• 한국임상약학회지
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• 제28권3호
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• pp.194-203
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• 2018

Background: Bone fractures are high in elderly patients with type 2 diabetes mellitus (T2DM). Hyperglycemia and chronic kidney disease may increase the risk of fracture prevalence via altered bone metabolism, but whether glycemic control and kidney function are associated with the risk of fracture prevalence remains unclear. This study evaluated the relationship between glycemic control and baseline estimated glomerular filtration rate (eGFR) and risk of fracture prevalence in older and middle-aged patients with T2DM. Methods: Patients who underwent a general medical check-up between 2009 and 2013 were selected from the Korean National Health Insurance Sharing Service records. Chi-square test and multiple logistic regression analysis were used to assess the relationship between glycemic control and eGFR and risk of fracture prevalence. Results: Cumulative fracture prevalence were higher in patients with T2DM, irrespective of whether they had tight or less stringent glycemic control (fasting blood glucose [FBG] ${\geq}110mg/dL$). After adjustment for baseline age and FBG, tight and less stringent glycemic control was significantly associated with increased adjusted risk of fracture prevalence in middle-aged patients with T2DM (OR=1.13, 95% CI, 1.05-1.21, p=0.0005 vs OR=1.13, 95% CI, 1.06-1.20, p=0.0001), but not in older patients. Baseline eGFR was not significantly related to fracture prevalence in either older or middle-aged patients. Conclusion: Less stringent glycemic control significantly increased the adjusted risk of fracture prevalence in middle-aged patients with T2DM. Further studies are needed to confirm the effect of tight glycemic control on fracture prevalence.

• 디지털융복합연구
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• 제12권6호
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• pp.655-667
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• 2014

본 연구는 질병과 관련한 온라인 포럼에서 추출한 언어 데이터를 통해 제 2형 당뇨병 환자의 질병에 대한 담론을 양적으로 분석하였다. 또한 환자 언어행위의 양적분석을 통해 환자들의 주요 관심사와 심리적 특징의 일반화가 가능한지에 대해 실증적으로 검증하였다. 분석방법으로는 기존의 인터뷰에 기반한 정성적 연구방법론과 달리 환자들의 담론 표본 전체를 파싱 (parsing)과 POS 태깅을 통해 언어학적으로 형태소 분류를 하였다. 주요 어휘빈도 추출과 N-gram을 통한 최빈도 구문구조 분석을 병행하여, 질병과 관련한 이슈의 주요 범주와 심리상태에 관한 언어적인 특징을 살펴보았다. 연구 결과 환자들의 자발적 대화는 주로 다이어트, 운동, 증상, 약물치료, 심리상태의 5가지 범주로 나타나고 있음을 확인하였고, 최빈도 구문구조 분석을 통해 질병치료와 식생활습관 개선 전반에 대한 부정적인 견해가 두드러진 것을 확인하였다. 결과적으로 의료진의 정확한 정보 전달과 전문가의 조언, 정서적 지원 등이 당뇨환자에 대한 심리적 상태에 중요한 만큼 심리치료 서비스이 개선이 필요할 것으로 보인다. 이런한 결과는 기존의 의료제도 안에서의 환자의 관심사와 심리적 특징이 온라인 상에서도 적절하게 투영되고 있음을 시사한다.

• Journal of Periodontal and Implant Science
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• 제44권4호
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• pp.158-168
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• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• Genomics & Informatics
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• 제8권3호
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• pp.131-137
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• 2010

Genome-wide association studies (GWASs) have greatly contributed to the identification of common variants responsible for numerous complex traits. There are, however, unavoidable limitations in detecting causal and/or rare variants for traits in this approach, which depends on an LD-based tagging SNP microarray chip. In an effort to detect potential casual and/or rare variants for complex traits, such as type 2 diabetes (T2D) and triglycerides (TGs), we conducted a targeted resequencing of loci identified by the Korea Association REsource (KARE) GWAS. The target regions for resequencing comprised whole exons, exon-intron boundaries, and regulatory regions of genes that appeared within 1 Mb of the GWA signal boundary. From 124 individuals selected in population-based cohorts, a total of 0.7 Mb target regions were captured by the NimbleGen sequence capture 385K array. Subsequent sequencing, carried out by the Roche 454 Genome Sequencer FLX, generated about 110,000 sequence reads per individual. Mapping of sequence reads to the human reference genome was performed using the SSAHA2 program. An average of 62.2% of total reads was mapped to targets with an average 22X-fold coverage. A total of 5,983 SNPs (average 846 SNPs per individual) were called and annotated by GATK software, with 96.5% accuracy that was estimated by comparison with Affymetrix 5.0 genotyped data in identical individuals. About 51% of total SNPs were singletons that can be considered possible rare variants in the population. Among SNPs that appeared in exons, which occupies about 20% of total SNPs, 304 nonsynonymous singletons were tested with Polyphen to predict the protein damage caused by mutation. In total, we were able to detect 9 and 6 potentially functional rare SNPs for T2D and triglycerides, respectively, evoking a further step of replication genotyping in independent populations to prove their bona fide relevance to traits.

