• Title/Summary/Keyword: impaired glucose tolerance

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Metabolic Syndrome and Associated Risk Factors Among the Clients of a Comprehensive Medical Examination Center (일 대학병원 종합건강증진센터를 내원한 수진자의 대사증후군과 관련요인)

  • Seo, Jung-A
    • Journal of East-West Nursing Research
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    • v.14 no.2
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    • pp.47-53
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    • 2008
  • Purpose: Metabolic syndrome (also known as insulin resistance syndrome) represents a constellation of hypertriglyceridemia, hypertension, impaired glucose tolerance, and obesity. Presently, the influence of various factors on metabolic syndrome was assessed in patients of a university hospital comprehensive medical examination center. Methods: Age, sex, blood pressure, height, weight, triglyceride level, high-density lipoprotein cholesterol, and glucose levels were measured in 67 people (37 males and 30 females). These factors were correlated with tobacco use, alcohol consumption, and exercise habits. Metabolic syndrome and abdominal obesity were assessed according to NCEP-ATP III criteria and the Asia-Pacific guidelines (male obesity defined as a waist circumference exceeding 90 cm), respectively. Data was analyzed using t-test, 2-test, and logistic regression. Results: Respective percentages were: tobacco use (14.9% of the 67 people), no tobacco use (85.1%), alcohol consumption (62.7%), no alcohol consumption (37.3%), regular exercise (25.4%), no regular exercise (74.6%). Logistic regression analysis revealed a gender-related odds ratio of 2.3 for metabolic syndrome and no exercise. Conclusions: Weight reduction and physical exercise may decrease the prevalence of metabolic syndrome. Early identification of metabolic syndrome and risk factor modification is prudent in cases of obesity, diabetes, hyperlipidemia, and hypertension.

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Effects of growth hormone treatment on glucose metabolism in idiopathic short stature (특발성 저신장증 환자에서 성장 호르몬 투여가 당 대사에 미치는 영향)

  • Kwon, Seung Yeon;Kim, Duk-Hee;Kim, Ho-Seong
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.665-671
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    • 2006
  • Purpose : To study the effects of growth hormone(GH) treatment on glucose metabolism and insulin resistance in children with idiopathic short stature(ISS). Methods : Glucose and insulin concentrations were measured during oral glucose tolerance test (OGTT) before and after GH treatment(0.6-0.7 IU/kg/week) in 20 patients with ISS. Insulin resistance was assessed by homeostasis model assessment(HOMA). Results : During OGTT, the mean blood glucose level did not show any significant changes after GH treatment. However, mean blood insulin levels of fasting and 30 minutes of OGTT showed significant increases after GH treatment, accompanying significant increases of insulin resistance. There was no difference in change of glucose, insulin levels and insulin resistance before and after GH treatment between two groups of body mass indices(BMI) of 25< and >25. There also was no significant difference between two groups of with and without family histories of diabetes mellitus (DM). There was no case of newly developed impaired glucose tolerance, fasting glucose tolerance, nor newly developed DM. Conclusion : GH treatment with doses of 0.6-0.7 IU/kg/week for mean 9.6 months in patients with ISS did not show any significant changes in blood glucose levels during OGTT. However, GH treatments induced considerably higher fasting insulin levels compared to pretreatment, resulting in statistically higher insulin resistance. Higher BMI and family history of DM did not induce any significant changes in glucose, insulin level and insulin resistance after GH treatment than the other groups.

Compound K attenuates hyperglycemia by enhancing glucagon-like peptide-1 secretion through activating TGR5 via the remodeling of gut microbiota and bile acid metabolism

  • Tian, Fengyuan;Huang, Shuo;Xu, Wangda;Chen, Lan;Su, Jianming;Ni, Haixiang;Feng, Xiaohong;Chen, Jie;Wang, Xi;Huang, Qi
    • Journal of Ginseng Research
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    • v.46 no.6
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    • pp.780-789
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    • 2022
  • Background: Incretin impairment, characterized by insufficient secretion of L-cell-derived glucagon-like peptide-1 (GLP-1), is a defining step of type 2 diabetes mellitus (T2DM). Ginsenoside compound K (CK) can stimulate GLP-1 secretion; however, the potential mechanism underlying this effect has not been established. Methods: CK (40 mg/kg) was administered orally to male db/db mice for 4 weeks. The body weight, oral glucose tolerance, GLP-1 secretion, gut microbiota sequencing, bile acid (BA) profiles, and BA synthesis markers of each subject were then analyzed. Moreover, TGR5 expression was evaluated by immunoblotting and immunofluorescence, and L-cell lineage markers involved in L-cell abundance were analyzed. Results: CK ameliorated obesity and impaired glucose tolerance in db/db mice by altering the gut microbiota, especially Ruminococcaceae family, and this changed microbe was positively correlated with secondary BA synthesis. Additionally, CK treatment resulted in the up-regulation of CYP7B1 and CYP27A1 and the down-regulation of CYP8B1, thereby shifting BA biosynthesis from the classical pathway to the alternative pathway. CK altered the BA pool by mainly increasing LCA and DCA. Furthermore, CK induced L-cell number expansion leading to enhanced GLP-1 release through TGR5 activation. These increases were supported by the upregulation of genes governing GLP-1 secretion and L-cell differentiation. Conclusions: The results indicate that CK improves glucose homeostasis by increasing L-cell numbers, which enhances GLP-1 release through a mechanism partially mediated by the gut microbiota-BA-TGR5 pathway. Therefore, that therapeutic attempts with CK might be useful for patients with T2DM.

