• Journal of Nutrition and Health
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• 제52권2호
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• pp.206-216
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• 2019

본 연구는 당뇨병 환자들의 소득수준에 따라 대사위험지표 관리수준을 비교하고, 최근 관리 추이를 관찰하여 궁극적으로 당뇨병 환자들의 합병증 예방 관련 전략을 마련할 수 있는 기초자료를 마련하기 위하여 1998 ~ 2014년 국민건강영양조사 자료를 분석하였다. 국민건강영양조사에 참여한 조사대상자 중 당뇨병 환자이면서 본인의 질환을 인지하고 있는 대상자들을 추출하였고, 가구소득정보를 이용하여 세 그룹으로 분류하여 분석하였다. 당뇨병 환자들의 기본정보, 생활습관정보, 영양소 섭취 정보, 혈액지표 등은 건강설문조사, 영양조사, 검진조사를 통해 수집되었다. 자료 분석은 변수 특성에 따라 카이검정, 일원분산분석 등을 실시하였고, 다중선형회귀분석을 이용하여 혈압 및 혈액지표의 보정평균을 산출하였다. 당뇨환자들의 공복혈당, HbA1c 및 혈중지질 농도의 평균은 소득수준에 따라 유의적인 차이를 보이지 않았다. 조사기간인 1998년부터 2014년간의 16년 동안 대사위험지표 변화 추이를 살펴본 결과, 모든 그룹에서 혈압의 유의미한 감소 추세를 보였다 (p < 0.001). 소득이 가장 높은 그룹에서는 공복혈당 (p = 0.004), 총 콜레스테롤 (p < 0.001), LDL-콜레스테롤 농도 (p = 0.01)가 유의하게 감소하는 추이를 보였고, HDL-콜레스테롤 농도 (p < 0.001)는 유의하게 증가하는 추이를 보였다. 저소득층에서는 공복혈당 (p = 0.02), 총 콜레스테롤 (p < 0.001), 중성지방 농도 (p = 0.003)가 시간 경과에 따라 유의적으로 감소하는 경향을 보였다. 그러나 중간소득층에서는 혈압을 제외한 모든 대사 위험 인자에 유의적인 변화 추이가 발견되지 않았다. 결론적으로 당뇨병 환자의 소득수준에 따른 대사 위험 인자의 관리수준에는 차이가 없었다. 최근 16년의 관찰 기간 동안 소득이 가장 높은 그룹과 가장 낮은 그룹은 대사 위험 인자의 유의미한 개선 추이를 보였으나, 중간소득 그룹은 변화가 관찰되지 않았다. 본 연구는 당뇨병 환자들의 지표 관리에 대한 전략 마련과 효과적인 보건대책을 위한 기초자료로서 중요한 의미가 있다고 사료된다.

• Preventive Nutrition and Food Science
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• 제10권1호
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• pp.64-67
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• 2005

Leptin is a small polypeptide hormone secreted primarily by adipocytes. Leptin regulates energy balance by decreasing food intake and increasing energy expenditure. This study investigated the relationships between serum leptin levels and BMI (body mass index) in 49 adults in Pohang, Korea. The subjects were 25 males and 24 females, aged 21 to 64 years attending an outpatient clinic at Handong University Sunlin Presbyterian Hospital. Values are given +/- the standard error of the mean. Our study shows that the serum leptin levels in these subjects were positively correlated with BMI. The leptin levels were higher in females (2.39+/-1.82 ng/mL) than in males (0.43+/-0.455ng/mL), although lower than previously reported. We therefore compared the serum leptin levels from the male Korean subjects (BMI 24.3+/-0.74㎏/㎡) with serum from six British males with a similar BMI (23.4+/-1.48㎏/㎡). The serum leptin concentrations (1.76+/-0.76 ng/mL) were lower than that of plasma (4.28+/-1.66 ng/mL) in the British subjects. The serum leptin in the British subjects (1.76+/-0.76ng/mL) was higher than that in the Koreans. There was no correlation between leptin levels and BMI in either male (slope 0.018 ± 0.036, p=0.624) or female (slope 0.382±0.433, p=0.417) type 2 diabetic patients in Pohang, Korea. Taken together, our study shows that the serum leptin level in Koreans varies with the BMI, but is lower than that of BMI-matched British subjects.

