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Continuity of care for patients with hypertension or diabetes mellitus reduced medical utilization, total medical costs, and cardiovascular events based on the Korean NHIS-HEALS cohort

2026-05-12T08:35:42Z

Title: Continuity of care for patients with hypertension or diabetes mellitus reduced medical utilization, total medical costs, and cardiovascular events based on the Korean NHIS-HEALS cohort Authors: Yun, Eun-Kyeong; Shim, Jae Yong; Shin, Sang-Jun; Kang, Hee-Taik Abstract: Background and aim: Continuous care of chronic diseases can improve the efficiency of medical system. This study aims to investigate whether continuity of care (CoC) for hypertension or diabetes mellitus (DM) improves medical utilization, costs, and health outcomes, including cardiovascular diseases (CVDs). Methods and results: For this study, 14,246 hypertensive and 9382 diabetic patients aged 60 years or older from the Korean NHIS-HEALS cohort were included. CoC was categorized into three tertiles by disease and sex. Medical utilization and costs were compared using negative binomial regression models and Gamma regression models after adjusting for potential confounders. Cox proportional hazards regression models were constructed to examine the association between the CoC index and the health outcomes (all-cause mortality, CVDs, ischemic heart diseases [IHDs], and cerebrovascular diseases [CbVDs]). In hypertensive patients, hospitalizations decreased across both sexes and emergency room (ER) visits decreased for females with increasing CoC index. Likewise, hospitalizations and medical costs related to DM decreased with increasing CoC index for both sexes. Clinic visits for DM were lowest in T3 group for both sexes. Higher CoC was associated with a lower risk of CVDs, including IHDs and CbVDs, in patients with hypertension or diabetes, as well as with all-cause mortality in patients with diabetes in the fully adjusted model. Conclusions: Continuous care for hypertension or diabetes was inversely associated with medical utilization in patients with hypertension or DM, as well as with medical costs in patients with DM. In addition, CoC decreased CVDs in patients with hypertension or diabetes and reduced all-cause mortality in patients with diabetes.

Diabetes-dependent association between metabolic score for visceral fat and chronic kidney disease: findings from a longitudinal cohort study

2026-06-12T08:06:50Z

Title: Diabetes-dependent association between metabolic score for visceral fat and chronic kidney disease: findings from a longitudinal cohort study Authors: Kwon, Yu-Jin; Song, Youhyun; Lee, Ji-Won; Heo, Seok-Jae; Lee, Jung Eun Abstract: Aims: Metabolic dysfunction drives chronic kidney disease (CKD). Although the metabolic score for visceral fat (METS-VF) emerged as a novel marker of cardiometabolic health, its association with CKD remains unclear. We investigated the association between METS-VF and incident CKD and determined whether this relationship varies according to diabetes status. Methods: This longitudinal study analyzed data from 8,092 participants in the Korean Genome and Epidemiology Study. METS-VF was categorized into quartiles. Hazard ratios (HRs) for CKD development were estimated using Cox proportional hazards model and underwent multivariate adjustment. Results: During a mean follow-up of 12.8 years, 2,202 incident CKD cases were identified. Compared to Q1, Q4 was associated with an increased CKD risk in the unadjusted model (HR: 2.941; 95% CI: 2.591-3.339; P < 0.001) which persisted after multivariate adjustment (adjusted HR: 1.373; 95% CI: 1.201-1.571; P < 0.001). Subgroup analyses revealed the association between METS-VF and incident CKD was significant only in individuals with normoglycemia. Conclusions: Higher METS-VF was associated with increased risk of CKD development; however, it was confined to individuals with normal glucose tolerance. This suggests METS-VF may serve as an exploratory marker for stratified risk assessment for early CKD risk before the onset of glucose dysregulation, emphasizing the critical window for early metabolic intervention.

