Increasing Age Associated with Higher Dipeptidyl Peptidase-4 Inhibition Rate Is a Predictive Factor for Efficacy of Dipeptidyl Peptidase-4 Inhibitors

홍상모,정창희,한송,박철영 대한당뇨병학회 2022 Diabetes and Metabolism Journal Vol.46 No.1

Background: It is not known which type 2 diabetes mellitus (T2DM) patients would most benefit from dipeptidyl peptidase-4 (DPP-4) inhibitor treatment. We aimed to investigate the predictors of response to DPP-4 inhibitors considering degree of DPP-4 inhibition.Methods: This study is a post hoc analysis of a 24-week, randomized, double-blind, phase III trial that compared the efficacy and safety of a DPP-4 inhibitor (gemigliptin vs. sitagliptin) in patients with T2DM. Subjects were classified into tertiles of T1 <65.26%, T2=65.26%–76.35%, and T3 ≥76.35% by DPP-4 inhibition. We analyzed the change from baseline in glycosylated hemoglobin (HbA1c) according to DPP-4 inhibition with multiple linear regression adjusting for age, ethnicity, body mass index, baseline HbA1c, and DPP-4 activity at baseline.Results: The mean age was greater in the high tertile group compared with the low tertile group (T1: 49.8±8.3 vs. T2: 53.1±10.5 vs. T3: 55.3±9.5, P<0.001) of DPP-4 inhibition. Although HbA1c at baseline was not different among tertiles of DPP-4 inhibition (P=0.398), HbA1c after 24-week treatment was lower in the higher tertile compares to the lower tertile (T1: 7.30%±0.88% vs. T2: 7.12%±0.78% vs. T3: 7.00%±0.78%, P=0.021). In multiple regression analysis, DPP-4 enzyme inhibition rate was not a significant determent for HbA1c reduction due to age. In subgroup analysis by tertile of DPP-4 inhibition, age was the only significant predictor and only in the highest tertile (R2=0.281, B=–0.014, P=0.024).Conclusion: This study showed that HbA1c reduction by DPP-4 inhibitor was associated with increasing age, and this association was linked with higher DPP-4 inhibition.

Higher Non-High-Density Lipoprotein Cholesterol Was Higher Associated With Cardiovascular Disease Comparing Higher LDL-C in Nine Years Follow Up: Cohort Study

홍상모,한경도,박정환,유성훈,이창범,김동선 한국지질동맥경화학회 2023 지질·동맥경화학회지 Vol.12 No.2

Objective: Non-high-density lipoprotein cholesterol (non-HDL-C) may be equivalent to or superior to low-density lipoprotein cholesterol (LDL-C) for the prediction of cardiovascular disease (CVD). However, studies comparing the predictive values of LDL-C and non-HDL-C levels for CVD have yielded conflicting results. In this study, we evaluated the relationship between non-HDL-C, LDL-C, and CVD using a large-scale population dataset from the National Health Information Database (NHID). Methods: We performed a retrospective observational cohort study of 3,866,366 individuals ≥ 20 years, from 2009 to 2018, using the NHID. The participants were divided into LDL-C and non-HDL-C quartiles. The outcome variables included stroke, myocardial infarction (MI), and both. All outcomes were analyzed using Cox proportional hazards regression analysis while controlling for baseline covariates (age, sex, smoking, drinking, regular exercise, body mass index, diabetes, hypertension, and statin use). Results: During 9.1 years of mean follow-up, stroke was diagnosed in 60,081 (1.55%), MI in 31,234 (0.81%), and both stroke and MI in 88,513 (2.29%) participants. Multivariate-adjusted hazard ratios (HRs) for patients in the highest non-HDL-C quartile demonstrated that these patients had a higher risk of stroke (HR, 1.254; 95% confidence interval [CI], 1.224–1.285), MI (HR, 1.918; 95% CI, 1.853–1.986), and both (HR, 1.456; 95% CI, 1.427–1.486) compared with participants in the lowest quartile. These were higher than the HRs for patients in the highest LDL-C quartile for stroke (HR, 1.134; 95% CI, 1.108–1.160), MI (HR, 1.601; 95% CI, 1.551–1.653), and both (HR, 1.281; 95% CI, 1.257–1.306). Conclusion: In our large population study, higher non-HDL-C levels were associated with CVD than LDL-C levels.

