Background
Smoking is a global health risk known to elevate hemoglobin (HB) levels through its effects on hematopoiesis. Urine cotinine, a metabolite strongly correlated with serum cotinine, serves as an effective biomarker for assessing smoking status. This study aimed to explore the relationship between urinary cotinine levels and both HB and hematocrit (HCT) levels in a Korean population.
Methods
The study analyzed 4,454 healthy participants, categorized into three groups based on urine cotinine tertiles. Steiger’s Z tests were used to assess correlations between HB, HCT levels, and urine cotinine. After adjusting for clinical variables, multiple linear regression was employed to evaluate the relationship between urine cotinine levels and HB/HCT. Receiver operating characteristic curves helped determine the cut-off values for urine cotinine in relation to HB and HCT levels.
Results
After adjusting for covariates, a positive correlation was found between urine cotinine and both HB and HCT levels. HB levels were 18% higher in the second tertile and 23% higher in the highest tertile than the lowest. Similarly, HCT levels increased by 44% in the second tertile and 50% in the highest tertile. The highest tertiles of HB and HCT had values of 504.650 and 202.950, respectively, with area under the curve values of 0.634 for HB and 0.616 for HCT.
Conclusion
This study demonstrates a significant correlation between urine cotinine levels and elevated HB and HCT levels in a representative Korean population. Clinicians should consider urine cotinine levels when assessing anemia in smokers or individuals exposed to secondhand smoke. Further research is needed to validate these findings.

Background
Insulin resistance (IR) influences lipid metabolism, particularly small dense low-density lipoprotein cholesterol (sdLDL-C), a key feature of diabetic dyslipidemia and a predictor of cardiovascular disease. The single-point insulin sensitivity estimator (SPISE) index is an effective tool for assessing IR. This study explored the relationship between the SPISE index and average low-density lipoprotein cholesterol (LDL-C) particle size in obese Korean adults.
Methods
Cardiovascular risk was assessed in 161 obese individuals. The participants were divided into three groups based on SPISE index tertiles. Steiger’s Z test was used to assess the differences in correlation coefficients among various IR indices and average LDL-C particle size. Multivariate linear regression models were used to determine the independent association between the SPISE index and average LDL-C particle size. Receiver operating characteristic (ROC) curves established the SPISE index cut-off for sdLDL-C particle dominance.
Results
The SPISE index was positively correlated with mean LDL-C particle size after adjusting for confounders. It demonstrated a stronger independent association with average LDL-C particle size (r=0.679, P<0.001) than with fasting insulin, the homeostatic model assessment for IR, and the quantitative insulin sensitivity check index (P<0.001 for all). ROC analysis identified an optimal SPISE index cutoff for sdLDL-C predominance of 4.955, with an area under the curve of 0.745.
Conclusion
Our findings indicate a direct correlation between the SPISE index and average LDL-C particle size, suggesting that the SPISE index may complement labor-intensive IR indices and sdLDL-C measurement techniques for estimating IR-induced sdLDL-C predominance.

Citations

• Association between the single-point insulin sensitivity estimator and cardiovascular disease incidence: A prospective nationwide cohort study involving two cohorts
  Xiaotong Yao, Lina Liu, Lifen Zhao, Nianzhu Zhang
  Atherosclerosis.2026; 412: 120591.     CrossRef

Background
In patients with breast cancer, a healthy diet can help reduce breast cancer-specific recurrence, mortality, and comorbid chronic disease rates. There have been few studies on dietary habits immediately after breast cancer diagnosis, especially those involving the Asian population. Therefore, this study aimed to compare the nutritional habits of newly diagnosed patients with breast cancer and the general population without cancer in Korea using propensity score (PS) matching.
Methods
We conducted a case-controlled study of 157 patients with breast cancer and 2,363 cancer-free control participants from the Korea National Health and Nutrition Examination Survey. The PS values for the predicted probability of patients with breast cancer and the general population were estimated using logistic regression analysis, including age and body mass index. The dietary patterns were assessed using a 24-hour recall of 1 day and the Food Frequency Questionnaire.
Results
PS matching showed that patients with breast cancer consumed fewer calories and carbohydrates; however, they consumed more protein and fat compared to the general population. Compared to the general population, patients with breast cancer consumed more healthy foods such as fish, seaweed, vegetables, fruit, mixed-grain rice, and nuts; however, they also consumed more soup, stew, and red meat.
Conclusion
Newly diagnosed patients with breast cancer have some healthy dietary habits compared to the general population. However, there is considerable room for improvement in their diet quality. Our results support the need to develop tailored dietary recommendations for patients with breast cancer during the diagnostic and posttreatment periods to improve their diet quality.

