Diabetes & Metabolism Journal

Original Articles

Effect on Glycemic, Blood Pressure, and Lipid Control according to Education Types: Mi-Ju Choi, Seung-Hyun Yoo, Kum-Rae Kim, Yoo-Mi Bae, Sun-Hee Ahn, Seong-Shin Kim, Seong-Ah Min, Jin-Sun Choi, Seung-Eun Lee, Yeo-Jin Moon, Eun Jung Rhee, Cheol-Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Diabetes Metab J. 2011;35(6):580-586. Published online December 26, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.6.580

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Background

Diabetes self-management education and reinforcement are important for effective management of the disease. We investigated the effectiveness of interactive small-group education on glycemic, blood pressure, and lipid levels.

Methods

For this study, 207 type 2 diabetes patients with suboptimal glycemic control (HbA1c levels >6.5%) were enrolled. The conventional education group received an existing education program from April to November in 2006, and the interactive education group received a new small-group education program from December 2006 to July 2007. The two groups were comparatively analyzed for changes in blood sugar, glycated hemoglobin, lipid, and blood pressure at baseline, 3, 6, and 12 months and the proportion of patients achieving target goals at 12 months.

Results

After 12 months of follow-up, HbA1c levels in the interactive education group were significantly lower than in the conventional education group (6.7% vs. 6.4%, P<0.001). Fasting and 2 hour postprandial glucose concentrations, total cholesterol, and low density lipoprotein cholesterol were significantly lower in the interactive education group than in the conventional education group. The proportion of patients that achieved target goals was significantly higher in the interactive education group.

Conclusion

The small-group educational method improved and re-established the existing group educational method. This finding suggests that the importance of education appears to be related to the method by which it is received rather than the education itself. Thus, the use of small-group educational methods to supplement existing educational methods established for diverse age levels should be considered in the future.

Citations

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The Effectiveness of Multidisciplinary Team-Based Education in the Management of Type 2 Diabetes
Jong Ho Kim, Yun Jeong Nam, Won Jin Kim, Kyung Ah Lee, A Ran Baek, Jung Nam Park, Jin Mi Kim, Seo Young Oh, Eun Heui Kim, Min Jin Lee, Yun Kyung Jeon, Bo Hyun Kim, In Joo Kim, Yong Ki Kim, Sang Soo Kim
The Journal of Korean Diabetes.2018; 19(2): 119. CrossRef
Diabetes Camp as Continuing Education for Diabetes Self-Management in Middle-Aged and Elderly People with Type 2 Diabetes Mellitus
So Young Park, Sun Young Kim, Hye Mi Lee, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Kang-Hee Sim, Sang-Man Jin
Diabetes & Metabolism Journal.2017; 41(2): 99. CrossRef
Impact of ENPP1 K121Q on Change of Insulin Resistance after Web-Based Intervention in Korean Men with Diabetes and Impaired Fasting Glucose
Ji Yeon Kang, Sook Hee Sung, Yeon Ju Lee, Tae In Choi, Seung Jin Choi
Journal of Korean Medical Science.2014; 29(10): 1353. CrossRef
It's Still Not Too Late to Make a Change: Current Status of Glycemic Control in Korea
Sang Yong Kim
Diabetes & Metabolism Journal.2014; 38(3): 194. CrossRef
Education as Prescription for Patients with Type 2 Diabetes Mellitus: Compliance and Efficacy in Clinical Practice
Mi Yeon Kim, Sunghwan Suh, Sang-Man Jin, Se Won Kim, Ji Cheol Bae, Kyu Yeon Hur, Sung Hye Kim, Mi Yong Rha, Young Yun Cho, Myung-Shik Lee, Moon Kyu Lee, Kwang-Won Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2012; 36(6): 452. CrossRef

Retrospective Analysis on the Efficacy, Safety and Treatment Failure Group of Sitagliptin for Mean 10-Month Duration: Won Jun Kim, Cheol-Young Park, Eun Haeng Jeong, Jeong Youn Seo, Ji Soo Seol, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Diabetes Metab J. 2011;35(3):290-297. Published online June 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.3.290

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Abstract PDF PubReader

Background

To investigate the clinical results of sitagliptin (SITA) and the characteristics of the treatment failure group or of low responders to SITA.

