• 대한임상검사과학회지
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• 제37권2호
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• pp.71-77
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• 2005

We experienced the specimen that contains a hemoglobin variant known as interference from HbAS in October 2003. It was the first case of Hb variants since Samsung Medical Center began conducting glycohemoglobin College of American Pathologists surveys in 1997. The purpose of this study is to share our experience with the specimen and promote the understanding of Hb variants & derivatives. We've performed cross checks to examine HbA1c by using two pieces of equipment; the TOSHOH G7 and BIO-RAD VARIANT-T(turbo), and Automatic High Performance Liquid Chromatography(HPLC) as an analytic measurement method. HPLC provides different fractional information of hemoglobin with a two-dimensional graph as well as numeric results. We have been performing a "Systematic Checking Process". Three specimen suspicious of Hb variants & derivatives were found through this process. College of American Pathologists notified that it is important for users to be aware of the limitation of their glycohemoglobin method to avoid reporting incorrect results due to interference from hemoglobin variants or hemoglobin adducts. Therefore, laboratory findings of Hb variants & derivatives are very important. The experience of qualified technicians with professional knowledge in Hb variants is the most important aspect in finding Hb variants. Korea is homogeneous in race and is not in an area with a higher finding rate of Hb variants. While 1,024 cases of Hb variants have been found in Japan, we do not have specific data on how many cases of Hb variants have been found in Korea. Considering Hb variant cases in Japan, which is geographically close to us, it is presumed that there must be various Hb variant cases in Korea. If domestic laboratories set a systemic protocol and build a network to share our experience in Hb variants, I expect the Korean Hb variants could also be listed on the world's Hb variant list.

• 기본간호학회지
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• 제15권2호
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• pp.178-185
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• 2008

Purpose: This study was done to investigate the relationship between depression, self-care activity and $HbA_1c$ in clients with type-2 diabetes mellitus (DM) clients. Method: This was a cross sectional descriptive study and data were collected between October 4 and 27, 2006 using a questionnaire. The participants were inpatients and outpatients with type-2 diabetes being seen in one of two hospitals. The questionnaire included general as well as disease related characteristics, a depression scale (CES-D), and the self-care activity scale developed by Kim (1996). $HbA_1c$ was obtained from medical records. Results: There were 50 men (41.7%) and 70 women (58.3%). The mean scores for depression and self-care activity were $18.22{\pm}10.03$ and 3.51, respectively. Almost half of the Participants (46.7%) had an $HbA_1c$ greater than 7%. Self-care activity was negatively correlated with depression (r=-.436, p=0.00) and $HbA_1c$ (r=-.269, p=0.03). Depression was positively correlated with $HbA_1c$ (r=-.325, p=0.00). Participants who had diabetes education showed a significantly lower level of $HbA_1c$ than the group who had never had diabetes education. Conclusions: It is Important to make ensure that patients with diabetes have education on diabetes mellitus and to screen and manage depression as part of the care for these patients.

• 대한임상검사과학회지
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• 제50권3호
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• pp.313-319
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• 2018

최근 골대사와 당뇨병 발생 기전의 관계에 대해 많은 연구가 진행되고 있으며, osteocalcin이 제 2형 당뇨병을 위한 치료법에 관련될 수 있다는 것이 밝혀지고 있다. 따라서 본 연구는 osteocalcin과 HbA1c의 상관관계를 알아보고자 한다. 2015년 1월 1일부터 2016년 12월 31일까지 광주 소재 한 종합병원 수진자 중 osteocalcin과 HbA1c를 비롯하여 칼슘, 카르복시말단펩티드, 총 콜레스테롤, 중성지방, 고밀도 지질단백 콜레스테롤, 저밀도 지질단백 콜레스테롤, 25-수산화비타민D, 키, 몸무게를 측정한 40세 이상의 성인 총 714명($70.8{\pm}10.4$세)을 연구대상자로 최종 선정하였다. 성별은 남자(452명, 63.3%)가 여자(262명, 36.7%)보다 많았다. 당뇨환자군에서 osteocalcin과 HbA1c는 약한 음의 상관관계(r=-0.183, P<0.001)가 있었고, 다른 요인들을 모두 보정했을 때에도 여전히 음의 상관관계(r=-0.251, P<0.001)가 있었다. 본 연구는 당뇨환자에서의 osteocalcin과 HbA1c가 음의 상관관계가 있음을 보여주었다. 골대사와 당대사의 생물학적 기전 및 관련요인들이 미치는 영향을 바탕으로 골대사와 당뇨병 발생의 상호관계에 대한 연구가 지속되어야 한다.

