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Article: Mendelian randomization shows depression increases the risk of type 2 diabetes.

Jin, Heejin / Lee, Sanghun / Won, Sungho

2023 Volume 14, Page(s) 1181851

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2023-08-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2606823-0
ISSN	1664-8021
ISSN	1664-8021
DOI	10.3389/fgene.2023.1181851
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Article ; Online: Possible link between statin and iron deficiency anemia: A South Korean nationwide population-based cohort study.

Ahn, Juhee / Lee, Sanghun / Won, Sungho

Science advances

2023 Volume 9, Issue 43, Page(s) eadg6194

Abstract: An extensive evaluation of disease occurrence after statin use based on a "hypothesis-free" approach remains scarce. To examine the effect of statin use on the potential risk of developing diseases, a propensity score-matched cohort study was executed ... ...

Abstract	An extensive evaluation of disease occurrence after statin use based on a "hypothesis-free" approach remains scarce. To examine the effect of statin use on the potential risk of developing diseases, a propensity score-matched cohort study was executed using data from the National Sample Cohort in South Korea. A total of 7847 statin users and 39,235 nonstatin users were included in the final analysis. The period of statin use was defined as our main time-dependent exposure and was divided into three periods: current, recent, and past. The main outcomes were defined as new-onset diseases with ≥100 events based on the International Statistical Classification of Diseases, 10th Revision. We calculated the adjusted hazard ratios and 95% confidence intervals (CIs) using Cox regression. We found that statin use significantly increased the risk of developing iron deficiency anemia up to 5.04 times (95% CI, 2.11 to 12.03). Therefore, the iron levels of patients using statins should be monitored carefully.
MeSH term(s)	Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Cohort Studies ; Anemia, Iron-Deficiency/epidemiology ; Retrospective Studies ; Republic of Korea/epidemiology
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2810933-8
ISSN	2375-2548 ; 2375-2548
ISSN (online)	2375-2548
ISSN	2375-2548
DOI	10.1126/sciadv.adg6194
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Article ; Online: Rex: R-linked EXcel add-in for statistical analysis of medical and bioinformatics data.

Lee, Bora / An, Jaehoon / Lee, Sungyoung / Won, Sungho

Genes & genomics

2023 Volume 45, Issue 3, Page(s) 295–305

Abstract: Background: Microsoft Excel has substantial functionalities for data management and analyses, and has been the most popular software in this field. However, in spite of Excel's user-friendly interface and functionality for data management, it provides ... ...

Abstract	Background: Microsoft Excel has substantial functionalities for data management and analyses, and has been the most popular software in this field. However, in spite of Excel's user-friendly interface and functionality for data management, it provides very few functions for in-depth statistical analyses, which has limited its wider application for this purpose. Objective: Here, we introduce Rex, an Excel add-in software implementing the powerful analytical and graphical functions of R within Excel. Methods: Rex was implemented using three types of programming software: R, JavaScript, and Microsoft VB.Net. Results: Rex provides a graphical user interface (GUI) through Excel, and statistical analysis can be conducted by pointing and clicking the menu without programming R. Rex covers a wide range of analyses from basic statistics to advanced analysis, including structural equation modeling, complex sampling design, and machine learning models, making it possible for researchers not skilled in using a command-line interface to conduct in-depth statistical analyses. Most Rex modules are available in a free version for non-commercial use, and it can be used for educational and public purposes. Conclusion: In this article, we introduce the framework and features of Rex with illustrative examples of its implementation.
MeSH term(s)	Software ; Computational Biology
Language	English
Publishing date	2023-01-25
Publishing country	Korea (South)
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2504587-8
ISSN	2092-9293 ; 1976-9571
ISSN (online)	2092-9293
ISSN	1976-9571
DOI	10.1007/s13258-022-01361-7
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Article ; Online: Impact of statins on the survival of patients with cancer: a nationwide population-based cohort study in South Korea.

Ahn, Juhee / Won, Sungho / Lee, Sanghun

Cancer communications (London, England)

2022 Volume 42, Issue 2, Page(s) 184–187

MeSH term(s)	Cohort Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Neoplasms/drug therapy ; Republic of Korea/epidemiology ; Risk Factors
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2022-01-08
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't
ISSN	2523-3548
ISSN (online)	2523-3548
DOI	10.1002/cac2.12252
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Article ; Online: Sex differences in the applicability of Western cardiovascular disease risk prediction equations in the Asian population.

