Objective: The impact of weight changes on blood pressure and blood test results was assessed over a two-year period, considering obesity status and age.

Methods: The study included 16,819 individuals, aged 20 to 69 years, who underwent health check-ups for three consecutive years starting in 2018. Participants were categorized into eight groups: obese (BMI ≥ 25 or waist circumference ≥ 85 cm for men and ≥ 90 cm for women) aged 20-39 years, obese 40-69 years, non-obese 20-39 years, and non-obese 40-69 years, for both men and women. Weight changes after two years were classified into seven categories: ≥ 5% decrease, 3% to <5% decrease, 1% to <3% decrease, no change (<1% decrease to <1% increase), 1 to <3% increase, 3 to <5% increase, and ≥ 5% increase. Trends in blood pressure and blood test results were evaluated.

Results: In the 40-69-year-old obese men group, significant improvements were observed in systolic and diastolic blood pressure, LDL-C, HDL-C, HbA1c, AST, ALT, and γ-GTP, with a weight decrease of ≥ 5% over two years, compared to the reference group with no weight change. In the 20-39-year-old obese men group, a weight decrease of ≥ 5% improved all these indicators except systolic blood pressure. Conversely, all indicators worsened with a weight increase of ≥ 5% among obese men. In the 40-69-year-old non-obese men group, improvements were observed in systolic and diastolic blood pressure, LDL-C, HDL-C, and ALT with a weight decrease of ≥ 5%, while all indicators except HbA1c deteriorated with a weight increase of ≥ 5%. Among the 20-39-year-old non-obese men group, weight changes of ≥ 5% were found to have an influence on blood pressure, lipid levels, and liver function. Interestingly no consistent trends were observed in women.

Conclusions: In obese men, weight changes of ≥ 5% over a two-year period were found to have an impact on blood pressure, lipid levels, glucose tolerance, and liver function across both age groups. Among the non-obese men, all parameters changed with weight changes, except glucose tolerance.

  A 57-year-old man underwent a health checkup at our clinic, including nasal esophagogastroduodenoscopy (EGD). A suspicious 10 mm irregularity was found in the stomach’s posterior wall, leading to concerns about early gastric cancer (type IIc). Biopsy results showed well-differentiated tubular adenocarcinoma (tub1). For endoscopic submucosal dissection, the patient was referred to the National Cancer Center Hospital East (cancer center). Similar to our findings, the cancer center’s pathology department confirmed tub1+tub2. Subsequent EGD suggested vanishing cancer. A surveillance approach was conducted. After 3 months, repeated EGD confirmed vanishing cancer, leading to annual follow-ups. While “vanishing cancer” is known clinically, its occurrence during post-health checkup prompted a brief literature review.

Objective: To report two cases of dabigatran-induced esophagitis (DIE), which was detected during upper gastrointestinal endoscopy (EGD) as part of a comprehensive medical checkup.

Methods: Two cases of DIE were detected during EGD performed as part of a comprehensive medical checkup at our hospital.

Results: Case 1: The patient, a 76-year-old man, had been taking oral dabigatran since the age of 68 years for atrial fibrillation. He had been aware of a small blockage in his esophagus since then. EGD performed at the time of his current medical checkup revealed white moss deposits on the esophagus. During his checkup interview, he was given instructions on how to take oral medication. Case 2: The patient was an 82-year-old man who had been taking dabigatran since the age of 72 years owing to atrial fibrillation (since the age of 63 years). He did not complain about esophageal symptoms; however, EGD revealed white moss deposits on the esophagus. Hence, he contacted his primary care physician, who changed his medication. At the next EGD, his esophageal findings had improved.

Conclusions: Dabigatran is an anticoagulant that has been commonly used in recent years; however, there have been many reports of esophageal lesions associated with it. Previously, the tartaric acid contained in the drug was thought to be the main cause of esophagitis. Nonetheless, dabigatran itself is likely cytotoxic, and the findings may change depending on the oral administration method at that time, so the disease is suspected. In such cases, detailed interviews and guidance, consideration of changing medications, and close collaboration with clinicians are necessary.