Diabetes & Metabolism Journal

Byoung Hyun Park (Park BH)

7 Articles

Waist Circumference May be More Important than Body Mass Index (BMI) in Determinants of Left Ventricular Mass in Korean Hypertensive Patients.: Yoon Hyeuk Lim, Byoung Hyun Park, Sung Zoo Kim, Chung Gu Cho; Korean Diabetes J. 2007;31(2):130-135. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.130

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Abstract PDF: BACKGROUND
In many studies, obesity is highly correlated with adverse coronary risk profile. Increased left ventricular (LV) mass is an independent risk factor for cardiovascular mortality and morbidity. Hypertension is an well known factor related with LV mass. Obesity also is related with LV mass and commonly associated with hypertension. However, few data are available concerning the relations of LV mass to central obesity, especially in Korean hypertensive patients. So, this study was to evaluate the significance of waist circumference in determinants of LV mass in Korean hypertensive patients. METHODS: A total of 74 hypertensive [40 women, 34 men; mean age, 62.5 years; mean body mass index (BMI), 25.0 kg/m2, 17 with type 2 diabetes] patients without prevalent cardiovascular disease were studied. Echocardiographic LV septal thickness, LV posterior wall thickness, LV dimension and LV mass were analysed. RESULTS: LV mass, diastolic left ventricular internal dimension and epicardial fat thickness were larger in men than in female. LV mass was larger in obese patients defined by body mass index and also in central obese patients defined by waist circumference. LV mass was correlated with sex, body mass index, waist circumference, diastolic left ventricular internal dimension, left ventricular posterior wall thickness and interventricular septal thickness. After controlling for age, sex and body mass index, waist circumference was correlated with LV posterior wall thickness and LV mass. CONCLUSION: Waist circumference may be more important than BMI in determinants of left ventricular mass in Korean hypertensive patients.

Randomized, Open Label, Multicenter Clinical Trial about the Effect of Cilazapril on Vascular Endothelial Function in Patients with Type 2 Diabetes Combined with Hypertension.: Sang Youl Rhee, Jeong Taek Woo, Sei Hyun Baik, Hyoung Woo Lee, In Kyu Lee, Hye Soon Kim, Moon Kyu Lee, Min Ho Shong, Chung Gu Cho, Byoung Hyun Park, Bong Soo Cha, Young Seol Kim; Korean Diabetes J. 2006;30(6):450-458. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.450

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BACKGROUND
The angiotensin converting enzyme inhibitor (ACEi) improves the vascular endothelial cell function and has a better clinical outcome by decreasing the LDL cholesterol oxidation, hypercoagulability, oxidative stress and improving the level of endothelial nitric oxide synthesis in patients with type 2 diabetes and hypertension. However, the correlations between the ACEi and the serum markers for the vascular endothelial function in previous studies were not consistent. SUBJECTS AND METHODS: Between July 2003 and April 2005, 104 type 2 diabetes patients with hypertension, who had been admitted to 9 major university hospitals in Korea, were examined. The subjects were randomly allocated to the cilazapril (2.5~5 mg/day) and atenolol (50~100 mg/day) treatment group and given a combination of hydrochlorothiazide and amlodipine. The lipid profile and the markers for endothelial function, such as vWF, VCAM, E-selectin, tPA, fibrinogen, adiponectin, hsCRP, nitrotyrosine were evaluated and the differences in the variables were compared with those obtained 6 months later. RESULTS: A total 56 subjects completed the 6-months follow up period. Regarding the baseline characteristics, there were no significant differences in the variables observed in the two groups except for HbA1c (P = 0.037), vWF (P = 0.048), and hsCRP (P = 0.038). After 6 months, both groups showed a significant and identical decrease in the systolic and diastolic blood pressure compared with the baseline (P < 0.002). However, there were no significant differences in the endothelial markers between each group. On the other hand, there was some deterioration in the triglyceride (P = 0.009) and HbA1c (P = 0.017) levels in the atenolol treatment groups. CONCLUSIONS: There were no significant differences in the endothelial function markers observed between the cilazapril and atenolol groups. However, cilazapril had an identical effect on the blood pressure reduction compared with atenolol but had fewer adverse effects on the glucose and lipid metabolism.

