Journal of Personalized Medicine最新文献

{"title":"Advancing Breast Cancer Care in Patients Aged 80 and Above: A Personalized and Multidisciplinary Management to Better Outcomes.","authors":"Maria Natale, Alba Di Leone, Domenico Fusco, Cristina Accetta, Andrea Bellieni, Beatrice Carnassale, Sabatino D'Archi, Flavia De Lauretis, Enrico Di Guglielmo, Antonio Franco, Diana Giannarelli, Stefano Magno, Francesca Moschella, Alejandro Martin Sanchez, Lorenzo Scardina, Marta Silenzi, Riccardo Masetti, Gianluca Franceschini","doi":"10.3390/jpm15030090","DOIUrl":"https://doi.org/10.3390/jpm15030090","url":null,"abstract":"<p><p><b>Background:</b> Breast cancer in women aged 80 years and older accounts for about 12% of cases, but its management is challenging due to the population's heterogeneity and the lack of relevant evidence-based guidelines. Treatment decisions must consider biological age, comorbidities, life expectancy, therapy-related toxicities, and tumor biology. This study evaluates the clinical outcomes of elderly breast cancer patients treated with a multidisciplinary approach, including oncologists, surgeons, and geriatric specialists. <b>Materials and Methods:</b> A retrospective analysis of breast cancer patients aged ≥80 years treated at Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy, from January 2016 to December 2020 was conducted. The study reviewed clinicopathological data, surgery, adjuvant therapies, and clinical outcomes. Treatment decisions were guided by multidisciplinary evaluations, including onco-geriatric assessments (GA) and guided treatment decisions. Primary outcomes included overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). Surgical and treatment-related complications were also documented. <b>Results:</b> A total of 238 patients aged ≥80 years were included in the study. Of these, 203 (85.3%) underwent breast-conserving surgery, while 35 (14.7%) underwent mastectomy. Axillary surgery was performed in 129 (54%) cases. Regarding adjuvant treatments, 93 (39.1%) patients received radiotherapy, and 101 (42.4%) received endocrine therapy alone. Chemotherapy was administered to six high-risk patients following GA, with no reported toxicities. Over a median follow-up of 42.3 months, the study reported one local recurrence (0.5%), one regional node recurrence (0.5%), and 19 cases of distant metastases (9%). A total of 19 patients (9%) died due to breast cancer. The overall complication rate was low, with 10% experiencing wound dehiscence, hematoma, lymphedema, or similar issues. Five-year survival outcomes were OS 73.3%, DFS 66.6%, and CSS 88.5%. <b>Conclusions:</b> This study highlights that a multidisciplinary approach to breast cancer management in patients aged ≥80 years yields favorable clinical outcomes with low recurrence, metastasis, and complication rates. The personalized treatment strategies, guided by onco-geriatric assessments, balance survival benefits with quality of life while minimizing risks of overtreatment or undertreatment. These findings emphasize the importance of individualized care in this complex patient population and offer valuable insights for optimizing management strategies as the elderly demographic continues to grow.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710035","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":"Executive Functions Training Improves Language Abilities in Aphasia Rehabilitation: A Systematic Review.","authors":"Laura Culicetto, Desirèe Latella, Viviana Lo Buono, Fabio Orecchio, Anna Maria Murdaca, Angelo Quartarone, Silvia Marino","doi":"10.3390/jpm15030092","DOIUrl":"https://doi.org/10.3390/jpm15030092","url":null,"abstract":"<p><p><b>Background/Objectives</b>: In recent years, the popularity of non-verbal cognitive training for aphasia has increased. Building on evidence that language abilities engage brain areas involved in executive functions (EFs) processing, this review aims to analyze the utility of EFs training alone or combined with traditional rehabilitation approaches to improve language abilities in aphasia. <b>Methods</b>: Systematic searches were performed in four databases evaluating studies focusing on the effects of EFs training in language rehabilitation, yielding 185 studies. After reading the full text of the selected studies and applying predefined inclusion criteria, nine studies were included based on pertinence and