Diabetes & Metabolism Journal

Dong Seop Choi (Choi DS)

37 Articles

Relationship Between Metabolic Syndrome and Risk of Chronic Complications in Koreans with Type 2 Diabetes.: Hye Soo Chung, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Doo Man Kim, Choon Hee Chung, Dong seop Choi; Korean Diabetes J. 2009;33(5):392-400. Published online October 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.5.392

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BACKGROUND
We examined the relationships between components of metabolic syndrome at the time of diagnosis of type 2 diabetes, and the development of chronic complications in Korean patients with type 2 diabetes. METHODS: The medical records of patients with type 2 diabetes who had undergone treatment for at least five years prior were collected from 10 general hospitals in Korea. Among a total of 1,418 patients reviewed for possible inclusion in this study, 603 patients were selected, and the occurrence of complications among these patients was evaluated. RESULTS: Among the 603 patients (male, 253; female, 350), 154 males (60.8%) and 266 females (76.0%) were diagnosed with metabolic syndrome at the time of initial diagnosis of type 2 diabetes. The incidence of chronic complications (average follow-up 15.2 +/- 4.9 years) included 60 cases of coronary artery disease (CAD), 57 cases of cerebrovascular accident (CVA), 268 cases of diabetic retinopathy (DR), 254 cases of diabetic nephropathy (DN), and 238 cases of diabetic peripheral neuropathy (DPN). As compared to patients without metabolic syndrome, the adjusted relative risks (95% CI) of incidental diabetic complications in patients with metabolic syndrome were 3.28 (1.40~7.71) for CAD, 2.04 (0.86~4.82) for CVA, 1.53 (1.10~2.14) for DR, 1.90 (1.29~2.80) for DN, and 1.51, (1.06~2.14) for DPN. With the addition of just one constituent of metabolic syndrome, the relative risk of developing CAD, CVD, DR, DN, and DPN increased by 2.08 (95% CI, 1.27~3.40), 1.16 (0.80~1.66), 1.09 (0.93~1.26), 1.29 (1.06~1.57) and 1.06 (0.87~1.26), respectively. CONCLUSION: Metabolic syndrome in Korean patients with type 2 diabetes increases the risk of developing both macrovascular and microvascular complications.

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COVID-19 pandemic: Effects of national lockdown on the state of health of patients with type 2 diabetes mellitus in a Moroccan population
Hamid Farhane, Majida Motrane, Fatima-Ezzahra Anaibar, Aïcha Motrane, Said Nassor Abeid, Nourdin Harich
Primary Care Diabetes.2021; 15(5): 772. CrossRef
Profil clinique du syndrome métabolique et facteurs associés à sa présence au cours du diabète de type 2 à Ouagadougou (Burkina Faso)
O. Guira, H. Tiéno, Y. Sagna, P. Mayodé, D. Yanogo, L. Zoungrana, C.-G. Kyélem, M.-T. Yaméogo, J.-Y. Drabo
Médecine des Maladies Métaboliques.2016; 10(1): 70. CrossRef
The Relationship between Metabolic Syndrome and Quality of Life in Korean Adult Women
Hyung-Su Park, Jong Park
The Journal of the Korea institute of electronic communication sciences.2013; 8(4): 639. CrossRef
Diabetes Risk Analysis Model with Personalized Food Intake Preference
So-Hye Jeon, Nam-Hyun Kim
Journal of the Korea Academia-Industrial cooperation Society.2013; 14(11): 5771. CrossRef
Comorbidity Study on Type 2 Diabetes Mellitus Using Data Mining
Hye Soon Kim, A Mi Shin, Mi Kyung Kim, Yoon Nyun Kim
The Korean Journal of Internal Medicine.2012; 27(2): 197. CrossRef
Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
Diabetes & Metabolism Journal.2012; 36(5): 357. CrossRef

The Effect of Cellular Phone-Based Telemedicine on Glycemic Control in Type 2 Diabetes Patients Using Insulin Therapy.: Yun Jeong Lee, Mi Hyun Jeong, Joo Hyung Kim, Juri Park, Hee Young Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2009;33(3):232-240. Published online June 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.3.232

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Abstract PDF

BACKGROUND
Cellular phones are extremely prevalent in modern society and they enable appropriate feedback mechanisms through real time monitoring and short message services regarding blood glucose levels. We investigated whether cellular phone-based telemedicine support system could improve blood glucose control in type 2 diabetes patients who were in inadequate glycemic control regardless of insulin therapy. METHODS: A randomized, controlled clinical trial was conducted involving 74 type 2 diabetic patients with suboptimal glycemic control (HbA1c levels > 7%) regardless of insulin therapy. The intervention (cellular phone-based telemedicine) group managed their blood glucose using a cellular phone for 3 months, while the control (self monitoring of blood glucose) group managed their blood glucose with a standard glucometer for the same period. RESULTS: Three months later, HbA1c levels were decreased in both groups. However, the decrease in the control group from 8.37% to 8.20% was only 0.20% (P = 0.152) which was not significant. In contrast, the intervention group had a significant reduction of 0.61% from 8.77% to 8.16% (P < 0.001). Moreover, among patients with a baseline > or = 8%, the patients in the intervention group showed a significant reduction of 0.81% from 9.16% to 8.34% (P < 0.001). CONCLUSION: HbA1c levels were significantly decreased in the cellular phone-based telemedicine group compared with the control group after 3 months. This study suggests that cellular phone-based telemedicine is helpful for better glucose control in type 2 diabetes patients who previously were unable to control glucose levels adequately with insulin therapy.

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A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients
Soo Lim, So-Youn Kim, Jung Im Kim, Min Kyung Kwon, Sei Jin Min, Soo Young Yoo, Seon Mee Kang, Hong Il Kim, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hayley Shin, Hak Chul Jang
Diabetes & Metabolism Journal.2011; 35(1): 50. CrossRef

Effects of Comprehensive Support on Glycemic Control Using Community Networks in Low- Income Elderly Patients with Diabetes.: Nam Hoon Kim, Yun Jeong Lee, Hye Ok Kim, Cho Rong Oh, Ju Ri Park, Soo Yoen Park, Hee Young Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim; Korean Diabetes J. 2008;32(5):453-461. Published online October 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.5.453

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BACKGROUND
Diabetes is common among elderly, and low-income is associated with poor adherence to treatment and increased mortality. We evaluated whether comprehensive support using community networks improves glycemic control among low-income elderly patients with diabetes. METHODS: A total of 49 low-income elderly patients with type 2 diabetes, mean age 73 years, were enrolled. For 1 year, study subjects underwent various lifestyle modification programs provided by community networks. The biochemical data including glycemic markers and anthropometric data were obtained at the baseline and at the end of the study. Also, the patients were asked to complete a questionnaire about their quality of life, self-confidence and self-care behavior. RESULTS: After lifestyle modification program, overall changes of fasting plasma glucose, HbA1c, blood pressure, body weight, and other biochemical markers were not significantly different. In a subgroup analysis of 21 patients with poorly controlled diabetes (fasting glucose > 140 mg/dL or HbA1c > 7.5%), fasting plasma glucose was significantly reduced (P = 0.030). Among patients with baseline HbA1c level > or = 8%, HbA1c levels after intervention decreased from 9.33 +/- 1.07% to 8.27 +/- 1.15% (P = 0.092). The results of the questionnaires revealed significant increases in the scores of quality of life, self-confidence and self-care behavior (P < 0.05). CONCLUSION: Among low-income, elderly patients with type 2 diabetes, lifestyle modification through community networks showed no significant changes in glycemic control markers. More intensive and precise interventions using community networks are needed for the glycemic control of low-income, elderly patients with type 2 diabetes.

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The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes
Ki wol Sung, Hye Seung Kang, Ji Ran Nam, Mi Kyung Park, Ji Hyeon Park
Journal of Korean Academy of Nursing.2018; 48(2): 182. CrossRef
Development of a scale to measure diabetes self‐management behaviors among older Koreans with type 2 diabetes, based on the seven domains identified by the American Association of Diabetes Educators
Kyoungsan Seo, Misoon Song, Suyoung Choi, Se‐an Kim, Sun Ju Chang
Japan Journal of Nursing Science.2017; 14(2): 161. CrossRef
Current Status and Effects of Dining with Diabetes in Korea and Abroad
Seung Hye Yang
The Journal of Korean Diabetes.2017; 18(2): 117. CrossRef
Diabetes Management through Care Communities
Kyeong Ok Yun
The Journal of Korean Diabetes.2016; 17(4): 271. CrossRef
Understanding Psycho-Social Aspects and Social Welfare Information of Low-Income Diabetes Patients
Been Yoo
The Journal of Korean Diabetes.2015; 16(3): 212. CrossRef
Newly Diagnosed Diabetes Mellitus With Pancreatic Cancer Manifested as Hyperglycemic Hyperosmolar State
Tae Hyung Kwon, Min Seong Kim, Jun Ho Jeon, Dong Il Jeong, Sang Seok Yun, Yong Kyu Lee
Journal of the Korean Geriatrics Society.2013; 17(2): 95. CrossRef
Development of a Comprehensive Self-Management Program Promoting Self Efficacy for Type 2 Diabetic Patients
Ju-Young Park, Il-Sun Ko
Journal of Korean Academy of Fundamentals of Nursing.2012; 19(1): 74. CrossRef

Effects of Telmisartan Compared with Valsartan on Plasma Adiponectin Levels and Arterial Stiffness in Patients with Type 2 Diabetes: A Pilot Study.: Soo Yeon Park, Sin Gon Kim, Juri Park, Yun Jeong Lee, Hee Young Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2008;32(3):236-242. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2006.32.3.236

