Association between BDNF Polymorphism and Depressive Symptoms in Patients Newly Diagnosed with Type 2 Diabetes Mellitus

Purpose@#Little is known about the relationship between brain-derived neurotrophic factor (BDNF) gene polymorphisms and psychiatric symptoms in diabetes patients. We investigated the effects of BDNF Val/66/Met polymorphism, glucose status, psychological susceptibility, and resilience on anxiety and depression symptoms in patients newly diagnosed with type 2 diabetes mellitus (T2DM). @*Materials and Methods@#We examined biochemical factors and BDNF polymorphism in 89 patients who were newly diagnosed with T2DM. Psychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale (HADS), and the ConnorDavidson Resilience Scale (CD-RISC) and Impact of Event Scale (IES) were used to assess psychological resilience and susceptibility to psychological distress, respectively. Logistic regression analyses were conducted to investigate factors associated with psychiatric symptoms. @*Results@#We determined that 62 patients (70%) were Met-carriers. No significant differences were found between the Val/Val homozygous and Met-carrier groups regarding age, sex, body mass index, and clinical factors related to glycemic control and lipid profiles. HADS-anxiety and HADS-depression scores and IES factor scores were higher in the Met-carrier than the Val/Val homozygous group. Hemoglobin A1c (HbA1c) level was significantly inversely correlated with the severity of depressive symptoms. Resilience factors showed significant inverse correlations, and IES factors showed positive correlations with depressive symptom severity. In the logistic regression analysis model, depressive symptoms were significantly associated with HbA1c and BDNF polymorphism, whereas only the hyperarousal factor of the IES scale was associated with anxiety. @*Conclusion@#Depressive symptoms are associated with the presence of the Met-carriers and lower HbA1c in patients newly diagnosed with T2DM.

A Case of Clozapine-induced Corneal and Lenticular Pigmentation

PURPOSE: To report a case of corneal and lenticular pigmentation after prolonged clozapine therapy. CASE SUMMARY: A 56-year-old male visited our hospital with a progressive decline in vision that affected both eyes. He had a history of schizophrenia. He was being treated with 200 mg clozapine and 1 mg lorazepam daily, and had been treated with clozapine for 5 years. At the first visit, his best-corrected-visual acuity was 20/32 in both eyes. Slit lamp examination of the corneas showed bright, fine, grayish-brown deposits on the endothelium, and on dilation, bilateral central stellate opacity of the anterior portion of the lens capsule was revealed. CONCLUSIONS: Clozapine may induce corneal and lenticular pigmentation and thus may lead to a decline in vision. Patients on long-term clozapine therapy should be considered for regular ophthalmic review.

Operation and Process Evaluation of a Community Meal Program for the Elderly in Rural Areas during Agricultural Off-Season Perceived by Cooking Volunteers / 대한지역사회영양학회지

OBJECTIVES: This study examined the practices of a community meal program for older adults in rural areas during the agricultural off-season. METHODS: A survey was conducted from December 12 to December 22, 2016. Self-administered questionnaires were distributed to 150 cooking volunteers, who had participated in the community meal program in 50 villages. A total of 114 responses were returned from 44 villages and used for data analysis. In addition, in-depth interviews were conducted with the volunteers of eight villages. RESULTS: Most of the cooking volunteers were 50 years old or older and they participated in serving older adults meals for good will. The cooking volunteers perceived that the older adults in their community did not eat various foods, had difficulties in grocery shopping, and frequently consumed salty foods. During the agricultural off-season, 40.9% of villages served the older adults meals 6–7 days a week and 95.5% provided meals for lunch. An average of 21 to 40 older adults were served meals in each village. The cooking volunteers reported that the food preparation and meal service times were sufficient, recipes provided were useful, and menus met the preference of the older adults. At the end of the program, they felt proud of serving meals for older adults in the community. An increased awareness of healthy eating, interest in health, and consumption of nutritious meals, a decrease in loneliness among older adults, and the promotion of fellowship in the community were rated highly. The cooking volunteers expected additional support for cooking personnel and insisted that the program should be provided for the entire agricultural off-seasons. CONCLUSIONS: The community meal program during the agricultural off-season for the elderly in rural areas was effective in improving the dietary life of older adults, relieving their feelings of isolation, and promoting fellowship of the community. The volunteers felt workload due to a shortage of volunteers but answered that they were rewarded by helping older adults in their community.

