SCI 발표논문

전체 4,588편

44082025

제1저자 안화영, 이민정 · 교신저자 조선욱

, , , , , , , , , ,
Selenium vs Control for Graves Ophthalmopathy in a Selenium-Sufficient Area: A Randomized Clinical Trial.
JAMA Ophthalmol. 2025;143(4):287-94.

Abstract
IMPORTANCE Graves ophthalmopathy significantly diminishes patients' quality of life due to its immune-mediated inflammatory effects on the orbital tissues. Selenium, with its antioxidative properties, has shown potential for improving Graves ophthalmopathy progression and quality of life (QOL); however, its effectiveness in selenium-sufficient regions is not well established.
OBJECTIVE To determine whether selenium supplementation improves QOL in patients with mild to moderate Graves ophthalmopathy in selenium-sufficient regions.
DESIGN, SETTING, AND PARTICIPANTS The Efficacy of Selenium Supplementation for Mild-to-Moderate Graves' Ophthalmopathy in a Selenium-Sufficient Area (SeGOSS) trial was a randomized, open-label multicenter study. Eighty-four patients with mild to moderate Graves' ophthalmopathy were enrolled; 70 completed the study. Participants were selected based on Graves ophthalmopathy diagnosis and sufficient selenium levels. Data were analyzed from October 2023 to March 2024.
INTERVENTIONS Participants received selenium supplementation combined with vitamin B complex for 6 months.
MAIN OUTCOMES AND MEASURES The primary outcome was improvements in Graves ophthalmopathy QOL (GO-QOL) scores at 6 months. Secondary outcomes included changes in GO-QOL scores at 3 months, the proportion of patients showing improvement based on GO-QOL scores, clinical activity score, and ophthalmic examinations at 3 months and 6 months, and changes in thyroid autoantibodies at 3 months and 6 months.
RESULTS There was no improvement in changes in the total GO-QOL scores between the selenium group (31 female patients [83.8%] and 7 male patients [16.2%]; mean [SD] age, 40.8 [11.7] years) and control group (24 female patients [72.7%] and 9 male patients [27.3%]; mean [SD] age, 42.9 [14.2] years) for the primary outcome at 6 months (mean [SD], 12.2 [22.5] vs mean [SD], 11.2 [20.2]; difference, 0.9; 95% CI, -9.3 to 11.3; P = .85). However, at 3 months, a higher proportion of patients in the selenium group showed improved GO-QOL scores compared with the control group (78.4 vs 48.5%; difference, 0.30; 95% CI, 0.08-0.51; P = .01). The selenium group also had higher rates of improvement in proptosis reduction (49.5 vs 15.1%; difference, 0.31; 95% CI, 0.11-0.51; P = .01) at 3 months, though these effects were not sustained at 6 months.
CONCLUSIONS AND RELEVANCE These results suggest that selenium supplementation did not improve QOL or clinical parameters in patients with mild to moderate GO in selenium-sufficient regions at 6 months. Some potential QOL benefits noted at 3 months supports consideration of further investigation of selenium for patients seeking treatment for Graves ophthalmopathy .
TRIAL REGISTRATION Clinical Research Information Service Identifier KCT0004040.
PubMed IF 10.5 내분비대사내과
44072025

제1저자 강현명, 김혜진, 정지원, 안진영, 송경호 · 교신저자 정혜원, 고재훈

, , , , , , , , , , , , , , , , , , ,
Natural Boosting and the Immunogenicity of the XBB.1.5 Monovalent Vaccine in the Coronavirus Disease 2019 Endemic Era: A Longitudinal Observational Study.
J Infect Dis. 2025;231(2):392-402.

Abstract
BACKGROUND With the transition from the coronavirus disease 2019 (COVID-19) pandemic into endemicity, changes in group immunity and the effect of updated XBB.1.5 monovalent vaccine (MonoV) need to be investigated.
METHODS A multicenter vaccine cohort was followed for 3 years, and the investigation period was classified into the pre-Omicron, Omicron, and endemic eras. Thirteen sampling points were assessed, including pre- and post-MonoV administration. Specimens were classified as vaccinated, molecularly or serologically diagnosed breakthrough infection (BI), natural boosting (NB), or waned.
RESULTS A total of 327 healthcare workers contributed 2645 blood samples from March 2021 to December 2023. The log10 anti-spike protein antibody (SAb) levels, elevated by vaccination, declined linearly in the pre-Omicron era, were maintained during the Omicron era due to BIs, and increased in the endemic era (slope = 0.02, P = .02) without additional vaccination. NB cases increased significantly across the epidemiologic eras. The incidence rate ratios were 2.72 (P < .001) for Omicron/pre-Omicron and 3.39 (P < .001) for endemic/Omicron. Plaque reduction neutralization test (PRNT) titers against circulating strains (XBB.1.5 and XBB.1.9.1) in the NB group maintained previous levels, but ratios to wild-type PRNT and fold changes exhibited significantly enhanced activity. The XBB.1.5 MonoV increased PRNT by 5.8-fold against XBB.1.5 and 6.6-fold against JN.1, showing stronger enhancement against subsequent epidemic strains than the bivalent vaccine.
CONCLUSIONS Group immunity in the COVID-19 endemic era exhibited maintained SAb levels and adjusted neutralizing activities through BI and NB. The XBB.1.5 MonoV significantly enhanced neutralizing activity against the vaccine strain and robust immunity against the subsequent epidemic JN.1 strain.
PubMed IF 4.1 감염내과
44062025

제1저자 김성래 · 교신저자 박현선, 고성준

, ,
Association of childhood obesity or weight change with early-onset follicular occlusion triad in children.
Br J Dermatol. 2025;192(3):430-439.

Abstract
BACKGROUND The effects of childhood obesity or weight gain on the development of early-onset follicular occlusion triad (FOT), which includes hidradenitis suppurativa (HS), acne conglobata (AC) and dissecting cellulitis of the scalp (DCS) in children, remain unknown.
OBJECTIVES To investigate the association between body mass index (BMI) and changes in BMI and the development of early-onset FOT in children.
METHODS This nationwide population-based longitudinal cohort study included a cohort of 2 012 928 Korean children who underwent two consecutive health examinations at 30-36 months and 42-48 months of age, respectively, between 2009 and 2020. BMI and changes in BMI were derived during these health screenings. We performed multivariate Cox proportional hazards regression analyses to estimate the risk of early-onset FOT, including HS, AC and DCS.
RESULTS During follow-up, 1283 FOT events, including 143 cases of HS, 1068 cases of AC and 72 cases of DCS, were identified. Children with obesity had an elevated risk of early-onset FOT than those with a normal weight [FOT: adjusted hazard ratio (aHR) 1.49, 95% confidence interval (CI) 1.21-1.84; HS: aHR 2.30, 95% CI 1.39-3.82; AC: aHR 1.36, 95% CI 1.07-1.73]. BMI gain was correlated with an elevated risk of early-onset FOT, particularly HS, whereas BMI loss was linked to a decreased risk of early-onset FOT, especially HS. Children who developed obesity had an increased risk of early-onset FOT (aHR 1.51, 95% CI 1.07-2.14) vs. those who maintained a normal weight. Children with obesity who reduced to a normal weight exhibited a decreased risk of early-onset FOT [FOT: aHR 0.41, 95% CI 0.17-0.96 (Ptrend = 0.02); HS: Ptrend = 0.05] than children with obesity who retained their weight.
CONCLUSIONS Childhood obesity is associated with an elevated risk of early-onset FOT, including HS and AC. Weight gain is correlated with an increased risk of early-onset FOT, especially HS, while weight loss is associated with a decreased risk of early-onset FOT, particularly HS. Implementing purposeful weight-reduction strategies may be helpful in preventing the development of early-onset FOT.
PubMed IF 8.2 소화기내과
44052025

제1저자 오미진 · 교신저자 조수정

, , , , , , , , , , , ,
Application of artificial intelligence in the detection of Borrmann type 4 advanced gastric cancer in upper endoscopy (with video).
Cancer. 2025;131(4):e35768.