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Abstract PDF: BACKGROUND
Telmisartan, used for the treatment of hypertension, has been shown to function as a partial agonist of peroxime proliferative activated receptor-nu (PPAR-nu). Theoretically, telmisartan which simultaneously blocks the angiotensin II receptor and activates PPAR-nu should be more effective in improving atherosclerotic surrogate markers than angiotensin II receptor blockers alone. Therefore, this pilot study was designed to evaluate and compare the efficacy of telmisartan and valsartan on plasma adiponectin levels and pulse wave velocity as a marker of arterial stiffness in patients with type 2 diabetes. METHODS: Thirty two patients with type 2 diabetes (mean duration 7.6 +/- 5.1 years) taking oral hypoglycemic agents were randomly assigned to receive telmisartan or valsartan for 12 weeks. RESULTS: Telmisartan and valsartan treatment significantly increased circulating adiponectin levels (P = 0.013 and P = 0.013, respectively) and reduced systolic (P = 0.001 and P = 0.002, respectively) and diastolic blood pressure (P = 0.001 and P < 0.001, respectively), and brachial-ankle PWV (P = 0.019 and P = 0.002, respectively), without significant differences between the two treatments. Before and after treatment, the fasting plasma glucose, interleukin-6, homeostasis model of assessment insulin resistance (HOMAIR) levels and lipid profile were unchanged in both treatment groups. CONCLUSION: Contrary to our expectation, telmisartan, even with its partial PPAR-nu activity, is not superior to valsartan in improving plasma adipocytokine levels and arterial stiffness in patients with type 2 diabetes. These data suggest that the partial PPAR-nu activity of telmisartan beyond valsartan may have less significant therapeutic implications than expected in treating patients with type 2 diabetes.

Effects of Troglitazone on the Expression of VEGF and TGF-beta in Cultured Rat Mesangial Cells.: Dong Lim Kim, Nan Hee Kim, Dong Seop Choi; Korean Diabetes J. 2007;31(3):220-229. Published online May 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.3.220

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Abstract PDF: BACKGROUND
Clinical study reported that troglitazone ameliorated microalbuminuria in diabetic nephropathy. However, the mechanism of action is not fully understood. Vascular endothelial growth factor (VEGF) is known as vascular permeability factor and it is considered the most likely cause of glomerular hyperfiltration and proteinuria in diabetic nephropathy. Transforming growth factor-beta (TGF-beta) is a potent inducer of extracellular matrix production and fibrosis in renal cells and one of the important cytokine in the pathogenesis of diabetic nephropathy. To determine whether troglitazone affects VEGF and TGF-beta production in diabetic nephropathy, we examined the effects of troglitazone on the VEGF and TGF-beta expression in cultured rat mesangial cells exposed to high glucose concentration. METHODS: Rat mesangial cells were cultured in media with D-glucose 5.5 mM (NG) or D-glucose 30 mM (HG), or D-glucose 30 mM/troglitazone 20 micrometer(HTz) and for 6, 24, or 72 hours, respectively. VEGF and TGF-beta expression were assessed by semiquantitative RT-PCR and western blot analysis. RESULTS: Troglitazone decreased the VEGF164 and VEGF120 mRNA expressions in cultured rat mesangial cells exposed to high glucose concentration with incubation for 24 and 72 hours, respectively. VEGF protein was also decreased in experimental group treated with troglitazone (HTz) than in those with HG for 24 and 72 hours. However troglitazone had no effect on the expression of TGF-beta mRNA in mesangial cells. CONCLUSION: This study suggested that troglitazone may modulate the development and progression of diabetic nephropathy by reducing the expression of VEGF in mesangial cells

Comparison of the Efficacy and Safety of Glimepiride/Metformin Fixed Combination Versus Free Combination in Patients with Type 2 Diabetes: Multicenter, Randomized, Controlled Trial.: Seung Hwan Lee, In Kyu Lee, Sei Hyun Baik, Dong Seop Choi, Kyong Soo Park, Ki Ho Song, Kwan Woo Lee, Bong Soo Cha, Chul Woo Ahn, Hyoung Woo Lee, Choon Hee Chung, Moon Suk Nam, Hong Sun Baek, Yong Ki Kim, Hyo Young Rhim, Ho Young Son; Korean Diabetes J. 2006;30(6):466-475. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.466

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BACKGROUND
Failure to manage diabetes mellitus receiving monotherapy increases as the duration of the disease is protracted, and in many cases it becomes inevitable to introduce combined therapies. However, compliance of the patients tends to decrease. We conducted a clinical study to compare the efficacy and safety of preconstituted and fixed combination therapy of glimepiride plus metformin to those of free combination therapy. METHODS: Two hundred and thirteen patients with type 2 diabetes who had been diagnosed at least six months ago were randomly assigned either to a fixed group or a free group. The initial dosage was chosen according to the previous treatment history and then adjusted every two weeks following a predefined titration algorithm to meet the target mean fasting glucose levels (140 mg/dL). The medications were given for 16 weeks. The primary endpoint was the change in HbA1c level from baseline to week 16. Various parameters were checked as secondary outcome measures and safety criteria. RESULTS: HbA1c level of the fixed group and the free group decreased by 1.09% and 1.08%, respectively. The 95% CI of the changes' difference between the two groups (-0.21%, +0.19%) was within the predefined equivalence interval (-0.5%, +0.5%). Secondary outcome measures (the changes of fasting and postprandial plasma glucose level, response rate and compliance) and safety criteria (frequency of hypoglycemia and adverse reactions) were similar between the two groups. CONCLUSION: Fixed combination of glimepiride/metformin is as effective and safe therapy as free combination in type 2 diabetes patients.

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Efficacy and safety of glimepiride/metformin sustained release once daily vs. glimepiride/metformin twice daily in patients with type 2 diabetes
Y.-C. Hwang, M. Kang, C. W. Ahn, J. S. Park, S. H. Baik, D. J. Chung, H. C. Jang, K.-A. Kim, I.-K. Lee, K. W. Min, M. Nam, T. S. Park, S. M. Son, Y.-A. Sung, J.-T. Woo, K. S. Park, M.-K. Lee
International Journal of Clinical Practice.2013; 67(3): 236. CrossRef
Pharmacokinetic comparison of a new glimepiride 1-mg + metformin 500-mg combination tablet formulation and a glimepiride 2-mg + metformin 500-mg combination tablet formulation: A single-dose, randomized, open-label, two-period, two-way crossover study in
Bo-Hyung Kim, Kwang-Hee Shin, JaeWoo Kim, Kyoung Soo Lim, Kyu-pyo Kim, Jung-Ryul Kim, Joo-Youn Cho, Sang-Goo Shin, In-Jin Jang, Kyung-Sang Yu
Clinical Therapeutics.2009; 31(11): 2755. CrossRef

Efficacy Evaluation of Atorvastatin in Korean Hyperlipidemic Patients with Type 2 Diabetes Mellitus.: Dong Seop Choi, Duk Kyu Kim, Doo Man Kim, Seong Yeon Kim, Moon Suk Nam, Yong Soo Park, Ho Sang Shon, Chul Woo Ahn, Kwan Woo Lee, Ki Up Lee, Moon Kyu Lee, Choon Hee Chung, Bong Yeon Cha; Korean Diabetes J. 2006;30(4):292-302. Published online July 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.4.292

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BACKGROUND
NCEP ATP III Guideline recommends aggressive treatments of diabetic dyslipidemia, recognizing diabetes mellitus as CHD risk equivalents. This study was conducted to evaluate the effectiveness and safety of atorvastatin in hyperlipidemic patients with Type 2 diabetes mellitus through post-marketing drug use investigation of atorvastatin. METHODS: An open, multi-center, non-comparison, titrated dosage study was conducted in hyperlipidemic patients, who were treated with atorvastatin at first visiting hospitals from Mar. 2004 to Sep. 2004. 96 endocrinologists participated from 66 centers in this study. Total 2,182 hyperlipidemic patients were enrolled and 1,514 patients among them were accompanied by diabetes mellitus. Efficacy was evaluated at later than 4-week treatment by % change of total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol from baseline. Percent of patients reaching LDL-cholesterol level less than 100 mg/dL was also analyzed. The adverse events incidence and abnormalities of clinical laboratory values were evaluated for safety monitoring. RESULTS: Total cholesterol, triglycerides, and LDL-cholesterol level were reduced by 26.6%, 12.0%, and 34.8%, respectively, in diabetic hyperlipidemic patients after atorvastatin treatment. The patients with LDL-cholesterol level of less than 100 mg/dL were increased from 2.8% to 52.6%. Atorvastatin was considered to be safe because adverse drug reactions were reported in 32 patients (1.5%) of total 2,182 patients. CONCLUSION: Atorvastatin was effective and safe in hyperlipidemic patients with type 2 diabetes mellitus.

