Skip Navigation
Skip to contents

Diabetes Metab J : Diabetes & Metabolism Journal

Search
OPEN ACCESS

Search

Page Path
HOME > Search
24 "Won-Young Lee"
Filter
Filter
Article category
Keywords
Publication year
Authors
Funded articles
Original Articles
Drug/Regimen
Efficacy and Safety of Metformin and Atorvastatin Combination Therapy vs. Monotherapy with Either Drug in Type 2 Diabetes Mellitus and Dyslipidemia Patients (ATOMIC): Double-Blinded Randomized Controlled Trial
Jie-Eun Lee, Seung Hee Yu, Sung Rae Kim, Kyu Jeung Ahn, Kee-Ho Song, In-Kyu Lee, Ho-Sang Shon, In Joo Kim, Soo Lim, Doo-Man Kim, Choon Hee Chung, Won-Young Lee, Soon Hee Lee, Dong Joon Kim, Sung-Rae Cho, Chang Hee Jung, Hyun Jeong Jeon, Seung-Hwan Lee, Keun-Young Park, Sang Youl Rhee, Sin Gon Kim, Seok O Park, Dae Jung Kim, Byung Joon Kim, Sang Ah Lee, Yong-Hyun Kim, Kyung-Soo Kim, Ji A Seo, Il Seong Nam-Goong, Chang Won Lee, Duk Kyu Kim, Sang Wook Kim, Chung Gu Cho, Jung Han Kim, Yeo-Joo Kim, Jae-Myung Yoo, Kyung Wan Min, Moon-Kyu Lee
Received March 8, 2023  Accepted June 28, 2023  Published online May 20, 2024  
DOI: https://doi.org/10.4093/dmj.2023.0077    [Epub ahead of print]
  • 85 View
  • 7 Download
AbstractAbstract PDF
Background
It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia.
Methods
This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment.
Results
After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events.
Conclusion
The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.
Drug/Regimen
Efficacy and Safety of IDegAsp in a Real-World Korean Population with Type 2 Diabetes Mellitus
Shinae Kang, Yu-Bae Ahn, Tae Keun Oh, Won-Young Lee, Sung Wan Chun, Boram Bae, Amine Dahaoui, Jin Sook Jeong, Sungeun Jung, Hak Chul Jang
Received August 24, 2023  Accepted November 22, 2023  Published online February 27, 2024  
DOI: https://doi.org/10.4093/dmj.2023.0297    [Epub ahead of print]
  • 748 View
  • 50 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study investigated the real-world efficacy and safety of insulin degludec/insulin aspart (IDegAsp) in Korean adults with type 2 diabetes mellitus (T2DM), whose insulin treatment was switched to IDegAsp.
Methods
This was a multicenter, retrospective, observational study comprising two 26-week treatment periods, before and after switching to IDegAsp, respectively. Korean adults with uncontrolled T2DM treated with basal or premix insulin (±oral antidiabetic drugs) were enrolled. The primary objective was to compare the degree of glycosylated hemoglobin (HbA1c) change in each 26-week observation period. The analyses included changes in HbA1c, fasting plasma glucose (FPG), body weight, proportion of participants achieving HbA1c <7.0%, hypoglycemic events, and total daily insulin dose (ClinicalTrials.gov, number NCT04656106).
Results
In total, 196 adults (mean age, 65.95 years; mean T2DM duration, 18.99 years) were analyzed. The change in both HbA1c and FPG were significantly different between the pre-switching and the post-switching period (0.28% vs. –0.51%, P<0.001; 5.21 mg/dL vs. –23.10 mg/dL, P=0.005), respectively. After switching, the rate of achieving HbA1c <7.0% was significantly improved (5.10% at baseline vs. 11.22% with IDegAsp, P=0.012). No significant differences (before vs. after switching) were observed in body weight change, and total daily insulin dose. The rates of overall and severe hypoglycemia were similar in the two periods.
