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Cardiovascular Risk/Epidemiology
Psychotic Disorders and the Risk of Type 2 Diabetes Mellitus, Atherosclerotic Cardiovascular Diseases, and All-Cause Mortality: A Population-Based Matched Cohort Study
You-Bin Lee, Hyewon Kim, Jungkuk Lee, Dongwoo Kang, Gyuri Kim, Sang-Man Jin, Jae Hyeon Kim, Hong Jin Jeon, Kyu Yeon Hur
Diabetes Metab J. 2024;48(1):122-133.   Published online January 3, 2024
DOI: https://doi.org/10.4093/dmj.2022.0431
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Background
The effects of psychotic disorders on cardiometabolic diseases and premature death need to be determined in Asian populations.
Methods
In this population-based matched cohort study, the Korean National Health Insurance Service database (2002 to 2018) was used. The risk of type 2 diabetes mellitus (T2DM), acute myocardial infarction (AMI), ischemic stroke, composite of all cardiometabolic diseases, and all-cause death during follow-up was compared between individuals with psychotic disorders treated with antipsychotics (n=48,162) and 1:1 matched controls without psychiatric disorders among adults without cardiometabolic diseases before or within 3 months after baseline.
Results
In this cohort, 53,683 composite cases of all cardiometabolic diseases (during median 7.38 years), 899 AMI, and 1,216 ischemic stroke cases (during median 14.14 years), 7,686 T2DM cases (during median 13.26 years), and 7,092 deaths (during median 14.23 years) occurred. The risk of all outcomes was higher in subjects with psychotic disorders than matched controls (adjusted hazard ratios [95% confidence intervals]: 1.522 [1.446 to 1.602] for T2DM; 1.455 [1.251 to 1.693] for AMI; 1.568 [1.373 to 1.790] for ischemic stroke; 1.595 [1.565 to 1.626] for composite of all cardiometabolic diseases; and 2.747 [2.599 to 2.904] for all-cause mortality) during follow-up. Similar patterns of associations were maintained in subgroup analyses but more prominent in younger individuals (P for interaction <0.0001) when categorized as those aged 18–39, 40–64, or ≥65 years.
Conclusion
Patients with psychotic disorders treated with antipsychotics were associated with increased risk of premature allcause mortality and cardiometabolic outcomes in an Asian population. This relationship was more pronounced in younger individuals, especially aged 18 to 39 years.
Cardiovascular Risk/Epidemiology
Metabolic Syndrome Severity Score for Predicting Cardiovascular Events: A Nationwide Population-Based Study from Korea
Yo Nam Jang, Jun Hyeok Lee, Jin Sil Moon, Dae Ryong Kang, Seong Yong Park, Jerim Cho, Jang-Young Kim, Ji Hye Huh
Diabetes Metab J. 2021;45(4):569-577.   Published online January 30, 2021
DOI: https://doi.org/10.4093/dmj.2020.0103
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  • 13 Web of Science
  • 14 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population.
Methods
From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve.
Results
Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III.
Conclusion
The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.

