Decrease of glycogen synthase kinase 3β phosphorylation in the rat nucleus accumbens shell is necessary for amphetamineinduced conditioned locomotor activity

Phosphorylation levels of glycogen synthase kinase 3β (GSK3β) negatively correlated with psychomotor stimulant-induced locomotor activity. Locomotor sensitization induced by psychomotor stimulants was previously shown to selectively accompany the decrease of GSK3β phosphorylation in the nucleus accumbens (NAcc) core, suggesting that intact GSK3β activity in this region is necessary for psychomotor stimulants to produce locomotor sensitization. Similarly, GSK3β in the NAcc was also implicated in mediating the conditioned effects formed by the associations of psychomotor stimulants. However, it remains undetermined whether GSK3β plays a differential role in the two sub-regions (core and shell) of the NAcc in the expression of drug-conditioned behaviors. In the present study, we found that GSK3β phosphorylation was significantly lower in the NAcc shell obtained from rats expressing amphetamine (AMPH)-induced conditioned locomotor activity. Further, we demonstrated that these effects were normalized by treatment with lithium chloride, a GSK3β inhibitor. These results suggest that the behavior produced by AMPH itself and a conditioned behavior formed by associations with AMPH are differentially mediated by the two sub-regions of the NAcc.

Immunohistochemical detection of GluA1 subunit of AMPA receptor in the rat nucleus accumbens following cocaine exposure

α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors are differentially regulated in the nucleus accumbens (NAcc) of the brain after cocaine exposure. However, these results are supported only by biochemical and electrophysiological methods, but have not been validated with immunohistochemistry. To overcome the restriction of antigen loss on the postsynaptic target molecules that occurs during perfusion-fixation, we adopted an immersion-fixation method that enabled us to immunohistochemically quantify the expression levels of the AMPA receptor GluA1 subunit in the NAcc. Interestingly, compared to saline exposure, cocaine significantly increased the immunofluorescence intensity of GluA1 in two sub-regions, the core and the shell, of the NAcc on withdrawal day 21 following cocaine exposure, which led to locomotor sensitization. Increases in GluA1 intensity were observed in both the extra-post synaptic density (PSD) and PSD areas in the two sub-regions of the NAcc. These results clearly indicate that AMPA receptor plasticity, as exemplified by GluA1, in the NAcc can be visually detected by immunohistochemistry and confocal imaging. These results expand our understanding of the molecular changes occurring in neuronal synapses by adding a new form of analysis to conventional biochemical and electrophysiological methods.

Immunohistochemical detection of GluA1 subunit of AMPA receptor in the rat nucleus accumbens following cocaine exposure

α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors are differentially regulated in the nucleus accumbens (NAcc) of the brain after cocaine exposure. However, these results are supported only by biochemical and electrophysiological methods, but have not been validated with immunohistochemistry. To overcome the restriction of antigen loss on the postsynaptic target molecules that occurs during perfusion-fixation, we adopted an immersion-fixation method that enabled us to immunohistochemically quantify the expression levels of the AMPA receptor GluA1 subunit in the NAcc. Interestingly, compared to saline exposure, cocaine significantly increased the immunofluorescence intensity of GluA1 in two sub-regions, the core and the shell, of the NAcc on withdrawal day 21 following cocaine exposure, which led to locomotor sensitization. Increases in GluA1 intensity were observed in both the extra-post synaptic density (PSD) and PSD areas in the two sub-regions of the NAcc. These results clearly indicate that AMPA receptor plasticity, as exemplified by GluA1, in the NAcc can be visually detected by immunohistochemistry and confocal imaging. These results expand our understanding of the molecular changes occurring in neuronal synapses by adding a new form of analysis to conventional biochemical and electrophysiological methods.

Ezrin-radixin-moesin proteins are regulated by Akt-GSK3β signaling in the rat nucleus accumbens core

The ezrin-radixin-moesin (ERM) proteins are a family of membrane-associated proteins known to play roles in cell-shape determination as well as in signaling pathways. We have previously shown that amphetamine decreases phosphorylation levels of these proteins in the nucleus accumbens (NAcc), an important neuronal substrate mediating rewarding effects of drugs of abuse. In the present study, we further examined what molecular pathways may be involved in this process. By direct microinjection of LY294002, a PI3 kinase inhibitor, or of S9 peptide, a proposed GSK3β activator, into the NAcc core, we found that phosphorylation levels of ERM as well as of GSK3β in this site are simultaneously decreased. These results indicate that ERM proteins are under the regulation of Akt-GSK3β signaling pathway in the NAcc core. The present findings have a significant implication to a novel signal pathway possibly leading to structural plasticity in relation with drug addiction.

