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Prevalence and Clinical Characteristics of Aspirin Resistance in the Patients with Type 2 Diabetes Mellitus.

Mi Yeon KANG ; Young Min CHO ; Hyun Kyung KIM ; Jee Hyun AN ; Hwa Young AHN ; Ji Won YOON ; Hoon Sung CHOI ; Jie Seon LEE ; Kyong Soo PARK ; Seong Yeon KIM ; Hong Kyu LEE

Korean Diabetes Journal.2008;32(1):53-59. doi:10.4093/kdj.2008.32.1.53

BACKGROUND: We examined the prevalence and clinical characteristics of aspirin resistance in the Korean patients with type 2 diabetes mellitus. METHODS: We studied 181 Korean patients with type 2 diabetes mellitus who were taking aspirin (100 mg/day for > or = 3 months) and no other antiplatelet agents. The VerifyNow System was used to determine aspirin responsiveness. Aspirin resistance was defined as an aspirin reaction unit (ARU) > or = 550. We measured the cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) to evaluate arteriosclerosis. The anthropometric parameters, electrocardiogram, blood pressure, fasting plasma glucose, lipid profiles, hemoglobin A1c, highly sensitive C-reactive protein (hsCRP), homocysteine, and microalbuminuria were measured in each patient. RESULTS: The prevalence of aspirin resistance in type 2 diabetic patients was 9.4% (17 of 181). Those who had aspirin resistance were older than those without aspirin resistance (64.6 +/- 10.6 vs. 59.8 +/- 8.1, P = 0.024). Aspirin resistance was not associated with fasting plasma glucose, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, hemoglobin A1c, hsCRP, homocysteine, microalbuminuria, ABI, CAVI, and body mass index. CONCLUSION: Prevalence of aspirin resistance in the Korean patients with type 2 diabetes mellitus was 9.4%. Although aspirin resistance was associated with old age, we could not find any good clinical parameter to predict it. Therefore, aspirin resistance should be evaluated in diabetic patients taking aspirin for prevention of cardiovascular complications.
Ankle Brachial Index ; Arteriosclerosis ; Aspirin ; Blood Pressure ; C-Reactive Protein ; Cholesterol ; Diabetes Mellitus, Type 2 ; Electrocardiography ; Fasting ; Glucose ; Hemoglobins ; Homocysteine ; Humans ; Plasma ; Platelet Aggregation Inhibitors ; Prevalence

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Vascular Endothelial Growth Factor (VEGF) and Advanced Glycation End Products (AGEs) Overexpression in the Retina and Serum and Lens Opacities of Streptozotocin-induced Diabetic Rats.

Young Sook KIM ; Eun Jin SOHN ; Chan Sik KIM ; Yun Mi LEE ; Dong Ho JUNG ; Nan Hee KIM ; Hyun Young LEE ; Jung Yeon KIM ; Jin Sook KIM

Korean Diabetes Journal.2008;32(1):44-52. doi:10.4093/kdj.2008.32.1.44

BACKGROUND: Vascular Endothelial Growth Factor (VEGF) and Advanced Glycation End products (AGEs) have been implicated in the development of diabetic retinopathy. In this study, we examined the expression of VEGF and AGEs in the retina and serum, apoptosis in the retina, and lens opacities in streptozotocin (STZ)-induced diabetic rats. METHODS: The localization of VEGF and AGEs in the retina of STZ-induced diabetic rats was determined by immunohistochemical analysis, and apoptotic cell death was assessed using the TUNEL assay. In the serum, STZ-induced diabetic rats were assayed for VEGF and AGEs by ELISA. Lenses were also isolated to detect the opacity. RESULTS: Expression of VEGF and accumulation of AGEs were significantly increased in the retinal ganglion cell layers (GCL) and nuclear cell layers (NCL) of STZ-induced diabetic rats compared to normal control rats. In addition to cellular expression, serum VEGF and AGEs levels were also increased significantly in STZ-diabetic rats compared to normal rats (both P < 0.001) and there was a significant correlation between the serum VEGF and AGEs levels (r = 0.504). The lens opaque density of STZ-induced diabetic rats were significantly higher than in normal rats (P < 0.001). CONCLUSIONS: AGEs could be involved in the development of diabetic retinopathy through the induction of VEGF. One could possibly correlate this lens opaque formation with elevation of AGE induced VEGF level. Thus, this study should be considered as a basic research for studying pathology of the retina and lens in diabetic experimental models.
Animals ; Apoptosis ; Cataract ; Cell Death ; Diabetic Retinopathy ; Enzyme-Linked Immunosorbent Assay ; Glycosylation End Products, Advanced ; In Situ Nick-End Labeling ; Models, Theoretical ; Rats ; Retina ; Retinal Ganglion Cells ; Streptozocin ; Vascular Endothelial Growth Factor A

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Mutation Screening of HNF-1alpha Gene in Korean Women with Gestational Diabetes Mellitus.

