• Journal of Nutrition and Health
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• v.35 no.7
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• pp.737-742
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• 2002

To evaluate the effect of obesity on serum leptin and insulin levels in 80 elementary school children (aged 10.8 yr, 47 boys, 33 girls), we collected the anthropometric data and measured serum leptin and insulin levels. Serum leptin level and insulin resistance are known as factors which are associated with obesity and obesity related diseases such as diabetes, cardiovascular disease, hypertension. The results were as follows. The serum levels of insulin (p＜0.001), leptin (p＜0.001) and HOM $A_{IR}$ (p＜0.001) in obese group were significantly higher than those of other groups. The obesity indices correlated significantly to serum levels of insulin and leptin, but not to fasting glucose level. These results suggested that circulating leptin and insulin concentrations may act as a humoral signal indicator to adiposity-associated metabolic disorder in elementary school children.

• Nutrition Research and Practice
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• v.10 no.5
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• pp.507-515
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• 2016

BACKGROUND/OBJECTIVES: This study was designed to investigate whether Gynura procumbens extract (GPE) can improve insulin sensitivity and suppress hepatic glucose production in an animal model of type 2 diabetes. MATERIALS/METHODS: C57BL/Ksj-db/db mice were divided into 3 groups, a regular diet (control), GPE, and rosiglitazone groups (0.005 g/100 g diet) and fed for 6 weeks. RESULTS: Mice supplemented with GPE showed significantly lower blood levels of glucose and glycosylated hemoglobin than diabetic control mice. Glucose and insulin tolerance test also showed the positive effect of GPE on increasing insulin sensitivity. The homeostatic index of insulin resistance was significantly lower in mice supplemented with GPE than in the diabetic control mice. In the skeletal muscle, the expression of phosphorylated AMP-activated protein kinase, pAkt substrate of 160 kDa, and PM-glucose transporter type 4 increased in mice supplemented with GPE when compared to that of the diabetic control mice. GPE also decreased the expression of glucose-6-phosphatase and phosphoenolpyruvate carboxykinase in the liver. CONCLUSIONS: These findings demonstrate that GPE might improve insulin sensitivity and inhibit gluconeogenesis in the liver.

• Korean Journal of Pharmacognosy
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• v.38 no.1
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• pp.10-14
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• 2007

Type 2 diabetes mellitus relavant to insulin resistance is a chronic and hard to control. In order to develop an antidiabetic agent from natural products, anti-hyperglycemic effect of herbal formula containing Mori Follium, Euonymi Lignum Suberalatum and Ginseng Radix(MEG) was investigated in db/db mice. Treatment group was administered orally with MEG formula at a dose of 300 mg/kg for 5 weeks, and blood glucose, insulin and lipid levels were determined. MEG treatment group showed a marked decrease in fasting blood glucose level and insulin resistance index(IRI) compared to those in diabetic control. Improvement of insulin resistance(60.6%) was indicative of reducing lipid levels in plasma and triglyceride contents in muscle and adipose tissue. In addition, expressions of an insulin responsive gene, glucose transporter 4(Glut4), in muscle and adipose tissue were upregulated in MEG treatment group. Compared islet morphology between groups, MEG formula prevented the ${\beta}$-cell destruction caused by high blood glucose. Taken together, MEG formula can act as an anti-hyperglycemic agent with insulin sensitizing effect, and thus deserves a clinical trial in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.228-238
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• 2004

Purpose: Obesity is rapidly increasing in Korean children. Obesity is a risk factor for cardiovascular morbidity and is frequently associated with hypertension, diabetes mellitus and coronary artery disease. This study was designed to evaluate risk factors of the metabolic syndrome in obese children. Methods: From February 2000 to June 2004, eighty eight obese (body mass index ${\geq}95th$ percentile) children aged 4 to 15 years were included. We measured serum lipid levels (total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol), fasting sugar levels and insulin levels. Insulin resistance was determined by homeostasis model assessment, fasting insulin/glucose ratio and quantitative insulin sensitivity check index. Results: Clustering of risk factors for the metabolic syndrome in obese children demonstrated that 60.2% had more than one risk factors. Hypertension (14.8%), hypertriglyceridemia (14.8%), HDL-hypocholesterolemia (14.8%), LDL-hypercholesterolemia (12.5%) and hyperinsulinemia (12.5%) were observed. As BMI increased, there was statistically significant increase in systolic blood pressure, insulin and insulin resistance values. Insulin resistance was correlated to systolic blood pressure, serum lipid and insulin levels. The more risk factors for the metabolic syndrome obese children had, the higher was their insulin resistance. Conclusion: The increase in insulin resistance and clustering of risk factors for the metabolic syndrome are already apparent in obese children. Monitoring these risk factors for the metabolic syndrome should become a part of routine medical care for obese children.

