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[...]a substantial number of patients in the non-ASCVD group might not have undergone examinations to detect ASCVD; therefore, asymptomatic ASCVD may have remained undetected. [...]the authors divided the non-ASCVD group into three subgroups according to CAVI: low (CAVI <8), moderate (8≤CAVI<9), and high (CAVI ≥9). Shirai K, Utino J, Otsuka K, Takata M. A novel blood pressure-independent arterial wall stiffness parameter: cardio-ankle vascular index (CAVI).

This study investigated the association between relative hand grip strength (HGS) and glycemic status, such as impaired fasting glucose (IFG) and diabetes, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). We performed a cross-sectional study using the data from the KNHANES of 27,894 individuals from 2014 to 2019. Relative HGS was defined as the absolute HGS divided by body mass index and divided into quartiles in men and women. Odds ratios (OR) for diabetes and IFG were calculated using multivariate logistic regression analysis. All analyses were stratified by sex, and subgroup analysis was age-stratified. The lowest relative HGS quartile had a significant increase in the risk for diabetes (men: OR 2.72, 95% confidence interval [CI] 2.12-3.50; women: OR 3.38, 95% CI 2.70-4.24) and IFG (men: OR 1.35, 95% CI 1.15-1.59; women: OR 1.60, 95% CI 1.40-1.84). The ORs for diabetes and IFG according to the decreasing quartiles of relative HGS gradually increased in both sexes (P for trend <0.001). ORs and 95% CI of the lowest relative HGS quartile for diabetes were higher in the younger age group than that of the older age group (men: 4.47 and 2.80-7.14 for young adults; 2.41 and 1.37-4.25 for older adults; women: 5.91 and 3.06-9.38 for young adults; 1.47 and 0.92-2.33 for older adults). ORs and 95% CI for IFG was similar with the trend of ORs for diabetes (men: 1.80 and 1.43-2.26 for young adults; 1.17 and 0.75-1.84 for older adults; women: 2.20 and 1.77-2.72 for young adults; 1.33 and 0.86-2.07 for older adults). Lower relative HGS was associated with a higher risk of not only diabetes but also IFG in both sexes. These trends were stronger in younger adults than in older adults.

Muscles play an important role in energy metabolism. Several studies have investigated the association between muscle mass and metabolic syndrome (MetS), reporting conflicting results. However, studies concerning the association between muscle strength and MetS are limited. We aimed to investigate the association between relative handgrip strength (HGS) and MetS in Korean adults. We analyzed data from 5,014 Korean adults aged ≥20 years (2,472 men and 2,542 women) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2014-2015). The increasing quartiles of relative HGS (defined as the sum of both hands' HGS divided by body mass index) were inversely associated with the risk of MetS in both men and women (OR, 0.37; 95% CI, 0.30-0.45, vs OR, 0.19; 95% CI, 0.14-0.27, respectively) after multivariable adjustment for age, region of residence, smoking status, heavy alcohol consumption, regular exercise, family income, and education level. On multivariable logistic regression analyses, participants with the highest relative HGS had a significant decrease in relative risk of MetS, compared with those with the lowest relative HGS. The multivariable-adjusted ORs (with 95% CIs) for MetS in quartiles 1, 2, 3, and 4 were 1.00, 0.72 (0.55-0.94), 0.34 (0.26-0.46), and 0.22 (0.15-0.32) in men and 1.00, 0.50 (0.36-0.68), 0.26 (0.17-0.40), and 0.16 (0.09-0.27) in women, respectively. Relative HGS showed a highly significant inverse association with the risk of MetS in Korean adults, and it can be a novel biomarker for assessing the risk of MetS.

Esophageal pH monitoring and manometry are the gold standards for diagnosis of GERD and esophageal dysmotility [4]. [...]application of pH study and manometry in the present study could possibly alter the prevalence of GERD. [...]there are several interesting reports about proton pump inhibitor (PPI) therapies in diabetic patients. Because failure rates of PPIs in diabetic patients was higher in obese patients, it appears to be dependent on BMI. Hershcovici T, Jha LK, Gadam R, Cui H, Gerson L, Thomson S, Fass R. The relationship between type 2 diabetes mellitus and failure to proton pump inhibitor treatment in gastroesophageal reflux disease.

