• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.754-763
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• 2002

Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

• Journal of Korean Medicine for Obesity Research
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• v.4 no.1
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• pp.1-11
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• 2004

Objectives: The effects of peroxisome proliferator-activated receptor ${\gamma}2\;(PPAR{\gamma}2)$ Pro12Ala (P12A) polymorphism on body mass index (BMI) and type 2 diabetes are well documented; however, until now, only a few studies have evaluated the effects of this polymorphism on body fat distribution. This study was conducted to elucidate the effects of this polymorphism on computed tomography (CT)-measured body fat distribution and other obesity-related parameters in Korean female subjects. Methods & Results: The frequencies of $PPAR{\gamma}2$ genotypes were: PP type, 93.0%; PA type, 6.8%; and AA type, 0.2%. The frequency of the A allele was 0.035. Body weight (P .012), BMI (P .012), and waist-to-hip ratio (WHR) (P .001) were significantly higher in subjects with PA/AA compared with subjects with PP. When body composition was analyzed by bioimpedance analysis, lean body mass and body water content were similar between the 2 groups. However, body fat mass (P .003) and body fat percent (P .025) were significantly higher in subjects with PA/AA compared with subjects with PP. Among overweight subjects with BMI of greater than 25, PA/AA was associated with significantly higher abdominal subcutaneous fat (P .000), abdominal visceral fat (P .031), and subcutaneous upper and lower thigh adipose tissue (P .010 and .013). However, among lean subjects with BMI of less than 25, no significant differences associated with $PPAR{\gamma}2$ genotype were found, suggesting that the fat-accumulating effects of the PA/AA genotype were evident only among overweight subjects, but not among lean subjects. When serum lipid profiles, glucose, and liver function indicators were compared among overweight subjects, no significant difference associated with $PPAR{\gamma}2$ genotype was found. Changes in body weight, BMI, WHR, and body fat mass were measured among overweight subjects who finished a 1-month weight lose program of a hypocaloric diet and exercise; no significant differences associated with $PPAR{\gamma}2$ genotype were found. Conclusions: The results of this study suggest that the $PPAR{\gamma}2$ PA/AA genotype is associated with increased subcutaneous and visceral fat areas in overweight Korean female subjects, but does not significantly affect serum biochemical parameters and outcomes of weight loss programs.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.2
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• pp.149-156
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• 2022

Lipid accumulation product (LAP) is a new index reflecting central lipid accumulation and is known to be a strong independent indicator for identifying the risk of cardiovascular disease (CVD) or diabetes mellitus (DM). This study was conducted to assess the relationship between the homeostasis model assessment of insulin resistance (HOMA-IR) and LAP according to the presence or absence of obesity in Korean adults. The study was carried out using data from the 2019 Korean National Health and Nutrition Examination Survey (KNHANES) and included 6,090 adults aged 20 years or older. There were several key findings. First, after adjusting for related variables, the mean of the HOMA-IR levels (M±SE, 95% confidence interval) was positively associated with the quartiles of LAP in the overall population (P<0.001), non-obese (P<0.001) or obese groups (P<0.001). Second, in all the groups (overall population, non-obese and obese groups), the mean value of the fasting blood glucose (all, P<0.001), insulin (all, P<0.001), and the metabolic syndrome score (all, P<0.001) increased with the increasing quartiles of LAP. Insulin resistance was thus positively associated with an increase in the LAP in Korean adults with or without obesity.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.2
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• pp.171-180
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• 2003