• 생명과학회지
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• 제15권6호
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• pp.972-978
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• 2005

제주말의 혈통보존을 위한 기초자료를 마련할 목적으로 국내에서 사육중인 제주말 102두를 대상으로 적혈구항원형 및 혈액단백질형의 유전적 다형성을 조사한 결과는 다음과 같다. 적혈구항원형의 표현형 빈도는 $A^{af}$28두($27.45\%),\;C^{a}$ 101두 ($99.02\%),\;K^{-}$ 99두 ($97.06\%),\;U^{a}$ 64두 ($62.75\%),\;P^{b}$ 37두 ($36.27\%),\;Q^{c}$ 48두 ($47.06\%$)에서 높은 빈도를 나타냈으며, D시스템의 31개의 대립유전자 중 $D^{cgm/dghm}$ 14두($13.73\%),\;D^{adn/cgm}$ 10두($9.80\%),\;D^{ad/cgm}$ 9두($8.82\%),\;D^{dghm/dghm}$ 8두($7.84\%),\;D^{cgm/cgm}$ 8두($7.84\%$)에서 높은 빈도의 유전자형이 관찰되었다. 또한 null allele로 추정되는 $D^{ad/c(e)fgm}\;D^{adn/c(e)fgm}\;D^{c(d)fgm/dghm}$대립유전자가 4두에서 관찰되었다. 혈액단백질형은 $AL^{B}$ 49두($48.04\%),\;GC^{F}$ 101두($99.02\%),\;AlB^{K}$ 99두($97.06\%),\;ES^{FI}$ 37두($36.27\%),\;TF^{F2}$ 26두($25.49\%),\;HB^{B1}$ 46두($45.10\%$), and $PGD^{F}$ 88두($86.27\%$)로 높은 빈도를 보였으며, $HB^{A2B1}$ 4두($3.92\%),\;HB^{AB1}$ 2두($1.96\%),\;HB^{AB2}$ 1두($0.98\%),\;PGD^{D}$ 1두($0.98\%$가 특이하게 관찰되었다. 유전자 빈도는 $A^{af}$ (0.3726), $A^{C}$ (0.2647), $C^{-}$ (0.5050), $K^{-}$ (0.9853), $U^{-}$ (0.6863), $P^{b}$ (0.4657), $Q^{c}$ (0.5294), $D^{cgm}$ (0.3039), $HB^{B1}$(0.6863), $PGD^{F}$ (0.9265), $AL^{B}$ (0.6912), $ALB^{K}$ (0.9852), $GC^{F}$ (0.9950), $ES^{I}$ (0.5000) and $TF^{F2}$ (0.4950) 대립유전자가 가장 높은 빈도를 나타내었고 $D^{cgm(f)}$ (0.0196), $HB^{A}$ (0.0147), $HB^{A2}$ (0.0196), $ES^{G}$ (0.0441), $ES^{H}$ (0.0098), $TF^{E}$TF'(0.0246), $TF^{H2}$ (0.0049) and $PGD^{D}$ (0.0098)의 대립유전자가 제주말 에서 특이하게 관찰되었다. 결론적으로 혈액형에 의한 제주말의 유전적 다형은 $A^{af},\;A^{c},\;C^{-},\;K^{-},\;U^{-},\;P^{b},\;Q^{c},\;D^{cgm},\;D^{dghm},\;D^{adn},\;HB^{B1}$, $PGD^{F},\;AL^{B},\;A1B^{K},\;GC^{F},\;ES^{I},\;TF^{F2},\;AL^{B}$, 대립유전자의 빈도가 비교적 높은 것으로 관찰되었고 $A^{ab},\;A^{abf},\;D^{cgm(f)},\;(D^{cfg(k)m}$ 혹은$D^{c(e)fgm}),\;HB^{A},\;HB^{A2},\;ES^{H},\;TF^{E},\;TF^{H2},\;PGD^{D},\;AL^{B}$의 대립유전자가 제주말에서 특이하게 관찰되었다.

• 한국임상약학회지
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• 제25권2호
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• pp.74-79
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• 2015

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin $A_{1c}$ ($HbA_{1c}$) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for $HbA_{1c}$ values, amounts of $HbA_{1c}$ changes, and rates of $HbA_{1c}$ changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger $HbA_{1c}$ changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable $HbA_{1c}$ <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable $HbA_{1c}$ <6.5% was not significantly different, but time to achieve stable $HbA_{1c}$ <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the $HbA_{1c}$ goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.496-512
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• 2018

Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

• 농촌의학ㆍ지역보건
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• 제47권3호
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• pp.181-188
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• 2022

