SCI 발표논문

1. 44982025

   제1저자 하성찬 · 교신저자 김나영

   Ha S, Kim N, Choi SI, Nam RH, Jang JY, Kim EH, Song CH, Na HY, Kim W

   Age- and Sex-dependent Effects of High-fructose, High-fat Diets on Small Bowel Inflammation and Hepatic Steatosis in F344 Rats.

   J Neurogastroenterol Motil. 2025;31(4):477-490.

   Abstract

   BACKGROUND/AIMS The liver and small bowel are closely interrelated, and their diet-induced metabolic dysfunction-associated steatotic liver disease (MASLD) may also be influenced by age and sex. Therefore, this study aims to investigate the effects of age and sex on hepatic steatosis and small bowel inflammation induced by a high-fructose and high-fat diet (HFHFD) in rats.

   METHODS Male and female rats, aged 6 weeks (young) and 2 years (aged), were used. The HFHFD groups were provided with a high-fat diet and high-fructose water for 8 weeks. Liver and small bowel tissues were histologically analyzed. Tight junction protein expression in jejunal mucosa was analyzed, and immunohistochemistry was performed to detect claudin-2 (Cldn-2).

   RESULTS The histological inflammation scores of the old control groups were higher than those of the young control groups, regardless of sex. The jejunal villus/crypt ratio in the young rats was decreased in the male HFHFD group (P = 0.045). In contrast, in aged rats, the villus/crypt ratio decreased in the female HFHFD group (P = 0.076). Hepatic steatosis was higher for the male HFHFD groups (young, P = 0.003; aged, P = 0.005) and in the aged female HFHFD groups (P = 0.003). The correlation of jejunal inflammation scores with hepatic steatosis (P < 0.001) and Cldn-2 mRNA expression (P = 0.047) was significant, with the highest expression observed in aged female HFHFD rats.

   CONCLUSION MASLD may be associated with HFHFD-induced jejunal damage. In addition, the upregulation of Cldn-2 may contribute to MASLD in aged female rats.

   PubMed IF 3.7 소화기내과
2. 44972025

   제1저자 이민우, 박진명 · 교신저자 한경도, 이상협

   Lee MW, Park JM, Cho IR, Chung KH, Kim BS, Choi JH, Paik WH, Ryu JK, Han K, Lee SH

   Serum gamma-glutamyl transferase level is associated with the risk of pancreatic cystic neoplasms: A nationwide retrospective cohort study.

   World J Gastroenterol. 2025;31(40):110932.

   Abstract

   BACKGROUND Gamma-glutamyl transferase (GGT) is a known surrogate marker of hepatic dysfunction and oxidative stress. It has recently been reported to be associated with metabolic diseases, cardiovascular diseases, and malignancies including pancreatic cancer. However, data on its association with pancreatic cystic neoplasm (PCN), is unknown.

   AIM To investigate the association of GGT with the incidence of PCN.

   METHODS In this nationwide retrospective cohort study, participants who received general health checkup by National Health Insurance Service in 2009 were included. Newly diagnosed PCNs from one year after the checkup to 2020 were identified. Participants were divided into quartiles based on GGT levels. Multivariable cox proportional hazard models estimated the risk of PCNs according to GGT quartiles (Q1-Q4). Subgroup analyses by age, sex, and comorbidities, and sensitivity analyses varying lag periods and GGT categorizations were performed.

   RESULTS There were 28940 cases of PCNs among 2655665 eligible participants. The incidence rate was 1.09 cases per 1000 person-years, with a median follow-up of 10.32 (interquartile range: 10.09-10.58) years. In multivariate regression analysis, adjusted hazard ratios for GGT quartiles using Q1 group as a reference were: 1.04 [95% confidence interval (CI): 1.005-1.075] for Q2, 1.065 (95%CI: 1.03-1.102) for Q3, and 1.109 (95%CI: 1.07-1.15) for Q4. Subgroup analysis showed consistent results across age, sex, and comorbidities. In sensitivity analyses, the association remained robust even at 3-year and 5-year lag periods. A clear dose-response relationship was also observed when using GGT deciles (All P for trend < 0.001).

   CONCLUSION Higher GGT level is associated with increased risk of PCNs. Therefore, serum GGT levels might have a role as a biomarker for the development of PCNs.

   PubMed IF 7.7 소화기내과
3. 44962025

   제1저자 김태훈, 심재민, 최의근 · 교신저자 정보영

   Kim D, Shim J, Choi EK, Oh IY, Kim J, Lee YS, Park J, Ko JS, Park KM, Sung JH, Park HW, Park HS, Kim JY, Kang KW, Kim D, Park JK, Kim DH, Kim JB, Yu HT, Kim TH, Uhm JS, Pak HN, Joung B, ALONE-AF Investigators

   Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial.

   JAMA. 2025;334(14):1246-1254.

   Abstract

   IMPORTANCE Data from randomized clinical trials on a long-term anticoagulation strategy for patients after catheter-based ablation for atrial fibrillation (AF) are lacking.

   OBJECTIVE To evaluate whether discontinuing oral anticoagulant therapy provides superior clinical outcomes compared with continuing oral anticoagulant therapy in patients without documented atrial arrhythmia recurrence after catheter ablation for AF.

   DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial including 840 adult patients (aged 19-80 years) who were enrolled and randomized from July 28, 2020, to March 9, 2023, at 18 hospitals in South Korea. Enrolled patients had at least 1 non-sex-related stroke risk factor (determined using the CHA2DS2-VASc score [range, 0-9]) and no documented recurrence of atrial arrhythmia for at least 1 year after catheter ablation for AF. The CHA2DS2-VASc score is used as an assessment of stroke risk among patients with AF (calculated using point values for congestive heart failure, hypertension, ≥75 years of age, diabetes, stroke or transient ischemic attack, vascular disease, between 65 and 74 years of age, and sex category). The date of final follow-up was June 4, 2025.

   INTERVENTIONS The patients were randomly assigned in a 1:1 ratio to discontinue oral anticoagulant therapy (n = 417) or continue oral anticoagulant therapy (with direct oral anticoagulants; n = 423).

   MAIN OUTCOMES AND MEASURES The primary outcome was the first occurrence of a composite of stroke, systemic embolism, and major bleeding at 2 years. Individual components of the primary outcome (such as ischemic stroke and major bleeding) were assessed as secondary outcomes.

   RESULTS Of the 840 adults randomized, the mean age was 64 (SD, 8) years, 24.9% were women, the mean CHA2DS2-VASc score was 2.1 (SD, 1.0), and 67.6% had paroxysmal AF. At 2 years, the primary outcome occurred in 1 patient (0.3%) in the discontinue oral anticoagulant therapy group vs 8 patients (2.2%) in the continue oral anticoagulant therapy group (absolute difference, -1.9 percentage points [95% CI, -3.5 to -0.3]; P = .02). The 2-year cumulative incidence of ischemic stroke was 0.3% in the discontinue oral anticoagulant therapy group vs 0.8% in the continue oral anticoagulant therapy group (absolute difference, -0.5 percentage points [95% CI, -1.6 to 0.6]). Major bleeding occurred in 0 patients in the discontinue oral anticoagulant therapy group vs 5 patients (1.4%) in the continue oral anticoagulant therapy group (absolute difference, -1.4 percentage points [95% CI, -2.6 to -0.2]).

   CONCLUSIONS AND RELEVANCE Among patients without documented atrial arrhythmia recurrence after catheter ablation for AF, discontinuing oral anticoagulant therapy resulted in a lower risk for the composite outcome of stroke, systemic embolism, and major bleeding vs continuing direct oral anticoagulant therapy.

   TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04432220.

   PubMed IF 65.4 순환기내과
4. 44952025

   제1저자 신동우 · 교신저자 황진혁

   Shin DW, Cho JY, Cho S, Youn Y, Hwang JH

   Development of a serum protein biomarker panel for the diagnosis of pancreatic ductal adenocarcinoma using a machine learning approach.

   Sci Rep. 2025;15(1):35659.

   Abstract

   Early detection of pancreatic ductal adenocarcinoma (PDA) remains a major clinical challenge due to the lack of reliable biomarkers. We developed and validated a machine learning (ML)-based serum protein biomarker panel to enhance PDA diagnosis. Serum concentrations of 47 protein biomarkers were measured in 355 individuals using a Luminex™ bead-based immunoassay. Multiple ML algorithms were employed to construct a diagnostic model, with SHapley Additive exPlanations (SHAP) analysis used to determine the importance of each biomarker. The diagnostic performance of the panel was assessed by the area under the receiver operating characteristic curve (AUROC), F1 score, sensitivity, specificity, and accuracy, and further validated in an independent cohort of 130 individuals. Among the tested models, CatBoost demonstrated the highest diagnostic accuracy. SHAP analysis identified CA19-9, GDF15, and suPAR as key biomarkers, and the combined panel significantly outperformed CA19-9 alone in detecting PDA across all stages (AUROC 0.992 vs. 0.952) and in early-stage PDA (AUROC 0.976 vs. 0.868). Validation in another cohort confirmed the robustness of the model, with AUROC values of 0.977 for all stages and 0.987 for early-stage PDA. These findings suggest that ML-integrated biomarker panels may enable earlier and more accurate PDA detection in clinical practice.

