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Meniere's disease (MD) is a chronic inner ear disorder characterized by tinnitus, ear fullness, episodic vertigo, and fluctuating hearing loss, which significantly impacts quality of life and poses management challenges. Recent evidence suggests that upper respiratory infections (URIs) may contribute to MD's onset. This study examines the potential link between URIs and MD using data from the Korean National Health Insurance Service-National Sample Cohort (2002–2019). We analyzed 19,721 individuals with MD and 78,884 matched controls, adjusting for demographic factors and comorbidities using propensity score matching. Our results showed that individuals with a URI within one year prior to the index date exhibited a 2.01-fold greater likelihood of developing MD (95% confidence interval [CI] = 1.91–2.11, p < 0.001), while those with URIs within two years demonstrated a 1.54-fold higher probability (95% CI = 1.50–1.59, p < 0.001). Furthermore, we found that even remote URIs occurring up to two years before the index date significantly increased the risk of developing MD, underscoring the need for long-term patient follow-up. Overall, our study suggests that individuals with a history of URI may have an elevated risk of developing MD over multiple time frames, regardless of demographic or health profiles. [ABSTRACT FROM AUTHOR]

Despite growing interest in the preventive effects of statins, as lipid-lowering agents, on migraine attacks, comprehensive nationwide studies comparing migraine likelihood between statin users and controls are lacking. Our nested case–control study within the Korean National Health Insurance Service-Health Screening Cohort (2002–2019) investigated this association using 38,957 migraine patients and 155,828 controls, considering migraine subtypes (with/without aura) and statin types (lipophilic vs. hydrophilic). Using propensity score matching and adjusting for confounders, statin use was linked to reduced migraine likelihood overall (odds ratio (OR) 0.93), particularly for migraines with aura (OR 0.75) and without aura (OR 0.94). Lipophilic statins were effective for both subtypes, while hydrophilic statins mainly reduced the likelihood of migraines without aura. Subgroup analyses showed consistent benefits across demographics, but varied effectiveness based on weight, smoking, alcohol use, hemoglobin levels, and dyslipidemia history. In summary, this nationwide cohort study suggests that statin use may reduce migraine likelihood among Korean adults across diverse demographics and clinical profiles, but varied effectiveness based on certain lifestyle and comorbidity factors underscores the importance of considering individual patient profiles when assessing the potential benefits of statin therapy for migraine prevention. [ABSTRACT FROM AUTHOR]

Simple Summary: Using data from the Korean National Health Insurance Service—National Sample Cohort database, we evaluated whether patient-specific factors such as age, sex, income, residence, and the presence of comorbidities influence the relationship between gastric cancer (GC) and the likelihood of developing osteoporosis. Our study, with 1:4 propensity score matching and a stratified Cox proportional hazards model, showed that the hazard ratio of osteoporosis for the GC group was 1.13 (95%CI, 1.03–1.24) compared to that for the control group. In addition, subgroup analysis showed that age < 65 years, male sex, and a Charlson Comorbidity Index of 0 were risk factors for osteoporosis. Gastric cancer (GC) survivors may be more likely to develop osteoporosis. However, few studies on the relationship between GC and osteoporosis have been conducted on large patient populations. We aimed to determine the incidence of osteoporosis and identify related factors by comparing patients with GC and matched controls using the Korean National Health Insurance Service—National Sample Cohort (KNHIS-NSC). This study included 9078 patients with GC and 36,312 controls (1:4 propensity score-matched for sex, age, residence, and income). The hazard ratio (HR) for osteoporosis was significantly greater for GC patients than for controls according to Charlson Comorbidity Index (CCI) score-adjusted models (adjusted HR = 1.13). Kaplan–Meier analysis revealed that the cumulative incidence of osteoporosis during the follow-up period commencing from the index date was significantly greater in GC patients than in the controls (p = 0.0087). A positive correlation of osteoporosis with GC was detected for those aged < 65 years, males, and those with CCI scores = 0. In conclusion, the study findings suggest that men with GC aged < 65 years may be at an increased risk for osteoporosis. Research into additional risk factors and the optimal timing of interventions are needed to prevent fractures and minimize bone loss in GC survivors. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have reported controversial results on the association between gout and the risk of cancer. This study aimed to investigate the relationship between gout and the incidence of head and neck cancer (HNC). Methods: The data of participants who underwent health checkups in 2009 were analyzed using the National Health Insurance Database in South Korea. A total of 14,348 HNC patients and 57,392 control participants were analyzed for a prior history of gout. Overlap weighting was applied, and odds ratios (ORs) of gout for HNC patients were analyzed. The overlap-weighted model adjusted for demographic, socioeconomic, and lifestyle factors and comorbidities. HNC sites were classified as oral cavity cancer, oropharyngeal cancer, nasopharyngeal cancer, hypopharyngeal cancer, nasal cavity/sinus cancer, larynx cancer, or salivary gland cancer, and the ORs of gout were estimated for each site. Results: Overall, patients with HNC had 1.12-fold greater odds of having gout (95% confidence intervals [CIs] = 1.04–1.20). According to the site of HNC, oral cavity cancer, oropharynx cancer, and larynx cancer demonstrated high odds of having gout (OR = 1.25, 95% CI = 1.16–1.34 for oral cavity cancer; OR = 1.08, 95% CI = 1.01–1.15 for oropharynx cancer; and OR = 1.12, 95% CI = 1.06–1.20 for larynx cancer). On the other hand, nasal cavity/sinus cancer, nasopharynx cancer, and salivary gland cancer presented low odds of having gout (OR = 0.78, 95% CI = 0.72–0.84 for nasal cavity/sinus cancer; OR = 0.89, 95% CI = 0.83–0.96 for nasopharynx cancer; and OR = 0.88, 95% CI = 0.81–0.96 for salivary gland cancer). Conclusions: A prior history of gout was associated with a high overall incidence of HNC. Oral cavity cancer, oropharynx cancer, and larynx cancer have a high incidence in gout patients. However, nasal cavity/sinus cancer, nasopharyngeal cancer, and salivary gland cancer have low incidences in gout patients. The impact of gout on HNC risk should be specifically considered according to the site of the HNC. [ABSTRACT FROM AUTHOR]

Tonsillectomy has been suggested as a potential intervention to resolve psoriasis; however, its preventive effects on the development of psoriasis remain unclear. This study aimed to investigate the risk of developing late-onset psoriasis among a Korean adult population who had undergone tonsillectomy. Data from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2019 were utilized. Out of a total of 514,866 participants, 1082 participants aged 40 years or older who had undergone tonsillectomy were matched with 4328 control participants using overlap weighting adjustment based on the propensity score. The incidence and hazard ratio (HR) of psoriasis were calculated for both tonsillectomy and control groups. The incidence rates of psoriasis were 1.30% in the tonsillectomy group and 1.20% in the control group. The incidence of psoriasis (overlap-weighted HR = 1.08, 95% confidence of interval = 0.69–1.69, and p = 0.732) did not differ significantly between the patients who underwent tonsillectomy and those in the control group. The cumulative probability of developing psoriasis was not different between the two groups (Log-rank test: p = 0.440). These findings were consistent across subgroups divided by age, sex, income, and region of residence. We found that tonsillectomy did not confer a preventive effect on the development of late-onset psoriasis in the Korean adult population. [ABSTRACT FROM AUTHOR]

