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이광은 ( Kwang Eun Lee ),김유미 ( Yoo Mee Kim ),강은석 ( Eun Seok Kang ),김혜진 ( Hae Jin Kim ),정혜원 ( Hae Won Chung ),이시훈 ( Sh Hoon Lee ),김형진 ( Hyeung Jin Kim ),김대중 ( Dae Jung Kim ),김수경 ( Soo Kyung Kim ),안철우 ( Ch 대한내과학회 2002 대한내과학회지 Vol.63 No.5
N/A Background : It is well known that non-alcoholic fatty liver disease is associated with metabolic syndrome such as obesity, type II diabetes mellitus, dyslipidemia. Non-alcoholic fatty liver disease is frequently found in non-obese adults, but the meaning of it is unknown. So we studied the association of non-alcoholic fatty liver disease in non-obese adults and metabolic abnormalities. Methods : We examined 779 Korean adults above 30 years old (274 men, 505 women) participating in medical check-up in Health Promotion Center. Hepatitis B and C serologies were negative, and average weekly alcohol intake was .2 drinks. A standard interview, physical examination and biochemical study was conducted. An experienced operator carried out ultrasound liver studies. Results : 370 subjects had non-alcoholic fatty liver disease (47.3%). The frequency in men was higher than that in women (57.3 vs 42.2%, p<0.05). The frequency in non-obese (BMI<25 kg/m2, n=431) group was lower than that in obese (BMI.25 kg/m2, n=348) group (65.5 vs 32.3%, p<0.05). Compared with obese group, waist circumference, waist hip ratio, body fat, impaired fasting serum glucose, total cholesterol, HDL-cholesterol, total cholesterol to HDL-cholesterol ratio, fasting insulin, proinsulin, HOMA-IR and HOMA-beta were significantly different in non-obese, non-alcoholic fatty liver group. After multiple regression analysis, waist circumference was associated with non-alcoholic fatty liver disease in non-obese individuals. Odd ratios of insulin resistance in non-obese, non-alcoholic fatty liver group were 5.8 (CI: 3.1.10.9). Conclusion : The frequency of non-alcoholic fatty liver disease was very high in non-obese adults and well associated with central obesity and insulin resistance.(Korean J Med 63:488-495, 2002) Key Words : Non - alcoholic fatty liver disease, Body mass index, Metabolic syndrome, Central obesity
이시훈(Si Hoon Lee),강은석(Eun Seok Kang),이광은(Kwang Eun Lee),김하동(He Dong Jin),최성희(Seung Hee Choi),김대중(Dae Jung Kim),안철우(Chul Woo Ahn),차봉수(Bong Soo Cha),임승길(Sung Kil Lim),이현철(Hyun Chul Lee),허갑범(Kap Bum Huh) 대한내과학회 2002 대한내과학회지 Vol.63 No.1
목적: 본 연구는 한국인 성인에서 인슐린저항성에 따른 대사증후군과 그 구성요소들의 유병률을 분석하기 위하여 수행하였다. 대상 및 방법: 한국건강관리협회에서 건강검진을 받은 30세 이상 성인 남녀 1,091명을 무작위로 추출하여 혈당, 혈청 인슐린, 총콜레스테롤, HDL-콜레스테롤, 중성지방, 체질량지수, 허리둘레, 혈압, 경동맥 내막중막두께 및 복부초음파를 시행하였고, 대상군을 인슐린저항성 정도에 따라 인슐린감수성군, 중간군, 인슐린저항성군으로 삼등분하여 그들의 임상 및 검사결과에 따라 대사증후군의 발병률을 분석하였다. 결과: 인슐린감수성군과 비교할 때, 인슐린저항성군에서 대사증후군의 상대위험도는 84.1배 증가하였고, 당뇨병 및 내당능장애는 10.2배, 고혈압은 1.8배, 이상지혈증은 2.8배, 고콜레스테롤혈증은 2.5배, 지방간은 3배 증가하였고, 전신성비만보다 복부비만이 인슐린저항성에 더 기여하는 것으로 나타났다. 결론: 본 연구는 단면적으로 수행되었으나, 인슐린저항성이 대사증후군의 중요한 위험인자이고, 심장혈관질 환을 비롯한 성인병의 예측인자로써 큰 의미가 있음을 시사한다. 