Abstract
BACKGROUND Borrmann type-4 (B-4) advanced gastric cancer is challenging to diagnose through routine endoscopy, leading to a poor prognosis. The objective of this study was to develop an artificial intelligence (AI)-based system capable of detecting B-4 gastric cancers using upper endoscopy.
METHODS Endoscopic images from 259 patients who were diagnosed with B-4 gastric cancer and 595 controls who had benign conditions were retrospectively collected from Seoul National University Hospital for training and testing. Internal validation involved prospectively collected endoscopic videos from eight patients with B-4 gastric cancer and 148 controls. For external validation, endoscopic images and videos from patients with B-4 gastric cancer and controls at the Seoul National University Bundang Hospital were used. To calculate patient-based accuracy, sensitivity, and specificity, a diagnosis of B-4 was made for patients in whom greater than 50% of the images were identified as B-4 gastric cancer.
RESULTS The accuracy of the patient-based diagnosis was highest in the internal image test set, with accuracy, sensitivity, and specificity of 93.22%, 92.86%, and 93.39%, respectively. The accuracy of the model in the internal validation videos, the external validation images, and the external validation videos was 91.03%, 91.86%, and 86.71%, respectively. Notably, in both the internal and external video sets, the AI model demonstrated 100% sensitivity for diagnosing patients who had B-4 gastric cancer.
CONCLUSIONS An innovative AI-based model was developed to identify B-4 gastric cancer using endoscopic images. This AI model is specialized for the highly sensitive detection of rare B-4 gastric cancer and is expected to assist clinicians in real-time endoscopy.
PubMed IF 5.6 소화기내과
44042025

제1저자 이소령, 이경연 · 교신저자 최의근

, , , , , , , , , , , , , , ,
Perioperative Factor Xa Inhibitor Discontinuation for Patients Undergoing Procedures With Minimal or Low Bleeding Risk.
JAMA Netw Open. 2025;8(2):e2458742.

Abstract
IMPORTANCE Discontinuation of oral anticoagulant treatment is common in clinical practice due to concerns about bleeding, even for procedures with minimal to low bleeding risk.
OBJECTIVE To explore whether perioperative discontinuation of factor Xa inhibitors is associated with major bleeding and thromboembolic events in patients with atrial fibrillation (AF) undergoing procedures with minimal to low bleeding risk.
DESIGN, SETTING, AND PARTICIPANTS This prospective, multicenter, single-arm cohort study conducted in Korea included patients with AF who planned to undergo a procedure with minimal to low bleeding risk between September 25, 2020, and April 5, 2024.
EXPOSURE The PERIXa (Perioperative Factor Xa Inhibitor Discontinuation in Patients With Atrial Fibrillation Undergoing Minimal to Low Bleed Risk Procedures) protocol recommending giving the last dose of factor Xa inhibitor (ie, apixaban, edoxaban, or rivaroxaban) 24 hours before the procedure (ie, endoscopy, dental procedure, or ocular surgery) and restarting treatment with the inhibitor the next day.
MAIN OUTCOMES AND MEASURES The primary outcome was major bleeding, and the secondary outcome included a composite of thromboembolic events 30 days after the index procedure with minimal to low bleeding risk.
RESULTS In total, 1902 patients were included in the modified intention-to-treat analysis set encompassing all patients who underwent the intended procedure (mean [SD] age, 70.4 [8.8] years; 1135 [59.7%] male; mean [SD] CHA2DS2-VASc [congestive heart failure, hypertension, age 75 years or older, diabetes, stroke, vascular disease, age 65-74 years, and female sex; range, 0-9, with higher scores indicating higher risk of stroke] score, 2.8 [1.3]; mean [SD] HAS-BLED [hypertension, kidney or liver disease, stroke history, prior bleeding, unstable international normalized ratio, age >65 years, and drug or alcohol use; range, 0-9, with higher scores indicating higher risk of bleeding] score, 1.6 [0.7]). Among them, 921 (48.4%) were receiving apixaban, 616 (32.4%) were receiving edoxaban, and 365 (19.2%) were receiving rivaroxaban. Of the total procedures, 948 (49.8%) were endoscopy, 820 (43.1%) were dental procedures, and 120 (6.3%) were ocular surgery. The 30-day event rate of major bleeding was 0.1% (n = 2), and there were no composite thromboembolic events. The results were consistent in the per-protocol analysis, and no differences were observed by procedure category or factor Xa inhibitor type.
CONCLUSIONS AND RELEVANCE In this cohort study, patients with AF receiving a factor Xa inhibitor and undergoing a procedure with minimal to low bleeding risk had low rates of major bleeding and thromboembolism when following the standardized PERIXa protocol for perioperative management of oral anticoagulant treatment, suggesting that this may be a safe and reasonable option for this patient population.
PubMed IF 11.7 순환기내과
44032025

제1저자 박지석, 김지연 · 교신저자 전재익, 윤연이

, , , , , , , , , , ,
Artificial intelligence-enhanced comprehensive assessment of the aortic valve stenosis continuum in echocardiography.
EBioMedicine. 2025;112:105560.

Abstract
BACKGROUND Transthoracic echocardiography (TTE) is the primary modality for diagnosing aortic stenosis (AS), yet it requires skilled operators and can be resource-intensive. We developed and validated an artificial intelligence (AI)-based system for evaluating AS that is effective in both resource-limited and advanced settings.
METHODS We created a dual-pathway AI system for AS evaluation using a nationwide echocardiographic dataset (developmental dataset, n = 8427): 1) a deep learning (DL)-based AS continuum assessment algorithm using limited 2D TTE videos, and 2) automating conventional AS evaluation. We performed internal (internal test dataset [ITDS], n = 841) and external validation (distinct hospital dataset [DHDS], n = 1696; temporally distinct dataset [TDDS], n = 772) for diagnostic value across various stages of AS and prognostic value for composite endpoints (cardiovascular death, heart failure, and aortic valve replacement).
FINDINGS The DL index for the AS continuum (DLi-ASc, range 0-100) increased with worsening AS severity and demonstrated excellent discrimination for any AS (AUC 0.91-0.99), significant AS (0.95-0.98), and severe AS (0.97-0.99). DLi-ASc was independent predictor for composite endpoint (adjusted hazard ratios 2.19, 1.64, and 1.61 per 10-point increase in ITDS, DHDS, and TDDS, respectively). Automatic measurement of conventional AS parameters demonstrated excellent correlation with manual measurement, resulting in high accuracy for AS staging (98.2% for ITDS, 82.1% for DHDS, and 96.8% for TDDS) and comparable prognostic value to manually-derived parameters.
INTERPRETATION The AI-based system provides accurate and prognostically valuable AS assessment, suitable for various clinical settings. Further validation studies are planned to confirm its effectiveness across diverse environments.
FUNDING This work was supported by a grant from the Institute of Information & Communications Technology Planning & Evaluation (IITP) funded by the Korea government (Ministry of Science and ICT; MSIT, Republic of Korea) (No. 2022000972, Development of a Flexible Mobile Healthcare Software Platform Using 5G MEC); and the Medical AI Clinic Program through the National IT Industry Promotion Agency (NIPA) funded by the MSIT, Republic of Korea (Grant No.: H0904-24-1002).
PubMed IF 11.2 순환기내과
44022025

제1저자 김유혁, 윤지완 · 교신저자 조영민

, , , , , , ,
Artificial intelligence-based body composition analysis using computed tomography images predicts both prevalence and incidence of diabetes mellitus.
J Diabetes Investig. 2025;16(2):272-284.