Long-Term Prognosis and Systemic Impact of Acromegaly: Analyses Utilizing Korean National Health Insurance Data

홍상모,한경도,박철영 대한내분비학회 2025 Endocrinology and metabolism Vol.40 No.1

Acromegaly is a rare endocrine disorder caused by excessive growth hormone secretion. Its low prevalence poses challenges in studying its long-term prognosis and systemic effects. To address this research gap, we conducted five studies using nationwide cohort data from the Korean National Health Insurance Database (NHID). This review consolidates the findings of these studies, which examined various long-term effects of acromegaly. The results demonstrated significant associations between acromegaly and increased mortality, a higher prevalence of mortality, cardiovascular outcomes, neurodegenerative diseases, depression, end-stage kidney disease, respiratory complications, specifically bronchiectasis, spine & hip fracture, and malignancy. These findings highlight the critical need for early diagnosis, comprehensive care, and long-term monitoring, and underscore the importance of a multidisciplinary approach in managing acromegaly.

Comparative Study of Ex Vivo Antiplatelet Activity of Aspirin and Cilostazol in Patients with Diabetes and High Risk of Cardiovascular Disease

홍상모,이우제,박철영 대한내분비학회 2022 Endocrinology and metabolism Vol.37 No.2

Background: The role of aspirin in primary cardiovascular disease prevention in patients with diabetes remains controversial. However, some studies have suggested beneficial effects of cilostazol on cardiovascular disease in patients with diabetes. We prospectively investigated the antiplatelet effects of cilostazol compared with aspirin in patients with diabetes and cardiovascular risk factors. Methods: We randomly assigned 116 patients with type 2 diabetes and cardiovascular risk factors but no evident cardiovascular disease to receive aspirin at a dose of 100 mg or cilostazol at a dose of 200 mg daily for 14 days. The primary efficacy outcome was antiplatelet effects of aspirin and cilostazol assessed with the VerifyNow system (aspirin response units [ARU]) and PFA-100 (closuretime [CT]). Secondary outcomes were changes of clinical laboratory data (ClinicalTrials.gov Identifier: NCT02933788). Results: After 14 days, there was greater decrease in ARU in aspirin (–28.9%±9.9%) compared cilostazol (–0.4%±7.1%, P<0.001)and was greater increase in CT in aspirin (99.6%±63.5%) compared cilostazol (25.7%±54.1%, P<0.001). The prevalence of aspirin resistance was 7.5% according to VerifyNow (defined by ARU ≥550) and 18.9% according to PFA-100 (CT <192 seconds). Compared with aspirin, cilostazol treatment was associated with increased high density lipoprotein cholesterol (7.1%±12.7% vs. 4.2%±18.0%, P=0.006) and decreased triglycerides (–9.4%±33.7% vs. 4.4%±17.57%, P=0.016). However, there were no significant changes in total and low density lipoprotein cholesterol, C-reactive protein level, and cluster of differentiation 40 ligand between cilostazol and aspirin groups. Conclusion: Aspirin showed better antiplatelet effects assessed with VerifyNow and PFA-100 compared with cilostazol. However,there were favorable changes in atherogenic dyslipidemia only in the cilostazol.

