Journal of Korean Medical Science最新文献

{"title":"Psychotropic Drug Use in Korean Patients With Osteoarthritis.","authors":"Seong-Hun Kang, Hyun Ah Kim, Insun Choi, Chan Mi Park, Hoyol Jhang, Jinhyun Kim, Dong Jin Go, Suhyun Jang","doi":"10.3346/jkms.2025.40.e53","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e53","url":null,"abstract":"<p><strong>Background: </strong>There are few safe effective ways to relieve osteoarthritis (OA) pain; as a result, off-label psychotropic drug prescriptions have increased worldwide. This study examined the change in psychotropic drug prescriptions for patients with OA from 2011 to 2020 using the Korean National Health Insurance Service dataset.</p><p><strong>Methods: </strong>The study population consisted of patients with hip or knee OA aged ≥ 65 years. Psychotropic drugs included opioids, benzodiazepines, non-benzodiazepine hypnotics (Z-drugs), anti-epileptics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), typical antipsychotics, atypical antipsychotics, and anxiolytics. The prevalence and long-term (> 3 months) prescription rates of psychotropic drugs in OA patients were calculated.</p><p><strong>Results: </strong>The study included 1,821,158 patients with OA (mean age 71.7 years; 65.32% female). Of the cohort, 49% had comorbidities for which psychotropics were indicated. The prevalence of psychotropic prescriptions decreased from 58.2% to 52.0% in 2018 and then leveled off. The long-term prescription rate remained constant until 2018 and then increased slightly. The most commonly prescribed psychotropics were opioids and long- and short-acting benzodiazepines. The prescription rates of opioids and long-acting benzodiazepines decreased from 2011 to 2020. For those with psychiatric co-morbidities, the prescription rates of anti-epileptics and SNRIs increased, while the prescription rates of anti-epileptics, SSRIs, other antidepressants, and atypical psychotropics increased for those without such co-morbidities. The most commonly prescribed psychotropics were diazepam and alprazolam, excluding tramadol and tramadol-acetaminophen combination. For those with psychiatric co-morbidities, the prescription rates of gabapentin and fentanyl increased, while for those without such co-morbidities, the prescription rates of lorazepam, fentanyl, escitalopram and quetiapine increased.</p><p><strong>Conclusion: </strong>A significant number of older Korean patients with OA were prescribed psychotropic drugs in the absence of comorbidities requiring such drugs, including drugs that have little effect on OA and unfavorable safety profiles in older adults.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e53"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Linear Association Between Physical Activities and Type 2 Diabetes in 2.4 Million Korean Population, 2009-2022: A Nationwide Representative Study.","authors":"Wonwoo Jang, Seokjun Kim, Yejun Son, Soeun Kim, Hayeon Lee, Jaeyu Park, Kyeongmin Lee, Jiseung Kang, Damiano Pizzol, Jiyoung Hwang, Sang Youl Rhee, Dong Keon Yon","doi":"10.3346/jkms.2025.40.e42","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e42","url":null,"abstract":"<p><strong>Background: </strong>Although excessive physical activity (PA) does not always confer additional health benefits, there is a paucity of studies that have quantitatively examined the dose-response relationship between PA and type 2 diabetes. Therefore, this study investigated the relationship between the type 2 diabetes prevalence and intensity, frequency, and metabolic equivalent of task (MET) score of PA in a large population sample.</p><p><strong>Methods: </strong>We conducted a nationwide cross-sectional analysis examining sociodemographic variables, PA habits, and type 2 diabetes prevalence in 2,428,448 participants included in the Korea Community Health Survey. The non-linear association between MET score and odds ratios (ORs) for type 2 diabetes prevalence was plotted using a weighted generalized additive model. Categorical analysis was used to examine the joint association of moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), and the influence of PA frequency.