• Journal of Nutrition and Health
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• 제46권1호
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• pp.61-71
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• 2013

The aim of this study was to examine the relationship between dietary variables and the prevalence of insulin resistance (IR) in middle-aged Korean adults using data from the 2007-2009 Korea National Health and Nutrition Examination Survey. Because IR is closely linked with metabolic syndrome, subjects were divided into three groups according to symptoms of metabolic syndrome: the 'Normal group' without any symptoms, the 'Risk group' with one or two symptoms, and the Metabolic syndrome (MetS) group' with three or more symptoms. Subjects between the ages of 30 and 65 years with no prior diagnosis or treatment for diabetes, hypertension, or dyslipidemia were selected. The number of subjects per group was as follows: 2,085 adults in the Normal group, 3,699 adults in the Risk group, and 1,160 adults in the MetS group. Metabolic syndrome was defined according to Adult Treatment Panel III criteria with modified waist circumference cutoff values (men ${\geq}$ 90 cm, women ${\geq}$ 85 cm). Subjects with HOMA-IR > 2.0 were classified as IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated using the following formula: (fasting plasma glucose ${\times}$ fasting plasma insulin)/22.5. Nutrients and food groups intake were obtained from a single 24-hour recall. Subjects with IR in the Normal group were more obese and less physically active than non-IR subjects. In the MetS group, subjects with IR were more obese and had a lower prevalence of smoking and drinking, compared with non-IR subjects. Men with IR in the Normal group had a tendency to consume more oils and sugars than non-IR men, while women with IR in the same group had higher intake of carbohydrate, dietary glycemic index, and dietary glycemic load than non-IR women. Women with IR in the Risk group had lower energy intake but higher intake of oils and sugars than non-IR women. In the MetS group, consumption of fruits was higher in subjects with IR than in non-IR subjects. In conclusion, findings of this study suggest that dietary carbohydrate intake, including glycemic index, may be associated with IR in healthy women. Further research in prospective cohort studies in order to examine the effects of dietary carbohydrate on IR incidence will be necessary.

• Clinical and Experimental Reproductive Medicine
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• 제32권2호
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• pp.155-164
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• 2005

Objective: This study was performed to investigate the effects of pioglitazone, an insulin sensitizing agent, on insulin resistance, ovarian function and intraovarian stromal blood flow in patients with polycystic ovarian syndrome (PCOS). Material and Methods: Thirty patients with PCOS, aged 18~34 years, were recruited. Criteria for diagnosis of PCOS were as defined in 2003 Rotterdam consensus. They were treated for 6 months with pioglitazone at a dose of 30 mg/day orally. The hormonal blood profile, fasting serum glucose levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and an ovarian stromal artery (OSA) blood flow were assessed at baseline and after 6 months of treatment. Results: Eighteen (60.0%) of 30 patients treated with pioglitazone demonstrated a spontaneous ovulation After pioglitazone treatment, fasting insulin concentrations, serum glucose levels after 75 g OGTT significantly decreased (p=0.001, p=0.04, respectively), and fasting glucose to insulin (G/I) ratio significantly increased (p<0.001). The pioglitazone treatment induced a significant reduction in serum LH, testosterone (T) and free T levels (p<0.001, p=0.02, p=0.002, respectively). The resistance index (RI) values of OSA significantly increased after treatment (p<0.001). In analyzing pioglitazone-treated patients according to their body mass index (BMI), nonobese group as well as obese group showed a significant improvement in fasting G/I ratio (p<0.01). The pioglitazone treatment induced a significant reduction in serum LH and free T levels in nonobese group (p<0.001, p<0.05, respectively) as well as obese group (p=0.001, p<0.05, respectively). The RI values of OSA significantly increased in both nonobese and obese groups after pioglitazone treatment (p<0.001, p=0.003, respectively). Conclusions: Pioglitazone could ameliorate the glycoinsulinemic metabolism, and this beneficial effects of this drug could improve the endocrine-reproductive condition associated with the decrease of ovarian stromal artery blood flow, in both nonobese and obese patients with PCOS.

