Background: The association between low serum testosterone levels, visceral adipose tissue (VAT), and metabolic syndrome is now well known. However, the relationship between hepatic steatosis and serum testosterone levels has not been extensively studied. Our aim was to investigate the association of serum total testosterone levels with nonalcoholic fatty liver disease (NAFLD), adjusting for the influence of VAT and insulin resistance. Methods: This study is a retrospective observational cross-sectional one of healthy Korean men and was conducted at the Seoul National University Hospital Healthcare System Gangnam Center. We used data obtained from 495 men who were at least 20 years of age and who had undergone blood testing, abdominal computed tomography, and ultrasonography. Multiple logistic regression analysis was used to explore the association of serum total testosterone levels with NAFLD. Results: Men in the low serum testosterone quintile were at a higher risk for NAFLD than men in the highest serum testosterone quintile. After adjusting for age, smoking, diabetes, exercise, BMI, triglycerides, and high-density-lipoprotein cholesterol, subjects with serum testosterone levels in the lowest quintile had an odds ratio (OR) (95% confidence interval (CI)) of 5.12 (2.43–10.77) for NAFLD (p value, 0.0004). The inverse association between serum testosterone and NAFLD was attenuated by further adjustment for variables including VAT; however, it remained statistically significant (OR (95% CI): 4.52 (2.09–9.80) in the lowest quintile; p value=0.004). Conclusions: A low serum total testosterone level was independently associated with NAFLD. This report is the first one suggesting the association remains unchanged even after controlling for VAT and insulin resistance.

Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Owing to advertisements stating that HTPs are odorless, tar-free, and less harmful to health, the sales of HTPs have grown quickly enough to account for about 10% of the total tobacco market in a year. HTP use by young, highly educated, and high-income groups had a significant impact on both the overall tobacco market over the past 3 years and the smoking and quitting behaviors of smokers. Based on national smoking rate statistics, tobacco sales trends, and the number of visitors to smoking cessation clinics, the following changes have been identified: (1) The decline in current smoking rates has slowed or rose in some groups. (2) The decline in total cigarette sales has slowed but rose again in the first quarter of 2020. (3) The number of visitors to smoking cessation clinics decreased just after the advent of HTPs. These results may be due to the insufficient support of tobacco regulation policies but also coincide chronologically with the appearance of HTPs in South Korea. It is necessary to investigate the usage rate of various tobacco products, including HTPs and e-cigarettes, to examine the health risks of novel tobacco products and provide accurate information to users and policymakers. Finally, tobacco companies are continuously developing new product concepts to escape the regulation of existing cigarettes; thus, comprehensive management measures for all nicotine-containing products are needed.

Background: Many people use apps for smoking cessation, and the effectiveness of these apps has been proven in several studies. However, no study has classified these apps and only few studies have analyzed the characteristics of these apps that influence their quality. Objective: The purpose of this study was to analyze the content and the quality of smoking cessation apps by type and identify the characteristics that affect their overall quality. Methods: Two app marketplaces (App Store and Google Play) were searched in January 2018, and the search was completed by May 2020. The search terms used were “stop smoking,” “quit smoking,” and “smoking cessation.” The apps were categorized into 3 types (combined, multifunctional, and informational). The tailored guideline of Clinical Practice Guideline for Treating Tobacco Use and Dependence was utilized for evaluating app content (or functions), and the Mobile App Rating Scale (MARS) was used to evaluate the quality. Chi-square test was performed for the general characteristics, and one-way analysis of variance was performed for MARS analysis. To identify the general features of the apps that could be associated with the MARS and content scores, multiple regression analysis was done. All analyses were performed using SAS software (ver. 9.3). Results: Among 1543 apps, 104 apps met the selection criteria of this study. These 104 apps were categorized as combined type (n=44), functional type (n=31), or informational type (n=29). A large amount of content specified in the guideline was included in the apps, most notably in the combined type, followed by the multifunctional and informational type; the MARS scores followed the same order (3.64, 3.26, and 3.0, respectively). Regression analysis showed that the sector in which the developer was situated and the feedback channel with the developer had a significant impact on both the content and MARS scores. In addition, problematic apps such as those made by unknown developers or copied and single-function apps were shown to have a large market share. Conclusions: This study is the first to evaluate the content and quality of smoking cessation apps by classification. The combined type had higher-quality content and functionality than other app types. The app developer type and feedback channel with the app developer had a significant impact on the overall quality of the apps. In addition, problematic apps and single-function apps were shown to have a large market share. Our results will contribute to the use and development of better smoking cessation apps after considering the problems identified in this study.

Lee C, et al. J Korean Med Assoc. 2018 Mar;61(3):181-190. https://doi.org/10.5124/jkma.2018.61.3.181

Korean Circulation Journal 대한심장학회지 순환기 Kim CY, et al. Korean Circ J. 2022 Nov;53:e1. https://doi.org/10.4070/kcj.2022.0179