   PubMed IF 4.9 소화기내과
5. 44942025

   제1저자 고영혜, 이소령 · 교신저자 최의근

   Go YH, Lee SR, Choi EK, Ahn HJ, Han KD, Oh S, Lip GYH

   Direct oral anticoagulants in very elderly and high-bleeding-risk patients with atrial fibrillation often excluded from oral anticoagulation therapy: a nationwide population-based cohort study.

   Europace. 2025;27(10):8267820.

   Abstract

   AIMS In the Edoxaban Low-Dose for Elder Care Atrial Fibrillation Patients (ELDERCARE-AF) trial, very low-dose edoxaban (15 mg once daily) showed better efficacy and positive net clinical benefit compared with placebo in very elderly, high-bleeding-risk patients with atrial fibrillation (AF). However, there are limited data to generalize these results into daily practice. We aimed to investigate the optimal oral anticoagulant (OAC) strategy for the best net clinical benefit in ELDERCARE-AF-like patients.

   METHODS AND RESULTS We used the Korean nationwide claims database to identify AF patients aged ≥80 years from 2014 to 2017 who had one or more ELDERCARE-AF trial inclusion criteria. The risks of ischaemic stroke, major bleeding, all-cause death, and net clinical outcome were evaluated. Primarily, we compared patients without OAC therapy (non-OAC group) to patients with direct OAC (DOAC) therapy (DOAC group), using a propensity score weighting method. A total of 23 858 patients were included (no OAC: 16 575; warfarin: 2390; DOAC: 4893). Among the DOAC group, 69% used low dose, and 9% used very low dose. Compared with the non-OAC group, the DOAC group showed lower risks of ischaemic stroke (hazard ratio, 95% confidence interval: 0.81, 0.68-0.96) and all-cause death (0.91, 0.86-0.96) and a higher risk of major bleeding (1.44, 1.21-1.70). The DOAC group was associated with a lower risk of net clinical outcome compared with the non-OAC group (0.93, 0.88-0.98).

   CONCLUSION In very elderly, high-bleeding-risk patients with AF, DOACs that were prescribed in usual clinical practice showed better effectiveness and positive net clinical benefit compared with no OAC treatment.

   PubMed IF 10.2 순환기내과
6. 44932025

   제1저자 임수 · 교신저자 임수

   Lim S, Buranapin S, Bao X, Quiroga M, Park KH, Kang JH, Rinnov AR, Suwanagool A

   Once-weekly semaglutide 2·4 mg in an Asian population with obesity, defined as BMI ≥25 kg/m2, in South Korea and Thailand (STEP 11): a randomised, double-blind, placebo-controlled, phase 3 trial.

   Lancet Diabetes Endocrinol. 2025;13(10):838-847.

   Abstract

   BACKGROUND Consistent with WHO recommendations, obesity is defined as BMI ≥25 kg/m² in many Asian populations because of increased health risks at lower BMIs than in other populations. We aimed to investigate the efficacy and safety of once-weekly subcutaneous semaglutide 2·4 mg versus placebo in an Asian population with BMI ≥25 kg/m², together with lifestyle interventions.

   METHODS STEP 11 was a 44-week, randomised, double-blind, placebo-controlled, phase 3 trial conducted at 12 clinical sites in South Korea and Thailand. Adults (aged ≥18 years in Thailand and ≥19 years in South Korea) with obesity (BMI ≥25 kg/m²) of Asian descent, without diabetes, were randomly assigned 2:1 with a computer-generated sequence and block randomisation to once-weekly subcutaneous semaglutide 2·4 mg or placebo, with a reduced-calorie diet and increased physical activity. Participants, care providers, investigators, and assessors were masked to allocation. Coprimary endpoints, measured in all randomly assigned participants by intention to treat, were percentage bodyweight change and the proportion of participants reaching ≥5% bodyweight reduction. Confirmatory secondary endpoints were the proportion of participants with ≥10% and ≥15% bodyweight reductions and change in waist circumference. Safety was assessed via the assessment of adverse events in all participants who received at least one dose of semaglutide or placebo. This trial was registered at ClinicalTrials.gov (NCT04998136).

   FINDINGS Between Aug 15, 2022, and Nov 20, 2023, 150 participants were randomly assigned (101 to semaglutide 2·4 mg and 49 to placebo). Six (6%) in the semaglutide group and two (4%) in the placebo group discontinued treatment before week 44. 111 (74%) were female and 39 (26%) male, with a mean age of 39 years (SD 11), mean bodyweight of 83·8 kg (18·1), and mean BMI of 31·3 kg/m² (5·2). At week 44, mean change in bodyweight was -16·0% (SE 0·7) in the semaglutide 2·4 mg group versus -3·1% (0·9) in the placebo group (p<0·0001), and a greater proportion of participants reached bodyweight reductions of ≥5% (96 [96%] vs 12 [25%]; p<0·0001), ≥10% (78 [78%] vs 5 [10%]; p<0·0001), and ≥15% (53 [53·0%] vs 2 [4·2%]; p<0·0001) in the semaglutide 2·4 mg group. Mean change in waist circumference was -11·9 cm (SE 0·7) with semaglutide versus -3·0 cm (1·0) with placebo (p<0·0001). Adverse events were reported by 90 (89%) of 101 participants in the semaglutide 2·4 mg group and 38 (78%) of 49 participants in the placebo group, with 13 (13%) reporting serious adverse events in the semaglutide 2·4 mg group versus four (8%) in the placebo group. Gastrointestinal adverse events were the most common adverse events in participants in the semaglutide group.

   INTERPRETATION In this Asian population with obesity (BMI ≥25·0 kg/m²), once-weekly semaglutide 2·4 mg significantly reduced bodyweight and was well tolerated. The results have meaningful clinical and policy implications for Asian countries, where lower BMI thresholds are used to define obesity compared with other populations. The efficacy and safety of semaglutide 2·4 mg support its inclusion in local treatment guidelines. These findings might also inform reimbursement policies and national obesity strategies, highlighting the importance of population-specific approaches.

   FUNDING Novo Nordisk.

   TRANSLATIONS For the Thai and Korean translations of the abstract see Supplementary Materials section.

   PubMed IF 36.3 내분비대사내과
7. 44922025

   제1저자 김연욱 · 교신저자 김연욱

   Kim YW, Kwak KI, Choi AR, Park EJ, Lee BJ, Lee YJ, Lee CT

   Association of Pre- and Postdiagnosis Physical Activity, Promotion and Maintenance With Lung Cancer Survival: A Nationwide Cohort Study.

   J Cachexia Sarcopenia Muscle. 2025;16(5):e70092.

   Abstract

   BACKGROUND Physical activity (PA) is important for improving life expectancy and is suggested as a prognostic factor for various diseases. However, the association between PA and mortality outcomes in survivors of lung cancer remains unclear. Therefore, this study aimed to determine the association of PA levels, including changes before and after diagnosis, with mortality outcomes among survivors of lung cancer.

   METHODS We conducted a nationwide cohort study involving 23 257 individuals diagnosed with lung cancer between 1 January 2010 and 31 December 2016, who attended the National Health Screening Program within 2 years before and after diagnosis. Pre- and postdiagnosis leisure-time PA levels and changes in PA were assessed using self-administered questionnaires. Individuals who reported engaging in moderate-intensity exercise ≥ 5 days/week or vigorous-intensity exercise ≥ 3 days/week were classified as physically active. The amount of PA was calculated as the metabolic equivalent of task (MET)-min/week for each individual. All participants were followed from the date of diagnosis to 31 December 2022, for the outcome of mortality.

   RESULTS During the follow-up period of 165 344.0 person-years, 9094 deaths occurred (6633 lung cancer-specific and 2461 non-lung cancer deaths). Multivariable analyses revealed that both pre- and postdiagnosis PA were associated with significantly reduced risk of all-cause (aHR = 0.92, 95% CI = 0.88-0.97 for prediagnosis and aHR = 0.85, 95% CI = 0.81-0.89 for postdiagnosis) and lung cancer-specific (aHR = 0.93, 95% CI = 0.88-0.99 for prediagnosis and aHR = 0.89, 95% CI = 0.84-0.94 for postdiagnosis) mortality compared with inactivity. Significant dose-response relationships were observed between PA levels and mortality risk reduction. Compared with individuals who were consistently inactive before and after diagnosis, significant mortality risk reduction was seen in those who maintained PA (aHR = 0.77, 95% CI = 0.71-0.83 for all-cause and aHR = 0.81, 95% CI = 0.75-0.89 for lung cancer-specific mortality) and those who promoted PA after lung cancer diagnosis (aHR = 0.91, 95% CI = 0.85-0.96 for all-cause and aHR = 0.94, 95% CI = 0.88-1.00 for lung cancer-specific mortality). However, individuals who were active before diagnosis but became inactive after diagnosis showed no significant difference in survival outcomes compared with those who were consistently inactive.