Methods

A retrospective study of type 2 diabetic patients reviewed 99 cases, including 12 treatment failure cases, who stopped SITA because of worsening patients' condition, and 87 cases, who continued treatment over five visits (total 9.9±10.1 months) after receiving the prescription of SITA from December 2008 to June 2009. Subjects were classified as five groups administered SITA as an initial combination with metformin (MET), add-on to metformin or sulfonylurea, and switching from sulfonylurea or thiazolidinedione. The changes in HbA1c level from the first to last visit (ΔHbA1c) in treatment maintenance group were subanalyzed.

Results

The HbA1c level was significantly reduced in four groups, including initial coadministration of SITA with metformin (ΔHbA1c=-1.1%, P<0.001), add-on to MET (ΔHbA1c=-0.6%, P=0.017), add-on to sulfonylurea (ΔHbA1c=-0.5%, P<0.001), and switching from thiazolidinedione (ΔHbA1c=-0.3%, P=0.013). SITA was noninferior to sulfonlyurea (ΔHbA1c=-0.2%, P=0.63). There was no significant adverse effect. The treatment failure group had a longer diabeties duration (P=0.008), higher HbA1c (P=0.001) and fasting plasma glucose (P=0.003) compared to the maintenance group. Subanalysis on the tertiles of ΔHbA1c showed that low-response to SITA (tertile 1) was associated with a longer diabetes duration (P=0.009) and lower HbA1c (P<0.001).

Conclusion

SITA was effective and safe for use in Korean type 2 diabetic patients. However, its clinical responses and long-term benefit-harm profile is yet to be established.

Citations

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Development of a 13C Stable Isotope Assay for Dipeptidyl Peptidase-4 Enzyme Activity A New Breath Test for Dipeptidyl Peptidase Activity
Roger Yazbeck, Simone Jaenisch, Michelle Squire, Catherine A. Abbott, Emma Parkinson-Lawrence, Douglas A. Brooks, Ross N. Butler
Scientific Reports.2019;[Epub] CrossRef
Characterization of changes in HbA1c in patients with and without secondary failure after metformin treatments by a population pharmacodynamic analysis using mixture models
Yoko Tamaki, Kunio Maema, Makoto Kakara, Masato Fukae, Ryoko Kinoshita, Yushi Kashihara, Shota Muraki, Takeshi Hirota, Ichiro Ieiri
Drug Metabolism and Pharmacokinetics.2018; 33(6): 264. CrossRef
Effects of 6-Month Sitagliptin Treatment on Insulin and Glucagon Responses in Korean Patients with Type 2 Diabetes Mellitus
Hae Kyung Yang, Borami Kang, Seung-Hwan Lee, Hun-Sung Kim, Kun-Ho Yoon, Bong-Yun Cha, Jae-Hyoung Cho
Diabetes & Metabolism Journal.2015; 39(4): 335. CrossRef
Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin
Ye An Kim, Won Sang Yoo, Eun Shil Hong, Eu Jeong Ku, Kyeong Seon Park, Soo Lim, Young Min Cho, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi
Diabetes & Metabolism Journal.2015; 39(6): 489. CrossRef
Letter: Predictive Factors for Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2015;39:342-7)
Ye An Kim
Diabetes & Metabolism Journal.2015; 39(5): 444. CrossRef
Optimal Candidates for the Switch from Glimepiride to Sitagliptin to Reduce Hypoglycemia in Patients with Type 2 Diabetes Mellitus
Hyun Min Kim, Jung Soo Lim, Byung-Wan Lee, Eun-Seok Kang, Hyun Chul Lee, Bong-Soo Cha
Endocrinology and Metabolism.2015; 30(1): 84. CrossRef
One-year real-life efficacy of sitagliptin revealed importance of concomitant pioglitazone use in Japanese patients with type 2 diabetes mellitus
Ayako Suzuki, Nakayuki Yoshimura, Yamato Mashimo, Maiko Numakura, Yuko Fujimaki, Tomomi Maeda, Toshio Ishikawa, Shin Fujimori, Kazuhiro Eto
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2013; 7(3): 143. CrossRef
Clinical Characteristics of the Responders to Dipeptidyl Peptidase-4 Inhibitors in Korean Subjects with Type 2 Diabetes
Tae Jung Oh, Hye Seung Jung, Jae Hyun Bae, Yeong Gi Kim, Kyeong Seon Park, Young Min Cho, Kyong Soo Park, Seong Yeon Kim
Journal of Korean Medical Science.2013; 28(6): 881. CrossRef
Factors predicting therapeutic efficacy of combination treatment with sitagliptin and metformin in type 2 diabetic patients: the COSMETIC study
Soo Lim, Jee Hyun An, Hayley Shin, Ah Reum Khang, Yenna Lee, Hwa Young Ahn, Ji Won Yoon, Seon Mee Kang, Sung Hee Choi, Young Min Cho, Kyong Soo Park, Hak Chul Jang
Clinical Endocrinology.2012; 77(2): 215. CrossRef

