The Presence of Urinary Ketones according to Metabolic Status and Obesity

Background@#Recently, new concepts about obesity and normal weight subtypes with metabolic conditions are rising and ketone bodies are emerging as a significant indicator of metabolic health. This study aimed to find a relationship between ketonuria and those subtypes. @*Methods@#The data of 19,036 subjects were analyzed in this cross-sectional study (2013–2017 Korea National Health and Nutrition Examination Survey, KNHANES). Based on body mass index and adult treatment panel III with modification of waist circumference, individuals were categorized into 4 groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). Individuals were divided into 2 groups, positive and negative ketonuria groups, and the metabolic parameters were compared. @*Results@#The metabolic indicators of the positive ketonuria group showed better results than those of the negative ketonuria group and the MHNW group showed the highest proportion of positive ketonuria. The MHNW group showed higher urinary ketones than the MUO group (odds ratio [OR], 0.391; 95% confidence interval [CI], 0.254–0.601) in men. In women, OR of having ketonuria was 0.698 (95% CI, 0.486–1.002) in the MHO group and 0.467 (95% CI, 0.226–0.966) in the MUNW group compared to the MHNW group, respectively. @*Conclusion@#Compared to the MHNW group, the MUO group showed lower presence of ketonuria in men, and tendency to have less ketonuria in women.

The Effect of Xanthigen on the Expression of Brown Adipose Tissue Assessed by 18F-FDG PET

Brown adipose tissue (BAT) is related with energy expenditure, in contrary to fat-storing white adipose tissue. Recent studies have shown that cold exposure could be related with the expression of BAT in adult subjects assessed by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). In addition, the application in previous clinical trials showed positive effect of xanthigen containing fucoxanthin and punicic acid on body weight and liver fat content. In this short-term intervention study, we evaluated the effect of xanthigen on the expression of BAT by 18F-FDG PET. Two healthy obese premenopausal women were enrolled and xanthigen 600 mg (2 capsules including fucoxanthin 3 mg, punicic acid 174 mg) was given for 3 months without dietary and exercise intervention. Body composition and dietary intake were assessed monthly. Laboratory test and 18F-FDG PET were performed before and after intervention. After intervention, there was neither weight reduction nor remarkable laboratory change. However, BAT, assessed by 18F-FDG PET, was detected in both cervical, supraclavicular and paravertebral space in one subject, even though her body weight showed mild increase. This result suggested that xanthigen can induce BAT in a healthy adult. However, a further large well-controlled study is needed.

Obesity and Dysbiosis

Recent studies have described an association between obesity and gut microbiota, suggesting that the latter might play a critical role in the development of the former. Possible mechanisms by which gut microbiota can mediate obesity are by changes in gut microbiota which can influence energy absorption, modulate associated enzymes and induce low-grade inflammation. Several studies have reported beneficial effects of lactic acid bacteria (LAB), including anti-obesity effects and improvements in lipid profiles. However, other studies have reported of no beneficial effects of LAB on obesity, or even an increase in obesity. Using probiotics for the improvement of gut microbiota as a treatment for obesity is likely to be more complex than anticipated and may require a long-term complex program (e.g., 4R program: remove, replace, reinoculate, repair) and multiple follow-up evaluations over time.

Different Response of Body Weight Change According to Ketonuria after Fasting in the Healthy Obese

The relationship between obesity and ketonuria is not well-established. We conducted a retrospective observational study to evaluate whether their body weight reduction response differed by the presence of ketonuria after fasting in the healthy obese. We used the data of 42 subjects, who had medical records of initial urinalysis at routine health check-up and follow-up urinalysis in the out-patient clinic, one week later. All subjects in the initial urinalysis showed no ketonuria. However, according to the follow-up urinalysis after three subsequent meals fasts, the patients were divided into a non-ketonuria group and ketonuria group. We compared the data of conventional low-calorie diet programs for 3 months for both groups. Significantly greater reduction of body weight (-8.6 +/- 3.6 kg vs -1.1 +/- 2.2 kg, P < 0.001), body mass index (-3.16 +/- 1.25 kg/m2 vs -0.43 +/- 0.86 kg/m2, P < 0.001) and waist circumference (-6.92 +/- 1.22 vs -2.32 +/- 1.01, P < 0.001) was observed in the ketonuria group compared to the non-ketonuria group. Fat mass and lean body mass were also more reduced in the ketonuria group. In addition, serum free fatty acid concentration after intervention in the ketonuria group showed significant more increment than in the non-ketonuria group. The presence of ketonuria after fasting may be a predicting factor of further body weight reduction.