   CONCLUSIONS Both pre- and postdiagnosis PA are associated with reduced mortality in survivors of lung cancer in a dose-response manner. Maintenance and promotion of PA after diagnosis are key to achieving optimal benefits in overall survival.

   PubMed IF 9.9 호흡기내과
8. 44912025

   제1저자 강지훈, 박성준 · 교신저자 박경우

   Kang J^*, Park S^*, Park KW, Joo HJ, Chang K, Park Y, Song YB, Ahn SG, Suh JW, Lee SY, Cho JR, Her AY, Jeong YH, Kim BK, Kim MH, Shin ES, Lim DS, Hwang D, Han JK, Yang HM, Koo BK, Kim HS, PTRG Investigators

   Long-Term Impact of Platelet Reactivity and Clinical Risk on Clinical Outcomes in Patients With Coronary Artery Disease: Analysis of the PTRG-DES Registry.

   Circ Cardiovasc Interv. 2025;18(10):e015737.

   Abstract

   BACKGROUND Platelet reactivity (PR) and clinical risk factors are known to have impact on outcomes in patients receiving percutaneous coronary intervention (PCI). We aimed to assess the interaction of PR and clinical risk assessment using the Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS2P) on adverse clinical outcomes following PCI.

   METHODS From the PTRG-DES (Platelet function and Genotype-Related Long-Term Prognosis in Drug-Eluting Stent-Treated Patients With Coronary Artery Disease) registry, 11 714 patients who underwent PCI and had a mean platelet reactivity unit (PRU) value were studied. Clinical risk was stratified using the TRS2P as low clinical risk (score 0-1) or high clinical risk (≥2), and PR was stratified as high PR (HPR, PRU ≥252) and non-HPR (PRU <252). The primary outcome was a composite of cardiac death, myocardial infarction, and stent thrombosis. Landmark analysis was performed at 1- and 12 months after PCI.

   RESULTS Among total population, mean PRU was 217.8±78.7, and mean TRS2P was 1.56±1.12. Over the long-term follow-up period, the primary outcome occurred in 335 (5.3%) patients. Patients with both high clinical risk and HPR had the highest incidence of the primary outcome (9.4%), followed by high clinical risk/non-HPR (5.9%), low clinical risk/HPR (4.8%), and low clinical risk/non-HPR (3.9%) (P<0.001). Compared with low clinical risk/non-HPR patients, those with both high clinical risk and HPR had a 3.25-fold higher risk of the primary outcome (hazard ratio, 3.25 [95% CI, 2.38-4.42]; P<0.001). Both PRU and TRS2P were independent predictors of the primary outcome. In landmark analyses, the risk of primary outcome within 1 month after PCI were mainly determined by PRU, while outcome beyond 1 month after PCI was mainly determined by TRS2P.

   CONCLUSIONS In the secondary prevention after percutaneous coronary intervention, platelet reactivity and clinical risk had additive value in predicting outcomes. Platelet reactivity had greater relative impact within 1 month while clinical risk had greater relative impact beyond 1 month.

   REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT04734028.

   PubMed IF 7.2 순환기내과
9. 44902025

   제1저자 곽순구 · 교신저자 김형관

   Kwak S, Kim HK

   Redefining Left Ventricular Systolic Dysfunction in Hypertrophic Cardiomyopathy: Ejection Fraction and Global Longitudinal Strain.

   Heart Fail Clin. 2025;21(4):499-508.

   Abstract

   Hypertrophic cardiomyopathy (HCM) is an inherited disease characterized by increased myocardial thickness without cardiac, systemic, or metabolic causes to explain the observed left ventricular (LV) hypertrophy. Importantly, LV systolic dysfunction influences symptoms, heart failure, and the risk of SCD in HCM. LV global longitudinal strain (LV-GLS) is a sensitive marker for detecting subclinical LV dysfunction and improving risk stratification. Integrating LV-GLS with other imaging biomarkers, such as late gadolinium enhancement and left atrial reservoir strain, may improve risk prediction. Future research should focus on refining LV-GLS cutoffs and exploring its utility for personalized risk assessment in HCM.

   PubMed IF 1.3 순환기내과
10. 44892025

    제1저자 박지원, 김지원 · 교신저자 임예지, 김경임

    Park J^*, Kim JW^*, Nam JH, Kim Y, Kim JW, Kang S, Lim Y, Kim K, Lee KW

    Comparative analysis of osteoporotic versus pathologic fracture in metastatic colorectal cancer patients.

    Osteoporos Int. 2025;36(10):1941-1950.

    Abstract

    UNLABELLED In metastatic colorectal cancer (mCRC) patients, the incidence rate of osteoporotic fracture (OF) was comparable to that of pathologic fracture (4.5% vs 4.2% over 2 years), and even higher in those aged ≥ 70. Because age and osteoporosis are significant risk factors, assessing osteoporosis is critical to prevent OF in older mCRC patients.

    PURPOSE Fractures in patients with metastatic colorectal cancer (mCRC) have been reported; however, most of these are pathologic fractures (PFs). This study aimed to identify the incidence rates of and risk factors for osteoporotic fracture (OF) and PF.

    METHODS We retrospectively analyzed the clinical data of mCRC patients who received palliative chemotherapy.

    RESULTS We enrolled 622 patients (359 male) consecutively. The median patient age was 61 (range, 20-91) years. Before chemotherapy, 42 (6.8%) patients had bone metastases. During follow-up, 86 (13.8%) patients experienced 96 fracture events. The cumulative incidence rates over the 2-year period were 4.5% (95% confidence interval [CI], 2.9-6.1%) and 4.2% (95% CI, 2.6-5.8%) for OF and PF, respectively. The crude incidence rate of OF was higher than that of PF in patients aged ≥ 70 years with an incidence rate ratio of 4.65 (95% CI, 1.72-15.7). Multivariable analysis identified older age (hazard ratio [HR], 1.04 [95% CI, 1.00-1.08]; p = 0.03) and osteoporosis (HR, 4.79 [95% CI, 1.51-15.16]; p = 0.01) as significant risk factors for OF after adjustment for bone and cancer-related variables. For PF, bone metastasis was a significant risk factor (HR, 9.48 [95% CI, 4.02-22.38]; p < 0.01).

    CONCLUSIONS The incidence rate of OF was comparable to that of PF and even higher in mCRC patients aged ≥ 70 years. While bone metastasis was a risk factor for PF, advanced age and osteoporosis were the risk factors for OF. Therefore, osteoporosis assessment and treatment are crucial to prevent OF during chemotherapy, particularly in the elderly.

    PubMed IF 5.4 소화기내과
11. 44882025

    제1저자 박승신, 정현묵 · 교신저자 김정희

    Park SS^*, Jeong H^*, Ahn CH, Park MJ, Kong SH, Kim SW, Shin CS, Kim YH, Kim K, Kim JH

    Fracture risks in patients aged 50 years and older with panhypopituitarism: a nationwide cohort study.

    Osteoporos Int. 2025;36(10):1951-1963.

    Abstract

    UNLABELLED This study investigated fracture risks in 3,877 older adults with panhypopituitarism compared with matched controls using Korean health insurance data. Findings showed higher risks of major osteoporotic, spine, and hip fractures in both men and women with panhypopituitarism compared to controls, with a more pronounced increase in risk among men.

    PURPOSE Patients with hypopituitarism are known to have increased cardiovascular risk and mortality; however, data on fracture risk are limited. We aimed to identify gender- and site-specific fracture risks and factors associated with fractures in patients aged ≥ 50 years with panhypopituitarism, compared with age-, sex-, and index year-matched controls.

    METHODS Using the Korea National Health Insurance Service (NHIS) Database, we identified 3,877 patients with panhypopituitarism aged ≥ 50 years and 1:10 age-, sex-, and index year-matched controls. Demographics comorbidities, and fracture outcomes, including major osteoporotic fractures (MOFs), vertebral fractures (VFs), non-vertebral fractures (non-VFs), and hip fractures (HFs), were obtained using the International Classification of Disease-10 codes and hospital records.

