OBJECTIVES: Hypertriglyceridemic acute pancreatitis (HTG-AP) has a rapid onset and is associated with a high risk of progression and recurrence. Early identification of patients at risk of severe disease can help reduce the likelihood of multiple organ failure and mortality. This study aims to investigate the changes in inflammatory composite markers and D-dimer (D-D) levels in young and middle-aged/elderly patients with HTG-AP and to evaluate their predictive value for disease progression. METHODS: A total of 230 patients with HTG-AP admitted to Chongqing University Jiangjin Hospital (Jiangjin Central Hospital) between 2017 and 2023 were retrospectively enrolled. Patients were first divided into a young group (≤45 years) and a middle-aged/elderly group (>45 years), and then stratified into mild and severe groups based on disease severity. Inflammatory composite markers, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein-to-lymphocyte ratio (CLR), systemic inflammation response index (SIRI), systemic immune inflammation index (SII), as well as D-D levels, were compared among groups. Least absolute shrinkage and selection operator (LASSO) regression and Logistic regression were used to identify independent risk factors for disease progression in each age group. Receiver operating characteristic (ROC) curves and the DeLong test were used to assess and compare the predictive performance (area under the curve, AUC) of risk factors. Internal validation was performed using the bootstrap method (n=1 000). RESULTS: No significant differences in NLR, PLR, MLR, SIRI, SII, CLR, or D-D levels were observed between the young (n=127) and middle-aged/elderly (n=103) groups (all P>0.05). Among young patients, the severe group (n=59) had significantly higher NLR, SIRI, SII, CLR, and D-D levels compared to the mild group (n=68) (all P<0.05). Among middle-aged/elderly patients, CLR and D-D levels were significantly higher in the severe group (n=49) than in the mild group (n=54) (P<0.05). LASSO and Logistic regression analyses identified elevated D-D as an independent risk factor for disease progression in young patients (P=0.007, OR=1.458, 95% CI 1.107 to 1.920), while both D-D (P=0.001, OR=2.267, 95% CI 1.413 to 3.637) and CLR (P=0.003, OR=1.007, 95% CI 1.003 to 1.012) were independent risk factors in middle-aged/elderly patients. ROC analysis showed that D-D predicted disease progression in young and middle-aged/elderly patients with AUCs of 0.653 and 0.741, sensitivities of 67.8% and 57.1%, and specificities of 72.1% and 88.9%, respectively. CLR predicted progression in middle-aged/elderly patients with an AUC of 0.687, sensitivity of 63.3%, and specificity of 70.4%. DeLong test showed no significant difference in AUC between D-D and CLR for middle-aged/elderly patients (Z=0.993, P=0.321). Internal validation via bootstrap analysis yielded a D-D AUC of 0.732, with sensitivity and specificity of 68.1% and 91.0%, respectively. CONCLUSIONS Differences in inflammatory response and coagulation function exist across age groups and disease severities in HTG-AP patients. Elevated D-D is an independent predictor of disease progression in both young and middle-aged/elderly patients, while CLR also predicts progression in the latter group. D-D, in particular, demonstrates strong predictive value for severe disease in middle-aged/elderly patients with HTG-AP.
Humans ; Fibrin Fibrinogen Degradation Products/metabolism* ; Disease Progression ; Middle Aged ; Pancreatitis/etiology* ; Male ; Female ; Retrospective Studies ; Adult ; Biomarkers/blood* ; Hypertriglyceridemia/blood* ; Acute Disease ; Predictive Value of Tests ; Aged ; Inflammation ; C-Reactive Protein/analysis* ; Neutrophils ; Age Factors