Changes of Body Weight and Inflammatory Markers after 12-Week Intervention Trial: Results of a Double-Blind, Placebo-Control Pilot Study

PURPOSE: Low grade inflammation is a well-known characteristic in obese subjects. We investigated body weight changes and inflammatory markers after 12-week intervention trial. MATERIALS AND METHODS: Twenty-six obese subjects were enrolled and 19 (13 men and 6 women) completed the study. Sibutramine is an FDA-approved drug for body weight control; therefore, we chose this drug as the standard treatment medication in this study. Patients were randomly allocated to receive an anti-inflammatory agent (Diacerein treatment group; n = 12) or placebo (n = 7) for 12 weeks. Anthropometry, body proportion by dual-energy X-ray absorptiometry, and metabolic parameters at the beginning and end of study were measured and compared. RESULTS: The treatment group had a tendency towards more reduction in anthropometry as compared to the placebo group, in body weight reduction (- 7.0 kg vs. - 4.6 kg), body mass index (- 2.51 kg/m2 vs. - 1.59 kg/m2), and waist circumference (- 7.3 cm vs. - 4.4 cm). These reductions were not statistically significant. Changes in levels of high-sensitivity C-reactive protein and adiponectin in the treatment group were more favorable than in the placebo group. CONCLUSION: This small pilot study showed no statistical difference for changes in anthropometry, and inflammatory markers between the two groups. Therefore, we could not find any additional effects of Diacerein on weight loss and inflammatory variables in this study.

Ketonuria after Fasting may be Related to the Metabolic Superiority

Obese individuals are less able to oxidize fat than non-obese individuals. Caloric reduction or fasting can detect ketonuria. We investigated the differences of metabolic parameters in the presence of ketonuria after a minimum 8 hr fast in a cross-sectional analysis of 16,523 Koreans (6,512 women and 10,011 men). The relationship between the presence of ketonuria of all subjects and prevalence of obesity, central obesity, metabolic syndrome, and obesity-related metabolic parameters were assessed. The ketonuria group had lower prevalence of obesity, central obesity, and metabolic syndrome than the non-ketonuria group. In addition, all metabolic parameters (including body weight, waist circumference, blood glucose, high-density lipoprotein, triglyceride, blood pressure, and insulin) were favorable in the ketonuria group than in the non-ketonuria group, even after adjustment for age, tobacco use, and alcohol consumption. The odds ratios of having obesity (odds ratio [OR]=1.427 in women, OR=1.582 in men, P<0.05), central obesity (OR=1.675 in women, OR=1.889 in men, P<0.05), and metabolic syndrome (OR=3.505 in women, OR=1.356 in men, P<0.05) were increased in the non-ketonuria group compared to the ketonuria group. The presence of ketonuria after at least an 8 hr fast may be indicative of metabolic superiority.

Correlation of Undercarboxylated Osteocalcin (ucOC) Concentration and Bone Density with Age in Healthy Korean Women

Uncarboxylated osteocalcin (ucOC) is important in evaluating vitamin K status and it is inversely associated with bone mineral density (BMD). We studied the correlationship between ucOC and BMD in healthy Korean women. This study recruited 337 healthy women between ages 20-70 were recruited. Serum ucOC, calcium, alkaline phosphatase, body mass index (BMI), and BMD were measured and compared. Mean BMI was lowest (20.3+/-1.9 kg/m2) in the 20 yr old group and highest (24.8+/-2.6 kg/m2) in the 60 yr old group. Women age 20-70 yr old had ucOC inversely related to BMD independent of other factors that may influence BMD. Serum ucOC concentration and BMD of lumbar spine showed a significant inverse relationship. Serum mean alkaline phosphatase was lowest (122+/-30 IU/L) in the age 30 group and highest (190.3+/-55.8 IU/L) in the age 60 group. Serum ucOC was inversely associated with BMI, and positively associated with alkaline phosphatase. Uncarboxylated osteocalcin (ucOC) was inversely associated with spinal BMD in healthy Korean women. Serum mean ucOC was highest in the age 20 group, followed by age 50 group, which may indicate vitamin K insufficiency could be related to high bone turnover in these groups. These results suggest that vitamin K supplement may be considered to help both bone growth and bone loss during these periods.

