• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.21 no.1
• /
• pp.59-67
• /
• 2018

Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

• Journal of Preventive Medicine and Public Health
• /
• v.38 no.2
• /
• pp.203-207
• /
• 2005

Objectives: Recently, the American Diabetes Association (ADA) redefined the criteria of prediabetes, which has lowered the diagnostic level of fasting plasma glucose (FPG) from 110 to 125 mg/dl, down to levels between 100 to 125mg/dl. The purpose of this study was to determine the predictive cutoff level of FPG as a risk for the development of diabetes mellitus in Korean men. Methods: A retrospective cohort study was conducted on 11,423 (64.5%) out of 17,696 males $\leq$30 years of age, and who met the FPG of $\leq$125 mg/dl and hemoglobin A1c of $\leq$ 6.4% criteria, without a history of diabetes, and who were enrolled at the screening center of a certain university hospital between January and December 1999. The subjects were followed from January 1999 to December 2002 (mean follow-up duration; 2.3(${\pm}0.7$) years). They were classified as normal (FPG <100mg/dl), high glucose (FPG $\geq$100mg/dl and <110mg/dl) and impaired fasting glucose (FPG $\geq$110mg/dl and $\leq$125mg/dl) on the basis of their fasting plasma glucose level measured in 1999. We compared the incidence of diabetes between the 3 groups by performing Cox proportional hazards model and used receiver operating characteristic analyses of the FPG level, in order to estimate the optimal cut-off values as predictors of incident diabetes. Results: At the baseline, most of the study subjects were in age in their 30s to 40s (mean age, 41.8(${\pm}7.1$) year). The incidence of diabetes mellitus in this study was 1.19 per 1,000 person-years (95% CI=0.68-1.79), which was much lower than the results of a community-based study that was 5.01 per 1,000 person-years. The relative risks of incident diabetes in the high glucose and impaired fasting glucose groups, compared with the normal glucose group, were 10.3 (95% CI=2.58-41.2) and 95.2 (95% CI= 29.3-309.1), respectively. After adjustment for age, body mass index, and log triglyceride, a FPG greater than 100mg/dl remained significant predictors of incident diabetes. Using the receiver operating characteristic (ROC) curve, the optimal cutoff level of FPG as a predictor of incident diabetes was 97.5 mg/dl, with a sensitivity and a specificity of 81.0% and 86.0%, respectively. Conclusion: These results suggest that lowering the criteria of impaired fasting glucose is needed in Korean male adults. Future studies on community-based populations, including women, will be required to determine the optimal cutoff level of FPG as a predictor of incident diabetes.

• YAKHAK HOEJI
• /
• v.53 no.6
• /
• pp.357-367
• /
• 2009

A meta-analysis of 63 randomized controlled trials of Pioglitazone and Rosiglitazone in patients with type 2 diabetes was conducted. Pioglitazone significantly lowered fasting plasma glucose and triglyceride (TG) level and increased high-density lipoprotein cholesterol (HDL) level. Rosiglitazone significantly lowered hemoglobin A1C level and fasting plasma glucose, whereas it increased all kinds of lipids (HDL, LDL (low-density lipoprotein cholesterol), TG, total cholesterol). In comparison, glucose lowering effect was higher in Rosiglitazone, and Pioglitazone produced a more favorable lipid profile.

• Nutrition Research and Practice
• /
• v.3 no.1
• /
• pp.23-30
• /
• 2009

The aim of this study was to examine the hypoglycemic effect of chlorella in 6 week-old type 2 diabetic Goto-Kakizaki (GK, n=30) rats and 6 week-old normal Wistar (n=30) rats. Animals were randomly assigned to 3 groups respectively, and were fed three different experimental diets containing 0%, 3% or 5% (w/w) chlorella for 8 weeks. In diabetic GK rats, the insulinogenic-indices were not significantly different among the groups. The concentrations of fasting plasma glucagon and hepatic triglyceride, and the insulin/glucagon ratios of the GK-3% chlorella and GK-5% chlorella groups were significantly lower than those of the GK-control group. The HOMA-index and the concentrations of fasting blood glucose and plasma insulin of the GK-3% chlorella and GK-5% chlorella groups were slightly lower than those of the GK-control group. In normal Wistar rats, the insulinogenic-indices were not significantly different among the normal groups, but that of the Wistar-5% chlorella group was slightly higher than the other groups. The concentrations of fasting blood glucose and plasma insulin, and the HOMA-index of the Wistar-5% chlorella group were a little higher, and the fasting plasma glucagon concentration and the insulin/glucagon ratio of the Wistar-5% chlorella group were significantly higher than those of the Wistar-control and Wistar-3% chlorella groups. In conclusion, this study shows that the glucose-stimulated insulin secretion was not affected by the intake of chlorella, which could be beneficial, however, in improving insulin sensitivity in type 2 diabetic GK and normal Wistar rats.

