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Background This study aimed to investigate the association between handgrip strength (HGS) and cardiovascular disease (CVD) in individuals with metabolic dysfunction‐associated steatotic liver disease (MASLD) using data from the UK Biobank cohort. Methods A total of 201 563 participants were enrolled in this study. The HGS was measured using a Jamar J00105 hydraulic hand dynamometer. MASLD was defined as the presence of hepatic steatosis accompanied by one or more cardiometabolic criteria. Hepatic steatosis was identified using a fatty liver index ≥ 60. Advanced liver fibrosis was defined by a fibrosis‐4 (FIB‐4) score > 2.67. To examine the differences in the incidence of CVD, male and female participants were divided into non‐MASLD, MASLD with high HGS, MASLD with middle HGS, and MASLD with low‐HGS groups. Results Of the study participants, 75 498 (37.5%) were diagnosed with MASLD, with a mean age of 56.5 years, and 40.6% were male. The median follow‐up duration was 13.1 years. The frequency of incident CVD events increased significantly across groups: 10.9% in non‐MASLD, 13.3% in MASLD with high HGS, 14.8% in MASLD with middle HGS, and 18.4% in MASLD with low HGS for males (p < 0.001). In females, the frequency of incident CVD events was 6.1% in non‐MASLD, 9.2% in MASLD with high HGS, 10.7% in MASLD with middle HGS, and 13.3% in MASLD with low HGS (p < 0.001). Using the non‐MASLD group as a reference, multivariate‐adjusted hazard ratios (HRs) (95% confidence intervals [CI]) for CVD varied according to HGS in individuals with MASLD. In males with MASLD, HRs (95% CI) were 1.03 (0.96–1.10) for high HGS, 1.14 (1.07–1.21) for middle HGS, and 1.38 (1.30–1.46) for low HGS; in females with MASLD, they were 1.07 (0.97–1.18) for high HGS, 1.25 (1.14–1.37) for middle HGS, and 1.56 (1.43–1.72) for low HGS. The incidence of CVD events increased as HGS decreased in participants with MASLD, regardless of the presence or absence of advanced liver fibrosis (all p < 0.001). Conclusions This large prospective cohort study using the UK Biobank showed that in MASLD, a decrease in HGS was associated with increased CVD risk.

Purpose: Falls are the leading cause of injury among hospitalized patients, particularly among older patients. We investigated the association between serum phosphate (s-phosphate) levels and the risk of in-hospital falls. Patients and Methods: This retrospective observational cohort study included all patients aged over 50 years who were admitted to Yongin Severance Hospital in South Korea between January 2018 and March 2021. Demographic, anthropometric, and biochemical parameters were recorded on admission. S-phosphate levels were classified into three groups: below normal (<2.8 mg/dL), normal (2.8-4.4 mg/dL), and above normal ([greater than or equal to]4.5 mg/dL). The normal group was further stratified into tertiles (2.8-3.2, 3.3-3.7, and 3.8-4.4 mg/dL). The incidence of in-hospital falls was compared between the five groups. Logistic regression analyses were performed to assess the association between s-phosphate levels and the incidence of falls during the hospital stay, with clinical factors included as covariates in the multivariable models. Results: A total of 15,485 patients (female: 52.1%) with a median age of 70.0 years (interquartile range: 60.0-79.0 years) were included in the analysis, of whom 295 (1.9%) experienced a fall during the hospital stay. The incidence of falls was significantly higher among patients with lower s-phosphate levels, and this relationship also applied among patients with s-phosphate levels within the normal range as well. The association between lower s-phosphate levels and increased risk of falls remained significant in the adjusted analyses. Conclusion: A lower s-phosphate level on admission was independently associated with an increased risk of in-hospital falls. Further studies are needed to determine whether the s-phosphate level on admission could improve prediction of the risk of in-hospital falls. Keywords: in-hospital falls, older adults, blood biochemistry, risk prediction

