and HC groups, suggesting that metachronous lesions might arise from this underlying tumor microenvironment.
CONCLUSIONS Our results suggest that mRNA expressions of NRF2 and PD-L1 in the normal colon tissue may serve as early molecular markers in colorectal carcinogenesis with distinct sex-specific patterns.
PubMed IF 4.3 소화기내과
392026

제1저자 이태민, 강소라 · 교신저자 이희선, 이학승

, , , , , , , , , , ,
Artificial Intelligence-Driven Electrocardiogram Screening for Asymptomatic Left Ventricular Systolic Dysfunction in the General Population.
JACC Adv. 2026;5(4):102660.

Abstract
BACKGROUND Asymptomatic left ventricular systolic dysfunction (LVSD) is a well-established precursor of overt heart failure (HF), yet it often remains undiagnosed in the general population. Artificial intelligence-enabled electrocardiogram (ECG) analysis offers a scalable approach for early detection.
OBJECTIVES The purpose of this study was to evaluate the diagnostic performance of an artificial intelligence-enabled ECG model (AiTiALVSD) for identifying asymptomatic LVSD in a large health screening population.
METHODS In this retrospective, single-center study, we evaluated the AiTiALVSD model among 40,713 self-referred adults who underwent a total of 60,711 ECG-transthoracic echocardiography (TTE) pairs between 2011 and 2023. LVSD was defined as a left ventricular ejection fraction ≤40%. Model discrimination was assessed using the area under the receiver-operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and diagnostic performance metrics were compared with established HF risk scores.
RESULTS Among 60,711 ECG-TTE pairs, 32 cases (0.054%) met the criteria for LVSD. The AiTiALVSD model demonstrated excellent discrimination (AUROC 0.973; AUPRC 0.328), with a sensitivity of 90.6%, specificity of 99.4%, positive predictive value of 7.7%, and a negative predictive value of 100%. Established HF risk scores, including the MESA (Multi-Ethnic Study of Atherosclerosis) 5-year HF score and Pooled Cohort Equations to Prevent HF score, showed inferior discrimination (AUROC: 0.696 and 0.672, respectively). The MESA score was not designed to detect prevalent LVSD and was calculated without natriuretic peptide data, which may have disadvantaged its performance in this comparison. Simulation analyses suggested that approximately 1,841 ECGs and 13 confirmatory TTEs would be required to detect one case of LVSD.
CONCLUSIONS In a real-world screening population with an extremely low prevalence of LVSD, the AiTiALVSD model demonstrated high diagnostic accuracy, supporting its potential role as a rule-out screening tool for HF prevention. Prospective validation is warranted.
PubMed IF 5.5 순환기내과
382026

제1저자 장서윤 · 교신저자 신동엽

, , , , , , , , , ,
Prognostic Landscape of TP53 Mutations in Hematologic Malignancies.
Cancer Res Treat. 2026;58(2):656-663.

Abstract
PURPOSE While TP53 mutations are well known to be associated with adverse prognosis in hematological diseases, their functional impact remains incompletely understood. This study examines the spectrum of TP53 mutations across various hematologic malignancies and evaluates their functional impact.
MATERIALS AND METHODS Using targeted sequencing panels, we analyzed TP53 mutations in the bone marrow aspiration samples of a retrospective cohort of 856 patients diagnosed with hematologic malignancies. To assess the impact of TP53 mutations, we applied the evolutionary action (EAp53) score and the relative fitness score (RFS), previously proposed functional scoring methods. The effects of variant allele frequency (VAF), disruptive mutations, EAp53 score, and RFS on overall survival (OS) were evaluated.
RESULTS TP53 mutations were associated with inferior OS compared with wildtype TP53 (median OS 10.0 months versus not estimable; hazard ratio (HR) 4.6; p<0.001). In the acute myeloid leukemia, multiple myeloma, and myelodysplastic syndrome subgroups, TP53 mutations had a significant adverse impact on OS. (HRs 3.8, 4.2, 6.0, respectively; p<0.001, p=0.005, p<0.001, respectively). Patients with VAF >50% had significantly poorer OS compared to those with VAF ≤50% (median OS 7.5 months versus 22.8 months; HR 2.2, p=0.016). Moreover, patients in the high-risk RFS group (RFS >0.22) had significantly worse OS compared to those in the low-risk RFS group (RFS ≤0.22) (median OS 5.6 months versus 16.3 months; HR 2.2, p=0.041). However, no significant survival difference was observed between the EAp53 high-risk (>75) and low-risk (≤75) groups, or between patients with disruptive and non-disruptive mutations.
CONCLUSION Our findings highlight VAF and RFS as valuable tools for stratifying TP53-mutant patients into high-risk and low-risk groups.
PubMed IF 4.2 혈액종양내과
372026

제1저자 정시현, 문인태 · 교신저자 윤연이

, , , , , , , , ,
Deep learning-based multi-view echocardiographic framework for comprehensive diagnosis of pericardial disease.
Eur Heart J Digit Health. 2026;7(3):ztag028.

Abstract
AIMS Pericardial disease spans a wide spectrum from small effusions to life-threatening tamponade or constriction. Transthoracic echocardiography (TTE) is the main diagnostic tool, but its interpretation is limited by operator dependence and incomplete functional assessment. Existing deep learning (DL) models focus mainly on effusion detection, lacking broader evaluation.
METHODS AND RESULTS We developed a DL-based framework that performs sequential assessment of pericardial disease: (i) morphological features, including effusion amount (normal/small/moderate/large) and pericardial thickening/adhesion (yes/no), from five B-mode views, and (ii) haemodynamic significance (yes/no), incorporating Doppler and inferior vena cava measurements. The developmental dataset comprises 2253 TTEs from multiple Korean institutions (225 for internal testing), and the independent external test set consists of 274 TTEs. In the internal test set, diagnostic accuracy was 81.8-97.3% for effusion, 91.6% for thickening/adhesion, and 86.2% for haemodynamic significance. External test set accuracy was 80.3-94.2%, 94.5%, and 85.5%, respectively. Area under the receiver operating curves for the three tasks were 0.92-0.99, 0.90, and 0.79 internally, and 0.95-0.98, 0.85, and 0.76 externally. Sensitivity for thickening/adhesion and haemodynamic significance improved from 66.7% to 77.3%, and 68.8% to 80.8%, respectively, when poor image quality were excluded. Similar performance gains were observed in subgroups with complete target views and a higher number of available video clips.
CONCLUSION This study presents the first DL-based TTE model for broader pericardial disease evaluation, integrating morphological with supportive functional assessments. The proposed framework demonstrated strong generalizability and aligned with the real-world diagnostic workflow. However, caution is warranted when interpreting results under suboptimal imaging conditions.
PubMed IF 5.3 순환기내과
362026

