• Title/Summary/Keyword: Cardiovascular disease risk factor

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Non-alcoholic Fatty Liver Disease Classification using Gray Level Co-Ocurrence Matrix and Artificial Neural Network on Non-alcoholic Fatty Liver Ultrasound Images (비알콜성 지방간 초음파 영상에 GLCM과 인공신경망을 적용한 비알콜성 지방간 질환 분류)

  • Ji-Yul Kim;Soo-Young Ye
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.735-742
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    • 2023
  • Non-alcoholic fatty liver disease is an independent risk factor for the development of cardiovascular disease, diabetes, hypertension, and kidney disease, and the clinical importance of non-alcoholic fatty liver disease has recently been increasing. In this study, we aim to extract feature values by applying GLCM, a texture analysis method, to ultrasound images of patients with non-alcoholic fatty liver disease. By applying an artificial neural network model using extracted feature values, we would like to classify the degree of fat deposition in non-alcoholic fatty liver into normal liver, mild fatty liver, moderate fatty liver, and severe fatty liver. As a result of applying the GLCM algorithm, the parameters Autocorrelation, Sum of squares, Sum average, and sum variance showed a tendency for the average value of the feature values to increase as it progressed from mild fatty liver to moderate fatty liver to severe fatty liver. The four parameters of Autocorrelation, Sum of squares, Sum average, and sum variance extracted by applying the GLCM algorithm to ultrasound images of non-alcoholic fatty liver disease were applied as inputs to the artificial neural network model. The classification accuracy was evaluated by applying the GLCM algorithm to the ultrasound images of non-alcoholic fatty liver disease and applying the extracted images to an artificial neural network, showing a high accuracy of 92.5%. Through these results, we would like to present the results of this study as basic data when conducting a texture analysis GLCM study on ultrasound images of patients with non-alcoholic fatty liver disease.

The Hypoglycemic Effect of Supungsunkihwan on Impaired Glucose Tolerance & Mild NIDDM Patiens (수풍순기환(搜風順氣丸)이 내당능장애 환자와 경증 당뇨병환자의 혈당조절에 미치는 영향)

  • Kwon, Young-Gu;Choi, Ki-Lim;Lee, Jin-Sin;Ahn, Young-Min;Ahn, Se-Young;Doo, Ho-Kyung;Lee, Byung-Cheol
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.285-290
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    • 2001
  • Purpose : Impaired glucose tolerance (IGT) was standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes, replacing groups such as 'borderline' and 'chemical' diabetes. The main clinical significance of IGT is as a risk factor for type 2 diabetes and as a risk factor for cardiovascular disease and as a component of the metabolic syndrome. In 1997 the American Diabetes Association(ADA) was proposed the new classification and diagnostic criteria for diabetes, which is strict with the diagnostic baseline of Diabetes from 140mg/dl to 126mg/dl. And it's main purpose is to prevent chronic complications by early diagnosis and treatments. In the oriental medicine, Supungsunkihwan has been used in treatments of Diabetes including IGT & NIDDM, however there is not enough studies about the its objective hypoglycemic effect. so in order to investigate whether there is hypoglycemic effect of Supungsunkihwan, clinical studies were performed with IGT and mild NIDDM patients. Methods : Prior to the study, fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. In addition, ECG, cholesterol, TG, HbA1c levels were measured, and the dinical characteristics of patients that can be influence to the blood sugar level such as age, gender, rest type, diet type were surveyed. Supungsukihwan was administered for 7 days, and FBS & PP2hrs were measured again after the therapy. Result : PP2hrs glucose levels were decreased by the administration of Supungsunkihwan. And It's hypoglycemic effects has the correlation with age. That is, the more age increase, the more hypoglycemic effect decrease. Conclusion : Supungsukihwan has hypoglycmic effects on IGT & mild NIDDM patients and it is more effective when administrated to young patients relatively.

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Association between hemoglobin glycation index and cardiometabolic risk factors in Korean pediatric nondiabetic population

