• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.315-322
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• 2009

Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.747-753
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• 2008

Purpose : Diabetes mellitus is a major risk factor for the development of cardiovascular disease. Early atherosclerotic changes in the arterial walls begin in adolescence and the risk factors are associated with its development. To assess the usefulness of carotid artery intima-media thickness (IMT), as a marker of early atherosclerosis, we evaluated the structural and functional characteristics of the carotid artery and investigated their relationshop with the metabolic and anthropometric parameters in children and adolescents with type 1 diabetes. Methods : For this study, we enrolled 23 children with type 1 diabet and 19 age and sex-equivalent healthy children as the control group. Metabolic and anthropometric parameters such as serum lipid levels, plasma glycated hemoglobin (HbA1c), and body mass index were measured after a 12-h fasting period. The carotid artery IMT was measured by a high-quality ultrasound system, and compliance, and distensibility were calculated by an equation. Results : There were no significant differences between the 2 groups with regard to the sex ratio, age, blood pressure and serum cholesterol levels' however, HbA1c levels were significantly higher in the diabetic children ($8.5{\pm}1.8$ vs. $5.0{\pm}0.2$, P=0.001). Ultrasonographic findings showed that compared with the control group, the diabetic group had higher IMT ($0.45{\pm}0.06mm$ vs. $0.41{\pm}0.04mm$, P=0.04), but there were no significant differences in compliance and distensibility. The HbA1c (P=0.002) and high-density lipoprotein cholesterol (P=0.026) levels were independent IMT predictors in the diabetic group. Conclusion : Here, the carotid artery IMT was higher in the diabetic group, and it is correlated with atherosclerotic risk factor. Thus, carotid IMT could be evaluated as a marker of early atherosclerosis in diabetic children.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.339-348
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• 2019

The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.

• Korean Journal of Community Nutrition
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• v.8 no.6
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• pp.803-813
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• 2003

Literature suggests that iron deficiency anemia is prevalent among pregnant women all over the world. This study was designed to evaluate the iron status of pregnant women during the fist five months, with the intention of determining ways to reduce the prevalence of iron deficiency anemia among pregnant women in Korea. We collected dietary information and measured the biochemical status of iron in 171 pregnant women over 16 weeks of gestation (=16.7$\pm$2.34 week). Dietary intakes for 3 days were collected using the 24 hour recall and food record methods. The daily Fe intake was measured using the food frequency method. The Body Mass Index (BMI), calculated by using the pre-pregnancy weight and height, indicated that 31.3% of subjects were under-weight. We divided the subjects into normal and anemic group by using the serum ferritin levels. It appeared that the mean dietary intake of iron was 52.3% of the recommended level for pregnant women. The dietary quality evaluation showed that pregnant women ate only 58% of the recommended amount in the food groups of meat, fish, eggs, beans and milk and dairy products. The hematological indices showed that the mean Hemoglobin (Hb) was 11.9 g/dl, Hematocrit (Hct) was 35.1%, ferritin was 23.9 $ng/ml$, and transferrin was 297.3 ${\mu}g/dl$. The dietary intake of iron was significantly lower and the vitamin C intake was significantly higher in the anemic group. The pre-pregnancy BMI was significantly lower in the anemic group. Variables affecting iron intake were the Fe intake frequency index and the food group score. The Fe index showed significantly positive correlation with the pre-pregnancy food intake and the food group score. Hb showed a significantly positive correlation with the pre-pregnancy food intake. We concluded that strategies to improve iron status be implemented in the pre-pregnant stage so as to reduce the prevalence of iron deficiency and that we should stress on the importance of an adequate diet as well as the maintenance of a heathy weight.

• Archives of Obesity and Metabolism
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• v.1 no.2
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• pp.74-77
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• 2022