</p><p><strong>Results: </strong>MET score and diabetes prevalence revealed a non-linear association with the nadir at 1,028 MET-min/week, beyond which ORs increased with additional PA. Joint analysis of MPA and VPA showed the lowest OR of 0.79 (95% confidence interval, 0.75-0.84) for those engaging in 300-600 MET-min/week of MPA and > 600 MET-min/week of VPA concurrently, corresponding with World Health Organization recommendations. Additionally, both \"weekend warriors\" and \"regularly active\" individuals showed lower ORs compared to the inactive, although no significant difference was noted between the active groups.</p><p><strong>Conclusion: </strong>In a large South Korean sample, higher PA is not always associated with a lower prevalence of type 2 diabetes, as the association follows a non-linear pattern; differences existed across sociodemographic variables. Considering the joint association, an adequate combination of MPA and VPA is recommended. The frequency of PA does not significantly influence the type 2 diabetes prevalence.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e42"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-ECG Supported Decision-Making for Coronary Angiography in Acute Chest Pain: The QCG-AID Study.","authors":"Jiesuck Park, Joonghee Kim, Soyeon Ahn, Youngjin Cho, Yeonyee E Yoon","doi":"10.3346/jkms.2025.40.e105","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e105","url":null,"abstract":"<p><p>This pilot study evaluates an artificial intelligence (AI)-assisted electrocardiography (ECG) analysis system, QCG, to enhance urgent coronary angiography (CAG) decision-making for acute chest pain in the emergency department (ED). We retrospectively analyzed 300 ED cases, categorized as non-coronary chest pain (Group 1), acute coronary syndrome (ACS) without occlusive coronary artery disease (CAD) (Group 2), and ACS with occlusive CAD (Group 3). Six clinicians made urgent CAG decision using a conventional approach (clinical data and ECG) and a QCG-assisted approach (including QCG scores). The QCG-assisted approach improved correct CAG decisions in Group 2 (36.0% vs. 45.3%, <i>P</i> = 0.003) and Group 3 (85.3% vs. 90.0%, <i>P</i> = 0.017), with minimal impact in Group 1 (92.7% vs. 95.0%, <i>P</i> = 0.125). Diagnostic accuracy for ACS improved from 77% to 81% with QCG assistance and reached 82% with QCG alone, supporting AI's potential to enhance urgent CAG decision-making for ED chest pain cases.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e105"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Recovery From SARS-CoV-2 Infection Among Immunocompromised Children Despite Limited Neutralizing Antibody Response: A Virologic and Sero-Immunologic Analysis of a Single-Center Cohort.","authors":"Doo Ri Kim, Byoung Kwon Park, Jin Yang Baek, Areum Shin, Ji Won Lee, Hee Young Ju, Hee Won Cho, Keon Hee Yoo, Ki Woong Sung, Chae-Hong Jeong, Tae Yeul Kim, June-Young Koh, Jae-Hoon Ko, Yae-Jean Kim","doi":"10.3346/jkms.2025.40.e52","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e52","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised (IC) pediatric patients are at increased risk of severe acute respiratory syndrome coronavirus 2 infection, but the viral kinetics and sero-immunologic response in pediatric IC patients are not fully understood.</p><p><strong>Methods: </strong>From April to June 2022, a prospective cohort study was conducted. IC pediatric patients hospitalized for coronavirus disease 2019 (COVID-19) were enrolled. Serial saliva swab and serum specimens were subjected to reverse transcription polymerase chain reaction assays with mutation sequencing, viral culture, anti-spike-protein, anti-nucleocapsid antibody assays, plaque reduction neutralization test (PRNT) and multiplex cytokine assays.