제1저자 박진아 · 교신저자 조재영

, , , ,
Obstructive sleep apnea in never-smokers with newly diagnosed lung cancer: a prospective study in a predominantly female Korean population.
Sci Rep. 2026;16(1):10.1038/s41598-026-45232-7.

Abstract
Emerging evidence suggests a link between obstructive sleep apnea (OSA) and lung cancer, but tobacco smoking may confound this relationship. This prospective study evaluated the prevalence and clinical features of OSA among never-smokers with lung cancer. Newly diagnosed, never-smoking lung cancer patients underwent respiratory polygraphy before cancer treatment. Of 77 enrolled, 67 patients were analyzed (age, 65 years; women, 83.6%; body mass index, 24 kg/m²). OSA (respiratory event index [REI] ≥ 5/hour) was present in 47.8% of the patients-specifically, in 29.4%, 60.0%, 65.0%, and 44.0% of the patients with stage I, II, III, and IV lung cancer, respectively (P = 0.175). 20.9% of the patients had moderate-to-severe OSA (REI ≥ 15/hour). Adenocarcinoma was the predominant histologic type (97%), and 67.2% had advanced-stage (stage III/IV) lung cancer. REI and the percent night time with oxygen saturation < 90% (T90) did not differ between the patients with advanced- and early-stage lung cancer (REI: 5.3/hour vs. 3.0/hour, P = 0.171; T90: 0.6% vs. 0.2%, P = 0.139). In multivariable logistic regression analyses, neither REI nor T90 was associated with advanced-stage lung cancer. Nearly half of never-smokers with lung cancer had OSA, with many having moderate-to-severe disease, underscoring the need for proper diagnosis and management.Clinical Trial Registration: NCT05224180.
PubMed IF 4.9 호흡기내과
352026

제1저자 전유경 · 교신저자 윤혁,황성욱

, , , , , , ,
Real-World Experience of Switching from Intravenous to Subcutaneous Vedolizumab in Korean Patients with Inflammatory Bowel Disease.
Gut Liver. 2026;20(2):266-274.

Abstract
BACKGROUND/AIMS Subcutaneous (SC) vedolizumab (VDZ) has recently become available for patients with inflammatory bowel disease (IBD) in Korea. This retrospective observational study aimed to evaluate the clinical outcomes and safety of switching from intravenous (IV) to SC VDZ.
METHODS Patients with IBD who switched from IV to SC VDZ between 2023 and 2024 were included. The primary outcome was the 24-week persistence rate of SC VDZ. Secondary outcomes included clinical factors associated with SC VDZ persistence, safety profiles, subsequent treatment courses after discontinuation of SC VDZ, and recapture success rate after reverting to IV VDZ.
RESULTS A total of 101 patients with IBD (72 with ulcerative colitis [UC] and 29 with Crohn's disease) were included. After 24 weeks, 72 patients (71.3%) maintained SC VDZ. Corticosteroid use at switching was the strongest predictor of 24-week SC VDZ failure in both the overall IBD cohort (p=0.018) and in patients with UC (p=0.027) in multivariable analyses. Kaplan-Meier analysis showed that patients with UC with intensified IV dosing intervals (p=0.021), failure to clinical remission (p=0.038), or concomitant corticosteroid use at switching (p<0.001) were more likely to discontinue SC VDZ. Injection-site reactions occurred in 24 patients (23.8%). A total of 34 patients (33.7%) discontinued SC VDZ; 19 resumed IV VDZ; and 13 initiated another advanced therapy. The recapture success rate after reverting to IV VDZ was 73.7%, with higher success in those who discontinued because of injection-site reactions or poor adherence.
CONCLUSIONS SC VDZ persistence is significantly influenced by disease activity at the time of switching.
PubMed IF 4.1 소화기내과
342026

제1저자 임선희, 최용훈 · 교신저자 김나영

, ,
The Role of Serum Pepsinogen Tests for Detecting Gastric Cancer Between Sexes and Among Age Groups.
Gut Liver. 2026;20(2):176-198.

Abstract
Gastric cancer (GC) remains a significant concern worldwide, with a very high incidence in Japan, South Korea, and China. Early diagnosis of GC is important for reducing its mortality; to achieve this, screening of individuals at a high risk for developing GC should include frequent esophagogastroduodenoscopy. Currently, various population-based GC screening strategies are being implemented in South Korea, Japan, and the Matsu region of Taiwan. Many studies have suggested that serum pepsinogens (sPGs) can be used as GC biomarkers in South Korea, China, Europe, and other countries; indeed, Japan first included the sPG test in GC screening prior to 1990. However, while the role of sPGs (particularly type 1) as a marker of atrophic gastritis is well known, studies on the association between sPG levels and GC have mainly focused on the association with intestinal-type GC. Recent studies have demonstrated that sPGII is associated with severe inflammation and proliferation. Specifically, high sPGII levels and Helicobacter pylori positivity are associated with an increased risk of early diffuse-type GC, particularly in young females. In this review, the physiology of sPGs and the usefulness of sPG levels in the detection of intestinal- or diffuse-type GC are discussed in terms of sex and age.
PubMed IF 4.1 소화기내과
332026

제1저자 장지은,최용훈 · 교신저자 김나영

, ,
Sex Differences in the Effect of Changes in Body Mass Index on the Risk of Developing Gastric Cancer: Findings from a Nationwide Retrospective Cohort Study.
Gut Liver. 2026;20(2):225-235.

