• Biomolecules & Therapeutics
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• v.20 no.2
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• pp.220-225
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• 2012

To develop a ginseng product possessing an efficacy for diabetes, ginseng radix ethanol extract was treated with pectinase and obtained the GINST. In the present study, we evaluate the beneficial effect of GINST on high fat diet (HFD)-induced hyperglycemia and hyperlipidemia and action mechanism(s) in ICR mice. The mice were randomly divided into five groups: regular diet group (RD), high fat diet group (HFD), HFD plus GINST at 75 mg/kg (GINST75), 150 mg/kg (GINST150), and 300 mg/kg (GINST300). Oral glucose tolerance test reveals that GINST improves the glucose tolerance after glucose challenge. Fasting plasma glucose and insulin levels were decreased by 4.3% and 4.2% in GINST75, 10.9% and 20.0% in GINST150, and 19.6% and 20.9% in GINST300 compared to those in HFD control group. Insulin resistance indices were also markedly decreased by 8.2% in GINST75, 28.7% in GINST150, and 36.4% in GINST300, compared to the HFD control group. Plasma triglyceride, total cholesterol and non-esterified fatty acid levels in the GINST300 group were decreased by 13.5%, 22.7% and 24.1%, respectively, compared to those in HFD control group. Enlarged adipocytes of HFD control group were markedly decreased in GINST-treated groups, and shrunken islets of HFD control mice were brought back to near normal shape in GINST300 group. Furthermore, GINST enhanced phosphorylation of AMP-activated protein kinase (AMPK) and glucose transporter 4 (GLUT4). In summary, GINST prevents HFD-induced hyperglycemia and hyperlipidemia through reducing insulin resistance via activating AMPK-GLUT4 pathways, and could be a potential therapeutic agent for type 2 diabetes.

• The Korean Journal of Physiology and Pharmacology
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• v.24 no.5
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• pp.403-412
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• 2020

Diabetic nephropathy (DN) is a hyperglycemia-induced progressive development of renal insufficiency. Excessive glucose can increase mitochondrial reactive oxygen species (ROS) and induce cell damage, causing mitochondrial dysfunction. Our previous study indicated that cilostazol (CTZ) can reduce ROS levels and decelerate DN progression in streptozotocin (STZ)-induced type 1 diabetes. This study investigated the potential mechanisms of CTZ in rats with DN and in high glucose-treated mesangial cells. Male Sprague-Dawley rats were fed 5 mg/kg/day of CTZ after developing STZ-induced diabetes mellitus. Electron microscopy revealed that CTZ reduced the thickness of the glomerular basement membrane and improved mitochondrial morphology in mesangial cells of diabetic kidney. CTZ treatment reduced excessive kidney mitochondrial DNA copy numbers induced by hyperglycemia and interacted with the intrinsic pathway for regulating cell apoptosis as an antiapoptotic mechanism. In high-glucose-treated mesangial cells, CTZ reduced ROS production, altered the apoptotic status, and down-regulated transforming growth factor beta (TGF-β) and nuclear factor kappa light chain enhancer of activated B cells (NF-κB). Base on the results of our previous and current studies, CTZ deceleration of hyperglycemia-induced DN is attributable to ROS reduction and thereby maintenance of the mitochondrial function and reduction in TGF-β and NF-κB levels.

• The Korean Journal of Food And Nutrition
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• v.30 no.4
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• pp.696-702
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• 2017

Metabolic syndrome, including obesity, glucose intolerance and elevated blood pressure, is related to type 2 diabetes and cardiovascular disease. Previous studies have reported the anti-oxidative, anti-inflammatory and anti-diabetic effects of purple corn extract. We investigated the efficacy of purple corn extract (PC) against high-fat diet (HFD)-induced obesity and glucose intolerance, and examined the underlying mechanisms by analyzing expression of proteins and genes involved in glucose regulation and macrophage infiltration. C57BL/6 mice were fed with normal chow diet (ND), or HFD treated with distilled water (DW, control) or PC, for 10 weeks. Although body weights were similar in the HFD-fed groups, we observed a decrease in the liver and epididymal adipose tissue (EAT) weights, and enhanced glucose tolerance test (GTT) results in the PC group, as compared with DW group. Liver showed increased Akt phosphorylation in the PC-treated mice; however, no changes were observed in the EAT, for all groups. In PC-treated mice, decreased macrophage infiltration was seen in the EAT, with a reduced expression of macrophage marker genes. Finally, proinflammatory cytokine gene expressions were decreased by PC in the EAT, and a modest trend for downregulation was observed in the liver. Hence, we conclude that PC may decrease glucose intolerance by increasing the phosphorylation of Akt and reducing the macrophage infiltration into the EAT.

• Health Policy and Management
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• v.32 no.3
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

• Korean Journal of Food Science and Technology
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• v.52 no.1
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• pp.81-88
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• 2020

The biological activities of Platycodon grandiflorum (PG) root extracts have been studied intensively, whereas there are limited number of studies on PG seed extract (PGSE). PGSE was prepared by ethanol extraction, and its antidiabetic effect was evaluated in mice with type 2 diabetes (C57BLKS/J-db/db). Results indicated that the administration of high-dose PGSE (600 mg/kg, wb) significantly stabilized the blood glucose levels, as evidenced by the results of the oral glucose tolerance test. Mice treated with high-dose PGSE exhibited significantly lower serum hemoglobin A1c, insulin, and leptin levels after eight weeks of feeding trial (p<0.05). High-dose PGSE administration significantly improved glucose uptake in the femoral muscle of db/db mice by activating both IRS-1/PI3K/AKT/AS160 and AMPK phosphorylation pathways. GLUT4 translocation from the cytosol to the plasma membrane increased 1.7-fold in the PGSE high-dose group. These results suggest that PGSE has potential for development as an antidiabetic agent.

