Antioxidant-Rich Dietary Intervention Improves Cardiometabolic Profiles and Arterial Stiffness in Elderly Koreans with Metabolic Syndrome

Purpose@#Oxidative stress plays an important role in the pathogenesis of chronic metabolic diseases. This study investigated the effect of the antioxidant-rich dietary intervention on oxidative stress, metabolic parameters, and arterial stiffness in elderly Koreans with metabolic syndrome (MetS). @*Materials and Methods@#Thirty-one subjects with MetS were enrolled and randomly divided into dietary intervention group and control group. Subjects in the intervention group received three meal boxes prepared with antioxidant-rich ingredients every day for 4 weeks, and subjects in the control group maintained their usual diets. Anthropometric and various biochemical parameters related to oxidative stress, inflammation, and MetS were assessed. Brachial-ankle pulse wave velocity (baPWV) and fat measurement using computed tomography were also conducted before and after 4 weeks. @*Results@#There were significant differences in waist circumference, visceral to subcutaneous fat ratio, lipid peroxidation, oxidized low density lipoprotein (oxLDL), systolic and diastolic blood pressure, lipid parameters, advanced glycation end products, and baPWV between before and after the study in the experimental group (all p<0.05). Significant inter-group differences were observed between the experimental and control group in terms of the differences in body mass index, waist circumference, oxygen radical absorbance capacity, protein carboxylation, lipid peroxidation, oxLDL, blood pressure, lipid parameters, and baPWV between before and after the study (all p<0.05). @*Conclusion@#Antioxidant-rich dietary intervention for a 4-week period ameliorated the state of oxidative stress and improved the components of MetS including central obesity, dyslipidemia, hypertension, and arterial stiffness in elderly Koreans with MetS.

Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts

Background@#Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the presence of NAFLD based on clinical parameters of patients with T2DM. @*Methods@#A total of 698 patients with T2DM who visited five medical centers were included. NAFLD was evaluated using transient elastography. Univariate logistic regression analyses were performed to identify potential contributors to NAFLD, followed by multivariable logistic regression analyses to create the final prediction model for NAFLD. @*Results@#Two NAFLD prediction models were developed, with and without serum biomarker use. The non-laboratory model comprised six variables: age, sex, waist circumference, body mass index (BMI), dyslipidemia, and smoking status. For a cutoff value of ≥60, the prediction accuracy was 0.780 (95% confidence interval [CI], 0.743 to 0.817). The second comprehensive model showed an improved discrimination ability of up to 0.815 (95% CI, 0.782 to 0.847) and comprised seven variables: age, sex, waist circumference, BMI, glycated hemoglobin, triglyceride, and alanine aminotransferase to aspartate aminotransferase ratio. Our non-laboratory model showed non-inferiority in the prediction of NAFLD versus previously established models, including serum parameters. @*Conclusion@#The new models are simple and user-friendly screening methods that can identify individuals with T2DM who are at high-risk for NAFLD. Additional studies are warranted to validate these new models as useful predictive tools for NAFLD in clinicalpractice.

Non-Laboratory-Based Simple Screening Model for Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Developed Using Multi-Center Cohorts

Background@#Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. Type 2 diabetes mellitus (T2DM) is a risk factor that accelerates NAFLD progression, leading to fibrosis and cirrhosis. Thus, here we aimed to develop a simple model to predict the presence of NAFLD based on clinical parameters of patients with T2DM. @*Methods@#A total of 698 patients with T2DM who visited five medical centers were included. NAFLD was evaluated using transient elastography. Univariate logistic regression analyses were performed to identify potential contributors to NAFLD, followed by multivariable logistic regression analyses to create the final prediction model for NAFLD. @*Results@#Two NAFLD prediction models were developed, with and without serum biomarker use. The non-laboratory model comprised six variables: age, sex, waist circumference, body mass index (BMI), dyslipidemia, and smoking status. For a cutoff value of ≥60, the prediction accuracy was 0.780 (95% confidence interval [CI], 0.743 to 0.817). The second comprehensive model showed an improved discrimination ability of up to 0.815 (95% CI, 0.782 to 0.847) and comprised seven variables: age, sex, waist circumference, BMI, glycated hemoglobin, triglyceride, and alanine aminotransferase to aspartate aminotransferase ratio. Our non-laboratory model showed non-inferiority in the prediction of NAFLD versus previously established models, including serum parameters. @*Conclusion@#The new models are simple and user-friendly screening methods that can identify individuals with T2DM who are at high-risk for NAFLD. Additional studies are warranted to validate these new models as useful predictive tools for NAFLD in clinicalpractice.

