Jung-sun Lim, Seonghye Kim, In Young Cho, Dong Wook Shin. J Obes Metab Syndr -0001;0:0-. https://doi.org/10.7570/jomes25088

Purpose: The factors associated with the dietary supplement (DS) use of Asian breast cancer survivors in consideration of the duration of use and types of DS have not been well established. Methods: We recruited 693 Korean female breast cancer survivors at two university-affiliated hospitals and collected study data through a self-administered questionnaire and a review of medical records. A multiple logistic regression analysis was conducted to evaluate the multivariable-adjusted association between DS use and study variables. Results: The prevalence of any (≥2 weeks) and long-term (≥6 months) DS use among study participants was 48.2% and 12.0%, respectively. Education level, alcohol use, adequate physical activity (≥150 min/week), and time lapse after cancer diagnosis were positively associated with any DS use. Among DS users, as compared with short-term (≥2 weeks and <6 months) users, long-term users were more likely to have a higher cancer stage, more diverse cancer treatment modalities, a shorter time since cancer diagnosis, and lower fear of cancer recurrence. When we repeated the analysis for each DS type, time lapse after cancer diagnosis showed a consistently inverse association with long-term use of the most frequently consumed DS (multivitamins, followed by vitamin D/calcium, vitamin C, and omega-3). The number of cancer treatment modalities was positively associated with the long-term use of multivitamins and vitamin D/calcium. Alcohol consumption and low bone mineral density were positively associated with long-term vitamin D/calcium use. Conclusions: The factors associated with DS use differed by the duration of DS use and specific DS type. Long-term DS use was more frequently associated with cancer-related factors.

Objectives: Estimating the risk of diabetes mellitus (DM) is important for the proper management of patients with spinal cord injury (SCI). We investigated the short-term and long-term risks of DM among patients with SCI, according to the presence or severity of post-SCI disability and the level of injury. Methods: We conducted a retrospective cohort study using the Korean National Health Insurance Service (2010–2018) database. After matching by age and sex, 6129 SCI patients and 22,979 controls were included. The primary outcome was incident DM, and risk was evaluated for both the short term (within 1 year after SCI) and the long term (after 1 year of SCI diagnosis). Results: The risk of DM was higher among patients with cervical- and thoracic-level SCI accompanied by disability compared to the controls during follow-up (4.6 ± 2.6 years). The short-term risk of DM was higher among patients with SCI (odds ratio [OR] 2.51, 95% confidence interval [CI] 1.91–3.27) than among the controls and it was even higher among patients with severe disability (OR 5.38, 95% CI 2.91–9.27). According to the level of injury, patients with cervical SCI had the highest short-term risk of DM (with disability, OR 4.93, 95% CI 3.07–7.63). There was no significant increase of DM risk in the long term, after 1 year of SCI diagnosis. Conclusions: Patients with SCI accompanied by severe disability and cervical-level injury had higher risks of pronounced DM in the short term. The findings of this study emphasize the need for active surveillance of DM among patients with high-level SCI and disability, especially in the short term, in addition to continuous monitoring and proper management of DM in the long term.

We investigated the risk of MI by RA status and seropositivity and performed exploratory analysis of biologic DMARD (bDMARD) and targeted synthetic DMARD (tsDMARD) use. This retrospective cohort study used the Korean National Health Insurance System database. Patients aged ≥ 40 years newly diagnosed with RA (n = 36,377) were matched 1:3 with non-RA controls (n = 109,131). Fine and Gray subdistribution hazard models estimated subdistribution hazard ratios (sHR) for MI risk by RA status, seropositivity, bDMARD, and tsDMARD use. During a mean follow-up of 5.6 ± 2.3 years, 1201 MI events in non-RA, 738 in RA, 186 in seronegative RA (SNRA), 552 in seropositive RA (SPRA), 64 with bDMARD use, and 4 with tsDMARD use were identified. Patients with RA had a 1.8-fold increased MI risk compared to non-RA (sHR: 1.84, 95% CI: 1.67-2.01). SNRA and SPRA showed similar risks (sHR: 1.74, 95% CI: 1.49-2.04, and sHR: 1.87, 95% CI: 1.69-2.07, respectively). MI risk remained elevated both with and without bDMARD use (sHR: 2.34, 95% CI: 2.05-2.67; sHR: 1.81, 95% CI: 1.72-1.91, respectively). Non-use of tsDMARDs was associated with increased MI risk (sHR: 1.86, 95% CI: 1.77-1.96), whereas tsDMARD use was not significantly associated with MI (sHR: 1.43, 95% CI: 0.90-2.28). RA was associated with increased MI risk irrespective of seropositivity status. Exploratory analyses suggested that tsDMARD users did not exhibit increased MI risk, although the small number of events warrants large-scale prospective studies.