Conclusion
In real-world clinical practice in Korea, the change of insulin regimen to IDegAsp was associated with an improvement in glycemic control without increase of hypoglycemia, supporting the use of IDegAsp for patients with T2DM uncontrolled with basal or premix insulin.
Cardiovascular risk/Epidemiology
Risk of Cardiovascular Disease according to Baseline Low-Density Lipoprotein Cholesterol Level in Different Age Groups in Korean Diabetes Population: A Cohort Study
Tae Kyung Yoo, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee
Diabetes Metab J. 2024;48(2):265-278.   Published online February 26, 2024
DOI: https://doi.org/10.4093/dmj.2022.0443
  • 941 View
  • 191 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The association between low-density lipoprotein (LDL-C) levels and cardiovascular disease (CVD) risk in different age groups within the diabetes mellitus (DM) population remains unclear. The cohort study was conducted to investigate this relationship.
Methods
We assessed the 2009 to 2012 Korean National Health Screening and National Health Insurance Service records, with follow-up to the primary outcome (myocardial infarction [MI] or stroke) or December 2018. After excluding the participants with a history of MI or stroke, 2,227,394 participants with DM were included and categorized according to baseline LDL-C levels and age. Cox proportional hazards modeling was conducted. The CVD risk of age <40 years and LDL-C <70 mg/dL was set as the reference. In each age group, LDL-C <70 mg/dL was used as a reference for the subgroup analysis.
Results
The cut-off LDL-C value for increased MI risk in each age group varied (<40 years old, LDL-C ≥160 mg/dL: hazard ratios [HR], 2.03; 95% confidence interval [CI], 1.644 to 2.506) (40–49-year-old, LDL-C <115 mg/dL: HR, 1.245; 95% CI, 1.04 to 1.489) (50–59-year-old, LDL-C <115 mg/dL: HR, 1.21; 95% CI, 1.014 to 1.445) (60-69-year-old, LDL-C <145 mg/dL: HR, 1.229; 95% CI, 1.022 to 1.479) (≥70 years old group, LDL-C <100 mg/dL: HR, 1.238; 95% CI, 1.018 to 1.504). The cut-off LDL-C values for increased stroke risk varied in each age subgroup (<40 years old, LDL-C ≥160 mg/dL: HR, 1.395; 95% CI, 1.094 to 1.779) (40–49-year-old, LDL-C <145 mg/dL: HR, 1.13; 95% CI, 1.019 to 1.253) (50–59-year-old, LDL-C <160 mg/dL: HR, 1.079; 95% CI, 1.008 to 1.154) (60–69-year-old, LDL-C <130 mg/dL: HR, 1.07; 95% CI, 1.022 to 1.119) (≥70 years old, LDL-C <115 mg/dL: HR, 1.064; 95% CI, 1.019 to 1.112).
Conclusion
The effect of LDL-C on the risk of CVD differs depending on the age of the population with DM.
Sulwon Lecture 2023
Metabolic Risk/Epidemiology
Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective
Inha Jung, Dae-Jeong Koo, Won-Young Lee
Received October 4, 2023  Accepted December 26, 2024  Published online February 2, 2024  
DOI: https://doi.org/10.4093/dmj.2023.0350    [Epub ahead of print]
  • 1,126 View
  • 62 Download
AbstractAbstract PDFPubReader   ePub   
It has been generally accepted that insulin resistance (IR) and reduced insulin secretory capacity are the basic pathogenesis of type 2 diabetes mellitus (T2DM). In addition to genetic factors, the persistence of systemic inflammation caused by obesity and the associated threat of lipotoxicity increase the risk of T2DM. In particular, the main cause of IR is obesity and subjects with T2DM have a higher body mass index (BMI) than normal subjects according to recent studies. The prevalence of T2DM with IR has increased with increasing BMI during the past three decades. According to recent studies, homeostatic model assessment of IR was increased compared to that of the 1990s. Rising prevalence of obesity in Korea have contributed to the development of IR, non-alcoholic fatty liver disease and T2DM and cutting this vicious cycle is important. My colleagues and I have investigated this pathogenic mechanism on this theme through clinical and experimental studies over 20 years and herein, I would like to summarize some of our studies with deep gratitude for receiving the prestigious 2023 Sulwon Award.