Insulin-like Growth Factor 1 Level and Its Relating Factor in Korean Healthy Adults / 가정의학회지

BACKGROUND: The concern about growth hormone, used for treatment of growth hormone deficiency, wasting diseases, is increasing recently. There is much to be desired about the study for the reference range of insulin-like growth factor-1 (IGF-1) of Korean healthy adults, because there was a lack of studies of IGF-1 level. The authors investigated the concentration of IGF-1 according to age groups, and its correlation factors in healthy adults in Korea. METHODS: The subjects were 10,681 Korean healthy adults (5,263 females, 5,418 males) aged over 20 years, who visited the Department of Family Practice and Community Health in a university hospital from March 1998 to December 2003. We excluded the subjects with DM, liver diseases, renal diseases, thyroid diseases, and cancer. We measured the serum IGF-1, fasting glucose, lipid profile, serum albumin, protein, waist circumference, hip circumference, and body mass index. RESULTS: IGF-1 level showed gender difference (184.6 +/- 86.3 ng/mL for men, 178.6 +/- 91.8 ng/mL for women) and decreased significantly with age. Age was the most reliable correlation factor with IGF-1 (R: -0.325 for men, R: -0.463 for women). After adjusting fot age and weight, IGF-1 showed correlations with total protein, albumin, creatinine, triglycerides, and HDL cholesterol for men and height, waist circumference, body mass index, waist-hip ratio, systolic blood pressure, total protein, albumin, creatinine, triglycerides, and HDL cholesterol for women. CONCLUSION: IGF-1 concentration decreased with age over 20 years old. It showed the highest correlation with age in both gender.

Association of Insulin-like Growth Factor-1 (IGF-1) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) with the Metabolic Syndrome

BACKGROUND: Insulin-like growth factor-1 (IGF-1) has been suggested to be involved in the pathogenesis of atherosclerosis. The biological activity of IGF-1 is influenced by IGF binding protein-3 (IGFBP-3). We hypothesized that IGF-1 and IGFBP-3 levels may be associated with the metabolic syndrome which is a cluster of cardiovascular risk factors. METHODS: We assessed the circulating levels of IGF-1 and IGFBP-3 in 12,415 individuals (men 6,626, women 5,789), aged 18~81 years, who visited a hospital for regular health examination. The metabolic syndrome was defined according to the definition of the National Cholesterol Education Program Adult Panel III (NCEP-ATP III). RESULTS: The IGF-1 concentrations were positively correlated with the waist circumference and systolic blood pressure. The IGFBP-3 concentrations were positively correlated with the waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood sugar, and triglyceride, and negatively correlated with HDL cholesterol. The subjects in the lowest IGF-1 quartile had a significantly higher adjusted odds ratio (OR) of the metabolic syndrome compared with the highest IGF-1 quartile group (adjusted for age, smoking, alcohol intake, and physical activity). Conversely, the subjects in the highest IGFBP-3 quartile group had a significantly higher adjusted OR of the metabolic syndrome compared with the lowest IGFBP-3 quartile group. CONCLUSION: The subjects with low IGF-1 level or high IGFBP-3 level showed increased prevalence of the metabolic syndrome. The metabolic syndrome is recognized as a cluster of cardiovascular risk factors. Therefore, the results of this study suggest that low IGF-1 or high IGFBP-3 can be considered to increase the risk of cardiovascular diseases.

