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Original Articles
Guideline/Fact Sheet
Dyslipidemia Fact Sheet in South Korea, 2022
Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong, on Behalf of the Committee of Public Relation of the Korean Society of Lipid and Atherosclerosis
Diabetes Metab J. 2023;47(5):632-642.   Published online August 2, 2023
DOI: https://doi.org/10.4093/dmj.2023.0135
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022.
Methods
We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020.
Results
In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL.
Conclusion
Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.

Citations

Citations to this article as recorded by  
  • Oxidative Balance Score and New-Onset Type 2 Diabetes Mellitus in Korean Adults without Non-Alcoholic Fatty Liver Disease: Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) Cohort
    Mid-Eum Moon, Dong Hyuk Jung, Seok-Jae Heo, Byoungjin Park, Yong Jae Lee
    Antioxidants.2024; 13(1): 107.     CrossRef
  • Comparison of metabolic and neurological comorbidities in Asian patients with psoriasis and atopic dermatitis
    Hee Joo Yang, Mi Young Lee, Jeong Hyeon Lee, Chang Jin Jung, Woo Jin Lee, Chong Hyun Won, Mi Woo Lee, Joon Min Jung, Sung Eun Chang
    Scientific Reports.2024;[Epub]     CrossRef
  • Exploring Utilization and Establishing Reference Intervals for the Apolipoprotein B Test in the Korean Population
    Rihwa Choi, Sang Gon Lee, Eun Hee Lee
    Diagnostics.2023; 13(20): 3194.     CrossRef
Lifestyle
Ultra-Processed Food Consumption and Obesity in Korean Adults
Jee-Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
Diabetes Metab J. 2023;47(4):547-558.   Published online April 26, 2023
DOI: https://doi.org/10.4093/dmj.2022.0026
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AbstractAbstract PDFPubReader   ePub   
Background
This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults.
Methods
We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity).
Results
Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared.
Conclusion
Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.

Citations

Citations to this article as recorded by  
  • Diet quality partially mediates the association between ultraprocessed food consumption and adiposity indicators
    Jee‐Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
    Obesity.2023; 31(9): 2430.     CrossRef
  • Development of a Semi-Quantitative Food-Frequency Questionnaire for Korean Adults with Obesity
    Jina Chung, Seoeun Ahn, Hyojee Joung, Sangah Shin
    Nutrients.2023; 15(22): 4848.     CrossRef
Cardiovascular Risk/Epidemiology
Cardiovascular Outcomes according to Comorbidities and Low-Density Lipoprotein Cholesterol in Korean People with Type 2 Diabetes Mellitus
Min Kyong Moon, Junghyun Noh, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong, on Behalf of the Committee of Practice Guideline of Korean Lipid and Atheroscelerosis
Diabetes Metab J. 2023;47(1):45-58.   Published online January 26, 2023
DOI: https://doi.org/10.4093/dmj.2021.0344
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  • 4 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
There are no clear data to support the cardiovascular (CV) risk categories and low-density lipoprotein cholesterol (LDL-C) treatment goals in Korean people with type 2 diabetes mellitus (T2DM). We evaluated the incidence of cardiovascular disease (CVD) according to comorbidities and suggested LDL-C treatment goals in Korean people with T2DM in nationwide cohort data.
Methods
Using the Korean National Health Insurance Service database, 248,002 people aged 30 to 90 years with T2DM who underwent routine health check-ups during 2009 were included. Subjects with previous CVD were excluded from the study. The primary outcome was incident CVD, defined as a composite of myocardial infarction and ischemic stroke during the follow-up period from 2009 to 2018.
Results
The mean age of the study participants was 59.6±10.9 years, and median follow-up period was 9.3 years. CVD incidence increased in the order of DM duration of 5 years or more (12.04/1,000 person-years), hypertension (HT) (12.27/1,000 personyears), three or more CV risk factors (14.10/1,000 person-years), and chronic kidney disease (18.28/1,000 person-years). The risk of incident CVD increased linearly from an LDL-C level of ≥70 mg/dL in most patients with T2DM. In T2DM patients without HT or with a DM duration of less than 5 years, the CVD incidence increased from LDL-C level of ≥100 mg/dL.
Conclusion
For primary prevention of CVD in Korean adults with T2DM, it can be helpful to lower LDL-C targets when there are chronic kidney disease, HT, a long duration of diabetes mellitus, or three or more CV risk factors.

