Diabetes & Metabolism Journal

Original Articles

Complications
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 Metab J. 2023;47(2):232-241. Published online January 19, 2023; DOI: https://doi.org/10.4093/dmj.2021.0355

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Background
We aimed to evaluate whether non-alcoholic fatty liver disease (NAFLD) with or without sarcopenia is associated with progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM).
Methods
We investigated 852 T2DM patients who underwent abdominal ultrasonography, bioelectrical impedance analysis, and carotid artery ultrasonography at baseline and repeated carotid ultrasonography after 6 to 8 years. NAFLD was confirmed by abdominal ultrasonography, and sarcopenia was defined as a sex-specific skeletal muscle mass index (SMI) value <2 standard deviations below the mean for healthy young adults. SMI was calculated by dividing the sum of appendicular skeletal mass by body weight. We investigated the association between NAFLD with or without sarcopenia and the progression of carotid atherosclerosis.
Results
Of the 852 patients, 333 (39.1%) were classified as NAFLD without sarcopenia, 66 (7.7%) were classified as sarcopenia without NAFLD, and 123 (14.4%) had NAFLD with sarcopenia at baseline. After 6 to 8 years, patients with both NAFLD and sarcopenia had a higher risk of atherosclerosis progression (adjusted odds ratio, 2.20; P<0.009) than controls without NAFLD and sarcopenia. When a subgroup analysis was performed on only patients with NAFLD, female sex, absence of central obesity, and non-obesity were significant factors related to increased risk of plaque progression risk in sarcopenic patients.
Conclusion
NAFLD with sarcopenia was significantly associated with the progression of carotid atherosclerosis in T2DM patients.

Citations

Citations to this article as recorded by

Metabolic-associated fatty liver disease and sarcopenia: A double whammy
Aditya Viswanath, Sherouk Fouda, Cornelius James Fernandez, Joseph M Pappachan
World Journal of Hepatology.2024; 16(2): 152. CrossRef
Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease
Suprabhat Giri, Prajna Anirvan, Sumaswi Angadi, Ankita Singh, Anurag Lavekar
World Journal of Gastrointestinal Pathophysiology.2024;[Epub] CrossRef
Association between non-alcoholic fatty liver disease and risk of sarcopenia: a systematic review and meta-analysis
Chao Deng, Qifeng Ou, Xuee Ou, Ding Pan
BMJ Open.2024; 14(5): e078933. CrossRef
Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy decreases lean body mass and appendicular skeletal muscle mass index even until one year after the final treatment in patients with B-cell non-Hodgkin lymphoma
Sanshiro Nakao, Daiji Ngayama, Chiaki Nakaseko, Naomi Shimizu
Journal of Chemotherapy.2024; : 1. CrossRef
Clinical Characteristics of Sarcopenia in Nonalcoholic Fatty Liver Disease: A Systemic Scoping Review
Tingdan Ye, Ke Mi, Lin Zhu, Jonathan Li, Calvin Q. Pan
Obesity Facts.2024; : 1. CrossRef
Association of nonalcoholic fatty liver disease and carotid media‐intima thickness: A systematic review and a meta‐analysis
Manouchehr Khoshbaten, Sepideh H. Maleki, Sara Hadad, Amrit Baral, Ana V. Rocha, Laxmi Poudel, Alireza Abdshah
Health Science Reports.2023;[Epub] CrossRef
Cardiometabolic risk factors in patients with type 2 diabetes and sarcopenia
Yu. G. Samoilova, M. V. Matveeva, E. A. Khoroshunova, D. V. Podchinenova, L. L. Maksimova, G. G. Gorbach, A. B. Trivozhenko, V. A. Avkhimenko
Cardiovascular Therapy and Prevention.2023; 23(1): 3655. CrossRef

Complications
Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease: Da Hea Seo, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongha Seo, Seongbin Hong, Yong-ho Lee, Young Ju Choi, Eunjig Lee, So Hun Kim; Diabetes Metab J. 2022;46(4):630-639. Published online January 26, 2022; DOI: https://doi.org/10.4093/dmj.2021.0130

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Background
Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and CKD is uncertain, particularly in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with T2DM.
Methods
In this longitudinal cohort study of patients with T2DM, 3,188 patients with preserved renal function were followed up for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography, without any other causes of chronic liver disease. Advanced liver fibrosis of NAFLD was defined as a fibrosis-4 index ≥2.67. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m².
Results
At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3±3.6 years, 472 (14.8%) patients developed incident CKD: 220 (15.1%) in the non-NAFLD group, 231 (14.1%) in the NAFLD without advanced fibrosis group and 28 (31.1%) in the NAFLD with advanced fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared to the non-NAFLD group (P=0.435). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio, 1.75; 95% confidence interval, 1.15 to 2.66; P=0.009).
Conclusion
Advanced liver fibrosis in patients with NAFLD is independently associated with an increased risk of incident CKD in patients with T2DM.

