Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease: Diagnosis and Treatment / 임상당뇨병

Stroke is one of the major complications of diabetes and increases morbidity and mortality. Hyperglycemia confers increased risk of stroke occurrence. Furthermore, cardiometabolic risk factors such as hypertension and dyslipidemia frequently coexist in patients with diabetes and increase the risk of stroke. Some recent cardiovascular outcome trials of newer anti-diabetic medications have shown beneficial effects on cardiovascular complications. Prevention and improving outcomes of stroke in patients with diabetes requires proper management of hyperglycemia and additional risk factors. This review is an evidence-based approach to the epidemiology, glycemic control, effects of anti-diabetic medications on stoke, and risk factor management for prevention and improving outcomes of stroke for patients with diabetes.The prevalence of non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of metabolic syndrome, is rapidly increasing in Korean populations and is estimated to reach 39% among Korean adults. NAFLD is one of the strongest risk factors of type 2 diabetes mellitus (T2DM), and the presence of NAFLD in T2DM patients is associated with a worse natural course of diabetic complications. The gold standard for diagnosing NAFLD is liver biopsy, which involves sampling error, high cost, and other disadvantages related to its invasive nature. We summarize non-invasive diagnostic NAFLD algorithms including biomarkers and four major imaging tools (ultrasonography, computed tomography, magnetic resonance imaging, and liver FibroScanⓇ) for diagnosing NAFLD including hepatic fibrosis. To prevent NASH (nonalcoholic steatohepatitis) or liver fibrosis, a combination of lifestyle modification with a low caloric diet and exercise, anti-diabetic agents, and non-anti-diabetic agents should be applied.

Neuropathic Pain in Guillain-Barre Syndrome Associated with Scrub Typhus

Guillain-Barre syndrome (GBS) is usually characterized by acute areflexic ascending paralysis with minimal sensory involvement. Only a few cases of GBS associated with scrub typhus have been reported. Previous case reports focused on the laboratory findings, pathogenesis, and clinical manifestation. Unlike the previous case, neuropathic pain was a prominent symptom of GBS in our case. We report scrub-typhus-related GBS with a detailed description of the clinical manifestations, especially neuropathic pain, along with results of serial follow-up electrodiagnostic studies.

Alteration of Lipid Profiles in Patients with Subclinical Hypothyroidism

OBJECTIVE: Overt hypothyroidism has been associated with abnormalities of lipid metabolism; however conflicting results regarding the degree of lipid changes in subclinical hypothyroidism (SCH) have been reported. The aim of this study was to assess differences in lipid profile parameters between people with and without SCH in Korean population. METHODS: Serum lipid parameters of 37 patients with SCH and 44 euthyroid control subjects were evaluated in a retrospective cross-sectional study. RESULTS: The mean serum triglycerides (TG) level was significantly higher in patients with SCH than in controls (p < 0.05). The mean serum high-density lipoprotein cholesterol (HDL-C) level was significantly lower in patients with SCH than in controls (p < 0.05). When adjusted by age, the odds ratio for the association of HDL-C with SCH was significant at 0.893 (95% confidence interval 0.809–0.986) compared with that of the euthyroid controls. No association with SCH was found with total cholesterol level, low-density lipoprotein cholesterol level or serum thyroid-stimulating hormone level. In addition, the lipid profile did not differ significantly between premenopausal and postmenopausal women. CONCLUSIONS: We found variations of lipid profiles in patients with SCH, characterized by a significantly lower HDL-C level.