Development and evaluation of a food frequency questionnaire for Vietnamese female immigrants in Korea: the Korean Genome and Epidemiology Study (KoGES)

The objectives of this study were to develop a food-frequency questionnaire (FFQ) for Vietnamese female immigrants in Korea and to evaluate the validity of the FFQ. A total of 80 food items were selected in developing the FFQ according to consumption frequency, the contribution of energy and other nutrients, and the cooking methods based on one-day 24 hour recall (24HR) from 918 Vietnamese female immigrants between November 2006 and November 2007. The FFQ was validated by comparison with 24HR of 425 Vietnamese female immigrants between November 2008 and August 2009. The absolute nutrient intake calculated from the FFQ was higher than that estimated by 24HR for most nutrients. The correlation coefficients between 24HR and FFQ ranged from 0.10 (vitamin C) - 0.36 (energy) for crude intake, 0.05 (vitamin E) - 0.32 (calcium) for per 1000 kcal, and 0.08 (zinc) - 0.34 (calcium) for energy-adjusted, respectively. More than 70% of subjects were classified into the same or adjacent agreement groups for nutrients other than fiber, sodium, vitamin A, vitamin C, and vitamin E, while less than 10% of subjects were classified into complete disagreement groups. We conclude that the FFQ appears to be an acceptable tool for estimating nutrient intake and dietary patterns of Vietnamese female immigrants in Korea. Future studies to validate the FFQ using various biomarkers or other dietary assessment methods are needed.

Tumor Necrosis Factor (TNF-alpha) and C-reactive Protein (CRP) are Positively Associated with the Risk of Chronic Kidney Disease in Patients with Type 2 Diabetes

PURPOSE: Chronic low-grade inflammation may induce chronic kidney disease in patients with type 2 diabetes. This study investigated the relation between inflammatory biomarkers and chronic kidney disease in patients with type 2 diabetes, which has not yet been reported in Asian populations. MATERIALS AND METHODS: A cross-sectional study was performed in 543 patients recruited from diabetic clinics for an ongoing, prospective study. Multivariate logistic regression was used to evaluate the association between inflammatory biomarkers and the presence of chronic kidney disease (estimated glomerular filtration rate < 60 mL/min per 1.73 m2 by the simplified Modification of Diet in Renal Disease equation using plasma creatinine). RESULTS: The risk of chronic kidney disease increased in the highest quartiles of C-reactive protein (CRP) [multivariate odds ratio (OR) = 3.73; 95% CI = 1.19-1.70] and tumor necrosis factor-alpha (multivariate OR = 4.45; 95% CI = 1.63-12.11) compared to the lowest quartiles after adjustments for age, sex, zinc intake, and other putative risk factors for chronic kidney disease. CONCLUSION: Our results suggest that CRP and tumor necrosis factor-alpha may be independent risk factors for chronic kidney disease in patients with type 2 diabetes. A causal mechanism of this association should be evaluated in a follow-up study of Korean patients with type 2 diabetes.

Consumption of Health Functional Foods by Elementary Schoolchildren in Korea

We surveyed 837 students attending elementary schoolchildren in Korea for health functional foods (HFF) consumption and significant variables for their HFF consumption including demographic characteristics, parental health concern on offsprings, food eating frequency of subjects and beliefs on potential efficacy of HFF by subjects. The consumption prevalence of HFF was 45.9%, and among all types of HFF, nutritional supplements were taken most frequently, followed by apricot extract-fermented products > lactic acid bacteria containing products > EPA/DHA containing products > red ginseng products. HFF consumption was higher in subjects had parents of high education level (p < .05) and those from families with a high socioeconomic status (p < .01) in comparison to each corresponding group. Health concern on offsprings by parents (p < .001) and consumption ratio of HFF by family (p < .001) was higher in consumers than in nonconsumers of HFF. Total score of dietary assessment was higher in consumers than in nonconsumers of HFF (p < .01), and consumers had a more positive view concerning the potential efficacy of HFF than did nonconsumers (p < .001). Most consumers of HFF took HFF when they were healthy (42.5%), and they did not feel special effects through HFF consumption (47.7%). Most consumers of HFF got the information on HFF from family and relatives (24.8%), and most of them purchased HFF at pharmacy or oriental medicine clinics (53.9%). HFF consumers preferred multi-vitamins and Ca-supplements most among the vitamin . mineral supplements belonged to HFF. Given the widespread consumption of HFF by elementary schoolchildren, the reasonable consumption of these products for the contribution to their overall health and well-being should be emphasized through nutrition education for them and their family.