Citations

Citations to this article as recorded by  
  • Metabolic syndrome awareness in the general Korean population: results from a nationwide survey
    Hyun-Jin Kim, Mi-Seung Shin, Kyung-Hee Kim, Mi-Hyang Jung, Dong-Hyuk Cho, Ju-Hee Lee, Kwang Kon Koh
    The Korean Journal of Internal Medicine.2024; 39(2): 272.     CrossRef
  • BMI-based metabolic syndrome severity score and arterial stiffness in a cohort Chinese study
    Miao Wang, Chi Wang, Maoxiang Zhao, Shouling Wu, Hao Xue, Hongbin Liu
    Nutrition, Metabolism and Cardiovascular Diseases.2024;[Epub]     CrossRef
  • Omics biomarkers and an approach for their practical implementation to delineate health status for personalized nutrition strategies
    Jaap Keijer, Xavier Escoté, Sebastià Galmés, Andreu Palou-March, Francisca Serra, Mona Adnan Aldubayan, Kristina Pigsborg, Faidon Magkos, Ella J. Baker, Philip C. Calder, Joanna Góralska, Urszula Razny, Malgorzata Malczewska-Malec, David Suñol, Mar Galofr
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  • Development and validation of a continuous metabolic syndrome severity score in the Tehran Lipid and Glucose Study
    Mohammadjavad Honarvar, Safdar Masoumi, Ladan Mehran, Davood Khalili, Atieh Amouzegar, Fereidoun Azizi
    Scientific Reports.2023;[Epub]     CrossRef
  • Associations of metabolic syndrome, its severity with cognitive impairment among hemodialysis patients
    Yuqi Yang, Qian Li, Yanjun Long, Jing Yuan, Yan Zha
    Diabetology & Metabolic Syndrome.2023;[Epub]     CrossRef
  • Resistin serum levels and its association with clinical profile and carotid intima-media thickness in psoriasis: a cross-sectional study
    Sofia Makishi Schlenker, Sofia Inez Munhoz, André Rochinski Busanello, Matheus Guedes Sanches, Barbara Stadler Kahlow, Renato Nisihara, Thelma Larocca Skare
    Anais Brasileiros de Dermatologia.2023; 98(6): 799.     CrossRef
  • Cholecystectomy Increases the Risk of Type 2 Diabetes in the Korean Population
    Ji Hye Huh, Kyong Joo Lee, Yun Kyung Cho, Shinje Moon, Yoon Jung Kim, Eun Roh, Kyung-do Han, Dong Hee Koh, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm
    Annals of Surgery.2023; 278(2): e264.     CrossRef
  • Cardiorespiratory Endurance is Associated with Metabolic Syndrome Severity in Men
    V. V. Sverchkov, E. V. Bykov
    Journal Biomed.2023; 19(2): 61.     CrossRef
  • Effect of a Wearable Device–Based Physical Activity Intervention in North Korean Refugees: Pilot Randomized Controlled Trial
    Ji Yoon Kim, Kyoung Jin Kim, Kyeong Jin Kim, Jimi Choi, Jinhee Seo, Jung-Been Lee, Jae Hyun Bae, Nam Hoon Kim, Hee Young Kim, Soo-Kyung Lee, Sin Gon Kim
    Journal of Medical Internet Research.2023; 25: e45975.     CrossRef
  • Independent association between age- and sex-specific metabolic syndrome severity score and cardiovascular disease and mortality
    Mohammadjavad Honarvar, Ladan Mehran, Safdar Masoumi, Sadaf Agahi, Shayesteh Khalili, Fereidoun Azizi, Atieh Amouzegar
    Scientific Reports.2023;[Epub]     CrossRef
  • Optimal Low-Density Lipoprotein Cholesterol Levels in Adults Without Diabetes Mellitus: A Nationwide Population-Based Study Including More Than 4 Million Individuals From South Korea
    Ji Hye Huh, Sang Wook Park, Tae-Hwa Go, Dae Ryong Kang, Sang-Hak Lee, Jang-Young Kim
