Insulin Sensitivity and Beta Cell Function in Obese Korean Children and Adolescents with Normal Glucose Tolerance / 대한소아내분비학회지

PURPOSE: Obesity and insulin resistance are well known risk factors of type 2 diabetes. Impaired fasting glucose and impaired glucose tolerance (IGT) are called prediabetes and considered as a spectrum of disease and the insulin secretory function and insulin sensitivity are an emerging important issues. The aim of this study was to investigate the beta cell function and insulin sensitivity in Korean obese children who have normal glucose tolerance (NGT). METHODS: The data from two hundred fifty children and adolescents (M/F 165/85, age 12.0 +/- 2.7) were included. Fasting glucose, insulin, total cholesterol, triglyceride, LDL-cholesterol, HDL-choldesterol and oral glucose tolerance test (OGTT) results were analyzed. In this study, insulinogenic index (IGI) and whole body insulin sensitivity index (WBISI) were calculated from oral glucose tolerance test as markers of insulin secretory function and insulin sensitivity. Subjects were divided into 4 groups by glucose level in 120min (Glu120m) quartiles. Hyperbolic feedback curves were drawn with IGI and WBISI. RESULTS: 1) Height, weight, age, sex and BMI were not significantly different among 4 groups. 2) Fasting glucose levels among 4 groups were not significantly different. 3) HOMA-IR was significantly different according to Glu120m. 4) WBISI was significantly decreased according to Glu120m. 5) Leftward shift toward IGT in the feedback curve was significant in higher Glu120m groups. CONCLUSION: Obese children with high normal levels in oral glucose tolerance test may have a gradual deterioration in glucose stimulated insulin response and have an increased risk of IGT and diabetes. More mechanistic studies for the transition from NGT to IGT and ultimately diabetes should be followed.

Insulin Sensitivity and Beta Cell Function in Obese Korean Children and Adolescents with Normal Glucose Tolerance / 대한소아내분비학회지

PURPOSE: Obesity and insulin resistance are well known risk factors of type 2 diabetes. Impaired fasting glucose and impaired glucose tolerance (IGT) are called prediabetes and considered as a spectrum of disease and the insulin secretory function and insulin sensitivity are an emerging important issues. The aim of this study was to investigate the beta cell function and insulin sensitivity in Korean obese children who have normal glucose tolerance (NGT). METHODS: The data from two hundred fifty children and adolescents (M/F 165/85, age 12.0 +/- 2.7) were included. Fasting glucose, insulin, total cholesterol, triglyceride, LDL-cholesterol, HDL-choldesterol and oral glucose tolerance test (OGTT) results were analyzed. In this study, insulinogenic index (IGI) and whole body insulin sensitivity index (WBISI) were calculated from oral glucose tolerance test as markers of insulin secretory function and insulin sensitivity. Subjects were divided into 4 groups by glucose level in 120min (Glu120m) quartiles. Hyperbolic feedback curves were drawn with IGI and WBISI. RESULTS: 1) Height, weight, age, sex and BMI were not significantly different among 4 groups. 2) Fasting glucose levels among 4 groups were not significantly different. 3) HOMA-IR was significantly different according to Glu120m. 4) WBISI was significantly decreased according to Glu120m. 5) Leftward shift toward IGT in the feedback curve was significant in higher Glu120m groups. CONCLUSION: Obese children with high normal levels in oral glucose tolerance test may have a gradual deterioration in glucose stimulated insulin response and have an increased risk of IGT and diabetes. More mechanistic studies for the transition from NGT to IGT and ultimately diabetes should be followed.

