• Clinical and Experimental Pediatrics
• /
• 제51권3호
• /
• pp.256-261
• /
• 2008

목 적 : 렙틴과 아디포넥틴은 대표적인 adipocytokine으로 비만도 및 인슐린 저항성이 증가함에 따라 혈중 렙틴은 증가하고 아디포넥틴은 감소하는 것으로 알려져 있다. 본 연구에서는 건강한 소아에서 렙틴/아디포넥틴 비와 인슐린 저항성 사이에 어떠한 연관성이 있는지 알아보고자 하였다. 방 법 : 7-15세의 건강한 소아 77명(남아 36명, 여아 41명)을 대상으로 하여 신체계측을 하고 공복 후 채혈하여 혈당, 인슐린, 렙틴, 아디포넥틴, 총 테스토스테론, 에스트라디올 및 SHBG를 측정하였다. 활성 남성호르몬 농도로는 FAI를, 인슐린 저항성의 척도로는 HOMA-IR을 사용하였다. 결 과 : 남아에서 HOMA-IR은 연령, 사춘기 단계, FAI, 렙틴 및 렙틴/아디포넥틴 비와 의미있는 양의 상관관계를 보였다. 여아에서는 HOMA-IR과 연령, %WFH, 사춘기 단계, 에스트라디올, 렙틴, 그리고 렙틴/아디포넥틴 비 사이에 의미있는 양의 상관성이 관찰되었다. 다중회귀분석 결과, 남아에서 렙틴/아디포넥틴 비는 연령, %WFH, 및 FAI로 보정한 후에도 HOMA-IR과 독립적인 연관성을 보였다(P=0.010). 여아에서는 렙틴/아디포넥틴 비와 HOMA-IR 사이에 독립적인 연관성을 보이지 못하였다. 결 론 : 비만하지 않은 건강한 소아에서도 렙틴/아디포넥틴 비는 인슐린 저항성과 의미있는 연관성을 보였으며, 남아에서는 연령, 비만도 및 남성호르몬 농도로 보정한 후에도 렙틴/아디포넥틴 비와 인슐린 저항성 사이에 독립적인 연관성이 있었다.

• Journal of Preventive Medicine and Public Health
• /
• 제45권2호
• /
• pp.62-69
• /
• 2012

Objectives: Chronic inflammation is now thought to play a key pathogenetic role in the associations of obesity with insulin resistance and diabetes. Based on our recent findings on persistent organic pollutants (POPs) including the lack of an association between obesity and either insulin resistance or diabetes prevalence among subjects with very low concentrations of POPs, we hypothesized that POP concentrations may be associated with inflammation and modify the associations between inflammation and insulin resistance in non-diabetic subjects. Methods: Cross-sectional associations among serum POPs, C-reactive protein (CRP), and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated in 748 non-diabetic participants aged ${\geq}20$ years. Nineteen types of POPs in 5 subclasses were selected because the POPs were detectable in ${\geq}60%$ of the participants. Results: Among the five subclasses of POPs, only organochlorine (OC) pesticides showed positive associations with CRP concentrations, while polychlorinated biphenyls (PCBs) showed inverse associations with CRP concentrations. There were statistically significant interactions between CRP and OC pesticides and between CRP and PCBs, in estimating HOMA-IR (P for interaction <0.01 and <0.01, respectively). CRP was not associated with HOMA-IR among subjects with low concentrations of OC pesticides or PCBs, while CRP was strongly associated with HOMA-IR among subjects with high concentrations of these POPs. Conclusions: In the current study, OC pesticides were associated with increased levels of CRP, a marker of inflammation, and both OC pesticides and PCBs may also modify the associations between CRP and insulin resistance.

• Journal of Nutrition and Health
• /
• 제53권4호
• /
• pp.356-368
• /
• 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
• /
• 제42권6호
• /
• pp.488-495
• /
• 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.

• 생물정신의학
• /
• 제10권2호
• /
• pp.107-115
• /
• 2003

Objective:The purpose of this study was to know about the mechanism of pathogenesis of type 2 diabetes mellitus by using of blood glucose, glucoregulatory factor, insulin resistance in schizophrenic patients receiving antipsychotics. Method:Modified oral glucose tolerance tests were performed in 20 schizophrenic patients receiving haloperidol, risperidone and olanzapine. Insulin, glucagon, C-peptide and cortisol were measured in 0, 15, 45, 75 minutes after glucose loading, and insulin resistance was calculated by HOMA(homeostasis model assessment) method. Result:Olanzapine-treated patients had significant glucose elevation 45 minutes after glucose challenge. Also modest increases in HOMA IR values were detected in patients treated with olanzapine. Conclusion:Olanzapine treatment of non-diabetic patients with schizophrenia can be associated with type 2 diabetes mellitus through the elevation of glucose and insulin resistance. Elevated insulin resistance may be a causative mechanism of type 2 diabetes mellitus in patients receiving olanzapine.

• 대한의생명과학회지
• /
• 제12권3호
• /
• pp.191-196
• /
• 2006

Cardiovascular disease (CVD) risk factors may be acting several decades before CVD becomes manifest. Data from young subjects may be valuable in further elucidating at this issue. We evaluated the association between baPWV (brachial-ankle pulse wave velocity) and cardiovascular risk factors in apparently healthy young adults. A total of 46 male and 91 female adolescents aged $18{\sim}25 years$ were studied. baPWV increased in a dose-responsive manner as the number of metabolic syndrome components. In both gender groups, baPWV was positively correlated with age. In males, waist, circumference total cholesterol, and LDL-cholesterol were positively correlated with baPWV, and in females, blood pressure (BP) was positively correlated with baPWV. Age, gender, mean BP, and Homeostasis model assessment insulin resistance (HOMA-IR) were found to be independent factors associated with baPWV levels. In conclusion, mean BP, age, gender, and HOMA-IR were associated with baPWV in young adults. This result suggests that multiple cardiovascular risk factors may be associated with an increased risk of arterial stiffness in young adults.

