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What is the meaning of hs-CRP and HbA1c in patients with dry eye syndrome in diabetes?

  • Kang, Ji-Hun;Shin, Sang-Yol
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.3
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    • pp.185-190
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    • 2020
  • The purpose of this study was to investigate the effects of systemic chronic inflammatory state on dry eye syndrome as a local chronic inflammatory condition. From June 16, 2016 to December 31, 2016, 726 patients who visited the general health examination center were screened using the Schirmer's test and the metabolic syndrome screening test. A total of 214 patients who were studied for hs-CRP and HbA1c were simultaneously selected for the study as well. Dry eye syndrome significantly increased in higher age groups (p<0.001) and women (p=0.020); there was no significant relationship with fasting plasma glucose, hs-CRP. In addition, as HbA1c increased the risk for dry eye syndrome also increased (β=1.960, p=0.025). Therefore, dry eye syndrome may not caused by microvascular changes in the lacrimal gland due to chronic inflammatory conditions. In diabetic patients, long-term blood glucose control may be more important than short-term blood glucose control. The high prevalence of dry eye syndrome in diabetic patients is thought to be due to autonomic dysfunction rather than microvascular changes caused by chronic inflammation.

Non-alcoholic Fatty Liver Disease (NAFLD) and Significant Hepatic Fibrosis Defined by Non-invasive Assessment in Patients with Type 2 Diabetes

  • Sobhonslidsuk, Abhasnee;Pulsombat, Akharawit;Kaewdoung, Piyaporn;Petraksa, Supanna
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1789-1794
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    • 2015
  • Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.

The Differences of Serum Homocysteine Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type with or without Depressive Symptoms (경도인지장애, 알쯔하이머형 치매 환자에서 우울증상 유무에 따른 혈중 호모시스테인의 차이)

  • Hwangbo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.40-45
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    • 2014
  • Objectives : Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. Methods : A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). Results : The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. Conclusions : These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.

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Association between Metabolic Syndrome and Participation in Clean-up Work at the Hebei Spirit Oil Spill (허베이 스피리트호 원유유출시 방제작업과 대사증후군의 연관성)

  • Lee, Ik-Jin;Jang, Bong-Ki;Lee, Jong-Wha;Son, Bu-Soon;Cheong, Hae-Kwan;Ha, Mina;Choi, Young-Hyun;Park, Myungsook
    • Journal of Environmental Health Sciences
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    • v.41 no.5
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    • pp.335-348
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    • 2015
  • Objectives: We aimed to assess the risk of metabolic syndrome one year after the 2007 Hebei Spirit oil spill in Taean, Korea among people exposed to spilt oil during clean-up work. Methods: A total of 6,923 adults, including 3,019 males and 3,904 females, participated in the study. Health examinations and blood tests (total cholesterol, triglycerides, HDL, fasting blood sugar) were performed. A logistic regression model adjusting for age, gender, smoking history, drinking history, income, education, and marital status was used to estimate the risk of metabolic syndrome associated with the level of oil spill exposure. Results: The prevalence of metabolic syndrome was 24.9% among males and 18% among females. Compared with people living within 20 km of the coastline, the risk of metabolic syndrome among people living within 0.8 km of the coastline was significantly higher (male OR=1.696, 95% CI=1.320-2.178, female OR=1.992, 95% CI=1.549-2.561), including a significant dose-response relationship for distance from early contaminate coastline (p<0.001). The risk of metabolic syndrome was higher according to the increase of duration of cleaning work. The risk of metabolic syndrome among people who participated in the clean-up work for more than 116 days, compared with people who participated in the cleaning work for or less 14 days, was significantly higher (male OR=1.845, 95% CI=1.448-2.353, female OR=1.752, CI=1.378-2.228), with a significant dose-response relationship for days of clean-up work (p<0.001). Conclusion: This study showed that there is a significant association between exposure to the oil spill during the clean-up work, distance from early contaminate coastline and the risk of metabolic syndrome in a doseresponse manner.