Meaning of the DR-70(TM) Immunoassay for Patients with the Malignant Tumor

BACKGROUND: The DR-70(TM) immunoassay is a newly developed cancer diagnostic test which quantifies the serum fibrin degradation products (FDP), produced during fibrinolysis, by antibody reaction. The purpose of this study was to evaluate the potential of DR-70(TM) immunoassay in screening malignant tumor. METHODS: Sample subjects were 4,169 adults, both male and female, who visited the health promotion center of a general hospital from March 2004 to April 2005 and underwent the DR-70(TM) immunoassay test and other tests for cancer diagnosis. The patient group was defined as 42 adults out of the sample subjects who were newly diagnosed with cancer during the same time period when the DR-70(TM) immunoassay test was performed. Final confirmation of a malignant tumor was made by pathological analysis. RESULTS: The mean DR-70(TM) level was 0.83+/-0.65 microgram/ml (range: 0.00 (0.0001)~7.42 microgram/ml) in the control group (n=4,127) as opposed to 2.70+/-2.33 microgram/ml (range: 0.12 ~ 9.30 microgram/ml) in the cancer group (n=42), and statistical significance was established (p<0.0001, Student t-test). When categorized by the type of malignant tumor, all cancer patients with the exception of the subgroups of colon and rectal cancer showed significantly higher mean DR-70(TM) levels compared with the control group (p<0.0001, Kruscal-Wallis test). The receiver operating characteristic (ROC) curve analysis revealed < or = 1.091 microgram/ml as the best cut-off value. Using this cut-off value, the DR-70(TM) immunoassay produced a sensitivity of 71.4%, a specificity of 70.1%, a positive predictability of 69.4%, and a negative predictability of 69.2% (1). CONCLUSION: A significant increase in the mean DR-70(TM) value was observed in the cancer group (thyroidal, gastric, breast, hepatic and ovarian) compared with the control group. In particular, the specificity and sensitivity of the DR-70(TM) immunoassay was relatively high in the subgroups of breast, gastric, and thyroidal cancer patients. There is need for further studies on a large number of malignant tumor patients to see how the DR-70(TM) level might be changed according to the differentiation grade and postoperative prognosis of the malignant tumor.

Hormone Replacement Therapy (HRT), Other Reproductive and Life Style Variables and Rheumatoid Arthritis in Postmenopausal Women / 대한류마티스학회지

OBJECTIVE: To compare the differences of hormone replacement therapy (HRT) and reproductive, life style characteristics in postmenopausal women with and without rheumatoid arthritis (RA). METHODS: A total of 360 women, 120 rheumatoid arthritis patients and 240 age matched healthy women were randomly selected from the health care center. Subjects were labeled as rheumatoid arthritis and normal menopausal women. Each group was compared for their HRT status, life style and reproductive characteristics. RESULTS: There were significantly less HRT received subjects in RA group (50.0% vs 76.1%, respectively, OR=0.30, p<0.05). More frequently alcohol consumed in RA group (26.7% vs 11.7%, respectively, p<0.05). There was no significant difference in the history of hysterectomy and smoking as well as body mass index (BMI) between the two groups. Women with serum follicular stimulating hormone (FSH) over 40 IU/L were more frequently observed in RA group (70.0% vs 57.5%, respectively, OR=1.75, p<0.05). CONCLUSION: Increased FSH and history of alcohol drinking were more frequently observed in patients with RA, whereas history of HRT was lower in RA group comparing to that of the control. A prospective study should be designed to confirim the protective effect of HRT and reproductive characteristics on postmenopausal RA patients.

Changes in Heart Rate Variability after Weight Reduction in the Obese

BACKGROUND: Obesity increases morbidities and mortalities due to cardiovascular diseases. In previous studies, decrease in heart rate variability was associated with cardiovascular death and reduced heart rate variability in the obese had been reported. The authors investigated immediate changes in the heart rate variability after weight reduction in obese individuals. METHODS: The subjects for this study were 39 Korean adults (35 female, 4 male), who visited obesity clinic in a university hospital from January 2002 to July 2003. At first visit, weight, height, body mass index (BMI) and waist circumference of the subjects were measured. We also measured parameters of heart rate variability: Mean Heart Rate (MHR), Standard Deviation of N-N interval (SDNN), The Square Root of the Mean Squared Difference of successive NN intervals (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Weight reduction protocol included nutritional counseling, exercise, behavioral modification and anti-obesity medications, if needed. RESULTS: At 12 weeks of intervention, weight, BMI, waist circumference, fat mass, and lean body mass significantly decreased (3.90+/-3.11 kg, -1.50+/-1.21 kg/m2, -4.45+/-5.61 cm, -3.03+/-2.45 kg, -1.32+/-1.16 kg, P <0.01, respectively). MHR (-6.17+/-9.65 bpm, P <0.01) and LF/ HF (-0.61+/-1.56, P <0.05) showed significant reduction. Changes of weight and LF were positively correlated (r=0.338, P <0.01). Changes of waist circumference was correlated with changes of SDNN (r= 0.331, P <0.05). Changes of BMI showed positive correlation with changes in TP (r=0.327, P <0.05) and LF (r=0.345, P <0.05). CONCLUSION: Short term intervention for obese people decreased sympathetic nervous activity.

