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Biomedical subjects

Dae Jung Kim

Publications and source records attributed to Dae Jung Kim.

At least 19 recordsLinked to original sources
PubMed2007

Effects of rosiglitazone and metformin on inflammatory markers and adipokines: decrease in interleukin-18 is an independent factor for the improvement of homeostasis model assessment-beta in type 2 diabetes mellitus.

OBJECTIVE: We examined the individual pharmacological effects of the addition of rosiglitazone and metformin to glimepiride on inflammatory markers and adipokines in patients with type 2 diabetes mellitus. We analysed the relationships between these variables, the measurements of insulin sensitivity and beta-cell function in patients treated with rosiglitazone plus glimepiride. DESIGN AND PATIENTS: One hundred twenty (120) patients with type 2 diabetes mellitus were randomized and treated with glimepiride plus rosiglitazone or glimepiride plus metformin for 12 weeks. The plasma concentrations of the inflammatory markers and adipokines were measured at baseline and after 12 weeks. MEASUREMENTS: Markers of insulin sensitivity and beta-cell function were determined by the quantitative insulin sensitivity check index (QUICKI) and the homeostasis model assessment of beta-cell function (HOMA-beta), respectively. Plasma concentrations of adiponectin were measured by radioimmunoassay. Plasma concentrations of resistin, tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and interleukin-18 (IL-18) were measured using ELISA. RESULTS: Improvements in fasting insulin level, QUICKI and HOMA-beta were noted in the rosiglitazone-treated group. Only the QUICKI value improved in the metformin-treated group. Adiponectin concentrations significantly increased in the rosiglitazone-treated group after 12 weeks. Significant decreases in resistin, C-reactive protein, TNF-alpha, IL-6 and IL-18 were seen in the rosiglitazone-treated patients but not in the metformin-treated patients. The independent risk factor for the HOMA-beta change according to stepwise multivariate regression analysis was a change in IL-18. CONCLUSIONS: Rosiglitazone, but not metformin, improved the plasma concentrations of inflammatory markers and adipokines in patients with type 2 diabetes mellitus. A decrease in IL-18 is an independent factor for the improvement of HOMA-beta in type 2 diabetes mellitus.

Adiponectin↗
PubMed2006

Prevalence of the metabolic syndrome among Korean adults using the new International Diabetes Federation definition and the new abdominal obesity criteria for the Korean people.

This study was performed to compare the prevalence of the metabolic syndrome according to the International Diabetes Federation (IDF) and National Cholesterol Education Program (NCEP) definitions, and abdominal obesity criteria of WHO and the Korean Society for the Study of Obesity (KSSO) in Korean adults. A total of 4452 adults aged > or =20 years from the Korean National Health and Nutrition Examination Survey 2001 were analyzed. The prevalence of the metabolic syndrome estimated by NCEP definition with WHO criteria, NCEP with KSSO, IDF with WHO, and IDF with KSSO were 26.7%, 23.7%, 23.8% and 17.5%, respectively. The agreement percent among the four definitions ranged from 88.7% to 100% in men, and from 85.6% to 94.9% in women. The NCEP-defined metabolic syndrome was more strongly associated with hypertension and diabetes than the IDF-defined metabolic syndrome (age-adjusted odds ratio: 5.1 versus 3.6 for hypertension and 6.4 versus 3.2 for diabetes in men, respectively; 5.4 versus 3.4-4.3 for hypertension and 11.1 versus 3.8-4.2 for diabetes in women, respectively). Both definitions of the metabolic syndrome were associated with coronary heart disease or stroke only in women. Prospective studies are warranted to evaluate the predictive ability of the new definition of the metabolic syndrome and the new criteria of abdominal obesity for cardiovascular morbidity and mortality in Korean adults.

Adult↗
PubMed2006

Normal serum aminotransferase levels and the metabolic syndrome: Korean National Health and Nutrition Examination Surveys.

