Background: The mortality of sepsis without direct drugs is high. The association between prediabetes, based on a single fasting glucose (FG), or long-term type 2 diabetes mellitus (T2DM) and sepsis remains unclear. Methods: Of the adults aged ≥20 years who were included in the National Health Screening Program (NHSP) in 2009, 40% were randomly sampled. After excluding patients with type 1 diabetes mellitus, with missing information, and who were diagnosed with sepsis during the wash-out (between 2001 and the NHSP) or 1-year lag period, a cohort comprised of 3,863,323 examinees. Body mass index (BMI) measurements, FG tests, and self-reported questionnaires on health-related behaviors were conducted. Individual information was followed up until 2020 and censored upon the first occurrence of sepsis or death. The incidence of sepsis was compared using a multivariable regression adjusted for age, sex, income, BMI, smoking, drinking, physical activity levels, and chronic diseases. Results: The cohort was divided into those with normal FG (n=2,675,476), impaired fasting glucose (IFG) (n=890,402, 23.0%), T2DM <5 years (n=212,391, 5.5%), or T2DM for ≥5 years (n=85,054, 2.2%). The groups with IFG (adjusted hazard ratio [aHR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), T2DM <5 years (aHR, 1.43; 95% CI, 1.40 to 1.47), and T2DM for ≥5 years (aHR, 1.82; 95% CI, 1.77 to 1.87) exhibited significantly higher incidence of sepsis (P<0.001), with the greatest risk in patients with T2DM aged <40 years (aHR, 1.96; 95% CI, 1.71 to 2.25). Conclusion Patients with long-standing and young-onset T2DM show a substantially high risk of sepsis, emphasizing the need for infection prevention and vaccination.

Background: The mortality of sepsis without direct drugs is high. The association between prediabetes, based on a single fasting glucose (FG), or long-term type 2 diabetes mellitus (T2DM) and sepsis remains unclear. Methods: Of the adults aged ≥20 years who were included in the National Health Screening Program (NHSP) in 2009, 40% were randomly sampled. After excluding patients with type 1 diabetes mellitus, with missing information, and who were diagnosed with sepsis during the wash-out (between 2001 and the NHSP) or 1-year lag period, a cohort comprised of 3,863,323 examinees. Body mass index (BMI) measurements, FG tests, and self-reported questionnaires on health-related behaviors were conducted. Individual information was followed up until 2020 and censored upon the first occurrence of sepsis or death. The incidence of sepsis was compared using a multivariable regression adjusted for age, sex, income, BMI, smoking, drinking, physical activity levels, and chronic diseases. Results: The cohort was divided into those with normal FG (n=2,675,476), impaired fasting glucose (IFG) (n=890,402, 23.0%), T2DM <5 years (n=212,391, 5.5%), or T2DM for ≥5 years (n=85,054, 2.2%). The groups with IFG (adjusted hazard ratio [aHR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), T2DM <5 years (aHR, 1.43; 95% CI, 1.40 to 1.47), and T2DM for ≥5 years (aHR, 1.82; 95% CI, 1.77 to 1.87) exhibited significantly higher incidence of sepsis (P<0.001), with the greatest risk in patients with T2DM aged <40 years (aHR, 1.96; 95% CI, 1.71 to 2.25). Conclusion Patients with long-standing and young-onset T2DM show a substantially high risk of sepsis, emphasizing the need for infection prevention and vaccination.

Background: The mortality of sepsis without direct drugs is high. The association between prediabetes, based on a single fasting glucose (FG), or long-term type 2 diabetes mellitus (T2DM) and sepsis remains unclear. Methods: Of the adults aged ≥20 years who were included in the National Health Screening Program (NHSP) in 2009, 40% were randomly sampled. After excluding patients with type 1 diabetes mellitus, with missing information, and who were diagnosed with sepsis during the wash-out (between 2001 and the NHSP) or 1-year lag period, a cohort comprised of 3,863,323 examinees. Body mass index (BMI) measurements, FG tests, and self-reported questionnaires on health-related behaviors were conducted. Individual information was followed up until 2020 and censored upon the first occurrence of sepsis or death. The incidence of sepsis was compared using a multivariable regression adjusted for age, sex, income, BMI, smoking, drinking, physical activity levels, and chronic diseases. Results: The cohort was divided into those with normal FG (n=2,675,476), impaired fasting glucose (IFG) (n=890,402, 23.0%), T2DM <5 years (n=212,391, 5.5%), or T2DM for ≥5 years (n=85,054, 2.2%). The groups with IFG (adjusted hazard ratio [aHR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), T2DM <5 years (aHR, 1.43; 95% CI, 1.40 to 1.47), and T2DM for ≥5 years (aHR, 1.82; 95% CI, 1.77 to 1.87) exhibited significantly higher incidence of sepsis (P<0.001), with the greatest risk in patients with T2DM aged <40 years (aHR, 1.96; 95% CI, 1.71 to 2.25). Conclusion Patients with long-standing and young-onset T2DM show a substantially high risk of sepsis, emphasizing the need for infection prevention and vaccination.

