Background:Korean Red Ginseng (KRG) has been investigated as adjunctive therapy for type 2 diabetes mellitus (T2DM), but randomized controlled evidence evaluating metabolic efficacy and short-term safety in patients receiving stable oral antidiabetic therapy remains limited. Methods:In this 12-week randomized, double-blind, placebo-controlled trial, 70 adults with well-controlled T2DM receiving stable oral antidiabetic medications were assigned to KRG (2 g/day) or placebo. Outcomes included oral glucose tolerance test (OGTT)-derived insulin, C-peptide, and glucagon responses, insulin sensitivity indices, fasting plasma glucose (FPG), HbA1c, oxidative stress markers, antioxidant capacity, lipid profiles, and renal and hepatic safety parameters. Between-group comparisons used baseline-adjusted ANCOVA with Benjamini-Hochberg false discovery rate correction; efficacy analyses included participants with post-baseline data (n = 65). Results:Compared with placebo, KRG was associated with lower 120-min OGTT insulin (adjusted mean difference -6.992, 95% CI -14.205 to -0.222; p = 0.047) and higher ISI(0-120) (5.400, 0.972 to 9.829; p = 0.018). KRG was also associated with lower oxidized low-density lipoprotein (-5.645, -10.054 to -1.238; p = 0.013), malondialdehyde (-0.571, -1.090 to -0.053; p = 0.031), total cholesterol (-12.633, -24.752 to -0.515; p = 0.041), and low-density lipoprotein cholesterol (-10.171, -18.130 to -2.211; p = 0.013). FPG, 2-h glucose, and HbA1c did not differ significantly between groups. No hypoglycemic events occurred, and renal and hepatic safety markers remained stable. Conclusions:KRG was well tolerated and associated with favorable effects on selected indices of postprandial insulin sensitivity, lipid peroxidation markers, and lipid profile in this well-controlled T2DM population. Its short-term metabolic effects may be more apparent in post-load insulin dynamics than in conventional glycemic markers.

Diabetes is highly prevalent in individuals with pancreatic ductal adenocarcinoma (PDAC) and even precedes diagnosis of PDAC; however, the mechanisms of pancreatic cancer-associated blood glucose deterioration remain largely unknown. Here, we constructed a prospective cohort of patients undergoing pancreatectomy to investigate the underlying mechanism of PDAC-associated hyperglycemia. A total of 160 patients who underwent pancreatectomy (72 patients with PDAC and 88 patients without PDAC) were enrolled at a tertiary care hospital. Glucometabolic parameters under oral glucose tolerance test were assessed in both pre- and postoperative periods, and patient-derived blood and pancreatic tissue samples were collected. Compared with patients without PDAC, patients with PDAC showed severe hyperglycemia with impaired insulin secretion before surgery. However, despite identical type of pancreatectomy in both groups, hyperglycemia improved more significantly and insulin secretory function declined less after pancreatectomy in patients with PDAC. Plasma Wnt5a and pancreatic islet β-catenin levels were higher in patients with PDAC and correlated with the degree of hyperglycemia and insulin deficiency. Plasma Wnt5a levels also correlated with tumor size and pancreatic islet β-catenin expression in patients with PDAC. In rodent islets, Wnt5a treatment suppressed insulin release, which was recovered by inhibition of β-catenin. Collectively, impaired pancreatic insulin secretion by aberrant Wnt5a/β-catenin activation may underlie the hyperglycemia associated with PDAC. Our finding provides insights into the unique molecular mechanism of pancreatic cancer-associated hyperglycemia, paving the way for the identification of potential biomarker and therapeutic targets for this condition. Pancreatic ductal adenocarcinoma (PDAC) is a lethal cancer with low survival. Many patients with PDAC also develop diabetes, but the connection between the two is still unclear. Researchers aimed to explore this link by studying 160 patients, including those with PDAC and those without PDAC, who had surgery to remove part of their pancreas. The study involved measuring blood sugar and insulin levels before and after surgery. Patients with PDAC had higher blood sugar levels and lower insulin production than those without PDAC before surgery. After the surgery, patients with PDAC showed greater improvement in blood sugar control and a smaller decrease in insulin secretion than patients without PDAC. A protein called Wnt5a secreted by cancer was higher in patients with PDAC and might be linked to reduced insulin production. This protein could serve as a marker for early detection of PDAC-related diabetes. This summary was initially drafted using artificial intelligence, then revised and fact-checked by the author.

