Biomarkers/blood* ; COVID-19/diagnosis* ; Chemokine CXCL10/blood* ; Humans ; Lung Diseases/virology* ; Severity of Illness Index

BACKGROUND: Handgrip strength is a simple, convenient and economic tool measuring the muscle strength. A few studies investigated the relationship between diabetes and handgrip strength but the results are conflicting. This study investigated the association of handgrip strength with diabetes among the adult Koreans. METHODS: This cross-sectional study analyzed data from participants aged 20 years or more (n=8,082) who measured height, weight, handgrip strength and fasting blood glucose in the 2014–2015 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (RHGS) was defined as the sum of the greatest handgrip strengths in both hands divided by body mass index. To investigate the association of diabetes with handgrip strength, complex sample multivariate logistic regression analyses were done after adjusting for socioeconomic (age, sex, education), lifestyle (smoking, alcohol drinking, physical activity, obesity) and comorbid (chronic obstructive pulmonary disease, stroke, coronary artery disease, arthritis) variables. Stratified analysis were done according to socioeconomic and lifestyle variables. RESULTS: The prevalence of diabetes was 8.3% (standard error, 0.4). After adjusting for socioeconomic, lifestyle, and comorbid variables, the risk of diabetes increased according to the decrease in sex-specific quartile of RHGS (P(trend)<0.001). Individuals with lower RHGS (per 1 standard deviation decrease) had higher odds of diabetes (adjusted odds ratio, 1.6; 95% confidence interval, 1.3–2.0). Furthermore, lower RHGS was associated with higher odds for diabetes throughout the strata of socioeconomic and lifestyle variables. CONCLUSIONS: This population-based, nationally representative study suggests that lower RHGS is associated with the increased risk of diabetes regardless of socioeconomic and lifestyle variables.
Adult ; Alcohol Drinking ; Blood Glucose ; Body Mass Index ; Coronary Artery Disease ; Cross-Sectional Studies ; Diabetes Mellitus ; Fasting ; Hand ; Hand Strength ; Humans ; Korea ; Life Style ; Logistic Models ; Lung Diseases, Obstructive ; Motor Activity ; Muscle Strength ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Stroke

BACKGROUND: It is unclear whether impaired pulmonary function serves as a risk factor for decreased renal function. This study investigated the association between the forced vital capacity (FVC) and chronic kidney disease (CKD) in middle-aged and elderly men.METHODS: We investigated the association between FVC and CKD in 412 Korean men aged ≥50 years, without diabetes, who have not received treatment for chronic lung disease. CKD was defined based on evidence of renal tissue damage or reduced renal function indicated by estimated glomerular filtration rate < 60 mL/min/1.73 m² or proteinuria level ≥1+. We assessed the association between FVC and CKD using multivariate logistic regression analysis after adjusting for confounders.RESULTS: The overall prevalence of CKD was 29.2% in the study population. Multivariate logistic regression analysis showed that the odds ratio with a 95% confidence interval for CKD was 0.96 (0.92–0.99) with a 1% increment in FVC after adjusting for age, body mass index, smoking status, alcohol intake, regular exercise, systolic and diastolic blood pressures, fasting plasma glucose, triglyceride, and high-density lipoprotein-cholesterol levels, as well as antihypertensive and antidyslipidemic medications.CONCLUSION: We observed that FVC was independently and inversely associated with CKD. This finding suggests that careful monitoring of renal function is necessary to evaluate possible kidney dysfunction in patients with decreased FVC.
Aged ; Blood Glucose ; Body Mass Index ; Fasting ; Glomerular Filtration Rate ; Humans ; Kidney ; Logistic Models ; Lung Diseases ; Male ; Odds Ratio ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic ; Respiratory Function Tests ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Vital Capacity