Health Functional Food Use and Related Variables Among the Middle-Aged in Korea

Various types of health functional foods (HFF) are popularly used among middle-aged. We surveyed 946 middle-aged in Korea for HFF use and significant variables for their HFF use including demographic characteristics, health related variables and nutritional beliefs. The use prevalence of HFF was 58.9%, and among all types of HFF, red ginseng products were taken most frequently, followed by nutritional supplements, ginseng products > mushroom products. HFF was taken more frequently in subjects from high monthly family income (p < .001), and in those from families with a high socioeconomic status (p < .001) in comparison to each corresponding group. Mean age of users was higher than nonusers (p < .001). Self concern about health (p < .001) and usage ratio of HFF by family (p < .001) were higher in users than in nonusers of HFF. Total dietary assessment score was not different in two groups, and users had a more positive view concerning the potential health benefit of HFF than nonusers (p < .001). Most users of HFF took HFF when they were healthy (52.8%) and experienced a little effect through the HFF use (51.2%). Most users of HFF obtained the information on HFF through family and relatives (30.5%) and most of them purchased HFF at pharmacy or oriental medicine clinics (44.5%). HFF users preferred multivitamin and Ca-supplements most among the vitamind mineral supplements belonged to HFF. Given the widespread use of HFF and inappropriate usage of HFF among subjects, the proper use of these products for the contribution to their optimal nutrition and overall health is a subject that should be formed through practical nutrition education considering the various variables affecting their HFF use.

Balloon Dilatation for Corrosive Esophageal Strictures in Children: Radiologic and Clinical Outcomes

OBJECTIVE: We retrospectively evaluated the effectiveness of the esophageal balloon dilatation (EBD) in children with a corrosive esophageal stricture. MATERIALS AND METHODS: The study subjects included 14 patients (M:F = 8:6, age range: 17-85 months) who underwent an EBD due to a corrosive esophageal stricture. The causative agents for the condition were glacial acetic acid (n = 9) and lye (n = 5). RESULTS: A total of 52 EBD sessions were performed in 14 patients (range 1-8 sessions). During the mean 15-month follow-up period (range 1-79 months), 12 patients (86%) underwent additional EBD due to recurrent esophageal stricture. Dysphagia improved after each EBD session and oral feeding was possible between EBD sessions. Long-term success (defined as dysphagia relief for at least 12 months after the last EBD) was achieved in two patients (14%). Temporary success of EBD (defined as dysphagia relief for at least one month after the EBD session) was achieved in 17 out of 52 sessions (33%). A submucosal tear of the esophagus was observed in two (4%) sessions of EBD. CONCLUSION: Only a limited number of children with corrosive esophageal strictures were considered cured by EBD. However, the outcome of repeated EBD was sufficient to allow the children to eat per os prior to surgical management.

Dietary factors related to body weight in adult Vietnamese in the rural area of Haiphong, Vietnam: the Korean Genome and Epidemiology Study (KoGES)

