• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2002년도 제11차 추계학술대회
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• pp.3-4
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• 2002

• 한국임상약학회지
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• 제19권2호
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• pp.96-104
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• 2009

배경: 당뇨병 환자에게 관상동맥심질환은 생존률, 건강 상태 유지 및 삶의 질에 주요한 영향을 미치는 합병증이며 적극적인 당뇨병 치료는 이러한 심혈관 합병증을 예방할 수 있으나 당뇨병의 적극적 치료와 관리에는 많은 비용이 소요된다. 목적: 제2형 당뇨병 환자를 대상으로 메트포르민과 글리메피리드 병합요법과 메트포르민과 피오글리타존 병합요법의 비용-효과성을 비교하고자 하였다. 연구방법: 마르코프 코호트 프로세스(Markov Cohort Process Model) 모형을 이용하여 비용-효과분석을 실시하였다. 연장된 수명 (life years gained, LYG)과 삶의 질(quality)을 보정하여 증가된 QALYs를 주요 효과 지표로 측정하였고, 총비용으로는 직접의료비용과, 환자와 가족의 교통비를 직접비의료비용으로 고려하였고 환자와 가족의 시간비용을 간접비용으로 포함하였다. 연구결과: 비용-효과분석 결과, 메트포르민과 글리메피리드 병합요법의 경우 총 비용은 5,962,288원, 효과는 7.94LYG, 6.43QALY이었다. 반면 메트포르민과 피오글리타존 병합요법은 총 비용 10,982,243원, 효과 8.62LYG, 6.99QALY으로, 점증적 비용-효과비(ICER)는 7,402,663원/LYG과 8,934,546원/QALY 이었다. 결론: 우리 사회의 연장된 수명(LYG)에 따른 지불의사가 700만원 이하인 경우는 메트포르민과 글리메피리드 병합요법이 비용-효과적인 대안이며 700만원 이상인 경우에는 메트포르민과 피오글리타존 병합요법이 비용-효과적인 대안이 될 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3123-3128
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• 2014

The liver is normally the major site of glucose metabolism in intact organisms and the most important target organ for the action of insulin. It has been widely accepted that insulin resistance (IR) is closely associated with postoperative recurrence of hepatocellular carcinoma (HCC). However, the relationship between IR and drug resistance in liver cancer cells is unclear. In the present study, IR was induced in HepG2 cells via incubation with a high concentration of insulin. Once the insulin-resistant cell line was established, the stability of HepG2/IR cells was further tested via incubation in insulin-free medium for another 72h. Afterwards, the biological effects of insulin resistance on adhesion, migration, invasion and sensitivity to cis-platinum (DDP) of cells were determined. The results indicated that glucose consumption was reduced in insulin-resistant cells. In addition, the expression of the insulin receptor and glucose transportor-2 was downregulated. Furthermore, HepG2/IR cells displayed markedly enhanced adhesion, migration, and invasion. Most importantly, these cells exhibited a lower sensitivity to DDP. By contrast, HepG2/IR cells exhibited decreased adhesion and invasion after treatment with the insulin sensitizer pioglitazone hydrochloride. The results suggest that IR is closely related to drug resistance as well as adhesion, migration, and invasion in HepG2 cells. These findings may help explain the clinical observation of limited efficacy for chemotherapy on a background of IR, which promotes the invasion and migration of cancer cells.

• 한국컴퓨터정보학회논문지
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• 제21권7호
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• pp.61-66
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• 2016

The frequency of obesity has risen dramatically in recent years but only few safe and effective drugs are currently available. In addition, obesity can induce type 2 diabetes (T2DM), hyperlipidemia and fatty liver disease. Recently, protective effect of purslane extract (PE) on obesity has been reported, but little is known about the role and mechanism of PE in obesity. This study aimed to evaluate the effect of PE on obesity and diabetes in obese mice. In addition, the effect of PE was compared with anti-obesity and diabetes drugs. High-fat diet (HFD)-induced obese mice were treated for 8 weeks with drugs as follows: PE, orlistat, metformin, voglibose or pioglitazone. While PE mixed with normal diet did not have any effects on BW in non-obese mice, PE mixed with HFD significantly reduced BW gain, insulin resistance, and glucose intolerance, without affecting food intake and appetite in obese mice. The effect was comparable to the effects of anti-obesity and diabetes drugs. Furthermore, PE significantly increased the activity of hepatocellular anti-oxidant enzymes, leading to protection of liver from oxidative stress in obese mice. These results suggest that PE treatment may be a useful tool for preventing obesity and complication of obesity.

• 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.

