Endocrinology and Metabolism

Original Articles

Obesity and Metabolism
Comparison of Serum Adipocytokine Levels according to Metabolic Health and Obesity Status: Tae Hoon Lee, Won Seon Jeon, Ki Joong Han, Shin Yeoung Lee, Nam Hee Kim, Hyun Beom Chae, Choel Min Jang, Kyung Mo Yoo, Hae Jung Park, Min Kyung Lee, Se Eun Park, Hyung Geun Oh, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee; Endocrinol Metab. 2015;30(2):185-194. Published online June 30, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.2.185

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Background

Metabolic health is an emerging concept that is highly correlated with various metabolic complications, and adipocytokines have been causally linked to a wide range of metabolic diseases. Thus, this study compared serum adipocytokine levels according to metabolic health and obesity status.

Methods

Four hundred and fifty-six nondiabetic subjects (mean age, 40.5 years) were categorized into four groups according to metabolic health and obesity status: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUHNO), and metabolically unhealthy obese (MUHO). Being metabolically healthy was defined as the presence of fewer than two of the following five metabolic abnormalities: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostatic model assessment of insulin resistance index. Obesity status was assessed using body mass index (BMI), with obesity defined as a BMI higher than 25 kg/m². Levels of serum interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor α (TNF-α), and adipocyte fatty acid binding protein (A-FABP) were also evaluated.

Results

Of the 456 subjects, 247 (54.2%) were in the MHNO group, 66 (14.5%) were in the MHO group, 66 (14.5%) were in the MUHNO group, and 77 (16.9%) were in the MUHO group. There were no significant differences in IL-6 or MCP-1 levels among the groups, but levels of TNF-α and A-FABP were significantly higher in the MUHNO group compared to the MHNO group.

Conclusion

High TNF-α and A-FABP levels are significantly associated with metabolically unhealthiness in nonobese Korean individuals.

Citations

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Differences in the levels of inflammatory markers between metabolically healthy obese and other obesity phenotypes in adults: A systematic review and meta-analysis
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Pattern of Adiponectin, Osteocalcin, Irisin, FGF-21, and MCP-1 According to the Body Size Phenotype: Could They Be Markers of Metabolic Health in Mexican-Mestizo Middle-Aged Women?
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Poor Vitamin D Status in Active Pulmonary Tuberculosis Patients and Its Correlation with Leptin and TNF-α
Qiuzhen WANG, Aiguo MA, Tianlin GAO, Yufeng LIU, Lisheng REN, Lei HAN, Boyang WEI, Qian LIU, Chunjiang DONG, Yuze MU, Duo LI, Frans J KOK, Evert G SCHOUTEN
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Christine Graf, Nina Ferrari
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Ligiane Marques Loureiro, Suzane Lessa, Rodrigo Mendes, Sílvia Pereira, Carlos José Saboya, Andrea Ramalho
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Being Metabolically Healthy, the Most Responsible Factor for Vascular Health
Eun-Jung Rhee
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Kofaktoren und Komorbiditäten bei Necrobiosis lipoidica – Analyse der deutschen DRG‐Daten von 2012
Finja Jockenhöfer, Knut Kröger, Joachim Klode, Regina Renner, Cornelia Erfurt‐Berge, Joachim Dissemond
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Response: Comparison of Serum Adipocytokine Levels according to Metabolic Health and Obesity Status (Endocrinol Metab2015;30:185-94, Tae Hoon Lee et al.)
Eun-Jung Rhee
Endocrinology and Metabolism.2015; 30(3): 416. CrossRef
Letter: Comparison of Serum Adipocytokine Levels according to Metabolic Health and Obesity Status (Endocrinol Metab2015;30:185-94, Tae Hoon Lee et al.)
Mikyung Kim
Endocrinology and Metabolism.2015; 30(3): 414. CrossRef
Adipokine Profiles and Metabolic Health
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Obesity and Metabolism
Increased Risk of Diabetes Development in Subjects with the Hypertriglyceridemic Waist Phenotype: A 4-Year Longitudinal Study: Ki Joong Han, Shin Yeoung Lee, Nam Hee Kim, Hyun Beom Chae, Tae Hoon Lee, Choel Min Jang, Kyung Mo Yoo, Hae Jung Park, Min Kyung Lee, Won Seon Jeon, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee; Endocrinol Metab. 2014;29(4):514-521. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.514

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Background

The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults.

