• Kidney Research and Clinical Practice
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• v.35 no.2
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• pp.69-77
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• 2016

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease, and its pathogenesis is complex and has not yet been fully elucidated. Abnormal glucose and lipid metabolism is key to understanding the pathogenesis of DN, which can develop in both type 1 and type 2 diabetes. A hallmark of this disease is the accumulation of glucose and lipids in renal cells, resulting in oxidative and endoplasmic reticulum stress, intracellular hypoxia, and inflammation, eventually leading to glomerulosclerosis and interstitial fibrosis. There is a growing body of evidence demonstrating that dysregulation of 50 adenosine monophosphate-activated protein kinase (AMPK), an enzyme that plays a principal role in cell growth and cellular energy homeostasis, in relevant tissues is a key component of the development of metabolic syndrome and type 2 diabetes mellitus; thus, targeting this enzyme may ameliorate some pathologic features of this disease. AMPK regulates the coordination of anabolic processes, with its activation proven to improve glucose and lipid homeostasis in insulin-resistant animal models, as well as demonstrating mitochondrial biogenesis and antitumor activity. In this review, we discuss new findings regarding the role of AMPK in the pathogenesis of DN and offer suggestions for feasible clinical use and future studies of the role of AMPK activators in this disorder.

• Archives of Obesity and Metabolism
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• v.2 no.1
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• pp.25-28
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• 2023

Early evaluation of obesity is important. Obesity is defined as an excessive accumulation of fat that causes harm to health. Among patients who visit a hospital for weight-related issues, diseases other than body fat gain may be present; however, people often cannot distinguish between these issues and concerns. Therefore, among patients who visit the hospital with weight gain concerns, it is necessary to determine whether the weight gain is actually the result of excessive fat accumulation. After being diagnosed with obesity, the cause and degree of obesity, the amount and distribution of body fat, and the degree of risk should be evaluated. Additionally, obesity-related complications should be identified and, even if there are no complications, all related risk factors should be evaluated and managed. In all these processes, diagnostic methods such as history taking, physical examination, body fat measurement, blood tests, and imaging tests are necessary, but history taking and physical examination, which can provide a lot of information from the beginning, should not be overlooked.

• Archives of Obesity and Metabolism
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• v.2 no.1
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• pp.1-5
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• 2023

The importance of weight discrimination for people with obesity has been highlighted by research which has found that more than 40% of those living with obesity have experienced weight discrimination. Evidence suggests that weight bias among obese individuals puts their health at risk more than health issues caused by obesity itself. Although bias, stigma, and discrimination towards individuals living with obesity are factors that make it difficult for them to lose weight, weight bias and stigma among healthcare professionals are common, causing individuals living with obesity to avoid treatment and potentially exacerbating obesity-related health issues. The concept that one's own efforts matter contributes to stigma, discrimination, and bias. This issue will be more frequent among primary care providers treating individuals living with obesity; thus, it is important to acknowledge the issues of bias, stigma, and discrimination towards individuals living with obesity and to seek out solutions. In this review, I will discuss the concept of weight bias, stigma, and discrimination, the problems they cause, and seek solutions to weight prejudice, stigma, and discrimination.

• Archives of Obesity and Metabolism
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• v.2 no.1
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• pp.6-10
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• 2023

Compensatory changes in energy consumption and neuro-hormonal changes following weight loss make it difficult to maintain the reduced weight and may cause weight regain. Therefore, establishing a long-term weight control plan and strategy starting from the initial weight loss period is necessary. Both the patient and doctor should know that weight loss cannot occur continuously, and that maintaining weight after the weight loss period is the basic course of obesity treatment. No single dietary pattern is effective for weight maintenance, and a variety of dietary control methods - such as calorie restriction and healthy proportions of carbohydrates, proteins, fats, and meal replacements - should be used to target an integrated and healthy dietary habit. An increase in physical activity is needed for weight loss and maintenance; however, rather than recommending an excessive amount of exercise, it is better to set realistic and long-term achievable goals. It is necessary to reset the goal according to the patient's weight maintenance stage and continuously apply behavioral therapies, such as self-monitoring and stress management. In previous studies, since the degree of weight loss and changes in behavioral patterns over the course of one year were important factors in maintaining long-term weight loss, obesity therapists should closely examine patient data and behavioral patterns across a period of one year and actively intervene when needed.

• Archives of Obesity and Metabolism
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• v.2 no.2
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• pp.54-63
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• 2023

Estrogen is crucial in regulating food intake, energy expenditure, glucose metabolism, and lipid metabolism. During menopause, the decline in estrogen levels predisposes women to weight gain, abdominal obesity, insulin resistance, type 2 diabetes, hypertension, and cardiovascular disease (CVD). Menopausal hormone therapy (MHT) prevents weight gain, improves lipid metabolism by lowering low-density lipoprotein cholesterol while raising high-density lipoprotein cholesterol, and delays the onset of type 2 diabetes in menopausal women. The effect of MHT on CVD in menopausal women remains controversial. The Women's Health Initiative study was terminated prematurely after it revealed that hormone administration increased the risk of myocardial infarction, stroke, and thromboembolism. However, some studies have found that MHT had no effect or decreased the risk of CVD. The inconsistent results were likely due to multiple factors, including the timing of hormone therapy initiation, duration of therapy, type and dosage, and presence or absence of CVD risk factors at the start of treatment. Despite its benefits in terms of managing weight gain and reducing the risk of type 2 diabetes, dyslipidemia, and CVD associated with obesity, it is not recommended as the primary therapy for weight loss or diabetes prevention. MHT is primarily indicated for postmenopausal women, who are likely to benefit from its potential to prevent weight gain and improve lipid metabolism.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Clinical Nutrition Research
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• v.13 no.1
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• pp.61-73
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• 2024