A Study about Compassion Fatigue, Compassion Satisfaction and Burnout in Comprehensive Nursing Care and General Ward Nurses / 임상간호연구

PURPOSE: The purpose of this study was to compare the differences in compassion fatigue, compassion satisfaction and burnout between nurses working at comprehensive nursing care unit and general ward. METHODS: The subjects were 35 nurses in general ward and 42 nurses in the Comprehensive Nursing Care unit in one hospital. Measurement instrument included the Stamm's professional quality of life (ProQOL) version 5-Korean. Descriptive statistics, t-test, paired t-test, and ANCOVA were used to analyze the data. RESULTS: Nurses working at the Comprehensive nursing care unit demonstrated significantly lower compassion fatigue (F=17.00, p < .001), higher compassion satisfaction (F=14.39, p < .001), and lower levels of burnout (F=40.07, p < .001) than control group. CONCLUSION: Compassion fatigue and burnout were lower and compassion satisfaction was higher among nurses working at comprehensive nursing unit than general ward. In order to improve quality of the comprehensive nursing care services, there is a need to be concerned with the nurse's compassion fatigue, compassion satisfaction, and burnout.

Influence of Ageing Knowledge and Family Strengths on Ageism among the Nursing Students / 재활간호학회지

PURPOSE: This study was to examine the level of aging knowledge, family strengths and ageism in addition to identify the influence of ageism among nursing students. METHODS: The participants were 235 nursing students at a university. Data were collected from May 14, to June 8, 2018. Data were analyzed with t-test, One-way ANOVA, Pearson's correlation coefficient and stepwise multiple regression using the SPSS/WIN 22 program. RESULTS: Average score in ageism was 41.41±7.65, indicating the moderate to severe level of ageism. Ageism of nursing students was negatively correlated with ageing knowledge and family strengths. The significant predictors for ageism in nursing students were experience of living with grandparents (β=−.21, p=.001), family strengths (β=−.20, p=.002), ageing knowledge (β=−.15, p=.022), grade (β=.13, p=.040). CONCLUSION: Based on these results, it is necessary to develop and apply an educational program to improve the awareness of ageism among nursing students.

Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes

PURPOSE: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperlactatemia in patients with type 2 diabetes. MATERIALS AND METHODS: This was a cross-sectional study from a tertiary university-affiliated medical center. A total of 1954 type 2 diabetes patients were recruited in 2007–2011, and stratified according to the estimated glomerular filtration rate of 60 mL/min/1.73 m2. Lactic acidosis was defined as plasma lactate levels >5 mmol/L and arterial pH <7.35. RESULTS: Metformin was used in 61.4% of the patients with type 2 diabetes mellitus. Plasma lactate levels were not different in the patients with and without metformin use. There was no difference in prevalence of hyperlactatemia and lactic acidosis between the patients with and without metformin use (18.9% vs. 18.7%, p=0.905 for hyperlactatemia and 2.8% vs. 3.3%, p=0.544 for lactic acidosis). Similar results were observed in the patients with estimated glomerular filtration rate <60 mL/min/1.73 m². Most patients with lactic acidosis had at least one condition related to hypoxia or poor tissue perfusion. Multiple regression analysis indicated no association between metformin use and lactic acidosis, whereas tissue hypoxia was an independent risk factor for lactic acidosis [odds ratio 4.603 (95% confidence interval, 1.327–15.965)]. CONCLUSION: Metformin use was not associated with hyperlactatemia or lactic acidosis in patients with type 2 diabetes.