Treatment of Obesity with Drugs

Oesity is a major global health problem. However, current therapeutic strategies for obesity are limited. Obesity results from an imbalance between energy intake and energy expenditure, and the treatment of obesity is based on the correction of this metabolic imbalance. Anti-obesity drugs can shift this balance in a favorable way by reducing food intake, altering metabolism, and by increasing energy expenditure. There is a growing consensus that pharmacotherapy is appropriate for many individuals who are unable to lose weight through less intensive measures. However, side effects may ensue phamacotherapy for obesity. Only two drugs (sibutramine and orlistat) are currently approved for the long-term treatment of obesity. Sibutramine inhibits the reuptake of serotonin and norepinephrine. Orlistat works by blocking the pancreatic lipase. However, phamarcotherapy may not be the ultimate resolution for obesity management. Because the underlying pathophysiology in each individual varies in many aspects, it is recommended to provide individualized and tailored medication in addition to other antiobesity supportive treatments.

Study on the Insulin Resistance According to Obesity in the Patients with Polycystic Ovarian Syndrome / 대한산부인과학회잡지

OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a heterogenous dysfunctional endocrinologic disorder with unknown etiology, clinically characterized by obesity, chronic anovulation, masculinization and infertility. Recently, the association between polycystic ovarian syndrome and insulin resistance have been brought up and insulin resistance is one of the most important factor related to the development of obesity. However, not all polycystic ovarian syndrome patients are obese, it would give a clue to understanding pathophysiology of obesity and PCOS if insulin resistance could be classified according to the degree of obesity in PCOS. Thus, we performed this prospective study to know the relationship between insulin resistance and obesity in the patients with PCOS. METHODS: Fourty eight polycystic ovary patients were included at Samsung Cheil Hospital from April to October 2002. These patients were grouped according to obeseness. HOMA index was used to evaluate insulin resistance calculated by using fasting blood sugar and serum insulin level. RESULTS: Twenty patients (41%) were classified as obese group, twenty eight patients (59%) had normal body mass index. Increased insulin resistance was observed in the patients with polycystic ovarian syndrome. And it was significantly higher in the obese patients compared to the patients with normal body mass index (6.8+/-2.8 vs. 2.7+/-0.9, t-test, p<0.01). CONCLUSION: For increased insulin resistance, immediate management would be needed in the patients of polycystic ovarian syndrome, especially combined with obesity.

Changes of bone mineral density after 2-yrs treatment with HRT and alendronate in osteoporotic Korean women

BACKGROUND: Alendronate is one of the anti-resorptive drugs for the treatment of osteoporosis and results in a decrease of bone turnover. HRT is also known to decrease the bone turnover. Combination therapy with HRT and alendronate has made significant increase of BMD in postmenopausal women. But there were no available long-term results about combination therapy of HRT and alendronate on Korean osteoporotic women. METHODS: Eighty postmenopausal women with osteoporosis who visited the Climacteric clinic in Samsung Cheil Hospital & Women's Health Care Center from Apil to July 1999 were subjects. Randomized open labeled case control study was made. We evaluated 37 postmenopausal osteoporotic Korean women who were treated for 2 years after enrollment. Subjects in Group I were treated with HRT only, and group II had HRT with alendronate 10 mg daily. Subjects also were measured BMD at lumbar spine and markers of bone turnover before, one and two year after treatment. RESULTS: Common reasons for dropouts were side effects of HRT such as breast tenderness, irregular vaginal bleeding, economic problems, long distance from clinic etc. BMD in lumbar spine was increased 10.1% in the first year, and 12.0% in the second year in subjects treated with HRT and alendronate. But in HRT only group BMD increased to 6.4% in the first year and 7.8% at second year. Markers of bone turnover were decreased significantly in both groups compared with baseline value, but the percent changes of markers after 1 year and 2 years between the two groups were not significant. CONCLUSION: This study demonstrated that, in postmenopausal Korean women with osteoporosis, 2 years of combination therapy with HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT only group.

