Diabetes & Metabolism Journal

Hyun Kyu Kim (Kim HK)

8 Articles

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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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.

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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

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 Influence of Metabolic Syndrome on the Intima-Medial Thickness and Cardiovascular Risk Factors in Type 2 Diabetes.: Kwang Pyo Son, Young Je Chae, Tae Yu Lee, In Kyung Jeong, Mina Hur, Gu Young Jo, Young Lee, Seong Jin Lee, Chul Young Park, Ki Won Oh, Eon Kyung Hong, Hyun Kyu Kim, Jae Myoung Yu, Doo Man Kim, Sung Hee Lim, Moon Ki Choi, Hyung Jun Yoo, Sung Woo Park; Korean Diabetes J. 2004;28(5):392-406. Published online October 1, 2004

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Abstract PDF: BACKGROUND
Metabolic syndrome (MS) is usually present in type 2 DM (T2DM), and it is associated with atherosclerosis. The aim of this study is to exam the influence of MS on the intima-medial thickness(IMT) and the cardiovascular risk factors for type 2 diabetic patients. SUBJECTS AND METHODS: A cross sectional study was performed on 82 patients with Type 2 diabetes mellitus (DM) and 84 healthy controls. MS was defined according to the NCEP-ATP III criteria. Those subjects with any history of cerebro vascular accident, ischemic heart disease or acute inflammation were excluded. The cardiovascular risk factors (hsCRP, lipid profile, homocysteine, and uric acid), the status of glucose metabolism (HbA1c, fasting glucose, insulin, and HOMA-IR), the diabetic microvascular complications and the IMT at both common carotid arteries were measured. RESULTS: 1) For patients with T2DM, the levels of waist circumference, blood pressure, TG (1.7+/-1.4 vs 2.2+/-1.4 mmol/L), HDL-C (1.5+/-0.4 vs. 1.3+/-0.3 mmol/L), LDL-C (2.7+/-0.7 vs 3.1+/-0.9 mmol/L), TC/HDL-C (3.5 vs. 41), log of (hsCRP) (-0.11+/-0.4 vs 0.17+/-0.4), mean carotid IMT (0.63+/-0.12 vs. 0.74+/-0.12 mm) and max IMT (0.68+/-0.14 vs. 0.86+/-0.15 mm) were significantly different from the healthy control group. 2) The prevalence of MS in the T2DM groups was 64%. However, a decrease of the waist circumference, as measured by the modified Asian criteria, increased the crude prevalence of MS by up to 75%. 3) Diabetic patients with MS had a higher incidence of hypertension, a lower level of HDL-C, and higher levels of waist circumference, HOMA-IR, TG, and TC/HDL-C, a greater extent of microvasculopathy, an increased log (hsCRP), homocysteine, and carotid IMT than did diabetic patients without MS. 4) Among the component of MS, the presence of hypertriglyceridemia had an influence on the IMT mean and max. 5) The carotid IMT of patients with DM correlated with age, homocysteine, log (hsCRP), and uric acid on univariate analysis, and age and homocysteine we found to be independent risk factors of carotid IMT on multivariated analysis. CONCLUSION: Metabolic syndrome in subjects with glucose intolerance increases the risk of atherosclerosis.

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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Abstract PDF: 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.

Risk Factors of Peripheral Vascular Disease (PVD) and Nutritional Factors in Diabetic Patients over 60 Years Old Complicated with PVD Diagnosed by Ankle-Brachial Index ( ABI ).: Yoo Sun Chung, Hyung Joon Yoo, Sung O Seo, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1999;23(6):814-821. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The subjects with diabetes mellitus are at high risk for peripheral vascular disease (PVD). The ABI (Ankle-Brachial Index) was done for diagnosis of PVD in diabetes. Numerous studies have been conducted to determine the risk factors for diabetes PVD. Most of the risk factors have been found are largely affected by the age and patients nutritional status to some extent. Especially in older diabetes, risk factors cannot be evaluated by numerical values only, for most patients are in background of poor nutritional support. Therefore, in this study, our aim was to evaluate on the influences of the nutritional status as the risk factors for PVD in older patients, ie., 60 years and older. METHODS: We selected 59 patients who are above 60 years old and took neither anti-hypertensive drug nor lipid lowering agents. All subjects ABI was measured by IMEXLAB 9000 and the study group was stratified according to the ABI values: the normal (ABI >10), PVD group (ABI <0.9). The ABI (Ankle-Brachial Index) was measured by The data were analyzed using one-way analysis of variance. If statistically significant effect was found, post hoc analysis (e.g., Newman-Keuls' test) was performed to evaluate the difference between the groups. The values are expressed as the mean+/-standard error (SE). RESULT: There was significant difference in smoking (ABI < 0.9; 0.54+/-0.16 packs/day, ABI > 1.0; 0.35+/-0.08 packs/day), the serum level triglyceride(ABI < 0.9; 1.960.19 mmol/L, ABI > 1.0; 1.56 + 0.21 mmol/L), HDL-cholesterol(ABI < 0.9; 0.88+/-0.11 mmol/L, ABI > 1.0; 1.10+/-0.08 mmol/1) when compared between the normal and ABI decreased subjects(P < 0.05). However, we found no significant differences in systolic blood pressure, total cholesterol and LDL-C between the two groups. Serum level of the nutritional factors such as albumin, transferrin, total lympocyte count, folate, zinc were lower than the normal values in both groups. However, these levels were not statistically significant when two groups compared. CONCLUSION: The relationship between the known PVD risk factors and PVD in older diabetes was weak. Therefore, based on the findings from this study, we suggest that when investigators interpretate the risk factors of PVD in elderly patients one must consider nutritional effects along the other factors.