Increasing evidence suggests an association between elevated serum aminotransferase level and the metabolic syndrome. However, the significance of relatively low levels of aminotransferase in relation to the metabolic syndrome has not been fully investigated in the general population. We investigated the association between serum amiontransferase level and the metabolic syndrome using data from a nationwide survey in Korea. We measured serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and metabolic conditions among 9771 participants aged 20 or more in the 1998 and 2001 Korean National Health and Nutrition Examination Surveys. Metabolic syndrome was defined according to NCEP-ATP III criteria with a modified waist circumference cutoff (men > 90 cm; women > 80 cm). Serum aminotransferase level, even within normal range, was associated with the metabolic syndrome independent of age, body mass index, waist circumference, smoking, and alcohol intake. Compared with the lowest level (< 20 IU/L), the adjusted odds ratios (95% CI) for an AST level of 20-29, 30-39, 40-49 and > or = 50 IU/L were 1.10 (0.85-1.42), 1.37 (1.02-1.83), 1.62 (1.08-2.43), and 2.25 (1.47-3.44) in men, and 1.18 (0.99-1.41), 1.43 (1.29-1.83), 1.71 (1.09-2.68), and 2.14 (1.20-3.80) in women, respectively. Corresponding odds ratios for ALT levels were 1.27 (0.99-1.63), 1.69 (1.28-2.23), 2.17 (1.58-2.99), and 2.65 (1.96-3.58) in men, and 1.44 (1.22-1.70), 1.65 (1.26-2.15), 2.94 (1.93-4.47), and 2.25 (1.54-3.30) in women, respectively. In conclusion, elevated serum aminotransferase levels, even in the normal to near normal range, are associated with features of the metabolic syndrome.

Adult↗
PubMed2006

Appropriate waist circumference cutoff points for central obesity in Korean adults.

BACKGROUND: The International Diabetes Federation consensus recently proposed a new definition for the diagnosis of metabolic syndrome, incorporating ethnically specific waist circumference (WC) cutoff points. OBJECTIVE: We investigated the ethnically appropriate WC cutoff values for central obesity in Korean adults to predict increased risk of elevated triacylglycerol, reduced HDL cholesterol, elevated blood pressure, elevated fasting plasma glucose, or two or more of these factors. DESIGN: We used data from 6561 adults, aged 20-80 years, who participated in the Korean Health and Nutritional Examination Survey of 1998, a cross-sectional health survey of a nationally representative sample of Koreans. RESULTS: Based on the receiver operating characteristic curve analysis, the WC value for predicting metabolic risk factors in Koreans was about 85 cm for men and 80 cm for women. The odds ratio for the risk of two or more metabolic risk factors increased abruptly in men with WC >or= 90 cm and women with WC >or= 85 cm. The 80th percentile for WC in the Korean population was 90 cm for men and 86.5 cm for women. Thus, the appropriate WC cutoff point for central obesity in Koreans was determined to be 90 cm for men and 85 cm for women. CONCLUSIONS: Based on our criteria, the prevalence of central obesity was 19.8% in Korean men and 24.5% in Korean women. These findings suggest the applicability of ethnically specific cutoff points for WC in assessing central obesity.

Adult↗
PubMed2006

A case report of familial benign hypocalciuric hypercalcemia: a mutation in the calcium-sensing receptor gene.

Familial benign hypocalciuric hypercalcemia (FBHH) is an autosomal dominant trait with high penetrance, clinically manifesting a relatively benign, lifelong, persistent hypercalcemia and hypocalciuria without hypercalcemic related complications. The calcium-sensing receptor (CaSR) plays an important role in the regulation of PTH secretion and calcium metabolism. Here we present a family with FBHH of an autosomal dominant inheritance. A heterozygous mutation of E297K (GAG --> AAG, exon 4) of CaSR gene was found in 3 family members. To our knowledge, it is the first confirmed case of FBHH with CaSR gene mutation in Korea.

Adult↗
PubMed2006

Does birthweight predict adolescent adiponectin levels?

