- Insulin Resistance and severity of coronary artery diseases in Patients with Coronary Artery Diseases.
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Dae Jung Kim, Jae Hyun Nam, Dong Hoon Choi, Hyeung Jin Kim, Soo Kyung Kim, Se Hwa Kim, Yumie Rhee, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyeong Rae Kim, Hyun Chul Lee, Kap Bum Huh
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Korean Diabetes J. 2002;26(3):189-198. Published online June 1, 2002
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 Abstract
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- BACKGROUND
Insulin resistance (IR) has been identified as a risk factor of atherosclerosis, which may be induced through a mechanism brought about by hypertension, obesity, glucose intolerance and dyslipidemia. The purpose of this study was to investigate the relationship between coronary artery disease (CAD) and insulin resistance. METHODS: Of 92 subjects having undergone coronary angiography 70 with significantly stenotic coronary artery were designated as the CAD group, with the other 22, without stenosis, as the control group. The CAD group was subdivided into 3 smaller groups according to the severity of their CAD; these being 1-vessel disease (group 1, n=31), 2-vessel disease (group 2, n=25), and 3-vessel disease (group 3, n=14). RESULTS: Kitt for patients with CAD was significantly lower than in the control group, and also for those in group 1 compared to groups 2 and 3, 2.72+/-1.29, 2.25+/-0.68 and 2.21+/-0.78%/min, with that of the controls being 3.01+/-1.22%/min p<0.05). There were significant differences between the IR group and the non-IR group in the common carotid artery intima-media thickness (1.09mm vs. 0.87mm, p<0.05), the waist-hip ratio (1.09 vs. 0.93, p<0.05) and the body fat contents (32% vs. 27%, p<0.05).Insulin resistance was assessed by the short insulin tolerance test, and the insulin resistance (IR) group was defined as having a Kitt less than 2.5%/min. CONCLUSION: These results suggest that insulin resistance is an important risk factor for CAD, and is related to the severity of coronary atherosclerosis.
- Therapeutic Effect of Recombinant Human Erythropoietin on Anemia with Erythropoietin Deficiency in Early Diabetic Nephropathy.
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Dae Jung Kim, Soo Kyung Kim, Hyeung Jin Kim, Yoo Mee Kim, Yong Seok Yun, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyeong Rae Kim, Hyun Chul Lee, Kap Bum Huh
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Korean Diabetes J. 2001;25(5):364-373. Published online October 1, 2001
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Abstract
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- BACKGROUND
We have previously reported that reduced erythropoietin (Epo) responsiveness to anemia could explain the anemia in diabetic patients before advanced diabetic nephropathy. Thus, the aim of this randomized prospective study is to investigate the therapeutic effect of recombinant human erythropoietin (rHuEpo) on anemia with Epo deficiency in early diabetic nephropathy. METHODS: Twenty-nine diabetic patients with the normocytic normochromic anemia of Epo deficiency were randomized into Epo-treatment group (n=20, M:F= 8:12, mean age=52.9+/-9.2) and control group (n=9, M:F=4:5, mean age=53.6+/-12.4). Twenty patients of Epo-treatment group were treated with rHuEpo (Epokine (CheilJedang Co.) 4,000unit/day SC., 3 times/week) for 8 weeks. The Epo- treatment group were divided into the responder or non-responder. Patients with increments in Hemoglobin (Hb) during the follow-up duration was above 2 g/dL, or with the final Hb was above 14 g/dL in men or 13g/dL in women were decided the responder. In order to analyze factors affecting the therapeutic effects of rHuEpo, the clinical and biochemical characteristics were compared between the responder and non-responder group. RESULTS: There was no difference in the clinical and biochemical characteristics between the Epo-treatment and the control group at randomization. The responder group (n=14) had significant increments in Hb, compared to the non-responder group (n=6) or the control group (13.6+/-1.0 vs. 10.1+/-1.5 vs 11.2+/-1.2 g/dL, p < 0.001, respectively). The treatment duration of rHuEpo in the responder group was 4.9+/-2.3 weeks. Among the Epo-treatment group, there was no differences between the responder and the non-responder group in sex, age, duration of diabetes, serum creatinine level, 24 hour urinary albumin excretion rates, HbA1C, frequency or severity of microangiopathy, and serum Epo level. However, the responder group had higher serum ferritin (240.3+/-108.4 vs 25.8+/-3.0 g/L, p<0.05) and transferin saturation level (32.7+/-7.9 vs 21.2+/-5.3 %, p<0.05). CONCLUSION: These results concluded that the administration of rHuEpo could be useful in treating anemia with Epo deficiency in early diabetic nephropathy and that the degree of iron storage and functional iron deficiency might affect the therapeutic effects of rHuEpo on this type of anemia.
- Associations of Carotid Intinma-Media Thickness Measured by High Resolution B-mode Ultrasonography and Atherosclerotic Risk Factors in NIDDM Patients.
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Hyun Chul Lee, Jae Hyun Nam, Seong Kil Lim, Kap Bum Huh, Kyeong Rae Kim, Soo Yeon Nam, Seok Won Park, Churl Woo Ahn, Young Deuk Song, Dae Jung Kim, Young Guk Ko
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Korean Diabetes J. 1999;23(3):234-242. Published online January 1, 2001
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- BACKGROUND
Atherosclerosis is more prevalent in diabetic patients, severe and wide spread than in non-diabetic subjects and clinically evident as macrovascular diseases such as coronary, cerebro- vascular and peripheral arterial diseases which are important causes of frequent morbidity and premature mortality. But atherosclerotic vascular lesions are not easily detectable, before they advanced and cause symptoms. Measurement of carotid Intima-Media thickness(IMT) by high- resolution B-mode ultrasonography is a useful, non-invasive method to detect early atherosclerotic vascular changes. In this study, we investigated associations of IMT with cardiovascular risk factors. METHODS: High-resolution B-mode ultrasonography was performed in 63 non-insulin-dependent diabetic patients in order to determine maximal and mean carotid IMT. Blood pressure, glucose, HbA total cholesterol, HDL cholesterol and triglyceride levels were measured on a regular basis in the last 12 months before the carotid ultrasonography. The mean and last values at the time of the carotid ultrasonography were analyzed in relationship to the IMT. RESULTS: Carotid IMT was increased in NIDDM patients with male sex, smoking habit and hypertension. Systolic blood pressure (r=0.252, p=0.050) and LDL cholesterol levels (r=0.273, p=0.031) at the time of carotid ultrasonography showed a correlation with the IMT. Mean triglyceride (r=0.368, p=0.018) and HbA1c>, levels (r=0.288, p=0.045) of the last 12 months were correlated with the IMT. CONCLUSION: Increased carotid IMT was associated with male sex, smoking, hypertension, systolic blood pressure, LDL cholesterol, mean HbA, and triglyceride levels.
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