Proliferative Ability of Aortic Smooth Muscle Cells and Lipid Peroxidation of Red Blood Cell Membrane in Diabetic Rats.: Sae Young Park, Hyung Joon Yoo, Kyun Soo Kim, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1999;23(6):785-792. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Diabetes mellitus is a known risk factor for atherosclerosis, and lipid peroxidation, expression of oxidative stress, is also known to related to diabetes mellitus. The purpose of this study was to investigate the proliferative behaviour of cultured vascular smooth muscle cells (VSMCs) and the alteration of lipid peroxidation in relation to the pathogenesis of diabetic atherosclerosis. METHODS: Seven streptozotocin-induced insulin dependent diabetic Sprague Dawley rats and 7 normal rats were studied. Using enzyme method, aortic VSMCs was cultured in diabetic rats. and proliferation was compared between normal and diabetic rat. The membrane lipid peroxidaton of erythrocytes was determined by measurement of malonyl- dialdehyde(MDA), an end-product of fatty acid peroxidation with thiobarbituric acid (TBA) reaction. MDA-TBA colored complex concentration was calculated with the extinction coefficient of MDA-TBA complex at 532nm = 1.56X105cm-lM-1. RESULT: 1. The proliferative ability of cultured VSMCs was much higher in diabetic rats than in nondiabetic ones (p<0.05). 2. Compared with normal control rats, MDA concentration of diabetic rats was significantly increased (p<0.05). CONCLUSION: We concluded that proliferation of cultured VSMCs is due to oxidative stress in diabetes mellitus as a result of the increased proliferative ability of cultured VSMCs combined with increased lipid pemxidation in diabetic rats.

Metabolic Factors Influencing Serum Potassium Levels in Diabetic Ketoacidosis.: Sung Jin Kim, Seung Oh Suh, Sung Hee Ihm, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Moon Gi Choi, Hyung Joon Yoo; Korean Diabetes J. 1999;23(5):661-668. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The serum K level is normal or high in the majority of patients with diabetic ketoacidosis (DKA) despite significant total body K+ deficits. This might be due to the combined effects of severe acidosis, insulin deficiency, volume contraction, hyperglycemia and hypertonicity that usually accompany DKA. The aim of this study was to investigate the most likely determinants of the serum K+ levels among metabolic derangements observed in DKA patients. METHODS: The subjects were 88 DKA patients who had normal or high initial serum K+ levels. We anaylzed the correlation between initial serum K' levels and metabolic parameters (arterial pH, arterial HCO(3-) level, anion gap, serum glucose level, osmolality, BUN and fasting C-peptide levels), by simple linear regression analysis and stepwise multiple regression analysis. RESULT: Serum K+ levels correlated significantly with initial arterial pH(r=-0.38, p<0.001), HCO(3-) (r=-0.35, p<0.001), anion gap(r=0.21, p<0.05), serum glucose (r=0.22, p<0.05) and fasting C-peptide (r=-0.33, p<0.05) levels. Among these, arterial HCO(3-), serum glueose and fasting C-peptide levels had significant and independent effects on serum K+ levels. These levels could account for about 33% of the observed variance in serum K+ levels. CONCLUSION: These results suggest that metabolic acidosis and hyperglycemia in DKA, which result primarily from insulin deficit, are the main determinants of increased serum K+ levels.

HbA1c Concentration of Elderly Diabetic Patients with the Hypoglycemic Shock who were Admitted via Emergency Room.: Jin Cheol Park, Hyung Joon Yoo, Hae Seang Yim, Yong Tae Kim, Do Kyun Jin, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1998;22(4):546-551. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Mild degree of hypoglycemia is not unusual during drug therapy in elderly diabetic patients. However it is very difficult that the precise incidence of hypoglycemia is measured in elderly patients because the decreased cognitive function and autonomic dysfunction contribute to atypical hypoglycemic symptoms and signs. Therefore, most cases of elderly diabetic patients with hypoglycemia are discovered in comatose mental state. We did this study to evaluate the clinical charaeteristics of elderly diabetic patients with the hypoglycemic shock who were admitted via emergency room. METHODS: We analyzed the precipitating factors, mental status, and blood chemistries of the adult group(n=22, age 51+3.6 year, BMI-19 kg/m2) and elderly group(n=37, age=72+4.3 year, BMI=23 kg/m) that were classified by the point of 65 years old who were admitted via emergency room in state of the hypoglycemic shock. RESULTS: 1) In the precipitating factor of hypoglycemia, irregular oral intake was found in 64%(14/22) of the adult group and 64%(23/37) of the elderly group, and drug overdose was found in 27 %(1.6/22) of the adult group and 24%(9/37) of the elderly group. But there, was no significant difference between the adult and elderly group. 2) Those who arrived at the emerency room in comatose mental status were found in 45.5 % of adult group and 54.1 % of elderly group, that was no difference stastically. 3) HbA 1c was 5.8 +- 0.27% in elderly group and 8.0 +- 0.63% in the adult group who arrived at the emergency room, which was stastically significant difference between two groups. CONCLUSION: We concluded that lower HbA 1c in the elderly group than adult group who arrived at the emergency room suggest there was probability of unrecognized mild hypoglycemia before the onset of hypoglycemic shock.

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