The objectives of this study were to examine the association between dietary factors and underweight and overweight adult Vietnamese living in the rural areas of Vietnam. A cross-sectional study of 497 Vietnamese aged 19 to 60 years (204 males, 293 females) was conducted in rural areas of Haiphong, Vietnam. The subjects were classified as underweight, normal weight, and overweight based on BMI. General characteristics, anthropometric parameters, blood profiles, and eating habits were obtained and dietary intake was assessed using 24-hour recalls for 2 consecutive days. A high prevalence of both underweight (BMI or = 23 kg/m2) individuals was observed (14.2% and 21.6% for males and 18.9% and 20.6% for females, respectively). For both genders, the overweight group were older than the under- and normal weight groups (P = 0.0118 for males and P = 0.0002 for females). In female subjects, the overweight group consumed significantly less cereals (P = 0.0033), energy (P = 0.0046), protein (P = 0.0222), and carbohydrate (P = 0.0017) and more fruits (P = 0.0026) than the underweight group; however, no such differences existed in males. The overweight subjects overate more frequently (P = 0.0295) and consumed fish (P = 0.0096) and fruits (P = 0.0083) more often. The prevalence of both underweight and overweight individuals pose serious public health problems in the rural areas of Vietnamese and the overweight group was related to overeating and high fish and fruit consumption. These findings may provide basic data for policymakers and dieticians in order to develop future nutrition and health programs for rural populations in Vietnam.

Comparison of Health Risks according to the Obesity Types Based Upon BMI and Waist Circumference in Korean Adults: The 1998-2005 Korean National Health and Nutrition Examination Surveys

This study was performed to examine the health risks according to the obesity types based upon body mass index (BMI) and waist circumference (WC) cutoffs. The subjects were 8,966 adults aged 40-79 years from the 1998, 2001 and 2005 Korean National Health and Nutrition Examination Surveys. The subjects were classified into 4 types of obesity groups based on BMI and WC: BMIWC (BMI > or = 25 kg/m2 and WC >or = 90 cm for males and > or = 85 cm for females), WC (BMI or = 90 cm for males and > or = 85 cm for females), BMI (BMI >or = 25 kg/m2 and < 90 cm for males and < 85 cm for females), normal (BMI < 25 kg/m2 and < 90 cm for males and < 85 cm for females) groups. More than half (n = 5,103) of the subjects fell into the normal group and BMIWC group accounts for 58%, followed by BMI group of 27% and WC group of 16%. Mean ages of subjects were highest in WC group and lowest in BMI group. Blood levels of total cholesterol, triglyceride, LDL-cholesterol and glucose, and blood pressures were higher and HDL-cholesterol was lower in 3 types of obesity groups (BMIWC, WC, BMI) than in the normal group. Among the 3 obesity groups, energy and fat intake was significantly higher in BMIWC than in normal group in males, however, no differences were found among the 4 groups in females. The three obesity groups had greater odds ratios for hypertension, diabetes mellitus, hypercholesterolemia, hyper-LDL-cholesterolemia, hypo-HDL-cholesterolemia, hypertriglyceridemia, and metabolic syndrome compared to the normal group. Among 3 obesity groups, BMIWC group had the highest odds ratios for hypertension, diabetes mellitus, and metabolic syndrome. Especially BMIWC and WC groups showed the highest odds ratios for diabetes mellitus and metabolic syndrome, suggesting the potential role of abdominal obesity in diabetes mellitus and metabolic syndrome. Our data indicate that different types of obesity may show different degrees of health risks. The appropriate selection and use of obesity indexes may be effective for management of obesity as well as obesityrelated diseases.

Socioeconomic Factors Relating to Obesity and Inadequate Nutrient Intake in Women in Low Income Families Residing in Seoul

This study was performed to investigate socioeconomic factors relating to obesity and inadequate nutrient intake in women in low income families residing in Seoul. The subjects were 125 women (aged 41-87 y) recruited from the local health center for free health examination for low income families. The socioeconomic status such as educational level, income level, and housing condition were poor. For subjects aged less than 65 years, the prevalence of obesity was 44% based on BMI (> or = 25 kg/m2), 48% based on WHR (> or = 0.85), and 50% based on waist circumference (> or = 80 cm) and for those more than 65 years, these were greater and 57%, 81%, and 79%, respectively. The main food sources of daily diet were vegetables, grains, and fruits. Energy and other nutrient intake was not adequate for all subjects and the inadequacy was more profound in the elderly, showing percentages of subjects whose intake was less than EAR were greater than 50% for all nutrients except for iron and below RI were also greater than 50% for all nutrients. The prevalence of obesity and nutrient inadequacy were not associated with socioeconomic status in subjects aged less than 65 years, however, obesity was associated with household income and nutrient inadequacy was related to education (vitamin A) and housing status (protein, phosphate, and iron) in the elderly. After adjustment for ages, in the elderly, OR for obesity (BMI > or = 25, OR = 12.601; 95% CI = 2.338-67.911) and central obesity (WC > or = 80 cm, OR = 4.778; 95% CI = 1.103-20.696) were greater in subjects who earned less than 500 thousand Won per month than who earned more. For inadequate nutrient intake, the OR for inadequate intake of Vitamin A (OR = 4.555; 95% CI = 1.491-13.914) was greater in subjects with no education than those educated. Subjects without her own house had greater risk for inadequate intake for protein (OR = 3.660; 95% CI = 1.118-11.981), phosphate (OR = 3.428; 95% CI = 1.157-10.158), and iron (OR = 3.765; 95% CI = 1.205-11.766) than subjects possessing her house. In elderly females in low income families, the socioeconomic status was associated with the risk for obesity (income level) and inadequate nutrient intake (education level and housing status). More attention on these groups should be given for prevention of obesity and inadequate nutrient intake.