• Nutrition Research and Practice
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• 제6권5호
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• pp.405-413
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• 2012

Rho iso-alpha acids-rich extract (RIAA) from Humulus lupulus (hops) and proanthocyanidins-rich extracts (PAC) from Acacia nilotica exert anti-inflammatory and anti-diabetic activity in vitro and in vivo. We hypothesized that a combination of these two extracts would exert enhanced effects in vitro on inflammatory markers and insulin signaling, and on nonfasting glucose and insulin in db/db mice. Over 49 tested combinations, RIAA:PAC at 5:1 ($6.25{\mu}g/mL$) exhibited the greatest reductions in $TNF{\alpha}$-stimulated lipolysis and IL-6 release in 3T3-L1 adipocytes, comparable to $5{\mu}g/mL$ troglitazone. Pretreatment of 3T3-L1 adipocytes with this combination ($5{\mu}g/mL$) also led to a 3-fold increase in insulin-stimulated glucose uptake that was comparable to $5{\mu}g/mL$ pioglitazone or $901{\mu}g/mL$ aspirin. Finally, db/db mice fed with RIAA:PAC at 5:1 (100 mg/kg) for 7 days resulted in 22% decrease in nonfasting glucose and 19% decrease in insulin that was comparable to 0.5 mg/kg rosiglitazone and better than 100 mg/kg metformin. RIAA:PAC mixture may have the potential to be an alternative when conventional therapy is undesirable or ineffective, and future research exploring its long-term clinical application is warranted.

• Molecules and Cells
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• 제41권10호
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• pp.900-908
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• 2018

Insulin resistance is closely associated with metabolic diseases such as type 2 diabetes, dyslipidemia, hypertension and atherosclerosis. Thiazolidinediones (TZDs) have been developed to ameliorate insulin resistance by activation of peroxisome proliferator-activated receptor (PPAR) ${\gamma}$. Although TZDs are synthetic ligands for $PPAR{\gamma}$, metabolic outcomes of each TZD are different. Moreover, there are lack of head-to-head comparative studies among TZDs in the aspect of metabolic outcomes. In this study, we analyzed the effects of three TZDs, including lobeglitazone (Lobe), rosiglitazone (Rosi), and pioglitazone (Pio) on metabolic and thermogenic regulation. In adipocytes, Lobe more potently stimulated adipogenesis and insulin-dependent glucose uptake than Rosi and Pio. In the presence of pro-inflammatory stimuli, Lobe efficiently suppressed expressions of pro-inflammatory genes in macrophages and adipocytes. In obese and diabetic db/db mice, Lobe effectively promoted insulin-stimulated glucose uptake and suppressed pro-inflammatory responses in epididymal white adipose tissue (EAT), leading to improve glucose intolerance. Compared to other two TZDs, Lobe enhanced beige adipocyte formation and thermogenic gene expression in inguinal white adipose tissue (IAT) of lean mice, which would be attributable to cold-induced thermogenesis. Collectively, these comparison data suggest that Lobe could relieve insulin resistance and enhance thermogenesis at low-concentration conditions where Rosi and Pio are less effective.

• IMMUNE NETWORK
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• 제11권1호
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• pp.59-67
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• 2011

Background: Insulin resistance is an integral feature of metabolic syndromes, including obesity, hyperglycemia, and hyperlipidemia. In this study, we evaluated whether the aloe component could reduce obesity-induced inflammation and the occurrence of metabolic disorders such as blood glucose and insulin resistance. Methods: Male C57BL/6 obese mice fed a high-fat diet for 54 days received a supplement of aloe formula (PAG, ALS, Aloe QDM, and Aloe QDM complex) or pioglitazone (PGZ) 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. Results: Aloe QDM lowered fasting blood glucose and plasma insulin compared with HFD. Obesity-induced inflammatory cytokine (IL-$1{\beta}$, -6, -12, TNF-${\alpha}$) and chemokine (CX3CL1, CCL5) mRNA and protein were decreased markedly, as was macrophage infiltration and hepatic triglycerides by Aloe QDM. At the same time, Aloe QDM decreased the mRNA and protein of $PPAR{\gamma}/LXR{\alpha}$ and $11{\beta}$-HSD1 both in the liver and WAT. Conclusion: Dietary aloe formula reduces obesity-induced glucose tolerance not only by suppressing inflammatory responses but also by inducing anti-inflammatory cytokines in the WAT and liver, both of which are important peripheral tissues affecting insulin resistance. The effect of Aloe QDM complex in the WAT and liver are related to its dual action on $PPAR{\gamma}$ and $11{\beta}$-HSD1 ression and its use as a nutritional intervention against T2D and obesity-related inflammation is suggested.