Weight Control Behaviors, Health-related Quality of Life and Nutritional Status by Overestimation of Body Image among Young Korean Females: Data from the Fifth Korea National Health and Nutrition Examination Survey, 2010-2011 (20·30대 여성의 체형 과대인식에 따른 체중조절행위, 삶의 질, 식행동 및 영양소 섭취상태: 2010-2011년 국민건강영양조사 자료 이용)

  • Park, Seulki;Hyun, Taisun;Lee, Hongmie
    • Korean Journal of Community Nutrition
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    • v.20 no.5
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    • pp.362-374
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    • 2015
  • Objectives: This study was performed to investigate the effects of overestimation of their own body shape on weight control behaviors, mental condition, physical activity, dietary behavior, health-related quality of life, and nutritional status among young Korean females. Methods: A total of 1,514 women aged 20-39 years who are not pregnant and lactating among those who participated in the Fifth Korea National Health and Nutrition Examination Survey (2010~2011), were analyzed and grouped into underestimation (n=120), normal estimation (NE, n=840), and overestimation (OE, n=554), based on their body perception compared to actual percent ideal body weights. Variables were compared between OE group and NE group. Results: The subjects in OE group were significantly younger (29.5 vs. 30.5 years, respectively p < 0.05) and had lower body mass index (20.9 vs. 22.2 respectively, p < 0.01), health-related quality of life measured by EQ-5D (EuroQol-5 Dimension)(0.97 vs. 0.98 respectively, p < 0.05), nutrition adequacy ratio (NAR) of protein (0.91 vs. 0.93 respectively, p < 0.05), phosphorous (0.93 vs. 0.96 respectively, p < 0.05), and iron (0.70 vs. 0.75 respectively, p < 0.01), and index of nutrition quality (INQ) of iron (0.84 vs. 0.89 respectively, p < 0.05) compared to those in the NE group. The results of logistic regression showed that unmarried status (OR 1.32; 1.01~1.72) and severely underweight/underweight status (OR 1.94; 1.01~3.75)/(OR 1.81; 1.34~2.45) were significantly related to the probability of overestimation by the subjects. Significantly more women in OE group practiced fasting, skipping meals, and taking prescribed pills to lose body weights and had skipped breakfast compared to those in the NE group. Conclusions: The results of this study suggested that the Korean young women's distorted perception of own body shape may be associated with undesirable weight control behavior, low quality of life, and lower nutritional status. Therefore, nutrition education for this group should include information on correct body shape perception and its importance.

Effect of Body Composition, Serum Lipid Level and Resting Metabolic Rate by Nutritional Education and Exercise Program in Middle Aged Women (중년여성에 대한 영양교육 및 운동 프로그램이 신체조성, 혈청지질 농도 및 휴식대사량에 미치는 영향)

  • Lee, Jung-Sook;Park, Ji-Sun;Lee, Ga-Hee;Ko, Young-Sook;Kim, Eun-Kyung
    • Journal of the Korean Dietetic Association
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    • v.14 no.1
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    • pp.64-76
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    • 2008
  • The purpose of this study was to investigate the change of body composition, biochemical index level, resting metabolic rate and daily activities by the public health center's health-promoted program in overweight middle aged women. The workout program of 12 subjects constituted by exercise(aerobic exercise & resistance training) and nutritional education for 10 weeks. As the results, there was a significant decrease in all the weight(59.0$\pm$8.9 vs 57.2$\pm$8.3kg, p<0.05), body fat percentage(33.4$\pm$4.3 vs 30.5$\pm$4.5%, p<0.05) and body fat mass(19.8$\pm$5.4 vs 17.7$\pm$4.9kg, p<0.05) after program. Fat free mass and RMR which tend to be higher after than before program were found not to be significantly. In addition, the serum HDL-cholesterol(54.3$\pm$8.1 vs 59.7$\pm$13.9mg/dl, p<0.05) and TG level(65.2$\pm$418 vs 89.4$\pm$65.6mg/dl, p<0.05) of the subjects increased at the end of the study significantly and significant correlation found between total-cholesterol and TG before program. When the other laboratory parameter were compared before and after program, hematocrit(35.1$\pm$3.3 vs 39.7$\pm$3.3%, p<0.001), platelet(225.9$\pm$49.6 vs 244.3$\pm$49.7cell/ul, p<0.05) and fasting glucose(88.0$\pm$6.5 vs 76.6$\pm$9.7mg/dl, p<0.001) increased significantly but hemoglobin(13.3$\pm$1.3 vs 12.9$\pm$1.3mg/dl, p<0.01) decreased. And in activities analysis, 'moderate activity(18.8 vs 5.8minutes, p<0.05)' clearly showed a significant decrease but 'severe activity(17.7 vs 11.4minutes, p<0.05)' showed a increase. These results suggest that continuous health-promoted program involved exercise and nutritional education at the public health center are effective to reduce body fat and to improve resting metabolic rate(RMR). Further research is required to develop more effective public health program for the middle aged women in community.