• 응용통계연구
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• 제31권5호
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• pp.573-585
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• 2018

본 연구에서는 제 2형 당뇨(type 2 diabetes mellitus)의 발병 확률을 예측하기 위해 11가지 위험요인을 가지고 로지스틱 회귀모형과 순수 베이지안 분류기 모형에 적합시킨다. 그런 다음 이를 시각적으로 쉽게 이해하는데 도움을 주는 노모그램 구축 방법을 소개한다. 분석은 2013-2015년 6기 국민건강영양조사 데이터를 가지고 분석하였다. 또 로지스틱 회귀모형에 세 가지 상호작용 항을 넣어 분석의 질을 높이고자 하였고 베이지안 노모그램에 left-aligned 방법을 사용하여 비교하기 쉽게 만들었다. 최종적으로 두 노모그램을 비교하고 효용성을 알아보았다. 마지막으로 ROC 곡선을 이용하여 노모그램이 적절한지 검증하였다.

• 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.

• Anatomy and Cell Biology
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• 제56권4호
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• pp.552-561
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• 2023

The endocrinology of type 2 diabetes (T2D) and its predisposing factors have been studied extensively while its skeletal effects have received negligible research despite this being a global disease. The cellular and molecular association between proximal humeral fractures and T2D has not been fully elucidated. We aimed to study bone cell quantities and immunolabel osteogenic and antiosteogenic cytokines. The study used 12-week-old rats (23 males) consisting of 8 Sprague Dawley (SD) and 15 Zucker Diabetic Sprague Dawley (ZDSD). Weekly mass measurements were taken while fasting blood glucose levels were recorded every 2 weeks with oral glucose tolerance tests conducted once every 4 weeks. Upon termination at the age of 28 weeks, humeri were fixed in 10% buffered formalin, prior to decalcification in ethylenediaminetetraacetic acid. The bone samples were then processed in ascending grades of alcohol using an automatic processor before embedding in paraffin wax. Sections were cut at 5 ㎛ thickness in a series for Haematoxylin and Eosin stain, and immunohistochemistry was performed with the anti-tartrate-resistant acid phosphatase (TRAP), anti-alkaline phosphatase (ALP), anti-bone morphogenetic protein 3 (BMP3), anti-transforming growth factor beta 1 (TGFβ1), anti-aged glycation end product (AGE) antibodies in the sequence. ZDSD rats had more adipocytes, BMP3 and AGEs expression with higher numbers of TRAP positive osteocytes and fewer ALP cells although no differences were found in TGFβ1 immunopositivity. We also found that T2D increases the number of AGEs immuno-positive cells, as well as its extracellular expression, thus providing a conducive environment for the interaction of the osteogenic cytokine and its antagonist to suppress osteoblastogenesis. ZDSD groups had higher adipocyte numbers therefore increased marrow adiposity in T2D.

• BMB Reports
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• 제55권9호
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• pp.453-458
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• 2022

Diabetes mellitus (DM) is a serious disease in which blood sugar levels rise abnormally because of failed insulin production or decreased insulin sensitivity. Although many studies are being conducted for the treatment or early diagnosis of DM, it is not fully understood how mitochondrial genome (mtDNA) abnormalities appear in patients with DM. Here, we induced iPSCs from fibroblasts, PBMCs, or pancreatic cells of three patients with type 2 DM (T2D) and three patients with non-diabetes counterpart. The mtDNA mutations were detected randomly without any tendency among tissues or patients. In T2D patients, 62% (21/34) of iPSC clones harbored multiple mtDNA mutations, of which 37% were homoplasmy at the 100% mutation level compared to only 8% in non-diabetes. We next selected iPSC clones that were a wild type or carried mutations and differentiated into pancreatic cells. Oxygen consumption rates were significantly lower in cells carrying mutant mtDNA. Additionally, the mutant cells exhibited decreased production of insulin and reduced secretion of insulin in response to glucose. Overall, the results suggest that screening mtDNA mutations in iPSCs from patients with T2D is an essential step before pancreatic cell differentiation for disease modeling or autologous cell therapy.

• Journal of Korean Biological Nursing Science
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• 제2권1호
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• pp.64-75
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• 2000

This study was conducted to identify the effects of exercise therapy applied in an efficacy expectation promoting program that was based on Bandura's self efficacy model on self-efficacy, cardiopulmonary function and metabolism in type 2 diabetes mellitus patients. The study design was nonequivalent pre-test post-test control design. 34 type 2 diabetes mellitus patients who received follow-up care regularly through the diabetic out-patient clinic were randomly sampled for this study. Twenty patients were assigned to the experimental group and fourteen patients were assigned to the control group. To the experimental group, exercise therapy applied in an efficacy expectation promoting program that is composed of individualized exercise prescription for 12 weeks was provided. In case of the control group, they were instructed to continue their usual lives. Data collection period was from March 1998 to June 2000 Data were analyzed using SPSS/WINDOW 10.0 program. The results were as follows. In experimental group, The score of self efficacy has increased from 64.20 to 66.65 after exercise therapy applied in an efficacy expectation promoting program and it was statistically significant(t=2.07, p=.04). The anaerobic threshold has increased from $18.20\;m{\ell}$/kg/min to $19.07\;m{\ell}$/kg/min and it was statistically significant(t=2.05, p=.04). Level of fasting blood sugar has decreased from $188.20\;mg/d{\ell}$ to $155.55\;mg/d{\ell}$ after exercise therapy applied in an efficacy expectation promoting program and it was statistically significant.(t=-2.69, p=.01). For the lipid metabolism, percent body fat has decreased from 27.16% to 26.57% after exercise therapy applied in an efficacy expectation promoting program. In conclusion, the exercise therapy applied in an efficacy expectation promoting program showed positive effect of self-efficacy, cardiopulmonary function and glucose and lipid metabolism.

• 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.