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Kap Bum Huh  (Huh KB) 43 Articles
Associations between ApoB/ApoA-I Ratios and Metabolic Syndrome and its Components in Patients with Type 2 Diabetes.
Jung Eun Kim, Wha Young Kim, Yoon Jung Lee, Ji Eun Park, Young Ju Choi, Kap Bum Huh, Ji Yun Hwang
Korean Diabetes J. 2009;33(2):143-154.   Published online April 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.2.143
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AbstractAbstract PDF
BACKGROUND
The Apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I) is a powerful clinical indicator of metabolic syndrome. However, few studies have searched for an association between ApoB/ApoA-I and metabolic syndrome in Korean patients with type 2 diabetes. We investigated the relation between ApoB/ApoA-I and the risk of metabolic syndrome and its components. METHODS: Subjects were 812 (424 males and 388 females) Korean patients who were being treated for type 2 diabetes at Huh's Diabetes Center in Seoul. The patients were classified into quartiles (lowest:Q1-highest:Q4) of ApoB/ApoA-I by gender. Anthropometric and hematological characteristics and dietary intake using a food frequency questionnaire were assessed. RESULTS: The prevalence of metabolic syndrome in our sample was 47.9% in males and 66.5% in females. The odds ratios (OR) for metabolic syndrome and for having its components were significantly increased from Q2 to Q4 quartiles of ApoB/ApoA-I in males (OR = 5.37; 95% CI = 2.98-9.65 and OR = 7.41; 95% CI = 4.04-13.6) and females (OR = 2.57; 95% CI = 1.28-5.15 and OR = 8.49; 95% CI = 4.28-16.8). These trends withstood adjustment for age, duration of type 2 diabetes, fasting blood glucose levels, and macronutrient intake both in males (OR = 5.24; 95% CI = 2.80-9.24 and OR = 7.98; 95% CI = 4.09-15.6) and in females (OR=4.41; 95% CI = 2.26-8.61 and OR = 8.29; 95% CI = 3.85-17.8). CONCLUSION: ApoB/ApoA-I appeared to be independently associated with risk of having metabolic syndrome and its components in Korean patients with type 2 diabetes after adjustment for putative risk factors including macronutrient intake, a particularly important lifestyle factor for patients with type 2 diabetes. A follow-up study of this population should evaluate the mechanisms underlying the relation between ApoB/ApoA-I and metabolic syndrome and its components.

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  • Association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome in Korean women with type 2 diabetes mellitus
    Ji Soo Oh, Hyesook Kim, Aswathy Vijayakumar, Oran Kwon, Young Ju Choi, Kap Bum Huh, Namsoo Chang
    Nutrition Research and Practice.2016; 10(1): 67.     CrossRef
  • Hepatoprotective Effects of Soybean Embryo by Enhancing Adiponectin-Mediated AMP-Activated Protein KinaseαPathway in High-Fat and High-Cholesterol Diet-Induced Nonalcoholic Fatty Liver Disease
    Jihye Hong, Sera Kim, Hyun-Sook Kim
    Journal of Medicinal Food.2016; 19(6): 549.     CrossRef
  • The Relationship between Factors of Metabolic Syndrome in Korean Adult Males and the Parents' Family History of Diabetes
    Hyung-Su Park, Jin-Gyu Jeong, Jin-Ho Yu
    The Journal of the Korea institute of electronic communication sciences.2013; 8(5): 779.     CrossRef
Clinical Characteristics of Korean Type 2 Diabetic Patients According to Insulin Secretion and Insulin Resistance.
Kyoung Eun Song, Dae Jung Kim, Ji Won Park, Hong Keun Cho, Kwan Woo Lee, Kap Bum Huh
Korean Diabetes J. 2007;31(2):123-129.   Published online March 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.2.123
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  • 10 Crossref
AbstractAbstract PDF
BACKGROUND
Korean type 2 diabetic patients are known to differ from western diabetes because of their unique characteristics, such as non-obese but centrally obese anthropometry and relatively more insulin secretory defects than insulin resistance compared to western diabetic patients. METHODS: We recruited 1,646 diabetic patients in the present study and excluded the 45 patients with fasting C-peptide < 0.20 nmol/L. We had assessed insulin secretion by fasting serum C-peptide level and insulin resistance by short insulin tolerance test (Kitt ; rate constant for plasma glucose disappearance, %/min) in the private diabetes clinic. The insulin secretory defect was divided by severe (C-peptide < 0.37 nmol/L), moderate (C-peptide 0.37~0.56 nmol/L), and normal (C-peptide > or = 0.57 nmol/L) group. The insulin resistance was divided by insulin resistant (IR) (Kitt < 2.5 %/min) and insulin sensitive (IS) (Kitt > or = 2.5 %/min) group. RESULTS: We analysed the data of 1,601 type 2 diabetic patients (831 men and 770 women, age 56.5 +/- 10.8 years, duration of diabetes 9.6 +/- 7.3 years). The prevalence of BMI > or = 25.0 kg/m2 is 42.5% and BMI > or = 23.0 kg/m2 is 70.2%. The prevalence of abdominal obesity (waist > or = 90 cm in men and 80 cm in women) is 45.2% (36.0% and 55.2%, respectively in men and women). Fasting C-peptide level is 0.64 +/- 0.29 nmol/L and Kitt value is 2.03 +/- 0.96%/min. According to fasting C-peptide level, the degree of insulin secretory defect were severe (13.1%), moderate (33.0%) and normal (53.9%). According to Kitt value, the IR group is 70.6% and the IS group is 29.4%. CONCLUSION: Obese type 2 diabetes is markedly increasing in Korea. Therefore, the major problem in Korean type 2 diabetic patients is being changed into insulin resistance instead of insulin secretory defect.

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  • Effect of Euonymus alatus Extracts on Diabetes Related Markers in Pancreatic β-Cells and C57BL/Ksj-db/db Mice
    Ye Rin Kim, Eun-young Kim, Seong Uk Lee, Young Wan Kim, Yoon Hee Kim
    Journal of the Korean Society of Food Science and Nutrition.2022; 51(9): 894.     CrossRef
  • Effect of Nutrition Counseling by Nutrition Care Process on Diet Therapy Practice and Glycemic Control in Type 2 Diabetic Patients
    Tae-Jeong Bae, Na-Eun Jeon, Soo-Kyong Choi, Jung-Sook Seo
    Korean Journal of Community Nutrition.2020; 25(3): 214.     CrossRef
  • Calpain-10 and Adiponectin Gene Polymorphisms in Korean Type 2 Diabetes Patients
    Ji Sun Nam, Jung Woo Han, Sang Bae Lee, Ji Hong You, Min Jin Kim, Shinae Kang, Jong Suk Park, Chul Woo Ahn
    Endocrinology and Metabolism.2018; 33(3): 364.     CrossRef
  • Obesity and Insulin Resistance According to Age in Newly Diagnosed Type 2 Diabetes Patients in Korea
    Ju Won Lee, Nam Kyu Kim, Hyun Joon Park, Jun Yeob Lee, Seon Yoon Choi, Eun Mi Lee, So Young Ock, Su Kyoung Kwon, Young Sik Choi, Bu Kyung Kim
    Kosin Medical Journal.2016; 31(2): 157.     CrossRef
  • The Insulin Resistance but Not the Insulin Secretion Parameters Have Changed in the Korean Population during the Last Decade
    Hae Kyung Yang, Jin Hee Lee, In-Young Choi, Hyuk Sang Kwon, Jeong Ah Shin, Seung Hee Jeong, Seung-Hwan Lee, Jae Hyoung Cho, Ho Young Son, Kun Ho Yoon
    Diabetes & Metabolism Journal.2015; 39(2): 117.     CrossRef
  • The Effects of Low-Calorie Diets on Abdominal Visceral Fat, Muscle Mass, and Dietary Quality in Obese Type 2 Diabetic Subjects (Korean Diabetes J 2009;33:526-36)
    Hee-Jung Ahn, Kyung-Wan Min
    Korean Diabetes Journal.2010; 34(1): 68.     CrossRef
  • Effects ofSasa BorealisLeaf Extract on the Glucose Tolerance of Major Foods for Carbohydrate
    Eun-Kyoung Yun, Young-Ran Heo, Hyeon-Sook Lim
    The Korean Journal of Nutrition.2010; 43(3): 215.     CrossRef
  • The Effects of Low-Calorie Diets on Abdominal Visceral Fat, Muscle Mass, and Dietary Quality in Obese Type 2 Diabetic Subjects (Korean Diabetes J 2009;33:526-36)
    Won-Young Lee
    Korean Diabetes Journal.2010; 34(1): 66.     CrossRef
  • Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea
    Eun-Gyoung Hong
    Korean Diabetes Journal.2009; 33(1): 13.     CrossRef
  • Hypoglycemic effect of Chlorella vulgaris intake in type 2 diabetic Goto-Kakizaki and normal Wistar rats
    Hyejin Jeong, Hye Jin Kwon, Mi Kyung Kim
    Nutrition Research and Practice.2009; 3(1): 23.     CrossRef
The Effect of Growth Hormone on Insulin Resistance and Atherosclerotic Risk Factors in Obese Patients with Uncontrolled Type 2 Diabetes Mellitus.
