Background: Prevention of contrast-induced nephropathy (CIN) is crucial in acute myocardial infarction (AMI) patients undergoing coronary interventions. Previous studies suggest that high-dose statins may aid in CIN prevention, yet comparative studies among different statin types using cystatin C (cysC) as a biomarker for CIN are absent. This study evaluated the effectiveness of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN (cysC-CIN) in AMI patients. Methods: This multicenter registry included 431 patients (rosuvastatin 20 mg: n = 231, atorvastatin 40 mg: n = 200). The primary endpoint was cysC-CIN incidence within 48 hours post contrast; the secondary endpoints were creatinine-based CIN (cr-CIN) incidence within 72 hours post contrast and post 30 days adverse events. Results: The incidences of cysC-CIN (12.1% vs. 7.5%, P = 0.103) and cr-CIN (6.2% vs. 3.5%, P = 0.103) were higher in the atorvastatin group without significant statistical differences.Multivariable regression analysis, which was adjusted for CIN risk factors and the variables with univariate association, showed no increased odds ratio (OR) (OR, 2.185; 95% confidence interval [CI], 0.899, 5.315; P = 0.085) for cysC-CIN in the atorvastatin group compared to the rosuvastatin group. However, statin-naïve atorvastatin subgroup had significantly increased odds of cysC-CIN compared to the rosuvastatin group (OR, 2.977; 95% CI, 1.057, 8.378; P = 0.039). At post 30 days renal, cardiovascular, and mortality event rates were both low and similar between the two groups. Conclusion No significant difference in cysC-CIN incidence was found between the highdose rosuvastatin and atorvastatin groups in AMI patients and cysC was more sensitive to the early detection of CIN than creatinine.

Background: Prevention of contrast-induced nephropathy (CIN) is crucial in acute myocardial infarction (AMI) patients undergoing coronary interventions. Previous studies suggest that high-dose statins may aid in CIN prevention, yet comparative studies among different statin types using cystatin C (cysC) as a biomarker for CIN are absent. This study evaluated the effectiveness of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN (cysC-CIN) in AMI patients. Methods: This multicenter registry included 431 patients (rosuvastatin 20 mg: n = 231, atorvastatin 40 mg: n = 200). The primary endpoint was cysC-CIN incidence within 48 hours post contrast; the secondary endpoints were creatinine-based CIN (cr-CIN) incidence within 72 hours post contrast and post 30 days adverse events. Results: The incidences of cysC-CIN (12.1% vs. 7.5%, P = 0.103) and cr-CIN (6.2% vs. 3.5%, P = 0.103) were higher in the atorvastatin group without significant statistical differences.Multivariable regression analysis, which was adjusted for CIN risk factors and the variables with univariate association, showed no increased odds ratio (OR) (OR, 2.185; 95% confidence interval [CI], 0.899, 5.315; P = 0.085) for cysC-CIN in the atorvastatin group compared to the rosuvastatin group. However, statin-naïve atorvastatin subgroup had significantly increased odds of cysC-CIN compared to the rosuvastatin group (OR, 2.977; 95% CI, 1.057, 8.378; P = 0.039). At post 30 days renal, cardiovascular, and mortality event rates were both low and similar between the two groups. Conclusion No significant difference in cysC-CIN incidence was found between the highdose rosuvastatin and atorvastatin groups in AMI patients and cysC was more sensitive to the early detection of CIN than creatinine.

Background: Prevention of contrast-induced nephropathy (CIN) is crucial in acute myocardial infarction (AMI) patients undergoing coronary interventions. Previous studies suggest that high-dose statins may aid in CIN prevention, yet comparative studies among different statin types using cystatin C (cysC) as a biomarker for CIN are absent. This study evaluated the effectiveness of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN (cysC-CIN) in AMI patients. Methods: This multicenter registry included 431 patients (rosuvastatin 20 mg: n = 231, atorvastatin 40 mg: n = 200). The primary endpoint was cysC-CIN incidence within 48 hours post contrast; the secondary endpoints were creatinine-based CIN (cr-CIN) incidence within 72 hours post contrast and post 30 days adverse events. Results: The incidences of cysC-CIN (12.1% vs. 7.5%, P = 0.103) and cr-CIN (6.2% vs. 3.5%, P = 0.103) were higher in the atorvastatin group without significant statistical differences.Multivariable regression analysis, which was adjusted for CIN risk factors and the variables with univariate association, showed no increased odds ratio (OR) (OR, 2.185; 95% confidence interval [CI], 0.899, 5.315; P = 0.085) for cysC-CIN in the atorvastatin group compared to the rosuvastatin group. However, statin-naïve atorvastatin subgroup had significantly increased odds of cysC-CIN compared to the rosuvastatin group (OR, 2.977; 95% CI, 1.057, 8.378; P = 0.039). At post 30 days renal, cardiovascular, and mortality event rates were both low and similar between the two groups. Conclusion No significant difference in cysC-CIN incidence was found between the highdose rosuvastatin and atorvastatin groups in AMI patients and cysC was more sensitive to the early detection of CIN than creatinine.

