Endocrinology and Metabolism

Kyu Chang Won (Won KC)

7 Articles

Clinical Study
A Novel Index Using Soluble CD36 Is Associated with the Prevalence of Type 2 Diabetes Mellitus: Comparison Study with Triglyceride-Glucose Index: Ho Jin Kim, Jun Sung Moon, Il Rae Park, Joong Hee Kim, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee; Endocrinol Metab. 2017;32(3):375-382. Published online September 18, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.3.375

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Background

Plasma soluble cluster determinant 36 (sCD36) level is closely related with insulin resistance and atherosclerosis, but little is known whether it could be a surrogate for estimating risk of developing diabetes or not. To address this, we evaluated association between sCD36 index, the product of sCD36 and fasting plasma glucose (FPG), and the prevalence of type 2 diabetes mellitus (T2DM), and then compared with triglyceride-glucose (TyG) index which has been suggested simple index for insulin resistance.

Methods

This was cross-sectional study, and participants were classified as normal glucose tolerance (NGT), prediabetes, and T2DM according to glucose tolerance. The formula of TyG index was ‘ln [FPG (mg/dL)×triglyceride (mg/dL)/2],’ and the sCD36 index was ‘ln [sCD36 (pg/mL)×FPG (mg/dL)/2].’

Results

One hundred and fifty-five subjects (mean age, 55.2 years) were enrolled, and patients with T2DM were 75. Both indexes were significantly increased in prediabetes and T2DM rather than NGT, and sCD36 index was positively correlated with both glycosylated hemoglobin and homeostasis model assessment of insulin resistance (r=0.767 and r=0.453, respectively; P<0.05) and negatively with homeostasis model assessment estimate of β-cell function (r=−0.317). The odds ratio (OR) of sCD36 index for T2DM was 4.39 (95% confidential interval, 1.51 to 12.77) after adjusting age, gender, blood pressure, smoking, alcohol, non-high density lipoprotein cholesterol and high-sensitivity C-reactive protein. However, OR of TyG index did not remained significance after adjustment.

Conclusion

sCD36 index has an independent association with the risk of T2DM, and showed better correlation than TyG index. These results suggest sCD36 index might be useful surrogate marker for the risk of diabetes.

Citations

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The triglyceride-glucose index as an indicator of insulin resistance and cardiometabolic risk in Brazilian adolescents
Miriam Beatrís Reckziegel, Patrik Nepomuceno, Tania Machado, Jane Dagmar Pollo Renner, Hildegard Hedwig Pohl, Carlos Alberto Nogueira-de-Almeida, Elza Daniel de Mello
Archives of Endocrinology and Metabolism.2023;[Epub] CrossRef
The association of soluble cluster of differentiation 36 with metabolic diseases: A potential biomarker and therapeutic target
Yun Li, Yaxi Chen, Xiong Z. Ruan
Pediatric Discovery.2023;[Epub] CrossRef
Kidney lipid dysmetabolism and lipid droplet accumulation in chronic kidney disease
Alla Mitrofanova, Sandra Merscher, Alessia Fornoni
Nature Reviews Nephrology.2023; 19(10): 629. CrossRef
Diabetic cardiac autonomic neuropathy: insulin resistance, lipid profile, and omega-3 polyunsaturated fatty acids
Martin-Yurii Markevich, Volodymyr Segin, Victoria Serhiyenko, Alexandr Serhiyenko
InterConf.2023; (35(163)): 213. CrossRef
Insulin resistance estimated by estimated glucose disposal rate predicts outcomes in acute ischemic stroke patients
Zhengzhao Lu, Yunyun Xiong, Xueyan Feng, Kaixuan Yang, Hongqiu Gu, Xingquan Zhao, Xia Meng, Yongjun Wang
Cardiovascular Diabetology.2023;[Epub] CrossRef
Usefulness of SPISE Index for Screening and Detection of Early Stages of Insulin Resistance among Chilean Young Adults
Isabel Pereyra González, Sandra Lopez-Arana
Annals of Nutrition and Metabolism.2023; 79(4): 372. CrossRef
Oxidative Stress Induced by Lipotoxicity and Renal Hypoxia in Diabetic Kidney Disease and Possible Therapeutic Interventions: Targeting the Lipid Metabolism and Hypoxia
Seung Yun Chae, Yaeni Kim, Cheol Whee Park
Antioxidants.2023; 12(12): 2083. CrossRef
Proteomic analysis of epicardial adipose tissue from heart disease patients with concomitant heart failure with preserved ejection fraction
Shan He, Huagang Zhu, Jianjun Zhang, Xiaopeng Wu, Lei Zhao, Xinchun Yang
International Journal of Cardiology.2022; 362: 118. CrossRef
DIABETIC CARDIAC AUTONOMIC NEUROPATHY: SIMVASTATIN, INSULIN RESISTANCE AND LIPIDS
Victoria Serhiyenko, Marta Hotsko, Samir Ajmi, Alexandr Serhiyenko
InterConf.2022; (18(95)): 531. CrossRef
New insights into renal lipid dysmetabolism in diabetic kidney disease
Alla Mitrofanova, George Burke, Sandra Merscher, Alessia Fornoni
World Journal of Diabetes.2021; 12(5): 524. CrossRef
The Role of CD36 in Type 2 Diabetes Mellitus: β-Cell Dysfunction and Beyond
Jun Sung Moon, Udayakumar Karunakaran, Elumalai Suma, Seung Min Chung, Kyu Chang Won
Diabetes & Metabolism Journal.2020; 44(2): 222. CrossRef
The Multifunctionality of CD36 in Diabetes Mellitus and Its Complications—Update in Pathogenesis, Treatment and Monitoring
Kamila Puchałowicz, Monika Ewa Rać
Cells.2020; 9(8): 1877. CrossRef