Objective This study investigated the association between relative hand grip strength (HGS) and glycemic status, such as impaired fasting glucose (IFG) and diabetes, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods We performed a cross-sectional study using the data from the KNHANES of 27,894 individuals from 2014 to 2019. Relative HGS was defined as the absolute HGS divided by body mass index and divided into quartiles in men and women. Odds ratios (OR) for diabetes and IFG were calculated using multivariate logistic regression analysis. All analyses were stratified by sex, and subgroup analysis was age-stratified. Results The lowest relative HGS quartile had a significant increase in the risk for diabetes (men: OR 2.72, 95% confidence interval [CI] 2.12–3.50; women: OR 3.38, 95% CI 2.70–4.24) and IFG (men: OR 1.35, 95% CI 1.15–1.59; women: OR 1.60, 95% CI 1.40–1.84). The ORs for diabetes and IFG according to the decreasing quartiles of relative HGS gradually increased in both sexes (P for trend <0.001). ORs and 95% CI of the lowest relative HGS quartile for diabetes were higher in the younger age group than that of the older age group (men: 4.47 and 2.80–7.14 for young adults; 2.41 and 1.37–4.25 for older adults; women: 5.91 and 3.06–9.38 for young adults; 1.47 and 0.92–2.33 for older adults). ORs and 95% CI for IFG was similar with the trend of ORs for diabetes (men: 1.80 and 1.43–2.26 for young adults; 1.17 and 0.75–1.84 for older adults; women: 2.20 and 1.77–2.72 for young adults; 1.33 and 0.86–2.07 for older adults). Conclusion Lower relative HGS was associated with a higher risk of not only diabetes but also IFG in both sexes. These trends were stronger in younger adults than in older adults.

The fatty liver index (FLI) is a simple tool used to assess metabolic dysfunction-associated fatty liver disease (MAFLD). Previous studies have shown the utility of the FLI as an early predictor of diabetes for patients with prediabetes. We evaluated whether the FLI could predict the development of type 2 diabetes mellitus (T2DM) with normal glucose tolerance (NGT) by performing a retrospective assessment of a community-based cohort over the course of 18 years. We analyzed data of 6,083 adults with NGT available from the Korean Genome and Epidemiology Study database. Participants were stratified into the following three groups based on the FLI: low, FLI < 30; intermediate, FLI 30–59; and high, FLI ≥ 60. Cox proportional hazards regression models evaluated the T2DM risk differences. Insulin sensitivity and secretion markers were compared using multivariate linear regression and an analysis of covariance. The predictability of the FLI for T2DM was analyzed by comparing the area under the receiver-operator characteristic (ROC) curve (AUC) values from the ROC analysis. The cumulative incidence of T2DM was 31.9% for the high FLI group; however, it was 11.3% for the low FLI group (log-rank test, P < 0.0001). For individuals with NGT, a high FLI was associated with an increased T2DM risk (hazard ratio [HR], 3.42; 95% confidence interval [CI], 2.91–4.00). After adjusting for insulin sensitivity and secretion markers, FLI remained an independent predictor of T2DM (HR, 1.96, 95% CI, 1.54–2.50). The homeostasis model assessment of insulin resistance results and composite insulin sensitivity index of the high FLI group were higher than those of the other groups (P < 0.0001). However, the disposition index and insulin secretion-sensitivity index-2 of the high FLI group were lower than those of the intermediate FLI group (P = 0.027 and P = 0.011, respectively). The ROC analysis confirmed that the FLI had the highest predictive ability for T2DM (AUC, 0.654; P < 0.05) development in individuals with NGT compared to other insulin sensitivity and secretion markers. The FLI is an early predictor of T2DM that reflects underlying insulin sensitivity and β-cell function. These findings underscore the role of liver steatosis in the early T2DM pathogenesis and highlight the need for early preventive lifestyle interventions among individuals with normoglycemia and high FLI values.

Early detection of thyroid cancer improves patient survival rate from 51.9% to 99.9%. Fine needle aspiration cytology is the primary method for diagnosing thyroid cancer; however, this method is associated with limitations, including diagnostic uncertainty and potential complications. Despite numerous studies to identify diagnostic biomarkers for thyroid cancer, none has been found to date. Therefore, new methods that do not rely on biomarkers are warranted to aid thyroid cancer diagnosis. Here, we suggest a novel approach using 3D gold nanoclusters to obtain Surface-enhanced Raman scattering (SERS) spectra using the serum samples of patients with thyroid cancer and normal individuals. Briefly, an evaporation-based 3D printing technique was employed to fabricate nanoclusters containing serum. SERS spectra were collected from 50 normal individuals and 50 patients with thyroid cancer. The spectra were then analysed using machine learning with 1D and 2D convolutional neural networks (CNNs) architecture. Notably, the 2D CNN exhibited superior performance for the classification of thyroid cancer cases, with sensitivity of 93.1% and specificity of 84.0%. Such findings suggest the potential use of metabolite analysis for the diagnosis of thyroid cancer without finding biomarkers. This SERS measurement approach using 3D nanoclusters may also be leveraged for the diagnosis of other diseases.