Citations

• Factors Influencing the Relationship Between Sugar Consumption and Depression Among Women Under Breast Cancer Treatment
  Yu-Chen Liu, Wen-Hung Kuo, Chiao Lo, Chiun-Sheng Huang, Meei-Shyuan Lee, Jen-Ho Chang, Chia-Chen Hsieh, Fei-Hsiu Hsiao
  Behavioral Sciences.2025; 15(7): 940.     CrossRef

Background
The International Classification of Primary Care-2 (ICPC-2) is a classification method designed for primary care. Although previous studies have found that ICPC-2 is a useful tool for demonstrating the relationship between patients’ expectations and health providers’ diagnoses, its utility of ICPC-2 has yet to be fully studied in Korea. This study aimed to evaluate the practicality of ICPC-2 in Korean primary care.
Methods
The study was conducted at primary care clinics in Seoul and Gyeonggi areas from October to November 2015. Third-year family medicine residents examined and analyzed the medical records of patients who visited primary care physicians using ICPC-2, and the results were compared with those obtained using the International Classification of Diseases-10 (ICD-10) (Korean version: Korean Standard Classification of Diseases-7).
Results
A total of 26 primary care physicians from 23 primary care clinics participated in the study. Furthermore, 2,458 ICD-10 codes and 6,091 ICPC-2 codes were recorded from the data of 1,099 patients. The common disease codes were vasomotor and allergic rhinitis (J30), according to ICD-10, and acute upper respiratory infection (R74) in ICPC-2. Comparing disease status by body systems, the proportion of gastrointestinal disease with ICD-10 codes was significantly higher than that with ICPC-2 codes (P<0.001). Furthermore, patients with >4 diagnoses accounted for 36% of the ICD-10 classifications, whereas those with >4 diagnoses accounted for 4% of the ICPC-2 classifications.
Conclusion
Introducing ICPC as a complementary means for diagnosing common diseases could be a practical approach in Korean primary care.

Citations

• Evaluation of Diagnoses According to ICD‐10 and ICPC‐2 in Family Medicine Practice: A Retrospective Study
  Olgun Göktaş, Marta Laranjo
  International Journal of Clinical Practice.2025;[Epub]     CrossRef

Background
The association between serum cholesterol levels and depression has been studied extensively; however, results are inconsistent. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and depressive symptoms among Korean adults.
Methods
This cross-sectional study used data obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey. In total, 40,904 adults were included in the final analysis. Participants were categorized into five groups according to their LDL-C levels, using the Korean guidelines for dyslipidemia. Symptoms of depression were evaluated using a self-reported questionnaire. Weighted logistic regression was used to examine the relationship between LDL-C levels and self-reported depressive symptoms.
Results
Compared with the intermediate category, the lowest (<70 mg/dL) and highest (≥160 mg/dL) LDL-C categories were associated with depressive symptoms, after adjusting for potential confounding factors (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.008–1.409; OR, 1.241; 95% CI, 1.073–1.435, respectively). The highest LDL-C category was positively associated with depressive symptoms in those who were middle-aged, female, had a low body mass index, and taking or not taking dyslipidemia medications.
Conclusion
A U-shaped association was identified between LDL-C categories and self-reported depressive symptoms. Our findings suggest that LDL-C levels that are too low or too high are associated with self-reported depressive symptoms. Further prospective studies are needed to determine the causal relationship of this association.

Citations

• Diabetes Is Positively Associated With High Risk of Depression in Korean Cervical Cancer Patients: Korean National Health and Nutrition Examination Survey 2010–2021
  Seon-Mi Lee, Daun Shin, Aeran Seol, Sanghoon Lee, Hyun-Woong Cho, Kyung-Jin Min, Jin-Hwa Hong, Jae-Kwan Lee, Nak-Woo Lee, Jae-Yun Song, Won Jun Choi
  Psychiatry Investigation.2025; 22(1): 57.     CrossRef
• Associations of uric acid and lipids with depression, dimensions of depression and anxiety symptoms
  Kyriakos Kintzoglanakis, Pavlos Kolias, Leonidas Pavlou-Skantzis, Panagiota Ntamka, Anastasios Malles, Ioannis Georgantzinos, Anastasia Vasiliki Tzina, Tatiana Themeli, Dimitrios S. Karagiannakis
  Discover Mental Health.2025;[Epub]     CrossRef
• Causal relationship between depression and hypercholesterolemia: A bidirectional 2-sample Mendelian randomization study
  Zhen Zhang, Yongyan Song
  Medicine.2024; 103(21): e38234.     CrossRef
• Factor Structures in the Depressive Symptoms Domains in the 9Q for Northern Thai Adults and Their Association with Chronic Diseases
  Suttipong Kawilapat, Patrinee Traisathit, Narong Maneeton, Sukon Prasitwattanaseree, Thoranin Kongsuk, Suwanna Arunpongpaisal, Jintana Leejongpermpoon, Supattra Sukhawaha, Benchalak Maneeton
  Behavioral Sciences.2024; 14(7): 577.     CrossRef

Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.