Original Articles
Basic Research
Glucagon-Like Peptide Receptor Agonist Inhibits Angiotensin II-Induced Proliferation and Migration in Vascular Smooth Muscle Cells and Ameliorates Phosphate-Induced Vascular Smooth Muscle Cells Calcification
Jinmi Lee, Seok-Woo Hong, Min-Jeong Kim, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Diabetes Metab J. 2024;48(1):83-96.   Published online January 3, 2024
DOI: https://doi.org/10.4093/dmj.2022.0363
  • 1,957 View
  • 175 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Glucagon-like peptide-1 receptor agonist (GLP-1RA), which is a therapeutic agent for the treatment of type 2 diabetes mellitus, has a beneficial effect on the cardiovascular system.
Methods
To examine the protective effects of GLP-1RAs on proliferation and migration of vascular smooth muscle cells (VSMCs), A-10 cells exposed to angiotensin II (Ang II) were treated with either exendin-4, liraglutide, or dulaglutide. To examine the effects of GLP-1RAs on vascular calcification, cells exposed to high concentration of inorganic phosphate (Pi) were treated with exendin-4, liraglutide, or dulaglutide.
Results
Ang II increased proliferation and migration of VSMCs, gene expression levels of Ang II receptors AT1 and AT2, proliferation marker of proliferation Ki-67 (Mki-67), proliferating cell nuclear antigen (Pcna), and cyclin D1 (Ccnd1), and the protein expression levels of phospho-extracellular signal-regulated kinase (p-Erk), phospho-c-JUN N-terminal kinase (p-JNK), and phospho-phosphatidylinositol 3-kinase (p-Pi3k). Exendin-4, liraglutide, and dulaglutide significantly decreased the proliferation and migration of VSMCs, the gene expression levels of Pcna, and the protein expression levels of p-Erk and p-JNK in the Ang II-treated VSMCs. Erk inhibitor PD98059 and JNK inhibitor SP600125 decreased the protein expression levels of Pcna and Ccnd1 and proliferation of VSMCs. Inhibition of GLP-1R by siRNA reversed the reduction of the protein expression levels of p-Erk and p-JNK by exendin-4, liraglutide, and dulaglutide in the Ang II-treated VSMCs. Moreover, GLP-1 (9-36) amide also decreased the proliferation and migration of the Ang II-treated VSMCs. In addition, these GLP-1RAs decreased calcium deposition by inhibiting activating transcription factor 4 (Atf4) in Pi-treated VSMCs.
Conclusion
These data show that GLP-1RAs ameliorate aberrant proliferation and migration in VSMCs through both GLP-1Rdependent and independent pathways and inhibit Pi-induced vascular calcification.