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Response: A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
Diabetes & Metabolism Journal.2011; 35(1): 88. CrossRef
A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients
Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
Korean Diabetes Journal.2010; 34(6): 359. CrossRef
The Association of Plasma HDL-Cholesterol Level with Cardiovascular Disease Related Factors in Korean Type 2 Diabetic Patients
Hye Sook Hong, Jong Suk Park, Han Kyoung Ryu, Wha Young Kim
Korean Diabetes Journal.2008; 32(3): 215. CrossRef

VEGF-Angiopoietin-Tie2 System in Diabetic Retinopathy.: Nan Hee Kim, Hee Young Kim, Ji A Seo, Kye Won Lee, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Yoon Shin Park, Inho Jo, Dong Seop Choi; Korean Diabetes J. 2005;29(2):122-132. Published online March 1, 2005

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Abstract PDF: BACKGROUND
Ischemia-induced neovascularization can cause the loss of vision in retinal disorders such as diabetic retinopathy. Recent studies have shown that the angiopoietin-Tie2 system is a major regulator of vascular integrity and it is involved in pathologic angiogenesis. However, its role in the pathophysiology of diabetic retinopathy is not yet known. We examined the regulation of the VEGF-angiopoietin-Tie2 system in both in vitro and in vivo studies to discover their possible role in diabetic retinopathy. METHODS: We investigated the effects of a well-known angiogenic stimulus, hypoxia(2% O2 concentration) and vascular endothelial growth factor(VEGF, 10 ng/mL) on the expression of the angiopoietin-Tie2 mRNA in bovine retinal pericytes(BRP) and bovine aortic endothelial cells(BAEC). We also examined the expressions of VEGF-angiopoietin-Tie2 mRNA in retinas of type 2 diabetic OLETF(Otsuka-Long-Evans-Tokushima-Fatty) rats at 30 and 50 weeks. We also investigated the effect of angiotensin II receptor type 1(AT1) antagonist on the VEGFangiopoietin-Tie2 expression. RESULTS: Hypoxia and VEGF treatment significantly increased angiopoietin-1(Ang1) mRNA expression in the BRPs. In contrast, the angiopoietin-2(Ang2) mRNA expression was unaltered in the BRPs treated with hypoxia and VEGF. Significant up-regulation of Tie2 mRNA expression was found and this lasted up to 12 h. However, using BAECs, we found that only the Ang2 expression responded to these two angiogenic stimuli. In OLETF rats, the Ang-Tie2 expression patterns were similar with those of the BAECs. Ang2 and VEGF mRNA were increased at 30 and 50 weeks for the OLETF rats, whereas the Ang1 expression was not changed. The up-regulation of Ang2 and VEGF was decreased with the losartan treatment, an AT1 receptor antagonist. Tie2 mRNA expression was increased only at 50 weeks and it did not show any decrement by the losartan treatment. CONCLUSION: Our data suggest that hypoxia and VEGF treatment differentially regulate the angiopoietin-Tie2 system in the two vascular cells. Ang2 and VEGF expressions were predominantly increased in type 2 diabetic rats, and the unopposed action of Ang2 with VEGF might be involved in the development of diabetic retinopathy. The renin-angiotensin system may be a potential mechanism for the up-regulated VEGF-Ang2 system

Correlation of C-reactive Protein with Components of Metabolic Syndrome in Elderly Korean Women with Normal or Impaired Glucose Tolerance.: Soon Beom Kwon, Kyung Mook Choi, Soo Yeon Park, Hye Jin Yoo, Ohk Hyun Ryu, Sang Soo Park, Hee Young Kim, Kye Won Lee, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2004;28(5):432-440. Published online October 1, 2004

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Abstract PDF: BACKGROUND
Previous studies have reported that type 2 diabetes is associated with the increased blood concentrations of markers for the acute phase response, such as C-reactive protein (CRP), serum sialic acid and fibrinogen. The purpose of this study was to verify whether the pro-inflammatory cytokine- induced acute-phase response is a major pathogenic mechanism for type 2 diabetes in elderly Korean women. METHODS: We randomly selected a total of 232 non-smoking and non-diabetic female subjects among a total of 1,737 elderly subjects aged over 60 years who had participated in a population based study in Seoul, Korea (SWS Study 1999). We compared concentrations of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), as well as the acute-phase reactant C-reactive protein (CRP), between the subjects with normal glucose tolerance (NGT) and the subjects with impaired glucose tolerance (IGT). RESULTS: The IGT group showed higher serum high-sensitivity CRP (hs-CRP) concentrations than did the NGT group (the median was 1.2 versus 0.9, respectively, p<0.05). Moreover, a close relationship between serum hs-CRP concentrations and many components of the metabolic syndrome was found. However, serum concentrations of pro-inflammatory cytokines, IL-6 and TNF-alpha were not increasedin the IGT group, and they were not closely correlated with the components of metabolic syndrome. Multiple regression analysis using a stepwise selection method showed that the white blood cell counts, body mass index (BMI), fasting insulin, post-load 2h glucose, hematocrit and LDL cholesterol were associated with hs-CRP. CONCLUSIONS: The present study confirms the relationship between C-reactive protein, impaired glucose tolerance and metabolic syndrome in elderly Korean women.

Serum CRP levels are associated with Estradiol levels and Insulin Resistance Syndrome in Korean Women.: Kwon Beom Kim, Hee Young Kim, Kye Won Lee, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Chol Shin, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2004;28(4):324-337. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Several reports have recently suggested a positive correlation between components of metabolic syndrome (MS) or insulin resistance syndrome (IRS) and markers of the acute-phase response, including C-reactive protein (CRP). These results imply that MS and type 2 diabetes are the results of ongoing inflammatory process. Whether estrogen plays a beneficial role in preventing atherosclerosis has been a matter of controversy. The objective of this study was to evaluate the relationship between the serum levels of estradiol (E2) and the components of the MS and CRP in nondiabetic subjects of Ansan Health Study (AHS). METHODS: Eight-hundred and ninety-one healthy non-diabetic women aged over 18 years were enrolled. After measurements of the anthropometric and metabolic parameters, correlation and multiple linear regression analyses were performed with regard to the CRP level, as a dependent variable, and with regards to age, blood pressure (BP), body mass index (BMI), lipid profiles, fasting plasma glucose levels, HOMA-IR and fat content as independent variables. RESULTS: In the multiple linear regression analysis, the CRP concentration was found to be independently associated with the E2 level, total fat content, leukocyte counts, and total cholesterol level in all subjects and the serum E2 levels was correlated with age, HOMA-IR, total cholesterol and the CRP level. When subjects were grouped according to their number of MS or IRS components, the CRP levels were found to show statistically significant differences between the MS and IRS groups. CONCLUSION: As a marker of chronic inflammation, the serum CRP level was independently associated with the components of MS and IRS. Also, the serum CRP and E2 levels were positively correlated. These results suggest that estrogen and CRP might play some independent roles in chronic inflammation which is a part of MS and IRS.

Plasma and urinary Vascular Endothelial Growth Factor and Diabetic Nephropathy in Type 2 Diabetes Mellitus.: Jeong Heon Oh, Hye Jin Yoo, Soo Yeon Park, Ohk Hyun Ryu, Sang Soo Park, Soon Beom Kwon, Hee Young Kim, Ji A Seo, Kye Won Lee, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Dae Ryong Cha, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2004;28(2):111-121. Published online April 1, 2004

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Abstract PDF: BACKGROUND
VEGF(vascular endothelial growth factor) has been implicated in the pathogenesis of neovascularization and endothelial dysfunction in diabetes mellitus. However, its precise role in diabetic nephropathy is still unknown. Our aims were to determine whether alterations of plasma and urinary VEGF levels were related to diabetic microvascular complications, especially nephropathy in type 2 diabetic patients. METHODS: 107 type 2 diabetic patients, without non-diabetic kidney diseases, and 47 healthy control subjects were studied. The urinary albumin excretion was defined as the albumin-to-creatinine ratio(ACR) in 24 hour urine samples. The study subjects were divided into four groups: a nondiabetic healthy control group(n=47), a normoalbuminuric diabetic group(ACR <30mug/mg, n=37), a microalbuminuric diabetic group(ACR 30~299mug/mg, n=37) and an overt proteinuric diabetic group(ACR=300mug/mg, n=33). The plasma and urinary VEGF levels were measured in these subjects by enzyme-linked immunosorbent assays. RESULTS: 1) The urinary VEGF concentrations were significantly higher in the diabetic groups than in the controls, even in the normoalbuminuric stage(log VEGF/Cr, normoalbuminuria; 4.33+/-1.06 vs. control; 3.53+/-0.79, p=0.009). The levels of urinary VEGF excretions increased with advancing diabetic nephropathy stage. 2) The plasma and urinary VEGF levels were higher in the hypertensive diabetic than the normotensive diabetic patients. 3) In the diabetic patients, the level of plasma VEGF was positively correlated with the BUN(r=0.398, p=0.039) and urinary ACR (r=0.251, p=0.044). The level of urinary VEGF was positively correlated with the urinary ACR(r=0.645, p<0.001), and creatinine(r=0.336, p=0.009), but negatively correlated with the level of serum albumin(r=-0.557, p<0.001). Both the levels of urinary VEGF and serum creatinine were independently correlated with the urinary ACR. CONCLUSIONS: The excretion of urinary VEGF increased at a relatively earlier stage in diabetic nephropathy and was significantly correlated with the excretion of urinary albumin. These results suggested the possibility of urinary VEGF as a sensitive marker or the detection of diabetic nephropathy and in predicting disease progression.