Citations

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Salvador Benlloch, Francesc Moncho, Jose Luis Górriz
Nefrología.2024; 44(2): 129. CrossRef
Longitudinal Outcomes Associated With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Meta-analysis of 129 Studies
Kai En Chan, Elden Yen Hng Ong, Charlotte Hui Chung, Christen En Ya Ong, Benjamin Koh, Darren Jun Hao Tan, Wen Hui Lim, Jie Ning Yong, Jieling Xiao, Zhen Yu Wong, Nicholas Syn, Apichat Kaewdech, Margaret Teng, Jiong-Wei Wang, Nicholas Chew, Dan Yock Young
Clinical Gastroenterology and Hepatology.2024; 22(3): 488. CrossRef
Association of NAFLD/NASH, and MAFLD/MASLD with chronic kidney disease: an updated narrative review
Amedeo Lonardo
Metabolism and Target Organ Damage.2024;[Epub] CrossRef
Targeting metabolic-associated fatty liver disease in diabetic kidney disease: A call to action
Salvador Benlloch, Francesc Moncho, Jose Luis Górriz
Nefrología (English Edition).2024; 44(2): 129. CrossRef
Epidemiology, screening, and co-management of type 2 diabetes mellitus and metabolic dysfunction–associated steatotic liver disease
Xiaolong Qi, Jie Li, Cyrielle Caussy, Gao-Jun Teng, Rohit Loomba
Hepatology.2024;[Epub] CrossRef
Impact of dietary fiber intake on non-alcoholic fatty liver disease risk in Korean patients with obesity and type 2 diabetes mellitus
Ji-Sook Park, Hina Akbar, Young-Seol Kim, Jung-Eun Yim
Journal of Nutrition and Health.2024; 57(3): 282. CrossRef
Digestive system diseases and a chronic kidney disease — the two sides of the healthcare global problems
A.M. Osadchuk, I.D. Loranskaya, M.A. Osadchuk
Russian Journal of Preventive Medicine.2024; 27(7): 108. CrossRef
Sex and Gender Differences in Liver Fibrosis: Pathomechanisms and Clinical Outcomes
Mohamad Jamalinia, Amedeo Lonardo, Ralf Weiskirchen
Fibrosis.2024; 2(1): 10006. CrossRef
Risk Factors for Cataracts in Patients with Diabetes Mellitus
Adriana Ivanescu, Simona Popescu, Laura Gaita, Oana Albai, Adina Braha, Romulus Timar
Journal of Clinical Medicine.2024; 13(23): 7005. CrossRef
MAFLD and NAFLD in the prediction of incident chronic kidney disease
So Yoon Kwon, Jiyun Park, So Hee Park, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Janghyun Koh, Jae Hwan Jee, Jae Hyeon Kim, Mira Kang, Sang-Man Jin
Scientific Reports.2023;[Epub] CrossRef
Associations of non-invasive indices of liver steatosis and fibrosis with progressive kidney impairment in adults with type 2 diabetes
Mei Chung Moh, Sharon Li Ting Pek, Kenny Ching Pan Sze, Serena Low, Tavintharan Subramaniam, Keven Ang, Wern Ee Tang, Simon Biing Ming Lee, Chee Fang Sum, Su Chi Lim
Acta Diabetologica.2023; 60(6): 827. CrossRef
Pancreatic beta-cell specific BAG3 knockout results in chronic hyperinsulinemia inducing insulin resistance
Verena Damiani, Alessia Lamolinara, Ilaria Cicalini, Maria Concetta Cufaro, Francesco Del Pizzo, Federica Di Marco, Piero Del Boccio, Beatrice Dufrusine, Michael Hahne, Rossano Lattanzio, Damiana Pieragostino, Manuela Iezzi, Massimo Federici, Maria Cateri
Molecular Metabolism.2023; 74: 101752. CrossRef
Utility of non-invasive liver fibrosis markers to predict the incidence of chronic kidney disease (CKD): A systematic review, meta-analysis, and meta-regression
Rudi Supriyadi, Theo Audi Yanto, Timotius Ivan Hariyanto, Ketut Suastika
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(8): 102814. CrossRef
Significance of Diabetic Kidney Disease Biomarkers in Predicting Metabolic-Associated Fatty Liver Disease
Jaehyun Bae, Byung-Wan Lee
Biomedicines.2023; 11(7): 1928. CrossRef
Hepatic Fibrosis Evaluated in Patients with Type 2 Diabetes with and without Chronic Kidney Disease
Therese Adrian, Mads Hornum, Filip Krag Knop, Karl Bang Christensen, Thomas Almdal, Peter Rossing, Lisa Í Lídaa, Niels Søndergaard Heinrich, Vincent Oltman Boer, Anouk Marsman, Esben Thade Petersen, Hartwig Roman Siebner, Bo Feldt-Rasmussen
Nephron.2023; 147(11): 673. CrossRef
Clinical Interest of Serum Alpha-2 Macroglobulin, Apolipoprotein A1, and Haptoglobin in Patients with Non-Alcoholic Fatty Liver Disease, with and without Type 2 Diabetes, before or during COVID-19
Olivier Deckmyn, Thierry Poynard, Pierre Bedossa, Valérie Paradis, Valentina Peta, Raluca Pais, Vlad Ratziu, Dominique Thabut, Angelique Brzustowski, Jean-François Gautier, Patrice Cacoub, Dominique Valla
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Fibrosis Risk in Nonalcoholic Fatty Liver Disease Is Related to Chronic Kidney Disease in Older Type 2 Diabetes Patients
Yifan Sun, Liang Hong, Zhe Huang, Lihong Wang, Yanqin Xiong, Shuhang Zong, Rui Zhang, Jun Liu, Shufei Zang
The Journal of Clinical Endocrinology & Metabolism.2022; 107(9): e3661. CrossRef
Beyond Liver Disease: Non-Alcoholic Fatty Liver Disease and Advanced Liver Fibrosis in Kidney Disease
Eugene Han
Diabetes & Metabolism Journal.2022; 46(4): 564. CrossRef
A higher FIB‐4 index is associated with an increased incidence of renal failure in the general population
Eva Maria Schleicher, Simon Johannes Gairing, Peter Robert Galle, Julia Weinmann‐Menke, Jörn M. Schattenberg, Karel Kostev, Christian Labenz
Hepatology Communications.2022; 6(12): 3505. CrossRef
Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease (Diabetes Metab J 2022;46:630-9)
Ji Hye Huh
Diabetes & Metabolism Journal.2022; 46(6): 953. CrossRef
Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease (Diabetes Metab J 2022;46:630-9)
Da Hea Seo, So Hun Kim
Diabetes & Metabolism Journal.2022; 46(6): 956. CrossRef