Jae Hyun Nam, Soo Jee Yoon, Dol Mi Kim, Chul Sik Kim, Joo Young Nam, Jong Suk Park, Jina Park, Chul Woo Ahn, Suk Won Park, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2003;27(2):141-152.   Published online April 1, 2003
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BACKGROUND
Insulin resistance in visceral obesity constitutes a risk factor for the development of atherosclerosis. The insulin resistance in obese type 2 diabetic patients can be improved by a decrease in the visceral fat and an increase in the skeletal muscle, which may influence the insulin sensitivity. Growth hormone (GH) accelerates lipolysis and promotes protein conservation. The effects of GH therapy, with diet restriction, on lipolysis and protein anabolism, were evaluated, which may change body composition, insulin resistance and atherosclerotic risk factors in obese type 2 diabetes mellitus. METHODS: Sixteen obese type 2 diabetic patients (31~56yrs), who had high glucose levels (glucose 12.8+/-1.7 mmol/L, HbA1c 10.2+/-2.1%), were treated with recombinant human GH (GH; 1 unit/d, 5 times/week), diet restriction (25 kcal/kg ideal body weight/day) and exercise (250 kcal/day) for 12 weeks. They underwent anthropometric measurement, bioelectrical impedance for total body fat and lean body mass, as well as computed tomography, for visceral and subcutaneous fat, at the umbilicus and muscle area at the mid-thigh levels. All subjects underwent the test for GH response to hypoglycemia. The insulin sensitivity index (ISI) was measured using insulin tolerance tests (ITT). RESULTS: 1. The visceral fat area (VFA)/thigh muscle area (TMA) ratio was more decreased in the GH-treated group than in the control group, but there was no change of body weight. 2. The ISI was significantly increased in only the GH-treated group, which was negatively correlated with the VFA/TMA ratio. The serum free fatty acid, fibrinogen and plasminogen activator inhibitor-1 were significantly decreased after the GH treatment. The serum glucose level and HbA1c remained unchanged during the GH therapy, but were significantly decreased after 3 months. 3. The total cholesterol and triglyceride levels were decreased in the GH treated group. 4. The insulin-like growth factor-I, fasting c-peptide and insulin level were all significantly increased after the GH treatment. CONCLUSION: This study suggested that in type 2 diabetic patients, with insulin resistance and uncontrolled blood sugar, GH treatment caused a decrease in the visceral fat and an increase in the muscle mass, which could result in the improvement of the ISI, atherosclerotic risk factors and dyslipidemia.
High Sensitive C-reactive Protein and Carotid Intima Media Thickness in Korean Population.
Dae Jung Kim, Seung Hee Choi, Se Hwa Kim, Sang Su Chung, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2003;27(1):49-62.   Published online February 1, 2003
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BACKGROUND
A chronic inflammatory response is an important component in the development and progression of atherosclerosis. Since the development of the high-sensitive C-reactive protein (hs-CRP) assay, the association between subtle increases in the hs-CRP concentration and the development of atherosclerosis, has recently been reported. In this study, the relationship between hs-CRP, conventional cardiovascular risk factors and carotid intima media thickness (IMT), were investigated, and whether hs-CRP concentrations analyzed to see if it could be used as an independent risk factor, of early subclinical atherosclerosis in apparently healthy subjects. METHODS: This report was conducted as part of the Korean Metabolic Syndrome Study. Of 1,230 individuals having undergone a routine check-up, 849 were selected, based on their medical history of cardiovascular diseases. The hs-CRP was measured by an ELISA method, using human anti-CRP (CRP II Latex X2, Denka Seiken, Japan). RESULTS: The distribution of the hs-CRP concentration was positively skewed, and the hs-CRP levels ranged from 0.10 to 43.7 mg/L (mean 2.06, median 0.77 mg/L). There were significant positive correlations between the hs-CRP and age, BMI, waist, BP, insulin resistance (HOMA-IR) and the TC/HDL-C ratio. From a multiple regression analysis, independent relationships between the hs-CRP and obesity, hypertension, age ( 60 years), current smoking, male and insulin resistance were found. There were positive correlations between the carotid IMT and age, BMI, waist circumference, SBP, DBP, TC, TG, LDL-C, fasting blood glucose, HOMA-IR and hs-CRP, and a negative correlation between the carotid IMT and the HDL-C. From the multiple regression analysis, independent relationships between the carotid IMT and age, SBP, TC/HDLc, HOMA-IR, waist circumference, and DBP also persisted. After adjusting for the conventional risk factors in the multiple regression, there was no longer a significant relationship between the hs-CRP and the carotid IMT. CONCLUSION: There were strong correlations between the hs-CRP and the conventional cardiovascular risk factors, especially with that of obesity. Also, a highly significant association was also found between the hs-CRP and the carotid IMT. However, the hs-CRP, per se, is not a major independent risk factor of early subclinical atherosclerosis in Koreans.
Prevalence of Metabolic Syndrome according to the New Criteria for Obesity.
Hae Won Chung, Dae Jung Kim, He Dong Jin, Seung Hee Choi, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2002;26(5):431-442.   Published online October 1, 2002
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BACKGROUND
The prevalence of obesity is known to be lower in Asian population than that in Europe. But, the health risks associated with obesity occur at a lower body mass index (BMI) in Asian. The aim of this study was to assess the prevalence of the metabolic syndrome and its components in Korean adult population according to the new criteria for obesity proposed in Asia-Pacific Perspective. METHODS: From individuls, who participated in medical check-up of Korean Association of Health (KAH), 1,230 individuals were included in the analysis. In patients with type 2 diabetes (n=131), subjects with impaired fasting glucose (IFG) (n=84), or individuals who have insulin-resistance but show normal fasting glucose (NFG) (n=1015), the metabolic syndrome was defined as presence of at least two of the following components; hypertension, dyslipidemia, and obesity. RESULTS: Metabolic syndrome was present in 19% of men and 16% of women. In detail, about 10% in NFG, 50% in IFG, and 70% of patients with type 2 diabetes fulfilled the criteria of metabolic syndrome. In comparison with the lowest tertile of waist circumference and BMI, the prevalence of the metabolic syndrome increased about 13 fold in subjects with the highest tertile. Using a multiple regression analysis, HOMA-IR was associated with an increased risk for the metabolic syndrome (RR=2.23, p=0.001). CONCLUSION: The metabolic syndrome, according to the new criteria for obesity in Asian-Pacific Perspective in Korean adult population, is seen as much as Western countries. Insulin resistance and hyperinsulinemia can be suggested as the main causes of the metabolic syndrome.
Insulin Resistance and severity of coronary artery diseases in Patients with Coronary Artery Diseases.
Dae Jung Kim, Jae Hyun Nam, Dong Hoon Choi, Hyeung Jin Kim, Soo Kyung Kim, Se Hwa Kim, Yumie Rhee, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyeong Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2002;26(3):189-198.   Published online June 1, 2002
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BACKGROUND
Insulin resistance (IR) has been identified as a risk factor of atherosclerosis, which may be induced through a mechanism brought about by hypertension, obesity, glucose intolerance and dyslipidemia. The purpose of this study was to investigate the relationship between coronary artery disease (CAD) and insulin resistance. METHODS: Of 92 subjects having undergone coronary angiography 70 with significantly stenotic coronary artery were designated as the CAD group, with the other 22, without stenosis, as the control group. The CAD group was subdivided into 3 smaller groups according to the severity of their CAD; these being 1-vessel disease (group 1, n=31), 2-vessel disease (group 2, n=25), and 3-vessel disease (group 3, n=14). RESULTS: Kitt for patients with CAD was significantly lower than in the control group, and also for those in group 1 compared to groups 2 and 3, 2.72+/-1.29, 2.25+/-0.68 and 2.21+/-0.78%/min, with that of the controls being 3.01+/-1.22%/min p<0.05). There were significant differences between the IR group and the non-IR group in the common carotid artery intima-media thickness (1.09mm vs. 0.87mm, p<0.05), the waist-hip ratio (1.09 vs. 0.93, p<0.05) and the body fat contents (32% vs. 27%, p<0.05).Insulin resistance was assessed by the short insulin tolerance test, and the insulin resistance (IR) group was defined as having a Kitt less than 2.5%/min. CONCLUSION: These results suggest that insulin resistance is an important risk factor for CAD, and is related to the severity of coronary atherosclerosis.
