Diabetes & Metabolism Journal

Hong-Kyu Kim (Kim HK)

7 Articles

Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography (Diabetes Metab J 2023;47:104-17): Hwi Seung Kim, Hong-Kyu Kim, Chang Hee Jung; Diabetes Metab J. 2023;47(2):304-305. Published online March 15, 2023; DOI: https://doi.org/10.4093/dmj.2023.0058

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Association of NAFLD/NASH, and MAFLD/MASLD with chronic kidney disease: an updated narrative review
Amedeo Lonardo
Metabolism and Target Organ Damage.2024;[Epub] CrossRef

Metabolic Risk/Epidemiology
Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography: Hwi Seung Kim, Jiwoo Lee, Eun Hee Kim, Min Jung Lee, In Young Bae, Woo Je Lee, Joong-Yeol Park, Hong-Kyu Kim, Chang Hee Jung; Diabetes Metab J. 2023;47(1):104-117. Published online January 26, 2023; DOI: https://doi.org/10.4093/dmj.2022.0081

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Background
The association of myosteatosis measured using visual muscular quality map in computed tomography (CT) with nonalcoholic fatty liver disease (NAFLD), its severity, and fibrosis was analyzed in a large population.
Methods
Subjects (n=13,452) with abdominal CT between 2012 and 2013 were measured total abdominal muscle area (TAMA) at L3 level. TAMA was segmented into intramuscular adipose tissue and skeletal muscle area (SMA), which was further classified into normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA). The following variables were adopted as indicators of myosteatosis: SMA/body mass index (BMI), NAMA/BMI, NAMA/TAMA, and LAMA/BMI. NAFLD and its severity were assessed by ultrasonography, and liver fibrosis was measured by calculating the NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4) scores.
Results
According to multiple logistic regression analyses, as quartiles of SMA/BMI, NAMA/BMI, and NAMA/TAMA increased, the odds ratios (ORs) for NAFLD decreased in each sex (P for trend <0.001 for all). The ORs of moderate/severe NAFLD were significantly higher in the Q1 group than in the Q4 group for SMA/BMI, NAMA/BMI, and NAMA/TAMA in men. The ORs of intermediate/high liver fibrosis scores assessed by NFS and FIB-4 scores increased linearly with decreasing quartiles for SMA/BMI, NAMA/BMI, and NAMA/TAMA in each sex (P for trend <0.001 for all). Conversely, the risk for NAFLD and fibrosis were positively associated with LAMA/BMI quartiles in each sex (P for trend <0.001 for all).
Conclusion
A higher proportion of good quality muscle was associated with lower risks of NAFLD and fibrosis.

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Association between atherogenic dyslipidemia and muscle quality defined by myosteatosis
Hwi Seung Kim, Yun Kyung Cho, Myung Jin Kim, Eun Hee Kim, Min Jung Lee, Woo Je Lee, Hong-Kyu Kim, Chang Hee Jung
Frontiers in Endocrinology.2024;[Epub] CrossRef
Myosteatosis Predicts Bariatric Surgery Response: A Longitudinal Study in Patients With Morbid Obesity
Eugene Han, Mi Kyung Kim, Hye Won Lee, Seungwan Ryu, Hye Soon Kim, Byoung Kuk Jang, Youngsung Suh
The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef
Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography (Diabetes Metab J 2023;47:104-17)
Hwi Seung Kim, Hong-Kyu Kim, Chang Hee Jung
Diabetes & Metabolism Journal.2023; 47(2): 304. CrossRef
Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography (Diabetes Metab J 2023;47:104-17)
Eun Roh
Diabetes & Metabolism Journal.2023; 47(2): 301. CrossRef
Sarcopenia, a condition shared by various diseases: can we alleviate or delay the progression?
Giovanni Tarantino, Gaia Sinatti, Vincenzo Citro, Silvano Santini, Clara Balsano
Internal and Emergency Medicine.2023; 18(7): 1887. CrossRef
Association of Visceral Fat Obesity, Sarcopenia, and Myosteatosis with Non-Alcoholic Fatty Liver Disease without Obesity
Hong-Kyu Kim, Sung-Jin Bae, Min Jung Lee, Eun Hee Kim, Hana Park, Hwi Seung Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee, Jaewon Choe
Clinical and Molecular Hepatology.2023; 29(4): 987. CrossRef
Current view of the surgical anatomy of the anterolateral abdominal wall muscles and their aponeuroses
A.V. Pavlov, A.S. Baranova, A.V. Fedoseyev, A.I. Vvedensky, G.S. Lazutina, N.V. Ovchinnikova, I.V. Bakharev
Operativnaya khirurgiya i klinicheskaya anatomiya (Pirogovskii nauchnyi zhurnal).2023; 7(3): 44. CrossRef
Muscle Fat Content Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis in Chinese Adults
W. Guo, X. Zhao, D. Cheng, X. Liang, M. Miao, X. Li, J. Lu, N. Xu, Shuang Hu, Qun Zhang
The Journal of nutrition, health and aging.2023; 27(11): 960. CrossRef

