건강한 한국인 여성에서의 골밀도와 혈청 렙틴의 연관성

이유미,김대중,김세화,안철우,차봉수,김경래,이현철,임승길 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.2

연구배경: 혈청 렙틴은 식욕억제 효과와 여러 기관에서의 기능 외에도 골대사에 중요한 영향을 주는 인자로 알려져 있다. 그러나 렙틴의 골대사에 관여하는 각 세포와 실제 사람의 골밀도와의 관계에 대한 논란은 많다. 이에 건강한 한국인 여성에서의 골밀도와 혈청 렙틴과의 관계를 살펴보고자 하였다. 방법: 만성질환이 없는 67명의 폐경 전 여성과 73명의 폐경 후 여성을 대상으로 하여 요추부 및 대퇴경부의 골밀도를 DNA를 이용하여 촬영하고 혈청 렙틴을 측정하여 비고 분석하였다. 결과: 폐경 후 여성에서만 요추부 골밀도와 혈청렙틴이 양의 상관관계를 보였으며 이 관계는 연령과체지방지수 및 폐경기간을 보정한 후에도 양의 관계를보이는 경향이었다. 또한 가장 낮은 혈청 렙틴 농도를 보인 폐경 후 여성의 경우 높은 농도를 보인 여성들에 비해 의미 있게 낮은 요추부 및 대퇴경부 골밀도를 보였다. 결론: 건강한 한국인 여성에서의 혈청 렙틴은 골밀도와 약한 양의 상관관계를 보였으나, 폐경 상태에 따라 달라짐을 볼 수 있었다. Background: Leptin is known to affect bone metabolism both centrally and peripherally. This study was performed to investigate the relationship between leptin and bone mineral density (BMD) in healthy premenopausal and postmenopausal Korean women. Methods: 140 women were recruited for a routine health check-up. Anthro-pometric and biochemical data were checked as usual. BMDs were measured by dual x-ray absorptiometry of the spine and femur in 67 premenopausal women and 73 postmenopausal women, in addition to their serum leptin levels. Results: Serum leptin level showed no correlation with BMD in premenopausal women, but there was a positive correlation betwen serum leptin and spinal BMD in postmenopausal women (r=0.468, p<O.001). After the correcting for age, body mass index, and duration of menopause, the serum leptin level and BMD still showed a positive correlation(r=0.217, p=0.088) although weak The women in the lowest quartile of serum leptin level showed significantly lower lumbar and femoral neck BMD. Conclusion: Leptin level seems to have a weak relationship with BMD showing different features in premenopausal and postmenopausal women (J Kor SOC Endocrinol 18: 177-183, 2003).

아동ㆍ청소년기 복합외상경험과 성인기 대인외상의 관계: 해리경험, 관계중독, 내면화된 수치심의 매개효과

오유미(Yumi Oh),이민규(Min Kyu Rhee) 대한스트레스학회 2021 스트레스硏究 Vol.29 No.1

본 연구에서는 아동ㆍ청소년기 복합외상경험과 성인기 대인외상과의 관계에서 해리경험, 관계중독, 내면화된 수치심의 매개효과를 검증하였다. 성인 238명을 대상으로 외상경험 척도, 한국판 사건충격척도 수정판, 해리 경험 척도, 관계중독질문지, 내면화된 수치심 척도로 설문을 실시했고 자료 분석은 기술 통계분석, 상관 분석, 신뢰도 분석, 구조방정식 모델이 사용되었다. 연구 결과, 아동ㆍ청소년기 복합외상경험에서 해리경험, 관계중독, 내면화된 수치심을 매개로 하여 성인기 대인외상에 영향을 미치는 삼중 매개효과가 유의한 것으로 확인되었다. 본 연구의 의의와 제한점을 논의하였고, 추후 연구에 필요한 시사점을 제안하였다. Background: The purpose of this study is to verify the mediating effects of dissociation experience, relationship addiction, and internalized shame in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Methods: Two hundred and thirty-eight adults participated in this study. They were administered the Korean versions of the Trauma Antecedents Questionnaire, Impact of Event Scale-Revised, Dissociative Experiences Scale, Relationship Addiction Questionnaire, and Internalized Shame Scale. The data were analyzed with descriptive statistics, correlation analysis, reliability analysis, and structural equation modeling. Results: First, dissociation and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Second, relationship addiction and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Third, dissociation, relationship addiction, and internalized shame had a triple mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Conclusions: Therapeutic intervention for revictimization should address symptoms such as dissociation, relationship addiction, and internalized shame. In addition, people with complex trauma experiences in childhood-adolescence require preventive intervention to avoid further exposure to interpersonal trauma.