Therapeutic Effect of Recombinant Human Erythropoietin on Anemia with Erythropoietin Deficiency in Early Diabetic Nephropathy.
Dae Jung Kim, Soo Kyung Kim, Hyeung Jin Kim, Yoo Mee Kim, Yong Seok Yun, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyeong Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2001;25(5):364-373.   Published online October 1, 2001
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BACKGROUND
We have previously reported that reduced erythropoietin (Epo) responsiveness to anemia could explain the anemia in diabetic patients before advanced diabetic nephropathy. Thus, the aim of this randomized prospective study is to investigate the therapeutic effect of recombinant human erythropoietin (rHuEpo) on anemia with Epo deficiency in early diabetic nephropathy. METHODS: Twenty-nine diabetic patients with the normocytic normochromic anemia of Epo deficiency were randomized into Epo-treatment group (n=20, M:F= 8:12, mean age=52.9+/-9.2) and control group (n=9, M:F=4:5, mean age=53.6+/-12.4). Twenty patients of Epo-treatment group were treated with rHuEpo (Epokine (CheilJedang Co.) 4,000unit/day SC., 3 times/week) for 8 weeks. The Epo- treatment group were divided into the responder or non-responder. Patients with increments in Hemoglobin (Hb) during the follow-up duration was above 2 g/dL, or with the final Hb was above 14 g/dL in men or 13g/dL in women were decided the responder. In order to analyze factors affecting the therapeutic effects of rHuEpo, the clinical and biochemical characteristics were compared between the responder and non-responder group. RESULTS: There was no difference in the clinical and biochemical characteristics between the Epo-treatment and the control group at randomization. The responder group (n=14) had significant increments in Hb, compared to the non-responder group (n=6) or the control group (13.6+/-1.0 vs. 10.1+/-1.5 vs 11.2+/-1.2 g/dL, p < 0.001, respectively). The treatment duration of rHuEpo in the responder group was 4.9+/-2.3 weeks. Among the Epo-treatment group, there was no differences between the responder and the non-responder group in sex, age, duration of diabetes, serum creatinine level, 24 hour urinary albumin excretion rates, HbA1C, frequency or severity of microangiopathy, and serum Epo level. However, the responder group had higher serum ferritin (240.3+/-108.4 vs 25.8+/-3.0 g/L, p<0.05) and transferin saturation level (32.7+/-7.9 vs 21.2+/-5.3 %, p<0.05). CONCLUSION: These results concluded that the administration of rHuEpo could be useful in treating anemia with Epo deficiency in early diabetic nephropathy and that the degree of iron storage and functional iron deficiency might affect the therapeutic effects of rHuEpo on this type of anemia.
Atherosclerotic Severity and Risk Factors in Type 2 Diabetic Patients with Visceral (Metabolic) Obesity in Korea.
Jae Hyun Nam, Suk Won Park, Chul Woo Ahn, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2001;25(1):20-34.   Published online February 1, 2001
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BACKGROUND
Type 2 diabetes with hypertension and dyslipidemia are frequently associated with metabolic obesity. It is proposed that such individuals might be characterized by increased insulin resistance and visceral fat, and that macrovascular complications might be more common in these individuals. Thereofer, the aim of this study was to investigate the atherosclerotic severity and risk factors in type 2 diabetic patients with metabolic obesity (MO) in Korea. METHODS: Coronary artery calcification (CAC) score, intima-media thickness (IMT) of common carotid artery, and ankle-brachial pressure index (ABPI) were measured. Insulin sensitivity index (ISI) was also measured by the plasma glucose disappearance rate (kitt: %/min). RESULTS: 1. Among 530 type 2 diabetes mellitus (DM) patients, the percent of under-weight (UW), normal-weight (NW), over-weight (OW) and obese (OB) (BMI< 20, 20-25, 25-29.9 and >30, respectively) were 8.9%, 62.1%, 25.1% and 3.9%, respectively. Waist-hip ratio and systolic blood pressure (sBP) were significantly different among the groups according to BMI. Serum triglyceride (TG), HDL-C, free fatty acid (fFA), fibrinogen and fasting c-peptide were significantly different among the groups. The percents of patients with insulin resistance in UW, NW, OW and OB groups were 28%, 60%, 68% and 75%, respectively. The visceral fat area/subcutaneous fat area ratio and visceral fat area/thigh muscle area ratio were significantly increased according to ISI. 2. The patients with MO have above the median values of WHR (0.95 in men and 0.91 in women). sBP, TG, HDL-C, fFA,fibrinogen and ISI were significantly different between the patients with MO and the patients without MO. 3. In OW group as well as NW group, carotid IMT, ABPI and CAC score were significantly different between the patients with MO and the patients without MO. However, these were not different between NW group and OW group. CONCLUSION: In conclusion, this study suggest that patients with MO have more advanced atherosclerosis and aggravated risk profiles for atherosclerosis than those without MO, regardless of BMI.
Limitation of Validity of Homeostasis Model Assessment as a Index of Insulin Resistance.
Yong Seok Yun, Seok Won Park, Young Duk Song, Hyo Kyung Park, Oh Yoen Kim, Chul Woo Ahn, Jae Hyun Nam, Su Youn Nam, Bong Soo Cha, Chong Ho Lee, Sumg Gil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2000;24(5):541-551.   Published online January 1, 2001
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AbstractAbstract
BACKGROUND
Homeostasis model assessment of insulin resistance (HOMAIR) had been proposed as a simple and inexpensive alternative to other complex procedures measuring insulin resistance. We evaluated the validity of HOMAIR, comparing to total glucose disposal rate measured by euglycemic clamp test in 63 subjects with normal glucose tolerance, 21 with impaired glucose tolerance and 47 with type 2 DM. METHODS: HOMAIR and HOMA cell function (Homeostasis model assessment of cell function) were calculated with formula described by Matthews [HOMAIR: fasting insulin ( U/mL) X fasting glucose (mmol/L) / 22.5, HOMA cell function: 20 X fasting insulin ( U/mL) / (fasting glucose (mmol/L) - 3.5)]. 2-hour euglycemic (5 mmol/L) hyper insulinemic (717 pmol/L) clamp test were carried out. RESULTS: The strong inverse correlation (r=-0.658, <0.001) was shown between log transformed HOMAIR and total glucose disposal rates. The agreement of two methodes in the categorization according to insulin resistance was moderate (weighed kappa=0.45). The magnitude of correlation coefficients were smaller in subjects with lower BMI (BMI < 23.7 kg/m2, r = -0.441 vs BMI > or = 23.7 kg/m2, r = -0.693, p = 0.0183), lower HOMA cell function (HOMA cell function < 57.2, r = -0.514 vs HOMA cell function > or = 57.2, r = -0.773, p = 0.0091) and higher fasting glucose levels (fasting glucose < 102 mg/dL, r = -0.697 vs fasting glucose > or = 102 mg/dL, r = -0.59, p = 0.0735). The results of correlation analysis was not significant in diabetics with lower BMI. CONCLUSION: Limitation of validity of HOMAIR should be carefully considered in subjects with lower BMI and lower fasting insulin to glucose levels, such as lean type 2 diabetes with insulin secretory defects.
The Role of beta-cell Dysfunction and Insulin Resistance in the Development of Post-renal Transplantation Diabetes Mellitus.