Clinical significance of acanthosis nigricans in children and adolescents with obesity induced metabolic complications (비만으로 인한 대사적 합병증을 가진 소아 및 청소년에서 흑색가시세포증의 임상적 의의)

  • Chueh, Hee Won;Cho, Gyu Rang;Yoo, Jaeho
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.987-994
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    • 2007
  • Purpose : This study investigated the clinical significance of AN in children and adolescents with obesity induced metabolic complications. Methods : Forty-nine patients who had obesity induced metabolic complications were participated in this cross-sectional study. Obesity induced metabolic complications are as follows: hypertension, dyslipidemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), nonalcoholic steatohepatitis (NASH), homeostasis model assessment of insulin resistance (HOMA-IR)>3.16. Clinical characteristics, such as, age, percentage-weight-for-height (PWH), pubertal status, blood pressure (BP), fasting plasma insulin level, fasting and post-oral glucose tolerance test 2-hour glucose levels, liver function test, lipid profile, HOMA-IR were compared according to the presence of AN. Results : Sixty-five percent of patients had AN, 57.1% NASH, 57.1% dyslipidemia, 55.1% hypertension, 46.9% IFG, 24.5% HOMA-IR>3.16 and 16.2% IGT. The patients who were moderately to severely obese with AN had higher incidence of IGT and HOMA-IR>3.16. The patients with AN had significantly higher diastolic BP ($79.4{\pm}6.9$ vs $75.4{\pm}5.6mmHg$), fasting levels of plasma insulin ($10.6{\pm}6.0$ vs $6.2{\pm}5.4{\mu}IU/mL$), HOMA-IR index ($2.6{\pm}1.4$ vs $1.4{\pm}1.3$) and PWH ($42.4{\pm}13.0$ vs $34.3{\pm}1.8%$). The increasing tendency for the presence of AN was significantly related to the cumulative number of obesity induced metabolic complications. Binary logistic regression analysis revealed that the presence of AN was significantly associated with fasting plasma insulin level, PWH and IFG. Conclusion : AN could be useful as a clinical surrogate of obesity induced metabolic complications.

Anti-diabetic Effects of Triticum aestivum L. Water Extracts in db/db Mice as an Animal Model of Diabetes Mellitus Type II (제2형 당뇨모델 db/db 마우스에서 밀순 물추출물의 항당뇨 효과)

  • Lee, Sun-Hee;Lim, Sung-Won;Lee, Young-Mi;Hur, Jung-Mu;Lee, Hoi-Seon;Kim, Dae-Ki
    • Korean Journal of Pharmacognosy
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    • v.41 no.4
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    • pp.282-288
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    • 2010
  • We evaluated the anti-diabetic effects of Triticum aestivum sprout water extract (TA) in diabetes mellitus type 2. For the experiments, the diabetic animal model db/db mice were divided to 3 groups: diabetic control (db/db) and two experimental groups orally treated with 25 and 100 mg/kg single dose of TA (TA-25 and TA-100, respectively). The lean mice were used as the non-diabetic normal control. All mice have free access to water and AIN-93 diet. TA was administrated to diabetic mice for 5 weeks and the diabetic clinical markers, including blood glucose level, body weight, food intake and insulin level, were measured at a time. After administration for 5 weeks, the blood glucose level was decreased 1.10 and 1.98 folds in TA-25 and TA-100 groups, respectively, compared with db/db group. The body weight and diet consumption were significantly reduced by TA treatment in dose-dependent manner. The treatments of TA-100 also significantly decreased remarkedly liver weight and slightly serum insulin levels when compared with them of the diabetic control group. However the immunohistochemical staining for insulin clearly showed high expression of insulin in the pancreatic islet cells derived from all db/db mice, even if TA was administrated. Moreover, TA-100 treatment significantly improved impaired glucose tolerance in diabetic db/db mice. The results suggest that TA has anti-hyperglycemic effect attenuating blood glucose in the animal model of type 2 diabetes and might be useful as a functional diet for human diabetic diseases.

