3.ENPP1 K121Q Genotype Not Associated with Coronary Artery Calcification in Korean Patients with Type 2 Diabetes Mellitus.
Dae Joon JEONG ; Dong Gyu LEE ; Hee Jung KIM ; Eun Hee CHO ; Sang Wook KIM
Korean Diabetes Journal 2010;34(5):320-326
BACKGROUND: Ectonucleotide pyrophosphatase/phosphodiesterase-1 (ENPP1) generates inorganic pyrophosphate, a solute that serves as an essential physiological inhibitor of calcification. Inactivating mutations of ENPP1 are associated with generalized calcification in infancy and an increased risk of developing type 2 diabetes mellitus (T2DM). We hypothesized that the ENPP1 K121Q variant may be associated with increased coronary artery calcification in T2DM patients. METHODS: The study subjects were aged 34 to 85 years and showed no evidence of clinical cardiovascular disease prior to recruitment. A total of 140 patients with T2DM were assessed for their coronary artery calcium (CAC) scores and ENPP1 K121Q polymorphisms were identified. RESULTS: The prevalence of subjects carrying the KQ genotype was 12.9% (n = 18). There were no 121QQ homozygotes. Patients with the KQ genotype did not show a significantly higher CAC score (122 vs. 18; P = 0.858). We matched each patient with the KQ genotype to a respective control with the KK genotype by gender, age, and duration of diabetes. When compared to matched controls, we observed no significant difference in CAC score (P = 0.959). CONCLUSIONS: The ENPP1 K121Q polymorphism does not appear to be associated with coronary artery calcification in patients with T2DM.
Aged
;
Calcium
;
Cardiovascular Diseases
;
Coronary Vessels
;
Diabetes Mellitus, Type 2
;
Diphosphates
;
Genotype
;
Homozygote
;
Humans
;
Lifting
;
Phosphoric Diester Hydrolases
;
Prevalence
;
Pyrophosphatases
4.The Effect of Tribbles-Related Protein 3 on ER Stress-Suppressed Insulin Gene Expression in INS-1 Cells.
Young Yun JANG ; Nam Keong KIM ; Mi Kyung KIM ; Ho Young LEE ; Sang Jin KIM ; Hye Soon KIM ; Hye Young SEO ; In Kyu LEE ; Keun Gyu PARK
Korean Diabetes Journal 2010;34(5):312-319
BACKGROUND: The highly developed endoplasmic reticulum (ER) structure in pancreatic beta cells is heavily involved in insulin biosynthesis. Thus, any perturbation in ER function inevitably impacts insulin biosynthesis. Recent studies showed that the expression of tribbles-related protein 3 (TRB3), a mammalian homolog of Drosophilia tribbles, in various cell types is induced by ER stress. Here, we examined whether ER stress induces TRB3 expression in INS-1 cells and found that TRB3 mediates ER stress-induced suppression of insulin gene expression. METHODS: The effects of tunicamycin and thapsigargin on insulin and TRB3 expression in INS-1 cells were measured by Northern and Western blot analysis, respectively. The effects of adenovirus-mediated overexpression of TRB3 on insulin, PDX-1 and MafA gene expression in INS-1 cells were measured by Northern blot analysis. The effect of TRB3 on insulin promoter was measured by transient transfection study with constructs of human insulin promoter. RESULTS: The treatment of INS-1 cells with tunicamycin and thapsigargin decreased insulin mRNA expression, but increased TRB3 protein expression. Adenovirus-mediated overexpression of TRB3 decreased insulin gene expression in a dose-dependent manner. A transient transfection study showed that TRB3 inhibited insulin promoter activity, suggesting that TRB3 inhibited insulin gene expression at transcriptional level. Adenovirus-mediated overexpression of TRB3 also decreased PDX-1 mRNA expression, but did not influence MafA mRNA expression. CONCLUSIONS: This study showed that ER stress induced TRB3 expression, but decreased both insulin and PDX-1 gene expression in INS-1 cells. Our data suggest that TRB3 plays an important role in ER stress-induced beta cell dysfunction.
Blotting, Northern
;
Blotting, Western
;
Endoplasmic Reticulum
;
Endoplasmic Reticulum Stress
;
Gene Expression
;
Humans
;
Insulin
;
Insulin-Secreting Cells
;
RNA, Messenger
;
Thapsigargin
;
Transfection
;
Tunicamycin
5.A Comparative Study of Diet in Good and Poor Glycemic Control Groups in Elderly Patients with Type 2 Diabetes Mellitus.