Complications
Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function: Da Hea Seo, Moonsuk Nam, Mihye Jung, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, So Hun Kim; Diabetes Metab J. 2020;44(6):875-886. Published online July 10, 2020; DOI: https://doi.org/10.4093/dmj.2019.0221

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Background

Recent studies have demonstrated that the levels of adipocyte fatty acid-binding protein (A-FABP) are closely associated with diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to examine the association between serum A-FABP level and rapid renal function decline in patients with T2DM and preserved renal function.

Methods

This was a prospective observational study of 452 patients with T2DM and preserved renal function who had serial measurements of estimated glomerular filtration rate (eGFR). Rapid renal function decline was defined as an eGFR decline of >4% per year. The association between baseline serum A-FABP level and rapid renal function decline was investigated.

Results

Over a median follow-up of 7 years, 82 participants (18.1%) experienced rapid renal function decline. Median A-FABP levels were significantly higher in patients with rapid renal function decline, compared to non-decliners (20.2 ng/mL vs. 17.2 ng/mL, P=0.005). A higher baseline level of A-FABP was associated with a greater risk of developing rapid renal function decline, independent of age, sex, duration of diabetes, body mass index, systolic blood pressure, history of cardiovascular disease, baseline eGFR, urine albumin creatinine ratio, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein and use of thiazolidinedione, insulin, angiotensin-converting-enzyme inhibitors and angiotensin II-receptor blockers and statin (odds ratio, 3.10; 95% confidence interval, 1.53 to 6.29; P=0.002).