Renal Cell Carcinoma is More Aggressive in Turkish Patients with the Metabolic Syndrome

  • Ozbek, Emin;Otunctemur, Alper;Sahin, Suleyman;Dursun, Murat;Besiroglu, Huseyin;Koklu, Ismail;Polat, Emre Can;Erkoc, Mustafa;Danis, Eyyup;Bozkurt, Muammer
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7351-7354
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    • 2013
  • Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.

Serum Ferritin as a Risk Factor in Type 2 Diabetes Mellitus (2형 당뇨병 발생위험인자로서의 혈청 Ferritin의 의의)

  • Kim, Jeong Hyeon;Kim, Ho Seong;Kim, Deok Hui
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1239-1243
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    • 2005
  • Purpose : Iron accumulation interferes with hepatic insulin extraction and affects insulin synthesis and secretion. The purpose of this study is to investigate the correlation between serum ferritin and type 2 diabetes mellitus. Methods : We compared the serum ferritin level among 18 patients in an impaired glucose tolerance (IGT) group, 36 in a type 1 diabetes group, eight in a type 2 diabetes group and 29 in a healthy control group. The correlation between serum ferritin levels and sex, body mass indices(BMI), blood pressure(BP), serum fasting sugar level and serum fasting insulin level were also analyzed. Results : The mean log ferritin were $1.33{\pm}0.32$(healthy control group), $1.63{\pm}0.19$(IGT group) and $1.90{\pm}0.30$(type 2 diabetes group). In the IGT group, log ferritin was higher than in the healthy control group(P=0.001). The log ferritin of the type 2 diabetes group was higher than that of the healthy control group(P=0.001). Comparing log ferritin to other factors, log ferritin had a significant positive correlation with body mass indices(P<0.001), systolic blood pressure(P=0.001), and fasting glucose(P=0.001), fasting insulin(P=0.002). Conclusion : Compared to the normal healthy group, serum ferritin concentrations were significantly higher in the IGT group and the type 2 diabetes group. The elevation of serum ferritin concentration may be a risk factor of type 2 diabetes mellitus.

Beneficial effect of Combination with Korean Red Ginseng and Morus alba in metabolic syndrome (고과당식이 랫드모델에서 홍삼과 상엽 혼합투여에 의한 대사증후군 개선효과)

  • Lee, Yun Jung;Kim, Hye Yoom;Yoon, Jung Joo;Lee, So Min;Ahn, You Mee;Kho, Joung Hyun;Kho, Min Chul;Lee, Ho Sub;Choi, Kyung Min;Kang, Dae Gill
    • The Korea Journal of Herbology
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    • v.27 no.6
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    • pp.99-105
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    • 2012
  • Objectives : Korean red ginseng and Morus alba L. are used as a traditional treatment for diabetes. This study was designed to elucidate whether combination with Korean red ginseng and Morus alba L. (MPM) ameliorates metabolic syndrome in fructose-fed rats. Methods : Animals were divided into four groups; Control receiving tap water, fructose-fed, rosiglitazone-treated fructose-fed rats, and MPM-treated fructose-fed rats both receiving supplemented with 60% fructose (n=10). The MPM or rosiglitazone groups initially received a high-fructose (HF) diet alone for 8 weeks, with supplementation with MPM or rosiglitazone occurring during the final 6 weeks. Results : MPM and rosiglitazone, synthetic $PPAR{\gamma}$ agonist, treatment significantly prevented the increase in fasting serum glucose, leptin, triglyceride, and low density lipoprotein in the HF group when comparing with the control group. MPM and rosiglitazone also led to an increase in high density lipoprotein level in the HF group. The administration of MPM and rosiglitazone prevented the development of the metabolic disturbances such as impaired glucose tolerance, and blood pressure. MPM suppressed increased expressions of endothelin-1 (ET-1) in HF rat aorta. In addition, MPM significantly increased IR-${\beta}$ and PPAR-${\gamma}$ expression in muscle. Conclusions : Based on these results, we suggest that the administration of MPM improves metabolic syndrome through the alteration in lipid profiles and suppression of insulin resistant and blood pressure.