Citations

Citations to this article as recorded by  
  • Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s
    Andrea Etrusco, Mislav Mikuš, Antonio D’Amato, Fabio Barra, Petar Planinić, Trpimir Goluža, Giovanni Buzzaccarini, Jelena Marušić, Mara Tešanović, Antonio Simone Laganà
    Biomedicines.2024; 12(3): 653.     CrossRef
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
  • 1,279 View
  • 143 Download
AbstractAbstract PDFSupplementary MaterialPubReader   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
  • 5,515 View
  • 210 Download
  • 4 Web of Science
  • 5 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract 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  
  • 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.2024; 109(3): e1194.     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
    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
  • 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
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
  • 3,468 View
  • 57 Download
  • 1 Crossref
PDFPubReader   ePub   

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
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
  • 7,869 View
  • 192 Download
  • 10 Web of Science
  • 12 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract 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  
  • Dietary and other lifestyle factors and their influence on non-communicable diseases in the Western Pacific region
    Xiaomin Sun, Dong Keon Yon, Tuan Thanh Nguyen, Kumpei Tanisawa, Kumhee Son, Ling Zhang, Jing Shu, Wen Peng, Yuexin Yang, Francesco Branca, Mark L. Wahlqvist, Hyunjung Lim, Youfa Wang
    The Lancet Regional Health - Western Pacific.2024; 43: 100842.     CrossRef
  • The Concentrations of Interleukin-6, Insulin, and Glucagon in the Context of Obesity and Type 2 Diabetes and Single Nucleotide Polymorphisms in IL6 and INS Genes
    Magdalena Król-Kulikowska, Iwona Urbanowicz, Marta Kepinska, Mayank Choubey
    Journal of Obesity.2024; 2024: 1.     CrossRef
  • 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
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
  • 3,723 View
  • 74 Download
  • 1 Crossref
PDFPubReader   ePub   

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
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
  • 7,640 View
  • 236 Download
  • 22 Web of Science
  • 21 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract 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  
  • Psychological resilience mediates the relationship between diabetes distress and depression among persons with diabetes in a multi-group analysis
    Ajele Kenni Wojujutari, Erhabor Sunday Idemudia, Lawrence Ejike Ugwu
    Scientific Reports.2024;[Epub]     CrossRef
  • 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
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
  • 3,798 View
  • 58 Download
PDFPubReader   ePub   
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
  • 10,744 View
  • 201 Download
  • 24 Web of Science
  • 23 Crossref
AbstractAbstract 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
    Tongran Zhang, Nannan Wang, Lingqiang Zhu, Lihua Chen, Huisheng Liu
    Biomedicines.2023; 11(3): 856.     CrossRef
  • Reasons for Hospitalization Among Australians With Type 1 or Type 2 Diabetes and COVID-19
    Dunya Tomic, Jonathan E. Shaw, Dianna J. Magliano
    Canadian Journal of Diabetes.2023;[Epub]     CrossRef
  • Anti-SARS-CoV-2 antibody levels predict outcome in COVID-19 patients with type 2 diabetes: a prospective cohort study
    Sylvia Mink, Christoph H. Saely, Andreas Leiherer, Matthias Frick, Thomas Plattner, Heinz Drexel, Peter Fraunberger
    Scientific Reports.2023;[Epub]     CrossRef
  • Mortality-related risk factors of inpatients with diabetes and COVID-19: A multicenter retrospective study in Belgium
    Thomas Servais, France Laurent, Thomas Roland, Camelia Rossi, Elodie De Groote, Valérie Godart, Ernestina Repetto, Michel Ponchon, Pascale Chasseur, Laurent Crenier, Sandrine Van Eeckhoudt, John Yango, Philippe Oriot, Mirela Morisca Gavriliu, Stéphanie Ro
    Annales d'Endocrinologie.2023;[Epub]     CrossRef
  • Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations
    Dan Ziegler, Solomon Tesfaye, Vincenza Spallone, Irina Gurieva, Juma Al Kaabi, Boris Mankovsky, Emil Martinka, Gabriela Radulian, Khue Thy Nguyen, Alin O Stirban, Tsvetalina Tankova, Tamás Varkonyi, Roy Freeman, Péter Kempler, Andrew JM Boulton
    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
    Yahya Mahamat-Saleh, Thibault Fiolet, Mathieu Edouard Rebeaud, Matthieu Mulot, Anthony Guihur, Douae El Fatouhi, Nasser Laouali, Nathan Peiffer-Smadja, Dagfinn Aune, Gianluca Severi
    BMJ Open.2021; 11(10): e052777.     CrossRef
  • 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)
    Kyuho Kim, Tae Jung Oh
    Diabetes & Metabolism Journal.2020; 44(6): 938.     CrossRef
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
  • 12,547 View
  • 344 Download
  • 43 Web of Science
  • 42 Crossref
AbstractAbstract PDFPubReader   

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.