BACKGRUOUND:This study assessed the efficacy and safety of HD-6277, a novel oral G protein-coupled receptor 40 (GPR40) agonist in adults with inadequate control of type 2 diabetes mellitus (T2DM). METHODS:This double-blind, randomized, placebo-controlled phase 2 trial recruited 112 individuals aged 18-75 years with T2DM and glycosylated hemoglobin (HbA1c) levels between 7.0% and 10.0% while on diet and exercise alone for at least 8 weeks before screening. Parallel-group randomized trials of HD-6277 (50 and 100 mg groups vs. placebo) were conducted for 12 weeks. The primary outcome was the change in HbA1c levels from baseline to week 12. Secondary outcomes included changes in HbA1c, fasting plasma glucose (FPG), postprandial glucose, insulin, glycoalbumin, and C-peptide at weeks 4, 8, and 12. RESULTS:At week 12, HD-6277 at 50 and 100 mg demonstrated statistically significant reductions in HbA1c compared to placebo, with least square (LS) mean differences of -0.73% (95% confidence interval [CI], -1.11 to -0.35; P=0.0002) and -0.85% (95% CI, -1.21 to -0.50; P<0.0001), respectively. Both doses also produced clinically meaningful reductions in FPG. Additionally, HD- 6277 at 100 mg significantly increased the insulinogenic index compared to placebo, with an LS mean difference of 1.91 (95% CI, 0.34 to 3.48; P=0.0175). No clinically relevant treatment-related adverse events were observed. CONCLUSION:HD-6277 at 50 and 100 mg improved glycemic control and was well-tolerated in adults with T2DM inadequately managed with diet and exercise. GPR40 agonists may offer a promising new therapeutic option for T2DM.

Introduction: This case describes a 64-year-old female receiving herbal medicine and acupuncture for pain whose uncontrolled glycemic markers and symptoms improved with continued treatment.Case presentation: The patient initially received acupuncture for neck pain for two months, with minimal relief. Considering coexisting edema, insomnia, and fatigue, three months of herbal medicine were administered, during which glucose (310 mg/dL) and HbA1c (9.5%) spiked without any identifiable cause. Believing that these uncontrolled glycemic markers were related to overall symptoms, Chaihu-Jia-Longgu-Muli-Tang (CHJLGMLT; Shihogayonggolmoryo-tang) was prescribed for two more months, followed by one month of Linggui-Zhugan-Tang (LGZGT; Yeonggyechulgam-tang). After two months of CHJLGMLT, HbA1c improved to 5.8%, glucose to 123 mg/dL; after one month of LGZGT, HbA1c was 5.9%, and glucose remained at 123 mg/dL. Neck pain dropped from Numerical Rating Scale 8 to 5, insomnia from 6 to 3, fatigue from 9 to 5, and edema from 4 to 2.Conclusion: This case report suggests that Korean integrative medicine can contribute to improved glycemic control and reduced polypharmacy in diabetic patients. Further large-scale trials and standardized guidelines are required to validate its efficacy and safety.

The TOujeo BEyond glucose control (TOBE) study evaluated clinical outcomes with insulin glargine 300 units/mL (Gla-300) in insulin-naïve Korean people with type 2 diabetes mellitus (T2DM) in a real-world setting. This 24-week, prospective, non-interventional, multicenter, open-label, single-arm, observational study included adults aged ≥ 20 years with T2DM suboptimally controlled with oral hypoglycemic agents and/or glucagon-like peptide 1 receptor agonists who require basal insulin. Eligible participants were assigned to either general target glycated hemoglobin (HbA1c < 7 Despite various efforts in managing diabetes, individuals with type 2 diabetes mellitus (T2DM) encounter numerous challenges to achieve good glycemic control. The major cause is failure to initiate insulin therapy in a timely manner, primarily because of the fear of hypoglycemia. Insulin glargine 300 units/mL (Gla-300) has smooth and prolonged activity resulting in stable and sustained glycemic control, thus reducing the risk of hypoglycemia. Studies on efficacy and safety of Gla-300 in various populations have been published globally. However, there are limited real-world studies in Asian populations. This study evaluated effectiveness and safety of Gla-300 in Korean people with T2DM who were not on insulin prior to this study but were taking oral glucose-lowering medications. The participants were assigned to two groups: general glycated hemoglobin (HbA1c) target (HbA1c < 7