Metabolic Risk/Epidemiology
Sex Differences of Visceral Fat Area and Visceral-to-Subcutaneous Fat Ratio for the Risk of Incident Type 2 Diabetes Mellitus: Eun Hee Kim, Hong-Kyu Kim, Min Jung Lee, Sung-Jin Bae, Jaewon Choe, Chang Hee Jung, Chul-Hee Kim, Joong-Yeol Park, Woo Je Lee; Diabetes Metab J. 2022;46(3):486-498. Published online November 18, 2021; DOI: https://doi.org/10.4093/dmj.2021.0095

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Background
This study aimed to determine the optimal cut-off values of visceral fat area (VFA) and visceral-to-subcutaneous fat ratio (VSR) for predicting incident type 2 diabetes mellitus (T2DM).
Methods
A total of 10,882 individuals (6,835 men; 4,047 women) free of T2DM at baseline aged between 30 and 79 years who underwent abdominal computed tomography scan between 2012 and 2013 as a part of routine health check-ups were included and followed. VFA, subcutaneous fat area, and VSR on L3 vertebral level were measured at baseline.
Results
During a median follow-up of 4.8 years, 730 (8.1% for men; 4.3% for women) incident cases of T2DM were identified. Receiver operating characteristic curve analysis showed that the optimal cut-off values of VFA and VSR for predicting incident T2DM were 130.03 cm² and 1.08 in men, respectively, and 85.7 cm² and 0.48 in women, respectively. Regardless of sex, higher VFA and VSR were significantly associated with a higher risk of incident T2DM. Compared with the lowest quartiles of VFA and VSR, the highest quartiles had adjusted odds ratios of 2.62 (95% confidence interval [CI], 1.73 to 3.97) and 1.55 (95% CI, 1.14 to 2.11) in men, respectively, and 32.49 (95% CI, 7.42 to 142.02) and 11.07 (95% CI, 3.89 to 31.50) in women, respectively.
Conclusion
Higher VFA and VSR at baseline were independent risk factors for the development of T2DM. Sex-specific reference values for visceral fat obesity (VFA ≥130 cm² or VSR ≥1.0 in men; VFA ≥85 cm² or VSR ≥0.5 in women) are proposed for the prediction of incident T2DM.

