Jae Hyun Jung

Metabolic syndrome: prevalence and risk factors in Korean gout patients.

Background/Aims We performed this study to investigate associations between metabolic syndrome, chronic kidney disease (CKD), and gout. Methods We reviewed the medical records of 151 patients with gout at the Department of Rheumatology in Korea University Ansan Hospital. The following measures were examined: waist circumference, blood pressure, alcohol consumption, and levels of triglyceride, high density lipoprotein cholesterol, fasting serum glucose, serum uric acid (SUA), creatinine, insulin, and C-peptide. We assessed metabolic syndrome by the homeostasis model assessment of insulin resistance (HOMA-IR) index and renal function by the Modification of Diet in Renal Disease equation; patients were classified according to World Health Organization Asia-Pacific obesity criteria. Results The prevalence of metabolic syndrome in gout patients (50.8%) was higher than in non-gout patients. The mean SUA level was significantly higher in gout patients with metabolic syndrome (9.13 ± 3.15 mg/dL) than in gout patients without metabolic syndrome (8.14 ± 2.07 mg/dL). The mean SUA level was also significantly higher in patients with gout and CKD (9.55 ± 2.86 mg/dL) than in patients with gout but no CKD (7.74 ± 2.27 mg/dL). In gout patients, HOMA-IR was positively correlated with waist circumference (r = 0.409, p = 0.001). Conclusions The prevalence of metabolic syndrome in patients with gout was 50.8%, which is higher than the prevalence in the general Korean population. Hyperuricemia in gout patients was correlated with metabolic syndrome and CKD. Insulin resistance may provide clues to better understand the relationship between metabolic syndrome, CKD, and gout.

Endovascular balloon angioplasty versus stenting in patients with Takayasu arteritis: A meta-analysis

Background: Symptomatic or significant vascular lesions of Takayasu arteritis (TA) need interventions. Although percutaneous transluminal angioplasty with balloon is a less invasive and safe method, stent implantation in TA can be an alternative option. However, superiority between balloon angioplasty and stenting in TA is not conclusive. Methods: A meta-analysis comparing balloon angioplasty and stenting outcomes was performed using the MEDLINE and EMBASE databases. Results: A total of 7 studies on 266 patients and 316 lesions were included. Balloon angioplasty was performed in 186 lesions and stenting in 130 lesions. There were no significant differences in the incidence of both restenosis and other complications between balloon angioplasty and stenting [odds ratio (OR) = 2.39, 95% confidence interval (CI) = 0.66–8.66, P = .18; OR = 1.80, 95% CI = 0.49–6.65, P = .38, respectively]. In the renal arteries, the risk of restenosis in stenting was significantly higher than that in balloon angioplasty (OR = 4.40, 95% CI = 2.14–9.02, P < .001). The clinical efficacy of improving renal hypertension between balloon angioplasty and stenting at the renal artery lesions was similar (OR = 0.65, 95% CI = 0.28–1.51, P = .31); however, acute vascular complications were significantly fewer in stenting than in balloon angioplasty (OR = 0.07, 95% CI = 0.02–0.29, P < .001). Conclusion: This meta-analysis found that balloon angioplasty can yield better results in renal artery interventions than stenting. Nonetheless, it is desirable to avoid vessel dissections during balloon angioplasty, which can eventually require stent implantations.

Association between osteoarthritis and mental health in a Korean population: a nationwide study

Osteoarthritis (OA) is a chronic disease and has become a major health problem in recent years. OA causes chronic pain and disability and can induce mental disorders such as stress perception, depression and suicidal ideation. We investigated the incidence of perceived stress, depressed mood and suicidal ideation in OA patients, using the 2010–2012 Korea National Health and Nutrition Examination Survey (KNHANES).

Association of factor XIII Val34Leu polymorphism and coronary artery disease: A meta-analysis

BACKGROUND Factor XIII plays an important role in the stabilization of the linkage between fibrins and in the pathophysiology of coronary artery disease (CAD). The association between factor XIII Val34Leu polymorphism and CAD risk remains controversial. METHODS We conducted a meta-analysis of 36 studies involving 26,940 cases and 34,694 controls. Subgroup analyses were performed with division of data into disease (myocardial infarction [MI], CAD without MI), age, and sex. RESULTS Factor XIII Val34Leu polymorphism was significantly associated with ove all CAD risk (odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.03-1.06, p = 0.004) and MI risk (OR = 1.15, 95% CI 1.07-1.25, p = 0.0003), but not with CAD without MI risk (OR = 1.00, 95% CI 0.87-1.15, p = 0.96). In the subgroup analysis by age and sex, there was no association between Val34Leu polymorphism and CAD. CONCLUSIONS This meta-analysis found that factor XIII Val34Leu polymorphism was associated with CAD risk, especially MI, but not with CAD without MI. In addition, age and sex did not affect the relationship between factor XIII Val34Leu polymorphism and CAD risk.