Citations

Citations to this article as recorded by  
  • Lipid Management in Korean People with Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
    Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
    Diabetes & Metabolism Journal.2023; 47(1): 1.     CrossRef
  • Optimal Low-Density Lipoprotein Cholesterol Level for Primary Prevention in Koreans with Type 2 Diabetes Mellitus
    Ji Yoon Kim, Nam Hoon Kim
    Diabetes & Metabolism Journal.2023; 47(1): 42.     CrossRef
  • Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
    Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
    Journal of Lipid and Atherosclerosis.2023; 12(1): 12.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors
    Ye Seul Yang
    The Journal of Korean Diabetes.2023; 24(3): 135.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
    Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae J
    Diabetes & Metabolism Journal.2023; 47(5): 575.     CrossRef
  • Management of Dyslipidemia in Patients with Diabetes Mellitus
    Kyung Ae Lee
    The Journal of Korean Diabetes.2023; 24(3): 111.     CrossRef
  • Significant Gap Between Guidelines and Practice in the Management of LDL Cholesterol: Insight From the Survey of the Korean Society of Myocardial Infarction
    Sang Yeub Lee, Kyung Hoon Cho, Jang Hoon Lee, Young Joon Hong, Jin yong Hwang, Myung Ho Jeong, Weon Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
Cardiovascular Risk/Epidemiology
Association between Low-Density Lipoprotein Cholesterol Level and Cardiovascular Outcomes in Korean Adults: A Nationwide Cohort Study
Junghyun Noh, Min Kyong Moon, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong, on Behalf of the Committee of Practice Guideline of Korean Lipid and Atheroscelerosis
Diabetes Metab J. 2023;47(1):59-71.   Published online January 26, 2023
DOI: https://doi.org/10.4093/dmj.2021.0320
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To validate the treatment target of low-density lipoprotein cholesterol (LDL-C) level according to the cardiovascular disease (CVD) risk which was recommended by Korean dyslipidemia guideline.
Methods
We used the Korean National Health Insurance Service database which included 3,958,048 people aged 20 to 89 years who underwent regular health screening. The primary outcome was incident CVD, defined as a composite of myocardial infarction and stroke during the follow-up period from 2009 to 2018.
Results
The risk of CVD increased from LDL-C level of 70 mg/dL in very high-risk and high-risk groups and from 130 mg/dL in moderate-risk and low-risk groups. Adjusted hazard ratios (HRs) of LDL-C ranges 70–99, 100–129, 130–159, 160–189, and ≥190 mg/dL were 1.20 (95% confidence interval [CI], 1.08–1.33), 1.27 (1.15–1.42), 1.39 (1.23–1.56), 1.69 (1.45–1.96), and 1.84 (1.49– 2.27) in very high-risk group, and 1.07 (1.02–1.13), 1.16 (1.10–1.21), 1.29 (1.22–1.36), 1.45 (1.36–1.55), and 1.73 (1.58–1.90) in high-risk group. Adjusted HRs (95% CI) of LDL-C ranges 130–159, 160–189, and ≥190 mg/dL were 1.15 (1.11–1.20), 1.28 (1.22– 1.34), and 1.45 (1.36–1.54) in moderate-risk group and 1.07 (1.02–1.13), 1.20 (1.13–1.26), and 1.47 (1.37–1.57) in low-risk group.
Conclusion
We confirmed the incidence of CVD was increased in higher LDL-C range. The risk of CVD increased from ≥70 mg/dL of LDL-C in very high-risk and high-risk groups, and from ≥130 mg/dL of LDL-C in moderate-risk and low-risk groups in Korean adults.