Citations

Citations to this article as recorded by  
  • A combined extract containing Schisandra chinensis (SCE) reduced hepatic triglyceride accumulation in rats fed a high-sucrose diet
    Haneul Lee, Eun Young Kang, Joowon Lee, Yejin Kim, Sumin Kang, Hayoon Kim, Hyun Kyung Kim, Gyoungok Gang, Sang-gil Lee, Cao Lei, Gwang-woong Go
    Food Science and Biotechnology.2024; 33(6): 1449.     CrossRef
  • Association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes mellitus: nationwide population based study
    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    BMJ.2024; : e076388.     CrossRef
  • Risk Scores for Prediction of Major Cardiovascular Events in Non-Alcoholic Fatty Liver Disease: A No Man’s Land?
    Liliana Gheorghe, Roxana Nemteanu, Andreea Clim, Gina Eosefina Botnariu, Irina Iuliana Costache, Alina Plesa
    Life.2023; 13(4): 857.     CrossRef
  • Increased expression of sodium-glucose cotransporter 2 and O-GlcNAcylation in hepatocytes drives non-alcoholic steatohepatitis
    Hye Jin Chun, Eun Ran Kim, Minyoung Lee, Da Hyun Choi, Soo Hyun Kim, Eugene Shin, Jin-Hong Kim, Jin Won Cho, Dai Hoon Han, Bong-Soo Cha, Yong-ho Lee
    Metabolism.2023; 145: 155612.     CrossRef
  • Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study
    Goh Eun Chung, Kyungdo Han, Kyu-Na Lee, Jung Ho Bae, Sun Young Yang, Su-Yeon Choi, Jeong Yoon Yim, Nam Ju Heo
    Diabetes & Metabolism.2023; 49(4): 101454.     CrossRef
  • Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: A network meta-analysis
    Min Jeong Park, Hayeon Kim, Myeong Gyu Kim, Kyungim Kim
    Clinical and Molecular Hepatology.2023; 29(3): 693.     CrossRef
  • Histological analysis of hypoglycemic agents on liver fibrosis in patients with non-alcoholic fatty liver disease: a systematic review
    Qingxing Xie, Xiaohui Pan, Xinyue Zhang, Jinfang Ma, Ge Peng, Nanwei Tong
    Chinese Medical Journal.2023; 136(16): 2014.     CrossRef
  • Hepatotropc effects of glucose-lowering drugs: non-alcoholic fatty liver disease in focus
    E. V. Uzhakova, Z. E. Zshanko, E. N. Smirnova
    Experimental and Clinical Gastroenterology.2023; (6): 121.     CrossRef
  • Complementary effects of dapagliflozin and lobeglitazone on metabolism in a diet-induced obese mouse model
    Yun Kyung Lee, Tae Jung Oh, Ji In Lee, Bo Yoon Choi, Hyen Chung Cho, Hak Chul Jang, Sung Hee Choi
    European Journal of Pharmacology.2023; 957: 175946.     CrossRef
  • Hepatic T-cell senescence and exhaustion are implicated in the progression of fatty liver disease in patients with type 2 diabetes and mouse model with nonalcoholic steatohepatitis
    Byeong Chang Sim, Yea Eun Kang, Sun Kyoung You, Seong Eun Lee, Ha Thi Nga, Ho Yeop Lee, Thi Linh Nguyen, Ji Sun Moon, Jingwen Tian, Hyo Ju Jang, Jeong Eun Lee, Hyon-Seung Yi
    Cell Death & Disease.2023;[Epub]     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
  • Circ_0004535/miR-1827/CASP8 network involved in type 2 diabetes mellitus with nonalcoholic fatty liver disease
    Min Li, Ai Zeng, Xinle Tang, Hui Xu, Wei Xiong, Yanying Guo
    Scientific Reports.2023;[Epub]     CrossRef
