Background/Aims: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from the KNHANES VII (2018) and VIII (2019–2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome. Results: The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females. Conclusions The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.

Background/Aims: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from the KNHANES VII (2018) and VIII (2019–2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome. Results: The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females. Conclusions The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.

Background/Aims: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from the KNHANES VII (2018) and VIII (2019–2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome. Results: The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females. Conclusions The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.

Background/Aims: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from the KNHANES VII (2018) and VIII (2019–2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome. Results: The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females. Conclusions The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.

Background/Aims: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from the KNHANES VII (2018) and VIII (2019–2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome. Results: The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females. Conclusions The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.

Background: Low-density lipoprotein cholesterol is an important marker highly associated with cardiovascular disease. Since the direct measurement of it is inefficient in terms of cost and time, it is common to estimate through the Friedewald equation developed about 50 years ago. However, various limitations exist since the Friedewald equation was not designed for Koreans. This study proposes a new low-density lipoprotein cholesterol estimation equation for South Koreans using nationally approved statistical data. Methods: This study used data from the Korean National Health and Nutrition Examination Survey from 2009 to 2019. The 18,837 subjects were used to develop the equation for estimating low-density lipoprotein cholesterol. The subjects included individuals with low-density lipoprotein cholesterol levels directly measured among those with high-density lipoprotein cholesterol, triglycerides, and total cholesterol measured. We compared twelve equations developed in the previous studies and the newly proposed equation (model 1) developed in this study with the actual low-density lipoprotein cholesterol value in various ways. Results: The low-density lipoprotein cholesterol value estimated using the estimation formula and the actual low-density lipoprotein cholesterol value were compared using the root mean squared error. When the triglyceride level was less than 400 mg/dL, the root mean squared of the model 1 was 7.96, the lowest compared to other equations, and the model 2 was 7.82. The degree of misclassification was checked according to the NECP ATP III 6 categories. As a result, the misclassification rate of the model 1 was the lowest at 18.9%, and Weighted Kappa was the highest at 0.919 (0.003), which means it significantly reduced the underestimation rate shown in other existing estimation equations. Root mean square error was also compared according to the change in triglycerides level. As the triglycerides level increased, the root mean square error showed an increasing trend in all equations, but it was confirmed that the model 1 was the lowest compared to other equations. Conclusion The newly proposed low-density lipoprotein cholesterol estimation equation showed significantly improved performance compared to the 12 existing estimation equations. The use of representative samples and external verification is required for more sophisticated estimates in the future.

Background: According to the results of the age-standardized suicide rate (suicide deaths per 100,000 population) published by Organization for Economic Cooperation and Development countries from 2003 to 2019, the suicide rate in Korea is ranked first almost every year, so it should be managed at the national level. To reduce the suicide rate, many scholars are studying suicide. The suicidal process begins with suicidal ideation, progresses through suicide attempts, and ends with suicide. Among them, the frequency of suicidal thoughts was found to be highly correlated with suicide plans and attempts, and it is said that 60% of those who change from suicidal ideation to attempts appear within one year. Therefore, research related to suicidal ideation to lower the suicide rate will contribute to preventing suicide at an early stage. Methods: This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among them, data from 2013, 2015, 2017, and 2019 surveyed adults were compared for suicidal ideation among 18,339 adults. Considering the characteristics of the KNHANES data, complex sample analysis was performed considering the primary extraction unit (region), stratification variables, and weights. The Rao-Scott χ 2 test was stratified by age group to confirm the distribution of suicidal ideation according to general characteristics. Univariate and multiple logistic regression analyses were performed to understand the effect on suicidal ideation. Results: Among all subjects, the rate of suicidal ideation was 4.75%, and among the age groups, the rate of suicidal thoughts was the highest among those over 80 years old (10.39%). Compared to those who were 50s, those in their 30s had the lowest suicidal ideation (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.39–0.70), and those in their 80s had the highest rate of suicidal ideation (OR, 1.97; 95% CI, 1.38–2.82). Except for those in their 20s, the rate of suicidal ideation tends to increase with age. Overall, the lower 25% of the Euro Quality of Life–5 Dimensions (EQ-5D) index, depression lasting more than two weeks, and subjects with poor subjective health or high stress were more likely to have suicidal ideation.In particular, EQ-5D Index (OR, 5.86; 95% CI, 3.73–9.20), depressive symptoms (OR, 19.65; 95% CI, 9.94–38.83) in 20s, and stress in 80s (OR, 10.87; 95% CI, 5.63–20.96) was the highest, and those had the good subjective health perception in 30s (OR, 0.10; 95% CI, 0.05–0.20) was lowest. Participants in their 30s, 40s, and 60s who were divorced or widowed and those in their 50s and 60s who had never married or lived together were more likely toconsider suicide ideation. Except for those in their 20s and 80s, the rate of suicidal ideation tends to increase with lower household income levels. Conclusions In the results of this study, it can be seen that a combination of factors such as a person’s personality traits, stress or coping ability to various events, social support, and mental or physical limitations influence suicidal behavior. Suicidal ideation is not simply affected by a single factor but may be influenced by multiple factors.