• Natural Product Sciences
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• v.18 no.4
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• pp.254-260
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• 2012

Adipose inflammation is linked to the development of insulin resistance and type 2 diabetes. Hesperidin (HES) is a flavonoid with antioxidant, anti-inflammatory and anti-diabetic properties. However, whether HES improves inflammation-mediated insulin resistance in adipose tissues remains unclear. The purpose of this study was to investigate whether HES attenuates inflammation-mediated insulin resistance in adipose tissue. Herein, RAW 264.7 cells and differentiated 3T3-L1 adipocytes were pretreated with various concentrations of HES in complete media for 1 h and then cultured in the presence or absence of LPS or TNF-${\alpha}$. Our results demonstrated that HES remarkably inhibited LPS-induced production of IL-6, TNF-${\alpha}$, and NO by RAW 264.7 cells in a dose-dependent manner. Also, HES inhibited TNF-${\alpha}$-induced production of IL-6 and $PGE_2$ in differentiated 3T3-L1 cells, while upregulated TNF-${\alpha}$-suppressed expression of adiponectin and PPAR-${\gamma}$ mRNA. These findings suggest that HES may ameliorate inflammation-mediated insulin resistance in adipose tissue.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.159-164
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• 2014

Purpose: The purpose of this study is to confirm the effect of antiplatelet drugs in diabetic peripheral vasculopathy in diabetic foot patients. Materials and Methods: We designed a retrospective study in diabetic foot patients with diabetic peripheral vasculopathy. From October 2007 to December 2013, 278 cases in 139 patients who took antiplatelet drugs over at least a six-month period were included in this study. We categorized these patients according to the type of drug used. The efficacy of antiplatelet drugs was evaluated using anklebrachial index (ABI) and pulse wave velocity (PWV). Results: Only the aspirin group showed a statistically significant increase of ABI after antiplatelet therapy ($1.10{\pm}0.12$ to $1.12{\pm}0.11$). In addition, only the cilostazol group showed a statistically significant decrease of PWV after antiplatelet therapy ($1,701.20{\pm}396.56$ to $1,627.42{\pm}324.98$). Conclusion: Aspirin and cilostazol may be used in treatment of diabetic peripheral vasculopathy, whereas dual antiplatelet therapy with aspirin and clopidogrel has no specific benefits in diabetic peripheral vasculopathy.

• Journal of Genetic Medicine
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• v.17 no.1
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• pp.1-10
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• 2020

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, which is characterized by the oligo/anovulation, hyperandrogenism (HA) and polycystic ovarian morphology which are diagnostic criteria. PCOS has diverse clinical aspects in addition to those diagnostic criteria including increased risk for cardiovascular diseases, metabolic syndrome, dyslipidemia, type 2 diabetes and impaired fertility. Because of the heterogeneity of the disease, the pathogenesis of the disease has not been elucidated yet. Therefore, there is no cure for the endocrinopathy. HA and insulin resistance (IR) has been considered two major pillars of the pathogenesis of PCOS. Recent advances in animal studies revealed the critical role of neuroendocrine abnormalities in developing PCOS. Several pathways related to neuroendocrine origin have been investigated such as hypothalamus pituitary ovarian axis, hypothalamus pituitary adrenal axis and hypothalamus pituitary adipose axis. This review summarizes the current knowledge about the role of HA and IR in developing PCOS. In addition, we review the results of recent genome wide association studies for PCOS. This new perspective improves our understanding of the role of neuroendocrine origins in PCOS and suggest a novel potential therapeutic target for the treatment of PCOS.

• Biomedical Science Letters
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• v.29 no.2
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• pp.58-65
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• 2023

Pu-erh tea, a popular and traditional Chinese tea, possesses various health-promoting effects, including inhibiting tumor cell progression and preventing type II diabetes and neurodegenerative disorders. However, the precise anti-inflammatory mechanisms are not well understood. In present study, we elucidated the anti-inflammatory mechanism of Pu-erh tea in lipopolysaccharide (LPS)-activated RAW264.7 cells. We explored the effects of Pu-erh tea on the levels of inflammatory-related genes, including inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2 and prostaglandin E₂ (PGE₂) in LPS-activated RAW264.7 cells. Moreover, we investigated its regulatory effects on nuclear factor-kappa B (NF)-κB and hypoxia-inducible-factor (HIF)-1α activation. The findings of this study demonstrated that Pu-erh tea inhibited the LPS-increased inflammatory cytokines and PGE₂ release, as well as COX-2 and iNOS expression. Moreover, we confirmed that the anti-inflammatory mechanism of Pu-erh tea occurs via the inhibition of NF-κB and HIF-1α activation. Conclusively, these findings provide experimental evidence that Pu-erh tea may be useful candidate in the treatment of inflammatory-related diseases.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.