Methods

A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as ≥150 mg/dL and enlarged WC was defined as ≥90 cm for men and ≥85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes.

Results

A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model.

Conclusion

Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes.

Citations

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Review Article

Obesity and Metabolism
Antiobesity Pharmacotherapy for Patients with Type 2 Diabetes: Focus on Long-Term Management: Won Seon Jeon, Cheol-Young Park; Endocrinol Metab. 2014;29(4):410-417. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.410

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Abstract PDF PubReader

Type 2 diabetes and obesity have a complex relationship; obesity is linked to insulin resistance, the precursor to type 2 diabetes. The management of obesity is an important method to delay onset of diabetes and improve the glycemic durability of antidiabetic agents. However, insulin and some of the oral hypoglycemic agents used to treat diabetes cause significant weight gain, and it is difficult for patients with diabetes to reduce and maintain their weight by life-style changes alone. Thus, antiobesity medications or bariatric surgery may be a necessary adjunct for certain obese patients with diabetes. In 2012, the U.S. Food and Drug Administration (FDA) approved lorcaserin and phentermine/topiramate extended-release for the management of chronic weight, and approval for naltrexone/bupropion sustained-release as an adjunct to exercise and reduced caloric intake followed in 2014. Liraglutide is pending FDA approval for antiobesity drug. Here we review the efficacy of approved and new promising drugs for the management of obesity.

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Original Articles

Age Is the Strongest Effector for the Relationship between Estimated Glomerular Filtration Rate and Coronary Artery Calcification in Apparently Healthy Korean Adults: Hyun Beom Chae, Shin Yeoung Lee, Nam Hee Kim, Ki Joong Han, Tae Hoon Lee, Choel Min Jang, Kyung Mo Yoo, Hae Jung Park, Min Kyung Lee, Won Seon Jeon, Se Eun Park, Heui-Soo Moon, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee; Endocrinol Metab. 2014;29(3):312-319. Published online September 25, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.3.312

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Background

Chronic kidney disease (CKD) is considered one of the most common risk factors for cardiovascular disease. Coronary artery calcification (CAC) is a potential mechanism that explains the association between renal function and cardiovascular mortality. We aimed to evaluate the association between renal function and CAC in apparently healthy Korean subjects.

Methods

A total of 23,617 participants in a health-screening program at Kangbuk Samsung Hospital were included in the study. Estimated glomerular filtration rate (eGFR) was assessed using the Cockcroft-Gault equation. Coronary artery calcium score (CACS) was measured via multidetector computed tomography. Subjects were divided into three groups according to the CKD Staging system with eGFR grade: stage 1, eGFR ≥90 mL/min/1.73 m²; stage 2, eGFR 60 to 89 mL/min/1.73 m²; and stage 3, eGFR 30 to 59 mL/min/1.73 m².

Results

The mean age of the participants was 41.4 years and the mean eGFR was 103.6±21.7 mL/min/1.73 m². Hypertension and diabetes were noted in 43.7% and 5.5% of the participants, respectively. eGFR showed a weakly negative but significant association with CACS in bivariate correlation analysis (r=-0.076, P<0.01). Mean CACS significantly increased from CKD stage 1 to 3. The proportion of subjects who had CAC significantly increased from CKD stage 1 to 3. Although the odds ratio for CAC significantly increased from stage 1 to 3 after adjustment for confounding factors, this significance was reversed when age was included in the model.

Conclusion

In early CKD, renal function negatively correlated with the degree of CAC in Korean subjects. Age was the strongest effector for this association.

