social resistance ; Chemotherapy-Oncologic Procedure ; Singular ; Etoposide ; Hydatidiform Mole, Invasive

Obesity that caused by high-fat diet, heredity, drinking, or lack of exercise is related to metabolic syndrome, insulin resistance, type 2 diabetes and cardiovascular disease and it becomes a serious social problem. Although obesity shows low-grade chronic inflammation which induces from immune response in adipose tissue, relation between inflammation and pathogenesis of obesity has not been incompletely understood. Therefore, study for immune response in obesity is essential to design effective therapeutic strategy.
Adipose Tissue ; Cardiovascular Diseases ; Diet, High-Fat ; Drinking ; Heredity ; Inflammation* ; Insulin Resistance ; Obesity* ; Social Problems

BACKGROUND: Surveillance of TB drug resistance (DR) is essential for providing information on the magnitude and trends in resistance, for developing treatment guidelines and for monitoring the effect of interventions. Up to now national surveys of drug resistance of M. tuberculosis have been conducted four times since 1994 among patients registered at health centers. The purpose of this study is to estimate the prevalence of primary drug resistance among new cases identified in private sector, and to compare it with the previous national drug resistance surveys. METHODS: The study collected results of drug susceptibility testing (DST) performed at the Korean Institute of Tuberculosis by the request of private sector from January 2003 to December 2005, and then finally selected new cases for the analysis from the database of Korean TB Surveillance (KTBS) by matching patients' name and social identification numbers. RESULTS: Of the 5,132 new patients included in the study, 689 (13.4%) patients were found to have drug resistance at least one drug, 530 patients (10.3%) were isoniazid resistant, 195 patients (3.8%) were multi-drug resistant (MDR), and 21 patients (0.4%) were extensively drug resistant (XDR). The rate of drug resistance tended to decrease annually but it was not statistically significant. When compared with previous national DR surveys in 2003 and in 2004 respectively, they were not significantly different. CONCLUSION: The prevalence of DR among new cases managed in the private sector did not show significant difference from that of new patients registered in the public sector in the same year.
Drug Resistance ; Humans ; Isoniazid ; Prevalence ; Private Sector ; Public Sector ; Social Identification ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: The “Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)” is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. METHODS: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. RESULTS: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. CONCLUSION: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the “Tuberculosis Relief Belt Supporting Project” compensated for these limitations.
Drug Resistance ; Health Care Costs ; Health Expenditures ; Humans ; Medically Uninsured ; Nursing ; Poverty* ; Retrospective Studies ; Social Class ; Transportation ; Tuberculosis*

BACKGROUND: An important metabolic feature of acromegaly is a reduced action of insulin on hepatic gluconeogenesis and peripheral glucose disposal which mediated by growth hormone hypersecretion. Octreotide, a synthetic octapeptide somatostatin analogue exerts complex effects on hormonal and metabolic regulations affecting glucose homeostasis. This study was designed to ascertain the shorterm effect of octreotide on glucose tolerance in acromegaly. METHODS: 10 patients (five men and five women, age 47.9+/-11.8) were injected subcutaneously with octreotide, 100 micrograms for 24 hours. Patients were assessed with respect to growth hormone, glucose, and insulin response to a standard 100 g oral glucose tolerance test (OGTT) before and during the last 2 hour of octreotide infusion. RESULTS: During the therapy, there was significant decrease in mean blood glucose response to OGTT (678.4+/-51.9 vs 581.9+/-47.3 mg/dL/2hr: mean areas under the glucose curve, p=0.01) and mean serum insulin response to oral glucose load was significantly reduced in all patients (339.2+/-106.2 vs 256.7+/-111.3 U/mL/2hr: mean areas under the insulin curve, p=0.01). Using glucose tolerance test criteria three patients of 10 had normal glucose tolerance, four and three had impaired glucose tolerance and diabetes, respectively, at base line. While on octreotide these composition was changed to six patients of NGT, three of IGT and one diabetes. CONCLUSION: We conclude that insulin resistance mediated by GH hypersecretion was improved by shorterm octreotide treatment.
Acromegaly* ; Blood Glucose ; Female ; Gluconeogenesis ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Homeostasis ; Humans ; Infusions, Subcutaneous* ; Insulin ; Insulin Resistance ; Male ; Octreotide* ; Social Control, Formal ; Somatostatin