• Clinical and Experimental Pediatrics
• /
• 제52권3호
• /
• pp.370-375
• /
• 2009

목 적 : 터너증후군 환자에서 대사증후군과 심혈관 질환의 위험성이 높다. 성인 연령의 터너증후군 환자들에서 대사증후군 관련요인을 분석하고, 인슐린 저항성의 대사위험성을 알아보기 위한 연구를 시행하였다. 방 법 : 43명의 성인 터너증후군 환자에서 대사증후군의 빈도와 관련 요인 값들을 분석하였다. HOMA-IR을 이용하여 인슐린 저항성군과 비저항성군으로 분류한 후 각 집단을 분석하고, HOMA- IR과 대사 증후군 관련요인의 상관관계를 알아보았다. 결 과 : 대사증후군은 터너증후군 환자의 7%에서 보였고 각 항목에 대해서 인슐린 저항성은 16.3%, 복부 비만이 15.4%, 고중성지방이 2.3%, 저HDL 콜레스테롤이 9.3%였고, 고혈압이 36.8 %였다. 체질량지수, 허리둘레, 공복 혈당, HOMA-IR, 수축기 혈압은 인슐린 저항성군에서 의미 있게 높게 나왔으며, HOMA-IR은 체질량지수, 허리둘레, 공복 혈당, 수축기 혈압과 양의 상관관계를 보였다(P<0.05). 결 론 : 터너증후군 성인 환자들에서 대사증후군의 위험성이 있으며, 인슐린 저항성과 대사증후군 관련요인 간에 상관관계를 보인다. 터너증후군 환자들에게서 대사관련 요인을 일정기간 마다 검사하여 대사증후군 또는 인슐린 저항성으로의 진행여부를 감시하고 심혈관 합병증을 예방하는 것이 필요하다.

• 대한지역사회영양학회지
• /
• 제17권2호
• /
• pp.243-257
• /
• 2012

The purpose of this study was to evaluate pancreatic ${\beta}$-cell function of Korean adult and to examine the associations between ${\beta}$-cell function and nutrient intakes. Data were analyzed for 1,917 male and 2,885 female subjects older than 30 years using 'The Forth Korean National Health and Nutrition Survey in 2009'. We calculated HOMA ${\beta}$-cell (The homeostasis model assessment of ${\beta}$-cell function) using fasting glucose and fasting insulin for assessing ${\beta}$-cell function. Subjects were divided into HHG (High HOMA ${\beta}$-cell Group) or LHG (Low HOMA ${\beta}$-cell Group) according to median of HOMA ${\beta}$-cell, and then nutrient intakes were compared between two groups. In the entire study population, HHG showed lower percent of carbohydrate intakes (p < 0.05), and higher fat (p < 0.01), percent of fat (p < 0.05), vitamin A (p < 0.05), carotene (p < 0.05) and riboflavin (p < 0.05) intakes than LHG. In addition, levels of HOMA ${\beta}$-cell were negatively correlated with percent of carbohydrate (${\beta}$ = -0.040, p < 0.05), and positively correlated with percent of fat (${\beta}$ = 0.046, p < 0.01). The subjects were then divided into two subgroups according to body mass index values, either $23kg/m^2$ (under- and normal-weight) or ${\geq}23kg/m^2$ (over-weight and obese). Significant differences of some nutrients intakes and correlations with HOMA ${\beta}$-cell were observed only in under- and normal weight subjects, but not in over-weight and obese subjects. In conclusion, high carbohydrate, lower fat and lower vitamin intakes may be related with pancreatic ${\beta}$-cell dysfunction in under- and normal-weight Korean.

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

• Nutrition Research and Practice
• /
• 제16권4호
• /
• pp.450-463
• /
• 2022

BACKGROUND/OBJECTIVES: Adolescents who skip breakfast have an increased prevalence of chronic diseases. Thus, we aimed to evaluate whether the intake of rice-based breakfast had positive effects on blood glucose indices and to determine the possibility of diabetes prevalence in Korean youths who habitually skip breakfast. SUBJECTS/METHODS: In this randomized parallel-group controlled trial, 81 subjects who were suitable for compliance among 105 middle-and high-school students aged 12-18 years who usually skipped breakfast were included in this study (rice-meal group [RMG], n = 26; wheat-meal group [WMG], n = 29; general-meal group [GMG], n = 26). The RMG and WMG received a rice-based breakfast and a wheat-based breakfast for 12 weeks, respectively. The anthropometric indices, blood glucose indices, and metabolites were measured at baseline and the endpoint, respectively. RESULTS: The mean body weights in the RMG, WMG, and GMG groups at the endpoint were 62.44 kg, 61.80 kg, and 60.28 kg, respectively, and the mean body weights of the WMG and GMG groups at the endpoint were significantly higher than that at baseline (P < 0.05). The levels of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly decreased in the RMG group at the endpoint compared to baseline (P < 0.05, P < 0.05, respectively). The levels of tryptophan and tyrosine in the WMG group at the endpoint were significantly higher than that those at baseline (P < 0.01, P < 0.05, respectively). CONCLUSIONS: Rice-based breakfast has positive effects on fasting insulin levels and HOMA-IR in Korean adolescents who skip breakfast. Additionally, it was found that a skipping breakfast could increase the prevalence of diabetes in adolescents who skip breakfast. Therefore, in addition to reducing breakfast skipping, it is vital to develop a rice-based menu that fits teenage preferences to prevent chronic diseases such as diabetes.