Nutrient intake and dietary quality of Korean adults according to chronic obstructive pulmonary disease (COPD): Based on the 2012~2014 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: Food intake of COPD patients decreases because of appetite loss, depression, and breathing problems while eating, which increase the likelihood of patients becoming malnourished. This study investigated the nutrient intake and dietary quality of people with and without COPD in Korea. METHODS: There were 2,160 adults aged 50 and over who participated in the 5~6th Korea National Health and Nutrition Examination Survey. The subjects were divided into the COPD group and non-COPD group according to the rate of forced expiratory volume at 1 second (FEV1) against forced vital capacity (FVC). Consumption of food and nutrients were calculated based on the nutrition examination survey. Statistical analyses were conducted using SPSS 19.0. RESULTS: Among individuals in their 50s, intake of vitamin B1 in the COPD group was significantly less than the NCOPD group, while intake of sodium in the COPD group was significantly greater than the NCOPD group. Among individuals in their 60s, the energy intake of the COPD group was significantly less than that of the NCOPD group. The COPD group showed significantly less intake of vitamin B1 and vitamin C, but greater intake of sodium than the NCOPD group. In the group aged 70 and over, The COPD group had significantly less intake of vitamin B1 than the NCOPD group and showed lower nutrient adequacy ratio values in protein, vitamin B1, vitamin B2, and iron than the NCOPD group. CONCLUSION: The COPD group consumed less energy and certain nutrients, and their dietary quality was poor compared to the NCOPD group. Thus, more detailed research is required to understand the concrete relationship between COPD and malnutrition.

Difference in food and nutrient intakes in Korean elderly people according to chewing difficulty: using data from the Korea National Health and Nutrition Examination Survey 2013 (6th)

BACKGROUND/OBJECTIVES: Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS: This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing “very difficult” or “difficult”, were combined to form the chewing difficulty group. Similarly, those who found chewing “moderately difficult”, “easy”, and “very easy” were combined to form the normal chewing group. RESULTS: Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS: The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.

Comparative study on prevalence and components of metabolic syndrome and nutritional status by occupation and gender: Based on the 2013 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: In this study, factors of metabolic syndrome and nutritional status were examined according to gender and occupations using the 2013 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: This study was conducted on 1,750 workers (male : 892, female : 858) aged between 30 and 64, who participated in a health survey, health examination, and nutrition survey using the 6th 2013 KNHANES. Occupations were classified into white collar and blue collar workers, and nutrient intake was analyzed using a food frequency questionnaire. Analysis of complex sample design data through SPSS 19.0 was used for analysis. RESULTS: The prevalence rate of metabolic syndrome among blue collar (35.1%) was higher than that among white collar workers (26.8%) in male subjects (p < 0.05) as well as in blue collar (24.8%) compared to white collar workers (8.9%) in female subjects (p < 0.001). Intake frequency per week, considering one portion by food category, showed significant differences in cooked rice (p < 0.05) and bakeries and confectioneries (p < 0.05) in make workers as well as stew and casserole (p < 0.01) and fruits (p < 0.05) in female workers. With regard to nutrient intake by occupation and gender, white collar workers consumed a greater amount of nutrients (not including total energy intake) compared to blue collar workers in both male and female workers. With regard to nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) according to gender and occupation, white collar workers showed higher numbers than blue collar workers in both male and female subjects. CONCLUSIONS: This study examined the prevalence rates of metabolic syndrome and nutrient intake according to gender and occupation. In both male and female subjects, blue collar workers showed higher prevalence rates compared to white collar workers, and their diet quality was worse than white collar workers' diet quality. Considering this result, customized nutrition education according to gender and occupation should be provided to workers to prevent diseases.

Perceptions of Medical Personnel toward Burnout using Q Methodology / 간호행정학회지

PURPOSE: This exploratory study was done to categorize medical personnel's perceptions of burnout and analyzed the characteristics. METHODS: Q methodology was applied using a 45 Q-sample categorized on an 11-point scale which was completed by nurses and doctors working at a university hospital in Seoul, Korea. Collected data were analyzed using the PC-QUANL program. RESULTS: Medical personnel's perceptions of burnout were categorized into three types; 33.83% of the total variance was explained. The first type was 'functionally deteriorating pressure' the second type was 'daily powerlessness' and the third was 'achievement-oriented re-energization'. CONCLUSION: There is a need to establish and apply intervention strategies for each type to alleviate medical personnel burnout and increase work efficiency to qualitatively improve medical services.

