• Clinical and Experimental Reproductive Medicine
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• 제48권4호
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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 Reproductive Medicine
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• 제35권3호
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• pp.223-229
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• 2008

목 적: 본 예비 연구는 비만하지 않은 다낭성난소증후군 환자들에게서 인슐린 저항성, 혈중 호르몬 농도 및 혈중 지질 농도에 관한 metformin의 효과를 알아보기 위해 수행하였다. 연구방법: 본 연구는 2006년 6월부터 2007년 9월까지 본원에서 다낭성난소증후군으로 진단받은 16명의 비만하지 않은 환자를 대상으로 하였다. 혈액 검사는 metformin 치료 전과 치료 후 6개월이 경과한 후에 실시하였으며 공복 혈당과 공복 인슐린 치, 75 g의 액상 포도당 섭취 후 2시간째의 혈당과 혈중 인슐린 농도를 측정 하였다. 혈중 호르몬 및 혈중 지질 농도는 FSH, LH, estradiol, testosterone, free testosterone, serum lipid profile을 포함하였다. 인슐린 저항성을 평가하기 위해 공복 시 혈당/인슐린 비율 (fasting glucose/insulin ratio; FGIR)과 액상 포도당 섭취 후 2시간째의 혈당/인슐린 비율을 산출하여 추정하였다. 또한 HOMA beta cell function 및 HOMA IR을 산출함으로써 인슐린 저항성 및 췌장 베타세포 기능을 조사하였다. 결 과: Metformin으로 치료한 후, 75 g 경구 당 부하 후 2시간째 측정한 glucose/insulin 비율은 증가되었으며 (p=0.04), HOMA IR은 치료 후 유의하게 감소가 있었다 (p=0.000). 그러나 혈중 지질 농도는 의미 있는 변화를 보이지 않았다. 혈중 free testosterone 농도는 치료 후 감소하였고 (p=0.001), LH 농도 및 LH/FSH 비도 감소하였다 (p=0.000, p=0.034). 결 론: 본 예비 연구는 metformin이 비만하지 않은 다낭성난소증후군 환자들에게서 인슐린 감수성을 개선하고, 고안드로겐혈증을 완화시키는 효과가 있을 수 있다는 것을 보여준다. Metformin의 역할을 결정하기 위하여 향후 보다 다수의 환자 군을 대상으로 하여 장기적인 추적 관찰을 수반한 심도 있는 연구가 이루어져야 할 것이다.

• 대한핵의학회지
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• 제5권2호
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• pp.1-6
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• 1971

The correlation between the plasma insulin, and glucose concentration was studied in healthy Korean adults consisting of 20 males and 22 females of 16 to 38 years of age. The blood samples of above subjects were obtained through cubital vein at arbitrary times, during their usual working hours. Plasma insulin was assayed by means of double antibody system of radioimnmunoassy technics, and blood glucose was determined by means of Van Slyke-Folch method. Results were as follows: 1. There were no differences in the blood sugar levels in relation to the plasma insulin concentration either by sex or age. 2. In the case, when the plasma insulin concentration was within $200m{\mu}D/ml$, the correlation between the insulin, and glucose concentration existed, the ratio of which was expressed as; Plasma glucose concentration(mg/dI)=$91.9+0.08{\times}Insulin$ concentration r=0.62 3. Insulinogenic index was 12.4%, which was somewhat higher than other reports. 4. It is suggested that the correlation between plasma insulin and glucose concentration could be determined at arbitrary times instead of fasting times.

• 한국식품영양학회지
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• 제30권4호
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• pp.830-840
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• 2017

Excessive body weight gain during the growth period of early life may predispose individuals towards obesity and metabolic disorder in later life. We investigated the possibility of using the food efficiency ratio as an early indicator for predicting susceptibility to diet-induced obesity and insulin resistance. Four-week-old, prepubertal, male Sprague Dawley rats were divided into obesity-prone and obesity-resistant groups based on food efficiency ratio values after five days on a high-fat diet. Metabolic parameters measured after 2, 6, and 10 weeks, and specific phenotypes were compared with each group. Obesity-prone rats had higher increases in body weight and fat mass compared to obesity-resistant rats over the study period. Obesity-prone rats became glucose intolerant early in this study and remained so throughout the experimental period, with increases in fat weight and leptin levels occurring first, followed by increases in insulin level. Gluconeogenesis and insulin resistance significantly increased in obesity-prone groups in which activities of glucose-6-phosphatase and phosphoenolpyruvate carboxykinase were increased and glucokinase activity decreased. Higher food efficiency ratio at an early age was closely correlated with body fat accumulation, hyperleptinemia, and hyperinsulinemia of middle and elderly age. We suggest a high food efficiency ratio in prepubertal subjects may be a useful predictor of future obesity and insulin resistance.