Growing research has proposed that rheumatoid arthritis (RA) and chronic periodontitis (CP) share similar pathophysiological mechanisms involving inflammation and tissue destruction. However, the potential correlation of CP as a contributing factor for the occurrence of RA warrants validation in the Korean population, where both diseases are prevalent, especially considering the increasingly aging demographic in Korea. This study examined 5139 RA cases and 509,727 matched controls from a Korean national cohort dataset (2002–2019) by carefully employing propensity score matching to ensure comparability between groups. Baseline characteristics were compared using standardized differences, and logistic regression was employed to estimate the impact of CP history on RA likelihood while controlling for covariates. We fully examined medical records documenting CP occurrences within the two-year period leading up to the index date, conducting comprehensive subgroup analyses. While a 1-year history of CP did not show a significant association with likelihood of RA, a 2-year history of CP increased RA likelihood by 12%, particularly among older adults, females, rural residents, and those with certain comorbidities such as hypercholesterolemia. Interestingly, this association persisted even among individuals with non-smoking habits, normal weight, and infrequent alcohol consumption. These findings suggest that chronic CP exposure for at least 2 years may independently elevate RA risk in Korean adults. The association in certain subgroups appears to suggest a predisposition toward genetic susceptibilities over lifestyle and environmental factors. Predicting RA in CP patients may be challenging, emphasizing the importance of regular RA screening, especially in high-risk subgroups. [ABSTRACT FROM AUTHOR]

Background/Introduction: Odontogenic infection is one of the main etiologies of deep neck infection (DNI). However, the relationship between chronic periodontitis (CP) and the incidence of DNI has not been examined. This study aimed to evaluate the incidence of DNI and peritonsillar abscess (PTA) after CP. Methods: The Korean National Health Insurance Service-National Sample Cohort 2002–2019 was used. In Study I, 4585 PTA patients were matched with 19,340 control I participants. A previous history of CP for 1 year was collected, and the odds ratios (ORs) of CP for PTA were analyzed using conditional logistic regression. In Study II, 46,293 DNI patients and 185,172 control II participants were matched. A previous history of CP for 1 year was collected, and conditional logistic regression was conducted for the ORs of CP for DNI. Secondary analyses were conducted in demographic, socioeconomic, and comorbidity subgroups. Results: In Study I, a history of CP was not related to the incidence of PTA (adjusted OR = 1.28, 95% confidence interval [CI] = 0.91–1.81). In Study II, the incidence of DNI was greater in participants with a history of CP (adjusted OR = 1.55, 95% CI = 1.41–1.71). The relationship between CP history and DNI was greater in groups with young, male, low-income, and rural residents. Conclusions: A prior history of CP was associated with a high incidence of DNI in the general population of Korea. Patients with CP need to be managed for the potential risk of DNI. [ABSTRACT FROM AUTHOR]

While headaches frequently occur in individuals with chronic kidney disease (CKD), there are few statistical evaluations of their connection to migraines in population-based studies. In this nationwide longitudinal follow-up study of Korean health examination data (2002–2019), a total of 15,443 participants with CKD and 61,772 matched controls were enrolled. We applied overlap-weighted Cox proportional hazard regression models to assess hazard ratios, examining the correlation between CKD and the development of migraines. After accounting for various factors, we observed a modest reduction of approximately 11% in the likelihood of migraine occurrence among CKD patients (95% confidence intervals = 0.81–0.97) during the 16-year monitoring period. Subgroup analysis revealed a significant association among specific demographic and health conditions, including individuals aged 70 or older, females, overweight individuals, nonsmokers, and those without hypertension or diabetes. Our research may indicate a potential relationship between CKD and the onset of migraines in Korean adults, suggesting a slight reduction in the probability of the occurrence of migraines among those with CKD. These findings emphasize the need for attentive follow-up and preventive management in individuals without the identified protective factors, particularly in male CKD patients under the age of 70 with hypertension. [ABSTRACT FROM AUTHOR]

Recent research suggests a potential relevance between chronic periodontitis (CP) and Parkinson's disease (PD), raising concerns about comorbid PD among elderly CP patients. However, the epidemiologic basis for this association remains unclear. Employing a nested case-control design, this study explored the association between CP and subsequent PD occurrences in Korean adults, leveraging a validated national population-based dataset covering the period from 2002 to 2019. It included 8794 PD patients and 35,176 matched control individuals, established through propensity score matching for age, sex, residential area, and income. Baseline characteristics were compared using standardized differences, and logistic regression was employed to assess the impact of CP histories on PD likelihood while controlling for covariates. We performed a thorough examination of CP events within both 1-year and 2-year intervals preceding the index date, incorporating subgroup analyses. Our analysis revealed no statistically significant association between CP history and PD development overall. However, subgroup analysis revealed a slightly increased likelihood of PD development among CP individuals with a high disease burden (Charlson Comorbidity Index score ≥ 2). In conclusion, although our study did not find a significant overall association between CP history and PD development, the elevated likelihood of PD in subgroups with high disease burden may suggest that comorbidities influence PD probability among certain CP patients. Considering comorbid conditions in PD screening for some individuals with CP may be also important. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a leading cause of global mortality. While recent reports suggest potential connections between CKD and chronic rhinosinusitis (CRS), further research is needed to elucidate the direct association between CKD and CRS. This study investigated the association between CKD and CRS using data from the Korean National Health Insurance Service Health Screening Cohort. Participants were recruited according to medical claim codes, and individuals with CKD were matched in a 1:4 ratio with the control group. Covariates, such as demographics, health-related data, and medical history were used. The incidence rates and hazard ratio of CRS were analyzed. A further analysis was performed based on the presence of nasal polyps. Among the 514,866 participants, 16,644 patients with CKD and 66,576 matched controls were included in the analysis. The CKD group demonstrated a higher incidence of CRS than the controls: 18.30 versus 13.10 per 10,000 person-years. The CKD group demonstrated a higher risk of CRS than the control group (1.28 adjusted hazard ratio). In additional analyses, the CKD group did not exhibit a statistically significant correlation for the development of CRS with nasal polyps. This study suggests that CKD is associated with an increased risk for CRS. [ABSTRACT FROM AUTHOR]

Given the global significance of gout and gastric cancer (GC) as major health problems with interrelated impacts, we examined the development of GC in Korean patients with gout. We conducted a nested case–control study using data from 10,174 GC patients and 40,696 control patients from the Korean National Health Insurance Service-National Sample Cohort database. Propensity score matching (1:4) with propensity score overlap-weighted adjustment was used to reduce selection bias and estimate the odds ratio (OR) and 95% confidence intervals (CIs) for the association between gout and GC. An adjusted OR for GC was not significantly higher in patients with gout than in control patients (1.02; 95% CI, 0.93–1.12; p = 0.652). Additionally, no association between gout and GC was observed in subgroup analyses such as sex, age, level of income, region of residence, or Charlson Comorbidity Index score. In conclusion, these results suggest that gout is not a significant independent risk factor for GC among the Korean population. Additional investigation is required to establish a causal association between gout and GC, and to generalize these results to general populations. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the changes in physical activity levels and the rate of falls during the COVID-19 pandemic in the Korean population. The Korean Community Health Survey (KCHS) conducted in 2019 was compared with that conducted in 2020. Simple or multiple linear regression with complex sampling was conducted to calculate the estimated value (EV) of physical activity in the 2020 group vs. the 2019 group. The odds ratio (OR) of fall histories was calculated using simple or multiple logistic regression with complex sampling for the 2020 group compared to the 2019 group. The time spent on vigorous and moderate physical activity was lower in the 2020 group than in the 2019 group (EV = −10.0, 95% CI = −12.1 to −8.0, P < 0.001 for vigorous exercise and EV = −24.0, 95% CI = −26.7 to −21.4, P < 0.001 for moderate exercise). The rate of falls was lower in the 2020 group than in the 2019 group (OR = 0.66, 95% CI = 0.62 to 0.70, P < 0.001). Vigorous and moderate exercise decreased after the COVID-19 pandemic compared to before the pandemic. The occurrence of falls was lower during the COVID-19 pandemic than in the pre-pandemic period. [ABSTRACT FROM AUTHOR]