relevance to the topic. This systematic review has been registered in the Prospective Register of Systematic Reviews (PROSPERO 2024) with the number CRD42024519087. <b>Results</b>: The results of the analyzed studies indicate that various EFs training methods, such as computer-assisted executive control training, Cognitive Flexibility in Aphasia Therapy (CFAT), and the Dr. Neuronowski^® program, as well as the combination of transcranial direct current stimulation (tDCS) with EFs training, can lead to improvements in language abilities in people with aphasia. Additionally, EFs training often results in specific effects on treated functions like working memory (near transfer effects) and untreated ones such as spoken sentence comprehension (far transfer effects). <b>Conclusions</b>: Despite the heterogeneity of the treatments and the small simple size of the studies analyzed, preliminary results are promising. Future research should further explore the effectiveness and specific contribution of EFs training to improving language functions in aphasia.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710312","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":"Association of Aspirin Use in Primary Prevention and Cardiovascular Events: A Retrospective Analysis of the VITAL Cohort.","authors":"Daniel Caldeira, Mariana Alves, Nilza Gonçalves, João Costa, Joaquim J Ferreira, Fausto J Pinto","doi":"10.3390/jpm15030089","DOIUrl":"https://doi.org/10.3390/jpm15030089","url":null,"abstract":"<p><p><b>Background:</b> Aspirin is part of the therapeutic antithrombotic armamentarium for the management of patients with established clinically relevant atherosclerosis or thrombotic cardiovascular disease. Personalized medicine identifies those who benefit most or face fewer risks from aspirin. The role of aspirin in primary prevention is still debatable. We aimed to assess the risks and benefits of aspirin in this setting, using the data of the prospective VITAL (VITamins and Lifestyle) study. <b>Methods:</b> We conducted a retrospective evaluation of the VITAL cohort. In this analysis, participants were split according to aspirin usage. Aspirin use was evaluated regarding all-cause mortality, CV mortality, major cardiovascular event (MACE), myocardial infarction, coronary heart disease, total stroke, and hemorrhagic stroke. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to explore the association between cardiovascular events and aspirin usage. The estimates were adjusted for demographic and clinical variables. <b>Results:</b> The aspirin users (<i>n</i> = 11,570) were older, more frequently men, the body mass index was higher, and the proportion of smokers was smaller compared with non-users (<i>n</i> = 13,927). After adjusting for demographic and clinical variables, aspirin was not identified as a predictor of cardiovascular death (HR 1.17, 95%CI 0.89 to 1.55), major cardiovascular events (HR 1.04, 95%CI 0.89 to 1.22), coronary heart disease (HR 1.16, 95%CI 0.98 to 1.37), nor stroke (HR 1.01, 95%CI 0.77 to 1.31). <b>Conclusion:</b> In this retrospective analysis of the VITAL cohort, aspirin was not associated with a reduced risk of cardiovascular mortality or events.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710098","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":"Toric Aberrometric Extended Depth of Focus Intraocular Lens: Visual Outcomes, Rotational Stability, Patients' Satisfaction, and Spectacle Independence.","authors":"Erika Bonacci, Camilla Pagnacco, Marco Anastasi, Alessandra De Gregorio, Giorgio Marchini, Emilio Pedrotti","doi":"10.3390/jpm15030088","DOIUrl":"https://doi.org/10.3390/jpm15030088","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate visual outcomes, rotational stability, patients' satisfaction, and spectacle independence after bilateral Toric extended depth of focus intraocular lens (EDOF IOL) implantation. <b>Methods</b>: Prospective observational study including cataract patients with bilateral corneal astigmatism between 0.75 and 3.00 D implanted with Toric EDOF IOLs. After three months distance corrected and uncorrected visual acuity at 4 m (DCVA and UDVA), 80 cm (DCI80VA and UI80VA), 67 cm (DCI67VA and UI67VA), and 40 cm (DCNVA and UNVA), IOL stability by Toric IOL Assistant tool (Osiris T, CSO, Florence, Italy), binocular defocus curves, contrast sensitivity (CS), halometry, reading performance, and