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ABSTRACT: The relationship between body composition parameters such as thigh and calf circumference and insulin resistance or atherosclerosis in type 2 diabetes is poorly understood. The aim of this study was to investigate the relationship between insulin resistance, atherosclerosis, and thigh and calf circumference in patients with type 2 diabetes.
A total of 4,427 subjects with type 2 diabetes were enrolled in this study. Insulin sensitivity was assessed according the rate constant for plasma glucose disappearance (Kitt) determined via the short insulin tolerance test. Biochemical and anthropometric profiles were measured according to a standardized protocol. Visceral fat thickness and carotid intima media thickness (IMT) were measured by ultrasonography.
Insulin sensitivity index (Kitt) was significantly correlated with weight adjusted thigh and calf circumference. Thigh circumference was inversely associated with IMT in men and women and calf circumference was negatively correlated with IMT in women. Multiple stepwise regression analysis revealed that thigh circumference was independently correlated with insulin sensitivity index (Kitt) and IMT. Furthermore, in multivariate logistic regression analysis, thigh circumference was an independent determinant factor for carotid atherosclerosis in patients with type 2 diabetes even after adjusting for other cardiovascular risk factors.
Thigh and calf circumference were correlated with insulin resistance and carotid atherosclerosis, and thigh circumference was independently associated with insulin resistance and carotid atherosclerosis in patients with type 2 diabetes.
Cardiovascular Diabetology 06/2012; 11:62. · 3.35 Impact Factor
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ABSTRACT: The inflammatory marker, C-reactive protein (CRP) is associated with long-term cardiovascular events. The aim of the study
was to investigate the factors contributing to serum CRP, assess the relationship between CRP level and the parameters of
visceral obesity, and examine the association between leptin and CRP level in type 2 diabetic patients. 150 patients with
type 2 diabetes were enrolled. These patients were recently diagnosed (≤3years) with type 2 diabetes and were drug naive
or taking sulfonylureas only. BMI, WC, and serum concentration of CRP, glycosylated hemoglobin (HbA1c), glucose, lipids, plasminogen
activator-1 (PAI-1) and leptin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis
model assessment (HOMA-IR). We measured the carotid intima-media thickness (IMT). Fat mass assessed by dual-energy X-ray absorptionmetry
and abdominal fat distribution was determined by CT scan. Serum concentration of CRP was significantly correlated with BMI
(γ=0.257, P<0.01), WC (γ=0.293, P<0.01), fat mass (γ=0.213, P<0.01), total adipose tissue (γ=0.263, P<0.01), visceral adipose tissue (γ=0.296, P<0.01), insulin (γ=0.189, P=0.047), PAI-1 (γ=0.206, P<0.01), leptin (γ=0.322, P<0.01), mean IMT (γ=0.132, P=0.042), and HOMA-IR (γ=0.172, P=0.045). After adjustment for age and gender, multiple regression analysis showed that serum CRP was significantly associated
with leptin (β=0.326, P=0.01) and visceral adipose tissue (β=0.265, P=0.035). In conclusion, serum CRP level is significantly associated with obesity, especially the visceral adipose tissue,
and serum leptin is another important independent factor associated with CRP in Korean type 2 diabetic patients.
KeywordsCRP-Leptin-Visceral adipose tissue-Type 2 diabetes
Acta Diabetologica 04/2012; 47(2):113-118. · 2.78 Impact Factor
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Soon Ae Kim,
Woo Ho Shim,
Eun Hae Lee,
Young Mi Lee,
Sun Hee Beom,
Eun Sook Kim,
Jeong Seon Yoo,
Ji Sun Nam, Min Ho Cho,
Jong Suk Park,
Chul Woo Ahn,
Kyung Rae Kim
Diabetes & metabolism journal 06/2011; 35(3):300-1.
