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Original Articles
- Metabolic Risk/Epidemiology
- Differential Impact of Obesity on the Risk of Diabetes Development in Two Age Groups: Analysis from the National Health Screening Program
- Tae Kyung Yoo, Kyung-Do Han, Yang-Hyun Kim, Ga Eun Nam, Sang Hyun Park, Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2023;47(6):846-858. Published online August 23, 2023
- DOI: https://doi.org/10.4093/dmj.2022.0242
- 502 View
- 32 Download
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Abstract
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Supplementary Material
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ePub - Background
The effect of obesity on the development of type 2 diabetes mellitus (DM) in different age groups remains unclear. We assessed the impact of obesity on the development of DM for two age groups (40-year-old, middle age; 66-year-old, older adults) in the Korean population.
Methods
We analyzed Korean National Health Insurance Service data of 4,145,321 Korean adults with 40- and 66-year-old age without DM, between 2009 and 2014. Participants were followed up until 2017 or until the diagnosis of DM. We assessed the risk of DM based on the body mass index and waist circumference of the participants. Multiple confounding factors were adjusted.
Results
The median follow-up duration was 5.6 years. The association of general and abdominal obesity with the risk of DM development was stronger in the 40-year-old group (general obesity: hazard ratio [HR], 3.566, 95% confidence interval [CI], 3.512 to 3.622; abdominal obesity: HR, 3.231; 95% CI, 3.184 to 3.278) than in the 66-year-old group (general obesity: HR, 1.739; 95% CI, 1.719 to 1.759; abdominal obesity: HR, 1.799; 95% CI, 1.778 to 1.820). In the 66-year-old group, abdominal obesity had a stronger association with the development of DM as compared to general obesity. In the 40-year-old group, general obesity had a stronger association with the risk of DM development than abdominal obesity.
Conclusion
The influence of general and abdominal obesity on the development of DM differed according to age. In older adults, abdominal obesity had a stronger association with DM development than general obesity.
- Lifestyle
- Changes in Patterns of Physical Activity and Risk of Heart Failure in Newly Diagnosed Diabetes Mellitus Patients
- Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2022;46(2):327-336. Published online November 24, 2021
- DOI: https://doi.org/10.4093/dmj.2021.0046
- 4,585 View
- 203 Download
- 5 Citations
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Graphical Abstract
Abstract
PDFSupplementary MaterialPubReader ePub - Background
Exercise is recommended for type 2 diabetes mellitus (T2DM) patients to prevent cardiovascular disease. However, the effects of physical activity (PA) for reducing the risk of heart failure (HF) has yet to be elucidated. We aimed to assess the effect of changes in patterns of PA on incident HF, especially in newly diagnosed diabetic patients.
Methods
We examined health examination data and claims records of 294,528 participants from the Korean National Health Insurance Service who underwent health examinations between 2009 and 2012 and were newly diagnosed with T2DM. Participants were classified into the four groups according to changes in PA between before and after the diagnosis of T2DM: continuously inactive, inactive to active, active to inactive, and continuously active. The development of HF was analyzed until 2017.
Results
As compared with those who were continuously inactive, those who became physically active after diagnosis showed a reduced risk for HF (adjusted hazard ratio [aHR], 0.79; 95% confidence interval [CI], 0.66 to 0.93). Those who were continuously active had the lowest risk for HF (aHR, 0.77; 95% CI, 0.62 to 0.96). As compared with those who were inactive, those who exercised regularly, either performing vigorous or moderate PA, had a lower HF risk (aHR, 0.79; 95% CI, 0.69 to 0.91).
Conclusion
Among individuals with newly diagnosed T2DM, the risk of HF was reduced in those with higher levels of PA after diagnosis was made. Our results suggest either increasing or maintaining the frequency of PA after the diagnosis of T2DM may lower the risk of HF. -
Citations
Citations to this article as recorded by
- Evaluation and Management of Patients With Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon
International Journal of Heart Failure.2023; 5(1): 1. CrossRef - Evaluation and Management of Patients with Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon
Diabetes & Metabolism Journal.2023; 47(1): 10. CrossRef - Associations Between Physical Activity and the Risk of Hip Fracture Depending on Glycemic Status: A Nationwide Cohort Study
Kyoung Min Kim, Kyoung Jin Kim, Kyungdo Han, Yumie Rhee
The Journal of Clinical Endocrinology & Metabolism.2023;[Epub] CrossRef - Association of plasma brain-derived neurotrophic factor levels and frailty in community-dwelling older adults
Eun Roh, Soon Young Hwang, Eyun Song, Min Jeong Park, Hye Jin Yoo, Sei Hyun Baik, Miji Kim, Chang Won Won, Kyung Mook Choi
Scientific Reports.2022;[Epub] CrossRef - The associations between changes in hepatic steatosis and heart failure and mortality: a nationwide cohort study
Jiyun Park, Gyuri Kim, Hasung Kim, Jungkuk Lee, Sang-Man Jin, Jae Hyeon Kim
Cardiovascular Diabetology.2022;[Epub] CrossRef
- Evaluation and Management of Patients With Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
Response
- Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
- Inha Jung, Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2021;45(5):793-794. Published online September 30, 2021
- DOI: https://doi.org/10.4093/dmj.2021.0222
- 2,935 View
- 56 Download
- 1 Citations
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Citations
Citations to this article as recorded by- Recurrent depression relates to worse outcomes than single episode depression among Hispanic adolescents with diabetes
Keiliany Rivera-Santiago, Eduardo Cumba-Aviles, Demivette Gómez-Rivera
Health Psychology Report.2023;[Epub] CrossRef
- Recurrent depression relates to worse outcomes than single episode depression among Hispanic adolescents with diabetes
Original Article
- Metabolic Risk/Epidemiology
- Dose-Dependent Effect of Smoking on Risk of Diabetes Remains after Smoking Cessation: A Nationwide Population-Based Cohort Study in Korea
- Se Eun Park, Mi Hae Seo, Jung-Hwan Cho, Hyemi Kwon, Yang-Hyun Kim, Kyung-Do Han, Jin-Hyung Jung, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2021;45(4):539-546. Published online March 4, 2021
- DOI: https://doi.org/10.4093/dmj.2020.0061
- 6,663 View
- 179 Download
- 10 Citations
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Graphical Abstract
Abstract
PDFSupplementary MaterialPubReader ePub
- Background
This study aimed to evaluate the dose-dependent effects of smoking on risk of diabetes among those quitting smoking.