Treatment of obesity includes diet therapy, exercise therapy, cognitive behavioral therapy, drug therapy, and bariatric surgery. Most obese patients lose weight by combining diet, exercise, cognitive behavioral therapy or medication. But, in some cases, only one of these treatments is preferred. A 56-year-old male patient had a body mass index (BMI) of 33.1 kg/m² and a waist circumference of 108 cm. He had been treated for hypertension; diabetes and dyslipidemia were diagnosed but not treated. However, at the initial visit to treat obesity, he was diagnosed with type 2 diabetes mellitus and dyslipidemia again. So he decided to treat these two diseases with drugs first and modify his lifestyle. He started walking more than 20,000 steps every day and then he really walked about 15,000 steps every day during 5 months, although diet calorie or alcohol drinking amount was not significantly decreased. After about 6 months, the patient's weight decreased by 10.1 kg, the BMI decreased by 4.1 kg/m², the waist circumference decreased by 10 cm, the glycated hemoglobin (HbA1c) decreased by 4.59%, the visceral fat area decreased by 115 cm², and the subcutaneous fat decreased by 38 cm². As a result of body composition analysis, muscle mass increased by 1.2 kg, and the percentage of body fat decreased by 10.4%. The walking exercise does not have any space restrictions and has high accessibility by using a mobile phone app. Therefore, considering the patient's situation, it would be better to treat obese patients by first recommending walking exercises and increasing the number of steps to lose weight and improve the comorbidities.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.19 no.6
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• pp.547-557
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• 1986

The characteristics of the three alkaline proteinases, Enz. A, B and C, from the pyloric caeca of mackerel have been investigated. The optimum condition for the activity of the Enz. A, B and C was pH 9.4, 9.8 and 9.8 at $45^{\circ}C$ for $2\%$ casein solution, and was pH 9.2 10.2 and 9.8 at $45^{\circ}C$ for $5\%$ hemoglobin denatured by urea, respectively. Enz. A, B and C by heat treatment at $50^{\circ}C$ for 5 min were inactivated 90, 33 and $37\%$, respectively, over the original activity. The reaction rate of the three alkaline proteinases was constant to the reaction time to 40 min in the reaction condition of $2{\mu}g/ml$ of enzyme concentration and $2\%$ casein solution. The reaction rate equation and Km value against casein substrate determined by the method of Lineweaver and Burk were: Enz. A, Y=3.6X and $Km=5.0{\times}10^{-3}\%$; Enz. B, Y=6.0X and $Km=1.0{\times}10^{-3}\%$; Enz. C, Y=4.2X and $Km=3.6{\times}10^{-3}\%$. The three alkaline proteinases were inactivated by $Ag^+$ and $Hg^{2+}$, but activated by $Mn^{2+},\;Sn^{2+}\;and\;Pb^{2+}$, Enz. B and C were remarkably inhibited by the soybean trypsin inhibitor. Molecular weight of Enz. A, B and C determined by SDS-polyacrylamide gel electrophoresis and Sephadex G-100 gel filtration was in the range of $27,500{\pm}2,500,\;20,500{\pm}1,500\;and\;15,250{\pm}250$, respectively.

• Proceedings of the Ginseng society Conference
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• 2007.12a
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• pp.57-58
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• 2007