BACKGROUND: Chronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that alitretinoin is an effective and well-tolerated treatment for CHE. However, there is a relative lack of data on the effectiveness of alitretinoin in elderly patients. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of oral alitretinoin in elderly patients with moderate to severe CHE in Korea. METHODS: We retrospectively investigated 46 CHE patients who were treated with either 10 mg or 30 mg of alitretinoin between June of 2016 and July of 2018. The physician's global assessment (PGA) was used to evaluate treatment efficacy. All adverse events were retrospectively evaluated with respect to laboratory testing, including complete blood cell count, fasting blood chemistry, lipid profile, and liver and thyroid function tests. RESULTS: The mean patient age in this study was 71.0±5.1 years. The treatment period was over eight weeks. A total of 38 of 46 patients (82.6%) exhibited clinical improvement with PGA ratings of ‘clear’ or ‘almost clear.’ There were 13 patients (28.3%) who experienced an adverse effect, with the most common being headache (13.0%) and gastrointestinal symptoms (8.7%) followed by xerosis (6.5%). A total of 13 patients developed or exhibited worsening hypertriglyceridemia (28.3%). CONCLUSION: Alitretinoin can be considered a safe and effective treatment option in elderly patients with moderate to severe CHE.
Aged ; Blood Cell Count ; Chemistry ; Eczema ; Fasting ; Hand ; Headache ; Humans ; Hypertriglyceridemia ; Korea ; Liver ; Retrospective Studies ; Thyroid Function Tests ; Treatment Outcome

BACKGROUND/OBJECTIVES: Increased consumption of instant noodles has recently been reported to be positively associated with obesity and cardiometabolic syndrome in South Korea, which has the highest per capita instant noodle consumption worldwide. This study aimed to investigate the association between instant noodle consumption and cardiometabolic risk factors among college students in Seoul. SUBJECTS/METHODS: The study subjects consisted of 3,397 college students (1,782 male; 1,615 female) aged 18-29 years who participated in a health checkup. Information on instant noodle consumption was obtained from the participants' answers to a question about their average frequency of instant noodle intake over the 1 year period prior to the survey. RESULTS: Statistical analysis using a general linear model that adjusted for age, body mass index, gender, family income, health-related behaviors, and other dietary factors important for cardiometabolic risk, showed a positive association between the frequency of instant noodle consumption and plasma triglyceride levels, diastolic blood pressure, and fasting blood glucose levels in all subjects. Compared to the group with the lowest frequency of instant noodle intake (≤ 1/month), the odds ratio for hypertriglyceridemia in the group with an intake of ≥ 3/week was 2.639 [95% confidence interval (CI), 1.393–5.000] for all subjects, while it was 2.149 (95% CI, 1.045–4.419) and 5.992 (95% CI, 1.859–21.824) for male and female students, respectively. In female students, diastolic blood pressure was also higher among more frequent consumers of instant noodles. CONCLUSIONS: Our results suggest that frequent consumption of instant noodles may be associated with increased cardiometabolic risk factors among apparently healthy college students aged 18–29 years.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Fasting ; Female ; Humans ; Hypertriglyceridemia ; Korea ; Linear Models ; Male ; Obesity ; Odds Ratio ; Overweight ; Plasma ; Risk Factors* ; Seoul* ; Triglycerides

BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) is an emerging problem in Asia, but little is known about the disease in the nonobese population. The aims of this study were to investigate the prevalence of NAFLD and the factors associated with it in a nonobese Korean population and to compare the clinical characteristics of nonobese and obese subjects with NAFLD. METHODS: This cross-sectional study used data from 2,058 subjects who participated in a medical checkup program. RESULTS: The prevalence of NAFLD was 12.4% (213/1,711) in the nonobese population. A higher body mass index (BMI), higher homeostasis model assessment of insulin resistance (HOMA-IR) values, higher alanine aminotransferase (ALT) levels, triglyceride concentrations 150 mg/dL, and hyperuricemia were independently associated with the presence of NAFLD in the nonobese subjects. Compared with the obese subjects with NAFLD, the nonobese subjects with NAFLD were composed of a higher proportion of females and had lower BMIs, smaller waist circumferences, lower HOMA-IR values, and fewer metabolic irregularities. CONCLUSIONS: Higher BMIs, HOMA-IR values, ALT levels, hypertriglyceridemia, and hyperuricemia were associated with NAFLD in the nonobese subjects. Clinicians should be particularly aware of the possibility of NAFLD in nonobese Asian people.
Adult ; Alanine Transaminase/blood ; Anthropometry ; Asian Continental Ancestry Group/*statistics & numerical data ; Body Mass Index ; Cross-Sectional Studies ; Female ; Homeostasis ; Humans ; Hypertriglyceridemia/complications ; Hyperuricemia/complications ; Insulin Resistance ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/blood/*epidemiology/*etiology ; Obesity/complications ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Triglycerides/blood ; Waist Circumference

