Validation of Foot Pressure Variables during Walking according to Glycated Hemoglobin Levels / 임상당뇨병

The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure.

Cohort profile: the Ewha Birth and Growth Study / 한국역학회지

With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.

Cohort profile: the Ewha Birth and Growth Study / 한국역학회지

With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.

Implementation of Outcome-Based Medical Education Theory into the Pre-existing Curriculum / 이화의대지

OBJECTIVES: This paper aims to describe an outcome-based curriculum development process at a medical school that has difficulty in advancement from the higher stage outcomes to the individual lesson outcomes, and to propose a way to implement it practically. METHODS: We reviewed the objectives, strategies and previous products of the school's taskforce activities and suggested the principle of bidirectional approaches of outcome based curriculum development. RESULTS: The developing strategy identified such as firstly, the evaluation of present curriculum and then, the review of the outcomes developed previously with considering the nation-wide environmental change in medical education. Then, we selected one example course which was focused the resources of the school to, and finally the product of the example course was propagated to the other courses with central monitoring. CONCLUSION: Bidirectional model of ‘Top-down’ plus ‘Bottom-up’ approaches could be an efficient way to develop the outcome-based curriculum in a medical school, which has difficulties to advance the developing process due to various reasons including limited resources.

Progressive Pituitary Involvement in a Patient with Localized Granulomatosis with Polyangiitis / 이화의대지

Localized granulomatosis with polyangiitis (loc-GPA) is a milder disease state of GPA restricted to the respiratory tract. Transition from localized form to systemic/generalized disease is predicted to occur in approximately 10% of the patients. We report an unusual case of loc-GPA involving multiple cranial nerves, which in 3 years progressed into systemic disease involving pituitary gland. Initially antineutrophil cytoplasmic antibody (ANCA) was negative, but as symptoms of diabetes insipidus started, ANCA became positive. Clinical course of ANCA negative loc-GPA should be carefully monitored for development of systemic disease. ANCA may be a useful marker for detecting transition from localized to systemic disease.

Development of guide to clinical performance and basic clinical skills for medical students / 한국의학교육

The aim of this report was to discuss the development and content of a guide on clinical performance and basic clinical skills for medical students. We published the first edition of this guide in 2010 and will publish the second edition in 2016. Initially, we took a survey on important clinical presentations and fundamental clinical and technical skills in 41 medical schools in Korea. Ultimately, we chose 80 core clinical presentations and 56 clinical skills. In the guide to basic clinical skills, we described the physical examination and technical skills according to the preprocedural preparation, procedure, and postprocedural process. In the guide on clinical performance, we reviewed patient encounters-from history taking and the physical examination to patient education. We included communication skills, principles of patient safety, and clinical reasoning schemes into the guides. In total, 43 academic faculty members helped develop the basic clinical skills guide, 75 participated in establishing the clinical performance guide, and 16 advisors from 14 medical specialty societies contributed to the guide. These guides can help medical students approach patients holistically and safely.

Increased Epicardial Adipose Tissue Thickness in Type 2 Diabetes Mellitus and Obesity

BACKGROUND: Epicardial adipose tissue (EAT) is suggested to play an important role in the progression of metabolic syndrome. We aimed to establish a simple method to measure EAT and examine the differences in EAT thickness according to the presence of type 2 diabetes mellitus or obesity. METHODS: A total of 94 patients (42.6% type 2 diabetes mellitus, 53.2% obese, mean age 61+/-13) who underwent multidetector computed tomography were enrolled. Thickness of EAT was measured on the parasternal short and horizontal long axis view. Epicardial fat area (EFA) was measured at the level of left main coronary artery (LMCA). RESULTS: All EAT thicknesses were correlated with EFA at the LMCA level (r=0.235 to 0.613, all Ps<0.05), and EAT thickness in the left atrioventricular groove (LAVG) had the highest correlation coefficient (r=0.613). EFA, and EAT thicknesses in the LAVG and the left ventricular apex were higher in the group with type 2 diabetes mellitus than in the group without type 2 diabetes mellitus when adjusted only for body mass index. When adjusted only for type 2 diabetes mellitus, EFA, and EAT thicknesses in the LAVG and the right atrioventricular groove were higher in obese group than in nonobese group. CONCLUSION: In conclusion, EAT thickness can be easily measured and represent EFA. EAT thickness, especially in LAVG, was higher in groups with type 2 diabetes mellitus and obesity independently. These findings implicate that EAT thickness may be a useful indicator for type 2 diabetes mellitus and obesity.