The Cutoff Value of HbA1c in Predicting Diabetes in Korean Adults in a University Hospital in Seoul.: Ji Cheol Bae, Eun Jung Rhee, Eun Suk Choi, Ji Hoon Kim, Won Jun Kim, Seung Hyun Yoo, Se Eun Park, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Korean Diabetes J. 2009;33(6):503-510. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.503

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Abstract PDF

BACKGROUND
Glycated hemoglobin (HbA1c) levels represent a 2~3 month average of blood glucose concentration. The use of HbA1c as a diagnostic tool for diabetes is gaining interest. Therefore, we determined the cutoff point of HbA1c for predicting abnormal glucose tolerance status in non-diabetic Korean subjects. METHODS: We analyzed the data from 1,482 subjects without diabetes mellitus in whom a 75-g oral glucose tolerance test (OGTT) was performed due to suspected abnormal glucose tolerance. We obtained an HbA1c cutoff point for predicting diabetes using Receiver Operating Characteristic (ROC) curve analysis. RESULTS: A cut-off point of 5.95% HbA1c yielded sensitivity of 60.8% and specificity of 85.6%, respectively, for predicting diabetes. There was a difference in HbA1c cut-off value between men and women, 5.85% and 6.05%, respectively. CONCLUSION: To use the cut-off point of 5.95% HbA1c for predicting undiagnosed diabetes in Koreans may be reliable. However, studies of different ethnic groups have reported disparate HbA1c cut-off points. Thus, ethnicity, age, gender, and population prevalence of diabetes are important factors to consider in using elevated HbA1c value as a tool to diagnose diabetes.

Citations

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The Cutoff Value of HbA1c in Predicting Diabetes and Impaired Fasting Glucose
Seyoung Kwon, Youngak Na
The Korean Journal of Clinical Laboratory Science.2017; 49(2): 114. CrossRef
Role of HbA1c in the Screening of Diabetes Mellitus in a Korean Rural Community
Jae Hyun Kim, Gun Woo Kim, Mi Young Lee, Jang Yel Shin, Young Goo Shin, Sang Baek Koh, Choon Hee Chung
Diabetes & Metabolism Journal.2012; 36(1): 37. CrossRef
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 & Metabolism Journal.2012; 36(2): 151. CrossRef
The Utility of HbA1c as a Diagnostic Criterion of Diabetes
Hee-Jung Kim, Eun Young Choi, Eal Whan Park, Yoo Seock Cheong, Hong-Yoen Lee, Ji Hyun Kim
Korean Journal of Family Medicine.2011; 32(7): 383. CrossRef
2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea
Seung-Hyun Ko, Sung-Rea Kim, Dong-Joon Kim, Seung-Joon Oh, Hye-Jin Lee, Kang-Hee Shim, Mi-Hye Woo, Jun-Young Kim, Nan-Hee Kim, Jae-Taik Kim, Chong Hwa Kim, Hae Jin Kim, In-Kyung Jeong, Eun-Kyung Hong, Jae-Hyoung Cho, Ji-Oh Mok, Kun-Ho Yoon
Diabetes & Metabolism Journal.2011; 35(5): 431. CrossRef
2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea
Seung-Hyun Ko, Dong-Joon Kim, Seung-Joon Oh, Hye-Jin Lee, Kang-Hee Shim, Mi-Hye Woo, Jun-Young Kim, Nan-Hee Kim, Jae-Taik Kim, Chong Hwa Kim, Hye Jin Kim, In-Kyung Jeong, Eun-Gyoung Hong, Jae-Hyoung Cho, Ji-Oh Mok, Kun-Ho Yoon, Sung-Rea Kim
Journal of Korean Diabetes.2011; 12(4): 183. CrossRef