The effect of topiramate monotherapy on bone mineral density and markers of bone and mineral metabolism in premenopausal women with epilepsy

Heo, Kyoung,Rhee, Yumie,Lee, Hyang Woon,Lee, Sang Ahm,Shin, Dong Jin,Kim, Won‐,Joo,Song, Hong‐,Ki,Song, Kijun,Lee, Byung In Blackwell Publishing Ltd 2011 Epilepsia Vol.52 No.10

<P><B>Summary</B></P><P><B>Purpose: </B> To investigate the effect of topiramate on bone mass and metabolism in premenopausal women with epilepsy.</P><P><B>Methods: </B> Thirty‐six women on long‐term (at least 1 year) topiramate monotherapy were compared with 36 women taking carbamazepine, 32 women taking valproate, and 36 age‐ and sex‐matched controls. Subjects completed bone mineral density (BMD) studies. Serum was analyzed for indices of bone metabolism.</P><P><B>Key Findings: </B> BMD Z‐scores, and serum 25‐hydroxyvitamin D and 1alpha,25‐dihydroxyvitamin D<SUB>3</SUB> concentrations did not differ among the groups. Serum calcium concentrations were significantly lower in patients receiving topiramate than in those receiving valproate, and in patients receiving carbamazepine than in those receiving valproate and controls. Patients taking topiramate had lower levels of parathyroid hormone compared with controls and those taking carbamazepine or valproate. Patients receiving topiramate had higher levels of bone‐specific alkaline phosphatase and osteocalcin when compared with controls and higher levels of C‐terminal telopeptide of type 1 collagen when compared with those taking carbamazepine or valproate. Patients receiving carbamazepine had higher levels of bone‐specific alkaline phosphatase compared with controls and those receiving valproate. Serum bicarbonate concentrations were significantly lower in patients receiving topiramate than in the other groups.</P><P><B>Significance: </B> Our results demonstrate that use of topiramate is associated with lower parathyroid hormone and bicarbonate concentrations along with mild hypocalcemia and increased bone turnover, which suggests that topiramate may have long‐term effects on bone.</P>

Plasma periostin associates significantly with non-vertebral but not vertebral fractures in postmenopausal women: Clinical evidence for the different effects of periostin depending on the skeletal site