OBJECTIVE: Low birthweight is associated with insulin resistance later in life, and adiponectin is known to play an important role in insulin resistance. We have investigated whether birthweight has a relationship with adiponectin levels in adolescence. PATIENTS: An at-home questionnaire survey was completed by 660 middle-school students (aged 12-15 years) in Seoul, Korea, and 152 participants were selected randomly based on their birthweight. MEASUREMENTS Subjects were separated into three groups according to birthweight. We recorded the birthweight and measured anthropometric factors including blood pressure, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-beta), and adiponectin levels of the subjects. These parameters were compared among the groups. The relationship between birthweight and physiological characteristics in adolescence was examined. RESULTS: Systolic blood pressure, lipid profiles and fasting plasma glucose were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide and HOMA-IR were higher in the low birthweight tertile. After adjustment for confounding factors, birthweight was inversely related to diastolic blood pressure, insulin, C-peptide and HOMA-IR. Adiponectin level had a significant relationship with current body mass index (BMI) (r=-0.291; P< 0.001) but not with birthweight (r = 0.117; P = 0.166). CONCLUSIONSP: Although birthweight is closely related to insulin resistance during adolescence, adiponectin levels during adolescence had no significant relationship with birthweight. This result implies that low birthweight may not permanently affect adiponectin levels, but current body size is more closely associated with a decreased adiponectin level. However, the limited importance of birthweight as a determining factor on the adiponectin level later in life needs to be further evaluated.

Adiponectin↗
PubMed2006

High plasma concentration of remnant lipoprotein cholesterol in obese children and adolescents.

OBJECTIVE: Remnant lipoproteins (RLPs) are the products of the lipolytic degradation of triglyceride-rich lipoproteins produced by the liver and intestine. Recent studies have demonstrated that RLPs are correlated with cardiovascular risk. We assessed the relationship between obesity and RLP and evaluated the factors related to RLP in children and adolescents. RESEARCH DESIGN AND METHODS: We measured BMI, waist circumference, blood pressure, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, fasting glucose, insulin, total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, and RLP cholesterol in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti-apolipoprotein (apo) B-100 and anti-apoA-I antibodies. Based on the BMI percentile, the subjects were divided into two groups: normal (< 85th percentile) and overweight (> or = 85th percentile). RESULTS: RLP cholesterol was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral-to-subcutaneous fat area ratio, total cholesterol, triglycerides, HDL cholesterol, apoB, and homeostasis model assessment of insulin resistance (HOMA-IR). According to the multivariate regression analysis, triglycerides (beta = 0.928, P < 0.001) were independently correlated with RLP cholesterol. After excluding lipid profiles as an independent variable, the multivariate regression analysis revealed that HOMA-IR (beta = 0.231, P = 0.007) and systolic blood pressure (beta = 0.169, P = 0.046) were independently associated with RLP cholesterol. CONCLUSIONS: RLP cholesterol was significantly higher in obese children and adolescents. Triglycerides, systolic blood pressure, and insulin resistance were related to RLP cholesterol.

Abdominal Fat↗
PubMed2006

Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults.

We investigated the cutoff values of surrogate of insulin resistance for diagnosing metabolic syndrome in Korean adults. The data from 976 non-diabetic individuals (484 men and 492 women) aged 30-79 yr were analyzed. We determined the odds ratios for the prevalence of metabolic syndrome according to the quartiles of fasting insulin, homeostasis model for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as independent variables, while adjusting for age, sex, and body mass index. The cutoff values of fasting insulin, HOMA-IR, and QUICKI were estimated by the areas under the receiver-operating characteristic (ROC) curves. The cutoff points for defining insulin resistance are a fasting insulin level of 12.94 microU/mL, HOMA-IR=3.04 as the 75th percentile value, and QUICKI=0.32 as the 25th percentile value. Compared with the lowest quartile, the adjusted odds ratios for the prevalence of metabolic syndrome in the highest quartiles of fasting insulin, HOMA-IR, and QUICKI were 1.95 (1.26-3.01), 2.27 (1.45-3.56), and 2.27 (1.45-3.56), respectively. The respective cutoff values for fasting serum insulin, HOMA-IR, and QUIC-KI by ROC analysis were 10.57 microU/mL (sensitivity 58.5%, specificity 66.8%), 2.34 (sensitivity 62.8%, specificity 65.7%), and 0.33 (sensitivity 61.2%, specificity 66.8%). Fasting insulin, HOMA-IR, and QUICKI can be used as surrogate measures of insulin resistance in Korean non-diabetic adults.