We present a case of tuberculosis-associated hemophagocytic lymphohistiocytosis in a 14-year-old girl. The patient presented with weight loss, malaise, fatigue, prolonged fever, and generalized lymphadenopathy. Laboratory investigation revealed pancytopenia (white blood cells, 2,020 cells/microL; hemoglobin, 10.2 g/dL; platelets, 52,000 cells/microL), hypertriglyceridemia (229 mg/dL), and hyperferritinemia (1,420 ng/mL). Bone marrow biopsy showed a hypocellular bone marrow with a large numbers of histiocytes and marked hemophagocytosis; based on these findings, she was diagnosed with hemophagocytic lymphohistiocytosis. Polymerase chain reaction (PCR) with both the bone marrow aspiration and sputum samples revealed the presence of Mycobacterium tuberculosis. Antitubercular therapy with immune modulation therapy including dexamethasone and intravenous immunoglobulin was initiated. The results of all laboratory tests including bone marrow biopsy and PCR with both the bone marrow aspiration and sputum samples were normalized after treatment. Thus, early bone marrow biopsy and the use of techniques such as PCR can avoid delays in diagnosis and improve the survival rates of patients with tuberculosis-associated hemophagocytic lymphohistiocytosis.
Adolescent* ; Biopsy ; Blood Cells ; Bone Marrow ; Dexamethasone ; Diagnosis ; Fatigue ; Female ; Fever ; Histiocytes ; Humans ; Hypertriglyceridemia ; Immunoglobulins ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic* ; Mycobacterium tuberculosis ; Pancytopenia ; Polymerase Chain Reaction* ; Sputum ; Survival Rate ; Tuberculosis ; Weight Loss

Dry eye syndrome (DES) is recognized as a public health concern. One of the pathophysiologies in the development of DES is inflammation, and metabolic syndrome (MetS), which is highly prevalent in the general population, is a well-known chronic and systemic inflammatory condition. Despite the increasing interest regarding a relationship between DES and MetS, information is lacking on the association between DES and MetS and its individual components. We investigated the association between DES symptoms and MetS and its components among adults aged ≥ 19 years using population-based data from the Korea National Health and Nutrition Examination Survey V. A sample group of 15,294 adults (42.67% men and 57.33% women) completed household interviews in which they provided blood (for high-density lipoprotein cholesterol, triglyceride, and glucose) and anthropometric measurements (including waist circumference, weight, and height) to define MetS. We also collected information regarding sociodemographic and behavioral risk factors. The survey results showed that 11.50% of men and 22.35% of women experienced DES and 5.30% of patients had both DES and diagnosis of MetS, including 204 men and 606 women. Thus, no significant difference was observed between DES and the diagnosis of MetS according to sex (P = 0.4008 in men; P = 0.0804 in women); however, a significant association was observed between DES and hypertriglyceridemia in women (OR, 1.13; 95% CI, 1.01-1.29). Therefore, hypertriglyceridemia might be an important factor in the association between DES and MetS. Further longitudinal research is needed to evaluate this relationship.
Adult ; Aged ; Blood Glucose/analysis ; Body Height ; Body Weight ; Cholesterol, HDL/blood ; Cross-Sectional Studies ; Dry Eye Syndromes/complications/*diagnosis/epidemiology ; Female ; Humans ; Hypertriglyceridemia/complications/diagnosis ; Interviews as Topic ; Male ; Metabolic Syndrome X/complications/*diagnosis/epidemiology ; Middle Aged ; Nutrition Surveys ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Sex Factors ; Triglycerides/blood ; Waist Circumference ; Young Adult