Family history of chronic renal failure is associated with malnutrition in Korean hemodialysis patients

The present study was to investigate the nutritional status and factors related to malnutrition in end-stage renal disease (ESRD) patients requiring hemodialysis (HD) in South Korea. Subjects were ESRD outpatients from general hospitals or HD centers in Seoul referred to the dialysis clinic for maintenance HD care. A total of 110 patients (46 men and 64 women; mean ages 58.6 +/- 1.0 y) were eligible for this study. The family history of chronic renal failure (CRF) was considered positive if a patient reported having either a first-degree or second-degree relative with CRF. Malnutrition was defined as a triceps skinfold thickness or mid-arm muscle circumference below the fifth percentile for age and sex and forty-seven of the 110 patients were malnourished. Almost all (94%) patients had anemia (hemoglobin: or =1.2) (P=0.0178), and those with a family history of CRF (P=0.0255). Multiple logistic regression was used to examine the relationship between malnutrition and potential risk factors. After adjusting for age, sex, and other putative risk factors for malnutrition, the OR for malnutrition was greater in HD patients with a family history of CRF (OR, 3.290; 95% CI, 1.003-10.793). Active nutrition monitoring is needed to improve the nutritional status of HD patients. A family history of CRF may be an independent risk factor for malnutrition in Korean HD patients. A follow-up study is needed to investigate whether there is a causal relationship between a family history of CRF and malnutrition in Korean ESRD patients.

Associations between ApoB/ApoA-I Ratios and Metabolic Syndrome and its Components in Patients with Type 2 Diabetes / 당뇨병

BACKGROUND: The Apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I) is a powerful clinical indicator of metabolic syndrome. However, few studies have searched for an association between ApoB/ApoA-I and metabolic syndrome in Korean patients with type 2 diabetes. We investigated the relation between ApoB/ApoA-I and the risk of metabolic syndrome and its components. METHODS: Subjects were 812 (424 males and 388 females) Korean patients who were being treated for type 2 diabetes at Huh's Diabetes Center in Seoul. The patients were classified into quartiles (lowest:Q1-highest:Q4) of ApoB/ApoA-I by gender. Anthropometric and hematological characteristics and dietary intake using a food frequency questionnaire were assessed. RESULTS: The prevalence of metabolic syndrome in our sample was 47.9% in males and 66.5% in females. The odds ratios (OR) for metabolic syndrome and for having its components were significantly increased from Q2 to Q4 quartiles of ApoB/ApoA-I in males (OR = 5.37; 95% CI = 2.98-9.65 and OR = 7.41; 95% CI = 4.04-13.6) and females (OR = 2.57; 95% CI = 1.28-5.15 and OR = 8.49; 95% CI = 4.28-16.8). These trends withstood adjustment for age, duration of type 2 diabetes, fasting blood glucose levels, and macronutrient intake both in males (OR = 5.24; 95% CI = 2.80-9.24 and OR = 7.98; 95% CI = 4.09-15.6) and in females (OR=4.41; 95% CI = 2.26-8.61 and OR = 8.29; 95% CI = 3.85-17.8). CONCLUSION: ApoB/ApoA-I appeared to be independently associated with risk of having metabolic syndrome and its components in Korean patients with type 2 diabetes after adjustment for putative risk factors including macronutrient intake, a particularly important lifestyle factor for patients with type 2 diabetes. A follow-up study of this population should evaluate the mechanisms underlying the relation between ApoB/ApoA-I and metabolic syndrome and its components.