Abstract
BACKGROUND/AIMS This study examined sex differences in the effect of changes in body mass index (BMI) on the development of gastric cancer (GC) in South Korea.
METHODS Using data from the National Health Insurance Service-Health Screening Cohort, a retrospective cohort study involving 333,169 Koreans with a median follow-up of 12 years was conducted. BMI was categorized into five groups (<18.5, 18.5-22.9, 23.0-24.9 [reference], 25.0-29.9, and ≥30.0 kg/m²) and the risk of developing GC was evaluated according to changes in BMI by calculating the hazard ratio (HR) using Cox proportional hazard regression.
RESULTS Among males, BMI ≥30.0 kg/m² was associated with a 1.27-fold higher overall risk of developing GC (95% confidence interval [CI], 1.02 to 1.57), but not in females. For non-cardia GC, a U-shaped association between BMI and risk of developing GC was observed in males, although statistical significance was observed only for BMI 18.5-22.9 kg/m². Additionally, an increase in BMI to 23.0-24.9 kg/m² was associated with a decreased non-cardia GC risk among males. In females, the largest waist circumference category was significantly associated with an increased risk of developing overall GC (HR, 1.37; 95% CI, 1.07 to 1.74).
CONCLUSIONS This study demonstrated that maintaining a BMI in the range of 23.0-24.9 kg/m² is optimal for minimizing the risk of non-cardia GC, particularly in males. In females, visceral obesity, represented by a large waist circumference as a proxy, was associated with an increased risk of developing GC.
PubMed IF 4.1 소화기내과
322026

제1저자 박찬순, 장문영 · 교신저자 한경도, 박준빈

, , , , , , , , , ,
Maternal smoking based on pre-birth health examination and risk of neurodevelopmental disorders in offspring: insights from a Korean mother-child cohort.
BMC Med. 2026;24(1):10.1186/s12916-026-04782-3.

Abstract
BACKGROUND Neurodevelopmental disorders affect a substantial proportion of children and often persist into adulthood, with lifelong consequences. We investigated the association between maternal smoking and neurodevelopmental disorders in offspring.
METHODS We performed a nationwide population-based mother-child cohort study of infants born between 2009 and 2018. Maternal smoking status was obtained from the closest NHIS general health examination conducted within 2 years prior to delivery and categorized as never, former, or current smokers. Offspring were followed up until 2021 for diagnoses of intellectual disability, autism spectrum disorder (ASD) (ascertained through governmental disability registration), and attention-deficit/hyperactivity disorder (ADHD) (ascertained through insurance records).
RESULTS Among the 861,876 offspring (51.4% boys; median follow-up 8.3 years), 790,728 (91.7%) were born to never-smoking mothers, 36,046 (4.2%) to former smokers, and 35,102 (4.1%) to current smokers. Offspring of women with any history of smoking had a higher cumulative incidence of all neurodevelopmental disorders than those of never smokers (all log-rank P < 0.001). After multivariate adjustment, maternal smoking was associated with a significantly increased risk of each outcome. Compared with offspring of never smokers, offspring of former smokers had hazard ratios (HRs) of 1.21 (95% confidence interval [CI] 1.04-1.41) for intellectual disability, 1.29 (95% CI 1.10-1.51) for ASD, and 1.18 (95% CI 1.12-1.26) for ADHD. Compared with offspring of never smokers, offspring of current smokers had higher risks (HR 1.44, 95% CI 1.25-1.66 for intellectual disability; HR 1.52, 95% CI 1.31-1.76 for ASD; HR 1.35, 95% CI 1.27-1.42 for ADHD). HR varied across pack-year tertiles among both former and current smokers; elevated risk estimates were observed even in the lowest tertile, particularly among current smokers across outcomes and among former smokers for intellectual disability and ADHD, without a strictly monotonic gradient.
CONCLUSIONS Maternal smoking status as assessed from pre-birth health examinations was associated with increased risks of intellectual disability, ASD, and ADHD in their offspring. These findings support public health efforts to reduce smoking in women of reproductive age.
PubMed IF 8.7 순환기내과
312026

제1저자 김준모, 김경훈 · 교신저자 김광수, 김세훈

, , , , , , , , , ,
Prediction of antibiotic-associated cutaneous adverse drug reactions using electronic health record foundation models.
NPJ Digit Med. 2026;9(1):10.1038/s41746-026-02503-x.

Abstract
Cutaneous adverse drug reactions (CADRs) are the most common form of adverse drug reactions, ranging from mild rashes to life-threatening diseases, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. However, there is no effective tool to predict antibiotic-associated CADRs. In this study, we propose an antibiotic-associated CADR prediction model using electronic health record (EHR) foundation models (FMs). EHR FMs are based on the pretraining-finetuning paradigms of language models, corresponding medical codes and their sequences to words and sentences. We included 802,131 inpatients across three tertiary hospitals in Korea, combining EHR data with nursing statements and reports to extract skin rash records. Our approach achieved the best predictive performance compared to all the other baseline models across all datasets. To enhance clinical relevance, we classified CADRs into immediate and delayed types and conducted a detailed sub-analysis. Finally, we found that properly configured EHR FMs can effectively predict the risk of developing antibiotics-associated CADRs, particularly for delayed-type reactions where predictive testing options are limited.
PubMed IF 18 알레르기내과
302026

제1저자 박상현 · 교신저자 한정규, 김용훈

, , , , , , , , , , , , , , , , , , , ,
Biodegradable Polymer Versus Polymer-Free Ultrathin Sirolimus-Eluting Stents in Complex Percutaneous Coronary Intervention: Post Hoc Analysis of the Stent Arm Registry From the HOST-IDEA Randomized Trial.
J Am Heart Assoc. 2026;15(5):e043441.