PURPOSE: The purpose of the study was to investigate the association between food intakes and cardiovascular disease (CVD) risk factors in Korean women with type 2 diabetes mellitus (T2DM). METHODS: The data were collected from the 2007~2012 Korea National Health and Nutrition Examination Survey (KNHANES). In this study, subjects were divided into two groups, the normal fasting glucose (NFG) group (n = 7,738) and the T2DM group (n = 225). Dietary intake was derived from the nutrition survey, which was collected by trained dietitians using 24-hour dietary recall through the face-to-face interview method in the sample person's home. RESULTS: After adjustment for confounding factors, mean fruit (p = 0.0265), fruit and vegetable without kimchi (p = 0.0295), and fish (p = 0.0112) intakes were significantly lower in the T2DM group than in the NFG group. In the multiple logistic regression analysis, odds ratio (OR) for risk of high systolic blood pressure (≥ 140 mmHg) was lower in the over the median compared to under the median for fruit intakes (OR; 0.657, 95% CI; 0.523~0.824). The OR for the risk of hypertriglyceridemia was lower in the over the median compared to under the median for fruit and vegetable without kimchi (OR; 0.828, 95% CI; 0.7111~0.963) and fish (OR; 0.783, 95% CI; 0.673~0.910) intakes. CONCLUSION: These results show that intakes of fruits, fish, and fruits and vegetables without kimchi have beneficial effects on CVD in Korean women with T2DM.
Blood Pressure ; Cardiovascular Diseases* ; Diabetes Mellitus, Type 2* ; Fasting ; Female ; Fruit* ; Glucose ; Humans ; Hypertriglyceridemia ; Korea* ; Logistic Models ; Methods ; Nutrition Surveys ; Nutritionists ; Odds Ratio ; Risk Factors* ; Vegetables

OBJECTIVETo investigate the prevalence and distribution characteristics of dyslipidemia among Shandong residents aged 18-69 years.

METHODSThe levels of triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and total cholesterol (TC) were determined in fasting serum of 5 ml venous blood for subjects aged 18-69 years who were selected by multi-stage stratified cluster random sampling from 20 counties in July, 2011 in 140 counties of Shandong province. The prevalence of dyslipidemia, hypercholesterolemia, high blood LDL-C, low blood HDL-C and hypertriglyceridemia were analyzed by the complex weighting. The prevalence of dyslipidemia, hypercholesterolemia, high blood LDL-C, low blood HDL-C and hypertriglyceridemia were compared for different characteristics by Rao-Scott χ(2).

RESULTSThe prevalence of dyslipidemia among 15 350 subjects was 22.70% (3 572), with higher in males (26.91% (2 110/7 683)) than in females (18.41% (1 462/7 667)). The prevalence of hypercholesterolemia was 3.39% (n=582), with higher in Eastern Shandong (4.59% (185/3 704)). The prevalence of high blood LDL-C was 0.56% (n=94), with higher in Eastern Shandong (0.79% (32/3 074)). The prevalence of low blood HDL-C was 11.41% (n=1 789). The prevalence of hypertriglyceridemia was 13.02% (n=2 059), higher in urban residents (16.54% (814/4 804)) than in rural (11.52% (1 245/10 546)) (χ(2)=71.54, P<0.001). The difference between the prevalence of low blood HDL-C and hypertriglyceridemia was not significant among Eastern Shandong, Central-South and Northwest.

CONCLUSIONDyslipidemia rate was higher among adult residents in Shandong province. The rate was higher for men than for women. The prevalence of hypercholesterolemia and high blood LDL-C were higher in Eastern Shandong than the other areas. The hypertriglyceridemia and low blood HDL-C were two major types of dyslipidemia.