Background and Objective: This study aimed to analyze case reports and retrospective chart reviews to identify diabetes patients’ characteristics, evaluation methods, and intervals in Korean medicine (KM) practice, providing foundational data for designing applicable clinical programs in primary KM institutions.Materials and Methods: The study included case reports and retrospective chart reviews on diabetes, prediabetes, or complications treated with KM, focusing on blood glucose control. OASIS, RISS, and KCI were searched on August 3, 2024, and data on the treatment environment, visit patterns, complications, comorbidities, and treatment methods were extracted. Studies not evaluating clinical outcomes, lacking blood glucose or glycated hemoglobin A1c (HbA1c) measures, or not targeting diabetes or related conditions were excluded, with the quality of literature assessed using the CARE and JBI checklists.Results: In the 47 selected studies, the treatment approaches were classified into KM alone, integrative treatment with conventional medicine (CM), and treatments focused on complications or comorbidities. Treatment methods included herbal medicine, acupuncture, moxibustion, and cupping therapy. Fasting blood sugar (FBS), postprandial 2-hour glucose (PP2), and HbA1c were mainly used for assessment. FBS and PP2 [.1] were assessed more frequently than HbA1c. The visit frequency, treatment duration, and follow-up periods varied depending on the type of treatment administered.Discussion: This study emphasizes the feasibility of KM treatments for diabetes mellitus in KM institutions and suggests the need for practical clinical processes to overcome current limitations. However, further research and institutional improvements, such as the application of medical insurance fees, are necessary.

BackgroundGuidelines for switching to triple combination therapy directly after monotherapy failure are limited. This study investigated the efficacy, long-term sustainability, and safety of either mono or dual add-on therapy using alogliptin and pioglitazone for patients with type 2 diabetes mellitus (T2DM) who did not achieve their target glycemic range with metformin monotherapy. MethodsThe Practical Evidence of Antidiabetic Combination Therapy in Korea (PEAK) was a multicenter, placebo-controlled, double-blind, randomized trial. A total of 214 participants were randomized to receive alogliptin+pioglitazone (Alo+Pio group, n=70), alogliptin (Alo group, n=75), or pioglitazone (Pio group, n=69). The primary outcome was the difference in glycosylated hemoglobin (HbA1c) levels between the three groups at baseline to 24 weeks. For durability, the achievement of HbA1c levels <7% and <6.5% was compared in each group. The number of adverse events was investigated for safety. ResultsAfter 24 weeks of treatment, the change of HbA1c in the Alo+Pio, Alo, and Pio groups were –1.38%±0.08%, –1.03%±0.08%, and –0.84%±0.08%, respectively. The Alo+Pio group had significantly lower HbA1c levels than the other groups (P=0.0063, P<0.0001) and had a higher proportion of patients with target HbA1c achievement. In addition, insulin sensitivity and β-cell function, lipid profiles, and other metabolic indicators were also improved. There were no significant safety issues in patients treated with triple combination therapy. ConclusionEarly combination triple therapy showed better efficacy and durability than the single add-on (dual) therapy. Therefore, combination therapy with metformin, alogliptin, and pioglitazone is a valuable early treatment option for T2DM poorly controlled with metformin monotherapy.

OBJECTIVE:The aim of this study was to investigate the role of the follistatin-like 1 (Fstl1) and disco-interacting protein 2 homolog A (DIP2a) axis in relation to lipid metabolism during and after endurance exercise and to elucidate the mechanisms underlying the metabolic effects of Fstl1 on adipocytes, considering its regulation by exercise and muscle mass and its link to obesity. METHODS:Twenty-nine sedentary males participated in endurance exercise, and blood samples were collected during and after the exercise. Body composition, Fstl1, glycerol, epinephrine, growth hormone, and atrial natriuretic peptide were measured. 3T3-L1 adipocytes, with or without DIP2a knockdown, were treated with Fstl1 to assess glycerol release, cyclic AMP/cyclic GMP production, and hormone sensitive lipase phosphorylation. The association between DIP2a gene expression levels in human adipose tissues and exercise-induced lipolysis was examined. RESULTS:Fstl1 levels significantly increased during endurance exercise and following recovery, correlating with lean body mass and lipolysis. In 3T3-L1 adipocytes, Fstl1 increased glycerol release, cyclic GMP production, and hormone sensitive lipase activation, but these effects were attenuated by DIP2a knockdown. DIP2a gene expression in human adipose tissues correlated with serum glycerol concentrations during endurance exercise. CONCLUSIONS:Fstl1 is a myokine facilitating lipid mobilization during and after endurance exercise through DIP2a-mediated lipolytic effects in adipocytes.