• 한국식품영양학회지
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• 제21권4호
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• pp.530-535
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• 2008

Evidence for the effects of different health behaviors, including diet, in elderly diabetes is currently limited. The aim of this study was to compare the quality of diet and health behaviors in Korean elderly T2DM patients, using a glycemic control. T2DM elders(>65 yr, n=48) were recruited and categorized by the concentration of glycated-hemoglobin HbA1c; subjects with HbA1c<7% were the good control(GC) group, and subjects with $HbA1c{\geq}8%$ constituted the poor control(PC) group. General characteristics, self-management behavior questionnaires, and 3-d diet records were all collected and assessed. No significant differences in general characteristics between GC and PC were detected, with the exception of a higher level of education in GC(p<0.05). A twofold longer duration of diabetes was observed in PC as compared to GC(p<0.01). The GC group did exercise for a longer time(p<0.001), and had an earlier beginning of diabetes self-management education (DSME) by healthcare practitioners using a team teach as compared with the PC group(p<0.05). The total dietary quality index(p<0.001) and individual index for carbohydrate(p<0.001) or vegetables and fruit(p<0.05) were better in GC than in PC. Therefore, the earlier DSME including intensive exercise and balanced diet selection should be expected to improve glycemic control in diabetic Korean elders.

• 근관절건강학회지
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• 제19권1호
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• pp.57-70
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• 2012

Purpose: This study aimed to investigate the level of physical activity and to identify factors related with physical activity for the elderly with Diabetes Mellitus (DM). Methods: The subjects were 154 diabetic outpatient at 3 hospitals located in J city. Data were collected from February 1 to 17 in 2012. Data were analysed using Chi-square test, ANOVA, and logistic regression by SPSS/WIN 18.0. Results: Mean physical activity level per week measured by International Physical Activity Questionnaire (IPAQ) was $2247.01{\pm}2533.73$ MET-minutes (minimally active). There were significant differences in the level of physical activity by age, spouse, education, job, admission, duration of DM, and DM therapy. There were significant differences in subjective health status, objective and subjective obesity, satisfaction with physical body, perception of aging, self-efficacy, perceived benefits, perceived barriers, and social support among the inactive, minimally active, and health enhancing physical activity groups. Factors influencing the level of health enhancing physical activity were spouse (OR=10.192), self-efficacy (OR=5.351), subjective obesity (OR=.114), and perceived barriers (OR=.069). Conclusions: The level of physical activity of elderly patients with DM was minimally inactive. Physical activity program enhancing self-efficacy and decreasing perceived barriers, as well as improving the correct perception of subjective obesity is recommended as a nursing intervention.

• 대한임상검사과학회지
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• 제41권1호
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• pp.37-41
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• 2009

Measurement of hemoglobin A1c is used as an objective indicator of long-term blood glucose control in diabetic patients. We evaluated recently introduced Norudia$^{(R)}$ HbA1c (Daiichi Pure Chemical Co. Ltd, Tokyo, Japan) test reagent using enzyme method for HbA1c assay. Linearity, precision and correlation with VARIANT$^{TM}$ II Turbo HbA1c analyzer (BIO-RAD, Hercules, CA, USA) were evaluated. The reference range was determined from 201 healthy subjects. The Norudia$^{(R)}$ HbA1c test reagent was founded to be linear in a range of 5.6% to 14.0% ($r^2=0.9885$). The within-run and between-day precision were 0.954% and 1.03% for low level (HbA1c 5.24%), 0.67% and 1.28% for high level (HbA1c 9.01%), respectively. Comparison study between Norudia$^{(R)}$ HbA1c test reagent and VARIANT$^{TM}$ II Turbo showed good correlation with a slope of 1.0489. an intercept at -0.9717, and coefficient of correlation was 0.9907. The reference range of HbA1c obtained from this reagent was 4.07-5.50%. The Norudia$^{(R)}$ HbA1c test reagent showed good linearity, precision and correlation with HbA1c analyzer with HPLC method. In addition, the exclusive analyzer is not required for assay and then this kit may be useful for HbA1c assay in clinical laboratory.