  • Lee, Bora;Heo, You Jung;Lee, Young Ah;Lee, Jieun;Kim, Jae Hyun;Lee, Seong Yong;Shin, Choong Ho;Yang, Sei Won
    • Annals of Pediatric Endocrinology and Metabolism
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    • v.23 no.4
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    • pp.196-203
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    • 2018
  • Purpose: The hemoglobin glycation index (HGI) represents the degree of nonenzymatic glycation and has been positively associated with cardiometabolic risk factors (CMRFs) and cardiovascular disease in adults. This study aimed to investigate the association between HGI, components of metabolic syndrome (MS), and alanine aminotransferase (ALT) in a pediatric nondiabetic population. Methods: Data from 3,885 subjects aged 10-18 years from the Korea National Health and Nutrition Examination Survey (2011-2016) were included. HGI was defined as subtraction of predicted glycated hemoglobin ($HbA1_c$) from measured $HbA1_c$. Participants were divided into 3 groups according to HGI tertile. Components of MS (abdominal obesity, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure), and proportion of MS, CMRF clustering (${\geq}2$ of MS components), and elevated ALT were compared among the groups. Results: Body mass index (BMI) z-score, obesity, total cholesterol, ALT, abdominal obesity, elevated triglycerides, and CMRF clustering showed increasing HGI trends from lower-to-higher tertiles. Multiple logistic regression analysis showed the upper HGI tertile was associated with elevated triglycerides (odds ratio, 1.65; 95% confidence interval, 1.18-2.30). Multiple linear regression analysis showed HGI level was significantly associated with BMI z-score, $HbA1_c$, triglycerides, and ALT. When stratified by sex, age group, and BMI category, overweight/obese subjects showed linear HGI trends for presence of CMRF clustering and ALT elevation. Conclusion: HGI was associated with CMRFs in a Korean pediatric population. High HGI might be an independent risk factor for CMRF clustering and ALT elevation in overweight/obese youth. Further studies are required to establish the clinical relevance of HGI for cardiometabolic health in youth.

Nafamostat Mesilate Inhibits TNF-${\alpha}$-Induced Vascular Endothelial Cell Dysfunction by Inhibiting Reactive Oxygen Species Production

  • Kang, Min-Woong;Song, Hee-Jung;Kang, Shin Kwang;Kim, Yonghwan;Jung, Saet-Byel;Jee, Sungju;Moon, Jae Young;Suh, Kwang-Sun;Lee, Sang Do;Jeon, Byeong Hwa;Kim, Cuk-Seong
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.3
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    • pp.229-234
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    • 2015
  • Nafamostat mesilate (NM) is a serine protease inhibitor with anticoagulant and anti-inflammatory effects. NM has been used in Asia for anticoagulation during extracorporeal circulation in patients undergoing continuous renal replacement therapy and extra corporeal membrane oxygenation. Oxidative stress is an independent risk factor for atherosclerotic vascular disease and is associated with vascular endothelial function. We investigated whether NM could inhibit endothelial dysfunction induced by tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$ ). Human umbilical vein endothelial cells (HUVECs) were treated with TNF-${\alpha}$ for 24 h. The effects of NM on monocyte adhesion, vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1) protein expression, p38 mitogenactivated protein kinase (MAPK) activation, and intracellular superoxide production were then examined. NM ($0.01{\sim}100{\mu}g/mL$) did not affect HUVEC viability; however, it inhibited the increases in reactive oxygen species (ROS) production and p66shc expression elicited by TNF-${\alpha}$ (3 ng/mL), and it dose dependently prevented the TNF-${\alpha}$ -induced upregulation of endothelial VCAM-1 and ICAM-1. In addition, it mitigated TNF-${\alpha}$ -induced p38 MAPK phosphorylation and the adhesion of U937 monocytes. These data suggest that NM mitigates TNF-${\alpha}$ -induced monocyte adhesion and the expression of endothelial cell adhesion molecules, and that the anti-adhesive effect of NM is mediated through the inhibition of p66shc, ROS production, and p38 MAPK activation.

Effect of Genetic Predisposition on Blood Lipid Traits Using Cumulative Risk Assessment in the Korean Population

  • Go, Min-Jin;Hwang, Joo-Yeon;Kim, Dong-Joon;Lee, Hye-Ja;Jang, Han-Byul;Park, Kyung-Hee;Song, Ji-Hyun;Lee, Jong-Young
    • Genomics & Informatics
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    • v.10 no.2
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    • pp.99-105
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    • 2012
  • Dyslipidemia, mainly characterized by high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels, is an important etiological factor in the development of cardiovascular disease (CVD). Considering the relationship between childhood obesity and CVD risk, it would be worthwhile to evaluate whether previously identified lipid-related variants in adult subjects are associated with lipid variations in a childhood obesity study (n = 482). In an association analysis for 16 genome-wide association study (GWAS)-based candidate loci, we confirmed significant associations of a genetic predisposition to lipoprotein concentrations in a childhood obesity study. Having two loci (rs10503669 at LPL and rs16940212 at LIPC) that showed the strongest association with blood levels of TG and HDL-C, we calculated a genetic risk score (GRS), representing the sum of the risk alleles. It has been observed that increasing GRS is significantly associated with decreased HDL-C (effect size, $-1.13{\pm}0.07$) compared to single nucleotide polymorphism combinations without two risk variants. In addition, a positive correlation was observed between allelic dosage score and risk allele (rs10503669 at LPL) on high TG levels (effect size, $10.89{\pm}0.84$). These two loci yielded consistent associations in our previous meta-analysis. Taken together, our findings demonstrate that the genetic architecture of circulating lipid levels (TG and HDL-C) overlap to a large extent in childhood as well as in adulthood. Post-GWAS functional characterization of these variants is further required to elucidate their pathophysiological roles and biological mechanisms.