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The Outcome of Nutrition Support of Surgery Patients with Hypermetabolic Severity by Total Parenteral Nutrition and Enteral Nutrition and Biochemical Data (경장영양과 중시정맥영양을 공급받는 외과계 수술 환자의 과대사 정도에 따른 영양 섭취량 및 생화학적 검사 결과)

  • Rha Mi-Yong;Kim Eun-Mi;Cho Young-Y.;Seo Jeong-Meen;Choi Hay-Mie
    • Korean Journal of Community Nutrition
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    • v.11 no.2
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    • pp.289-297
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    • 2006
  • This study evaluated the nutrition intake and changes in laboratory data of surgery patients with hypermetabolic severity on nutrition support. From January 2002 to September 2002, 66 hospitalized surgery patients who had received enteral nutrition (EN, n=19) and total parenteral nutrition (TPN, n=47) for more than 7 days were prospectively and retrospectively recruited. The laboratory data was examined pre-operatively, and on the post-operative 1, 3, 7 day and at the time of discharge. The characteristics of the patients were examined for the hypermetabolic severity, The hypermetabolic scores were determined by high fever ($>38^{\circ}C$), rapid breathing (>30 breaths/min), rapid pulse rate (>100 beats/min) , leukocytosis ($WBC>12,000/{\mu}l$), leukocytopenia ($WBC>3,000/{\mu}l$), status of infection, inflammatory bowel disease, surgery and trauma. The scores for the hypermetabolic status were divided into three groups (mild 0-10, moderate 11-40, severe>41). According to the results of the study, 38.3% (n=23), 45.4% (n=30) and 19.6% (n=13) were in the mild, moderate, and severe groups, respectively. There was a decrease in the serum albumin level and weight loss according to the hypermetabolic severity. However, the white blood cells (WBC), fasting blood sugar (FBS), c-reactive protein (CRP), total bilirubin, GOT, and GPT increased. The nutritional intake was TPN (32.5 kcal/kg, protein 1.2 g/kg, fat 0.25 g/kg), EN (28.1 kcal/kg, protein 1.0 g/kg, fat 1.01 g/kg). The serum albumin, hemoglobin and cholesterol were higher in the EN group than in the TPN group. But the FBS, total bilirubin, GOT and GPT were higher in the TPN group than the EN group. In conclusion, there was a negative correlation between the changes in the laboratory data and the hypermetabolic severity. There was an increase in the number of metabolic complications in the TPN group.

Seasonal Nutrient Intakes of Elderly Women Living Alone as Compared to Those Living with Family in the Gyeongpuk Rural Area (경북 농촌지역 여성 독거노인과 가족동거노인의 계절별 영양소섭취 비교)

  • Lim, Young-Jee;Choi, Young-Sun
    • Korean Journal of Community Nutrition
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    • v.12 no.1
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    • pp.58-67
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    • 2007
  • For the rapidly growing elderly population, the achievement and maintenance of good nutritional status is critical to health, functioning and quality of life. Elderly women living alone have been identified as a group associated with poor nutrition. The purpose of this study was to assess dietary intakes of elderly women living alone as compared to those of elderly women living with family in a rural area and to examine seasonal variation. The subjects are 49 elderly women living alone and 41 elderly women living with family who reside in Goryeong-gun, Gyeongbuk, and their food intakes were assessed once each time in summer 2005, winter 2005-2006, and spring 2006. The average ages were 74.7 years for living alone and 72.8 years for living with family. Education level was not different between the two groups. Height, weight, body mass index, systolic and diastolic blood pressures, and fasting blood glucose were not significantly different between the two groups. Average intakes of major nutrients, nutrient adequacy ratio, mean adequacy ratio and index of nutritional quality were lower in the elderly women living alone compared with the elderly women living with family in summer, but the differences in intakes of most nutrients became insignificant both in winter and in spring. High carbohydrate and low fat diet was prevalent and intakes of carbohydrate and fat in summer deviated from macronutrient acceptable distribution ranges. Percentages of the subjects who consumed energy less than 75% of the estimated energy requirement and nutrients less than the estimated average requirement were higher than those reported by the Third National Health and Nutrition Examination Survey. In summer, the percentage of the subjects who consumed energy less than both 75% of the estimated energy requirement and 4 nutrients less than estimated average requirements was 58.5% of the elderly women living alone, which was higher than 26.5% of the elderly women living with family and that of National Nutrition Survey. Therefore, nutrition policies including nutrition education and support are necessary to improve nutritional status of elderly, especially elderly women living alone and should reflect regional and seasonal characteristics.