Citations

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  • Efficacy and Safety of a Single-Pill Triple Combination of Olmesartan, Amlodipine, and Rosuvastatin in Hypertensive Patients with Low-to-Moderate Cardiovascular Risk: A Multicenter, Randomized, Open-Label, Active-Control, Phase IV Clinical Trial
    Byung Jin Kim, Kwang Soo Cha, Wook Hyun Cho, Eung Ju Kim, Seung-Hyuk Choi, Moo Hyun Kim, Sang-Hyun Kim, Jun-Bean Park, Seong-Mi Park, Il Suk Sohn, Kyu Hyung Ryu, In-Ho Chae
    Journal of Cardiovascular Pharmacology and Therapeutics.2023;[Epub]     CrossRef
Corrigendum
Association between Changes in Anthropometric Indices and in Fasting Insulin Levels among Healthy Korean Adolescents: The JS High School Study
Ji Hye Park, Seyeon Mun, Dong Phil Choi, Joo Young Lee, Hyeon Chang Kim
Diabetes Metab J. 2022;46(1):164-164.   Published online January 27, 2022
DOI: https://doi.org/10.4093/dmj.2022.0025
Corrects: Diabetes Metab J 2019;43(2):183
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Original Articles
Complications
Association of Snoring with Prediabetes and Type 2 Diabetes Mellitus: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort
So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
Diabetes Metab J. 2020;44(5):687-698.   Published online April 16, 2020
DOI: https://doi.org/10.4093/dmj.2019.0128
  • 4,954 View
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Evidence suggests that habitual snoring is an independent risk factor for poor glycemic health. We examined the associations between snoring with prediabetes and diabetes in Korean population.

Methods

Self-reported snoring characteristics were collected from 3,948 middle-aged adults without prior cardiovascular diseases. Multivariable linear regression assessed the association of snoring intensity, frequency, disruptiveness, and disrupted breathing with fasting glucose and glycosylated hemoglobin (HbA1c) level. Then, multinomial regression evaluated how increasing snoring symptoms are associated with the risk for prediabetes and diabetes, adjusting for socioeconomic and behavioral risk factors of diabetes, obesity, hypertension, and other sleep variables.

Results

Higher snoring intensity and frequency were positively associated with fasting glucose and HbA1c levels. Participants presenting the most severe snoring were at 1.84 times higher risk (95% confidence interval [CI], 1.09 to 2.29) for prediabetes and 2.24 times higher risk (95% CI, 1.84 to 2.95) for diabetes, compared to non-snorers. Such graded association was also observed amongst the most frequent snorers with higher risk for prediabetes (odds ratio [OR], 1.78; 95% CI, 1.29 to 2.22) and diabetes (OR, 2.03; 95% CI, 1.45 to 2.85). Disruptive snoring (OR, 1.60; 95% CI, 1.12 to 2.28) and near-daily disruptive breathing (OR, 2.18; 95% CI, 1.02 to 4.19) were associated with higher odds for diabetes. Such findings remained robust after additional adjustment for sleep duration, excessive daytime sleepiness, unwakefulness, and sleep-deprived driving.

Conclusion

Snoring is associated with impaired glucose metabolism even in otherwise metabolically healthy adults. Habitual snorers may require lifestyle modifications and pharmacological treatment to improve glycemic profile.

