• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.370-375
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• 2009

목 적 : 터너증후군 환자에서 대사증후군과 심혈관 질환의 위험성이 높다. 성인 연령의 터너증후군 환자들에서 대사증후군 관련요인을 분석하고, 인슐린 저항성의 대사위험성을 알아보기 위한 연구를 시행하였다. 방 법 : 43명의 성인 터너증후군 환자에서 대사증후군의 빈도와 관련 요인 값들을 분석하였다. HOMA-IR을 이용하여 인슐린 저항성군과 비저항성군으로 분류한 후 각 집단을 분석하고, HOMA- IR과 대사 증후군 관련요인의 상관관계를 알아보았다. 결 과 : 대사증후군은 터너증후군 환자의 7%에서 보였고 각 항목에 대해서 인슐린 저항성은 16.3%, 복부 비만이 15.4%, 고중성지방이 2.3%, 저HDL 콜레스테롤이 9.3%였고, 고혈압이 36.8 %였다. 체질량지수, 허리둘레, 공복 혈당, HOMA-IR, 수축기 혈압은 인슐린 저항성군에서 의미 있게 높게 나왔으며, HOMA-IR은 체질량지수, 허리둘레, 공복 혈당, 수축기 혈압과 양의 상관관계를 보였다(P<0.05). 결 론 : 터너증후군 성인 환자들에서 대사증후군의 위험성이 있으며, 인슐린 저항성과 대사증후군 관련요인 간에 상관관계를 보인다. 터너증후군 환자들에게서 대사관련 요인을 일정기간 마다 검사하여 대사증후군 또는 인슐린 저항성으로의 진행여부를 감시하고 심혈관 합병증을 예방하는 것이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7139-7142
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• 2015

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin > 12 ng/ml and HOMA > 4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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• pp.59-67
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• 2018

Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

• 농촌의학ㆍ지역보건
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• 제43권1호
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• pp.18-30
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• 2018

본 연구는 농촌 지역에 거주하며 당뇨병이 없는 건강한 성인을 대상으로 혈청 비타민 D와 인슐린 저항성 및 췌장의 베타세포 기능과의 관련성을 확인하기 위하여 시행되었다. 연구대상은 전라남도 해남군에 소재한 종합병원 건강검진실에서 건강검진을 받은 당뇨병이 없는 20세 이상 성인 374명이었고, 분산분석과 공분산분석을 이용하여 혈청 비타민 D 수준에 따라 HOMA-IR과 $HOMA-{\beta}$을 비교하였다. 분석결과, 연구대상 중 비타민 D 결핍군, 불충분군, 충분군은 각각 38.5%, 48.1%, 13.4%이었다. 비타민 D 수준에 따른 HOMA-IR 평균은 충분군 $1.92{\pm}1.08$, 불충분군 $1.99{\pm}1.04$, 결핍군 $2.91{\pm}1.05$로 통계적으로 유의한 차이가 있었으며, 다른 관련변수를 통제한 상태에서 비교한 공분산 분석 결과에서도 비타민 D 수준에 따른 HOMA-IR은 통계적으로 유의한 차이가 있었다. 비타민 D 수준에 따른 $HOMA-{\beta}$ 평균은 충분군 $84.69{\pm}1.07$, 불충분군 $78.41{\pm}1.04$, 결핍군 $80.48{\pm}1.04$ 이었고, 통계적으로 유의한 차이가 없었다. 결론적으로 우리나라 농촌지역 성인의 혈청 비타민 D 수준은 부족한 경우가 매우 높았고, 비타민 D 수준에 따른 인슐린 저항성은 관련이 있음을 알 수 있었다. 인슐린 저항성 및 당뇨병 예방을 위해서 비타민 D의 충분한 형성을 위한 보충제, 햇볕 노출과 영양 섭취 등에 대한 충분한 정보 및 교육이 필요할 것으로 생각된다.

