• 대한화학회지
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• 제68권4호
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• pp.191-198
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• 2024

내분비 교란 화학물질(EDCs)은 생체 외부로부터 유입되어 인체의 내분비 기관 내에서 호르몬 작용을 교란시키는 화합물이다. 파라벤, 벤조페논, 비스페놀, 프탈레이트 등이 대표적이며, 현재 광범위한 분야에서 사용되고 있다. 하지만 이들에게 지속적으로 노출되면 혈당조절, 생식, 대사, 신경계 발달, 임신, 출산, 성장 등에 부정적인 영향을 끼칠 수 있다. 본 연구에서는 EDCs의 노출정도를 파악하기 위하여 인체시료(소변)를 liquid-liquid-extraction을 사용하여 전처리한 뒤 UPLC-MS/MS로 효과적이고 빠르게 분석하였다. 이와 같이 분석조건을 확립하고, 분석법의 유효성 검증을 통해 동시분석법의 신뢰도를 평가하였다. 결과는 정확도가 75.28~122.36%, 정밀도가 2.16~22.74%의 수치를 보였다. 본 연구에서 확립된 분석법은 추후 인체시료 중 EDCs의 노출을 평가하고 모니터링할 수 있는 연구의 방법론으로 이용될 수 있을 것이다.

• Clinical and Experimental Pediatrics
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• 제50권2호
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• pp.190-197
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• 2007

목 적: 1형 당뇨병 소아, 청소년에서 혈당 조절이 불량하면 성장 장애와 미세혈관 합병증이 발생할 수 있다. 1형 당뇨병이 성장에 미치는 영향과 미세혈관 합병증(당뇨병성 신병증 또는 망막병증) 발생과 관련된 요인을 파악하고자 하였다. 방 법: 서울대병원에서 추적 중인 16세 이상의 154명 환자들의 의무기록을 후향적으로 분석하였다. 성인키 SDS(standard deviation score)에 영향을 미치는 요인을 분석하였고 합병증 유무, 미세알부민뇨의 경과에 따라 군을 나누어 특징을 비교하였다. 결 과: 성인키 SDS는 $-0.11{\pm}1.15$(여 $-0.26{\pm}1.33$, 남 $0.04{\pm}0.91$)였다. 성인키 SDS는 중간부모키 SDS에 비해 작았고(여 P=0.001, 남 P=0.002), 진단시 키 SDS에 비해서도 유의하게 감소하였다(여 P<0.001, 남 P=0.013). 진단시 사춘기 유무, 합병증 유무, 혈당 조절 정도, 이환 기간은 성인키 SDS에 영향을 미치지 않았다. 사춘기 시작시 키 SDS, 중간부모키 SDS, 사춘기 성장이 성인키 SDS에 영향을 미치는 요인이었다. 합병증이 발생한 37명(24%) 중에서 신병증은 29명, 망막병증은 19명, 동반된 경우는 11명이었다. 사춘기 전에 발병한 환자들은 사춘기에 발병한 환자들에 비해 첫 합병증이 발생한 연령은 더 낮았으나 첫 합병증 발생까지의 유병 기간은 더 길었다. 합병증이 발생한 그룹은 합병증이 없는 그룹보다 평균당화혈색소가 더 높았다. 미세알부민뇨가 소실된 환자들은 미세알부민뇨가 지속되거나 현성 신병증으로 진행한 환자들에 비해 평균당화혈색소, 수축기 혈압, 두 번째 측정한 24시간 소변 미세알부민 수치가 더 낮았다. 결 론: 1형 당뇨병 환자의 성인키는 혈당 조절 정도의 영향을 받지 않았지만, 중간부모키, 진단시 키에 비해 감소하여 당뇨병의 여러 요인에 의해 성장소실이 가능함을 알 수 있었다. 미세혈관 합병증 발생을 예방하기 위해서는 철저한 혈당 조절이 필요하다. 혈당 조절이 불량하거나 사춘기가 시작되면 미세혈관 합병증에 대한 선별검사를 시행해야 한다.

