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Biomedical subjects

Byung Jin Kim

Publications and source records attributed to Byung Jin Kim.

12 recordsLinked to original sources

An association of a variety of cardiovascular risk factors with low grade albuminuria in Korean men.

BACKGROUND: Recent studies have challenged the original definition of microalbuminuria when used to assess the risk of coronary heart disease or death. However, no large study has been conducted on Asian subjects regarding this topic to date. Therefore, we investigated the relationship between albuminuria below 17 microg/mg and other cardiovascular risk factors in apparently healthy Korean men. METHODS: We enrolled 2474 men with albuminuria below 17 microg/mg to participate in this study. We evaluated a variety of cardiovascular risk factors as well as the urine albumin creatinine ratio (UACR). The subjects were stratified into five groups by their UACR values and comparisons were made among the five groups. RESULTS: The comparisons showed that the UACR was progressively higher in subjects with a larger waist circumference and BMI as well as higher values for: serum triglyceride, glucose, hsCRP, and the systolic BP, in addition to a higher prevalence of diabetes and metabolic syndrome. When we excluded subjects with hypertension and diabetes, the results were similar. CONCLUSIONS: Our findings suggest that low grade albuminuria in Korean men was associated with a variety of cardiovascular risk factors, and this finding was unchanged when we excluded subjects with diabetes and hypertension. Further studies are warranted to evaluate the clinical implications of our findings.

Adult↗

Assessment of factors affecting plasma BNP levels in patients with chronic atrial fibrillation and preserved left ventricular systolic function.

BACKGROUND: Several studies have reported that plasma brain natriuretic peptide (BNP) levels are increased in patients with chronic atrial fibrillation (AF). The objective of this study was to assess the factors influencing plasma BNP levels in patients with chronic AF and preserved left ventricular (LV) systolic function. METHODS: Transthoracic echocardiography was performed in 104 patients (48 men, 56 women; mean age, 63.9+/-10.7 years) with chronic AF. At the same time, plasma BNP levels were measured with a Triage kit (Biosite, San Diego, CA). RESULTS: Women, long duration of AF, and hypertension were more prevalent in the highest quartile group of BNP levels than in the lowest quartile of BNP. Significant correlations were observed between plasma BNP levels and the following: mitral E velocity (r=0.343), mitral annular E' velocity (r=-0.402), ratio of mitral E velocity and mitral annular E' velocity (r=0.487), left atrial(LA) size (r=0.653), LA volume index (r=0.775), right atrial (RA) volume index (r=0.563), maximal velocity (V(max)) of mitral regurgitation (MR) (r=0.448), tricuspid regurgitation (TR) V(max) (r=0.532) and LV mass index (r=0.581). In stepwise multiple linear regression analysis, LA volume index (beta=0.326, p<0.001), LV mass index (beta=0.395, p<0.001) and duration of AF (beta=0.492, p<0.001) independently predicted plasma BNP levels in the study subjects. The patients with increased LA volume index exhibited a longer duration of AF, larger RA volume index and LV mass index, higher MR V(max), TR V(max) and plasma BNP level. CONCLUSIONS: LA volume index, LV mass index and duration of AF are independent predictors of plasma BNP levels in patients with chronic AF and preserved LV systolic function.

Atrial Fibrillation↗

Presence and severity of coronary artery disease and changes in B-type natriuretic peptide levels in patients with a normal systolic function.

B-type brain natriuretic peptide (BNP) levels increase during myocardial ischemia. Here, the authors undertook to evaluate the correlation between changes in plasma BNP levels during exercise and the presence and severity of coronary artery disease (CAD). The study subjects consisted of 159 hospitalized patients with a normal systolic function. Patients were allocated to a control group (N = 101, comprising patients with coronary artery stenosis of < 50%) or to a CAD group (N = 58, comprising patients with stenosis of > or = 50% or a greater coronary artery lesion). In addition, the CAD group was further subdivided into a single-vessel disease (VD) subgroup (N = 31) and a multi-VD subgroup (N = 27). All 159 study subjects underwent coronary angiography (CAG), and plasma BNP levels were measured before and immediately after exercise. A comparative study of BNP levels in the control and CAD groups before and after exercise revealed that BNP levels in the CAD group were significantly higher [22.4 (5.0-28.5) vs. 54.3 (13.1-74.6), P = 0.000; 35.0 (6.2-37.6) vs. 82.5 (23.2-102.8) pg/mL, P = 0.002, respectively]. Changes in BNP levels during exercise in the CAD group tended to be greater than in the control group, but without significance [12.6 (0-13.6) vs. 28.3 (2.8-25.5) pg/mL; P = 0.083]. Subgroup analysis showed that BNP levels tended to be positively related to the proportion of disease vessels, but statistical significance was only found between the control and multi-VD subgroup. Summarizing, this study shows that BNP level changes caused by exercise are closely related with the presence of CAD in patients with a normal systolic function. However, the relationship between these level changes and CAD severity requires further evaluation.