With increasing interest in the inflammation-pathogen infection hypothesis and its potential links to Alzheimer's disease (AD) development, there is growing consideration of using upper respiratory infection (URI) treatments as interventions for AD. This nested case–control study explored the potential association between prior URI histories and AD development in a Korean adult population using the national health screening cohort data (2002–2019). The study included 26,920 AD patients and 107,680 matched control individuals, focusing on those seeking respiratory treatment. Logistic regression analyses assessed the impact of URI histories and treatment on AD risk while adjusting for covariates. Our results revealed that over a 1-year period, individuals with URI histories (≥1, ≥2, or ≥3 instances) exhibited decreasing probabilities of developing AD, with risk reductions of 19%, 15%, and 12%, respectively. Expanding our investigation to a 2-year period consistently showed a 17% reduction in AD risk. This effect remained robust across diverse demographic groups and after adjusting for covariates, encompassing comorbidities, hypertension, hyperlipidemia, blood glucose levels, and lifestyle factors. Subgroup analyses further substantiated this association. In conclusion, our findings cautiously suggest a potential protective role of prior URI treatment histories in mitigating the risk of AD development. [ABSTRACT FROM AUTHOR]

Despite the growing prevalence of gout and its associated health concerns as a chronic disorder, population-based studies on its link to migraines are scarce. We conducted a 16-year longitudinal study in a Korean population to investigate the relationship between gout and migraines, including different subtypes. We enrolled 23,137 patients with gout and matched them with 92,548 controls based on age, sex, income, and residence. Using Cox proportional hazards models, we calculated hazard ratios to assess the likelihood of migraines while considering relevant factors. During the follow-up, 1000 gout patients and 3214 controls experienced migraines. After adjusting for various factors, including demographics, health-related variables, and weight categories, the gout group had a 1.26-fold higher likelihood of developing migraines compared to the group without gout. This association was particularly strong for migraines without aura, while it was not significant for migraines with aura. In summary, our study reveals a significant link between gout and migraines in the Korean population, emphasizing the complex relationship among chronic disorders, with a specific focus on migraine subtypes. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the association between tonsillectomy and cardiovascular diseases (CVDs) in the Korean adult population. Using data from the 2002–2015 Korean National Health Insurance Service-Health Screening Cohort, a total of 1082 participants aged 40 years or older who had undergone tonsillectomy were matched with 4328 control individuals for age, sex, income, and region of residence. We evaluated the incidence of CVDs in both the tonsillectomy and control groups and calculated the hazard ratios (HRs) of stroke, ischemic heart disease (IHD), and heart failure (HF) for participants who underwent tonsillectomy using a stratified Cox proportional hazard model. The incidence rates of stroke (81.3 vs. 46.6 per 10,000 person-years) and IHD (112.3 vs. 64.9 per 10,000 person-years) were significantly higher in patients who had undergone tonsillectomy than in the control group. After adjustment, the tonsillectomy group exhibited a 1.78-fold and 1.60-fold higher occurrence of stroke (CI = 1.32–2.42, p < 0.001) and IHD (CI = 1.24–2.08, p < 0.001), respectively, compared to the control group. However, there was no significant difference in the incidence rate of tonsillectomy and control groups (11.1 vs. 6.1 per 10,000 person-years). The HR of HF did not differ significantly between the tonsillectomy and control groups in the adjusted model (p = 0.513). We identified a significant relationship between a history of tonsillectomy and occurrence of stroke/IHD in the Korean adult population. [ABSTRACT FROM AUTHOR]

This article examines the complications and risk factors associated with foreign bodies (FBs) in the external auditory canal (EAC). The study analyzed 455 cases over an 8-year period and found that younger age, longer duration of impaction, nongraspable and animate FBs, and FBs touching the tympanic membrane (TM) were independent risk factors for complications. The authors recommend prompt removal of FBs and direct referral to an otolaryngologist for patients with these risk factors. The findings can be used to inform triage and treatment decisions for patients with FBs in the EAC. [Extracted from the article]

We investigated the association of proton pump inhibitor (PPI) use with the risk of stroke and ischemic heart disease (IHD). The Korean National Health Insurance Service-Health Screening cohort from 2002 to 2003, the participants of which were followed up until 2019, was used. In study I, 45,905 participants who were diagnosed with stroke were matched with 91,810 control I participants. The history of PPI medication was examined. In study II, 40,928 participants who were diagnosed with IHD were matched with 81,856 control II participants. In both study I and study II, the previous history of PPI medication was examined. A propensity score overlap-weighted multivariable logistic regression analysis was conducted to estimate the overlap-weighted odds ratios (ORs) of PPI use for stroke (study I) and IHD (study II). Current PPI use was linked with higher odds for stroke in study I. The odds for stroke were higher in groups with a longer duration of PPI use (OR = 0.96 [95% CI = 0.92–1.00] < 1.55 [1.50–1.61] < 1.62 [1.57–1.68] for < 30 days, 30 to 180 days, and ≥180 days of PPI use). Previous PPI use was linked with higher odds for IHD in study II. The odds for stroke were higher in groups with a longer duration of PPI use (OR = 1.13 [95% CI = 1.08–1.18] < 2.12 [2.04–2.21] < 2.60 [2.51–2.69] for <30 days, 30 to 180 days, and ≥180 days of PPI use). Current PPI medication is associated with a high risk of stroke and IHD. A longer duration of PPI medication was related to a higher risk of stroke and IHD. However, a prior history of PPI medication was not linked with a high risk of stroke or IHD. [ABSTRACT FROM AUTHOR]

A previous study reported a high risk of benign prostatic hyperplasia (BPH) in patients with gout. This study intended to evaluate the risk of BPH in gout patients. A total of 514,866 Korean National Health Insurance Service—Health Screening Cohorts were retrieved from 2002 to 2019. Among these individuals, 14,961 gout patients and 58,764 control participants were matched based on demographic factors. The incidence of BPH during the follow-up periods was collected for both the gout and control groups. The risk of BPH was analyzed using stratified Cox proportional hazard models, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Secondary analyses were conducted based on demographic factors and comorbidities. The incidence of BPH was 23.40% in gout patients and 20.70% in control participants. In the adjusted model, the HR of BPH was 1.13-fold higher in gout patients than in the control group (95% CI = 1.09–1.18). Compared with the ≥60-year-old group, the <60-year-old group demonstrated a higher HR for BPH in gout patients (1.19 [1.13–1.24] vs. 1.07 [1.01–1.13]). The risk of BPH in gout patients was consistent according to various comorbidities. Patients with gout demonstrated a greater risk of BPH than participants without gout. The young adult population had a higher risk of BPH related to gout. [ABSTRACT FROM AUTHOR]

The current study aimed to investigate the association between asthma and periodontitis in the Korean adult population. Data from the Korean Genome and Epidemiology Study Health Examinees between 2004 and 2016 were considered. Of the 173,209 participants, 2521 asthmatic and 132,806 control participants were selected. The participants were categorized according to their current status of asthma, as 'well-controlled', 'being treated', and 'not being treated'. The prevalence of periodontitis was found to be significantly higher in the participants with asthma (13.1%) than in the controls (7.3%). In the fully adjusted model, the patients with asthma had a higher odds ratio (OR = 1.79, 95% confidence interval [CI] = 1.59–2.02, p < 0.001) for periodontitis than those without asthma. The results were consistent across all the age and sex subgroups. The adjusted ORs for periodontitis were 2.15 (95% CI = 1.68–2.76, p < 0.001) in the 'well-controlled' asthma group, 1.44 (95% CI = 1.16–1.78, p < 0.001) in the 'being treated' asthma group, and 1.86 (95% CI = 1.55–2.22, p < 0.001) in the 'not being treated' asthma group compared to the control group. Overall, we found asthma to be associated with periodontitis in Korean adults, and the participants with well-controlled asthma had the highest ORs for periodontitis. [ABSTRACT FROM AUTHOR]