Jae Hyun Nam, Hyun Chul Lee, Churl Woo Ahn, Jang Il Mun, Soon Il Kim, Kiil Park, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Kap Bum Huh
Korean Diabetes J. 2000;24(4):485-514.   Published online January 1, 2001
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BACKGROUND
Our study was undertaken to investigate the pathogenesis and possible risk factors for post-renal transplantation diabetes mellitus (PTDM). METHODS: we recruited 114 patients with normal glucose tolerance, and performed the 75 g oral glucose tolerance tests (OGTT) and the short insulin tolerance tests 1 week before and 9~12 months after transplantation, respectively. RESULTS: The subjects were classified into three groups on the basis of OGTT after transplantation by WHO criteria: 1) 36 (31.6%) subjects with normal glucose tolerance; 2) 51 (45.7%) subjects with impaired glucose tolerance; and 3) 27 (23.7%) subjects with post-renal transplantation diabetes mellitus. Dosages of steroid and cyclosporin-A (CsA) were equivalent among the 3 groups. Before transplantation, the fasting and 2-h plasma glucose, and proinsulin/insulin (PI/I) ratios were significantly higher in the IGT and PTDM groups than in the NGT group, but insulin sensitivity index (ISI) was not different among 3 groups. In addition, the area under the curve (AUC)-insulin on OGTT was significantly lower in the PTDM group than in the NGT group. After transplantation, however, ISI was increased in all groups. Furthermore, the ISI and PI/I ratios revealed significantly higher values in the PTDM group than in the NGT group after transplantation. CONCLUSION: These results revealed that fasting and 2-h plasma glucose levels, as well as proinsulin/insulin ratio before transplantation, which may all be indicators of beta-cell dysfunction, could be the predictors for the development of PTDM and beta-cell dysfunction rather than insulin resistance was proved to be the main factor for the pathogenesis of PTDM.
A Case of Bartter's Syndrome occurring in Diabetes Mellitus.
Jang Yel Shin, Jeung Rae Cho, Do Young Kim, Joon Kye Lee, Chul Woo Ahn, Jae Hyun Nam, Soo Yon Nam, Young Duk Song, Kyu Hun Choi, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Jai Ho Han, Heun Ju Jung
Korean Diabetes J. 2000;24(1):90-96.   Published online January 1, 2001
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Bartter's syndrome is characterized by hypokalemia, metabolic alkalosis, hyperreninemia and secondary hyperaldosteronism without hypertension and edema, Histologically, existing hyperplasia of the juxtaglomerular cell occurs mostly in childhood or adolescence, and initial presentation in patients over 40 years old of age is very rare. It has been recorded that Bartter's syndrome is associated with glucose intolerance, but not with overt diabetes mellitus. Whether this association is coincidental or causal is uncertain, although hypokalemia can cause glucose intolerance. We experienced a case of Bartters syndrome in 44 years old non-insulin dependent diabetic woman. She improved with potassium supplements along with combination of prostaglandin synthetase inhibitor and aldosterona antagonist. We report present case with the review of literature.
The Combined Effects of Protein Malnutrition and Chronic Alcohol lntake on lnsulin Secretion and Sensitivity in Growing Rats.
Bong Soo Cha, Chul Woo Ahn, Hae II Lee, Yong Seok Yoon, Jae Kyeung Sung, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 2000;24(1):19-36.   Published online January 1, 2001
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BACKGROUND
This investigation was performed to examine the combined effects of protein malnutrition and chronic moderate amount of alcohol intake on insulin secretory capacity and sensitivity in growing rats. METHODS: Weanling 4-week-old male Sprague-Dawley rats were fed low protein [5%, (wt/wt)] or control (C, 20%) diet from 4 to 12 weeks and alcohol (5g/kg/d) or saline gavage from 8 to 12 weeks. All rats were divided into the 4 groups according to different diet protocols: group 1 (protein-deficient alcohol rats), group II (protein-deficient saline rats), group III (protein-sufficient alcohol rats), and group IV (protein-sufficient saline or control rats), At the age of 12 weeks, we determined the insulin secretory capacity and sensitivity in the 4 different diet groups. RESULTS: The results are summarized as following: 1. Normal weight gain was nearly completely arrested in protein-deficient rats compared to control rats. In protein-sufficient rats, chronic alcohol intake decreased body weight gain. Pancreatic weight adjusted with body weight was not different among the 4 groups, but epididymal fat weight adjusted with body weight was decreased in group II compared to group IV. 2. Intraperitoneal glucose tolerance was improved in group I compared to the other groups. Insulin responses to glucose challenge were markedly decreased in group II compared to group IV, but not in group l. 3. Glucose disposal rate during euglycemic clamp test was diminished in group II compared to qroup IV, but there were no differences between group I and group I 3. Glycogen synthase activities of skeletal muscle after 2 hour hyperinsulinemic state were not different among the 4 groups. 4. There were no differences of reserved insulin content of whole pancreas adjusted with pancreas weight among the 4 groups. 5. In light microscopic findings of pancreatic islets, sizes of islets, islet cells and nuclei were decreased in protein-deficlent rats compared to control rats. However, the sizes of islet cells and nuclei were further decreased in group II compared to group l. CONCLUSION: These results suggest that impaired insulin secretion and decreased insulin sensitivity due to protein malnutrition can be restored by chronic, moderate amount of alcohol intake, but these beneficial effects may not be appeared in protein-sufficient state. Therefore, the chronic alcohol intake differently influences glucose metabolism according to individual nutritional status, and further studies for the effects of alcohol intake in lean diabetic patients are required to extrapolate these resuits in human.
Role of Nitric Oxide on the Insulin Secretion of Rat Pancreas.
Moon Suk Nam, Sung Ki Kim, Seong Bin Hong, Yeo Joo Kim, Mi Rim Kim, Yong Seong Kim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1999;23(6):748-756.   Published online January 1, 2001
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BACKGROUND
Diabetes mellitus could occur when insulin secretion of pancreas is inadequate in response to blood glucose. The mechanisms on failure of pancreatic beta cell are still not known. Several recent experiments have reported that nitric oxide (NO) may be considered as a modulator of insulin secretion and impairment associated with the beta cell. The present study was purposed to investigate the role of nitric oxide on the secretion of insulin of rat pancreas in vivo and in vitro. METHODS: The plasma insulin and glucose were measured after intravenous injection of nitric oxide synthase (NOS) inhibitor (NG-nitro-L-arginine methyl. ester, L-NAME) in male rat. Insulin release was determmed during stimulation of NOS inhibitor and nitric oxide donor (hydroxylamine) in the isolated pancreatic islets. RESULT: 1. The insulin secretory response with L-arginine stimulation after injection of NOS inhibitor (L-NAME) in rat was increased resulting in mild hypoglycemia which recovered promptly. This showed that NO were related with L-arginine induced insulin secretion. 2. After isolation of pancreatic islet, 11,0 mM glucose induced insulin release was increased in culture media and L-arginine (1.0 mM) induced insulin release was also increased compared with control (6.72+/-0.66 vs. 3.48+/-0.42 prnol/islet/hour, p<0.05). 3. L-arginine induced insulin release was increased with L-NAME in the isolated rat pancreatic islets (12.5+/-1.38 vs, 7.23+/-0.93 ng/islet/ hour, p<0.05). 4. Glucose induced insulin release was progressively inhibited by NO donor hydroxylamine in the isolated rat pancreas islet (6.72+/-0.75 vs. 2.46+/-0.60 pmol/islet/hour p<0.05). CONCLUSION: These results strongly suggest that nitric oxide is a negative modulator of insulin release in normal rats induced by the nutrient secretagogues L-arginine and glucose in vivo and in vitro. Further investigation on the mechanism of nitric oxide in insulin secretory pathway will be necessary.
Reduced Erythropoietin Responsiveness to Anemia in Diabetic Patients before Advanced Diabetic Nephropathy.