Brachial-ankle Pulse Wave Velocity in Koreans with the Metabolic Syndrome.: Kyung Mook Choi, Kye Won Lee, Sul Hye Ryoung, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2004;28(1):36-44. Published online February 1, 2004

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Abstract PDF: BACKGROUND
The clustering of cardiovascular risk factors is known as metabolic syndrome. In this study, the association between the brachial-ankle pulse wave velocity(baPWV), a novel non-invasive means of measuring atherosclerosis, and the cardiovascular risk factors of the metabolic syndrome were investigated. METHODS: The study group comprised 460 non-diabetic Koreans, male:female ratio 158:302, with a mean age of 52.4+/-11.3 years. The anthropometric parameters, blood pressure, fasting blood glucose(FBG), lipid profiles, ankle-brachial pressure index(ABI) and baPWV were measured in each subject. RESULTS: The ABI and baPWV levels were significantly higher in the men than the women. In both the men and women, the baPWV was closely associated with the cardiovascular risk factors of the metabolic syndrome. Those who had more metabolic syndrome components showed higher baPWV levels. Women with metabolic syndrome showed higher baPWV levels compared to those without (1517+/-281 vs. 1336+/-250, P<0.001). A multiple regression analysis showed the baPWV to be significantly associated with systolic blood pressure, age, gender, body mass index (BMI) and FBG (adjusted R-square 0.554). CONCLUSIONS: The present study shows that the baPWV was significantly associated with the features of metabolic syndrome, including the FBG, in non-diabetic Koreans.

Relations between Insulin Resistance and Hematologic Parameters in Elderly Koreans: Southwest Seoul (SWS) Study.: Kye Won Lee, Hye Jin Yoo, Soo Yeon Park, Ohk Hyun Ryu, Sang Soo Park, Soon Beom Kwon, Hee Young Kim, Ji A Seo, Jeong Heon Oh, Dong Hyun Shin, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Hyoung Jin Kim; Korean Diabetes J. 2003;27(4):352-361. Published online August 1, 2003

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Abstract PDF: BACKGROUND
The clustering of cardiovascular risk factors is known as insulin resistance syndrome. Hyperinsulinemia has been suggested as a cardiovascular risk factor due to the capacity of insulin to induce vascular endothelial proliferation and atherosclerosis. Insulin also has been shown to stimulate erythroid colony formation independently of erythropoietin. WBC count is one of the major components of the inflammatory process and is increased by IL-6, which is high in those with features of insulin resistance. In this study, we investigated whether insulin resistance affects hematological parameters. METHODS: In this study, 1,314, randomly selected, non-diabetic, elderly subjects over 60 years living in the southwest area of Seoul were recruited. Subjects underwent 75 g OGTT and careful physical examinations during evaluation, and were interviewed using a standardized questionnaire. Biochemical data and hematologic parameters were also measured. Insulin resistance was calculated by HOMA (homeostasis model assessment) method. Analysis of variance, Duncan's multiple comparisons and multiple linear regression analysis were carried out. RESULTS: In the male non-smoking group we found a correlation between insulin resistance and hemoglobin concentration (r=0.20, p=0.0186). In the female non- smoking group we found correlations between insulin resistance and both hemoglobin concentration (r=0.10, p=0.0017) and white blood cell (WBC) count (r=0.15, p=0.001). Hemoglobin concentration and WBC count were also correlated with BMI, systolic and diastolic blood pressure, lipid profiles and fasting insulin levels in female non-smokers. In multiple regression analysis, using HOMA IR as a dependent variable, we found significance in the variables of hemoglobin concentration, WBC count, age, BMI and triglyceride level. CONCLUSION: Our study provided evidence for a relation between insulin resistance and hematological parameters such as hemoglobin concentration and WBC count in elderly Koreans. This suggests that increased hemoglobin level and WBC count could be considered as novel aspects of the met.

VEGF in the Pathogenesis of Diabetic Nephropathy.: Nan Hee Kim, Dong Seop Choi; Korean Diabetes J. 2003;27(2):95-105. Published online April 1, 2003

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Abstract PDF: No abstract available.

Effects of Nateglinide on the Control of Mealtime Glucose Excursions in Korean Patients with Type 2 Diabetes.: Hyeon Man Kim, Yoon Seok Chung, Kwan Woo Lee, Dae Jung Kim, Hyun Chul Lee, Dong Rim Kim, Dong Seop Choi, Eun Sook Oh, Moo Il Kang, Kwang Woo Lee, Chul Young Park, In Myung Yang, Jin Woo Kim, Young Seol Kim, Hyong Gi Jung; Korean Diabetes J. 2002;26(5):405-415. Published online October 1, 2002

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Abstract PDF: BACKGROUND
Nateglinide belong to a new family of insulin secretagogues that stimulate the early phase of insulin secretion. This study was designed to evaluate the efficacy and adverse effect of nateglinide in Korean type 2 diabetes patients, whose diabetes were inadequately controlled by medical nutrition therapy, focusing on the changes in mealtime glucose excursion (PBG), fasting blood glucose (FBG), glycated hemoglobin (HbA1c) and plasma insulin. SUBJECTS AND METHODS: This multicentered open-label trial was conducted on 66 Korean patients with type 2 diabetes mellitus. The subjects comprised of 36 males and 30 females, with a mean age, and duration of diabetes of 53.9+/-9.6(34~69) years and 39.5+/-44.0 months, respectively. The inclusion criteria were as follows: 1) FBG and PBG before the trial of 6.7~11.1 mmol/l and above 11.1 mmol/l, respectively, 2) changes of FBG and PBG during the 2-week-diet treatment of less than 1.7 mmol/l. PBG, FGB, HbA1c and plasma insulin levels were measured at weeks -2, 0, 2, 4, 8 and 12. Any adverse effects were noted during the study. The data were analyzed by the intent-to treat (ITT) and the per protocol (PP) methods. RESULTS: Nineteen cases were excluded due to protocol violation or withdrawal. The PBG level was significantly decreased during the study 13.7 2.6 mmol/l, before the trail to 9.6 2.8 mmol/l after (p=0.001) which was particularly marked during the first 2 weeks. The FBG, HbA1c and fasting plasma insulin levels were also significantly decreased, from 9.0+/-1.2 to 8.2+/-2.0 mmol/l, p=0.0063), from 8.0+/-1.3% to 7.0+/-1.1% (p=0.0001) and from 9.8 7.2 to 8.0 5.5 pmol/l (p<0.05), respectively. Three adverse events suggested the nateglinide-related diabetes was not serious. CONCLUSION: This study revealed that nateglinide could be used as an effective glucose-lowering agent, especially for the control of mealtime glucose excursion in Korean type 2 diabetes patients who were inadequately controlled by diet alone.

Detection of Diabetic Autonomic Neuropathy by 24-Hour Heart Rate Variability Analysis in Type 2 Diabetes Mellitus Patients.: Young Hee Rho, Nan Hee Kim, Dong Lim Kim, Dong Hyun Shin, Sin Gon Kim, Kyung Mook Choi, Woo Hyuk Song, Sei Hyun Baik, Woo Keun Seo, Min Kyu Park, Dong Seop Choi; Korean Diabetes J. 2002;26(3):208-219. Published online June 1, 2002

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Abstract PDF: BACKGROUND
Diabetic autonomic neuropathy is a relatively common diabetic complication, associated with high long-term mortality. Ewing's test is known as the 'gold standard' for evaluating and diagnosing this disease, yet is not widely used due to the inconvenient procedures of the test. 24-hour Holter EKG monitoring, and the analytical product, heart rate variability, is being introduced as a relatively simple and reliable procedure for the evaluation of diabetic autonomic neuropathy. We explored whether such heart rate variability products derived from Holter monitoring, correlated with the presence, absence, or severity of diabetes mellitus, and whether it correlated well with conventional autonomic tests. METHODS: We compared 59 type 2 diabetic patients with 71 normal subjects. All underwent 24-hr Holter EKG monitoring and basic autonomic evaluations, such as the head-up tilting, hand grip, and deep breathing-heart rate variability tests. Those who had diabetes also underwent evaluation for basic blood chemistry, and complication studies, for things such as: 24-hour urine albumin excretion, fundoscopy and nerve conduction. RESULTS: Variables for heart rate variability were expressed as SDDN, rMSSD, LF, HF, and LF/HF, where SDDN is the Standard Deviation of all RR intervals, rMSSD the square root of the mean of the sum of the squares of differences between adjacent RR intervals, LF the power in the Low Frequency range and HF the power in the High Frequency range, with LF/HF being the ratio between LF and HF. Heart rate variability was significantly lower in terms of rMSSD, LF, HF, but not in terms of the LF/HF ratio, for the diabetic patients compared to the normal subjects. These three variables also correlated with the conventional autonomic tests of systolic blood pressure changes during standing up (negatively), and heart rate variability during deep breathing (positively). SDDN, rMSSD, LF, and HF also correlated negatively with the duration of diabetes. SDDN, LF and HF were significantly lower among patients who had complications such as: retinopathy, nephropathy or peripheral neuropathy, than in those who did not. CONCLUSION: Heart rate variability was lower in type 2 diabetic patients than the control subjects, which correlated well with the duration of diabetes mellitus, diabetic chronic complications and the conventional autonomic nervous function tests, so could be an useful adjunct or even a replacement, for conventional autonomic nervous system testing procedures. More research is needed in this field.