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Mohammad Jalali, Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi, Farhad Hosseinpanah
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Biochemical Pharmacology.2024; 221: 116043. CrossRef
Prediction of high visceral adipose tissue for sex‐specific community residents in Taiwan
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Guidelines for obesity clinic consultations in primary healthcare clinics
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Journal of the Korean Medical Association.2024; 67(4): 240. CrossRef
Correlation between fat-to-muscle mass ratio and cognitive impairment in elderly patients with type 2 diabetes mellitus: a cross-sectional study
Fan Wu, Yanlan Liu, Chenying Lin, Nahal Haghbin, Longfei Xia, Yaoshuang Li, Tong Chen, Huina Qiu, Weiran Jiang, Jingbo Li, Jingna Lin
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Jonathan P. Bennett, Carla M. Prado, Steven B. Heymsfield, John A. Shepherd
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Establishment of a novel weight reduction model after laparoscopic sleeve gastrectomy based on abdominal fat area
Tianyi Feng, Sanyuan Hu, Changrong Song, Mingwei Zhong
Frontiers in Surgery.2024;[Epub] CrossRef
Combined associations of visceral adipose tissue and adherence to a Mediterranean lifestyle with T2D and diabetic microvascular complications among individuals with prediabetes
Hao-Wen Chen, Kuan Liu, Bi-Fei Cao, Qi Zhong, Rui Zhou, Liang-Hua Li, Shi-Ao Wang, Yan-Fei Wei, Hua-Min Liu, Xian-Bo Wu
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Visceral fat area and subcutaneous fat area as measures of body composition in soft tissue sarcoma
Eric Robles Garibay, Sylvia M. Cruz, Sean J. Judge, Arta M. Monjazeb, Steven W. Thorpe, William J. Murphy, Jing Lyu, Shuai Chen, Cyrus P. Bateni, Robert J. Canter
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Visceral to subcutaneous fat area ratio predicts severe abdominal adhesions in definitive surgery for anastomotic fistula after small intestine resection
Fan Yang, Weiliang Tian, Shikun Luo, Wuhan Li, Guoping Zhao, Risheng Zhao, Tao Tian, Yunzhao Zhao, Zheng Yao, Qian Huang
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Assessing Patients beyond the Simple Optics of BMI: The Concomitant Role of Sarcopenia and BMI in Predicting Kidney Transplant Outcomes
Christopher Seet, Laura Clementoni, Mohammed Rashid Akhtar, Pankaj Chandak, Mohammed Saoud, Amr Elsaadany, Muhammad Magdi Yaqoob, Ismail Heyder Mohamed, Muhammad Arslan Khurram
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Serum immunoglobulin A levels: Diagnostic utility in alcoholic liver disease and association with liver fibrosis in steatotic liver disease
Tatsuki Ichikawa, Mio Yamashima, Shinobu Yamamichi, Makiko Koike, Yusuke Nakano, Hiroyuki Yajima, Osamu Miyazaki, Tomonari Ikeda, Takuma Okamura, Kazuyoshi Nagata, Kenichi Sawa, Kazutaka Niiya, Kazuhiko Nakao
Biomedical Reports.2024;[Epub] CrossRef
Myosteatosis Predicts Bariatric Surgery Response: A Longitudinal Study in Patients With Morbid Obesity
Eugene Han, Mi Kyung Kim, Hye Won Lee, Seungwan Ryu, Hye Soon Kim, Byoung Kuk Jang, Youngsung Suh
The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef
Body Composition and Metabolic Dysfunction Really Matter for the Achievement of Better Outcomes in High-Grade Serous Ovarian Cancer
Mauricio A. Cuello, Fernán Gómez, Ignacio Wichmann, Felipe Suárez, Sumie Kato, Elisa Orlandini, Jorge Brañes, Carolina Ibañez
Cancers.2023; 15(4): 1156. CrossRef
MEDICINAL BIOMAGNETISM FOR THE TREATMENT OF OBESITY
Ana Vergínia Campagnollo Bueno, Michelli Gonçalves Seneda, Ângela Mara Rambo, Ana Clara Campagnolo Gonçalves Toledo, Caroline Cabral de Azevedo, Adriane Viapiana Bossa
Health and Society.2023; 3(01): 411. CrossRef
