• Journal of Nutrition and Health
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• 제53권4호
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• pp.356-368
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• 2020

Purpose: Histidine-containing dipeptides, which are rich in chicken, have been reported to reduce the risk of metabolic abnormalities via anticarbonylation mechanism in animal models. To determine the effect of dietary histidine-containing dipeptides on metabolic risk factors in humans, the relation between chicken consumption and insulin resistance were determined in a population consuming high carbohydrate and low protein. Methods: A total of 7,183 subjects (2,929 men and 4,254 women) aged ≥ 50 years from the Korea National Health and Nutrition Examination Survey (KNHANES) were divided into three groups according to chicken consumption (rarely, monthly, and weekly), and evaluated for the metabolic risk factors using homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) in this cross-sectional study. The fourth and fifth (IV-1-3 & V-1) KNHANES, which had blood insulin data, were chosen for the current study. Results: The chicken consumption was significantly associated with insulin (p for trend = 0.018) and HOMA-IR (p for trend = 0.023) in men. In particular, the 'weekly' chicken consuming men in the lowest tertile (< 65.0%) of carbohydrate intake group had significantly lower HOMA-IR (p for trend = 0.033) and higher QUICKI (p for trend = 0.043) than the 'rarely' intake group. In addition, the odds ratio for abnormal HOMA-IR was 0.55 (95% confidence interval [CI], 0.31-0.99) and QUICKI was 0.47 (95% CI, 0.26-0.86) for the 'weekly' chicken consuming group. Conclusion: The 'weekly' chicken consumption had a beneficial effect on insulin resistance and it may partially be due to the major bioactive components in chicken, histidine-containing dipeptides.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.488-495
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• 2018

Background: Skeletal muscle plays a major role in glucose metabolism. We investigated the association between thigh muscle mass, insulin resistance, and incident type 2 diabetes mellitus (T2DM) risk. In addition, we examined the role of body mass index (BMI) as a potential effect modifier in this association. Methods: This prospective study included 399 Japanese Americans without diabetes (mean age 51.6 years) who at baseline had an estimation of thigh muscle mass by computed tomography and at baseline and after 10 years of follow-up a 75-g oral glucose tolerance test and determination of homeostasis model assessment of insulin resistance (HOMA-IR). We fit regression models to examine the association between thigh muscle area and incidence of T2DM and change in HOMA-IR, both measured over 10 years. Results: Thigh muscle area was inversely associated with future HOMA-IR after adjustment for age, sex, BMI, HOMA-IR, fasting plasma glucose, total abdominal fat area, and thigh subcutaneous fat area at baseline (P=0.033). The 10-year cumulative incidence of T2DM was 22.1%. A statistically significant interaction between thigh muscle area and BMI was observed, i.e., greater thigh muscle area was associated with lower risk of incident T2DM for subjects at lower levels of BMI, but this association diminished at higher BMI levels. Conclusion: Thigh muscle mass area was inversely associated with future insulin resistance. Greater thigh muscle area predicts a lower risk of incident T2DM for leaner Japanese Americans.

• Clinical and Experimental Pediatrics
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• 제45권6호
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• pp.764-772
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• 2002

