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Objectives@#This study addressed longstanding issues in Korea’s public health dentist system by defining and standardizing job duties. A practical job description was drafted based on job analysis results to promote work efficiency and lay the groundwork for future educational programs. @*Methods@#The job description elements were selected and drafted based on previous studies.These drafts were revised and refined with expert panel validation. @*Results@#The main job duties of public health dentists encompass community oral health, dental practice, public oral health research, and special oral health, tailored for institutions such as health sub-centers, health centers, health clinics, national health organizations, and correctional facilities. For community oral health at public health subcenters involves 12 key duties including projects, education, and community engagement. Public health centers/clinics focus on 16 key duties mainly around health project planning and evaluation. Dental care across both settings has 15 main duties. Public oral health research emphasizes community surveys and epidemiology. Special oral health in correctional facilities covers 11 main duties including education and external resource linking. @*Conclusions@#It concluded that for the development of public health dentists in South Korea, it is necessary to develop public health dentist education programs to promote the performance of public health dentists and to equip them with the competencies necessary to perform such duties, focusing on job descriptions organized around the characteristics of workplaces and major tasks.
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In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.
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Background@#There was limited evidence to evaluate the association between lifestyle habits and continuous glucose monitoring (CGM) metrics. Thus, we aimed to depict the behavioral and metabolic determinants of CGM metrics in insulin-treated patients with type 2 diabetes mellitus (T2DM). @*Methods@#This is a prospective observational study. We analyzed data from 122 insulin-treated patients with T2DM. Participants wore Dexcom G6 and Fitbit, and diet information was identified for 10 days. Multivariate-adjusted logistic regression analysis was performed for the simultaneous achievement of CGM-based targets, defined by the percentage of time in terms of hyper, hypoglycemia and glycemic variability (GV). Intake of macronutrients and fiber, step counts, sleep, postprandial C-peptide-to-glucose ratio (PCGR), information about glucose lowering medications and metabolic factors were added to the analyses. Additionally, we evaluated the impact of the distribution of energy and macronutrient during a day, and snack consumption on CGM metrics. @*Results@#Logistic regression analysis revealed that female, participants with high PCGR, low glycosylated hemoglobin (HbA1c) and daytime step count had a higher probability of achieving all targets based on CGM (odds ratios [95% confidence intervals] which were 0.24 [0.09 to 0.65], 1.34 [1.03 to 1.25], 0.95 [0.9 to 0.99], and 1.15 [1.03 to 1.29], respectively). And participants who ate snacks showed a shorter period of hyperglycemia and less GV compared to those without. @*Conclusion@#We confirmed that residual insulin secretion, daytime step count, HbA1c, and women were the most relevant determinants of adequate glycemic control in insulin-treated patients with T2DM. In addition, individuals with snack consumption were exposed to lower times of hyperglycemia and GV.
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Background@#We aimed to investigate the moderating effects of obesity, age, and sex on the association between sleep duration and the development of diabetes in Asians. @*Methods@#We analyzed data from a cohort of the Korean Genome and Epidemiology Study conducted from 2001 to 2020. After excluding shift workers and those with diabetes at baseline, 7,407 participants were stratified into three groups according to sleep duration: ≤5 hoursight, >5 to 7 hoursight (reference), and >7 hoursight. The Cox proportional hazards analyses were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes mellitus (T2DM). Subgroup analyses were performed according to obesity, age, and sex. @*Results@#During 16 years of follow-up, 2,024 cases of T2DM were identified. Individuals who slept ≤5 hight had a higher risk of incident diabetes than the reference group (HR, 1.17; 95% CI, 1.02 to 1.33). The subgroup analysis observed a valid interaction with sleep duration only for obesity. A higher risk of T2DM was observed in the ≤5 hoursight group in non-obese individuals, men, and those aged 7 hoursight group in obese individuals (HRs were 1.34 [95% CI, 1.11 to 1.61], 1.22 [95% CI, 1 to 1.49], and 1.18 [95% CI, 1.01 to 1.39], respectively). @*Conclusion@#This study confirmed the effect of sleep deprivation on the risk of T2DM throughout the 16-year follow-up period. This impact was confined to non-obese or young individuals and men. We observed a significant interaction between sleep duration and obesity.
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Bilateral internal auditory canal (IAC) tumors are usually pathognomonic for vestibular schwannomas in the setting of neurofibromatosis type 2 (NF2). Descriptions of bilateral nonschwannomatous IAC tumors, such as metastasis that may mimic NF2, are limited to case reports. Here, we report a case of unusual metastatic bilateral IAC tumor originating from the ovary with a rapidly progressive pattern, which we initially suspected to be NF2.
