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Volume 36(5); October 2012
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Reviews
Clinical Relevance of Adipokines
Matthias Blüher
Diabetes Metab J. 2012;36(5):317-327.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.317
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AbstractAbstract PDFPubReader   

The incidence of obesity has increased dramatically during recent decades. Obesity increases the risk for metabolic and cardiovascular diseases and may therefore contribute to premature death. With increasing fat mass, secretion of adipose tissue derived bioactive molecules (adipokines) changes towards a pro-inflammatory, diabetogenic and atherogenic pattern. Adipokines are involved in the regulation of appetite and satiety, energy expenditure, activity, endothelial function, hemostasis, blood pressure, insulin sensitivity, energy metabolism in insulin sensitive tissues, adipogenesis, fat distribution and insulin secretion in pancreatic β-cells. Therefore, adipokines are clinically relevant as biomarkers for fat distribution, adipose tissue function, liver fat content, insulin sensitivity, chronic inflammation and have the potential for future pharmacological treatment strategies for obesity and its related diseases. This review focuses on the clinical relevance of selected adipokines as markers or predictors of obesity related diseases and as potential therapeutic tools or targets in metabolic and cardiovascular diseases.

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Transcriptional Regulation of Pyruvate Dehydrogenase Kinase
Ji Yun Jeong, Nam Ho Jeoung, Keun-Gyu Park, In-Kyu Lee
Diabetes Metab J. 2012;36(5):328-335.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.328
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AbstractAbstract PDFPubReader   

The pyruvate dehydrogenase complex (PDC) activity is crucial to maintains blood glucose and ATP levels, which largely depends on the phosphorylation status by pyruvate dehydrogenase kinase (PDK) isoenzymes. Although it has been reported that PDC is phosphorylated and inactivated by PDK2 and PDK4 in metabolically active tissues including liver, skeletal muscle, heart, and kidney during starvation and diabetes, the precise mechanisms by which expression of PDK2 and PDK4 are transcriptionally regulated still remains unclear. Insulin represses the expression of PDK2 and PDK4 via phosphorylation of FOXO through PI3K/Akt signaling pathway. Several nuclear hormone receptors activated due to fasting or increased fat supply, including peroxisome proliferator-activated receptors, glucocorticoid receptors, estrogen-related receptors, and thyroid hormone receptors, also participate in the up-regulation of PDK2 and PDK4; however, the endogenous ligands that bind those nuclear receptors have not been identified. It has been recently suggested that growth hormone, adiponectin, epinephrine, and rosiglitazone also control the expression of PDK4 in tissue-specific manners. In this review, we discuss several factors involved in the expressional regulation of PDK2 and PDK4, and introduce current studies aimed at providing a better understanding of the molecular mechanisms that underlie the development of metabolic diseases such as diabetes.

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Management of Type 2 Diabetes Mellitus in Older Adults
Kyung Soo Kim, Soo Kyung Kim, Kyung Mi Sung, Yong Wook Cho, Seok Won Park
Diabetes Metab J. 2012;36(5):336-344.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.336
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AbstractAbstract PDFPubReader   

In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in older adults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in older adults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for older adults with diabetes.

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Editorial
C-Peptide and Vascular Complications in Type 2 Diabetic Subjects
Seok Man Son
Diabetes Metab J. 2012;36(5):345-349.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.345
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  • The Correlation Between C-Peptide and Severity of Peripheral Atherosclerosis in Type 2 Diabetes Mellitus
    Maisa A Wahab, Alshaymaa Alhabibi, Ahmed Khairy Sakr, Mohamed Yahia Zakaria, Ola I Saleh, Inass Hassan Ahmad, Eman Abdelrahman, Randa Taha, Fayka Karem Abdel Azeem Ahmed, Bothayna Ismail, Lamiaa Hosney Azel, Asmaa S Hassan, Hanaa Mohammed Eid El Sayed, Sa
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2617.     CrossRef
  • Disordered glycemic control in women with type 2 diabetes is associated with increased TNF receptor-2 levels
    Patricia Pulido-Perez, Enrique Torres-Rasgado, Ricardo Pérez-Fuentes, José Luis Rosales-Encina, Jorge Rodríguez-Antolín, Jose R. Romero
    Journal of Diabetes and its Complications.2021; 35(9): 107974.     CrossRef
  • C-peptide concentrations in patients with type 2 diabetes treated with insulin
    Mehmet Uzunlulu, Aytekin Oguz, Müzeyyen Arslan Bahadir, Ayse Naciye Erbakan, Mirac Vural Keskinler, Banu Alpaslan Mesci
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Original Articles
The Association of Self-Reported Coronary Heart Disease with Diabetes Duration in Korea
Hye Mi Kang, Yun Jeong Lee, Dong-Jun Kim
Diabetes Metab J. 2012;36(5):350-356.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.350
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AbstractAbstract PDFPubReader   
Background

This study aimed to investigate the association of diabetes duration with self-reported coronary heart disease (CHD) in Korea.