Abstract
BACKGROUND The performance of third-generation drug-eluting stents with ultrathin struts and advanced polymer technology in complex percutaneous coronary intervention (PCI) remains unclear. This study compared the clinical outcomes of Coroflex ISAR polymer-free sirolimus-eluting stent (SES) and Orsiro biodegradable polymer SES, 2 third-generation drug-eluting stents, based on PCI complexity.
METHODS A post hoc analysis of the HOST-IDEA (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Coronary Intervention With Next-Generation Drug-Eluting Stent Platforms and Abbreviated Dual Antiplatelet Therapy) trial, which randomized 2013 patients undergoing PCI with Coroflex ISAR or Orsiro SES based on the duration of dual antiplatelet therapy (3 versus 12 months), was conducted herein. The baseline characteristics were balanced through propensity score matching. Complex PCI satisfied ≥1 of the following criteria: ≥3 stents implanted, ≥3 lesions or vessels treated, bifurcation PCI, total stent length of ≥60 mm, left main PCI, or heavy calcification. Target lesion failure (TLF) at 1 year, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization, was the primary end point.
RESULTS Each stent group comprised 546 patients after propensity score matching. In total, 336 and 756 patients underwent complex PCI and noncomplex PCI, respectively. Complex PCI exhibited a significant association with a higher risk of TLF compared with noncomplex PCI (5.7% versus 1.3%, P<0.01). In the complex PCI group, the TLF rate in the Coroflex ISAR SES group was significantly higher than that in the Orsiro SES group (8.9% versus 2.4%; hazard ratio [HR], 3.74 [95% CI, 1.24-11.26]; P=0.02). However, the TLF rates in the 2 stent groups in the noncomplex PCI group were comparable (1.1% versus 1.6%; HR, 0.66 [95% CI, 0.19-2.35]; P=0.53; P for interaction=0.04). Multivariable analysis identified Coroflex ISAR SES and chronic kidney disease as independent predictors of TLF.
CONCLUSIONS Orsiro SES was associated with significantly better TLF outcomes than the Coroflex ISAR SES in complex PCI; however, no significant difference was observed in noncomplex PCI.
PubMed IF 6 순환기내과
292026

제1저자 하성찬 · 교신저자 김나영

, ,
Age- and sex-dependent alterations of jejunal microbiota in Fischer 344 rats fed with a high-fructose, high-fat diet: depletion of Lactobacillus intestinalis in small bowel contents.
Front Microbiol. 2026;17:1779112.

Abstract
INTRODUCTION Our previous research demonstrated that a high-fat diet (HFD) induced jejunal inflammation and hepatic steatosis, suggesting that small bowel microbiota contribute to these pathologies. This study investigated age- and sex-specific alterations in jejunal microbiota following a high-fructose, high-fat diet (HFHFD) in F344 rats.
METHODS Six-week-old and two-year-old rats of both sexes were fed an HFHFD for 8 weeks, after which jejunal contents were collected for metagenomic analysis. Taxonomic profiling and linear discriminant analysis were performed, and Spearman's rank correlation analysis was used to evaluate associations with jejunal inflammation and hepatic steatosis. Beta-diversity analysis was conducted to assess group separation. In vitro, HIEC-6 human intestinal epithelial cells were used to test the protective effect of Lactobacillus intestinalis under palmitic acid-induced lipotoxic stress.
RESULTS HFHFD reduced the Firmicutes/Bacteroidetes ratio in young females and in aged rats of both sexes. Notably, Lactobacillus intestinalis-which supports barrier function-decreased in young males and aged females. In contrast, Akkermansia muciniphila increased across all HFHFD groups, particularly in young females and aged rats. Bacteroides vulgatus increased in aged HFHFD-fed rats of both sexes, while Bacteroides caccae was elevated in females across both age groups. Furthermore, the Lactobacillus reuteri group decreased only in young HFHFD rats. L. intestinalis and L. reuteri groups negatively correlated with jejunal inflammation and hepatic steatosis, whereas B. caccae and A. muciniphila showed positive correlations with both pathogenic phenotypes. Beta-diversity revealed a pronounced diet- and sex-dependent separation in young rats, which was attenuated in aged groups. In HIEC-6 cells, L. intestinalis significantly restored viability under palmitic acid-induced lipotoxic stress, though its conditioned medium did not.
DISCUSSION Collectively, HFHFD induces age- and sex-dependent dysbiosis in the jejunum, and L. intestinalis may serve as a potential probiotic for metabolic dysfunction-associated steatotic liver disease.
PubMed IF 5.8 소화기내과
282026

제1저자 이민우, 김성훈, 백우현 · 교신저자 조재희, 이상협

, , , , , , , , , , , ,
Role of endoscopic ultrasonography in differential diagnosis of gallbladder wall thickening: a multi-center retrospective study.
HPB (Oxford). 2026;28(3):324-332.

Abstract
BACKGROUND There are limited data on the usefulness of endoscopic ultrasonography (EUS) in determining malignancy in gallbladder wall thickening.
METHODS In this multicenter retrospective study, patients who underwent EUS for gallbladder wall thickening from 2011 to 2021 at seven tertiary hospitals were reviewed. The main outcome was the diagnostic performance of EUS in differentiating gallbladder tumors. Logistic regression analyses were performed to identify key EUS findings.
RESULTS We reviewed 309 patients who underwent EUS for gallbladder wall thickening and excluded 83 patients who did not undergo surgical resection. Among 226 patients who underwent cholecystectomy, 48 patients were diagnosed with gallbladder tumors and 176 patients were diagnosed with benign diseases. EUS showed a sensitivity of 79.31 % and a specificity of 92.86 % for diagnosing gallbladder tumors. Multivariate analysis revealed that wall thickness greater than 14 mm (P < 0.001) and disrupted layer (P < 0.001) were associated with gallbladder tumors. On the other hand, the presence of intramuscular cysts (P = 0.013) and comet tail sign (P = 0.004) were associated with benign diseases.
CONCLUSION EUS is a useful method for differential diagnosis of gallbladder wall thickening. Wall thickness greater than 14 mm and layer disruption are key findings of gallbladder tumors.
PubMed IF 3.3 소화기내과
272026

제1저자 이승환 · 교신저자 조영민

, , , , , , , , , , , , , , ,
Efficacy and safety of combining empagliflozin in people with type 2 diabetes mellitus uncontrolled with metformin and sitagliptin: A randomised, double-blind, multicentre, therapeutic confirmatory phase 3 clinical trial.
Diabetes Obes Metab. 2026;28(3):2027-2037.