The Association between Osteoarthritis and Occupational Clusters in the Korean Population: A Nationwide Study

Osteoarthritis (OA) is a considerable health problem worldwide. It is known to be associated with certain occupational risk factors. We examined the prevalence rate of OA by occupational cluster. Data were collected from the Korea National Health and Nutrition Examination Surveys (2010–2013). The total number of unweighted sample size was 9,905 participants: 4,460 men and 5,445 women, and OA prevalence was 5.3% and 18.4% respectively. OA patients were defined as participants with knee/hip joint pain and radiographic change of knee/hip joint. Occupational type was classified as either white, pink, blue, or green collar based on the occupational characteristics following physical demand: white for manager and professionals; pink for clerks and service/sales workers; blue for craft/trade workers, machine operators and assemblers, and elementary manual workers; and green for agricultural/fishery workers. We calculated the odds ratios (ORs) and 95% confidence intervals (95% CI) for the odds of a participant’s having OA according to the occupational cluster, with gender stratification. The multiple logistic regression model showed that, compared to the white collar group, the ORs of the pink, blue, and green collar workers were 1.23 (95% CI 0.64–2.36), 1.85 (95% CI 1.18–2.88), and 2.91 (95% CI 1.86–4.54), respectively, in males, and 2.53 (95% CI 1.71–3.73), 2.86 (95% CI 1.94–4.21), and 3.90 (95% CI 2.60–5.83), respectively in females. The prevalence rate of OA was associated with the occupational cluster, in order from highest to lowest: green, blue, pink, and white collar.

Effects of Oral Contraceptives on Rheumatoid Arthritis in Korean Menopausal Women: A Nationwide Cross-Sectional Study

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease with a multifactorial etiology. The higher prevalence of RA in women than in men may originate from differences in sex hormone levels or types. Ethnicity may interact with hormonal factors to produce various observed differences in the prevalence of RA. Oral contraceptives (OCs) are a source of exogenous sex hormones and can affect the prevalence of RA. We investigated the effects of OCs on RA in Korean menopausal women using a national data set. Data were collected from a cross-sectional study of 8789 eligible participants who completed the 2008-2012 Korea National Health and Nutrition Examination Survey. To balance the distribution of baseline characteristics between those participants who had ever used OCs and those who had not, we employed propensity score matching to adjust for differences. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the effects of OCs on the incidence of RA. The development of RA in Korean women rapidly increased during the perimenopause. After propensity score matching, the use of OCs was associated with RA (OR 1.24, 95% CI 1.01-1.51, P = 0.04). However, hormone replacement therapy (HRT) was not associated with RA regardless of whether OCs had been used (OR 0.80, 95% CI 0.62-1.04, P = 0.09, and OR 1.00, 95% CI 0.66-1.52, P = 0.99, respectively). Our findings suggest that factors associated with sex hormones influence the prevalence of RA.

Erosive Arthritis Resembling Osteomyelitis In Behcet's Disease

Erosive arthritis in Behcets disease (BD) is rare and confused with infectious diseases such as osteomyelitis. Clinical course and imaging may be similar in BD-related arthritis and osteomyelitis. A 48-year woman diagnosed with BD developed recurrent pain in both feet. Magnetic resonance imaging of her feet showed bony erosions and suggested osteomyelitis with myositis or septic arthritis, but the response to antibiotics was equivocal. We diagnosed BD-related arthritis and started treatment with methotrexate, and increased azathioprine and sulfasalazine, and her joint symptoms improved. BD-related arthritis should be considered in the differential diagnosis of BD patients with articular manifestations that may mimic septic arthritis.

Association of the F13A1 Val34Leu polymorphism and recurrent pregnancy loss: A meta-analysis

OBJECTIVE Factor XIII (FXIII) plays role in stabilizing the linkage between fibrins during blood clotting and has been implicated in recurrent pregnancy loss (RPL). The relationship between the Val34Leu polymorphism in F13A1, which encodes the enzymatic subunit of FXIII, and RPL is unclear. The aim of this meta-analysis was to evaluate the association betweenF13A1 Val34Leu and the risk of RPL. STUDY DESIGN We performed a meta-analysis of 11 studies involving 1092 cases and 678 controls using published literature from PubMed and Embase. RESULTS We detected an association in recessive (Val/Val vs. Val/Leu+Leu/Leu; OR=0.71, 95% CI=0.51-0.99, P=0.04), and one of the two co-dominant (Val/Val vs. Val/Leu; OR=0.71, 95% CI=0.52-0.98, P=0.03) models of in heritance. Subgroup analysis revealed that the F13A1 Val34Leu polymorphism was associated with RPL in Asians (Val vs. Leu; OR=0.53, CI=0.33-0.85, P=0.01). However, there was no association between F13A1 Val34Leu and RPL in Europeans and South Americans. CONCLUSION Our meta-analysis supports an association between F13A1 Val34Leu and RPL.