• Journal of mucopolysaccharidosis and rare diseases
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• 제2권2호
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• pp.35-37
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• 2016

Prader-Willi syndrome (PWS) often develops type 2 diabetes mellitus (T2DM) related to severe obesity. The prevalence of T2DM in adults with PWS (7-20%) exceeds greatly the prevalence in the general population (5-7%). It is uncommon for pre-pubertal children with PWS to develop overt diabetes or glucose intolerance. GH therapy and genotype did not influence the development of altered glucose metabolism. It has been assumed that T2DM in PWS develops as a consequence of morbid obesity and concomitant insulin resistance. However recent studies suggest the relationship between morbid obesity and T2DM development is more complex and appears to differ in PWS subjects compared to non-PWS subjects. PWS patients had relatively lower fasting insulin levels and increased adiponectin levels compared with BMI-matched obese control despite of similar levels of leptin. So PWS children may be protected to some extent form of obesity-associated insulin resistance. Although there's no data, it seems logical to approach diabetes management including weight loss and increased exercise, using similar pharmacological agents as with non-PWS obesity-related diabetes such as metformin or thiazolidinedione, with the introduction of insulin as required. On the other hand, several recent T2DM in PWS case reports suggest favorable outcomes using Glucagon-like peptide 1 (GLP-1) analog with regard to ghrelin reduction, control of glucose and appetite, weight loss and pre-prandial insulin secretion. The role of GLP-1 agonist therapy is promising, but has not yet been fully elucidated.

• 대한의생명과학회지
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• 제25권3호
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• pp.256-266
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• 2019

In this study, obese adults were compared for their ability to predict obesity and lipid related variables and their optimal cutoff values to predict metabolic syndrome and insulin resistance. In this study, 9,256 adults aged 20 years or older and less than 80 years old, who were in the Gyeonggi region from January 2014 to December 2016 and who were examined at a general hospital, were enrolled. The diagnostic criteria for obesity were WHO (World Health Organization), and BMI $25kg/m^2$ or more presented in the Asia-Pacific region. Metabolic syndrome was diagnosed based on the criteria of American Heart Association / National Heart, Lung, and Blood Institute (AHA / NHLBI). According to the results of receiver operating characteristic curve (ROC) analysis, Triglyceride / HDL-cholesterol (TG / HDL-C), Triglyceride and Glucose (TyG) index, lipid accumulation product (LAP) and visceral adiposity index (VAI) showed high predictive power for diagnosing metabolic syndrome. The diagnostic accuracy of LAP (AUC: 0.854) for males and VAI (0.888) for females was the highest. The optimal cutoff value of LAP was 42.71 for male and 35.44 for female, and the cutoff value of VAI was 1.92 for male and 2.15 for female. In addition, WHtR (waist to height ratio), TyG index, and LAP were used as predictors of insulin resistance in obese adults. Therefore, LAP and VAI were superior to other indicators in predicting metabolic syndrome in obese adults.

• 수면정신생리
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• 제12권1호
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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.

• Journal of Nutrition and Health
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• 제38권7호
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• pp.553-560
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• 2005

The purpose of this study was to examine the lipid peroxidation, plasma antioxidant status and insulin resistance in childhood obesity. To this end, we measured blood lipid profiles, glucose, insulin concentrations, plasma antioxidant vitamins, baseline conjugated diene formation as a measure of LDL oxidation in vivo and TRAP (total radical trapping antioxidant potential) of 93 school children (58 nonobese, 35 overweight-obese). Insulin resistance was estimated by homeostasis model assessment of insulin resistance (HOMA-IR). The overweight-obese children showed significantly higher levels of leptin (p < 0.0001) and triglyceride (p < 0.05) and significantly lower level of plasma Iycopene (p < 0.001) and $\gamma$-tocopherol (p < 0.05) compared with the normal weight children. Furthermore, the levels of TRAP were significantly lower in overweight-obese children (p < 0.05). Significant positive relationships between plasma leptin and conjugated dienes formation (p < 0.005) and inverse relationship between plasma leptin and lipid corrected levels of $\beta$-carotene (p < 0.05), Iycopene (p < 0.05) were observed. Our results showed an increased lipid peroxidation and decreased antioxidant capacity in childhood obesity which could be involved in the atherosclerotic process.

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

• IMMUNE NETWORK
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• 제12권3호
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• pp.96-103
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• 2012

Obesity-induced disorders contribute to the development of metabolic diseases such as insulin resistance, fatty liver diseases, and type 2 diabetes (T2D). In this study, we evaluated whether the Aloe QDM complex could improve metabolic disorders related to blood glucose levels and insulin resistance. Male C57BL/6 obese mice fed a high-fat diet for 54 days received a supplement of Aloe QDM complex or pioglitazone (PGZ) or metformin (Met) and were compared with unsupplemented controls (high-fat diet; HFD) or mice fed a regular diet (RD). RT-PCR and western blot analysis were used to quantify the expression of obesity-induced inflammation. Dietary Aloe QDM complex lowered body weight, fasting blood glucose, plasma insulin, and leptin levels, and markedly reduced the impairment of glucose tolerance in obese mice. Also, Aloe QDM complex significantly enhanced plasma adiponectin levels and insulin sensitivity via AMPK activity in muscles. At the same time, Aloe QDM decreased the mRNA and protein of $PPAR{\gamma}/LXR{\alpha}$ and scavenger receptors in white adipose tissue (WAT). Dietary Aloe QDM complex reduces obesity-induced glucose tolerance not only by suppressing $PPAR{\gamma}/LXR{\alpha}$ but also by enhancing AMPK activity in the WAT and muscles, both of which are important peripheral tissues affecting insulin resistance. The Aloe QDM complex could be used as a nutritional intervention against T2D.