    RESULTS The mean ages of male and female panhypopituitary patients were 63.5 and 63.6 years, respectively. Male patients exhibited a significantly elevated risk of MOFs (hazard ratio [HR] = 2.16, 95% confidence interval [CI] = 1.87-2.48), VFs (HR = 2.13, 95% CI = 1.80-2.51), non-VFs (HR = 2.41, 95% CI = 1.94-3.00), and HFs (HR = 2.28, 95% CI = 1.59-3.27) compared to controls (all P < 0.001). Similarly, female patients demonstrated a significantly increased risk of MOFs (HR = 1.29, 95% CI = 1.16-1.42), VFs (HR = 1.45, 95% CI = 1.29-1.63), and HFs (HR = 1.68, 95% CI = 1.26-2.24) compared to controls (all P < 0.001), but not non-VFs. In addition to known risk factors like age, female sex, and fracture history, cerebrovascular disease, dementia, and low income were also associated with higher MOFs.

    CONCLUSION Patients with panhypopituitarism, particularly males, have a higher risk of fracture than matched controls. Comorbidities such as dementia and cerebrovascular disease may further increase the risk of fractures.

    PubMed IF 5.4 내분비대사내과
12. 44872025

    제1저자 최용훈 · 교신저자 김나영

    Choi Y, Kim N, Park JH, Song CH, Oh HJ

    Expression Rates of Sex Hormone Receptors with Their Clinical Correlates in Gastric Cancer Patients and Normal Controls.

    World J Mens Health. 2025;43(4):980-991.

    Abstract

    PURPOSE Sex hormones affect development and prognosis of gastric cancer (GC). This study aimed to compare the sex hormone receptor expression between control and GC, and to evaluate its correlation with patient characteristics.

    MATERIALS AND METHODS 110 patients (74 with GC, 36 controls) underwent immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) for estrogen receptors (ERs) α and β and androgen receptor (AR). The effect of ERs and AR on the clinicopathological and tumor characteristics were analyzed.

    RESULTS The positive rate of ERα, ERβ, and AR in GC tissue was 64.9%, 78.4%, and 60.8% by IHC and 41.4%, 27.6%, and 48.3% in RT-PCR respectively. In control, the positive rate of those was 16.7%, 80.6%, and 38.9% by IHC and 22.2%, 58.3%, and 19.4% in RT-PCR respectively. The IHC and RT-PCR results showed concordance with each other, and ERα and AR expressions were positively correlated with cancer, while ERβ showed the opposite pattern. ERα expression was correlated with Helicobacter pylori negativity (p<0.001), diffuse or mixed-type histology (p=0.014), and undifferentiated histology (p<0.001), and AR expression was related to H. pylori negativity (p<0.001), cardiac cancer (p=0.040), and undifferentiated histology (p<0.001). The higher expression rate of ERα in males and that of AR in females seemed to be related with cancer, showing sex differences.

    CONCLUSIONS The expression rates of ERα, ERβ, and AR were different depending on sex, histologic type and H. pylori infection status, which may explain sex-based differences in GC.

    PubMed IF 4.3 소화기내과
13. 44862025

    제1저자 김학령 · 교신저자 김명아

    Kim HL, Park SM, Yoon HJ, Jin SA, Rhee MY, Shin MS, Hong KS, Kim HJ, Song S, Kim SJ, Kim MA

    Clinical Factors Associated With Three-Year Cardiovascular Outcomes in Women Who Underwent Invasive Coronary Angiography: Data From the KoRean wOmen'S chest pain rEgistry (KoROSE).

    Korean Circ J. 2025;55(10):877-888.

    Abstract

    BACKGROUND AND OBJECTIVES This study aimed to assess clinical factors that predict long-term clinical outcomes in women who underwent invasive coronary angiography (ICA).

    METHODS A total of 741 Korean women (mean age 63.9±9.3 years) who underwent ICA for suspected angina were selected from a nationwide registry database. The three-year incidence of composite major adverse cardiovascular events (MACEs) including cardiac death, acute coronary syndrome, stroke, and heart failure requiring hospitalization was assessed.

    RESULTS Within 3 years of clinical follow-up, there were 42 MACEs (5.7%). Multiple Cox regression analysis identified tachycardia (heart rate ≥100 beats per minute: hazard ratio [HR], 4.04; 95% confidence interval [CI], 1.19-13.71; p=0.025), multi-vessel disease (HR, 2.08; 95% CI, 1.04-4.19; p=0.038), left ventricular hypertrophy (left ventricular mass index >95 g/m²: HR, 2.79; 95% CI, 1.37-5.65; p=0.004), and the use of diuretics (HR, 2.51; 95% CI, 1.10-5.76; p=0.029) as significant predictors of 3-year MACEs. For subjects with three of 4 these clinical factors, the risk of MACE increased by 11.79 times compared to subjects with 0-2 clinical factors (95% CI, 4.55-30.56; p<0.001).

    CONCLUSIONS In Korean women undergoing elective ICA, tachycardia, multi-vessel disease, left ventricular hypertrophy and the use of diuretics were associated with 3-year MACEs. These indicators should be considered in managing women with suspected angina.

    PubMed IF 3.4 순환기내과
14. 44852025

    제1저자 송진희, 최용훈 · 교신저자 김나영

    Song CH, Choi Y, Kim N, Nam RH, Kim JW, Jang JY, Kim EH, Ha S, Lee HN

    Sex-Specific Molecular Markers NRF2 and PD-L1 in Colon Carcinogenesis: Implications for Right-Sided Colon Cancer.

    Cancer Res Treat. 2025;57(4):1090-1103.

    Abstract

    PURPOSE This study examined the roles of nuclear factor erythroid 2-related factor 2 (NRF2) and programmed death ligand 1 (PD-L1) in colon carcinogenesis, underscoring on sex and differences in tumor location.

    MATERIALS AND METHODS A total of 378 participants were enrolled from Seoul National University Bundang Hospital: 88 healthy controls (HC), 139 patients with colorectal adenoma (AD), and 151 patients with colorectal cancer (CRC). Quantitative real-time polymerase chain reaction (PCR), methylation-specific PCR, and immunohistochemistry (IHC) were performed utilizing tumor samples from patients and normal mucosa in the HC group.

    RESULTS NRF2 mRNA expression was higher in the CRC group than in the HC and AD groups, with decreased NRF2 methylation in the AD and CRC groups. NRF2 protein expression, as evaluated by IHC, increased in the AD and CRC groups relative to that in the HC group. PD-L1 protein expression was remarkably higher in the CRC group than in the HC and AD groups. These patterns were consistent in both males and females. In sex- and CRC location-specific analyses, NRF2 methylation was lower in female than in male patients with CRC. NRF2 protein expression was significantly higher in females, particularly in patients with right-sided CRC. Moreover, females exhibited increased PD-L1 mRNA expression compared to males in the AD group, and PD-L1 mRNA levels were higher in females with right-sided CRC than in those with cancer at other locations.

    CONCLUSION Differences in NRF2 and PD-L1 expression indicate site-specific colon carcinogenesis based on sex, particularly in females with right-sided CRC.

    PubMed IF 4.2 소화기내과
15. 44842025

    제1저자 김윤규 · 교신저자 박준원

    Kim YK, Curtis JR, Choi SR, Yeo J, Kim MJ, Lee YJ, Lee EB, Park JW

    Time-Dependent Effect of Prophylactic Trimethoprim-Sulfamethoxazole on the Incidence of Serious Infections in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Target Trial Emulation Study.

    Arthritis Rheumatol. 2025;77(10):1407-1415.

    Abstract

    OBJECTIVE The objective of this study was to investigate the effect of prophylactic trimethoprim-sulfamethoxazole (TMP-SMX) on the incidence of serious infections in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).

    METHODS This multicenter cohort study was designed to emulate a target trial that studied 296 patients with AAV who were treated with rituximab (RTX) or cyclophosphamide (CYC) as induction therapy. Patients were grouped based on the administration of TMP-SMX within 14 days following induction therapy (n = 240 and 56 patients in prophylaxis and control groups, respectively) (intention-to-treat) and also as a time-dependent exposure (time-varying). Inverse probability weighting was applied to minimize the baseline imbalance between the two groups. The primary outcome was one-year incidence of serious infection.

    RESULTS During the 252.1 person-years of observation, 77 cases of serious infections were recorded in 65 patients with a fatality rate of 18.5%. Most serious infections (n = 66, 85.7%) occurred within the first 180 days of observation. The prophylaxis group showed a significantly lower incidence of serious infections than the control group (hazard ratio [HR] 0.48 [95% confidence interval (CI) 0.32-0.72]). However, this beneficial effect of TMP-SMX was only significant during the first 180 days (HR 0.41 [95% CI 0.22-0.76]) and not thereafter (HR 3.67 [95% CI 0.46-29.43]) (interaction P = 0.044). This result was also consistent with the time-varying analysis result. Based on one case of severe adverse drug reaction related to TMP-SMX, the number needed to harm was 127.4, whereas the number needed to treat to prevent one serious infection was 8.0.