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Triglyceride-Glucose Index for the Diagnosis of Metabolic Syndrome: A Cross-Sectional Study of 298,652 Individuals Receiving a Health Check-Up in China
    Mingfei Jiang, Xiaoran Li, Huan Wu, Fan Su, Lei Cao, Xia Ren, Jian Hu, Grace Tatenda, Mingjia Cheng, Yufeng Wen, Hou De Zhou
    International Journal of Endocrinology.2022; 2022: 1.     CrossRef
  • Changes in body composition, body balance, metabolic parameters and eating behavior among overweight and obese women due to adherence to the Pilates exercise program
    Hyun Ju Kim, Jihyun Park, Mi Ri Ha, Ye Jin Kim, Chaerin Kim, Oh Yoen Kim
    Journal of Nutrition and Health.2022; 55(6): 642.     CrossRef
  • Metabolic Syndrome Severity Score, Comparable to Serum Creatinine, Could Predict the Occurrence of End-Stage Kidney Disease in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
    Pil Gyu Park, Jung Yoon Pyo, Sung Soo Ahn, Jason Jungsik Song, Yong-Beom Park, Ji Hye Huh, Sang-Won Lee
    Journal of Clinical Medicine.2021; 10(24): 5744.     CrossRef
Drug/Regimen
Cardiovascular Safety of Sodium Glucose Cotransporter 2 Inhibitors as Add-on to Metformin Monotherapy in Patients with Type 2 Diabetes Mellitus
Ja Young Jeon, Kyoung Hwa Ha, Dae Jung Kim
Diabetes Metab J. 2021;45(4):505-514.   Published online October 30, 2020
DOI: https://doi.org/10.4093/dmj.2020.0057
  • 7,832 View
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  • 10 Web of Science
  • 11 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Using real-world data, cardiovascular safety was investigated in metformin users newly starting sodium glucose cotransporter 2 (SGLT2) inhibitors compared with other glucose-lowering drugs in Korea.
Methods
This was a retrospective observational study using the National Health Insurance Service claims database in Korea. The study period was from September 2014 to December 2016. The study included subjects who were newly prescribed SGLT2 inhibitors or other glucose-lowering drugs while on metformin monotherapy; cohort 1 was composed of new users of SGLT2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors and cohort 2 included new users of SGLT2 inhibitors versus sulfonylureas. To balance the patient characteristics, propensity score matching was performed at a 1:1 ratio. Cardiovascular outcomes included hospitalization for heart failure (HHF), all-cause mortality, HHF plus all-cause mortality, myocardial infarction (MI), stroke, and modified major adverse cardiovascular events (MACEs).
Results
After propensity score matching, each cohort group was well balanced at baseline (21,688 pairs in cohort 1 and 20,120 pairs in cohort 2). As the second-line treatment, use of SGLT2 inhibitors was associated with a lower risk of HHF and HHF plus all-cause mortality compared with DPP-4 inhibitors. In addition, use of SGLT2 inhibitors versus sulfonylurea as add-on therapy to metformin was associated with decreased risks of HHF, all-cause mortality, HHF plus all-cause mortality, MI, stroke, and modified MACEs.
Conclusion
SGLT2 inhibitors can be a good second-line drug to reduce the incidence of cardiovascular diseases compared with DPP-4 inhibitors or sulfonylureas in people with type 2 diabetes mellitus.

