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Increased Epicardial Adipose Tissue Thickness in Type 2 Diabetes Mellitus and Obesity
Do Kyeong Song, Young Sun Hong, Hyejin Lee, Jee-Young Oh, Yeon-Ah Sung, Yookyung Kim
Diabetes Metab J. 2015;39(5):405-413.   Published online October 22, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.5.405
  • 3,868 View
  • 62 Download
  • 53 Web of Science
  • 50 Crossref
AbstractAbstract PDFPubReader   
Background

Epicardial adipose tissue (EAT) is suggested to play an important role in the progression of metabolic syndrome. We aimed to establish a simple method to measure EAT and examine the differences in EAT thickness according to the presence of type 2 diabetes mellitus or obesity.

Methods

A total of 94 patients (42.6% type 2 diabetes mellitus, 53.2% obese, mean age 61±13) who underwent multidetector computed tomography were enrolled. Thickness of EAT was measured on the parasternal short and horizontal long axis view. Epicardial fat area (EFA) was measured at the level of left main coronary artery (LMCA).

Results

All EAT thicknesses were correlated with EFA at the LMCA level (r=0.235 to 0.613, all Ps<0.05), and EAT thickness in the left atrioventricular groove (LAVG) had the highest correlation coefficient (r=0.613). EFA, and EAT thicknesses in the LAVG and the left ventricular apex were higher in the group with type 2 diabetes mellitus than in the group without type 2 diabetes mellitus when adjusted only for body mass index. When adjusted only for type 2 diabetes mellitus, EFA, and EAT thicknesses in the LAVG and the right atrioventricular groove were higher in obese group than in nonobese group.

Conclusion

In conclusion, EAT thickness can be easily measured and represent EFA. EAT thickness, especially in LAVG, was higher in groups with type 2 diabetes mellitus and obesity independently. These findings implicate that EAT thickness may be a useful indicator for type 2 diabetes mellitus and obesity.

Citations

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FTO Gene Variants Are Associated with PCOS Susceptibility and Hyperandrogenemia in Young Korean Women
Do Kyeong Song, Hyejin Lee, Jee-Young Oh, Young Sun Hong, Yeon-Ah Sung
Diabetes Metab J. 2014;38(4):302-310.   Published online August 20, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.4.302
  • 4,123 View
  • 44 Download
  • 25 Web of Science
  • 24 Crossref
AbstractAbstract PDFPubReader   
Background

The fat mass and obesity-associated (FTO) gene is associated with obesity and type 2 diabetes mellitus. Obesity and insulin resistance are also common features of polycystic ovary syndrome (PCOS). Therefore, the FTO gene might be a candidate gene for PCOS susceptibility. The aim of the present study was to evaluate the effects of FTO gene variants on PCOS susceptibility and metabolic and reproductive hormonal parameters.

Methods

We recruited 432 women with PCOS (24±5 years) and 927 healthy women with regular menstrual cycles (27±5 years) and performed a case-control association study. We genotyped the single nucleotide polymorphisms rs1421085, rs17817449, and rs8050136 in the FTO gene and collected metabolic and hormonal measurements.

Results

Logistic regression revealed that the G/G genotype (rs1421085, 1.6%), the C/C genotype (rs17817449, 1.6%), and the A/A genotype (rs8050136, 1.6%) were strongly associated with an increased risk of PCOS (odds ratio, 2.551 to 2.559; all P<0.05). The strengths of these associations were attenuated after adjusting for age and BMI. The women with these genotypes were more obese and exhibited higher free androgen indices (P<0.05) and higher free testosterone levels (P=0.053 to 0.063) compared to the other genotypes. However the significant differences disappeared after adjusting for body mass index (BMI). When we analyzed the women with PCOS and the control groups separately, there were no significant differences in the metabolic and reproductive hormonal parameters according to the FTO gene variants.

