1.Comparative efficacy and safety of warfarin and direct oral anticoagulants in patients with end-stage kidney disease and atrial fibrillation
Yujin YANG ; Sun Hwa LEE ; Wonmook HWANG ; Ji Hoon JUNG ; Jae-Hyeong PARK
The Korean Journal of Internal Medicine 2026;41(1):107-117
Background/Aims:
Patients with atrial fibrillation (AF) and end-stage kidney disease (ESKD) require careful anticoagulation because thrombotic and bleeding risks are both elevated. We evaluated the efficacy and safety of warfarin, direct oral anticoagulants (DOACs), and no anticoagulation in Korean patients with ESKD and AF.
Methods:
In this multicenter retrospective study, we included 933 patients with ESKD and nonvalvular AF treated between 2010 and 2023. Patients were assigned to three groups by initial treatment: no anticoagulation (n = 604), warfarin (n = 197), or DOACs (n = 132). The primary efficacy outcome was ischemic stroke or systemic embolism (IS/SE); the primary safety outcome was major bleeding (MB). Secondary outcomes were intracranial hemorrhage (ICH), gastrointestinal bleeding (GIB), and all-cause mortality. Inverse probability of treatment weighting was used to adjust for confounding.
Results:
Both warfarin (adjusted hazard ratio [aHR], 0.55) and DOACs (aHR, 0.36) significantly reduced the risk of IS/SE compared with no anticoagulation. However, warfarin increased MB risk compared with no anticoagulation (aHR, 2.69), including ICH and GIB. DOACs also increased MB risk versus no anticoagulation (aHR, 1.37), driven primarily by ICH. Compared with warfarin, DOACs showed a lower MB risk (aHR, 0.51). Both warfarin and DOACs reduced all-cause mortality relative to no anticoagulation (aHR, 0.53 and 0.57, respectively).
Conclusions
Among Korean patients with ESKD and AF, both warfarin and DOACs reduced IS/SE but increased MB. Given their lower MB risk than warfarin, DOACs may be preferable for anticoagulation in this high-risk population.
2.Factors associated with glycemic control in Korean older adults with diabetes living alone: A secondary analysis
Hee Jung KIM ; Sun Ju CHANG ; Yujin PARK ; Joo Ri KIM ; Yeon Woo JUNG ; Gi Won CHOI
Journal of Korean Gerontological Nursing 2026;28(2):148-160
Older adults living alone face challenges in managing diabetes, yet research on glycemic control in this group is limited. This study analyzed data from the Korean National Health and Nutrition Examination Survey (2016~2021) to identify factors associated with glycemic control in 453 older adults with diabetes living alone. Methods: Glycemic control was categorized as good (glycated hemoglobin [HbA1c]<7.0%) or poor (HbA1c≥7.0%). Complex sample logistic regression examined demographic, disease and health-related, behavioral, and psychological factors associated with glycemic control. Results: Older adults aged ≥80 years had better glycemic control than those aged 65~69 years, while a diabetes duration of ≥15 years and higher body mass index were linked to poorer control. Strength training 5~7 days per week was associated with better control, whereas non-adherence to a healthy diet was unexpectedly linked to better outcomes. Conclusion: These findings highlight the need for tailored interventions to improve diabetes self-management and support healthy aging among older adults living alone. They also offer practical insights into shaping community-based health programs and social support systems for this population.
3.Comorbidity network of post-traumatic stress and depressive symptoms during the COVID-19 pandemic in Korea
Yujin LEE ; Ji Su YANG ; Alexander C. TSAI ; Jee In KANG ; Hearan KOO ; Hyeon Woo YIM ; Hyeon Chang KIM ; Sun Jae JUNG
Epidemiology and Health 2026;48(1):e2026006-
OBJECTIVES:
The coronavirus disease 2019 (COVID-19) pandemic had direct effects on population health through infection and morbidity, as well as indirect effects on population mental health. We estimated the network structure of post-traumatic stress symptoms (PTSS) and depressive symptoms throughout the pandemic in Korea and aimed to identify the most central and bridging symptoms.
METHODS:
Participants aged 30–64 years completed mental health surveys across 3 phases of the COVID-19 pandemic: March 2020 (n=1,925), February–March 2021 (n=1,754), and December 2021–January 2022 (n=1,595). Using PTSS and depressive symptom data, we conducted network analyses, and the primary measures of symptom importance (centrality) were expected influence and bridge expected influence.
RESULTS:
In the comorbidity network, although the most central symptoms fluctuated over the course of the pandemic, sleep problems were consistently identified as the most influential bridge symptoms throughout. The symptom network structure differed between the subacute and chronic phases of the pandemic.