Abstract
AIM This study evaluated the efficacy and safety of empagliflozin 10 and 25 mg compared to placebo as add-on treatment for people with type 2 diabetes mellitus (T2DM) uncontrolled after ≥8 weeks of treatment with metformin and sitagliptin.
MATERIALS AND METHODS A randomised, double-blind, multicentre, therapeutic confirmatory, phase 3 clinical trial was conducted in 172 patients with T2DM. Participants with glycosylated haemoglobin (HbA1c) levels 7%-10% receiving sitagliptin and metformin were randomised 1:1:1 to empagliflozin 10 mg, empagliflozin 25 mg, or placebo. The primary endpoint was the change in HbA1c from baseline to week 24.
RESULTS After 24 weeks of treatment, HbA1c levels were significantly decreased in the empagliflozin 10 and 25 mg group versus the placebo group; the adjusted mean differences with empagliflozin 10 and 25 mg versus placebo were -0.7% (95% CI -1.0, -0.4; p <.0001) and -0.8% (95% CI -1.1, -0.5; p <.0001), respectively. Fasting plasma glucose levels were also significantly decreased in both empagliflozin groups compared to the placebo group (both p <.0001). More patients reached HbA1c <7% or <6.5% after 24 weeks in the empagliflozin 10 and 25 mg groups versus the placebo group (both p <.05). Efficacy was maintained in the empagliflozin groups during a 28-week extension period. Empagliflozin add-on was associated with improvements in albuminuria and body weight. The incidence of adverse events was similar across groups; add-on empagliflozin was well tolerated.
CONCLUSIONS These results suggest that coadministration of empagliflozin safely improves glycemic control in Korean patients with T2DM uncontrolled by sitagliptin and metformin.
PubMed IF 6.1 내분비대사내과
262026

제1저자 박혜인조, 김영철 · 교신저자 오윤규

, , , , , , , , , , , , , , , , , , , , , , , ,
Evaluating the Safety and effectivenesS in adult KorEaN patients treated with Tolvaptan for management of autosomal domInAnt poLycystic kidney disease (ESSENTIAL): final report.
Kidney Res Clin Pract. 2026;45(2):220-231.

Abstract
BACKGROUND Tolvaptan, a selective vasopressin V2 receptor antagonist, was first approved by the Korean Ministry of Food and Drug Safety in 2015 as a treatment option for autosomal dominant polycystic kidney disease (ADPKD). To prescribe tolvaptan safely and effectively, we designed the phase 4 clinical trial among Korean ADPKD patients with chronic kidney disease stages 1 to 3.
METHODS A total of 117 Korean patients aged 19 to 50 years with rapidly progressing ADPKD were enrolled in the study. Tolvaptan was prescribed for 24 months with the maximum tolerable dose up to 120 mg/day. The primary outcome was the incidence of treatment-emergent adverse events (TEAEs) including hepatic adverse events. The secondary outcomes were the annual mean percent change of total kidney volume (TKV) and the annual mean change of estimated glomerular filtration rate (eGFR).
RESULTS A total of 489 TEAEs occurred in 106 patients (90.6%). A total of 17 cases of hepatic adverse events (14.5%) occurred during the study period and mostly within the first 18-month period. However, liver enzymes were normalized after drug discontinuation. Although it was not statistically significant, patients with a previous history of liver disease as well as those with mild elevation of liver enzyme showed a higher frequency of hepatic adverse events. Compared with the predicted value from the calculation, tolvaptan attenuated both TKV growth and eGFR decline rate.
CONCLUSION Although the incidence of hepatic adverse events was higher in Korean ADPKD patients compared to the previous studies, tolvaptan can be prescribed safely and effectively using meticulous titration and 1-month interval monitoring.
PubMed IF 3.5 신장내과
252026

제1저자 정광록, 이종찬, 김진호 · 교신저자 황진혁

, , , , , , , ,
Comprehensive clinico-genomic analysis of pancreatic ductal adenocarcinoma: Overcoming biases and limitations.
Cancer Lett. 2026;639:218176.

Abstract
Pancreatic ductal adenocarcinoma (PDAC) has an exceptionally poor prognosis. Most genomic studies conducted to discover potential targets to improve PDAC prognosis have been constrained by biased cohort compositions and limited clinical information. Therefore, we aimed to develop a large-scale, unbiased, and well-organized PDAC genomic dataset. Primary pancreatic tissue samples were exclusively obtained from patients with PDAC using endoscopic ultrasound-guided fine-needle biopsy, and whole-exome sequencing (WES) and whole-transcriptome sequencing (WTS) were conducted. Subsequently, comprehensive clinico-genomic analysis was performed by integrating this genomic dataset with detailed clinical information. A unique and unbiased genomic dataset, comprising 205 WES and 93 WTS datasets from 237 Asian patients with PDAC, was developed. The clinico-genomic analysis revealed distinct genetic features associated with various clinical phenotypes. Specifically, patients with liver metastasis exhibited a high frequency of TP53 mutation, increased chromosomal instability, and high frequency of copy number variants as well as KRAS allelic imbalance. Additionally, potential biomarkers derived from broad genomic data, including tumor mutation burden, mutation signatures, scar-based homologous recombination deficiency signatures, and RNA subtypes, were validated for their clinical utility. This large-scale, unbiased genomic dataset addresses the limitations of previous genomic studies in PDAC, facilitating comprehensive clinico-genomic analyses with significant clinical utility.
PubMed IF 11.8 소화기내과
242026

제1저자 정경연, 박소연 · 교신저자 최만호, 김정희

, , , , , , , , , , , , , , , , ,
Clinical Utility of Salivary Steroid Profiling for the Differential Diagnosis of Adrenal Diseases.
J Clin Endocrinol Metab. 2026;111(3):e827-e836.