Conclusion

The rs1421085, rs17817449, and rs8050136 variants of the FTO gene were associated with PCOS susceptibility and hyperandrogenemia in young Korean women. These associations may be mediated through an effect of BMI.

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Peroxisome Proliferator-activated Receptor-gamma (PPARgamma) Polymorphism in Korean Women with Polycystic Ovary Syndrome.
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Korean Diabetes J. 2007;31(6):480-487.   Published online November 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.6.480
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BACKGROUND
Polycystic ovary syndrome (PCOS) is a common endocrine disease affecting 5~10% of women with reproductive age. Familial aggregation suggests the evidence supporting a genetic basis for PCOS. The mode of inheritance of PCOS is not yet clear, however, probably polygenic and might be related to insulin resistance. Polymorphism of peroxisome proliferator-activated receptor (PPAR)-gamma gene is a susceptible gene for the development of obesity and diabetes. In this study, we examined the frequency and genetic effect of PPAR-gamma polymorphism on insulin resistance or hyperandrogenemia in Korean women with PCOS. METHODS: One-hundred twenty five Korean women with PCOS were evaluated for their metabolic and reproductive hormonal status. PPAR-gamma polymorphism was analyzed. RESULTS: Genetic frequency of PPAR-gamma was not significantly different between women with PCOS (n = 125) and those with regular menstrual cycles (n = 344). PCOS with Pro12Ala polymorphism had significantly higher levels of waist circumference and subcutaneous fat area compared with those with Pro12Pro genotype. They also had tendency of higher levels of fasting glucose concentration, body mass index (BMI) and visceral fat area. After BMI adjustment, this polymorphism was related to lower fasting insulin and higher insulin sensitivity index, and higher sex hormone binding globulin and lower free testosterone levels. CONCLUSION: Pro12Ala polymorphism of PPAR-gamma gene might be associated with obesity. However, after BMI adjustment, it may have favorable effect on insulin resistance and hyperandrogenemia. Because this study has limitations to conclude the genetic causality, further study is needed to support these findings.
Prevalence of Metabolic Syndrome in Young Korean Women with Polycystic Ovary Syndrome.
Hyejin Lee, Jee Young Oh, Youngsun Hong, Yeon Ah Sung, Hyewon Chung
Korean Diabetes J. 2006;30(4):285-291.   Published online July 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.4.285
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AbstractAbstract PDF
BACKGROUND
Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and consequent hyperinsulinemia. Insulin resistance plays an important role in the development of metabolic syndrome (MS). We conducted a cross-sectional study to determine the prevalence of the MS and whether the insulin resistance or hyperandrogenemia is related to the MS in young Korean women with PCOS. METHODS: 143 women with PCOS (mean age 26+/-5 years) were studied to evaluate the prevalence of MS by modified Adult Treatment Panel III. Insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp technique. RESULTS: The prevalence of MS in women with PCOS was 11.9%, 2.8-fold higher than age matched women in Korean urban population. The most frequent component of MS was low HDL cholesterol (39.4%), and the least frequent one was high fasting serum glucose levels (6.7%). The frequency of MS was 40.7% in obese PCOS (BMI > or = 25 kg/m2, n = 38), 10.0% in overweight PCOS (BMI 23~24.9 kg/m2, n = 13), and 0% in lean PCOS (BMI < 23 kg/m2, n = 92). The frequency of MS was 26.1% in insulin resistant PCOS (insulin mediated glucose uptake, IMGU < lowest 10th percentile of lean controls, n = 65), whereas no one had MS in insulin sensitive PCOS (IMGU > or = lowest 10th percentile of lean controls, n = 78). CONCLUSION: MS is frequent in young women with PCOS, and obesity and insulin resistance might be essential for the development of MS in this study group.

