Small extracellular vesicles (EVs), including exosomes, in body fluids have important applications in the noninvasive liquid biopsy-based diagnosis of cancer. Current EV-based diagnostic techniques still face practical challenges, such as inefficient EV isolation. Here, we report an efficient, resource-free pre-enrichment approach using (-)-epigallocatechin-3-gallate (EGCG), a polyphenolic biomolecule, to isolate and detect exosomal microRNAs (miRNAs) in human blood plasma samples. Our system comprises three steps: (1) EGCG-mediated EV aggregation, (2) filter-based EV isolation, and (3) molecular beacon-based detection of target miRNA in EVs. Using blood samples from cancer patients with gastric cancer or hepatocellular carcinoma, we constructed an EGCG-assisted miRNA diagnostic system. For both cancers, the levels of target miRNAs (miR-21, -27a, and -375) in EVs were strongly correlated with those in the publicly available GEO database. Our approach, an easy-to-use method for efficient EV isolation and the detection of miRNA in clinical samples, is applicable for molecular diagnostics in precision medicine.

We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20-29 and 30-39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

Background active screening can improve health outcomes for people with prediabetes. However, its efficacy in older adults remains uncertain. Objective the study aimed to analyse the progression from prediabetes to diabetes in older adults, including associated complications and mortality rates, to determine the benefits of active screening. Design retrospective cohort study. Setting Korean National Health Insurance Service claims database. Subjects a total of 36,946 adults aged ≥65 years who underwent national health examinations from 2006 to 2008. Methods follow-up was until 31 December 2015. Cox’s proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for death and diabetic complications. Results over a median follow-up of 8.2 years, 19.3% of older adults with prediabetes progressed to diabetes. Compared with normoglycaemic adults, the multivariable-adjusted HRs (95% CI) for major adverse cardiovascular events were 1.01 (0.95–1.07), 1.08 (0.95–1.23), 1.14 (1.05–1.23) and 1.50 (1.35–1.68) in adults with prediabetes, newly diagnosed diabetes, diabetes not on insulin and diabetes on insulin, respectively. The corresponding HRs (95% CI) for diabetic retinopathy risk were 1.28 (1.15–1.43), 3.16 (2.71–3.69), 6.58 (6.02–7.19) and 9.17 (8.21–10.24). Diabetic nephropathy risk also significantly increased. Conclusions progression from prediabetes to diabetes is an important concern among older adults. Prediabetes is associated with the risk of microvascular complications, but not cardiovascular complications and mortality. Therefore, active regular screening for prediabetes is necessary to prevent microvascular complications.

Background: We determined the case fatality rate associated with hospitalization due to hyperglycemic crises and investigated the relationship between obesity status and case fatality for hyperglycemic crises.Methods: From the Korean National Health Insurance Service-National Sample Cohort, 729 adults who visited the emergency room or were hospitalized due to hyperglycemic crises between January 1, 2010, and December 31, 2019, were included. Preobesity or obesity was defined as a body mass index ≥23.0 kg/m2. Case fatality rates are presented as the proportion of adults who died within 30 days of hospitalization. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for 30-day fatalities according to preobesity or obesity status.Results: The 30-day case fatality rate for hyperglycemic crises was 11.2%. In those aged ≥65 years, the fatality rate was twice as high as that in those aged 20 to 64 years (13.8% vs. 6.8%). Adults with preobesity or obesity had a lower fatality rate than those with normal weight (9.5% vs. 14.0%). After adjustment for confounding variables, preobesity or obesity was found to be significantly associated with a decreased risk for 30-day case fatality compared to normal weight (HR, 0.63; 95% CI, 0.40–0.98).Conclusions: In Korea, hyperglycemic crises had a high fatality rate. Management needs to be improved to prevent hyperglycemic crises and reduce mortality.