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Original Article
Clinical Diabetes & Therapeutics
Association between Serum Selenium Level and the Presence of Diabetes Mellitus: A Meta-Analysis of Observational Studies
Juno Kim, Hye Soo Chung, Min-Kyu Choi, Yong Kyun Roh, Hyung Joon Yoo, Jung Hwan Park, Dong Sun Kim, Jae Myung Yu, Shinje Moon
Diabetes Metab J. 2019;43(4):447-460.   Published online January 2, 2019
DOI: https://doi.org/10.4093/dmj.2018.0123
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  • 35 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Epidemiological studies have suggested an association between selenium (Se) and diabetes mellitus (DM). However, different studies have reported conflicting results. Therefore, we performed a comprehensive meta-analysis to clarify the impact of Se on DM.

Methods

We searched the PubMed database for studies on the association between Se and DM from inception to June 2018.

Results

Twenty articles evaluating 47,930 participants were included in the analysis. The meta-analysis found that high levels of Se were significantly associated with the presence of DM (pooled odds ratios [ORs], 1.88; 95% confidence interval [CI], 1.44 to 2.45). However, significant heterogeneity was found (I2=82%). Subgroup analyses were performed based on the Se measurement methods used in each study. A significant association was found between high Se levels and the presence of DM in the studies that used blood (OR, 2.17; 95% CI, 1.60 to 2.93; I2=77%), diet (OR, 1.61; 95% CI, 1.10 to 2.36; I2=0%), and urine (OR, 1.49; 95% CI, 1.02 to 2.17; I2=0%) as samples to estimate Se levels, but not in studies on nails (OR, 1.24; 95% CI, 0.52 to 2.98; I2=91%). Because of significant heterogeneity in the studies with blood, we conducted a sensitivity analysis and tested the publication bias. The results were consistent after adjustment based on the sensitivity analysis as well as the trim and fill analysis for publication bias.

Conclusion

This meta-analysis demonstrates that high levels of Se are associated with the presence of DM. Further prospective and randomized controlled trials are warranted to elucidate the link better.