Methods

Among data from 34,145 persons compiled in the third Korean National Health and Nutrition Examination Survey in 2005, laboratory test and nutritional survey data from 5,531 persons were examined. The participants were asked to recall a physician's diagnosis of CHD (angina or myocardial infarction).

Results

Age- and sex-adjusted relative risk for CHD was 1.51 (95% confidence interval [CI], 0.64 to 3.59; not significant) for diabetes with duration of <1 year, 2.27 (95% CI, 1.14 to 4.54; P=0.020) for diabetes with a duration of 1 to 5 years, and 3.29 (95% CI, 1.78 to 6.08; P<0.001) for diabetes with a duration >5 years, compared with non-diabetes as a control. Even after adjusting for age, sex, current smoking status, waist circumference, hypertension, triglycerides, high density lipoprotein cholesterol, and fasting plasma glucose, relative risk for CHD was 2.87 (95% CI, 1.01 to 8.11; P=0.047) in diabetes with a duration of 6 to 10 years and 4.07 (95% CI, 1.73 to 9.63; P=0.001) in diabetes with duration of >10 years with non-diabetes as a control.

Conclusion

CHD prevalence increased with an increase in diabetes duration in Korean men and women. Recently detected diabetes (duration <1 year) was not significantly associated with CHD prevalence compared to non-diabetes. However, diabetes of a duration of >5 years was associated with an increase in CHD compared to non-diabetics after adjusting for several CHD risk factors.

Citations

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  • Predictive nomogram for coronary heart disease in patients with type 2 diabetes mellitus
    Shucai Xiao, Youzheng Dong, Bin Huang, Xinghua Jiang
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
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    Jin Hwa Kim, Hak Yeon Bae, Sang Yong Kim
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Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
Diabetes Metab J. 2012;36(5):357-363.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.357
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AbstractAbstract PDFPubReader   
Background

The aim of this study is to investigate the cardio-metabolic parameters and surrogate markers of insulin resistance in a discordant group of type 2 diabetes (T2DM) subjects who satisfy the Adults Treatment Panel (ATP) III criteria, but not the International Diabetes Federation (IDF) criteria, for metabolic syndrome (MetS).

Methods

We assessed the prevalence of MetS in T2DM subjects (n=167) who were selected from subjects registered at the diabetes center of Dong-A University Medical Center. We used the ATP III criteria and the IDF criteria for the diagnosis of MetS and sorted the subjects into 2 MetS groups: one group diagnosed per ATP III criteria (MetSa) and one diagnosed per IDF criteria (MetSi). We then compared the clinical characteristics, metabolic parameters (homeostasis model assessment of insulin resistance, aspartate aminotransferase, alanine aminotransferase, and uric acid values) and co-morbidities (prevalence of microalbuminuria, fatty liver, and cardiovascular disease) between the MetSa, MetSi, and discordant MetS groups.

Results

The prevalence of MetS in the MetSa group (73.6%) was higher than in the MetSi group (62.2%). The MetS prevalence in the discordant group was 11.4%. The discordant group showed no significant differences in clinical characteristics (except waist circumference and body mass index), metabolic parameters, or prevalence of co-morbidities, as compared with subjects with MetS by both criteria.

Conclusion

In this study, cardio-metabolic features of the subjects diagnosed with MetS using ATP III criteria, but not IDF criteria, are not significantly different from those of subjects diagnosed with MetS using both criteria.

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    Ping Liu, Shujian Sui, Dongling Xu, Xiaowei Xing, Caixia Liu
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Effects of a 6-Month Exenatide Therapy on HbA1c and Weight in Korean Patients with Type 2 Diabetes: A Retrospective Cohort Study
Juyoung Shin, Jin-Sun Chang, Hun-Sung Kim, Sun-Hee Ko, Bong-Yun Cha, Ho-Young Son, Kun-Ho Yoon, Jae-Hyoung Cho
Diabetes Metab J. 2012;36(5):364-370.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.364
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AbstractAbstract PDFPubReader   
Background

While many studies have shown the good efficacy and safety of exenatide in patients with diabetes, limited information is available about exenatide in clinical practice in Korean populations. Therefore, this retrospective cohort study was designed to analyze the effects of exenatide on blood glucose level and body weight in Korean patients with type 2 diabetes mellitus.

Methods

We reviewed the records of the patients with diabetes who visited Seoul St. Mary's Hospital and for whom exenatide was prescribed from June 2009 to October 2011. After excluding subjects based on their race/ethnicity, medical history, whether or not they changed more than 2 kinds of oral hypoglycemic agents with exenatide treatment, loss to follow-up, or whether they stopped exenatide therapy within 6 months, a total of 52 subjects were included in the final analysis.

Results

The mean glycated hemoglobin (HbA1c) level and weight remarkably decreased from 8.5±1.7% to 6.7±1.0% (P<0.001) and from 82.3±15.8 kg to 78.6±16.3 kg (P<0.001), respectively. The multiple regression analysis indicated that the reduction in HbA1c level was significantly associated with a shorter duration of diabetes, a higher baseline HbA1c level, and greater weight reduction, whereas weight loss had no significant correlation with other factors. No severe adverse events were observed.

