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Aim: We aimed to demonstrate the bioequivalence of a fixed‐dose combination (FDC) tablet of metformin 1000 mg and linagliptin 5 mg compared with the coadministration of their respective extended‐release (XR) single tablets in healthy Korean adults under fasting conditions. Methods: This randomized, open‐label, 2‐sequence, 2‐period crossover study included 64 healthy Korean adults. The participants received a single dose of the FDC tablet or the individual XR tablets of metformin and linagliptin, with a 49 days washout period between treatments. Blood samples were collected over a 72‐h period to measure the pharmacokinetic parameters, including area under the curve (AUC) and maximum concentration ( C max ). The safety and tolerability were also assessed. Results: Our pharmacokinetic analysis showed that the AUC and C max for both metformin and linagliptin in the FDC tablet were within the bioequivalence range of 80%–125% compared with those of the individual XR tablets. Specifically, the geometric mean ratios (FDC to coadministration) for metformin were 101.1% (95% confidence interval (CI): 97.8–104.5) for AUC and 97.6% (95% CI: 94.5–100.9) for C max and those for linagliptin were 98.4% (95% CI: 95.7–101.2) for AUC and 96.7% (95% CI: 93.9–99.5) for C max . No serious adverse events (AEs) were reported, and both treatments were well tolerated. Conclusion: The metformin/linagliptin 1000 mg/5 mg FDC tablet is bioequivalent to coadministration of individual XR tablets in healthy Korean adults under fasting conditions. The FDC tablet was well tolerated, indicating that it is a safe and effective option that could improve medication adherence and treatment outcomes in patients with type 2 diabetes.

In the current study, we aimed to examine the association between knee pain and diet quality in women aged ≥ 50 years using data from the Korea National Health and Nutrition Examination Survey. This was a population-based, cross-sectional study. Diet quality was assessed using the Diet Quality Index-International (DQI-I), and knee pain and osteoarthritis were self-reported. A multivariate logistic regression model was used to adjust for age, body mass index, household income, marital status, education, occupation, smoking status, hazardous alcohol use, regular physical activity, menopause, and chronic diseases, including hypertension, diabetes, dyslipidemia, osteoarthritis, and depression. A total of 3,881 women were included in this study, and the prevalence of knee pain was 25.4%. The intakes of total energy, protein, and fat were lower in women with knee pain than in those without (all P < 0.01), while the carbohydrate intake was higher (P = 0.01). No significant differences were noted in the scores for variety, overall balance, and moderation components, except for the item of total fat intake, between the DQI-I scores for women with and without knee pain, after adjusting for age. Women without knee pain showed higher scores in several items of the adequacy component (P < 0.05) than did women with knee pain. The total DQI-I scores were lower in women with knee pain than in women without knee pain, after adjusting for covariates, including osteoarthritis (OR = 0.985, 95% CI = 0.973–0.997, P = 0.01). Knee pain independent of osteoarthritis was associated with poor diet quality in community-dwelling women aged ≥ 50 years.

Background Ambient fine particulate matter is a rising concern for global public health. It was recently suggested that exposure to fine particulate matter may contribute to the development of diabetes and dyslipidaemia. This study aims to examine the potential associations of ambient particulate matter exposure with changes in fasting glucose and lipid profiles in Koreans. Method We used the data from the National Health Insurance Service–National Sample Cohort (NHIS-NSC), a nationwide database representative of the Korean population. A total of 85,869 individuals aged ≥20 years were included. Multiple regression analyses were conducted to assess the associations between exposure to particulate matter and changes in fasting glucose and lipid profiles at 2-year intervals after adjusting for confounders. Results Significant associations were observed between an increase in interquartile range for particulate matter < 2.5 μm in diameter (PM 2.5 ) and elevated levels of fasting glucose and low-density lipoprotein cholesterol ( p for trend = 0.015 and 0.010, respectively), while no association for particulate matter sized 2.5–10 μm in diameter (PM 10–2.5 ) was noted after adjusting for the other covariates. Sub-group analyses showed stronger associations in individuals who were older (≥60 years) or physically inactive. Conclusions Fine particulate matter exposure affects worsening fasting glucose and low-density lipoprotein cholesterol levels, with no evidence of an association for coarse particulate matter.