Citations

Citations to this article as recorded by  
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    Krystyna Pyrzynska, Aleksandra Sentkowska
    Biological Trace Element Research.2024; 202(7): 2993.     CrossRef
  • Increased Expression of PHGDH Under High-Selenium Stress In Vivo
    Qin Wang, Jianrong Wang, Xue Zhang, Yiqun Liu, Feng Han, Xuesong Xiang, Yanbin Guo, Zhen-wu Huang
    Biological Trace Element Research.2024;[Epub]     CrossRef
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    Xiaxia Cai, Zhuo Hu, Mingyuan Zhang, Qinyu Dang, Qian Yang, Xiaoyan Zhao, Yandi Zhu, Yadi Zhang, Yuchen Wei, Haiqin Fang, Huanling Yu
    Journal of Trace Elements in Medicine and Biology.2024; 83: 127410.     CrossRef
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    Katarzyna Napiórkowska-Baran, Paweł Treichel, Marta Czarnowska, Magdalena Drozd, Kinga Koperska, Agata Węglarz, Oskar Schmidt, Samira Darwish, Bartłomiej Szymczak, Zbigniew Bartuzi
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    Giuseppe Genchi, Graziantonio Lauria, Alessia Catalano, Maria Stefania Sinicropi, Alessia Carocci
    International Journal of Molecular Sciences.2023; 24(3): 2633.     CrossRef
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    International Journal of Molecular Sciences.2023; 24(13): 10887.     CrossRef
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    Maha Alharithy, Nora Alafif
    Metabolites.2023; 13(6): 767.     CrossRef
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    Life.2023; 13(9): 1849.     CrossRef
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    Marek Kieliszek, Iqra Bano, Hamed Zare
    Biological Trace Element Research.2022; 200(3): 971.     CrossRef
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    Fatih Ciftci, Sumeyra Ayan, Nilüfer Duygulu, Yasemin Yilmazer, Zeynep Karavelioglu, Meyrem Vehapi, Rabia Cakır Koc, Mustafa Sengor, Hakan Yılmazer, Didem Ozcimen, Oguzhan Gunduz, Cem Bulent Ustundag
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  • The role of selenium in type-2 diabetes mellitus and its metabolic comorbidities
    Holger Steinbrenner, Leonidas H. Duntas, Margaret P. Rayman
    Redox Biology.2022; 50: 102236.     CrossRef
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    Giulia Barchielli, Antonella Capperucci, Damiano Tanini
    Antioxidants.2022; 11(2): 251.     CrossRef
  • Selenium and Selenoproteins at the Intersection of Type 2 Diabetes and Thyroid Pathophysiology
    Francesca Gorini, Cristina Vassalle
    Antioxidants.2022; 11(6): 1188.     CrossRef
  • Higher selenium was associated with higher risk of diabetes: Consistent evidence from longitudinal and cross-sectional studies based on nail and serum selenium measures
    Ranqi Shao, Liqin Su, Li Li, Jinghuan Wu, Xiaohong He, Deqian Mao, Yibin Cheng, Jingyi Liu, Chen Chen, Yinlong Jin, Sujuan Gao
    Science of The Total Environment.2022; 840: 156618.     CrossRef
  • The Roles and Pathogenesis Mechanisms of a Number of Micronutrients in the Prevention and/or Treatment of Chronic Hepatitis, COVID-19 and Type-2 Diabetes Mellitus
    Khalid M. Sumaily
    Nutrients.2022; 14(13): 2632.     CrossRef
  • Associations between Circulating SELENOP Level and Disorders of Glucose and Lipid Metabolism: A Meta-Analysis
    Ruirui Yu, Zhoutian Wang, Miaomiao Ma, Ping Xu, Longjian Liu, Alexey A. Tinkov, Xin Gen Lei, Ji-Chang Zhou
    Antioxidants.2022; 11(7): 1263.     CrossRef
  • Cross-Sectional Association of Blood Selenium with Glycemic Biomarkers among U.S. Adults with Normoglycemia in the National Health and Nutrition Examination Survey 2013–2016
    Jingli Yang, En Chen, Cheukling Choi, Kayue Chan, Qinghua Yang, Juwel Rana, Bo Yang, Chuiguo Huang, Aimin Yang, Kenneth Lo
    Nutrients.2022; 14(19): 3972.     CrossRef
  • Plasma and vitreous selenium concentrations in patients with type 2 diabetes and diabetic retinopathy
    Chunmiao Wang, Ruijin Ran, Xin Jin, Xiaohong Zhu
    Medicine.2022; 101(39): e30877.     CrossRef
  • Emerging roles of selenium on metabolism and type 2 diabetes
    Jiuxiang Zhao, Hong Zou, Yanling Huo, Xiaoyi Wei, Yu Li
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Selenium: Role in preserving and improving health and preventing disease
    Goran Belojević
    Galenika Medical Journal.2022; 1(4): 90.     CrossRef
  • A comprehensive review on the neuropathophysiology of selenium
    Mohammad Naderi, Pankaj Puar, Mahtab Zonouzi-Marand, Douglas P. Chivers, Som Niyogi, Raymond W.M. Kwong
    Science of The Total Environment.2021; 767: 144329.     CrossRef
  • Dietary selenium intake and risk of hospitalization for type 2 diabetes in the Moli-sani study cohort
    Marco Vinceti, Marialaura Bonaccio, Tommaso Filippini, Simona Costanzo, Lauren A. Wise, Augusto Di Castelnuovo, Emilia Ruggiero, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello
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  • A systematic review and dose-response meta-analysis of exposure to environmental selenium and the risk of type 2 diabetes in nonexperimental studies
    Marco Vinceti, Tommaso Filippini, Lauren A. Wise, Kenneth J. Rothman
    Environmental Research.2021; 197: 111210.     CrossRef
  • Selenium as a Bioactive Micronutrient in the Human Diet and Its Cancer Chemopreventive Activity
    Dominika Radomska, Robert Czarnomysy, Dominik Radomski, Anna Bielawska, Krzysztof Bielawski
    Nutrients.2021; 13(5): 1649.     CrossRef
  • Selenium in Human Health and Gut Microflora: Bioavailability of Selenocompounds and Relationship With Diseases
    Rannapaula Lawrynhuk Urbano Ferreira, Karine Cavalcanti Maurício Sena-Evangelista, Eduardo Pereira de Azevedo, Francisco Irochima Pinheiro, Ricardo Ney Cobucci, Lucia Fatima Campos Pedrosa
    Frontiers in Nutrition.2021;[Epub]     CrossRef
  • Ferroptosis and Its Potential Role in Metabolic Diseases: A Curse or Revitalization?
    Jia-Yue Duan, Xiao Lin, Feng Xu, Su-Kang Shan, Bei Guo, Fu-Xing-Zi Li, Yi Wang, Ming-Hui Zheng, Qiu-Shuang Xu, Li-Min Lei, Wen-Lu Ou-Yang, Yun-Yun Wu, Ke-Xin Tang, Ling-Qing Yuan
    Frontiers in Cell and Developmental Biology.2021;[Epub]     CrossRef
  • Selenium Intake and Glycemic Control in Young Adults With Normal-Weight Obesity Syndrome
    Acsa de Castro Santos, Anna Flavia Ferreira Passos, Luciana Carla Holzbach, Cristiane Cominetti
    Frontiers in Nutrition.2021;[Epub]     CrossRef
  • Development and Therapeutic Potential of Selenazo Compounds
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    Journal of Medicinal Chemistry.2020; 63(4): 1473.     CrossRef
  • Selenium in thyroid disorders — essential knowledge for clinicians
    Kristian Hillert Winther, Margaret Philomena Rayman, Steen Joop Bonnema, Laszlo Hegedüs
    Nature Reviews Endocrinology.2020; 16(3): 165.     CrossRef
  • Safety of selenium‐enriched biomass of Yarrowia lipolytica as a novel food pursuant to Regulation (EU) 2015/2283
    Dominique Turck, Jacqueline Castenmiller, Stefaan De Henauw, Karen Ildico Hirsch‐Ernst, John Kearney, Alexandre Maciuk, Inge Mangelsdorf, Harry J McArdle, Androniki Naska, Carmen Pelaez, Kristina Pentieva, Alfonso Siani, Frank Thies, Sophia Tsabouri, Marc
    EFSA Journal.2020;[Epub]     CrossRef
  • The Association of Circulating Selenium Concentrations with Diabetes Mellitus


