저체온요법을 시행 받은 병원 외 심정지 환자들의 저체온요법 동안 혈당의 변화와 혈당과 예후의 관계

김기태,이병국,이형연,이거성,정용훈,정경운,류현호,전병조,문정미 대한중환자의학회 2012 Acute and Critical Care Vol.27 No.4

Background: The aim of this study was to analyze the dynamics of blood glucose during therapeutic hypothermia (TH) and the association between in-hospital mortality and blood glucose in out-of-hospital cardiac arrest survivors (OHCA) treated with TH. Methods: The OHCA treated with TH between 2008 and 2011 were identified and analyzed. Blood glucose values were measured every hour during TH and collected. Mean blood glucose and standard deviation (SD) were calculated using blood glucose values during the entire TH period and during each phase of TH. The primary outcome was in-hospital mortality. Results: One hundred twenty patients were analyzed. The non-shockable rhythm (OR = 8.263, 95% CI 1.622-42.094, p = 0.011) and mean glucose value during induction (OR = 1.010, 95% CI 1.003-1.016, p = 0.003) were independent predictors of in-hospital mortality. The blood glucose values decreased with time, and median glucose values were 161.0 (116.0-228.0) mg/dl, 128.0 (102.0-165.0) mg/dl, and 105.0 (87.5-129.3) mg/dl during the induction, maintenance, and rewarming phase, respectively. The 241 (180-309) mg/dl of the median blood glucose value before TH was significantly lower than 183 (133-242) mg/dl of the maximal median blood glucose value during the cooling phase (p < 0.001). Conclusions: High blood glucose was associated with in-hospital mortality in OHCA treated with TH. Therefore, hyperglycaemia during TH should be monitored and managed. The blood glucose decreased by time during TH. However, it is unclear whether TH itself, insulin treatment or fluid resuscitation with glucose-free solutions affects hypoglycaemia.

복막투석시 포도당의 이동과 한외여과 한외여과에 당 수송체가 미치는 영향

김화정(Hwa Jeong Kim),박민선(Min Sun Park),윤견일(Kun Il Yoon) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4

Purpose - The purpose of this study was to evaluate the role of glucose transporter in peritoneal glucose and fluid transport. Methods: Male Sprague-Dawley rats were used. 5mL normal saline with(CB) and without(C) Cytochalasin B(1 ㎛) was intraperitoneally injected once. From the next day 25mL commercial dialysis solutions containing 4.25M glucose was injected into the peritoneal cavity twice a day for 8 weeks in a half of each group(CB-IP, n=6 and C-IP, n=8). The other half of each group served as control without IP(C- Control, n=7 and CB-Control, n=7). A 2 hour dwell study was performed using dialysis solutions containing 4.25Yo glucose. Intraperitoneal volume(IPV) after 2 hours of dwell was measured and peritoneal fluid absorption rate(Qa) was calculated as RISA disappearance rate. Dialysate glucose amount remaining after 2 hour dwell(DGA) was calculated and ex- pressed as 96 of the initial value. Results: IPV was significantly higher in CB than in C in both IP and Control IPV was significantly lower in C-IP than in C-Control and CB-IP while it was similar between CB-Control and CB-IP. Qa was significantly higher in IP than in Control. DGR was significantly higher in CB than in C and in control than in IP. Conclusion: Longterm peritoneal exposure to high glucose dialysis solution increased peritoneal glucose absorption and decreased ultrafiltration volume in rat. A single IP use of glucose transporter inhibitor attenuated increased glucose absorption and decreased ultrafiltration after longterm peritoneal exposure to dialysate.

