Factors Associated for Mild Cognitive Impairment in Older Korean Adults with Type 2 Diabetes Mellitus

BACKGROUND: The aim of this study was to identify factors associated with mild cognitive impairment (MCI) in older Korean adults with type 2 diabetes mellitus. METHODS: A total of 226 older (age > or =65 years) adults without a history of cerebrovascular disease or dementia participated in this study. Cognitive function was assessed with the Montreal Cognitive Assessment-Korean version (MoCA-K). A MoCA-K score or =74 years old vs. 65-68 years old; odds ratio [OR], 3.69; 95% confidence interval [CI], 1.55 to 8.82; P=0.003), educational background (college graduation vs. no school or elementary school graduation; OR, 0.16; 95% CI, 0.05 to 0.46; P=0.001), and systolic blood pressure (> or =135 mm Hg vs. < or =120 mm Hg; OR, 3.25; 95% CI, 1.29 to 8.17; P=0.012) were associated with MCI. CONCLUSION: More concentrated efforts focused on early detection and appropriate management of MCI may be required in older Korean adults with type 2 diabetes mellitus.

Gender Differences in the Association of Socioeconomic Status with Metabolic Syndrome in Middle-Aged Koreans / 대한내과학회지

BACKGROUND/AIMS: The association of socioeconomic status with metabolic syndrome could differ according to cultural and social background. This study examined the potential influence of gender. METHODS: A total of 3,291 middle-aged Korean subjects who participated in the 2005 Korean National Health and Nutrition Examination Survey were included. Socioeconomic status was measured using educational background (no school or graduated elementary school, and graduated middle school, high school, or college). RESULTS: The prevalence of metabolic syndrome was 34.5% in men and 29.8% in women. After adjusting for age, women with more education had a lower prevalence (no school or graduated elementary school, mean +/- SEM, 35.5 +/- 2.3%; middle school, 37.3 +/- 2.4; high school, 26.0 +/- 1.8; college, 21.5 +/- 2.6; p for trend < 0.001). In contrast, in men, there was no difference in the prevalence of metabolic syndrome according to educational background. This result could not be explained by smoking, alcohol consumption, exercise, or diet. CONCLUSIONS: The data suggest that socioeconomic status is closely related to the prevalence of metabolic syndrome in Korean middle-aged women, but not in men.

Body Mass Index and Waist Circumference According to Glucose Tolerance Status in Korea: The 2005 Korean Health and Nutrition Examination Survey

The purpose of this study was to investigate the stage of glucose intolerance in which persons showed a maximum obesity in Korea. A total of 4,479 participants, who were involved in the 2005 Korean National Health and Nutrition Examination Survey, was examined. The participants were divided into 5 groups by fasting plasma glucose (FPG); normal fasting glucose (NFG)1, FPG or = 126 mg/dL or with anti-diabetes drugs. In those with FPG < 110 mg/dL, body mass index (BMI) and waist circumference (WC) were increased with increase of FPG (BMI in men; NFG1, 23.3 +/- 0.1; NFG2, 24.4 +/- 0.1; IFG1, 25.0 +/- 0.2 kg/m2, in women; NFG1, 23.0 +/- 0.1; NFG2, 24.0 +/- 0.1; IFG1, 24.8 +/- 0.2 kg/m2, WC in men; NFG1, 82.1 +/- 0.3; NFG2, 85.3 +/- 0.3; IFG1, 86.7 +/- 0.5 cm, in women; NFG1, 77.1 +/- 0.2; NFG2, 79.4 +/- 0.3; IFG1, 81.8 +/- 0.6 cm). In IFG2 and diabetes range, there was no more increase of BMI and WC with increase of FPG in each sex. The data suggest that degree of obesity increases with an increase of FPG in range of FPG < 100 mg/dL, peaked in FPG of 100-109 mg/dL, and then plateaus in higher FPG range in general Korean population.