Lim, Hee-Sook / Han, Hyein / Won, Sungho / Ji, Sungin / Park, Yoonhyung / Lee, Hae-Young

PloS one

2024 Volume 19, Issue 1, Page(s) e0292067

Abstract: Aims: Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, ... ...

Abstract	Aims: Cardiovascular diseases (CVDs) are the most common cause of death, but they can be effectively managed through appropriate prevention and treatment. An important aspect in preventing CVDs is assessing each individual's comprehensive risk profile, for which various risk engines have been developed. The important keys to CVD risk engines are high reliability and accuracy, which show differences in predictability depending on disease status or race. Framingham risk score (FRS) and the atherosclerotic cardiovascular disease risk equations (ASCVD) were applied to the Korean population to assess their suitability. Methods: A retrospective cohort study was conducted using National Health Insurance Corporation sample cohort from 2003 to 2015. The enrolled participants over 30 years of age and without CVD followed-up for 10 years. We compared the prediction performance of FRS and ASCVD and calculated the relative importance of each covariate. Results: The AUCs of FRS (men: 0.750; women: 0.748) were higher than those of ASCVD (men: 0.718; women: 0.727) for both sexes (Delong test P <0.01). Goodness of fits (GOF) were poor for all models (Chi-square P < 0.001), especially, underestimation of the risk was pronounced in women. When the men's coefficients were applied to women's data, AUC (0.748; Delong test P<0.01) and the GOF (chi-square P = 0.746) were notably improved in FRS. Hypertension was found to be the most influential variable for CVD, and this is one of the reasons why FRS, having the highest relative weight to blood pressure, showed better performance. Conclusion: When applying existing tools to Korean women, there was a noticeable underestimation. To accurately predict the risk of CVD, it was more appropriate to use FRS with men's coefficient in women. Moreover, hypertension was found to be a main risk factor for CVD.
MeSH term(s)	Humans ; Male ; Female ; Adult ; Cardiovascular Diseases/epidemiology ; Risk Assessment ; Retrospective Studies ; Sex Characteristics ; Reproducibility of Results ; Risk Factors ; Hypertension/epidemiology ; Atherosclerosis/epidemiology
Language	English
Publishing date	2024-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0292067
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Article ; Online: Longitudinal mortality of preserved ratio impaired spirometry in a middle-aged Asian cohort.

Sin, Sooim / Lee, Eun Ju / Won, Sungho / Kim, Woo Jin

BMC pulmonary medicine

2023 Volume 23, Issue 1, Page(s) 155

Abstract: Background: Although preserved ratio impaired spirometry (PRISm) has been determined to have poor prognosis, it is a heterogeneous state, and studies regarding its prognosis in Asians are limited. This study investigated the long-term all-cause and ... ...

Abstract	Background: Although preserved ratio impaired spirometry (PRISm) has been determined to have poor prognosis, it is a heterogeneous state, and studies regarding its prognosis in Asians are limited. This study investigated the long-term all-cause and cardiovascular mortality of patients with PRISm compared with those of patients with chronic obstructive pulmonary disease (COPD) and normal individuals in the Korean middle-aged general population. Methods: Participants were recruited between 2001 and 2002 from a community-based prospective cohort in South Korea. Mortality data were collected over a 16.5-year mean follow-up period. The all-cause and cardiovascular mortality risks of PRISm were compared between patients with COPD and healthy controls. Results: The PRISm group had a mean age of 53.4 years and mean body mass index of 24.9 kg/m Conclusion: In our population-based cohort, all-cause and cardiovascular mortality risk did not increase in individuals with PRISm compared with normal individuals. Further studies are needed to distinguish a lower-risk subgroup of PRISm with certain characteristics, such as middle-aged, light-smoking Asians without additional cardiovascular risk.
MeSH term(s)	Middle Aged ; Humans ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Lung ; Spirometry ; Cardiovascular Diseases/epidemiology
Language	English
Publishing date	2023-05-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2059871-3
ISSN	1471-2466 ; 1471-2466
ISSN (online)	1471-2466
ISSN	1471-2466
DOI	10.1186/s12890-023-02451-2
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Article ; Online: Long-Term Nonoperative Management is Associated With Lower Mean 9-Year Follow-Up Survival Compared to Total Knee Arthroplasty in Knee Osteoarthritis Patients-Survival Analysis of a Nationwide South Korean Cohort.

Han, Hyein / Ro, Du Hyun / Won, Sungho / Han, Hyuk-Soo

The Journal of arthroplasty

2023 Volume 38, Issue 8, Page(s) 1470–1476.e1

Abstract: Background: Total knee arthroplasty (TKA) and medications are both considered as a treatment for knee osteoarthritis. However, the impact of the TKA on long-term survival remains controversial. This study aimed to compare 9-year follow-up survival ... ...