Background: Prevention of contrast-induced nephropathy (CIN) is crucial in acute myocardial infarction (AMI) patients undergoing coronary interventions. Previous studies suggest that high-dose statins may aid in CIN prevention, yet comparative studies among different statin types using cystatin C (cysC) as a biomarker for CIN are absent. This study evaluated the effectiveness of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN (cysC-CIN) in AMI patients. Methods: This multicenter registry included 431 patients (rosuvastatin 20 mg: n = 231, atorvastatin 40 mg: n = 200). The primary endpoint was cysC-CIN incidence within 48 hours post contrast; the secondary endpoints were creatinine-based CIN (cr-CIN) incidence within 72 hours post contrast and post 30 days adverse events. Results: The incidences of cysC-CIN (12.1% vs. 7.5%, P = 0.103) and cr-CIN (6.2% vs. 3.5%, P = 0.103) were higher in the atorvastatin group without significant statistical differences.Multivariable regression analysis, which was adjusted for CIN risk factors and the variables with univariate association, showed no increased odds ratio (OR) (OR, 2.185; 95% confidence interval [CI], 0.899, 5.315; P = 0.085) for cysC-CIN in the atorvastatin group compared to the rosuvastatin group. However, statin-naïve atorvastatin subgroup had significantly increased odds of cysC-CIN compared to the rosuvastatin group (OR, 2.977; 95% CI, 1.057, 8.378; P = 0.039). At post 30 days renal, cardiovascular, and mortality event rates were both low and similar between the two groups. Conclusion No significant difference in cysC-CIN incidence was found between the highdose rosuvastatin and atorvastatin groups in AMI patients and cysC was more sensitive to the early detection of CIN than creatinine.

Background: The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults. Methods: We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea. Results: The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics). Conclusion Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.

Background: The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults. Methods: We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea. Results: The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics). Conclusion Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.

Background: The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults. Methods: We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea. Results: The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics). Conclusion Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.

Background: The prevalence of both obstructive sleep apnea and allergic rhinitis is high and these often co-exist. This study investigated the association between allergic rhinitis-related factors and the risk of sleep apnea in Korean adults. Methods: We conducted a cross-sectional study involving 8,956 Korean adults aged 40 years or older who participated in the 8th Korea National Health and Nutrition Examination Survey between 2019 and 2021. Allergic rhinitis-related factors were divided into two categories: allergic rhinitis symptoms (symptoms) and prevalence of allergic disease (prevalence). Symptoms were investigated through a questionnaire and the prevalence of allergic disease was based on the doctor’s diagnosis. The risk of sleep apnea was calculated through the STOP-Bang questionnaire (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender), and a score of ≥3 is considered as a high-risk group. Logistic regression analysis was used to investigate the effect of symptoms or prevalence on the risk of sleep apnea. Results: The risk of sleep apnea increased 1.26 times (95% confidential interval [CI], 1.10–1.44) in patients with symptoms and was higher in patients with severe rhinitis (odds ratio [OR], 1.43; 95% CI, 1.12–1.83). A higher risk of sleep apnea was associated with allergic disease, including allergic rhinitis, asthma, and atopic dermatitis (OR, 1.31; 95% CI, 1.02–1.66, adjusted for general characteristics). Conclusion Severe allergic rhinitis symptoms and a history of allergic disease increased the risk of obstructive sleep apnea.

Background: The most important aspect of a retrospective cohort study is the operational definition (OP) of the disease. We developed a detailed OP for the detection of sodiumglucose cotransporter-2 inhibitors (SGLT2i) related to diabetic ketoacidosis (DKA). The OP was systemically verified and analyzed. Methods: All patients prescribed SGLT2i at four university hospitals were enrolled in this experiment. A DKA diagnostic algorithm was created and distributed to each hospital;subsequently, the number of SGLT2i-related DKAs was confirmed. Then, the algorithm functionality was verified through manual chart reviews by an endocrinologist using the same OP. Results: A total of 8,958 patients were initially prescribed SGLT2i. According to the algorithm, 0.18% (16/8,958) were confirmed to have SGLT2i-related DKA. However, based on manual chart reviews of these 16 cases, there was only one case of SGLT2i-related DKA (positive predictive value = 6.3%). Even after repeatedly narrowing the diagnosis range of the algorithm, the effect of a positive predictive value was insignificant (6.3–10.0%, P > 0.999). Conclusion Owing to the nature of electronic medical record data, we could not create an algorithm that clearly differentiates SGLT2i-related DKA despite repeated attempts. In all retrospective studies, a portion of the samples should be randomly selected to confirm the accuracy of the OP through chart review. In retrospective cohort studies in which chart review is not possible, it will be difficult to guarantee the reliability of the results.

Hypoglycemia is one of the severe complications of diabetes. To prevent hypoglycemia, an emphasis is placed on maintaining an appropriate balance between nutrition, activity, and treatment, which can be achieved by the repetition of self-trials based on self-monitoring. Clinicians routinely focus on patients’ contribution, including timely intake of an adequate amount of carbohydrates, physical activity, antidiabetic medication, and abstinence from alcohol. Recently, many guidelines have highlighted the importance of clinicians’ factors and recommend individualized treatments according to lifestyle patterns and specific needs following the de-intensification of treatment. The optimal value of hemoglobin A1c (HbA1c) levels for blood glucose level regulation remains controversial among countries, but it generally does not exceed 8.0%. In populations that are at a risk of hypoglycemia, such as the older adults, it is advisable to adjust the target blood glucose level to less than 8.0%. Meanwhile, a blood glucose level of 7.0%–7.5% is generally recommended for healthy older adults. If the expected lifetime is shorter than 10 years or in patients with chronic kidney disease and severe cardiovascular disease, the HbA1c level target can be increased to 7.5%–8.0%. For even shorter lifetime expectancy, the target can be adjusted up to 8.0%–9.0%. To prevent hypoglycemia, the target blood glucose level needs to be adjusted, particularly in older adult patients. Ultimately, it is important to identify the maximum blood glucose levels that do not cause hypoglycemia and the minimum blood glucose levels that do not cause hyperglycemia-associated complications.