Methods
We analyzed clinical data from a total of 5,198,792 individuals age 20 years or older who received health care check-up arranged by the national insurance program of Korea between 2009 and 2016 using the Korean National Health Insurance Service database. Cumulative smoking was estimated by pack-years. Smokers were classified into four categories according to the amount of smoking: light smokers (0.025 to 5 smoking pack-years), medium smokers (5 to 14 smoking pack-years), heavy smokers (14 to 26 smoking pack-years), and extreme smokers (more than 26 smoking pack-years).
Results
During the study period, 164,335 individuals (3.2% of the total population) developed diabetes. Compared to sustained smokers, the risk of diabetes was significantly reduced in both quitters (hazard ratio [HR], 0.858; 95% confidence interval [CI], 0.838 to 0.878) and nonsmokers (HR, 0.616; 95% CI, 0.606 to 0.625) after adjustment for multiple risk factors. The risk of diabetes gradually increased with amount of smoking in both quitters and current smokers. The risk of diabetes in heavy (HR, 1.119; 95% CI, 1.057 to 1.185) and extreme smokers (HR, 1.348; 95% CI, 1.275 to 1.425) among quitters was much higher compared to light smokers among current smokers.
Conclusion
Smoking cessation was effective in reducing the risk of diabetes regardless of weight change. However, there was a potential dose-dependent association between smoking amount and the development of diabetes. Diabetes risk still remained in heavy and extreme smokers even after smoking cessation. -
Citations
Citations to this article as recorded by- Chronic cigarette smoking is associated with increased arterial stiffness in men and women: evidence from a large population-based cohort
Omar Hahad, Volker H. Schmitt, Natalie Arnold, Karsten Keller, Jürgen H. Prochaska, Philipp S. Wild, Andreas Schulz, Karl J. Lackner, Norbert Pfeiffer, Irene Schmidtmann, Matthias Michal, Jörn M. Schattenberg, Oliver Tüscher, Andreas Daiber, Thomas Münzel
Clinical Research in Cardiology.2023; 112(2): 270. CrossRef - Association between Meal Frequency and Type 2 Diabetes Mellitus in Rural Adults: A Large-Scale Cross-Sectional Study
Bota Baheti, Xiaotian Liu, Mu Wang, Caiyun Zhang, Xiaokang Dong, Ning Kang, Linlin Li, Xing Li, Songcheng Yu, Jian Hou, Zhenxing Mao, Chongjian Wang
Nutrients.2023; 15(6): 1348. CrossRef - Impaired Lung Function and Lung Cancer Incidence: A Nationwide Population-Based Cohort Study
Hye Seon Kang, Yong-Moon Park, Seung-Hyun Ko, Seung Hoon Kim, Shin Young Kim, Chi Hong Kim, Kyungdo Han, Sung Kyoung Kim
Journal of Clinical Medicine.2022; 11(4): 1077. CrossRef - Smoking cessation and risk of type 2 diabetes
Jana Malinovská, Jana Urbanová, Veronika Vejtasová, Alexandra Romanová, Sabina Pálová, Syed Taha Naeem, Jan Brož
Vnitřní lékařství.2022; 68(1): E04. CrossRef - Association between lung function and the risk of atrial fibrillation in a nationwide population cohort study
Su Nam Lee, Seung-Hyun Ko, Sung-Ho Her, Kyungdo Han, Donggyu Moon, Sung Kyoung Kim, Ki-Dong Yoo, Yu-Bae Ahn
Scientific Reports.2022;[Epub] CrossRef - Sex differences in factors associated with prediabetes in Korean adults
Jin Suk Ra
Osong Public Health and Research Perspectives.2022; 13(2): 142. CrossRef - Smoking and diabetes interplay: A comprehensive review and joint statement
Vincent Durlach, Bruno Vergès, Abdallah Al-Salameh, Thibault Bahougne, Farid Benzerouk, Ivan Berlin, Carole Clair, Jacques Mansourati, Alexia Rouland, Daniel Thomas, Philippe Thuillier, Blandine Tramunt, Anne-Laurence Le Faou
Diabetes & Metabolism.2022; 48(6): 101370. CrossRef - Impact of healthy lifestyle on the risk of type 2 diabetes mellitus in southwest China: A prospective cohort study
Yanli Wu, Xi He, Jie Zhou, Yiying Wang, Lisha Yu, Xuejiao Li, Tao Liu, Jianhua Luo
Journal of Diabetes Investigation.2022; 13(12): 2091. CrossRef - Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef - Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death
So-Ryoung Lee, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip
Journal of Clinical Medicine.2021; 10(11): 2238. CrossRef
- Chronic cigarette smoking is associated with increased arterial stiffness in men and women: evidence from a large population-based cohort
Response
- Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide Cohort Study (Diabetes Metab J 2020;44:737-46)
- Sun Joon Moon, Eun-Jung Rhee, Won-Young Lee, Kun-Ho Yoon
- Diabetes Metab J. 2020;44(6):942-943. Published online December 23, 2020