Randomized Controlled Trial

Effects of Adding omega-3 Fatty Acids to Simvastatin on Lipids, Lipoprotein Size and Subspecies in Type 2 Diabetes Mellitus with Hypertriglyceridemia.: Won Jun Kim, Chang Beom Lee, Cheol Young Park, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Dae Jung Kim, Hae Jin Kim, Seung Jin Han, Hong Keum Cho; Korean Diabetes J. 2009;33(6):494-502. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.494

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Abstract PDF: BACKGROUND
omega-3 fatty acids are known to improve lipid profiles, the distribution of lipoprotein subclasses, and secondary prevention against post-myocardial infarction. Rare reports have emerged of synergistic results of omega-3 fatty acids with simvastatin in cases of type 2 diabetes mellitus with hypertriglyceridemia. The purpose of this study was to determine the combined relationship of omega-3 fatty acids plus simvastatin on lipid, lipoprotein size and the types of subspecies. METHODS: This randomized, multi-center, comparison study evaluated eight weeks of combination therapy (omega-3 fatty acids (Omacor) 4 g/day plus simvastatin 20 mg/day) or monotherapy (simvastatin 20 mg/day) for at least six weeks in 62 diabetic patients. Subjects with a triglyceride concentration of more than 200 mg/dL were eligible for inclusion. RESULTS: No significant differences for omega-3 fatty acids + simvastatin versus simvastatin alone were observed for triglycerides (-22.7% vs. -14.3%, P = 0.292), HDL peak particle size (+2.8% vs. -0.4%, P = 0.076), LDL mean particle size (+0.4% vs -0.1%, P = 0.376) or LDL subspecies types, although the combination therapy showed a tendency toward lower triglycerides, larger HDL, and LDL particle sizes than did the monotherapy. There were no significant differences between the two groups in regard to HDL-C, LDL-C, or HbA1c levels. There were no serious adverse events and no abnormalities in the laboratory values associated with this study. CONCLUSION: omega-3 fatty acids were a safeform of treatment in hypertriglyceridemic patients with type 2 diabetes mellitus. But, regarding efficacy, a much larger sample size and longer-term follow-up may be needed to distinguish between the effects of combination therapy and monotherapy.

Editorial

Coronary Artery Calcification and Serum Apolipoprotein A-1 in Patients with Type 2 Diabetes.: Ki Won Oh; Korean Diabetes J. 2009;33(6):464-465. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.464

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Abstract PDF: No abstract available.

Original Article

Adipokine Concentrations in Pregnant Korean Women with Normal Glucose Tolerance and Gestational Diabetes Mellitus.: Eun Suk Oh, Jung Hee Han, Sung Min Han, Jee Aee Im, Eun Jung Rhee, Cheol Young Park, Ki Won Oh, Won Young Lee; Korean Diabetes J. 2009;33(4):279-288. Published online August 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.4.279

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Abstract PDF

BACKGROUND
The aims of this study were to compare adipokine concentrations of pregnant women in the 24th~28th weeks of gestation to those of non-pregnant women. We compared the concentrations of adipokines in women with gestational diabetes mellitus (GDM), gestational impaired glucose tolerance (GIGT) and normal glucose tolerance (NGT). We also investigated the role of adipokines in the development of gestational glucose intolerance. METHODS: We surveyed 129 pregnant women who underwent a 100 g oral glucose tolerance test (OGTT) during the 24th~28th weeks of gestation. Participants were classified into three groups: (1) NGT (n = 40), (2) GIGT (n = 45), and (3) GDM (n = 44). Pregnant subjects with NGT were matched to non-pregnant controls for BMI and age (n = 41). RESULTS: Pregnant women with NGT exhibited significantly decreased adiponectin levels and elevated leptin levels compared to non-pregnant controls. Mean plasma resistin levels were significantly higher in women with GDM and GIGT than in women with NGT. Resistin and fasting glucose were significant predictors for the development of gestational glucose intolerance. CONCLUSION: Plasma adiponectin levels were decreased and leptin levels were increased in pregnant subjects with NGT compared to BMI and age matched non-pregnant controls. Women with GDM and GIGT exhibit significantly elevated concentrations of resistin compared with women with NGT. Increased resistin levels were also associated with the development of gestational glucose intolerance. Resistin may play an important role on the development of gestational glucose intolerance in Korean women.

