1.Associated factors of osteoporosis and the impact of osteoporosis on all-cause mortality in incident hemodialysis older patients
Seunghye LEE ; Yoomee KANG ; Yu Ah HONG ; Sung Joon SHIN ; Soon Hyo KWON ; Sungjin CHUNG ; Young Youl HYUN ; Sang Heon SONG ; Jae Won YANG ; Won Min HWANG ; Jang-Hee CHO ; Kyung Don YOO ; In O SUN ; Gang-Jee KO ; Byung Chul YU ; Hyunsuk KIM ; Woo Yeong PARK ; Tae Won LEE ; Dong Jun PARK ; Eunjin BAE ;
Kidney Research and Clinical Practice 2026;45(1):110-119
Background:
With the aging population and advancements in medical care worldwide, the number of older patients with end-stage kidney disease continues to rise. This study aimed to identify factors associated with osteoporosis and osteopenia in older patients undergoing incident hemodialysis and assess their impact on mortality.
Methods:
We analyzed a large multicenter retrospective cohort of patients aged ≥70 years undergoing incident hemodialysis to identify factors associated with osteoporosis using logistic regression analysis and to assess the association of death with osteoporosis and osteopenia using Cox multivariable analysis.
Results:
Among 710 patients, 39.0% and 19.6% had osteoporosis and osteopenia, respectively. Osteoporosis was significantly associated with female sex, a history of fractures, and the absence of phosphate binder use. During a median follow-up of 36.8 months, 348 participants (58.8%) died. Mortality rates were the highest in the osteoporosis group (79.8%), followed by the osteopenia (77.2%) and normal bone mineral density (BMD) groups (35.2%). Cox regression analysis revealed that even after adjusting for covariates, the osteoporosis group was significantly associated with a higher mortality risk than the normal BMD group. Osteoporosis at the start of hemodialysis was significantly associated with higher mortality.
Conclusion
We should consider the importance of bone health in patients undergoing incident hemodialysis and pay attention to the use of phosphate binders and fracture prevention.
2.Impact of obesity on renal function in elderly Korean adults: a national population-based cohort study
Jihyun YANG ; Hui Seung LEE ; Chi-Yeon LIM ; Hyunsuk KIM ; Sungjin CHUNG ; Soon Hyo KWON ; Jang-Hee CHO ; Kyung Don YOO ; Woo Yeong PARK ; In O SUN ; Byung Chul YU ; Gang-Jee KO ; Jae Won YANG ; Won Min HWANG ; Sang Heon SONG ; Sung Joon SHIN ; Yu Ah HONG ; Eunjin BAE ; Young Youl HYUN
Kidney Research and Clinical Practice 2026;45(1):65-76
Background:
Obesity is a well-known risk factor for chronic kidney disease and its progression. However, the impact of obesity on the renal function of the elderly population is uncertain. We investigated the association between obesity and renal outcomes in the elderly.
Methods:
We analyzed 130,504 participants from the Korean National Health Insurance Service-Senior cohort. Obesity was classified according to body mass index (BMI), sex-specific waist circumference (WC), and the presence of metabolic syndrome. The primary outcome was renal function decline, defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 50% from baseline or new-onset end-stage renal disease.
Results:
During a follow-up period of 559,531.1 person-years (median, 4.3 years), 2,486 participants (19.0%; incidence rate of 4.44 per 1,000 person-years) showed renal function decline. A multivariate Cox proportional hazards model revealed that BMI/WC was not associated with renal function decline. However, the group with metabolic syndrome had a significantly increased risk of renal function decline compared to the group without metabolic syndrome (adjusted hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.13–1.36). Compared with the non-metabolic syndrome group, the adjusted HRs (95% CI) for participants with one through five components were 0.96 (0.84–1.11), 1.10 (0.96–1.27), 1.24 (1.06–1.45), 1.37 (1.12–1.66), and 1.99 (1.42–2.79), respectively (p for trend < 0.001).
Conclusion
In elderly Korean adults, metabolic syndrome and the number of its components were associated with a higher risk of renal function decline, but BMI or WC was not significant.
3.Validation of Devices for the Five Times Sit To Stand Test:Comparing Plantar Pressure and Head Motion Analysis with Manual Measurement
Sanghyun JEE ; Chan Woong JANG ; Kyoungmin PARK ; Sanghoon SHIN ; Min-Chul PAEK ; Jung Hyun PARK
Yonsei Medical Journal 2025;66(1):51-57
Purpose:
This study aims to evaluate a new method for the five times sit to stand test (FTSST), crucial for addressing frailty in an aging population. It utilizes a smart insole for plantar pressure analysis and a marker-less motion capture device for head height analysis.