High glucose diets shorten lifespan of Caenorhabditis elegans via ectopic apoptosis induction

Shin Sik Choi 한국영양학회 2011 Nutrition Research and Practice Vol.5 No.3

Diets based on carbohydrates increase rapidly the blood glucose level due to the fast conversion of carbohydrates to glucose. High glucose diets have been known to induce many lifestyle diseases. Here, we demonstrated that high glucose diet shortened the lifespan of Caenorhabditis elegans through apoptosis induction. Control adult groups without glucose diet lived for 30 days, whereas animals fed 10 mg/L of D-glucose lived only for 20 days. The reduction of lifespan by glucose diet showed a dose-dependent profile in the concentration range of glucose from 1 to 20 mg/L. Aging effect of high glucose diet was examined by measurement of response time for locomotion after stimulating movement of the animals by touching. Glucose diet decreased the locomotion capacity of the animals during mid-adulthood. High glucose diets also induced ectopic apoptosis in the body of C. elegans, which is a potent mechanism that can explain the shortened lifespan and aging. Apoptotic cell corpses stained with SYTO 12 were found in the worms fed 10 mg/L of glucose. Mutation of core apoptotic regulatory genes, CED-3 and CED-4, inhibited the reduction of viability induced by high glucose diet, which indicates that these regulators were required for glucose-induced apoptosis or lifespan shortening. Thus, we conclude that high glucose diets have potential for inducing ectopic apoptosis in the body, resulting in a shortened lifespan accompanied with loss of locomotion capacity.

High glucose diets shorten lifespan of Caenorhabditis elegans via ectopic apoptosis induction

Choi, Shin-Sik The Korean Nutrition Society 2011 Nutrition Research and Practice Vol. No.

Diets based on carbohydrates increase rapidly the blood glucose level due to the fast conversion of carbohydrates to glucose. High glucose diets have been known to induce many lifestyle diseases. Here, we demonstrated that high glucose diet shortened the lifespan of Caenorhabditis elegans through apoptosis induction. Control adult groups without glucose diet lived for 30 days, whereas animals fed 10 mg/L of D-glucose lived only for 20 days. The reduction of lifespan by glucose diet showed a dose-dependent profile in the concentration range of glucose from 1 to 20 mg/L. Aging effect of high glucose diet was examined by measurement of response time for locomotion after stimulating movement of the animals by touching. Glucose diet decreased the locomotion capacity of the animals during mid-adulthood. High glucose diets also induced ectopic apoptosis in the body of C. elegans, which is a potent mechanism that can explain the shortened lifespan and aging. Apoptotic cell corpses stained with SYTO 12 were found in the worms fed 10 mg/L of glucose. Mutation of core apoptotic regulatory genes, CED-3 and CED-4, inhibited the reduction of viability induced by high glucose diet, which indicates that these regulators were required for glucose-induced apoptosis or lifespan shortening. Thus, we conclude that high glucose diets have potential for inducing ectopic apoptosis in the body, resulting in a shortened lifespan accompanied with loss of locomotion capacity.

전기방사로 합성된 산화아연 나노섬유의 Glucose 감응특성

최종명,변준혁,김상섭,Choi, Jong-Myoung,Byun, Joon-Hyuk,Kim, Sang Sub 한국재료학회 2015 한국재료학회지 Vol.25 No.12

The development of glucose biosensors has been attracting much attention because of their importance in monitoring glucose in the human body; such sensors are used to diagnose diabetes and related human diseases. Thanks to the high selectivity, sensitivity to glucose detection, and relatively low-cost fabrication of enzyme-immobilized electrochemical glucose sensors, these devices are recognized as one of the most intensively investigated glucose sensor types. In this work, ZnO nanofibers were synthesized using an electrospinning method with polyvinyl alcohol zinc acetate as precursor material. Using the synthesized ZnO nanofibers, we fabricated glucose biosensors in which glucose oxidase was immobilized on the ZnO nanofibers. The sensors were used to detect a wide range of glucose from 10 to 700 M with a sensitivity of $10.01nA/cm^2-{\mu}M$, indicating that the ZnO nanofiber-based glucose sensor can be used for the detection of glucose in the human body. The control of nanograins in terms of the size and crystalline quality of the individual nanofibers is required for improving the glucose-sensing abilities of the nanofibers.