Abstract
AIM/INTRODUCTION We assess the efficacy of artificial intelligence (AI)-based, fully automated, volumetric body composition metrics in predicting the risk of diabetes.
MATERIALS AND METHODS This was a cross-sectional and 10-year retrospective longitudinal study. The cross-sectional analysis included health check-up data of 15,330 subjects with abdominal computed tomography (CT) images between January 1, 2011, and September 30, 2012. Of these, 10,570 subjects with available follow-up data were included in the longitudinal analyses. The volume of each body segment included in the abdominal CT images was measured using AI-based image analysis software.
RESULTS Visceral fat (VF) proportion and VF/subcutaneous fat (SF) ratio increased with age, and both strongly predicted the presence and risk of developing diabetes. Optimal cut-offs for VF proportion were 24% for men and 16% for women, while VF/SF ratio values were 1.2 for men and 0.5 for women. The subjects with higher VF/SF ratio and VF proportion were associated with a greater risk of having diabetes (adjusted OR 2.0 [95% CI 1.7-2.4] in men; 2.9 [2.2-3.9] in women). In subjects with normal glucose tolerance, higher VF proportion and VF/SF ratio were associated with higher risk of developing prediabetes or diabetes (adjusted HR 1.3 [95% CI 1.1-1.4] in men; 1.4 [1.2-1.7] in women). These trends were consistently observed across each specified cut-off value.
CONCLUSIONS AI-based volumetric analysis of abdominal CT images can be useful in obtaining body composition data and predicting the risk of diabetes.
PubMed IF 3.6 내분비대사내과
44012025

제1저자 양석훈 · 교신저자 구본권

, , , , , , , , , , , , , , , , , , , , ,
Predictors for Vulnerable Plaque in Functionally Significant Lesions.
JACC Cardiovasc Imaging. 2025;18(2):195-206.

Abstract
BACKGROUND Vulnerable plaque presents prognostic implications in addition to functional significance.
OBJECTIVES The aim of this study was to identify relevant features of vulnerable plaque in functionally significant lesions.
METHODS In this multicenter, prospective study conducted across 5 countries, including patients who had invasive fractional flow reserve (FFR) ≤0.80, a total of 95 patients with available pullback pressure gradient (PPG) and plaque analysis on coronary computed tomographic angiography and optical coherence tomography were analyzed. Vulnerable plaque was defined as the presence of plaque rupture or thin-cap fibroatheroma on optical coherence tomography. Among the 25 clinical characteristics, invasive angiographic findings, physiological indexes, and coronary computed tomographic angiographic findings, significant predictors of vulnerable plaque were identified.
RESULTS Mean percentage diameter stenosis, FFR, and PPG were 77.8% ± 14.6%, 0.66 ± 0.13, and 0.65 ± 0.13, respectively. Vulnerable plaque was present in 53 lesions (55.8%). PPG and FFR were identified as significant predictors of vulnerable plaque (P < 0.05 for all). PPG >0.65 and FFR ≤0.70 were significantly related to a higher probability of vulnerable plaque after adjustment for each other (OR: 6.75 [95% CI: 2.39-19.1]; P < 0.001] for PPG >0.65; OR: 4.61 [95% CI: 1.66-12.8]; P = 0.003 for FFR ≤0.70). When categorizing lesions according to combined PPG >0.65 and FFR ≤0.70, the prevalence of vulnerable plaque was 20.0%, 57.1%, 66.7%, and 88.2% in the order of PPG ≤0.65 and FFR >0.70, PPG ≤0.65 and FFR ≤0.70, PPG >0.65 and FFR >0.70, and PPG >0.65 and FFR ≤0.70 (P for trend < 0.001), respectively.
CONCLUSIONS Among low-FFR lesions, the presence of vulnerable plaque can be predicted by PPG combined with FFR without additional anatomical or plaque characteristics. (Precise Percutaneous Coronary Intervention Plan [P3] Study; NCT03782688).
PubMed IF 19 순환기내과
44002025

제1저자 이현정 · 교신저자 이승표

, , , , , , , , , , , , , ,
Diffuse Interstitial Fibrosis of the Myocardium Predicts Outcome in Moderate and Asymptomatic Severe Aortic Stenosis.
JACC Cardiovasc Imaging. 2025;18(2):180-191.

Abstract
BACKGROUND Patients with moderate or asymptomatic severe aortic stenosis (AS) are at risk of cardiovascular events.
OBJECTIVES The authors investigated the utility of cardiac magnetic resonance (CMR) to identify drivers of outcome in patients with moderate or asymptomatic severe AS.
METHODS A prospective, international, multicenter cohort (n = 457) of patients with moderate (aortic valve area [AVA]: 1.0-1.5 cm²) or asymptomatic severe AS (AVA ≤1.0 cm² and NYHA functional class I-II) patients underwent CMR. Diffuse interstitial fibrosis and scar in the myocardium were analyzed with extracellular volume fraction (ECV%) and late gadolinium enhancement (LGE). The outcome was a composite of mortality and heart failure admission.
RESULTS Median ECV% was 26.6% (IQR: 24.4%-29.9%), and LGE was present in 31.5% (median 0.8%; IQR: 0.1%-1.7%). Greater AS severity was associated with greater left ventricular mass and diastolic dysfunction, but not with ECV% or LGE. During a median 5.7 years of follow-up, 83 events occurred. Patients with events had higher ECV% (median ECV% 26.3% vs 28.2%; P = 0.003). Patients in the highest ECV% tertiles (ECV% >28.6%) had worse outcomes both in the entire cohort and in those with NYHA functional class I moderate or severe AS, and ECV% was independently associated with outcome (adjusted HR: 1.05; P = 0.039). The ECV% had significant incremental prognostic value when added to parameters of AS severity and cardiac function, comorbidities, aortic valve replacement, and LGE (P < 0.05).
CONCLUSIONS Increased diffuse interstitial fibrosis of the myocardium is associated with poor outcomes in patients with moderate and asymptomatic severe AS and can help identify those who require closer surveillance for adverse outcomes.
PubMed IF 19 순환기내과
43992025

제1저자 김정희 · 교신저자 윤지원

, , , , , , ,
Body composition and cardiometabolic risks of patients with adrenal tumours in relation to hormonal activity: a large cross-sectional single-centre study.
Eur J Endocrinol. 2025;192(2):141-149.