• 대한지역사회영양학회지
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• 제17권2호
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• pp.243-257
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• 2012

The purpose of this study was to evaluate pancreatic ${\beta}$-cell function of Korean adult and to examine the associations between ${\beta}$-cell function and nutrient intakes. Data were analyzed for 1,917 male and 2,885 female subjects older than 30 years using 'The Forth Korean National Health and Nutrition Survey in 2009'. We calculated HOMA ${\beta}$-cell (The homeostasis model assessment of ${\beta}$-cell function) using fasting glucose and fasting insulin for assessing ${\beta}$-cell function. Subjects were divided into HHG (High HOMA ${\beta}$-cell Group) or LHG (Low HOMA ${\beta}$-cell Group) according to median of HOMA ${\beta}$-cell, and then nutrient intakes were compared between two groups. In the entire study population, HHG showed lower percent of carbohydrate intakes (p < 0.05), and higher fat (p < 0.01), percent of fat (p < 0.05), vitamin A (p < 0.05), carotene (p < 0.05) and riboflavin (p < 0.05) intakes than LHG. In addition, levels of HOMA ${\beta}$-cell were negatively correlated with percent of carbohydrate (${\beta}$ = -0.040, p < 0.05), and positively correlated with percent of fat (${\beta}$ = 0.046, p < 0.01). The subjects were then divided into two subgroups according to body mass index values, either $23kg/m^2$ (under- and normal-weight) or ${\geq}23kg/m^2$ (over-weight and obese). Significant differences of some nutrients intakes and correlations with HOMA ${\beta}$-cell were observed only in under- and normal weight subjects, but not in over-weight and obese subjects. In conclusion, high carbohydrate, lower fat and lower vitamin intakes may be related with pancreatic ${\beta}$-cell dysfunction in under- and normal-weight Korean.

• 대한치과의사협회지
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• 제47권2호
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• pp.90-101
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• 2009

The aim of this study was to appraise the influence of conventional periodontal treatment on metabolic control in Korean type 2 diabetic patients. In addition, their periodontal change was compared with non-diabetic patients. Before and after treatment, it was performed to measure periodontal and metabolic indices in thirteen type 2 diabetic patients. Periodontal indices included plaque index, gingival index, bleeding on probing, probing pocket depth, gingival recession, and clinical attachment level. Metabolic indices included glycated hemoglobin(HbA1c), fasting plasma glucose, fasting plasma insulin, total cholesterol, triglyceride, and HDL-cholesterol. Plaque index, gingival index, bleeding on probing, probing pocket depth, and gingival recession showed significant improvements in the statistics. Diabetic patients showed no statistically significant differences in the changes of periodontal indices compared with non-diabetic patients. HbA1c values decreased in five of the thirteen subjects and fasting plasma glucose levels were reduced in four of the seven subjects after periodontal treatment. All five subjects whom HOMA values were calculated in showed the increases of insulin secretions. The results of this study ascertained the possibility of the better glycemic contol after conventional periodontal treatment in Korean type 2 diabetic patients and diabetes were well healed of their periodontal diseases after the treatment.

• Nutrition Research and Practice
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• 제16권4호
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• pp.450-463
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• 2022