• 약학회지
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• 제52권5호
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• pp.345-354
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• 2008

This study was designed to investigate the anti-diabetic effect and mechanism of Korean red ginseng extract through transcriptomics in C57BL/KsJ db/db mice. The db/db mice were randomly divided into six groups: diabetic control group (DC), red ginseng extract low dose group (RGL, 100 mg/kg), red ginseng extract high dose group (RGH, 200 mg/kg), metformin group (MET, 300 mg/kg), glipizide group (GPZ, 15 mg/kg) and pioglitazone group (PIO, 30 mg/kg), and treated with drugs once per day for 10 weeks. At the end of treatment, we measured blood glucose, insulin, hemoglobin A1c (HbA1c), triglyceride (TG), adiponectin, leptin, non-esterified fatty acid (NEFA). RGL-treated group lowered the blood glucose and HbA1c levels by 19.6% and 11.4% compared to those in diabetic control group. In addition, plasma adiponectin and leptin levels in RGL-treated groups were increased by 20% and 12%, respectively, compared to those in diabetic control. Morphological analyses of liver, pancreas and epidydimal adipose tissue were done by hematoxylin-eosin staining, and pancreatic islet insulin and glucagon levels were detected by double-immunofluorescence staining. RGL-treated group revealed higher insulin contents and lower glucagon contents compared to diabetic control. To elucidate an action mechanism of Korean red ginseng, DNA microarray analyses were performed in liver and fat tissues, and western blot and RT-PCR were conducted in liver for validation. According to hierarchical clustering and principal component analysis of gene expression Korean red ginseng treated groups were close to metformin treated group. In summary, Korean red ginseng lowered the blood glucose level through protecting destruction of islet cells and shifting glucose metabolism from hepatic glucose production to glucose utilization and improving insulin sensitivity through enhancing plasma adiponectin and leptin levels.

• 한국식품영양과학회지
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• 제34권9호
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• pp.1336-1343
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• 2005

일본에서는 녹나무 줄기에서 분리한 정유의 하나인 camphor는 강심제등 약용으로 사용하고 있지만, 녹나무 잎 추출물에 대한 연구도 적고 특히 항당뇨 효과에 대한 연구는 거의 없었다. 본 연구에서는 녹나무 잎 추출물이 in vitro에서 인슐린 작용, 인슐린 분비 또는 탄수화물의 소화에 효과적인지를 조사함으로 항당뇨에 효과적인지 여부를 조사하였다. 녹나무 잎을 $70\%$ 에탄올로 추출한 후 메탄올과 물을 섞은 용액으로 단계별로 XAD-4 column으로 분획 하였다. 녹나무 잎 추출물은 고농도(1 mg/mL)에서도 MTT로 측정하였을 때 세포 독성을 나타내지 않았다 녹나무 잎 추출분획 물 중 40과 $60\%$ 메탄올층은 3T3-L1 지방세포에 처리하였을 때 인슐린의 작용을 향상시켜 포도당의 흡수를 증가시키는 효과가 매우 컸다. 이 추출분획 물들은 3T3-L1 지방세포에 존재하는 인슐린의 작용을 향상시켜 인슐린을 10 nM을 처리한 것보다도 효과적으로 포도당 흡수를 증가시켰다. 또한 $40\%$ 메탄올층은 3T3-L1 섬유아세포에 분화 유도물질를 처리하였을 때 PPAR$\gamma$인 pioglitazone과 마찬가지로 지방 세포로의 분화를 촉진시키고 지방의 축적도 증가시켰다. 그러므로 $40\%$ 메탄올층에는 PPAR-$\gamma$ agonist로 작용하는 물질이 함유되어 있을 가능성이 높다. 베타세포라인인 Min6세포에 녹나무 잎 추출분획물을 처리한 후 저농도와 고농도 포도당 자극시 인슐린 분비를 측정하였을 때 두 농도에서 모두 인슐린 분비에 영향을 미치지 않았다. 또한 녹나무 잎 추출분획물은 탄수화물의 소화에 작용하는 효소인 $\alpha$-glucoamylase의 활성에 영향을 미치지 않았다. 결론적으로 녹나무 잎에는 인슐린 분비나 탄수화물의 소화에 관여하는 성분의 없지만, 인슐린 작용을 향상시키는 인슐린 민감성물질이 함유되어 있을 가능성이 높다. 특히 $40\%$ 메탄올층에는 PPAR$\gamma$ agnist로 작용하는 인슐린 민감성 물질이 존재할 가능성이 높다.