당뇨병 발생에는 생활습관이나 생활환경과 관련된 다양한 원인들이 있는데 최근 연구에서 중금속에 많이 노출된 사람에서 당뇨병 발생 및 당뇨병의 악화가 늘어났다는 역학적 연구가 많이 발표되고 있다. 이에 국내 대규모 철강공업단지를 가진 일개 도시 지역 주민을 대상으로 당화혈색소와 체내 중금속의 상관성을 파악하고자 하였다. 2008~2009년 연구대상 총 414명에 대한 설문조사와 생체시료를 채취하였다. 설문은 성별, 연령, 인구학적 특성, 흡연, 음주, 직업, 당뇨진단 유무 등의 항목으로 구성하였다. 혈액을 채취하여 HbA1c, 혈중 납 농도를 측정하였고, 소변을 채취하여 요중 카드뮴, 무기비소, 수은 농도를 측정하였다. HbA1c는 6.5%기준으로 미만군과 이상군으로 분류하였다. 각 중금속별 10분위수부터 90분위수 농도에 해당하는 기준으로 미만군과 이상군 등 두 군을 분류하였다. 당뇨관련검사 결과 HbA1c 6.5% 기준으로 이상군은 남자 14(9.9%)명, 여자 17(6.2%)명이었다. 혈중 납의 기하평균 농도는 2.48 (1.80) ㎍/dl, 요중 카드뮴의 기하평균농도는 1.20 (2.26) ㎍/g creatinine, 요중 무기비소의 기하평균농도는 12.08 (1.80) ㎍/g creatinine, 요중 수은의 기하평균농도는 1.63 (2.23) ㎍/g creatinine 이었다. 연령, 지역, 성별, 흡연으로 보정하였을때 요중 카드뮴 농도 30분위수 이상군이 미만군에 비하여 교차비 5.26(95% 신뢰구간 : 1.44~19.17)으로 유의하게 높았다. 납, 무기비소, 수은은 HbA1c(6.5% 기준) 변수와의 교차분석에서 유의한 분포 차이는 없었다. 여러 요인을 보정하고도 요중 카드뮴과 HbA1c의 유의한 양의 상관관계를 파악하였고, 특히 유의한 상관관계를 보인 요중 카드뮴 농도의 특정 컷오프 값을 찾아내어 이를 통해 우리나라에 적합한 생물학적 노출값 설정의 참고자료로 활용될 수 있다는 점에서 의의가 있다고 생각한다.

• Journal of Acupuncture Research
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• 제32권4호
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• pp.17-27
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• 2015

Objectives : The purpose of this study is to evaluate the correlation between HbA1c and pain intensity in diabetic peripheral neuropathy patients, and to compare the difference between two groups divided by the risk of complications. Methods : The participants were 46 men and women suffering from neuropathic pain diagnosed with diabetes mellitus who visited the Hospital of Traditional Korean Medicine, Semyung University from June, 2014 to August, 2015. Age, duration of diabetes mellitus, numeric rating scale(NRS), and Michigan neuropathy screening instrument(MNSI) were used as evaluation tools. Results : 1. In all 46 cases, there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 2. Among 23 cases with a high risk of complications (more than 7.0 % of HbA1c, group A), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 3. Among 23 cases with a low risk of complications(less than 7.0 % of HbA1c, group B), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 4. Means of duration of diabetes mellitus, NRS, MNSIQ, and MNSIE were higher in group A than group B, but there were no significant correlations in statistics. Conclusions : This study could not find statistically significant correlations between pain intensity and HbA1c in diabetic peripheral neuropathy patients, so more studies are required in the future.

• Journal of Preventive Medicine and Public Health
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• 제43권5호
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• pp.451-454
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• 2010

Objectives: The American Diabetes Association (ADA) has recently recommended the HbA1c assay as one of four options for making the diagnosis of diabetes mellitus, with a cut-point of $\geq$ 6.5%. We compared the HbA1c assay and the fasting plasma glucose level for making the diagnosis of diabetes among Korean adults. Methods: We analyzed 8710 adults (age 45-74 years), who were not diagnosed as having diabetes mellitus, from the Namwon study population. A fasting plasma glucose level of $\geq$126 mg/dL and an A1c of $\geq$ 6.5% were used for the diagnosis of diabetes. The kappa index of agreement was calculated to measure the agreement between the diagnosis based on the fasting plasma glucose level and the HbA1c. Results: The kappa index of agreement between the fasting plasma glucose level and HbA1c was 0.50. Conclusions: The agreement between the fasting plasma glucose and HbA1c for the diagnosis of diabetes was moderate for Korean adults.

• The Journal of Advanced Prosthodontics
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• 제11권5호
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• pp.247-252
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• 2019

PURPOSE. To evaluate the effect of periodontal and prosthodontic therapy on glycated hemoglobin A(HbA1c) level in patients with diabetes. MATERIALS AND METHODS. This is a retrospective study of 70 patients suffering from diabetes who visited the Kyungpook National University Hospital between January 2016 and May 2018. Patients underwent medical evaluation for their routine check-up, which includes laboratory test for HbA1c levels. Among the 70 patients, 35 patients also visited Kyungpook National University Dental Hospital during the same period to receive periodontal and prosthodontic therapy, while the other 35 patients did not receive such therapy. The HbA1c levels were compared before and after periodontal and prosthodontic therapy. Comparisons between groups and within groups were performed using independent t-test. RESULTS. The HbA1c levels in the group who have received periodontal and prosthodontic therapy decreased from 7.2 to 6.7 (P=.001). The HbA1c levels in the control group decreased from 7.2 to 7.1 (P=.580). The difference in changes between the two patient groups was statistically significant (P=.011). CONCLUSION. Periodontal and prosthodontic therapy can be effective on glycemic control in patients with diabetes.