Purpose: The purpose of this study was to investigate the relationship of self-efficacy, knowledge about the disease, and self-care behavior to the metabolic level in patients with NIDDM. Method: Data were collected from March 15 to April 15, 2001. Participants in the study were 48 patients with NIDDM who were seen regularly at the endocrinology out-patient department of Gwangju Christian Hospital. The data were collected through individual interviews and patient blood samples. The data were analyzed with SPSS/PC+, using t-test, ANOVA, Pearson correlation coefficients and Cronbach's Alpha. Result: 1. The mean score for self-efficacy was $71.37{\pm}15.56$, knowledge $15.00{\pm}2.84$, self-care behavior $63.18{\pm}13.10$. The mean score for HbAlc level was $7.66{\pm}1.77%$, HDL cholesterol level, $46.22{\pm}13.04 mg/dl$ and total cholesterol level, $187.93{\pm}41.45 mg/dl$. 2. There was a significant difference between patients with a spouse and those without one (t=-2.08, p=0.042), in knowledge according to level of obesity (t=5.14, p=0.010), duration of illness (t=3.22, p=0.031) and presence of complications related to diabetes (t=-2.58, p= 0.013). There were no significant differences in self-care behavior, but there were significant differences in sugar metabolic level according to sex (t=-2.02, p=0.050). 3. The correlation between diabetic patients' self-efficacy, knowledge and self-care behaviour and metabolic control was significantly related only to self-efficacy and self-care behavior (r=.692, p=0.000). Conclusion: It is necessary to improve self-efficacy, knowledge, and self-care behavior for patients with NIDDM by using nursing intervention programs to promote and maintain metabolic control.

• Korean Journal of Human Ecology
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• v.11 no.1
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• pp.95-106
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• 2002

This study was done to investigate the perception and need of the nutrition counseling of the people living in Daejon. Results were as follows: Nutrition knowledge score increased with education level. It showed tendency that women's scores were higher than men's. Only 15.5% of the participants were experienced in nutrition counseling mostly with medical doctor or nurse in the general hospital. Their satisfaction level was above average, which means positive reaction on nutrition counseling. In the case of the people who paid nutrition counseling fee, they thought that fee level was reasonable. Participants whose education level was higher thought less frequently that the nutrition counseling fee charged currently in the general hospital was expensive. The prevalent contents they want in the nutrition counseling included the prevention and the treatment of the specific disease and food safety (pesticides and food-born illness). As means of nutrition counseling they preferred internet (or PC) and interview. The higher the education status and the less the age, the higher preference, there was for internet or PC. As a source of nutrition knowledge, participants gave high credit on the professional books, academic journals, and advices from dietitian, nutritionist, medical doctor and pharmacist; in the other hand, they gave low credit on the newspaper, magazine, TV or radio, and advices from family or relatives, and friends. They thought most of the adult-onset disease (especially obesity, hyperlipidemia, and diabetes) were closely related to diet. However, percentage of the participants who thought that diet and kidney disease were related was relatively low.

• Korean Journal of Occupational Health Nursing
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• v.21 no.3
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• pp.209-220
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• 2012

Purpose: This study examined the influencing factors for metabolic syndrome and the annual medical expenditures of metabolic syndrome among public officials. Methods: The National Health Insurance data in 2009 were collected for 364,932 public officials and the heath examination results and annual medical expenditures were analyzed using PASW 18.0 program. Results: The prevalence of metabolic syndrome is 17.6%, and it was higher in male officials than that of females in all age groups. In men, the influencing factors for metabolic syndrome were: age, family history of stroke, cardiovascular disease, hypertension, and diabetes mellitus, smoking, alcohol consumption, exercise, and obesity. However, in women, health-related behaviors such as smoking, alcohol consumption and exercise did not affect metabolic syndrome. People who had metabolic syndrome showed significantly higher medical expenditures than those without metabolic syndrome. The odds ratios of having the highest quartile in medical expenditures were 1.372 (95% CI 1.252~1.504, p<.001) in women with metabolic syndrome and 1.213 (95% CI: 1.184~1.243, p<.001) in men. Conclusion: The results implied that health-related behaviors were associated with metabolic syndrome, and resulted in higher medical expenditures. In order not only to decrease the risk of metabolic syndrome but also reduce medical expenditures, nurses should plan health promotion strategies to educate public officials about healthy life strategies.