Citations

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Maternal serum level of resistin is associated with risk for gestational diabetes mellitus: A meta-analysis
Shi-Min Hu, Meng-Shi Chen, Hong-Zhuan Tan
World Journal of Clinical Cases.2019; 7(5): 585. CrossRef
Letter: Adipokines and Insulin Resistance According to Characteristics of Pregnant Women with Gestational Diabetes Mellitus (Diabetes Metab J 2017;41:457-65)
Ohk-Hyun Ryu
Diabetes & Metabolism Journal.2018; 42(1): 87. CrossRef
Adipokines and Insulin Resistance According to Characteristics of Pregnant Women with Gestational Diabetes Mellitus
Eon Ju Jeon, Seong Yeon Hong, Ji Hyun Lee
Diabetes & Metabolism Journal.2017; 41(6): 457. CrossRef

Review

Diabetes and Osteoporosis.: Ki Won Oh; Korean Diabetes J. 2009;33(3):169-177. Published online June 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.3.169

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Abstract PDF

Increased life expectancy and increased obesity have contributed to an increasing incidence of osteoporosis and diabetes mellitus. Recent meta-analyses and cohort studies confirm that diabetes is associated with a higher risk of fracture. Patients with type 2 diabetes exhibit increased fracture risks despite a higher bone mass, which are mainly attributable to non-skeletal risk factors. Patients with type 1 diabetes may have impaired bone formation because of absence of the anabolic effects of insulin and insulin-like growth factor I (IGF-I) system. Several clinical studies have reported adverse skeletal actions of peroxisome proliferator-activated receptor gamma (PPARgamma) agonist in humans. Obesity regulates bone metabolism not only by increasing weight loading but also by modulating adipokines that are known to affect bone remodeling.

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Relationship between hs-CRP and HbA1c in Diabetes Mellitus Patients: 2015–2017 Korean National Health and Nutrition Examination Survey
Yo-Han Seo, Hee-Young Shin
Chonnam Medical Journal.2021; 57(1): 62. CrossRef
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Yo-Han Seo, Hee-Young Shin
The Korean Journal of Clinical Laboratory Science.2018; 50(3): 313. CrossRef
Bergapten exerts inhibitory effects on diabetes-related osteoporosis via the regulation of the PI3K/AKT, JNK/MAPK and NF-κB signaling pathways in osteoprotegerin knockout mice
Xue-Ju Li, Zhe Zhu, Si-Lin Han, Zi-Long Zhang
International Journal of Molecular Medicine.2016; 38(6): 1661. CrossRef
The association of Osteoporosis and Thyroid Hormone in euthyroid adults
Hyun Yoon, Eun-Jin Ryu
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(2): 1137. CrossRef
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Influencing Factors of Bone Mineral Density in Men
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Original Articles

The Relationship between Serum Retinol-Binding Protein 4 Levels and Coronary Artery Disease in Korean Adults.: Ji Hoon Kim, Eun Jung Rhee, Eun Suk Choi, Jong Chul Won, Cheol Young Park, Won Young Lee, Ki Won Oh, Byung Jin Kim, Ki Chul Sung, Bum Soo Kim, Jin Ho Kang, Sung Woo Park, Sun Woo Kim, Man Ho Lee, Jung Roe Park; Korean Diabetes J. 2009;33(2):105-112. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.105

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Abstract PDF

BACKGROUND
A recently discovered adipokine, retinol-binding protein-4 (RBP-4), is reportedly associated with insulin resistance and metabolic syndrome. This study was performed to analyze the relationship between serum RBP-4 levels and coronary artery disease (CAD) in Korean adults. METHODS: In 235 subjects (mean age 58 years) in whom coronary artery angiograms were performed due to complaints of chest pain, serum RBP-4 levels were measured by enzyme-linked immunosorbent assay. Coronary artery angiograms were performed in all subjects and the severity of CAD was assessed by the number of stenotic vessels. The presence of metabolic syndrome was defined by AHA/NHLBI criteria with body mass index substituted for waist circumference. RESULTS: Coronary angiogram showed that 101 subjects (43%) had normal coronary vessel, 82 subjects (34.9%) had 1-vessel disease, 31 subjects (13.2%) had 2-vessel disease and 21 subjects (8.9%) had 3-vessel disease. Subjects with coronary artery stenosis showed a higher mean age (60.5 +/- 10.0 years), fasting glucose (123.3 mg +/- 45.0 mg/dL) and lower mean value for high-density lipoprotein cholesterol (HDL-C) level (49.0 +/- 13.2 mg/dL), although serum RBP-4 levels were not significantly different between those with and without CAD. Mean age and fasting glucose level increased significantly as the number of stenotic vessels increased, although serum RBP4 level showed no significant differences among the different groups. Among the metabolic parameters, only serum triglyceride levels showed a significant correlation with serum RBP-4 levels. CONCLUSION: There was no difference in mean serum RBP-4 levels between subjects with or without coronary artery disease in Korean adults. Further studies are warranted to draw a clear conclusion on the effect of RBP-4 on atherosclerosis.