    Xiao-Long Liao, Zhong-Hua Wang, Xiu-Na Liang, Jun Liang, Xue-Biao Wei, Shou-Hong Wang, Wei-Xin Guo
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 4755.     CrossRef
  • A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Hashimoto’s Thyroiditis
    Kristian Hillert Winther, Enrico Papini, Roberto Attanasio, Roberto Negro, Laszlo Hegedüs
    European Thyroid Journal.2020; 9(2): 99.     CrossRef
  • Systems Biology of Selenium and Complex Disease
    Huimin Ying, Yan Zhang
    Biological Trace Element Research.2019; 192(1): 38.     CrossRef
  • Effectiveness and safety of selenium supplementation for type 2 diabetes mellitus in adults: a systematic review of randomised controlled trials
    A. Stróżyk, Z. Osica, J. D. Przybylak, M. Kołodziej, B. M. Zalewski, B. Mrozikiewicz‐Rakowska, H. Szajewska
    Journal of Human Nutrition and Dietetics.2019; 32(5): 635.     CrossRef
  • Selenium and Health: An Update on the Situation in the Middle East and North Africa
    Sohayla A. Z. Ibrahim, Abdelhamid Kerkadi, Abdelali Agouni
    Nutrients.2019; 11(7): 1457.     CrossRef
Editorial
Others
Fifty Years of Compassionate Care and Harmonious Collaboration of the Korean Diabetes Association: The 50th Anniversary of Korean Diabetes Association
Jong Chul Won, Eun-Jung Rhee, Hyung Joon Yoo
Diabetes Metab J. 2018;42(6):475-479.   Published online December 17, 2018
DOI: https://doi.org/10.4093/dmj.2018.0231
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  • 34 Download
  • 2 Web of Science
  • 1 Crossref
PDFPubReader   

Citations

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  • DMJ, Better than Yesterday, More Brilliant Tomorrow
    Kyu Chang Won
    Diabetes & Metabolism Journal.2019; 43(1): 1.     CrossRef
Sulwon Lecture 2016
Clinical Care/Education
Comprehensive Approach for Managing the Older Person with Diabetes Mellitus
Hyung Joon Yoo
Diabetes Metab J. 2017;41(3):155-159.   Published online May 18, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.3.155
  • 3,778 View
  • 43 Download
  • 2 Web of Science
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AbstractAbstract PDFPubReader   

Care of the elderly population with diabetes may not be restricted to the management of hyperglycemia, associated risk factors, and specific diabetic complications. An integrated approach should also include the assessment and management of gerontological problems. Both diabetes mellitus and aging interact toward the direction of the increased incidence of geriatric syndromes. Education is a common element of both diabetes control and geriatric syndrome care. However, it has been perceived that conventional education programs for diabetics are not as effective for the elderly. We have designed geriatric reinforced education (GRE) for application in older diabetics with geriatric syndromes. We observed that the application of GRE improved the glucose control and the status of geriatric syndromes in older adults with diabetes. In summary, in terms of integrating the care of coexisting diabetes and geriatric problems, GRE may be a beneficial tool for the management of older adults with diabetes.

Citations

Citations to this article as recorded by  
  • The Relationship Between Diabetes Knowledge Level, Physical Activity, and Quality of Life in Older Adults
    Burçin AKÇAY, Tuğba KURU ÇOLAK, Sultan İĞREK, Bahar ÖZGÜL, Adnan APTI
    Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi.2023; 5(2): 162.     CrossRef
  • Evaluation of diabetes self-management education in geriatrics with type 2 diabetes in Turkey
    Emre S. SAYGILI, Ersen KARAKILIÇ, Serap YASA, Emine ŞEN
    Minerva Endocrinology.2022;[Epub]     CrossRef
  • Treatment Goals for Glycemia in Older Patients with Diabetes Mellitus
    Jung Ah Lim
    The Journal of Korean Diabetes.2019; 20(4): 220.     CrossRef
  • Circular RNA and its mechanisms in disease: From the bench to the clinic
    Bing Han, Jie Chao, Honghong Yao
    Pharmacology & Therapeutics.2018; 187: 31.     CrossRef
Original Articles
Is A1C Variability an Independent Predictor for the Progression of Atherosclerosis in Type 2 Diabetic Patients?
Chul Sik Kim, So Young Park, Sung Hoon Yu, Jun Goo Kang, Ohk Hyun Ryu, Seong Jin Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo-Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo
Korean Diabetes J. 2010;34(3):174-181.   Published online June 30, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.3.174
  • 4,385 View
  • 29 Download
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

Little is known about the relative contribution of long-term glycemic variability to the risk of macrovascular complications in type 2 diabetes. This study was conducted to evaluate the effect of A1C variability on the progression of carotid artery intima-media thickness (IMT) in type 2 diabetic patients.

Methods

Among type 2 diabetic patients who visited Hallym University Sacred Heart Hospital from March 2007 to September 2009, 120 patients who had carotid artery IMT measured annually and A1C checked every three months for at least one year were analyzed. Individual A1C variability was defined as the standard deviation (SD) of five A1C levels taken every three months for approximately one year. Change in IMT was defined as an increase in IMT on follow-up measurement. The association between the SD of A1C and changes in IMT was evaluated.

Results

With greater A1C variability, there was a greater increase in the mean IMT (r = 0.350, P < 0.001) of the carotid artery. After adjusting for confounding factors that may influence IMT, A1C variability was significantly associated with the progression of IMT (r = 0.222, P = 0.034). However, the SD of A1C was not a significant independent risk factor for the progression of IMT in multiple regression analysis (β = 0.158, P = 0.093).

Conclusion

Higher A1C variability is associated with IMT progression in type 2 diabetic patients; however, it is not an independent predictor of IMT progression. Overall glycemic control is the most important factor in the progression of IMT.