목 적 : 영양과잉과 활동량의 감소로 비만한 소아가 급속히 증가하고있다. 성인에서는 비만에 의하여 인슐린 저항성과 고인슐린혈증, 당 및 지질대사 이상, 고혈압, 심혈관질환 등이 발생하며, 남녀간에 차이가 있는 것으로 알려져 있다. 소아 청소년 시기에 비만이 인슐린 저항성 및 지질대사 이상에 미치는 영향을 알아보고자 본 연구를 시행하였다. 방 법 : 1999년부터 2001년까지 비만을 주소로 내원한 비만아 중 90 백분위수 이상인 35명의 비만아[나이 : $10.6{\pm}2.8$년; 남(n=20), 여(n=15)]에 대하여 체중과 키를 계측하였고, 공복시 혈중 콜레스테롤, 중성지방, 고밀도 콜레스테롤, 저밀도 콜레스테롤, 혈당과 혈중 인슐린 농도를 측정하였다. 인슐린 저항성 지표로 공복 인슐린/혈당비(FIGR), HOMA-IR[$(glucose(mmol/L){\times}insulin({\mu}U/mL)$/22.5]를 이용하였다. 결 과 : 1) 체질량지수(BMI) : 전체 비만아의 BMI는 $27.1{\pm}5.4kg/m^2$(범위 20.6-44.0)로, 5명이 90-95 백분위수이었고, 30명이 95 백분위수 이상의 고도 비만을 보였으며, 남녀간에 차이는 없었다. 남녀 모두에서 연령과 상관관계가 보였다. 2) 공복시 인슐린 농도 : 인슐린 농도는 $20.7{\pm}10.6{\mu}U/mL$(범위 4.8-53.0)로, 남녀간에 차이는 없었다. 고인슐린혈증은 여아에 비하여 남아에서 유의하게 빈도가 높았다(27% vs 75%). 연령과 상관관계가 없었다. 3) 혈중 지질대사 : 혈중 중성지방이 150 mg/dL 이상인 비만아는 13명(37%), 고밀도 콜레스테롤이 40mg/dL 이하인 군은 2명(5.7%)이었다. 4) HOMA-IR과 인슐린 농도와의 관계 : 인슐린 저항성의 지표인 HOMA-IR은 인슐린 농도와 인슐린/혈당비에 대해 각각 양의 상관관계를 보였다(인슐린 : r=0.960, P<0.01; 인슐린/혈당비 : r=0.842, P<0.01). 5) BMI와 HOMA-IR, 인슐린 농도, 지질대사와의 관계 : BMI는 인슐린 농도, HOMA-IR, FIGR과 유의한 양의 상관관계를 보였으며(인슐린 r=0.629; HOMA-IR r=0.622; FIGR r=0.583; P<0.01), 남자에서 여자에 비하여 더 강한 상관관계를 보였다. 남녀 모두에서 BMI는 총콜레스테롤, 중성지방, 고밀도 콜레스테롤 및 저밀도 콜레스테롤과 상관관계가 관찰되지 않았다. 6) 공복시 혈중 인슐린 농도와 혈중 지질농도 : 중성지방은 남자에서 인슐린 농도와 유의한 양의 상관관계가 있었으나(r=0.544, P=0.013), 여아에서는 상관관계가 없었으며, 고밀도 콜레스테롤도 남자에서만 인슐린 농도와 약한 상관관계가 있었다(남자 : r=-0.431, P=0.058). 결 론 : 소아와 청소년에서는 지질대사 이상을 반영하는데 있어 BMI보다 인슐린 농도가 더 연관성이 크므로, 공복시 인슐린 농도를 측정하는 것이 비만에 의한 대사 이상을 평가하는데 큰 도움이 될 것으로 사료되며, 여자에 비하여 남자에서는 심혈관질환 및 대사 이상을 강화시킬 수 있는 고인슐린혈증의 빈도가 높기 때문에 더욱 더 적극적인 치료가 요구될 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제63권3호
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• pp.110-114
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• 2020

Background: Subclinical hypothyroidism (SH) is a common condition in obese children. However, its effect on glucose and lipid metabolism in obese children remains controversial. Purpose: The present study aimed to investigate the association between SH and metabolic parameters. Methods: A total of 215 obese children and adolescents aged 6-18 years were included in this retrospective cross-sectional study. The patients' anthropometric measurements such as thyrotropin (TSH), free thyroxine (fT4), fasting plasma glucose, and insulin levels, as well as homeostasis model assessment for insulin resistance (HOMA-IR) index, and lipid profiles were evaluated. The patients were allocated to the SH group (fT4 normal, TSH 5-10 mIU/L) (n=77) or the control group (fT4 normal, TSH<5 mIU/L) (n=138). The glucose and lipid metabolisms of the 2 groups were compared. Results: SH was identified in 77 of 215 patients (36%). Mean body mass index was similar in both groups. The mean serum insulin, HOMA-IR, and triglyceride (TG) levels were higher and the mean high-density lipoprotein cholesterol level was lower in the SH group than in the control group (P=0.007, P=0.004, P=0.01, and P=0.02, respectively). A positive correlation was observed between TSH level and insulin level, HOMA-IR, and TG level. Conclusion: SH was identified in some of the obese children and adolescents. A clear association was observed between SH, insulin resistance, and dyslipidemia in obese children.

• Nutrition Research and Practice
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• 제1권1호
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• pp.65-69
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• 2007

We examined the associations between adiponectin or leptin and serum ICAM-1 levels in seventy-six hypercholesterolemic patients (mean age 59 yrs, 25 males and 51 females, LDL-cholesterol>=130mg/dL at screening). Blood lipid profiles and HOMA-IR derived from fasting glucose and insulin concentrations were determined. Serum levels of adiponectin, leptin and ICAM-1 were analyzed using ELISA The results showed that serum levels of leptin were positively associated with serum levels of ICAM-1 independent of age, sex and BMI (r=0.392, p<0.001). Serum levels of adiponectin were negatively associated with serum levels of ICAM-1 independent of age, sex and BMI (r=-0.343, p<0.005). Stepwise multiple linear regression analysis showed that serum leptin was an independent factor to be associated with serum ICAM-1 levels after adjusting for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.001). With respect to adiponectin, its association with serum ICAM-1 was attenuated but still significant when further adjustments were made for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.005). In conclusion, this study suggests that adiponectin and leptin are associated with endothelial derived inflammation.

