The Kaohsiung journal of medical sciences最新文献

{"title":"Association Between Preoperative Dyslipidemia and the Prognosis of Patients With Endometrial Cancer: A Retrospective Cohort Study.","authors":"Song Li, Rong-He Sun, Qing Chen, Zeng-Shu Huang, Yun-Fei Wang, Chang-Zhong Li","doi":"10.1002/kjm2.70195","DOIUrl":"10.1002/kjm2.70195","url":null,"abstract":"<p><p>Endometrial cancer (EC) is closely related to metabolic disorders. We aimed to investigate whether preoperative dyslipidemia independently affects the prognosis of patients with EC. One hundred and ninety-four women diagnosed with EC by pathology and who had undergone standardized surgical treatment at the Affiliated Hospital of Jining Medical College between June 2013 and December 2016 were enrolled. Participants were divided into high and low blood lipid groups based on the appropriate and abnormal stratification criteria in the Chinese Blood Lipid Management Guidelines (2023). Their clinical characteristics, preoperative blood lipids, and survival data were retrospectively collected and analyzed. A univariate Cox proportional hazards regression model showed that age at diagnosis, preoperative triglycerides (TG), preoperative high-density lipoprotein cholesterol (HDL-C), International Federation of Obstetrics and Gynecology (FIGO) stage, and histological type were risk factors affecting overall survival (OS) in patients with EC (p < 0.05). Furthermore, preoperative high TG levels (≥ 1.7 mmol/L) and low HDL-C levels (< 1.0 mmol/L) had statistically significant negative impacts on the OS of patients with EC (both p < 0.05) in a multivariate Cox regression model. Moreover, the median survival time significantly differed based on TG and HDL-C levels (low-level vs high-level: 91.2 months vs 81.6 months, p < 0.05; 72.8 months vs. 90.9 months, p < 0.05; respectively). In conclusion, higher TG or lower HDL-C levels are associated with worse prognoses in patients with EC, which could serve as important biomarkers for evaluating the prognosis of patients with EC.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70195"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-9 Restricts Insulin Secretion by Targeting Rab34, Which Mediates Lysosomal Degradation of Proinsulin.","authors":"Zhen-Zhen Guo, Ao-Ying Li, Ting-Ting Xiang, Zu-Hao Zhang, Ao Deng, Yang Han","doi":"10.1002/kjm2.70202","DOIUrl":"10.1002/kjm2.70202","url":null,"abstract":"<p><p>Insulin secretion is a complex, vesicular transport process. Rab34 is a key regulator of intracellular vesicle transport; however, its role in insulin secretion has not yet been reported. miRNA-9 is vital for the development and progression of the diagnosis and treatment of type 2 diabetes. This study aimed to investigate whether miR-9 targets Rab34 to regulate insulin secretion in beta (β) cells and its molecular mechanism. We used miR-9 mimics, miR-9 inhibitors, and dual-luciferase reporter gene detection to prove that miR-9 is regulated by targeting Rab34 in Min6 cells. Transmission electron microscopy revealed a decrease in the number of insulin particles when Rab34 was overexpressed in β cells. Regarding the mechanism, Rab34 overexpression induced a decrease in the number of proinsulin-containing particles in β cells and significantly promoted proinsulin degradation. Immunofluorescence microscopy revealed that Rab34 overexpression resulted in insulin granule clustering. Conversely, Rab34 depletion maintained proinsulin and increased insulin secretion. miR-9 overexpression inhibited insulin secretion, and miR-9 downregulation promoted insulin secretion. Immunofluorescence results revealed that Rab34 induced insulin secretory vesicles toward the autophagic degradation pathway. Therefore, we concluded that miR-9 inhibits insulin secretion by promoting Rab34 expression, which regulates insulin secretion by mediating the degradation of proinsulin and autophagic degradation pathways in β cells.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70202"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic, Environmentally Relevant PM_2.5 Exposure Exacerbates Metabolic Dysfunction-Associated Steatotic Liver Disease and Early-Stage Renal Dysfunction in a Rodent Model.","authors":"Yi-Siao Chen, Hugo You-Hsien Lin, Chien-Tzu Lin, Si-Hua Huang, Ming-Lun Yeh, Ming-Lung Yu, Jin-Ching Lee, Yao-Chi Chung, Wei-Ming Li, Ching-Chia Li, Shiu-Feng Huang, Chia-Hung Yen","doi":"10.1002/kjm2.70206","DOIUrl":"10.1002/kjm2.70206","url":null,"abstract":"<p><p>While epidemiological studies link fine particulate matter (PM_2.5) exposure to metabolic dysfunction-associated steatotic liver disease (MASLD) and renal dysfunction, a translational gap exists, as most animal models utilize acute, high-dose exposures that poorly reflect chronic, moderate-level human scenarios. To address this, we established a long-term (seven-month) mouse model (n = 8 per group) combining a Western diet (WD) with a chronic PM_2.5 exposure paradigm