    CONCLUSION Prophylactic TMP-SMX significantly reduced the risk of serious infections in patients with AAV, particularly during the first six months of induction therapy with RTX or CYC.

    PubMed IF 9.9 류마티스내과
16. 44832025

    제1저자 고윤미, 허문행 · 교신저자 김윤준

    Ko Y, Hur MH, Park Y, Park J, Shin H, Lee YB, Cho EJ, Lee JH, Yu SJ, Yoon JH, Kim YJ

    Comparison of the Efficacy of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter-2 Inhibitors in Diabetic Patients with Steatotic Liver Disease.

    Gut Liver. 2025;19(5):758-769.

    Abstract

    BACKGROUND/AIMS There is currently insufficient evidence to recommend one oral hypoglycemic agent over another for diabetic patients to reduce hepatic steatosis or prevent advanced fibrosis. We aimed to evaluate the efficacy of dipeptidyl peptidase-4 inhibitors (DPP-4i) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in patients with type 2 diabetes mellitus (DM) and metabolic dysfunction-associated steatotic liver disease (MASLD).

    METHODS This study included diabetic patients with steatotic liver disease who newly received either a DPP-4i or an SGLT-2i as a second-line treatment between 2014 and 2021 at a single tertiary hospital. MASLD was categorized as MASLD-H (radiologic steatosis with a hepatic steatosis index [HSI]>36) or MASLD-I (radiologic steatosis only). Changes in the HSI and fibrosis-4 (FIB-4) index were compared at 1 and 3 years after treatment initiation.

    RESULTS A total of 3,493 patients were consecutively enrolled, with 3,001 receiving DPP-4i treatment and 492 receiving SGLT-2i treatment. After applying propensity score matching, the SGLT-2i group showed a significantly greater reduction in the HSI than the DPP-4i group in the DM-MASLD population at both 1 year (DM-MASLD-H: DPP-4i vs SGLT-2i, -1.4% vs -3.7%, p<0.001; DM-MASLD-I: -1.3% vs -3.8%, p<0.001) and 3 years (DM-MASLD-H: -2.0% vs -4.0%, p=0.001; DM-MASLD-I: -2.4% vs -4.2, p=0.025). The FIB-4 indices of both groups increased; however, the increase at year 1 was more significant in the DPP-4i than in the SGLT-2i group (DM-MASLD-H: 11.4% vs 5.2%, p<0.001; DM-MASLD-I: 10.7% vs 4.3%, p=0.014).

    CONCLUSIONS In patients with DM-MASLD, SGLT-2i treatment was associated with a greater reduction in hepatic steatosis and delayed fibrotic progression than DPP-4i treatment.

    PubMed IF 4.1 소화기내과
17. 44822025

    제1저자 전중원, 김영애 · 교신저자 황진혁, 우상명

    Chun JW, Kim YA, Lee JW, Lee D, Jang DK, Lee YS, Lee JC, Lee WJ, Hwang JH, Woo SM

    Effectiveness and cost analysis of liposomal irinotecan in patients with pancreatic adenocarcinoma: a multicenter real-world study.

    Ther Adv Med Oncol. 2025;17:17588359251370492.

    Abstract

    BACKGROUND Systemic chemotherapy is crucial for pancreatic adenocarcinoma (PAC). It serves as a palliative chemotherapy for unresectable PAC and as a (neo-)adjuvant chemotherapy for (borderline) resectable PAC. Survival benefits were found with the use of liposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI/5-FU/LV) in the global phase III NAPOLI-1 trial. However, limited evidence supports the cost-effectiveness of liposomal irinotecan throughout the PAC treatment course.

    OBJECTIVES We investigated the real-world efficacy and cost implications of nal-IRI/5-FU/LV in PAC management.

    DESIGN A multicenter real-world study.

    METHODS We analyzed real-world data from electronic health records to evaluate outcomes of nal-IRI/5-FU/LV exposure in this retrospective study. Effectiveness was assessed using overall survival (OS). Medical costs were those incurred from imaging or laboratory tests, chemotherapy, surgery, radiotherapy, and supportive care during inpatient, outpatient, and emergency department visits. Propensity score matching was used to adjust for potential differences in patient characteristics between the nal-IRI and non-liposomal irinotecan groups. The incremental cost-effectiveness ratio (ICER) was calculated by dividing cost differences by survival gains.

    RESULTS Overall, 1734 patients diagnosed with PAC were screened, and 705 who received at least one cycle of chemotherapy were included in the analysis. The median OS was significantly longer in the nal-IRI group than in the non-liposomal irinotecan group (28.0 vs 18.3 months, p = 0.011). Patients in the nal-IRI group had more hospital visits and admissions during follow-up and incurred higher costs ($61,430 vs $39,129 per patient), which resulted in an ICER of $2787 per month of survival gained ($33,285 per life-year gained).

    CONCLUSION Despite its higher cost, nal-IRI/5-FU/LV significantly improved the survival of patients with PAC compared to the conventional chemotherapies. Our findings suggest that it may be a cost-effective treatment option for gemcitabine failure despite the high cost of liposomal irinotecan, considering the poor prognosis of PAC.

    PubMed IF 4.1 소화기내과
18. 44812025

    제1저자 양현림, 박성아 · 교신저자 이진우

    Yang HL, Park SA, Lee HY, Lee H, Ryu HG, Lee HC, Lee SM, Lee J

    Associations of driving pressure and mechanical power with postoperative pulmonary complications in one-lung ventilated surgery.

    J Clin Anesth. 2025;106:111981.

    Abstract

    BACKGROUND The potential clinical value of driving pressure (DP) and mechanical power (MP) as digital biomarkers for predicting postoperative pulmonary complications (PPC) has been emphasized. Although several studies have explored this association, evidence from clinical cohorts involving large patient populations remains limited.

    METHODS A retrospective cohort study was conducted between October 2004 and May 2023 on patients who underwent OLV surgery. The association between time-weighted median dynamic DP or MP and PPC was analyzed using multivariate logistic regression models adjusted for confounders. Additionally, risk threshold analysis was conducted to propose thresholds for an increased risk of PPC.

    RESULTS Among the 3386 (using plateau pressure; Pplat) or 4951 (using peak inspiratory pressure; PIP) patients included, PPC occurrence was 19.31 % and 17.43 %, respectively. The mean of the time-weighted median DP derived from Pplat (DP-Pplat) and MP derived from Pplat (MP-Pplat) were 14.6 cmH₂O and 7.1 J/min, while DP-PIP and MP-PIP were 17.2 cmH₂O and 6.4 J/min. Both calculation methods showed that DP had an independent association with the occurrence of PPC, with an odds ratio of 1.047 [95 % CI 1.019-1.075, p < 0.05] and 1.036 [95 % CI 1.013-1.059, p < 0.05] using Pplat and PIP, respectively. However, MP was not found to be independently associated with PPC using either method, with an odds ratio of 1.033 [95 % CI 0.980-1.089, p = 0.226] and 1.048 [95 % CI 0.992-1.106, p = 0.092] using Pplat and PIP, respectively. The risk threshold for DP-Pplat was 15 cmH₂O, whereas for DP-PIP, it was 18 cmH₂O.

    CONCLUSIONS In this OLV surgery population, a DP-Pplat-limited mechanical ventilation strategy of 15 cmH₂O or DP-PIP of 18 cmH₂O was associated with lower risk of PPC.

    PubMed IF 6 호흡기내과
19. 44802025

    제1저자 김태민 · 교신저자 Sophia S Randolph

    Kim TM, Lakhani NJ, Soumerai J, Kamdar M, Gainor JF, Messersmith W, Fanning P, Guan S, Jin F, Forgie A, Wan HI, Pons J, Randolph SS, Kim WS

    Evorpacept plus rituximab for the treatment of relapsed or refractory non-Hodgkin lymphoma: results from the phase I ASPEN-01 study.

    Haematologica. 2025;110(9):2102-2112.