- DOI: https://doi.org/10.4093/dmj.2020.0266
- 3,388 View
- 74 Download
- 1 Citations
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Citations
Citations to this article as recorded by- Mechanisms and clinical relevance of the bidirectional relationship of viral infections with metabolic diseases
Nikolaos Perakakis, Hani Harb, Benjamin G Hale, Zsuzsanna Varga, Charlotte Steenblock, Waldemar Kanczkowski, Vasileia Ismini Alexaki, Barbara Ludwig, Peter Mirtschink, Michele Solimena, Nicole Toepfner, Sebastian Zeissig, Manuel Gado, Irene Alma Abela, Fe
The Lancet Diabetes & Endocrinology.2023; 11(9): 675. CrossRef
- Mechanisms and clinical relevance of the bidirectional relationship of viral infections with metabolic diseases
Original Article
- Cardiovascular risk/Epidemiology
- Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study
- Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2021;45(3):379-389. Published online December 11, 2020
- DOI: https://doi.org/10.4093/dmj.2020.0008
- 6,631 View
- 214 Download
- 20 Citations
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Graphical Abstract
Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Previous studies have suggested that depression in patients with diabetes is associated with worse health outcomes. The aim of this study was to evaluate the risk of cardiovascular disease (CVD) and mortality in patients with diabetes with comorbid depression.
Methods
We examined the general health check-up data and claim database of the Korean National Health Insurance Service (NHIS) of 2,668,615 participants with type 2 diabetes mellitus who had examinations between 2009 and 2012. As NHIS database has been established since 2002, those who had been diagnosed with depression or CVD since 2002 were excluded. The 2,228,443 participants were classified into three groups according to the claim history of depression; normal group (n=2,166,979), transient depression group (one episode of depression, n=42,124) and persistent depression group (at least two episodes of depression, n=19,340). The development of CVD and mortality were analyzed from 2009 to 2017.
Results
Those with depression showed a significantly increased risk for stroke (transient depression group: hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.15 to 1.26) (persistent depression group: HR, 1.54; 95% CI, 1.46 to 1.63). Those with depression had an increased risk for myocardial infarction (transient depression group: HR, 1.25; 95% CI, 1.18 to 1.31) (persistent depression group: HR, 1.38; 95% CI, 1.29 to 1.49). The persistent depression group had an increased risk for all-cause mortality (HR, 1.66; 95% CI, 1.60 to 1.72).
Conclusion
Coexisting depression in patients with diabetes has a deleterious effect on the development of CVD and mortality. We suggest that more attention should be given to patients with diabetes who present with depressive symptoms. -
Citations
Citations to this article as recorded by- The mediating effect of depression on new-onset stroke in diabetic population: Evidence from the China health and retirement longitudinal study
Gege Jiang, Yaoling Wang, Liping Wang, Minfang Chen, Wei Li
Journal of Affective Disorders.2023; 321: 208. CrossRef - Frailty and outcomes in lacunar stroke
Sima Vazquez, Zehavya Stadlan, Justin M Lapow, Eric Feldstein, Smit Shah, Ankita Das, Alexandria F Naftchi, Eris Spirollari, Akash Thaker, Syed Faraz Kazim, Jose F Dominguez, Neisha Patel, Christeena Kurian, Ji Chong, Stephan A Mayer, Gurmeen Kaur, Chirag
Journal of Stroke and Cerebrovascular Diseases.2023; 32(2): 106942. CrossRef - Comparison of Operational Definition of Type 2 Diabetes Mellitus Based on Data from Korean National Health Insurance Service and Korea National Health and Nutrition Examination Survey
Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko
Diabetes & Metabolism Journal.2023; 47(2): 201. CrossRef - The Association between Dietary Carotenoid Intake and Risk of Depression among Patients with Cardiometabolic Disease
Jie Liang, Yuhao Wang, Min Chen
International Heart Journal.2023; 64(2): 223. CrossRef - Associations of concomitant retinopathy and depression with mortality in a nationally representative population
Zheng Lyu, Yilin Chen, Zhuoting Zhu, Xiaoyang Luo, Ying Cui, Jie Xie, Zhifan Chen, Junbin Liu, Xiyu Wu, Gabrella Bulloch, Qianli Meng
Journal of Affective Disorders.2023; 336: 15. CrossRef - Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses
Chiara Possidente, Giuseppe Fanelli, Alessandro Serretti, Chiara Fabbri