Citations

Citations to this article as recorded by  
  • Long-Term Risk of Cardiovascular Disease Among Type 2 Diabetes Patients According to Average and Visit-to-Visit Variations of HbA1c Levels During the First 3 Years of Diabetes Diagnosis
    Hyunah Kim, Da Young Jung, Seung-Hwan Lee, Jae-Hyoung Cho, Hyeon Woo Yim, Hun-Sung Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Association Between Long-Term Visit-to-Visit Hemoglobin A1c and Cardiovascular Risk in Type 2 Diabetes: The ACCORD Trial
    Dan Huang, Yong-Quan Huang, Qun-Ying Zhang, Yan Cui, Tian-Yi Mu, Yin Huang
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • Association of Longitudinal Values of Glycated Hemoglobin With Cardiovascular Events in Patients With Type 2 Diabetes and Multivessel Coronary Artery Disease
    Paulo Cury Rezende, Mark Andrew Hlatky, Whady Hueb, Rosa Maria Rahmi Garcia, Luciano da Silva Selistre, Eduardo Gomes Lima, Cibele Larrosa Garzillo, Thiago Luis Scudeler, Gustavo Andre Boeing Boros, Fernando Faglioni Ribas, Carlos Vicente Serrano, Jose An
    JAMA Network Open.2020; 3(1): e1919666.     CrossRef
  • Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes
    Yifei Mo, Jian Zhou, Xiaojing Ma, Wei Zhu, Lei Zhang, Jie Li, Jingyi Lu, Cheng Hu, Yuqian Bao, Weiping Jia
    Diabetes and Vascular Disease Research.2018; 15(5): 402.     CrossRef
  • Relationship of HbA1c variability, absolute changes in HbA1c, and all-cause mortality in type 2 diabetes: a Danish population-based prospective observational study
    Mette V Skriver, Annelli Sandbæk, Jette K Kristensen, Henrik Støvring
    BMJ Open Diabetes Research & Care.2015; 3(1): e000060.     CrossRef
  • Association between hemoglobin A1c variability and subclinical coronary atherosclerosis in subjects with type 2 diabetes
    Hae Kyung Yang, Borami Kang, Seung-Hwan Lee, Kun-Ho Yoon, Byung-Hee Hwang, Kiyuk Chang, Kyungdo Han, Gunseog Kang, Jae Hyoung Cho
    Journal of Diabetes and its Complications.2015; 29(6): 776.     CrossRef
  • Glycated hemoglobin as a marker of subclinical atherosclerosis and cardiac remodeling among non-diabetic adults from the general population
    Robin Haring, Sebastian E. Baumeister, Wolfgang Lieb, Bettina von Sarnowski, Henry Völzke, Stephan B. Felix, Matthias Nauck, Henri Wallaschofski
    Diabetes Research and Clinical Practice.2014; 105(3): 416.     CrossRef
  • HbA1c Variability and Micro- and Macrovascular Complications of Diabetes
    Hae Kyung Yang, Seung-Hwan Lee
    The Journal of Korean Diabetes.2014; 15(4): 202.     CrossRef
  • HbA1c variability and the development of microalbuminuria in type 2 diabetes: Tsukuba Kawai Diabetes Registry 2
    A. Sugawara, K. Kawai, S. Motohashi, K. Saito, S. Kodama, Y. Yachi, R. Hirasawa, H. Shimano, K. Yamazaki, H. Sone
    Diabetologia.2012; 55(8): 2128.     CrossRef
Risk Factors for Early Development of Macrovascular Complications in Korean Type 2 Diabetes.
Hae Ri Lee, Jae Myung Yu, Moon Gi Choi, Hyung Joon Yoo, Eun Gyoung Hong
Korean Diabetes J. 2009;33(2):134-142.   Published online April 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.2.134
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  • 4 Crossref
AbstractAbstract PDF
BACKGROUND
The average duration of diabetes and predictive factors of macrovascular complications in Korean diabetic patients remain to be elucidated. This study examines the average duration of diabetes up to the onset of macrovascular complications and clinically important factors of early development of these complications in Korean type 2 diabetic patients. METHODS: Clinical characteristics in type 2 diabetics with (n = 121) and without macrovascular complications (n = 115) were analyzed. In addition, early onset (< or = 5 years, n = 54) and late onset groups (> 5 years, n = 67) were compared, as were the clinical characteristics between male and female patients in the macrovascular complications group. RESULTS: The average duration of diabetes was 8.7 +/- 7.8 years in the macrovascular complications group. Average age, systolic and diastolic blood pressures and smoking history were all higher in the macrovascular complications group than the control group. However, HbA1c levels and prevalence of microvascular complications were higher in the controls. Average age was lower in the early onset group and many more patients of that group had a smoking history. In the analysis based on sex, marcrovascular complications developed earlier in male patients. In addition, the prevalence of family history of diabetes was higher in males and 77.8% of male patients had a smoking history (female: 3.4%). CONCLUSION: Our study confirms that older age, high blood pressure and smoking history are major risk factors for the development of macrovascular complications. Moreover, a smoking history in males can be both risk and predictive factors for earlier development of macrovascular complications in Korean type 2 diabetic patients. We also found that several clinical characteristics including age, family history of diabetes, hypertension and smoking history, vary between the sexes, and these findings can provide useful indices for the prevention of macrovascular complications.

