• Biomolecules & Therapeutics
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• v.26 no.1
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• pp.29-38
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• 2018

During cancer progression, cancer cells are repeatedly exposed to metabolic stress conditions in a resource-limited environment which they must escape. Increasing evidence indicates the importance of nicotinamide adenine dinucleotide phosphate (NADPH) homeostasis in the survival of cancer cells under metabolic stress conditions, such as metabolic resource limitation and therapeutic intervention. NADPH is essential for scavenging of reactive oxygen species (ROS) mainly derived from oxidative phosphorylation required for ATP generation. Thus, metabolic reprogramming of NADPH homeostasis is an important step in cancer progression as well as in combinational therapeutic approaches. In mammalian, the pentose phosphate pathway (PPP) and one-carbon metabolism are major sources of NADPH production. In this review, we focus on the importance of glucose flux control towards PPP regulated by oncogenic pathways and the potential therein for metabolic targeting as a cancer therapy. We also summarize the role of Snail (Snai1), an important regulator of the epithelial mesenchymal transition (EMT), in controlling glucose flux towards PPP and thus potentiating cancer cell survival under oxidative and metabolic stress.

• 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.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.55-61
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• 2015

Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.

• Korean Journal of Clinical Laboratory Science
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• v.45 no.4
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• pp.131-138
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• 2013

Insulin resistance and pancreatic beta cell dysfunction have been established as being related to the diabetes. Lately, what is emphasizing is that those have been shown as something related to the metabolic syndrome and cardiovascular disease. Homeostasis model assessment (HOMA), simple index is calculated on blood levels of fasting glucose and insulin. And HOMA has been widely validated and applied for insulin resistance and pancreatic beta cell dysfunction. We also assessed the factors relative to insulin resistance and ${\beta}$ cell function determined by HOMA. The data from the 2010 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 3,465 nondiabetic subjects (male 1,357, female 2,108). At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid (Total cholesterol, HDL cholesterol, LDL cholesterol and Triglycerides) profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA ${\beta}$-cell) were calculated from fasting glucose and insulin levels. In male, the value of HOMA-IR and HOMA ${\beta}$-cell was the highest among 30's and decreased as the age increased. In female, the value of HOMA-IR increased with age, while HOMA ${\beta}$-cell decreased. High HOMA-IR and low HOMA ${\beta}$-cell were associated with the highest value of fasting glucose and systolic blood pressure. Low HOMA-IR and high HOMA ${\beta}$-cell showed the lowest concentration of fasting glucose and the highest concentration of HDL cholesterol. High HOMA-IR and high HOMA ${\beta}$-cell were connected with BMI, Total cholesterol, LDL cholesterol, and Triglycerides. There was a negative correlation between HOMA ${\beta}$-cell and age. The correlation coefficients of HOMA-IR and HOMA ${\beta}$-cell showed the highest value among weight, BMI and WC.

• Nutrition Research and Practice
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• v.8 no.4
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• pp.469-475
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• 2014

BACKGROUND/OBJECTIVE: The goal of the present study was to investigate the effects of moderate caloric restriction on ${\beta}$-cell function and insulin sensitivity in middle-aged obese Korean women. SUBJECTS/METHODS: Fifty-seven obese pre-menopausal Korean women participated in a 12-week calorie restriction program. Data on total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and fasting serum levels of glucose, insulin, C-peptide, blood pressure, leptin and anthropometrics were collected. A dietary intake assessment was based on three days of food recording. Additionally, ${\beta}$-cell function [homeostasis model assessment of ${\beta}$-cell (HOMA-${\beta}$), insulinogenic index (ISI), C-peptide:glucose ratio, and area under curve insulin/glucose ($AUC_{ins/glu}$)] and insulin sensitivity [homeostasis model assessment for insulin resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI) and Matsuda index (MI)] were recorded. RESULTS: When calories were reduced by an average of 422 kcal/day for 12 weeks, BMI (-2.7%), body fat mass (-10.2%), and waist circumference (-5%) all decreased significantly (P < 0.05). After calorie restriction, weight, body fat percentage, hip circumference, BP, TC, HDL-C, LDL-C, plasma glucose at fasting, insulin at fasting and 120 min, $AUC_{glu}$ and the insulin area under the curve all decreased significantly (all P < 0.05), while insulin sensitivity (HOMA-IR, QUICKI and Matsuda index) measured by OGTT improved significantly (P < 0.01). CONCLUSIONS: Moderate weight loss due to caloric restriction with reduction in insulin resistance improves glucose tolerance and insulin sensitivity in middle-aged obese women and thereby may help prevent the development of type 2 diabetes mellitus.

