1.Efficacy and Safety of Metformin and Atorvastatin Combination Therapy vs. Monotherapy with Either Drug in Type 2 Diabetes Mellitus and Dyslipidemia Patients (ATOMIC): Double-Blinded Randomized Controlled Trial
Jie-Eun LEE ; Seung Hee YU ; Sung Rae KIM ; Kyu Jeung AHN ; Kee-Ho SONG ; In-Kyu LEE ; Ho-Sang SHON ; In Joo KIM ; Soo LIM ; Doo-Man KIM ; Choon Hee CHUNG ; Won-Young LEE ; Soon Hee LEE ; Dong Joon KIM ; Sung-Rae CHO ; Chang Hee JUNG ; Hyun Jeong JEON ; Seung-Hwan LEE ; Keun-Young PARK ; Sang Youl RHEE ; Sin Gon KIM ; Seok O PARK ; Dae Jung KIM ; Byung Joon KIM ; Sang Ah LEE ; Yong-Hyun KIM ; Kyung-Soo KIM ; Ji A SEO ; Il Seong NAM-GOONG ; Chang Won LEE ; Duk Kyu KIM ; Sang Wook KIM ; Chung Gu CHO ; Jung Han KIM ; Yeo-Joo KIM ; Jae-Myung YOO ; Kyung Wan MIN ; Moon-Kyu LEE
Diabetes & Metabolism Journal 2024;48(4):730-739
Background:
It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia.
Methods:
This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment.
Results:
After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events.
Conclusion
The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.
2.Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample
Jina HAN ; Hye Jin BAEK ; Eunbi NOH ; Kyuhyun YOON ; Jung Ae KIM ; Sukhyun RYU ; Kay O LEE ; No Yai PARK ; Eunok JUNG ; Sangil KIM ; Hyukmin LEE ; Yoo-Sung HWANG ; Jaehun JUNG ; Hun Jae LEE ; Sung-il CHO ; Sangcheol OH ; Migyeong KIM ; Chang-Mo OH ; Byengchul YU ; Young-Seoub HONG ; Keonyeop KIM ; Sunjae JUNG ; Mi Ah HAN ; Moo-Sik LEE ; Jung-Jeung LEE ; Young HWANGBO ; Hyeon Woo YIM ; Yu-Mi KIM ; Joongyub LEE ; Weon-Young LEE ; Jae-Hyun PARK ; Sungsoo OH ; Heui Sug JO ; Hyeongsu KIM ; Gilwon KANG ; Hae-Sung NAM ; Ju-Hyung LEE ; Gyung-Jae OH ; Min-Ho SHIN ; Soyeon RYU ; Tae-Yoon HWANG ; Soon-Woo PARK ; Sang Kyu KIM ; Roma SEOL ; Ki-Soo PARK ; Su Young KIM ; Jun-wook KWON ; Sung Soon KIM ; Byoungguk KIM ; June-Woo LEE ; Eun Young JANG ; Ah-Ra KIM ; Jeonghyun NAM ; ; Soon Young LEE ; Dong-Hyun KIM
Epidemiology and Health 2023;45(1):e2023075-
OBJECTIVES:
We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea.
METHODS:
In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022.
RESULTS:
In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%.
CONCLUSIONS
The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
3.Potential Role of Cytosolic RNA Sensor MDA5 as an Inhibitor for Keratinocyte Differentiation in the Pathogenesis of Psoriasis
Dong-Kyun HONG ; Mi-Ra CHOI ; Yul-Lye HWANG ; Jae Kyung LEE ; Young LEE ; Young-Joon SEO ; Sooil KIM ; Young-Ho LEE ; Chang-Deok KIM ; Jeung-Hoon LEE
Annals of Dermatology 2021;33(4):339-344
Background:
Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood.
Objective:
The purpose of this study is to uncover possible roles of MDA5 in psoriasis.
Methods:
Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus.
Results:
As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes.
Conclusion
These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.
4.Activation of NLRP3 Inflammasome by Palmitic Acid in Human Sebocytes
Yu-Ra JUNG ; Jung-Min SHIN ; Chang-Hyeon KIM ; Sooil KIM ; Chang-Deok KIM ; Young-Joon SEO ; Jeung-Hoon LEE ; Myung IM ; Young LEE ; Young Ho LEE
Annals of Dermatology 2021;33(6):541-548
Background:
Sebocytes are the main cells involved in the pathogenesis of acne by producing lipids and inflammatory cytokines. Although palmitic acid (PA) has been suggested to induce an inflammatory reaction, its effect on sebocytes remains to be elucidated.