BACKGROUND: Recent studies have shown that omentin-1 derived from adipokines can affect physiological regulations and some metabolic dis-eases such as type 2 diabetes mellitus (T2DM). METHODS: The purpose of this study was to examine the impact of 12 weeks of aerobic (cycle ergometer), resistance, and combined exercises on omentin-1 level, glucose and insulin resistance indices in overweight middle age women with T2DM. In this study, 60 overweight middle age diabetic women were selected using simple random sampling and they were assigned to three groups of aerobic exercise (n=12), resistant exercise (n=12) and combined exercise (n=13), and one control group (n=15). Exercises were done in a three times per week sessions for a total of 12 weeks. Blood samples were collected before each exercise session and 24 hours after of the last session. RESULTS: Present study showed that fasting blood sugar decreased significantly in all intervention groups, while homeostasis model assessment of insulin resistance (HOMA-IR) decreased only in the aerobic and combined exercises groups. Furthermore, there was a significant increase in the omentin-1 level only in the combined exercise group. CONCLUSION: Compared to aerobic and resistance exercises, 12 weeks of combined exercise was more efficient in improving HOMA-IR and increasing serum omentin-1 among women with T2DM.
Adipokines ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Exercise* ; Fasting ; Female ; Glucose ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Middle Aged ; Overweight ; Social Control, Formal

OBJECTIVETo explore the relationship between socioeconomic status (SES) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM).

METHODSThe medical records of Tianjin Third Central Hospital were retrospectively reviewed to identify patients who had been hospitalized for treatment of T2DM but without diagnosis of NAFLD between 2007 and 2012 and who had required a second hospitalization during this same period. Each patient was contacted by telephone for self-reporting of SES. Analysis was carried out with patients grouped according to SES (high vs. low) to determine association of SES with incidence of NAFLD at the second hospitalization; the relative risk (RR), attributable risk (AR) and attributable risk percent (ARP) were calculated. Furthermore, the correlation of SES with other clinical and socio-psychological variables was assessed.

RESULTSThe patients in the high and low SES groups showed no significant differences at baseline. For development of NAFLD by the time of the second hospitalization, the low SES group had an RR of 2.19, an AR of 20.74%, and an ARP of 54.39%. Correlation analysis showed that SES was positively correlated with body mass index (r=-0.582) and levels of glycated hemoglobin (r=-0.421), fasting serum insulin (r=-0.570), insulin resistance (as assessed by the HOMA method) (r=-0.487), low-density lipopmtein (r=-0.396) and C-reactive protein (r=-0.353) (all P<0.05), and negatively correlated with high-density lipopmtein (r =0.539) and with the scores for physical functioning (r =0.241), general health (r=0.234), social functioning (r =0.286), emotional health (r=0.251), and mental health (r=0.215) (all P<0.05).

CONCLUSIONSES is an influencing factor of NAFLD in patients with T2DM and is closely related to obesity, insulin resistance, lipid metabolic disorder, chronic inflammation and life quality in patients with NAFLD and T2DM.

OBJECTIVES: We aimed to determine the characteristics affecting insulin resistance in non-obese middle-aged adults in a rural community. METHODS: A total of 1,270 non-diabetic adults aged between 40 and 64 years old with body mass index (BMI) less than 25 kg/m2 were analyzed. Subjects with insulin resistance were defined as those who had the highest quartile value of the homeostasis model assessment of insulin resistance (HOMA-IR) in a non-diabetic population. RESULTS: A total of 217 subjects (20.6%) had insulin resistance. Prevalence of metabolic syndrome was significantly higher in insulin-resistant subjects in both men (29.3% vs. 10.3%) and women (34.1% vs. 15.6%). Among metabolic syndrome components, elevated waist circumference and elevated triglyceride were higher in insulin-resistant subjects in both genders. After being controlled for socioeconomic status and lifestyle related covariates, the association between insulin resistance and BMI was statistically significant in the category of 23.0-24.9 kg/m2 in men (adjusted OR, 4.63; 95% confidence interval [95% CI], 1.77-12.15) using the category of 18.5-20.9 kg/m2 as a reference. In addition, the association between insulin resistance and abdominal obesity was statistically significant only for men (adjusted OR, 2.57; 95% CI, 1.29-5.11). CONCLUSION: Insulin resistance appears to be highly associated with high BMI and abdominal obesity, even in non-obese, non-diabetic middle-aged men.
Adult ; Aged ; Body Mass Index ; Cohort Studies ; Female ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Life Style ; Male ; Metabolic Diseases ; Obesity, Abdominal ; Prevalence ; Rural Population ; Social Class ; Waist Circumference