Neuroscience & Biobehavioral Reviews.2023; 152: 105298. CrossRef - Prevalence of depression and association with all-cause and cardiovascular mortality among individuals with type 2 diabetes: a cohort study based on NHANES 2005–2018 data
Zhen Feng, Wai Kei Tong, Xinyue Zhang, Zhijia Tang
BMC Psychiatry.2023;[Epub] CrossRef - Cholecystectomy Increases the Risk of Type 2 Diabetes in the Korean Population
Ji Hye Huh, Kyong Joo Lee, Yun Kyung Cho, Shinje Moon, Yoon Jung Kim, Eun Roh, Kyung-do Han, Dong Hee Koh, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm
Annals of Surgery.2023; 278(2): e264. CrossRef - Risk of depression in patients with acromegaly in Korea (2006-2016): a nationwide population-based study
Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
European Journal of Endocrinology.2023; 189(3): 363. CrossRef - The association between cardiovascular drugs and depression/anxiety in patients with cardiovascular disease: A meta-analysis
Lijun Zhang, Yanping Bao, Shuhui Tao, Yimiao Zhao, Meiyan Liu
Pharmacological Research.2022; 175: 106024. CrossRef - Association of mental health with the risk of coronary artery disease in patients with diabetes: A mendelian randomization study
Teng Hu, Fangkun Yang, Kewan He, Jiajun Ying, Hanbin Cui
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(3): 703. CrossRef - Comorbidity of Type 2 Diabetes Mellitus and Depression: Clinical Evidence and Rationale for the Exacerbation of Cardiovascular Disease
Mengmeng Zhu, Yiwen Li, Binyu Luo, Jing Cui, Yanfei Liu, Yue Liu
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef - Understanding and Utilizing Claim Data from the Korean National Health Insurance Service (NHIS) and Health Insurance Review & Assessment (HIRA) Database for Research
Dae-Sung Kyoung, Hun-Sung Kim
Journal of Lipid and Atherosclerosis.2022; 11(2): 103. 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 - Evaluation of rosmarinic acid against myocardial infarction in maternally separated rats
Himanshu Verma, Anindita Bhattacharjee, Naveen Shivavedi, Prasanta Kumar Nayak
Naunyn-Schmiedeberg's Archives of Pharmacology.2022; 395(10): 1189. CrossRef - Lipid cutoffs for increased cardiovascular disease risk in non-diabetic young people
Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
European Journal of Preventive Cardiology.2022; 29(14): 1866. CrossRef - Risk factors associated with mortality among individuals with type 2 diabetes and depression across two cohorts
Christopher Rohde, Jens Steen Nielsen, Jakob Schöllhammer Knudsen, Reimar Wernich Thomsen, Søren Dinesen Østergaard
European Journal of Endocrinology.2022; 187(4): 567. CrossRef - Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
Jin Hwa Kim
Diabetes & Metabolism Journal.2021; 45(5): 789. CrossRef - Increased Risk of Cardiovascular Disease and Mortality in Patients with Diabetes and Coexisting Depression: A Nationwide Population-Based Cohort Study (Diabetes Metab J 2021;45:379-89)
Inha Jung, Eun-Jung Rhee, Won-Young Lee
Diabetes & Metabolism Journal.2021; 45(5): 793. CrossRef - Affective Temperament and Glycemic Control – The Psychological Aspect of Obesity and Diabetes Mellitus
Natalia Lesiewska, Anna Kamińska, Roman Junik, Magdalena Michalewicz, Bartłomiej Myszkowski, Alina Borkowska, Maciej Bieliński
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 4981. CrossRef
- The mediating effect of depression on new-onset stroke in diabetic population: Evidence from the China health and retirement longitudinal study
Response
- Response: Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults (Diabetes Metab J 2020;44:592-601)
- Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2020;44(5):781-782. Published online October 21, 2020
- DOI: https://doi.org/10.4093/dmj.2020.0221
- 3,447 View
- 58 Download
Original Article
- COVID-19
-
- Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide Cohort Study
- Sun Joon Moon, Eun-Jung Rhee, Jin-Hyung Jung, Kyung-Do Han, Sung-Rae Kim, Won-Young Lee, Kun-Ho Yoon
- Diabetes Metab J. 2020;44(5):737-746. Published online October 21, 2020
- DOI: https://doi.org/10.4093/dmj.2020.0141
- 9,792 View
- 200 Download
- 20 Citations
-
Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Inconsistent results have been observed regarding the independent effect of diabetes on the severity of coronavirus disease 2019 (COVID-19). We conducted a nationwide population-based cohort study to evaluate the relationship between diabetes and COVID-19 severity in South Korea.