Adolescent ; Adult ; Aged ; Body Weight ; China ; epidemiology ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypercholesterolemia ; epidemiology ; Hypertriglyceridemia ; epidemiology ; Male ; Middle Aged ; Prevalence ; Rural Population ; Triglycerides ; blood ; Urban Population ; Young Adult

BACKGROUND: We aimed to determine the major contributing component of metabolic syndrome (MetS) that results in an elevated small dense LDL cholesterol (sdLDL-C) concentration and sdLDL-C/LDL-C ratio. METHODS: Four hundred and forty-seven subjects (225 men; 222 women) with MetS were randomly selected from the Korean Metabolic Syndrome Research Initiatives-Seoul cohort study. Age- and sex-matched healthy controls (181 men; 179 women) were also randomly selected from the same cohort. RESULTS: A comparison of the median values of the sdLDL-C concentration between subgroups, divided according to whether subjects met or did not meet the criteria for each MetS component in patients with MetS, revealed a significant difference in the sdLDL-C concentration only between subgroups divided according to whether subjects met or did not meet the triglyceride (TG) criteria (P<0.05 for each gender). The TG level showed a good correlation with sdLDL-C concentration (correlation coefficients [r]=0.543 for men; 0.653 for women) and the sdLDL-C/LDL-C ratio (r=0.789 for men; 0.745 for women). Multiple linear regression analyses conducted for the MetS group concordantly identified TG as one of the most significant contributors to sdLDL-C concentration (beta=0.1747+/-0.0105, P<0.0001) and the sdLDL-C/LDL-C ratio (beta=6.9518+/-0.3011, P<0.0001). CONCLUSIONS: Among five MetS components, only the abnormal TG level was a differentiating factor for sdLDL-C concentration and sdLDL-C/LDL-C ratio. These results were reproducible in both genders, with or without MetS.
Adult ; Case-Control Studies ; Cholesterol, LDL/*blood ; Cohort Studies ; Female ; Humans ; Hypertriglyceridemia/*complications/diagnosis ; Linear Models ; Male ; Metabolic Syndrome X/*complications/diagnosis ; Middle Aged ; Risk Factors ; Triglycerides/blood

BACKGROUND: The aim of this study was to assess the dietary fiber intake of middle-aged adults in Gyeonggi and to evaluate its relation with the metabolic syndrome. METHODS: From April 2013 to October 2014, 279 (60 men, 210 women) middle-aged adults subject older than 30 years of age were recruited. Two-day dietary intake data were collected from each subject using the 24-hour recall method. Metabolic syndrome was diagnosed by anthropometric measurements, blood pressure, and blood analysis. RESULTS: When the subjects were divided into tertile groups by dietary fiber intake per 1,000 kcal, the middle tertile group showed higher fiber intake of 118.8% above the reference intake of 12 g/1,000 kcal, and the highest tertile group showed a higher fiber intake of 165.0% above the reference intake. The group with greater dietary fiber intake showed more mineral and vitamin intake but less energy, fat, and cholesterol intake. The major food groups that contributed to the dietary fiber in the lowest and the middle tertiles were vegetables, grains, fruits, and legumes, but in the highest tertile, legumes contributed more than fruits. The risk of metabolic syndrome (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.18-0.77), abdominal obesity (OR 0.45, 95% CI 0.23-0.85,) and hypertriglyceridemia (OR 0.42, 95% CI 0.21-0.83) were significantly reduced in the middle tertile compared to the lowest tertile. CONCLUSIONS: The results suggest that there is a correlation between dietary fiber intake and risk factors for metabolic syndrome. It is highly expected that consuming sufficient amount of fruits and vegetables as a major source of dietary fiber can prevent and manage metabolic syndrome and chronic disease.
Adult* ; Blood Pressure ; Edible Grain ; Cholesterol ; Chronic Disease ; Dietary Fiber* ; Fabaceae ; Fruit ; Gyeonggi-do ; Humans ; Hypertriglyceridemia ; Male ; Obesity, Abdominal ; Prevalence* ; Risk Factors ; Vegetables ; Vitamins