Coronary Angiography↗

Comparison of the relationships between serum apolipoprotein B and serum lipid distributions.

BACKGROUND: Apolipoprotein B (apo B) has been reported to be a better predictor of coronary artery disease than cholesterol indices. The objectives of this study were to evaluate concordances/discordances between cholesterol indices and apo B and to assess the factors that influence them. METHODS: For this study, 11 816 individuals (6965 males, 4851 females), none of whom had a past history of coronary artery disease, were selected from among visitors to the health promotion center at Kangbuk Samsung Hospital between January and December 2002. We assessed concordances between the biochemical indices of atherogenicity and evaluated factors associated with discordances. RESULTS: Apo B and various cholesterol indices were correlated, although concordance fell within the range 47%-56%. Multinomial logistic regression analysis showed an increasing risk of a disproportionately higher apo B than LDL-cholesterol in males, the elderly, smokers, individuals with metabolic syndrome, in those with high HDL-cholesterol or triglyceride (TG) concentrations or larger waist circumferences, and in those with low total cholesterol (TC). CONCLUSIONS: The introduction of apo B to standard lipid profile testing could improve the evaluation of risk factors of coronary artery disease and aid more accurate assessment of the effects of cholesterol-lowering therapy, particularly in males, the elderly, smokers, or in individuals with metabolic syndrome, high HDL-cholesterol, high TGs, larger waist circumferences, or low TC.

Adult↗

Dynamic regulation of hypothalamic neuropeptide gene expression and food intake by melanocortin analogues and reversal with melanocortin-4 receptor antagonist.

Melanocortins are known to be involved in the inhibition of food intake and energy metabolism. Acute and chronic intracerebroventricular administration of several different analogues of alpha-MSH, such as alpha-MSH, NDP-MSH, alpha-MSH-ND, [Gln(6)]alpha-MSH-ND, and [Lys(6)]alpha-MSH-ND, which were substituted in the position of His(6) with Gln and Lys, and cyclic16k-MSH to C57J/BL6 mice resulted in a significant inhibition of both time course food intake and body weight gain, compared to the saline-administered control. However, [Gln(6)]alpha-MSH-ND(6-10), the truncated form of [Gln(6)]alpha-MSH-ND, had no inhibitory effects on food intake. In situ hybridization analysis revealed that the expression levels of AGRP and NPY in the hypothalamus were significantly and rapidly diminished while POMC expression was strongly induced by [Gln(6)]alpha-MSH-ND. Administration of JKC-363, a selective MC4R-specific antagonist, coupled with [Gln(6)]alpha-MSH-ND, specifically reversed the [Gln(6)]alpha-MSH-ND-induced inhibition of food intake, but also reversed the hypothalamic expression levels of neuropeptides such as AGRP, NPY, MCH, and POMC, which suggests [Gln(6)]alpha-MSH-ND can function as a selective MC4R agonist.

Amino Acid Sequence↗

Severe coronary artery spasm can be associated with hyperthyroidism.

BACKGROUND: Coronary artery spasm is not infrequently seen in Korea. Most of the patients with coronary spasm show a focal spasm in coronary angiography. However, the cause of the disease is not well known. There have been a few anecdotal case reports of coronary artery spasm associated with hyperthyroidism, but there has not been a report concerning a large series of such patients. Over a period of 5 years and 8 months, we experienced eight patients having the diffuse or severe type of coronary artery spasm in association with hyperthyroidism. METHODS: We investigated the characteristics of the patients with coronary artery spasm, which was diagnosed by coronary angiography or by provocation with an intracoronary injection of acetylcholine or ergonovine. The demographic data, coronary angiographic findings, thyroid function test results, and the follow-up clinical data of the eight patients having coronary artery spasm associated with hyperthyroidism were analyzed. RESULTS: All eight patients had Graves' disease. In six patients, the coronary arterial vasoconstriction developed during the coronary angiography without an injection of ergonovine. In three patients, the left main stem coronary artery was involved in the spasm. Among these eight patients, five were female, and all of these female patients were < or = 51 years old. All of the patients were treated with anti-thyroid medications, calcium channel blockers, and long-acting nitroglycerines; they all remained free of chest pain during the median follow-up period of 5 years. CONCLUSIONS: A severe form of coronary artery spasm could be associated with hyperthyroidism. A high level of suspicion and the thyroid function study should be mandatory for patients with coronary artery spasm, especially for the young female patients.

Angina, Unstable↗

Situational syncope induced by belching.

We describe a case of situational syncope induced by belching. The patient showed severe syncope with a high-degree atrioventricular block just after belching, but has not experienced syncope or dizziness over a 3-month follow-up after permanent pacemaker implantation.

Eructation↗

Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome.