Ketoacidosis with Hypertriglyceridemia-Induced Pancreatitis in a Patient with Gestational Diabetes: A Case Report.: Hyun Hee Chung, Sang Hyun Park, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee; Endocrinol Metab. 2012;27(1):89-92. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.89

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Abstract PDF

Hypertriglyceridemia-induced acute pancreatitis in pregnancy is not a common complication. Moreover, ketoacidosis in gestational diabetes occurs rarely. Here we report a case of ketoacidosis with hypertriglyceridemia-induced pancreatitis in a patient with gestational diabetes that was successfully treated with insulin and supportive care. In this case, a 36-year-old woman (at 32 weeks' gestation) was diagnosed with gestational diabetes 4 weeks prior, but did not have well controlled blood sugar. She complained of severe epigastric pain concomitant with nausea and vomiting. Radiology and laboratory tests found hypertriglyceridemia (1,996 mg/dL), acute pancreatitis, and ketoacidosis with absence of fetal deceleration on a non-stress test. The patient's condition improved with insulin therapy and fluid replacement. To our knowledge, this is the first report of a case of ketoacidosis with hypertriglyceridemia-induced pancreatitis in a patient with gestational diabetes.

Citations

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Acute Pancreatitis in a Pregnant Patient with Type IV Hyperlipoproteinemia
Sang Ho Lee, Jae Hyuck Jun, Young Seok Doh, Ji Woong Jang, Sae Hee Kim, Il Hyun Baek, Sung Hee Jung
The Korean Journal of Pancreas and Biliary Tract.2019; 24(2): 73. CrossRef
Hypertriglyceridemia-Induced Acute Pancreatitis
Jin Myung Park
The Korean Journal of Pancreas and Biliary Tract.2017; 22(4): 158. CrossRef
Cheese-like Material in the Heart: An Autopsy Case Report of Severe Hypertriglyceridemia in Diabetic Ketoacidosis Patient
Joo Young Na, Eun Hee Kim, Bon Young Koo, Ik Jo Chung, Byung Ha Choi, Nak Eun Chung
Korean Journal of Legal Medicine.2013; 37(4): 212. CrossRef

The Effect of Leptin Level Fluctuations by a Repeated Fasting/Refeeding on the Leptin Sensitivity in OLETF Rats.: Sung Chul Park, Yong Hoon Park, So Young Park, Jong Yeon Kim, Yoon Ki Park, Tae Hyung Lee, Kyu Chang Won, Yong Woon Kim; J Korean Endocr Soc. 2008;23(5):310-318. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.310