Dementia, a clinical syndrome affecting memory, thinking, and social abilities primarily caused by neurodegeneration, is becoming one of the greatest health and socioeconomic burdens in the aging society. The age-standardized prevalence of dementia for people aged 60 or older was 5% to 7% in most world regions, affecting 47 million people in 2015. This number is expected to almost double every 20 years. Although aging is the greatest but non-modifiable risk factor, approximately 35% of the risk has been attributed to the combination of potentially modifiable risk factors including education, diet and lifestyle factors, psychiatric factors, and metabolic factors. There is ample evidence that people with glucose intolerance, insulin resistance, and metabolic syndrome are at higher risk for cognitive impairment and dementia compared to age- and sex-matched controls. Meta-analyses and large-scaled pooled analyses demonstrate that diabetes is associated with an approximately 60% to 70% increased risk of all types of dementia. In this article, the associations of hyperglycemia, hypoglycemia, and glucose variability with cognitive dysfunction and dementia are demonstrated. Also, the underlying mechanism of this connection and possible effects of anti-diabetic medications are discussed.
Aging ; Cognition Disorders ; Dementia ; Diabetes Mellitus ; Diet ; Education ; Glucose ; Glucose Intolerance ; Hyperglycemia ; Hypoglycemia ; Insulin Resistance ; Life Style ; Memory ; Prevalence ; Risk Factors ; Social Skills ; Thinking

BACKGROUND: How community-based group resistance exercises affect the transition from robustness to frailty remains unclear. Thus, we conducted a retrospective cohort study to determine whether the trajectory from robustness to frailty over age differed depending on the duration of participation in group exercises. METHODS: We analyzed the Kihon Checklist (KCL) score of community-dwelling elderly residents of Sumoto city, Hyogo prefecture, who participated in community-based group resistance exercises between April 2010 and December 2019. Finally, 2567 older individuals were analyzed using multilevel modeling. The explanatory variables of interest were the frailty score measured using the KCL for each individual, where 0-3, 4-7, and ≥8 points denoted robustness, pre-frailty, and frailty, respectively. We considered age, sex, systolic blood pressure, pulse, duration of participation, and change in KCL score from baseline as possible confounders. Participants were classified as follows based on the duration of participation in the exercises: <3 times, short-term participation group; 4-6 times; mid-term participation group; and 7-13 times, long-term participation group. The mean duration from the baseline physical test for the total sample was 2.35 years (SD=2.51). RESULTS: The participants' mean total KCL score at baseline was 4.9±3.7. Multilevel modeling analysis revealed that the KCL scores changed by 0.82 points for each additional year of age (p<0.001) and changed by - 0.93 points for long-term participate group (p<0.001). The Estimated Marginal Means (EMM) of the KCL score was 3.98 (95%CI: 3.69, 4.28) points in the short-term participation group and was significantly worse than that of the long-term participation group at 70 years of age (p=0.001). The EMM was 4.49 (95%CI: 4.24, 4.74) at 75 years of age in the mid-term participation group and was significantly worse than that of the long-term participation group. The EMM was 3.87 (95%CI: 3.57, 4.16) in the long-term participation group and significantly better than that of the short-term (p<0.001) and mid-term (p=0.002) participation groups. CONCLUSION Participation in community-based group resistance exercises prolongs the transition from robustness to frailty. The improved KCL scores at baseline in the long-term participation group remained in the robust range at 75 years of age, which suggests the importance of initiating participation before the onset of functional decline.
Aged ; Checklist ; Cohort Studies ; Exercise Test ; Female ; Frailty/prevention & control* ; Humans ; Independent Living ; Japan/epidemiology* ; Male ; Resistance Training ; Retrospective Studies ; Social Participation