Citations

Citations to this article as recorded by  
  • Evaluation and Management of Patients With Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
    Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon
    International Journal of Heart Failure.2023; 5(1): 1.     CrossRef
  • Evaluation and Management of Patients with Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
    Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon
    Diabetes & Metabolism Journal.2023; 47(1): 10.     CrossRef
  • Advances in Research on Type 2 Diabetes Mellitus Targets and Therapeutic Agents
    Jingqian Su, Yingsheng Luo, Shan Hu, Lu Tang, Songying Ouyang
    International Journal of Molecular Sciences.2023; 24(17): 13381.     CrossRef
  • Cardioprotective effects of dipeptidyl peptidase-4 inhibitors versus sulfonylureas in addition to metformin: A nationwide cohort study of patients with type 2 diabetes
    Jui Wang, Hon-Yen Wu, Kuo-Liong Chien
    Diabetes & Metabolism.2022; 48(3): 101299.     CrossRef
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    Ja Young Jeon, Dae Jung Kim
    Journal of Diabetes Investigation.2022; 13(4): 614.     CrossRef
  • The Impact of Novel Anti-Diabetic Medications on CV Outcomes: A New Therapeutic Horizon for Diabetic and Non-Diabetic Cardiac Patients
    Israel Mazin, Fernando Chernomordik, Paul Fefer, Shlomi Matetzky, Roy Beigel
    Journal of Clinical Medicine.2022; 11(7): 1904.     CrossRef
  • Effect of Sodium-Glucose Cotransporter Inhibitors on Major Adverse Cardiovascular Events and Hospitalization for Heart Failure in Patients With Type 2 Diabetes Mellitus and Atrial Fibrillation
    Chang Hee Kwon, Ye-Jee Kim, Min-Ju Kim, Myung-Jin Cha, Min Soo Cho, Gi-Byoung Nam, Kee-Joon Choi, Jun Kim
    The American Journal of Cardiology.2022; 178: 35.     CrossRef
  • Using real-world data for supporting regulatory decision making: Comparison of cardiovascular and safety outcomes of an empagliflozin randomized clinical trial versus real-world data
    Ha Young Jang, In-Wha Kim, Jung Mi Oh
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Cardiovascular Safety of SGLT2 Inhibitors Compared to DPP4 Inhibitors and Sulfonylureas as the Second-Line of Therapy in T2DM Using Large, Real-World Clinical Data in Korea
    Kyuho Kim, Sung Hee Choi
    Diabetes & Metabolism Journal.2021; 45(4): 502.     CrossRef
  • The effect of sodium‐glucose transport protein 2 inhibitors on mortality and heart failure in randomized trials versus observational studies
    Jesper Krogh, Carsten Hjorthøj, Søren L. Kristensen, Christian Selmer, Steen B. Haugaard
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    Enrico Longato, Benedetta Maria Bonora, Barbara Di Camillo, Giovanni Sparacino, Lara Tramontan, Angelo Avogaro, Gian Paolo Fadini
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Brief Report
Cardiovascular risk/Epidemiology
Clinical Impact of Dysglycemia in Patients with an Acute Myocardial Infarction
Jae-Wook Chung, Yeong-Seon Park, Jeong-Eon Seo, Yeseul Son, Cheol-Woo Oh, Chan-Hee Lee, Jong-Ho Nam, Jung-Hee Lee, Jang-Won Son, Ung Kim, Jong-Seon Park, Kyu-Chang Won, Dong-Gu Shin
Diabetes Metab J. 2021;45(2):270-274.   Published online April 16, 2020
DOI: https://doi.org/10.4093/dmj.2019.0164
  • 5,585 View
  • 119 Download
  • 8 Web of Science
  • 8 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   

This study aimed to determine the impact of dysglycemia on myocardial injury and cardiac dysfunction in acute myocardial infarctions (AMIs). From 2005 to 2016, a total of 1,593 patients with AMIs who underwent percutaneous coronary intervention were enrolled. The patients were classified into five groups according to the admission glucose level: ≤80, 81 to 140, 141 to 200, 201 to 260, and ≥261 mg/dL. The clinical and echocardiographic parameters and 30-day mortality were analyzed. The peak troponin I and white blood cell levels had a positive linear relationship to the admission glucose level. The left ventricular ejection fraction had an inverted U-shape trend, and the E/E' ratio was U-shaped based on euglycemia. The 30-day mortality also increased as the admission glucose increased, and the cut-off value for predicting the mortality was 202.5 mg/dL. Dysglycemia, especially hyperglycemia, appears to be associated with myocardial injury and could be another adjunctive parameter for predicting mortality in patients with AMIs.