  • Stratification by obesity class, rather than age, can identify a higher percent of children at risk for non‐alcoholic fatty liver disease and metabolic dysfunction
    Aurelia Radulescu, Adam J. Dugan, Mary Killian, Suzanna L. Attia, Marialena Mouzaki, George J. Fuchs, Rohit Kohli, Henrietta Bada, Philip A. Kern, Samir Softic
    Pediatric Obesity.2022;[Epub]     CrossRef
  • Renal Tubular Damage Marker, Urinary N-acetyl-β-D-Glucosaminidase, as a Predictive Marker of Hepatic Fibrosis in Type 2 Diabetes Mellitus
    Hae Kyung Kim, Minyoung Lee, Yong-ho Lee, Eun Seok Kang, Bong-Soo Cha, Byung-Wan Lee
    Diabetes & Metabolism Journal.2022; 46(1): 104.     CrossRef
  • Dulaglutide Ameliorates Palmitic Acid-Induced Hepatic Steatosis by Activating FAM3A Signaling Pathway
    Jinmi Lee, Seok-Woo Hong, Min-Jeong Kim, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
    Endocrinology and Metabolism.2022; 37(1): 74.     CrossRef
  • State-of-the-Art Overview of the Pharmacological Treatment of Non-Alcoholic Steatohepatitis
    Yongin Cho, Yong-ho Lee
    Endocrinology and Metabolism.2022; 37(1): 38.     CrossRef
  • Ezetimibe combination therapy with statin for non-alcoholic fatty liver disease: an open-label randomized controlled trial (ESSENTIAL study)
    Yongin Cho, Hyungjin Rhee, Young-eun Kim, Minyoung Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Jin-Young Choi, Yong-ho Lee
    BMC Medicine.2022;[Epub]     CrossRef
  • Obesity is an important determinant of severity in newly defined metabolic dysfunction-associated fatty liver disease
    Ji Hye Huh, Kwang Joon Kim, Seung Up Kim, Bong-Soo Cha, Byung-Wan Lee
    Hepatobiliary & Pancreatic Diseases International.2022; 21(3): 241.     CrossRef
  • Anti-Obesity and Anti-Hyperglycemic Effects of Meretrix lusoria Protamex Hydrolysate in ob/ob Mice
    Min Ju Kim, Ramakrishna Chilakala, Hee Geun Jo, Seung-Jae Lee, Dong-Sung Lee, Sun Hee Cheong
    International Journal of Molecular Sciences.2022; 23(7): 4015.     CrossRef
  • The associations of hepatic steatosis and fibrosis using fatty liver index and BARD score with cardiovascular outcomes and mortality in patients with new-onset type 2 diabetes: a nationwide cohort study
    Jiyun Park, Gyuri Kim, Bong-Sung Kim, Kyung-Do Han, So Yoon Kwon, So Hee Park, You-Bin Lee, Sang-Man Jin, Jae Hyeon Kim
    Cardiovascular Diabetology.2022;[Epub]     CrossRef
  • Cumulative Exposure to High γ-Glutamyl Transferase Level and Risk of Diabetes: A Nationwide Population-Based Study
    Ji-Yeon Park, Kyungdo Han, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
    Endocrinology and Metabolism.2022; 37(2): 272.     CrossRef
  • SGLT-2 inhibitors and GLP-1 receptor agonists in metabolic dysfunction-associated fatty liver disease
    Jun Sung Moon, Jun Hwa Hong, Yong Jin Jung, Ele Ferrannini, Michael A. Nauck, Soo Lim
    Trends in Endocrinology & Metabolism.2022; 33(6): 424.     CrossRef
  • Plasma Aldo-Keto Reductase Family 1 Member B10 as a Biomarker Performs Well in the Diagnosis of Nonalcoholic Steatohepatitis and Fibrosis