Citations

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  • Impact of new-onset diabetes on clinical outcomes after ST segment-elevated myocardial infarction
    Ji-Yeoun Seo, Jin-Sun Park, Kyoung-Woo Seo, Hyoung-Mo Yang, Hong-Seok Lim, Byoung-Joo Choi, So-Yeon Choi, Myeong-Ho Yoon, Gyo-Seung Hwang, Seung-Jea Tahk, Joon-Han Shin
    Scandinavian Cardiovascular Journal.2019; 53(6): 379.     CrossRef
  • Associations Between the Continuity of Ambulatory Care of Adult Diabetes Patients in Korea and the Incidence of Macrovascular Complications
    Young-Hoon Gong, Seok-Jun Yoon, Hyeyoung Seo, Dongwoo Kim
    Journal of Preventive Medicine and Public Health.2015; 48(4): 188.     CrossRef
  • Relationship of Daily Activity and Biochemical Variables in the Elderly with Diabetes Mellitus
    Ki-Wol Sung
    Journal of Korean Academy of Nursing.2011; 41(2): 182.     CrossRef
  • Epidemiology of Micro- and Macrovascular Complications of Type 2 Diabetes in Korea
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    Diabetes & Metabolism Journal.2011; 35(6): 571.     CrossRef
Effects of Type 2 Diabetes Mellitus on Risk Factors of Acute Coronary Syndrome.
Hong Ju Moon, Jun Goo Kang, Min Ho Jo, Byung Wan Lee, Cheol Young Park, Seong Jin Lee, Eun Kyung Hong, Jae Myoung Yu, Doo Man Kim, Sung Hee Ihm, Hyun Kyu Kim, Chong Yun Rhim, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park
Korean Diabetes J. 2006;30(6):435-441.   Published online November 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.6.435
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  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
Diabetes mellitus (DM) is equivalent as well a risk factor of cardiovascular disease. We analyzed the effects of DM on clinical risk factors of acute coronary syndrome by comparing DM group with Non-DM group. METHODS: A total of 847 (514 males and 333 females) patients with acute coronary syndrome was selected from 1664 patients who had undergone coronary angiography (CAG). These patients comprised 105 subjects with non-ST elevation myocardial infarction (MI), 313 with ST elevation MI and 429 with unstable angina. According to the presence of DM, we retrospectively reviewed the measured basic demographics, biochemical markers and coronary angiographic findings. RESULTS: In the multivariated analysis, history of hypertension (P = 0.001), C-reactive protein (CRP) level (P = 0.001) and triglyceride level (P = 0.018) were independent risk factors in type 2 diabetic group. Also the frequency of multiple coronary vessel disease was higher in DM group than non-DM group on the coronary angiographic finding CONCLUSIONS: Classic risk factors for acute coronary syndrome are strong predictors in patients with type 2 DM. Among these factors, the most important powerful risk factor is history of hypertension.