Abstract
OBJECTIVE We aimed to examine how different types of adrenal hormone excess influence body composition.
DESIGN A retrospective, cross-sectional, single-centre study.
METHODS We retrospectively enrolled 2971 consecutive adults with adrenal tumours and age-, sex-, and body mass index-matched controls at a 1:3 ratio. The area and attenuation of skeletal muscle and fat at the L3 vertebrae were measured using computed tomography-based analysis software. Prevalence ratios of cardiometabolic outcomes were calculated using the Poisson regression.
RESULTS Patients with non-functioning adenoma (n = 1354) and mild autonomous cortisol secretion (MACS; n = 786) showed similar body compositions. Patients with overt Cushing's syndrome (CS) had the highest visceral fat (VF) area to skeletal muscle area ratio (1.14), while pheochromocytoma (PHEO) patients had the lowest (0.52). Muscle attenuation was lowest in CS and highest in PHEO (32.6 vs 41.5 Hounsfield units, P < .001). Mild autonomous cortisol secretion patients had higher risks of hypertension and dyslipidaemia than non-functioning adenoma patients. Non-functioning adenoma and MACS patients had higher VF area and lower muscle/fat attenuation compared with controls, while primary aldosteronism patients had body compositions similar to controls, except for higher fat attenuation.
CONCLUSIONS Adrenal tumours are associated with altered body composition. Even patients with non-functioning adenoma and MACS had increased VF area and lower muscle and fat attenuation compared with controls, indicating potential cardiometabolic risks.
PubMed IF 6.7 내분비대사내과
43982025

제1저자 최정민, 이소령 · 교신저자 최의근

, , , , , , , , , , , , , ,
Clinical outcomes of Asian patients with newly diagnosed atrial fibrillation and previously diagnosed atrial fibrillation: Insights from the CODE-AF Registry.
Heart Rhythm. 2025;22(2):424-431.

Abstract
BACKGROUND Atrial fibrillation (AF) may have different clinical features in its early phase.
OBJECTIVE The purpose of this study was to compare the characteristics and clinical outcomes of early-phase AF with later-phase AF using a large multicenter prospective registry (CODE-AF [COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation]).
METHODS Patients enrolled between June 2016 and March 2021 were divided into 2 groups based on AF duration: (1) newly diagnosed (AF duration ≤90 days); and (2) previously diagnosed (AF duration >90 days). Baseline characteristics and clinical outcomes were compared.
RESULTS Among the 10,001 study participants (mean age 67.0 ± 14.5 years; 64% men), 22% were defined as newly diagnosed and 78% as previously diagnosed. Newly diagnosed patients had fewer comorbidities and more unhealthy social behaviors. Despite lower prescription rates of oral anticoagulant, direct oral anticoagulants were more frequently used. The newly diagnosed group also had a higher composite clinical outcome risk within 90 days (adjusted hazard ratio 1.81, 95% confidence interval 1.30-2.53, P <.001) and revealed a higher risk of all bleeding and heart failure admission within 90 days. No significant differences remained between the groups over 36-month follow-up.
CONCLUSION Patients with early-stage AF were younger and had fewer comorbidities. Although there was a higher risk of heart failure admissions and minor bleeding, the risks of death, stroke, and major bleeding were not significantly increased. Structured monitoring and management during the initial months are essential to address these risks.
PubMed IF 7 순환기내과
43972025

제1저자 박준석, 우성진, 최영근 · 교신저자 박현선, 고성준

, , , , , , , , ,
Antibiotic usage within the first year of life has a protective effect against ulcerative colitis in South Korea: A nationwide cohort study.
Dig Liver Dis. 2025;57(2):616-623.

Abstract
BACKGROUND Antibiotic usage in early life has been proposed as a risk factor for inflammatory bowel disease, especially Crohn's disease. However, most studies were conducted in Western countries.
AIMS We evaluated the association between antibiotic usage and the incidence of inflammatory bowel disease in the Asian population.
METHODS This nationwide population-based retrospective cohort study included 2,941,889 South Korean infants born between 2007 and 2015, using the National Health Insurance Service database. We assessed whether antibiotic use was associated with the incidence of inflammatory bowel disease. Additionally, we conducted sensitivity analyses, considering protopathic bias and dietary variables. The Cox proportional hazards model was used.
RESULTS Among 2,941,889 infants, 2,566,390 (87 %) used antibiotics within a year after birth. Antibiotic usage within a year, number of antibiotic classes, and cumulative days of usage were shown to decrease the risk of ulcerative colitis. This association was particularly prominent with earlier antibiotic exposure. Penicillin was the only antibiotic class related to the reduced risk. The results were robust after adjusting for dietary variables and considering protopathic effect.
CONCLUSIONS Antibiotic exposure during the first year of life, particularly at a younger age, is linked to a reduced risk of early-onset ulcerative colitis in South Korea.
PubMed IF 4.9 소화기내과
43962025

제1저자 허문행, Terry Cheuk-Fung Yip, 김승업, 이현웅, 이한아, 이형철 · 교신저자 이정훈

, , , , , , , , , , , , , , , , , , , , , ,
A machine learning model to predict liver-related outcomes after the functional cure of chronic hepatitis B.
J Hepatol. 2025;82(2):235-244.

Abstract
BACKGROUND & AIMS The risk of hepatocellular carcinoma (HCC) and hepatic decompensation persists after hepatitis B surface antigen (HBsAg) seroclearance. This study aimed to develop and validate a machine learning model to predict the risk of liver-related outcomes (LROs) following HBsAg seroclearance.
METHODS A total of 4,787 consecutive patients who achieved HBsAg seroclearance between 2000 and 2022 were enrolled from six centers in South Korea and a territory-wide database in Hong Kong, comprising the training (n = 944), internal validation (n = 1,102), and external validation (n = 2,741) cohorts. Three machine learning-based models were developed and compared in each cohort. The primary outcome was the development of any LRO, including HCC, decompensation, and liver-related death.
RESULTS During a median follow-up of 55.2 (IQR 30.1-92.3) months, 123 LROs were confirmed (1.1%/person-year) in the Korean cohort. The model with the best predictive performance in the training cohort was selected as the final model (designated as PLAN-B-CURE), which was constructed using a gradient boosting algorithm and seven variables (age, sex, diabetes, alcohol consumption, cirrhosis, albumin, and platelet count). Compared to previous HCC prediction models, PLAN-B-CURE showed significantly superior accuracy in the training cohort (c-index: 0.82 vs. 0.63-0.70, all p <0.001; area under the receiver-operating characteristic curve: 0.86 vs. 0.62-0.72, all p <0.01; area under the precision-recall curve: 0.53 vs. 0.13-0.29, all p <0.01). PLAN-B-CURE showed a reliable calibration function (Hosmer-Lemeshow test p >0.05) and these results were reproduced in the internal and external validation cohorts.
CONCLUSION This novel machine learning model consisting of seven variables provides reliable risk prediction of LROs after HBsAg seroclearance that can be used for personalized surveillance.
IMPACT AND IMPLICATIONS Using large-scale multinational data, we developed a machine learning model to predict the risk of liver-related outcomes (i.e., hepatocellular carcinoma, decompensation, and liver-related death) after the functional cure of chronic hepatitis B (CHB). The new model named PLAN-B-CURE was constructed using seven variables (age, sex, alcohol consumption, diabetes, cirrhosis, serum albumin, and platelet count) and a gradient boosting machine algorithm, and it demonstrated significantly better predictive accuracy than previous models in both the training and validation cohorts. The inclusion of diabetes and significant alcohol intake as model inputs suggests the importance of metabolic risk factor management after the functional cure of CHB. Using seven readily available clinical factors, PLAN-B-CURE, the first machine learning-based model for risk prediction after the functional cure of CHB, may serve as a basis for individualized risk stratification.
PubMed IF 40.1 소화기내과
43952025

제1저자 최유민, 김동현, 조은주 · 교신저자 유수종, 김범준

, , , , , , ,
The sV184A Variant in HBsAg Specific to HBV Subgenotype C2 Leads to Enhanced Viral Replication and Apoptotic Cell Death Induced by PERK-eIF2α-CHOP-Mediated ER Stress.
J Med Virol. 2025;97(2):e70253.