The Association of Self-Reported Coronary Heart Disease with Diabetes Duration in Korea

BACKGROUND: This study aimed to investigate the association of diabetes duration with self-reported coronary heart disease (CHD) in Korea. METHODS: Among data from 34,145 persons compiled in the third Korean National Health and Nutrition Examination Survey in 2005, laboratory test and nutritional survey data from 5,531 persons were examined. The participants were asked to recall a physician's diagnosis of CHD (angina or myocardial infarction). RESULTS: Age- and sex-adjusted relative risk for CHD was 1.51 (95% confidence interval [CI], 0.64 to 3.59; not significant) for diabetes with duration of 5 years, compared with non-diabetes as a control. Even after adjusting for age, sex, current smoking status, waist circumference, hypertension, triglycerides, high density lipoprotein cholesterol, and fasting plasma glucose, relative risk for CHD was 2.87 (95% CI, 1.01 to 8.11; P=0.047) in diabetes with a duration of 6 to 10 years and 4.07 (95% CI, 1.73 to 9.63; P=0.001) in diabetes with duration of >10 years with non-diabetes as a control. CONCLUSION: CHD prevalence increased with an increase in diabetes duration in Korean men and women. Recently detected diabetes (duration 5 years was associated with an increase in CHD compared to non-diabetics after adjusting for several CHD risk factors.

Metabolic Syndrome versus Framingham Risk Score for Association of Self-Reported Coronary Heart Disease: The 2005 Korean Health and Nutrition Examination Survey

BACKGROUND: Several studies in Western populations have indicated that metabolic syndrome (MetS) is inferior to the Framingham risk score (FRS) in predicting coronary heart disease (CHD). However there has been no study about the predictability of MetS vs. FRS for CHD in Korea. METHODS: Among the 43,145 persons from the third Korea National Health and Nutrition Examination Survey in 2005, laboratory test and nutritional survey data from 5,271 persons were examined. Participants were also asked to recall a physician's diagnosis of CHD. RESULTS: The median age was 46 (range, 20 to 78) in men (n=2,257) and 44 (range, 20 to 78) years in women (n=3,014). Prevalence of self-reported CHD was 1.7% in men and 2.1% in women. Receiver operating characteristic curves and their respective area under the curve (AUC) were used to compare the ability of the FRS and the number of components of MetS to predict self-reported CHD in each sex. In men, AUC of FRS was significantly larger than that of MetS (0.767 [0.708 to 0.819] vs. 0.677 [0.541 to 0.713], P<0.01). In women, AUC of FRS was comparable to that of MetS (0.777 [0.728 to 0.826] vs. 0.733 [0.673 to 0.795]), and was not significant. CONCLUSION: The data suggested that FRS was more closely associated with CHD compared to MetS in Korean men.

Total Energy Intake May Be More Associated with Glycemic Control Compared to Each Proportion of Macronutrients in the Korean Diabetic Population

BACKGROUND: Major macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans. METHODS: A total of 334 individuals with diabetes (175 men, age 57.4+/-0.8 years; 159 women, age 60.9+/-0.9 years) who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c or =8.1%). Dietary intake was assessed by using a 24-recall item questionnaire. RESULTS: High total energy intake was associated with poor glycemic control (HbA1c or =8.1%, 2,144+/-73 kcal; P value for trend=0.002). Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted. CONCLUSION: Total energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.

A case of Graves' disease associated with myasthenia gravis and complicated with moyamoya disease / 대한내과학회지

Moyamoya disease (MMD) is a cerebrovascular disorder characterized by bilateral stenosis or occlusion of the terminal portions of the internal carotid arteries. MMD is also accompanied by typical net-like collateral vessels in the basal ganglia. Although the etiology of MMD remains unknown, hereditary, immunogenic, and hemodynamic factors have been implicated as underlying mechanisms of MMD. Here, the authors report on one patient with a rare combination of Graves' disease-associated thyrotoxicosis, myasthenia gravis, and MMD, where cerebrovascular ischemic events occurred during a thyrotoxic state.

Successful Treatment of Gastric Hamartomatous Polyp with Hemorrhage by Endoscopic Mucosal Resection / 대한소화기내시경학회지

Hamartomatous polyp is an uncommon lesion. Most of the gastric hamartomatous polyps occur in patients in their 40s because of polyposis coli. Gastric hamartomaotus polyps are usually asymptomatic, but they occasionally manifest with hematemesis or anemia. If they are congenital, then sessile polyps in children should be observed with some measurable frequency. However, many reports have revealed that if the polyp size is big and the risk of rebleeding is high, then ESD or surgical resection can be used to completely remove them. An inverted gastric hamartomatous polyp may have an early gastric cancer component. We report here on an unusual polyp in a 14-years male who presented with hematemesis. Those were about two 3 cm sized large polyps at the proximal antrum and mid body of the stomach, respectively. The polyps were successfully removed by an endoscopic mucosal resection and the lesions were diagnosed as gastric harmatomas.