• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.13-20
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• 2005

Purpose : Obesity is, along with metabolic syndrome, closely related with nonalcoholic fatty liver disease. This study tried to evaluate the prevalence of nonalcoholic liver disease in obese children and verify the factors associated with the disease. Methods : Two hundred and seventy nine children who showed a body mass index of 95 percentile over the baseline in health examinations of surrounding schools were evaluated. Questionnaires, body measurements, blood examinations, and ultrasonographic measurements of abdominal fat were examined. Results : Out of 279 children enrolled for the study, 27 children were found to possess nonalcoholic liver disease(9.7%). Among those found to be positive for nonalcoholic liver disease, it's prevalence increased to 15.2%(22 out of 144 children) among children with severe obesity. Factors known to be involved with metabolic syndrome, namely waist/hip circumference ratio and thickness of abdominal fat, were found to be closely related to nonalcoholic fatty liver as well. Conclusion : The prevalence of nonalcoholic fatty liver in obese children was 9.7%, with higher incidence observable in severer obesity. Factors responsible for metabolic syndrome were closely associated with nonalcoholic fatty liver disease, and the level of insulin resistance, which is an useful index in both diseases, can be utilized in evaluation of the effect of treatment and control of risk factors.

• Journal of Life Science
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• v.32 no.12
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• pp.962-970
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• 2022

Nonalcoholic steatohepatitis (NASH) is the progressive stage of nonalcoholic fatty liver disease (NAFLD) that highly increases the risk of cirrhosis and liver cancer, and there are few therapeutic options available in the clinic. Poricoic acid (PoA), a component of Poria cocos Wolf, has a wide range of pharmacological activities; however, little is known about its effects on NASH. The preventive effects of PoA on NASH were examined in vivo and in vitro by analyzing triglyceride synthesis, inflammation and fibrosis. In the high fat and methionine-choline deficient diet (HFMCD)-induced NASH mice, PoA reduced the liver weight and the levels of alanine aminotransferase and aspartate aminotransferase compared with non-treated HFMCD group. The staining with Oil Red O and hematoxylin and eosin revealed that PoA administration reduced red staining and the size of lipid droplet. qPCR analysis showed that PoA also reduced the expression of genes related to triglyceride synthesis. Further, immunostaining with CD68 and qPCR analysis revealed that PoA reduced the staining with CD68 and the expression of inflammatory genes induced by HFMCD. Moreover, PoA reduced the staining with sirius red and antibody of α-smooth muscle actin and also reduced the expression of genes related to fibrosis. The treatment of PoA to AML12 cells reduced the increase in triglyceride amount and expression of genes associated with triglyceride synthesis, inflammation and fibrosis. Taken together, our study indicate that PoA has therapeutic effect on NASH through preventing triglyceride synthesis, inflammation and fibrosis.

• 건강소식
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• v.35 no.12
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• pp.38-39
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• 2011

간은 우리 몸에 필요한 단백질과 여러 가지 영양소를 만들고 저장하며 건강에 해로운 물질을 해독하는 일을 한다. 이러한 간에 이상이 생기면 간장질환이 발생하게 되며, 간장질환은 급격히 발생하는 A형 간염에서부터 6개월 이상 지속되는 만성간염, 지방간, 간경변, 간암까지 매우 다양하다. 이 중 대표적인 질환으로 지방간을 들 수 있다. 연말 각종 모임이나 회식, 송년회 등 잦은 술자리로 인한 문제는 과음으로 오는 지방간이다. 지방간은 과음으로 인한 알코올성 지방간과 비만, 당뇨, 고지혈증 등으로 인한 비알코올성 지방간이 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.179-184
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• 2007

Purpose: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. Methods: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. Results: When the mean of ages ($10.5{\pm}1.6$ vs. $10.7{\pm}2.0$ years), total cholesterol levels ($183.0{\pm}29.1$ vs. $183.7{\pm}31.3$ mg/dL), HDL-cholesterol levels ($53.0{\pm}10.2$ vs. $55.7{\pm}13.0$ mg/dL), LDL-cholesterol levels ($113.4{\pm}30.2$ vs. $113.0{\pm}30.0$ mg/dL), triglyceride levels ($99.4{\pm}62.9$ vs. $114.2{\pm}47.3$ mg/dL), obesity indexes ($44.7{\pm}12.2$ vs. $47.9{\pm}15.1%$), and body fat percentages ($32.7{\pm}5.0$ vs. $34.0{\pm}4.8%$) of group 1 (ALT${\leq}$40 IU/L) were compared with those of group 2 (ALT${\geq}$41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG${\geq}$110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). Conclusion: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.

• The Monthly Diabetes
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• s.257
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• pp.34-35
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• 2011

당뇨병과 간은 상관관계가 없는 것 같지만 그동안 당뇨병과 간에 대한 연구가 여러 차례 진행돼 왔다. 우리나라에서 2001년 연구한 바에 따르면 제 2형 당뇨병에서 C형 간염의 발생률이 높은 것으로 나타났다. 뿐만 아니라 당뇨병환자에서 비알콜성 지방간이 흔하게 관찰되는 것으로 보고되고 있다. 반면 간 질환자에서 당뇨병 발생빈도가 10~30%로 매우 높게 나타나 당뇨병과 간이 밀접한 연관성이 있음을 짐직할 수 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.185-192
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• 2007