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Potential Protective Role of Blood Pressure-Lowering Drugs on the Balance between Hemostasis and Fibrinolysis in Hypertensive Patients at Rest and During Exercise
Annabella Braschi
American Journal of Cardiovascular Drugs.2019; 19(2): 133. CrossRef

Two Cases of Fulminant Type 1 Diabetes.: Yu Min Lee, Kyoung Hee Kweon, Seoung Hoon Baek, Ha Young Kim, Byoung Hyun Park, Chung Gu Cho; Korean Diabetes J. 2005;29(4):378-382. Published online July 1, 2005

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Abstract PDF: Type 1 diabetes is characterized by insulin deficiency due to destruction of pancreatic beta-cells. Patients with type 1 diabetes, with no islet autoantibodies, but with acute onset, are classified as having idiopathic of type 1B diabetes. In 2000, this diabetes subtype was described and named "fulminant type 1 diabetes". The clinical characteristics of this subtype of type 1 diabetes are: a remarkably abrupt onset of disease, very short(<1 week) duration of diabetic symptoms, acidosis at diagnosis, negative status of islet-related autoantibodies, virtually no C-peptide secretion(<10 microgram/day in urine), a near normal HbA1c level and an elevated serum pancreatic enzyme level. Since 1988, several cases showing the clinical characteristics of fulminant type diabetes have been reported, with this subtype accounting for approximately 20% of Japanese type 1 diabetes. There have been few cases of fulminant type 1 diabetes in Korea. Herein, our experience of two cases of fulminant type 1 diabetes is reported, with a review of the literature.

Prolonged QT Interval and the BMI, Systolic BP and HDL-Cholesterol in Type 2 Diabetic Patients.: Chunggu Cho, Hye Jung No, Hyo Jeong Oh, Bong Joon Yang, Ha Young Kim, Byoung Hyun Park; Korean Diabetes J. 2005;29(3):215-222. Published online May 1, 2005

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Abstract PDF: BACKGROUND
A prolonged QT interval is considered as an indicator of an increased risk of coronary heart disease, malignant ventricular arrhythmias and/or sudden death. QT interval prolongation has been reported to be a common finding in patients with obesity and diabetic autonomic neuropathy and it is well known that both leptin and insulin stimulate sympathetic activity. The waist to hip ratio and the plasma insulin levels were recently reported to be correlated with the QT intervals and the sympathovagal balance. The aim of the present study was to evaluate the association of the features of metabolic syndrome and the QT interval in type 2 diabetic patients. METHODS: We studied 114 type 2 diabetes(45 males and 69 females). The QT intervals were measured by a software program and then the QTc was calculated. The fasting glucose, total cholesterol, triglyceride and high-density lipoprotein(HDL)-cholesterol, HbAIC and Cpeptide were measured. All the patients received clinical tests for cardiovascular autonomic dysfunction by the Ewing's method. RESULTS: A significant difference was found in the mean QT interval between the patients with an autonomic score>=1 and the patients who were without cardiac autonomic neuropathy(autonomic score=0). On Pearson's simple regression analysis, the QT interval showed positive correlations with the BMI, fasting C-peptide, systolic blood pressure(sBP), and age. The QT interval also showed negative correlation with the HDL-cholesterol. The associations of the QTc with triglyceride, fasting glucose, and the autonomic score did not reach statistical significance. On the multiple regression analysis, the QT interval was independently correlated with BMI, systolic BP and HDL-cholesterol but not with the other variables that we tested(c-peptide, autonomic score, diastolic blood pressure, glycated hemoglobin, triglyceride and cholesterol). CONCLUSION: Our results suggest that a variety of features of metabolic syndrome are associated with QT interval prolongation in the type 2 diabetic patients

Evaluation of Erectile Dysfunction in type 2 Diabetes: Prevalence, Clinical characteristics and Treatment effect of sildenafil citrate.: Byoung Hyun Park, Joung Sik Rim, Chung Gu Cho; Korean Diabetes J. 2002;26(3):199-207. Published online June 1, 2002