Yong Seok Yun, Sung Cheol Kim, Nae Chun Yoo, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Jee Sook Hahn, Kap Bum Huh
Korean Diabetes J. 1999;23(5):669-677.   Published online January 1, 2001
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BACKGROUND
We have often encountered some diabetie patients, in whom the causes of anemia were not clearly identified, despite differential hematologic studies. We, therefore, studied the clinical and biochemical characteristics of diabetic patients with anemia of uncertain cause. The study measured erythropoietin levels in diabetic subjects without significant diabetic renal disease. METHODS: Among 62 medical records of diabetic patients with anemia, showing no evidence of advanced diabetic nephropathy (creatinine clearance > 30 mL/min/1.73m2), the causes of the anemia were evaluated. In addition, we recruited 35 diabetic patients with uncertain causes of anemia, in order to evaluate the serum erythropoietin(Epo) responsiveness. Also, we compared their Epo levels to a group of non-diabetie subjects with similar degree of anemia. RESULT: The causes of anemia were not able to be identified in 28 (45.2 %) of 62 patients. The serum Epo levels of diabetic patients with anemia of uncertain cause (17.6+/-8.1), were significantly lower than those of non-diabetic patients with the same degree of decrease in hemoglobin levels (144.9+/-108.0 mIU/mL, p<0.001). The hemoglobin levels of diabetic patients were correlated with creatinine clearance (r=0.34, p=0.03), serum creatinine levels (r=-0.49, p=0.003), and albumin excretion rate (r=-0.44, p=0.009). But, showed no relation with age, duration of diabetes, glycated hemoglobin, presence of retinopathy or neuropathy. CONCLUSION: We concluded that reduced Epo responsiveness to anemia could explain the anemia present in diabetic patient but without advanced diabetic nephropathy. This may reflect early renal interstitial damage.
Floow-up Study of Clinical and Immunogenetic Chracteristics and Basal C-peptidein Korea Young Age Onset Diabetic Patients.
Hyun Chul Lee, Duk Hi Kim, Jae Hyun Nam, Chul Woo Ahn, Seong Kil Lim, Kap Bum Huh, Soo Yeon Nam, Seok Won Park, Young Deuk Song, Hyun Soo Kim, Jin Wook Kweon, Kyung Hee Chang, Kyung Rae Kim
Korean Diabetes J. 1999;23(3):288-298.   Published online January 1, 2001
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BACKGROUND
This study was undertaken to observe the changes of basal C-peptide level and to compare the clinical and immunogenetic characteristics in newly dignosed young age-onset diabetics in Korea. We studied predictors effecting the change of insulin secretory capacity in these patients. METHODS: 82 newly diagnosed young diabetic patients (mean age; 23.0+7.1, M:F=46:36) were divided into 3 groups according to the initial fasting serum C-peptide level (Classification I, group 1; C-peptide < 0.6 ng/mL, group 2; 0.6 ng/mL C-peptide <1.2 ng/mL, and group 3; 1.2 ng/mL C-peptide) and reclassified by the follow-up (mean follow-up; 3.7 year) fasting serum C-peptide level. RESULTS: According to the initial fasting serum C-peptide level, 17.1% (14/82) of the patients were classified as group 1, 35.4% (29/82) as group 2, and 47.5%(39/82) as group 3. In group 3, body mass index (BMI, p<0.01) and maximal BMI (p<0.01) at onset, family history of diabetes (p=0.01) and stimulated C-peptide increment were significantly higher than those in group 1 and 2. Presence of urine ketone (p<0.01), history of diabetic keto- acidosis (p<0.01), and frequency of insulin therapy at diagnosis (p<0.01) were significantly lower than those in group 1 and 2. No significant differences in onset age, sex, weight loss at onset, HbA1c, anti GAD antibody and HLA-DR were found among the 3 groups. After certain follow-up periods, 37.8% (31/82) of the patients were reclassified as group 1, 24.4% (20/82) as group 2, and 37.8% (31/82) as group 3 according to the follow-up fasting serum C-peptide level(classification II). All of the patients in group 1 in classification I were reclassified as group 1 in classification II. In group 2, 44.8% were reclassified as group 1 and 17.3% were reclassified in group 3. In group 3, 15.4% (6/39) of patients showed a significant decrease in insulin secretory capacity and were reclassified as type I diabetes, and their predictors for decreased insulin secretory capacity were low BMI at onset, low slimulated C-peptide increment, and antiGAD antibody. CONCLUSION: Our study showed that classification of newly diagnosed young diabetics by fasting C-peptide level is not always easy. Therefore follow-up measurement of C-peptide and consideration of clinical characteristics are needed in discriminating the type of diabetes in these groups of diabetics in Korea.
Associations of Carotid Intinma-Media Thickness Measured by High Resolution B-mode Ultrasonography and Atherosclerotic Risk Factors in NIDDM Patients.
Hyun Chul Lee, Jae Hyun Nam, Seong Kil Lim, Kap Bum Huh, Kyeong Rae Kim, Soo Yeon Nam, Seok Won Park, Churl Woo Ahn, Young Deuk Song, Dae Jung Kim, Young Guk Ko
Korean Diabetes J. 1999;23(3):234-242.   Published online January 1, 2001
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BACKGROUND
Atherosclerosis is more prevalent in diabetic patients, severe and wide spread than in non-diabetic subjects and clinically evident as macrovascular diseases such as coronary, cerebro- vascular and peripheral arterial diseases which are important causes of frequent morbidity and premature mortality. But atherosclerotic vascular lesions are not easily detectable, before they advanced and cause symptoms. Measurement of carotid Intima-Media thickness(IMT) by high- resolution B-mode ultrasonography is a useful, non-invasive method to detect early atherosclerotic vascular changes. In this study, we investigated associations of IMT with cardiovascular risk factors. METHODS: High-resolution B-mode ultrasonography was performed in 63 non-insulin-dependent diabetic patients in order to determine maximal and mean carotid IMT. Blood pressure, glucose, HbA total cholesterol, HDL cholesterol and triglyceride levels were measured on a regular basis in the last 12 months before the carotid ultrasonography. The mean and last values at the time of the carotid ultrasonography were analyzed in relationship to the IMT. RESULTS: Carotid IMT was increased in NIDDM patients with male sex, smoking habit and hypertension. Systolic blood pressure (r=0.252, p=0.050) and LDL cholesterol levels (r=0.273, p=0.031) at the time of carotid ultrasonography showed a correlation with the IMT. Mean triglyceride (r=0.368, p=0.018) and HbA1c>, levels (r=0.288, p=0.045) of the last 12 months were correlated with the IMT. CONCLUSION: Increased carotid IMT was associated with male sex, smoking, hypertension, systolic blood pressure, LDL cholesterol, mean HbA, and triglyceride levels.
A Case of Insulin Dependent Diabetes Mellitus with MELAS Syndrome Associated with a Mutation of Mitochondrial DNA.
Min Ho Choi, Hyun Mi Rhim, Ki Won Oh, Moo Il Kang, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1999;23(2):207-214.   Published online January 1, 2001
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Mitochondrial mutations are associated with a wide range of disorders (Kearns-Sayre and chronic progressive external ophthalmoplegia syndromes, Myoclonic epilepsy and ragged-red fibre disease, Mitoehondrial encephalomyopathy, lactic acidosis, and stroke-like episodes, Leighs disease ancl cerebellar ataxia plus pigmentary retinopathy syndromes), which is inherited maternally. A-to-G mutation at nuclcotide position 3243 was originally identified in MEI.AS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes) and accounted for about 80% of the MELAS cases, Recently, this mutation was reported in maternally inherited NIDDM patients. It was also repoded that approximatedly 1% of diabetic patients have this mutation. We performed the molecular genetic analysis of mtDNA in one female insulin dependent diabetic patient with MELAS syndrome and her family members, and also confirmed the A-to-G mutation at nucleotide 3243 of the mtRNA Leu(UUR) gene in their family members.
Risk Factors for Peripheral Arterial Disease as Screened by Plethysmography in Patients with NIDDM.
Hyuk Jae Chang, Dae Jung Kim, Byoung Joo Choi, Young Guk Ko, Churl Woo Ahn, Dong Ryeol Ryu, Yong Seok Yun, Seol Hye Han, Jae Hyun Nam, Seok Won Park, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Won Heum Shim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1999;23(2):172-181.   Published online January 1, 2001
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BACKGROUND
Peripheral arterial disease (PAD) is one of the clinical manifestations of the atherosclerotic disease process. Early onset and rapid progression of PAD in diabetic patients has been well documented. PAD in diabetic patients has also been associated with an increased risk for total and cardiovascular mortality. Plethysmography is a noninvasive test to screen for the presence of PAD. Thus the aim of this study is to assess the risk factors for PAD screened by plethysmography in NII)DM patients. METHODS: A total of 289 NIDDM patients who undlerwent plethysmography were entered into our annlysis. Clinical characteristics of 38 patients with an ankle-brachial index of <0.9 (group B) were conapared with those of 231 patients with an ankle-brachial index of >1.0 (group A). RESULTS: Abnormalities in plethysmographic findings were found in 45.7% of diabetic patients. Age, duration of diabetes, hypertension, smoking, previous history of vascular diseases, HDL cholesterol, TC/HDL, and LDL/HDL appeared to be factors significantly related to PAD. Fasting sugar, HbAlc, total cholesterol, LDL cholestero1, trigly ceride, fibrinogen, lipoprotein(a), and waist-hip ratio were not significantly different between the two groups. The multiple logistic regression analysis showed the signficant contribution of the previous history of vascular disease (p=0.0028) and age (p-0.0115) to PAD in diabetic patients. CONCLUSION: The prevalence of PAD defined by plethysmography in our subjects was 45.7% higher than expected, suggests that efforts for early detection and prevention of PAD should be emphasized in diabetic patients.