Abstract
HBV genotype C, particularly subgenotype C2, is associated with an elevated risk of HCC and aggressive disease activity. We previously identified a nonsynonymous sV184A variant in the HBsAg region, predominantly in HBV subgenotype C2. This study investigates the mechanistic role of the sV184A variant in promoting liver disease progression. Analysis of 109 chronically HBV-infected patients revealed that the sV184A variant correlates with significantly elevated HBV DNA. Both patient data and public database indicated that sV184A is associated with high frequency of BCP mutations, however, the high HBV DNA in the sV184A group are independent of the presence of BCP mutations. In vitro and in vivo studies demonstrated that the sV184A variant enhances HBV replication and induces ER stress via the PERK-eIF2α-CHOP pathway, leading to apoptosis. HBV large surface (LHB)(LHB) protein was found to be a key factor, responsible for the strong ER stress, as the sV184A variant increases LHB protein stability. Pharmacological inhibition of PERK signaling or mutation of the LHB mitigated HBV proliferation and apoptosis induced by the sV184A variant. The sV184A variant specific to HBV subgenotype C2 significantly promotes HBV replication and apoptosis, serving as a driver of advanced liver disease and potentially increasing mutation rates in affected patients.
PubMed IF 3.7 소화기내과
43942025

제1저자 김준열 · 교신저자 이상협

, , , , , , , ,
Endoscopic hemostasis with a self-expandable metal stent as bridge therapy for hemobilia.
Endosc Int Open. 2025;13:a24807065.

Abstract
BACKGROUND AND STUDY AIMS Management of hemobilia is often challenging. Recently, endoscopic hemostasis with a self-expandable metal stent (SEMS) has shown promising efficacy for controlling bleeding at the endoscopic sphincterotomy site. This study aimed to assess efficacy and feasibility of endoscopic hemostasis as bridge therapy for hemobilia.
PATIENTS AND METHODS Patients with hemobilia between 2008 and 2023 were retrospectively reviewed. We compared efficacy of hemostasis between the initial endoscopic hemostasis group (ENDO group) and the initial angiographic embolization group (EMBO group). The primary outcome was initial hemostasis success rate and the secondary outcomes were delayed bleeding rate, subsequent embolization rate, 28-day mortality, transfusion amount, time to first hemostasis, total hemobilia time, and incidence of hypovolemic shock.
RESULTS A total of 26 patients with hemobilia were included in this study and 17 patients (65.4%) were identified as the ENDO group and nine patients (34.6%) were classified as the EMBO group. The success rate of initial hemostasis was 88.2% (15/17) in the ENDO group and 100% (9/9) in the EMBO group ( P = 0.529). The rate of delayed bleeding in the ENDO group was 17.6% (3/17) and 0.0% (0/9) in the EMBO group ( P = 0.529). Total hemobilia time was shorter in the ENDO group than in the EMBO group (mean: 281.5 ± 1022.4 minutes vs. 5002.8 ± 7982.6 minutes; P < 0.001) Stent insertion depth was associated with successful hemostasis without delayed bleeding. ( P = 0.015).
CONCLUSIONS Endoscopic hemostasis using SEMS for hemobilia appeared to be a feasible bridge therapy.
PubMed IF 2.9 소화기내과
43932025

제1저자 여무한, 이소령 · 교신저자 최의근, 한경도

, , , , , , , , , ,
Proteinuria and the risk of Incident atrial fibrillation according to glycemic stages: a nationwide population-based cohort study.
Cardiovasc Diabetol. 2025;24(1):41.

Abstract
BACKGROUND Diabetes mellitus (DM) and proteinuria each independently raise the risk of atrial fibrillation (AF). We aimed to investigate the relationship between proteinuria and the risk of incident AF across glycemic stages.
METHODS A cohort of 4,044,524 individuals without prior AF and type 1 DM was selected from the 2009 Korean National Health Insurance Service health checkup data. The individuals were categorized into five glycemic stages: normal, prediabetes, new-onset DM, early DM (< 5 years), and late DM (≥ 5 years). Proteinuria was graded using a urine dipstick test. The development of incident AF was tracked until 2023.
RESULTS Overall, the cohort (mean age 47 ± 14 years, 44.8% female) showed increasing annual AF incidence rates from 2.05 to 7.22 per 1000 person-years from normal to late DM (p < 0.001). Incidence rates increased from 2.46 to 8.18 per 1000 person-years with increasing proteinuria (p < 0.001). Adjusted Cox regression models revealed a heightened AF risk with higher proteinuria across all glycemic stages (adjusted hazard ratios for urine dipstick 3+/4+: 1.58, 1.64, 2.39, 2.12, and 2.53 for normal, prediabetes, new-onset DM, early DM, and late DM, respectively). The proteinuria-AF association was more pronounced in individuals with DM than in those without DM but was similar among the new-onset and established DM groups.
CONCLUSIONS Proteinuria is an independent and significant risk factor for incident AF at all glycemic stages. The risk of incident AF in patients with DM can be stratified by measuring the level of proteinuria rather than comparing the duration of DM. Tailoring clinical strategies to proteinuria level could potentially mitigate this risk, improving patient outcomes.
PubMed IF 15.6 순환기내과
43922024

제1저자 Takashi Kadowaki · 교신저자 Takashi Kadowaki, 임수

, , , , , , , ,
Clinical characteristics affecting weight loss in an East Asian population receiving semaglutide: A STEP 6 subgroup analysis.
Obes Res Clin Pract. 2024;18(6):457-464.

Abstract
OBJECTIVE To explore the effects of semaglutide versus placebo on body weight (BW) by subgroups of baseline characteristics.
METHODS In STEP 6, Japanese and Korean adults with overweight or obesity were randomized to subcutaneous semaglutide 2.4 mg, semaglutide 1.7 mg, or placebo for 68 weeks. A subset of Japanese participants with type 2 diabetes (T2D) was also included. In this post-hoc analysis, change from baseline in BW (%) was assessed by subgroups of baseline characteristics including baseline BW, body mass index, age, sex, glycemic status, dyslipidemia, and hypertension.
RESULTS Of 401 participants (148 female and 253 male) included, the estimated mean change in BW was clinically relevant across all subgroups for semaglutide 2.4 mg, ranging from -9.40 % to -16.42 %. Estimated treatment differences also favored both semaglutide doses versus placebo. Significant treatment-by-subgroup interactions were observed for sex with semaglutide 1.7 mg and 2.4 mg versus placebo at week 68 (p = 0.0008 and p = 0.0005, respectively). Significant treatment-by-subgroup interactions were also observed for presence of T2D and dyslipidemia at baseline, for semaglutide 2.4 mg versus placebo only (p = 0.0381 and p = 0.0181, respectively).
CONCLUSIONS Semaglutide reduces BW in a wide demographic of people with a range of weight-related comorbidities in an East Asian population.
PubMed IF 2.4 내분비대사내과
43912025

제1저자 박흥우 · 교신저자 이현승

, ,
The role of mTOR activation in steroid-resistant asthma: insights from particulate matter-induced mouse model and patient studies.
Inflamm Res. 2025;74(1):19.

