- Metabolic Abnormalities according to Severity of Non-alcoholic Fatty Liver Disease in Korean Adults.
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H J Kim, D J Kim, S K Kim, S H Kim, Y M Rhee, C W Ahn, B S Cha, Y D Song, S K Lim, K R Kim, H C Lee, K B Huh
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J Korean Endocr Soc. 2002;17(4):514-525. Published online August 1, 2002
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 Abstract
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- BACKGROUND
We evaluated the frequency of non-alcoholic fatty liver diseases, and the associations between the metabolic abnormalities and severity of non-alcoholic fatty liver disease in Korean adults using ultrasonography. METHODS: We examined 1074 Korean adults above the age of 30 years, comprising of 502 men and 572 women, participating in medical check-ups at the Health Promotion Center. Hepatitis B and C serologies were negative, and the average weekly alcohol intake was < or = 2 standard drinks. A standard interview, physical exam and biochemical study, were conducted, and an experienced operator carried out ultrasound liver studies. RESULTS: 522 of the subjects had non-alcoholic fatty liver disease, and the remaining 552 did not. The frequency in the men was higher than that in the women (57 vs 42%, p<0.05). The frequency of non-alcoholic fatty liver disease in the subjects without diabetes, obesity or dyslipidemia was 20%. We classified subjects into 4 groups: the controls (n=552) and those with mild (n=218), moderate (n=273) or severe fatty liver disease (n=31), according to their ultrasonographic findings. BMI, waist circumference, body fat, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, the total- to HDL-cholesterol ratio, impaired fasting glucose, hypertension and insulin resistance, were all significantly increased with the increased severity of non-alcoholic fatty liver disease (p<0.05). Following the multiple regression analyses, waist, alanine aminotransferase, HOMAIR, the total- to HDL-cholesterol ratio, aspartate aminotransferase and systolic blood pressure, were all associated with the severity of non-alcoholic fatty liver disease. Odd ratios of insulin resistance in the mild, moderate and severe non-alcoholic fatty liver disease were 14.7 (CI: 6.8~32.0), 6.9 (CI: 4.6~10.3) and 5.7 (CI3.6~8.8), respectively. The percentages of subjects with insulin resistance in each group were 7.6, 32.0, 36.0 and 55.0% (p<0.05), respectively. The percentages of subjects with risk of non-alcoholic steatohepatitis in each groups were 5.0, 21.6, 27.8 and 58.1% (p<0.05) respectively. CONCLUSION: The frequency of non-alcoholic fatty liver disease was relatively high in Korean adults. Proportional differences in metabolic abnormalities, relation to the severity of non-alcoholic fatty liver disease, were found by ultrasonography.
- A Case of Insulinoma without Peripheral Hyperinsulinemia.
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S W Park, J G Chae, C C Choi, S K Lee, K U Lee, D J Han, I C Lee, K B Sung, S H Kim, Y K Shong, J Y Park, G S Kim
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J Korean Endocr Soc. 1995;10(4):434-438. Published online November 7, 2019
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Abstract
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- Insulinoma is a disorder characterized by hypoglycemia due to endogenous hyperinsulinemia. The elevated plasma insulin level and hypoglycemia should be established for the diagnosis of an insulinoma. Other laboratory methods such as immunoreactive insulin to glucose(IRI/G) ratio, C-peptide, proinsulin, and some provocation tests are also employed to detect an insulinoma because hyperinsulinemia is often not found. Especially, IRI/G ratio has been considered as very sensitive and specific test to confirm the insulinoma without peripheral hyperinsulinemia. We report a case of insulinoma without hyperinsulinemia and elevation of IRI/G ratio, which was diagnosed by endoscopic ultrasonography and THPVS(Transhepatic portal venous sampling). It is suggested that more confirmatory tests will be necessary for the diagnosis of insulinoma especially when it is highly suspected although IRI/G ratio is not increased.
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