Methods
Patients with laboratory-confirmed COVID-19 aged ≥30 years were enrolled and medical claims data were obtained from the Korean Health Insurance Review and Assessment Service. Hospitalization, oxygen treatment, ventilator application, and mortality were assessed as severity outcomes. Multivariate logistic regression analyses were performed after adjusting for age, sex, and comorbidities.
Results
Of 5,307 COVID-19 patients, the mean age was 56.0±14.4 years, 2,043 (38.5%) were male, and 770 (14.5%) had diabetes. The number of patients who were hospitalized, who received oxygen, who required ventilator support, and who died was 4,986 (94.0%), 884 (16.7%), 121 (2.3%), and 211 (4.0%), respectively. The proportion of patients with diabetes in the abovementioned outcome groups was 14.7%, 28.1%, 41.3%, 44.6%, showing an increasing trend according to outcome severity. In multivariate analyses, diabetes was associated with worse outcomes, with an adjusted odds ratio (aOR) of 1.349 (95% confidence interval [CI], 1.099 to 1.656; P=0.004) for oxygen treatment, an aOR of 1.930 (95% CI, 1.276 to 2.915; P<0.001) for ventilator use, and an aOR of 2.659 (95% CI, 1.896 to 3.729; P<0.001) for mortality.
Conclusion
Diabetes was associated with worse clinical outcomes in Korean patients with COVID-19, independent of other comorbidities. Therefore, patients with diabetes and COVID-19 should be treated with caution. -
Citations
Citations to this article as recorded by- Impact of COVID-19 on the Microbiome and Inflammatory Status of Type 2 Diabetes Patients
Gratiela Gradisteanu Pircalabioru, Georgiana Alexandra Grigore, Ilda Czobor Barbu, Mariana-Carmen Chifiriuc, Octavian Savu
Biomedicines.2023; 11(1): 179. CrossRef - Bidirectional Relationship between Glycemic Control and COVID-19 and Perspectives of Islet Organoid Models of SARS-CoV-2 Infection
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Biomedicines.2023; 11(3): 856. CrossRef - Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations
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Diabetes Research and Clinical Practice.2022; 186: 109063. CrossRef - The Role of Diabetes and Hyperglycemia on COVID-19 Infection Course—A Narrative Review
Evangelia Tzeravini, Eleftherios Stratigakos, Chris Siafarikas, Anastasios Tentolouris, Nikolaos Tentolouris
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef - The interrelationship between diabetes mellitus and COVID-19
ThekraAbdulaali Abed, ZainabAdil Ghani Chabuck
Medical Journal of Babylon.2022; 19(1): 1. CrossRef - Impact of Type 2 Diabetes Mellitus on the Incidence and Outcomes of COVID-19 Needing Hospital Admission According to Sex: Retrospective Cohort Study Using Hospital Discharge Data in Spain, Year 2020
Jose M. de Miguel-Yanes, Rodrigo Jimenez-Garcia, Javier de Miguel-Diez, Valentin Hernández-Barrera, David Carabantes-Alarcon, Jose J. Zamorano-Leon, Ricardo Omaña-Palanco, Ana Lopez-de-Andres
Journal of Clinical Medicine.2022; 11(9): 2654. CrossRef - Diabetes Fact Sheet in Korea 2021
Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
Diabetes & Metabolism Journal.2022; 46(3): 417. CrossRef - The burden and risks of emerging complications of diabetes mellitus
Dunya Tomic, Jonathan E. Shaw, Dianna J. Magliano
Nature Reviews Endocrinology.2022; 18(9): 525. CrossRef - Clinical Characteristics and Outcomes of Patients Hospitalized with COVID-19 at Case Hospital, Uganda
Mirriam Apiyo, Ronald Olum, Amina Kabuye, Betty Khainza, Anne M. Amate, Vittal Byabashaija, Derrick Nomujuni, Kato Sebbaale, Peter Senfuka, Simon Kazibwe, Gurav Sharma, Lindsay Davidson, Felix Bongomin, Diamantis Kofteridis
Interdisciplinary Perspectives on Infectious Diseases.2022; 2022: 1. CrossRef - Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning
Daniel J. Drucker
Cell Metabolism.2021; 33(3): 479. CrossRef - Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19
Sang Youl Rhee, Jeongwoo Lee, Hyewon Nam, Dae-Sung Kyoung, Dong Wook Shin, Dae Jung Kim
Diabetes & Metabolism Journal.2021; 45(2): 251. CrossRef - COVID-19 vaccine acceptance among high-risk populations in Uganda
Felix Bongomin, Ronald Olum, Irene Andia-Biraro, Frederick Nelson Nakwagala, Khalid Hudow Hassan, Dianah Rhoda Nassozi, Mark Kaddumukasa, Pauline Byakika-Kibwika, Sarah Kiguli, Bruce J. Kirenga
Therapeutic Advances in Infectious Disease.2021; 8: 204993612110243. CrossRef - Caracterización clínica, según niveles de glucemia, de pacientes hospitalizados por COVID-19: serie de casos
Irene Stulin, Maria Montes de Oca, Gabriela Blanco, Laura Sánchez, Isabel-Carlota Silva, Jennireth Quevedo, Maria Cristina Arvelo, Nathalia Valera, Irene Papa, Hospital Centro Médico de Caracas, Caracas, Venezuela Bacci, Fátima de Abreu, Héctor Villarroel
Investigación Clínica.2021; 62: 27. CrossRef - COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society
Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim
Endocrinology and Metabolism.2021; 36(4): 757. CrossRef - Diabetes Mellitus and COVID-19: Review Article
Mahmoud Nassar, Ahmed Daoud, Nso Nso, Luis Medina, Victoria Ghernautan, Harangad Bhangoo, Andrew Nyein, Mahmoud Mohamed, Ahmed Alqassieh, Karim Soliman, Mostafa Alfishawy, Issac Sachmechi, Anoop Misra