Purpose: This study was conducted to evaluate the role of adiponectin, leptin, and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) in obese children, and to elucidatethe relationship between these adipokines and insulin resistance. Methods: A total of 61 obese children (M : F=42 : 19, mean age 11.2${\pm}$1.3 years) admitted to our facility between March 2004 and June 2005 were included in this study. Patients were divided into three groups based on their NAFLD status obese children without fatty liver (N=23); obese children with simple steatosis (N=20); and obese children with non-alcoholic steatohepatitis (NASH) (N=18). The serum levels of adiponectin, leptin, and TNF-${\alpha}$ were measured, and insulin resistance determined by homeostasis model assessment (HOMA-IR) was calculated to estimate insulin resistance. In addition, the VSR (visceralsubcutaneous fat ratio) was estimated using abdominal computed tomography. Results: There was no difference in serum TNF-${\alpha}$ and leptin levels observed between the 3 groups (22.13${\pm}$6.37 vs. 21.35${\pm}$6.95 vs. 25.17${\pm}$9.30; p=0.342 & 20.29${\pm}$8.57 vs. 16.42${\pm}$6.85 vs. 20.10${\pm}$7.86; p=0.330). However, the serum adiponectin level was significantly lower in children with non-alcoholic steatohepatitis (NASH) than in the other two groups (6.08${\pm}$1.38 in children without steatosis vs. 5.69${\pm}$0.79 in simple steatosis vs. 4.93${\pm}$1.75 in NASH; p=0.026). In addition, the VSR was significantly increased in the NASH group (0.31${\pm}$0.08 vs. 0.32${\pm}$0.11 vs. 0.47${\pm}$0.14; p=0.001), and HOMA-IR revealed a significant difference among the three groups (4.77${\pm}$3.67 vs. 6.89${\pm}$7.05 vs. 10.42${\pm}$6.73; p=0.000). However, there was no significant correlation observed between the adiponectin levels and the HOMA-IR or the VSR (r=-0.117; p=0.450 & r=-0.106; p=0.499). Conclusion: Insulin resistance may affect the development of hepatic steatosis and steatohepatitis in children, and the results of this study suggest that, of several adipokines evaluated, adiponectin is important in the progression of steatosis to steatohepatitis in obese children.

• The Journal of the Korean life insurance medical association
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• v.25
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• pp.103-118
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• 2006

근래에 한국의 생명보험 시장에는 주요 질병의 보장을 위한 상품들이 연일 쏟아져 나오고 있다. 그러나 이와 함께 증가될 수 있는 리스크에 대한 대비는 상대적으로 부족한 실정이다. 특히 간질환에 의한 급부발생이 타질환에 비하여 현격하게 높은 국내 실정에 맞게 언더라이팅 초점이 맞추어져야 할 필요가 있다. 간질환 유발인자로 대표적인 것은 B형 간염이지만, 과다한 알코올 섭취에 의한 간질환 역시 매해 빠른 속도로 증가하는 추세이다. 따라서 본 논문에서는 알코올에 의한 질환의 종류와 이와 관련된 보험금 청구 통계, 그리고 음주로 인한 교통사고의 폐해에 대해 살펴보고, 알코올 남용자를 사전에 판별할 방법을 찾아보고자 한다. 일반적으로 알려져 있는 알코올 관련 질환으로는 지방간, 알코올성 간염, 알코올성 간경변이 있으며, 이로 인한 급부발생율은 급격히 증가하고 있다. 음주로 인한 폐해는 단순히 간질환에 그치지 않고 있으며, 교통사고의 상당수가 음주와 관련이 되어있다. 이러한 리스크에 대해 국내의 상당수 보험사들은 혈액검사를 통하여 간기능에 대한 기준을 설정하여 언더라이팅을 하고 있다. 현재 주로 시행되고 있는 간기능 검사들에 대한 정확도에 대해서는 논란이 있을 수 있다. 따라서 보다 정밀한 검사법들에 대한 연구가 필요할 것이다. 외국의 경우, 보험을 가입하고자 하는 보험 대상자들은 직업이나 흡연, 위험 취미뿐만 아니라 알코올과 관련된 일정한 양식의 질문표에 대하여 성실하게 고지하도록 하고 있다. 국내에도 알코올과 관련된 자세한 고지항목을 첨부하여, 일정 기준에 미치지 못하는 가입자에 대하여 표준미달체로 분류하여 보다 정밀한 검진을 통해 세밀한 언더라이팅이 이루어져야 하겠다. 이와 아울러, 알코올로 인한 사회적 폐해의 심각성에 대한 인식 확대를 위한 각 보험사 및 유관기관의 노력이 전개된다면, 음주에 대한 진사 절차가 수월해질 것으로 기대된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.149-152
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• 2008

Obesity tracks from childhood into adulthood, and the persistence of obesity rises with age among obese children. Obesity are independent risk factors for increased morbidity and mortality throughout the lifecycle. Obese individuals develop resistance to the cellular actions of insulin, characterized by an impaired ability of insulin to inhibit glucose output from the liver and to promote glucose uptake in fat and muscle. Insulin resistance is a key etiological factor for type 2 diabetes mellitus, dyslipidemia, hypertension, nonalcoholic steatohepatitis, polycystic ovarian syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.51-57
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• 2010

Purpose: It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism. Methods: We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism. Results: The mean age at the time of diagnosis of hypopituitarism was 10.4${\pm}$3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1${\pm}$2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis. Conclusion: Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.125-130
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• 2017

Objective: The purpose of this case report is to describe the efficacy of treatment with Korean medicine of a patient with nonalcoholic steatohepatitis (NASH) and metabolic syndrome. Methods: The patient was treated with Korean medicine (Saenggangunbi-tang) from April 27, 2016 to October 22, 2016. Results: Post-treatment, the patient's AST and ALT levels were significantly decreased. Triglyceride levels were within the normal range during the treatment. Abdominal ultrasonography revealed a significant improvement in hepatic steatosis. Conclusions: The results suggest that Saenggangunbi-tang could be an effective treatment for NASH with metabolic syndrome.