Eun Bong Lee

An elevated risk of dementia among anemic population has been reported in previous studies. However, measurement on the risk of individual subtypes of dementia has been limited. We aimed to quantify risk of dementia and its subtypes in the general population with anemia, using Korean National Health Insurance Service data linked to biennial national health check-ups. We conducted a cohort study on propensity-score fine-stratification (PSS)-weighted 50,008 anemic and 992,497 non-anemic participants aged ≥ 60 years who underwent three consecutive check-ups during 2006-2011. Anemia was defined as hemoglobin levels (Hb) <12 g/dL (females) or < 13 g/dL (males) and non-anemia as levels above the cut-offs at all three check-ups, requiring chronicity of low Hb. The primary outcome was incident dementia. Secondary outcomes included Alzheimer's disease (AD) and vascular dementia (VD). We estimated PSS-weighted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models. Dose-responsive (Hb ≥ 10 g/dL as mild, < 10 g/dL as moderate-to-severe) and subgroup (age, sex, income, diabetes, and cardiovascular disease at baseline) analyses were done. Over 11.8 years on average, 430,161 dementia cases developed with a HR (95% CI) of 1.09 (1.08-1.11) for dementia, 1.10 (1.08-1.11) for AD, and 1.04 (1.01-1.07) for VD. The risk of dementia was higher for moderate-to-severe anemia (HR 1.20, 95% CI 1.15-1.26) than mild anemia (HR 1.09, 95% CI 1.08 - 1.10) versus non-anemia. The association was consistent across subgroups, being greater in males than females (p for interaction < 0.05, HR 1.14, 95% CI 1.12-1.17 in males, HR 1.07, 95% CI 1.05-1.09 in females). This large population-based cohort study shows that the risk of dementia associated with persistent anemia was greater for AD than VD, of which association was dose-responsive and affected by sex.

Sung Ik Cho, M.D., Ji In Jung, M.D., Ju Yeon Kim, M.D., Jin Kyun Park, M.D., Ph.D., Eun Young Lee, M.D., Ph.D., Eun Bong Lee, M.D., Ph.D., Jun Won Park, M.D.. J Rheum Dis -0001;0:. https://doi.org/10.4078/jrd.2025.0206

Objective: To identify factors associated with adverse outcomes in Korean patients with systemic lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH) confirmed by right heart catheterization (RHC). Methods: This multicentre retrospective study included 68 patients with SLE-PAH diagnosed by RHC at eight tertiary centres. Baseline demographic, clinical, laboratory and haemodynamic data were collected, along with SLE Disease Activity Index (SLEDAI) scores and PAH-related parameters. Primary endpoint was a composite outcome of worsening PAH symptoms requiring treatment escalation, lung transplantation, death or hospitalization. Univariable and multivariable logistic regression analyses were performed to identify independent predictors. Results: Of 68 patients, 35 (51.3%) experienced composite outcomes. Compared with those without composite outcomes, patients with composite outcomes had significantly shorter baseline 6-min walk distances (P = 0.024), higher tricuspid regurgitation velocity (P = 0.032), higher right ventricular systolic pressure (P = 0.035), higher mean pulmonary arterial pressure (mPAP) (P < 0.001), higher mean physician global assessment scores (P = 0.001), higher mean SLEDAI scores (P = 0.005) and more frequent use of combination PAH therapy (P = 0.033). In multivariable analysis, elevated mPAP (odds ratio (OR) 5.401; 95% confidence interval (CI) 1.129–25.837, P = 0.035), higher SLEDAI (OR 5.495; 95% CI 1.041–29.012, P = 0.045) and combination PAH therapy (OR 1.695; 95% CI 1.015–3.267, P = 0.017) remained independent predictors of composite outcomes. Conclusions: Elevated mPAP, active lupus and use of combination PAH therapy were independently associated with poor outcomes in SLE-PAH, highlighting the relevance of comprehensive haemodynamic assessment and careful management of lupus activity.

Objectives: To compare the efficacy of tacrolimus (TAC) plus glucocorticoids (GCs) with that of TAC plus mycophenolate mofetil (MMF) and GCs for the induction of remission in proliferative lupus nephritis (LN). Methods: This multicentre cohort study, designed as a target trial emulation, included patients with biopsy-proven proliferative LN who received TAC-based induction therapy. Patients were classified into the TAC + GC and TAC + MMF + GC groups. The primary outcome was total renal response at 12 months, which was defined as a complete or partial renal response. To address baseline imbalances between the groups, inverse probability of treatment weighting (IPTW) was applied. Binary logistic regression was used to estimate the odds ratio (OR) for the renal response. Results: In total, 115 patients (48 with TAC + GC and 67 with TAC + MMF + GC) were included in the study. A 12-month total renal response was achieved in 16 (33.3%) patients in the TAC + GC group and 40 (59.7%) patients in the TAC + MMF + GC group (p = .009). After IPTW adjustment, the TAC + MMF + GC group showed significantly higher 12-month total renal response (IPTW-adjusted OR 2.84 [1.31-6.35]). Adverse drug reactions occurred in 7 patients in the TAC + GC group and 11 patients in the TAC + MMF + GC group. Conclusions: In patients with proliferative LN, TAC + MMF + GC therapy was associated with a significantly higher 12-month renal response than TAC + GC. These findings support TAC + MMF + GC as the preferred TAC-based induction regimen for proliferative LN.