Adult↗
PubMed2005

Normative values of carotid artery intima-media thickness in healthy Korean adults and estimation of macrovascular diseases relative risk using this data in type 2 diabetes patients.

The objectives of this study were to determine normative values of carotid intima-media thickness (IMT) in healthy Korean subjects and to use these values to estimate the relative risk of macrovascular diseases in patients with type 2 diabetes mellitus (T2DM). High-resolution B-mode ultrasonography was performed in 1,229 healthy subjects and 830 T2DM patients. Height, weight, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, and fasting insulin level were measured. Subjects were classified as healthy subjects; T2DM patients without ischemic heart disease (IHD), stroke, and peripheral arterial occlusive diseases (PAOD); T2DM patients with IHD, stroke, or PAOD. IMT was significantly increased as age increased. Patients with T2DM had higher IMTs compared to healthy subjects. Independent risk factors of IMT were age, systolic blood pressure, BMI for healthy subjects, and age, duration of diabetes, LDL-cholesterol for T2DM subjects. According to presence of increased IMT, the relative risks of IHD, stroke, and PAOD in diabetic subjects, were 2.34 (CI; 1.32-4.14), 2.95 (CI; 1.46-5.54), and 3.64 (CI; 1.66-7.40), respectively. This study suggests normative values that can be used as an index for carotid artery IMT of healthy Korean subjects, and that IMT data reflects the risk of macrovascular diseases in T2DM.

Adult↗
PubMed2005

The prevalence of the metabolic syndrome in Korean adults: comparison of WHO and NCEP criteria.

The aims of this study were to compare the prevalence of the metabolic syndrome according to the WHO and NCEP ATP III criteria in Korean adults, and to compare the prevalence of the metabolic syndrome with the results in previous Korean studies. The study comprised 1,230 subjects (627 men, 603 women) aged 30-79 years (mean 52.4 +/- 10.3 years) who underwent medical check-up from April to June, 2001 in the Korea Association of Health (KAH). The prevalence of the metabolic syndrome according to the modified WHO criteria was 21.8 % of men and 19.4 % of women. However, the prevalence was increased 1.6 times (34.2 % ) in men and 2.0 times (38.7 % ) in women using the modified NCEP criteria. The prevalence of the metabolic syndrome has varied widely according to differences in the criteria. Thus, further studies are necessary to define the appropriate criteria of the metabolic syndrome for Korean adults.

Adult↗
PubMed2005

Role of copper chloride on the surface of activated carbon in adsorption of methyl mercaptan.

In this paper, adsorption characteristics of methyl mercaptan on virgin activated carbon and copper chloride impregnated activated carbons were studied by using a dynamic adsorption method in a fixed bed. The activated carbons were characterized by nitrogen adsorption, XRD, TGA and solubility tests. The impregnation of copper chloride on the activated carbon significantly enhanced the adsorption capacity of methyl mercaptan, despite a notable decrease in microporosity. It is likely that copper chloride may act as adsorption site for methyl mercaptan. Copper chloride on the activated carbon in a range of 3-20 wt% Cu content was present mostly in the amorphous form of CuCl(2), according to the results of the solubility, XRD and TGA tests. Starting at 10 wt% in Cu loading, the adsorption capacity for methyl mercaptan decreases gradually. It is likely that a decrease in the degree of copper chloride dispersion and an accessibility of small pores may lead to the decrease in the adsorption capacity of the activated carbon for methyl mercaptan.

