Low birth weight is associated with insulin resistance and type 2 diabetes in adults. The fetal programming hypothesis has shown that insulin resistance and its associated metabolic disturbances result from a poor gestational environment, for which low birth weight is a surrogate. An at-home questionnaire survey was performed on 660 middle school students (12-15 years) in Seoul, Korea, and 152 cases were randomly selected based on their birth weight. Subjects were divided into three groups according to birth weight. We recorded their birth weight and measured their current anthropometric data, blood pressure, lipid profile, HOMA-IR, and HOMA-beta, and compared these parameters among the groups. The relation of birth weight to physiological characteristics in adolescence was examined. Systolic blood pressure, lipid profiles, and fasting plasma glucose, HOMA-beta were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide, and HOMA-IR were higher in the lower birth weight tertile. After adjustment for confounding factors, birth weight was inversely related to diastolic blood pressure, insulin, C-peptide, and HOMA-IR. We conclude that low birth weight may predict the risk of the insulin resistance and its progression over age, and that adequate gestational nutrition is therefore necessary to prevent low birth weight.
Male ; Korea/epidemiology ; Insulin-Secreting Cells/physiology ; *Insulin Resistance ; Insulin/blood ; Hyperinsulinism/epidemiology/etiology/metabolism ; Humans ; Female ; Child ; C-Peptide/blood ; Blood Pressure ; *Birth Weight ; Adolescent

OBJECTIVETo explore the relationship between serum level of leptin and the components of metabolic syndrome in a group of mid-aged Chinese population.

METHODS345 adults (184 men and 161 women) aged 46 - 53 were enrolled from Fetal Origin of Adult Disease (FOAD) cohort to participate the clinic examination including anthropometry, measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum levels of lipid and leptin. HOMA-IR index was calculated to estimate individual insulin resistance. Metabolic syndrome (MS) was diagnosed according to the definition criteria issued by the International Diabetes Federation (IDF) in 2005.

RESULTSThe prevalences of central obesity, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein (HDL-C), IFG, higher blood pressure and MS were 53.0%, 47.5%, 34.2%, 26.7%, 33.9%, 31.9% in this mid-aged population, respectively. Serum geometric mean level of leptin was higher in females than in males. Serum level of leptin increased with the prevalence of MS and components of abnormal metabolism. The serum level of leptin compared with central obesity, higher blood pressure, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein cholesterol (HDL-C), IFG and MS was significantly higher respectively (P < 0.05) without HDL-C in males. The serum level of leptin increased with the number of components of abnormal metabolism subjects had (P < 0.001).

CONCLUSIONThe serum level of leptin in this population is significantly associated with MS and components of MS. Hyperleptinemia could be a new component of metabolic syndrome. It might be a target in selection of MS and relative diseases.

China ; epidemiology ; Cholesterol, HDL ; blood ; Cohort Studies ; Female ; Humans ; Hyperinsulinism ; blood ; Insulin ; metabolism ; Insulin Resistance ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; epidemiology ; Middle Aged ; Obesity ; blood

PURPOSE: To investigate the contribution of HCV infection to insulin resistance in chronic haemodialysis patients. MATERIALS AND METHODS: The study was performed with 55 patients who were on regular haemodialysis therapy three times per week. Of the 55 patients, 34 (20 females and 14 males with an average age of 40.9 years) were anti-HCV (+) and were defined as the HCV (+) group. The remaining 21 patients (8 females and 11 males with an average age of 50 years) were negative for HCV and other viral markers and were defined as the HCV (-) group. BMI of all patients were below 27. Insulin resistance (IR) was calculated according to the HOMA formula and patients were called HOMA-IR (+) if their HOMA scores were higher than 2.5. All of the HOMA-IR (+) patients in both groups were called the HOMA-IR (+) subgroup. None of the patients had a history of drug use or any diseases that were related to insulin resistance except uremia. In both groups and the healthy control group, insulin and glucose levels were studied at three different venous serum samples taken at 5- minute intervals after 12 hours of fasting. Other individual variables were studied at venous serum samples taken after 12 hours of fasting. RESULTS: HOMA scores were (3)2.5 in 22 of 34 HCV (+) patients (64.7%) and 7 of 21HCV (-) patients (33.33%) (p=0.024). Insulin levels of HCV (+) group (13.32 +/- 9.44mIU/mL) were significantly higher than HCV (-) (9.07 +/- 7.39mIU/mL) and the control groups (6.40 +/- 4.94mIU/ mL) (p=0.039 and p=0.021 respectively). HCV (+) patients were younger (40.94 +/- 17.06 and 52.62 +/- 20.64 years, respectively) and had longer dialysis duration (7.18 +/- 3.61 and 2.91 +/- 2.69 years, respectively). Significant positive correlations of HOMA score with insulin (r=0.934, p=0.000) and fasting glucose levels (r=0.379, p=0.043) were found in the HOMA- IR (+) subgroup. Also, a significant positive correlation was found between ALT and insulin levels in the HOMA IR (+) subgroup. C-peptide levels of both HCV (+) and (-) groups were significantly higher than the control group (p < 0.001). There were not any significant correlations between HOMA score and some of the other individual variables including levels of triglyceride, ferritin, ALT, iPTH and Mg in any of the groups. CONCLUSION: In chronic haemodialysis patients; HCV infection is related to a high prevalence of insulin resistance, higher insulin and glucose levels.
*Renal Dialysis ; Middle Aged ; Male ; Kidney Failure, Chronic/*complications ; *Insulin Resistance ; Insulin/blood ; Hyperinsulinism/epidemiology ; Humans ; Hepatitis C/*epidemiology ; Female ; C-Peptide/blood ; Adult