Negative Association between Obesity Index and Thyroid Hormones in Euthyroid Children

BACKGROUND: The number of obese people is increasing worldwide; in particular, childhood obesity is becoming a major problem. Obesity elevates the risk of various endocrine-metabolic diseases, and it was recently reported that there was a correlation between obesity and thyroid hormone level. The present study aimed to investigate the correlation between the obesity index and thyroid hormone level in healthy children with normal thyroid function. METHODS: The study subjects included children 7-12 years of age with normal thyroid function who participated in follow-up observations from 2011 to 2014 as participants in the Ewha Infant Growth Cohort (2001-2006). Subjects with a body mass index (BMI) > or =85th percentile were classified in the overweight group for the analysis (37 subjects, 14.5%). RESULTS: No significant differences in thyroid-stimulating hormone (TSH) or free thyroxine (FT4) levels were observed between the overweight and normal groups containing a total of 256 children (122 boys, 134 girls). Waist circumference, BMI z score, and WHtR were negatively correlated with TSH levels after adjusting for age, sex, birth weight and puberty status (P=0.03, P=0.04, P=0.05). However other obesity index did not show any relationship with TSH or FT4 levels. CONCLUSION: In children with normal thyroid function, waist circumference and BMI z score showed a negative correlation with TSH levels.

Disturbance of the Glutamatergic System in Mood Disorders

The role of glutamatergic system in the neurobiology of mood disorders draws increasing attention, as disturbance of this system is consistently implicated in mood disorders including major depressive disorder and bipolar disorder. Thus, the glutamate hypothesis of mood disorders is expected to complement and improve the prevailing monoamine hypothesis, and may indicate novel therapeutic targets. Since the contribution of astrocytes is found to be crucial not only in the modulation of the glutamatergic system but also in the maintenance of brain energy metabolism, alterations in the astrocytic function and neuroenergetic environment are suggested as the potential neurobiological underpinnings of mood disorders. In the present review, the evidence of glutamatergic abnormalities in mood disorders based on postmortem and magnetic resonance spectroscopy (MRS) studies is presented, and disrupted energy metabolism involving astrocytic dysfunction is proposed as the underlying mechanism linking altered energy metabolism, perturbations in the glutamatergic system, and pathogenesis of mood disorders.

FTO Gene Variants Are Associated with PCOS Susceptibility and Hyperandrogenemia in Young Korean Women

BACKGROUND: The fat mass and obesity-associated (FTO) gene is associated with obesity and type 2 diabetes mellitus. Obesity and insulin resistance are also common features of polycystic ovary syndrome (PCOS). Therefore, the FTO gene might be a candidate gene for PCOS susceptibility. The aim of the present study was to evaluate the effects of FTO gene variants on PCOS susceptibility and metabolic and reproductive hormonal parameters. METHODS: We recruited 432 women with PCOS (24+/-5 years) and 927 healthy women with regular menstrual cycles (27+/-5 years) and performed a case-control association study. We genotyped the single nucleotide polymorphisms rs1421085, rs17817449, and rs8050136 in the FTO gene and collected metabolic and hormonal measurements. RESULTS: Logistic regression revealed that the G/G genotype (rs1421085, 1.6%), the C/C genotype (rs17817449, 1.6%), and the A/A genotype (rs8050136, 1.6%) were strongly associated with an increased risk of PCOS (odds ratio, 2.551 to 2.559; all P<0.05). The strengths of these associations were attenuated after adjusting for age and BMI. The women with these genotypes were more obese and exhibited higher free androgen indices (P<0.05) and higher free testosterone levels (P=0.053 to 0.063) compared to the other genotypes. However the significant differences disappeared after adjusting for body mass index (BMI). When we analyzed the women with PCOS and the control groups separately, there were no significant differences in the metabolic and reproductive hormonal parameters according to the FTO gene variants. CONCLUSION: The rs1421085, rs17817449, and rs8050136 variants of the FTO gene were associated with PCOS susceptibility and hyperandrogenemia in young Korean women. These associations may be mediated through an effect of BMI.