Hun Sung KIM ; Sun Hee HWANG ; Eun Sun CHOI ; So Young PARK ; Chang Hoon YIM ; Ki Ok HAN ; Hyun Koo YOON ; Ho Yeon CHUNG ; Kyung Seon KIM ; Jeong BOK ; Jong Young LEE ; Sung Hoon KIM

Korean Diabetes Journal.2008;32(1):38-43. doi:10.4093/kdj.2008.32.1.38

BACKGROUNDS: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first detection during pregnancy and mostly caused by insulin resistance and beta-cell dysfunction like type 2 diabetes. However, autoimmune or monogenic diabetes can contribute to GDM. Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes characterized by an early age of onset and an autosomal dominant pattern of inheritance. Most MODY cases are attributable to mutations in HNF-1alpha gene, also known as MODY3. We investigated whether mutations in HNF-1alpha gene are present in Korean women with GDM. METHODS: A total of 96 Korean women with GDM who have a family history of DM were screened for mutations in the HNF-1alpha gene. We evaluated the clinical characteristics of GDM women with HNF-1alpha gene mutations. RESULTS: Five of 96 patients (5.2%) were found to have a mutation in HNF-1alpha gene. Four of those (-23C > G, 833G > A (Arg278Gln), 923C > T, IVS5 + 106A > G) were novel and one (-124G > C) in promoter region was reported in previous study. The mean age of GDM women with mutations of HNF-1alpha gene was 34 years. Four women with MODY3 gene mutations required insulin therapy during pregnancy. GDM women with MODY3 gene mutations appeared to be decreased insulin secretion (HOMA-%B) than those without mutations. CONCLUSIONS: We have found the existence of MODY3 as well as novel HNF-1alpha gene mutations in Korean women with GDM.
Age of Onset ; Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Glucose Intolerance ; Hepatocyte Nuclear Factor 1-alpha ; Humans ; Insulin ; Insulin Resistance ; Mass Screening ; Pregnancy ; Promoter Regions, Genetic ; Wills

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Association between Apolipoprotein E Polymorphism and Type 2 Diabetes in Subjects Aged 65 or Over.

You Jin LEE ; Hak Chul JANG ; Eun Hye KIM ; Hye Jin KIM ; Seok Bum LEE ; Sung Hee CHOI ; Soo LIM ; Kyoung Un PARK ; Young Joo PARK ; Ki Woong KIM

Korean Diabetes Journal.2008;32(1):30-37. doi:10.4093/kdj.2008.32.1.30

BACKGROUND: Increased prevalence of diabetes in recent years is linked with increased cardiovascular morbidity and mortality. Apolipoprotein E (apo E) polymorphism is well known to be related to hyperlipidemia and coronary heart disease, but only a few studies investigated the association between apo E polymorphism and diabetes or insulin resistance. In Korea, two studies with relatively small subjects reported controversial results. Therefore, we investigated the association between apo E polymorphism and diabetes in elderly community population. METHODS: 982 elderly people aged 65 or over in Seongnam city were enrolled. We measured anthropometric variables and blood pressure and performed biochemical tests including fasting glucose, fasting insulin, HbA1c, and lipid profiles. Apo E polymorphism was determined by PCR-RFLP method. RESULTS: Frequencies of apo E isoforms and alleles were similar to those of other reports. Subjects with e4 allele had significantly higher total and LDL-cholesterol levels. However, there were no differences in cholesterol levels between normal subjects and diabetes. Diabetes was not related to apo E polymorphism. CONCLUSION: In Korean aged 65 or over, subjects with diabetes didn't have increased total or LDL-cholesterol, triglyceride, and decreased HDL-cholesterol levels. Diabetes and apo E polymorphism were not related.
Aged ; Alleles ; Apolipoproteins ; Apolipoproteins E ; Blood Pressure ; Cholesterol ; Coronary Disease ; Fasting ; Glucose ; Humans ; Hyperlipidemias ; Insulin ; Insulin Resistance ; Korea ; Prevalence ; Protein Isoforms

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The Effect of alpha-Lipoic Acid on Proteinuria and Renal TGFbeta Expression in Obese Type 2 Diabetic Rat Model.