Simple Summary: Using Korean National Health Insurance Service-National Sample Cohort database, we studied whether patient-specific factors such as age, gender, socioeconomic status, and presence of comorbidities may influence the relationship between gout and the likelihood of developing CRC. Our nested case-control study with propensity score overlap-weighted multivariate logistic regression analyses suggest that patients with gout are not at higher risk for CRC than a control group, indicating that gout may not significantly and independently contribute to the CRC risk of the general population. Nevertheless, within a specific subgroup of patients aged less than 65 years, there appeared to be a moderately reduced probability of CRC development. Further comprehensive research is necessary to substantiate this association and gain a better understanding of the underlying causal factors. Considering the global importance of both gout and colorectal cancer (CRC) as significant health issues with mutual relevance, we aimed to examine the risk of colorectal cancer in Korean patients with gout. In this nested case-control study, we used data from 9920 CRC patients and 39,680 controls the Korean National Health Insurance Service-National Sample Cohort database. Propensity score overlap-weighted multivariate logistic regression analyses, adjusted for confounders, were used to assess the odds ratio (OR) and 95% confidence interval (CI) of the association between gout and CRC. Adjusted OR for CRC were similar between patients with gout and the control group (0.95; 95% CI, 0.86–1.04; p = 0.282). However, after adjustment, subgroup analysis revealed an 18% reduction in the probability of CRC among patients younger than 65 years with gout (95% CI, 0.70–0.95; p = 0.009). Conversely, absence of an association between gout and subsequent CRC persisted regardless of sex, income, residence, and Charlson Comorbidity Index score, even among individuals aged 65 years or older. These results imply that gout may not be a significant independent risk factor for CRC among the general population. However, in patients younger than 65 years with gout, a slightly reduced likelihood of CRC was observed. Further research is necessary to establish a causal relationship between gout and CRC and to generalize these findings to other populations. [ABSTRACT FROM AUTHOR]

Simple Summary: We conducted a study using the Korean National Health Insurance Service–National Sample Cohort database to investigate if a hazard connection existed between prior use of proton pump inhibitors (PPIs) and the development of colorectal cancer (CRC) in the Korean population. Our research, which employed a nested case–control study with a statistical technique known as "propensity score nested weighted multivariate logistic regression", revealed that the risk of developing CRC increased regardless of whether individuals had a history of PPI use or the duration of PPI use. This suggests that prior use of PPIs, whether currently or in the past, and regardless of the duration, may be linked to an increased likelihood of CRC within the Korean population, highlighting the need for cautious and precise adherence to PPI medications according to treatment guidelines to mitigate potential adverse effects. The potential connection between proton pump inhibitors (PPIs) and colorectal cancer (CRC) risk remains unclear, with specific ethnic genetic backgrounds playing a role in PPI-induced adverse effects. In this nested case–control study, we investigated the risk of CRC in relation to preceding PPI use and the duration of use using data from the Korean National Health Insurance Service–National Sample Cohort database, including 9374 incident CRC patients and 37,496 controls. To assess the impact of preceding PPI exposure (past vs. current) and use duration (days: <30, 30–90, and ≥90) on incident CRC, we conducted propensity score overlap-weighted multivariate logistic regression analyses, adjusted for confounding factors. Our findings revealed that past and current PPI users had an increased likelihood of developing CRC. Regardless of duration, individuals who used PPIs also had higher odds of developing CRC. Subgroup analyses revealed that CRC occurrence increased independent of history or duration of prior PPI use, consistent across various factors such as age, sex, income level, and residential area. These findings suggest that PPI use, regardless of past or present use and duration of use, may be related to an increased risk of developing CRC in the Korean population. [ABSTRACT FROM AUTHOR]

Esophageal cancer constitutes a global public health challenge. However, South Korean population-specific information on the association of lifestyle (smoking, alcohol consumption, and obesity status) with esophageal cancer risk is sparse. This nested case–control study analyzed the Korean national health screening cohort data (2002–2019) of 1114 patients with esophageal cancer and 4456 controls (1:4 propensity-score matched for sex, age, income, and residential region). Conditional and unconditional logistic regression analyses, after adjustment for multiple covariates, determined the effects of lifestyle factors on esophageal cancer risk. Smoking and alcohol consumption increased the esophageal cancer risk (adjusted odds ratio [95% confidence interval]: 1.37 [1.15–1.63] and 1.89 [1.60–2.23], respectively). Overweight (body mass index [BMI] ≥ 23 to <25 kg/m2), obese I (BMI ≥ 25 to <30 kg/m2), or obese II (BMI ≥ 30 kg/m2) categories had reduced odds of esophageal cancer (0.76 [0.62–0.92], 0.59 [0.48–0.72], and 0.47 [0.26–0.85], respectively). In the subgroup analyses, the association of incident esophageal cancer with smoking and alcohol consumption persisted, particularly in men or those aged ≥55 years, whereas higher BMI scores remained consistently associated with a reduced esophageal cancer likelihood across all age groups, in both sexes, and alcohol users or current smokers. Underweight current smokers exhibited a higher propensity for esophageal cancer. In conclusion, smoking and alcohol drinking may potentially increase the risk, whereas weight maintenance, with BMI ≥ 23 kg/m2, may potentially decrease the risk, for esophageal cancer in the South Korean population. Lifestyle modification in the specific subgroups may be a potential strategy for preventing esophageal cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates the potential link between Alzheimer's disease (AD) and the probability of developing various cancers using a large cohort dataset in Korea from matching 24,664 Korean citizens with AD and without a history of cancer with 98,656 non-AD and noncancer Korean citizens. The results revealed that patients with AD had a significantly lower likelihood of developing overall malignancy as well as specific types of cancer compared to the control group. Notably, pancreatic cancer showed the strongest inverse relationship with AD. The protective effect against certain organ-specific cancers persisted throughout the 16-year follow-up period, particularly in individuals aged 60 years and above. These findings suggest that Korean patients with AD may have a decreased risk of malignancy, highlighting the need to explore the connection between AD and cancer risk. The link between Alzheimer's disease and cancer risk is a concern in public health. However, research has yielded limited and sometimes contrasting results, suggesting the need for more validation. We analyzed a large cohort to examine the long-term association between Alzheimer's disease (AD) and the risk of developing cancer. In total, 24,664 AD patients and 98,656 control participants were selected from the National Health Insurance Cohort database of Korea, spanning from 2002 to 2019. Propensity score matching and overlap-weighted adjustment techniques were used to balance the standardized differences between the AD and control groups. The Cox proportional hazards model was applied to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for various cancers, considering relevant covariates. Results indicated that patients with AD had a significantly lower likelihood of overall malignancy (HR 0.63; 95% CI, 0.59–0.68) and each of the 10 site-specific cancers compared to the control group. Among these, pancreatic cancer (HR, 0.50) exhibited the strongest inverse association, followed by hepatic (HR, 0.60), gastric (HR, 0.63), kidney (HR, 0.63), lung (HR, 0.64), thyroid (HR, 0.65), colorectal (HR, 0.67), gallbladder and biliary duct (HR, 0.73), hematologic malignancy (HR, 0.73), and bladder cancers (HR, 0.76). This protective effect against certain organ-specific cancers persisted over the 16-year follow-up period, except for in kidney cancer and hematologic malignancies. The protective effect against specific cancer types (gastric, colorectal, lung, hepatic, and pancreatic) was more prominent in individuals aged 60 years and older, regardless of their sex. However, there were some variations in the specific types of cancer observed between males and females. In summary, Korean patients with AD had a lower risk of cancer, especially in individuals 60 years and older, during the 16-year follow-up period. [ABSTRACT FROM AUTHOR]

Simple Summary: This research investigates the potential link between gum disease and stomach cancer in the Korean population. In this study, we analyzed data from over 10,000 people with gastric cancer and 40,000 healthy individuals. The results indicate that individuals who had gum disease in the past one to two years were more likely to develop stomach cancer. This association was consistently observed in different groups, such as men under 65 years old. The study emphasizes the importance of regular screening for stomach cancer, particularly for those at high risk, such as individuals with a history of gum disease. These findings contribute to our understanding of the connection between oral health and stomach cancer and may guide future preventive measures. There is limited information regarding the potential association between chronic periodontitis (CP) and gastric cancer, especially in the Korean population. This study aimed to explore this relationship. This nested case–control study analyzed data from 10,174 patients with gastric cancer and 40,696 controls from the Korean National Health Insurance Service–National Sample Cohort using propensity score matching. Standardized differences were used to compare baseline characteristics between study groups. Logistic regression analyses adjusted for confounders were conducted to assess the association between history of CP and gastric cancer occurrence. CP histories and comprehensive subgroup analyses in the 1- and 2-year periods preceding the index date were evaluated. Individuals with a history of CP within the 1-year and 2-year periods showed an increased likelihood of developing gastric cancer. Subgroup analyses consistently supported these findings in male participants aged <65 years and individuals with various income levels or living in residential areas. However, no significant associations were observed among participants aged ≥65 years. In conclusion, CP may be a potential risk factor for gastric cancer development in the Korean population. Regular screening for gastric cancer may be necessary for high-risk individuals, specifically men aged <65 years with a history of CP. [ABSTRACT FROM AUTHOR]

Background: Whether migraine is related to the risk of cardiovascular diseases (CVDs) remains unclear. Therefore, we conducted a longitudinal follow-up study to address the association between migraine and the development of CVDs in Korea. Methods: Using data from the national health screening cohort, we included 45,246 patients diagnosed with migraine between 2002 and 2019 and age-, sex-, income-, and residential region-matched nonmigraine participants at a ratio of 1:4. Participants with previous CVDs were excluded. Cox proportional hazards regression models were used to estimate the hazard ratios of three CVDs, stroke, ischemic heart disease, and heart failure, in patients with migraine after adjusting for potential cardiovascular risk factors. Results: The incidence rate differences of stroke, ischemic heart disease, and heart failure among patients with migraine were 2.61, 1.69, and 0.11, respectively. The probability of developing stroke and ischemic heart disease in patients with migraine was significantly higher than that in controls after controlling for multiple confounders (adjusted hazard ratio [HR] = 1.35, 95% confidence interval [CI] = 1.31–1.39 and adjusted HR = 1.31, 95% CI = 1.26–1.35, respectively). However, when compared with the patients without migraine, patients with migraine did not have an increased HR of developing heart failure (adjusted HR = 1.01, 95% CI = 0.95–1.08). The overall migraine group, as well as groups stratified by migraine subtypes with and without aura, each showed a significantly higher probability of subsequent stroke and ischemic heart disease than the control group. Conclusions: Our longitudinal follow-up study demonstrated a significant association between the presence of migraine and the development of stroke and ischemic heart disease in Korea, even after adjusting for cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) and Parkinson's disease (PD) are common illnesses found in the geriatric population. A potential link between CKD and PD emergence has been hypothesized; however, existing conclusions are disputed. In this longitudinal research, we analyzed data acquired from the Korean National Health Insurance Service-Health Screening Cohort. The dataset comprised the health information of 16,559 individuals clinically diagnosed with CKD and 66,236 control subjects of comparable ages, all aged ≥40 years. These subjects participated in health examinations from 2002 to 2019. To assess the correlation between CKD and PD, we employed overlap-weighted Cox proportional hazard regression models. The unadjusted, crude hazard ratio for PD was greater in the CKD group than in the control group (crude hazard ration (HR) 1.20; 95% confidence interval (CI) = 1.04–1.39; p = 0.011). However, the Cox proportional hazard regression analysis, incorporating propensity score overlap weighting, revealed no significant discrepancy after considering confounding variables such as demographic factors, socio-economic status, lifestyle, and concurrent health conditions (adjusted HR (aHR), 1.09; 95% CI = 0.97–1.22; p = 0.147). Subgroup analyses showed a higher probability of PD development among certain CKD individuals, including those who resided in rural areas (aHR, 1.19; 95% CI = 1.03–1.37; p = 0.022), maintained a normal weight (aHR, 1.29; 95% CI = 1.08–1.56; p = 0.006), or had fasting blood glucose levels ≥100 mg/dL (aHR, 1.18; 95% CI = 1.00–1.39; p = 0.046). Therefore, these clinical or environmental factors may influence the incidence of PD in CKD patients. In conclusion, our results suggest that the general CKD population may not exhibit a greater propensity for PD than their non-CKD counterparts. However, this might be contingent upon specific lifestyle and comorbid conditions. Thus, certain lifestyle alterations could be crucial in mitigating the potential manifestation of PD in patients diagnosed with CKD. [ABSTRACT FROM AUTHOR]

Background: During the coronavirus disease (COVID-19) pandemic, the amount of moderate- to high-intensity physical activity significantly decreased. Therefore, the epidemiology of musculoskeletal diseases could possibly have changed. We assessed changes in the incidence of and variance in non-traumatic orthopedic diseases before and after the COVID-19 pandemic in Korea. Methods: This study included data from the Korea National Health Insurance Service, which covers the entire Korean population (approximately 50 million), from January 2018 to June 2021. Using International Classification of Diseases, Tenth Revision codes, 12 common orthopedic diseases were evaluated, including cervical disc disorders, lumbar disc disorders, forward head posture, myofascial pain syndrome, carpal tunnel syndrome, tennis elbow, frozen shoulder, rheumatoid arthritis, gout, hip fracture, distal radius fracture, and spine fracture diseases. "Pre-COVID-19" was the period until February 2020, and "COVID-19 pandemic period" was the period starting March 2020. Differences in the mean incidence and variance of diseases before and during the COVID-19 pandemic were compared. Results: In most cases, the incidence of orthopedic diseases decreased at the beginning of the pandemic and then increased thereafter. Among the 12 diseases, the incidence of three diseases showed a statistically significant change. The incidence of myofascial pain syndrome (P < 0.001) was lower during the COVID-19 pandemic than during the pre-COVID-19 period. The incidences of frozen shoulder (P < 0.001) and gout (P = 0.043) were higher during the COVID-19 pandemic than during the pre-COVID-19 period. However, no statistical difference in disease variations was observed between the two periods. Conclusions: The incidence of orthopedic diseases varied during the COVID-19 pandemic among the Korean population. Although the incidence of myofascial pain syndrome was lower, that of frozen shoulder and gout was higher during the COVID-19 pandemic than during the pre-COVID-19 period. No disease variations during the COVID-19 pandemic were found. [ABSTRACT FROM AUTHOR]

The present study evaluated the association of long-term statin use with the diagnosis and mortality of esophageal cancer in a Korean population. The Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2019 was enrolled. Esophageal cancer patients were matched with control participants for demographic variables. The statin prescription histories were collected and grouped into <180 days, 180 to 545 days, and >545 days of duration. Propensity score overlap weighting was applied to minimize the bias between the esophageal cancer and control groups. The odds ratios (ORs) of the duration of statin use for esophageal cancer were analyzed using propensity score overlap weighted multivariable logistic regression analysis. The esophageal cancer group was classified as dead and surviving patients, and the ORs of the duration of statin use for the mortality of esophageal cancer were analyzed in an identical manner. Secondary analyses were conducted according to comorbid factors. Patients with esophageal cancer did not show lower odds for the duration of statin prescription in the overall study population (OR = 1.30, 95% CI = 1.03–1.65, p = 0.027 for 180 to 545 days and OR = 1.29, 95% CI = 1.08–1.55, p = 0.006 for >545 days). Subgroups of nonsmokers, past and current smokers, alcohol consumption ≥ 1 time a week, SBP < 140 mmHg and DBP < 90 mmHg, fasting blood glucose ≥ 100 mg/dL, total cholesterol ≥ 200 mg/dL, CCI score = 0, and nondyslipidemia history demonstrated low odds for the duration of statin prescription. Both types of statins, hydrophilic and lipophilic statins, were not related to a lower rate of esophageal cancer. The mortality of esophageal cancer was not associated with the duration of statin prescription. A subgroup with total cholesterol ≥ 200 mg/dL showed lower odds of statin prescription for mortality of esophageal cancer. The duration of statin prescription was not related to a lower rate or mortality of esophageal cancer in the adult Korean population. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) and Alzheimer's disease (AD) are common chronic diseases in the elderly population. Although a relationship between CKD and the occurrence of AD has been proposed, previous research results have been disputed, and further investigation is necessary to confirm this relationship. In this longitudinal follow-up study, we examined data from the Korean National Health Insurance Service-Health Screening Cohort, consisting of 15,756 individuals with CKD and 63,024 matched controls aged ≥40 years who received health check-ups between 2002 and 2019. Overlap-weighted Cox proportional hazard regression models were exploited to calculate hazard ratios (HRs) for the association between CKD and AD. During the monitoring period, individuals with CKD had a greater incidence of AD than those without CKD (15.80 versus 12.40 per 1000 person years). After accounting for various factors, CKD was significantly associated with a 1.14-fold increased likelihood of developing AD, with a 95% confidence interval ranging from 1.08 to 1.20. In subgroup analysis, this relationship persisted irrespective of age (≥70 or <70), sex, income, smoking status, alcohol consumption, place of residence, or fasting blood glucose level. Additionally, the association between CKD and AD was still evident among patients who were overweight or obese, those with normal blood pressure or cholesterol levels, and those without any other health conditions or with a CCI score of ≥2. These results suggest that CKD could increase the probability of developing AD in the Korean adult population irrespective of demographic or lifestyle conditions. This may make it challenging to predict AD in patients with CKD, emphasizing the importance of frequent AD screening and management. [ABSTRACT FROM AUTHOR]

Objective: Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory diseases. The effect of chronic inflammation caused by CRS on the occurrence of various cancers has not been thoroughly evaluated. This study aimed to investigate the increased incidences of 10 types of cancers among CRS patients with/without nasal polyps (NP) using a national population‐based database from the Korean Health Insurance Review and Assessment Service. Study Design: A case–control cohort study. Methods: We compared the prevalence of various comorbidities between CRS and control participants from a national cohort dataset of the Korean Health Insurance Review and Assessment Service. Methods: CRS participants (n = 6,919) and non‐CRS (n = 27,676) participants were selected from among the 514,866 participants from 2002 to 2015. A stratified Cox proportional hazards model was utilized to assess the hazard ratio (HR) of CRS for 10 types of cancers. Results: A stratified Cox proportional hazard model demonstrated that the adjusted HR for hematologic malignancy was significantly higher in the CRS patients than in the controls regardless of the presence of NP (2.90 for total CRS; 2.15 for CRS with NP; 4.48 for CRS without NP). The HR for thyroid cancer was significantly higher in the CRS patients without NP but not in those with NP (1.50 for total CRS; 1.78 for CRS without NP). Conclusion: This study showed that CRS participants had a significantly higher prevalence of hematologic malignancy and thyroid cancer. Level of Evidence: 4 Laryngoscope, 133:1044–1051, 2023 [ABSTRACT FROM AUTHOR]

A connection between asthma and the occurrence of Parkinson's disease (PD) has been suggested, but the findings have been contentious and require verification. In this nested case–control study using data from the Korean National Health Insurance Service—Health Screening Cohort (2002–2019), which comprised 9029 participants with PD and 36,116 matched controls, we explored the relationship between asthma and incident PD. An overlap-weighted logistic regression model was used to measure the probability of asthma and PD. After adjusting for various covariates, we found that asthma was related to a 1.11-fold greater probability of PD (95% confidence interval: 1.06–1.16). A subgroup analysis showed that this effect was independent of age, sex, residential area, or alcohol consumption, and that it was still noticeable even among patients with a high income; those with a normal weight or obesity; those who were non-smokers or current smokers; and those with no history of chronic obstructive pulmonary disease, hypertension, hyperglycemia, hyperlipidemia, or anemia. Thus, these findings may indicate that asthma may slightly augment the likelihood of PD in the Korean adult population regardless of demographic or lifestyle factors, making it difficult to predict PD in asthma patients. [ABSTRACT FROM AUTHOR]

Several epidemiological studies have demonstrated that genetic and environmental factors contribute to the development of allergic diseases. However, there is limited information on these factors in the Korean population. This study investigated the importance of genetic and environmental factors in allergic diseases, such as allergic rhinitis, asthma, allergic conjunctivitis, or atopic dermatitis, by comparing the disease incidence in Korean adult monozygotic and dizygotic twins. This cross-sectional study utilized data from 1296 twin pairs, including 1052 monozygotic and 244 dizygotic twins, aged over 20 years, from the Korean Genome and Epidemiology Study (2005–2014). The study utilized binomial and multinomial logistic regression models to compute odds ratios of disease concordance. The concordance rate (92%) of the presence or absence of atopic dermatitis in monozygotic twins was slightly higher than that in dizygotic twins (90.2%), which only had a borderline significance (p = 0.090). The concordance rates of other allergic diseases within monozygotic twins were lower compared to dizygotic twins (asthma, 94.3% vs. 95.1%; allergic rhinitis, 77.5% vs. 78.7%; allergic conjunctivitis, 90.6% vs. 91.8%), of which the differences were not statistically significant. Monozygotic twins had a higher proportion of cases in which both siblings had allergic diseases than dizygotic twins (asthma, 1.1% vs. 0.0%; allergic rhinitis, 6.7% vs. 3.3%; atopic dermatitis, 2.9% vs. 0.0%; allergic conjunctivitis, 1.5% vs. 0.0%), of which the differences were also not statistically significant. In conclusion, our results appear to indicate the relative importance of environmental factors over genetic factor in the development of allergic diseases in Korean adult monozygotic twins. [ABSTRACT FROM AUTHOR]

This study aims to investigate the association between chronic kidney disease (CKD) and sudden sensorineural hearing loss (SSNHL) using a population-based cohort study. We used data from the Korean National Health Insurance Service–Health Screening Cohort. Participants were selected based on diagnosis and treatment codes, and CKD participants were 1:4 matched with control participants. Covariates, including demographic and lifestyle factors, and comorbidities were considered in the analysis. We calculated the incidence rate and hazards ratio of SSNHL. A total of 16,713 CKD participants and 66,852 matched controls were enrolled. The CKD group had a higher incidence rate of SSNHL compared to the control group at 2.16 and 1.74 per 1000 person-years, respectively. The CKD group exhibited a higher risk for SSNHL compared to the control group with adjusted HR 1.21. In the subgroup analysis, the presence of cardiovascular risk factors was associated with a diminished effect of CKD on the risk of developing SSNHL. This study provides strong evidence of an association between CKD per se and an increased risk of SSNHL even after adjusting for various demographic and comorbidity factors. The findings suggest that CKD patients may require more comprehensive monitoring for hearing loss. [ABSTRACT FROM AUTHOR]

The correlation between statin use and the development of gallstone disease remains controversial. Existing data, primarily based on Caucasian populations, are biased, thus necessitating validation studies involving Asian cohorts. We conducted a nested case–control study using data from the Korean National Health Insurance Service Health Screening Cohort (2002–2019) to determine the likelihood of gallstone disease according to periods of previous statin use and type of statin. Among the 514,866 participants, 22,636 diagnosed with gallstones at ≥2 clinic visits (using the International Classification of Diseases, 10th revision, code K80) were matched 1:4 to 90,544 controls for age, sex, income, and residential area, and their statin prescription history for 2 years prior to the index date was examined. Propensity-score-weighted odds ratios (ORs) for gallstone disease were calculated using conditional logistic regression. Long-term use (>545 days) of any statin or lipophilic statins was associated with lower odds of incident gallstones (OR = 0.91, 95% confidence interval [CI] = 0.86–0.96, p < 0.001 and OR = 0.88, 95% CI = 0.83–0.93, p < 0.001, respectively) after adjusting for confounders. Short-term use (180–545 days) of any statin or hydrophilic statins was not statistically related to incident gallstones. In summary, prior statin medication, particularly long-term lipophilic statin use, may confer a preventive advantage against gallstone disease. [ABSTRACT FROM AUTHOR]

To date, no clear conclusion on the relationships of gout with the occurrence of typical neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD), has been reached. This study aimed to determine whether the patients with gout are at a lower or higher probability of developing AD or PD than those without gout. Longitudinal follow-up data of a representative sample of Korean adults were assessed. 18,079 individuals diagnosed with gout between 2003 and 2015 were enrolled in the gout group. The comparison group comprised 72,316 demographics-matched individuals not diagnosed with gout. Longitudinal associations of gout with AD or PD were estimated using Cox proportional hazard regression adjusting for potential confounders. The adjusted hazard ratios (HRs) of AD and PD in the gout group were 1.01 and 1.16 times higher than controls, but these differences were not statistically significant (95% confidence interval [CI] = 0.92–1.12 and 95% CI = 0.97–1.38, respectively). Although there was no significant association in the entire sample, AD and PD probabilities in patients with gout were significantly higher in participants < 60 years, and PD probabilities in patients with gout were significantly higher in overweight participants. Our findings identify significant correlations of gout with AD and PD in participants < 60 years and gout with PD in those with overweight, indicating that gout may play a role in the development of neurodegenerative diseases in younger or overweight populations. Further investigations should be performed to corroborate these findings. [ABSTRACT FROM AUTHOR]

This study evaluated the impact of pre-existing gout on the occurrence of benign paroxysmal positional vertigo (BPPV), Meniere's disease, and vestibular neuronitis, with the goal of identifying novel associations of gout with other comorbid diseases. The 2002–2019 Korean National Health Insurance Service Health Screening Cohort data were retrospectively analyzed. 23,827 patients with gout were matched to 95,268 controls without gout for age, sex, income, region of residence, and index date. The occurrence of BPPV, Meniere's disease, and vestibular neuronitis was evaluated in both groups. The hazard ratios (HRs) of gout for BPPV, Meniere's disease, and vestibular neuronitis were calculated using a stratified Cox proportional hazard model. Participants with gout demonstrated a 1.13-fold higher risk of BPPV (95% CI, 1.06–1.21, p < 0.001) and a 1.15-fold higher risk of Meniere's disease (95% CI, 1.15–1.37, p < 0.001) than the matched control group. However, the HR for vestibular neuronitis was not significantly higher in the gout group (adjusted HR = 1.06, 95% CI, 0.93–1.21, p = 0.391). A previous history of gout was related to a higher risk of BPPV and Meniere's disease. Additional studies are necessary to elucidate the mechanism underlying the relationship between gout and comorbid diseases such as BPPV and Meniere's disease. [ABSTRACT FROM AUTHOR]

This study undertook to determine the changes in the numbers of outpatient visits for various ophthalmic diseases during the COVID-19 pandemic compared with before. The monthly outpatient visits for 14 common ophthalmic diseases were enumerated based on the ICD-10 codes in Korean National Health Insurance Service data. The differences in the mean outpatient visits and disease variance 'before' and 'during COVID-19' were calculated. Subsequently, subgroup analyses according to age and sex were performed. The number of outpatient visits for conjunctivitis, scleritis & episcleritis, keratitis, cataract, diabetic retinopathy, and traumatic ophthalmic disease were lower during than before COVID-19 (all P < 0.001). The lower numbers of outpatient visits for ophthalmic disorders during COVID-19 were consistent across the age and sex subgroups. All ophthalmic diseases other than endophthalmitis showed no change of variation 'during' relative to 'before' COVID-19. In conclusion, during the COVID-19 pandemic, the ophthalmic outpatient visits decreased for infectious and inflammatory diseases, screening diseases, and traumatic diseases. However, COVID-19 is not considered to have had a significant effect on variation. [ABSTRACT FROM AUTHOR]

A high rate of Meniere's disease (MD) in patients with osteoporosis has been suggested. This research intended to estimate the bidirectional association of MD with osteoporosis. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort 2002–2019 was examined. In study I, 9529 patients with MD and 38,116 control I participants were analyzed for a previous history of osteoporosis. In study II, 65,858 patients with osteoporosis and 65,858 control II participants were analyzed for a previous history of MD. Stratified Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MD for osteoporosis in study I and of osteoporosis for MD in study II. The rate of a prior history of osteoporosis was 13.3% for the MD group and 11.3% for the control I group. The patients with MD had a 1.12 times higher HR for previous osteoporosis (95% CI = 1.04–1.20). In study II, the rate or a prior history of MD was 3.7% for patients with osteoporosis and 2.0% for the control II group. The patients with osteoporosis had a 1.50 times higher HR for previous MD (95% CI = 1.40–1.61). Most subgroups according to age, sex, and comorbid conditions demonstrated consistent bidirectional associations between MD and osteoporosis. Adult patients with MD had a greater risk of osteoporosis. In addition, adult patients with osteoporosis also showed a higher risk of MD. [ABSTRACT FROM AUTHOR]

This study investigated the contribution of genetic and environmental factors to cardiometabolic diseases (CMDs) by comparing disease concordance in monozygotic and dizygotic twins. This cross-sectional study analyzed 1294 (1040 monozygotic and 254 dizygotic) twin pairs (>20 years) based on the Korean Genome and Epidemiology Study data (2005–2014). The odds ratios of disease concordance were calculated using binomial and multinomial logistic regression models. The occurrence of CMDs (hypertension, hyperlipidemia, type 2 diabetes, cerebral stroke, transient ischemic attack, and ischemic heart disease) and related physical and laboratory levels did not differ between the monozygotic and dizygotic twin groups. The odds for concordance of the presence/absence of CMDs and the likelihood of incident CMD within monozygotic twins were comparable to that of dizygotic twins. The absolute differences in hemoglobin A1c, insulin, low- and high-density lipoprotein cholesterol, total cholesterol, triglycerides, and systolic blood pressure were lower in monozygotic twins than in dizygotic twins. Absolute differences in fasting glucose and diastolic blood pressure did not differ between groups. Although baseline levels of several laboratory parameters related to CMD showed a strong likelihood of heritability in monozygotic twins, CMD phenotype appears to be largely affected by environmental factors. [ABSTRACT FROM AUTHOR]

Previous studies have proposed an association between osteoporosis and renal stones. The current analyses intended to investigate the bidirectional relationship between osteoporosis and renal stones. The ≥40-year-old population in the National Health Insurance Service-Health Screening cohort (2002–2015) was analyzed. In study I, 67,811 patients with osteoporosis and 67,811 control I participants were matched. The hazard ratio (HR) of osteoporosis for renal stones was calculated using stratified Cox proportional hazard models. In study II, 25,261 patients with renal stones and 101,044 control II participants were matched. The HR of renal stones for osteoporosis was estimated using stratified Cox proportional hazard models. In study I, 3.4% (2276/67,811) of osteoporosis patients and 2.5% (1696/67,811) of control I participants had renal stones. Osteoporosis patients had a 1.36 times higher HR for renal stones than control I participants (95% confidence intervals [CI] = 1.28–1.45). In study II, 9.2% (2319/25,261) of renal stone patients and 7.6% (7658/101,044) of control II participants had osteoporosis. Renal stone patients had a 1.26 times higher HR for osteoporosis than control II participants (95% CI = 1.21–1.32). Adults with osteoporosis had a higher risk of renal stones. Moreover, adults with renal stones had a higher risk of osteoporosis. [ABSTRACT FROM AUTHOR]

The current research investigated the impacts of smoking, alcohol consumption, and obesity on the development of nephrolithiasis. We included ≥40-year-old Koreans from the Korean National Health Insurance Service-Health Screening Cohort. A total of 28,395 nephrolithiasis patients were compared with 113,580 control participants. Previous histories of smoking, alcohol consumption, and obesity were examined before the presence of nephrolithiasis. Conditional logistic regression analysis was performed to estimate the odds ratios (ORs) of smoking, alcohol consumption, and obesity for nephrolithiasis. Further analyses were conducted, according to age, sex, smoking, alcohol consumption, and obesity. The current smoking status was not linked with the presence of nephrolithiasis. Alcohol consumption was linked with a lower likelihood of the presence of nephrolithiasis (adjusted OR (aOR) = 0.89, 95% confidence intervals (CI) = 0.86–0.92, p < 0.001). Being obese was associated with a greater likelihood of the presence of nephrolithiasis ((95% CI) = 1.27 (1.22–1.31) < 1.42 (1.37–1.46) < 1.59 (1.47–1.71) for overweight < obese I < obese II). The relation of alcohol consumption and obesity with nephrolithiasis was consistent in the subgroups. The presence of nephrolithiasis was positively linked with obesity and negatively linked with alcohol consumption. [ABSTRACT FROM AUTHOR]