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2021; 15(6): 102268. CrossRef - Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic
Mohammad Keykhaei, Sogol Koolaji, Esmaeil Mohammadi, Reyhaneh Kalantar, Sahar Saeedi Moghaddam, Arya Aminorroaya, Shaghayegh Zokaei, Sina Azadnajafabad, Negar Rezaei, Erfan Ghasemi, Nazila Rezaei, Rosa Haghshenas, Yosef Farzi, Sina Rashedi, Bagher Larijan
Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1919. CrossRef - A Systematic Review and Meta-analysis of Diabetes Associated Mortality in Patients with COVID-19
Puneeta Gupta, Meeta Gupta, Neena KAtoch, Ketan Garg, Bhawna Garg
International Journal of Endocrinology and Metabolism.2021;[Epub] CrossRef - Diabetes, Obesity, and COVID-19
Sang Youl Rhee
The Journal of Korean Diabetes.2021; 22(3): 174. CrossRef - Diabetes, hypertension, body mass index, smoking and COVID-19-related mortality: a systematic review and meta-analysis of observational studies
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Review
- Guideline/Fact Sheet
- Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus: A Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
- Byung-Wan Lee, Yong-ho Lee, Cheol-Young Park, Eun-Jung Rhee, Won-Young Lee, Nan-Hee Kim, Kyung Mook Choi, Keun-Gyu Park, Yeon-Kyung Choi, Bong-Soo Cha, Dae Ho Lee, Korean Diabetes Association (KDA) Fatty Liver Research Group
- Diabetes Metab J. 2020;44(3):382-401. Published online May 11, 2020
- DOI: https://doi.org/10.4093/dmj.2020.0010
- 11,157 View
- 313 Download
- 41 Citations
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Abstract
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This clinical practice position statement, a product of the Fatty Liver Research Group of the Korean Diabetes Association, proposes recommendations for the diagnosis, progression and/or severity assessment, management, and follow-up of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). Patients with both T2DM and NAFLD have an increased risk of non-alcoholic steatohepatitis (NASH) and fibrosis and a higher risk of cardiovascular diseases and diabetic complications compared to those without NAFLD. With regards to the evaluation of patients with T2DM and NAFLD, ultrasonography-based stepwise approaches using noninvasive biomarker models such as fibrosis-4 or the NAFLD fibrosis score as well as imaging studies such as vibration-controlled transient elastography with controlled attenuation parameter or magnetic resonance imaging-proton density fat fraction are recommended. After the diagnosis of NAFLD, the stage of fibrosis needs to be assessed appropriately. For management, weight reduction achieved by lifestyle modification has proven beneficial and is recommended in combination with antidiabetic agent(s). Evidence that some antidiabetic agents improve NAFLD/NASH with fibrosis in patients with T2DM is emerging. However, there are currently no definite pharmacologic treatments for NAFLD in patients with T2DM. For specific cases, bariatric surgery may be an option if indicated.
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Original Articles
- Cardiovascular Risk/Epidemiology
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- Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults
- Eun-Jung Rhee, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
- Diabetes Metab J. 2020;44(4):592-601. Published online April 20, 2020
- DOI: https://doi.org/10.4093/dmj.2019.0104
- Correction in: Diabetes Metab J 2020;44(5):783
- 5,918 View
- 139 Download
- 16 Citations
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Abstract
PDFSupplementary MaterialPubReader ePub
Background Recent studies suggest an association between diabetes and increased risk of heart failure (HF). However, the associations among obesity status, glycemic status, and risk of HF are not known. In this study, we analyzed whether the risk of HF increases in participants according to baseline glycemic status and whether this increased risk is associated with obesity status.
Methods We analyzed the risk of HF according to baseline glycemic status (normoglycemia, impaired fasting glucose [IFG], and diabetes) in 9,720,220 Koreans who underwent Korean National Health Screening in 2009 without HF at baseline with a median follow-up period of 6.3 years. The participants were divided into five and six groups according to baseline body mass index (BMI) and waist circumference, respectively.
Results Participants with IFG and those with diabetes showed a 1.08- and 1.86-fold increased risk of HF, respectively, compared to normoglycemic participants. Compared to the normal weight group (BMI, 18.5 to 22.9 kg/m2), the underweight group (BMI <18.5 kg/m2) showed a 1.7-fold increased risk of HF, and those with BMI ≥30 kg/m2 showed a 1.1-fold increased risk of HF, suggesting a J-shaped association with BMI. When similar analyses were performed for different glycemic statuses, the J-shaped association between BMI and HF risk was consistently observed in both groups with and without diabetes.