2형 당뇨병 치료제의 최근동향

  • 허갑범
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2001.04a
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    • pp.115-126
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    • 2001
  • 1988년 Reaven이 인슐린저항성증후군(insulin resistance syndrome)의 개념을 처음 소개한 후 전세계적으로 관심이 증가하고 있다. 인슐린저항성증후군은 대사성증후군 (metabolic syndrome), X 증후군(syndrome X)이라고도 하며, 인슐린 저항성에 따른 고인슐린혈증, 내당능장애(impaired glucose tolerance)와 2형 당뇨병(인슐린 비의존형 당뇨병), 이상지질혈증(dyslipidemia), 고혈압 등 일련의 질환은 동일인에서 흔히 병발하고, 이들은 모두 죽상경화증(atherosclerosis)의 위험인자라는 관점에서 상호연관성을 갖는 질환군이라는 개념이다. 2형 당뇨병은 인슐린에 대한 말초조직의 저항성과 상대적으로 감소된 인슐린 분비능의 결과라고 할 수 있다. 또한 상당수의 2형 당뇨병은 비만, 특히 복부비만을 동반하고 있으며, 비만은 그 자체로 인슐린 저항성을 유발한다. 결국 인슐린 저항성이 장기간 개선되지 못하게 되면 2형 당뇨병이 유발되게 된다. 따라서 2형 당뇨병에 대한 최선의 치료는 혈당조절 뿐만 아니라 인슐린 저항성과 관련된 심혈관계 위험인자를 개선시키는 것을 목표로 해야 한다. 그 증거로 당뇨병 조절과 관련한 대규모 전향적 연구인 UKPDS(United Kingdom Prospective Diabetes Study)의 결과를 보면, 2형 당뇨병에서 설폰요소제(sulfonylurea)나 인슐린으로 10년동안 혈당조절을 했을 때 미세혈관 합병증은 의미있게 감소시켰으나 대혈관 합병증의 발생률은 의미있는 감소를 보이지 못하였다. 반면 대혈관 합병증이 미세혈관 합병증보다 사망에 기여하는 비율이 70배 이상이라는 사실은 당뇨병의 치료가 혈당조절에만 초점이 맞추어져서는 안 되며 심혈관계 위험인자를 개선시키는 치료가 동시에 진행되어야 한다는 점을 시사한다.시료에서 매우 드물게 관찰된다. 음극선발광(cathodoluminescence) 영상의 해석을 통해 저어콘 결정의 성장사를 유추하였으며, 이를 바탕으로 이온현미분석 점(spot)을 정하였다. U-Pb-Th 자료는 퍼스(Perth) 저어콘 스탠다드 (CZ3, 564 Ma, $^{206}$Pb/$^{238}$U=0.0914)를 사용하였다. 아래에 기술하는 연대는 모두 $^{206}$Pb/$^{238}$U 연대에 해당된다. 두 개의 화강암질 편마암 시료로부터 구한 U-Pb 저어콘 연대는 각각 812 $\pm$ 14 Ma(1006-8)와 822 $\pm$ 17 Ma(1006-9)로 분석오차 내에서 서로 일치한다. 이 결과는 춘천 및 전곡 지역의 석류석 각섬암에서 보고된 Sm-Nd 전암연대(852 $\pm$ 24 Ma 및 824 $\pm$ 143 Ma; Lee and Cho, 1995; Ree et al., 1996)와 잘 부합한다. 따라서 후기 원생대 기간 중 화성활동이 한반도에서 광범위하게 일어났음을 시사한다. 한편, 1006-9 시료에서는 예외적으로 한 개의 저어콘 입자 주변부(rim)에서 매우 얇은 과성장띠가 관찰되었으며, 두 개의 점 분석으로부터 구한 U-Pb 저어콘 연대는 약 235 Ma이다. 이 띠는 또한 변성기원의 저어콘에서 흔히 관찰되는 작은 W (<0.05) 비를 보인다. 1006-5 시료는 위 두 시료로부터 수 km 떨어진 지점에서 채집하였으나, 저어콘 연대는 상이한 기록을 보여준다. 즉 매우 작은 Th/U (<0.01) 값을 갖는 저어콘의 주변부에서 223 $\pm$ 5 Ma의 연대가 잘 정의되며, 이는 1006-9 시료에서 관찰된 결과와

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Nonalcoholic Fatty Liver Disease in Children with Hypopituitarism (뇌하수체저하증 소아에서 발생한 비알코올성 지방간질환)

  • Yoon, Jung-Min;Ko, Jae-Sung;Seo, Jeong-Kee;Shin, Choong-Ho;Yang, Sei-Won;Moon, Jin-Soo;Yang, Hye-Ran;Chang, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.51-57
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    • 2010
  • Purpose: It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism. Methods: We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism. Results: The mean age at the time of diagnosis of hypopituitarism was 10.4${\pm}$3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1${\pm}$2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis. Conclusion: Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.