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Objectives@#This study aims to explore the experience of caregivers in oral health care of the elderly in long-term care facilities, identify the problems, and collect opinions, and to seek improvement directions for strengthening competency and improving services of oral health care for the elderly. @*Methods@#Data on the experience in oral health care of the elderly were collected through focus group interviews (FGI) targeting caregivers in long-term care facilities. The grounded theory method was used. The interview content was categorized by open coding, and a paradigm model was presented by identifying the relationship between the categories through axial coding. Selective coding found core categories. @*Results@#As a result of categorizing the caregivers’ oral care experience of the elderly, 15 categories, 40 sub-categories, and 125 concept/phenomena codes were derived. The central phenomenon was the difficulty of implementing sustainable oral health care. The deterioration of the mental and physical functions of the elderly, the work characteristics of caregivers, and the lack of linkage with internal and external resources of the facility acted as causal conditions for the central phenomenon. The caregiver’s oral health education experience acted as an intervening condition. In an effort to improve the problem, an interaction strategy was derived. @*Conclusions@#It is possible to seek delivery of sustainable oral health care services by caregivers by improving the quality of oral health education and establishing an oral health care service system for the elderly.
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Objectives@#This study aims to suggest ways to improve the oral care competencies of caregivers by strengthening oral care services for the elderly with mobility difficulties in long-term care facilities. @*Methods@#Through a web survey, 215 caregivers were invited, their actual situation was identified, and necessary educational tasks were listed. We developed 16 types of card news, two types of songs, and four types of video clips that can be used in the field for the listed educational topics. Several meetings with expert developers resulted in developing the components and design of an oral health management platform for caregivers in long-term care facilities. @*Results@#As a result of the web survey, many caregivers in long-term care facilities needed education or information on oral care methods, and many people felt difficulties in oral care for the elderly. About 40% of the caregivers had no experience in oral health education, and many learned how to care through unsystematic apprenticeships. Most of the education content that caregivers prioritized were brushing teeth and denture management, but there were also needs such as management of dementia and bedridden patients, non-cooperative oral care, nutrition management, and oral auxiliary products use. @*Conclusions@#In conclusion, this study reviewed and suggested digital platforms such as strengthening caregivers’ competency in long-term care facilities, providing customized educational information, discovering oral problems of the elderly, and reporting oral difficulties to experts.
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With the emergence of various classes of blood glucose-lowering agents, choosing the appropriate drug for each patient is emphasized in diabetes management. Among incretin-based drugs, glucagon-like peptide 1 (GLP-1) receptor agonists are a promising therapeutic option for patients with diabetic kidney disease (DKD). Several cardiovascular outcome trials have demonstrated that GLP-1 receptor agonists have beneficial effects on cardiorenal outcomes beyond their blood glucose-lowering effects in patients with type 2 diabetes mellitus (T2DM). The renal protective effects of GLP-1 receptor agonists likely result from their direct actions on the kidney, in addition to their indirect actions that improve conventional risk factors for DKD, such as reducing blood glucose levels, blood pressure, and body weight. Inhibition of oxidative stress and inflammation and induction of natriuresis are major renoprotective mechanisms of GLP-1 analogues. Early evidence from the development of dual and triple combination agents suggests that GLP-1 receptor agonists will probably become popular treatment options for patients with T2DM.
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BACKGROUND/OBJECTIVES@#Hydrolyzed formula is often fed to infants with gastrointestinal or immune issues, such as malabsorption or cow's milk allergy, because enzymatic treatment has rendered it more digestible and less allergenic than standard cow's milk formula (SF). Partially hydrolyzed formula (PHF) should be considered for those infants who are intolerant to extensively hydrolyzed formula. However, there are concerns about the nutritional insufficiencies of PHF. We aimed to evaluate the effects of PHF on the growth and health indicators in infants who were at high-risk of allergic disease and potential candidates for consuming PHF. @*SUBJECTS/METHODS@#A total of 83 infants aged 0–2 mon with a family history of allergies were assigned to consume either PHF or SF until 24 weeks of age. Anthropometric measures were obtained at baseline, 12 weeks, and 24 weeks; blood samples were drawn and evaluated at the end of the study. @*RESULTS@#No significant differences were observed in weight, height, and weight-for-height at any time point in each sex between the PHF and SF groups. At 24 weeks of age, the weightfor-age and height-for-age z-scores of the SF group were higher than those of the PHF group, but there was no significant difference in the weight-for-height z-score. There were no significant differences in levels of white blood cells, hemoglobin, ferritin, protein, albumin, aspartate aminotransferase, alanine aminotransferase, eosinophil cationic protein, and immunoglobulin E. @*CONCLUSIONS@#In this study, there were no differences in growth and blood panels between the infants consuming PHF or SF. Therefore, infants who are unable to tolerate SF can be fed PHF without nutritional concerns about growth.