• Korean Journal of Community Nutrition
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• v.17 no.5
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• pp.530-542
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• 2012

The purposes of this study were to investigate blood profiles and nutrient intakes of groups that are different in obese levels, and to find the credible predictor of insulin resistance. The subjects were classified as normal weight (%IBW${\leq}$ 110), obese without MS and obese with MS according to IDF definition of the risk group in metabolic syndrome (MS). Subjects of this study were included 137 (59 boys, 78 girls) free living children and adolescents (mean age $12.6{\pm}3.4$ years) in Gangneung area, South Korea. %IBW of normal weight (94.9%), obese without MS (123.8%) and obese with MS (131.5%) were significantly different among groups. HOMA-IR had positive correlations with TG (r = 0.634), waist circumference (r = 0.553), atherogenic index (r = 0.513), %IBW (r = 0.453) and ALT (r = 0.360), but showed negative correlations with HDL cholesterol (r = -0.417, p < 0.001). HOMA-IR showed positive correlation with polyunsaturated fatty acid intake (p < 0.05). The energy intake of obese with MS was 1762 kcal/day which was not significantly different from those of normal weight and obese without MS. Total fatty acid intakes of two obese groups were significantly higher than that of normal weight. The results of this study suggest that waist circumference and ALT as well as TG, atherogenic index and weight can be credible indices to predict the insulin resistance in children and in adolescents. In addition, nutrition education and adequate diet should be provided to prevent MS in children and in adolescents.

• Korean Journal of Exercise Nutrition
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• v.16 no.1
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• pp.11-17
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• 2012

The purposes of this study were to investigate the effects of acute exercise on blood vaspin, glucose level, and inflammatory cytokines in middle-aged women with pre-diabetes. Nineteen middle-aged women (normal women, n = 11) and women with pre-diabetes(n = 8), who were apparently healthy and not taking any medications affecting their blood pressure or blood glucose, participated. Body fatness parameters including body mass index, body fat percentage, and waist circumference were measured using a bio-impedance analyzer. Resting blood pressure was measured in duplicate, and mean values were used for the data analysis. Regardless of group assignments, all subjects participated in a 3-day consecutive walking exercise at an intensity of 65% VO_2max targeting an energy expenditure of 1200 kcal (400 kcal per day). The major outcome variables included total cholesterol, triglycerides, high-density lipoprotein cholesterol, glucose, vaspin, interleukin-6, and adiponectin levels. Unlike normal women, women with pre-diabetes had a significant improvement in the homeostatic model assessment of insulin resistance (p < 0.025) with no significant group difference in response to acute exercise. The findings suggest that acute exercise results in a significant improvement in insulin sensitivity without any change in serum vaspin levels in women with pre-diabetes.

• Korean Journal of Community Nutrition
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• v.16 no.1
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• pp.126-135
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• 2011

Obesity is characterized by increased storage of fatty acids in an adipose tissue and closely associated with the development of insulin resistance and cardiovascular diseases (CVD) through secretion of adipokines. This study was done to compare serum insulin, leptin, adiponectin and high sensitivity C-reactive protein (hs-CRP) levels according to body masss index (BMI) in Korean adult women aged 19 to 50. In addition, we examined the association of BMI, serum lipids and Homa-IR with serum adiponectin, leptin and hs-CRP levels. The subjects were divided into 3 groups by their BMI, normal weight (BMI ${\leq}$ 22.9, n = 30), overweight (23.0 ${\leq}$ BMI ${\leq}$ 24.9, n = 71) and obese group (25.0 ${\leq}$ BMI, n = 59). Serum levels of total-cholesterol, TG, and LDL-cholesterol were significantly higher in obese group than in normal weight group. LDL/HDL ratio and AI were significantly higher in obese group than in normal or overweight group. Fasting serum levels of glucose and insulin and Homa-IR as a marker of insulin resistance were significantly higher in obese group than in overweight group. Serum leptin level was significantly higher in obese group while serum adiponectin level was significantly lower in obese group compared to other two groups. hs-CRP was significantly increased in obese group. Correlation data show that serum adiponectin level was positively correlated with serum HDLcholesterol level and was negatively correlated with BMI, WC, TG, LDL-cholesterol, Homa-IR, hs-CRP and leptin. In addition, serum leptin level was positively correlated with BMI, WC, glucose, insulin, Homa-IR and hs-CRP. These results might imply that the regulation of key adipokines such as adiponectin might be a strategy for the prevention or treatment of obesity-associated diseases such as diabetes and CVD.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.4
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• pp.374-379
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• 2021

