Diabetes & Metabolism Journal

Original Articles

Metabolic Risk/Epidemiology
Harnessing Metabolic Indices as a Predictive Tool for Cardiovascular Disease in a Korean Population without Known Major Cardiovascular Event: Hyun-Jin Kim, Byung Sik Kim, Yonggu Lee, Sang Bong Ahn, Dong Wook Kim, Jeong-Hun Shin; Diabetes Metab J. 2024;48(3):449-462. Published online February 1, 2024; DOI: https://doi.org/10.4093/dmj.2023.0197

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Background
This study evaluated the usefulness of indices for metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR), as predictive tools for cardiovascular disease in middle-aged Korean adults.
Methods
The prospective data obtained from the Ansan-Ansung cohort database, excluding patients with major adverse cardiac and cerebrovascular events (MACCE). The primary outcome was the incidence of MACCE during the follow-up period.
Results
A total of 9,337 patients were included in the analysis, of whom 1,130 (12.1%) experienced MACCE during a median follow-up period of 15.5 years. The metabolic syndrome severity Z-score, metabolic syndrome severity score, hepatic steatosis index, and NAFLD liver fat score were found to significantly predict MACCE at values above the cut-off point and in the second and third tertiles. Among these indices, the hazard ratios of the metabolic syndrome severity score and metabolic syndrome severity Z-score were the highest after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) of the 10-year atherosclerotic cardiovascular disease (ASCVD) score for predicting MACCE was 0.716, and the metabolic syndrome severity Z-score had an AUC of 0.619.
Conclusion
The metabolic syndrome severity score is a highly reliable indicator and was closely associated with the 10-year ASCVD risk score in predicting MACCE in the general population. Given the specific characteristics and limitations of metabolic syndrome severity scores as well as the indices of NAFLD and IR, a more practical scoring system that considers these factors is essential to achieve greater accuracy in forecasting cardiovascular outcomes.

Citations

Citations to this article as recorded by

Risk-associated and clinically informative biomarkers for cardiovascular risk stratification in metabolic dysfunction–Associated steatotic liver disease
Jiaxin Zhong, Yiwei Zhao, Huifen He, Yi Lan, Zixin Cai
American Journal of Preventive Cardiology.2026; 26: 101415. CrossRef
Association of metabolic syndrome and its severity with liver fibrosis: a cross-sectional study based on NHANES 2017–March 2020, 2021–2023
Jiahui Yang, Xufeng Li, Fang Qi
BMC Gastroenterology.2026;[Epub] CrossRef
Comparing non-alcoholic fatty liver disease indices in predicting the prevalence and incidence of metabolic syndrome in middle-aged adults
Byung Sik Kim, Hyun-Jin Kim, Seong Won Jeon, Kyung Hwan Kim, Dong Wook Kim, Jeong-Hun Shin
Heliyon.2025; 11(7): e43073. CrossRef
Long-term clinical outcome and risk stratification across stages of cardiovascular-kidney-metabolic syndrome in a nationwide cohort
Hyun-Jin Kim, Byung Sik Kim, Hasung Kim, Jungkuk Lee, Ha Hye Jo, Dong Wook Kim, Jeong-Hun Shin, Ki-Chul Sung
The Korean Journal of Internal Medicine.2025; 40(6): 975. CrossRef
Association of the triglyceride-glucose index with cardiovascular outcomes across cardiovascular-kidney-metabolic syndrome stages
Byung Sik Kim, Hyun-Jin Kim, Shinje Moon, Hasung Kim, Jungkuk Lee, Jeong-Hun Shin
The Korean Journal of Internal Medicine.2025; 40(6): 961. CrossRef
Cardiovascular risk across stages of cardiovascular-kidney-metabolic syndrome in South Korea, 2002–2022: A population-based cohort study
Jaehyeong Cho, Tae Hyeon Kim, Yejun Son, Yesol Yim, Jeongseon Oh, Hyunjee Kim, Jinyoung Jeong, Jiyeon Oh, Sooji Lee, Louis Jacob, Hanseul Cho, Yerin Hwang, Dong Keon Yon
Medicine.2025; 104(51): e45960. CrossRef
Association between mixed exposure to per- and polyfluoroalkyl substances and metabolic syndrome in Korean adults: Data from the Korean National environmental health survey cycle 4
Seung Min Chung, Kyun Hoo Kim, Jun Sung Moon, Kyu Chang Won
International Journal of Hygiene and Environmental Health.2024; 261: 114427. CrossRef
Estimated pulse wave velocity as a forefront indicator of developing metabolic syndrome in Korean adults
Hyun-Jin Kim, Byung Sik Kim, Dong Wook Kim, Jeong-Hun Shin
The Korean Journal of Internal Medicine.2024; 39(4): 612. CrossRef

Basic Research
Role of Autophagy in Granulocyte-Colony Stimulating Factor Induced Anti-Apoptotic Effects in Diabetic Cardiomyopathy: Guang-Yin Shen, Jeong-Hun Shin, Yi-Sun Song, Hyun-Woo Joo, In-Hwa Park, Jin-Hee Seong, Na-Kyoung Shin, A-Hyeon Lee, Young Jong Cho, Yonggu Lee, Young-Hyo Lim, Hyuck Kim, Kyung-Soo Kim; Diabetes Metab J. 2021;45(4):594-605. Published online February 26, 2021; DOI: https://doi.org/10.4093/dmj.2020.0049