해당억제제로서의 불소나트륨이 혈당 측정에 미치는 영향: 국민건강영양조사 진단의학검사 검체를 이용한 혈당 측정치 비교 연구

이용화,차영주,윤여민,김현수,황유성,채석래,송정한,박해일,성문우,황동희,김정호,이봉숙 대한진단검사의학회 2009 Annals of Laboratory Medicine Vol.29 No.6

배경 : 당뇨 진단을 위해 정확한 혈당 측정은 필수적이며, 이를 위해 검체 내 해당작용을 최소화시키는 것이 권장되고 있다. 현재까지는 해당작용을 억제하기 위해 채혈과 검체 처리 시 불 소염 첨가법 또는 혈청분리용기를 이용한 냉장 보관법 등 두 가 지 방법이 제시되고 있다. 저자들은 국민건강영양조사 진단의 학검사에 참여한 피검자의 혈액을 이용하여 두 방법의 혈당 측 정을 비교하였다. 방법 : 남녀 피검자 1,103명으로부터 혈청분리용기와 불소염 용기에 정맥혈을 채취하였다. 혈청분리용기의 검체는 15분간의 응고 유도를 포함하여 30분 이내에 혈청을 분리한 후 냉장 보관 하였고 불소염 검체는 혈장분리가 안 된 상태로 냉장 보관하였 다. 두 방법 간의 혈당 측정치를 비교 분석하였다. 결과 : 혈청분리용기 검체의 평균 혈당농도는 99.0 mg/dL로 서, 불소염 검체의 96.5 mg/dL보다 유의하게 높았다(P<0.05). 두 방법 간 결과는 매우 강한 상관성을 보였으나(R=0.9899), 불소염 검체가 2.6 mg/dL의 음성 평균 오차를 보였다. 시간 경 과에 따른 두 방법 간 혈당 농도의 차이에 있어서 유의한 변화 는 없었다. 결론 : 불소염 용기 사용 시 관찰되는 혈당 농도의 음성 오차 는 당뇨의 유병률 조사에 영향을 미칠 것으로 판단되며, 불소염 용기 사용보다 혈청분리용기를 이용한 검체 채취 후 30분 이내 혈청 분리와 냉장 보관이 분석 전 영향을 최소화할 뿐만 아니라 채혈 양과 검체 용기 수를 줄이는 데에도 일조할 것으로 판단되 었다. Background : Accurate measurement of blood glucose concentrations is essential for defining diabetes, and the minimization of ex vivo glycolysis has been recommended. Recent guidelines advocate two kinds of methods for sample collection and processing: either the sodium fluoride (NaF) method or immediate refrigeration using a serum separation tube (SST). We investigated the difference between the two methods in measuring subsequent glucose concentrations using blood specimens from participants recruited for the fourth Korean National Health and Nutrition Examination Survey. Methods : Paired venous blood samples were collected in an SST and a NaF tube from 1,103 men and women. SST serum was separated within 30 min, including standing for 15 min, and then refrigerated. The NaF samples were refrigerated, but not separated until immediately before analysis. We compared the blood glucose concentrations between the SST (SST glucose) and NaF (NaF glucose) methods. Results : The mean SST glucose was significantly higher than NaF glucose (99.0 mg/dL vs 96.5 mg/dL, P<0.05). NaF glucose showed a negative mean bias of 2.6 mg/dL vs SST glucose but showed high correlation (R=0.9899). There was no significant correlation between the bias of blood glucose concentrations by two methods and the storage time of NaF glucose. Conclusions : The negative bias associated with the use of NaF tubes may significantly affect the prevalence of diabetes. Serum separation and refrigeration within 30 min after venous sampling is recommended over NaF method, not only to minimize the preanalytical impact on detecting diabetes but also to reduce sample volume and number of tubes.

The Uptake of 2-deoxy-D-glucose (2dGlc) by the Endogenous Sugar Transporter(s) of Spodoptera frugiperda CLone 21-AE Cells and the Inhibition of 2dGlc Transport in the Insect Cells by Fructose and Cytoc halasin B