• 운동영양학회지
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• 제24권4호
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• pp.34-43
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• 2020

[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

• Nutrition Research and Practice
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• 제3권4호
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• pp.315-322
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• 2009

This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition education program was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided according to the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin $B_2$, and folate per 1,000 kcal/day were significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34 subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These results indicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipid concentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.

• 보건행정학회지
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• 제29권4호
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• pp.431-444
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• 2019

Background: This study aimed to properly manage diseases such as blood sugar control so that patients with diabetes can benefit from both medication and health activities. Also, these health practices are greatly influenced by self-rated health, a subjective assessment of health status. Because self-rated health does not necessarily match the objective health status, it is important to identify which factors affect self-rated health. Methods: For the study, the data was gathered from the 4th-6th National Health Nutrition Survey (2007-2015). Out of the total 73,353 participants in the survey, 2,303 patients with uncontrolled blood sugar with an HbA1c level of more than 7% were selected for the final study. Dependent variables fell into two categories depending on how the participant reported whether he or she was in good health or not. Independent variables included socio-demographics, health behavioral, and health status factors. This study performed logistic regression analysis. Results: Out of 2,303 participants, 18.1% reported that their heath was 'good,' despite the fact that their blood sugar level was not controlled. After running a logistic regression model, the odds ratio of groups that perceive subjective health awareness as good was higher in the groups of people as below: in the people over 60 years old; in the people who graduated from a junior college or higher than those who had a level of education of primary school completion or less; in the people living in Chungnam than those living in Seoul; and in the group with hypertriglyceridemia. Conclusion: The study identified factors associated with those failed to perceive the blood sugar level as a severe health problem despite of the fact that blood sugar was not controlled. To improve public health, diabetes management policies need to be addressed to population groups with these problems above.

• 생명과학회지
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• 제17권6호통권86호
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• pp.859-866
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• 2007

본 연구는 임신횐쥐에서 운동이 혈중 인슐린과 렙틴 농도, 그리고 골격근의 GLUT-4와 VAMP-2단백질 발현에 변화를 조사하기 위하여 수행되었다. 본 연구에서 비임신 횐쥐에 비해 임신 횐쥐에서 혈중 인슐린 농도가 유의하게 증가되었고, 렙틴 농도는 유의하게 감소하는 것으로 나타났다. 임신횐쥐에게 달리기 운동을 적용한 결과 임신으로 증가된 인슐린 농도를 유의하게 감소시키면서 렙틴 농도의 감소를 억제시키는 것으로 나타났다. 골격근에서 GLUT-4와 VAMP-2 단백질 발현량을 조사한 결과 비임신 횐쥐에 비해 임신 횐쥐에서 이러한 단백질 발현이 유의하게 감소되었지만, 임신 중 달리기운동을 경험한 횐쥐에서 GLUT-4와 VAMP-2 발현 모두 유의하게 증가되는 것으로 나타났다. 이와 잘이 임신으로 인한 혈중 인슐린 및 렙틴의 변화가 골격근에서 당을 근조직으로 흡수하는 신호 전달 경로와 수송체의 발현 손상과 연관되어있음을 보여주는 것이다. 하지만 임신 횐쥐에서 달리기 운동은 인슐린과 렙틴 농도의 변화를 완화시킴으로써 골격근의GLUT-4와 VAMP-2발현을 유의하게 증가시키는 것으로 나타났다.

• Journal of Nutrition and Health
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• 제47권3호
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• pp.157-166
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• 2014

본 연구는 고서당식이에 첨가된 안정화미강이 혈당조절에 미치는 영향에 대하여 조사하여 향후 안정화미강 첨가 식품을 인체실험에 적용하는데 기초자료로서 이용되고자 하였다. 4주령의 수컷 C57BL/6 mice를 정상식이 대조군 (ND), 고서당식이 대조군 (HSD), 안정화미강 첨가 식이군 (HSD-SRB)으로 배정하였다. 안정화미강 첨가 식이는 선행연구에 근거하여 식이 중량의 20%로 설정하였다. 12주 동안 식이 섭취 후 혈당, 혈청 인슐린, 간 조직의 글리코겐, 혈청 아디포넥틴, 혈청 및 간 조직의 중성지방을 측정하였다. 그 결과 HSD군에 비해 HSD-SRB군에서 체중 및 부고환지방 무게를 감소하는 경향이 있었고 공복혈당과 혈당반응곡선면적을 감소하였다. 또한 안정화미강 첨가 식이를 섭취하였을 때 혈청 및 간의 중성지방 농도가 감소됨에 따라 인슐린 저항성과 췌장의 베타세포 기능을 개선한 것으로 제안한다. 이로써 고서당식이에 안정화미강을 20% 첨가하였을 때 혈당조절 개선효과 가능성을 확인할 수 있었으며, 향후 안정화미강을 첨가한 건강 지향적인 제품 개발과 이 제품을 인체에 적용하기 위한 기초자료로 활용 가능할 것으로 사료된다.