equivalent to a human exposure of ~50 μg/m³, assessing key biomarkers, organ histopathology, and hepatic gene expression. While the WD was the primary driver of MASLD-related steatosis and insulin resistance, PM_2.5 co-exposure acted as a distinct modifier of hepatic pathogenesis. Specifically, the WD + PM group exhibited significantly exacerbated hepatic pathology compared to WD alone, characterized by a ~55% increase in serum ALT (p < 0.05) and a 4.7-fold increase in collagen deposition area (p < 0.05), alongside the marked upregulation of pro-inflammatory (TNF-α, CCL2) and pro-fibrotic (α-SMA, COL1A1) genes. In the kidney, PM_2.5 exposure independently elevated serum creatinine levels (by ~64% vs. controls, p < 0.05) and increased the incidence of proteinuria (75% in WD + PM vs. 0% in controls). These functional alterations occurred without inducing major structural damage. This study provides crucial experimental evidence that moderate, chronic air pollution aggravates diet-induced hepatic inflammation/fibrosis and contributes to early-stage renal dysfunction, underscoring the multi-organ health threats to metabolically vulnerable populations.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70206"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deubiquitinase USP38 Stabilizes PLK1 Expression to Boost DNA Damage Repair in Ovarian Cancer.","authors":"Yuan Ma, Ying Li, Kai-Li Li","doi":"10.1002/kjm2.70197","DOIUrl":"10.1002/kjm2.70197","url":null,"abstract":"<p><p>Ovarian cancer (OC) is one of the most prevalent and severe gynecological malignant tumors. DNA damage repair (DDR) is essential in maintaining genome stability. This study aims to investigate the effects and mechanisms of USP38 and PLK1 on DNA damage repair and malignant behavior in OC cells. Bioinformatics analysis was conducted to assess the expression of USP38 and PLK1 in OC tissues and predict downstream target proteins of USP38 and potential deubiquitination sites of target proteins. Expression levels of USP38 and PLK1 were analyzed by qPCR and WB. Cell proliferation ability was assessed by EdU experiment assay and colony formation assay. Apoptosis level was analyzed by TUNEL assay. The CO-IP assay was applied to assess the binding of USP38 and PLK1. The ubiquitination experiment was employed to evaluate the ubiquitination of PLK1 by USP38. The comet assay was utilized to analyze DNA damage in cells. USP38 and PLK1 were highly expressed in OC. The binding of USP38 to PLK1 mediated the deubiquitination of PLK1 and stabilized the protein level of PLK1. Silencing USP38 reduced the proliferation ability of OC cells and elevated the apoptosis rate of cancer cells. Mechanically, silencing USP38 decreased the expression level of PLK1 protein, repressing DDR in cancer cells. Deubiquitinase USP38 binds to PLK1 to stabilize PLK1 expression, facilitating DDR in OC cells and enhancing cancer cell proliferation, thereby reducing the apoptosis rate of cancer cells.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70197"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraben Exposure in the General Taiwanese Population: Reference Values, Personal Care Products, and Cumulative Risk Assessment.","authors":"Jung-Wei Chang, Yen-Hsuan Huang, Hsin-Chang Chen, Vinoth Kumar Ponnusamy, Wan-Ting Chang, Po-Chin Huang","doi":"10.1002/kjm2.70208","DOIUrl":"10.1002/kjm2.70208","url":null,"abstract":"<p><p>Parabens (parahydroxybenzoates), which are frequently used as preservatives in pharmaceuticals, foodstuffs, and personal care products, have recently attracted considerable attention due to their adverse health effects and endocrine-disrupting properties. This study aimed to determine the background urinary concentrations of parabens in a representative sample of the general population in Taiwan. A total of 1967 participants were enrolled in this cross-sectional study. The subjects were recruited from the Taiwan Environmental Survey for Toxicants (2013-2016). Urine samples were collected from participants, and questionnaires were administered. Urinary concentrations of parabens, including methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), and butylparaben (BuP), were quantified through ultra-high-performance liquid chromatography coupled with tandem mass spectrometry. Overall, 95th percentile reference values (RV95s) were used to establish the background concentrations of these parabens. The highest geometric mean concentration was obtained for MeP (357 μg/L), followed by PrP (89.3 μg/L), EtP (34.2 μg/L), and BuP (5.31 μg/L). Urinary concentrations of these parabens were higher in adults than in minors. The RV95s of paraben were 954, 101, 219, and 14.2 μg/L for MeP, EtP, PrP, and BuP, respectively. Of the 1967 participants, 55.4% had a HI value that exceeded the threshold of 1. This finding indicates a potential concern under conservative screening assumptions, rather than definitive evidence of adverse health risk. PrP was identified as the primary determinant of HI, accounting for 71.4% of the observed effect. The RV95s for the urinary concentrations of particular parabens are significantly higher in Taiwan than in other countries. Moreover, a notable correlation was observed between personal care product use and the urinary paraben concentrations. Further evaluation of the health implications of paraben exposure among the Taiwanese population is warranted.