• 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.

• 대한임상검사과학회지
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• 제41권2호
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• pp.62-66
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• 2009

HbA1c is the major fraction of glycated hemoglobin, and used primarily to identify the average plasma glucose concentration over prolonged periods of time, mostly 2-3 months. It is used as markers for the diagnosis and monitoring of diabetic patients and increasingly used a marker in health screening check up for general populations. In this study, HbA1c was measured with Cobas integra 800 (Roche Diagnostics, Mannheim, Germany), using immunoturbidimetry principles. We established the reference interval for HbA1c with Cobas integra 800 and evaluated its significance. The study subjects were 36,140 (male 57.5%, and female 42.2%) who visited the Health Promotion Center of a tertiary care center in Seoul for health checkup from January to September, 2008. HbA1c levels were measured with immunoturbidimetric method. Statistical evaluation was done with SPSS. Comparison between male and female was checked with Mann-Whitney test, and among age groups with Kruskal-Wallis test. Reference interval for HbA1c was from 4.8% to 6.1%. There was no significant difference between male and female with Mann-Whitney test (P=0.539). There was significant difference among age groups with Kruskal-Wallis test (P<0.05). Reference interval for HbA1c with Cobas integra 800 was 4.8~6.1%, which was different from conventional one, 4.4-6.4%. Establishment of reference interval for each principle is needed.

• 한국식품영양학회지
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• 제26권4호
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• pp.909-918
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• 2013

The objective of this study is to investigate the effects of dietary nutrient intakes for markers of blood glucose and inflammation which is important to the progress of type 2 diabetes and the development of its complications. For this study, 76 adults with diabetes (42 males, 34 females) were recruited from a group of patients who had visited the department of endocrine medicine. Data on anthropometric characteristics, clinical indices such as hemoglobin A1c (HbA1c) and C-reactive protein (CRP), and dietary nutrient intakes were collected. Our results have shown that 66% of subjects were either overweight or obese. Serum analysis indicates that levels of C-peptide, glucose, HbA1c, CRP, triglyceride, LDL-cholesterol were higher than normal range. Results from the dietary nutrient intake survey displayed that intakes of cholesterol and sodium were higher than Dietary Reference Intakes for Koreans. On the contrary, folate intake was lower than the guideline. Within the females, energy contribution from carbohydrate was higher than Korean Diabetes Association guideline. Statistical analysis has revealed a negative correlation between serum HbA1c level and dietary intakes of polyunsaturated fatty acid (PUFA), n-3 PUFA, ${\beta}$-carotene and vitamin E after adjustments for age, BMI, smoking habits, alcohol consumption, exercise and ingestion of diabetes mellitus medication (p<0.05). Serum CRP level was inversely associated with dietary intakes of carbohydrate, protein, vitamin C and fiber (p<0.05). Our results suggest that dietary nutrient intakes may influence the levels of HbA1c and CRP, and subsequently, it may help in the management/treatment of type 2 diabetes.

• Journal of Obesity & Metabolic Syndrome
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• 제27권4호
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• pp.238-247
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• 2018

Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

• The Journal of Korean Physical Therapy
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• 제22권6호
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• pp.65-70
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• 2010

Purpose: Exercise has been shown to be a simple and economical therapeutic modality that may be considered as an effective aid for diabetic mellitus. For example, exercise training increases insulin sensitivity in type 2 diabetes. But we found no reported of how exercise affect type 1 diabetes. This study investigated the impact of aerobic and graduated treadmill exercise regimens on body weight, glucose and insulin concentrations, lipid profiles, and oxidative stress indicators in rats with streptozotocin (STZ) induced diabetes. Glycosylated hemoglobin ($HbA_{1c}$) was determined as an indicator of glucose control during exercise. Methods: In our study, a total of 40 rats were used. Three groups of 10 rats each were given STZ to induce diabetes. The remaining 10 rats became the normal group. After 28 days we determined biochemical parameters such as glucose, glycosylated hemoglobin ($HbA_{1c}$), insulin concentration, serum total cholesterol (TC), triglycerides (TG), and high-density lipoprotein (HDL). Superoxide dismutase (SOD) and catalase activities were also measured. Results: Concentrations of blood glucose and $HbA_{1c}$ in the moderated exercise groups were significantly decreased after 28 days compared with the control group (p<0.05). There was a significant reduction in serum TC and TG in the experimental groups. The activity of SOD increased significantly by 17.70% and 48.25% respectively. Conclusion: These results indicate that physical training and exercise training affects body weight, fasting blood glucose, $HbA_{1c}$, insulin, lipid profiles, and antioxidant status in rats with streptozotocin-induced diabetes. We suggest that graduated treadmill exercise may have therapeutic, preventative, and protective effects against diabetes mellitusby improving glycemic control, oxidant defenses, and lipid metabolism.