Conclusion Participants with IFG and diabetes showed a significantly increased HF risk compared to normoglycemic participants. This increased risk of HF was mostly prominent in underweight and class II obese participants than in participants with normal weight.
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Citations
Citations to this article as recorded by- Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
Endocrinology and Metabolism.2023; 38(1): 10. CrossRef - Research on obesity using the National Health Information Database: recent trends
Eun-Jung Rhee
Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35. CrossRef - Impact of mental disorders on the risk of heart failure among Korean patients with diabetes: a cohort study
Tae Kyung Yoo, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee
Cardiovascular Diabetology.2023;[Epub] CrossRef - The Influence of Obesity and Metabolic Health on Vascular Health
Eun-Jung Rhee
Endocrinology and Metabolism.2022; 37(1): 1. CrossRef - Changes in Patterns of Physical Activity and Risk of Heart Failure in Newly Diagnosed Diabetes Mellitus Patients
Inha Jung, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
Diabetes & Metabolism Journal.2022; 46(2): 327. 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 - Impact of hypoglycemia at the time of hospitalization for heart failure from emergency department on major adverse cardiovascular events in patients with and without type 2 diabetes
Seon-Ah Cha, Jae-Seung Yun, Gee-Hee Kim, Yu-Bae Ahn
Cardiovascular Diabetology.2022;[Epub] CrossRef - Insulin resistance and heart failure with preserved ejection fraction. Pathogenetic and therapeutic crossroads
O. V. Tsygankova, N. E. Evdokimova, V. V. Veretyuk, L. D. Latyntseva, A. S. Ametov
Diabetes mellitus.2022; 25(6): 535. CrossRef - The association between metabolic syndrome and heart failure in middle-aged male and female: Korean population-based study of 2 million individuals
Tae-Eun Kim, Hyeongsu Kim, JiDong Sung, Duk-Kyung Kim, Myoung-Soon Lee, Seong Woo Han, Hyun-Joong Kim, Sung Hea Kim, Kyu-Hyung Ryu
Epidemiology and Health.2022; 44: e2022078. CrossRef - Diabetes and Heart Failure
Eun-Jung Rhee
The Journal of Korean Diabetes.2021; 22(1): 12. CrossRef - Prediabetes and the risk of heart failure: A meta‐analysis
Xiaoyan Cai, Xiong Liu, Lichang Sun, Yiting He, Sulin Zheng, Yang Zhang, Yuli Huang
Diabetes, Obesity and Metabolism.2021; 23(8): 1746. CrossRef - Diabetes and Heart Failure
Eun-Jung Rhee
Cardiovascular Prevention and Pharmacotherapy.2021; 3(2): 21. CrossRef - Effects of Lipid Overload on Heart in Metabolic
Diseases
An Yan, Guinan Xie, Xinya Ding, Yi Wang, Liping Guo
Hormone and Metabolic Research.2021; 53(12): 771. CrossRef - Obesity Degree and Glycemic Status: Factors That Should Be Considered in Heart Failure
Hye Soon Kim
Diabetes & Metabolism Journal.2020; 44(4): 529. CrossRef - Letter: Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults (Diabetes Metab J 2020;44:592-601)
Darae Kim
Diabetes & Metabolism Journal.2020; 44(5): 777. CrossRef - Response: Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults (Diabetes Metab J 2020;44:592-601)
Eun-Jung Rhee, Won-Young Lee
Diabetes & Metabolism Journal.2020; 44(5): 781. CrossRef
- Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
- Lifesytle
- Changes in the Quality of Life in Patients with Type 2 Diabetes Mellitus According to Physician and Patient Behaviors
- Young-Joo Kim, In-Kyung Jeong, Sin-Gon Kim, Dong Hyeok Cho, Chong-Hwa Kim, Chul-Sik Kim, Won-Young Lee, Kyu-Chang Won, Jin-Hye Cha, Juneyoung Lee, Doo-Man Kim
- Diabetes Metab J. 2020;44(1):91-102. Published online October 23, 2019
- DOI: https://doi.org/10.4093/dmj.2018.0251
- 5,286 View
- 86 Download
- 5 Citations
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Abstract
PDFSupplementary MaterialPubReader
Background Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM.
Methods Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used.
Results The weighted impact score change for local or long-distance journey (
P =0.0049), holidays (P =0.0364), and physical health (P =0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change.Conclusion This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.