CONCLUSIONS
We found evidence of changes in the network structure of PTSS and depressive symptoms, even as sleep problems retained a consistent role as a bridging symptom. Although overall network structures varied across phases of the pandemic, the bridging role of sleep-related symptoms remained consistently strong, suggesting that sleep problems may represent a general and enduring mechanism underlying PTSS–depression comorbidity. During future pandemics, prompt screening for sleep problems may help prevent the development of comorbidity between PTSS and depressive symptoms.
4.Advances of MRI in pulmonary diseases
Mengqi ZHANG ; Jiannan LIU ; Yujin SUN
Chinese Journal of Medical Imaging Technology 2025;41(5):839-842
MRI is a non-invasive imaging technique with high soft tissue contrast,multi sequences and multi parameters imaging capabilities,which has been widely used in researches of lung diseases in recent years.However,MRI application still faces certain challenges due to the unique physiological structure of lung and respiratory motion artifacts on images.The advances of MRI in pulmonary diseases were reviewed in this article.
5.Advances of MRI in pulmonary diseases
Mengqi ZHANG ; Jiannan LIU ; Yujin SUN
Chinese Journal of Medical Imaging Technology 2025;41(5):839-842
MRI is a non-invasive imaging technique with high soft tissue contrast,multi sequences and multi parameters imaging capabilities,which has been widely used in researches of lung diseases in recent years.However,MRI application still faces certain challenges due to the unique physiological structure of lung and respiratory motion artifacts on images.The advances of MRI in pulmonary diseases were reviewed in this article.
6.Fact sheet: nationwide trends in dietary intakes among Korean adults, 2013-2022
Hannah OH ; Garam JO ; Oh Yoen KIM ; Hyunjung LIM ; SuJin SONG ; Jeong-Hwa CHOI ; Jae Hyun BAE ; Eun-Sun JIN ; Rockli KIM ; Yujin LEE ; In-Kyung JEONG ; Min-Jeong SHIN ;
The Korean Journal of Internal Medicine 2025;40(3):427-437
Background/Aims:
Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis.
Methods:
We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality).
Results:
In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups.
Conclusions
Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.
7.Fact sheet: nationwide trends in dietary intakes among Korean adults, 2013-2022
Hannah OH ; Garam JO ; Oh Yoen KIM ; Hyunjung LIM ; SuJin SONG ; Jeong-Hwa CHOI ; Jae Hyun BAE ; Eun-Sun JIN ; Rockli KIM ; Yujin LEE ; In-Kyung JEONG ; Min-Jeong SHIN ;
The Korean Journal of Internal Medicine 2025;40(3):427-437
Background/Aims:
Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis.
Methods:
We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality).
Results:
In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups.
Conclusions
Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.
8.Fact sheet: nationwide trends in dietary intakes among Korean adults, 2013-2022
Hannah OH ; Garam JO ; Oh Yoen KIM ; Hyunjung LIM ; SuJin SONG ; Jeong-Hwa CHOI ; Jae Hyun BAE ; Eun-Sun JIN ; Rockli KIM ; Yujin LEE ; In-Kyung JEONG ; Min-Jeong SHIN ;
The Korean Journal of Internal Medicine 2025;40(3):427-437
Background/Aims:
Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis.
Methods:
We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality).
Results:
In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups.
Conclusions
Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.
9.Fact sheet: nationwide trends in dietary intakes among Korean adults, 2013-2022
Hannah OH ; Garam JO ; Oh Yoen KIM ; Hyunjung LIM ; SuJin SONG ; Jeong-Hwa CHOI ; Jae Hyun BAE ; Eun-Sun JIN ; Rockli KIM ; Yujin LEE ; In-Kyung JEONG ; Min-Jeong SHIN ;
The Korean Journal of Internal Medicine 2025;40(3):427-437
Background/Aims:
Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis.
Methods:
We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality).
Results:
In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups.
Conclusions
Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.
10.Fact sheet: nationwide trends in dietary intakes among Korean adults, 2013-2022
Hannah OH ; Garam JO ; Oh Yoen KIM ; Hyunjung LIM ; SuJin SONG ; Jeong-Hwa CHOI ; Jae Hyun BAE ; Eun-Sun JIN ; Rockli KIM ; Yujin LEE ; In-Kyung JEONG ; Min-Jeong SHIN ;
The Korean Journal of Internal Medicine 2025;40(3):427-437
Background/Aims:
Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis.
Methods:
We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality).
Results:
In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups.
Conclusions
Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.

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