- Leptin Concentration in Diabetin and Non-diabetin Subjects in the Community Population.
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Kee Up Lee, Seong Kwan Hong, Sang Wook Kim, Young Il Kim, Yun Ey Chung, Moo Song Lee, Joong Yeoul Park, Jin Yup Kim
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Korean Diabetes J. 1999;23(4):592-600. Published online January 1, 2001
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- BACKGROUND
It has been suggested that adipose tissue releases leptin, a satiety factor, which circulates in blood and acts on the hypothalamus to suppress appetite. However, serum leptin concentration in obese human subjects is higher than that in lean subjects, suggesting leptin resistance. Although there have been several studies investigating serum leptin concentrations in Korean subjects, there has been no population-based study. This study was undertaken to investigate serum leptin concentration and associated factors in diabetic and non-diabetic subjects living in a rural area of Korea. METHOD: Among 898 subjects originally included in the Jung-up epidemiologic study, 119 men and 124 women with varying degrees of glucose tolerance were randomly selected. Serum leptin concentration was measured by radioimmunoassay. RESULTS: In agreement with previous studies, women had significantly higher serum leptin concentration than men. Serum leptin concentration in Korean men and women was apparently lower than in other populations, even after adjustment for BMI. Leptin concentration was not different among the three groups of glucose tolerance (normal glucose tolerance, impaired glucose tolerance and diabetes). Serum leptin concentration was positively correlated with serum true insulin, proinsulin and BMI in non-diabetic subjects. Serum leptin concentration was also significantly related with serum proinsulin/true insulin ratio in non-diabetic women. CONCLUSION: Serum leptin concentration in Korean subjects was lower than that reported in other populations. Serum leptin concentration was associated with BMI, serum true insulin and proinsulin levels in non-diabetic subjects, but not in diabetic ubjects.
- Microalbuminuria in Diabetic and Non-diabetic Subjects: A population Based Study.
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Young Il Kim, Yun Ey Chung, Jin Yup Kim, Sang Wook Kim, Eun Sook Kim, Moo Song Lee, Joong Yeoul Park, Sung Kwan Hong, Ki Up Lee
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Korean Diabetes J. 1999;23(1):79-86. Published online January 1, 2001
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Microalbuminuria is associated with increased cardiovascular mortality in type 2 diabetic patients and non-diabetic subjects. This study was undertaken to determine the prevalence ot microalbuminuria among diabetic and non-diabetic subjects in Korea and to determine the factors associated with microalbuminuria. METHOD: A sample of 1,791 subjects aged > 40 years living in Jungup district were selected from the 28,380 inhabitants using a random cluster sampling method. Among these subjects, 1,006 of them (56.1%) underwent the 75 g oral glucose tolerance test that was also part of the timed overnight urine collection. 46 subjects were excluded because they had signs of urinary tract infection (n=41) or overt proteinuria (n=5). Microalbuminuria was defined as urinary albumin excretion rate (UAER) between 20 and 200 pg/min. RESULTS: Subjects with microalbuminuria had a higher weight and body mass index (BMI), abdominal circumference, systolic and diastolic blood pressure (BP), fasting and 2hr plasma glucose, fasting semm insulin and proinsulin concentrations than subjects without microalbuminuria. The prevalence of micro- albuminuria increased as the glucose tolerance worsened[6.0% in normal glucose tolerance, 11.8% in impaired glucose tolerance (IGT) and 21.8% in diabetes, respectively; x trend=25.9, p<0.(0001]. Mean UAER of subjects with hypertension was greater than that of subjects without hypertension (7.8+0.9ug/min vs. 9.6+0.7ug/min, p<0.001). Univariate analysis revealed that the UAER was significantly (p<0.05) correlated with weight and BMI, abdominal circumference, systolic and diastolic BP, fasting and 2hr plasma glucose, fasting serum insulin and proinsulin after sex-adjustment. Multiple regression analysis revealed that weight or BMI, diastolic BP, 2hr plasma glucose and fasting serum insulin were independently associated with UAER in non-diabetic subjects. CONCLUSION: The present study demonstrates that the prevalence of microalburninuria is higher in patients with glucose intolerance. The association of the UAER with BMI, diastolic BP, 2hr plasma glucose and fasting serum insulin suggest that microalbuminuria is a feature of the insulin resistance syndrome.