Citations

Citations to this article as recorded by  
  • Gender-Based Differences in the Management and Prognosis of Acute Coronary Syndrome in Korea
    Hee Tae Yu, Kwang Joon Kim, Woo-Dae Bang, Chang-Myung Oh, Ji-Yong Jang, Sung-Soo Cho, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
    Yonsei Medical Journal.2011; 52(4): 562.     CrossRef
The Relationship Between the C1818T Polymorphism in Exon 4 of the klotho Gene with Fasting Glucose and Insulin Levels in Korean Women.
Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Seong Gyun Kim, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park
Korean Diabetes J. 2005;29(3):189-197.   Published online May 1, 2005
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AbstractAbstract PDF
BACKGROUND
A novel gene, termed klotho has been identified as a suppressor of several aging phenotypes, and a genetic defect of klotho in mice resulted in a syndrome resembling human aging, i.e., a short lifespan, infertility, arteriosclerosis, skin atrophy, osteoporosis, and pulmonary emphysema. Since klotho mice also showed an abnormal glucose metabolism, we investigated the relationship between the C1818T polymorphism in exon 4 of the klotho gene and fasting glucose and insulin resistance in Korean women to observe its contribution to glucose metabolism. METHODS: The weight, height, blood pressure, fasting blood glucose, insulin, and lipid profiles were measured in 241 women(mean age, 51.2+/-7.0yr) by using the standard methods. Homeostasis model assessment(HOMA)-insulin resistance(IR), the quantitative insulin sensitivity check index(QUICKI) and HOMAbeta-cell were calculated. The genotyping of the C1818T polymorphism in exon 4 of the klotho gene was performed by allelic discrimination with using a 5' nuclease polymerase chain reaction assay. RESULTS: The allele frequencies were 0.805 for the C allele and 0.195 for the T allele, and they were in Hardy-Weinberg equilibrium(P=0.290). The mean fasting blood glucose(P= 0.005) and HOMA IR(P=0.035) were significantly higher in the T allele carriers compared with the non-carriers. After adjustment was made for age, fasting blood glucose was persistently significant(P=0.015), but the HOMA-IR became marginally significant(P=0.063). In the premenopausal women, the T allele carriers showed a higher mean fasting blood glucose(P=0.038), insulin(P=0.024), HOMA-IR(P=0.010), total cholesterol(P=0.039), and triglyceride levels(P=0.031) than in the non-carriers. After adjustment was made for age, the fasting blood glucose, insulin, HOMA-IR and triglyceride were persistently significant(P= 0.043, P=0.026, P=0.011, P=0.040). Also, the QUICKI, total cholesterol and low-density ilpo-protein cholesterol became marginally significant(P=0.073, P=0.061, P=0.098). For the postmenopausal women, the T allele carriers showed a tendency for higher mean fasting blood glucose levels(P=0.065) and lower HOMA beta-cell levels(P=0.085) than in the noncarriers. These differences became non-significant after adjustment was made for age. CONCLUSION: We observed that the C1818T polymorphism in exon 4 of the klotho gene was partly associated with glucose metabolism in Korean women. Also, these data suggest that the C1818T polymorphism is related with some cardiovascular risk factors in Korean women. The mechanism linking this gene with glucose metabolism warrants further study
Mitogenic Effects and Signaling Pathway of Insulin-Like Growth Factor-I (IGF-I) in the Rat Beta Cell Line (INS-1).
In Kyung Jeong, Ja Young Kim, Hyung Joon Yoo, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim
Korean Diabetes J. 2004;28(6):478-489.   Published online December 1, 2004
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BACKGROUND
Nutrients and growth factors are known to stimulate pancreatic beta cell mitogenesis. IGF-I acts as a survival factor by limiting apoptosis and stimulating proliferation in many cell types. However, the appropriate mitogenic signaling pathways have not been defined. The aim of this study is to elucidate the mitogenic effect and signaling pathways of IGF-I in the rat beta cell line (INS-I). METHODS: The studies were performed using the rat pancreatic beta cell line, INS-1. INS-1 cells were cultured in RPMI 1640 containing serum-free, 0.2% BSA and 11.1 mmol/L glucose media for 24 hours, and the cells were then treated with IGF-I and different concentrations of glucose or tyrosine phosphorylation inhibitors, or insulin. The cell proliferation was measured by the [3H]thymidine uptake and MTT assay. The cell cycle was analyzed by a flow cytometer by using propidium iodide staining. Western blot analyses were performed using antibodies against PY20 and phospho-MAPK. RESULTS: 1) MTT assay and the [3H]thymidine uptake showed that IGF-I stimulated the INS-1 cell proliferation in a dose dependent manner. Glucose was noted to independently increase the INS-1 cell proliferation. A combination of IGF-I and glucose has a synergistic effect on the proliferation of INS-I cells. Insulin did not influence on the mitogenic effect of IGF-I. 2) The S fraction of INS-1 cells treated with IGF-I was increased in a dose dependent manner. IGF-I stimulated the exit from G1 into the S phase of the cell cycle. 3) Investigation of the role of the PI3K and MAPK, by using of the inhibitors LY294002, wortmannin, and PD98059, demonstrated that the activation of MAPK, but not PI3K, required to stimulate the proliferation of INS-1 cells. 4) IGF-I stimulated the phosphorylation activation of pp60 and phospho-MAPK in the INS-1 cells. IGF-I induced the beta cell proliferation, and this was mediated via a signaling mechanism that was facilitated by MAPK. CONCLUSION: The proliferative effect of IGF-I on pancreatic beta cell seems to be mediated through MAPK signaling pathway.
Alcohol Drinking Problems and Diabetes Self-care in Male Diabetics.
Soo Mi Jang, Kyung Ae Choi, Hyung Joon Yoo
Korean Diabetes J. 2004;28(2):139-148.   Published online April 1, 2004
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BACKGROUND
Heavy alcohol drinking negatively influences the self-care of diabetics requiring strict management of their lifestyle. However, related studies on the clinical interventions for diabetics with alcohol drinking problems are rare. Thus, the relationship between alcohol drinking problems and self-care of male diabetics was studied, and the physician's recognition of the drinking problems also evaluated. METHODS: The subjects of this study were 88 middle-aged male diabetics. They were selected from 4 general hospitals between Nov. 2001 and Feb. 2002. The subjects' alcohol drinking problems and degree of diabetes self-care were examined. Their charts were also reviewed for the physician's recognition of diabetic' alcohol related drinking problems. RESULT: Among the subjects, 53.4% were categorized as problem drinkers and 26% as alcohol dependent. Furthermore, 67.5% of diabetics with drinking problems had their alcohol drinking problems recognized by the physician. The mean self-care among diabetics with and without alcohol drinking problems were 15.0. The mean self-care among diabetics without alcohol drinking problems was 20.6(p<0.001). CONCLUSION: In this study, the importance of educator's sensitivity to diabetics' drinking problems and the use of screening tools to find alcohol drinking problems at an early stage have been highlighted. Further studies on the development of new program are suggested in order to effectively intervene in diabetics with alcohol drinking problems.