subjective and objective (Root mean square-RMS, modulation transfer function-MTF, cut-off and point-spread-function-PSF-Strehl ratio) visual quality were evaluated. <b>Results</b>: Forty eyes from 20 astigmatic patients were enrolled. Mean refractive spherical equivalent and residual cylinder were -0.21 ± 0.74 D and 0.29 ± 0.31 D, respectively. No patients needed additional surgery due to IOL rotation. Binocular UDVA, UI80VA, UI67VA, and UNVA ≤ 0.2 logMAR was found in 90%, 95%, 85%, and 80%. Distance-corrected visual outcomes have overall shown higher performances. All visual acuities at defocus curves were ≤0.125 logMAR between +0.50 D and -2.00 D. PSF-Strehl ratio, MTF cut-off, RMS were 0.26 ± 0.28, 19.82 ± 12.35, 0.31 ± 0.17. Reading analysis reached 125.42 ± 27.21 words/minute, 92.56 ± 7.82, 0.17 ± 0.15 logMAR and 0.50 ± 0.11 logRAD for mean reading speed, visual acuity score, reading acuity, and critical print size, respectively. CS was higher in photopic conditions. Subjective spectacle independence was achieved in 80% of patients. <b>Conclusions</b>: Toric EDOF IOL showed rotational stability and reliable astigmatic correction. It provided spectacle independence and good performance from distance to near distance, reaching high patient satisfaction without undermining binocular quality of vision.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710303","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":"Comment on Zieliński, G.; Gawda, P. Analysis of the Use of Sample Size and Effect Size Calculations in a Temporomandibular Disorders Randomised Controlled Trial-Short Narrative Review. <i>J. Pers. Med.</i> 2024, <i>14</i>, 655.","authors":"Juliana Homem Padilha Spavieri, Thamiris Costa de Lima, Luiz Ricardo Garcêz, Roger Berg Rodrigues Pereira, Ana Carolina de Jacomo Claudio, Thais Cristina Chaves","doi":"10.3390/jpm15030085","DOIUrl":"https://doi.org/10.3390/jpm15030085","url":null,"abstract":"<p><p>We have thoroughly reviewed the article titled \"Analysis of the Use of Sample Size and Effect Size Calculations in a Temporomandibular Disorders Randomised Controlled Trial-Short Narrative Review\" by Zieliński G and Gawda P, recently published in the Journal of Personalized Medicine (2024; 14: 655) [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710114","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":"Reply to Spavieri, J.H.P. et al. Comment on \"Zieliński, G.; Gawda, P. Analysis of the Use of Sample Size and Effect Size Calculations in a Temporomandibular Disorders Randomised Controlled Trial-Short Narrative Review. <i>J. Pers. Med.</i> 2024, <i>14</i>, 655\".","authors":"Grzegorz Zieliński, Piotr Gawda","doi":"10.3390/jpm15030086","DOIUrl":"https://doi.org/10.3390/jpm15030086","url":null,"abstract":"<p><p>We have received a request to respond to a comment on our article published in the <i>Journal of Personalized Medicine</i> (2024; 14: 655) [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709993","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":"Impact of Enhanced Recovery After Surgery with Neuromuscular Monitoring and Sugammadex on Healthcare Costs and Effectiveness of Recovery in Patients Following Anterior Cervical Spine Discectomy.","authors":"Hung-Te Hsu, Szu-Yu Chen, Yu-Kai Huang, Kuang-I Cheng, Shih-Feng Weng, Zhi-Fu Wu","doi":"10.3390/jpm15030087","DOIUrl":"https://doi.org/10.3390/jpm15030087","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Anterior cervical spine surgery (ACSS) is an effective surgical procedure used to treat degenerative cervical spine disease. Enhanced recovery after surgery (ERAS) is a new and promising paradigm for ACSS. The purpose of this study is to investigate the role of neuromuscular monitoring with sugammadex in the ERAS protocol, which had not been confirmed in ACSS. <b>Methods</b>: In this retrospective study, the electronic medical records of patients aged 20 to 80 years who had undergone first-time ACSS performed in the period from 1 December 2018 to 31 December 2023 were reviewed. Patients were divided into ERAS and non-ERAS groups. Inverse probability of treatment weighting (IPTW) was used to balance differences between the groups. Statistical analyses were conducted using SPSS 20, including independent samples t-tests, chi-square tests, linear regression, and logistic regression. <b>Results</b>: A total of 394 patients were included in this study: 