Citations

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Coronary artery calcium and risk of chronic kidney disease in young and middle-aged adults
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New Model for Predicting the Presence of Coronary Artery Calcification
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Obesity and Metabolism
Association of Serum Adipocyte-Specific Fatty Acid Binding Protein with Fatty Liver Index as a Predictive Indicator of Nonalcoholic Fatty Liver Disease: Won Seon Jeon, Se Eun Park, Eun-Jung Rhee, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Won-Young Lee; Endocrinol Metab. 2013;28(4):283-287. Published online December 12, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.4.283

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Background

Adipocyte-specific fatty acid-binding protein (A-FABP) is a cytoplasmic protein expressed in macrophages and adipocytes and it plays a role in insulin resistance and metabolic syndrome. Recently, the fatty liver index (FLI) was introduced as an indicator of nonalcoholic fatty liver disease (NAFLD). In this study, we aimed to investigate the relationship between baseline serum A-FABP levels and FLI after 4 years in apparently healthy subjects.

Methods

A total of 238 subjects without a past history of alcoholism or hepatitis were recruited from a medical check-up program. The NAFLD state was evaluated 4 years later in the same subjects using FLI. Fatty liver disease was diagnosed as diffusely increased echogenicity of the hepatic parenchyma compared to the kidneys, vascular blurring, and deep-echo attenuation. NAFLD was defined as subjects with fatty liver and no history of alcohol consumption (>20 g/day).

Results

Baseline serum A-FABP levels were significantly associated with FLI after adjustment for age and sex (P<0.001). The subjects with higher A-FABP levels had a higher mean FLI (P for trend=0.006). After adjusting for age and sex, serum A-FABP levels at baseline were shown to be significantly associated with FLI as a marker of development of NAFLD after 4 years (odds ratio, 2.68; 95% confidence interval, 1.24 to 5.80 for highest tertile vs. lowest tertile; P=0.012).

Conclusion

This study demonstrated that higher baseline serum A-FABP levels were associated with FLI as a predictive indicator of NAFLD after 4 years of follow-up in healthy Korean adults.

Citations

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Obesity and Metabolism
The Relationship of Body Composition and Coronary Artery Calcification in Apparently Healthy Korean Adults: Jung-Hee Yu, Seo Hyoung Yim, Su Hyeon Yu, Ji Yong Lee, Jong Dae Kim, Mi Hae Seo, Won Seon Jeon, Se-Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee; Endocrinol Metab. 2013;28(1):33-40. Published online March 25, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.1.33

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Abstract PDF Supplementary Material PubReader

Background

We investigated the association of coronary artery calcium score (CACS) with body composition and insulin resistance in apparently healthy Korean adults.

Methods

Nine hundred forty-five participants (mean age, 48.9 years; 628 men) in a medical check-up program were selected for analysis. Body composition was assessed by bioelectrical impedance analysis (BIA). Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). The CACS was assessed by multidetector computed tomography.

Results

One hundred forty-six subjects (15.4%) showed coronary artery calcification and 148 subjects (15.7%) had metabolic syndrome. CACS showed a significant positive correlation with age, fasting glucose level, waist circumference (WC), blood pressure, hemoglobin A1c, HOMA-IR, and waist-hip ratio (WHR) assessed by BIA. CACS had a negative correlation with high density lipoprotein cholesterol (HDL-C). Subjects with high CACS showed significantly higher mean WHRs and lower mean values for lean body mass compared with subjects without coronary artery calcification. In logistic regression analyses with coronary artery calcification as the dependent variable, the highest quartile of WHR showed a 3.125-fold increased odds ratio for coronary artery calcification compared with the lowest quartile after adjustment for confounding variables. When receiver operating characteristics analyses were performed with coronary artery calcification as the result variable, WHR showed the largest area under the curve (AUC) value among other variables except for age and WC in women (AUC=0.696 for WHR, 0.790 for age, and 0.719 for WC in women).

Conclusion

In our study population of apparently healthy Korean adults, WHR was the most significant predictor for coronary artery calcification among other confounding factors, suggesting that it may have implication as a marker for early atherosclerosis.

Citations

Citations to this article as recorded by

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