The High Prevalence of Sarcopenia in Rheumatoid Arthritis in the Korean Population: A Nationwide Cross-Sectional Study.

Rheumatoid arthritis (RA) includes musculoskeletal symptoms that lead to disuse atrophy of muscles and changes in body composition. Musculoskeletal symptoms and loss of physical function may be associated with sarcopenia, which is characterized by muscle loss. This study aimed to investigate the prevalence of sarcopenia and its association with RA in a Korean population. We analyzed nationwide data from the Korea National Health and Nutrition Examination Survey of 7389 men and 9798 women. Binomial logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia prevalence in participants with RA. The prevalence of sarcopenia was 23.0% in men, 25.0% in women, 61.5% in men with RA, 32.3% in women with RA, 22.8% in men without RA, and 24.9% in women without RA. After adjusting for potential confounding variables, the prevalence of sarcopenia was higher in men with RA than in men without RA (OR, 3.11; 95% CI, 1.29-7.46), but this difference was not observed in women. In subgroup analysis which was stratified by age (age under 40, age between 40 and 59, age over 60), the OR for sarcopenia was higher in men with age over 60 years (OR, 4.12; 95% CI, 1.48-11.44) and women with age between 40 and 59 (OR, 2.29; 95% CI, 1.05-5.00). The prevalence of sarcopenia was higher in Korean men with RA and women with RA in middle age, suggesting the management of muscle loss will be needed, especially in Koreans with RA.

Association between interleukin-1, interleukin-6, and tumor necrosis factor-alpha polymorphisms and juvenile idiopathic arthritis: a meta-analysis.

INTRODUCTION: In juvenile idiopathic arthritis (JIA), interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha (TNF-α) are associated with development and progression of JIA. We investigated whether IL-1, IL-6, and TNF-α polymorphisms were associated with susceptibility to JIA. EVIDENCE ACQUISITION: A meta-analysis was conducted on the associations between IL-1α-899 C/T, IL-1ß-511 C/T, IL-6-174 G/C, and TNF-α-308 G/A and -238 G/A polymorphisms, and JIA (PubMed and Embase). EVIDENCE SYNTHESIS: A total of 27 studies involving 4678 JIA patients and 7634 controls were considered in the meta-analysis. There was no association between the IL-1α-899 C/T, IL-1ß-511 C/T, IL-6-174 G/C, and TNF-α-308 G/A and -238 G/A polymorphisms, and JIA in allele contrast or any other genetic models. In subgroup analysis based on subtype, except for the dominant model of TNF-α-238 G/A, systemic JIA was not significantly associated with IL-6 and TNF-α polymorphisms. In Caucasians, the dominant and additive models of IL-1ß-511 C/T were significantly associated with JIA (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.09-2.00, P=0.01; OR 1.46, 95% CI 1.05-2.03, P=0.02, respectively). CONCLUSIONS: This meta-analysis showed no association between IL-1, IL-6, and TNF-α polymorphisms, and JIA, but the TT genotype of IL-1ß -511 C/T was associated with higher prevalence of JIA in Caucasians.

Prevalence of chronic obstructive pulmonary disease in patients with rheumatoid arthritis: A cross-sectional study.

OBJECTIVE: Rheumatoid arthritis (RA) and chronic obstructive pulmonary disease (COPD) are both chronic inflammatory diseases; the prevalence of COPD in RA patients is known to be high. However, the prevalence of both RA and COPD differs according to sex; the relationship between RA and COPD may also vary according to sex. Therefore, we investigated the prevalence of COPD and its association in patients with RA in Korea by sex. METHODS: We conducted a nationwide cross-sectional study using data from the Korea National Health and Nutrition Examination Survey. A total of 12 417 men and 15 878 women were included. In this study, RA was defined as physician diagnosed or currently under RA treatment. COPD was defined based on spirometry results, chronic symptoms, and smoking history. Multivariable logistic regression models were employed and we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for COPD prevalence in patients with RA. RESULTS: The prevalence of COPD was 15.5% in men with RA, 3.5% in women with RA, 7.8% in men without RA, and 2.2% in women without RA. After adjustment for potential confounding variables, including smoking status, RA was significantly associated with COPD in men (OR 2.16, 95% CI 1.06-4.40), but not in women (OR 1.58, 95% CI 0.81-3.10). CONCLUSIONS: In Korea, the prevalence of COPD was high in patients with RA of both sexes; RA and COPD was significantly likely to be associated in men, but not in women.

Evaluating the effect of a smartphone app-based self-management program for people with COPD: A randomized controlled trial.