Chong-Kee Lee 대한의생명과학회 2003 Biomedical Science Letters Vol.9 No.4

The baculovirus/Spodoptera frugiperda (Sf) cell system has become popular for the production of large amounts of the human erythrocyte glucose transporter, GLUT1, heterologously. However, it was not possible to show that the expressed transporter in insect cells could actually transport glucose. The possible reason for this was that the activity of the endogenous insect glucose transporter was extremely high and so rendered transport activity resulting from the expression of exogenous transporter very difficult to detect. Sf21-AE cells are commonly employed as the host permissive cell line to support the baculovirus AcNPV replication and protein synthesis. The cells grow well on TC-100 medium that contains 0.1% D-glucose as the major carbon source, strongly suggesting the presence of endogenous glucose transporters. However, unlike the human glucose transporter, very little is known about properties of the endogenous sugar transporter(s) in insect cells. Thus, the uptake of 2-deoxy-D-glucose (2dGlc) by Sf21-AE cells and the inhibition of 2dGlc transport in the insect cells by fructose and cytochalasin B were investigated in the present work. The binding assay of cytochalasin B was also performed, which could be used as a functional assay for the endogenous glucose transporter(s) in the insect cells. Sf21-AE cells were infected with the recombinant virus AcNPV-GT or no virus, at a multiplicity of infection (MOI) of 5. Infected cells were resuspended in PBS plus and minus 300 mM fructose, and plus and minus 20 цM cytochalasin B for use in transport assays. Uptake was measured at 28℃ for 1 min, with final concentration of 1 mM deoxy-D-glucose, 2-[1,2-³H]- or glucose, L-[1, ³H]-, used at a specific radioactivity of 4 Ci/mol. The results obtained demonstrated that the sugar uptake in uninfected cells was stereospecific, and was strongly inhibited by fructose but only poorly inhibitable by cytochalasin B. It is therefore suggested that the Sf21-AE glucose transporter has very low affinity for cytochalasin B, a potent inhibitor of human erythrocyte glucose transporter.

신장 근위세뇨관세포에서 고포도당이 IGF-I 결합과 포도당운반계에 미치는 영향

한호재,박권무,손창호,윤용달,Han, Ho-jae,Park, Kwon-moo,Son, Chang-ho,Yoon, Yong-dal 대한수의학회 1997 大韓獸醫學會誌 Vol.37 No.2

Diabetes mellitus is associated with a wide range of pathophysiological in the kidney. This study was designed to examine the effects of high glucose concentration on IGF-I binding and glucose transporters in renal proximal tubule cells. The results were as follows : The binding of $^{125}I-IGF-I$ reached the peak at the 30 minutes and gradually decreased by the time dependent manner. The binding of $^{125}I-IGF-I$ was inhibited by the unlabelled IGF-I($10^{-14}{\sim}10^{-8}M$) in a concentration dependent manner. The relative affinity of IGF-I receptor for IGF-I, IGF-II and insulin exhibited typical type 1 binding(IGF-I > insulin > IGF-II). However IGF-II did not compete for the cultured cell membrane $^{125}I-IGF-I$ binding site at $10^{-14}{\sim}10^{-8}M$. Under optimal conditions, IGF-I binding to the membranes from 5mM and 20mM glucose treated cells was analyzed. It was found that 20mM glucose treated cells exhibited higher binding activity for IGF-I. In order to further substantiate this increase in IGF-I binding sites, we performed affinity-labelling studies. The cross-linked cell membrane subjected to SDS-PAGE; labelled material was detected by autoradiography. 20mM glucose treated cells exhibited higher levels. The initial rate of $methyl-{\alpha}-D-glucopyranoside({\alpha}-MG)$ uptake was significantly lower($74.41{\pm}6.71%$) in monolayers treated with 20mM glucose than those of 5mM glucose. However, 3-O-methyl-D-glucose(3-O-MG) uptake was not affected by glucose concentration in culture media. IGF-I significantly increased ${\alpha}-MG$ uptake in both 5mM and 20mM glucose treated cells. However, 3-O-MG uptake was not affected by IGF-I in both conditions. In conclusion, 20mM glucose increased binding sites of $^{125}I-IGF-I$, inhibited Na/glucose cotransporter activity. But 20mM glucose did not change facilitated glucose transporter.