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Objective:To investigate the effectiveness of surgical treatment for patients with T 4 stage prostate cancer. Methods:The clinical data and prognosis of 18 patients with T 4 stage prostate cancer treated in Shanghai Tenth People's Hospital from July 2013 to December 2019 were retrospectively analyzed. The average age of these 18 patients was 68.3 (53-81)years. 10 patients were castration resistant prostate cancer (CRPC) and 8 patients were hormone-sensitive prostate cancer (HSPC). 10 CRPC patients were treated with surgical treatment due to bladder clot packing and/or lower urinary tract obstruction. 8 HSPC patients had severe hematuria, severe dysuria and local symptoms. The KPS scores of all patients were ≥80 points with an average score of 84 (80-90). The average QOL score of 18 patients was 28 (21-32). 2 cases in 18 patients underwent total pelvic resection for rectal invasion (one CRPC and one HSPC). 7 cases underwent radical cystoprostatectomy for ureteral invasion (5 cases of CRPC, 2 cases of HSPC), 9 cases underwent bladder preservation surgery for bladder neck invasion (4 cases of CRPC, 5 cases of HSPC), of which 4 cases of enlarged lymph node dissection were all HSPC patients. Results:All cases of T 4 stage prostate cancer patients operation were successfully completed, the average operation time was 256 (219-310)min and the median intraoperative blood loss was about 300 (250-350)ml. Four of them (3 cases of CRPC and 1 case of HSPC) received blood transfusion after operation. The average postoperative hospital stay was 21(11-37) days. All 18 cases were followed up and the median follow-up time was 23.8 months. There was no perioperative death, and no bladder-preserving patients had true urinary incontinence or bladder outlet stenosis.2 CRPC cases died 8 and 15 months after surgery respectively, 7 patients were PSA relapse treated with docetaxel or abiterone therapy, and 1 HSPC patient with rectal invasion was followed up for 58 months after total pelvic resection, the PSA level was still 0.003ng/ml, no distant metastasis was found. 8 cases of hormone-sensitive patients were treated with endocrine therapy, and PSA was less than 0.2 ng/ml. The average QOL of 18 patients 3 months after operation was 37 points (25-45), which was significantly higher than that before operation. The average maximum urine flow rate of patients with bladder preservation was 23(19-25)ml/s. Conclusions:For T 4 stage prostate cancer, surgical treatment is feasible and safe for doctors with extensive surgical experience. For CRPC patients, the surgery can significantly improve short-term symptoms and quality of life, and long-term benefits need to be further evaluated with a large sample. For HSPC patients, it can not only improve clinical symptoms and QOL of patients, but also provide long-term benefits.
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Objectives@#In order to understand the factors that influence the oral health-related quality of life of older adults, we investigated the quality of life, oral health status, and oral health behavior of older adults in a metropolitan city in Korea. @*Methods@#Data were collected from October 2019 to March 2020, after approval was obtained from the authors’ institutional review board. Oral examinations were administered and a structured questionnaire was distributed to 150 older adults at a public nursing home. Data on sociodemographic factors, oral health behaviors, general health questions, and oral health-related quality of life (assessed with the Oral Health Impact Profile-14 [OHIP-14]) were collected with the questionnaire.To assess the general health condition of the participants, grip strength and upper arm and calf circumference were measured. Multiple logistic regression analysis was used to determine the correlation between oral health-related quality of life and other variables. @*Results@#Whether brushing was performed, the number of remaining teeth, and the presence of periodontal disease were found to correlate with OHIP-14 scores (P<0.05). Oral Health Impact Profile-14 scores and sociodemographic factors in older adults through multiple logistic regression analyses with general health, oral health habits and conditions, and need for assistance with daily oral health care. Correlations between OHIP-14 scores and general health variables, such as thigh circumference and grip strength, revealed a low oral health-related quality of life in participants who needed help during brushing (P<0.05). @*Conclusions@#Results of the study confirmed a relationship between OHIP-14 scores and oral health and habits among older adults in public nursing homes with socioeconomic status, and general health, and oral health, and each variable affects the relationship. Further analysis and additional epidemiological studies are needed to understand the interrelationships.