사례로 본 한·일 양국기업의 사회적 책임의 성공유형 : 환경적 측면 중심으로

홍상모,김현식,이명호 한국외국어대학교 지식출판콘텐츠원 글로벌경영연구소 2013 글로벌경영연구 = Journal of global business research Vol.25 No.2

재벌(Chaebol)은 한국전쟁 이후 국가의 산업발전을 견인하며 탄생한 기업의 형태이다. 이들 기업은 발전을 거듭하며 세대교체가 이루어지는 과정에서 친인척 간에 세습 기반을 통해 도의적으로 많은 문제들을 양산하여 왔다. 산업발전의 테두리에서 옹호되어 오던 경영자의 자금 횡령과 유용이 권력형 비리나 갑의 횡포 등으로 확산되면서 최근에는 경제민주화가 이슈로 등장하였다. 단순한 경영진의 도덕성 문제에서 출발한 기업 비리나 불투명성이 사회 양극화가 심화되며 더 이상 간과할 수 없는 법적 문제로 비화된데 기인한 결과이다. 이런 와중에 경영진 쇄신을 비롯한 지속가능 성장의 경영 기반 확립을 위해 근로조건 개선, 제품 및 생태계 다양성의 존중, 기후 변화 등에 관심을 가지는 사회적 활동이 상당한 호응을 얻고 있다(Carroll, 1999; UNIDO, 2007). 다만, 우리나라에서는 그 출발이 늦고, 확실한 개념이 정립되지 않은 상황이어서 아직까지 경영의 불투명성과 기업의 도덕성 문제를 해결하기 위한 노력에 국한되어 있는 실정이다. 따라서 사회적 책임에 대한 국내 기업의 현황을 일본의 친환경 경영활동을 통한 구체적 사례와 비교하여 우리가 나아가야 할 방향을 정리하였다.

한국 노인 여성에서 골다공증은 삶의 질의 저하와 연관이 있다

홍상모,최웅환 대한골다공증학회 2011 Osteoporosis and Sarcopenia Vol.9 No.2

Objectives: There are lack of study for the association between osteoporosis and reduced quality of life in Korean. In this study, the association between osteoporosis and reduced quality of life were analyzed. Methods: We used the data from the fourth Korea National Health and Nutrition Examination Survey (KNHNES), and 891 women were enrolled who were over the age of 50. Bone mineral density was measured by dual-energy X-ray absorptiometry. The quality of life were measured EuroQol-5 Dimension (EQ-5D). Results: The quality of life of osteoporosis patients, were reduced in all dimensions of EQ-5D, except EuroQol;anxiety and depression. However, EuroQol; anxiety depression side (P=0.05) and VAS (P=0.039) of EQ-5D had significant difference among osteoporosis, osteopenia, and normal group even after adjusted with age, weight, waist circumference, and blood levels of vitamin D. In addition, bone density and EQ-5D utility values had positive association even after adjusted with age and weight, waist circumference, blood levels of vitamin D (R2=0.137, B=0.148, P=0.011). Conclusions: The elderly women with osteoporosis were significantly associated with decreased quality of life. Thus, the quality of life should be considered in treating of osteoporosis patients.

Changes of Central Obesity is the Major Determinant of Influences of Weight Reduction on Bone Mineral Density

홍상모,안유헌,최웅환 대한골다공증학회 2011 Osteoporosis and Sarcopenia Vol.9 No.1

Objectives: Obesity and osteoporosis have been increasing for decades but their relationship to bone mineral density (BMD) and fat mass has not been defined. The aim of this study was to investigate how changes in body composition affect BMD after a weight reduction. Materials and Methods: We reviewed 48 middle-aged obese women who had participated in our diet program and succeeded in reducing their weight. Body composition was measured by the dual-energy X-ray absorptiometry method, and metabolic syndrome was defined as described in the ATP-III guidelines. All differences between baseline and 12 weeks later were expressed as [{12th week data–baseline data}/baseline data×100]. Results: The mean age of the participants was 38.29±10.89 years, and the mean follow-up time was 85 days. The mean body mass index was 31.50±5.19 kg/m^2. Basal BMD decreased with age and increased with weight and appendicular lean mass. In a regression analysis, appendicular lean mass was positively correlated with leg BMD (R^62=0.235, B=0.015, P<0.001) and age (B=-0.002, P=0.046), and appendicular lean mass (B=0.019, P=0.049) was the main determinant of total BMD (R^2=0.272). After weight reduction, the total body BMD change ratio (R^2=0.281) was negatively related to the change of fat mass, trunk fat mass (B=-0.042, P=0.087) and waist circumference (B=-0.108, P=0.014)Conclusions: Our findings suggest that BMD is determined by muscle mass, and that changes in central obesity may also affect BMD.