The Uptake of 2-deoxy-D-glucose (2dGlc) by the Endogenous Sugar Transporter(s) of Spodoptera frugiperda Clone 21-AE Cells and the Inhibition of 2dGIc Transport in the Insect Cells by Fructose and Cytoc halasin B

Lee, Chong-Kee The Korean Society for Biomedical Laboratory Scien 2003 Journal of biomedical laboratory sciences Vol.9 No.4

The baculovirus/Spodoptera frugiperda (Sf) cell system has become popular for the production of large amounts of the human erythrocyte glucose transporter, GLUT1, heterologously. However, it was not possible to show that the expressed transporter in insect cells could actually transport glucose. The possible reason for this was that the activity of the endogenous insect glucose transporter was extremely high and so rendered transport activity resulting from the expression of exogenous transporter very difficult to detect. Sf21-AE cells are commonly employed as the host permissive cell line to support the baculovirus AcNPV replication and protein synthesis. The cells grow well on TC-100 medium that contains 0.1 % D-glucose as the major carbon source, strongly suggesting the presence of endogenous glucose transporters. However, unlike the human glucose transporter, very little is known about properties of the endogenous sugar transporter(s) in insect cells. Thus, the uptake of 2-deoxy-D-glucose (2dGlc) by Sf21-AE cells and the inhibition of 2dGlc transport in the insect cells by fructose and cytochalasin B were investigated in the present work. The binding assay of cytochalasin B was also performed, which could be used as a functional assay for the endogenous glucose transporter(s) in the insect cells. Sf21-AE cells were infected with the recombinant virus AcNPV-GT or no virus, at a multiplicity of infection (MOI) of 5. Infected cells were resuspended in PBS plus and minus 300 mM fructose, and plus and minus 20 $\mu$M cytochalasin B for use in transport assays. Uptake was measured at 28$^{\circ}C$ for 1 min, with final concentration of 1 mM deoxy-D-glucose, 2-[1,2-$^3$H]- or glucose, L-[l,$^3$H]-, used at a specific radioactivity of 4 Ci/mol. The results obtained demonstrated that the sugar uptake in uninfected cells was stereospecific, and was strongly inhibited by fructose but only poorly inhibitable by cytochalasin B. It is therefore suggested that the Sf21-AE glucose transporter has very low affinity for cytochalasin B, a potent inhibitor of human erythrocyte glucose transporter.

NaF(sodium fluoride)용기를 이용한 Glucose와 HbA1c의 성적에 관한 비교분석

정안나 ( An Na Jung ),최정미 ( Jung Mi Choi ),최삼규 ( Sam Kyu Choi ),조영숙 ( Young Sook Cho ),박정오 ( Jung Oh Park ) 대한임상검사과학회 2003 대한임상검사과학회지(KJCLS) Vol.35 No.1

The blood glucose and hemoglobin A1c (HbA1c) tests play important roles in many diabetes research projects, including the Diabetes Control and Complications Trial (DCCT). This study was conducted to research the effectiveness of conducting HbA1c tests with NaF containers that have been used for blood glucose testing in diabetes screening. We performed glucose tests (HA7170, Hexokinase method) and HbA1cs (Variant II, HPLC method) with 150 patient subjects. The correlation coefficients value(r) was 0.9943 (P<0.01, y=0.9967x+0.0275) for HbA1c tests using the EDTA and NaF containers. Compared with glucose concentrations, mean HbA1c concentrations were 70-110 mg/dL 5.21±0.52%, 110-200 mg/dL 5.36±0.88%, and 200-400 mg/dL 9.71±3.22% with the correlation coefficients value(r)=0.6381(P<0.01, y=0.0227x+ 2.9434). These results suggest that performing blood glucose and HbA1c tests with NaF containers at the same time is a possibility. In the abnormal range of blood glucose test levels(110 mg/dL > blood glucose>200 mg/dL), the rate of accordance with HbA1c readings is greater than 95%. In the range of normal blood glucose test levels(110 mg/dL < blood glucose < 200 mg/dL), occurrences where there are high blood glucose readings and normal HbA1c readings is greater than 50%. In general, HbA1c values have been referred to in monitoring MBG (Mean Blood Glucose), but for more precise data, it is important that both tests be conducted together. Furthermore, HbA1c testing is more useful than blood glucose testing because HbA1c determines MBG concentrations that are less affected by time variations than blood glucose test results.