Kim, Beom-Jun,Rhee, Yumie,Kim, Chong Hwa,Baek, Ki Hyun,Min, Yong-Ki,Kim, Deog-Yoon,Ahn, Seong Hee,Kim, Hyeonmok,Lee, Seung Hun,Lee, Sun-Young,Kang, Moo-Il,Koh, Jung-Min Elsevier 2015 Bone Vol.81 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Periostin is preferentially expressed by the periosteum, which mainly covers the long bones. Therefore, the role of periostin in osteoporotic fracture (OF) may differ depending on bone type. We performed a case–control study to investigate whether periostin can serve as a predictor of OF risk, particularly after dividing OFs into non-vertebral and vertebral fractures.</P> <P><B>Methods</B></P> <P>Among 532 consecutive postmenopausal women not taking any drug or without any disease that could affect bone metabolism, 133 cases with OF (<I>i.e.</I>, non-vertebral and/or vertebral fractures) and 133 age- and body mass index-matched controls were enrolled. Non-vertebral (<I>i.e.</I>, forearm, humerus, hip, and pelvis; n=81) and morphological vertebral (n=62) fractures were identified by an interviewer-assisted questionnaire and lateral thoracolumbar radiographs, respectively. Bone mineral density (BMD) and plasma periostin levels were also measured.</P> <P><B>Results</B></P> <P>Plasma periostin was markedly higher in subjects with non-vertebral fracture than their controls even after adjustment for BMD and potential confounders (<I>P</I> =0.006). Each standard deviation increment of plasma periostin was associated with a multivariable-adjusted odds ratio of 1.59 for non-vertebral fracture. The odds for non-vertebral fracture were 2.48-fold higher in subjects in the highest periostin tertile compared with those in the lowest periostin tertile (95% confidence interval=1.10–5.61). However, associations between plasma periostin and vertebral fracture were not observed, regardless of the adjustment model used. Consistently, plasma periostin levels were inversely associated with proximal femur BMD (<I>P</I> =0.007 to 0.030) but not lumbar spine BMD. In subgroup analyses, plasma periostin had no correlation with the levels of classical bone turnover markers.</P> <P><B>Conclusions</B></P> <P>Plasma periostin may be a potential biomarker of the risk of OF, especially in non-spinal skeletal sites, such as the limbs, rather than spine.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Subjects with osteoporotic non-vertebral fracture showed markedly higher plasma periostin levels than their controls. </LI> <LI> Subjects in the highest periostin tertile had a 2.48-fold higher risk of non-vertebral fracture. </LI> <LI> Vertebral fracture did not associate with plasma periostin levels, regardless of the adjustment model used. </LI> <LI> Consistently, plasma periostin levels were inversely associated with proximal femur BMD but not lumbar spine BMD. </LI> </UL> </P>

Is focused parathyroidectomy appropriate for patients with primary hyperparathyroidism?

Won Woong Kim,Yumie Rhee,Eun Jeong Ban,Cho Rok Lee,Sang-Wook Kang,Jong Ju Jeong,Kee-Hyun Nam,Woong Youn Chung,Cheong Soo Park 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.91 No.3

Purpose: The aim of this study was to determine whether focused or complete parathyroidectomy was more appropriate and to compare follow-up data in primary hyperparathyroidism (PHPT). Methods: We retrospectively analyzed 225 operations for PHPT at Yonsei University Health System between 2000 and 2012. After excluding 93 patients, the remaining 132 were divided into 2 groups: those who underwent focused parathyroidectomy (FP) and those who underwent conventional parathyroidectomy (CP). We compared clinicopathological features; preoperative calcium, parathyroid hormone (PTH), phosphorus, vitamin D, 24-hour urine calcium, and alkaline phosphatase levels; postoperative calcium and PTH levels; pathologic diagnosis; multiplicity; and results of a localization study between the 2 groups. Results: There was no significant difference in the rates of development of postoperative persistent hyperparathyroidism (1/122 FP patients and 1/10 CP patients) between the 2 groups due to a technical reason (FP 0.8% vs. CP 10.0%, P = 0.146). Multiglandular disease (MGD) was uncommon in all cases (6 of 132, 4.5%). All MGD cases were diagnosed using a preoperative localization study. Sestamibi scan and ultrasonography sensitivity were 94.2% and 90.2%, respectively. Conclusion: We suggest that FP is appropriate in PHPT, except in cases of MGD if detected before the operation using preoperative imaging. Knowledge of hereditary PHPT and improved preoperative localization studies, such as high-resolution ultrasonography, contributed to the decision to perform FP rather than CP in all cases of unilateral results of the localizing study.