Conclusion

A high level of serum A-FABP is associated with an increased risk of rapid renal function decline in patients with T2DM and preserved renal function. This suggests that A-FABP could play a role in the progression of DKD in the early stages.

Citations

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An In-Silico Approach to Identify Therapeutic Target and Markers Associated with Diabetic Nephropathy
Bhuvnesh Rai, Pramod Kumar Maurya, Medha Srivastava, Prabhakar Mishra, Mehar Hasan Asif, Swasti Tiwari
Current Diabetes Reviews.2025;[Epub] CrossRef
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Ellen M. van der Ark-Vonk, Mike V. Puijk, Gerard Pasterkamp, Sander W. van der Laan
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High-expression of FABP4 in Tubules is a Risk Factor for Poor Prognosis in DKD Patients
Yao Huang, Xinyuan Cui, Zheng Li, Shuguang Yuan, Yachun Han, Xiangqing Xu, Xiao Fu, Kewen Shi, Zurong Zhang, Jinying Wei, Shiyu Xia, Yang Xiao, Song Xue, Lin Sun, Hong Liu, Xuejing Zhu
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Risk factors for rapid kidney function decline in diabetes patients
Jixin Xing, Linxi Huang, Weifu Ren, Xiaobin Mei
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Serum fatty acid-binding protein 4 as a biomarker for early detection of diabetic nephropathy in type 2 diabetes
Amr M. Shaker, Maggie E. Mohamed, Tarek Ramzy, Mayssa I. Ali
The Egyptian Journal of Internal Medicine.2023;[Epub] CrossRef
Circulating thrombospondin-2 level for identifying individuals with rapidly declining kidney function trajectory in type 2 diabetes: a prospective study of the Hong Kong West Diabetes Registry
Chi-Ho Lee, David Tak-Wai Lui, Chloe Yu-Yan Cheung, Carol Ho-Yi Fong, Michele Mae-Ann Yuen, Wing-Sun Chow, Aimin Xu, Karen Siu-Ling Lam
Nephrology Dialysis Transplantation.2023;[Epub] CrossRef
Analysis of Inflammatory Cytokines and Estimated Glomerular Filtration Rate Decline in Japanese Patients with Diabetic Kidney Disease: A Pilot Study
Yuka Sugawara, Yosuke Hirakawa, Koki Mise, Kosuke Kashiwabara, Ko Hanai, Satoshi Yamaguchi, Akihiro Katayama, Yasuhiro Onishi, Yui Yoshida, Naoki Kashihara, Yutaka Matsuyama, Tetsuya Babazono, Masaomi Nangaku, Jun Wada
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The role of statins in patients with early diabetic nephropathy
Xi Zhao, Shu Chun Zhou, Xiu Fang Wang, Hong Wu Liao
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Bang-Gee Hsu, Chin-Yee Mah, Du-An Wu, Ming-Chun Chen
International Journal of Environmental Research and Public Health.2022; 19(15): 9459. CrossRef
Fatty acid-binding protein 4 in kidney diseases: From mechanisms to clinics
Weijing Lai, Min Shi, Rongshuang Huang, Ping Fu, Liang Ma
European Journal of Pharmacology.2022; 931: 175224. CrossRef
Serum fatty acid-binding protein 4 levels and responses of pancreatic islet β-cells and α-cells in patients with type 2 diabetes
Hong Wang, Jie Cao, Jian-bin Su, Xue-qin Wang, Xing Wang, Dong-mei Zhang, Xiao-hua Wang
Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef
The Low-Expression Variant of FABP4 Is Associated With Cardiovascular Disease in Type 1 Diabetes
Emma H. Dahlström, Jani Saksi, Carol Forsblom, Nicoline Uglebjerg, Nina Mars, Lena M. Thorn, Valma Harjutsalo, Peter Rossing, Tarunveer S. Ahluwalia, Perttu J. Lindsberg, Niina Sandholm, Per-Henrik Groop
Diabetes.2021; 70(10): 2391. CrossRef
White adipocyte-targeted dual gene silencing of FABP4/5 for anti-obesity, anti-inflammation and reversal of insulin resistance: Efficacy and comparison of administration routes
Jee Young Chung, Juhyeong Hong, Hyung-Jin Kim, Yoonsung Song, Seok-Beom Yong, Jieun Lee, Yong-Hee Kim
Biomaterials.2021; 279: 121209. CrossRef