    Abstract

    CD47 overexpression has been associated with tumor cell survival. We present the safety, pharmacokinetics, pharmacodynamics, and preliminary anti-tumor activity of evorpacept, a novel fusion protein comprising a high-affinity CD47-SIRPα immune checkpoint inhibitor to promote tumor cell phagocytosis and inactive Fc domain to spare healthy cells, plus rituximab in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL) from the phase I ASPEN-01 study. Thirty-three patients received intravenous evorpacept (10 mg/kg [N=22] or 15 mg/kg [N=11] once weekly) until disease progression, in combination with fixed-duration intravenous rituximab (375 mg/m2 once weekly for 4 weeks, then every 4 weeks for 8 months). Evorpacept plus rituximab was well tolerated, with no dose-limiting toxicities; no maximum tolerated dose was identified. The most common treatment-related adverse events (TRAE) were rash (24.2%) and fatigue (15.2%); most TRAE (70.0%) were mild-to-moderate in severity. Four (12.1%) patients reported grade 3 TRAE: anemia, neutropenia, decreased neutrophil count, increased alanine aminotransferase, decreased lymphocyte count, and decreased platelet count (1 of each). Two (6.1%) patients experienced grade 4 TRAE (neutropenia, decreased neutrophil count). Six (18.2%) patients experienced serious AE (not treatment-related): asthma, dyspnea, respiratory failure, gastrointestinal infection, pneumonia, cardiac failure, and disease progression (1 of each). Two (6.1%) deaths occurred (not treatment-related). Pharmacokinetics/ pharmacodynamics were consistent with previous studies, with complete CD47 target occupancy (≥85%) achieved at both doses. In response-evaluable patients (N=32), objective response rate was 50.0% (95% confidence interval: 33.1-69.8%). The safety, tolerability, and promising anti-tumor activity of evorpacept plus rituximab support continued evaluation of this combination in NHL (clinicaltrials gov. Identifier: NCT03013218).

    PubMed IF 8.2 혈액종양내과
20. 44792025

    제1저자 임주현 · 교신저자 박진영

    Lim JH, Poļaka I, Ražuka-Ebela D, Bogdanova I, Parshutin S, Leja M, Park JY

    Positive association between anti-Helicobacter pylori IgG antibody titers and atrophic gastritis in a Latvian cohort.

    Gastric Cancer. 2025;28(5):749-759.

    Abstract

    BACKGROUND Although H. pylori is the most important risk factor for gastric cancer, the role of anti-H. pylori antibody titers in gastric carcinogenesis has not been investigated outside Asia. We aimed to analyze the relationship between H. pylori antibody titers and the risk of gastric precancerous lesions in a Caucasian population.

    METHODS We analyzed the GISTAR pilot study data on participants from Latvia with available anti-H. pylori IgG antibody serology and histopathological information. Participants were classified into four groups according to antibody titer: low-negative (LN), high-negative (HN), low-positive (LP), and high-positive (HP). Odds ratios (ORs) for atrophic gastritis among the 4 groups were compared using logistic regression.

    RESULTS Among a total of 1725 individuals, 970 with available histopathological information were included. A total of 738 individuals (76.1%) had histologically diagnosed atrophic gastritis. Risk of histological atrophic gastritis for each group compared to LN was as follows: HN (OR, 1.52; 95% confidence interval (CI) 0.85-2.72), LP (OR 2.04; 95% CI 1.25-3.32), and HP (OR, 2.47; 95% CI 1.50-4.07). Antibody titer as a continuous variable showed a positive relationship with histological atrophic gastritis (OR 1.09 per 10 EIU; 95% CI 1.04-1.14). The positive relationship was clearer among those aged ≥ 50 years.

    CONCLUSIONS Anti-H. pylori antibody titer was positively related to the risk of atrophic gastritis in a middle-aged Caucasian population, suggesting its potential complementary role in gastric cancer risk stratification in a European setting where upper endoscopic examination is less routinely available.

    PubMed IF 6.1 소화기내과
21. 44782025

    제1저자 강준규, 최진호 · 교신저자 이상협

    Kang J, Choi JH, Lee SH, Kim J, Lee TS, Chang SH, Song YS, Cho IR, Paik WH, Ryu JK

    Korean Red ginseng supplements improve quality of life in patients with mild chronic pancreatitis symptoms: A prospective clinical trial.

    J Ginseng Res. 2025;49(5):502-508.

    Abstract

    BACKGROUND Managing symptoms of chronic pancreatitis (CP) remains a significant challenge. Korean Red ginseng (KRG), a well-known herbal supplement, has shown potential benefits in various health conditions, prompting its investigation in CP patients.

    METHODS We conducted a single-arm, prospective clinical trial to evaluate the effect of KRG on quality of life in CP patients exhibiting mild symptoms, as defined by a Clinical Global Impression (CGI) score of 0 or 1. 40 patients were enrolled and assessed at baseline, as well as at 30, 90, and 180 days. The primary outcome was an improvement in CGI scores, with secondary outcomes including changes in Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q) scores.

    RESULTS A total of 40 patients were enrolled in this study, and 39 participants were analyzed. Results showed significant improvements in CGI scores at all examined intervals (days 0-30, 0-90, 0-180; p < 0.05). The PEI-Q score also significantly improved from day 0 to day 180 (p < 0.05). Two adverse events (AEs) probably related to KRG were reported, and all AEs were improved with conservative managements.

    CONCLUSION KRG supplementation significantly improves quality of life in CP patients with mild symptoms. These findings suggest that KRG may be a beneficial adjunct therapy in this patient population. Further research is needed to explore KRG's pharmacological mechanisms, its use in combination with other treatments, and its effects in patients with more severe symptoms. (CRIS number: KCT0009681).

    PubMed IF 7.5 소화기내과
22. 44772025

    제1저자 박평강, 황주현, 김용준 · 교신저자 한승석, 김현제

    Park PG^*, Hwang J^*, Kim Y^*, Hong M, Yun D, Yoon H, Kang C, Bae S, Kwak SH, Kim YC, Moon KC, Lee DS, Kim YS, Kang HG, Kim HJ, Han SS

    Inflammatory Milieu by Crosstalk between Glomerulus and Proximal Tubular Cells in Type 2 Diabetes Mellitus Kidney Disease.

    Diabetes Metab J. 2025;49(5):1024-1039.

    Abstract

    BACKGRUOUND Due to the limited availability of therapeutic agents for type 2 diabetic kidney disease (T2DKD), there is a need for further knowledge derived from experimental models and innovative techniques. In addressing this issue, single-cell RNA sequencing (scRNA-seq) has been exclusively applied to a genetically modified diabetic kidney disease model, but not to an induced model representing T2DKD. Herein, we analyzed scRNA-seq and other experiments from an induced T2DKD model and validated the results in human-derived biospecimens.

    METHODS The model was induced by combining a high-fat diet with streptozotocin to simulate induced T2DKD. scRNA-seq, histological, and flow cytometric analyses were conducted, and the results were compared with control mice. The findings were then applied to human T2DKD kidneys.

    RESULTS Biochemical and histological analyses unveiled early-stage T2DKD features, such as hyperfiltration, increased proteinuria, glomerulomegaly, and interstitial fibrosis. scRNA-seq identified that proximal tubules secreted a variety of chemokines, potentially in response to crosstalk with glomeruli. Notably, C-X-C motif chemokine 12 (CXCL12) emerged as a key player in potentially promoting T-cell recruitment. Flow cytometry substantiated T-cell infiltration into the kidney of the T2DKD model. This finding was further corroborated in human biopsied kidney tissues, showing a correlation between elevated CXCL12 levels and T2DKD progression.

    CONCLUSION The induced T2DKD model highlights the pivotal role of CXCL12-mediated T-cell infiltration, stemming from the crosstalk between proximal tubules and glomeruli. This data serves as a foundation for future studies, promising a therapeutic target for T2DKD.

    PubMed IF 8.2 신장내과
23. 44762025

    제1저자 박제연, 정고은 · 교신저자 한경도, 조은주

    Park J, Chung GE, Yu SJ, Kim YJ, Yoon JH, Han K, Cho EJ

    All-cause and disease-specific mortality in young adults with MASLD: A nationwide cohort study.

    JHEP Rep. 2025;7(9):101477.

    Abstract

    BACKGROUND & AIMS Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a major cause of chronic liver disease globally, particularly among young adults. We aimed to analyze all-cause and disease-specific mortality in young adults with MASLD.

    METHODS In this nationwide cohort study, we analyzed data from the Korean National Health Insurance Service, focusing on individuals aged 20 to 39 years who underwent health screenings between 2009 and 2012. The participants were categorized into two groups: those with MASLD and those without steatotic liver disease (SLD). SLD was defined by a fatty liver index ≥30. Mortality risk was analyzed via Cox proportional hazards models.

    RESULTS A total of 5,699,047 participants were included in the study, 25.4% of whom had MASLD. During a median follow-up of 10.6 years (interquartile range, 9.5-11.2), all-cause death occurred in 11,706 (0.8%) participants in the MASLD group and in 19,611 (0.5%) in the non-SLD group. Young adults with MASLD had a significantly greater risk of all-cause mortality than those without steatosis (adjusted hazard ratio [aHR], 1.15; 95% CI 1.12-1.19). The MASLD group also had an increased risk of mortality related to cardiovascular disease, liver cancer, and liver disease, whereas the risk of extrahepatic cancer-related mortality did not significantly differ between the two groups. Compared to men with MASLD, women with MASLD had higher risks of all-cause, cardiovascular, extrahepatic cancer, and liver disease-related mortality, although the risk of liver cancer-related mortality was similar between the sexes.