Mi Hye WOO ; Soojin PARK ; Jeong Taek WOO ; Ryowon CHOUE
Korean Diabetes Journal 2010;34(5):303-311
BACKGROUND: Identification of dietary patterns is important for glycemic management in elderly patients with type 2 diabetes mellitus (T2DM). METHODS: Elderly T2DM patients (> 65 years of age, n = 48) were categorized based on their concentration of glycated hemoglobin (HbA1c). Subjects with HbA1c levels below 7% were placed in the good control (GC) group and those with HbA1c levels equal to or above 8% were placed in the poor control (PC) group. Anthropometric data, blood parameters, and dietary intake records were compared between the groups. Statistical analysis included Student's t-test, chi-square test, and Pearson correlation coefficient test. RESULTS: Anthropometric data, including body mass index (24.7 +/- 2.9 kg/m2), did not differ between the GC and PC groups. Significant abnormalities in blood glucose levels (P < 0.01), lean body mass (P < 0.01), and plasma protein and albumin levels (P < 0.05, P < 0.01) were found in the PC group. In contrast to the GC group, the PC group depended on carbohydrate (P = 0.014) rather than protein (P = 0.013) or fat (P = 0.005) as a major source of energy, and had a lower index of nutritional quality for nutrients such as protein (P = 0.001), and all vitamins and minerals (P < 0.001, 0.01, or 0.05 for individual nutrients), except vitamin C, in their usual diet. Negative correlations between HbA1C levels and protein (r = -0.338, P < 0.05) or fat (r = -0.385, P < 0.01) intakes were also found. CONCLUSIONS: Healthcare professionals should encourage elderly diabetic patients to consume a balanced diet to maintain good glycemic control.
Aged
;
Ascorbic Acid
;
Blood Glucose
;
Body Mass Index
;
Delivery of Health Care
;
Diabetes Mellitus, Type 2
;
Diet
;
Hemoglobins
;
Humans
;
Micronutrients
;
Minerals
;
Nutritive Value
;
Plasma
;
Vitamins
7.The Relationship between the Level of Fatness and Fitness during Adolescence and the Risk Factors of Metabolic Disorders in Adulthood.
Yoonsuk JEKAL ; Ji Eun YUN ; Sang Wook PARK ; Sun Ha JEE ; Justin Y JEON
Korean Diabetes Journal 2010;34(2):126-134
BACKGROUND: The purpose of the current study was to investigate the association between the level of obesity and physical fitness (PF) during adolescence and the risk factors of metabolic disorders during adulthood. METHODS: In the current analysis, 3,993 Korean adults (mean age, 38.70 +/- 1.69 years) were recruited. The level of body index (BI) and PF were examined during adolescence through high school record, and their health examination data, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), total cholesterol (TC), and current body mass index (BMI) were obtained from National Health Insurance Corporation Data. Gender-specific analyses were administered to compare health exam data across the level of BI, the level of PF, and a mixed level of BI and PF. RESULTS: Most obese males during high school had statistically higher SBP, DBP, FG, and BMI in adulthood, and most obese females had higher BMI, as compared to most lean males or females. Least fit males during high school had statistically higher BMI in adulthood, and least fit females had statistically higher SBP, DBP, FG, TC, and BMI, as compared to most fit males or females. There was a significant relationship between the mixed level of BI and PF and SBP, DBP, TC and current BMI in both genders. CONCLUSION: Maintaining a healthy level of body weight and PF during adolescence is recommended to prevent the development of metabolic diseases in adulthood.
Adolescent
;
Adult
;
Blood Pressure
;
Body Mass Index
;
Body Weight
;
Cholesterol
;
Fasting
;
Female
;
Glucose
;
Humans
;
Male
;
Metabolic Diseases
;
National Health Programs
;
Obesity
;
Physical Fitness
;
Risk Factors
8.The Clinical Characteristics of the Newly Diagnosed Early Onset (< 40 Years Old) Diabetes in Outpatients' Clinic.
Kyung Soo KIM ; Hyun Ju OH ; Ji Woon KIM ; Yeo Kyung LEE ; Soo Kyung KIM ; Seok Won PARK ; Yoo Lee KIM ; Won Keun PARK ; Yong Wook CHO
Korean Diabetes Journal 2010;34(2):119-125
BACKGROUND: The prevalence of type 2 diabetes in young adults and adolescents has increased in the last decade according to the increasing obese population. The aim of this study was to examine the clinical characteristics of patients diagnosed with diabetes mellitus before the age of 40 years as compared with patients diagnosed at older ages. METHODS: This was a cross-sectional, retrospective study using data from 350 diabetic patients who were diagnosed with diabetes in an outpatient setting between January 2005 and December 2007. Patients were diagnosed according to the criteria set forth by the American Diabetes Association. We examined the clinical characteristics and laboratory data of the patients through review of medical records and compared the early-onset diabetic patients (< 40 years old) and the usual-onset diabetic patients (> or = 40 years old). RESULTS: The frequency of early-onset diabetes and usual-onset diabetes were 31.1% (n=109) and 68.9% (n=241), respectively. The early-onset diabetic patients more often had a positive family history of diabetes; higher HbA1c, fasting glucose, and postprandial glucose levels; experienced typical symptoms more frequently; had microalbuminuria more frequently; and required insulin therapy as initial treatment more frequently as compared to usual-onset diabetic patients, and these differences were significant. Conversely, hypertension was significantly more common in the usual-onset diabetic patients. CONCLUSION: It could be concluded that we should control early onset diabetes more strictly to prevent its complication because early onset diabetic patients represented more severe hyperglycemia and had more prevalent microalbuminuria.