• 한국임상약학회지
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• 제25권2호
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• pp.74-79
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• 2015

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin $A_{1c}$ ($HbA_{1c}$) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for $HbA_{1c}$ values, amounts of $HbA_{1c}$ changes, and rates of $HbA_{1c}$ changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger $HbA_{1c}$ changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable $HbA_{1c}$ <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable $HbA_{1c}$ <6.5% was not significantly different, but time to achieve stable $HbA_{1c}$ <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the $HbA_{1c}$ goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

• Journal of Nutrition and Health
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• 제44권6호
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• pp.577-591
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• 2011

A food exchange system for diabetes is a useful tool for meal planning and nutritional education. The first edition of the Korean food exchange lists was developed in 1988 and the second edition was revised in 1995. With recent changes in the food marketplace and eating patterns of Koreans, the third edition of food exchange lists was revised in 2010 by the Korean Diabetes Association, the Korean Nutrition Society, the Korean Society of Community Nutrition, the Korean Dietetic Association and the Korean Association of Diabetes Dietetic Educators through a joint research effort. The third edition is based on nutritional recommendations for people with diabetes and focuses on adding foods to implement personalized nutrition therapy considering individual preferences in diverse dietary environment. Foods were selected based on scientific evidence including the 2007 Korea National Health and Nutrition Examination Survey data analysis and survey responses from 53 diabetes dietetic educators. While a few foods were deleted, a number of foods were added, with 313 food items in food group lists and 339 food items in the appendix. Consistent with previous editions, the third edition of the food exchange lists included six food categories (grains, meat, vegetables, fats and oils, milk, and fruits). The milk group was subdivided into whole milk group and low fat milk. The standard nutrient content in one exchange from each food group was almost the same as the previous edition. Korea Food & Drug Administration's FANTASY (Food And Nutrient daTA SYstem) database was used to obtain nutrient values for each individual food and to determine the serving size most appropriate for matching reference nutrients values by each food group. The revised food exchange lists were subjected to a public hearing by experts. The third edition of the food exchange lists will be a helpful tool for educating people with diabetes to select the kinds and amounts of foods for glycemic control, which will eventually lead to preventing complications while maintaining the pleasure of eating.

• Journal of Nutrition and Health
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• 제53권3호
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• pp.244-254
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• 2020

본 연구는 선씀바귀의 항산화 및 탄수화물 소화효소 억제 효과를 평가하여 제 2형 당뇨환자에게 중요한 항산화제 및 혈당 상승 억제제로서의 가능성을 타진하고자 하였다. 선씀바귀 추출물의 총 폴리페놀, 플라보노이드 함량과 in vitro 항산화 활성 및 소화효소 저해 활성을 조사한 결과 ISE가 ISW보다 총페놀과 플라보노이드 함량이 높았고 항산화 활성 및 소화효소 저해 활성 또한 높았다. ISE의 계통분획물 중에 에틸아세테이트 분획물과 부탄올 분획물의 소화효소 저해 활성이 가장 우수하고, 추출물의 항산화활성과 탄수화물 소화효소 억제효과가 총 페놀 및 플라보노이드함량과 높은 상관성을 가지는 것으로 볼 때, ISW에 비해 상대적으로 높은 ISE의 항산화 및 소화효소 저해 활성은 페놀 화합물, 특히 플라보노이드 화합물 때문임을 알 수 있었다. 따라서 ISE와 에틸아세테이트 그리고 부탄올 분획물은 우수한 항당뇨 기능성 소재라고 판단된다.