Sur8 mediates tumorigenesis and metastasis in colorectal cancer

Sur8, a scaffold protein of the Ras pathway, interacts with Ras and Raf and modulates the Ras-extracellular signal-regulated kinase (ERK) pathway. Here we show that Sur8 is overexpressed in established human colorectal cancer (CRC) cell lines and CRC patient tissues. Moreover, Sur8 expression is increased during liver metastasis in CRC patients. Sur8 knockdown decreases ERK and Akt activities in CRC cell lines, regardless of their K-Ras, B-Raf or PI3K mutation status. Overexpression or knockdown of Sur8 increases or decreases, respectively, the proliferation or transformation of CRC cell lines. Sur8 knockdown attenuates the migration and invasion of HCT116 CRC cells. Subcutaneous or orthotopic injection of HCT116 cells harboring a doxycycline (Dox)-mediated Sur8 knockdown system in nude mice resulted in decreased tumorigenic potential and inhibited the liver metastatic potential of HCT116 cells. Taken together, our data support the role of Sur8 as a promoter of tumorigenesis and liver metastasis in CRC through its modulation of the Ras-ERK and PI3K-Akt signaling pathways.

A study on the Needs for Nutrition Management Program for Elderly Who use Welfare Facilities / 대한지역사회영양학회지

OBJECTIVES: This study was performed to investigate the nutritional status, health conditions, eating habits and experience and demand for nutrition.dietary management of senior citizens. And these data are formed foundation of development of nutrition.dietary management education program and contents in welfare facilities for the aged. METHODS: We visited 3 public health centers, 3 senior citizens centers, and 4 welfare centers in Seoul, Gyeonggi-do, Chungnam province, and Daejeon area and carried out interview by semi-structured questionnaire for senior citizens older than 65 years who use those facilities. RESULTS: The study included 17%, 30.7% and 52.3% of senior citizens from public health centers, seniorcitizen centers and and welfare centers, respectively. The age range of 43.9% of the population was 65-74 years and and 56.1% were older than 75 years. We observed that 83.2% of subjects took some medicines due to diseases that they have and 58.0% took prescription medicines for hypertension. The thing that they considered the most when selecting food was 'the taste'(p<0.05). Regarding the level of practice to keep the dietary life, they answered more than 'average' for most of items but answered less than 'average' for lot of salt intake, drinking, exercise. For the experience of nutritionddietary life education, only 19.8% answered 'Yes' and the service for nutritionddietary life management showed the highest score in the demand for 'provide nutritious food'. For the size of consulting group for nutrition/dietary life education, the public health center and welfare center preferred a larger group size but the senior citizens center preferred a smaller group. With regard to who will carry out the consulting, the demand for dietitian was the highest and the operation type showed the high demand in the order of consulting, education. The contents that they want to have consultation in nutritionddietary life education were diet therapy for diseases and the ordinary diet therapy for health. CONCLUSIONS: This study suggested the management of nutritionddietry life necessitates qualitative measures according to the different types of welfare facilities. For these, it is in need of development of counseling and education program included therapy for disease. Above all, the policy to secure dietitian of welfare facilities for the aged to perform these should be achived.

Soluble Epoxide Hydrolase Inhibitory Activity from Euphorbia supina Rafin

In our search for natural soluble epoxide hydrolase (sEH) inhibitors from plants, an extract of the dried whole plants of Euphorbia supina Rafin was found to significantly inhibit sEH activity in vitro. Phytochemical investigation of E. supina resulted in isolation of 17 compounds (1 - 17), including triterpenes (1 - 4), phenolic compounds (5 - 8), and flavonoid derivatives (9 - 17). The structures of the isolated compounds were established mainly by extensive analysis of the 1D and 2D NMR, and MS data. All of the isolated compounds were evaluated for their sEH inhibitory activity. Among the isolated phenolic compounds, 8 was identified as a significant inhibitor of sEH, with an IC50 value of 15.4 +/- 1.3 microM. Additionally, a kinetic analysis of isolated compounds (2, 5, 8 - 11, 13, and 17) indicated that the inhibitory effects of flavonoid derivatives 10 and 11 were of mixed-type, with inhibitory constants (Ki) ranging from 3.6 +/- 0.8 to 21.8 +/- 1.0 microM, whereas compounds 2, 5, 8, 9, 13, and 17 were non-competitive inhibitors with inhibition Ki values ranging from 3.3 +/- 0.2 to 39.5 +/- 0.0 microM.