Association of hemoglobin levels with metabolic syndrome and its components in older korean males: A nationwide population-based cross-sectional study

2026-07-13T02:06:57Z

Title: Association of hemoglobin levels with metabolic syndrome and its components in older korean males: A nationwide population-based cross-sectional study Authors: Park, Jae-Min Abstract: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities associated with an increased risk of cardiovascular disease, type 2 diabetes mellitus, and mortality. Hemoglobin levels have been suggested to be associated with metabolic disorders and cardiometabolic risk factors; however, evidence regarding their relationship with MetS remains inconsistent, particularly in older populations. This study aimed to investigate the association between hemoglobin levels, MetS, and its components in older Korean males. This study analyzed data from the sixth Korea National Health and Nutrition Examination Survey (2013-2015). A total of 1680 men aged >= 60 years with normal hemoglobin levels (13-17 g/dL) were included, after excluding participants with cancer, chronic kidney disease, insufficient fasting time, or missing data. Participants were categorized into tertiles according to their hemoglobin levels. MetS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III criteria with Korean-specific waist circumference cutoffs, as the presence of at least 3 of the following components: abdominal obesity, elevated blood pressure, high fasting plasma glucose, high triglyceride levels, and low high-density lipoprotein cholesterol. Weighted logistic regression analyses were performed to evaluate the associations between hemoglobin tertiles and MetS and its components. The prevalence of MetS increased across hemoglobin tertiles (33.8%, 38.3%, and 48.8%, respectively). Participants in the highest tertile had significantly higher odds of having MetS (adjusted odds ratio [OR], 1.78; 95% confidence interval [CI], 1.28-2.47). Higher hemoglobin levels were also associated with abdominal obesity (OR, 2.03; 95% CI, 1.39-2.97), high fasting plasma glucose (OR, 1.71; 95% CI, 1.22-2.41), and high triglyceride levels (OR, 2.30; 95% CI, 1.64-3.22), but were not significantly associated with elevated blood pressure or low high-density lipoprotein cholesterol. Higher hemoglobin levels were significantly associated with an increased prevalence of MetS and several of its components in older Korean males. These findings suggest that hemoglobin levels may serve as a simple and accessible marker for identifying older adults at increased metabolic risk.

Association between dietary patterns and CAIDE-predicted dementia risk: A 20-year cohort of the Korean Genome and Epidemiology study

2026-06-11T07:48:54Z

Title: Association between dietary patterns and CAIDE-predicted dementia risk: A 20-year cohort of the Korean Genome and Epidemiology study Authors: Youn, Ji-Eun; Heo, Seok-Jae; Lee, Yae-Ji; Han, Tae-hwa; Kwon, Yu-Jin; Lee, Ji-Won Abstract: This study examined associations between dietary habits and the risk of developing Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE)-predicted late-life dementia risk in Korean adults. A total of 5,042 participants aged 40-69 years were included. We assessed associations between dietary patterns-the Mediterranean diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, Korean Healthy Eating Index (KHEI), and Empirical Dietary Inflammatory Index (EDII)-and CAIDE-predicted high risk of dementia. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, and cumulative incidence was assessed using Kaplan-Meier analysis. Longitudinal trajectories of CAIDE scores over a 10-year period were analyzed using linear mixed-effects models. During follow-up of 15.83 years, 30.9% progressed to CAIDE-predicted high risk of dementia. The highest tertile of the Mediterranean diet, MIND diet, and KHEI were associated with lower cumulative incidence (P = .008, P < .001, and P < .001) and reduced risk of progression to CAIDE-predicted high risk of dementia (HR 0.78, 95% CI 0.67-0.90, HR 0.80, 95% CI 0.69-0.93, and HR 0.80, 95% CI 0.70-0.91, respectively) along with lower CAIDE score (P < .001, P < .001, P = .002). Conversely, the highest EDII tertile showed the highest cumulative incidence (P < .001), an increased risk of progression to CAIDE-predicted high risk of dementia (HR 1.15, 95% CI 1.01-1.32), and elevated CAIDE scores (P < .001). Greater adherence to the Mediterranean diet, MIND diet, and KHEI, and lower consumption of pro-inflammatory diets were associated with a lower risk of high CAIDE-predicted late-life dementia and slower accumulation of risk factors.