Cumulative exposure to metabolic syndrome in a national population-based cohort of young adults and sex-specific risk for type 2 diabetes
Min-Kyung Lee, Jae-Hyuk Lee, Seo Young Sohn, Jiyeon Ahn, Oak-Kee Hong, Mee-Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Kyungdo Han, Hyuk-Sang Kwon
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
The correlation between visceral fat/subcutaneous fat area ratio and monocyte/high-density lipoprotein ratio in patients with type 2 diabetes mellitus and albuminuria
Haiyan Lin, Jun Zhu, Chen Zheng, Xiaoming Xu, Shandong Ye
Journal of Diabetes and its Complications.2023; 37(11): 108521. CrossRef
Effects of the abdominal fat distribution on the relationship between exposure to air pollutants and thyroid hormones among Korean adult males
Hyun-Jin Kim, Byungmi Kim, Seyoung Kim, Hyuktae Kwon, Jae Moon Yun, Belong Cho, Jin-Ho Park
European Journal of Medical Research.2023;[Epub] CrossRef
Association of Visceral Fat Obesity, Sarcopenia, and Myosteatosis with Non-Alcoholic Fatty Liver Disease without Obesity
Hong-Kyu Kim, Sung-Jin Bae, Min Jung Lee, Eun Hee Kim, Hana Park, Hwi Seung Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee, Jaewon Choe
Clinical and Molecular Hepatology.2023; 29(4): 987. CrossRef
Visceral adipose tissue reference data computed for GE HealthCare DXA from the National Health and Nutrition Examination Survey data set
Jonathan P. Bennett, Brandon K. Quon, Bo Fan, En Liu, Leila Kazemi, Rosa C. Villegas‐Valle, Raj Ahgun, Xian‐pin Wu, Hou‐De Zhou, Ying Lu, John A. Shepherd
Obesity.2023; 31(12): 2947. CrossRef
Comparison of bioelectrical body and visceral fat indices and anthropometric measures in relation to type 2 diabetes by sex among Chinese adults, a cross-sectional study
Jiangshan He, Binbin Zhang, Yaqi Fan, Yuxue Wang, Mianzhi Zhang, Chunjun Li, Li Zhang, Pei Guo, Minying Zhang
Frontiers in Public Health.2023;[Epub] CrossRef
The predictive significance of lipid accumulation products for future diabetes in a non-diabetic population from a gender perspective: an analysis using time-dependent receiver operating characteristics
Jiajun Qiu, Maobin Kuang, Yang Zou, Ruijuan Yang, Qing Shangguan, Dingyang Liu, Guotai Sheng, Wei Wang
Frontiers in Endocrinology.2023;[Epub] CrossRef
Cellular interplay between cardiomyocytes and non-myocytes in diabetic cardiomyopathy
Ren Jie Phang, Rebecca H. Ritchie, Derek J. Hausenloy, Jarmon G. Lees, Shiang Y. Lim
Cardiovascular Research.2022;[Epub] CrossRef
Implication of Sex Differences in Visceral Fat for the Assessment of Incidence Risk of Type 2 Diabetes Mellitus
Sang Hyeon Ju, Hyon-Seung Yi
Diabetes & Metabolism Journal.2022; 46(3): 414. CrossRef
Visceral fat area and body fat percentage measured by bioelectrical impedance analysis correlate with glycometabolism
Shuying Li, Shaoping Li, Jie Ding, Weihong Zhou
BMC Endocrine Disorders.2022;[Epub] CrossRef
The Demographic Specific Abdominal Fat Composition and Distribution Trends in US Adults from 2011 to 2018
Furong Xu, Jacob E. Earp, Bryan J. Blissmer, Ingrid E. Lofgren, Matthew J. Delmonico, Geoffrey W. Greene
International Journal of Environmental Research and Public Health.2022; 19(19): 12103. CrossRef
Visceral Obesity Is a More Important Factor for Colorectal Adenomas than Skeletal Muscle or Body Fat
Ji Yeon Seo, Yoo Min Han, Su Jin Chung, Seon Hee Lim, Jung Ho Bae, Goh Eun Chung
Cancers.2022; 14(21): 5256. CrossRef
Recent Advances in Visceral Obesity and Related Diseases
佳佳魏
Advances in Clinical Medicine.2022; 12(12): 11686. CrossRef
Gender differences in the ideal cutoffs of visceral fat area for predicting MAFLD in China
Pingping Yu, Huachao Yang, Xiaoya Qi, Ruixue Bai, Shouqin Zhang, Jianping Gong, Ying Mei, Peng Hu
Lipids in Health and Disease.2022;[Epub] CrossRef