Purpose: Ginseng is a well-known medical plant used in traditional Oriental medicine. Korean red ginseng (KRG) has been known to have potent biological activities such as radical scavenging, vasodilating, anti-tumor and anti-diabetic activities. However, the mechanism of the beneficial effects of KRG on diabetes is yet to be elucidated. The present study was designed to investigate the anti-diabetic effect and mechanism of KRG extract in C57BL/KsJ db/db mice. Methods: 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. During the experiment, body weight and blood glucose levels were measured once every week. At the end of treatment, we measured Hemoglobin A1c (HbA1c), blood glucose, insulin, triglyceride (TG), adiponectin, leptin, non-esterified fatty acid (NEFA). Morphological analyses of liver, pancreas and white adipose tissue were done by histological observation through hematoxylin-eosin staining. Pancreatic islet insulin and glucagon levels were detected by double-immunofluorescence staining. To elucidate an action of mechanism of KRG, DNA microarray analyses were performed, and western blot and RT-PCR were conducted for validation. Results: Compared to the DC group mice, body weight gain of PIO treated group mice showed 15.2% increase, but the other group mice did not showed significant differences. Compared to the DC group, fasting blood glucose levels were decreased by 19.8% in RGL, 18.3% in RGH, 67.7% in MET, 52.3% in GPZ, 56.9% in PIO-treated group. With decreased plasma glucose levels, the insulin resistance index of the RGL-treated group was reduced by 27.7% compared to the DC group. Insulin resistance values for positive drugs were all markedly decreased by 80.8%, 41.1% and 68.9%, compared to that of DC group. HbA1c levels in RGL, RGH, MET, GPZ and PIO-treated groups were also decreased by 11.0%, 6.4%, 18.9%, 16.1% and 27.9% compared to that of DC group, and these figure revealed a similar trend shown in plasma glucose levels. Plasma TG and NEFA levels were decreased by 18.8% and 16.8%, respectively, and plasma adiponectin and leptin levels were increased by 20.6% and 12.1%, respectively, in the RGL-treated group compared to those in DC group. Histological analysis of the liver of mice treated with KRG revealed a significantly decreased number of lipid droplets compared to the DC group. The control mice exhibited definitive loss and degeneration of islet, whereas mice treated with KRG preserved islet architecture. Compared to the DC group mice, KRG resulted in significant reduction of adipocytes. From the pancreatic islet double-immunofluorescence staining, we observed KRG has increased insulin production, but decreased glucagon production. KRG treatment resulted in stimulation of AMP-activated protein kinase (AMPK) phosphorylation in the db/db mice liver. To elucidate mechanism of action of KRG extract, microarray analysis was conducted in the liver tissue of mice treated with KRG extract, and results suggest that red ginseng affects on hepatic expression of genes responsible for glycolysis, gluconeogenesis and fatty acid oxidation. In summary, multiple administration of KRG showed the hypoglycemic activity and improved glucose tolerance. In addition, KRG increased glucose utilization and improved insulin sensitivity through inhibition of lipogenesis and activation of fatty acid $\beta$-oxidation in the liver tissue. In view of our present data, we may suggest that KRG could provide a solid basis for the development of new anti-diabetic drug.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.463-470
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• 2018

Objectives: The aim of this study was to identify the validity of phase angle as a prognostic factor for survival in patients with metastatic cancer. Methods: Data of patients with metastatic cancer who visited the Korean medicine cancer center at Kyung Hee University Hospital in Gangdong from April 2016 to February 2018 were collected for this study. The values of phase angle (PhA) and blood hemoglobin (Hb), C-reactive protein (CRP), and serum albumin levels were also investigated by bioelectrical impedance analysis (BIA). Results: In total, 86 patients were analyzed. The cut-off value of the phase angle was determined as 5.0. Univariate and multivariate analysis revealed that phase angle (HR 3.15, 95% CI 1.79-5.54) and CRP (HR 2.15, 95% CI 1.24-3.73) predicted survival with statistical significance. The median overall survival of the low PhA group ($PhA{\leq}5.0$) was 1.8 months (95% CI 0.6-2.9 months) and 7.2 months (95% CI 5.2-9.2 months) in the high PhA group (PhA>5.0)(p<0.001). Conclusions: The phase angle could be an independent prognostic factor for patients with metastatic cancer. Further research is required to confirm these findings and their correlation with other indexes.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.6
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• pp.1497-1501
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• 2006

The therapeutic anti-diabetic effect of Nelumbo Folium and a poly herbal formula (NOC) was evaluated in the streptozotocin (STZ 60 mg/kg, I.p.) induced diabetic rats. For this study, test articles were orally administrated once a day from 7 d after STZ-injection for 3 weeks. The fasting blood glucose, body weight, pancreas weight changes, oral glucose tolerance test, hemoglobin Alc (Hb A1c) level changes and the histopathological changes were observed. WNL-treated rat had lower fasting blood glucose levels compared to control group and NOC-treated rat had significantly lower fasting blood glucose levels, compared to control group (p < 0.05). After 21 days of extract treatment, body weight in control was reduced (p < 0.001). WNL and NOC groups were also reduced compared to control group but insignificantly. Pancreas weight of control group was reduced (p < 0.001), but the weight of NOC group were increased (P< 0.05). During the 2 h oral glucose tolerance test (OGTT), WNL group were improved compared to control group (P < 0.05). NOC group were improved compared to control group but insignificantly. WNL and NOC groups had lower Hb Alc level compared to control group. In addition, atrophy of islet and decrease of insulin-producing cells were detected in STZ induced diabetes rats. However, these diabetic changes were decreased in WNL and NOC groups. These results suggest that N. Folium and NOC have favorable effects to inhibit the changes on the fasting blood glucose levels, pancreas weight, glucose tolerance, hemoglobin Alc and the histopathological changes of pancreas in STZ-induced diabetes.