Background: The present study investigated the role of synergistic interaction between hyperuricemia and abdominal obesity as a risk factor for the components of metabolic syndrome.Methods: We performed a cross-sectional study using the data of 16,094 individuals from the seventh Korean National Health and Nutrition Examination Survey (2016 to 2018). The adjusted odds ratios of metabolic syndrome and its components were analyzed by multivariate logistic regression analysis. The presence of synergistic interaction between hyperuricemia and abdominal obesity was evaluated by calculating the additive scales—the relative excess risk due to interaction, attributable proportion due to interaction, and synergy index (SI).Results: There was a synergistic interaction between hyperuricemia and abdominal obesity in hypertriglyceridemia (men: SI, 1.39; 95% confidence interval [CI], 1.01 to 1.98; women: SI, 1.61; 95% CI, 1.02 to 2.69), and low high-density lipoprotein cholesterol (HDL-C) (men: SI, 2.03; 95% CI, 1.41 to 2.91; women: SI, 1.70; 95% CI, 1.05 to 2.95). There was no significant synergistic interaction between hyperuricemia and abdominal obesity for the risk of high blood pressure (men: SI, 1.22; 95% CI, 0.85 to 1.77; women: SI, 1.53; 95% CI, 0.79 to 2.97), and hyperglycemia (men: SI, 1.03; 95% CI, 0.72 to 1.47; women: SI, 1.39; 95% CI, 0.75 to 2.57).Conclusion: Hyperuricemia and abdominal obesity synergistically increased the risk of hypertriglyceridemia and low HDL-C in both sexes.

Providing continuous self-care support to the growing diabetes population is challenging. Strategies are needed to enhance engagement in self-care, utilizing innovative technologies for personalized feedback. This study aimed to assess the feasibility of the Automated Personalized Self-Care program among type 2 diabetes patients and evaluate its preliminary effectiveness. A parallel randomized pilot trial with qualitative interviews occurred from May 3, 2022, to September 27, 2022. Participants aged 40–69 years with type 2 diabetes and HbA1c ≥ 7.0% were recruited. The three-month program involved automated personalized goal setting, education, monitoring, and feedback. Feasibility was measured by participants' engagement and intervention usability. Preliminary effectiveness was examined through self-care self-efficacy, self-care behaviors, and health outcomes. Qualitative interviews were conducted with the intervention group. A total of 404 patients were screened. Out of the 61 eligible patients, 32 were enrolled, resulting in a recruitment rate of 52.5%. Retention rates at three months were 84.2% and 84.6% in the intervention and control groups, respectively. Among the intervention group, 81.3% satisfied adherence criteria. Mobile application's usability scored 66.25, and participants' satisfaction was 8.06. Intention-to-treat analysis showed improvements in self-measured blood glucose testing, grain intake, and HbA1c in the intervention group. Qualitative content analysis identified nine themes. Feasibility of the program was verified. A larger randomized controlled trial is needed to determine its effectiveness in self-care self-efficacy, self-care behaviors, and health outcomes among type 2 diabetes patients. This study offers insights for optimizing future trials assessing clinical effectiveness. Clinical Research Information Service, KCT0008202 (registration date: 17 February 2023).

Tow-dimensional and 3-dimensional colloidal structures have been used to study surface-enhanced Raman scattering and localized surface plasmon resonance because of their regular stacking structures. However, freely controlling the number and size of the colloidal assemblies remains a challenge. In this study, we demonstrated the fabrication and mechanism of tiny nanoclusters using spontaneous evaporation-based nanofountain pens (NFPs). A micrometer-scale NFP nozzle was fabricated using a glass capillary. The gold nanoparticles (AuNPs) dispersed ink formed the pendant droplet at the NFP nozzle tip, where the AuNPs accumulated within the pendant droplet because of evaporation. The accumulated AuNPs were transferred onto the substrate via a stamp-like process to create nanoclusters. Using water evaporation analyzed by diffusion equations, we showed that reducing the AuNP accumulation to one hundred is possible. This precise adjustment enables fabrication until submicrometer-level nanoclusters. The fabrication method using NFPs can create 3D structures, and this operation is not significantly affected by the size or composition of the AuNPs. This could be expanded to metabolite-included nanocluster where metabolite can be located at the hot spot among AuNPs. Therefore, we expect that this will be utilized to create SERS signals and conduct disease diagnosis research using extremely small amounts of metabolites.