Skipping meals is a poor eating behaviour known to result in poor diet quality and health outcomes. Nevertheless, it has become increasingly common over the past few decades in many countries. This study aimed to examine the potential association between the use of workplace foodservices and skipping meals among Korean adult workers using data from the Korea National Health and Nutrition Examination Survey 2016–2018, a nationwide cross-sectional survey of a representative Korean population. A total of 5,137 workers aged 20–64 years were included. Dietary assessment was conducted using a 24-hour dietary recall. In total, 41.2% participants skipped one meal or more per day. The percentage of workers who skipped meals was 43.1±1.0% among participants who did not use workplace foodservices compared to 31.8±1.9% among those who did (P<0.01). Skipping meals was significantly associated with not using workplace foodservices, after adjusting for other confounders including sociodemographic variables, health-related variables, and meal procurement source (odds ratio = 3.4; 95% confidence interval = 2.6–4.4; P<0.01). We found a significant association between using workplace foodservices and reduced skipping meals in Korean adult workers. This study suggests the importance of the provision of workplace foodservices for workers to potentially reduce poor eating behaviours such as skipping meals.

Background The present study was designed to investigate the hypothesis that the outer wall at the carotid bifurcation is the most common area of atherosclerotic plaque deposition due to the low shear stress. Hypothesis We hypothesized that the most common site of arteriosclerosis in carotid arteries is different in the early and late stages. Methods This is an observational study of patients with <50% stenosis of the common and internal carotid arteries (ICAs) identified by Duplex ultrasound in our health promotion center. Plaque location was categorized as a quarter of the cross‐section in the distal common carotid artery (CCA) and proximal ICA. Carotid plaque score (CPS) was calculated by the addition of one point for each detected section. The sum of CPSs was calculated for each section. Results Among 3996 Duplex scans of carotid arteries in 999 patients between June 2020 and October 2020, a total of 569 patients (73.6% male; mean age, 68.4± 9.1 years; 652 CCAs and 567 ICAs) were included. Total CPS was high in the anterior and posterior sections. The distribution in the ICA was: 308 (31.0%) anterior, 90 (9.0%) medial, 373 (37.5%) posterior, and 224 (22.5%) lateral section. The distribution in the CCA was 385 (32.6%) anterior, 103 (8.7%) medial, 528 (44.7%) posterior, and 165 (14.0%) lateral section. The axial distribution of posterior and lateral sections was significantly different according to the directional flow (p < .001). Conclusions Anterior and posterior sections of the CCA and ICA were atherosclerotic plaque‐prone sites. This result is different from the tendency of atherogenesis to affect the lateral section having low shear stress at the carotid bifurcation.

The ATPase activity of NLRP3 has pivotal role in inflammasome activation and is recognized as a good target for the development of the NLRP3 inflammasome-specific inhibitor. However, signals in the vicinity of the ATPase activity of NLRP3 have not been fully elucidated. Here, we demonstrate NLRP3 inflammasome-specific action of a benzoxathiole derivative, BOT-4-one. BOT-4-one exhibited an inhibition of NLRP3 inflammasome activation, which was attributable to its alkylating capability to NLRP3. In particular, the NLRP3 alkylation by BOT-4-one led to an impaired ATPase activity of NLRP3, thereby obstructing the assembly of the NLRP3 inflammasome. Additionally, we found that NLRP3 alkylators, including BOT-4-one, enhance the ubiquitination level of NLRP3, which might also contribute to the inhibition of NLRP3 inflammasome activation. Finally, BOT-4-one appeared to be superior to other known NLRP3 alkylators in inhibiting the functionality of the NLRP3 inflammasome and its resulting anti-inflammatory activity was confirmed in vivo using a monosodium urate-induced peritonitis mouse model. Collectively, the results suggest that NLRP3 alkylators function by inhibiting ATPase activity and increasing the ubiquitination level of NLRP3, and BOT-4-one could be the type of NLRP3 inhibitor that may be potentially useful for the novel development of a therapeutic agent in controlling NLRP3 inflammasome-related diseases.

Background Polypharmacy is a global public health concern. This study aimed to determine the prevalence of polypharmacy and trends in the use of commonly used and potentially inappropriate medications among older Korean patients. Methods Individuals aged ≥ 65 years who were prescribed any medication between 2014 and 2018 were selected from the Korean National Health Information Database. Joinpoint regression analyses were used to determine trends in the age-adjusted polypharmacy rates by age group. The prescription rates of the most commonly used medications and the most commonly used potentially inappropriate medications were analysed by year or age group for patients with polypharmacy using the chi-square and proportion difference tests. Results This study included 1,849,968 patients, 661,206 (35.7%) of whom had polypharmacy. Age-adjusted polypharmacy rates increased significantly between 2014 and 2018 ( P  = 0.046). Among patients with polypharmacy, the most commonly prescribed medications were aspirin (100 mg), atorvastatin, metformin, glimepiride, and rosuvastatin. The most commonly prescribed and potentially inappropriate medications were alprazolam, diazepam, amitriptyline, zolpidem, and dimenhydrinate. There was a significant decrease in the prescription rates for each of these drugs in 2018 compared with 2014 among patients with polypharmacy (all P  < 0.001), whereas there was a significant increase in alprazolam prescription among patients aged ≥ 85 years when analysed by age group ( P  < 0.001). Conclusions This study revealed an increasing prevalence of polypharmacy among older adults. Additionally, it highlighted that the utilisation of commonly prescribed potentially inappropriate medications, such as benzodiazepines and tricyclic antidepressants, has remained persistent, particularly among patients aged ≥ 85 years who practiced polypharmacy. These findings provide evidence-based guidance for the development of robust polypharmacy management strategies to ensure medication safety among older adults.