• 대한간호학회지
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• 제35권2호
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• pp.283-291
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• 2005

Purpose: The purpose of this study was to explore the levels of depression experienced by clients (N=152) with Type 2 Diabetes Mellitus(DM), and to compare the levels of self care activity, metabolic control and cardiovascular risk factors between depressed and non-depressed clients. Method: Participants aged 50 and above were conveniently recruited in B city. The levels of depression, self-care activity, metabolic control of glucose and lipids, and cardiovascular risk factors of the participants were measured by using questionnaires and blood tests from November, 2003 to June, 2004. Data was analyzed with descriptive statistics, Pearson correlation, Spearman rho and t-test using the SPSS WIN 10.0 program. Result: The prevalence of depression(CES-D=16) among the participants was $44.1\%$. The levels of self-care activities(p=.012), glucose(p=.019), total cholesterol(p=.022), LDL(.007) and cardiovascular risk factors(p=.012) were significantly higher in the depressed group than those in the non-depressed group. Conclusion: Based on the findings, we concluded that many DM patients experience depression and the depression of type 2 DM clients is significantly related with self care activities, diabetic control, and cardiovascular complications. However, this study did not address causality among these variables. Therefore, further research, such as a longitudinal cohort study, is needed to identify causality among these variables.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.139-146
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• 2012

Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

• 대한핵의학회지
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• 제35권1호
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• pp.81-82
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• 2001

A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialysate mixed with 111 MBq of Tc-99m sulfur colloid were administered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%.$^{1)}$ Inguinal hernias were frequently manifested as scrotal swelling. Leakages of dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clinical findings of inguinal hernia.$^{1,2)}$ In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.

• 한국식품영양학회지
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• 제30권2호
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• pp.371-377
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• 2017

Muscle atrophy is characterized by a decrease in the mass of the muscle. With an increase in life expectancy and chronic illnesses, the incidence of muscle atrophy is increasing and the quality of life of patients is decreasing. Thus, reducing muscle atrophy is of high clinical and socio-economic importance. Mistletoe is a semi-parasitic plant that has been used as a traditional medicine in many countries to treat various human illnesses. It has been reported that Korean mistletoe extract (KME) has diverse biological functions including anti-tumor, anti-oxidant, anti-diabetic, anti-obesity properties, and extension of lifespan. Especially, we have recently reported that KME improves exercise endurance in mice, indicating its beneficial roles in enhancing the capacity of skeletal muscle. In this study, we investigated whether KME could activate the signaling pathway related to protein synthesis in a mouse model of muscle atrophy. Interestingly, KME efficiently activated the Akt/mTOR pathway, and Akt and mTOR are important signaling hub molecules for the acceleration of protein synthesis in muscle cells. In addition, KME also increased the activity of S6 kinase which is involved in the regulation of muscle cell size. Moreover, the ERK activity, required for transcription of ribosomal RNA for protein synthesis, was also enhanced in KME-treated mouse muscle. These data support the idea that KME increases muscle mass via increased protein synthesis. Our findings also suggest that Korean mistletoe might be a promising candidate for the development of functional foods that are beneficial for preventing muscle atrophy.

• Journal of Dairy Science and Biotechnology
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• 제29권1호
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• pp.17-22
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• 2011

Milk intake is widely recommended for healthy diet, not only for bone growth and maintenance, but also as a protein, calcium and magnesium sources as part of an adequate diet. Many research suggest that milk and dairy products are associated with a lower risk of type 2 diabetes mellitus (T2DM). Milk and dairy products are low Glycemic index (GI) and Glycemic load (GL) foods. The GI and GL are useful tools to choose foods to help control blood glucose levels in people with diabetes. The GI and GL of milk are 32~42 and 4~5, respectively, and which are about 1/2 and 1/5 of boiled rice. The mechanisms underlying the effects of dairy on T2DM development includes the calcium and vitamin D content in dairy foods and the possible positive effect of high milk and calcium intake on weight control. The role of dairy products on reducing the risk of diabetes can be inferred from the reports that lower serum IGF-1 levels were positively associated with diabetes and the girls with low milk intake had significantly lower IGF-1. Accumulating data from both patients and animal models suggest that microbial ecosystems associated with the human body, especially the gut microbiota, may be associated with several important diseases, such as inflammatory bowel disease, obesity, diabetes and cardiovascular disease. It was thought that fermented milk containing lots of probiotics can be useful for controling blood glucose levels and preventing complication of diabetes, but sucrose in commercial yogurt should be substituted. There are some reports of oligosaccharide, xylitol, and stevia as a potentially useful sweetener in the diabetic diet.