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Background@#To evaluate the association of time to reach the target glycosylated hemoglobin (HbA1c) level with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus (T2DM). @*Methods@#In a longitudinal observational cohort, 194 patients with T2DM newly diagnosed between January 2011 and March 2013 were followed up over 6 years. Patients were classified according to the time needed to reach the target HbA1c (<7.0%): <3, 3 to 6 (early achievement group), and ≥6 months (late achievement group). Risks of microvascular complications including diabetic retinopathy, nephropathy, and neuropathy as well as macrovascular events including ischemic heart disease, ischemic stroke, and peripheral arterial disease were assessed by multivariable Cox proportional hazards analysis. @*Results@#During a median follow-up of 6.53 years, 66 microvascular and 14 macrovascular events occurred. Maintenance of durable glycemic control over 6 years was more likely in the early achievement groups than in the late achievement group (34.5%, 30.0%, and 16.1% in <3, 3 to 6, and ≥6 months, respectively, P=0.039). Early target HbA1c achievement was associated with lower risk of composite diabetic complications (adjusted hazard ratio [HR, 0.47; 95% confidence interval [CI], 0.26 to 0.86 in <3 months group) (adjusted HR, 0.50; 95% CI, 0.23 to 1.10 in 3 to 6 months group, in reference to ≥6 months group). Similar trends were maintained for risks of microvascular and macrovascular complications, although statistical significance was not reached for macrovascular complications. @*Conclusion@#Early target HbA1c achievement was associated with long-term durable glycemic control and reduced risk of diabetic complications in newly diagnosed T2DM.
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BackgroundThe age- and sex-related differences on the impacts of body composition on diabetes mellitus (DM) remain uncertain.MethodsThe fourth and fifth Korea National Health and Nutrition Examination Survey included 15,586 subjects over 30 years of age who completed dual-energy X-ray absorptiometry. We conducted a cross-sectional study to investigate whether muscle mass index (MMI), defined as appendicular skeletal muscle divided by body mass index (BMI), and fat mass index (FMI), defined as trunk fat mass divided by BMI, were differently associated with DM according to age and sex.ResultsIn multivariate logistic regression, the risk for DM significantly increased across quartiles of FMI in men aged ≥70. Meanwhile, MMI showed a protective association with DM in men of the same age. The odds ratios (ORs) for the highest quartile versus the lowest quartile of FMI and MMI were 3.116 (95% confidence interval [CI], 1.405 to 6.914) and 0.295 (95% CI, 0.157 to 0.554), respectively. In women, the ORs of DM was significantly different across FMI quartiles in those over age 50. The highest quartile of FMI exhibited increased ORs of DM in subjects aged 50 to 69 (OR, 1.891; 95% CI, 1.229 to 2.908) and ≥70 (OR, 2.275; 95% CI, 1.103 to 4.69) compared to lowest quartile. However, MMI was not significantly associated with DM in women of all age groups.ConclusionBoth FMI and MMI were independent risk factors for DM in men aged 70 years or more. In women over 50 years, FMI was independently associated with DM. There was no significant association between MMI and DM in women.
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Objectives@#In order to understand the factors that influence the oral health-related quality of life of older adults, we investigated the quality of life, oral health status, and oral health behavior of older adults in a metropolitan city in Korea. @*Methods@#Data were collected from October 2019 to March 2020, after approval was obtained from the authors’ institutional review board. Oral examinations were administered and a structured questionnaire was distributed to 150 older adults at a public nursing home. Data on sociodemographic factors, oral health behaviors, general health questions, and oral health-related quality of life (assessed with the Oral Health Impact Profile-14 [OHIP-14]) were collected with the questionnaire.To assess the general health condition of the participants, grip strength and upper arm and calf circumference were measured. Multiple logistic regression analysis was used to determine the correlation between oral health-related quality of life and other variables. @*Results@#Whether brushing was performed, the number of remaining teeth, and the presence of periodontal disease were found to correlate with OHIP-14 scores (P<0.05). Oral Health Impact Profile-14 scores and sociodemographic factors in older adults through multiple logistic regression analyses with general health, oral health habits and conditions, and need for assistance with daily oral health care. Correlations between OHIP-14 scores and general health variables, such as thigh circumference and grip strength, revealed a low oral health-related quality of life in participants who needed help during brushing (P<0.05). @*Conclusions@#Results of the study confirmed a relationship between OHIP-14 scores and oral health and habits among older adults in public nursing homes with socioeconomic status, and general health, and oral health, and each variable affects the relationship. Further analysis and additional epidemiological studies are needed to understand the interrelationships.