The relationship between the newly proposed steatotic liver disease (SLD) subtypes--metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic alcohol-associated liver disease (MetALD)--and dementia is understudied. We evaluated the dementia risk associated with these subtypes. This retrospective cohort study included 296,001 participants aged over 60 who underwent health examinations between 2009 and 2010. Participants were categorized into non-SLD (reference), MASLD, and MetALD groups and followed up until dementia onset, death, or December 31, 2019. SLD was defined by a fatty liver index [greater than or equal to] 30, with (i) MASLD based on cardiometabolic risk factors, and (ii) MetALD as MASLD with moderate alcohol intake. Outcomes included overall dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Subdistribution hazard ratios (SHRs) was calculated using the Fine-Gray model, treating death as a competing risk. Over 7,430,253 person-years of follow-up, 11,345 dementia cases occurred (10,863 AD and 2,159 VaD). Adjusted SHRs for MASLD were 1.10 (1.07-1.13) for AD and 1.20 (1.13-1.27) for VaD. For MetALD, SHRs were 0.90 (0.87-0.94) for AD and 1.53 (1.40-1.66) for VaD. Dementia risk in both MASLD and MetALD increased over longer periods, with MetALD initially linked to increased VaD risk and decreased AD risk, which reversed after three years. MASLD and MetALD were associated with increased risks of AD and VaD; MetALD showing a stronger association with VaD. Understanding the distinct effects of different SLD subtypes on dementia is crucial for improving risk assessment and management strategies.

Background Perceived health status (PHS) can be influenced by mental health. A negative correlation between high levels of depression and self-evaluation of health has been reported, but research focusing on depression as a risk factor for poor PHS has been limited in Asia. This study aimed to analyse the association between depression and PHS in Korean adult women and explore the degree of depression’s association on poor PHS. Methods We conducted a cross-sectional study for adult women in Korea using data from the Korean National Health and Nutrition Examination Survey from 2014, 2016, 2018, 2020 and 2022. Depression was assessed using the nine-item Patient Health Questionnaire, and PHS was evaluated through a self-report questionnaire. Multivariate logistic regression analyses were used to identify the association between depression and PHS after adjusting for various covariates. Results A total of 15,082 Korean adult women were included. A significant inverse relationship was found between depression and PHS across all adjusted models, with an odds ratio of 3.18 (95% confidence interval 2.37–4.27; P  < 0.01). Poor PHS had a stronger association with depression than with chronic diseases such as hypertension, diabetes, and dyslipidemia. Conclusions Depression was strongly associated with poor PHS among Korean adult women. These findings highlight the importance of the implementation of mental health policies and programs to improve PHS. Future longitudinal studies are required to further validate these findings and explore causal relationships.

This study aimed to determine the potential association between handgrip strength and nutritional quality in Korean men aged ≥20 years using data from the Korea National Health and Nutrition Examination Survey 2016 to 2018. This population-based cross-sectional study included 5,748 men aged ≥20 years. A dietary intake survey was performed using the 24-hr dietary recall method. Nutritional quality was examined using the Index of Nutritional Quality (INQ) score. A high INQ score reflected poor nutritional quality, with insufficient intake of many nutrients. Multivariate linear regression was used to determine the association between handgrip strength and INQ scores after adjusting for other covariates. The intake of carbohydrates, fiber, calcium, and vitamins B2 and C was significantly positively associated with a higher quartile for handgrip strength for those aged ≥65 years (all p < .01). A significant inverse association was found between the quartiles of handgrip strength and INQ scores among men aged ≥65 years after adjusting for all covariates (β = −0.26, p < .01). This association was not found among those aged <65 years (p = .25). The age-specific association between handgrip strength and nutritional quality underscores the importance of public policies that promote sufficient and comprehensive nutrient intake among older adults. Handgrip strength may be useful in clinical practice as a simple and cost-effective tool for screening for nutritional quality in older adults.