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관상동맥질환 및 뇌경색이 동반된 인슐린비의존형 당뇨병에 있어서 파라옥소나제 유전자다형성
김우식(Woo Shik Kim),김영설(Young Seol Kim),김상화(Sang Hwa Kim),팽정령(Jung Rhung Paeng),우정택(Jeong Tack Woo),김성운(Sung Woon Kim),최영길(Young Kil Choi),양인명(In Myung Yang) 대한내과학회 1998 대한내과학회지 Vol.55 No.5
N/A Objectives: Paraoxonase is a high-density-lipoprotein-associated enzyme capable of hydrolysing lipid peroxides. Thus it might protect lipoproteins from oxidation. It has two isoforms, which arise from a glutamine (A isoform) to arginine (B isoform) interchange at position 192. More recently, Ruiz et al. investigated the relationship between the paraoxonase genetic polymorphism and coronary heart disease in a case-control study of NIDDM in France. We investigated the correlation between the polymorphism of paraoxonase gene and cardiovascular disease in Korean diabetic patients. Methods: Of 106 patients with NIDDM, 50 had confirmed cardiovascular disease (coronary heart disease or ischemic stroke). The other 56 patients had no history of such disease and ECG abnormality. An additional control group of non-diabetic, healthy subjects (N=55) was selected. The polymorphism of paraoxonase gene was assessed by VCB-RFLP in their blood leukocytes DNA. Results: The healthy control revealed paraoxonase genotype frequencies of 18.1% AA, 36.4% AB and 45.5% BB. The NIDDM group revealed paraoxonase genotype frequencies of 11.3% AA, 39.6% AB, 49.1% BB. The genotype frequencies did not differ between healthy control with diabetic group. The genotype frequencies did not differ between diabetic group with coronary heart disease and diabetic control group(AA; 8.4% vs 12.5%, AR; 45.8% vs 37.5%, BB; 45.8% vs 50.0%). There was also no difference in genotype frequencies between diabetic group with ischemic stroke and diabetic control (AA; 11.5% vs 12.5%, AB; 38.5% vs 37.5%, BB; 50.0% vs 50.0%). In multiple logistic regression analysis with other risk factors, hypertension emerged as the most related factors for cardiovascular disease, but paraoxonase genotype was not associated with the presence of cardiovascular disease. Conclusion: In Korean diabetic patients, the polymorphism of paraoxonase gene might not be associated with the presence of coronary heart disease or ischemic stroke.
고콜레스테롤혈증 성인환자에서 무증상 갑상선 기능저하증의 빈도와 혈청 콜레스테롤 치에 대한 혈청 TSH 의 영향
정원제(Won Jea Jeong),박병헌(Byeong Heon Park),박철영(Cheol Young Park),류미숙(Mee Sook Ryu),오승준(Seung Joon Oh),우정택(Jeong Tack Woo),김성운(Sung Woon Kim),양인명(In Myoung Yang),김진우(Jin Woo Kim),최영길(Young Kil Choi),팽정령( 대한내과학회 2002 대한내과학회지 Vol.62 No.2
N/A Background: Subclinical hypothyroidism is frequently discovered from hypercholesterolemic adults. It is defined as an asymptomatic state which characterized by normal free thyroxine (FT4) and elevated thyroid stimulating hormone (TSH) level. Hypercholesterolemia is a major risk factor for coronary heart disease, however hypercholesterolemia caused by hypothyroidism can be easily managed by thyroid hormone replacement. The screening of thyroid disease in hypercholesterolemia patient must be emphasized in order to find out correctable hypothyroidism. So we screened the prevalence of overt and subclinical hypothyroidism at different hypercholesterol levels in middle-aged men and women and also analyzed the correlation between TSH and total cholesterol level. Methods: We measured serum TSH levels and FT4 by radioimmunoassay from 491 patients with hypercholesterolemia. The subjects were divided into two groups according to serum cholesterol level. Group I was serum cholesterol ≥240 -〈300 mg/dL and group II was ≥300 mg/dL. Subclinical hypothyroidism was defined as TSH levels higher than 4 mU/L, in the presence of normal FT4 concentration. Results: The overall prevalence of subclinical and overt hypothyroidism was 3.4% and 2.5% in men and 4.7% and 3.5% in women of middle age. In men the prevalence of overt and subclinical hypothyroidism increased from 2.3% of group I to 16.1% in the group II (p<0.05). In women that increased from 5.2 % to 12.9 % (p<0.05). After age correction, an increase of 1 mU/L TSH in men was associated with an increase of 3.2 mg/dL total cholesterol (p<0.01). A similar trend was also found in women (2.1 mg/dL p=0.052). Conclusion: In this population, the prevalence of hypothyroidism is up to 16.1% in middle-aged men, 12.9% in middle-aged women with high total cholesterol and it may justify screening of thyroid disease in hypercholesterolemic patients especially in clinical practice.(Korean J Med 62:187-193, 2002)