Objective:
In the present study, we investigated whether PA promotes inflammasome-mediated inflammation of sebocytes both in vivo and in vitro.
Methods:
We intradermally injected PA into the mice ears. And, we treated cultured human sebocytes with PA. Inflammasome-mediated inflammation was verified by immunohistochemistry, Western blot and ELISA.
Results:
PA-treated mice developed an inflammatory response associated with increased interleukin (IL)-1β expression in the sebaceous glands. When PA was added to cultured human sebocytes, caspase-1 activation and IL-1β secretion were significantly enhanced. In addition, NLRP3 knockdown attenuated IL-1β production by sebocytes stimulated with PA. PA-mediated inflammasome activation required reactive oxygen species.
Conclusion
These findings indicate that PA activates the NLRP3 inflammasome before induction of an inflammatory response in sebocytes. Thus, PA may play a role in the inflammation of acne
5.Potential Role of Cytosolic RNA Sensor MDA5 as an Inhibitor for Keratinocyte Differentiation in the Pathogenesis of Psoriasis
Dong-Kyun HONG ; Mi-Ra CHOI ; Yul-Lye HWANG ; Jae Kyung LEE ; Young LEE ; Young-Joon SEO ; Sooil KIM ; Young-Ho LEE ; Chang-Deok KIM ; Jeung-Hoon LEE
Annals of Dermatology 2021;33(4):339-344
Background:
Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood.
Objective:
The purpose of this study is to uncover possible roles of MDA5 in psoriasis.
Methods:
Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus.
Results:
As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes.
Conclusion
These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.
6.Regional Gray Matter Volume Related to High Occupational Stress in Firefighters
Deokjong LEE ; Woojin KIM ; Jung Eun LEE ; Junghan LEE ; Seung-Koo LEE ; Sei-Jin CHANG ; Da Yee JEUNG ; Dae-Sung HYUN ; Hye-Yoon RYU ; Changsoo KIM ; Young-Chul JUNG
Journal of Korean Medical Science 2021;36(50):e335-
Background:
Firefighters inevitably encounter emotionally and physically stressful situations at work. Even firefighters without diagnosed post-traumatic stress disorder receive clinical attention because the nature of the profession exposes them to repetitive trauma and high occupational stress. This study investigated gray matter abnormalities related to high occupational stress in firefighters using voxel-based morphometry (VBM) and surface-based morphometry (SBM).
Methods:
We assessed 115 subjects (112 males and 3 females) using magnetic resonance imaging and evaluated occupational stress by the Korean Occupational Stress Scale-26 (KOSS-26). Subjects were classified into highly or lowly stressed groups based on the median value of the KOSS-26.
Results:
In VBM analysis, we found that firefighters with high occupational stress had lower gray matter volume (GMV) in both sides of the insula, the left amygdala, the right medial prefrontal cortex (mPFC), and the anterior cingulate cortex than firefighters with low occupational stress. In SBM analysis based on regions of interest, the GMV of the bilateral insula and right mPFC were also lower in the highly stressed group. Within the highly stressed group, low GMV of the insula was significantly correlated with the length of service (left: r = −0.347, P = 0.009; right: r = −0.333, P = 0.012).
Conclusion
Our findings suggest that regional GMV abnormalities are related to occupational stress. Regional gray matter abnormalities and related emotional dysregulation may contribute to firefighter susceptibility to burnout.
7.Effect of Diquafosol on Hyperosmotic Stress-induced Tumor Necrosis Factor-α and Interleukin-6 Expression in Human Corneal Epithelial Cells
Yeoun Hee KIM ; In Jun YANG ; Ly Thi Huong NGUYEN ; Sang Il GUM ; Sung YU ; Gwang Ja LEE ; Bo Ae KIM ; Jae Chang JUNG ; Young Jeung PARK
Korean Journal of Ophthalmology 2020;34(1):1-10
Blotting, Western
;
Conjunctival Diseases
;
Dry Eye Syndromes
;
Epithelial Cells
;
Fluorescent Antibody Technique
;
Humans
;
Immunohistochemistry
;
Inflammation
;
Interleukin-6
;
Necrosis
;
Phosphorylation
;
Real-Time Polymerase Chain Reaction
;
RNA, Messenger
;
Tears
;
Tumor Necrosis Factor-alpha
;
Wounds and Injuries
8.Possible Role of Lysine Demethylase 2A in the Pathophysiology of Psoriasis
Dong Ha KIM ; Mi-Ra CHOI ; Jae Kyung LEE ; Dong-Kyun HONG ; Kyung Eun JUNG ; Chong Won CHOI ; Young LEE ; Chang-Deok KIM ; Young-Joon SEO ; Jeung-Hoon LEE
Annals of Dermatology 2020;32(6):481-486
Background:
Psoriasis is a common chronic inflammatory skin disease. The development of psoriasis is dependent on many intercellular events such as innate immunity and T cell-mediated inflammation. Furthermore, genetic factors are strongly implicated in the pathophysiology of psoriasis. Although a variety of susceptible genes are identified, it is likely that many important genes remain undisclosed.