Gastrodia elata Blume Attenuates 2, 4-Dinitrochlorobenzene-induced Atopic Dermatitis-like Skin Lesions in Balb/c Mice and SD Rats

Gastrodia elata Blume is a well-known kind of natural products used as a folk medicine for thousands of years. However, anti-atopic dermatitis-like effects of G. elata Blume had not been evaluated until now. The aim of the present study is to investigate the protective effects of water extract from the roots of G. elata Blume (GE) on 2, 4-dinitrochlorobenzene-induced atopic dermatitis-like skin lesions using balb/c mice. Combination treatment of GE (at a dose of 12.5 mg/kg body weight by administrated per os + 0.5 mg/cm2 as ointment to apply on ear and dorsal skin) was significantly inhibited spleen weight, ear thickness, levels of serum immunoglobulin E and number of mast cells, compared with that of 2, 4-dinitrochlorobenzene-included groups without GE. Furthermore, combination application by oral administration plus by ointment of GE significantly inhibited the histamine release from rat peritoneal mast cells. These results suggest that combination treatment of oral administration plus ointment form of GE could be helpful as a potentially natural pharmaceutical treatment on atopic-like dermatitis.

Effectiveness of Nutrition Education and Counseling on the Salty Taste Assessment, Nutrition Knowledge and Dietary Attitude of Hemodialysis Patients / 대한지역사회영양학회지

The purpose of this study was to evaluate the effectiveness of nutrition education and counseling on the salty taste assessment, nutrition knowledge and dietary attitude of 21 hemodialysis patients. Five times of the nutrition education and three times of nutrition counseling were performed for a period of 5 months. Biochemical analysis revealed that creatinine was significantly high (p < 0.001), blood urea nitrogen and serum albumin were significantly low (p < 0.05, p < 0.01) and Na, K, Cl, K, P and uric acid were not significantly different. The distribution rate of unsalty taste preference were significantly high and the distribution rate of salty taste preference were significantly low after nutrition education and counseling (p < 0.001). Nutrition knowledge significantly improved following 5th month of education and counseling (p < 0.01). Particularly, the scores for questions related to sodium were improved. The dietary attitude was significantly improved during the counseling period (p < 0.05). There were improvements in responses to 'use food exchange list on diet' and 'habitually add salt or soy sauce before the meal'. According to these results, salty taste assessment, nutrition knowledge and dietary attitude were significantly improved by the hemodialysis diet therapy practices of hemodialysis patients. Therefore, we conclude that there was a need for low-salt diet education and nutrition counseling to help them recognize the taste of low-salt foods and strive towards a preference for less salty tasting foods and the consumption of a low-salt diet.

Association Between Blood Sugar Level, Psychological Impact, and Emotional Symptoms in Patients Newly Diagnosed with Diabetes / 임상당뇨병

As the duration of diabetes mellitus (DM) increases, the risk of complications increases and the prevalence of depression becomes higher. Most studies on depression in Korean patients with DM have focused on a point 5-10 years after diagnosis, and there has not been much data reported regarding the early stages of DM, including newly developed DM. In this study, we examined whether blood glucose levels could be associated with emotional symptoms such as depression (DS) and anxiety (AS) in patients newly diagnosed with DM. Serum glucose and HbA1c were measured in 89 patients with DM. The Impact of Event Scale (IES) was used to investigate the extent of the psychological impact of a diagnosis of DM. The IES comprises four elements: hyperarousal, intrusiveness, avoidance, and sleep problems. DS and AS were investigated using the Hospital Anxiety and Depression Scales. DS was observed in 32 patients (36%) and AS was observed in 21 patients (23.6%), indicating a higher prevalence of DS and AS than in the general population. There was an inverse correlation between HbA1c and DS (Pearson's correlation coefficient: R = -0.227; P = 0.035), but no correlation was found for AS. The four elements of the IES had significant correlations with DS and AS. Logistic regression analysis showed that sleep problems (OR = 1.437) and HbA1c (OR = 0.51) were associated with DS, but only intrusiveness (OR = 0.629) showed a correlation with AS. In patients newly diagnosed with DM, DS is associated with sleep problems and low HbA1c levels. Emotional symptoms should be considered as part of glucose control, and efforts to mitigate psychological stress during the initial period of diabetes management should be made.