Affecting Factors of Insulin Resistance in Obese Children and Adolescents / 소아과

PURPOSE: Insulin resistance is the most important risk factor linked to the development of impaired glucose tolerance (IGT), diabetes mellitus and cardiovascular diseases in childhood and adolescent obesity, The purpose of this study was to see whether insulin resistance of obese adolescent is higher than that of obese children. and to analyze gender difference and affecting factors of insulin resistance. METHODS: Of the 9, 837 school children from 5 to 16 tears old, 92 obese children and 187 adolescent, underwent a two-hour oral glucose tolerance test and plasma glucose, insulin, lipid profiles, leptin and high sensitive C-reactive protein (hs-CRP) were measure. RESULTS: Plasma insulin levels of female were higher compared to those of males during oral glucose tolerance test (P< 0.05). Four (4.3%) in obese children and twenty five (13.3%) in obese adolescents met the criteria of IGT. Female, leptin, adiponectin and triglyceride concentrations were strongly correlated with homeostatic model assessment insulin-resistance (HOMA-IR) by multiple linear regression analysis (P< 0.05). CONCLUSION: Obese adolescents might have higher insulin concentrations compared to obese children and obese girls higher insulin concentrations than obese boys. Obese boys and children with impaired glucose tolerance have higher insulin concentrations than those with normal glucose tolerance. HOMA-IR was significantly correlated with female, plasma leptin, adiponectin and triglyceride concentrations.

A Clinical Study of Juvenile Dermatomyositis / 대한류마티스학회지

OBJECTIVE: Juvenile dermatomyositis (JDM) is a multisystemic inflammatory disease in which the muscle, skin and gastrointestinal tract are prominently involved. It is characterized early in its course by microvasculopathy of varying severity and later by the development of calcinosis. The purpose of this study is to evaluate the clinical features, laboratory data, and outcome of patients with JDM. METHODS: We identified 21 patients (8 males and 13 females: average age 7.1+/-4.9 years) diagnosed as JDM at Yonsei Medical Center between March 1986 and August 2001 by retrospective chart review. The diagnosis of JDM was based on the published criteria proposed by Bohan and Peter in 1975. RESULTS: The average time between the initial symptoms and the diagnosis of JDM was 4.0+/-7.5 months (range, 1~36 months) with the peak of onset in the summer months (June to august, 48%). The most common presenting feature was proximal muscle weakness followed by skin rash. Other symptoms were respiratory symptoms (33%) and calcinosis (10%). Laboratoy abnormalities included elevation of CPK (81%), AST (62%), LDH (43%) and antinuclear antibody (47%). Electromyograms were abnormal in 13 of 16 performed, showing characteristic myopathic abnormalities. Muscle biopsies revealed typical changes in 11 of 17 performed. All patients were treated with prednisolone (1~2 mg/kg/day) as part of their initial therapy, and 6 cases received intravenous high dose methylprednisolone (30 mg/kg/dose for 3 days). Methotrexate (5 cases), cyclosporine (5 cases), hydroxychloroquine (3 cases), and NSAIDs (2 cases) were given as a second drug, if required. Eleven cases had a monocyclic, 5 cases a chronic polycyclic, and 5 cases a chronic continuous course. One fulminant type case died of sepsis secondary to cellulitis on both axilla. CONCLUSION: The results of our review agree with other studies reported, but our study showed less occurrence of respiratory symptoms and calcinosis than other reports, and showed the peak incidence in the summer months. Given the fact that the number of our sample was small, future multicenter studies will be necessary.

The Effects of Glutamine on Blastulation of Human Embryos on Vero Cells In Vitro / 대한불임학회지

This study was conducted to investigate the effects of Tissue Culture Medium 199 (TCM) and Dulecco's Modified Eagle Medium (DMEM) on the blastulation and grade of human oocytes on Vero cells in vitro. A cohort of 79 and 93 oocytes in metaphase II stage were used in TCM 199 and DMEM respectively. No differences were found in the nurser of oocytes showing two-pronuclei between TCM (82.3%) and DMEM (86.0%). The number of fertilized oocytes reaching the blastocyst was not significant in TCM (60.0%) and DMEM (63.1%).4 total of 89 blastocysts were categorized into the four grades (BG1, BG2, BG3 and early) depending on their morphology. The number of embryos achieving the blastocyst grade 1 (BG1) was significantly higher (p<0.05) in DMEM (50.8%) than TCM (15.0%). It is concluded that cultured oocytes in DMEM with glutamine on Vero cells should be significantly increased BG1.