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70208"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a Non-Invasive Predictive Model Based on PIVKA-II Combined With MRI Imaging Features for Evaluating Microvascular Invasion in Hepatocellular Carcinoma.","authors":"Di Gao, Rui-Qi Jin, Hong-Wei Wang","doi":"10.1002/kjm2.70203","DOIUrl":"10.1002/kjm2.70203","url":null,"abstract":"<p><p>This study developed a non-invasive model using PIVKA-II and MRI features to predict microvascular invasion in hepatocellular carcinoma, providing a reliable tool for early risk assessment and personalized treatment planning. The study included 98 patients with pathologically confirmed HCC (Child-Pugh A, BCLC stage A), comprising 43 MVI-positive and 55 MVI-negative cases. Baseline clinical characteristics and MRI features were collected. Univariate analysis identified candidate variables associated with MVI, which were subsequently included in multivariate logistic regression analysis to identify independent influencing factors. A nomogram prediction model was developed based on the independent factors. The model's diagnostic performance, calibration, and clinical applicability were evaluated. The diagnostic value of PIVKA-II alone for MVI was analyzed. The MVI-positive group showed significantly higher alpha-fetoprotein ≥ 400 ng/mL, PIVKA-II levels, and aspartate aminotransferase levels. ROC curve analysis showed that PIVKA-II alone had an AUC of 0.682 for diagnosing MVI, with a maximum Youden's index of 33.57, a cut-off value of 741.5 mAU/mL, 37.21% sensitivity, 96.36% specificity. Tumor diameter, peritumoral abnormal enhancement, intratumoral arteries, and mean tumor ADC value showed significant differences between the two groups. Elevated PIVKA-II, intratumoral arteries, and mean tumor ADC value were independent influencing factors for MVI in HCC. A nomogram incorporating these factors achieved an AUC of 0.81, outperforming PIVKA-II alone. The model demonstrated good calibration and clinical utility. The non-invasive predictive nomogram constructed by combining PIVKA-II with MRI features demonstrates good predictive value and clinical applicability for assessing MVI in HCC patients. [Correction added on 25 March 2026, after first online publication: In the sentence \"A nomogram incorporating these factors achieved.......\" the value \"0.85\" is changed to \"0.81\" in this version.].</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70203"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triglyceride-Glucose Index-Based Nomogram for Predicting Short-Term Mortality in Sepsis Patients.","authors":"Jing Zhang, Yu-Jing Jiang, Ya-Ting Lv, Tong-Qin Li, Li Ma","doi":"10.1002/kjm2.70199","DOIUrl":"10.1002/kjm2.70199","url":null,"abstract":"<p><p>The triglyceride-glucose (TyG) index, a marker of insulin resistance, is associated with outcomes in critical illness; however, its predictive role for 28-day mortality in Asian patients with sepsis has not been established. To address this, the current investigation was designed to evaluate its prognostic significance and to construct a risk prediction model for short-term mortality. This retrospective study analyzed sepsis patients admitted to the intensive care unit (ICU) of the Second Hospital of Lanzhou University from January 1, 2018 to December 31, 2023. Participants were randomly split into training/validation cohorts (7:3 ratio). Multivariate logistic regression identified independent predictors. A nomogram was constructed by these predictors and it was validated using ROC curves (ROC), calibration plots, and decision curve analysis (DCA). A nomogram integrating seven variables-age, respiratory failure within 48 h, multiple organ dysfunction syndrome (MODS) within 48 h, international normalized ratio (INR), lactate level, prognostic nutrition index (PNI), and TyG index-predicted 28-day mortality with AUCs of 0.855 (training, 95% CI: 0.818-0.891) and 0.826 (validation, 95% CI: 0.764-0.887), outperforming SOFA and APACHE II scores. Calibration curves confirmed alignment with actual outcomes, and DCA demonstrated broad clinical utility. The TyG index is an independent predictor of 28-day sepsis mortality. The validated nomogram based on the TyG index enhances risk stratification, aiding clinicians in early decision-making to improve patient outcomes and care quality.