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Soon Ae Kim,
Woo Ho Shim,
Eun Hae Lee,
Young Mi Lee,
Sun Hee Beom,
Eun Sook Kim,
Jeong Seon Yoo,
Ji Sun Nam, Min Ho Cho,
Jong Suk Park,
Chul Woo Ahn,
Kyung Rae Kim
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ABSTRACT: Sitagliptin is a highly selective dipeptidyl peptide-4 (DPP-4) inhibitor that increases blood levels of active glucagon-like peptide (GLP)-1 and glucose-dependent insulinotrophic polypeptide (GIP), resulting in increased insulin secretion. While studies conducted in other countries have indicated the efficacy and safety of using sitagliptin to treat type 2 diabetes mellitus (T2DM), its predictors of effects to sitagliptin are not well understood. Therefore, we evaluated the predictive clinical parameters for the therapeutic benefits of sitagliptin when added to an ongoing metformin or sulfonylurea therapy in Korean T2DM subjects.
We obtained data from 251 Korean T2DM subjects who had recently started taking sitagliptin as add-on therapy. Exclusion criteria included any insulin use. Changes in HbA1c (ΔHbA1c) and fasting plasma glucose (ΔFPG) were assessed by comparing baseline levels prior to sitagliptin administration to levels 12 and 24 weeks after treatment. Responders were defined as subjects who experienced decrease from baseline of >10% in ΔHbA1c or >20% in ΔFPG levels at 24 weeks.
We classified 81% of the subjects (204 out of 251) as responders. The responder group had a lower mean body mass index (23.70±2.40 vs. 26.00±2.26, P≤0.01) and were younger (58.83±11.57 years vs. 62.87±12.09 years, P=0.03) than the non-responder group.
In Korean T2DM subjects, sitagliptin responders had lower body mass index and were younger compared to non-responders.
Diabetes & metabolism journal 04/2011; 35(2):159-65.
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ABSTRACT: Cardiovascular disease risk increases after menopause, which may be related to insulin resistance, and arterial stiffness is a significant predictor of atherosclerosis. We investigated the relationships among insulin resistance, adiponectin, and arterial stiffness in normoglycemic normotensive postmenopausal women.
From 9,555 participants who had routine health checkups, 455 normoglycemic normotensive postmenopausal women were enrolled. Serum concentrations of glucose, total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). Pulse wave velocity (PWV) was evaluated to assess arterial stiffness.
The women were stratified into three groups according to their HOMA-IR values, and comparisons were made among the three groups. There were significant differences in metabolic parameters between the groups. The mean age, body mass index, waist circumference, fasting plasma glucose, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), aortic PWV, and peripheral PWV increased sequentially with the degree of insulin resistance. Meanwhile, HDL-C and adiponectin levels decreased with the worsening of insulin resistance. Age, body mass index, fasting plasma glucose, TG, insulin, SBP, HOMA-IR, aortic PWV, and peripheral PWV were significantly higher in women with central obesity, and HDL-C and adiponectin were significantly lower in women with central obesity. Aortic PWV and peripheral PWV were significantly correlated with age, waist circumference, total cholesterol, SBP, DBP, insulin, and HOMA-IR, but adiponectin was not associated with PWV. The results of multiple regression analysis indicated that SBP, DBP, and insulin resistance were independently correlated with PWV.
Insulin resistance was independently associated with PWV in normoglycemic normotensive postmenopausal women.