Citations

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Retinol binding protein 4 levels relate to the presence and severity of coronary artery disease
Gokay Nar, Sara Sanlialp, Rukiye Nar
Journal of Medical Biochemistry.2021; 40(4): 384. CrossRef

Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men.: Eun Suk Choi, Eun Jung Rhee, Ji Hoon Kim, Jong Chul Won, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Korean Diabetes J. 2008;32(6):498-505. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.498

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Abstract PDF

BACKGROUND
Insulin resistance and progressive pancreatic beta cell dysfunction have been identified as the two fundamental features in the type 2 diabetes. Homeostasis model assessment (HOMA), based on plasma levels of fasting glucose and insulin, has been widely validated and applied for quantifying insulin resistance and secretion. This study was performed to assess the predictive value of HOMA indices for future diabetes risk. METHODS: In 14,976 Korean men, in which medical check-up was performed both in 2002 and 2006 in a university hospital health promotion center in Seoul, Korea, prospective assessment for diabetes risk was assessed. At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA beta-cell) were calculated from fasting glucose and insulin levels. RESULTS: After 4 years, 286 subjects (1.9%) were newly diagnosed as diabetes mellitus. These patients (mean age 40.3 years) were age-matched with 632 control subjects (mean age 39.8 years) and diabetes risk was assessed with HOMA indices. Among the parameters, body mass index, fasting glucose and HOMA beta-cell were the significant determinants for future diabetes risk. When the subjects were divided into two groups according to the baseline median values of HOMA-IR and HOMA beta-cell, and assessed jointly, those with the low HOMA beta-cell and high HOMA-IR showed the highest risk for future diabetes (RR 39.065, 95% CI 11.736~130.035, P < 0.01). The subjects with low baseline HOMA beta-cell showed higher RR for diabetes than those with high baseline HOMA-IR (4.413 vs. 3.379, P = 0.018, P = 0.051). CONCLUSION: High HOMA-IR and low HOMA beta-cell were associated with the highest risk for future diabetes in this prospective study of Korean male subjects. These data suggest the value of HOMA indices for diabetes risk in epidemiologic studies in Asian subjects.

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Editorial

Cystatin C is a Valuable Marker for Predicting Future Cardiovascular Diseases in Type 2 Diabetic Patients.: Ki Won Oh; Korean Diabetes J. 2008;32(6):474-476. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.474

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Abstract PDF

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Increased Serum Cystatin C Levels Were Associated with Depressive Symptoms in Patients with Type 2 Diabetes
Yue Huang, Wenxun Huang, Jing Wei, Zubin Yin, Hanjing Liu
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 857. CrossRef

Original Articles

Comparison of the Predictability of Cardiovascular Disease Risk According to Different Metabolic Syndrome Criteria of American Heart Association/National Heart, Lung, and Blood Institute and International Diabetes Federation in Korean Men.: Do Young Lee, Eun Jung Rhee, Eun Suk Choi, Ji Hoon Kim, Jong Chul Won, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Korean Diabetes J. 2008;32(4):317-327. Published online August 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.4.317