Journal Article↗
PubMed2005

Predictive clinical parameters for therapeutic efficacy of rosiglitazone in Korean type 2 diabetes mellitus.

This study evaluated the efficacy of rosiglitazone in non-obese and obese Korean type 2 diabetic patients of long duration. A total of 125 patients (M:F=44:81, mean age: 58.4+/-9.1 years, BMI: 24.2+/-2.7 kg/m2, duration of diabetes: 11.0+/-6.4 years) were randomly allocated to 12 weeks of rosiglitazone treatment (4 mg per day) or a control group. Responders were defined as patients who experienced fasting plasma glucose (FPG) reduction of >20% or HbA1c reduction of >1 (%). Rosiglitazone significantly improved glycemic control by reducing FPG and HbA1c (-3.4 mmol/l and -1.1%, P<0.001, respectively). It also significantly increased HOMA(beta-cell function) (+9.7, P<0.01) and QUICKI (+0.029, P<0.001), and decreased HOMA(IR) (-1.73, P<0.001). Females and those with higher waist-hip ratio made up a greater portion of rosiglitazone-responders. Responders (45 patients, 75%) also showed significantly higher FPG, HbA1c, systolic blood pressures, fasting insulin levels and HOMA(IR), and lower QUICKI than nonresponders. Among these parameters of responders, waist-hip ratio of non-obese subgroup, initial glycemic control of obese subgroup, and systolic blood pressure of both subgroups lost their significance after subdivision analysis. However, the baseline HOMA(IR) and QUICKI were significantly correlated with the response rate to rosiglitazone. Moreover, in multiple logistic regression analysis, HOMA(IR) and QUICKI retained their significance as the independent predictors. Even in Korean type 2 diabetic patients of long duration but with relatively preserved beta-cell function, rosiglitazone improved glycemic control, insulin sensitivity, and beta-cell function. In this ethnic group, female gender, central obesity, and especially severe insulin resistance were identified as predictive clinical parameters of rosiglitazone-responders.

Adult↗
PubMed2005

Alterations in peripheral blood levels of TIMP-1, MMP-2, and MMP-9 in patients with type-2 diabetes.

BACKGROUND AND AIM: In vivo and in vitro experimental findings indicate that the hyperglycemic diabetic milieu can induce altered expression of the matrix metalloproteinase (MMP) genes and contribute to imbalances in vascular matrix homeostasis. We examined the plasma levels of enzymes and inhibitors involved in extracellular matrix turnover. METHODS: We measured the plasma concentrations of MMP-2, MMP-9, and tissue inhibitor of metalloproteinase 1 (TIMP-1) in 80 type-2 diabetic subjects without uremia and in 80 age-matched controls. In addition, we determined the plasma levels of intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and high sensitive(hs) C-reactive protein (CRP) in both groups. RESULTS: Plasma MMP-2, TIMP-1, and hs-CRP concentrations were significantly elevated in diabetic patients as compared to the control subjects (p<0.05). Plasma levels of MMP-2, MMP-9, TIMP-1, VCAM-1, ICAM-1, and hs-CRP were found not to be significantly associated with age, duration of diabetes, blood pressure, or serum lipid concentrations. CONCLUSIONS: Plasma MMP-2, TIMP-1 and hs-CRP concentrations were significantly increased in type-2 diabetic patients.

Blood Pressure↗
PubMed2005

Ectopic expression of vasopressin V1b and V2 receptors in the adrenal glands of familial ACTH-independent macronodular adrenal hyperplasia.