• 대한임상검사과학회지
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• 제55권1호
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• pp.9-15
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• 2023

본 연구의 목적은 당뇨 검사결과와 간기능검사와의 관계연구이다. 간성당뇨는 제2형 당뇨와는 다르게 간기능 이상으로 기인하는 것이다. 본 연구에서 간기능 검사의 주요 효소검사인 아스파르트산 아미노전이효소(aspartate aminotransferase, AST), 알라닌 아미노전이효소(alanine aminotransferase, ALT) 그리고 AST/ALT ratio (De Ritis ratio)와 당뇨관련 검사와의 관계를 주로 확인하였다. 연구 결과 AST와 글루코스(glucose) (r=0.14, P<0.01); ALT 및 글루코스(r=0.21, P<0.01); AST 및 당화혈색소(HbAlc) (r=0.15, P<0.01); ALT와 HbAlc (r=0.20, P<0.01), 모든 변수는 양의 상관관계를 나타났으며, De Ritis ratio는 글루코스 (r=-0.20, P<0.01)와 당화혈색소 (r=-0.14, P<0.01)와 음의 상관관계를 보였다. AST와 ALT 그리고 De Ritis ratio 를 독립변수로 하고 글루코스 (R²=0.05) 와 HbA1c (R²=0.04) 를 종속변수로 하여 회귀분석한 결과 독립변수는 종속변수에 통계적으로 유의하게 영향을 나타내는 것으로 나타났다. AST는 ALT 보다 혈당과 당화혈색소에서 상관관계가 낮게 나타났으며, ALT가 증가하는 것은 즉, De Ritis ratio 감소의 원인이 된다. 따라서, De Ritis ratio는 당뇨관련 검사와의 관계에서 의미가 있는 것으로 볼 수 있다.

• 치위생과학회지
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• 제17권4호
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• pp.290-297
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• 2017

이 연구는 한국 성인의 HbA1c 조절 상태에 따른 구강건강상태를 비교하고자 제 6기 국민건강영양조사에 참여하여 HbA1c를 측정한 만 19세 이상 4,991명을 대상으로 연구를 진행한 결과 다음과 같은 결론을 얻었다. HbA1c의 조절 상태가 HbA1c ${\geq}6.6$인 당뇨 집단은 7.2%였으며 성별로는 여자 5.9%, 남자 8.5%였다. 당뇨 집단의 비율은 연령이 증가할수록, 월 평균 가구 소득과 교육수준이 낮을수록 높아졌다. T-Health 지수와 FS-T 지수는 건강 집단의 남자와 여자가 약간 높았고. 연령이 낮아질수록, 월 평균 가구 소득과 교육수준이 높아질수록 T-Health 지수가 높았다. MT 지수는 당뇨 집단에서 여자(3.775개)가 남자(2.317개)보다 많았다. 또한 연령이 증가할수록 상실치수는 높아졌고, 소득과 교육수준은 높아질수록 상실치수는 적어졌다. T-Health 지수는 건강 집단에서 여자 대비 남자가 3.346점 높았고, 70세 이상 대비 50대에서 15.130점, 60대가 7.944점 높았다. 당뇨 집단의 월 평균 가구 소득이 상인 집단 대비 하인 집단이 5.715점 낮았고, 교육수준에서는 중졸 이하가 7.437점, 중졸이 4.822점 낮았다. FS-T 지수는 건강 집단의 여자 대비 남자가 0.536점 낮았고, 70세 이상 대비 60대가 4.622점, 40대가 10.805점으로 연령이 낮아질수록 점수는 높아졌다. 건강 집단의 월 평균 가구 소득이 상 집단 대비 하 집단이 1.467점 낮았고, 교육수준 또한 대졸 이상 대비 초졸 이하가 2.534점 낮았다. MT 지수는 연령별 건강 집단의 70세 이상 대비 60대가 2.382개, 50대 4.374개, 40대 4.643개 적었다. 교육수준별에서는 건강 집단의 대졸 이상 대비 초졸 이하가 1.385개 많았고, 당뇨 집단에서는 초졸 이하가 2.328개 많았다. 결론적으로 구강 건강 문제에 관한 상담 및 교육을 지속적으로 제공함으로써 구강건강 관리의 중요성에 대한 인식을 넓히고, HbA1c 수준에 따라 당뇨병 환자를 관리할 수 있는 의료 및 구강보건과 관련된 다양한 매체 및 교육 방법이 개발되어야 한다.