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.

Triglyceride Glucose Index Is Superior to the Homeostasis Model Assessment of Insulin Resistance for Predicting Nonalcoholic Fatty Liver Disease in Korean Adults

BACKGROUND: Recently, the triglyceride glucose (TyG) index has been considered a surrogate marker of insulin resistance which is a well-known pathogenic factor in nonalcoholic fatty liver disease (NAFLD). However, few studies have investigated the relationship between the TyG index and NAFLD. Thus, we investigated the relationship between the TyG index and NAFLD and the effectiveness of the TyG index compared with the homeostasis model assessment of insulin resistance (HOMA-IR) in identifying NAFLD in Korean adults. METHODS: Participants of 4,986 who underwent ultrasonography in a health promotion center were enrolled. The TyG index was calculated as ln [fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2], and HOMA-IR was estimated. NAFLD was diagnosed by ultrasonography. RESULTS: Significant differences were observed in metabolic parameters among the quartiles of the TyG index. The prevalence of NAFLD significantly increased with increment in the TyG index. After adjusting for multiple risk factors, a logistic regression analysis was performed. When the highest and lowest quartiles of the TyG index and HOMA-IR were compared, the odds ratios for the prevalence of NAFLD were 2.94 and 1.93 (95% confidence interval, 2.32 to 3.72 and 1.43 to 2.61; both P for trend <0.01), respectively. According to the receiver operating characteristic analysis, the TyG index was superior to HOMA-IR in predicting NAFLD. CONCLUSION: The TyG index and prevalence of NAFLD were significantly related and the TyG index was superior to HOMA-IR in predicting NAFLD in Korean adults.

Plasma MicroRNA-21, 26a, and 29a-3p as Predictive Markers for Treatment Response Following Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma

BACKGROUND: We investigated an association between the levels of plasma microRNA (miRNA)-21,

Calpain-10 and Adiponectin Gene Polymorphisms in Korean Type 2 Diabetes Patients

BACKGROUND: Genetic variations in calpain-10 and adiponectin gene are known to influence insulin secretion and resistance in type 2 diabetes mellitus. Recently, several single nucleotide polymorphisms (SNPs) in calpain-10 and adiponectin gene have been reported to be associated with type 2 diabetes and various metabolic derangements. We investigated the associations between specific calpain-10 and adiponectin gene polymorphisms and Korean type 2 diabetes patients. METHODS: Overall, 249 type 2 diabetes patients and 131 non-diabetic control subjects were enrolled in this study. All the subjects were genotyped for SNP-43 and -63 of calpain-10 gene and G276T and T45G frequencies of the adiponectin gene. The clinical characteristics and measure of glucose metabolism were compared within these genotypes. RESULTS: Among calpain-10 polymorphisms, SNP-63 T/T were more frequent in diabetes patients, and single SNP-63 increases the susceptibility to type 2 diabetes. However, SNP-43 in calpain-10 and T45G and intron G276T in adiponectin gene were not significantly associated with diabetes, insulin resistance, nor insulin secretion. CONCLUSION: Variations in calpain-10, SNP-63 seems to increase the susceptibility to type 2 diabetes in Koreans while SNP-43 and adiponectin SNP-45, -276 are not associated with impaired glucose metabolism.

Insulin autoimmune syndrome associated with alpha-lipoic acid in a young woman with no concomitant disease / 영남의대학술지

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia, extremely high serum insulin levels, and high titers of autoantibodies against endogenous insulin, in the absence of exogenous insulin injection. IAS often occurs following exposure to sulfhydryl-containing drugs, including alpha-lipoic acid (ALA). A 30-year-old woman without diabetes visited our outpatient clinic with recurrent hypoglycemia. She had been taken ALA for weight reduction since 3 weeks ago. Further hypoglycemia work up revealed very high insulin levels, C-Peptide levels and positive insulin antibodies. And conventional imaging examinations were negative for insulinoma or other pancreatic tumors. Finally, the diagnosis of Insulin autoimmune syndrome (IAS) was made. Following the cessation of ALA, hypoglycemia improved, with no medication, and the patient experienced no further hypoglycemic attacks over the next month. The use of ALA as a nutritional supplement is increasing. We report a case of IAS associated with ALA in a non-diabetic patient.

