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Bone Mineral Density in Prediabetic Men.

Ju Hee LEE ; Yun Hyeong LEE ; Kyoung Hye JUNG ; Min Kyeong KIM ; Hye Won JANG ; Tae Kyun KIM ; Hyun Jin KIM ; Young Suk JO ; Minho SHONG ; Tae Yong LEE ; Bon Jeong KU

Korean Diabetes Journal.2010;34(5):294-302. doi:10.4093/kdj.2010.34.5.294

BACKGROUND: There are many studies regarding the effects of insulin on bone metabolism and changes in bone mineral density (BMD) in the setting of diabetes. The effect of prediabetes on BMD is not known. METHODS: A total of 802 men participated in the Korea Rural Genomic Cohort Study (in Geumsan County). According to the results of an oral glucose tolerance test, subjects were classified into normal, prediabetic, and diabetic categories. One hundred twenty-four subjects diagnosed with type 2 diabetes were excluded, leaving 678 subjects for the study inclusion. BMD was estimated with a quantitative ultrasonometer. RESULTS: The average BMD T scores of normal and prediabetic subjects were -1.34 +/- 1.42 and -1.33 +/- 1.30, respectively; there was no significant difference in the BMD T scores between these groups. The BMD T score was inversely associated with age and positively correlated with body weight, body mass index, total cholesterol, low density lipoprotein cholesterol, and HbA1c. On multiple linear regression analysis, low density lipoprotein cholesterol was the only statistically significant variable for prediabetes (beta = 0.007, P = 0.005). On the stepwise regression analysis, age (beta = -0.026, P < 0.001), the body mass index (beta = 0.079, P < 0.001), and low density lipoprotein cholesterol (beta = 0.004, P = 0.016) were significant variables for prediabetes. CONCLUSIONS: There was no significant difference in the BMD T score between the normal and prediabetic subjects. Further studies are needed regarding the association of fracture risk and changes in BMD with the development of overt diabetes.
Body Mass Index ; Body Weight ; Bone Density ; Cholesterol ; Cholesterol, LDL ; Cohort Studies ; Glucose Tolerance Test ; Humans ; Insulin ; Korea ; Linear Models ; Lipoproteins ; Male ; Prediabetic State

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The Association of Brachial-Ankle Pulse Wave Velocity with 30-Minute Post-Challenge Plasma Glucose Levels in Korean Adults with No History of Type 2 Diabetes.

Eun Suk CHOI ; Eun Jung RHEE ; Ji Hoon CHOI ; Ji Cheol BAE ; Seung Hyun YOO ; Won Jun KIM ; Se Eun PARK ; Cheol Young PARK ; Won Young LEE ; Yong Kyun CHO ; Ki Won OH ; Sung Woo PARK ; Sun Woo KIM

Korean Diabetes Journal.2010;34(5):287-293. doi:10.4093/kdj.2010.34.5.287

BACKGROUND: Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT). METHODS: In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed. RESULTS: Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables. CONCLUSIONS: Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.
Adult ; Atherosclerosis ; Blood Pressure ; Cholesterol ; Cholesterol, LDL ; Confounding Factors (Epidemiology) ; Fasting ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Lipoproteins ; Plasma ; Prediabetic State ; Pulse Wave Analysis ; Vascular Stiffness

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The Association of Brachial-Ankle Pulse Wave Velocity with Acute Postprandial Hyperglycemia in Korean Prediabetic and Diabetic Subjects.

Chul Woo AHN

Korean Diabetes Journal.2010;34(5):284-286. doi:10.4093/kdj.2010.34.5.284

No abstract available.
Hyperglycemia ; Pulse Wave Analysis

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Role of Pyruvate Dehydrogenase Kinase 4 in Regulation of Blood Glucose Levels.

Nam Ho JEOUNG ; Robert A HARRIS

Korean Diabetes Journal.2010;34(5):274-283. doi:10.4093/kdj.2010.34.5.274

In the well-fed state a relatively high activity of the pyruvate dehydrogenase complex (PDC) reduces blood glucose levels by directing the carbon of pyruvate into the citric acid cycle. In the fasted state a relatively low activity of the PDC helps maintain blood glucose levels by conserving pyruvate and other three carbon compounds for gluconeogenesis. The relative activities of the pyruvate dehydrogenase kinases (PDKs) and the opposing pyruvate dehydrogenase phosphatases determine the activity of PDC in the fed and fasted states. Up regulation of PDK4 is largely responsible for inactivation of PDC in the fasted state. PDK4 knockout mice have lower fasting blood glucose levels than wild type mice, proving that up regulation of PDK4 is important for normal glucose homeostasis. In type 2 diabetes, up regulation of PDK4 also inactivates PDC, which promotes gluconeogenesis and thereby contributes to the hyperglycemia characteristic of this disease. When fed a high fat diet, wild type mice develop fasting hyperglycemia but PDK4 knockout mice remain euglycemic, proving that up regulation of PDK4 contributes to hyperglycemia in diabetes. These finding suggest PDK4 inhibitors might prove useful in the treatment of type 2 diabetes.
Animals ; Blood Glucose ; Carbon ; Citric Acid Cycle ; Diet, High-Fat ; Fasting ; Gluconeogenesis ; Glucose ; Homeostasis ; Hyperglycemia ; Ketone Bodies ; Mice ; Mice, Knockout ; Oxidoreductases ; Phosphoric Monoester Hydrolases ; Phosphotransferases ; Protein Kinases ; Protein-Serine-Threonine Kinases ; Pyruvate Dehydrogenase Complex ; Pyruvic Acid ; Up-Regulation