Cardiovascular Risk/Epidemiology
Impact of Diabetes Control on Subclinical Atherosclerosis: Analysis from Coronary Computed Tomographic Angiography Registry: Gyung-Min Park, Chang Hoon Lee, Seung-Whan Lee, Sung-Cheol Yun, Young-Hak Kim, Yong-Giun Kim, Ki-Bum Won, Soe Hee Ann, Shin-Jae Kim, Dong Hyun Yang, Joon-Won Kang, Tae-Hwan Lim, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park, Hong-Kyu Kim, Jaewon Choe, Sang-Gon Lee; Diabetes Metab J. 2020;44(3):470-479. Published online November 22, 2019; DOI: https://doi.org/10.4093/dmj.2019.0073

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Background

There are limited data on the impact of diabetes control on the risk of subclinical coronary atherosclerosis.

Methods

We analyzed 6,434 consecutive asymptomatic individuals without previous history of coronary artery disease who underwent coronary computed tomographic angiography (CCTA) (mean age, 53.7±7.6 years and 4,694 men [73.0%]). The degree and extent of subclinical coronary atherosclerosis were assessed by CCTA, and ≥50% diameter stenosis was defined as significant. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Study participants were categorized as normal (n=5,319), controlled diabetes (glycosylated hemoglobin [HbA1c] <7%, n=747), or uncontrolled diabetes (HbA1c ≥7%, n=368), respectively.

Results

Compared with normal individuals, there were no statistically significant differences in the risk of for any atherosclerotic plaque (odds ratio [OR], 1.16; 95% confidence interval [CI], 0.98 to 1.38; P=0.086) and significant coronary artery stenosis (OR, 1.08; 95% CI, 0.82 to 1.42; P=0.583) in controlled diabetic individuals. In contrast, uncontrolled diabetic individuals had consistently higher risks of any atherosclerotic plaque (OR, 2.16; 95% CI, 1.70 to 2.75; P<0.001) and significant coronary artery stenosis (OR, 3.34; 95% CI, 2.52 to 4.43; P<0.001) than normal individuals. During a follow-up of median 5.4 years, there was no significant difference in cardiac events between normal and controlled diabetic individuals (P=0.365). However, uncontrolled diabetes was associated with an increased risk of cardiac events compared with normal individuals (P<0.001) and controlled diabetic individuals (P=0.023).

Conclusion

Asymptomatic uncontrolled diabetes was associated with significant subclinical coronary atherosclerosis with subsequent high risk for cardiac events.

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Carotid Ultrasound Abnormalities of People Living With HIV in Kunming, China: Multiple Correspondence Analysis Approach to Identify Influencing Factors
Shuishui Pan, Haiyan Fu, Zhiqiong Ai, Chongxi Li, Jinsong Bai
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Differential Impact of Degree of Hypertension on Subclinical Coronary Atherosclerosis in Asymptomatic Subjects With and Without Diabetes Mellitus
Hyun Woo Park, Sangyong Jo, Kyung Sun Park, Hyeji Lee, Young-Jee Jeon, Sangwoo Park, Soe Hee Ann, Yong-Giun Kim, Seong Hoon Choi, Woon Jung Kwon, Young-Rak Cho, Jon Suh, Gyung-Min Park
The American Journal of Cardiology.2023; 203: 343. CrossRef
Exosomal MALAT1 Derived from High Glucose-Treated Macrophages Up-Regulates Resistin Expression via miR-150-5p Downregulation
Kou-Gi Shyu, Bao-Wei Wang, Wei-Jen Fang, Chun-Ming Pan, Chiu-Mei Lin
International Journal of Molecular Sciences.2022; 23(3): 1095. CrossRef
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Su Bin Kim, Hae Won Jung
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Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study
Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim
Diabetes & Metabolism Journal.2021; 45(3): 368. CrossRef
Frequency and Significance of Right Bundle Branch Block and Subclinical Coronary Atherosclerosis in Asymptomatic Individuals
Hyeji Lee, Young-Jee Jeon, Byung Ju Kang, Tae Young Lee, Eun Ji Park, Sangwoo Park, Soe Hee Ann, Yong-Giun Kim, Yongjik Lee, Seong Hoon Choi, Gyung-Min Park
The American Journal of Cardiology.2021; 158: 30. CrossRef
The association between glucose-related variables and plaque morphology in patients with ST-segment elevated myocardial infarction
Jinxin Liu, Shanjie Wang, Can Cui, Hengxuan Cai, Rong Sun, Weili Pan, Shaohong Fang, Bo Yu
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N. A. Koziolova, P. G. Karavaev, A. S. Veklich
Kardiologiia.2020; 60(4): 109. CrossRef

Epidemiology
Longitudinal Changes of Body Composition Phenotypes and Their Association with Incident Type 2 Diabetes Mellitus during a 5-Year Follow-up in Koreans: Hong-Kyu Kim, Min Jung Lee, Eun-Hee Kim, Sung-Jin Bae, Jaewon Choe, Chul-Hee Kim, Joong-Yeol Park; Diabetes Metab J. 2019;43(5):627-639. Published online April 19, 2019; DOI: https://doi.org/10.4093/dmj.2018.0141

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Background

To elucidate longitudinal changes of complex body composition phenotypes and their association with incident type 2 diabetes mellitus.