Menopause (New York, N.Y.) 03/2010; 17(4):779-84. · 3.08 Impact Factor
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Jong Suk Park, Min Ho Cho,
Ji Sun Nam,
Jeong Seon Yoo,
Yoon Bum Lee,
Jung Min Roh,
Chul Woo Ahn,
Sun Ha Jee,
Bong Soo Cha,
Eun Jig Lee,
Sung Kil Lim,
Kyung Rae Kim,
Hyun Chul Lee
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ABSTRACT: Apolipoprotein B to A-1 (apo B/A-1) ratio is reportedly a better predictor of atherosclerotic vascular disease than low-density lipoprotein cholesterol (LDL-C). The aim of this study was to assess the association of serum apo B/A-1 ratio with insulin resistance and adiponectin in patients with different grades of glucose intolerance. Patients were divided according to glucose tolerance into 3 groups: normal glucose tolerance without metabolic syndrome (n = 229), impaired fasting glucose (subjects with fasting plasma glucose level between 100 and 125 mg/dL, n = 658), and type 2 diabetes mellitus (n = 381). Serum concentrations of apo B, apo A-1, glucose, total cholesterol (TC), triglycerides, and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the homeostasis model assessment of insulin resistance index (HOMA-IR). There were significant differences in metabolic parameters among the groups, including waist circumference, insulin, HOMA-IR, and apo B/A-1 ratio, which increased sequentially with glucose intolerance, whereas adiponectin level decreased with increasing severity of glucose intolerance. The apo B/A-1 ratio was significantly correlated with TC, triglycerides, LDL-C, HDL-C, adiponectin, and HOMA-IR in normal glucose tolerance, impaired fasting glucose, and type 2 diabetes mellitus. Multiple regression analysis showed that apo B/A-1 ratio was significantly associated with TC, LDL-C, HDL-C, and adiponectin. In conclusion, apo B/A-1 ratio was significantly associated with insulin resistance according to glucose intolerance; and serum adiponectin was an important independent factor associated with apo B/A-1 ratio in Koreans.
Metabolism: clinical and experimental 11/2009; 59(5):677-82. · 2.59 Impact Factor
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ABSTRACT: We evaluated the role of oxidative stress in diabetic nephropathy by measuring intracellular reactive oxygen species (ROS) and redox-sensitive transcription factors in isolated peripheral mononuclear cells (PBMC) in 66 diabetic patients with or without diabetic nephropathy (Groups III and II, respectively) and 49 normal controls (Group I). Stimulated ROS was significantly higher in Group III compared to Group II (increment of H(2)O(2)-induced ROS production: 21.8+/-2.2% vs. 11.1+/-2.0%; increment of PMA-induced ROS production 23.5+/-4.5% vs. 21.6+/-2.2%; both respectively), and the activity of nuclear factor-kappa B (NF-kappaB) and activator protein-1 (AP-1), but not specificity protein 1 (Sp1) was significantly higher in Group III than in Group II (2.53-fold vs. 2.0-fold vs. 1.43-fold, respectively). Both PBMC- and urinary TGF-beta1 levels were higher in Group III than Group II (3.23+/-0.39 ng/g vs. 1.99+/-0.68 ng/g in PBMCs, 16.88+/-6.84 (ng/g Cr) vs. 5.61+/-1.57 (ng/g Cr) in urine, both respectively), and they correlated with the activity of NF-kappaB and AP-1 and 24-h urine albumin excretion (UAE). Increased intracellular ROS generation in PBMCs of diabetic patients is involved in the pathogenesis of diabetic nephropathy via activation NF-kappaB and AP-1 and an increased expression of TGF-beta1.
Diabetes research and clinical practice 08/2008; 81(1):25-32. · 2.16 Impact Factor
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Hai Jin Kim, Min Ho Cho,
Jong Suk Park,
Ji Sun Nam,
Eun Seok Kang,
Chul Woo Ahn,
Bong Soo Cha,
Eun Jig Lee,
Sung Kil Lim,
Kyung Rae Kim,
Hyun Chul Lee,
Kap Bum Huh
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ABSTRACT: Our aim was to study whether visceral adiposity is a predictor of diabetic fatty liver in Korean type 2 diabetes mellitus. In this study, abdominal ultrasonography was used to assess the presence of fatty liver in 1,898 patients with type 2 diabetes. We measured visceral fat thickness by high-resolutional ultrasonography and insulin resistance by Kitt. Half of the cohort had a fatty liver (50.2%). High visceral fat thickness had the highest odds ratio for developing fatty liver in both sexes (odds ratio [S.D]: 3.14 [2.24-4.69], p<0.00 in male, 2.84 [2.04-3.93], p<0.00 in female). In addition, visceral fat thickness of 42.45 and 37.7 mm in men and women, respectively, were chosen as the discriminating value to predict the presence of fatty liver with a sensitivity of 71% and 73% and a specificity of 70% and 70% in men and women, respectively. The area under the receiver-operating characteristics curve was 0.759 in men and 0.764 in women. Therefore we could conclude that the degree of visceral adiposity predicts the presence of fatty liver type 2 diabetes mellitus, whether centrally obese or not, suggesting that hepatic fat accumulation in a diabetic fatty liver may be influenced by visceral fat accumulation regardless of waist circumference.
