- The Clinical Significance of Anthropometric Measurements of Obesity in Type 2 Diabetics.
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Young Sun Choi, Si Hyung Park, Bo Wan Kim
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Korean Diabetes J. 2000;24(3):365-374. Published online January 1, 2001
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 Abstract
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- BACKGROUND
It is well demonstrated that obesity is associated with many chronic disorders like type 2 diabetes, dyslipidemia, and hypertension. In Korea, there are numerous reports revealed the possible relationship between anthropometric indices of obesity and the aformentioned disorders in nondiabetic healthy population, but the reports in type 2 diabetics are limited. Therefore, in this study we evaluated the relationship among the anthropometric indices and fasting insulin, C-peptide, and serum lipid levels in recently diagnosed type 2 diabetics. METHOD: A total of 160 type 2 diabetics were recruited from the out-patient department of endocrinoloy of Kyungpook National University Hospital from March to June 1999. The following subjects were excluded from the study: duration of type 2 diabetes > 5year, receiving of insulin or lipid lowering agents. For all participants, body mass index, percent of body fat, waist and hip circumference were measured. Fasting plasma insulin, C-peptide, blood glucose, HbA1c, total cholesterol, triglyceride and high-density lipoprotein cholesterol were also assayed. Partial correlation analysis was used to test the relationships between anthropometric indices and laboratory data. RESULTS: 1) In male subjects, fasting plasma insulin level was not significantly correlated with any of the anthropometric variables. However, in female subjects, fasting plasma insulin level was significantly correlated with body mass index, percent of body fat, and waist circumference. 2) Fasting plasma C-peptide level significantly correlated to all of the anthropometric variables in female patients, but in males only significant association was seen between fasting plasma C-peptide level and waist circumference. 3) Total cholesterol level was significantly correlated with percent of body fat and waist/hip ratio in male andfemale subjects respectively. CONCLUSION: Anthropometric indices of abdominal obesity appear to be correlated with insulin production and lipid changes in recently diagnosed type 2 diabetics. Waist circumference is a more useful predictor of hyperinsulinemia than waist/hip ratio in both sexes.
- Clinical Manifestation and Prognostic Factors in Nonketotic Hyperosmolar Coma.
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Bo Wan Kim, Jung Guk Kim, Sung Woo Ha, Hyun Jeong Lee, Jeung Hun Han, Sang Won Jung, Jick Hwa Nam, Si Hyung Park, Soon Hee Lee
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Korean Diabetes J. 1999;23(4):575-584. Published online January 1, 2001
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Abstract
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- BACKGROUND
Nonketotic hyperosmolar coma is usually a complication of non-insuli#n dependent diabetes and a syndrome of profound dehydration, hyperglycemia and hyperosmolarity. Therefore the patients present a progressive mental change. We evaluated the clinical manifestations of nonketotic hyperosmolar coma to assess the correlation between initial clinical manifestations and responses to treatment in patients with nonketotic hyperosmolar coma. METHODS: We studied 31 patients who had experienced proven nonketotic hyperosmolar coma at Kyungpook National University Hospital from March 1987 to February 1998. We divided nonketotic hyperosmolar coma patients into two groups, tbe complete recovery group and the incomplete recovery group, and compared clinical features and laboratory findings between these two groups. RESULTS: l) A total of 31 patients were studied. Eighteen patients were in the complete recovery group and thirteen patients were in the incomplete recovery group. 2) Mean age was 63.1+10.1 years old, initial blood glucose was 781.8+314.3 mg/dL, effective osmolarity was 342.6+34.9 mosm/L, arterial pH was 7.34. Serum creatinine level was 241.7+130.0 uol/L and BUN was 23.1+12.5 mmol/L. 3) Among clinical features of both groups (complete recovery and incomplete recovery groups), initial systolic blood pressure was 131.4+26.1 mmHg and 104.1+28.6 mmHg, diastolic blood pressure was 90.6+16.5 mmHg and 63.2+17.4 mmHg, and mean arterial blood pressure was 104.2 +18.2 mmHg and 76.8+19.7 mmHg. They revealed a significant difference statistically. 4) Arterial blood pH was 7.40 and 7.25, BUN was 18.4+11.7 mmol/L and 29.5+11.1mmol/L, and WBC count was 13850+4122/ mm and 19823+ 5946/mm. They revealed a significant difference statistically. 5) We also analyzed the significant factors together using multivariate logistic regression analysis. The only significant independent factor responsible for prognosis of nonketotic hyperosmolar coma was initial mean arterial blood pressure. CONCLUSION: Nonketotic hyperosmolar coma occurred more frequently in patients who were older and had abnormal renal function. The prognosis of patients was related with mean arterial blood pressure independently. Mean arterial blood pressure thought to be related to intravascular volume and arterial hypotension seems to reflect dehydration state. In conclusion, prevention and rapid correction of hypotension due to dehydration in older diabetics is the most important treatment to improve the prognosis.
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