Association between low bone mass and aortic valve sclerosis in Koreans

Choi, Han S.,Rhee, Yumie,Hur, Nam W.,Chung, Namsik,Lee, Eun J.,Lim, Sung-Kil Blackwell Publishing Ltd 2009 Clinical endocrinology Vol.71 No.6

<P>Summary</P><P>Background </P><P>Osteoporosis or low bone mass has been associated with cardiovascular disease and calcification in several clinical studies. However, few studies have assessed the relationship between bone mass and valvular calcification. The aim of this study was to evaluate the relationship between low bone mass and aortic valve sclerosis in Korean men and women.</P><P>Methods </P><P>A total of 211 men and 117 women were included in this study. Each subject’s bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry, and aortic valve sclerosis was assessed using transthoracic echocardiography. Association between low bone mass and aortic valve sclerosis was assessed with multivariate logistic regression analysis in this cross-sectional study.</P><P>Results </P><P>Of 328 total subjects enrolled in this study, 50 men (23·7%) and 18 women (15·4%) were found to have aortic valve sclerosis. The mean (±SD) BMD <I>T</I>-scores were −0·5 (±0·8) in men and −0·9 (±1·0) in women. After adjusting for covariates, only women with aortic valve sclerosis had significantly lower BMD <I>T</I>-scores than those without it. Multivariate logistic regression analysis showed that age, smoking and hypertension were independently associated with increased risk of aortic valve sclerosis in men. In women, however, logistic regression analysis showed that BMD <I>T</I>-score, as well as age, was an independent variable for aortic valve sclerosis. We also found that a <I>T</I>-score of less than −1·5 was significantly associated with increased risk of aortic valve sclerosis in women compared to normal <I>T</I>-scores.</P><P>Conclusion </P><P>Low bone mass might be independently associated with increased risk of aortic valve sclerosis in women, but not in men. Women with low bone mass should be further evaluated for the presence of aortic valve sclerosis and related cardiovascular diseases.</P>

Peripheral Effect of α-Melanocyte-stimulating Hormone on Fatty Acid Oxidation in Skeletal Muscle

An, Juan Ji,Rhee, Yumie,Kim, Se Hwa,Kim, Dol Mi,Han, Dong-He,Hwang, Jung Hee,Jin, Young-Jun,Cha, Bong Soo,Baik, Ja-Hyun,Lee, Won Tae,Lim, Sung-Kil American Society for Biochemistry and Molecular Bi 2007 The Journal of biological chemistry Vol.282 No.5

Severe Hypothyroidism Induced by Thyroid Metastasis of Colon Adenocarcinoma: A Case Report and Review of the Literature

YOUN, Jong Chan,RHEE, Yumie,PARK, Soo Young,KIM, Won Ho,KIM, Soo Jung,CHUNG, Hyun Cheol,HONG, Soon Won,LIM, Sung-Kil The Japan Endocrine Society 2006 Endocrine journal Vol.53 No.3

<P>An 85-year-old man who had undergone a right hemicolectomy for colon cancer presented with severe hypothyroidism and hoarseness 21 months after the operation. The serum thyrotropin (TSH) was markedly elevated to 118.14 μIU/mL and serum free thyroxine (fT4) level was markedly suppressed to 0.34 ng/dL. Symptoms of hoarseness and neck swelling were already evident 4 months prior at which time tests for normal thyroid function were performed. The patient was referred due to aggravated pain on his diffusely enlarged hard goiter. An enlarged thyroid with some calcification was noticed in the neck ultrasonography with multiple cervical lymphadenopathies. Core biopsy of the thyroid gland showed invasion of poorly differentiated adenocarcinoma cells. Immunohistochemical studies showed positive staining only for carcinoembryonic antigen (CEA). There were multiple lung parenchymal nodules and adrenal masses at the time of evaluation. The patient was started on palliative chemotherapy with thyroid hormone replacement and gradually became euthyroid. From these findings and the clinical observations, thyroid metastasis with hypothyroidism developing acutely from metastatic colon adenocarcinoma was diagnosed.</P>

Fidgetin-Like 1 Gene Inhibited by Basic Fibroblast Growth Factor Regulates the Proliferation and Differentiation of Osteoblasts

Park, Su Jin,Kim, Su Jin,Rhee, Yumie,Byun, Ji Hyun,Kim, Seong Hwan,Kim, Myoung Hee,Lee, Eun Jig,Lim, Sung-Kil Wiley (John WileySons) 2007 Journal of bone and mineral research Vol.22 No.6