Neurocognitive Changes and Their Neural Correlates in Patients with Type 2 Diabetes Mellitus

As the prevalence and life expectancy of type 2 diabetes mellitus (T2DM) continue to increase, the importance of effective detection and intervention for the complications of T2DM, especially neurocognitive complications including cognitive dysfunction and dementia, is receiving greater attention. T2DM is thought to influence cognitive function through an as yet unclear mechanism that involves multiple factors such as hyperglycemia, hypoglycemia, and vascular disease. Recent developments in neuroimaging methods have led to the identification of potential neural correlates of T2DM-related neurocognitive changes, which extend from structural to functional and metabolite alterations in the brain. The evidence indicates various changes in the T2DM brain, including global and regional atrophy, white matter hyperintensity, altered functional connectivity, and changes in neurometabolite levels. Continued neuroimaging research is expected to further elucidate the underpinnings of cognitive decline in T2DM and allow better diagnosis and treatment of the condition.

Current Status and Strategic Plan of Nutrition Education Comparing Nutrition Teachers with Dietitians in Schools, Gyeonggi Area / 대한지역사회영양학회지

The aim of this study was to investigate how implementation of direct nutrition education differs between nutrition teachers and dietitians in Gyeonggi Area. In this study, we collected data from 107 nutrition teachers and 129 dietitians in 2012. Among those who have answered they implemented direct nutrition education for the last one year, 36% were nutrition teachers and 10% were dietitians (p < 0.05). Among subjects who implemented direct education, a significantly greater percentage of nutrition teachers used a class as an education time to conduct creative hands-on-activity compare to dietitians (p < 0.05). However, for most dietitians, school meal time was more commonly used for direct nutrition education. When asked to make a suggestion regarding improvement for school nutrition education, the highest rate of people chose simplification of school administrative work (4.68 points) was needed. Developing nutrition education (4.55 points) showed the next highest rate. The rest of the answers were the following order; regular training of teaching methods (4.50 points), increasing awareness of school teachers (4.50 points), improving school facilities and financial support (4.47 points), preparing teaching plan (4.46 points), providing incentive for direct education (4.26 points), organizing regular class for nutrition education (4.17 points), and placing nutrition teachers (4.16 points). This study provides useful information including manageable workload of nutrition teachers and dietitians, capacity building and supportive school environment to be delivered with respect to nutrition education system in South Korea.

Development of a Korean Version of an Advance Directive Model via Cognitive Interview / 한국호스피스완화의료학회지

PURPOSE: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). METHODS: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. RESULTS: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. CONCLUSION: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.

The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence / 예방의학회지

OBJECTIVES: Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined. METHODS: The subjects consisted of 261 children aged 7-9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests. RESULTS: A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2?3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82). CONCLUSIONS: This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.

