1.Non-Linear Association Between Physical Activities and Type 2Diabetes in 2.4 Million Korean Population, 2009–2022: A Nationwide Representative Study
Wonwoo JANG ; Seokjun KIM ; Yejun SON ; Soeun KIM ; Hayeon LEE ; Jaeyu PARK ; Kyeongmin LEE ; Jiseung KANG ; Damiano PIZZOL ; Jiyoung HWANG ; Sang Youl RHEE ; Dong Keon YON
Journal of Korean Medical Science 2025;40(12):e42-
Background:
Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample.
Methods:
We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency.
Results:
MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups.
Conclusion
In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.
2.Non-Linear Association Between Physical Activities and Type 2Diabetes in 2.4 Million Korean Population, 2009–2022: A Nationwide Representative Study
Wonwoo JANG ; Seokjun KIM ; Yejun SON ; Soeun KIM ; Hayeon LEE ; Jaeyu PARK ; Kyeongmin LEE ; Jiseung KANG ; Damiano PIZZOL ; Jiyoung HWANG ; Sang Youl RHEE ; Dong Keon YON
Journal of Korean Medical Science 2025;40(12):e42-
Background:
Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample.
Methods:
We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency.
Results:
MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups.
Conclusion
In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.
3.Non-Linear Association Between Physical Activities and Type 2Diabetes in 2.4 Million Korean Population, 2009–2022: A Nationwide Representative Study
Wonwoo JANG ; Seokjun KIM ; Yejun SON ; Soeun KIM ; Hayeon LEE ; Jaeyu PARK ; Kyeongmin LEE ; Jiseung KANG ; Damiano PIZZOL ; Jiyoung HWANG ; Sang Youl RHEE ; Dong Keon YON
Journal of Korean Medical Science 2025;40(12):e42-
Background:
Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample.
Methods:
We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency.
Results:
MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups.
Conclusion
In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.
4.Non-Linear Association Between Physical Activities and Type 2Diabetes in 2.4 Million Korean Population, 2009–2022: A Nationwide Representative Study
Wonwoo JANG ; Seokjun KIM ; Yejun SON ; Soeun KIM ; Hayeon LEE ; Jaeyu PARK ; Kyeongmin LEE ; Jiseung KANG ; Damiano PIZZOL ; Jiyoung HWANG ; Sang Youl RHEE ; Dong Keon YON
Journal of Korean Medical Science 2025;40(12):e42-
Background:
Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the doseresponse relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample.
Methods:
We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency.
Results:
MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75–0.84) for those engaging in 300–600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both “weekend warriors” and “regularly active” individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups.
Conclusion
In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.
5.Ethyl acetate fraction of Sargassum pallidum extract attenuates particulate matterinduced oxidative stress and inflammation in keratinocytes and zebrafish
Chul Wook Kim ; Ji-Won Park ; Bohyun Yun ; WonWoo Lee ; Kyung-Min Choi ; Seung-Hong Lee
Asian Pacific Journal of Tropical Biomedicine 2024;14(4):137-146
Objective: To evaluate the effect of the ethyl acetate fraction derived from Sargassum pallidum extract against particulate matter (PM)-induced oxidative stress and inflammation in HaCaT cells and zebrafish. Methods: HaCaT cells and zebrafish were used to evaluate the protective effects of the ethyl acetate fraction of Sargassum pallidum extract against PM-induced oxidative stress and inflammation. The production of nitric oxide (NO), intracellular ROS, prostaglandin E2 (PGE2), and pro-inflammatory cytokines, and the expression levels of COX-2, iNOS, and NF-κB were evaluated in PM-induced HaCaT cells. Furthermore, the levels of ROS, NO, and lipid peroxidation were assessed in the PM-exposed zebrafish model. Results: The ethyl acetate fraction of Sargassum pallidum extract significantly decreased the production of NO, intracellular ROS, and PGE2 in PM-induced HaCaT cells. In addition, the fraction markedly suppressed the levels of pro-inflammatory cytokines and inhibited the expression levels of COX-2, iNOS, and NF-κB. Furthermore, it displayed remarkable protective effects against PM-induced inflammatory response and oxidative stress, represented by the reduction of NO, ROS, and lipid peroxidation in zebrafish. Conclusions: The ethyl acetate fraction of Sargassum pallidum extract exhibits a protective effect against PM-induced oxidative stress and inflammation both in vitro and in vivo and has the potential as a candidate for the development of pharmaceutical and cosmeceutical products.
