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Objectives: This study aimed to investigate both the linear and non-linear associations between serum 25-hydroxyvitamin D [25(OH)D] levels and serum uric acid concentrations in Korean adults, with a particular focus on the vitamin D-insufficient range (<30 ng/mL), and to explore the potential metabolic implications of this relationship. Methods: Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed 10,864 adults aged 19 years and older. Serum vitamin D levels were categorized into quartiles (Q1–Q4), and their relationships with uric acid concentrations were examined using Pearson correlation, analysis of variance (ANOVA), and restricted cubic spline regression. Multivariate models were adjusted for potential confounders including age, sex, body mass index (BMI), kidney function, chronic disease status, and macronutrient intake. Results: In unadjusted analysis, a statistically significant but weak negative correlation was observed between serum 25(OH)D and uric acid levels (Pearson’s r = −0.092, p < 0.001). However, in multivariate regression adjusting for confounders, a weak positive association emerged. Restricted cubic spline analysis revealed significant positive associations in the lower quartiles (Q1–Q3), with the strongest association in Q3 (β = 0.769, 95% CI: 0.34–1.19, p < 0.001). No significant association was observed in the highest quartile (Q4). Conclusions: Serum vitamin D and uric acid concentrations show a non-linear relationship, with a significant positive association within the vitamin D-insufficient range (<30 ng/mL). These findings provide new insights into the potential metabolic role of vitamin D and highlight the need for longitudinal and interventional studies to clarify causality and clinical significance.

Background/Objectives: Resistant starch intake has been shown to influence gut microbiota composition and affect metabolic markers. These effects may be partially attributed to enhanced short-chain fatty acid (SCFA)-mediated energy harvesting and hepatic lipogenesis induced by resistant starch fermentation. However, there is a lack of prospective research addressing these associations. To address this gap, we performed a double-blind, randomized dietary intervention study to investigate the impact of high versus low resistant starch consumption on metabolic markers and gut microbiota among adult women presenting with risk factors for metabolic syndrome. Methods: A total of 30 participants were randomly assigned to either the low-resistant starch (LRS) or high-resistant starch (HRS) diet groups. Each group, comprising 15 participants, consumed one food product per day enriched with either high or low resistant starch for 8 weeks. Changes in metabolic indices and gut microbiota were assessed and compared with baseline values, as assessed before diet (Week 0). Results: After 8 weeks of intervention, the HRS diet significantly increased body weight, body fat, and triglyceride (TG) level (mean change ≈ +40 mg/dL), while reducing blood pressure. Analysis of intestinal microbiota in the HRS group revealed a statistically significant increase in the genus Veillonella following the intervention. Conversely, the genus Marvinbryantia increased significantly in the LRS group. Conclusions: In women with metabolic risk factors, resistant starch supplementation elicited mixed metabolic responses—showing a modest reduction in blood pressure but concurrent increases in adiposity and TG concentrations. As the TG elevation reached a clinically meaningful magnitude, dietary interventions involving high-resistant starch should incorporate regular lipid monitoring to ensure cardiometabolic safety. Collectively, these findings highlight the complex interplay between SCFA-producing gut microbiota and host energy metabolism, suggesting that individualized dietary strategies may be required to optimize metabolic outcomes.

: Sarcopenia and metabolic dysfunction share common physiological mechanisms, and insulin resistance has been recognized as a major contributor to muscle loss. However, the independent association between circulating fasting insulin and muscle strength remains unclear. : We analyzed data from 8343 Korean adults aged ≥ 20 years who participated in the 2015 and 2019 Korea National Health and Nutrition Examination Surveys. Multivariate outliers were removed using the Mahalanobis distance, and sampling weights were applied to account for the complex survey design. Multivariable linear regression models were constructed with progressive adjustments for demographic and metabolic covariates, and stratified analyses were conducted by age, BMI category, and diabetes status. : Crude models showed a weak positive association between fasting insulin and handgrip strength in both sexes. However, after adjustment for age and BMI, the association became significantly inverse and remained consistent in fully adjusted models. The inverse association was most pronounced in individuals aged ≤ 65 years, with BMI < 23 kg/m , and without diabetes. : Elevated fasting insulin levels were independently associated with lower handgrip strength in Korean adults. These findings suggest that hyperinsulinemia may reflect early metabolic changes linked to subclinical muscle weakness, warranting further longitudinal investigation.

Background Sarcopenia is known to be related to an increased risk of chemotherapy toxicity and to a poor prognosis in patients with malignancy. We assessed the prognostic role of sarcopenia in patients with diffuse large B‐cell lymphoma (DLBCL). Methods In total, 187 consecutive patients with DLBCL treated with induction rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R‐CHOP) immunochemotherapy were reviewed. Sarcopenia was defined as the lowest sex‐specific quartile of the skeletal muscle index, calculated by dividing the pectoralis muscle area by the height. Clinical outcomes were compared between the sarcopenic and non‐sarcopenic groups. A nomogram was constructed from the Cox regression model for overall survival (OS). Results Treatment‐related mortality (21.7 vs. 5.0%, P = 0.002) and early discontinuation of treatment (32.6 vs. 14.9%, P = 0.008) were more common in the sarcopenic group than in the non‐sarcopenic group. The 5 year progression‐free survival (PFS) rates were 35.3% in the sarcopenic group and 65.8% in the non‐sarcopenic group (P < 0.001). The 5 year OS rates were 37.3% in the sarcopenic group and 68.1% in the non‐sarcopenic group (P < 0.001). Sarcopenia and the five variables of the International Prognostic Index (IPI) were independent prognostic factors in a multivariate analysis for PFS and OS and were used to construct the nomogram. The calibration plot showed good agreement between the nomogram predictions and actual observations. The c index of the nomogram (0.80) was higher than those of other prognostic indices (IPI, 0.77, P = 0.009; revised‐IPI, 0.74, P < 0.001; National Comprehensive Cancer Network‐IPI, 0.77, P = 0.062). Conclusions Sarcopenia is associated with intolerance to standard R‐CHOP chemotherapy as well as a poor prognosis. Moreover, sarcopenia itself can be included in prognostic models in DLBCL.

Background While there is growing interest in the correlation between chronic obstructive pulmonary disease (COPD) and non‐small cell lung cancer, very few studies have examined the interaction between COPD and small cell lung cancer (SCLC). Therefore, the aim of this study was to examine the impact of COPD on the survival of patients with SCLC. Methods The medical records of 110 patients with SCLC who received chemotherapy from July 2006 until April 2014 were retrospectively examined. The overall survival (OS) and progression‐free survival (PFS) rates of spirometry‐diagnosed COPD and non‐COPD groups were compared. Predictors for poorer survival were analyzed using Cox proportional hazards regression. Results Of the 110 SCLC patients, 57 (51.8%) had coexistent COPD. The median OS for the COPD group was 11.6 months and for the non‐COPD group was 11.2 months (log‐rank test, P = 0.581), whereas the median PFS rates were 6.65 and 6.57 months, respectively (log‐rank test, P = 0.559). Multivariate analysis identified Eastern Cooperative Oncology Group performance status ≥ 2 and extensive‐stage SCLC as independent risk factors for shorter OS; however, coexisting COPD was not a predictor of survival. Conclusions Although over half of the SCLC patients receiving chemotherapy had COPD, coexisting COPD had no impact on the survival of patients with SCLC.