</p><p><strong>Results: </strong>Eleven IC children were evaluated. Their COVID-19 symptoms resolved promptly (median, 2.5 days; interquartile range, 2.0-4.3). Saliva swab specimens contained lower viral loads than nasopharyngeal swabs (<i>P</i> = 0.008). All cases were BA.2 infection, and 45.5% tested negative within 14 days by saliva swab from symptom onset. Eight (72.7%) showed a time-dependent increase in BA.2 PRNT titers, followed by rapid waning. Multiplex cytokine assays revealed that monocyte/macrophage activation and Th₁ responses were comparable to those of non-IC adults. Activation of interleukin (IL)-1Ra and IL-6 was brief, and IL-17A was suppressed. Activated interferon (IFN)-γ and IL-18/IL-1F4 signals were observed.</p><p><strong>Conclusion: </strong>IC pediatric patients rapidly recovered from COVID-19 with low viral loads. Antibody response was limited, but cytokine analysis suggested an enhanced IFN-γ- and IL-18-mediated immune response without excessive activation of inflammatory cascades. To validate our observation, immune cell-based functional studies need to be conducted among IC and non-IC children.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e52"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Correction of Fig. 2 in the Article \"Temporal Radiographic Trajectory and Clinical Outcomes in COVID-19 Pneumonia: A Longitudinal Study\".","authors":"Dong-Won Ahn, Yeonju Seo, Taewan Goo, Ji Bong Jeong, Taesung Park, Soon Ho Yoon","doi":"10.3346/jkms.2025.40.e136","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e136","url":null,"abstract":"<p><p>This corrects the article on p. e25 in vol. 40, PMID: 40065711.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e136"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of 5-Year Survival Rate After Hip Fracture Surgery Using a Comprehensive Geriatric Assessment-Based Frailty Score Model.","authors":"Jung-Yeon Choi, Jung-Wee Park, Kwang-Il Kim, Young-Kyun Lee, Cheol-Ho Kim","doi":"10.3346/jkms.2025.40.e40","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e40","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures (HFs) are major osteoporotic injuries associated with morbidity, loss of independence, increased mortality, and an increased socioeconomic burden. The total number of HFs is increasing owing to an aging population. While studies have focused on 30-day or 1-year mortality after HF surgery, studies reporting long-term mortality are lacking. Our study bridges this knowledge gap by exploring the relationship between frailty, postoperative complications, and the 5-year mortality after HF surgery. This study aimed to identify the risk factors associated with 5-year mortality after HF surgery. The impact of the Hip-Multidimensional Frailty Score (Hip-MFS) and postoperative complications on 5-year mortality was compared.</p><p><strong>Methods: </strong>This retrospective study included 536 individuals aged 65 years and older with HFs who underwent surgery between 2009 and 2014. The Hip-MFS was calculated using the comprehensive geriatric assessment. Patients whose Hip-MFS score above 8 considered as frail. Postoperative complications included pneumonia, urinary tract infection, delirium, pulmonary thromboembolism, and unplanned intensive care unit admission after surgery. The primary outcome was 5-year mortality. Univariate and multivariate cox-regression, Kaplan-Meier analysis and log-rank tests were used to assess predictive value of frailty and postoperative complications on 5-year mortality.</p><p><strong>Results: </strong>The mean age was 80.5 ± 7.0 years and 71.3% (n = 382) were women. Overall, 48.3% (n = 259) were diagnosed with femoral neck fractures, and 51.7% (n = 277) were diagnosed with intertrochanteric fractures. A total of 223 (41.6%) patients experienced postoperative complications. The overall mortality rate was 60.4% (n = 324), with 1-year and 5-year mortality rates after HF surgery being 13.8% (n = 74) and 43.8% (n = 235), respectively. In the multivariate regression analysis, after adjusting for clinical and demographic factors, the high-risk Hip-MFS group and the group with postoperative complications had hazard ratios for 5-year survival of 1.513 (95% confidence interval [CI], 1.105-2.017; <i>P</i> = 0.010) and 1.470 (95% CI, 1.117-1.936; <i>P</i> = 0.006), respectively. Patients who had postoperative complications with a low Hip-MFS showed better 5-year survival than those without postoperative complications with a high Hip-MFS in the Kaplan-Meier curve (<i>P</i> = 0.013).