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Abstract PDF: BACKGROUND
The prevalence of erectile dysfunction has been reported to be three times higher in diabetics than nondiabetics. As the majority of type 2 diabetes develops later in life, any associated erectile dysfunction often ignored by physician as well as patients. The purpose of this study was to investigated the prevalence of erectile dysfunction in type 2 diabetes and to find any related clinical characteristics and the effect of sildenafil citrate treatment in these types of patient. METHODS: We studied 75 male type 2 diabetics who visited the Wonkwang University Hospital between March and July, 2000, and analyzed their International Index of Erectile Function questionaires. Erectile dysfunction was defined as a the total score less than 24 points according to the answers to six questions about erections. According to this definition, our patients were divided into two groups; the presence, and the absence, of erectile dysfunction. We also obtained details from the patients relating to their history of smoking, alcohol, consumption, diabetic foots and hypertension; measured their current weight, height, HbA1c, lipoprotein (a), lipid profile, albumin and QTc and evaluated the presence of diabetic retinopathy, nephropathy and neuropathy. A single oral dose of sildenafil, 25 mg, was started and the effect assessed by a global efficacy question every 4 weeks for 12 weeks. If there was no effect, we increased the dose to 50 or 100 mg. RESULTS: 1) The prevalence of erectile dysfunction in type 2 diabetics in this study was 77.3%. Most patients (86.2%) wanted their erectile dysfunction treated, but a minority (31%) had visited a private clinic to discuss the problem. 2) The prevalence of erectile dysfunction increased with age, increased duration of diabetes and HbA1c. The Body Mass Index (BMI) and serum albumin were inversely related to erectile dysfunction. 3) The erectile dysfunction was significantly associated with diabetic autonomic neuropathy and retinopathy. 4) The score from the questionaires of five relevant domains of sexual function (these being, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) were lower in the erectile dysfunctional group. 5) 18 patients were prescribed sildenafil, 61.6% of which reported improved erections by the end of the study, with 50% of these being satisfied with their erections. There were no side effects causing discontinuation of treatment. CONCLUSION: The prevalence of erectile dysfunction in type 2 diabetics in this study was 77.3%. The prevalence of erectile dysfunction increased with age, increased duration of diabetes and HbA1c. The BMI and serum albumin were inversely related to erectile dysfunction. The effect of sildenafil was simillar to that reported previously for other countries, and was effective in the treatment of erectile dysfunction in type 2 diabetics.

Effect of Nerve Growth Factor on Cultured Mouse Dorsal Root Ganglion Cells in Hyperglycemic Condition.: Byoung Hyun Park, Chung Gu Cho, Geun Young Jang, Ki Hun Kim, Seung Taeck Park; Korean Diabetes J. 2001;25(4):286-296. Published online August 1, 2001

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Abstract PDF: BACKGROUND
Multiple etiology of diabetic neuropathy has been proposed, including altered polyol metabolism, superoxide radical formation, protein glycation, vascular insufficiency, blunted nitric oxide production and neurotrophic factor (NTF) deficiency. Nerve growth factor (NGF) is a member and family of neurotrophic factors. NGF is produced in tissues innervated by its responsive neurons. In the peripheral nervous system, NGF messenger RNA (mRNA) is produced in target fields of small pain and temperature-mediating dorsal root ganglia (DRG) sensory neurons and sympathetic neurons. NGF has been shown to promote their survival, differentiation, and maintenance. However, the mechanism of neuronal damage in diabetes and the effect of NGF on diabetic neuropathy are not clear. METHODS: In order to clarify the effect of NGF, the changes of cell viability were evaluated by MTT assay on mouse cultured dorsal root ganglion cells which were grown with media containing concentrations of high glucose for inducing hyperglycemic condition. Furthermore, the neuroprotective effect of nerve growth factor (NGF) against hyperglycemia-induced dorsal root ganglion cell changes were also examined. RESULTS: 1. Cell viability of cultured mouse dorsal root ganglion cells treated with hyperglycemic media made with 15, 25 mM glucose was markedly decreased in a dose-dependent manner when compared with control medium (normoglycemic medium) containing concentration of 5.5 mM glucose (p<0.05). 2. Cultured dorsal root ganglion cells exposed to hyperglycemic medium made with 25 mM glucose for 72 hours showed morphological changes such as dissociations, loss of neurites and decrease of cell viability (p<0.05). 3. Pretreatment of 150 ng/mL NGF for 2 hours significantly increased the cell viability of cultured dorsal root ganglion cells which exposed to hyperglycemic medium (25 mM glucose for 72 hours). CONCLUSION: Findings from this study suggested that hyperglycemic condition induces the decrease of cell viability and morphological changes (loss of neurites, dissociation) on cultured dorsal root ganglion cells of mouse. Furthermore, selective neurotrophic factors such as NGF are very effective in preventing dysfunction and morphological changes of DRG cells induced by hyperglycemic condition.