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Background
We previously, reported that granulocyte-colony stimulating factor (G-CSF) reduces cardiomyocyte apoptosis in diabetic cardiomyopathy. However, the underlying mechanisms are not yet fully understood. Therefore, we investigated whether the mechanisms underlying of the anti-apoptotic effects of G-CSF were associated with autophagy using a rat model of diabetic cardiomyopathy.
Methods
Diabetic cardiomyopathy was induced in rats through a high-fat diet combined with low-dose streptozotocin and the rats were then treated with G-CSF for 5 days. Rat H9c2 cardiac cells were cultured under high glucose conditions as an in vitro model of diabetic cardiomyopathy. The extent of apoptosis and protein levels related to autophagy (Beclin-1, microtubule-binding protein light chain 3 [LC3]-II/LC3-I ratio, and P62) were determined for both models. Autophagy determination was performed using an Autophagy Detection kit.
Results
G-CSF significantly reduced cardiomyocyte apoptosis in the diabetic myocardium in vivo and led to an increase in Beclin-1 level and the LC3-II/LC3-I ratio, and decreased P62 level. Similarly, G-CSF suppressed apoptosis, increased Beclin-1 level and LC3-II/LC3-I ratio, and decreased P62 level in high glucose-induced H9c2 cardiac cells in vitro. These effects of G-CSF were abrogated by 3-methyladenine, an autophagy inhibitor. In addition, G-CSF significantly increased autophagic flux in vitro.
Conclusion
Our results suggest that the anti-apoptotic effect of G-CSF might be significantly associated with the up-regulation of autophagy in diabetic cardiomyopathy.

Citations

Citations to this article as recorded by

K41-A enhances the antiproliferative efficacy of cisplatin in neuroblastoma by modulating apoptosis and autophagy
Gamze Sanlav, Selen Kum Ozsengezer, Zekiye Altun, Erdal Bedir, Safiye Aktas, Nur Olgun
Journal of Pharmacy and Pharmacology.2026;[Epub] CrossRef
One‐Step Microfluidic Manufactured Fucose‐Decorated Sweetosomes Choose the Time and the Road for Their Intracellular Journey to Cancer Treatment
Mattia Tiboni, Mariele Montanari, Shiva Khorshid, Michele Verboni, Andrea Duranti, Simone Lucarini, Daniele Lopez, Annalisa Aluigi, Gianluca Morganti, Michele Menotta, Giovanna Panza, Daniel J. Klionsky, Barbara Canonico, Luca Casettari
Advanced Healthcare Materials.2026;[Epub] CrossRef
A new macrocyclic dansyl-cyclen fluorescent probe for the identification of mildly acidic intracellular compartments
Daniele Paderni, Daniele Lopez, Annarita Ciavarella, Mariele Montanari, Giovanna Panza, Maria Voccia, Mauro Formica, Barbara Canonico, Eleonora Macedi, Stefano Papa, Vieri Fusi
Inorganica Chimica Acta.2025; 581: 122620. CrossRef
Metformin activates autophagy and inhibits apoptosis and fetal heart abnormalities via the Dnmt3l/Usp18/STAT1 pathway
Ying Wei, Rui Meng, Xiaofeng Chen, Lina Guan, Jiale Yu, Yifan Wu, Cuige Shi, Jialing He, Dongmei Su, Xu Ma, Lei Sun
European Journal of Pharmacology.2025; 1005: 177997. CrossRef
Targeting autophagy in diabetic cardiomyopathy: From molecular mechanisms to pharmacotherapy
Jie Li, Yingying Xie, Shuwen Zheng, Haoming He, Zhe Wang, Xuexi Li, Siqi Jiao, Dong Liu, Furong Yang, Hailing Zhao, Ping Li, Yihong Sun
Biomedicine & Pharmacotherapy.2024; 175: 116790. CrossRef
Knockout of C1q/tumor necrosis factor-related protein-9 aggravates cardiac fibrosis in diabetic mice by regulating YAP-mediated autophagy
Shiyan Ruan, Jun Li, Shengyun Lei, Shaomeng Zhang, Dan Xu, Anju Zuo, Linxi Li, Yuan Guo
Frontiers in Pharmacology.2024;[Epub] CrossRef
Ginkgo biloba extract protects against diabetic cardiomyopathy by restoring autophagy via adenosine monophosphate‐activated protein kinase/mammalian target of the rapamycin pathway modulation
Xueyao Yang, Xin Zhao, Yanfei Liu, Yue Liu, Libo Liu, Ziyu An, Haoran Xing, Jinfan Tian, Xiantao Song
Phytotherapy Research.2023; 37(4): 1377. CrossRef
Antiatherosclerotic Effect and Molecular Mechanism of Salidroside
Si-Fan Fei, De-Bing Tong, Fang Jia
Reviews in Cardiovascular Medicine.2023;[Epub] CrossRef
Perspectives for Forkhead box transcription factors in diabetic cardiomyopathy: Their therapeutic potential and possible effects of salvianolic acids
Ronghui Han, Hemeng Huang, Weiyi Xia, Jingjin Liu, Hui Luo, Jing Tang, Zhengyuan Xia
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef

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