Citations

• Effect of a wearable-sensor-assisted multicomponent exercise program on physical fitness, cognition and quality of life in frail older adults
  Genghong Tu, Lining Liu, Huiyi Tang, Weizhong Chen, Bagen Liao
  Translational Exercise Biomedicine.2025; 2(3): 201.     CrossRef
• Frailty assessment utilization around the globe–a systematic review
  Samantha Gaston, Elle Billman, Lichy Han, David Drover
  The Journal of Frailty & Aging.2025; 14(6): 100088.     CrossRef
• Summary of best evidence for prevention and management of frailty
  Yinning Guo, Xueyi Miao, Jieman Hu, Li Chen, Yimeng Chen, Kang Zhao, Ting Xu, Xiaoman Jiang, Hanfei Zhu, Xinyi Xu, Qin Xu
  Age and Ageing.2024;[Epub]     CrossRef
• Frailty: Assessment and Intervention
  Hana Moon, Geon Ho Lee, DaeHyun Kim
  Keimyung Medical Journal.2024; 43(2): 100.     CrossRef
• Clinical practice guidelines for frailty vary in quality but guide primary health care: a systematic review
  Huaxin Si, Jiaqi Yu, Qinqin Liu, Yanyan Li, Yaru Jin, Yanhui Bian, Xiaoxia Qiao, Wenyu Wang, Lili Ji, Yan Wang, Jian Du, Cuili Wang
  Journal of Clinical Epidemiology.2023; 161: 28.     CrossRef
• Yaşlılarda Kırılganlığın Önlenmesi ve Yönetiminde Kanıta Dayalı Yaklaşımlar
  Ayşe Buket DOĞAN, Özlem CANBOLAT
  Sağlık Bilimlerinde Değer.2023; 13(3): 501.     CrossRef
• Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults
  Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han
  Epidemiology and Health.2023; 46: e2024008.     CrossRef
• Up-to-date knowledge of frailty
  Chang Won Won
  Journal of the Korean Medical Association.2022; 65(2): 108.     CrossRef
• Current status of nutrient intake in Korea: focused on macronutrients
  Seung-Won Oh
  Journal of the Korean Medical Association.2022; 65(12): 801.     CrossRef

Citations

• Serum uric acid: an independent risk factor for cardiovascular disease in Pakistani Punjabi patients
  Misbah Hussain, Muhammad Umer Ghori, Muhammad Naeem Aslam, Shahid Abbas, Muhammad Shafique, Fazli Rabbi Awan
  BMC Cardiovascular Disorders.2024;[Epub]     CrossRef
• U-shaped association of uric acid to overall-cause mortality and its impact on clinical management of hyperuricemia
  William T. Crawley, Cyprien G. Jungels, Kurt R. Stenmark, Mehdi A. Fini
  Redox Biology.2022; 51: 102271.     CrossRef
• U-shaped relationship between serum uric acid level and decline in renal function during a 10-year period in female subjects: BOREAS-CKD2
  Kazuma Mori, Masato Furuhashi, Marenao Tanaka, Keita Numata, Takashi Hisasue, Nagisa Hanawa, Masayuki Koyama, Arata Osanami, Yukimura Higashiura, Masafumi Inyaku, Megumi Matsumoto, Norihito Moniwa, Hirofumi Ohnishi, Tetsuji Miura
  Hypertension Research.2021; 44(1): 107.     CrossRef
• Association between uric acid and pulse wave velocity in hypertensive patients and in the general population: a systematic review and meta-analysis
  Paola Rebora, Anita Andreano, Nicola Triglione, Enrico Piccinelli, Matteo Palazzini, Lucia Occhi, Guido Grassi, Maria Grazia Valsecchi, Cristina Giannattasio, Alessandro Maloberti
  Blood Pressure.2020; 29(4): 220.     CrossRef

Citations

• Resource-based theory perspective in the textile industry: The impact of the digital supply chain on operational performance
  Feng Men, Rana Muhammad Shahid Yaqub, Rui Yan, Muhammad Irfan, Misal e Fatima
  Frontiers in Environmental Science.2022;[Epub]     CrossRef
• Association between levels of thiamine intake, diabetes, cardiovascular diseases and depression in Korea: a national cross-sectional study
  Hai Nguyen Duc, Hojin Oh, In Mo Yoon, Min-Sun Kim
  Journal of Nutritional Science.2021;[Epub]     CrossRef
• Interrelationships between obesity, blood pressure and metabolic profile in climacteric women
  Vivianne Margareth Chaves Pereira REIS, Rafael Silveira FREIRE, Maria Fernanda Santos Figueiredo BRITO, Lucinéia de PINHO, Josiane Santos Brant ROCHA, Marise Fagundes SILVEIRA
  Revista de Nutrição.2021;[Epub]     CrossRef
• Eating behavior and metabolic syndrome over time
  Yun-Mi Song, Kayoung Lee
  Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity.2020; 25(3): 545.     CrossRef
• Risk factors for disordered weight control behaviors among Korean adolescents: Multilevel analysis of the Korea Youth Risk Behavior Survey
  Yongjoo Kim, S. Bryn Austin, S.V. Subramanian, Jennifer J. Thomas, Kamryn T. Eddy, Debra L. Franko, Rachel F. Rodgers, Ichiro Kawachi
  International Journal of Eating Disorders.2018; 51(2): 124.     CrossRef