Journal of Korean Medical Science 04/2008; 23(2):256-61. · 0.99 Impact Factor
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Jong Suk Park, Min Ho Cho,
Kyung Yul Lee,
Chul Sik Kim,
Hai Jin Kim,
Ji Sun Nam,
Chul Woo Ahn,
Bong Soo Cha,
Eun Jig Lee,
Sung Kil Lim,
Kyung Rae Kim,
Hyun Chul Lee
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ABSTRACT: Diabetic patients have a threefold risk for cerebrovascular disease compared with nondiabetic controls. The aim of the present study was to investigate the association of insulin resistance with the pulsatility index (PI) of cerebral arteries in type 2 diabetic patients. We compared a group of 90 patients with stroke-free, type 2 diabetes and an age- and sex-matched control group of 45 healthy subjects without diabetes. We then evaluated the PI of the middle cerebral artery (MCA) by transcranial Doppler ultrasonography (TCD), and insulin resistance was determined by a short insulin tolerance test. The PI was significantly higher in diabetic patients than in healthy controls (p<0.05) and also higher in patients with insulin resistance than that seen in insulin sensitive diabetic patients (p<0.05). The PI of the MCA was significantly correlated with age (R=0.465, p<0.01), duration of diabetes (R=0.264, p=0.025) and hypertension (R=0.285, p=0.015) and inversely correlated with the insulin resistance index (Kitt: R=-0.359, p=0.030). A multiple regression analysis was performed with PI as the dependent variable and insulin resistance as an independent variable along with known clinical risk factors. Age (beta=0.393, p<0.01) and duration of diabetes (beta=0.274, p=0.043) exhibited a significant independent contribution to PI. PI could be a useful marker in the detection of diabetic cerebrovascular changes, and insulin resistance showed correlations with PI, but age and the duration of diabetes contributed independently to the variability in the PI.
Diabetes research and clinical practice 02/2008; 79(2):237-42. · 2.16 Impact Factor
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ABSTRACT: Riedel's thyroiditis is a rare form of chronic thyroiditis, characterised by a fibroinflammatory process that partially destroys the thyroid and often involves surrounding tissues. The relationship of Riedel's thyroiditis to other forms of thyroiditis is not clear. A case of Riedel's thyroiditis in a 51-year-old woman presenting with symptoms of subacute thyroiditis, is reported. She was diagnosed with subacute thyroiditis based on clinical manifestation and laboratory results. She was treated with glucocorticoids for six weeks, and then followed-up for 12 months. Three years later, she visited with tenderness and enlargement of thyroid mass, and laboratory and radiology findings suggested that she had a malignant thyroid tumor as well as subacute thyroiditis. After thyroidectomy, histopathologic findings showed that she had Riedel's thyroiditis in the presence of subacute thyroiditis. Until now, few cases of Riedel's thyroiditis in patients with a history of subacute thyroiditis have been reported in the literature. Although the etiology of Riedel's thyroiditis is unknown, it may develop in the course of subacute thyroiditis.