    Aron Park, Seung Joon Choi, Sungjin Park, Seong Min Kim, Hye Eun Lee, Minjae Joo, Kyoung Kon Kim, Doojin Kim, Dong Hae Chung, Jae Been Im, Jaehun Jung, Seung Kak Shin, Byung-Chul Oh, Cheolsoo Choi, Seungyoon Nam, Dae Ho Lee
    International Journal of Molecular Sciences.2022; 23(9): 5035.     CrossRef
  • Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
    Sihan Peng, Lu Liu, Ziyan Xie, Xiyu Zhang, Chunguang Xie, Sha Ye, Xiangeng Zhang, Xiaoli Liang, Hongyan Wang, Ya Liu
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Non-alcoholic fatty liver disease and sarcopenia is associated with the risk of albuminuria independent of insulin resistance, and obesity
    Eugene Han, Mi Kyung Kim, Seung-Soon Im, Byoung Kuk Jang, Hye Soon Kim
    Journal of Diabetes and its Complications.2022; 36(8): 108253.     CrossRef
  • Extra-Glycemic Effects of Anti-Diabetic Medications: Two Birds with One Stone?
    Eun-Jung Rhee
    Endocrinology and Metabolism.2022; 37(3): 415.     CrossRef
  • Plasma Metabolomics and Machine Learning-Driven Novel Diagnostic Signature for Non-Alcoholic Steatohepatitis
    Moongi Ji, Yunju Jo, Seung Joon Choi, Seong Min Kim, Kyoung Kon Kim, Byung-Chul Oh, Dongryeol Ryu, Man-Jeong Paik, Dae Ho Lee
    Biomedicines.2022; 10(7): 1669.     CrossRef
  • Association Between DPP4 Inhibitor Use and the Incidence of Cirrhosis, ESRD, and Some Cancers in Patients With Diabetes
    Yewon Na, Soo Wan Kim, Ie Byung Park, Soo Jung Choi, Seungyoon Nam, Jaehun Jung, Dae Ho Lee
    The Journal of Clinical Endocrinology & Metabolism.2022; 107(11): 3022.     CrossRef
  • Nonalcoholic fatty liver disease is associated with early left ventricular diastolic dysfunction in patients with type 2 diabeteS
    Walaa Sheba, Eman Morsy, Salah Altahan, Mona Ayaad, Sameh A. Lashen
    Alexandria Journal of Medicine.2022; 58(1): 117.     CrossRef
  • The association between changes in hepatic steatosis and hepatic fibrosis with cardiovascular outcomes and mortality in patients with New-Onset type 2 Diabetes: A nationwide cohort study
    Jiyun Park, Gyuri Kim, Bong-Sung Kim, Kyung-Do Han, So Yoon Kwon, So Hee Park, You-Bin Lee, Sang-Man Jin, Jae Hyeon Kim
    Diabetes Research and Clinical Practice.2022; 194: 110191.     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
  • The association of fatty liver index and BARD score with all-cause and cause-specific mortality in patients with type 2 diabetes mellitus: a nationwide population-based study
    Goh Eun Chung, Su-Min Jeong, Eun Ju Cho, Ji Won Yoon, Jeong-Ju Yoo, Yuri Cho, Kyu-na Lee, Dong Wook Shin, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Su Jong Yu
    Cardiovascular Diabetology.2022;[Epub]     CrossRef
  • Non-Albumin Proteinuria (NAP) as a Complementary Marker for Diabetic Kidney Disease (DKD)
    Jaehyun Bae, Young Jun Won, Byung-Wan Lee
    Life.2021; 11(3): 224.     CrossRef
  • Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: Diagnosis and Treatment
    Sook Jung Lee, Byung-Wan Lee
    The Journal of Korean Diabetes.2021; 22(1): 38.     CrossRef
  • Non-alcoholic fatty liver disease
    Elizabeth E Powell, Vincent Wai-Sun Wong, Mary Rinella
    The Lancet.2021; 397(10290): 2212.     CrossRef