• 대한간호학회지
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• 제27권3호
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• pp.694-704
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• 1997

This study was designed to assess the body fat distribution, and also to investigate the effects of body fat on glucose tolerance and on insulin secretion pattern by body mass index in offspring of parents with NIDDM. The subjects consisted of twenty parents with NIDDM who had been admitted to the Department of Internal Medicine or had been seen in the outpatient clinic at Kangnam St. Mary's Hospital, Catholic University between February to March, 1995. Twenty offspring were randomly selected from forty six offspring of twenty parents with NIDDM. As a control group, twenty healthy people without a family history of diabetes mellitus were matched by sex, age and body mass index(BMI). The results are as follows : 1. Mean fasting serum glucose and insulin levels and insulin / glucose ratio were significantly greater in offspring than in the control subjects with BMI 25kg /㎡ in the offspring and in the BMI<25kg /㎡ control subjects (P<0.05). 2. The total glucose area and insulin area were significantly greater in both the offsping and the control subjects with BMI≥25kg /㎡ than in both the offspring and the control subjects with BMI<25 kg /㎡(P<0.05). 3. Upper body skinfold thickness, Waist hip ratio(WHR), serum levels of total cholesterol and triglyceride(TG), total dietary calorie intake and protein intake in both the offspring and the control subjects with BMI≥25kg /㎡ were greater than those with BMI<25kg /㎡(P<0.05). On the other hand, HDL-cholesterol in both the offspring and the control subjects with BMI≥25kg /㎡ was lower than those with BMI< 25kg /㎡(P<0.05). 4. The major variables influencing the total glucose area were subscapular skinfold thickness and WHR and the major variables influencing the total insulin area were suprailiac skinfold thickness, WHR, TG and free fatty acid. In the light of the results, glucose intolerance and insulin resistance were affected by body mass index, Upper body fat, WHR and lipids(TG, Free fatty acid), it is implied that these are influencing factors on total glucose area and total insulin area. The identification of these factors might provide a useful tool to identify individuals at high risk of diabetes mellitus. Therefore, various nursing intervention programs to reduce obesity could be given to both the offspring of parents with NIDDM and to the obese healthy controls before diabetes mellitus develops.

• Nutrition Research and Practice
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• 제8권4호
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• pp.469-475
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• 2014

BACKGROUND/OBJECTIVE: The goal of the present study was to investigate the effects of moderate caloric restriction on ${\beta}$-cell function and insulin sensitivity in middle-aged obese Korean women. SUBJECTS/METHODS: Fifty-seven obese pre-menopausal Korean women participated in a 12-week calorie restriction program. Data on total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and fasting serum levels of glucose, insulin, C-peptide, blood pressure, leptin and anthropometrics were collected. A dietary intake assessment was based on three days of food recording. Additionally, ${\beta}$-cell function [homeostasis model assessment of ${\beta}$-cell (HOMA-${\beta}$), insulinogenic index (ISI), C-peptide:glucose ratio, and area under curve insulin/glucose ($AUC_{ins/glu}$)] and insulin sensitivity [homeostasis model assessment for insulin resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI) and Matsuda index (MI)] were recorded. RESULTS: When calories were reduced by an average of 422 kcal/day for 12 weeks, BMI (-2.7%), body fat mass (-10.2%), and waist circumference (-5%) all decreased significantly (P < 0.05). After calorie restriction, weight, body fat percentage, hip circumference, BP, TC, HDL-C, LDL-C, plasma glucose at fasting, insulin at fasting and 120 min, $AUC_{glu}$ and the insulin area under the curve all decreased significantly (all P < 0.05), while insulin sensitivity (HOMA-IR, QUICKI and Matsuda index) measured by OGTT improved significantly (P < 0.01). CONCLUSIONS: Moderate weight loss due to caloric restriction with reduction in insulin resistance improves glucose tolerance and insulin sensitivity in middle-aged obese women and thereby may help prevent the development of type 2 diabetes mellitus.