Abstract Disclosure: K. Kim: None. J. Seol A: None. S. Kwon: None. K. Kim: None. Osteoporosis and type 2 diabetes mellitus (T2D) share common risk factors, including aging and metabolic dysfunction, and recent studies have suggested potential metabolic effects of antiosteoporotic agents. Denosumab (DMAB), a receptor activator of nuclear factor-kappa B ligand (RANKL) inhibitor, has been hypothesized to improve glucose metabolism through its effects on bone turnover and inflammatory pathways, while Alendronate (ALD), a bisphosphonate, may also influence glucose homeostasis. However, evidence comparing the effects of these two treatments on T2D risk remains inconclusive. This nationwide cohort study aimed to compare the incidence of T2D in osteoporosis patients treated with DMAB versus ALD using large-scale real-world data. We analyzed data from the Korean Health Insurance Review and Assessment Service (2017–2022), identifying 316,026 patients who initiated either treatment. After 1:3 propensity score matching adjusting for age, sex, comorbidities, and prior medication use, 1,136 DMAB users and 3,303 ALD users were included in the analysis. The primary outcome was incident T2D, defined as a new diagnosis followed by an antidiabetic medication prescription within six months. Over a median follow-up of 4.7 years, 57 (5%) DMAB users and 196 (6%) ALD users developed T2D, with incidence rates of 10.7 and 12.4 per 1,000 person-years, respectively. DMAB use was not significantly associated with a reduced T2D risk compared to ALD (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.64–1.15). After adjusting for chronic kidney disease and fractures, the HR remained non-significant at 0.84 (95% CI 0.62–1.13; P=0.25), and further analysis using the Fine-Gray subdistribution hazard model to account for competing risk of death produced similar findings (HR 0.84, 95% CI 0.62–1.13; P=0.24). Subgroup analyses across sex, age groups, comorbidities, and concurrent medication use confirmed consistent results, with no significant interactions observed. Despite prior observational studies suggesting a potential metabolic benefit of DMAB, our findings indicate no significant difference in T2D risk between DMAB and ALD users. These results suggest that both medications have comparable effects on T2D risk in osteoporosis patients. Given the observational nature of the study and potential residual confounding factors, further prospective research with longer follow-up and detailed clinical data is warranted to clarify the long-term metabolic effects of antiosteoporotic agents. Presentation: Monday, July 14, 2025

Disclosure: S. Jang: None. K. Kim: None. C. Kim: None. S. Park: None. Introduction: The changes in body composition with aging are known to be associated with the risk of various chronic diseases. But the body composition changes with age among different races, is not well studied. This study aimed to investigate the racial differences in the changes of body composition according to age and the association with prevalent diabetes mellitus. Methods: A total of 37,153 participants was include in the study. 27,864 Korean from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008-2011 and 9,289 from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 whose age ranged from 20 to 85 years were analyzed. Body composition was measured by dual-energy X-ray absorptiometry (Hologic Horizon) in both cohorts. Relative body composition measures based on young adult (20-29 years) were compared. The association of body composition measures and diabetes were analyzed. Results: Compare to other three races from NHANES, Korean men and women had a lower BMI. Total percentage fat tended to increase with age in all races, but degree of increase with age was not higher in Korean men than in other races and a similar trend was observed in Korean women. Regarding the changes in lean mass, men and women showed different patterns. In men, non-Hispanic white showed peak levels in their 40s and then tended to decrease. All other races showed peaks in their 20s and 30s, and subsequently decreased. Compared to other races, the decline according to age was the largest in Korean men. For women, in all races, the pattern was maintained even after their 20s until their 40s or 50s, and then decreased. The degree of decline was similar in all races. In men, higher fat percentage and lower lean mass were associated with prevalent diabetes in all races. In women, however, higher fat percentage and lower lean mass were associated with prevalent diabetes in only Korean and non-Hispanic white. Conclusion: The changes in body composition according to age vary by race and its association with prevalent diabetes also differs. The clinical significance of changes in body composition according to age and race in chronic diseases needs to be further clarified. Presentation: Friday, June 16, 2023