Objectives: ：In this study, socio-demographic, drinking and emotional characteristics, and their correlations were compared among patients with alcohol use disorder (AUD) according to the presence or absence of any type of criminal record. Methods: ：Among patients admitted to the hospital with AUD, 27 with and 31 without criminal records were included. Socio-demographic data and drinking characteristics such as first drinking age, average daily alcohol consumption were collected. In addition, the severity of alcohol problems, the degree of change readiness for drinking alcohol, depressive symptoms, anxiety symptoms, and impulsivity were evaluated using scales and statistically analyzed. Pearson’s correlation test was applied to reveal the differences in correlation of the characteristics according to the presence or absence of criminal records. Results: ：The first drinking age was significantly earlier in the AUD group with criminal records. Interestingly, the degree of change readiness regarding alcohol problem as shown in SOCRATES-K was significantly higher in the AUD group with criminal records. Anxiety symptoms were statistically significantly higher in the AUD group with criminal records. In AUD with criminal records, first drinking age negatively correlated with the degree of change readiness. In AUD without criminal records, first drinking age correlated negatively with the severity of alcohol problem, and the degree of change readiness, and the degree of change readiness negatively with age, and the degree of change readiness positively with the severity of alcohol problem. In Both groups, anxiety symptoms positively correlated with depressive symptoms. Conclusions ：This study showed that AUD patients with criminal record had a faster first drinking age and the higher degree of change readiness regarding alcohol problem. Significantly higher symptoms of anxiety were also presented in AUD patients with criminal record than AUD patients who have no criminal records. Some differences were identified in correlations among characteristics between the two groups.

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1–2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

Giant cell hepatitis with autoimmune hemolytic anemia (AHA) is a rare disease of infancy characterized by the presence of both Coombs-positive hemolytic anemia and progressive liver disease with giant cell transformation of hepatocytes. Here, we report a case involving a seven-month-old male infant who presented with AHA followed by cholestatic hepatitis. The clinical features included jaundice, pallor, and red urine. Physical examination showed generalized icterus and splenomegaly. The laboratory findings suggested warm-type AHA with cholestatic hepatitis. Liver biopsy revealed giant cell transformation of hepatocytes and moderate lobular inflammation. The patient was successfully treated with four doses of rituximab. Early relapse of hemolytic anemia and hepatitis was observed, which prompted the use of an additional salvage dose of rituximab. He is currently in clinical remission.
Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune ; Biopsy ; Giant Cells ; Hepatitis ; Hepatocytes ; Humans ; Infant ; Inflammation ; Jaundice ; Liver ; Liver Diseases ; Male ; Pallor ; Physical Examination ; Rare Diseases ; Recurrence ; Rituximab ; Splenomegaly