Materials and Methods:
Thirty-five participants aged 50 years or older underwent FTSST assessment using three methods: manual measurement with a stopwatch (FTSST-M), plantar pressure analysis with smart insoles (FTSST-P), and head height analysis with a marker-less motion capture device (FTSST-H). Simultaneous measurements using three methods were done. Correlation between results of these methods were analyzed using intraclass correlation coefficient (ICC) and κ coefficient. Comprehensive clinical examinations were conducted with ethical approval.
Results:
Participants’ mean scores for FTSST-M, FTSST-P, and FTSST-H were 2.43±1.20, 2.43±1.29, and 2.37±1.31, respectively. Correlations of the times and corresponding scores between FTSST-P and FTSST-M, as well as FTSST-H and FTSST-M, exceeded 0.9 (ICC and κ coefficients, p<0.001). Using an FTSST score of 3 or less to indicate vulnerability, the κ value for vulnerability classification between two measurements was 0.886 (p<0.001).
Conclusion
This study showed strong correlation between FTSST results using smart insoles and marker-less motion capture, compared to conventional methods. These findings highlight the potential of these technologies for precise FTSST measurements, offering convenience and cost-effectiveness. Simultaneous use of these devices enables diverse analyses, enhancing our understanding of frailty.
4.Educational Level Modifies the Relationship between Standard Deviation of NN Intervals and Post-traumatic Stress Disorder Development over Two-years
Ji Min YOO ; Ju-Wan KIM ; Hee-Ju KANG ; Hyunseok JANG ; Jung-Chul KIM ; Ju-Yeon LEE ; Sung-Wan KIM ; Il-Seon SHIN ; Jae-Min KIM
Clinical Psychopharmacology and Neuroscience 2025;23(1):155-160
Objective:
This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD).
Methods:
Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted.
Results:
Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education.
Conclusion
The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.
5.Educational Level Modifies the Relationship between Standard Deviation of NN Intervals and Post-traumatic Stress Disorder Development over Two-years
Ji Min YOO ; Ju-Wan KIM ; Hee-Ju KANG ; Hyunseok JANG ; Jung-Chul KIM ; Ju-Yeon LEE ; Sung-Wan KIM ; Il-Seon SHIN ; Jae-Min KIM
Clinical Psychopharmacology and Neuroscience 2025;23(1):155-160
Objective:
This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD).
Methods:
Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted.
Results:
Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education.
Conclusion
The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.
6.Validation of Devices for the Five Times Sit To Stand Test:Comparing Plantar Pressure and Head Motion Analysis with Manual Measurement
Sanghyun JEE ; Chan Woong JANG ; Kyoungmin PARK ; Sanghoon SHIN ; Min-Chul PAEK ; Jung Hyun PARK
Yonsei Medical Journal 2025;66(1):51-57
Purpose:
This study aims to evaluate a new method for the five times sit to stand test (FTSST), crucial for addressing frailty in an aging population. It utilizes a smart insole for plantar pressure analysis and a marker-less motion capture device for head height analysis.
Materials and Methods:
Thirty-five participants aged 50 years or older underwent FTSST assessment using three methods: manual measurement with a stopwatch (FTSST-M), plantar pressure analysis with smart insoles (FTSST-P), and head height analysis with a marker-less motion capture device (FTSST-H). Simultaneous measurements using three methods were done. Correlation between results of these methods were analyzed using intraclass correlation coefficient (ICC) and κ coefficient. Comprehensive clinical examinations were conducted with ethical approval.
Results:
Participants’ mean scores for FTSST-M, FTSST-P, and FTSST-H were 2.43±1.20, 2.43±1.29, and 2.37±1.31, respectively. Correlations of the times and corresponding scores between FTSST-P and FTSST-M, as well as FTSST-H and FTSST-M, exceeded 0.9 (ICC and κ coefficients, p<0.001). Using an FTSST score of 3 or less to indicate vulnerability, the κ value for vulnerability classification between two measurements was 0.886 (p<0.001).
Conclusion
This study showed strong correlation between FTSST results using smart insoles and marker-less motion capture, compared to conventional methods. These findings highlight the potential of these technologies for precise FTSST measurements, offering convenience and cost-effectiveness. Simultaneous use of these devices enables diverse analyses, enhancing our understanding of frailty.
7.Educational Level Modifies the Relationship between Standard Deviation of NN Intervals and Post-traumatic Stress Disorder Development over Two-years
Ji Min YOO ; Ju-Wan KIM ; Hee-Ju KANG ; Hyunseok JANG ; Jung-Chul KIM ; Ju-Yeon LEE ; Sung-Wan KIM ; Il-Seon SHIN ; Jae-Min KIM
Clinical Psychopharmacology and Neuroscience 2025;23(1):155-160
Objective:
This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD).