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Abstract PDF

BACKGROUND
We compared the prevalences of two criteria of metabolic syndrome, that is, American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF), in Korean male adults and compared the predictability of insulin resistance and future cardiovascular diseases using Framingham Risk Score. METHODS: In total 23,467 male adults (mean age 43.3 years) who participated in medical check-up in 2005, the prevalences of metabolic syndrome according to AHA/NHLBI and IDF criteria and the presence of insulin resistance, defined by the highest quartile of Homeostasis Model Assessment of insulin resistance index (HOMA-IR), were compared. The relative risk (calculated risk/average risk) for 10-year risk for coronary artery disease (CHD) assessed by Framingham Risk Score were compared. RESULTS: 5.8% of the subjects had diabetes mellitus. 20.7% and 13.2%of the subjects had metabolic syndrome defined by AHA/NHLBI and IDF criteria, and the two criteria showed high agreement with kappa value of 0.737 (P < 0.01). More subjects in IDF-defined group had insulin resistance compared with AHA/NHLBI definition (59.8 vs. 54%, P < 0.01). The odds ratio for increased relative risk (> 1.0) for 10-year CHD were higher in AHA/NHLBI-defined subjects compared with IDF-defined subject (3.295 vs. 3.082). The Kappa values for the analysis of agreement between each criteria and prediction of insulin resistance or cardiovascular disease risk, were too low for comparison. CONCLUSION: In Korean males, the prevalence for metabolic syndrome defined by AHA/NHLBI criteria was higher than those defined by IDF criteria. IDF criteria detected more subjects with insulin resistance, but didn't have better predictability for CHD compared with AHA/NHLBI criteria.

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The Association of Pro12Ala Polymorphism in PPAR-gamma Gene with Coronary Artery Disease in Korean Subjects.: Chang Hee Kwon, Eun Jung Rhee, Se Yeon Kim, Eun Ran Kim, Chang Uk Chon, Chan Hee Jung, Ji Ho Yun, Byung Jin Kim, Ki Chul Sung, Bum Su Kim, Won Young Lee, Ki Won Oh, Jin Ho Kang, Sun Woo Kim, Man Ho Lee, Jung Roe Park; Korean Diabetes J. 2006;30(2):122-129. Published online March 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.2.122

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Abstract PDF: BACKGROUND
PPAR-gamma, a member of nuclear family, which is involved in the differentiation of adipose tissue, is reported to be associated in the pathogenesis of type 2 diabetes mellitus, insulin resistance and atherosclerosis. We conducted a research to see whether the prevalence of coronary artery disease is associated with Pro12Ala polymorphism in exon B of PPAR-gamma in Korean adults. METHODS: The study was conducted in 161 subjects (97 males, 64 females, mean age 57 year old) who underwent coronary angiogram due to chest pain. We assessed cardiovascular risk factors in all subjects, such as blood pressure, body mass index (BMI), fasting blood sugar and serum lipid profiles. Subjects were divided into four groups as normal, 1-vessel, 2-vessel and 3-vessel disease according to the number of stenosed coronary arteries. Genotypings of Pro12Ala polymorphism were done with Real-time polymerase chain reaction. RESULTS: Allelic frequency for proline was 0.957 and 0.043 for alanine, and they were in compliance with Hardy-Weinberg equilibrium (P = 0.85). 79 subjects (43.5%) had normal coronary artery, 52 subjects (31%), 1-vessel disease, 24 subjects (14.9%), 2-vessel disease and 15 subjects (9.3%), 3-vessel disease. When the cardiovascular risk factors were compared among these four groups, there were no meaningful differences except the age and high-density lipoprotein cholesterol levels, which were lost after adjustment for age and BMI. There were no significant differences in the prevalence or severity of coronary artery diseases according to the different genotypes of Pro12Ala polymorphism. CONCLUSIONS: There was no significantassociation between Pro12Ala polymorphism in exon B of PPAR-gamma and prevalence or severity of coronary artery disease in Korean adults. It is considered that further studies on the correlation between Pro12Ala polymorphism and coronary artery disease should be carried out in larger Korean population in the future

Clinical Characteristics and Analysis of Risk Factor for Gastroesophageal Reflux Disease in Diabetic Patient.: Kwang Hyuk Park, Seong Bo Yoon, Min Ho Jo, Eon Kyung Hong, Seong Jin Lee, In Kyung Jeong, Chul Young Park, Ki Won Oh, Hyun Kyu Kim, Jac Myoung Yu, Doo Man Kim, Sung Hee Lim, Moon Ki Choi, Hyung Jun Yoo, Sung Woo Park, Heung Young Oh, Jin Bae Kim, Il Hyun Baek, Myung Seok Lee; Korean Diabetes J. 2005;29(4):358-366. Published online July 1, 2005