Abstract
CONTEXT Although salivary steroid sampling offers several advantages, the diagnostic potential of salivary steroid metabolites remains largely unexplored.
OBJECTIVE This work aimed to evaluate the diagnostic utility of salivary steroid profiling in patients with adrenal diseases.
METHODS This prospective, multicenter study comprised 313 patients with nonfunctioning adrenal adenoma (NF), primary aldosteronism (PA), Cushing syndrome (CS), and mild autonomous cortisol secretion (MACS). Salivary samples for morning and night steroids were collected using standardized protocols. The liquid chromatography-mass spectrometry-based steroid profiling was applied to quantify cortisol, cortisone, tetrahydrocortisone (THE), 20α-dihydrocortisol (20α-DHF), 18-hydroxycortisol (18-OHF), and dehydroepiandrosterone sulfate (DHEA-S). The primary outcome was the diagnostic performance of morning and night salivary steroids.
RESULTS In the PA group, morning and night salivary levels of 18-OHF were higher compared to the other groups (all P < .05). Morning and night salivary levels of cortisone, THE, and 20α-DHF were significantly elevated in the CS group compared to other groups (all P < .05). Only night-time salivary levels of cortisone (P = .040) and 20α-DHF (P = .029) were elevated in the MACS group compared to the NF group. Receiver operating characteristic analyses indicated that morning salivary 18-OHF was moderately specific for PA, whereas night salivary 20α-DHF and cortisone provided robust diagnostic accuracy for CS. Combined night salivary steroids exhibited superior diagnostic performance compared to morning salivary steroids in the CS group (area under the curve, 0.903 vs 0.754; P = .007).
CONCLUSION Salivary steroid profiling holds promise as a noninvasive tool for the diagnosis of adrenal diseases.
PubMed IF 5.4 내분비대사내과
232026

제1저자 김학령 · 교신저자 김학령

, ,
Comparison of Long-Term Clinical Outcomes Between Immediate-Release and Slow-Release Carvedilol: A National Real-World Database Analysis.
J Clin Med. 2026;15(4):jcm15041417.

Abstract
Background: Carvedilol, a non-selective β- and α1-blocker, is available in immediate-release (IR) and slow-release (SR) formulations. While carvedilol IR requires twice-daily dosing, SR was developed to improve adherence by allowing once-daily administration. This study aimed to compare long-term clinical outcomes between SR and IR carvedilol. Methods: A total of 38,563 patients taking either SR (n = 6223) or IR carvedilol (n = 32,340) were retrospectively analyzed using national claims data. Baseline characteristics, medication adherence, and cardiovascular outcomes were evaluated over a median follow-up period of 730 days. Multivariable Cox regression analyses were performed to adjust for potential confounders. Results: Despite a higher burden of comorbidities in the SR group, patients taking SR carvedilol had significantly lower risks of major adverse cardiovascular events (MACE), non-fatal myocardial infarction, and heart failure hospitalization compared to those on IR carvedilol. The adjusted hazard ratio for MACE with SR compared to IR was 0.61 (95% CI, 0.556-0.670; p < 0.001). No significant difference in non-fatal stroke was observed between the groups. Conclusions: In this claims-based observational cohort, SR carvedilol was associated with more favorable long-term cardiovascular outcomes than IR carvedilol. However, this association does not establish causal superiority, and prospective randomized studies are needed to confirm these findings.
PubMed IF 3.3 순환기내과
222026

제1저자 장소현, 신민섭, 한지석 · 교신저자 이종찬, 전봉현, 김재희, 송지환, Luke P.Lee

, , , , , , , , , , , , , , , ,
Early diagnosis of pancreatic ductal adenocarcinoma by signal-enhanced lateral flow immunoassay: SELFI.
Nat Commun. 2026;17(1):10.1038/s41467-026-69204-7.

Abstract
Pancreatic ductal adenocarcinoma (PDAC) has a relatively low incidence but a high mortality rate, primarily due to difficulties in early detection. Current state-of-the-art methods for diagnosing early-stage PDAC tend to be invasive, time-consuming, and unreliable, primarily due to the difficulties associated with the early detection of pancreatic cancers. Here we show a quick and sensitive method for the early diagnosis of PDAC using a signal-enhanced lateral flow immunoassay called SELFI. We develop SELFI, which generates a strong colorimetric signal through multiple hotspots formed by plasmonic gold nanoparticles (AuNPs) assembled on a silica nanoparticle. Our SELFI assay achieves a 10,123-fold increase in the limit of detection compared to conventional lateral flow immunoassays using 20 nm AuNPs, providing results within 15 min. We demonstrate that SELFI enables early diagnosis of PDAC, as indicated by a receiver operating characteristic curve and a larger area under the curve compared to the enzyme-linked immunosorbent assay. SELFI's effective diagnostic features can enhance the timely identification of PDAC and may also serve in the early diagnosis of a range of other diseases.
PubMed IF 18.1 소화기내과
212026

제1저자 조인래, 장성훈 · 교신저자 이상협, 한경도

, , , , , , , ,
Pancreatic Cystic Neoplasm Risk Among Individuals With Diabetes.
JAMA Netw Open. 2026;9(2):e2556951.