Plasma Leptin Concentration, Obesity, and Insulin Resistance in Healthy Korean Population.: Dong Lim Kim, Nan Hee Kim, Dong Hyun Shin, Sin Gon Kim, Kyung Mook Choi, Jin Kwan Kim, Chol Shin, Seung Gwan Lee, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2002;26(2):100-111. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Leptin is a hormone that regulates food intake and body weight. It has been demonstrated that the plasma leptin levels correlates with body adiposity. Increased adiposity is accompanied by a low insulin sensitivity, which turns into insulin resistance. Recent studies suggest a complex interrelationship between leptin and insulin or insulin resistance. Therefore, the relationship between leptin and the variables of body adiposity, and insulin resistance in a non-diabetic population was examined. METHODS: 555 healthy non-diabetic people aged 20 to 80 were enrolled in this study. Leptin was measured by the mean radioimmunoassay. Multiple logistic regression analysis was performed with leptin as a dependent variable and with age, sex, BP, the lipid profile, the fasting plasma glucose levels, HOMA-IR and the trunk fat contents as independent variables. RESULTS: The plasma leptin concentrations were higher in women than in men. The leptin concentrations correlated with the body fat content, BMI and HOMA-IR but, less so with age, the fasting plasma glucose levels, the postprandial glucose levels, total cholesterol and LDL-cholesterol levels. After adjusting for the body mass index, the leptin levels significantly correlated with both the body fat content and the HOMA-IR. The results between males and females were similar when the data was analyzed after dividing by gender. Gender, the trunk fat content, HOMA-IR, and the total cholesterol and HDL cholesterol levels were independent variables which influences the log transformed leptin in multiple logistic regression analysis. When the subjects were grouped according to the number of insulin resistance syndrome including dyslipidemia, obesity, hypertension, and glucose intolerance, there was a linear increase in the leptin concentration with an increase in the number of the components of insulin resistance syndrome. CONCLUSION: The plasma leptin concentrations are related to adiposity, insulin resistance, and dyslipidemia in the non-diabetic Korean population. The relationship between leptin and insulin resistance independent of body fat suggests that insulin resistance might play some role in the development of hyperleptinemia and vice versa

Effect of Protein Kinase C Inhibitor on Glucose Transporter-1 (GLUT1) Expression in Cultured Rat Mesangial Cells.: Ie Byung Park, Dae Ryong Cha, Dong Rim Kim, Sin Gon Kim, Dong Hyun Shin, Kyung Mook Choi, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2001;25(3):218-229. Published online June 1, 2001

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Abstract PDF: BACKGROUND
Recent studies have suggested that increased glucose uptake via GLUT1 may be a major determinant of glucose utilization and extracellular matrix formation in mesangial cells. This study was to evaluate the effect of protein kinase C inhibitor on glucose transporter-1 (GLUT1) expression in cultured rat mesangial cells. METHODS: The GLUT1 expression was evaluated in mesangial cells exposed to various glucose concentrations of media (5.5 mM, 15 mM or 30 mM) and incubation times (6 hr, 24 hr or 72 hr) by semiquantitative RT-PCR and western blot analysis. The effect of protein kinase C (PKC) inhibitor, calphostin C and phorbol 12-myristate 13-acetate (PMA) on GLUT1 expression was also evaluated under the same conditions. RESULTS: The GLUT1 mRNA expressions were significantly increased in MG (15 mM) and HG (30 mM) than those in NG (5.5 mM) with incubation of 6 hr, 24 hr and 72 hr, respectively. In HG media, the GLUT1 mRNA expression with incubation of 24 hr and 72 hr were significantly increased than that with incubation of 6 hr, respectively. In HG media, the GLUT1 mRNA expressions were significantly reduced in calphostin C and PMA treated groups compared with those in untreated groups. In western blot analysis of HG media, GLUT1 proteins were identified in PMA- or calphostin C-untreated group and PMA 6 hr treated group, but not identified in PMA 24 hr treated group and in calphostin C-treated groups with incubation of 6 hr and 24 hr. CONCLUSION: PKC inhibitors decrease glucose-induced GLUT1 expression under high glucose concentration in mesangial cells. These results suggest that PKC pathway may regulate GLUT1 expression under high glucose concentration in cultured rat mesangial cells.

Effect of Probucol on the Apoptosis of Pancreatic Islet Cells in Multiple Low Dose Streptozotocin Induced Diabetic (LDSD) Mice.: Kyung Mook Choi, Dong Rim Kim, Nan Hee Kim, Chul Hwan Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2001;25(2):152-163. Published online April 1, 2001

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Abstract PDF: BACKGROUND
Type 1 Diabetes Mellitus(DM) is consequence of pancreatic beta cell destruction by immune interactions of auto-reactive T cells and cytokines. In individuals with genetic predisposition, an environmental insult triggers immune reaction against beta cells to produce clinical type 1 DM. Since the capacity to form new beta cells from precursors and power of replication appear to be limited, the susceptibility of beta cell to death may be the major underlying variable influencing the occurrence of type 1 DM. However, the precise mechanism of beta cell death is not known. Apoptosis is a physiologic form of cell death and recent studies reported that it could play an important role in beta cell death in experimental diabetic animal models such as multiple low dose streptozotocin diabetic (LDSD) mice or non- obese diabetic (NOD) mice. Probucol is a hypocholesterolemic agent with antioxidant properties. Some studies reported that the probucol could reduce the blood glucose level in type 1 animal models but the mechanism was not known. Therefore, this study was performed to define whether the probucol could decrease the degree of hyperglycemia and the mechanism of its attenuation on the severity of pancreatic insulitis by reducing the degree of apoptosis in LDSD mice. METHODS: We performed an experimental study with male Charles-River CD-1 mice. Mice were divided into the 30 streptozotocin-induced diabetics, 30 probucol- treated streptozotocin-induced diabetics. At 1, 5, 10, 15, and 20 days after streptozotocin administration, the blood glucose level was measured and mice were sacrificed to determine the grade of insulitis and apoptosis. The numbers of apoptotic cells of pancreatic islets were compared using double staining immunohistochemical method (TUNEL and insulin antibody staining). RESULTS: The level of blood glucose and the severity of insulitis were decreased in the probucol treated LDSD mice group significantly when compared with the control LDSD mice group. The numbers of apoptotic cells of pancreatic islets were decreased in the probucol group. The appearance of apoptosis of beta cells preceded the development of insulitis in LDSD mice. CONCLUSION: Probucol can reduce blood glucose level and the severity of insulitis by the decrease of apoptosis in LDSD mice.

Prevalence of Diabetes mellitus in Elderly Korean in Southwest Seoul (SWS Study): Comparision of 1997 ADA and 1985 WHO Criteria in Elderly Korean.: Sei Hyun Baik, Kyung Mook Choi, Young Jik Cho, Kyung Oh Kim, Dong Rim Kim, Nan Hee Kim, Shin Gon Kim, Dong Hyun Shin, Ie Byung Park, Dong Seop Choi; Korean Diabetes J. 2001;25(2):125-132. Published online April 1, 2001

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Abstract PDF: BACKGROUND
The prevalence of diabetes in Korea is increasing rapidly, however we do not have much reliable data to prove it. Thus, the Southwest Seoul Study (SWS Study) designed to investigate the prevalence of diabetes (Clinical impact of new diagnostic criteria of ADA compare to the one of WHO), other metabolic diseases, and the proportion of diabetes related mortalities in the elderly Korean southwest Seoul population in prospectively. However, in this report we summarized the prevalence of diabetes only. METHODS: Randomly selected 1,737 elderly subjects over 60 years who lived in southwest area of Seoul were recruited in this study. Subjects underwent 75 gOGTT, interviewed using the standardized questionnaire, and careful physical examinations during the evaluation. Biochemical data were collected from 1,652 subjects and were analysed for this report. Of 1,652 subjects, we identified 196 pre-diabetics. However, these subjects were included in this analysis. ADA criteria [FBS>or=126 mg/dL (7.0 mmol/L)] and WHO criteria [75 gOGTT, pp2h >or= 200 mg/dL (11.1 mmol/L)] were used as the criteria for diagnosis of diabetes. ADA and WHO criteria for impaired glucose tolerance [IGT, WHO: FBS<7.0 mmol/L, 7.8 mmol/L

Effect of Glycosaminoglycan on Proteinuria and Urinary N-acetyl- -D-Glucosaminidase Excretion in Otsuka Long-Evans Tokushima Fatty (OLETF) Rats.: Kyung Mook Choi, Dae Ryong Cha, Sang Youb Han, Dong Rim Kim, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2000;24(5):533-540. Published online January 1, 2001

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Abstract: BACKGROUND
Increased loss of proteoglycan (PG) characterized by an increased loss of anionic charges in the basement membrane has been considered as one of main factors causing urinary loss of albumin. The glycosaminoglycans (GAGs) are linear polymers of repeated disaccharides and the GAG chains are covalently bound to core proteins, forming proteoglycans. It is known that urinary N-acetyl- -D-glucosaminidase (NAG) excretion is a sensitive marker of renal damage and is increased before other renal functional parameters. The aim of this study was to investigate whether GAG treatment is capable of influencing urinary protein and NAG excretion in Otsuka Long-Evans Tokushima Fatty (OLETF) rats which are known as type 2 diabetic animal model. METHODS: Fifteen male OLETF rats and twenty male Long-Evans Tokushima Otsuka (LETO) rats were used for this study. LETO rats are non-diabetic control rats. All OLETF rats were randomly assigned to 2 groups: control group (n=10) given only tap water and GAG group (n=5) feeding with GAG 10 mg/kg from 7 weeks to 55 weeks of age. Measurement of body weight, blood glucose, serum BUN and creatinine was performed periodically. 24-hour urine collection for measurement of urinary protein and NAG excretion was done at 17, 25, 37, 46, 55 weeks of age. RESULTS: 1) OLETF rats showed higher body weight, blood glucose, 24-hour urinary protein and NAG excretion compared with LETO rats. But serum concentration of BUN and creatinine were not different between OLETF and LETO rats. 2) GAG-treated OLETF rats exhibited lower urinary protein/creatinine excretion (17.48+/-0.50 vs 22.49+/-0.11 mg/mg Cr, p< 0.05) and NAG (17.40+/-5.94 vs 43.73+/- 7.44 nmol/h/mg Cr, p< 0.05) excretion compared with non-treated OLETF rats. But body weights, blood glucose, serum concentration of BUN and creatinine were not different between GAG-treated OLETF rats and non-treated OLETF rats. CONCLUSION: 1) The urinary excretion of NAG may be a possible early marker of diabetic nephropathy in OLETF rats. 2) Urinary protein and NAG excretion were decreased in the GAG-treated OLETF rats. GAG seems to have a protective effect against development of diabetic nephropathy.