Citations

Citations to this article as recorded by  
  • Does seasonality affect snoring? A study based on international data from the past decade
    Ping Wang, Cai Chen, Xingwei Wang, Ningling Zhang, Danyang Lv, Wei Li, Fulai Peng, Xiuli Wang
    Sleep and Breathing.2023; 27(4): 1297.     CrossRef
  • Association Between Snoring and Diabetes Among Pre- and Postmenopausal Women
    Yun Yuan, Fan Zhang, Jingfu Qiu, Liling Chen, Meng Xiao, Wenge Tang, Qinwen Luo, Xianbin Ding, Xiaojun Tang
    International Journal of General Medicine.2022; Volume 15: 2491.     CrossRef
  • Elevated fasting insulin results in snoring: A view emerged from causal evaluation of glycemic traits and snoring
    Minhan Yi, Quanming Fei, Kun Liu, Wangcheng Zhao, Ziliang Chen, Yuan Zhang
    European Journal of Clinical Investigation.2022;[Epub]     CrossRef
  • Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar
    Hiba Bawadi, Asma Al Sada, Noof Al Mansoori, Sharifa Al Mannai, Aya Hamdan, Zumin Shi, Abdelhamid Kerkadi
    International Journal of Environmental Research and Public Health.2021; 18(8): 4017.     CrossRef
  • Changes in creatinine‐to‐cystatin C ratio over 4 years, risk of diabetes, and cardiometabolic control: The China Health and Retirement Longitudinal Study
    Shanhu Qiu, Xue Cai, Yang Yuan, Bo Xie, Zilin Sun, Tongzhi Wu
    Journal of Diabetes.2021; 13(12): 1025.     CrossRef
  • Association Between Self-Reported Snoring and Metabolic Syndrome: A Systematic Review and Meta-Analysis
    Jinsha Ma, Huifang Zhang, Hui Wang, Qian Gao, Heli Sun, Simin He, Lingxian Meng, Tong Wang
    Frontiers in Neurology.2020;[Epub]     CrossRef
  • Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes
    Yongin Cho
    Diabetes & Metabolism Journal.2020; 44(5): 668.     CrossRef
Metabolic Risk/Epidemiology
Sex-, Age-, and Metabolic Disorder-Dependent Distributions of Selected Inflammatory Biomarkers among Community-Dwelling Adults
So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
Diabetes Metab J. 2020;44(5):711-725.   Published online April 16, 2020
DOI: https://doi.org/10.4093/dmj.2019.0119
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Inflammatory cytokines are increasingly utilized to detect high-risk individuals for cardiometabolic diseases. However, with large population and assay methodological heterogeneity, no clear reference currently exists.

Methods

Among participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort, of community-dwelling adults aged 30 to 64 without overt cardiovascular diseases, we presented distributions of tumor necrosis factor (TNF)-α and -β, interleukin (IL)-1α, -1β, and 6, monocyte chemoattractant protein (MCP)-1 and -3 and high sensitivity C-reactive protein (hsCRP) with and without non-detectable (ND) measurements using multiplex enzyme-linked immunosorbent assay. Then, we compared each markers by sex, age, and prevalence of type 2 diabetes mellitus, hypertension, and dyslipidemia, using the Wilcoxon Rank-Sum Test.

Results

In general, there were inconsistencies in direction and magnitude of differences in distributions by sex, age, and prevalence of cardiometabolic disorders. Overall, the median and the 99th percentiles were higher in men than in women. Older participants had higher TNF-α, high sensitivity IL-6 (hsIL-6), MCP-1, hsCRP, TNF-β, and MCP-3 median, after excluding the NDs. Participants with type 2 diabetes mellitus had higher median for all assayed biomarkers, except for TNF-β, IL-1α, and MCP-3, in which the medians for both groups were 0.00 due to predominant NDs. Compared to normotensive group, participants with hypertension had higher TNF-α, hsIL-6, MCP-1, and hsCRP median. When stratifying by dyslipidemia prevalence, the comparison varied significantly depending on the treatment of NDs.

Conclusion

Our findings provide sex-, age-, and disease-specific reference values to improve risk prediction and diagnostic performance for inflammatory diseases in both population- and clinic-based settings.

Citations

Citations to this article as recorded by  
  • Association between physical activity and inflammatory markers in community-dwelling, middle-aged adults
    So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Justin Y. Jeon, Hyeon Chang Kim
    Applied Physiology, Nutrition, and Metabolism.2021; 46(7): 828.     CrossRef
  • The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges
    Thomas S. Buttle, Claire Y. Hummerstone, Thippeswamy Billahalli, Richard J. B. Ward, Korina E. Barnes, Natalie J. Marshall, Viktoria C. Spong, Graham H. Bothamley, Selvakumar Subbian
    PLOS ONE.2021; 16(8): e0247745.     CrossRef
Metabolic Risk/Epidemiology
Association between the Thigh Muscle and Insulin Resistance According to Body Mass Index in Middle-Aged Korean Adults
Ji Eun Heo, Jee-Seon Shim, Hokyou Lee, Hyeon Chang Kim
Diabetes Metab J. 2020;44(3):446-457.   Published online April 16, 2020
DOI: https://doi.org/10.4093/dmj.2019.0110
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We examined the associations between thigh muscle area (TMA) and insulin resistance (IR) according to body mass index (BMI) in middle-aged Korean general population.