• Archives of Pharmacal Research
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• 제27권7호
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• pp.790-796
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• 2004

Ginseng is a shade-loving perennial herb that is cultivated mainly in Korea, Japan, and China. The ginseng root has been used as a tonic remedy, and its antidiabetic activity has been demonstrated as early as 1920s. Although wild ginseng was anecdotally thought to be superior to cultivated ginseng as far as pharmacological properties were concerned, there have been no prior reports on the antidiabetic effect of wild ginseng. In this study, we investigated the preventative anti-diabetic and anti-obese effects of wild ginseng ethanol extract (WGEE). In the preventive experiment, WGEE co-administered with a high fat diet significantly inhibited body weight gain, fasting blood glucose, triglyceride, and free fatty acid levels in a dose dependent manner. WGEE-treated mice at doses of 250 and 500 mg/kg improved the insulin resistance index by 55％ and 61％ compared to the high fat diet (HFD) control, respectively. Diameters of white and brown adipocytes were also decreased by 62％ and 46％ in the WG500-treated group compared to those in HFD fed control mice. Taken together, WGEE has potential as a preventive agent for type 2 diabetes mellitus (and possibly obesity) and deserves clinical trial in the near future.

• 대한임상검사과학회지
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• 제54권2호
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• pp.149-156
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• 2022

본 연구는 지질 축적 지수(lipid accumulation product, LAP)는 중심 지질 축적을 반영하는 새로운 지표로서, 심혈관 위험이나 당뇨병의 강력한 위험인자로 알려져 있다. 본 연구의 목적은 대한민국 20 성인에서 비만의 유무에 따른 지질 축적 지수와 인슐린저항성(homeostasis model assessment of insulin resistance, HOMA-IR)의 관련성에 대하여 조사하였다. 본 연구는 2019년도 국민건강영양조사 자료(2019 Korean National Health and Nutrition Examination Survey, KNHANES V-3)를 이용하여 20세 이상의 대한민국 성인 6,090명을 대상으로 실시하였다. 본 연구결과에서 중요한 결과는 다음과 같다. 첫째, 연령, 성별, 음주습관, 흡연습관, 운동습관, 수축기 및 이완기혈압, 혈중 요소 질소 및 크레아티닌을 보정한 후의 결과에서, 전체인구(P<0.001), 비만이 아닌 군(P<0.001) 및 비만군(P<0.001)에서 LAP의 사분위수가 증가함에 따라 HOMA-IR 평균값(M±SE, 95% confidence interval)이 증가하였다. 둘째, 전체인구, 비만이 아닌 군 및 비만군에서, 공복혈당(모든 그룹, P<0.001), 인슐린(모든 그룹, P<0.001) 및 대사증후군 점수(모든 그룹, P<0.001)의 평균값(M±SE, 95% CI)은 LAP의 사분위수가 증가함에 따라 증가하였다. 결론적으로, 대한민국 성인 중 비만군과 비만이 아닌 군 모두에서 지질 축적 지수가 증가함에 따라 인슐린저항성이 증가하였다.

• 보건교육건강증진학회지
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• 제26권2호
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• pp.149-155
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• 2009

Metabolically obese but normal weight(MONW) syndrome is characterized, with potentially increased risks for development of the insulin resistance or metabolic syndrome despite their normal body mass index(BMI) < 25 kg/m2. Such characteristics could confer upon MONW individuals a type 2 diabetes mellitus and cardiovascular diseases(CVD) risk however, research on MONW is scarce. MONW individuals have metabolic disturbances typical of obese persons and are identified by having a high amount of visceral fat, a low BMI, a high fat mass, a low lean body mass, low insulin sensitivity, and high triglyceride concentrations. The purpose of this study is to review several markers as potential modulators in individuals displaying the "MONW". Body fat appears to be functionally comparable with a dynamic endocrine organ, producing and secreting various adipocy tokines, such as leptin, adiponectin, CRP, tumor necrosis factor(TNF-), interleukin(IL)-6, all of which play an important role in the onset of cardiovascular disease, and insulin resistance. Otherwise, physical activity and a lower inflammation state might be helped to reduce the number of persons at risk of diabetes, CVD complications, or premature mortality. We should provide a method to optimal treatments resolving the emerging public health problem to prevention of MONW by providing guideline for physical activity as an optimal treatment for the MONW Korean. Furthermore we expect to develop a new strategy to manage MONW Korean in this society in terms of reducing medical costs and enhancing public health care for uprising population with MONW.