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70199"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Comment on: \"Based on a Single Case, Cardiopulmonary Training Cannot Be Recommended as Therapy for Hemiparesis in MELAS With Ischemic Stroke\".","authors":"Yen-Sen Lu, Ko-Long Lin","doi":"10.1002/kjm2.70295","DOIUrl":"10.1002/kjm2.70295","url":null,"abstract":"","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70295"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Serum-Based Fibrosis Scores for Clinically Significant Liver Fibrosis in an East Asian Cohort.","authors":"Sheng-Feng Lin, Chun-Chao Chang","doi":"10.1002/kjm2.70296","DOIUrl":"10.1002/kjm2.70296","url":null,"abstract":"<p><p>Serum-based fibrosis scores are widely used for noninvasive risk stratification in chronic liver disease; however, direct comparisons across liver disease etiologies remain limited, particularly in Asian populations with a high prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. This study retrospectively analyzed the data of adults who underwent transient elastography (FibroScan) at a university-affiliated hospital. Three fibrosis scores were evaluated: Fibrosis-4 index (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and metabolic dysfunction-associated fibrosis-5 (MAF-5). Associations with advanced fibrosis (F3-F4) were examined using logistic regression. Discrimination was assessed using the area under the receiver operating characteristic curve (AUROC). Of the 2355 participants, the etiologic subgroups included metabolic dysfunction-associated steatotic liver disease (MASLD; n = 1070), HBV infection (n = 1459), and HCV infection (n = 250); 10.4% of the participants had advanced fibrosis (F3-F4). In the overall cohort, all scores were significantly associated with advanced fibrosis (p < 0.001) and demonstrated similar overall discrimination with AUROC in a range of 0.824-0.839. MAF-5 had the highest AUROC (0.839; 95% confidence interval [CI], 0.811-0.867) and greater risk classification compared with FIB-4 (net reclassification improvement = 0.168; 95% CI, 0.093-0.244). Subgroup analysis revealed that MAF-5 exhibited consistent discrimination across etiologies, with AUROCs of 0.822 (0.781-0.863) in MASLD, 0.843 (95% CI, 0.804-0.882) in HBV, and 0.810 (95% CI, 0.735-0.886) in HCV. Commonly used serum-based fibrosis scores exhibited comparable discrimination for advanced fibrosis. However, the metabolically informed MAF-5 score modestly improved risk classification across diverse liver disease etiologies.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70296"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Carotid Atherosclerosis and Mild Behavioral Impairment: A Cross-Sectional Study in a Community-Dwelling Population.","authors":"Po-Han Chen, Yi-Ya Fang, Yen-Ju Lin, Mei-Feng Huang, Yi-Chun Yeh, Hsiu-Fen Lin, Cheng-Sheng Chen","doi":"10.1002/kjm2.70297","DOIUrl":"10.1002/kjm2.70297","url":null,"abstract":"<p><p>Mild behavioral impairment (MBI) is a late-life neuropsychiatric syndrome proposed as an early clinical manifestation of neurodegenerative disease. Vascular pathology contributes to late-life cognitive and behavioral changes; however, its relationship with MBI remains insufficiently characterized. This cross-sectional study investigated whether structural carotid atherosclerosis is associated with MBI and its symptom domains in 563 community-dwelling, dementia-free adults aged ≥ 50 from the Kaohsiung Atherosclerosis Longitudinal Study between 2018 and 2021. MBI was assessed using the informant-rated Mild Behavioral Impairment Checklist, evaluating apathy/motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, and abnormal thought/perception. Structural carotid atherosclerosis was evaluated by ultrasound, assessing plaques and mean carotid intima-media thickness (cIMT) across the common carotid artery (CCA), bifurcation, and internal carotid artery. Advanced structural atherosclerosis was defined as the presence of plaque or top-quartile cIMT. Multivariable regression models examined associations between carotid atherosclerosis and MBI severity, adjusting for demographics, medical conditions, and global cognition. Advanced structural atherosclerosis was independently associated with higher MBI scores (β = 0.143, p = 0.001). Elevated cIMT-but not plaque-was significantly associated with MBI severity. Segment-specific analyses showed increased CCA IMT was the only vascular marker significantly related to MBI total scores. Furthermore, advanced structural atherosclerosis was associated with increased odds of decreased motivation, impulse dyscontrol, and social inappropriateness. In conclusion, structural carotid atherosclerosis, particularly elevated CCA IMT, is associated with greater MBI symptom burden in middle-to-older adults. Subclinical vascular pathology may contribute to early neurobehavioral changes, highlighting the importance of vascular health in identifying individuals at risk for neurodegenerative disorders.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"e70297"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}