To evaluate the effect of dapagliflozin on body composition such as total body fat (BF) mass, abdominal visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) areas compared with glimepiride in Korean patients with type 2 diabetes.

Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by airflow limitation and chronic inflammation of the lungs that is a leading cause of death worldwide. Since the complete pathological mechanisms at the single-cell level are not fully understood yet, an integrative approach to characterizing the single-cell-resolution landscape of COPD is required. To identify the cell types and mechanisms associated with the development of COPD, we conducted a meta-analysis using three single-cell RNA-sequencing datasets of COPD. Among the 154,011 cells from 16 COPD patients and 18 healthy subjects, 17 distinct cell types were observed. Of the 17 cell types, monocytes, mast cells, and alveolar type 2 cells (AT2 cells) were found to be etiologically implicated in COPD based on genetic and transcriptomic features. The most transcriptomically diversified states of the three etiological cell types showed significant enrichment in immune/inflammatory responses (monocytes and mast cells) and/or mitochondrial dysfunction (monocytes and AT2 cells). We then identified three chemical candidates that may potentially induce COPD by modulating gene expression patterns in the three etiological cell types. Overall, our study suggests the single-cell level mechanisms underlying the pathogenesis of COPD and may provide information on toxic compounds that could be potential risk factors for COPD.

Abstract Background The gender disparity in the thyroid cancer incidence rate, which is 3-folds higher in women than in men, has been hypothesized to be related to estrogen and estrogens receptors (ERs). Recent evidence suggests that nuclear receptor-interacting protein 1 (NRIP1) is known as a coregulator of ERs and a direct target of microRNA-346 (miR-346), which was reported as a biomarker for follicular thyroid carcinoma (FTC). In this study, we investigated the roles of miR-346 on behavioral traits and estrogen-associated pathogenesis of FTCs. Methods Two Human follicular thyroid carcinomas (FTC-133 and RO82-W-1) were used. To examine the effects of miR-346 and estrogen on behavioral traits and estrogen-associated pathogenesis of FTCs, FTC-133 and RO82-W-1 were transfected with the inhibitor targeting human miR-346 or the non-specific miR (-Control), then were treated with 100nM or 200nM of estradiol-17 β (E2). Cell migration and invasion assays were performed; gene and protein levels of NRIP1, ERα, and ERβ were examined by qPCR and western blot, respectively. In addition, cell cycle-regulating genes, epithelial biomarkers, mesenchymal biomarkers were also examined. Results E2 decreased the number of invaded and migrated cells regardless of miR-346-downregulation in both FTCs. Downregulation of miR-346 itself also had protective effects on invasion and migration of both FTCs, and it augmented the inhibitory effects of E2. E2 decreased both gene and protein levels of NRIP1 in FTC-133 while miR-346 downregulation did in RO82-W-1. E2 and miR-346 downregulation decreased the gene and protein expressions of ERα while it increased ERβ, accordingly, decreasing the ratio of ERα to ERβ in both FTCs. E2 significantly decreased cellular proliferation in miR-346 downregulated FTCs. These support that miR-346 has significant roles in estrogen-associated pathogenesis of FTCs by regulating NRIP1 and the interaction of ERα and ERβ. Downregulation of miR-346 increased gene expressions of occluding and cloudin-1 (CLDN1) while decreasing vimentin in FTC-133, it significantly increased gene expressions of CLDN1 in RO82-W-1. These suggest miR-346 in involved in maintaining integrity of FTCs. Conclusion Inhibition of miR-346 in FTCs have protective effects on metastasis, thereby, miR-346 is suggested as a therapeutic target for FTC.