Methods

TMA was measured using quantitative computed tomography and corrected by body weight (TMA/Wt) in 1,263 men, 788 premenopausal women, and 1,476 postmenopausal women all aged 30 to 64 years. The tertiles of TMA/Wt were calculated separately for men and for premenopausal and postmenopausal women. Homeostatic model assessment for insulin resistance (HOMA-IR) was performed using fasting blood glucose and insulin levels, and increased IR was defined according to sex-specific, top quartiles of HOMA-IR. Associations between the TMA/Wt tertiles and increased IR according to the BMI categories (<25 and ≥25 kg/m2) were assessed using multivariable logistic regression analysis.

Results

In men with higher BMIs, but not in those with lower BMIs, the presence of an increased IR had significantly higher odds ratios in the lower TMA/Wt tertiles, even after adjustment for visceral fat area. However, in premenopausal and postmenopausal women, there was no significant inverse association between TMA/Wt tertiles and increased IR, regardless of BMI category.

Conclusion

Our findings suggest that the thigh muscle is inversely associated with IR in men, particularly in those with higher BMIs.

Citations

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  • Risk of sleep apnea associated with higher blood pressure among Chinese and Korean Americans
    Brittany N. Morey, Yuxi Shi, Soomin Ryu, Susan Redline, Ichiro Kawachi, Hye Won Park, Sunmin Lee
    Ethnicity & Health.2024; : 1.     CrossRef
  • Sex-specific equations to estimate body composition: Derivation and validation of diagnostic prediction models using UK Biobank
    Yueqi Lu, Ying Shan, Liang Dai, Xiaosen Jiang, Congying Song, Bangwei Chen, Jingwen Zhang, Jing Li, Yue Zhang, Junjie Xu, Tao Li, Zuying Xiong, Yong Bai, Xiaoyan Huang
    Clinical Nutrition.2023; 42(4): 511.     CrossRef
  • Gender Differences in Relation to Body Composition, Insulin Resistance, and Islet Beta Cell Function in Newly Diagnosed Diabetic or Pre-Diabetic Patients
    Minglei Ma, Tao Jiang, Zhen Wen, Dongxue Zhang, Lei Xiu
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 723.     CrossRef
  • Non-Alcoholic Fatty Liver Disease with Sarcopenia and Carotid Plaque Progression Risk in Patients with Type 2 Diabetes Mellitus
    Yongin Cho, Hye-Sun Park, Byung Wook Huh, Yong-ho Lee, Seong Ha Seo, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, So Hun Kim
    Diabetes & Metabolism Journal.2023; 47(2): 232.     CrossRef
  • Prospective External Validation of an Algorithm Predicting Hourly Basal Insulin Infusion Rates from Characteristics of Patients with Type 1 Diabetes Treated with Insulin Pumps
    Jana S. Schmelzer, Melanie Kahle-Stephan, Juris J. Meier, Michael A. Nauck
    Experimental and Clinical Endocrinology & Diabetes.2023; 131(10): 539.     CrossRef
  • Establishing reference values for percentage of appendicular skeletal muscle mass and their association with metabolic syndrome in Korean adolescents
    Da Hye Lee, Sung-Chan Kang, Seung-Sik Hwang, Yun Jeong Lee, Hwa Young Kim, Seong Yong Lee, Choong Ho Shin, Jaehyun Kim
    Annals of Pediatric Endocrinology & Metabolism.2023; 28(4): 237.     CrossRef
  • Evaluating Triglyceride and Glucose Index as a Simple and Easy-to-Calculate Marker for All-Cause and Cardiovascular Mortality
    Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
    Journal of General Internal Medicine.2022; 37(16): 4153.     CrossRef
  • Association between Lower-to-Upper Ratio of Appendicular Skeletal Muscle and Metabolic Syndrome
    Hyun Eui Moon, Tae Sic Lee, Tae-Ha Chung
    Journal of Clinical Medicine.2022; 11(21): 6309.     CrossRef
Complications
Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study
Yoo-Ri Chung, Kyoung Hwa Ha, Hyeon Chang Kim, Sang Jun Park, Kihwang Lee, Dae Jung Kim
Diabetes Metab J. 2019;43(5):640-648.   Published online February 20, 2019
DOI: https://doi.org/10.4093/dmj.2018.0137
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).