The Effect of Ginkgo Biloba Extract on Diabetic Peripheral Neuropathy - A 12 week, randomized, placebo-controlled, double-blind trial -.: Kyung Mook Choi, Dong Rim Kim, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2000;24(3):375-384. Published online January 1, 2001

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Abstract PDF: BACKGROUND
In the pathogenesis of diabetic neuropathy, metabolic derangement and ischemic damage have been considered as the major possible mechanisms. Ginkgo biloba extract was known to improve microcirculation by its vasodilator and antiplatelet effects, and used for peripheral and cerebral circulatory disorder. It also acts as free radical scavenger and inhibits oxidative damage. Thus, in this study we evaluate the effects of Ginkgo biloba extract on symptoms and nerve conduction study in patients with diabetic peripheral neuropathy. METHODS: In this study, over 3 months period, we recruited a total of 33 type 2 diabetic patients with peripheral neuropathy. Nineteen patients were randomly assigned to receive placebo, and fourteen patients to receive Ginkgo biloba extract (40 mg tid) for a duration of 12 weeks. We measured fasting blood glucose, postprandial 2 hour blood glucose levels, glycosylated hemoglobin and the lipid profiles. Clinical evaluation included neuropathy symptom score and nerve conduction study, and it was performed before and after the treatment. RESULTS: During the treatment, fasting blood glucose, postprandial 2 hour blood glucose, glycosylated hemoglobin and the lipid profiles were not significantly changed. Furthermore, no significant changes of neuropathy symptom score were observed during the treatment period. However, in Ginkgo biloba extract treatment group, motor nerve conduction velocities of median and ulnar nerve were improved significantly when compared to the placebo group. CONCLUSION: With the 12 weeks Ginkgo biloba extract treatment, we observed some improvement of nerve conduction velocity without any serious side effect.

The Effect of BCG Vaccine on Recent Onset Type 1 Diabetes Mellitus Patients.: Jeong Heon Oh, Sei Hyun Baik, Kyung Mook Choi, Nan Hee Kim, Ie Byung Park, Dong Seop Choi; Korean Diabetes J. 2000;24(3):340-347. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Type 1 diabetes mellitus (Type 1 DM) results from autoimmune destruction of -cells of the pancreas. Many treatments aimed at inducing remission of newly diagnosed type 1 DM or preventing of type 1 DM in high risk group are being conducted. BCG is known to modulate the development of spontaneous diabetes in animal model of type 1 DM. In some studies, single injection of BCG induced clinical remission in recent onset type 1 DM patients. However, the effect of BCG on human is still controversial. Thus, we performed a prospective study to evaluate the effect of BCG on type 1 DM. METHODS: We enrolled a total of 23 type 1 DM patients within 6 months period. Randomly selected 14 patients were injected 0.1 ml BCG intradermally and 9 patients were injected normal saline. Fasting and postprandial 2 hour C-peptides, and insulin requirements were measured in all patients at enrollment and at 6, 12 and 24 months after BCG vaccination. RESULTS: At enrollment, there was no significant difference in age, sex, duration of diabetes, HbA1-C, body mass index, fasting and postprandial 2 hour C-peptides, and insulin requirement between BCG group and control group. During follow-up, there was no significant difference in fasting and postprandial 2 hour C-peptides. However postprandial 2 hour C-peptides in BCG group were higher than those in control group at 12 and 24 months (p-value>0.05). Insulin requirements also were lower in BCG group than in control group at 12 and 24 months (p-value>0.05). Clinical remission has been sustained in 2 BCG vaccinated patients at 6 and 12 months. In one of the two patients, remission was sustained for 36 months. CONCLUSION: BCG vaccine is safe and convenient to use, however, a large study is warranted for the use of BCG as a therapy of type 1 DM.

The Relation Between DHEA, DHEAS and Syndrome X, Cardiovascular Complication in Type 2 Diabetes Mellitus.: Yong Hyun Kim, Jeong Heon Oh, Nan Hee Kim, Kyung Mook Choi, Sang Jin Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2000;24(2):234-244. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Insulin is known as a major factor that regulates secretion of DHEA and DHEAS. Numerous studies are exist to investigate the relationship between DHEA(S) and insulin resistance. Furthermore, numerous previous studies revealed that insulin resistance plays a major role in the pathogenic relationship between DHEA(S) and type 2 diabetes mellitus. However, number of studies to investigate the difference of levels of DHEA(S) according to the presence of syndrome X in type 2 diabetes mellitus are limited. METHODS: In type 2 diabetes, aged from 40 to 70 years old, the levels of serum DHEA and DHEAS was compared between the subejcts with or without syndrome X as well as the normal age and sex matched control. Furthermore, correlation between serum DHEA/DHEAS and insulin resistance, and the levels of DHEA/DHEAS according to the cardiovascular complication status was also evaluated. RESULTS: 1. No statistical difference in serum DHEA and DHEAS was observed among the 3 groups. However, the serum DHEA and DHEAS levels were lower in type 2 diabetes with syndrome X and higher in normal control. 2. No correlation was observed between DHEA, DHEAS and insulin resistance factors. 3. No stastistical difference in serum DHEA and DHEAS was observed in type 2 diabetic patients with cardiovascular complications. However, the level of DHEA was lower in the patients with cardiovascular complications. 4. No stastistical difference in serum DHEA and DHEAS was observed according to the presence of cardiovascular complications when analysis was performed in 55 years and younger subjects. 5. The level of DHEA was lower in the presence of cardiovascular complication when only male diabetic subjects were included in the analysis, but the level of DHEAS showed no difference according to the cardiovascular complication status. CONCLUSION: No statistical difference of the levels of serum OHEA and DHEAS was observed according to the presence of syndrome X in type 2 diabetes patients, However, the level of serum DHEA tended to be lower in the presence of cardiovascular complications. The levels of DHEA in male diabetic subjects were lower in the presence of cardiovascular complication, thus, we suspected that DHEA may play a potential role as one of risk factors of cardiovascular complications in this subgroup.

Effects of Insulin and Vitamin E on the Apoptosis of Pancreatic Islet Cells in Multiple Low dose Streptozotocin Induced Diabetic (LDSD) Mice.: Yong Hyun Kim, Jeong Hun Oh, Nan Hee Kim, Kyung Muk Choi, Sang Jin Kim, Sei Hyun Baik, Eung Seok Lee, Min Chul Lee, Dong Seop Choi; Korean Diabetes J. 1999;23(6):757-767. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Type 1 diabetes mellitus results from irreversible loss of beta cells in pancreatic islet. It is generally known that abnormal MHC expression and interaction of variable cytokines play a role in beta cell death, but the precise mechanism of beta cell death is unknown. Apoptosis is a physiological form of cell death and can play an important role in beta cell death in experimental diabetic animal models. Thus, in insulin and vitamin E treated LDSD mice and streptozotocin treated control mice. We attempted to comparing the levels of blood glucose (BG), the degree of insulitis, and number of apoptotic cells. Our study goal was to understand inhibition of apoptosis which thought to play an important mechanism in reducing the degree of hyperglycemia and insulitis. METHODS: In 3 LDSD mice groups (group 1: control group with streptozotocin only, group 2: streptozotocin plus insulin, group 3: streptozotocin plus vitamin E), the effects of insulin and vitamin E on the blood glucose levels and the degree of insulitis were evaluated. The number of apoptotic cells of pancreatic islet was compared using double staining immunohistochemical method. RESULT: The levels of BG, degree of insulitis and the rate of apoptosis of pancreatic islet cells were decreased in insulin and vitamin E treated groups when compared to the control group. There was no difference in number of apoptotic cells between insulin and vitamin E treated group, but levels of BG and degree of insulitis were higher in vitamin E treated group than insulin treated group as time elapsed. CONCLUSION: Insulin and vitamin E can decrease the elevation of BG and the degree of insulitis via inhibition of apoptosis in LDSD mice.

A Case of Severe Hypertriglyceridemia with Diabetic Ketoacidosis.: Dong Seop Choi, Jeong Heon Oh, Ie Byung Park, Jin Won Kim, Kyung Mook Choi, Yong Hyun Kim, Nan Hee Kim, Sang Jin Kim, Sei Hyun Baik; Korean Diabetes J. 1999;23(5):715-721. Published online January 1, 2001

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Abstract PDF: Severe hypertriglyceridemia exceeding 5.6 mmol/L in diabetic ketoacidosis occasionally occur in patients with type 1 diabetes mellitus. The pattern of dyslipidemia is usually Fredrickson classification type lV. But it also exists in type III and type V. However, extreme triglyceridemia, triglyceride level exceeds 22.6 mmol/L, occur rarely in the modern era of insulin therapy. And the pattern is usually Fredrickson type I. The severe hypertriglyceridemia in diabetic ketoacidosis is mainly due to lipoprotein lipase deficiency, and secondly to insulin deficiency. The severity usually improves with insulin replacement. In patients with extreme hypertriglyceri-demia, serum electrolyte values of the patients are fallaciously low, and it leads to the misinterpretation of biochemical results and to the inappropriate treatment. We reported a case of a 25 years old female patient with diabetic ketoacidosis and extreme hypertriglyceridemia. At admission, the color of her serum was milky, her plasma triglyceride concentration was 144.7 mmol/L (12864 mg/dL), cholesterol was 25.5 mmol/L (982 mg/dl), and HDL-cholesterol was 0.77 mmol/L (40 mg/dL). The biochemical values at admission could not be measured. Empirical therapy was administered with the use of insulin and fluid. After the initial treatment with insulin and fluid, plasma triglyceride declined rapidly and was nearly normal after 72 hours. We also measured fasting blood glucose concentration and lipid profiles from her father and two sisters. Their plasma glucose and lipid profiles were normal.