BACKGROUND: Associations between hyperuricemia, cardiovascular diseases and diabetes have been reported, but few of the studies have been conducted in the Korean population. The present study examined a Korean adult population with respect to the relationships between serum uric acid concentrations and hypertension, insulin resistance, and the risk factors of metabolic syndrome. METHODS AND RESULTS: A total of 53,477 subjects were divided into 4 groups according to serum uric acid quartiles. The incidence of hypertension in all subjects was higher in the first quartile than in the third plus fourth quartile (odds ratio (OR) 1.192, p < 0.001). Homeostasis model assessment index was found to be associated with serum uric acid concentration in all subjects (OR 1.193, p < 0.001), and the serum uric acid concentration was positively correlated with the risk factors of metabolic syndrome. In addition, the number of metabolic syndrome variables increased as serum uric acid concentration increased. CONCLUSIONS: Serum uric acid concentration was found to be independently correlated with hypertension, insulin resistance and the risk factors of metabolic syndrome. In addition, even those with a serum uric acid concentration in the normal range showed an increased risk of metabolic syndrome as serum uric acid concentration increased.

Adult↗

In normoglycemic Koreans, insulin resistance and adipocity are independently correlated with high blood pressure.

BACKGROUND: There is some controversy about the role of insulin resistance (IR) in the regulation of blood pressure (BP). Moreover, a large study of the association between BP and IR has not been conducted in normal glucose tolerance Asians. The present study investigated the relationships between IR, body mass index (BMI) and waist circumference and BP in normoglycemic Koreans. METHODS AND RESULTS: Anthropometric indices of adiposity, metabolic variables (fasting serum insulin and a homeostasis model assessment (HOMA) index of insulin sensitivity), BP and several cardiovascular risk factors were measured during a cross-sectional survey of 49,076 normoglycemic Korean subjects. A high BP was defined as a systolic BP >/=140 mmHg or a diastolic BP >/=90 mmHg. The prevalence of high BP by HOMA grading was 0.985 (95% confidence interval (CI) 0.857-1.132, p=0.835), 1.180 (95% CI 1.032-1.350, p=0.016), 1.289 (95% CI 1.129-1.472, p<0.001), and 1.540 (95% CI 1.341-1.768, p<0.001) times higher in subjects in the second, third, fourth, and fifth quintiles, respectively, compared with those in the first quintile. In addition, age, sex, waist circumference and BMI were found to be significantly associated with a high BP. CONCLUSION: IR, BMI and waist circumference are independently correlated with high BP in normoglycemic Koreans.

Adult↗

Relationship between peripheral leukocyte count and the severity of stable angina determined by coronary angiography.

BACKGROUND: Inflammation has been demonstrated to be an important risk factor for the development of cardiovascular disease (CVD). The relationship of the peripheral leukocyte count to the severity of stable angina remains to be clarified. The present study analyzed the relationship of the peripheral leukocyte count to the severity of stable angina determined by coronary angiography. METHODS: The data from 108 patients with stable angina, and 92 subjects with normal coronary angiograms were reviewed, and the role of the peripheral leukocyte count as a risk factor for stable angina evaluated. In addition, the correlation of the peripheral leukocyte count and the severity of stable angina, as assessed by the Gensini's score in the stable angina group, were analyzed. RESULTS: Age, the prevalence of hypertension and diabetes, and the fasting blood sugar were significantly higher, and the HDL was lower in the stable angina than the control group. A multivariate analysis showed that a peripheral leukocyte count over 6,800/mm3 was an independent variable, but with no statistical significance (p=0.067), and diabetes (OR=3.02, 95% CI: 1.29-7.02) and old age (OR=3.62, 95% CI: 1.3-9.87) were independent risk factors for stable angina. A positive correlation between peripheral leukocyte count and Gensini's score was noted in the stable angina group even after adjusting for age, fasting blood sugar, blood pressure and lipid profiles (R2=0.198, p=0.015). CONCLUSION: An increased peripheral leukocyte count is considered not so much an indicator of the pathogenesis of stable angina, but as a predictor for disease progression. Furthermore, it is considered that the above correlation will be helpful in screening high-risk groups that require relatively active interventional therapy.

Adult↗

Effects of high molecular weight water-soluble chitosan on in vitro fertilization and ovulation in mice fed a high-fat diet.

A high molecular weight water-soluble chitosan (WSC) with an average molecular weight of 300 kD and a deacethylation level of over 90% was produced using a simple multi-step membrane separation process. It is known that WSC prevents obesity induced by a high-fat diet. Consequently, this study investigated whether or not WSC improved the ovarian dysfunction caused by obesity in mice. The mice were fed a high density protein and lipid diet for 4 weeks, followed by the administration of WSC at 480 mg/kg body weight per day for 4 days. Thereafter, the changes in body weight, ovulation rate, in vivo and in vitro fertilization and embryonic development were measured. WSC markedly reduced the body weight of obese mice fed with a high-fat diet, but not in mice fed with a normal diet. WSC had significant effects on the ovulation rate, both the in vivo and in vitro fertilization rates and embryonic development. These results indicate an improvement in the ovarian and oviduct dysfunction caused by obesity, and suggest an adjustment in the internal secretions and metabolic functions.

Animals↗