Insulin autoimmune syndrome associated with alpha-lipoic acid in a young woman with no concomitant disease / 영남의대학술지

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia, extremely high serum insulin levels, and high titers of autoantibodies against endogenous insulin, in the absence of exogenous insulin injection. IAS often occurs following exposure to sulfhydryl-containing drugs, including alpha-lipoic acid (ALA). A 30-year-old woman without diabetes visited our outpatient clinic with recurrent hypoglycemia. She had been taken ALA for weight reduction since 3 weeks ago. Further hypoglycemia work up revealed very high insulin levels, C-Peptide levels and positive insulin antibodies. And conventional imaging examinations were negative for insulinoma or other pancreatic tumors. Finally, the diagnosis of Insulin autoimmune syndrome (IAS) was made. Following the cessation of ALA, hypoglycemia improved, with no medication, and the patient experienced no further hypoglycemic attacks over the next month. The use of ALA as a nutritional supplement is increasing. We report a case of IAS associated with ALA in a non-diabetic patient.

Obesity and Hyperglycemia in Korean Men with Klinefelter Syndrome: The Korean Endocrine Society Registry

BACKGROUND: The aim of this study was to investigate the prevalence of obesity in Korean men with Klinefelter syndrome (KS) and the associated risk factors for obesity and hyperglycemia. METHODS: Data were collected retrospectively from medical records from 11 university hospitals in Korea between 1994 and 2014. Subjects aged ≥18 years with newly diagnosed KS were enrolled. The following parameters were recorded at baseline before treatment: chief complaint, height, weight, fasting glucose level, lipid panel, blood pressure, testosterone, luteinizing hormone, follicle-stimulating hormone, karyotyping patterns, and history of hypertension, diabetes, and dyslipidemia. RESULTS: Data were analyzed from 376 of 544 initially enrolled patients. The rate of the 47 XXY chromosomal pattern was 94.1%. The prevalence of obesity (body mass index ≥25 kg/m²) in Korean men with KS was 42.6%. The testosterone level was an independent risk factor for obesity and hyperglycemia. CONCLUSION: Obesity is common in Korean men with KS. Hypogonadism in patients with KS was associated with obesity and hyperglycemia.

Oxidative stress, point-of-care test, and metabolic syndrome

No abstract available.

Serum osteoprotegerin is associated with vascular stiffness and the onset of new cardiovascular events in hemodialysis patients

BACKGROUND/AIMS: Osteoprotegerin (OPG) and fetuin-A are vascular calcification regulators that may be related to high cardiovascular (CV) mortality in hemodialysis (HD) patients. We evaluated the relationship between OPG, fetuin-A, and pulse wave velocity (PWV), a marker of vascular stiffness, and determined whether OPG and fetuin-A were independent predictors of CV events in HD patients. METHODS: We conducted a prospective observational study in 97 HD patients. OPG and fetuin-A were measured at baseline and arterial stiffness was evaluated by PWV. All patients were stratified into tertiles according to serum OPG levels. RESULTS: A significant trend was observed across increasing serum OPG concentration tertiles for age, HD duration, systolic blood pressure, cholesterol, triglycerides, and PWV. Multiple linear regression analysis revealed that diabetes (beta = 0.430, p = 0.000) and OPG levels (beta = 0.308, p = 0.003) were independently associated with PWV. The frequency of new CV events was significantly higher in the upper OPG tertiles compared with those in the lower OPG tertiles. In Cox proportional hazards analysis, upper tertiles of OPG levels were significantly associated with CV events (hazard ratio = 4.536, p = 0.011). CONCLUSIONS: Serum OPG, but not fetuin-A, levels were closely associated with increased vascular stiffness, and higher OPG levels may be independent predictors of new CV events in HD 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.

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.