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Abstract PDF: BACKGROUND
A high prevalence of gastroesophageal reflux disease(GERD) has been reported in diabetic patient. However, the exact mechanisms of GERD in diabetic patient have not been described. In several studies, diabetic neuropathy and dysfunction of the autonomic nervous system have been suggested as risk factors of GERD. However, there have been no studies on the exact prevalence or risk factors of GERD in Korean diabetic patients. Therefore, the prevalence of GERD in Korean diabetics patients was examined, and the risk factors for GERD, the differences in symptoms between GERD and non-GERD patients, and the degree of symptom relief after treatment were also analyzed. METHODS: A total of 310 diabetic patients, who underwent an upper gastroendoscopy due to diverse gastrointestinal symptoms, between April 2001 and November 2003, were enrolled. The diagnostic criteria or GERD included the upper gastroendoscopic view, which was analyzed using the scale of 'The Los Angeles Classification of Esophagus' from grades A to D. The prevalence and symptoms of GERD patients and the variable risk factors, such as blood glucose level, smoking and diabetic neuropathy, were examined. RESULTS: 1) There was an 18.4% prevalence of GERD in diabetic patients. 2) The clinical characteristics, including sex, age and serum lipid level, of the GERD group were not significantly different to those of the control group. However, the duration of smoking, the fasting and postprandial 2-hour serum glucose levels, and the diabetic neuropathy significantly affected GERD, 3) The main symptoms of the GERD group were dyspepsia(47.4%) and heart burn(26.3%). 4) The degree of subjective symptom relief in the GERD group after treatment with the proton pump inhibitor, pantoprazole(40mg), was remarkably lower than in the control group for approximately 1 month. CONCLUSION: In this study, the prevalence of GERD in diabetic patient was higher than that found in the general population which suggests that GERD in diabetic patient was due to a poorly controlled serum glucose level and diabetic neuropathy. The chief complaints pertaining to gastrointestinal symptoms in both study groups were non-specific. However, the recovery from symptoms in the GERD group was lower than the control group following drug therapy. The causes of the lower response rate in the GERD group will need to be examined in further studies.

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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Abstract 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

The Association of Interleukin-6 Gene Promoter Region Polymorphism G174C with Insulin Resistance and Metabolic Syndrome in Korean Women.: Eun Jung Rhee, Won Young Lee, Se Yeon Kim, Eun Sook Oh, Ki Hyun Baek, Ki Won Oh, Moo Il Kang, Sun Woo Kim; Korean Diabetes J. 2005;29(3):181-188. Published online May 1, 2005

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Abstract PDF: BACKGROUND
Interleukin(IL)-6 is a cytokine that is produced from immune cells and adipose tissue. It is thought to be a factor to explain the link between insulin resistance and inflammation, and it is also thought to be involved in glucose metabolism and lipid metabolism. We observed the frequency of the G174C polymorphism in the IL-6 gene promoter region in Korean women and we investigated the association of fasting glucose, insulin resistance indices and metabolic syndrome. METHODS: Measurements of the blood pressure, body fat, fasting glucose, insulin, lipid profiles and anthropometric measurements were done for 268 Korean women(mean age 51.4yrs, range 37~73yrs). Homeostasis model assessement(HOMA) and the quantitative insulin sensitivity check index(QUICKI) were calculated and the presence of metabolic syndrome was assessed according to ATP III criteria. Genotyping was done with the PCRRFLP method on the blood samples of the participants. RESULTS: The allele frequencies were 0.965 for the G allele and 0.035 for the C allele, and they were in Hardy-Weinberg equilibrium(P=0.50). The fasting insulin level and HOMA were significantly higher and the QUICKI was significantly lower in the C allele carriers compared with non-carriers. Although the prevalence of metabolic syndrome was not significantly different according to the different genotypes, among the individual components, the prevalence of hypertriglyceridemia was significantly higher in the C allele carriers compared with the non-carriers. There were no differences in the prevalence of normoglycemia, fasting hyperglycemia and provisional diabetes according to the different genotypes. CONCLUSION: The G174C polymorphism in The IL-6 promoter region was not frequently observed in Korean women. The insulin resistance indices were higher in the C allele carriers compared with the non-carriers. Although the prevalence of metabolic syndrome was not associated with the polymorphism, the prevalence of hypertriglyceridemia was higher in The C allele carriers, suggesting that it is possibile for candidate gene of insulin resistance

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