Objective: We aimed to evaluate associations between the ratio of serum estrone (E1) to estradiol (E2) and parameters related to serum glucose metabolism and insulin resistance in women with polycystic ovary syndrome (PCOS). Methods: In total, 133 women between the ages of 18 and 35 diagnosed with PCOS were enrolled in this study. All participants with PCOS underwent blood tests to determine hormonal and biochemical metabolic parameters and a standard 2-hour 75-g oral glucose tolerance test. They were divided into two groups according to the serum E1-to-E2 ratio: group 1 (E1/E2 ratio <2.0) and group 2 (E1/E2 ratio ≥2.0). Results: In the comparative analysis, the waist-to-hip ratio (WHR) was the only clinical variable that was significantly different between the two groups. Patients with a higher E1/E2 ratio showed higher fasting insulin levels, homeostasis model for insulin resistance, and postprandial glucose level at 2 hours (PPG2). In a correlation analysis, only PPG2 was significantly related to the serum E1/E2 ratio. However, after controlling for the confounding effects of body mass index (BMI) and WHR, fasting glucose was also significantly correlated with the serum E1/E2 ratio. Conclusion: Women with PCOS with a higher serum E1/E2 ratio were found to be more likely to show higher fasting insulin and postprandial glucose levels. Significant correlations were found between the serum E1/E2 ratio and both fasting and postprandial serum glucose levels after adjusting for BMI and WHR in women with PCOS.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.764-772
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• 2002

Purpose : Obesity is closely related to insulin resistance, compensatory hyperinsulinemia and dyslipidemia in adults. We identified the effect of obesity measured by BMI and insulin resistance on dyslipidemia in children and adolescents. Methods : The fasting serum insulin, glucose, total cholesterol, triglyceride, HDL- and LDL-cholesterol were measured and insulin resistance(HOMA-IR) was calculated in 35 children with simple obesity(age :$10.6{\pm}2.8$ years; male 20, female 15; BMI : $27.1{\pm}5.4kg/m^2$). Results : The hypertriglyceridemia(37%), hyperinsulinemia(54%) and HDL-hypocholesterolemia(5.7%) were observed. HOMA-IR was well expressed by fasting insulin. As BMI increased, there was a statistically significant increase in insulin resistance and insulin level in both sexes. BMI was not related with lipid profile in both sexes. Triglyceride was correlated with only insulin level and insulin resistance index in boys. In girls, there was no correlation between triglyceride, HDL-cholesterol and insulin(insulin resistance). Conclusion : These results suggest that hypertriglyceridemia was dependent on insulin resistance in pre-adult males. Monitoring of insulin resistance and those risk factors known to become a part of insulin resistance syndrome should become part of routine medical care for obese children.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.370-375
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• 2009

Purpose : The risk of metabolic syndrome (MS) and cardiovascular disease in Turner syndrome (TS) patients is high. We analyzed metabolic factors in adults with TS and evaluated the metabolic risk of insulin resistance. Methods : Forty-three adults with TS were enrolled. The frequency of MS and the values of the metabolic factors were analyzed. Patients were divided into insulin resistant and non-resistant groups according to values of homeostasis model assessment of insulin resistance (HOMA-IR). The correlations of HOMA-IR with metabolic parameters were analyzed. Results : The frequency of MS was 7% and those of each metabolic parameter were as follows: insulin resistance, 16.3%; central obesity, 15.4%; hypertriglyceridemia, 2.3%; low HDL cholesterol, 9.3%; hypertension, 36.8%. The insulin-resistant group had significantly higher values of body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), HOMA-IR, and systolic blood pressure (SBP) than the non-resistant group (P<0.05). HOMA-IR showed a significantly positive correlation with BMI, WC, FPG, and SBP and showed a negative correlation with HDL cholesterol. Conclusion : This study suggests that adults with TS have a high risk of metabolic syndrome, and insulin resistance is correlated with metabolic factors. Therefore, TS patients should have their metabolic parameters monitored regularly to minimize metabolic complications and prevent cardiovascular diseases.