Citations

Citations to this article as recorded by  
  • Optimal Low-Density Lipoprotein Cholesterol Levels in Adults Without Diabetes Mellitus: A Nationwide Population-Based Study Including More Than 4 Million Individuals From South Korea
    Ji Hye Huh, Sang Wook Park, Tae-Hwa Go, Dae Ryong Kang, Sang-Hak Lee, Jang-Young Kim
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
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    Shao-Yong Cheng, Hao Wang, Shi-Hua Lin, Jin-Hui Wen, Ling-Ling Ma, Xiao-Ce Dai
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
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    Bo-Yeon Kim
    Diabetes & Metabolism Journal.2021; 45(5): 787.     CrossRef
  • Clinical Impact of Dysglycemia in Patients with an Acute Myocardial Infarction (Diabetes Metab J 2021;45:270-4)
    Chan-Hee Lee
    Diabetes & Metabolism Journal.2021; 45(5): 791.     CrossRef
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Original Articles
Others
Hemorheologic Alterations in Patients with Type 2 Diabetes Mellitus Presented with an Acute Myocardial Infarction
Kyu-Hwan Park, Ung Kim, Kang-Un Choi, Jong-Ho Nam, Jung-Hee Lee, Chan-Hee Lee, Jang-Won Son, Jong-Seon Park, Dong-Gu Shin, Kyu-Chang Won, Jun Sung Moon, Yu Kyung Kim, Jang-Soo Suh
Diabetes Metab J. 2018;42(2):155-163.   Published online March 21, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.2.155
  • 4,244 View
  • 41 Download
  • 14 Web of Science
  • 12 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Hemorheologic indices are known to be related to vascular complications in variable clinical settings. However, little is known about the associations between hemorheologic parameters and acute myocardial infarction (AMI) in type 2 diabetes mellitus (T2DM). The purpose of this study was to demonstrate the changes of hemorheologic environment inside of blood using hemorheologic parameters, especially the elongation index (EI) and critical shear stress (CSS) in diabetics with versus without AMI.

Methods

A total of 195 patients with T2DM were enrolled. Patients were divided into the study group with AMI (AMI+, n=77) and control group (AMI−, n=118) who had no history of coronary artery disease. Hemorheologic parameters such as EI and CSS were measured and compared between the two groups.

Results

The EI was lower (30.44%±1.77% in AMI+ and 31.47%±1.48% in AMI−, P<0.001) but the level of CSS was higher (316.13±108.20 mPa in AMI+ and 286.80±85.34 mPa in AMI−, P=0.040) in the AMI+. The CSS was significantly related to the erythrocyte sedimentation rate (R2=0.497, P<0.001) and use of dipeptidyl peptidase-4 inhibitors (R2=0.574, P=0.048).

Conclusion

Diabetics with AMI resulted in adverse hemorheologic changes with lower EI and higher CSS compared to diabetic subjects without AMI. Evaluation of the hemorheologic parameters may provide valuable supplementary information for managing patients with AMI and T2DM.

Citations

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    Felipe A. Bustamante-Barrientos, Maxs Méndez-Ruette, Luis Molina, Tania Koning, Pamela Ehrenfeld, Carlos B. González, Ursula Wyneken, Roberto Henzi, Luis Federico Bátiz
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  • Improved Erythrocyte Deformability Induced by Sodium-Glucose Cotransporter 2 Inhibitors in Type 2 Diabetic Patients
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An Autopsy Case of Diabetes Mellitus with Extensive Atherosclerotic Complication.
Seok Hyung Kim, Jeong Wook Seo, In Ae Park, Seong Hoe Park, Eui Keun Ham, Hyun Soon Lee
Korean Diabetes J. 2000;24(1):97-101.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
A variety of circulatory abnormalities including atherosclerosis is a major complication of diabetes mellitus. In contrast to Western countries, incidence of extensive atherosclerotic complication is thought to be very low in Korean diabetic patients. METHODS: Recently, we have experienced an autopsy case of 66-year-old male with type 2 diabetes mellitus having severe atherosclerosis in major arteriss. RESULTS: Autopsy examination revealed severe ulcerative atherosclerosis in aorta and atheromatous embolization in numerous small and medium sized arteries of lung, kidney, liver, and intestine. Multiple old infarcts were noticed in myocardium and brain. In addition, severe diabetic nephropathy and pyelonephritis were also observed in kidneys. CONCLUSION: The cause of death in this case is assumed to be myocaridial infarction associated with obstruction of coronary arteries. This case suggests that incidence of extensive atherosclerosis in Korean diabetic patients may not be rare, if autopsy examination are performed more thoroughly on these patients.

Diabetes Metab J : Diabetes & Metabolism Journal