Abstract
IMPORTANCE With advancements in imaging technology and more frequent health evaluations, the incidence and prevalence of pancreatic cysts have gradually increased. Certain types of pancreatic cystic neoplasms are precancerous lesions associated with an increased risk of pancreatic cancer. Hence, identifying risk factors and preventing their occurrence are crucial. Nonetheless, population-based research on modifiable risk factors remains lacking.
OBJECTIVE To investigate the association of diabetes and related factors with risk of developing pancreatic cysts.
DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study included adults (aged ≥20 years) who underwent health examinations in 2009 through medical institutions designated by the Korean National Health Insurance Service. Participants were followed up until December 31, 2020. Data were analyzed from March 23, 2023, to February 8, 2024.
EXPOSURE All participants were categorized according to diabetes status as having normoglycemia, impaired fasting glucose, shorter diabetes duration (<5 years), or longer diabetes duration (≥5 years). Demographic characteristics, lifestyle factors, and comorbidities at the time of health examinations were investigated.
MAIN OUTCOMES AND MEASURES Adjusted hazard ratios (AHRs) for pancreatic cyst occurrence for each diabetes status group were estimated using Cox proportional hazards regression models, adjusting for potential confounders.
RESULTS Among the entire study population of 3 856 676 adults (mean [SD] age, 47.1 [14.0] years; 54.5% male), 330 138 (8.6%) had diabetes. The median observation period was 10.3 (IQR, 10.1-10.6) years. A total of 31 877 patients (0.8%) developed pancreatic cysts during the observation period. Compared with individuals with normoglycemia, AHRs for the development of pancreatic cysts were 1.06 (95% CI, 1.03-1.08) for those with impaired fasting glucose, 1.23 (1.18-1.28) for those with a shorter diabetes duration, and 1.37 (1.31-1.44) for those with a longer diabetes duration. Subgroup analyses showed higher AHRs for pancreatic cyst occurrence associated with diabetes among individuals younger than 60 years (AHR, 1.34 [95% CI, 1.27-1.40]), males (AHR, 1.32 [95% CI, 1.26-1.38]), and current smokers (AHR, 1.40 [95% CI, 1.30-1.51]) with diabetes compared with patients 60 years or older (AHR, 1.21 [95% CI, 1.16-1.27]), females (AHR, 1.20 [95% CI, 1.15-1.26]), never smokers (AHR, 1.22 [95% CI, 1.18-1.28]), and former smokers (AHR, 1.25 [95% CI, 1.16-1.35]) with diabetes.
CONCLUSIONS AND RELEVANCE In this cohort study of 3 856 676 Korean adults, longer diabetes duration was associated with an increased risk of pancreatic cysts. The risk of pancreatic cyst occurrence was higher among younger male individuals with diabetes compared with their counterparts. Smoking cessation was associated with a lower risk of pancreatic cysts. Further studies incorporating imaging and longitudinal data are needed to clarify the clinical significance of pancreatic cysts in individuals with diabetes.
PubMed IF 11.7 소화기내과
202026

제1저자 손희준 · 교신저자 조영민

, ,
The Expanding Role of Continuous Glucose Monitoring in the Management and Prevention of Type 2 Diabetes.
Diabetes Ther. 2026;17(2):201-216.

Abstract
Continuous glucose monitoring (CGM) has transformed diabetes management by providing continuous, high-resolution insight into glucose dynamics. Initially developed for type 1 diabetes, CGM now demonstrates substantial clinical and behavioral benefits for individuals with type 2 diabetes across diverse therapeutic settings. This narrative review synthesizes current evidence on the expanding role of CGM in optimizing glycemic control and promoting patient-driven lifestyle modification.Across randomized and real-world studies, CGM consistently improves glycosylated hemoglobin, increases time in range, and reduces glycemic variability, regardless of insulin use. Beyond metabolic outcomes, CGM enhances treatment satisfaction, psychological well-being, and self-efficacy, particularly when combined with structured education and feedback. By enabling individuals to visualize real-time glucose responses to daily behaviors, CGM serves as a powerful catalyst for sustained behavioral change and personalized self-management.In addition to its therapeutic applications, CGM also provides diagnostic insight by revealing unrecognized glucose excursions that conventional monitoring may miss, facilitating earlier identification of dysglycemia in at-risk individuals. Yet significant barriers persist, including device costs, limited insurance coverage, and the difficulty of translating raw data into actionable insights for patients and clinicians.In conclusion, CGM has evolved from a glucose-monitoring device to a comprehensive platform that supports both clinical decision-making and behavioral empowerment, bridging the continuum from diabetes prevention to long-term management.
PubMed IF 4.2 내분비대사내과
192026

제1저자 정영미 · 교신저자 김원, 조금준

, , , , ,
Metabolic dysfunction-associated steatotic liver disease and adverse pregnancy outcomes: a nationwide cohort study.
Hepatol Int. 2026;20(1):69-80.

Abstract
PURPOSE A recent international consensus introduced revised nomenclature for steatotic liver disease (SLD). This study evaluated the impact of SLD subtypes on adverse pregnancy outcomes (apos) using updated criteria.
METHODS In this nationwide, population-based study, we analyzed 290,527 female who underwent health check-ups within 1 year before pregnancy and delivered singleton infants. Participants were categorized into non-SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD) groups.
RESULTS A total of 290,527 female were analyzed. Compared to female without SLD, those with MASLD (adjusted odds ratio [aOR] 2.44, 95% CI 2.33-2.55), MetALD (aOR 2.45, 95% CI 2.26-2.66) and ALD (aOR 2.28, 95% CI 2.11-2.47) had significantly higher risks of apos. These associations were observed for gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and preterm birth. Both MASLD and ALD were associated with increased risk of low birthweight (aOR 1.15, 95% CI 1.05-1.27 and aOR 1.21, 95% CI 1.02-1.43, respectively), whereas MetALD was not (aOR 0.96, 95% CI 0.79-1.18). Due to the low incidence of placental abruption across all groups (0.3-0.5%), associations with this outcome remained inconclusive. Additionally, a higher number of cardiometabolic risk factors (CMRFs) was associated with an increased risk of apos (p for trend of odds < 0.0001).
CONCLUSION MASLD, MetALD, and ALD were independently associated with increased risks of apos, with risk further amplified by a greater number of CMRFs. These findings underscore the importance of enhanced prenatal management for female with pre-existing SLD, particularly those with multiple CMRFs, to mitigate the risk of apos.
PubMed IF 7.8 소화기내과
182026

제1저자 전유경 · 교신저자 윤혁

, , , , , , ,
Trends and Impacts of Advanced Therapy on Chronic Opioid Use in Asian Patients with Inflammatory Bowel Disease.
Inflamm Bowel Dis. 2026;32(2):245-252.