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Abstract PDF

BACKGROUND
Leptin resistance is a common feature in obese subjects and animals, and this is commonly accompanied with hyperleptinemia. We speculated that one of the causes of leptin resistance is a persistently elevated leptin concentration and then we hypothesized that fluctuations of serum leptin would increase leptin sensitivity in the leptin-resistant state. METHODS: We used a repeated fasting and refeeding (RFR) protocol to produce fluctuation in leptin levels in 7 month-old Otsuka Long-Evans Tokushima Fatty (OLETF) rats and Long-Evans Tokushima Otsuka (LETO) rats, We then measured the leptin sensitivity following an intracerebroventricular (i.c.v.) infusion of leptin. RESULTS: The OLETF rats exhibited severe visceral fat deposition, hyperleptinemia and leptin resistance. However, in the OLETF-RFR rats, the anorexic effect following i.c.v. leptin infusion was restored. Moreover, the visceral fat mass and serum leptin levels decreased, while the serum adiponectin levels were elevated in the OLETF-RFR rats compared to the OLETF-Control rats. The leptin receptor content in the hypothalamus increased in the OLETF-RFR rats compared to the OLETF-Control rats, and the leptin receptor content in the OLETF-RFR rats decreased compared to that in the the LETO-Control rats. CONCLUSION: These results suggest that the intermittent suppression of the serum leptin level reversed the leptin resistance in OLEFT rats, and this may have occurred due to an increased number of leptin receptors in the hypothalamus.

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Reduced Striatal Dopamine Transporter Availability and Heightened Response to Natural and Pharmacological Stimulation in CCK-1R-Deficient Obese Rats
Sevag Hamamah, Andras Hajnal, Mihai Covasa
International Journal of Molecular Sciences.2023; 24(11): 9773. CrossRef
Improvement of Leptin Resistance
Yong Woon Kim
Yeungnam University Journal of Medicine.2013; 30(1): 4. CrossRef
The Effect of Food Restriction on Appetite Regulating Hormones and Adiponectin Activity
Ki Hoon Kim, Hyun Kook Kim
Korean Journal of Nutrition.2012; 45(1): 5. CrossRef
The Effect of Leptin Level Fluctuations by a Repeated Fasting/Refeeding on the Leptin Sensitivity in OLETF Rats
Min Seon Kim
Journal of Korean Endocrine Society.2008; 23(5): 298. CrossRef

Naloxone Increases the Anorexic Effect of MTII in OLETF Rats.: Jang Ho Bae, Yong Hoon Park, Sung Ho Kim, So Young Park, Jong Yeon Kim, Jo Young Son, Jung Yoon Huh, Kyu Chang Won, Yong Woon Kim; J Korean Endocr Soc. 2008;23(1):18-26. Published online February 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.1.18

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Abstract PDF

BACKGROUND
Leptin, an adipocyte-derived hormone, inhibits obesity in lean subjects, but is not widely used because of leptin resistance. Thus, circumventing the arcuate nucleus of the hypothalamus, the site responsible for leptin resistance, has been evaluated for treatment of obesity. However, chronic treatment of melanotan II (MTII), a synthetic agonist of the melanocortin 3/4 receptor, induces tachyphylaxis. Here, we evaluated whether naloxone, a non-specific agouti-related peptide (AgRP) antagonist, increases the anorexic effect of MTII in Otsuka Long-Evans Tokushima Fatty (OLETF) rats. METHODS: We measured food intake following intracerebroventricular (i.c.v.) infusion of MTII and/or naloxone in OLETF rats. Sprague-Dawley rats were used as a normal control group. RESULTS: The anorexic effect of i.c.v. MTII infusion decreased with time in OLETF rats, indicating the development of tachyphylaxis. In normal control rats, naloxone alone decreased AgRP expression in the hypothalamus but failed to induce anorexia. Moreover, there was no additional anorexic effect with co-treatment of naloxone and MTII. In OLETF rats, naloxone alone did not show an anorexic effect despite increased POMC expression in the hypothalamus. However, naloxone sensitized the anorexic effect of MTII when treated together. CONCLUSION: These results suggest that naloxone augmented the anorexic effect of MTII when treated together in OLETF rats, but had no effect alone. These results suggest that a combination therapy of naloxone and a melanocortin receptor activator would be an effective modality for treatment of obesity.