• Clinical and Experimental Reproductive Medicine
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• 제35권3호
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• pp.223-229
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• 2008

목 적: 본 예비 연구는 비만하지 않은 다낭성난소증후군 환자들에게서 인슐린 저항성, 혈중 호르몬 농도 및 혈중 지질 농도에 관한 metformin의 효과를 알아보기 위해 수행하였다. 연구방법: 본 연구는 2006년 6월부터 2007년 9월까지 본원에서 다낭성난소증후군으로 진단받은 16명의 비만하지 않은 환자를 대상으로 하였다. 혈액 검사는 metformin 치료 전과 치료 후 6개월이 경과한 후에 실시하였으며 공복 혈당과 공복 인슐린 치, 75 g의 액상 포도당 섭취 후 2시간째의 혈당과 혈중 인슐린 농도를 측정 하였다. 혈중 호르몬 및 혈중 지질 농도는 FSH, LH, estradiol, testosterone, free testosterone, serum lipid profile을 포함하였다. 인슐린 저항성을 평가하기 위해 공복 시 혈당/인슐린 비율 (fasting glucose/insulin ratio; FGIR)과 액상 포도당 섭취 후 2시간째의 혈당/인슐린 비율을 산출하여 추정하였다. 또한 HOMA beta cell function 및 HOMA IR을 산출함으로써 인슐린 저항성 및 췌장 베타세포 기능을 조사하였다. 결 과: Metformin으로 치료한 후, 75 g 경구 당 부하 후 2시간째 측정한 glucose/insulin 비율은 증가되었으며 (p=0.04), HOMA IR은 치료 후 유의하게 감소가 있었다 (p=0.000). 그러나 혈중 지질 농도는 의미 있는 변화를 보이지 않았다. 혈중 free testosterone 농도는 치료 후 감소하였고 (p=0.001), LH 농도 및 LH/FSH 비도 감소하였다 (p=0.000, p=0.034). 결 론: 본 예비 연구는 metformin이 비만하지 않은 다낭성난소증후군 환자들에게서 인슐린 감수성을 개선하고, 고안드로겐혈증을 완화시키는 효과가 있을 수 있다는 것을 보여준다. Metformin의 역할을 결정하기 위하여 향후 보다 다수의 환자 군을 대상으로 하여 장기적인 추적 관찰을 수반한 심도 있는 연구가 이루어져야 할 것이다.

• Journal of Nutrition and Health
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• 제46권1호
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• pp.61-71
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• 2013

The aim of this study was to examine the relationship between dietary variables and the prevalence of insulin resistance (IR) in middle-aged Korean adults using data from the 2007-2009 Korea National Health and Nutrition Examination Survey. Because IR is closely linked with metabolic syndrome, subjects were divided into three groups according to symptoms of metabolic syndrome: the 'Normal group' without any symptoms, the 'Risk group' with one or two symptoms, and the Metabolic syndrome (MetS) group' with three or more symptoms. Subjects between the ages of 30 and 65 years with no prior diagnosis or treatment for diabetes, hypertension, or dyslipidemia were selected. The number of subjects per group was as follows: 2,085 adults in the Normal group, 3,699 adults in the Risk group, and 1,160 adults in the MetS group. Metabolic syndrome was defined according to Adult Treatment Panel III criteria with modified waist circumference cutoff values (men ${\geq}$ 90 cm, women ${\geq}$ 85 cm). Subjects with HOMA-IR > 2.0 were classified as IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated using the following formula: (fasting plasma glucose ${\times}$ fasting plasma insulin)/22.5. Nutrients and food groups intake were obtained from a single 24-hour recall. Subjects with IR in the Normal group were more obese and less physically active than non-IR subjects. In the MetS group, subjects with IR were more obese and had a lower prevalence of smoking and drinking, compared with non-IR subjects. Men with IR in the Normal group had a tendency to consume more oils and sugars than non-IR men, while women with IR in the same group had higher intake of carbohydrate, dietary glycemic index, and dietary glycemic load than non-IR women. Women with IR in the Risk group had lower energy intake but higher intake of oils and sugars than non-IR women. In the MetS group, consumption of fruits was higher in subjects with IR than in non-IR subjects. In conclusion, findings of this study suggest that dietary carbohydrate intake, including glycemic index, may be associated with IR in healthy women. Further research in prospective cohort studies in order to examine the effects of dietary carbohydrate on IR incidence will be necessary.