- Prevalence of Insulin Resistance Syndrome in Subjects Living in Jungup District , Korea.
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Sang Wook Kim, Jin Yub Kim, Eun Sook Kim, Young Il Kim, Moo Song Lee, Hyeong Ho Kim, Joong Yeoul Park, Sung Kwan Hong, Ki Up Lee
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Korean Diabetes J. 1999;23(1):70-78. Published online January 1, 2001
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The clustering of hypertension, impaired glucose tolerance, low HDL cholesteml and high triglyceride is known as insulin resistance syndrome (IRS). We studied the prevalence of insulin resistance syndrome among subjects living in Jungup district, Korea. METHODS: Among a total of 151,000 subjects over 40 years of years living in Jungup district, a sample of 1,791 was selected using a random cluster sampling method. Oral glucose tolerance test revealed 1,018 subjects with normal or impaired glucose tolerance. The IRS was defined as the coexistence of two or more components of triad; hypertension, impaired glucose tolerance and dyslipidemia (triglycerides >= 200mg/dL and HDL <45 mg/dL for woman, HDL < 35 mg/dL for men). RESULTS: Twenty-one percent of men and 45% of women were obese and 50.8% and 61.9% were hypertensive. Eleven percent of men and 16 percent of women were found to have dyslipidemia. The prevalence of impaired glucose tolerance was 10.2% for men and 15.7% for women. The prevalence of IRS in the Jungup population was 12.8% for men and 19.6% for women. The prevalence of IRS increased according to the plasma level of insulin. There was a positive correlation between the number of components of IRS and the level of fasting plasma insulin. CONCLUSION: We conclude that the prevalence of IRS is high in Korean subjects. The close correlation between the IRS components and fasting insulin level suggests that cardiovascular risk is associated with insulin resistance.
- Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Korean Adults Living in Jungup District, South Korea.
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Young Il Kim, Chul Soo Choi, Sang Wook Kim, Jong Soo Lee, Hyeong Ho Kim, Moo Sung Lee, Sang Il Lee, Joong Yeoul Park, Sung Kwan Hong, Ki Up Lee
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Korean Diabetes J. 1998;22(3):363-371. Published online January 1, 2001
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Similar to other countries that underwent industrialization in recent years, the prevalence of diabetes has increased dramatically in Far East Asian countries. While the prevalence of diabetes in South Korean adults was estimated to be less than 0.5% in 1960s, a recent study from Yonchon County showed a dramatic increase to 7.2%. This was the only study performed in population-based subjects. We studied the prevalence of diabetes and impaired glucose tolerance(IGT) among subjects living in Jungup clistrict, Chonlabuk-do, South Korea. METHODS: Among a total of 28,380 subjects aged over 40 years living in Jungup district a sample of 1,791 subjects living in six villages was selected using a random cluster sampling method. Among these subjects, 1,108 subjects(61.9%) completed 75g oral glucose tolerance test(OGTT). RESULTS: When the WHO criteria were used, the prevalence of diabetes and IGT were 7.1% and 8.5%, respectively, after correction for Segi's standard world population. Among the diabetic subjects, 62% of the patients did not know that they had diabetes previously. When the 1997 ADA criteria after OGTT were employed, the prevalence of diabetes and IGT/IFG(impaired fasting glucose) was 8.5% and 11.1%, respectively. The mean body mass index(BMI) of whole subjects was 22.9+2.7 for men and 24.3+3.2kg/m for women. Among subjects with normal glucose tolerance, IGT and diabetes, 31.5%, 42.3% and 50.0% of subjects were currently obese(BMI >25kg/m), respectively. The prevalence of both diabetes and IGT increased with inereasing waist-to-hip ratio(WHR) in men and women. On the other hand, the prevalence of diabetes and glucose intolerance increased with increasing BMI only in women but not in men. CONCLUSION: The prevalence of diabetes and IGT in the present study was quite similar to that in the previous Yonchon study. This prevalence of diabetes is higher than or similar to that reported in the Caucasian(~ 3% 8%), even though mean BMI of this community population(23.9 kg/m) is lower than that in the Caucasian (24.5~28.0 kg/m). It can be speculated that Far East Asian penple are more prone to develop diabetes for their degree of obesity.
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