Pathogenetic Heterogeneity of Type 2 Diabetes Mellitus in Korea.
Seok Won Park, Yong Seok Yun, Young Duk Song, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1999;23(1):62-69.   Published online January 1, 2001
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BACKGROUND
Insulin resistance and insulin sec- retory dysfunction are considered as pathogenetic meehanisms leading to type 2 diabetes mellitus. In Korea, clinical features of type 2 diabetes are quite different from those of western countries. There are many non-obese patients and some even experienced considerable weight 1oss around the onset of diabetes mellitus. We investigated the insulin secretory function and in vivo insulin sensitivity in Korean patients with type 2 diabetes. METHODS: 38 patients with type 2 diabetes mellitus (age; 47.3+/-9.1 yrs) and 30 control subjects (age; 25.72.7 yrs) were included in this study. Type 2 diabetic subjects were further divided into obese (BMI >25, n=13) and non-obese (BMI<25, n=25) groups. Insulin secretory responses to the 75g aal gluxse loading and euglycemic hyperinsulinemic clamp test were performed on all subjects. RESULTS: Type 2 diabetic subjects had significantly lower serum insulin levels at 30 min of OGTT, regardless of their obesity, compared to the control subjects. Mean glucose disposal rates (M-values) were decreased by 36% in non-obese type 2 diabetic subjects and 58% in obese type 2 diahetic subjects compared to the control subjects. But, about half (12/25) of non-obese type 2 diabetic subjects and 30% (4/13) of obese type 2 diabetic subjects had normal insulin sensitivity, defined by 95% confidence interval of control subjects. Insulin sensitivity index (M-value) was correlated with BMI, WHR, fasting insulin, and HDL-cholesterol concentrations in type 2 diabetic subjects. CONCLUSION: In Korean type 2 diabetic subjects, impairment of early-phase insulin secretion may be an universal finding, but insulin resistance is observed in about 60% of subjects. This result suggest that there is pathogenetic heterogeneity of type 2 diabetes rnellitus in Korea.
Insulin Resistance and Related Factors in the Healthy Young Men.
Seok Won Park, Yoon Sok Chung, Yong Seok Yun, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1998;22(4):504-512.   Published online January 1, 2001
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BACKGROUND
Resistance to insulin-stimulated glucose uptake is present in the majority of patients with obesity, glucose intolerance, hypertension, dyslipidemia, and coronary artery disease. It is known that values for insulin-stimulated glucose uptake(insulin sensitivity) vary widely within individuals with normal glucose tolerance. We investigated the variations in insulin sensitivity and related factors in the nonobese healthy young men. METHODS: Insulin sensitivity was considered as whole body insulin-stimulated glucose uptake rate(M), determined by euglycemic hyperinsulinemic clamp technique in 44 non-obese healthy young men with normal glucose tolerance. Plasma glucose, insulin, and C-peptide concentrations after a standard oral glucose tolerance test and total cholesterol, triglyceride, and HDL-cholesterol levels were measured after 12-hours fasting. The subjects were divided into four quartiles based on the insulin sensitivity (M) and their clinical and biochemical characteristics were compared. RESULTS: Glucose disposal rates (M-values) were ranged from 4.14 to 11.06 mg/kg/min and distributed normally. The plasma glucose levels were not different between quartiles but plasma insulin levels of quartile 1 were significantly higher than the other three quartiles during oral glucose tolerance test. There was a curvilinear relationship between insulin sensitivity and acute insulin response (Ins[o-30]) to oral glucose challenge. There were negative cnrrelations between insulin sensitivity and BMI, percent ideal body weight, WHR, body fat content, fasting insulin level, insulin response area during OGTT, and fasting serum triglyceride level. HDL-cholesterol concentration was positively correlated with insulin sensitivity. In multiple linear regression analysis, body fat content, fasting insulin, and HDL-cholesterol were independent variables, which were related to the insulin sensitivity. CONCLUSION: There were considerable variations in insulin sensitivity in the nonobese healthy young men with normal glucose tolerance and the related independent factors were body fat content, fasting insulin, and HDL-cholesterol cancentrations.
Insulin Gene Polymorphisms in non-insulin-dependent Diabetes Mellitus ( NIDDM ) in Korean.
Jin Suk Kwon, Seok Won Park, Bong Soo Cha, Young Duk Song, Churl Woo Ahn, Keun Soo Jang, Soo Jin Kim, Seung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1998;22(4):442-449.   Published online January 1, 2001
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BACKGROUND
Many epidemiologic and family studies indicated stronger influence of genetic factors in NiDDM compared to IDDM, and there has been investigations to identify the susceptibility genes but without definite results. Insulin gene with its regulator region has been considered as a possible candidate gene of NIDDM because of relative deficiency in insulin secretion. So, we investigated the possible relationship between insulin gene polymorphisms and NIDDM in Korean. METHODS: we investigated -23 Hph I and +1,127 Pst I restriction site on insulin gene region in 67 NIDDM patients and 33 healthy controls by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) method, and compared the allelic frequencies. We also compared the insulin secretory capacity, degree of blood glucose control, and family history of diabetes mellitus according to insulin gene polymorphism. RESULTS: l. Insulin gene polymorphism on -23 Hph I restriction site or +1,127 Pst I restrietion site does not confer susceptibility to NIDDM in Korea, 2. No differences were observed in onset age, family history of diabetes mellitus, insulin secretory capacity, and degree of blood glucose control, according to insulin gene polymorphism. CONCLUSION: Insulin gene polymorphism on Hph I site and Pst I site probably does not play an important role in the pathogenesis of NIDDM in Korean population.
Comparison of the New Diagnostic Criteria for Diabetes Mellitus Recommended by the Expert Committee of the American Diabetes Association with the Criteria by the NDDG or WHO in Koreans with Fasting Plasma Glucose between 110 and 139 mg / dL.
Yeo Joo Kim, Moon Suk Nam, Mi Rim Kim, Yong Seong Kim, Kwan Woo Lee, Hyeon Man Kim, Choon Hee Chung, Su Youn Nam, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Sam Kweon, Yong Wook Cho, Kap Bum Huh
Korean Diabetes J. 1998;22(2):209-217.   Published online January 1, 2001
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BACKGROUND
The current diagnostic criteria for diabetes mellitus announced by National Diabetes Data Group(NDDG) in 1979 were revised by Expert Committee of World Health Organization(WHO) in both 1980 and 1985. However, according to advancement in the knowledge of the etiology and pathogenesis of diabetes mellitus, the International Expert Committee working under the sponsorship of the American Diabetes Association(ADA) decided to adopt the resolution proposing that the criteria of fasting glucose level applied to diagnosis of diabetes mellitus should be lowered at the 57 ADA conference held in Boston, USA in June 1997(97 ADA). Hereupon, by comparing the diagnostic criteria of the former (NDDG/WHO) with the later, the authors have examined the usefulness of new diaignostic criteria, 97 ADA. METHOD: We collected the data from 13 university hospitals in Korea which contain the results of 75 gram oral glucose tolerance test(OGTT) for 532 Kareans between 110 and 139 mg/dL in fasting plasma glucose. We have then evaluated the results by classifying and comparing them in accordance with the criteria of NDDG/WHO and 97 ADA, respectively. RESULTS: 1. The number which tested for oral glucose tolerance was 532 and the majority of tests have been carried out between 110 and 119 mg/dL in fasting plasma glucose. 2. When we have classified the same results of OGTT by respective diagnostic criteria of NDDG/ WHO and 97 ADA, the NDDG/WHO have diagnosed 50.4%(268/532) of the total number of people as diabetes mellitus, while the '97 ADA has shown that only 33.1%(176/532) of it corresponded to the same diagnosis. On the other hand, the diagnosis rate of impaired fasting glucose(IFG) or impaired glucose tolerance(IGT) has shown 28.8~ 31.8%(NDDG/ WHO) and 66.9%(97 ADA), respectively. 3. Following the diagnostic criteria of the 97 ADA, we have separated the results into two groups which were above and below 126 mg/dL in fasting glucose. In addition, when we have again classified two groups by the criteria of the NDDG/WHO, the group above 126mg/dL in fasting glucose, which was all diagnosed as diabetes mellitus in 97 ADA has represented a ratio of 72.2%(127/176) in same diagnosis. However, within the group below 126mg/ dL, in fasting glucose being classitied as IFG in the 97 ADA, its diagnosis rate of diabetes mellitus has also shown 39.7%(141/356) applying to the criteria of the NDDG/WHO. CONCLUSION: The criteria of the 97 ADA can simply make a diagnosis of diabetes mellitus with fasting plasma glucose and additionally fmd out the IFG whose rate is 17.9 20% regarded as a normal condition by NDDG/WHO, whereas the existing criteria of the NDDG/WHO have to carry out the OGTT which is difficult in clinics. However, since among the patients ot 50.4% diagnosed as diabetes mellitus by NDDG/WHO, the 97 ADA classifies 17.3% of them as IFG, it is regarded that the need of OGTT for the diagnosis of diabetes mellitus can not be passed over in the future.