Methods

We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.

Results

The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).

Conclusion

This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU.

Citations

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  • Incretin‐based drugs and the risk of diabetic retinopathy among individuals with type 2 diabetes: A systematic review and meta‐analysis of observational studies
    Samuel Igweokpala, Naheemot Olaoluwa Sule, Antonios Douros, Oriana H. Y. Yu, Kristian B. Filion
    Diabetes, Obesity and Metabolism.2024; 26(2): 721.     CrossRef
  • Weight loss, bariatric surgery, and novel antidiabetic drugs effects on diabetic retinopathy: a review
    Alejandro M. Perez, Emily Neag, Jayanth Sridhar, Basil K. Williams
    Current Opinion in Ophthalmology.2024;[Epub]     CrossRef
  • Role of Systemic Factors in Improving the Prognosis of Diabetic Retinal Disease and Predicting Response to Diabetic Retinopathy Treatment
    Joe Mellor, Anita Jeyam, Joline WJ. Beulens, Sanjeeb Bhandari, Geoffrey Broadhead, Emily Chew, Ward Fickweiler, Amber van der Heijden, Daniel Gordin, Rafael Simó, Janet Snell-Bergeon, Anniina Tynjälä, Helen Colhoun
    Ophthalmology Science.2024; : 100494.     CrossRef
  • Prognostic factors for the development and progression of proliferative diabetic retinopathy in people with diabetic retinopathy
    Jennifer Perais, Ridhi Agarwal, Jennifer R Evans, Emma Loveman, Jill L Colquitt, David Owens, Ruth E Hogg, John G Lawrenson, Yemisi Takwoingi, Noemi Lois
    Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
  • Rapid Reduction of HbA1c and Early Worsening of Diabetic Retinopathy: A Real-world Population-Based Study in Subjects With Type 2 Diabetes
    Rafael Simó, Josep Franch-Nadal, Bogdan Vlacho, Jordi Real, Ester Amado, Juana Flores, Manel Mata-Cases, Emilio Ortega, Mercedes Rigla, Joan-Anton Vallés, Cristina Hernández, Didac Mauricio
    Diabetes Care.2023; 46(9): 1633.     CrossRef
  • Effects of newer-generation anti-diabetics on diabetic retinopathy: a critical review
    Dimitrios P. Ntentakis, Victor San Martin Carvalho Correa, Anastasia Maria Ntentaki, Eleni Delavogia, Toshio Narimatsu, Nikolaos E. Efstathiou, Demetrios G. Vavvas
    Graefe's Archive for Clinical and Experimental Ophthalmology.2023;[Epub]     CrossRef
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Epidemiology
Association between Changes in Anthropometric Indices and in Fasting Insulin Levels among Healthy Korean Adolescents: The JS High School Study
Ji Hye Park, Seyeon Mun, Dong Phil Choi, Joo Young Lee, Hyeon Chang Kim
Diabetes Metab J. 2019;43(2):183-191.   Published online January 22, 2019
DOI: https://doi.org/10.4093/dmj.2018.0034
Correction in: Diabetes Metab J 2022;46(1):164
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

This study investigated the association between changes in anthropometric indices and fasting insulin levels among healthy adolescents and whether the association differed by baseline obesity status.

Methods

This analysis was based on data collected for the JS High School study; 884 healthy adolescents aged 15 to 16 years followed up for 24 to 30 months were included. Changes in anthropometric indices and fasting insulin levels were computed as the difference between baseline and follow-up values. Multivariate linear regression models were used to determine the association between changes in anthropometric indices and fasting insulin levels. Based on body mass index (BMI)-for-age and waist circumference (WC)-for-age percentiles, participants were classified as normal weight (<85th percentile), overweight (85th percentile to <95th percentile), or obese (≥95th percentile).