Pelvic Ultrasonography Findings in Girls with Precocious Puberty / 대한소아내분비학회지

PURPOSE: We analyzed pelvic ultrasonography (USG) findings in girls with central precocious puberty (CPP) and assessed the role of uterine and ovarian measurements in discriminating between CPP and other pubertal conditions. METHODS: Seventy-four girls (chronological age 7.8 +/- 0.5 years, bone age 9.9 +/- 0.8 years) with precocious pubertal signs were enrolled. Measurements of uterine and ovarian parameters by pelvic USG included antero-posterior diameters of the uterine fundus and cervix, diameter of each ovary, number of follicles, and maximal diameter of the largest follicle. The pelvic USG parameters were compared between girls with CPP (n = 49) and girls with atypical premature thelarche (PT) (n = 25). RESULTS: Antero-posterior diameter of uterine fundus (1.05 +/- 0.34 vs. 0.74 +/- 0.78 cm, P = 0.001), maximal ovarian diameter (2.13 +/- 0.48 vs. 1.84 +/- 0.74 cm, P = 0.048) and mean ovarian area (2.31 +/- 0.79 vs. 1.69 +/- 0.71 cm, P = 0.002) were significantly greater in girls with CPP than in girls with atypical PT. For the diagnosis of CPP, the sensitivity and specificity of A-P diameter of uterine fundus (> 0.9 cm) was 65.3% and 84.0%, the sensitivity and specificity of maximal ovarian diameter (> 2.0 cm) was 55.1% and 76%, and the sensitivity and specificity of mean ovarian area (> 2.0 cm2) was 62.9% and 80.0%. CONCLUSION: Girls with CPP had significantly higher dimensions of the uterus and ovary measurements compared to girls with atypical PT, but sensitivity and specificity were not high enough to differentiate CPP from atypical PT. Pelvic USG may help the diagnosis of CPP in girls.

Clinical Pathway for Childhood Asthma in an Emergency Department: Comparison Between the Correct Versus Incorrect Application Groups / 소아알레르기및호흡기학회지

PURPOSE: This study aimed to determine whether the standard clinical pathway based on evidence is applicable to pediatric asthma patients in the emergency room, and whether it is better for treatment effectiveness. METHODS: The clinical pathway was applied to children who visited our emergency room due to acute asthma between January 1 and December 31, 2009. Medical records of the emergency room were reviewed to see if the clinical pathway was correctly applied. The patients were divided into 2 groups: those who the pathway was correctly applied and those who the pathway was incorrectly applied to (group B, n=41). RESULTS: Acute asthma exacerbation occurred in 24 children (47%) in group A, while it occurred in 27 children (53%) in group B. The majority of patients in group B had moderate asthma exacerbation. The incorrect application of the clinical pathway and no use or insufficient use of inhaled anticholinergics was most frequently noted. The most common cause for the incorrect application of the clinical pathway was its misunderstanding of residents. The hospitalization rate was higher in group B than in group A. CONCLUSION: The application of the clinical pathway to pediatric asthma patients in the emergency room increased treatment effectiveness. However, training for the residents and intensive care for the patient with moderate asthma exacerbation are necessary for correct application of the clinical pathway.

A determinant of insulin resistance in patients with schizophrenia / 대한내과학회지

BACKGROUND/AIMS: As compared with the general population, patients with schizophrenia have a higher risk of obesity and glucose metabolism impairment. Moreover, some antipsychotic drugs add to this risk owing to side effects such as weight gain. However, few reports exist regarding the pathophysiology of insulin resistance in drug-naive or drug-free schizophrenic patients. Therefore, the aim of the present study was to investigate the factors that contribute to insulin resistance in antipsychotic drug-naive and drug-free schizophrenic patients. METHODS: Nineteen (4 men, 15 women) drug-naive or drug-free subjects with schizophrenia and nineteen age- and sex-matched controls were recruited for participation in this study. We measured weight, height, waist circumference, biochemical profiles, body fat percentage, and calculated body mass indices (BMI) in all patients. Furthermore, we correlated HOMA-IR, a marker for insulin resistance, with anthropometric measures and clinical characteristics. RESULTS: There were no significant differences in BMI, waist circumference, or body fat percentage between the two groups. In addition, there were no differences in blood pressure, glucose, HbA1c, insulin, HOMA-IR, total cholesterol, HDL-cholesterol, or LDL-cholesterol; however, triglyceride levels and 24 hr urine free cortisol levels were higher in schizophrenic patients. There was also a significant correlation between HOMA-IR and both age and waist circumference in the control group. Additionally, HOMA-IR was significantly correlated with 24 hr urine free cortisol levels in schizophrenic patients. CONCLUSIONS: The study shows that risk factors for insulin resistance in drug-naive or drug-free schizophrenic patients do not differ from those of the control group; however, the major determinant of insulin resistance in schizophrenia patients was that of increased cortisol levels.

