Effects of macronutrients in mixed meals on postprandial glycemic response / 한국영양학회지

PURPOSE: The aim of study was to determine the effects of carbohydrate, fat, protein, and fiber contents on glycemic responses in a single food item or meal. METHODS: Glycemic responses were measured in 30 healthy young adults (17 males and 13 females) with various test foods, including rice, egg whites, bean sprouts, olive oil, noodles, prune, broccoli, Korean dishes, Western dishes, and salad dishes, etc. Test foods were designed to contain various carbohydrate, fat, protein, and fiber contents in single or mixed foods or dishes. After 12 hours of fasting, participants consumed test foods, and the glycemic response was measured for a subsequent 120 min (0, 15, 30, 60, 90, and 120 min). Three hundred and fifty three glycemic responses from 62 foods were collected. The incremental area under the curve (AUC) was calculated for each test food for each subject to examine glycemic responses. Statistical analysis was conducted to identify which macronutrient (carbohydrate, fat, protein and fiber) affected the AUC using a mixed model. RESULTS: Carbohydrates (β= 37.18, p < 0.0001) significantly increased while fat (β= −32.70, p = 0.0054) and fiber (β= −32.01, p = 0.0486) significantly reduced the glycemic response. CONCLUSION: It can be concluded that the glycemic response of a meal can be modified depending on the fat and fiber contents of ingredient foods, even though carbohydrate content is maintained.

Comparison of different scoring systems evaluating short-term prognosis of patients with hepatitis B associated acute hepatic failure / 实用医学杂志

Objective To assessment short-term prognosis in patients with acute on chronic liver failure , several scoring systems were compared. Methods Two hundred and sixteen patients with acute on chronic liver failure were divided into survival group and death group according to the results of 90 days after admission.CTP , MELD,APACHEⅡ, SOFA and SMSVH score were calculated.After ROC curves were performed ,the areas under the curves of these scoring systems were compared. Results The areas under the ROC curves of MELD, APACHEⅡ, SOFA, CTP and SMSVH were 0.88, 0.76, 0.89,0.79and 0.69,respectively. The areas under the curves of SOFA and MELD were larger than the APACHEⅡ, CTP and SMSVH (P0.05). The area under the curve of CTP was larger than the APACHEⅡ, but there was no statistically significant difference (P > 0.05). The area under the curve of SMSVH were less than 0.7. Conclusions The SOFA, MELD,CTP and APACHEⅡcan predict the short-term prognosis of acute on chronic liver failure. The SOFA and MELD are the best scoring systems.CTP,APACHEⅡ are better than SMSVH. SMSVH fail to predict the prognosis of acute on chronic liver failure.

Effects of xylooligosaccharide-sugar mixture on glycemic index (GI) and blood glucose response in healthy adults / 한국영양학회지

PURPOSE: The objective of this study was to investigate the effects of xyloologosaccharide (XOS)-sugar mixture on glycemic index (GI) and blood glucose in human subjects. METHODS: Randomized double-blind cross-over studies were conducted to examine the effect of sucrose with 14% xyloologosaccharide powder (Xylo 14) and sucrose with 20% xylooligosaccharide powder (Xylo 20) on GI and postprandial glucose response at 15, 30, 45, 60, 90, and 120 min. RESULTS: GIs of Xylo 14 and Xylo 20 were 60.0 +/- 23.5 classified within medium GI range, and 54.3 +/- 17.7 within low GI range, respectively. Xylo 14 and Xylo 20 showed significantly lower area under the glucose curve (AUC) for 0-15 min (p = 0.0113), 0-30 min (p = 0.0004), 0-45 min (p < 0.0001), 0-60 min (p < 0.0001), 0-90 min (p < 0.0001), and 0-120 min (p = 0.0001). In particular, compared with glucose, the blood glucose levels of Xylo 14 and Xylo 20 were significantly lower at every time point between 15 and 120 min. CONCLUSION: The results of this study suggested that Xylo 14 and Xylo 20 had an acute suppressive effect on GI and the postprandial glucose surge.

A pilot study on area under curve of mycophenolic acid as a guide for its optimal use in renal transplant recipients.

Background & objectives: The immunosuppressants administered to renal transplant subjects are usually monitored therapeutically to prevent graft rejection and drug toxicity. Mycophenolic acid (MPA) is an immunosuppressant. The present prospective study was undertaken to establish the utility of plasma level monitoring of MPA and to correlate it with clinical outcomes in renal transplant receipients. Methods: MPA plasma level at 2, 4 and 9 h and the area under concentration-time curve (AUC) were estimated using high performance liquid chromatography in 24 renal transplant recipients receiving immunosuppressant MPA plus tacrolimus and steroid. Results: There was wide inter-individual variation in MPA plasma level and the AUC. The incidences of gastrointestinal adverse drug events (diarrhoea and acidity) were significantly more in the high MPA AUC patients. Though biopsy proven acute rejection was not found, of the six subjects with lower MPA AUC (<30 mg.h/l), three were clinically diagnosed to develop tacrolimus nephrotoxicity. The Gastrointestinal Symptom Rating Scale (GSRS) and Gastrointestinal Quality of Life Index (GIQLI) scores represented better health related quality of life in lower MPA AUC than in the higher MPA AUC (>60 mg.h/l). Interpretation & conclusions: The present findings suggest the MPA AUC of 30 - 60 mg.h/l in the maintenance stage of renal transplant patients to have optimum clinical benefit and relegated adverse events profile indicating the usefulness of AUC of MPA with limited sampling strategy in optimizing its use.

Evaluation of the Diagnostic Performance of Fibrin Monomer in Disseminated Intravascular Coagulation / 대한진단검사의학회지

BACKGROUND: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD. METHODS: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed. RESULTS: The reference limit in the control individuals was determined to be 7.80 microg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC. CONCLUSIONS: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.

Evaluation of the Diagnostic Performance of Fibrin Monomer in Disseminated Intravascular Coagulation / 대한진단검사의학회지

BACKGROUND: Fibrin-related markers (FRM) such as fibrin monomer (FM) and D-dimer (DD) are considered useful biological markers for the diagnosis of disseminated intravascular coagulation (DIC). However, no studies on the diagnostic performance of different FRMs have been published in Korea. The aim of this study was to evaluate the diagnostic performance of FM for DIC in comparison with DD. METHODS: The reference limit of FM was determined based on plasma sample data obtained from 210 control individuals. To evaluate diagnostic performance, FM data from the plasma samples of 139 patients with DIC-associated diseases were obtained for DIC scoring. FM was measured by immunoturbidimetry using STA-LIATEST FM (Diagnostica Stago, France). Patients were classified according to the DIC score as non-DIC, non-overt DIC, or overt DIC. ROC curve analyses were performed. RESULTS: The reference limit in the control individuals was determined to be 7.80 microg/mL. Patients with DIC-associated diseases were categorized as non-DIC (N=43), non-overt DIC (N=80), and overt DIC (N=16). ROC curve analyses showed that the diagnostic performance of FM was comparable to DD in both non-overt DIC and overt DIC (P=0.596 and 0.553, respectively). In addition, FM had higher sensitivity, specificity, positive predictive value, and negative predictive value than DD for differentiating overt DIC from non-DIC. CONCLUSIONS: This study demonstrated that the diagnostic performance of FM for DIC was comparable to DD. FM might be more sensitive and more specific than DD in the diagnosis of overt DIC, but not non-overt DIC.