Results

Changes in BMI, WC, waist-hip ratio, and waist-height ratio were significantly associated with changes in fasting insulin levels in both sexes (P<0.05). In analyses stratified by baseline obesity status, the association between change in BMI and change in fasting insulin was significantly stronger in overweight (males: standardized β=1.136; females: standardized β=1.262) and obese (males: standardized β=1.817; females: standardized β=2.290) participants than in those with normal weight (males: standardized β=0.957; females: standardized β=0.976) at baseline. Results were similar for changes in WC.

Conclusion

Changes in anthropometric indices were positively associated with fasting insulin level increases. Moreover, those who were overweight or obese at baseline had a higher absolute increase in fasting insulin levels per one standard deviation unit increase in anthropometric indices than adolescents with normal weight.

Citations

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  • Rice-based breakfast improves fasting glucose and HOMA-IR in Korean adolescents who skip breakfast, but breakfast skipping increases aromatic amino acids associated with diabetes prediction in Korean adolescents who skip breakfast: a randomized, parallel-
    Hyun Suk Kim, Su-Jin Jung, Soyoung Jang, Min Jung Kim, Youn-Soo Cha
    Nutrition Research and Practice.2022; 16(4): 450.     CrossRef
Epidemiology
Serum 25-Hydroxyvitamin D Concentration Is Independently Inversely Associated with Insulin Resistance in the Healthy, Non-Obese Korean Population
So Young Ock, Kyoung Hwa Ha, Bu Kyung Kim, Hyeon Chang Kim, Jee-Seon Shim, Myung Ha Lee, Young Me Yoon, Dae Jung Kim
Diabetes Metab J. 2016;40(5):367-375.   Published online July 26, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.5.367
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We evaluated the associations between 25-hydroxyvitamin D (25(OH)D) concentrations in serum and insulin resistance in the healthy Korean population.

Methods

We conducted this cross-sectional analysis in 1,807 healthy Korean people (628 men and 1,179 women) aged 30 to 64 years in the Cardiovascular and Metabolic Disease Etiologic Research Center study. All participants were assessed for 25(OH)D, fasting glucose, and insulin levels, and completed a health examination and lifestyle questionnaire according to standard procedures. Insulin resistance was defined as the homeostasis model assessment insulin resistance higher than the 75 percentile.

Results

Compared to those in the highest tertile (≥14.3 ng/mL), the odds ratio (OR) for insulin resistance was 1.37 (95% confidence interval [CI], 1.01 to 1.86) for the 1st tertile (<9.7 ng/mL) and 1.19 (95% CI, 0.08 to 1.62) for the 2nd tertile (9.7 to 14.3 ng/mL) after adjusting for age, gender, waist circumference, alcohol consumption, smoking status, physical exercise, season, and cohort. After stratification of the subjects by adiposity, these associations remained only in non-obese subjects (lowest tertile vs. highest tertile, multivariable OR, 1.64; 95% CI, 1.05 to 2.56).

Conclusion

Serum 25(OH)D has an independent inverse association with insulin resistance in the healthy, non-obese Korean population, even among people with vitamin D insufficiency.

Citations

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Appendicular Skeletal Muscle Mass and Insulin Resistance in an Elderly Korean Population: The Korean Social Life, Health and Aging Project-Health Examination Cohort
Seung Won Lee, Yoosik Youm, Won Joon Lee, Wungrak Choi, Sang Hui Chu, Yeong-Ran Park, Hyeon Chang Kim
Diabetes Metab J. 2015;39(1):37-45.   Published online February 16, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.1.37
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AbstractAbstract PDFPubReader   
Background

Increasing evidence supports an association between age-related loss of muscle mass and insulin resistance. However, the association has not been fully investigated in the general population. Thus, we investigated the association between appendicular skeletal muscle mass (ASM) and insulin resistance in an elderly Korean population.