Long Menstrual Cycle Is Associated with Type 2 Diabetes Mellitus in Korean Women

BACKGROUND: Long menstrual cycle is a risk factor for developing type 2 diabetes and cardiovascular disease in women. We aimed to evaluate the association between existing type 2 diabetes and oligomenorrhea before diagnosis of diabetes, and to observe the differences in this association among obese and non-obese Korean women. METHODS: Patients with type 2 diabetes (n=118) and without any clinical evidence of abnormal glucose regulation (n=258) who attended the outpatient clinic of a university hospital and were over age 30. Patients self-reporting a menstrual cycle over 40 days during their 20s were defined as oligomenorrhea before diagnosis of diabetes. Obesity was defined as having a body mass index (BMI) over 25 kg/m2. RESULTS: The frequency of oligomenorrhea before diagnosis of diabetes was almost two-fold higher in women with type 2 diabetes than in the control group (16.1% vs. 8.5%, P=0.03). Oligomenorrhea was associated with type 2 diabetes after adjusting for age, BMI, systolic blood pressure, triglycerides, and high density lipoprotein cholesterol (odds ratio, 3.89; 95% confidence interval, 1.37 to 11.04). Among women with oligomenorrhea before diagnosis of diabetes, the frequency of type 2 diabetes was significantly higher in obese subjects than in their non-obese counterparts (90.9% vs. 30.0%, P=0.03). CONCLUSION: Having a long menstrual cycle could be a risk factor for the development of type 2 diabetes, especially in obese women.

Prognostic Role of Rb, p16, Cyclin D1 Proteins in Soft Tissue Sarcomas / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to determine the expressions of Rb, p16, and cyclin D1 in soft tissue sarcomas, and we also wanted to identify the prognostic factors according to the clinicalpathologic features. MATERIALS AND METHODS: We reviewed the charts and radiographic films of 66 sarcoma patients. Tissue samples were collected from these patients. Immunochemistry was performed using formalin-fixed, paraffin-embedded tissue samples to examine the expressions of p16, Rb, and cyclin D1 proteins. RESULTS: The median duration of overall survival was 47.8 months (range, 20.0 to 70.7 months) and the 5 years survival rate was 39%. As for the correlation between the degree of immunohistochemical staining for Rb protein and the histological tumor grades, there was a significant difference with a p-value of 0.019. However, no significant correlation was shown for p16 and cyclin D1. The overall survival duration of the Rb negative group (staining cell <20%) and the heterogeneous group (cell staining 20 to 80%) was 53.5+/-6.6 months and the overall survival duration of the Rb homogeneous group was 18.3+/-6.4 months, and there was a significant difference with a p-value of 0.016. However, no significant difference was shown between the survival rate according to the p16 and cyclin D1 expressions. On the multivariate analysis that was done with Rb, p16, the tumor size, grade and site, and patient age, the Rb gene expression was the most significant independent prognostic factor with a risk ratio of 3.01 (p=0.04). CONCLUSION: The expression of Rb protein was correlated with the histologic grade and overall survival of patients with soft tissue sarcomas.

Analysis of Risk Factors for Low Bone Mineral Density in Patients with Inflammatory Bowel Disease / 대한소화기학회지

BACKGROUND/AIMS: Several clinical risk factors for low bone mineral density (BMD) in the patients with inflammatory bowel disease (IBD) have been suggested. However, its prevalence and pathophysiology in Korean population have not been fully studied. The aim of this study was to investigate the prevalence and risk factors for low BMD in Korean IBD patient. METHODS: BMD of the lumbar spine and femur was evaluated using dual-energy X-ray absorptiometry in 30 patients with IBD. Biochemical parameters of bone metabolism, such as serum calcium, phosphorus, osteocalcin, and deoxypyridinoline were measured. The associations between low BMD and clinical parameters such as disease duration, disease activity, drug history, body mass index (BMI), and others were evaluated retrospectively using medical records. RESULTS: Low BMD at the lumbar spine or femur was observed in 63.3% of the patients, and there was no significant difference between the patients with Crohn's disease and ulcerative colitis. Clinical and biochemical parameters were irrelevant to BMD. In the patients without glucocorticoid treatment prior to BMD measurement, already 50.0% of patients had low BMD. CONCLUSIONS: Low BMD is a common feature in Korean IBD patients, even those who do not use glucocorticoid. The multiple factors may be involved in the pathogenesis of low BMD. Therefore, BMD should be examined in all IBD patients, irrespective of glucocorticoid treatment.