Methods

A total of 17,280 (mean age, 48.1±8.2 years) Korean adults who underwent medical check-ups were included. The mean follow-up duration was 5.5±0.5 years. Body compositions were assessed using a bioelectrical impedance analysis. Four body composition phenotypes were defined using the median of appendicular skeletal muscle mass (ASM) index and fat mass index: low muscle/low fat (LM/LF); high muscle (HM)/LF; LM/high fat (HF); and HM/HF groups.

Results

Of the individuals in the LM/LF or HM/HF groups, over 60% remained in the same group, and over 30% were moved to the LM/HF group. Most of the LM/HF group remained in this group. In the baseline HM/LF group, approximately 30% stayed in the group, and the remaining individuals transitioned to the three other groups in similar proportions. Incident diabetes was significantly lower in participants who remained in the HM/LF group than those who transitioned to the LM/LF or LM/HF group from the baseline HM/LF group in men. ASM index was significantly associated with a decreased risk for incident diabetes in men regardless of obesity status (adjusted odds ratio [OR], 0.71 per kg/m²; 95% confidence interval [CI], 0.52 to 0.97 in non-obese) (adjusted OR, 0.87; 95% CI, 0.77 to 0.98 in obese) after adjusting for other strong risk factors (e.g., baseline glycosylated hemoglobin and homeostasis model assessment of insulin resistance).

Conclusion

Maintenance of ASM may be protective against the development of type 2 diabetes mellitus in men, regardless of obesity status.

Citations

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Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model
Hye Ah Lee, Hyesook Park
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Association of Visceral Fat Obesity, Sarcopenia, and Myosteatosis with Non-Alcoholic Fatty Liver Disease without Obesity
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Response: Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea (Diabetes Metab J 2012;36:151-6): Hong-Kyu Kim, Sung-Jin Bae, Jaewon Choe; Diabetes Metab J. 2012;36(3):253-253. Published online June 14, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.3.253

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Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea: Hong-Kyu Kim, Sung-Jin Bae, Jaeone Choe; Diabetes Metab J. 2012;36(2):151-156. Published online April 17, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.2.151

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Background

We performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea.

Methods

We retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women) which were measured during regular health check-ups. After excluding subjects with previously diagnosed diabetes mellitus (n=1,812) and with overt anemia (n=318), 35,624 subjects (21,201 men and 14,423 women) were included in the analysis.

Results

Among the 35,624 subjects, 11,316 (31.8%) subjects were categorized as increased risk for diabetes (IRD) by fasting plasma glucose (FPG) criteria, 6,531 (18.1%) subjects by HbA1c criteria, and 13,556 (38.1%) subjects by combined criteria. Therefore, although HbA1c criteria alone identifies 42% [(11,316-6,531)/11,316] fewer subjects with IRD than does FPG criteria, about 20% [(13,556-11,316)/11,316] more subjects could be detected by including new HbA1c criteria in addition to FPG criteria. Among the 13,556 subjects with IRD, 7,025 (51.8%) met FPG criteria only, 2,240 (16.5%) met HbA1c criteria only, and 4,291 (31.7%) met both criteria. Among subjects with impaired fasting glucose, 65% were normal, 32% were IRD, and 3% were diabetes by HbA1c criterion. In receiver operating characteristic curve analysis, cutoff point of HbA1c with optimal sensitivity and specificity for identifying IRD was 5.4%.

Conclusion

Although HbA1c criteria alone identifies fewer subjects with IRD than does FPG criteria, about 20% more could be detected by addition of HbA1c criteria. Further studies are needed to define optimal cutoff point of HbA1c and to establish screening and management guidelines for IRD.

Citations

Citations to this article as recorded by

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