• Safety and Health at Work
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• v.8 no.2
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• pp.117-129
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• 2017

Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.3
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• pp.563-572
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• 2011

The purpose of this study was to investigate incidence and related factors of the metabolic syndrome in a Korean medicine hospital. The 716 subjects were analyzed using biochemical data and survey who took medical examination in Daejeon Korean Medicine Hospital for general health check-up. This investigation was conducted from February in 2008 to July in 2010. The metabolic syndrome was diagnosed according to the definition by the NCEP ATP III. The abdominal obesity guidelines for waist circumference applied by the WHO Western Pacific Region, IASO and IOTF: The Asia-Pacific Perspective in 2000. Incidence of metabolic syndrome was 12% (14.6% in men, 8.2% in women). The groups that have two metabolic risk factors were 21.9% in men and 7.5% in women. The incidence increased with ageing. The mean of metabolic syndrome`s triglyceride was in hypertriglyceridemia, and that of their BMI in men was in primary obese and that of their AST, ALT, ${\gamma}$-GTP means were in abnormal liver function. Smokers in men have metabolic syndrome 10 times more than non-smokers in men. Exercisers that do the exercise once or twice a week in women have metabolic syndrome 0.2 times more than non-exerciser in women. Women that have family history of stroke, were associated with metabolic syndrome by $x^2$-test. Men that have family history of hypertension, have metabolic syndrome 4 times more than otherwise men. Men that have family history of diabetes mellitus, have metabolic syndrome 3 times more than otherwise men.

• The Korean Journal of Physiology and Pharmacology
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• v.25 no.3
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• pp.177-187
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• 2021

Metabolic syndrome (MBS) is a widespread disease that has strongly related to unhealthy diet and low physical activity, which initiate more serious conditions such as obesity, cardiovascular diseases and type 2 diabetes mellitus. This study aimed to examine the therapeutic effects of morin, as one of the flavonoids constituents, which widely exists in many herbs and fruits, against some metabolic and hepatic manifestations observed in MBS rats and the feasible related mechanisms. MBS was induced in rats by high fructose diet feeding for 12 weeks. Morin (30 mg/kg) was administered orally to both normal and MBS rats for 4 weeks. Liver tissues were used for determination of liver index, hepatic expression of glucose transporter 2 (GLUT2) as well as both inflammatory and fibrotic markers. The fat/muscle ratio, metabolic parameters, systolic blood pressure, and oxidative stress markers were also determined. Our data confirmed that the administration of morin in fructose diet rats significantly reduced the elevated systolic blood pressure. The altered levels of metabolic parameters such as blood glucose, serum insulin, serum lipid profile, and oxidative stress markers were also reversed approximately to the normal values. In addition, morin treatment decreased liver index, serum liver enzyme activities, and fat/muscle ratio. Furthermore, morin relatively up-regulated GLUT2 expression, however, down-regulated NF-κB, TNF-α, and TGF-β expressions in the hepatic tissues. Here, we revealed that morin has an exquisite effect against metabolic disorders in the experimental model through, at least in part, antioxidant, anti-inflammatory, and anti-fibrotic mechanisms.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.3
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• pp.425-431
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• 2015

Estrogen deficiency is associated with increased body weight and fat mass, resulting in obesity-associated complications such as insulin resistance, cardiovascular disease, and type-2 diabetes. The present study was performed to investigate the effect of black rice (Oryza sativa L.) extracts (BRE) on body weight and fat mass in ovariectomized rats. Ovariectomized (or sham-operated) rats were randomly blocked into three groups (n=8~10 per group): sham operated group (S), ovariectomized control group (OVX), and ovariectomized group with BRE 30 mg/kg B.W. (BRE). High fat diet (fat calories 45%) was fed to all experimental rats for 12 weeks. Final body weight, weight gain, and body fat weight showed significant increases in the OVX group, whereas they were reduced by BRE supplementation. Serum TAG, T-chol level, and adipocyte size were not significantly different among the three groups. However, ovariectomy-induced hepatic steatosis was improved in BRE-treated group. Moreover, in the BRE group, serum leptin levels was significantly lower and fecal total lipid concentrations was significantly higher compared to the OVX group. The gathered data suggest that BRE is a potentially useful ingredient to protect against estrogen deficiency-related obesity and its related diseases.