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Ubiquitous Diabetes Management System via Interactive Communication Based on Information Technologies: Clinical Effects and Perspectives.

Jae Hyoung CHO ; Hun Sung KIM ; Jae Hoon HAN ; Jin Hee LEE ; Jeong Ah OH ; Yoon Hee CHOI ; Kun Ho YOON

Korean Diabetes Journal.2010;34(5):267-273. doi:10.4093/kdj.2010.34.5.267

New diabetes management systems based on interactive communication have been introduced recently, accompanying rapid advances in information technology; these systems are referred to as "ubiquitous diabetes management systems." In such ubiquitous systems, patients and medical teams can communicate via Internet or telecommunications, with patients uploading their glucose data and personal information, and medical teams sending optimal feedback. Clinical evidence from both long-term and short-term trials has been reported by some researchers. Such systems appear to be effective not only in reducing the levels of HbA1c but also in stabilizing glucose control. However, most notably, evidence for the cost-effectiveness of such a system should be demonstrated before it can be propagated out to the general population in actual clinical practice. To establish a cost-effective model, various types of clinical decision supporting software designed to reduce the labor time of physicians must first be developed. A number of sensors and devices for monitoring patients' data are expected to be available in the near future; thus, methods for automatic interconnections between devices and web charts were also developed. Further investigations to demonstrate the clinical outcomes of such a system should be conducted, hopefully leading to a new paradigm of diabetes management.
Delivery of Health Care ; Diabetes Mellitus ; Glucose ; Humans ; Internet ; Software Design ; Telecommunications

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Response: Lack of Association between Serum Cystatin C Levels and Coronary Artery Disease in Diabetic Patients (Korean Diabetes J 2010;34:95-100).

Eun Hee KIM ; Ki Up LEE

Korean Diabetes Journal.2010;34(3):209-210. doi:10.4093/kdj.2010.34.3.209

No abstract available.
Coronary Artery Disease ; Coronary Vessels ; Cystatin C ; Humans

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Letter: Lack of Association between Serum Cystatin C Levels and Coronary Artery Disease in Diabetic Patients (Korean Diabetes J 2010;34:95-100).

Kyu Chang WON

Korean Diabetes Journal.2010;34(3):207-208. doi:10.4093/kdj.2010.34.3.207

No abstract available.
Coronary Artery Disease ; Coronary Vessels ; Cystatin C ; Humans

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Homocysteine as a Risk Factor for Development of Microalbuminuria in Type 2 Diabetes.

Eun Hee CHO ; Eun Hee KIM ; Won Gu KIM ; Eun Hui JEONG ; Eun Hee KOH ; Woo Je LEE ; Min Seon KIM ; Joong Yeol PARK ; Ki Up LEE

Korean Diabetes Journal.2010;34(3):200-206. doi:10.4093/kdj.2010.34.3.200

BACKGROUND: Kidney function is critical in homocysteine clearance, and plasma homocysteine level is frequently increased in patients with renal failure. On the other hand, recent studies in animals have shown that hyperhomocysteinemia induces renal injury. In this study, we determined whether hyperhomocysteinemia can be a risk factor for the development of microalbuminuria in patients with type 2 diabetes. METHODS: A nested case-control study. Of 887 patients with type 2 diabetes who did not have microalbuminuria at baseline, 76 developed microalbuminuria during follow-up (mean, 36.0 +/- 11.7 months; range, 18 to 76 months). The control group consisted of 152 age- and sex-matched subjects who did not develop microalbuminuria. Baseline plasma homocysteine concentrations were measured in stored samples. RESULTS: Baseline plasma homocysteine concentrations and mean HbA1C levels during follow-up were significantly higher in patients who developed microalbuminuria than in those who remained normoalbuminuric. Multivariate logistic regression analysis showed that baseline plasma homocysteine level and mean HbA1C were independent predictors of microalbuminuria in type 2 diabetes. CONCLUSION: Hyperhomocysteinemia was associated with increased risk of microalbuminuria in patients with type 2 diabetes supporting the concept that hyperhomocysteinemia has an etiologic role in the pathogenesis of diabetic nephropathy.
Animals ; Case-Control Studies ; Diabetes Mellitus ; Diabetic Nephropathies ; Follow-Up Studies ; Hand ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Kidney ; Logistic Models ; Plasma ; Renal Insufficiency ; Risk Factors

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Effects of Rosiglitazone on Inflammation in Otsuka Long-Evans Tokushima Fatty Rats.