한국인의 나이와 성별, 지역에 따른 골밀도의 변화(2003~2004)

홍상모,안유헌,최웅환 대한골다공증학회 2010 Osteoporosis and Sarcopenia Vol.8 No.2

목적: 골다공증의 유병률은 증가하고 있으나 우리의 골다공증 진단 기준이 없는 것이 현실이다. 이에 본 연구에서는 우리 골밀도 자료를 아이와 지역, 성별, 부위에 따라 분석하여 보았다. 방법: 2003~2004년에 시행한 골밀도 검사 50,208 예의 요추와 50,026 예의 대퇴골의 골밀도를 각 연령군으로 나누어서 후향적으로 분석하였다. 골밀도 검사는 DEXA-법을 이용하여 측정하였다. 결과: 여성 요추 골밀도는 35~44세 군에서 0.985 ±0.129 g/cm2로 가장 높았고 이후 감소하기 시작하여 폐경기에 골밀도의 감소가 가장 컸다. 남성에서는 25~34세의 골밀도(1.011±0.118 g/cm2)가 가장 높았다. 대퇴골의 골밀도는 여성의 경우 35~44세에서 0.864±0.114 g/cm2로, 남성의 경우 25~34세에서 골밀도가 0.960±0.133 g/cm2로 가장 높았다. 지역에 따라서는 서울 이외의 지역의 peak BMD가 높았으나 오히려 골밀도의 감소 속도는 빨랐다. 결론: 우리나라인구 집단에서의 골밀도는 남성에서는 30살 전후로 여성에서는 40세 전후로 최대 골밀도에 도달하는 것을 관찰할 수 있었으며 서울보다 서울 이외의 지역에서의 골밀도의 감소가 심하였다.

The incidence of hip fracture and mortality rate after hip fracture in Korea: A nationwide population-based cohort study

홍상모,한경도 대한골다공증학회 2019 Osteoporosis and Sarcopenia Vol.5 No.2

Objectives: Osteoporotic hip fractures are associated with high mortality in the older population. Few population studies have reported the long-term trends of incidence and mortality rate of hip fracture among the older in Korea. This study assessed the incidence and mortality rate within 1 year after hip fracture from 2006 to 2015 in South Korea. Methods: The National Health Information Database was used to identify adults aged 60 years and older with a diagnosis of hip fracture and died within 1 year from hip fracture. Regression analyses were performed to estimate the change of the incidence of hip fracture and the related mortality rate. Results: The events causing hip fracture increased 1.85 times (1.91 times in women and 1.71 times in men), and the incidence of hip fracture increased 1.23 times (1.30 times in women and 1.11 times in men) from 2006 to 2015. The mortality rate after hip fracture decreased by 10% in women; however, it increased by 13% in men. These trends were more prominent in the older population. Conclusions: Although the mortality rate after hip fracture in women decreased, other parameters associated with hip fracture have worsened during the last decade. Nationwide programs were urgently needed to reduce the future socioeconomic burdens of hip fractures.

구연발표 : 폐경 전후 여성에서의 Testosterone과 대사증후군의 인자간의 연관성

홍상모,강준구,이창범,박용수,김동선,안유현,김태화,최웅환 대한비만학회 2004 대한비만학회 학술대회 Vol.- No.-