Citations

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Naloxone Increases the Anorexic Effect of Melanocortin II
Seungjoon Park
Journal of Korean Endocrine Society.2008; 23(1): 15. CrossRef

Association of Polymorphism in beta3-Adrenergic Receptor Gene with Fat Distribution.: Tae Sung Yun, Yong Deuk Kim, Hye Soon Kim, Mi Jung Kim, Young Sung Suh, Jung Hyeok Kwon, Jin Soo Choi, Jung Guk Kim, Sung Woo Ha, Bo Wan Kim, Kyu Chang Won, Hyong Woo Lee, Ho Sang Shon, Ji Hyun Lee, Hyun Dae Yoon, Won Ho Kim, Young Gil Yun, In Kyu Lee; J Korean Endocr Soc. 2003;18(2):184-192. Published online April 1, 2003

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Abstract PDF: BACKGROUND
Reasons for obesity include environmental factors and, more largely so, genetic factors. There have been many studies on these genetic factors. So far, genes related to obesity such as Leptin, Uncoupling Protein(UCP), Peroxisome proliferator activated receptor-gamma(PPAR-gamma), and Beta3-adrener-gic receptor(beta3-AR) gene have been discovered. Among these, beta3-AR is expressed in visceral adipose tissue and is thought to contribute to the regulation of resting metabolic rate and lipolysis. The missense mutation of beta3-AR gene, resulting in replacement of tryptophan by arginine at position 64(Trp64Arg), is associated with decreased resting metabolic rate and weightgain. We performed this study to determine if Trp64Arg polymorphism of beta3-AR gene is associatedwith obesity in Koreans. METHOD: We investigated the relationship between the beta3-AR gene mutation and body mass index (BMI), waist circumference, hip circumference, waist to hip ratio(WHR), area of subcutaneous fat, area of visceral fat, visceral to subcutaneous fat ratio(VSR), and lipid profile. 198 subjects were included in this study of which 97 were of normal weight and 101 were obese. Anthropometric data was obtained from physical examination and medical records. RESULT: In the cases of beta3-AR gene mutation of the obese group, the ratio of Trp/Arg and Arg/Arg are 43% and 5%, respectively, which were higher than the normal group(36%, 1%), although a statistical significant was not found. There was significant difference in the are of subcutaneous fat. Normal group(Trp/Trp) measured at 213.9+/-109.6cm2 versus 244.0+/-127.7cm2 (Trp/Arg) and 323.9+/-189.9cm2(Arg/Arg) for the mutation groups. Circumference of waist, circumference of hip, WHR, area of visceral fat, and VSR were higher in the mutation groups than in normal subject, but not significantly different. CONCLUSION: These results suggest that a genetic mutation in the beta3-AR gene can affect body fat composition, and is associated with obesity in Korean adults.