Citations

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  • Relationship between flavonoids intake and metabolic syndrome in Korean women with polycystic ovary syndrome
    Ji Soo Oh, Mi Jin Ahn, Chan Jung Han, Hyesook Kim, Oran Kwon, Hye Won Chung, Namsoo Chang
    Journal of Nutrition and Health.2014; 47(3): 176.     CrossRef
  • Inappropriate gonadotropin secretion in polycystic ovary syndrome: The relationship with clinical, hormonal and metabolic characteristics
    A Ra Shim, Yu Im Hwang, Kyung Jin Lim, Young Mi Choi, Young Eun Jeon, Seok Kyo Seo, Si Hyun Cho, Young Sik Choi, Byung Seok Lee
    Korean Journal of Obstetrics & Gynecology.2011; 54(11): 659.     CrossRef
  • Diagnosis and Treatment of Polycystic Ovary Syndrome
    Hyejin Lee, Yeon-ah Sung
    Journal of Korean Endocrine Society.2007; 22(4): 252.     CrossRef
Randomized Controlled Trial
The Comparison of Efficacy with alpha-lipoic Acid Treatment Methods in Diabetic Polyneuropathy.
Hyejin Lee, Kyung Wan Min, Kyung Ah Han
Korean Diabetes J. 2006;30(2):112-121.   Published online March 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.2.112
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AbstractAbstract PDF
BACKGROUND
Diabetic neuropathy represents a major health problem, as it is responsible for substantial morbidity, increased mortality, and impaired quality of life. Antioxidant treatment has been shown to prevent nerve dysfunction, providing a rationale for a potential therapeutic value in diabetic patients. The safety and efficacy of alpha-lipoic acid (ALA) given intravenously were proved in many studies, but the oral treatment remains to be established. Therefore we compare the efficacy and safety of ALA given intravenously followed by oral treatment and given only orally. METHODS: 45 outpatients were randomly assigned to sequential treatment with ALA intravenously for 2 weeks, followed by orally for 10 weeks (group 1, n = 21); ALA orally for 12 weeks (group 2, n = 24). The primary end point was change of the sum score of severity and duration of total symptom score (TSS). HbA1c and safety parameters were determined at baseline and after 12 weeks. RESULTS: The TSS was significantly decreased from baseline to 2 week and 12 week in both groups. But no significant differences between the two groups were noted at 2 week and 12 week. There were no significant changes in HbA1c and safety parameters between baseline and 12 week. The rate of adverse events were 47.6% in group 1 and 12.5% in group 2. CONCLUSION: We conclude that both methods of ALA treatment are effective to improve the symptoms of diabetic polyneuropathy, and the safety was probably superior in oral treatment method
Original Article
Eighteen-Year Trends in Korean Diabetic Patients(1981 through 1998).
Hyejin Lee, Kyung Ah Han, Kyung Wan Min, Eung Jin Kim
Korean Diabetes J. 2005;29(3):239-246.   Published online May 1, 2005
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AbstractAbstract PDF
BACKGROUND
This study was conducted to determine trends in the age, gender, body mass index(BMI), and fasting blood glucose of the diagnosed Korean diabetic patients. METHODS: The medical records were obtained on 32,867 Korean diabetic patients who were treated at the Eulji Diabetes Center from 1981 to 1998. We investigated the age, gender, height, weight, BMI and fasting blood glucose. Regression analysis was used to analyze the time trends. RESULTS: BMI(from 23.2kg/m2 to 24.1kg/m2, P<0.001) and weight(from 59.6kg to 61.9kg, P<0.001) were gradually increased over the 18 years. and these factors were still significant after correction for age. The age of onset(from 45year to 51year, P<0.001) was also increased over the 18 years. The fasting blood glucose level was decreased from 10.2 mmol/L to 7.2mmol/L P<0.001). The portion of male patients was significantly decreased over the 18 years(from 52.1% to 47.4%). CONCLUSION: Over the 18years, the weight and BMI at the time of diagnosis were increased. And the onset age of diabetes was increased, according to an aging society. As it was easy to gain access the medical service, the fasting blood glucose level was decreased, and the prevalence of female patients was increased over 18 years in Korea

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