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Background@#To evaluate the association of time to reach the target glycosylated hemoglobin (HbA1c) level with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus (T2DM). @*Methods@#In a longitudinal observational cohort, 194 patients with T2DM newly diagnosed between January 2011 and March 2013 were followed up over 6 years. Patients were classified according to the time needed to reach the target HbA1c (<7.0%): <3, 3 to 6 (early achievement group), and ≥6 months (late achievement group). Risks of microvascular complications including diabetic retinopathy, nephropathy, and neuropathy as well as macrovascular events including ischemic heart disease, ischemic stroke, and peripheral arterial disease were assessed by multivariable Cox proportional hazards analysis. @*Results@#During a median follow-up of 6.53 years, 66 microvascular and 14 macrovascular events occurred. Maintenance of durable glycemic control over 6 years was more likely in the early achievement groups than in the late achievement group (34.5%, 30.0%, and 16.1% in <3, 3 to 6, and ≥6 months, respectively, P=0.039). Early target HbA1c achievement was associated with lower risk of composite diabetic complications (adjusted hazard ratio [HR, 0.47; 95% confidence interval [CI], 0.26 to 0.86 in <3 months group) (adjusted HR, 0.50; 95% CI, 0.23 to 1.10 in 3 to 6 months group, in reference to ≥6 months group). Similar trends were maintained for risks of microvascular and macrovascular complications, although statistical significance was not reached for macrovascular complications. @*Conclusion@#Early target HbA1c achievement was associated with long-term durable glycemic control and reduced risk of diabetic complications in newly diagnosed T2DM.
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BackgroundThe age- and sex-related differences on the impacts of body composition on diabetes mellitus (DM) remain uncertain.MethodsThe fourth and fifth Korea National Health and Nutrition Examination Survey included 15,586 subjects over 30 years of age who completed dual-energy X-ray absorptiometry. We conducted a cross-sectional study to investigate whether muscle mass index (MMI), defined as appendicular skeletal muscle divided by body mass index (BMI), and fat mass index (FMI), defined as trunk fat mass divided by BMI, were differently associated with DM according to age and sex.ResultsIn multivariate logistic regression, the risk for DM significantly increased across quartiles of FMI in men aged ≥70. Meanwhile, MMI showed a protective association with DM in men of the same age. The odds ratios (ORs) for the highest quartile versus the lowest quartile of FMI and MMI were 3.116 (95% confidence interval [CI], 1.405 to 6.914) and 0.295 (95% CI, 0.157 to 0.554), respectively. In women, the ORs of DM was significantly different across FMI quartiles in those over age 50. The highest quartile of FMI exhibited increased ORs of DM in subjects aged 50 to 69 (OR, 1.891; 95% CI, 1.229 to 2.908) and ≥70 (OR, 2.275; 95% CI, 1.103 to 4.69) compared to lowest quartile. However, MMI was not significantly associated with DM in women of all age groups.ConclusionBoth FMI and MMI were independent risk factors for DM in men aged 70 years or more. In women over 50 years, FMI was independently associated with DM. There was no significant association between MMI and DM in women.
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Objective@#We aimed to investigate the association between statin use and the risk of major osteoporotic fractures in patients with metabolic syndrome (MetS). @*Methods@#A nested case-control study was performed in patients with MetS (≥50 years) who had no history of osteoporotic fracture using the Korean National Health Insurance ServiceHealth Screening Cohort. This study included 17,041 patients diagnosed with new-onset osteoporotic fractures and controls matched in a 1:1 ratio by age, sex, body mass index, cohort entry date, and follow-up duration. Conditional logistic regression analysis was used to evaluate covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). @*Results@#During a 4-year follow-up period, the risk of major osteoporotic fractures was significantly reduced by 9% (OR, 0.91; 95% CI, 0.85–0.97) in statin users compared with that in non-users. Among subtypes of major osteoporotic fracture, a risk reduction with statin therapy was significant for vertebral fracture (OR, 0.86; 95% CI, 0.79–0.94) but not for non-vertebral fracture (OR, 0.97; 95% CI, 0.88–1.06). Longer duration (OR, 0.97; 95% CI, 0.96–0.99, per 1-year increase) and higher cumulative dose (OR, 0.97; 95% CI, 0.95–0.99, per 365 defined daily doses) of statins were negatively associated with the risk of major osteoporotic fracture. @*Conclusion@#This study supports the hypothesis that statin therapy has a beneficial effect on major osteoporotic fractures, especially vertebral fractures, in patients with MetS.