Spinal bone mineral density related with YSM in Korean menopausal women

BACKGROUND: Estrogen deficiency after menopause is a major reason of bone loss in postmenopausal women. YSM (years since menopause) is negatively related with BMD in postmenopausal women. Bone loss after menopause is accelerated in early stage of menopause, and then decreases. There are some evidence that body weight can prevent bone loss in menopausal women. Therefore, we evaluated associations of the general characteristics and lumbar BMD of postmenopausal Korean women, and determined the rate of bone loss after menopause at 5-year interval. METHODS: BMD was measured by DEXA system and physical, anthropometric data including body fat were obtained in 1006 peri - and postmenopausal women. Pearsons correlation coefficient were made among pesical, anthropometric data and lumbar BMD. To determine the contributable factors for lumbar BMD, multiple regression analysis was done. RESULTS: 1) In Pearsons correlation analysis among body composition YSM and spinal BMD, YSM was strongly associated negatively with spinal BMD. 2) On the other hand, weight and BMI was associated positively with spinal BMD. 3) The percent difference in spinal BMD between perimenopause and 5-years after menopause was 15.3% 4) Years since menopause, body weight was revealed as an important factor that predicted spinal BMD by multiple stepwise regression analysis. CONCLUSIONS: We conclude that YSM and body weight were revealed as important factors that can predict spinal BMD in postmenopausal women.

A prospective study for weight changes associated with pregnancy

BACKGROUND: This prospective study was performed to evaluate factors influencing weight changes pregnancy period and pospartum period. METHODS: A total of 195 women followed by prenatal care of the department of OBGY at Ajou University hospital, Suwon, Korea, between march, 1998 and march, 2000. Parity, activity, alcohol, smoking, age of menarche, and age of first and last pregnancy were recorded for prenatal information. Anthropometric measurements was checked at regular visits until 6 weeks after delivery and by telephone call at 6 months and 1 year postpartum. RESULTS: Mean age was 30.1 years old and mean body mass index was 21.1 kg/m2. Mean total weight gain during pregnancy was 13.6+/-4.63 kg and wide range was at third trimester. It shows that weight reduced gradually until 6 months postpartum but increased after that time. 1 year postpartum weight gain had high correlation(R=0.999, 0.01) with 6 months postpartum weight gain. Total pregnancy weight gain, weight retention on 6 week postpartum were not significantly correlated with 1 year postpartum weight gain. OR for becoming overweight on 1 year postpartum(> OR =5.2 kg) with excessive rate of gain on 6 months postpartum(> OR =2.9 kg) was 5.41(95% CI 2.20 13.31) adjusted by multiple logistic regression analysis(age, activity level, parity). OR for becoming overweight on 1 year postpartum with excessive rate of Total pregnancy weight gain(> OR =13.6 kg) was 4.48(95% CI 1.84 10.89) by multiple logistic regression analysis. CONCLUSION: 1 year postpartum weight gain had the correlation with only 6 months postpartum weight gain.

Relationship of body fat, lipid, blood pressure, glucose in serum to waist-hip ratio between obese and normal body mass index group

BACKGROUND: Obesity is a risk factor for developing hyperlipidemia and cardiovascular diseases. Various diagnostic methods and criteria of obesity have been developed. The predictive values of health risk factors(hyperlipidemia, hypertension, diabetes mellitus, and body fatness) were different for cardiovascular diseases. We reviewed the medical records to assess the relation of health risk factors to waist-hip ratio(WHR) and body mass index (BMI). METHODS: We gathered 5100 cases who have taken medical examination from March 1995 to February 1996 at Ajou University Hospital and measured BMI, WHR, body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar etc.. Except 1350 abnormal cases on current illness and laboratory study, 3750 healthy cases were analysed. First we divided the healthy cases into obese and non-obese group according to BMI 25kg/m2 in men and women. And then, the obese and non-obese group was divided into central and non-central obese type by WHR 0.8 in women and 0.9 in men. RESULTS: Except only diastolic blood pressure in male, other lab data such as body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar in male and female were significantly different between the two groups divided by WHR in BMI_0.9. Women had higher(P_0.8. CONCLUSIONS: We thought that the increase of WHR was risk factor for hyperlipidemia, hypertension, diabetes mellitus in men and women when BMI was less than 25kg/m2. In obese group(BMI>_225kg/m2), increase of WHR was risk factor for hyperlipidemia in men and hyperlipidemia and hypertension in women.

The study of serum lipid in diabetic patients

No abstract available.

Quality of life in the diabetic patients

No abstract available.