AIM: To examine the effect of a 6-month, smartphone app-based self-management program for people with chronic obstructive pulmonary disease (COPD). BACKGROUND: Technological interventions have been used for chronic disease management, but the effect of a self-management program using a smartphone app has not been evaluated in people with COPD. METHODS: For this randomized controlled trial, patients with COPD (N = 44) were recruited in pulmonary medicine outpatient clinics at two, metropolitan, tertiary care, academic hospitals. Eligible participants were randomized into two groups and received group education and exercise sessions in the first month of the 6-month intervention. Participants in the experimental group received a smartphone app-based self-management program, which included education, exercises, self-monitoring of symptoms and exercise, and social support. Participants in the control group received one call a month from the research staff. Self-care behavior was measured as a primary outcome. All measures were administered at baseline and at 6 months. RESULTS: After randomization, the experimental group numbered 22, the control group numbered 20, and 2 participants dropped out. Significant differences between groups were found in change score for self-care behavior, total activity count per wear time, and percent time spent in moderate-to-vigorous physical activity over 6 months. CONCLUSION: A self-management program, using a smartphone app, can effect behavioral change in people with COPD. This program could be a boon to patients with COPD who have limited access to a health care provider, no opportunities for pulmonary rehabilitation, and frequent exacerbations.

Tumour necrosis factor alpha gene polymorphisms in women with recurrent pregnancy loss: a meta-analysis.

Tumour necrosis factor alpha (TNF-α) concentration is associated with recurrent pregnancy loss (RPL). Moreover, TNF-α promoter polymorphisms affect cellular TNF-α concentrations. Although several studies on TNF-α polymorphisms have been reported, these studies only define specific loci and result in conflicting conclusions. The meta-analysis in this study was performed to examine the relationship between various TNF-α polymorphisms and RPL. We searched for articles, using MEDLINE and Embase, and performed meta-analysis of 21 studies involving 3437 cases and 4016 controls. The results demonstrated that the -308G/A polymorphism is positively associated with RPL, particularly in cases involving three or more miscarriages. For -1031T/C, -863C/A, and -376G/A polymorphisms, recessive and homozygote models revealed significant associations with RPL. However, -857C/T, -238G/A, and +488G/A polymorphisms showed no association with RPL. A subgroup analysis with respect to ethnicity demonstrated that the -308G/A and -238G/A polymorphisms are associated with RPL in Asian and Middle Eastern populations, respectively. This meta-analysis showed the associations between TNF-α polymorphisms and RPL. However, further studies of genetic polymorphisms in TNF-α other than -308G/A and -238G/A are required.

Relationship between coffee consumption and serum uric acid level in the general Korean population: A nationwide cross-sectional study.

OBJECTIVE: Coffee is one of the world's most consumed beverages, and its consumption is increasing. Serum uric acid levels are affected by dietary factors, and increased levels can cause a variety of diseases, including gout. This study aimed to investigate the relationship between coffee consumption and serum uric acid levels in the general Korean population. METHODS: A nationwide cross-sectional study was conducted using data from the Korean National Health and Nutrition Examination Survey in 2016. A total of 3005 participants who checked serum uric acid levels and a completed coffee consumption survey were included (1146 men and 1859 women). The amount of coffee consumption was examined via self-reporting and categorized as none, <1 cup, 1-2 cups, 2-5 cups, and ≥5 cups of coffee consumed daily. RESULTS: The mean serum uric acid level of the men was 5.91 ± 1.24 mg/dL and that of women was 4.29 ± 0.97 mg/dL. In the multiple linear regression analysis, there were no significant differences in the serum uric acid levels between the non-coffee-drinking group and the coffee-drinking group (<1 cup, 1-2 cups, 2-5 cups, and ≥5 cups of coffee) in both men and women (P = .569, .258, .466, and .751, respectively, in men; .185, .520, .116, and .302, respectively, in women). CONCLUSIONS: There was no significant relationship between coffee consumption and serum uric acid levels in the general Korean population.

Clinical Findings of Ankylosing Spondylitis With and Without Human Leukocyte Antigen (HLA)-B27 and HLA-B51.

INTRODUCTION: Ankylosing spondylitis (AS) and Behçet's disease are known to be associated with the human leukocyte antigen (HLA)-B27 and HLA-B51 genes, respectively. However, many of their clinical findings-including articular and extra-articular symptoms-are similar, making diagnosis a challenge in the early stage of the disease. The aim of this study was to investigate the differences in clinical findings of AS patients with and without the HLA-B27 gene. MATERIALS AND METHODS: We performed a retrospective chart review of 151 AS patients. The following clinical findings were evaluated: oral ulcer, genital ulcer, skin manifestation, uveitis, peripheral arthritis; and gastrointestinal, cardiac and pulmonary involvement. Patients were divided into 4 groups based on absence or presence of the HLA-B27 and HLA-B51 genes. The number of patients with each clinical finding was subsequently examined in each group. RESULTS: The incidence of uveitis was significantly higher in the HLA-B27-positive group (P = 0.004); however, other clinical findings did not differ significantly according to the absence or presence of the HLA-B27 gene. There were no significant differences in the clinical findings of patients with positive and negative HLA-B51. CONCLUSION: HLA-B27 was associated with the development of uveitis but not with other clinical findings or disease activity in AS patients. HLA-B51 was not associated with the clinical findings or disease activity of AS.

