Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Objectives: Interest in the association between particulate air pollution and appendicitis risk has been increasing in recent years, and previous studies have suggested a link between particulate matter ≤ 10 μm in diameter (PM10 ) and appendicitis. However, robust evidence is currently lacking. This study explored the association between short-term PM10 exposure and appendicitis using data from Ewha Womans University Mokdong Hospital, Seoul, Korea, between January 1, 2001 and December 31, 2018. Methods: We employed a time-stratified case-crossover design using data from 6,526 appendicitis patients taken from the hospital’s electronic medical records system. We analyzed the data using a conditional logistic regression model adjusted for daily mean temperature and relative humidity. The effect size of PM10 was estimated in terms of each 10 μm/m3 increase in PM10 concentration. Sex, season, and age group were analyzed as subgroups. Results: Appendicitis patients had been exposed to higher levels of PM10 concentrations 3 days (OR 1.045, 95% CI : 1.007–1.084) and 7 days (OR, 1.053; 95% CI, 1.005–1.103) before hospital admission. The case-crossover analysis stratified by sex, age, and season showed that the male sex, being aged under 10, and the cold season were associated with a significantly stronger association between appendicitis and PM10 concentrations. Conclusion Our study found that PM10 concentrations were associated with appendicitis in boys aged under 10. The cold season was also a risk factor. Further research with a larger sample size and with other pollutants is required to clarify the association between PM10 and appendicitis.

Eighty-five Korean kidney transplant recipients who received three doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine were tested with anti-receptor binding domain (RBD) antibody and neutralizing antibody. High anti-RBD antibody (≥ 100 U/mL) and neutralizing antibody responses (≥ 30%) were detected in 51/85 (60.0%) patients.When we divided the patients with the time from transplantation to vaccination (< 1, 1–2.4, 2.5–4.9, and ≥ 5-year), anti-RBD antibody titers were 3.2 U/mL, 27.8 U/mL, 370.2 U/mL, and 5,094.2 U/mL (P < 0.001) and anti-neutralizing antibody levels were 2.2%, 11.6%, 45.6%, and 93.0% (P < 0.001), respectively. Multivariate analysis revealed increased antibody responses when the time from transplantation to vaccination was five years or longer (odds ratio, 12.0; confidence interval, 2.7–52.8). Korean kidney transplant recipients had suboptimal antibody responses after the third dose of SARS-CoV-2 vaccine. A shorter time from transplantation to vaccination was a risk factor for a low antibody response.

Postpartum hemorrhage (PPH) is a major cause of maternal mortality and the risk factors for PPH differ among studies. In this large-scale study, we investigated whether the anesthetic method used was associated with PPH after cesarean section. Methods: We extracted data on cesarean sections performed between January 2008 and June 2013 from the National Health Insurance Service database. The anesthetic methods were categorized into general, spinal and epidural anesthesia. To compare the likelihood of PPH among deliveries using different anesthetic methods, crude and adjusted odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression analysis. Results: Data from 330,324 cesarean sections were analyzed, and 21,636 cases of PPH were identified. Univariate analysis showed that general and epidural anesthesia increased the risk of PPH compared to spinal anesthesia. The OR for PPH was highest for morbidly adherent placenta, followed by placenta previa, placental abruption, and hypertension. When other clinical covariates were controlled for, general and epidural anesthesia still remained significant risk factors for PPH compared to spinal anesthesia. Conclusions: This study showed that general and epidural anesthesia elevated the risk of PPH compared to spinal anesthesia during cesarean section. Since we could not consider the potential bias of group differences in indications, more in-depth clinical trials are needed to validate our findings. Obstetric factors such as placental abnormalities had high odds ratios and thus are more important than the choice of anesthetic method, which should be based on the patient’s clinical condition and institutional resources.

OBJECTIVES: Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents. METHODS: We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed. RESULTS: The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years. CONCLUSIONS In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.

OBJECTIVES: Since exposure to sexual content and early sexual initiation among adolescents have become serious social issues in Korea, an in-depth analysis of trends in the prevalence of sexual experience among Korean adolescents is necessary to project the trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on the prevalence of sexual experience in Korean adolescents. METHODS: We analyzed age-specific, period-specific, and birth cohort–specific trends in the prevalence of sexual experience among 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 years to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey. Joinpoint regression analysis was conducted to examine significant changes in the prevalence of sexual experience and to find the optimal number and location of places where trends changed. RESULTS: The prevalence of sexual experience generally increased with age in all periods in both boys and girls. In boys, the prevalence of sexual experience increased in recent periods, especially in the age group of 12-13 years, while the prevalence of sexual experience decreased in the age group of 16-17 years. In girls, the age group of 12-13 years showed an increased prevalence of sexual experience in recent periods. However, the prevalence showed a decreasing trend in the age group of 16-17 years. CONCLUSIONS In boys and girls, sexual experience increased with age, although this tendency has slowed in recent cohorts. Therefore, early sex education is needed.