• Natural Product Sciences
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• 제19권4호
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• pp.316-323
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• 2013

Adipose tissue-derived chronic inflammation contributes to development of insulin resistance in obesity, leading to type 2 diabetes and cardiovascular disease. Baicalin, a flavonoid, has antioxidant, anti-inflammatory, antihyperglycemic, anti-adipogenic, and antiobesity effects. However, whether baicalin attenuates adipose tissue-derived development of insulin resistance remains still unclear. This study was to investigate effect of baicalin on the inflammatory changes involved in the development of insulin resistance in adipose tissue. RAW 264.7 cells and differentiated 3T3-L1 adipocytes were pretreated with various concentrations of baicalin in complete media for 1 h and then cultured in the presence or absence of LPS or TNF-${\alpha}$. Our results demonstrated that baicalin remarkably inhibited LPS-induced production of TNF-${\alpha}$, IL-6, and NO by RAW 264.7 cells in a dose-dependent manner. Baicalin also inhibited TNF-${\alpha}$-induced production of IL-6 and $PGE_2$ in differentiated 3T3-L1 cells in a dose-dependent manner, while upregulated TNF-${\alpha}$-suppressed expression of adiponectin and PPAR-${\gamma}$ mRNA and IRS-1 protein. These findings suggest that baicalin may prevent the adipose tissue-derived development of insulin resistance in obesity.

• Nutrition Research and Practice
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• 제4권4호
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• pp.311-316
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• 2010

The purpose of this study was to investigate the relationship between birth weight and appetite related hormones, insulin resistance, and antioxidant status in overweight children aged 9-10 years. Thirty-four healthy overweight children (18 boys, 16 girls) were evaluated with respect to anthropometric measurement, lipid profiles, leptin, ghrelin, glucose, insulin, C-peptide, lipid soluble vitamins, and antioxidant enzyme activities. I found that birth weight was negatively correlated with insulin resistance parameters, ghrelin, and coenzyme Q10 levels. There was a significant positive correlation between present BMI and leptin level, while a negative correlation was noted between the BMI and $\alpha$-tocopherol and lycopene levels. When total subjects were classified into three groups by tertiles of birth weight, the lowest tertile of birth weight (LTB) group showed higher levels of fasting glucose, HOMA-IR, and ghrelin level than the highest tertile of birth weight (HTB) groups. On the other hand, HTB group showed an increased oxidative stress (decreased coenzyme Q10 level and catalase activity) compared to the LTB group. In conclusion, plasma ghrelin level might play an important role in accelerated growth in overweight children with LTB. Increased insulin resistance is present in overweight children with LTB, while decreased coenzyme Q10 and catalase activity in overweight children with HTB. These results suggest that birth weight might be an important factor for determination of treatment for obesity related complications in childhood obesity.

• 대한임상검사과학회지
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• 제52권4호
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• pp.327-334
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• 2020

본 연구는 대한민국 비만 성인에서 대사증후군과 대사증후군 구성요소의 증가와 인슐린저항성(homeostasis model assessment of insulin resistance, HOMA-IR) 및 베타세포기능(homeostasis model assessment of beta cell function, HOMA-B)의 관련성을 조사하였다. 본 연구는 2010년 국민건강영양조사 자료(2010 Korean National Health and Nutrition Examination Survey, KNHANES V-1)의 20세 이상 성인 1,860명을 대상으로 실시하였다. 본 연구의 주요한 결과는 다음과 같다. 첫째, 대사증후군(P<0.001) 및 대사증후군 구성요소의 증가(P<0.001)는 HOMA-IR의 증가와 관련이 있었다. 둘째, 증가된 혈압군(P<0.001)과 증가된 혈당군(P<0.001)의 HOMA-B는 정상군보다 낮았고, 복부비만군(P=0.003)과 감소된 저밀도 콜레스테롤군(P=0.030)의 HOMA-B는 정상군보다 높았다. 그럼에도 불구하고 대사증후군 및 대사증후군 구성요소의 증가에 따라 HOMA-B은 감소하였다. 결론적으로, 대한민국 비만 성인에서 대사증후군 및 대사증후군 구성요소의 증가에 따라 인슐린저항성은 증가하였고 베타세포기능은 감소하였다.

• Molecules and Cells
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• 제47권2호
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• pp.100031.1-100031.13
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• 2024

It is now well-accepted that obesity-induced inflammation plays an important role in the development of insulin resistance and type 2 diabetes. A key source of the inflammation is the murine epididymal and human visceral adipose tissue. The current paradigm is that obesity activates multiple proinflammatory immune cell types in adipose tissue, including adipose-tissue macrophages (ATMs), T Helper 1 (Th1) T cells, and natural killer (NK) cells, while concomitantly suppressing anti-inflammatory immune cells such as T Helper 2 (Th2) T cells and regulatory T cells (Tregs). A key feature of the current paradigm is that obesity induces the anti-inflammatory M2 ATMs in lean adipose tissue to polarize into proinflammatory M1 ATMs. However, recent single-cell transcriptomics studies suggest that the story is much more complex. Here we describe the single-cell genomics technologies that have been developed recently and the emerging results from studies using these technologies. While further studies are needed, it is clear that ATMs are highly heterogeneous. Moreover, while a variety of ATM clusters with quite distinct features have been found to be expanded by obesity, none truly resemble classical M1 ATMs. It is likely that single-cell transcriptomics technology will further revolutionize the field, thereby promoting our understanding of ATMs, adipose-tissue inflammation, and insulin resistance and accelerating the development of therapies for type 2 diabetes.