Abstract
Particulate matter (PM) exposure has been proposed as one of the causes of steroid resistance. However, studies investigating this using patient samples or animals are still lacking. Therefore, in this study, we aimed to investigate the changes in cytokines and mTOR (mammalian target of rapamycin) activation in patients with steroid resistant asthma and the role of mTOR in a mouse model of steroid resistant asthma induced by PM. In mouse experiment, on administering PM10 and allergen (Dp) through the intranasal route for 3 weeks, airway hyperresponsiveness (AHR), eosinophils, and airway inflammation were increased. However, administering rapamycin (mTOR inhibitor) together with PM and Dp led to significant decrease in all of the abovementioned features; additionally, the population of IL-13 + or IL-17 + cells in CD62^lowCD44^high subset of CD4 + T cells, which serves as an effector/memory cell marker, showed a significant decrease when compared to the group that received PM and Dp. When Dp was administered once after a rest period, the mice exposed to PM and Dp exhibited resurgence in asthma features and elevated effector/memory IL-13 + or IL-17 + cell populations. Rapamycin administration inhibited this effect. In human PBMC, in the steroid Non-Responder (NR) group, cytokines with p-mTOR double-positive population of effector/memory CD4 T cells (CCR7-CD45RA-CD4 + in CD62-CD27-CD45RO+) was significantly higher than that of the Normal or steroid Responder (R) groups. These data demonstrates that rapamycin can inhibit asthmatic features in mouse model of PM induced steroid-resistant asthma. And we suggest that rapamycin could act on effector/memory CD4 + T cells through in vitro and patient sample experiments.
PubMed IF 6.2 알레르기내과
43902025

제1저자 Sushrut Jangi · 교신저자 윤혁

, , , , ,
Specific Bacterial Co-abundance Groups Are Associated With Inflammatory Status in Patients With Ulcerative Colitis.
J Crohns Colitis. 2025;19(1):7731334.

Abstract
BACKGROUND AND AIMS While there is increasing interest in microbiome-directed therapies for patients with ulcerative colitis (UC), the identification of microbial targets remains elusive, underlining the need for novel approaches.
METHODS Utilizing metagenomic data from the Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease (SPARC IBD), available via the IBD Plexus Program of the Crohn's & Colitis Foundation, we used a tree-based dichotomous approach to assemble distinct clusters of species-level bacterial co-abundance groups (CAGs). We evaluated the abundance of bacterial CAGs and fungal taxa during remission (n = 166) and activity (n = 46). We examined if the bacterial CAGs identified in our cohorts were conserved in 2 healthy cohorts and a Korean UC cohort.
RESULTS CAG3 and CAG8, dominated by bacteria from the family Lachnospiraceae, were associated with remission. Low abundance of CAG8 and elevated abundance of Candida genus were predictive of active UC. Constituents from CAG8 were influential hub species of the remission-associated microbial UC network, including Ruminococcus gnavus, Erysipelatoclostridium ramosum, Blautia, and Dorea species. These hub species interactions were preserved in 2 healthy cohorts and were partially recapitulated in a Korean UC cohort. CAG8 abundance correlated with the secondary bile acid production pathway. Bacterial CAGs did not correlate with Candida; however, Bifidobacterium adolescentis and Alistipes putredinis were negatively associated with Candida.
CONCLUSIONS Lachnospiraceae-dominated bacterial CAGs were associated with remission in UC, with key bacterial interactions within the CAG also observed in 2 healthy cohorts and a Korean UC cohort. Bacterial CAG-based analyses may aid in designing candidate consortia for microbiome-based therapeutics.
PubMed IF 10.3 소화기내과
43892025

제1저자 이도훈 · 교신저자 김선, 고영일, 윤성수

, , , , , , , , , , , ,
Increased local DNA methylation disorder in AMLs with DNMT3A-destabilizing variants and its clinical implication.
Nat Commun. 2025;16(1):560.

Abstract
The mechanistic link between the complex mutational landscape of de novo methyltransferase DNMT3A and the pathology of acute myeloid leukemia (AML) has not been clearly elucidated so far. Motivated by a recent discovery of the significance of DNMT3A-destabilizing mutations (DNMT3A^INS) in AML, we here investigate the common characteristics of DNMT3A^INS AML methylomes through computational analyses. We present that methylomes of DNMT3A^INS AMLs are considerably different from those of DNMT3A^R882 AMLs in that they exhibit increased intratumor DNA methylation heterogeneity in bivalent chromatin domains. This epigenetic heterogeneity was associated with the transcriptional variability of developmental and membrane-associated factors shaping stem cell niche, and also was a predictor of the response of AML cells to hypomethylating agents, implying that the survival of AML cells depends on stochastic DNA methylations at bivalent domains. Altogether, our work provides a novel mechanistic model suggesting the genomic origin of the aberrant epigenomic heterogeneity in disease conditions.
PubMed IF 18.1 혈액종양내과
43882025

제1저자 박창희, 김록현 · 교신저자 김미소, 최재용

, , , , , , , , , , , , ,
Genomic profiling of intimal sarcoma reveals molecular subtypes with distinct tumor microenvironments and therapeutic implications.
ESMO Open. 2025;10(1):104097.

Abstract
BACKGROUND Intimal sarcoma is a rare and aggressive soft-tissue sarcoma with limited treatment options. We explored genomic profiles of intimal sarcoma to uncover therapeutic implications.
MATERIALS AND METHODS We analyzed tumor tissues from patients with intimal sarcoma who visited the Seoul National University Hospital (SNUH) using whole-exome, whole-transcriptome, and clinical next-generation sequencing (NGS), integrated with intimal sarcoma NGS data from two public cohorts. We examined expression characteristics and tumor-infiltrating lymphocytes (TILs) according to molecular subtypes.
RESULTS Our study included 42 samples in total. Thirty-three patients showing copy number variation (CNV) enrichment with frequent CDK4/MDM2 amplifications were classified as the CNV-high (CNV-H) subtype. Five patients showing predominant MLH1 mutations or homozygous deletions were classified as the microsatellite instability-high-like (MSI-H-like) subtype. Hallmark pathways up-regulated in the CNV-H subtype included Wnt β-catenin and Hedgehog signaling. In the MSI-H-like subtype, interferon-γ response, tumor necrosis factor-α signaling via nuclear factor-κB, interferon-α response, inflammatory response, and interleukin-6-Jak-Stat3 signaling were up-regulated. CNV-H subtype samples predominantly showed an immune-desert phenotype, whereas MSI-H-like subtype samples predominantly showed an immune-inflamed phenotype. Two MSI-H-like subtype patients received pembrolizumab and experienced tumor shrinkage.
CONCLUSIONS We identified two intimal sarcoma molecular subtypes. Compared with CNV-H, MSI-H-like is enriched in pathways associated with tumor immune responses and TILs. Further efforts and clinical trials to better define these molecular subtypes are warranted to open new avenues for personalized treatment approaches and improve patient outcomes.
PubMed IF 10.6 혈액종양내과
43872025

제1저자 김연욱, 주동현 · 교신저자 김연욱

, , , , , , , , , ,
Gender Disparities and Lung Cancer Screening Outcomes Among Individuals Who Have Never Smoked.
JAMA Netw Open. 2025;8(1):e2454057.