Visceral Fat Thickness Predicts Fatty Liver in Koreans with Type 2 Diabetes Mellitus

Our aim was to study whether visceral adiposity is a predictor of diabetic fatty liver in Korean type 2 diabetes mellitus. In this study, abdominal ultrasonography was used to assess the presence of fatty liver in 1,898 patients with type 2 diabetes. We measured visceral fat thickness by high-resolutional ultrasonography and insulin resistance by Kitt. Half of the cohort had a fatty liver (50.2%). High visceral fat thickness had the highest odds ratio for developing fatty liver in both sexes (odds ratio [S.D]: 3.14 [2.24-4.69], p<0.00 in male, 2.84 [2.04-3.93], p<0.00 in female). In addition, visceral fat thickness of 42.45 and 37.7 mm in men and women, respectively, were chosen as the discriminating value to predict the presence of fatty liver with a sensitivity of 71% and 73% and a specificity of 70% and 70% in men and women, respectively. The area under the receiver-operating characteristics curve was 0.759 in men and 0.764 in women. Therefore we could conclude that the degree of visceral adiposity predicts the presence of fatty liver type 2 diabetes mellitus, whether centrally obese or not, suggesting that hepatic fat accumulation in a diabetic fatty liver may be influenced by visceral fat accumulation regardless of waist circumference.

Assessment of Abdominal Fat and Mid-Thigh Low-Density Muscle Areas in Patients with Schizophrenia / 대한정신약물학회지

OBJECTIVE: Patients with schizophrenia are at a higher risk for developing insulin resistance and type 2 diabetes mellitus (T2DM). However, few studies have examined abdominal fat and mid-thigh low-density muscle areas, which are known risk factors for insulin resistance and T2DM, in patients with schizophrenia. Therefore, we measured the abdominal fat and mid-thigh low-density muscle areas of schizophrenics and compared them with normal controls. METHODS: Nineteen (four men and 15 women) drug-naive or -free subjects who met the DSM IV criteria for schizophrenia and 19 age- and sex-matched controls were recruited. We measured weight, height, waist circumference, and percent body fat, and calculated the body mass index (BMI). Abdominal fat and mid-thigh low-density muscle areas were evaluated using computed tomography. RESULTS: There was no significant difference in terms of age and BMI between the two groups. The areas of abdominal fat (262.4+/-101.8 vs. 257.1+/-93.8 cm2 ; p=0.919), subcutaneous fat (182.4+/-72.8 vs. 180.5+/-75.1 cm2 ; p=0.988), visceral fat (79.9+/-47.2 vs. 76.6+/-49.3 cm2 ; p=0.872), and mid-thigh low-density muscle (15.0+/-9.9 vs. 15.4+/-5.2 cm2, p=0.373) did not differ between schizophrenics and controls. CONCLUSION: Abdominal obesity is a well-recognized risk factor for developing certain medical conditions such as insulin resistance and T2DM. We demonstrated that drug-naive or- free patients with schizophrenia do not have increased visceral fat or mid-thigh low-density muscle areas, which might have explained the higher prevalence of insulin resistance and T2DM in these patients.

The Relation between Birth Weight and Insulin Resistance in Korean Adolescents

Low birth weight is associated with insulin resistance and type 2 diabetes in adults. The fetal programming hypothesis has shown that insulin resistance and its associated metabolic disturbances result from a poor gestational environment, for which low birth weight is a surrogate. An at-home questionnaire survey was performed on 660 middle school students (12-15 years) in Seoul, Korea, and 152 cases were randomly selected based on their birth weight. Subjects were divided into three groups according to birth weight. We recorded their birth weight and measured their current anthropometric data, blood pressure, lipid profile, HOMA-IR, and HOMA-beta, and compared these parameters among the groups. The relation of birth weight to physiological characteristics in adolescence was examined. Systolic blood pressure, lipid profiles, and fasting plasma glucose, HOMA-beta were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide, and HOMA-IR were higher in the lower birth weight tertile. After adjustment for confounding factors, birth weight was inversely related to diastolic blood pressure, insulin, C-peptide, and HOMA-IR. We conclude that low birth weight may predict the risk of the insulin resistance and its progression over age, and that adequate gestational nutrition is therefore necessary to prevent low birth weight.