Background: Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality.Methods: We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses.Results: During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability.Conclusion: This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.

Traditionally, sarcopenia has defined as amount of absolute muscle mass adjusted by height in the elderly people. However, relative muscle mass adjusted by weight has been used extensively in most non-alcoholic fatty liver disease (NAFLD) studies. Here, we attempted to investigate the pitfall of adjusted muscle mass by weight to evaluate association between sarcopenia and NAFLD. Adult subjects (n = 1343) who underwent a health check-up were finally included for analysis. The weight-adjusted skeletal muscle mass index (wSMI) and height-adjusted SMI (hSMI) calculated by dividing the total appendicular skeletal muscle (ASM) by weight or the square of height, respectively. Prevalence of sarcopenia defined by wSMI in the NAFLD group was significantly higher than in the control group (1.3% vs. 8.8%, p < 0.001). However, there was no difference in the prevalence of sarcopenia defined by hSMI between the control and NAFLD groups (2.0% vs. 0.8%, p = 0.055). Since body weight was the most potent independent risk factor for NAFLD in multivariable logistic regression analysis, abnormal rates (<−1 SD) of almost all parameters increased in the NAFLD population, after weight adjustment. However, abnormal rates of non-metabolic parameter did not increase in NAFLD, after height adjustment. Only metabolic parameters showed relationship with NAFLD, after height adjustment. As NAFLD is highly associated with body weight, careful attention should be given in the case of studying the relationship of NAFLD with sarcopenia adjusted by body weight.

To characterize the carriage of antibiotic resistance genes (ARGs) in the gut microbiome of healthy individuals. Fecal carriage of ARGs was investigated in 61 healthy individuals aged 30 to 59 years through whole metagenome sequencing of the gut microbiome and a targeted metagenomic approach. The number of ARGs in the gut microbiome was counted and normalized per million predicted genes (GPM). In the Korean population, the resistome ranged from 49.7 to 292.5 GPM (median 89.7). Based on the abundance of ARGs, the subjects were categorised into high (> 120 GPM), middle (60‒120 GPM), and low (< 60 GPM) ARG groups. Individuals in the high ARG group tended to visit hospitals more often (P = 0.065), particularly for upper respiratory tract infections (P = 0.066), and carried more blaCTX-M (P = 0.008). The targeted metagenome approach for bla and plasmid-mediated quinolone resistance (PMQR) genes revealed a high fecal carriage rate; 23% or 13.1% of the subjects carried blaCTX-M or blaCMY-2, respectively. Regarding PMQR genes, 59% of the subjects carried PMQR, and 83% of them harboured 2‒4 PMQR genes (qnrB 44.3%, qnrS 47.5% etc.). The presence of blaCTX-M correlated with ARG abundance in the gut resistome, whereas PMQR genes were irrelevant to other ARGs (P = 0.176). Fecal carriage of blaCTX-M and PMQR genes was broad and multiplexed among healthy individuals.

Background: Many studies have reported that dog ownership is effective in encouraging physical activity. However, the association between living with a dog and enhanced physical activity has not been clearly verified. Thus, this study aimed to investigate the effects of dog ownership on the amount of physical activity in a representative sample of Korean adults. Methods: This cross-sectional study administered the International Physical Activity Questionnaire (IPAQ) to 1,299 individuals who visited the international healthcare center of one hospital in Seoul, Korea, between August and December in 2018. Based on responses to the IPAQ survey, the amount and duration of physical activity was calculated to analyze relationships with dog ownership. Results: The total amount (P=0.02) and duration of physical activity (P=0.02) and the duration of vigorous-intensity physical activity (P=0.04) were significantly higher among dog owners than non-dog owners. The duration of daily physical activity increased with dog ownership by 18.6 minutes (P=0.01). A comparison of dog owners according to whether they walked with their dogs revealed that dog walking had no significant effect on the amount and duration of physical activity, inactivity, or health-enhancing physical activity status. There was a sex-specific association between dog ownership and total duration of physical activity in females. Conclusion: The duration of physical activity increased by dog ownership. However, the higher levels of physical activity among dog owners may not necessarily be explained by dog ownership or walking with dogs. This outcome suggests that raising a dog can help promote physical activity.

Visceral larva migrans (VLM) is one of the clinical syndromes of human toxocariasis. We report a case of hepatic VLM presenting preprandial malaise and epigastric discomfort in a 58-year-old woman drinking raw roe deer blood. The imaging studies of the abdomen showed a 74-mm hepatic mass featuring hepatic VLM. Anti-Toxocara canis immunoglobulin G (IgG) was observed in enzyme-linked immunosorbent assay (ELISA) and western blot. Despite anthelmintic treatment, the patient complained of newly developed cough and skin rash with severe eosinophilia. Hepatic lesion increased in size. The patient underwent an open left lobectomy of the liver. After the surgery, the patient was free of symptoms such as preprandial malaise, epigastric discomfort, cough, and skin rash. Laboratory test showed a normal eosinophilic count at postoperative 1 month, 6 months, 1 year, and 4 years. The initial optical density value of 2.55 of anti-T. canis IgG in ELISA was found to be negative (0.684) at postoperative 21 months. Our case report highlights that a high degree of clinical suspicion for hepatic VLM should be considered in a patient with a history of ingestion of raw food in the past, presenting severe eosinophilia and a variety of symptoms which reflect high worm burdens. Symptom remission, eosinophilia remission, and complete radiological resolution of lesions can be complete with surgery.