Short Insulin Tolerance Test(SITT) for the Determination of in vivo Insulin Sensitivity-A Comparison with Euglycemic Clamp Test.
Seok Won Park, Yong Seok Yun, Churl Woo Ahn, Jae Hyun Nam, Suk Ho Kwon, Min Kyung Song, Seol Hye Han, Bong Soo Cha, Young Duk Son, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1998;22(2):199-208.   Published online January 1, 2001
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BACKGROUND
The euglycemic hyperinsulinemic clamp technique is currently regarded as gold standard for measuring insulin sensitivity, but it requires sophisticated equipment and highly trained personnel. We investigated the reliability of short insulin tolerance test as a simple tesl to measure in vivo insulin sensitivity. METHODS: Short insulin tolerance test(SITT) and euglyeemic hyperinsulinemic clamp test were performed at random order in 14 healthy subjects and 10 abnormal glucose tolerant subjects. The plasma glucose disappearance rate(kitt: %/min) after iv injection of regular insulin(0.1U/kg) was determinecl and compared to insulin sensitivitv indices(M, M/I) of euglycemic hyperinsulinemic clamp test. RESULTS: The mean Kitt value of healthy subjects was 3.50+0.75%/min and that of subjects with abnormal glucose tolerance was 2.56+0.56%/min. Changing sampling time from 15 min to 18~21 min and sampling interval from 3 min to 1.5 min had no influence on Kitt value. Kitt values were reproducible in six subjects, with a CV of 8.8+2.0%. There was a highly significant correlations between the Kitt value derived from SITT and M or M/I derived from euglycemic hyperinsulinemic clamp test. There were no significant adverse effects including hypoglycemic symptom while performing SITT. CONCLUSION: SITT is simple, safe, rapid to perform, and provides reliable index of in vivo insulin sensitivity. It seems particularly suitable for studies involving large series of subjects or including repeated evaluation of insulin sensitivity.
Visceral Fat Accumulation and the Fatty Acid Composition of Serum Phospholipids in Middle-Aged Women with Different Degrees of Glucose Tolerance.
Jee Young Yoon, Jong Ho Lee, Yang Cha Lee, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1997;21(4):444-456.   Published online January 1, 2001
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BACKGROUND
The aim of this study was to determine visceral fat accumulation and the fatty acid composition of serum phospholipids(PL) in middleaged female volunteers with different degrees of glucose tolerance and to analyze the factors that could be responsible for the observed differences between different degrees of glucose tolerance. METHODS: Anthropometric measurements and computed tomography measurements at umbilicus and thigh midway between the patella and pubis were performed in 125 subjects with normal glucose tolerance(NGT), 62 subjects with impaired glucose tolerance(IGT) and 50 subjects with non-insulin-dependent diabetes mellitus(NIDDM), Normal weight subjects were divided into 3 groups; NGT, IGT and long term NIDDM and overweight subjects into 4 groups; NGT, IGT, newly-onset NIDDM and long-term NIDDM. An oral glucose tolerance test(OGTT), the fatty acid composition of serum PL, fasting serum levels of IGF-1 were determined. RESULTS: Visceral fat area and visceral to subcutaneous fat ratio were higher in overweight control than normal weight control and higher in long-term NIDDM groups than controls. Thigh fat and muscle areas and serum levels of growth hormone and IGF-1 were lower in long-term NIDDM groups than controls. Insulin response area during OGTT was the highest in IGT groups and the lowest in NIDDM groups. The progression from the NGT group to the NGT and NlDDM groups was associated with an increase in glucose and free fatty acid areas during OGTT. Overweight long-term NIDDM group showed the lowest serum level of IGF-1 and the highest areas of glucose and FFA. The low ratio(about 0.64.~0.71) of polyunsaturated to saturated fatty acids in serum PL was found in diabetic groups. Long-term NIDDM groups showed an increase in proportions of palrnitic (C16:0), stearic(C18:0), dihomo-r-linolenic(C20:3w6) and docosapentaenoic(C22:3w6) and and a decrease in linoleic(C18:2w6), a-linolenic(C18;3w3), C20:4/20:3 (5-desaturase activity) and C18:1/18:0(9-desa-turase activity) in their serum PL compared with NGT groups. CONCLUSION: This study suggests that an increase in visceral fat and a decrease in thigh fat and muscle may be related to reduced secretion of growth hormone and insulin in long-term NIDDM subjects, These endocrine perturbations can be exacerbated by the prolonged exposure of hyperglycemia and high serum level of free fatty acid. In addition, lang term NIDDM may decrease 5-desaturase activity and 9-desaturase activity. Thus, the factors regulating fatty acid composition of serum PL in long-term NIDDM are affected by not only dietary fat but stored fat and serum concentrations of glucose and hormones, including insulin.
Angiotensin 1 Converting Enzyme ( ACE ) Gene Polymorphism According to Micro- and Mocro - angiopathy in non-insulin Dependent Diabetes Mellitus.
Moon Suk Nam, Hyun Chul Lee, Ji Hyun Lee, Bong Soo Cha, Su Youn Nam, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Kap Bum Huh
Korean Diabetes J. 1997;21(4):397-405.   Published online January 1, 2001
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BACKGROUND
Chronic micro- and macro-angiopathy in diabetes are clinically significant complications that affect both quality and length of life in diabetic patients. Angiotensin 1 converting enzyme (ACE) is of key importance in regulating systemic and renal circulation by converting angiotensin-1 into -2 and inactivating bradykinin, Recent reports suggest that the ACE gene polymorphism is associated with susceptibility to micro- and macro-angiopathy in diabetes. But the results are diffetent according to the type of diabetes and complication. METHODS: We investigated the alleles of the ACE gene and measured the ACE activity in the 169 cases of non-insulin dependent diabetic patients and in the 95 cases of controls matched with age and BMI. RESULTS: The measured ACE activity was well correlated with the count of D allele. We found no differences of ACE alleles between in diabetes and control. No association was found between ACE gene polymorphism and diabetic microangiopathy(retinopathy or nephropathy). But DD genotypes (homozy-gotes for the deletion polymorphism) and D allele were found more frequently in diabetic patients with coronary artery obstructive diseases than in patients without coronary artery obstructive diseases in coronary angiography. CONCLUSION: These data indicate that ACE gene polymorphism in non-insulin dependent diabetes is associated with coronary artery obstructive diseases, but not with chronic microangiopathy.
A Case of Diabetic Muscle Infarction in a Patient with Insulin Dependent Diabetes Mellitus.