    CONCLUSION Young adults with MASLD are at a significantly increased risk of all-cause and disease-specific mortality. These findings underscore the importance of early detection and intervention to mitigate the long-term outcomes of MASLD in young adults.

    IMPACT AND IMPLICATIONS Global increases in obesity among adolescents and young adults are driving an increase in the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in these populations. In this nationwide cohort study, young adults with MASLD were found to have a significantly greater risk of all-cause mortality, as well as mortality related to cardiovascular disease, liver cancer, and liver disease than those without steatosis. Therefore, early detection and timely intervention for MASLD in young adults are crucial to improving clinical outcomes and reducing the global burden of the disease.

    PubMed IF 8.7 소화기내과
24. 44752025

    제1저자 김주연 · 교신저자 박준원

    Kim JY, Choi SR, Park JK, Lee EY, Lee EB, Park JW

    Clinical Factors Associated With Pneumocystis Pneumonia Despite Its Primary Prophylaxis: When to Stop Prophylaxis?

    Arthritis Rheumatol. 2025;77(9):1263-1272.

    Abstract

    OBJECTIVE Although previous studies show that primary prophylaxis against Pneumocystis jirovecii pneumonia (PJP) is effective in patients with rheumatic diseases receiving immunosuppressive treatment, there is limited evidence regarding the optimal timing for prophylaxis withdrawal. This study aimed to identify the risk factors for PJP despite prophylaxis and provide evidence for an optimal prophylaxis schedule.

    METHODS This case-control study included 1,294 prophylactic episodes in 1,148 patients with rheumatic disease who received immunosuppressants and prophylactic trimethoprim-sulfamethoxazole (TMP-SMX). The primary outcome was a one-year incidence of PJP. A Cox proportional hazards model with least absolute shrinkage and selection operator was used to evaluate clinical factors associated with outcomes.

    RESULTS During 1,174 person-years of observation, 10 cases of PJP were identified, with an incidence rate of 0.85 per 100 person-years. The mean ± SD duration of TMP-SMX prophylaxis was 181.9 ± 128.7 days. Except in one case, PJP occurred after discontinuation of TMP-SMX, with a median (interquartile range [IQR]) interval of 117.0 (86.0-161.0) days. The dose of glucocorticoids at the time of TMP-SMX discontinuation was significantly higher in the PJP group relative to the control group (median [IQR]: 22 [20-40] vs 10 [5-15] mg). Discontinuing TMP-SMX while on a glucocorticoid dose >12.5 mg/day of prednisone equivalent significantly increased the risk of PJP (adjusted hazard ratio: 13.84; 95% confidence interval, 1.71-111.80). There were 63 cases of adverse events during the observation period, and 10 (15.9%) were attributed to TMP-SMX with probable causality.

    CONCLUSION Tapering glucocorticoids with 12.5 mg/day of prednisone equivalent could be a reasonable timepoint to initiate the withdrawal of PJP prophylaxis in patients with rheumatic diseases.

    PubMed IF 9.9 소화기내과
25. 44742025

    제1저자 양석훈, Xinyang Hu, Jinlong Zhang · 교신저자 구본권, 남창욱, Jian\'an Wang

    Yang S, Hu X, Zhang J, Jiang J, Hahn JY, Doh JH, Lee BK, Kim W, Huang J, Jiang F, Zhou H, Chen P, Tang L, Jiang W, Chen H, Chen X, He W, Ahn SG, Tahk SJ, Kim U, Hwang D, Kang J, Ki YJ, Shin ES, Nam CW, Wang J, Koo BK, FLAVOUR Investigators

    Long-Term Outcomes After Fractional Flow Reserve vs Intravascular Ultrasound to Guide PCI: The FLAVOUR Trial Extended Follow-Up.

    J Am Coll Cardiol. 2025;86(8):593-606.

    Abstract

    BACKGROUND The optimal treatment strategy for patients with intermediate coronary stenosis remains uncertain.

    OBJECTIVES The aim of this study was to investigate the long-term outcomes of a randomized, open-label, multinational trial comparing fractional flow reserve (FFR)-guided vs intravascular ultrasound (IVUS)-guided treatment strategies.

    METHODS Patients aged ≥19 years with de novo intermediate coronary stenosis (40%-70%) and target vessel diameters ≥2.5 mm were randomized 1:1 to FFR- or IVUS-guided treatment across 18 sites in Korea and China. The primary endpoint was a composite of all-cause death, myocardial infarction, and any revascularization occurring after the index procedure. Secondary endpoints included individual components of the primary outcome and per vessel outcomes according to treatment type. Extended follow-up continued through September 2024.

    RESULTS Between July 2016 and August 2019, 1,682 patients were assigned to the FFR-guided (n = 838) and IVUS-guided (n = 844) groups. Over a median follow-up period of 6.3 years (Q1-Q3: 5.6-6.9 years), the primary outcome occurred in 339 patients (22.0%), with no statistically significant difference between groups (179 [23.1%] for FFR vs 160 [20.9%] for IVUS; HR: 1.15; 95% CI: 0.93-1.42; P = 0.208). The revascularization rate after the index procedure was higher in the FFR group (113 [14.9%] vs 87 [11.8%]; HR: 1.32; 95% CI: 1.00-1.75; P = 0.049), particularly for target vessel revascularization (72 [9.6%] vs 44 [6.2%]; HR: 1.67; 95% CI: 1.15-2.43; P = 0.007). Landmark analysis at 2 years and per vessel analyses indicated that the higher revascularization rate after the index procedure was driven primarily by late (2-7 years) revascularizations in vessels in which percutaneous coronary intervention (PCI) was initially deferred. Nevertheless, the overall rate of target vessel PCI, including procedures at index and during follow-up, was significantly lower in the FFR group (38.8% vs 60.5%; P < 0.001), with no statistically significant differences in the annual cumulative incidence of death or myocardial infarction between groups.

    CONCLUSIONS FFR-guided and IVUS-guided treatment strategies resulted in comparable long-term outcomes, with no significant difference in patient-oriented composite outcomes. Although FFR-guided treatment was associated with a higher incidence of late target vessel revascularization, the overall target vessel PCI rate, accounting for both the index procedure and revascularization during follow-up, remained significantly lower in the FFR-guided treatment group, with comparable rates of hard outcomes between the 2 groups.

    PubMed IF 22.3 순환기내과
26. 44732025

    제1저자 박제연, 정고은 · 교신저자 한경도, 조은주

    Park J^*, Chung GE^*, Yu SJ, Kim YJ, Yoon JH, Han K^*, Cho EJ^*

    Associations between steatotic liver disease subtypes and incident atrial fibrillation in young adults: a nationwide cohort study.

    Cardiovasc Diabetol. 2025;24(1):348.

    Abstract

    BACKGROUND/AIM Metabolic dysfunction is emerging as a significant risk factor for atrial fibrillation (AF) and serves as a foundational component of both metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with moderate alcohol intake (MetALD). As the prevalence of steatotic liver disease (SLD) rises among young adults, clarifying its association with AF in this population has become a clinical priority. Accordingly, we aimed to investigate the link between different SLD subtypes and the risk of incident AF in young adults.

    METHODS In this nationwide cohort study, we analyzed data from the Korean National Health Insurance Service and included individuals aged 20-39 years who underwent health screening examinations between 2009 and 2012. The participants were categorized into either the non-SLD group or the SLD group, which was defined by a fatty liver index ≥ 30. SLD was further subclassified into MASLD, MetALD, and alcohol-associated liver disease (ALD) for analysis. The risk of incident AF was evaluated using Cox proportional hazards models.

    RESULTS A total of 6,375,710 young adults (mean age 30.9 years; 59.4% male) were included, with a median follow-up period of 10.6 years. The prevalence of SLD was 27.8%, which included cases of MASLD (81.7%), MetALD (13.5%), and ALD (4.7%). The risk of incident AF was significantly elevated in individuals with SLD, with progressive increases across MASLD, MetALD, and ALD subtypes. Compared with those of the non-SLD group, the adjusted hazard ratios for AF were 1.09 (95% confidence interval [CI], 1.05-1.31) in the MASLD group, 1.29 (95% CI, 1.22-1.36) in the MetALD group, and 1.52 (95% CI, 1.41-1.65) in the ALD group.

    CONCLUSION SLD is associated with new-onset AF, with a progressively increased risk across MASLD, MetALD, and ALD subtypes in young adults. Given the modifiable nature of these risks, early interventions are essential to prevent long-term cardiovascular complications and reduce the future disease burden.

    PubMed IF 15.6 소화기내과
27. 44722025

    제1저자 공병수 · 교신저자 조영민, 공병수

    Kong BS, Lee H, L'Yi S, Hong S, Cho YM

    Mitochondrial-encoded peptide MOTS-c prevents pancreatic islet cell senescence to delay diabetes.