Is knee osteoarthritis related to coffee drinking? A nationwide cross-sectional observational study.

AIMS: Coffee is one of the most consumed beverages globally, and coffee consumption is increasing. Osteoarthritis (OA), the most common musculoskeletal disease in the elderly, is also becoming more prevalent. Coffee is associated with various diseases, but there has not yet been a study of the relationship between coffee and knee OA. Therefore, we investigated this relationship in elderly Koreans. METHODS: Data from 2012 to 2013 were collected from the Korea National Health and Nutrition Examination Survey. We included 2302 participants in our study: 897 men and 1405 women. Participants with knee OA were defined as those whose knee joints exhibited radiographic change of Kellgren-Lawrence grade 2 or higher. Daily coffee consumption amounts were categorized as none, < 2 cups, 2-3 cups, 4-6 cups, and ≥ 7 cups based on self-reporting. RESULTS: A multiple logistic regression model, the odds ratios (ORs) of knee OA in the < 2 cup, 2-3 cup, 4-6 cup, and ≥ 7 cup groups compared to the no-coffee group in men were 1.13 (95% CI 0.50-2.55), 1.79 (95% CI 0.81-3.97), 2.21 (95% CI 0.91-5.35), and 3.81 (95% CI 1.46-12.45), respectively. There was no significant association between coffee consumption and knee OA prevalence in women. CONCLUSION: Daily more than 7 cups of coffee drinking was associated with a prevalence of knee OA in Korean men, and although the ORs did not increase significantly across consumption levels, the prevalence of knee OA tended to increase with increasing coffee consumption.

Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study.

OBJECTIVE: The incidence of osteoarthritis (OA) increases after menopause, and may be related to hormonal changes in women. Estrogen deficiency is known to affect the development of OA, and menopausal hormone therapy (MHT) is suggested to be related to the development of OA. However, the relationship between knee OA and MHT remains controversial. The association between knee OA prevalence and MHT was investigated using large-scale national data. METHODS: Data were collected from 4,766 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2009-2012). MHT was defined as regular hormone medication for ≥1 year, and demographic and lifestyle variables were compared between the MHT and non-MHT groups. Knee OA was defined according to symptoms and radiographic findings. RESULTS: In the multiple logistic regression models, the OA odds ratio was 0.70 for the MHT group (95% confidence interval 0.50-0.99), compared with the non-MHT group. CONCLUSIONS: The prevalence of knee OA was lower in participants with MHT than in those without MHT.

Risk factors and outcomes of sepsis-induced myocardial dysfunction and stress-induced cardiomyopathy in sepsis or septic shock: A comparative retrospective study.

While both sepsis-induced myocardial dysfunction (SIMD) and stress-induced cardiomyopathy (SICMP) are common in patients with sepsis, the pathogenesis of the 2 diseases is different, and they require different treatment strategies. Thus, we aimed to investigate risk factors and outcomes between the 2 diseases.This retrospective study enrolled patients diagnosed with sepsis or septic shock, admitted to intensive care unit via emergency department in Korea University Anam Hospital, and who underwent transthoracic echocardiography within the first 24 hours of admission.In all, 25 patients with SIMD and 27 patients with SICMP were enrolled. Chronic obstructive pulmonary disease and a history of heart failure (HF) were more prevalent in both the SIMD and SICMP groups than in the control group. In the SIMD and SICMP groups, levels of inflammatory cytokines were similar. Serum troponin level was significantly elevated in the SICMP and SIMD group compared to the control group. N-terminal pro-brain natriuretic peptide (NT pro-BNP) level was significantly elevated in the SIMD group compared to the SICMP group or control group. The in-hospital mortality rate in the SIMD and SICMP group was about 40%, showing increased trends compared with the control group. The in-hospital mortality rate was significantly increased in SIMD group with EF<30% than in SICMP group with EF<30%. In multiple logistic regression analysis, a past history of diabetes mellitus (DM) and HF was significantly associated with the incidence of SIMD. Younger age, elevated levels of NT pro-BNP, and positive result of blood culture also showed significant odds ratio regard to the occurrence of SIMD. However, only elevated lactate and troponin level were positively associated with the incidence of SICMP.The SIMD and SICMP had different risk factors. The risk factors of SIMD were younger age, history of DM, history of HF, elevated NT pro-BNP, and positive result of blood culture. The elevated levels of lactate and troponin were identified as risk factors of SICMP. More importantly, in-hospital mortality rate from SIMD and SICMP showed increased trend and worse outcome in SIMD group with reduced EF<30%. Thus, developing SIMD or SICMP reflected poor prognosis in sepsis or septic shock.