Tarsal Tunnel Syndrome Combined with Diabetic Neuropathy

OBJECTIVE: To investigate the frequency of tarsal tunnel syndrome (TTS) in the diabetic neuropathy patients. METHOD: Electrodiagnostic study was performed to diagnose diabetic neuropathy and tarsal tunnel syndrome (TTS) in 56 patients (male 25, female 31) with diabetes mellitus. The frequency of combined TTS in diabetic neuropathy patients was calculated. RESULTS: Out of 56 diabetic patients, 52 patients were diagnosed as diabetic peripheral neuropathy. The frequency of concomitant TTS was 22 cases in 52 diabetic patients with diabetic neuropathy. CONCLUSION: In diabetic neuropathy group, the frequency of TTS was higher than general population.

Analysis of risk factors associated with male lower urinary tract symptoms in the metabolic syndrome

PUROPOSE: The purpose of this study was to evaluate the relationship between lower urinary tract symptoms (LUTS) and the metabolic syndrome in the elderly male. MATERIAL AND METHODS: The metabolic syndrome group of 348 patients (64.4+/-8.6 years old) and the control group of 150 patients (66.0+/-7.0 years old) were included in the study. The voiding factors, such as International Prostate Symptom Score (IPSS), quality of life score, prostate volume, maximal urine flow rate, residual urine volume, and prostate-specific antigen (PSA) were investigated. Waist circumference, blood pressure, fasting glucose, HDL-cholesterol, triglyceride were measured for the evaluation of the metabolic syndrome. RESULTS: Waist circumference (beta=0.025, p<0.001), systolic (beta=0.004, p<0.05) and diastolic blood pressure (beta=0.006, p<0.05) were positively correlated with prostate volume. In the logistic regression analysis of voiding factors according to metabolic syndrome factors, the patients who have central obesity (Odds ratio [OR]=2.931), central obesity and hypertension (OR=3.598), central obesity and diabetes (OR=2.508), hypertension and low HDL-cholesterolemia (OR=2.326), central obesity, hypertension and diabetes (OR=3.083), central obesity, hypertension and low HDL cholesterolemia (OR=3.440) represented a significantly increased age-adjusted risk of benign prostatic enlargement (25g or more). OR of symptomatic benign prostatic hyperplasia (BPH) was 3.178 in the patients with cental obesity, and 2.381 in the patients with both central obesity and hypertension. CONCLUSIONS: In male elderly, the metabolic syndrome was closely related with LUTS and its main risk factor was central obesity, represented as waist circumference.

The clinical characteristics of Korean women with polycystic ovary syndrome / 대한내과학회지

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by chronic anovulation and hyperandrogenism and this malady arises in 5~10% of reproductive women. There may be significant ethnic and racial variations in the clinical presentation of PCOS. The current study is aimed to define the clinical characteristics, including the metabolic features, of Korean women with PCOS. METHODS: We recruited 156 patients with PCOS and 252 healthy regular cycling women as controls between March 2003 and May 2006. The diagnosis of PCOS was made according to the criteria of the European Society of Human Reproduction and Embryology in 2003. The anthropometric measurements including weight, height, waist circumference, and physical examination for the modified Ferriman-Gallwey hirsutism scoring scale were performed. Reproductive hormones, blood lipids and standard 75g oral glucose tolerance tests were done to assess glucose tolerance and insulin sensitivity. RESULTS: Twenty six percent of the women with PCOS were obese and 6.4% of them had hirsutism. One of the 156 women (0.6%) with PCOS was newly diagnosed with diabetes mellitus and 25 of them (16.0%) had impaired glucose tolerance. The triglyceride levels and plasma glucose levels at 0, 30, 60, 90 and 120 minute and the plasma insulin levels at 30, 60, 90 and 120 minutes after initiating the oral glucose tolerance test in women with PCOS were significantly higher compared to those values for the controls. The HOMA-IR was significantly higher in the women with PCOS compared to the controls, even after adjusting for age and the body mass index. CONCLUSIONS: Obesity and clinical hyperandrogenism were not frequent in Korean women with PCOS, but this population did display distinct insulin resistance.