• Preventive Nutrition and Food Science
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• 제21권2호
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• pp.104-109
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• 2016

In the current study, we investigated the longitudinal association between dietary acid load and the risk of insulin resistance (IR) in the Tehranian adult population. This longitudinal study was conducted on 925 participants, aged 22~80 years old, in the framework of the third (2006~2008) and fourth (2009~2011) phases of the Tehran Lipid and Glucose Study. At baseline, the dietary intake of subjects was assessed using a validated semi-quantitative food frequency questionnaire, and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated at baseline. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up; IR was defined according to optimal cut-off values. Multiple logistic regression models were used to estimate the risk of IR according to the PRAL and NEAP quartile categories. Mean age and body mass index of the participants were 40.3 years old of $26.4kg/m^2$, respectively. Mean PRAL and NEAP scores were -11.2 and 35.6 mEq/d, respectively. After adjustment for potential confounders, compared to the lowest quartile of PRAL and NEAP, the highest quartile was accompanied with increased risk of IR [odds ratio (OR)=2.81, 95% confidence interval (CI)=1.32~5.97 and OR=2.18, 95% CI=1.03~4.61, respectively]. Our findings suggest that higher acidic dietary acid-base load, defined by higher PRAL and NEAP scores, may be a risk factor for the development of IR and related metabolic disorders.

• 한방비만학회지
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• 제5권1호
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• pp.121-131
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• 2005

During last few decades dietary guidelines for the weight management mainly have focused on a low-fat, high carbohydrate diet. Carbohydrate was supposed to be low-dense, highly satiating as well as it affects little on the lipogenesis. Although low-fat diet has significant weight-reducing effect, the loss was modest and usually regained after cessation of the diet. Furthermore, low-fat, modest-carbohydrate diet did not impact on the ever increasing rates of overweight and obesity. Alternative approaches include low-carbohydrate diet, high-carbohydrate diet and low-glycemic index diet. Although none of above mentioned diet have sufficient evidence for standard weight management diet, short-term efficacy and safety are being approved continuously. Low-carbohydrate diet contains less than 45% of carbohydrate in daily energy consumption, it is claimed to have more satiating effect and to improve metabolism. However, low compliance due to the limitation of food choice should be considered on prescribing the diet. High-carbohydrate which contains 90% of carbohydrate in total daily energy consumption, is effective in providing satiety and lowering total calorie intake and cholesterol. On the other hand, nutritional unbalance should be took into account. Low-glycemic index diet is based on the theory that contemporary diet contains significantly less fiber and unrefined carbohydrate, therefore insulin secretion is disturbed. Because low glycemic index food slowly increase blood glucose and insulin level, it induces much satiating effect and may decrease calorie ultimate intake. However, poor standardization of glycemic index is one of the main obstacle for the diet to be applied in the clinic. Meanwhile, high fructose food and beverage should be discouraged because it has little satiating effect and may cause insulin resistance. High fiber food is another recommendation for healthy, lean diet.

• Clinical and Experimental Reproductive Medicine
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• 제21권1호
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• pp.83-88
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• 1994

This study was designed to investigate the relationship between insulin resistance and obesity in the pathogenesis of polycystic ovarian syndrome(PCO). Twenty-two women with PCO, of whom thirteen were non-obese with body mass index(BMI, kg/$m^2$) of <25 and nine were obese with BMI${\geq}$25 were studied. Eight non-obese control women and seven obese control women were studied. Serum concentrations of testosterone, lutenizing hormone(LH)/follicle-stimulating hormone(FSH) ratio, and insulin-like growth factor I (IGF-I) were found to be significantly higher(P<0.05) in PCO women compared with control women, which clearly is not related to obesity. Serum glucose, insulin, and C-peptide levels were measured during a 2-hour oral glucose tolerance test(OGTT). Non-obese and obese women with PCO both(P<0.05) compared with control women demonstrated significant hyperinsulinemia after OGTT. The degree of hyperinsulinemia was found to be significantly higher in the obese women with PCO compared with the non-obese women with PCO. We concluded that obesity may contribute to hyperinsulinemia, however may not playa central role in the pathogenesis of PCO.

