Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults. This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance. E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=3.95; never: mean=9.18; P<0.001). The e-cigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03-1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03-2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14-12.30). Our findings suggest that e-cigarette use is significantly associated with insulin resistance.

Background: Caffeine, a widely consumed stimulant, affects sleep and mental health. Shift work disrupts the circadian rhythm and has been associated with various mental health issues, such as depression, anxiety, and suicidal ideation. Objective: This study explored the associations between caffeine consumption, sleep duration, and mental health outcomes, particularly suicidal ideation, among shift workers in Korea. Methods: Data from the 6th Korea National Health and Nutrition Examination Survey (2013, 2015), which comprised 4723 adults aged 19 and older, were analyzed. Participants were categorized into groups based on average daily coffee consumption and work patterns. Multiple logistic regression analyses were conducted to determine the impact of caffeine consumption and work patterns on mental health outcomes. Results: Participants worked longer hours, reported higher perceived stress levels, and slightly decreased sleep duration as daily coffee consumption increased. However, no significant differences were observed in depression or suicidal ideation across the coffee consumption groups. Logistic regression analysis indicated a trend towards higher suicidal ideation risk with increased coffee intake, particularly among those who consumed three or more cups per day (OR 5.67, 95% CI 1.82–17.59). Conclusion: This study suggests a complex relationship between caffeine consumption, work patterns, and mental health outcomes. Although caffeine intake is associated with increased work hours and stress, its impact on suicidal ideation is influenced by occupational factors.

Patients with irritable bowel syndrome (IBS) are at increased risk of osteoporosis and osteoporotic fracture. This study investigated whether IBS medication attenuated the rate of osteoporosis and osteoporotic fracture risk. We conducted a retrospective large-scale multicenter study across eight hospital databases encoded in the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). The primary outcome was the incidence of osteoporosis, whereas secondary outcomes were osteoporotic fractures. After 1:4 matching, 24,723 IBS patients, 78,318 non-IBS patients, 427,640 non-IBS patients with IBS medication, and 827,954 non-IBS patients without IBS medication were selected. The risk of osteoporosis was significantly increased in the IBS group compared to the non-IBS group (hazard ratio (HR) 1.33; confidence interval (CI) 1.17~1.51). Even in patients who were not diagnosed with IBS, the risk of osteoporosis was significantly increased in those with IBS medication compared to those without (HR 1.77, CI 1.62~1.93). The risk of osteoporotic fracture was significantly increased in the IBS medication group (HR 1.69, CI 1.55~1.84). Patients exposed to IBS treatment even without IBS diagnosis were at increased risk of osteoporosis and osteoporotic fracture. Early diagnosis and treatment of osteoporosis should be considered in patients who have received medication for IBS symptoms.

Gyu Lee Kim, M.D., Seung Hun Lee, M.D., Ph.D., Yun Jin Kim, M.D., Ph.D., Jeong Gyu Lee, M.D., Ph.D., Yu Hyeon Yi, M.D., Ph.D., Young Jin Tak, M.D., Ph.D., Young Jin Ra, M.D., Sang Yeoup Lee, M.D., Ph.D., Young Hye Cho, M.D., Ph.D., Eun Ju Park, M.D., Young In Lee, M.D., Jung In Choi, M.D., Sae Rom Lee, M.D., Ryuk Jun Kwon, M.D. and Soo Min Son, M.D.. J Hosp Palliat Care 2023;26:60-8. https://doi.org/10.14475/jhpc.2023.26.2.60

Elevated uric acid levels are linked with obesity and diabetes. Existing research mainly examines the relationship between sugar-sweetened carbonated beverage (SSB) consumption and uric acid levels. This study explored the association between the quantity and frequency of SSB consumption and elevated uric acid levels in Korean adults. Data from 2881 participants aged 19–64 years (1066 men and 1815 women) in the 2016 Korea National Health and Nutrition Examination Survey were analyzed. Serum uric acid levels were categorized into quartiles, with the highest defined as high uric acid (men, ≥6.7 mg/dL; women, ≥4.8 mg/dL). SSB consumption was classified into quartiles (almost never, <1 cup (<200 mL), 1–3 cups (200–600 mL), ≥3 cups (≥600 mL)) and frequency into tertiles (almost never, ≤1/week, ≥2/week). Multivariate logistic regression assessed the association, with separate analyses for men and women. Increased daily SSB consumption and frequency were significantly associated with high uric acid levels in men but not in women. After adjusting for sociodemographic and health characteristics, consuming ≥3 cups (≥600 mL) of SSBs per day and SSBs ≥ 2/week were significantly associated with high serum uric acid levels in men, but this association was not observed in women. The study concludes that increased SSB intake is linked to elevated uric acid levels in Korean men, but not in women.