- The Prevalence of the Mitochondrial DNA 16189 Variant in Korean Adults and Its Association with Insulin Resistance.
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Seong Yeun Kim, Hang Kyu Lee, Do Joon Park, Bo Yeon Cho, Suk Kyeong Kim, Geon Sang Park, Jae Hyun Kim, Kyong Soo Park, Bong Sun Kang
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Korean Diabetes J. 1999;23(3):299-306. Published online January 1, 2001
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Abstract
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- BACKGROUND
Mutations in mitochondrial DNA (mtDNA) are of potential importance in the pathogenesis of diabetes mellitus. MtDNA 3243 mutation (G->A) is famous and associated with insulin secretory defect, but it is found in only 0.52% of type 2 diabetes mellitus and it can explain only a small proportion of the patients with diabetes mellitus. Recently Poulton et al. showed that the 16189 variant (T C transition) in mtDNA was associated with insulin resistance in Caucasians. They showed that the prevalence of the 16189 variant in the American was 11% and the people with the 16189 variant had higher fasting insulin and HOMA insulin resistance than the people without the 16l89 variant. In this study, we investigated the prevalence of the 161S9 variant in Korean adults and its association with insulin resistance. METHODS: We utilized the stored blood samples from community-based diabetes survey conducted in Yonchon County, Korea in 1993. We randomly selected 160 samples. We extracted the DNA from peripheral blood samples and examined the 16189 variant by PCR and restrictive enzyme digestion. We measured BMI, waist-hip ratio, blood pressure, fasting glucose, postprandial 2 hour glucose, fasting insulin, total cholesterol, triglyceride and HDL- cholesterol. HOMA insulin resistance and beta-cell function were calculated from fasting glucose and fasting insulin. RESULTS: The prevalence of the 16189 variant in Korean adults was 28.8% (46/160), higher than in the American, but the same as in the Japanese. The subjects with the 16189 variant had higher fasting glucose and BMI than the subjects without the 16189 variant, but fasting insulin, HOMA insulin resistance, beta-cell function, cholesterol and blood pressure were not different between the two groups. CONCLUSION: The prevalence of the 16189 variant in the Korean is higher than in the Caucasian but the same as in the Japanese. Our results support that a frequent mitochondrial variant may contribute to the phenotype related to insulin resistance. However, further detailed studies must be made in a large number of patients.
- The Effect of Acarbose as an Adjuvant Therapy in Sulfonylurea-Treated NIDDM Patients.
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Yun Yong Lee, Geon Sang Park, Jin Seong Kim, Byeong Sool Mun, Do Joon Park, Chan Soo Shin, Kyeong Soo Park, Seong Yeon Kim, Hong Kyu Lee
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Korean Diabetes J. 1997;21(4):484-492. Published online January 1, 2001
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Abstract
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- BACKGROUND
Acarbose-an aglucosidase inhibitor-is known to have a glucose lowering effect by delaying the digestion of complex carbohydrates in the small intestine. Acarbose especially prevents the abnormally high increment of postprandial blood glucose, reduces postprandial hyperinsulinemia and probably, alleviates insulin resistance. The aim of this study is to evaluate the glucose lowering effect of acarbose as an adjunt with a sulfonylurea in the treatment of NIDDM patients who have been poorly controlled with the use of sulfonylurea alone. METHODS: Forty NIDDM patients, who were poorly controlled with sulfonylurea alone, were randomly selected frorn outpatient diabetic clinic for study. For 16 weeks, they recieved either acarbose or placebo in additian to sulfonylurea under double blind method. RESULTS: 1) The metabohc parameters measured before initiation of either treatment regimen were similiar. 2) The HbAlc in placebo group increased from 8.9% to 9.0%. In contrast, in the acarbose group, HbAlc value decreased from 9.3% to 8.1%(p<0.05). 3) Mean fasting plasma glucose and 1-h postprandial glucose levels were reduced significantly in the acarbose group(p<0.001), especially in I-h postpandial glucose level in comparison with placebo group(p <0.0001). 4) Mean fasting, 1-h postprandial insulin levels decreased with time in the acarbose group in comparison with placebo group, but the decrease was not statistically significant. 5) Lipid profiles did not change during 16weeks of treatment period. 6) Adverse effects were observed in 3 patients on acarbose and 2 patients on placebo. CONCLUSION: Acarbose can be used as an effective adjuvant therapy to sulfonylurea in NIDDM patients who are poorly controlled with sulfonylurea alone.
- Serum Fasting Proinsulin Level as a Predictor for Development of NIDDM in Korean Subjects.
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Geon Sang Park, Chan Soo Shin, Kyong Soo park, Seong Yeon Kim, Hong Kyu Lee, Sun Ja Kwon, Yong Soo Park
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Korean Diabetes J. 1997;21(4):365-371. Published online January 1, 2001
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Abstract
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- BACKGROUND
Proinsulin is raised in people with NIDDM. Hyperproinsulinemia is thought to be a predictor for the subsequent development of NIDDM. We studied to investigate whether hyperproinsulinemia can predict the development of NIDDM in Korean subjects. METHOD: This study was performed as a nested case-control study. The case group was 67 newly developed diabetic patients out of 1193 initially non-diabetic cohott in Yonchon county. We have also selected 66 age-sex-B541-WHR matched control group who remain non-diabetic for 2 years. We compared baseline insulin, proinsulin and proinsulin/insulin ratio between two groups, RESULTS: There was no significant difference in baseline fasting insulin levels[46,77+/-17.3 vs 42.87+/- 11.6(pmol/L)] between converters to diabetes and non-converters. However, the baseline proinsulin levels in converters to diabetes were higher than those in non-converters.[16.07+/-14.3 vs 8.72+/-5.2(pmol/L)) The baseline proinsulin/imulin ratio in converters was also higher than those in non-converters. [0.30+/-0.17 vs 0.20+/-0.10] CONCLUSION: The results suggest that fasting hyper-proinsulinemia may be a predictor for subsequent development of NIDDM in Korean subjects.
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