- Relationship between Serum Homocysteine Levels and Vascular Complications in Type 2 Diabetic Patients.
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Seung Jin Choi, Jae Taek Kim, Yeon Sahng Oh, Soon Hyun Shinn
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Korean Diabetes J. 2002;26(2):112-125. Published online April 1, 2002
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 Abstract
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- BACKGROUND
Chronic complications in type 2 diabetic patients have microvascular and macrovascular components. Previous studies have shown that incidence of macrovascular complications correlates with the serum homocysteine levels, but the relationship is unclear. In addition, the connection between the microvascular complications and the serum homocysteine levels is still obscure and controversial. In this study, the relationship between the serum homocysteine levels and microvascular and macrovascular complications were evaluated in type 2 diabetic patients. METHODS: In 58 type 2 diabetic patients, the serum homocysteine levels, folic acid levels, Vit B12 levels, PAI-1 levels, the standard risk factors for macrovascular complications, the fasting serum glucose levels, the HbA1C levels, and the fasting insulin and C-peptide concentrations, the renal function tests, and the carotid intima-media thickness were measured and the relationship between them and the serum homocysteine level was analyzed according to the presence and absence of macrovascular and microvascular complications. RESULTS: 1) In type 2 diabetic patients, the mean serum homocysteine level was 9.9+/-.2 mol/L. The serum homocysteine level showed no relationship with the clinical and biochemical variables including the risk factors for atherosclerosis except the serum creatinine and creatinine clearance. 2) The maximum, minimum, and mean of the intima- media thickness of right carotid artery were 4.00+/-.20, 0.50+/-.04, 1.04+/-.62 mm, of left carotid artery were 3.54+/-.00, 0.31+/-.02, 1.03+/-.55 mm, and means were 3.77+/-.10, 0.44+/-.03, 1.03+/-.54 mm, and correlated with the serum homocysteine leve l (p=0.03), but only the serum LDL cholesterol level independently correlated with the intima-media thickness (p=0.04). 3) The serum homocysteine level (p=0.01) and intima-media thickness (p<0.01) was significantly higher in type 2 diabetic patients with macrovascular complications than without it. 4) The serum homocysteine level did not correlate with the incidence microvascular complications, but the intima-media thickness did correlate with diabetic nephropathy (p=0.03). CONCLUSIONS: The serum homocysteine level did not correlated with the incidence of diabetic microvascular complications. However, there was a small correlation with the risk factors of macrovascular complications. The intima- media thickness correlated with the incidence of macrovascular complications, and the relationship with diabetic nephropathy requires further study.
- Interleukin-6 polymorphism in Korean Obese and Type 2 Diabetic Subjects.
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Jae Taek Kim, Seung Jin Choi, Mi Kyung Lee, Ae Ja Park, Yeon Sahng Oh, Soon Hyun Shin
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Korean Diabetes J. 2001;25(5):337-342. Published online October 1, 2001
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Abstract
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- BACKGROUND
Interleukin (IL)-6 is produced by many different cell types, including adipose tissue, and the release is greater in obese subjects. Recently, it has been reported that polymorphism in the 5' flanking region of the IL-6 gene may contribute to the insulin resistance and lipid abnormality. However, there are limited number of studies reported on the relationship between IL-6 polymorphism and insulin resistance syndrome. Therefore, the aim of this study was to examine the relationships among this polymorphism, obesity and diabetes in Korean subjects. METHODS: We examined a total of 177 Korean individuals, including 113 type 2 diabetic subjects. Sixty-three subjects were non-obese diabetics (age; 56.4+/-9.8 yr, body mass index (BMI); 22.5+/-1.7 kg/m2), 50 of them were obese diabetic subjects (age; 54.8+/-10.7 yr, BMI; 27.6+/-2.2 kg/m2), and 64 were overweight or obese subjects (age; 49.1+/-11.4 yr, BMI; 25.4 1.5 kg/m2). We evaluated IL-6 gene polymorphism using PCR-restriction fragment length polymorphism. RESULTS: There were 176 GG (99.4%), 1 GC (0.56%) and 0 CC (0%) individuals, and the allele frequencies were 99.7% for G and 0.28% for C. Allele frequencies of C in obese diabetic subjects were 1.02%. The frequency of C allele was substantially lower than that reported in Caucasian. CONCLUSION: This results suggest that the IL-6 polymorphism is not associated with obesity nor diabetes in Korean subjects.
- Plasma Proinsulin Secretion in Impaired Glucose Tolerance and Newly Diagnosed Type 2 Diabetes Mellitus.
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Byoung Ho Kong, Seung Jin Choi, Jae Tack Kim, Yeon Shang Oh, Soon Hyun Shinn
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Korean Diabetes J. 2000;24(4):467-475. Published online January 1, 2001
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Abstract
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- BACKGROUND
Type 2 diabetes mellitus is characterized beta cell dysfunction and insulin resistance but the relative roles of the two factors are different in various ethnic groups. The changes in plasma proinsulin levels is thought to be a marker for the beta-cell dysfunction. To study the role of beta cell dysfunction in the pathogenesis of type 2 diabetes mellitus we compared the concentrations of plasma insulin, C-peptide and proinsulin among the control group, impaired glucose tolerance (IGT) group and newly diagnosed Type 2 Diabetes Mellitus (DM) group during the oral glucose tolerance test. METHODS: In 47 newly diagnosed patients with type 2 DM, 9 IGT and 13 controls the 75g oral glucose tolerance test (OGTT) were performed and samples were analyzed for glucose, insulin, C-peptide and proinsulin. RESULTS: 1) In IGT group plasma insulin, C-peptide and proinsulin concentrations were increased markedly during OGTT but were blunted in type 2 diabetes group. 2) The basal plasma proinsulin level was 7.7+/-4.4 pmol/L in control group, 15.2+/-6.9 pmol/L (p<0.005) in IGT group, and 16.9+/-8.3 pmol/L (p<0.005) in type 2 DM group, and the proinsulin levels at 60 min, 90 min, 120 min during OGTT were significantly elevated in IGT group than those of control group. 3) The plasma proinsulin/insulin ratio were significantly increased in IGT group and type 2 DM group at basal and 30 min during OGTT. 4) The proinsulin response areas were significantly increased in IGT group (110.7+/- 13.1 pmol/L/hr, p=0.048) than those of control group (73.6+/-5.1 pmo l/L/hr) and type 2 DM group (80.5+/-5.9 pmol/L/hr). CONCLUSION: Beta cell secretory defects such as proinsulin secretion were present in impaired glucose tolerance and the changes of insulin secretory function might have a role in the pathogenesis of type 2 DM.
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