The Association between Midnight Salivary Cortisol and Metabolic Syndrome in Korean Adults

BACKGROUND: The common characteristics of metabolic syndrome (MetS) and Cushing's syndrome suggest that excess cortisol may be involved in the pathogenesis of MetS. Salivary cortisol measurements are simple and can be surrogates for plasma free cortisol, which is the most biologically active form. We evaluated the association between levels of midnight salivary cortisol and MetS in Korean adults. METHODS: A total of 46 subjects, aged 20 to 70 years, who visited the Health Care Center at Konkuk University Hospital from August 2008 to August 2009 were enrolled. We compared the levels of midnight salivary cortisol in subjects with MetS with those in subjects without MetS. We analyzed the associations between midnight salivary cortisol levels and components of MetS. RESULTS: Midnight salivary cortisol levels were higher in the MetS group (70+/-42.4 ng/dL, n=12) than that in the group without MetS (48.1+/-36.8 ng/dL, n=34) (P=0.001). Positive correlations were observed between midnight salivary cortisol levels and waist circumference, fasting blood glucose, and homeostasis model assessment of insulin resistance. The risk for MetS was significantly higher in subjects with midnight salivary cortisol levels > or =100 ng/dL than in those with levels <50 ng/dL (odds ratio, 5.9; 95% confidence interval, 2.35 to 36.4). CONCLUSION: The results showed a positive correlation between midnight salivary cortisol levels and MetS, suggesting that hypercortisolism may be related to MetS.

Candidate Dipeptidyl Peptidase-4 Inhibitors for the Treatment of Type 2 Diabetes

No abstract available.

Treatment Strategy for Diabetes with Cardiovascular Disease / 임상당뇨병

Individuals with diabetes mellitus are at 2- to 3-fold increased risk of cardiovascular disease relative to individuals without diabetes, and hypoglycemia is associated with increased cardiovascular mortality in diabetic patients. Here, we present a discussion of multiple hypoglycemic drugs and their cardiovascular effects. In addition, we provide summary recommendations for glucose-lowering regimens in patients with diabetes and cardiovascular diseases.

A Case of Type 2 Diabetes Mellitus Improved after Surgical Treatment of Primary Hyperparathyroidism / 임상당뇨병

Patients with primary hyperparathyroidism often exhibit insulin resistance and glucose intolerance. In previous studies, glucose intolerance was improved by parathyroidectomy in primary hyperparathyroidism. We report a case of type 2 diabetes mellitus that improved after resection of a parathyroid adenoma along with a review of the literature.

A Case of Osteomalacia Related to Adefovir in a Patient with Chronic Hepatitis B / 대한소화기학회지

Adefovir dipivoxil, an acyclic nucleoside analogue, has been approved for the treatment of patients with chronic hepatitis B. This agent is efficacious particularly in those who have developed lamivudine resistance. The report according to hypophosphatemia induced by low dose adefovir therapy is very rare. We report one case in which osteomalacia with hypophosphatemia developed in a patient with chronic hepatitis B on adefovir dipivoxil at a low dose, 10 mg daily. A 66-year-old man, who had been taking adefovir for more than 4 years due to lamivudine resistance, presented with muscle weakness and bone pain in both thighs. After 3 years of adefovir therapy, hypophosphatemia and elevated serum alkaline phosphatase levels had been noted. A bone scan showed multiple hot uptakes. All the image findings and clinical symptoms, such as bone pain and muscle weakness were improved after correcting the hypophosphatemia with oral phosphorous supplementation.

A case of Haemophilus aphrophilus native valve endocarditis / 대한내과학회지

Haemophilus aphrophilus, a fastidious, gram-negative oropharyngeal species grouped as a HACEK organism, is a rare cause of infective endocarditis. Three cases of endocarditis with Haemophilus aphrophilus were reported in Korea, and all of them required valve replacement surgery. We describe a case of native valve infective endocarditis with cerebral embolism and infarction caused by Haemophilus aphrophilus in a 61-year-old woman who was successfully treated with antibiotic therapy for 6 weeks without valve replacement surgery.

Gluteal and Thigh Compartment Syndrome due to Rhabdomyolysis Following Prolonged Immobilization: A Case Report / 대한신장학회지

Compartment syndrome is rarely associated with non-traumatic rhabdomyolysis. We report the case of a 23-year-old man who developed compartment syndrome associated with rhabdomyolysis caused by prolonged immobilization after antidepressive drug overdose. Elevation of serum creatine phosphokinase and myoglobinuria indicated rhabdomyolysis. Painful swelling of the right buttock and thigh and right lower limb paralysis with sensory and motor deficit were suggestive of gluteal and thigh compartment syndrome with the complication of sciatic nerve injury. The patient received an immediate fasciotomy, medical treatment and rehabilitation. At five months after initial treatment, the patient could walk independently with nearly full recovery of his right lower limb function.

Overlap Syndrome of Amyopathic Antisynthetase Syndrome and Systemic Lupus Erythematosus: A Case Report / 대한류마티스학회지

Interstitial lung disease (ILD) with autoantibodies against antisynthetase may occur in the absence of clinically apparent myositis. We report 58-year-old woman who initially presented with dyspnea. The patient showed positive immunologic markers reflecting systemic lupus erythematosus, destructive polyarthritis, Raynaud's phenomenon, and ILD. There is no proximal muscle weakness in her symptoms. This syndrome was confirmed by positive antibodies to Jo-1. For the early diagnosis of this syndrome, the possibility of this syndrome including other connective tissue disease should be considered in patients presenting with symptoms related to ILD and positive anti-nuclear antibody.