The association between inflammatory bowel disease [IBD] and cancer remains poorly defined in Asian populations. Therefore, we conducted a nationwide population-based study to determine the cancer risk in Korean patients with IBD. Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD (5595 Crohn’s disease [CD] and 10 049 ulcerative colitis [UC]) from 2011 to 2014. Standardized incidence ratios [SIRs] of overall and site-specific cancers in IBD patients in comparison with the general population were calculated. The overall cancer risk was higher in CD patients [SIR, 2.2; 95% confidence interval, 1.5–3.0 in men and 3.3; 2.4–4.5 in women] and UC patients [1.9; 1.6–2.3 in men and 1.9; 1.5–2.4 in women]. There were significantly increased risks for the following cancers: small bowel cancer [31.2; 3.8–112.8], colorectal cancer [CRC] [3.7; 1.6–7.2] and haematological cancer [4.0; 1.1–10.3] in men with CD; small bowel cancer [61.1; 7.4–220.6], CRC [4.7; 1.5–10.9], liver cancer [15.3; 5.6–33.2], pancreatic cancer [8.6; 1.0–31.0] and haematological cancer [11.0; 3.6–25.7] in women with CD; CRC [2.1; 1.3–3.3] and cancer of the prostate [3.5; 2.1–5.5], brain/central nervous system [6.1; 1.3–17.9] and thyroid [2.2; 1.1–3.9] in men with UC; and CRC [3.0; 1.5–5.3], cancer of the liver [4.4; 1.6–9.7] and cervix uteri [5.7; 2.4–11.1], and haematological cancer [3.5; 1.1–8.1] in women with UC. Women with CD had an increased risk of non-Hodgkin lymphoma [NHL] and leukaemia. Women with UC had an increased risk of NHL. Korean patients with IBD are at increased risk for overall, intestinal and haematological cancer.

Recent studies suggest that handgrip strength is linked with cognitive impairment at older ages. However, it remains unclear as to whether muscular strength influences subsequent cognitive performance, or whether lower levels of cognitive function increase the likelihood of muscle strength decline. to investigate the directional relationship between handgrip strength and cognitive impairment using longitudinal data among older adults. repeated measures of handgrip strength and cognitive function were collected in a sample of 5,995 participants of the Korean Longitudinal Study of Aging (KLoSA) over a period of 8 years. Time-lagged general estimating equations, while accounting for correlation among repeated measures, was used to assess the temporal effect of handgrip strength on cognitive impairment and vice versa with adjustment for other confounding factors. after adjustment, greater handgrip strength was related to subsequent reduction in the risk of cognitive impairment, such that participants in the highest quartile presented approximately 50% decrease in their risk of cognitive impairment [adjusted odds ratio (OR) = 0.499 (95% CI 0.422 to 0.589] compared to the lowest quartile after controlling for potential confounding factors. Conversely, cognitive impairment was a significant predictor of reduced muscular strength [β regression coefficient -0.804, 95% CI, -1.168 to -0.439, for participants with dementia compared with those with normal cognitive function]. in conclusion, a significant bi-directional relationship was found between muscular strength and cognitive function, suggesting that these may have shared common pathways that are worthy of being further elucidated in future studies.

Objectives The work of public officers involves repeated and long-term exposure to heavy workloads, high job strain and workplace violence, all of which negatively impact physical and mental health. This study aimed to evaluate and compare the incidences of diseases among different categories of public officers in Korea, in order to further understand the health risks associated with these occupations. Design A cohort study using the National Health Insurance data. Participants We collated claims data between 2002 and 2014 for 860 221 public officers. Primary and secondary outcome measures Age-standardised rates were calculated using the direct standardisation method, and HRs were calculated using the Cox proportional hazard regression models. Results Overall, we found that police officers and firefighters had a higher incidence of a range of diseases when compared with national and regional government officers (NRG). The most prominent HRs were observed among police officers for angina pectoris (HR: 1.52, 95% CI 1.49 to 1.54), acute myocardial infarction (HR: 1.84, 95% CI 1.77 to 1.92) and cerebrovascular disease (HR: 1.36, 95% CI 1.31 to 1.40). Firefighters were more susceptible to physical ailments and were at a significantly higher risk for traumatic stress disorders (HR: 1.40, 95% CI 1.26 to 1.56) than NRGs. Conclusion Compared withNRGs, police officers had higher HRs for all measured diseases, except for traumatic stress disorders. While firefighters had higher HRs for almost all diseases examined, public education officers had a higher HR for traumatic stress disorders, when compared with NRGs.

OBJECTIVE Dipeptidyl peptidase 4 inhibitors (DPP-4i) are useful incretin-based antidiabetes drugs. However, there is a concern that DPP-4i may adversely impact the exocrine pancreas, owing to their pleiotropic effects. In this study, we investigated whether DPP-4i are associated with pancreatitis and pancreatic cancer using a nationwide population-based cohort study. RESEARCH DESIGN AND METHODS We included patients newly diagnosed with type 2 diabetes who were treated with antidiabetes drugs (n = 33,208) from 2007 to 2013. The data were obtained from the Korean National Health Insurance Service–Health Screening Cohort database (n = 514,866). Risk was estimated using a Cox proportional hazards model with time-dependent covariates. A 6-month lag time was used to account for a possible latency time. The risk across various time segments since the first prescription of DPP-4i was also analyzed. RESULTS Out of 33,208 subjects, 10,218 were new users of DPP-4i and 22,990 were new users of other antidiabetes drugs. DPP-4i significantly increased the risks of pancreatitis (adjusted hazard ratio [aHR] 1.24, 95% CI 1.01–1.52; P = 0.037) and pancreatic cancer (aHR 1.81, 95% CI 1.16–2.82; P = 0.009) with a 6-month drug use lag period. The risk of pancreatitis and pancreatic cancer was generally consistent in the first 12 months and 1 year after the initial prescription without showing an increasing trend according to exposure duration. CONCLUSIONS DPP-4i use is associated with increased risks of pancreatitis and pancreatic cancer in patients with newly diagnosed type 2 diabetes. However, the absence of increasing trend according to exposure duration suggests the chances of reverse causality, and long-term pancreatic safety of DPP-4i has to be further investigated.