Complications
Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function: Da Hea Seo, So Hun Kim, Joon Ho Song, Seongbin Hong, Young Ju Suh, Seong Hee Ahn, Jeong-Taek Woo, Sei Hyun Baik, Yongsoo Park, Kwan Woo Lee, Young Seol Kim, Moonsuk Nam; Diabetes Metab J. 2019;43(6):840-853. Published online March 12, 2019; DOI: https://doi.org/10.4093/dmj.2018.0186

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Background

Recent evidences indicate that early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease. We have investigated the association between carotid atherosclerosis and rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function.

Methods

In a prospective, multicenter cohort, a total of 967 patients with type 2 diabetes mellitus and preserved renal function were followed for 6 years with serial estimated glomerular filtration rate (eGFR) measurements. Common carotid intima-media thickness (CIMT) and presence of carotid plaque were assessed at baseline. Rapid renal function decline was defined as an eGFR decline >3.3% per year.

Results

Over a median follow-up of 6 years, 158 participants (16.3%) developed rapid renal function decline. While there was no difference in CIMT, the presence of carotid plaque in rapid decliners was significantly higher than in non-decliners (23.2% vs. 12.2%, P<0.001). In multivariable logistic regression analysis, presence of carotid plaque was an independent predictor of rapid renal function decline (odds ratio, 2.33; 95% confidence interval, 1.48 to 3.68; P<0.0001) after adjustment for established risk factors. The model including the carotid plaque had better performance for discrimination of rapid renal function decline than the model without carotid plaque (area under the receiver operating characteristic curve 0.772 vs. 0.744, P=0.016).

Conclusion

Close monitoring of renal function and early intensive management may be beneficial in patients with type 2 diabetes mellitus and carotid plaques.

Citations

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Impact of diabetes distress on glycemic control and diabetic complications in type 2 diabetes mellitus
Hye-Sun Park, Yongin Cho, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, Young Ju Suh, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Kwan Woo Lee, So Hun Kim
Scientific Reports.2024;[Epub] CrossRef
The Association between the Severity of Distal Sensorimotor Polyneuropathy and Increased Carotid Atherosclerosis in Individuals with Type 2 Diabetes
Dong-Yi Hsieh, Yun-Ru Lai, Chih-Cheng Huang, Chi-Ping Ting, Wen-Chan Chiu, Yung-Nien Chen, Chia-Yi Lien, Ben-Chung Cheng, Ting-Yin Lin, Hui Ching Chiang, Cheng-Hsien Lu
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Correlation analysis of carotid plaque in young patients with newly diagnosed type 2 diabetes and platelet-to-lymphocyte ratio and neutrophil–lymphocyte ratio
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Yiwen Li, Yanfei Liu, Shiwei Liu, Mengqi Gao, Wenting Wang, Keji Chen, Luqi Huang, Yue Liu
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Carotid intima-media thickness and atherosclerotic plaques are associated with renal function decline: a 14-year longitudinal population-based study
Miriam Goepfert, Till Ittermann, Marcus Dörr, Nele Friedrich, Henry Völzke, Thomas Dabers, Stephan B Felix, Ulf Schminke, Sylvia Stracke, Sabrina von Rheinbaben
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Luca Truscello, Dina Nobre, Vehashini Sabaratnam, Olivier Bonny, Grégoire Wuerzner, Michel Burnier, Fadi Fakhouri, Menno Pruijm, Anne Zanchi
Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef
Explainable Artificial Intelligence Paves the Way in Precision Diagnostics and Biomarker Discovery for the Subclass of Diabetic Retinopathy in Type 2 Diabetics
Fatma Hilal Yagin, Seyma Yasar, Yasin Gormez, Burak Yagin, Abdulvahap Pinar, Abedalrhman Alkhateeb, Luca Paolo Ardigò
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Letter: Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function (Diabetes Metab J 2019;43:840–53)
Min-Ji Kim, Jae-Han Jeon
Diabetes & Metabolism Journal.2020; 44(1): 201. CrossRef
Response: Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function (Diabetes Metab J 2019;43:840–53)
Da Hea Seo, So Hun Kim, Moonsuk Nam
Diabetes & Metabolism Journal.2020; 44(1): 205. CrossRef
Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function
Da Hea Seo, Moonsuk Nam, Mihye Jung, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, So Hun Kim
Diabetes & Metabolism Journal.2020; 44(6): 875. CrossRef
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Clinical Care/Education
Impact of Socioeconomic Status on Health Behaviors, Metabolic Control, and Chronic Complications in Type 2 Diabetes Mellitus: So Hun Kim, Seung Youn Lee, Chei Won Kim, Young Ju Suh, Seongbin Hong, Seong Hee Ahn, Da Hae Seo, Moon-Suk Nam, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Yongsoo Park, Kwan Woo Lee, Young Seol Kim; Diabetes Metab J. 2018;42(5):380-393. Published online June 29, 2018; DOI: https://doi.org/10.4093/dmj.2017.0102