OBJECTIVE: To evaluate the value of anti-carbamylated protein (CarP) antibody in the diagnosis of rheumatoid arthritis-associated intersitial lung diseas (RA-ILD). METHODS: Clinical and laboratory data and serum samples of patients with RA between December 2017 and June 2019 in Department of Rheumatology, General Hospital of Ningxia Medical University were collected. The patients were subclassified as RA-ILD and RA-without ILD based on computed tomography scans of the chest, Enzyme 1inked immunosorbent assay (ELISA) was used to assess anti-CarP antibody in the serum of each group. The occurrence of ILD and other laboratory indexes were analyzed. Comparison of measurement data between the 2 groups was performed by two independent sample t-test or Mann-Whitney U nonparametric test, while the count data were compared by Chi square test; Receiver operating characteristic curve (ROC) was drawn to determine the cut-off value of anti-CarP antibody to RA-ILD diagnosis and to analyze its diagnostic efficacy. RESULTS: The anti-CarP antibody level in the RA-ILD group was 21.14 (12.29, 29.75), which was significantly higher than that in the RA-without ILD group 11.6 (6.66, 19.05) (P=0.000). The difference was statistically significant (P<0.05). The positive rate of anti-CarP antibody in RA-ILD group (53%) was significantly higher than that in RA-without ILD group (16%) (P<0.05); There was no significant differences in the levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) between the two groups (P>0.05). The age and disease activity score (DAS28) in the RA-ILD group were significantly higher than those in the RA-withhout ILD group (P<0.05). The proportion of men and smoking in the RA-ILD group was higher than that in the RA-without ILD group, but the difference was not statistically significant. The ROC curve showed that the anti-CarP antibody had a cut off value of 20.56 U/mL, with the sensitivity of 53.50%, and specificity of 84.20%, the area under the ROC curve were 0.76. Spearman correlation analysis showed that rheumatoid factor (RF) and age were positively correlated with anti-CarP antibody (r=0.172, P=0.043; r=0.200, P=0.006). Anti-CarP antibody level was not associated with the DAS28 score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-CCP antibody, swollen joint count, and tender joint count (P>0.05). CONCLUSION The anti-CarP antibody level in RA-ILD patients is higher than that in RA-without ILD, suggesting that anti-CarP antibody may have a role in the development of RA-ILD.
Arthritis, Rheumatoid ; Autoantibodies ; Blood Sedimentation ; Humans ; Lung Diseases ; Male ; Peptides, Cyclic ; Rheumatoid Factor

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; < 1,000 g) or extremely preterm (EP; < 28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.
Adolescent ; Adult ; Anxiety ; Autism Spectrum Disorder ; Blood Pressure ; Bronchopulmonary Dysplasia ; Cardiovascular Diseases ; Caregivers ; Cohort Studies ; Depression ; Education ; Executive Function ; Humans ; Infant, Newborn ; Insulin ; Intelligence ; Lung ; Mental Health ; Pensions ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Ventilation ; Quality of Life ; Registries ; Reproduction ; Schizophrenia ; Survivors

PURPOSE: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. METHODS: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. RESULTS: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (±14.90), 41.15 (±16.04), 53.44 (±24.67), and 54.33 (±22.80) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ≥70 years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ≥36.5℃ (OR 3.12, 95% CI: 1.17~8.17); age ≥70 years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ≥36.5℃ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. CONCLUSION: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.
Blood Pressure ; Body Mass Index ; Body Temperature ; Critical Care* ; Hospitals, Teaching ; Humans ; Hypoalbuminemia ; Intensive Care Units* ; Korea ; Logistic Models ; Lung Diseases ; Nursing Care ; Oxygen ; Pressure Ulcer ; Risk Factors ; Serum Albumin ; Skin

PURPOSE: We aimed to compare the clinical characteristics between neonates with persistent pulmonary hypertension of neonates (PPHN) with parenchymal lung disease (PLD) and those with idiopathic PPHN. METHODS: We reviewed the medical records of 67 neonates with gestational ages not lesser than 34⁺⁰ weeks who were born at Inje University Sanggye Paik Hospital between June 1, 2005 and December 31, 2016. We excluded 10 neonates who presented with congenital anomalies (n=3), dextrocardia (n=1), triple X syndrome (n=1), death before treatment (n=1), neonatal asphyxia (n=2), and congenital diaphragmatic hernia (n=2). Neonates were categorized into 2 groups—PPHN with PLD (PLD group, those diagnosed with PLD such as respiratory distress syndrome or meconium aspiration syndrome, n=36) and idiopathic PPHN (idiopathic group, n=21). We compared the clinical characteristics, treatment, and laboratory findings between the groups. RESULTS: The PLD group neonates showed a greater requirement for positive pressure ventilation in the delivery room, higher frequency of meconium staining of amniotic fluid, and greater need for surfactant application than those belonging to the idiopathic group. In contrast, epinephrine use was more common in the idiopathic PPHN group than in the PLD group. The 1-minute Apgar score and pH observed on initial capillary blood gas analysis were lower in the PLD than in the idiopathic group. Severity scores were higher in the idiopathic than in the PLD group 4–7 days after birth. CONCLUSION: In our study, an overall simplified severity score in the first week after birth was higher in the idiopathic than in the PLD group. These results were particularly statistically significant over postnatal days 4–7.
Amniotic Fluid ; Apgar Score ; Asphyxia ; Blood Gas Analysis ; Capillaries ; Delivery Rooms ; Dextrocardia ; Epinephrine ; Female ; Gestational Age ; Hernias, Diaphragmatic, Congenital ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Infant, Newborn* ; Lung Diseases* ; Lung* ; Meconium ; Meconium Aspiration Syndrome ; Medical Records ; Parturition ; Positive-Pressure Respiration

OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) is elevated in inflammatory diseases, but its clinical significance in systemic sclerosis (SSc) is unclear. This study evaluated NLR in diagnosing SSc and in predicting lung involvement such as interstitial lung disease (ILD). METHODS: The medical records of 88 patients with SSc and 50 healthy controls were reviewed. Exclusion criteria included active infection or the presence of any hematological, cardiovascular, or metabolic disorder. The NLR was compared between patients with SSc and healthy controls, and associations between NLR and lung involvement were analyzed. RESULTS: The NLR was significantly higher in patients with SSc compared to healthy controls (NLR, 3.95±6.59 vs. 2.00±1.07, p<0.01). Patients with SSc and ILD had higher NLR levels than those without ILD (p<0.01, p<0.05). NLR was negatively associated with forced vital capacity (r=−0.341, p<0.01), but not with diffusing capacity for carbon monoxide. Receiver-operating characteristics analysis of NLR to predict ILD in patients with SSc showed that the area under the curve was 0.763. The cut-off NLR value for prediction of lung involvement was determined to be 2.59 (sensitivity, 0.700; specificity, 0.729; p<0.01). CONCLUSION: NLR may be a promising marker that reflects ILD in patients with SSc, and values greater than 2.59 were useful in predicting ILD.
Blood Platelets ; Carbon Monoxide ; Diagnosis* ; Humans ; Lung ; Lung Diseases, Interstitial* ; Lymphocytes ; Medical Records ; Neutrophils ; Scleroderma, Systemic* ; Sensitivity and Specificity ; Vital Capacity

Interstitial lung disease (ILD) is a major cause of death in patients with dermatomyositis (DM). This study was aimed to examine the utility of the erythrocyte sedimentation rate (ESR) as a predictor of ILD and prognostic marker of mortality in patients with DM. One hundred-and-fourteen patients with DM were examined, including 28 with clinically amyopathic DM (CADM). A diagnosis of ILD was made based on high resolution computed tomography (HRCT) scans. The association between elevated ESR and pulmonary impairment and mortality was then examined. ILD was diagnosed in 53 (46.5%) of 114 DM patients. Cancer was diagnosed in 2 (3.8%) of 53 DM patients with ILD and in 24 (92.3%) of those without ILD (P < 0.001). The median ESR (50.0 mm/hour) in patients with ILD was significantly higher than that in patients without ILD (29.0 mm/hour; P < 0.001). ESR was inversely correlated with forced vital capacity (Spearman rho = - 0.303; P = 0.007) and carbon monoxide diffusing capacity (rho = - 0.319; P = 0.006). DM patients with baseline ESR > or = 30 mm/hour had significantly higher mortality than those with ESR < 30 mm/hour (P = 0.002, log-rank test). Patients with a persistently high ESR despite immunosuppressive therapy was associated with higher mortality than those with a normalized ESR (P = 0.039, log-rank test). Elevated ESR is associated with increased mortality in patients with DM due to respiratory failure. Thus, monitoring ESR should be an integral part of the clinical care of DM patients.
Adult ; Asian Continental Ancestry Group ; Blood Sedimentation ; Carbon Monoxide/metabolism ; Cohort Studies ; Dermatomyositis/blood/*diagnosis/mortality ; Disease Progression ; Erythrocytes/*cytology ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/therapeutic use ; Lung Diseases, Interstitial/*complications/diagnosis ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Republic of Korea ; Respiratory Function Tests ; Retrospective Studies ; Risk Factors ; Survival Analysis

BACKGROUNDImmunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic disease that can involve multiple organs and various clinical phenotypes. The purpose of this study was to analyze different types of organ involvement in IgG4-RD patients in China.

METHODSWe conducted a prospective cohort study on IgG4-RD patients to analyze the clinical manifestations and rare features of IgG4-RD. Patients were grouped into different types according to organ involvement regarding organ number and organ site. The constituent ratio in different types was also analyzed.

RESULTSA total of 200 IgG4-RD patients, with a male:female ratio of 2.08:1, were grouped into different types. Cases having involvement of two or three organs were the most common whereas the fewest number of patients had multi-organ (≥4) involvement. Serum IgG4 and IgE levels, IgG4/IgG ratio, and percentage of eosinophils increased as the number of involved organs increased. In addition, constituent ratio analysis revealed that patients with salivary gland/lacrimal gland swelling, who also constituted the largest number of IgG4-RD patients, had higher serum IgG4 concentrations and IgG4/IgG values, had higher percentage of Eos, and were more likely to have had a history of allergies relative to patients with internal organ involvement.

CONCLUSIONSThe characteristic feature of IgG4-RD is multiple organ involvement with various clinical manifestations and different types. Although serum IgG4 levels increased with the number of involved organs, serum IgG4 levels were higher for those patients with salivary gland/lacrimal gland swelling compared with those with internal organ involvement. Thus, valuable clues to the differential diagnosis of IgG4-RD could be obtained by examining the clinical patterns of organ involvement.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autoimmune Diseases ; complications ; pathology ; Eosinophils ; metabolism ; Female ; Humans ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Kidney ; pathology ; Lacrimal Apparatus ; pathology ; Lung ; pathology ; Male ; Middle Aged ; Pituitary Gland ; pathology ; Prospective Studies ; Prostate ; pathology ; Salivary Glands ; pathology ; Thyroid Gland ; pathology ; Uterus ; pathology ; Young Adult