Adolescent
;
Diabetes Mellitus
;
Fasting
;
Glucose
;
Humans
;
Hyperglycemia
;
Hypertension
;
Insulin
;
Medical Records
;
Outpatients
;
Prevalence
;
Retrospective Studies
;
Young Adult
9.The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients.
Korean Diabetes Journal 2010;34(2):111-118
BACKGROUND: Diabetic peripheral polyneuropathy (DPP) is one of the common complications of diabetes mellitus (DM) and can lead to foot ulcers or amputation. The pathophysiology of DPP includes several factors such as metabolic, vascular, autoimmune, oxidative stress and neurohormonal growth-factor deficiency and recent studies have suggested the use of serum gamma-glutamyl transferase (GGT) as an early marker of oxidative stress. Therefore, we investigated whether serum GGT may be useful in predicting DPP. METHODS: We assessed 90 patients with type 2 DM who were evaluated for the presence of DPP using clnical neurologic examinations including nerve conduction velocity studies. We evaluated the association between serum GGT and the presence of DPP. RESULTS: The prevalence of DPP was 40% (36 cases) according to clinical neurological examinations. The serum GGT concentration was significantly elevated in type 2 diabetic patients with DPP compared to patients without DPP (P < 0.01). There were other factors significantly associated with DPP including smoking (P = 0.019), retinopathy (P = 0.014), blood pressure (P < 0.05), aspartate aminotransferase (P = 0.022), C-reactive protein (P = 0.036) and urine microalbumin/creatinine ratio (P = 0.004). Serum GGT was independently related with DPP according to multiple logistic analysis (P < 0.01). CONCLUSION: This study shows that increased levels of serum GGT may have important clinical implications in the presence of DPP in patients with type 2 diabetes.
Amputation
;
Aspartate Aminotransferases
;
Blood Pressure
;
C-Reactive Protein
;
Diabetes Complications
;
Diabetes Mellitus
;
Foot Ulcer
;
gamma-Glutamyltransferase
;
Humans
;
Neural Conduction
;
Neurologic Examination
;
Oxidative Stress
;
Polyneuropathies
;
Prevalence
;
Smoke
;
Smoking
;
Transferases
10.The Effects of Resistance Training on Muscle and Body Fat Mass and Muscle Strength in Type 2 Diabetic Women.
Hwi Ryun KWON ; Kyung Ah HAN ; Yun Hyi KU ; Hee Jung AHN ; Bo Kyung KOO ; Ho Chul KIM ; Kyung Wan MIN
Korean Diabetes Journal 2010;34(2):101-110
BACKGROUND: Our goal was to investigate the effects of low intensity resistance training on body fat, muscle mass and strength, cardiovascular fitness, and insulin sensitivity in type 2 diabetes. METHODS: Twenty-eight overweight women with type 2 diabetes were randomly assigned to a resistance training group (RG, n = 13) or a control group (CG, n = 15). RG performed resistance training using elastic bands, of which strength was equal to 40 to 50% of one repetition maximum (1RM), for three days per week. Each exercise consisted of three sets for 60 minutes. We assessed abdominal fat using computed tomography, muscle mass using dual-energy X-ray absorptiometry, and muscle strength using Keiser's chest and leg press. Insulin sensitivity was measured using the insulin tolerance test, and aerobic capacity was expressed as oxygen uptake at the anaerobic threshold (AT-VO2) before and after the 12-week exercise program. RESULTS: The age of participants was 56.4 +/- 7.1 years, duration of diabetes was 5.9 +/- 5.5 years, and BMI was 27.4 +/- 2.5 kg/m2, without significant differences between two groups. During intervention, a greater increase in muscle mass and greater decreases in both total fat mass and abdominal fat were observed in RG compared to those of CG (P = 0.015, P = 0.011, P = 0.010, respectively). Increase in 1RM of upper and lower extremities was observed in the RG (P = 0.004, P = 0.040, respectively), without changes in AT-VO2 and insulin resistance in either group. CONCLUSION: In conclusion, the low intensity resistance training was effective in increasing muscle mass and strength and reducing total fat mass without change of insulin sensitivity in type 2 diabetic patients.
Abdominal Fat
;
Absorptiometry, Photon
;
Adipose Tissue
;
Anaerobic Threshold
;
Diabetes Mellitus, Type 2
;
Female
;
Humans
;
Insulin
;
Insulin Resistance
;
Leg
;
Lower Extremity
;
Muscle Strength
;
Muscles
;
Overweight
;
Oxygen
;
Resistance Training
;
Thorax