Right Paraesophageal Lymph Node Metastasis in Papillary Thyroid Cancer and Prophylactic Dissection: A Retrospective Study / 대한내분비외과학회지

PURPOSE: The purpose of this study is to determine the status of nodal disease, including the right paraesophageal node, in papillary thyroid carcinoma (PTC). METHODS: A total of 116 patients with PTC underwent total thyroidectomy and prophylactic central node dissection, including right paraesophageal lymph nodes (RPE LNs). Metastases to RPELNs were analyzed by site and clinicopathologic variables. Recurrence rate and post-operative complications were also evaluated by comparing the right paraesophageal lymph node dissection (RPE LND) with the non-RPE LND group. RESULTS: Central node metastases were detected in 57 (49.1%) patients; paratracheal and pre-tracheal lymph node metastases, total RPE LN metastases, and metastases only in RPE LN occurred in 50 (43.1%), 18 (15.5%), and 5 (4.3%) patients, respectively. Age, tumor size, tumor longitudinal location, extrathyroidal extension, and multicentricity were insignificant in RPE LN metastasis (P>.05). Although there was no significant statistical difference, tumors with lymphatic invasion and larger tumors (>1 cm) had more frequent RPE LN metastases. RPE LN metastases were frequent in deeply located tumors instead of superficially located tumors (P=0.015). Compared with the non-RPE LND group, the incidence of post-operative complications (transient hypocalcemia and vocal cord palsy) was not significantly different and there was no recurrence in both groups during the follow up period. CONCLUSION: The metastatic rate of the right paraesophageal lymph nodes was 15.5%; 83.3% of these were macrometastatic. Prophylactic RPE dissection compared with the non-RPE LND group, however, did not show a survival difference for 5 years.

Response: Predictive Clinical Parameters for the Therapeutic Efficacy of Sitagliptin in Korean Type 2 Diabetes Mellitus (Diabetes Metab J 2011;35:159-65)

No abstract available.

Serum Cystatin C Reflects the Progress of Albuminuria

BACKGROUND: Research on the relationship between urinary albumin excretion and serum cystatin C in diabetes is restricted to cross-sectional studies. In this study, we investigated how well serial measurements of serum cystatin C level reflect changes in the urinary albumin excretion rate. METHODS: We enrolled and retrospectively collected data on 1,058 participants with type 2 diabetes who were older than 18 years and who had more than 3 years of follow-up with serial measurements of albuminuria and serum cystatin C at an outpatient clinic. RESULTS: With the use of a linear mixed model, we found that the albuminuria level for each patient over time corresponded with the annual change in serum cystatin C-based estimated glomerular filtration rate (cysC-eGFR) but did not correspond with the creatinine-based eGFR calculated by the modification of diet in renal disease formula (MDRD-eGFR). The discrepancy in the direction of the trend was smaller with cysC-eGFR than with MDRD-eGFR. CONCLUSION: Serum cystatin C level reflects the trend in albuminuria level more accurately than serum creatinine level in Korean type 2 diabetes mellitus patients.

Predictive Clinical Parameters for the Therapeutic Efficacy of Sitagliptin in Korean Type 2 Diabetes Mellitus

BACKGROUND: Sitagliptin is a highly selective dipeptidyl peptide-4 (DPP-4) inhibitor that increases blood levels of active glucagon-like peptide (GLP)-1 and glucose-dependent insulinotrophic polypeptide (GIP), resulting in increased insulin secretion. While studies conducted in other countries have indicated the efficacy and safety of using sitagliptin to treat type 2 diabetes mellitus (T2DM), its predictors of effects to sitagliptin are not well understood. Therefore, we evaluated the predictive clinical parameters for the therapeutic benefits of sitagliptin when added to an ongoing metformin or sulfonylurea therapy in Korean T2DM subjects. METHODS: We obtained data from 251 Korean T2DM subjects who had recently started taking sitagliptin as add-on therapy. Exclusion criteria included any insulin use. Changes in HbA1c (DeltaHbA1c) and fasting plasma glucose (DeltaFPG) were assessed by comparing baseline levels prior to sitagliptin administration to levels 12 and 24 weeks after treatment. Responders were defined as subjects who experienced decrease from baseline of >10% in DeltaHbA1c or >20% in DeltaFPG levels at 24 weeks. RESULTS: We classified 81% of the subjects (204 out of 251) as responders. The responder group had a lower mean body mass index (23.70+/-2.40 vs. 26.00+/-2.26, P< or =0.01) and were younger (58.83+/-11.57 years vs. 62.87+/-12.09 years, P=0.03) than the non-responder group. CONCLUSION: In Korean T2DM subjects, sitagliptin responders had lower body mass index and were younger compared to non-responders.