163 in the non-ERAS group and 231 in the ERAS group. In the ERAS group, significant reductions were observed in several key outcomes compared with the non-ERAS group: LOS was reduced by 0.62 days (<i>p</i> < 0.001), hospital costs were lowered by NTD 13,174.40 (<i>p</i> < 0.001), ventilator time was decreased by 149.40 min (<i>p</i> < 0.001), time to first oral intake was shortened by 4.71 h (<i>p</i> < 0.001), and time to first ambulation was reduced by 8.00 h (<i>p</i> < 0.001). No significant differences in complication rates were observed between the two groups. <b>Conclusions</b>: The ACSS-tailored ERAS pathway with NMM and sugammadex can reduce LOS, cost, and speed of patient recovery without increasing complications.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710356","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":"Minimally Invasive Lapidus Arthrodesis Associated with Distal Osteotomy of M1: A Combined Procedure for Hallux Valgus Correction.","authors":"Fabrizio De Marchi, Ilaria Alice Crippa, Andrea Bobba, Alessandro Pudda, Filippo Maria Anghilieri, Francesco Verde, Filippo Familiari, Lorenzo Monti","doi":"10.3390/jpm15030081","DOIUrl":"https://doi.org/10.3390/jpm15030081","url":null,"abstract":"<p><p><b>Background</b>: Hallux valgus is a common painful condition with tri-planar deformity of the first ray. Surgical correction consists of distal osteotomy of the first metatarsal and its lateral translation. However, in the case of hypermobility of the first cuneo-metatarsal joint (TMTJ), the associated Lapidus procedure is indicated to correct deformities along all three anatomical planes. Lapidus procedure is reported to have several contraindications and complications; for this reason, many surgeons proposed technical modification to the original procedure. We present the results of a novel surgical technique for hallux valgus correction with minimally invasive arthrodesis of first TMTJ without proximal correction of deformity, combined with a distal Austin-Chevron procedure. Materials and <b>Methods</b>: We retrospectively evaluated patients who underwent surgical correction of hallux valgus with our technique between January 2010 and January 2020. We collected data on demographics, anesthesiologic technique, associated surgical procedures, post-operative functional results, and complications. Dorso-plantar and lateral radiographs were performed at 6, 12, and 24 weeks after surgery or until fusion was documented. Clinical assessment considered gait analysis, pain or other disturbance, type of shoes worn, and use of orthosis. <b>Results</b>: A total of 240 patients were enrolled. AOFAS score, hallux valgus angle, and inter-metatarsal angle showed a significant improvement. Complications consisted of distal osteotomy non-union (1%), pain or protrusion of the screw (13%), and recurrence of deformity (2%). Overall, patients were very satisfied with the surgery in 192/278 (69%) cases, moderately satisfied in 67/278 (24%) cases, satisfied in 8/278 (3%) cases, and dissatisfied in 11/278 (4%) cases. <b>Conclusions</b>: Our novel surgical technique which combines in situ arthrodesis of the first tarso-metatarsal joint (TMTJ) with a distal Austin-Chevron procedure offers an effective alternative for correcting hallux valgus with first-ray hypermobility, minimizing complications associated with traditional methods.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710362","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":"A Personalized, Risk-Based Approach to Active Surveillance for Prostate Cancer with Takeaways from Broader Oncology Practices: A Mixed Methods Review.","authors":"Jeroen J Lodder, Sebastiaan Remmers, Roderick C N van den Bergh, Arnoud W Postema, Pim J van Leeuwen, Monique J Roobol","doi":"10.3390/jpm15030084","DOIUrl":"https://doi.org/10.3390/jpm15030084","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To summarize the current state of knowledge regarding personalized, risk-based approaches in active surveillance (AS) for prostate cancer (PCa) and to explore the lessons learned from AS practices in other types of cancer. <b>Methods</b>: This mixed methods review combined a systematic review and a narrative review. The systematic review was conducted according to the Preferred Reporting Items for Systematic rviews and Meta-Analyses (PRISMA) guidelines, with searches performed in the