Abstract	Background: Total knee arthroplasty (TKA) and medications are both considered as a treatment for knee osteoarthritis. However, the impact of the TKA on long-term survival remains controversial. This study aimed to compare 9-year follow-up survival between a TKA group with a nonoperative medication group. Methods: From 2007 to 2009, knee osteoarthritis patients were divided into TKA (N = 2,228) and nonoperative medication (N = 76,430) groups, and followed for up to 9 years. The hazard ratio (HR) and subdistribution HR (SHR) were derived from Cox proportional hazards regressions and Fine and Gray analyses, respectively. Results: The TKA group had a significantly lower adjusted mortality rate (adjusted HR , 0.78, 95% confidence interval [CI], 0.68-0.9) than the nonoperative medication group. Dose-response relationship between medication possession ratio and mortalities for overall (adjusted HR , 1.02; 95% CI, 1.01-1.04) and cardiovascular (CV) death (adjusted SHR, 1.03; 95% CI, 1.01-1.05) was also found. Also, there were significant interactions that indicate stronger protective survival effects of the TKA in several covariates: age >75 years (P = .04 for overall; P = .009 for CV), hypertension (P = .006 for overall), and ischemic heart disease (P = .009 for CV). Conclusions: This study suggests that TKA patients had better mean 9-year follow-up survival than the nonoperative medication group after adjusting for baseline differences. For overall death, including CV death, adjusted mortality rates were higher in the medication group and showed a dose-response relationship. Specifically, the protective effect of the TKA for overall or CV deaths was found to be higher for age >75, hypertension, or ischemic heart disease patients. Level of evidence: III.
MeSH term(s)	Humans ; Aged ; Arthroplasty, Replacement, Knee ; Osteoarthritis, Knee/surgery ; Follow-Up Studies ; Proportional Hazards Models ; Myocardial Ischemia/surgery ; Hypertension/surgery ; Republic of Korea/epidemiology ; Treatment Outcome
Language	English
Publishing date	2023-02-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.01.058
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Article ; Online: Comparative effectiveness and safety of ticagrelor and clopidogrel in patients with or without chronic liver disease: a nationwide cohort study.

Hong, Bin / Bea, Sungho / You, Seng Chan / Chang, Yoosoo / Kim, Won / Shin, Ju-Young

The American journal of medicine

2024

Abstract: Background: Although the effectiveness and safety of ticagrelor versus clopidogrel may differ in patients with chronic liver disease, there is a scarcity of evidence comparing ticagrelor and clopidogrel in patients with chronic liver disease. We aimed ... ...

Abstract	Background: Although the effectiveness and safety of ticagrelor versus clopidogrel may differ in patients with chronic liver disease, there is a scarcity of evidence comparing ticagrelor and clopidogrel in patients with chronic liver disease. We aimed to evaluate the risk of major adverse cardiovascular events (MACE) and major bleeding associated with ticagrelor versus clopidogrel in patients undergoing percutaneous coronary intervention (PCI) due to acute coronary syndrome by chronic liver disease status. Methods: Using the Korean healthcare database, we included adult patients who underwent PCI and initiated ticagrelor or clopidogrel treatment within 7 days of an acute coronary syndrome diagnosis. Patients were divided into two mutually exclusive groups: patients with chronic liver disease and patients without chronic liver disease. Within each group, the hazard ratios (HRs) with 95% confidence intervals (CIs) of MACE and major bleeding associated with ticagrelor versus clopidogrel were calculated using a Cox proportional hazards model within a 1:1 propensity score (PS) matched cohort. Results: The final cohort included 14,261 and 148,535 patients with and without chronic liver disease, respectively. After PS matching, the risk of MACE (with chronic liver disease, HR: 1.01, 95% CI: 0.91-1.13; without chronic liver disease, HR: 1.02, 95% CI: 0.98-1.05; P for homogeneity: 0.865) and major bleeding (with chronic liver disease, HR: 1.07, 95% CI: 0.71-1.61; without chronic liver disease, HR: 1.32, 95% CI: 1.15-1.53; P for homogeneity: 0.342) for ticagrelor versus clopidogrel do not vary with chronic liver disease status. Conclusions: Among acute coronary syndrome patients undergoing PCI, the use of ticagrelor versus clopidogrel was associated with a similar risk of MACE and an increased risk of major bleeding, but these risks did not vary with chronic liver disease status.
Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2024.03.042
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Article ; Online: missForest with feature selection using binary particle swarm optimization improves the imputation accuracy of continuous data.