• Nutrition Research and Practice
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• 제11권3호
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• pp.198-205
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• 2017

BACKGROUND/OBJECTIVES: The anti-diabetic activity of pear through inhibition of ${\alpha}-glucosidase$ has been demonstrated. However, little has been reported about the effect of pear on insulin signaling pathway in obesity. The aims of this study are to establish pear pomace 50% ethanol extract (PPE)-induced improvement of insulin sensitivity and characterize its action mechanism in 3T3-L1 cells and high-fat diet (HFD)-fed C57BL/6 mice. MATERIALS/METHODS: Lipid accumulation, monocyte chemoattractant protein-1 (MCP-1) secretion and glucose uptake were measure in 3T3-L1 cells. Mice were fed HFD (60% kcal from fat) and orally ingested PPE once daily for 8 weeks and body weight, homeostasis model assessment of insulin resistance (HOMA-IR), and serum lipids were measured. The expression of proteins involved in insulin signaling pathway was evaluated by western blot assay in 3T3-L1 cells and adipose tissue of mice. RESULTS: In 3T3-L1 cells, without affecting cell viability and lipid accumulation, PPE inhibited MCP-1 secretion, improved glucose uptake, and increased protein expression of phosphorylated insulin receptor substrate 1 [p-IRS-1, ($Tyr^{632})$)], p-Akt, and glucose transporter type 4 (GLUT4). Additionally, in HFD-fed mice, PPE reduced body weight, HOMA-IR, and serum lipids including triglyceride and LDL-cholesterol. Furthermore, in adipose tissue, PPE up-regulated GLUT4 expression and expression ratio of p-IRS-1 ($Tyr^{632})/IRS$, whereas, down-regulated p-IRS-1 ($Ser^{307})/IRS$. CONCLUSIONS: Our results collectively show that PPE improves glucose uptake in 3T3-L1 cells and insulin sensitivity in mice fed a HFD through stimulation of the insulin signaling pathway. Furthermore, PPE-induced improvement of insulin sensitivity was not accompanied with lipid accumulation.

• Clinical and Experimental Reproductive Medicine
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• 제29권1호
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• pp.67-76
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• 2002

Objective: To assess the difference of baseline hormonal status and pathophysio logy, and confirm the risk factors for long term complication according to Body Mass Index in women with polycystic ovary syndrome. Materials and Methods: Serum level of LH, FSH, Estradiol, Prolactin, Testosterone, DHEA-S, fasting insulin were measured and 100 gm oral glucose tolerance test and endometrial biopsy were performed in total 75 chronic anovulation patients and 20 normal cycling infertility patients. 95 evaluated patients were divided into 3 groups including patients with chronic anovulation having BMI below 25, BMI beyond 25.1, normal cycling infertility patients, Group 1 (n=39), Group 2 (n=36), Group 3 (n=20), respectively. Statistical analysis was performed respect to relationship between BMI and measured hormone level, sum of glucose level during 100 gm OGTT, insulin resistance using t-test, ANOVA test, Post Hoc test, Mann-Whitney test. p<0.05 was considered as statistically significant. Results: Serum LH level and LH/FSH ratio was significantly higher in Group 1, compared than Group 2 or 3 (p<0.05), BMI and LH, LH/FSH ratio was negatively correlated (r=-0.351, r=-0.318). There was no significant difference according to BMI in FSH, testosterone, estradiol, prolactin, DHEA-S level. Fasting insulin and sum of glucose level during 100 gm OGTT were significantly higher in Group 2 compared than Group 1 or Group 3 (p<0.05), there was no significant difference between Group 1 and Group 3. Insulin resistance was more frequently identified in Group 2 compared than Group 1 (p=0.001). Conclusions: BMI and LH, LH/FSH ratio were negatively correlated, so clinical significance of LH, LH/FSH ratio in diagnosis of PCOS may be attenuated by increasing body weight. Overweight patients with chronic anovulation may be the risk group for developing insulin resistance, hyperinsulinemia, glucose intolerance, later type 2 DM. Hyperinsulinemia may operate mainly in overweight chronic anovulation patients in development of hyperandrogenism.