Medline, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar databases. Only studies evaluating personalized, risk-based AS programs for PCa were included. The narrative review focused on AS approaches in other solid tumors (thyroid, breast, kidney, and bladder cancer) to contextualize the findings and highlight lessons learned. <b>Results</b>: After screening 3137 articles, 9 were suitable for inclusion, describing the following four unique risk-based AS tools: PRIAS, Johns Hopkins, Canary PASS, and STRATCANS. These models were developed using data from men with low-risk (Grade Group 1) disease, with little to no magnetic resonance imaging (MRI) data. They used patient information such as (repeated) prostate-specific antigen (PSA) measurements and biopsy results to predict the risk of upgrading at the next biopsy or at radical prostatectomy, or to assign a patient to a pre-defined risk category with a corresponding pre-defined follow-up (FU) regimen. Performance was moderate across models, with the area under the curve/concordance index values ranging from 0.58 to 0.85 and calibration was generally good. The PRIAS, Canary PASS, and STRATCANS models demonstrated the benefits of less burdensome biopsies, clinic visits, and MRIs during FU when used, compared to current one-size-fits-all practices. Although little is known about risk-based AS in thyroid, breast, kidney, and bladder cancer, learning from their current practices could further refine patient selection, streamline monitoring protocols, and address adoption barriers, improving AS's overall effectiveness in PCa management. <b>Conclusions</b>: Personalized, risk-based AS models allow for a reduction in the FU burden for men at low risk of progression while maintaining sensitive FU visits for those at higher risk. The comparatively limited evidence and practice of risk-based AS in other cancer types highlight the advanced state of AS in PCa.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710025","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":"Sex-Specific Associations Between Dynapenia and Risk of Atherosclerotic Cardiovascular Disease: A Machine-Learning-Based Approach.","authors":"Gyumin Lee, Hye-Jin Kim, Heeji Choi, Seung-Ho Shin, Chulho Kim, Sang-Hwa Lee, Jong-Hee Sohn, Jae Jun Lee","doi":"10.3390/jpm15030083","DOIUrl":"https://doi.org/10.3390/jpm15030083","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dynapenia, age-associated loss in muscle strength, is an emerging risk factor for atherosclerotic cardiovascular disease (ASCVD), which may have different effects depending on sex. This study aims to investigate the association between dynapenia and ASCVD risk, evaluate its predictive significance among traditional factors, and explore sex-specific patterns through machine learning models. <b>Methods</b>: This retrospective case-control study uses data from 19,582 participants aged 40-79 from the Korean National Health and Nutrition Examination Survey (KNHANES). ASCVD risk is assessed using the American College of Cardiology/American Heart Association 10-year risk algorithm, with dynapenia defined based on hand grip strength. Multivariable logistic regression and ML algorithms, including light gradient boosting (LGB) and XGBoost (XGB), are applied to examine predictive factors. Model performance is evaluated via the area under the receiver operating characteristic curve (AUROC), and Shapley additive explanation (SHAP) analysis highlights variable importance. <b>Results</b>: Dynapenia prevalence is higher in women (33.4%) than men (13.9%) at high ASCVD risk. Logistic regression shows dynapenia is significantly associated with high ASCVD risk in women (odds ratio, 1.47; 95% confidence interval, 1.20-1.81) but not in men. Machine learning models demonstrate excellent predictive performance, with XGB achieving the highest AUROC (0.950 in men and 0.963 in women). The SHAP analysis identifies dynapenia as a critical risk factor in women, while body mass index, educational status, and household income are influential in both sexes. <b>Conclusions</b>: Dynapenia is a significant ASCVD risk factor in women, emphasizing sex-specific prevention strategies. Machine learning enhances risk assessment precision, underscoring muscle health's role in cardiovascular care.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710017","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}