• 한국응용과학기술학회지
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• 제35권4호
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• pp.1145-1155
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• 2018

본 연구는 비만여대생을 대상으로 섭식제한(DG), 유산소운동(EG), 섭식제한과 유산소운동(DEG) 그룹으로 나누어 체중, 비만의 개선, 혈중지질성분 및 대사성위험요인에 미치는 영향을 분석하였다. 실험은 8주간 주 5회 실시하였으며, DG는 1일 에너지 섭취열량을 300kcal를 제한하였고, EG는 런닝머신을 이용하여 300kcal를 소비시켰으며, DEG는 각각 150kcal를 제한과 소비시켰다. 결과, 신체조성의 경우 DG에서는 체중(p<.011), BMI(p<.008)가 감소하였고, EG와 DEG에서는 체중(p<.044, p<.017), 체지방량(p<.047, p<.018), BMI(p<.03, p<.008), 체지방률(p<.036, p<.015), WHR(p<.049, p<.027)이 유의하게 감소하였다. 혈중지질성분은 DG에서 HDL-C(p<.028), EG에서 TG(p<.038), DEG에서는 TC(p<.014), LDL-C(p<.007)에서 유의하게 감소하였다. 대사성위험요인은 DG에서 HOMA-IR(p<.035), leptin(p<.007), EG에서 FBG(p<.043), leptin(p<.003), DEG에서 FBG(p<.014), insulin(p<.005), HOMA-IR(p<.005), leptin(p<.016), resistin(p<.040)에서 유의한 차이가 나타났다. 따라서 본 연구의 결과로부터 비만여대생들이 섭식제한, 유산소운동의 단독처치보다 섭식제한과 유산소운동을 병행하는 것이 신체조성, 혈중지질성분, 대사성위험요인의 개선에 가장 효과가 있을 것으로 판단된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권1호
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• pp.44-51
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• 2012

Purpose: Tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) polymorphism has been suggested to play an important role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) in obese adults, and known to be a mediator of insulin resistance. In this study, we evaluated the role of TNF-${\alpha}$ promoter polymorphisms and insulin resistance in the development of NAFLD in obese children. Methods: A total of 111 obese children (M:F=74:37; mean age, $11.1{\pm}2.0$ yrs) were included. The children were divided into 3 groups: controls (group I, n=61), children with simple steatosis (group II, n=17), and children with non-alcoholic steatohepatitis (group III, n=33). Serum TNF-${\alpha}$ levels, homeostasis model assessment of insulin resistance (HOMA-IR), and TNF-${\alpha}$ -308 and -238 polymorphisms were evaluated. Results: There were no differences in TNF-${\alpha}$ polymorphism at the -308 or the -238 loci between group I and group II + III ($p$=0.134 and $p$=0.133). The medians of HOMA-IR were significantly different between group I and group II + III ($p$=0.001), with significant difference between group II and group III ($p$=0.007). No difference was observed in the HOMA-IR among the genotypes at the -308 locus ($p$=0.061) or the -238 locus ($p$=0.207) in obese children. Conclusion: TNF-${\alpha}$ promoter polymorphisms at the -308 and -238 loci were not significantly associated with the development of NAFLD in children; nevertheless, insulin resistance remains a likely essential factor in the pathogenesis of NAFLD in obese children, especially in the progression to NASH.

• 대한한의학회지
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• 제36권1호
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• pp.75-85
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• 2015

Objectives: Type 2 diabetes mellitus is a metabolic disease characterized by insulin resistance and high blood glucose level from progressive insulin secretory defect. The rhizome of Atractylodes japonica Koidz. (AJ) has been used for treatment of retention of water in oriental medicine. The aim of this study is to examine the effects of AJ on type 2 diabetes rats. Methods: Type 2 diabetes was induced by 60% high fat diet and low dose streptozotocin. Rats were divided into 4 groups (n = 6); Nor (normal control group), Con (diabetic group treated with vehicle), Met (diabetic group treated with 200 mg/kg metformin) and AJ (diabetic group treated with 100 mg/kg AJ). The body weights and food intakes were measured during the treatment period. After 4 weeks treatment, blood glucose level, HOMA-IR, and protein expressions of IRS-1, p-IRS-1, PPAR-${\gamma}$, and GLUT4 were measured, and histopathological examination of beta cell was performed. Results: Compared with the control group, blood glucose level and HOMA-IR were reduced in rats treated with AJ. Impaired beta cells in pancreas of rats were recovered and phosphorylation of IRS-1 was increased in rats treated with AJ. And also, protein expressions of PPAR-${\gamma}$ and GLUT4 were increased by treatment of AJ. Conclusions: The results suggest that Atractylodes japonica Koidz. may have anti-diabetic effect on type 2 diabetic rats through regulation of blood glucose level and insulin resistance. Therefore Atractylodes japonica Koidz. may have positive effects on patients with type 2 diabetes.