Skeletal muscle is regarded as an endocrine and paracrine organ. Muscle-derived secretory proteins, referred to as myokines, mediate interactions between skeletal muscle mass and other organs such as the liver, adipose tissue, pancreas, bone, and the cardiovascular system. As individuals age, reduced levels of physical activity and sarcopenia (loss of skeletal muscle mass and strength) are associated with physical frailty and disability. Recently, several studies have suggested that the loss of skeletal muscle mass may contribute to metabolic disease. Therefore, herein, we focus on the relationships between skeletal muscle mass and metabolic diseases, including metabolic syndrome and non-alcoholic fatty liver disease.

Among the possible venous thromboembolic events in nephrotic syndrome, renal vein thrombosis and pulmonary embolism are common, while portal vein thrombosis (PVT) is rare. This report describes a 26-year-old man with histologically proven minimal change disease (MCD) complicated by PVT. The patient presented with epigastric pain and edema. He had been diagnosed with MCD five months earlier and achieved complete remission with corticosteroids, which were discontinued one month before the visit. Full-blown relapsing nephrotic syndrome was evident on laboratory and clinical findings, and an abdominal computed tomography revealed PVT. He immediately received immunosuppressants and anticoagulation therapy. An eight-week treatment resulted in complete remission, and a follow-up abdominal ultrasonography showed disappearance of PVT. In conclusion, PVT is rare and may not be easily diagnosed in patients with nephrotic syndrome suffering from abdominal pain. Early recognition of this rare complication and prompt immunosuppression and anticoagulation therapy are encouraged to avoid a fatal outcome.
Abdominal Pain ; Adrenal Cortex Hormones ; Adult ; Anticoagulants ; Edema ; Fatal Outcome ; Follow-Up Studies ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Proteinuria ; Pulmonary Embolism ; Renal Veins ; Thrombosis ; Ultrasonography ; Venous Thrombosis*

PURPOSE: The objective of this study was to investigate clinical and laboratory parameters that could predict which patients could maintain adequate glycemic control after switching from initial insulin therapy to oral hypoglycemic agents (OHAs) among patients with type 2 diabetes (T2D). MATERIALS AND METHODS: We recruited 275 patients with T2D who had been registered in 3 cohorts of initiated insulin therapy and followed up for 33 months. The participants were divided into 2 groups according to whether they switched from insulin to OHAs (Group I) or not (Group II), and Group I was further classified into 2 sub-groups: maintenance on OHAs (Group IA) or resumption of insulin (Group IB). RESULTS: Of 275 patients with insulin initiation, 63% switched to OHAs (Group I) and 37% continued insulin (Group II). Of these, 44% were in Group IA and 19% in Group IB. The lowest tertile of baseline postprandial C-peptide-to-glucose ratio (PCGR), higher insulin dose at switching to OHAs, and higher HbA1c level at 6 months after switching to OHAs were all associated with OHA failure (Group IB; p=0.001, 0.046, and 0.014, respectively). The lowest tertile of PCGR was associated with ultimate use of insulin (Group IB and Group II; p=0.029). CONCLUSION: Higher baseline level of PCGR and lower HbA1c levels at 6 months after switching to OHAs may be strong predictors for the successful maintenance of OHAs after switching from insulin therapy in Korean patients with T2D.
Cohort Studies ; Diabetes Mellitus, Type 2 ; Humans ; Hypoglycemic Agents* ; Insulin*

PURPOSE: The objective of this study was to investigate clinical and laboratory parameters that could predict which patients could maintain adequate glycemic control after switching from initial insulin therapy to oral hypoglycemic agents (OHAs) among patients with type 2 diabetes (T2D). MATERIALS AND METHODS: We recruited 275 patients with T2D who had been registered in 3 cohorts of initiated insulin therapy and followed up for 33 months. The participants were divided into 2 groups according to whether they switched from insulin to OHAs (Group I) or not (Group II), and Group I was further classified into 2 sub-groups: maintenance on OHAs (Group IA) or resumption of insulin (Group IB). RESULTS: Of 275 patients with insulin initiation, 63% switched to OHAs (Group I) and 37% continued insulin (Group II). Of these, 44% were in Group IA and 19% in Group IB. The lowest tertile of baseline postprandial C-peptide-to-glucose ratio (PCGR), higher insulin dose at switching to OHAs, and higher HbA1c level at 6 months after switching to OHAs were all associated with OHA failure (Group IB; p=0.001, 0.046, and 0.014, respectively). The lowest tertile of PCGR was associated with ultimate use of insulin (Group IB and Group II; p=0.029). CONCLUSION: Higher baseline level of PCGR and lower HbA1c levels at 6 months after switching to OHAs may be strong predictors for the successful maintenance of OHAs after switching from insulin therapy in Korean patients with T2D.
Cohort Studies ; Diabetes Mellitus, Type 2 ; Humans ; Hypoglycemic Agents* ; Insulin*

Diabetes is one of the most common and rapidly increasing chronic metabolic disorders in the world. It causes serious complications and mortality, with a large burden to the public health care system and to individual patients. Hypoglycemia is an acute complication of diabetes that increases morbidity, mortality, and economic costs. It remains a major limiting factor in the attainment of optimal glycemic control in patients with diabetes. Medical expenditures for potentially preventable severe hypoglycemia are substantial, with the highest proportion of direct medical costs resulting from a relatively small number of patients. Severe hypoglycemia, which is generally associated with insulin or sulfonylurea therapy, can be serious, and hospitalization has been a major driver of increasing healthcare resource use and costs. Patients with increased numbers of non-severe hypoglycemia events are at risk for long-term complications and mortality, reductions in quality of life, increased fear and anxiety, reduced work productivity, and increased healthcare costs. Although the prevalence and incidence of hypoglycemia in diabetes are rapidly increasing in Korea, the economic consequences of hypoglycemia remain unclear.
Anxiety ; Delivery of Health Care ; Diabetes Mellitus ; Efficiency ; Health Care Costs* ; Health Expenditures ; Hospitalization ; Humans ; Hypoglycemia* ; Incidence ; Insulin ; Korea ; Mortality ; Prevalence ; Public Health ; Quality of Life