  • Allopurinol ameliorates high fructose diet induced hepatic steatosis in diabetic rats through modulation of lipid metabolism, inflammation, and ER stress pathway
    In-Jin Cho, Da-Hee Oh, Jin Yoo, You-Cheol Hwang, Kyu Jeung Ahn, Ho-Yeon Chung, Soung Won Jeong, Ju-Young Moon, Sang-Ho Lee, Sung-Jig Lim, In-Kyung Jeong
    Scientific Reports.2021;[Epub]     CrossRef
  • Patient Management in Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus
    A. E. Bagriy, A. D. Zubov, M. V. Khomenko, E. S. Mikhailichenko, E. A. Pylaeva, N. A. Khaustova, E. V. Bryukhovetskaya
    Russian Journal of Gastroenterology, Hepatology, Coloproctology.2021; 31(2): 14.     CrossRef
  • Liver Fibrosis Indices for the Prediction of Mortality in Korean Subjects: A 16-Year Prospective Cohort Study
    Tae Jung Oh, Kyuho Kim, Jae Hoon Moon, Sung Hee Choi, Nam H Cho, Hak Chul Jang
    Journal of the Endocrine Society.2021;[Epub]     CrossRef
  • Reduced Rank Regression-Derived Dietary Patterns Related to the Fatty Liver Index and Associations with Type 2 Diabetes Mellitus among Ghanaian Populations under Transition: The RODAM Study
    Tracy Bonsu Osei, Anne-Marieke van Dijk, Sjoerd Dingerink, Felix Patience Chilunga, Erik Beune, Karlijn Anna Catharina Meeks, Silver Bahendeka, Matthias Bernd Schulze, Charles Agyemang, Mary Nicolaou, Adriaan Georgius Holleboom, Ina Danquah
    Nutrients.2021; 13(11): 3679.     CrossRef
  • Efficacy and Safety of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
    Yuan Zhu, Jiao Xu, Dong Zhang, Xingyu Mu, Yi Shi, Shangtao Chen, Zengxiang Wu, Shuangqing Li
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Liver fibrosis indices are related to diabetic peripheral neuropathy in individuals with type 2 diabetes
    Kyuho Kim, Tae Jung Oh, Hyen Chung Cho, Yun Kyung Lee, Chang Ho Ahn, Bo Kyung Koo, Jae Hoon Moon, Sung Hee Choi, Hak Chul Jang
    Scientific Reports.2021;[Epub]     CrossRef
  • Evaluation of Grapefruit Juice in terms of Interleukin 18 Gene Expression in Rats with Fatty Liver and Healthy Rats
    Simin Bahmanpoor, Noosha Zia-Jahromi
    journal of ilam university of medical sciences.2021; 29(4): 74.     CrossRef
Original Article
Cardiovascular Risk/Epidemiology
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
  • 6,770 View
  • 144 Download
  • 16 Web of Science
  • 19 Crossref
AbstractAbstract 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.

Citations

Citations to this article as recorded by  
  • Association between underweight and risk of heart failure in diabetes patients
    Tae Kyung Yoo, Kyung‐Do Han, Eun‐Jung Rhee, Won‐Young Lee
    Journal of Cachexia, Sarcopenia and Muscle.2024; 15(2): 671.     CrossRef
  • 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
  • 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 & Metabolism Journal.2023; 47(6): 846.     CrossRef
  • Characterization of the oxidative stress and inflammatory markers in metabolically healthy obese individuals
    Hazhmat Ali
    Al-Kufa University Journal for Biology.2023; 15(3): 28.     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

Diabetes Metab J : Diabetes & Metabolism Journal