The authors evaluated the incidence of hip fracture and subsequent mortality in Korea using nationwide data obtained from the Health Insurance Review and Assessment Service. This study was performed on patient population, aged 50-yr or older who underwent surgical procedures because of hip fracture (ICD10; S720, S721). All patients were followed using patient identification code to identify deaths. Crude hip fracture rates increased from 191.9/100,000 in 2005 to 207.0/100,000 in 2008 in women and from 94.8/100,000 in 2005 to 97.8/100,000 in 2008, in men respectively. Crude mortality within 12 months after hip fracture showed a similar trend (18.8% in 2005 and 17.8% in 2007). The mean of standardized mortality ratio of hip fracture was 6.1 at 3 months, 3.5 at 1 yr, and 2.3 at 2 yr post-fracture. The increasing incidence and the high mortality after hip fracture are likely to become serious public health problems and a public health program should begin to prevent hip fractures in Korea.

Although the Korean population does not have high risk for osteoporosis, the numbers of osteoporosis-related fractures represent a considerable economic burden to society. The purpose of this study was to determine the incidence and residual lifetime risk of osteoporosis-related fractures in Korea, using data from the Health Insurance Review and Assessment Service (HIRA), which includes nationwide information compiled by the Korean government. All new visits or admissions to Korean clinics or hospitals for fractures were recorded prospectively in a nationwide cohort by the Korean HIRA using the International Classification of Diseases, 10th revision, codes and procedure codes. These data were retrospectively evaluated to determine the incidence and residual lifetime risk of osteoporosis-related fractures (hip, spine, distal radius, and humerus fractures), in men and women aged 50 years or more between 2005 and 2008. The annual incidences of osteoporosis-related fractures were 1,661, 1,646, 1,623, and 1,614 per 100,000 person-years in men and women aged 50 years or more from the year 2005 to 2008. The annual incidence of osteoporosis-related fracture in women was three times that of men. The incidence of osteoporosis-related fractures increased with advancing age. In Korea, at the age of 50 years, the residual lifetime probabilities of osteoporosis-related fractures are 59.5% for women and 23.8% for men. This study presents the baseline data for treatment and research on osteoporosis and provides an estimate of osteoporosis-related fractures in Korea.

No abstract

Gestational diabetes mellitus (GDM) is a worldwide, growing complication during pregnancy (1). Many risk factors for GDM have been identified, including obesity prior to and during pregnancy, older maternal age, previous history of GDM, and family history of diabetes (1). However, these risk factors are not sufficient to predict GDM development in almost half of all cases (2). Hence, it is necessary to identify other risk factors, including potential nutritional factors.Vitamin D deficiency has recently been drawing the interest of medical researchers with its link to adverse outcomes of various diseases, other than bone diseases (3-6). Serum levels of 25-hydroxyvitamin D (25-OH-D), a good measure of vitamin D status in humans, are inversely related to hypertension, diabetes, carotid atherosclerosis, myocardial infarction, congestive heart failure, stroke, microalbuminuria, and kidney dysfunction (3-6). In a recent cross-sectional study on a Korean population, women less than 50 y old with more serum 25-OH-D (75 nmol/L) had a significantly lower prevalence of type 2 diabetes than those with less 25-OH-D (25 nmol/L) (7). In addition, serum 25-OH-D levels were significantly negatively associated with fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) values in all participants. As GDM has a similar pathophysiology to type 2 diabetes (1), serum 25-OH-D levels in the first trimester may be a risk factor for GDM in Korean women. In previous studies, there is still some controversy about the association of vitamin D deficiency in the first trimester with adverse pregnancy outcomes such as GDM development, pre-eclampsia, infections, caesarean section, and fetal growth restric- Summary The association between vitamin D deficiency in the first trimester and GDM development remains controversial in various ethnicities. We prospectively assessed whether pregnant women with vitamin D deficiency during early pregnancy had an increased likelihood of GDM development or poor fetal growth or pregnancy outcomes compared to those with sufficient vitamin D levels. Serum 25-OH-D measurements and fetal ultrasonograms were carried out at 12-14, 20-22, and 32-34 wk in 523 pregnant women. Each woman was screened for GDM at 24-28 wk. There were no differences in serum 25-OH-D levels at 12-14 wk or 22-24 wk of pregnancy between GDM and non-GDM women after adjusting for maternal age, BMI at prepregnancy, BMI at first visit, BMI at GDM screening, gestational age at sampling, previous history of GDM, vitamin D intake, and seasonal variation in sampling. The risk of GDM, insulin resistance, and impaired b-cell function had no association with serum 25-OH-D levels in crude or adjusted logistic regression analysis. GDM was not associated with maternal serum 25-OH-D deficiency during the first trimester or fetal growth during the first and second trimesters. Pregnancy outcomes such as miscarriage, Apgar 1, Apgar 5 and birth weight were independent of maternal serum 25-OH-D levels during the first, second and third ...