Methods:
Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted.
Results:
Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education.
Conclusion
The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.
8.Educational Level Modifies the Relationship between Standard Deviation of NN Intervals and Post-traumatic Stress Disorder Development over Two-years
Ji Min YOO ; Ju-Wan KIM ; Hee-Ju KANG ; Hyunseok JANG ; Jung-Chul KIM ; Ju-Yeon LEE ; Sung-Wan KIM ; Il-Seon SHIN ; Jae-Min KIM
Clinical Psychopharmacology and Neuroscience 2025;23(1):155-160
Objective:
This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD).
Methods:
Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted.
Results:
Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education.
Conclusion
The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.
9.Validation of Devices for the Five Times Sit To Stand Test:Comparing Plantar Pressure and Head Motion Analysis with Manual Measurement
Sanghyun JEE ; Chan Woong JANG ; Kyoungmin PARK ; Sanghoon SHIN ; Min-Chul PAEK ; Jung Hyun PARK
Yonsei Medical Journal 2025;66(1):51-57
Purpose:
This study aims to evaluate a new method for the five times sit to stand test (FTSST), crucial for addressing frailty in an aging population. It utilizes a smart insole for plantar pressure analysis and a marker-less motion capture device for head height analysis.
Materials and Methods:
Thirty-five participants aged 50 years or older underwent FTSST assessment using three methods: manual measurement with a stopwatch (FTSST-M), plantar pressure analysis with smart insoles (FTSST-P), and head height analysis with a marker-less motion capture device (FTSST-H). Simultaneous measurements using three methods were done. Correlation between results of these methods were analyzed using intraclass correlation coefficient (ICC) and κ coefficient. Comprehensive clinical examinations were conducted with ethical approval.
Results:
Participants’ mean scores for FTSST-M, FTSST-P, and FTSST-H were 2.43±1.20, 2.43±1.29, and 2.37±1.31, respectively. Correlations of the times and corresponding scores between FTSST-P and FTSST-M, as well as FTSST-H and FTSST-M, exceeded 0.9 (ICC and κ coefficients, p<0.001). Using an FTSST score of 3 or less to indicate vulnerability, the κ value for vulnerability classification between two measurements was 0.886 (p<0.001).
Conclusion
This study showed strong correlation between FTSST results using smart insoles and marker-less motion capture, compared to conventional methods. These findings highlight the potential of these technologies for precise FTSST measurements, offering convenience and cost-effectiveness. Simultaneous use of these devices enables diverse analyses, enhancing our understanding of frailty.
10.Validation of Devices for the Five Times Sit To Stand Test:Comparing Plantar Pressure and Head Motion Analysis with Manual Measurement
Sanghyun JEE ; Chan Woong JANG ; Kyoungmin PARK ; Sanghoon SHIN ; Min-Chul PAEK ; Jung Hyun PARK
Yonsei Medical Journal 2025;66(1):51-57
Purpose:
This study aims to evaluate a new method for the five times sit to stand test (FTSST), crucial for addressing frailty in an aging population. It utilizes a smart insole for plantar pressure analysis and a marker-less motion capture device for head height analysis.
Materials and Methods:
Thirty-five participants aged 50 years or older underwent FTSST assessment using three methods: manual measurement with a stopwatch (FTSST-M), plantar pressure analysis with smart insoles (FTSST-P), and head height analysis with a marker-less motion capture device (FTSST-H). Simultaneous measurements using three methods were done. Correlation between results of these methods were analyzed using intraclass correlation coefficient (ICC) and κ coefficient. Comprehensive clinical examinations were conducted with ethical approval.
Results:
Participants’ mean scores for FTSST-M, FTSST-P, and FTSST-H were 2.43±1.20, 2.43±1.29, and 2.37±1.31, respectively. Correlations of the times and corresponding scores between FTSST-P and FTSST-M, as well as FTSST-H and FTSST-M, exceeded 0.9 (ICC and κ coefficients, p<0.001). Using an FTSST score of 3 or less to indicate vulnerability, the κ value for vulnerability classification between two measurements was 0.886 (p<0.001).
Conclusion
This study showed strong correlation between FTSST results using smart insoles and marker-less motion capture, compared to conventional methods. These findings highlight the potential of these technologies for precise FTSST measurements, offering convenience and cost-effectiveness. Simultaneous use of these devices enables diverse analyses, enhancing our understanding of frailty.

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