Seok Woo KANG ; Seong Jin LEE ; Dong Sun KIM ; Tae Wha KIM

Korean Diabetes Journal.2008;32(1):21-29. doi:10.4093/kdj.2008.32.1.21

BACKGROUND: It is well known that renal TGFbeta expression is related to the development of diabetic nephropathy. Alpha-lipoic acid (ALA), a potent antioxidant and cofactor of mitochondrial respiratory enzymes, can improve the insulin resistance and the vascular endothelial dysfunction, and suppresses the development of diabetic vascular complications. This study was undertaken to investigate whether ALA could reduce urinary protein excretion and renal TGFbeta protein expression in obese type 2 diabetes mellitus animal model, Otsuka Long-Evans Tokushima Fatty (OLETF) rat. METHODS: Obese 30 male OLETF rats were randomly divided to 3 groups at the age of 30 weeks. The rats in the Control group fed normal rat chow while the rats in the ALA group were fed with rat chow containing ALA (0.5% of food weight). Ten rats in the Pair-fed group were fed with normal rat chow, but were given the same amount of food as consumed by the ALA group. During 5 weeks of ALA feeding, food intake and body weight were checked in metabolic chamber. Blood glucose levels, HbA1c and urinary protein excretion were measured at 30 weeks and 35 weeks of age, and renal TGFbeta protein expression at 35 weeks of age was measured by Western blot and represented by relative unit (RU). Immunohistochemical staining for TGFbeta protein in renal tissue was also examined at 35 weeks of age. RESULTS: Food intake, body weight, blood glucose levels, HbA1c and urinary protein excretion among the Control, ALA and Pair-fed groups at 30 weeks of age were not different. At 35 weeks of age, food intake was significantly decreased in the ALA group than the Control group (Control group vs. ALA group, 27.7 +/- 1.1 g/day vs. 22.4 +/- 1.4 g/day, P < 0.001), and body weight was significantly decreased in the ALA group than the Control and Pair-fed groups (Control group: 694.4 +/- 10.3 g, ALA group: 600.4 +/- 7.4 g, Pair-fed group: 685.4 +/- 11.6 g, P < 0.001). Blood glucose levels were significantly decreased in the ALA group than the Control and Pair-fed groups (Control group: 157.7 +/- 4.6 mg/dL, ALA group: 130.7 +/- 4.8 mg/dL, Pair-fed group: 153.7 +/- 3.3 mg/dL, P < 0.001) although blood glucose levels from 30 weeks to 34 weeks of age and HbA1c at 35 weeks of age were not different among the groups. Urinary protein excretion and renal TGFbeta protein expression were significantly decreased in the ALA group than the Control and Pair-fed groups (urinary protein excretion, Control group: 5.033 +/- 0.254 mg/mgCr, ALA group: 3.633 +/- 0.303 mg/mgCr, Pair-fed group: 4.977 +/- 0.339 mg/mgCr, P < 0.001; renal TGFbeta protein expression, Control group: 7.09 +/- 0.17 RU, ALA group: 4.14 +/- 0.26 RU, Pair-fed group: 7.00 +/- 0.29 RU, P < 0.001). In the ALA group at 35 weeks of age, urinary protein excretion and renal TGFbeta protein expression were positively related in the Control, ALA and Pair-fed groups (Control group, r = 0.847, P = 0.002; ALA group, r = 0.954, P < 0.001; Pair-fed group, r = 0.858, P = 0.002). TGFbeta staining in glomeruli was observed in all groups but was decreased in the ALA group at 35 weeks of age. CONCLUSION: These results suggest that ALA may prevent the increase of food intake, body weight, blood glucose, urinary protein excretion and renal TGFbeta protein expression in obese type 2 diabetic rat model. The effect of ALA on diabetic nephropathy presented as proteinuria and renal TGFbeta expression in diabetic patients needs to be further clarified.
Animals ; Blood Glucose ; Blotting, Western ; Body Weight ; Diabetes Mellitus, Type 2 ; Diabetic Angiopathies ; Diabetic Nephropathies ; Eating ; Humans ; Insulin Resistance ; Male ; Models, Animal ; Proteinuria ; Rats ; Rats, Inbred OLETF ; Thioctic Acid ; Transforming Growth Factor beta

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Protective Effects of Lithospermic Acid B on Diabetic Nephropathy in OLETF Rats Comparing with Amlodipine and Losartan.