Effect of Protein Kinase C Inhibitors on Expression of TGF-betamRNA in Cultured Mesangial Cells Under High Glucose Concentration.: Yoon Sang Choi, Dong Seop Choi; Korean Diabetes J. 1999;23(5):635-646. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Diabetic nephropathy is characterized by hypertrophy of both glomerular and tubular elements, thickening of the glomerular and tubular basement membranes, progressive accumulation of extracellular matrix components in mesangium, and tubulointerstitial fibrosis. Hyperglycemia increases the level of diacylglycerol (DAG) and activates protein kinase C (PKC) in mesangial cells and other vascular tissues. PKC activation regulates a number of vascular functions such as vascular permeability, contractility, cellular proliferation, basement membrane synthesis, signal transduction mechanisms for hormones and growth factors, In addition, glomerular mesangial cells play an important role in the development of diabetic nephropathy. Mesangial cells have many functions such as contractile properties, phagocytosis of macromolecules, synthesis of matrix proteins, and production of and response to growth factors (e.g., PDGF, TGF beta). Also, these growth factors play important roles for mesangial cell proliferation and in pathophysiology of diabetic nephropathy. Specifically, TGF beta is a key mediator in development of diabetic nephropathy. This study was performed to evaluate the relationship between PKC activation and TGF f3 production in mesangial cells under high glucose condition. METHODS: The expression of the TGF beta mRNA was evaluated in cultured human mesangial cells by semiquantitive RT-PCR, under varying degree of glucose concentrations (5 mM, 10 mM, 30 mM) with and without treatment of PKC inhibitors (calphostin C, Vitamin-E). RESULT: In control group (no treatment), ratio of TGF beta/beta-aetin mRNA in 5mM, 10mM, 30mM glucose were 1.694+/-0.223, 3.383+/-2.089, 5,474+/-1.74S, respectively. In calphostin C treated group, ratio of TGF beta/beta-actin mRNA in 5mM, 10mM, 30mM glucose were 1.457+/-0,322, 1.379+/-0.138, 1.205+/-0.050, respectively. In vitamin E treated group, ratio of TGF beta/beta-actin mRNA in 5mM, 10rnM, 30mM glucose were 1.198+/-0.081, 1.995+/-1.625, O.S04+/-0.570, respectively. In 10mM glucose concentration, ratios of TGF beta/beta-actin mRNA were reduced in calphostin C and vitamin E treated groups, compared with those in control group. But, there were no statistical significancies (p=0.191, 0.208). In high glucose concentration (30mM), ratios of TGF /3/f3-actin mRNA were significantly reduced in calphostin C and vitamin E treated groups compared with those in control group (p<0.05), respectively. CONCLUSIONS: These results indicate that high glucose concentration induce TGF beta expression in eultured mesangial cells through PKC activation. This suggests that selective PKC beta isoform inhibitors may be useful for treatment and prevention of diabetie nephropathy.

Prevalence of Islet Cell Autoantibodies and Mitochondrial DNA Mutation among Typical and Atypical Type 1 Diabetic Patients in Korea.: Hong kyu Lee, Kee Up Lee, Sung Kwan Hong, Byuong Doo Rhee, Dong Seop Choi, Hyoung Woo Lee, Sang Wook Kim, Hee Jin Kim, Nan Hee Kim, Kyong Soo Park, Woo Je Lee, Kyung Soo Ko; Korean Diabetes J. 1999;23(4):541-551. Published online January 1, 2001

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Abstract PDF: BACKGROUND
American Diabetes Association (ADA) proposed new criteria for the classification of diabetic patients, which were mainly based on the presence of autoimmune markers. But it is questionable if we can apply the new ADA criteria to Korean type 1 diabetic patients directly. In this study, we measured several autoantibodies to islet cell in Korean subjects with typical and atypical clinical manifestations of type 1 diabetes mellitus. And mutation of mitochondrial DNA was analyzed in the same patients. METHODS: We measured fasting serum C-peptide in 1870 diabetic patients attending the diabetes clinic of Asan Medical Center. Among the 117 patients with fasting serum C-peptide less than 0.6 ng/mL, glucagon-stimulated C-peptide was measured, and 57 Patients showed the level less than 1 ng/mL and they were diagnosed as type 1 diabetic patients. They were subgrouped into typical (n=26, needed insulin injection within 1 year after diagnosis) and atypical (n=30, did not need insulin for more than l year after diagnosis) type 1 diabetic patients. ICA was measured by indirect immunofluorescence method. Anti-GAD antibody was measured by radioimmunoassay. Anti-ICA512 antibody was measured by western blotting. Mitochondrial DNA 3243 mutation was detected using restriction enzyme Apa-I digestion of the amplified genomic DNA from the subjects. RESULTS: 1) Median age of onset was 40 years for atypical type 1 diabetes patients, while it was 27.5 years for typical type 1 diabetes patients. Average duration of insulin requirement was 0.18 years for typical group and 5.73 years for atypical group. In this series, only typical type 1 diabetic patients experienced diabetic ketoacidosis. 2) Only 50 % of typical type 1 diabetic patients and 47 % of atypical type 1 diabetic patients had at least one autoantibody among ICA, anti-GAD antibody and anti-ICA512 antibody. 3) Mitochondrial DNA 3243 point mutation was detected in 3 patients with atypical type 1 diabetes (10 %), but it was not found in patients with typical type 1 diabetes. CONCLUSION: These results suggest that the prevalence of autoantibodies in Korean type 1 diabetic patients was lower than that reported in Caucasians irrespective of clinical features. Therefore, it may not be easy to apply this new diabetes classification of ADA to Korean type 1 diabetic patients. In addition, mitochondrial DNA mutation may be responsible for some of the Korean atypical type 1 diabetic patients.

Serum Levels of Sialic acid, CRP, and TNF-a in Type 2 Diabetin Patients with Syndrome X.: Dong Seop Choi, Sang Jin Kim, Se Hyeon Paek, Kyung Mook Choi, Nan Hee Kim, Jung Heon Oh, Young Hyun Kim; Korean Diabetes J. 1999;23(3):307-314. Published online January 1, 2001

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Abstract PDF: diabetic nephropathy and macro- vascular complications. Thus it is possible to conBACKGROUND: Type 2 diabetes is associated with increased blood concentrations of acute phase reactants including; sialic acid, ai-acid glycoprotein, serum amyloid A, and the main cytokine mediator of acute phase response, interleukin-6. Through the action of cytokines on many tissues, acute phase response could be a major contributor of biochemical and clinical features of metabolic syndrome X and type 2 DM. We investigated whether sialic acid, CRP, and TNF-a levels were elevated in type 2 diabetic patients who had features of syndrome X and whether they were correlated with diabetic vascular complications. METHODS: Group 1 was type 2 diabetic patients with any of 4 or 5 features of syndrome X (n=24). Group 2 was type 2 diabetic patients with 0 or 1 features of syndrome X (n=29), and group 3 was healthy nondiabetic control subjects (n=19). We compared the levels of sialic acid, CRP, and TNF-a in group 1, 2 and 3. We also observed the relationship between sialic acid, CRP, TNF-a levels and diabetic micro, macrovascular complications and studied the correlation between these markers and components of syndrome X. RESULTS: Group 1 had significantly higher sialic acid levels than group 2 (68.3+19 vs. 59.9+9.7 mg/dL, p=0.047). But the CRP, and TNF-a levels were similar in three groups. Serum sialic acid levels were signifieantly higher in proteinuria group than in normo- and microalbuminuria groups (81+27.6 vs. 59.9+7.1, 61.2+7.9 mg/dL, p=0.001, 0.005). Serum CRP levels were also higher in proteinuria groups (32.9+59.8 vs. 6.4+1.9, 6.0+3.1mg/L, p=0.017, p=0.037). Serum sialic acid levels were significantly higher in the macrovascular complication group (70.5 +21.3 vs. 60.5+ 6.8 mg/dL, p=0.015). Levels of sialic acid were correlated with urinary albumin excretion rate, log triglyceride, CRP, and fasting C-peptide. Levels of CRP were correlated with sialic acid and fasting C-peptide. CONCLUSION: Serum sialic acid levels were significantly elevated in type 2 diabetic patients who had features of syndrome X, and were also elevated in patients with sider that the mechanisms involved in the acute phase response can contribute to the pathophysiology of type 2 diabetes and syndrome X. Vascular complications do further increase stress reactions in type 2 diabetes.