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Objectives@#In this study, I aimed to evaluate the inhibitory effect of bile acids on the inflammatory response and osteoclastogenesis in RAW 264.7 cells activated through lipopolysaccharide (LPS) and receptor activator of nuclear factor-kB ligand (RANKL) of the periodontal pathogen Porphyromonas gingivalis. @*Methods@#Myelomonocytic RAW 264.7 cells were activated through P. gingivalis LPS to induce inflammatory response, and were treated with three bile acids, including taurodeoxycholate, taurocholate, and glycocholate at different concentrations. The cytotoxicity of bile acids was assessed through the MTT assay. To evaluate the inhibitory effect of bile acids on inflammatory response, the induction levels of the pro-inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-a were measured using ELISA 12 h after the treatment. Additionally, after activating the cells with RANKL to promote osteoclastogenesis, we examined whether bile acids suppressed osteoclast differentiation using the tartrate-resistant acid phosphatase staining. @*Results@#In the cell viability test, taurodeoxycholate and taurocholate did not exhibit any cytotoxic effect on RAW 264.7 cells at concentrations equal to or less than 200 mM, and glycocholate was non-cytotoxic until the maximal concentration (4,000 mM). All the three bile acids exhibited an inhibitory effect on inflammatory response, as the production levels of pro-inflammatory cytokines, including IL-6 and TNF-a, decreased with an increase in the concentration of the three bile acids in a dose-dependent manner. The expression of IL-6 reduced remarkably upon treatment with taurodeoxycholate and glycocholate (P<0.001), while the expression of TNF-a decreased slightly upon treatment with glycocholate (P<0.05). Moreover, only glycocholate at a concentration of 1,000 mM suppressed osteoclast differentiation of RAW 264.7 cells (P<0.001), while taurodeoxycholate and taurocholate did not exhibit an inhibitory effect on osteoclastogenesis. @*Conclusions@#Here, I showed that all the three bile acids (taurodeoxycholate, taurocholate, and glycocholate) inhibited P. gingivalis LPS-induced inflammatory response, and glycocholate partially suppressed RANKL-mediated osteoclastogenesis in RAW 264.7 cells.
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Objectives@#In this study, I aimed to evaluate the inhibitory effect of bile acids on the inflammatory response and osteoclastogenesis in RAW 264.7 cells activated through lipopolysaccharide (LPS) and receptor activator of nuclear factor-kB ligand (RANKL) of the periodontal pathogen Porphyromonas gingivalis. @*Methods@#Myelomonocytic RAW 264.7 cells were activated through P. gingivalis LPS to induce inflammatory response, and were treated with three bile acids, including taurodeoxycholate, taurocholate, and glycocholate at different concentrations. The cytotoxicity of bile acids was assessed through the MTT assay. To evaluate the inhibitory effect of bile acids on inflammatory response, the induction levels of the pro-inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)-a were measured using ELISA 12 h after the treatment. Additionally, after activating the cells with RANKL to promote osteoclastogenesis, we examined whether bile acids suppressed osteoclast differentiation using the tartrate-resistant acid phosphatase staining. @*Results@#In the cell viability test, taurodeoxycholate and taurocholate did not exhibit any cytotoxic effect on RAW 264.7 cells at concentrations equal to or less than 200 mM, and glycocholate was non-cytotoxic until the maximal concentration (4,000 mM). All the three bile acids exhibited an inhibitory effect on inflammatory response, as the production levels of pro-inflammatory cytokines, including IL-6 and TNF-a, decreased with an increase in the concentration of the three bile acids in a dose-dependent manner. The expression of IL-6 reduced remarkably upon treatment with taurodeoxycholate and glycocholate (P<0.001), while the expression of TNF-a decreased slightly upon treatment with glycocholate (P<0.05). Moreover, only glycocholate at a concentration of 1,000 mM suppressed osteoclast differentiation of RAW 264.7 cells (P<0.001), while taurodeoxycholate and taurocholate did not exhibit an inhibitory effect on osteoclastogenesis. @*Conclusions@#Here, I showed that all the three bile acids (taurodeoxycholate, taurocholate, and glycocholate) inhibited P. gingivalis LPS-induced inflammatory response, and glycocholate partially suppressed RANKL-mediated osteoclastogenesis in RAW 264.7 cells.
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Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.