6.Catalpa bignonioides extract improves exercise performance through regulation of growth and metabolism in skeletal muscles
Hoibin Jeong ; Dong-joo Lee ; Sung-Pil Kwon ; SeonJu Park ; Song-Rae Kim ; Seung Hyun Kim ; Jae-Il Park ; Deug-chan Lee ; Kyung-Min Choi ; WonWoo Lee ; Ji-Won Park ; Bohyun Yun ; Su-Hyeon Cho ; Kil-Nam Kim
Asian Pacific Journal of Tropical Biomedicine 2024;14(2):47-54
Objective: To evaluate the effects of Catalpa bignonioides fruit extract on the promotion of muscle growth and muscular capacity in vitro and in vivo. Methods: Cell viability was measured using the 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyltetrazolium bromide assay. Cell proliferation was assessed using a 5-bromo-2’-deoxyuridine (BrdU) assay kit. Western blot analysis was performed to determine the protein expressions of related factors. The effects of Catalpa bignonioides extract were investigated in mice using the treadmill exhaustion test and whole-limb grip strength assay. Chemical composition analysis was performed using high-performance liquid chromatography (HPLC). Results: Catalpa bignonioides extract increased the proliferation of C2C12 mouse myoblasts by activating the Akt/mTOR signaling pathway. It also induced metabolic changes, increasing the number of mitochondria and glucose metabolism by phosphorylating adenosine monophosphate-activated protein kinase. In an in vivo study, the extract-treated mice showed improved motor abilities, such as muscular endurance and grip strength. Additionally, HPLC analysis showed that vanillic acid may be the main component of the Catalpa bignonioides extract that enhanced muscle strength. Conclusions: Catalpa bignonioides improves exercise performance through regulation of growth and metabolism in skeletal muscles, suggesting its potential as an effective natural agent for improving muscular strength.
7.A Novel Approach to Total Ankle Arthroplasty with Simultaneous Structural Tibial Cut Autograft for Anterior Tibial Bone Defects
Yeo Kwon YOON ; Kwang Hwan PARK ; Dong Woo SHIM ; Wonwoo LEE ; Seung Hwan HAN ; Jin Woo LEE
Clinics in Orthopedic Surgery 2024;16(4):674-678
Severe bone defects pose a clinical challenge in total ankle arthroplasty (TAA) and are frequently considered contraindicated. We introduce an innovative approach that utilizes a structural tibial cut autograft to address anterior distal tibia bone defects during TAA. This technique is a viable alternative to employing revision TAA systems or resorting to excessively high tibial cuts. Furthermore, it facilitates achieving favorable sagittal alignment and ensures adequate fixation strength of the tibial component.
8.Validity and Reliability of the Korean Version of Reduced Morningness– Eveningness Questionnaire: Results From a General Population-Based Sample
Heewon HWANG ; Taesic LEE ; Wonwoo LEE ; Kyung Min KIM ; Kyoung HEO ; Min Kyung CHU
Journal of Korean Medical Science 2024;39(38):e257-
Background:
Chronotype refers to individual variations in diurnal preferences that manifest as everyday behaviors, including sleep patterns. Traditionally, the Horne & Östberg Morningness–Eveningness Questionnaire (MEQ), which comprises of 19 items, has been the standard for determining chronotype. However, its length makes it cumbersome for widespread application. To address this issue, the reduced MEQ (rMEQ), a concise version containing only five items from the MEQ, was developed for a more practical approach to chronotype assessment. This study aimed to evaluate the validity and reliability of Korean version of rMEQ in a sample from the general Korean population.
Methods:
The Korean version of the rMEQ comprises of items 1, 7, 10, 18, and 19 of the original MEQ. The validity of the rMEQ was assessed by correlating its scores with those of the MEQ and Munich Chronotype Questionnaire (MCTQ). Its reliability was determined by calculating internal consistency.
Results:
A total of 3,030 individuals participated in the study, yielding an average rMEQ score of 14.0 ± 3.4. There was a substantial positive correlation between the rMEQ and MEQ scores (r = 0.859, P < 0.001). Furthermore, the rMEQ scores were significantly negatively correlated with the midpoint of sleep on free days corrected for sleep debt as measured by the MCTQ (r = −0.388, P < 0.001), indicating a robust association with chronotype. The internal consistency of rMEQ, measured using Cronbach’s alpha, was 0.609.
Conclusion
This study finds the Korean version of the rMEQ to be a valid and reliable instrument for assessing chronotype in the general population.
9.Anaplastic Large Cell Lymphoma Mimicking a Muscle Abscess:A Case Report
Jaehyeok BAEK ; Younghyun KIM ; Wonwoo LEE ; Yeo Kwon YOON ; Jin Woo LEE ; Dong Woo SHIM
Journal of Korean Foot and Ankle Society 2023;27(3):108-111
Anaplastic large cell lymphoma (ALCLs) are a group CD30-positive mature T-cell lymphomas, an uncommon subtype of non-Hodgkin lymphomas, characterized by diverse clinical and genetic features. Among the types of ALCL, anaplastic lymphoma kinase (ALK)-negative ALCL, though typically involves the lymph nodes, can infrequently invade other tissues. When soft tissue involvement occurs, it may mimic the clinical presentation of infectious diseases, leading to potential misdiagnosis. Therefore, a histological examination is necessary to differentiate between ALK-negative ALCL and similar phenotypes associated with infectious conditions. This paper reports a case of ALCL, initially misdiagnosed as an infection.
10.Development and Validation of MRI-Based Radiomics Models for Diagnosing Juvenile Myoclonic Epilepsy
Kyung Min KIM ; Heewon HWANG ; Beomseok SOHN ; Kisung PARK ; Kyunghwa HAN ; Sung Soo AHN ; Wonwoo LEE ; Min Kyung CHU ; Kyoung HEO ; Seung-Koo LEE
Korean Journal of Radiology 2022;23(12):1281-1289
Objective:
Radiomic modeling using multiple regions of interest in MRI of the brain to diagnose juvenile myoclonic epilepsy (JME) has not yet been investigated. This study aimed to develop and validate radiomics prediction models to distinguish patients with JME from healthy controls (HCs), and to evaluate the feasibility of a radiomics approach using MRI for diagnosing JME.
Materials and Methods:
A total of 97 JME patients (25.6 ± 8.5 years; female, 45.5%) and 32 HCs (28.9 ± 11.4 years; female, 50.0%) were randomly split (7:3 ratio) into a training (n = 90) and a test set (n = 39) group. Radiomic features were extracted from 22 regions of interest in the brain using the T1-weighted MRI based on clinical evidence. Predictive models were trained using seven modeling methods, including a light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, with radiomics features in the training set. The performance of the models was validated and compared to the test set. The model with the highest area under the receiver operating curve (AUROC) was chosen, and important features in the model were identified.
Results:
The seven tested radiomics models, including light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, showed AUROC values of 0.817, 0.807, 0.783, 0.779, 0.767, 0.762, and 0.672, respectively. The light gradient boosting machine with the highest AUROC, albeit without statistically significant differences from the other models in pairwise comparisons, had accuracy, precision, recall, and F1 scores of 0.795, 0.818, 0.931, and 0.871, respectively. Radiomic features, including the putamen and ventral diencephalon, were ranked as the most important for suggesting JME.
Conclusion
Radiomic models using MRI were able to differentiate JME from HCs.


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