Individualized diabetes nutrition education improves compliance with diet prescription

This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition education program was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided according to the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin B2, and folate per 1,000 kcal/day were significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34 subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These results indicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipid concentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.

Dietary Intakes and Eating Behaviors of Vietnamese Female Immigrants to Korea through Marriage and Korean Spouses and Correlations of Their Diets / 대한지역사회영양학회지

This study aimed to examine nutritional status and similarities of diets between Vietnamese female immigrants and Korean spouses and dietary changes of Vietnamese females after immigration. Subjects were 608 couples visiting 13 medical centers for the Cohort of Intermarried Women in Korea from November 2006 to November 2007. Anthropometric and biochemical measurements were obtained and dietary intakes were assessed using one-day 24-hour recall. Sixty-eight percent of wives answered there have been changes in their diets and consumptions of meats, fish, dairy products, vegetables, and fruits increased after immigration. Energy intakes of wives and spouses were 1491.7 kcal and 1788.8 kcal, respectively, showing most couples (80.1%) consumed less than the Korean estimated energy requirements. More than half of the couples were below the Korean estimated average requirements of zinc, vitamin B2, and folate. The correlation coefficients between couples ranged 0.15-0.38 for unadjusted, 0.22-0.35 for per 1000 kcal, and 0.21-0.40 for energyadjusted, respectively. The proportions of couples in the same quartiles of each nutrient intake and in the same answers of each question of Mini Dietary Assessment were about 30% across nutrients and around 50% across questions. The length of residence is related to similarities of nutrient intakes between couples: similarities decreased after 3 years of residence in Korea. In conclusion, nutritional intakes of inter-married couples were inadequate although wives reported that their dietary intakes increased after immigration. Inadequate nutrient intakes of wives were partly explained by similar diets between couples because these wives without enough adjustment to Korean culture were more likely to follow what their spouses ate. Findings from this study may be helpful to improve the nutritional status of inter-married couples and make policies and programs for them. A follow-up study should identify factors affecting inadequate nutritional status of intermarried couples and similarities of their diets.

The Association of Plasma HDL-Cholesterol Level with Cardiovascular Disease Related Factors in Korean Type 2 Diabetic Patients / 당뇨병

BACKGROUND: Cardiovascular disease (CVD) is the major cause of death in type 2 diabetic patients. The purpose of this study was to investigate the characteristics of Korean type 2 diabetes mellitus (DM) patients according to plasma high density lipoprotein (HDL) cholesterol level and to document the effect of diet on HDL-cholesterol. METHODS: The subjects were 252 (male: 134, female: 118) Korean type 2 DM patients recruited from a general hospital's DM clinic and divided into low HDL-cholesterol group (male or = 40 mg/dL, female > or = 50 mg/dL). Anthropometric and hematological variables and dietary intake were assessed by the groups. RESULTS: The subject's mean age was 60.2 +/- 1.1 years and duration of diabetes was 9.5 +/- 1.0 years. Anthropometric measurements (body fat mass, % body fat, WHR, fat free mass, and muscle mass) and BMI were not significantly different between two groups. The male subjects with low HDL-cholesterolemia showed higher Atherogenic Index (AI, P < 0.001) and higher % carbohydrate from energy than control group (P < 0.01). The female subjects with low HDL-cholesterolemia showed higher AI (P < 0.001) and a tendency of higher triglyceride level and lower intake of energy, protein, lipid, vitamin B1 and vitamin E (P < 0.05) than control group. CONCLUSION: The subject with low HDL-cholesterolemia showed significantly higher AI. Male subject with low HDL-cholesterolemia consumed higher carbohydrate and female subject with low HDL-cholesterolemia showed lower intakes of many nutrients. This result suggests the importance of an adequate and balanced diet to manage type 2 DM patients to prevent CVD complications.