Evaluation of Lung Epithelial Permeability in Patients with Type 2 Diabetes Mellitus using 99mTc-DTPA Aerosol Scintigraphy.: Ji Sung Yoon, Mi Jung Eun, Si Hyung Lee, Jae Hong Kim, Young Hoon Hong, Kyu Chang Won, Ihn Ho Cho, Hyoung Woo Lee; J Korean Endocr Soc. 2002;17(2):246-256. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Diabetes mellitus is often accompanied by complicated microangiopathy, such as, retinopathy, nephropathy, peripheral neuropathy, cardiovascular autonomic neuropathy or macroangiopathy, as well as by coronary artery disease and cerebrovascular disease. However, there have been few reports concerning the pulmonary involvement of diabetes. Recently, capillary basement membrane thickening, nonenzymatic glycosylation of tissue proteins, abnormalities of endothelial cells and increased damage by free radicals were reported as the underlying basis for the reduced lung permeability. 99mTc-DTPA aerosol scintigraphy is a noninvasive, accurate method, which evaluates the permeability of lung epithelial membranes. The clearance rate of 99mTc-DTPA in lungs may correlate inversely with the lung's epithelial permeability. We investigated the relationship between microangiopathies and the lung epithelial permeability in patients with diabetes using 99mTc-DTPA aerosol scintigraphy. METHODS: The study group comprised of 33 patients with type 2 diabetes mellitus, with no clinical evidence of past or present respiratory disease. The patients were divided into two groups in relation to the complications. Group 1: 16 patients with more than one of the complications of retinopathy, nephropathy, cardiovascular autonomic neuropathy and/or peripheral neuropathy, and comprised of 3 males and 13 females, with a mean age of 52.9 +/- 9.6 years. Group 2: 17 patients with no complications, and comprised of 5 males and 12 females with a mean age of 52.8 +/- 11.5 years. Group 3: as a control group, comprised of 11 healthy people: 4 males 4 and 7 females with a mean age of 44.2 +/- 12.5 years. 99m-Tc-DTPA aerosol scintigraphy was performed in the subjects by inhalation of 30 mCi 99mTc-DTPA aerosol and oxygen (9 l/min) using an aero-vent jet nebulizer as the lung delivery system. To evaluate the diabetic complications, CAN (Cardiovascular Autonomic Neuropathy), and NCV (Nerve Conduction Velocity) tests for peripheral neuropathy, fundoscopy for retinopathy and 24 hours urine microalbumin for nephropathy were performed. RESULTS: The mean durations of diabetes in Groups 1 and 2 were 11.1 +/- 4.7 years and 3.8 +/- 2.1 years, respectively (p<0.05). The mean clearance rates of 99mTc-DTPA were found to be 72.1 +/- 19.5min, 52.6 +/- 19.7 min, and 47.1 +/- 10.9 min for Groups 1, 2, and 3, respectively. The mean clearance rate of Group 1 was significantly longer than for Groups 2 and 3 (p<0.05). In other words, the pulmonary epithelial permeability was reduced in diabetic patients with complications compared to the patients without complication and/or the normal controls. Significant positive correlation was found between the pulmonary clearance rate of 99mTc-DTPA, and peripheral neuropathy and cardiovascular autonomic neuropathy (p<0.05). Conclusions: The lungs may be a target organ for diabetes, and impaired pulmonary epithelial permeability seems to be closely related to other diabetic microangiopathies. Therefore, we recommend that 99mTc-DTPA aerosol scintigraphy be used as a technique for assessing lung injury in diabetic patients.

The Effects of Type 1 diabetes on the Metabolism and Density of Bone in Children.: Sang Jun Lee, Dong Wook Lee, Hyun Dae Yoon, Kyu Chang Won, Hyoung Woo Lee, Yoon Jung Cho, Heung Sik Kim, Seung Beom Han, In Kyu Lee, Hee Ja Lee; J Korean Endocr Soc. 2000;15(4-5):582-590. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The effects of type 1 diabetes mellitus on the metabolism and density of bone in children are still controversial. The aim of this study was to evaluate the effects of type 1 diabetes on markers of bone metaboism and BMD in children by analyzing BMI, HbA1c, biochemical markers, sex hormones, bone metabolism and BMD related factors. MRTHODS: We compared 36 patients (15 males, 21 females) with type 1 diabetes mellitus to 167 healthy children (84 males, 83 females) who lived in Taegu. We measured FBS, serum calcium, phosphorus, HbA1c, osteocalcin, testosterone and estradiol for analyzing the factors which influence on bone metabolism and BMD. BMD was measured at lumbar spine, femur and total body by DEXA. RESULTS: The BMI and serum level of osteocalcin were not different in both groups. Serum calcium level was significantly lower in the diabetic group than that of control group. BMD had no difference in both groups. There was no correlation between BMD and glycemic control (HbA1c) or duration of diabetes. There was good correlation (r=0.78, p<0.01) between serum testosterone level and BMD in male patient group. There was negative correlation (r=-0.4) between serum osteocalcin level and BMD. There was significant correlation (male: r=0.76, female: r=0.66) between lean body mass and BMD in both group. CONCLUSION: The BMD was not decreased significantly and bone turn-over was normal in children with noncomplicated type 1 diabetes mellitus, and BMD was not influenced by the duration or degree of metabolic control of diabetes. But, we need further study including other risk factors that have influences on BMD and bone metabolism in type 1 diabetes mellitu.

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