Abstract
IMPORTANCE Lung cancer in individuals who have never smoked (INS) is a growing global concern, with a rapidly increasing incidence and proportion among all lung cancer cases. Particularly in East Asia, opportunistic lung cancer screening (LCS) programs targeting INS have gained popularity. However, the sex-specific outcomes and drawbacks of screening INS remain unexplored, with data predominantly focused on women.
OBJECTIVE To compare LCS outcomes between Asian women and men with no smoking history.
DESIGN, SETTING, AND PARTICIPANTS This multicenter cohort study was conducted at health checkup centers in South Korea from 2009 to 2021. Participants included individuals aged 50 to 80 years with no smoking history who underwent low-dose computed tomography (LDCT) screening. Data were retrospectively analyzed from November 2023 to June 2024.
EXPOSURES Opportunistic LDCT screening for lung cancer.
MAIN OUTCOMES AND MEASURES Participants were followed up until December 2022 for the outcome of death. Lung cancer diagnosis, diagnostic characteristics, clinical course, and lung cancer-specific deaths (LCSD) were compared between women and men.
RESULTS A total of 21 062 participants (16 133 [76.6%] women and 4929 [23.4%] men) with a mean (SD) age of 59.8 (7.2) years were included. From baseline screening, 176 participants (139 women [0.9%] and 37 men [0.8%]) were diagnosed with lung cancer (screen-detected); 131 of 139 women (94.3%) and 33 of 37 men (89.2%) were diagnosed with stage 0 to I disease, with 133 of 139 women (95.7%) and 36 of 37 men (97.3%) having adenocarcinoma. There were no significant sex-based differences in stage or histologic type distribution. Among the 21 062 screened individuals, LCSD was reported in 8 women and 3 men during a mean (SD) follow-up of 83.8 (41.7) months. Multivariable analyses found no significant association between sex and cumulative hazards of lung cancer diagnosis (adjusted hazard ratio [aHR], 0.90 [95% CI, 0.64-1.26] for men vs women) or LCSD (aHR, 1.06 [95% CI, 0.28-4.00] for men vs women). The estimated 5-year lung cancer-specific survival rate was 97.7% for women and 100% for men with screen-detected lung cancer, showing no significant sex differences.
CONCLUSIONS AND RELEVANCE In this cohort study of Asian individuals with no smoking history who underwent LDCT screening, no significant sex-based differences were detected in lung cancer diagnosis, stage distribution, or LCSD. These findings suggest that men and women who have never smoked would experience similar risks of overdiagnosis with little to no benefit when exposed to indiscriminate screening.
PubMed IF 11.7 호흡기내과
43862025

제1저자 김성래 · 교신저자 고성준, 박현선

, , ,
Association of Infantile Antibiotic Exposure and its Changes with Pediatric Alopecia Areata.
J Invest Dermatol. 2025;145(1):188-190.e15.

PubMed IF 7 소화기내과
43852025

제1저자 김동현, 전은태 · 교신저자 이현우

, , , , , , ,
Longitudinal Changes in Maximal Forced Inspiratory Flow and Clinical Outcomes in Patients With COPD.
Chest. 2025;167(1):76-86.

Abstract
BACKGROUND COPD primarily impairs expiratory flow due to progressive airflow obstruction and reduced lung elasticity. Increasing evidence underlines the importance of inspiratory flow as a biomarker for selecting inhaler devices and providing ancillary aerodynamic information.
RESEARCH QUESTION Do the longitudinal changes in maximum forced inspiratory flow (FIFmax) influence acute exacerbations and lung function decline in patients with COPD?
STUDY DESIGN AND METHODS This longitudinal study evaluated FIFmax in patients with COPD over a 7-year period from 2004 to 2020. Eligible patients were categorized into two groups based on FIFmax trajectory: the increased FIFmax group and the decreased FIFmax group. The study assessed the annual rate of acute exacerbations and the annual decline rate of FEV₁. Subgroup analyses were conducted based on treatment status, with a focus on inhaled therapy and inhaler device usage.
RESULTS Among the eligible 956 patients with COPD, 56.5% belonged to the increased FIFmax group. After propensity score matching, the increased FIFmax group experienced lower rates of severe exacerbations (0.16 per year vs 0.25 per year, P = .017) and a slower decline in FEV₁ (0 [interquartile range, -51 to 71] mL/y vs -43 [interquartile range, -119 to 6] mL/y; P < .001) compared with the decreased FIFmax group. These associations were particularly prominent in patients using specific inhaler therapies such as dry powder inhalers.
INTERPRETATION This study showed that the longitudinal changes in FIFmax are associated with clinical outcomes in patients with COPD. Patients with increased FIFmax experienced a lower rate of severe exacerbations and a slower decline in lung function. These findings suggest the potential benefits of optimizing inspiratory flow in COPD management, although further studies are needed to confirm these observations due to potential confounding factors.
PubMed IF 9.8 소화기내과
43842025

제1저자 원종철 · 교신저자 임수

, , , , , , , , ,
Efficacy and Safety of Sarpogrelate on Symptom Improvement in Patients with Peripheral Arterial Disease (PAD) and/or Being at Risk of PAD: A Single Arm, Multi-Centered, Open-Label Trial.
Curr Vasc Pharmacol. 2025;23(1):45-56.

Abstract
AIMS To assess the efficacy and safety of sarpogrelate (300 mg) for symptom improvement in patients having peripheral arterial disease (PAD) and/or being at risk of PAD in clinical practice using the Peripheral Artery Questionnaire (PAQ).
BACKGROUND Symptomatic changes with antiplatelets in patients with PAD are limited.
OBJECTIVE To determine the effect and safety of sarpogrelate on the PAQ at 24 weeks from baseline.
METHODS A total of 1003 patients having PAD and/or being at risk of PAD from 17 tertiary hospitals in South Korea who were treated with sarpogrelate, were enrolled in this study. PAQs were collected at baseline and at 12 and 24 weeks, together with physical examination and vital signs measurements. Lifestyle pattern was also investigated.
RESULTS The average PAQ Summary Score in the efficacy evaluation analysis group significantly improved from 62.9 ± 23.7 at baseline to 68.9 ± 21.7 at 24 weeks (P<0.0001). Physical limitation items significantly improved from 69.5 ± 30.0 at baseline to 72.9 ± 28.3 after 24 weeks (P=0.0011). Symptom stability also significantly improved from 52.1 ± 21.6 at baseline to 63.6 ± 22.9 after 24 weeks (P<0.0001). Symptoms, treatment satisfaction, quality of life, and social limitation domains all improved after treatment. A total of 201 patients reported adverse events (20.0%), not directly associated with treatment.
CONCLUSION Treatment with 300 mg (orally) of sarpogrelate demonstrated statistically significant improvements in all domains and for the summary score of the PAQ at 24 weeks, it gave good results in terms of safety. Sarpogrelate may be helpful in reducing symptoms related to PAD.
PubMed IF 2.4 내분비대사내과
43832025

제1저자 손장원 · 교신저자 임수

, , , ,
Development and clinical application of bioelectrical impedance analysis method for body composition assessment.
Obes Rev. 2025;26(1):e13844.

Abstract
Obesity, which is characterized by excessive body fat, increases the risk of chronic diseases, such as type 2 diabetes, cardiovascular diseases, and certain cancers. Sarcopenia, a decline in muscle mass, is also associated with many chronic disorders and is therefore a major concern in aging populations. Body composition analysis is important in the evaluation of obesity and sarcopenia because it provides information about the distribution of body fat and muscle mass. It is also useful for monitoring nutritional status, disease severity, and the effectiveness of interventions, such as exercise, diet, and drugs, and thus helps assess overall health and longevity. Computed tomography, magnetic resonance imaging, and dual-energy X-ray absorptiometry are commonly used for this purpose. However, they have limitations, such as high cost, long measurement time, and radiation exposure. Instead, bioelectrical impedance analysis (BIA), which was introduced several decades ago and has undergone significant technological advancements, can be used. It is easily accessible, affordable, and importantly, poses no radiation risk, making it suitable for use in hospitals, fitness centers, and even at home. Herein, we review the recent technological developments and clinical applications of BIA to provide an updated understanding of BIA technology and its strengths and limitations.
PubMed IF 7.6 내분비대사내과
43822025

제1저자 김학령 · 교신저자 김학령

, , , ,
Arterial Stiffness and Histologically Confirmed Helicobacter pylori Infection in Young Adults.
Helicobacter. 2025;30(4):e70067.

