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Cardiovascular Risk/Epidemiology
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Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes
Min Jeong Park, Kyung Mook Choi
Diabetes Metab J. 2022;46(1):49-62.   Published online January 27, 2022
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  • 5 Web of Science
  • 9 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
Despite strenuous efforts to reduce cardiovascular disease (CVD) risk by improving cardiometabolic risk factors, such as glucose and cholesterol levels, and blood pressure, there is still residual risk even in patients reaching treatment targets. Recently, researchers have begun to focus on the variability of metabolic variables to remove residual risks. Several clinical trials and cohort studies have reported a relationship between the variability of metabolic parameters and CVDs. Herein, we review the literature regarding the effect of metabolic factor variability and CVD risk, and describe possible mechanisms and potential treatment perspectives for reducing cardiometabolic risk factor variability.


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    So Yoon Kwon, Gyuri Kim, Seohyun Kim, Jae Hyeon Kim
    Diabetes Research and Clinical Practice.2024; : 111767.     CrossRef
  • Long-term variability in physiological measures in relation to mortality and epigenetic aging: prospective studies in the USA and China
    Hui Chen, Tianjing Zhou, Shaowei Wu, Yaying Cao, Geng Zong, Changzheng Yuan
    BMC Medicine.2023;[Epub]     CrossRef
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    Frontiers in Physiology.2023;[Epub]     CrossRef
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    Diabetes Research and Clinical Practice.2023; 199: 110666.     CrossRef
  • Association between lipid variability and the risk of mortality in cancer patients not receiving lipid-lowering agents
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    Frontiers in Oncology.2023;[Epub]     CrossRef
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    Endocrine.2023; 84(3): 914.     CrossRef
  • Variability of Metabolic Risk Factors: Causative Factor or Epiphenomenon?
    Hye Jin Yoo
    Diabetes & Metabolism Journal.2022; 46(2): 257.     CrossRef
  • Long-Term Variability in Physiological Measures in Relation to Mortality and Epigenetic Aging: Prospective Studies in the US and China
    Hui Chen, Tianjing Zhou, Shaowei Wu, Yaying Cao, Geng Zong, Changzheng Yuan
    SSRN Electronic Journal .2022;[Epub]     CrossRef
Original Articles
The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients
Ho Chan Cho
Korean Diabetes J. 2010;34(2):111-118.   Published online April 30, 2010
  • 4,763 View
  • 44 Download
  • 13 Crossref
AbstractAbstract PDFPubReader   

Diabetic peripheral polyneuropathy (DPP) is one of the common complications of diabetes mellitus (DM) and can lead to foot ulcers or amputation. The pathophysiology of DPP includes several factors such as metabolic, vascular, autoimmune, oxidative stress and neurohormonal growth-factor deficiency and recent studies have suggested the use of serum gamma-glutamyl transferase (GGT) as an early marker of oxidative stress. Therefore, we investigated whether serum GGT may be useful in predicting DPP.


We assessed 90 patients with type 2 DM who were evaluated for the presence of DPP using clnical neurologic examinations including nerve conduction velocity studies. We evaluated the association between serum GGT and the presence of DPP.


The prevalence of DPP was 40% (36 cases) according to clinical neurological examinations. The serum GGT concentration was significantly elevated in type 2 diabetic patients with DPP compared to patients without DPP (P < 0.01). There were other factors significantly associated with DPP including smoking (P = 0.019), retinopathy (P = 0.014), blood pressure (P < 0.05), aspartate aminotransferase (P = 0.022), C-reactive protein (P = 0.036) and urine microalbumin/creatinine ratio (P = 0.004). Serum GGT was independently related with DPP according to multiple logistic analysis (P < 0.01).


This study shows that increased levels of serum GGT may have important clinical implications in the presence of DPP in patients with type 2 diabetes.