• Journal of Yeungnam Medical Science
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• 제12권2호
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• pp.319-330
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• 1995

임신시 발생하는 인슐린 저항성과 인슐린 분비 증가의 기전을 규명하기 위하여 Sprague-Dawley 종 암컷 흰쥐를 이용하여 정맥당부하 검사와 호르몬 및 지방 대사물질과 조직에서의 인슐린 수용체 결합, 당원질 합성효소를 분석한 결과를 요약하면 다음과 같다. 정맥당부하검사에서 임신군에서 전체적인 곡선이 대조군에 비하여 아래에 위치하였다. 그러나 당부하시 인슐린 분비는 현저히 증가하였으며 혈당에 대한 비(${\mu}U/mg$)로 비교하여 임신군에서 $56.9{\pm}8.9$였고 대조군에서 $23.6{\pm}2.8$로서 인슐린 저항성을 확인할 수 있었다. 인슐린 분비반응의 증가는 태반 호르몬인 progesterone의 증가와 강한 상관관계를 나타내었다. 당부하검사후 당원질 (mg/100mg tissue)은 골격근(soleus)에서는 임신군과 대조군간에 유의한 차이가 없었으나 간조직에서는 임신군에서 $4.7{\pm}0.9$으로 대조군의 $9.9{\pm}1.3$에 비하여 통계적으로 유의하게 감소하였다. 당원질로 합성된 $^{14}C$-glucose의 활동도도 마찬가지로 골격근에서는 임신군과 대조군간에 유의한 차이가 없었으나 간조직에서는 현저한 감소를 보였다. 당원질 합성 효소(glycogen synthase)는 골격근에서는 대조군이 높았고 간장조직에서는 임신군이 높았으나 유의한 차이는 없었다. 당부하검사후 간장조직의 crude membrane에서의 인슐린-인슐린 수용체 결합반응에서는 두 군 사이에 유의한 차이가 없었다. 이상의 결과로 보아 정상임신흰쥐에서 인슐린 저항성이 발생하였으나 인슐린 분비의 현저한 증가로 내당능의 감소는 나타나지 않았으며 인슐린의 분비증가는 progesterone의 증가와 상관관계가 있었다. 인슐린 저항성은 간에서 가장 현저하게 나타났으며 그 원인은 인슐린 수용체의 결합과정보다는 수용체 전 과정이거나 수용체 후 과정일 것으로 추정된다.

• 한국임상수의학회지
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• 제29권4호
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• pp.271-276
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• 2012

사람에 연구에 따르면 심부전 진단에 널리 사용되는 NT-proBNP농도는 비만, 비만 관련인자들과 밀접한 상관 관계가 있는 것으로 알려져 있다. 그러나 이러한 상관관계는 아직까지 수의분야에서는 입증된 바가 없다. 따라서 본 연구에서는 다양한 정도의 이첨판 패쇄부전증(CMVI)에 이환된 73마리 개 집단에서 NT-proBNP와 비만 및 비만 관련인자들간의 상호관계를 조사하였다. 절식시 혈당 농도, 지방관련 인자(i.e., total triglycerides [TG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C]), fructosamine, insulin 및 NT-proBNP 농도를 측정하였다. Insulin/glucose ratio 역시 계산하였다. NT-proBNP 농도는 CMVI에 의한 심부전의 정도에 따라 농도변화가 관찰되었으며, body condition scores (BCS), insulin 및 fructosamine 농도와도 관련이 있었다. 또한 본 연구를 통해 비만과 혈중 NT-proBNP농도 간에 상관관계 역시 확인되었다. 또한 NT-proBNP농도는 비만과 관련 있는 인자인 fructosamine과 insulin농도와도 관련이 있었다. 본 연구는 개에서 NT-proBNP농도와 비만 정도와 상관관계를 입증한 첫 보고이다.