</p><p><strong>Conclusion: </strong>A high Hip-MFS risk and postoperative complications were associated with an increased 5-year mortality rate. In comparison to the occurrence of postoperative complications, the frailty status evaluated using the Hip-MFS had a more significant impact on long-term mortality after HF surgery.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 12","pages":"e40"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between the Distance From Donors and Ischemic Time in Heart Transplantation of Korea and Its Clinical Impact.","authors":"Jung Yeon Jin, Chee-Hoon Lee, Mi Hee Lim, Soo Yong Lee, Min Ho Ju, Hyung Gon Je","doi":"10.3346/jkms.2025.40.e60","DOIUrl":"10.3346/jkms.2025.40.e60","url":null,"abstract":"<p><strong>Background: </strong>The heart donor allocation system in South Korea is divided into three regions, with priority given to recipients within the same region over those in other regions of the same tier. It is commonly believed that heart transplantation (HT) within the same region can reduce ischemic time (IT), although its clinical impact remains unclear. The purpose of this study is to compare the characteristics and outcomes of intra-region HT and inter-region HT.</p><p><strong>Methods: </strong>From 2014 to 2022, a total of 115 adult patients underwent isolated HT at a tertiary hospital. Of these, 58 recipients (54.5 ± 10.3 years, female, 36.2%) underwent intra-region HT and 57 recipients (53.9 ± 14.1 years, female, 31.6%) underwent inter-region HT. Extracorporeal membrane oxygenation-bridged HTs accounted for 50.0% and 54.4% of cases, respectively (<i>P</i> = 0.638). There were no differences in preoperative characteristics between the two groups.</p><p><strong>Results: </strong>The median inter-hospital distance (38.0 [32.0-112.0] km vs. 351.0 [300.0-390.5] km, <i>P</i> < 0.001) and total IT (153 [123-170] minute vs. 265 [243-298] minute, <i>P</i> < 0.001) were longer in the inter-region group than intra-region group. Despite these differences, both groups showed similar clinical outcomes. The 30-day mortality rates were 5.2% and 5.3% (<i>P</i> < 0.99), respectively. There were no differences in postoperative cardiac index, early adverse outcomes, or long-term survival between the two groups. The inter-hospital distance and cold IT showed a strong positive correlation (time [minute] = 39.462 + 0.410 × distance [km]).</p><p><strong>Conclusion: </strong>Despite the difference in IT, there was no difference in postoperative outcomes between the two groups. Based on these findings, the effect of donor location on the outcomes of HT in South Korea is not considered significant.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 11","pages":"e60"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications.","authors":"Sin Young Ham, Seungjae Lee, Min-Kyung Kim, Jaehyun Jeon, Eunyoung Lee, Subin Kim, Jae-Phil Choi, Hee-Chang Jang, Sang-Won Park","doi":"10.3346/jkms.2025.40.e38","DOIUrl":"10.3346/jkms.2025.40.e38","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is a newly emerged infectious disease that needs further clinical investigation. Characterizing the temporal pattern of combined infections in patients with COVID-19 may help clinicians understand the clinical nature of this disease and provide valuable diagnostic and therapeutic guidelines.</p><p><strong>Methods: </strong>We retrospectively analyzed COVID-19 patients isolated in four study hospitals in Korea for one year period from May 2021 to April 2022 when the delta and omicron variants were dominant. The temporal characteristics of combined infections based on specific diagnostic tests were analyzed.