따라서 성인병의 예방을 위해서 앞으로는 건강검진에 인슐린저항성을 평가하는 항목을 도입할 것을 권장한다. Background: This study was initiated to evaluate the prevalence of metabolic syndrome and its components as risk factors for cardiovascular disease according to insulin resistance in the Korean adult population. Methods: This study was conducted as a branch of the Korean Metabolic Syndrome (KMS) Study: 1,091 individuals aged 30 79 years participating in medical check-up in Korea Association of Health (KAH) were included in this study. We checked fasting blood sugar, fasting insulin, proinsulin, lipid profiles (total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol), body mass index, waist circumference, blood pressure, carotid intima-media thickness (IMT) and abdominal ultrasonography. We divided all of the examinees into three groups (insulin sensitive, intermediate, resistant tertiles) according to their degree of insulin resistance and correlated this with the prevalence of metabolic syndrome. Results: The relative risk of metabolic syndrome was 84.1-fold higher in the insulin resistant tertile group compared to the insulin sensitive tertile group. Diabetes mellitus or impaired fasting glucose (IFG) was 10.2-fold; hypertension, 1.8-fold; dyslipidemia, 2.8-fold; hypercholesterolemia, 2.5-fold; fatty liver, 3.0-fold. Abdominal obesity rather than general obesity was more contributory to insulin resistance. Conclusion: Although this is a cross-sectional study, we can show that insulin resistance is one of the most-striking risk factors in metabolic syndrome and can be used as a predictor of cardiovascular diseases. Furthermore, we should monitor the healthy insulin-resistant population to prevent ongoing cardiovascular diseases. More prolonged data should be gained to refine the correlations of insulin resistance to metabolic syndrome.(Korean J Med 63:54-60, 2002)
원저 : 한국 성인 대사증후군 환자에서 허리둘레의 기준치수에 관한 연구
최성희 ( Sung Hee Choi ),김대중 ( Dae Jung Kim ),이광은 ( Kwang Eun Lee ),김유미 ( Yoo Mee Kim ),송영득 ( Young Duk Song ),김하동 ( Ha Dong Kim ),안철우 ( Chul Woo Ahn ),차봉수 ( Bong Soo Cha ),허갑범 ( Kap Bum Huh ),이현철 ( Hyun 대한비만학회 2004 The Korean journal of obesity Vol.13 No.1
연구 배경: 대사증후군의 진단 기준은 현재 National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III) 의 기준이 세계적으로 받아들여지고 있다. 그러나, 서양인의 체형에 근거한 이러한 진단기준은 동양인에게 부적합한 것으로 보고되고 있다. 2000년 WHO 서태평양 지부에서는 동양인의 비만의 진단 기준으로 체질량 지수는 25.0㎏/㎡ 이상, 복부비만의 허리 둘레의 기준치는 남 Backgrounds: The metabolic syndrome is the clustering of cardiovascular risk factors such as glucose intolerance, hypertension, dyslipidemia and visceral obesity. The National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III) criterion
인슐린 저항성이 있는 제 2형 당뇨병 환자에서 Rosiglitazone의 치료 효과 및 반응도 예측인자의 분석
김유미 ( Yoo Mee Kim ),김대중 ( Dae Jung Kim ),강은석 ( Eun Seok Kang ),김혜진 ( Hae Jin Kim ),이광은 ( Kwang Eun Lee ),정혜원 ( Hae Won Chung ),최성희 ( Seung Hee Choi ),안철우 ( Chul Woo Ahn ),차봉수 ( Bong Soo Cha ),송영득 ( Yo 대한내과학회 2003 대한내과학회지 Vol.64 No.1
목적 : Rosiglitazone은 thiazolidinedione계 약물로, PPARγ 핵수용체에 작용하여 인슐린 저항성과 관련된 여러 가지 대사장애를 개선시킬 수 있는 약물로 알려져 있다. 본 연구는 metformin과 sulfonylurea 등의 기존의 경구 혈당 강하제로 혈당조절이 되지 않고, 인슐린 저항성을 갖은 제 2형 당뇨병 환자를 대상으로 rosiglitazone 병용투여를 통해 혈당조절 정도와 인슐린 저항성 및 인슐린 분비능의 개선정도를 Background : Rosiglitazone, an insulin sensitizer of thiazolidinedione class, is known as a highly selective and potent agonist for the peroxisome proliferator-activated receptor-γ. This study was performed to evaluate the antidiabetic activity and insuli