Background: The mortality of sepsis without direct drugs is high. The association between prediabetes, based on a single fasting glucose (FG), or long-term type 2 diabetes mellitus (T2DM) and sepsis remains unclear. Methods: Of the adults aged ≥20 years who were included in the National Health Screening Program (NHSP) in 2009, 40% were randomly sampled. After excluding patients with type 1 diabetes mellitus, with missing information, and who were diagnosed with sepsis during the wash-out (between 2001 and the NHSP) or 1-year lag period, a cohort comprised of 3,863,323 examinees. Body mass index (BMI) measurements, FG tests, and self-reported questionnaires on health-related behaviors were conducted. Individual information was followed up until 2020 and censored upon the first occurrence of sepsis or death. The incidence of sepsis was compared using a multivariable regression adjusted for age, sex, income, BMI, smoking, drinking, physical activity levels, and chronic diseases. Results: The cohort was divided into those with normal FG (n=2,675,476), impaired fasting glucose (IFG) (n=890,402, 23.0%), T2DM <5 years (n=212,391, 5.5%), or T2DM for ≥5 years (n=85,054, 2.2%). The groups with IFG (adjusted hazard ratio [aHR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), T2DM <5 years (aHR, 1.43; 95% CI, 1.40 to 1.47), and T2DM for ≥5 years (aHR, 1.82; 95% CI, 1.77 to 1.87) exhibited significantly higher incidence of sepsis (P<0.001), with the greatest risk in patients with T2DM aged <40 years (aHR, 1.96; 95% CI, 1.71 to 2.25). Conclusion Patients with long-standing and young-onset T2DM show a substantially high risk of sepsis, emphasizing the need for infection prevention and vaccination.

Background: Body weight variability is associated with health status, lifestyle, and chronic diseases. However, there is limited evidence of its association with mortality in young adults. This study aimed to explore the impact of body weight variability on all-cause and cause-specific mortality risks among young adults in South Korea. Methods: This retrospective cohort study included 1,771,152 young adults aged 20–39 years who underwent health examinations provided by the Korean National Health Insurance Service between 2009 and 2010 and were followed up until 2021. Body weight variability was assessed using the variability independent of mean (VIM). The association between VIM quartiles in terms of body weight and mortality was analyzed using a Cox regression model. Results: During a mean follow-up period of 10.8 years, 11,708 all-cause deaths occurred. Compared to the lowest VIM quartile (Q1) group, the all-cause mortality risk was 1.07 times higher in the Q3 group (95% confidence interval [CI], 1.02–1.13) and 1.20 times higher in the Q4 group (95% CI, 1.14– 1.26). The all-cause mortality risk increased with higher VIM quartiles. Higher body weight variability has also been associated with mortality from suicide, gastrointestinal diseases, and endocrine diseases. These associations persisted across subgroups categorized by sex, weight change, and body mass index. Conclusion This large-scale nationwide cohort study indicates that higher body weight variability in young adults may elevate the risk of all-cause mortality, mortality from suicide, and gastrointestinal and endocrine diseases. These findings underscore the importance of maintaining stable body weight in young adults.

Background: Body weight variability is associated with health status, lifestyle, and chronic diseases. However, there is limited evidence of its association with mortality in young adults. This study aimed to explore the impact of body weight variability on all-cause and cause-specific mortality risks among young adults in South Korea. Methods: This retrospective cohort study included 1,771,152 young adults aged 20–39 years who underwent health examinations provided by the Korean National Health Insurance Service between 2009 and 2010 and were followed up until 2021. Body weight variability was assessed using the variability independent of mean (VIM). The association between VIM quartiles in terms of body weight and mortality was analyzed using a Cox regression model. Results: During a mean follow-up period of 10.8 years, 11,708 all-cause deaths occurred. Compared to the lowest VIM quartile (Q1) group, the all-cause mortality risk was 1.07 times higher in the Q3 group (95% confidence interval [CI], 1.02–1.13) and 1.20 times higher in the Q4 group (95% CI, 1.14– 1.26). The all-cause mortality risk increased with higher VIM quartiles. Higher body weight variability has also been associated with mortality from suicide, gastrointestinal diseases, and endocrine diseases. These associations persisted across subgroups categorized by sex, weight change, and body mass index. Conclusion This large-scale nationwide cohort study indicates that higher body weight variability in young adults may elevate the risk of all-cause mortality, mortality from suicide, and gastrointestinal and endocrine diseases. These findings underscore the importance of maintaining stable body weight in young adults.