Activin A Converts Pancreatic Ductal Cells into Insulin-Secreting Cells.
Kyoung Hee Lee, Mi Kyung Park, Han Wook Kang, Hyun Jin Kim, In Kyung Jeong, Hyung Joon Yoo, Jae Hoon Jeong, Yong Ki Min, Myung Shik Lee, Kwang Won Kim, Moon Kyu Lee
Korean Diabetes J. 2004;28(1):20-27.   Published online February 1, 2004
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BACKGROUND
Islet transplantation as a potential treatment for diabetes has been investigated extensively over the past years. One of the major limitations to successful islet transplantation is shortage of insulin-producing tissue, which has stimulated the search for alternative sources, and recently, attention has been focused on the possible use of controlled differentiation of stem cells to obtain specialized cells useful in treating many diseases. It is currently believed that pancreatic progenitor or stem cells exist in the ductal cell population. Activin A is a member of the TGFbeta superfamily, which can block the exocrine pancreatic development and potentiate the endocrine development of the pancreas. In this study, whether activin A could expand and/or differentiate the ductal cells into insulin-producing cells was examined. METHODS: From a collagenase P digested pancreas, ductal tissue was cultured under conditions that allowed expansion as a monolayer, where the cells were overlaid with a rat tail collagen I-coated dish. Activin A cDNA was transfected into rat ductal cells by using Lipofectamine, and the insulin secretion, content and differentiation markers examined. RESULT: The clumps of ductal tissue adhered to the dish 24 hr later, and formed a complete monolayer after 3 days of culture. Activin A overexpression significantly increased both the insulin secretion and content from the ductal cells. The glucose(16.7mM)-induced insulin secretion was also significantly increased. Immunohistochemistry and RT-PCR analyses revealed expression of PDX-1, as well as insulin & GLUT2. CONCLUSION: Activin A overexpression could potentiate the differentiation of pancreatic ductal cells, which might provide a potential new source of cinsulin- producing cells for transplantation
Effect of Glucose Concentrations on the Cell Proliferation and Expression of L-type Calcium Channel mRNA in Cultured Rat Aortic Vascular Smooth Muscle Cells.
Young Jung Cho, Hyung Joon Yoo, Hong Woo Nam, Ji Young Suh, In Kyung Jeong, Sung Hee Ihm, Hyeon Kyu Kim, Cheol Young Park, Jae Myung Yoo, Doo Man Kim, Moon Gi Choi, Sung Woo Park
Korean Diabetes J. 2003;27(3):253-259.   Published online June 1, 2003
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BACKGROUND
Vascular smooth muscle cell (VSMC) proliferation is one of the major pathogenic mechanisms for atherosclerosis. It is known that L-type calcium channels play a role in VSMC proliferation in diabetic rats. However, there have been no studies that show an association between the L-type calcium channels and the VSMC proliferation due to various glucose concentrations in the culture media. Therefore, the association between the voltage-dependent L-type calcium channels of the VSMCs, and the growth of vascular smooth muscle cells, was examined. METHODS: Rat aortic VSMCs were isolated from the aorta of Sprague-Dawley and OLETF rats, using an enzymic method. The VSMCs were cultured in various concentrations of glucose (5.5, 11.0, 16.6, 25, 30 and 40 mM). The VSMCs (1x10(4) cells in 24-well plates) were incubated in the presence of Bay K 8644 (10(-6)M), both with and without verapamil (10(-6)M), for 48 hours. The proliferation was then assessed by the MTT (methylthiazole tetrazolium) assay, and the expression of L-type calcium channel mRNA by RT-PCR. RESULTS: The vascular smooth muscle cell proliferation was significantly increased, in a dose-dependent manner, with glucose concentrations below 25 mM in both in a dose-dependent manner, with glucose concentrations below 25 mM in both kinds of rat. However, the increase in the VSMC proliferation of the OLETF rat was significantly higher than in the Sprague-Dawley rat. After the Bay K 8644 treatment, with the same glucose concentration, the VSMC proliferation and the expression of L-type calcium channel mRNA were significantly increased in both kinds of rat. After treatment with verapamil, the increased VSMC proliferation and expression of L-type calcium channel mRNA, due to the Bay K 8644, were suppressed to control levels in both kinds of rat. CONCLUSION: The results suggest that below certain concentrations of glucose, 25 mM, the L-type calcium channels may play a role in the VSMC proliferation of OLETF and Sprague-Dawley rats. The growth of the VSMCs in OLETF rats, due to various glucose concentrations (< 25 mM), was significantly higher than in the Sprague-Dawley rats.
Effect of Advanced Glycation End Products on Rat Aortic Vascular Smooth Muscle Cells.
Jin Young Song, Sung Hee Ihm, Ji Young Suh, Young Joong Cho, Hyung Joon Yoo, Sung Woo Park, Ja Hei Ihm
Korean Diabetes J. 2002;26(2):91-99.   Published online April 1, 2002
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BACKGROUND
Diabetes mellitus is an epidemiologically proven risk factor for atherosclerosis. Advanced glycation end products (AGE) have been implicated in the pathogenesis of many diabetic vascular complications. AGE not only change the physicochemical properties of proteins, but also induce a wide range of cell-mediated responses. However, biological effects of AGE on the vascular smooth muscle cells (VSMCs) have not been fully explained despite of presence of an AGE-receptor on the VSMCs. METHODS: In order to test whether AGE promotes atherosclerosis by stimulation of the growth promoting signal transduction pathways in the VSMCs, the proliferation of rat aortic VSMCs cultured in the presence of AGE-BSA with/without anti-AGE antibodies, the MAP kinase inhibitor and antioxidants was measured. The VSMCs (1 x 104 cells in 24-well plates) isolated from the aorta of Sprague-Dawley rats were incubated for 48 hours and the proliferation was assessed by a MTT assay. RESULTS: AGE-BSA increased the proliferation of rat aortic VSMCs by 1.5~1.6 fold at the g/mL level. The stimulatory effect of AGE-BSA (5 microgram/mL) was blocked by the anti-AGE antibodies (100 microgram/mL). PD98059 at 50 M inhibited the AGE - BSA - induced VSMC proliferation, suggesting that MAP kinase activation might be responsible for the proliferative response of the VSMCs to AGE. AGE - BSA - induced VSMC proliferation was also attenuated by N-acetylcysteine (1 micro M) and butylated hydroxyanisole (10 micro M), implying that increased intracellular oxidative stress might be also involved in the proliferative response to AGE. CONCLUSION: These results suggest AGE play a role in diabetic atherosclerosis by stimulating of the growth promoting signal transduction pathways in the VSMCs.
The Relation of Diabetes Control to Stress Amounts Associated with Life Events in Diabetics.