Endocrine Journal 09/2007; 54(4):559-62. · 2.03 Impact Factor
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Jong Suk Park, Min Ho Cho,
Kyung Yul Lee,
Chul Sik Kim,
Hai Jin Kim,
Ji Sun Nam,
Chul Woo Ahn,
Bong Soo Cha,
Sung Kil Lim,
Kyung Rae Kim,
Hyun Chul Lee
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ABSTRACT: Atherosclerosis is one of the major causes of morbidity and mortality in patients with type 2 diabetes mellitus. Pioglitazone has been reported to have antiatherogenic effects. The aim of this study was to investigate whether pioglitazone affects pulsatility index (PI) of the cerebral arteries and the carotid intima-media thickness in type 2 diabetic patients. A total of 40 type 2 diabetic patients were included in this study. They were divided into 2 groups: the pioglitazone-treated group (pioglitazone 15 mg/d with gliclazide 80-320 mg/d for 12 weeks) and the gliclazide-treated group (gliclazide 80-320 mg/d for 12 weeks). Transcranial Doppler ultrasonography was performed for each cerebral artery, and PI was calculated as (systolic velocity-diastolic velocity)/mean velocity. The pioglitazone treatment significantly increased high-density lipoprotein cholesterol and decreased triglyceride levels and insulin resistance. This study revealed that the change in mean intima-media thickness was not significant in both groups, but the change in PI was significantly decreased with pioglitazone compared to gliclazide. In conclusion, pioglitazone decreased PI and improved cerebrovascular resistance in type 2 diabetic patients.
Metabolism 09/2007; 56(8):1081-6. · 2.66 Impact Factor
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Jong Suk Park,
Jina Park,
Chul Sik Kim, Min Ho Cho,
Hai Jin Kim,
Jeong-Ho Kim,
Chul Woo Ahn,
Kyung Rae Kim,
Bong Soo Cha,
Sung Kil Lim,
Hyun Chul Lee
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ABSTRACT: The aim of this study was to investigate whether low-density lipoprotein (LDL) particle size is associated with insulin resistance and to explore the association between LDL particle size and preclinical atherosclerosis in nondiabetic Korean population. We measured the carotid intima-media thickness (IMT), LDL particle size, and insulin resistance in 136 nondiabetic subjects. Low-density lipoprotein particle size was significantly correlated with insulin resistance, but the independent risk factors of LDL particle size determined by the multiple regression analysis were age, triglyceride, and high-density lipoprotein cholesterol (HDL-C). Carotid IMT was associated with traditional risk factors of atherosclerosis, which are age, HDL-C, LDL cholesterol, systolic and diastolic blood pressure, but LDL particle size was not correlated with carotid IMT. We conclude that LDL particle size was associated with insulin resistance, but age, triglyceride, and HDL-C contributed independently to the variability in LDL particle size, and LDL particle size was not a predictor of preclinical atherosclerosis in nondiabetic Koreans.
Metabolism 01/2007; 55(12):1610-5. · 2.66 Impact Factor
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ABSTRACT: Syphilis is an unexpected diagnosis in the stomach, and the reduced incidence of syphilis has made its clinical presentation less widely appreciated. We report a 43-yr-old man suffering from epigastric tenderness with an initial diagnosis of gastric carcinoma; gastric syphilis was confirmed by demonstrating spirochetes in a gastric biopsy specimen by silver impregnation. Excessive lymphoplasmacytic infiltration with diffuse thickening of gastric rugae should raise suspicion of gastric syphilis, which should be considered in the differential diagnosis of diffuse erosive gastritis and infiltrative lesions of the stomach.
Journal of Korean Medical Science 07/2006; 21(3):559-62. · 0.99 Impact Factor
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ABSTRACT: This study is about contents gathering, manipulating and delivering to customer in Internet portal company by using messaging and XML technology instead of EJB/CORBA. We can find total architecture, merit, value and direction for further work of proposed architecture in this article. Additionally, we can find a simple implementation for technical verification
Industrial Electronics, 2001. Proceedings. ISIE 2001. IEEE International Symposium on; 02/2001