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Background

The aim of the study was to assess the impact of socioeconomic status (SES) on health behaviors, metabolic control, and chronic complications in people with type 2 diabetes mellitus (T2DM) from South Korea, a country with universal health insurance coverage and that has experienced rapid economic and social transition.

Methods

A total of 3,294 Korean men and women with T2DM aged 30 to 65 years, participating in the Korean National Diabetes Program (KNDP) cohort who reported their SES and had baseline clinical evaluation were included in the current cross-sectional analysis. SES included the level of education and monthly household income.

Results

Lower education level and lower income level were closely related, and both were associated with older age in men and women. Women and men with lower income and education level had higher carbohydrate and lower fat intake. After adjustment for possible confounding factors, higher education in men significantly lowered the odds of having uncontrolled hyperglycemia (glycosylated hemoglobin ≥7.5%) (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.43 to 0.91 for highest education; P_trend=0.048), while higher household income in men significantly lowered the odds of having diabetic retinopathy (OR, 0.59; 95% CI, 0.37 to 0.95 for highest income level; P_trend=0.048). In women, lower income was associated with a higher stress level.

Conclusion

Men with lower SES had higher odds of having diabetic retinopathy and uncontrolled hyperglycemia, showing the need to improve care targeted to this population.

Citations

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Thamer Alobaid, Janaka Karalliedde, Matthew DL O’Connell, Luigi Gnudi, Katie Sheehan, Ka Keat Lim, Salma Ayis, Munmun Chattopadhyay
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Obesity and Metabolic Syndrome
Beneficial Effects of Aerobic Exercise Training Combined with Rosiglitazone on Glucose Metabolism in Otsuka Long Evans Tokushima Fatty Rats: Shan-Ji Piao, So Hun Kim, Young Ju Suh, Seong-Bin Hong, Seong Hee Ahn, Da Hae Seo, In-Sun Park, Moonsuk Nam; Diabetes Metab J. 2017;41(6):474-485. Published online November 15, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.6.474

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Background

Regular aerobic exercise is essential for the prevention and management of type 2 diabetes mellitus and may be particularly beneficial for those treated with thiazolidinediones, since it may prevent associated weight gain. This study aimed to evaluate the effect of combined exercise and rosiglitazone treatment on body composition and glucose metabolism in obese diabetes-prone animals.

Methods

We analyzed metabolic parameters, body composition, and islet profiles in Otsuka Long Evans Tokushima Fatty rats after 28 weeks of aerobic exercise, rosiglitazone treatment, and combined exercise and rosiglitazone treatment.

Results

Combined exercise with rosiglitazone showed significantly less increase in weight and epididymal fat compared to rosiglitazone treatment. Aerobic exercise alone and combined rosiglitazone and exercise treatment led to similar retention of lean body mass. All experimental groups showed a decrease in fasting glucose. However, the combined exercise and rosiglitazone therapy group showed prominent improvement in glucose tolerance compared to the other groups. Rescue of islet destruction was observed in all experimental groups, but was most prominent in the combined therapy group.

Conclusion

Regular aerobic exercise combined with rosiglitazone treatment can compensate for the adverse effect of rosiglitazone treatment and has benefit for islet preservation.

Citations

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