Background: Body weight variability is associated with health status, lifestyle, and chronic diseases. However, there is limited evidence of its association with mortality in young adults. This study aimed to explore the impact of body weight variability on all-cause and cause-specific mortality risks among young adults in South Korea. Methods: This retrospective cohort study included 1,771,152 young adults aged 20–39 years who underwent health examinations provided by the Korean National Health Insurance Service between 2009 and 2010 and were followed up until 2021. Body weight variability was assessed using the variability independent of mean (VIM). The association between VIM quartiles in terms of body weight and mortality was analyzed using a Cox regression model. Results: During a mean follow-up period of 10.8 years, 11,708 all-cause deaths occurred. Compared to the lowest VIM quartile (Q1) group, the all-cause mortality risk was 1.07 times higher in the Q3 group (95% confidence interval [CI], 1.02–1.13) and 1.20 times higher in the Q4 group (95% CI, 1.14– 1.26). The all-cause mortality risk increased with higher VIM quartiles. Higher body weight variability has also been associated with mortality from suicide, gastrointestinal diseases, and endocrine diseases. These associations persisted across subgroups categorized by sex, weight change, and body mass index. Conclusion This large-scale nationwide cohort study indicates that higher body weight variability in young adults may elevate the risk of all-cause mortality, mortality from suicide, and gastrointestinal and endocrine diseases. These findings underscore the importance of maintaining stable body weight in young adults.

Background: Body weight variability is associated with health status, lifestyle, and chronic diseases. However, there is limited evidence of its association with mortality in young adults. This study aimed to explore the impact of body weight variability on all-cause and cause-specific mortality risks among young adults in South Korea. Methods: This retrospective cohort study included 1,771,152 young adults aged 20–39 years who underwent health examinations provided by the Korean National Health Insurance Service between 2009 and 2010 and were followed up until 2021. Body weight variability was assessed using the variability independent of mean (VIM). The association between VIM quartiles in terms of body weight and mortality was analyzed using a Cox regression model. Results: During a mean follow-up period of 10.8 years, 11,708 all-cause deaths occurred. Compared to the lowest VIM quartile (Q1) group, the all-cause mortality risk was 1.07 times higher in the Q3 group (95% confidence interval [CI], 1.02–1.13) and 1.20 times higher in the Q4 group (95% CI, 1.14– 1.26). The all-cause mortality risk increased with higher VIM quartiles. Higher body weight variability has also been associated with mortality from suicide, gastrointestinal diseases, and endocrine diseases. These associations persisted across subgroups categorized by sex, weight change, and body mass index. Conclusion This large-scale nationwide cohort study indicates that higher body weight variability in young adults may elevate the risk of all-cause mortality, mortality from suicide, and gastrointestinal and endocrine diseases. These findings underscore the importance of maintaining stable body weight in young adults.

Objectives: The objective of this study was to develop and validate a multicenter-based, multi-model, time-series deep learning model for predicting drug-induced liver injury (DILI) in patients taking angiotensin receptor blockers (ARBs). The study leveraged a national-level multicenter approach, utilizing electronic health records (EHRs) from six hospitals in Korea. Methods: A retrospective cohort analysis was conducted using EHRs from six hospitals in Korea, comprising a total of 10,852 patients whose data were converted to the Common Data Model. The study assessed the incidence rate of DILI among patients taking ARBs and compared it to a control group. Temporal patterns of important variables were analyzed using an interpretable timeseries model. Results: The overall incidence rate of DILI among patients taking ARBs was found to be 1.09%. The incidence rates varied for each specific ARB drug and institution, with valsartan having the highest rate (1.24%) and olmesartan having the lowest rate (0.83%). The DILI prediction models showed varying performance, measured by the average area under the receiver operating characteristic curve, with telmisartan (0.93), losartan (0.92), and irbesartan (0.90) exhibiting higher classification performance. The aggregated attention scores from the models highlighted the importance of variables such as hematocrit, albumin, prothrombin time, and lymphocytes in predicting DILI. Conclusions Implementing a multicenter-based timeseries classification model provided evidence that could be valuable to clinicians regarding temporal patterns associated with DILI in ARB users. This information supports informed decisions regarding appropriate drug use and treatment strategies.