Hyperglycemia is among the main risk factors for severe COVID-19. We evaluated the association of glycated albumin (GA) and GA/HbA1c ratio with progression of COVID-19 from mild to severe disease in patients with type 2 diabetes mellitus (T2DM). Our retrospective study included 129 patients aged over 18 years with COVID-19 and T2DM who did not have any need of oxygen supplement. Of these, 59 patients whose COVID-19 was aggravated and required oxygen supplementation eventually were classified as having severe disease. Clinical and laboratory data were compared between mild and severe cases. The median of GA (18.4% vs. 20.95%, p = 0.0013) and GA/HbA1c (2.55 vs. 2.68, p = 0.0145) were higher in severe disease than in mild disease and positively correlated with C-reactive protein (Kendal Tau coefficient 0.200 and 0.126, respectively; all p < 0.05). Multiple logistic regression analysis showed that GA (odds ratio (OR), 1.151; 95% confidence interval (CI), 1.024–1.294) and GA/HbA1c (OR, 8.330; 95% CI, 1.786–38.842) increased the risk of severe disease. Patients with GA 20% or higher were 4.03 times more likely to progress from mild to severe disease. GA and GA/HbA1c ratio predicted progression of COVID-19 from mild to severe disease in patients with T2DM.

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.

Background: Shift work is associated with obesity and metabolic syndrome. However, this association in the normal-weight population remains unclear. This study aimed to investigate whether shift work is associated with normal-weight obesity (NWO).Methods: From the nationally representative Korea National Health and Nutrition Examination Survey (KNHANES) dataset (2008 to 2011), 3,800 full-time workers aged ≥19 years with a body mass index (BMI) ≤25 kg/m2 were analysed. We defined NWO as BMI ≤25 kg/m2 and body fat percentage ≥25% in men and ≥37% in women. Working patterns were classified into “daytime,” “other than daytime,” and “shift.” Multivariable logistic regression analysis was performed to evaluate the relationship between shift work and NWO.Results: Shift work was associated with higher odds of NWO than daytime work (adjusted odds ratio [aOR], 1.47; 95% confidence interval [CI], 1.04 to 2.09) and night/evening work (aOR, 1.87; 95% CI, 1.11 to 3.14) after adjustment for type of work, working hours, age, sex, BMI, 25-hydroxyvitamin D levels, homeostatic model assessment for insulin resistance, and other sociodemographic factors. In subgroup analyses, the association between shift work and NWO was more robust in those aged ≥60 years and those working ≥56 hours/week.Conclusion: Shift work was associated with NWO in community-dwelling Korean adults, independent of age, sex, BMI, and other covariates.

Abstract Objective Shift working is known to be associated with metabolic syndrome and increased cardiovascular risk. In this study, we aimed to investigate whether shift work is associated with normal weight obesity (NWO), defined as normal weight with high body fat percentage. Method: From the national representative Korea National Health and Nutrition Examination Survey dataset (KNHANES 2008-2011), data of 3800 full-time workers with age≥ 19 years and body mass index (BMI)≤ 25 kg/m 2 were analyzed. In this study, we defined NWO was defined as BMI≤25 kg/m 2 and body fat (BF)percentage≥25% in men and≥37% in women according to the most strict threshold from literature review. Working patterns were classified into 'daytime', 'other than daytime', and 'shift time' based on the self-reported survey data. Multivariable logistic regression was performed to evaluate the relationship between shift time workers and NWO. Prespecified subgroup analysis were analyzed to determine the consistency of the result. Result: Shift work was associated with elevated odds of NWO than daytime work (adjusted odds ratio [aOR] 1.47, 95% CI 1. 04-2. 09) and night/evening work (aOR 1.87, 95% CI 1.11-3.14), after adjustment for working form, working hours, age, sex, BMI, vitamin D, homeostatic model assessment for insulin resistance, and other sociodemographic factors. In the subgroup analysis, association between shift work and NWO were consistent, and, those age ≥ 60 years (aOR 2.23, p=0. 043; p for interaction=0. 097) or working hours ≥ 56 hours per week (aOR 2. 00, p=0. 013; p for interaction=0. 057) showed a tendency to increase the risk. Conclusion Shift working was associated with NWO in Korean community-dwelling adults, independent of age, sex, BMI, and other covariates. Keywords: Shift work, Obesity, Normal weight obesity, Body fat percentage, KNHANES Presentation: No date and time listed