OBJECTIVETo assess the prevalence of the metabolic syndrome in Shanghai residents.

METHODSA cross-sectional study was conducted in Shanghai with a representative sample of 14,327 Chinese adults from 15 to 74 years of age. The sample was randomly selected using stratified cluster sampling. The criteria of International Diabetes Federation (IDF), the US National Cholesterol Education Program Adult Treatment Panel III (ATP III) guidelines and the China Diabetes Society (CDS), respectively, were applied for diagnosis.

RESULTSDiagnosed by using the IDF criterion, the crude prevalence of metabolic syndrome was 17.51%, and the age and gender-adjusted prevalence was 12.81% (95% CI: 12.26 - 13.36). The prevalence of the metabolic syndrome was higher in females than in males (14.79% and 10.93%, respectively), and higher in urban residents than in rural ones (13.71% and 10.72%, respectively). The age-specific prevalence of the metabolic syndrome increased in both male and female residents and the prevalence of metabolic syndrome in females 45 years of age or elder was significantly increased. The prevalence of having at least 3 parameters of metabolic syndrome was 22.28%. According to the ATP III guideline, the crude and age-adjusted prevalence of metabolic syndrome was 12.03% and 8.62%, respectively. Based on the criterion of CDS, they were 13.98% and 10.41%.

CONCLUSIONThere is a high prevalence of metabolic syndrome in Shanghai residents. Metabolic syndrome has become a noteworthy public health problem. It suggests that community-integrated control of metabolic syndrome should have its priority.

Adolescent ; Adult ; Aged ; Aging ; China ; epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus ; epidemiology ; Female ; Humans ; Hyperinsulinism ; epidemiology ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Syndrome ; Young Adult

Obesity has been implicated as a significant risk factor for multiple medical condition including hypertention, glucose intolerance, hyperlipidemia, hyperinsulinemia and fatty liver. Furthermore, obesity in childhood is believed to be a reliable predictor of a similar condition in adulthood. During the recent years, there has been a rapid rise in the incidence of childhood obesity in Korea due to increased dietary intake rich in caloric content. This study was undertaken to investigate the epidemiology and potential health complications of obesity observed in elmentary school students. A total of 3,103 children (1630 boys and 1,473 girls), ages ranging from 6 to 12, were studied with personal interview, physical examination, and laboratory evaluation. The results were as follows: 1) The prevalence of obesity was 13.44% with approximately equal distribution among boys (14.42%) and girls (12.36%). 2) The prevalence of childhood obesity in Seoul was significantly higher (18.62%) than that in Suwon (7.85%) and in Hongchon (6.02%). 3) A higher incidence of hypertension was dectected in obese subjects and this was more obvious in girls. 4) Hyperlipidemia and elevated Atherogenic Index were more frequently observed in obese group. 5) although fasting blood glucose levels were similar in both groups. AST and ALT abnormalities were much more prevalent in obese group. It is concluded that hypertension and other metabolic abnormalities are much more frequently observed in obese children and that our effects should be focused on the earliest dection, prevention and management of childhood obesity.
Blood Glucose ; Child* ; Epidemiology ; Fasting ; Fatty Liver ; Female ; Glucose Intolerance ; Gyeonggi-do ; Humans ; Hyperinsulinism ; Hyperlipidemias ; Hypertension ; Incidence ; Korea ; Obesity* ; Pediatric Obesity ; Physical Examination ; Prevalence ; Risk Factors ; Seoul