Intima-media Thickness of the Common Carotid Artery and Carotid Atherosclerotic Plaques as Predictors for Occurrence of Clinical Macrovascular Complication in Type 2 Diabetes.: Byoung Hyun Park, Chung Gu Cho; Korean Diabetes J. 2000;24(5):603-613. Published online January 1, 2001

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Abstract: BACKGROUND
This study was undertaken to investigate that intima-media thickness and plaque of the carotid artery, as measured by high resolution B-mode ultrasonography, can be used as predictors for occurrence of clinical macrovascular complication in type 2 diabetes patients. METHODS: High resolution B-mode ultrasonographic examination was performed in 39 type 2 diabetes, including 16 diabetes with macrovascular complication, and in 18 non-diabetic control subjects. Concurrently serum total cholesterol, HDL cholesterol, triglyceride, lipoprotein (a), HbA1c, C-peptide levels and body mass index (BMI) were measured and history of hypertension, smoking, duration of diabetes and occurrence of macrovascular complication during the last 6 months were investigated. RESULTS: 1) Significant differences in common carotid IMT (0.72+/-0.08 mm, vs 0.93+/- 0.26 mm), existence of atherosclerotic plaque (50%, vs 69%), plaque number (0.5+/- 0.86, vs 0.69+/-2.37) and carotid stenosis (0%, vs 18%) were found between control and type 2 diabetes (p<0.05). 2) Significant differences in age (67.63+/-4.30, vs 60.6+/-12.0), lipoprotein (a) (63.65+/- 32.2 mg/dL, vs 35.22+/-34.74 mg/dL), common carotid IMT (1.08+/-0.27 mm, vs 0.82+/- 0.20 mm), existence of atherosclerotic plaque (87.5%, vs 56.5%), plaque number (2.88+/-3.16, vs 0.91+/-1.02), end diastolic ventricular septal thickness (10.82+/-1.88 mm, vs 8.76+/-2.92 mm) and end diastolic left ventricular posterior wall thickness (10.79+/-1.60 mm, vs 9.1+/-2.56 mm) were found between type 2 diabetes patients with macrovascular complication and without macrovascular complication (p<0.05). 3) Age (r=0.363, p=0.023), hypertension (r=0.32, p=0.047), carotid plaque existence (r=0.377, p=0.018) and plaque number (r=0.662, p=0.000) showed a correlation with the IMT in type 2 diabetes. 4) Most common involving site of atherosclerotic plaques was carotid bulb and more extensive involvement was showed in type 2 diabetes with macrovascular complication than without macrovascular complication. 5) The sensitivity of common carotid IMT (> control mean IMT + 2 SD; >1.22 mm) for prediction of macrovascular complication in type 2 diabetes patients was 25%, the specificity 95.7%, the positive predictive value 80%, the negative predictive value 61.8%. 6) The sensitivity of existence of carotid plaque for prediction of macrovascular complication in type 2 diabetes patients was 87.5%, the specificity 60.9%, the positive predictive value 60.9%, the negative predictive value 87.5%. CONCLUSION: Increases in IMT and plaque of the carotid artery, as measured by high resolution B-mode ultrasonography, can be used as predictors for occurrence of clinical macrovascular complication in type 2 diabetes patients.

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