Joon Ho Jang, Jae Hyun Nam, Woong Chul Kang, Jung Il Jung, Suk Ho Kwon, Yong Suck Yoon, Bong Soo Cha, Young Joon Won, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1997;21(3):314-320.   Published online January 1, 2001
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Diabetic muscle infarction(DMI) is an uncommonly reported complicatian of diabetes mellitus, DMI tends to occur in younger, poorly controlled diabetic patients with other end organ complications(retinopathy, nephropathy, neuropathy). The typical feature of DMI is abrupt onset of thigh pain, tenderness, and swelling, over a period of days, and a firm mass develops. There are no associated systemic symptoms or signs indicative of infection and no skin discoloration suggestive of cellulitis or thrombophlebitis. The patient was diagnosed as DMI with the findings of ultrasonographic, bone scan and magnetic resonance imaging as well as typical clinical and laboratory findings. The painful mass persists for weeks, occasionally with exacerbation of symptoms, and then spontaneously resolves over several montks. Immobilization of the extremity with prolonged bed rest and strict sugar control has had beneficial results. We report a case of diabetic muscle infarction in a 30-year-old woman with insulin dependent diabetes mellitus
Thebeta3-adrenergic Receptor Gene Polymorphism in Non-Insulin Dependent Diabetes Mellitus.
Ji Hyun Lee, Hai Ri Li, Sang Won Lee, Su Youn Nam, Young Jun Won, Bong Soo Cha, Moon Suk Nam, Young Duk Song, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1997;21(2):130-137.   Published online January 1, 2001
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BACKGROUND
The B3-adrenergic receptor, located mainly in adipose tissue, is known to be involved in the regulation of lipolysis and thermogenesis. Recently studies have shown that the B3-adrenergic receptor gene polymorphism is associated with Non-Insulin Dependent Diabetes Mellitus(NIDDM) and insulin resistance. We investigated the relationship between the B3-adrenergic receptor gene polymorphism and the cli!ical and biochemical features of NIDDM patients. METHODS: Anthropometeric and biochemi al characteristics were determined for 134 NIDDM subjects and 30 nondiabetic controls. All subjects were genotyped for the 0-adrenergic receptor gene mutation using restriction fragment length polymorphism assay. RESULTS: The allelic frequency of the mutated allele was similar in NIDDM subjects and nondiabetic controls(11%, 12% respectively). There was no difference in the Arg64 allelic frequency of the B3-adrenergic receptor gene according to the onset age of diabetes. In diabetic group, the clinical and biochemical characteristics were not statistically different between the B3-adrenergic receptor gene mutation and nonmutation group. In control group, also no clinical differences were found between mutation and non-mutation group. When comparing frequency of obesity according to the B3-adrenergic receptor gene mutation in diabetic patients, we did not find the difference between the two groups. CONCLUSION: These results suggest that the b3-adrenergic receptor gene is not a major determinant for the development of obesity and NIDDM in Korea.
A case of insulinoma localized by endoscopic ultrasonography and intraoperative ultrasonography.
Jae Sik Cho, Kyeong Mi Lee, Eun Jig Lee, Kyung Rac Kim, Jae Bok Jng, Hyun Chul Le, Kap Bum Huh, Hee Dae Lee, Ki Hwang Kim, Ki Bum Lee
Korean Diabetes J. 1993;17(3):315-320.   Published online January 1, 2001
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AbstractAbstract PDF
No abstract available.
A clinical trial of celiprolol in type II diabetic patients with essential hypertension.
Seung Woo Park, Yoon Sok Chung, June O Park, Seog Won Park, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(3):307-313.   Published online January 1, 2001
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No abstract available.
The relationship between renin-aldosterone system and obesity in non-insulin dependent diabetes mellitus(NIDDM).
Kwang Jin Ahn, Yoon Sok Chung, Choon Hee Chung, Eun Jig Lee, Sung Kil Lim, Kyung Rac Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(3):283-291.   Published online January 1, 2001
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AbstractAbstract PDF
No abstract available.
Effects of w3 fatty acid supplementation on serum lipids in patients with non-insulin dependent diabetes mellitus.
Yoon Sok Chung, Seog Won Park, Jin Ahn Kim, Eun Jig Lee, Sung Kil Lim, Kyung Rac Kim, Hyun Chul Lee, Kap Bum Huh, In Kyoung Paik, Ji Young Yoon, Hee Son Kim, Hyun Jong Chang
Korean Diabetes J. 1993;17(3):267-274.   Published online January 1, 2001
  • 1,160 View
  • 17 Download
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No abstract available.
Type V hyperlipopropteinemia during acute pancreatitis in diabetic and recurrent pancreatitic patient.
Gil Jin Jang, Yoon Sok Chung, Dong Woon Jun, Seog Won Park, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(2):225-229.   Published online January 1, 2001
  • 839 View
  • 16 Download
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No abstract available.
Gastric emptying in diabetic patients and effect of cisapride.
Hyun Seung Shin, Yoon Sok Chung, Jae Hee Chung, Young Sik Lee, Seog Won Park, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(2):207-216.   Published online January 1, 2001
  • 931 View
  • 16 Download
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No abstract available.
Clinical Effect of cliostazol in non-insulin deptendent diabetic patients with peripheral vascular disease.
Yoon Sok Chung, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(1):111-117.   Published online January 1, 2001
  • 799 View
  • 17 Download
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No abstract available.
Effects of acipimox on lipid and glucose metabolism in NIDDM patients with concomitant hyperlipidemia.
Seog Won Park, Yoon Sok Chung, Hyun Seung Shin, Choon Hee Chung, Kwang Jin Ahn, Sung Kim Lim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(1):99-104.   Published online January 1, 2001
  • 910 View
  • 17 Download
AbstractAbstract PDF
No abstract available.
Clinical study of cilostazol in diabetic patients with peripheralvascular disease.
Tai Hee Lee, Young Kil Choi, Kap Bum Huh, Soon Hyun Shin, Hong Kyu Lee, Ho Young Son, Young Seol Kim, Hyun Chul Lee, Min Young Chung
Korean Diabetes J. 1992;16(4):325-334.   Published online January 1, 2001
  • 1,089 View
  • 23 Download
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No abstract available.
Effect of nutritional support on underweight non-insulin dependent diabetics.
Yoon Sok Chung, Hyun Chul Lee, Kap Bum Huh, Jong Ho Lee, In Kyung Paik, Mi Sook Choi, Soo Jae Moon, Seong Su Cheong
Korean Diabetes J. 1992;16(1):55-62.   Published online January 1, 2001
  • 882 View
  • 16 Download
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No abstract available.
Influence of body fat distribution onglucose tolerance and serum lipids in patients with non-insulin dependent diabetes mellitus.
Mi Sook Choi, Jong Ho Lee, In Kyoung Paik, Yoon Sok Chung, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1992;16(1):45-53.   Published online January 1, 2001
  • 763 View
  • 16 Download
AbstractAbstract PDF
No abstract available.
Influence of duration of diabetes on nutritional status in non-insulin dependent diabetes mellitus.
Mi Sook Choi, Jong Ho Lee, In Kyoung Paik, Kwang Jin Ahn, Yoon Sok Chung, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1992;16(1):35-44.   Published online January 1, 2001
  • 822 View
  • 16 Download
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No abstract available.
Is the pancreas of cytomegalovirus genome in type I diabetic Koreans significant?.
Yoon Sok Chung, Hyun Chul Lee, Kwang Jin Ahn, Eun Jig Lee, Seung Kil Lim, Kap Bum Huh, Dong Soo Kim, Duk Hi Kim, Jeong Im Lee
Korean Diabetes J. 1991;15(2):213-219.   Published online January 1, 2001
  • 1,079 View
  • 17 Download
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No abstract available.
Insulin secretory capacity of human fetal pancreas.
Hyun Chul Lee, Kwang Jin Ahn, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Kap Bum Huh
Korean Diabetes J. 1991;15(2):197-203.   Published online January 1, 2001
  • 859 View
  • 16 Download
AbstractAbstract PDF
No abstract available.
A follow-up study of diabetic retinopathy by fundus photography in diabetic patients.
Choon Hee Chung, Kwang Jin Ahn, Young Duk Song, Mi Rim Kim, Kawn Woo Lee, Seung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Seung Chul Lee, Oh Woong Kwon, Yong Wook Cho
Korean Diabetes J. 1991;15(1):91-101.   Published online January 1, 2001
  • 997 View
  • 16 Download
AbstractAbstract PDF
No abstract available.
The effect of interleukin-1 beta on isolated rat pancreatic islets.
Hyun Chul Lee, Kwang Jin Ahn, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Kap Bum Huh
Korean Diabetes J. 1991;15(1):73-78.   Published online January 1, 2001
  • 898 View
  • 16 Download
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No abstract available.

Diabetes Metab J : Diabetes & Metabolism Journal