Abstract
Helicobacter pylori (HP) infection has been linked to systemic inflammation and vascular dysfunction, potentially contributing to arterial stiffness. Research in younger populations is limited, highlighting the need to explore its early cardiovascular impact. This study investigated the association between histologically confirmed HP infection and arterial stiffness. Data were retrospectively analyzed from a cohort of adults who underwent health check-ups and gastric mucosal biopsies to confirm HP infection. A mong them, young adults aged 19-39 years were included in the analysis. Arterial stiffness was assessed using estimated PWV (ePWV), which was calculated using age and mean arterial pressure according to validated equations. Among 7803 participants, 4289 (53.9%) tested positive for HP. ePWV was significantly higher in HP-positive individuals (6.66 ± 0.60 vs. 6.33 ± 0.58 m/s; p < 0.001), with a linear increase observed across HP severity levels (analysis of variaungnce p < 0.01). A positive correlation was identified between the Updated Sydney System (USS) score and ePWV (p < 0.001). Multiple linear regression analysis demonstrated an independent association between USS score and ePWV after adjusting for confounders. Logistic regression analysis showed that severe HP infection was associated with a markedly higher likelihood of elevated ePWV (odds ratio, 3.87; 95% CI. 3.25-4.60; p < 0.001). HP infection was independently associated with increased arterial stiffness in young adualts, with greater infection severity linked to higher ePWV levels. Early detection may help reduce long-term cardiovascular risk.
PubMed IF 4.6 순환기내과
43812025

제1저자 백우현, 박주경 · 교신저자 박도현

, , , , , , , ,
Safety and efficacy of HK-660S in patients with primary sclerosing cholangitis: A randomized double-blind phase 2a trial.
Clin Mol Hepatol. 2025;31(1):119-130.

Abstract
BACKGROUND/AIMS A clinical unmet need persists for medications capable of modulating the progression of primary sclerosing cholangitis (PSC). This study aimed to assess the clinical feasibility of HK-660S (beta-lapachone) in PSC.
METHODS In this multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2 trial, participants were assigned in a 2:1 ratio to receive either 100 mg of HK-660S or a placebo twice daily for 12 weeks. The primary outcomes were the reduction in serum alkaline phosphatase (ALP) levels and the percentage of participants showing improvements in PSC severity, as determined by magnetic resonance cholangiopancreatography with the Anali score. Secondary endpoints included changes in liver stiffness and adverse events.
RESULTS The analysis included 21 patients, 15 receiving HK-660S, and six receiving a placebo. Improvements in the Anali score were observed in 13.3% of the HK-660S group, with no improvements in the placebo group. HK-660S treatment resulted in a 15.2% reduction in mean ALP levels, compared to a 6.6% reduction in the placebo group. A stratified ad-hoc analysis based on baseline ALP levels showed a statistically significant response in the HK-660S group among those with ALP levels greater than twice the upper limit of normal, with a 50% responder rate (p=0.05). Additionally, 26.7% of the HK-660S group showed improvements in the enhanced liver fibrosis score, with no improvements in the placebo group. HK-660S was generally well tolerated.
CONCLUSION HK-660S is well tolerated among patients with PSC and may improve bile duct strictures, decrease serum ALP levels, and reduce liver fibrosis (cris.nih.go.kr, Number KCT0006590).
PubMed IF 21.7 소화기내과
43802025

제1저자 박남영, 이재민 · 교신저자 이상협

, , , , , , ,
Risk Factors of Acute Pancreatitis in Young Adults: A Nationwide Population-Based Cohort Study in South Korea.
Pancreas. 2025;54(1):e39-e44.

Abstract
OBJECTIVES This study aimed to identify the risk factors for acute pancreatitis (AP) in young adults in their 20s based on data from the nationwide cohort in South Korea.
MATERIALS AND METHODS From the 2009 national health examination database of South Korea, a total of 471,098 individuals between the ages of 20 and 29 were analyzed. To identify the newly developed AP, the linked claims database was used.
RESULTS The incidence rates of AP were 18.8 and 9.8 per 100,000 person-years in male and female participants, respectively. Alcohol consumption and smoking were associated with the heightened risk of AP. The risk of AP development was increased as daily alcohol consumption increased. In addition, ex-smokers and current smokers showed higher AP risk than never smokers. Hypertriglyceridemia and obesity were associated with the increased AP risk as well. Compared with female participants, male participants showed a higher risk of AP in univariate analysis but showed a lower risk of AP in multivariate analysis.
CONCLUSIONS In the young adult population, alcohol consumption, smoking, hypertriglyceridemia, and obesity were associated with an elevated risk of developing AP. It is important to identify and manage the modifiable AP risk factors in young adults to minimize the socioeconomic burden of AP.
PubMed IF 2.2 소화기내과
43792025

제1저자 곽민선 · 교신저자 양주동

, , , , , ,
MASLD/MetALD and mortality in individuals with any cardio-metabolic risk factor: A population-based study with 26.7 years of follow-up.
Hepatology. 2025;81(1):228-237.

Abstract
BACKGROUND AND AIMS A new term, metabolic dysfunction-associated steatotic liver disease (MASLD), has been proposed by a multi-society expert panel. However, it remains unclear whether hepatic steatosis per se in MASLD contributes to an increased risk of mortality in individuals with any cardio-metabolic risk factor (CMRF), which is also a significant risk factor for increased mortality. This study aimed to compare all-cause and cause-specific mortality between the "MASLD/MetALD" and "no steatotic liver disease (SLD)" groups in individuals with any CMRF.
APPROACH AND RESULTS A population-based cohort study was conducted using 10,750 participants of the Third National Health and Nutrition Examination Survey. All-cause and cause-specific (cardiovascular, cancer, diabetes, and liver) mortality risks were compared between the "MASLD," "MetALD," and "no SLD" groups using the Cox proportional hazards model with complex survey design weights, adjusted for confounders. Over 26 years, the "MASLD" group did not show significantly increased all-cause (adjusted HR 1.04[95% CI: 0.95-1.14], p = 0.413), cardiovascular (0.88 [0.75-1.04], p = 0.139), or cancer (1.06[0.84-1.33], p = 0.635) mortality risk compared to the "no SLD" group in individuals with any CMRF. The MetALD group was associated with increased all-cause (1.41 [1.05-1.89], p = 0.022), cancer (2.35 [1.33-4.16], p = 0.004), and liver (15.04 [2.96-76.35], p = 0.002) mortality risk compared with the no SLD group. This trend was more pronounced in the MetALD group with advanced fibrosis assessed by Fibrosis-4 (FIB-4).
CONCLUSIONS In individuals with CMRF, the presence of steatotic liver disease (MASLD) alone did not increase the risk of mortality, except in cases with more alcohol consumption (MetALD). Therefore controlling metabolic risk factors and reducing alcohol consumption in people with MASLD or MetALD will be crucial steps to improve long-term health outcomes.
PubMed IF 18 소화기내과

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