• 센서학회지
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• 제25권6호
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• pp.435-439
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• 2016

We report a novel detection technology for glycated hemoglobin (HbA1c) that is measured primarily to identify the three-month average plasma glucose concentration. In enzymatic measuring of glycated hemoglobin, the generated hydrogen peroxide was then used as a reducing agent of gold (III) for the synthesis of gold (0). Gold nanoparticles obtained from this novel approach were measured by optical and piezoelectric methods. In optical method, we have developed polymer based film-type sensor cartridge filled with all the reagents for glycated hemoglobin analysis and the cartridge worked very well having the detection limit of 0.53% of glycated hemoglobin. On the other hand, quartz crystal microbalance (QCM) sensors also have been developed to determine the abilities of surface modified QCM sensors at various levels of the concentration of glycated hemoglobin to bind gold nanoparticles and limit of detection was 0.90%. Finally, despite of relatively lower sensitivities of QCM sensor and film-type optical sensor than well-plate based optical detection, these two sensors were available to measure the glycated hemoglobin level for diabetes patients and normal person.

• Bulletin of the Korean Chemical Society
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• 제31권7호
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• pp.2103-2106
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• 2010

• Journal of Microbiology and Biotechnology
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• 제27권1호
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• pp.26-35
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• 2017

The hydrolysis of proteins constitutes an invaluable tool, granting access to a variety of peptide fragments with potentially interesting biological properties. Therefore, a hemoglobin (Hb) hydrolysate of Crocodylus siamensis was generated by digestion under acidic conditions. The antibacterial and antioxidant activities of the Hb hydrolysate were assessed in comparison with intact Hb. A disc diffusion assay revealed that the Hb hydrolysate exhibited antibacterial activity against eight strains of gram-positive bacteria and showed a higher efficacy than intact Hb. Moreover, the antioxidant activity of intact Hb and its hydrolysate was evaluated using ABTS and DPPH radical scavenging assays. The Hb hydrolysate exhibited free radical scavenging rates of 6-32%, whereas intact Hb showed a slightly higher activity. In addition, non-toxicity to human erythrocytes was observed after treatment with quantities of Hb hydrolysate up to $10{\mu}g$. Moreover, active fragmented Hb (P3) was obtained after purifying the Hb hydrolysate by reversed-phase HPLC. Scanning electron microscopy demonstrated the induction of bacterial cell membrane abnormalities after exposure to P3. Antibacterial and antioxidant activities play crucial roles for supporting the wound healing activity. Consequently, an in vivo mice excisional skin wound healing assay was carried out to investigate the effects of intact Hb treatment on wound healing in more detail. The results clearly demonstrate that intact Hb is capable of promoting 75% wound closure within 6 days. These findings imply that intact Hb of C. siamensis and its acid hydrolysate may serve as valuable precursors for food supplementary products benefitting human health.