Conclusion

These results suggest that a 6-month exenatide injection therapy significantly improved patients' HbA1c levels and body weights without causing serious adverse effects in Korean patients with type 2 diabetes.

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The Risk of Bladder Cancer in Korean Diabetic Subjects Treated with Pioglitazone
Sun Ok Song, Kwang Joon Kim, Byung-Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2012;36(5):371-378.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.371
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AbstractAbstract PDFPubReader   
Background

There is growing concern regarding the increased incidence of bladder cancer in diabetic patients using pioglitazone. This study aimed to investigate the association between bladder cancer and the use of pioglitazone in Korean diabetics.

Methods

This retrospective, matched case-control study included a case group (n=329) of diabetic patients with bladder cancer who presented at the Severance Hospital from November 2005 to June 2011. The control group consisted of patients without bladder cancer (1:2 ratio matching for sex and age, n=658) who were listed on the Severance Hospital diabetes registry.

Results

The percentage of subjects who had ever used pioglitazone was significantly lower in the case group than in the control group (6.4% vs. 15.0%, P<0.001). Multivariate conditional logistic analysis revealed that independent factors affecting bladder cancer were smoking (odds ratio [OR], 11.64; 95% confidence interval [CI], 6.56 to 20.66; P<0.001), coexisting cancer (OR, 6.11; 95% CI, 2.25 to 16.63; P<0.001), and hemoglobin levels (OR, 0.78; 95% CI, 0.69 to 0.88; P<0.001). The OR of the history of pioglitazone use was 2.09 and was not significantly different between the two groups (95% CI, 0.26 to 16.81; P=0.488).

Conclusion

A relationship between pioglitazone use and incidence of bladder cancer was not observed in Korean diabetic patients. This suggests that the risk for bladder cancer in Korean diabetic subjects treated with pioglitazone might be different from that of Caucasian populations. Large-scale, well-designed and multi-center studies are needed to further evaluate this relationship.

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Correlations between Glucagon Stimulated C-peptide Levels and Microvascular Complications in Type 2 Diabetes Patients
Hye-Jin Yoon, Youn-Zoo Cho, Ji-young Kim, Byung-Joon Kim, Keun-Young Park, Gwan-Pyo Koh, Dae-Ho Lee, Dong-Mee Lim
Diabetes Metab J. 2012;36(5):379-387.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.379
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AbstractAbstract PDFPubReader   
Background

This study aimed to investigate whether stimulated C-peptide is associated with microvascular complications in type 2 diabetes mellitus (DM).

Methods

A cross-sectional study was conducted in 192 type 2 diabetic patients. Plasma basal C-peptide and stimulated C-peptide were measured before and 6 minutes after intravenous injection of 1 mg glucagon. The relationship between C-peptide and microvascular complications was statistically analyzed.

Results

In patients with retinopathy, basal C-peptide was 1.9±1.2 ng/mL, and stimulated C-peptide was 2.7±1.6 ng/mL; values were significantly lower compared with patients without retinopathy (P=0.031 and P=0.002, respectively). In patients with nephropathy, basal C-peptide was 1.6±0.9 ng/mL, and stimulated C-peptide was 2.8±1.6 ng/mL; values were significantly lower than those recorded in patients without nephropathy (P=0.020 and P=0.026, respectively). Stimulated C-peptide level was associated with increased prevalence of microvascular complications. Age-, DM duration-, and hemoglobin A1c-adjusted odds ratios for retinopathy in stimulated C-peptide value were 4.18 (95% confidence interval [CI], 1.40 to 12.51) and 3.35 (95% CI, 1.09 to 10.25), respectively. The multiple regression analysis between nephropathy and C-peptide showed that stimulated C-peptide was statistically correlated with nephropathy (P=0.03).

Conclusion

In patients with type 2 diabetes, the glucagon stimulation test was a relatively simple method of short duration for stimulating C-peptide response. Stimulated C-peptide values were associated with microvascular complications to a greater extent than basal C-peptides.

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Letter
Letter: Balsamic Vinegar Improves High Fat-Induced Beta Cell Dysfunction via Beta Cell ABCA1 (Diabetes Metab J 2012;36:275-9)
Jae-Hyoung Cho
Diabetes Metab J. 2012;36(5):388-389.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.388
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  • Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight
    Eleni I Petsiou, Panayota I Mitrou, Sotirios A Raptis, George D Dimitriadis
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Response
Response: Balsamic Vinegar Improves High Fat-Induced Beta Cell Dysfunction via Beta Cell ABCA1 (Diabetes Metab J 2012;36:275-9)
Hannah Seok, Bong Soo Cha
Diabetes Metab J. 2012;36(5):390-390.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.390
  • 2,347 View
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Citations

Citations to this article as recorded by  
  • Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight
    Eleni I Petsiou, Panayota I Mitrou, Sotirios A Raptis, George D Dimitriadis
    Nutrition Reviews.2014; 72(10): 651.     CrossRef

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