Association between Growth Differentiation Factor 15 (GDF15) and Cardiovascular Risk in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

We investigated an association between serum Growth Differentiation Factor 15 (GDF15) level and cardiovascular risk in patients with newly diagnosed type 2 diabetes mellitus (T2D). A total of 107 participants were screened for T2D and divided into a T2D group and a control group (without diabetes). We used the Framingham risk score (FRS) and the New Pooled Cohort Equation score to estimate the 10-year risk of atherosclerotic cardiovascular disease. Serum GDF15 levels were measured using an enzyme-linked immunosorbent assay. Correlation analyses were performed to evaluate the associations between GDF15 level and cardiovascular risk scores. The mean serum GDF15 level was elevated in the T2D group compared to the control group (P < 0.001). A positive correlation was evident between serum GDF15 level and age (r = 0.418, P = 0.001), the FRS (r = 0.457, P < 0.001), and the Pooled Cohort Equation score (r = 0.539, P < 0.001). After adjusting for age, LDL-C level, and body mass index (BMI), the serum GDF15 level was positively correlated with the FRS and the New Pooled Cohort Equation score. The serum GDF15 level is independently associated with cardiovascular risk scores of newly diagnosed T2D patients. This suggests that the level of GDF15 may be a useful predictive biomarker of cardiovascular risk in newly diagnosed T2D patients.

Validation of Waist-to-Height Ratio for Predicting Metabolic Syndrome in Patients with Prediabetes

BACKGROUND: Metabolic syndrome is associated with type 2 diabetes and cardiovascular disease in patients with prediabetes. The aim of this study was to investigate and compare WHtR (Waist-to-Height Ratio) as a predictor of metabolic syndrome with other anthropometric indices as in Body Mass Index (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) in prediabetes. METHODS: A total of 816 subjects with prediabetes were recruited from a community based Cohort Study. Receiver operating characteristic (ROC) curve was performed to find the optimal cutoff value of WHtR. Area under the curve (AUC) was calculated for each anthropometric index and correlation coefficient between WHtR and various dermographic and clinical factors was calculated. RESULTS: WHtR had a significant correlation with metabolic parameters except for fasting glucose and increased with increasing number of risk factors for metabolic syndrome. AUC of WHtR was significantly higher than that of other anthropometric indices. The optimal cutoff value of WHtR was 0.53 for metabolic syndrome in prediabetes. CONCLUSION: WHtR may be the simple and effective anthropometric index for predicting metabolic syndrome in prediabetic patients.

A Case of Low Bone Mineral Density with Vitamin D Deficiency Due to Prolonged Lactation and Severe Malnutrition

Malnutrition associated vitamin D deficiency contributes to the calcium loss from bone and results in osteoporosis and osteomalacia at final stage. Osteomalacia is characterized with softening of bone secondary to defective bone mineralization. Here, we report a case of possible osteomalacia caused by prolonged lactation and severe malnutrition in 35-year-old female. She was a housewife and her body mass index was 11.8 kg/m2. She was diagnosed with severe osteoporosis in regular health check-up 2 years ago, but did not take any medication. Nine months ago, she had been treated with anti-tuberculosis medications for 6 month due to active pulmonary tuberculosis. After complete remission of pulmonary tuberculosis, she had lost her appetite severely. Furthermore, she felt gait difficulty and suffered from generalized bone pain. On serologic examination, hypocalcemia, hypophosphatemia, high alkaline phosphatase, low vitamin D3 and high parathyroid hormone level were seen. In the bone mineral density, Z-score from her lumbar spine was -6.5. She was treated with oral calcium and vitamin D3 intramuscularly. After 1 year treatment, she felt significant improvement in bone pain and could walk alone. Also her serum calcium, phosphate and vitamin D3 level are all normalized.

Literature review & case report : the conservative treatment of unicystic ameloblastoma

An Ameloblastoma is one of the most common odontogenic tumors. The treatment of ameloblastoma has been controversial because of this disease entity as a slow-growing, locally invasive tumor with high rate of recurrence. Recurrence rate of ameloblastoma are reported 15% to 25% after radical treatment and 75% to 90% after conservative treatment. On the other hand, Robinson and Gardner reported that the recurrence rate after conservative treatment of unicystic ameloblastoma was lower than those of multicystic or solid lesion. In this report, what we want to show is to review the articles to find out pros and cons of conservative treatment of ameloblastoma. In addition we would like to discuss which requies conservative treatment or radical treatment are more acceptable through our case report.

Reconstruction using mandibular horizontal distraction osteogenesis and implant prosthesis in mandibular deficiency: a case report

Distraction osteogenesis is a biologic process in which new bone is formed between bone fragments being separated by a tractional force. This technique has the advantage of initiating new bone growth without bone transplantation and promoting the growth of soft tissue. Mandibular distraction osteogenesis has shown to be effective to treat congenital or acquired mandibular hypoplasias. On the basis of positive results with implant-supported prostheses, the use of implants in the distracted site can significantly help stabilize the prosthesis. We obtained good result in the patient with mandibular deficiency due to trauma, who have been reconstructed with distraction osteogenesis and implant. We report our experiences with literature view.

Genetic and Neuropsychological Factor Analysis on the Cognitive Function of the Elderly Population: APOE Genotype and Age Effect Analysis / 대한임상병리학회지

BACKGROUND: APOE (Apolipoprotein E) has been known as a risk factor for Alzheimer disease. Studies have demonstrated that different APOE E4 phenotypes appear to modulate the effects of cognitive aging in healthy elderly Caucasian populations. APOE E4 allele has different odds ratio risk for Alzheimer disease according to the age of the subject. Previously, we reported the APOE genotype effect on the cognitive function of the elderly populations without dementia. At this time we studied on the APOE E4 genotype combined with age. METHODS: We examined the different effects of APOE E4 allele on the neuropsychological func-tions of 201 community-dwelling Korean elderly individuals without dementia according age. We used the multivariate general linear model analyses. We made a model with the education year, APOE E4 presence, age (same or more than 70-year-old vs. less than 70-year-old) and APOE E4 presence combined with the age. RESULTS: APOE E4 allele did not show the significant effect on the neuropsychological test when ages are not considered. When the APOE E4 allele and age is combined, the recency, delayed recall and cued recall of the Elderly Verbal Learning Test (EVLT) shows a significant result from the multivariate general linear model anlayses. CONCLUSIONS: APOE E4 allele has a different effect on the cognitive function of the elderly popula-tion according to the age.