OBJECTIVE: ACTH-independent macronodular adrenal hyperplasia (AIMAH) is a rare and unusual cause of Cushing's syndrome, characterized by bilateral nodular adrenocortical hyperplasia and hypersecretion of cortisol. Familial AIMAH has rarely been reported. Recently, the aberrant expression of adrenal receptors for various ligands in AIMAH patients has become important in explaining the pathogenesis of AIMAH. In this study, we present the cases of two sisters who were affected with AIMAH. PATIENTS AND MEASUREMENTS: Two sisters, aged 46 and 58, respectively, at the time of diagnosis, were found to have Cushing's syndrome due to AIMAH. We performed provocation tests with various materials and reverse transcription polymerase chain reaction (RT-PCR) with their resected adrenal tissues to examine the hyper-responsiveness to steroidogenesis and the overexpression of related receptors, respectively. RESULTS: Provocation tests in vivo indicated that arginine vasopressin (AVP) promoted cortisol secretion through vasopressin V1a as well as V1b and V2 receptors. RT-PCR analysis revealed an abnormal cDNA expression of vasopressin V1b and V2 receptors, none of which is known to be normally expressed in the adrenal glands. CONCLUSION: The expression of ectopic vasopressin V1b and V2 receptors may be involved in the aetiology of AIMAH, at least in the case of the sibling patients presented here.

Adrenal Glands↗
PubMed2005

Clinical features of bone metastases resulting from thyroid cancer: a review of 28 patients over a 20-year period.

Bone is the second most frequent site of metastasis resulting from thyroid cancer. Many studies have investigated clinical features and prognostic factors of distant metastases stemming from thyroid cancer in Western countries. The purpose of this study was to review clinical characteristics of Korean patients with bone metastasis originating from thyroid cancer. Between January 1985 and August 2004, 28 patients with thyroid cancer were diagnosed with bone metastases at the Yonsei Severance Hospital in Seoul, Korea. Their clinical characteristics were analyzed retrospectively. Incidence of bone metastasis from follicular thyroid cancer was 6.8% (9 of 132 patients), and 0.4% (13 of 3,154 patients) from papillary thyroid cancer, with an odds ratio of 17.67 (95% confidence interval; 7.41-42). Twelve patients had no symptoms of bone metastasis. Overall mean number of metastasis sites was 2.6 +/- 1.9, and 12 patients had a solitary bone metastasis. Survival rates between the synchronous and metachronous metastasis groups were not significantly different, and the number of metastasis sites did not affect survival. However, the survival of patients that underwent curative treatment was longer than those with palliation (P = 0.0317). In Korea, the overall incidence of bone metastasis resulting from thyroid cancer was less than our expectation. Many patients were asymptomatic, and had a tendency of undergoing less aggressive or palliative treatment, even though the long-term survival of distant metastasis resulting from thyroid cancer with active treatment is relatively good. Further studies of the prognostic factors and effectiveness of various treatments of these patients are needed to enhance survival.

Adenocarcinoma, Follicular↗
PubMed2005

Three novel VHL germline mutations in Korean patients with von Hippel-Lindau disease and pheochromocytomas.

Von Hippel-Lindau (VHL) disease is an autosomal dominant inherited tumor syndrome associated with germline mutations in the VHL gene. VHL disease, as well as several other cancer syndromes, has been associated with an increased risk of pheochromocytomas, which are catecholamine-secreting tumors of the adrenal gland. VHL disease genotype-phenotype correlations have been well established based on the type of mutations in the VHL gene. However, although many groups have reported VHL germline mutations in different countries, no previous report has described VHL gene mutations in VHL disease and/or pheochromocytoma patients in Korea. In this study, we used direct sequencing to investigate VHL germline mutations in Korean patients with VHL disease or pheochromocytomas (11 VHL patients and 3 additional members from 7 families, 2 patients from 1 family with familial pheochromocytoma, and 2 cases of isolated pheochromocytoma). We found a total of 7 VHL germline mutations (6 missense and 1 frameshift), 3 of which were novel (323_324delGC, 355T>C and 361G>A). No VHL germline mutation was found in the 2 patients with isolated pheochromocytomas and paragangliomas. This study provides informative data for VHL germline mutations and VHL-related phenotypes in Korea.

Adrenal Gland Neoplasms↗