BACKGROUND/AIMS: Diabetes is one of the risk factors of gallstone diseases. Many studies found a positive association between insulin and gallstones in individuals with diabetes. However, this association is unclear in non-diabetes. So we conducted a case-control study for the evaluation of the association between gallstone diseases and fasting serum insulin level, insulin resistance in non-diabetic Korean general population. METHODS: This study was a prospective case-control study on 118 Korean subjects which included clinical examination, abdominal ultrasound, and blood chemistries. Serum fasting insulin level were determined by radioimmunoassay and concentrations of cholesterol, glucose, and triglycerides by standard enzymatic colorimetric methods. Insulin resistance was determined by the homeostasis model assessment (HOMA-IR). Body mass index (BMI), percentage of body fat, and waist hip ratio were also measured. RESULTS: We studied 118 subjects with no clinical evidence of diabetes mellitus and serum glucose<126 mg/dL. Compared with controls (n=89), cases (n=29) had higher levels of serum insulin, glucose, triglyceride levels, and BMI. In t-test and chi-square test for variables, the association between gallstone disease and serum insulin, HOMA-IR index, and BMI were statistically significant (p<0.05). In multiple logistic regression analysis, gallstone disease risk increased with the level of serum insulin (p=0.024, odds ratio=1.376) and HOMA-IR index (p=0.013, odds ratio=2.006). CONCLUSIONS: We suggest that hyperinsulinemia and insulin resistance could be associated with gallstone formation in individuals without clinical diagnosis of diabetes mellitus and with normal serum glucose level.
Adult ; Body Mass Index ; Case-Control Studies ; Female ; Gallstones/*epidemiology/etiology ; Humans ; Hyperinsulinism/complications ; Insulin/*blood ; *Insulin Resistance ; Korea ; Male ; Middle Aged ; Regression Analysis ; Risk Factors

Obesity is an important health problem in the world and related to many critical diseases, such as diabetes, cardiovascular disease, and metabolic syndrome. Obesity leads to fat infiltration of multiple organs and infiltrated adipose tissue produces many cytokines resulting in the dysfunction of organs such as the gallbladder. In the biliary diseases, obesity and overweight have been known as a major risk factor for gallstones. According to current studies, obesity, insulin resistance, hyperinsulinemia, and metabolic syndrome are related to various gallbladder diseases including gallbladder stones, cholecystitis, gallbladder polyps, and gallbladder cancers. We reviewed further literature on the obesity and gallbladder diseases, in aspects of epidemiology, mechanism, pathology and prevention.
Body Mass Index ; Cholecystitis/etiology ; Exercise ; Gallbladder Diseases/drug therapy/epidemiology/*etiology/prevention & control ; Gallbladder Neoplasms/epidemiology/etiology ; Gallstones/epidemiology/etiology ; Humans ; Hyperinsulinism ; Hypolipidemic Agents/therapeutic use ; Insulin Resistance ; Obesity/*complications ; Ursodeoxycholic Acid/therapeutic use ; Weight Loss

Colorectal cancer appears to have rapidly increased over the past two decades in Korea. Environmental factors, characterized by a western life style, seem to be closely related to the increased risk of colorectal cancer. Higher intakes of meat, a lower vegetable intake, a lack of physical activity, obesity, and alcohol drinking have been suggested to be risk factors for colorectal cancer in the numerous epidemiologic studies. Several specific associations have also been observed between genetic polymorphisms and colorectal cancer. Moreover, it has been postulated that environmental factors and a genetic predisposition work in concert in colorectal cancer development. A stronger association between red meat intake and colorectal cancer among those with rapid acetylators at either the NAT1 or NAT2 locus was reported, particularly for colorectal cancer associated with K-ras mutations. The protective effect of the homozygous variant TT form of the MTHFR genotype on the risk of colon cancer seems to be modified by the level of methyl diets, i.e., by folate, which has a protective effect, or conversely by alcohol. The insulin-related pathway, which possibly explains at a mechanistic level the effect of physical activity and obesity on colon cancer, appears to be a common denominator in colon cancer and in other metabolic disorders, such as diabetes mellitus and dyslipidemia. Hyperinsulinemia has been proposed as an explanation for the association between a Western lifestyle and colon cancer risk. Further studies, that incorporate both genetic and environmental factors, are needed to fully explain and identify the underlying pathway of colorectal carcinogenesis.
Alcohol Drinking ; Carcinogenesis ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Diabetes Mellitus ; Diet ; Dyslipidemias ; Epidemiologic Studies ; Folic Acid ; Genetic Predisposition to Disease ; Genotype ; Hyperinsulinism ; Korea ; Life Style ; Meat ; Molecular Epidemiology* ; Motor Activity ; Obesity ; Polymorphism, Genetic ; Risk Factors ; Vegetables