Fenofibrate Reduces Age-related Hypercholesterolemia in Normal Rats on a Standard Diet

  • Han, Ying;Do, Mi-Hyang;Kim, Mi-Sun;Seo, Eun-Hui;Park, Mi-Kyoung;Kim, Duk Kyu;Lee, Hye-Jeong;Seo, Su-Yeong
    • The Korean Journal of Physiology and Pharmacology
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    • v.14 no.2
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    • pp.77-81
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    • 2010
  • Plasma cholesterol is increased in normal aging in both rodents and humans. This is associated with reduced elimination of cholesterol and decreased receptor-mediated clearance of plasma low-density lipoprotein (LDL) cholesterol. The aims of this study were: (1) to determine age-related changes in plasma lipid profiles, and (2) to determine the effect of fenofibrate, an activator of peroxisome proliferator activated receptor alpha (PPAR $\alpha$), on plasma lipid profiles in normal rats on a standard diet. Male Sprague-Dawley (SD) rats (n=15) were fed standard chow and water from 10 to 25 weeks of age. During that period, we measured daily food intake, body weight, fasting and random blood glucose levels, plasma total cholesterol (TC), triglycerides (TG), and free fatty acid (FFA) levels. At 20 weeks of age, all rats were randomly divided into two groups: a fenofibrate group (in which rats were gavaged with 300 mg/kg/day of fenofibrate) and a control group (gavaged with water). Fenofibrate treatment lasted 5 weeks. There were no significant changes in daily food intake, blood glucose, and plasma TG level with age. Body weight, plasma TC, and FFA levels were significantly increased with age. Fenofibrate significantly decreased plasma concentrations of TC and FFA, which had been increased with age. However, fenofibrate did not influence the plasma concentration of TG, which had not increased with age. These results suggest that fenofibrate might have a novel role in preventing age-related hypercholesterolemia in SD rats on a normal diet.

Standardization of Reference Values among Laboratories of Korean Association of Health Promotion-3rd Attempt (한국건강관리협회 임상병리검사결과 참고범위 설정 및 표준화 (3회차))

  • Lee, Gap-No;Yun, Jong-Hyeon;Jo, Han-Ik;Jeong, Hu-Geun;Park, Hyeon-Mo;Yun, Cheong-Ha;Kim, Sang-In
    • Journal of Korea Association of Health Promotion
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    • v.2 no.1
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    • pp.1-8
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    • 2004
  • Background : Since 2001 the Korean Association of Health Promotion has attempted to establish her own reference valves that can be used in her all fifteen branch laboratories instead of using those adapted from the published data or there commended data by the reagent companies supplied as inserts. However, the previous two reference values derived from the statistics(year 2001 and 2002) were need to adjust to apply to actual practice. Besides there was an unavoidable situation that the reagent has to be changed to other companies in 2002 that creates another statistical problem. Subsequently, the third attempt to derive the reference ranges of tests in KAHP to solve those problems and define common)v acceptable reference ranges was done and and reported here. Methods : Al1 the results performed during January 2, 2003 through September 30, 2003 were collected in Excel tile format. All the data include dthe necessary information such as age and sex. The age was grouped in six; baby(0-3y), children(4-l2y), adolescent(13-l8y), adult(19-S4y), younger elderly (65-79y),old elderly(oyer 80y), with references of statistics in medical informatics and WHO classification. The data were statistically analyzed with SAS 6.04 for-Gaussian distribution as the previous two occasions. None of the tests showed Gaussian distribution. These procedures had been repeated twice or three times after trimming out the results lying outside three standard deviations. Though, all the tests showed non-Gaussian distribution. Subsequently, the reference ranges were defined in the range from the point of lower 2.5% to the point of higher 97.5 %. And in case the lower range could be "0", the reference ranges were defined in the range of 0 to 95%.Results : The reference ranges of most of 56 test items were newly assigned. Also with adaptation of the recommendation of WHO etc. on fasting blood sugar, hemoglobin, cholesterol. Among these there were eight tests that needed reference ranges by the age groups and nine tests by the sex. Conclusions : The third attempt will credit more the reference range of all15 laboratories of Korean Association of Health Promotion, which will be essential part of the better service to the patient and clients to visit KAHP.

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