Abstract
OBJECTIVE Opioid use in Asian patients with inflammatory bowel disease (IBD) remains poorly understood. This study aimed to investigate the trends in chronic opioid use, associated clinical factors, and effects of advanced therapy (AT) on opioid use in Korean patients with IBD.
METHODS This nationwide cohort study used administrative claims data from the Korean National Health Insurance Service (2010-2022). Chronic opioid use was defined as opioid use for ≥90 days or ≥3 prescriptions within a calendar year. Logistic regression was used to identify clinical factors associated with chronic opioid use. The impact of AT on opioid use was analyzed through pre- and post-initiation comparisons using McNemar's tests, generalized estimating equations (GEE), and a linear mixed model.
RESULTS Chronic opioid use increased over the study period, with a higher prevalence in Crohn's disease (CD) than in ulcerative colitis (UC) (CD: 1.38%, UC: 0.53% in 2010; CD: 5.38%, UC: 1.98% in 2020). Among 49 548 newly diagnosed IBD patients, female sex, steroid and immunomodulator treatments, hospitalizations, emergency room visits, and mental disorders were positively associated with chronic opioid use in CD and UC. AT was positively associated with chronic opioid use in UC (odds ratio [OR] 1.627, P < .0001) but negatively associated with CD (OR 0.786, P = .0013). In CD, AT significantly reduced opioid users (McNemar's test: P < .0001; GEE: OR 0.478, P < .0001) and average daily doses (mean difference -15.8 morphine milligram equivalents, P = .0073).
CONCLUSION Chronic opioid use has increased over the past decade among Korean patients with IBD, particularly among those with CD. AT is crucial for reducing opioid use in patients with CD.
PubMed IF 5.5 소화기내과
172026

제1저자 한정규, 이해나, 신다솜 · 교신저자 김효수, 김종일

, , , , , , , , , , ,
Directed differentiation of human mesenchymal stromal cells into functional endothelial cells having IKAROS-mediated immune tolerance properties.
Biomaterials. 2026;325:123606.

Abstract
We report an efficient method for the directed differentiation of mesenchymal stromal cells derived from embryonic stem cells (EMSCs) into functional endothelial cells (EC), addressing the challenges of direct conversion, such as cellular senescence. We found that transduction of one transcription factor, ER71, was required for the efficient derivation of induced endothelial cells from EMSCs (MiECs). Addition of transforming growth factor-β inhibitor (SB431542), vascular endothelial growth factor, and ascorbic acid to the culture media enhanced the differentiation efficiency. After one week of the induction protocol, 75.4 ± 4.5 % of EMSCs were directly differentiated into ECs as defined by double-positivity for VE-cadherin/PECAM1. MiECs demonstrated endothelial characteristics and functions. Interestingly, the immune tolerance of MSCs was potentiated in MiECs, and were mediated by IKAROS, a direct transcriptional target of ER71. We established an efficient protocol for direct differentiation of MSCs into functional ECs with immune tolerance properties based on ER71 transduction. This technology provides the allogenic cell source for ready-to-use cell therapies for diseases or conditions requiring vascularization.
PubMed IF 13.6 순환기내과
162026

제1저자 김학령 · 교신저자 김학령

, , , , , ,
Invasively measured aortic pulse pressure and long-term prognosis in patients undergoing invasive coronary angiography: a prospective observational study.
J Hypertens. 2026;44(2):354-359.

Abstract
BACKGROUND Although the invasive measurement of intra-arterial pressure is considered the gold standard, it is not feasible for routine clinical practice. This study aimed to investigate the prognostic value of invasively measured aortic pulse pressure (aPP) in patients undergoing invasive coronary angiography (ICA).
METHODS A total of 1110 patients who underwent ICA (mean age 65 years, 35.5% female) were prospectively enrolled. Just before ICA, aortic pressures were measured using a pigtail catheter positioned 3 cm above the aortic valve. Major adverse cardiovascular events (MACE), a composite of cardiac death, nonfatal acute myocardial infarction, coronary revascularization, and ischemic stroke, were assessed during clinical follow-up after ICA.
RESULTS During a median follow-up of 6.3 years (interquartile range, 2.8-8.9 years), there were 153 cases of MACE (13.8%). Patients with MACE had a higher aPP compared to those without MACE (83.0 ± 25.3 vs. 62.9 ± 18.1 mmHg; P < 0.001). Kaplan-Meier survival analysis demonstrated that a higher aPP (≥78 mmHg) was associated with an increased risk of MACE (log-rank P < 0.001). Multiple Cox regression analysis revealed that an increase in aPP by 10 mmHg was significantly associated with a higher risk of MACE, even after adjusting for potential confounders (hazard ratio, 1.68; 95% confidence interval, 1.49-1.82; P < 0.001).
CONCLUSION Invasively measured aPP is a strong and independent predictor of long-term cardiovascular outcomes in patients undergoing ICA. aPP could be a valuable addition to current risk assessment tools in this high-risk population.
PubMed IF 5.6 순환기내과
152026

제1저자 한정규 · 교신저자 한정규

, , , , , , ,
Rebound Phenomenon of Platelet Reactivity After Cessation of Long-Term Clopidogrel Therapy.
JACC Asia. 2026;6(2):249-252.

PubMed IF 6.1 순환기내과

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