Methods

This cross-sectional study included 158 men (mean age, 71.8) and 241 women (mean age, 70.6) from the Korean Social Life, Health and Aging Project, which started in 2011. In this study, ASM was measured by bioelectrical impedance analysis and was analyzed in three forms: ASM (kg), ASM/height2 (kg/m2), and ASM/weight (%). The homeostasis model assessment of insulin resistance (HOMA-IR) was used as a measure of insulin resistance. The relationships between the ASM values and the HOMA-IR were investigated by multiple linear regression models.

Results

The HOMA-IR was positively associated with ASM (β=0.43, P<0.0001) and ASM/height2 (β=0.36, P<0.0001) when adjusted for sex and age. However, after additional adjustment for body weight, HOMA-IR was inversely associated with ASM (β=-0.43, P<0.001) and ASM/height2 (β=-0.30, P=0.001). Adjustment for other potential confounders did not change these associations. Conversely, HOMA-IR was consistently and inversely associated with ASM/weight before and after adjustment for other potential confounders.

Conclusion

Our results support the idea that lower skeletal muscle mass is independently associated with insulin resistance in older adults. When evaluating sarcopenia or muscle-related conditions in older adults, their whole body sizes also need to be considered.

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Response
Original Article
Prevalence of Dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005
Myung Ha Lee, Hyeon Chang Kim, Song Vogue Ahn, Nam Wook Hur, Dong Phil Choi, Chang Gyu Park, Il Suh
Diabetes Metab J. 2012;36(1):43-55.   Published online February 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.1.43
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AbstractAbstract PDFPubReader   
Background

Dyslipidemia is a disorder of lipid metabolism, including elevated total cholesterol, elevated triglyceride, elevated low density lipoprotein cholesterol (LDL-C), and decreased high density lipoprotein cholesterol (HDL-C). The objective of this study was to investigate recent changes in the prevalence of dyslipidemia and also the rates of awareness, treatment, and control of dyslipidemia among Korean adults.

Methods

Dyslipidemia is defined according to the National Cholesterol Education Program-Adult Treatment Panel III as total cholesterol ≥240 mg/dL, LDL-C ≥160 mg/dL, HDL-C <40 mg/dL, and triglyceride ≥200 mg/dL. The prevalence of dyslipidemia was estimated for adults aged ≥20 years using the Korea National Health and Nutrition Survey (KNHANES) in 1998 (n=6,923), 2001 (n=4,882), and 2005 (n=5,323). Rates of awareness, treatment and control of dyslipidemia were calculated for adults aged ≥30 years using the KNHANES in 2005 (n=4,654).

Results

The prevalence of dyslipidemia (aged ≥20 years) increased from 32.4% in 1998 to 42.6% in 2001 and 44.1% in 2005. Compared with the KNHANES in 1998, the prevalence of dyslipidemia was 47% (95% confidence interval [CI], 35% to 59%) higher in 2001 and 61% (95% CI, 49% to 75%) higher in 2005. In 2005, only 9.5% of people with dyslipidemia were aware of the disease, 5.2% used lipid-lowering medication, and 33.2% of patients with treatment reached treatment goals.

Conclusion

The prevalence of dyslipidemia in Korea gradually increased between 1998 and 2005. These findings suggest that more intense efforts for the prevention and treatment of dyslipidemia may lead to further improvement in the management of dyslipidemia.

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    Preventive Medicine.2013; 57(4): 304.     CrossRef
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    Journal of Clinical Periodontology.2013; 40(5): 437.     CrossRef
  • Trends in Cardiovascular Health Metrics among Korean Adults
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    Korean Journal of Family Medicine.2013; 34(6): 403.     CrossRef
  • Increasing achievement of the target goals for glycemic, blood pressure and lipid control for adults with diagnosed diabetes in Korea
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    Endocrine Journal.2013; 60(10): 1179.     CrossRef
  • Response: Prevalence of Dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005 (Diabetes Metab J 2012;36:43-55)
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  • Letter: Prevalence of Dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005 (Diabetes Metab J 2012;36:43-55)
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    Diabetes & Metabolism Journal.2012; 36(2): 163.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal