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PURPOSE: This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women. METHODS: Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report. RESULTS: The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score< or =-2) and 14.3% women had higher BMD (Z-score< or = 0) than women of same age. BTMs were not significantly different between high-BMD (Z-score> or =0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors. CONCLUSION: Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.
Adolescent ; Alcohol Drinking ; Asian Continental Ancestry Group ; Biological Markers/*metabolism ; Body Composition ; Bone Density ; Bone and Bones/*metabolism/radiography/ultrasonography ; Calcium/metabolism ; Collagen Type I/metabolism ; Female ; Health Promotion ; Humans ; Knowledge ; Life Style ; Osteocalcin/metabolism ; Peptides/metabolism ; Phosphorus/metabolism ; Republic of Korea ; Self Efficacy ; Women/*psychology ; Young Adult

PURPOSE: This randomized control trial was designed to examine the effect on the self-managing ability for promoting bone health of mobile typeebone health intervention (mobile typeeBHI). METHODS: The mobile typeeBHI consisted of amobile application called “Strong bone, Fit body” (SbFb) and group education. A total of 82 college women with low bone mass (Z score <−1) participated. They were assigned randomly to three groups, experimental group I, (n = 28), experimental group II (n = 32), and control group (n = 22). This study ran from June 2014 to January 2015. The outcome variables were bone mineral density, minerals related to bone metabolism (calcium, phosphorus, vitamin D), biochemical markers related to bone remodeling (osteocalcin, C-terminal telopeptide, sclerostin), food intake diary by 24 hours recall, and psychosocial variables related to bone health (knowledge, health belief and selfefficacy). Data were analyzed using SAS program and a computer aided nutritional analysis program. RESULTS: Both the experimental group I, who used mobile typeeBHI, and experimental group II, who only received group education, showed outcomes regarding knowledge of the benefits of exercise and calcium as compared with the control group. The two experimental groups also demonstrated results in the serum levels of calcium, vitamin D, and sclerostin compared to those of the control group. CONCLUSION: Although both experimental groups exhibited positive outcomes in regards to the promotion of bone health, this study did not show an additional effect of the mobile application on selfmanagement ability for the promotion of bone health. Nonetheless, the SbFb application is very meaningful as it is the first application developed with the aim of improving women's bone health.
Biomarkers ; Bone Density ; Bone Remodeling ; Calcium ; Eating ; Education ; Female ; Humans ; Metabolism ; Minerals ; Miners ; Mobile Applications ; Nutrition Assessment ; Phosphorus ; Vitamin D ; Vitamins ; Young Adult*

Objective: Creatine, energy buffer in high energy demanding systems including muscle and brain, may play a beneficial role against neuroinflammation in Alzheimer’s disease (AD), and thus be a potential biomarker. This study aimed to compare the levels of plasma creatine between persons with and without AD and investigate associations of plasma creatine levels with cognitive function and blood-based inflammatory markers. Methods: We classified elderly participants by cognitive statuses: normal cognition (NC, n=17), mild cognitive impairment (MCI,n=21), and AD (n=21). To assess cognitive function and inflammatory condition, we performed neuropsychological tests and mea-sured plasma C-reactive protein (CRP) levels, respectively. Results: Plasma creatine levels were comparable among participants with AD, MCI, and NC. In overall participants, plasma cre-atine levels were not associated with neuropsychological test scores, but negatively associated with plasma CRP levels. In AD group, plasma creatine levels were negatively associated with neuropsychological test scores and, although not significant, CRP levels (p=0.086). In participants without AD (NC plus MCI), these associations disappeared. Conclusion Plasma creatine levels may not be useful as a biomarker indicating cognitive statuses. However, our results suggest that, in AD, plasma levels of creatine might reflect the extent of neuroinflammation as well as cognitive deterioration.

Background: Smartphone usage is indispensably beneficial to people’s everyday lives. However, excessive smartphone usage has been associated with physical and mental health problems. This study aimed to evaluate the association of smartphone usage with depressive symptoms, suicidal thoughts, and suicide attempts in Korean adolescents. Methods: This cross-sectional study was conducted in 54,603 Korean adolescent participants (26,930 male and 27,673 female) in the Korea Youth Risk Behavior Survey in 2017 who reported their smartphone use. We performed multiple logistic regression analysis to evaluate the association of smartphone use with mental health after adjusting for relevant covariates. Results: Among the participants, 25.6% of male students and 38.4% of female students reported using their smartphone for at least 30 hours per week. As time duration of smartphone usage increased, the risk of experiencing depressive symptoms, suicidal thoughts, and suicide attempt tended to increase, with odds ratios (95% confidence interval) of 1.18 (1.10–1.26), 1.18 (1.08–1.29), and 1.34 (1.11–1.60), respectively, for high smartphone usage compared with low smartphone usage. These associations remained significant with only slight change in odds ratios after consideration of problems that may be caused by smartphone usage, such as conflicts with family members or peers, or disturbance in school work. Conclusion Smartphone overuse was independently associated with an increased risk of mental health problems, which did not seem to be mediated by the problems caused by smartphone usage.

Background and Objectives: This study analyzed skin prick tests conducted on respiratory allergy patients in the Busan area for a 40-year period and estimated future changes in inhaled allergens.Subjects and Method This study conducted a retrospective analysis of patients who underwent skin prick tests for respiratory allergies at two hospitals. We analyzed 5942 test results out of the total tests of 6174 recorded from 1982 to 2021. Results: For over 40 years, the main inhalant allergens in the Busan area, including house dust mites (HDM), pollen, have been found to be similar to those in other regions. The sensitization rate of HDM was very high, around 50%-60%, in the early 1990s and the early 2010s, and it showed a gradual increase over time. The sensitization rate of pollen were high at 10- year cycles. The sensitization rate of tree pollens showed a decreasing trend after reaching its peak in the late 1980s, but has been steadily increasing since the 2010s, with a sharp rise (over 25%) observed in 2019-2020. The sensitivity to weed and grass pollens was relatively high in the late 1990s and late 2000s, and exhibited a declining trend since. Among the animal allergens, the sensitization rate of cat allergen was the highest (45%). Conclusion We identified high rates of sensitization to house dust mites and tree pollens, and age-related changes over time. With the increasing prevalence of pet ownership, further research is necessary to monitor sensitization changes. Additionally, due to climate change, continuous monitoring of allergen sensitization rates to pollens and molds is called for.

Tumoral calcinosis (TC) is a condition resulting from extensive calcium phosphate precipitation, primarily in the periarticular tissues around major joints. Calciphylaxis is a fatal ischemic vasculopathy mainly affecting dermal blood vessels and subcutaneous fat. This syndrome is rare and predominantly occurs in patients with end-stage renal disease. Here, we report on a rare case involving a patient with TC complicated with calciphylaxis. Our patient was a 31-year-old man undergoing hemodialysis who presented with masses on both shoulders and necrotic cutaneous ulcers, which were associated with secondary hyperparathyroidism, on his lower legs. He underwent subtotal parathyroidectomy, and sodium thiosulfate (STS) was administered for 27 weeks. Twenty months after beginning the STS treatment course, he experienced dramatic relief of his TC and calciphylaxis.
Adult ; Blood Vessels ; Calcinosis* ; Calciphylaxis* ; Calcium ; Humans ; Hyperparathyroidism, Secondary ; Joints ; Kidney Failure, Chronic ; Leg ; Parathyroidectomy* ; Renal Dialysis ; Shoulder ; Sodium* ; Subcutaneous Fat ; Ulcer

Severe eating disorders characterized by repetitive episodes of purging and vomiting can occasionally trigger acute kidney injury. However, interstitial nephritis induced by episodes of repeated vomiting has rarely been reported, and the pathophysiology of this entity remains unknown. A 26-year-old man was admitted to our hospital because of known hypokalemia. His serum electrolyte profile showed: sodium 133 mEq/L, potassium 2.6 mEq/L, chloride 72 mEq/L, total carbon dioxide 50 mEq/L, blood urea nitrogen/creatinine ratio (BUN/Cr) 21.9/1.98 mg/dL, and magnesium 2.0 mg/dL. Arterial blood gas analysis showed: pH 7.557, partial pressure of carbon dioxide 65.8 mmHg, and bicarbonate 58.5 mEq/L. His urinary potassium concentration was 73.2 mEq/L, and Cr was 111 mg/dL. Renal biopsy revealed acute tubular necrosis and tubulointerstitial nephritis with a few shrunken glomeruli. Repeated psychogenic vomiting may precipitate acute kidney injury and interstitial nephritis secondary to volume depletion and hypokalemia. Serum electrolyte levels and renal function should be carefully monitored in patients diagnosed with eating disorders to prevent tubular ischemia and interstitial nephritis.
Acute Kidney Injury ; Adult ; Anorexia Nervosa* ; Anorexia* ; Biopsy ; Blood Gas Analysis ; Carbon Dioxide ; Eating ; Humans ; Hydrogen-Ion Concentration ; Hypokalemia ; Ischemia ; Magnesium ; Male* ; Necrosis ; Nephritis, Interstitial* ; Partial Pressure ; Potassium ; Sodium ; Urea ; Vomiting

End-stage renal disease (ESRD) patients on hemodialysis have poor nutritional status and associated problems such as inflammation and sarcopenia. Blood urea nitrogen (BUN) is an important measure of uremic toxins, and urea reduction is a marker of hemodialysis efficacy. However, a low protein diet for lower BUN could aggravate malnutrition in patients, and optimal pre-dialysis BUN is not defined. We investigated the association of pre-dialysis BUN with patients’ comorbidities and the relationship between pre-dialysis BUN and serum albumin as a nutrient marker. Among the 67 patients, the average pre- and post-dialysis BUN were 59.2 and 15.0 mg/dL, respectively, serum creatinine was 10.1 mg/dL, and the average serum albumin was 4.0 g/dL. Patients’ age was negatively correlated with serum creatinine (r=−0.277, p<0.05) and albumin (r=−0.453, p<0.001). Predialysis BUN showed a significant positive correlation with serum albumin (r=0.287, p<0.05) and creatinine (r=0.454, p<0.001). However, the predialysis BUN was not significantly related to diabetes, coronary artery disease, congestive heart failure, or cerebrovascular disease. Hemodialysis patients with high pre-dialysis BUN and high serum creatinine could be regarded as having good nutritional status. The significance of this study lies in the potential utility of pre-dialysis blood urea nitrogen as an indicator of the nutritional status of patients. Liberal protein intake might be recommended to adequately dialyzed patients.

Background: The incidence of early-onset diabetes is increasing among young adults.However, there are limited data on the characteristics and management of young Korean adults with diabetes. This study assessed the clinical and demographic characteristics, health behaviors, and mental health among young Korean adults with diabetes mellitus. Methods: This cross-sectional study included young Korean adults with diabetes (n = 225) with an onset age of 20–39 years from four university hospitals. Demographic characteristics, management of diabetes, and mental health were assessed using a questionnaire survey. Results: Type 2 diabetes was the most common type (73.3%), and 13.8% of participants were classified as other types or unknown. Approximately, 64.7% of participants had a strong family history of diabetes, and 76% had treatment within three months of diagnosis.Approximately, 11.1% of participants had diabetic complications; 39.1% of participants received insulin injections, including oral anti-diabetic medications. Additionally, 30.4% were smokers, and only 28% had active physical activity; 26.5% of participants had >3 hours of screen time. One third of participants never had breakfast, and 60.5% went out to eat at least three times a week. Half of the participants showed moderate to severe stress perception, and 21.4% of patients had moderate to severe levels of depression based on the Korean version of Beck Depression Inventory score. Conclusion Early-onset diabetes was associated with a strong family history and early insulin treatment. Young adults with diabetes had poor health behaviors and frequent mental depression. These findings suggest the necessity of health policies for improving health behaviors and mental distress.