Eun Seok KANG ; Beom Seok KIM ; Chul Hoon KIM ; Gi Ho SEO ; Seung Jin HAN ; Sung Wan CHUN ; Kyu Yeon HUR ; Chul Woo AHN ; Hunjoo HA ; Mankil JUNG ; Bong Soo CHA ; Hyun Chul LEE

Korean Diabetes Journal.2008;32(1):10-20. doi:10.4093/kdj.2008.32.1.10

BACKGROUND: Lithospermic acid B (LAB), an active component isolated from Salvia miltiorrhizae, has been reported to have renoprotective effects in type 1 and type 2 diabetic animal models. We examined the effects of LAB on the prevention of diabetic nephropathy compared with amlodipine, a calcium channel blocker, and losartan, an angiotensin receptor blocker, in Otsuka Long-Evans-Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes. METHODS: LAB (20 mg/kg), amlodipine (10 mg/kg), or losartan (10 mg/kg) was given orally once daily to 10-week-old male OLETF rats for 28 weeks. RESULTS: None of LAB, losartan, and amlodipine exhibited effects on blood glucose levels. Treatment with amlodipine or losartan resulted in similar reductions in blood pressure; however, LAB was less effective in lowering blood pressure. Albuminuria was markedly suppressed by losartan and LAB, but not by amlodipine. LAB treatment decreased levels of renal lipid peroxidation, monocyte chemoattractant protein-1 (MCP-1), and transforming growth factor-beta1 (TGF-beta1). CONCLUSION: These results suggest that LAB has beneficial effects on the diabetic nephropathy in OLETF rats by decreasing oxidative stress and inflammation as potent as losartan.
Albuminuria ; Amlodipine ; Angiotensins ; Animals ; Benzofurans ; Blood Glucose ; Blood Pressure ; Calcium Channels ; Chemokine CCL2 ; Depsides ; Diabetic Nephropathies ; Humans ; Inflammation ; Lipid Peroxidation ; Losartan ; Male ; Models, Animal ; Oxidative Stress ; Pyridines ; Rats ; Rats, Inbred OLETF ; Salvia miltiorrhiza ; Thiazoles

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Diabetic Nephropathy - Preventive effects of lithospermic acid B (LAB).

Eun Gyoung HONG

Korean Diabetes Journal.2008;32(1):7-9. doi:10.4093/kdj.2008.32.1.7

No abstract available.
Benzofurans ; Depsides ; Diabetic Nephropathies

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Insulin Resistance in Polycystic Ovary Syndrome.

Yeon Ah SUNG

Korean Diabetes Journal.2008;32(1):1-6. doi:10.4093/kdj.2008.32.1.1

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women of reproductive age and now recognized as an important metabolic and reproductive disorder. The majority of women with PCOS have insulin resistance and this is regarded to have a central etiological role in PCOS. Insulin resistance and concomitant hyperinsulinemia modifies reproductive function by driving androgen production, suppression of sex hormone-binding globulin (SHBG) and disruption of insulin signaling pathways in the central nervous system. Insulin resistance, together with defects in insulin secretion, confers markedly increased risk for type 2 diabetes mellitus and metabolic syndrome. There are post-binding defects in insulin receptor signaling, with selective resistance to insulin's metabolic actions and preserved other actions. Genetic and environmental abnormalities interact to produce peripheral insulin resistance in PCOS. The numerous in vivo and in vitro data supporting the central role of insulin resistance in the pathogenesis of PCOS have led a new therapy for PCOS with insulin-sensitizing agents.
Central Nervous System ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hyperinsulinism ; Insulin ; Insulin Resistance ; Polycystic Ovary Syndrome ; Receptor, Insulin ; Sex Hormone-Binding Globulin

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Response: Effects of Aerobic Exercise Intensity on Insulin Resistance in Patients with Type 2 Diabetes Mellitus (Korean Diabetes J 33:(5)401-411, 2009).

Yun Hyi KU ; Bo Kyung KOO ; Kyung Wan MIN

Korean Diabetes Journal.2009;33(6):549-550. doi:10.4093/kdj.2009.33.6.549

No abstract available.
Diabetes Mellitus, Type 2 ; Exercise ; Humans ; Insulin ; Insulin Resistance

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Letter: Effects of Aerobic Exercise Intensity on Insulin Resistance in Patients with Type 2 Diabetes Mellitus (Korean Diabetes J 33(5):401-411, 2009).

Dong Lim KIM

Korean Diabetes Journal.2009;33(6):547-548. doi:10.4093/kdj.2009.33.6.547

No abstract available.
Diabetes Mellitus, Type 2 ; Exercise ; Humans ; Insulin ; Insulin Resistance

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