Jin, Heejin / Jung, Surin / Won, Sungho

Genes & genomics

2022 Volume 44, Issue 6, Page(s) 651–658

Abstract: Background: Missing data are a common problem in large-scale datasets and its appropriate handling is crucial for data analyses. Missingness can be categorized as (1) missing completely at random (MCAR), (2) missing at random (MAR), and (3) missing not ... ...

Abstract	Background: Missing data are a common problem in large-scale datasets and its appropriate handling is crucial for data analyses. Missingness can be categorized as (1) missing completely at random (MCAR), (2) missing at random (MAR), and (3) missing not at random (MNAR). Different missingness mechanisms require different imputation strategies. Multiple imputation, an approach for averaging outcomes across multiple imputed data, is more suitable than single imputation for dealing with various missing mechanisms. missForest, a nonparametric missing value imputation strategy using random forest, is one of the most prevalent multiple imputation methods for missing-data because it can be applied to mixed-type data and does not require distributional assumptions. However, a recent study found that missForest can produce biased results for non-normal data. In addition, missForest is computationally expensive. Objective: Therefore, we aimed to further develop the missForest algorithm by combining a binary particle swarm optimization (BPSO)-based feature-selection strategy. Methods: The BPSO is an evolutionary algorithm that is well known for global optimization and computational efficiency. By using the BPSO-based feature selection step prior to imputing missing values with missForest, the imputation accuracy for continuous variables could be increased by pruning redundant variables. Results: In this study, missForest with BPSO (BPSOmf) showed better imputation accuracy than missForest alone with respect to continuous variables by feature selection prior to the imputation step. Conclusions: BPSOmf is an appropriate and robust method when the imputation target data consist mainly of continuous variables.
MeSH term(s)	Algorithms ; Research Design
Language	English
Publishing date	2022-04-06
Publishing country	Korea (South)
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2504587-8
ISSN	2092-9293 ; 1976-9571
ISSN (online)	2092-9293
ISSN	1976-9571
DOI	10.1007/s13258-022-01247-8
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Article ; Online: Relative contributions of the host genome, microbiome, and environment to the metabolic profile.

Kim, Kangjin / Lee, Yunhwan / Won, Sungho

Genes & genomics

2022 Volume 44, Issue 9, Page(s) 1081–1089

Abstract: Background: Metabolic syndrome is as a well-known risk factor for cardiovascular disease, which is associated with both genetic and environmental factors. Recently, the microbiome composition has been shown to affect the development of metabolic ... ...

Abstract	Background: Metabolic syndrome is as a well-known risk factor for cardiovascular disease, which is associated with both genetic and environmental factors. Recently, the microbiome composition has been shown to affect the development of metabolic syndrome. Thus, it is expected that the complex interplay among host genetics, the microbiome, and environmental factors could affect metabolic syndrome. Objective: To evaluate the relative contributions of genetic, microbiome, and environmental factors to metabolic syndrome using statistical approaches. Methods: Data from the prospective Korean Association REsource project cohort (N = 8476) were used in this study, including single-nucleotide polymorphisms, phenotypes and lifestyle factors, and the urine-derived microbial composition. The effect of each data source on metabolic phenotypes was evaluated using a heritability estimation approach and a prediction model separately. We further experimented with various types of metagenomic relationship matrices to estimate the phenotypic variance explained by the microbiome. Results: With the heritability estimation, five of the 11 metabolic phenotypes were significantly associated with metagenome-wide similarity. We found significant heritability for fasting glucose (4.8%), high-density lipoprotein cholesterol (4.9%), waist-hip ratio (7.7%), and waist circumference (5.6%). Microbiome compositions provided more accurate estimations than genetic factors for the same sample size. In the prediction model, the contribution of each source to the prediction accuracy varied for each phenotype. Conclusion: The effects of host genetics, the metagenome, and environmental factors on metabolic syndrome were minimal. Our statistical analysis suffers from a small sample size, and the measurement error is expected to be substantial. Further analysis is necessary to quantify the effects with better accuracy.
MeSH term(s)	Humans ; Metabolic Syndrome/genetics ; Metabolome ; Microbiota/genetics ; Polymorphism, Single Nucleotide ; Prospective Studies
Language	English
Publishing date	2022-07-08
Publishing country	Korea (South)
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2504587-8
ISSN	2092-9293 ; 1976-9571
ISSN (online)	2092-9293
ISSN	1976-9571
DOI	10.1007/s13258-022-01277-2
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