    Exp Mol Med. 2025;57(8):1861-1877.

    Abstract

    Mitochondria are crucial for cell survival and function, partly through peptides encoded by the mitochondrial genome. Although mitochondrial dysfunction is a hallmark of age-related diseases and senescence, the role of mitochondrial-genome-encoded peptides in pancreatic β-cell senescence during type 1 and type 2 diabetes pathogenesis is largely unexplored. Here we show that MOTS-c levels decrease with aging and senescence in pancreatic islet cells. Treating aged C57BL/6 mouse pancreatic islets with MOTS-c reduced pancreatic islet senescence by modulating nuclear gene expression and metabolites involved in β-cell senescence. MOTS-c treatment improved pancreatic islet senescence and glucose intolerance in S961-treated C57BL/6 and in nonobese diabetic mice. In humans, circulating MOTS-c levels are lower in type 2 diabetes patients compared with healthy controls. Our findings suggest that mitochondrial-encoded MOTS-c regulate pancreatic islet cell senescence and that MOTS-c could act as a senotherapeutic agent to prevent pancreatic islet cell senescence and diabetes progression.

    PubMed IF 17.5 내분비대사내과
28. 44712025

    제1저자 곽낙원, 김중엽 · 교신저자 임재준

    Kwak N, Kim JY, Han A, Berry C, Beumont M, Tweed C, Crook A, Dheda K, Fabiane S, Fadeyi MO, Foraida S, Gils T, Hoang TTT, Jham MA, Murphy RA, Nguyen BH, Nguyen TMP, Nyang'wa BT, Oelofse S, Hahn S, Yim JJ

    Optimal dosing and duration of linezolid for the treatment of multidrug-resistant and rifampicin-resistant tuberculosis: an individual patient data meta-analysis.

    Eur Respir J. 2025;66(2):13993003.00315-2025.

    Abstract

    BACKGROUND The optimal dosing strategy of linezolid for treating multidrug-resistant and rifampicin-resistant tuberculosis remains unclear. We conducted an individual patient data meta-analysis to determine the optimal linezolid dosing strategy.

    METHODS We searched for randomised controlled trials and prospective cohort studies on short-course all‑oral regimens containing linezolid for treating multidrug-resistant and rifampicin-resistant tuberculosis in PubMed, Embase and Scopus up to 31 August 2023. Patients were grouped according to linezolid dosing patterns. Time to treatment success and adverse events of grade 3 and higher were analysed using the Fine-Gray sub-distribution hazard model.

    RESULTS Of 12 eligible studies, eight (four randomised controlled trials, four prospective studies) were included. Overall, 945 patients were grouped as follows: group 1 (600 mg·day^-1 linezolid for 8 weeks), group 2 (600 mg·day^-1 for 16 weeks, then 300 mg·day^-1 for 8 weeks), group 3 (600 mg·day^-1 for 39 weeks) and group 4 (1200 mg·day^-1 for 25 weeks). Proportions of patients achieving treatment success were 59.1%, 90.4%, 91.3% and 96.0%, respectively. Compared with group 2, group 1 (adjusted sub-distribution hazard ratio (SHR) 0.24, 95% CI 0.08-0.71) and group 3 (adjusted SHR 0.36, 95% CI 0.16-0.81) had lower success rates. While group 4 showed no significant difference in treatment success versus group 2 (adjusted SHR 0.57, 95% CI 0.23-1.43), it had a higher rate of adverse events of grade 3 and higher (adjusted SHR 2.29, 95% CI 1.37-3.83).

    CONCLUSION A dosing strategy of 600 mg·day^-1 linezolid for 16 weeks then 300 mg·day^-1 for 8 weeks could be optimal for treating multidrug-resistant and rifampicin-resistant tuberculosis when considering effectiveness and safety.

    PubMed IF 23.8 호흡기내과
29. 44702025

    제1저자 이소령, 최정민 · 교신저자 최의근

    Lee SR, Choi J, Kwon S, Ahn HJ, Lee KY, Choi JI, Lee SH, Heo JH, Oh IY, On YK, Yu HT, Lee KN, Kim NH, Park HW, Lee KH, Shin SY, Park HS, Han S, Oh S, Lip GYH, Park JS, Choi EK

    Apixaban outcomes in atrial fibrillation patients with a single-dose reduction criterion: ASPIRE 1-year results.

    Eur Heart J Cardiovasc Pharmacother. 2025;11(5):403-411.

    Abstract

    AIMS This study, using a prospective cohort, evaluated the effectiveness and safety of off-label reduced-dose apixaban vs. the on-label dose in atrial fibrillation (AF) patients meeting a single-dose reduction criterion.

    METHODS AND RESULTS The efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE) study is a multicentre, prospective observational cohort involving AF patients who met a single-dose reduction criterion of apixaban. Patients were divided into two groups: an on-label standard dose (5 mg twice daily) and an off-label reduced dose (2.5 mg twice daily). The primary effectiveness outcome was stroke/systemic embolism (SSE), and the primary safety outcome was major bleeding. Of 1944 patients (mean age 74.3 ± 7.9 years, 56% women), 997 (51%) were receiving off-label reduced-dose apixaban. The off-label reduced-dose group was older, had more comorbidities, higher concomitant antiplatelet use, and higher CHA2DS2-VASc and HAS-BLED scores. During follow-up (1.0 ± 0.2 year), crude incidence rates were 0.9 vs. 0.7 per 100 person-years for SSE and 0.5 vs. 1.0 for major bleeding in the on-label vs. off-label groups. After inverse probability of treatment weighting, the off-label reduced-dose group showed no significant differences in the risk of SSE [hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.28-1.59, P = 0.370] and major bleeding (HR 1.38, 95% CI 0.44-4.35, P = 0.578) compared with the on-label standard dose group.

    CONCLUSION In Korean patients with AF meeting a single-dose reduction criterion of apixaban, off-label reduced-dose apixaban showed no significant differences in SSE and major bleeding compared with the on-label standard dose. These findings suggest that individualized anticoagulation strategies, such as reduced-dose apixaban, may be beneficial for patients with a high risk of bleeding.

    PubMed IF 8.2 순환기내과
30. 44692025

    제1저자 여무한, 이소령 · 교신저자 최의근, 온영근

    Yeo M, Lee SR, Choi J, Lee KY, Ahn HJ, Kwon S, Lee JH, Cho Y, Oh IY, Lim HE, Cho MS, Nam GB, Oh S, On YK, Choi EK

    Atrial fibrillation burden and symptom, quality of life, and healthcare resource utilization after cryoballoon ablation in persistent atrial fibrillation.

    Europace. 2025;27(8):8243878.

    Abstract

    AIMS To investigate the relationship between continuously monitored atrial fibrillation (AF) burden after cryoballoon ablation (CBA) and improvements in AF-related symptoms, quality of life (QoL), and AF-related healthcare resource utilization (HCRU) in early persistent AF.

    METHODS AND RESULTS This secondary analysis of the multicentre COOL-PER trial included patients with early persistent AF who underwent CBA and continuous monitoring via an implantable loop recorder. Post-CBA AF burden was defined as the percentage of time in AF between 9- and 12-month after CBA, categorized as <0.1%, 0.1 to <10%, and ≥10%. Symptom improvement was assessed using the European Heart Rhythm Association symptom score and QoL with the SF-36 survey. AF-related HCRU was defined as rhythm control interventions after the 90-day blanking period and cardiovascular-related hospitalizations or emergency room visits. Among 130 patients (mean baseline AF burden 77 ± 34%), AF burden significantly decreased post-CBA, with 50.0% achieving <0.1%, 28.5% in 0.1 to <10%, and 21.5% ≥ 10%. Symptom improvement rate was highest in the <0.1% group (89.2%), followed by the 0.1 to <10% (78.4%) and ≥10% (46.4%) groups (P < 0.001). Significant QoL improvement was observed in the <0.1% and 0.1 to <10% groups but not in the ≥10% group. Rhythm control interventions and cardiovascular-related hospitalizations or emergency room visits were more frequent in the ≥10% group (29%, 43%) than in the 0.1 to <10% (5.4%, 22%) and <0.1% (1.5%, 7.7%) groups (both P < 0.001).

    CONCLUSION In early persistent AF, lower AF burden 1-year post-CBA was associated with greater AF-related symptom improvement, significant QoL enhancement, and reduced HCRU during follow-up.

    PubMed IF 10.2 순환기내과

서울대학교병원 내과 교실이 발표한 SCI 논문입니다. 제목을 누르면 Abstract · 그림 등을, 저자 이름을 누르면 소속 · PubMed · ORCID 를 볼 수 있습니다. 굵은 이름은 동문과 연결된 저자입니다.