A few retrospective studies have suggested the risk of urolithiasis associated with the use of proton pump inhibitors (PPIs). The current research intended to estimate the risk of urolithiasis according to previous PPI use. A nested case-control study was conducted using the National Health Insurance Service-National Health Screening Cohort in Korea. A total of 28,962 patients with urolithiasis and 115,848 control participants were selected. The previous prescription history of PPI with days of PPI prescription was collected. To calculate the odds ratios (OR) of past, current, and days of PPI use for urolithiasis, logistic regression models were used. Subgroup analyses were conducted. The urolithiasis group demonstrated a higher rate of current PPI users than the control group (60.9% vs. 43.7%). The current PPI users indicated 2.49 times higher odds for urolithiasis than no PPI users (95% confidence intervals [CI] = 2.33–2.66). A longer duration of PPI use was associated with greater odds for urolithiasis (adjusted OR = 1.65 (95% CI = 1.54–1.77) < 1.97 (95% CI = 1.84–2.11) < 2.32 (95% CI = 2.14–2.49) for 1–19 days, 30–364 days, and 365 or more days of PPI prescription). All subgroup analyses described a consistently positive association of previous PPI use with urolithiasis. Prior PPI use was related to a higher risk of urolithiasis. The relationship between previous PPI use and urolithiasis demonstrated a dose-response association. [ABSTRACT FROM AUTHOR]

Previous researchers have suggested an elevated risk of thyroid cancer (TC) in patients with psoriasis with mixed results. The current study evaluated the relationship of psoriasis with the risk of TC in an adult population. The data from the Korean National Health Insurance Service—Health Screening Cohort ≥ 40 years old were analyzed. In total, 6822 patients with TC were equalized with 27,288 control participants using overlap weighting adjustment based on the propensity score. The history of psoriasis was compared between the TC and control groups using multivariable logistic regression analysis. Secondary analyses were conducted according to age, sex, income, region of residence, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, obesity, smoking, alcohol consumption, the Charlson Comorbidity Index scores, hypothyroidism, goiter, thyrotoxicosis, and thyroiditis. The history of psoriasis was not different in patients with TC (overlap-weighted odds ratio (OR) = 1.02, 95% confidence intervals (CI) = 0.85–1.22). The <55-year-old group showed a high rate of TC associated with psoriasis (overlap-weighted OR = 1.69, 95% CI = 1.22–2.36, p = 0.002). The population without hypothyroidism demonstrated an increased rate of TC related to psoriasis (overlap-weighted OR = 1.29, 95% CI = 1.06–1.57, p = 0.012). The patients with hypothyroidism showed a low rate of TC for psoriasis (overlap-weighted OR = 0.59, 95% CI = 0.37–0.96, p = 0.034). None of the other subgroups showed an association between psoriasis and TC. Psoriasis was not related to the risk of TC in the overall adult population. Young adults and populations without hypothyroidism indicated an elevated rate of TC for psoriasis. [ABSTRACT FROM AUTHOR]

We explored the genetic and environmental inter-relationships among osteoporosis, fracture, arthritis, and bone mineral density concordance in monozygotic twins compared to those in dizygotic twins. This cross-sectional research assessed data of 1032 monozygotic and 242 dizygotic twin pairs aged >20 years included in the Healthy Twin Study data of the Korean Genome and Epidemiology Study between 2005 and 2014. Outcomes of interest included illness concordance and absolute differences in dual-energy X-ray absorptiometry (DEXA) T-scores. We found comparable concordances of osteoporosis, fractures, osteoarthritis, and rheumatoid arthritis between monozygotic and dizygotic twins. Medical histories of osteoporosis, fractures caused by accident or falling, osteoarthritis, and rheumatoid arthritis were not distinct between monozygotic and dizygotic twins. Accidental fracture occurrence in both monozygotic twins showed significantly lower odds than that in dizygotic twins. Genetic influence on liability to fracture risk might thus be maintained. DEXA T-scores for bone mineral density indicated more comparable tendencies within monozygotic twin pairs than within dizygotic ones, suggesting the relative importance of genetic contribution to bone mineral density. The relative importance of genetic factors in bone mineral density is sustained between monozygotic twins; overt disease expression of osteoporosis, fractures, or arthritis may be affected by environmental factors. [ABSTRACT FROM AUTHOR]

Summary: This study aimed to examine the association between a history of metabolic syndrome (MetS) and osteoporosis with specific characteristics. The results showed that MetS was inversely associated with osteoporosis. In contrast, MetS was positively associated with osteoporosis in both obese men and postmenopausal obese women. Purpose: Although several previous studies have investigated the association between MetS and osteoporosis, their findings remain controversial. This study aimed to examine the association between a MetS history and osteoporosis using a subset of data from a large, long-term, national database. Methods: This nested case–control study used the National Health Information Database (NHID) of the Korea National Health Insurance Service (NHIS) from 2009 to 2017. Osteoporosis (n = 459,771) and control (n = 459,771) participants were matched in a 1:1 ratio by age, gender, income, and region of residence. MetS was defined based on the modified National Cholesterol Education Program-Adult Treatment Panel III criteria. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for osteoporosis in patients with MetS and its components were analyzed using logistic regression. Subgroup analyses were performed according to the combination of gender, menopausal status, and obesity status. Results: The adjusted OR (95% CI) for osteoporosis in patients with MetS was 0.95 (0.94–0.96). This finding was consistent with the subgroup analyses in normal weight men, premenopausal (pre-MP) women with all obesity statuses, and postmenopausal (post-MP) underweight and normal weight women. In contrast, the opposite was observed for obese men (OR = 1.05, 95% CI = 1.01–1.09) and post-MP obese women (OR = 1.05, 95% CI = 1.01–1.08). Conclusion: This study results suggested that MetS was associated with a low occurrence of osteoporosis. In contrast, MetS was associated with a high occurrence of osteoporosis in both obese men and post-MP obese women. [ABSTRACT FROM AUTHOR]

Background: Identifying the risk factors for falls among the elderly population is arguably one of the most imperative public health issues in the current aging society. Objectives: This study aimed to determine the associations between depressive symptoms, subjective cognitive decline (SCD), and poor subjective sleep quality and the risk of slips/falls in a Korean older population. Methods: This cross-sectional study involved 228,340 elderly individuals living in Korea. Measurements included self-reported depressive symptoms, SCD, and self-reported sleep quality. The risk of slips/falls was dichotomized depending on whether slips/falls had occurred during the past year, and the associations between different risk factors and slips/falls were explored. Multiple logistic regression was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Complex sampling methods were used to estimate the weighted value of each participant. Results: The risk of slips/falls was significantly associated with high levels of depressive symptoms (adjusted OR 1.06, 95% CI: 1.05–1.07) and SCD (adjusted OR 1.33, 95% CI: 1.19–1.50). Regarding each sleep quality component, the adjusted ORs for slips/falls were 1.85 for very poor sleep quality, 1.49 for long sleep latency, 1.04 for <5 h of sleep duration, 1.32 for low sleep efficiency, 2.78 for high sleep disturbance, 1.52 for the use of sleep medication ≥3 times a week, and 1.82 for high daytime dysfunction due to sleep problems compared to the respective good sleep conditions. Conclusions: Our results demonstrated that depressive symptoms, SCD, and poor subjective sleep quality are independent factors affecting the occurrence of slips/falls. Thus, efforts to manage depressive symptoms and cognitive decline early and to improve sleep quality can be an alternative strategy to decrease the likelihood of falls. [ABSTRACT FROM AUTHOR]