Efficacy and Safety of Glimepiride: A Novel Sulfonylurea Drug compared with Gliclazide in the Treatment of Type 2 Diabetes Mellitus: an Open , Randomized Comparative Multi - Center Clinical Study.: Sung Kwan Hong, Ki Up Lee, Yeon Sang Oh, Ho Young Son, Kwang Won Kim, Hyun Chul Lee, Kyung Rae Kim, Dong Seop Choi, Ie Byung Park, Young Seol Kim, Kwan Woo Lee, Hong Kyu Lee, Soon Hyun Shin; Korean Diabetes J. 1999;23(1):87-97. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Glimepiride (HOE490, Amaryl (R)) is a new, third generation sulfonylurea, which binds to a different protein of the sulfonylurea receptor than other sulfonylureas. Although there have been many studies proving the efficacy of glimepiride on Caucasian diabetic patients, only a few studies are available on Asian diabetic patients. We performed an open, randomized, comparative multicenter clinical trial to assess the efficacy and safety of glimepiride in Korean type 2 diabetic patients. METHOD: We recruited 262 type 2 cliabetic patients at 12 different university hospitals whose blood glucose was not controlled effectively with diet alone. Patients were randomized to 1~2mg glimepiride or 40~80mg gliclazide depending on the fasting blood glucose level. Doses were increased stepwise, up to 8mg for glimepiride (once-daily) and 320mg for gliclazide (>80 mg as dividedose) respectively, until metabolic control (fasting blood glucose < 7.9 mmol/L) or maximum dose was achieved. The quality of rnetabolic control was assessed by fasting blood glucose and HbA 1c as primary variables. Insulin, C-peptide and weight were monitored as secondary variables. Safety was assessed by obtaining patient history and laboratory values of relevant variables. RESULTS: Of the 262 patients randomized to treatment, 160(61%) patients completed the 18-week study. The rate of successful blood glucose control (3.9

Serum Levels of Transforming Growth Factor ( TGF ) -beta1 in Type 2 Diabetic Patients.: Nan Hee Kim, Jung Heon Oh, Young Hyun Kim, Ie Byung Park, Sang Jin Kim, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 1998;22(4):522-530. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Transforming growth factor(TGF)-Bl is a potent inducer of extracellular matrix production and of fibrogenesis and has been associated wnh the occurrence of diabetic complications. Our aim was to determine whether circulating levels of TGF-gl are altered in type 2 DM and, if so, whether they are correlated with blorxi glucose levels and show an association with diabetic complications. METHOD: Serum levels of TGF-gl were measured by quantitative sandwitch enzyme immunoassay in 76 type 2 DM patients and were correlated with clinical and biochemical parameters and the presence of diabetic complications. Result: 1) Serum TGF-B1 levels were correlated with fasting blood glucose levels (r=0.30, p=0.007) and inversely correlated with duration of diabetes (r=-0.31, p=0.007), BUN (r=-0.31, p=0.034), and creatinine (r=-0.40, p=0.004). In linear logistic regression analysis, duration of diabetes and HbA 1C <- were independently related to serum TGF-B1 levels. 2) Serum levels of TGF-B1 were significantly decreased in proteinuria group (n=23) than in normoalbuminuria group (n=26) (69.5+27.5 vs 85.7 +23 ng/mL, p=0.022). TGF-B1 concentrations were inversely correlated with serum creatinine and age in normoalbuminuria group (r=-0.40, p

The Frequency of ICA and anti-GAD Antibody in Korean IDDM and NIDDM Patients.: Kyung Soo Ko, Sung Kwan Hong, Ki Up Lee, Nan Hee Kim, Dong Seop Choi, Sung Hee Ihm, Sung Woo Park, Chul Hee Kim, Dong Won Byun, Kyo Il Suh, Hak Chul Chang, Byoung Doo Rhee; Korean Diabetes J. 1998;22(3):312-319. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been suggested that the clinical and immunological characteristics of diabetes mellitus in Koreans are different from those of Caucasians. This study was undertaken to investigate the prevalence of autoimmune markers in Korean adults with IDDM and recent-onset NIDDM. METHODS: Seventy-seven Korean adults with IDDM and 245 recently(within 2 years) diagnosed NIDDM were included in the study. Islet cell cytoplasmic antibody was measured by immunohistochemical method, and anti-glutamic acid decarboxylase (anti-GAD) antibody was measured by radioimmunoassay. RESULTS: 1) The prevalence of ICA, anti-GAD antibody positivity was 27% and 40% in IDDM patients, and 5% and 4% in recent-onset NIDDM patients, respectively. 2) The prevalence of ICA positivity in IDDM patients decreased from 42% within one year to 21% over one year after clinical onset of disease. On the other hand, the positivity of anti-GAD antibody did not change according to the duration of diabetes. 3) The prevalence of ICA tends to be lower in IDDW patients with low serum C-peptide concentrations. In contrast, the prevalence of anti-GAD antibody was not different according to sernm C-peptide levels. CONCLUSION: These results suggested that the prevalence of ICA and antii-GAD antibody was lower in Korean adult IDDM and recent-onset NIDDM patients than that in Caucasians.

The Correlations between DHEA, DHEA-S and Insulin Resistance Parameters in Korean.: Ie Byung Park, Dong Seop Choi; Korean Diabetes J. 1998;22(2):182-191. Published online January 1, 2001

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Abstract PDF: BACKGROUND
DHEA-S(dehydroepiandrosterone-sulfate) is the most abundantly produced adrenal steroid, but its physiological role has not been established yet. Increasing evidence suggests that insulin may act to lower serum DHEA-S levels in human. Some epidemiological studies report that serum DHEA, DHEA-S levels are reduced in pathological states characterized by insulin resistance and hyperinsulinemia such as obesity, hypertension, and untreated type 2 diabetes mellitus. This study was undertaken to investigate the relationship between DHEA, DHEA-S and insulin resistance parameters, such as BMI, blood pressure, fasting blood glucose (FBG), basal insulin level and lipid profile in Korean subjects. METHODS: The subjects were 369 Koreans(223 men, 146 women, age range: 15~75 year old) who visited the Anam Hospital for health check-up. In the morning, height, weight and blood pressure were measured and blood samples were collected for determinations of FBG, insulin, lipid profile, DHEA-S and DHEA. RESULTS: There was an inverse correlation between advancing age and serum DHEA, DHEA-S concentrations in all subjects. Although there was no significant correlation between advancing age and basal insulin levels or G/1(glucose/insulin) ratio, there were significant correlations between advancing age and insulin resistance parameters, such as BMI, diastolic BP, systolic BP, total cholesterol, triglyceride, LDL-cholesterol and FBG. In men under 50 years, DHEA was positively correlated with total cholesteral and HDL-cholesterol and negatively correlated with basal insulin level(p<0.05) and G/I ratio(p<0.001), But, in men over 50 years and in women, the correlation between DHEA, DHEA-S and other parameters was not observed. CONCLUSION: No consistent associations of DHEA, DHEA-S with various parameters of insulin resistance were observed in Koreans. However, in men under 50 years of age, DHEA and DHEA-S were associated with parameters of insulin resistance syndrome, suggesting that DHEA and DHEA-S may be related with insulin resistance only in this group.

Progressive Decline of beta-cell Function in Type 2 Diabetes Mellitus.: Dong Seop Choi; Korean Diabetes J. 1998;22(1):1-10. Published online January 1, 2001

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Abstract PDF: No abstract available.

Urinary albumin excretion, von Willebrand factor and macrovascular disease in patients with NIDDM.: Sin Gon Kim, Soo Mi Kim, Dong Hyun Shin, Nan Hee Kim, Yoon Sang Choi, Ie Byung Park, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 1997;21(2):176-184. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Increased urinary albumin excretion (UAE) is not only an independent predictor of progressive renal disease but also an important marker of atherosclerotic disease in patients with NIDDM. However, the pathaphysiologic basis of this observation is poorly understood. Recently, one interesting hypothesis suggested: UAE rnerely reflects a glomerular manifestation of an otherwise generalized vascular dysfunction(hyperpermeable state), and Stehouwer et al. Reported a strong relationship between plasma von Willebrand factor level(a measure of endothelial dysfunction), UAE and cardiovascular diseases. Therefore, we studied the relationship between UAE, plasma vWF and macrovascular disease in patients with NIDDM. METHODS: We measured UAE and plasma vWF levels in 102 patients with NIDDM, and investigated the telationship between these values and macrovascular diseses. Also, we assesed the risk factars for macrovascular disease. RESULTS: 1) Among total of 102 patients, nonnoalbuminuria, microalbuminuria and macroalbuminuria group were 58 patients(56.9%), 28 patients(27.5%) and 16 patients(15.6%), respectively. 2) The prevalencies of hypertension, diabetic retinopathy and macrovascular diseases were the highest in macroalbuminuria group, followed by microalbuminuria and norrnoalbuminuria group in order of frequency. 3) Plasma vWF and UAE levels were significantly correlated(r=0.44). 4) Plasma vWF concentrations were higher in patients with macrovascular diseases than in those without macrovascular diseases, and also higher in patients with retinopathy compared with those without retinopathy. 5) Multivariate logistic regression analysis showed that age, smoking and vWF were independent risk factors for macrovascular diseases. CONCLUSION: 1) As plasma vWF and UAE values were increased, more macrovascular diseases were observed in patients with NIDDM. 2) Plasma vWF may be used as an indicator of macrovascular disease in patients with NIDDM.

A case of familial hypertriglyceridemia associated with cutaneousxanthomatosis.: Chul Weon Choi, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 1992;16(3):241-245. Published online January 1, 2001

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Abstract PDF: No abstract available.

Some immunogenetic characteristics and clinical heterogeneity of young adult-onset insulin-dependent diabetes mellitus in Korea.: Ryoung Doo Rhee, Ki Up Lee, Hyung Joo Ryu, Sung Woo Park, Dong Seop Choi, Hoon Han, Geum Ryong Kim, Chan Soo Shin, Kyong Soo Park, Bong Kyu Lee, Chang Soon Koh, Hun Ki Min; Korean Diabetes J. 1992;16(1):25-34. Published online January 1, 2001

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Abstract PDF: No abstract available.

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