Case Report : The Hypoglycemic Effect of Gamiyookmigihwang-tang on A Mild Diabetes Mellitus patient with Impaired Glucose Tolerance & Impaired Fasting Glucose (가미육미지황탕(加味六味地黃湯)이 공복혈당장애와 내당능장애를 가진 경증 당뇨병환자의 혈당조절에 미치는 영향 1례)

  • Kim, In Soo;Kim, Myeong Sin;Lee, Young Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.677-682
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    • 2013
  • Impaired glucose tolerance(IGT) & Impaired fasting glucose(IFG) were standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes. The main clinical significance of IGT & IFG shows some risk factors on type 2 diabetes, cardiovascular disease and component of the metabolic syndrome. In 1997, the American Diabetes Association(ADA) proposed the new classification and diagnostic criteria for diabetes, which wss striction on the diagnostic baseline of Diabetes from 140 mg/dl to 126 mg/dl. This is because that the early diagnosis and treatments can prevent chronic complications. In the oriental medicine, Gamiyookmigihwang-tang has been using for the treatments of Diabetes including IGT & IFG; however, there have not been enough studies about the effect of the glycemic control objectively. So clinical studies have been performed on a mild DM(Diabetes Mellitus) patient with IGT and IFG in order to investigate whether there is hypoglycemic effect of Gamiyookmigihwang-tang. Prior to the study, for two weeks fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. in addition ECG, T-cholesterol, TG, HbA1c levels were measured; then, Gamiyookmigihwang-tang has administrated for 4 weeks. and FBS, PP2hrs, T-cholesterol, TG, HbA1c were measured again after the herb medicine treatment. FBS, PP2hrs glucose levels and other measuring levels (T-cholesterol, TG, HbA1c) were decreased by the administration of Gamiyookmigihwang-tang. Gamiyookmigihwang-tang has hypoglycemic effects on a mild DM patient with IGT and IFG.

Factors Influencing Atrial Fibrillation & Embolization in Mitral Valve Surgery (승모판 수술환자에 있어서 심방세동과 색전증에 영향을 주는 요소)

  • Jo, Gwang-Jo;Kim, Jong-Won;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1404-1415
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    • 1992
  • To understand the factors influencing Atrial fibrillation and embolism in mitral valve surgery and prevent their risk, we have reviewed our 324 patients who underwent mitral valve surgery from Fev. 1982 to May 1992. Age, disease duration, lesion type, left ventricular function and left atrial dimension were chosen as preoperative factors influencing the incidence of atrial fibrillation and embolism and their postoperative course, The number and type of replaced valve, site of atriotmy, LA obliteration, ACT and use of Defibrillator were chaser. as operative factors influencing postoperative rhythm change and postop emb-olization. The results of analyses were as follows 1. The incidence of preoperative atrial fibrillation, systemic embolism and LA throbmus was 63. 6%, 10.56% and 19.8% relatively. 2. The preoperative factors of atrial fibrillation onset was old age, prolonged symptom duration, stenotic lesion, lager LAD and lower ejection fraction. In the preoperative systemic embolism preoperative factors were old age, female, stenotic lesion. The left atrial thrombus found more commonly in patients with atrial fibrillation, old age, prolonged symptom duration, stenotic lesion and low ejection fraction. 3. The preoperative atrial fibriation persisted postoperatively in 165[50.9%] and converted to normal sinus rhythm in 50[15.4%]. The preoperative normal sinus rhythm per-eisted in 100[31%] and atrial fibrillation was occured postoperatively in 9[2.7%]. The prolonged symptom duration was the preoperative factor of persist atrial fibrillation. 4. Among 95 long term follow-up patients, atiral fibrillation was continued in 59[60%]. Conversion to normal sinus rhythm was more common significantly in left atriotomy and bileaflet valve replacement. 5. There were 12 patients who had postoperative embolism. Female, persist atrial fibrillation, no LA olbiteration and tilting disc monocusp valve were considered as possible factors influencing postoperative embolism but was impossible to analyse their statistical significance due to small sample size. So we have concluded that the patients with above risk factors need anticoagulant and early surgical intervention. Left atriotomy with minimal atrial injury, left auricular obliteration and bileaflet valve replacement may be needed to reduce postoperative atrial fibrillation persist and embolism.

