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조남한,홍은경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.3
Background: Oral glucose tolerance test to diagnose diabetes was first introduced by Jarney and Isaacson in 1918. This method was advocated because of its diagnostic accuracy and also provides the two hours glucose changing pattern. Twenty-five percent (296 mL) glucose solution has been used as the standard diagnostic method in Korea. However, large volume of the solution frequently cause vomiting during the tests. Thus, 50% solution (150 mL) was recently introduced, but the potential difficulty of gastric emptying caused by its hyperosmolarity, and degree of diagnostic accuracy was questioned. Therefore, in this study, we evaluated two type of solutions by comparing the followings in both an animal and human models: (1) glucose changing pattern during the two hour oral glucose tolerance test, (2) Preference evaluation in human model. Methods: Fifteen male Sprague-Dawley rats and 15 human subjects underwent 2 hours OGTT offer 10∼14 hours fasting. Two grams glucose per kg body weight was feed to the SD rat. In human, 75 gm glucose in 296 mL (25%) and 150 mL (50%) glucose solution was ingested at two different time, but testing was done within 24 hours a part. Five blood samples (fasting, 30, 60, 90, and 120 minutes) were collected and separated for serum. Glucose was assayed using YSI 2300-STAT (Yellow Springs Instrument Ca., Ohio, USA) by glucose oxidase method. Results: In animal study, despite the lower fasting glucose level, 30, 60 and 120 minutes glucose level was higher in 50% solution when compared to the 25% but the mean values were not statistically different. The glucose area under the curve (GAUC) in 50% was higher than 25% but not statistically different. The peak glucose level was observed at 60 minutes In both solutions. In human study, although mean values were not statistically different, all glucose values except 30 minutes were higher in 50% solution. Furthermore, GAUC was not statistically different between the two solutians. In preference test, the study subjects significantly (p$lt;0.05) preferred the 50% solution as more favorable amount for the test. No differences in the tolerable level of sweetness, level of thirsty after ingestion, nausea, vomiting, head and stomachache was observed. Conclusion: In this study, we found that the gastro-intestinal glucose kinetics of the 25% and 50% glucose solution used during the OGTT was very similar in both an animal and human model. Furthermore, the preference evaluation showed favorable results in 50% solution. The use of 50% solution reconcile vomiting problem during the test but the same diagnostic accuracy was preserved. Therefore, 50% solution merits its scientific value as the diagnostic solution, and hope to contribute to favor the OGTT for diagnosis of diabetes mellitus in the future.
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The Epidemiology of Diabetes in Korea: From the Economics to Genetics
조남한 대한당뇨병학회 2010 Diabetes and Metabolism Journal Vol.34 No.1
To determine the factors responsible for the dramatic increase in the prevalence of diabetes in Korea. A computerized literature survey was conducted to evaluate the risk factors for Type 2 diabetes mellitus (T2DM) in Korea, including genome-wide association studies. National Statistics gross national income data was integrated with the reported prevalence of diabetes to evaluate the relationship between diabetes and the economic growth. The strength of the association was evaluated using measures of effect size, such as odds ratio and relative risks. The putative risk factors identified in Korean studies are very similar to the risk factors identified from the other countries, including genetic background. Genome-wide association studies reported relative risks of 1.5or less, indicating that no single gene is associated with the risk of T2DM. The scientific evidence suggests that the dramatic increase in the incidence and prevalence of T2DM in Korea is related to the economic development of Korea, which has a direct influence on health policy, as well as an individual’s health behaviors. We expect to observe the current diabetes incidence rates until the key risk factors are present for long enough in our society, at which point we would expect to start observing a more gradual increase in both the incidence and prevalence of T2DM in Korea.
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Prevalence of Widespread Pain and Its Influence on Quality of Life: Population Study in Korea
조남한,김인제,임승헌,김현아 대한의학회 2012 Journal of Korean medical science Vol.27 No.1
The objective of this study was to examine the prevalence and risk factors for widespread pain and its influence on quality of life in residents of Korean communities. A rural and an urban community were selected, and 5,037 subjects were surveyed. Participants were asked if they had pain, aching, or stiffness in any of their joints on most days. Widespread pain was defined as pain above the waist, below the waist, on both sides of the body and in the axial region. The prevalence of widespread pain was 12% (16.2% and 5.5% in females and males, respectively). It was more frequent among females and increased with age in both genders. Age, female gender, and the presence of hand or knee arthritis were significantly associated with widespread pain after multivariate analysis. Except for mental health, all the items in the SF-12 were adversely affected in the widespread pain group after adjustment for confounding factors. Our findings show that the prevalence of widespread pain among residents of Korean communities is comparable to that reported among Caucasians. The significantly worse quality of life among subjects with widespread pain suggests that it may cause major health issues in the aging population.
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