• Biomedical Science Letters
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• v.22 no.3
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• pp.107-114
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• 2016

Maintenance of fasting blood glucose levels is important for glucose homeostasis. Disruption of feedback mechanisms are a major reason for elevations of glucose level in blood, which is a risk factor for type 2 diabetes mellitus that is mainly caused by malfunction of pancreatic beta-cell and insulin. The fasting blood glucose level has been known to be influenced by genetic and environmental factors. Mitochondria have many functions for cell survival and death: glucose metabolism, fatty acid oxidation, ATP generation, reactive oxygen species (ROS) metabolism, calcium handling, and apoptosis regulation. In addition to these functions, mitochondria change their morphology dynamically in response to multiple signals resulting in fusion and fission. In this study, we aimed to examine association between fasting blood glucose levels and variants of the genes that are reported to have functions in mitochondrial dynamics, fusion and fission, using a cohort study. A total 416 SNPs from 36 mitochondrial dynamics genes were selected to analyze the quantitative association with fasting glucose level. Among the 416 SNPs, 4 SNPs of PRKACB, 13 SNPs of PPP3CA, 6 SNPs of PARK2, and 3 SNPs of GDAP1 were significantly associated. In this study, we were able to confirm an association of mitochondrial dynamics genes with glucose levels. To our knowledge our study is the first to identify specific SNPs related to fasting blood glucose level.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.17-22
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• 2005

Sleep-disordered breathing (SDB) is associated with increased cardiovascular and cerebrovascular morbidity. Epidemiological and clinic-based studies have shown that SDB is related to impaired glucose tolerance and increased insulin resistance, independent of obesity. Despite of a consistent association between SDB and impaired glucose-insulin metabolism, the mechanism underlying this relationship has not been fully elucidated. It is recognized that hypoxemia and hypercapnia that occur in SDB provoke sympathetic nervous activity and catecholamine, epinephrine and norepinephrine, and cortisol are released. Sympathetic hyperactivity and increased catecholamines can impair glucose homeostasis by increasing glycogenolysis and gluconeogenesis, which can result in increased circulating insulin levels and increased risk of insulin resistance. A prospective study is needed to investigate the causal relationship between SDB and impaired glucose-insulin metabolism in a healthy population without diabetes, hypertension and obesity as etiologic risk factors.

• Korean Journal of Biological Psychiatry
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• v.10 no.2
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• pp.107-115
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• 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.

• The Korea Journal of Herbology
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• v.22 no.2
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• pp.155-161
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• 2007

Objectives: Evidences suggests that Ginkgo biloba, a widely used traditional medicine, shows a hypoglycemic effect. Thus, we investigatd the effect of G. biloba extract (GB) on glucose uptake in L6 rat skeletal muscle cells. Method : Effect of GB on glucose uptake and phosphatidylinositol (PI) 3-kinase activity were assessed using Glucose uptake assay and PI 3-kinase assay, respectively. Also, AMP-activated protein kinase (AMPK), p38 mitogen activated protein kinase (p38 MAPK) expression were identified by Western blot. Results : Glucose uptake assay revealed that GB increased glucose uptake about 2.5-fold compared to thecontrol. GB stimulated the activity of PI 3-kinase which is a major switch element on the glucose uptake pathway. About a 6.5-fold increase in activity of PI 3-kinase was observed with GB. We then assessed the activity of AMPK, another regulatory molecule on the glucose uptake pathway. The result was that GB increased the phosphorylation level of both AMPK ${\alpha}$l and ${\alpha}$2. The activity of p38 MAPK, a downstream mediator of AMPK, was also increased by CB. Conclusion : These results suggest that GB may stimulate glucose uptake through both PI 3-kinase and AMPK mediated pathways in L6 skeletal muscle cells thereby contributing to glucose homeostasis.

• Korean Journal of Pharmacognosy
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• v.39 no.3
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• pp.228-232
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• 2008

Antidiabetic effects of an aqueous and solvent extract prepared from the root, stem and fruit parts of Acanthopanax senticosus, were investigated in experimental Streptozotocin (STZ)-induced diabetic rats model. The n-butanol and water extracts of A. senticosus were orally administrated once a day for 6 days. The n-butanol extracts of fruit (FB) showed highest efficiency than other groups (water extracts of stem, root and fruit; butanol extracts of stem, root) on serum glucose values in the STZ-induced diabetic rats. We have studied gene expression of glucose transporter genes in C2C12 skeletal muscle cell line during differentiation treated by the n-butanol and water extracts of A. senticosus, SW, RW, FW, SB, RB and FB. The GLUT4 gene was high expressed by FB treatment. These findings suggest that FB of A. senticosus have GLUT4 gene expression activity for glucose homeostasis and may have beneficial effects on blood glucose lowering in the diabetic patients.