A diet rich in proinflammatory components and inflammation are suggested to be significant risk factors for multiple sclerosis (MS). This study aimed to investigate the association between the risk of MS and the inflammatory potential of an individual's diet and dietary diversity through pro-inflammatory/anti-inflammatory food intake score (PAIFIS) and dietary diversity score (DDS). In a hospital-based case-control study, 397 participants, including 197 patients with MS and 200 healthy participants aged over 18 years, were evaluated. The history of smoking, dietary intake, and anthropometric characteristics, including body mass index, waist circumference, total body fat, and fat-free mass were assessed. A validated 160-item semiquantitative food frequency questionnaire was used to calculate the PAIFIS and DDS scores. The mean age of the participants was 32.45 ± 8.66 years, and most were females (274, 79.4%). The PAIFIS score was significantly higher among MS patients than healthy participants (p = 0.001). Between PAIFIS and DDS, only PAFIS was significantly related to MS risk (odds ratio, 1.002; 95% confidence interval, 1.001-1.004; p = 0.001). PAIFIS, as an index of dietary inflammation, can predict MS. Further studies are needed to document these findings.

• Archives of Obesity and Metabolism
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• v.1 no.1
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• pp.14-25
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• 2022

In 1971, Dr. Akira Endo succeeded in isolating a cholesterol synthesis inhibitor, compactin. Later, compactin was renamed mevastatin, meaning that it stops the synthesis of mevalonate, which is considered the first statin. However, mevastatin is not commercially released, whereas lovastatin, developed by Alfred Albert of Merk in 1979, was the first commercially developed statin. After the 4S study, the first largescale clinical trial with statins conducted in Scandinavia showed a dramatic secondary preventive effect against cardiovascular disease, and the effectiveness of statins in patients with dyslipidemia was repeatedly demonstrated. Subsequently, many oral drugs that affect blood lipid concentration; statins and ezetimibe aimed at reducing low-density lipoprotein (LDL)) cholesterol; fibrates and omega 3 formulations aimed at reducing triglycerides were widely developed and used in Korea. In this article, we review the results of clinical studies on representative cardiovascular diseases for four types of oral drugs for dyslipidemia, which are currently the most commonly used in Korea.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.127-139
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• 2019

Purpose : The lipid profile is a major predictive index for cardiovascular disease, but there have only been a few studies conducted on the relationship between lipid ratio and cardiovascular disease risk factors in the Korean population. To address this research gap, we investigated the association between three lipid ratios and cardiovascular disease risk factors among Korean adults. Methods : This study used data from the seventh Korea National Health and Nutrition Examination Survey conducted in 2016. Lipid ratios included triglyceride (TG)/high density lipoprotein cholesterol (HDL), total cholesterol (TC)/HDL, and low density lipoprotein cholesterol (LDL)/HDL. Cardiovascular risk factors included in this research were: systolic blood pressure $(SBP){\geq}140$, diastolic blood pressure $(DBP){\geq}90$, fasting blood sugar $(FBS){\geq}126$, $HbA1c{\geq}6.5$, body mass index $(BMI){\geq}25$, waist circumference (WC) $men{\geq}90$, $women{\geq}85$, and metabolic syndrome (MetS). A complex samples logistic regression test was performed to analyze the association between lipid ratios and cardiovascular disease risk factors. Results : 1) TG/HDL ratio had statistically significant relationships with DBP, FBS, HbA1c, BMI, WC and MetS. 2) TC/HDL ratio was correlated to SBP, DBP, FBS, BMI, WC, and MetS. 3) LDL/HDL ratio had association with BMI, WC, and MetS. Conclusion : We identified significant association between lipid ratios and cardiovascular disease risk factors. The three lipid ratios were particularly strongly associated with BMI, WC, and MetS.

• Environmental Analysis Health and Toxicology
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• v.24 no.4
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• pp.287-292
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• 2009

Over the a few decades, the incidences of obesity and associated metabolic syndrome diseases have been increased dramatically and resulted in a global health crisis. Recent findings suggest endocrine disrupting chemicals (EDCs) as an obesogen, because they disrupt normal development and homeostatic controls over adipogenesis and energy balance in obesity. Furthermore, risk of cardiovascular disease and mortality is elevated among those who were obese during childhood. Thus, we focused on etiology of obesity in children and performed biological monitoring of bisphenol A (BPA), which is a broadly exposed EDC in environment. Study subjects were age and sex-matched obese and normal children in Seoul (N=52; age, $8.67{\pm}1.46$ years). Exposure levels of BPA were analyzed with HPLC/FLD as a conjugated form in urine. As results, ranges of urinary BPA were 0~54.38 ${\mu}g/g$ creatinine (median, 4.57 ${\mu}g/g$ creatinine). Levels of urinary BPA were 1.7 fold higher in the obese children than those in the controls (medians of obese and control children, 7.31 and 4.25 ${\mu}g/g$ creatinine, respectively, p=0.22). In the near future, enlarge scaled studies should be performed to confirm the risk of BPA for obesity.