Jin Woo LEE ; Il Seong NAM-GOONG ; Jae Geun KIM ; Chang Ho YUN ; Se Jin KIM ; Jung Il CHOI ; Young IL KIM ; Eun Sook KIM

Korean Diabetes Journal.2010;34(3):191-199. doi:10.4093/kdj.2010.34.3.191

BACKGROUND: Inflammation plays a role in the response to metabolic stress in type 2 diabetes. However, the effects of rosiglitazone on inflammation of skeletal muscle have not been fully examined in type 2 diabetes. METHODS: We investigated the effects of the insulin-sensitizing anti-diabetic agent, rosiglitazone, on the progression of skeletal muscle inflammation in Otsuka Long-Evans Tokushima Fatty (OLETF) type 2 diabetic rats. We examined the expression of serologic markers (serum glucose, insulin and free fatty acid) and inflammatory cytokines (tumor-necrosis factor-alpha, interleukin [IL]-1beta and IL-6) in OLETF rats from early to advanced diabetic stage (from 28 to 40 weeks of age). RESULTS: Serum glucose and insulin concentrations were significantly decreased in rosiglitazone-treated OLETF rats compared to untreated OLETF rats. Rosiglitazone treatment significantly decreased the concentrations of serum inflammatory cytokines from 28 to 40 weeks of age. The mRNA expression of various cytokines in skeletal muscle was reduced in rosiglitazone-treated OLETF rats compared with untreated OLETF rats. Furthermore, rosiglitazone treatment resulted in the downregulation of ERK1/2 phosphorylation and NF-kappaB expression in the skeletal muscle of OLETF rats. CONCLUSION: These results suggest that rosiglitazone may improve insulin sensitivity with its anti-inflammatory effects on skeletal muscle.
Animals ; Cytokines ; Diabetes Mellitus, Type 2 ; Down-Regulation ; Glucose ; Inflammation ; Insulin ; Insulin Resistance ; Interleukins ; Muscle, Skeletal ; NF-kappa B ; Phosphorylation ; Rats ; Rats, Inbred OLETF ; RNA, Messenger ; Stress, Physiological ; Thiazolidinediones

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Association between Obesity and Physical Fitness, and Hemoglobin A1c Level and Metabolic Syndrome in Korean Adults.

Yoonsuk JEKAL ; Mi Kyung LEE ; Sukyung PARK ; Seung Hwan LEE ; Jun Young KIM ; Jung Ui KANG ; Masayo NARUSE ; Sang Hwan KIM ; Sun Hyeon KIM ; Sang Hui CHU ; Sang Hoon SUH ; Justin Y JEON

Korean Diabetes Journal.2010;34(3):182-190. doi:10.4093/kdj.2010.34.3.182

BACKGROUND: The purpose of the current study was to investigate the association of obesity level, physical fitness level, hemoglobin A1c (HbA1c) level and metabolic syndrome (MetS) risk factors among Korean adults. METHODS: A total of 557 adults (272 males and 285 females) who underwent medical check-up at local hospital were recruited. In addition to regular health check-up, cardiopulmonary fitness, muscular endurance were measured and their association were analyzed. RESULTS: The prevalence of MetS was 31.7% for males and 23.7% for females. Females with the higher muscular endurance had lower waist circumference, triglyceride level, and HbA1c level than those with the lower muscular endurance. Males with the higher level of cardiopulmonary fitness had lower diastolic blood pressure, lower high-sensitivity C-reactive protein level and higher high density lipoprotein cholesterol level than males with the lower level of cardiopulmonary fitness. Females with the higher level of cardiopulmonary fitness had lower body weight, body mass index, systolic blood pressure, and fasting blood glucose level than females with the lower level of cardiopulmonary fitness. Participants with the higher level of adiposity and the lower level of physical fitness were 5.26 times (95% confidence interval [CI], 2.19 to 12.62), 5.71 times (95% CI, 2.23 to 14.60) more likely to have MetS, respectively, in male and female compared to participants who were neither obese nor have the lower level of fitness. CONCLUSION: This study suggests that maintaining a healthy body weight as well as a certain level of fitness is important for the prevention of MetS.
Adiposity ; Adult ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; C-Reactive Protein ; Cholesterol ; Cholesterol, HDL ; Fasting ; Female ; Hemoglobins ; Humans ; Hypotension ; Lipoproteins ; Male ; Obesity ; Physical Fitness ; Prevalence ; Risk Factors ; Waist Circumference

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