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Cholesteryl Ester Transfer Protein (CETP) Deficiency and CETP Inhibitors

  • Mabuchi, Hiroshi;Nohara, Atsushi;Inazu, Akihiro
    • Molecules and Cells
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    • v.37 no.11
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    • pp.777-784
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    • 2014
  • Epidemiologic studies have shown that low-density lipoprotein cholesterol (LDL-C) is a strong risk factor, whilst high-density lipoprotein cholesterol (HDL-C) reduces the risk of coronary heart disease (CHD). Therefore, strategies to manage dyslipidemia in an effort to prevent or treat CHD have primarily attempted at decreasing LDL-C and raising HDL-C levels. Cholesteryl ester transfer protein (CETP) mediates the exchange of cholesteryl ester for triglycerides between HDL and VLDL and LDL. We have published the first report indicating that a group of Japanese patients who were lacking CETP had extremely high HDL-C levels, low LDL-C levels and a low incidence of CHD. Animal studies, as well as clinical and epidemiologic evidences, have suggested that inhibition of CETP provides an effective strategy to raise HDL-C and reduce LDL-C levels. Four CETP inhibitors have substantially increased HDL-C levels in dyslipidemic patients. This review will discuss the current status and future prospects of CETP inhibitors in the treatment of CHD. At present anacetrapib by Merck and evacetrapib by Eli Lilly are under development. By 100mg of anacetrapib HDL-C increased by 138%, and LDL-C decreased by 40%. Evacetrapib 500 mg also showed dramatic 132% increase of HDL-C, while LDL-C decreased by 40%. If larger, long-term, randomized, clinical end point trials could corroborate other findings in reducing atherosclerosis, CETP inhibitors could have a significant impact in the management of dyslipidemic CHD patients. Inhibition of CETP synthesis by antisense oligonucleotide or small molecules will produce more similar conditions to human CETP deficiency and may be effective in reducing atherosclerosis and cardiovascular events. We are expecting the final data of prospective clinical trials by CETP inhibitors in 2015.

PDGFC, MARK3 and BCL2 Polymorphisms are Associated with Left Ventricular Hypertrophy in Korean Population

  • Jeon, Tae-Eun;Jin, Hyun-Soek
    • Biomedical Science Letters
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    • v.25 no.3
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    • pp.237-246
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    • 2019
  • Left ventricular hypertrophy (LVH) refers to the expansion and the enlarged myocardium due to the increased resistance to ejection from the left ventricle to the aorta and/or the periphery, or the long-term burden imposed by the blood increase. Hypertension is a major risk factor that accounts for more than 50% of the causes of cardiovascular disease. If hypertension endure in the long term, the myocardium responds to abnormal heartbeat in the heart. Therefore, the prevalence of left ventricular hypertrophy also increases. As a result of genome-wide association study (GWAS) analysis for European people, PDGFC, MARK3, and BCL2 were related to blood pressures. In this study, the genetic polymorphisms of PDGFC, MARK3, and BCL2 were extracted and selected based on Korean genomic and epidemiologic data, and then logistic regression analysis was performed on LVH. As a result, one SNP (rs9307953) in PDGFC gene, four SNPs (rs6575983, rs17679475, rs2273703 and rs10141388) in MARK3 gene and two SNPs (rs17756073 and rs17070739) in BCL2 gene were statistically significant. The rs6575983 of the MARK3 gene showed the highest significance level ($P=7.2{\times}10^{-3}$) among the SNPs and the relative risk of 1.08 (95% confidence interval: 1.06 to 1.45). These results suggest that the polymorphisms of PDGFC, MARK3, and BCL2 not only affect European blood pressures but also correlate with LVH in Korean. These results suggest that increased understanding of the genetic correlations of the pathogenesis of LVH.

The Relationship of Abdominal Obesity and Lipid Profiles by Computed Tomography in Adult Women (전산화 단층촬영을 이용한 성인여성의 복부비만과 지질대사지표와의 연관성)

  • Kim, Mi-Young
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.33-39
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    • 2008
  • Abdominal obesity, especially, visceral obesity is thought to be a risk factor of type 2 diabetes and cardiovascular disease such as hypertension, hyperlipidemia, coronary artery disease. Based on previous studies visceral fat accumulation is highly related to these diseases compared to subcutaneous fat accumulation. The purpose of this study was to see the relation between abdominal obesity and lipid profiles in adult women. The included subjects were 25 adult women(BMI > $23\;kg/m^2$), who visited the obesity clinic in a general hospital from April 2006 to September 2007. Blood pressure, fasting glucose and lipid profiles were measured. The abdominal fat distribution had been assessed by CT scan at the level of L4-L5. From bivariate analyses, the visceral fat accumulation showed negative correlations with TC and TC/HDL. The BMI, total abdominal fat and Visceral fat/Subcutaneous fat ratio showed significant correlations with visceral fat accumulation. From linear regression analyses of all the study subjects, TC, TG and HDL were found to be determinants of the visceral fat accumulation($R^2\;=\;0.474$).

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