Background: Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disease where deficiency of sterol 27-hydroxylase leads to reduced production of CDCA. In such cases, life expectancy is only 4–6 decades, with progressive neurologic dysfunction such as dementia and spinal cord paresis, unless the condition is diagnosed early and treated appropriately. Herein, we aim to raise awareness regarding the importance of ophthalmic examination in evaluating of xanthoma. Clinical Cases: Case 1: In a 58-year-old man with no neurological symptoms; bilateral cataracts were detected during the initial diagnostic process. This patient had two siblings with xanthoma; one died from cerebral infarction and the other from biliary tract cancer. Another sibling had premature acute cardiovascular disease without xanthomas. Baseline lipid profiles were nearly within the normal range, while lipoprotein A was approximately 2.5 times higher than the normal. CTX was confirmed by the detection of a homozygous mutation in the CYP27A1 gene and high plasma cholestanol level (8.5 mg/L; reference range 0.0–5.0 mg/L). He has been taking oral CDCA (250 mg, three times daily). Case 2: In a 24-year-old man with no neurological symptoms or intellectual disability, premature bilateral cataracts were detected 1 year prior to diagnosis of CTX. None of his family members had xanthoma or premature cardiovascular disease. Lipid profile showed a similar pattern to that of Case 1; CTX was confirmed by the detection of a homozygous mutation in the CYP27A1 gene and high plasma cholestanol level (21.33 mg/L). One year after starting CDCA (250 mg, three times daily), cholestanol levels dropped to 7.34 mg/L. They were measured annually and identified as 5.08 mg/L, 4.2 mg/L, 4.7 mg/L, and 3.8 mg/L at 24, 38, 61, and 72 months, respectively. It took approximately 2 years for the normalization of his cholestanol level. There were no recurrences of xanthoma or progression of complications in target organs after 6 years of treatment. Conclusion: Early diagnosis improves the outcomes of CTX, allowing proper treatment. Bilateral cataracts caused by cholestanol buildup on the crystalline lens due to CTX usually occur within the first three decades of life. This manifestation does not occur in patients with xanthoma, familial hypercholesterolemia, or sitosterolemia. Taken together, this report suggests that premature bilateral cataracts are a specific marker that can accelerate early diagnosis of CTX. References: (1) Duell PB et al. Diagnosis, Treatment and Clinical Outcomes in 43 Cases with CTX. Journal of Clinical Lipidology. 2018;12:1169 (2) Salen G, Steiner RD. Epidemiology, diagnosis, and treatment of CTX. J Inherit Metab Dis 2017: 40:771

The use of Pipelines for long-distance transportation of crude oil, natural gas and similar applications is increasing and has pivotal importance in recent times. High specific strength plays a crucial role in improving transport efficiency through increased pressure and improved laying efficiency through reduced diameter and weight of line pipes. TRIP-based high-strength and high-ductility alloys comprise a mixture of ferrite, bainite, and retained austenite that provide excellent mechanical properties such as dimensional stability, fatigue strength, and impact toughness. This study performs microstructure analysis using both Nital etching and LePera etching methods. At the time of Nital etching, it is difficult to distinctly observe second phase. However, using LePera etching conditions it is possible to distinctly measure the M/A phase and ferrite matrix. The fraction measurement was done using OM and SEM images which give similar results for the average volume fraction of the phases. Although it is possible to distinguish the M/A phase from the SEM image of the sample subjected to LePera etching. However, using Nital etching is nearly impossible. Nital etching is good at specific phase analysis than LePera etching when using SEM images.

Objective: For improving meat quality especially tenderness, male cattle are usually castrated to removes both the testicles. This study was conducted to evaluate the effect castration method (half- and complete-castration) on meat yield and quality characteristics of Hanwoo male cattle. Methods: Thirty-two similar age (5.9 months) Hanwoo male calves were divided into: half-castration (HC) and complete-castration (CC) groups (n = 16 per group). At 7 months of age, all the animals were castrated in which the HC calves had only one testicle surgically removed while, the CC calves had both testicles surgically removed. The castrated animals were reared under identical conditions until 25 months of age. After slaughter, the carcasses were evaluated for carcass traits and meat yield of primal cuts. For examination of the castration effect on meat quality, L. lumborum and semimembranosus muscles were used. The meat samples were analyzed for chemical composition, color, pH, shear force and water holding capacity, fatty acids, metabolites and volatile aroma compounds. Results: The HC group showed higher meat yields of all primal cuts (p<0.05). As a result, the total meat yield was higher by approximately 44 kg in the HC group (303.32 kg, corresponding to 67.88%) compared to the CC group (259.30 kg, corresponding to 62.11%) (p<0.05). In terms of meat quality, the HC resulted in two times greater fat content in both muscles examined compared to intact males. More importantly, the shear force values did not differ between HC and CC groups for L. lumborum muscles (p>0.05). The meat from HC animals exhibited higher amount of free amino acids associated with sweetness (p<0.05). Furthermore, the castration method only exhibited a negligible effect on metabolites and volatile aroma compounds in the cooked meat. Conclusion: Half-castration emerged as an alternative practice to be used for increasing the yield and tenderness of male cattle meat.

Background: Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. Methods: Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. Results: When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. Conclusion: We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.