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    Joonhyoung Kim, Kyungdo Han, Juhwan Yoo, Kyung-Ah Park, Sei Yeul Oh
    Neurological Sciences.2022; 43(5): 3395.     CrossRef
  • Validity of the diagnosis of diabetic microvascular complications in Korean national health insurance claim data
    Hyung Jun Kim, Moo-Seok Park, Jee-Eun Kim, Tae-Jin Song
    Annals of Clinical Neurophysiology.2022; 24(1): 7.     CrossRef
  • The association of liver enzymes with diabetes mellitus risk in different obesity subgroups: A population-based study
    Dinghao Zheng, Xiaoyun Zhang, Lili You, Feng Li, Diaozhu Lin, Kan Sun, Meng Ren, Li Yan, Wei Wang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Early Biomarkers of Neurodegenerative and Neurovascular Disorders in Diabetes
    Aleksandra Gasecka, Dominika Siwik, Magdalena Gajewska, Miłosz J. Jaguszewski, Tomasz Mazurek, Krzysztof J. Filipiak, Marek Postuła, Ceren Eyileten
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  • Dissociable Contributions of Precuneus and Cerebellum to Subjective and Objective Neuropathy in HIV
    Natalie M. Zahr, Kilian M. Pohl, Adolf Pfefferbaum, Edith V. Sullivan
    Journal of Neuroimmune Pharmacology.2019; 14(3): 436.     CrossRef
  • Evaluation of Serum Gamma Glutamyl Transferase Levels in Diabetic Patients With and Without Retinopathy
    Neda Valizadeh, Rasoul Mohammadi, Alireza Mehdizadeh, Qader Motarjemizadeh, Hamid Reza Khalkhali
    Shiraz E-Medical Journal.2018;[Epub]     CrossRef
  • The Effect of Cigarette Smoking on Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis
    Carole Clair, Marya J. Cohen, Florian Eichler, Kevin J. Selby, Nancy A. Rigotti
    Journal of General Internal Medicine.2015; 30(8): 1193.     CrossRef
  • Evaluation of oxidative stress markers and vascular risk factors in patients with diabetic peripheral neuropathy
    Noha Ahmed El Boghdady, Gamal Ali Badr
    Cell Biochemistry and Function.2012; 30(4): 328.     CrossRef
  • Angiotensin-converting enzyme gene single polymorphism as a genetic biomarker of diabetic peripheral neuropathy: longitudinal prospective study
    J. Jurado, J. Ybarra, J.H. Romeo, M. Garcia, E. Zabaleta-del-Olmo
    Journal of Diabetes and its Complications.2012; 26(2): 77.     CrossRef
  • Routine enzymes in the monitoring of type 2 diabetes mellitus
    Osman Evliyaoğlu, Erkan Kibrisli, Yaşar Yildirim, Osman Gökalp, Leyla Çolpan
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  • Antioxidant Effects of Fermented Red Ginseng Extracts in Streptozotocin-Induced Diabetic Rats
    Hyun-Jeong Kim, Sung-Gyu Lee, In-Gyeong Chae, Mi-Jin Kim, Nam-Kyung Im, Mi-Hee Yu, Eun-Ju Lee, In-Seon Lee
    Journal of Ginseng Research.2011; 35(2): 129.     CrossRef
  • Serum γ‐glutamyltransferase and associated damage among a She Chinese population
    Y. Lin, Y. Xu, G. Chen, B. Huang, J. Yao, Z. Chen, L. Yao, F. Lin, Y. Qiao, Z. Chen, S. Zhu, H. Huang, J. Wen
    Diabetic Medicine.2011; 28(8): 924.     CrossRef
The Effect of Gamma-Glutamyltransferase on Impaired Fasting Glucose or Type 2 Diabetes in Korean Men.
Tae Yeon Kim, Do Hoon Kim, Chang Hae Park, Kyung Hwan Cho, Seung Hwan Lee, Hyuk Ga, Hwan cheol Kim
Korean Diabetes J. 2009;33(3):215-224.   Published online June 1, 2009
  • 2,292 View
  • 20 Download
  • 1 Crossref
AbstractAbstract PDF
We sought to determine the association between serum gamma-glutamyltransferase (GGT) levels within the normal range and the risk for development of impaired fasting glucose (IFG) or type 2 diabetes. METHODS: This retrospective cohort study spanned four years (2002~2006) with 1,717 Korean men who underwent periodic health examinations at a university hospital in Incheon, Korea and were not diagnosed with IFG or type 2 diabetes. Fasting plasma glucose levels were measured at the annual health examination. IFG and diabetes were defined as a serum fasting glucose concentration of 100~125 mg/dL and more than 126 mg/dL, respectively. Cox's proportional hazards model was used to evaluate the association between serum GGT levels and development of IFG or type 2 diabetes. RESULTS: There was a strong dose-response relationship between serum GGT levels and the incidence of IFG and diabetes. A total of 570 cases (33.2%) of incident IFG and 50 cases (2.9%) of diabetes were found. After controlling potential predictors, the relative risks for the incidence of IFG for GGT levels < or = 19, 20~25, 26~34, 35~50 and > or = 51 were 1.00, 0.99, 1.17, 1.23 and 1.38 respectively (P for trend 0.015), and for the incidence of diabetes were 1.00, 1.44, 1.80, 2.55 and 2.58 respectively (P for trend 0.050). CONCLUSION: The risk for development of IFG and type 2 diabetes increased in a dose-dependent manner as serum GGT increased within its normal range in Korean men.


Citations to this article as recorded by  
  • Evaluation of Serum Gamma Glutamyl Transferase Levels in Diabetic Patients With and Without Retinopathy
    Neda Valizadeh, Rasoul Mohammadi, Alireza Mehdizadeh, Qader Motarjemizadeh, Hamid Reza Khalkhali
    Shiraz E-Medical Journal.2018;[Epub]     CrossRef

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