BACKGROUND/OBJECTIVES: Adolescents who skip breakfast have an increased prevalence of chronic diseases. Thus, we aimed to evaluate whether the intake of rice-based breakfast had positive effects on blood glucose indices and to determine the possibility of diabetes prevalence in Korean youths who habitually skip breakfast. SUBJECTS/METHODS: In this randomized parallel-group controlled trial, 81 subjects who were suitable for compliance among 105 middle-and high-school students aged 12-18 years who usually skipped breakfast were included in this study (rice-meal group [RMG], n = 26; wheat-meal group [WMG], n = 29; general-meal group [GMG], n = 26). The RMG and WMG received a rice-based breakfast and a wheat-based breakfast for 12 weeks, respectively. The anthropometric indices, blood glucose indices, and metabolites were measured at baseline and the endpoint, respectively. RESULTS: The mean body weights in the RMG, WMG, and GMG groups at the endpoint were 62.44 kg, 61.80 kg, and 60.28 kg, respectively, and the mean body weights of the WMG and GMG groups at the endpoint were significantly higher than that at baseline (P < 0.05). The levels of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly decreased in the RMG group at the endpoint compared to baseline (P < 0.05, P < 0.05, respectively). The levels of tryptophan and tyrosine in the WMG group at the endpoint were significantly higher than that those at baseline (P < 0.01, P < 0.05, respectively). CONCLUSIONS: Rice-based breakfast has positive effects on fasting insulin levels and HOMA-IR in Korean adolescents who skip breakfast. Additionally, it was found that a skipping breakfast could increase the prevalence of diabetes in adolescents who skip breakfast. Therefore, in addition to reducing breakfast skipping, it is vital to develop a rice-based menu that fits teenage preferences to prevent chronic diseases such as diabetes.

• 생물정신의학
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• 제10권2호
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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.

• 운동영양학회지
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• 제24권1호
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• pp.19-23
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• 2020

[Purpose] Blood glucose and insulin resistance were lower following hypoxic exposure in previous studies. However, the effect of hypoxia as therapy in obese model has not been unknown. [Methods] Six-week-old mice were randomly divided into chow diet (n=10) and high-fat diet (HFD) groups (n=20). The chow diet group received a non-purified commercial diet (65 % carbohydrate, 21 % protein, and 14 % fat) and water ad libitum. The HFD group was fed an HFD (Research Diet, #D12492; 60% kcal from fat, 5.24 kcal/g). Both groups consumed their respective diet for 7 weeks. Subsequently, HFD-induced mice (12-weeks-old) were randomly divided into two treatment groups : HFD-Normoxia (HFD; n=10) and HFD-Hypoxia (HYP; n=10, fraction of inspired=14.6%). After treatment for 4 weeks, serum glucose, insulin and oral glucose tolerance tests (OGTT) were performed. [Results] Homeostatic model assessment values for insulin resistance (HOMA-IR) of the HYP group tended to be lower than the HFD group. Regarding the OGTT, the area under the curve was 13% lower for the HYP group than the HFD group. [Conclusion] Insulin resistance tended to be lower and glucose uptake capacity was significantly augmented under hypoxia. From a clinical perspective, exposure to hypoxia may be a practical method of treating obesity.

• Journal of Nutrition and Health
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• 제49권6호
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• pp.411-419
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• 2016

본 연구는 고지방식이와 쑥추출물이 흰쥐의 지질대사, 인슐린저항성, 아디포카인 분비에 미치는 효과를 측정하였다. 고지방식이에 의해 부고환지방과 복막후강지방의 축적이 증가되었고, 그 결과 혈장 항염증성 아디포카인은 감소하고 염증성 아디포카인은 증가하여 아디포넥틴/렙틴 및 아디포넥틴/PAI-1 비가 저하되는 불균형을 초래하였다. 내장지방 축적과 관련된 아디포카인의 불균형은 TG, TG/HDL-C, TC/HDL-C를 증가시키고 HOMA-IR의 증가를 유발한 것으로 추정된다. 이에 비해 쑥 에탄올추출물의 첨가는 부고환지방과 복막후강지방의 축적을 완화함으로써 PAI-1과 렙틴을 감소시켜 아디포넥틴/렙틴 및 아디포넥틴/PAI-1 비의 저하를 억제하고 아디포카인의 균형을 상대적으로 유지하였으며, TG, TG/HDL-C, TC/HDL-C 및 HOMA-IR 수치가 감소하였다. 따라서 쑥 에탄올추출물은 내장지방 축적을 억제하고 아디포카인의 분비, 특히 염증성물질인 렙틴과 PAI-1의 분비를 저하시켜 아디포카인의 균형을 조절함으로써 지질대사 및 인슐린저항성을 개선하는 효과가 있는 것으로 나타났다.