A randomized study to establish the effects of spirulina in type 2 diabetes mellitus patients

Spirulina is a microscopic and filamentous cyanobacterium that contains essential amino acids, essential fatty acids, vitamins, minerals and anti-oxidative components. The purpose of this study was to examine effects of spirulina intervention in Korean patients with type 2 diabetes. The subjects were 37 type 2 diabetic patients who visited a diabetic clinic in Seoul and randomly assigned into spirulina (8 g/day) or control group. During the intervention period of 12 weeks, subjects were asked to keep usual diet and prohibited to take any functional foods or dietary supplements. Spirulina supplementation for 12 weeks did not affect anthropometric parameters, however, lowered plasma triglycerides level significantly (p<0.05). Spirulina supplementation also resulted in a significant reduction in plasma malondialdehyde level (p<0.05) and an increase in plasma adiponectin level (p<0.1). The lipid lowering effect of spirulina supplementation was different according to serum lipid levels of the subjects before entering the intervention. The subjects with higher initial triglyceride level showed higher reduction in plasma triglyceride and blood pressure. The subjects with higher initial total cholesterol and LDL-cholesterol level showed higher reduction in plasma concentrations of total cholesterol, LDL-cholesterol, IL-6, and blood pressure. It seems that spirulina supplementation is more effective in subjects with dyslipidemia. This study provides the evidence for beneficial effects of spirulina supplementation on blood lipid profiles, inflammatory variables, and antioxidant capacity in Korean patients with type 2 diabetes. The results suggest that spirulina is a promising agent as a functional food for diabetes management.

Nutritional status and the role of diabetes mellitus in hemodialysis patients

This study was aimed to investigate the nutritional status and the role of diabetes mellitus in hemodialysis (HD) patients. Anthropometric, biochemical, and dietary assessments for HD 110 patients (46 males and 64 females) were conducted. Mean body mass index (BMI) was 22.1 kg/m2 and prevalence of underweight (BMI<18.5 kg/m2) was 12%. The hypoalbuminemia (<3.5 g/dl) was found in 15.5% of the subject, and hypocholesterolemia (<150 mg/dl) in 46.4%. About half (50.9%) patients had anemia (hemoglobin: <11.0 g/dL). High prevalence of hyperphosphatemia (66.4%) and hyperkalemia (43.5%) was also observed. More than 60 percent of subjects were below the recommended intake levels of energy (30-35 kcal/kg IBW) and protein (1.2 g/kg IBW). The proportions of subjects taking less than estimated average requirements for calcium, vitamin B1, vitamin B2, vitamin C, and folate were more than 50%, whereas, about 20% of the subjects were above the recommended intake of phosphorus and potassium. Diabetes mellitus was the main cause of ESRD (45.5%). The diabetic ESRD patients showed higher BMI and less HD adequacy than nondiabetic patients. Diabetic patients also showed lower HDL-cholesterol levels. Diabetic ESRD patients had less energy from fat and a greater percentage of calories from carbohydrates. In conclusion, active nutrition monitoring is needed to improve the nutritional status of HD patients. A follow-up study is needed to document a causal relation between diabetes and its impact on morbidity and mortality in ESRD patients.

Impact of Diabetes Duration on the Cardiovascular Disease Risk Factors in Korea Type 2 DM Patients

The purpose of this study was to investigate the impact DM duration on cardiovascular disease risk factors in Korean Type 2 diabetes mellitus patients. The subject were 250 (male: 134, female: 118) Korean Type 2 DM patients recruited from a general hospital's DM clinic. Anthropometric and hematological variables and dietary intake were assessed. The subject's mean age was 60.2 years and duration of diabetes was 9.5 years. As far as DM duration was concerned, male subjects with long duration (> or = 5 years and longer) showed significantly lower weight, fat free mass, skeletal muscle mass, BMI (p or = 5 years and longer) showed significantly higher fat free mass (p < 0.05) and skeletal muscle mass (p < 0.05), Hemoglobin A1c (p < 0.01), HDL-cholesterol (p < 0.01) and triglyceride (p < 0.05), dietary intakes of protein (p < 0.05) and fat (p < 0.05) compared to those with less 5years of duration. In conclusion, Type II DM patients of long duration had higher blood lipid concentrations and higher carbohydrates intakes. Subjects followed diet prescription strictly showed lower blood lipid concentration, suggesting the effectiveness of diet to manage Type 2 DM patients.