</p><p><strong>Results: </strong>A total of 16,967 COVID-19 patients were screened, 2,432 (14.3%) of whom underwent diagnostic microbiologic tests according to the clinical decision-making, 195 of whom had positive test results, and 0.55% (94/16,967) of whom were ultimately considered to have clinically meaningful combined infections. The median duration for the diagnosis of combined infections was 15 (interquartile range [IQR], 5-25) days after admission. The proportion of community-acquired coinfections (≤ 2 days after admission) was 11.7% (11/94), which included bacteremia (10/94, 10.63%) and tuberculosis (1/94, 1.06%). Combined infections after 2 days of admission were diagnosed at median 16 (IQR, 9-26) days, and included bacteremia (72.3%), fungemia (19.3%), cytomegalovirus (CMV) diseases (8.4%), <i>Pneumocystis jerovecii</i> pneumonia (PJP, 8.4%) and invasive pulmonary aspergillosis (IPA, 4.8%).</p><p><strong>Conclusion: </strong>Among COVID-19 patients with risk factors for severe complications, 0.55% had laboratory-confirmed combined infections, which included community and nosocomial pathogens in addition to unusual pathogens such as CMV disease, PJP and IPA.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 11","pages":"e38"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In This Issue on 24-March-2025.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e126","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e126","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 11","pages":"e126"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Patterns of the Relationship Between Gynecological Malignancy and Obesity Index: A Nationwide Retrospective Cohort Study in Korea.","authors":"Seo Young Kang, Ye-Jee Kim, Sehee Kim, Hye Soon Park","doi":"10.3346/jkms.2025.40.e31","DOIUrl":"10.3346/jkms.2025.40.e31","url":null,"abstract":"<p><strong>Background: </strong>In Korea, the patterns of prevalence of gynecological cancers have shifted due to rising obesity-related cancer cases. We evaluated the associations of body mass index (BMI) and waist circumference (WC) with the risk of gynecological malignancy in Korean women.</p><p><strong>Methods: </strong>Using National Health Insurance Service cohort data, we analyzed 365,581 participants among the 1,999,980 women aged ≥ 19 years who underwent health check-ups at the baseline year 2009-2010, excluding those who died, those with prior cancer diagnoses, underwent hysterectomy and/or salpingo-oophorectomy before the index date (January 1st, 2011), or missing/outliers BMI and WC values. Follow-up extended to December 31st, 2021, evaluating the incidences of endometrial, ovarian, and cervical cancer. The hazard ratios (HRs) and 95% confidence intervals (CIs) for each gynecological malignancy according to BMI and WC were calculated using Cox proportional hazard regression.</p><p><strong>Results: </strong>Among the 365,581 participants, 898, 1,268, and 873 cases of endometrial, ovarian, and cervical cancer occurred, respectively. HRs (95% CIs) for endometrial cancer were 1.37 (1.15-1.63), 1.63 (1.38-1.94), and 3.64 (2.81-4.70) for BMIs of 23.0-24.9, 25.0-29.9, and ≥ 30 kg/m² compared to BMI of 18.5-22.9 kg/m² (<i>P</i> for trend < 0.001). HRs (95% CIs) for ovarian cancer were 1.16 (1.00-1.33), 1.19 (1.03-1.37), and 1.49 (1.12-1.98) for BMIs of 23.0-24.9, 25.0-29.9, and ≥ 30 kg/m² compared to BMI of 18.5-22.9 kg/m² (<i>P</i> for trend = 0.002). No significant association was found between BMI and the risk for cervical cancer (<i>P</i> for trend = 0.266). HRs (95% CIs) for endometrial cancer were 1.35 (1.09-1.66), 1.41 (1.14-1.74), and 1.90 (1.55-2.34) for the 2nd, 3rd, and 4th quartiles of WCs compared to the 1st quartile (<i>P</i> for trend <0.001). Ovarian cancer tended to increase and cervical cancer tended to decrease as WC increased (<i>P</i> for trend = 0.035 for ovarian cancer, <i>P</i> for trend = 0.034 for cervical cancer).</p><p><strong>Conclusion: </strong>In Korean women, the risks of endometrial and ovarian cancers increased significantly from the pre-obese level as BMI and WC increased, while cervical cancer risk tended to increase as WC decreased. Management of obesity should be reinforced for the prevention of obesity-related gynecological cancers, considering the increasing incidence of these cancers among Korean women.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 11","pages":"e31"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}