• Nutrition Research and Practice
• /
• v.5 no.2
• /
• pp.107-111
• /
• 2011

The objective of this study was to investigate the hypoglycemic effects of quercetin (QE) in animal models of diabetes mellitus (DM). A starch solution (1 g/kg) with and without QE (100 mg/kg) or acarbose (40 mg/kg) was orally administered to streptozotocin (STZ)-induced diabetic rats after an overnight fast. Postprandial plasma glucose levels were measured and incremental areas under the response curve were calculated. To study the effects of chronic feeding of QE, five-week-old db/db mice were fed an AIN-93G diet, a diet containing QE at 0.08%, or a diet containing acarbose at 0.03% for 7 weeks after 1 week of adaptation. Plasma glucose and insulin, blood glycated hemoglobin, and maltase activity of the small intestine were measured. Oral administration of QE (100 mg/kg) or acarbose (40 mg/kg) to STZ-treated rats significantly decreased incremental plasma glucose levels 30-180 min after a single oral dose of starch and the area under the postprandial glucose response, compared with the control group. QE (0.08% of diet) or acarbose (0.03% of diet) offered to db/db mice significantly reduced both plasma glucose and blood glycated hemoglobin compared to controls without significant influence on plasma insulin. Small intestine maltase activities were significantly reduced by consumption of QE or acarbose. Thus, QE could be effective in controlling fasting and postprandial blood glucose levels in animal models of DM.

• Korean Journal of Community Nutrition
• /
• v.3 no.5
• /
• pp.685-694
• /
• 1998

This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index$(kg/m^2$, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model $R^2$=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model $R^2$=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7331-7333
• /
• 2013

Aim: To investigate associations of fasting insulin and glucose levels in serum with hepatocellular carcinoma risk. Materials and Methods: This hospital based study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Nepalese Army Institute of Health Sciences, between 1st December, 2011 and 31st June, 2013. The variables collected were age, fasting plasma glucose, fasting plasma insulin and ALT. Quantitative determination of human insulin concentrations was accomplished by chemiluminescence enzyme immunoassay. Results: Of the total 220 subjects enrolled in our present study, 20 cases were of HCC and 200 were healthy controls. The maximum number of cases of hepatocellular carcinoma in category cutpoints of fasting insulin levels fell in the range of >6.10 ${\mu}U/ml$. The highest insulin levels (>6.10 ${\mu}U/ml$) were seen to be associated with an 2.36 fold risk of HCC when compared with fasting insulin levels of (<2.75 ${\mu}U/ml$). Furthermore, the insulin levels (2.75-4.10 ${\mu}U/ml$) of category cutpoints also conferred a 1.57 fold risk for HCC when compared with lowest fasting insulin levels of (<2.75 ${\mu}U/ml$). Conclusions: The effect of an insulin level in increasing HCC risk appeared consistent, influencing incidence, risk of recurrence, overall survival, and treatment-related complications in HCC patients.

• Proceedings of the PSK Conference
• /
• 2003.04a
• /
• pp.307.1-307.1
• /
• 2003

Metfotrmin is a biguanide antihyperglycemic agent often used for the treatment of non-insulin dependent diabetics(NIDDM). Metformin lowers both fasting and postprandial plasma glucose concentrations by improving insulin sensitivity at hepatic and peripheral tissues. The pharmacokinetics and pharmacodynamics of metformin were studied in Korean healthy volunteers at fasting state over 10 hours. (omitted)

• The Korean Journal of Nuclear Medicine
• /
• v.5 no.2
• /
• pp.1-6
• /
• 1971

The correlation between the plasma insulin, and glucose concentration was studied in healthy Korean adults consisting of 20 males and 22 females of 16 to 38 years of age. The blood samples of above subjects were obtained through cubital vein at arbitrary times, during their usual working hours. Plasma insulin was assayed by means of double antibody system of radioimnmunoassy technics, and blood glucose was determined by means of Van Slyke-Folch method. Results were as follows: 1. There were no differences in the blood sugar levels in relation to the plasma insulin concentration either by sex or age. 2. In the case, when the plasma insulin concentration was within $200m{\mu}D/ml$, the correlation between the insulin, and glucose concentration existed, the ratio of which was expressed as; Plasma glucose concentration(mg/dI)=$91.9+0.08{\times}Insulin$ concentration r=0.62 3. Insulinogenic index was 12.4%, which was somewhat higher than other reports. 4. It is suggested that the correlation between plasma insulin and glucose concentration could be determined at arbitrary times instead of fasting times.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.2
• /
• pp.1031-1033
• /
• 2014

Aim: To investigate the effect of hyperglycemia and hyperinsulinemia on prostate cancer risk. Materials and Methods: This hospital based study was carried out using data retrieved from the register maintained in the Department of Biochemistry of a tertiary care hospital of Kathmandu, Nepal between $31^{st}$ December, 2011 and $31^{st}$ October, 2013. The variables collected were age, serum cholesterol, serum calcium, PSA, fasting blood glucose, serum insulin. Analysis was performed by descriptive statistics and testing of hypothesis using Excel 2003, R 2.8.0, Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results: Of the total 125 subjects enrolled in our present study, 25 cases were of PCa and 100 were healthy controls. The mean value of fasting plasma glucose was 95.5 mg/dl in cases of prostatic carcinoma and the mean value of fasting plasma insulin was $5.78{\mu}U/ml$ (p value: 0.0001*). The fasting insulin levels ${\mu}U/ml$ were categorized into the different ranges starting from ${\leq}2.75$, >2.75 to ${\leq}4.10$, >4.10 to ${\leq}6.10$, > $6.10{\mu}U/ml$. The maximum number of cases of prostatic carcinoma of fasting insulin levels falls in range of > $6.10{\mu}U/ml$. The highest insulin levels (> $6.10{\mu}U/ml$) were seen to be associated with an 2.55 fold risk of prostatic carcinoma when compared with fasting insulin levels of (< $2.75{\mu}U/ml$). Conclusions: Elevated fasting levels of serum insulin appear to be associated with a higher risk of prostate cancer.