Objective:
The aim of this study is to investigate the possible role of lysine demethylase 2A (KDM2A) in the pathophysiology of psoriasis.
Methods:
We examined the expression of KDM2A using a well established imiquimod-induced psoriasiform dermatitis model.
Results:
Immunohistochemistry analysis showed that expression of KDM2A was increased in imiquimod-induced psoriasiform dermatitis. Consistent with this result, KDM2A level was markedly increased in the epidermis of psoriatic patient. When keratinocytes were stimulated with TLR3 agonist poly(I:C), KDM2A was increased at both the mRNA and protein levels. Poly(I:C) increased the expression of psoriasis-related cytokines including tumor necrosis factor-α, interleukin-8, and CCL20, and KDM2A inhibitor daminozide enhanced the poly(I:C)-induced cytokine expression. Finally, topical co-application of imiquimod and daminozide exacerbated the imiquimod-induced psoriasiform dermatitis.
Conclusion
Together, these results suggest that KDM2A is increased to negatively regulate the inflammatory reaction of epidermal keratinocytes in psoriasis.
9.Clinical Course and Outcomes of 3,060 Patients with Coronavirus Disease 2019 in Korea, January–May 2020
Ho Kyung SUNG ; Jin Yong KIM ; Jeonghun HEO ; Haesook SEO ; Young soo JANG ; Hyewon KIM ; Bo Ram KOH ; Neungsun JO ; Hong Sang OH ; Young Mi BAEK ; Kyung-Hwa PARK ; Jeung A SHON ; Min-Chul KIM ; Joon Ho KIM ; Hyun-Ha CHANG ; Yukyung PARK ; Yu Min KANG ; Dong Hyun LEE ; Dong Hyun OH ; Hyun Jung PARK ; Kyoung-Ho SONG ; Eun Kyoung LEE ; Hyeongseok JEONG ; Ji Yeon LEE ; Ja-Young KO ; Jihee CHOI ; Eun Hwa RYU ; Ki-hyun CHUNG ; Myoung-don OH ;
Journal of Korean Medical Science 2020;35(30):e280-
Background:
The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea.
Methods:
Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation.
Results:
The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3–4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5–7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50–59, 60–69, 70–79, and ≥ 80 years of age, respectively.
Conclusion
In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.
10.The development of food image detection and recognition model of Korean food for mobile dietary management
Seon Joo PARK ; Akmaljon PALVANOV ; Chang Ho LEE ; Nanoom JEONG ; Young Im CHO ; Hae Jeung LEE
Nutrition Research and Practice 2019;13(6):521-528
BACKGROUND/OBJECTIVES: The aim of this study was to develop Korean food image detection and recognition model for use in mobile devices for accurate estimation of dietary intake. SUBJECTS/METHODS: We collected food images by taking pictures or by searching web images and built an image dataset for use in training a complex recognition model for Korean food. Augmentation techniques were performed in order to increase the dataset size. The dataset for training contained more than 92,000 images categorized into 23 groups of Korean food. All images were down-sampled to a fixed resolution of 150 × 150 and then randomly divided into training and testing groups at a ratio of 3:1, resulting in 69,000 training images and 23,000 test images. We used a Deep Convolutional Neural Network (DCNN) for the complex recognition model and compared the results with those of other networks: AlexNet, GoogLeNet, Very Deep Convolutional Neural Network, VGG and ResNet, for large-scale image recognition. RESULTS: Our complex food recognition model, K-foodNet, had higher test accuracy (91.3%) and faster recognition time (0.4 ms) than those of the other networks. CONCLUSION: The results showed that K-foodNet achieved better performance in detecting and recognizing Korean food compared to other state-of-the-art models.
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