<P>The FIGNL1 gene was proven to be a new subfamily member of ATPases associated with diverse cellular activities (AAA proteins). In this in vitro study, the AAA proteins inhibited osteoblast proliferation and stimulated osteoblast differentiation. We showed that FIGNL1 may play some regulatory role in osteoblastogenesis. INTRODUCTION: The fidgetin-like 1 (FIGNL1) gene encodes a new subfamily member of ATPases associated with diverse cellular activities (AAA proteins). Although the FIGNL1 protein localizes to both the nucleus and cytoplasm, the function of FIGNL1 remains unknown. In a previous study, we identified several genes that mediate the anabolic effects of basic fibroblast growth factor (bFGF) on bone by using microarray data. FIGNL1 was one of the genes that downregulated >2-fold in MC3T3-E1 cells after treatment with bFGF. Therefore, this study was aimed to identify and confirm the function of FIGNL1 on osteoblastogenesis. MATERIALS AND METHODS: We examined the effect of the FIGNL1 gene on proliferation, differentiation, and apoptosis in mouse osteoblast cells (MC3T3-E1 and mouse primary calvarial cells) using flow cytometry, RT-PCR, cell proliferation assay, and cell death assay. MC3T3-E1 cells and mouse calvarial cells were transfected with small interfering RNA (siRNA) directed against the FIGNL1 or nontargeting control siRNA and examined by cell proliferation and cell death assays. Also, FIGNL1 was fused to enhance green fluorescent protein (EGFP), and the EGFP-fused protein was transiently expressed in MC3T3-E1 cells. RESULTS: Reduced expression of FIGNL1 by bFGF and TGF-beta1 treatment was verified by RT-PCR analysis. Overexpression of FIGNL1 reduced the proliferation of MC3T3-E1 and calvarial cells, more than the mock transfected control cells did. In contrast, siFIGNL1 transfection significantly increased the proliferation of osteoblasts, whereas overexpression of FIGNL1 did not seem to alter apoptosis in osteoblasts. Meanwhile, overexpression of FIGNL1 enhanced the mRNA expression of alkaline phosphatase (ALP) and osteocalcin (OCN) in osteoblasts. In contrast, siFIGNL1 decreased the expression of ALP and OCN. A pEGFP-FIGNL1 transfected into MCT3-E1 cells had an initially ubiquitous distribution and rapidly translocated to the nucleus 1 h after bFGF treatment. CONCLUSIONS: From these results, we proposed that FIGNL1, a subfamily member of the AAA family of proteins, might play some regulatory role in osteoblast proliferation and differentiation. Further analyses of FIGNL1 will be needed to better delineate the mechanisms contributing to the inhibition of proliferation and stimulation of osteoblast differentiation.</P>

Teriparatide therapy for bisphosphonate-related osteonecrosis of the jaw associated with dental implants.

Doh, Re-Mee,Park, Hye-Jeong,Rhee, Yumie,Kim, Hyun Sil,Huh, Jisun,Park, Wonse Published for the International Congress of Oral I 2015 Implant dentistry Vol.24 No.2

<P>This report describes a case of teriparatide (TPTD) therapy for bisphosphonate (BP)-related osteonecrosis of the jaw induced after implant placement. A 75-year-old woman taking oral BP was referred with uncontrolled osteonecrosis of the mandible related to the implant placement. With conservative treatment, BP was suspended and daily subcutaneous injections of 20 μm/d TPTD were started. After 4 months of the therapy, fixture removal and sequestrectomy were performed. Histological analysis revealed necrotic lamellar bone and empty osteocytic lacunae. In contrast, multiple irregular reversal lines of the lamellar bone and active osteoblasts were noted adjacent to the lesion. There was a significant increase in serum C-terminal telopeptide cross-link of type 1 collagen and serum osteocalcin after commencement of the therapy. After 7 months off therapy, the serum levels of the 2 markers remained at a high level compared with the baseline.</P>