Jung Won Lim, Hyung Joon Yoo, Kyung Ae Choi, Sung Hee Lim, Yoo Sun Chung, Sung O Seo, Chul Su Choi, Hyun Kyu Kim, Jae Myung Yoo, Doo Man Kim, Moon Gi Choi, Sung Woo Park, Young Joong Cho
Korean Diabetes J. 2001;25(3):240-249.   Published online June 1, 2001
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BACKGROUND
The life events which diabetic patients experience has an influence on conduct and communication pattern that is essential to control diabetes. The psychosocial life events which patients experienced in recently, as well as in the past has an important meanings in the process of the plan, implementation and evaluation of diabetic control. However, the most researches on this issues are scanty. Thus, we evaluated the relation of diabetic control to stress amounts associated with the life event which diabetic patients experience for the past one year. METHODS: In this study, 81 diabetic patients admitted to H hospital from March, 1999 to February 2000 were examined in stress amounts associated with life events, blood sugar, HbA1C, duration, complication, family history, treatment to inspect the hypothesis that stress experiences for recent 1 year are related to diabetic control. The 'Life Psychosocial Event Scale' invented by Lee was used. To examine the hypothesis that diabetic control may be influenced by the amount of stress, we investigated the difference of the means between the two groups (upper 30% of patients vs. lower 30% of patients) by T-test. RESULTS: The mean age was 56.9+/-15.1 years and the mean duration of diabetes was 8.9+/-7 years. Fasting plasma glucose (FPG) was 200.3+/-71.0 mg/dL, PP2 was 292.9+/-87.2 mg/dL, HbA1C was 10.5+/-2.6%, complication was 0.8+/-0.9. The age showed negative correlation with stress amounts. The other variables did not show significant correlation with stress amounts. Thus, our study indicated that the hypothesis that stress experiences for recent 1 year are related to diabetic control was rejected. However, considering the perception-phenomenological approach on stress, if we study the relationship between stress with diabetic control inclusively, it seems that we can recognize such relationship. CONCLUSION: To address relation between stress with diabetic control inclusively, we need to consider stress factors in diversified aspects more than only one. Therefore, we must investigate how do patients perceive and cope with stress inclusively, because the crisis of life is influenced on the stress coping skill of patients. The study on this issue must be continued to identified the key factors associated with stress in diabetes.
Case Report
Two Cases of Hyperamylasemia not Aassociated with Acute Pancreatits in Non-ketotic Hyperosmolar Syndrome.
Jong Hyung Choi, Doo Man Kim, Han Su Cho, Ki Sung Lee, Ji Young Seo, Hyun Kyoo Kim, Cheol Soo Choi, Sung Hee Ihm, Jae Myung Yu, Moon Ki Choi, Hyung Joon Yoo, Sung Woo Park
Korean Diabetes J. 2000;24(5):614-618.   Published online January 1, 2001
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AbstractAbstract
The serum amylase level is widely used as a screening test for acute pancreatitis and rises also in a wide variety of diseases involving the pancreas, salivary glands, intestines, liver, genitourinary tract, and lung, in metabolic aberrations such as diabetic ketoacidosis, and even during normal pregnancy. Although it is commonly assumed that the diseased organ is releasing amylase into the serum, in many conditions the precise relationship between the hyperamylasemia and the condition is not clear. Serum amylase is abnormally elevated in more than 60% of patients with diabetic ketoacidosis, but increased pancreatic enzyme activity, even in combination with abdominal pain, should not be diagnosed as acute pancreatitis. In nonketotic hyperosmolar syndrome, elevated serum amylase level without pancreatitis has not been reported. Nonketotic hyperosmolar syndrome is usually a complcation of type 2 DM and characterized by severe hyperosmolarity (serum osmolality> or =320 mOsm/L), hyperglycemia (serum glucose> or = 600 mg/dL) and dehydration. We experienced two cases of nonketotic hyperosmolar syndrome with elevated serum amylase. Serum amylase level was 1556 U/L in first case, 229 U/L in second case. Two patients did not complain of abdominal pain, nausea, vomiting and abdomen CT with enhancement showed the normal pancreases.
Randomized Controlled Trial
The Effects of Teaching Methods on the Dietary Compliance and Hemoglobin A1c Level in Patients with Diabetes Mellitus.
Sung Oh Chung, O Keum Song, Jae Min Ko, Jun Hwan Wi, Tae Hoon Lee, Ju Hyup Yum, Dae Kyoung Cho, Jin Hee Son, Hong Woo Nam, Hyung Joon Yoo, Young Nam Lee, Sung Gon Kim, Hyun Kyung Moon, Eul Sang Kim
Korean Diabetes J. 2000;24(5):560-573.   Published online January 1, 2001
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AbstractAbstract
BACKGROUND
Diet control plays an important role in diabetic management, but it is often hard for diabetic patients to follow the dietary control program. Poor dietary compliance leads to metabolic derangements in patients with diabetes and it may derive mainly from defects in dietary education program rather than from patients themselves. Therefore, we performed a randomized prospective study to compare the effects of three different teaching methods for diet control. METHODS: Forty eight diabetic patients with poor glycemic control (mean HbA1c 11.4+/-1.5%) were enrolled during hospitalization and allocated at random to three different teaching methods i.e. Conventional diet sheet instruction (Group 1), Food recording on every meal (Group 2), and Meal time demonstration (Group 3). For evaluation, knowledge about DM diet and barriers to diet control were assessed by a questionnaire. Consistency in carbohydrate intake (Coefficient of variation) and serial HbA1C measurements were used for the estimation of dietary compliance and glycemic control respectively. RESULTS: During five months' follow-up period, there was no remarkable improvement in knowledge about diabetic diet control, dietary compliance and glycemic control in Group 1 patients. But both dietary compliance and glycemic control improved in Group 2 and 3 patients during follow-up period. In Group 2 CV (Coefficient of Variation ) fell from 36.4+/-15.2% to 27.7+/-17.3% and in Group 3 from 32.1+/-9.6% to 23.2+/-10.5% (p<0.05). In Group 2 HbA1c fell from 12+/-2.2% to 8.3 +/-2.0% and in Group 3 from 11.5+/-2.0% to 7.5+/-1.9% (p<0.01). The change of HbA1c level showed an appreciable correlation with dietary compliance (r= 0.75). Among the perceived barriers to dietary practice in patients of Group 2 and Group 3, extrinsic factors related to knowledge lowered during the intervention (p<0.05). Even though Group 3 patients had good dietary compliance, they still felt that intrinsic factors related to motive and attitude were the major barriers at the end of the study (p<0.05). CONCLUSION: We found that meal time demonstration teaching method may improve dietary compliance and glycemic control compared with the conven tional diet sheet instruction method.

Diabetes Metab J : Diabetes & Metabolism Journal
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