• Clinical and Experimental Reproductive Medicine
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• 제50권3호
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• pp.200-205
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• 2023

Objective: Polycystic ovary (PCO), a diagnostic component of polycystic ovary syndrome (PCOS), requires either an ovarian volume (OV) criterion or a follicle number per ovary (FNPO) criterion. This study investigated the association of OV and FNPO criteria with various manifestations of PCOS. Methods: This cross-sectional study was conducted at a university hospital among 100 patients newly diagnosed with PCOS (according to the revised Rotterdam criteria). Fasting blood samples were collected to measure glucose, total testosterone (TT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), lipid, insulin, and hemoglobin A1c levels. An oral glucose tolerance test was performed. Transabdominal or transvaginal ultrasound of the ovaries was done, depending on patients' marital status. All investigations were conducted in the follicular phase of the menstrual cycle. OV >10 mL and/or FNPO ≥12 indicated PCO. A homeostasis model assessment of insulin resistance (IR) value ≥2.6 indicated IR, and metabolic syndrome (MS) was defined according to the international harmonization criteria. Results: Seventy-six participants fulfilled the OV criterion, 70 fulfilled the FNPO criterion, and 89 overall had PCO. Both maximum OV and mean OV had a significant correlation with TT levels (r=0.239, p=0.017 and r=0.280, p=0.005, respectively) and the LH/FSH ratio (r=0.212, p=0.034 and r=0.200, p=0.047, respectively). Mean OV also had a significant correlation with fasting insulin levels (r=0.210, p=0.036). Multivariate binary logistic regression analysis showed that IR (odds ratio [OR], 9.429; 95% confidence interval [CI], 1.701 to 52.271; p=0.010) and MS (OR, 7.952; 95% CI, 1.821 to 34.731; p=0.006) had significant predictive associations with OV alone, even after adjustment for age and body mass index. Conclusion: OV may be more closely related to the androgenic and metabolic characteristics of PCOS than FNPO.

• 한국산림과학회지
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• 제98권6호
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• pp.681-689
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• 2009

8주간 옻나무 추출액을 섭취하며 운동을 병행하였을 때 혈중 지질 성분, 인슐린 저항성에 미치는 영향에 대해 연구하였다. 6주된 SD계 수컷 쥐를 대상으로 CON(대조군), RVS(추출액 섭취군), EXE(운동군), 그리고 RVS-EXE(추출액 섭취와 운동 병행군)로 구분하였다. 각 집단의 체중은 EXE(202%)와 RVS-EXE(203%)가 CON(253%)과 RVS(239%)에 비해 통계적으로 유의하게 낮은 증가를 보였다. 저장지방은 옻나무 추출액 혹은 운동에 의해 유의하게 감소하는 것으로 나타났다. 혈중 지질성분은 RVS와 RVS-EXE에서 CON에 비하여 통계적으로 유의하게 개선되는 것으로 나타났다. 혈중 글루코스는 CON에 비하여 다른 집단에서 유의하게 낮은 것으로 나타났으며, 인슐린 역시 동일하였으나, RVS-EXE에서 유의한 상승작용이 나타났다. HOMA 지수는 인슐린과 동일한 결과를 나타내었다. 이와 같은 결과를 종합해 볼 때 옻나무 추출액 섭취와 함께 운동의 병행은 저장지방을 감소시키고 혈중 지질을 억제하며, 인슐린 저항성을 개선시키므로 대사증후군 즉, 당뇨병, 비만, 고지혈증 등을 효과적으로 억제할 수 있다는 점을 시사한다.