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Citations
Citations to this article as recorded by- Spline Longitudinal Multi-response Model for the Detection of Lifestyle-
Based Changes in Blood Glucose of Diabetic Patients
Anna Islamiyati
Current Diabetes Reviews.2022;[Epub] CrossRef - Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes
Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
Endocrinology and Metabolism.2022; 37(4): 641. CrossRef - Agriophyllum Oligosaccharides Ameliorate Diabetic Insulin Resistance Through INS-R/IRS/Glut4-Mediated Insulin Pathway in db/db Mice and MIN6 Cells
Shuyin Bao, Xiuzhi Wang, Sung Bo Cho, Yan-Ling Wu, Chengxi Wei, Shuying Han, Liming Bao, Qiong Wu, Wuliji Ao, Ji-Xing Nan
Frontiers in Pharmacology.2021;[Epub] CrossRef - Glycolipid metabolism and liver transcriptomic analysis of the therapeutic effects of pressed degreased walnut meal extracts on type 2 diabetes mellitus rats
Yulan Li, Dan Chen, Chengmei Xu, Qingyujing Zhao, Yage Ma, Shenglan Zhao, Chaoyin Chen
Food & Function.2020; 11(6): 5538. CrossRef - Cause-of-death statistics in 2018 in the Republic of Korea
Hyun-Young Shin, Jin Kim, Seokmin Lee, Min Sim Park, Sanghee Park, Sun Huh
Journal of the Korean Medical Association.2020; 63(5): 286. CrossRef
- Spline Longitudinal Multi-response Model for the Detection of Lifestyle-
Based Changes in Blood Glucose of Diabetic Patients
- Epidemiology
- Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study
- Eun-Jung Rhee, Jung-Hwan Cho, Hyemi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
- Diabetes Metab J. 2019;43(6):794-803. Published online March 22, 2019
- DOI: https://doi.org/10.4093/dmj.2018.0184
- 4,273 View
- 59 Download
- 8 Citations
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Abstract
PDFPubReader
Background Short stature and leg length are associated with risk of diabetes and obesity. However, it remains unclear whether this association is observed in Asians. We evaluated the association between short stature and increased risk for diabetes using the Korean National Health Screening (KNHS) dataset.
Methods We assessed diabetes development in 2015 in 21,122,422 non-diabetic Koreans (mean age 43 years) enrolled in KNHS from 2009 to 2012 using International Classification of Diseases 10th (ICD-10) code and anti-diabetic medication prescription. Risk was measured in age- and sex-dependent quintile groups of baseline height (20 to 39, 40 to 59, ≥60 years).
Results During median 5.6-year follow-up, 532,918 cases (2.5%) of diabetes occurred. The hazard ratio (HR) for diabetes development gradually increased from the 5th (reference) to 1st quintile group of baseline height after adjustment for confounding factors (1.000, 1.076 [1.067 to 1.085], 1.097 [1.088 to 1.107], 1.141 [1.132 to 1.151], 1.234 [1.224 to 1.244]), with similar results in analysis by sex. The HR per 5 cm height increase was lower than 1.00 only in those with fasting blood glucose (FBG) below 100 mg/dL (0.979 [0.975 to 0.983]), and in lean individuals (body mass index [BMI] 18.5 to 23 kg/m2: 0.993 [0.988 to 0.998]; BMI <18.5 kg/m2: 0.918 [0.9 to 0.935]).
Conclusion Height was inversely associated with diabetes risk in this nationwide study of Korean adults. This association did not differ by sex, and was significant in lean individuals and those with normal FBG levels.
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- The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
- Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
- Diabetes Metab J. 2019;43(2):206-221. Published online December 27, 2018
- DOI: https://doi.org/10.4093/dmj.2018.0039
- 5,024 View
- 100 Download
- 22 Citations
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Abstract
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Background Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI).
Methods Our study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data.
Results A total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS.
Conclusion WC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.
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Review
- GLP-1 Receptor Agonist and Non-Alcoholic Fatty Liver Disease
- Jinmi Lee, Seok-Woo Hong, Eun-Jung Rhee, Won-Young Lee
- Diabetes Metab J. 2012;36(4):262-267. Published online August 20, 2012
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Abstract
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Non-alcoholic fatty liver disease (NAFLD), one of the most common liver diseases, is caused by the disruption of hepatic lipid homeostasis. It is associated with insulin resistance as seen in type 2 diabetes mellitus. Glucagon-like peptide-1 (GLP-1) is an incretin that increases insulin sensitivity and aids glucose metabolism. In recent
in vivo andin vitro studies, GLP-1 presents a novel therapeutic approach against NAFLD by increasing fatty acid oxidation, decreasing lipogenesis, and improving hepatic glucose metabolism. In this report, we provide an overview of the role and mechanism of GLP-1 in relieving NAFLD.-
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Original Article
- The Association of Unintentional Changes in Weight, Body Composition, and Homeostasis Model Assessment Index with Glycemic Progression in Non-Diabetic Healthy Subjects
- Eun-Jung Rhee, Ji-Hun Choi, Seung-Hyun Yoo, Ji-Cheol Bae, Won-Jun Kim, Eun-Suk Choi, Se Eun Park, Cheol-Young Park, Seok Won Park, Ki-Won Oh, Sung-Woo Park, Sun-Woo Kim, Won-Young Lee
- Diabetes Metab J. 2011;35(2):138-148. Published online April 30, 2011
- DOI: https://doi.org/10.4093/dmj.2011.35.2.138
- 3,433 View
- 37 Download
- 14 Citations
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Abstract
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Background We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention.
Methods From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weight×100. Subjects were divided into three groups according to weight change status in four years: weight loss (≤-5.0%), stable weight (-5.0 to 5.0%), weight gain (≥5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes.
Results Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA β-cell function in four years was a negative predictor for glycemic progression.
Conclusion Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.
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