Background. Several experimental studies have suggested beneficial effects of Ceriporia lacerata on glucose metabolism. However, there has been no human study assessing the effects of C. lacerata on glucose metabolism. Therefore, we investigated whether C. lacerata improves glucose control and insulin resistance in type 2 diabetes patients. Methods. Ninety patients diagnosed with type 2 diabetes (T2DM) for more than 6 months were enrolled. Subjects were randomly divided into placebo ( n = 45 ) or C. lacerata ( n = 45 ) groups and then assigned to take placebo or C. lacerata capsules (500 mg/capsule) for a 12-week intervention period. Biochemical markers, including fasting glucose, 2-hour postprandial plasma glucose, and lipid profile levels, as well as insulin, c-peptide, and Hba1c, were measured. Furthermore, insulin sensitivity indices, such as HOMA-IR, HOMA-beta, and QUICKI, were assessed before and after the 12-week administration. Results. Eighty-four patients completed the study. There were no significant differences in fasting, postprandial glucose, HbA1c, or lipid parameters. HOMA-IR and QUICKI indices were improved at week 12 in the C. lacerata group, especially in subjects with HOMA-IR of 1.8 or more ( p < 0.05 ). Fasting, postprandial c-peptide, and insulin levels decreased at week 12 in the C. lacerata group ( p < 0.05 ). These significant differences were not observed in the placebo group. Conclusion. Twelve-week administration of C. lacerata in T2DM patients resulted in significant improvement in insulin resistance, especially in those with lower insulin sensitivity. A larger population study with a longer follow-up period and an effort to elucidate the mechanism is warranted to further assess the effects of C. lacerata on T2DM patients.

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 Connor-Davidson 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.

Type 2 diabetes is the fastest growing metabolic disease in the world. Recently, muscle is considered an endocrine organ which secretes various peptides that play an important role in insulin resistance and metabolic syndrome. We assessed 4 different myokines, irisin, interleukin-13 (IL-13), follistatin-related protein-1 (FSTL-1), and fractalkine, in normal, prediabetes, and diabetes patients. A total of 126 participants who visited Gangnam Severance Hospital were enrolled and divided into normal, prediabetes, and diabetes groups based on oral glucose tolerance test and hemoglobin a1c. A cross-sectional study was conducted to measure and compare serum levels of irisin, IL-13, FSTL-1, and fractalkine among the groups. Irisin level showed a tendency to increase in prediabetes group compared to normal group (P < .1) but showed a significant decrease when comparing diabetes from prediabetes group (P < .001). IL-13 decreased in diabetes group compared to prediabetes and normal group (P < .001, P < .05, respectively). FSTL-1 of diabetes group was lower than that of prediabetes group (P < .05), and fractalkine was higher in diabetes group compared to that of prediabetes and normal group (P < .01, P < .01, respectively). Irisin, IL-13, and FSTL-1 levels were reduced in diabetes group compared to normal or prediabetes group while fractalkine showed a progressive increase from normal to diabetes group. Further studies are warranted to study the roles of various myokine in diabetes through a larger prospective study.

Background Dyslipidemia is a well-known risk factor for cardiovascular disease (CVD). Recently, atherogenic index of plasma (AIP) has been proposed as a novel predictive marker for CVD, and there are few cross sectional studies that demonstrated a relationship between AIP and coronary artery disease. We investigated the association between AIP and the progression of coronary artery calcification (CAC) in Korean adults without CVD. Methods A total of 1,124 participants who had undergone CAC measurement at least twice by multi-detector CT in a health care center were enrolled. Anthropometric profiles and multiple cardiovascular risk factors were assessed. The AIP was defined as the base 10 logarithm of the ratio of the concentration of TG to HDL-C. The CAC progression was defined as either incident CAC in a CAC-free population at baseline or an increase of ≥ 2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACS) among subjects with detectable CAC at baseline Results CAC progression was observed in 290 subjects (25.8%) during the mean 4.2 years of follow-up. All subjects were stratified into three groups according to AIP. There were significant differences in cardiovascular parameters among the groups at baseline. The follow-up CAC and the incidence of CAC progression increased gradually with the rising AIP tertiles. In the logistic regression analysis, the odds ratio for CAC progression was 2.27 when comparing the highest to the lowest tertile of the AIP (95% CI: 1.61-3.19; P for trend <0.01). However, this association was attenuated after adjustment for multiple risk factors (P for trend = 0.67). Conclusions There is a significant correlation between AIP and CAC and its progression in subjects without CVD, but AIP is not an independent predictor of CAC progression.